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Identifying predictive markers for survival in malignant biliary obstruction following percutaneous transhepatic biliary drainage
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-15 DOI: 10.1016/j.crad.2024.106772
K. Chan , G. Vigneswaran , S. Modi , C. Sew Hee , D. Maclean , B. Stedman , T. Bryant , B. Maher

Aim

Malignant biliary obstructive disease is commonly managed with percutaneous transhepatic biliary drainage (PTBD). Traditionally, outcomes are evaluated collectively despite substantial variability in the underlying aetiology and extent of disease. The purpose of this study was to investigate whether variability in survival could be explained by different underlying patient and disease factors.

Materials and methods

A single centre, retrospective study was performed looking at first-time malignant PTBD and respective survival outcomes between 2017- 2021. Survival censoring was taken as June 2022. Predictors included aetiology, age, preprocedural serum haemoglobin, and bilirubin. Subgroups were dichotomised with respect to median values. Kaplan–Meier survival analysis and the log rank test were used for univariate analysis and Cox proportional hazards regression for multivariate analysis.

Results

One hundred fifty-six patients were identified, including 62 pancreatic, 19 ampullary/duodenal, 55 hilar cholangiocarcinoma, and 20 non hepatobiliary cancers. Median overall survival for the entire cohort was 136 days. The underlying aetiology significantly impacted median survival with non-hepatobiliary obstruction faring the worst; 53 days, and was in stark contrast to cholangiocarcinoma (347 days, p < 0.001). On multivariate analysis, we found that in addition to aetiology, patients > 70 years, preprocedural haemoglobin (< 110) and bilirubin (> 232) were all independent prognosticators and had significantly worse survival (HR 1.2, 1.8, 1.6, and 1.4, respectively, all p < 0.05).

Conclusion

Age, underlying malignant aetiology, preprocedural haemoglobin, and bilirubin were identified as independent predictors of post-PTBD survival. Careful patient selection may therefore improve patient outcomes following PTBD.
{"title":"Identifying predictive markers for survival in malignant biliary obstruction following percutaneous transhepatic biliary drainage","authors":"K. Chan ,&nbsp;G. Vigneswaran ,&nbsp;S. Modi ,&nbsp;C. Sew Hee ,&nbsp;D. Maclean ,&nbsp;B. Stedman ,&nbsp;T. Bryant ,&nbsp;B. Maher","doi":"10.1016/j.crad.2024.106772","DOIUrl":"10.1016/j.crad.2024.106772","url":null,"abstract":"<div><h3>Aim</h3><div>Malignant biliary obstructive disease is commonly managed with percutaneous transhepatic biliary drainage (PTBD). Traditionally, outcomes are evaluated collectively despite substantial variability in the underlying aetiology and extent of disease. The purpose of this study was to investigate whether variability in survival could be explained by different underlying patient and disease factors.</div></div><div><h3>Materials and methods</h3><div>A single centre, retrospective study was performed looking at first-time malignant PTBD and respective survival outcomes between 2017- 2021. Survival censoring was taken as June 2022. Predictors included aetiology, age, preprocedural serum haemoglobin, and bilirubin. Subgroups were dichotomised with respect to median values. Kaplan–Meier survival analysis and the log rank test were used for univariate analysis and Cox proportional hazards regression for multivariate analysis.</div></div><div><h3>Results</h3><div>One hundred fifty-six patients were identified, including 62 pancreatic, 19 ampullary/duodenal, 55 hilar cholangiocarcinoma, and 20 non hepatobiliary cancers. Median overall survival for the entire cohort was 136 days. The underlying aetiology significantly impacted median survival with non-hepatobiliary obstruction faring the worst; 53 days, and was in stark contrast to cholangiocarcinoma (347 days, p &lt; 0.001). On multivariate analysis, we found that in addition to aetiology, patients &gt; 70 years, preprocedural haemoglobin (&lt; 110) and bilirubin (&gt; 232) were all independent prognosticators and had significantly worse survival (HR 1.2, 1.8, 1.6, and 1.4, respectively, all p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Age, underlying malignant aetiology, preprocedural haemoglobin, and bilirubin were identified as independent predictors of post-PTBD survival. Careful patient selection may therefore improve patient outcomes following PTBD.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"82 ","pages":"Article 106772"},"PeriodicalIF":2.1,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Right coronary artery pericoronary fat attenuation index as a future predictor for acute coronary events in nonobstructive coronary artery disease – a prospective single centre study
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-12 DOI: 10.1016/j.crad.2024.106774
B. Biradar , J. Valakkada , A. Ayappan , S. Kannath , B. Sasidharan , A. Alex

AIM

Evaluation of pericoronary adipose tissue changes induced by inflammation by non-invasive techniques is challenging.

PURPOSE

To find the association between pericoronary adipose tissue attenuation (FAI) changes and future acute coronary events in nonobstructive coronary artery disease.

MATERIALS AND METHODS

Ours was a single-centre, prospective observational study on patients with atypical chest pain who underwent coronary computed tomography angiography (CCTA). In patients with CADRADS 1 to 3 nonobstructive coronary artery disease (CAD), pericoronary FAI was measured around the proximal right coronary artery (RCA) and coronary artery segment with plaque using semi-automated postprocessing software. Patients were followed up for development of acute coronary events (ACE). Kaplan–Meier curves were used to see event-free survival rates.

RESULTS

Of 120 patients with a mean follow-up period of 67 months, 21 patients developed acute coronary events. RCA-FAI and lesion FAI of patients with ACE were significantly higher as compared to patients without events. ROC curve analysis showed RCA-FAI as the best predictor of ACE at a cut-off point of > -77.3 Hounsfield unit (HU) (with an AUC of 0.915) with high sensitivity (95.24%), specificity (83.84%), and negative predictive value (98.80%). On multivariate analysis, RCA-FAI, diabetes mellitus, and stenosis ≥50% were independent risk factors of ACE with hazard ratios of 1.335 (1.173–1.518), 4.950 (1.716–14.278), and 7.446 (2.257–24.566), respectively.

CONCLUSION

RCA FAI can predict ACE in nonobstructive coronary artery disease patients. Detection of high RCA FAI of > -77.3 HU on CCTA can help to identify high-risk patients who need regular follow-up and early initiation of interventions.
{"title":"Right coronary artery pericoronary fat attenuation index as a future predictor for acute coronary events in nonobstructive coronary artery disease – a prospective single centre study","authors":"B. Biradar ,&nbsp;J. Valakkada ,&nbsp;A. Ayappan ,&nbsp;S. Kannath ,&nbsp;B. Sasidharan ,&nbsp;A. Alex","doi":"10.1016/j.crad.2024.106774","DOIUrl":"10.1016/j.crad.2024.106774","url":null,"abstract":"<div><h3>AIM</h3><div>Evaluation of pericoronary adipose tissue changes induced by inflammation by non-invasive techniques is challenging.</div></div><div><h3>PURPOSE</h3><div>To find the association between pericoronary adipose tissue attenuation (FAI) changes and future acute coronary events in nonobstructive coronary artery disease.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Ours was a single-centre, prospective observational study on patients with atypical chest pain who underwent coronary computed tomography angiography (CCTA). In patients with CADRADS 1 to 3 nonobstructive coronary artery disease (CAD), pericoronary FAI was measured around the proximal right coronary artery (RCA) and coronary artery segment with plaque using semi-automated postprocessing software. Patients were followed up for development of acute coronary events (ACE). Kaplan–Meier curves were used to see event-free survival rates.</div></div><div><h3>RESULTS</h3><div>Of 120 patients with a mean follow-up period of 67 months, 21 patients developed acute coronary events. RCA-FAI and lesion FAI of patients with ACE were significantly higher as compared to patients without events. ROC curve analysis showed RCA-FAI as the best predictor of ACE at a cut-off point of &gt; -77.3 Hounsfield unit (HU) (with an AUC of 0.915) with high sensitivity (95.24%), specificity (83.84%), and negative predictive value (98.80%). On multivariate analysis, RCA-FAI, diabetes mellitus, and stenosis ≥50% were independent risk factors of ACE with hazard ratios of 1.335 (1.173–1.518), 4.950 (1.716–14.278), and 7.446 (2.257–24.566), respectively.</div></div><div><h3>CONCLUSION</h3><div>RCA FAI can predict ACE in nonobstructive coronary artery disease patients. Detection of high RCA FAI of &gt; -77.3 HU on CCTA can help to identify high-risk patients who need regular follow-up and early initiation of interventions.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"82 ","pages":"Article 106774"},"PeriodicalIF":2.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic resonance imaging–based nomograms predict high-risk cytogenetic abnormalities in multiple myeloma: a two-centre study
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-05 DOI: 10.1016/j.crad.2024.106768
S. Liu , C. Liu , H. Pan , S. Li , P. Teng , Z. Li , J. Sun , T. Ren , G. Liu , J. Zhou

Aim

The study aim to use magnetic resonance imaging (MRI) radiomic features to predict high-risk cytogenetic abnormalities (HRCAs) to improve outcomes in patients with multiple myeloma (MM).

Materials and Methods

One hundred ninety-five patients with MM from two centres undergoing MRI were retrospectively recruited. Patients from Institution I (71 and 88 HRCAs and non-HRCAs, respectively) identified by fluorescence in situ hybridisation were randomly divided into training (n = 111) and validation (n = 48) cohorts. Patients from Institution II served as the external test cohort (n = 36). Radiomics or combined models based on T1WI, T2WI, and FS-T2WI images and clinical factors were constructed using logistic regression and 10-fold cross-validation in the training cohort. Nomogram performance was evaluated and compared using C-index, bootstrapping, accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and Akaike information criterion. C-indexes were used to select the most efficient radiomics predictive model. Optimal model performance was tested in an external cohort.

Results

FT2+age, FT2+1+age, and FT2+2+1+age combined models were outstanding in differentiating the HRCAs of MM patients in single-, double-, and multi-sequence MRI images, respectively. The C-indexes of the training and validation cohorts corrected via the 1000 bootstrap method were 0.79 and 0.80, 0.83 and 0.84, and 0.88 and 0.84, respectively. In the external test cohort, the C-index of radiomics nomograms was 0.70, 0.76, and 0.77, respectively.

Conclusion

MRI radiomics can be used to predict HRCAs in MM patients, which will be helpful for clinical decision-making and prognosis evaluation before treatment.
{"title":"Magnetic resonance imaging–based nomograms predict high-risk cytogenetic abnormalities in multiple myeloma: a two-centre study","authors":"S. Liu ,&nbsp;C. Liu ,&nbsp;H. Pan ,&nbsp;S. Li ,&nbsp;P. Teng ,&nbsp;Z. Li ,&nbsp;J. Sun ,&nbsp;T. Ren ,&nbsp;G. Liu ,&nbsp;J. Zhou","doi":"10.1016/j.crad.2024.106768","DOIUrl":"10.1016/j.crad.2024.106768","url":null,"abstract":"<div><h3>Aim</h3><div>The study aim to use magnetic resonance imaging (MRI) radiomic features to predict high-risk cytogenetic abnormalities (HRCAs) to improve outcomes in patients with multiple myeloma (MM).</div></div><div><h3>Materials and Methods</h3><div>One hundred ninety-five patients with MM from two centres undergoing MRI were retrospectively recruited. Patients from Institution I (71 and 88 HRCAs and non-HRCAs, respectively) identified by fluorescence in situ hybridisation were randomly divided into training (n = 111) and validation (n = 48) cohorts. Patients from Institution II served as the external test cohort (n = 36). Radiomics or combined models based on T1WI, T2WI, and FS-T2WI images and clinical factors were constructed using logistic regression and 10-fold cross-validation in the training cohort. Nomogram performance was evaluated and compared using C-index, bootstrapping, accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and Akaike information criterion. C-indexes were used to select the most efficient radiomics predictive model. Optimal model performance was tested in an external cohort.</div></div><div><h3>Results</h3><div>FT<sub>2</sub>+age, FT<sub>2+1</sub>+age, and FT<sub>2+2+1</sub>+age combined models were outstanding in differentiating the HRCAs of MM patients in single-, double-, and multi-sequence MRI images, respectively. The C-indexes of the training and validation cohorts corrected via the 1000 bootstrap method were 0.79 and 0.80, 0.83 and 0.84, and 0.88 and 0.84, respectively. In the external test cohort, the C-index of radiomics nomograms was 0.70, 0.76, and 0.77, respectively.</div></div><div><h3>Conclusion</h3><div>MRI radiomics can be used to predict HRCAs in MM patients, which will be helpful for clinical decision-making and prognosis evaluation before treatment.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"82 ","pages":"Article 106768"},"PeriodicalIF":2.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The super-resolution reconstruction in diffusion-weighted imaging of preoperative rectal MR using generative adversarial network (GAN): Image quality and T-stage assessment 使用生成对抗网络（GAN）对直肠 MR 术前弥散加权成像进行超分辨率重建：图像质量和T期评估
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-01 DOI: 10.1016/j.crad.2024.08.031
J. Cui , S. Miao , J. Wang , J. Chen , C. Dong , D. Hao , J. Li

Aims

To assess the feasibility of using a generative adversarial network (GAN) to improve diffusion-weighted imaging (DWI) resolution in rectal MR scans for rectal carcinoma (RC), and to evaluate both the image quality and the diagnostic utility of super-resolution DWI (SR-DWI) in T stage assessment.

Materials and methods

In this retrospective investigation, a total of 291 patients diagnosed with RC during the period spanning May 2018 to December 2021 were included. The generated SR-DWI was evaluated against the original DWI using multi-scale structural similarity and peak signal-to-noise ratio. Two radiologists scored the SR-DWI and original DWI using a 4-point Likert scale in image quality. Moreover, both radiologists independently evaluated the T category staging based on T2WI and SR-DWI. Interobserver agreement was assessed using Cohen's kappa.

Results

The PSRN and MS-SSIM values of SR-DWI (4 ×) were significantly higher compared to those of SR-DWI (16 ×). Regarding the details of anatomic structures and overall image quality parameters, both radiologists exhibited a preference for SR DWI with 16 × enlargement over SR DWI with 4 × enlargement, yielding significantly superior ratings (both p < 0.001). The T-staging accuracy rates of SR-DWI (16 ×) performed by radiologist 1 and radiologist 2 were significantly superior to those achieved with T2WI (0.621 vs. 0.768, p = 0.027; 0.653 vs 0.810, p = 0.014).

Conclusions

Our study demonstrates that the adapted super-resolution approach can significantly improve the overall image quality and details of anatomic structure of DWI in rectal MR. And SR-DWI offer better diagnostic accuracy in RC T staging when compared with T2WI.
目的评估使用生成式对抗网络（GAN）提高直肠癌（RC）直肠 MR 扫描中扩散加权成像（DWI）分辨率的可行性，并评估超分辨率 DWI（SR-DWI）在 T 分期评估中的图像质量和诊断效用。在这项回顾性调查中，共纳入了2018年5月至2021年12月期间确诊的291例RC患者。使用多尺度结构相似性和峰值信噪比对生成的 SR-DWI 与原始 DWI 进行了评估。两名放射科医生使用 4 点李克特量表对 SR-DWI 和原始 DWI 的图像质量进行评分。此外，两名放射科医生还根据 T2WI 和 SR-DWI 独立评估 T 类分期。使用科恩卡帕评估了观察者之间的一致性。SR-DWI 的 PSRN 和 MS-SSIM 值（4 ×）明显高于 SR-DWI（16 ×）。在解剖结构细节和整体图像质量参数方面，两位放射科医生都表现出对放大 16 倍的 SR DWI 比放大 4 倍的 SR DWI 的偏好，两者的评分明显更高（均<0.001）。放射科医师 1 和放射科医师 2 进行的 SR-DWI（16 ×）T 分期准确率明显优于 T2WI（0.621 vs. 0.768，p = 0.027；0.653 vs. 0.810，= 0.014）。我们的研究表明，经过调整的超分辨率方法能显著提高直肠磁共振 DWI 的整体图像质量和解剖结构细节。与 T2WI 相比，SR-DWI 对直肠癌 T 分期的诊断准确性更高。
{"title":"The super-resolution reconstruction in diffusion-weighted imaging of preoperative rectal MR using generative adversarial network (GAN): Image quality and T-stage assessment","authors":"J. Cui ,&nbsp;S. Miao ,&nbsp;J. Wang ,&nbsp;J. Chen ,&nbsp;C. Dong ,&nbsp;D. Hao ,&nbsp;J. Li","doi":"10.1016/j.crad.2024.08.031","DOIUrl":"10.1016/j.crad.2024.08.031","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the feasibility of using a generative adversarial network (GAN) to improve diffusion-weighted imaging (DWI) resolution in rectal MR scans for rectal carcinoma (RC), and to evaluate both the image quality and the diagnostic utility of super-resolution DWI (SR-DWI) in T stage assessment.</div></div><div><h3>Materials and methods</h3><div>In this retrospective investigation, a total of 291 patients diagnosed with RC during the period spanning May 2018 to December 2021 were included. The generated SR-DWI was evaluated against the original DWI using multi-scale structural similarity and peak signal-to-noise ratio. Two radiologists scored the SR-DWI and original DWI using a 4-point Likert scale in image quality. Moreover, both radiologists independently evaluated the T category staging based on T2WI and SR-DWI. Interobserver agreement was assessed using Cohen's kappa.</div></div><div><h3>Results</h3><div>The PSRN and MS-SSIM values of SR-DWI (4 ×) were significantly higher compared to those of SR-DWI (16 ×). Regarding the details of anatomic structures and overall image quality parameters, both radiologists exhibited a preference for SR DWI with 16 × enlargement over SR DWI with 4 × enlargement, yielding significantly superior ratings (both <em>p</em> &lt; 0.001). The T-staging accuracy rates of SR-DWI (16 ×) performed by radiologist 1 and radiologist 2 were significantly superior to those achieved with T2WI (0.621 vs. 0.768, p = 0.027; 0.653 vs 0.810, <em>p</em> = 0.014).</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that the adapted super-resolution approach can significantly improve the overall image quality and details of anatomic structure of DWI in rectal MR. And SR-DWI offer better diagnostic accuracy in RC T staging when compared with T2WI.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"79 12","pages":"Pages e1530-e1538"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transarterial chemoembolization combined with microwave ablation versus repeated resection for recurrent small hepatocellular carcinoma after resection: What is the better treatment? 经动脉化疗栓塞联合微波消融与反复切除术治疗切除术后复发的小肝癌：哪种治疗方法更好？
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-01 DOI: 10.1016/j.crad.2024.08.020
J. Ji , L.-l. Yan , Y. Ma , C. Xu , W.-Z. Zhou , P.-h. Lv

Purpose

This study aimed to compare the effectiveness of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) versus repeated hepatic resection (RHR) in patients with recurrent small hepatocellular carcinoma (sHCC) following primary resection.

Materials and Methods

A total of 59 patients diagnosed with recurrent sHCC (≤3 cm) and treated with either TACE-MWA or RHR were recruited from two centers between June 2015 and October 2021. Patients were matched using propensity scores at a 1:1 ratio. Disease-free survival (DFS), overall survival (OS), and complications were assessed and compared between the two treatment groups.

Results

After propensity score matching, 38 patients were included, with 19 in each group. Prior to matching, the 1-, 3-, and 5-year DFS rates for the TACE-MWA group were 68.1%, 46.6%, and 23.3%, respectively, and for the RHR group, they were 84.6%, 47.3%, and 47.3%, respectively. The corresponding 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 83.7%, and 47.8%, while for RHR, they were 100.0%, 95.0%, and 45.2%. After matching, the 1-, 3-, and 5-year DFS rates were 78.0%, 48.3%, and 24.1% for TACE-MWA, and 77.5%, 38.7%, and 38.7% for RHR. The 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 88.9%, and 54.9%, and for RHR, they were 100.0%, 93.3%, and 44.4%. Statistical analysis showed no significant differences in DFS rates (P=0.834 before matching, P=0.490 after matching) or OS rates (P=0.825 before matching, P=0.625 after matching) between the two groups.

Conclusions

TACE-MWA demonstrates comparable effectiveness to RHR in managing recurrent sHCC.
本研究旨在比较经导管动脉化疗栓塞联合微波消融术（TACE-MWA）与重复肝切除术（RHR）对初次切除术后复发的小肝细胞癌（sHCC）患者的疗效。2015年6月至2021年10月期间，两个中心共招募了59名确诊为复发性sHCC（≤3厘米）并接受TACE-MWA或RHR治疗的患者。患者按 1:1 的比例进行倾向评分匹配。对两组患者的无病生存期（DFS）、总生存期（OS）和并发症进行了评估和比较。经过倾向评分匹配后，共纳入 38 例患者，每组 19 例。匹配前，TACE-MWA 组的 1 年、3 年和 5 年 DFS 率分别为 68.1%、46.6% 和 23.3%，RHR 组分别为 84.6%、47.3% 和 47.3%。TACE-MWA相应的1年、3年和5年OS率分别为100.0%、83.7%和47.8%，而RHR则分别为100.0%、95.0%和45.2%。匹配后，TACE-MWA 的 1 年、3 年和 5 年 DFS 率分别为 78.0%、48.3% 和 24.1%，RHR 的 1 年、3 年和 5 年 DFS 率分别为 77.5%、38.7% 和 38.7%。TACE-MWA的1年、3年和5年OS率分别为100.0%、88.9%和54.9%，RHR的1年、3年和5年OS率分别为100.0%、93.3%和44.4%。统计分析显示，两组患者的 DFS 率（配对前 P=0.834，配对后 P=0.490）或 OS 率（配对前 P=0.825，配对后 P=0.625）无明显差异。TACE-MWA在治疗复发性sHCC方面的疗效与RHR相当。
{"title":"Transarterial chemoembolization combined with microwave ablation versus repeated resection for recurrent small hepatocellular carcinoma after resection: What is the better treatment?","authors":"J. Ji ,&nbsp;L.-l. Yan ,&nbsp;Y. Ma ,&nbsp;C. Xu ,&nbsp;W.-Z. Zhou ,&nbsp;P.-h. Lv","doi":"10.1016/j.crad.2024.08.020","DOIUrl":"10.1016/j.crad.2024.08.020","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to compare the effectiveness of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) versus repeated hepatic resection (RHR) in patients with recurrent small hepatocellular carcinoma (sHCC) following primary resection.</div></div><div><h3>Materials and Methods</h3><div>A total of 59 patients diagnosed with recurrent sHCC (≤3 cm) and treated with either TACE-MWA or RHR were recruited from two centers between June 2015 and October 2021. Patients were matched using propensity scores at a 1:1 ratio. Disease-free survival (DFS), overall survival (OS), and complications were assessed and compared between the two treatment groups.</div></div><div><h3>Results</h3><div>After propensity score matching, 38 patients were included, with 19 in each group. Prior to matching, the 1-, 3-, and 5-year DFS rates for the TACE-MWA group were 68.1%, 46.6%, and 23.3%, respectively, and for the RHR group, they were 84.6%, 47.3%, and 47.3%, respectively. The corresponding 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 83.7%, and 47.8%, while for RHR, they were 100.0%, 95.0%, and 45.2%. After matching, the 1-, 3-, and 5-year DFS rates were 78.0%, 48.3%, and 24.1% for TACE-MWA, and 77.5%, 38.7%, and 38.7% for RHR. The 1-, 3-, and 5-year OS rates for TACE-MWA were 100.0%, 88.9%, and 54.9%, and for RHR, they were 100.0%, 93.3%, and 44.4%. Statistical analysis showed no significant differences in DFS rates (P=0.834 before matching, P=0.490 after matching) or OS rates (P=0.825 before matching, P=0.625 after matching) between the two groups.</div></div><div><h3>Conclusions</h3><div>TACE-MWA demonstrates comparable effectiveness to RHR in managing recurrent sHCC.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"79 12","pages":"Pages e1443-e1450"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Behaviour of simple thymic cysts over time; is surveillance required? 单纯胸腺囊肿的长期表现；是否需要监测？
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-01 DOI: 10.1016/j.crad.2024.08.025
J. Mayhew, M. Kong, A. Bahl, D. Kohat, L. Wing, R. Benamore

Aim

Anterior mediastinal lesions can be a source of uncertainty on imaging, and thymic cysts present a unique diagnostic challenge. Differentiation of non-simple fluid-containing benign simple thymic cysts from small thymic neoplasms is challenging with computed tomography (CT) alone. Additionally, the malignant potential of simple thymic cysts is unclear and guidelines for imaging surveillance are not established.

Materials and Methods

All imaging studies containing the phrase “thymic cyst” were identified at our institution between October 2012 and October 2022. Studies were excluded if the main radiological diagnosis was anything other than a thymic cyst. This yielded 107 individual patient records, of which 11 did not meet inclusion criteria, leaving 96 unique patients.

Results

While most cysts evaluated remained stable throughout the period of surveillance (53%; n=51), some increased in size (13%), some decreased in size (6%), and some fluctuated (5%). Some cysts changed in internal attenuation/signal characteristics in keeping with interval haemorrhage (6%). 34% of cysts (n=31) demonstrate internal average attenuation values of more than 20HU. Of the entire cohort of patients studied over 10 years, none developed malignancy within the period of surveillance.

Conclusion

Unilocular thymic cysts are most often discovered incidentally but their imaging characteristics can be difficult to interpret on CT, as they are commonly hyperdense and may change in size and internal content. Once simple thymic cysts are adequately characterised with magnetic resonance imaging (MRI) then extended radiological surveillance may not be required.
前纵隔病变可能是影像学上的一个不确定因素，而胸腺囊肿则是一个独特的诊断难题。仅靠计算机断层扫描（CT）来鉴别非单纯性良性单纯胸腺囊肿和胸腺小肿瘤具有挑战性。此外，单纯性胸腺囊肿的恶性可能性尚不明确，影像学监测指南也未确定。我院在 2012 年 10 月至 2022 年 10 月期间对所有含有 "胸腺囊肿 "字样的影像学研究进行了鉴定。如果主要放射学诊断不是胸腺囊肿，则排除这些研究。这样就得到了 107 份患者病历，其中 11 份不符合纳入标准，剩下的 96 份是唯一的患者病历。虽然大多数接受评估的囊肿在整个监测期间保持稳定（53%；n=51），但也有一些囊肿增大（13%）、缩小（6%）和波动（5%）。一些囊肿的内部衰减/信号特征发生了变化，与出血间隔一致（6%）。34%的囊肿（31 个）显示内部平均衰减值超过 20HU。在长达10年的研究中，所有患者均未在监测期内发生恶性肿瘤。单发性胸腺囊肿多为偶然发现，但其影像学特征在 CT 上很难解释，因为它们通常密度过高，而且大小和内部内容物可能会发生变化。一旦通过磁共振成像（MRI）充分确定了单纯性胸腺囊肿的特征，可能就不需要延长放射监测时间了。
{"title":"Behaviour of simple thymic cysts over time; is surveillance required?","authors":"J. Mayhew,&nbsp;M. Kong,&nbsp;A. Bahl,&nbsp;D. Kohat,&nbsp;L. Wing,&nbsp;R. Benamore","doi":"10.1016/j.crad.2024.08.025","DOIUrl":"10.1016/j.crad.2024.08.025","url":null,"abstract":"<div><h3>Aim</h3><div>Anterior mediastinal lesions can be a source of uncertainty on imaging, and thymic cysts present a unique diagnostic challenge. Differentiation of non-simple fluid-containing benign simple thymic cysts from small thymic neoplasms is challenging with computed tomography (CT) alone. Additionally, the malignant potential of simple thymic cysts is unclear and guidelines for imaging surveillance are not established.</div></div><div><h3>Materials and Methods</h3><div>All imaging studies containing the phrase “thymic cyst” were identified at our institution between October 2012 and October 2022. Studies were excluded if the main radiological diagnosis was anything other than a thymic cyst. This yielded 107 individual patient records, of which 11 did not meet inclusion criteria, leaving 96 unique patients.</div></div><div><h3>Results</h3><div>While most cysts evaluated remained stable throughout the period of surveillance (53%; n=51), some increased in size (13%), some decreased in size (6%), and some fluctuated (5%). Some cysts changed in internal attenuation/signal characteristics in keeping with interval haemorrhage (6%). 34% of cysts (n=31) demonstrate internal average attenuation values of more than 20HU. Of the entire cohort of patients studied over 10 years, none developed malignancy within the period of surveillance.</div></div><div><h3>Conclusion</h3><div>Unilocular thymic cysts are most often discovered incidentally but their imaging characteristics can be difficult to interpret on CT, as they are commonly hyperdense and may change in size and internal content. Once simple thymic cysts are adequately characterised with magnetic resonance imaging (MRI) then extended radiological surveillance may not be required.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"79 12","pages":"Pages 956-961"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interventional radiology procedures, facilities, and workforce across England and Wales: a snapshot retrospective evaluation from 2017 to 2021 英格兰和威尔士的介入放射学程序、设施和劳动力：2017 年至 2021 年的快照回顾性评估
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-01 DOI: 10.1016/j.crad.2024.08.032
G. Najafi , R. Lakshminarayan , P. Haslam , I. McCafferty , R. Morgan , R. Uberoi , M. Hamady

Aims

There is no comprehensive data collection outlining the numbers and types of interventional radiology (IR) procedures in the United Kingdom. Similarly, limited data are available on the IR facilities and workforce within the National Health Services (NHS) trusts. The purpose of this study is to evaluate the number/type of IR procedures, facilities, and workforces across England and Wales.

Materials and Methods

This retrospective study used the 2000 Freedom of Information Act to obtain information regarding the IR procedures performed in NHS trusts in England and Wales from 2017 to 2021. We collected additional information on IR workforce and facilities, including the number of IR consultants, nurses, trainees, and angiographic suites and day case units; analysed procedures by complexity; and performed data analysis by region.

Results

A total of 1,340,352 IR procedures were analysed. An increasing trend was observed in the number of IR procedures from 2017 to 2021 (p=0.07, R=0.93). There were more intermediate and complex procedures than simple ones (p=0.0001). Notable geographical variation was observed in terms of IR facilities including angiographic suites and day case units, and the number of IR consultants, nurses, and trainees.

Conclusions

The IR field continues to grow as evidenced by increasing trends in the number and complexity of the procedures over the years. There is an uneven IR workforce, services, and facilities distribution across England and Wales. Therefore, there is a crucial need for centralised data collection to evaluate and monitor interventions besides comprehensive revision of UK IR service provision.
目前还没有全面的数据收集来概述英国介入放射学（IR）手术的数量和类型。同样，有关国民健康服务（NHS）信托机构内 IR 设施和工作人员的数据也很有限。本研究的目的是评估英格兰和威尔士的 IR 程序、设施和工作人员的数量/类型。这项回顾性研究利用 2000 年的《信息自由法》（Freedom of Information Act），获取了 2017 年至 2021 年期间英格兰和威尔士的 NHS 信托机构所实施的 IR 程序的相关信息。我们还收集了有关 IR 工作人员和设施的其他信息，包括 IR 顾问、护士、受训人员以及血管造影室和日间病例室的数量；按复杂程度对手术进行了分析；并按地区进行了数据分析。共分析了 1,340,352 例 IR 手术。从2017年到2021年，IR手术数量呈上升趋势（=0.07，R=0.93）。中级和复杂手术多于简单手术（=0.0001）。在包括血管造影室和日间病例室在内的IR设施以及IR顾问、护士和受训人员数量方面，观察到明显的地域差异。多年来，血管造影手术的数量和复杂程度呈上升趋势，这证明血管造影领域在不断发展。英格兰和威尔士的 IR 工作人员、服务和设施分布不均。因此，除了全面修订英国 IR 服务提供情况外，还亟需集中收集数据，以评估和监测干预措施。
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引用次数: 0
Preoperative prognostic prediction for invasive pulmonary adenocarcinoma: Impact of 18F-FDG PET/CT semi-quantitative parameters associated with new histological subtype classification 浸润性肺腺癌术前预后预测：与新组织学亚型分类相关的 18F-FDG PET/CT 半定量参数的影响。
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-01 DOI: 10.1016/j.crad.2024.08.034
K. Wang, N. Tu, H. Feng, Y. Zhou, L. Bu

Aims

To explore the preoperative predictive value of 18F-FDG PET/CT for poor prognostic histologic subtypes of invasive pulmonary adenocarcinoma (IPA) under new classification.

Materials and Methods

This study included 316 patients. Histopathology of IPA was evaluated by recording the percentage of each histologic component. PET/CT parameters were compared among IPAs with different risks of recurrence. Optimum cutoff values of PET/CT parameters were calculated using ROC curve analysis. Overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan–Meier method, and survival differences between groups were tested using log-rank test. Multivariate analysis for survival was performed using the Cox regression model.

Results

Patients were divided into low (LRR), intermediate (IRR), and modified high (mHRR) risk of recurrence group incorporating typical (HRR-T) and nontypical (HRR-NT) subgroups based on histologic patterns. There were significant differences in SUVmax, SUVmean, SUVmin, SUVSD, TLG, and tumor size among three groups. HRR-NT had lower SUVmax, SUVmean, SUVmin, SUVSD and TLG than HRR-T subgroup, and higher SUVmax, SUVmean, SUVmin, SUVSD, MTV, TLG and tumor size than IRR group. ROC curve analysis showed that SUVmax had highest AUC (0.815) in distinguishing LRR and IRR. TLG had highest AUC (0.741) in distinguishing IRR and mHRR. Multivariable analysis showed that tumor size and SUVmax were independent predictors of DFS and OS.

Conclusions

High risk of recurrence of IPA exhibited higher 18F-FDG uptake and tumor size. Tumor size and SUVmax could be used as preoperative surrogates for the IASLC grading system. 18F-FDG PET/CT can improve the preoperative prognostic prediction for IPA patients.
目的：探讨新分类下18F-FDG PET/CT对浸润性肺腺癌（IPA）预后不良组织学亚型的术前预测价值：本研究共纳入 316 例患者。通过记录每种组织学成分的百分比来评估 IPA 的组织病理学。比较了不同复发风险的IPA的PET/CT参数。使用 ROC 曲线分析法计算 PET/CT 参数的最佳临界值。用 Kaplan-Meier 法计算总生存期（OS）和无病生存期（DFS），并用对数秩检验检测组间生存期差异。采用 Cox 回归模型对生存率进行多变量分析：根据组织学模式将患者分为低复发风险组（LRR）、中复发风险组（IRR）和改良高复发风险组（mHRR），并纳入典型亚组（HRR-T）和非典型亚组（HRR-NT）。三组的 SUVmax、SUVmean、SUVmin、SUVSD、TLG 和肿瘤大小均有明显差异。HRR-NT组的SUVmax、SUVmean、SUVmin、SUVSD和TLG均低于HRR-T亚组，而SUVmax、SUVmean、SUVmin、SUVSD、MTV、TLG和肿瘤大小均高于IRR组。ROC 曲线分析显示，SUVmax 在区分 LRR 和 IRR 方面的 AUC 最高（0.815）。TLG在区分IRR和mHRR时具有最高的AUC（0.741）。多变量分析显示，肿瘤大小和SUVmax是DFS和OS的独立预测因子：结论：IPA的高复发风险表现为较高的18F-FDG摄取率和肿瘤大小。肿瘤大小和SUVmax可作为IASLC分级系统的术前替代指标。18F-FDG PET/CT 可以改善 IPA 患者的术前预后预测。
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引用次数: 0
Feasibility of using synthetic MRI to predict lymphatic vascular space invasion status in early-stage cervical cancer: added value to morphological MRI 利用合成磁共振成像预测早期宫颈癌淋巴管间隙侵犯状况的可行性：形态学磁共振成像的附加值
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-01 DOI: 10.1016/j.crad.2024.08.021
Z.B. Huang , L.L. Wang , X.Q. Xu , D. Pylypenko , H.L. Gu , Z.F. Tian , W.W. Tang

Objectives

To investigate the feasibility of synthetic magnetic resonance imaging (syMRI) in predicting the lymphatic vascular space invasion (LVSI) status of early-stage cervical cancer, and its added value to morphological MRI.

Materials and Methods

A total of 72 patients with pathology-confirmed early-stage cervical cancer were enrolled, and classified into LVSI- positive (n=41) and LVSI- negative (n=31) groups. Together with morphological parameters including gross tumor volume (GTV) and maximum tumor diameter (MTD), the T1, T2, and proton density (PD) values of the tumors were also measured and compared between two groups. Binary logistic regression analysis was used to identify the independent variable associated with LVSI. Receiver operating characteristic curve analyses and DeLong tests were used to evaluate and compare the performances of significant parameters or their combination in predicting LVSI.

Results

LVSI- positive group showed significantly higher GTV (P=0.008) and MTD (P=0.019), and lower T1 (P<0.001) and PD values (P=0.041) than LVSI- negative group. However, no statistical significance was observed regarding the T2 values (P=0.331). Binary logistic regression indicated that T1 value (odds ratio [OR] = 0.993; P=0.001) and MTD (OR=1.903, P=0.027) were independent variables associated with LVSI in early cervical cancer. Optimal performance could be achieved [area under ROC curve (AUC) = 0.784; cut-off value = 0.56; sensitivity = 80.5%; specificity = 71.0%] when combining T1 and MTD for predicting LVSI. Its performance was significantly better than that of MTD alone (AUC, 0.784 vs 0.662, P=0.035).

Conclusion

syMRI might be a feasible approach, and it can provide added value to morphological MRI in predicting the LVSI status of early-stage cervical cancer.
研究合成磁共振成像（syMRI）预测早期宫颈癌淋巴管间隙侵犯（LVSI）状态的可行性及其对形态学磁共振成像的附加价值。研究共纳入了72例经病理证实的早期宫颈癌患者，并将其分为LVSI阳性组（=41）和LVSI阴性组（=31）。除了肿瘤总体积（GTV）和肿瘤最大直径（MTD）等形态学参数外，还测量了肿瘤的T1、T2和质子密度（PD）值，并在两组之间进行了比较。二元逻辑回归分析用于确定与 LVSI 相关的自变量。接收者操作特征曲线分析和 DeLong 检验用于评估和比较重要参数或其组合在预测 LVSI 方面的性能。与LVSI阴性组相比，LVSI阳性组的GTV（=0.008）和MTD（=0.019）明显较高，T1（<0.001）和PD值（=0.041）较低。然而，T2值（=0.331）无统计学意义。二元逻辑回归表明，T1 值（几率比 [OR] = 0.993; =0.001）和 MTD（OR=1.903, =0.027）是与早期宫颈癌 LVSI 相关的独立变量。结合 T1 和 MTD 预测 LVSI 可达到最佳效果[ROC 曲线下面积 (AUC) = 0.784；临界值 = 0.56；灵敏度 = 80.5%；特异度 = 71.0%]。在预测早期宫颈癌的 LVSI 状态时，syMRI 可能是一种可行的方法，它能为形态学 MRI 提供附加值。
{"title":"Feasibility of using synthetic MRI to predict lymphatic vascular space invasion status in early-stage cervical cancer: added value to morphological MRI","authors":"Z.B. Huang ,&nbsp;L.L. Wang ,&nbsp;X.Q. Xu ,&nbsp;D. Pylypenko ,&nbsp;H.L. Gu ,&nbsp;Z.F. Tian ,&nbsp;W.W. Tang","doi":"10.1016/j.crad.2024.08.021","DOIUrl":"10.1016/j.crad.2024.08.021","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the feasibility of synthetic magnetic resonance imaging (syMRI) in predicting the lymphatic vascular space invasion (LVSI) status of early-stage cervical cancer, and its added value to morphological MRI.</div></div><div><h3>Materials and Methods</h3><div>A total of 72 patients with pathology-confirmed early-stage cervical cancer were enrolled, and classified into LVSI- positive (<em>n</em>=41) and LVSI- negative (<em>n</em>=31) groups. Together with morphological parameters including gross tumor volume (GTV) and maximum tumor diameter (MTD), the T1, T2, and proton density (PD) values of the tumors were also measured and compared between two groups. Binary logistic regression analysis was used to identify the independent variable associated with LVSI. Receiver operating characteristic curve analyses and DeLong tests were used to evaluate and compare the performances of significant parameters or their combination in predicting LVSI.</div></div><div><h3>Results</h3><div>LVSI- positive group showed significantly higher GTV (<em>P</em>=0.008) and MTD (<em>P</em>=0.019), and lower T1 (<em>P</em>&lt;0.001) and PD values (<em>P</em>=0.041) than LVSI- negative group. However, no statistical significance was observed regarding the T2 values (<em>P</em>=0.331). Binary logistic regression indicated that T1 value (odds ratio [OR] = 0.993; <em>P</em>=0.001) and MTD (OR=1.903, <em>P</em>=0.027) were independent variables associated with LVSI in early cervical cancer. Optimal performance could be achieved [area under ROC curve (AUC) = 0.784; cut-off value = 0.56; sensitivity = 80.5%; specificity = 71.0%] when combining T1 and MTD for predicting LVSI. Its performance was significantly better than that of MTD alone (AUC, 0.784 vs 0.662, <em>P</em>=0.035).</div></div><div><h3>Conclusion</h3><div>syMRI might be a feasible approach, and it can provide added value to morphological MRI in predicting the LVSI status of early-stage cervical cancer.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"79 12","pages":"Pages e1459-e1465"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142184873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond the throat: Imaging of parapharyngeal space lesions 喉咙之外咽旁间隙病变成像
IF 2.1 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical radiology
Pub Date : 2024-12-01 DOI: 10.1016/j.crad.2024.08.030
P. Rai , K. Bhattacharya , S. Rastogi , P. Joshi , K. Rabade , N. Shetty , S. Kulkarni
The parapharyngeal space (PPS) is a pyramidal-shaped fat-filled space in the head and neck, between the base of the skull and the hyoid bone.
It is a vital anatomic structure in head and neck imaging and serves as a path for the spread of infection or tumor, a critical landmark for diagnosing various lesions in this region, and a potential site of infections. The purpose of this pictorial review is to illustrate the anatomy of the PPS, the pathologies in and around PPS, and the distinguishing imaging characteristics of these lesions. It also explores the limitations and challenges of imaging techniques in certain scenarios as well as the surgical approaches for PPS masses, emphasizing their radiological relevance.
The review aims to underscore the significance of a multidisciplinary approach, involving radiologists, otolaryngologists, and head and neck surgeons, in interpreting imaging findings and determining the most appropriate management strategies for PPS lesions for improved patient outcomes.
咽旁间隙（PPS）是头颈部的一个金字塔形脂肪填充间隙，位于颅底和舌骨之间。
{"title":"Beyond the throat: Imaging of parapharyngeal space lesions","authors":"P. Rai ,&nbsp;K. Bhattacharya ,&nbsp;S. Rastogi ,&nbsp;P. Joshi ,&nbsp;K. Rabade ,&nbsp;N. Shetty ,&nbsp;S. Kulkarni","doi":"10.1016/j.crad.2024.08.030","DOIUrl":"10.1016/j.crad.2024.08.030","url":null,"abstract":"<div><div>The parapharyngeal space (PPS) is a pyramidal-shaped fat-filled space in the head and neck, between the base of the skull and the hyoid bone.</div><div>It is a vital anatomic structure in head and neck imaging and serves as a path for the spread of infection or tumor, a critical landmark for diagnosing various lesions in this region, and a potential site of infections. The purpose of this pictorial review is to illustrate the anatomy of the PPS, the pathologies in and around PPS, and the distinguishing imaging characteristics of these lesions. It also explores the limitations and challenges of imaging techniques in certain scenarios as well as the surgical approaches for PPS masses, emphasizing their radiological relevance.</div><div>The review aims to underscore the significance of a multidisciplinary approach, involving radiologists, otolaryngologists, and head and neck surgeons, in interpreting imaging findings and determining the most appropriate management strategies for PPS lesions for improved patient outcomes.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"79 12","pages":"Pages 912-920"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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