Clinical radiology最新文献

Aim: To evaluate radiation dose among physicians, nurses, nuclear medicine (NM) technicians, and radiographers at a single institution and to compare the difference in the measured dose during COVID-19 with other periods.

Materials and methods: A retrospective analysis of the occupational radiation doses received by all workers in diagnostic radiography and NM departments at a single institution during a 5-year period (2018-2022) was performed. Dose measurements were recorded for 94 radiology personnel: radiographers, NM technicians, physicians, and nurses. In addition to descriptive statistics, the Mann-Whitney U-test was used to compare the average annual effective dose between male and female workers and between the periods before and during COVID-19. Kruskal-Wallis test was used to compare effective radiation doses from different quadrants.

Results: The annual average effective doses were found to be between 0.58 and 0.72 mSv for males and 0.68 and 0.85 mSv for females. All radiographers, 86% of nurses, and 69% of physicians have received annual average effective doses below 0.99 mSv. The average annual effective doses for all radiation workers were similar in the period before COVID-19 when compared to the period during COVID-19 except for nurses who had significantly lower (P<0.05) doses before COVID-19.

Conclusion: The average annual effective doses of radiation workers during 2018-2022 were well below the annual dose limit. A relatively higher average effective dose was received among NM technicians compared with other radiation occupational workers. While the caseload during the COVID-19 pandemic was lower due to government policies, the radiation dose to healthcare workers during the pandemic was similar to that before the pandemic.

Purpose: This study examined the literature to compare the accuracy, sensitivity, and specificity of dual-energy subtraction radiography (DESR) with conventional radiography (CR) in the detection of pulmonary nodules. To our knowledge, no meta-analysis has been conducted to compare DESR with CR.

Material and methods: The authors searched Pubmed using the terms "Dual-energy subtraction radiography," and "Dual-Energy Chest Radiography." Only studies comparing the detection of pulmonary nodules between DESR and CR were included. Studies utilizing artificial intelligence were excluded. The primary study outcomes analyzed were the mean difference of receiver operating characteristic area under the curve (ROC AUC), mean difference of sensitivity, and mean difference of specificity.

Results: Twenty-three studies between 1994 and 2022 were included. Of these twenty-three, eighteen reported ROC AUC statistics. The difference between DESR ROC AUC (mean = 0.7702, SD = 0.1361) and CR ROC AUC (mean = 0.7106, SD = 0.1183) was 0.0597 (P<0.001). Sensitivity data was reported for thirteen of the twenty-three selected studies. The difference between DESR sensitivity (mean = 0.5753, SD = 0.1546) and CR sensitivity (mean = 0.4391, SD = 0.1007) was 0.136 (P<0.001). Specificity data were reported for ten of the twenty-three selected studies. The difference between DESR specificity (mean = 0.753, SD = 0.1575) and CR specificity (mean = 0.764, SD = 0.1168) was -0.011 (P=0.767). This was not statistically significant.

Conclusions: DESR showed superior sensitivity and ROC AUC values compared with CR in detecting pulmonary nodules. There was no difference in specificity.

Aim: To evaluate the feasibility and safety of surgical resection combined with microwave ablation (MWA) for patients with multiple high-risk pulmonary nodules.

Materials and methods: From September 2010 to November 2023, a total of 166 early multiple high-risk pulmonary nodule patients in our institution were retrospectively analyzed. Fifty-three patients who underwent surgical resection in combination with MWA were considered as the observation group, and 113 patients who underwent two operations or one operation to remove nodules in two lobes of the lungs were considered as the control group. The primary endpoint was postoperative progression-free survival (PFS). Secondary endpoints were lung function, postoperative complications, and length and cost of hospitalization.

Results: In the observation group, the median PFS was 37 months (1-63 months), 9 patients (16.98%) had postoperative recurrence, and the 1-year and 3-year PFS rates were 97.6% and 89.0%, respectively. In the control group, the median PFS was 36 months (1-56 months), 10 patients (8.84%) had postoperative recurrence, and the 1-year and 3-year PFS rates were 99% and 97.8%, respectively. The difference between the two groups was not statistically significant (P = 0.392). Lung function measurements showed a decrease in patients after surgery (P<0.05), and no significant change in patients after MWA (P > 0.05). Compared with two surgical resections, the combined treatment required less hospitalization and cost (P < 0.05).

Conclusion: For patients with multiple high-risk pulmonary nodules, surgical resection in combination with microwave ablation is an effective and safe treatment, which has less hospitalization and cost than using surgical resection alone.

Aim: The aim of this study was to explore the relationship between epicardial adipose tissue (EAT), paracardial adipose tissue (PaAT), pericardial adipose tissue (PeAT), and fat ratio with left ventricular (LV) involvement, assessing the prognostic significance of cardiac fat in arrhythmogenic right ventricular cardiomyopathy (ARVC).

Materials and methods: Ninety-two ARVC patients (mean age: 45.74 years; 63% male) were included and followed up for 92 months. Measured in cardiac magnetic resonance imaging (MRI) cine views, EAT, PaAT, PeAT, and fat ratio (EAT/PaAT) were analyzed to identify the association with major adverse cardiac events (MACEs) (sudden cardiovascular death, aborted cardiac arrest, heart failure hospitalization, and sustained documented ventricular tachycardia).

Results: Among the 92 participants, 28 (30.43%) MACEs occurred during the follow-up. Significantly higher EAT, PaAT, PeAT, and fat ratio were observed in patients with LV involvement than in those without (p = 0.001, p = 0.002, p = 0.001, p = 0.003, respectively) in violin plots. A worse prognosis in ARVC patients was associated with a higher volume of EAT (log rank p = 0.0031). In multivariate Cox regression analysis, EAT (Hazard Ratio [HR]: 1.056, 95% confidence interval [CI]: 1.011-1.103, p = 0.013) and 5-year risk score (HR: 1.018, 95% CI: 1.002-1.034, p = 0.030) were identified as independent prognostic predictors for MACEs. Additional prognostic information over conventional outcome predictors was provided by EAT (Uno C-statistics: 0.645 vs. 0.665, p = 0.007).

Conclusion: higher cardiac fat volume was found to be correlated with LV involvement. Independent risk factors for MACEs in ARVC were identified as EAT and 5-year risk score, and the incremental prognostic value to established predictors in ARVC was provided by EAT.

Aims: To investigate radiology staff perceptions of an AI tool for chest radiography triage, flagging findings suspicious for lung cancer to expedite same-day CT chest examination studies.

Materials and methods: Surveys were distributed to all radiology staff at three time points: at pre-implementation, one month and also seven months post-implementation of artificial intelligence (AI). Survey questions captured feedback on AI use and patient impact.

Results: Survey response rates at the three time periods were 23.1% (45/195), 14.9% (29/195) and 27.2% (53/195), respectively. Most respondents initially anticipated AI to be time-saving for the department and patient (50.8%), but this shifted to faster follow-up care for patients after AI implementation (51.7%). From the free text comments, early apprehension about job role changes evolved into frustration regarding technical integration challenges after implementation. This later transitioned to a more balanced view of recognised patient benefits versus minor ongoing logistical issues by the late post-implementation stage. There was majority disagreement across all survey periods that AI could be considered to be used autonomously (53.3-72.5%), yet acceptance grew for personal AI usage if staff were to be patients themselves (from 31.1% pre-implementation to 47.2% post-implementation).

Conclusion: Successful AI integration in radiology demands active staff engagement, addressing concerns to transform initial mixed excitement and resistance into constructive adaptation. Continual feedback is vital for refining AI deployment strategies, ensuring its beneficial and sustainable incorporation into clinical care pathways.

Aim: Various magnetic resonance imaging (MRI) sequences can be utilized to visualize human meningeal lymphatic vessels (MLVs) for investigating the associations between MLVs and central nervous system (CNS) disorders. This study aimed to compare the quality of contrast-enhanced 3D-T2WI and 3D-T2-fluid-attenuated inversion recovery (FLAIR) MRI sequences to display human MLVs.

Materials and methods: Sixty-two patients (27 males, 35 females; mean age 55.8 ± 14.9 years) underwent 3D-T2WI and 3D-T2-FLAIR scan in combination with Gd-DTPA injection to show MLVs.

Results: (1) The positivity rates of the 3D-T2WI sequence were 98.4%, 29.0%, and 46.8%, around the dural sinus, middle meningeal artery, and ethmoid sinus, respectively. The positivity rates of the 3D-T2-FLAIR sequence were 100%, 48.4%, and 66.1%, respectively. The positivity rate was significantly higher with the 3D-T2-FLAIR sequence compared with the 3D-T2WI sequence for the middle meningeal artery and ethmoid sinus regions (p < 0.05). (2) In patients with brain lesions and intracranial space-occupying lesions, the positivity rate was significantly higher with the 3D-T2-FLAIR sequence compared with the 3D-T2WI sequence for the middle meningeal artery and ethmoid sinus regions (p < 0.05). (3) The mean cross-sectional areas of MLVs around the dural sinus, middle meningeal artery, and ethmoid sinus were all higher using the 3D-T2-FLAIR sequence compared with the 3D-T2WI sequence at all three sites (p < 0.01). (4) The signal intensity was significantly higher using the 3D-T2-FLAIR sequence compared with the 3D-T2WI sequence around the dural sinus and ethmoid sinus (p < 0.001).

Conclusion: The 3D-T2-FLAIR sequence contrast-enhanced scan showed superior visualization of MLVs compared with the 3D-T2WI sequence.