European Journal of Radiology最新文献

{"title":"Non-emergent hemoptysis in patients with primary or metastatic lung tumors: The role of transarterial embolization","authors":"Ruben Geevarghese ,&nbsp;Elena Petre ,&nbsp;Etay Ziv ,&nbsp;Ernesto Santos ,&nbsp;Lee Rodriguez ,&nbsp;Ken Zhao ,&nbsp;Vlasios S. Sotirchos ,&nbsp;Stephen B. Solomon ,&nbsp;Erica S. Alexander","doi":"10.1016/j.ejrad.2024.111786","DOIUrl":"10.1016/j.ejrad.2024.111786","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the role of systemic arterial embolization for the management of non-emergent hemoptysis in patients with primary or metastatic lung tumors.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective single center study of consecutive patients who underwent systemic arterial embolization for non-emergent hemoptysis between 2011 and 2023. Study endpoints included technical success, clinical success (partial or complete resolution of hemoptysis) and overall survival. Hemoptysis-free and overall survival were estimated using the Kaplan-Meier method. Predictive factors for hemoptysis-free survival and overall survival were evaluated using univariate analysis (Cox regression). Post-procedural 30-day adverse events were recorded in line with Common Terminology Criteria for Adverse Events (CTCAE) v5.0.</div></div><div><h3>Results</h3><div>A total of 30 patients were identified. Technical success was achieved in 24/30 (80 %) patients. Clinical success following embolization was achieved in 23/30 (76.7 %) patients. Median length of hospitalization was 5 days (Range: 1 to 16 days). Median overall survival was 194 days (95 % CI: 89 to 258). Median hemoptysis-free survival was 286 days (95 % CI: 42 to not reached). No significant clinical or procedural predictors of hemoptysis-free survival or overall survival were identified. Serious adverse events (CTCAE Grade &gt; 3) occurred in 1 patient (3.4 % − fatal respiratory failure).</div></div><div><h3>Conclusion</h3><div>Embolization of non-emergent hemoptysis in patients with lung malignancies is safe and effective. Recurrence is however high in this patient population, likely due to the nature of the underlying disease.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111786"},"PeriodicalIF":3.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461238","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}

{"title":"Understanding the risk of ionizing radiation in breast imaging: Concepts and quantities, clinical importance, and future directions","authors":"S. Di Maria ,&nbsp;T.J.A. van Nijnatten ,&nbsp;C.R.L.P.N. Jeukens ,&nbsp;S. Vedantham ,&nbsp;M. Dietzel ,&nbsp;P. Vaz","doi":"10.1016/j.ejrad.2024.111784","DOIUrl":"10.1016/j.ejrad.2024.111784","url":null,"abstract":"<div><h3>Background</h3><div>Conventional mammography remains the primary imaging modality for state-of-the-art breast imaging practice and its benefit (both on diagnostic and screening) was largely reported. In mammography, the typical Mean Glandular Dose (MGD) from X-ray radiation to the breast spans, on average, from 1 to 10 mGy, depending on breast thicknesses, percentage of fibroglandular tissue, and on the examination purpose.</div></div><div><h3>Methods</h3><div>The aim of this narrative review is to describe the extent of radiation risk in X-ray breast imaging and discuss the main steps and parameters (e.g. MGD, screening frequency and number of examination views) that may have an influence on the radiation risk assessment.</div></div><div><h3>Results</h3><div>Even though the radiation doses used with these examinations are very low, as compared to other medical or natural radiation exposures, there is a non-negligible associated risk of radiation-induced cancer. Accurate radiation risk assessment permits to better balance the overall estimation of the benefit-to-risk ratio in X-ray breast imaging.</div></div><div><h3>Conclusions</h3><div>It is expected that a better knowledge about radiation-induced cancer risk among population could improve the communications skills between patients and clinicians and could help to increase the awareness in women about radiation risk perception for a transparent and proper informed choice of imaging exam.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111784"},"PeriodicalIF":3.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“3 + X D” structured report in radiology standardized resident training: Can it meet high-level teaching objectives?","authors":"Qingling Yang ,&nbsp;Rui Peng ,&nbsp;Lina Ma ,&nbsp;Ye Han ,&nbsp;Lei Yuan ,&nbsp;Danqing Yin ,&nbsp;Aceng Li ,&nbsp;Yang Wang ,&nbsp;Minwen Zheng ,&nbsp;Yayu Huang ,&nbsp;Jing Ren","doi":"10.1016/j.ejrad.2024.111780","DOIUrl":"10.1016/j.ejrad.2024.111780","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of the innovative “3 + X D” structured report (SR) designed based on Bloom’s taxonomy on the learning outcomes of radiology residents during standardized training.</div></div><div><h3>Methods</h3><div>This is a prospective study that recruited 120 radiology residents from our hospital between 2020 and 2022. Randomly selected 60 residents from the 2020 grade to constituted the control group, and randomly selected 60 residents from the 2021 grade to formed the experimental group. The former group was trained utilizing the Free-text Reports (FTR) template, while the latter group received training with the “3 + X D” structured reports (SR) template. The learning outcomes of both groups was evaluated utilizing both objective and subjective measures. Objective assessments encompassed examinations of theoretical knowledge, diagnostic skills, and total scores, aligning with the cognitive domains of remembering, understanding, applying, and analyzing as outlined by Bloom’s Taxonomy. Subjective assessments, on the other hand, comprised survey questionnaires administered to residents and feedback from clinical instructors, which correlated with the higher-order cognitive level of analyzing, evaluating, and creating within Bloom’s Taxonomy.</div></div><div><h3>Results</h3><div>On 60 residents (mean age, 24.15 years ± 2.11[SD]; 25 male) from control group, and 60 residents (mean age, 24.58 years ± 1.88 [SD]; 27 male) from experimental group. Following the training, significant improvements were observed in the theoretical knowledge, diagnostic skills, and total scores for both groups (<em>p</em> &lt; 0.001). Furthermore, the experimental group demonstrated significantly higher diagnostic skills and total scores compared to the control group (<em>p</em> &lt; 0.001). However, no significant difference was observed in the theoretical knowledge exam between the two groups (<em>p</em> = 0.236). The questionnaire used for subjective assessments had good reliability (Cronbach α was 0.826) and acceptable validity (The KMO was 0.692). Additionally, the survey questionnaires indicated that the experimental group rated higher than the control group in terms of cultivating imaging thinking ability, diagnostic confidence, diagnostic speed, and the convenience of the templates (<em>p</em> &lt; 0.001). Clinicians’ feedback scores for the experimental group markedly surpassed those for the control group (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Utilizing the “3 + X D” SR template grounded in Bloom’s taxonomy for training, the professional competency of radiology residents, particularly their diagnostic skills, saw a marked enhancement, successfully meeting the higher-level educational objectives. Consequently, the “3 + X D” SR template is highly recommended for the standardized training of radiology residents.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111780"},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461145","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}

{"title":"MRI-only breast cancers are less aggressive than cancers identifiable on conventional imaging","authors":"Melis Baykara Ulusan ,&nbsp;Francesca Ferrara ,&nbsp;Emine Meltem ,&nbsp;Paola Clauser ,&nbsp;Thomas H. Helbich ,&nbsp;Pascal A.T. Baltzer","doi":"10.1016/j.ejrad.2024.111781","DOIUrl":"10.1016/j.ejrad.2024.111781","url":null,"abstract":"<div><h3>Background</h3><div>Magnetic resonance imaging (MRI) has a superior sensitivity for the diagnosis of breast cancer, leading to lesions primarily detected by MRI. Some of these lesions cannot be identified by targeted second-look ultrasound (SLUS) examinations and are thus referred to as MRI-only lesions. We hypothesize that biologically more aggressive cancers lead to more distinct tissue damage improving visibility on SLUS.</div></div><div><h3>Objective</h3><div>To investigate whether there are differences in cancer subtypes between MRI-only and SLUS-detected malignant lesions.</div></div><div><h3>Methods</h3><div>This retrospective single-center observational study evaluated 435 patients who received breast MRI examinations between January 2017 and December 2022, with at least one lesion primarily detected on MRI and histologically confirmed as malignant. Demographic characteristics, lesion type (mass or non-mass), MRI-assessed lesion size (mm), histological diagnosis, stage, immunohistochemical analysis (ER, PR, HER-2, Ki-67), and lymph node status were assessed and compared between MRI-only and SLUS-detected.</div></div><div><h3>Results</h3><div>Among 435 patients (mean age of 57.4 ± 13.3), 34.02 % (n = 148) were in the MRI-only group, while the remaining 65.98 % (n = 287) were identified by SLUS. MRI-only cases were significantly smaller in size (10 mm vs 20 mm), mostly staged as T1 (66.9 %) and showed features associated with less biological aggressiveness (higher pure ductal carcinoma in situ rates: 30.4 % vs 5.2 %; lower Ki-67, median values: 10 vs 20) compared to SLUS-detected cases (<em>P</em> &lt; 0.001). SLUS-detected cancers had higher ratios of microscopic (4.9 % vs 3.4 %) and macroscopic axillary metastasis (26.8 % vs 7.4 %) compared to MRI-only lesions (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>MRI-only lesions presented histologically and immunohistochemically with less aggressive patterns compared to those detected via SLUS.</div><div>Clinic Impact: Our data provide evidence that MRI-only lesions are biologically less aggressive and of lower stage, offering the potential of earlier treatment chance since they are visible on MRI before becoming more aggressive and destructive.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111781"},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461237","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}

{"title":"Real-World evaluation of an AI triaging system for chest X-rays: A prospective clinical study","authors":"Srinath Sridharan ,&nbsp;Alicia Seah Xin Hui ,&nbsp;Narayan Venkataraman ,&nbsp;Prasanna Sivanath Tirukonda ,&nbsp;Ram Pratab Jeyaratnam ,&nbsp;Sindhu John ,&nbsp;Saraswathy Suresh Babu ,&nbsp;Perry Liew ,&nbsp;Joe Francis ,&nbsp;Tsai Koh Tzan ,&nbsp;Wong Kang Min ,&nbsp;Goh Min Liong ,&nbsp;Charlene Liew Jin Yee","doi":"10.1016/j.ejrad.2024.111783","DOIUrl":"10.1016/j.ejrad.2024.111783","url":null,"abstract":"<div><div>Chest X-rays (CXRs) are crucial for diagnosing and managing lung conditions. While CXR is a common and cost-effective diagnostic tool, interpreting the high volume of CXRs is challenging due to workforce limitations. Artificial intelligence (AI) offers promise in enhancing efficiency and accuracy. However, real-world applicability and generalizability across diverse patient cohorts remain areas of concerns. In our study, the LUNIT INSIGHT CXR Triage software was evaluated in a diverse patient cohort. Forty-three radiologists, blinded to AI results, assessed CXRs categorized into normal, non-urgent, and urgent using a 3-tier classification system. Performance metrics and turnaround times were analyzed.</div><div>The AI system demonstrated sensitivity of 89% for normal CXRs, specificity of 93%, PPV of 83%, and NPV of 95%, with an F1 score of 0.86 and an AUC of 0.91. For non-urgent CXRs, sensitivity and specificity were 93% and 91%, with PPV and NPV at 94% and 89%, respectively, and an F1 score of 0.94 and an AUC of 0.92. In the urgent category, sensitivity was 82%, specificity 99%, PPV 90%, and NPV 98%. Subgroup analysis revealed consistently high accuracy across various age groups (Young, Adult, Senior), genders, and ethnicities (Chinese, Malay, Indian, Others), with sensitivity, specificity, and AUC consistently above 84%. The AI system also significantly reduced turnaround times across all subgroups, indicating its robust performance and generalizability in diverse healthcare settings.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111783"},"PeriodicalIF":3.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432468","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}

{"title":"Organ-Specific Iron Overload in Non-Transfusion-Dependent Thalassemia Patients: Insights from Quantitative MRI Evaluation","authors":"Xiaojing Ning ,&nbsp;Siyu Tan ,&nbsp;Fei Peng ,&nbsp;Chaotian Luo ,&nbsp;Cheng Tang ,&nbsp;Fangyan Xiao ,&nbsp;Peng Peng","doi":"10.1016/j.ejrad.2024.111750","DOIUrl":"10.1016/j.ejrad.2024.111750","url":null,"abstract":"<div><h3>Objective</h3><div>To elucidate the iron load in different organs of non-transfusion-dependent thalassemia (NTDT) patients using magnetic resonance imaging (MRI) T2* scan.</div></div><div><h3>Methods</h3><div>Thirty-four NTDT patients, including 28 NTDT iron chelation without and 6 NTDT with iron chelation, together with 15 normal controls, underwent MRI examination between December 2022 and July 2024 were enrolled in the study. Measured T2* of the pituitary gland, kidney cortex, heart, liver, pancreas, spleen. Liver and spleen volumes were evaluated.</div></div><div><h3>Results</h3><div>Of the 28 patients in NTDT without iron chelation group, 19 patients with iron overload in the liver, 9 patients with iron overload in the kidneys, and 4 patients with iron overload in the spleen. Most patients with abnormal kidney and spleen iron (76.9 %) had liver iron overload. Compared with the control group, NTDT without iron chelation patients had lower T2* in the liver, kidney, and spleen (p &lt; 0.05). And heart T2* was correlated with kidney T2* (r = 0.480, p = 0.010) and pancreas (r = 0.411, p = 0.037). Liver T2* was correlated with spleen T2* (r = 0.479, p = 0.011). Pancreas T2* was correlated with pituitary T2* (r = -0.433, p = 0.031).</div></div><div><h3>Conclusions</h3><div>NTDT patients exhibit significant organ-specific iron overload, particularly in the liver, kidneys, and spleen. The correlations between iron levels in different organs suggest interconnected mechanisms of iron accumulation. These findings highlight the importance of regular MRI screening to monitor and manage iron overload in NTDT patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111750"},"PeriodicalIF":3.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497616","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}

{"title":"A systematic scoping review exploring variation in practice in specimen mammography for Intraoperative Margin Analysis in Breast Conserving Surgery and the role of artificial intelligence in optimising diagnostic accuracy","authors":"Thomas J.E. Hubbard ,&nbsp;Ola Shams ,&nbsp;Benjamin Gardner ,&nbsp;Finley Gibson ,&nbsp;Sareh Rowlands ,&nbsp;Tim Harries ,&nbsp;Nick Stone","doi":"10.1016/j.ejrad.2024.111777","DOIUrl":"10.1016/j.ejrad.2024.111777","url":null,"abstract":"<div><h3>Purpose</h3><div>Specimen Mammography (SM) is commonly used in Breast Conserving Surgery (BCS) for intraoperative margin analysis. A systematic scoping review was conducted to identify sources of methodological variation in Specimen Mammography Interpretation (SMI) and assess the role of Artificial Intelligence (AI) techniques to optimise Diagnostic Accuracy (DA).</div></div><div><h3>Methods</h3><div>Embase, Pubmed, Cochrane and web of science databases were searched. Studies were included if SM was used for margin analysis for BCS with reported DA compared with pathological margin status and data extracted.</div></div><div><h3>Results</h3><div>1242 unique studies were identified, of which 40 were included. 39/40 studies did not utilise AI for SMI, with 4 studies comparing 2 relevant techniques, giving 43 non-AI study arms for analysis. There was wide variation in SM techniques, including number of views and location of SM. Specialist performing SMI in usual clinical practice was surgeon (13/39 studies;33 %), radiologist(s) (16/39;41 %), surgeon and radiologist (3/39;8 %) or not stated (7/39;18 %) which differed from the study specialist in 15/39 (38 %) of studies. Diagnostic accuracy in studies ranged from sensitivity 19–91.7 % and specificity 25–100 %.</div></div><div><h3>Conclusions</h3><div>There is marked variation in current techniques used for SM for intraoperative margin analysis with correspondingly disparate DA. Only 1 study applied AI to SMI, and we identify how AI could optimise SMI and a template for future work to apply AI techniques to SMI, reduce unwarranted variation and optimise DA.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111777"},"PeriodicalIF":3.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast enhanced mammography (CEM) guided biopsy using a prone table: A retrospective analysis of the preliminary experience in a single CEM referral center","authors":"Jacopo Nori Cucchiari ,&nbsp;Lucia Giudice ,&nbsp;Ludovica Anna Incardona ,&nbsp;Giacomo Di Filippo ,&nbsp;Giulia Bicchierai ,&nbsp;Elsa Cossu ,&nbsp;Chiara Bellini ,&nbsp;Ermanno Vanzi ,&nbsp;Diego De Benedetto ,&nbsp;Federica Di Naro ,&nbsp;Cecilia Boeri ,&nbsp;Sofia Vidali ,&nbsp;Vittorio Miele","doi":"10.1016/j.ejrad.2024.111779","DOIUrl":"10.1016/j.ejrad.2024.111779","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluates the procedural efficacy and patient experience of Contrast Enhanced Mammography (CEM)-guided biopsies performed in a prone position using the Giotto Class 30,000 system. The emphasis is on the procedural advantages and clinical outcomes for “enhancing-only lesions” (EOLs).</div></div><div><h3>Methods</h3><div>A retrospective analysis of 524 CEM examinations conducted from December 2023 to June 2024 at a tertiary referral center was performed. Patients referred for pre-surgical staging or evaluation of inconclusive findings from conventional imaging were included. The study utilized dual-energy imaging and vacuum-assisted biopsy techniques, focusing on patients with at least one EOL identified in their initial CEM. Exclusions were based on the absence of a primary or follow-up CEM conducted at our facility Endpoints of this work included procedure efficiency which was evaluated in terms of technical success (biopsy completion with adequate sampling), dose distribution and timing and detection of additional lesions and patients’ comfort evaluation, based on the rate of complications (hematomas) and procedure interruption due to patients’ specific request or fainting events.</div></div><div><h3>Results</h3><div>Among the evaluated cases, 37 EOLs were biopsied. The average procedure time was 15.8 min. Biopsies were successfully completed in 100% of cases. However, complications occurred in 27% of cases, primarily as hematomas and a significant histological finding rate of 97.3% was recorded.</div></div><div><h3>Conclusions</h3><div>The use of the Giotto Class 30,000 system for CEM-guided biopsies in a prone position demonstrated high procedural success and was well-tolerated by patients, highlighting its potential to enhance procedural comfort and efficiency. These preliminary results validate the innovative approach, though further studies are required to solidify these findings and explore long-term outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111779"},"PeriodicalIF":3.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399828","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}

{"title":"Scandinavian Neurotrauma Guidelines: Frequency of intracranial hemorrhage in patients over 65 years old and on anti-platelet medication","authors":"Susanna Anetta Rathkjen ,&nbsp;Flemming Skjøth ,&nbsp;Maria Arvad Serifi ,&nbsp;Andrew England ,&nbsp;Helle Precht","doi":"10.1016/j.ejrad.2024.111778","DOIUrl":"10.1016/j.ejrad.2024.111778","url":null,"abstract":"<div><h3>Purpose</h3><div>In 2013, the Scandinavian Neurotrauma Committee, produced an evidence-based guideline for the use of Computed Tomography (CT) in patients presenting following recent (&lt;24 h) head injury (HI). A head CT scan is recommended for medium-risk patients with a Glasgow Coma Scale (GCS) score of 14–15, who are &gt; 65 years old and on anti-platelet medication. The aim of this study was to determine the prevalence of intracranial hemorrhage (ICH) on head CT scans in this population, and to test for associations between ICH and baseline characteristics, symptoms and objective clinical findings.</div></div><div><h3>Methods</h3><div>This register-based retrospective study determined the prevalence of ICH on head CT scans performed over a 1-year period based on written CT-reports. Patient medical charts and imaging records were examined for data on symptomatology, objective findings and comorbidities.</div></div><div><h3>Results</h3><div>The study population included 325 unique head CT scans with a 5.2% prevalence of ICH. Risk ratios (RR’s) signified higher risk of ICH with a GCS score of 14 compared to a GCS score of 15 (RR 5.35, 95%CI 2.14–13.47). ICH risk was lower in patients on Clopidogrel medication compared to Acetylsalicylic Acid medication (RR 0.33, 95%CI 0.12–0.93).</div></div><div><h3>Conclusions</h3><div>The associations between ICH and the GCS score call attention to the importance of comprehensive clinical examination of HI patients to minimize CT overuse. The implications for patients and healthcare resources in scanning patients &gt; 65 years on anti-platelet medication should be determined by future prospective studies.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111778"},"PeriodicalIF":3.2,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting the technical outcome of catheter-directed sclerotherapy for ovarian endometriomas","authors":"Dong Kyu Kim ,&nbsp;Seok Kyo Seo ,&nbsp;Kichang Han ,&nbsp;Man-Deuk Kim ,&nbsp;Joon Ho Kwon ,&nbsp;Gyoung Min Kim ,&nbsp;Hyung Cheol Kim ,&nbsp;Jinyoung Choi ,&nbsp;Juil Park ,&nbsp;Sungmo Moon ,&nbsp;Jong Yun Won","doi":"10.1016/j.ejrad.2024.111773","DOIUrl":"10.1016/j.ejrad.2024.111773","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify factors related to technical outcomes of catheter-directed sclerotherapy (CDS) and suggest selection criteria for CDS in patients with ovarian endometrioma.</div></div><div><h3>Method</h3><div>This retrospective study included patients with endometriomas treated with CDS between November 2015 and June 2023. The characteristics of the endometriomas, including diameter, morphology (unilocular or multilocular), and T2 signal intensity were evaluated using pre-procedure magnetic resonance imaging. Moreover, the size of the catheter (7- or 8.5-French) and route of access (transabdominal vs. transvaginal) was also analyzed. Multivariate logistic regression analyses were used to identify factors associated with the technical outcomes of CDS.</div></div><div><h3>Results</h3><div>Technical success was defined as successful completion of the following: 1) insertion of a 7- or 8.5-French catheter into the endometrioma, 2) full aspiration of the internal content, and 3) completion of sclerotherapy without ethanol leakage. Of the 323 women (mean age = 32.2 ± 6.0 years) with 401 endometriomas included in our study, technical success was achieved in 377 endometriomas (94.0 %). No major complications were observed. In the multivariate analysis, a diameter &lt; 3 cm (odds ratio, 25.641; <em>p</em> &lt; 0.001), T2 dark signal intensity (odds ratio, 7.462; <em>p</em> = 0.001), and transvaginal access (odds ratio, 4.016; <em>p</em> = 0.004) were associated with technical failure.</div></div><div><h3>Conclusions</h3><div>Small endometrioma size (&lt;3cm), T2 dark signal intensity, and transvaginal access were identified as significant risk factors for technical failure during catheter-directed sclerotherapy.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111773"},"PeriodicalIF":3.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406286","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}