European Journal of Radiology最新文献

{"title":"Differences in axillary ultrasound protocols among prospective de-escalating axillary surgical staging trials in clinically node negative early breast cancer patients","authors":"T.J.A. van Nijnatten ,&nbsp;S.P. Poplack ,&nbsp;R.A. Wijgers ,&nbsp;F. Kilburn-Toppin ,&nbsp;A. Athanasiou ,&nbsp;J.M. Chang ,&nbsp;M.L. Smidt","doi":"10.1016/j.ejrad.2024.111775","DOIUrl":"10.1016/j.ejrad.2024.111775","url":null,"abstract":"<div><h3>Background</h3><div>Surgical axillary staging of the axilla is a topic of debate regarding the potential of de-escalation in clinically node negative (cN0) early breast cancer patients treated with breast-conserving therapy. Axillary ultrasound is important to determine clinical nodal status. The aim of the current narrative review is to provide an overview of prospective trials on de-escalating axillary surgical staging in cN0 early breast cancer patients, with an emphasis on axillary ultrasound protocols.</div></div><div><h3>Methods</h3><div>This narrative review provides an overview of the prospective de-escalating axillary surgical staging trials, in terms of comparing sentinel lymph node biopsy (SLNB) versus complete omission of SLNB, in cT1/2N0 patients treated with breast-conserving therapy. Information from each trial was collected, including reported axillary ultrasound protocols (including cortical thickness cut-off value) and axillary ultrasound-guided biopsy technique (fine-needle aspiration or core-needle biopsy).</div></div><div><h3>Results</h3><div>There is one recently published prospective trial and three ongoing prospective trials within the topic of this narrative review. Number of included patients in these trials ranges from 1405 to 5505 patients. The included trials differed whether or not to include patients with suspicious axillary ultrasound findings and a negative ultrasound-guided biopsy. Cortical thickness cut-off value ranged from 2.3 mm to 3.0 mm. Different ultrasound-guided biopsy techniques were performed among the included trials.</div></div><div><h3>Conclusion</h3><div>Prospective de-escalating axillary surgical staging trials in clinically node negative early breast cancer patients treated with breast-conserving therapy do report differences in terms of axillary ultrasound protocols and ultrasound-guided biopsy techniques. Axillary ultrasound protocols do require uniformity in order to improve extrapolation of these trial results.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111775"},"PeriodicalIF":3.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380375","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":"Exploring the impact of work experience on the detection of specific cancers across different breast density levels on screening mammograms","authors":"Phuong Dung (Yun) Trieu ,&nbsp;Melissa L. Barron ,&nbsp;Dania Abu Awwad ,&nbsp;Sarah J. Lewis","doi":"10.1016/j.ejrad.2024.111776","DOIUrl":"10.1016/j.ejrad.2024.111776","url":null,"abstract":"<div><h3>Purpose</h3><div>This study explores the attributes of true positive and false positive rates in screening mammogram test sets assessed by breast screening radiologists in order to identify the combined impact of prior images, breast density and lesion features with experience factors linked to diagnostic performance.</div></div><div><h3>Methods</h3><div>869 radiologists’ first-time readings across nine mammogram BREAST test sets with 361 normal and 179 cancer mammograms were collected between 2014 and 2023. Participants viewed digital mammograms on diagnostic monitors and localized abnormal lesions. The performances of readers in normal and cancer cases were compared with the ground truth and analyzed in four quartiles of breast density, lesion types and the availability of prior images using Man-Whitney U and Kruskal Wallis tests. The general linear model was applied to determine independent and significant covariates that affected the true positives and false positives. The correlation of the readers’ experience with the performances in different case and lesion features was explored using Spearman test.</div></div><div><h3>Results</h3><div>The combination of lesion appearance and the availability of prior images had a significant impact on false positive results (P=0.033). The model that included lesion appearance, breast density, and no prior image status significantly influenced case true positives of readers (P=0.026). Meanwhile, the model considering only lesion appearance and breast density (P=0.002) had a significant effect on lesion true positives. There was a positive correlation observed between the number of cases read per week and readers’ performances, including TP rates and lesion sensitivity across various lesion types (P&lt;0.05). Radiologists reading over 100 cases weekly achieved 80 % true positive rate for architectural distortion, asymmetric density, and masses, while this threshold increased to over 150 cases for calcifications. Detecting mixed lesion types required reading more than 60 cases weekly. Radiologists with over 5 years’ experience achieved 70–75 % accuracy in localizing cancer lesions.</div></div><div><h3>Conclusion</h3><div>Findings highlight the significant combined impact of breast density, prior image availability, lesion characteristics, and breast screening readers’ experience on breast cancer detection.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111776"},"PeriodicalIF":3.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437885","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":"PSMA PET/CT for treatment response evaluation at predefined time points is superior to PSA response for predicting survival in metastatic castration-resistant prostate cancer patients","authors":"F. Kleiburg ,&nbsp;L.F. de Geus-Oei ,&nbsp;S.A.C. Luelmo ,&nbsp;R. Spijkerman ,&nbsp;J.J. Goeman ,&nbsp;F.A.J. Toonen ,&nbsp;F. Smit ,&nbsp;T. van der Hulle ,&nbsp;L. Heijmen","doi":"10.1016/j.ejrad.2024.111774","DOIUrl":"10.1016/j.ejrad.2024.111774","url":null,"abstract":"<div><h3>Background</h3><div>In metastatic castration-resistant prostate cancer (mCRPC), using serum prostate-specific antigen (PSA) levels to evaluate treatment response is not always accurate. This study aimed to assess the efficacy of PSMA PET/CT at specific time points for evaluating treatment response and predicting survival in mCRPC patients, compared to PSA.</div></div><div><h3>Methods</h3><div>Sixty mCRPC patients underwent [¹⁸F]PSMA-1007 PET/CT at baseline and for treatment response evaluation of either androgen receptor-targeted agents (after 3 months) or chemotherapy (after completion), and were retrospectively analysed. Visual assessment categorised overall response and response of the worst responding lesion as partial response, stable disease, or progressive disease, using the EAU/EANM criteria. Additionally, percentage changes in SUV_max, total tumour volume and total lesion uptake (tumour volume * SUV_mean) were calculated. PSA response was defined according to the PCWG3 criteria. Cox regression analysis identified predictors of overall survival.</div></div><div><h3>Results</h3><div>PSMA PET/CT and PSA response were discordant in 47 % of patients, and PSMA PET/CT response was worse in 89 % of these cases. Overall response on PSMA PET/CT independently predicted overall survival (progression versus non-progression: HR = 4.05, p &lt; 0.001), outperforming PSA response (progression versus non-progression: HR = 2.53, p = 0.010) and other PSMA PET/CT parameters. Among patients with a PSA decline of &gt; 50 %, 31 % showed progressive disease on PSMA PET/CT, correlating with higher mortality risk (progression versus non-progression: HR = 4.38, p = 0.008). No flare in PSMA uptake was observed in this cohort.</div></div><div><h3>Conclusions</h3><div>PSMA PET/CT for assessing treatment response at predefined time points was superior to PSA-based response for predicting overall survival in mCRPC patients treated with androgen receptor-targeted agents and chemotherapy. PSMA PET/CT showed the ability to detect disease progression earlier than PSA levels, which can affect treatment decisions and has the potential to improve patient outcomes. We recommend further research to validate these findings in larger patient cohorts, to extend the number of treatments, and to evaluate cost-effectiveness and impact on patient outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111774"},"PeriodicalIF":3.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497619","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":"Does ultrasound guidance decrease femoral access site complications in neurointerventional procedures? A retrospective cohort study","authors":"Tze Phei Kee ,&nbsp;Emily M Chung ,&nbsp;Saba Ghazimoghadam ,&nbsp;Manjula Maganti ,&nbsp;Shigeta Miyake ,&nbsp;Andrew Falzon ,&nbsp;Timo Krings","doi":"10.1016/j.ejrad.2024.111771","DOIUrl":"10.1016/j.ejrad.2024.111771","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasound has been increasingly used to guide femoral arterial access for neuroendovascular procedures. Its effect on the safety outcomes has yet to be established.</div></div><div><h3>Purpose</h3><div>The purpose is to determine the effect of ultrasound-guided punctures on femoral access site complications (ASC), and to identify other potential predictors of ASC.</div></div><div><h3>Materials and Methods</h3><div>We conducted a retrospective analysis of all the neurovascular cases performed with femoral arterial access between Jan 2016 and Dec 2022. Two groups of patients were selected: the first group had femoral arterial puncture without ultrasound guidance between Jan 2016 and Dec 2017 while the second group received femoral arterial puncture with ultrasound guidance between July 2019 and Dec 2022. Univariable and multivariable logistic regression analysis was conducted.</div></div><div><h3>Results</h3><div>A total of 2347 patients and 3181 procedures were included – 1376 in the non-ultrasound group and 1805 in the ultrasound group. The complication rate of femoral arterial access was 2 % (58/3181). There was no statistically significant difference in complication rate between the ultrasound and the non-ultrasound groups (p-value 0.821). Interventional procedures (in particular EVT), larger sheath size use (&gt;/=7Fr) and DAPT were shown to be the independent predictors of femoral arterial ASC (p-value &lt; 0.001), in both univariable and multivariable analyses. The use of larger sheath size and EVT procedures have lower odds of having complications in the ultrasound group compared to the non-ultrasound group (OR: 0.42 (0.09–1.83); p = 0.249 and OR: 0.64 (0.09–4.59); p = 0.663, respectively).</div></div><div><h3>Conclusion</h3><div>Our study found that the use of ultrasound does not have statistically significant impact on the safety outcome of femoral arterial access in neuro-endovascular procedures. It is, however, of benefit in high-risk cases. Independent predictors of femoral ASC include interventional vs diagnostic procedures, larger sheath size and DAPT intake. In these high-risk cases, ultrasound guidance helps to minimize femoral ASC.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111771"},"PeriodicalIF":3.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389142","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":"Prediction of PD-L1 expression in unresectable hepatocellular carcinoma with gadoxetic acid-enhanced MRI","authors":"Jun Gu Kang ,&nbsp;Kyunghwa Han ,&nbsp;Taek Chung ,&nbsp;Hyungjin Rhee","doi":"10.1016/j.ejrad.2024.111772","DOIUrl":"10.1016/j.ejrad.2024.111772","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop a model to predict programmed death-ligand 1 (PD-L1) expression in unresectable hepatocellular carcinoma (HCC) based on gadoxetic acid-enhanced magnetic resonance imaging (MRI) findings and clinical characteristics.</div></div><div><h3>Materials and methods</h3><div>We enrolled patients with unresectable HCC who underwent gadoxetic acid-enhanced MRI between January 2021 and May 2023. Immunohistochemical staining of PD-L1 was performed on a biopsy specimen. Patients with a history of any prior treatment for HCC or those lacking an MRI scan within 30 days of the biopsy date were excluded. Using the clinical and MRI findings, we developed a PD-L1 prediction score using logistic regression.</div></div><div><h3>Results</h3><div>This study included 49 patients with HCC (median age, 64 years; interquartile range, 57–73 years; 44 men). Among these, 15 (31 %) were positive for PD-L1 expression. The PD-L1 prediction score was defined as the sum of arterial phase hypoenhancement (score 1), necrosis (score 1), and AFP &gt;4000 ng/mL (score 2). The AUC value of the PD-L1 prediction score was 0.838 (95 % confidence interval [CI], 0.715–0.962). When the PD-L1 prediction score was ≥3, the sensitivity, specificity, and positive predictive value of PD-L1 positivity were 67 %, 91 %, and 77 %, respectively.</div></div><div><h3>Conclusion</h3><div>We developed a PD-L1 prediction score for unresectable HCC with high specificity that could potentially contribute to the identification of effective candidates for immune checkpoint inhibitors.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111772"},"PeriodicalIF":3.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389144","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":"Differentiation of osteoblastic metastases and bone islands on dual-energy computed tomography in patients with untreated lung cancer","authors":"Jie Li ,&nbsp;Linfeng Cai ,&nbsp;Nan Jiang ,&nbsp;Jianfang Liu","doi":"10.1016/j.ejrad.2024.111770","DOIUrl":"10.1016/j.ejrad.2024.111770","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic efficacy of quantitative dual-energy computed tomography (CT) parameters for distinguishing osteoblastic metastases (OBMs) from bone islands (BIs) in untreated lung cancer.</div></div><div><h3>Material and Methods</h3><div>Dual-energy CT images of 24 patients with OBMs and 56 patients with BIs obtained between January 2019 and December 2021 were retrospectively analyzed. The CT_70keV value, calcium_(water) density [Dcalcium_(water)], and water_(calcium) density [Dwater_(calcium)] were analyzed. Diagnostic performance was assessed by measuring the area under the curve (AUC), and specificity, sensitivity, and accuracy were determined.</div></div><div><h3>Results</h3><div>A total of 70 OBMs and 67 BIs were included. The AUC values of CT_70keV, Dcalcium_(water), and Dwater_(calcium) showed no significant differences (0.950 vs. 0.947 vs. 0.929, respectively; <em>P</em> &gt; 0.05). The optimal CT_70keV cutoff value was 885.1 HU, with specificity, sensitivity, and accuracy of 81.4 %, 92.5 %, and 86.9 %, respectively. When using Dcalcium(water) &lt; 254.9 mg/cm³ and Dwater(calcium) &lt; 1250.6 mg/cm³, respectively, 119 of 137 lesions showed consistent diagnostic results (true or false). Sub-analysis of these 119 lesions showed specificity of 92.1 %, which was higher than that of CT_70keV (<em>P</em> = 0.021). The AUC, sensitivity, and accuracy were 0.974, 92.9 %, and 92.4 %, respectively, which were not significantly different from those of CT_70keV (<em>P</em> = 0.230, 0.906, and 0.220, respectively). Among the 18 lesions showing inconsistent diagnoses, Dcalcium_(water) diagnosed 11 lesions correctly, and Dwater_(calcium) diagnosed the remaining seven lesions correctly.</div></div><div><h3>Conclusion</h3><div>The combination of Dcalcium_(water) and Dwater_(calcium) demonstrated a promising role in the differentiation of OBMs from BIs in lung cancer patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111770"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406274","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":"Automated extraction of body composition metrics from abdominal CT or MR imaging: A scoping review","authors":"Christopher Winder ,&nbsp;Matthew Clark ,&nbsp;Russell Frood ,&nbsp;Lesley Smith ,&nbsp;Andrew Bulpitt ,&nbsp;Gordon Cook ,&nbsp;Andrew Scarsbrook","doi":"10.1016/j.ejrad.2024.111764","DOIUrl":"10.1016/j.ejrad.2024.111764","url":null,"abstract":"<div><h3>Purpose</h3><div>To review methodological approaches for automated segmentation of subcutaneous adipose tissue, visceral adipose tissue, and skeletal muscle from abdominal cross-sectional imaging for body composition analysis.</div></div><div><h3>Method</h3><div>Four databases were searched for publications describing automated segmentation of subcutaneous adipose tissue, visceral adipose tissue, and/or skeletal muscle from abdominal CT or MR imaging between 2019 and 2023. Included reports were evaluated to assess how imaging modality, cohort size, vertebral level, model dimensionality, and use of a volume or single slice affected segmentation accuracy and/or clinical utility. Exclusion criteria included reports not in English language, manual or semi-automated segmentation methods, reports prior to 2019 or solely of paediatric patients, and those not describing the use of abdominal CT or MR.</div></div><div><h3>Results</h3><div>After exclusions, 172 reports were included in the review. CT imaging was utilised approximately four times as often as MRI, and segmentation accuracy did not significantly differ between the two modalities. Cohort size had no significant effect on segmentation accuracy. There was little evidence to refute the current practice of extracting body composition metrics from the third lumbar vertebral level. There was no clear benefit of using a 3D model to perform segmentation over a 2D approach.</div></div><div><h3>Conclusion</h3><div>Automated segmentation of intra-abdominal soft tissues for body composition analysis is an intense area of research activity. Segmentation accuracy is not affected by cross-sectional imaging modality. Extracting metrics from a single slice at the third lumbar vertebral level is a common approach, however, extracting metrics from a volumetric slab surrounding this level may increase the resilience of the technique, which is important for clinical translation. A paucity of publicly available datasets led to most reports using different data sources, preventing direct comparison of segmentation techniques. Future efforts should prioritise creating a standardised dataset to facilitate benchmarking of different algorithms and subsequent clinical adoption.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111764"},"PeriodicalIF":3.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377822","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":"Application of improved urate analysis algorithm based on spectral parameters in Podagra: A prospective study","authors":"Yiteng Zhang ,&nbsp;Yi Liu ,&nbsp;Yi Zhao ,&nbsp;Yu Zhang ,&nbsp;Chunchao Xia ,&nbsp;Zheng Ye ,&nbsp;Hanyu Li ,&nbsp;Zimam Romman ,&nbsp;Hui Yao ,&nbsp;Zhenlin Li ,&nbsp;Jing Tang","doi":"10.1016/j.ejrad.2024.111769","DOIUrl":"10.1016/j.ejrad.2024.111769","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore whether the improved urate analysis (IUA) algorithm based on spectral parameters can reduce false positives in CT gout images compared with current urate analysis (CUA) algorithm.</div></div><div><h3>Materials and methods</h3><div>This prospective study was performed from May 2022 to May 2023. Spectral feet CT images of suspected gout participants were reconstructed by IUA and CUA algorithm. Qualitative diagnosis of IUA and CUA images was recorded and compared with the reference standard (ultrasound + conventional CT). Artifacts on IUA and CUA images of non-gout participants were recorded and compared; the maximum cross-sectional area of the maximum tophi (S_IT-max) on IUA and CUA images of participants with gout were measured and compared.</div></div><div><h3>Results</h3><div>There are 65 participants (mean age, 43.9 years ± 13.1 [SD]; 65 men) with 114 feet studies in the gout group, and 33 participants (mean age, 43.4 years ± 15.0 [SD]; 30 men) with 65 feet studies in the non-gout group. For all 179 feet studies, IUA images had higher specificity (19.2–86.6 % vs. 1.3–44.3 %) and accuracy (63.1–88.8 % vs. 41.3–57.0 %) than CUA images (<em>P</em> &lt; 0.001). In the non-gout group, the reduction rates of artifacts from the nail bed, skin, beam hardening, vascular structures, tendons, and total artifacts on the IUA images compared to the CUA images was 40.5 %, 48.9 %, 74.3 %, 99.2 %, 99.6 %, and 80.0 %, respectively (<em>P</em> &lt; 0.001). For 82 feet studies with tophi, S_IT-max was higher on CUA images than IUA images (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The improved urate analysis algorithm based on spectral parameters can reduce image artifacts and improve diagnostic efficacy.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111769"},"PeriodicalIF":3.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364885","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":"Contrast-Enhanced Stereotactic Biopsy (CESB): Patient selection and practical considerations","authors":"M.B.I. Lobbes ,&nbsp;J. Theunissen ,&nbsp;A. Valentijn-Morsing ,&nbsp;Y. Vissers ,&nbsp;L. Bouwman","doi":"10.1016/j.ejrad.2024.111768","DOIUrl":"10.1016/j.ejrad.2024.111768","url":null,"abstract":"<div><div>Since its introduction in 2012, contrast-enhanced mammography (CEM) has shown increased clinical relevance as a diagnostic tool in breast imaging. Its diagnostic accuracy is on par with breast MRI, rendering it a viable and potentially cost-effective alternative for breast MRI indications, especially in areas with lower accessibility to MRI. Like MRI, CEM occasionally shows ‘CEM-only’ lesions, <em>i.e.,</em> areas of contrast enhancement without corresponding findings on low-energy images, ultrasound, or digital tomosynthesis. The current workaround usually consists of performing MRI-guided biopsy. However, contrast-enhanced stereotactic biopsy (CESB) offers a new alternative and has become commercially available since 2020. This narrative review will outline patient selection, the procedure, important considerations when performing CESB, and an overview of current literature.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111768"},"PeriodicalIF":3.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375347","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":"Effect of “T2-rim sign” related parameters on high-intensity focused ultrasound ablation of uterine fibroids","authors":"Lu Wang ,&nbsp;Yang Liu ,&nbsp;Jinfeng Lin ,&nbsp;Jinghe Deng ,&nbsp;Mengchu Yang ,&nbsp;Fajin Lv","doi":"10.1016/j.ejrad.2024.111767","DOIUrl":"10.1016/j.ejrad.2024.111767","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the effect of “high-signal-intensity peripheral rim on T2-weighted MR images (T2-rim sign)” related parameters on non-perfused volume ratio (NPVR) after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.</div></div><div><h3>Methods</h3><div>Data from 616 patients with uterine fibroids treated with HIFU were retrospectively analyzed. Univariate and multivariate logistic regression was used to analyze the factors influencing the ablation effect. The effect of T2-rim sign on ablation parameters and results was also analyzed. Spearman correlation analysis was used to compare the correlation between coverage ratio, average thickness of T2-rim sign and NPVR in 207 cases of fibroids with T2-rim sign.</div></div><div><h3>Results</h3><div>The presence of T2-rim sign was an independent risk factor affecting the ablation effect. The coverage ratio of T2-rim sign was negatively correlated with treatment efficiency (r = -0.174, p = 0.012) and NPVR (r = -0.186, p = 0.007), and positively correlated with energy efficiency factor (EEF) (r = 0.156, p = 0.024). The average thickness of T2-rim sign was positively correlated with treatment intensity (r = 0.203, p = 0.003) and negatively correlated with NPVR (r = -0.363, p &lt; 0.001). There was a negative correlation between the average thickness of the T2-rim sign and NPVR in isointense fibroids (r = -0.484, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The presence of T2-rim sign increases the difficulty of ablation and reduces the ablation effect. In clinical practice, the presence and related parameters of T2-rim sign should be fully considered when screening for HIFU indications and formulating treatment plans.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111767"},"PeriodicalIF":3.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364886","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}