European Journal of Radiology最新文献_第9页

A liver CT based nomogram to preoperatively predict lung metastasis secondary to hepatic alveolar echinococcosis 术前基于肝脏CT的影像学预测肝肺泡包虫病继发肺转移。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111865

Jing Chen , Li Wei , Chun-mei Deng , Jing Xiong , Song-mei Chen , Ding Lu , Zhi-Hong Li , Yao Chen , Jun Xiao , Tian-wu Chen

Purpose

To develop a nomogram based on liver CT and clinical features to preoperatively predict lung metastasis (LM) secondary to hepatic alveolar echinococcosis (HAE).

Methods

A total of 291 consecutive HAE patients from Institution A undergoing preoperative abdominal contrast-enhanced CT and chest unenhanced CT were retrospectively reviewed, and were randomly divided into the training and internal validation sets at the 7:3 ratio. 82 consecutive patients from Institution B were enrolled as an external validation set. A nomogram was constructed based on the significant CT and clinical features of HAE from the training set selected by univariable and multivariable analyses to predict LM, and its predictive accuracy was assessed by area under the receiver operating characteristic curve (AUC) and Brier score. Decision-curve analysis was applied to evaluate the clinical effectiveness. This nomogram was verified in two independent validation sets.

Results

Eosinophil (odds ratio [OR] = 9.60; 95 % confidence interval [CI]: 1.80–51.11), lesion size (OR = 1.02; 95 %CI: 1.01–1.04), and moderate-severe invasion of inferior vena cava (IVC) (OR = 5.57; 95 %CI: 1.82–17.10) were independently associated with LM (all P-values < 0.05). The nomogram based on the three independent predictors displayed AUCs of 0.875 (95 %CI, 0.824–0.927), 0.872 (95 %CI, 0.787–0.957) and 0.836 (95 %CI, 0.729–0.943), and Brier score of 0.105, 0.1 and 0.118 in the training, internal validation and external validation sets, respectively. Decision-curve analysis showed good clinical utility.

Conclusion

A nomogram based on eosinophil, lesion size and moderate-severe invasion of IVC showed good ability and accuracy for preoperative prediction of LM due to HAE.

目的：建立一种基于肝脏CT和临床特征的形态图，用于术前预测肝肺泡包虫病（HAE）继发肺转移（LM）。方法：回顾性分析A机构连续接受术前腹部增强CT和胸部未增强CT检查的291例HAE患者，并按7:3的比例随机分为训练组和内部验证组。从B机构连续入组82例患者作为外部验证组。基于单变量和多变量分析选择的训练集中HAE的显著CT和临床特征构建nomogram来预测LM，并通过受试者工作特征曲线下面积（area under receiver operating characteristic curve， AUC）和Brier评分评估其预测准确性。采用决策曲线分析评价临床疗效。在两个独立的验证集中验证了该nomogram。结果：嗜酸性粒细胞(优势比[OR] = 9.60；95%可信区间[CI]: 1.80-51.11)、病变大小(OR = 1.02；95% CI: 1.01-1.04)，中重度下腔静脉（IVC）侵犯(OR = 5.57；95% CI: 1.82-17.10)与LM独立相关（所有p值均为p值）。结论：基于嗜酸性粒细胞、病变大小和中重度下腔静脉浸润的nomogram预测HAE致LM的能力和准确性较好。

{"title":"A liver CT based nomogram to preoperatively predict lung metastasis secondary to hepatic alveolar echinococcosis","authors":"Jing Chen , Li Wei , Chun-mei Deng , Jing Xiong , Song-mei Chen , Ding Lu , Zhi-Hong Li , Yao Chen , Jun Xiao , Tian-wu Chen","doi":"10.1016/j.ejrad.2024.111865","DOIUrl":"10.1016/j.ejrad.2024.111865","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop a nomogram based on liver CT and clinical features to preoperatively predict lung metastasis (LM) secondary to hepatic alveolar echinococcosis (HAE).</div></div><div><h3>Methods</h3><div>A total of 291 consecutive HAE patients from Institution A undergoing preoperative abdominal contrast-enhanced CT and chest unenhanced CT were retrospectively reviewed, and were randomly divided into the training and internal validation sets at the 7:3 ratio. 82 consecutive patients from Institution B were enrolled as an external validation set. A nomogram was constructed based on the significant CT and clinical features of HAE from the training set selected by univariable and multivariable analyses to predict LM, and its predictive accuracy was assessed by area under the receiver operating characteristic curve (AUC) and Brier score. Decision-curve analysis was applied to evaluate the clinical effectiveness. This nomogram was verified in two independent validation sets.</div></div><div><h3>Results</h3><div>Eosinophil (odds ratio [OR] = 9.60; 95 % confidence interval [CI]: 1.80–51.11), lesion size (OR = 1.02; 95 %CI: 1.01–1.04), and moderate-severe invasion of inferior vena cava (IVC) (OR = 5.57; 95 %CI: 1.82–17.10) were independently associated with LM (all <em>P</em>-values < 0.05). The nomogram based on the three independent predictors displayed AUCs of 0.875 (95 %CI, 0.824–0.927), 0.872 (95 %CI, 0.787–0.957) and 0.836 (95 %CI, 0.729–0.943), and Brier score of 0.105, 0.1 and 0.118 in the training, internal validation and external validation sets, respectively. Decision-curve analysis showed good clinical utility.</div></div><div><h3>Conclusion</h3><div>A nomogram based on eosinophil, lesion size and moderate-severe invasion of IVC showed good ability and accuracy for preoperative prediction of LM due to HAE.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111865"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791360","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

Non-enhancing asymmetries on screening contrast-enhanced mammography: Is further diagnostic workup required? 造影剂增强乳腺 X 线照相术筛查中的非增强不对称现象：是否需要进一步诊断？

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111883

Noam Nissan , Jeffrey S. Reiner, Victoria L. Mango, Hila Fruchtman-Brot , Rosa Elena Ochoa Albiztegui, Yuki Arita, Jill Gluskin , Tali Amir, Kimberly Feigin, Maxine S. Jochelson , Janice S. Sung

Objectives

Asymmetries on screening contrast-enhanced mammography (CEM) often lead to patient recall. However, in diagnostic settings, negative CEM has effectively classified these as normal or benign, questioning the need for further workup of non-enhancing asymmetries (NEAs).

Material and methods

A computational search of all screening CEM examinations performed between December-2012 and June-2021 was conducted to identify cases reporting NEAs. Their diagnostic workup was reviewed, and the positive predictive value for cancer was statistically compared to that of enhancing asymmetries on screening CEMs.

Results

During the study period, 97 cases of 106 NEAs were identified among 3,482 screening CEM exams (2.8 %). NEAs were classified as asymmetry (n = 83), focal asymmetry (n = 22), and global asymmetry (n = 1), with no cases of developing asymmetry. The mean size of NEAs was 1.0 ± 0.7 cm (range: 0.3–4.9 cm). Diagnostic workup for NEAs included additional mammographic views (AMV) (n = 63), AMV plus ultrasound (n = 30), AMV plus MRI (n = 1), and all three modalities (n = 3), leading to four biopsies. None of the NEAs were malignant on follow-up, as opposed to enhancing asymmetries (P < 0.05).

Conclusion

NEAs detected on CEM were relatively uncommon and were usually investigated with additional mammographic views and US, yielding no cancer. Ruling out malignancy based on lack of enhancement without further workup may reduce patient recall rates and improve CEMs specificity.

目的：对比增强乳房x光检查（CEM）的不对称常常导致患者回忆。然而，在诊断设置中，阴性CEM有效地将这些分类为正常或良性，质疑是否需要进一步检查非增强不对称（NEAs）。材料和方法：对2012年12月至2021年6月期间进行的所有筛查CEM检查进行计算检索，以确定报告NEAs的病例。对他们的诊断检查进行了回顾，并对癌症的阳性预测值与筛查CEMs时增强不对称的预测值进行了统计比较。结果：在研究期间，在3,482例筛查CEM检查中发现97例106例NEAs（2.8%）。NEAs分为非对称性（n = 83）、局灶性不对称性（n = 22）和全局性不对称性（n = 1），未发现非对称性病例。NEAs平均大小为1.0±0.7 cm（范围0.3 ~ 4.9 cm）。NEAs的诊断检查包括额外的乳房x光检查（AMV）（n = 63）， AMV +超声检查（n = 30）， AMV + MRI检查（n = 1），以及所有三种方式（n = 3），包括4次活检。结论：在CEM上检测到的NEAs相对罕见，通常在额外的乳房x线摄影和超声检查下进行调查，不会导致癌症。在没有进一步检查的情况下，基于缺乏增强而排除恶性肿瘤可能会降低患者的回忆率并提高CEMs的特异性。

{"title":"Non-enhancing asymmetries on screening contrast-enhanced mammography: Is further diagnostic workup required?","authors":"Noam Nissan , Jeffrey S. Reiner, Victoria L. Mango, Hila Fruchtman-Brot , Rosa Elena Ochoa Albiztegui, Yuki Arita, Jill Gluskin , Tali Amir, Kimberly Feigin, Maxine S. Jochelson , Janice S. Sung","doi":"10.1016/j.ejrad.2024.111883","DOIUrl":"10.1016/j.ejrad.2024.111883","url":null,"abstract":"<div><h3>Objectives</h3><div>Asymmetries on screening contrast-enhanced mammography (CEM) often lead to patient recall. However, in diagnostic settings, negative CEM has effectively classified these as normal or benign, questioning the need for further workup of non-enhancing asymmetries (NEAs).</div></div><div><h3>Material and methods</h3><div>A computational search of all screening CEM examinations performed between December-2012 and June-2021 was conducted to identify cases reporting NEAs. Their diagnostic workup was reviewed, and the positive predictive value for cancer was statistically compared to that of enhancing asymmetries on screening CEMs.</div></div><div><h3>Results</h3><div>During the study period, 97 cases of 106 NEAs were identified among 3,482 screening CEM exams (2.8 %). NEAs were classified as asymmetry (n = 83), focal asymmetry (n = 22), and global asymmetry (n = 1), with no cases of developing asymmetry. The mean size of NEAs was 1.0 ± 0.7 cm (range: 0.3–4.9 cm). Diagnostic workup for NEAs included additional mammographic views (AMV) (n = 63), AMV plus ultrasound (n = 30), AMV plus MRI (n = 1), and all three modalities (n = 3), leading to four biopsies. None of the NEAs were malignant on follow-up, as opposed to enhancing asymmetries (P < 0.05).</div></div><div><h3>Conclusion</h3><div>NEAs detected on CEM were relatively uncommon and were usually investigated with additional mammographic views and US, yielding no cancer. Ruling out malignancy based on lack of enhancement without further workup may reduce patient recall rates and improve CEMs specificity.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111883"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823916","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

Establishing national diagnostic reference levels in fluoroscopy and fluoroscopically guided interventions in Ireland and comparing these with national diagnostic reference levels in Europe and internationally 在爱尔兰建立透视检查和透视引导干预的国家诊断参考水平，并将其与欧洲和国际的国家诊断参考水平进行比较。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111890

Lee O’Hora, Kirsten O’Brien, John Tuffy, Agnella Craig, Noelle Neville, Kay Sugrue, Margaret Keaveney, Emma O’Brien, Eimear Quinn, Sean Egan

Purpose

The purpose of this work was to establish national Irish diagnostic reference levels (DRLs) for a clinically representative and comprehensive list of clinical indications, anatomical regions, and common procedures for fluoroscopy and fluoroscopically guided interventions and compare these, where possible, to other DRLs established at a national level.

Method

A list of clinical indications, anatomical regions and common procedures was established. A national database of service providers was used to identify all medical radiological facilities providing fluoroscopy and fluoroscopically guided intervention services. These facilities were issued with an online survey. National Pka DRLs were set as the 75th percentile of the distribution of median values obtained. A national median dose was also established which is the 50th percentile of the median doses provided by facilities for the same patients and conditions as the national DRL value. The broad categorisation of equipment type was also considered. Where statistically significant differences were found between different detector types, detector specific national DRLs were established (flat panel detector and image intensifier specific DRLs).

Results

National Pka DRLs were established for 52 fluoroscopy and fluoroscopically guided intervention clinical indications, anatomical regions, and procedures. In addition, equipment specific (flat panel detector and image intensifier based systems) adult DRLs were established for the EVAR and lumbar puncture under fluoroscopy procedures. Paediatric DRLs were established for two fluoroscopy and fluoroscopically guided intervention clinical indications, anatomical regions, and procedures across various weight categories. Comparisons with other nationally set DRLs and other relevant literature suggest that Irish DRLs are typically lower than those established elsewhere.

Conclusions

This work provided a unique opportunity to establish national DRLs based on census data for a wide range of clinical indications, anatomical regions, and procedures across adult and paediatric fluoroscopy and fluoroscopically guided interventions. Where comparisons with other nationally established work was possible Irish values are largely below other DRLs.

目的：本研究的目的是为临床代表性和全面的临床适应症、解剖区域和常见的透视检查和透视指导干预程序建立爱尔兰国家诊断参考水平（drl），并在可能的情况下将其与国家一级建立的其他诊断参考水平进行比较。方法：建立临床适应证、解剖区域及常用手术方法。使用全国服务提供者数据库来确定提供透视和透视引导介入服务的所有医疗放射设施。这些设施发放了一份在线调查。国家Pka drl设为所得中位数分布的第75百分位。还确定了国家中位剂量，即设施为与国家DRL值相同的患者和条件提供的中位剂量的第50个百分位数。还审议了设备类型的广泛分类。如果不同类型的探测器之间存在统计学差异，则建立探测器特定的国家drl（平板探测器和图像增强器特定的drl）。结果：建立了52例透视及透视引导下介入治疗的临床适应症、解剖区域和手术方式的国家Pka drl。此外，在透视下，为EVAR和腰椎穿刺建立了专用设备（平板探测器和基于图像增强器的系统）。针对两种透视和透视引导下的干预临床适应症、解剖区域和不同体重类别的手术，建立了儿科drl。与其他国家制定的drl和其他相关文献的比较表明，爱尔兰的drl通常低于其他地方制定的drl。结论：这项工作提供了一个独特的机会，基于广泛的临床适应症、解剖区域、成人和儿童透视检查和透视指导干预的程序的普查数据建立国家drl。在与其他国家建立的工作进行比较时，爱尔兰的价值大大低于其他drl。

{"title":"Establishing national diagnostic reference levels in fluoroscopy and fluoroscopically guided interventions in Ireland and comparing these with national diagnostic reference levels in Europe and internationally","authors":"Lee O’Hora, Kirsten O’Brien, John Tuffy, Agnella Craig, Noelle Neville, Kay Sugrue, Margaret Keaveney, Emma O’Brien, Eimear Quinn, Sean Egan","doi":"10.1016/j.ejrad.2024.111890","DOIUrl":"10.1016/j.ejrad.2024.111890","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this work was to establish national Irish diagnostic reference levels (DRLs) for a clinically representative and comprehensive list of clinical indications, anatomical regions, and common procedures for fluoroscopy and fluoroscopically guided interventions and compare these, where possible, to other DRLs established at a national level.</div></div><div><h3>Method</h3><div>A list of clinical indications, anatomical regions and common procedures was established. A national database of service providers was used to identify all medical radiological facilities providing fluoroscopy and fluoroscopically guided intervention services. These facilities were issued with an online survey. National Pka DRLs were set as the 75th percentile of the distribution of median values obtained. A national median dose was also established which is the 50th percentile of the median doses provided by facilities for the same patients and conditions as the national DRL value. The broad categorisation of equipment type was also considered. Where statistically significant differences were found between different detector types, detector specific national DRLs were established (flat panel detector and image intensifier specific DRLs).</div></div><div><h3>Results</h3><div>National Pka DRLs were established for 52 fluoroscopy and fluoroscopically guided intervention clinical indications, anatomical regions, and procedures. In addition, equipment specific (flat panel detector and image intensifier based systems) adult DRLs were established for the EVAR and lumbar puncture under fluoroscopy procedures. Paediatric DRLs were established for two fluoroscopy and fluoroscopically guided intervention clinical indications, anatomical regions, and procedures across various weight categories. Comparisons with other nationally set DRLs and other relevant literature suggest that Irish DRLs are typically lower than those established elsewhere.</div></div><div><h3>Conclusions</h3><div>This work provided a unique opportunity to establish national DRLs based on census data for a wide range of clinical indications, anatomical regions, and procedures across adult and paediatric fluoroscopy and fluoroscopically guided interventions. Where comparisons with other nationally established work was possible Irish values are largely below other DRLs.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111890"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893365","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

Mapping the values of radiology 映射放射学的价值。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111901

Bjørn Hofmann

Radiology is polyvalent, as it is valuable in many ways to many groups, such as to individuals, professionals, and populations. However, not all values are positive. While Value-Based HealthCare (VBHC) has moved the focus from volume-based to value-based health care and Value-Based Radiology (VBR) has highlighted a vast variety of values in radiology, such frameworks provide no measures to differentiate, assess, and balance the various values. Based on value theory this article provides a value map for radiology. The map can be helpful to a) identify and understand the complexity of values in radiology, b) differentiate and assess the values of radiology’s various tasks and aspects, c) to address potential value conflicts in radiology, and d) to maximize the positive and minimize its negative value. Mapping the values of radiology thus is crucial for understanding and increasing the importance of imaging.

放射学是多价的，因为它在许多方面对许多群体都有价值，例如对个人、专业人员和人群。然而，并非所有的值都是正的。虽然基于价值的医疗保健（VBHC）已将重点从基于量的医疗保健转移到基于价值的医疗保健，而基于价值的放射学（VBR）强调了放射学中各种各样的价值，但这些框架没有提供区分、评估和平衡各种价值的措施。本文以价值理论为基础，提出了放射学的价值图。该地图有助于a)识别和理解放射学价值的复杂性，b)区分和评估放射学各种任务和方面的价值，c)解决放射学中潜在的价值冲突，d)最大化其积极价值并最小化其消极价值。因此，绘制放射学的价值对于理解和提高成像的重要性至关重要。

引用次数: 0

Navigating the future of mammography: How women’s perceptions of AI may guide tomorrow’s screening practice 引领乳房x光检查的未来：女性对人工智能的看法如何指导未来的筛查实践。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111870

Sophia Zackrisson , Anetta Bolejko

引用次数: 0

Three-dimensional volumetric CT image fusion and trans-abdominal US: Adjunct guidance to portal vein cannulation for TIPS 三维容积 CT 图像融合和经腹 US：TIPS 门静脉插管的辅助指导。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111875

Ni Zhao , Anya Shi , Weile Huang , Jianan He , Dashuai Wang , Yongyu Zhang , Hui Guo , Bin Zhou , Hairun Gan , Pengfei Pang

Purpose

To describe portal vein cannulation under adjunct guidance for transjugular intrahepatic portosystemic shunts (TIPS).

Methods

Medical records of 86 patients who underwent TIPS, including conventional TIPS, 3D volumetric CT image fusion (CT-fluoroscopy image fusion)-guided TIPS, and trans-abdominal ultrasound (US)-guided TIPS at our institute from March 2016 to June 2024 were reviewed. Baseline characteristics, clinical outcomes, and procedural data were analyzed.

Results

Technical success was achieved in 35 conventional TIPS patients (92.11 %), 20 CT-fluoroscopy image fusion-guided TIPS patients (95.24 %), and 26 transabdominal US-guided TIPS patients (96.30 %). Among patients who underwent a successful procedure, the procedural time and contrast usage were lower in the CT-fluoroscopy image fusion-guided and trans-abdominal US-guided TIPS groups than in the conventional group. There was a statistical significance in the cumulative fluoroscopic time between CT-fluoroscopy image fusion-guided TIPS and conventional TIPS groups (43.19 ± 14.92 vs 63.05 ± 30.33 min, p = 0.012). No immediate experienced complications were observed. Furthermore, the incidence of post-procedural complications among the three groups was not statistically different during follow-up.

Conclusions

CT-fluoroscopy image fusion and trans-abdominal US-guided portal vein cannulation are feasible, safe, and effective adjunct methods for patients undergoing TIPS. These methods provide shorter procedural time and lower contrast usage for TIPS placement.

目的：探讨在辅助指导下门静脉插管治疗经颈静脉肝内门静脉系统分流术（TIPS）。方法：回顾我院2016年3月至2024年6月行常规TIPS、三维体积CT图像融合（CT-透视图像融合）引导下TIPS、经腹超声（US）引导下TIPS的86例患者的病历。分析基线特征、临床结果和手术数据。结果：常规TIPS 35例（92.11%），ct -透视图像融合引导TIPS 20例（95.24%），经腹us引导TIPS 26例（96.30%）技术成功。在手术成功的患者中，ct -透视图像融合引导和经腹us引导的TIPS组的手术时间和造影剂使用低于常规组。ct -透视影像融合引导下TIPS组与常规TIPS组的累积透视时间比较，差异有统计学意义（43.19±14.92 vs 63.05±30.33 min, p = 0.012）。没有观察到直接的并发症。随访期间，三组患者术后并发症发生率无统计学差异。结论：ct -透视影像融合及经腹us引导门静脉插管是TIPS患者可行、安全、有效的辅助方法。这些方法为TIPS放置提供了更短的操作时间和更低的对比度使用。

{"title":"Three-dimensional volumetric CT image fusion and trans-abdominal US: Adjunct guidance to portal vein cannulation for TIPS","authors":"Ni Zhao , Anya Shi , Weile Huang , Jianan He , Dashuai Wang , Yongyu Zhang , Hui Guo , Bin Zhou , Hairun Gan , Pengfei Pang","doi":"10.1016/j.ejrad.2024.111875","DOIUrl":"10.1016/j.ejrad.2024.111875","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe portal vein cannulation under adjunct guidance for transjugular intrahepatic portosystemic shunts (TIPS).</div></div><div><h3>Methods</h3><div>Medical records of 86 patients who underwent TIPS, including conventional TIPS, 3D volumetric CT image fusion (CT-fluoroscopy image fusion)-guided TIPS, and <em>trans</em>-abdominal ultrasound (US)-guided TIPS at our institute from March 2016 to June 2024 were reviewed. Baseline characteristics, clinical outcomes, and procedural data were analyzed.</div></div><div><h3>Results</h3><div>Technical success was achieved in 35 conventional TIPS patients (92.11 %), 20 CT-fluoroscopy image fusion-guided TIPS patients (95.24 %), and 26 transabdominal US-guided TIPS patients (96.30 %). Among patients who underwent a successful procedure, the procedural time and contrast usage were lower in the CT-fluoroscopy image fusion-guided and <em>trans</em>-abdominal US-guided TIPS groups than in the conventional group. There was a statistical significance in the cumulative fluoroscopic time between CT-fluoroscopy image fusion-guided TIPS and conventional TIPS groups (43.19 ± 14.92 vs 63.05 ± 30.33 min, <em>p = 0.012</em>). No immediate experienced complications were observed. Furthermore, the incidence of post-procedural complications among the three groups was not statistically different during follow-up.</div></div><div><h3>Conclusions</h3><div>CT-fluoroscopy image fusion and <em>trans</em>-abdominal US-guided portal vein cannulation are feasible, safe, and effective adjunct methods for patients undergoing TIPS. These methods provide shorter procedural time and lower contrast usage for TIPS placement.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111875"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821948","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

VI steps to achieve VI-RADS assessment VI步骤实现VI- rads评估。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111868

Sitthipong Srisajjakul , Patcharin Prapaisilp , Sirikan Bangchokdee

Bladder cancer is categorized into nonmuscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC), distinguished by the presence of detrusor muscle invasion. Urothelial cell carcinoma is the most common subtype of bladder cancer. Transurethral resection of bladder tumor (TURBT) is the standard approach for staging and managing NMIBC, while radical cystectomy remains the cornerstone treatment for MIBC.

Multiparametric magnetic resonance imaging (mpMRI), comprising morphological imaging sequences (high-resolution T2-weighted images) and functional imaging sequences (dynamic contrast-enhanced images and diffusion-weighted images), serves as an ideal modality. It provides high-contrast resolution for visualizing bladder wall layers, thereby enabling proper and timely staging of bladder cancer. MRI can guide sampling resection and identify patients understaged after primary TURBT, facilitating appropriate surgical restaging.

In 2018, the Vesical Imaging Reporting and Data System (VI-RADS), implementing a 5-point scale, was developed to standardize MRI protocols and reporting criteria—including tumor location, size, morphology, and invasiveness. The aim of this article is to navigate through all the steps to achieve VI-RADS assessment and to discuss practical pearls and pitfalls in the use of mpMRI. This approach can aid in pre-TURBT prediction of muscle invasion, representing an important asset in bladder cancer staging.

膀胱癌分为非肌肉浸润性膀胱癌（NMIBC）和肌肉浸润性膀胱癌（MIBC），其特征是存在逼尿肌浸润。尿路上皮细胞癌是膀胱癌最常见的亚型。经尿道膀胱肿瘤切除术（turt）是NMIBC分期和治疗的标准方法，而根治性膀胱切除术仍然是MIBC的基础治疗方法。多参数磁共振成像（mpMRI）由形态学成像序列（高分辨率t2加权图像）和功能成像序列（动态对比度增强图像和弥散加权图像）组成，是一种理想的方式。它提供了高对比度分辨率的可视化膀胱壁层，从而使膀胱癌的适当和及时的分期。MRI可以指导采样切除，识别原发性turt后分期不足的患者，促进适当的手术再分期。2018年，实施5分制的膀胱成像报告和数据系统（VI-RADS）被开发出来，用于标准化MRI协议和报告标准，包括肿瘤位置、大小、形态和侵袭性。本文的目的是浏览实现VI-RADS评估的所有步骤，并讨论mpMRI使用中的实际珍珠和陷阱。这种方法可以帮助在turt前预测肌肉侵袭，代表膀胱癌分期的重要资产。

{"title":"VI steps to achieve VI-RADS assessment","authors":"Sitthipong Srisajjakul , Patcharin Prapaisilp , Sirikan Bangchokdee","doi":"10.1016/j.ejrad.2024.111868","DOIUrl":"10.1016/j.ejrad.2024.111868","url":null,"abstract":"<div><div>Bladder cancer is categorized into nonmuscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC), distinguished by the presence of detrusor muscle invasion. Urothelial cell carcinoma is the most common subtype of bladder cancer. Transurethral resection of bladder tumor (TURBT) is the standard approach for staging and managing NMIBC, while radical cystectomy remains the cornerstone treatment for MIBC.</div><div>Multiparametric magnetic resonance imaging (mpMRI), comprising morphological imaging sequences (high-resolution T2-weighted images) and functional imaging sequences (dynamic contrast-enhanced images and diffusion-weighted images), serves as an ideal modality. It provides high-contrast resolution for visualizing bladder wall layers, thereby enabling proper and timely staging of bladder cancer. MRI can guide sampling resection and identify patients understaged after primary TURBT, facilitating appropriate surgical restaging.</div><div>In 2018, the Vesical Imaging Reporting and Data System (VI-RADS), implementing a 5-point scale, was developed to standardize MRI protocols and reporting criteria—including tumor location, size, morphology, and invasiveness. The aim of this article is to navigate through all the steps to achieve VI-RADS assessment and to discuss practical pearls and pitfalls in the use of mpMRI. This approach can aid in pre-TURBT prediction of muscle invasion, representing an important asset in bladder cancer staging.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111868"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885486","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

Impact of reactive sclerosis on outcome of MR-HIFU for osteoid osteomas 反应性硬化对骨样骨瘤MR-HIFU结果的影响。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2024.111902

Bernd Erber , Anna Geßl , Paul Reidler , Hans Roland Dürr , Alexander Klein , Max Seidensticker , Moritz Wildgruber , Jens Ricke , Bastian Sabel

Objectives

To evaluate the influence of clinical and procedural factors, particularly the thickness of reactive sclerosis, on clinical outcome of MR-guided high-intensity focused ultrasound (MR-HIFU) for the treatment of symptomatic osteoid osteomas (OO) of the extremities.

Materials and methods

18 consecutive patients (median age 19.5y) with symptomatic OO of the extremities eligible for MR-HIFU were enrolled in this ongoing prospective study (German Clinical Trials Register; nr. DRKS00015448). The Functional Assessment of Cancer Therapy − Bone Pain (FACT-BP) score was used for evaluation of symptoms and quality of life parameters at 1-week, 2-week, 1-month, 6-month and 12-month follow-up (FU) after intervention. MRI was performed prior as well as, 6 and 12 months after intervention. Assessment included procedural and imaging parameters, with a specific focus on the thickness of the reactive sclerosis surrounding the nidus.

Results

Symptoms and quality of life parameters significantly improved between baseline and all FUs on the FACT-BP (mean score at baseline: 29.7; at 6-month-FU: 5.5; at 12-month-FU: 3.4, all p < 0.01). A strong correlation was found between scores of FACT-BP and the thickness of reactive sclerosis surrounding the nidus (r = 0.62 at 6-month-FU; p = 0.006) with an optimal cutoff of 0.6 cm identified for predicting a good clinical outcome.

Conclusion

MR-HIFU is an effective method for the treatment of symptomatic osteoid osteomas of the extremities in pediatric and adult patients, with the thickness of reactive sclerosis surrounding the nidus being a relevant factor influencing patient outcomes and emphasizing its importance in MR-HIFU assessment and planning.

目的：评价临床和程序因素，特别是反应性硬化的厚度对磁共振引导下高强度聚焦超声（MR-HIFU）治疗四肢症状性骨样骨瘤（OO）临床结果的影响。材料和方法：连续18例（中位年龄19.5岁）符合MR-HIFU条件的四肢症状性OO患者被纳入这项正在进行的前瞻性研究(德国临床试验注册；nr DRKS00015448)。在干预后1周、2周、1个月、6个月和12个月的随访（FU）中，采用肿瘤治疗功能评估-骨痛（FACT-BP）评分评估患者的症状和生活质量参数。在干预前、干预后6个月和12个月分别进行MRI检查。评估包括手术和影像学参数，特别关注病灶周围反应性硬化的厚度。结果：症状和生活质量参数在基线和FACT-BP的所有FUs之间显著改善(基线时平均得分：29.7；6个月fu: 5.5；结论：MR-HIFU是治疗儿童和成人四肢症状性骨样骨瘤的有效方法，病灶周围反应性硬化厚度是影响患者预后的相关因素，在MR-HIFU评估和计划中具有重要意义。

{"title":"Impact of reactive sclerosis on outcome of MR-HIFU for osteoid osteomas","authors":"Bernd Erber , Anna Geßl , Paul Reidler , Hans Roland Dürr , Alexander Klein , Max Seidensticker , Moritz Wildgruber , Jens Ricke , Bastian Sabel","doi":"10.1016/j.ejrad.2024.111902","DOIUrl":"10.1016/j.ejrad.2024.111902","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the influence of clinical and procedural factors, particularly the thickness of reactive sclerosis, on clinical outcome of MR-guided high-intensity focused ultrasound (MR-HIFU) for the treatment of symptomatic osteoid osteomas (OO) of the extremities.</div></div><div><h3>Materials and methods</h3><div>18 consecutive patients (median age 19.5y) with symptomatic OO of the extremities eligible for MR-HIFU were enrolled in this ongoing prospective study (German Clinical Trials Register; nr. DRKS00015448). The Functional Assessment of Cancer Therapy − Bone Pain (FACT-BP) score was used for evaluation of symptoms and quality of life parameters at 1-week, 2-week, 1-month, 6-month and 12-month follow-up (FU) after intervention. MRI was performed prior as well as, 6 and 12 months after intervention. Assessment included procedural and imaging parameters, with a specific focus on the thickness of the reactive sclerosis surrounding the nidus.</div></div><div><h3>Results</h3><div>Symptoms and quality of life parameters significantly improved between baseline and all FUs on the FACT-BP (mean score at baseline: 29.7; at 6-month-FU: 5.5; at 12-month-FU: 3.4, all p < 0.01). A strong correlation was found between scores of FACT-BP and the thickness of reactive sclerosis surrounding the nidus (r = 0.62 at 6-month-FU; p = 0.006) with an optimal cutoff of 0.6 cm identified for predicting a good clinical outcome.</div></div><div><h3>Conclusion</h3><div>MR-HIFU is an effective method for the treatment of symptomatic osteoid osteomas of the extremities in pediatric and adult patients, with the thickness of reactive sclerosis surrounding the nidus being a relevant factor influencing patient outcomes and emphasizing its importance in MR-HIFU assessment and planning.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111902"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926935","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}

引用次数: 0

[18F]FDG PET/CT versus Dynamic Contrast-Enhanced CT for the diagnosis of solitary pulmonary Nodule: A Head-to-Head comparative Meta-Analysis [18]FDG PET/CT与动态增强CT诊断孤立性肺结节：一项头对头的比较meta分析。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2025.111916

Hang Long , Binwei Hao , Yuxi Cao , Yaoyao Cai , Shuang Wei , Xiansheng Liu

Purpose

This head-to-head comparative meta-analysis aimed to evaluate the comparative diagnostic efficacy of [¹⁸F]FDG PET/CT and dynamic contrast-enhanced CT(DCE-CT) for the differentiation between malignant and benign pulmonary nodules.

Methods

An extensive search was conducted in the PubMed, Embase, and Web of Science to identify available publications up to March 23, 2024. Studies were included if they evaluated the diagnostic efficacy of [¹⁸F]FDG PET/CT and DCE-CT for the characterization of pulmonary nodules. Sensitivity and specificity were assessed using the inverse variance method, followed by transformation via the Freeman-Tukey double inverse sine transformation. The quality of the included studies utilizing the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

Results

Seven articles involving 1,183 patients were included in the meta-analysis. The sensitivity of [¹⁸F]FDG PET/CT was comparable to that of DCE-CT (0.88 vs. 0.87, P = 0.95). Similarly, the specificity of [¹⁸F]FDG PET/CT was not significantly different from that of DCE-CT (0.63 vs. 0.54, P = 0.47). No significant publication bias was detected for any outcome (Egger’s test: all P > 0.05). For DCE-CT, meta-regression analysis identified the mean lesion size of pulmonary nodules (<20 mm vs. ≥ 20 mm, P = 0.01) as a potential source of heterogeneity. Meanwhile, the number of patients (<100 vs. ≥ 100, P < 0.01) for PET/CT may also contribute to the heterogeneity.

Conclusions

Our meta-analysis indicates that [¹⁸F]FDG PET/CT demonstrates similar sensitivity and specificity to DCE-CT for the diagnosis of pulmonary nodules. However, the number of the head-to-head studies were relatively small, further larger sample prospective research is required to confirm these findings.

目的：本首尾对比荟萃分析旨在评价[18F]FDG PET/CT与动态对比增强CT（DCE-CT）鉴别肺结节良恶性的比较诊断效果。方法：在PubMed， Embase和Web of Science中进行了广泛的搜索，以确定截至2024年3月23日的可用出版物。如果研究评估了[18F]FDG PET/CT和DCE-CT对肺结节特征的诊断效果，则纳入研究。采用方差反方法评估敏感性和特异性，然后通过Freeman-Tukey双反正弦变换进行变换。使用诊断准确性研究质量评估（QUADAS-2）工具纳入研究的质量。结果：meta分析纳入了7篇文章，涉及1183名患者。[18F]FDG PET/CT的灵敏度与DCE-CT相当（0.88 vs. 0.87, P = 0.95）。同样，[18F]FDG PET/CT的特异性与DCE-CT无显著差异（0.63 vs. 0.54, P = 0.47）。任何结果均未发现显著的发表偏倚（Egger检验：均P < 0.05）。对于DCE-CT， meta回归分析确定了肺结节的平均病变大小(结论：我们的meta分析表明[18F]FDG PET/CT在诊断肺结节方面具有与DCE-CT相似的敏感性和特异性。然而，头对头研究的数量相对较少，需要进一步的大样本前瞻性研究来证实这些发现。

{"title":"[18F]FDG PET/CT versus Dynamic Contrast-Enhanced CT for the diagnosis of solitary pulmonary Nodule: A Head-to-Head comparative Meta-Analysis","authors":"Hang Long , Binwei Hao , Yuxi Cao , Yaoyao Cai , Shuang Wei , Xiansheng Liu","doi":"10.1016/j.ejrad.2025.111916","DOIUrl":"10.1016/j.ejrad.2025.111916","url":null,"abstract":"<div><h3>Purpose</h3><div>This head-to-head comparative <em>meta</em>-analysis aimed to evaluate the comparative diagnostic efficacy of [<sup>18</sup>F]FDG PET/CT and dynamic contrast-enhanced CT(DCE-CT) for the differentiation between malignant and benign pulmonary nodules.</div></div><div><h3>Methods</h3><div>An extensive search was conducted in the PubMed, Embase, and Web of Science to identify available publications up to March 23, 2024. Studies were included if they evaluated the diagnostic efficacy of [<sup>18</sup>F]FDG PET/CT and DCE-CT for the characterization of pulmonary nodules. Sensitivity and specificity were assessed using the inverse variance method, followed by transformation via the Freeman-Tukey double inverse sine transformation. The quality of the included studies utilizing the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.</div></div><div><h3>Results</h3><div>Seven articles involving 1,183 patients were included in the <em>meta</em>-analysis. The sensitivity of [<sup>18</sup>F]FDG PET/CT was comparable to that of DCE-CT (0.88 vs. 0.87, <em>P</em> = 0.95). Similarly, the specificity of [<sup>18</sup>F]FDG PET/CT was not significantly different from that of DCE-CT (0.63 vs. 0.54, <em>P</em> = 0.47). No significant publication bias was detected for any outcome (Egger’s test: all <em>P</em> > 0.05). For DCE-CT, <em>meta</em>-regression analysis identified the mean lesion size of pulmonary nodules (<20 mm vs. ≥ 20 mm, <em>P</em> = 0.01) as a potential source of heterogeneity. Meanwhile, the number of patients (<100 vs. ≥ 100, <em>P</em> < 0.01) for PET/CT may also contribute to the heterogeneity.</div></div><div><h3>Conclusions</h3><div>Our <em>meta</em>-analysis indicates that [<sup>18</sup>F]FDG PET/CT demonstrates similar sensitivity and specificity to DCE-CT for the diagnosis of pulmonary nodules. However, the number of the head-to-head studies were relatively small, further larger sample prospective research is required to confirm these findings.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111916"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002619","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

Technical and clinical reasons for negative skin test results following intradermal testing of contrast media

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-02-01 DOI: 10.1016/j.ejrad.2025.111939

Ingrid Böhm

引用次数: 0