Journal of Clinical Imaging Science最新文献

Objectives: This study evaluates the effectiveness and complication rates of a non-cooled microwave ablation (MWA) system compared to a radiofrequency ablation (RFA) system for treating benign thyroid nodules.

Material and methods: Between October 2022 and July 2023, 56 patients (38 females, mean age: 51.75±10.7 years) with benign thyroid nodules, confirmed twice by fine-needle aspiration biopsy (FNAB), were included. Ultrasound (US) guidance was used to treat 62 nodules under local anesthesia. Nodule volume, diameters, and echogenicity were assessed before and after the procedures. Data were analyzed using Statistical Package for the Social Sciences (SPSS) 21.

Results: At 3, 6, and 12 months, volume reduction was significantly greater in the non-cooled MWA group compared to the RFA group (P = 0.022, P = 0.002, P < 0.001). Both methods showed significant volume reduction at all follow-ups (P < 0.001). Age, sex, and multinodular goiter presence did not significantly affect treatment response (P > 0.05). Nodule structure was not a significant factor at 3 months (P = 0.242) but was significant at 6 and 12 months (P = 0.003, P = 0.002). No complications were observed.

Conclusion: The non-cooled MWA system demonstrated superior efficacy compared to RFA, with similar procedural times and complication rates. Further studies with larger cohorts are needed to confirm these findings.

Primary cerebellar angiosarcoma is an exceptionally rare intracranial malignancy, with only 22 cases reported in the literature. We report the case of a 67-year-old male who presented with a severe headache, unsteady gait, and giddiness. Computed tomography of the brain demonstrated a hemorrhagic lesion in the right cerebellar hemisphere with associated vasogenic edema and early hydrocephalus. Magnetic resonance imaging revealed a right cerebellar intra-axial lesion with mixed signal intensities and a characteristic peripheral "bull's eye" enhancement pattern. Histopathological evaluation showed a vasoformative neoplasm with atypical endothelial cells, high mitotic activity, and immunopositivity for CD31 and erythroblast transformation specific (ETS)-related gene (ERG), consistent with low-grade angiosarcoma. The patient underwent gross total resection and remained recurrence-free 16 months postoperatively. This case underscores the importance of multi-modality imaging in the early recognition of hemorrhagic cerebellar tumors and reinforces the role of radiological-pathological correlation in diagnosis and treatment planning. Given its rarity, diagnosis of cerebellar angiosarcoma requires a high index of suspicion, supported by advanced imaging and immunohistochemical profiling. Multidisciplinary management is essential, and further case documentation is necessary to guide therapeutic strategies and prognostication.

Fibroblast activation protein (FAP), widely overexpressed in the tumor stroma of various cancers, has emerged as a promising target for cancer imaging. Radiopharmaceuticals designed to target FAP offer significantly improved tumor-to-background contrast compared to traditional imaging agents, thereby enhancing the precision of cancer detection. This review summarizes recent advancements in FAP-targeted diagnosis radiopharmaceuticals, highlighting their advantages and future potential.

Inferior vena cava (IVC) pathology is often underrecognized on non-dedicated imaging examinations, yet it carries significant diagnostic and clinical implications, particularly in acute emergency settings. This review highlights the complementary roles of ultrasound (US) and computed tomography (CT) in the assessment of IVC abnormalities. The US provides real-time, bedside evaluation of IVC patency, caliber, and hemodynamics, whereas CT offers detailed anatomic and structural characterization critical for diagnosis and management. The review aims to systematically discuss congenital variants, thrombotic, traumatic, systemic conditions, and neoplastic involvement of the IVC, emphasizing their imaging features and clinical relevance.

Objectives: This study presents a comprehensive bibliometric analysis of Indian research on the application of generative artificial intelligence (GAI) in healthcare imaging from 2017 to 2025. It aims to evaluate the research output, citation impact, collaborative patterns, and key thematic areas to understand India's position in this rapidly evolving global landscape.

Material and methods: We used a comprehensive search strategy on the Scopus database, limited to publications with an Indian affiliation from 2017 to 2025. Data on author names, affiliations, publication years, keywords, and citations were extracted from 383 records. The analysis employed citation analysis, co-authorship networks, and keyword co-occurrence analysis, with VOSviewer software used for data visualization.

Results: Globally, 2,761 papers were published in this field, with an average growth rate of 133.2%. India ranked third globally in publication volume with 383 papers, but its average citations per paper (CPP) were 6.55, much below the global average of 21.71. Conference papers dominated India's output (58.49%) but had a low CPP of 2.92, in contrast to higher-impact journal articles (11.29 CPP). Key institutions such as SRM Institute of Science and Technology were highly productive, while others, such as the GLA University, demonstrated high citation impact. The most prevalent keywords were "generative adversarial networks" and "medical imaging," highlighting a strong focus on technical applications.

Conclusion: Indian research in GAI in healthcare imaging is marked by a significant increase in output, establishing the country as a major contributor. Although India ranks third globally in research output, its citation impact remains below the global average, reflecting the need to improve research quality, visibility, and international collaboration.

Amnesia is a well-documented complication following surgical repair of anterior communicating artery (ACoA) aneurysms. 3D MRI has clarified that it is primarily caused by infarction of the subcallosal artery, the largest unpaired perforating branch of the ACoA. Bilateral infarction of the columns of the fornix, a core component of the Papez circuit, has been identified as the anatomical basis of such amnesia. Another perforating artery prone to surgical injury is the recurrent artery of Heubner (RAH), which arises from the A1 to A2 junction of the anterior cerebral artery and is usually present bilaterally. When RAH infarction co-occurs with subcallosal artery infarction during ACoA aneurysm surgery, memory impairment may be accompanied by reduced processing speed and a worse long-term outcome. We report a 63-year-old man who underwent surgical clipping for a ruptured ACoA aneurysm. 3D-MR images obtained 10 months postoperatively revealed bilateral infarctions in the subcallosal artery territory, including the columns of the fornix, as well as a right-sided infarction in the RAH territory. Clinical correlation showed that these findings matched the patient's paradoxical cognitive profile, confirmed by formal neuropsychological testing 5 years after clipping. He demonstrated a dissociation between exceptionally gifted-level intellectual ability and comparatively lower scores in memory and processing speed. His full-scale intelligence quotient (IQ) was 144, with a verbal IQ of 156 and working memory of 150, while his general memory score was 115 and processing speed was 110. Although these latter scores fell within the high-average range, they represented a meaningful decline relative to his potential. This profile supports a dual circuit model: Subcallosal artery infarction disrupts the Papez circuit, impairing memory, while RAH infarction contributes to inefficiency through frontostriatal disconnection. This case of paradoxical giftedness with memory decline underscores the value of 3D MR imaging in revealing memory decline masked by cognitive reserve.

Adamantinoma-like Ewing sarcoma (ALES) of the parotid gland is an exceptionally rare neoplasm. We report the case of a 57-year-old male with a history of p16-positive tonsillar squamous cell carcinoma who presented 2 years after remission with excessive mucus production and neck stiffness. Imaging identified a left parotid mass, and diagnosis was confirmed through surgical pathology, with molecular testing revealing a Fused in Sarcoma-Fifth Ewing Variant (FUS-FEV) fusion gene. Treatment included radical parotidectomy, adjuvant external beam radiation, and systemic chemotherapy following the Ewing sarcoma paradigm. Despite initial response, the patient experienced significant toxicities and eventually succumbed to disease-related complications. This case illustrates the challenges in diagnosing and managing rare parotid malignancies and highlights the importance of multidisciplinary care.

Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal-derived neoplasm that most commonly arises in the lung. It can also occur in other parts of the body. Primary IMT of the gallbladder is exceptionally uncommon. Due to the absence of large-sample studies, the current understanding of gallbladder IMT remains largely limited to case reports. This article reports the diagnosis and treatment course of a 13-year-old male with inflammatory myofibroblastoma of the gallbladder. It specifically focuses on delineating its distinct imaging characteristics across ultrasonography, computed tomography, and magnetic resonance imaging, aiming to enhance the accuracy of pre-operative diagnosis and provide valuable insights into the literature for this rare condition.

Transcription Factor E3 (TFE3)-rearranged renal cell carcinoma (RCC) is rare. Radiologically, TFE3-rearranged RCC typically appears as a hyperattenuating mass with calcifications. Calcifications typically appear as small punctate or irregular coarse deposits, which are pathologically associated with granular and collagenous stromal degeneration. Here, we report a case of TFE3-rearranged RCC with extensive calcification in a young female, emphasizing imaging-pathologic correlation to enhance diagnostic accuracy. This case underscores the importance of recognizing atypical radiological features in rare RCC subtypes.