Journal of Medical Imaging and Radiation Oncology最新文献_第7页

ChatGPT's Methodological Perspectives on Information Quality in Interventional Radiology ChatGPT介入放射学信息质量的方法学视角。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-30 DOI: 10.1111/1754-9485.70018

Deniz Esin Tekcan Sanli, Ahmet Necati Sanli

引用次数: 0

Management of Glioblastoma in Elderly Patients in a Single Australian Centre 澳大利亚单一中心老年患者胶质母细胞瘤的管理。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-27 DOI: 10.1111/1754-9485.70010

Kimberley Budgen, Danica Cossio, Danny R. Youlden, Nathan Dunn, Suzanne Poulgrain, Katharine Cuff, Margaret McGrath, Andrew Pullar, Matthew C. Foote, Rumal Jayalath, Julie Moore, Mark B. Pinkham

Introduction

Glioblastoma management in elderly patients is challenging. The aim of this study was to review oncological treatment strategies at a single institution from 2011 to 2020.

Methods

Patients aged ≥ 70 years who received radiotherapy and/or chemotherapy for radiological or histological glioblastoma were identified from a centralised database. Patients receiving supportive care only were excluded, whether or not they had surgery at diagnosis. Clinicopathologic data and treatment modalities were collected. Median survival from diagnosis was calculated by the Kaplan–Meier method.

Results

Seventy-eight people were identified during the study period, median age 74.5 years (range 70–88). Seventy-five people had surgery (24 biopsy only, and 51 resection) and three people had radiological diagnosis only. The most common first-line treatment was concurrent chemoradiation (33/78, 42%). Only 18/33 (55%) went on to receive adjuvant temozolomide, median of five cycles (interquartile range [IQR] 2–6). The most common radiotherapy dose was 40 Gy in 15 fractions (52/73, 71%) and 60 Gy in 30 fractions was less frequently prescribed over time. Second-line therapy for recurrent or progressive disease was received in 23% overall, and varied in modality. Median survival was 7.0 months (IQR 4.4–12.5), and 6.4% (CI 4.3%–9.1%) at 2 years.

Conclusion

Survival is poor for elderly patients with glioblastoma despite treatment. Concurrent chemoradiation was the most common treatment strategy, and 40 Gy in 15 fractions was the most common radiotherapy schedule. A small proportion of people received treatment for recurrent disease, and modality varied greatly.

老年胶质母细胞瘤患者的治疗具有挑战性。本研究的目的是回顾2011年至2020年在单一机构的肿瘤治疗策略。方法：年龄≥70岁接受放射学或组织学胶质母细胞瘤放疗和/或化疗的患者从集中数据库中确定。仅接受支持性治疗的患者被排除在外，无论他们在诊断时是否进行了手术。收集临床病理资料及治疗方法。诊断后的中位生存期采用Kaplan-Meier法计算。结果：78人在研究期间被确定，中位年龄74.5岁（范围70-88）。75人接受了手术（24人只做了活检，51人只做了切除），3人只做了放射诊断。最常见的一线治疗是同步放化疗（33/ 78,42 %）。只有18/33（55%）继续接受替莫唑胺辅助治疗，5个周期的中位数（四分位数范围[IQR] 2-6）。最常见的放疗剂量为15次40 Gy(52/ 73,71%)， 30次60 Gy的剂量随着时间的推移越来越少。总有23%的患者接受了复发或进展性疾病的二线治疗，并且治疗方式各不相同。中位生存期为7.0个月（IQR 4.4-12.5）， 2年为6.4% （CI 4.3%-9.1%）。结论：老年胶质母细胞瘤患者虽经治疗，但生存率较差。同步放化疗是最常见的治疗策略，最常见的放疗方案是15次40 Gy。一小部分人接受复发性疾病的治疗，治疗方式差异很大。

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引用次数: 0

Feasibility of Therapist-Driven MR-Guided Adaptive Radiotherapy for Oligometastatic Disease: Geometric Accuracy and Dosimetric Impact 治疗师驱动的磁共振引导的低转移性疾病适应性放疗的可行性：几何精度和剂量学影响。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-26 DOI: 10.1111/1754-9485.70016

Amanda Moreira, Winnie Li, Iymad R. Mansour, Mame Faye, Ali Hosni, Aruz Mesci, Enrique Gutierrez-Valencia, Patricia Lindsay, Peter Chung, Jeff Winter

Introduction

MRI-guided adaptive radiation therapy (ART) is the resource-intensive process of daily treatment plan modification. This study aims to demonstrate the feasibility of radiation therapist (RT)-led MRI-guided ART for oligometastatic disease (OMD) by comparing geometric accuracy and dosimetric differences between RT and radiation oncologist (RO) re-contouring.

Methods

Five RTs and five ROs retrospectively re-contoured gross target volumes (GTVs) and organs-at-risk (OARs) for eight OMD cases. RT and RO contours were compared against consensus RO Simultaneous Truth and Performance Level Estimation (RO-STAPLE) contours using the Dice similarity coefficient (DICE), mean distance to agreement (MDA), planning target volume (PTV) D95 and OAR D0.5cc using the Wilcoxon signed-rank test. Moreover, an RO qualitatively scored all contours using a 5-point Likert scale.

Results

We found very good geometric accuracy with average (±standard deviation) GTV DICE of 0.82 ± 0.06 for RTs and 0.85 ± 0.09 for ROs and MDA of 0.88 ± 0.03 mm for RT and 0.75 ± 0.05 mm for ROs relative to the RO-STAPLE. Qualitative GTV Likert scores were excellent, 4.8/5 for RTs and 4.7/5 for ROs. Mean percent difference in PTV D95 compared to RO-STAPLE was small but significantly higher for RTs (0.5% ± 1.5%) compared with ROs (−0.7% ± 1.9%, p < 0.05). Mean relative change in OAR D0.5cc results was small with −1% ± 6% for RTs and −1% ± 12% for ROs.

Conclusions

Here we provide the first report of geometric and dosimetric contouring uncertainty for MR-guided online ART for OMD. Our results show that RT re-contouring maintains similar performance for eligible targets and OARs compared with RO contours, establishing the initial feasibility of an RT-led workflow.

简介：mri引导下的适应性放射治疗（ART）是一种资源密集型的日常治疗方案修改过程。本研究旨在通过比较放射治疗（RT）和放射肿瘤学家（RO）重新轮廓的几何精度和剂量学差异，证明放射治疗（RT）主导的mri引导ART治疗寡转移性疾病（OMD）的可行性。方法：回顾性重建8例OMD患者的总靶体积（gtv）和危险器官（OARs），共5例rt和5例ROs。使用Dice相似系数（Dice）、平均协议距离（MDA）、计划目标体积（PTV） D95和OAR D0.5cc，使用Wilcoxon符号秩检验将RT和RO轮廓与共识RO同时真相和性能水平估计（RO- staple）轮廓进行比较。此外，RO使用5点李克特量表对所有轮廓进行定性评分。结果：相对于RO-STAPLE，我们发现具有良好的几何精度，rrt的平均（±标准差）GTV DICE为0.82±0.06，ROs为0.85±0.09，rrt的MDA为0.88±0.03 mm， ROs为0.75±0.05 mm。定性GTV Likert评分非常好，RTs为4.8/5，ROs为4.7/5。与RO-STAPLE相比，PTV D95的平均百分比差异很小，但RTs（0.5%±1.5%）明显高于ROs(-0.7%±1.9%)，p结论：在这里，我们首次报道了mri引导下在线ART治疗OMD的几何和剂量轮廓不确定性。我们的研究结果表明，与RO轮廓相比，RT重新轮廓在符合条件的目标和桨上保持了相似的性能，从而建立了RT主导工作流程的初步可行性。

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引用次数: 0

Comment on ‘The Quality of Information Produced by ChatGPT About Conditions Managed by Interventional Radiologists’ 对“ChatGPT提供的有关介入放射科医生管理病情的信息质量”的评论。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-23 DOI: 10.1111/1754-9485.70015

Hinpetch Daungsupawong, Viroj Wiwanitkit

引用次数: 0

Surveillance After Treatment of Adenoid Cystic Carcinoma of the Head and Neck: Review of Institutional Outcomes and Proposed Surveillance Imaging Protocol 头颈部腺样囊性癌治疗后的监测：机构结果和拟议的监测成像方案的回顾。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-19 DOI: 10.1111/1754-9485.70013

Esther Duruchukwu, Anna Lawless, Dasantha Jayamanne, David Veivers, Andrew Wignall, Leo Pang, Joseph Chan, Mark Stevens, Thomas Eade, Adrian Lee, Alexander Guminski, Sarah Bergamin

Introduction

Long term survival for adenoid cystic carcinoma (ACC) arising from the head and neck declines for many decades after initial treatment due to late disease relapse. Follow up and surveillance imaging practices vary due to limited evidence as well as a lack of international guidelines (until 2021).

Methods

A retrospective cohort study was conducted for patients treated curatively for ACC between 2007 and 2024 at a single institution. Clinicopathologic information, treatment details, patterns of follow-up (including radiologic investigations) and oncological outcomes are reported.

Results

51 patients comprised the study cohort. Median age was 50 years; 96% of patients underwent surgery and adjuvant radiation therapy. Median follow-up was 7.65 years. 5-year overall survival (OS) and disease-free survival (DFS) were 88% and 73% respectively. 18% and 61% of patients underwent surveillance imaging within 3- and 12-months of treatment completion respectively. 80% of first recurrences were detected on surveillance imaging. Half the episodes of first disease recurrence occurred within 5 years of initial treatment, a further 25% within 10 years and the remaining 25% occurred > 10 years post treatment.

Conclusion

This cohort of patients curatively treated for ACC at a single institution highlights the propensity for late distant relapse as well as heterogeneity of surveillance imaging. A local institutional protocol is proposed based upon the 2021 ASCO guidelines to standardise clinical and radiologic follow-up for this group.

导论：头颈部腺样囊性癌（ACC）的长期生存率在最初治疗后几十年由于疾病晚期复发而下降。由于证据有限以及缺乏国际指南（直到2021年），后续和监测成像做法各不相同。方法：回顾性队列研究对2007年至2024年在单一机构治愈的ACC患者进行了研究。报告临床病理信息、治疗细节、随访模式（包括放射学调查）和肿瘤结果。结果：51例患者纳入研究队列。中位年龄为50岁；96%的患者接受了手术和辅助放射治疗。中位随访时间为7.65年。5年总生存率（OS）为88%，无病生存率（DFS）为73%。18%和61%的患者分别在治疗完成后的3个月和12个月内接受了影像学检查。80%的首次复发是在监测影像上发现的。一半的首次疾病复发发生在最初治疗的5年内，另外25%发生在10年内，其余25%发生在治疗后10年。结论：这组在单一机构接受治疗的ACC患者突出了晚期远处复发的倾向以及监测成像的异质性。根据2021年ASCO指南，提出了一项本地机构方案，以标准化该组的临床和放射学随访。

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引用次数: 0

Enhancing Cultural Safety and Diagnostic Accuracy in Radiology for TGD Individuals 提高TGD患者的放射学培养安全性和诊断准确性。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-19 DOI: 10.1111/1754-9485.70014

Deniz Esin Tekcan Sanli, Ahmet Necati Sanli

引用次数: 0

Assessing the Impact of Reduced L1 Bone Density on Surgical Stabilisation of Rib Fractures in Elderly Patients: A Study on Fracture Nonunion Rates, Analgesia Usage and Hospital Length of Stay 评估L1骨密度降低对老年患者肋骨骨折手术稳定的影响：骨折不愈合率、镇痛药使用和住院时间的研究

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-19 DOI: 10.1111/1754-9485.70003

Joseph K. Hwang, Philip A. Jeremic, Ian Hughes, John Grieve, Elizabeth Wake, Don Campbell, Bhavik Patel

Introduction

Rib fractures following falls are common among patients over 70 years of age. While nonoperative management is standard, surgical stabilisation of rib fractures (SSRF) is increasingly performed in selected elderly patients despite concerns about frailty and comorbidities. Although osteoporosis significantly increases fracture risk, rib fractures have not traditionally been categorised as fragility fractures.

Methods

This study retrospectively evaluated bone mineral density (BMD), represented by L1 vertebral Hounsfield units (HU) and correlated clinical outcomes in patients with rib fractures from trauma. A control group of 100 age- and sex-matched nontrauma patients was included for comparison.

Results

Overall, trauma patients exhibited higher mean L1 HU values, 125.0, compared to controls, 105.5 (p = 3 × 10⁻⁵). Within the patients sustaining rib fractures, the low-energy trauma group had lower mean L1 HU values (112.6) than those from high-energy trauma (133, p = 0.002), suggesting a link between lower BMD and susceptibility to rib fractures. Low BMD (L1 HU ≤ 110) was not associated with worse clinical outcomes such as hospital length of stay, analgesia requirements or fracture healing, whether managed operatively or nonoperatively. Low BMD did not affect rib union post-SSRF, with no hardware failures. These results suggest that low BMD alone should not contraindicate SSRF.

Conclusion

The authors recommend routine osteoporosis screening using opportunistic L1 HU measurement on trauma CT scans, particularly in elderly patients sustaining low-energy trauma, to facilitate early osteoporosis management and reduce future fracture risk.

跌倒后肋骨骨折在70岁以上的患者中很常见。虽然非手术治疗是标准的，但手术稳定肋骨骨折（SSRF）越来越多地用于特定的老年患者，尽管担心虚弱和合并症。虽然骨质疏松症显著增加骨折风险，但肋骨骨折传统上并未被归类为脆性骨折。方法：本研究回顾性评估了创伤性肋骨骨折患者的骨矿物质密度（BMD），以L1椎体Hounsfield单位（HU）为代表，以及相关的临床结果。对照组包括100名年龄和性别匹配的非创伤患者进行比较。结果：总体而言，创伤患者的平均L1 HU值为125.0，高于对照组的105.5 （p = 3 × 10-5）。在持续肋骨骨折的患者中，低能创伤组的平均L1 HU值（112.6）低于高能创伤组（133,p = 0.002），这表明低骨密度与肋骨骨折易感性之间存在联系。无论是手术还是非手术治疗，低骨密度（L1 HU≤110）与较差的临床结果（如住院时间、镇痛需求或骨折愈合）无关。低骨密度不影响ssrf后的肋骨愈合，没有硬件故障。这些结果表明，低骨密度本身不应成为SSRF的禁忌症。结论：作者推荐在创伤CT扫描中使用机会性L1 HU测量常规骨质疏松症筛查，特别是在遭受低能量创伤的老年患者中，以促进早期骨质疏松症管理并降低未来骨折风险。

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引用次数: 0

Imaging Characteristics of Hypothalamic Hamartomas in an Australian Paediatric Population 澳大利亚儿童下丘脑错构瘤的影像学特征。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-18 DOI: 10.1111/1754-9485.70011

Jonathan Erickson, Harry D'Souza, George Wang, Caoilfhionn Ni Leidhin, Rahul Lakshmanan, Michael Mason, Richard Warne

Background

Hypothalamic hamartoma (HH) is a rare congenital malformation that can significantly disrupt patient quality of life and typically presents with either central precocious puberty or gelastic seizures.

Objective

We seek to add to the current literature through a retrospective review of all cases of HH seen at our paediatric tertiary centre over the previous two decades. We also sought to test the novel hypothesis that lesions located closer to or contacting the infundibulum were more likely to present with central precocious puberty (CPP).

Materials and Methods

Retrospective review of the public PACS system was performed, yielding a total of sixteen patients with HH identified on MRI between January 2000 and February 2022. Imaging and patient records were retrospectively evaluated.

Results

Six patients presented with central precocious puberty (CPP), six with gelastic or other seizure disorders, and four had alternate presenting issues. Our study demonstrates a statistically significant relationship between pedunculated lesions and CPP and between sessile/intrahypothalamic lesions and gelastic seizure/neuropsychiatric symptoms. We did not demonstrate a relationship between tumour location relative to the infundibulum or mammillary bodies and clinical manifestations.

Conclusion

Hypothalamic hamartomas are rare congenital malformations which typically present with one of two classical phenotypes: CPP or gelastic seizure. The study demonstrates a statistically significant relationship between pedunculated lesions and CPP and between lesions with third ventricular involvement and gelastic seizure/neuropsychiatric symptoms. We did not demonstrate a clear relationship between specific tumour location within the hypothalamus and phenotype; larger cohort studies are recommended to further investigate this hypothesis.

背景：下丘脑错构瘤（HH）是一种罕见的先天性畸形，可显著影响患者的生活质量，通常表现为中枢性性早熟或弹性癫痫发作。目的：我们试图通过对过去二十年来在我们的儿科三级中心看到的所有HH病例的回顾性审查来增加当前的文献。我们还试图验证一个新的假设，即靠近或接触漏斗的病变更有可能出现中枢性性早熟（CPP）。材料和方法：对公共PACS系统进行回顾性审查，在2000年1月至2022年2月期间共获得16例MRI确诊的HH患者。回顾性评价影像学和患者记录。结果：6例患者表现为中枢性性早熟（CPP）， 6例有弹性或其他癫痫发作障碍，4例有交替出现的问题。我们的研究表明，带蒂病变与CPP之间以及无梗/下丘脑内病变与弹性癫痫/神经精神症状之间存在统计学上的显著关系。我们没有证明肿瘤位置相对于十二指肠或乳腺与临床表现之间的关系。结论：下丘脑错构瘤是一种罕见的先天性畸形，典型表现为两种典型表型之一：CPP或弹性癫痫发作。该研究表明，有蒂病变与CPP之间、第三心室受累病变与弹性癫痫/神经精神症状之间存在统计学上的显著关系。我们没有证明下丘脑内特定肿瘤位置与表型之间的明确关系；建议进行更大规模的队列研究来进一步调查这一假设。

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引用次数: 0

A Survey Study on the Roles, Responsibilities and Workforce Characteristics of Radiation Oncology Nurses in Australia 澳大利亚放射肿瘤学护士角色、职责及劳动力特点调查研究。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-16 DOI: 10.1111/1754-9485.70002

Michelle Roach, Pauline Rose, Diana Ngo, Anisha Pradhan, Eliza Bailey, Sylvia Barker, Stacey Buxton, Meg Hughes, Karen Jones, Paula Macleod, Kirsten Oataway, Gabrielle Vigar, Gemma McErlean

Introduction

Radiation Oncology Nurses (RONs) are key members of the radiation oncology team; however, the role of the RON is not always clear. The aims of this study were to provide an overview of the RON workforce in Australia, to describe the roles and responsibilities of RONs, and to identify challenges and job satisfaction of RONs.

Methods

This was a two-part multi-methods survey study. Two self-reported questionnaires were distributed online using purposive and snowball sampling: Radiation Oncology Facility Survey (ROFS) and RON Workforce Survey (RONWS). The surveys used tick boxes, Likert scale and open and closed-ended questions. Frequencies and percentages were calculated for categorical variables; mean/standard deviation for continuous variables.

Results

A total of 42 responses were received for the ROFS and 139 for the RONWS, representing all States and Territories in Australia except the Australian Capital Territory (ACT): 52% were metropolitan and 50% were public facilities. Only 17% reported radiation oncology specific training, but 58% had plans to further their education. 80% reported being satisfied with their career and position, believing their role was recognised and generally respected among colleagues and patients. Areas of dissatisfaction included salary, staffing resources and opportunities for advancement.

Conclusion

This is the largest study of RONs in Australia, revealing that RON is a satisfying oncology specialty. Data from this study can be used to identify opportunities for improvement in staffing, engagement and retention of RONs, possibly leading to the development of national guidelines for radiation oncology nursing in Australia.

简介：放射肿瘤学护士（RONs）是放射肿瘤学团队的重要成员；然而，RON的角色并不总是明确的。本研究的目的是提供澳大利亚RON劳动力的概述，描述RON的角色和责任，并确定RON的挑战和工作满意度。方法：采用两部分多方法调查研究。两份自我报告的调查问卷采用有目的和滚雪球抽样的方式在线分发：放射肿瘤学设施调查（ROFS）和放射肿瘤学工作人员调查（RONWS）。调查使用了勾选框、李克特量表以及开放式和封闭式问题。计算分类变量的频率和百分比；连续变量的均值/标准差。结果：共收到42份关于ROFS和139份关于RONWS的回复，代表了除澳大利亚首都直辖区（ACT）外的澳大利亚所有州和地区：52%是大都市，50%是公共设施。只有17%的人表示接受过放射肿瘤学的专门培训，但58%的人计划继续深造。80%的人对自己的职业和职位感到满意，认为自己的角色得到了同事和病人的认可和尊重。不满意的领域包括工资、人力资源和晋升机会。结论：这是澳大利亚最大的关于RON的研究，表明RON是一个令人满意的肿瘤学专业。这项研究的数据可以用来确定在人员配备、参与和保留RONs方面的改进机会，可能会导致澳大利亚放射肿瘤学护理国家指南的制定。

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引用次数: 0

The Australian National Lung Cancer Screening Program: A Radiologist's Perspective 澳大利亚国家肺癌筛查计划：放射科医生的观点。

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology

Pub Date : 2025-08-16 DOI: 10.1111/1754-9485.70012

Samantha J. Ellis, Mark W. McCusker, Stephen Melsom, Diane M. Pascoe, Catherine M. Jones, Miranda Siemienowicz

On July 1, 2025, Australia commenced screening eligible participants in a ground-breaking health initiative with the launch of a national lung cancer screening program (NLCSP). Designed for individuals at high risk, this program aims to promote early detection and improve both survival rates and treatment outcomes. Radiology will serve as a cornerstone of the program's success. This article provides a comprehensive overview from the radiologist's perspective.

2025年7月1日，澳大利亚启动了国家肺癌筛查计划（NLCSP），开始在一项突破性的健康倡议中对符合条件的参与者进行筛查。该项目专为高危人群设计，旨在促进早期发现，提高生存率和治疗效果。放射学将成为该计划成功的基石。本文从放射科医生的角度提供了一个全面的概述。

引用次数: 0