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Molecular Breast Imaging Biopsy with a Dual-Detector System. 使用双探测器系统进行分子乳腺成像活检。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-06-01 DOI: 10.1148/rycan.230186
Katie N Hunt, Amy Lynn Conners, Lacey Gray, Carrie B Hruska, Michael K O'Connor

Purpose To develop a molecular breast imaging (MBI)-guided biopsy system using dual-detector MBI and to perform initial testing in participants. Materials and Methods The Stereo Navigator MBI Accessory biopsy system comprises a lower detector, upper fenestrated compression paddle, and upper detector. The upper detector retracts, allowing craniocaudal, oblique, or medial or lateral biopsy approaches. The compression paddle allows insertion of a needle guide and needle. Lesion depth is calculated by triangulation of lesion location on the upper detector at 0° and 15° and relative lesion activity on upper and lower detectors. In a prospective study (July 2022-June 2023), participants with Breast Imaging Reporting and Data System category 2, 3, 4, or 5 breast lesions underwent MBI-guided biopsy. After injection of 740 MBq technetium 99m sestamibi, craniocaudal and mediolateral oblique MBI (2-minute acquisition per view) confirmed lesion visualization. A region of interest over the lesion permitted depth calculation in the system software. Upper detector retraction allowed biopsy device placement. Specimen images were obtained on the retracted upper detector, confirming sampling of the target. Results Of 21 participants enrolled (mean age, 50.6 years ± 10.1 [SD]; 21 [100%] women), 17 underwent MBI-guided biopsy with concordant pathology. No lesion was observed at the time of biopsy in four participants. Average lesion size was 17 mm (range, 6-38 mm). Average procedure time, including preprocedure imaging, was 55 minutes ± 13 (range, 38-90 minutes). Pathology results included invasive ductal carcinoma (n = 1), fibroadenoma (n = 4), pseudoangiomatous stromal hyperplasia (n = 6), and fibrocystic changes (n = 6). Conclusion MBI-guided biopsy using a dual-head system with retractable upper detector head was feasible, well tolerated, and efficient. Keywords: Breast Biopsy, Molecular Breast Imaging, Image-guided Biopsy, Molecular Breast Imaging-guided Biopsy, Breast Cancer Clinical trial registration no. NCT06058650 © RSNA, 2024.

目的 利用双探测器MBI开发分子乳腺成像(MBI)引导活检系统,并在参与者中进行初步测试。材料与方法 立体导航仪 MBI 附件活检系统由一个下部探测器、上部栅格压缩桨和上部探测器组成。上部探测器可伸缩,允许颅尾、斜向、内侧或外侧活检入路。压迫桨可插入导针和穿刺针。病变深度是通过对上部探测器 0° 和 15° 处的病变位置以及上下探测器上的相对病变活动进行三角测量计算得出的。在一项前瞻性研究(2022 年 7 月至 2023 年 6 月)中,患有乳腺成像报告和数据系统 2、3、4 或 5 类乳腺病变的参与者接受了 MBI 引导下的活检。注射 740 MBq锝 99m sestamibi 后,颅尾和内外侧斜位 MBI(每个视图采集 2 分钟)确认病灶可见度。病灶上的感兴趣区可在系统软件中进行深度计算。上部探测器回缩后可放置活检装置。在缩回的上部探测器上获取标本图像,确认目标取样。结果 在 21 名参加者(平均年龄 50.6 岁 ± 10.1 [SD];21 名女性 [100%])中,17 人在 MBI 引导下进行了活检,病理结果一致。有四名参与者在活检时未观察到病变。病变平均大小为 17 毫米(范围为 6-38 毫米)。包括术前成像在内的平均手术时间为 55 分钟 ± 13 分钟(38-90 分钟不等)。病理结果包括浸润性导管癌(1 例)、纤维腺瘤(4 例)、假血管瘤基质增生(6 例)和纤维囊性变(6 例)。结论 使用带有可伸缩上部探测头的双头系统进行 MBI 引导活检是可行、耐受性好且高效的。关键词乳腺活检 分子乳腺成像 图像引导活检 分子乳腺成像引导活检 乳腺癌 临床试验注册号NCT06058650 © RSNA, 2024.
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引用次数: 0
Performance of Lung-RADS Version 2022 in Classifying Airway Nodules. 肺-RADS 2022 版在气道结节分类中的表现
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.249012
Cristina Marrocchio, Carlotta Zilioli
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引用次数: 0
An Update on MR Spectroscopy in Cancer Management: Advances in Instrumentation, Acquisition, and Analysis. 癌症管理中 MR 光谱的最新进展:仪器、采集和分析方面的进展。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.230101
Eva Martinez Luque, Zexuan Liu, Dongsuk Sung, Rachel M Goldberg, Rishab Agarwal, Aditya Bhattacharya, Nadine S Ahmed, Jason W Allen, Candace C Fleischer

MR spectroscopy (MRS) is a noninvasive imaging method enabling chemical and molecular profiling of tissues in a localized, multiplexed, and nonionizing manner. As metabolic reprogramming is a hallmark of cancer, MRS provides valuable metabolic and molecular information for cancer diagnosis, prognosis, treatment monitoring, and patient management. This review provides an update on the use of MRS for clinical cancer management. The first section includes an overview of the principles of MRS, current methods, and conventional metabolites of interest. The remainder of the review is focused on three key areas: advances in instrumentation, specifically ultrahigh-field-strength MRI scanners and hybrid systems; emerging methods for acquisition, including deuterium imaging, hyperpolarized carbon 13 MRI and MRS, chemical exchange saturation transfer, diffusion-weighted MRS, MR fingerprinting, and fast acquisition; and analysis aided by artificial intelligence. The review concludes with future recommendations to facilitate routine use of MRS in cancer management. Keywords: MR Spectroscopy, Spectroscopic Imaging, Molecular Imaging in Oncology, Metabolic Reprogramming, Clinical Cancer Management © RSNA, 2024.

磁共振光谱(MRS)是一种非侵入性成像方法,能够以局部、多重和非电离的方式对组织进行化学和分子分析。由于代谢重编程是癌症的一个特征,MRS 为癌症诊断、预后、治疗监测和患者管理提供了宝贵的代谢和分子信息。本综述介绍了 MRS 用于临床癌症管理的最新情况。第一部分概述了 MRS 的原理、当前的方法和感兴趣的常规代谢物。综述的其余部分集中在三个关键领域:仪器的进步,特别是超高强度 MRI 扫描仪和混合系统;新兴的采集方法,包括氘成像、超极化碳 13 MRI 和 MRS、化学交换饱和转移、扩散加权 MRS、MR 指纹和快速采集;以及人工智能辅助分析。综述最后提出了未来的建议,以促进 MRS 在癌症管理中的常规应用。关键词MR 光谱 光谱成像 肿瘤学分子成像 代谢重编程 临床癌症管理 © RSNA, 2024.
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引用次数: 0
Integrating Whole-Slide Imaging and MRI Data for Outcome Prediction after Prostatectomy in Localized Prostate Cancer. 整合整体滑动成像和磁共振成像数据,预测局部前列腺癌前列腺切除术后的结果。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.240095
Stephanie A Harmon, Baris Turkbey
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引用次数: 0
Assessment of AI Risk Scores on Screening Mammograms Preceding Breast Cancer Diagnosis. 乳腺癌诊断前筛查乳房 X 线照片的 AI 风险评分评估。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.249011
Sneha Mittal, Maggie Chung
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引用次数: 0
Development and Validation of a Multimodality Model Based on Whole-Slide Imaging and Biparametric MRI for Predicting Postoperative Biochemical Recurrence in Prostate Cancer. 基于全滑动成像和双参数磁共振成像的多模态模型的开发与验证,用于预测前列腺癌术后生化复发。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.230143
Chenhan Hu, Xiaomeng Qiao, Renpeng Huang, Chunhong Hu, Jie Bao, Ximing Wang

Purpose To develop and validate a machine learning multimodality model based on preoperative MRI, surgical whole-slide imaging (WSI), and clinical variables for predicting prostate cancer (PCa) biochemical recurrence (BCR) following radical prostatectomy (RP). Materials and Methods In this retrospective study (September 2015 to April 2021), 363 male patients with PCa who underwent RP were divided into training (n = 254; median age, 69 years [IQR, 64-74 years]) and testing (n = 109; median age, 70 years [IQR, 65-75 years]) sets at a ratio of 7:3. The primary end point was biochemical recurrence-free survival. The least absolute shrinkage and selection operator Cox algorithm was applied to select independent clinical variables and construct the clinical signature. The radiomics signature and pathomics signature were constructed using preoperative MRI and surgical WSI data, respectively. A multimodality model was constructed by combining the radiomics signature, pathomics signature, and clinical signature. Using Harrell concordance index (C index), the predictive performance of the multimodality model for BCR was assessed and compared with all single-modality models, including the radiomics signature, pathomics signature, and clinical signature. Results Both radiomics and pathomics signatures achieved good performance for BCR prediction (C index: 0.742 and 0.730, respectively) on the testing cohort. The multimodality model exhibited the best predictive performance, with a C index of 0.860 on the testing set, which was significantly higher than all single-modality models (all P ≤ .01). Conclusion The multimodality model effectively predicted BCR following RP in patients with PCa and may therefore provide an emerging and accurate tool to assist postoperative individualized treatment. Keywords: MR Imaging, Urinary, Pelvis, Comparative Studies Supplemental material is available for this article. © RSNA, 2024.

目的 开发并验证一种基于术前磁共振成像、手术全切片成像(WSI)和临床变量的机器学习多模态模型,用于预测前列腺癌(PCa)根治性前列腺切除术(RP)后的生化复发(BCR)。材料与方法 在这项回顾性研究中(2015 年 9 月至 2021 年 4 月),363 名接受前列腺癌根治术的男性 PCa 患者按 7:3 的比例被分为训练组(n = 254;中位年龄 69 岁 [IQR 64-74 岁])和测试组(n = 109;中位年龄 70 岁 [IQR 65-75 岁])。主要终点是无生化复发生存期。采用最小绝对收缩和选择算子 Cox 算法选择独立的临床变量并构建临床特征。放射组学特征和病理组学特征分别使用术前 MRI 和手术 WSI 数据构建。结合放射组学特征、病理组学特征和临床特征,构建了多模态模型。使用哈雷尔一致性指数(C指数)评估多模态模型对BCR的预测性能,并与所有单模态模型(包括放射组学特征、病理组学特征和临床特征)进行比较。结果 放射性组学特征和病理组学特征对测试队列的 BCR 预测均有良好的表现(C 指数分别为 0.742 和 0.730)。多模态模型的预测性能最好,在测试集上的 C 指数为 0.860,明显高于所有单模态模型(所有 P 均小于 0.01)。结论 多模态模型可有效预测PCa患者RP术后的BCR,因此可为术后个体化治疗提供一个新兴的准确工具。关键词磁共振成像、泌尿系统、骨盆、比较研究 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Erratum for: The Era of ChatGPT and Large Language Models: Can We Advance Patient-centered Communications Appropriately and Safely? 勘误:ChatGPT 和大型语言模型时代:我们能否适当而安全地推进以患者为中心的交流?
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.249009
Wendy Tu, Bonnie N Joe
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引用次数: 0
Prognostic Value of Preoperative MRI-derived 3D Quantitative Tumor Arterial Burden in Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization. 接受经动脉化疗栓塞术的肝细胞癌患者术前磁共振成像衍生三维定量肿瘤动脉负担的预后价值
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.230167
Gang Peng, Xiao-Yu Huang, Ya-Nan Wang, Xiao-Jing Cao, Xiang Zhou

Purpose To investigate the association of tumor arterial burden (TAB) on preoperative MRI with transarterial chemoembolization refractoriness (TACER) and progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC). Materials and Methods This retrospective study included patients with HCC who underwent repeated transarterial chemoembolization (TACE) treatments between January 2013 and December 2020. HCC was confirmed with pathology or imaging, and patients with other tumors, lost follow-up, or with a combination of other treatments were excluded. TACER was defined as viable lesions of more than 50% or increase in tumor number after two or more consecutive TACE treatments, continuous elevation of tumor markers, extrahepatic spread, or vascular invasion. TAB assessed with preoperative MRI was divided into high and low groups according to the median. A Cox proportional hazards model was used to determine the predictors of TACER and PFS. Results A total of 355 patients (median age, 61 years [IQR, 54-67]; 306 [86.2%] men, 49 [13.8%] women) were included. During a median follow-up of 32.7 months, the high TAB group had significantly faster TACER and decreased PFS than the low TAB group (all log-rank P < .001). High TAB was the strongest independent predictor of TACER and PFS in multivariable Cox regression analyses (hazard ratio [HR], 2.23 [95% CI: 1.51, 3.29]; HR, 2.30 [95% CI: 1.61, 3.27], respectively), especially in patients with Barcelona Clinic Liver Cancer stage A or a single tumor. The restricted cubic spline plot demonstrated that the HR of TACER and PFS continuously increased with increasing TAB. Conclusion High preoperative TAB at MRI was a risk factor for faster refractoriness and progression in patients with HCC treated with TACE. Keywords: Interventional-Vascular, MR Angiography, Hepatocellular Carcinoma, Transarterial Chemoembolization, Progression-free Survival, MRI Supplemental material is available for this article. © RSNA, 2024.

目的 探讨肝细胞癌(HCC)患者术前磁共振成像显示的肿瘤动脉负担(TAB)与经动脉化疗栓塞难治性(TACER)和无进展生存期(PFS)的关系。材料与方法 这项回顾性研究纳入了在 2013 年 1 月至 2020 年 12 月期间接受过多次经动脉化疗栓塞(TACE)治疗的 HCC 患者。HCC经病理学或影像学证实,排除了患有其他肿瘤、失去随访或合并其他治疗的患者。TACER定义为连续两次或两次以上TACE治疗后,存活病灶超过50%或肿瘤数量增加、肿瘤标志物持续升高、肝外扩散或血管侵犯。术前 MRI 评估的 TAB 根据中位数分为高低两组。采用 Cox 比例危险模型确定 TACER 和 PFS 的预测因素。结果 共纳入 355 名患者(中位年龄 61 岁 [IQR,54-67];男性 306 [86.2%],女性 49 [13.8%])。在中位 32.7 个月的随访期间,高 TAB 组的 TACER 明显快于低 TAB 组,PFS 明显低于低 TAB 组(所有对数秩 P < .001)。在多变量考克斯回归分析中,高TAB是TACER和PFS的最强独立预测因子(危险比[HR]分别为2.23[95% CI:1.51, 3.29];HR分别为2.30[95% CI:1.61, 3.27]),尤其是在巴塞罗那临床肝癌A期或单发肿瘤患者中。限制性立方样条曲线图显示,随着 TAB 的增加,TACER 和 PFS 的 HR 不断增加。结论 MRI术前TAB高是导致接受TACE治疗的HCC患者耐药和病情进展更快的危险因素。关键词血管介入 MR 血管造影 肝细胞癌 经动脉化疗栓塞 无进展生存期 MRI 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Individual Participant Data Meta-Analyses for Diagnostic Accuracy Research: Challenges and Lessons Learned from the LI-RADS IPD Group. 用于诊断准确性研究的个体参与者数据元分析:LI-RADS IPD 小组的挑战和经验教训》。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.240015
Andreu F Costa, Matthew D F McInnes, Christian B van der Pol, Eric Lam, Haben Dawit, Jean-Paul Salameh, Brooke Levis, Mustafa R Bashir
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引用次数: 0
Advances in Tumor Management: Harnessing the Potential of Histotripsy. 肿瘤治疗的进展:发挥组织切削术的潜力。
IF 5.6 Q1 ONCOLOGY Pub Date : 2024-05-01 DOI: 10.1148/rycan.230159
Yash Verma, Arosh S Perera Molligoda Arachchige

Tissue ablation techniques have long been used in clinical settings to treat various oncologic diseases. However, many of these techniques are invasive and can cause substantial adverse effects. Histotripsy is a noninvasive, nonionizing, nonthermal tissue ablation technique that has the potential to replace surgical interventions in various clinical settings. Histotripsy works by delivering high-intensity focused ultrasound waves to target tissue. These waves create cavitation bubbles within tissues that rapidly expand and collapse, thereby mechanically fractionating the tissue into acellular debris that is subsequently absorbed by the body's immune system. Preclinical and clinical studies have demonstrated the efficacy of histotripsy in treating a range of diseases, including liver, pancreatic, renal, and prostate tumors. Safety outcomes of histotripsy have been generally favorable, with minimal adverse effects reported. However, further studies are needed to optimize the technique and understand its long-term effects. This review aims to discuss the importance of histotripsy as a noninvasive tissue ablation technique, the preclinical and clinical literature on histotripsy and its safety, and the potential applications of histotripsy in clinical practice. Keywords: Tumor Microenvironment, Ultrasound-High-Intensity Focused (HIFU), Ablation Techniques, Abdomen/GI, Genital/Reproductive, Nonthermal Tissue Ablation, Histotripsy, Clinical Trials, Preclinical Applications, Focused Ultrasound © RSNA, 2024.

组织消融技术长期以来一直被用于临床治疗各种肿瘤疾病。然而,其中许多技术都是侵入性的,并可能造成严重的不良影响。组织切削术是一种非侵入性、非电离、非热组织消融技术,有可能在各种临床环境中取代外科手术。组织切削术的工作原理是向目标组织输送高强度聚焦超声波。这些超声波会在组织内产生空化泡,空化泡会迅速膨胀和塌陷,从而将组织机械地分化成无细胞碎片,这些碎片随后会被人体免疫系统吸收。临床前和临床研究已经证明了组织切碎术在治疗肝脏、胰腺、肾脏和前列腺肿瘤等一系列疾病方面的疗效。组织切碎术的安全性总体良好,不良反应极少。然而,还需要进一步的研究来优化该技术并了解其长期效果。本综述旨在讨论组织切碎术作为一种无创组织消融技术的重要性、有关组织切碎术及其安全性的临床前和临床文献,以及组织切碎术在临床实践中的潜在应用。关键词肿瘤微环境 超声-高强度聚焦 (HIFU)、消融技术、腹部/消化道、生殖/生殖系统、非热组织消融、组织切削术、临床试验、临床前应用、聚焦超声 © RSNA, 2024.
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引用次数: 0
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Radiology. Imaging cancer
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