Katsutoshi Sugimoto, Fuminori Moriyasu, Marco Dioguardi Burgio, Valérie Vilgrain, Daniel Jesper, Deike Strobel, Valentin Blank, Thomas Karlas, Edward G Grant, Linda C Kelahan, Helena Gabriel, Byung Ihn Choi, Takashi Nishimura, Hiroko Iijima, Theodore J Dubinsky, Jing Gao, Dong Ho Lee, Jae Young Lee, Yanan Zhao, Pintong Huang, Jie Zeng, Adrian Lim, Xiaoyan Xie, Richard G Barr, Vito Cantisani, Giovanna Ferraioli, Kentaro Sakamaki, Takao Itoi, Masayoshi Kage, Hirohisa Yano
Background Attenuation coefficient (AC) and shear-wave speed (SWS) are established US markers for assessing patients with metabolic dysfunction-associated steatotic liver disease (MASLD), while shear-wave dispersion slope (DS) is not. Purpose To assess the relationship between the multiparametric US imaging markers DS, AC, and SWS and liver histopathologic necroinflammation in patients with MASLD. Materials and Methods This international multicenter prospective study enrolled consecutive patients with biopsy-proven MASLD between June 2019 and March 2023. Before biopsy, all participants underwent multiparametric US, and measurements of DS, AC, and SWS were obtained. Multivariable linear regression analyses were performed to assess the association of clinical variables and imaging markers with pathologic findings. The diagnostic performance of imaging markers for determining inflammation grade, steatosis grade, and fibrosis stage was assessed using the area under the receiver operating characteristic curve (AUC). Results A total of 124 participants (mean age, 53 years ± 15 [SD]; 62 males) were evaluated. In multivariable regression, lobular inflammation was associated with DS (regression coefficient, 0.06; P = .02), alanine aminotransferase level (regression coefficient, 0.002; P = .002), and Hispanic or Latino ethnicity (regression coefficient, -0.68; P = .047), while steatosis was associated with AC (regression coefficient, 3.66; P < .001) and fibrosis was associated with SWS (regression coefficient, 2.02; P < .001) and body mass index (regression coefficient, 0.05; P = .02). DS achieved an AUC of 0.72 (95% CI: 0.63, 0.82) for identifying participants with inflammation grade A2 or higher (moderate to severe inflammation). AC showed excellent performance for identifying participants with grade S1 (mild) or higher steatosis (AUC, 0.92 [95% CI: 0.87, 0.97]), while SWS showed excellent performance for identifying participants with fibrosis stage F2 or higher (clinically significant fibrosis) (AUC, 0.91 [95% CI: 0.86, 0.96]). Of the three US markers, SWS showed the highest AUC (0.81 [95% CI: 0.74, 0.89]) for the diagnosis of metabolic dysfunction-associated steatohepatitis. Conclusion Of the three US imaging markers (DS, AC, and SWS), DS was most associated with lobular inflammation grade at histologic examination and demonstrated fair diagnostic performance in distinguishing moderate to severe lobular inflammation. ClinicalTrials.gov Identifier: NCT04012242 Published under a CC BY 4.0 license. Supplemental material is available for this article. See also the editorial by Yin in this issue.
{"title":"US Markers and Necroinflammation, Steatosis, and Fibrosis in Metabolic Dysfunction-associated Steatotic Liver Disease: The iLEAD Study.","authors":"Katsutoshi Sugimoto, Fuminori Moriyasu, Marco Dioguardi Burgio, Valérie Vilgrain, Daniel Jesper, Deike Strobel, Valentin Blank, Thomas Karlas, Edward G Grant, Linda C Kelahan, Helena Gabriel, Byung Ihn Choi, Takashi Nishimura, Hiroko Iijima, Theodore J Dubinsky, Jing Gao, Dong Ho Lee, Jae Young Lee, Yanan Zhao, Pintong Huang, Jie Zeng, Adrian Lim, Xiaoyan Xie, Richard G Barr, Vito Cantisani, Giovanna Ferraioli, Kentaro Sakamaki, Takao Itoi, Masayoshi Kage, Hirohisa Yano","doi":"10.1148/radiol.233377","DOIUrl":"10.1148/radiol.233377","url":null,"abstract":"<p><p>Background Attenuation coefficient (AC) and shear-wave speed (SWS) are established US markers for assessing patients with metabolic dysfunction-associated steatotic liver disease (MASLD), while shear-wave dispersion slope (DS) is not. Purpose To assess the relationship between the multiparametric US imaging markers DS, AC, and SWS and liver histopathologic necroinflammation in patients with MASLD. Materials and Methods This international multicenter prospective study enrolled consecutive patients with biopsy-proven MASLD between June 2019 and March 2023. Before biopsy, all participants underwent multiparametric US, and measurements of DS, AC, and SWS were obtained. Multivariable linear regression analyses were performed to assess the association of clinical variables and imaging markers with pathologic findings. The diagnostic performance of imaging markers for determining inflammation grade, steatosis grade, and fibrosis stage was assessed using the area under the receiver operating characteristic curve (AUC). Results A total of 124 participants (mean age, 53 years ± 15 [SD]; 62 males) were evaluated. In multivariable regression, lobular inflammation was associated with DS (regression coefficient, 0.06; <i>P</i> = .02), alanine aminotransferase level (regression coefficient, 0.002; <i>P</i> = .002), and Hispanic or Latino ethnicity (regression coefficient, -0.68; <i>P</i> = .047), while steatosis was associated with AC (regression coefficient, 3.66; <i>P</i> < .001) and fibrosis was associated with SWS (regression coefficient, 2.02; <i>P</i> < .001) and body mass index (regression coefficient, 0.05; <i>P</i> = .02). DS achieved an AUC of 0.72 (95% CI: 0.63, 0.82) for identifying participants with inflammation grade A2 or higher (moderate to severe inflammation). AC showed excellent performance for identifying participants with grade S1 (mild) or higher steatosis (AUC, 0.92 [95% CI: 0.87, 0.97]), while SWS showed excellent performance for identifying participants with fibrosis stage F2 or higher (clinically significant fibrosis) (AUC, 0.91 [95% CI: 0.86, 0.96]). Of the three US markers, SWS showed the highest AUC (0.81 [95% CI: 0.74, 0.89]) for the diagnosis of metabolic dysfunction-associated steatohepatitis. Conclusion Of the three US imaging markers (DS, AC, and SWS), DS was most associated with lobular inflammation grade at histologic examination and demonstrated fair diagnostic performance in distinguishing moderate to severe lobular inflammation. ClinicalTrials.gov Identifier: NCT04012242 Published under a CC BY 4.0 license. <i>Supplemental material is available for this article.</i> See also the editorial by Yin in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gradualism: How Supplemental Breast Cancer Screening Will Become a Reality.","authors":"Thomas H Helbich, Panagiotis Kapetas","doi":"10.1148/radiol.241563","DOIUrl":"10.1148/radiol.241563","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Top 10 Tips for Writing an Outstanding Peer Review of an Original Research Article for <i>Radiology</i>.","authors":"Ariane R Panzer","doi":"10.1148/radiol.241208","DOIUrl":"10.1148/radiol.241208","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
History: A 65-year-old male patient with a history of sarcomatoid renal cell carcinoma and prior right nephrectomy developed recurrent disease adjacent to the inferior vena cava. The patient underwent surveillance imaging 7 months after initiation of treatment with maximum-dose pazopanib and less than 1 month after completing a 2-month regimen of palliative stereotactic body radiation therapy to the right nephrectomy bed and site of recurrence. (Stereotactic body radiation therapy was initiated 5 months after pazopanib treatment was initiated.) One month after initiating treatment with pazopanib and 6 months before the surveillance imaging, the patient developed diarrhea and required ongoing treatment with loperamide to control symptoms. He denied any fatigue, mouth sores, or extremity pain, but described some abdominal pain and discomfort associated with the diarrhea. He was not experiencing any fevers, and vital signs were normal. White blood cell count was normal at 5100/μL (5.1 ×109/L) (normal range, 4200-10 200/μL [4.2-10.2 ×109/L]), with all components of the differential count also being normal. A normal serum albumin level of 3.9 g/dL (39 g/L) (normal range, 3.5-5.0 g/dL [35-50 g/L]) and low serum total protein level of 6.1 g/dL (61 g/L) (normal range, 6.3-7.9 g/dL [63-79 g/L]) were noted. A comprehensive metabolic panel was performed, indicating a serum chloride level of 98 mmol/L (normal, 100-108 mmol/L) and alkaline phosphatase level of 121 U/L (2.02 μkat/L) (normal, 45-115 U/L [0.75-1.92 μkat/L]). The patient underwent surveillance imaging with contrast-enhanced CT of the abdomen and pelvis in the venous phase (Figure).
{"title":"Case 332.","authors":"Cameron Adler, Christine Menias","doi":"10.1148/radiol.232149","DOIUrl":"https://doi.org/10.1148/radiol.232149","url":null,"abstract":"<p><strong>History: </strong>A 65-year-old male patient with a history of sarcomatoid renal cell carcinoma and prior right nephrectomy developed recurrent disease adjacent to the inferior vena cava. The patient underwent surveillance imaging 7 months after initiation of treatment with maximum-dose pazopanib and less than 1 month after completing a 2-month regimen of palliative stereotactic body radiation therapy to the right nephrectomy bed and site of recurrence. (Stereotactic body radiation therapy was initiated 5 months after pazopanib treatment was initiated.) One month after initiating treatment with pazopanib and 6 months before the surveillance imaging, the patient developed diarrhea and required ongoing treatment with loperamide to control symptoms. He denied any fatigue, mouth sores, or extremity pain, but described some abdominal pain and discomfort associated with the diarrhea. He was not experiencing any fevers, and vital signs were normal. White blood cell count was normal at 5100/μL (5.1 ×10<sup>9</sup>/L) (normal range, 4200-10 200/μL [4.2-10.2 ×10<sup>9</sup>/L]), with all components of the differential count also being normal. A normal serum albumin level of 3.9 g/dL (39 g/L) (normal range, 3.5-5.0 g/dL [35-50 g/L]) and low serum total protein level of 6.1 g/dL (61 g/L) (normal range, 6.3-7.9 g/dL [63-79 g/L]) were noted. A comprehensive metabolic panel was performed, indicating a serum chloride level of 98 mmol/L (normal, 100-108 mmol/L) and alkaline phosphatase level of 121 U/L (2.02 μkat/L) (normal, 45-115 U/L [0.75-1.92 μkat/L]). The patient underwent surveillance imaging with contrast-enhanced CT of the abdomen and pelvis in the venous phase (Figure).</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reporting and Data System for Musculoskeletal Infections: Could This Bring Musculoskeletal Radiology Up to Date?","authors":"Mark E Schweitzer","doi":"10.1148/radiol.241775","DOIUrl":"10.1148/radiol.241775","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"AI-powered Diagnostics: Transforming Prostate Cancer Diagnosis with MRI.","authors":"Patricia M Johnson, Hersh Chandarana","doi":"10.1148/radiol.241009","DOIUrl":"10.1148/radiol.241009","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"AI-Enhanced CTA and Histology: Advancing Aortic Stenosis Diagnosis With Tissue Characterization.","authors":"Ana G Almeida","doi":"10.1148/radiol.241642","DOIUrl":"10.1148/radiol.241642","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenhui Zhou, Benjamin L Franc, Wendy B DeMartini, Eric L Rosen
Two complementary patient cases are presented to highlight the importance of estrogen receptor (ER)-targeting imaging in treatment planning and selection for endocrine therapy in breast cancer patients. This article will discuss the radiopharmaceuticals and biology, imaging interpretation, and current clinical applications of ER-targeting imaging using fluorine 18 fluoroestradiol PET.
本文介绍了两个互补病例,以突出雌激素受体(ER)靶向成像在乳腺癌患者治疗计划和内分泌治疗选择中的重要性。本文将讨论使用氟 18 氟雌二醇 PET 进行雌激素受体靶向成像的放射性药物和生物学、成像解读和当前的临床应用。
{"title":"Estrogen Receptor-targeted PET Imaging for Breast Cancer.","authors":"Wenhui Zhou, Benjamin L Franc, Wendy B DeMartini, Eric L Rosen","doi":"10.1148/radiol.240315","DOIUrl":"10.1148/radiol.240315","url":null,"abstract":"<p><p>Two complementary patient cases are presented to highlight the importance of estrogen receptor (ER)-targeting imaging in treatment planning and selection for endocrine therapy in breast cancer patients. This article will discuss the radiopharmaceuticals and biology, imaging interpretation, and current clinical applications of ER-targeting imaging using fluorine 18 fluoroestradiol PET.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":null,"pages":null},"PeriodicalIF":12.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}