Najim el Khababi, R. Beets-Tan, L. Curvo-Semedo, R. Tissier, J. Nederend, M. Lahaye, M. Maas, G. Beets, D. Lambregts
Objectives: To investigate uniformity and pitfalls in structured radiological staging of rectal cancer. Methods: Twenty-one radiologists (12 countries) staged 75 rectal cancers on MRI using a structured reporting template. Interobserver agreement (IOA) was calculated as the percentage agreement between readers (categorical variables) and Krippendorff’s α (continuous variables). Agreement with an expert consensus served as a surrogate standard of reference to estimate diagnostic accuracy. Polychoric correlation coefficients were used to assess correlations between diagnostic confidence and accuracy (=agreement with expert consensus). Results: Uniformity to diagnose high-risk (≥cT3 ab) versus low-risk (≤cT3 cd) cT-stage, cN0 versus cN+, lateral nodes and tumour deposits, MRF and sphincter involvement, and solid versus mucinous tumours was high with IOA > 80% in the majority of cases (and >80% agreement with expert consensus). Results for assessing extramural vascular invasion, cT-stage (cT1-2/cT3/cT4a/cT4b), cN-stage (cN0/N1/N2), relation to the peritoneal reflection, extent of sphincter involvement (internal/intersphincteric/external) and morphology (solid/annular/semi-annular) were considerably poorer. IOA was high (α = 0.72–0.84) for tumour height/length and extramural invasion depth, but low for tumour-MRF distance and number of (suspicious) nodes (α = 0.05–0.55). There was a significant positive correlation between diagnostic confidence and accuracy (=agreement with expert consensus) (p < 0.001-p = 0.003). Conclusions: - Several staging items lacked sufficient reproducibility. - Results for cT- and N-staging g improved when using a dichotomized stratification. - Considering the significant correlation between diagnostic confidence and accuracy, a confidence level may be incorporated into structured reporting for specific items with low reproducibility. Advances in knowledge: Although structured reporting aims to achieve uniformity in reporting, several items lack sufficient reproducibility and might benefit from dichotomized assessment and incorporating confidence levels.
{"title":"Pearls and pitfalls of structured staging and reporting of rectal cancer on MRI: an international multireader study","authors":"Najim el Khababi, R. Beets-Tan, L. Curvo-Semedo, R. Tissier, J. Nederend, M. Lahaye, M. Maas, G. Beets, D. Lambregts","doi":"10.1259/bjr.20230091","DOIUrl":"https://doi.org/10.1259/bjr.20230091","url":null,"abstract":"Objectives: To investigate uniformity and pitfalls in structured radiological staging of rectal cancer. Methods: Twenty-one radiologists (12 countries) staged 75 rectal cancers on MRI using a structured reporting template. Interobserver agreement (IOA) was calculated as the percentage agreement between readers (categorical variables) and Krippendorff’s α (continuous variables). Agreement with an expert consensus served as a surrogate standard of reference to estimate diagnostic accuracy. Polychoric correlation coefficients were used to assess correlations between diagnostic confidence and accuracy (=agreement with expert consensus). Results: Uniformity to diagnose high-risk (≥cT3 ab) versus low-risk (≤cT3 cd) cT-stage, cN0 versus cN+, lateral nodes and tumour deposits, MRF and sphincter involvement, and solid versus mucinous tumours was high with IOA > 80% in the majority of cases (and >80% agreement with expert consensus). Results for assessing extramural vascular invasion, cT-stage (cT1-2/cT3/cT4a/cT4b), cN-stage (cN0/N1/N2), relation to the peritoneal reflection, extent of sphincter involvement (internal/intersphincteric/external) and morphology (solid/annular/semi-annular) were considerably poorer. IOA was high (α = 0.72–0.84) for tumour height/length and extramural invasion depth, but low for tumour-MRF distance and number of (suspicious) nodes (α = 0.05–0.55). There was a significant positive correlation between diagnostic confidence and accuracy (=agreement with expert consensus) (p < 0.001-p = 0.003). Conclusions: - Several staging items lacked sufficient reproducibility. - Results for cT- and N-staging g improved when using a dichotomized stratification. - Considering the significant correlation between diagnostic confidence and accuracy, a confidence level may be incorporated into structured reporting for specific items with low reproducibility. Advances in knowledge: Although structured reporting aims to achieve uniformity in reporting, several items lack sufficient reproducibility and might benefit from dichotomized assessment and incorporating confidence levels.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129303066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-23DOI: 10.37766/inplasy2023.5.0088
Haofeng Chen, Xinyue Huang, Yifang Bao, Chongbo Zhao, Jie Lin
OBJECTIVESThe purpose of this study was to evaluate the diagnostic value of quantitative magnetic resonance neurography (MRN) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We also compared various MRN parameters and determined the best performing one.METHODSThrough literature searches in PubMed, Embase, Cochrane, Ovid MEDLINE and ClinicalTtrials.gov until March 1, 2023, we selected studies with the diagnostic performance of MRN in CIDP patients. The pooled estimated sensitivity and specificity of quantitative MRN parameters were determined by a bivariate random-effects model. Subgroup analysis was performed to evaluate the proper quantitative parameters and nerve sites.RESULTSA total of 14 quantitative MRN studies with 23 results gave a pooled sensitivity of 0.73 (95% CI 0.66-0.79) and a pooled specificity of 0.89 (95% CI 0.84-0.92). The area under the curve (AUC) was 0.89 (95%CI 0.86-0.92). Subgroup analysis of quantitative parameters showed the fractional anisotropy (FA) with the highest sensitivity of 0.85 (95% CI 0.77-0.90) and cross-sectional area (CSA) with the highest specificity of 0.95 (95% CI 0.85-0.99). The pooled correlation coefficient for interobserver agreements was 0.90 (95%CI 0.82-0.95).CONCLUSIONQuantitative MRN has considerable diagnostic value in CIDP patients with accuracy and reliability. FA and CSA can be promising parameters in the future diagnosis of CIDP patients.ADVANCES IN KNOWLEDGEThis is the first meta-analysis of quantitative MRN in the diagnosis of CIDP.We have selected reliable parameters with cut-off value and providednew insights for subsequent diagnosis of CIDP.
目的探讨定量磁共振神经造影(MRN)对慢性炎症性脱髓鞘性多根神经病变(CIDP)的诊断价值。我们还比较了各种MRN参数，并确定了表现最好的一个。方法通过PubMed、Embase、Cochrane、Ovid MEDLINE和clinicaltrials .gov等截止到2023年3月1日的文献检索，选择MRN对CIDP患者有诊断作用的研究。定量MRN参数的综合估计灵敏度和特异性由双变量随机效应模型确定。进行亚组分析以评估合适的定量参数和神经部位。结果共14项定量MRN研究，23项结果，合并敏感性为0.73 (95% CI 0.66-0.79)，合并特异性为0.89 (95% CI 0.84-0.92)。曲线下面积(AUC)为0.89 (95%CI 0.86 ~ 0.92)。定量参数亚组分析显示，分数各向异性(FA)的灵敏度最高为0.85 (95% CI 0.77 ~ 0.90)，横截面积(CSA)的特异性最高为0.95 (95% CI 0.85 ~ 0.99)。观察者间一致性的合并相关系数为0.90 (95%CI 0.82-0.95)。结论定量MRN对CIDP患者的诊断具有较高的准确性和可靠性。FA和CSA可以作为未来诊断CIDP患者的有希望的参数。这是第一次对定量mri诊断CIDP的荟萃分析。我们选择了具有截止值的可靠参数，为CIDP的后续诊断提供了新的见解。
{"title":"The diagnostic value of quantitative assessment of MR neurography in chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review and meta-analysis.","authors":"Haofeng Chen, Xinyue Huang, Yifang Bao, Chongbo Zhao, Jie Lin","doi":"10.37766/inplasy2023.5.0088","DOIUrl":"https://doi.org/10.37766/inplasy2023.5.0088","url":null,"abstract":"OBJECTIVES\u0000The purpose of this study was to evaluate the diagnostic value of quantitative magnetic resonance neurography (MRN) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We also compared various MRN parameters and determined the best performing one.\u0000\u0000\u0000METHODS\u0000Through literature searches in PubMed, Embase, Cochrane, Ovid MEDLINE and ClinicalTtrials.gov until March 1, 2023, we selected studies with the diagnostic performance of MRN in CIDP patients. The pooled estimated sensitivity and specificity of quantitative MRN parameters were determined by a bivariate random-effects model. Subgroup analysis was performed to evaluate the proper quantitative parameters and nerve sites.\u0000\u0000\u0000RESULTS\u0000A total of 14 quantitative MRN studies with 23 results gave a pooled sensitivity of 0.73 (95% CI 0.66-0.79) and a pooled specificity of 0.89 (95% CI 0.84-0.92). The area under the curve (AUC) was 0.89 (95%CI 0.86-0.92). Subgroup analysis of quantitative parameters showed the fractional anisotropy (FA) with the highest sensitivity of 0.85 (95% CI 0.77-0.90) and cross-sectional area (CSA) with the highest specificity of 0.95 (95% CI 0.85-0.99). The pooled correlation coefficient for interobserver agreements was 0.90 (95%CI 0.82-0.95).\u0000\u0000\u0000CONCLUSION\u0000Quantitative MRN has considerable diagnostic value in CIDP patients with accuracy and reliability. FA and CSA can be promising parameters in the future diagnosis of CIDP patients.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000This is the first meta-analysis of quantitative MRN in the diagnosis of CIDP.We have selected reliable parameters with cut-off value and providednew insights for subsequent diagnosis of CIDP.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121996062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Jenkins, A. MacCormick, J. Zhong, G. Makris, N. Gafoor, David Chan
Objective: This analysis of the MACAFI (multicentre audit of cholecystostomy and further interventions) data aims to assess the procedural technique and technical specifications related to percutaneous cholecystostomy (PC) insertion in patients with acute calculous cholecystitis (ACC). PC can be performed either with transperitoneal (TP) or a transhepatic (TH) approach. There is no clear evidence for the superiority of either technique. Methods: The data set included patients who underwent PC for ACC between first January 2019 and first January 2021. Data included patient demographics, imaging diagnosis, insertion technique, tube size, and outcomes including 6 month follow-up. Results: 1186 patients from 36 sites were identified through the MACAFI study with 913 patients having access route recorded. A transhepatic route was used in 572 [62.6%] compared to 308 TP [33.7%]. There was an increased rate of bleeding when using the TH route (2.6% vs 0.3%, p = 0.01) although other post-procedural complications (such as bile leak) were similar between the two groups. No significant difference was demonstrated in 30- or 90-day mortality (TH vs TP, 8.7vs 9.3%, p = 0.86 and 13.8vs 15.4%, p = 0.58, respectively). The readmission rate with recurrent cholecystitis was significantly greater in those with TH compared to TP approach (22.0% vs 14.9%, p = 0.01, respectively). Conclusion: The TP PC approach may be safer than TH, with lower bleeding complication rate and fewer readmissions. Advances in knowledge: A transperitoneal approach for cholecystostomy was associated with lower bleeding complication rate and lower rate of readmissions with recurrent cholecystitis compared to the transhepatic approach.
目的:本研究对MACAFI(多中心审计胆囊造口及进一步干预)数据进行分析，旨在评估急性结石性胆囊炎(ACC)患者经皮胆囊造口术(PC)插入的手术技术和技术规范。PC可以通过经腹腔(TP)或经肝(TH)入路进行。没有明确的证据证明这两种技术的优越性。方法:数据集包括2019年1月1日至2021年1月1日期间因ACC接受PC治疗的患者。数据包括患者人口统计学、影像学诊断、插入技术、管大小和包括6个月随访在内的结果。结果:通过MACAFI研究确定了来自36个地点的1186例患者，记录了913例患者的通路。572例(62.6%)采用经肝途径，308例(33.7%)采用经肝途径。使用TH路径时出血率增加(2.6% vs 0.3%， p = 0.01)，尽管其他术后并发症(如胆汁泄漏)在两组之间相似。30天或90天死亡率无显著差异(TH vs TP, 8.7vs 9.3%， p = 0.86; 13.8vs 15.4%， p = 0.58)。与TP入路相比，经TH入路复发胆囊炎的再入院率显著高于经TP入路(22.0% vs 14.9%， p = 0.01)。结论:TP - PC入路较TH入路安全，出血并发症发生率低，再入院率低。知识进展:与经肝入路相比，经腹膜入路胆囊造瘘术出血并发症发生率低，复发性胆囊炎再入院率低。
{"title":"Transhepatic or transperitoneal technique for cholecystostomy: results of the multicentre retrospective audit of cholecystostomy and further interventions (MACAFI)","authors":"P. Jenkins, A. MacCormick, J. Zhong, G. Makris, N. Gafoor, David Chan","doi":"10.1259/bjr.20220279","DOIUrl":"https://doi.org/10.1259/bjr.20220279","url":null,"abstract":"Objective: This analysis of the MACAFI (multicentre audit of cholecystostomy and further interventions) data aims to assess the procedural technique and technical specifications related to percutaneous cholecystostomy (PC) insertion in patients with acute calculous cholecystitis (ACC). PC can be performed either with transperitoneal (TP) or a transhepatic (TH) approach. There is no clear evidence for the superiority of either technique. Methods: The data set included patients who underwent PC for ACC between first January 2019 and first January 2021. Data included patient demographics, imaging diagnosis, insertion technique, tube size, and outcomes including 6 month follow-up. Results: 1186 patients from 36 sites were identified through the MACAFI study with 913 patients having access route recorded. A transhepatic route was used in 572 [62.6%] compared to 308 TP [33.7%]. There was an increased rate of bleeding when using the TH route (2.6% vs 0.3%, p = 0.01) although other post-procedural complications (such as bile leak) were similar between the two groups. No significant difference was demonstrated in 30- or 90-day mortality (TH vs TP, 8.7vs 9.3%, p = 0.86 and 13.8vs 15.4%, p = 0.58, respectively). The readmission rate with recurrent cholecystitis was significantly greater in those with TH compared to TP approach (22.0% vs 14.9%, p = 0.01, respectively). Conclusion: The TP PC approach may be safer than TH, with lower bleeding complication rate and fewer readmissions. Advances in knowledge: A transperitoneal approach for cholecystostomy was associated with lower bleeding complication rate and lower rate of readmissions with recurrent cholecystitis compared to the transhepatic approach.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"129 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128340328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Martí-Bonmatí, L. Cerdà-Alberich, Alexandre Pérez-Enguix, R. Díaz Beveridge, E. M. Montalvá Orón, J. Pérez Rojas, Á. Alberich-Bayarri
Patients with pancreatic ductal adenocarcinoma (PDAC) are generally classified into four categories based on contrast-enhanced CT at diagnosis: resectable, borderline resectable, unresectable, and metastatic disease. In the initial grading and staging of PDAC, structured radiological templates are useful but limited, as there is a need to define the aggressiveness and microscopic disease stage of these tumours to ensure adequate treatment allocation. Quantitative imaging analysis allows radiomics and dynamic imaging features to provide information of clinical outcomes, and to construct clinical models based on radiomics signatures or imaging phenotypes. These quantitative features may be used as prognostic and predictive biomarkers in clinical decision making, enabling personalized management of advanced PDAC. Deep Learning and Convolutional Neural Networks also provide high level bioinformatics tools that can help define features associated with a given aspect of PDAC biology and aggressiveness, paving the way to define outcomes based on these features. Thus, the prediction of tumour phenotype, treatment response and patient prognosis may be feasible by using such comprehensive and integrated radiomics models. Despite these promising results, quantitative imaging is not ready for clinical implementation in PDAC. Limitations include the instability of metrics and lack of external validation. Large properly annotated datasets, including relevant semantic features (demographics, blood markers, genomics), image harmonization, robust radiomics analysis, clinically significant tasks as outputs, comparisons with gold standards (such as TNM or pretreatment classifications) and fully independent validation cohorts, will be required for the development of trustworthy radiomics and Artificial Intelligence solutions to predict PDAC aggressiveness in a clinical setting.
{"title":"Pancreatic cancer, Radiomics and Artificial Intelligence: A Review.","authors":"L. Martí-Bonmatí, L. Cerdà-Alberich, Alexandre Pérez-Enguix, R. Díaz Beveridge, E. M. Montalvá Orón, J. Pérez Rojas, Á. Alberich-Bayarri","doi":"10.1259/bjr.20220072","DOIUrl":"https://doi.org/10.1259/bjr.20220072","url":null,"abstract":"Patients with pancreatic ductal adenocarcinoma (PDAC) are generally classified into four categories based on contrast-enhanced CT at diagnosis: resectable, borderline resectable, unresectable, and metastatic disease. In the initial grading and staging of PDAC, structured radiological templates are useful but limited, as there is a need to define the aggressiveness and microscopic disease stage of these tumours to ensure adequate treatment allocation. Quantitative imaging analysis allows radiomics and dynamic imaging features to provide information of clinical outcomes, and to construct clinical models based on radiomics signatures or imaging phenotypes. These quantitative features may be used as prognostic and predictive biomarkers in clinical decision making, enabling personalized management of advanced PDAC. Deep Learning and Convolutional Neural Networks also provide high level bioinformatics tools that can help define features associated with a given aspect of PDAC biology and aggressiveness, paving the way to define outcomes based on these features. Thus, the prediction of tumour phenotype, treatment response and patient prognosis may be feasible by using such comprehensive and integrated radiomics models. Despite these promising results, quantitative imaging is not ready for clinical implementation in PDAC. Limitations include the instability of metrics and lack of external validation. Large properly annotated datasets, including relevant semantic features (demographics, blood markers, genomics), image harmonization, robust radiomics analysis, clinically significant tasks as outputs, comparisons with gold standards (such as TNM or pretreatment classifications) and fully independent validation cohorts, will be required for the development of trustworthy radiomics and Artificial Intelligence solutions to predict PDAC aggressiveness in a clinical setting.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"163 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126281000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radiological investigations are essential in the management of oesophageal and gastro-oesophageal junction cancers. The current multi modal combination of computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography combined with CT (PET/CT) and endoscopic ultrasound (EUS) has limitations, which hinders the prognostic and predictive information that can be used to guide optimum treatment decisions. Therefore, the development of improved imaging techniques is vital to improve patient management. This review describes the current evidence for state-of-the-art imaging techniques in oesophago-gastric cancer including high resolution magnetic resonance imaging (MRI), diffusion-weighted MRI, dynamic contrast-enhanced MRI, whole-body MRI, perfusion CT, novel PET tracers, and integrated PET/MRI. These novel imaging techniques may help clinicians improve the diagnosis, staging, treatment planning, and response assessment of oesophago-gastric cancer.
{"title":"State-of-the-art imaging in oesophago-gastric cancer.","authors":"S. Withey, V. Goh, K. Foley","doi":"10.1259/bjr.20220410","DOIUrl":"https://doi.org/10.1259/bjr.20220410","url":null,"abstract":"Radiological investigations are essential in the management of oesophageal and gastro-oesophageal junction cancers. The current multi modal combination of computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography combined with CT (PET/CT) and endoscopic ultrasound (EUS) has limitations, which hinders the prognostic and predictive information that can be used to guide optimum treatment decisions. Therefore, the development of improved imaging techniques is vital to improve patient management. This review describes the current evidence for state-of-the-art imaging techniques in oesophago-gastric cancer including high resolution magnetic resonance imaging (MRI), diffusion-weighted MRI, dynamic contrast-enhanced MRI, whole-body MRI, perfusion CT, novel PET tracers, and integrated PET/MRI. These novel imaging techniques may help clinicians improve the diagnosis, staging, treatment planning, and response assessment of oesophago-gastric cancer.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128352401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Azadikhah, B. Varghese, X. Lei, Chloe Martin-King, S. Cen, V. Duddalwar
OBJECTIVETo perform a systematic assessment and analyze the quality of radiomics methodology in current literature in the evaluation of renal masses using the Radiomics Quality Score (RQS) approach.METHODSWe systematically reviewed recent radiomics literature in renal masses published in PubMed, EMBASE, Elsevier, and Web of Science. Two reviewers blinded by each other's scores evaluated the quality of radiomics methodology in studies published from 2015 to August 2021 using the RQS approach. Owing to the diversity in the imaging modalities and radiomics applications a meta-analysis could not be performed.RESULTSBased on our inclusion/exclusion criteria, a total of 87 published studies were included in our study. The highest RQS was noted in three categories: reporting of clinical utility, gold standard, and feature reduction. The average RQS of the two reviewers ranged from 5 ≤ RQS≤19, with the maximum attainable RQS being 36. Very few (7/87 i.e., 8%) studies received an average RQS that ranged from 17 < RQS≤19, which represents studies with the highest RQS in our study. Many (39/87 i.e., 45%) studies received an average RQS that ranged from 13 < RQS≤15. No significant inter reviewer scoring differences were observed.CONCLUSIONSWe report that the overall scientific quality and reporting of radiomics studies in renal masses is suboptimal, and subsequent studies should bolster current deficiencies to improve reporting of radiomics methodologies.ADVANCES IN KNOWLEDGEThe RQS approach is a meaningful quantitative scoring system to assess radiomics methodology quality and supports a comprehensive evaluation of the radiomics approach before its incorporation into clinical practice.
目的对现有文献中采用放射组学质量评分(RQS)评价肾肿块的放射组学方法进行系统评价和分析。方法我们系统地回顾了最近在PubMed、EMBASE、Elsevier和Web of Science上发表的有关肾脏肿块的放射组学文献。在2015年至2021年8月期间发表的研究中，两名审稿人使用RQS方法评估了放射组学方法的质量。由于成像方式和放射组学应用的多样性，不能进行荟萃分析。结果根据我们的纳入/排除标准，共有87篇已发表的研究被纳入我们的研究。最高RQS在三个类别中被注意到:临床效用报告、金标准和特征减少。两位审稿人的平均RQS为5≤RQS≤19，最高可达RQS为36。很少有研究(7/87，即8%)的平均RQS在17 < RQS≤19之间，这是我们研究中RQS最高的研究。许多研究(39/87，即45%)的平均RQS在13 < RQS≤15之间。审稿人之间的评分没有显著差异。结论:肾包块放射组学研究的总体科学质量和报告不理想，后续研究应弥补目前的不足，以改善放射组学方法的报告。RQS方法是一种有意义的定量评分系统，用于评估放射组学方法的质量，并支持在放射组学方法纳入临床实践之前对其进行全面评估。
{"title":"Radiomics quality score in renal masses: a systematic assessment on current literature.","authors":"A. Azadikhah, B. Varghese, X. Lei, Chloe Martin-King, S. Cen, V. Duddalwar","doi":"10.1259/bjr.20211211","DOIUrl":"https://doi.org/10.1259/bjr.20211211","url":null,"abstract":"OBJECTIVE\u0000To perform a systematic assessment and analyze the quality of radiomics methodology in current literature in the evaluation of renal masses using the Radiomics Quality Score (RQS) approach.\u0000\u0000\u0000METHODS\u0000We systematically reviewed recent radiomics literature in renal masses published in PubMed, EMBASE, Elsevier, and Web of Science. Two reviewers blinded by each other's scores evaluated the quality of radiomics methodology in studies published from 2015 to August 2021 using the RQS approach. Owing to the diversity in the imaging modalities and radiomics applications a meta-analysis could not be performed.\u0000\u0000\u0000RESULTS\u0000Based on our inclusion/exclusion criteria, a total of 87 published studies were included in our study. The highest RQS was noted in three categories: reporting of clinical utility, gold standard, and feature reduction. The average RQS of the two reviewers ranged from 5 ≤ RQS≤19, with the maximum attainable RQS being 36. Very few (7/87 i.e., 8%) studies received an average RQS that ranged from 17 < RQS≤19, which represents studies with the highest RQS in our study. Many (39/87 i.e., 45%) studies received an average RQS that ranged from 13 < RQS≤15. No significant inter reviewer scoring differences were observed.\u0000\u0000\u0000CONCLUSIONS\u0000We report that the overall scientific quality and reporting of radiomics studies in renal masses is suboptimal, and subsequent studies should bolster current deficiencies to improve reporting of radiomics methodologies.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000The RQS approach is a meaningful quantitative scoring system to assess radiomics methodology quality and supports a comprehensive evaluation of the radiomics approach before its incorporation into clinical practice.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114684180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal hydatid is an uncommon finding, reported in less than 5% patients with hydatid infection. Hydatid involvement of ureter and urinary bladder is an even rarer entity. Renal hydatid is typically unilateral, solitary and arise from cortex. It is essential to be aware of the imaging features of the hydatid cyst for proper diagnosis. Knowledge of the imaging features of various stages is essential since treatment decision is based on cyst stage. Hydatid cyst can mimic several entities both benign and malignant. We present a pictorial review to illustrate the radiological imaging features of hydatid disease involving kidney, ureter and bladder region and its complications.
{"title":"Imaging of hydatid cyst of kidney, Ureter and Urinary Bladder: A pictorial review.","authors":"Shivani Gupta, C. Das","doi":"10.1259/bjr.20211373","DOIUrl":"https://doi.org/10.1259/bjr.20211373","url":null,"abstract":"Renal hydatid is an uncommon finding, reported in less than 5% patients with hydatid infection. Hydatid involvement of ureter and urinary bladder is an even rarer entity. Renal hydatid is typically unilateral, solitary and arise from cortex. It is essential to be aware of the imaging features of the hydatid cyst for proper diagnosis. Knowledge of the imaging features of various stages is essential since treatment decision is based on cyst stage. Hydatid cyst can mimic several entities both benign and malignant. We present a pictorial review to illustrate the radiological imaging features of hydatid disease involving kidney, ureter and bladder region and its complications.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132963048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Houlihan, G. Workman, A. Hounsell, K. Prise, S. Jain
Brachytherapy is an effective treatment in the curative management of prostate and gynaecological cancers. With advances in technology, brachytherapy has increased in complexity in recent years. Human error, equipment malfunction, patient organ motion and radioactive source displacement can result in substantial deviation of delivered dose from planned dose. To limit adverse clinical outcomes, adequate steps to improve the robustness of pathway processes, ensure the implementation of appropriate treatment margins and confirm the delivered dose must be considered. In vivo brachytherapy is one such method of dose validation which, if implemented appropriately within clinical practice, is an attractive technique for reducing dosimetric uncertainties and identifying potential errors. This review aims to describe the dosimetric uncertainties and potential errors associated with brachytherapy, the potential for in vivo dosimetry in adaptive brachytherapy as a key method of dose validation, and the clinical considerations and future directions of in vivo dosimetry. Advances in knowledge This paper describes the potential role for in vivo dosimetry in the reduction of uncertainties in pelvic brachytherapy, the pertinent factors for consideration in clinical practice, and the future potential for in vivo dosimetry in the personalisation of brachytherapy.
{"title":"In vivo dosimetry in pelvic brachytherapy.","authors":"O. Houlihan, G. Workman, A. Hounsell, K. Prise, S. Jain","doi":"10.1259/bjr.20220046","DOIUrl":"https://doi.org/10.1259/bjr.20220046","url":null,"abstract":"Brachytherapy is an effective treatment in the curative management of prostate and gynaecological cancers. With advances in technology, brachytherapy has increased in complexity in recent years. Human error, equipment malfunction, patient organ motion and radioactive source displacement can result in substantial deviation of delivered dose from planned dose. To limit adverse clinical outcomes, adequate steps to improve the robustness of pathway processes, ensure the implementation of appropriate treatment margins and confirm the delivered dose must be considered. In vivo brachytherapy is one such method of dose validation which, if implemented appropriately within clinical practice, is an attractive technique for reducing dosimetric uncertainties and identifying potential errors. This review aims to describe the dosimetric uncertainties and potential errors associated with brachytherapy, the potential for in vivo dosimetry in adaptive brachytherapy as a key method of dose validation, and the clinical considerations and future directions of in vivo dosimetry. Advances in knowledge This paper describes the potential role for in vivo dosimetry in the reduction of uncertainties in pelvic brachytherapy, the pertinent factors for consideration in clinical practice, and the future potential for in vivo dosimetry in the personalisation of brachytherapy.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"168 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124680657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Benson, J. Rodgers, C. Nelder, A. Clough, E. Pitt, J. Parker, L. Whiteside, L. Davies, Rachael Bailey, J. McMahon, H. Kolbe, A. Cree, M. Dubec, M. V. van Herk, A. Choudhury, P. Hoskin, C. Eccles
OBJECTIVESAccurate image registration is vital in cervical cancer where changes in both planning target volume (PTV) and organs at risk (OAR) can make decisions regarding image registration complicated. This work aims to determine the impact of a dedicated educational tool compared with experience gained in MR guided radiotherapy (MRgRT).METHODSTen therapeutic radiographers acted as observers and were split into two groups based on previous experience with MRgRT and Monaco treatment planning system. Three CBCT- CT, three MR-CT and two MR-MR registrations were completed per patient by each observer. Observers recorded translations, time to complete image registration and confidence. Data was collected in two phases; prior to and following the introduction of a cervix registration guide.RESULTSNo statistically significant differences were noted between imaging modalities. Each group was assessed independently pre and post education, no statistically significant differences were noted in either CBCT-CT or MR-CT imaging. Group one MR-MR imaging showed a statistically significant reduction in inter-observer variability (p=0.04), in group two, the result was not statistically significant (p=0.06). Statistically significant increases in confidence were seen in all three modalities (p≤0.05).CONCLUSIONSAt our institution radiographers consistently registered images across three different imaging modalities regardless of their previous experience. The implementation of an image registration guide had limited impact on inter and intra-observer variability. Radiographers' confidence showed statistically significant improvements following the use of the registration manual.ADVANCES IN KNOWLEDGEThis work helps evaluate training methods for novel roles that are developing in MRgRT.
{"title":"The impact of an educational tool in cervix image registration across three imaging modalities.","authors":"R. Benson, J. Rodgers, C. Nelder, A. Clough, E. Pitt, J. Parker, L. Whiteside, L. Davies, Rachael Bailey, J. McMahon, H. Kolbe, A. Cree, M. Dubec, M. V. van Herk, A. Choudhury, P. Hoskin, C. Eccles","doi":"10.1259/bjr.20211402","DOIUrl":"https://doi.org/10.1259/bjr.20211402","url":null,"abstract":"OBJECTIVES\u0000Accurate image registration is vital in cervical cancer where changes in both planning target volume (PTV) and organs at risk (OAR) can make decisions regarding image registration complicated. This work aims to determine the impact of a dedicated educational tool compared with experience gained in MR guided radiotherapy (MRgRT).\u0000\u0000\u0000METHODS\u0000Ten therapeutic radiographers acted as observers and were split into two groups based on previous experience with MRgRT and Monaco treatment planning system. Three CBCT- CT, three MR-CT and two MR-MR registrations were completed per patient by each observer. Observers recorded translations, time to complete image registration and confidence. Data was collected in two phases; prior to and following the introduction of a cervix registration guide.\u0000\u0000\u0000RESULTS\u0000No statistically significant differences were noted between imaging modalities. Each group was assessed independently pre and post education, no statistically significant differences were noted in either CBCT-CT or MR-CT imaging. Group one MR-MR imaging showed a statistically significant reduction in inter-observer variability (p=0.04), in group two, the result was not statistically significant (p=0.06). Statistically significant increases in confidence were seen in all three modalities (p≤0.05).\u0000\u0000\u0000CONCLUSIONS\u0000At our institution radiographers consistently registered images across three different imaging modalities regardless of their previous experience. The implementation of an image registration guide had limited impact on inter and intra-observer variability. Radiographers' confidence showed statistically significant improvements following the use of the registration manual.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000This work helps evaluate training methods for novel roles that are developing in MRgRT.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124700027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVEThe present systematic review and meta-analysis compared the diagnostic performance of F-18 fluorodeoxyglucose positron emission tomography (F-18FDG PET) and conventional imaging, including magnetic resonance imaging, echocardiography, and computed tomography, in characterising cardiac masses.METHODSA literature search of the PubMed, Cochrane, and EMBASE databases for studies comparing the diagnostic accuracies of F-18 FDG PET and conventional imaging in characterising cardiac masses, from inception of indexing to July 31, 2020, was performed. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality. Sensitivity and specificity across the studies were determined, positive and negative likelihood ratios (LR + and LR-, respectively) were calculated, and summary receiver operating characteristic curves were constructed.RESULTSOf six included studies (n = 212 patients), F-18 FDG PET demonstrated a pooled sensitivity of 0.89 (95% confidence interval [CI] 0.81-0.94) and a pooled specificity of 0.89 (95% CI 0.80-0.94). LR syntheses yielded an overall LR +of 7.9 (95% CI 4.3-14.6) and LR- of 0.12 (95% CI 0.07-0.22). The calculated pooled diagnostic odds ratio (DOR) was 64 (95% CI 23-181). For conventional imaging, the pooled sensitivity was 0.70 (95% CI 0.57-0.81) and the pooled specificity was 0.96 (95% CI 0.88-0.98). LR syntheses yielded an overall LR +of 16.1 (95% CI 5.8-44.5) and LR- of 0.31 (95% CI 0.21-0.46). The evaluated pooled DOR was 52 (95% CI 17-155).CONCLUSIONF-18 FDG PET and conventional imaging demonstrated comparable diagnostic accuracies for the characterisation of cardiac masses. Further large multicentre studies are, however, required to corroborate the diagnostic performances of F-18 FDG PET and conventional imaging for the characterisation of cardiac masses.ADVANCES IN KNOWLEDGENo previous studies have comprehensively analysed the diagnostic performance of F-18 FDG PET/CT compared with conventional imaging techniques including echocardiography, computed tomography, and magnetic resonance imaging. According to the current study, F-18 FDG PET/CT yielded a pooled DOR of 64, whereas other conventional imaging techniques demonstrated a DOR of 52. As such, F-18 FDG PET/CT demonstrated sensitivity and specificity, with a high pooled DOR comparable with other conventional imaging modalities.
目的本系统综述和荟萃分析比较F-18氟脱氧葡萄糖正电子发射断层扫描(F-18FDG PET)和常规成像(包括磁共振成像、超声心动图和计算机断层扫描)在诊断心脏肿块方面的表现。方法对PubMed、Cochrane和EMBASE数据库进行文献检索，比较F-18 FDG PET和常规成像在心脏肿块特征方面的诊断准确性，从索引开始到2020年7月31日。使用诊断准确性研究质量评估-2工具评估研究质量。确定各研究的敏感性和特异性，计算阳性和阴性似然比(分别为LR +和LR-)，并构建总体受试者工作特征曲线。结果在纳入的6项研究中(n = 212例患者)，F-18 FDG PET的综合敏感性为0.89(95%可信区间[CI] 0.81-0.94)，综合特异性为0.89 (95% CI 0.80-0.94)。LR合成的总体LR +为7.9 (95% CI 4.3-14.6)， LR-为0.12 (95% CI 0.07-0.22)。计算的合并诊断优势比(DOR)为64 (95% CI 23-181)。对于常规影像学，合并敏感性为0.70 (95% CI 0.57-0.81)，合并特异性为0.96 (95% CI 0.88-0.98)。LR合成的总LR +为16.1 (95% CI 5.8-44.5)， LR-为0.31 (95% CI 0.21-0.46)。评估的合并DOR为52 (95% CI 17-155)。结论f -18 FDG PET与常规影像学对心脏肿块的诊断准确性相当。然而，需要进一步的大型多中心研究来证实F-18 FDG PET和常规成像对心脏肿块特征的诊断性能。之前的研究已经全面分析了F-18 FDG PET/CT与常规成像技术(包括超声心动图、计算机断层扫描和磁共振成像)的诊断性能。根据目前的研究，F-18 FDG PET/CT的综合DOR为64，而其他传统成像技术的DOR为52。因此，F-18 FDG PET/CT表现出敏感性和特异性，与其他传统成像方式相比，DOR具有较高的综合DOR。
{"title":"Diagnostic test accuracies of F-18 FDG PET for characterization of cardiac masses compared to conventional imaging techniques: Systematic review and Meta-analysis.","authors":"Keunyoung Kim, W. Ko, Seong-Jang Kim","doi":"10.1259/bjr.20210263","DOIUrl":"https://doi.org/10.1259/bjr.20210263","url":null,"abstract":"OBJECTIVE\u0000The present systematic review and meta-analysis compared the diagnostic performance of F-18 fluorodeoxyglucose positron emission tomography (F-18FDG PET) and conventional imaging, including magnetic resonance imaging, echocardiography, and computed tomography, in characterising cardiac masses.\u0000\u0000\u0000METHODS\u0000A literature search of the PubMed, Cochrane, and EMBASE databases for studies comparing the diagnostic accuracies of F-18 FDG PET and conventional imaging in characterising cardiac masses, from inception of indexing to July 31, 2020, was performed. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality. Sensitivity and specificity across the studies were determined, positive and negative likelihood ratios (LR + and LR-, respectively) were calculated, and summary receiver operating characteristic curves were constructed.\u0000\u0000\u0000RESULTS\u0000Of six included studies (n = 212 patients), F-18 FDG PET demonstrated a pooled sensitivity of 0.89 (95% confidence interval [CI] 0.81-0.94) and a pooled specificity of 0.89 (95% CI 0.80-0.94). LR syntheses yielded an overall LR +of 7.9 (95% CI 4.3-14.6) and LR- of 0.12 (95% CI 0.07-0.22). The calculated pooled diagnostic odds ratio (DOR) was 64 (95% CI 23-181). For conventional imaging, the pooled sensitivity was 0.70 (95% CI 0.57-0.81) and the pooled specificity was 0.96 (95% CI 0.88-0.98). LR syntheses yielded an overall LR +of 16.1 (95% CI 5.8-44.5) and LR- of 0.31 (95% CI 0.21-0.46). The evaluated pooled DOR was 52 (95% CI 17-155).\u0000\u0000\u0000CONCLUSION\u0000F-18 FDG PET and conventional imaging demonstrated comparable diagnostic accuracies for the characterisation of cardiac masses. Further large multicentre studies are, however, required to corroborate the diagnostic performances of F-18 FDG PET and conventional imaging for the characterisation of cardiac masses.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000No previous studies have comprehensively analysed the diagnostic performance of F-18 FDG PET/CT compared with conventional imaging techniques including echocardiography, computed tomography, and magnetic resonance imaging. According to the current study, F-18 FDG PET/CT yielded a pooled DOR of 64, whereas other conventional imaging techniques demonstrated a DOR of 52. As such, F-18 FDG PET/CT demonstrated sensitivity and specificity, with a high pooled DOR comparable with other conventional imaging modalities.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125923058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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