Pub Date : 2023-10-06DOI: 10.5812/iranjradiol-136102
Seyyed Mohammad Hosseini, Masoumeh Gity, Parham Talebi Boroujeni, Mona Asghari Ahmadabad, Ali Jahanshahi
Context: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory condition of the breasts with an unknown etiology, which can mimic breast cancer on conventional ultrasound. Other imaging modalities, such as mammography and magnetic resonance imaging, cannot efficiently differentiate this condition from malignancies. Elastography is a novel imaging technique used to evaluate tissue elasticity. Objectives: This systematic review aimed to investigate the imaging features of IGM on elastography and also to determine whether this modality is useful for distinguishing IGM from other breast malignancies. Materials and Methods: A comprehensive literature search was conducted across several databases, including Medline, Embase, Cochrane Library, Scopus, and Web of Science, in October 2022. The Joanna Briggs Institute (JBI) critical appraisal tool was used for the quality assessment of the studies. Results: After screening 851 articles, seven studies investigating ultrasound elastography were found to meet the inclusion criteria. Regarding the quantitative findings, both the strain ratio and shear wave velocity were observed to be higher in malignant masses as compared to IGM. Additionally, qualitative scoring systems, such as the Tsukuba and Tozaki classifications, assigned higher scores to malignant lesions. Five of the included studies in this review proposed a specific cut-off point for differentiating IGM from malignancies, using either shear wave velocity, strain ratio, or elasticity scores. In four of the studies, these criteria exhibited sensitivity and specificity of approximately 90%. Conclusion: The current findings suggest that ultrasound elastography can serve as a valuable tool for distinguishing IGM from breast malignancies. By potentially reducing the number of unnecessary tissue biopsies, this modality may lead to a more efficient patient evaluation process.
背景:特发性肉芽肿性乳腺炎(IGM)是一种病因不明的乳房良性炎症，在常规超声检查下可与乳腺癌相似。其他成像方式，如乳房x线摄影和磁共振成像，不能有效地将这种疾病与恶性肿瘤区分开来。弹性成像是一种用于评估组织弹性的新型成像技术。目的:本系统综述旨在探讨IGM的弹性成像特征，并确定这种模式是否有助于将IGM与其他乳腺恶性肿瘤区分开来。材料与方法:于2022年10月对Medline、Embase、Cochrane Library、Scopus和Web of Science等多个数据库进行了全面的文献检索。乔安娜布里格斯研究所(JBI)的关键评估工具被用于研究的质量评估。结果:在筛选了851篇文章后，有7篇关于超声弹性成像的研究符合纳入标准。定量结果显示，恶性肿块的应变比和横波速度均高于IGM。此外，定性评分系统，如Tsukuba和Tozaki分类，给恶性病变更高的分数。本综述中纳入的五项研究提出了区分IGM与恶性肿瘤的特定截止点，使用剪切波速、应变比或弹性评分。在其中四项研究中，这些标准的敏感性和特异性约为90%。结论:超声弹性成像可作为鉴别IGM与乳腺恶性肿瘤的有效工具。通过潜在地减少不必要的组织活检的数量，这种方式可能导致更有效的患者评估过程。
{"title":"Application of Elastography in the Diagnosis of Idiopathic Granulomatous Mastitis (IGM): A Systematic Review","authors":"Seyyed Mohammad Hosseini, Masoumeh Gity, Parham Talebi Boroujeni, Mona Asghari Ahmadabad, Ali Jahanshahi","doi":"10.5812/iranjradiol-136102","DOIUrl":"https://doi.org/10.5812/iranjradiol-136102","url":null,"abstract":"Context: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory condition of the breasts with an unknown etiology, which can mimic breast cancer on conventional ultrasound. Other imaging modalities, such as mammography and magnetic resonance imaging, cannot efficiently differentiate this condition from malignancies. Elastography is a novel imaging technique used to evaluate tissue elasticity. Objectives: This systematic review aimed to investigate the imaging features of IGM on elastography and also to determine whether this modality is useful for distinguishing IGM from other breast malignancies. Materials and Methods: A comprehensive literature search was conducted across several databases, including Medline, Embase, Cochrane Library, Scopus, and Web of Science, in October 2022. The Joanna Briggs Institute (JBI) critical appraisal tool was used for the quality assessment of the studies. Results: After screening 851 articles, seven studies investigating ultrasound elastography were found to meet the inclusion criteria. Regarding the quantitative findings, both the strain ratio and shear wave velocity were observed to be higher in malignant masses as compared to IGM. Additionally, qualitative scoring systems, such as the Tsukuba and Tozaki classifications, assigned higher scores to malignant lesions. Five of the included studies in this review proposed a specific cut-off point for differentiating IGM from malignancies, using either shear wave velocity, strain ratio, or elasticity scores. In four of the studies, these criteria exhibited sensitivity and specificity of approximately 90%. Conclusion: The current findings suggest that ultrasound elastography can serve as a valuable tool for distinguishing IGM from breast malignancies. By potentially reducing the number of unnecessary tissue biopsies, this modality may lead to a more efficient patient evaluation process.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135351226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-25DOI: 10.5812/iranjradiol-136495
Lyo Min Kwon, Jin Woo Choi, Hyo-Cheol Kim
Background: Solitary fibrous tumors (SFT) are rare soft tissue tumors with a typically benign clinical course; however, up to 35% of SFT exhibit metastasis, resulting in a poor prognosis. The management of hepatic metastasis of SFT is yet to be established because of its rarity of cases. Objectives: Herein, we report the clinical results of 13 transarterial chemoembolization (TACE) sessions for hepatic metastasis in 5 patients with SFT. Patients and Methods: Patients with hepatic metastases from SFT who underwent TACE between May 2005 and April 2021 were retrospectively reviewed. Tumor response was evaluated using the modified response evaluation criteria in solid tumors (mRECIST). Results: Five patients (one male, mean age: 59.2 years) underwent 13 TACE sessions, resulting in four partial responses (PR, 30.8%), four stable disease cases (30.8%), and five progressive disease cases (38.5%). No severe complications occurred. Four of seven sessions (57.1%) of selective TACE showed partial response (PR). The mean progression-free survival (PFS) was 2.3 months (range: 0 - 8 months), and for sessions with PR, the mean PFS was 6.3 months (range: 3 - 8 months). The mean overall survival was 32.7 months (range: 18 - 44 months). Conclusion: This report suggests that TACE might be a potentially safe treatment option for hepatic metastasis of SFT, and it could offer a benefit in controlling local tumor growth in cases where selective TACE is applicable.
{"title":"Transarterial Chemoembolization for Hepatic Metastasis of Solitary Fibrous Tumor: Report of Five Patients","authors":"Lyo Min Kwon, Jin Woo Choi, Hyo-Cheol Kim","doi":"10.5812/iranjradiol-136495","DOIUrl":"https://doi.org/10.5812/iranjradiol-136495","url":null,"abstract":"Background: Solitary fibrous tumors (SFT) are rare soft tissue tumors with a typically benign clinical course; however, up to 35% of SFT exhibit metastasis, resulting in a poor prognosis. The management of hepatic metastasis of SFT is yet to be established because of its rarity of cases. Objectives: Herein, we report the clinical results of 13 transarterial chemoembolization (TACE) sessions for hepatic metastasis in 5 patients with SFT. Patients and Methods: Patients with hepatic metastases from SFT who underwent TACE between May 2005 and April 2021 were retrospectively reviewed. Tumor response was evaluated using the modified response evaluation criteria in solid tumors (mRECIST). Results: Five patients (one male, mean age: 59.2 years) underwent 13 TACE sessions, resulting in four partial responses (PR, 30.8%), four stable disease cases (30.8%), and five progressive disease cases (38.5%). No severe complications occurred. Four of seven sessions (57.1%) of selective TACE showed partial response (PR). The mean progression-free survival (PFS) was 2.3 months (range: 0 - 8 months), and for sessions with PR, the mean PFS was 6.3 months (range: 3 - 8 months). The mean overall survival was 32.7 months (range: 18 - 44 months). Conclusion: This report suggests that TACE might be a potentially safe treatment option for hepatic metastasis of SFT, and it could offer a benefit in controlling local tumor growth in cases where selective TACE is applicable.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135816545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-07DOI: 10.5812/iranjradiol-133256
Behzad Amanpour-Gharaei, Shirin Haghshenas Bilehsavar, Ahmad Pour-Rashidi, Mohsen Izanlou, Yasaman Bastanipour, Hassan Hashemi, M. Oghabian, Elham Nazar, Samira Raminfard
Introduction: Intracranial chondroma and chondrosarcoma are very rare tumors that mainly originate from the base of the skull. Advanced neuroimaging studies, including magnetic resonance spectroscopy (MRS), play a pivotal role in both tumor diagnosis and presurgical planning. Case Presentation: We present two cases of intracranial cartilaginous tumors, including a chondroma and a chondrosarcoma, both of which presented with severe headaches. Due to inconclusive conventional MRI and MRS results, they were both primarily diagnosed as intra-axial brain tumors. However, pathological reports later confirmed the diagnosis of a chondroma and a chondrosarcoma. Conclusion: Based on the present findings, the use of advanced neuroimaging techniques, such as MRS, may improve diagnostic accuracy. We believe that MRS can play a significant role in the surgical planning of similar cases. Also, reporting rare cases worldwide can contribute to the improvement of radiographic diagnosis.
{"title":"Magnetic Resonance Spectroscopy Findings of Intracranial Chondroma and Chondrosarcoma with a Non-Skull Base Origin: A Report of Two Cases","authors":"Behzad Amanpour-Gharaei, Shirin Haghshenas Bilehsavar, Ahmad Pour-Rashidi, Mohsen Izanlou, Yasaman Bastanipour, Hassan Hashemi, M. Oghabian, Elham Nazar, Samira Raminfard","doi":"10.5812/iranjradiol-133256","DOIUrl":"https://doi.org/10.5812/iranjradiol-133256","url":null,"abstract":"Introduction: Intracranial chondroma and chondrosarcoma are very rare tumors that mainly originate from the base of the skull. Advanced neuroimaging studies, including magnetic resonance spectroscopy (MRS), play a pivotal role in both tumor diagnosis and presurgical planning. Case Presentation: We present two cases of intracranial cartilaginous tumors, including a chondroma and a chondrosarcoma, both of which presented with severe headaches. Due to inconclusive conventional MRI and MRS results, they were both primarily diagnosed as intra-axial brain tumors. However, pathological reports later confirmed the diagnosis of a chondroma and a chondrosarcoma. Conclusion: Based on the present findings, the use of advanced neuroimaging techniques, such as MRS, may improve diagnostic accuracy. We believe that MRS can play a significant role in the surgical planning of similar cases. Also, reporting rare cases worldwide can contribute to the improvement of radiographic diagnosis.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48136610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-09DOI: 10.5812/iranjradiol-123989
Mehdi Karami, Amirreza Sajjadieh Khajouei, Shahram Abdi, Mohaddeseh Behjati
Background: Despite the important role of coronary computed tomography angiography (CCTA) in determining the features of coronary atherosclerotic plaques, very few studies have investigated the role of plaque dimensions in the process of coronary artery obstruction. Therefore, this study aimed to assess the relationship between the characteristics and dimensions of calcified plaques and coronary artery stenosis using CCTA. Objectives: This study aimed to evaluate the relationship between calcified plaque dimensions and coronary artery stenosis in patients undergoing CCTA. Patients and Methods: This cross-sectional study was conducted on 211 plaques of candidate patients for prospective and retrospective electrocardiography (ECG)-gated CCTA, using spiral scanning at 120 kV. The length, width, thickness, and luminal areas of calcified plaques were assessed in all coronary arteries. Results: The mean rate of stenosis was estimated to be 56.1 ± 24.4%. The number of patients with stenosis < 50% was 100 (47.3%). Stenosis had a significant relationship with the plaque luminal area and the luminal dimeter of the normal coronary artery proximal and distal to the plaque (P < 0.05). However, there was no significant correlation between stenosis and normal luminal area (P > 0.05). Meanwhile, a significant relationship was found between stenosis and the width and length of plaques (P < 0.05). Conclusion: The present results indicated a significant association between stenosis and the width, length, and luminal area of plaques. It can be concluded that plaque dimensions are a predictive factor for stenosis.
{"title":"Evaluation of the Relationship Between the Characteristics and Dimensions of Calcified Plaques and Coronary Artery Stenosis in Patients Undergoing Coronary Computed Tomography Angiography","authors":"Mehdi Karami, Amirreza Sajjadieh Khajouei, Shahram Abdi, Mohaddeseh Behjati","doi":"10.5812/iranjradiol-123989","DOIUrl":"https://doi.org/10.5812/iranjradiol-123989","url":null,"abstract":"Background: Despite the important role of coronary computed tomography angiography (CCTA) in determining the features of coronary atherosclerotic plaques, very few studies have investigated the role of plaque dimensions in the process of coronary artery obstruction. Therefore, this study aimed to assess the relationship between the characteristics and dimensions of calcified plaques and coronary artery stenosis using CCTA. Objectives: This study aimed to evaluate the relationship between calcified plaque dimensions and coronary artery stenosis in patients undergoing CCTA. Patients and Methods: This cross-sectional study was conducted on 211 plaques of candidate patients for prospective and retrospective electrocardiography (ECG)-gated CCTA, using spiral scanning at 120 kV. The length, width, thickness, and luminal areas of calcified plaques were assessed in all coronary arteries. Results: The mean rate of stenosis was estimated to be 56.1 ± 24.4%. The number of patients with stenosis < 50% was 100 (47.3%). Stenosis had a significant relationship with the plaque luminal area and the luminal dimeter of the normal coronary artery proximal and distal to the plaque (P < 0.05). However, there was no significant correlation between stenosis and normal luminal area (P > 0.05). Meanwhile, a significant relationship was found between stenosis and the width and length of plaques (P < 0.05). Conclusion: The present results indicated a significant association between stenosis and the width, length, and luminal area of plaques. It can be concluded that plaque dimensions are a predictive factor for stenosis.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135697508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.5812/iranjradiol-136311
Sang-Un Kim, Saelin Oh, Kee-Hyoung Lee, C. Kang, K. Ahn
Background: Deep learning methods used for bone age assessment (BAA) mostly employ the whole hand or regional convolutional neural networks without carpal bones; therefore, their application is insufficient in young children. Objectives: This study aimed to improve the accuracy of BAA in young children by integrating a carpal bone analysis and to achieve a similar BAA accuracy for all age groups. Patients and Methods: A hybrid Greulich-Pyle (GP) and modified Tanner-Whitehouse deep learning model for BAA was trained by integrating an additional carpal bone analysis of an open dataset. A total of 453 hand radiographs from a single institution were selected for external validation. To create the reference standard, three human experts conducted a BAA, based on the GP Atlas, and then, interobserver agreement was evaluated. The model performance was estimated by comparing the mean absolute difference (MAD) and the root mean square error (RMSE) between the two BAA models, including one with a carpal bone analysis (M1) and one without a carpal bone analysis (M2), and the reference standard. The MAD of each model was compared between sex and age groups with respect to four major developmental stages, that is, pre-puberty, early and mid-puberty, late puberty, and post-puberty. Results: The M1 model showed a higher accuracy with a lower MAD (0.366; 95% confidence interval (CI): 0.337 - 0.395) compared to the M2 model (0.388; 95% CI: 0.358 - 0.418) for all age groups, with a significant difference (P < 0.001). The RMSE values versus the reference standard were 0.483 and 0.505 years for the M1 and M2 models, respectively. According to sex and developmental stage distributions, the M1 model had a greater predictive ability compared to the M2 model for pre-pubertal patients, regardless of sex (P = 0.008 for males and P = 0.022 for females). Conclusion: Based on the present findings, the integration of a carpal bone analysis into the BAA model improved its accuracy, especially in young children.
{"title":"Improvement of Bone Age Assessment Using a Deep Learning Model in Young Children: Significance of Carpal Bone Analysis","authors":"Sang-Un Kim, Saelin Oh, Kee-Hyoung Lee, C. Kang, K. Ahn","doi":"10.5812/iranjradiol-136311","DOIUrl":"https://doi.org/10.5812/iranjradiol-136311","url":null,"abstract":"Background: Deep learning methods used for bone age assessment (BAA) mostly employ the whole hand or regional convolutional neural networks without carpal bones; therefore, their application is insufficient in young children. Objectives: This study aimed to improve the accuracy of BAA in young children by integrating a carpal bone analysis and to achieve a similar BAA accuracy for all age groups. Patients and Methods: A hybrid Greulich-Pyle (GP) and modified Tanner-Whitehouse deep learning model for BAA was trained by integrating an additional carpal bone analysis of an open dataset. A total of 453 hand radiographs from a single institution were selected for external validation. To create the reference standard, three human experts conducted a BAA, based on the GP Atlas, and then, interobserver agreement was evaluated. The model performance was estimated by comparing the mean absolute difference (MAD) and the root mean square error (RMSE) between the two BAA models, including one with a carpal bone analysis (M1) and one without a carpal bone analysis (M2), and the reference standard. The MAD of each model was compared between sex and age groups with respect to four major developmental stages, that is, pre-puberty, early and mid-puberty, late puberty, and post-puberty. Results: The M1 model showed a higher accuracy with a lower MAD (0.366; 95% confidence interval (CI): 0.337 - 0.395) compared to the M2 model (0.388; 95% CI: 0.358 - 0.418) for all age groups, with a significant difference (P < 0.001). The RMSE values versus the reference standard were 0.483 and 0.505 years for the M1 and M2 models, respectively. According to sex and developmental stage distributions, the M1 model had a greater predictive ability compared to the M2 model for pre-pubertal patients, regardless of sex (P = 0.008 for males and P = 0.022 for females). Conclusion: Based on the present findings, the integration of a carpal bone analysis into the BAA model improved its accuracy, especially in young children.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48955335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-17DOI: 10.5812/iranjradiol-131845
A. Rajaei, Khatereh Mohammadi, Mahbobeh Oroei, F. Farsad
Background: Osteoporosis is a common chronic disease that can cause fractures and other complications. Early diagnosis and prompt treatment of this disease can reduce the risk of fracture. The trabecular bone score (TBS) is a valuable tool for evaluating bone microarchitecture in patients with osteoporosis. Objectives: The present study aimed to evaluate the association of TBS score with bone mineral density (BMD) as the gold standard in patients with osteoporosis. Patients and Methods: This cross-sectional study was performed on 254 patients admitted to Resalat Hospital in Tehran, Iran. The BMD and TBS were concurrently evaluated, and TBS validity for osteoporosis diagnosis was assessed based on BMD as the gold standard. The agreement between TBS and BMD results was measured using the kappa statistic. All analyses were performed in MedCalc version 18.11.3.8 and SPSS version 18, and the level of statistical significance was set at < 0.05. Results: In this study, the majority of the patients were female (88.2%) and younger than 65 years (63.0%). Osteopenia and osteoporosis were diagnosed in 42.1% and 18.9% of the patients, respectively. The sensitivity of TBS for diagnosing osteoporosis versus osteopenia and osteopenia versus a normal status was higher in patients aged ≥ 65 years compared to those aged < 65 years (63.33% vs. 27.78% and 86.66% vs. 63.63%, respectively). Overall, TBS demonstrated a high diagnostic ability for differentiating osteoporosis versus normal BMD (AUC = 0.911, P < 0.001). Conclusion: Based on the findings, TBS alone is not sufficient for diagnosing osteoporosis and cannot replace BMD. Therefore, a combination of BMD and TBS techniques can be the best approach for diagnosing osteoporosis, especially in patients aged ≥ 65 years.
{"title":"Diagnostic Value of Trabecular Bone Score in Osteoporosis","authors":"A. Rajaei, Khatereh Mohammadi, Mahbobeh Oroei, F. Farsad","doi":"10.5812/iranjradiol-131845","DOIUrl":"https://doi.org/10.5812/iranjradiol-131845","url":null,"abstract":"Background: Osteoporosis is a common chronic disease that can cause fractures and other complications. Early diagnosis and prompt treatment of this disease can reduce the risk of fracture. The trabecular bone score (TBS) is a valuable tool for evaluating bone microarchitecture in patients with osteoporosis. Objectives: The present study aimed to evaluate the association of TBS score with bone mineral density (BMD) as the gold standard in patients with osteoporosis. Patients and Methods: This cross-sectional study was performed on 254 patients admitted to Resalat Hospital in Tehran, Iran. The BMD and TBS were concurrently evaluated, and TBS validity for osteoporosis diagnosis was assessed based on BMD as the gold standard. The agreement between TBS and BMD results was measured using the kappa statistic. All analyses were performed in MedCalc version 18.11.3.8 and SPSS version 18, and the level of statistical significance was set at < 0.05. Results: In this study, the majority of the patients were female (88.2%) and younger than 65 years (63.0%). Osteopenia and osteoporosis were diagnosed in 42.1% and 18.9% of the patients, respectively. The sensitivity of TBS for diagnosing osteoporosis versus osteopenia and osteopenia versus a normal status was higher in patients aged ≥ 65 years compared to those aged < 65 years (63.33% vs. 27.78% and 86.66% vs. 63.63%, respectively). Overall, TBS demonstrated a high diagnostic ability for differentiating osteoporosis versus normal BMD (AUC = 0.911, P < 0.001). Conclusion: Based on the findings, TBS alone is not sufficient for diagnosing osteoporosis and cannot replace BMD. Therefore, a combination of BMD and TBS techniques can be the best approach for diagnosing osteoporosis, especially in patients aged ≥ 65 years.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49466135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-11DOI: 10.5812/iranjradiol-133022
S. Gharibi, M. Ghavami, Hamid Khederlou, Seyyed Mojtaba Ghorashi, S. Dabiran, Fahime Zeinalkhani
Background: Due to its non-specific symptoms, pulmonary arterial hypertension (PAH) is difficult to diagnose via non-invasive methods. Various diagnostic tests are required to evaluate PAH patients. The increased diameter of the main pulmonary artery in computed tomography (CT) imaging represents a high probability of PAH. Moreover, N-terminal pro B-type natriuretic peptide (NT-proBNP) and pro B-type natriuretic peptide (proBNP) can be considered as prognostic predictors in patients with PAH. Objectives: This study aimed to evaluate the correlation of CT-based main pulmonary artery diameter (MPAD) and the serum level of NT-proBNP (as a strong pro-inflammatory factor) with the severity of PAH in echocardiography among patients with PAH. Patients and Methods: In this cross-sectional study, a total of 63 hospitalized patients with PAH due to chronic obstructive pulmonary disease were recruited from 2019 to 2020 after initial evaluations and collection of serum NT-proBNP measurements and echocardiographic findings. On the chest CT scans, the largest diameter of the pulmonary artery trunk was determined, and then, correlation of CT-based MPAD with both PAH severity on echocardiography and NT-proBNP level in patients with PAH were evaluated. Results: The results of the present study on 63 patients (70% male; mean age, 67.02 years) showed a significant positive correlation between the MPAD and NT-proBNP level (r = 0.444, P < 0.001). Moreover, a significant positive relationship was observed between the pulmonary artery pressure (PAP) and NT-proBNP (r = 0.353, P = 0.005) and also between MPAD and PAP (r = 0.306, P = 0.015). In PAH patients, the mean values of MPAD, PAP, and NT-proBNP were 32.58 mm, 47.9 mmHg, and 6563 pg/mL, respectively. Conclusion: Considering the significant positive correlation between PAP, MPAD, and NT-proBNP level in subgroup comparisons based on MPAD and PAP, if the MPAD is abnormal on CT scan, additional echocardiographic assessments and serum NT-proBNP measurements can be helpful.
{"title":"Evaluation of the Correlation of Pulmonary Arterial Hypertension (PAH) with the Pulmonary Artery Trunk Diameter and Serum Level of N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) in Patients with PAH","authors":"S. Gharibi, M. Ghavami, Hamid Khederlou, Seyyed Mojtaba Ghorashi, S. Dabiran, Fahime Zeinalkhani","doi":"10.5812/iranjradiol-133022","DOIUrl":"https://doi.org/10.5812/iranjradiol-133022","url":null,"abstract":"Background: Due to its non-specific symptoms, pulmonary arterial hypertension (PAH) is difficult to diagnose via non-invasive methods. Various diagnostic tests are required to evaluate PAH patients. The increased diameter of the main pulmonary artery in computed tomography (CT) imaging represents a high probability of PAH. Moreover, N-terminal pro B-type natriuretic peptide (NT-proBNP) and pro B-type natriuretic peptide (proBNP) can be considered as prognostic predictors in patients with PAH. Objectives: This study aimed to evaluate the correlation of CT-based main pulmonary artery diameter (MPAD) and the serum level of NT-proBNP (as a strong pro-inflammatory factor) with the severity of PAH in echocardiography among patients with PAH. Patients and Methods: In this cross-sectional study, a total of 63 hospitalized patients with PAH due to chronic obstructive pulmonary disease were recruited from 2019 to 2020 after initial evaluations and collection of serum NT-proBNP measurements and echocardiographic findings. On the chest CT scans, the largest diameter of the pulmonary artery trunk was determined, and then, correlation of CT-based MPAD with both PAH severity on echocardiography and NT-proBNP level in patients with PAH were evaluated. Results: The results of the present study on 63 patients (70% male; mean age, 67.02 years) showed a significant positive correlation between the MPAD and NT-proBNP level (r = 0.444, P < 0.001). Moreover, a significant positive relationship was observed between the pulmonary artery pressure (PAP) and NT-proBNP (r = 0.353, P = 0.005) and also between MPAD and PAP (r = 0.306, P = 0.015). In PAH patients, the mean values of MPAD, PAP, and NT-proBNP were 32.58 mm, 47.9 mmHg, and 6563 pg/mL, respectively. Conclusion: Considering the significant positive correlation between PAP, MPAD, and NT-proBNP level in subgroup comparisons based on MPAD and PAP, if the MPAD is abnormal on CT scan, additional echocardiographic assessments and serum NT-proBNP measurements can be helpful.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42310273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-17DOI: 10.5812/iranjradiol-134455
Mahboobeh Sheikhi, S. Sina, M. Karimipourfard
Background: Dual-energy computed tomography (DECT) scan has been proposed as an effective modality for determining the chemical composition of renal stone subtypes. Objectives: This study aimed to evaluate and compare the efficacy of DECT in the identification of renal stone type and composition versus biochemical analysis as the gold standard. Materials and Methods: The type of 146 renal stones, removed from patients by surgery, was determined in a medical laboratory. The stones were then inserted into the kidney of an anthropomorphic Rando phantom, and DECT scans were acquired. The stone type, specified by the scanner software, was compared with the results of biochemical analysis as the gold standard. Results: The DECT scans showed acceptable accuracy in identifying the chemical composition of renal stone subtypes. Based on the comparison of biochemical analysis and DECT results, the accuracy values for cystine, uric acid, and calcium-oxalate stones were 97%, 100%, and 97%, respectively. Conclusion: Based on the present results, DECT could detect pure uric acid, cystine, and calcium-oxalate stone types with high sensitivity. However, for mixed stones, the stone type, directly identified by DECT scan, was not reliable.
{"title":"Dual-energy Computed Tomography (DECT) Scan for Determination of Renal Stone Composition: A Phantom Study","authors":"Mahboobeh Sheikhi, S. Sina, M. Karimipourfard","doi":"10.5812/iranjradiol-134455","DOIUrl":"https://doi.org/10.5812/iranjradiol-134455","url":null,"abstract":"Background: Dual-energy computed tomography (DECT) scan has been proposed as an effective modality for determining the chemical composition of renal stone subtypes. Objectives: This study aimed to evaluate and compare the efficacy of DECT in the identification of renal stone type and composition versus biochemical analysis as the gold standard. Materials and Methods: The type of 146 renal stones, removed from patients by surgery, was determined in a medical laboratory. The stones were then inserted into the kidney of an anthropomorphic Rando phantom, and DECT scans were acquired. The stone type, specified by the scanner software, was compared with the results of biochemical analysis as the gold standard. Results: The DECT scans showed acceptable accuracy in identifying the chemical composition of renal stone subtypes. Based on the comparison of biochemical analysis and DECT results, the accuracy values for cystine, uric acid, and calcium-oxalate stones were 97%, 100%, and 97%, respectively. Conclusion: Based on the present results, DECT could detect pure uric acid, cystine, and calcium-oxalate stone types with high sensitivity. However, for mixed stones, the stone type, directly identified by DECT scan, was not reliable.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49648239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-24DOI: 10.5812/iranjradiol-133070
Qimin Zhang, Jiajia Xu, Mengye Xiong, Yiqing Tan
Background: Hepatocellular carcinoma (HCC) is characterized by high morbidity and mortality rates around the world, ranking the sixth most common malignant tumor and the second cause of cancer-related mortality. Most patients are diagnosed in the advanced stage, and therefore, there are limited therapeutic options. Transarterial chemoembolization (TACE), anti-angiogenic therapy, and immune checkpoint inhibitors (ICIs) are the research hotspots in HCC treatment. Objectives: This study aimed to explore the treatment efficacy and safety of TACE for refractory HCC patients after anti-angiogenic therapy combined with ICIs. Patients and Methods: In this study, patients with HCC, who progressed after anti-angiogenic therapy combined with ICIs, were included from July 2019 to October 2022. The progression-free survival (PFS) was evaluated by the Kaplan-Meier method, and the tumor response was determined based on the modified Immune Response Evaluation Criteria in Solid Tumors (iRECIST). The Common Terminology Criteria for Adverse Events version 5.0 were also used to assess the adverse events. Results: A total of 34 patients were evaluated in this study, with a median PFS of five months (95% CI: 3.7 months, 6.3 months). The univariate analysis suggested that the level of aspartate aminotransferase was significantly associated with PFS (P < 0.05). The objective response rates within three and six months were 26.4% and 14.6%, and the disease control rates were 58.8% and 55.9%, respectively. During the follow-up, one or more types of adverse events were reported in 10 (58.8%) patients after treatment with atezolizumab and bevacizumab, while severe adverse events beyond grade III did not occur in any of the patients. Conclusion: The TACE may improve the survival of HCC patients, whose disease progresses after anti-angiogenic therapy combined with ICIs. However, the lack of a control group is one of the limitations of this study.
{"title":"Transarterial Chemoembolization for Refractory Hepatocellular Carcinoma Following Anti-angiogenic Therapy Combined with Immune Checkpoint Inhibitors: A Retrospective Single-center Analysis","authors":"Qimin Zhang, Jiajia Xu, Mengye Xiong, Yiqing Tan","doi":"10.5812/iranjradiol-133070","DOIUrl":"https://doi.org/10.5812/iranjradiol-133070","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) is characterized by high morbidity and mortality rates around the world, ranking the sixth most common malignant tumor and the second cause of cancer-related mortality. Most patients are diagnosed in the advanced stage, and therefore, there are limited therapeutic options. Transarterial chemoembolization (TACE), anti-angiogenic therapy, and immune checkpoint inhibitors (ICIs) are the research hotspots in HCC treatment. Objectives: This study aimed to explore the treatment efficacy and safety of TACE for refractory HCC patients after anti-angiogenic therapy combined with ICIs. Patients and Methods: In this study, patients with HCC, who progressed after anti-angiogenic therapy combined with ICIs, were included from July 2019 to October 2022. The progression-free survival (PFS) was evaluated by the Kaplan-Meier method, and the tumor response was determined based on the modified Immune Response Evaluation Criteria in Solid Tumors (iRECIST). The Common Terminology Criteria for Adverse Events version 5.0 were also used to assess the adverse events. Results: A total of 34 patients were evaluated in this study, with a median PFS of five months (95% CI: 3.7 months, 6.3 months). The univariate analysis suggested that the level of aspartate aminotransferase was significantly associated with PFS (P < 0.05). The objective response rates within three and six months were 26.4% and 14.6%, and the disease control rates were 58.8% and 55.9%, respectively. During the follow-up, one or more types of adverse events were reported in 10 (58.8%) patients after treatment with atezolizumab and bevacizumab, while severe adverse events beyond grade III did not occur in any of the patients. Conclusion: The TACE may improve the survival of HCC patients, whose disease progresses after anti-angiogenic therapy combined with ICIs. However, the lack of a control group is one of the limitations of this study.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46783753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-20DOI: 10.5812/iranjradiol-134454
Mahboobeh Sheikhi, S. Sina, M. Karimipourfard, Fereshteh Khodadadi Shoushtari
Background: Dual-energy computed tomography (DECT) scan is a non-invasive method for the in vivo identification of renal stone composition. However, DECT scanners have several demerits, including high cost, low accessibility, and high radiation dose to patients. Objectives: The present study aimed to investigate the efficacy of deep neural networks in the classification of renal stone types using single-energy CT imaging. The Taguchi method was used for the optimization of hyperparameters. Patients and Methods: A total of 146 pure renal stone samples were first surgically collected from the patients. The stones were then inserted into a Rando phantom and scanned using a DECT scanner. An ultra-low-dose CT scan was acquired to determine the stone position prior to the DECT scan. The result of chemical analysis was used as the gold standard for determining the stone composition throughout the study. Several neural networks, including ResNet-50, ResNet-18, GoogLeNet, and VGG-19, were used to classify the stone images into three composition groups, including uric acid, calcium oxalate, and cystine. Moreover, the Taguchi method was employed to optimize the network hyperparameters. The signal-to-noise ratio (SNR) was also analyzed to determine the optimal arrangement. Results: In this study, CT scans of 53 uric acid, 55 calcium oxalate, and 38 cystine stones, with diameters of 1 - 3 mm, were acquired. The deep learning findings showed that the ResNet-18 network had the highest accuracy for 120-kVp and 135-kVp CT scanning, while ResNet-50 performed better in 80-kVp CT scanning. The ResNet-50 network showed the best performance of all networks in predicting stone types in 80-kVp scanning, as indicated by its high sensitivity, specificity, and precision. Conclusion: The present results indicated that our deep learning approach could be used for the in vivo determination of renal stone types. Moreover, low-dose or ultra-low-dose single-energy CT scanning is more widely accessible and safer in terms of radiation exposure.
{"title":"A Study Toward Automatic Identification of Renal Stone Composition in Single-energy or Ultra-low-dose CT Scan Using Deep Neural Networks","authors":"Mahboobeh Sheikhi, S. Sina, M. Karimipourfard, Fereshteh Khodadadi Shoushtari","doi":"10.5812/iranjradiol-134454","DOIUrl":"https://doi.org/10.5812/iranjradiol-134454","url":null,"abstract":"Background: Dual-energy computed tomography (DECT) scan is a non-invasive method for the in vivo identification of renal stone composition. However, DECT scanners have several demerits, including high cost, low accessibility, and high radiation dose to patients. Objectives: The present study aimed to investigate the efficacy of deep neural networks in the classification of renal stone types using single-energy CT imaging. The Taguchi method was used for the optimization of hyperparameters. Patients and Methods: A total of 146 pure renal stone samples were first surgically collected from the patients. The stones were then inserted into a Rando phantom and scanned using a DECT scanner. An ultra-low-dose CT scan was acquired to determine the stone position prior to the DECT scan. The result of chemical analysis was used as the gold standard for determining the stone composition throughout the study. Several neural networks, including ResNet-50, ResNet-18, GoogLeNet, and VGG-19, were used to classify the stone images into three composition groups, including uric acid, calcium oxalate, and cystine. Moreover, the Taguchi method was employed to optimize the network hyperparameters. The signal-to-noise ratio (SNR) was also analyzed to determine the optimal arrangement. Results: In this study, CT scans of 53 uric acid, 55 calcium oxalate, and 38 cystine stones, with diameters of 1 - 3 mm, were acquired. The deep learning findings showed that the ResNet-18 network had the highest accuracy for 120-kVp and 135-kVp CT scanning, while ResNet-50 performed better in 80-kVp CT scanning. The ResNet-50 network showed the best performance of all networks in predicting stone types in 80-kVp scanning, as indicated by its high sensitivity, specificity, and precision. Conclusion: The present results indicated that our deep learning approach could be used for the in vivo determination of renal stone types. Moreover, low-dose or ultra-low-dose single-energy CT scanning is more widely accessible and safer in terms of radiation exposure.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48591245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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