Background: With the development of computed tomography (CT) technology, the number of infants undergoing CT examination has increased. Recently, problems associated with radiation exposure have attracted the public attention, and low-dose CT examination has become the research focus. Objectives: This study aimed to explore the feasibility of a fixed ultralow tube current combined with iDose4 iterative reconstruction at a low tube voltage (80 kV) in low-dose CT scanning of infant lungs. Patients and Methods: Ninety infants, aged 0 - 3 years, undergoing enhanced chest CT scan (including plain CT scan and arterial scan), were included in the experimental group. In the experimental group, plain CT scan was performed at 80 kV under a fixed tube current (30 mA), and arterial phase CT scan was carried out at 80 kV with automatic tube current modulation (30 - 150 mA). Meanwhile, 90 infants, aged 0 - 3 years, undergoing non-enhanced chest CT scan, were randomly recruited as the control group. For the control group, plain CT scan was performed at 80 kV with automatic tube current modulation (30-150 mA). In each examination, the iDose4 iterative reconstruction technique was used for reconstruction. The volume CT dose index (CTDIvol), dose-length product (DLP), effective dose (ED, measured using a 32-cm diameter phantom), signal-to-noise ratio (SNR), and overall subjective quality of plain CT scans were analyzed and compared between the experimental and control groups. Results: Regarding the radiation dose in different age groups, the ED (mSv) was significantly lower in the experimental group compared to the control group (0-1-year-old subgroup: 0.48 ± 0.05 mSv in the experimental group vs. 0.91 ± 0.19 mSv in the control group, P < 0.05; 1-2-year-old subgroup: 0.50 ± 0.01 mSv in the experimental group vs. 0.75 ± 0.10 mSv in the control group, P < 0.05; and 2-3-year-old subgroup: 0.46 ± 0.05 mSv in the experimental group vs. 0.79 ± 0.11 mSv in the control group, P < 0.05). The image SNR was higher in the control group compared to the experimental group (P < 0.05), while the difference in subjective image quality was not significant between the experimental and control groups (P < 0.05). Conclusion: The chest CT examination of infants, aged 0 - 3 years, at a low tube voltage (80 kV) and a fixed tube current (30 mA), combined with the iDose4 iterative reconstruction technique, and the obtained images met the diagnostic criteria...
{"title":"A Study of Fixed Current and Automatic Tube Current Modulation at a Fixed Low Tube Voltage in Low-dose Computed Tomography (CT) Imaging of Infant Lungs","authors":"Wushuang Chen, Shilong Tang, Zhe Xu, Xin Chen, Yinglan Zheng, Ling He","doi":"10.5812/iranjradiol-126362","DOIUrl":"https://doi.org/10.5812/iranjradiol-126362","url":null,"abstract":"Background: With the development of computed tomography (CT) technology, the number of infants undergoing CT examination has increased. Recently, problems associated with radiation exposure have attracted the public attention, and low-dose CT examination has become the research focus. Objectives: This study aimed to explore the feasibility of a fixed ultralow tube current combined with iDose4 iterative reconstruction at a low tube voltage (80 kV) in low-dose CT scanning of infant lungs. Patients and Methods: Ninety infants, aged 0 - 3 years, undergoing enhanced chest CT scan (including plain CT scan and arterial scan), were included in the experimental group. In the experimental group, plain CT scan was performed at 80 kV under a fixed tube current (30 mA), and arterial phase CT scan was carried out at 80 kV with automatic tube current modulation (30 - 150 mA). Meanwhile, 90 infants, aged 0 - 3 years, undergoing non-enhanced chest CT scan, were randomly recruited as the control group. For the control group, plain CT scan was performed at 80 kV with automatic tube current modulation (30-150 mA). In each examination, the iDose4 iterative reconstruction technique was used for reconstruction. The volume CT dose index (CTDIvol), dose-length product (DLP), effective dose (ED, measured using a 32-cm diameter phantom), signal-to-noise ratio (SNR), and overall subjective quality of plain CT scans were analyzed and compared between the experimental and control groups. Results: Regarding the radiation dose in different age groups, the ED (mSv) was significantly lower in the experimental group compared to the control group (0-1-year-old subgroup: 0.48 ± 0.05 mSv in the experimental group vs. 0.91 ± 0.19 mSv in the control group, P < 0.05; 1-2-year-old subgroup: 0.50 ± 0.01 mSv in the experimental group vs. 0.75 ± 0.10 mSv in the control group, P < 0.05; and 2-3-year-old subgroup: 0.46 ± 0.05 mSv in the experimental group vs. 0.79 ± 0.11 mSv in the control group, P < 0.05). The image SNR was higher in the control group compared to the experimental group (P < 0.05), while the difference in subjective image quality was not significant between the experimental and control groups (P < 0.05). Conclusion: The chest CT examination of infants, aged 0 - 3 years, at a low tube voltage (80 kV) and a fixed tube current (30 mA), combined with the iDose4 iterative reconstruction technique, and the obtained images met the diagnostic criteria...","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43288282","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 : 2023-04-24DOI: 10.5812/iranjradiol-131348
Luyun Chen, Yuanyi Huang
Background: Pulmonary mass-like lesions are one of the common manifestations of respiratory disorders. Differential diagnosis of these lesions is a major challenge in imaging studies. Objectives: This study aimed to explore the efficacy of spectral computed tomography (CT) features combined with conventional CT features in the differential diagnosis of pulmonary mass-like lesions. Patients and Methods: This case-control study was performed on a malignant group consisting of patients and a benign group consisting of controls. The imaging characteristics and spectral CT parameters were evaluated in 77 patients who met the inclusion criteria. A multivariate logistic regression analysis was performed to determine independent predictors of malignant pulmonary lump-like lesions. Three models were established, including a radiomic feature model, a spectral CT model, and a combined model. A receiver operating characteristic (ROC) curve was also plotted to evaluate the diagnostic efficiency of the models. Results: Some CT features were significantly different between the malignant and benign groups, including the long-axis diameter (44.86 ± 18.42 in the malignant group vs. 55.59 ± 22.57 in the benign group; P = 0.07), mediastinal lymphadenopathy (25.00% in the benign group vs. 62.26% in the malignant group; P = 0.02), and mediastinal lymph node confluence (4.17% in the benign group vs. 41.51% in the malignant group; P = 0.01). The CT values at 40 keV (157.25 ± 79.23 vs. 148.46 ± 25.36, P = 0.047) and K40 - 70 keV (2.76 ± 2.05 vs. 2.52 ± 0.60, P = 0.04) were significantly higher in the benign group compared to the malignant group in the arterial phase (AP). Besides, the iodine concentration (IC) (14.73 ± 10.65 vs. 13.44 ± 3.24, P = 0.039; 17.52 ± 5.29 vs. 13.87 ± 5.81, P = 0.035), normalized iodine concentration (NIC) (0.15 ± 0.06 vs. 0.11 ± 0.05, P = 0.015; 0.41 ± 0.11 vs. 0.35 ± 0.10, P = 0.017), and Zeff value (8.46 ± 0.63 vs. 8.43 ± 0.28, P = 0.034; 8.60 ± 0.29 vs. 8.39 ± 0.33, P = 0.035) were significantly higher in the benign group compared to the malignant group, both in the AP and venous phase (VP). The logistic regression model, integrating CT features and spectral CT parameters, showed the highest diagnostic efficacy (area under the curve [AUC], 0.956; sensitivity, 87.5%; specificity, 90.6%). Conclusion: The quantitative spectral CT parameters, combined with conventional CT features, could help distinguish benign and malignant pulmonary mass-like lesions, providing an essential basis for developing treatment plans.
{"title":"Application of Spectral Computed Tomography (CT) Combined with Conventional CT Features in Differentiating Malignant Pulmonary Mass-Like Lesions","authors":"Luyun Chen, Yuanyi Huang","doi":"10.5812/iranjradiol-131348","DOIUrl":"https://doi.org/10.5812/iranjradiol-131348","url":null,"abstract":"Background: Pulmonary mass-like lesions are one of the common manifestations of respiratory disorders. Differential diagnosis of these lesions is a major challenge in imaging studies. Objectives: This study aimed to explore the efficacy of spectral computed tomography (CT) features combined with conventional CT features in the differential diagnosis of pulmonary mass-like lesions. Patients and Methods: This case-control study was performed on a malignant group consisting of patients and a benign group consisting of controls. The imaging characteristics and spectral CT parameters were evaluated in 77 patients who met the inclusion criteria. A multivariate logistic regression analysis was performed to determine independent predictors of malignant pulmonary lump-like lesions. Three models were established, including a radiomic feature model, a spectral CT model, and a combined model. A receiver operating characteristic (ROC) curve was also plotted to evaluate the diagnostic efficiency of the models. Results: Some CT features were significantly different between the malignant and benign groups, including the long-axis diameter (44.86 ± 18.42 in the malignant group vs. 55.59 ± 22.57 in the benign group; P = 0.07), mediastinal lymphadenopathy (25.00% in the benign group vs. 62.26% in the malignant group; P = 0.02), and mediastinal lymph node confluence (4.17% in the benign group vs. 41.51% in the malignant group; P = 0.01). The CT values at 40 keV (157.25 ± 79.23 vs. 148.46 ± 25.36, P = 0.047) and K40 - 70 keV (2.76 ± 2.05 vs. 2.52 ± 0.60, P = 0.04) were significantly higher in the benign group compared to the malignant group in the arterial phase (AP). Besides, the iodine concentration (IC) (14.73 ± 10.65 vs. 13.44 ± 3.24, P = 0.039; 17.52 ± 5.29 vs. 13.87 ± 5.81, P = 0.035), normalized iodine concentration (NIC) (0.15 ± 0.06 vs. 0.11 ± 0.05, P = 0.015; 0.41 ± 0.11 vs. 0.35 ± 0.10, P = 0.017), and Zeff value (8.46 ± 0.63 vs. 8.43 ± 0.28, P = 0.034; 8.60 ± 0.29 vs. 8.39 ± 0.33, P = 0.035) were significantly higher in the benign group compared to the malignant group, both in the AP and venous phase (VP). The logistic regression model, integrating CT features and spectral CT parameters, showed the highest diagnostic efficacy (area under the curve [AUC], 0.956; sensitivity, 87.5%; specificity, 90.6%). Conclusion: The quantitative spectral CT parameters, combined with conventional CT features, could help distinguish benign and malignant pulmonary mass-like lesions, providing an essential basis for developing treatment plans.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134954829","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 : 2023-04-10DOI: 10.5812/iranjradiol-129458
Wen Tang, M. Cao, Qilong Chen, Hong Yang, Ying Yang
Background: In the past several years, emerging imaging techniques, such as computed tomography angiography (CTA), Doppler ultrasound, and magnetic resonance imaging (MRI), have been used for investigating the anatomy and perfusion of perforator complexes. Preoperative CTA can provide explicit information on perforator flaps, which not only helps surgeons to evaluate the optimal design of flaps with respect to the lateral circumflex femoral artery (LCFA) territory and the concomitant venous drainage pattern, but also reduces postoperative complications and secondary operation rates. Objectives: This study aimed to evaluate the clinical feasibility of a low-dose CTA protocol with adaptive statistical iterative reconstruction (ASIR) for patients scheduled for anterolateral thigh perforator flap (ALTPF) surgery. Patients and Methods: This prospective randomized controlled trial was conducted in a single institution from August 2016 to July 2017. A total of 60 inpatients scheduled for the ALTPF surgery were randomly allocated into three groups (n = 20 per group): Group A, filtered back projection (FBP) reconstruction with a tube voltage of 120 kVp; group B, ASIR with a tube voltage of 100 kVp; and group C, ASIR with a tube voltage of 80 kVp. The vessel attenuation value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) were compared between the three groups. Additionally, a four-point Likert scale was used to evaluate the subjective quality of images. The scan length, dose-length product (DLP), CT dose index (CTDI), and effective dose (ED) were also recorded and compared. Results: The age, sex, and body mass index (BMI) were not significantly different between the three groups (P > 0.05 for all). The FOM of images in the three segments was significantly higher in group C compared to the other two groups (P < 0.001 for all). The results of subjective evaluation revealed no poor-quality images, and the Likert score did not significantly differ between the groups. Compared to group A and group B, significant reductions were observed in CTDI, DLP, and ED in group C. Conclusion: The 80-kVp protocol with ASIR not only reduced the radiation dose, but also exhibited lower performance compared to the 120-kVp protocol with FBP and the 80-kVp protocol with ASIR; it also yielded relatively satisfactory image quality.
{"title":"Clinical Feasibility of a Low-dose Computed Tomography Angiography Protocol with an Iterative Reconstruction Algorithm in Preoperative Examinations for Anterolateral Thigh Perforator Flap Surgery","authors":"Wen Tang, M. Cao, Qilong Chen, Hong Yang, Ying Yang","doi":"10.5812/iranjradiol-129458","DOIUrl":"https://doi.org/10.5812/iranjradiol-129458","url":null,"abstract":"Background: In the past several years, emerging imaging techniques, such as computed tomography angiography (CTA), Doppler ultrasound, and magnetic resonance imaging (MRI), have been used for investigating the anatomy and perfusion of perforator complexes. Preoperative CTA can provide explicit information on perforator flaps, which not only helps surgeons to evaluate the optimal design of flaps with respect to the lateral circumflex femoral artery (LCFA) territory and the concomitant venous drainage pattern, but also reduces postoperative complications and secondary operation rates. Objectives: This study aimed to evaluate the clinical feasibility of a low-dose CTA protocol with adaptive statistical iterative reconstruction (ASIR) for patients scheduled for anterolateral thigh perforator flap (ALTPF) surgery. Patients and Methods: This prospective randomized controlled trial was conducted in a single institution from August 2016 to July 2017. A total of 60 inpatients scheduled for the ALTPF surgery were randomly allocated into three groups (n = 20 per group): Group A, filtered back projection (FBP) reconstruction with a tube voltage of 120 kVp; group B, ASIR with a tube voltage of 100 kVp; and group C, ASIR with a tube voltage of 80 kVp. The vessel attenuation value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) were compared between the three groups. Additionally, a four-point Likert scale was used to evaluate the subjective quality of images. The scan length, dose-length product (DLP), CT dose index (CTDI), and effective dose (ED) were also recorded and compared. Results: The age, sex, and body mass index (BMI) were not significantly different between the three groups (P > 0.05 for all). The FOM of images in the three segments was significantly higher in group C compared to the other two groups (P < 0.001 for all). The results of subjective evaluation revealed no poor-quality images, and the Likert score did not significantly differ between the groups. Compared to group A and group B, significant reductions were observed in CTDI, DLP, and ED in group C. Conclusion: The 80-kVp protocol with ASIR not only reduced the radiation dose, but also exhibited lower performance compared to the 120-kVp protocol with FBP and the 80-kVp protocol with ASIR; it also yielded relatively satisfactory image quality.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47809474","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 : 2023-03-29DOI: 10.5812/iranjradiol-129700
Saeed Keshmiri, Meysam Velayati, S. Momenzadeh
Background: Biolaser is an emerging technology, which has attracted the attention of many surgeons and specialists in different medical fields. Objectives: This study aimed to evaluate the clinical effectiveness of ultrasound-guided biolaser radiation versus ozone therapy in reducing chronic pain in patients with knee osteoarthritis during a three-month follow-up. Patients and Methods: Sixty patients referring to pain clinic of Shohadaye-Tajrish and Akhtar hospitals in 2017, were included in this randomized single-blind clinical trial study. According to a randomized table of numbers, in Biolaser group (n = 30): 10 mL of normal saline + 5 mL of lidocaine 1% + BioLaser + Physical Therapy and in the Ozone group (n = 30), received 10 mL Ozone (30 mic/mL) plus 5 mL lidocaine 1% + BioLaser placebo + Physical Therapy received. The patients were evaluated for pain using visual analog scale (VAS) and knee function with Knee injury and Osteoarthritis Outcome Score (KOOS) questioner. The patients were followed up 4 & 12 weeks and reviewed at weeks 12 after the injection by an observer who was unaware of the groups (IRCT20111121008146N15). Results: Comparison of the mean age (56.8 ± 8.5 years in the biolaser group vs. 51.5 ± 5.4 years in the ozone therapy group; P = 0.721) and body mass index (31.1 ± 3.4 kg/m2 in the biolaser group vs. 30.5 ± 2.6 kg/m2 in the ozone therapy group; P = 0.214) did not indicate any significant differences between the two groups. The pain severity decreased significantly at different times in the biolaser and ozone therapy groups (P = 0.018). The knee pressure sensitivity score was 1.3 ± 0.5 in the biolaser group and 1.6 ± 0.4 in the ozone therapy group at 12 weeks post-treatment (P = 0.037). The knee circumference was also 35.6 ± 3.0 cm in the biolaser group and 39.7 ± 3.9 cm in the ozone therapy group at 12 weeks post-treatment (P = 0.032). The KOOS performance score was 46.9 ± 9.4 in the biolaser group and 49.3 ± 7.9 in the ozone therapy group (P = 0.187). Besides, the KOOS quality of life score was 10 ± 1.3 in the biolaser group and 10.4 ± 1.5 in the ozone therapy group (P = 0.586). Conclusion: Biolaser therapy under ultrasound guidance was found to be a safe, non-invasive, and effective method, which could improve chronic pain in knee osteoarthritis during a three-month follow-up.
背景:生物激光是一项新兴技术，已经引起了许多外科医生和不同医学领域专家的关注。目的:本研究旨在评估超声引导生物激光照射与臭氧治疗在减轻膝骨关节炎患者慢性疼痛方面的临床效果，为期三个月的随访。患者与方法:选取2017年在Shohadaye-Tajrish和Akhtar医院疼痛门诊就诊的60例患者进行随机单盲临床研究。根据随机数字表，Biolaser组(n = 30):生理盐水10 mL + 1%利多卡因5 mL + Biolaser +物理治疗;Ozone组(n = 30):臭氧10 mL (30 mic/mL) + 1%利多卡因5 mL + Biolaser安慰剂+物理治疗。采用视觉模拟评分法(VAS)和膝关节功能评分法(膝关节损伤和骨关节炎预后评分法(oos))对患者进行疼痛评估。患者随访4周和12周，并在注射后12周由不知道组的观察员(IRCT20111121008146N15)进行复查。结果:生物激光治疗组平均年龄(56.8±8.5岁)与臭氧治疗组平均年龄(51.5±5.4岁)比较;P = 0.721)，体重指数(生物激光组31.1±3.4 kg/m2 vs臭氧组30.5±2.6 kg/m2);P = 0.214)，两组间无显著差异。生物激光治疗组和臭氧治疗组不同时间疼痛程度均明显减轻(P = 0.018)。治疗后12周，生物激光组膝关节压敏评分为1.3±0.5分，臭氧组为1.6±0.4分(P = 0.037)。治疗后12周，生物激光组膝关节围度为35.6±3.0 cm，臭氧组为39.7±3.9 cm (P = 0.032)。生物激光治疗组的KOOS评分为46.9±9.4分，臭氧治疗组为49.3±7.9分(P = 0.187)。生物激光治疗组的KOOS生活质量评分为10±1.3分，臭氧治疗组的KOOS生活质量评分为10.4±1.5分(P = 0.586)。结论:超声引导下的生物激光治疗是一种安全、无创、有效的治疗方法，在三个月的随访中可以改善膝关节骨性关节炎的慢性疼痛。
{"title":"Clinical Effectiveness of Ultrasound-Guided Biolaser Versus Ozone Therapy in Reducing Chronic Pain in Knee Osteoarthritis: A Three-Month Follow-Up Study","authors":"Saeed Keshmiri, Meysam Velayati, S. Momenzadeh","doi":"10.5812/iranjradiol-129700","DOIUrl":"https://doi.org/10.5812/iranjradiol-129700","url":null,"abstract":"Background: Biolaser is an emerging technology, which has attracted the attention of many surgeons and specialists in different medical fields. Objectives: This study aimed to evaluate the clinical effectiveness of ultrasound-guided biolaser radiation versus ozone therapy in reducing chronic pain in patients with knee osteoarthritis during a three-month follow-up. Patients and Methods: Sixty patients referring to pain clinic of Shohadaye-Tajrish and Akhtar hospitals in 2017, were included in this randomized single-blind clinical trial study. According to a randomized table of numbers, in Biolaser group (n = 30): 10 mL of normal saline + 5 mL of lidocaine 1% + BioLaser + Physical Therapy and in the Ozone group (n = 30), received 10 mL Ozone (30 mic/mL) plus 5 mL lidocaine 1% + BioLaser placebo + Physical Therapy received. The patients were evaluated for pain using visual analog scale (VAS) and knee function with Knee injury and Osteoarthritis Outcome Score (KOOS) questioner. The patients were followed up 4 & 12 weeks and reviewed at weeks 12 after the injection by an observer who was unaware of the groups (IRCT20111121008146N15). Results: Comparison of the mean age (56.8 ± 8.5 years in the biolaser group vs. 51.5 ± 5.4 years in the ozone therapy group; P = 0.721) and body mass index (31.1 ± 3.4 kg/m2 in the biolaser group vs. 30.5 ± 2.6 kg/m2 in the ozone therapy group; P = 0.214) did not indicate any significant differences between the two groups. The pain severity decreased significantly at different times in the biolaser and ozone therapy groups (P = 0.018). The knee pressure sensitivity score was 1.3 ± 0.5 in the biolaser group and 1.6 ± 0.4 in the ozone therapy group at 12 weeks post-treatment (P = 0.037). The knee circumference was also 35.6 ± 3.0 cm in the biolaser group and 39.7 ± 3.9 cm in the ozone therapy group at 12 weeks post-treatment (P = 0.032). The KOOS performance score was 46.9 ± 9.4 in the biolaser group and 49.3 ± 7.9 in the ozone therapy group (P = 0.187). Besides, the KOOS quality of life score was 10 ± 1.3 in the biolaser group and 10.4 ± 1.5 in the ozone therapy group (P = 0.586). Conclusion: Biolaser therapy under ultrasound guidance was found to be a safe, non-invasive, and effective method, which could improve chronic pain in knee osteoarthritis during a three-month follow-up.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47475987","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 : 2023-03-06DOI: 10.5812/iranjradiol-130478
Makiko Murota, T. Norikane, Y. Yamamoto, Mariko Ishimura, Katsuya Mitamura, Yasukage Takami, Kengo Fujimoto, K. Satoh, Naoya Yokota, Ryou Ishikawa, Y. Nishiyama
Background: Cystic and cavitary lung cancer (CCLC) is infrequently observed on computed tomography (CT) scans; however, its diagnosis is often overlooked or delayed. Objectives: The current study aimed to investigate the CT and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) features of CCLC. Patients and Methods: A total of 809 patients who underwent lung tumor resection were examined in this study, and the presence of cystic and cavitary lesions on CT scans was investigated. Based on the CT scans, CCLC was identified in 102 consecutive patients. The diameters of the whole nodule and the airspace portion of the lesion, morphological patterns of cystic and cavitary lesions, presence of ground glass opacity (GGO), and loculation pattern (including the presence of a septum) were evaluated. The positron emission tomography (PET) scans of CCLC were also assessed visually and semi-quantitatively. Results: A total of 104 CCLC lesions were evaluated in this study. The histological analysis indicated 85 cases of adenocarcinoma (AD) and 19 cases of squamous cell carcinoma (SCC). The morphological patterns of cystic and cavitary lesions were classified into four types. The presence of GGO, type 4 morphological pattern (a soft-tissue-density structure intermixed within clusters of a cavitary lesion), and multilocular with septum (MS) loculation pattern were significantly different according to the histological type. The maximum standardized uptake value (SUVmax) on PET scans was significantly lower in AD compared to SCC (P = 0.002). In the solid nodule part of cystic and cavitary lesions, the MS pattern was significantly more common in AD (P = 0.044). Conclusion: When cystic and cavitary lesions are observed on CT scans, the presence of GGO and the MS pattern should be considered, as it may help differentiate the histological findings.
{"title":"Cystic and Cavitary Lung Cancer: Its Characteristic Features on CT and FDG-PET Scans","authors":"Makiko Murota, T. Norikane, Y. Yamamoto, Mariko Ishimura, Katsuya Mitamura, Yasukage Takami, Kengo Fujimoto, K. Satoh, Naoya Yokota, Ryou Ishikawa, Y. Nishiyama","doi":"10.5812/iranjradiol-130478","DOIUrl":"https://doi.org/10.5812/iranjradiol-130478","url":null,"abstract":"Background: Cystic and cavitary lung cancer (CCLC) is infrequently observed on computed tomography (CT) scans; however, its diagnosis is often overlooked or delayed. Objectives: The current study aimed to investigate the CT and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) features of CCLC. Patients and Methods: A total of 809 patients who underwent lung tumor resection were examined in this study, and the presence of cystic and cavitary lesions on CT scans was investigated. Based on the CT scans, CCLC was identified in 102 consecutive patients. The diameters of the whole nodule and the airspace portion of the lesion, morphological patterns of cystic and cavitary lesions, presence of ground glass opacity (GGO), and loculation pattern (including the presence of a septum) were evaluated. The positron emission tomography (PET) scans of CCLC were also assessed visually and semi-quantitatively. Results: A total of 104 CCLC lesions were evaluated in this study. The histological analysis indicated 85 cases of adenocarcinoma (AD) and 19 cases of squamous cell carcinoma (SCC). The morphological patterns of cystic and cavitary lesions were classified into four types. The presence of GGO, type 4 morphological pattern (a soft-tissue-density structure intermixed within clusters of a cavitary lesion), and multilocular with septum (MS) loculation pattern were significantly different according to the histological type. The maximum standardized uptake value (SUVmax) on PET scans was significantly lower in AD compared to SCC (P = 0.002). In the solid nodule part of cystic and cavitary lesions, the MS pattern was significantly more common in AD (P = 0.044). Conclusion: When cystic and cavitary lesions are observed on CT scans, the presence of GGO and the MS pattern should be considered, as it may help differentiate the histological findings.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48891306","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 : 2023-02-27DOI: 10.5812/iranjradiol-126595
Lea Chocardelle, M. Djelouah, C. Durot, D. Morland, A. Delmer, E. Durot, C. Hoeffel
Background: T-cell lymphomas constitute a heterogeneous group of hematological malignancies with global poor outcomes. Computed tomography (CT)-based texture analysis (CTTA) is a promising technique to predict the survival of these patients. Objectives: The present study aimed to investigate whether CTTA features on the pretreatment unenhanced CT scans of 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) examination can predict the survival of patients with T-cell lymphomas. Patients and Methods: In this retrospective cohort study, patients with T-cell lymphomas, undergoing pretreatment 18F-FDG PET/CT scan during 2008 - 2019, were included, and their clinical and biological characteristics were collected. The mean gray value, entropy, kurtosis, skewness, and standard deviation were derived from the pixel distribution histogram before and after spatial filtration at different anatomic scales in up to five lesions per patient, indicating a high focal uptake on 18F-FDG PET scan. A Lasso-penalized Cox regression analysis was performed to identify independent predictors of overall survival (OS), progression-free survival at 24 months (PFS24), and PFS. Results: A total of 23 patients (7 females and 16 males; median age, 69 years; age range, 33 - 86 years) were included in this study. The CTTA was performed for 60 lesions. The median OS and PFS were 391 days (range, 10 - 3,463 days) and 268 days (range, 10 - 2,321 days), respectively. No CT texture parameter was associated with PFS or PFS24. The standard deviation at a coarse filter scale was independently associated with a poor OS (hazard ratio [HR] = 1.009, confidence interval [CI]: 1.0012 - 1.016, P = 0.02). A value above 143 was associated with a poor prognosis with a specificity of 81%. Conclusion: The pretreatment CTTA-derived tumor standard deviation at a coarse filter scale may be a predictive biomarker of OS in patients with T-cell lymphomas.
{"title":"Computed Tomography-Based Texture Analysis as a Predictor of Survival in Patients with T-Cell Lymphomas","authors":"Lea Chocardelle, M. Djelouah, C. Durot, D. Morland, A. Delmer, E. Durot, C. Hoeffel","doi":"10.5812/iranjradiol-126595","DOIUrl":"https://doi.org/10.5812/iranjradiol-126595","url":null,"abstract":"Background: T-cell lymphomas constitute a heterogeneous group of hematological malignancies with global poor outcomes. Computed tomography (CT)-based texture analysis (CTTA) is a promising technique to predict the survival of these patients. Objectives: The present study aimed to investigate whether CTTA features on the pretreatment unenhanced CT scans of 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) examination can predict the survival of patients with T-cell lymphomas. Patients and Methods: In this retrospective cohort study, patients with T-cell lymphomas, undergoing pretreatment 18F-FDG PET/CT scan during 2008 - 2019, were included, and their clinical and biological characteristics were collected. The mean gray value, entropy, kurtosis, skewness, and standard deviation were derived from the pixel distribution histogram before and after spatial filtration at different anatomic scales in up to five lesions per patient, indicating a high focal uptake on 18F-FDG PET scan. A Lasso-penalized Cox regression analysis was performed to identify independent predictors of overall survival (OS), progression-free survival at 24 months (PFS24), and PFS. Results: A total of 23 patients (7 females and 16 males; median age, 69 years; age range, 33 - 86 years) were included in this study. The CTTA was performed for 60 lesions. The median OS and PFS were 391 days (range, 10 - 3,463 days) and 268 days (range, 10 - 2,321 days), respectively. No CT texture parameter was associated with PFS or PFS24. The standard deviation at a coarse filter scale was independently associated with a poor OS (hazard ratio [HR] = 1.009, confidence interval [CI]: 1.0012 - 1.016, P = 0.02). A value above 143 was associated with a poor prognosis with a specificity of 81%. Conclusion: The pretreatment CTTA-derived tumor standard deviation at a coarse filter scale may be a predictive biomarker of OS in patients with T-cell lymphomas.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42119410","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 : 2023-02-25DOI: 10.5812/iranjradiol-129454
Dan Zhang, R. Liu, Beibei Yu, Maosheng Xu, C. Zou
Background: The virtual touch quantification (VTQ) using acoustic radiation force impulse (ARFI) is a type of ARFI technology, which has been widely used against many diseases. The sensitivity and specificity of VTQ in differentiating immunoglobulin A nephropathy (IgAN) patients from healthy controls remain unestablished. Objectives: The present study aimed to measure the VTQ values of renal parenchyma in patients with IgAN and to evaluate the efficacy of these values in distinguishing IgAN patients from healthy individuals. Patients and Methods: Ultrasound examinations were performed for the experimental and control groups. All routine ultrasound data, including the renal parenchymal thickness, renal volume, resistive index (RI) of interlobar renal arteries, and peak velocity of interlobar renal arteries, were collected. The VTQ values were measured in the middle and lower renal parenchyma using the VTQ technique. A receiver operating characteristic (ROC) curve was plotted to evaluate the efficacy of VTQ in differentiating IgAN patients from healthy individuals. Results: The VTQ values, RI values of interlobar arteries, and peak velocity of interlobar arteries were significantly different between patients with IgAN and the controls (2.14 ± 0.31 vs. 2.62 ± 0.24 m/s, 0.68 ± 0.05 vs. 0.63 ± 0.03 m/s, and 0.56 ± 0.59 vs. 0.60 ± 0.58 m/s; P < 0.05 for all). The VTQ values were associated with the renal parenchymal thickness, peak flow velocity of interlobular arteries, and Lee’s grade (P < 0.05 for all). The ROC curve analysis revealed that VTQ values might be used as a diagnostic method for differentiating IgAN patients (area under the curve [AUC] = 0.909) from healthy controls. Conclusion: The VTQ values significantly decreased in patients with IgAN and might play an important role in distinguishing IgAN patients from healthy individuals, with high sensitivity and specificity.
{"title":"Efficacy of Virtual Touch Quantification Technique for Differentiating Patients with Immunoglobulin A Nephropathy (IgAN) from Healthy Controls","authors":"Dan Zhang, R. Liu, Beibei Yu, Maosheng Xu, C. Zou","doi":"10.5812/iranjradiol-129454","DOIUrl":"https://doi.org/10.5812/iranjradiol-129454","url":null,"abstract":"Background: The virtual touch quantification (VTQ) using acoustic radiation force impulse (ARFI) is a type of ARFI technology, which has been widely used against many diseases. The sensitivity and specificity of VTQ in differentiating immunoglobulin A nephropathy (IgAN) patients from healthy controls remain unestablished. Objectives: The present study aimed to measure the VTQ values of renal parenchyma in patients with IgAN and to evaluate the efficacy of these values in distinguishing IgAN patients from healthy individuals. Patients and Methods: Ultrasound examinations were performed for the experimental and control groups. All routine ultrasound data, including the renal parenchymal thickness, renal volume, resistive index (RI) of interlobar renal arteries, and peak velocity of interlobar renal arteries, were collected. The VTQ values were measured in the middle and lower renal parenchyma using the VTQ technique. A receiver operating characteristic (ROC) curve was plotted to evaluate the efficacy of VTQ in differentiating IgAN patients from healthy individuals. Results: The VTQ values, RI values of interlobar arteries, and peak velocity of interlobar arteries were significantly different between patients with IgAN and the controls (2.14 ± 0.31 vs. 2.62 ± 0.24 m/s, 0.68 ± 0.05 vs. 0.63 ± 0.03 m/s, and 0.56 ± 0.59 vs. 0.60 ± 0.58 m/s; P < 0.05 for all). The VTQ values were associated with the renal parenchymal thickness, peak flow velocity of interlobular arteries, and Lee’s grade (P < 0.05 for all). The ROC curve analysis revealed that VTQ values might be used as a diagnostic method for differentiating IgAN patients (area under the curve [AUC] = 0.909) from healthy controls. Conclusion: The VTQ values significantly decreased in patients with IgAN and might play an important role in distinguishing IgAN patients from healthy individuals, with high sensitivity and specificity.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41325934","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 : 2023-02-15DOI: 10.5812/iranjradiol-133421
H. Park, Y. Yoon, H. Kim
Introduction: Myoepithelial carcinomas are rare malignant neoplasms, which are known to arise from the salivary glands or other organs. Case Presentation: Here, we present a case of myoepithelial carcinoma in a 64-year-old woman, presenting to a clinic with a painful ankle mass for the past three years. Ultrasonography showed a 1 cm, iso- to hypoechoic mass on the medial malleolus of the right ankle. Magnetic resonance imaging (MRI) revealed a well-defined mass with iso-signal intensity on T1-weighted images and high signal intensity on T2-weighted images. On the enhanced image, the mass showed homogenous enhancement. In diffusion-weighted images with a high b-value, the lesion showed restriction with a low apparent diffusion coefficient (ADC). Surgical removal was performed, and pathological analysis revealed myoepithelial carcinoma. Conclusion: Myoepithelial carcinoma of the extrasalivary glands is a very uncommon phenomenon. Despite its rarity, it should be considered as a differential diagnosis when a soft tissue mass of the ankle shows malignant potential in radiological findings.
{"title":"Subcutaneous Myoepithelial Carcinoma of the Ankle","authors":"H. Park, Y. Yoon, H. Kim","doi":"10.5812/iranjradiol-133421","DOIUrl":"https://doi.org/10.5812/iranjradiol-133421","url":null,"abstract":"Introduction: Myoepithelial carcinomas are rare malignant neoplasms, which are known to arise from the salivary glands or other organs. Case Presentation: Here, we present a case of myoepithelial carcinoma in a 64-year-old woman, presenting to a clinic with a painful ankle mass for the past three years. Ultrasonography showed a 1 cm, iso- to hypoechoic mass on the medial malleolus of the right ankle. Magnetic resonance imaging (MRI) revealed a well-defined mass with iso-signal intensity on T1-weighted images and high signal intensity on T2-weighted images. On the enhanced image, the mass showed homogenous enhancement. In diffusion-weighted images with a high b-value, the lesion showed restriction with a low apparent diffusion coefficient (ADC). Surgical removal was performed, and pathological analysis revealed myoepithelial carcinoma. Conclusion: Myoepithelial carcinoma of the extrasalivary glands is a very uncommon phenomenon. Despite its rarity, it should be considered as a differential diagnosis when a soft tissue mass of the ankle shows malignant potential in radiological findings.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43205233","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 : 2023-02-13DOI: 10.5812/iranjradiol-129097
Chao Ma, Yan Wang, Xiaohui Li, F. Duan
Context: Transarterial embolization/chemoembolization (TAE/TACE) has been shown to be effective against ruptured hepatocellular carcinoma (HCC). However, the early clinical mortality remains unpredictable. Objectives: To conduct a comprehensive quantitative evaluation of early mortality after emergency TAE/TACE for spontaneous HCC rupture and to perform an overall analysis of risk factors to gather more representative data. Methods: The PubMed/Medline, Web of Science, and Embase databases were searched, and relevant studies were retrieved using the corresponding English keywords. Next, the literature was screened according to the inclusion and exclusion criteria. Finally, Stata version 15.1 and R Project 4.1.2 were used for meta-analysis. Results: A total of 24 studies (n = 1,083) were included in this meta-analysis. The combined 30-day mortality following emergency TAE/TACE for spontaneous HCC rupture was 28.8% (95% confidence interval [CI]: 23.4 - 34.4%). After correcting for publication bias, the combined 30-day mortality rate was estimated at 28.1% (95% CI: 22.7 - 33.6%). The results of subgroup and regression analyses also revealed that preoperative liver cirrhosis and bilobar tumor distribution were significantly associated with increased 30-day mortality following TAE/TACE (P < 0.05 for all). After re-stratification of studies by publication time, it was found that the 30-day mortality after TAE/TACE treatment for spontaneous HCC rupture has decreased significantly in the past two years (P = 0.0074); the corresponding value was 19.1% (95% CI: 14.3 - 24.3%) during 2020 - 2021 and 31.6% (95% CI: 26.4 - 36.9%) during 2001 - 2010. Three independent factors, including liver cirrhosis, bilobar tumor distribution, and period of time, may be potential factors for heterogeneity. Conclusion: In recent years, although early mortality has significantly reduced after emergency TAE/TACE for spontaneous HCC rupture, it is still not negligible. Before TAE/TACE, it is necessary for clinicians to predict the adverse outcomes, as well as the risk factors and disease-related factors, and to formulate appropriate intervention measures.
{"title":"Early Mortality After Emergency Transarterial Embolization/Chemoembolization for Spontaneous Rupture of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis","authors":"Chao Ma, Yan Wang, Xiaohui Li, F. Duan","doi":"10.5812/iranjradiol-129097","DOIUrl":"https://doi.org/10.5812/iranjradiol-129097","url":null,"abstract":"Context: Transarterial embolization/chemoembolization (TAE/TACE) has been shown to be effective against ruptured hepatocellular carcinoma (HCC). However, the early clinical mortality remains unpredictable. Objectives: To conduct a comprehensive quantitative evaluation of early mortality after emergency TAE/TACE for spontaneous HCC rupture and to perform an overall analysis of risk factors to gather more representative data. Methods: The PubMed/Medline, Web of Science, and Embase databases were searched, and relevant studies were retrieved using the corresponding English keywords. Next, the literature was screened according to the inclusion and exclusion criteria. Finally, Stata version 15.1 and R Project 4.1.2 were used for meta-analysis. Results: A total of 24 studies (n = 1,083) were included in this meta-analysis. The combined 30-day mortality following emergency TAE/TACE for spontaneous HCC rupture was 28.8% (95% confidence interval [CI]: 23.4 - 34.4%). After correcting for publication bias, the combined 30-day mortality rate was estimated at 28.1% (95% CI: 22.7 - 33.6%). The results of subgroup and regression analyses also revealed that preoperative liver cirrhosis and bilobar tumor distribution were significantly associated with increased 30-day mortality following TAE/TACE (P < 0.05 for all). After re-stratification of studies by publication time, it was found that the 30-day mortality after TAE/TACE treatment for spontaneous HCC rupture has decreased significantly in the past two years (P = 0.0074); the corresponding value was 19.1% (95% CI: 14.3 - 24.3%) during 2020 - 2021 and 31.6% (95% CI: 26.4 - 36.9%) during 2001 - 2010. Three independent factors, including liver cirrhosis, bilobar tumor distribution, and period of time, may be potential factors for heterogeneity. Conclusion: In recent years, although early mortality has significantly reduced after emergency TAE/TACE for spontaneous HCC rupture, it is still not negligible. Before TAE/TACE, it is necessary for clinicians to predict the adverse outcomes, as well as the risk factors and disease-related factors, and to formulate appropriate intervention measures.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45741311","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 : 2023-02-13DOI: 10.5812/iranjradiol-129661
In Young Choi, Suk Keu Yeom, Beom Jin Park, Deuk Jae Sung, Min Ju Kim, Na Yeon Han, Yang Shin Park, Sang Hoon Cha, So Yeon Kim, Jung-Woo Choi
Background: Inflammatory myofibroblastic tumors (IMTs) of the gastrointestinal (GI) tract are rare phenomena, and the computed tomography (CT) findings of GI IMTs are not well-established. Objectives: To describe the characteristics of CT scans, pathological specimens, and histological subtypes of GI IMTs in adults. Patients and Methods: The multidetector computed tomography (MDCT) scans of 11 adult patients (8 males, 3 females; age range, 19 - 76 years) with pathologically proven GI tract IMTs (stomach, small bowel, and colon) were retrospectively evaluated by two abdominal radiologists. The radiological features of IMTs were investigated. The imaging features were correlated with three microscopic IMT subtypes (myxoid vascular, spindle cell, and hypocellular fibrous). Immunohistochemistry was also performed on the specimens, including smooth muscle actin (SMA), vimentin, desmin, S-100, and anaplastic lymphoma kinase. Results: The tumor size ranged from 1.4 to 15 cm (mean, 5.7 cm). Two growth patterns were classified, namely, wall-thickening (n = 3) and solitary mass-forming (n = 8) patterns; each pattern was matched with a characteristic pathological subtype. All solitary, well-circumscribed masses corresponded to the spindle cell type. Low-attenuation wall thickening with perienteric infiltration was observed in three patients with a wall-thickening pattern. All solitary, well-circumscribed masses (n = 8) showed homogeneous enhancement with variable internal low attenuation, correlated with cystic degeneration, necrosis, myxoid change (n = 6), and hemorrhagic necrosis (n = 2). No patient showed bowel obstruction, while one patient showed regional lymphadenopathy. Immunophenotypes were not correlated with any growth pattern or histological subtype. Conclusion: The GI IMTs can be classified into two patterns, including wall-thickening and well-circumscribed masses, each matched with a characteristic pathological subtype, which can help explain the tumor behavior. Concomitant CT findings may also provide diagnostic clues for IMT.
{"title":"Multidetector Computed Tomography Imaging Features of Inflammatory Myofibroblastic Tumors of the Gastrointestinal Tract in Adults: Radiological, Histopathological, and Immunohistochemical Features","authors":"In Young Choi, Suk Keu Yeom, Beom Jin Park, Deuk Jae Sung, Min Ju Kim, Na Yeon Han, Yang Shin Park, Sang Hoon Cha, So Yeon Kim, Jung-Woo Choi","doi":"10.5812/iranjradiol-129661","DOIUrl":"https://doi.org/10.5812/iranjradiol-129661","url":null,"abstract":"Background: Inflammatory myofibroblastic tumors (IMTs) of the gastrointestinal (GI) tract are rare phenomena, and the computed tomography (CT) findings of GI IMTs are not well-established. Objectives: To describe the characteristics of CT scans, pathological specimens, and histological subtypes of GI IMTs in adults. Patients and Methods: The multidetector computed tomography (MDCT) scans of 11 adult patients (8 males, 3 females; age range, 19 - 76 years) with pathologically proven GI tract IMTs (stomach, small bowel, and colon) were retrospectively evaluated by two abdominal radiologists. The radiological features of IMTs were investigated. The imaging features were correlated with three microscopic IMT subtypes (myxoid vascular, spindle cell, and hypocellular fibrous). Immunohistochemistry was also performed on the specimens, including smooth muscle actin (SMA), vimentin, desmin, S-100, and anaplastic lymphoma kinase. Results: The tumor size ranged from 1.4 to 15 cm (mean, 5.7 cm). Two growth patterns were classified, namely, wall-thickening (n = 3) and solitary mass-forming (n = 8) patterns; each pattern was matched with a characteristic pathological subtype. All solitary, well-circumscribed masses corresponded to the spindle cell type. Low-attenuation wall thickening with perienteric infiltration was observed in three patients with a wall-thickening pattern. All solitary, well-circumscribed masses (n = 8) showed homogeneous enhancement with variable internal low attenuation, correlated with cystic degeneration, necrosis, myxoid change (n = 6), and hemorrhagic necrosis (n = 2). No patient showed bowel obstruction, while one patient showed regional lymphadenopathy. Immunophenotypes were not correlated with any growth pattern or histological subtype. Conclusion: The GI IMTs can be classified into two patterns, including wall-thickening and well-circumscribed masses, each matched with a characteristic pathological subtype, which can help explain the tumor behavior. Concomitant CT findings may also provide diagnostic clues for IMT.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135952434","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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