Pub Date : 2022-09-11DOI: 10.5812/iranjradiol-119266
Tao Dai, Shuai Zhu, Fuchang Han, Mingji Ye, Wang Xiang, W. Tan, Xiaming Pei, Shenghui Liao, Y. Xie
Background: Accurate differentiation of angiomyolipoma (AML) from renal cell carcinoma (RCC) is important in RCC diagnosis. Objectives: This study aimed to evaluate the performance of different supervised machine learning (ML) algorithms for RCC based on computed tomography (CT) examinations. Patients and Methods: The CT images of known cases of RCC or renal AML were collected and divided into training and testing groups. The texture features of CT images were drawn and quantified in MaZda software; a total of 352 features were drawn from each image. Top 10 features with statistical significance for differentiation of RCC from benign tumors in the training group were selected to establish diagnosis models based on 16 supervised ML algorithms. Next, the models were compared regarding accuracy and specificity. The trained models were further examined by comparison with data from the testing group. Results: Among 16 classifiers trained in this study, the logistic regression, linear discriminant analysis, k-nearest neighbor algorithm, support vector machines (SVMs), ridge classifier, AdaBoost classifier, gradient boosting classifier, and CatBoost classifier showed good performance in discriminating RCC from AML (accuracy, ≥ 0.7; area under the (receiver operating characteristic (ROC)) curve (AUC) ≥ 0.75) in both training and testing datasets. Conclusion: Based on the ML algorithms for big data, diagnostic classifiers can be valuable tools for an accurate diagnosis of RCC. By comparing different algorithms, the present results indicated potential algorithms for the development of RCC diagnostic classifiers.
{"title":"Benchmarking Machine Learning Algorithms for Diagnosis of Renal Cell Carcinoma","authors":"Tao Dai, Shuai Zhu, Fuchang Han, Mingji Ye, Wang Xiang, W. Tan, Xiaming Pei, Shenghui Liao, Y. Xie","doi":"10.5812/iranjradiol-119266","DOIUrl":"https://doi.org/10.5812/iranjradiol-119266","url":null,"abstract":"Background: Accurate differentiation of angiomyolipoma (AML) from renal cell carcinoma (RCC) is important in RCC diagnosis. Objectives: This study aimed to evaluate the performance of different supervised machine learning (ML) algorithms for RCC based on computed tomography (CT) examinations. Patients and Methods: The CT images of known cases of RCC or renal AML were collected and divided into training and testing groups. The texture features of CT images were drawn and quantified in MaZda software; a total of 352 features were drawn from each image. Top 10 features with statistical significance for differentiation of RCC from benign tumors in the training group were selected to establish diagnosis models based on 16 supervised ML algorithms. Next, the models were compared regarding accuracy and specificity. The trained models were further examined by comparison with data from the testing group. Results: Among 16 classifiers trained in this study, the logistic regression, linear discriminant analysis, k-nearest neighbor algorithm, support vector machines (SVMs), ridge classifier, AdaBoost classifier, gradient boosting classifier, and CatBoost classifier showed good performance in discriminating RCC from AML (accuracy, ≥ 0.7; area under the (receiver operating characteristic (ROC)) curve (AUC) ≥ 0.75) in both training and testing datasets. Conclusion: Based on the ML algorithms for big data, diagnostic classifiers can be valuable tools for an accurate diagnosis of RCC. By comparing different algorithms, the present results indicated potential algorithms for the development of RCC diagnostic classifiers.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47651472","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 : 2022-08-21DOI: 10.5812/iranjradiol-121728
Mahsa Karbasi, R. Behzadmehr, M. Tarzamni, R. Javadrashid
Background: Pulmonary embolism (PE) is a potentially fatal condition. Knowledge of the prognostic factors for PE may facilitate the management of these patients. Pulmonary CT angiography (PCTA) can play an effective role in their management. Objectives: To evaluate the prognostic value of certain PCTA-derived indicators of right ventricular dysfunction in patients with acute PE. Methods: A total of 61 hemodynamically stable patients with acute PE underwent PCTA and were followed-up for 60 days. The Qanadli index and 60-day mortality represented the PE severity and prognostic endpoints, respectively. The clinical significance of the following variables in predicting PE severity and mortality was examined: an abnormally positioned interventricular septum, right ventricular to left ventricular diameter ratio (RVD/LVD) on the axial plane, contrast medium reflux into the inferior vena cava (IVC), transverse diameter of the pulmonary trunk, and bolus-time curve indicators. Results: The 60-day mortality was estimated at 14.8% in this study. An abnormal interventricular septum morphology, RVD/LVD ratio, and contrast medium reflux into the IVC were significantly correlated with the Qanadli index. The pulmonary trunk diameter was the only predictor of 60-day mortality (optimal cutoff value, 33.5 mm; sensitivity, 66.7%; and specificity, 65.4%). The bolus-time curve indicators did not have any significant predictive value. Conclusion: Some PCTA-derived indicators of right ventricular dysfunction may serve as severity/prognostic predictors in hemodynamically stable patients with acute PE.
{"title":"The Prognostic Significance of Pulmonary CT Angiography in Predicting the Outcomes of Acute Pulmonary Thromboembolism","authors":"Mahsa Karbasi, R. Behzadmehr, M. Tarzamni, R. Javadrashid","doi":"10.5812/iranjradiol-121728","DOIUrl":"https://doi.org/10.5812/iranjradiol-121728","url":null,"abstract":"Background: Pulmonary embolism (PE) is a potentially fatal condition. Knowledge of the prognostic factors for PE may facilitate the management of these patients. Pulmonary CT angiography (PCTA) can play an effective role in their management. Objectives: To evaluate the prognostic value of certain PCTA-derived indicators of right ventricular dysfunction in patients with acute PE. Methods: A total of 61 hemodynamically stable patients with acute PE underwent PCTA and were followed-up for 60 days. The Qanadli index and 60-day mortality represented the PE severity and prognostic endpoints, respectively. The clinical significance of the following variables in predicting PE severity and mortality was examined: an abnormally positioned interventricular septum, right ventricular to left ventricular diameter ratio (RVD/LVD) on the axial plane, contrast medium reflux into the inferior vena cava (IVC), transverse diameter of the pulmonary trunk, and bolus-time curve indicators. Results: The 60-day mortality was estimated at 14.8% in this study. An abnormal interventricular septum morphology, RVD/LVD ratio, and contrast medium reflux into the IVC were significantly correlated with the Qanadli index. The pulmonary trunk diameter was the only predictor of 60-day mortality (optimal cutoff value, 33.5 mm; sensitivity, 66.7%; and specificity, 65.4%). The bolus-time curve indicators did not have any significant predictive value. Conclusion: Some PCTA-derived indicators of right ventricular dysfunction may serve as severity/prognostic predictors in hemodynamically stable patients with acute PE.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43763133","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 : 2022-08-16DOI: 10.5812/iranjradiol-120373
Jinghao Chen, Jie Zhou, S. Gong, Ruochen Cong, Jing Xiao, Zhenyu Xu, Jushun Yang
Background: The application of multislice spiral computed tomography (MSCT) scan has improved the diagnosis of small bowel diseases (SBDs). Objectives: This study aimed to develop a structured report (SR) template for SBDs based on MSCT scans and to compare its value with free-text reports (FTRs) by radiologists with different levels of seniority in radiology. Patients and Methods: A total of 120 SBD cases were confirmed based on the clinical manifestations, surgery, colonoscopy, and pathology. An SR template for small bowel imaging was developed, and six radiologists were divided into inexperienced and experienced groups. Sixty cases with small intestinal MSCT data were available for FTRs and another 60 cases for SRs after training. The report accuracy, satisfaction, and completion time were compared between the two reporting methods. Results: The writing time of SRs was significantly shorter than that of FTRs. By using FTRs, the experienced group showed higher levels of sensitivity for all diseases (i.e., intestinal wall, intestinal peripheral artery, blood vessel, bone, and other abdominal organ diseases) (P < 0.05). The experienced group showed a low misdiagnosis rate for all diseases (P < 0.05), except for bone disease (P = 0.161). By using SRs, the experienced group only showed a low misdiagnosis rate for the intestinal wall disease (P < 0.05). High sensitivity for the intestinal wall disease (P < 0.05) and intestinal peripheral artery disease (P = 0.024), along with improved sensitivity for bone lesions (P < 0.05), was reported in this group. In the inexperienced group, SRs improved sensitivity for all diseases (P < 0.05), except for intestinal wall disease (P > 0.05). The satisfaction scores for both inexperienced and experienced groups improved by using SRs (4 vs. 2.6 for the inexperienced group and 4.1 vs. 3.2 for the experienced group; P < 0.05 for both). Conclusion: The SRs were superior to FTRs in terms of writing efficiency, accuracy, and satisfaction. They could improve the accuracy of inexperienced radiologists in diagnosis and help detect small bowel diseases (SBDs).
{"title":"Impact of a Structured Report Template on the Quality of Multislice Spiral Computed Tomography Scan Reports for Small Bowel Diseases: A Preliminary Study","authors":"Jinghao Chen, Jie Zhou, S. Gong, Ruochen Cong, Jing Xiao, Zhenyu Xu, Jushun Yang","doi":"10.5812/iranjradiol-120373","DOIUrl":"https://doi.org/10.5812/iranjradiol-120373","url":null,"abstract":"Background: The application of multislice spiral computed tomography (MSCT) scan has improved the diagnosis of small bowel diseases (SBDs). Objectives: This study aimed to develop a structured report (SR) template for SBDs based on MSCT scans and to compare its value with free-text reports (FTRs) by radiologists with different levels of seniority in radiology. Patients and Methods: A total of 120 SBD cases were confirmed based on the clinical manifestations, surgery, colonoscopy, and pathology. An SR template for small bowel imaging was developed, and six radiologists were divided into inexperienced and experienced groups. Sixty cases with small intestinal MSCT data were available for FTRs and another 60 cases for SRs after training. The report accuracy, satisfaction, and completion time were compared between the two reporting methods. Results: The writing time of SRs was significantly shorter than that of FTRs. By using FTRs, the experienced group showed higher levels of sensitivity for all diseases (i.e., intestinal wall, intestinal peripheral artery, blood vessel, bone, and other abdominal organ diseases) (P < 0.05). The experienced group showed a low misdiagnosis rate for all diseases (P < 0.05), except for bone disease (P = 0.161). By using SRs, the experienced group only showed a low misdiagnosis rate for the intestinal wall disease (P < 0.05). High sensitivity for the intestinal wall disease (P < 0.05) and intestinal peripheral artery disease (P = 0.024), along with improved sensitivity for bone lesions (P < 0.05), was reported in this group. In the inexperienced group, SRs improved sensitivity for all diseases (P < 0.05), except for intestinal wall disease (P > 0.05). The satisfaction scores for both inexperienced and experienced groups improved by using SRs (4 vs. 2.6 for the inexperienced group and 4.1 vs. 3.2 for the experienced group; P < 0.05 for both). Conclusion: The SRs were superior to FTRs in terms of writing efficiency, accuracy, and satisfaction. They could improve the accuracy of inexperienced radiologists in diagnosis and help detect small bowel diseases (SBDs).","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47888878","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 : 2022-08-10DOI: 10.5812/iranjradiol-120514
Sunay Sibel Karayol, Kudret Cem Karayol
Background: Fibromyalgia is recognized as a chronic pain syndrome. Widespread pain is a common symptom in fibromyalgia, indicating a potential dysfunction in the processing of painful sensations in the central nervous system. Objectives: This study aimed to investigate changes in the severity of clinical symptoms in fibromyalgia patients and to evaluate the apparent diffusion coefficients and metabolites in the brain of these patients. Patients and Methods: This cross-sectional study included 28 female outpatients with complaints of widespread pain, who were diagnosed with fibromyalgia syndrome. Magnetic resonance imaging, magnetic resonance spectroscopy, and diffusion tensor examinations were applied to evaluate patients diagnosed with fibromyalgia before treatment. Results: The mean age of the patients included in this study was 39.1 ± 8.6 years (range, 24 - 55 years). A statistically significant strong positive correlation was found between the scores of the visual analog scale and the fibromyalgia impact questionnaire. Besides, significant associations were found between the scores of the visual analog scale and fibromyalgia impact questionnaire and the results of fractional anisotropy, apparent diffusion coefficient, and peak values of some metabolites in spectroscopy. Conclusion: The results of this study suggest that metabolites play an inhibitory or excitatory role in the central pain mechanisms of fibromyalgia as a chronic pain syndrome.
{"title":"Correlation of Brain Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging with the Severity of Clinical Symptoms in Fibromyalgia Patients","authors":"Sunay Sibel Karayol, Kudret Cem Karayol","doi":"10.5812/iranjradiol-120514","DOIUrl":"https://doi.org/10.5812/iranjradiol-120514","url":null,"abstract":"Background: Fibromyalgia is recognized as a chronic pain syndrome. Widespread pain is a common symptom in fibromyalgia, indicating a potential dysfunction in the processing of painful sensations in the central nervous system. Objectives: This study aimed to investigate changes in the severity of clinical symptoms in fibromyalgia patients and to evaluate the apparent diffusion coefficients and metabolites in the brain of these patients. Patients and Methods: This cross-sectional study included 28 female outpatients with complaints of widespread pain, who were diagnosed with fibromyalgia syndrome. Magnetic resonance imaging, magnetic resonance spectroscopy, and diffusion tensor examinations were applied to evaluate patients diagnosed with fibromyalgia before treatment. Results: The mean age of the patients included in this study was 39.1 ± 8.6 years (range, 24 - 55 years). A statistically significant strong positive correlation was found between the scores of the visual analog scale and the fibromyalgia impact questionnaire. Besides, significant associations were found between the scores of the visual analog scale and fibromyalgia impact questionnaire and the results of fractional anisotropy, apparent diffusion coefficient, and peak values of some metabolites in spectroscopy. Conclusion: The results of this study suggest that metabolites play an inhibitory or excitatory role in the central pain mechanisms of fibromyalgia as a chronic pain syndrome.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42577068","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 : 2022-08-07DOI: 10.5812/iranjradiol-122258
Mohammad Reza Erfaghi, Abtin Doroudinia, Mehrdad Bakhshayesh karam, H. Emami
Background: Melanoma is one of the most serious types of skin cancer and one of the leading causes of cancer-related mortality worldwide. Objectives: This study aimed to investigate the association between 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan findings and the pathological characteristics of primary tumors in patients with malignant melanoma. Patients and Methods: In this cross-sectional study, the baseline data of 103 patients with cutaneous or mucosal melanoma (stage III or IV) were recorded, and tumor characteristics and PET/CT scan findings were analyzed. The association between each pathological finding and PET/CT results was also investigated. Results: Patients without a free margin had a significantly higher mean standardized uptake value (SUVmax) of lung metastasis compared to patients with a free margin (3.12 vs. 1.69; P = 0.047). Also, patients with ulceration had a significantly higher mean SUVmax of lung metastasis compared to patients without ulceration (3.28 vs. 1.81; P = 0.041). Based on the results, increased primary tumor thickness was associated with a higher SUVmax of lung metastasis. However, there was no significant association between the metastasis type (single vs. multiple) and free margin, ulceration, or Ki-67 protein. The mean SUVmax of lung metastasis was significantly higher in mucosal melanoma compared to cutaneous melanoma. However, the mean SUVmax values of other metastases (bone, liver, and lymph nodes), even the primary lesion itself, were not significantly different between cutaneous melanoma and mucosal melanoma. Conclusion: The primary tumor margin status, ulceration, tumor thickness, primary tumor location (cutaneous vs. mucosal), and the presence of lung metastasis were significantly associated with PET/CT scan findings.
{"title":"Association of Tumor Metabolic Activity on PET/CT Scan with Pathological Characteristics in Patients with Malignant Melanoma","authors":"Mohammad Reza Erfaghi, Abtin Doroudinia, Mehrdad Bakhshayesh karam, H. Emami","doi":"10.5812/iranjradiol-122258","DOIUrl":"https://doi.org/10.5812/iranjradiol-122258","url":null,"abstract":"Background: Melanoma is one of the most serious types of skin cancer and one of the leading causes of cancer-related mortality worldwide. Objectives: This study aimed to investigate the association between 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan findings and the pathological characteristics of primary tumors in patients with malignant melanoma. Patients and Methods: In this cross-sectional study, the baseline data of 103 patients with cutaneous or mucosal melanoma (stage III or IV) were recorded, and tumor characteristics and PET/CT scan findings were analyzed. The association between each pathological finding and PET/CT results was also investigated. Results: Patients without a free margin had a significantly higher mean standardized uptake value (SUVmax) of lung metastasis compared to patients with a free margin (3.12 vs. 1.69; P = 0.047). Also, patients with ulceration had a significantly higher mean SUVmax of lung metastasis compared to patients without ulceration (3.28 vs. 1.81; P = 0.041). Based on the results, increased primary tumor thickness was associated with a higher SUVmax of lung metastasis. However, there was no significant association between the metastasis type (single vs. multiple) and free margin, ulceration, or Ki-67 protein. The mean SUVmax of lung metastasis was significantly higher in mucosal melanoma compared to cutaneous melanoma. However, the mean SUVmax values of other metastases (bone, liver, and lymph nodes), even the primary lesion itself, were not significantly different between cutaneous melanoma and mucosal melanoma. Conclusion: The primary tumor margin status, ulceration, tumor thickness, primary tumor location (cutaneous vs. mucosal), and the presence of lung metastasis were significantly associated with PET/CT scan findings.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45995459","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 : 2022-07-27DOI: 10.5812/iranjradiol-121918
S. Albeshan, Y. Alashban, N. Shubayr, Arwa Alkhudairy, Fatma Eliraqi
Background: Similar to most imaging procedures, the high quality of images is a key factor in ensuring that mammography delivers its full potential benefits. Radiographers play a central role in the acquisition of high-quality images, as they are responsible for not only breast positioning and compression, but also quality control and patient care. Objectives: To identify the challenges and difficulties of radiographers in daily practice and to determine the main components of mammography that require further training and education. Patients and Methods: An online survey was conducted to collect data regarding the radiographers’ demographic data, institution profile, image assessment tools, mammography challenges, quality control, and continuing professional development. Results: A total of 73 radiographers participated in this study, the majority of whom were full-time radiographers with a bachelor’s degree in radiography. Less than half of the participants had been a mammographer for more than five years. The American College of Radiology (ACR) criteria were the most familiar image quality assessment tool (52%). The most frequently used scale to evaluate image quality was posterior breast tissue visualization on both craniocaudal (CC) and mediolateral oblique (MLO) views, followed by the pectoral muscle volume determined on the MLO view. Overall, positioning, artifacts, and compression were the main reasons for repeat mammography. Also, wheelchair-bound patients, overweight patients, and breast compression were the greatest challenges of patient positioning. Conclusion: This pilot study highlighted the importance of developing in-house training courses for radiographers, which focus on patient positioning, image quality assessment, and patient-centered needs to improve practice standards. However, further studies on a larger sample size are needed to validate the present results.
{"title":"An Evaluation of Radiographers’ Experience in Mammography: An Explanatory Study","authors":"S. Albeshan, Y. Alashban, N. Shubayr, Arwa Alkhudairy, Fatma Eliraqi","doi":"10.5812/iranjradiol-121918","DOIUrl":"https://doi.org/10.5812/iranjradiol-121918","url":null,"abstract":"Background: Similar to most imaging procedures, the high quality of images is a key factor in ensuring that mammography delivers its full potential benefits. Radiographers play a central role in the acquisition of high-quality images, as they are responsible for not only breast positioning and compression, but also quality control and patient care. Objectives: To identify the challenges and difficulties of radiographers in daily practice and to determine the main components of mammography that require further training and education. Patients and Methods: An online survey was conducted to collect data regarding the radiographers’ demographic data, institution profile, image assessment tools, mammography challenges, quality control, and continuing professional development. Results: A total of 73 radiographers participated in this study, the majority of whom were full-time radiographers with a bachelor’s degree in radiography. Less than half of the participants had been a mammographer for more than five years. The American College of Radiology (ACR) criteria were the most familiar image quality assessment tool (52%). The most frequently used scale to evaluate image quality was posterior breast tissue visualization on both craniocaudal (CC) and mediolateral oblique (MLO) views, followed by the pectoral muscle volume determined on the MLO view. Overall, positioning, artifacts, and compression were the main reasons for repeat mammography. Also, wheelchair-bound patients, overweight patients, and breast compression were the greatest challenges of patient positioning. Conclusion: This pilot study highlighted the importance of developing in-house training courses for radiographers, which focus on patient positioning, image quality assessment, and patient-centered needs to improve practice standards. However, further studies on a larger sample size are needed to validate the present results.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42726257","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 : 2022-07-25DOI: 10.5812/iranjradiol-122269
N. Sadighi, Mona Bahreini, B. Jahanbin, M. Gity, M. Rahmani, Arvin Arian, Sina Delazar, N. Ahmadinejad
Background: Breast microcalcifications are a category of lesions that can lead to malignancies. They remain a major concern in imaging of suspected cases. Vacuum-assisted biopsy (VAB) has been proposed as a safe and effective measure to evaluate microcalcifications. Objectives: The present study aimed to assess the results of VAB for breast microcalcifications. Patients and Methods: This cross-sectional study was conducted on patients with microcalcifications detected on mammograms. Patients were recruited through simple random sampling during 2019 - 2020, based on the inclusion criteria. The inclusion criteria were microcalcifications on mammography, classified as the breast imaging-reporting and data system (BI-RADS) categories 3, 4B, 4C, and 5, and undergoing mammography-guided VAB for the microcalcifications. Patients with missing data and those who could not be followed-up for at least six months were excluded from the study. They were assessed regarding different imaging characteristics of lesions, including the breast density, BI-RADS classification, microcalcification distribution and morphology, and other demographic and clinical features before biopsy. Additionally, the results of stereotactic-guided VAB were assessed for various benign and malignant pathologies of microcalcifications. The results of descriptive and analytical tests for various radiological and pathological features of lesions were reported. Results: A total of 257 patients, with a mean age of 50.3 ± 8.3 yars, were included in this study. Almost half of the patients (n = 125, 48.6%) had a C-grade breast composition. Regarding the BI-RADS classification, 206 (80.2%) patients were diagnosed with 4B lesions, followed by 44 (17.1%) patients with 4C lesions. The assessment of the pattern of microcalcification distribution in imaging showed that more than half of the patients (n = 148, 57.6%) had lesions in multiple groups. The most prevalent morphology of microcalcifications was punctate amorphous (n = 109, 42.4%). The majority of patients (n = 180, 70%) had benign findings in the pathological assessment, and only 69 (26.8%) had malignant features in pathology. The distribution of malignancies differed among various BI-RADS categories. In the 4B category of lesions, there were 166 benign lesions versus 32 malignant lesions, while in the 4C category, there were 10 benign lesions versus 34 malignant lesions (P < 0.001). Conclusion: This study described the findings of successful stereotactic-guided VAB for breast microcalcifications. VAB can be implemented as a promising assessment tool to evaluate suspected breast microcalcifications effectively.
{"title":"Successful Stereotactic-Guided Vacuum-Assisted Biopsy in the Evaluation of Breast Microcalcifications: A Study in a Single Tertiary Referral Center in the Middle East","authors":"N. Sadighi, Mona Bahreini, B. Jahanbin, M. Gity, M. Rahmani, Arvin Arian, Sina Delazar, N. Ahmadinejad","doi":"10.5812/iranjradiol-122269","DOIUrl":"https://doi.org/10.5812/iranjradiol-122269","url":null,"abstract":"Background: Breast microcalcifications are a category of lesions that can lead to malignancies. They remain a major concern in imaging of suspected cases. Vacuum-assisted biopsy (VAB) has been proposed as a safe and effective measure to evaluate microcalcifications. Objectives: The present study aimed to assess the results of VAB for breast microcalcifications. Patients and Methods: This cross-sectional study was conducted on patients with microcalcifications detected on mammograms. Patients were recruited through simple random sampling during 2019 - 2020, based on the inclusion criteria. The inclusion criteria were microcalcifications on mammography, classified as the breast imaging-reporting and data system (BI-RADS) categories 3, 4B, 4C, and 5, and undergoing mammography-guided VAB for the microcalcifications. Patients with missing data and those who could not be followed-up for at least six months were excluded from the study. They were assessed regarding different imaging characteristics of lesions, including the breast density, BI-RADS classification, microcalcification distribution and morphology, and other demographic and clinical features before biopsy. Additionally, the results of stereotactic-guided VAB were assessed for various benign and malignant pathologies of microcalcifications. The results of descriptive and analytical tests for various radiological and pathological features of lesions were reported. Results: A total of 257 patients, with a mean age of 50.3 ± 8.3 yars, were included in this study. Almost half of the patients (n = 125, 48.6%) had a C-grade breast composition. Regarding the BI-RADS classification, 206 (80.2%) patients were diagnosed with 4B lesions, followed by 44 (17.1%) patients with 4C lesions. The assessment of the pattern of microcalcification distribution in imaging showed that more than half of the patients (n = 148, 57.6%) had lesions in multiple groups. The most prevalent morphology of microcalcifications was punctate amorphous (n = 109, 42.4%). The majority of patients (n = 180, 70%) had benign findings in the pathological assessment, and only 69 (26.8%) had malignant features in pathology. The distribution of malignancies differed among various BI-RADS categories. In the 4B category of lesions, there were 166 benign lesions versus 32 malignant lesions, while in the 4C category, there were 10 benign lesions versus 34 malignant lesions (P < 0.001). Conclusion: This study described the findings of successful stereotactic-guided VAB for breast microcalcifications. VAB can be implemented as a promising assessment tool to evaluate suspected breast microcalcifications effectively.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44756652","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 : 2022-07-25DOI: 10.5812/iranjradiol-126548
W. Hsu, Chu-Hao Weng, Marcelo Chen, Chih-Chiao Lee
Introduction: Minor complications have been reported following extracorporeal shock wave lithotripsy (ESWL), including renal colic, gross hematuria, urinary obstruction, and hematoma. Some rare major complications have been also reported, such as abscess formation, acute pancreatitis with abscess, and splenic rupture. Here, we present the computed tomographic (CT) findings of a patient with necrotizing fasciitis, along with abscess formation after ESWL, which rapidly invaded the neck, chest, and abdominal wall. Case Presentation: A 67-year-old woman presented with persistent cough, intermittent nausea, and progressive right flank pain for one month after ESWL, which was performed for a right upper ureteral stone, measuring 1.2 × 0.3 cm, with right hydronephrosis detected on abdominal X-ray and renal ultrasound. The initial abdominal CT scan showed perirenal and pararenal hematoma of the right kidney, extending to the right posterior pararenal space, right psoas muscle, and right paraspinal region. Empiric antibiotic treatment was prescribed for the patient. After one week of treatment, the follow-up CT scan showed perirenal and pararenal abscesses with necrotizing fasciitis, invading the posterior region up to the paraspinal region and then migrating upward to the chest wall, axillary, supra-clavicular, and infra-clavicular regions, and the neck. The abscess also caused downward damage to the abdominal wall. Four weeks after a surgical intervention, the inflammatory process almost resolved. Conclusion: Although the possibility of post-ESWL necrotizing fasciitis is acutely low, it is important to consider this fatal complication.
{"title":"Necrotizing Fasciitis Extending to the Neck After Extracorporeal Shock Wave Lithotripsy: A Case Report","authors":"W. Hsu, Chu-Hao Weng, Marcelo Chen, Chih-Chiao Lee","doi":"10.5812/iranjradiol-126548","DOIUrl":"https://doi.org/10.5812/iranjradiol-126548","url":null,"abstract":"Introduction: Minor complications have been reported following extracorporeal shock wave lithotripsy (ESWL), including renal colic, gross hematuria, urinary obstruction, and hematoma. Some rare major complications have been also reported, such as abscess formation, acute pancreatitis with abscess, and splenic rupture. Here, we present the computed tomographic (CT) findings of a patient with necrotizing fasciitis, along with abscess formation after ESWL, which rapidly invaded the neck, chest, and abdominal wall. Case Presentation: A 67-year-old woman presented with persistent cough, intermittent nausea, and progressive right flank pain for one month after ESWL, which was performed for a right upper ureteral stone, measuring 1.2 × 0.3 cm, with right hydronephrosis detected on abdominal X-ray and renal ultrasound. The initial abdominal CT scan showed perirenal and pararenal hematoma of the right kidney, extending to the right posterior pararenal space, right psoas muscle, and right paraspinal region. Empiric antibiotic treatment was prescribed for the patient. After one week of treatment, the follow-up CT scan showed perirenal and pararenal abscesses with necrotizing fasciitis, invading the posterior region up to the paraspinal region and then migrating upward to the chest wall, axillary, supra-clavicular, and infra-clavicular regions, and the neck. The abscess also caused downward damage to the abdominal wall. Four weeks after a surgical intervention, the inflammatory process almost resolved. Conclusion: Although the possibility of post-ESWL necrotizing fasciitis is acutely low, it is important to consider this fatal complication.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41947600","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 : 2022-07-23DOI: 10.5812/iranjradiol-110538
Zhangping Zhao, Ying Xie, Xingming Xu, Yinbao Hu, Youjian Zou
Background: Hepatocellular carcinoma (HCC) is currently the fourth most common malignant tumor and the second most fatal tumor in China, posing serious threats to the health and life of individuals. Objectives: This retrospective study aimed to investigate the treatment benefits and side effects of transarterial chemoembolization with drug-eluting bead microspheres (DEB-TACE) for HCC patients with conventional TACE (cTACE) resistance. Patients and Methods: A total of 17 HCC patients with cTACE resistance, treated by DEB-TACE, were retrospectively analyzed from July 2017 to December 2019. According to the modified response evaluation criteria in solid tumors (mRECIST), the efficacy of treatment was classified into complete remission (CR), partial remission (PR), stable disease (SD), and progressive disease (PD), and the objective remission rate (ORR) and the disease control rate (DCR) were also measured at 6 and 12 weeks post-DEB-TACE treatment. Changes in liver enzymes, routine blood tests, and alpha-fetoprotein (AFP) levels were also documented. Besides, the patients’ adverse reactions were observed within one week after surgery to assess the safety of DEB-TACE therapy. Results: In patients with cTACE resistance, the CR, PR, SD, PD, ORR, and DCR were 0, 35.29%, 47.06%, 17.65%, 35.29%, and 82.35% at six weeks after DEB-TACE and 5.88%, 47.06%, 29.41%, 17.65%, 52.94%, and 82.35% after 12 weeks, respectively. In the first week after DEB-TACE, the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, and white blood cells elevated temporarily (P < 0.05), and side effects, such as slight pain, fever, nausea, and vomiting, occurred after surgery. Following liver protection and symptomatic treatment, the patients recovered well. Conclusion: Based on the results of this study, DEB-TACE has treatment benefits and few side effects for HCC patients with cTACE resistance.
{"title":"Treatment Benefits and Side Effects of Transarterial Chemoembolization with Drug-Eluting Bead Microspheres (DEB-TACE) in Hepatocellular Carcinoma Patients with Conventional TACE Resistance: A Retrospective Study","authors":"Zhangping Zhao, Ying Xie, Xingming Xu, Yinbao Hu, Youjian Zou","doi":"10.5812/iranjradiol-110538","DOIUrl":"https://doi.org/10.5812/iranjradiol-110538","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) is currently the fourth most common malignant tumor and the second most fatal tumor in China, posing serious threats to the health and life of individuals. Objectives: This retrospective study aimed to investigate the treatment benefits and side effects of transarterial chemoembolization with drug-eluting bead microspheres (DEB-TACE) for HCC patients with conventional TACE (cTACE) resistance. Patients and Methods: A total of 17 HCC patients with cTACE resistance, treated by DEB-TACE, were retrospectively analyzed from July 2017 to December 2019. According to the modified response evaluation criteria in solid tumors (mRECIST), the efficacy of treatment was classified into complete remission (CR), partial remission (PR), stable disease (SD), and progressive disease (PD), and the objective remission rate (ORR) and the disease control rate (DCR) were also measured at 6 and 12 weeks post-DEB-TACE treatment. Changes in liver enzymes, routine blood tests, and alpha-fetoprotein (AFP) levels were also documented. Besides, the patients’ adverse reactions were observed within one week after surgery to assess the safety of DEB-TACE therapy. Results: In patients with cTACE resistance, the CR, PR, SD, PD, ORR, and DCR were 0, 35.29%, 47.06%, 17.65%, 35.29%, and 82.35% at six weeks after DEB-TACE and 5.88%, 47.06%, 29.41%, 17.65%, 52.94%, and 82.35% after 12 weeks, respectively. In the first week after DEB-TACE, the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, and white blood cells elevated temporarily (P < 0.05), and side effects, such as slight pain, fever, nausea, and vomiting, occurred after surgery. Following liver protection and symptomatic treatment, the patients recovered well. Conclusion: Based on the results of this study, DEB-TACE has treatment benefits and few side effects for HCC patients with cTACE resistance.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49228807","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 : 2022-07-16DOI: 10.5812/iranjradiol-111729
M. Hasani, M. Keshavarzi, L. Khojastepour
Background: Considering the late ossification potential of spheno-occipital synchondrosis (SOS), it can be used as a tool to estimate age in adolescents. The time of SOS fusion is known to vary in different populations. Objectives: This study aimed to assess the degree of SOS fusion in Iranian individuals, using cone-beam computed tomography (CBCT) scan. Patients and Methods: The CBCT images of 240 patients (126 females and 114 males), aged 6 - 25 years, were assessed regarding the degree of SOS fusion, based on a four-stage scoring system. Spearman’s correlation coefficient test and regression analysis were performed to assess the correlation between age and fusion stage. Mann-Whitney test was also applied to determine differences between males and females. Besides, Kruskal-Wallis test was used to assess differences in the median values. Results: The SOS was completely open at the mean age of 7.63 years in females and 8.85 years in males. The mean age of partially fused SOS (stage 1) was eight years in females and 10 years in males. Besides, the mean age of completely fused SOS (stage 3) was 12 years in females and 16 years in males. The results of Spearman’s correlation coefficient test showed a significant positive relationship between age and the degree of SOS fusion in males and females (rs = 0.783, P < 0.001 in females and rs = 0.911, P < 0.001 in males). Conclusion: The SOS closure degree can be applied for age estimation in the Iranian population. This study presented a method which is highly accurate for age estimation.
{"title":"Spheno-Occipital Synchondrosis Fusion Degree as an Age Estimation Tool: A Cone-Beam Computed Tomography Study","authors":"M. Hasani, M. Keshavarzi, L. Khojastepour","doi":"10.5812/iranjradiol-111729","DOIUrl":"https://doi.org/10.5812/iranjradiol-111729","url":null,"abstract":"Background: Considering the late ossification potential of spheno-occipital synchondrosis (SOS), it can be used as a tool to estimate age in adolescents. The time of SOS fusion is known to vary in different populations. Objectives: This study aimed to assess the degree of SOS fusion in Iranian individuals, using cone-beam computed tomography (CBCT) scan. Patients and Methods: The CBCT images of 240 patients (126 females and 114 males), aged 6 - 25 years, were assessed regarding the degree of SOS fusion, based on a four-stage scoring system. Spearman’s correlation coefficient test and regression analysis were performed to assess the correlation between age and fusion stage. Mann-Whitney test was also applied to determine differences between males and females. Besides, Kruskal-Wallis test was used to assess differences in the median values. Results: The SOS was completely open at the mean age of 7.63 years in females and 8.85 years in males. The mean age of partially fused SOS (stage 1) was eight years in females and 10 years in males. Besides, the mean age of completely fused SOS (stage 3) was 12 years in females and 16 years in males. The results of Spearman’s correlation coefficient test showed a significant positive relationship between age and the degree of SOS fusion in males and females (rs = 0.783, P < 0.001 in females and rs = 0.911, P < 0.001 in males). Conclusion: The SOS closure degree can be applied for age estimation in the Iranian population. This study presented a method which is highly accurate for age estimation.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42653132","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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