Pub Date : 2022-06-16DOI: 10.5812/iranjradiol-122423
M. Ota, F. Hyodo, S. Matsuo, Takashi Kato, N. Kawai, F. Nakamura, Keita Fujimorto, Y. Kaneko, H. Kato, M. Matsuo
Background: 99mTc -sestamibi myocardial perfusion imaging (MIBI) washout is associated with myocardial mitochondrial damage in patients with a successful percutaneous coronary intervention (PCI) following acute myocardial infarction (AMI) and may predict the functional improvement of the left ventricle in follow-ups. Objectives: This study aimed to investigate the clinical efficacy of 99mTc-MIBI washout in patients with AMI by measuring the mean defect area based on 99mTc-MIBI myocardial perfusion-single photon emission computed tomography (MP-SPECT) rest imaging in early and delayed phases and comparing it with the defect area based on 99mTc-MIBI MP-SPECT adenosine stress imaging based on a two-day rest/stress protocol. Patients and Methods: This study was conducted on 29 consecutive patients with AMI (23 males and 6 females; mean age, 71 ± 8.4 years), who underwent MP-SPECT using a standard two-day rest/stress protocol. The rest 99mTc-MIBI MP-SPECT images were acquired in the early phase at one hour after the injection of 99mTc-MIBI and in the delayed phase at three hours after the early phase. The total perfusion deficit (TPD) score for SPECT was measured to compare the defect area between the rest-early phase, rest-delayed phase, and post-stress imaging conditions. Results: Based on the results, the post-stress TPD score was significantly lower than the rest-delayed phase score (TPD: 22.2% ± 14.3% vs. 27.8% ± 14.0%; P < 0.001). Also, the rest-early phase score was significantly lower than the rest-delayed phase score (TPD: 21.5% ± 14.9% vs. 27.8% ± 14.0%; P < 0.001). However, no significant difference was observed between the post-stress score and the rest-early phase score. Conclusion: The combination of rest-early phase, delayed phase, and post-stress 99mTc-MIBI imaging using a two-day protocol after AMI reperfusion was a clinically useful method, which could identify residual ischemia and predict the left ventricular function improvement in the chronic phase of disease while reducing the exposure dose.
{"title":"Investigation of the Clinical Efficacy of 99mTc-Sestamibi Washout in Patients with Acute Myocardial Infarction and Comparison with Stress Myocardial Imaging with 99mTc -Sestamibi Using a Two-Day Protocol","authors":"M. Ota, F. Hyodo, S. Matsuo, Takashi Kato, N. Kawai, F. Nakamura, Keita Fujimorto, Y. Kaneko, H. Kato, M. Matsuo","doi":"10.5812/iranjradiol-122423","DOIUrl":"https://doi.org/10.5812/iranjradiol-122423","url":null,"abstract":"Background: 99mTc -sestamibi myocardial perfusion imaging (MIBI) washout is associated with myocardial mitochondrial damage in patients with a successful percutaneous coronary intervention (PCI) following acute myocardial infarction (AMI) and may predict the functional improvement of the left ventricle in follow-ups. Objectives: This study aimed to investigate the clinical efficacy of 99mTc-MIBI washout in patients with AMI by measuring the mean defect area based on 99mTc-MIBI myocardial perfusion-single photon emission computed tomography (MP-SPECT) rest imaging in early and delayed phases and comparing it with the defect area based on 99mTc-MIBI MP-SPECT adenosine stress imaging based on a two-day rest/stress protocol. Patients and Methods: This study was conducted on 29 consecutive patients with AMI (23 males and 6 females; mean age, 71 ± 8.4 years), who underwent MP-SPECT using a standard two-day rest/stress protocol. The rest 99mTc-MIBI MP-SPECT images were acquired in the early phase at one hour after the injection of 99mTc-MIBI and in the delayed phase at three hours after the early phase. The total perfusion deficit (TPD) score for SPECT was measured to compare the defect area between the rest-early phase, rest-delayed phase, and post-stress imaging conditions. Results: Based on the results, the post-stress TPD score was significantly lower than the rest-delayed phase score (TPD: 22.2% ± 14.3% vs. 27.8% ± 14.0%; P < 0.001). Also, the rest-early phase score was significantly lower than the rest-delayed phase score (TPD: 21.5% ± 14.9% vs. 27.8% ± 14.0%; P < 0.001). However, no significant difference was observed between the post-stress score and the rest-early phase score. Conclusion: The combination of rest-early phase, delayed phase, and post-stress 99mTc-MIBI imaging using a two-day protocol after AMI reperfusion was a clinically useful method, which could identify residual ischemia and predict the left ventricular function improvement in the chronic phase of disease while reducing the exposure dose.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41849355","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 : 2022-06-15DOI: 10.5812/iranjradiol-120677
Rae Rim Ryu, Young Joong Kim, Jae Young Seo, Keumwon Kim, Jin Suk Kim
Background: Mammography (MMG) and ultrasonography (US) have been used as standard imaging modalities for the diagnosis of breast cancer. However, several drawbacks have been attributed to these modalities. Breast-specific gamma imaging (BSGI), as a nuclear medicine imaging technique, has been introduced as a supplementary tool for diagnosing breast cancer. Objectives: This study aimed to determine whether the addition of BSGI to MMG or US interpretations could improve the diagnostic accuracy and reduce the need for further examinations or unnecessary biopsies of breast lesions. Patients and Methods: This retrospective study was conducted on 548 patients with 638 breast lesions from February 2013 to December 2018. The performance of BSGI, MMG, and US was examined for identifying breast cancer and high-risk lesions. Subgroups were classified by adding the results of BSGI for BI-RADS 0 and 4a lesions on MMG and BI-RADS 4a lesions on US. The diagnostic performance of each subgroup was then compared. The sensitivity, specificity, positive predictive value, and negative predictive value were also calculated. The diagnostic accuracy was determined by measuring the area under the receiver operating characteristic curve (AUC). Besides, factors associated with false-positive and false-negative results of BSGI were extracted. Results: The BSGI showed a sensitivity of 88.26% for breast cancer diagnosis, which was comparable to the sensitivity of MMG (87.95%) and lower than that of US (97.83%). The specificity and AUC of BSGI (81.62% and 0.85, respectively) were superior to those of MMG (66.83% and 0.77, respectively) and US (15.20% and 0.57, respectively). In the subgroup analysis of MMG, the sensitivity, positive predictive value, and AUC of MMG0+BSGI and MMG4a+BSGI increased significantly compared to MMG alone. In the MMG4a+BSGI group, the specificity also significantly increased. In the US subgroups, the specificity and AUC of US4a+BSGI increased significantly compared to US alone. Based on the results, a low Ki-67 index was associated with a false-negative result of BSGI. Conclusion: The addition of BSGI to MMG or US could improve the diagnostic performance, especially for BI-RADS 0 and 4a lesions. Additionally, the concomitant use of BSGI with MMG or US might reduce the need for an additional examination or unnecessary biopsy.
{"title":"Breast-specific Gamma Imaging (BSGI) as a Complementary Imaging Tool for BI-RADS 0 and 4a Lesions on Mammography or Ultrasonography","authors":"Rae Rim Ryu, Young Joong Kim, Jae Young Seo, Keumwon Kim, Jin Suk Kim","doi":"10.5812/iranjradiol-120677","DOIUrl":"https://doi.org/10.5812/iranjradiol-120677","url":null,"abstract":"Background: Mammography (MMG) and ultrasonography (US) have been used as standard imaging modalities for the diagnosis of breast cancer. However, several drawbacks have been attributed to these modalities. Breast-specific gamma imaging (BSGI), as a nuclear medicine imaging technique, has been introduced as a supplementary tool for diagnosing breast cancer. Objectives: This study aimed to determine whether the addition of BSGI to MMG or US interpretations could improve the diagnostic accuracy and reduce the need for further examinations or unnecessary biopsies of breast lesions. Patients and Methods: This retrospective study was conducted on 548 patients with 638 breast lesions from February 2013 to December 2018. The performance of BSGI, MMG, and US was examined for identifying breast cancer and high-risk lesions. Subgroups were classified by adding the results of BSGI for BI-RADS 0 and 4a lesions on MMG and BI-RADS 4a lesions on US. The diagnostic performance of each subgroup was then compared. The sensitivity, specificity, positive predictive value, and negative predictive value were also calculated. The diagnostic accuracy was determined by measuring the area under the receiver operating characteristic curve (AUC). Besides, factors associated with false-positive and false-negative results of BSGI were extracted. Results: The BSGI showed a sensitivity of 88.26% for breast cancer diagnosis, which was comparable to the sensitivity of MMG (87.95%) and lower than that of US (97.83%). The specificity and AUC of BSGI (81.62% and 0.85, respectively) were superior to those of MMG (66.83% and 0.77, respectively) and US (15.20% and 0.57, respectively). In the subgroup analysis of MMG, the sensitivity, positive predictive value, and AUC of MMG0+BSGI and MMG4a+BSGI increased significantly compared to MMG alone. In the MMG4a+BSGI group, the specificity also significantly increased. In the US subgroups, the specificity and AUC of US4a+BSGI increased significantly compared to US alone. Based on the results, a low Ki-67 index was associated with a false-negative result of BSGI. Conclusion: The addition of BSGI to MMG or US could improve the diagnostic performance, especially for BI-RADS 0 and 4a lesions. Additionally, the concomitant use of BSGI with MMG or US might reduce the need for an additional examination or unnecessary biopsy.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46079168","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 : 2022-05-19DOI: 10.5812/iranjradiol-122440
Abtin Doroudinia, Najmeh Darvishian, Mehrdad Bakhshayesh karam, H. Emami
Background: The use of 68Ga-PSMA PET/CT scan has recently received particular attention in the evaluation of prostate cancer patients. Objectives: The present study aimed to evaluate the relationship between the PSA level, Gleason score, and 68Ga-PSMAPET/CT findings in prostate cancer patients. Patients and Methods: In this cross-sectional study, 80 male patients with a definitive diagnosis of prostate cancer, who were candidates for 68Ga-PSMA PET/CT scan for both initial staging and restaging, were included. Restaging indicated biochemical recurrence, which refers to a detectable level of PSA after being documented undetectable following a definitive primary treatment. All prostate cancer patients, who were not initially treated with a definitive therapy, were excluded from the study. A cutoff value ≥ 4 was considered significant for SUVmax to differentiate benign from malignant 68Ga-PSMA-avid lesions. Any 68Ga-PSMA uptake outside the prostate bed, especially in the lymph nodes, bones, and visceral organs, was considered metastatic. Results: Comparison of the PSA level between two subgroups with and without metastasis demonstrated a higher PSA level in patients with metastatic abdominal lymph nodes and a slightly higher PSA level in patients with metastatic pelvic lymph nodes. No significant correlation was found between the Gleason score and the total PSA. There was also no significant association between the level of PSA and the type of Lymph node involvement (single or multiple) in different involved areas. Besides, there was no significant correlation between the SUVmax and the level of PSA and the Gleason score in different involved areas. Conclusion: The SUVmax value in 68Ga PSMA PET/CT scan provides a reliable predictor for neither the grade of prostate cancer, nor the metastatic status associated with cancer progression. The measurement of total PSA may predict metastasis to the abdominal and pelvic lymph nodes caused by prostate cancer.
{"title":"Evaluation of the Relationship Between Prostate-Specific Antigen Levels, Gleason Scores, and 68Ga-PSMA PET/CT Scan Findings in Prostate Cancer Patients","authors":"Abtin Doroudinia, Najmeh Darvishian, Mehrdad Bakhshayesh karam, H. Emami","doi":"10.5812/iranjradiol-122440","DOIUrl":"https://doi.org/10.5812/iranjradiol-122440","url":null,"abstract":"Background: The use of 68Ga-PSMA PET/CT scan has recently received particular attention in the evaluation of prostate cancer patients. Objectives: The present study aimed to evaluate the relationship between the PSA level, Gleason score, and 68Ga-PSMAPET/CT findings in prostate cancer patients. Patients and Methods: In this cross-sectional study, 80 male patients with a definitive diagnosis of prostate cancer, who were candidates for 68Ga-PSMA PET/CT scan for both initial staging and restaging, were included. Restaging indicated biochemical recurrence, which refers to a detectable level of PSA after being documented undetectable following a definitive primary treatment. All prostate cancer patients, who were not initially treated with a definitive therapy, were excluded from the study. A cutoff value ≥ 4 was considered significant for SUVmax to differentiate benign from malignant 68Ga-PSMA-avid lesions. Any 68Ga-PSMA uptake outside the prostate bed, especially in the lymph nodes, bones, and visceral organs, was considered metastatic. Results: Comparison of the PSA level between two subgroups with and without metastasis demonstrated a higher PSA level in patients with metastatic abdominal lymph nodes and a slightly higher PSA level in patients with metastatic pelvic lymph nodes. No significant correlation was found between the Gleason score and the total PSA. There was also no significant association between the level of PSA and the type of Lymph node involvement (single or multiple) in different involved areas. Besides, there was no significant correlation between the SUVmax and the level of PSA and the Gleason score in different involved areas. Conclusion: The SUVmax value in 68Ga PSMA PET/CT scan provides a reliable predictor for neither the grade of prostate cancer, nor the metastatic status associated with cancer progression. The measurement of total PSA may predict metastasis to the abdominal and pelvic lymph nodes caused by prostate cancer.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44613599","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 : 2022-05-02DOI: 10.5812/iranjradiol-114808
Jingzi Yao, Li Chen, Danru Liu, L. Fu, Yong Wang, Limin Chen
Background: Ultrasound Breast Imaging-Reporting and Data System (BI-RADS) classification may underestimate ductal carcinoma in situ (DCIS). Currently, there is a lack of research on ultrasound BI-RADS underestimating DCIS. Objectives: To improve the diagnosis of DCIS, this study aimed to investigate factors associated with the underestimation of DCIS, based on ultrasound BI-RADS assessments. Methods: In this cross-sectional study, consecutive patients with breast ultrasound BI-RADS classification and biopsy results were retrospectively examined. DCIS was found in the pathology reports of all patients. DCIS cases classified as BI-RADS 4A or lower were considered as underestimations of DCIS, while DCIS cases classified as BI-RADS 4B or higher were considered as non-underestimation of DCIS. The demographics, clinical manifestations, features of breast images, BI-RADS classification, and pathological results of the two groups were compared to explore possible associated factors. A stepwise logistic regression analysis was also carried out based on the significance of factors associated with the underestimation of DCIS according to the BI-RADS assessment. Results: Between January 2015 and May 2017, a total of 296 breast DCIS lesions were diagnosed in 294 female patients. Overall, 65 lesions (22.0%) were underestimated DCIS, and 231 lesions (78.0%) were non-underestimated DCIS; no significant differences were found between their clinical presentations. The univariate analysis showed that the age of the patients, presence of microinvasions, maximum lesion diameter, shape, margin, orientation, echo pattern, posterior acoustic features, ultrasound pattern, and vascularity of lesions were possibly associated factors, which could lead to the underestimation of DCIS. The logistic regression analysis showed that age above 50 years, maximum lesion diameter < 10 mm, lack of microinvasion, and circumscribed margins were associated with the underestimation of DCIS. Conclusion: In this study, 22% of DCIS lesions was underestimated by the BI-RADS assessment. The patient’s age, maximum lesion diameter, microinvasion, and lesion margin were associated with the underestimation of DCIS.
{"title":"Underestimation of Breast Cancer Based on Ultrasound Breast Imaging-Reporting and Data System (BI-RADS) Assessment of Ductal Carcinoma In Situ: A Retrospective Study of 296 Lesions","authors":"Jingzi Yao, Li Chen, Danru Liu, L. Fu, Yong Wang, Limin Chen","doi":"10.5812/iranjradiol-114808","DOIUrl":"https://doi.org/10.5812/iranjradiol-114808","url":null,"abstract":"Background: Ultrasound Breast Imaging-Reporting and Data System (BI-RADS) classification may underestimate ductal carcinoma in situ (DCIS). Currently, there is a lack of research on ultrasound BI-RADS underestimating DCIS. Objectives: To improve the diagnosis of DCIS, this study aimed to investigate factors associated with the underestimation of DCIS, based on ultrasound BI-RADS assessments. Methods: In this cross-sectional study, consecutive patients with breast ultrasound BI-RADS classification and biopsy results were retrospectively examined. DCIS was found in the pathology reports of all patients. DCIS cases classified as BI-RADS 4A or lower were considered as underestimations of DCIS, while DCIS cases classified as BI-RADS 4B or higher were considered as non-underestimation of DCIS. The demographics, clinical manifestations, features of breast images, BI-RADS classification, and pathological results of the two groups were compared to explore possible associated factors. A stepwise logistic regression analysis was also carried out based on the significance of factors associated with the underestimation of DCIS according to the BI-RADS assessment. Results: Between January 2015 and May 2017, a total of 296 breast DCIS lesions were diagnosed in 294 female patients. Overall, 65 lesions (22.0%) were underestimated DCIS, and 231 lesions (78.0%) were non-underestimated DCIS; no significant differences were found between their clinical presentations. The univariate analysis showed that the age of the patients, presence of microinvasions, maximum lesion diameter, shape, margin, orientation, echo pattern, posterior acoustic features, ultrasound pattern, and vascularity of lesions were possibly associated factors, which could lead to the underestimation of DCIS. The logistic regression analysis showed that age above 50 years, maximum lesion diameter < 10 mm, lack of microinvasion, and circumscribed margins were associated with the underestimation of DCIS. Conclusion: In this study, 22% of DCIS lesions was underestimated by the BI-RADS assessment. The patient’s age, maximum lesion diameter, microinvasion, and lesion margin were associated with the underestimation of DCIS.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48831936","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 : 2022-05-02DOI: 10.5812/iranjradiol-118338
Yufeng Zhu, Jie He, Xingcai Luo
Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide. Cases of HCC in Africa and East Asia account for 80% of all HCC cases around the world. China is one of the countries with a high incidence rate of HCC. Objectives: This case-control study aimed to explore the prognostic value of computed tomography (CT) texture features in patients with HCC following stereotactic ablative radiotherapy (SABR). Patients and Methods: A total of 100 HCC patients, treated with SABR from January 2019 to January 2021, were divided into good prognosis (n = 57) and poor prognosis (n = 43) groups. The patients’ general data and CT texture features were then compared. Factors associated with a poor prognosis were investigated in a multivariate logistic regression analysis. A clinical feature model, a CT texture feature model, and a joint model of clinical features and CT texture features were established, and their prognostic values were evaluated by plotting the receiver operating characteristic (ROC) curves. Moreover, a nomogram prediction model was developed according to the multivariate analysis results, and its prediction efficiency was assessed. Results: Age ≤ 40 years, serum alpha-fetoprotein level > 9 ng/mL, gamma-glutamyl transpeptidase > 60 U/L, aspartate aminotransferase > 40 U/L, lesion size > 5 cm, unsmooth tumor margins, no tumor capsule or incomplete capsule, multiple tumors, portal phase CT value of cancer > 135%, and a relative washout ratio > -24% in the portal phase of cancer were risk factors for a poor prognosis in HCC patients after SABR. The area under the ROC curve and sensitivity and specificity of the joint model were 0.817 (95% confidence interval [CI]: 0.773 - 0.861, P < 0.001), 80.47%, and 91.05%, respectively, which significantly exceeded those of the other two models. The nomogram prediction model showed high accuracy and validity. Conclusion: The texture features of CT images before SABR are of a high prognostic value for HCC patients and contribute to the selection of appropriate treatment protocols.
{"title":"Prognostic Value of Computed Tomography Texture Features in Patients with Hepatocellular Carcinoma Following Stereotactic Ablative Radiotherapy","authors":"Yufeng Zhu, Jie He, Xingcai Luo","doi":"10.5812/iranjradiol-118338","DOIUrl":"https://doi.org/10.5812/iranjradiol-118338","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide. Cases of HCC in Africa and East Asia account for 80% of all HCC cases around the world. China is one of the countries with a high incidence rate of HCC. Objectives: This case-control study aimed to explore the prognostic value of computed tomography (CT) texture features in patients with HCC following stereotactic ablative radiotherapy (SABR). Patients and Methods: A total of 100 HCC patients, treated with SABR from January 2019 to January 2021, were divided into good prognosis (n = 57) and poor prognosis (n = 43) groups. The patients’ general data and CT texture features were then compared. Factors associated with a poor prognosis were investigated in a multivariate logistic regression analysis. A clinical feature model, a CT texture feature model, and a joint model of clinical features and CT texture features were established, and their prognostic values were evaluated by plotting the receiver operating characteristic (ROC) curves. Moreover, a nomogram prediction model was developed according to the multivariate analysis results, and its prediction efficiency was assessed. Results: Age ≤ 40 years, serum alpha-fetoprotein level > 9 ng/mL, gamma-glutamyl transpeptidase > 60 U/L, aspartate aminotransferase > 40 U/L, lesion size > 5 cm, unsmooth tumor margins, no tumor capsule or incomplete capsule, multiple tumors, portal phase CT value of cancer > 135%, and a relative washout ratio > -24% in the portal phase of cancer were risk factors for a poor prognosis in HCC patients after SABR. The area under the ROC curve and sensitivity and specificity of the joint model were 0.817 (95% confidence interval [CI]: 0.773 - 0.861, P < 0.001), 80.47%, and 91.05%, respectively, which significantly exceeded those of the other two models. The nomogram prediction model showed high accuracy and validity. Conclusion: The texture features of CT images before SABR are of a high prognostic value for HCC patients and contribute to the selection of appropriate treatment protocols.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44658378","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 : 2022-05-01DOI: 10.5812/iranjradiol-118828
S. Çınaroğlu, K. Zor, Kursat Guresci, H. Keleş
Background: Orbital decompression is performed to reduce intraorbital pressure by removing the fat tissue and bone around the orbit. Access to proper equipment, experienced personnel, and adequate anatomical knowledge are essential to perform this procedure. To achieve maximum decompression, surgeons need to open the orbit up to the apex, including the optic foramen and the annulus of Zinn. Objectives: This study aimed to determine the location of the sphenoid sinus relative to the optic foramen using CT scan, which is essential for orbital decompression surgery, in the Central Anatolia Region, Turkey. Patients and Methods: This cross-sectional study was conducted on 64 patients from the Turkish population between March 15 and April 15, 2021 in the Central Anatolia Region. The patients were selected using the purposive sampling method. Based on the cranial CT scans, a total of 128 orbits were evaluated using the hospital’s picture archiving and communication system. Patients included in this study were admitted to the hospital with headache. However, their CT images, evaluated by an experienced radiologist, were reported to be normal. The relationship between the optic foramen and the anterior surface of the sphenoid sinus was examined, and the location of the optic foramen was determined as anterior, posterior, or equal to the sphenoid sinus. Descriptive statistics were measured for statistical analysis. Results: The participants of this study included 32 men and 32 women in the age range of 20 - 67 years. Based on the analyses, the optic foramen was mainly opposite to the anterior aspect of the sphenoid sinus in both females and males; this finding was more prominent in females. In the right orbit, the mean distance of the optic foramen to the anterior surface of the sphenoid sinus was +6.97 mm if the optic foramen was anterior to the anterior surface of the sphenoid sinus, while it was -4.1 mm if the optic foramen was located posteriorly to the anterior surface of the sphenoid sinus. Similarly, in the left orbit, the mean distance of the optic foramen to the anterior surface of the sphenoid sinus was +6.97 mm if the optic foramen was located anteriorly, while it was -4.15 mm if the optic foramen was located posteriorly to the anterior surface of the sphenoid sinus. The position of the optic foramen was symmetrical in 60.9% of cases in the two orbits. Conclusions: Based on the results of CT scan, the optic foramen was mainly located opposite to the anterior aspect of the sphenoid sinus; this finding was more frequently observed in females (59.4%) than in males (40.6%). The present results can provide further information for surgeons to perform orbital decompression or surgeries posterior to the orbit.
{"title":"Location of the Optic Foramen Relative to the Sphenoid Sinus and Orbital Apex Structures","authors":"S. Çınaroğlu, K. Zor, Kursat Guresci, H. Keleş","doi":"10.5812/iranjradiol-118828","DOIUrl":"https://doi.org/10.5812/iranjradiol-118828","url":null,"abstract":"Background: Orbital decompression is performed to reduce intraorbital pressure by removing the fat tissue and bone around the orbit. Access to proper equipment, experienced personnel, and adequate anatomical knowledge are essential to perform this procedure. To achieve maximum decompression, surgeons need to open the orbit up to the apex, including the optic foramen and the annulus of Zinn. Objectives: This study aimed to determine the location of the sphenoid sinus relative to the optic foramen using CT scan, which is essential for orbital decompression surgery, in the Central Anatolia Region, Turkey. Patients and Methods: This cross-sectional study was conducted on 64 patients from the Turkish population between March 15 and April 15, 2021 in the Central Anatolia Region. The patients were selected using the purposive sampling method. Based on the cranial CT scans, a total of 128 orbits were evaluated using the hospital’s picture archiving and communication system. Patients included in this study were admitted to the hospital with headache. However, their CT images, evaluated by an experienced radiologist, were reported to be normal. The relationship between the optic foramen and the anterior surface of the sphenoid sinus was examined, and the location of the optic foramen was determined as anterior, posterior, or equal to the sphenoid sinus. Descriptive statistics were measured for statistical analysis. Results: The participants of this study included 32 men and 32 women in the age range of 20 - 67 years. Based on the analyses, the optic foramen was mainly opposite to the anterior aspect of the sphenoid sinus in both females and males; this finding was more prominent in females. In the right orbit, the mean distance of the optic foramen to the anterior surface of the sphenoid sinus was +6.97 mm if the optic foramen was anterior to the anterior surface of the sphenoid sinus, while it was -4.1 mm if the optic foramen was located posteriorly to the anterior surface of the sphenoid sinus. Similarly, in the left orbit, the mean distance of the optic foramen to the anterior surface of the sphenoid sinus was +6.97 mm if the optic foramen was located anteriorly, while it was -4.15 mm if the optic foramen was located posteriorly to the anterior surface of the sphenoid sinus. The position of the optic foramen was symmetrical in 60.9% of cases in the two orbits. Conclusions: Based on the results of CT scan, the optic foramen was mainly located opposite to the anterior aspect of the sphenoid sinus; this finding was more frequently observed in females (59.4%) than in males (40.6%). The present results can provide further information for surgeons to perform orbital decompression or surgeries posterior to the orbit.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42970688","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 : 2022-04-25DOI: 10.5812/iranjradiol-120758
Mahmoud Shiri Kahnouei, M. Giti, M. Akhaee, A. Ameri
Background: Mammography is the most reliable and popular method in the clinical diagnosis of breast cancer. Calcifications are subtle lesions in mammograms that can be cancerous and difficult to detect for radiologists. Computer-aided detection (CAD) can help radiologists identify malignant lesions. Objectives: This study aimed to propose a deep learning based CAD system for detecting calcifications in mammograms. Patients and Methods: A total of 815 in-house mammograms were collected from 204 women undergoing screening mammography. Calcifications in the mammograms were annotated by specialists. Each mammogram was divided into patches of fixed size, and then, patches containing calcifications were extracted, along with the same number of normal patches. A ResNet-50 Convolutional Neural Network (CNN) was trained for classification of patches into normal and calcification groups using training data and then the performance of the trained CNN was tested with new test data. Results: The proposed patch learning approach (PLA) showed a classification accuracy of 96.7% in the binary classification of patches. Therefore, it could detect calcification regions in a given mammogram. The PLA achieved sensitivity and specificity of 96.7% and 96.7%, respectively, with an area under the curve of 98.8%. Conclusion: The present results highlighted the efficacy of the proposed PLA, especially for limited training data. Direct comparison with previous studies is not possible due to differences in datasets. Nevertheless, the PLA accuracy in detecting calcifications was higher than that of deep learning based CAD systems in previous studies. The effective performance of PLA may be attributed to the manual removal of uninformative patches, as they were not used in the training set.
{"title":"Microcalcification Detection in Mammograms Using Deep Learning","authors":"Mahmoud Shiri Kahnouei, M. Giti, M. Akhaee, A. Ameri","doi":"10.5812/iranjradiol-120758","DOIUrl":"https://doi.org/10.5812/iranjradiol-120758","url":null,"abstract":"Background: Mammography is the most reliable and popular method in the clinical diagnosis of breast cancer. Calcifications are subtle lesions in mammograms that can be cancerous and difficult to detect for radiologists. Computer-aided detection (CAD) can help radiologists identify malignant lesions. Objectives: This study aimed to propose a deep learning based CAD system for detecting calcifications in mammograms. Patients and Methods: A total of 815 in-house mammograms were collected from 204 women undergoing screening mammography. Calcifications in the mammograms were annotated by specialists. Each mammogram was divided into patches of fixed size, and then, patches containing calcifications were extracted, along with the same number of normal patches. A ResNet-50 Convolutional Neural Network (CNN) was trained for classification of patches into normal and calcification groups using training data and then the performance of the trained CNN was tested with new test data. Results: The proposed patch learning approach (PLA) showed a classification accuracy of 96.7% in the binary classification of patches. Therefore, it could detect calcification regions in a given mammogram. The PLA achieved sensitivity and specificity of 96.7% and 96.7%, respectively, with an area under the curve of 98.8%. Conclusion: The present results highlighted the efficacy of the proposed PLA, especially for limited training data. Direct comparison with previous studies is not possible due to differences in datasets. Nevertheless, the PLA accuracy in detecting calcifications was higher than that of deep learning based CAD systems in previous studies. The effective performance of PLA may be attributed to the manual removal of uninformative patches, as they were not used in the training set.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45590193","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 : 2022-04-15DOI: 10.5812/iranjradiol-118739
C. Jung, Bong Man Kim, Min Jeong Choi, You Me Kim, K. Lee, Sang Yoon Kim, S. Jo
Introduction: Bronchobiliary fistula (BBF) is a rare, but serious disease; therefore, early diagnosis and treatment are essential. Recently, the use of a minimally invasive procedure that directly embolizes the BBF has emerged as a useful therapeutic alternative for conventional treatments, such as drainage tube insertion or fistulectomy. Case Presentation: Here, we report a case of a 56-year-old man, who was successfully treated with percutaneous transhepatic embolization using n-butyl cyanoacrylate and microcoils and was symptom-free for two years after the procedure. Conclusion: Percutaneous transhepatic embolization can be a successful alternative option for the treatment of BBF. Improved outcomes are expected in long-term follow-ups, especially when n-butyl cyanoacrylate and microcoils are used together.
{"title":"Successful Percutaneous Transhepatic Embolization of the Bronchobiliary Fistula Secondary to Biloma Using n-Butyl Cyanoacrylate and Microcoils","authors":"C. Jung, Bong Man Kim, Min Jeong Choi, You Me Kim, K. Lee, Sang Yoon Kim, S. Jo","doi":"10.5812/iranjradiol-118739","DOIUrl":"https://doi.org/10.5812/iranjradiol-118739","url":null,"abstract":"Introduction: Bronchobiliary fistula (BBF) is a rare, but serious disease; therefore, early diagnosis and treatment are essential. Recently, the use of a minimally invasive procedure that directly embolizes the BBF has emerged as a useful therapeutic alternative for conventional treatments, such as drainage tube insertion or fistulectomy. Case Presentation: Here, we report a case of a 56-year-old man, who was successfully treated with percutaneous transhepatic embolization using n-butyl cyanoacrylate and microcoils and was symptom-free for two years after the procedure. Conclusion: Percutaneous transhepatic embolization can be a successful alternative option for the treatment of BBF. Improved outcomes are expected in long-term follow-ups, especially when n-butyl cyanoacrylate and microcoils are used together.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48160412","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 : 2022-04-15DOI: 10.5812/iranjradiol-121155
Arvin Arian, K. Dinas, G. Pratilas, S. Alipour
: The main advantage of the BI-RADS system is that when correctly applied, the ACR and BI-RADS classifications are the only necessary tools for a practical and scientific communication between radiologists and clinicians regarding the breast findings. The BI-RADS provides a common standardized language of communication by minimizing subjective interpretations. A non-specialist clinician, without an in-depth knowledge of breast imaging, should be assisted on how to manage or refer patients based on standard algorithms. Dedicated breast clinicians, despite their high level of knowledge and experience regarding breast disease and management, are not radiologists; therefore, the BI-RADS can help them organize a follow-up and perform further diagnostic examinations. Besides, radiologists who are specialized in using different modalities communicate better with each other about breast images if the BI-RADS terminology and management guidelines are applied. In this study, we present a concise and simplified description for all sections of the BI-RADS to facilitate its understanding and practical use for all practitioners, not only breast radiologists.
{"title":"The Breast Imaging-Reporting and Data System (BI-RADS) Made Easy","authors":"Arvin Arian, K. Dinas, G. Pratilas, S. Alipour","doi":"10.5812/iranjradiol-121155","DOIUrl":"https://doi.org/10.5812/iranjradiol-121155","url":null,"abstract":": The main advantage of the BI-RADS system is that when correctly applied, the ACR and BI-RADS classifications are the only necessary tools for a practical and scientific communication between radiologists and clinicians regarding the breast findings. The BI-RADS provides a common standardized language of communication by minimizing subjective interpretations. A non-specialist clinician, without an in-depth knowledge of breast imaging, should be assisted on how to manage or refer patients based on standard algorithms. Dedicated breast clinicians, despite their high level of knowledge and experience regarding breast disease and management, are not radiologists; therefore, the BI-RADS can help them organize a follow-up and perform further diagnostic examinations. Besides, radiologists who are specialized in using different modalities communicate better with each other about breast images if the BI-RADS terminology and management guidelines are applied. In this study, we present a concise and simplified description for all sections of the BI-RADS to facilitate its understanding and practical use for all practitioners, not only breast radiologists.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45479130","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 : 2022-02-26DOI: 10.5812/iranjradiol.118837
C. Kadıyoran, P. Yilmaz
Background: Activation of monocytes and lower high-density lipoprotein (HDL) levels accelerate atherosclerosis. The monocyte-to-HDL ratio (MHR) and the coronary artery disease-reporting and data system (CAD-RADS) score are recognized as proper indicators of the atherosclerotic process. Objectives: This study aimed to investigate the relationship between the CAD-RADS score and the left ventricular mass (LVM) and MHR and to evaluate the role of MHR as a predictive marker for the CAD-RADS score. Methods: In this study, the data of 160 patients, who underwent coronary computed tomography angiography (CCTA) for cardiac assessment in our radiology unit between January 2019 and January 2021, were collected and evaluated retrospectively. The CAD-RADS score, LVM, and MHR were calculated for the patients. Patients and Methods: The multivariate analysis showed independent relationships between CAD-RADS scores and high-sensitive C-reactive protein (hs-CRP) (β = 407, P < 0.001), MHR (β = 351, P < 0.001), age (β = 0.254, P < 0.001), male sex (β = 0.179, P < 0.001), and diabetes mellitus (β = 0.122, P = 0.008). The cutoff values of MHR (9.4 for CAD-RADS-1, 11.5 for CAD-RADS-2, 12.8 for CAD-RADS-3, and 14.0 for CAD-RADS-4) showed high sensitivity and specificity for the CAD-RADS scores. Conclusion: Based on the results, MHR may be associated with the CAD-RADS score and increased LVM. As an inexpensive and reliable test, MHR may be useful for the early diagnosis and follow-up of atherosclerotic heart diseases.
背景:单核细胞的激活和高密度脂蛋白(HDL)水平的降低加速了动脉粥样硬化。单核细胞/高密度脂蛋白比率(MHR)和冠状动脉疾病报告和数据系统(CAD-RADS)评分被认为是动脉粥样硬化过程的适当指标。目的:本研究旨在探讨CAD-RADS评分与左心室质量(LVM)和MHR的关系，并评价MHR作为CAD-RADS评分的预测指标的作用。方法:在本研究中，收集了2019年1月至2021年1月期间在我们放射科接受冠状动脉ct血管造影(CCTA)进行心脏评估的160例患者的数据并进行回顾性评估。计算患者CAD-RADS评分、LVM和MHR。患者与方法:多因素分析显示，CAD-RADS评分与高敏c -反应蛋白(hs-CRP) (β = 407, P < 0.001)、MHR (β = 351, P < 0.001)、年龄(β = 0.254, P < 0.001)、男性(β = 0.179, P < 0.001)、糖尿病(β = 0.122, P = 0.008)之间存在独立关系。MHR的截止值(CAD-RADS-1为9.4,CAD-RADS-2为11.5,CAD-RADS-3为12.8,CAD-RADS-4为14.0)对CAD-RADS评分具有较高的敏感性和特异性。结论:基于上述结果，MHR可能与CAD-RADS评分和LVM升高有关。作为一种廉价、可靠的检测方法，MHR可用于动脉粥样硬化性心脏病的早期诊断和随访。
{"title":"Monocyte-to-High-Density Lipoprotein Ratio may be Related to the Coronary Artery Disease Reporting and Data System Score and Increased Left Ventricular Mass","authors":"C. Kadıyoran, P. Yilmaz","doi":"10.5812/iranjradiol.118837","DOIUrl":"https://doi.org/10.5812/iranjradiol.118837","url":null,"abstract":"Background: Activation of monocytes and lower high-density lipoprotein (HDL) levels accelerate atherosclerosis. The monocyte-to-HDL ratio (MHR) and the coronary artery disease-reporting and data system (CAD-RADS) score are recognized as proper indicators of the atherosclerotic process. Objectives: This study aimed to investigate the relationship between the CAD-RADS score and the left ventricular mass (LVM) and MHR and to evaluate the role of MHR as a predictive marker for the CAD-RADS score. Methods: In this study, the data of 160 patients, who underwent coronary computed tomography angiography (CCTA) for cardiac assessment in our radiology unit between January 2019 and January 2021, were collected and evaluated retrospectively. The CAD-RADS score, LVM, and MHR were calculated for the patients. Patients and Methods: The multivariate analysis showed independent relationships between CAD-RADS scores and high-sensitive C-reactive protein (hs-CRP) (β = 407, P < 0.001), MHR (β = 351, P < 0.001), age (β = 0.254, P < 0.001), male sex (β = 0.179, P < 0.001), and diabetes mellitus (β = 0.122, P = 0.008). The cutoff values of MHR (9.4 for CAD-RADS-1, 11.5 for CAD-RADS-2, 12.8 for CAD-RADS-3, and 14.0 for CAD-RADS-4) showed high sensitivity and specificity for the CAD-RADS scores. Conclusion: Based on the results, MHR may be associated with the CAD-RADS score and increased LVM. As an inexpensive and reliable test, MHR may be useful for the early diagnosis and follow-up of atherosclerotic heart diseases.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48794934","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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