PURPOSE We aimed to assess the awareness of interventional radiology (IR) among medical students, and to evaluate an IR curriculum in China. METHODS Between the academic years of 2008 and 2016, 517 third-year medical undergraduates, who successfully applied for an IR curriculum, received a survey related to IR before taking the course. Final exams were conducted after the IR course. RESULTS A total of 355 of the 517 medical students (68.67%) answered the survey; 81.97% of the respondents had heard of IR, 40.28% believed they understood what IR is, but no one was familiar with IR. The four most common pathways for medical students to acquire IR knowledge were via new media (e.g., internet, apps) (42.82%), a teacher/textbook (36.90%), a friend (32.68%), and traditional media (26.48%). The most familiar interventional procedures to respondents were percutaneous transluminal coronary angioplasty (PTCA, 78.59%) and transcatheter arterial chemoembolization (TACE, 44.51%). The results of the survey also indicated that 68.45% of the respondents wanted to learn about IR, but that only 47 male students (13.24%) considered a career in IR. The pass rate of the IR course final exam was 87.04%, i.e., 87.04% of the students successfully completed the course and final exam. CONCLUSION The IR knowledge of medical students in China is worse than that of European medical students. We suggest that providing medical students with general information about IR in the media, as well as via teaching and textbooks in medical school, requires prompt and significant attention. An IR curriculum is beneficial for increasing the IR knowledge of undergraduates.
{"title":"Awareness of interventional radiology before professional training and outcome measurement of an interventional radiology curriculum: a survey of third-year undergraduates in a Chinese medical college.","authors":"Zi-Xuan Wang, Tao Shan","doi":"10.5152/dir.2019.19054","DOIUrl":"https://doi.org/10.5152/dir.2019.19054","url":null,"abstract":"PURPOSE\u0000We aimed to assess the awareness of interventional radiology (IR) among medical students, and to evaluate an IR curriculum in China.\u0000\u0000\u0000METHODS\u0000Between the academic years of 2008 and 2016, 517 third-year medical undergraduates, who successfully applied for an IR curriculum, received a survey related to IR before taking the course. Final exams were conducted after the IR course.\u0000\u0000\u0000RESULTS\u0000A total of 355 of the 517 medical students (68.67%) answered the survey; 81.97% of the respondents had heard of IR, 40.28% believed they understood what IR is, but no one was familiar with IR. The four most common pathways for medical students to acquire IR knowledge were via new media (e.g., internet, apps) (42.82%), a teacher/textbook (36.90%), a friend (32.68%), and traditional media (26.48%). The most familiar interventional procedures to respondents were percutaneous transluminal coronary angioplasty (PTCA, 78.59%) and transcatheter arterial chemoembolization (TACE, 44.51%). The results of the survey also indicated that 68.45% of the respondents wanted to learn about IR, but that only 47 male students (13.24%) considered a career in IR. The pass rate of the IR course final exam was 87.04%, i.e., 87.04% of the students successfully completed the course and final exam.\u0000\u0000\u0000CONCLUSION\u0000The IR knowledge of medical students in China is worse than that of European medical students. We suggest that providing medical students with general information about IR in the media, as well as via teaching and textbooks in medical school, requires prompt and significant attention. An IR curriculum is beneficial for increasing the IR knowledge of undergraduates.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2019.19054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47485211","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}
A. Tavare, A. Wigham, Anastasia Hadjivassilou, A. Alvi, A. Papadopoulou, A. Goode, N. Woodward, D. Patch, D. Yu, N. Davies
PURPOSE Transjugular intrahepatic portosystemic shunt (TIPS) creation is used to treat portal hypertension complications. Often the most challenging and time-consuming step in the procedure is the portal vein (PV) puncture. TIPS procedures are associated with prolonged fluoroscopy time and high patient radiation exposures. We measured the impact of transabdominal ultrasound guidance for PV puncture on duration of fluoroscopy time and dose. METHODS We retrospectively analyzed the radiation dose for all TIPS performed over a four-year period with transabdominal ultrasound guidance for PV puncture (n=212, with 210 performed successfully and data available for 206); fluoroscopy time, dose area product (DAP) and skin dose were recorded. RESULTS Mean fluoroscopy time was 12 min 9 s (SD, ±14 min 38 s), mean DAP was 40.3±73.1 Gy·cm2, and mean skin dose was 404.3±464.8 mGy. CONCLUSION Our results demonstrate that ultrasound-guided PV puncture results in low fluoroscopy times and radiation doses, which are markedly lower than the only published dose reference levels.
{"title":"Use of transabdominal ultrasound-guided transjugular portal vein puncture on radiation dose in transjugular intrahepatic portosystemic shunt formation.","authors":"A. Tavare, A. Wigham, Anastasia Hadjivassilou, A. Alvi, A. Papadopoulou, A. Goode, N. Woodward, D. Patch, D. Yu, N. Davies","doi":"10.5152/dir.2016.15601","DOIUrl":"https://doi.org/10.5152/dir.2016.15601","url":null,"abstract":"PURPOSE\u0000Transjugular intrahepatic portosystemic shunt (TIPS) creation is used to treat portal hypertension complications. Often the most challenging and time-consuming step in the procedure is the portal vein (PV) puncture. TIPS procedures are associated with prolonged fluoroscopy time and high patient radiation exposures. We measured the impact of transabdominal ultrasound guidance for PV puncture on duration of fluoroscopy time and dose.\u0000\u0000\u0000METHODS\u0000We retrospectively analyzed the radiation dose for all TIPS performed over a four-year period with transabdominal ultrasound guidance for PV puncture (n=212, with 210 performed successfully and data available for 206); fluoroscopy time, dose area product (DAP) and skin dose were recorded.\u0000\u0000\u0000RESULTS\u0000Mean fluoroscopy time was 12 min 9 s (SD, ±14 min 38 s), mean DAP was 40.3±73.1 Gy·cm2, and mean skin dose was 404.3±464.8 mGy.\u0000\u0000\u0000CONCLUSION\u0000Our results demonstrate that ultrasound-guided PV puncture results in low fluoroscopy times and radiation doses, which are markedly lower than the only published dose reference levels.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 3 1","pages":"206-210"},"PeriodicalIF":2.1,"publicationDate":"2017-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.15601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43292648","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}
PURPOSE We aimed to evaluate the safety and effectiveness of fluoroscopy-guided gastroduodenal metallic stent placement with different approaches in malignant obstruction. METHODS We retrospectively assessed 53 patients (33 men and 20 women; mean age, 58.7±15 years) who underwent stent placement between February 2004 and April 2014. All patients had unresectable tumors. The most common causes of obstruction were gastric (38%) and pancreatic cancers (36%). Uncovered self-expandable metallic stents (SEMS) were placed under fluoroscopic guidance. In addition to transoral approach in 46 patients (86.7%), transgastric and transhepatic approaches were used in six patients (11.3%) and one patient (1.8%), respectively. Gastric outlet obstruction scoring system (GOOSS) was used to evaluate oral intake before and after stenting. Patients were followed until death or the end of the study. RESULTS Technical and clinical success rates were 100% and 92%, respectively. The median stent patency was 76 days (range, 4-985 days). Mean preprocedural GOOSS score of 0.1 increased to postprocedural GOOSS score of 2.42 (P < 0.001). Afferent loop decompression was achieved in one symptomatic patient. Neither mortality nor major complications occurred due to stenting. Stent migration occurred in one patient (2%) and stent obstruction occurred in two patients (4%). Combined biliary and duodenal stenting were performed in 21 patients (40%). Post-stenting GOOSS scores were predictive of survival (P = 0.003). CONCLUSION Fluoroscopic metallic stent placement for palliation of malignant gastroduodenal obstruction is safe and effective with high technical and clinical success rates and minimal complications. High technical success rates can be achieved using different approaches.
{"title":"Palliation of malignant gastroduodenal obstruction: fluoroscopic metallic stent placement with different approaches.","authors":"E. Bulut, T. Ciftci, O. Akhan, D. Akıncı","doi":"10.5152/dir.2016.16165","DOIUrl":"https://doi.org/10.5152/dir.2016.16165","url":null,"abstract":"PURPOSE\u0000We aimed to evaluate the safety and effectiveness of fluoroscopy-guided gastroduodenal metallic stent placement with different approaches in malignant obstruction.\u0000\u0000\u0000METHODS\u0000We retrospectively assessed 53 patients (33 men and 20 women; mean age, 58.7±15 years) who underwent stent placement between February 2004 and April 2014. All patients had unresectable tumors. The most common causes of obstruction were gastric (38%) and pancreatic cancers (36%). Uncovered self-expandable metallic stents (SEMS) were placed under fluoroscopic guidance. In addition to transoral approach in 46 patients (86.7%), transgastric and transhepatic approaches were used in six patients (11.3%) and one patient (1.8%), respectively. Gastric outlet obstruction scoring system (GOOSS) was used to evaluate oral intake before and after stenting. Patients were followed until death or the end of the study.\u0000\u0000\u0000RESULTS\u0000Technical and clinical success rates were 100% and 92%, respectively. The median stent patency was 76 days (range, 4-985 days). Mean preprocedural GOOSS score of 0.1 increased to postprocedural GOOSS score of 2.42 (P < 0.001). Afferent loop decompression was achieved in one symptomatic patient. Neither mortality nor major complications occurred due to stenting. Stent migration occurred in one patient (2%) and stent obstruction occurred in two patients (4%). Combined biliary and duodenal stenting were performed in 21 patients (40%). Post-stenting GOOSS scores were predictive of survival (P = 0.003).\u0000\u0000\u0000CONCLUSION\u0000Fluoroscopic metallic stent placement for palliation of malignant gastroduodenal obstruction is safe and effective with high technical and clinical success rates and minimal complications. High technical success rates can be achieved using different approaches.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 3 1","pages":"211-216"},"PeriodicalIF":2.1,"publicationDate":"2017-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.16165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48212450","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}
Lijuan Shen, LiangPing Zhou, Xiaohan Liu, Xiaoqun Yang
PURPOSE Clear cell renal cell carcinoma (ccRCC) is the most common primary malignant urologic tumor. The Fuhrman grading system is an independent indicator for aggressiveness and prognosis of ccRCC. We aimed to assess the possible diagnostic role of biexponentially and monoexponentially fitted signal attenuation for the Fuhrman grading. METHODS A total of 33 patients with ccRCC underwent multiple b values (0, 20, 50, 100, 150, 250, 400, 600, 800, 1000 s/mm2) diffusion-weighted imaging (DWI). Biexponential parameters (fast ADC [ADCf], slow ADC [ADCs], and fraction of ADCf [f]) and monoexponential apparent diffusion coefficient were calculated, and correlated with the Fuhrman grade of ccRCC respectively. The performance of biexponential parameters in differentiating Fuhrman low- and high-grade tumors was assessed and compared with ADC value by receiver operating characteristic analysis. RESULTS Qualified images and diffusion-weighted parameters were obtained for all patients. The ADCf and f value were positively correlated, whereas ADCs and ADC value were negatively correlated with Fuhrman grade. Significant differences were observed in ADCf (P < 0.001), ADCs (P = 0.005), and f values (P < 0.001) of high- and low-grade ccRCCs. When differentiating Fuhrman low-grade tumors from high-grade, the ADCf revealed an area under receiver operating characteristic curve of 0.959, which was higher than the ADC value (0.789; P = 0.046), while ADCs (0.807) and f (0.833) showed no significant difference from ADC (P = 0.85 for ADCs, P = 0.73 for f). CONCLUSION Biexponential DWI provides additional parameters for ccRCC. ADCf is more accurate compared with the ADC value in characterizing Fuhrman grade of ccRCC.
目的:透明细胞肾细胞癌是泌尿系统最常见的原发性恶性肿瘤。Fuhrman分级系统是ccRCC侵袭性和预后的独立指标。我们的目的是评估双指数和单指数拟合信号衰减在Fuhrman分级中的可能诊断作用。方法对33例ccRCC患者行多重b值(0、20、50、100、150、250、400、600、800、1000 s/mm2)弥散加权成像(DWI)。计算双指数参数(快速ADC [ADCf]、慢速ADC [ADC]和ADCf的分数[f])和单指数表观扩散系数，分别与ccRCC的Fuhrman分级相关。评估双指数参数在鉴别Fuhrman低级别和高级别肿瘤中的表现，并通过受试者工作特征分析与ADC值进行比较。结果所有患者均获得符合要求的图像和弥散加权参数。ADCf与f值呈显著正相关，ADC和ADC值与Fuhrman分级呈显著负相关。高、低分级ccrcc的ADCf (P < 0.001)、adc (P = 0.005)、f值(P < 0.001)差异有统计学意义。在区分Fuhrman低分级肿瘤和高分级肿瘤时，ADCf显示的受者工作特征曲线下面积为0.959，高于ADC值(0.789;P = 0.046)， ADC(0.807)和f(0.833)与ADC差异无统计学意义(ADC P = 0.85, f P = 0.73)。结论双指数DWI为ccRCC提供了附加参数。与ADC值相比，ADCf值在表征ccRCC的Fuhrman分级方面更为准确。
{"title":"Comparison of biexponential and monoexponential DWI in evaluation of Fuhrman grading of clear cell renal cell carcinoma.","authors":"Lijuan Shen, LiangPing Zhou, Xiaohan Liu, Xiaoqun Yang","doi":"10.5152/dir.2016.15519","DOIUrl":"https://doi.org/10.5152/dir.2016.15519","url":null,"abstract":"PURPOSE\u0000Clear cell renal cell carcinoma (ccRCC) is the most common primary malignant urologic tumor. The Fuhrman grading system is an independent indicator for aggressiveness and prognosis of ccRCC. We aimed to assess the possible diagnostic role of biexponentially and monoexponentially fitted signal attenuation for the Fuhrman grading.\u0000\u0000\u0000METHODS\u0000A total of 33 patients with ccRCC underwent multiple b values (0, 20, 50, 100, 150, 250, 400, 600, 800, 1000 s/mm2) diffusion-weighted imaging (DWI). Biexponential parameters (fast ADC [ADCf], slow ADC [ADCs], and fraction of ADCf [f]) and monoexponential apparent diffusion coefficient were calculated, and correlated with the Fuhrman grade of ccRCC respectively. The performance of biexponential parameters in differentiating Fuhrman low- and high-grade tumors was assessed and compared with ADC value by receiver operating characteristic analysis.\u0000\u0000\u0000RESULTS\u0000Qualified images and diffusion-weighted parameters were obtained for all patients. The ADCf and f value were positively correlated, whereas ADCs and ADC value were negatively correlated with Fuhrman grade. Significant differences were observed in ADCf (P < 0.001), ADCs (P = 0.005), and f values (P < 0.001) of high- and low-grade ccRCCs. When differentiating Fuhrman low-grade tumors from high-grade, the ADCf revealed an area under receiver operating characteristic curve of 0.959, which was higher than the ADC value (0.789; P = 0.046), while ADCs (0.807) and f (0.833) showed no significant difference from ADC (P = 0.85 for ADCs, P = 0.73 for f).\u0000\u0000\u0000CONCLUSION\u0000Biexponential DWI provides additional parameters for ccRCC. ADCf is more accurate compared with the ADC value in characterizing Fuhrman grade of ccRCC.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 2 1","pages":"100-105"},"PeriodicalIF":2.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.15519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46092766","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}
T. Vogl, J. Qian, A. Tran, E. Oppermann, N. Naguib, H. Korkusuz, Nour Eldin A. Nour Eldin, W. Bechstein
PURPOSE We aimed to evaluate the combining effects of transarterial chemoembolization (TACE) and open local thermal microwave ablation in a hepatocellular carcinoma animal model. METHODS Tumor cubes were implanted into the liver of 30 male inbred ACI rats. Groups of 10 animals were treated at 13 days (TACE or microwave ablation) and 16 days (microwave ablation) postimplantation with combined therapy of TACE (0.1 mg mitomycin C; 0.1 mg iodized oil; 5.0 mg degradable starch microspheres) and microwave ablation (2450 Mhz; 45 s; 35 W) (study group A), TACE alone (control group B), or microwave ablation alone (control group C). At day 12 and day 25 tumor size was measured via magnetic resonance imaging and the relative growth ratio was calculated. Hepatic specimens were immunohistochemically examined for the expression of vascular endothelial growth factor (VEGF). RESULTS Mean growth rates were 1.34±0.19 in group A, 3.19±0.13 in group B, and 4.18±0.19 in group C. Compared with control groups B and C, tumor growth rate in group A was significantly inhibited (P < 0.01). The VEGF-antibody reaction in peritumoral tissue (staining intensity at portal triad, percent antibody reaction and staining intensity at central vein) was significantly lower in group A compared with group B (P < 0.01). No significant difference between group A and group C could be observed. CONCLUSION This investigation shows improved results of TACE followed by microwave ablation as treatment of hepatocellular carcinoma in a rat model, compared with single therapy regimen regarding the inhibition of growth rate and reduction of VEGF-level in peritumoral tissue.
{"title":"Study on the effect of chemoembolization combined with microwave ablation for the treatment of hepatocellular carcinoma in rats.","authors":"T. Vogl, J. Qian, A. Tran, E. Oppermann, N. Naguib, H. Korkusuz, Nour Eldin A. Nour Eldin, W. Bechstein","doi":"10.5152/dir.2016.16617","DOIUrl":"https://doi.org/10.5152/dir.2016.16617","url":null,"abstract":"PURPOSE\u0000We aimed to evaluate the combining effects of transarterial chemoembolization (TACE) and open local thermal microwave ablation in a hepatocellular carcinoma animal model.\u0000\u0000\u0000METHODS\u0000Tumor cubes were implanted into the liver of 30 male inbred ACI rats. Groups of 10 animals were treated at 13 days (TACE or microwave ablation) and 16 days (microwave ablation) postimplantation with combined therapy of TACE (0.1 mg mitomycin C; 0.1 mg iodized oil; 5.0 mg degradable starch microspheres) and microwave ablation (2450 Mhz; 45 s; 35 W) (study group A), TACE alone (control group B), or microwave ablation alone (control group C). At day 12 and day 25 tumor size was measured via magnetic resonance imaging and the relative growth ratio was calculated. Hepatic specimens were immunohistochemically examined for the expression of vascular endothelial growth factor (VEGF).\u0000\u0000\u0000RESULTS\u0000Mean growth rates were 1.34±0.19 in group A, 3.19±0.13 in group B, and 4.18±0.19 in group C. Compared with control groups B and C, tumor growth rate in group A was significantly inhibited (P < 0.01). The VEGF-antibody reaction in peritumoral tissue (staining intensity at portal triad, percent antibody reaction and staining intensity at central vein) was significantly lower in group A compared with group B (P < 0.01). No significant difference between group A and group C could be observed.\u0000\u0000\u0000CONCLUSION\u0000This investigation shows improved results of TACE followed by microwave ablation as treatment of hepatocellular carcinoma in a rat model, compared with single therapy regimen regarding the inhibition of growth rate and reduction of VEGF-level in peritumoral tissue.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 2 1","pages":"150-155"},"PeriodicalIF":2.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.16617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45505988","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}
PURPOSE We aimed to evaluate the efficacy of magnetic resonance imaging (MRI)-directed cognitive fusion transrectal ultrasonography (TRUS)-guided anterior prostate biopsy for diagnosis of anterior prostate tumors and to illustrate this technique. METHODS A total of 39 patients with previous negative TRUS biopsy, but high clinical suspicion of occult prostate cancer, prospectively underwent prostate MRI including diffusion-weighted imaging (DWI). Patients with a suspicious anterior lesion on MRI underwent targeted anterior gland TRUS-guided biopsy with cognitive fusion technique using sagittal probe orientation. PIRADS version 1 scores (T2, DWI, and overall), lesion size, prostate-specific antigen (PSA), PSA density, and prostate gland volume were compared between positive and negative biopsy groups and between clinically significant cancer and remaining cases. Logistic regression analysis of imaging parameters and prostate cancer diagnosis was performed. RESULTS Anterior gland prostate adenocarcinoma was diagnosed in 18 patients (46.2%) on targeted anterior gland TRUS-guided biopsy. Clinically significant prostate cancer was diagnosed in 13 patients (33.3%). MRI lesion size, T2, DWI, and overall PIRADS scores were significantly higher in patients with positive targeted biopsies and those with clinically significant cancer (P < 0.05). Biopsies were positive in 90%, 33%, and 29% of patients with overall PIRADS scores of 5, 4, and 3 respectively. Overall PIRADS score was an independent predictor of all prostate cancer diagnosis and of clinically significant prostate cancer diagnosis. CONCLUSION Targeted anterior gland TRUS-guided biopsy with MRI-directed cognitive fusion enables accurate sampling and may improve tumor detection yield of anterior prostate cancer.
{"title":"MRI-directed cognitive fusion-guided biopsy of the anterior prostate tumors.","authors":"I. Murphy, E. NiMhurchu, R. Gibney, C. Mcmahon","doi":"10.5152/dir.2016.15445","DOIUrl":"https://doi.org/10.5152/dir.2016.15445","url":null,"abstract":"PURPOSE\u0000We aimed to evaluate the efficacy of magnetic resonance imaging (MRI)-directed cognitive fusion transrectal ultrasonography (TRUS)-guided anterior prostate biopsy for diagnosis of anterior prostate tumors and to illustrate this technique.\u0000\u0000\u0000METHODS\u0000A total of 39 patients with previous negative TRUS biopsy, but high clinical suspicion of occult prostate cancer, prospectively underwent prostate MRI including diffusion-weighted imaging (DWI). Patients with a suspicious anterior lesion on MRI underwent targeted anterior gland TRUS-guided biopsy with cognitive fusion technique using sagittal probe orientation. PIRADS version 1 scores (T2, DWI, and overall), lesion size, prostate-specific antigen (PSA), PSA density, and prostate gland volume were compared between positive and negative biopsy groups and between clinically significant cancer and remaining cases. Logistic regression analysis of imaging parameters and prostate cancer diagnosis was performed.\u0000\u0000\u0000RESULTS\u0000Anterior gland prostate adenocarcinoma was diagnosed in 18 patients (46.2%) on targeted anterior gland TRUS-guided biopsy. Clinically significant prostate cancer was diagnosed in 13 patients (33.3%). MRI lesion size, T2, DWI, and overall PIRADS scores were significantly higher in patients with positive targeted biopsies and those with clinically significant cancer (P < 0.05). Biopsies were positive in 90%, 33%, and 29% of patients with overall PIRADS scores of 5, 4, and 3 respectively. Overall PIRADS score was an independent predictor of all prostate cancer diagnosis and of clinically significant prostate cancer diagnosis.\u0000\u0000\u0000CONCLUSION\u0000Targeted anterior gland TRUS-guided biopsy with MRI-directed cognitive fusion enables accurate sampling and may improve tumor detection yield of anterior prostate cancer.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 2 1","pages":"87-93"},"PeriodicalIF":2.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.15445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49012509","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}
B. Schaarschmidt, B. Gomez, C. Buchbender, J. Grueneisen, F. Nensa, L. Sawicki, Verena Ruhlmann, A. Wetter, G. Antoch, P. Heusch
PURPOSE We aimed to investigate the accuracy of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) compared with contrast-enhanced 18F-FDG PET/computed tomography (PET/CT) for the characterization of incidental tracer uptake in examinations of the head and neck. METHODS A retrospective analysis of 81 oncologic patients who underwent contrast-enhanced 18F-FDG PET/CT and subsequent PET/MRI was performed by two readers for incidental tracer uptake. In a consensus reading, discrepancies were resolved. Each finding was either characterized as most likely benign, most likely malignant, or indeterminate. Using all available clinical information including results from histopathologic sampling and follow-up examinations, an expert reader classified each finding as benign or malignant. McNemar's test was used to compare the performance of both imaging modalities in characterizing incidental tracer uptake. RESULTS Forty-six lesions were detected by both modalities. On PET/CT, 27 lesions were classified as most likely benign, one as most likely malignant, and 18 as indeterminate; on PET/MRI, 31 lesions were classified as most likely benign, one lesion as most likely malignant, and 14 as indeterminate. Forty-three lesions were benign and one lesion was malignant according to the reference standard. In two lesions, a definite diagnosis was not possible. McNemar's test detected no differences concerning the correct classification of incidental tracer uptake between PET/CT and PET/MRI (P = 0.125). CONCLUSION In examinations of the head and neck area, incidental tracer uptake cannot be classified more accurately by PET/MRI than by PET/CT.
{"title":"Is integrated 18F-FDG PET/MRI superior to 18F-FDG PET/CT in the differentiation of incidental tracer uptake in the head and neck area?","authors":"B. Schaarschmidt, B. Gomez, C. Buchbender, J. Grueneisen, F. Nensa, L. Sawicki, Verena Ruhlmann, A. Wetter, G. Antoch, P. Heusch","doi":"10.5152/dir.2016.15610","DOIUrl":"https://doi.org/10.5152/dir.2016.15610","url":null,"abstract":"PURPOSE\u0000We aimed to investigate the accuracy of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) compared with contrast-enhanced 18F-FDG PET/computed tomography (PET/CT) for the characterization of incidental tracer uptake in examinations of the head and neck.\u0000\u0000\u0000METHODS\u0000A retrospective analysis of 81 oncologic patients who underwent contrast-enhanced 18F-FDG PET/CT and subsequent PET/MRI was performed by two readers for incidental tracer uptake. In a consensus reading, discrepancies were resolved. Each finding was either characterized as most likely benign, most likely malignant, or indeterminate. Using all available clinical information including results from histopathologic sampling and follow-up examinations, an expert reader classified each finding as benign or malignant. McNemar's test was used to compare the performance of both imaging modalities in characterizing incidental tracer uptake.\u0000\u0000\u0000RESULTS\u0000Forty-six lesions were detected by both modalities. On PET/CT, 27 lesions were classified as most likely benign, one as most likely malignant, and 18 as indeterminate; on PET/MRI, 31 lesions were classified as most likely benign, one lesion as most likely malignant, and 14 as indeterminate. Forty-three lesions were benign and one lesion was malignant according to the reference standard. In two lesions, a definite diagnosis was not possible. McNemar's test detected no differences concerning the correct classification of incidental tracer uptake between PET/CT and PET/MRI (P = 0.125).\u0000\u0000\u0000CONCLUSION\u0000In examinations of the head and neck area, incidental tracer uptake cannot be classified more accurately by PET/MRI than by PET/CT.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 2 1","pages":"127-132"},"PeriodicalIF":2.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.15610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44708218","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}
PURPOSE We aimed to assess computed tomography (CT) findings of pulmonary tuberculosis (TB) and TB pleurisy in diabetes mellitus (DM) patients and to evaluate the effect of duration of DM on radiologic findings of pulmonary TB and TB pleurisy. METHODS Ninety-three consecutive patients diagnosed as active pulmonary TB with underlying DM were enrolled in our study. As a control group, 100 pulmonary TB patients without DM were randomly selected. TB patients with DM were subdivided into two subgroups depending on diabetes duration of ≥10 years or <10 years. Medical records and CT scans of the patients were retrospectively reviewed and compared. RESULTS Bilateral pulmonary involvement (odds ratio [OR]=2.39, P = 0.003), involvement of all lobes (OR=2.79, P = 0.013), and lymph node enlargement (OR=1.98, P = 0.022) were significantly more frequent CT findings among TB patients with DM compared with the controls. There were no statistically significant differences in CT findings of pulmonary TB depending on the duration of DM. CONCLUSION Bilateral pulmonary involvement, involvement of all lobes, and lymph node enlargement are significantly more common CT findings in TB patients with underlying DM than in patients without DM. Familiarity with the CT findings may be helpful to suggest prompt diagnosis of pulmonary TB in DM patients.
{"title":"CT findings of pulmonary tuberculosis and tuberculous pleurisy in diabetes mellitus patients.","authors":"Jihyun Kim, I. Lee, J. Kim","doi":"10.5152/dir.2016.16157","DOIUrl":"https://doi.org/10.5152/dir.2016.16157","url":null,"abstract":"PURPOSE\u0000We aimed to assess computed tomography (CT) findings of pulmonary tuberculosis (TB) and TB pleurisy in diabetes mellitus (DM) patients and to evaluate the effect of duration of DM on radiologic findings of pulmonary TB and TB pleurisy.\u0000\u0000\u0000METHODS\u0000Ninety-three consecutive patients diagnosed as active pulmonary TB with underlying DM were enrolled in our study. As a control group, 100 pulmonary TB patients without DM were randomly selected. TB patients with DM were subdivided into two subgroups depending on diabetes duration of ≥10 years or <10 years. Medical records and CT scans of the patients were retrospectively reviewed and compared.\u0000\u0000\u0000RESULTS\u0000Bilateral pulmonary involvement (odds ratio [OR]=2.39, P = 0.003), involvement of all lobes (OR=2.79, P = 0.013), and lymph node enlargement (OR=1.98, P = 0.022) were significantly more frequent CT findings among TB patients with DM compared with the controls. There were no statistically significant differences in CT findings of pulmonary TB depending on the duration of DM.\u0000\u0000\u0000CONCLUSION\u0000Bilateral pulmonary involvement, involvement of all lobes, and lymph node enlargement are significantly more common CT findings in TB patients with underlying DM than in patients without DM. Familiarity with the CT findings may be helpful to suggest prompt diagnosis of pulmonary TB in DM patients.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 2 1","pages":"112-117"},"PeriodicalIF":2.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.16157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43758375","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}
D. Aberle, H. Charles, S. Hodak, Daniel K. O’Neill, R. Oklu, A. Deipolyi
With the rising epidemic of obesity, interventional radiologists are treating increasing numbers of obese patients, as comorbidities associated with obesity preclude more invasive treatments. These patients are at heightened risk of vascular and oncologic disease, both of which often require interventional radiology care. Obese patients pose unique challenges in imaging, technical feasibility, and periprocedural monitoring. This review describes the technical and clinical challenges posed by this population, with proposed methods to mitigate these challenges and optimize care.
{"title":"Optimizing care for the obese patient in interventional radiology.","authors":"D. Aberle, H. Charles, S. Hodak, Daniel K. O’Neill, R. Oklu, A. Deipolyi","doi":"10.5152/dir.2016.16230","DOIUrl":"https://doi.org/10.5152/dir.2016.16230","url":null,"abstract":"With the rising epidemic of obesity, interventional radiologists are treating increasing numbers of obese patients, as comorbidities associated with obesity preclude more invasive treatments. These patients are at heightened risk of vascular and oncologic disease, both of which often require interventional radiology care. Obese patients pose unique challenges in imaging, technical feasibility, and periprocedural monitoring. This review describes the technical and clinical challenges posed by this population, with proposed methods to mitigate these challenges and optimize care.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 2 1","pages":"156-162"},"PeriodicalIF":2.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44651870","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}
A. Del Ciello, P. Franchi, A. Contegiacomo, G. Cicchetti, L. Bonomo, A. Larici
Missed lung cancer is a source of concern among radiologists and an important medicolegal challenge. In 90% of the cases, errors in diagnosis of lung cancer occur on chest radiographs. It may be challenging for radiologists to distinguish a lung lesion from bones, pulmonary vessels, mediastinal structures, and other complex anatomical structures on chest radiographs. Nevertheless, lung cancer can also be overlooked on computed tomography (CT) scans, regardless of the context, either if a clinical or radiologic suspect exists or for other reasons. Awareness of the possible causes of overlooking a pulmonary lesion can give radiologists a chance to reduce the occurrence of this eventuality. Various factors contribute to a misdiagnosis of lung cancer on chest radiographs and on CT, often very similar in nature to each other. Observer error is the most significant one and comprises scanning error, recognition error, decision-making error, and satisfaction of search. Tumor characteristics such as lesion size, conspicuity, and location are also crucial in this context. Even technical aspects can contribute to the probability of skipping lung cancer, including image quality and patient positioning and movement. Albeit it is hard to remove missed lung cancer completely, strategies to reduce observer error and methods to improve technique and automated detection may be valuable in reducing its likelihood.
{"title":"Missed lung cancer: when, where, and why?","authors":"A. Del Ciello, P. Franchi, A. Contegiacomo, G. Cicchetti, L. Bonomo, A. Larici","doi":"10.5152/dir.2016.16187","DOIUrl":"https://doi.org/10.5152/dir.2016.16187","url":null,"abstract":"Missed lung cancer is a source of concern among radiologists and an important medicolegal challenge. In 90% of the cases, errors in diagnosis of lung cancer occur on chest radiographs. It may be challenging for radiologists to distinguish a lung lesion from bones, pulmonary vessels, mediastinal structures, and other complex anatomical structures on chest radiographs. Nevertheless, lung cancer can also be overlooked on computed tomography (CT) scans, regardless of the context, either if a clinical or radiologic suspect exists or for other reasons. Awareness of the possible causes of overlooking a pulmonary lesion can give radiologists a chance to reduce the occurrence of this eventuality. Various factors contribute to a misdiagnosis of lung cancer on chest radiographs and on CT, often very similar in nature to each other. Observer error is the most significant one and comprises scanning error, recognition error, decision-making error, and satisfaction of search. Tumor characteristics such as lesion size, conspicuity, and location are also crucial in this context. Even technical aspects can contribute to the probability of skipping lung cancer, including image quality and patient positioning and movement. Albeit it is hard to remove missed lung cancer completely, strategies to reduce observer error and methods to improve technique and automated detection may be valuable in reducing its likelihood.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":"23 2 1","pages":"118-126"},"PeriodicalIF":2.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2016.16187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44846867","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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