Clinical Imaging最新文献

英文中文

Radiomics and machine learning models for diagnosing microvascular invasion in cholangiocarcinoma: a systematic review and meta-analysis of diagnostic test accuracy studies

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-03-13 DOI: 10.1016/j.clinimag.2025.110456

Amir Mahmoud Ahmadzadeh , Nima Broomand Lomer , Drew A. Torigian

Purpose

We aimed to systematically assess the value of radiomics/machine learning (ML) models for diagnosing microvascular invasion (MVI) in patients with cholangiocarcinoma (CCA) using various radiologic modalities.

Methods

A systematic search of was conducted on Web of Sciences, PubMed, Scopus, and Embase. All the studies that assessed the value of radiomics models or ML models along with the use of imaging features were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria and METhodological RadiomICs Score (METRICS) were used for quality assessment. Pooled estimates for the diagnostic performance of radiomics/ML models were calculated. I-squared was used to assess heterogeneity, and sensitivity and subgroup analyses were performed to find the sources of heterogeneity. Deeks' funnel plots were used to assess publication bias.

Results

11 studies were included in the systematic review with only one study being about extrahepatic CCA. According to the METRICS, the mean score was 62.99 %. Meta-analyses were performed on intrahepatic CCA studies. The meta-analysis of the best ML models revealed an AUC of 0.93 in the training cohort and an AUC of 0.85 in the validation cohort. Regarding the best radiomics model, the AUC was 0.85 in the training cohort and 0.81 in the validation cohort.

Conclusion

Radiomics/ML models showed very good diagnostic performance regarding MVI diagnosis in patients with intrahepatic CCA and may provide a non-invasive method for this purpose. However, given the high heterogeneity and low number of the included studies, further multi-center studies with prospective design and robust external validation are essential.

{"title":"Radiomics and machine learning models for diagnosing microvascular invasion in cholangiocarcinoma: a systematic review and meta-analysis of diagnostic test accuracy studies","authors":"Amir Mahmoud Ahmadzadeh , Nima Broomand Lomer , Drew A. Torigian","doi":"10.1016/j.clinimag.2025.110456","DOIUrl":"10.1016/j.clinimag.2025.110456","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to systematically assess the value of radiomics/machine learning (ML) models for diagnosing microvascular invasion (MVI) in patients with cholangiocarcinoma (CCA) using various radiologic modalities.</div></div><div><h3>Methods</h3><div>A systematic search of was conducted on Web of Sciences, PubMed, Scopus, and Embase. All the studies that assessed the value of radiomics models or ML models along with the use of imaging features were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria and METhodological RadiomICs Score (METRICS) were used for quality assessment. Pooled estimates for the diagnostic performance of radiomics/ML models were calculated. I-squared was used to assess heterogeneity, and sensitivity and subgroup analyses were performed to find the sources of heterogeneity. Deeks' funnel plots were used to assess publication bias.</div></div><div><h3>Results</h3><div>11 studies were included in the systematic review with only one study being about extrahepatic CCA. According to the METRICS, the mean score was 62.99 %. Meta-analyses were performed on intrahepatic CCA studies. The meta-analysis of the best ML models revealed an AUC of 0.93 in the training cohort and an AUC of 0.85 in the validation cohort. Regarding the best radiomics model, the AUC was 0.85 in the training cohort and 0.81 in the validation cohort.</div></div><div><h3>Conclusion</h3><div>Radiomics/ML models showed very good diagnostic performance regarding MVI diagnosis in patients with intrahepatic CCA and may provide a non-invasive method for this purpose. However, given the high heterogeneity and low number of the included studies, further multi-center studies with prospective design and robust external validation are essential.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110456"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621332","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}

引用次数: 0

The 100 most-cited radiomics articles in cancer research: A bibliometric analysis

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-03-11 DOI: 10.1016/j.clinimag.2025.110442

Wenhao Zhang , Dongmei Zhuang , Wenzhuo Wei , Yuchen Yang , Lijun Ma , He Du , Anran Jin , Jingyi He , Xiaoming Li

Radiomics, an advanced medical imaging analysis technique introduced by Professor Lambin in 2012, has quickly become a key area of medical research. To explore emerging trends in cancer-related radiomics, we conducted a bibliometric analysis of the 100 most-cited articles (T100) in this field. Data were collected from the Web of Science Core Collection on October 7, 2023, and the articles were ranked by citation count. We extracted data such as authors, journals, citation counts, and publication years and analyzed it using Microsoft Excel 2019 and R 4.4.2. CiteSpace was used to create co-occurrence and citation burst maps to show the relationships between authors, countries, institutions, and keywords. The analysis revealed that the T100 came from 81 countries, with the U.S. contributing the most (56 articles). Harvard University was the leading institution, and the journal Radiology had the highest citation count. Aerts Hugo JWL was the most influential author. The study highlights that “lung cancer” and “artificial intelligence” are emerging as major research hotspots, shaping the future of cancer radiomics.

{"title":"The 100 most-cited radiomics articles in cancer research: A bibliometric analysis","authors":"Wenhao Zhang , Dongmei Zhuang , Wenzhuo Wei , Yuchen Yang , Lijun Ma , He Du , Anran Jin , Jingyi He , Xiaoming Li","doi":"10.1016/j.clinimag.2025.110442","DOIUrl":"10.1016/j.clinimag.2025.110442","url":null,"abstract":"<div><div>Radiomics, an advanced medical imaging analysis technique introduced by Professor Lambin in 2012, has quickly become a key area of medical research. To explore emerging trends in cancer-related radiomics, we conducted a bibliometric analysis of the 100 most-cited articles (T100) in this field. Data were collected from the Web of Science Core Collection on October 7, 2023, and the articles were ranked by citation count. We extracted data such as authors, journals, citation counts, and publication years and analyzed it using Microsoft Excel 2019 and R 4.4.2. CiteSpace was used to create co-occurrence and citation burst maps to show the relationships between authors, countries, institutions, and keywords. The analysis revealed that the T100 came from 81 countries, with the U.S. contributing the most (56 articles). Harvard University was the leading institution, and the journal <em>Radiology</em> had the highest citation count. Aerts Hugo JWL was the most influential author. The study highlights that “lung cancer” and “artificial intelligence” are emerging as major research hotspots, shaping the future of cancer radiomics.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110442"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609582","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}

引用次数: 0

Safety and efficacy of provocative angiography for localization and treatment of gastrointestinal hemorrhage

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-03-07 DOI: 10.1016/j.clinimag.2025.110441

Thomas J. An , Kaiz Esmail , Ivan Dimov , Ryan Adams , Vincent Wu , Patrick D. Sutphin , Sanjeeva Kalva , Omar Zurkiya

Purpose

Mesenteric angiography and embolization is an effective treatment of gastrointestinal bleeding. In the setting of occult bleeding, provocative maneuvers with intra-arterial vasodilators and thrombolytics can increase the diagnostic yield of angiography. This study aimed to assess the clinical outcomes of provocative angiography and factors that increase the positivity rate for active bleeding at the time of provocation.

Methods

An institutional database was used to retrospectively identify patients that underwent provocative angiography for identification and treatment of gastrointestinal bleeding between 2015 and 2024. Patient demographic data, laboratory values, and clinical outcomes were recorded from the electronic medical record. Provocative angiography was performed using intra-arterial injection of heparin, nitroglycerin, and/or tPA.

Results

Provocative angiography identified active gastrointestinal bleeding in 35 % (14/40) of patients. There was no significant difference in age, hemoglobin level, transfusion requirement, ICU admission, or vasopressor requirement between patients that were positive versus negative for bleeding. 50 % (20/40) of patients had undergone prior mesenteric angiography that was negative for active hemorrhage. The mean doses of heparin, nitroglycerin, and tPA were 4973 +/− 2242 U, 507.3 +/− 317.2 μg, and 16.9 +/− 8.3 mg, respectively. Active bleeding was treated successfully in 100 % (14/14) patients. There were no bleeding complications related to provocative maneuvers.

Discussion

Provocative angiography is safe and effective for the identification of intermittent gastrointestinal bleeding during mesenteric angiography. There were no factors identified that increased the likelihood of identification of active bleeding during provocative angiography. There were no bleeding complications related to provocative mesenteric angiography in this study.

{"title":"Safety and efficacy of provocative angiography for localization and treatment of gastrointestinal hemorrhage","authors":"Thomas J. An , Kaiz Esmail , Ivan Dimov , Ryan Adams , Vincent Wu , Patrick D. Sutphin , Sanjeeva Kalva , Omar Zurkiya","doi":"10.1016/j.clinimag.2025.110441","DOIUrl":"10.1016/j.clinimag.2025.110441","url":null,"abstract":"<div><h3>Purpose</h3><div>Mesenteric angiography and embolization is an effective treatment of gastrointestinal bleeding. In the setting of occult bleeding, provocative maneuvers with intra-arterial vasodilators and thrombolytics can increase the diagnostic yield of angiography. This study aimed to assess the clinical outcomes of provocative angiography and factors that increase the positivity rate for active bleeding at the time of provocation.</div></div><div><h3>Methods</h3><div>An institutional database was used to retrospectively identify patients that underwent provocative angiography for identification and treatment of gastrointestinal bleeding between 2015 and 2024. Patient demographic data, laboratory values, and clinical outcomes were recorded from the electronic medical record. Provocative angiography was performed using intra-arterial injection of heparin, nitroglycerin, and/or tPA.</div></div><div><h3>Results</h3><div>Provocative angiography identified active gastrointestinal bleeding in 35 % (14/40) of patients. There was no significant difference in age, hemoglobin level, transfusion requirement, ICU admission, or vasopressor requirement between patients that were positive versus negative for bleeding. 50 % (20/40) of patients had undergone prior mesenteric angiography that was negative for active hemorrhage. The mean doses of heparin, nitroglycerin, and tPA were 4973 +/− 2242 U, 507.3 +/− 317.2 μg, and 16.9 +/− 8.3 mg, respectively. Active bleeding was treated successfully in 100 % (14/14) patients. There were no bleeding complications related to provocative maneuvers.</div></div><div><h3>Discussion</h3><div>Provocative angiography is safe and effective for the identification of intermittent gastrointestinal bleeding during mesenteric angiography. There were no factors identified that increased the likelihood of identification of active bleeding during provocative angiography. There were no bleeding complications related to provocative mesenteric angiography in this study.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110441"},"PeriodicalIF":1.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592222","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}

引用次数: 0

CAR T-cell therapy chest CT manifestations

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-03-01 DOI: 10.1016/j.clinimag.2025.110439

Dorine de Jong , Saheeb Ahmed , Belinda Dsouza , Mary Salvatore , Benjamin May , Sophia Huang , Christian Gordillio , Ran Reshef , Kathleen M. Capaccione

Purpose

CAR T-cell therapy is an emerging anti-cancer therapeutic using modified T cells to attack a patient's cancer. The purpose of this study was to assess chest CT findings in patients undergoing CAR T-cell therapy to determine the most common CT manifestations.

Methods

We performed a retrospective test-retest study analyzing cases of patients who received CAR T-cell therapy who underwent chest CT prior to therapy and after therapy; a total of 349 patients were identified. CAR T-cell therapy was first administered in the mid 2010's, however we assessed for pre-treatment scans prior to this date. We reviewed patient's charts to collect demographic and clinical data. Two cardiothoracic radiologists reviewed chest CT scans prior to and post CAR T-cell therapy to determine new radiologic features post therapy. We analyzed which findings correlated with specific radiologic features on chest CT using student's t-tests or Chi squared tests.

Results

Pleural effusion was the most common CT manifestation resulting from CAR T-cell therapy, found in 26.3 % of patients. Patients with CT manifestations were more likely to present with dyspnea and cough (p = 0.000031 and p = 0.02, respectively).

Discussion

New symptoms in patients treated with CAR T-cell therapy may be an important harbinger of radiologic abnormalities. Clinicians should have a high index of suspicion for pleural effusions in patients presenting with symptoms who have undergone CAR T-cell therapy.

{"title":"CAR T-cell therapy chest CT manifestations","authors":"Dorine de Jong , Saheeb Ahmed , Belinda Dsouza , Mary Salvatore , Benjamin May , Sophia Huang , Christian Gordillio , Ran Reshef , Kathleen M. Capaccione","doi":"10.1016/j.clinimag.2025.110439","DOIUrl":"10.1016/j.clinimag.2025.110439","url":null,"abstract":"<div><h3>Purpose</h3><div>CAR T-cell therapy is an emerging anti-cancer therapeutic using modified T cells to attack a patient's cancer. The purpose of this study was to assess chest CT findings in patients undergoing CAR T-cell therapy to determine the most common CT manifestations.</div></div><div><h3>Methods</h3><div>We performed a retrospective test-retest study analyzing cases of patients who received CAR T-cell therapy who underwent chest CT prior to therapy and after therapy; a total of 349 patients were identified. CAR T-cell therapy was first administered in the mid 2010's, however we assessed for pre-treatment scans prior to this date. We reviewed patient's charts to collect demographic and clinical data. Two cardiothoracic radiologists reviewed chest CT scans prior to and post CAR T-cell therapy to determine new radiologic features post therapy. We analyzed which findings correlated with specific radiologic features on chest CT using student's <em>t-</em>tests or Chi squared tests.</div></div><div><h3>Results</h3><div>Pleural effusion was the most common CT manifestation resulting from CAR T-cell therapy, found in 26.3 % of patients. Patients with CT manifestations were more likely to present with dyspnea and cough (<em>p</em> = 0.000031 and <em>p</em> = 0.02, respectively).</div></div><div><h3>Discussion</h3><div>New symptoms in patients treated with CAR T-cell therapy may be an important harbinger of radiologic abnormalities. Clinicians should have a high index of suspicion for pleural effusions in patients presenting with symptoms who have undergone CAR T-cell therapy.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110439"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570582","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}

引用次数: 0

CT-guided biopsy of 18F-piflufolastat radiotracer avid lesions in osseous metastatic prostate disease: Initial experience, technical factors and biopsy yield

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-02-25 DOI: 10.1016/j.clinimag.2025.110437

Jordan Fenner , Mohammad Samim , Roy A. Raad , Dhruv S. Shankar , Christopher John Burke

Objectives

To evaluate the yield of CT-guided biopsy of 18F-piflufolastat PET avid osseous lesions in suspected prostate metastases.

Methods

Retrospective review of computed tomography guided biopsies targeting 18F-piflufolastat avid lesions on PET/CT or PET/MR performed between 2022 and 2024. Demographics, image modality, biopsy system, number of cores, lesion location, lean body mass corrected SUV (SUL) and pathology were recorded. Biopsied lesions were compared to the PROMISE (prostate cancer molecular imaging standardized evaluation) scoring system, version 2.

Results

Eighteen patients were included, average age 68.7 years. Lesions were defined as: ≥ 50 % sclerotic (n = 10), <50 % sclerotic (n = 7), occult (n = 0), and lytic (n = 1). A technically successful pathologic diagnosis was made in 94 % of biopsies (n = 17). Histopathological diagnosis included: metastatic prostate adenocarcinoma (n = 12), benign with fibrotic/densely sclerotic bone or normocellular bone marrow (n = 5), and metastatic non-small cell lung carcinoma (n = 1). The median SUL on PET for all patients was 7.9 (IQR 13.3), 2.6 (0.3) for benign biopsies, and 8.8 (12.5) for malignant biopsies. Major identifiable differences between biopsies yielding a metastatic versus benign diagnosis included: higher SUL (p-value = 0.03), target lesion volume (p-value = 0.01), and higher incidence of sclerotic lesions (p value = 0.003); however, multivariate analysis did not find these to be statistically significant predictors (p-value >0.05). The prostate cancer lesion biopsy positive group had significantly higher PROMISE scores than the negative group (p = 0.03).

Conclusion

CT-guided biopsy of bone lesions demonstrating avidity for 18F-piflufolastat can be performed with a high diagnostic yield.

{"title":"CT-guided biopsy of 18F-piflufolastat radiotracer avid lesions in osseous metastatic prostate disease: Initial experience, technical factors and biopsy yield","authors":"Jordan Fenner , Mohammad Samim , Roy A. Raad , Dhruv S. Shankar , Christopher John Burke","doi":"10.1016/j.clinimag.2025.110437","DOIUrl":"10.1016/j.clinimag.2025.110437","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the yield of CT-guided biopsy of 18F-piflufolastat PET avid osseous lesions in suspected prostate metastases.</div></div><div><h3>Methods</h3><div>Retrospective review of computed tomography guided biopsies targeting 18F-piflufolastat avid lesions on PET/CT or PET/MR performed between 2022 and 2024. Demographics, image modality, biopsy system, number of cores, lesion location, lean body mass corrected SUV (SUL) and pathology were recorded. Biopsied lesions were compared to the PROMISE (prostate cancer molecular imaging standardized evaluation) scoring system, version 2.</div></div><div><h3>Results</h3><div>Eighteen patients were included, average age 68.7 years. Lesions were defined as: ≥ 50 % sclerotic (<em>n</em> = 10), <50 % sclerotic (<em>n</em> = 7), occult (<em>n</em> = 0), and lytic (n = 1). A technically successful pathologic diagnosis was made in 94 % of biopsies (<em>n</em> = 17). Histopathological diagnosis included: metastatic prostate adenocarcinoma (<em>n</em> = 12), benign with fibrotic/densely sclerotic bone or normocellular bone marrow (<em>n</em> = 5), and metastatic non-small cell lung carcinoma (<em>n</em> = 1). The median SUL on PET for all patients was 7.9 (IQR 13.3), 2.6 (0.3) for benign biopsies, and 8.8 (12.5) for malignant biopsies. Major identifiable differences between biopsies yielding a metastatic versus benign diagnosis included: higher SUL (<em>p</em>-value = 0.03), target lesion volume (p-value = 0.01), and higher incidence of sclerotic lesions (<em>p</em> value = 0.003); however, multivariate analysis did not find these to be statistically significant predictors (<em>p</em>-value >0.05). The prostate cancer lesion biopsy positive group had significantly higher PROMISE scores than the negative group (<em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>CT-guided biopsy of bone lesions demonstrating avidity for 18F-piflufolastat can be performed with a high diagnostic yield.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110437"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527245","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}

引用次数: 0

Comparison of prognostic accuracy of HCC staging systems in patients undergoing TACE

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-02-25 DOI: 10.1016/j.clinimag.2025.110438

Victor Kasolowsky , Moritz Gross , David C. Madoff , James Duncan , Tamar Taddei , Mario Strazzabosco , Ariel Jaffe , Julius Chapiro

Purpose

To compare the prognostic power of commonly used staging systems of hepatocellular carcinoma (HCC) for predicting overall survival after transarterial chemoembolization (TACE).

Materials and methods

This retrospective single center study included patients with HCC who underwent TACE between 2008 and 2019 in a single tertiary care center. After initial screening of 408 consecutive patients, 317 patients with HCC treated with conventional or drug-eluting beads-TACE were included. Five HCC staging systems (Barcelona Clinic Liver Cancer, Hong Kong Liver Cancer, Japan Integrated Staging, Cancer of the Liver Italian Program and Okuda) were compared using Kaplan Meier survival analysis and a log-rank test with overall survival (OS) as the study endpoint. Uni- and multivariate analyses of system-specific variables were applied to stratify outcomes and compare the ability to predict OS of patients after TACE. Four different measures were used to assess the homogeneity (Likelihood ratio:LR), discriminatory ability (linear trend:LT and C-index) and explanatory ability (Akaike Information Criterion:AIC).

Results

The OS of the total cohort was 29.8 months. In terms of prognostic stratification, the BCLC staging system had the best performance (LT: 8.209, LR: 26.639, AIC: 317, c-index: 0.818) compared to HKLC (LT: 10.919, LR: 25.802, AIC: 443, c-index: 0.835), JIS (LT: 4.611, LR: 16.880, AIC: 449, c-index: 0.548), CLIP (LT: 6.738, LR: 13.109, AIC: 501, c-index: 0.782), and Okuda (LT: 7.185, LR: 0.760. LR: 16.356, AIC: 487, c-index: 0.760).

Conclusion

Across five commonly utilized international staging systems, the BCLC staging system demonstrated the greatest prognostic accuracy with respect to predicting OS of patients undergoing TACE.

{"title":"Comparison of prognostic accuracy of HCC staging systems in patients undergoing TACE","authors":"Victor Kasolowsky , Moritz Gross , David C. Madoff , James Duncan , Tamar Taddei , Mario Strazzabosco , Ariel Jaffe , Julius Chapiro","doi":"10.1016/j.clinimag.2025.110438","DOIUrl":"10.1016/j.clinimag.2025.110438","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the prognostic power of commonly used staging systems of hepatocellular carcinoma (HCC) for predicting overall survival after transarterial chemoembolization (TACE).</div></div><div><h3>Materials and methods</h3><div>This retrospective single center study included patients with HCC who underwent TACE between 2008 and 2019 in a single tertiary care center. After initial screening of 408 consecutive patients, 317 patients with HCC treated with conventional or drug-eluting beads-TACE were included. Five HCC staging systems (Barcelona Clinic Liver Cancer, Hong Kong Liver Cancer, Japan Integrated Staging, Cancer of the Liver Italian Program and Okuda) were compared using Kaplan Meier survival analysis and a log-rank test with overall survival (OS) as the study endpoint. Uni- and multivariate analyses of system-specific variables were applied to stratify outcomes and compare the ability to predict OS of patients after TACE. Four different measures were used to assess the homogeneity (Likelihood ratio:LR), discriminatory ability (linear trend:LT and C-index) and explanatory ability (Akaike Information Criterion:AIC).</div></div><div><h3>Results</h3><div>The OS of the total cohort was 29.8 months. In terms of prognostic stratification, the BCLC staging system had the best performance (LT: 8.209, LR: 26.639, AIC: 317, c-index: 0.818) compared to HKLC (LT: 10.919, LR: 25.802, AIC: 443, c-index: 0.835), JIS (LT: 4.611, LR: 16.880, AIC: 449, c-index: 0.548), CLIP (LT: 6.738, LR: 13.109, AIC: 501, c-index: 0.782), and Okuda (LT: 7.185, LR: 0.760. LR: 16.356, AIC: 487, c-index: 0.760).</div></div><div><h3>Conclusion</h3><div>Across five commonly utilized international staging systems, the BCLC staging system demonstrated the greatest prognostic accuracy with respect to predicting OS of patients undergoing TACE.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110438"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551513","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}

引用次数: 0

Health equity is now a National Patient Safety Goal

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-02-20 DOI: 10.1016/j.clinimag.2025.110435

Jinel Scott , Adebusayo Adewole , Latoya Jackson , Stephen Waite

Governmental data generated during the COVID 19 pandemic from 2019 to 2021 demonstrated that the virus disproportionately impacted communities of color. Specifically, Black, Hispanic, and Asian people were found to have substantially higher rates of infection, hospitalization, and death compared with White people. The extent of these disparities drew attention to other disparate outcomes including maternal mortality and morbidity, cancer outcomes, and overall life expectancy. Various professional organizations, including the Institute for Healthcare Improvement, began to add health equity to their strategic framework. In conjunction, this issue generated national attention reflected in the responses of federal and state governments as well as regulatory agencies. In addition to the ethical and moral reasons for intentional action to decrease these disparities and improve health equity, it became understood that significant economic costs are associated with health care disparities. If not adequately addressed, the economic consequence of these disparities will become exacerbated in the future as the United States becomes increasingly diverse. The Joint Commission has recently responded by distinguishing health equity as a significant patient safety and quality of care issue and identified it as the newest National Patient Safety Goal (NPSG). In this manuscript we discuss how healthcare institutions can comply with these new requirements and how radiology can contribute.

{"title":"Health equity is now a National Patient Safety Goal","authors":"Jinel Scott , Adebusayo Adewole , Latoya Jackson , Stephen Waite","doi":"10.1016/j.clinimag.2025.110435","DOIUrl":"10.1016/j.clinimag.2025.110435","url":null,"abstract":"<div><div>Governmental data generated during the COVID 19 pandemic from 2019 to 2021 demonstrated that the virus disproportionately impacted communities of color. Specifically, Black, Hispanic, and Asian people were found to have substantially higher rates of infection, hospitalization, and death compared with White people. The extent of these disparities drew attention to other disparate outcomes including maternal mortality and morbidity, cancer outcomes, and overall life expectancy. Various professional organizations, including the Institute for Healthcare Improvement, began to add health equity to their strategic framework. In conjunction, this issue generated national attention reflected in the responses of federal and state governments as well as regulatory agencies. In addition to the ethical and moral reasons for intentional action to decrease these disparities and improve health equity, it became understood that significant economic costs are associated with health care disparities. If not adequately addressed, the economic consequence of these disparities will become exacerbated in the future as the United States becomes increasingly diverse. The Joint Commission has recently responded by distinguishing health equity as a significant patient safety and quality of care issue and identified it as the newest National Patient Safety Goal (NPSG). In this manuscript we discuss how healthcare institutions can comply with these new requirements and how radiology can contribute.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110435"},"PeriodicalIF":1.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527348","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}

引用次数: 0

I saw the “bulge” sign: Gastroduodenal artery aneurysm mimicking duodenal bulb submucosal tumor

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-02-19 DOI: 10.1016/j.clinimag.2025.110434

Rui Zhong, Kui Zhao

Gastroduodenal artery (GDA) aneurysms are rare vascular anomalies that can present with nonspecific symptoms, making diagnosis challenging. We report a case of a 26-year-old male presenting with abdominal distension, initially suspected to have a duodenal submucosal tumor. Advanced imaging techniques, including endoscopic ultrasonography (EUS) and computed tomography angiography (CTA), revealed a GDA aneurysm compressing the duodenal bulb. The patient was managed conservatively with regular follow-up, remaining asymptomatic over six months. This case underscores the importance of considering vascular anomalies in differential diagnoses of submucosal tumors and highlights the role of multimodal imaging in accurate diagnosis.

引用次数: 0

Improving virtual readouts in the post-pandemic era 后流行病时代虚拟读数的改进

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-02-18 DOI: 10.1016/j.clinimag.2025.110433

Peter Liaw, Jennifer M. Cutts, Alexander Brook, Karen S. Lee, Yu-Ming Chang

引用次数: 0

MRI-derived radiomics models for prediction of Ki-67 index status in meningioma: a systematic review and meta-analysis

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging

Pub Date : 2025-02-17 DOI: 10.1016/j.clinimag.2025.110436

Nima Broomand Lomer , Fattaneh Khalaj , Hamed Ghorani , Mohammad Mohammadi , Delaram J. Ghadimi , Sina Zakavi , Mahshad Afsharzadeh , Houman Sotoudeh

Purpose

The Ki-67 marker reflects tumor proliferation and correlates with meningioma prognosis. Here we aim to evaluate the performance of MRI-derived radiomics for Ki-67 index prediction in meningiomas.

Methods

After a comprehensive search in Web of Science, PubMed, Embase, and Scopus, data extraction and risk of bias assessment was performed. Pooled sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) were computed. The summary receiver operating characteristic (sROC) curve was generated and area under the curve (AUC) was calculated. Separate meta-analyses were conducted for radiomics models and combined models. Heterogeneity was evaluated using the I² statistic, and subgroup analysis was performed to identify potential sources of heterogeneity. Sensitivity analysis was carried out to detect possible outliers.

Results

Seven studies were included, with six studies analyzed for radiomics model and four for combined model. For radiomics model, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 67 %, 82 %, 8.61, 3.54, 0.43, and 0.79, respectively. For combined model, pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 78 %, 78 %, 12.19, 3.47, 0.30, and 0.79, respectively. Sensitivity analysis identified no outliers. In radiomics model, potential sources of heterogeneity included mean age and the application of N4ITK bias correction. For combined model, heterogeneity was influenced by mean age, application of N4ITK bias correction, and the use of external validation.

Conclusion

Radiomics shows promising ability to predict the Ki-67 index status in meningioma patients, potentially enhancing clinical decision-making and management strategies.

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