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Evaluation of aortic stent endoleaks in the renally impaired patient with ferumoxytol-enhanced MR angiography 阿魏木糖醇增强MR血管造影对肾功能受损患者主动脉支架内漏的评价。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110383
Logan Hubbard, Sipan Mathevosian, Takegawa Yoshida, Cameron Hassani, Mohammad H Jalili, J. Paul Finn, Arash Bedayat

Purpose

To evaluate ferumoxytol-enhanced magnetic resonance angiography (FE-MRA) for assessment of endoleaks in patients with abdominal aortic aneurysms (AAA) and chronic kidney disease (CKD) status post endovascular aneurysm repair (EVAR).

Methods

Of 1854 patients who underwent FE-MRA at a single institution between 03/21/2014 and 08/21/2023, 21 patients with a history of AAA and CKD status post EVAR were retrospectively identified (IRB #13-001341). Multiplanar pre- and post-contrast HASTE, T1-VIBE, and high-resolution breath-held 3D MRA sequences were obtained, where a dose of 4 mg/kg of Ferumoxytol was infused over six minutes. All examinations were performed on either a Siemens 3.0 T Prisma Fit, a Siemens 3.0 T TIM Trio, or a Siemens 1.5 T Avanto MRI scanner. Image post-processing was performed using OsiriX and Vitrea software for endoleak identification and display.

Results

Twenty-six FE-MRA examinations were completed, where 24 were fully diagnostic and 2 were limited by metal artifact. Three patients underwent one follow-up examination, while one patient underwent two follow-up examinations. Endoleaks were identified in seven patients: one Type Ia, two Type Ib, and four Type II. The Type Ia endoleak patient received follow-up imaging two years after initial imaging. A Type II endoleak patient received follow-up imaging six months and one year after initial imaging. In both cases, the Type I and Type II endoleaks were reproducibly visualized. No contrast reactions occurred.

Conclusion

For patients with a history of AAA and CKD status post EVAR, FE-MRA is a safe, practical and effective imaging solution for evaluation of Type I and Type II endoleaks.
目的:评估铁氧体增强磁共振血管造影(FE-MRA)在评估腹主动脉瘤(AAA)患者内漏和血管内动脉瘤修补术(EVAR)后慢性肾病(CKD)状态方面的应用:在2014年3月21日至2023年8月21日期间,在一家机构接受FE-MRA检查的1854名患者中,回顾性地确定了21名有AAA病史和EVAR术后有慢性肾脏病(CKD)的患者(IRB #13-001341)。在六分钟内输注 4 毫克/千克 Ferumoxytol 的剂量后,获得了多平面对比前后 HASTE、T1-VIBE 和高分辨率呼吸保持三维 MRA 序列。所有检查均在西门子 3.0 T Prisma Fit、西门子 3.0 T TIM Trio 或西门子 1.5 T Avanto MRI 扫描仪上进行。使用 OsiriX 和 Vitrea 软件进行图像后处理,以识别和显示内漏:完成了 26 次 FE-MRA 检查,其中 24 次完全确诊,2 次受到金属伪影的限制。三名患者接受了一次随访检查,一名患者接受了两次随访检查。在七名患者中发现了内漏:一名 Ia 型,两名 Ib 型,四名 II 型。Ia 型内漏患者在初次成像两年后接受了随访成像。一名 II 型内漏患者在初次成像六个月和一年后接受了随访成像。在这两个病例中,Ⅰ型和Ⅱ型内漏均可重复观察到。结论:对于 EVAR 后有 AAA 病史和 CKD 状态的患者,FE-MRA 是评估 I 型和 II 型内漏的一种安全、实用和有效的成像解决方案。
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引用次数: 0
Inclusive AI for radiology: Optimising ChatGPT-4 with advanced prompt engineering 放射学包容性人工智能:利用先进的即时工程优化ChatGPT-4。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110385
Juhi Yasmeen , Md. Tauseef Qamar , Subuhi Yasmeen
This letter responds to the article “Encouragement vs. liability: How prompt engineering influences ChatGPT-4's radiology exam performance,” offering additional perspectives on optimising ChatGPT-4 for Radiology applications. While the study highlights the significance of prompt engineering, we suggest that addressing additional key challenges such as age-related diagnostic needs, socio-economic diversity, data security, and liability concerns is essential for responsible AI integration. Incorporating adaptive prompts, training the model on diverse datasets, and securely integrating it with electronic health records (EHRs) can enhance its reliability and inclusiveness. By balancing prompt design with privacy and accountability frameworks, ChatGPT-4 can become a more effective tool in radiology, aiding clinicians without compromising human oversight.
这封信回应了文章“鼓励与责任:及时的工程如何影响ChatGPT-4的放射学考试成绩”,提供了优化ChatGPT-4放射学应用的其他观点。虽然该研究强调了快速工程的重要性,但我们建议解决其他关键挑战,如与年龄相关的诊断需求、社会经济多样性、数据安全和责任问题,对于负责任的人工智能集成至关重要。结合自适应提示、在不同数据集上训练模型,并将其与电子健康记录(EHRs)安全地集成,可以增强其可靠性和包容性。通过平衡即时设计与隐私和问责框架,ChatGPT-4可以成为放射学中更有效的工具,在不损害人类监督的情况下帮助临床医生。
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引用次数: 0
Evaluating proprietary vs. open-source LLMs in radiology: Insights and future directions from the ChatGPT perspective 评估放射学中的专有法学硕士与开源法学硕士:从ChatGPT角度的见解和未来方向。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110393
Gunjan Ansari , Zaheer Kareem Ansari , Shahab Saquib Sohail , Dag Øivind Madsen
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引用次数: 0
Left ventricular wall thickness discrepancies at end-diastole and mid-diastole: Reference values for cardiac CT 舒张末期和舒张中期左心室壁厚度差异:心脏CT的参考值。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110390
Jiao Chen, Dan Zhao, Mengyu Xie, Jinqiu Wang, Chao Chen, Jinwen Wu, Ying Zhou

Purpose

To investigate differences in left ventricular wall thickness (LVWT) measurements between end-diastole and mid-diastole using cardiac computed tomography (CCT) and establish LVWT reference values stratified by phase, sex, and region.

Methods

Subjects who underwent CCT without a history of cardiovascular disease or risk factors were retrospectively included between 2021 and 2024. LVWT was manually measured in each segment according to the American Heart Association's 17-segment model at end-diastole and mid-diastole. Regional LVWT was calculated as the average value of relevant segments.

Results

The study included 187 subjects with a mean age of 51 ± 11 years, including 77 (41 %) men. Global LVWT was lower at end-diastole than at mid-diastole (5.7 ± 0.8 vs. 6.5 ± 0.9 mm, P < 0.001). Each segmental LVWT correlated significantly between end-diastole and mid-diastole (Pearson's correlation coefficient: 0.79–0.87). Segment 2 was thickest (8.1 ± 1.5 mm at end-diastole and 9.1 ± 1.7 mm at mid-diastole). LVWT was greater in men than in women (all P < 0.001). The upper limits of LVWT were 9.9 mm for women and 11.7 mm for men at end-diastole, and 11.8 mm for women and 13.1 mm for men at mid-diastole. LVWT progressively thinned from the base to the apex. Apical LVWT measured on short-axis and long-axis showed a small but statistically significant difference, particularly in Segment 16.

Conclusion

This study provides CCT reference values for LVWT at end-diastole and mid-diastole. Mid-diastolic LVWT was slightly greater than end-diastolic LVWT, with a statistically significant difference. Normal LVWT was greater in men than in women, with regional variations observed in both phases.
目的:利用心脏计算机断层扫描(CCT)研究舒张末期和舒张中期左室壁厚度(LVWT)测量的差异,并建立按阶段、性别和地区分层的LVWT参考值。方法:回顾性纳入2021年至2024年间无心血管疾病史或危险因素的CCT受试者。根据美国心脏协会舒张末期和舒张中期的17段模型,人工测量每段LVWT。区域LVWT计算为相关片段的平均值。结果:共纳入187例患者,平均年龄51±11岁,其中男性77例(41%)。整体LVWT在舒张末期低于舒张中期(5.7±0.8 vs 6.5±0.9 mm, P)。结论:本研究提供了舒张末期和舒张中期LVWT的CCT参考值。舒张中期LVWT略大于舒张末期LVWT,差异有统计学意义。正常LVWT在男性中大于女性,在两个阶段观察到区域差异。
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引用次数: 0
Ossification patterns of the C1 (atlas) and C2 (axis) vertebrae children 儿童C1(寰椎)和C2(轴椎)的骨化模式。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110395
Mehmet Cingoz , Mostafa Shehata , Burak Kandemirli , Eda Cingoz

Purpose

This retrospective study aimed to assess ossification patterns and synchondrosis fusion timelines of the C1 and C2 vertebrae in pediatric age group, to help differentiate injuries from normal variations and serve as a guide when evaluating incompletely fused synchondrosis.

Materials and methods

The study analyzed 432 CT examinations of children aged 0–72 months, conducted at a single institution between January 2010 and January 2018. The focus was assessment of the visibility and fusion of the three ossification centers and three synchondroses of the atlas, and six ossification centers and four synchondroses of the axis, based on age.

Results

Complete ossification of the anterior arch of the atlas was observed in 60.4 % of patients, increasing with age from 11.1 % in the 0–12 months age group to 97.3 % in the 61–72 months age group. Patency of the ventrolateral synchondrosis of the atlas decreased from 100 % in the 0–12 months age group to around 30 % in the 61–72 months age group. Subdental synchondrosis and neurocentral synchondrosis of the axis were patent in 47.0 % and 50.6 % of patients, respectively, both decreasing with age. The apicodental synchondrosis of the axis remained mostly patent (98.1 %). Overall, there was a trend of decreasing patency in synchondroses and increasing ossification with advancing age.

Conclusion

These findings provide a better understanding of normal ossification patterns and timelines, facilitating the accurate distinction between normal variations and traumatic injuries.
目的:本回顾性研究旨在评估儿童年龄组C1和C2椎体骨化模式和软骨联合融合时间线,以帮助区分损伤与正常变化,并作为评估不完全融合软骨联合的指导。材料和方法:本研究分析了2010年1月至2018年1月在一家机构进行的432例0-72个月儿童的CT检查。重点是评估寰椎的三个骨化中心和三个联合软骨的可见性和融合,以及轴的六个骨化中心和四个联合软骨,基于年龄。结果:60.4%的患者寰椎前弓完全骨化,随着年龄的增长,从0-12月龄组的11.1%增加到61-72月龄组的97.3%。寰椎腹外侧联合软骨的通畅度从0-12月龄组的100%下降到61-72月龄组的30%左右。牙下软骨联合症和中轴神经中枢软骨联合症分别为47.0%和50.6%,均随年龄增长而降低。轴端尖突软骨联合大部分未愈合(98.1%)。总的来说,随着年龄的增长,联合软骨的开放程度降低,骨化程度增加。结论:这些发现提供了对正常骨化模式和时间线的更好理解,有助于准确区分正常变异和创伤性损伤。
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引用次数: 0
Advancing breast cancer screening through information-theoretic approaches and AI 通过信息论方法和人工智能推进乳腺癌筛查。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110384
Sultan Alam
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引用次数: 0
Corrigendum to “Comprehensive multimodality imaging review of reproductive interventions and their complications” [Clin. Imaging (December 2024) 110312] “生殖干预及其并发症的综合多模态影像学回顾”的勘误表[临床。成像(2024年12月)110312]。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110387
Michelle Lee, Kira Melamud, Robert Petrocelli, Chrystia Slywotzky, Vinay Prabhu
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引用次数: 0
Updates on the MR safety guidelines – Essentials for radiologists 核磁共振安全指南的更新-放射科医生的要点。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110394
Ghazal Zandieh , Iman Yazdaninia , Shadi Afyouni , Ali Borhani , Takeshi Yokoo , Ihab R. Kamel
<div><div>Magnetic Resonance Imaging (MRI) is a sophisticated diagnostic tool that utilizes the magnetic properties of biological tissue to generate detailed images of internal structures without the use of ionizing radiation. Despite its benefits in providing high-contrast images of soft tissues, the strong magnetic fields used in MRI present a unique safety challenge. Increasing MRI-related accidents and the prevalence of patients with metallic implants in recent years underscore the critical need for stringent MR safety protocols. This article reviews the latest 2024 updates in the MRI safety manual by the American College of Radiology (ACR), highlighting the comprehensive efforts to manage risks associated with MRI, including projectile and burn incidents, patients with medical devices, and emerging complex MRI environments. The manual emphasizes the importance of specialized training for healthcare professionals to navigate the complexities of MRI safety to ensure patient and staff safety. This review also touches on the dynamic landscape of MRI safety standards, driven by technological advances and evolving clinical practices, aiming to provide a thorough understanding of current best practices in MRI safety management.</div></div><div><h3>List of updates</h3><div><ul><li><span>1.</span><span><div>Reformatted introduction: Provides a basic overview of MR risks and safety concerns, setting the stage for comprehensive safety protocols.</div></span></li><li><span>2.</span><span><div>Management of MR Safety and Policies: Updates guidelines for creating, implementing, and maintaining MR safety policies, emphasizing new considerations for policy development.</div></span></li><li><span>3.</span><span><div>MR Environment: Updates the fringe field limit to 9 gauss, reflecting the latest safety standards by the International Electrotechnical Commission (IEC).</div></span></li><li><span>4.</span><span><div>MR Personnel: Enhances MR Safety Training with updated language, introduces a training checklist, provides new staffing guidance, and incorporates remote scanning protocols.</div></span></li><li><span>5.</span><span><div>MR Screening: Reorganizes and clarifies the process for screening staff, patients, and materials for MR safety, including risk identification and the use of MR Safe attire.</div></span></li><li><span>6.</span><span><div>Final Stop/Final Check: Introduces routine and augmented protocols, including the mandatory removal of hearing aids before entering Zone IV.</div></span></li><li><span>7.</span><span><div>Zone IV Exam Preparation and Completion: A new section that outlines specific procedures for preparing and completing exams in the high-risk Zone IV area.</div></span></li><li><span>8.</span><span><div>MRI Fields and Safety Concerns: Reorganizes critical information on RF Magnetic Fields and Magnetic Field Gradient concerns, addressing whole-body, focal, and resonant heating, as well as auditory impacts and nerve stimulation.</div><
磁共振成像(MRI)是一种复杂的诊断工具,它利用生物组织的磁性来生成内部结构的详细图像,而不使用电离辐射。尽管它在提供软组织高对比度图像方面有好处,但MRI中使用的强磁场提出了一个独特的安全挑战。近年来,越来越多的核磁共振相关事故和金属植入物患者的流行强调了严格的核磁共振安全协议的迫切需要。本文回顾了美国放射学会(ACR)最新的2024年MRI安全手册,强调了与MRI相关的风险管理的综合努力,包括弹丸和烧伤事件、医疗器械患者和新兴的复杂MRI环境。该手册强调了对医疗保健专业人员进行专业培训的重要性,以指导MRI安全的复杂性,以确保患者和工作人员的安全。在技术进步和不断发展的临床实践的推动下,本综述还涉及MRI安全标准的动态景观,旨在提供对当前MRI安全管理最佳实践的透彻理解。更新列表。
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引用次数: 0
CME preferences and perspectives among practicing radiologists 执业放射科医师的CME偏好和观点。
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.clinimag.2024.110391
Christine Lamoureux , Eric Rohren , Edward Callaway , Erin Vair-Grilley , Scott G. Baginski , Phil Ramis , Tarek N. Hanna

Rationale and objectives

To evaluate radiologists' perspectives regarding American Medical Association Category 1 Continuing Medical Education (Cat-1 CME) activities in private practice (PP) and teleradiology (TR), as well as American Board of Radiology Maintenance of Certification (ABR MOC) program participation status.

Materials and methods

An electronic survey informed by existing literature regarding physician Cat-1 CME use and opinions was distributed via email to a national radiology practice. The survey was open for seventeen days in 2023, with a single reminder. Statistical analysis was performed using Pearson Chi square hypothesis testing and logistic regression modeling.

Results

Response rate was 19.2 % (599/3112). Of the 588 ABR certified, 65.6 % (n = 386) of respondents participated in ABR MOC, 50.9 % (n = 299) were in TR and 43.4 % (n = 255) were in PP. PP was associated with a greater participation in the ABR MOC program than TR (p0.05). Format (42 %) and content/topic (35 %) were the most important reasons for CME selection. PP radiologists preferred live in person lectures 1.94 times over TR. ABR MOC participants were 1.82 times more likely to select “cost” as the most important reason for choosing a Cat-1 CME activity, had lower odds of agreeing that Cat-1 CME helped maintain and improve skills, and had lower odds of being satisfied with Cat-1 CME activities available.

Conclusion

TR and PP settings in addition to ABR MOC participation status are associated with differences in Cat-1 CME-related preferences and perspectives.
基本原理和目标:评估放射科医生对美国医学协会第一类继续医学教育(Cat-1 CME)在私人执业(PP)和远程放射学(TR)中的活动,以及美国放射学维护认证委员会(ABR MOC)项目参与状况的看法。材料和方法:根据现有文献对医师Cat-1 CME的使用和意见进行电子调查,并通过电子邮件发送给国家放射学实践。这项调查在2023年开放了17天,只有一个提醒。采用皮尔逊卡方假设检验和logistic回归模型进行统计分析。结果:有效率为19.2%(599/3112)。在588名获得ABR认证的受访者中,65.6% (n = 386)的人参加了ABR MOC, 50.9% (n = 299)的人参加了TR, 43.4% (n = 255)的人参加了PP。PP对ABR MOC项目的参与程度高于TR (p0.05)。形式(42%)和内容/主题(35%)是选择CME的最重要原因。PP放射科医生比TR更喜欢现场讲座1.94倍。ABR MOC参与者选择“成本”作为选择Cat-1 CME活动的最重要原因的可能性是1.82倍,同意Cat-1 CME有助于维持和提高技能的几率较低,并且对可用的Cat-1 CME活动感到满意的几率较低。结论:TR和PP设置以及ABR MOC参与状态与Cat-1 cme相关偏好和观点的差异有关。
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引用次数: 0
Disparities in breast cancer screening and diagnosis: Urban-suburban contrasts in the wake of the COVID-19 pandemic
IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-31 DOI: 10.1016/j.clinimag.2025.110419
Sarah Ciccarelli , Natalia Eugene , Zi Zhang

Purpose

Compare the reduction and recovery of breast cancer screening and diagnostic services in urban versus suburban communities during the COVID-19 pandemic to identify opportunities for advancing equitable breast cancer detection.

Methods

This retrospective cohort study used the Montage™ data mining system to analyze percent change in the number of screening and diagnostic mammograms, breast biopsies, and breast cancer diagnoses at a single mid-Atlantic institution with urban and suburban sites centered in and around Philadelphia, Pennsylvania from 1/1/2019 to 12/31/2022, with urban-suburban subset comparison from 1/1/2019 to 12/31/2021.

Results

In 2020, screening mammogram volume dropped 23.9 % at urban sites and 1.6 % at suburban sites while diagnostic mammogram volume decreased 26.4 % at urban and 21.4 % at suburban sites. In 2021, screening volume at urban and suburban sites was 2.6 % and 31.0 % greater than pre-pandemic levels, and diagnostic volume was 28.5 % and 16.9 % below pre-pandemic levels. That same year, the proportion of invasive ductal carcinoma at urban sites increased by 26.2 %. In 2022, screening volume at all sites surpassed pre-pandemic levels by 19.5 % while diagnostic volume remained 21.7 % less than pre-pandemic levels.

Conclusion

The COVID-19 pandemic disproportionately reduced breast cancer screening and diagnostic services in urban communities, who experienced slower recovery and increased invasive breast cancer in the subsequent year. Throughout our institution, screening mammograms surpassed pre-pandemic levels in 2021 and 2022 while diagnostic services remained below pre-pandemic levels through 2022. Considering these findings, we must improve access to breast cancer screening and diagnosis to mitigate the long-term consequences of the pandemic.
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引用次数: 0
期刊
Clinical Imaging
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