Clinical Imaging最新文献

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Enhancing imaging findings of renal masses associated with pathogenic variations in the succinate dehydrogenase subunit B gene using ChatGPT 利用 ChatGPT 增强与琥珀酸脱氢酶亚基 B 基因致病变异有关的肾肿块的成像结果

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

Clinical Imaging

Pub Date : 2024-10-31 DOI: 10.1016/j.clinimag.2024.110339

Abdul Rahman, Baseera A., Shahab Saquib Sohail

引用次数: 0

Doing the heavy lifting: I saw the “dumbbell” sign 举重我看到了 "哑铃 "标志

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

Clinical Imaging

Pub Date : 2024-10-31 DOI: 10.1016/j.clinimag.2024.110337

Enrique José Catalá , Paulina Cardozo , Hernán Chaves

引用次数: 0

Emerging complications in the era of COVID-19 vaccination: role of radiologists and imaging COVID-19 疫苗接种时代新出现的并发症：放射科医生和影像学的作用。

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

Clinical Imaging

Pub Date : 2024-10-31 DOI: 10.1016/j.clinimag.2024.110338

Namratha Guruvaiah Sridhara , Nanditha Guruvaiah Sridhara , Janardhana Ponnatapura

COVID-19 was declared as a pandemic by the World Health Organization (WHO) in March 2020. The COVID-19 pandemic became a major public health burden with a high morbidity and mortality rate. In response to the pandemic, several COVID-19 vaccines were introduced to prevent infection and control the transmission of the virus. These vaccines have proven to be effective and relatively safe causing mild side effects in most individuals. However, these vaccines have also been associated with rare but life-threatening complications involving multiple body systems including the pulmonary, cardiovascular, lymphatic, vascular, gastrointestinal, and the central and peripheral nervous systems. This article describes the various severe complications and highlights the role of radiologists and imaging in aiding the prompt recognition of vaccine associated complications allowing for improved patient management.

2020 年 3 月，世界卫生组织（WHO）宣布 COVID-19 为大流行病。COVID-19 大流行已成为一个重大的公共卫生负担，发病率和死亡率都很高。为应对此次大流行，推出了几种 COVID-19 疫苗，以预防感染和控制病毒传播。事实证明，这些疫苗有效且相对安全，对大多数人的副作用较轻。然而，这些疫苗也会引起罕见但危及生命的并发症，涉及多个身体系统，包括肺、心血管、淋巴、血管、胃肠道以及中枢和外周神经系统。本文介绍了各种严重并发症，并强调了放射科医生和影像学在帮助及时识别疫苗相关并发症以改善患者管理方面的作用。

引用次数: 0

Exploring the accuracy of embedded ChatGPT-4 and ChatGPT-4o in generating BI-RADS scores: a pilot study in radiologic clinical support 探索嵌入式 ChatGPT-4 和 ChatGPT-4o 生成 BI-RADS 评分的准确性：放射临床支持中的试点研究。

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

Clinical Imaging

Pub Date : 2024-10-30 DOI: 10.1016/j.clinimag.2024.110335

Dan Nguyen , Arya Rao , Aneesh Mazumder , Marc D. Succi

This study evaluates the accuracy of ChatGPT-4 and ChatGPT-4o in generating Breast Imaging Reporting and Data System (BI-RADS) scores from radiographic images. We tested both models using 77 breast cancer images from radiopaedia.org, including mammograms and ultrasounds. Images were analyzed in separate sessions to avoid bias. ChatGPT-4 and ChatGPT-4o achieved a 66.2 % accuracy across all BI-RADS cases. Performance was highest in BI-RADS 5 cases, with ChatGPT-4 and ChatGPT4o scoring 84.4 % and 88.9 %, respectively. However, both models struggled with BIRADS 1–3 cases, often assigning higher severity ratings. This study highlights the limitations of current LLMs in accurately grading these images and emphasizes the need for further research in these technologies before clinical integration.

本研究评估了 ChatGPT-4 和 ChatGPT-4o 从放射影像生成乳腺影像报告和数据系统 (BI-RADS) 评分的准确性。我们使用来自 radiopaedia.org 的 77 幅乳腺癌图像（包括乳房 X 线照相术和超声波检查）对这两种模型进行了测试。为了避免偏差，我们对图像进行了单独分析。ChatGPT-4 和 ChatGPT-4o 在所有 BI-RADS 病例中都达到了 66.2% 的准确率。在 BI-RADS 5 病例中，ChatGPT-4 和 ChatGPT4o 的准确率最高，分别达到 84.4% 和 88.9%。然而，这两种模型在处理 BIRADS 1-3 病例时都很吃力，往往会给出较高的严重程度评级。这项研究强调了目前的 LLM 在对这些图像进行准确分级方面的局限性，并强调了在临床整合之前对这些技术进行进一步研究的必要性。

引用次数: 0

Collaborative approach to the integration of radiology teaching into clinical clerkships 将放射学教学融入临床实习的合作方法。

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

Clinical Imaging

Pub Date : 2024-10-29 DOI: 10.1016/j.clinimag.2024.110336

Lily M. Belfi , Anna Starikov , Grace Lo , Bryan C. Leppert , Demitri J. Merianos , Katherine Penziner , Zoe Verzani , June M. Chan

In this pilot study, a multidisciplinary group of educators describes their collaborative efforts to achieve successful integration of radiologist-led standardized interactive radiology teaching sessions into established Internal Medicine and Surgery clerkship curricula, with an overall improvement of student knowledge of radiology concepts, as well as a perceived improvement in understanding of the role of radiology in clinical care.

在这项试点研究中，一个由多学科教育工作者组成的小组描述了他们的合作努力，成功地将放射科医生主导的标准化互动放射学教学课程整合到既定的内科和外科实习课程中，全面提高了学生对放射学概念的认识，以及对放射学在临床护理中作用的理解。

引用次数: 0

Clinical and imaging aspects of pulmonary embolism: a primer for radiologists 肺栓塞的临床和影像学问题：放射科医生入门指南》（Clinical and imaging aspects of pulmonary embolism: a primer for radiologists）。

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

Clinical Imaging

Pub Date : 2024-10-23 DOI: 10.1016/j.clinimag.2024.110328

Syed Muhammad Awais Bukhari , Joshua G. Hunter , Kaustav Bera , Charit Tippareddy , Cody Reid Johnson , Shweta Ravi , Shashwat Chakraborti , Robert Chapman Gilkeson , Amit Gupta

Although many advancements have been made in imaging modalities that can be used to diagnose pulmonary embolism (PE), computed tomography pulmonary angiography (CTPA) is still the preferred gold standard for promptly diagnosing pulmonary embolism by looking for filling defects caused by the embolus lodged within the main pulmonary artery or its respective branches. The diagnosis is made by the radiologists in emergency settings where quick detection of a PE on CTPA helps the Pulmonary Embolism Response Team (PERT) in quick management. Thus, utmost care is needed to follow standard image acquisition protocols and optimal contrast administration techniques to achieve a contrast opacification of at least 210 Hounsfield units for the radiologists to easily pinpoint an embolus within the pulmonary arteries. Even following proper CTPA scan acquisition guidelines, a CTPA image is prone to several artifacts that can be mistaken for a PE, resulting in a false positive read. In addition to this, many incidental findings, that can be the etiology of chest pain in a PE-suspected patient, are often overlooked by emergency radiologists who try to be as quick as possible in their read so that timely management of PE can be ensued. Taking this into account, our review paper provides the audience with a comprehensive understanding of the clinical aspects of pulmonary embolism and the imaging modalities used for PE detection. The main focus is on CTPA, its acquisition protocols, and the various incidental findings and artifacts to look for while interpreting a CTPA scan.

Précis

Beyond the filling defects, a CTPA scan should also be assessed by the radiologists for any incidental findings while keeping in mind several associated pitfalls and artifacts of CTPA.

尽管可用于诊断肺栓塞（PE）的成像模式已取得了许多进展，但计算机断层扫描肺动脉造影术（CTPA）仍是及时诊断肺栓塞的首选金标准，它可通过观察栓子在主肺动脉或其相关分支内造成的充盈缺损来诊断肺栓塞。诊断由放射科医生在急诊环境中做出，CTPA 对肺栓塞的快速检测有助于肺栓塞应急小组（PERT）进行快速处理。因此，需要格外小心，遵循标准的图像采集协议和最佳的造影剂给药技术，以达到至少 210 Hounsfield 单位的造影剂不透明性，使放射科医生能轻松确定肺动脉内的栓子。即使遵循正确的 CTPA 扫描采集指南，CTPA 图像也很容易出现一些伪影，从而被误认为是 PE，造成假阳性读数。除此之外，急诊放射科医生往往会忽略许多偶然发现，而这些偶然发现可能是 PE 疑似患者胸痛的病因，他们会尽量加快读片速度，以便及时处理 PE。有鉴于此，我们的综述论文将让读者全面了解肺栓塞的临床方面以及用于检测肺栓塞的成像模式。重点是 CTPA、其采集协议以及在解读 CTPA 扫描时应注意的各种偶然发现和伪影。PRéCIS：除了充盈缺损外，放射科医生还应评估 CTPA 扫描的任何附带发现，同时牢记 CTPA 的一些相关误区和伪影。

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引用次数: 0

Imaging of necrotizing fasciitis 坏死性筋膜炎的影像学检查

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

Clinical Imaging

Pub Date : 2024-10-23 DOI: 10.1016/j.clinimag.2024.110331

Sergey Kochkine , David L. Payne , Katherine Chung , David Chen , Mark P. Bernstein , Alexander B. Baxter , John M. McMenamy

Necrotizing Fasciitis (NF) is a rare, but highly lethal, rapidly progressive necrotic infection of the soft-tissue fascia. More common in immunocompromised patients, NF typically affects the extremities, perineal area, genital area (Fournier gangrene), and less commonly the torso. Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. The key features of NF of radiography, ultrasound, CT, and MRI are reviewed, as are the inherent limitations of NF diagnosis for each modality. With a high level of sensitivity, specificity, and soft tissue contrast, MRI remains the gold standard imaging method for evaluation of NF.

坏死性筋膜炎（NF）是一种罕见但致死率极高的快速进展性软组织筋膜坏死性感染。NF 常见于免疫力低下的患者，通常累及四肢、会阴部、生殖器部位（富尼耶坏疽），躯干较少见。尽管 NF 通常需要临床诊断，但影像学检查是一种强有力的辅助手段，有助于对不明确的病例进行早期诊断。本文回顾了放射、超声、CT 和核磁共振成像对 NF 诊断的主要特征，以及每种成像模式对 NF 诊断的固有局限性。核磁共振成像具有高度敏感性、特异性和软组织对比度，仍然是评估 NF 的金标准成像方法。

引用次数: 0

Ethical principles for practice building in the era of targeted radioligand therapy 靶向放射性配体疗法时代实践建设的伦理原则。

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

Clinical Imaging

Pub Date : 2024-10-21 DOI: 10.1016/j.clinimag.2024.110334

Jacob A. Blythe , Thomas S.C. Ng

Theranostics is emerging as a critical pillar of oncologic management, as exemplified by the success of Lu-177-PSMA-617 for the treatment of castration-resistant prostate cancer. The emergence of such theranostic agents represents an opportunity to reconsider facets of nuclear medicine practice that will enable its engagement in high-volume radioligand delivery. In this article, we aim to explore simple ethical principles that can guide the development of theranostics programs as radiopharmaceutical agents proliferate and the typical nuclear medicine physician transitions from a primarily diagnostic role to a mixed diagnostic and therapeutic role. Such a mixed role will demand all the attendant competencies of direct patient care. We argue that restructuring nuclear medicine practice to meet this challenge involves developing processes for promoting the principle of fairness in patient selection for theranostic agents and for promoting the principle of responsibility during the administration of theranostic agents. We further specify that this responsibility extends to the patient receiving the therapy, the local community of the patient, and the general community exposed to the population of patients receiving theranostic agents.

Précis

The expansion of radioligand therapy requires promoting the ethical principle of fairness in patient selection and the ethical principle of responsibility in the delivery of radioligand therapy.

Theranostics 正在成为肿瘤治疗的一个重要支柱，Lu-177-PSMA-617 治疗耐受性前列腺癌的成功就是例证。这种治疗药物的出现为重新考虑核医学实践的方方面面提供了机会，使其能够参与大量放射性配体的递送。在本文中，我们旨在探讨一些简单的伦理原则，随着放射性药物制剂的激增以及典型核医学医生从以诊断为主向诊断和治疗混合角色的转变，这些原则可以指导治疗学项目的发展。这种混合角色需要具备直接护理病人的所有相关能力。我们认为，重组核医学实践以应对这一挑战，需要制定程序，在选择患者使用治疗药物时促进公平原则，在使用治疗药物期间促进责任原则。我们进一步明确，这一责任延伸至接受治疗的患者、患者所在社区以及与接受治疗药物的患者群体接触的一般社区。PRéCIS：要扩大放射性同位素治疗的范围，就必须在选择病人时提倡公平的伦理原则，在提供放射性同位素治疗时提倡负责任的伦理原则。

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引用次数: 0

Fractional order calculus model-derived histogram metrics for assessing pathological complete response to neoadjuvant chemotherapy in locally advanced rectal cancer 用于评估局部晚期直肠癌新辅助化疗病理完全反应的分数阶微积分模型衍生直方图指标。

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

Clinical Imaging

Pub Date : 2024-10-20 DOI: 10.1016/j.clinimag.2024.110327

Mi Zhou , Hongyun Huang , Deying Bao , Meining Chen

Aim

This study evaluates the value of diffusion fractional order calculus (FROC) model for the assessment of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer (LARC) by using histogram analysis derived from whole-tumor volumes.

Materials and methods

Ninety-eight patients were prospectively included. Every patient received MRI scans before and after nCRT using a 3.0-Tesla MRI machine. Parameters of the FROC model, including the anomalous diffusion coefficient (D), intravoxel diffusion heterogeneity (β), spatial parameter (μ), and the standard apparent diffusion coefficient (ADC), were calculated. Changes in median values (ΔX-median) and ratio (rΔX_-median) were calculated. Receiver operating characteristic (ROC) curves were used for evaluating the diagnostic performance.

Results

Pre-treatmentβ_-10th percentile values were significantly lower in the pCR group compared to the non-pCR group (p < 0.001). The Δβ_-median showed higher diagnostic accuracy (AUC = 0.870) and sensitivity (76.67 %) for predicting tumor response compared to MRI tumor regression grading (mrTRG) scores (AUC = 0.722; sensitivity = 90.0 %).

Discussion

The use of FROC alongside comprehensive tumor histogram analysis was found to be practical and effective in evaluating the tumor response to nCRT in LARC patients.

目的：本研究评估了扩散分数阶微积分（FROC）模型在局部晚期直肠癌（LARC）新辅助化放疗（nCRT）后病理完全反应（pCR）评估中的价值，该模型使用了从全肿瘤体积得出的直方图分析：前瞻性纳入98例患者。每位患者在接受 nCRT 治疗前后均使用 3.0 特斯拉核磁共振成像仪接受了核磁共振成像扫描。计算FROC模型的参数，包括异常扩散系数（D）、体内扩散异质性（β）、空间参数（μ）和标准表观扩散系数（ADC）。计算中值（ΔX-中值）和比值（rΔX-中值）的变化。采用接收者操作特征曲线（ROC）评估诊断效果：结果：与 MRI 肿瘤回归分级（mrTRG）评分（AUC = 0.722；灵敏度 = 90.0 %）相比，pCR 组治疗前β-10 百分位数值明显低于非CR 组（p -median 在预测肿瘤反应方面显示出更高的诊断准确性（AUC = 0.870）和灵敏度（76.67 %）：讨论：在评估LARC患者的肿瘤对nCRT的反应时，发现使用FROC与综合肿瘤直方图分析一起使用既实用又有效。

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引用次数: 0

Reply to “Enhancing breast imaging strategies: The role of ChatGPT in optimizing screening pathways” 对 "加强乳腺成像策略：ChatGPT 在优化筛查途径中的作用"。

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

Clinical Imaging

Pub Date : 2024-10-18 DOI: 10.1016/j.clinimag.2024.110313

Nina Capiro , Cheryce Fischer , Gelareh Sadigh

引用次数: 0

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Clinical Imaging

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