Academic Radiology最新文献_第10页

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.07.046

引用次数: 0

129Xe MRI Ventilation Textures and Longitudinal Quality-of-Life Improvements in Long-COVID 129Xe MRI 通气纹理与长期 COVID 患者生活质量的纵向改善

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.014

Rationale and Objectives

It remains difficult to predict longitudinal outcomes in long-COVID, even with chest CT and functional MRI. ¹²⁹Xe MRI reflects airway dysfunction, measured using ventilation defect percent (VDP) and in long-COVID patients, MRI VDP was abnormal, suggestive of airways disease. While MRI VDP and quality-of-life improved 15-month post-COVID infection, both remained abnormal. To better understand the relationship of airways disease and quality-of-life improvements in patients with long-COVID, we extracted ¹²⁹Xe ventilation MRI textures and generated machine-learning models in an effort to predict improved quality-of-life, 15-month post-infection.

Materials and Methods

Long-COVID patients provided written-informed consent to 3-month and 15-month post-infection visits. Pyradiomics was used to extract ¹²⁹Xe ventilation MRI texture features, which were ranked using a Random-Forest classifier. Top-ranking features were used in classification models to dichotomize patients based on St. George’s Respiratory Questionnaire (SGRQ) score improvement greater than the minimal-clinically-important-difference (MCID). Classification performance was evaluated using the area under the receiver-operator-characteristic-curve (AUC), sensitivity, and specificity.

Results

120 texture features were extracted from ¹²⁹Xe ventilation MRI in 44 long-COVID participants (54 ± 14 years), including 30 (52 ± 12 years) with ΔSGRQ ≥ MCID and 14 (58 ± 18 years) with ΔSGRQ < MCID. An MRI-texture model (AUC = 0.89) outperformed a clinical-measurement model (AUC = 0.72) for predicting improved SGRQ, 12 months later. Top-performing textures correlated with MRI VDP (P < .05), central-airways resistance (P < .05), forced-vital-capacity (ρ = .37, P = .01) and diffusing-capacity for carbon-monoxide (ρ = .39, P = .03).

Conclusion

A machine learning model exclusively trained on ¹²⁹Xe MRI ventilation textures explained improved SGRQ-scores 12 months later, and outperformed clinical models. Their unique spatial-intensity information helps build our understanding about long-COVID airway dysfunction.

理由和目标即使使用胸部 CT 和功能性 MRI，仍难以预测长期 COVID 的纵向预后。129Xe 磁共振成像可反映气道功能障碍，使用通气缺陷百分比（VDP）进行测量，在长期感染 COVID 的患者中，磁共振成像 VDP 异常，提示气道疾病。在感染 COVID 15 个月后，MRI VDP 和生活质量有所改善，但两者仍然异常。为了更好地了解气道疾病与长COVID患者生活质量改善之间的关系，我们提取了129Xe通气MRI纹理并生成了机器学习模型，以预测感染后15个月生活质量的改善情况。使用 Pyradiomics 提取 129Xe 通气 MRI 纹理特征，并使用随机森林分类器对这些特征进行排序。在分类模型中使用排名靠前的特征，根据圣乔治呼吸问卷 (SGRQ) 评分改善程度大于最小临床重要性差异 (MCID) 对患者进行二分。结果从 44 名长期 COVID 患者（54 ± 14 岁）的 129Xe 通气 MRI 中提取了 120 个纹理特征，其中 30 人（52 ± 12 岁）的ΔSGRQ ≥ MCID，14 人（58 ± 18 岁）的ΔSGRQ < MCID。在预测 12 个月后 SGRQ 的改善方面，MRI 纹理模型（AUC = 0.89）优于临床测量模型（AUC = 0.72）。表现最好的纹理与 MRI VDP（P <.05）、中枢气道阻力（P <.05）、强迫生命容量（ρ = .37，P = .01）和一氧化碳扩散容量（ρ = .39，P = .03）相关。其独特的空间强度信息有助于我们了解长期 COVID 的气道功能障碍。

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引用次数: 0

Imaging of Urinary Bladder and Ureteral Endometriosis with Emphasis on Diagnosis and Technique 膀胱输尿管子宫内膜异位症的影像诊断与技术探讨。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2023.10.053

Endometriosis is a chronic inflammatory gynecological condition affecting 10–15% of women in the reproductive age group. The urinary tract is the second most common extragenital organ system affected by endometriosis, and the urinary bladder and ureter are the two most common sites involved. Involvement of the urinary bladder can cause chronic debilitating symptoms, whereas ureteral involvement may lead to asymptomatic loss of renal function. Both conditions are frequently unsuspected, leading to a delay in diagnosis. Therefore, it is important to recognize this entity early, for which knowledge of imaging appearances and techniques is helpful. In this review article, we describe (a) endometriosis background, pathogenesis, definitions and clinical symptoms, (b) imaging appearance, with emphasis on ultrasound and MRI findings of urinary bladder and ureteric endometriosis, (c) ultrasound technique and MRI sequences useful for making the correct diagnosis, (d) overview of the treatment options and key imaging findings that are important to the surgeon for surgical planning, and (e) a structured reporting template useful for multidisciplinary patient management.

子宫内膜异位症是一种慢性炎症性妇科疾病，影响10-15%的育龄妇女。泌尿道是第二常见的受子宫内膜异位症影响的外生殖器系统，膀胱和输尿管是两个最常见的部位。累及膀胱可引起慢性衰弱症状，而累及输尿管可导致无症状的肾功能丧失。这两种情况往往不被怀疑，导致诊断延误。因此，早期识别这种实体是很重要的，因此影像学表现和技术的知识是有帮助的。在这篇综述文章中，我们描述(a)子宫内膜异位症的背景、发病机制、定义和临床症状，(b)影像表现，重点介绍膀胱和输尿管子宫内膜异位症的超声和MRI表现，(c)超声技术和MRI序列对正确诊断有用，(d)治疗方案概述和对外科医生手术计划重要的关键影像学表现。(e)对多学科患者管理有用的结构化报告模板。

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引用次数: 0

Prognostic Value and Pathological Correlation of Peritumoral Radiomics in Surgically Resected Non-Small Cell Lung Cancer 手术切除的非小细胞肺癌瘤周放射组学的预后价值和病理相关性

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.01.033

Rationale and Objectives

To determine the additional value of peritumoral radiomics in predicting overall survival (OS) in surgically resected non-small cell lung cancer (NSCLC) and its correlation with pathological findings.

Methods

A total of 526 patients with surgically resected NSCLC were included (191 training, 160 internal validation, and 175 external validation cohorts). CT images were used to segment the gross tumor volume (GTV) and peritumoral volume (PTV) within distances of 3, 6, 9 mm from the tumor boundary (PTV3, PTV6, and PTV9), and radiomic features were extracted. Four prognostic models for OS (GTV, GTV + PTV3, GTV + PTV6, and GTV + PTV9) were constructed using the training cohort. The prognostic ability and feature importance were evaluated using the validation cohorts. Pathological findings were compared between the two patient groups (n = 30 for each) having the top 30 and bottom 30 values of the most important peritumoral feature.

Results

The GTV + PTV3 models exhibited the highest predictive ability, which was higher than that of the GTV model in the internal validation cohort (C-index: 0.666 vs. 0.616, P = 0.027) and external validation cohort (C-index: 0.705 vs. 0.656, P = 0.048). The most important feature was GLDM_Dependence_Entropy, extracted from PTV3. High peritumoral GLDM_Dependence_Entropy was associated with a high proportion of invasive histological types, tumor spread through air spaces, and tumor-infiltrating lymphocytes (all P < 0.05).

Conclusion

The GTV and PTV3 combination demonstrated a higher prognostic ability, compared to GTV alone. Peritumoral radiomic features may be associated with various pathological prognostic factors.

理论依据和目标确定瘤周放射组学在预测手术切除非小细胞肺癌（NSCLC）总生存期（OS）方面的附加价值及其与病理结果的相关性：共纳入 526 例手术切除的 NSCLC 患者（191 例训练组、160 例内部验证组和 175 例外部验证组）。使用 CT 图像分割肿瘤边界 3、6、9 毫米距离内的肿瘤总体积（GTV）和瘤周体积（PTV）（PTV3、PTV6 和 PTV9），并提取放射学特征。利用训练队列构建了四个 OS 预后模型（GTV、GTV + PTV3、GTV + PTV6 和 GTV + PTV9）。利用验证队列评估了预后能力和特征重要性。比较了最重要瘤周特征值前 30 位和后 30 位的两组患者（每组 30 人）的病理结果：结果：GTV+ PTV3 模型的预测能力最高，在内部验证队列（C-index：0.666 vs. 0.616，P = 0.027）和外部验证队列（C-index：0.705 vs. 0.656，P = 0.048）中均高于 GTV 模型。最重要的特征是从 PTV3 提取的 GLDM_Dependence_Entropy。瘤周 GLDM_Dependence_Entropy 高与侵袭性组织学类型、肿瘤通过气隙扩散和肿瘤浸润淋巴细胞比例高相关（均为 P 结论：瘤周 GLDM_Dependence_Entropy 高与侵袭性组织学类型、肿瘤通过气隙扩散和肿瘤浸润淋巴细胞比例高相关：与单独使用 GTV 相比，GTV 和 PTV3 组合显示出更高的预后能力。瘤周放射学特征可能与各种病理预后因素有关。

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引用次数: 0

Chest Computed Tomography Radiomics for Determining Macrolide Resistance-Associated Gene Mutation Status in Children with Mycoplasma pneumoniae Pneumonia: A Two-Center Study 胸部计算机断层扫描放射组学用于确定肺炎支原体肺炎患儿的大环内酯类耐药性相关基因突变状态：一项双中心研究。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.05.008

Rationale and Objectives

The mutations in the 23S ribosomal RNA (rRNA) gene are associated with an increase in resistance to macrolides in children with Mycoplasma pneumoniae pneumonia (MPP). This study aimed to develop and validate a chest computed tomography (CT) radiomics model for determining macrolide resistance-associated gene mutation status in MPP.

Materials and Methods

A total of 258 MPP patients were retrospectively included from two institutions (training set: 194 patients from the first institution; external test set: 64 patients from the second). The 23S rRNA gene mutation status was tested by nasopharyngeal swab polymerase chain reaction. Radiomics features were extracted from chest CT images of pulmonary lesions segmented with semi-automatic delineation. Subsequently, radiomics feature reduction was applied to identify the most relevant features. Logistic regression and random forest algorithms were employed to establish the radiomics models, which were five-fold cross-validated in the training set and validated in the external test set.

Results

The radiomics feature selection resulted in eight features. After five-fold cross-validation in the training set, the mean areas under the receiver operating characteristic curve (AUCs) of the logistic regression and random forest models were 0.868 (95% confidence interval (CI): 0.813–0.923) and 0.941 (95% CI: 0.907–0.975), respectively. In the external test set, the corresponding AUCs were 0.855 (95% CI: 0.758–0.952) and 0.815 (95% CI: 0.705–0.925).

Conclusion

Chest CT radiomics is a promising diagnostic tool for determining macrolide resistance gene mutation status in MPP.

Availability of Data and Material

The datasets generated or analyzed during the study are available from the corresponding author on reasonable request.

理由和目标：23S核糖体RNA（rRNA）基因的突变与肺炎支原体肺炎（MPP）患儿对大环内酯类药物耐药性的增加有关。本研究旨在开发和验证胸部计算机断层扫描（CT）放射组学模型，以确定 MPP 中与大环内酯类药物耐药性相关的基因突变状态：材料：回顾性纳入了两家机构的 258 例 MPP 患者（训练集：第一家机构的 194 例患者；外部集：第二家机构的 194 例患者）：训练集：第一家机构的 194 例患者；外部测试集：第二家机构的 64 例患者）：64名患者）。通过鼻咽拭子聚合酶链反应检测 23S rRNA 基因突变情况。从胸部 CT 图像中提取放射组学特征，对肺部病变进行半自动分割。随后，对放射组学特征进行还原，以确定最相关的特征。采用逻辑回归和随机森林算法建立放射组学模型，在训练集中进行五倍交叉验证，并在外部测试集中进行验证：结果：放射组学特征选择产生了八个特征。在训练集中进行五倍交叉验证后，逻辑回归模型和随机森林模型的平均接收操作特征曲线下面积（AUC）分别为 0.868（95% 置信区间：0.813-0.923）和 0.941（95% 置信区间：0.907-0.975）。在外部测试集中，相应的AUC分别为0.855（95% CI：0.758-0.952）和0.815（95% CI：0.705-0.925）：胸部CT放射组学是确定MPP中大环内酯耐药基因突变状态的一种有前途的诊断工具：研究过程中生成或分析的数据集可向通讯作者索取。

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引用次数: 0

Normal Parathyroid Glands Are Most Often Seen on Neck Ultrasound 颈部超声最常显示正常的甲状旁腺。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.026

Rationale and Objectives

The dogma is that normal parathyroid glands (PTGs) are not visible on ultrasound (US). Recently, several studies have shown that PTGs present these US features: ovoid structure, homogeneous and hyperechoic. The primary objective was to assess the detection rate, standard size and locations of normal PTGs in a population of patients consulting for thyroid US exam. The secondary objective was to determine if the presence of a goiter or a thyroiditis could modify the visualization of normal PTGs.

Method

Single-center prospective study on 192 patients based on the typical US appearance previously described to identify one or more PTGs.

Results

One or more PTGs were visualized in 75% of patients (144/192). They were visualized preferentially at the lower pole of the thyroid gland and in the infra-thyroid region (66%). The mean (± SD) size of normal PTGs was 5.68 mm (± 1,42 mm) × 4.05 mm (± 1,03 mm) × 2,68 mm (± 0,61 mm) and mean volume was 33.3 mm3 (± 17.75 mm3). The presence of a goiter made the search for PTGs more difficult whereas the presence of thyroiditis facilitated it.

Conclusion

The US detection rate of PTGs is high (75%). The identification of PTGs could be particularly useful in the preoperative assessment before total thyroidectomy or parathyroid surgery. It could reduce the risk of postoperative hypoparathyroidism and improve the accuracy of postoperative US surveillance of thyroid cancer. Better knowledge of the usual anatomical location of normal PTGs could also enable better detection of abnormal glands.

理由和目标：有一种教条认为，正常的甲状旁腺（PTG）在超声波（US）上是不可见的。最近有几项研究表明，正常的甲状旁腺（PTG）在超声波检查中具有以下特征：卵圆形结构、均质和高回声。该研究的主要目的是评估甲状腺 US 检查就诊者中正常 PTG 的检出率、标准大小和位置。次要目标是确定甲状腺肿或甲状腺炎的存在是否会影响正常 PTG 的显示：方法：对192名患者进行单中心前瞻性研究，根据之前描述的典型US外观确定一个或多个PTG：结果：75%的患者（144/192）能看到一个或多个PTG。在甲状腺下极和甲状腺下区可观察到PTG（66%）。正常 PTG 的平均（± SD）尺寸为 5.68 毫米（± 1.42 毫米）×4.05 毫米（± 1.03 毫米）×2.68 毫米（± 0.61 毫米），平均体积为 33.3 立方毫米（± 17.75 立方毫米）。甲状腺肿的存在增加了寻找PTG的难度，而甲状腺炎的存在则有利于寻找PTG：结论：美国的 PTG 检出率很高（75%）。结论：US检查对PTG的检出率很高（75%），在甲状腺全切除术或甲状旁腺手术前的术前评估中，对PTG的识别尤其有用。它可以降低术后甲状旁腺功能减退的风险，并提高甲状腺癌术后US监测的准确性。更好地了解正常PTG的通常解剖位置也能更好地发现异常腺体。

{"title":"Normal Parathyroid Glands Are Most Often Seen on Neck Ultrasound","authors":"","doi":"10.1016/j.acra.2024.03.026","DOIUrl":"10.1016/j.acra.2024.03.026","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div><span>The dogma is that normal parathyroid glands<span> (PTGs) are not visible on ultrasound (US). Recently, several studies have shown that PTGs present these US features: ovoid structure, homogeneous and hyperechoic. The primary objective was to assess the detection rate, standard size and locations of normal PTGs in a population of patients consulting for thyroid US exam. The secondary objective was to determine if the presence of a goiter or a </span></span>thyroiditis could modify the visualization of normal PTGs.</div></div><div><h3>Method</h3><div>Single-center prospective study on 192 patients based on the typical US appearance previously described to identify one or more PTGs.</div></div><div><h3>Results</h3><div><span>One or more PTGs were visualized in 75% of patients (144/192). They were visualized preferentially at the lower pole of the thyroid gland and in the infra-thyroid region (66%). The mean (± SD) size of normal PTGs was 5.68 mm (± 1,42 mm)</span>    <span>2,68 mm (± 0,61 mm) and mean volume was 33.3 mm3 (± 17.75 mm3). The presence of a goiter made the search for PTGs more difficult whereas the presence of thyroiditis facilitated it.</span></div></div><div><h3>Conclusion</h3><div>The US detection rate of PTGs is high (75%). The identification of PTGs could be particularly useful in the preoperative assessment<span><span> before total thyroidectomy or </span>parathyroid<span> surgery. It could reduce the risk of postoperative hypoparathyroidism<span> and improve the accuracy of postoperative US surveillance of thyroid cancer. Better knowledge of the usual anatomical location of normal PTGs could also enable better detection of abnormal glands.</span></span></span></div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Contribution of Explainable Machine Learning Algorithms Using ROI-based Brain Surface Morphology Parameters in Distinguishing Early-onset Schizophrenia From Bipolar Disorder 使用基于 ROI 的脑表面形态学参数的可解释机器学习算法在区分早发性精神分裂症与躁郁症中的贡献。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.04.013

Rationale and Objectives

To differentiate early-onset schizophrenia (EOS) from early-onset bipolar disorder (EBD) using surface-based morphometry measurements and brain volumes using machine learning (ML) algorithms.

Method

High-resolution T₁-weighted images were obtained to measure cortical thickness (CT), gyrification, gyrification index (GI), sulcal depth (SD), fractal dimension (FD), and brain volumes. After the feature selection step, ML classifiers were applied for each feature set and the combination of them. The SHapley Additive exPlanations (SHAP) technique was implemented to interpret the contribution of each feature.

Findings

144 adolescents (16.2 ± 1.4 years, female = 39%) with EOS (n = 81) and EBD (n = 63) were included. The Adaptive Boosting (AdaBoost) algorithm had the highest accuracy (82.75%) in the whole dataset that includes all variables from Destrieux atlas. The best-performing algorithms were K-nearest neighbors (KNN) for FD subset, support vector machine (SVM) for SD subset, and AdaBoost for GI subset. The KNN algorithm had the highest accuracy (accuracy = 79.31%) in the whole dataset from the Desikan-Killiany-Tourville atlas.

Conclusion

This study demonstrates the use of ML in the differential diagnosis of EOS and EBD using surface-based morphometry measurements. Future studies could focus on multicenter data for the validation of these results.

理由和目标：利用基于表面的形态测量和机器学习（ML）算法测量脑容量，区分早发型精神分裂症（EOS）和早发型双相情感障碍（EBD）：获取高分辨率T1加权图像，测量皮质厚度（CT）、回旋度、回旋指数（GI）、沟深度（SD）、分形维度（FD）和脑容量。在特征选择步骤之后，对每个特征集和它们的组合应用了 ML 分类器。采用SHAPLEY Additive exPlanations（SHAP）技术来解释每个特征的贡献：共有 144 名青少年（16.2 ± 1.4 岁，女性占 39%）患有 EOS（81 人）和 EBD（63 人）。在包括Destrieux地图集所有变量的整个数据集中，自适应提升（AdaBoost）算法的准确率最高（82.75%）。在 FD 子集中表现最好的算法是 K-nearest neighbors (KNN)，在 SD 子集中表现最好的算法是支持向量机 (SVM)，在 GI 子集中表现最好的算法是 AdaBoost。在 Desikan-Killiany-Tourville 地图集的整个数据集中，KNN 算法的准确率最高（准确率=79.31%）：本研究证明了基于表面形态测量的 ML 在 EOS 和 EBD 鉴别诊断中的应用。未来的研究可侧重于多中心数据，以验证这些结果。

{"title":"The Contribution of Explainable Machine Learning Algorithms Using ROI-based Brain Surface Morphology Parameters in Distinguishing Early-onset Schizophrenia From Bipolar Disorder","authors":"","doi":"10.1016/j.acra.2024.04.013","DOIUrl":"10.1016/j.acra.2024.04.013","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>To differentiate early-onset schizophrenia (EOS) from early-onset bipolar disorder (EBD) using surface-based morphometry measurements and brain volumes using machine learning (ML) algorithms.</div></div><div><h3>Method</h3><div>High-resolution T<sub>1</sub><span>-weighted images were obtained to measure cortical thickness (CT), gyrification, gyrification index (GI), sulcal depth (SD), fractal dimension (FD), and brain volumes. After the feature selection step, ML classifiers were applied for each feature set and the combination of them. The SHapley Additive exPlanations (SHAP) technique was implemented to interpret the contribution of each feature.</span></div></div><div><h3>Findings</h3><div>144 adolescents (16.2 ± 1.4 years, female=39%) with EOS (<em>n</em> = 81) and EBD (<em>n</em><span> = 63) were included. The Adaptive Boosting (AdaBoost) algorithm had the highest accuracy (82.75%) in the whole dataset that includes all variables from Destrieux atlas. The best-performing algorithms were K-nearest neighbors (KNN) for FD subset, support vector machine (SVM) for SD subset, and AdaBoost for GI subset. The KNN algorithm had the highest accuracy (accuracy</span>  <!-->79.31%) in the whole dataset from the Desikan-Killiany-Tourville atlas.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the use of ML in the differential diagnosis of EOS and EBD using surface-based morphometry measurements. Future studies could focus on multicenter data for the validation of these results.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Radiologists Who Lost Their Way: Nazi Eugenics 迷失方向的放射科医生：纳粹优生学

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.07.022

引用次数: 0

Response to Letter to Editor re: “Value of Contrast-Enhanced Ultrasound Combined with Immune-Inflammatory Markers in Predicting Axillary Lymph Node Metastasis of Breast Cancer” 回复致编辑的信，内容为："对比增强超声与免疫炎症标志物相结合在预测乳腺癌腋窝淋巴结转移中的价值"。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.07.054

引用次数: 0

Interdisciplinary Approach to Expedited Outpatient Gastrostomy Tube Placement in Head and Neck Cancer Patients: A Single Center Retrospective Study 头颈部癌症患者快速门诊胃管置入的跨学科方法：单中心回顾性研究

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.008

Rationale and Objective

Treatment for head and neck cancer (HNC) can lead to decreased oral intake which often requires gastrostomy tube (g-tube) placement to provide nutritional support. A multidisciplinary team (MDT) consisting of interventional radiology (IR), HNC oncology and surgery, nutrition, and speech language pathology departments implemented an expedited outpatient g-tube placement pathway to reduce hospital stays and associated costs, initiate feeds sooner, and improve communication between care teams. This single center study investigates differences in complications, time to procedure and costs savings with implementing this pathway.

Methods

142 patients with HNC who underwent elective image guided g-tube placement by IR from 2015 to 2022 were identified retrospectively. 52 patients underwent the traditional pathway, and 90 patients underwent the expedited pathway. Patient demographics, procedure characteristics, periprocedural costs and 90-day complication rates were collected and compared statistically.

Results

The 90-day complication rate was comparable between groups (traditional = 32.7%; expedited = 22.2%; p-value = 0.17). The expedited pathway decreased the time from consult to procedure by 11.1 days (95% CI 7.6 – 14.6; p < 0.001) and decreased charge per procedure by $2940 (95% CI $989–$4891; p < 0.001).

Conclusion

A MDT for the treatment of patients with HNC successfully provided enteral nutrition support faster, with fewer associated costs, and in a more patient centered approach than previously done at this institution.

理由和目的：头颈癌（HNC）的治疗会导致口腔摄入量减少，通常需要放置胃造瘘管（g-tube）来提供营养支持。由介入放射学（IR）、HNC 肿瘤学和外科、营养学和语言病理学部门组成的多学科团队（MDT）实施了门诊病人快速胃管置入路径，以减少住院时间和相关费用、尽早开始喂养并改善护理团队之间的沟通。本项单中心研究调查了实施该路径在并发症、手术时间和成本节约方面的差异。方法：回顾性识别了2015年至2022年期间通过IR接受选择性图像引导g管置入术的142例HNC患者。52名患者接受了传统路径，90名患者接受了快速路径。收集了患者的人口统计学资料、手术特征、围手术期费用和90天并发症发生率，并进行了统计比较：结果：两组患者的 90 天并发症发生率相当（传统=32.7%；快速=22.2%；P 值=0.17）。加急路径将从就诊到手术的时间缩短了 11.1 天（95% CI 7.6 - 14.6；P 结论：MDT 是一种用于患者治疗的方法：治疗 HNC 患者的 MDT 成功地提供了肠内营养支持，与该机构以前的做法相比，速度更快、相关费用更低、更以患者为中心。

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引用次数: 0