Abstract Macrodystrophia lipomatosa (MDL) is a rare congenital, nonhereditary anomaly characterized by overgrowth of all the mesenchymal elements, predominantly the fibroadipose tissue in a sclerotomal distribution commonly involving the median nerve territory in the upper extremity and plantar nerve territory in the lower extremity. It can be either static or progressive, with the former being the more common. MDL is usually present since birth and the affected digit/region increases in length and girth, and growth ceases after puberty. We discuss a rare case of ulnar nerve territory involvement that progressed to grow even after puberty.
{"title":"Macrodystrophia Lipomatosa: A Rare Case of Ulnar Nerve Territory Involvement","authors":"Sonali Ullal, Shivani Arora","doi":"10.1055/s-0043-1777745","DOIUrl":"https://doi.org/10.1055/s-0043-1777745","url":null,"abstract":"Abstract Macrodystrophia lipomatosa (MDL) is a rare congenital, nonhereditary anomaly characterized by overgrowth of all the mesenchymal elements, predominantly the fibroadipose tissue in a sclerotomal distribution commonly involving the median nerve territory in the upper extremity and plantar nerve territory in the lower extremity. It can be either static or progressive, with the former being the more common. MDL is usually present since birth and the affected digit/region increases in length and girth, and growth ceases after puberty. We discuss a rare case of ulnar nerve territory involvement that progressed to grow even after puberty.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"44 11","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139149452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Differential diagnosis in radiology is a critical aspect of clinical decision-making. Radiologists in the early stages may find difficulties in listing the differential diagnosis from image patterns. In this context, the emergence of large language models (LLMs) has introduced new opportunities as these models have the capacity to access and contextualize extensive information from text-based input. Objective The objective of this study was to explore the utility of four LLMs—ChatGPT3.5, Google Bard, Microsoft Bing, and Perplexity—in providing most important differential diagnoses of cardiovascular and thoracic imaging patterns. Methods We selected 15 unique cardiovascular ( n = 5) and thoracic ( n = 10) imaging patterns. We asked each model to generate top 5 most important differential diagnoses for every pattern. Concurrently, a panel of two cardiothoracic radiologists independently identified top 5 differentials for each case and came to consensus when discrepancies occurred. We checked the concordance and acceptance of LLM-generated differentials with the consensus differential diagnosis. Categorical variables were compared by binomial, chi-squared, or Fisher's exact test. Results A total of 15 cases with five differentials generated a total of 75 items to analyze. The highest level of concordance was observed for diagnoses provided by Perplexity (66.67%), followed by ChatGPT (65.33%) and Bing (62.67%). The lowest score was for Bard with 45.33% of concordance with expert consensus. The acceptance rate was highest for Perplexity (90.67%), followed by Bing (89.33%) and ChatGPT (85.33%). The lowest acceptance rate was for Bard (69.33%). Conclusion Four LLMs—ChatGPT3.5, Google Bard, Microsoft Bing, and Perplexity—generated differential diagnoses had high level of acceptance but relatively lower concordance. There were significant differences in acceptance and concordance among the LLMs. Hence, it is important to carefully select the suitable model for usage in patient care or in medical education.
{"title":"Radiological Differential Diagnoses Based on Cardiovascular and Thoracic Imaging Patterns: Perspectives of Four Large Language Models","authors":"Pradosh Kumar Sarangi, A. Irodi, Swaha Panda, Debasish Swapnesh Kumar Nayak, Himel Mondal","doi":"10.1055/s-0043-1777289","DOIUrl":"https://doi.org/10.1055/s-0043-1777289","url":null,"abstract":"Abstract Background Differential diagnosis in radiology is a critical aspect of clinical decision-making. Radiologists in the early stages may find difficulties in listing the differential diagnosis from image patterns. In this context, the emergence of large language models (LLMs) has introduced new opportunities as these models have the capacity to access and contextualize extensive information from text-based input. Objective The objective of this study was to explore the utility of four LLMs—ChatGPT3.5, Google Bard, Microsoft Bing, and Perplexity—in providing most important differential diagnoses of cardiovascular and thoracic imaging patterns. Methods We selected 15 unique cardiovascular ( n = 5) and thoracic ( n = 10) imaging patterns. We asked each model to generate top 5 most important differential diagnoses for every pattern. Concurrently, a panel of two cardiothoracic radiologists independently identified top 5 differentials for each case and came to consensus when discrepancies occurred. We checked the concordance and acceptance of LLM-generated differentials with the consensus differential diagnosis. Categorical variables were compared by binomial, chi-squared, or Fisher's exact test. Results A total of 15 cases with five differentials generated a total of 75 items to analyze. The highest level of concordance was observed for diagnoses provided by Perplexity (66.67%), followed by ChatGPT (65.33%) and Bing (62.67%). The lowest score was for Bard with 45.33% of concordance with expert consensus. The acceptance rate was highest for Perplexity (90.67%), followed by Bing (89.33%) and ChatGPT (85.33%). The lowest acceptance rate was for Bard (69.33%). Conclusion Four LLMs—ChatGPT3.5, Google Bard, Microsoft Bing, and Perplexity—generated differential diagnoses had high level of acceptance but relatively lower concordance. There were significant differences in acceptance and concordance among the LLMs. Hence, it is important to carefully select the suitable model for usage in patient care or in medical education.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"63 3","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139149597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Rastogi, K. Bhattacharya, Aayush Mathur, Arpita A. Sahu, Amit Chaudhari, Epari Shridhar
A 50-year-old female presented with acute onset bilateral limb weakness, episodes of severe occipital headache with multiple episodes of loss ofconsciousnesswith a background history of left side neck pain, and occipital headache in the past 4 years. There was no signi fi cant past medical/surgical, social, or familyhistory.On examination,therewasleft-sided deviation of the tongue with left-sided face weakness. Bilateral upper limb has power was 2/5 and lowerlimb power was 3/5 without any bowel and bladder incontinence. On imaging, magnetic resonance imaging (MRI) revealed a large well-de fi ned lobulated extra-axial left petroclival dura-based mass. The mass was seen extending along the prepon-tine, left cerebellopontine, and cerebellomedullary cisterns and inferiorly into the spinal canal through the foramen magnum ( ► Fig. 1A – D ). The mass was isointense on T1-weighted(T1)imagingandonT2-weighted(T2)imaging.There was no signi fi cant diffusion restriction in diffusion-weighted imaging or blooming in gradient images. The tumor displayed intense, homogeneous post-contrast enhancement. The mass showed broad base along the tentorium cerebelli and clivus. Laterally the lesion was seen widening and eroding the hypo-glossal canal and extending intotheleft parapharyngeal
{"title":"Atypical Meningioma with Perineural Spread Along Hypoglossal Nerve","authors":"S. Rastogi, K. Bhattacharya, Aayush Mathur, Arpita A. Sahu, Amit Chaudhari, Epari Shridhar","doi":"10.1055/s-0043-1777743","DOIUrl":"https://doi.org/10.1055/s-0043-1777743","url":null,"abstract":"A 50-year-old female presented with acute onset bilateral limb weakness, episodes of severe occipital headache with multiple episodes of loss ofconsciousnesswith a background history of left side neck pain, and occipital headache in the past 4 years. There was no signi fi cant past medical/surgical, social, or familyhistory.On examination,therewasleft-sided deviation of the tongue with left-sided face weakness. Bilateral upper limb has power was 2/5 and lowerlimb power was 3/5 without any bowel and bladder incontinence. On imaging, magnetic resonance imaging (MRI) revealed a large well-de fi ned lobulated extra-axial left petroclival dura-based mass. The mass was seen extending along the prepon-tine, left cerebellopontine, and cerebellomedullary cisterns and inferiorly into the spinal canal through the foramen magnum ( ► Fig. 1A – D ). The mass was isointense on T1-weighted(T1)imagingandonT2-weighted(T2)imaging.There was no signi fi cant diffusion restriction in diffusion-weighted imaging or blooming in gradient images. The tumor displayed intense, homogeneous post-contrast enhancement. The mass showed broad base along the tentorium cerebelli and clivus. Laterally the lesion was seen widening and eroding the hypo-glossal canal and extending intotheleft parapharyngeal","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"61 8","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139150419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Chandramohan, Smitha Manchanda, Rupa Renganathan, P. Popat, Diva Shah, E. Dhamija, Anitha Sen
Abstract The new 2023 update of the International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer incorporates the advances made in the understanding of the pathology and molecular classifications into the staging system. While the new staging system aids in precision medicine and may lead to better documentation of prognostic risk categories of endometrial cancer, it is complex and calls for an integrated approach and better communication between multiple disciplines involved in the management of endometrial cancer. In this review article, we address how the referral patterns to imaging services might change considering the updated staging system for endometrial cancer. We also discuss the practical aspects and nuances involved in the radiology service delivery and reporting practices as we adopt the new FIGO staging system for managing endometrial cancer patients.
{"title":"Impact of the 2023 FIGO Staging System for Endometrial Cancer on the Use of Imaging Services: An Indian Perspective","authors":"A. Chandramohan, Smitha Manchanda, Rupa Renganathan, P. Popat, Diva Shah, E. Dhamija, Anitha Sen","doi":"10.1055/s-0043-1777355","DOIUrl":"https://doi.org/10.1055/s-0043-1777355","url":null,"abstract":"Abstract The new 2023 update of the International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer incorporates the advances made in the understanding of the pathology and molecular classifications into the staging system. While the new staging system aids in precision medicine and may lead to better documentation of prognostic risk categories of endometrial cancer, it is complex and calls for an integrated approach and better communication between multiple disciplines involved in the management of endometrial cancer. In this review article, we address how the referral patterns to imaging services might change considering the updated staging system for endometrial cancer. We also discuss the practical aspects and nuances involved in the radiology service delivery and reporting practices as we adopt the new FIGO staging system for managing endometrial cancer patients.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"123 3","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138999669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dheeksha D. S., Stuti Chandola, Aayush Jain, Neerja Gupta, M. Kabra, M. Jana
Abstract Skeletal dysplasias or osteochondrodysplasias comprise a large heterogeneous group of genetic disorders and possess significant overlap on imaging, which adds to the dilemma of the reporting radiologist. These entities are routinely evaluated with a detailed skeletal survey and hand radiographs form a crucial part of a complete survey. Certain conditions have characteristic imaging findings that enable a diagnosis be made on hand radiograph alone. Additionally, hand radiographs may also demonstrate findings that may be suggestive of a particular diagnosis/differential diagnoses and would warrant further assessment for proving the same. We aim to demonstrate the use of hand radiographs in diagnosis of various such entities through this review. Although they cannot replace a complete skeletal survey in the diagnosis, hand radiographs performed for other indications might alert a radiologist to the diagnosis of an unsuspected skeletal dysplasia.
摘要 骨骼发育不良或骨软骨发育不良是一大类异质性遗传疾病，在影像学上有明显的重叠，这给放射科医生的报告带来了难题。对这些疾病的常规评估是进行详细的骨骼检查，而手部 X 光片是完整检查的重要组成部分。某些疾病具有特征性的影像学检查结果，因此仅凭手部 X 光片就能做出诊断。此外，手部 X 光片也可能显示出提示特定诊断/鉴别诊断的结果，因此需要进一步评估以证明。我们旨在通过本综述展示手部 X 光片在诊断各种此类疾病中的应用。虽然手部X光片不能取代完整的骨骼检查诊断，但因其他适应症而进行的手部X光片检查可能会提醒放射科医生对未被怀疑的骨骼发育不良进行诊断。
{"title":"Hand Radiographs in Skeletal Dysplasia: A Pictorial Review","authors":"Dheeksha D. S., Stuti Chandola, Aayush Jain, Neerja Gupta, M. Kabra, M. Jana","doi":"10.1055/s-0043-1777320","DOIUrl":"https://doi.org/10.1055/s-0043-1777320","url":null,"abstract":"Abstract Skeletal dysplasias or osteochondrodysplasias comprise a large heterogeneous group of genetic disorders and possess significant overlap on imaging, which adds to the dilemma of the reporting radiologist. These entities are routinely evaluated with a detailed skeletal survey and hand radiographs form a crucial part of a complete survey. Certain conditions have characteristic imaging findings that enable a diagnosis be made on hand radiograph alone. Additionally, hand radiographs may also demonstrate findings that may be suggestive of a particular diagnosis/differential diagnoses and would warrant further assessment for proving the same. We aim to demonstrate the use of hand radiographs in diagnosis of various such entities through this review. Although they cannot replace a complete skeletal survey in the diagnosis, hand radiographs performed for other indications might alert a radiologist to the diagnosis of an unsuspected skeletal dysplasia.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"80 S11","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138999603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dewansh Mishra, C. Kesavadas, B. Thomas, Vishnu Shivshankar Pujari, Amalan Ignatius
Abstract Carotid body tumors are rare benign tumors that arise in the carotid space of neck typically presenting as soft to firm, painless swelling in the neck. While specific imaging characteristics have been previously described for carotid body tumors, we report a new imaging sign in three cases of carotid body tumors on computed tomography angiography.
{"title":"Central Nonenhancement Sign in Carotid Body Tumor on CT Angiography","authors":"Dewansh Mishra, C. Kesavadas, B. Thomas, Vishnu Shivshankar Pujari, Amalan Ignatius","doi":"10.1055/s-0043-1777322","DOIUrl":"https://doi.org/10.1055/s-0043-1777322","url":null,"abstract":"Abstract Carotid body tumors are rare benign tumors that arise in the carotid space of neck typically presenting as soft to firm, painless swelling in the neck. While specific imaging characteristics have been previously described for carotid body tumors, we report a new imaging sign in three cases of carotid body tumors on computed tomography angiography.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"19 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138999980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Naik, Mantu Jain, S. Bhoi, Sujit-Kumar Tripathy
Abstract Aim Osteoporosis is a common metabolic bone disease accounting for low back pain (LBP). It is diagnosed by dual-energy X-ray absorptiometry (DXA). Magnetic resonance imaging (MRI), a routine investigation for LBP, is also sensitive to detect fat fraction (FF) of the vertebral body that increases with increasing age. This study aimed to correlate vertebral marrow FF using MRI and bone mineral density (BMD). Material and Methods Patients presenting with low backache and suspected osteoporosis were included. All patients underwent an MRI of lumbosacral spine and DXA. Patients were categorized into an osteoporotic and a nonosteoporotic group based on the T-score obtained from DXA. “T-scores” of < –2.5 on BMD were considered as osteoporotic spine. T-score of > –2.5 was considered as nonosteoporotic. The FF obtained from the DIXON sequence of MRI was correlated between the two groups. Result Thirty-one patients were included with a mean age of 54.26 ± 11.6 years. Sixteen patients were osteoporotic based on the defined criteria in the methods. The mean vertebral marrow FF was significantly higher in the osteoporotic patients (64.98 ± 8.8%) compared with the nonosteoporotic (45.18 ± 13.2%) ( p = 0.001). The mean FF of the vertebra having fracture (69.19 ± 7.73%) was significantly higher than that of patients without fracture (57.96 ± 5.75%) ( p = 0.03). Taking a cutoff value of vertebral marrow FF of 54.85, the sensitivity and specificity of diagnosing osteoporosis were 93 and 80%, respectively, with a confidence interval of 95%. The area under the curve was 0.925. Conclusion Increased vertebral marrow FF is noted in the osteoporotic spine. FF has an inverse correlation with the T-score obtained from BMD. MRI with FF measurement can provide indirect evidence of osteoporosis, which can be done under one roof, especially in young patients where we need to avoid ionizing radiation.
{"title":"Correlation between Vertebral Marrow Fat Fraction in MRI Using DIXON Technique and BMD in DXA in Patients of Suspected Osteoporosis","authors":"S. Naik, Mantu Jain, S. Bhoi, Sujit-Kumar Tripathy","doi":"10.1055/s-0043-1776883","DOIUrl":"https://doi.org/10.1055/s-0043-1776883","url":null,"abstract":"Abstract Aim Osteoporosis is a common metabolic bone disease accounting for low back pain (LBP). It is diagnosed by dual-energy X-ray absorptiometry (DXA). Magnetic resonance imaging (MRI), a routine investigation for LBP, is also sensitive to detect fat fraction (FF) of the vertebral body that increases with increasing age. This study aimed to correlate vertebral marrow FF using MRI and bone mineral density (BMD). Material and Methods Patients presenting with low backache and suspected osteoporosis were included. All patients underwent an MRI of lumbosacral spine and DXA. Patients were categorized into an osteoporotic and a nonosteoporotic group based on the T-score obtained from DXA. “T-scores” of < –2.5 on BMD were considered as osteoporotic spine. T-score of > –2.5 was considered as nonosteoporotic. The FF obtained from the DIXON sequence of MRI was correlated between the two groups. Result Thirty-one patients were included with a mean age of 54.26 ± 11.6 years. Sixteen patients were osteoporotic based on the defined criteria in the methods. The mean vertebral marrow FF was significantly higher in the osteoporotic patients (64.98 ± 8.8%) compared with the nonosteoporotic (45.18 ± 13.2%) ( p = 0.001). The mean FF of the vertebra having fracture (69.19 ± 7.73%) was significantly higher than that of patients without fracture (57.96 ± 5.75%) ( p = 0.03). Taking a cutoff value of vertebral marrow FF of 54.85, the sensitivity and specificity of diagnosing osteoporosis were 93 and 80%, respectively, with a confidence interval of 95%. The area under the curve was 0.925. Conclusion Increased vertebral marrow FF is noted in the osteoporotic spine. FF has an inverse correlation with the T-score obtained from BMD. MRI with FF measurement can provide indirect evidence of osteoporosis, which can be done under one roof, especially in young patients where we need to avoid ionizing radiation.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"52 16","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138602178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ansan Joseph, J. Valakkada, A. Ayappan, S. Kannath, Pitchai Shivanesan
Abstract Background The best option among the endovascular options in long, complex femoropopliteal (FP) lesions, and factors affecting the patency have yet to be well described. There are few studies describing the mid- and long-term patency of endovascular stents in long-segment FP occlusions. Aim This study aimed to determine the technical success and mid-term patency of subintimal angioplasty with vasculomimetic stenting in Trans-Atlantic Inter-Society Consensus II (TASC) C and D FP disease. The patient and imaging factors that affect primary patency were also analyzed. Methods and Materials A single-center prospective study was performed on 52 consecutive patients undergoing endovascular treatment for TASC C and D FP disease from 2017 to 2021. Angioplasty with stenting was performed in all patients and followed up for 36 months. Endpoints were primary patency rates and amputation-free survival of the limb. Kaplan–Meier curves were used to see patency rates and amputation-free survival rates. Results A total of 52 patients underwent stenting with a technical success rate of 100% if the sub-intimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique was used. Primary stent patency at 6, 12, 18, 24, and 36 months was 89.8, 81.4, 76.2, 71.4, and 62.5%, respectively. Amputation-free survival was 98, 95.6, 91.8, and 85.7% at 12, 24, 30, and 36 months, respectively. Cox proportional regression analysis showed smoking and vessel wall calcium score more than 270 degrees as independent predictors of loss of primary patency (hazard ratio 0.35 confidence interval [CI]: 0.003–0.448) and 0.102 (CI: 0.022–0.47), respectively. Conclusion Subintimal angioplasty with vasculomimetic stent has good midterm patency in and amputation-free survival in long-segment FP occlusions. Smoking and severe vessel wall calcification adversely affect patency.
{"title":"Technical Success, Midterm Primary Patency, and Factors Affecting Primary Patency of Subintimal Angioplasty Followed by Vasculomimetic Stenting for Trans-Atlantic Intersociety Consensus II C and D Femoropopliteal Arterial Disease—A Prospective Study","authors":"Ansan Joseph, J. Valakkada, A. Ayappan, S. Kannath, Pitchai Shivanesan","doi":"10.1055/s-0043-1777015","DOIUrl":"https://doi.org/10.1055/s-0043-1777015","url":null,"abstract":"Abstract Background The best option among the endovascular options in long, complex femoropopliteal (FP) lesions, and factors affecting the patency have yet to be well described. There are few studies describing the mid- and long-term patency of endovascular stents in long-segment FP occlusions. Aim This study aimed to determine the technical success and mid-term patency of subintimal angioplasty with vasculomimetic stenting in Trans-Atlantic Inter-Society Consensus II (TASC) C and D FP disease. The patient and imaging factors that affect primary patency were also analyzed. Methods and Materials A single-center prospective study was performed on 52 consecutive patients undergoing endovascular treatment for TASC C and D FP disease from 2017 to 2021. Angioplasty with stenting was performed in all patients and followed up for 36 months. Endpoints were primary patency rates and amputation-free survival of the limb. Kaplan–Meier curves were used to see patency rates and amputation-free survival rates. Results A total of 52 patients underwent stenting with a technical success rate of 100% if the sub-intimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique was used. Primary stent patency at 6, 12, 18, 24, and 36 months was 89.8, 81.4, 76.2, 71.4, and 62.5%, respectively. Amputation-free survival was 98, 95.6, 91.8, and 85.7% at 12, 24, 30, and 36 months, respectively. Cox proportional regression analysis showed smoking and vessel wall calcium score more than 270 degrees as independent predictors of loss of primary patency (hazard ratio 0.35 confidence interval [CI]: 0.003–0.448) and 0.102 (CI: 0.022–0.47), respectively. Conclusion Subintimal angioplasty with vasculomimetic stent has good midterm patency in and amputation-free survival in long-segment FP occlusions. Smoking and severe vessel wall calcification adversely affect patency.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"22 11","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138602787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Swetha M. Nair, A. Sahu, Apurva Prasad, Asha Mary George, Atul Goel, Tejpal Gupta
Abstract Isocitrate dehydrogenase mutant gliomas generally have a better prognosis than their wild-type counterpart. Recurrences are generally within the radiation field in the primary tumoral bed. Remote recurrence is uncommon and is usually intraparenchymal. Transformation to a higher grade has been observed with TP53 mutants. Presentation of glioma as an extra-axial lesion is extremely uncommon. No such cases of remote intracranial extra-axial recurrence have been reported in the literature. We describe the unique imaging findings in this case and attempt to formulate possible diagnoses. Intraoperative and pathological findings confirmed this unusual recurrence pattern.
{"title":"Unusual Extra-Axial and Extracranial Recurrence in an IDH Mutant Astrocytoma: A Case Report","authors":"Swetha M. Nair, A. Sahu, Apurva Prasad, Asha Mary George, Atul Goel, Tejpal Gupta","doi":"10.1055/s-0043-1777012","DOIUrl":"https://doi.org/10.1055/s-0043-1777012","url":null,"abstract":"Abstract Isocitrate dehydrogenase mutant gliomas generally have a better prognosis than their wild-type counterpart. Recurrences are generally within the radiation field in the primary tumoral bed. Remote recurrence is uncommon and is usually intraparenchymal. Transformation to a higher grade has been observed with TP53 mutants. Presentation of glioma as an extra-axial lesion is extremely uncommon. No such cases of remote intracranial extra-axial recurrence have been reported in the literature. We describe the unique imaging findings in this case and attempt to formulate possible diagnoses. Intraoperative and pathological findings confirmed this unusual recurrence pattern.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"4 7","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138604589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maximizing Effective Utilization of Learning Resources, Including Online Tools, in Radiology Education","authors":"V. Chaudhary, S. Bano","doi":"10.1055/s-0043-1777130","DOIUrl":"https://doi.org/10.1055/s-0043-1777130","url":null,"abstract":"","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"16 7","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138602958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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