Rahul Bhagawati, Suman Hazarika, C. N. Gupta, S. Chanda
Abstract Background Injuries involving substantial bleeding, frequently encountered in victims of road traffic accidents, pose a significant risk to mortality. For abdominal trauma cases, accurately assessing internal bleeding and hematomas becomes crucial. Detecting hemoperitoneum, which indicates both blood loss and organ damage in the abdominal cavity, requires precise evaluation. Timely diagnosis and quantification of hemoperitoneum following road accidents are crucial during the critical golden hour, enabling prioritized medical intervention and potentially saving lives while enhancing overall patient care. However, achieving precise hemoperitoneum quantification in abdominal trauma faces challenges due to the intricate nature of overlapping Hounsfield unit (HU) regions. Methods In this feasibility study, we sought to assess the efficacy of the novel HUVAO (Hounsfield Unit-based Volume quantification of Asymmetrical Objects) segmentation algorithm for quantifying hemoperitoneum in thoracoabdominal non-contrast computed tomography (CT) images. Using 28 retrospective non-contrast CT scans of thoracoabdominal regions from trauma patients, we analyzed crucial imaging data without necessitating additional scans or contrast-enhanced procedures. The study aimed to compare HUVAO against classical algorithms and visual estimations by trained radiologists for hemoperitoneum segmentation in thoracoabdominal non-contrast CT images. Results Our findings revealed that although the technical feasibility of employing HUVAO and other segmentation algorithms for hemoperitoneum quantification is evident, the outcomes derived from these algorithms display notable discrepancies. Conclusion In assessing technical feasibility, we introduced the HUVAO segmentation algorithm for hemoperitoneum quantification, comparing its performance against classical segmentation algorithms and visual estimations from trained radiologists. While our results affirm the technical feasibility of HUVAO for this purpose, the observed variations underscore the task's inherent complexity. This emphasizes the limitations of relying solely on HU-based detection, advocating for integration with clinical data. This insight urges exploration of advanced techniques to boost accuracy and elevate patient care standards.
{"title":"Hemoperitoneum Quantification in Non-contrast CT: Evaluating Feasibility with the Novel HUVAO Segmentation Algorithm","authors":"Rahul Bhagawati, Suman Hazarika, C. N. Gupta, S. Chanda","doi":"10.1055/s-0043-1778672","DOIUrl":"https://doi.org/10.1055/s-0043-1778672","url":null,"abstract":"Abstract Background Injuries involving substantial bleeding, frequently encountered in victims of road traffic accidents, pose a significant risk to mortality. For abdominal trauma cases, accurately assessing internal bleeding and hematomas becomes crucial. Detecting hemoperitoneum, which indicates both blood loss and organ damage in the abdominal cavity, requires precise evaluation. Timely diagnosis and quantification of hemoperitoneum following road accidents are crucial during the critical golden hour, enabling prioritized medical intervention and potentially saving lives while enhancing overall patient care. However, achieving precise hemoperitoneum quantification in abdominal trauma faces challenges due to the intricate nature of overlapping Hounsfield unit (HU) regions. Methods In this feasibility study, we sought to assess the efficacy of the novel HUVAO (Hounsfield Unit-based Volume quantification of Asymmetrical Objects) segmentation algorithm for quantifying hemoperitoneum in thoracoabdominal non-contrast computed tomography (CT) images. Using 28 retrospective non-contrast CT scans of thoracoabdominal regions from trauma patients, we analyzed crucial imaging data without necessitating additional scans or contrast-enhanced procedures. The study aimed to compare HUVAO against classical algorithms and visual estimations by trained radiologists for hemoperitoneum segmentation in thoracoabdominal non-contrast CT images. Results Our findings revealed that although the technical feasibility of employing HUVAO and other segmentation algorithms for hemoperitoneum quantification is evident, the outcomes derived from these algorithms display notable discrepancies. Conclusion In assessing technical feasibility, we introduced the HUVAO segmentation algorithm for hemoperitoneum quantification, comparing its performance against classical segmentation algorithms and visual estimations from trained radiologists. While our results affirm the technical feasibility of HUVAO for this purpose, the observed variations underscore the task's inherent complexity. This emphasizes the limitations of relying solely on HU-based detection, advocating for integration with clinical data. This insight urges exploration of advanced techniques to boost accuracy and elevate patient care standards.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"48 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139528139","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}
Rahul Middha, Suryansh Arora, R. S. Jadon, Tamanna Veer Singh
{"title":"An Uncommon Presentation of a Common Disease: Periportal Infiltrating Form of Hepatic Lymphoma","authors":"Rahul Middha, Suryansh Arora, R. S. Jadon, Tamanna Veer Singh","doi":"10.1055/s-0043-1777297","DOIUrl":"https://doi.org/10.1055/s-0043-1777297","url":null,"abstract":"","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"29 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138624521","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 We present two cases of iatrogenic retroperitoneal perforation involving the ascending and descending colon. The unique imaging findings in these two cases demonstrate potential routes of communication for air originating in the retroperitoneum. In context of these cases, we review the clinical presentation, management, and anatomic features of retroperitoneal perforation. Along with clinical history, an understanding of retroperitoneal anatomic relationships can aid radiologists in identifying the origin of perforation.
{"title":"Retroperitoneal Colon Perforation with Review of Retroperitoneal Anatomic Relationships: Case Series with Review of Literature","authors":"Shina Satoh, Albert Hwang, Leonard Berliner","doi":"10.1055/s-0043-1777266","DOIUrl":"https://doi.org/10.1055/s-0043-1777266","url":null,"abstract":"Abstract We present two cases of iatrogenic retroperitoneal perforation involving the ascending and descending colon. The unique imaging findings in these two cases demonstrate potential routes of communication for air originating in the retroperitoneum. In context of these cases, we review the clinical presentation, management, and anatomic features of retroperitoneal perforation. Along with clinical history, an understanding of retroperitoneal anatomic relationships can aid radiologists in identifying the origin of perforation.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"33 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626912","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}
We showcase our 79-year-old female patient from Long Island, New York, who presented to the hospital in June 2023 with daily fevers, fatigue, generalized abdominal pain, intermittent nausea, anorexia, dark urine, and dry cough. The patient has a medical history of hypothyroidism, osteoporosis, and hepatitis C that was treated in 2019, and stage 0 ductal carcinoma in situ of the breast, for which she underwent lumpectomy in 2007. Our patient was found to have anemia with a hemoglobin of 7.9g/dL (11.5 – 15.5 g/dL) and thrombocytopenia with platelets of 74,000/mm 3 (150,000 – 400,000/mm 3 ). Computed tomography (CT) abdomen and pelvis demonstrated a 1.4cm hypodense right hepatic nodule, which was concerning for possible cholangiocarcinoma. Follow-up magnetic resonance imaging (MRI) abdomen and pelvis was performed and revealed the liver lesion to be benign appearing and unchanged from previous studies done in 2020. However, post-contrast T1-weighted MRIs showed mild splenomegaly (13.2 cm) with multiple ill-de fi ned, hypoattenuating splenic lesions measuring up to 1cm ( ► Fig. 1A and B ). These splenic lesions were not visible on other sequences, including unenhanced T1-weighted, T2-weighted, and diffusion-weighted sequence. These lesions were
{"title":"Multiple Splenic Lesions on MRI as a Radiologic Manifestation of Babesiosis","authors":"Sarah Byun, John Hines","doi":"10.1055/s-0043-1776779","DOIUrl":"https://doi.org/10.1055/s-0043-1776779","url":null,"abstract":"We showcase our 79-year-old female patient from Long Island, New York, who presented to the hospital in June 2023 with daily fevers, fatigue, generalized abdominal pain, intermittent nausea, anorexia, dark urine, and dry cough. The patient has a medical history of hypothyroidism, osteoporosis, and hepatitis C that was treated in 2019, and stage 0 ductal carcinoma in situ of the breast, for which she underwent lumpectomy in 2007. Our patient was found to have anemia with a hemoglobin of 7.9g/dL (11.5 – 15.5 g/dL) and thrombocytopenia with platelets of 74,000/mm 3 (150,000 – 400,000/mm 3 ). Computed tomography (CT) abdomen and pelvis demonstrated a 1.4cm hypodense right hepatic nodule, which was concerning for possible cholangiocarcinoma. Follow-up magnetic resonance imaging (MRI) abdomen and pelvis was performed and revealed the liver lesion to be benign appearing and unchanged from previous studies done in 2020. However, post-contrast T1-weighted MRIs showed mild splenomegaly (13.2 cm) with multiple ill-de fi ned, hypoattenuating splenic lesions measuring up to 1cm ( ► Fig. 1A and B ). These splenic lesions were not visible on other sequences, including unenhanced T1-weighted, T2-weighted, and diffusion-weighted sequence. These lesions were","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"39 3.4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275331","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}
Abhishek Gupta, A. Manchanda, Sapna Singh, Rajdeep Singh, N. Khurana, Aishwarya S. Durgad
Abstract Primary retroperitoneal masses include a diverse and uncommon group of lesions that arise within the retroperitoneal space, but do not originate from any retroperitoneal organs. The majority of the lesions are malignant and imaging plays a pivotal role in the detection, staging, and preoperative planning. The evaluation of primary retroperitoneal masses is often challenging owing to the unfamiliarity with the common imaging features of various diseases affecting it. This article describes the multidetector computed tomography appearance of some primary retroperitoneal masses.
{"title":"Primary Retroperitoneal Masses: A Pictorial Essay","authors":"Abhishek Gupta, A. Manchanda, Sapna Singh, Rajdeep Singh, N. Khurana, Aishwarya S. Durgad","doi":"10.1055/s-0043-1774296","DOIUrl":"https://doi.org/10.1055/s-0043-1774296","url":null,"abstract":"Abstract Primary retroperitoneal masses include a diverse and uncommon group of lesions that arise within the retroperitoneal space, but do not originate from any retroperitoneal organs. The majority of the lesions are malignant and imaging plays a pivotal role in the detection, staging, and preoperative planning. The evaluation of primary retroperitoneal masses is often challenging owing to the unfamiliarity with the common imaging features of various diseases affecting it. This article describes the multidetector computed tomography appearance of some primary retroperitoneal masses.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74887871","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 Objective The aim of the study was to evaluate the synergistic role and advantages of integrating noncontrast computed tomography (NCCT) and magnetic resonance cholangiopancreatography (MRCP) in disorders of the pancreatobiliary (PB) system. Methods In this cross-sectional and retrospective record-based study, radiological (NCCT and MRCP) data were collected retrospectively for a period of 3 years (June 2018–August 2020) from 52 patients. The results were compared to the final diagnosis on endoscopic retrograde cholangiopancreatography (ERCP) findings (gold standard). The data collected were analyzed by measuring the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and p -value for NCCT, MRCP, and integrated NCCT plus MRCP at different cutoff points. Subsequently, a receiver operating characteristic (ROC) curve was plotted to analyze different thresholds for NCCT, MRCP, and integrated NCCT plus MRCP. Results The most common pathologies identified were biliary dilations (18.4%), common bile duct (CBD) calculi (13.6%), and biliary strictures (12.0%). Overall, MRCP provided a higher percentage of correct diagnoses (81.6%) compared to CT (56.0%). Integrating NCCT with MRCP showed a significant increase in sensitivities and specificities when compared to NCCT or MRCP alone. Integrated NCCT plus MRCP showed excellent performance with an area under the curve (AUC) of ROC analysis of 0.937. Conclusion Our study showed that integrating NCCT and MRCP can prove to be an excellent tool in establishing a detailed diagnosis of PB disorders, better than either NCCT or MRCP alone. Due to the concurrent nature of PB disorders, it may be worth considering integrating NCCT and MRCP, given that there is an absence of contraindications to either modality.
{"title":"The Synergistic Role of Integrated Computed Tomography and Magnetic Resonance Cholangiopancreatography in Disorders of the Pancreatobiliary System","authors":"Santosh Rai, S. Srivastava, S. Gopal, Anika Tiku","doi":"10.1055/s-0043-1774297","DOIUrl":"https://doi.org/10.1055/s-0043-1774297","url":null,"abstract":"Abstract Objective The aim of the study was to evaluate the synergistic role and advantages of integrating noncontrast computed tomography (NCCT) and magnetic resonance cholangiopancreatography (MRCP) in disorders of the pancreatobiliary (PB) system. Methods In this cross-sectional and retrospective record-based study, radiological (NCCT and MRCP) data were collected retrospectively for a period of 3 years (June 2018–August 2020) from 52 patients. The results were compared to the final diagnosis on endoscopic retrograde cholangiopancreatography (ERCP) findings (gold standard). The data collected were analyzed by measuring the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and p -value for NCCT, MRCP, and integrated NCCT plus MRCP at different cutoff points. Subsequently, a receiver operating characteristic (ROC) curve was plotted to analyze different thresholds for NCCT, MRCP, and integrated NCCT plus MRCP. Results The most common pathologies identified were biliary dilations (18.4%), common bile duct (CBD) calculi (13.6%), and biliary strictures (12.0%). Overall, MRCP provided a higher percentage of correct diagnoses (81.6%) compared to CT (56.0%). Integrating NCCT with MRCP showed a significant increase in sensitivities and specificities when compared to NCCT or MRCP alone. Integrated NCCT plus MRCP showed excellent performance with an area under the curve (AUC) of ROC analysis of 0.937. Conclusion Our study showed that integrating NCCT and MRCP can prove to be an excellent tool in establishing a detailed diagnosis of PB disorders, better than either NCCT or MRCP alone. Due to the concurrent nature of PB disorders, it may be worth considering integrating NCCT and MRCP, given that there is an absence of contraindications to either modality.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75067836","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 Primary liver cancer is the third most common cause of cancer-related deaths worldwide with hepatocellular carcinoma (HCC) comprising the vast majority of the cases. HCC unlike most solid cancers can be diagnosed based on imaging findings alone using multiphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) without the need for histopathological confirmation in the majority of the cases. Liver Imaging Reporting and Data System (LI-RADS) was first introduced by the American College of Radiology in 2011 with the help of a multidisciplinary team of liver disease experts to improve the accuracy, consistency, and clarity of communication of imaging findings between radiologists and treating physicians. To date, LI-RADS has undergone four major updates in 2013, 2014, 2017, and 2018. This article reviews the technical aspects, categorization, and major and ancillary imaging features for the application of LI-RADS version 2018 using CT and MRI in routine clinical practice.
原发性肝癌是全球癌症相关死亡的第三大常见原因，肝细胞癌(HCC)占绝大多数病例。与大多数实体癌不同，HCC可以仅根据影像学结果诊断，大多数病例无需组织病理学证实，只需使用多相增强计算机断层扫描(CT)或磁共振成像(MRI)。肝脏影像学报告和数据系统(LI-RADS)于2011年由美国放射学会(American College of Radiology)在肝病多学科专家团队的帮助下首次推出，以提高放射科医生和治疗医生之间影像学发现沟通的准确性、一致性和清晰度。迄今为止，LI-RADS在2013年、2014年、2017年和2018年经历了四次重大更新。本文综述了LI-RADS 2018版在常规临床实践中使用CT和MRI的技术方面、分类以及主要和辅助成像特征。
{"title":"CT MRI LI-RADS in Routine Practice","authors":"K. Ganesan, Shivsamb Jalkote, S. Nellore","doi":"10.1055/s-0043-1774305","DOIUrl":"https://doi.org/10.1055/s-0043-1774305","url":null,"abstract":"Abstract Primary liver cancer is the third most common cause of cancer-related deaths worldwide with hepatocellular carcinoma (HCC) comprising the vast majority of the cases. HCC unlike most solid cancers can be diagnosed based on imaging findings alone using multiphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) without the need for histopathological confirmation in the majority of the cases. Liver Imaging Reporting and Data System (LI-RADS) was first introduced by the American College of Radiology in 2011 with the help of a multidisciplinary team of liver disease experts to improve the accuracy, consistency, and clarity of communication of imaging findings between radiologists and treating physicians. To date, LI-RADS has undergone four major updates in 2013, 2014, 2017, and 2018. This article reviews the technical aspects, categorization, and major and ancillary imaging features for the application of LI-RADS version 2018 using CT and MRI in routine clinical practice.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"27 1","pages":"173 - 184"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73377898","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}
Shameema Farook, Saumya Soni, Arpit Shantagiri, P. Gupta, A. Sinha, M. Prakash
Abstract Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life, and death. The diagnosis of sarcopenia is based on documentation of two of the three criteria: low muscle mass, low muscle strength, and low physical performance. Imaging-based assessment of muscle mass is preferred in both clinical and research settings. Anthropometry for the evaluation of muscle mass is prone to errors and is not recommended in the clinical setting. There is a lack of literature on the radiological assessment of sarcopenia and its association with prognosis in hepatobiliary, pancreatic, and gastrointestinal diseases. Thus, we aim to provide a review of studies that utilized radiological methods to assess sarcopenia and evaluate its impact on outcomes in patients with these diseases.
{"title":"Radiological Assessment of Sarcopenia and Its Clinical Impact in Patients with Hepatobiliary, Pancreatic, and Gastrointestinal Diseases: A Comprehensive Review","authors":"Shameema Farook, Saumya Soni, Arpit Shantagiri, P. Gupta, A. Sinha, M. Prakash","doi":"10.1055/s-0043-1772162","DOIUrl":"https://doi.org/10.1055/s-0043-1772162","url":null,"abstract":"Abstract Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life, and death. The diagnosis of sarcopenia is based on documentation of two of the three criteria: low muscle mass, low muscle strength, and low physical performance. Imaging-based assessment of muscle mass is preferred in both clinical and research settings. Anthropometry for the evaluation of muscle mass is prone to errors and is not recommended in the clinical setting. There is a lack of literature on the radiological assessment of sarcopenia and its association with prognosis in hepatobiliary, pancreatic, and gastrointestinal diseases. Thus, we aim to provide a review of studies that utilized radiological methods to assess sarcopenia and evaluate its impact on outcomes in patients with these diseases.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90060587","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. Chawla, Vasantha Choudhary, P. Morwani, Rajesh Kumar, Aditya Charan
1-month historyofon and offabdominal pain in the epigastric regionthataggravatedinthelast2days.Itwasoftenassociated with nausea, and occasional episodes of vomiting accompanied the pain in the past. It got worse after meals and resolved 1 to 2hours later. Therewas no operativehistoryand presence ofchronicailment.Onphysicalexamination,theabdomenwas soft on palpation. Blood investigations revealed normal complete blood count, serum amylase
{"title":"Left Paraduodenal Hernia and Its Laparoscopic Management","authors":"S. Chawla, Vasantha Choudhary, P. Morwani, Rajesh Kumar, Aditya Charan","doi":"10.1055/s-0043-1771195","DOIUrl":"https://doi.org/10.1055/s-0043-1771195","url":null,"abstract":"1-month historyofon and offabdominal pain in the epigastric regionthataggravatedinthelast2days.Itwasoftenassociated with nausea, and occasional episodes of vomiting accompanied the pain in the past. It got worse after meals and resolved 1 to 2hours later. Therewas no operativehistoryand presence ofchronicailment.Onphysicalexamination,theabdomenwas soft on palpation. Blood investigations revealed normal complete blood count, serum amylase","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81155438","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. Choudhari, S. Kulkarni, N. Shetty, K. Gala, Daksh Chandra, A. Baheti
Abstract Hepatocellular carcinoma (HCC) is a leading cause of morbidity and mortality worldwide, including in India. The incidence of HCC has been rising due to lifestyle diseases such as obesity, diabetes, non-alcoholic fatty liver disease (NAFLD), and alcoholic liver disease (ALD), as well as viral hepatitis infections. Various locoregional therapies (LRTs) are used to treat HCC, including thermal ablation, transarterial therapies, stereotactic body radiotherapy (SBRT), and transarterial radioembolization (TARE). Traditional response evaluation criteria like WHO and RECIST, which rely on size-based measurements, may not accurately assess treatment response to LRTs. To address this limitation, modified response evaluation criteria for solid tumors (mRECIST) and the LI-RADS treatment response algorithm (LR-TRA) have been developed. mRECIST assesses patient-level response, while LR-TRA provides lesion-level response assessment specifically for HCC treated with LRTs. This article discusses the imaging protocols for diagnosing HCC and the imaging appearances of treated lesions after different LRTs. It explains the criteria for categorizing treatment response, such as LR-TR viable, LR-TR non-viable, and LR-TR equivocal. It also highlights the challenges and future directions in response assessment, including the incorporation of ancillary findings, the assessment of patients receiving a combination of locoregional and systemic therapies, and the potential use of biomarkers like serum AFP, AFP-L3, and PIVKA-II. In conclusion, locoregional therapies have expanded the treatment options for HCC, and accurate response assessment is crucial for optimizing patient management. mRECIST and LR-TRA provide valuable tools for evaluating treatment response, and future updates are expected to address specific challenges and incorporate newer approaches like iRECIST and quantitative imaging assessment. Additionally, the use of biomarkers may complement imaging-based response assessment in the future.
{"title":"Response Assessment of Treated Hepatocellular Carcinoma","authors":"A. Choudhari, S. Kulkarni, N. Shetty, K. Gala, Daksh Chandra, A. Baheti","doi":"10.1055/s-0043-1768059","DOIUrl":"https://doi.org/10.1055/s-0043-1768059","url":null,"abstract":"Abstract Hepatocellular carcinoma (HCC) is a leading cause of morbidity and mortality worldwide, including in India. The incidence of HCC has been rising due to lifestyle diseases such as obesity, diabetes, non-alcoholic fatty liver disease (NAFLD), and alcoholic liver disease (ALD), as well as viral hepatitis infections. Various locoregional therapies (LRTs) are used to treat HCC, including thermal ablation, transarterial therapies, stereotactic body radiotherapy (SBRT), and transarterial radioembolization (TARE). Traditional response evaluation criteria like WHO and RECIST, which rely on size-based measurements, may not accurately assess treatment response to LRTs. To address this limitation, modified response evaluation criteria for solid tumors (mRECIST) and the LI-RADS treatment response algorithm (LR-TRA) have been developed. mRECIST assesses patient-level response, while LR-TRA provides lesion-level response assessment specifically for HCC treated with LRTs. This article discusses the imaging protocols for diagnosing HCC and the imaging appearances of treated lesions after different LRTs. It explains the criteria for categorizing treatment response, such as LR-TR viable, LR-TR non-viable, and LR-TR equivocal. It also highlights the challenges and future directions in response assessment, including the incorporation of ancillary findings, the assessment of patients receiving a combination of locoregional and systemic therapies, and the potential use of biomarkers like serum AFP, AFP-L3, and PIVKA-II. In conclusion, locoregional therapies have expanded the treatment options for HCC, and accurate response assessment is crucial for optimizing patient management. mRECIST and LR-TRA provide valuable tools for evaluating treatment response, and future updates are expected to address specific challenges and incorporate newer approaches like iRECIST and quantitative imaging assessment. Additionally, the use of biomarkers may complement imaging-based response assessment in the future.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"27 1","pages":"202 - 211"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81031390","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：