Pub Date : 2024-04-26DOI: 10.1016/j.redii.2024.100048
Youssef Zaarour , Haytham Derbel , Charles Tran , Laetitia Saccentia , Benjamin Longère , Maxime Blain , Giuliana Amaddeo , Alain Luciani , Hicham Kobeiter , Vania Tacher
Rationale and objectives
A new microcatheter was recently developed claiming to reduce beads reflux in drug-eluting bead transarterial chemoembolization (DEB-TACE). The aim of this study was to compare the reflux control microcatheter ability versus a standard microcatheter for TACE treatment in patients with hepatocellular carcinoma.
Material and methods
Patients were prospectively included between November 2017 and February 2022. They received a DEB-TACE treatment with charged radiopaque beads using standard microcatheters or the SeQure reflux control microcatheter (Guerbet, France) and were assigned respectively to a control and a test group. Beads distribution mismatch was evaluated between the targeted territory on treatment planning CBCT and beads’ spontaneous opacities on the post-intervention CBCT and the 1-month CT scanner.
Results
Twenty-three patients (21 men, median age 64 years [12.5 years]) with 37 hepatocellular carcinoma nodules were treated. The control group consisted of 13 patients – 19 nodules, while the test group included ten patients - 18 nodules. Non target embolization (NTE) was found in 20 % (2/10) of patients in the test group and 85 % (11/13) in the control group. NTE involved only an adjacent segment in the test group while it affected the adjacent biliary sector or even the contralateral liver lobe in the control group. No complication linked to NTE was found in the test group, while it led to one case of ischemic cholangitis and another case of biloma in the control group.
Conclusion
The reflux control microcatheter may be efficient in reducing NTE and thus eventual adverse events in comparison to standard of care end-hole microcatheters.
{"title":"Evaluation of a new beads reflux control microcatheter in drug-eluting bead transarterial chemoembolization","authors":"Youssef Zaarour , Haytham Derbel , Charles Tran , Laetitia Saccentia , Benjamin Longère , Maxime Blain , Giuliana Amaddeo , Alain Luciani , Hicham Kobeiter , Vania Tacher","doi":"10.1016/j.redii.2024.100048","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100048","url":null,"abstract":"<div><h3>Rationale and objectives</h3><p>A new microcatheter was recently developed claiming to reduce beads reflux in drug-eluting bead transarterial chemoembolization (DEB-TACE). The aim of this study was to compare the reflux control microcatheter ability versus a standard microcatheter for TACE treatment in patients with hepatocellular carcinoma.</p></div><div><h3>Material and methods</h3><p>Patients were prospectively included between November 2017 and February 2022. They received a DEB-TACE treatment with charged radiopaque beads using standard microcatheters or the SeQure reflux control microcatheter (Guerbet, France) and were assigned respectively to a control and a test group. Beads distribution mismatch was evaluated between the targeted territory on treatment planning CBCT and beads’ spontaneous opacities on the post-intervention CBCT and the 1-month CT scanner.</p></div><div><h3>Results</h3><p>Twenty-three patients (21 men, median age 64 years [12.5 years]) with 37 hepatocellular carcinoma nodules were treated. The control group consisted of 13 patients – 19 nodules, while the test group included ten patients - 18 nodules. Non target embolization (NTE) was found in 20 % (2/10) of patients in the test group and 85 % (11/13) in the control group. NTE involved only an adjacent segment in the test group while it affected the adjacent biliary sector or even the contralateral liver lobe in the control group. No complication linked to NTE was found in the test group, while it led to one case of ischemic cholangitis and another case of biloma in the control group.</p></div><div><h3>Conclusion</h3><p>The reflux control microcatheter may be efficient in reducing NTE and thus eventual adverse events in comparison to standard of care end-hole microcatheters.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"10 ","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000097/pdfft?md5=edeb8f240b5ccf0e9a313e6ce1bdde90&pid=1-s2.0-S2772652524000097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140646782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess the efficacy of the gelatin torpedoes embolization technique after lung neoplastic lesions percutaneous radiofrequency ablation (PRFA) to reduce chest tube placement rate and hospital length of stay, and the safety of this embolization technique.
Materials and methods
A total of 114 PRFA of lung neoplastic lesions performed in two centers between January 2017 and December 2022 were retrospectively reviewed. Two groups were compared, with 42 PRFA with gelatin torpedoes embolization technique (gelatin group) and 72 procedures without (control group). Procedures were performed by one of seven interventional radiologists using LeVeen CoAccess™ probe. Multivariate analyses were performed to identify risk factors for chest tube placement and hospital length of stay.
Results
There was a significantly lower chest tube placement rate in the gelatin group compared to the control group (3 [7.1 %] vs. 27 [37.5 %], p < 0,001). Multivariate analysis showed a significant association between chest tube placement and gelatin torpedoes embolization technique (OR: 0.09; 95 % CI: 0.02–0.32; p = 0.0006). No significant difference was found in hospital length of stay between the two groups. Multivariate analysis did not show a significant relationship between hospital length of stay and gelatin torpedoes embolization technique. No embolic complication occurred in the gelatin group.
Conclusion
Gelatin torpedoes embolization technique after PRFA of lung neoplastic lesions resulted in significantly reduced chest tube placement rate in our patient population. No significant reduction in hospital length of stay was observed. No major complication occurred in the gelatin group.
{"title":"Chest tube placement incidence when using gelatin sponge torpedoes after pulmonary radiofrequency ablation","authors":"Pauline Graveleau , Éric Frampas , Christophe Perret , Stéphanie Volpi , François-Xavier Blanc , Thomas Goronflot , Renan Liberge","doi":"10.1016/j.redii.2024.100047","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100047","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the efficacy of the gelatin torpedoes embolization technique after lung neoplastic lesions percutaneous radiofrequency ablation (PRFA) to reduce chest tube placement rate and hospital length of stay, and the safety of this embolization technique.</p></div><div><h3>Materials and methods</h3><p>A total of 114 PRFA of lung neoplastic lesions performed in two centers between January 2017 and December 2022 were retrospectively reviewed. Two groups were compared, with 42 PRFA with gelatin torpedoes embolization technique (gelatin group) and 72 procedures without (control group). Procedures were performed by one of seven interventional radiologists using LeVeen CoAccess™ probe. Multivariate analyses were performed to identify risk factors for chest tube placement and hospital length of stay.</p></div><div><h3>Results</h3><p>There was a significantly lower chest tube placement rate in the gelatin group compared to the control group (3 [7.1 %] vs. 27 [37.5 %], <em>p</em> < 0,001). Multivariate analysis showed a significant association between chest tube placement and gelatin torpedoes embolization technique (OR: 0.09; 95 % CI: 0.02–0.32; <em>p</em> = 0.0006). No significant difference was found in hospital length of stay between the two groups. Multivariate analysis did not show a significant relationship between hospital length of stay and gelatin torpedoes embolization technique. No embolic complication occurred in the gelatin group.</p></div><div><h3>Conclusion</h3><p>Gelatin torpedoes embolization technique after PRFA of lung neoplastic lesions resulted in significantly reduced chest tube placement rate in our patient population. No significant reduction in hospital length of stay was observed. No major complication occurred in the gelatin group.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"10 ","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000085/pdfft?md5=725b1046861ea7f764a7a3b33aab91c1&pid=1-s2.0-S2772652524000085-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140644325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.1016/j.redii.2024.100045
Annie-Lyne Petit , Rabih Alwan , Julien Behr , Paul Calame , Marion Lenoir , Hubert Ducou le Pointe , Éric Delabrousse
Background
Abdominal radiographs remain useful in newborns. Given the high radiation sensitivity of this population, it is necessary to optimize acquisition techniques to minimize radiation exposure.
Objective
Evaluate the effects of three additional filtrations on radiation dose and image quality in abdominal X-rays of newborns using an anthropomorphic phantom.
Material and method
Abdominal radiographs of an anthropomorphic newborn phantom were performed using acquisition parameters ranging from 55 to 70 kV and from 0.4 to 2.5 mAs, without and with three different additional filtrations: 0.1 mm copper (Cu) + 1 mm aluminum (Al), 0.2 mm copper + 1 mm aluminum, and 2 mm aluminum. For each X-ray the dose area product (DAP) was measured, the signal-to-noise ratio (SNR) was calculated, and image quality (IQ) was evaluated by two blinded radiologists using the absolute visual grading analysis (VGA) method.
Results
Adding an additional filtration resulted in a significant reduction in DAP, with a decrease of 42% using 2 mm Al filtration, 65% with 0.1 mm Cu + 1 mm Al filtration, and 78% with 0.2 mm Cu + 1 mm Al filtration (p < 0.01). The addition of 2 mm aluminum filtration does not significantly decrease the SNR (p = 0.31), CNR (p = 0.52) or the IQ (p = 0.12 and 0.401 for reader 1 and 2, respectively). However, adding copper-containing filtration leads to a significant decrease in, SNR, CNR and IQ.
Conclusion
Adding a 2 mm Al additional filtration for abdominal radiographs in newborns can significantly reduce the radiation dose without causing a significant decrease in image quality.
{"title":"Dose optimization in newborn abdominal radiography: Assessing the added value of additional filtration on radiation dose and image quality using an anthropomorphic phantom","authors":"Annie-Lyne Petit , Rabih Alwan , Julien Behr , Paul Calame , Marion Lenoir , Hubert Ducou le Pointe , Éric Delabrousse","doi":"10.1016/j.redii.2024.100045","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100045","url":null,"abstract":"<div><h3>Background</h3><p>Abdominal radiographs remain useful in newborns. Given the high radiation sensitivity of this population, it is necessary to optimize acquisition techniques to minimize radiation exposure.</p></div><div><h3>Objective</h3><p>Evaluate the effects of three additional filtrations on radiation dose and image quality in abdominal X-rays of newborns using an anthropomorphic phantom.</p></div><div><h3>Material and method</h3><p>Abdominal radiographs of an anthropomorphic newborn phantom were performed using acquisition parameters ranging from 55 to 70 kV and from 0.4 to 2.5 mAs, without and with three different additional filtrations: 0.1 mm copper (Cu) + 1 mm aluminum (Al), 0.2 mm copper + 1 mm aluminum, and 2 mm aluminum. For each X-ray the dose area product (DAP) was measured, the signal-to-noise ratio (SNR) was calculated, and image quality (IQ) was evaluated by two blinded radiologists using the absolute visual grading analysis (VGA) method.</p></div><div><h3>Results</h3><p>Adding an additional filtration resulted in a significant reduction in DAP, with a decrease of 42% using 2 mm Al filtration, 65% with 0.1 mm Cu + 1 mm Al filtration, and 78% with 0.2 mm Cu + 1 mm Al filtration (<em>p</em> < 0.01). The addition of 2 mm aluminum filtration does not significantly decrease the SNR (<em>p</em> = 0.31), CNR (<em>p</em> = 0.52) or the IQ (<em>p</em> = 0.12 and 0.401 for reader 1 and 2, respectively). However, adding copper-containing filtration leads to a significant decrease in, SNR, CNR and IQ.</p></div><div><h3>Conclusion</h3><p>Adding a 2 mm Al additional filtration for abdominal radiographs in newborns can significantly reduce the radiation dose without causing a significant decrease in image quality.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"10 ","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000061/pdfft?md5=74dae0f6a82cde59ddb22e12c46456d8&pid=1-s2.0-S2772652524000061-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140640922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-invasive subtyping of hepatocellular adenomas (HCA) remains challenging for several subtypes, thus carrying different levels of risks and management. The goal of this study is to devise a multivariable diagnostic model based on basic clinical features (age and sex) combined with MRI-radiomics and to evaluate its diagnostic performance.
Methods
This single-center retrospective case-control study included all consecutive patients with HCA identified within the pathological database from our institution from January 2003 to April 2018 with MRI examination (T2, T1-no injection/injection-arterial-portal); volumes of interest were manually delineated in adenomas and 38 textural features were extracted (LIFEx, v5.10). Qualitative (i.e., visual on MRI) and automatic (computer-assisted) analysis were compared. The prognostic scores of a multivariable diagnostic model based on basic clinical features (age and sex) combined with MRI-radiomics (tumor volume and texture features) were assessed using a cross-validated Random Forest algorithm.
Results
Via visual MR-analysis, HCA subgroups could be classified with balanced accuracies of 80.8 % (I-HCA or ß-I-HCA, the two being indistinguishable), 81.8 % (H-HCA) and 74.4 % (sh-HCA or ß-HCA also indistinguishable). Using a model including age, sex, volume and texture variables, HCA subgroups were predicted (multivariate classification) with an averaged balanced accuracy of 58.6 %, best=73.8 % (sh-HCA) and 71.9 % (ß-HCA). I-HCA and ß-I-HCA could be also distinguished (binary classification) with a balanced accuracy of 73 %.
Conclusion
Multiple HCA subtyping could be improved using machine-learning algorithms including two clinical features, i.e., age and sex, combined with MRI-radiomics. Future HCA studies enrolling more patients will further test the validity of the model.
{"title":"Assessment of a multivariable model using MRI-radiomics, age and sex for the classification of hepatocellular adenoma subtypes","authors":"Guillaume Declaux , Baudouin Denis de Senneville , Hervé Trillaud , Paulette Bioulac-Sage , Charles Balabaud , Jean-Frédéric Blanc , Laurent Facq , Nora Frulio","doi":"10.1016/j.redii.2024.100046","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100046","url":null,"abstract":"<div><h3>Objectives</h3><p>Non-invasive subtyping of hepatocellular adenomas (HCA) remains challenging for several subtypes, thus carrying different levels of risks and management. The goal of this study is to devise a multivariable diagnostic model based on basic clinical features (age and sex) combined with MRI-radiomics and to evaluate its diagnostic performance.</p></div><div><h3>Methods</h3><p>This single-center retrospective case-control study included all consecutive patients with HCA identified within the pathological database from our institution from January 2003 to April 2018 with MRI examination (T2, T1-no injection/injection-arterial-portal); volumes of interest were manually delineated in adenomas and 38 textural features were extracted (LIFEx, v5.10). Qualitative (i.e., visual on MRI) and automatic (computer-assisted) analysis were compared. The prognostic scores of a multivariable diagnostic model based on basic clinical features (age and sex) combined with MRI-radiomics (tumor volume and texture features) were assessed using a cross-validated Random Forest algorithm.</p></div><div><h3>Results</h3><p>Via visual MR-analysis, HCA subgroups could be classified with balanced accuracies of 80.8 % (I-HCA or ß-I-HCA, the two being indistinguishable), 81.8 % (H-HCA) and 74.4 % (sh-HCA or ß-HCA also indistinguishable). Using a model including age, sex, volume and texture variables, HCA subgroups were predicted (multivariate classification) with an averaged balanced accuracy of 58.6 %, best=73.8 % (sh-HCA) and 71.9 % (ß-HCA). I-HCA and ß-I-HCA could be also distinguished (binary classification) with a balanced accuracy of 73 %.</p></div><div><h3>Conclusion</h3><p>Multiple HCA subtyping could be improved using machine-learning algorithms including two clinical features, i.e., age and sex, combined with MRI-radiomics. Future HCA studies enrolling more patients will further test the validity of the model.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"10 ","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000073/pdfft?md5=94bef060382e3f1b831777f568634901&pid=1-s2.0-S2772652524000073-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.redii.2024.100042
Lorenzo Carlo Pescatori , Athena Galletto Pregliasco , Haytham Derbel , Laetitia Saccenti , Mario Ghosn , Maxime Blain , Julia Chalayea , Alain Luciani , Sebastien Mulé , Giuliana Amaddeo , Hicham Kobeiter , Vania Tacher
Purpose
The aim of this study was to report the safety and tumor response rate of combined transarterial radioembolization (TARE) through the intrahepatic arteries and transarterial chemoembolization (TACE) through the extrahepatic feeding arteries (EHFA) in patients with hepatocellular carcinoma (HCC).
Methods
Patients with HCC, who had both intrahepatic and extrahepatic arterial supply visible on preinterventional multiphase CT and were treated between 2016 and 2021 with a combination of TACE and TARE on the same nodule, were retrospectively included. Epidemiological, clinical, biological, and radiological characteristics were recorded. Safety and tumor response were assessed at 6 months.
Results
Nine patients (8 men, median age 62 years [IQR: 54–72 years]) were included. Seven patients had previous treatments on the target nodule (TARE: 5; TACE: 2). The median longest axis (LA) of the lesion was 70 mm (IQR: 60–79 mm). Three patients had portal vein invasion (VP3). The EHFA originated from the right diaphragmatic artery (n = 6), the right adrenal artery (n = 2), and the left gastric artery (n = 1). The LA of the tumor portion treated with TACE was 47 mm (range: 35–64 mm). The ratio between the LA of the entire lesion and the LA treated with TACE was 1.44 (range: 1.27–1.7). One major complication occurred: acute on chronic liver failure. Median follow-up was 23 months (range: 16–29 months). Seven patients underwent further treatment: on the same lesion (n = 2), on newly appeared nodules (n = 2), and systemic treatment (n = 3). At 6-month follow-up, seven patients showed a local objective response. Time-to-progression was 13 (3.5–19) months.
Conclusion
The combination of TARE and extrahepatic TACE for HCC with both intrahepatic and extrahepatic arterial supplies seems feasible and safe. Further studies are needed to validate the effectiveness of these preliminary results.
{"title":"Combination of intrahepatic TARE and extrahepatic TACE to treat HCC patients with extrahepatic artery supply: A case series","authors":"Lorenzo Carlo Pescatori , Athena Galletto Pregliasco , Haytham Derbel , Laetitia Saccenti , Mario Ghosn , Maxime Blain , Julia Chalayea , Alain Luciani , Sebastien Mulé , Giuliana Amaddeo , Hicham Kobeiter , Vania Tacher","doi":"10.1016/j.redii.2024.100042","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100042","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to report the safety and tumor response rate of combined transarterial radioembolization (TARE) through the intrahepatic arteries and transarterial chemoembolization (TACE) through the extrahepatic feeding arteries (EHFA) in patients with hepatocellular carcinoma (HCC).</p></div><div><h3>Methods</h3><p>Patients with HCC, who had both intrahepatic and extrahepatic arterial supply visible on preinterventional multiphase CT and were treated between 2016 and 2021 with a combination of TACE and TARE on the same nodule, were retrospectively included. Epidemiological, clinical, biological, and radiological characteristics were recorded. Safety and tumor response were assessed at 6 months.</p></div><div><h3>Results</h3><p>Nine patients (8 men, median age 62 years [IQR: 54–72 years]) were included. Seven patients had previous treatments on the target nodule (TARE: 5; TACE: 2). The median longest axis (LA) of the lesion was 70 mm (IQR: 60–79 mm). Three patients had portal vein invasion (VP3). The EHFA originated from the right diaphragmatic artery (<em>n</em> = 6), the right adrenal artery (<em>n</em> = 2), and the left gastric artery (<em>n</em> = 1). The LA of the tumor portion treated with TACE was 47 mm (range: 35–64 mm). The ratio between the LA of the entire lesion and the LA treated with TACE was 1.44 (range: 1.27–1.7). One major complication occurred: acute on chronic liver failure. Median follow-up was 23 months (range: 16–29 months). Seven patients underwent further treatment: on the same lesion (<em>n</em> = 2), on newly appeared nodules (<em>n</em> = 2), and systemic treatment (<em>n</em> = 3). At 6-month follow-up, seven patients showed a local objective response. Time-to-progression was 13 (3.5–19) months.</p></div><div><h3>Conclusion</h3><p>The combination of TARE and extrahepatic TACE for HCC with both intrahepatic and extrahepatic arterial supplies seems feasible and safe. Further studies are needed to validate the effectiveness of these preliminary results.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"9 ","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000036/pdfft?md5=7ee5a08ff6fac05f8e0be16d189510e3&pid=1-s2.0-S2772652524000036-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.redii.2024.100044
Shahriar Faghani , Rhodes G. Nicholas , Soham Patel , Francis I. Baffour , Mana Moassefi , Pouria Rouzrokh , Bardia Khosravi , Garret M. Powell , Shuai Leng , Katrina N. Glazebrook , Bradley J. Erickson , Christin A. Tiegs-Heiden
Background
Dual-energy CT (DECT) is a non-invasive way to determine the presence of monosodium urate (MSU) crystals in the workup of gout. Color-coding distinguishes MSU from calcium following material decomposition and post-processing. Most software labels MSU as green and calcium as blue. There are limitations in the current image processing methods of segmenting green-encoded pixels. Additionally, identifying green foci is tedious, and automated detection would improve workflow. This study aimed to determine the optimal deep learning (DL) algorithm for segmenting green-encoded pixels of MSU crystals on DECTs.
Methods
DECT images of positive and negative gout cases were retrospectively collected. The dataset was split into train (N = 28) and held-out test (N = 30) sets. To perform cross-validation, the train set was split into seven folds. The images were presented to two musculoskeletal radiologists, who independently identified green-encoded voxels. Two 3D Unet-based DL models, Segresnet and SwinUNETR, were trained, and the Dice similarity coefficient (DSC), sensitivity, and specificity were reported as the segmentation metrics.
Results
Segresnet showed superior performance, achieving a DSC of 0.9999 for the background pixels, 0.7868 for the green pixels, and an average DSC of 0.8934 for both types of pixels, respectively. According to the post-processed results, the Segresnet reached voxel-level sensitivity and specificity of 98.72 % and 99.98 %, respectively.
Conclusion
In this study, we compared two DL-based segmentation approaches for detecting MSU deposits in a DECT dataset. The Segresnet resulted in superior performance metrics. The developed algorithm provides a potential fast, consistent, highly sensitive and specific computer-aided diagnosis tool. Ultimately, such an algorithm could be used by radiologists to streamline DECT workflow and improve accuracy in the detection of gout.
{"title":"Development of a deep learning model for the automated detection of green pixels indicative of gout on dual energy CT scan","authors":"Shahriar Faghani , Rhodes G. Nicholas , Soham Patel , Francis I. Baffour , Mana Moassefi , Pouria Rouzrokh , Bardia Khosravi , Garret M. Powell , Shuai Leng , Katrina N. Glazebrook , Bradley J. Erickson , Christin A. Tiegs-Heiden","doi":"10.1016/j.redii.2024.100044","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100044","url":null,"abstract":"<div><h3>Background</h3><p>Dual-energy CT (DECT) is a non-invasive way to determine the presence of monosodium urate (MSU) crystals in the workup of gout. Color-coding distinguishes MSU from calcium following material decomposition and post-processing. Most software labels MSU as green and calcium as blue. There are limitations in the current image processing methods of segmenting green-encoded pixels. Additionally, identifying green foci is tedious, and automated detection would improve workflow. This study aimed to determine the optimal deep learning (DL) algorithm for segmenting green-encoded pixels of MSU crystals on DECTs.</p></div><div><h3>Methods</h3><p>DECT images of positive and negative gout cases were retrospectively collected. The dataset was split into train (<em>N</em> = 28) and held-out test (<em>N</em> = 30) sets. To perform cross-validation, the train set was split into seven folds. The images were presented to two musculoskeletal radiologists, who independently identified green-encoded voxels. Two 3D Unet-based DL models, Segresnet and SwinUNETR, were trained, and the Dice similarity coefficient (DSC), sensitivity, and specificity were reported as the segmentation metrics.</p></div><div><h3>Results</h3><p>Segresnet showed superior performance, achieving a DSC of 0.9999 for the background pixels, 0.7868 for the green pixels, and an average DSC of 0.8934 for both types of pixels, respectively. According to the post-processed results, the Segresnet reached voxel-level sensitivity and specificity of 98.72 % and 99.98 %, respectively.</p></div><div><h3>Conclusion</h3><p>In this study, we compared two DL-based segmentation approaches for detecting MSU deposits in a DECT dataset. The Segresnet resulted in superior performance metrics. The developed algorithm provides a potential fast, consistent, highly sensitive and specific computer-aided diagnosis tool. Ultimately, such an algorithm could be used by radiologists to streamline DECT workflow and improve accuracy in the detection of gout.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"9 ","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277265252400005X/pdfft?md5=66437ac222a529dcf1593eee24ff8ef8&pid=1-s2.0-S277265252400005X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of inspiration level on lung nodule volumetry","authors":"Arnaud Halter, Aïssam Labani, Catherine Roy, Mickaël Ohana","doi":"10.1016/j.redii.2024.100043","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100043","url":null,"abstract":"","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"9 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000048/pdfft?md5=3c5b28a086d78aa81a899ca63bcc23a5&pid=1-s2.0-S2772652524000048-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.redii.2024.100041
Sebastian Karpinski , Zamzam AL Bimani , Jessica L. Dobson , Wanzhen Zeng
Purpose
In lung cancer patients, the distinction between synchronous primary lung cancer and intrapulmonary metastasis can be challenging. The intensity of FDG uptake in pulmonary lesions has been shown to be potentially useful in classifying synchronous lung cancer. The aim of this retrospective study is to investigate the effectiveness of FDG uptake in differentiating metastases from synchronous primary lesions in the setting of lung cancer.
Methods
Consecutive patients with primary lung cancer with two or more malignant lung lesions referred for (18F)-FDG PET-CT imaging between 2010 and 2019 were reviewed and classified into synchronous and metastasis groups. Lesional maximum standardized uptake values (SUVmax), relative differences in SUVmax and SUVmax ratios were calculated and compared using receiver operating characteristic (ROC) curve analysis. Intra-group correlation in SUVmax between lesion pairs was examined using Pearson's and Spearman's correlation analysis.
Results
94 patients were included for analysis, divided into synchronous (n = 62; 68 lesion pairs) and metastasis (n = 32; 33 lesion pairs) groups. The correlation of FDG uptake between lesions in the metastasis group was strong (r = 0.81). A significant difference in mean relative difference in SUVmax (synchronous: 0.50±0.23 metastasis: 0.34±0.17, p = 0.001) and mean SUVmax ratio (synchronous: 2.6 ± 1.7 metastasis: 1.7 ± 0.6, p < 0.001) was observed. ROC analysis revealed a fair AUC (0.71–0.72) for these parameters, with an associated sensitivity of 59 % and specificity of 82 % at optimal cut-off values.
Conclusion
Differences in FDG uptake intensity among multiple synchronously presenting malignant nodules may be helpful to distinguish second primary lung tumours from metastatic spread.
{"title":"FDG uptake of pulmonary lesions in synchronous primary lung cancers and lung metastases","authors":"Sebastian Karpinski , Zamzam AL Bimani , Jessica L. Dobson , Wanzhen Zeng","doi":"10.1016/j.redii.2024.100041","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100041","url":null,"abstract":"<div><h3>Purpose</h3><p>In lung cancer patients, the distinction between synchronous primary lung cancer and intrapulmonary metastasis can be challenging. The intensity of FDG uptake in pulmonary lesions has been shown to be potentially useful in classifying synchronous lung cancer. The aim of this retrospective study is to investigate the effectiveness of FDG uptake in differentiating metastases from synchronous primary lesions in the setting of lung cancer.</p></div><div><h3>Methods</h3><p>Consecutive patients with primary lung cancer with two or more malignant lung lesions referred for (<sup>18</sup>F)-FDG PET-CT imaging between 2010 and 2019 were reviewed and classified into synchronous and metastasis groups. Lesional maximum standardized uptake values (SUV<sub>max</sub>), relative differences in SUV<sub>max</sub> and SUV<sub>max</sub> ratios were calculated and compared using receiver operating characteristic (ROC) curve analysis. Intra-group correlation in SUV<sub>max</sub> between lesion pairs was examined using Pearson's and Spearman's correlation analysis.</p></div><div><h3>Results</h3><p>94 patients were included for analysis, divided into synchronous (<em>n</em> = 62; 68 lesion pairs) and metastasis (<em>n</em> = 32; 33 lesion pairs) groups. The correlation of FDG uptake between lesions in the metastasis group was strong (<em>r</em> = 0.81). A significant difference in mean relative difference in SUV<sub>max</sub> (synchronous: 0.50±0.23 metastasis: 0.34±0.17, <em>p</em> = 0.001) and mean SUV<sub>max</sub> ratio (synchronous: 2.6 ± 1.7 metastasis: 1.7 ± 0.6, <em>p</em> < 0.001) was observed. ROC analysis revealed a fair AUC (0.71–0.72) for these parameters, with an associated sensitivity of 59 % and specificity of 82 % at optimal cut-off values.</p></div><div><h3>Conclusion</h3><p>Differences in FDG uptake intensity among multiple synchronously presenting malignant nodules may be helpful to distinguish second primary lung tumours from metastatic spread.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"9 ","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000024/pdfft?md5=3928493c6206c24f4ba9218cce673a0d&pid=1-s2.0-S2772652524000024-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.redii.2024.100040
Shenghua Zhu , Ramin Akbarian Aghdam , Sophia Liu , Rebecca E. Thornhill , Wanzhen Zeng
Background
Recent studies have shown that an increased number of axillary lymph node metastases is associated with non-visualized lymph nodes. The purpose of the study was to retrospectively analyze the incidence and characteristics of non-visualized sentinel lymph nodes (SLNs) in nodal metastases in breast cancer patients.
Methods
Consecutive women with breast cancer referred for lymphoscintigraphy from January 2021 to November 2022 were reviewed retrospectively. Findings from resected SLNs and non-SLNs and relevant histopathology were collected and analyzed.
Results
500 patients diagnosed with breast cancer were reviewed, excluding 93 patients due to neoadjuvant therapy, DCIS, recurrence, or incomplete clinical documentation. Of the 407 remaining patients, 108 patients were positive for axillary lymph node metastases (24 %) and were the focus of the study. Of this patient cohort, 38 patients (35 %) had non-detected SLNs by intraoperative gamma probe and 43 (40 %) had non-visualized SLNs by lymphoscintigraphy. There was statistically significant difference in primary tumor size (39.8 mm versus 28.9 mm), number of resected (6.9 ± 4.4 versus 4.6 ± 2.4) and positive (3.4 ± 2.2 versus 1.6 ± 1.3) lymph nodes, size (13.8 ± 6.1 mm versus 8.1 ± 4.5 mm), tumor grade and tumor stage between the SLN non-visualized and visualized groups. The multivariate logistic regression analysis showed that only lymph node size and number of lymph nodes resected were independent factors associated with SLN non-visualization.
Conclusions
We reported a high non-visualization rate of SLN in breast cancer patients with pathology-proven positive axillary nodes. The causes of the SLN non-visualization are not well understood and warrants further exploration.
{"title":"Non-visualization of axillary pathological lymph nodes in breast cancer patients on SPECT/CT and during operation","authors":"Shenghua Zhu , Ramin Akbarian Aghdam , Sophia Liu , Rebecca E. Thornhill , Wanzhen Zeng","doi":"10.1016/j.redii.2024.100040","DOIUrl":"https://doi.org/10.1016/j.redii.2024.100040","url":null,"abstract":"<div><h3>Background</h3><p>Recent studies have shown that an increased number of axillary lymph node metastases is associated with non-visualized lymph nodes. The purpose of the study was to retrospectively analyze the incidence and characteristics of non-visualized sentinel lymph nodes (SLNs) in nodal metastases in breast cancer patients.</p></div><div><h3>Methods</h3><p>Consecutive women with breast cancer referred for lymphoscintigraphy from January 2021 to November 2022 were reviewed retrospectively. Findings from resected SLNs and non-SLNs and relevant histopathology were collected and analyzed.</p></div><div><h3>Results</h3><p>500 patients diagnosed with breast cancer were reviewed, excluding 93 patients due to neoadjuvant therapy, DCIS, recurrence, or incomplete clinical documentation. Of the 407 remaining patients, 108 patients were positive for axillary lymph node metastases (24 %) and were the focus of the study. Of this patient cohort, 38 patients (35 %) had non-detected SLNs by intraoperative gamma probe and 43 (40 %) had non-visualized SLNs by lymphoscintigraphy. There was statistically significant difference in primary tumor size (39.8 mm versus 28.9 mm), number of resected (6.9 ± 4.4 versus 4.6 ± 2.4) and positive (3.4 ± 2.2 versus 1.6 ± 1.3) lymph nodes, size (13.8 ± 6.1 mm versus 8.1 ± 4.5 mm), tumor grade and tumor stage between the SLN non-visualized and visualized groups. The multivariate logistic regression analysis showed that only lymph node size and number of lymph nodes resected were independent factors associated with SLN non-visualization.</p></div><div><h3>Conclusions</h3><p>We reported a high non-visualization rate of SLN in breast cancer patients with pathology-proven positive axillary nodes. The causes of the SLN non-visualization are not well understood and warrants further exploration.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"9 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652524000012/pdfft?md5=3bc87f83c922eeb243331a60bae19db5&pid=1-s2.0-S2772652524000012-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-07DOI: 10.1016/j.redii.2023.100039
Kathryn McGillen , Nabeal Aljabban , Robert Wu , Benjamin Shin , Ian Schreibman , Franklin Luke , James Birkholz
Objective
Screening ultrasound for hepatocellular carcinoma (HCC) identifies lesions which require further characterization by a contrast-enhanced exam to non-invasively diagnose HCC. While ultrasound is recommended in screening, some HCC can be occult on grayscale imaging. The purpose of this study was to determine if the addition of ultrasound contrast (sulfahexafluoride) to screening ultrasound for HCC can identify more HCC lesions than grayscale sonographic imaging alone.
Methods
All HCC screening ultrasounds that also had contrast were evaluated in this retrospective study. Patients with a focal lesion seen only after administration of contrast (OAC) were noted, as well as any follow-up imaging or pathology results. Additional variables collected included patient demographics, cirrhosis type, and laboratory values.
Results
230 unique patients were included, of which 160 had imaging or pathology follow-up. 18 of these patients had an OAC lesion, of which 17 had follow-up. Among these OACs, there was one LIRADS M lesion (1/18, 5.6 %) and one bland portal vein thrombus identified, which were both confirmed on follow-up imaging. All LIRADS 4 OAC lesions were downgraded. No additional HCC were identified on follow-up imaging or pathology of these patients.
Conclusion
Addition of contrast to screening ultrasound did identify additional lesions, portal vein thrombus, and high grade malignancy. However, as the incidence of OAC lesions was low (7.8 %, 18/230) and most of the lesions were not malignant, addition of post contrast sweeps through the liver is of low value in the low to medium at-risk cirrhotic population in identifying occult HCC.
{"title":"Addition of contrast in ultrasound screening for hepatocellular carcinoma","authors":"Kathryn McGillen , Nabeal Aljabban , Robert Wu , Benjamin Shin , Ian Schreibman , Franklin Luke , James Birkholz","doi":"10.1016/j.redii.2023.100039","DOIUrl":"https://doi.org/10.1016/j.redii.2023.100039","url":null,"abstract":"<div><h3>Objective</h3><p>Screening ultrasound for hepatocellular carcinoma (HCC) identifies lesions which require further characterization by a contrast-enhanced exam to non-invasively diagnose HCC. While ultrasound is recommended in screening, some HCC can be occult on grayscale imaging. The purpose of this study was to determine if the addition of ultrasound contrast (sulfahexafluoride) to screening ultrasound for HCC can identify more HCC lesions than grayscale sonographic imaging alone.</p></div><div><h3>Methods</h3><p>All HCC screening ultrasounds that also had contrast were evaluated in this retrospective study. Patients with a focal lesion seen only after administration of contrast (OAC) were noted, as well as any follow-up imaging or pathology results. Additional variables collected included patient demographics, cirrhosis type, and laboratory values.</p></div><div><h3>Results</h3><p>230 unique patients were included, of which 160 had imaging or pathology follow-up. 18 of these patients had an OAC lesion, of which 17 had follow-up. Among these OACs, there was one LIRADS M lesion (1/18, 5.6 %) and one bland portal vein thrombus identified, which were both confirmed on follow-up imaging. All LIRADS 4 OAC lesions were downgraded. No additional HCC were identified on follow-up imaging or pathology of these patients.</p></div><div><h3>Conclusion</h3><p>Addition of contrast to screening ultrasound did identify additional lesions, portal vein thrombus, and high grade malignancy. However, as the incidence of OAC lesions was low (7.8 %, 18/230) and most of the lesions were not malignant, addition of post contrast sweeps through the liver is of low value in the low to medium at-risk cirrhotic population in identifying occult HCC.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"9 ","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772652523000182/pdfft?md5=45ff1f5c2f11de69586c2f7ff8c67cb7&pid=1-s2.0-S2772652523000182-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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