Polish journal of radiology最新文献

Purpose: This study explored the use of computer-aided diagnosis (CAD) systems to enhance mammography image quality and identify potentially suspicious areas, because mammography is the primary method for breast cancer screening. The primary aim was to find the best combination of preprocessing algorithms to enable more precise classification and interpretation of mammography images because the selected preprocessing algorithms significantly impact the effectiveness of later classification and segmentation processes.

Material and methods: The study utilised the mini-MIAS database of mammography images and examined the impact of applying various preprocessing method combinations to differentiate between malignant and benign breast lesions. The preprocessing steps included removing label information and pectoral muscle, followed by applying algorithms such as contrast-limited adaptive histogram equalisation (CLAHE), unsharp masking (USM), and median filtering (MF) to enhance image resolution and visibility. After preprocessing, a k-means clustering technique was used to extract potentially suspicious regions, and features were then extracted from these regions of interest (ROIs). The extracted feature datasets were classified using various machine learning algorithms, including artificial neural networks, random forest, and support vector machines.

Results: The findings showed that the combination of CLAHE, USM, and MF preprocessing algorithms resulted in the highest classification performance, outperforming the use of CLAHE alone.

Conclusions: The integration of advanced preprocessing techniques with machine learning significantly enhances the accuracy of mammography analysis, facilitating more precise differentiation between malignant and benign breast lesions.

Purpose: Isocitrate dehydrogenase (IDH) mutation status serves as a crucial prognostic indicator for glioma, typically assessed via immunohistochemical analysis post-surgery. Given the invasiveness of this approach, perhaps we can utilise convenient and noninvasive magnetic resonance imaging (MRI) methods to predict IDH mutation status. However, the current landscape lacks a standardised MRI technique for accurately predicting IDH mutations. In this study, we explore the potential of MRI diffusion kurtosis imaging (DKI) in forecasting the IDH mutation status of WHO grade II brain gliomas.

Material and methods: Twenty-five patients with WHO grade II gliomas were retrospectively included. Patients underwent routine MRI and DKI scanning before surgery, measuring tumoural solid portion, peritumoral oedema, and normal-appearing white matter (NAWM) DKI parameters, including fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), axial kurtosis (Ka), and axial radial kurtosis (Kr). The DKI parameter corrections were made (tumour or oedema parameters values divided by the NAWM value) to obtain the rFA (ratio of FA), rMD (ratio of MD), rMK (ratio of MK), rKA (ratio of KA), and rKr (ratio of Kr) values. Postoperative specimens were made of wax blocks and analysed by Sanger gene sequencing. DKI parameters between the 2 groups were compared by independent sample t-tests. The ROC curve was used to analyse the diagnostic value of each parameter.

Results: Twenty-five patients were diagnosed with IDH-mutant (16 cases) and IDH-wild type (9 cases). The rFA and rMK values in the parenchymal region of IDH wild-type tumour were higher than those of IDH mutant, while the rMD values were lower than those of IDH mutant, and the difference between them was statistically significant (p < 0.05). The values of DKI parameters of peritumoral oedema in the 2 groups were not statistically significant.

Conclusions: DKI can provide microstructural changes of diseased tissues and provide more imaging information for preoperative non-invasive judgment of IDH mutation status of WHO grade II gliomas. The values of rMK, rFA, and rMD are helpful in the assessment IDH mutation status, benefiting accurate diagnoses and treatment decisions.

Purpose: Recurrent malignant ascites is a common and challenging condition in cancer patients, often lacking a standardized treatment protocol. Small-scale studies in the literature have been insufficient to establish a treatment standard. The aim of our study was to investigate the effectiveness and safety of pigtail peritoneal catheter application in the treatment of malignant ascites.

Material and methods: We conducted a retrospective analysis of patients who had pigtail catheters inserted between January 2017 and December 2022. The study focused on the success rate of the procedure, catheter dwell time, complication rates, and the factors influencing these outcomes.

Results: A total of 196 patients, 102 of whom were female, with malignant ascites were included in the study. The median age was 65.5 years. The procedure had a 100% success rate, with no procedure-related deaths or major complications. The overall minor complication rate, including bleeding, minor cellulitis, leakage, and blockage, was 52%. Patients with comorbidities experienced statistically significantly more complications (p < 0.05). The median catheter dwell time was 31 days (range: 3-181 days).

Conclusions: Pigtail peritoneal catheters provide effective and safe minimally invasive fluid drainage for the treatment of malignant ascites. The most critical factors for preventing procedure-related complications and ensuring procedural success include proper indication, correct timing, procedural expertise, and the involvement of well-trained patients and caregivers.

Purpose: To study the distinct imaging characteristics of parenchymal neurocysticercosis (NCC) that aid in distinguishing it from other diseases.

Material and methods: Two hundred fifty patients with NCC were selected based on identification of the scolex. T2 weighted, T1 fluid attenuated inversion recovery (FLAIR), T2 FLAIR, susceptibility weighted imaging, constructive interference in steady state, diffusion weighted imaging, and T1 weighted contrast sequences were performed. The imaging characteristics of the cysts at various stages were analyzed.

Results: This study presents previously undocumented imaging findings of NCC, establishing absolute, major, and minor criteria for its diagnosis based on magnetic resonance imaging features.

Conclusions: Utilizing imaging criteria for diagnosing NCC, as per the study's sequences, can effectively narrow down differential diagnoses and lead to accurate identification.

Purpose: Monocyte chemoattractant protein-1 (MCP-1/CCL2) plays a key role for infiltration of monocytes/macrophages and studies have demonstrated that the MCP-1/C-C chemokine receptor 2 (CCR2) axis might be involved in the pathogenesis and progression of abdominal aortic aneurysms (AAA). Molecular imaging has shown potential for human clinical research studies. We evaluated the expression of CCR2 in patients with small AAA using single-photon emission computed tomography (SPECT) with the technetium-99m-6-hydrazinylnicotinoyl-C-C-chemokine receptor-2 ligand (^99mTc-HYNIC-CCR2-L).

Material and methods: A pilot study was performed to evaluate patients with small asymptomatic AAA. The equipment used was a Symbia T2 (Siemens, Germany), with radiolabeled ^99mTc-HYNIC-CCR2-L. The SPECT uptake and activity were assessed and counted based on the region of interest (ROI), with nonparametric statistics being employed to compare the aneurysms site, left ventricle (Control 1) and regions with a nondiseased aorta (Control 2).

Results: The three patients were male (100%) (mean age 81 years, and mean AAA maximum diameter of 40 mm, SD 3 mm). All patients tolerated the studies well. Images were obtained at one, two and four hours. The ROI mean value of the aneurysm site was 37,783 (SD 11,890), compared to the left ventricle (Control 1) 16,779 (SD 4397) (p-value = 0.0001); ROI for the nondiseased aortic region (Control 2) was significantly lower, 12,520 (SD 2141) (p-value = 0.0001).

Conclusions: Significant differences of CCR2 expression SPECT were found in the AAA site compared to the left ventricle and nondiseased aortic segments. The introduction of well-designed longitudinal studies with nuclear imaging modalities may assist in the molecular characterization of aneurysmal and rupture prediction.

Intramedullary tumours (IMTs) are the least common neoplasms of the spinal canal. The majority of them are ependymomas and astrocytomas, the third commonest is haemangioblastoma, while other tumours of the spinal cord are relatively rare. This review presents on update on the imaging of spinal cord tumours. Magnetic resonance imaging (MRI) is the imaging method of choice in diagnosing IMTs, with other modalities playing a supplementary role. The authors discuss the MRI protocol in IMTs including advanced techniques and present the imaging features of particular tumours. The differentiation of IMTs from other spinal cord diseases is also presented.

Purpose: The incidence of renal cell carcinoma has been steadily increasing over the past two decades, raising the need for minimally invasive approaches. We sought to present the methodology of the percutaneous cryoablation (PCA) procedure developed based on one year of experience with 81 PCA procedures.

Material and methods: The percutaneous cryoablation programme at Wroclaw Medical University Hospital has been successfully operating for a year. During this period, patients who were ineligible for partial nephrectomy either because of numerous comorbidities or strong preference against surgery were treated with PCA. Each procedure was conducted with the close cooperation of an interventional radiologist and a urologist.

Results: Over the past year, 81 procedures in 74 individuals have been performed and thoroughly analysed. The mean and median effective radiation doses were 12.57 mSv and 10.76 mSv, respectively. Comprehensive details of our workflow are described within the body of the manuscript.

Conclusions: Percutaneous cryoablation is a technically effective treatment approach for carefully selected individuals with small renal masses. However, starting a PCA programme from scratch necessitates creation of detailed protocols, as well as close interventional radiologist and urologist cooperation. This review outlines the established workflow and shares insights gained from one year of experience with percutaneous cryoablation.

Purpose: Diagnosis of perianal fistula represents a challenge for surgeons. It is well known that magnetic resonance imaging (MRI) plays an important role in that. The new 3D MRI sequence VISTA (Volume ISotopic Turbo spin echo Acquisition) can improve detection and characterization of perianal fistula compared with two-dimensional (2D) sequences. The aim of the study was to compare the diagnostic performance of the new 3D MRI sequence VISTA with the widely routinely used T2 FSE pulse sequence in depiction and characterization of perianal fistula by using the contrast-enhanced (CE) 3D T1 sequence THRIVE (T1-weighted high-resolution isotropic volume examination) as a reference standard.

Material and methods: Forty adult patients were enrolled in this prospective study. They underwent MRI perianal region examination using routine T2 TSE and CE 3D T1 sequence THRIVE with addition of the new 3D MRI sequence VISTA. T2, 3D VISTA and (CE) 3D T1 sequence THRIVE images were evaluated by two radiologists separately for detection and characterization of perianal fistula, then comparison between of T2 and 3D VISTA sequences was done using (CE) 3D T1 sequence THRIVE as a reference. Each sequence sensitivity, specificity and accuracy were calculated by both readers.

Results: For reader 1, the sensitivity, specificity and accuracy were 92.5%, 90.5% and 93.6% for 3D VISTA and 84.1%, 83.7% and 87.3% for T2 FSE. For reader 2, the sensitivity, specificity and accuracy were 91.5%, 92.8% and 94.8% for 3D VISTA and 82.9%, 84.5% and 86.7% for T2 FSE.

Conclusions: Using CE 3D T1 sequence THRIVE as the reference standard, 3D VISTA pulse sequence on the perianal region has better diagnostic performance in the detection and characterization of perianal fistula as compared to the routinely used T2 FSE sequence.

This study evaluates diverse educational resources to address the gaps in diagnostic radiology education for medical students, aiming to identify tools that enhance theoretical knowledge and practical diagnostic skills. Employing a multi-faceted review, we analyzed digital platforms, academic databases, and social media for resources beneficial to medical students in radiology, assessing their accessibility, content quality, and educational value. Our investigation uncovered a broad spectrum of resources, from foundational platforms to advanced simulation tools, varying in their approach to teaching radiology. Traditional resources provide essential theoretical knowledge, while digital tools, including interactive case studies and multimedia content, offer immersive learning experiences. Notably, resources integrating machine learning and social media facilitate dynamic, peer-to-peer learning and up-to-date case discussions. Despite the minimal current focus on VR, its role in enhancing interactive learning is notable. The diversity in educational tools highlights the evolving nature of radiology education, reflecting a shift towards more engaging and practical learning methodologies. Identifying and integrating a variety of educational resources into radiology education can significantly enhance learning outcomes for medical students, preparing them for the complexities of modern diagnostic radiology with a well-rounded educational approach.