Polish journal of radiology最新文献

Secondary iron overload in pediatric oncology patients is related to excessive iron accumulation in the liver, with subsequent cirrhosis and dangerous complications affecting numerous other organs. Liver iron concentration (LIC) correlates linearly with the total body iron stores; therefore, the quantification of hepatic iron is of major research interest. Although liver biopsy has been considered the gold standard for identifying iron overload, magnetic resonance imaging (MRI) is a non-invasive and highly accurate alternative method for the assessment of hemochromatosis. Our intention is to present a brief description of MRI-based procedures and a comparison of selected methods. Briefly, among the available methods, the liver-to-muscle signal intensity is accessible and easy to apply; however, it assumes that muscle is pathology-free, which may not always be true. Transverse relaxometry is a valid method and allows for the identification of a low iron burden. However, this technique is unfortunately prone to motion artifacts and provides inconsistent results in cases of heavy iron overload. Finally, quantitative susceptibility mapping (QSM) is a notable procedure considered to be of significant interest for the future. The exact correlation between QSM and LIC, as measured by liver biopsy has yet to be established.

Purpose: Accurate prediction of overall survival (OS) in glioma patients is crucial for optimising treatment decisions. Despite advancements in imaging and machine learning, challenges persist due to tumour heterogeneity and confounding factors. This scoping review systematically assesses state-of-the-art image-based OS prediction models for glioma, focusing on tumour characteristics, imaging modalities, preprocessing techniques, and machine learning methods.

Material and methods: This scoping review was conducted following the Joanna Briggs Institute guidelines, comprising five key stages: identifying the research question, searching for relevant literature, selecting studies, charting the data, and collating, summarising, and reporting the results.

Results: The initial search identified 3238 records, of which 70 articles were included in the final analysis. Most studies originated from China, the United States, and India, with datasets averaging approximately 450 cases. To enhance predictive accuracy, various techniques were utilised, including image segmentation, multimodal magnetic resonance imaging (MRI) protocols, and advanced feature extraction methods. Notably, T1-weighted contrast-enhanced MRI and grade-specific glioma analyses improved model performance. Although deep learning models generally outperformed traditional methods, they required large, balanced datasets. Hybrid models showed promising potential; however, their performance was inconsistent due to challenges such as limited image quality and issues with model interpretability.

Conclusions: Increasing sample size alone does not guarantee improved accuracy in glioma prediction models, because data quality and feature selection are critical factors. Incorporating diverse imaging modalities can significantly enhance predictive performance. To ensure greater clinical reliability in decision-making, integrating clinical features with imaging data is essential.

Parsonage-Turner syndrome (PTS), also known as neuralgic amyotrophy (NA), is an idiopathic inflammatory neuropathy of the brachial plexus presenting with neuropathic pain and motor deficits of the shoulder girdle. Routinely, PTS must be differentiated from infectious variants of brachial plexitis, especially early manifestations of neuroborreliosis. Both conditions can quickly lead to significant disability, so early, targeted therapy based on a correct diagnosis is essential for a favourable clinical outcome. High-resolution ultrasound (HRUS) can quickly and non-invasively differentiate PTS from infectious forms of brachial plexitis by detecting nerve twisting and swelling with the so-called "hourglass-like" constriction sign. The following article presents the authors' proposal for an HRUS protocol for the brachial plexus and shows typical ultrasound findings in PTS and brachial plexitis with Banwarth's syndrome due to Borrelia infection.

Purpose: This study aims to compare the clinical, imaging, and pathological characteristics of benign and malignant solitary pulmonary cystic nodules, and identify key indicators associated with malignant risk and invasion depth, assisting clinicians in early detection and assessment of tumour invasiveness.

Material and methods: This study conducted a retrospective analysis of patients with pulmonary cystic nodules who underwent surgical treatment, and it classified them into benign and malignant groups based on postoperative pathological results. We collected patients' clinical data, serum biomarkers, and CT imaging data and compared them using univariate analysis of variance. We included statistically significant indicators in a multivariate regression model to identify independent predictive factors for early malignant transformation of cystic lung cancer. Additionally, we collected the pathological types and tissue infiltration grades of the malignant group and further explored the relationship between imaging features and pathological grading by comparing the imaging characteristics corresponding to different pathological infiltration degrees, and visualised the results using a forest plot.

Results: Following multifactorial Cox analysis age, CA199, homogeneity of cyst wall thickness, cystic wall finish, number of cystic cavities, ground glass sign, and the nodule's relationship to surrounding tissues (burr, pleural indentation sign) had a significant effect on the evolution of cystic malignant nodules. Finally, in the malignant nodule group, the presence or absence of the ground glass sign was statistically significant concerning the different pathologic grades.

Conclusions: Our multivariate predictive study indicates that certain imaging features of pulmonary cystic nodules may suggest malignant progression and are associated with different levels of pathological invasion.

Secondary haemochromatosis among paediatric oncologic patients is associated with various long-term complications. The liver is the most important organ for assessment of iron overload because the iron concentration is linearly correlated with total body iron stores. In the paediatric population, liver biopsy is considered too invasive for routine use. Therefore, evaluation of iron overload with magnetic resonance imaging is an alternative method. Reliable assessment of iron burden is necessary for early detection and severity grading. In the last 2 decades multiple methods for iron quantification with magnetic resonance imaging (MRI) have been developed. Both gradient-echo and spin-echo imaging, including signal intensity ratio and relaxometry strategies, are in clinical use. However, there are no universally accepted MRI protocols for paediatric oncology patients suspected of secondary haemochromatosis. If diagnosed and treated early, haemochromatosis progression can be distinctively altered. Iron overload impacts hepatocytes, pancreas's beta cells, heart, and spleen. Each organ displays distinct patterns of iron distribution, which require targeted imaging methods. This review will address the importance of using magnetic resonance imaging for iron measurements, as well as the evaluation for the liver, pancreas, and spleen.

Purpose: Acute adrenal haemorrhage is a rare occurrence caused most commonly by trauma or ruptured neoplasms. In the case of the latter, rapid adrenal tumour growth resulting in elevated intracapsular pressure leads to capsular tear and massive retroperitoneal bleeding. Endovascular embolisation has been reported as a successful and safe method of treatment in selected patients. The aim of this paper was to report multicentre experience with endovascular treatment of patients presenting with acute adrenal gland haemorrhages caused by neoplasms.

Material and methods: This is a multi-centre retrospective study focusing on patients treated by endovascular embolisation because of malignant adrenal haemorrhages in an acute setting from 2012 to 2024.

Results: In total, 13 patients (10 men and 3 women, mean age: 65.4 years) were included in the study. All subjects presented with neoplastic haemorrhages - 8 presented with adrenal metastasis and 5 were primary neoplasms. In all cases a contrast-enhanced computed tomography confirmed the bleeding. Procedures were performed under local anaesthesia via femoral access. Embolic agents were adopted according to the type of vessel lesion and operator preference. Technical success, defined as cessation of adrenal bleeding detectable at control angiography, was 100%; 1 patient required a second embolisation after 24 hours due to recurrence. Clinical success considered as haemodynamic stability and clinical improvement was obtained in 85% (11/13 patients). No major complications were observed.

Conclusions: Malignant acute adrenal haemorrhages can be safely and effectively treated with endovascular means after thorough and careful anatomical examination of the arterial supply.

Magnetic resonance imaging (MRI) is an important diagnostic tool in oral and maxillofacial surgery due to its superior ability to visualise soft tissue and complex anatomical structures without ionising radiation. This narrative review, conducted using a structured literature search following PRISMA guidelines, aims to provide oral and maxillofacial surgery trainees with a structured guide for understanding and interpreting MRI of the head and neck region. Emphasis is placed on enhancing the ability to read common MRI sequences, particularly T1- and T2-weighted images, and on appreciating the value of MRI in diagnosing a range of conditions, including soft tissue lesions, temporomandibular joint disorders, vascular abnormalities, and tumours. To support learning, a selection of case examples is included to illustrate both normal structures and pathological changes. The review also draws attention to the current lack of formal MRI education in oral and maxillofacial surgery training and stresses the need for more organised, interdisciplinary teaching approaches.

Purpose: The aim of this study was to evaluate the performance of the ChatGPT-o1-preview language model in solving the Polish National Specialization Exam (PES) in radiology and imaging diagnostics and compare its results with previous versions of the model.

Material and methods: A set of 119 valid radiology exam questions from Spring 2023 was analyzed. Each question was classified by type, subtype, and clinical relevance. ChatGPT answered each question five times using a standardized prompt with a 5-point confidence scale. Performance was assessed using accuracy and declared and calculated difficulty indices. Statistical analysis was performed in Python with a significance level of p < 0.05, and results were compared with a previous model version.

Results: The model achieved a score of 93.33% correct answers, comparable to the average physician score of 94.86%. ChatGPT-o1-preview showed exceptional accuracy in "memory" questions, with over 96% correct answers. This result, significantly higher than that of the older ChatGPT-3.5 model (52%), demonstrates progress in artificial intelligence (AI) capabilities. The model also exhibited higher confidence in its responses, indicating better adaptation to medical exams.

Conclusions: Despite its high accuracy, the study was based on a relatively small set of questions, which limits the ability to fully assess the model's effectiveness. The results indicate the potential of AI as a tool to support clinical work, but further, more extensive research is necessary to evaluate its applicability and reliability in the medical environment.

Purpose: To evaluate the relationship between different techniques, lesion characteristics, and the development of pneumothorax (Ptx), chest tube-requiring Ptx, and type 1 parenchymal contusion (T1PC) in computed tomography-guided transthoracic lung biopsies (CTTB).

Material and methods: This retrospective study included 510 patients who underwent CTTB between 2015 and 2020. Patients were classified according to needle system (coaxial (Cx)/non-coaxial (NCx)), needle gauge, use of autologous blood clot (OBC), lesion size, location, approach path, pleural puncture count, number of specimens, and presence of emphysema along the needle tract. Complications were assessed with post-procedural CT. Univariate and multivariate logistic regression analyses were performed.

Results: Ptx was more frequent in males, in the presence of emphysema along the needle tract, with middle lobe lesions, lateral approach, ≥ 3 pleural passes, ≥ 3 samples, and when using 18G NCx or 19G Cx needles. OBC use reduced Ptx risk. Chest tube-requiring Ptx was significantly associated with ≥ 3 pleural passes, ≥ 3 samples, and 19G Cx needles. T1PC was most common with 17G Cx needle use and when ≥ 3 samples were obtained. Multivariate analysis showed that 18G NCx and 19G Cx needles reduced T1PC risk, while the absence of Ptx increased its likelihood.

Conclusion: In CT-guided lung biopsies, complication risk can be reduced by optimizing technique, limiting pleural punctures and specimen numbers, and considering OBC use, needle gauge, and patient-specific factors.