Clinical radiology最新文献

{"title":"Access to prior screening mammograms affects the specificity but not sensitivity of radiologists' performance.","authors":"J D Akwo, P D Yun Trieu, M L Barron, T Reynolds, S J Lewis","doi":"10.1016/j.crad.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.crad.2024.09.007","url":null,"abstract":"<p><strong>Aims: </strong>To establish the impact that access to prior mammograms has on radiologists' performance and the influence of radiologists' characteristics and breast density on their subsequent performance.</p><p><strong>Methods: </strong>Eight participants independently interpreted 72 digital screening mammograms in two reading sessions using the Royal Australian and New Zealand College of Radiologist's classification. In the first reading session, participants were given access to current and prior mammograms. In the second reading session six months later, participants only had access to the current mammograms. Radiologists' specificity, sensitivity, lesion sensitivity, Receiver Operating Characteristic (ROC) curve, and Jacknife Alternative Free-response ROC (JAFROC) were calculated. A Paired T-test was used to compare readings with and without prior mammograms, and to assess if breast density influenced participants performance. Independent Sample T-test was used to compare performance across radiologists' characteristics. A relative risk analysis was conducted to assess the probability of false positives and false negatives when prior mammograms were available.</p><p><strong>Results: </strong>Access to prior mammograms improved specificity in dense and non-dense breasts (p≤0.01) and reduced false positives (p = 0.01) but had no effect on sensitivity (p = 0.37), lesion sensitivity (p = 0.67), ROC (p = 0.16), and JAFROC (p = 0.24). Prior mammogram also reduced the probability of false positives (RR = 0.38; 95%CI:0.26-0.57, p<0.0001) without affecting the false negative rate (RR = 1.14; 95%CI:0.88-1.49, p = 0.30). The impact of prior mammograms on performance was not influenced by breast density or radiologists' characteristics.</p><p><strong>Conclusions: </strong>Access to prior mammograms improves radiologists' specificity and reduces false positives without affecting sensitivity and the false negative rate regardless of radiologists' characteristics and breast density.</p>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of the diagnostic accuracy of peritoneal biopsy with an 18G cutting needle under ultrasonography guidance and the contribution of CT findings to diagnosis before biopsy (our 8-year clinical experience).","authors":"C Cakir, E Inci, F Kilinc, O Yildiz","doi":"10.1016/j.crad.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.crad.2024.09.002","url":null,"abstract":"<p><strong>Aim: </strong>Ultrasound-guided percutaneous core needle biopsy is an important technique in diagnosing mesenteric involvement. Diagnostic results were compared with pre-biopsy CT findings. The purpose of this study was to determine the diagnostic efficiency of omental lesion biopsies performed under ultrasound guidance and to investigate the relationship between pre-biopsy diagnostic CT findings.</p><p><strong>Materials and methods: </strong>Demographic data of 70 patients who underwent omental biopsy under ultrasound guidance in our clinic between August 2015 and July 2023, the presence of a primary malignancy focus during the investigations conducted during the research, biopsy histopathology results, and pre-biopsy CT findings were retrospectively reviewed.</p><p><strong>Results: </strong>This retrospective study included who underwent omental biopsy under ultrasound guidance, 48 (69%) were female, and 22 (31%) were male, with an average age of 61 (age range 15-95), and an average body mass index [BMI] of 27.7 ± 6.9. Five (7%) of the 70 biopsy procedures were not pathologically diagnostic. Diagnostic results were compared with pre-biopsy CT findings. In all omental lesions, the percentage of omental infiltrative involvement in diagnostic CT was subjectively evaluated by two radiologists. 65 patients diagnosed pathologically, 47 (67%) were malignant, and 18 (26%) were benign. No complications occurred.</p><p><strong>Conclusion: </strong>Peritoneal biopsies under ultrasound guidance for mesenteric diseases detected on CT are a reliable procedure that can be easily applied. Ultrasonography imaging helps identify appropriate locations for targeted biopsies before deep percutaneous biopsy, increasing diagnostic accuracy, especially when omental lesions appear as infiltrative thickenings.</p>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging recommendations for soft-tissue sarcomas: model guidelines from diagnosis to post-treatment follow-up","authors":"M. Hussein, H. Gupta, A. Ahuja, S. Thaker","doi":"10.1016/j.crad.2024.08.023","DOIUrl":"https://doi.org/10.1016/j.crad.2024.08.023","url":null,"abstract":"Soft-tissue sarcomas (STSs) are a heterogeneous group of malignancies of mesenchymal origin with an incidence of 4–8 per 100,000 within Europe; they consist of various subtypes, each expressing distinct morphological, histopathological, and molecular features. According to the 2020 World Health Organization (WHO) classification, STSs are divided into 11 broad categories comprising approximately 80 entities. STS management guidelines are constantly evolving due to the development of newer diagnostic methods and treatments including the discovery of new chemotherapeutic agents and immunomodulators. Although the referral, diagnostic, and management pathways may vary in different healthcare systems, the core management principles remain the same.","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an automated report comparison tool on trainee report modification rate at a tertiary hospital.","authors":"M J Stewart, R P Lim, J Feldman, N Yang","doi":"10.1016/j.crad.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.crad.2024.09.001","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to compare trainee-modified report percentage rate and trainee/consultant satisfaction regarding the feedback process before and after implementation of an automated report comparison tool.</p><p><strong>Materials and methods: </strong>An automated report comparison tool utilising natural language processing, presenting the trainee's preliminary report beside the final consultant report with changes highlighted, was used in a prospective interventional study. Modification rates, including character counts, of co-authored computed tomography (CT) studies were recorded before and after tool implementation over two 6-month periods and compared with Student's t-test. Trainees and consultants were surveyed before and after the interventional period for time spent and feedback satisfaction.</p><p><strong>Results: </strong>In total, 3851 (81.7%) of 4175 reports were modified in the baseline preimplementation phase, and 5215 (69.6%) of 7489 reports were modified during the postimplementation phase (p < .001). The average character count change preimplementation was 132, corresponding to 9.0% of the original preliminary report, compared with 91 characters and 7.1% postimplementation, respectively (p < .001). This statistically significant difference generally applied regardless of the level of trainee experience. Prospective data collected in the preimplementation period revealed that for more than two-thirds of after-hours shifts, trainees spent fewer than 5 minutes receiving feedback on their after-hours work. At the conclusion of the implementation phase, 92.3% of trainees and 70% of consultants agreed that the report comparison tool improved feedback.</p><p><strong>Conclusion: </strong>Following the implementation of an automated report comparison tool, there was a reduction in trainee report modification rates and subjectively improved trainee feedback. This adjunct to existing feedback mechanisms presents a relatively simple intervention to facilitate efficient case review and feedback.</p>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RCR meetings","authors":"","doi":"10.1016/S0009-9260(24)00438-0","DOIUrl":"10.1016/S0009-9260(24)00438-0","url":null,"abstract":"","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0009926024004380/pdfft?md5=855d5b33b5bc7f72e378c2cdc0ab9f95&pid=1-s2.0-S0009926024004380-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142158488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative prognostic prediction for invasive pulmonary adenocarcinoma: Impact of ¹⁸F-FDG PET/CT semi-quantitative parameters associated with new histological subtype classification.","authors":"K Wang, N Tu, H Feng, Y Zhou, L Bu","doi":"10.1016/j.crad.2024.08.034","DOIUrl":"https://doi.org/10.1016/j.crad.2024.08.034","url":null,"abstract":"<p><strong>Aims: </strong>To explore the preoperative predictive value of ¹⁸F-FDG PET/CT for poor prognostic histologic subtypes of invasive pulmonary adenocarcinoma (IPA) under new classification.</p><p><strong>Materials and methods: </strong>This study included 316 patients. Histopathology of IPA was evaluated by recording the percentage of each histologic component. PET/CT parameters were compared among IPAs with different risks of recurrence. Optimum cutoff values of PET/CT parameters were calculated using ROC curve analysis. Overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier method, and survival differences between groups were tested using log-rank test. Multivariate analysis for survival was performed using the Cox regression model.</p><p><strong>Results: </strong>Patients were divided into low (LRR), intermediate (IRR), and modified high (mHRR) risk of recurrence group incorporating typical (HRR-T) and nontypical (HRR-NT) subgroups based on histologic patterns. There were significant differences in SUV_max, SUV_mean, SUV_min, SUV_SD, TLG, and tumor size among three groups. HRR-NT had lower SUV_max, SUV_mean, SUV_min, SUV_SD and TLG than HRR-T subgroup, and higher SUV_max, SUV_mean, SUV_min, SUV_SD, MTV, TLG and tumor size than IRR group. ROC curve analysis showed that SUV_max had highest AUC (0.815) in distinguishing LRR and IRR. TLG had highest AUC (0.741) in distinguishing IRR and mHRR. Multivariable analysis showed that tumor size and SUV_max were independent predictors of DFS and OS.</p><p><strong>Conclusions: </strong>High risk of recurrence of IPA exhibited higher ¹⁸F-FDG uptake and tumor size. Tumor size and SUV_max could be used as preoperative surrogates for the IASLC grading system. ¹⁸F-FDG PET/CT can improve the preoperative prognostic prediction for IPA patients.</p>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG bispectral index sensor guidance improves accuracy and safety of procedural sedation.","authors":"A Oh, N Karim, A Pitt, S Hodgetts, D W Edwards, D Mullan, H-U Laasch","doi":"10.1016/j.crad.2024.08.033","DOIUrl":"https://doi.org/10.1016/j.crad.2024.08.033","url":null,"abstract":"<p><strong>Purpose: </strong>To re-audit compliance with an amended sedation protocol following the latest national guidelines. To confirm the improved safety achieved through EEG guidance for drug administration during procedural sedation.</p><p><strong>Materials and methods: </strong>Following the revision of the departmental protocol, 14 standards were set. Sedation data and outcomes in 150 consecutive patients undergoing fluoroscopic and combined endoscopic procedures were evaluated against these. Combination sedo-analgesia was titrated by the interventional radiology nurses guided by bispectral index sensor (BIS) measurements to achieve readings between 80 and 85. Doses were stratified by patient age and ASA status. Nasal oxygen was given and standard monitoring including pulse oximetry and capnography were used alongside to assess for complications, notably hypoxaemia of ≤ 94%.</p><p><strong>Results: </strong>85% were non-vascular procedures, the bulk made up of oesophageal stent insertion, gastrostomy, oesophageal dilatation of radiation strictures and biliary procedures. Mean procedure time was 32.9 minutes (10-170). Mean doses of midazolam and fentanyl were 3.99mg (±1.9) and 92.3μg (±35.4), respectively. 84% of patients were classified as having received light or moderate sedation (BIS 70-89). Three standards for patient sedation were missed, but no patient required sedation reversal or airway management, and none developed hypoxaemia.</p><p><strong>Conclusions: </strong>BIS guidance of sedation administration allows real-time assessment of the patient's response to sedo-analgesia administered and allows prediction about the safety of further drug administration. It identifies patients waking up, allowing this to be anticipated and reduces interruptions of the procedure. It offers clear clinical advantages to interval assessment of patients' response to clinical stimuli and reduces under-as well as oversedation.</p>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The super-resolution reconstruction in diffusion-weighted imaging of preoperative rectal MR using generative adversarial network (GAN): Image quality and T-stage assessment","authors":"J. Cui, S. Miao, J. Wang, J. Chen, C. Dong, D. Hao, J. Li","doi":"10.1016/j.crad.2024.08.031","DOIUrl":"https://doi.org/10.1016/j.crad.2024.08.031","url":null,"abstract":"To assess the feasibility of using a generative adversarial network (GAN) to improve diffusion-weighted imaging (DWI) resolution in rectal MR scans for rectal carcinoma (RC), and to evaluate both the image quality and the diagnostic utility of super-resolution DWI (SR-DWI) in T stage assessment. In this retrospective investigation, a total of 291 patients diagnosed with RC during the period spanning May 2018 to December 2021 were included. The generated SR-DWI was evaluated against the original DWI using multi-scale structural similarity and peak signal-to-noise ratio. Two radiologists scored the SR-DWI and original DWI using a 4-point Likert scale in image quality. Moreover, both radiologists independently evaluated the T category staging based on T2WI and SR-DWI. Interobserver agreement was assessed using Cohen's kappa. The PSRN and MS-SSIM values of SR-DWI (4 ×) were significantly higher compared to those of SR-DWI (16 ×). Regarding the details of anatomic structures and overall image quality parameters, both radiologists exhibited a preference for SR DWI with 16 × enlargement over SR DWI with 4 × enlargement, yielding significantly superior ratings (both < 0.001). The T-staging accuracy rates of SR-DWI (16 ×) performed by radiologist 1 and radiologist 2 were significantly superior to those achieved with T2WI (0.621 vs. 0.768, p = 0.027; 0.653 vs 0.810, = 0.014). Our study demonstrates that the adapted super-resolution approach can significantly improve the overall image quality and details of anatomic structure of DWI in rectal MR. And SR-DWI offer better diagnostic accuracy in RC T staging when compared with T2WI.","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional radiology procedures, facilities, and workforce across England and Wales: a snapshot retrospective evaluation from 2017 to 2021","authors":"G. Najafi, R. Lakshminaranan, P. Haslam, I. McCafferty, R. Morgan, R. Uberoi, M. Hamady","doi":"10.1016/j.crad.2024.08.032","DOIUrl":"https://doi.org/10.1016/j.crad.2024.08.032","url":null,"abstract":"There is no comprehensive data collection outlining the numbers and types of interventional radiology (IR) procedures in the United Kingdom. Similarly, limited data are available on the IR facilities and workforce within the National Health Services (NHS) trusts. The purpose of this study is to evaluate the number/type of IR procedures, facilities, and workforces across England and Wales. This retrospective study used the 2000 Freedom of Information Act to obtain information regarding the IR procedures performed in NHS trusts in England and Wales from 2017 to 2021. We collected additional information on IR workforce and facilities, including the number of IR consultants, nurses, trainees, and angiographic suites and day case units; analysed procedures by complexity; and performed data analysis by region. A total of 1,340,352 IR procedures were analysed. An increasing trend was observed in the number of IR procedures from 2017 to 2021 (=0.07, R=0.93). There were more intermediate and complex procedures than simple ones (=0.0001). Notable geographical variation was observed in terms of IR facilities including angiographic suites and day case units, and the number of IR consultants, nurses, and trainees. The IR field continues to grow as evidenced by increasing trends in the number and complexity of the procedures over the years. There is an uneven IR workforce, services, and facilities distribution across England and Wales. Therefore, there is a crucial need for centralised data collection to evaluate and monitor interventions besides comprehensive revision of UK IR service provision.","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the throat: Imaging of parapharyngeal space lesions","authors":"P. Rai, K. Bhattacharya, S. Rastogi, P. Joshi, K. Rabade, N. Shetty, S. Kulkarni","doi":"10.1016/j.crad.2024.08.030","DOIUrl":"https://doi.org/10.1016/j.crad.2024.08.030","url":null,"abstract":"The parapharyngeal space (PPS) is a pyramidal-shaped fat-filled space in the head and neck, between the base of the skull and the hyoid bone.","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}