Diagnostic and interventional radiology最新文献

{"title":"Preoperative prediction of lymphovascular invasion and T-staging of rectal cancer via a dual-energy computed tomography iodine map: a feasibility study.","authors":"Jinliang Zhang, Hui Qi, Chun Yang, Ling Liu, Yuxin Wang, Wei Li","doi":"10.4274/dir.2024.242755","DOIUrl":"10.4274/dir.2024.242755","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the value of dual-energy computed tomography (DECT) in predicting lymphovascular invasion (LVI) and the accuracy of preoperative T-staging of rectal cancer (RC).</p><p><strong>Methods: </strong>Forty-nine patients with RC who had not received radiotherapy were enrolled to undergo a DECT scan. All patients underwent surgical tumor resection within 3-5 days after the DECT scan. Preoperative T-staging of RC based on images was performed by experienced radiologists. The normalized iodine concentrations (NIC) of the tumor and the perirectal adipose tissue (PAT) from the arterial phase (AP) and venous phase (VP) were measured using DECT. The tumor LVI and T-staging confirmed by pathology were used as the gold standard for grouping (group A, LVI-; group B, LVI+; group C, T1-2; and group D, T3-4a). The NIC values between two groups were compared using the Mann-Whitney U test, with <i>P</i> < 0.05 indicating a statistically significant difference. The accuracy of NIC in predicting LVI and distinguishing T1-2 RC from T3-4a RC were determined via receiver operating characteristic curve analysis, and the optimal cut-off of NIC was determined using the area under the curve.</p><p><strong>Results: </strong>The tumor NIC values were significantly higher in the LV+ group than in the LVI- group in the VP (0.728 ± 0.031 vs. 0.669 ± 0.034, <i>P</i> < 0.001). The NIC values of PAT were significantly higher in the T3-4a group than in the T1-2 group in both the AP (4.034 ± 0.991 vs. 3.115 ± 0.581, <i>P</i> < 0.05) and the VP (5.481 ± 1.054 vs. 3.450 ± 0.980, <i>P</i> < 0.001). The accuracy of using NIC values to distinguish between the LVI+ group and the LVI- group and to diagnose the T3-4a group were 85.7% and 89.8%, respectively. However, there was no statistically significant difference between the NIC value in the LVI+ group and in the LVI- group in the AP. There was also no statistical difference in the tumor NIC value between the T1-2 group and the T3-4a group.</p><p><strong>Conclusion: </strong>The tumor and PAT NIC are valuable indicators in RC that can preoperatively predict LVI and improve the accuracy of preoperative RC T-staging.</p><p><strong>Clinical significance: </strong>The use of DECT improves the T-staging and LVI prediction of RC, which is helpful in guiding the clinical selection of appropriate treatment modalities and improving prognostic outcomes.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"1-9"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staged angioplasty using a full-length balloon catheter to achieve maturation of arteriovenous fistulas.","authors":"Miju Bae, Chang Ho Jeon, Sung Woon Chung, Chung Won Lee, Up Huh, Jongwon Kim, Hyuncheol Jeong","doi":"10.4274/dir.2024.232607","DOIUrl":"10.4274/dir.2024.232607","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of staged full-length balloon-assisted maturation (BAM) for the maturation of arteriovenous fistulas (AVFs) on entire segmental veins, including stenosis, causing primary AVF failure.</p><p><strong>Methods: </strong>This study included patients who underwent AVF surgery using an autogenous vein between February 2020 and June 2021 and received staged angioplasty with a full-length balloon catheter. To minimize balloon overlap and the risk of barotrauma to the immature vein, serial-staged upsizing balloon angioplasty with a long balloon catheter covering the entire vein segment was employed approximately 2 weeks apart.</p><p><strong>Results: </strong>Twenty-three patients (mean age, 69.50 years; mean follow-up, 620.62 days) with average diameters of the radial artery and cephalic vein at 2.14 ± 0.5 mm and 2.43 ± 0.5 mm, respectively, were enrolled. In the first procedure, the average AVF diameter and flow were 4.03 ± 0.57 mm and 438.08 ± 220.95 mL/min, respectively, with juxta-anastomotic stenosis (JAS) present in 61.5% of cases. After staged full-length BAM, the average fistula diameter and flow improved to 5.95 ± 0.86 mm and 717.52 ± 305.95 mL/min, respectively. Maturation was achieved in 87% of the cases. No hematomas or ruptures occurred around the arterialized veins. Despite successful maturation and cannulation, 65.2% of the patients required additional percutaneous transluminal angioplasty (PTA) during the follow-up period. The necessity for PTA was determined by the presence of JAS prior to the first staged full-length BAM, with an odds ratio of 11.74 (95% confidence interval: 1.31-104.96, <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>Staged full-length BAM can be safely used in patients with small veins requiring further maturation. Most patients achieved successful cannulation following maturation without post-procedural complications.</p><p><strong>Clinical significance: </strong>Staged full-length BAM is a safe and effective method for enhancing maturation in patients with underdeveloped small veins.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"45-51"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting checklists as compulsory supplements to artificial intelligence manuscript submissions.","authors":"Michail E Klontzas","doi":"10.4274/dir.2024.242849","DOIUrl":"10.4274/dir.2024.242849","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"17-18"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of guided reporting: quality and reading time of automatically generated radiology report in breast magnetic resonance imaging using a dedicated software solution.","authors":"Martin H Maurer, Daniel Lorenz, Maximilian Clemens Otterbach, Igor Toker, Alexander Huppertz","doi":"10.4274/dir.2024.242702","DOIUrl":"10.4274/dir.2024.242702","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Unstructured, free-text dictation (FT), the current standard in breast magnetic resonance imaging (MRI) reporting, is considered time-consuming and prone to error. The purpose of this study is to assess the usability and performance of a novel, software-based guided reporting (GR) strategy in breast MRI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eighty examinations previously evaluated for a clinical indication (e.g., mass and focus/non-mass enhancement) with FT were reevaluated by three specialized radiologists using GR. Each radiologist had a different number of cases (R1, n = 24; R2, n = 20; R3, n = 36). Usability was assessed by subjective feedback, and quality was assessed by comparing the completeness of automatically generated GR reports with that of their FT counterparts. Errors in GR were categorized and analyzed for debugging with a final software version. Combined reading and reporting times and learning curves were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Usability was rated high by all readers. No non-sense, omission/commission, or translational errors were detected with the GR method. Spelling and grammar errors were observed in 3/80 patient reports (3.8%) with GR (exclusively in the discussion section) and in 36/80 patient reports (45%) with FT. Between FT and GR, 41 patient reports revealed no content differences, 33 revealed minor differences, and 6 revealed major differences that resulted in changes in treatment. The errors in all patient reports with major content differences were categorized as content omission errors caused by improper software operation (n = 2) or by missing content in software v. 0.8 displayable with v. 1.7 (n = 4). The mean combined reading and reporting time was 576 s (standard deviation: 327 s; min: 155 s; max: 1,517 s). The mean times for each reader were 485, 557, and 754 s, and the respective learning curves evaluated by regression models revealed statistically significant slopes (&lt;i&gt;P&lt;/i&gt; = 0.002; &lt;i&gt;P&lt;/i&gt; = 0.0002; &lt;i&gt;P&lt;/i&gt; &lt; 0.0001). Overall times were shorter compared with external references that used FT. The mean combined reading and reporting time of MRI examinations using FT was 1,043 s and decreased by 44.8% with GR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;GR allows for complete reporting with minimized error rates and reduced combined reading and reporting times. The streamlining of the process (evidenced by lower reading times) for the readers in this study proves that GR can be learned quickly. Reducing reporting errors leads to fewer therapeutic faults and lawsuits against radiologists. It is known that delays in radiology reporting hinder early treatment and lead to poorer patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical significance: &lt;/strong&gt;While the number of scans and images per examination is continuously rising, staff shortages create a bottleneck in radiology departments. The IT-based GR method can be a major boon, improving radiologist efficiency, report quality, and the ","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"19-28"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow-diverting stents in the management of extracranial carotid artery aneurysms.","authors":"Celal Cinar, Erol Akgul, Alperen Elek, Mahmut Kusbeci, Egemen Ozturk, Hasan Bilen Onan, Irem Islek, Mohammad Naim Forogh, Mohammad Nawas Nasiri, Ismail Oran","doi":"10.4274/dir.2024.242946","DOIUrl":"https://doi.org/10.4274/dir.2024.242946","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the indications and therapeutic efficacy of flow-diverting stents (FDSs) in the management of extracranial carotid artery aneurysms (ECAAs) and dissections.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 18 patients treated for ECAAs with an FDS between 2010 and 2024. Patient demographics, aneurysm characteristics, procedural details, and clinical and radiologic follow-up outcomes were extracted from medical records. Procedures were performed under general anesthesia using standard endovascular techniques. Patients received preoperative and postoperative antiplatelet therapy and were fully anticoagulated during the procedure. Follow- up assessments included digital subtraction angiography or computed tomography angiography at 6-12 months and clinical evaluations to monitor symptom resolution and complications.</p><p><strong>Results: </strong>Eighteen patients, with an average age of 46.44 ± 17.54 years, underwent 19 endovascular interventions. Technical success was achieved in all cases. Single stent deployment was used in 15 aneurysms, and telescopic stent deployment in 7. Total occlusion of the aneurysm was achieved in 94.4% of cases. One patient required retreatment due to the separation of two overlapped telescopic stents. All patients were discharged within 2 days post-procedure, with symptomatic patients experiencing the complete resolution of symptoms. No complications or adverse events were reported during the follow-up period.</p><p><strong>Conclusion: </strong>The endovascular treatment of ECAAs with FDSs appears to be a safe and effective alternative, achieving high technical success and positive clinical outcomes.</p><p><strong>Clinical significance: </strong>The use of FDSs for treating ECAAs significantly improves patient outcomes with minimal complications.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal for training: the educational value of a musculoskeletal embolization patellar tendinopathy model.","authors":"Emeric Gremen, Julien Ghelfi, Marylène Bacle, Julien Frandon","doi":"10.4274/dir.2024.243005","DOIUrl":"https://doi.org/10.4274/dir.2024.243005","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of balloon angioplasty under intravascular ultrasound guidance in calcified below-the-knee tibial arteries.","authors":"Muhammed Said Beşler, Asiye Sözeri, Murat Canyiğit","doi":"10.4274/dir.2024.243022","DOIUrl":"https://doi.org/10.4274/dir.2024.243022","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the optimal balloon diameter for intravascular ultrasound (IVUS)-guided balloon angioplasty in calcified below-the-knee (BTK) tibial artery lesions.</p><p><strong>Methods: </strong>Between February 2024 and April 2024, a retrospective review was conducted on 17 patients with Rutherford category 4-6 severely calcified tibial arteries with >70% stenosis, treated with IVUS-guided balloon angioplasty. Sequentially, 3 mm and then 3.5 mm diameter balloons were inflated. The minimum lumen diameter and area were measured before and after the procedure in the proximal, mid, and distal segments of the tibial arteries. One- and three-month follow-ups were conducted using Doppler ultrasound.</p><p><strong>Results: </strong>Significant increases in lumen diameter (<i>P</i> < 0.001 for all) and lumen area (<i>P</i> < 0.001, <i>P</i> = 0.003, <i>P</i> = 0.002, respectively) were observed in the proximal, mid, and distal segments of the BTK arteries following IVUS-guided 3.5 mm balloon angioplasty. Ultra-low iodinated contrast media was used [median 2 mL (range, 1-4 mL)]. Lumen area increase ratios were similar among the proximal, mid, and distal segments (<i>P</i> = 0.905). No target vessel revascularization, major amputation, or mortality was observed during follow-up. Wound healing was seen in 62.5% of the cases with foot ulcers.</p><p><strong>Conclusion: </strong>In the treatment of calcified BTK tibial arteries, a gradual balloon diameter increase up to 3.5 mm in IVUS-guided balloon angioplasty is safe and effective.</p><p><strong>Clinical significance: </strong>Gradual balloon diameter increase up to 3.5 mm under IVUS guidance in calcified BTK lesions demonstrates significant potential. It enables ultra-low contrast usage, provides low complication rates, and achieves high patency and limb salvage, along with satisfactory wound healing in the short term.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental study of a canine model for a newly designed adjustable prefenestration aortic stent graft","authors":"Lei Zhang, Chang Shu, Yuchen Qiu, Zeliang Fu, Pengcheng Guo, Xin Li","doi":"10.4274/dir.2023.232440","DOIUrl":"10.4274/dir.2023.232440","url":null,"abstract":"<p><strong>Purpose: </strong>When performing thoracic aortic endovascular repair (TEVAR) on lesions of the aortic arch, physician-modified fenestration or <i>in situ</i> fenestration is often used to maintain patent branches. We designed a new adjustable prefenestration aortic stent graft that can both isolate pathologies in the aortic arch and obtain patent branches simultaneously. In this study, we use this new type of stent to perform fenestrated TEVAR in a canine’s aorta. This study aims to evaluate the safety and feasibility of the new device, which may provide preliminary data for potential human application.</p><p><strong>Methods: </strong>Eight Labrador Retriever canines underwent fenestrated TEVAR using the new stent device. Digital subtract angiography (DSA) was performed before and after fenestrated TEVAR to evaluate the safety and feasibility of the procedure. For the device deployment, at the “large curvature” side in the endograft, there is a rectangular prefenestration area (2 × 5 cm) without the polytetrafluoroethylene membrane, and at both longer side edges of the fenestration, there are two slide rails. A moveable membrane that covers the same area as the prefenestration area is initially set at the prefenestration position. A stay line is connected from the distal site of the moveable membrane that controls it to the distal position along the slide rail, which releases the fenestration. After the positioning of the prefenestration is determined, the outer sheath of the delivery system is released, and the stay line at the end of the delivery system is pulled outside the body. The animals were divided into a 1-month group (n = 4) and a 3-month group (n = 4) after the fenestrated TEVAR. Computed tomography (CT) was performed before euthanasia, and video of the DSA during the procedures and CT angiography (CTA) images were then studied.</p><p><strong>Results: </strong>The procedure success rate was 100%, but the total survival rate was only 87.5%. There were no aortic-related deaths during follow-up, and during the operation, there were no stent-graft-related accidents. In addition, no stent-graft migrations were observed in the CTA, and all branch arteries were kept patent by the adjustable fenestration. Finally, histological examination and electron microscope results showed no obvious vascular injury or inflammation.</p><p><strong>Conclusion: </strong>Based on the results of this study, we judge the safety and feasibility of the use of the newly designed adjustable prefenestration aortic stent graft in a fenestrated-TEVAR canine model to be acceptable. Our preliminary data may serve as an initial reference for evaluating the potential application of the new stent in humans.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"402-408"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between computed tomography-based body composition parameters and hepatic venous pressure gradient in patients with cirrhosis: a systematic review and meta-analysis","authors":"Siwei Yang, Zhiyuan Zhang, Qiyang Chen, Yuefeng Hu, Tianhao Su, Xuedong Sun, Long Jin","doi":"10.4274/dir.2023.232553","DOIUrl":"10.4274/dir.2023.232553","url":null,"abstract":"<p><strong>Purpose: </strong>Computed tomography (CT)-based body composition parameters and the hepatic venous pressure gradient (HVPG) are key characteristics in patients with liver cirrhosis. The present study aims to explore the correlation between CT-based body composition parameters and HVPG, as well as the difference in HVPG between patients with and patients without sarcopenia.</p><p><strong>Methods: </strong>A literature search for studies reporting the correlation between HVPG and CT-based body composition parameters published in English up to August 2023 in four databases, Embase, MEDLINE (via PubMed), Web of Science, and Cochrane Library, was conducted. The correlation coefficient between HVPG and CT-based body composition parameters was the primary outcome, and the difference in the HVPG value between the sarcopenia and non-sarcopenia groups was the secondary outcome. A meta-analysis was conducted using a random-effects models. The methodologic quality was assessed using the Quality Assessment of Diagnostic Studies instrument.</p><p><strong>Results: </strong>A total of 652 articles were identified, of which nine studies (n = 1,569) met the eligibility criteria. Among them, seven studies reported the primary outcome via the muscle index, five via the skeletal muscle index (SMI), two via the psoas-muscle-related index (PRI), and three via two adipose tissue indexes. A total of five studies reported the secondary outcome: four via SMI and one via PRI. No evidence of a significant correlation was determined between the various body composition parameters and the HVPG value, either in the muscle index or the adipose tissue index. Higher HVPG values were observed in patients with sarcopenia than in patients without sarcopenia [pooled standardized mean difference (SMD): 0.628 (−0.350, 1.606), <i>P</i> < 0.001; <i>I²</i> = 92.8%; <i>P</i> < 0.001] when an Asian sarcopenia definition was adopted. In contrast, when a Western cut-off value was applied, the HVPG value was higher in patients without sarcopenia than in patients with sarcopenia [pooled SMD: −0.201 (−0.366, −0.037), <i>P</i> = 0.016; <i>I²</i> = 0.00%; <i>P</i> = 0.785].</p><p><strong>Conclusion: </strong>No sufficient evidence regarding a correlation between the CT-based body composition and HVPG value was discovered. The difference in the HVPG value between the sarcopenia and non-sarcopenia groups was likely dependent on the sarcopenic cut-off value.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"385-401"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of multishot echo-planar imaging (RESOLVE) and non-echo-planar imaging (HASTE) diffusion-weighted imaging in cholesteatoma with an emphasis on signal intensity ratio measurement","authors":"Ahmet Bozer, Zehra Hilal Adıbelli, Yeşim Yener, Abdullah Dalgıç","doi":"10.4274/dir.2024.242767","DOIUrl":"10.4274/dir.2024.242767","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic efficacy of multishot echo-planar imaging (EPI) [RESOLVE (RS)] and non-EPI (HASTE) diffusion-weighted imaging (DWI) in detecting cholesteatoma (CHO), and to explore the role of signal intensity (SI) ratio measurements in addressing diagnostic challenges.</p><p><strong>Methods: </strong>We analyzed RS-EPI and non-EPI DWI images from 154 patients who had undergone microscopic middle ear surgery, with pathological confirmation of their diagnoses. Two radiologists, referred to as Reader A and Reader B, independently reviewed the images without prior knowledge of the outcomes. Their evaluation focused on lesion location, T1-weighted (T1W) signal characteristics, and contrast enhancement in temporal bone magnetic resonance imaging. Key parameters included lesion hyperintensity, size, SI, SI ratio, and susceptibility artifact scores across both imaging modalities.</p><p><strong>Results: </strong>Of the patients, 62.3% (96/154) were diagnosed with CHO, whereas 37.7% (58/154) were found to have non-CHO conditions. In RS-EPI DWI, Reader A achieved 89.6% sensitivity, 79.3% specificity, 87.8% positive predictive value (PPV), and 82.1% negative predictive value (NPV). Non-EPI DWI presented similar results with sensitivities of 89.6%, specificities of 86.2%, PPVs of 91.5%, and NPVs of 83.3%. Reader B’s results for RS-EPI DWI were 82.3% sensitivity, 84.5% specificity, 89.8% PPV, and 74.2% NPV, whereas, for non-EPI DWI, they were 86.5% sensitivity, 89.7% specificity, 93.3% PPV, and 80% NPV. The interobserver agreement was excellent (RS-EPI, κ: 0.84; non-EPI, κ: 0.91). The SI ratio measurements were consistently higher in non-EPI DWI (Reader A: 2.51, Reader B: 2.46) for the CHO group compared with RS-EPI. The SI ratio cut-off (>1.98) effectively differentiated hyperintense lesions between CHO and non-CHO groups, demonstrating 82.9% sensitivity and 100% specificity, with an area under the curve of 0.901 (95% confidence interval: 0.815–0.956; <i>P</i> < 0.001). Susceptibility artifact scores averaged 1.18 ± 0.7 (Reader A) and 1.04 ± 0.41 (Reader B) in RS-EPI, with non-EPI DWI recording a mean score of 0.</p><p><strong>Conclusion: </strong>Both RS-EPI and non-EPI DWI exhibited high diagnostic accuracy for CHO. While RS-EPI DWI cannot replace non-EPI DWI, their combined use improves sensitivity. SI ratio measurement in non-EPI DWI was particularly beneficial in complex diagnostic scenarios.</p><p><strong>Clinical significance: </strong>This study refines CHO diagnostic protocols by showcasing the diagnostic capabilities of both RS-EPI and non-EPI DWI and highlighting the utility of SI measurements as a diagnostic tool. These findings may reduce false positives and aid in more accurate treatment planning, offering substantial insights for clinicians in managing CHO.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"370-377"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}