Diagnostic and interventional radiology最新文献

{"title":"Diagnostic value of the flare sign in predicting extracapsular extension in metastatic axillary lymph nodes and nodal status on breast magnetic resonance imaging.","authors":"Cihan Özgür, Baran Serdar Sunal, Savaş Hereklioğlu, Meltem Öznur, Sibel Özkan Gürdal","doi":"10.4274/dir.2024.242906","DOIUrl":"10.4274/dir.2024.242906","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in predicting extracapsular extension (ECE) and axillary nodal status in the axillary metastatic lymph nodes of patients with breast cancer.</p><p><strong>Methods: </strong>The preoperative MRI scans of 92 patients with breast cancer and axillary metastases who did not receive neoadjuvant treatment between January 2018 and January 2024 were retrospectively examined. The presence of an increased signal in the axillary fatty tissue surrounding the lymph node (flare sign) on T2-weighted images, irregular nodal contour (shaggy margin), axillary asymmetry (difference in the number and size of lymph nodes compared with the unaffected axilla), loss of the fatty hilum in the most suspicious lymph node, and morphological features on T1-weighted images were assessed. Each dissected axillary lymph node was examined for ECE, and the histopathological results were recorded.</p><p><strong>Results: </strong>Axillary flare sign was significantly associated with the presence of ECE (<i>P</i> < 0.001), number of lymph nodes with ECE (<i>P</i> < 0.001), the presence of ≥4 axillary metastatic lymph nodes (<i>P</i> < 0.001), size of the primary tumor (<i>P</i> = 0.033), lymphovascular invasion in the primary tumor (<i>P</i> < 0.001), and presence of perineural invasion (<i>P</i> = 0.001). The flare sign exhibited 65.7% sensitivity, 96% specificity, 97.8% positive predictive value, 51.1% negative predictive value, and 73.9% accuracy in predicting ECE. Additionally, the receiver operating characteristic curve analysis revealed an area under the curve of 0.808 (95% confidence interval: 0.719-0.898).</p><p><strong>Conclusion: </strong>The flare sign has high performance in predicting ECE and axillary nodal status and is associated with primary tumor aggressiveness, indicating its potential utility in preoperative evaluation.</p><p><strong>Clinical significance: </strong>The flare sign on breast MRI may play a crucial role in preoperative planning, surgical decision-making, and axillary status assessment by accurately predicting ECE.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589760","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}

{"title":"Assessing hepatic steatosis by magnetic resonance in potential living liver donors","authors":"Diğdem Kuru Öz, Zeynep Ellik, Ayşegül Gürsoy Çoruh, Mehmet Adıgüzel, Mesut Gümüşsoy, Saba Kiremitci, Onur Elvan Kırımker, Hale Gökcan, Atilla Halil Elhan, Deniz Balcı, Berna Savaş, Ayşe Erden, Ramazan İdilman","doi":"10.4274/dir.2024.242697","DOIUrl":"10.4274/dir.2024.242697","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the accuracy of magnetic resonance imaging-proton density fat fraction (MRI-PDFF) measurements for detecting liver fat content in potential living liver donors and to compare these results using liver biopsy findings.</p><p><strong>Methods: </strong>A total of 139 living liver donors (men/women: 83/56) who underwent MRI between January 2017 and September 2021 were included in this analysis retrospectively. The PDFFs were measured using both MR spectroscopy (MRS) and chemical shift-based MRI (CS-MRI) for each donor in a blinded manner.</p><p><strong>Results: </strong>Significant positive correlations were found between liver biopsy and MRS-PDFF and CS-MRI PDFF in terms of hepatic steatosis detection [r = 0.701, 95% confidence interval (CI): 0.604–0.798, r = 0.654, 95% CI: 0.544–0.765, <i>P</i> < 0.001, respectively). A weak level correlation was observed between liver biopsy, MRI methods, and vibration-controlled transient elastography attenuation parameters in 42 available donors. Based on receiver operating characteristic (ROC) analysis, MRS-PDFF and CS-MRI PDFF significantly distinguished >5% of histopathologically detected hepatic steatosis with an area under the ROC curve (AUC) of 0.837 ± 0.036 (<i>P</i> < 0.001, 95% CI: 0.766–0.907) and 0.810 ± 0.036 (<i>P</i> < 0.001, 95% CI: 0.739–0.881), respectively. The negative predictive values (NPVs) of MRS-PDFF and CS-MRI PDFF were 88.3% and 81.3%, respectively. In terms of distinguishing between clinically significant hepatic steatosis (≥10% on histopathology), the AUC of MRS-PDFF and CS-MRI were 0.871 ± 0.034 (<i>P</i> < 0.001 95% CI: 0.804–0.937) and 0.855 ± 0.036 (<i>P</i> < 0.001, 95% CI: 0.784–0.925), respectively. The NPVs of MRS-PDFF and CS-MRI were 99% and 92%, respectively.</p><p><strong>Conclusion: </strong>The methods of MRS-PDFF and CS-MRI PDFF provide a non-invasive and accurate approach for assessing hepatic steatosis in potential living liver donor candidates. These MRI PDFF techniques present a promising clinical advantage in the preoperative evaluation of living liver donors by eliminating the requirement for invasive procedures like liver biopsy.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"351-356"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910843","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":"Challenges associated with percutaneous nephrostomy in infants","authors":"Iraklis-Georgios Kagias, Panagiotis Nikolinakos, Chloe Mortensen, Joseph M Norris","doi":"10.4274/dir.2023.232507","DOIUrl":"10.4274/dir.2023.232507","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"378-379"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479285","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":"Pivotal role of the synovioentheseal complex in the imaging of arthritis and rheumatic diseases","authors":"Adalet Elçin Yıldız, Üstün Aydıngöz","doi":"10.4274/dir.2024.242740","DOIUrl":"10.4274/dir.2024.242740","url":null,"abstract":"<p><p>Imaging plays a key role in the diagnosis and management of rheumatic diseases. Although joints and periarticular tissue are commonly involved in rheumatic diseases, entheses further away from joints, such as in the Achilles tendon or plantar fascia insertion onto the calcaneus, as well as skin and subcutaneous tissue, are among other -sometimes overlooked- targets. The link of enthesitis, which describes inflammation at the insertions of ligaments, tendons, or joint capsules, with spondyloarthritis (SpA) was established just before the turn of the century as a characteristic feature based on imaging studies with histopathological correspondence. To highlight the association between enthesitis and synovitis in SpA, the anatomical unit of the “synovioentheseal complex” (SEC) and the concepts of “functional enthesis” and “articular enthesis,” apart from the better known “insertional enthesis,” were introduced to encompass other inflammatory lesions associated with SpA. Studies from the last two decades revealed the involvement of the SEC in rheumatic and non-rheumatic disorders with different pathogeneses. Although such involvement is sometimes distinctive, it does not necessarily point to a specific diagnosis at other times. Nevertheless, the potential of SEC inflammation in the differentiation of SpA from other forms of arthritis remains important. The purpose of this review was to provide essential information concerning the involvement of the SEC in the diagnosis of rheumatic diseases and arthritis, focusing on imaging characteristics.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"409-418"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295737","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":"Pre-procedure ¹⁸F-FDG PET/CT imaging improves the performance of CT-guided transthoracic biopsy","authors":"Ai-Fang Jin, Zhe-Huang Luo, Wan-Ling Qi, Qian Liu","doi":"10.4274/dir.2023.232364","DOIUrl":"10.4274/dir.2023.232364","url":null,"abstract":"<p><strong>Purpose: </strong>To compare computed tomography (CT)-guided transthoracic lung biopsies (CTLB) with and without pre-procedure ¹⁸F-fludeoxyglucose positron emission tomography (¹⁸F-FDG PET)/CT images in the diagnosis of pulmonary nodules/masses.</p><p><strong>Methods: </strong>This is a case-control study in a single center. The data of patients with a transthoracic lung biopsy guided by CT and pre-procedure ¹⁸F-FDG PET/CT (group 2, here called the “PETCTLB” group), including demographics, clinical characteristics, and biopsy-related parameters, were collected. The PET/CT scan was performed within 15 days before the biopsy. The data from patients with CTLB were used as controls (group 1). Biopsies for all patients were performed by the same physician between January 2019 and December 2021. The final diagnosis was based on surgical outcomes, or imaging findings, and the results of at least one 6-month follow-up. The demographics and clinical characteristics of patients, lesions and biopsy-related variables, diagnostic yields, and incidence of complications were compared between the two groups. Two-tailed t-tests were used to compare the mean values in the two independent groups, while categorical variables were compared using the Pearson chi-squared test, and <i>P</i> values < 0.05 were considered to be significant.</p><p><strong>Results: </strong>A total of 84 patients were included, and 84 biopsies of 84 lung nodules/masses were analyzed. The demographics and clinical characteristics of group 2 (n = 39; 21 men; mean age, 63.2 ± 9.29 years) and group 1 (n = 45; 30 men; mean age, 61.2 ± 12.3 years) had no significant difference (<i>P</i> = 0.230 and 0.397, respectively). The procedure duration (11.1 ± 3.0 vs. 12.9 ± 3.3 minutes, <i>P</i> = 0.008), the number of samples (2.6 ± 0.5 vs. 3.1 ± 0.4, <i>P</i> < 0.001), diagnostic accuracy (97.4% vs. 82.2%, <i>P</i> = 0.033), and bleeding complication (25.6% vs. 42.2%, <i>P</i> = 0.034) of group 2 and group 1 were statistically different.</p><p><strong>Conclusion: </strong>A biopsy guided by CT plus pre-procedure ¹⁸F-FDG PET/CT (PETCTLB) is a safe procedure that can provide a precise diagnosis in the majority of lung nodules/masses. It has better diagnostic performance than CTLB.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"380-384"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641835","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":"Choosing the right artificial intelligence solutions for your radiology department: key factors to consider","authors":"Deniz Alis, Toygar Tanyel, Emine Meltem, Mustafa Ege Seker, Delal Seker, Hakkı Muammer Karakaş, Ercan Karaarslan, İlkay Öksüz","doi":"10.4274/dir.2024.232658","DOIUrl":"10.4274/dir.2024.232658","url":null,"abstract":"<p><p>The rapid evolution of artificial intelligence (AI), particularly in deep learning, has significantly impacted radiology, introducing an array of AI solutions for interpretative tasks. This paper provides radiology departments with a practical guide for selecting and integrating AI solutions, focusing on interpretative tasks that require the active involvement of radiologists. Our approach is not to list available applications or review scientific evidence, as this information is readily available in previous studies; instead, we concentrate on the essential factors radiology departments must consider when choosing AI solutions. These factors include clinical relevance, performance and validation, implementation and integration, clinical usability, costs and return on investment, and regulations, security, and privacy. We illustrate each factor with hypothetical scenarios to provide a clearer understanding and practical relevance. Through our experience and literature review, we provide insights and a practical roadmap for radiologists to navigate the complex landscape of AI in radiology. We aim to assist in making informed decisions that enhance diagnostic precision, improve patient outcomes, and streamline workflows, thus contributing to the advancement of radiological practices and patient care.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"357-365"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862435","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":"Imaging findings of primary lung tumors in children","authors":"H Nursun Özcan, Fırat Atak, Berna Oğuz, Tezer Kutluk, Mithat Haliloğlu","doi":"10.4274/dir.2024.242714","DOIUrl":"10.4274/dir.2024.242714","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric lung tumors are primarily discussed in the surgical literature. However, limited research has been reported on their imaging findings, and only a few tumor types have been documented. Therefore, the aim of this article is to describe the imaging features of primary lung tumors in children.</p><p><strong>Methods: </strong>The archives of the pediatric radiology unit were reviewed for primary lung tumors documented between 2007 and 2023. In total, 24 patients (9 girls and 15 boys; aged 5 months to 16 years) were included in the study. Their demographic characteristics, clinical presentation, and histopathologic results were obtained. All imaging studies were reviewed by two radiologists for various findings (e.g., lymphadenopathy, atelectasis, pleural effusion, calcification, multiplicity, pneumothorax, axial and lobar location, laterality, tumor margin, mediastinal shift, contrast enhancement pattern, signal intensity on T1- and T2-weighted images, and diffusion pattern), and a final decision was made by consensus. The mean tumor size was compared between the benign and malignant groups using a t-test.</p><p><strong>Results: </strong>There were 15 (62.5%) benign tumors, as follows: inflammatory myofibroblastic tumor (IMT; n = 10, 41%), hemangioma (n = 2, 8%), pneumocytoma (n = 2, 8%), and mature cystic teratoma (n = 1, 4%). Moreover, there were 9 (37.5%) malignant tumors, as follows: pleuropulmonary blastoma (PPB; n = 6, 25%), adenocarcinoma (n = 2, 8%), and lymphoepithelioma-like carcinoma (LELC) (n = 1, 4%). The most frequently reported symptoms were cough, fever, dyspnea, chest pain, and recurrent infection; six patients reported no clinical symptoms. Fifteen tumors (62%) were located in the right lung. The mean tumor diameter at the time of diagnosis was 6.4 ± 3 cm (benign group: 6.7 ± 3.4 cm; malignant group: 6 ± 2.3 cm, <i>P</i> > 0.050). Calcification was present in 80% of the patients with IMT. At the time of diagnosis, two (8.3%) patients were found to have metastasis: one was diagnosed with adenocarcinoma and the other with LELC. Tumors were located peripherally in 18 (75%) patients.</p><p><strong>Conclusion: </strong>The symptoms associated with lung masses are non-specific. There is no correlation between tumor size and malignancy. The most common tumors observed in this study were IMT and PPB, respectively. IMT is highly associated with calcification.</p><p><strong>Clinical significance: </strong>Primary lung tumors are rarely seen in children, and they have different histopathological types. Calcification might be an important radiological clue for the diagnosis of IMT, which is the most common lung tumor in children.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"419-426"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295736","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}