Diagnostic and interventional radiology最新文献

{"title":"The value of dual-energy computed tomography angiography-based virtual monoenergetic imaging for evaluations after cerebral aneurysm clipping.","authors":"Zhihua Lu, Suying Wu, Feijian Wu, Qingdong Jin, Qingjing Huang, Baoteng Zhang","doi":"10.4274/dir.2024.242975","DOIUrl":"10.4274/dir.2024.242975","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to research the optimal energy range of dual-energy computed tomography angiography (DECTA)-based virtual monoenergetic imaging (VMI) for evaluations after cerebral aneurysm clipping.</p><p><strong>Methods: </strong>Sixty patients who underwent DECTA after cerebral aneurysm clipping were analyzed retrospectively. Conventional computed tomography angiography (CTA) was compared with VMIs at 60, 70, 80, 90, and 100 keV. The mean attenuation and standard deviation values within the regions of interest placed in the brain parenchyma and arteries with the worst artifact were measured, respectively. The ΔCT and artifact index (AI) values were calculated to assess the artifact severity. The contrast-to-noise ratio (CNR) was calculated to assess vascular contrast. Two radiologists assessed brain parenchyma and cerebrovascular scores qualitatively using a five-point Likert scale.</p><p><strong>Results: </strong>Quantitative analysis showed that the artifacts of VMIs were significantly reduced compared with conventional CTA (<i>P</i> ≤ 0.014), except for the ΔCT and AI of 60 keV and the ΔCT of 70 keV. However, there was no significant difference in the vascular contrast on VMIs compared with conventional CTA, except for the CNR of 60 keV (<i>P</i> = 0.008). In qualitative analysis, the proportions of brain parenchyma scores and cerebrovascular scores ≥4 on the VMIs of 70 and 80 keV were higher than those of conventional CTA and other VMIs.</p><p><strong>Conclusion: </strong>For the patients who underwent DECTA after cerebral aneurysm clipping, the 70-80 keV VMIs are expected to be the optimal energy range for balancing clip artifacts and visibility of adjacent vessels.</p><p><strong>Clinical significance: </strong>Studying the optimal energy range of DECTA-based VMI for post-operative assessment of aneurysm clipping can reduce metal artifacts in images and increase vascular contrast. This facilitates the follow-up of patients after aneurysm clipping, offers timely and accurate detection of postoperative complications, provides assistance to clinicians in diagnosis and treatment, and improves patient prognosis.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"264-273"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827656","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":"Breast cancer detection and classification with digital breast tomosynthesis: a two-stage deep learning approach.","authors":"Yazeed Alashban","doi":"10.4274/dir.2024.242923","DOIUrl":"10.4274/dir.2024.242923","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to propose a new computer-assisted two-staged diagnosis system that combines a modified deep learning (DL) architecture (VGG19) for the classification of digital breast tomosynthesis (DBT) images with the detection of tumors as benign or cancerous using the You Only Look Once version 5 (YOLOv5) model combined with the convolutional block attention module (CBAM) (known as YOLOv5-CBAM).</p><p><strong>Methods: </strong>In the modified version of VGG19, eight additional layers were integrated, comprising four batch normalization layers and four additional pooling layers (two max pooling and two average pooling). The CBAM was incorporated into the YOLOv5 model structure after each feature fusion. The experiment was carried out using a sizable benchmark dataset of breast tomography images. A total of 22,032 DBT examinations from 5,060 patients were included in the data.</p><p><strong>Results: </strong>Test accuracy, training loss, and training accuracy showed better performance with our proposed architecture than with previous models. Hence, the modified VGG19 classified DBT images more accurately than previously possible using pre-trained model-based architectures. Furthermore, a YOLOv5-based CBAM precisely discriminated between benign lesions and those that were malignant.</p><p><strong>Conclusion: </strong>DBT images can be classified using modified VGG19 with accuracy greater than the previously available pre-trained models-based architectures. Furthermore, a YOLOv5-based CBAM can precisely distinguish between benign and cancerous lesions.</p><p><strong>Clinical significance: </strong>The proposed two-tier DL algorithm, combining a modified VGG19 model for image classification and YOLOv5-CBAM for lesion detection, can improve the accuracy, efficiency, and reliability of breast cancer screening and diagnosis through innovative artificial intelligence-driven methodologies.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"206-214"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794458","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":"Consolidation in the right middle lobe in pediatric bronchial-pulmonary artery shunt: radiology's Aunt Minnie?","authors":"Chi Wang, Rongchang Wu, Zihan Wang, Shuai Ma, Xinyu Yuan, Yuchun Yan, Yun Peng","doi":"10.4274/dir.2024.242908","DOIUrl":"10.4274/dir.2024.242908","url":null,"abstract":"<p><strong>Purpose: </strong>By retrospectively studying the chest computed tomography (CT) data of children with bronchial artery (BA)-pulmonary artery fistula, this study summarizes the characteristic imaging features of the disease and provides imaging support for the diagnosis and clinical treatment of these children.</p><p><strong>Methods: </strong>Digital subtraction angiography and CT angiography data were collected from 74 children with pulmonary hemorrhage following BA embolization. Bronchial-pulmonary shunt was present in 30 cases.</p><p><strong>Results: </strong>Of the 74 children with pulmonary hemorrhage in this study, seven exhibited signs of consolidation in the middle lobe of the right lung, and bronchial-pulmonary shunt existed in all of them. A total of 30 children with BA-pulmonary artery shunt (PAS) had BA tortuosity and thickening. Regarding primary BA-PAS, the middle lobe and lower lobe of the right lung were involved in 94.1% (16) of the children. Those with a fistula located in the middle lobe of the right lung accounted for 58.8% (10 cases), of which 40.0% (four cases) presented consolidation. In this study, 41.2% (seven) of the children with primary BA-PAS exhibited no abnormal changes on chest CT, and 58.8% (10 cases) exhibited abnormal changes in the unilateral lung.</p><p><strong>Conclusion: </strong>For children with pulmonary hemorrhage who have consolidation in the right middle lobe, the formation of BA-PAS should be anticipated. The possibility of primary BA-PAS should not be disregarded in children with pulmonary hemorrhage with tortuosity and dilation of BAs, despite no apparent abnormalities on lung CT, or ground-glass density or consolidation on only one side.</p><p><strong>Clinical significance: </strong>The chest CT of patients with pulmonary hemorrhage showed consolidation of the right middle lobe of the lung, which was highly likely to indicate BA-PAS.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"280-284"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497016","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":"Evaluating Microsoft Bing with ChatGPT-4 for the assessment of abdominal computed tomography and magnetic resonance images.","authors":"Alperen Elek, Duygu Doğa Ekizalioğlu, Ezgi Güler","doi":"10.4274/dir.2024.232680","DOIUrl":"10.4274/dir.2024.232680","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of Microsoft Bing with ChatGPT-4 technology in analyzing abdominal computed tomography (CT) and magnetic resonance images (MRI).</p><p><strong>Methods: </strong>A comparative and descriptive analysis was conducted using the institutional picture archiving and communication systems. A total of 80 abdominal images (44 CT, 36 MRI) that showed various entities affecting the abdominal structures were included. Microsoft Bing's interpretations were compared with the impressions of radiologists in terms of recognition of the imaging modality, identification of the imaging planes (axial, coronal, and sagittal), sequences (in the case of MRI), contrast media administration, correct identification of the anatomical region depicted in the image, and detection of abnormalities.</p><p><strong>Results: </strong>Microsoft Bing detected that the images were CT scans with 95.4% accuracy (42/44) and that the images were MRI scans with 86.1% accuracy (31/36). However, it failed to detect one CT image (2.3%) and misidentified another CT image as an MRI (2.3%). On the other hand, it also misidentified four MRI as CT images (11.1%) and one as an X-ray (2.7%). Bing achieved an 83.75% success rate in correctly identifying abdominal regions, with 90% accuracy for CT scans (40/44) and 77.7% for MRI scans (28/36). Concerning the identification of imaging planes, Bing achieved a success rate of 95.4% for CT images and 83.3% for MRI. Regarding the identification of MRI sequences (T1-weighted and T2-weighted), the success rate was 68.75%. In the identification of the use of contrast media for CT scans, the success rate was 64.2%. Bing detected abnormalities in 35% of the images but achieved a correct interpretation rate of 10.7% for the definite diagnosis.</p><p><strong>Conclusion: </strong>While Microsoft Bing, leveraging ChatGPT-4 technology, demonstrates proficiency in basic task identification on abdominal CT and MRI, its inability to reliably interpret abnormalities highlights the need for continued refinement to enhance its clinical applicability.</p><p><strong>Clinical significance: </strong>The contribution of large language models (LLMs) to the diagnostic process in radiology is still being explored. However, with a comprehensive understanding of their capabilities and limitations, LLMs can significantly support radiologists during diagnosis and improve the overall efficiency of abdominal radiology practices. Acknowledging the limitations of current studies related to ChatGPT in this field, our work provides a foundation for future clinical research, paving the way for more integrated and effective diagnostic tools.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"196-205"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999603","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":"Dual-energy computed tomography-based volumetric thyroid iodine quantification: correlation with thyroid hormonal status, pathologic diagnosis, and phantom validation.","authors":"Younghen Lee","doi":"10.4274/dir.2025.243132","DOIUrl":"10.4274/dir.2025.243132","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between intrathyroidal iodine concentration (IC) (mg I/mL) and thyroid hormonal status or pathologic diagnosis with the use of dual-energy computed tomography (DECT).</p><p><strong>Methods: </strong>We retrospectively included patients who underwent neck CT examination between September 2016 and August 2021 using a dual-layer DECT scanner (120 kilovolt peak) for preoperative thyroid imaging. We performed volumetric IC measurements at the thyroid parenchyma on the additional iodine map generated from non-contrast images. We then compared the mean IC of thyroid parenchyma based on thyroid hormonal status (hypothyroid, euthyroid, and hyperthyroid) and diffuse thyroid disease (DTD). Additionally, we determined the accuracy of iodine quantification with our site-specific DECT acquisition protocol using a Gammex^TM phantom containing seven iodine inserts with different ICs ranging from 2 to 20 mgI/mL.</p><p><strong>Results: </strong>Among the 578 patients (M:F: 87:491, age: 48.6 ± 11.7 years) who were finally selected, the mean thyroid parenchymal ICs was the lowest in the hyperthyroid group, followed by the hypothyroid group, and then the euthyroid group (0.68 ± 0.37, n = 44 vs. 1.13 ± 0.42, n = 61 vs. 1.32 ± 0.43, n = 473, <i>P</i> < 0.01, respectively). In the patients with euthyroidism, the mean parenchymal IC was already lower in the patients with pathologically proven DTD than in those without DTD (1.22 ± 0.44 mgI/mL vs. 1.45 ± 0.37 mgI/mL, <i>P</i> < 0.01). Based on the phantom study, the median percentage deviations from the expected values were 5.1% for ICs of 2-20 mgI/mL.</p><p><strong>Conclusion: </strong>DECT-based IC quantification could be a potentially useful method for identifying patients with thyroid hormone dysfunction or DTD without the use of contrast media.</p><p><strong>Clinical significance: </strong>Without the need for intravenous administration, DECT-based intrathyroidal IC quantification provides potentially valuable information from the non-contrast CT image of the thyroid parenchyma.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"226-233"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656431","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":"Maximum standardized uptake value-to-tumor size ratio in fluorodeoxyglucose F18 positron emission tomography/computed tomography: a simple prognostic parameter for non-small cell lung cancer.","authors":"Soo Jeong Kim, Koeun Lee, Hyun Joo Lee, Du-Young Kang, Young Hwan Kim","doi":"10.4274/dir.2024.242837","DOIUrl":"10.4274/dir.2024.242837","url":null,"abstract":"<p><strong>Purpose: </strong>By correcting the effect of tumor size on metabolic activity, the maximum standardized uptake value-to-tumor size (SUV_max:tumor size) ratio on fluorodeoxyglucose F18 positron emission tomography (¹⁸F-FDG PET)/computed tomography (CT) scans can be a prognostic parameter of non-small cell lung cancer (NSCLC). The current study evaluates the prognostic value of SUV_max:tumor size ratio on pretreatment ¹⁸F-FDG PET/CT scans in patients with NSCLC. Furthermore, the SUV_max:tumor size ratio is compared with other established PET parameters.</p><p><strong>Methods: </strong>This study included 108 patients with NSCLC who underwent pretreatment ¹⁸F-FDG PET/CT scans and curative lung surgery. The associations between the SUV_max:tumor size ratio and other conventional PET parameters were investigated. The recurrence-free survival according to the SUV_max:tumor size ratio was also analyzed. In addition, the SUV_max:tumor size ratio was compared according to postoperative pathologic findings.</p><p><strong>Results: </strong>In total, 72 (66.7%) of the 108 participants presented with adenocarcinoma (ADC). Nineteen (17.6%) patients experienced recurrence during a median follow-up period of 32.3 months. The median SUV max:tumor size ratio was 2.37 (1.23 for ADCs and 3.90 for other histologic types). The SUV_max:tumor size ratio was associated with SUV_max and mean SUV, as well as metabolic tumor volume and total lesion glycolysis. Patients with an SUV_max:tumor size ratio higher than the median had a worse recurrence outcome than those with an SUV_max:tumor size ratio lower than the median. Participants with ADC who presented with lymphovascular invasion had a higher SUV_max:tumor size ratio than those without. The presence of lymph node metastasis and advanced histologic grade were associated with a high SUV_max:tumor size ratio in patients with ADC.</p><p><strong>Conclusion: </strong>The SUV_max:tumor size ratio on pretreatment ¹⁸F-FDG PET/CT scans was associated with aggressive tumor behavior and poor outcome in NSCLCs, particularly ADC.</p><p><strong>Clinical significance: </strong>The SUV_max:tumor size ratio on pretreatment ¹⁸F-FDG PET/CT scans has a prognostic value in patients with NSCLCs, especially ADC.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"274-279"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361317","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":"Open- and closed-type congenital cholesteatomas of the middle ear: computed tomography differentiation and correlation with surgical staging.","authors":"Minjung Seong, Hyung-Jin Kim, Yikyung Kim, Sung Tae Kim","doi":"10.4274/dir.2024.242913","DOIUrl":"10.4274/dir.2024.242913","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the differences in computed tomography (CT) features between closed-type congenital cholesteatoma (CCC) and open-type congenital cholesteatoma (OCC) of the middle ear and to evaluate the usefulness of preoperative CT examination for staging workup of congenital cholesteatoma (CC) in correlation with the surgical findings.</p><p><strong>Methods: </strong>We retrospectively reviewed the preoperative CT scans of the temporal bone obtained from 80 patients with surgically confirmed CC of the middle ear. All patients had a solitary lesion, except for one patient with two lesions, resulting in 81 CCs, which formed the basis of this study. We compared the CT features between CCCs and OCCs, focusing on their morphological characteristics, such as size, shape, location, and bone change. Based on the Potsic classification, the stage of CCs was determined at CT and surgery, and the results were compared between CCCs and OCCs.</p><p><strong>Results: </strong>Of the 81 CCs, surgery revealed 43 CCCs and 38 OCCs. On CT scans, CCC was frequently seen as a small (median: 3.15 mm), round to oval (65.1%) mass, most commonly located in the anterosuperior quadrant (74.4%) of the middle ear with less frequent ossicular erosion (14.0%). In contrast, OCC was frequently seen as a large (median: 6.70 mm), irregular (94.7%) mass, most commonly located in the posterosuperior quadrant (68.4%) of the middle ear with frequent ossicular erosion (55.3%). The size, shape, location, and presence of ossicular erosion were significantly different between the two types. Overall, the CT and surgical stages of CCs demonstrated good agreement (kappa value: 0.77) and the CT and surgical stages of OCCs were statistically significantly higher than those of CCCs (<i>P</i> < 0.001 in both).</p><p><strong>Conclusion: </strong>CT is useful for preoperative determination of the types and staging of CC of the middle ear.</p><p><strong>Clinical significance: </strong>Preoperative differentiation between CCC and OCC is important to avoid reoperation and prevent an extensive surgery. By providing valuable information on the morphology and extent of the lesions, CT is useful for not only the accurate preoperative determination of the type of CCs but also the accurate prediction of staging of the lesion, which should be important to preparing optimal treatment plans.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"180-186"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794466","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":"Long-term outcomes of catheter-directed sclerotherapy for ovarian endometrioma.","authors":"Jae Hwan Lee, Jihyung Yoon, Chong-Ho Lee, Kun Yung Kim, Chang Jin Yoon, Minuk Kim, Seul Ki Kim","doi":"10.4274/dir.2024.242874","DOIUrl":"10.4274/dir.2024.242874","url":null,"abstract":"<p><strong>Purpose: </strong>Although favorable results have been reported on catheter-directed sclerotherapy (CDS) for ovarian endometrioma, a thorough evaluation of its long-term efficacy is lacking. This study evaluates the long-term efficacy and safety of CDS with 99% ethanol for treatment of ovarian endometrioma.</p><p><strong>Methods: </strong>Between January 2020 and February 2022, data from 33 consecutive patients with symptomatic ovarian endometriomas who underwent CDS were retrospectively evaluated. All patients underwent pre-procedural and 6- and 12-month post-procedural ultrasonography. To assess the effect on ovarian reserve, serum anti-Müllerian hormone (AMH) levels were measured before and after the procedure. Procedure-related complications were also assessed.</p><p><strong>Results: </strong>The mean volume of endometriomas decreased from 80.22 ± 66.43 to 0.73 ± 1.10 mL (<i>P</i> < 0.001), and the mean percentage of volume reduction was 98.99% ± 1.53%. No recurrences were observed during the follow-up period. In patients whose serum AMH levels were monitored for 1 year, no significant change in AMH level before and after CDS was observed (3.07 ± 1.81 vs. 2.72 ± 2.02 ng/mL, <i>P</i> = 0.190). One patient complained of moderate abdominal pain after CDS, which was conservatively managed.</p><p><strong>Conclusion: </strong>CDS remained safe and effective in treating ovarian endometrioma at the 1-year follow-up. Ovarian function after CDS was well preserved.</p><p><strong>Clinical significance: </strong>CDS is a safe and effective treatment option for patients with ovarian endometrioma without compromising ovarian function.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"249-252"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361315","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":"Renal bleeding: imaging and interventions in patients with tumors.","authors":"Emad D Singer, Niloofar Karbasian, Douglas S Katz, Vincenzo K Wong, Mohamed E Abdelsalam, Nir Stanietzky, Trinh T Nguyen, Anuradha S Shenoy-Bhangle, Mohamed Badawy, Margarita V Revzin, Mostafa A Shehata, Mohamed Eltaher, Khaled M Elsayes, Brinda Rao Korivi","doi":"10.4274/dir.2024.242822","DOIUrl":"10.4274/dir.2024.242822","url":null,"abstract":"<p><p>In patients with cancer, spontaneous renal bleeding can stem from a range of underlying factors, necessitating precise diagnostic tools for effective patient management. Benign and malignant renal tumors are among the primary culprits, with angiomyolipomas and renal cell carcinomas being the most common among them. Vascular anomalies, infections, ureteral obstructions, and coagulation disorders can also contribute to renal-related bleeding. Cross-sectional imaging techniques, particularly ultrasound and computed tomography (CT), play pivotal roles in the initial detection of renal bleeding. Magnetic resonance imaging and CT are preferred for follow-up evaluations and aid in detecting underlying enhancing masses. IV contrast-enhanced ultrasound can provide additional information for active bleeding detection and differentiation. This review article explores specific disorders associated with or resembling spontaneous acute renal bleeding in patients with renal tumors; it focuses on the significance of advanced imaging techniques in accurately identifying and characterizing renal bleeding in these individuals. It also provides insights into the clinical presentations, imaging findings, and treatment options for various causes of renal bleeding, aiming to enhance the understanding, diagnosis, and management of the issue.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"161-170"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317156","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":"Combining transarterial chemoembolization, radiofrequency ablation, and iodine-125 seed implantation for recurrent hepatocellular carcinoma post-hepatectomy.","authors":"Yong Zhong, Li Wang, Weibin Dan, Dan Liang","doi":"10.4274/dir.2024.242814","DOIUrl":"10.4274/dir.2024.242814","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and iodine-125 (125I) seed implantation (TACE-RFA-125I) for recurrent hepatocellular carcinoma (HCC) after hepatectomy.</p><p><strong>Methods: </strong>The study retrospectively analyzed patients with recurrent HCC who received TACE-RFA-125I or TACE-RFA treatment in our institution between January 2013 and January 2023. Overall survival (OS), progression-free survival (PFS), and recurrence were compared between the two groups.</p><p><strong>Results: </strong>A total of 187 patients were enrolled in this study, with 105 in the TACE-RFA-125I group and 82 in the TACE-RFA group. There were 67 men and 15 women in the TACE-RFA group, with an average age of 55.4 ± 10.9 years, and 93 men and 12 women in the TACE-RFA-125I group, with an average age of 55.5 ± 10.7 years. The TACE-RFA-125I group exhibited a significantly improved survival benefit compared with the TACE-RFA group (median OS: 49 months vs. 32 months, <i>P</i> < 0.001; median PFS: 24 months vs. 16 months, <i>P</i> < 0.001). The univariate and multivariate analyses revealed that TACE-RFA-125I was a protective factor for OS and PFS. A total of 32 patients in the TACE-RFA group experienced recurrence during follow-up, with local recurrence in 12 cases, intrahepatic recurrence in 10 cases, and extrahepatic metastases in 10 cases. A total of 28 patients in the TACE-RFA-125I group experienced recurrence, 6 with local recurrence, 12 with intrahepatic recurrence, and 10 with extrahepatic metastases. No procedure-related deaths occurred in this study.</p><p><strong>Conclusion: </strong>In patients with recurrent HCC, TACE-RFA-125I demonstrates promising tumor control and acceptable safety.</p><p><strong>Clinical significance: </strong>This study provides promising clinical guidance for patients with recurrent HCC after hepatectomy and is expected to provide beneficial strategies for the treatment of this disease.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"253-258"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727035","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}