Diagnostic and interventional radiology最新文献

{"title":"Burnout and the role of mentorship for radiology trainees and early career radiologists","authors":"Richard J Fagan, Dane Eskildsen, Tara Catanzano, Rachel Stanietzky, Serageldin Kamel, Mohamed Eltaher, Khaled M Elsayes","doi":"10.4274/dir.2024.242825","DOIUrl":"10.4274/dir.2024.242825","url":null,"abstract":"<p><p>Burnout is a widespread issue among physicians, including radiologists and radiology trainees. Long hours, isolation, and substantial stress levels contribute to healthcare workers experiencing a substantially higher rate of burnout compared with other professionals. Resident physicians, continuously exposed to stressors such as new clinical situations and performance feedback, are particularly susceptible. Mentorship has proven to be an effective strategy in mitigating burnout. Various mentorship delivery models exist, all aiming to have mentors serve as role models to mentees, thereby alleviating stress and anxiety. Physician groups and healthcare enterprises have actively implemented these programs, recognizing them as both successful and cost-effective. This article explores different mentorship models, their implementation processes, and the effectiveness of these programs as a standard component of academic departments.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"313-317"},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247644","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":"A comparison of two artificial intelligence-based methods for assessing bone age in Turkish children: BoneXpert and VUNO Med-Bone Age.","authors":"Evrim Özmen, Hande Özen Atalay, Evren Uzer, Mert Veznikli","doi":"10.4274/dir.2024.242790","DOIUrl":"10.4274/dir.2024.242790","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the validity of two artificial intelligence (AI)-based bone age assessment programs, BoneXpert and VUNO Med-Bone Age (VUNO), compared with manual assessments using the Greulich-Pyle method in Turkish children.</p><p><strong>Methods: </strong>This study included a cohort of 292 pediatric cases, ranging in age from 1 to 15 years with an equal gender and number distribution in each age group. Two radiologists, who were unaware of the bone age determined by AI, independently evaluated the bone age. The statistical study involved using the intraclass correlation coefficient (ICC) to measure the level of agreement between the manual and AI-based assessments.</p><p><strong>Results: </strong>The ICC coefficients for the agreement between the manual measurements of two radiologists indicate almost perfect agreement. When all cases, regardless of gender and age group, were analyzed, an almost perfect positive agreement was observed between the manual and software measurements. When bone age calculations were analyzed separately for boys and girls, no statistically significant differences were found between the two AI-based methods in any subgroup. For boys regardless of age, the ICCs were 0.995 for VUNO and 0.994 for BoneXpert (z = 1.597, <i>P</i> = 0.110), while for girls, the ICCs were 0.994 and 0.995, respectively (z = -1.303, <i>P</i> = 0.193). The overall agreement with manual measurements was high for both VUNO and BoneXpert. In both boys and girls, the agreement remained consistent across different age groups. These findings indicate that both AI-based bone age assessment tools have a high degree of agreement with manual measurements across all age and gender groups, with no significant superiority of one method over the other.</p><p><strong>Conclusion: </strong>Both BoneXpert and VUNO demonstrated high validity in assessing bone age, with no statistically significant differences between the two methods across gender or pubertal status groups. Notably, this study represents the first evaluation of both BoneXpert and VUNO for bone age assessment in Turkish children, highlighting their potential as reliable and clinically relevant tools for this population.</p><p><strong>Clinical significance: </strong>Investigating the most suitable AI program for the Turkish population could be clinically significant.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105422","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":"Feasibility study of computed high b-value diffusion-weighted magnetic resonance imaging for pediatric posterior fossa tumors.","authors":"Semra Delibalta, Barış Genç, Meltem Ceyhan Bilgici, Kerim Aslan","doi":"10.4274/dir.2024.242720","DOIUrl":"https://doi.org/10.4274/dir.2024.242720","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic efficacy of computed diffusion-weighted imaging (DWI) in pediatric posterior fossa tumors generated using high b-values.</p><p><strong>Methods: </strong>We retrospectively performed our study on 32 pediatric patients who had undergone brain magnetic resonance imaging for a posterior fossa tumor between January 2016 and January 2022. The DWIs were evaluated for each patient by two blinded radiologists. The computed DWI (cDWI) was mathematically derived using a mono-exponential model from images with b = 0 and 1,000 s/mm² and high b-values of 1,500, 2,000, 3,000, and 5,000 s/mm². The posterior fossa tumors were divided into two groups, low grade and high grade, and the tumor/thalamus signal intensity (SI) ratios were compared. The Mann-Whitney U test and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance of the acquired DWI (DWI₁₀₀₀), apparent diffusion coefficient (ADC)₁₀₀₀ maps, and cDWI (cDWI1500, cDWI₂₀₀₀, cDWI₃₀₀₀, and cDWI₅₀₀₀).</p><p><strong>Results: </strong>The comparison of the two tumor groups revealed that the tumor/thalamus SI ratio on the DWI₁₀₀₀ and cDWI (cDWI1500, cDWI₂₀₀₀, cDWI₃₀₀₀, and cDWI₅₀₀₀) was statistically significantly higher in high-grade tumors (<i>P</i> < 0.001). In the ROC curve analysis, higher sensitivity and specificity were detected in the cDWI1500, cDWI₂₀₀₀, cDWI₃₀₀₀, and ADC₁₀₀₀ maps (100%, 90.90%) compared with the DWI₁₀₀₀ (80%, 81.80%). cDWI₃₀₀₀ had the highest area under the curve (AUC) value compared with other parameters (AUC: 0.976).</p><p><strong>Conclusion: </strong>cDWI generated using high b-values was successful in differentiating between low-grade and high-grade posterior fossa tumors without increasing imaging time.</p><p><strong>Clinical significance: </strong>cDWI created using high b-values can provide additional information about tumor grade in pediatric posterior fossa tumors without requiring additional imaging time.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105425","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":"A retrospective evaluation of the potential of ChatGPT in the accurate diagnosis of acute stroke.","authors":"Beyza Nur Kuzan, İsmail Meşe, Servan Yaşar, Taha Yusuf Kuzan","doi":"10.4274/dir.2024.242892","DOIUrl":"https://doi.org/10.4274/dir.2024.242892","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Stroke is a neurological emergency requiring rapid, accurate diagnosis to prevent severe consequences. Early diagnosis is crucial for reducing morbidity and mortality. Artificial intelligence (AI) diagnosis support tools, such as Chat Generative Pre-trained Transformer (ChatGPT), offer rapid diagnostic advantages. This study assesses ChatGPT's accuracy in interpreting diffusion-weighted imaging (DWI) for acute stroke diagnosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted to identify the presence of stroke using DWI and apparent diffusion coefficient (ADC) map images. Patients aged &gt;18 years who exhibited diffusion restriction and had a clinically explainable condition were included in the study. Patients with artifacts that affected image homogeneity, accuracy, and clarity, as well as those who had undergone previous surgery or had a history of stroke, were excluded from the study. ChatGPT was asked four consecutive questions regarding the identification of the magnetic resonance imaging (MRI) sequence, the demonstration of diffusion restriction on the ADC map after sequence recognition, and the identification of hemispheres and specific lobes. Each question was repeated 10 times to ensure consistency. Senior radiologists subsequently verified the accuracy of ChatGPT's responses, classifying them as either correct or incorrect. We assumed a response to be incorrect if it was partially correct or suggested multiple answers. These responses were systematically recorded. We also recorded non-responses from ChatGPT-4V when it failed to provide an answer to a query. We assessed ChatGPT-4V's performance by calculating the number and percentage of correct responses, incorrect responses, and non-responses across all images and questions, a metric known as \"accuracy.\" ChatGPT-4V was considered successful if it answered ≥80% of the examples correctly.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 530 diffusion MRI, of which 266 were stroke images and 264 were normal, were evaluated in the study. For the initial query identifying MRI sequence type, ChatGPT-4V's accuracy was 88.3% for stroke and 90.1% for normal images. For detecting diffusion restriction, ChatGPT-4V had an accuracy of 79.5% for stroke images, with a 15% false positive rate for normal images. Regarding identifying the brain or cerebellar hemisphere involved, ChatGPT-4V correctly identified the hemisphere in 26.2% of stroke images. For identifying the specific brain lobe or cerebellar area affected, ChatGPT-4V had a 20.4% accuracy for stroke images. The diagnostic sensitivity of ChatGPT-4V in acute stroke was found to be 79.57%, with a specificity of 84.87%, a positive predictive value of 83.86%, a negative predictive value of 80.80%, and a diagnostic odds ratio of 21.86.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Despite limitations, ChatGPT shows potential as a supportive tool for healthcare professionals in interpreting diffusion examinations in","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105423","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":"Quadratus lumborum block for procedural and postprocedural analgesia in renal cell carcinoma percutaneous cryoablation.","authors":"Saman Fouladirad, Jasper Yoo, Behrang Homayoon, Jun Wang, Pedro Lourenço","doi":"10.4274/dir.2024.232100","DOIUrl":"https://doi.org/10.4274/dir.2024.232100","url":null,"abstract":"<p><p>This study assesses the efficacy of the quadratus lumborum block (QLB) in the management of procedural and periprocedural pain associated with small renal mass cryoablation. To the best of our knowledge, this is the first study that examines the use of QLB for pain management during percutaneous cryoablation of renal cell carcinoma (RCC). A single-center retrospective review was conducted for patients who underwent cryoablation for RCC with QLB between October 2020 and October 2021. The primary study endpoint included a total dose of procedural conscious sedation and administered, postprocedural analgesia. Technical success in cryoablation was achieved in every case. No patients required additional analgesic during or after the procedure, and no complications resulted from the use of the QLB. The QLB procedure appears to be an effective locoregional block for the management of procedural and periprocedural pain associated with renal mass cryoablation.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105426","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":"Detection of synovial inflammation in the sacroiliac joint space through intravoxel incoherent motion imaging: an alternative to contrast agents.","authors":"Murat Ağırlar, Barış Genç, Aysu Başak Özbalcı","doi":"10.4274/dir.2024.242749","DOIUrl":"https://doi.org/10.4274/dir.2024.242749","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;We investigated the diagnostic accuracy of simplified intravoxel incoherent motion (IVIM) imaging for detecting synovial inflammation in the sacroiliac joint (SIJ) in a population with active sacroiliitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In accordance with the Assessment of Spondyloarthritis International Society criteria, 86 SIJs of 46 patients with active sacroiliitis were included in this retrospective study conducted between November 2020 and January 2022. Based on T1-weighted post-gadolinium images, the SIJs were divided into two groups: synovial inflammation positive (SIP) (n = 28) and synovial inflammation negative (SIN) (n = 58). Synovial areas in the SIJ space were independently and blindly reviewed for the presence of inflammation by two radiologists with differing levels of expertise in radiology. Using four b values, apparent diffusion coefficient (ADC)= ADC (0, 800) and the simplified 3T IVIM method parameters true diffusion coefficient (D&lt;sub&gt;1&lt;/sub&gt;)= ADC (50, 800), D= ADC (400, 800), f&lt;sub&gt;1&lt;/sub&gt;= f (0, 50, 800), f&lt;sub&gt;2&lt;/sub&gt;= f (0, 400, 800), pseudodiffusion coefficient (D*)= D* (0, 50, 400, 800), ADC&lt;sub&gt;low&lt;/sub&gt; = ADC (0, 50), and ADC&lt;sub&gt;diff&lt;/sub&gt;= ADC&lt;sub&gt;low&lt;/sub&gt; - D were generated voxel by voxel for each patient. The IVIM and ADC parameters at the SIN and SIP joints were compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The D parameter was significantly increased in SIP areas (1.23 ± 0.34 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s) compared with SIN areas (1.02 ± 0.16 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s) (&lt;i&gt;P&lt;/i&gt; = 0.004). Conversely, the D* parameter was significantly decreased in SIP areas (21.78 ± 3.77 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s) compared with SIN areas (16.19 ± 4.58 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s) (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). When the optimal cut-off value of 1.11 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s was selected, the sensitivity for the D value was 71% and the specificity was 72% [area under the curve (AUC): 0.716)]. When the optimal cut-off value of 21.06 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s was selected, the sensitivity for the D* value was 78.6%, and the specificity was 79.3% (AUC: 0.829). The interclass correlation coefficient was excellent for f&lt;sub&gt;1&lt;/sub&gt;, f&lt;sub&gt;2&lt;/sub&gt; D*, D, and ADC&lt;sub&gt;diff&lt;/sub&gt;, good for ADC&lt;sub&gt;low&lt;/sub&gt; and D&lt;sub&gt;1&lt;/sub&gt;, but reasonable for ADC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The presence of synovial inflammation in the SIJ can be evaluated with high sensitivity and specificity using only four b values through the simplified IVIM method without the need for a contrast agent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical significance: &lt;/strong&gt;IVIM imaging is a technique that allows us to gain insights into tissue perfusion without the administration of contrast agents, utilizing diffusion-weighted images. In this study, for the first time, we demonstrated the potential of detecting synovial inflammation in the SIJ using IVIM, specifically through the pseudodiffusion (D*) parameter, without ","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999602","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic artery embolization in the treatment of blunt splenic injury: single level 1 trauma center experience.","authors":"Katelyn Gill, Sarah Aleman, Alexandra H Fairchild, Bahri Üstünsöz, Dan Laney, Alison A Smith, Hector Ferral","doi":"10.4274/dir.2024.242789","DOIUrl":"https://doi.org/10.4274/dir.2024.242789","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the experience of a single level 1 trauma center in the management of blunt splenic injuries (BSI).</p><p><strong>Methods: </strong>This is a retrospective study with Institutional Review Board approval. The medical records of 450 patients with BSI treated between January 2016 and December 2022 were reviewed. Seventy-two patients were treated with splenic artery embolization (SAE), met the study criteria, and were eligible for data analysis. Spleen injuries were graded in accordance with the American Association for the Surgery of Trauma Organ Injury Scale. Univariate data analysis was performed, with <i>P</i> < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The splenic salvage rate was 90.3% (n = 65/72). Baseline demographics were similar between the groups (<i>P</i> > 0.05). Distal embolization with Gelfoam^® had similar rates of splenic salvage to proximal embolization with coils (90% vs. 94.1%, <i>P</i> > 0.05). There was no significant difference in the rate of splenic infarction between distal embolization with Gelfoam^® (20%, 4/20) and proximal embolization with coils (17.6%, 3/17) (<i>P</i> > 0.05). There was no significant difference in procedure length (68 vs. 75.8 min) or splenic salvage rate (88.5% vs. 92.1%) between proximal and distal embolization (<i>P</i> > 0.05). There was no significant difference in procedure length (69.1 vs. 73.6 min) or splenic salvage rate (93.1% vs. 86.4%) between Gelfoam^® and coil embolization (<i>P</i> > 0.05). Combined proximal and distal embolization was associated with a higher rate of splenic abscess formation (25%, 2/8) when compared with proximal (0%, 0/26) or distal (0%, 0/38) embolization alone (<i>P</i> = 0.0003). The rate of asymptomatic and symptomatic splenic infarction was significantly higher in patients embolized at combined proximal and distal locations (<i>P</i> = 0.04, <i>P</i> = 0.01).</p><p><strong>Conclusion: </strong>The endovascular management of BSI is safe and effective. The overall splenic salvage rate was 90.3%. Distal embolization with Gelfoam^® was not associated with higher rates of splenic infarction when compared with proximal embolization with coils. Combined proximal and distal embolization was associated with a higher incidence of splenic infarction and splenic abscess formation.</p><p><strong>Clinical significance: </strong>Distal splenic embolization with Gelfoam^® is safe and may be beneficial in the setting of blunt splenic trauma.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579209","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":"Diagnostic performance of the O-RADS MRI system for magnetic resonance imaging in discriminating benign and malignant adnexal lesions: a systematic review, meta-analysis, and meta-regression.","authors":"Gülsüm Kılıçkap","doi":"10.4274/dir.2024.242784","DOIUrl":"https://doi.org/10.4274/dir.2024.242784","url":null,"abstract":"<p><strong>Purpose: </strong>After the introduction of the Ovarian-Adnexal Reporting and Data System (O-RADS) for magnetic resonance imaging (MRI), several studies with diverse characteristics have been published to assess its diagnostic performance. This systematic review and meta-analysis aimed to assess the diagnostic performance of O-RADS MRI scoring for adnexal masses, accounting for the risk of selection bias.</p><p><strong>Methods: </strong>The PubMed, Scopus, Web of Science, and Cochrane databases were searched for eligible studies. Borderline or malignant lesions were considered malignant. All O-RADS MRI scores ≥4 were considered positive. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The pooled sensitivity, specificity, and likelihood ratio (LR) values were calculated, considering the risk of selection bias.</p><p><strong>Results: </strong>Fifteen eligible studies were found, and five of them had a high risk of selection bias. Between-study heterogeneity was low-to-moderate for sensitivity but substantial for specificity (I2 values were 35.5% and 64.7%, respectively). The pooled sensitivity was significantly lower in the studies with a low risk of bias compared with those with a high risk of bias (93.0% and 97.5%, respectively; <i>P</i> = 0.043), whereas the pooled specificity was not different (90.4% for the overall population). The negative and positive LRs were 0.08 [95% confidence interval (CI) 0.05–0.11] and 10.0 (95% CI 7.7–12.9), respectively, for the studies with low risk of bias and 0.03 (95% CI 0.01–0.10) and 10.3 (95% CI 3.8–28.3), respectively, for those with high risk of bias.</p><p><strong>Conclusion: </strong>The overall diagnostic performance of the O-RADS system is very high, particularly for ruling out borderline/malignant lesions, but with a moderate ruling-in potential. Studies with a high risk of selection bias lead to an overestimation of sensitivity.</p><p><strong>Clinical significance: </strong>The O-RADS system demonstrates considerable diagnostic performance, particularly in ruling out borderline or malignant lesions, and should routinely be used in practice. The high between-study heterogeneity observed for specificity suggests the need for improvement in the consistent characterization of the benign lesions to reduce false positive rates.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554380","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":"Survival prediction using apparent diffusion coefficient values in recurrent glioblastoma under bevacizumab treatment: an updated systematic review and meta-analysis","authors":"Dong Liu, Zhangyu Li","doi":"10.4274/dir.2024.232550","DOIUrl":"10.4274/dir.2024.232550","url":null,"abstract":"<p><p>Bevacizumab is a common strategy for the treatment of recurrent glioblastoma. Survival status is a crucial issue for patients with recurrent glioblastoma, and the apparent diffusion coefficient (ADC) values of the lower Gaussian curve have been reported to have the potential to predict prognosis in recurrent glioblastoma. In the present study, we aimed to clarify the survival prediction of ADC values in patients with recurrent glioblastoma receiving bevacizumab treatment through a systematic review and meta-analysis of randomized clinical trials, comparing ADC values higher than the cut-off values with those lower than the cut-off values to determine which type of ADC values can be associated with significant survival benefits. Different survival indicators were analyzed, including overall survival (OS) and progression-free survival (PFS). Ten studies with a total of 782 patients with recurrent glioblastoma were included. The focused outcomes were OS and PFS. Our results showed that ADC values lower than the cut-off values were associated with significant benefits for OS status compared with ADC values higher than the cut-off values. Similar significant benefits were observed for PFS. The meta-analysis results suggest that ADC values lower than the cut-off values might be associated with significant benefits for OS and PFS when compared with ADC values higher than the cut-off values. However, bias in relation to the different stages of recurrent glioblastoma and different types, doses, and regimens of bevacizumab should not be ignored.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"270-274"},"PeriodicalIF":1.4,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641836","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}