Diagnostic and interventional radiology最新文献

{"title":"Large language models in radiology: fundamentals, applications, ethical considerations, risks, and future directions.","authors":"Tugba Akinci D'Antonoli, Arnaldo Stanzione, Christian Bluethgen, Federica Vernuccio, Lorenzo Ugga, Michail E Klontzas, Renato Cuocolo, Roberto Cannella, Burak Koçak","doi":"10.4274/dir.2023.232417","DOIUrl":"10.4274/dir.2023.232417","url":null,"abstract":"<p><p>With the advent of large language models (LLMs), the artificial intelligence revolution in medicine and radiology is now more tangible than ever. Every day, an increasingly large number of articles are published that utilize LLMs in radiology. To adopt and safely implement this new technology in the field, radiologists should be familiar with its key concepts, understand at least the technical basics, and be aware of the potential risks and ethical considerations that come with it. In this review article, the authors provide an overview of the LLMs that might be relevant to the radiology community and include a brief discussion of their short history, technical basics, ChatGPT, prompt engineering, potential applications in medicine and radiology, advantages, disadvantages and risks, ethical and regulatory considerations, and future directions.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41102193","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":"Head-to-head comparison of ¹⁸F-FDG PET/CT and ¹⁸F-FDG PET/MRI for lymph node metastasis staging in non-small cell lung cancer: a meta-analysis.","authors":"Min Zhang, Zhikang Liu, Yuhang Yuan, Wenwen Yang, Xiong Cao, Minjie Ma, Biao Han","doi":"10.4274/dir.2023.232280","DOIUrl":"10.4274/dir.2023.232280","url":null,"abstract":"<p><strong>Purpose: </strong>The current meta-analysis aimed to compare the diagnostic performance of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) with ¹⁸F-FDG PET/magnetic resonance imaging (MRI) in non-small cell lung cancer (NSCLC) lymph node metastasis staging.</p><p><strong>Methods: </strong>We searched the PubMed, Web of Science, and Embase databases for relevant articles between November 1992 and September 2022. Studies evaluating the head-to-head comparison of ¹⁸F-FDG PET/CT and ¹⁸F-FDG PET/MRI for lymph node metastasis in patients with NSCLC were included. The quality of each study was assessed using the Quality Assessment of Diagnostic Performance Studies-2 tool.</p><p><strong>Results: </strong>The analysis includes six studies with a total of 434 patients. The pooled sensitivity of ¹⁸F-FDG PET/CT and ¹⁸F-FDG PET/MRI was 0.78 [95% confidence interval (CI): 0.59-0.90] and 0.84 (95% CI: 0.68-0.93), and the pooled specificity was 0.87 (95% CI: 0.72-0.94) and 0.87 (95% CI: 0.80-0.92), respectively. The accuracy of ¹⁸F-FDG PET/CT and ¹⁸F-FDG PET/MRI was 0.81 (95% CI: 0.71-0.90) and 0.84 (95% CI: 0.75-0.92), respectively. When the pre-test probability was set at 50%, the post-test probability for ¹⁸F-FDG PET/CT could increase to 85%, and the post-test probability for ¹⁸F-FDG PET/MRI could increase to 87%.</p><p><strong>Conclusion: </strong>¹⁸F-FDG PET/CT and ¹⁸F-FDG PET/MRI have similar diagnostic performance in detecting lymph node metastasis in NSCLC. However, the results of this study were from a small sample study, and further studies with larger sample sizes are needed.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641834","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":"Donor bile duct evaluation with magnetic resonance cholangiography in living-donor liver transplantation: a novel anatomical classification for predicting surgical techniques.","authors":"Afak Durur Karakaya, Cemal Aydın Gündoğmuş, Turan Kanmaz, Cihan Karataş, Samet Kapakin","doi":"10.4274/dir.2023.232321","DOIUrl":"10.4274/dir.2023.232321","url":null,"abstract":"<p><strong>Purpose: </strong>To propose a novel, inclusive classification that facilitates the selection of the appropriate donor and surgical technique in living-donor liver transplantation (LDLT).</p><p><strong>Methods: </strong>The magnetic resonance cholangiography examinations of 201 healthy liver donors were retrospectively evaluated. The study group was classified according to the proposed classification. The findings were compared with the surgical technique used in 93 patients who underwent transplantation. The Couinaud, Huang, Karakas, Choi, and Ohkubo classifications were also applied to all cases.</p><p><strong>Results: </strong>There were 118 right-lobe donors (58.7%) and 83 left-lateral-segment donors (41.3%). Fifty-six (28.8%) of the cases were classified as type 1, 136 (67.7%) as type 2, and 7 (3.5%) as type 3 in the proposed classification; all cases could be classified. The number of individuals able to become liver donors was 93. A total of 36 cases were type 1, 56 were type 2, and 1 was type 3. Of the type 1 donors, 83% required single anastomosis during transplantation, whereas six patients classified as type 1 required two anastomoses, all of which were caused by technical challenges during resection. Moreover, 51.8% of the cases classified as type 2 required additional anastomosis during transplantation. The type 3 patient required three anastomoses. The type 1 and type 2 donors required a different number of anastomoses (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The proposed classification in this study includes all anatomical variations. This inclusive classification accurately predicts the surgical technique for LDLT.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41116590","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":"Reproducibility of rCBV in glioblastomas using T2*-weighted perfusion MRI: an evaluation of sampling, normalization, and experience.","authors":"Sabahattin Yüzkan, Samet Mutlu, Mehmet Karagülle, Merve Şam Özdemir, Hamit Özgül, Mehmet Ali Arıkan, Burak Koçak","doi":"10.4274/dir.2023.232442","DOIUrl":"10.4274/dir.2023.232442","url":null,"abstract":"<p><strong>Purpose: </strong>The reproducibility of relative cerebral blood volume (rCBV) measurements among readers with different levels of experience is a concern. This study aimed to investigate the inter-reader reproducibility of rCBV measurement of glioblastomas using the hotspot method in dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC-MRI) with various strategies.</p><p><strong>Methods: </strong>In this institutional review board-approved single-center study, 30 patients with glioblastoma were retrospectively evaluated with DSC-MRI at a 3.0 Tesla scanner. Three groups of reviewers, including neuroradiologists, general radiologists, and radiology residents, calculated the rCBV based on the number of regions of interest (ROIs) and reference areas. For statistical analysis of feature reproducibility, the intraclass correlation coefficient (ICC) and Bland-Altman plots were used. Analyses were made among individuals, reader groups, reader-group pooling, and a population that contained all of them.</p><p><strong>Results: </strong>For individuals, the highest inter-reader reproducibility was observed between neuroradiologists [ICC: 0.527; 95% confidence interval (CI): 0.21-0.74] and between residents (ICC: 0.513; 95% CI: 0.20-0.73). There was poor reproducibility in the analyses of individuals with different levels of experience (ICC range: 0.296-0.335) and in reader-wise and group-wise pooling (ICC range: 0.296-0.335 and 0.397-0.427, respectively). However, an increase in ICC values was observed when five ROIs were used. In an analysis of all strategies, the ICC for the centrum semiovale was significantly higher than that for contralateral white matter (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The inter-reader reproducibility of rCBV measurement was poor to moderate regardless of whether it was calculated by neuroradiologists, general radiologists, or residents, which may indicate the need for automated methods. Choosing five ROIs and using the centrum semiovale as a reference area may increase reliability for all users.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106175","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":"Effect of lipiodol marking before CT-guided cryoablation on the outcome of sporadic renal cell carcinoma.","authors":"Yasuhiro Ushijima, Daisuke Okamoto, Nobuhiro Fujita, Keisuke Ishimatsu, Noriaki Wada, Seiichiro Takao, Ryo Murayama, Masahiro Itoyama, Kousei Ishigami","doi":"10.4274/dir.2023.232381","DOIUrl":"10.4274/dir.2023.232381","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study evaluates the impact of preoperative lipiodol marking on the outcomes of computed tomography (CT)-guided cryoablation for histologically diagnosed sporadic renal cell carcinoma (RCC).</p><p><strong>Methods: </strong>This study analyzed the data of 173 patients who underwent CT-guided cryoablation for histologically proven sporadic RCC at a single institution between April 2014 and December 2020. The local control rate (LCR), recurrence-free survival rate (RFSR), overall survival rate (OSR), changes in renal function, and complications in patients with (n = 85) and without (n = 88) preoperative lipiodol marking were compared.</p><p><strong>Results: </strong>The 5-year LCR and 5-year RFSR were significantly higher in patients with lipiodol marking (97.51% and 93.84%, respectively) than in those without (72.38% and 68.10%, respectively) (<i>P</i> value <0.01, log-rank test). There were no significant differences between the two groups regarding the 5-year OSR (97.50% vs. 86.82%) or the deterioration in chronic kidney disease stage (12.70% vs. 16.43%). Grade ≥3 complications occurred in patients with lipiodol marking (n = 2, retroperitoneal hematoma and cerebral infarction in 1 patient each) and without (n = 5; urinary fistula in 2, colonic perforation in 2, urinary infection in 1).</p><p><strong>Conclusion: </strong>Lipiodol marking before CT-guided cryoablation for sporadic RCC is a feasible approach to improving local control and RFS while mitigating the decline in renal function. Additionally, it may help reduce complications.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073639","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":"Focal fatty sparing areas of the pediatric steatotic liver: pseudolesions on hepatobiliary phase magnetic resonance images.","authors":"Gözde Özer, H Nursun Özcan, Berna Oğuz, Mithat Haliloğlu","doi":"10.4274/dir.2023.232447","DOIUrl":"10.4274/dir.2023.232447","url":null,"abstract":"<p><strong>Purpose: </strong>Focal fatty sparing in liver can be detected as hyperintense pseudolesions on hepatobiliary phase magnetic resonance imaging (MRI). Distinguishing these pseudolesions from liver lesions may make diagnosis challenging. The aim of this study was to evaluate the imaging features of fatty sparing areas on liver MRI in pediatric patients who have been administered gadoxetate disodium.</p><p><strong>Methods: </strong>A total of 63 patients between January 2018 and June 2023 underwent gadoxetate disodium-enhanced liver MRI, and 9 (14%) patients with a focal fatty sparing were included in the study. The fat spared areas were evaluated qualitatively and quantitatively including signal intensity measurements and fat fraction calculations.</p><p><strong>Results: </strong>The liver MRI examinations of 9 patients (5 boys, 4 girls; aged 8-18 years, median age: 14.4) using gadoxetate disodium were evaluated. Based on in-phase and opposed-phase sequences, 13 areas of focal fatty sparing were identified. The mean fat fraction of the liver and fat spared areas were 26.2% (range, 15-47) and 9% (range, 2-17), respectively. All fat spared areas were hyperintense in the hepatobiliary phase images. The mean relative enhancement ratios of the liver and fat spared areas were 0.78 (range, 0.35-1.6) and 1.11 (range, 0.45-1.9), respectively.</p><p><strong>Conclusion: </strong>Focal fatty sparing in liver in children was observed as hyperintense on hepatobiliary phase MRI, and it should not be identified as a focal liver lesion.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458527","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":"Preoperative simulation results and intraoperative image fusion guidance for transjugular intrahepatic portosystemic shunt placement: a feasibility study of nineteen patients.","authors":"Xin Wei, Hong Hu, Lin Qi, Liming Zhong, Yunguo Liao, Jiaqi Pu","doi":"10.4274/dir.2022.221652","DOIUrl":"10.4274/dir.2022.221652","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose is to evaluate the feasibility and efficacy of preoperative simulation results and intraoperative image fusion guidance during transjugular intrahepatic portosystemic shunt (TIPS) creation.</p><p><strong>Methods: </strong>Nineteen patients were enrolled in the present study. The three-dimensional (3D) structures of the bone, liver, portal vein, inferior vena cava, and hepatic vein in the contrast-enhanced computed tomography (CT) scanning area were reconstructed in the Mimics software. The virtual Rosch-Uchida liver access set and the VIATORR stent model were established in the 3D Max software. The puncture path from the hepatic vein to the portal vein and the release position of the stent were simulated in the Mimics and 3D Max software, respectively. The simulation results were exported to Photoshop software, and the 3D reconstructed top of the liver diaphragm was used as the registration point to fuse with the liver diaphragmatic surface of the intraoperative fluoroscopy image. The selected portal vein system fusion image was overlaid on the reference display screen to provide image guidance during the operation. As a control, the last 19 consecutive cases of portal vein puncture under the guidance of conventional fluoroscopy were analyzed retrospectively, including the number of puncture attempts, puncture time, total procedure time, total fluoroscopy time, and total exposure dose (dose area product).</p><p><strong>Results: </strong>The average time of preoperative simulation was about 61.26 ± 6.98 minutes. The average time of intraoperative image fusion was 6.05 ± 1.13 minutes. The median number of puncture attempts was not significantly different between the study group (n = 3) and the control group (n = 3; <i>P</i> = 0.175). The mean puncture time in the study group (17.74 ± 12.78 min) was significantly lower than that in the control group (58.32 ± 47.11 min; <i>P</i> = 0.002). The mean total fluoroscopy time was not significantly different between the study group (26.63 ± 12.84 min) and the control group (40.00 ± 23.44 min; <i>P</i> = 0.083). The mean total procedure time was significantly lower in the study group (79.74 ± 37.39 min) compared with the control group (121.70 ± 62.24 min; <i>P</i> = 0.019). The dose area product of the study group (220.60 ± 128.4 Gy. cm²) was not significantly different from that of the control group (228.5 ± 137.3 Gy. cm²; <i>P</i> = 0.773). There were no image guidance-related complications.</p><p><strong>Conclusion: </strong>The use of preoperative simulation results and intraoperative image fusion to guide a portal vein puncture is feasible, safe, and effective when creating a TIPS. The method is cheap and may improve portal vein puncture, which may be valuable for hospitals lacking intravascular ultrasound and digital subtraction angiography (DSA) equipment equipped with a CT-angiography function.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9205191","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":"Transperineal microwave thermoablation for benign prostatic hyperplasia-related lower urinary tract symptoms in an elderly patient.","authors":"Yaşar Türk, İsmail Devecioğlu, Nusret Can Çilesiz, Barış Nuhoğlu","doi":"10.4274/dir.2024.232639","DOIUrl":"https://doi.org/10.4274/dir.2024.232639","url":null,"abstract":"<p><p>Transperineal prostate microwave thermoablation (TPMT) has been established as a safe means of treating benign prostatic hyperplasia (BPH); however, its effectiveness in addressing BPH-related lower urinary tract symptoms (LUTS) remains unexplored. This case study aims to evaluate the efficacy of TPMT in LUTS attributed to BPH. An 84-year-old man with LUTS due to BPH-induced bladder outlet obstruction, unresponsive to previous medical treatments, and failed prostate artery embolization, underwent TPMT. Three coaxial needles were positioned at the midline, right, and left sides of the hypertrophic transitional zone of the prostate. Microwave energy, with parameters determined using liver data and targeted ablation area, was applied at 2,450 MHz in continuous mode. The tissue temperature was monitored using bilateral thermocouple sensors. The patient exhibited no changes in defecation rhythm, abdominal discomfort, or anorectal pain. Temporary postoperative hematuria was promptly resolved through saline irrigation within 6 hours, and hematological evaluations showed normal results. Significant clinical improvements were observed (e.g., prostate volume, prostate-specific antigen levels) accompanied by an increase in peak flow rate. Thus, TPMT appears to be a promising intervention for bladder outlet stenosis and LUTS induced by BPH.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989598","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":"Institutional clinical indication-based typical dose values of multiphasic abdominopelvic computed tomography examinations.","authors":"Süleyman Filiz, Safiye Gürel, Kamil Gürel","doi":"10.4274/dir.2024.232551","DOIUrl":"https://doi.org/10.4274/dir.2024.232551","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aimed to obtain clinical indication-based typical dose values and size-specific dose estimates (SSDEs) for multiphasic abdominopelvic computed tomography (CT) examinations and to review our data with published diagnostic reference levels (DRLs).</p><p><strong>Methods: </strong>In this retrospective study, multiphasic liver, kidney, pancreas, and mesenteric ischemia protocol CT scans performed at our center between January 2018 and December 2021 were analyzed. The clinical indications were hepatocellular carcinoma, renal cell carcinoma, pancreas adenocarcinoma, and mesenteric ischemia. The computed tomography dose index volume (CTDI_vol) and dose-length product (DLP) values were recorded, and the SSDE and effective dose (ED) values were calculated. The water-equivalent diameter (Dw) value required for the SSDE calculation was measured using the automated calculation of the Dw program.</p><p><strong>Results: </strong>The total number of patients was 514, with 86 patients excluded from this study. The dose values were calculated for 426 patients (183 female and 243 male; 111 liver, 120 kidney, 85 pancreas, and 110 mesenteric). The median values for the CTDI_vol, DLP, SSDE, and ED were 6.86 mGy, 683.02 mGy. cm, 8.75 mGy, and 10.45 mSv for the liver CT; 8.37 mGy, 908.37 mGy.cm, 10.37 mGy, and 13.89 mSv for the kidney CT; 7.82 mGy, 517.98 mGy.cm, 10.01 mGy, and 7.92 mSv for the pancreas CT; and 9.48 mGy, 983.68 mGy.cm, 12.78 mGy, and 13.86 mSv for the mesenteric CT, respectively. All dose values were lower than the published DRLs.</p><p><strong>Conclusion: </strong>The literature reveals large differences in the multiphasic abdominopelvic CT protocols, especially in the number of phases and scan length. This situation makes comparing dose values difficult. Dose studies revealing the protocol parameters in detail are needed so that institutions can compare and optimize their own protocols. Additionally, users should periodically check the dose values in their own institutions.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905257","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":"Endovascular recanalization of infra-popliteal TASC C and TASC D lesions in patients with critical limb-threatening ischemia: a single-center experience.","authors":"Mehmet Koray Akkan, Ali Can Yalçın, Zeydanlı Tolga, Fatih Öncü, Erhan Turgut Ilgıt, Ahmet Baran Önal, Mustafa Hakan Zor, Abdullah Özer","doi":"10.4274/dir.2024.232524","DOIUrl":"https://doi.org/10.4274/dir.2024.232524","url":null,"abstract":"<p><strong>Purpose: </strong>The present study aims to (1) assess the technical success and limb salvage rates of endovascular therapy in patients with critical limb-threatening ischemia (CLTI) and infra-popliteal Trans-Atlantic Inter-Society Consensus (TASC) C/D lesions according to the updated 2015 TASC II classification and (2) to present our institutional experience.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted on patients with TASC C/D CLTI who underwent endovascular treatment between 2012 and 2017. The follow-up protocol consisted of Doppler ultrasound conduction every 3 months for the first year unless patients showed symptoms of CLTI. Patients with at least 1 year of follow-up data were included in the study, and if applicable their 3-year results were evaluated in terms of primary patency, absence of amputation, amputation-free survival, and overall survival.</p><p><strong>Results: </strong>A total of 248 patients and 287 limbs (238 TASC D lesions and 49 TASC C lesions) were treated via infra-popliteal percutaneous transluminal angioplasty. The overall technical success was 87%, the primary patency rate was 41.5% in the first year, and the freedom from amputation rates were 80.8% in 1 year and 67.7% in 3 years.</p><p><strong>Conclusion: </strong>In patients with infra-popliteal arterial occlusive diseases, endovascular treatment methods demonstrate a high rate of technical success and favorable outcomes in limb preservation.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641831","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}