Journal of Computer Assisted Tomography最新文献

{"title":"Usefulness of Dual-Energy CT for Differentiating Hemorrhage From Iodine Extravasation in Meningiomas After Preoperative Embolization.","authors":"Ryutaro Uchimura, Zaw Aung Khant, Hidetaka Hayashi, Yasunori Nagayama, Hiroyuki Uetani, Yasuyuki Kaku, Tatsuhiro Nagatomo, Yoshitaka Tamura, Kiyotaka Yokogami, Akitake Mukasa, Hiro Kiyosue, Minako Azuma, Toshinori Hirai","doi":"10.1097/RCT.0000000000001685","DOIUrl":"10.1097/RCT.0000000000001685","url":null,"abstract":"<p><strong>Objective: </strong>Discriminating between hemorrhage and iodine extravasation can pose challenges in conventional computed tomography (CCT) images following preoperative embolization for meningioma. This study aimed to assess the efficacy of dual-energy computed tomography (DECT) in differentiating hemorrhage from iodine extravasation after preoperative embolization for meningioma.</p><p><strong>Methods: </strong>Twenty-one consecutive meningioma patients who underwent CCT before and DECT immediately after preoperative embolization were included in this study. Two independent observers conducted qualitative assessments on CCT and virtual noncontrast (VNC) images and iodine maps (IMs) to differentiate between hemorrhage and iodine extravasation. One observer recorded CT values of hemorrhage and iodine extravasation on CCT and VNC images. The ratio of maximum attenuation to minimum attenuation on VNC images was defined as the VNC ratio. Statistical analysis included Kappa ( κ ) statistics, unpaired t tests, and receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Interobserver agreement for qualitative assessment was fair ( κ  = 0.231) for CCT alone and good ( κ  = 0.723) for CCT plus VNC imaging and IM. The addition of VNC imaging and IM to CCT improved differential confidence in 16 (76%) and 18 (86%) cases of the two observers, respectively, increasing the area under the receiver operating characteristic curve (AUROC) from 0.868 to 0.895 and 0.658 to 0.947, respectively. At a cutoff value of 1.527, the VNC ratio was significantly higher for hemorrhage than iodine extravasation ( P  < 0.05), with the highest diagnostic performance (AUROC, 1).</p><p><strong>Conclusions: </strong>DECT with VNC imaging and IM is useful for differentiating hemorrhage from iodine extravasation in meningiomas with preoperative embolization.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 3","pages":"493-501"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968005","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":"The Value of Whole-Volume Radiomics Machine Learning Model Based on Multiparametric MRI in Predicting Triple-Negative Breast Cancer.","authors":"Tingting Xu, Xueli Zhang, Huan Tang, Ting Hua Bd, Fuxia Xiao, Zhijun Cui, Guangyu Tang, Lin Zhang","doi":"10.1097/RCT.0000000000001691","DOIUrl":"10.1097/RCT.0000000000001691","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the value of radiomics analysis in the precise diagnosis of triple-negative breast cancer (TNBC) based on breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and apparent diffusion coefficient (ADC) maps.</p><p><strong>Methods: </strong>This retrospective study included 326 patients with pathologically proven breast cancer (TNBC: 129, non-TNBC: 197). The lesions were segmented using the ITK-SNAP software, and whole-volume radiomics features were extracted using a radiomics platform. Radiomics features were obtained from DCE-MRI and ADC maps. The least absolute shrinkage and selection operator regression method was employed for feature selection. Three prediction models were constructed using a support vector machine classifier: Model A (based on the selected features of the ADC maps), Model B (based on the selected features of DCE-MRI), and Model C (based on the selected features of both combined). Receiver operating characteristic curves were used to evaluate the diagnostic performance of the conventional MR image model and the 3 radiomics models in predicting TNBC.</p><p><strong>Results: </strong>In the training dataset, the AUCs for the conventional MR image model and the 3 radiomics models were 0.749, 0.801, 0.847, and 0.896. The AUCs for the conventional MR image model and 3 radiomics models in the validation dataset were 0.693, 0.742, 0.793, and 0.876, respectively.</p><p><strong>Conclusions: </strong>Radiomics based on the combination of whole volume DCE-MRI and ADC maps is a promising tool for distinguishing between TNBC and non-TNBC.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"407-416"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780234","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":"Virtual Chest Radiographs Developed From Computed Tomography Images for Differentiating Central Venous Versus Misplaced Arterial Lines and for Training Radiologists.","authors":"Satoru Morita, Akihiro Inoue, Yasuhiro Kunihiro, Toshihiro Ono, Sota Endo, Takahiro Yamamoto, Hiroshi Yamazaki, Yoshiko Bamba, Shigeki Yamaguchi, Shuji Sakai","doi":"10.1097/RCT.0000000000001690","DOIUrl":"10.1097/RCT.0000000000001690","url":null,"abstract":"<p><strong>Objective: </strong>Radiographic findings to identify central venous catheter misplacement in the arteries, which can cause lethal complications, have not been fully evaluated, and its training is difficult because it is rare. The purpose of this study is to clarify radiographic findings for differentiating central venous and misplaced arterial lines using virtual chest radiographs and elucidate their usefulness in training radiologists.</p><p><strong>Methods: </strong>This retrospective study included 150 patients (mean age, 67 [SD, ±12] years; 97 men) who underwent colon cancer surgery between January 2018 and December 2020. Virtual chest radiographs, including 6 oblique projections at 5° intervals, were developed from the computed tomography images using ray-sum reconstruction. Virtual venous and arterial lines were drawn from the right neck to the superior vena cava and aorta, respectively. Diagnostic abilities, including area under the curve (AUC) analysis of the 7 proposed radiographic findings for differentiating these lines in 100 patients, were evaluated. The diagnostic performance, including AUC analysis by 5 radiologists in the other 50 patients, was compared before and after disclosing these results to the radiologists.</p><p><strong>Results: </strong>The findings of crossing over the right paratracheal stripe and running along the paracaval line showed the highest AUC for indicating arterial and venous lines in the frontal, right anterior oblique 15°, and left anterior oblique 15° projections (AUC = 0.992, 0.991, and 0.979, and 1.000, 0.994, and 0.998, respectively). The diagnostic performance of the radiologists improved after informing them of these results (AUC, 0.982-0.999 to 0.993-1.000 [ P  = 0.145-1.000] for the frontal projections and 0.932-0.970 to 0.967-0.995 [ P  = 0.075-0.150] for the oblique projections).</p><p><strong>Conclusions: </strong>Virtual chest radiographs created from computed tomography images were useful for clarifying radiographic findings for differentiating central venous and misplaced arterial lines and for training radiologists.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 3","pages":"440-447"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968298","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":"Validating a Practical Correction for Intravenous Contrast on Computed Tomography-Based Muscle Density.","authors":"Jevin Lortie, Deborah Ufearo, Scott Hetzel, Perry J Pickhardt, Timothy P Szczykutowicz, Adam J Kuchnia","doi":"10.1097/RCT.0000000000001682","DOIUrl":"10.1097/RCT.0000000000001682","url":null,"abstract":"<p><strong>Objective: </strong>Computed tomography (CT) measured muscle density is prognostic of health outcomes. However, the use of intravenous contrast obscures prognoses by artificially increasing CT muscle density. We previously established a correction to equalize contrast and noncontrast muscle density measurements. While this correction was validated internally, the objective of this study was to obtain external validation using different patient cohorts, muscle regions, and CT series.</p><p><strong>Methods: </strong>CT images from 109 patients with kidney tumors who received abdominal CT scans with a multiphase intravenous contrast protocol were analyzed. Paraspinal muscle density measurements taken during noncontrast, venous phase, and delayed phase contrast scans were collected. An a priori correction of -7.5 Hounsfield units (HU) was applied to muscle measurements. Equivalence testing was utilized to determine statistical similarity.</p><p><strong>Results: </strong>In the sample of 109 patients (mean age: 63 years [SD: 14.3]; 41.3% female), densities in smaller regions of interest within the paraspinal muscles and the entire paraspinal muscle density (PS) in venous and delayed phase contrast scans were higher than in noncontrast. Equivalence testing showed that average corrected contrast and noncontrast muscle densities were within 3 HU for both muscle measures for the total patient sample, and for a majority of male and female subsamples. The correction is suitable for regions of interests of venous contrast (90% CI: -1.90, -0.69 HU) and delayed contrast scans (90% CI: 0.075, 1.29 HU) and within the PS measures of venous contrast (90% CI: -2.04, -0.94 HU) and delayed contrast scans (90% CI: -0.11, 0.89 HU).</p><p><strong>Conclusions: </strong>The previously established correction for contrast of -7.5 HU was applied in a new patient population, axial muscle region, muscle measurement size, and expanded on previously studied contrast phases. The correction produced contrast-corrected muscle densities that were statistically equivalent to noncontrast muscle densities. The simplicity of the correction gives clinicians a tool that seamlessly integrates into practice or research to improve harmonization of data between contrast and noncontrast scans.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 3","pages":"480-485"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12071502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020756","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":"Deep Learning Reconstruction for Enhanced Resolution and Image Quality in Breath-Hold MRCP: A Preliminary Study.","authors":"Kaori Shiraishi, Takeshi Nakaura, Naofumi Yoshida, Kensei Matsuo, Naoki Kobayashi, Masamichi Hokamura, Hiroyuki Uetani, Yasunori Nagayama, Masafumi Kidoh, Kosuke Morita, Yuichi Yamashita, Yasuhito Tanaka, Hideo Baba, Toshinori Hirai","doi":"10.1097/RCT.0000000000001680","DOIUrl":"10.1097/RCT.0000000000001680","url":null,"abstract":"<p><strong>Objective: </strong>This preliminary study aims to assess the image quality of enhanced-resolution deep learning reconstruction (ER-DLR) in magnetic resonance cholangiopancreatography (MRCP) and compare it with non-ER-DLR MRCP images.</p><p><strong>Methods: </strong>Our retrospective study incorporated 34 patients diagnosed with biliary and pancreatic disorders. We obtained MRCP images using a single breath-hold MRCP on a 3T MRI system. We reconstructed MRCP images with ER-DLR (matrix = 768 × 960) and without ER-DLR (matrix = 256 × 320). Quantitative evaluation involved measuring the signal-to-noise ratio (SNR), contrast, contrast-to-noise ratio (CNR) between the common bile duct and periductal tissues, and slope. Two radiologists independently scored image noise, contrast, artifacts, sharpness, and overall image quality for the 2 image types using a 4-point scale. Results are expressed as median and interquartile range (IQR), and we compared quantitative and qualitative scores employing the Wilcoxon test.</p><p><strong>Results: </strong>In quantitative analyses, ER-DLR significantly improved SNR (21.08 [IQR: 14.85, 31.5] vs 15.07 [IQR: 9.57, 25.23], P  < 0.001), CNR (19.29 [IQR: 13.87, 24.98] vs 11.23 [IQR: 8.98, 15.74], P  < 0.001), contrast (0.96 [IQR: 0.94, 0.97] vs 0.9 [IQR: 0.87, 0.92], P  < 0.001), and slope of MRCP (0.62 [IQR: 0.56, 0.66] vs 0.49 [IQR: 0.45, 0.53], P  < 0.001). The qualitative evaluation demonstrated significant improvements in the perceived noise ( P  < 0.001), contrast ( P  = 0.013), sharpness ( P  < 0.001), and overall image quality ( P  < 0.001).</p><p><strong>Conclusions: </strong>ER-DLR markedly increased the resolution, SNR, and CNR of breath-hold-MRCP compared to cases without ER-DLR.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 3","pages":"367-376"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026059","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 Multiparametric MRI for Detection of Prostate Cancer After Focal Therapy.","authors":"Robert D Petrocelli, Barun Bagga, Sooah Kim, Vinay Prabhu, Kun Qian, Ezequiel Becher, Samir S Taneja, Angela Tong","doi":"10.1097/RCT.0000000000001703","DOIUrl":"10.1097/RCT.0000000000001703","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive focal therapy of low- to intermediate-risk prostate cancer is becoming more common and has demonstrated lower morbidity compared to other treatments. Multiparametric prostate magnetic resonance imaging (mpMRI) has the potential to be an effective posttreatment evaluation method for residual/recurrent neoplasm.</p><p><strong>Objective: </strong>This study aimed to evaluate the ability of mpMRI to detect residual/recurrent neoplasm after focal therapy treatment of prostate cancer using a 3-point Likert scale.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent focal therapy utilizing cryoablation, high-frequency ultrasound, and radiofrequency ablation for low- to intermediate-risk prostate cancer with baseline mpMRI and biopsy and a 6- to 12-month follow-up mpMRI and biopsy. Three abdominal fellowship-trained readers were asked to evaluate the follow-up mpMRI utilizing a 3-point Likert scale based on the level of suspicion as \"nonviable,\" \"equivocal,\" or \"viable.\" Diagnostic statistics and Light's κ for interreader variability were calculated.</p><p><strong>Results: </strong>A total of 142 patients were included (mean age, 65 ± 7 years). When considering \"equivocal\" or \"viable\" as positive, the overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC) for detecting recurrent grade group (GG) 2 or greater disease for Reader 1 were 0.47, 0.83, 0.24, 0.93, and 0.65; for Reader 2, 0.73, 0.75, 0.26, 0.96, and 0.74; and for Reader 3, 0.73, 0.57, 0.17, 0.95, and 0.65. When considering \"viable\" as positive, the overall sensitivity, specificity, PPV, NPV, and AUC for Reader 1 were 0.47, 0.92, 0.41, 0.94, and 0.69; for Reader 2, 0.33, 0.97, 0.56, 0.93, and 0.65; and for Reader 3, 0.53, 0.84, 0.29, 0.94, and 0.69. κ was 0.39.</p><p><strong>Conclusions: </strong>This study suggests that DCE and DWI are the most important sequences in mpMRI and demonstrates the efficacy of utilizing a 3-point grading system in detecting and diagnosing prostate cancer after focal therapy.</p><p><strong>Clinical impact: </strong>mpMRI can be used to monitor for residual/recurrent disease after focal therapy.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"391-398"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813375","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":"The Utility of Cardiac Computed Tomographic Angiography in Differentiating Between Papillary Fibroelastoma, Infective Endocarditis, and Degeneration of the Aortic Valve.","authors":"Wen-Chi Hsu, Aws Kamona, Dilek Oncel, Elliot K Fishman, Cheng Ting Lin","doi":"10.1097/RCT.0000000000001696","DOIUrl":"10.1097/RCT.0000000000001696","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac computed tomography angiography (CCTA) has significantly advanced the visualization of cardiac structures, particularly valves. We assessed the diagnostic performance of CCTA in diagnosing the most common disorders affecting the aortic valves requiring surgery-papillary fibroelastoma, infective endocarditis, and degeneration.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent aortic valve resection between 2016 and 2023 and had a preceding CCTA. Pathologic diagnoses were categorized into the following 3 groups: papillary fibroelastoma, infective endocarditis, and degeneration. Each case was independently evaluated by 3 cardiac-trained radiologists.</p><p><strong>Results: </strong>The study group consisted of 50 patients with aortic valvular disorder-14 papillary fibroelastoma, 13 endocarditis, and 23 degeneration. Diagnostic accuracy varied from 70% to 74% among the 3 readers, with a pooled accuracy of 71% and consensus accuracy of 76%. Most errors involved small (≤7 mm) papillary fibroelastomas. Both papillary fibroelastomas and endocarditis-related vegetations typically presented with nodules on CT; however, nodule stalks were only observed with papillary fibroelastomas. Echocardiography aided in distinguishing between the disorders by detecting leaflet perforation and aortic regurgitation in cases of infective endocarditis.</p><p><strong>Conclusions: </strong>This study evaluated cardiac CTA for noninvasive characterization of aortic valvular disorders prior to resection. Reader accuracy ranged from 70% to 74%, improving to 76% with consensus interpretations. Small papillary fibroelastomas (≤7 mm) and overlapping imaging features, such as nodular lesions and leaflet thickening, were diagnostic challenges. Greater awareness of these CT characteristics is essential for accurate diagnosis and clinical management.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 3","pages":"417-421"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002631","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":"Pseudocavity on Thin-slice CT Can Be a Suggestion of Bronchiolar Adenoma: A Preliminary Study on 80 Cases With Bronchiolar Adenoma of the Lung.","authors":"Fei Li, Yanli He, Hengli Yang, Xiaoyan Qu, Yanyan Li, Danting Shang, Gangfeng Li","doi":"10.1097/RCT.0000000000001761","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001761","url":null,"abstract":"<p><strong>Objectives: </strong>At present, the study of bronchiolar adenoma (BA) mainly focuses on its pathologic characteristics, but there is limited understanding of its clinical manifestations and imaging signs. This article aims to summarize the clinical manifestations and imaging features of 80 cases of BA, with the goal of achieving a comprehensive and systematic understanding of BA.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 80 patients with BA confirmed by surgical pathology in our hospital. All subjects underwent thin-slice CT examination. The basic information, tumor history, clinical manifestations, and CT imaging features of the lesions were collected. The subjects' age, maximum diameter of BA, and shortest distance from the pleura were analyzed by t-test or 1-way ANOVA, while other clinical and radiologic characteristics were compared for differences among different BA types by the χ2 test or Fisher exact probability method.</p><p><strong>Results: </strong>The majority of the 80 patients were female, with an average age of 59.08±10.16 years. The majority of them do not manifest any clinical symptoms. All lesions are located in the subpleural area, including 63 cases in the lower lobe of the lungs. The average size of the tumors was 10.31±5.01 mm. The majority of the lesions exhibited irregular morphology (53 cases, 66.25%) and predominantly comprised solid nodules (46 cases, 57.50%). There were statistically significant differences in lesion morphology, boundary, and pseudocavity among pure ground-glass nodular BA, mixed ground-glass nodular BA, and solid density nodular BA. Compared with pure ground-glass density BA (1 case, 1.25%) and mixed ground-glass density BA (7 cases, 8.75%), the boundary of solid nodules BA (42 cases, 52.50%) was significantly clearer (P<0.001). The presence of pseudocavity was found to be significantly higher in individuals with solid nodules compared with those with pure ground-glass nodules (P<0.0167). Compared with BA without pseudocavity, BA with pseudocavity exhibited a clearer lung interface (P<0.001), more abnormal vessel signs (P=0.007), and a higher incidence of malignant preoperative diagnosis (P=0.020).</p><p><strong>Conclusions: </strong>BA mostly occurs in middle-aged and elderly women without any clinical symptoms. The imaging manifestations of BA are diverse, mainly presenting as irregular solid nodules. The interface between the tumor and lung is clear, and pseudocavity formation is common. In addition, BA with pseudocavity often exhibits abnormal vascular signs, which can lead to misdiagnosis as malignancy before surgery.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003766","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":"Imaging Features and Reliability of Percutaneous Biopsy of Metanephric Adenoma of the Kidney.","authors":"Ghada Issa, Jessie L Chai, Sharath Bhagavatula, Raquel O Alencar","doi":"10.1097/RCT.0000000000001753","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001753","url":null,"abstract":"<p><strong>Purpose: </strong>To describe imaging features of metanephric adenomas, assess the reliability of a diagnosis with image-guided percutaneous renal mass biopsy, and evaluate patient survival outcomes.</p><p><strong>Materials and methods: </strong>In this IRB-approved, HIPAA-compliant retrospective study, our institution's radiology report database was searched for the term \"metanephric adenoma\" from 2010 to 2020. Patient information, imaging mass characteristics, and percutaneous biopsy technique and complications were recorded. Analyses of per-tumor growth rate, per-procedure diagnostic rates, and per-patient disease-specific and metastasis-free survival were evaluated.</p><p><strong>Results: </strong>The database search yielded 8 tumors (mean diameter 2.0 cm, range 1.0 to 3.1 cm) in 8 patients (median age 60.5 y, range 40 to 66 y; 6 women) who underwent percutaneous biopsies and had imaging available for review. All tumors (8/8) were solitary, well-defined, and hypoenhancing on post-contrast images. For those with available MR, 100% (5/5) demonstrated restricted diffusion. On unenhanced CT, 62.5% (5/8) were hyperdense. The mean tumor growth rate was 0.7 mm/y (range: -0.1 to 3 mm/y) with a median imaging follow-up of 83.4 months (range: 1.6 to 198.0 mo). Specific diagnosis of metanephric adenoma on the first percutaneous biopsy was found in 75% (6/8) of patients; with repeat biopsy in 2 patients confirming metanephric adenoma. Per-patient survival outcome after a median clinical follow-up of 151.8 months (range: 1.6 to 250.6 mo) showed 100% disease-specific and metastasis-free survival.</p><p><strong>Conclusions: </strong>Metanephric adenomas are usually solitary, well-defined, and hypoenhancing masses on imaging, hyperattenuating compared with the renal parenchyma on noncontrast CT, and with restricted diffusion on MR. Image-guided percutaneous biopsy results of this tumor are reliable and safe.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993118","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":"Early Experience With Postmortem CT Imaging.","authors":"Kalpana Kanal, David Zamora, Richard Harruff, Jeffrey Robinson, William Shuman, Dushyant Sahani, J Matthew Lacy, Nicole Yarid, Jonathan Medverd","doi":"10.1097/RCT.0000000000001732","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001732","url":null,"abstract":"<p><strong>Objective: </strong>Postmortem computed tomography (PMCT) is a procedure fairly unfamiliar to many US radiologists. We embarked on a collaboration between the department of radiology and the medical examiner's office (MEO) with the purpose of introducing PMCT into the autopsy workflow and the goal of assisting forensic pathologist decision-making regarding the need for autopsy in determining cause of death.</p><p><strong>Methods: </strong>Establishing this service involved coordination, education, and extensive planning involving numerous professionals volunteering their time and effort. For the last 2 years, PMCT has been performed on cases requested by the MEO. Two emergency radiologists issued double-read reports detailing the PMCT findings, and the MEO completed a report detailing the PM examination process, which always included an external examination and often included an autopsy. Shared documentation summarized decedent and case information (eg, medical history), radiology primary findings and impressions, and the pathology report findings (including autopsy conclusions, when performed).</p><p><strong>Results: </strong>As of July 2024, 116 PMCT examinations have been performed, of which 64 (55.2%) underwent formal autopsy, 2 (1.7%) received limited autopsy, and 50 (43.1%) had no subsequent autopsy performed. MEO conducted external exam only when PMCT findings were conclusive for the cause of the death, demonstrating that CT had a role in supplanting the need for an autopsy. Indications for PMCT included Rule out trauma, assess extent of trauma, and family/religious objection. The manner of death for these cases was classified as accident, homicide, natural, suicide, traffic related, or undetermined.</p><p><strong>Conclusions: </strong>PMCT can be a valuable service to decedent families as well as to forensic pathologists who often operate in a limited resource environment. We anticipate that PMCT will become a standard discipline in forensic analysis. This service can often reduce the need for traditional autopsy and provides the potential to honor cultural sentiments and religious needs surrounding traditional autopsy. Establishing such a service requires the co-operation of many stakeholders, sometimes across institutional boundaries. PMCT broadens the experience of the radiologist and provides the potential for collaborative research and educational opportunities between radiology and the MEO. Lessons learned from this study may be useful for other jurisdictions implementing PMCT.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026674","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}