Journal of Computer Assisted Tomography最新文献

{"title":"T1WI Radiomics Analysis of Anterior Scalene Muscle: A Preliminary Application in Neurogenic Thoracic Outlet Syndrome.","authors":"Meng Sun, Le Fang, Peiyun Tang, Fangruyue Wang, Ling Jiang, Tianwei Wang","doi":"10.1097/RCT.0000000000001701","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001701","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to analyze the differences in radiomic features of the anterior scalene muscle and evaluate the diagnostic performance of MRI-based radiomics model for neurogenic thoracic outlet syndrome (NTOS).</p><p><strong>Materials and methods: </strong>Imaging data of patients with NTOS who underwent preoperative brachial plexus magnetic resonance neurography were collected and were randomly divided into training and test groups. The anterior scalene muscle area was sliced in the T1WI sequence as the region of interest for the extraction of radiomics features. The most significant features were identified using feature selection and dimensionality-reduction methods. Various machine learning algorithms were applied to construct regression models. Model performance was evaluated using area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>Totally, 267 radiomics features were extracted, of which 57 showed significant differences (P ≤ 0.05) between the abnormal and normal anterior scalene muscle groups. The least absolute shrinkage and selection operator regression model identified 13 optimal radiomic features with nonzero coefficients for constructing the model. In the training set, the AUROCs of diagnostic models built by different machine learning algorithms, ranked from highest to lowest, were as follows: support vector machine (SVM), 0.953; multilayer perception (MLP), 0.936; logistic regression (LR), 0.926; light gradient boosting machine (LightGBM), 0.906; and K-nearest neighbors (KNN), 0.813. In the testing set, the rankings were as follows: LR, 0.933; SVM, 0.886; KNN, 0.843; LightGBM, 0.824; and MLP, 0.706.</p><p><strong>Conclusions: </strong>NTOS is attributed to anterior scalene muscle abnormalities and exhibits distinct radiomic features. Integrating these features with machine learning can improve traditional manual image interpretation, offering further clarity in NTOS diagnosis.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780227","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":"Resident Education in the Age of AI.","authors":"Erin Gomez, Cheng Ting Lin","doi":"10.1097/RCT.0000000000001697","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001697","url":null,"abstract":"<p><strong>Abstract: </strong>Artificial intelligence (AI) is a rapidly expanding field of interest to radiologists for its utility as an adjunct in detecting and reporting disease and its potential influence on the role of radiologists and their practices. As radiology educators, we are responsible for developing and providing access to curricular elements that will prepare residents to be good stewards of artificial intelligence resources while also acquiring fundamental knowledge and skills that are essential to daily practice. Residency programs should consider collaborative approaches as well as solicit support from national societies in the development and curation of their AI curricula.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780226","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, Fuxia Xiao, Zhijun Cui, Guangyu Tang, Lin Zhang","doi":"10.1097/RCT.0000000000001691","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","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":"Evaluation of Amide Proton Transfer Imaging Combined With Serum Squamous Cell Carcinoma Antigen for Grading Cervical cancer.","authors":"Xiao-Yan Zhang, Chen Xu, Xing-Chen Wu, Qian-Qian Qu, Kai Deng","doi":"10.1097/RCT.0000000000001699","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001699","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to investigate the efficacy of amide proton transfer-weighted (APT) imaging combined with serum squamous cell carcinoma antigen (SCC-Ag) in grading cervical cancer.</p><p><strong>Methods: </strong>Sixty-three patients with surgically confirmed cervical SCC were enrolled and categorized into 3 groups: highly differentiated (G1), moderately differentiated (G2), and poorly differentiated (G3). The diagnostic efficacies of APT imaging and serum SCC-Ag, alone or in combination, for grading cervical SCC were compared.</p><p><strong>Results: </strong>The APT values measured by the 2 observers were in excellent agreement (intraclass correlation coefficient >0.75). Mean (± standard deviation) APT values for the high, moderate, and poor differentiation groups were 2.542 ± 0.215% (95% confidence interval [CI]: 2.423-2.677), 2.784 ± 0.175% (95% CI: 2.701-2.856), and 3.120 ± 0.221% (95% CI: 2.950-3.250), respectively. APT values for groups G2 and G3 were significantly higher than those for G1 (P < 0.05). APT values for identifying cervical SCC in groups G1 and G2, G2 and G3, and G1 and G3, had areas under the receiver operating characteristic curve, sensitivities, and specificities of 0.815 (95% confidence interval [CI]: 0.674-0.914), 82.1%, and 72.2%, 0.882 (95% CI: 0.751-0.959), 70.6%, and 92.7%, and 0.961 (95% CI: 0.835-0.998), 94.1%, and 94.4%, respectively. APT values were significantly and positively correlated with the histological grade of cervical SCC (Spearman's correlation [rs] = 0.731, P < 0.01). Serum SCC-Ag levels for the high, moderate, and poor differentiation groups were 1.60 (0.88-4.63) ng/mL, 4.10 (1.85-6.98) ng/mL, and 26.10 (9.65-70.00) ng/mL, respectively. The differences were statistically significant only between groups G1 and G3 and G2 and G3 (P < 0.05), whereas the differences between groups G1 and G2 were not statistically significant (P > 0.05). Spearman's analysis revealed a positive correlation between SCC-Ag levels and the histological grade of cervical SCC (rs = 0.573, P < 0.01). The diagnostic efficacy of APT imaging for the histological grading of cervical SCC was better than that of serum SCC-Ag, and the discriminatory efficacy of the combination of the 2 parameters was better than that of either alone.</p><p><strong>Conclusions: </strong>The diagnostic efficacy of APT imaging was better than that of serum SCC-Ag, and the combined diagnostic utility of APT and SCC-Ag was better than that of the individual parameters.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710170","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":"Improving Image Quality and Visualization of Hepatocellular Carcinoma in Arterial Phase Imaging Using Contrast Enhancement-Boost Technique.","authors":"Gayoung Yoon, Jhii-Hyun Ahn, Sang-Hyun Jeon","doi":"10.1097/RCT.0000000000001684","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001684","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the image quality and visualization of hepatocellular carcinoma (HCC) on arterial phase computed tomography (CT) using the contrast enhancement (CE)-boost technique.</p><p><strong>Methods: </strong>This retrospective study included 527 consecutive patients who underwent dynamic liver CT between June 2021 and February 2022. Quantitative and qualitative image analyses were performed on 486 patients after excluding 41 patients. HCC conspicuity was evaluated in 40 of the 486 patients with at least one HCC in the liver. Iodinated images obtained by subtracting nonenhanced images from arterial phase images were combined to generate CE-boost images. For quantitative image analysis, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured for the liver, pancreas, muscles, and aorta. For qualitative analysis, the overall image quality and noise were graded using a 3-point scale. Artifact, sharpness, and HCC lesion conspicuity were assessed using a 5-point scale. The paired-sample t test was used to compare quantitative measures, whereas the Wilcoxon signed-rank test was used to compare qualitative measures.</p><p><strong>Results: </strong>The mean SNR and CNR of the aorta, liver, pancreas, and muscle were significantly higher, and the image noise was significantly lower in the CE-boost images than in the conventional images (P < 0.001). The mean CNR of HCC was also significantly higher in the CE-boost images than in the conventional images (P < 0.001). In the qualitative analysis, CE-boost images showed higher scores for HCC lesion conspicuity than conventional images (P < 0.001).</p><p><strong>Conclusions: </strong>The overall image quality and visibility of HCC were improved using the CE-boost technique.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604805","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":"Simultaneous Injection of Contrast and Saline Using Spiral Flow-Generating Tube for Hepatic Dynamic Computed Tomography: Effect on Enhancement of Liver Parenchyma and Metastases to the Liver.","authors":"Hiroji Nagata, Hisako Iori, Shiori Yoshida, Hiroki Kawashima, Yuka Nishino, Ryo Sakasai, Hiroshi Yamamura, Tetsuya Minami","doi":"10.1097/RCT.0000000000001620","DOIUrl":"10.1097/RCT.0000000000001620","url":null,"abstract":"<p><strong>Purpose: </strong>Recently, there have been a few reports regarding the usefulness of a novel saline injection technique using a spiral flow-generating tube. The purpose of this study was to evaluate whether simultaneous saline injection using a spiral flow-generating tube was able to improve hepatic contrast enhancement and lesion conspicuity of metastatic liver tumors.</p><p><strong>Methods: </strong>We randomized a total of 411 patients with various liver diseases including metastases by total body weight (A, n = 204) and contrast dilution protocol (B, n = 207). Group A received 400 mgI/kg of contrast medium alone without a spiral flow-generating tube; group B received contrast medium 400 mgI/kg simultaneous with injection of a 0.57-ml/kg physiologic saline solution through a spiral flow-generating tube. Abdominal aorta computed tomography (CT) number, hepatic enhancement (ΔHU), percentage of tests demonstrating an enhancement effect of the liver parenchyma exceeding Δ50 HU in 3 measured segments (S2, S6, and S8), and the contrast-to-noise ratio of the metastatic liver tumors were measured.</p><p><strong>Results: </strong>The mean aortic CT number of group B (417.0 HU ± 61.7; P < 0.01) was approximately 10% higher than that of group A (384.6 ± 79.1 HU). The average ΔHU was 59.8 ± 11.4 HU for group A and 61.7 ± 11.7 for group B. The ΔHU for group B was significantly higher than that for group A ( P = 0.017). The percentage of tests demonstrating with the enhancement effect of group B was more than 80% in all subgroups; however, that of group A was less than 80% in all subgroups. The contrast-to-noise ratio of group B (7.8 ± 3.3 HU) was significantly higher compared to that of group A (6.5 ± 2.8 HU) ( P < 0.05).</p><p><strong>Conclusions: </strong>Because of the volume effect, injecting a contrast medium diluted with normal saline improved the degree of hepatic and aortic contrast enhancement and achieved better visualization of liver metastases.</p><p><strong>Clinical impact: </strong>The use of spiral flow-generating tube may help diagnostic of hepatic and aortic contrast enhancement and liver metastases.</p><p><strong>Importance: </strong>The use of a spiral flow-generating tube improved the degree of hepatic and aortic contrast enhancement and achieve better visualization of liver metastases.</p><p><strong>Points: </strong>The use of low-concentration syringe formulations is limited by body weight. However, the use of spiral flow-generating tube provides low-concentration contrast medium regardless of body weight.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"875-881"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317455","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":"Respiratory Displacement of the Right Adrenal Vein: Comparison of Inspiratory and Expiratory Computed Tomography With Catheter Venography.","authors":"Junko Hara, Shiro Ishii, Hayato Tanabe, Ryo Yamakuni, Hiroki Suenaga, Teruyuki Kono, Daichi Kuroiwa, Hirofumi Sekino, Michio Shimabukuro, Hiroshi Ito","doi":"10.1097/RCT.0000000000001625","DOIUrl":"10.1097/RCT.0000000000001625","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to reveal the respiratory displacement of the right adrenal vein (RAV) to predict the exact location of the RAV during adrenal venous sampling (AVS).</p><p><strong>Methods: </strong>Computed tomography (CT) scans obtained 45 seconds (breath-hold at inhalation) and 70 seconds (breath-hold at exhalation) after contrast material injection were compared to venograms of the RAV of patients with primary aldosteronism who underwent AVS between January 2016 and December 2020. The craniocaudal distance between the center of the Th11/12 disc and the RAV orifice was measured; the craniocaudal location of the RAV orifice was also specified relative to vertebral bodies and intervertebral discs on inspiratory phase CT (In-CT), expiratory phase CT (Ex-CT), and catheter venography. The transverse and vertical angles of the RAV and the position of the RAV orifice on the inferior vena cava (IVC) circumference were measured on In-CT and Ex-CT.</p><p><strong>Results: </strong>In total, 51 patients (30 males, 21 females; mean age, 54.9 ± 11.1 years) were included. Craniocaudal distances between the center of the Th11/12 disc and RAV orifice were significantly different among the following 3 acquisitions: catheter venography versus In-CT (15.2 ± 8.4 mm); venography versus Ex-CT (5.6 ± 4.1 mm); and In-CT versus Ex-CT (19.6 ± 8.0 mm) (all, P < 0.001). The craniocaudal location of the RAV orifice on venography was significantly closer to that on Ex-CT than on In-CT ( P < 0.001); measurements using venograms compared with In-CT and Ex-CT scans were within 1 level difference in 18 (35.3%) and 47 (92.2%) patients, respectively ( P < 0.001). The vertical angle of the RAV was significantly more likely to be smaller on In-CT than on Ex-CT ( P < 0.001).</p><p><strong>Conclusions: </strong>RAV locations and angles change with respiratory motion. It is crucial to consider the respiratory phase of CT because it can enable a more accurate prediction of the location of the RAV during AVS.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"882-888"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862620","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":"Impact on Image Quality and Diagnostic Performance of Dual-Layer Detector Spectral CT for Pulmonary Subsolid Nodules: Comparison With Hybrid and Model-Based Iterative Reconstruction.","authors":"Li Ding, Xiaomei Li, Jie Lin, Shuting Deng, Mingwang Chen, Weiwei Deng, Yikai Xu, Zhao Chen, Chenggong Yan","doi":"10.1097/RCT.0000000000001640","DOIUrl":"10.1097/RCT.0000000000001640","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the image quality and diagnostic performance of pulmonary subsolid nodules on conventional iterative algorithms, virtual monoenergetic images (VMIs), and electron density mapping (EDM) using a dual-layer detector spectral CT (DLSCT).</p><p><strong>Methods: </strong>This retrospective study recruited 270 patients who underwent DLSCT scan for lung nodule screening or follow-up. All CT examinations with subsolid nodules (pure ground-glass nodules [GGNs] or part-solid nodules) were reconstructed with hybrid and model-based iterative reconstruction, VMI at 40, 70, 100, and 130 keV levels, and EDM. The CT number, objective image noise, signal-to-noise ratio, contrast-to-noise ratio, diameter, and volume of subsolid nodules were measured for quantitative analysis. The overall image quality, image noise, visualization of nodules, artifact, and sharpness were subjectively rated by 2 thoracic radiologists on a 5-point scale (1 = unacceptable, 5 = excellent) in consensus. The objective image quality measurements, diameter, and volume were compared among the 7 groups with a repeated 1-way analysis of variance. The subjective scores were compared with Kruskal-Wallis test.</p><p><strong>Results: </strong>A total of 198 subsolid nodules, including 179 pure GGNs, and 19 part-solid nodules were identified. Based on the objective analysis, EDM had the highest signal-to-noise ratio (164.71 ± 133.60; P < 0.001) and contrast-to-noise ratio (227.97 ± 161.96; P < 0.001) among all image sets. Furthermore, EDM had a superior mean subjective rating score (4.80 ± 0.42) for visualization of GGNs compared to other reconstructed images (all P < 0.001), although the model-based iterative reconstruction had superior subjective scores of overall image quality. For pure GGNs, the measured diameter and volume did not significantly differ among different reconstructions (both P > 0.05).</p><p><strong>Conclusions: </strong>EDM derived from DLSCT enabled improved image quality and lesion conspicuity for the evaluation of lung subsolid nodules compared to conventional iterative reconstruction algorithms and VMIs.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"921-929"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878781","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":"Radiogenomics of Intrahepatic Cholangiocarcinoma: Correlation of Imaging Features With BAP1 and FGFR Molecular Subtypes.","authors":"Veronica Cox, Milind Javle, Jia Sun, Hyunseon Kang","doi":"10.1097/RCT.0000000000001638","DOIUrl":"10.1097/RCT.0000000000001638","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical research has shown unique tumor behavioral characteristics of BRCA -associated protein-1- ( BAP1 -) and fibroblast growth factor receptor ( FGFR )-mutated intrahepatic cholangiocarcinomas (CCAs), with BAP1 -mutated tumors demonstrating more aggressive forms of disease and FGFR -altered CCAs showing more indolent behavior. We performed a retrospective case-control study to evaluate for unique imaging features associated with BAP1 and FGFR genomic markers in intrahepatic CCA (iCCA).</p><p><strong>Methods: </strong>Multiple imaging features of iCCA at first staging were analyzed by 2 abdominal radiologists blinded to genomic data. Growth and development of metastases at available follow-up imaging were also recorded, as were basic clinical cohort data. Types of iCCA analyzed included those with BAP1 , FGFR , or both alterations, as well as cases with low mutational burden or mutations with low clinical impact, which served as a control or \"wild-type\" group. There were 18 cases in the FGFR group, 10 with BAP1 mutations, and 31 wild types (controls).</p><p><strong>Results: </strong>Cases with BAP1 mutations showed significantly larger growth at first year of follow-up ( P = 0.03) and more frequent tumor-associated biliary ductal dilatation ( P = 0.04) compared with controls. FGFR -altered cases showed more infiltrative margins compared with controls ( P = 0.047) and demonstrated less enhancement between arterial to portal venous phases ( P = 0.02). BAP1 and FGFR groups had more cases with stage IV disease at presentation than controls ( P = 0.025, P = 0.006).</p><p><strong>Conclusion: </strong>Compared with wild-type iCCAs, FGFR -mutated tumors often demonstrate infiltrative margins, and BAP1 tumors show increased biliary ductal dilatation at presentation. BAP1 -mutated cases had significantly larger growth at first-year restaging.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"868-874"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537958","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":"Volumetric Analysis: Effect on Diagnosis and Management of Indeterminate Solid Pulmonary Nodules in Routine Clinical Practice.","authors":"Robert S Lim, Jarrett Rosenberg, Martin J Willemink, Sarah N Cheng, Henry H Guo, Philip D Hollett, Margaret C Lin, Mohammad H Madani, Lynne Martin, Brian P Pogatchnik, Michael Pohlen, Jody Shen, Emily B Tsai, Gerald J Berry, Gregory Scott, Ann N Leung","doi":"10.1097/RCT.0000000000001630","DOIUrl":"10.1097/RCT.0000000000001630","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of volumetric analysis on the diagnosis and management of indeterminate solid pulmonary nodules in routine clinical practice.</p><p><strong>Methods: </strong>This was a retrospective study with 107 computed tomography (CT) cases of solid pulmonary nodules (range, 6-15 mm), 57 pathology-proven malignancies (lung cancer, n = 34; metastasis, n = 23), and 50 benign nodules. Nodules were evaluated on a total of 309 CT scans (average number of CTs/nodule, 2.9 [range, 2-7]). CT scans were from multiple institutions with variable technique. Nine radiologists (attendings, n = 3; fellows, n = 3; residents, n = 3) were asked their level of suspicion for malignancy (low/moderate or high) and management recommendation (no follow-up, CT follow-up, or care escalation) for baseline and follow-up studies first without and then with volumetric analysis data. Effect of volumetry on diagnosis and management was assessed by generalized linear and logistic regression models.</p><p><strong>Results: </strong>Volumetric analysis improved sensitivity ( P = 0.009) and allowed earlier recognition ( P < 0.05) of malignant nodules. Attending radiologists showed higher sensitivity in recognition of malignant nodules ( P = 0.03) and recommendation of care escalation ( P < 0.001) compared with trainees. Volumetric analysis altered management of high suspicion nodules only in the fellow group ( P = 0.008). κ Statistics for suspicion for malignancy and recommended management were fair to substantial (0.38-0.66) and fair to moderate (0.33-0.50). Volumetric analysis improved interobserver variability for identification of nodule malignancy from 0.52 to 0.66 ( P = 0.004) only on the second follow-up study.</p><p><strong>Conclusions: </strong>Volumetric analysis of indeterminate solid pulmonary nodules in routine clinical practice can result in improved sensitivity and earlier identification of malignant nodules. The effect of volumetric analysis on management recommendations is variable and influenced by reader experience.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"906-913"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537959","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}