Ahmet Baytok, Gökhan Ecer, Mehmet Balasar, Mustafa Koplay
{"title":"Computed tomography and magnetic resonance imaging characteristics of renal cell carcinoma: Differences between subtypes and clinical evaluation.","authors":"Ahmet Baytok, Gökhan Ecer, Mehmet Balasar, Mustafa Koplay","doi":"10.25259/JCIS_160_2024","DOIUrl":"10.25259/JCIS_160_2024","url":null,"abstract":"<p><p>This review discusses the evaluation of renal cell carcinoma (RCC) subtypes using computed tomography (CT) and magnetic resonance imaging (MRI). RCC is a malignancy with different histopathological subtypes, constituting approximately 90% of adult kidney tumors. It has been reported that these subtypes show significant differences in terms of clinical behavior, treatment response, and prognosis. In the study, CT and MRI findings of subtypes such as clear cell RCC (ccRCC), papillary RCC (pRCC), chromophobe RCC (chRCC), medullary RCC (mRCC), collecting duct RCC (cdRCC), and multiloculated cystic RCC (mcRCC) were compared. It was stated that CT is the first-choice imaging method in the staging and surgical planning of RCC and provides detailed information about the tumor size, vascularity, and metastatic spread. On the other hand, it has been emphasized that MRI allows better characterization of RCC subtypes with its soft-tissue resolution and contrast agent usage advantage. The study draws attention to the different imaging features of each subtype and details the role of these findings in the clinical decision-making process. It has been stated that ccRCC exhibits intense contrast enhancement and rapid washout pattern in the corticomedullary phase on CT and appears hyperintense on T2A and hypointense on T1 weighted imaging (T1A) on MRI. It has been stated that pRCC has hypovascular features, has lower contrast enhancement, and has homogeneous borders. It has been stated that chRCC has a less vascular structure and exhibits moderate contrast enhancement in the corticomedullary phase. It has been reported that mRCC has invasive features and is usually diagnosed at an advanced stage while cdRCC has a very aggressive clinical course. It has been stated that mcRCC contains distinct cystic areas between the septa, has a well-circumscribed structure, and generally has a low malignancy potential. As a result, it has been stated that detailed evaluation of CT and MRI findings of RCC subtypes plays a critical role in the diagnosis, treatment, and prognosis of these subtypes. It has been emphasized that the findings presented in this study will contribute to the development of more targeted treatment approaches in RCC management.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"10"},"PeriodicalIF":1.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kento Hatakeyama, Tomoki Tozawa, Atsuko Noguchi, Naoko Mori
{"title":"Long-term follow-up and transcatheter embolization of extrahepatic congenital portosystemic shunt with shifting hemodynamics.","authors":"Kento Hatakeyama, Tomoki Tozawa, Atsuko Noguchi, Naoko Mori","doi":"10.25259/JCIS_156_2024","DOIUrl":"10.25259/JCIS_156_2024","url":null,"abstract":"<p><p>Congenital portosystemic shunt (CPSS) is a rare vascular anomaly in which portal vein blood flows into the systemic circulation without passing through the liver. They occur in approximately 1 in 30,000-50,000 live births. We present an 11-year-old patient with an extrahepatic CPSS managed with long-term follow-up. The initial clinical presentation showed no significant abnormalities. Subsequent assessments revealed slightly elevated ammonia (NH<sub>3</sub>) and total bile acids (TBAs). Two times angiography at the ages of 2 and 11 years confirmed a shunt between the portal vein and left renal vein, with a gradual shift in blood flow dominance from the celiac artery-splenic vein system to the superior mesenteric artery-superior mesenteric vein system as the patient aged. Due to the risk of complications, transcatheter shunt embolization was performed, utilizing 12 coils to achieve complete shunt embolization. Post-embolization, NH3, and TBA levels normalized, and the patient remained asymptomatic. This case highlights the importance of timing in CPSS intervention, particularly with shifting hemodynamics and underscores the need for further studies on optimal intervention timing in pediatric CPSS.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"9"},"PeriodicalIF":1.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Basic verification of myocardial extracellular volume quantification by prototype photon-counting detector computed tomography: A phantom study.","authors":"Seitaro Oda, Yoshinori Funama, Shinichi Kojima, Kazuma Yokoi, Isao Takahashi, Yuko Aoki, Taiga Goto, Kana Tanaka, Fuyuhiko Teramoto, Masafumi Kidoh, Yasunori Nagayama, Takeshi Nakaura, Toshinori Hirai","doi":"10.25259/JCIS_157_2024","DOIUrl":"10.25259/JCIS_157_2024","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the accuracy of myocardial extracellular volume (ECV) quantification using a prototype photon-counting detector (PCD) computed tomography (CT) and examine the association between radiation dose and spectral image settings.</p><p><strong>Material and methods: </strong>A multi-energy CT phantom that simulated the blood pool and myocardium was used. The tube voltage was set at 120 kVp and three types of tube current-time products (105, 150, and 300 mAs) were applied for pre- and post-contrast scans. Virtual monoenergetic images (VMIs) at 50-100 keV were reconstructed. The ECV value was calculated from the CT numbers between pre-contrast and post-contrast. We compared the accuracy of ECV values at each VMI level.</p><p><strong>Results: </strong>Each radiation dose setting demonstrated a small but significant difference in ECV values at each keV level. ECV was overestimated at higher keV in all radiation dose settings. A significant difference in ECV value variabilities was found among keV levels in all three radiation dose settings, with higher keV exhibiting greater variability. The variation was particularly large in the low-dose setting. The residual values were significantly larger at higher keV levels in all radiation dose settings. The residual values were smaller at 50 and 60 keV with no significant difference in 150- and 300-mAs settings.</p><p><strong>Conclusion: </strong>Setting appropriate VMI keV and radiation dose settings was necessary when quantifying myocardial ECV with PCD-CT because the keV levels caused differences in the quantification value and measurement variation.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"8"},"PeriodicalIF":1.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahim Ismail, Derrek Schartz, Mark Manganaro, Casey Paton, Alex Kessler
{"title":"The imaging presentation of head and neck oncologic emergencies.","authors":"Rahim Ismail, Derrek Schartz, Mark Manganaro, Casey Paton, Alex Kessler","doi":"10.25259/JCIS_35_2023","DOIUrl":"10.25259/JCIS_35_2023","url":null,"abstract":"<p><p>This review describes the radiographic findings in emergencies of head and neck cancers (HNCs) in both undiagnosed and previously treated patients, with an emphasis on the temporal urgency of each presentation and in association with the relevant clinical presentation and necessary treatments to enhance understanding and recognition. The various presentations of HNC will be described by the organ system of their presenting complaint. The development and complications of each will be elaborated, with a focus on the clinical presentation in the emergency department and the imaging findings that are critical to recognize in making the diagnosis. Each presentation will be exhibited with a specific patient case and the exact computed tomography, magnetic resonance imaging, ultrasound, or digital subtraction angiography images obtained will be shown. Cases include airway obstruction due to glottic tumor or metastatic cervical lymphadenopathy; airway obstruction due to surgical complications of hematoma, or post-radiation soft-tissue edema; vascular complications of tumor or nodal compression, carotid blowout, carotid stenosis, or occlusion; orbital complications of compartment syndrome; and orthopedic complications of osteomyelitis and osteoradionecrosis. Eleven HNC patient cases are presented with their associated 32 images. HNC patients present with challenging imaging features in the emergent setting. Difficulty in discerning the correct diagnosis arises from the complex head and neck anatomy, often compounded by an advanced stage at presentation and poor functional status. Radiologist familiarity with common HNC emergent presentations is essential for accurate diagnosis and timely treatment.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"7"},"PeriodicalIF":1.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xin He, Xinxing Ma, Nan Jiang, Chunjiao Weng, Ling Yang
{"title":"Computed tomography and magnetic resonance imaging features of abdominal and pelvic leiomyomatosis peritonealis disseminata: A retrospective observational study.","authors":"Xin He, Xinxing Ma, Nan Jiang, Chunjiao Weng, Ling Yang","doi":"10.25259/JCIS_144_2024","DOIUrl":"10.25259/JCIS_144_2024","url":null,"abstract":"<p><strong>Objectives: </strong>Leiomyomatosis peritonealis disseminata (LPD) is a rare and specific type of leiomyomatosis that is often misdiagnosed as malignant tumor with peritoneal metastasis, and accurate diagnosis is critical to treatment planning. The purpose of this study is to investigate the radiological features of LPD, analyze, and summarize its differential diagnosis and clinical features to improve the understanding of this rare disease.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on clinical and radiological features from 10 patients with pathologically confirmed LPD between 2012 and 2024. The computed tomography (CT) and magnetic resonance imaging (MRI) findings were examined, focusing on parameters such as location, morphology, size, quantity, enhancement patterns, and their relationship with adjacent organs. In addition, the radiological features and the key points of differential diagnosis were summarized.</p><p><strong>Results: </strong>All the 10 LPD patients presented with multifocal lesions in the abdomen and pelvis, and 7 of them had a history of hysteromyoma surgery. The number of lesions was all ≥2, most of them were round or quasi-circular, with clear boundaries and smooth edges, did not invade the neighboring parenchymal organs, with a length of about 1.5~16.8 cm. The lesions were located in the pelvic cavity in 6 cases, the abdominal wall in 6 cases, the intestinal wall in 3 cases, the rectouterine pouch in 1 case, the omentum in 5 cases, the abdominal cavity in 1 case, and the mesentery in 1 case. There were 7 cases with minimal pelvic fluid and 1 case with liver spread. CT showed circular solid nodules with clear boundaries. The density of small lesions was homogeneous. Cystic changes were observed in some large lesions. On MRI, T1-weighted imaging showed hypo to isointense, T2-weighted imaging (T2WI) mostly showed hypointense, and T2WI in some large lesions showed slightly high signal intensity, diffusion-weighted imaging signal intensity was not higher than that of myometrium, apparent diffusion coefficient showed isointense, and solid components of the lesions were significantly more homogeneous enhanced after enhancement, and the enhancement degree was similar to that of normal myometrium.</p><p><strong>Conclusion: </strong>Although the imaging findings of LPD are similar to malignant tumors with peritoneal implantation and metastasis, they have certain characteristics, which are helpful for differential diagnosis combined with the clinical history of patients.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"6"},"PeriodicalIF":1.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multimodality imaging in cardiac sarcoidosis: A case series of diverse phenotypes.","authors":"Hongyan Qiao, Hao Tian, Mengdi Jiang, Jinghui Li, Tian Lan, Minjie Lu","doi":"10.25259/JCIS_143_2024","DOIUrl":"10.25259/JCIS_143_2024","url":null,"abstract":"<p><p>Cardiac sarcoidosis (CS) represents a rare yet potentially life-threatening condition characterized by non-specific clinical symptoms that maybe easily missed by clinicians. In this case series, the clinical presentations, various imaging modalities' characteristics, and the management of four patients, each with distinct phenotypes of CS confirmed through endomyocardial biopsy, are discussed. Advanced imaging techniques, including positron emission tomography, revealed the focal septal uptake of <sup>18</sup>F fluorodeoxyglucose, which suggests an ongoing inflammation, whereas contrast-enhanced cardiac magnetic resonance demonstrates septal late gadolinium enhancement, which indicates replacement fibrosis. These features of multimodality imaging in CS can assist in patient diagnosis and treatment.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"5"},"PeriodicalIF":1.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Another year of Service to the Global Radiology Community.","authors":"Vikram Dogra","doi":"10.25259/JCIS_5_2025","DOIUrl":"10.25259/JCIS_5_2025","url":null,"abstract":"","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"4"},"PeriodicalIF":1.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wai Ip Li, Tak Kwong Chan, Koon Kiu Ng, Boom Ting Kung
{"title":"Predictive value of technetium-99m sodium pertechnetate thyroid scintigraphy in determining the permanence of congenital hypothyroidism.","authors":"Wai Ip Li, Tak Kwong Chan, Koon Kiu Ng, Boom Ting Kung","doi":"10.25259/JCIS_79_2024","DOIUrl":"10.25259/JCIS_79_2024","url":null,"abstract":"<p><strong>Objectives: </strong>We aim to investigate the predictive value of [<sup>99m</sup>Tc] pertechnetate thyroid scintigraphy in determining the permanence of congenital hypothyroidism (CH).</p><p><strong>Material and methods: </strong>A retrospective analysis of [<sup>99m</sup>Tc] pertechnetate thyroid scans performed for evaluation of CH at the Nuclear Medicine Unit of a hospital in Hong Kong between January 1, 2008, and December 31, 2018, was conducted. Scintigraphic findings and parameters at diagnosis, including thyroid stimulating hormone (TSH), free thyroxine (fT4), gender, and gestational age, were reviewed. The need for lifelong thyroxine replacement therapy was reviewed.</p><p><strong>Results: </strong>The study included 85 subjects, with 74 (87.1%) presenting with eutopic thyroid and 11 (12.9%) showing thyroid dysgenesis. Patients with scintigraphic evidence of thyroid dysgenesis required permanent thyroid hormone replacement therapy. Among the patients with eutopic thyroid, a higher TSH level was associated with the need for lifelong thyroid hormone replacement therapy (cutoff TSH value 18.72 mIU/L, sensitivity 77.3% and specificity 53.8%). Gender, gestational age, and fT4 did not show significant differences between the transient and permanent CH groups in patients with eutopic thyroid.</p><p><strong>Conclusion: </strong>Scintigraphic findings of thyroid dysgenesis indicate a high prevalence of permanent CH. In patients with eutopic thyroid, higher TSH levels predict the requirement for lifelong thyroid hormone replacement therapy. These results provide insights into the prediction of CH and aid in individualized treatment decisions for patients with CH.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"3"},"PeriodicalIF":1.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Aortomesenteric angle: A contrast-enhanced computed tomography analysis of respiratory phase and visceral fat impact.","authors":"Hirofumi Sekino, Shiro Ishii, Yumi Saito, Junko Hara, Ryo Yamakuni, Kenji Fukushima, Hiroshi Ito","doi":"10.25259/JCIS_65_2024","DOIUrl":"10.25259/JCIS_65_2024","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to evaluate the relationship between the aortomesenteric angle at end-inspiration and end-expiration and its variation rate with several anthropometric parameters.</p><p><strong>Material and methods: </strong>Sagittal reconstructed computed tomography (CT) images of 59 patients who underwent contrast-enhanced CT at end-inspiration and end-expiration between 2015 and 2020 were reviewed. All these patients underwent dynamic contrast CT during both inspiration and expiration for adrenal venous sampling purposes. Two experienced radiologists measured the aortomesenteric angle during both end-inspiration and end-expiration, and its variation rate. Pearson's or Spearman's correlation analysis was used to assess correlations between the angle or variation rate and height, weight, body mass index (BMI), visceral fat, subcutaneous fat, and diaphragm motion.</p><p><strong>Results: </strong>The aortomesenteric angle was significantly larger at end-expiration (88.65 ± 25.15, 95% confidence interval [CI] 82.09-95.20) compared to end-inspiration (62.22 ± 21.90, 95% CI 56.51-67.93, <i>P</i> < 0.001). The aortomesenteric angles at both end-inspiration and end-expiration correlated significantly with weight, BMI, visceral fat, and subcutaneous fat. The strongest correlation was between aortomesenteric angle and visceral fat at both end-inspiration (r = 0.523, <i>P</i> < 0.001) and end-expiration (r = 0.546, <i>P</i> < 0.001). The variation rate correlated only with diaphragm motion (r = 0.550, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The aortomesenteric angle at end-expiration was significantly larger than at end-inspiration, with the strongest correlation found between the angle and visceral fat.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"2"},"PeriodicalIF":1.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Czepe, Piotr Przybylski, Elżbieta Czekajska-Chehab
{"title":"Novel case of coronary artery ectasia and myocardial bridging in one segment detected by coronary computed tomography angiography.","authors":"Gabriel Czepe, Piotr Przybylski, Elżbieta Czekajska-Chehab","doi":"10.25259/JCIS_149_2024","DOIUrl":"10.25259/JCIS_149_2024","url":null,"abstract":"<p><p>Coronary artery ectasia (CAE) is defined as a dilation exceeding 1.5 times the diameter of an adjacent normal artery, predominantly affecting males. Myocardial bridging (MB) is a condition in which the coronary artery runs intramurally within myocardial tissue. Coronary computed tomography angiography (CCTA) offers high-resolution imaging, facilitating accurate diagnosis of these conditions. This report presents the first documented case of a 78-year-old female with CAE and superficial MB coexisting in the same segment of the left anterior descending artery that was detected incidentally by CCTA.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"15 ","pages":"1"},"PeriodicalIF":1.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}