Journal of Medical Imaging and Radiation Oncology最新文献

{"title":"Size and Morphology of Ultrasound Detected Gallbladder Polyps and the Surveillance Implications of Adopting the Society of Radiologists in Ultrasound Consensus Conference Recommendations: A Waikato Experience.","authors":"Matthew Jeans, Mohammed Dragh, Martin Necas, Jian Ng","doi":"10.1111/1754-9485.13854","DOIUrl":"https://doi.org/10.1111/1754-9485.13854","url":null,"abstract":"<p><strong>Introduction: </strong>Gallbladder polyps, the majority of which are benign, represent a common incidental finding during hepatobiliary ultrasound and generate a significant volume of follow-up imaging. The Society of Radiologists in Ultrasound (SRU) has recently released Consensus Conference Recommendations for the management of incidentally detected gallbladder polyps to address the volume of follow-up imaging without losing sensitivity for detecting neoplastic polyps with malignant potential. The primary aim of this study was to determine the prevalence of morphological polyp types in our population. The secondary aim was to determine the potential implications of adopting this new guideline.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients with gallbladder polyps detected on ultrasound scans performed at Waikato Hospital in the year 2018. Individual gallbladder polyps were analysed by size and morphology according to the categories outlined in the SRU Consensus Recommendations. Outcome data included the findings of subsequent ultrasound imaging in the 3 years following the index scan. Histology results in patients who underwent a cholecystectomy were reviewed.</p><p><strong>Results: </strong>The study cohort comprised 251 patients with 407 polyps; 51.6% of polyps were deemed 'extremely low risk'; 48.2% were deemed 'low-risk' and one polyp (0.2%) was deemed 'intermediate risk'. Nearly all polyps identified were < 10 mm in size (96.3%). The majority of gallbladder polyps required no follow-up (88.4%). Of those who underwent follow-up imaging, 89.6% of polyps were unchanged, had decreased in size or were no longer visualised. Of the 28 patients who underwent a subsequent cholecystectomy, 20 had no polyps found, six had nonneoplastic polyps and two were found to have neoplastic polyps including one with invasive gallbladder carcinoma.</p><p><strong>Conclusion: </strong>Adopting the SRU Consensus Recommendations could prevent potentially unnecessary follow-up ultrasounds and improve resource utilisation without loss of sensitivity in detecting gallbladder carcinoma. Consideration, however, should be given to altering these guidelines on a local level to accommodate the increased incidence of gallbladder carcinoma in Māori patients.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730410","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 of Abdominal Complications in Children With Acute Lymphoblastic Leukaemia.","authors":"Luke R Holmes, Rishi S Kotecha, Derek J Roebuck","doi":"10.1111/1754-9485.13852","DOIUrl":"https://doi.org/10.1111/1754-9485.13852","url":null,"abstract":"<p><p>Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy and remains one of the most common causes of cancer-related death in children and adolescents. Five-year overall survival rates now exceed 90% with current multidrug chemotherapeutic regimens. This improvement, coupled with the toxicity of chemotherapy, has led to the mortality from treatment-related toxicity approaching rates that are associated with relapse. This manuscript reviews the imaging features of the common treatment-associated abdominal complications in children with ALL.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730404","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":"Radiological Insights Into the Pericardium: A Comprehensive Review.","authors":"Felipe Aluja-Jaramillo, Omar Andrés Pantoja-Burbano, Fernando R Gutiérrez, Carlos Previgliano, Sanjeev Bhalla","doi":"10.1111/1754-9485.13856","DOIUrl":"https://doi.org/10.1111/1754-9485.13856","url":null,"abstract":"<p><p>The pericardium is not simply a two-layered membrane surrounding the heart and great vessels. Pericardial effusion is the most common manifestation of various pathological conditions involving the pericardium. Therefore, we are tempted to think of the pericardium as a virtual space containing only fluid, but it can also contain solid and cystic lesions. We must recall that clinical symptoms are non-specific and may mimic cardiac, pulmonary, or pleural diseases. Imaging findings are not specific for a particular pathology, but when combined with the clinical history, can provide sufficient information to make an accurate differential diagnosis. In this review, we will identify selected entities affecting the pericardium, from benign to malignant, with a brief description of their clinical characteristics.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730407","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 of Adrenal Incidentalomas: What Actually Happens in Everyday Clinical Practice?","authors":"Brian Ngo, Tracy Liu, Eddie Lau","doi":"10.1111/1754-9485.13853","DOIUrl":"https://doi.org/10.1111/1754-9485.13853","url":null,"abstract":"<p><strong>Introduction: </strong>There are numerous guidelines offering varying advice on the management of adrenal incidentalomas. The American College of Radiology (ACR) white paper recommends no follow-up for lesions with benign appearances. Our aim was to audit the indications for adrenal CT in the context of the ACR recommendations and to assess the long-term follow-up and outcome of these incidental lesions.</p><p><strong>Methods: </strong>A retrospective cohort study was performed identifying patients who had undergone adrenal CT from 1 January 2016 to 31 December 2018. Patients with symptoms of adrenal hypersecretion and malignancy were excluded. Radiology reports were analysed, with collected data also including patient demographics, referring team, lesion characteristics, radiologist recommendations, biochemical tests and histology.</p><p><strong>Results: </strong>A total of 168 adrenal CTs were performed in 130 patients during the study period. 88 CTs (52%) were not in accordance with the ACR recommendations, as they were for the evaluation of adrenal incidentalomas previously characterised as benign. 93% of lesions had benign imaging appearances, none of which demonstrated evidence of malignant transformation. 70% of patients with benign-appearing lesions had excess imaging deemed not required as per the ACR recommendations.</p><p><strong>Conclusion: </strong>A large proportion of adrenal CTs are performed to evaluate incidental lesions previously characterised as benign. The ACR white paper recommends that these do not require further imaging; however, in most cases, this is not being followed. Radiologists should be encouraged to recommend no follow-up for benign-appearing adrenal lesions in accordance with the ACR recommendations and have confidence that it is reasonable and safe to do so.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674175","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":"Novel Application of Lutetium-177-Prostate Specific Membrane Antigen (LuPSMA) Radioligand Therapy for Metastatic Synovial Sarcoma.","authors":"Rhiannon S McBean, Annaleis M Tatkovic, Sepinoud Firouzmand, Francis Tomlinson, Paul Eliadis, David C Wong","doi":"10.1111/1754-9485.13838","DOIUrl":"https://doi.org/10.1111/1754-9485.13838","url":null,"abstract":"<p><p>Intracranial synovial sarcoma is exceedingly rare, with only 24 cases reported in the literature. Given prostate specific membrane antigen (PSMA) expression is found in the neovascular endothelium of solid tumours, including sarcomas, Lutetium-177-PSMA (LuPSMA) presents a potential therapeutic option. The case presented here describes the first application of LuPSMA in a patient with synovial sarcoma. Our patient, a 27-year-old female underwent seven LuPSMA treatment cycles over the last 8 months of her life. Disease stability and prolongation in time to progression was observed across the treatment course with subjective tumour regression also seen after two cycles. Overall, our initial experience with this novel approach demonstrates proof-of-principle of LuPSMA treatment beyond prostate cancer, for patients with other PSMA-expressing cancer diseases.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674176","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":"Adverse Reactions to Urinary Contrast: A Case Report and Systematic Review.","authors":"Shuang Xu, Nicholas Watson, Li Wang, Jie Ding, Aidan Callinan","doi":"10.1111/1754-9485.13848","DOIUrl":"https://doi.org/10.1111/1754-9485.13848","url":null,"abstract":"<p><strong>Objective: </strong>Intra-urinary iodinated contrast agents are commonly used in urological procedures, but research of allergic reactions is rare. This study presents a rare case of an intra-urinary contrast reaction, followed by a comprehensive literature review of adverse reactions to intra-urinary contrast.</p><p><strong>Methods: </strong>PubMed and Embase databases were searched using Medical Subject Headings terms related to urinary procedures and contrast reactions, with additional articles identified through reference reviews.</p><p><strong>Results: </strong>Adverse reactions to intra-urinary contrast agents are rare, with most reactions being mild. Severe reactions were infrequent, and both patient-related and contrast-related factors were identified as influencing the likelihood of adverse events. However, the role of previous intravenous contrast reactions as a predisposing factor and the effectiveness of premedication in preventing these reactions remain uncertain. Furthermore, clinical guidelines for diagnosing and managing such reactions are lacking.</p><p><strong>Conclusion: </strong>Although urinary contrast reactions are uncommon, they can range from mild to severe, including anaphylaxis. Further research is needed to establish standardized premedication protocols and management strategies, and a better understanding of predisposing factors could enhance patient safety in urological procedures involving contrast agents.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649270","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":"Beware the Iron Rich Gravel: Implications for MRI Safety in Australia.","authors":"Giles Kisby, Michael Paddock, Alicia Harvey, Peter Shipman, Rahul Lakshmanan","doi":"10.1111/1754-9485.13849","DOIUrl":"https://doi.org/10.1111/1754-9485.13849","url":null,"abstract":"<p><p>Through this case report of a child with intra-orbital and intra-cranial iron-rich gravel foreign bodies, shown on our testing to be strongly ferromagnetic, we aim to raise awareness about the potential for these environmental foreign bodies, which are ubiquitous in Australia, to cause serious harm to patients who undergo MRI. Importantly, environmental foreign bodies of very high (metallic) attenuation on CT should be treated as potentially MRI unsafe until proven otherwise.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585913","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":"Differentiation Between Radiation Necrosis and True Tumour Progression After Radiotherapy to Intracranial Metastases.","authors":"Arian Lasocki, Joseph Sia, Stephen L Stuckey","doi":"10.1111/1754-9485.13847","DOIUrl":"https://doi.org/10.1111/1754-9485.13847","url":null,"abstract":"<p><p>Differentiating between radiation necrosis and true tumour progression after radiotherapy is challenging due to overlapping imaging appearances. This review outlines useful techniques and imaging features for making this distinction, as well as potential pitfalls. Both radiation necrosis and true tumour progression commonly manifest as peripherally enhancing lesions on post-contrast T1-weighted imaging, but the enhancing rim should be thin in radiation necrosis, while more discrete nodular enhancement suggests active tumour. Other features on post-contrast MRI that suggest radiation necrosis include enhancing lesions across anatomical boundaries, clustering of enhancing lesions and a change in lesion shape. Central diffusion restriction corresponding to the central necrotic area favours radiation necrosis, but there are potential pitfalls to be aware of, including hypercellular tumours, coagulative necrosis due to bevacizumab and intra-lesional haemorrhage. Radiation necrosis typically results in small, clustered foci of magnetic susceptibility on susceptibility-sensitive sequences, and the absence of such foci should raise concern for active tumour. When uncertainty remains, ancillary techniques such as MR perfusion and amino acid PET can improve confidence. Atypical appearances of radiation necrosis can occur, for example, cystic radiation necrosis or radiation necrosis occurring after radiotherapy to adjacent structures. It is also important for the radiologist to be aware of additional factors that may increase the likelihood of either radiation necrosis or tumour necrosis or influence patient management.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585919","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":"How I Do It-How to Report the \"Complex\" Ovarian Mass on US.","authors":"Susanne Johnson","doi":"10.1111/1754-9485.13846","DOIUrl":"https://doi.org/10.1111/1754-9485.13846","url":null,"abstract":"<p><strong>Background: </strong>Transvaginal ultrasound (TV-US) of the pelvis is now a standard component of the diagnostic armamentarium in gynaecology. After undergoing specialised training, healthcare professionals (sonographers, gynaecologists, and radiologists) performing such scans can diagnose pelvic pathology accurately. TV-US is fast to perform and cheaper than cross-sectional imaging. Many gynaecology services now offer ultrasound as a well-established part of one-stop clinics, where a diagnosis can be made at the first visit and the patient pathway expedited.</p><p><strong>Purpose: </strong>Predicting the risk of malignancy in adnexal masses is so important. This review describes my systematic approach to reporting a \"complex ovarian mass\" on TV-US, as a subspecialist gynaecologist-sonologist.</p><p><strong>Conclusion: </strong>Using International Ovarian Tumour Analysis (IOTA) language and IOTA risk of malignancy algorithms allows us to describe and categorise adnexal masses on ultrasound and to predict the risk and stage of malignancy. With experience, experts can also predict the histopathological subtype. This level of diagnostic performance allows us to streamline the patient journey and to reach a diagnosis and management plan faster. You will never call an ovarian mass 'complex' again!</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542350","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":"Simulation-Based Quality Improvement and Training to Improve Door to Puncture Time for Mechanical Thrombectomy.","authors":"Sophie Dunkerton, Robert Fang, Nicole Sng, Greg Lock, Claire Muller, William Collins, Sandra Concha Blamey, Georgina Cameron, Laura Owens, Grace Aw","doi":"10.1111/1754-9485.13845","DOIUrl":"https://doi.org/10.1111/1754-9485.13845","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical Thrombectomy (MT) exists as the gold standard for the management of acute ischaemic stroke secondary to large vessel occlusion. There is a direct correlation between reduced time to reperfusion and improved patient outcomes. Our study aimed to optimise processes and reduce the time from the patient's arrival at hospital to vascular puncture for MT (DTP time) through simulation-based quality improvement and staff training.</p><p><strong>Methods: </strong>This single-centre prospective study involved two simulation exercises completed over 3 months from March to May 2023. The multidisciplinary simulations involved staff following the MT patient's hyperacute journey from the time of arrival to the Emergency Department triage. Data from all patients at our centre who underwent MT in the 6-month period pre- and post-simulation training were included. The primary outcome measured was the DTP time. For statistical analysis, a paired t-test was used to compare values.</p><p><strong>Results: </strong>In the period prior to the simulation exercises, our hospital recorded 19 direct-to-hospital presentations for patients requiring MT, where we recorded a mean DTP time of 132.38 min. Post the simulation training, we recorded 26 direct-to-hospital presentations, with a mean DTP time of 104.52 min (a reduction of 27.86 min, p = 0.02). Our study did not find any statistically significant difference in DTP time for patients who were inter-hospital transfer presentations.</p><p><strong>Conclusions: </strong>We validated simulation-based training as an effective intervention for reducing time to reperfusion for patients undergoing MT. Implementation of regular training for staff can improve patient outcomes.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542357","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}