Journal of Medical Imaging and Radiation Oncology最新文献

{"title":"Evaluation of ultra-low-dose CT with tin filter for craniosynostosis.","authors":"Wilson Tao, Robert Goetti","doi":"10.1111/1754-9485.13812","DOIUrl":"https://doi.org/10.1111/1754-9485.13812","url":null,"abstract":"<p><strong>Introduction: </strong>CT has replaced skull radiography as the gold standard for assessment of craniosynostosis in children. To minimise the risks of ionising radiation in this radiosensitive population, low-dose CT protocols are increasingly being adopted. This study evaluates the effectiveness of an ultra-low-dose CT protocol with a tin filter in reducing radiation exposure whilst maintaining diagnostic quality for craniosynostosis, and its utility in the evaluation of other findings not appreciable on skull radiography.</p><p><strong>Methods: </strong>Twenty-seven patients who underwent ultra-low-dose CT for craniosynostosis were compared with an age-matched control group who received standard-dose CT for indications other than craniosynostosis. Differences in radiation dosimetry and quantitative image quality parameters were analysed using independent two-tailed t-tests. Radiologist reports were also examined for the frequency of other incidental radiological findings.</p><p><strong>Results: </strong>Mean effective dose for the 27 ultra-low-dose CT scans was 0.14 mSv, a 92% reduction compared with the control group. Image quality, measured by contrast-to-noise ratio, was significantly lower in the ultra-low-dose scans compared with the standard-dose scans; however, all scans were diagnostic for detecting or excluding craniosynostosis. Hydrocephalus was able to be ruled out in all 27 ultra-low-dose scans.</p><p><strong>Conclusion: </strong>Ultra-low-dose CT with a tin filter allows for the diagnosis of craniosynostosis with a 92% dose reduction compared with the standard CT protocol. Despite lower image quality with the ultra-low-dose protocol when compared to standard CT, all 27 scans were adequate for craniosynostosis diagnosis. Additionally, it allowed for the assessment of other relevant findings not appreciable with skull radiography, highlighting its advantages as the new clinical standard for craniosynostosis assessment.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729675","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":"Paraganglioma and phaeochromocytoma in adult Fontan patients.","authors":"Stephanie Bm Tan, Maria Luz Garagiola, Xiaoyang Liu, Tae Kyoung Kim, Ciara Mo Brien","doi":"10.1111/1754-9485.13809","DOIUrl":"https://doi.org/10.1111/1754-9485.13809","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to address the gap in knowledge in the incidence, presentation and imaging features of PPGL in Fontan patients. It has been hypothesised in the literature that Fontan circulation patients have an increased incidence of these tumours. This study is the largest cohort of adult Fontan patients in North America. The Fontan procedure is a palliative procedure for single ventricle congenital heart disease where the systemic venous return is directed into the pulmonary circulation. Fontan patients are at increased risk of developing several extracardiac complications including phaeochromocytoma and paraganglioma (PPGL).</p><p><strong>Methods: </strong>This retrospective single-centre study includes all adult patients who were treated between 1 September 2015 and 1 September 2022 in a tertiary referral centre for adult congenital heart disease. Imaging and electronic medical records were retrospectively searched for the presence of PPGL.</p><p><strong>Results: </strong>Five hundred and forty-seven Fontan patients were included in the study. Three patients had PPGL with an incidence of 0.5%. Two patients were diagnosed with paraganglioma and one with phaeochromocytoma. All patients were female. Median age of Fontan procedure was 1.8 years (range: 1.75-27 years). Median age of PPGL diagnosis was 19 years (range: 12-39 years). Median time from Fontan operation to diagnosis of PPGL was 12 years (range: 10.3-17.2 years).</p><p><strong>Conclusion: </strong>Fontan patients are at increased risk of PPGL. Clinically, the diagnosis of PPGL is challenging as symptoms and serum markers can be confounding in this population; however, the imaging features of PPGL remain typical making the role of the radiologist crucial.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622029","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":"Publication output of RANZCR radiation oncologists in 2022-23.","authors":"Daniel Roos, Lisa Milner, Therese Kang, Emma Quinn, Wee Loon Ong","doi":"10.1111/1754-9485.13807","DOIUrl":"https://doi.org/10.1111/1754-9485.13807","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this work was to determine the current publication output of Royal Australian and New Zealand College of Radiologists radiation oncologists (ROs) to serve as a baseline contributing to future assessment of the effectiveness of the College's Research Action Plan 2024-26.</p><p><strong>Methods: </strong>An online survey was sent to all ROs in the College's member database in March-April 2024 requesting a list of publications between 2022 and 2023. A PubMed search was performed to cross-check the self-reported publications. Given the low response rate (8%), an additional PubMed search was performed for the non-responders. The primary outcomes were publication proportions and rates, and the secondary outcomes were demographic correlates (gender, country, seniority).</p><p><strong>Results: </strong>There were 536 eligible ROs (56% males; 80% practicing in Australia; median 12.4 years post-Fellowship) with 1,012 unique publications identified. The proportions of ROs with at least one publication in any-, first- and last-author positions averaged 45%, 15% and 17% per year, respectively. On multivariable analysis, there were statistically significant differences in publications by seniority (higher proportions of last-authorships but lower proportions of first-authorships, for those ≥5 years post-Fellowship) and by country (lower any-, and last-authorships for New Zealand [NZ] than Australia or Singapore). The mean numbers of any-, first- and last-authorships were 1.6, 0.18 and 0.29 per RO per year, respectively. On multivariable analysis, there were statistically significant differences by gender (males had more any-, and first-authorships), seniority (senior ROs had more last-authorships but less first-authorships) and country (lower numbers of any-, and last-authorships for New Zealand).</p><p><strong>Conclusion: </strong>This organization-wide study provides comprehensive baseline RO publication data and identifies opportunities for the College to further address correlated disparities.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622031","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":"Radiotherapy for node-positive prostate cancer in the PSMA-PET era: The need for prospective clinical trials.","authors":"Wee Loon Ong, Therese Min Jung Kang, Andrew Loblaw","doi":"10.1111/1754-9485.13806","DOIUrl":"https://doi.org/10.1111/1754-9485.13806","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621984","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":"Comparing DCE-MRI and DSA: Understanding the embolization of hypervascular spinal metastases.","authors":"Muhammad Adnan, Ameer Mustafa Farukh, Syed Muhammad Sinaan Ali, Muhammad Mubashir, Imaan Jauhar, Abdul Raheem","doi":"10.1111/1754-9485.13808","DOIUrl":"https://doi.org/10.1111/1754-9485.13808","url":null,"abstract":"<p><p>This study aims to examine and compare the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and Digital Subtraction Angiography (DSA) in evaluating hypervascular spinal metastases. A comprehensive literature review was conducted, utilizing top-tier databases such as PubMed, Scopus and Google Scholar, to compile an authoritative and up-to-date overview of the current advancements in the field. We synthesized key studies focusing on the advantages, limitations and efficacy of both imaging techniques. DCE-MRI provides a non-invasive method for evaluating tissue morphology, perfusion and vascularity, offering valuable information for cancer diagnosis and treatment monitoring. In contrast, DSA is an invasive procedure primarily used for embolization and diagnosing cerebrovascular events. Both modalities have distinct features regarding image acquisition, contrast agents, resolution and accessibility. DCE-MRI shows promise for cancer-related applications, offering advantages over conventional MRI by incorporating anatomical and hemodynamic parameters. While DSA remains important for cases requiring critical vascular information, further research is necessary to explore its potential therapeutic benefits in assessing vessel patency. Continued investigations are crucial to uncover additional insights and therapeutic applications for both DCE-MRI and DSA in medical imaging.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622026","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":"Current utilisation of advanced techniques and technologies in palliative radiation therapy in Australia and New Zealand.","authors":"Pavthrun Pathmanathan, Daniel Roos, Kathy Pope, Melissa L James, Minjae Lah, Chris M Frampton","doi":"10.1111/1754-9485.13805","DOIUrl":"https://doi.org/10.1111/1754-9485.13805","url":null,"abstract":"<p><strong>Introduction: </strong>The techniques employed in palliative radiation therapy are highly variable, ranging from basic (2D/3D-conformal) to more advanced (beam modulation and stereotactic techniques), and their relative use has not previously been formally investigated at a national level. The purpose of this work was to assess the current utilisation of palliative techniques and technologies in Australia and New Zealand (ANZ).</p><p><strong>Methods: </strong>A voluntary, anonymous, internet-based, RANZCR approved survey was offered to all practising radiation oncology (RO) Fellows in ANZ. Participants selected their preferred methods of managing patients in five case studies involving bone, brain, lung metastases and locally advanced lung cancer.</p><p><strong>Results: </strong>From October 2022 to February 2023, 146 of 485 eligible participants (30%) responded. In all, 61% and 81% would treat an uncomplicated breast cancer solitary spinal metastasis with stereotactic body radiation therapy routinely and ideally, respectively; 11% and 32% would treat a solitary lung cancer brain metastasis with dedicated stereotactic radiosurgery routinely and ideally; 36% and 56% would treat multiple low-volume brain metastases with a stereotactic technique routinely and ideally. There was negligible difference in the routine and preferred use of advanced technologies for a solitary bowel cancer lung metastasis; 69% and 77% would treat a locally advanced primary lung cancer with an advanced technique routinely and ideally. Relative to Australia, NZ ROs routinely treat uncomplicated solitary spinal metastases (P < 0.001), solitary brain metastases (P < 0.001), multiple low-volume brain metastases (P < 0.02), and locally advanced primary lung cancer (P < 0.001) more commonly with basic technologies, mainly due to limited local availability of advanced technology and departmental waiting lists.</p><p><strong>Conclusion: </strong>Participants generally favoured treating with advanced techniques and technologies in palliative settings, if available, but there were notable disparities between the two countries. Enhanced local access and clinical training may facilitate optimal utilisation of advanced technologies and improve clinical outcomes.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581685","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":"Contrast-enhanced mammography improves patient access to functional breast imaging.","authors":"Donna B Taylor, Meredith A Kessell, Paul M Parizel","doi":"10.1111/1754-9485.13789","DOIUrl":"https://doi.org/10.1111/1754-9485.13789","url":null,"abstract":"<p><p>Imaging research pathways focus increasingly on the development of individualised approaches to breast cancer detection, diagnosis and management. Detection of breast cancer with X-ray mammography may fail in some cancer subtypes with limited changes in morphology/tissue density and in women with dense breasts. International organisations offer recommendations for contrast-enhanced breast imaging, as it provides superior sensitivity for screening, local staging and assessment of neoadjuvant treatment response, when compared with standard X-ray mammography (including tomosynthesis) and breast ultrasound. Arguably, the evidence base is stronger for contrast-enhanced MRI (CE-MRI). Unfortunately, patient access to breast MRI in rural and remote areas is limited by practical limitations and equipment licensing restrictions. Moreover, breast MRI is an expensive test, likely to be out of reach for many women. Contrast-enhanced mammography (CEM) offers an attractive alternative to improve patient access to functional breast imaging. It is a new type of digital, dual energy X-ray mammography that can be performed on most modern units, following a relatively inexpensive hard- and software upgrade. In this paper, we review the rapidly accumulating evidence that CEM can provide similar diagnostic accuracy to CE-MRI, though at a significantly lower cost and offering greater comfort to the patient. The adoption of CEM can help meet the anticipated increased demand for CE-MRI.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558070","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":"PHACEing a challenging diagnosis: Should we expand the phenotype?","authors":"Stacy K Goergen, LuFee Wong, Michael C Fahey","doi":"10.1111/1754-9485.13804","DOIUrl":"https://doi.org/10.1111/1754-9485.13804","url":null,"abstract":"<p><p>PHACE syndrome is a challenging but important prenatal diagnosis due to its protean clinical consequences. The 'tilted telephone receiver' sign (TTRS), consisting of asymmetric cerebellar volume reduction and marked counterclockwise, Dandy-Walker-like upward vermis rotation on prenatal MRI and ultrasound has high specificity for PHACE. Recently, a case report of the prenatal imaging findings in an infant with PHACE described more mild upward vermis rotation and cerebellar clefting. It recommended consideration of expansion of the currently accepted phenotype to improve prenatal detection of the condition. We describe a case with imaging features essentially indistinguishable from the recently published case of PHACE with mild upward vermis rotation, asymmetric cerebellar hemispheric volume loss and a cerebellar hemispheric cleft. Our patient did not have PHACE postnatally at 1 year of follow up. Neurodevelopmental testing in infancy demonstrated mildly atypical development. Fetuses with asymmetric cerebellar hemispheric volume loss, a cleft in the smaller hemisphere and only mild upward vermis rotation, consistent with the proposed 'expanded PHACE phenotype' do not always have PHACE. Erroneously adverse prenatal prognostic counselling may result from such prenatal phenotypic expansion.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558071","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":"Assessment of cervical spine CT by an image quality audit using qualitative and quantitative methods.","authors":"Hooryia Bajwa, Thenugaa Sritharan, Tanita Botha, Price Jackson, Kim McAnulty, Lincoln J Lim, Phillip V Tran, Shane Reeves, Leah Biffin, Harish Narayanan","doi":"10.1111/1754-9485.13791","DOIUrl":"https://doi.org/10.1111/1754-9485.13791","url":null,"abstract":"<p><strong>Introduction: </strong>To study the feasibility and assess the correlation of qualitative and quantitative methods for an image quality (IQ) audit of a Cervical spine CT.</p><p><strong>Methods: </strong>Five radiologists retrospectively performed a blinded visual grading analysis (VGA) on 20 studies (10 from Protocol 1 and 10 from Protocol 2), using the RANZCR CT IQ Self-Audit worksheet. A Visual Grading Analysis Score (VGAS) and Area under the curve using Visual Grading Characteristics (AUC_VGC) were the figures of merit. Quantitative metrics for noise and contrast were correlated to the qualitative assessment.</p><p><strong>Results: </strong>No statistically significant difference was observed in the IQ, VGAS_Protocol 1 = 0.65, 95% CI [0.54, 0.75] and VGAS_{Protocol 2} = 0.73, 95% CI [0.67, 0.79] and AUC_VGC = 0.548, 95% CI [0.40, 0.69]. Protocol 2 indicated a statistically significant average dose reduction of 35% in CTDI_vol (P = 0.020) and a higher noise; however, the difference was statistically insignificant. There was a moderate correlation between the manual noise measurements in soft tissue and air (P = 0.035) and a strong correlation between the manual and automated noise measurements (P < 0.001). The contrast resolution-based quantitative parameter, EdgeGradientSoft, correlated to the qualitative scores (P = 0.031).</p><p><strong>Conclusion: </strong>Validated VGA tools can be used for IQ audits; however, tailoring the image criteria and rating scale to the clinical practice is suggested. The use of contrast-based IQ metrics showed encouraging results, and further larger-scale studies are needed to explore their potential use in quality management.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558069","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":"Comparing the efficacy of different embolisation materials in improving pain and fertility outcomes in patients with varicoceles: A systematic review.","authors":"Daniel Kasunic, Mitchell Crebert, Patrick-Julien Treacy, Daniel Steffens, Sascha Karunaratne, Richard Waugh, Ruban Thanigasalam, Scott Leslie","doi":"10.1111/1754-9485.13801","DOIUrl":"https://doi.org/10.1111/1754-9485.13801","url":null,"abstract":"<p><p>Radiological embolisation has emerged as a safe and effective alternative to surgery for varicocele treatment. While systematic reviews have compared embolisation to surgery, attempts to compare different embolisation materials have been limited. The objective was to conduct a systematic review assessing the potential benefits of combining coils with sclerosants for varicocele embolisation on fertility, pain, recurrence and complication rates in male patients, as compared to using coils alone. The search was conducted through MEDLINE, Embase and CENTRAL databases from inception to May 2023. Comparative studies that reported male varicocele patients treated with embolisation using either coils or coils with sclerosants were included, with primary outcomes of either fertility, pain or recurrence. Pearling of reference lists was also performed to identify additional articles. Risk of bias for each study was assessed using the Downs and Black Checklist. Overall, 21 studies (2236 patients) were included. Patients were treated with coils in 14 studies, and nine studies used coils with sclerosants. An improvement in sperm concentration and motility was identified post-embolisation in most studies that reported these outcomes. Pregnancy and recurrence rates were comparable between the two materials. All four studies that reported pain outcomes following embolisation noted improvement in pain scores. Only one comparative study was included, for recurrence. This review has identified improvements in pain and fertility following varicocele embolisation. However, it could not be determined which material was superior due to the lack of high-quality comparative studies in the literature.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502087","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}