Journal of Medical Imaging and Radiation Oncology最新文献

{"title":"Exploration of Diffusion Tensor Imaging for Delineating Target Volume Boundary in Glioblastoma Radiotherapy","authors":"Lei Tian,&nbsp;Wenyan Wang,&nbsp;Wei Sun,&nbsp;Huandi Zhou,&nbsp;Zhiqing Xiao,&nbsp;Xuetao Han,&nbsp;Xing Kang,&nbsp;Xiaoying Xue","doi":"10.1111/1754-9485.13873","DOIUrl":"10.1111/1754-9485.13873","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The objective of this study is to investigate the variations in diffusion tensor imaging (DTI) parameters at different distances surrounding the operative cavity, with a specific focus on exploring the potential utility of DTI in accurately delineating radiotherapy clinical target volume for glioblastoma patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted on 41 patients with glioblastoma, in which apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured at various distances beyond the surgical cavity. Recurrent patients were prospectively followed up according to the RANO criteria, aiming to investigate discrepancies between ADC and FA values in recurrent regions compared to normal control tissues prior to recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rADC and rFA ratio approach 1 at a distance of 3 cm beyond the cavity. At the edge of the operative cavity and 2 cm beyond, the subtotal resection (STR) group exhibited higher ADC and rADC values compared to the gross total resection (GTR) group (<i>p</i> &lt; 0.05). Similarly, FA and rFA values in the STR group were lower than those in the total resection group both at 1 cm beyond and 2 cm beyond (<i>p</i> &lt; 0.05). Conventional MRI did not reveal any abnormalities prior to marginal or distant recurrence; however, the ADC value within this region was higher than that of control normal tissues (<i>p</i> = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The margins of GBM tumour invasion are typically not isotropic and could be &gt; 2 cm and sometimes up to 3 cm. We recommend appropriately larger expansion of the target volume for patients with subtotal tumour resection. The utilisation of DTI in delineating the boundary of GBM's radiotherapy clinical target volume represents a promising avenue that holds potential to enhance precision and accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 5","pages":"601-609"},"PeriodicalIF":1.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13873","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing the Next Layer: Embedding Future Readiness Into Radiology Training","authors":"Jyothirmayi Velaga","doi":"10.1111/1754-9485.13870","DOIUrl":"10.1111/1754-9485.13870","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 5","pages":"561-562"},"PeriodicalIF":1.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258233","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":"Real-World Long-Term Outcomes of Operated and Non-Operated Rectal Cancer in the Elderly: A 14-Year Retrospective Multicentre Study","authors":"Harun Demir,&nbsp;Gül Kanyılmaz,&nbsp;İbrahim Babalıoğlu,&nbsp;Bedriye Doğan,&nbsp;Meryem Aktan,&nbsp;Berrin Benli Yavuz,&nbsp;Ayşe Sümeyye Safi","doi":"10.1111/1754-9485.13872","DOIUrl":"10.1111/1754-9485.13872","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Surgical resection is the cornerstone of rectal cancer treatment. Following neoadjuvant chemoradiotherapy (nCRT), many patients undergo surgery. Another group of patients may not undergo surgery for various reasons, regardless of nCRT response. This study investigates the differences in clinical characteristics and long-term oncological outcomes of operated and non-operated elderly rectal cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre observational retrospective cohort analysis included 296 elderly patients (169 surgery, 127 non-surgical) treated at three tertiary cancer centres in Turkey between January 2010 and April 2024. Clinicopathologic features and survival outcomes were compared between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the surgery group were younger (<i>p</i> &lt; 0.000) and had better performance scores (<i>p</i> &lt; 0.000). There were no differences in initial clinical (c) T stages or cM stages; however, cN2 patients were more prevalent in the surgical group and cN1 patients were more prevalent in the non-surgical group (<i>p</i> = 0.010). No differences in radiotherapy treatment schedules were observed among the groups. The surgical group received more concurrent (<i>p</i> = 0.046) and adjuvant (<i>p</i> &lt; 0.000) chemotherapy. Patient refusal (63.8%) was the most common reason among non-surgical patients. The surgery group showed better overall survival (OS) (median, 99 vs. 33 months) (<i>p</i> &lt; 0.000), local recurrence-free survival (LRFS) (97.8% vs. 65.8% at 3 years, <i>p</i> &lt; 0.000), and distant metastasis-free survival (DMFS) (80.3% vs. 73.3% at 3 years, <i>p</i> = 0.022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows that elderly rectal cancer patients without surgery had poor survival and tumour control. Surgical resection in rectal cancer is very important and should be strongly recommended for all medically suitable elderly patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 5","pages":"586-592"},"PeriodicalIF":1.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258234","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":"Are We Off the Hook? An Update in Breast Localisation Trends","authors":"Sian Chin,&nbsp;Sally Burrows,&nbsp;Donna Taylor","doi":"10.1111/1754-9485.13866","DOIUrl":"10.1111/1754-9485.13866","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hookwire localisation (HWL) is the most established method of localising impalpable breast lesions. Previous cross-sectional study of Australian and New Zealand surgeons in 2016 found HWL to be the most widely used breast lesion localisation technique (LLT). Many non-wire techniques have subsequently been developed to address the limitations of HWL. The aim of this study is to assess current trends in the use of breast LLTs in Australia and New Zealand and to compare results with previous findings of a prior study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Attendees of a national Breast Conference were invited to participate in an online survey between 25 March and 21 April 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>100 complete responses were received. The number of respondents using each LLT was: HWL 95, Magseed 30, Carbon-track 26, SCOUT 19, IOUS 13, ROLLIS 9, ROLL 4, MOLLI 2. Considering the LLTs they used the most, 73 respondents stated HWL, 14 Magseed, 6 carbon-track and 4 ROLLIS. Magseed and ROLLIS were more likely to be the most used LLT of respondents in public practice, and HWL was more likely to be the most used LLT in private practice (<i>p</i> = 0.010). Since 2016, the use of radioguided techniques has increased (4%–13%, <i>p</i> = 0.036).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HWL remains the most used LLT; however, non-wire LLTs are being used more frequently. Although non-wire LLTs have many advantages, familiarity and cost likely also influence the choice of technique.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 5","pages":"547-553"},"PeriodicalIF":1.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225710","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":"Beyond the Image—Advancing Culturally Safe Radiology for Aboriginal and Torres Strait Islander Health","authors":"Shabnam Mohamad Shafiq,&nbsp;Amlan Chowdhury,&nbsp;Ji Woo Kim","doi":"10.1111/1754-9485.13871","DOIUrl":"10.1111/1754-9485.13871","url":null,"abstract":"<p>Despite the growing recognition of cultural safety in Australian healthcare, radiology remains an area where Aboriginal and Torres Strait Islander peoples continue to face substantial barriers. Although medical education has integrated broader Indigenous health training, clinical radiology has often been overlooked. The common misconception that radiology is a technical, patient-detached specialty has contributed to a lack of culturally competent training for radiologists and radiographers. Given the high burden of diseases requiring imaging, such as chronic respiratory illness, otitis media, cardiovascular disease and trauma-related injuries, culturally safe radiological services are vital for achieving health equity.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 5","pages":"583-585"},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13871","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural History of True Renal Artery Aneurysms: A Multi-Centre Retrospective Cohort Study and Proposed Algorithm for Follow-Up","authors":"Hayley Briody,&nbsp;Emma Tong,&nbsp;Alyssa Clark,&nbsp;Ronan J. Lee,&nbsp;Kevin P. Sheahan,&nbsp;Ronan Motyer,&nbsp;Emma Dunne,&nbsp;Conor Brosnan,&nbsp;Douglas P. Mulholland,&nbsp;Michael J. Lee","doi":"10.1111/1754-9485.13869","DOIUrl":"10.1111/1754-9485.13869","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify the pattern of growth of true renal artery aneurysms (RAA) in a multicentre cohort and to propose an algorithm for the follow-up of asymptomatic RAA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of all patients identified to have true RAA with subsequent follow-up cross-sectional imaging at three centres over a 15-year period was performed. Aneurysm maximal diameter was measured on initial and latest imaging and growth pattern assessed by two radiologists in consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 155 patients with 171 aneurysms were identified with follow-up imaging. Mean initial aneurysm size was 1.27 cm (range 0.3–3.4 cm) with a mean follow-up time of 61.08 months (range 12–182.5 months). 159 (93%) aneurysms remained stable in size over time. Overall mean growth rate was 0.015 cm/y. RAA ≤ 1.5 cm at diagnosis were associated with significantly lower mean growth rates (0.01 cm/year; <i>p</i> = 0.0059). No RAA rupture occurred during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study demonstrates an indolent course of RAA with no ruptures reported and stability over time demonstrated in 93% of a multicentre cohort. These findings are in agreement with multiple other published studies. A positive impact on cost, equity of resources, and cumulative radiation exposure with rationalisation of RAA surveillance warrants its consideration, particularly in low risk cohorts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 4","pages":"462-467"},"PeriodicalIF":2.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159022","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":"A Greener Path for Interventional Radiology","authors":"Sara Lojo-Lendoiro,&nbsp;Jose María Abadal Villayandre,&nbsp;Elena Lonjedo Vincent,&nbsp;Ángel Morales Santos,&nbsp;Àlex Rovira","doi":"10.1111/1754-9485.13867","DOIUrl":"10.1111/1754-9485.13867","url":null,"abstract":"<div>\u0000 \u0000 <p>The healthcare sector contributes substantially to global greenhouse gas (GHG) emissions, with hospital services being a major source. Interventional radiology (IR), as a resource-intensive subspecialty, has a disproportionately high environmental impact due to its reliance on advanced imaging equipment, sterile disposable materials and climate-controlled facilities. This narrative review aims to raise awareness of the environmental responsibilities of interventional radiologists and propose practical strategies to reduce the carbon, water and ecological footprints associated with IR procedures and operations. The manuscript describes best practices in energy and waste management, the use of environmentally friendly equipment and sustainable facility design, while addressing current barriers to their implementation. Through evidence-based recommendations and practical examples, this position paper advocates for a greener and more sustainable future in interventional radiology.</p>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 4","pages":"498-508"},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094080","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":"Physiological Zonal Anatomical Variation and Distribution of PSMA Activity Within the Prostate on PSMA PET: A Study of 93 Prostatectomy Specimens Correlated to MRI and Histology","authors":"Leon Vasquez,&nbsp;Dalveer Singh,&nbsp;Michael Kreltszheim,&nbsp;Hemamali Samaratunga,&nbsp;Zachary Drew,&nbsp;Chris Rothe","doi":"10.1111/1754-9485.13855","DOIUrl":"10.1111/1754-9485.13855","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aims to describe and quantify the normal physiologic zonal variation of PSMA expression within the prostate gland on 18F-DCFPyL-PSMA-PET imaging with histopathologic correlation, to aid in the accurate diagnosis of central zone (CZ) lesions. We also aim to quantify a normal range of CZ avidity and identify normal cut-off values below which CZ uptake can be safely considered physiologic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Prostate MR and 18F-DCFPyL-PSMA-PET imaging studies were assessed along with the review of histopathology for 93 consecutive patients who underwent radical prostatectomy for prostate cancer. Prostate MR and PSMA PET data sets were fused with standardised volumes of interest (VOI) placed on each zone (CZ, PZ &amp; TZ) bilaterally based on MR T2 sequence prostate zonal anatomy. SUVmax and SUVmean values for each VOI were measured. Semi-quantitative histopathological correlation was performed for ten selected cases. The CZ, TZ and PZ in each sample were assessed for PSMA receptor density and graded by staining intensity and the percentage of cells staining with this level of intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A higher intensity of PSMA uptake was seen with respect to both SUVmax and SUVmean in the CZ compared to both the PZ and TZ. Histological analysis also provided concordant results, providing direct cellular surface correlation to the imaging findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Increased physiological PSMA expression (and thus molecular PSMA intensity) on PET/CT was seen in the CZ. This knowledge will improve confidence during interpretation of intra-prostatic findings on staging or restaging PSMA PET/CT studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 4","pages":"447-451"},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094088","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":"MRI Signatures of Parotid Tumours Impacting Management Decisions: A Retrospective Study With Radiology and Pathology Correlation","authors":"Nivedita Chakrabarty,&nbsp;Prathamesh Pai,&nbsp;Arpita Sahu,&nbsp;Oindrila Roy Chowdhury,&nbsp;Pashmina Kandalgaonkar,&nbsp;Tapish Dadlani,&nbsp;Munita Menon,&nbsp;Suman Kumar Ankathi","doi":"10.1111/1754-9485.13865","DOIUrl":"10.1111/1754-9485.13865","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fine needle aspiration (FNA) from parotid tumour is inadequate and nondiagnostic in 8% and FNA/biopsy from deep lobe is technically challenging; hence, our first objective was to evaluate MRI findings which best predict the benign and malignant nature of parotid tumour. Our second objective was to develop MRI signatures for parotid tumour histopathologies including grades of carcinoma, to help in decision making regarding elective neck dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two head and neck radiologists retrospectively evaluated and developed signatures of common benign and malignant parotid tumours using morphology and signal intensity–related variables for 98 patients on MRI available in PACS from 01 January 2016 to 26 December 2022. T1 weighted image (WI), T2WI, short tau inversion recovery, diffusion WI/apparent diffusion coefficient and postcontrast T1WI sequences were evaluated. The developed MRI signatures were then validated by a blinded third radiologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sensitivity, specificity, accuracy, positive and negative predictive values using MRI signatures were 92.31%, 100%, 94.23%, 100% and 81.25%, respectively, for benign and malignant nature of parotid tumours with a highly significant <i>p</i>-value (&lt; 1e-04). Developed MRI signatures also showed high statistical performance and significant <i>p-</i>value for parotid tumour histopathologies and grades of mucoepidermoid carcinoma (MEC). T2 signal intensity and enhancement patterns can help identify low-grade MEC, impacting management decisions regarding elective neck dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MRI can predict the benign and malignant nature, parotid tumour histopathologies and grades of MEC when typical signatures are present, impacting management decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 4","pages":"452-461"},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13865","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of Routine Pelvic Examination in the Follow-Up of Patients Receiving Adjuvant Radiation Therapy for Endometrial Cancer: An Australian Tertiary-Centre Experience","authors":"M. C. Knox,&nbsp;A. Salkeld,&nbsp;A. Brand,&nbsp;U. Herbst,&nbsp;J. Chard,&nbsp;N. Thiruthaneeswaran","doi":"10.1111/1754-9485.13864","DOIUrl":"10.1111/1754-9485.13864","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pelvic examination is a routine component of post-treatment surveillance for endometrial cancer, supported by global guidelines. However, there is no evidence of oncological or quality-of-life benefit, with data suggesting associated discomfort and potential psychological harm. We evaluate the value of routine pelvic examination in follow-up protocols after adjuvant radiation therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed all patients receiving adjuvant radiation therapy for endometrial carcinoma across two combined cancer services between January 2017 and December 2022. All stages and histological subtypes were eligible. At least 12 months of documented follow-up was required. Patients were stratified by FIGO stage (2009 and 2023) and ESGO/ESTRO risk group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and sixty-four of 395 patients met inclusion criteria, with a median follow-up of 34 months. Whilst demographics were widely distributed, the most common features included endometrioid histology (76.5%), FIGO 2023 stage II (48.5%) and ESGO/ESTRO high-risk (36.7%).</p>\u0000 \u0000 <p>Disease recurrence was identified in 41 patients (15.5%). Only four patients had isolated local recurrence, with most also having distant disease at detection. Only three patients had asymptomatic recurrence found on examination (1.1% of cohort), with only one proceeding to salvage therapy (0.4% of cohort). As expected, higher-risk groups were associated with worse overall survival (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found routine pelvic examination following adjuvant radiation therapy for endometrial cancer results in low recurrence detection rates, with salvageable local recurrences being rare. We advocate for the omission of routine pelvic examination from follow-up protocols for patients receiving adjuvant radiation therapy, with either clinic-based or telephone-based follow-up being offered on a risk-stratified basis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 4","pages":"531-539"},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13864","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}