Radiologia Medica最新文献

{"title":"Ultrasound-guided thread versus ultrasound-guided needle release of the A1 pulley: a cadaveric study.","authors":"Suren Jengojan, Philipp Sorgo, Johannes Streicher, Žiga Snoj, Gregor Kasprian, Gerlinde Gruber, Gerd Bodner","doi":"10.1007/s11547-024-01875-y","DOIUrl":"10.1007/s11547-024-01875-y","url":null,"abstract":"<p><strong>Purpose: </strong>To assess and compare two ultrasound-guided, minimally invasive procedures to release the A1-pulley (needle release and thread release) regarding efficacy and safety in an anatomical specimen model.</p><p><strong>Materials and methods: </strong>Twenty-one ultrasound-guided needle releases and 20 ultrasound-guided thread releases were performed on digits of Thiel-embalmed anatomical specimens. A scoring system was developed to assess ultrasound visibility, intervention outcome (incomplete, almost complete, or full transection of the A1 pulley), and injury to adjacent structures (neurovascular structures, tendons, A2 pulley). Statistical analysis was performed to compare the score of the two groups (group 1: needle release,group 2: thread release). A P-value of ≤ 0.05 was considered significant.</p><p><strong>Results: </strong>Needle release was completely successful in 15 cases (71.5%), almost complete release was achieved in four cases (19%), and incomplete transection occurred in two cases (9.5%). Thread release was completely successful in 17 cases (85%), and almost complete transection was observed in the remaining three cases (15%). In both procedures no neurovascular structures were harmed. Slight injury of flexor tendons occurred in two cases (9.5%) in needle release and in five cases (25%) in thread release. There were no significant statistical differences between the groups regarding ultrasound visibility, intervention safety and outcome, (P > 0.05).</p><p><strong>Conclusion: </strong>Ultrasound-guided needle release and ultrasound-guided thread release have similar success of release, both being effective and safe techniques for the release of the A1 pulley.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1513-1521"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do large language models answer breast cancer quiz questions? A comparative study of GPT-3.5, GPT-4 and Google Gemini.","authors":"Giovanni Irmici, Andrea Cozzi, Gianmarco Della Pepa, Claudia De Berardinis, Elisa D'Ascoli, Michaela Cellina, Maurizio Cè, Catherine Depretto, Gianfranco Scaperrotta","doi":"10.1007/s11547-024-01872-1","DOIUrl":"10.1007/s11547-024-01872-1","url":null,"abstract":"<p><p>Applications of large language models (LLMs) in the healthcare field have shown promising results in processing and summarizing multidisciplinary information. This study evaluated the ability of three publicly available LLMs (GPT-3.5, GPT-4, and Google Gemini-then called Bard) to answer 60 multiple-choice questions (29 sourced from public databases, 31 newly formulated by experienced breast radiologists) about different aspects of breast cancer care: treatment and prognosis, diagnostic and interventional techniques, imaging interpretation, and pathology. Overall, the rate of correct answers significantly differed among LLMs (p = 0.010): the best performance was achieved by GPT-4 (95%, 57/60) followed by GPT-3.5 (90%, 54/60) and Google Gemini (80%, 48/60). Across all LLMs, no significant differences were observed in the rates of correct replies to questions sourced from public databases and newly formulated ones (p ≥ 0.593). These results highlight the potential benefits of LLMs in breast cancer care, which will need to be further refined through in-context training.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1463-1467"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics and 256-slice-dual-energy CT in the automated diagnosis of mild acute pancreatitis: the innovation of formal methods and high-resolution CT.","authors":"Aldo Rocca, Maria Chiara Brunese, Antonella Santone, Giulia Varriano, Luca Viganò, Corrado Caiazzo, Gianfranco Vallone, Luca Brunese, Luigia Romano, Marco Di Serafino","doi":"10.1007/s11547-024-01878-9","DOIUrl":"10.1007/s11547-024-01878-9","url":null,"abstract":"<p><strong>Introduction: </strong>Acute pancreatitis (AP) is a common disease, and several scores aim to assess its prognosis. Our study aims to automatically recognize mild AP from computed tomography (CT) images in patients with acute abdominal pain but uncertain diagnosis from clinical and serological data through Radiomic model based on formal methods (FMs).</p><p><strong>Methods: </strong>We retrospectively reviewed the CT scans acquired with Dual Source 256-slice CT scanner (Somatom Definition Flash; Siemens Healthineers, Erlangen, Germany) of 80 patients admitted to the radiology unit of Antonio Cardarelli hospital (Naples) with acute abdominal pain. Patients were divided into 2 groups: 40 underwent showed a healthy pancreatic gland, and 40 affected by four different grades (CTSI 0, 1, 2, 3) of mild pancreatitis at CT without clear clinical presentation or biochemical findings. Segmentation was manually performed. Radiologists identified 6 patients with a high expression of diseases (CTSI 3) to formulate a formal property (Rule) to detect AP in the testing set automatically. Once the rule was formulated, and Model Checker classified 70 patients into \"healthy\" or \"unhealthy\".</p><p><strong>Results: </strong>The model achieved: accuracy 81%, precision 78% and recall 81%. Combining FMs results with radiologists agreement, and applying the mode in clinical practice, the global accuracy would have been 100%.</p><p><strong>Conclusions: </strong>Our model was reliable to automatically detect mild AP at primary diagnosis even in uncertain presentation and it will be tested prospectively in clinical practice.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1444-1453"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional radiology in the 3rd millennium: past, present and future perspectives.","authors":"Francesco Giurazza, Raffaella Niola","doi":"10.1007/s11547-024-01894-9","DOIUrl":"10.1007/s11547-024-01894-9","url":null,"abstract":"","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1429-1430"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of ultrasound-guided vacuum-assisted breast biopsy in the management of radiologic-pathologic discordance: a retrospective single-centre study.","authors":"Giulia Vatteroni, Giulia Pinna, Rubina Manuela Trimboli, Riccardo Levi, Isabella Bolengo, Francesco Patrone, Daria Volpe, Bethania Fernandes, Daniela Bernardi","doi":"10.1007/s11547-024-01864-1","DOIUrl":"10.1007/s11547-024-01864-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of US-guided vacuum-assisted biopsy (US-VAB) in radiologic-pathologic (rad-path) discordance in women with suspicious breast lesions.</p><p><strong>Methods: </strong>Two thousand three hundred and sixty patients with 2385 BI-RADS category 4 and 5 lesions underwent percutaneous US-guided CNB. Thirty-six lesions were classified as discordant benign and underwent second-line US-VAB. A 14-gauge needle was utilized for CNB and 10-gauge for US-VAB. Final pathology was the reference standard for women who underwent surgery, imaging follow-up in other cases. Rates of malignancy for US-VAB and subsequent surgery were evaluated. Lesions with upgrade and no upgrade to second-line VAB were compared in terms of patient's age, lesion type and characteristics, size and BI-RADS category. Positive predictive value (PPV), negative predictive value (NPV) for BI-RADS categories and diagnostic performance for second-line US-VAB were calculated. p value < 0.05 was considered statistically significant (t-test, Mann-Whitney, χ²).</p><p><strong>Results: </strong>US-VAB identified 10 B2, 9 B3 and 17 B5 lesions with upgrade to malignancy of 47.2% (17/36). There were 8 invasive no special type, 7 ductal in situ, 1 invasive lobular carcinoma and 1 angiosarcoma, and their distribution among BI-RADS categories was: 2/2 in BI-RADS 5 (100%), 12/18 in BI-RADS 4C (67%) and 3/16 in BI-RADS 4B lesions (19%) (p = 0.006). Of the remaining 19 lesions, 6 underwent surgery and 2 were upgraded to ductal carcinoma in situ; 13 underwent radiological follow-up and one resulted malignant. False-negative rate for US-VAB was 15.8% (3/19) with final upgrade to malignancy of 55% (20/36). The univariate analysis revealed mass shape (p = 0.008) and BI-RADS categories (p = 0.006) to be associated with upgrade to malignancy. Sensitivity, specificity, PPV, NPV and accuracy for US-VAB were 85, 100, 100, 84 and 92%, respectively.</p><p><strong>Conclusions: </strong>US-VAB identified almost 50% of cancers missed by CNB, avoiding surgical biopsies and validating as an effective mini-invasive approach in rad-path discordance.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1454-1462"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac MRI in heart failure with preserved ejection fraction.","authors":"Agostino Meduri, Alessio Perazzolo, Riccardo Marano, Massimo Muciaccia, Francesco Lauriero, Giuseppe Rovere, Lorenzo Giarletta, Eleonora Moliterno, Luigi Natale","doi":"10.1007/s11547-024-01874-z","DOIUrl":"10.1007/s11547-024-01874-z","url":null,"abstract":"<p><p>Patients who have heart failure with preserved ejection fraction (HFpEF) have signs and symptoms of heart failure, yet their ejection fraction remains greater than or equal to 50 percent. Understanding the underlying cause of HFpEF is crucial for accurate diagnosis and effective treatment. This condition can be caused by multiple factors, including ischemic or nonischemic myocardial diseases. HFpEF is often associated with diastolic dysfunction. Cardiac magnetic resonance (CMR) allows for a precise examination of the functional and structural alterations associated with HFpEF through the measurement of volumes and mass, the assessment of systolic and diastolic function, and the analysis of tissue characteristics. We will discuss CMR imaging indicators that are specific to patients with HFpEF and their relation to the disease. These markers can be acquired through both established and emerging methods.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1468-1484"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring kappa statistics considerations between two raters.","authors":"Tianfei Yu, Siyuan Qian, Ming Li","doi":"10.1007/s11547-024-01836-5","DOIUrl":"10.1007/s11547-024-01836-5","url":null,"abstract":"","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1555-1556"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemic core detection threshold of computed tomography perfusion (CTP) in acute stroke.","authors":"Luigi Asmundo, Moreno Zanardo, Massimo Cressoni, Federico Ambrogi, Luciano Bet, Fabio Giatsidis, Giovanni Di Leo, Francesco Sardanelli, Paolo Vitali","doi":"10.1007/s11547-024-01868-x","DOIUrl":"10.1007/s11547-024-01868-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the accuracy of detecting ischemic core volume using computed tomography perfusion (CTP) in patients with suspected acute ischemic stroke compared to diffusion-weighted magnetic resonance imaging (DW-MRI) as the reference standard.</p><p><strong>Methods: </strong>This retrospective monocentric study included patients who underwent CTP and DW-MRI for suspected acute ischemic stroke. The ischemic core size was measured at DW-MRI. The detectability threshold volume was defined as the lowest volume detected by each method. Clinical data on revascularization therapy, along with the clinical decision that influenced the choice, were collected. Volumes of the ischemic cores were compared using the Mann-Whitney U test.</p><p><strong>Results: </strong>Of 83 patients who underwent CTP, 52 patients (median age 73 years, IQR 63-80, 36 men) also had DW-MRI and were included, with a total of 70 ischemic cores. Regarding ischemic cores, only 18/70 (26%) were detected by both CTP and DW-MRI, while 52/70 (74%) were detected only by DW-MRI. The median volume of the 52 ischemic cores undetected on CTP (0.6 mL, IQR 0.2-1.3 mL) was significantly lower (p < 0.001) than that of the 18 ischemic cores detected on CTP (14.2 mL, IQR 7.0-18.4 mL). The smallest ischemic core detected on CTP had a volume of 5.0 mL. Among the 20 patients with undetected ischemic core on CTP, only 10% (2/20) received thrombolysis treatment.</p><p><strong>Conclusions: </strong>CTP maps failed in detecting ischemic cores smaller than 5 mL. DW-MRI remains essential for suspected small ischemic brain lesions to guide a correct treatment decision-making.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1522-1529"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of two different artificial intelligence (AI) methods for assessing carpal bone age compared to the standard Greulich and Pyle method.","authors":"Davide Alaimo, Maria Chiara Terranova, Ettore Palizzolo, Manfredi De Angelis, Vittorio Avella, Giuseppe Paviglianiti, Giuseppe Lo Re, Domenica Matranga, Sergio Salerno","doi":"10.1007/s11547-024-01871-2","DOIUrl":"10.1007/s11547-024-01871-2","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate the agreement between bone age assessments conducted by two distinct machine learning system and standard Greulich and Pyle method.</p><p><strong>Materials and methods: </strong>Carpal radiographs of 225 patients (mean age 8 years and 10 months, SD = 3 years and 1 month) were retrospectively analysed at two separate institutions (October 2018 and May 2022) by both expert radiologists and radiologists in training as well as by two distinct AI software programmes, 16-bit AI^tm and BoneXpert® in a blinded manner.</p><p><strong>Results: </strong>The bone age range estimated by the 16-bit AI^tm system in our sample varied between 1 year and 1 month and 15 years and 8 months (mean bone age 9 years and 5 months SD = 3 years and 3 months). BoneXpert® estimated bone age ranged between 8 months and 15 years and 7 months (mean bone age 8 years and 11 months SD = 3 years and 3 months). The average bone age estimated by the Greulich and Pyle method was between 11 months and 14 years, 9 months (mean bone age 8 years and 4 months SD = 3 years and 3 months). Radiologists' assessments using the Greulich and Pyle method were significantly correlated (Pearson's r > 0.80, p < 0.001). There was no statistical difference between BoneXpert® and 16-bit AI^tm (mean difference = - 0.19, 95%CI = (- 0.45; 0.08)), and the agreement between two measurements varies between - 3.45 (95%CI = (- 3.95; - 3.03) and 3.07 (95%CI - 3.03; 3.57).</p><p><strong>Conclusions: </strong>Both AI methods and GP provide correlated results, although the measurements made by AI were closer to each other compared to the GP method.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1507-1512"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value of sequential circulating tumor DNA analysis using next-generation sequencing and epigenetic modifications for guiding thermal ablation for colorectal cancer metastases: a prospective study.","authors":"Tom Boeken, Olivier Pellerin, Camille Bourreau, Juliette Palle, Claire Gallois, Aziz Zaanan, Julien Taieb, Widad Lahlou, Alessandro Di Gaeta, Marc Al Ahmar, Xavier Guerra, Carole Dean, Pierre Laurent Puig, Marc Sapoval, Helena Pereira, Hélène Blons","doi":"10.1007/s11547-024-01865-0","DOIUrl":"10.1007/s11547-024-01865-0","url":null,"abstract":"<p><strong>Introduction: </strong>While thermal ablation is now a standard treatment option for oligometastatic colorectal cancer patients, selecting those who will benefit most from locoregional therapies remains challenging. This proof-of-concept study is the first to assess the feasibility of routine testing of ctDNA before and after thermal ablation with curative intent, analyzed by next-generation sequencing (NGS) and methylation specific digital droplet PCR (ddPCR). Our prospective study primary objective was to assess the prognostic value of ctDNA before thermal ablation.</p><p><strong>Methods: </strong>This single-center prospective study from November 2021 to June 2022 included colorectal cancer patients referred for curative-intent thermal ablation. Cell-free DNA was tested at different time points by next-generation sequencing and detection of WIF1 and NPY genes hypermethylation using ddPCR. The ctDNA was considered positive if either a tumor mutation or hypermethylation was detected; recurrence-free survival was used as the primary endpoint.</p><p><strong>Results: </strong>The study enrolled 15 patients, and a total of 60 samples were analyzed. The median follow-up after ablation was 316 days, and median recurrence-free survival was 250 days. CtDNA was positive for 33% of the samples collected during the first 24 h. The hazard ratio for progression according to the presence of baseline circulating tumor DNA was estimated at 0.14 (CI 95%: 0.03-0.65, p = 0.019). The dynamics are provided, and patients with no recurrence were all negative at H24 for ctDNA.</p><p><strong>Discussion: </strong>This study shows the feasibility of routine testing of ctDNA before and after thermal ablation with curative intent. We report that circulating tumor DNA is detectable in patients with low tumor burden using 2 techniques. This study emphasizes the potential of ctDNA for discerning patients who are likely to benefit from thermal ablation from those who may not, which could shape future referrals. The dynamics of ctDNA before and after ablation shed light on the need for further research and larger studies.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1530-1542"},"PeriodicalIF":9.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}