Clinical ImagingPub Date : 2025-02-25DOI: 10.1016/j.clinimag.2025.110437
Jordan Fenner , Mohammad Samim , Roy A. Raad , Dhruv S. Shankar , Christopher John Burke
{"title":"CT-guided biopsy of 18F-piflufolastat radiotracer avid lesions in osseous metastatic prostate disease: Initial experience, technical factors and biopsy yield","authors":"Jordan Fenner , Mohammad Samim , Roy A. Raad , Dhruv S. Shankar , Christopher John Burke","doi":"10.1016/j.clinimag.2025.110437","DOIUrl":"10.1016/j.clinimag.2025.110437","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the yield of CT-guided biopsy of 18F-piflufolastat PET avid osseous lesions in suspected prostate metastases.</div></div><div><h3>Methods</h3><div>Retrospective review of computed tomography guided biopsies targeting 18F-piflufolastat avid lesions on PET/CT or PET/MR performed between 2022 and 2024. Demographics, image modality, biopsy system, number of cores, lesion location, lean body mass corrected SUV (SUL) and pathology were recorded. Biopsied lesions were compared to the PROMISE (prostate cancer molecular imaging standardized evaluation) scoring system, version 2.</div></div><div><h3>Results</h3><div>Eighteen patients were included, average age 68.7 years. Lesions were defined as: ≥ 50 % sclerotic (<em>n</em> = 10), <50 % sclerotic (<em>n</em> = 7), occult (<em>n</em> = 0), and lytic (n = 1). A technically successful pathologic diagnosis was made in 94 % of biopsies (<em>n</em> = 17). Histopathological diagnosis included: metastatic prostate adenocarcinoma (<em>n</em> = 12), benign with fibrotic/densely sclerotic bone or normocellular bone marrow (<em>n</em> = 5), and metastatic non-small cell lung carcinoma (<em>n</em> = 1). The median SUL on PET for all patients was 7.9 (IQR 13.3), 2.6 (0.3) for benign biopsies, and 8.8 (12.5) for malignant biopsies. Major identifiable differences between biopsies yielding a metastatic versus benign diagnosis included: higher SUL (<em>p</em>-value = 0.03), target lesion volume (p-value = 0.01), and higher incidence of sclerotic lesions (<em>p</em> value = 0.003); however, multivariate analysis did not find these to be statistically significant predictors (<em>p</em>-value >0.05). The prostate cancer lesion biopsy positive group had significantly higher PROMISE scores than the negative group (<em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>CT-guided biopsy of bone lesions demonstrating avidity for 18F-piflufolastat can be performed with a high diagnostic yield.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110437"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527245","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}
Clinical ImagingPub Date : 2025-02-20DOI: 10.1016/j.clinimag.2025.110435
Jinel Scott , Adebusayo Adewole , Latoya Jackson , Stephen Waite
{"title":"Health equity is now a National Patient Safety Goal","authors":"Jinel Scott , Adebusayo Adewole , Latoya Jackson , Stephen Waite","doi":"10.1016/j.clinimag.2025.110435","DOIUrl":"10.1016/j.clinimag.2025.110435","url":null,"abstract":"<div><div>Governmental data generated during the COVID 19 pandemic from 2019 to 2021 demonstrated that the virus disproportionately impacted communities of color. Specifically, Black, Hispanic, and Asian people were found to have substantially higher rates of infection, hospitalization, and death compared with White people. The extent of these disparities drew attention to other disparate outcomes including maternal mortality and morbidity, cancer outcomes, and overall life expectancy. Various professional organizations, including the Institute for Healthcare Improvement, began to add health equity to their strategic framework. In conjunction, this issue generated national attention reflected in the responses of federal and state governments as well as regulatory agencies. In addition to the ethical and moral reasons for intentional action to decrease these disparities and improve health equity, it became understood that significant economic costs are associated with health care disparities. If not adequately addressed, the economic consequence of these disparities will become exacerbated in the future as the United States becomes increasingly diverse. The Joint Commission has recently responded by distinguishing health equity as a significant patient safety and quality of care issue and identified it as the newest National Patient Safety Goal (NPSG). In this manuscript we discuss how healthcare institutions can comply with these new requirements and how radiology can contribute.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110435"},"PeriodicalIF":1.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527348","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}
Clinical ImagingPub Date : 2025-02-19DOI: 10.1016/j.clinimag.2025.110434
Rui Zhong, Kui Zhao
{"title":"I saw the “bulge” sign: Gastroduodenal artery aneurysm mimicking duodenal bulb submucosal tumor","authors":"Rui Zhong, Kui Zhao","doi":"10.1016/j.clinimag.2025.110434","DOIUrl":"10.1016/j.clinimag.2025.110434","url":null,"abstract":"<div><div>Gastroduodenal artery (GDA) aneurysms are rare vascular anomalies that can present with nonspecific symptoms, making diagnosis challenging. We report a case of a 26-year-old male presenting with abdominal distension, initially suspected to have a duodenal submucosal tumor. Advanced imaging techniques, including endoscopic ultrasonography (EUS) and computed tomography angiography (CTA), revealed a GDA aneurysm compressing the duodenal bulb. The patient was managed conservatively with regular follow-up, remaining asymptomatic over six months. This case underscores the importance of considering vascular anomalies in differential diagnoses of submucosal tumors and highlights the role of multimodal imaging in accurate diagnosis.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110434"},"PeriodicalIF":1.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454742","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}
Clinical ImagingPub Date : 2025-02-18DOI: 10.1016/j.clinimag.2025.110433
Peter Liaw, Jennifer M. Cutts, Alexander Brook, Karen S. Lee, Yu-Ming Chang
{"title":"Improving virtual readouts in the post-pandemic era","authors":"Peter Liaw, Jennifer M. Cutts, Alexander Brook, Karen S. Lee, Yu-Ming Chang","doi":"10.1016/j.clinimag.2025.110433","DOIUrl":"10.1016/j.clinimag.2025.110433","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110433"},"PeriodicalIF":1.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436593","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}
Clinical ImagingPub Date : 2025-02-17DOI: 10.1016/j.clinimag.2025.110436
Nima Broomand Lomer , Fattaneh Khalaj , Hamed Ghorani , Mohammad Mohammadi , Delaram J. Ghadimi , Sina Zakavi , Mahshad Afsharzadeh , Houman Sotoudeh
{"title":"MRI-derived radiomics models for prediction of Ki-67 index status in meningioma: a systematic review and meta-analysis","authors":"Nima Broomand Lomer , Fattaneh Khalaj , Hamed Ghorani , Mohammad Mohammadi , Delaram J. Ghadimi , Sina Zakavi , Mahshad Afsharzadeh , Houman Sotoudeh","doi":"10.1016/j.clinimag.2025.110436","DOIUrl":"10.1016/j.clinimag.2025.110436","url":null,"abstract":"<div><h3>Purpose</h3><div>The Ki-67 marker reflects tumor proliferation and correlates with meningioma prognosis. Here we aim to evaluate the performance of MRI-derived radiomics for Ki-67 index prediction in meningiomas.</div></div><div><h3>Methods</h3><div>After a comprehensive search in Web of Science, PubMed, Embase, and Scopus, data extraction and risk of bias assessment was performed. Pooled sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) were computed. The summary receiver operating characteristic (sROC) curve was generated and area under the curve (AUC) was calculated. Separate meta-analyses were conducted for radiomics models and combined models. Heterogeneity was evaluated using the I<sup>2</sup> statistic, and subgroup analysis was performed to identify potential sources of heterogeneity. Sensitivity analysis was carried out to detect possible outliers.</div></div><div><h3>Results</h3><div>Seven studies were included, with six studies analyzed for radiomics model and four for combined model. For radiomics model, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 67 %, 82 %, 8.61, 3.54, 0.43, and 0.79, respectively. For combined model, pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 78 %, 78 %, 12.19, 3.47, 0.30, and 0.79, respectively. Sensitivity analysis identified no outliers. In radiomics model, potential sources of heterogeneity included mean age and the application of N4ITK bias correction. For combined model, heterogeneity was influenced by mean age, application of N4ITK bias correction, and the use of external validation.</div></div><div><h3>Conclusion</h3><div>Radiomics shows promising ability to predict the Ki-67 index status in meningioma patients, potentially enhancing clinical decision-making and management strategies.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110436"},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465254","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}
Clinical ImagingPub Date : 2025-02-12DOI: 10.1016/j.clinimag.2025.110432
Mohammad H. Jalili , Alex Chung , Daniel Bradley , Cameron Hassani , Ashley E. Prosper , J. Paul Finn , Arash Bedayat
{"title":"Advanced imaging for pre- and post-operative evaluation of tetralogy of Fallot","authors":"Mohammad H. Jalili , Alex Chung , Daniel Bradley , Cameron Hassani , Ashley E. Prosper , J. Paul Finn , Arash Bedayat","doi":"10.1016/j.clinimag.2025.110432","DOIUrl":"10.1016/j.clinimag.2025.110432","url":null,"abstract":"<div><div>Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease and imaging plays a key role in diagnosis, pre-operative planning and follow up, with MRI as the gold standard for imaging in these patients despite echocardiography being more widely available. While static MRI sequences are suitable for evaluation of anatomical structures, dynamic imaging is required for volume and flow measurements through valves, chambers, and surgical conduits. Newer techniques with 4D data acquisitions allow for feasible 2D cine reconstruction in desired planes. Ferumoxytol, a blood pool contrast agent with long intravascular half-life, facilitates acquisition of 4D flow and 4D MUSIC (multiphase, steady-state imaging with contrast) sequences, eliminating need for repeated contrast administrations. In this article we review conglomerate of TOF anomalies, their historical and current surgical managements with respective devices, as well as cutting-edge MRI techniques for their evaluation.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110432"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419471","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}
Clinical ImagingPub Date : 2025-02-10DOI: 10.1016/j.clinimag.2025.110430
C. Jaramillo, S. Tabaza, E. Ferguson, E. Odisio, D. Ocazionez, C. Duran, B. Akkanti, M. Awiwi, M. Hanna
{"title":"Chronic thromboembolic pulmonary hypertension: Role of imaging in diagnosis and guiding the treatment","authors":"C. Jaramillo, S. Tabaza, E. Ferguson, E. Odisio, D. Ocazionez, C. Duran, B. Akkanti, M. Awiwi, M. Hanna","doi":"10.1016/j.clinimag.2025.110430","DOIUrl":"10.1016/j.clinimag.2025.110430","url":null,"abstract":"<div><div>Chronic thromboembolic pulmonary hypertension is a life-threatening condition resulting from unresolved thromboemboli that obstructs pulmonary arteries, leading to increased pulmonary vascular resistance and right heart failure. Accurate and timely diagnosis is critical for effective management and improving patient outcomes. Imaging plays a crucial role in the diagnosis, with CT pulmonary angiography being the primary modality due to its ability to provide detailed visualization of pulmonary vasculature and parenchymal changes. The ventilation/perfusion scan remains an essential tool, particularly for initial screening, given its high sensitivity in detecting perfusion defects. Recent advancements in imaging, including dual-energy CT and magnetic resonance imaging, offer additional functional and anatomical insights, further aiding in comprehensive patient evaluation. Imaging is also crucial for pre-operative planning in candidates for pulmonary endarterectomy and for monitoring post-operative recovery and disease progression. By integrating multiple imaging modalities, clinicians can achieve a more accurate diagnosis, optimize treatment strategies, and improve long-term outcomes for patients with CTEPH.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110430"},"PeriodicalIF":1.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386986","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}
Clinical ImagingPub Date : 2025-02-08DOI: 10.1016/j.clinimag.2025.110431
Esteban A. Barreto , Alexander W. Burns , Jerome Watts , Pooja Agrawal , Anirudh Sudarshan , Jerome Seglah , Ayub Khan , David Bowen , Pragya Dhar , Neha Udayakumar , Gezzer Ortega , Lucy B. Spalluto , Efrén J. Flores
{"title":"A qualitative, community-based needs assessment to inform the development of a radiology health equity curriculum","authors":"Esteban A. Barreto , Alexander W. Burns , Jerome Watts , Pooja Agrawal , Anirudh Sudarshan , Jerome Seglah , Ayub Khan , David Bowen , Pragya Dhar , Neha Udayakumar , Gezzer Ortega , Lucy B. Spalluto , Efrén J. Flores","doi":"10.1016/j.clinimag.2025.110431","DOIUrl":"10.1016/j.clinimag.2025.110431","url":null,"abstract":"<div><h3>Background</h3><div>Recognizing barriers to care is crucial for radiologists to ensure equitable access and quality care for all patients. Health equity trainings have shown promising results in helping providers understand unique patient needs.</div></div><div><h3>Purpose</h3><div>To perform community-based focus groups to gather needs assessment data as the foundation for a health equity curriculum for radiology professionals.</div></div><div><h3>Methods</h3><div>We conducted focus groups to gather in-depth qualitative data regarding health inequities in radiology. Radiology residents, medical students, and community partners were recruited from two large academic medical centers, three medical schools, three radiology trainee programs, and five community organizations. Focus groups were conducted in-person and virtually from December 2022 to April 2023, recorded, and transcribed. Qualitative analysis with multiple coding of verbatim transcripts was performed by study staff, overseen by a senior analyst.</div></div><div><h3>Results</h3><div>Study participants included trainees (medical students, <em>n</em> = 19; and radiology residents, <em>n</em> = 6), and community partners (<em>n</em> = 14) across 4 focus groups. Three major themes emerged from our discussions: (1) Awareness of Healthcare Inequities, (2) A Gap Between Knowledge and Practice, and (3) Achieving Equity in Radiology Care. Trainees highlighted current gaps in education while expressing a desire to receive applied learning experiences to prevent gaps from widening. Community partners shared difficult experiences and expressed a desire to be heard.</div></div><div><h3>Conclusion</h3><div>Health equity training can help future radiologists better understand diverse patient needs. Fostering community partnerships can ensure that the voices of diverse communities guide the development of health equity curricula in radiology.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110431"},"PeriodicalIF":1.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378433","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}
Clinical ImagingPub Date : 2025-02-06DOI: 10.1016/j.clinimag.2025.110422
Partha Pratim Ray
{"title":"Prompting large language models for inner gains in radiology studies","authors":"Partha Pratim Ray","doi":"10.1016/j.clinimag.2025.110422","DOIUrl":"10.1016/j.clinimag.2025.110422","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110422"},"PeriodicalIF":1.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143272975","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}