Clinical Imaging最新文献

{"title":"Fluoroscopy in pediatric radiology: Review of current use and alternatives","authors":"Santiago Martinez-Correa ,&nbsp;Tatiana Morales-Tisnés ,&nbsp;Laura S. De Leon-Benedetti ,&nbsp;Claudia Lazarte-Rantes ,&nbsp;Hansel J. Otero","doi":"10.1016/j.clinimag.2025.110454","DOIUrl":"10.1016/j.clinimag.2025.110454","url":null,"abstract":"<div><div>Fluoroscopy has long been an essential imaging modality in pediatric radiology. However, concerns about radiation exposure in children and the need for on-site staff have led to a decline in its use and the exploration of alternative imaging techniques. Data from the Pediatric Health Information System and our institution show a decrease in fluoroscopic studies among pediatric inpatients, from 56,371 per year (2017–2020) to 46,973 per year (2020−2023). Alternative modalities such as endoscopy, ultrasound, and computed tomography demonstrate promise in assessing conditions of the respiratory, gastrointestinal, and urinary systems. Although fluoroscopy remains valuable in certain scenarios, these alternative imaging modalities offer advantages in terms of diagnostic accuracy, accessibility, costs, and reduced radiation exposure. However, the final choice of imaging technique should be based on careful consideration of the specific clinical context, patient factors, and available resources. In this review, we present institutional and national trends on the utilization of fluoroscopic studies over the past years, along with a side-by-side comparison of traditional fluoroscopic studies commonly performed in children and newer alternative modalities.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110454"},"PeriodicalIF":1.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654744","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":"ChatGPT vs. Gemini: Comparative accuracy and efficiency in Lung-RADS score assignment from radiology reports","authors":"Ria Singh ,&nbsp;Mohamed Hamouda ,&nbsp;Jordan H. Chamberlin ,&nbsp;Adrienn Tóth ,&nbsp;James Munford ,&nbsp;Matthew Silbergleit ,&nbsp;Dhiraj Baruah ,&nbsp;Jeremy R. Burt ,&nbsp;Ismail M. Kabakus","doi":"10.1016/j.clinimag.2025.110455","DOIUrl":"10.1016/j.clinimag.2025.110455","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the accuracy of large language models (LLMs) in generating Lung-RADS scores based on lung cancer screening low-dose computed tomography radiology reports.</div></div><div><h3>Material and methods</h3><div>A retrospective cross-sectional analysis was performed on 242 consecutive LDCT radiology reports generated by cardiothoracic fellowship-trained radiologists at a tertiary center. LLMs evaluated included ChatGPT-3.5, ChatGPT-4o, Google Gemini, and Google Gemini Advanced. Each LLM was used to assign Lung-RADS scores based on the findings section of each report. No domain-specific fine-tuning was applied. Accuracy was determined by comparing the LLM-assigned scores to radiologist-assigned scores. Efficiency was assessed by measuring response times for each LLM.</div></div><div><h3>Results</h3><div>ChatGPT-4o achieved the highest accuracy (83.6 %) in assigning Lung-RADS scores compared to other models, with ChatGPT-3.5 reaching 70.1 %. Gemini and Gemini Advanced had similar accuracy (70.9 % and 65.1 %, respectively). ChatGPT-3.5 had the fastest response time (median 4 s), while ChatGPT-4o was slower (median 10 s). Higher Lung-RADS categories were associated with marginally longer completion times. ChatGPT-4o demonstrated the greatest agreement with radiologists (κ = 0.836), although it was less than the previously reported human interobserver agreement.</div></div><div><h3>Conclusion</h3><div>ChatGPT-4o outperformed ChatGPT-3.5, Gemini, and Gemini Advanced in Lung-RADS score assignment accuracy but did not reach the level of human experts. Despite promising results, further work is needed to integrate domain-specific training and ensure LLM reliability for clinical decision-making in lung cancer screening.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110455"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629032","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":"Radiomics and machine learning models for diagnosing microvascular invasion in cholangiocarcinoma: a systematic review and meta-analysis of diagnostic test accuracy studies","authors":"Amir Mahmoud Ahmadzadeh ,&nbsp;Nima Broomand Lomer ,&nbsp;Drew A. Torigian","doi":"10.1016/j.clinimag.2025.110456","DOIUrl":"10.1016/j.clinimag.2025.110456","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to systematically assess the value of radiomics/machine learning (ML) models for diagnosing microvascular invasion (MVI) in patients with cholangiocarcinoma (CCA) using various radiologic modalities.</div></div><div><h3>Methods</h3><div>A systematic search of was conducted on Web of Sciences, PubMed, Scopus, and Embase. All the studies that assessed the value of radiomics models or ML models along with the use of imaging features were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria and METhodological RadiomICs Score (METRICS) were used for quality assessment. Pooled estimates for the diagnostic performance of radiomics/ML models were calculated. I-squared was used to assess heterogeneity, and sensitivity and subgroup analyses were performed to find the sources of heterogeneity. Deeks' funnel plots were used to assess publication bias.</div></div><div><h3>Results</h3><div>11 studies were included in the systematic review with only one study being about extrahepatic CCA. According to the METRICS, the mean score was 62.99 %. Meta-analyses were performed on intrahepatic CCA studies. The meta-analysis of the best ML models revealed an AUC of 0.93 in the training cohort and an AUC of 0.85 in the validation cohort. Regarding the best radiomics model, the AUC was 0.85 in the training cohort and 0.81 in the validation cohort.</div></div><div><h3>Conclusion</h3><div>Radiomics/ML models showed very good diagnostic performance regarding MVI diagnosis in patients with intrahepatic CCA and may provide a non-invasive method for this purpose. However, given the high heterogeneity and low number of the included studies, further multi-center studies with prospective design and robust external validation are essential.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110456"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621332","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 radiology resident competency in identifying conditions amenable to interventional radiology and recognition of procedural complications","authors":"Kevin Pierre,&nbsp;Abheek Raviprasad,&nbsp;Vladislav Maksimchuk,&nbsp;Chase Labiste,&nbsp;Christopher Sistrom,&nbsp;Roberta Slater,&nbsp;Linda Lanier,&nbsp;Austin Trupp,&nbsp;Hugh Davis,&nbsp;Anthony Mancuso,&nbsp;Dhanashree Rajderkar","doi":"10.1016/j.clinimag.2025.110453","DOIUrl":"10.1016/j.clinimag.2025.110453","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to assess the ability of radiology residents to identify conditions that may benefit from IR intervention and recognize complications of IR procedures during a simulated emergency radiology call shift.</div></div><div><h3>Materials and methods</h3><div>This study utilized the Wisdom in Diagnostic Imaging Simulation (WIDI SIM) platform, an emergency imaging simulation designed to assess radiology resident preparedness for independent call. During an 8-hour simulation, residents were tested on 65 cases across various imaging modalities of varying complexity, including normal studies. We identified four cases involving conditions amenable to IR intervention or post-procedural complications that were included in simulations administered between 2016 and 2023. Cases were assessed using a standardized grading rubric by subspecialty radiology faculty, with errors subsequently classified by type.</div></div><div><h3>Results</h3><div>A total of 1152 scores from radiology residents were assessed on four IR cases over the course of seven years of testing. Cases included splenic trauma with pseudoaneurysm, pseudoaneurysm following renal transplant biopsy, ruptured hepatocellular carcinoma, and IVC filter complication. Analysis revealed that residents underperformed in identifying conditions amenable to IR intervention and recognizing post-procedural complications. Points were primarily lost to observational error.</div></div><div><h3>Conclusions</h3><div>Timely diagnosis of these conditions is imperative to prevent life-threatening complications. Our results highlighted challenges in radiology residents' proficiency in identifying these conditions. Addressing these challenges through simulation training and targeted education is essential to improve resident competency in diagnosing conditions amenable to IR intervention and recognizing post-procedural complications.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110453"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654743","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":"The 100 most-cited radiomics articles in cancer research: A bibliometric analysis","authors":"Wenhao Zhang ,&nbsp;Dongmei Zhuang ,&nbsp;Wenzhuo Wei ,&nbsp;Yuchen Yang ,&nbsp;Lijun Ma ,&nbsp;He Du ,&nbsp;Anran Jin ,&nbsp;Jingyi He ,&nbsp;Xiaoming Li","doi":"10.1016/j.clinimag.2025.110442","DOIUrl":"10.1016/j.clinimag.2025.110442","url":null,"abstract":"<div><div>Radiomics, an advanced medical imaging analysis technique introduced by Professor Lambin in 2012, has quickly become a key area of medical research. To explore emerging trends in cancer-related radiomics, we conducted a bibliometric analysis of the 100 most-cited articles (T100) in this field. Data were collected from the Web of Science Core Collection on October 7, 2023, and the articles were ranked by citation count. We extracted data such as authors, journals, citation counts, and publication years and analyzed it using Microsoft Excel 2019 and R 4.4.2. CiteSpace was used to create co-occurrence and citation burst maps to show the relationships between authors, countries, institutions, and keywords. The analysis revealed that the T100 came from 81 countries, with the U.S. contributing the most (56 articles). Harvard University was the leading institution, and the journal <em>Radiology</em> had the highest citation count. Aerts Hugo JWL was the most influential author. The study highlights that “lung cancer” and “artificial intelligence” are emerging as major research hotspots, shaping the future of cancer radiomics.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110442"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609582","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":"Safety and efficacy of provocative angiography for localization and treatment of gastrointestinal hemorrhage","authors":"Thomas J. An ,&nbsp;Kaiz Esmail ,&nbsp;Ivan Dimov ,&nbsp;Ryan Adams ,&nbsp;Vincent Wu ,&nbsp;Patrick D. Sutphin ,&nbsp;Sanjeeva Kalva ,&nbsp;Omar Zurkiya","doi":"10.1016/j.clinimag.2025.110441","DOIUrl":"10.1016/j.clinimag.2025.110441","url":null,"abstract":"<div><h3>Purpose</h3><div>Mesenteric angiography and embolization is an effective treatment of gastrointestinal bleeding. In the setting of occult bleeding, provocative maneuvers with intra-arterial vasodilators and thrombolytics can increase the diagnostic yield of angiography. This study aimed to assess the clinical outcomes of provocative angiography and factors that increase the positivity rate for active bleeding at the time of provocation.</div></div><div><h3>Methods</h3><div>An institutional database was used to retrospectively identify patients that underwent provocative angiography for identification and treatment of gastrointestinal bleeding between 2015 and 2024. Patient demographic data, laboratory values, and clinical outcomes were recorded from the electronic medical record. Provocative angiography was performed using intra-arterial injection of heparin, nitroglycerin, and/or tPA.</div></div><div><h3>Results</h3><div>Provocative angiography identified active gastrointestinal bleeding in 35 % (14/40) of patients. There was no significant difference in age, hemoglobin level, transfusion requirement, ICU admission, or vasopressor requirement between patients that were positive versus negative for bleeding. 50 % (20/40) of patients had undergone prior mesenteric angiography that was negative for active hemorrhage. The mean doses of heparin, nitroglycerin, and tPA were 4973 +/− 2242 U, 507.3 +/− 317.2 μg, and 16.9 +/− 8.3 mg, respectively. Active bleeding was treated successfully in 100 % (14/14) patients. There were no bleeding complications related to provocative maneuvers.</div></div><div><h3>Discussion</h3><div>Provocative angiography is safe and effective for the identification of intermittent gastrointestinal bleeding during mesenteric angiography. There were no factors identified that increased the likelihood of identification of active bleeding during provocative angiography. There were no bleeding complications related to provocative mesenteric angiography in this study.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110441"},"PeriodicalIF":1.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592222","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":"Single session segmentation and live registration for augmented reality image guidance of cryoneurolysis","authors":"Anna Sophia McKenney ,&nbsp;Leah Shulman ,&nbsp;Mauro Dominguez ,&nbsp;Michael Evans ,&nbsp;Andras Lasso ,&nbsp;Anupam S. Chauhan ,&nbsp;Jeffrey W. Milsom ,&nbsp;Art Sedrakyan ,&nbsp;Bradley B. Pua","doi":"10.1016/j.clinimag.2025.110440","DOIUrl":"10.1016/j.clinimag.2025.110440","url":null,"abstract":"<div><h3>Purpose</h3><div>Interventional radiology procedures typically utilize multiple imaging modalities for navigation in real time, and augmented reality (AR) has emerging potential to improve this. This case is a first in human novel single session workflow that incorporated an AR-headset for navigational guidance during an intercostal cryoneurolysis procedure.</div></div><div><h3>Methods</h3><div>A quadragenarian woman in a tertiary care center with chronic neuropathic pain was treated with cryoneurolysis. An augmented reality headset was incorporated using cone-beam CT in a novel workflow in this IDEAL stage-I study. Outcomes measured included technical success, length of time in procedure, and subjective clinician reactions.</div></div><div><h3>Results</h3><div>The procedure with AR-integration was completed in a single session, including cone-beam computed tomography (CBCT) imaging, automatic segmentation, segmentation review, registration of the 3D-imaging dataset to the AR system fiducials, and ultrasound-guided cryoablation of the affected nerve. The AR-system allowed for simultaneous viewing of segmented CT-based anatomy and projected real-time ultrasound images, which improved visualization and procedural ergonomics. A web-based system (ImagineHive) which utilizes customized versions of 3D-Slicer and TotalSegmentator was used for segmentation and image analysis. The workflow from CBCT to registration was completed in 32 min, and showed the potential for further efficiency with greater experience. The procedure was successful, and the patient experienced symptom improvement without adverse events at the six-week follow-up.</div></div><div><h3>Conclusion</h3><div>This case highlights the potential of AR-technology integrated with intraoperative CBCT, and a streamlined segmentation workflow, to optimize patient care outcomes in the interventional radiology setting. Future research should focus on assessing the accuracy, cost-effectiveness, and usability of these integrated technologies across various procedures.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110440"},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777051","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":"CAR T-cell therapy chest CT manifestations","authors":"Dorine de Jong ,&nbsp;Saheeb Ahmed ,&nbsp;Belinda Dsouza ,&nbsp;Mary Salvatore ,&nbsp;Benjamin May ,&nbsp;Sophia Huang ,&nbsp;Christian Gordillio ,&nbsp;Ran Reshef ,&nbsp;Kathleen M. Capaccione","doi":"10.1016/j.clinimag.2025.110439","DOIUrl":"10.1016/j.clinimag.2025.110439","url":null,"abstract":"<div><h3>Purpose</h3><div>CAR T-cell therapy is an emerging anti-cancer therapeutic using modified T cells to attack a patient's cancer. The purpose of this study was to assess chest CT findings in patients undergoing CAR T-cell therapy to determine the most common CT manifestations.</div></div><div><h3>Methods</h3><div>We performed a retrospective test-retest study analyzing cases of patients who received CAR T-cell therapy who underwent chest CT prior to therapy and after therapy; a total of 349 patients were identified. CAR T-cell therapy was first administered in the mid 2010's, however we assessed for pre-treatment scans prior to this date. We reviewed patient's charts to collect demographic and clinical data. Two cardiothoracic radiologists reviewed chest CT scans prior to and post CAR T-cell therapy to determine new radiologic features post therapy. We analyzed which findings correlated with specific radiologic features on chest CT using student's <em>t-</em>tests or Chi squared tests.</div></div><div><h3>Results</h3><div>Pleural effusion was the most common CT manifestation resulting from CAR T-cell therapy, found in 26.3 % of patients. Patients with CT manifestations were more likely to present with dyspnea and cough (<em>p</em> = 0.000031 and <em>p</em> = 0.02, respectively).</div></div><div><h3>Discussion</h3><div>New symptoms in patients treated with CAR T-cell therapy may be an important harbinger of radiologic abnormalities. Clinicians should have a high index of suspicion for pleural effusions in patients presenting with symptoms who have undergone CAR T-cell therapy.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"121 ","pages":"Article 110439"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570582","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":"CT-guided biopsy of 18F-piflufolastat radiotracer avid lesions in osseous metastatic prostate disease: Initial experience, technical factors and biopsy yield","authors":"Jordan Fenner ,&nbsp;Mohammad Samim ,&nbsp;Roy A. Raad ,&nbsp;Dhruv S. Shankar ,&nbsp;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), &lt;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 &gt;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}

{"title":"Comparison of prognostic accuracy of HCC staging systems in patients undergoing TACE","authors":"Victor Kasolowsky ,&nbsp;Moritz Gross ,&nbsp;David C. Madoff ,&nbsp;James Duncan ,&nbsp;Tamar Taddei ,&nbsp;Mario Strazzabosco ,&nbsp;Ariel Jaffe ,&nbsp;Julius Chapiro","doi":"10.1016/j.clinimag.2025.110438","DOIUrl":"10.1016/j.clinimag.2025.110438","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the prognostic power of commonly used staging systems of hepatocellular carcinoma (HCC) for predicting overall survival after transarterial chemoembolization (TACE).</div></div><div><h3>Materials and methods</h3><div>This retrospective single center study included patients with HCC who underwent TACE between 2008 and 2019 in a single tertiary care center. After initial screening of 408 consecutive patients, 317 patients with HCC treated with conventional or drug-eluting beads-TACE were included. Five HCC staging systems (Barcelona Clinic Liver Cancer, Hong Kong Liver Cancer, Japan Integrated Staging, Cancer of the Liver Italian Program and Okuda) were compared using Kaplan Meier survival analysis and a log-rank test with overall survival (OS) as the study endpoint. Uni- and multivariate analyses of system-specific variables were applied to stratify outcomes and compare the ability to predict OS of patients after TACE. Four different measures were used to assess the homogeneity (Likelihood ratio:LR), discriminatory ability (linear trend:LT and C-index) and explanatory ability (Akaike Information Criterion:AIC).</div></div><div><h3>Results</h3><div>The OS of the total cohort was 29.8 months. In terms of prognostic stratification, the BCLC staging system had the best performance (LT: 8.209, LR: 26.639, AIC: 317, c-index: 0.818) compared to HKLC (LT: 10.919, LR: 25.802, AIC: 443, c-index: 0.835), JIS (LT: 4.611, LR: 16.880, AIC: 449, c-index: 0.548), CLIP (LT: 6.738, LR: 13.109, AIC: 501, c-index: 0.782), and Okuda (LT: 7.185, LR: 0.760. LR: 16.356, AIC: 487, c-index: 0.760).</div></div><div><h3>Conclusion</h3><div>Across five commonly utilized international staging systems, the BCLC staging system demonstrated the greatest prognostic accuracy with respect to predicting OS of patients undergoing TACE.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110438"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551513","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}