Clinical Imaging最新文献

{"title":"Fluoroscopic guided percutaneous sacroplasty utilizing a single curved needle: technical notes","authors":"Teymour Sadrieh ,&nbsp;Anas S. Al-Smadi ,&nbsp;Ali Shaibani ,&nbsp;Ramez N. Abdalla ,&nbsp;Sameer A. Ansari ,&nbsp;Donald Cantrell","doi":"10.1016/j.clinimag.2025.110607","DOIUrl":"10.1016/j.clinimag.2025.110607","url":null,"abstract":"<div><h3>Purpose</h3><div>Percutaneous sacroplasty is the current standard of care for the management of painful sacral insufficiency fractures, and has proven to provide significant pain relief and functional improvement for patients. Currently, there is no widely accepted standard technique for sacroplasty. In this study, we describe a new fluoroscopy guided technique using a single curved needle to treat sacral insufficiency fractures at any sacral level.</div></div><div><h3>Methods</h3><div>This is a retrospective case series and technical notes. A retrospective review of the pre-operative notes, procedure reports, and post-operative clinic visits was performed. Parameters recorded were pre-operative pain score, comorbidities, procedure details including radiation dose and duration, complications, and postoperative outcomes.</div></div><div><h3>Results</h3><div>From January 2023 to June 2024, four curved needle sacroplasties were performed on three patients (two females, one male) at our institution: two for bilateral sacral fractures in a single patient, one for a left sacral fracture, and one for a right sacral fracture. Patient ages ranged from 58 to 90. The average fluoroscopy time was 19.5 min (range: 13.7–24.9 min), and the average radiation dose was 774.8 mGy (range: 622.1–1027 mGy). No procedural complications were observed. Postoperatively, there was good functional improvement for all patients and VAS scores dropped by an average of 5.5 points, reflecting significant pain relief.</div></div><div><h3>Conclusions</h3><div>Percutaneous sacroplasty utilizing a curved needle is a novel technique for treating sacral insufficiency fractures. This technique allows the ability to inject cement in various directions with a single needle. This approach potentially reduces procedural time and radiation exposure.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"127 ","pages":"Article 110607"},"PeriodicalIF":1.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076488","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":"Prognostic value of incidental coronary artery calcium detected on routine chest computed tomography: A systematic review and meta-analysis","authors":"Arthur Santos Lima ,&nbsp;Beatriz de Carvalho Villela ,&nbsp;Hugo Nunes Pustilnik ,&nbsp;Beatriz Dacach Assis ,&nbsp;Jorge Andion Torreão ,&nbsp;Luiz Eduardo Fonteles Ritt","doi":"10.1016/j.clinimag.2025.110595","DOIUrl":"10.1016/j.clinimag.2025.110595","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the prognostic value of incidental coronary artery calcium (CACi) identified on routine chest computed tomography (CT) scans in predicting cardiovascular outcomes and its association with statin prescription in asymptomatic individuals.</div></div><div><h3>Methods</h3><div>We searched MEDLINE/PubMed, EMBASE, and Cochrane Library for randomized clinical trials, prospective cohort studies, and retrospective cohort studies. Search terms included combinations of “CT,” “routine,” “thorax,” “coronary,” and “calcification. The primary outcomes were cardiovascular mortality and statin initiation in asymptomatic patients with incidental CAC detected on routine chest CT. Statistical analysis was performed using the R software, specifically version 4.3.2.Outcomes included cardiovascular mortality and major adverse cardiovascular events (MACE). Secondary outcomes included statin initiation and medication adherence as reported by each study.</div></div><div><h3>Results</h3><div>67,127 patients were included from 7 studies, of which 4 were RCT. Follow up ranged from 6 to 135 months and the prevalence of male participants was 86 %. The results indicated a significantly higher likelihood of cardiovascular mortality in the group with incidental CAC presence (OR: 7.38, 95 % CI: 4.10–13.28, <em>p</em> &lt; 0.001). Heterogeneity was considered moderate, with an I² of 45 % and a Chi² of 7.26.</div></div><div><h3>Conclusions</h3><div>Incidental coronary artery calcium quantification on routine chest computed tomography is a valuable tool for cardiovascular risk stratification, and the detection of incidental coronary arterial calcium is related with and increased risk of cardiovascular mortality.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110595"},"PeriodicalIF":1.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922918","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":"Vendor-neutral MR bone imaging in musculoskeletal imaging","authors":"Tomohiro Nakamura ,&nbsp;Akitoshi Inoue ,&nbsp;Tatsuya Oki ,&nbsp;Shin Kato ,&nbsp;Yoshiyuki Watanabe","doi":"10.1016/j.clinimag.2025.110598","DOIUrl":"10.1016/j.clinimag.2025.110598","url":null,"abstract":"<div><div>A vendor-neutral MR bone imaging technique based on 3D time-of-flight MR angiography with spoiled gradient recalled acquisition in the steady state (TOF-SPGR) was developed to enhance the depiction of bone and calcification/ossification. This approach is independent of scanner manufacturer and application type, enabling reduced radiation exposure by replacing or triaging further CT examinations. This article describes the optimization of scan parameters for clinical musculoskeletal protocols and explores its clinical applications with representative cases.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110598"},"PeriodicalIF":1.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925585","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":"Correlation between radiologic feature and spread through air space in lung solid adenocarcinoma 30.0 mm or less in maximum diameter","authors":"Pengfei Li ,&nbsp;Qi Sun ,&nbsp;Rowena Yip ,&nbsp;David F. Yankelevitz ,&nbsp;Wen Cheng ,&nbsp;Claudia I. Henschke","doi":"10.1016/j.clinimag.2025.110578","DOIUrl":"10.1016/j.clinimag.2025.110578","url":null,"abstract":"<div><h3>Purpose</h3><div>Tumor spread through air space (STAS) is recognized as an important prognostic indicator for lung cancer patients. However, few studies have focused on radiologic features for predicting STAS in patients with small solid lung adenocarcinomas 30.0 mm or less in maximum diameter. We aim to determine predictors of STAS using demographics and pre-surgery CT features, and the correlation between CT-guided biopsy and STAS.</div></div><div><h3>Methods</h3><div>Retrospective study of 511 participants in the Mount Sinai Health System with first primary clinical stage IA solid adenocarcinoma ≤30.0 mm in maximum diameter who received surgical treatment. STAS-positive and STAS-negative patients were compared using Wilcoxon rank-sum test and Chi-squared/Fisher exact test. Significant predictors of STAS were identified using multivariable analyses.</div></div><div><h3>Results</h3><div>Of 511 patients with surgically resected solid ADCs ≤30.0 mm (42 % male, 58 % female, median age 70 years [IQR: 64–77]), STAS was present in 63 (12.3 %). Multivariable analyses showed STAS was significantly associated with distance to the mediastinal pleura (OR = 0.97; 95 % CI, 0.96–0.99; <em>P</em> &lt; .001) and diaphragmatic pleura (OR = 0.99; 95 % CI, 0.99–1.00; <em>P</em> = .03), distal post-obstructive changes (OR = 0.2; 95 % CI, 0.1–0.5; <em>P</em> &lt; .001) and vascular embedding (OR = 2.2; 95 % CI, 1.1–4.4; <em>P</em> = .02) after adjusting for age, sex and smoking. No significant relationship was found between preoperative CT-guided biopsy and STAS presence.</div></div><div><h3>Conclusion</h3><div>Among solid ADCs ≤30.0 mm, distance to the mediastinal and diaphragmatic pleura, vascular embedding and distal post-obstructive changes were significant radiologic predictors of STAS. No significant difference existed in frequency of STAS between patients with and without pre-operative CT-guided biopsy, reducing concerns about its impact on STAS.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110578"},"PeriodicalIF":1.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922919","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":"I saw the “crescent” sign: Waxing clues and waning lumen","authors":"Zoe Ziwei Chen ,&nbsp;Anna Luisa Kuhn","doi":"10.1016/j.clinimag.2025.110597","DOIUrl":"10.1016/j.clinimag.2025.110597","url":null,"abstract":"<div><div>The “crescent” sign is characterized by a crescent-shaped rim of hyperintensity on T1-weighted fat-saturated magnetic resonance imaging (MRI), surrounding a narrowed arterial lumen. It represents an intramural hematoma, most often seen in cases of arterial dissection. Although the differential diagnosis for neck pain and headache is broad, the “crescent” sign in the appropriate clinical and radiologic setting is highly suggestive of an internal carotid artery (ICA) dissection. In this case study, we present a 58-year-old man with a history of hypertension and hyperlipidemia who presented with acute onset headache and neck pain. Imaging revealed classic features of left ICA dissection, including vessel wall irregularity on computed tomography angiography (CTA) and the crescent sign on MRI.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110597"},"PeriodicalIF":1.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895405","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":"Evaluating large language models for imaging modality selection: Potential to reduce unnecessary contrast agent use and radiation exposure","authors":"Deniz Esin Tekcan Sanli ,&nbsp;Ahmet Necati Sanli","doi":"10.1016/j.clinimag.2025.110591","DOIUrl":"10.1016/j.clinimag.2025.110591","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110591"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908252","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":"Reply to letter to the editor “Patient-centered research in radiology: A Canadian perspective”","authors":"Farhad Niaghi ,&nbsp;Rawan Abu Muhgli ,&nbsp;Waqas Ahmad ,&nbsp;Osama Majeed ,&nbsp;Faisal Khosa","doi":"10.1016/j.clinimag.2025.110593","DOIUrl":"10.1016/j.clinimag.2025.110593","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110593"},"PeriodicalIF":1.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892183","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":"Accuracy of visual estimation of embolized splenic volume in N-butyl cyanoacrylate splenic embolization: Insights from a quality assurance study","authors":"Kausthubh Hegde ,&nbsp;Patrick D. Sutphin","doi":"10.1016/j.clinimag.2025.110596","DOIUrl":"10.1016/j.clinimag.2025.110596","url":null,"abstract":"<div><div>This retrospective quality assurance review evaluates the concordance between visual intra-procedural angiographic estimates and CT-derived volumetric measurements of splenic embolization using n-butyl cyanoacrylate (n-BCA) with tantalum in 15 patients at a single institution. In this internal audit, 3D-Slicer software was used to segment and calculate splenic volumes from pre- and post-procedure CT scans in a series of cases where n-BCA was used for non-traumatic splenic embolization.</div><div>The median pre- and post-embolization splenic volumes were 883.32 cm³ [interquartile range (IQR) = 620.52–1234.4 cm³] and 223.68 cm³ [IQR = 34.99–555.25 cm³], respectively. The corresponding median percentage of embolized splenic parenchyma was 78.88 % [IQR = 55.51–90.88 %], compared to a median angiographic estimate of 80 % [IQR = 60–100 %] recorded in procedural documentation.</div><div>Correlation analysis between the visual angiographic estimate and volumetric calculations derived from cross-sectional CT scans showed a Pearson correlation coefficient (r) of 0.95 (<em>p</em> &lt; 0.00001) and a coefficient of determination (r²) of 0.90. These findings suggest that intra-procedural visual estimates, as routinely documented by interventional radiologists at our institution, reasonably reflect the splenic embolization extent when using n-BCA.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110596"},"PeriodicalIF":1.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879864","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":"Critical radiology results in thoracic imaging; categorization by urgency and clinical outcome","authors":"Hee Young Lee ,&nbsp;Ji Young Jeon ,&nbsp;So Hyun Park","doi":"10.1016/j.clinimag.2025.110594","DOIUrl":"10.1016/j.clinimag.2025.110594","url":null,"abstract":"<div><h3>Background</h3><div>Timely communication of critical radiology results (CRRs) is vital for patient safety. However, data on the categorization and active follow-up of CRRs in thoracic imaging remain limited.</div></div><div><h3>Purpose</h3><div>The aim of our study was to investigate the prevalence of CRRs in thoracic radiology and to assess the extent to which clinical follow-up was performed.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed 741 CRRs from chest computed tomography (CT) and radiography between August 2018 and March 2021 at a tertiary care hospital. All CRRs were classified using the American College of Radiology three-tier urgency system and communicated through a structured electronic alert system. Active follow-up was defined as documentation of diagnostic or therapeutic response.</div></div><div><h3>Results</h3><div>Of 741 CRRs, 667 (90.0 %) were from CT and 74 (10.0 %) from radiography. The most common clinical settings were outpatient (43.3 %), followed by inpatients (35.8 %) and emergency department (20.9 %). CRRs were categorized as Category 1 (15.8 %), Category 2 (70.6 %), and Category 3 (7.3 %) based on the urgency. Pulmonary embolism and suspected malignancy were the most frequent actionable findings. Active clinical responses were documented in 733 cases (98.9 %), including all Category 1 CRRs. However, 1.1 % of cases, mostly Category 3 or incidental findings, lacked documented follow-up, particularly in outpatient or cross-specialty scenarios.</div></div><div><h3>Conclusion</h3><div>A structured alert system for CRRs enabled prompt communication and follow-up adherence. However, non-urgent but actionable findings are still at risk of being lost to follow-up. Enhanced and integrated tracking systems are essential to ensure consistent and comprehensive management of all actionable radiologic findings.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110594"},"PeriodicalIF":1.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895404","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":"Reply: Imaging decision support with large language models","authors":"Eren Çamur ,&nbsp;Turay Cesur ,&nbsp;Yasin Celal Güneş ,&nbsp;Yusuf Öztürk ,&nbsp;Yunus Şerefettin ,&nbsp;Ersin Doğanözü ,&nbsp;Ayşegül Akçebe ,&nbsp;Ahmet Kürşad Güneş ,&nbsp;İbrahim Ethem Cakcak","doi":"10.1016/j.clinimag.2025.110592","DOIUrl":"10.1016/j.clinimag.2025.110592","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"126 ","pages":"Article 110592"},"PeriodicalIF":1.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977365","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}