Clinical ImagingPub Date : 2024-05-07DOI: 10.1016/j.clinimag.2024.110173
Kanhai S. Amin, Howard P. Forman, Melissa A. Davis
{"title":"Response to letter","authors":"Kanhai S. Amin, Howard P. Forman, Melissa A. Davis","doi":"10.1016/j.clinimag.2024.110173","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110173","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140906305","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 : 2024-05-07DOI: 10.1016/j.clinimag.2024.110171
Oliver Casagrande Calomeno Domit , Diogo Goulart Corrêa
{"title":"I saw the “shrimp sign”: Cerebellar progressive multifocal leukoencephalopathy","authors":"Oliver Casagrande Calomeno Domit , Diogo Goulart Corrêa","doi":"10.1016/j.clinimag.2024.110171","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110171","url":null,"abstract":"<div><p>The shrimp sign is characterized by a well-defined lesion in the deep cerebellar white matter, with hyperintense signal on T2- and hypointense signal on T1-weighted imaging, abutting and outlining the dentate nucleus, unilaterally or bilaterally. This sign has high sensitivity and specificity for cerebellar progressive multifocal leukoencephalopathy (PML) within the correct clinical scenario. In this article, we present a case of cerebellar PML in a woman living with human immunodeficiency virus, who was not using antiretroviral therapy, and presented the shrimp sign on brain MRI.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140952277","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 : 2024-04-29DOI: 10.1016/j.clinimag.2024.110168
Ali Borhani , Harry Luu , Alireza Mohseni , Ziyi Xu , Mohammadreza Shaghaghi , Celestina Tolosa , Mohammad Mirza Aghazadeh Attari , Seyedeh Panid Madani , Haneyeh Shahbazian , Pegah Khoshpouri , Shadi Afyouni , Ghazal Zandieh , Ihab R. Kamel , Amy K. Kim
{"title":"Screening for exclusion of high-risk bleeding features of esophageal varices in cirrhosis through CT and MRI","authors":"Ali Borhani , Harry Luu , Alireza Mohseni , Ziyi Xu , Mohammadreza Shaghaghi , Celestina Tolosa , Mohammad Mirza Aghazadeh Attari , Seyedeh Panid Madani , Haneyeh Shahbazian , Pegah Khoshpouri , Shadi Afyouni , Ghazal Zandieh , Ihab R. Kamel , Amy K. Kim","doi":"10.1016/j.clinimag.2024.110168","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110168","url":null,"abstract":"<div><h3>Background & aim</h3><p>Esophageal varices (EV) screening guidelines have evolved with improved risk stratification to avoid unnecessary esophagogastroduodenoscopy (EGD) in individuals with low bleeding risks. However, uncertainties persist in the recommendations for certain patient groups, particularly those with hepatocellular carcinoma (HCC) and/or receiving non-selective beta-blockers (NSBB) without prior endoscopy. This study assessed the efficacy of imaging in ruling out EVs and their high-risk features associated with bleeding in patients with cirrhosis and with HCC. We also evaluated the impact of NSBB on the detection of these characteristics.</p></div><div><h3>Methods</h3><p>A total of 119 patients undergoing EGD with CT and/or MRI within 90 days of the procedure were included. 87 patients had HCC. A new imaging grading system was developed utilizing the size of EVs and the extent of their protrusion into the esophagus lumen. The negative predictive value (NPV) of EVimaging(−) versus EVimaging (+) (grades 1–3) in ruling out the presence of EV and/or high-risk features by EGD was calculated. The predictive performance of imaging was determined by logistic regression.</p></div><div><h3>Results</h3><p>The NPV of imaging for detecting EV and high-risk features was 81 % and 92 %, respectively. Among HCC patients, the NPV for EV and high-risk features was 80 % and 64 %, respectively. Being on NSBB didn't statistically impact the imaging detection of EV. Imaging was a better predictor of high-risk EGD findings than Child-Turcotte-Pugh scores.</p></div><div><h3>Conclusions</h3><p>Our results suggest that imaging can effectively rule out the presence of EV and high-risk features during EGD, even in patients with HCC and/or receiving NSBB.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824886","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 : 2024-04-28DOI: 10.1016/j.clinimag.2024.110170
Bárbara Lacerda Teixeira , Pedro Silva Cunha , Ana Sofia Jacinto , Guilherme Portugal , Sérgio Laranjo , Bruno Valente , Ana Lousinha , Madalena Coutinho Cruz , Ana Sofia Delgado , Manuel Brás , Margarida Paulo , Cátia Guerra , Ruben Ramos , Iládia Fontes , Rui Cruz Ferreira , Mário Martins Oliveira
{"title":"Epicardial adipose tissue volume assessed by cardiac CT as a predictor of atrial fibrillation recurrence following catheter ablation","authors":"Bárbara Lacerda Teixeira , Pedro Silva Cunha , Ana Sofia Jacinto , Guilherme Portugal , Sérgio Laranjo , Bruno Valente , Ana Lousinha , Madalena Coutinho Cruz , Ana Sofia Delgado , Manuel Brás , Margarida Paulo , Cátia Guerra , Ruben Ramos , Iládia Fontes , Rui Cruz Ferreira , Mário Martins Oliveira","doi":"10.1016/j.clinimag.2024.110170","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110170","url":null,"abstract":"<div><h3>Introduction</h3><p>In patients with atrial fibrillation (AF), up to one third have recurrence after a first catheter ablation (CA). Epicardial adipose tissue (EAT) has been considered to be closely related to AF, with a potential role in its recurrence. We aimed to evaluate the association between the volume of EAT measured by cardiac computed tomography (CT) and AF recurrence after CA.</p></div><div><h3>Methods</h3><p>Consecutive AF patients underwent a standardized cardiac CT protocol for quantification of EAT, thoracic adipose volume (TAV) and left atrium (LA) volume before CA. An appropriate cut-off of EAT was determined and risk recurrence was estimated.</p></div><div><h3>Results</h3><p>305 patients (63.6 % male, mean age 57.5 years, 28.2 % persistent AF) were followed for 24 months; 23 % had AF recurrence at 2-year mark, which was associated with higher EAT (<em>p</em> = 0.037) and LAV (<em>p</em> < 0.001). Persistent AF was associated with higher EAT volumes (<em>p</em> = 0.010), TAV (<em>p</em> = 0.003) and LA volumes (p < 0.001). EAT was predictive of AF recurrence (<em>p</em> = 0.044). After determining a cut-off of 92 cm<sup>3</sup>, survival analysis revealed that EAT volumes > 92 cm<sup>3</sup> showed higher recurrence rates at earlier time points after the index ablation procedure (<em>p</em> = 0.006), with a HR of 1.95 (<em>p</em> = 0.008) of AF recurrence at 2-year. After multivariate adjustment, EAT > 92 cm<sup>3</sup> remained predictive of AF recurrence (<em>p</em> = 0.028).</p></div><div><h3>Conclusion</h3><p>The volume of EAT measured by cardiac CT can predict recurrence of AF after ablation, with a volume above 92 cm<sup>3</sup> yielding almost twice the risk of arrhythmia recurrence in the first two years following CA. Higher EAT and TAV are also associated with persistent AF.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0899707124001001/pdfft?md5=289f5d768cfef50209e84bc3b1813635&pid=1-s2.0-S0899707124001001-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140815964","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 : 2024-04-28DOI: 10.1016/j.clinimag.2024.110169
Laura E. Minton , Yolanda Bryce
{"title":"The life and legacy of Hedvig Hricak, MD, PhD","authors":"Laura E. Minton , Yolanda Bryce","doi":"10.1016/j.clinimag.2024.110169","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110169","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140815965","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 : 2024-04-22DOI: 10.1016/j.clinimag.2024.110167
Katherine Frederick-Dyer , Meridith J. Englander , Geraldine McGinty , Kristin K. Porter , David W. Jordan , Kirti Magudia , Peter R. Eby , Elizabeth H. Dibble , Candice Johnstone , Gaurang V. Shah , Lisa A. Mullen , Kathryn Zamora , Maryellyn Gilfeather , Kimberly Feigin , Christina Ferraro , Joshua M. McDonald , Jordan Perchik , Alisha Rathi , Ilse Castro-Aragon , Elizabeth Kagan Arleo
{"title":"ACR joins more than 75 health care organizations in affirming that abortion is an essential component of reproductive healthcare","authors":"Katherine Frederick-Dyer , Meridith J. Englander , Geraldine McGinty , Kristin K. Porter , David W. Jordan , Kirti Magudia , Peter R. Eby , Elizabeth H. Dibble , Candice Johnstone , Gaurang V. Shah , Lisa A. Mullen , Kathryn Zamora , Maryellyn Gilfeather , Kimberly Feigin , Christina Ferraro , Joshua M. McDonald , Jordan Perchik , Alisha Rathi , Ilse Castro-Aragon , Elizabeth Kagan Arleo","doi":"10.1016/j.clinimag.2024.110167","DOIUrl":"10.1016/j.clinimag.2024.110167","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792789","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 : 2024-04-21DOI: 10.1016/j.clinimag.2024.110164
Itamar D. Futterman , Hila Friedmann , Oleksii Shpanel-Yukhta , Howard Minkoff , Shoshana Haberman
{"title":"Use of natural language processing to uncover racial bias in obstetrical documentation","authors":"Itamar D. Futterman , Hila Friedmann , Oleksii Shpanel-Yukhta , Howard Minkoff , Shoshana Haberman","doi":"10.1016/j.clinimag.2024.110164","DOIUrl":"10.1016/j.clinimag.2024.110164","url":null,"abstract":"<div><p>Natural Language Processing (NLP), a form of Artificial Intelligence, allows free-text based clinical documentation to be integrated in ways that facilitate data analysis, data interpretation and formation of individualized medical and obstetrical care. In this cross-sectional study, we identified all births during the study period carrying the radiology-confirmed diagnosis of fibroid uterus in pregnancy (defined as size of largest diameter of >5 cm) by using an NLP platform and compared it to non-NLP derived data using ICD10 codes of the same diagnosis. We then compared the two sets of data and stratified documentation gaps by race. Using fibroid uterus in pregnancy as a marker, we found that Black patients were more likely to have the diagnosis entered late into the patient's chart or had missing documentation of the diagnosis.</p><p>With appropriate algorithm definitions, cross referencing and thorough validation steps, NLP can contribute to identifying areas of documentation gaps and improve quality of care.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796460","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 : 2024-04-21DOI: 10.1016/j.clinimag.2024.110166
Maria El Homsi , Aron Bercz , Stephanie Chahwan , Maria Clara Fernandes , Sidra Javed-Tayyab , Jennifer S. Golia Pernicka , Josip Nincevic , Viktoriya Paroder , Lisa Ruby , J. Joshua Smith , Iva Petkovska
{"title":"Watch & wait - Post neoadjuvant imaging for rectal cancer","authors":"Maria El Homsi , Aron Bercz , Stephanie Chahwan , Maria Clara Fernandes , Sidra Javed-Tayyab , Jennifer S. Golia Pernicka , Josip Nincevic , Viktoriya Paroder , Lisa Ruby , J. Joshua Smith , Iva Petkovska","doi":"10.1016/j.clinimag.2024.110166","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110166","url":null,"abstract":"<div><p>Rectal cancer management has evolved over the past decade with the emergence of total neoadjuvant therapy (TNT). For select patients who achieve a clinical complete response following TNT, organ preservation by means of the watch-and-wait (WW) strategy is an increasingly adopted alternative that preserves rectal function and quality of life without compromising oncologic outcomes. Recently, published 5-year results from the OPRA trial demonstrated that organ preservation can be achieved in approximately half of patients managed with the WW strategy, with most local regrowth events occurring within two years. Considering the potential for local regrowth, the implementation of the WW strategy mandates rigorous clinical and radiographic surveillance. Magnetic resonance imaging (MRI) serves as the conventional imaging modality for local staging and surveillance of rectal cancer given its excellent soft-tissue resolution. This review will discuss the current evidence for the WW strategy and the role of restaging rectal MRI in determining patient eligibility for this strategy. Restaging rectal MRI acquisition parameters and treatment response assessment, including important factors to assess, pitfalls, and classification systems, will be discussed in the context of the WW strategy.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140646118","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 : 2024-04-21DOI: 10.1016/j.clinimag.2024.110165
Ella Atzil , Katerina Dodelzon
{"title":"“A patient's doctor”- A high school freshman's reflection on the field of breast imaging","authors":"Ella Atzil , Katerina Dodelzon","doi":"10.1016/j.clinimag.2024.110165","DOIUrl":"10.1016/j.clinimag.2024.110165","url":null,"abstract":"<div><p>Despite an increasing focus on gender diversity in radiology the underrepresentation of women in radiology has not significantly improved over the last two decades, with women continuing to representing just a quarter of the radiology workforce since 2007 (AAMC, 2019<span><sup>1</sup></span>). Although multifactorial, lack of perceived patient interaction in the field has been reported to be one of the main deterring factors in why women chose not to pursue radiology (Arleo et al., 2016; Fielding et al., 2007<span><sup>2</sup></span><sup>,</sup><span><sup>3</sup></span>). With increasing advances and integration of medical imaging into medical care (Brink and Hricak, 2023<span><sup>4</sup></span>), Radiology's impact on daily patient care will continue to increase and with it, the need for an expert and diverse radiologist workforce. Thus, exposure to the field and its patient-centered focus to younger women, especially those students who are already interested in STEM, presently is ever more important. Such early exposure can provide for longitudinal engagement with the field and its numerous career opportunities, dispel the many myths of the specialty as one of isolation and lack of patient contact, and popularize the field among young adults. Current investment in mentoring young women, prior to the cementing of rather pervasive misconceptions about Radiology during their undergraduate and medical education, can help support a more diverse future for our field.</p><p>Below is one rising high-school freshman's reflection on the field of breast imaging after a 10-day summer shadowing experience with Department of Radiology.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763946","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}