Academic Radiology最新文献

{"title":"Contrast-enhanced ultrasound for assessing pre-operative lymphatic vessel function and post-operative anastomotic patency in lymphatic-venous anastomosis: a retrospective observational study.","authors":"Zishan Zeng, Zijie Liu, Houyu Xia, Jia Zhu, Zhengren Liu, Lili Zhang","doi":"10.1016/j.acra.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.acra.2025.02.001","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Lymphedema represents a significant global health challenge, severely impacting patient quality of life. Lymphatic-venous Anastomosis （LVA） is commonly employed as an effective intervention for patients with lymphedema. However, existing imaging tests for localizing lymphatic vessels exhibit various limitations; Consequently, there is a need for a more effective comprehensive method that can be employed for both preoperative localization of lymphatic vessels and postoperative patency assessment.</p><p><strong>Methods: </strong>Under local anesthesia, Contrast-enhanced Ultrasound (CEUS) was utilized to assess lymphatic vessel function and localize it prior to LVA in eight patients with refractory lymphedema following breast cancer surgery. High-frequency Ultrasound was employed for the localization of superficial vein. One-week post-surgery, CEUS was performed on all patients to assess the patency of anastomoses, and to evaluate surgical outcomes based on the number of visible patent anastomoses, anastomotic patency rates, and other indicators.</p><p><strong>Results: </strong>Prior to surgery, 68 pooled lymphatic vessels were visualized in eight patients, six of them exhibited tortuous and dilated. Lymphatic vessels with uniform internal diameter and intact continuity were selected for preoperative localization of LVA. Postoperatively, the anastomoses were clearly visualized and demonstrated a relatively high patency rate (26/41,63.2%). The patent anastomoses underwent \"spider-like\" changes. The internal diameters of the collecting lymphatic vessels were narrower post-operation compared to pre-operation measurements. Furthermore, six months after surgery, the internal diameters of the collecting lymphatic vessels of the affected limbs had decreased, with the maximum reduction reaching 11 cm.</p><p><strong>Conclusion: </strong>The cases in this study underscore the utility of CEUS in both preoperative assessment and localization of LVA and postoperative evaluation of anastomotic patency. This could represent a new technique that might supersede traditional methods such as Indocyanine Green (ICG) and become a routine assessment tool after LVA.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perilesional Enhancement: A Valuable Feature for Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma in CEUS LI-RADS M.","authors":"Xia Meng, Ye Yun, Wei Jiang, Yu-Wen Bi, Ting Dai, Zhi-Xia Sun","doi":"10.1016/j.acra.2024.12.071","DOIUrl":"https://doi.org/10.1016/j.acra.2024.12.071","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>We investigated whether the peritumoral enhancement feature can aid in discriminating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC) in contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System M (LR-M).</p><p><strong>Materials and methods: </strong>Between May 2018 and July 2024, 147 LR-M and 320 LR-5. lesions with pathologically confirmed HCC and ICC diagnoses after CEUS were examined. We evaluated the diagnostic efficacy of HCC with different diameters (≤3, 3-5, and 5-7cm) in the LR-M by peritumoral enhancement. We analysed the correlation between pathological perilesional hepatic sinusoid vessels and perilesional enhancement on CEUS in LR-M. The diagnostic performance of LR-5 with and without perilesional enhancement was evaluated.</p><p><strong>Results: </strong>There were 93/107 HCC lesions and 1/40 ICC lesion with perilesional hepatic sinusoid vessels in LR-M. CEUS revealed perilesional enhancement in 81.31% (87/107) of HCC lesions and 10.00% (4/40) of ICC lesions. There was a correlation between perilesional hepatic sinusoid vessel and perilesional enhancement with correlation coefficients of 0.738. The diagnostic efficacy of 5-7cm lesions was the best, and the sensitivity, specificity, accuracy, and AUC were 0.900, 0.864, 0.885, and 0.882. After perilesional enhancement was added to LR-5, 91 cases of HCC in LR-M were adjusted into LR-5. The adjusted diagnostic efficacy was significantly improved.</p><p><strong>Conclusion: </strong>Perilesional enhancement on CEUS correlates with perilesional hepatic sinusoid vessel. Perilesional enhancement is a valuable feature for distinguishing HCC and ICC and could be added as a feature in CEUS LI-RADS.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Multiparametric Clear Cell Likelihood Score for Characterization of Subcentimeter Solid Renal Lesions: A Multi-institutional Study.","authors":"Run Wang, Fan Meng, Xiaoxia Li, Pingyi Zhu, Jianyi Qu, Jianjun Zhou, Ying Xiong, Shunfa Huang, Chenchen Dai","doi":"10.1016/j.acra.2025.01.007","DOIUrl":"https://doi.org/10.1016/j.acra.2025.01.007","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Early characterization of subcentimeter (≤1cm) renal lesions is crucial for effective clinical management. This study aims to validate the diagnostic performance of the multiparametric MRI (mpMRI) clear cell likelihood score (ccLS) category in diagnosing subcentimeter clear cell renal cell carcinoma (ccRCC).</p><p><strong>Materials and methods: </strong>This retrospective study included consecutive patients with subcentimeter solid renal masses who underwent mpMRI between September 2009 and September 2022 at three hospitals. Two urological radiologists independently scored each lesion using the ccLS algorithm. Diagnostic accuracy was calculated using contingency tables, and the distribution of ccRCC by ccLS was tabulated. Interobserver agreement was evaluated with the Cohen κ statistic.</p><p><strong>Results: </strong>50 patients (mean age: 52 years±13, 24 men) with 51 subcentimeter lesions were included. Of the 51 lesions [mean size: 9 mm±1 (range, 6-10 mm)], 23 (45%) were benign, and 20 (39%) were ccRCC. The sensitivity, specificity, and positive predictive value for diagnosing ccRCC when ccLS was 4 or higher were 75% (95% CI: 60, 86), 84% (95% CI: 73, 91), and 75% (95% CI: 60, 86), respectively. The negative predictive value of a ccLS of 2 or lower was 96% (95% CI: 81, 99). The percentages of ccRCC were 8% (1/12), 0% (0/14), 25% (9/36), 81% (17/21), and 69% (13/19) for ccLSs of 1-5, respectively. The interobserver agreement was moderate (κ=0.48; 95% CI: 0.32, 0.63).</p><p><strong>Conclusion: </strong>Subcentimeter solid renal lesions can be qualitatively assessed by mpMRI. The mpMRI ccLS category demonstrated acceptable accuracy in diagnosing subcentimeter ccRCC.</p><p><strong>Data availability statement: </strong>Data generated or analyzed during the study are available from the corresponding author by request.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Noninvasive Diagnostics for Hepatic Steatosis in MASLD: The Pivotal Role of UDFF.","authors":"Jinrong Qu","doi":"10.1016/j.acra.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.acra.2025.02.013","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The CrowdStrike Incident and Practice Disruption: IT Concepts to Address Business Continuity.","authors":"Vrushab Gowda, Tarik Alkasab, Rajiv Gupta, Stephen Ledbetter, Tyler Martin, Miriam L Neuman, Atul B Shinagare, Onofrio A Catalano","doi":"10.1016/j.acra.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.acra.2025.02.005","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Peer Reviewer Instructions of Radiology Journals to Recommended Peer Review Checklists.","authors":"Omar Msto Hussain Nasser, Paul Cronin, James V Rawson","doi":"10.1016/j.acra.2025.01.018","DOIUrl":"https://doi.org/10.1016/j.acra.2025.01.018","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>The objective of this study was to identify differences in peer review guidance provided to reviewer by journals, and to compare radiology journal instructions to recommended peer review checklists.</p><p><strong>Methods: </strong>Peer review instructions from four prominent radiology journals (Radiology, JACR, Academic Radiology, AJR) were obtained from journal websites and instructions to reviewers in the journal. Two recommended checklists from radiology literature published by Provenzale and Stanley in 2005 with 30 items, and another by Duchesne and Jannin with 69 items published in 2008 were utilized. Journal-based instructions were compared to both recommended checklists using Excel.</p><p><strong>Results: </strong>Variability was observed in the online available instructions for reviewers of the four radiology journals. Radiology journals' instructions for reviewers were more likely to address certain parts of the manuscript. Items that were consistently emphasized included rationale, reproducibility, results of statistical test, whether results justify the conclusion, whether the research question was addressed, and the clinical and practical applicability. Other items that were more likely to be mentioned in the instruction checklists include; if the abstract stands alone, a sufficient and concise background, logical flow of results that follows from the methods, appropriate tables and figures, and appropriate references. Items least likely to be addressed included the title, keywords, justification of study design and study methodology, unexpected results, generalizability of findings, and ethical considerations.</p><p><strong>Conclusion: </strong>Variability was observed in journals' guidelines for reviewers. This could be attributed to differences in journal aims, scopes, and article types. Radiology journals' instructions for reviewers are more likely to address certain parts of the manuscript.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography radiomics-based combined model for predicting thymoma risk subgroups: a multicenter retrospective study.","authors":"Yifei Liu, Chao Luo, Yongshun Wu, Shumin Zhou, Guangying Ruan, Haojiang Li, Wanyuan Chen, Yi Lin, Lizhi Liu, Tingting Quan, Xiaodong He","doi":"10.1016/j.acra.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.acra.2025.01.010","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Accurately distinguishing histological subtypes and risk categorization of thymomas is difficult. To differentiate the histologic risk categories of thymomas, we developed a combined radiomics model based on non-enhanced and contrast-enhanced computed tomography (CT) radiomics, clinical, and semantic features.</p><p><strong>Materials and methods: </strong>In total, 360 patients with pathologically-confirmed thymomas who underwent CT examinations were retrospectively recruited from three centers. Patients were classified using improved pathological classification criteria as low-risk (LRT: types A and AB) or high-risk (HRT: types B1, B2, and B3). The training and external validation sets comprised 274 (from centers 1 and 2) and 86 (center 3) patients, respectively. A clinical-semantic model was built using clinical and semantic variables. Radiomics features were filtered using intraclass correlation coefficients, correlation analysis, and univariate logistic regression. An optimal radiomics model (Rad_score) was constructed using the AutoML algorithm, while a combined model was constructed by integrating Rad_score with clinical and semantic features. The predictive and clinical performances of the models were evaluated using receiver operating characteristic/calibration curve analyses and decision-curve analysis, respectively.</p><p><strong>Results: </strong>Radiomics and combined models (area under curve: training set, 0.867 and 0.884; external validation set, 0.792 and 0.766, respectively) exhibited performance superior to the clinical-semantic model. The combined model had higher accuracy than the radiomics model (0.79 vs. 0.78, p<0.001) in the entire cohort. The original_firstorder_median of venous phase had the highest relative importance among features in the radiomics model.</p><p><strong>Conclusion: </strong>Radiomics and combined radiomics models may serve as noninvasive discrimination tools to differentiate thymoma risk classifications.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Discoid Morphology in Lateral Meniscal Tears: Introducing a Novel Meniscal Height Ratio.","authors":"Rida Salman, Jason Zarahi Amaral, Rebecca Schultz, Rioke Diejomaoh, Krishna Chandra, Jie C Nguyen, Indranil Kushare, Scott D McKay, J. Herman Kan","doi":"10.1016/j.acra.2025.01.039","DOIUrl":"10.1016/j.acra.2025.01.039","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Identifying underlying discoid morphology in the setting of a lateral meniscal tear (LMT) can be challenging with no clear consensus on its definition. We aim to determine the magnetic resonance imaging (MRI) characteristics of discoid morphology, including a novel meniscal height ratio.</p><p><strong>Methods: </strong>A retrospective study of patients undergoing arthroscopic repair of isolated LMT between 2018 and 2023. MRIs were reviewed for the presence of discoid morphology, meniscocapsular ligaments and bone contusion, tear patterns, and lateral/medial meniscal height comparison to generate a ratio. Logistic regression was employed to assess predictive factors for discoid. Descriptive statistics were used to determine MRI diagnostic performance and receiver operating characteristic (ROC) curve to identify an optimal threshold for the meniscal height ratio.</p><p><strong>Results: </strong>We included 283 knees (mean age 14.9 years; 76% male); 112 with discoid morphology (group 1, G1), and 171 non-discoid (group 2, G2). Lateral bone contusions were less common in G1 than G2 (P<0.001). Meniscocapsular ligaments were identified in 68% of G1 versus 88% in G2 (P=0.001). G1 patients had a significantly greater meniscal height ratio compared with G2 (P<0.001). Female sex, younger age and horizontal tears were statistically significantly associated with G1. ROC analysis identified an optimal threshold of 1.21. Similar diagnostic accuracy for binomially determining underlying discoid morphology comparing a height ratio of 1.21 and lateral tibiofemoral meniscal coverage >50%. Selectively combining both parameters gives 100% specificity.</p><p><strong>Conclusion: </strong>The meniscal height ratio plays a complementary role with other imaging and demographic findings to identify underlying discoid morphology.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Disease Progression in Thermal Ablation of Papillary Thyroid Cancer-A Large-sample Analysis.","authors":"Yu-Lin Fei, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Shi-Liang Cao, Jie Wu, Na Yu, Ming-An Yu","doi":"10.1016/j.acra.2025.01.042","DOIUrl":"https://doi.org/10.1016/j.acra.2025.01.042","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>This study aimed to analyze risk factors influencing disease progression in patients with papillary thyroid cancer (PTC) undergoing microwave ablation (MWA).</p><p><strong>Materials and methods: </strong>In this retrospective single-center study, 889 patients (647 women; median age, 40 years; age range, 14-80 years) who underwent MWA for PTC from June 2015 to December 2022 were enrolled. A least-absolute shrinkage and selection operator Cox regression model was employed to identify important factors for disease progression. Cox univariable and multivariable regression analyses were conducted to evaluate the association of variables with disease progression. Variables achieving statistical significance (P<0.05) were incorporated into a prognostic prediction model.</p><p><strong>Results: </strong>The median follow-up period was 25 months. Disease progression-free survival rates at 1, 2, and 3 years were 99.6%, 97.2%, and 95.9%, respectively. Independent predictors of disease progression included multifocality (hazard ratio [HR]=2.3, 95% confidence interval [CI]: 1.2-4.3; P=0.011), ultrasound-detected extrathyroidal extension (HR=2.3, 95% CI: 1.2-4.3; P=0.010), and larger maximum diameters (HR=1.8, 95% CI: 1.1-3.0; P=0.026). Additionally, multiple tumors (HR=2.9, 95% CI: 1.4-6.0; P=0.003) and larger maximum diameters (HR=1.8, 95% CI: 1.0-3.0; p=0.038) were significantly associated with new tumor occurrence. The Cox regression fitting of the nomogram demonstrated moderate prediction efficiency (consistency index 0.715).</p><p><strong>Conclusion: </strong>MWA is a feasible and effective treatment for patients with PTC. However, for patients with larger nodules, multiple nodules, and ultrasound-detected extrathyroidal extension, a more meticulous and precise ablation strategy is critical to minimize the risk of disease progression.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning with Multiphase CTA and CTP Images for Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Patients.","authors":"Hongyu Qu, Zhilin Zhang","doi":"10.1016/j.acra.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.acra.2025.02.014","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}