Michael F Morris, Danielle Summers, Leslie A Welk, Molly Harrison, Brian Johnston, Vilert A Loving
{"title":"Reply to \"Initial Attempted Contrast-Enhanced Mammography-Guided Biopsy for Suspicious Breast MRI Findings: A Single Institution's Experience\".","authors":"Michael F Morris, Danielle Summers, Leslie A Welk, Molly Harrison, Brian Johnston, Vilert A Loving","doi":"10.2214/AJR.24.32279","DOIUrl":"https://doi.org/10.2214/AJR.24.32279","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585152","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":"Beyond the <i>AJR</i>: Imaging Underutilization and Overutilization Are Both Patient Safety Issues.","authors":"Jinel Scott, Stephen Waite","doi":"10.2214/AJR.24.32244","DOIUrl":"https://doi.org/10.2214/AJR.24.32244","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549061","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}
Abin Sajan, Yan Epelboym, Ana Fernandez Martinez, Mark Little, Reza Talaie, Ari Isaacson
{"title":"Transarterial Embolization for Musculoskeletal Pain Management: <i>AJR</i> Expert Panel Narrative Review.","authors":"Abin Sajan, Yan Epelboym, Ana Fernandez Martinez, Mark Little, Reza Talaie, Ari Isaacson","doi":"10.2214/AJR.24.31626","DOIUrl":"10.2214/AJR.24.31626","url":null,"abstract":"<p><p>Musculoskeletal embolization has emerged in recent years as a treatment for chronic joint pain, as the inflammatory cascade responsible for such pain has become better understood. Studies have demonstrated a complex interplay between joint inflammation and synovial hypervascularity that causes growth of new unmyelinated nerve fibers responsible for pain. Embolization targets joint hypervascularity, to disrupt the inflammatory cycle and provide pain relief. The standard treatment algorithm for chronic joint pain is well-established and entails escalating therapeutic options that include exercise, self-management programs, analgesic medications, intra-articular injections, and finally surgical replacement or release. Genicular artery embolization (GAE), targeting abnormal vasculature around the knee joint, is the most heavily studied musucloskeletal embolization procedure, reflecting the high worldwide prevalence and increasing incidence of knee osteoarthritis. GAE is now supported by multiple prospective studies, including randomized control trials comparing GAE versus sham treatment. Embolization has also extended outside of the knee joint to include the shoulder (treatment of adhesive capsulitis or secondary stiff shoulder), elbow (medial/lateral epicondylitis), hip (osteoarthritis, great trochanteric pain syndrome), and ankle (plantar fasciitis). This AJR Expert Panel Narrative Review discusses the current status of transarterial embolization for musculoskeletal pain management, focusing on treatment of knee osteoarthritis and chronic shoulder pain.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549140","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":"Editorial Comment: MRI Radiomics and Machine Learning to Advance the Precision of HER2 Classification.","authors":"Manisha Bahl","doi":"10.2214/AJR.24.32269","DOIUrl":"https://doi.org/10.2214/AJR.24.32269","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549075","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}
Sirui Jiang, Syed Muhammad Awais Bukhari, Arjun Krishnan, Kaustav Bera, Avishkar Sharma, Danielle Caovan, Beverly Rosipko, Amit Gupta
{"title":"Deployment of Artificial Intelligence in Radiology: Strategies for Success.","authors":"Sirui Jiang, Syed Muhammad Awais Bukhari, Arjun Krishnan, Kaustav Bera, Avishkar Sharma, Danielle Caovan, Beverly Rosipko, Amit Gupta","doi":"10.2214/AJR.24.31898","DOIUrl":"10.2214/AJR.24.31898","url":null,"abstract":"<p><p>Radiology, as a highly technical and information-rich medical specialty, is well-suited for artificial intelligence (AI) product development, and many FDA-cleared AI medical devices are authorized for uses within the specialty. In this Clinical Perspective, we discuss the deployment of AI tools in radiology, exploring regulatory processes, the need for transparency, and other practical challenges. We further highlight the importance of rigorous validation, real-world testing, seamless workflow integration, and end-user education. We emphasize the role for continuous feedback and robust monitoring processes, to guide AI tools' adaptation and help ensure sustained performance. Traditional standalone and alternative platform-based approaches to radiology AI implementation are considered. The presented strategies will help achieve successful deployment and fully realize AI's potential benefits in radiology.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549062","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}
Ahmed O El Sadaney, Andrea Ferrero, Kishore Rajendran, Sören Jasper, Gina L Mazza, Stephen M Broski, Elisabeth Shanblatt, Tristan Nowak, Joel G Fletcher, Cynthia H McCollough, Francis I Baffour
{"title":"Opportunistic Bone Mineral Density Measurement Using Photon-Counting Detector CT Spectral Localizer Images: A Prospective Study.","authors":"Ahmed O El Sadaney, Andrea Ferrero, Kishore Rajendran, Sören Jasper, Gina L Mazza, Stephen M Broski, Elisabeth Shanblatt, Tristan Nowak, Joel G Fletcher, Cynthia H McCollough, Francis I Baffour","doi":"10.2214/AJR.24.31909","DOIUrl":"10.2214/AJR.24.31909","url":null,"abstract":"<p><p><b>Background:</b> Spectral localizer images from photon-counting detector (PCD) CT can be used for bone mineral density (BMD) evaluation given their 2D-projectional nature and material decomposition capability. As all CT examinations include localizer images, this approach could allow opportunistic osteoporosis screening in patients undergoing clinically indicated imaging by PCD CT. <b>Objective:</b> To assess the utility of PCD-CT spectral localizer images for opportunistic derivation of area BMD (aBMD) values and T-scores, using dual-energy X-ray absorptiometry (DXA) as the reference standard. <b>Methods:</b> This prospective study included patients ≥18 years old scheduled for clinically indicated lumbar spine CT between October 2023 and February 2024 and who underwent DXA within the 13 prior months or were scheduled for DXA within the subsequent 13 months. Participants underwent lumbar spine CT by PCD CT including spectral localizer images. Lumbar spine aBMD was extracted from clinical DXA reports. ROIs were placed on lumbar vertebral bodies and background soft tissues to extract areal densities from spectral localizer images using material decomposition; areal densities were used to derive lumbar spine aBMD values. The aBMD values were used to derive T-scores, which were classified as representing normal (≥-1) or abnormal (<-1) bone mass. DXA-derived and PCD-CT derived measurements were compared. <b>Results:</b> The study included 51 participants (mean age: 62 years [range, 28-83 years]; 31 female, 20 male). Mean DXA-derived T-score was 0.39±1.64; mean PCD-CT derived T-score was 0.28±1.77 (p=.29). Lin's concordance correlation coefficient between DXA-derived and PCD-CT T-scores was 0.90. The difference between DXA-derived and PCD-CT derived T-scores showed a small correlation with patient age (r=-0.13), absolute interval between DXA and PCD CT (r=.15), and BMI (r=0.28); this difference in scores did not show a significant difference between male and female patients (0.08 vs 0.13, respectively; p=.81). PCD-CT T-scores had sensitivity of 97%, specificity of 71%, PPV of 90%, and NPV of 91% for detecting abnormal bone mass using DXA-derived T-scores as the reference standard. <b>Conclusion:</b> PCD-CT spectral localizers showed clinical utility for deriving aBMD values and, consequently, T-scores. <b>Clinical Impact:</b> The T-score derived from PCD-CT spectral localizers may serve as an opportunistic screening tool for low bone mass and osteoporosis.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549139","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}
Jennifer S McDonald, John J Schmitz, Robert J McDonald
{"title":"Hyaluronidase Injection for Prevention of Moderate or Severe Complications After Contrast Media Extravasation: A Propensity-Score Matched Analysis.","authors":"Jennifer S McDonald, John J Schmitz, Robert J McDonald","doi":"10.2214/AJR.24.31986","DOIUrl":"https://doi.org/10.2214/AJR.24.31986","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549138","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":"Editor's Notebook: October 2024.","authors":"Andrew B Rosenkrantz","doi":"10.2214/AJR.24.31141","DOIUrl":"https://doi.org/10.2214/AJR.24.31141","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549076","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}
Xiaozhi Dang, Yi Gao, Yan Ju, Xiaojie Yuan, Huan Lin, Yi Ren, Yao Xiao, Rui Shu, Xiang Gu, Woo Kyung Moon, Hongping Song
{"title":"Automated Breast Ultrasound With Remote Reading for Primary Breast Cancer Screening: A Prospective Study Involving 46 Community Health Centers in China.","authors":"Xiaozhi Dang, Yi Gao, Yan Ju, Xiaojie Yuan, Huan Lin, Yi Ren, Yao Xiao, Rui Shu, Xiang Gu, Woo Kyung Moon, Hongping Song","doi":"10.2214/AJR.24.31830","DOIUrl":"10.2214/AJR.24.31830","url":null,"abstract":"<p><p><b>Background:</b> China has faced barriers to implementation of a population-based mammographic screening program. Breast ultrasound provides an alternative screening modality to mammography in low-resource settings. <b>Objective:</b> To evaluate the performance of ABUS with remote reading as the primary screening modality for breast cancer. <b>Methods:</b> This prospective study enrolled asymptomatic women 35-69 years old from 46 community health centers across 18 provinces representing all six regions of China from January 2021 to December 2021. Participants underwent screening ABUS as the sole breast cancer screening modality, with images acquired by a technologist at the community health center. The 3D volumetric data were transferred via cloud-based software to a single remote reading center, where examinations were interpreted independently in batches by two subspecialized breast radiologists using BI-RADS; a third radiologist at the remote reader center resolved discrepancies. Diagnostic reports were returned to the community centers, and patients sought follow-up care at local hospitals. The reference standard incorporated a combination of histopathology and 24-month follow-up. Outcomes measures included cancer detection rate, abnormal interpretation rate (AIR), sensitivity, specificity, biopsy rate, and PPV. <b>Results:</b> The final analysis included 5978 enrolled participants (median age, 46 years [IQR 40-52 years]) who underwent screening ABUS at the community health centers with subsequent remote reading. A total of 24 ABUS-detected cancers and two interval cancers were diagnosed. The cancer detection rate was 4.0 per 1000 women (95% CI: 2.7-5.9), and the AIR was 11.9% (95% CI: 11.1-12.7). A total of 95.8% (23/24) of ABUS-detected cancers were invasive. The 23 invasive cancers had a median diameter of 10.0 mm; 73.9% (17/23) were node-negative. Sensitivity was 92.3% (95% CI: 75.9-97.9), and specificity was 88.4% (95% CI: 87.6-89.2). The biopsy rate was 1.7% (95% CI: 1.4-2.0), and the PPV of biopsy was 24.0% (95% CI: 16.7-33.2). <b>Conclusion:</b> ABUS screening with remote reading met benchmark performance for cancer detection in comparison to mammography, with infrequent interval cancers. <b>Clinical Impact:</b> ABUS with remote reading holds promise in enhancing access to breast cancer screening and early detection in low-resource settings or underserved regions where mammographic screening is not established.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513470","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":"Editorial Comment: The Future Is Coming Soon, But It Is Not Here Yet.","authors":"Yoshito Tsushima","doi":"10.2214/AJR.24.32175","DOIUrl":"https://doi.org/10.2214/AJR.24.32175","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513472","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}