American Journal of Roentgenology最新文献

{"title":"Moving Towards Widespread Adoption of Prostate Cancer Screening With MRI: Questions Remaining for Optimization.","authors":"Benjamin Spilseth","doi":"10.2214/AJR.25.32892","DOIUrl":"https://doi.org/10.2214/AJR.25.32892","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607269","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":"Architectural Distortions Detected by DBT Alone With No Ultrasound Correlate and Nonmalignant Results on Core Needle Biopsy: Outcomes From an Imaging-Focused Management Strategy.","authors":"Derek L Nguyen, Eun L Langman, Karen S Johnson, Lars J Grimm","doi":"10.2214/AJR.25.32737","DOIUrl":"10.2214/AJR.25.32737","url":null,"abstract":"<p><p><b>Background:</b> Architectural distortions (ADs) detected on digital breast tomosynthesis (DBT) are more frequently associated with nonmalignant pathologies than those detected on digital mammography. <b>Objective:</b> To evaluate outcomes of ADs detected by DBT alone with no ultrasound correlate and nonmalignant results on core needle biopsy (CNB) when adopting a management strategy selectively incorporating imaging surveillance. <b>Methods:</b> This retrospective study included patients with ADs detected by DBT alone with no ultrasound correlate and nonmalignant results on stereotactic CNB with 12 vacuum-assisted 9-gauge cores from July 1, 2020, to December 31, 2023. ADs detected by DBT alone with no ultrasound correlate showing concordant benign pathology or radial scar without atypia on CNB were recommended to undergo 6-month and 12-month diagnostic imaging follow-up before returning to annual screening, whereas those showing atypia (with or without radial scar) on CNB were recommended to undergo surgical excision; however, patients could electively undergo the alternative management option. Malignancy rates were assessed, considering ADs to be nonmalignant based on results of repeat CNB, surgical excision, or 12-month diagnostic imaging follow-up. <b>Results:</b> The final sample included 106 patients (mean age, 58 years) with 109 ADs meeting selection criteria and that underwent repeat CNB, surgical excision, or 12 months of diagnostic imaging follow-up. The malignancy rate was 0% (0/58) for ADs showing benign pathology on CNB (49 with imaging surveillance, 2 with repeat CNB, 7 with excision), 0% (0/37) for ADs showing radial scar without atypia on CNB (22 with imaging surveillance, 14 with excision), 10% (1/10) for ADs showing radial scar with atypia on CNB (all with excision), and 40% (2/5) for ADs showing atypia without radial scar on CNB (2 with imaging surveillance, 3 with excision). Overall, the malignancy rate was 0% (0/94) versus 20% (3/15) in the absence versus presence, respectively, of atypia (with or without radial scar) on CNB. <b>Conclusions:</b> The malignancy rate was 0% for ADs without atypia, versus 20% for ADs with atypia, on CNB. <b>Clinical Impact:</b> Imaging surveillance may be a safe alternative to surgical excision for ADs detected by DBT alone with no ultrasound correlate showing benign pathology without atypia on CNB.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607261","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":"White Matter Hyperintensities and Mild Traumatic Brain Injury-Where Do We Go From Here?","authors":"Anthony M Alleman","doi":"10.2214/AJR.25.32891","DOIUrl":"https://doi.org/10.2214/AJR.25.32891","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569079","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>: How Does Noncontrast MRI Compare With Ultrasound For Hepatocellular Carcinoma Surveillance in a Prospective Randomized Trial?","authors":"Robert M Marks","doi":"10.2214/AJR.25.32893","DOIUrl":"https://doi.org/10.2214/AJR.25.32893","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569027","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":"NPV of Biparametric and Multiparametric Prostate MRI: A Comparative Systematic Review and Meta-Analysis.","authors":"Emmanuel Salinas-Miranda, Adam Birosh, Matthew D F Mcinnes, Rodney Henry Breau, Eric Lam, Trevor A McGrath, Trevor A Flood, Nicola Schieda","doi":"10.2214/AJR.24.32328","DOIUrl":"10.2214/AJR.24.32328","url":null,"abstract":"<p><p><b>Background:</b> Evidence supports comparable PPV between biparametric MRI (bpMRI) and multiparametric MRI (mpMRI). However, concern of missed cancers limits wider bpMRI adoption. <b>Objective:</b> To compare bpMRI and mpMRI in terms of the NPV for clinically significant prostate cancer. <b>Evidence Acquisition:</b> Multiple publication databases, trial registries, and conference proceedings were searched over varying timeframes for studies reporting comparative results for bpMRI and mpMRI. Information was extracted for negative examinations (PI-RADS or Likert category 1 or 2), which were classified as true or false negatives for clinically significant prostate cancer (International Society of Urological Pathology grade group ≥2), with pathologic reference standard (biopsy and/or radical prostatectomy). Risk of bias was assessed using QUADAS-Comparative. Pooled NPVs were calculated using random-effects meta-analysis. <b>Evidence Synthesis:</b> The meta-analysis included 18 studies. Fifteen studies evaluated simulated bpMRI examinations (examinations performed as mpMRI but interpreted with removal of dynamic contrast-enhancement images); three compared parallel arms of patients who underwent bpMRI or mpMRI. No study evaluated patients randomly allocated to undergo bpMRI or mpMRI. Three studies' reference standard included longitudinal follow-up biopsy. Pooled NPV was not significantly different between bpMRI (n=2857 patients) and mpMRI (n=2751 patients) overall [92% (95% CI: 89%, 94%) vs 92% (95% CI: 89%, 94%); p=.90], in nine studies after excluding those at high risk of bias in at least one domain for QUADAS-Comparative [92% (95% CI: 86%, 95%) vs 92% (95%: 95%, 96%), p=.83], in three studies of only 1.5-T examinations [89% (95% CI: 78%, 95%) vs 87% (95% CI: 77%), 93%], p=.76], in 12 studies of only 3-T examinations [93% (90%, 95%) vs 93% (91%, 95%); p=.90], in 12 studies of only biopsy-naïve patients [92% (95% CI: 88%, 94%) vs 91% (95% CI: 89%, 93%), p=.89], or in three studies of only previously biopsied patients [94% (95% CI: 89%, 97%) vs 94% (95% CI: 85%, 98%), p=.95]. <b>Conclusion:</b> This study found no evidence of a significant difference between bpMRI and mpMRI in NPV for clinically significant prostate cancer. <b>Clinical Impact:</b> The results provide further support for bpMRI as an alternative to mpMRI in clinical practice. Future studies should include randomized designs with longitudinal follow-up.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569042","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":"Private Equity Acquisitions of Radiology Practices From 2013 to 2023: National-and State-Level Analyses.","authors":"Mihir Khunte, Yashaswini Singh","doi":"10.2214/AJR.25.32738","DOIUrl":"10.2214/AJR.25.32738","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569050","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-Based Selection for Invasive Mediastinal Staging in Nonsmall Cell Lung Cancer: Role of Preoperative Imaging.","authors":"Yeon Joo Jeong","doi":"10.2214/AJR.25.32890","DOIUrl":"https://doi.org/10.2214/AJR.25.32890","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569075","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":"Sustainability in Radiology: Global Perspectives on Greener Healthcare-<i>AJR</i> Podcast Series on Sustainability, Episode 5.","authors":"Sean Woolen, Christopher P Hess, Elmar M Merkle, Charles Goh","doi":"10.2214/AJR.25.32864","DOIUrl":"https://doi.org/10.2214/AJR.25.32864","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569076","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":"Transparency and Stakeholder Engagement as Cornerstones for Effective Quality Initiatives in Medical Imaging.","authors":"Kishore Rajendran","doi":"10.2214/AJR.25.32859","DOIUrl":"https://doi.org/10.2214/AJR.25.32859","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569077","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":"Factors Associated With Aborted Whipple Procedures for Periampullary Carcinoma: A Multicenter Case-Control Study by the SAR Pancreatic Ductal Adenocarcinoma Disease Focus Panel.","authors":"Christian B van der Pol, Mustafa Sabil, Madeline Komar, Leyo Ruo, Jéssyca Silva, Lawrence Mbuagbaw, Joy Liau, Rina Nguyen, Andrew Chung, Zoe Hu, Sulaiman Nanji, Lyndon Luk, Michael D Kluger, Linda Chu, Atif Zaheer, Hamza A Ibad, Jin He, Chenchan Huang, Linda Le, Brock Hewitt, Zhen Jane Wang, Marc Zins, Sumit Rana, Benjamin Angliviel, Jena N Depetris, Samuel J Galgano, Candice W Bolan, Erik Soloff, Hina Arif-Tiwari, Avinash Kambadakone, Richard Kinh Gian Do, Elizabeth M Hecht","doi":"10.2214/AJR.24.32160","DOIUrl":"10.2214/AJR.24.32160","url":null,"abstract":"<p><p><b>Background:</b> A number of patients with periampullary carcinoma deemed resectable on preoperative CT have their curative-intent surgery aborted on the basis of intraoperative findings. <b>Objective:</b> This study sought to identify imaging and clinical factors associated with aborted curative-intent Whipple procedures for periampullary adenocarcinoma. <b>Methods:</b> Ten U.S., Canadian, and French institutions contributed data to this retrospective case-control study of 360 adults (220 men, 140 women; mean age, 68.6 ± 8.4 [SD] years) with periampullary adenocarcinoma who underwent curative-intent Whipple procedures between January 2016 and December 2022. A total of 180 patients for whom the procedure was aborted (cases) were matched by sex and 5-year age blocks with 180 patients for whom the procedure was completed (controls). Covariates included cancer type, tumor size and resectability on CT, CT reconstruction slice thickness including by phase, number of phases, multiplanar imaging, reconstruction at the workstation, possible metastases reported, structured versus unstructured report, reporting radiologist's experience, hepatic steatosis, preoperative liver MRI, endoscopic ultrasound, ERCP, multidisciplinary review, neoadjuvant therapy and response, and serum CA 19-9 and CEA levels. Logistic regression was performed with ORs and 95% CIs. <b>Results:</b> Whipple procedures were most frequently aborted due to metastases (67% [121/180]), followed by locally unresectable disease (28% [50/180]). Serum CA 19-9 levels of 37 U/mL or more were associated with aborted Whipple procedures with an OR of 3.75 (95% CI, 1.22-12.77) that increased to 5.47 (95% CI, 1.80-18.62) when a cutoff of 200 U/mL was applied. CT slice thickness ranged from 0.5 mm to 5 mm. CT examinations that used only slice thicknesses of 2.5 mm or more were independently associated with aborted Whipple procedures (OR = 4.28 [95% CI, 1.37-15.00]), including when assessing only pancreatic ductal adenocarcinoma. No other variables showed statistically significant association. <b>Conclusion:</b> Elevated serum CA 19-9 levels and preoperative CT using only slice thickness of 2.5 mm or more were associated with aborted curative-intent Whipple procedures. Many other imaging and clinical factors did not show an association. <b>Clinical Impact:</b> If curative-intent surgery is planned in patients with periampullary carcinoma, preoperative CT should be performed using reconstructions smaller than 2.5 mm to reduce the likelihood of incorrect staging.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569040","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}