American Journal of Roentgenology最新文献

{"title":"The Impact of MRI-Based Advanced Neuroimaging on Neurooncologists' Clinical Decision-Making in Patients With Posttreatment High-Grade Glioma: A Prospective Survey-Based Study.","authors":"Samir A Dagher, Ho-Ling Liu, Burak Berksu Ozkara, Susana Calle, Diana Kaya, Maria K Gule-Monroe, Noah N Chasen, Dawid Schellingerhout, Kim O Learned, Komal B Shah, Jason M Johnson, Jia Sun, Donald F Schomer, Vinodh A Kumar, Max Wintermark, Nazanin K Majd, Joo Yeon Nam, Melissa M Chen","doi":"10.2214/AJR.24.31595","DOIUrl":"10.2214/AJR.24.31595","url":null,"abstract":"<p><p><b>BACKGROUND.</b> Advanced MRI-based neuroimaging techniques, such as perfusion and spectroscopy, have been increasingly incorporated into routine follow-up protocols in patients treated for high-grade glioma (HGG), to help differentiate tumor progression from treatment effect. However, these techniques' influence on clinical management remains poorly understood. <b>OBJECTIVE.</b> The purpose of this article was to evaluate the impact of MRI-based advanced neuroimaging on clinical decision-making in patients with HGG after treatment. <b>METHODS.</b> This prospective study, performed at a comprehensive cancer center from March 1, 2017, to October 31, 2020, included adult patients treated by chemoradiation for WHO grade 4 diffuse glioma who underwent MRI-based advanced neuroimaging (comprising multiple perfusion imaging sequences and spectroscopy) to further evaluate findings on conventional MRI equivocal for tumor progression versus treatment effect. The ordering neurooncologists completed surveys before and after each advanced neuroimaging session. The percent of episodes of care with a change between the intended and actual management plan on the surveys conducted before and after advanced neuroimaging, respectively, was computed and compared with a published percent using the Wald test for independent samples proportions. <b>RESULTS.</b> The study included 63 patients (mean age, 54.6 ± 12.9 [SD] years; 36 women, 27 men) who underwent 70 advanced neuroimaging sessions. Ordering neurooncologists' intended and actual management plans on the surveys completed before and after advanced neuroimaging, respectively, differed in 44% (31/70; 95% CI: 33-56%) of episodes, which differed from the published frequency of 8.5% (5/59) (<i>p</i> < .001). These management plan changes included selection of a different plan for six of eight episodes with an intended plan to enroll patients in a clinical trial, 12 of 19 episodes with an intended plan to change chemotherapeutic agents, four of eight episodes with an intended plan of surgical intervention, and one of two episodes with an intended plan of reirradiation. The ordering neurooncologists found advanced neuroimaging to be helpful in 93% (65/70; 95% CI: 87-99%) of episodes. <b>CONCLUSION.</b> Neurooncologists' management plans changed in a substantial fraction of adult patients with HGG who underwent advanced neuroimaging to further evaluate conventional MRI findings equivocal for tumor progression versus treatment effect. <b>CLINICAL IMPACT.</b> The findings support incorporation of advanced neuroimaging into HGG posttreatment monitoring protocols.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977289","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 Role of Data in Radiology's Green Transformation: <i>AJR</i> Podcast Series on Sustainability, Episode 2.","authors":"Sean Woolen, Katherine Maturen","doi":"10.2214/AJR.24.31994","DOIUrl":"10.2214/AJR.24.31994","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127471","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":"Pitfalls in Interpretive Applications of Artificial Intelligence in Radiology.","authors":"Shima Behzad, Seyed M Hossein Tabatabaei, Max Y Lu, Liesl S Eibschutz, Ali Gholamrezanezhad","doi":"10.2214/AJR.24.31493","DOIUrl":"10.2214/AJR.24.31493","url":null,"abstract":"<p><p>Interpretive artificial intelligence (AI) tools are poised to change the future of radiology. However, certain pitfalls may pose particular challenges for optimal AI interpretative performance. These include anatomic variants, age-related changes, postoperative changes, medical devices, image artifacts, lack of integration of prior and concurrent imaging examinations and clinical information, and the satisfaction-of-search effect. Model training and development should account for such pitfalls to minimize errors and optimize interpretation accuracy. More broadly, AI algorithms should be exposed to diverse and complex training datasets to yield a holistic interpretation that considers all relevant information beyond the individual examination. Successful clinical deployment of AI tools will require that radiologist end users recognize these pitfalls and other limitations of the available models. Furthermore, developers should incorporate explainable AI techniques (e.g., heat maps) into their tools, to improve radiologists' understanding of model outputs and to enable radiologists to provide feedback for guiding continuous learning and iterative refinement. In this article, we provide an overview of common pitfalls that radiologists may encounter when using interpretive AI products in daily practice. We present how such pitfalls lead to AI errors and offer potential strategies that AI developers may use for their mitigation.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753463","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: Percutaneous Cryoablation Can Safely Control Foci of Treatment-Refractory Soft-Tissue Sarcoma.","authors":"Fabio Zecca","doi":"10.2214/AJR.24.31841","DOIUrl":"10.2214/AJR.24.31841","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899046","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: Radiologists Must Recognize the Limitations of Current Interpretative Artificial Intelligence Applications.","authors":"Antonio Luna","doi":"10.2214/AJR.24.31842","DOIUrl":"10.2214/AJR.24.31842","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899047","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":"Differentiation of Hepatocellular Adenoma Subtypes and Focal Nodular Hyperplasia on Gadoxetate Disodium-Enhanced MRI: An Updated Diagnostic Algorithm.","authors":"Jennie J Cao, Luyao Shen, Luke Yoon, Aya Kamaya, Justin R Tse","doi":"10.2214/AJR.24.31628","DOIUrl":"10.2214/AJR.24.31628","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629343","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":"Oral CT Contrast Agents: What's New and Why, From the <i>AJR</i> Special Series on Contrast Media.","authors":"Maurice M Heimer, Yuxin Sun, Peter J Bonitatibus, Benjamin M Yeh","doi":"10.2214/AJR.23.29970","DOIUrl":"10.2214/AJR.23.29970","url":null,"abstract":"<p><p>Current CT oral contrast agents improve the conspicuity of and confidence in bowel and peritoneal findings in many clinical scenarios, particularly for outpatient and oncologic abdominopelvic imaging. Yet, existing positive and neutral oral contrast agents may diminish the detectability of certain radiologic findings, frequently in the same scans in which the oral contrast agent improves the detectability of other findings. With ongoing improvements in CT technology, particularly multienergy CT, opportunities are opening for new types of oral contrast agents to further improve anatomic delineation and disease detection using CT. The CT signal of new dark oral contrast agents and of new high-<i>Z</i> oral contrast agents promises to combine the strengths of both positive and neutral oral CT contrast agents by providing distinct CT appearances in comparison with bodily tissues, iodinated IV contrast agents, and other classes of new CT contrast agents. High-<i>Z</i> oral contrast agents will unlock previously inaccessible capabilities of multienergy CT, particularly photon-counting detector CT, for differentiating simultaneously administered IV and oral contrast agents; this technique will allow generation of rich 3D, intuitive, perfectly coregistered, high-resolution image sets with individual contrast agent \"colors\" that provide compelling clarity for intertwined intraabdominal anatomy and disease processes.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159410","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>: Liver MRI Alters Treatment Plans in Select Patients With Colorectal Liver Metastasis.","authors":"Katerina Konstantinoff, Tyler J Fraum","doi":"10.2214/AJR.24.31006","DOIUrl":"10.2214/AJR.24.31006","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914136","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":"¹⁸F-Labeled Fluoroestradiol PET/CT: Current Status, Gaps in Knowledge, and Controversies-<i>AJR</i> Expert Panel Narrative Review.","authors":"Matthew F Covington, Sophia R O'Brien, Courtney Lawhn-Heath, Austin R Pantel, Gary A Ulaner, Hannah M Linden, Farrokh Dehdashti","doi":"10.2214/AJR.23.30330","DOIUrl":"10.2214/AJR.23.30330","url":null,"abstract":"<p><p>PET/CT using 16α-[¹⁸F]-fluoro-17β-estradiol (FES) noninvasively images tissues expressing estrogen receptors (ERs). FES has undergone extensive clinicopathologic validation for ER-positive breast cancer and in 2020 received FDA approval for clinical use as an adjunct to biopsy in patients with recurrent or metastatic ER-positive breast cancer. Clinical use of FES PET/CT is increasing but is not widespread in the United States. This <i>AJR</i> Expert Panel Narrative Review explores the present status and future directions of FES PET/CT, including image interpretation, existing and emerging uses, knowledge gaps, and current controversies. Specific controversies discussed include whether both FES PET/CT and FDG PET/CT are warranted in certain scenarios, whether further workup is required after negative FES PET/CT results, whether FES PET/CT findings should inform endocrine therapy selection, and whether immunohistochemistry should remain the stand-alone reference standard for determining ER status for all breast cancers. Consensus opinions from the panel include agreement with the appropriate clinical uses of FES PET/CT published by a multidisciplinary expert work group in 2023, anticipated expanded clinical use of FES PET/CT for staging ER-positive invasive lobular carcinomas and low-grade invasive ductal carcinomas pending ongoing clinical trial results, and the need for further research regarding the use of FES PET/CT for nonbreast malignancies expressing ER.</p>","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809752","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>: CT-Based Virtual Biopsy in Retroperitoneal Soft-Tissue Sarcomas.","authors":"Paolo Spinnato, Giuseppe Bianchi","doi":"10.2214/AJR.24.30965","DOIUrl":"10.2214/AJR.24.30965","url":null,"abstract":"","PeriodicalId":55529,"journal":{"name":"American Journal of Roentgenology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984640","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}