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Radiological extranodal extension in head and neck cancers: current evidence and challenges in imaging detection and prognostic impact. 头颈部肿瘤的淋巴结外延伸:影像学检测和预后影响的现有证据和挑战。
IF 2.1
BJR open Pub Date : 2025-08-26 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf021
Nivedita Chakrabarty, Abhishek Mahajan
{"title":"Radiological extranodal extension in head and neck cancers: current evidence and challenges in imaging detection and prognostic impact.","authors":"Nivedita Chakrabarty, Abhishek Mahajan","doi":"10.1093/bjro/tzaf021","DOIUrl":"10.1093/bjro/tzaf021","url":null,"abstract":"<p><p>Extranodal extension (ENE) is an established adverse prognostic indicator for head and neck cancers (HNC), and its presence entails adjuvant chemoradiotherapy, hence, it had been incorporated for the first time as the advanced regional node N3b category in the 8th edition of the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) Tumour Node Metastasis (TNM) classification for cancers of the oral cavity, human papillomavirus-negative oropharynx, hypopharynx, larynx and major salivary gland carcinomas. Pathological ENE is available for cases which are operated on, but cases which are managed non-surgically or unfit for surgery rely on imaging for providing the information on ENE, and this has prompted researchers across the globe to devise radiological grading for ENE. Radiological ENE has finally been given due credit and incorporated in the 9th version of AJCC TNM staging for nasopharyngeal carcinoma, which came into effect from January 2025. Knowledge of ENE status on baseline imaging prior to operation also helps in counselling patients regarding prognosis and planning adjuvant treatment. In this article, we have comprehensively reviewed the radiological/imaging ENE (rENE/iENE) grading proposed by researchers worldwide, extensively reviewed the existing evidence and challenges of using rENE/iENE for staging, grading, prognosticating and treating HNC, and also discussed the future scope of using rENE/iENE for managing patients with HNC of all the subsites, including thyroid cancers. Artificial intelligence-based studies for predicting rENE/iENE have also been discussed briefly.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf021"},"PeriodicalIF":2.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a biological at-risk volume using apparent diffusion coefficient for parotid-sparing radiation therapy planning. 利用表观扩散系数制定保甲状腺放射治疗计划的生物危险体积。
IF 2.1
BJR open Pub Date : 2025-08-13 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf020
Katelyn Cahill, Catriona Hargrave, Patrick O'Connor, Mark Denham, Nathan Hearn, Dinesh Vignarajah, Zack Y Shan, Myo Min
{"title":"Development of a biological at-risk volume using apparent diffusion coefficient for parotid-sparing radiation therapy planning.","authors":"Katelyn Cahill, Catriona Hargrave, Patrick O'Connor, Mark Denham, Nathan Hearn, Dinesh Vignarajah, Zack Y Shan, Myo Min","doi":"10.1093/bjro/tzaf020","DOIUrl":"10.1093/bjro/tzaf020","url":null,"abstract":"<p><strong>Objectives: </strong>Xerostomia toxicity continues to contribute towards a decrease in quality of life in head and neck cancer patients. Diffusion weighted MRI and the associated apparent diffusion coefficient (ADC) may identify the radiosensitive region within the parotid gland (PG). This study retrospectively assesses the feasibility of using percentile threshold values from the ADC map to generate a biological at-risk volume (BRV). The location and distribution of BRV are evaluated across the PG.</p><p><strong>Methods: </strong>Image registration between the planning CT and MRI-simulation images was performed and reviewed to ensure accurate translation of ADC data when contouring the PG. Histogram analysis was undertaken using the 20th, 30th, and 50th percentile ADC values of each contoured PG to form the BRV. The whole PG was split into 8 anatomical sectors at a common intersection point to evaluate the distribution of BRV throughout.</p><p><strong>Results: </strong>The BRV distribution for each percentile was mapped across the whole contoured PG and each anatomical sector contour. The largest distribution was predominantly found in the superolateral sectors.</p><p><strong>Conclusions: </strong>The 20th and 30th percentile ADC values can be used to form a BRV of the PG. The location of the BRV distribution indicates a potential relationship between ADC thresholds and the functional region of the PG.</p><p><strong>Advances in knowledge: </strong>The BRV is located in a favourable position within the PG and could be used to further spare this salivary gland during dose optimization. The feasibility of this approach will be explored in a future retrospective dosimetry study.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf020"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Progressive pulmonary fibrosis: current perspectives in diagnostic imaging. 进行性肺纤维化:诊断影像学的最新观点。
IF 2.1
BJR open Pub Date : 2025-07-24 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf018
Prerana Agarwal, Christopher L Schlett, Fabian Bamberg, Björn C Frye
{"title":"Progressive pulmonary fibrosis: current perspectives in diagnostic imaging.","authors":"Prerana Agarwal, Christopher L Schlett, Fabian Bamberg, Björn C Frye","doi":"10.1093/bjro/tzaf018","DOIUrl":"10.1093/bjro/tzaf018","url":null,"abstract":"<p><p>A subset of patients with interstitial lung diseases (ILDs) experiences disease progression despite standard treatment protocols. Similar to idiopathic pulmonary fibrosis, the archetype of progressive fibrotic ILDs, these patients exhibit worsening clinical symptoms, declining lung function, and progressive radiological changes, often resulting in shortened survival. This progressive disease pattern is classified under the term progressive pulmonary fibrosis or progressive fibrosing ILD. Radiological imaging, particularly high-resolution computed tomography (HRCT), is integral to diagnosing ILDs and plays a critical role within multidisciplinary ILD boards. HRCT is instrumental in identifying patients at a higher risk for disease progression and may provide valuable prognostic insights. Additionally, serial imaging is essential for detecting progression over time. While visual assessment remains the primary method for evaluating disease advancement, emerging quantitative techniques, including those utilizing machine learning, are currently undergoing validation.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf018"},"PeriodicalIF":2.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diffusion weighted imaging in musculoskeletal system: where are we now? 扩散加权成像在肌肉骨骼系统:我们现在在哪里?
IF 2.1
BJR open Pub Date : 2025-07-22 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf019
Sonal Saran, Avneesh Chhabra, Rajesh Botchu
{"title":"Diffusion weighted imaging in musculoskeletal system: where are we now?","authors":"Sonal Saran, Avneesh Chhabra, Rajesh Botchu","doi":"10.1093/bjro/tzaf019","DOIUrl":"10.1093/bjro/tzaf019","url":null,"abstract":"<p><p>Diffusion-weighted imaging (DWI) is an advanced MRI technique that harnesses the movement of water molecules within tissues to assess and characterize a wide range of musculoskeletal disorders. By differentiating between isotropic and anisotropic diffusion, DWI provides critical insights into tissue integrity and pathology, proving instrumental in diagnosing conditions. Its sensitivity to changes in tissue microstructure is quantified through metrics like the apparent diffusion coefficient (ADC) and fractional anisotropy (FA). Advanced methodologies, including diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI), further enhance DWI's ability to evaluate complex tissue architectures, offering vital information on muscle, ligament, tendon, and cartilage health. DWI also excels in the assessment of soft tissue tumours, infections, and joint pathologies, enabling accurate differentiation between benign and malignant lesions and facilitating early detection of conditions like osteomyelitis. Additionally, DWI plays a crucial role in monitoring treatment responses, with ADC changes correlating to tumour necrosis and recurrence. Despite its advantages, DWI faces limitations, such as technical artefacts and challenges in interpretation that can impact diagnostic accuracy. This review explores the diverse applications of DWI and DTI in musculoskeletal imaging, highlighting their potential to improve diagnostic precision and clinical outcomes while addressing ongoing challenges in the field.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf019"},"PeriodicalIF":2.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiological phenotypes in pulmonary sarcoidosis: a reliability study of newly defined high-resolution computer tomography phenotypes. 肺结节病的放射学表型:新定义的高分辨率计算机断层扫描表型的可靠性研究。
BJR open Pub Date : 2025-06-25 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf017
Julie Van Woensel, Jasenko Krdzalic, Tom de Jaegere, Marlou T H F Janssen, Sofia Ramiro, César Magro Checa, Robert B M Landewé, Rémy L M Mostard
{"title":"Radiological phenotypes in pulmonary sarcoidosis: a reliability study of newly defined high-resolution computer tomography phenotypes.","authors":"Julie Van Woensel, Jasenko Krdzalic, Tom de Jaegere, Marlou T H F Janssen, Sofia Ramiro, César Magro Checa, Robert B M Landewé, Rémy L M Mostard","doi":"10.1093/bjro/tzaf017","DOIUrl":"10.1093/bjro/tzaf017","url":null,"abstract":"<p><strong>Objectives: </strong>An accurate morphological classification of distinct pulmonary phenotypes in sarcoidosis is lacking. Recently, a multinational Delphi study was conducted to reach a consensus on recognizable high-resolution computer tomography (HRCT) phenotypes in pulmonary sarcoidosis as a basis for a more distinctive classification. The reliability of these phenotypes has not yet been evaluated.</p><p><strong>Methods: </strong>HRCT scans of adult sarcoidosis patients from the pulmonology department of a single sarcoidosis referral center were scored by three blinded independent readers. Seven phenotypes were distinguished as described in the Delphi study. They were divided into two subgroups: \"non-fibrotic\" and \"likely-to-be fibrotic\". Intra- and inter-reader reliability for scoring the predominant phenotype and the subgroup was assessed using weighted Kappa (K<sub>w</sub>) statistics.</p><p><strong>Results: </strong>Forty-five patients (mean age, 47 years ± 12, 28 men) were included. For the scoring of the predominant phenotype, inter-reader reliability between all readers was substantial with an overall Fleiss' kappa of 0.69 (CI 0.622-0.765, <i>P</i> < .001). We observed a substantial inter-reader reliability between readers A and B (<i>K</i> <sub>w</sub> of 0.76), between readers B and C (K<sub>w</sub> of 0.66) and between readers A and C (<i>K</i> <sub>w</sub> of 0.66). For the scoring of the subgroups \"non-fibrotic\" vs. \"likely-to-be fibrotic,\" overall Fleiss' Kappa was substantial (<i>K</i> = 0.78, CI 0.607-0.944, <i>P</i> < .001). We observed a <i>K</i> <sub>w</sub> score of 0.76 between readers A and B; 0.81 between readers A and C; 0.76 between readers B and C. Intra-reader reliability was substantial between the scores of A in scoring the predominant phenotypes (<i>K</i> <sub>w</sub> of 0.71) and it was almost perfect in scoring the subgroups (<i>K</i> <sub>w</sub> of 0.95). Intra-reader reliability was substantial between the scores of B in scoring the predominant phenotype (<i>K</i> <sub>w</sub> of 0.66) and subgroups (<i>K</i> <sub>w</sub> of 0.72).</p><p><strong>Conclusions: </strong>The inter- and intra-reader reliability of the newly proposed HRCT phenotypes obtained from the Delphi study is very acceptable.</p><p><strong>Advances in knowledge: </strong>This study is the first to assess the reliability of these HRCT phenotypes and supports the use of them for classification purposes in future clinical and pathogenetic studies.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf017"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Being a radiation oncologist: times of crisis for European graduates. 成为一名放射肿瘤学家:欧洲毕业生的危机时期。
BJR open Pub Date : 2025-06-09 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf016
Federico Gagliardi, Emma D'Ippolito, Roberta Grassi, Angelo Sangiovanni, Vittorio Salvatore Menditti, Dino Rubini, Paolo Gallo, Luca D'Ambrosio, Massimo Minerva, Viola Salvestrini, Francesca De Felice, Giuseppe Carlo Iorio, Antonio Piras, Luca Nicosia, Gian Marco Petrianni, Luca Boldrini, Valerio Nardone
{"title":"Being a radiation oncologist: times of crisis for European graduates.","authors":"Federico Gagliardi, Emma D'Ippolito, Roberta Grassi, Angelo Sangiovanni, Vittorio Salvatore Menditti, Dino Rubini, Paolo Gallo, Luca D'Ambrosio, Massimo Minerva, Viola Salvestrini, Francesca De Felice, Giuseppe Carlo Iorio, Antonio Piras, Luca Nicosia, Gian Marco Petrianni, Luca Boldrini, Valerio Nardone","doi":"10.1093/bjro/tzaf016","DOIUrl":"10.1093/bjro/tzaf016","url":null,"abstract":"<p><p>This study examines the shortage of radiation oncologists in Italy and Europe, analysing systemic challenges in postgraduate training and proposing solutions to enhance the appeal of radiation oncology. A review of literature from Italy and Europe evaluated trends in training programmes, workforce dynamics. Analysis included residency vacancies, economic constraints, training disparities, and visibility of the field during medical education. In Italy, 55.3% of radiation oncology residency positions have gone unfilled or been abandoned since 2016, with 90% of positions vacant in 2023. Contributing factors include inadequate exposure to radiotherapy during medical training, limited financial opportunities, negative societal perceptions, and high levels of burnout. Across Europe, similar challenges persist. Training disparities, outdated infrastructure, and regional inequalities exacerbate workforce shortages, particularly in low-income countries. Addressing the radiation oncology crisis requires a multifaceted strategy, including enhancing visibility of the field in medical education, improving working conditions, offering financial incentives, and addressing disparities in training quality across Europe. The European radiotherapist shortage is a systemic issue requiring coordinated efforts to standardize training, address economic barriers, and improve the specialty's appeal. By fostering collaboration and reform, European nations can meet the growing demand for cancer care and secure a sustainable workforce for the future.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf016"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial intelligence for cardiac imaging is ready for widespread clinical use: Pro Con debate AI for cardiac imaging. 人工智能心脏成像已准备好广泛的临床应用:赞成辩论人工智能心脏成像。
IF 2.1
BJR open Pub Date : 2025-06-06 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf015
Domenico Mastrodicasa, Marly van Assen
{"title":"Artificial intelligence for cardiac imaging is ready for widespread clinical use: Pro Con debate AI for cardiac imaging.","authors":"Domenico Mastrodicasa, Marly van Assen","doi":"10.1093/bjro/tzaf015","DOIUrl":"10.1093/bjro/tzaf015","url":null,"abstract":"<p><p>Artificial intelligence (AI) has made significant strides in cardiac imaging, offering advancements in image acquisition, risk prediction, and workflow automation. However, its readiness for widespread clinical adoption remains debated. This review explores both sides of the argument across key domains. It discusses the advantages and challenges of AI for cardiac imaging regarding pre-and post-processing, risk-stratification and prognostication, workflow augmentation, regulatory and ethical frameworks, and cost-effectiveness of AI tools. It will discuss the diagnostic accuracy shown by AI for automated measurements, improved image quality and workflow efficiency with AI-driven worklist prioritization. The potential of personalized care using AI-based prognostic models. It discusses regulatory frameworks for approving AI tools, while ethical frameworks to ensure safe and ethical use of AI are being implemented, simultaneously reimbursement is becoming available, signalling growing trust in their safety and efficacy. It also addresses the challenges AI has yet to overcome, such as the lack of generalizability across diverse populations, limited availability of outcome data and cost-efficacy studies. Despite progress, regulatory and ethical frameworks still struggle to keep pace with AI's rapid evolution, raising concerns about accountability, patient safety, bias, data privacy, and algorithmic transparency.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf015"},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Myelin mapping in patients with rheumatoid arthritis-related fatigue: a TBSS-MTR study of integrity. 类风湿性关节炎相关疲劳患者髓磷脂图谱:一项完整的tss - mtr研究
BJR open Pub Date : 2025-05-24 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf014
Maryam Alhashim, Neil Basu, Alison Murray, Gordon Waiter
{"title":"Myelin mapping in patients with rheumatoid arthritis-related fatigue: a TBSS-MTR study of integrity.","authors":"Maryam Alhashim, Neil Basu, Alison Murray, Gordon Waiter","doi":"10.1093/bjro/tzaf014","DOIUrl":"10.1093/bjro/tzaf014","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) patients frequently report fatigue, which notably diminishes their quality of life. Emerging research points to a correlation between inflammation-induced fatigue and brain structural alterations.</p><p><strong>Objectives: </strong>This study evaluates the variance in myelin integrity among patients with RA-related fatigue, investigating the potential of magnetization transfer ratio (MTR) as a biomarker, in comparison with healthy controls.</p><p><strong>Methods: </strong>A prospective cohort analysis was conducted comprised 60 RA patients with fatigue, categorized into active (<i>n</i> = 30) and non-active (<i>n</i> = 30) disease states, alongside 20 healthy controls (HC). A 3 Tesla MRI system was utilized to perform diffusion tensor imaging (DTI) and magnetization transfer imaging (MTI) sequences. MTR maps were generated using in-house MATLAB code and co-registered with DTI data using SPM8. These were then analyzed through tract-based spatial statistics (TBSS) with threshold-free cluster enhancement (TFCE) and corrected for multiple comparisons. MTR values were assessed using Randomize from the FSL toolkit, applying a general linear model (GLM) for voxel-wise analysis and TFCE for p-value generation, with family-wise error (FWE) control (<i>P</i> < .05) for multiple comparisons.</p><p><strong>Results: </strong>The RF group exhibited significantly lower myelin integrity (TFCE, <i>P</i> < .05) compared to HCs, particularly in the middle cerebellar peduncle and splenium of the corpus callosum, with no marked difference between active and non-active RA disease statuses. There is a discernible disparity in myelin integrity between RA patients with fatigue and healthy individuals, suggesting microstructural white matter alterations that are congruent with DTI findings.</p><p><strong>Conclusion: </strong>This study reveals that rheumatoid arthritis (RA) patients with fatigue exhibit significantly lower myelin integrity, particularly in the middle cerebellar peduncle and splenium of the corpus callosum, compared to healthy controls. Notably, this finding was consistent regardless of the active or non-active status of the RA disease, highlighting persistent white matter alterations in this patents cohort.</p><p><strong>Advances in knowledge: </strong>The research demonstrates that magnetization transfer ratio (MTR) imaging can effectively map microstructural changes in RA patients with fatigue, suggesting its potential as a biomarker for assessing white matter integrity in this condition. While it does not establish a direct causal relationship, it provides valuable insights into the role of MTR mapping in understanding brain alterations in patients with fatigue-related RA.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf014"},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding the variation of modern endoscopic ultrasound use in patients with oesophageal cancer (VALUE): protocol for a multi-methods study. 了解食管癌患者现代内镜超声使用的变化(VALUE):一项多方法研究的方案。
BJR open Pub Date : 2025-05-21 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf012
Kieran G Foley, Cherish Boxall, James Franklin, Andrew Cook, Tim Underwood, Gareth Griffiths, Kelly Cozens, Katherine Bradbury, Margaret Fay, David Chuter, Kerry-Ann Longman, Ben Lindfield, Chris Hurt
{"title":"Understanding the variation of modern endoscopic ultrasound use in patients with oesophageal cancer (VALUE): protocol for a multi-methods study.","authors":"Kieran G Foley, Cherish Boxall, James Franklin, Andrew Cook, Tim Underwood, Gareth Griffiths, Kelly Cozens, Katherine Bradbury, Margaret Fay, David Chuter, Kerry-Ann Longman, Ben Lindfield, Chris Hurt","doi":"10.1093/bjro/tzaf012","DOIUrl":"10.1093/bjro/tzaf012","url":null,"abstract":"<p><strong>Objectives: </strong>Over 9000 patients are diagnosed with oesophageal cancer annually in the United Kingdom (UK). Decision-making about treatment options is influenced by radiological staging, which may include computed tomography (CT), positron emission tomography (PET), and endoscopic ultrasound (EUS). The use of EUS varies considerably around the UK and, since the introduction of PET-CT, the added value of EUS has been questioned. The VALUE study aims to understand this variation and determine how often and why EUS changes treatment decisions. VALUE will also evaluate patient and clinician experiences and opinions of EUS.</p><p><strong>Methods: </strong>This is a prospective, observational study investigating EUS in oesophageal cancer staging. Patients will be recruited at up to eleven sites in the UK, where they will be consented (if eligible) and registered onto iMedidata RAVE. Clinical and demographic data, TNM staging, pre and post EUS treatment decisions, and complications will be collected. We will attempt to sample patients from ethnic minority backgrounds in the study population, as they are underrepresented in research. Up to 30 patients and 30 clinicians will be interviewed to evaluate the use of EUS and experiences of both patient and clinician. The primary endpoint is the proportion of cases that EUS changes treatment decisions. Secondary endpoints include identification of factors that clinicians' and patients consider when deciding if EUS should be used, the time from diagnosis to treatment decision before and after EUS, and the reasons why EUS changed management. The study has been registered on Clinicaltrials.gov: NCT06440174. The trial is open to recruitment.</p><p><strong>Results: </strong>In total, 180 patients with potentially curable oesophageal cancer who are suitable for EUS will participate. Recruitment is currently planned until September 2025 and study results will be reported after June 2026.</p><p><strong>Conclusion: </strong>The VALUE study will enable a better understanding of how and why EUS is used in oesophageal cancer. This research will identify important factors that clinicians and patients consider when deciding EUS use and determine the frequency that EUS changes treatment decisions in the modern staging pathway.</p><p><strong>Advances in knowledge: </strong>The VALUE study is a prospective, multi-centre observational study investigating the use of EUS in the modern era of oesophageal cancer staging. The study aims to determine how often and why EUS changes treatment decisions. A qualitative component will explore both clinician and patient attitudes towards EUS.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf012"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Imaging patterns and recommendations for diagnosis, staging, and management of lung cancer. 肺癌的诊断、分期和治疗的影像学模式和建议。
BJR open Pub Date : 2025-05-21 eCollection Date: 2025-01-01 DOI: 10.1093/bjro/tzaf013
Nivedita Chakrabarty, Abhishek Mahajan, Nitin Shetty, Naveen Mummudi, Devyani Niyogi, Falguni Hota, Deepak Dabkara, Reefath Jebraj, Nilendu Purandare, Vanita Noronha, Ashu Bhalla, Kumar Prabhash
{"title":"Imaging patterns and recommendations for diagnosis, staging, and management of lung cancer.","authors":"Nivedita Chakrabarty, Abhishek Mahajan, Nitin Shetty, Naveen Mummudi, Devyani Niyogi, Falguni Hota, Deepak Dabkara, Reefath Jebraj, Nilendu Purandare, Vanita Noronha, Ashu Bhalla, Kumar Prabhash","doi":"10.1093/bjro/tzaf013","DOIUrl":"10.1093/bjro/tzaf013","url":null,"abstract":"<p><p>Lung cancer is the second most commonly diagnosed cancer worldwide. In the present era of targeted therapy for various lung cancer mutations, it is essential to be aware of the imaging correlates of various lung cancer mutations on contrast enhanced computed tomography of thorax. In this article, we have discussed the imaging patterns of various types of lung cancer including different mutations and also comprehensively reviewed the imaging recommendations (National Comprehensive Cancer Network [NCCN], European Society of Medical Oncology [ESMO] and American Society of Clinical Oncology [ASCO]) and management guidelines of lung cancer (non-small cell, small cell and other neuroendocrine tumours). We have also discussed guidelines for screening, diagnosis, staging (recent 9th edition tumour node metastasis [TNM]), treatment response evaluation, and follow up. Role of interventional radiology in the treatment of primary lung cancer, lung metastasis, and management of posttreatment complications, have also been described in detail in this article. In addition, current status of artificial intelligence in lung cancer has also been briefly discussed.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf013"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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