BJR open最新文献

{"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}

{"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}

{"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}

{"title":"The effects of anti-PD-1 therapy on programmed death-ligand 1 expression and glucose metabolism of normal organs in patients with advanced non-small cell lung cancer.","authors":"Matthew Severyn, Eunice H L Lee, Gitasha Chand, Jessica Johnson, Damion Bailey, Kathryn Adamson, Vicky Goh, Daniel Johnathan Hughes, Gary J R Cook","doi":"10.1093/bjro/tzaf010","DOIUrl":"10.1093/bjro/tzaf010","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate how anti-PD-1 treatment affects both Programmed Death-Ligand 1 (PD-L1) expression and glucose metabolism within normal tissues of advanced non-small cell lung cancer (NSCLC) patients using a dual SPECT/CT and PET/CT imaging approach.</p><p><strong>Methods: </strong>Ten advanced NSCLC patients (NCT04436406) undergoing anti-PD-1 therapy ± chemotherapy underwent imaging at baseline and 9 weeks. PD-L1 expression was measured using [^99mTc]-labelled single-domain PD-L1 antibody single-photon emission computed tomography/computed tomography ([^99mTc]NM-01 SPECT/CT). Glucose uptake was measured using [¹⁸F]-Fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT). Two independent observers marked regions of interest across normal organs (liver, lung, spleen, bone marrow, muscle, kidney, pancreas, left ventricular myocardium, and blood pool) to determine maximum and mean standardized uptake values (SUV) at both time points. Observer agreement was measured with an intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>No significant changes in SUVs, indicating PD-L1 expression and glucose metabolism, were detected in normal organs after 9 weeks of treatment (all <i>P</i> > .05). No patients developed immune-related adverse events (irAEs) during the study period. Observer measurements showed excellent consistency with an ICC of 0.99 (95% confidence interval 0.99-0.99).</p><p><strong>Conclusions: </strong>Our study showed stable PD-L1 expression and glucose metabolism within normal organs in advanced NSCLC patients treated with anti-PD-1 therapy ± chemotherapy. Interobserver reliability between observers was excellent. Additional studies with larger patient groups and a specific focus on irAE cases are needed.</p><p><strong>Advances in knowledge: </strong>Through a dual-modality molecular imaging approach, this research provides novel insight into anti-PD-1 therapy's effects on PD-L1 expression and glucose metabolism in normal organs of NSCLC patients, demonstrating that these parameters remain stable post-treatment.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf010"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200872","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}

{"title":"A unified workflow for classifying patterns of locoregional failure using radiotherapy treatment planning dose distributions.","authors":"Ceilidh Welsh, Karl Harrison, Sara Lightowlers, Ian Gleeson, Alfred J W Beard, Emma Harris, Gillian C Barnett, Rajesh Jena","doi":"10.1093/bjro/tzaf007","DOIUrl":"10.1093/bjro/tzaf007","url":null,"abstract":"<p><strong>Objectives: </strong>This work describes a unified workflow for classifying patterns of locoregional recurrence (LRR) using radiotherapy planning dose distributions. This approach aims to incorporate dose parameters into LRR classifications and facilitate application across different treatment sites and dose prescriptions to standardise classification terminology.</p><p><strong>Methods: </strong>The relapse diagnostic CT (rCT) and manually delineated relapse gross tumour volume (rGTV) were co-registered with the radiotherapy planning CT (pCT) using deformable image registration (DIR). The DIR accuracy was quantified using the target registration error (TRE) using the absolute centroid distance between cancer site-specific regions of interest (ROIs). Dosimetric structures were delineated for planning regions receiving 95% of the dose prescribed to high-risk, intermediate-risk, and low-risk CTVs, relative to the cancer site or trial. The mapped rGTV was compared relative to each dose structure and classified into one of five categories: central and peripheral high-dose (Type A, Type B), central and peripheral elective-dose (Type C, Type D), and extraneous dose (Type E) failures.</p><p><strong>Results: </strong>The unified workflow was successfully implemented on two different patient use cases, one from the IMPORT HIGH breast cancer trial, one from the VoxTox head-and-neck study, classifying LRR as Type A and Type E failures, respectively.</p><p><strong>Conclusion: </strong>This workflow for classifying LRR is applicable across different cancer sites, despite differences in treatment protocol, target dose, and dose delivery. This provides a basis for utilising radiotherapy dose distributions to analyse patterns of failure irrespective of trial design or cancer-site.</p><p><strong>Advances in knowledge: </strong>Standardised classifications of LRR that are correlated with the planning dose distribution could provide insight into the underlying causes of LRR burden post-radiotherapy and allow for critical evaluation of the current concepts of defined clinical tumour volumes and optimal PTV dose regions.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf007"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509805","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}

{"title":"Quantitative assessment of lung opacities from CT of pulmonary artery imaging data in COVID-19 patients: artificial intelligence versus radiologist.","authors":"Ann Mari Svensson, Anna Kistner, Kristina Kairaitis, G Kim Prisk, Catherine Farrow, Terence Amis, Peter D Wagner, Atul Malhotra, Piotr Harbut","doi":"10.1093/bjro/tzaf008","DOIUrl":"https://doi.org/10.1093/bjro/tzaf008","url":null,"abstract":"<p><strong>Objectives: </strong>Artificial intelligence (AI) deep learning algorithms trained on non-contrast CT scans effectively detect and quantify acute COVID-19 lung involvement. Our study explored whether radiological contrast affects the accuracy of AI-measured lung opacities, potentially impacting clinical decisions. We compared lung opacity measurements from AI software with visual assessments by radiologists using CT pulmonary angiography (CTPA) images of early-stage COVID-19 patients.</p><p><strong>Methods: </strong>This prospective single-centre study included 18 COVID-19 patients who underwent CTPA due to suspected pulmonary embolism. Patient demographics, clinical data, and 30-day and 90-day mortality were recorded. AI tool (Pulmonary Density Plug-in, AI-Rad Companion Chest CT, SyngoVia; Siemens Healthineers, Forchheim, Germany) was used to estimate the quantity of opacities. Visual quantitative assessments were performed independently by 2 radiologists.</p><p><strong>Results: </strong>There was a positive correlation between radiologist estimations (<i>r</i> ² = 0.57) and between the AI data and the mean of the radiologists' estimations (<i>r</i> ² = 0.70). Bland-Altman plot analysis showed a mean bias of +3.06% between radiologists and -1.32% between the mean radiologist vs AI, with no outliers outside 2×SD for respective comparison.</p><p><p>The AI protocol facilitated a quantitative assessment of lung opacities and showed a strong correlation with data obtained from 2 independent radiologists, demonstrating its potential as a complementary tool in clinical practice.</p><p><strong>Conclusion: </strong>In assessing COVID-19 lung opacities in CTPA images, AI tools trained on non-contrast images, provide comparable results to visual assessments by radiologists.</p><p><strong>Advances in knowledge: </strong>The Pulmonary Density Plug-in enables quantitative analysis of lung opacities in COVID-19 patients using contrast-enhanced CT images, potentially streamlining clinical workflows and supporting timely decision-making.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf008"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082490","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}

{"title":"A service evaluation of the clinical contingencies implemented during a Linac replacement programme.","authors":"Chloe Wells, Mike Kirby","doi":"10.1093/bjro/tzaf006","DOIUrl":"https://doi.org/10.1093/bjro/tzaf006","url":null,"abstract":"<p><strong>Objective: </strong>A Linac Replacement Programme (LRP) was completed to ensure continuity of treatment whilst maintaining the highest standards of care. Clinical contingencies were devised to mitigate the impact of unscheduled interruptions during the LRP. This service evaluation was undertaken to appraise the effectiveness of contingencies on treatment delivery (TD) during the LRP.</p><p><strong>Method: </strong>The oncology management system MOSAIQ was used to generate reports of treatment adjustments. These reports were then generated for Linac service history in the 2019-2020 year for comparative analysis and causative factors in Linac breakdowns. Adjustments to treatment were analysed for each patient.</p><p><strong>Results: </strong>Of the 855 patients receiving treatment during the LRP, 184 were impacted in some way. Of these, 113 experienced some increase in overall treatment time (OTT); 742 (86.8%), therefore, experienced no increase in OTT, through deployment of clinical contingencies or not encountering machine breakdown during their treatment schedules. Throughout the LRP, Conebeam CT (CBCT) faults were the primary cause for machine closure. Due to this, breast patients remained on treatment at a higher rate than prostate patients who required 3D-geometric verification prior to TD.</p><p><strong>Conclusions: </strong>This project highlighted the importance of preparation for CBCT faults and patient categorization in the development of contingencies. The extended dose and fractionation 60 Gy in 20# presented increased opportunities for cancellation in prostate patients, however, the use of MV imaging to assess patient set-up enabled continuation of TD. Increases in OTT could not be eliminated completely, however, for 21.5% of patients who experienced treatment adjustments the implementation of contingencies effectively prevented them exceeding Royal College of Radiologists guidance of 2-day extension in OTT.</p><p><strong>Advances in knowledge: </strong>We believe this radiographer-led project is the first service evaluation reporting the practical effects on treatment of a LRP and impact of clinical contingencies used to mitigate and limit unscheduled interruptions in treatment and minimize the extension of OTT for patients during the transition.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf006"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028914","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}

{"title":"Don't be perplexed by the plexus! A practical approach to brachial plexus ultrasound.","authors":"James F Griffith","doi":"10.1093/bjro/tzaf003","DOIUrl":"10.1093/bjro/tzaf003","url":null,"abstract":"<p><p>Ultrasound is as accurate as MRI in the detection of most brachial pathologies but tends to be underutilized in clinical practice compared to MRI. The main reason for this under-usage is a relative lack of knowledge regarding how to perform brachial plexus ultrasound and a lack of awareness of the ultrasound appearances of brachial pathologies. This review serves to re-address this imbalance by providing a practical overview on how to perform brachial plexus ultrasound as well as highlighting the ultrasound appearances of common pathologies likely to be encountered in everyday clinical practice.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf003"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756206","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}

{"title":"The frequency and characterization of ovarian metastasis from nonovarian cancers using 18F-fluorodeoxyglucose PET/CT.","authors":"Nikoline D Frølich, Jeannette D Andersen, Helle D Zacho","doi":"10.1093/bjro/tzaf004","DOIUrl":"10.1093/bjro/tzaf004","url":null,"abstract":"<p><strong>Objective: </strong>Assessing the frequency of ovarian metastasis from nonovarian cancer (N-OC) and evaluate whether any PET-derived parameters can distinguish metastasis from primary ovarian cancer.</p><p><strong>Methods: </strong>Patients undergoing FDG PET/CT due to suspected ovarian malignancy from 2006 to 2021 with subsequent histologically proven ovarian metastasis from N-OC were included. Exclusion criteria included ovarian metastasis diagnosed prior to PET/CT or >3 months after. Baseline characteristics were collected from electronic medical records, and PET/CT data were analysed using Siemens syngo.via software.</p><p><strong>Results: </strong>Patients (<i>N</i> =1502) were scanned for suspected ovarian malignancies. Sixty-five patients (4%) were included. The most common origin of metastases was lower gastrointestinal cancer (<i>n</i> = 29, 45%), followed by gynaecological cancer (<i>n</i> = 10, 15%) and breast cancer (<i>n</i> = 9, 14%). Among patients with previous cancer history (<i>n</i> = 26), 18 experienced ovarian metastases from a known cancer. Time from primary diagnosis to ovarian metastasis ranged from 47 days to 11.4 years. There were no differences in maximized standardized uptake value, peak standardized uptake value, or clinical parameters between ovarian metastases and primary ovarian tumours.</p><p><strong>Conclusion: </strong>The frequency of ovarian metastases from N-OCs was 4%, the most common origin of metastases was lower gastrointestinal tract. Previous cancer history is an important factor in assessing an unknown tumour of the ovary, as metastases can occur several years later. No PET or clinical parameters were useful for separating primary ovarian cancer from ovarian metastases.</p><p><strong>Advances in knowledge: </strong>The study finds a low frequency of ovarian metastasis from N-OC and indicates that no PET or clinical parameters can distinguish ovarian metastasis from primary ovarian cancer.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf004"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756207","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}

{"title":"Outcomes with radiotherapy in multimodality treatment for hepatocellular carcinoma with portal vein tumour thrombosis.","authors":"Puja Sahai, Hanuman Prasad Yadav, Ashok Choudhury, Saggere Muralikrishna Shasthry, Ankur Jindal, Aprajita Mall, Amar Mukund, Yashwant Patidar, Mangu Srinivas Bharadwaj, Bangkim Chandra Khangembam, Guresh Kumar, Archana Rastogi, Viniyendra Pamecha","doi":"10.1093/bjro/tzaf002","DOIUrl":"https://doi.org/10.1093/bjro/tzaf002","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of the present study was to evaluate outcomes with radiation therapy (RT) in multimodality treatment for inoperable hepatocellular carcinoma (HCC) with portal vein tumour thrombosis (PVTT).</p><p><strong>Methods: </strong>The present retrospective study included 24 patients without extrahepatic metastases. The patients had received drug eluting beads - transarterial chemoembolization (DEB-TACE) (<i>n</i> = 10) and systemic treatment (<i>n</i> = 14) before RT. The dose fractionation was 12-31.5 Gy in 3-7 fractions of 4-5 Gy to PVTT or PVTT plus the liver parenchymal tumour. All patients were advised systemic treatment with sorafenib, lenvatinib, or nivolumab after RT. After RT, patients had received DEB-TACE within 8 weeks (<i>n</i> = 2) or at 5-10 months (<i>n</i> = 3). Treatment response was evaluated as per mRECIST and PERCIST, and Kaplan-Meier survival analysis was performed.</p><p><strong>Results: </strong>The disease control rate in PVTT was 50% at 3 months. The median overall survival (OS) was 10.9 months (95% CI, 0.74-21) for all patients. The 6-month, 1-year, 2-year, and 3-year OS rates were 75%, 45.8%, 25%, and 12.5%, respectively. The median OS was 30.4 months (95% CI, 12.1-48.7) versus 18.1 months (0.00-38.8) with complete or partial response versus stable or progressive disease in PVTT (<i>P</i> = .036). Eleven patients had a decline in Child Pugh score of 2 or more points within 3 months after RT. One patient underwent live donor liver transplantation (LDLT) and complete necrosis with no viable tumour was observed in the explant. The patient is cancer- and liver disease-free at 1 year after LDLT.</p><p><strong>Conclusions: </strong>The present study showed the benefit of radiotherapy with systemic therapy and DEB-TACE in patients with HCC with PVTT.</p><p><strong>Advances in knowledge: </strong>Radiotherapy as part of the multimodality treatment offers the potential to improve disease control and survival in patients with HCC with PVTT.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":"7 1","pages":"tzaf002"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652392","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}