British Journal of Radiology最新文献

{"title":"Imaging Endpoints for Biologic Therapy in Chronic Obstructive Pulmonary Disease.","authors":"Muhammad F A Chaudhary, Surya P Bhatt","doi":"10.1093/bjr/tqaf179","DOIUrl":"https://doi.org/10.1093/bjr/tqaf179","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a leading cause of respiratory morbidity and mortality. The disease is characterized by exacerbations, which result in high symptom burden and accelerated disease progression. A subset of patients exhibit a predominant type 2 inflammatory endotype, which is associated with increased risk of exacerbation and higher responsiveness to anti-inflammatory therapy. While biologics targeting type 2 inflammation and upstream alarmins have shown promise in reducing exacerbations and improving lung function, there is a need for clinical trial endpoints that reflect potential disease modification and enable anunderstanding of the mechanisms by which biologics may help patients with COPD. Measures of lung disease on imaging, including airway wall thickness, mucus plugging, and ventilation defect percentage, appear to be modifiable in response to therapy with biologics. The evidence base for treatment effects is derived largely from trials in asthma, but the findings can be extrapolated to COPD. Imaging endpoints have the potential to markedly decrease sample size requirements for clinical trials testing the effect of biologics on structural remodeling in COPD.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reevaluatıng Pı-rads 3 Lesıons Upgraded to 4: The Emergence of a New Subgroup?","authors":"Diğdem Kuru Öz, Sezer Nil Yılmazer Zorlu, Zeynep Eskalen, Nuray Haliloğlu, Ayşe Erden","doi":"10.1093/bjr/tqaf187","DOIUrl":"https://doi.org/10.1093/bjr/tqaf187","url":null,"abstract":"<p><strong>Objectives: </strong>The study aims to evaluate PI-RADS 4 lesions, including those with primary diffusion restriction (diffusion-weighted imaging score 4) and those upgraded from PI-RADS 3 due to positive dynamic contrast-enhanced findings, and to compare outcomes between these groups while also assessing cancer detection rates and prostatitis between upgraded cases and PI-RADS 3 lesions.</p><p><strong>Methods: </strong>In this single-center cohort study, peripheral zone lesions classified as PI-RADS 3 and 4 by multiparametric magnetic resonance imaging (MRI) and biopsied via MRI/Transrectal ultrasound-guided targeted biopsy were analyzed.</p><p><strong>Results: </strong>Of 420 peripheral zone lesions from 272 patients, 202 were PI-RADS 3, 81 PI-RADS 3 + 1, and 137 PI-RADS 4. Cancer detection rates significantly differed between PI-RADS 3 + 1 and PI-RADS 4 (38.3% vs 73% for overall cancer; 6.2% vs 30.7% for clinically significant cancer, p < 0.001). PI-RADS 3 + 1 lesions had significantly higher cancer detection rates than PI-RADS 3 lesions (38.3% vs 19.8%, p = 0.001). Prostatitis was significantly more prevalent in PI-RADS 3 (34.7%) and PI-RADS 3 + 1 (29.6%) than in PI-RADS 4 (10.9%) lesions (p < 0.001).</p><p><strong>Conclusion: </strong>PI-RADS 3 + 1 lesions show significantly different cancer detection rates from both PI-RADS 3 and 4, suggesting they should be managed as a distinct entity. Higher prevalence of prostatitis in PI-RADS 3 + 1 lesions indicates that clinical evaluation for inflammatory conditions may help reduce unnecessary biopsies in this subgroup.</p><p><strong>Advances in knowledge: </strong>PI-RADS 3 + 1 lesions show higher cancer detection than PI-RADS 3 but lower than PI-RADS 4, and are more frequently associated with prostatitis than PI-RADS 4. These findings support individualized management to avoid unnecessary biopsies.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Vessel Size, Dose Levels, and Body Habitus on Iodine Quantification in Cardiovascular Photon-Counting Computed Tomography.","authors":"Martin V Rybertt, Leening P Liu, Manoj Mathew, Pooyan Sahbaee, Harold I Litt, Peter B Noël","doi":"10.1093/bjr/tqaf181","DOIUrl":"https://doi.org/10.1093/bjr/tqaf181","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the performance of a clinical dual-source photon-counting computed tomography (PCCT) system in quantifying iodine within calcified vessels, using 3D-printed phantoms with vascular-like structures lined with calcium.</p><p><strong>Methods: </strong>Parameters assessed include lumen diameters (4, 6, 8, 10, and 12 mm), phantom sizes (S: 20 × 20 cm, M: 25 × 25 cm, L: 30 × 40 cm), and iodine concentrations (2, 5, and 10 mg/mL). Scans were performed with a cardiac high-pitch acquisition protocol at radiation dose levels of 5 and 10 mGy to systematically evaluate iodine quantification accuracy and spectral imaging performance.</p><p><strong>Results: </strong>The results indicate that for lumen diameters ≥6 mm, iodine quantification remains stable across all dose levels and smaller phantom sizes, where error remained consistently below 0.9 mg/mL. Furthermore, iodine quantification revealed a significant dependence on phantom size while selected radiation dose levels were insignificant. Virtual Monoenergetic Imaging (VMI) at 70 keV showed stable performance for larger lumens (≥6 mm) with variations of 20.3 ± 13.2 HU across all conditions, while smaller lumens remained stable in medium to small phantoms.</p><p><strong>Conclusions: </strong>These findings highlight the influence of lumen diameter, patient size, and radiation dose in optimizing PCCT protocols for spectral imaging. Results indicate that PCCT maintains stable and precise imaging performance across diverse patient anatomies, with robust differentiation of iodine and calcium in adjacent regions.</p><p><strong>Advances in knowledge: </strong>This study demonstrates PCCT's potential to enhance spectral imaging in vascular applications, characterizing iodine quantification at relevant lesion sizes for vascular imaging.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new era at BJR.","authors":"Stuart A Taylor, Andrew Nisbet","doi":"10.1093/bjr/tqaf185","DOIUrl":"https://doi.org/10.1093/bjr/tqaf185","url":null,"abstract":"","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of a quality assurance program on skeletal survey imaging for suspected non-accidental injury.","authors":"Jacques Bence, Martin Kidd, Richard D Pitcher","doi":"10.1093/bjr/tqaf184","DOIUrl":"https://doi.org/10.1093/bjr/tqaf184","url":null,"abstract":"<p><strong>Background: </strong>South Africa has one of the highest rates of child abuse. The skeletal survey (SS) is the radiological investigation for suspected paediatric non-accidental injury (NAI). Institutional policy is to perform the SS in accordance with The Royal College of Radiologists (RCR) 2017 guidelines. However, the SS is technically challenging, requiring several views with meticulous attention to radiographic detail. The optimal study is thus not always achieved, resulting in decreased diagnostic accuracy.</p><p><strong>Objectives: </strong>1. Assess pre-intervention (Institution name) compliance with RCR 2017 SS guidelines for suspected NAI. 2. Assess post-intervention (Institution name) compliance with RCR 2017 SS guidelines for suspected NAI.</p><p><strong>Method: </strong>A retrospective assessment of institutional percentage compliance with RCR 2017 SS guidelines for suspected paediatric NAI was followed by a 12-month educational intervention. Pre- and post-intervention compliance was compared utilizing the chi-square test.</p><p><strong>Results: </strong>The percentage compliance with standard RCR 2017 SS views in the post intervention period (mean 21.6/25, 86%) was significantly (p < 0.01) higher than the pre intervention period (mean 9/25, 36%). The most significant improvements were in the coned lateral joint and oblique chest views.</p><p><strong>Conclusion: </strong>The implementation of a simple institutional quality assurance program has the potential to improve imaging for NAI victims. The program described is broadly applicable to any healthcare or institutional setting.</p><p><strong>Advances in knowledge: </strong>This study, based on the RCR 2017 guidelines, forms part of a very small body of work on non-accidental injury quality assurance and is the only such analysis from the African continent.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic yield of multiple X-ray imaging requests of lower limb extremities.","authors":"Dania Abu Awwad, Don Nocum, Ernest Ekpo","doi":"10.1093/bjr/tqaf183","DOIUrl":"https://doi.org/10.1093/bjr/tqaf183","url":null,"abstract":"<p><strong>Objectives: </strong>The diagnosis pathway for patients presenting in the emergency department with lower limb trauma injuries requires adequate medical imaging of the regions of interest. Due to concerns of concurrent injury or overlapping symptoms, X-rays of multiple lower extremity regions may be requested simultaneously. This paper explores the diagnostic yield of imaging multiple lower limb regions following trauma.</p><p><strong>Methods: </strong>A retrospective audit of lower limb imaging requests for patients older than 18 years from two hospitals was conducted. Region requested, clinical history, and radiology findings for initial and secondary requests for adjacent body parts within 24 hours were collected and analysed using Chi square.</p><p><strong>Results: </strong>There were a total of 1473 examinations with 646 patients. Initial X-rays were significantly more likely to diagnose new, suspicious, and other findings compared to secondary X-rays of adjacent regions (χ2(3)=377.504, p < 0.001). Overall, 12.4% (n = 183/1473) of X-rays detected abnormalities such as fractures, and 160 of these 183 abnormalities (87.4%) were detected on the initial X-ray with the remaining 23 abnormalities (12.6%) detected in secondary X-rays. Only 0.9% (n = 6/646) of patients had a concurrent injury.</p><p><strong>Conclusion: </strong>X-ray imaging of multiple lower extremities adjacent to injured areas has low diagnostic yield. Thorough clinical assessment is needed to reduce low-value imaging in lower limb trauma.</p><p><strong>Advances in knowledge: </strong>Concurrent injury in lower limbs injuries is rare. When multiple X-ray requests are made of adjacent regions, 87.4% of all abnormalities were detected on initial imaging. The diagnostic yield of secondary X-rays is very low particularly when patients are asymptomatic.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Hypertension and the Role of MRI Flow Assessment: A Systematic Review.","authors":"Khalid S Alghamdi, Ahmed Maiter, Georgia A Hyde, Turki Alnasser, Michael Sharkey, Mahan Salehi, Pankaj Garg, Jim M Wild, David Kiely, Andrew J Swift, Samer Alabed","doi":"10.1093/bjr/tqaf182","DOIUrl":"https://doi.org/10.1093/bjr/tqaf182","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiac magnetic resonance imaging (CMR) plays an increasingly important role in non-invasive assessment of pulmonary hypertension (PH). This systematic review aimed to assess the utility, accuracy and clinical applications of CMR flow techniques in evaluating pulmonary arterial blood flow in patients with suspected or confirmed PH.</p><p><strong>Methods: </strong>MEDLINE and EMBASE databases were searched on 10 December 2024, utilising the following key terms: 'cardiac MRI', 'flow', and 'pulmonary hypertension'. Eligible studies were screened, and data extraction included study design, cohort characteristics, CMR flow techniques and outcomes. Risk of bias was assessed using the Newcastle-Ottawa scale.</p><p><strong>Results: </strong>38 studies (mean sample size: 30 [20-57]) published between 2012 to 2024 were included. These utilised 2D flow (19 studies), 4D flow (15 studies), black blood imaging (one study) and combined flow techniques (three studies). Vortex duration derived by 4D flow demonstrated the strongest correlation (r = 0.96) with mean pulmonary artery pressure and the highest diagnostic accuracy in identifying PH patients (area under the curve 0.99). Risk of bias rated 14 studies as good/very good and 13 as unsatisfactory, with none justifying their sample size selection.</p><p><strong>Conclusion: </strong>CMR flow parameters correlate strongly with right heart catheterisation (RHC) measurements and demonstrate high diagnostic accuracy in identifying patients with PH, with 4D flow potentially adding greater value. This systematic review reinforces the potential benefit of CMR flow techniques in the investigation, prognostication and monitoring of PH patients.</p><p><strong>Advances in knowledge: </strong>This systematic review is the first to evaluate the role of CMR flow techniques in PH and should inform guidelines on flow assessment in pulmonary hypertension.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the different imaging time points in delayed Dual-Energy CT extracellular volume in assessing the staging of liver fibrosis.","authors":"Chuanlin Yu, Wanjing Zhou, Yingjie Peng, Ting Dai, Peng Liu, Yaqiong He","doi":"10.1093/bjr/tqaf177","DOIUrl":"https://doi.org/10.1093/bjr/tqaf177","url":null,"abstract":"<p><strong>Objective: </strong>To stage liver fibrosis by using delayed dual-energy CT (DECT) and determine the optimal delay time for acquisition of delayed CT scans.</p><p><strong>Materials and methods: </strong>This prospective study included patients with chronic liver disease, who were scheduled to undergo multiphase abdominal DECT (including 3-min and 5-min delayed periods) and liver biopsies from January 2021 to December 2021. The iodine densities of the parenchyma and aorta were measured and extracellular volume (ECV) was calculated. Kendall rank correlation was employed to assess the relationship between the ECV and the fibrosis stage. Comparison of ECVs was made for different stages of liver fibrosis. In addition, the diagnostic performances of ECV for staging liver fibrosis were evaluated by using receiver operating characteristic (ROC) curve analysis, and area under the ROC curve (AUC) was calculated.</p><p><strong>Results: </strong>A total of 90 participants were evaluated, and distributed as follows: 10 in S1, 29 in S2, 25 in S3, and 26 in S4. Both ECV of 3-min delayed (ECV3 min) and 5-min delayed (ECV5 min) showed a positive correlation with the stage of liver fibrosis (ECV3 min: τ  =  0.478, P ＜ 0.01, moderate correlation; ECV5 min: τ  =  0.352, P ＜ 0.01, weak correlation). In terms of diagnostic performances, ECV3 min showed significantly higher diagnostic accuracy than ECV5 min for significant liver fibrosis (S2-4) (AUC: 0.87 vs. 0.79, P = 0.037), but no significant differences were observed for progressive fibrosis (S3-4) (AUC: 0.76 vs. 0.71, P = 0.206) or cirrhosis (S4) (AUC: 0.75 vs. 0.74, P = >0.774).</p><p><strong>Conclusion: </strong>DECT ECV may have some potential in noninvasively liver fibrosis staging, ECV3 min is not definitely inferior to ECV5 min.</p><p><strong>Advances in knowledge: </strong>A 3-min delay for the delayed-phase ECV assessment can guide clinical treatment decisions for patients and enhance the efficiency of scanning work, holding significant clinical value.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total body PET and Oncology (Invited Commentary).","authors":"Gary J R Cook","doi":"10.1093/bjr/tqaf180","DOIUrl":"https://doi.org/10.1093/bjr/tqaf180","url":null,"abstract":"<p><p>In recent years, total body positron emission tomography coupled with computed tomography (PET/CT) scanners have become commercially available, allowing coverage of all or most of the body in one scan with higher speed, lower administered radiation dose, improved sensitivity, scan quality and temporal resolution. This not only enables faster and higher quality clinical scans but opens up areas of research that would not have previously been possible or acceptable. For example, the ability to significantly reduce associated radiation burden opens PET research to normal volunteer cohorts and the increase in sensitivity and timing resolution allows exploitation of dynamic data acquisition for calculating kinetic indices of biological processes and producing parametric images beyond static standardised uptake value assessment. As total body PET technology advances and costs reduce, it is likely that availability as well as clinical and research applications will increase to allow this significant step in technology to contribute to clinical outcomes in oncology and other fields where PET is used.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Applications of Portable CT Scanners.","authors":"Rehab Naeem Khalid, Dufan Wu, Quirin D Strotzer, Junyoung Park, Rajiv Gupta","doi":"10.1093/bjr/tqaf175","DOIUrl":"https://doi.org/10.1093/bjr/tqaf175","url":null,"abstract":"<p><p>Portable Computed Tomography (CT) scanners have revolutionized diagnostic imaging by bringing advanced imaging capabilities directly to the point of care in critical settings such as intensive care units, operating rooms, ambulances, and other resource-limited environments. Integrating portable CT into clinical workflows improves patient outcomes through immediate, on-site imaging, eliminating the risks and delays associated with intra-hospital transportation. These systems are indispensable in critical care, reducing complications and time to diagnosis while enabling timely interventions for life-threatening conditions such as intracranial hemorrhage. Portable CT scanners are also transforming prehospital care, particularly in mobile stroke units, where they facilitate rapid diagnosis and treatment of strokes. This review examines the fundamentals of portable CT technology and its transformative role in various clinical scenarios such as ICUs and intraoperative imaging. It traces the evolution of CT from stationary Energy Integrating Detector-based systems to Portable Photon Counting Detector-based systems, highlighting the advantages of this technological transition. Key benefits include reduced patient complications, enhanced spatial resolution, improved diagnostic accuracy, lower radiation doses, and superior material differentiation, illustrated through clinical examples. As innovation advances in detector design and artificial intelligence, portable CT scanners are expected to grow further, expanding their clinical applications and solidifying their role as essential tools in modern diagnostic radiology.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}