British Journal of Radiology最新文献

{"title":"Incidental breast cancer on CT: factors associated with detection and relationship to prognostics and treatment options.","authors":"Ali Abougazia, Deepali Sharma, Omnia Abdelghani","doi":"10.1093/bjr/tqaf044","DOIUrl":"10.1093/bjr/tqaf044","url":null,"abstract":"<p><strong>Objectives: </strong>With the increasing use of CT, it may help detecting incidental breast cancers. Our study analysed the relationship between breast cancer detection on CT and features of the cancer, factors related to the scan and report, the treatment offered, and cancer prognostics, in NHS settings.</p><p><strong>Methodology: </strong>56 scans in 42 patients were retrospectively included.</p><p><strong>Results: </strong>38 reports (67.9%) missed the breast cancers. Missed cancers were found to be smaller (P = .0042), progressed more by the time they were diagnosed (P = .0011), and their initial treatment was delayed by a median of 3.4 years (P < .0001). Cancers were more likely to be missed out of hours (P = .0485), in an outpatient reporting session (P = .0397), when the cancer presented as a circumscribed mass (P = .0196), and when the breasts were dense (P = .0250).</p><p><strong>Conclusion: </strong>A significant percentage of breast cancer is missed on CT, with subsequent delay in starting treatment. Systematic approach when reporting, awareness of atypical cancer presentations, and minimizing distractions while reporting, may improve the detection of breast cancer on CT.</p><p><strong>Advances in knowledge: </strong>This study identified opportunities to detect, and the factors associated with missing and delayed treatment of, incidental breast cancer on CT, specifically in NHS settings. By increasing radiologists' awareness of those factors, it is hoped to prevent delay in treatment of this cohort of cancer patients.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"752-763"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555905","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":"Mastering CT-based radiomic research in lung cancer: a practical guide from study design to critical appraisal.","authors":"Ashley Horne, Azadeh Abravan, Isabella Fornacon-Wood, James P B O'Connor, Gareth Price, Alan McWilliam, Corinne Faivre-Finn","doi":"10.1093/bjr/tqaf051","DOIUrl":"10.1093/bjr/tqaf051","url":null,"abstract":"<p><p>Radiomics is a health technology that has the potential to extract clinically meaningful biomarkers from standard of care imaging. Despite a wealth of exploratory analysis performed on scans acquired from patients with lung cancer and existing guidelines describing some of the key steps, no radiomic-based biomarker has been widely accepted. This is primarily due to limitations with methodology, data analysis, and interpretation of the available studies. There is currently a lack of guidance relating to the entire radiomic workflow from study design to critical appraisal. This guide, written with early career lung cancer researchers, describes a more complete radiomic workflow. Lung cancer image analysis is the focus due to some of the unique challenges encountered such as patient movement from breathing. The guide will focus on CT imaging as these are the most common scans performed on patients with lung cancer. The aim of this article is to support the production of high-quality research that has the potential to positively impact outcome of patients with lung cancer.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"653-668"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"18F-FDG PET or PET/CT in detecting high-grade transformation of chronic lymphocytic leukaemia and indolent lymphomas: a systematic review and meta-analysis.","authors":"Osher N Y Lee, John Kuruvilla, David C Hodgson, Patrick Veit-Haibach, Ur Metser","doi":"10.1093/bjr/tqaf028","DOIUrl":"10.1093/bjr/tqaf028","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic accuracy of 18F-FDG positron emission tomography (PET) or PET/computed tomography (CT) in detecting histological transformation (HT) of indolent lymphomas.</p><p><strong>Methods: </strong>A systematic search of articles up to July 2024 was performed in Embase and Medline. Eligible studies included adults with histologically proven indolent lymphoma, 18F-FDG PET or PET/CT as the index test, and sufficient data to assess diagnostic performance. Summary receiver operating characteristic curves were plotted using a bivariate model to estimate diagnostic accuracy with area under the curve (AUC).</p><p><strong>Results: </strong>Fifteen studies with 1307 participants were included. Ten studies assessed PET ability to detect Richter's transformation, and 5 studies focused on HT in follicular lymphoma and other subtypes. A meta-analysis of the former showed pooled sensitivity of 0.90 (95% CI, 0.84-0.93) and specificity of 0.54 (95% CI, 0.28-0.77) when using a maximum standardized uptake value (SUVmax) threshold of around 5. AUC was 0.89. Pooled sensitivity was 0.74 (95% CI, 0.54-0.87), and specificity was 0.84 (95% CI, 0.67-0.93) when using an SUVmax threshold of around 10. Area under the curve was 0.84. For detecting HT in follicular lymphoma, thresholds were found higher than those for Richter's transformation.</p><p><strong>Conclusions: </strong>18F-FDG PET or PET/CT demonstrates good diagnostic accuracy to detect Richter's transformation, best when employing SUVmax ≥ 5. SUVmax thresholds may be limited in discriminating follicular lymphoma from HT, and alternatives should be sought.</p><p><strong>Advances in knowledge: </strong>If biopsy is feasible, SUVmax ≥ 5 can guide biopsy in patients with clinically suspicious Richter's transformation. If biopsy is infeasible, SUVmax ≥ 10 can better identify HT and guide patient management.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"669-678"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREDICTing Post-Embolization Syndrome after uterine fibroid embolization: the PREDICT-PES study.","authors":"Warren Clements, Matthew W Lukies, Madeleine Coleman, Rohan Nandurkar, Laura Le Mercier, Georgina Venn, Jim Koukounaras","doi":"10.1093/bjr/tqaf036","DOIUrl":"10.1093/bjr/tqaf036","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the rate of clinically significant post-embolization syndrome (csPES) in our cohort of patients after uterine artery embolization (UAE) for symptomatic fibroids and to identify risk factors associated with the development of csPES.</p><p><strong>Methods: </strong>Retrospective case-control study. All patients who underwent UAE for symptomatic fibroids between the 18-month period of March 1, 2022 and September 1, 2023 were recruited. csPES was defined as maximum pain score on visual analogue scale of >5 out of 10, plus at least 1 of: morphine patient-controlled analgesia dose >10 mg, fever, or use of 2 or more antiemetics.</p><p><strong>Results: </strong>A total of 69 patients were included, mean age 46.2 years, and median uterine volume 393 mL (range 80-2288 mL). The rate of csPES was 47.8% (33 patients). After adjusting for confounding using multiparametric logistic regression, a positive association was seen between nulliparity and developing csPES (OR: 5.51, 95% CI: 1.297-23.410, P = .021). In addition, a trend was shown between increasing age and a reduced odds of developing csPES (OR: 0.87, 95% CI: 0.748-1.002, P = .054).</p><p><strong>Conclusion: </strong>The rate of csPES in our cohort was 47.8%, and nulliparity was strongly associated with the development of csPES. We can use this to better counsel our patients regarding the odds of csPES when these risks are present at pre-procedure consultation and target additional interventions at reducing csPES in this population.</p><p><strong>Advances in knowledge: </strong>Clinically significant post-embolization syndrome is common after UAE for symptomatic fibroids. This study showed that nulliparity is a risk factor for developing, previously not known or reported.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"709-714"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of plan complexity on dose delivery deviations resulting from multileaf collimator positioning errors in volumetric modulated arc therapy.","authors":"Qinghe Peng, Peng Fan, Xunyu Wang, Fali Tao, Ruijun Niu, Li Chen","doi":"10.1093/bjr/tqaf053","DOIUrl":"10.1093/bjr/tqaf053","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the effect of plan complexity on dosimetric alterations induced by multileaf collimator (MLC) misplacements in volumetric modulated arc therapy (VMAT).</p><p><strong>Methods: </strong>Volumetric modulated arc therapy plans for 14 cervical and 10 lung cancer cases were reoptimized utilizing 3 distinct aperture shape controller (ASC) settings (none, very high, and very low), resulting in 3 plan groups: ASC-none, ASC-vh, and ASC-vl. Four types of MLC position errors were simulated: total shifts (Type 1), open/closed (Type 2), right-side shifts (Type 3), and left-side shifts (Type 4). Plan complexity was assessed using the small aperture score (SAS). Dose deviations resulting from various MLC positioning errors and SAS values were calculated and compared among the 3 ASC groups.</p><p><strong>Results: </strong>The variations in planning target volume (PTV) D95% for cervical cancer were approximately 0.6%, 3.7%, 1.9%, and 1.8% per millimetre for Types 1-4 errors, respectively. In the case of lung cancer, the changes were 2.3%, 9.3%, 5.3%, and 4.6% per millimetre. The ASC-vh and ASC-vl groups exhibited significantly reduced dose changes and SAS values in response to MLC errors, as compared to the ASC-none group (P < .05).</p><p><strong>Conclusions: </strong>Highly complex plans exhibit greater dose sensitivity to MLC positional errors. The application of ASC proves effective in reducing plan complexity and mitigating the influence of MLC errors on dose deviation.</p><p><strong>Advances in knowledge: </strong>By elucidating the relationship between dosimetric impacts from MLC errors and plan complexity, this study offers valuable guidance for the design of radiotherapy plans, helping to enhance the accuracy and effectiveness of VMAT treatments.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"785-792"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of trans-abdominal ultrasound for gallbladder cancer surveillance in patients with gallbladder polyps less than 10 mm in the United Kingdom.","authors":"Julia Lowin, Bernadette Sewell, Matthew Prettyjohns, Angela Farr, Kieran G Foley","doi":"10.1093/bjr/tqaf024","DOIUrl":"10.1093/bjr/tqaf024","url":null,"abstract":"<p><strong>Objectives: </strong>Gallbladder polyps (GBPs) are commonly detected with trans-abdominal ultrasound (TAUS). Gallbladder cancer (GBC) is associated with GBPs but the risk of malignancy is low. International guidelines recommend ultrasound surveillance (USS) in selected cases of GBPs <10 mm, with cholecystectomy advised if the polyp size increases. USS (including potential cholecystectomies) is resource intense. We evaluated the costs and potential cost-effectiveness of USS in a theoretical UK patient cohort with GBPs.</p><p><strong>Methods: </strong>A health economic model mapped expected management pathways over 2 years for 1000 GBP patients with and without USS, stratified by the initial size of GBP (<6 mm and 6-9 mm). We estimated USS resource and costs under alternate referral thresholds for cholecystectomy. Clinical data were extracted from a large-scale cohort study. TAUS and cholecystectomy costs were based on NHS tariffs. GBC costs were estimated from the literature. Outcomes included USS costs, expected numbers of GBC, and incremental cost for each case of GBC avoided.</p><p><strong>Results: </strong>The 2-year additional cohort costs of USS (n = number of cholecystectomies) were estimated between £213 441 (n = 50) and £750 045 (n = 253) in GBPs <6 mm and between £420 275 (n = 165) and £531 297 (n = 207) in GBPs 6-9 mm, balanced against avoidance of 1.3 (<6 mm) and 8.7 (6-9 mm) cases of GBC. Model findings were robust to plausible changes in inputs.</p><p><strong>Conclusions: </strong>Using published data, we demonstrated that, in patients with GBPs <10 mm, the costs of USS to avoid GBC outweigh potential GBC cost offsets and would result in high rates of cholecystectomy. Additional evidence is needed to establish the formal cost-effectiveness of GBP USS in the UK.</p><p><strong>Advances in knowledge: </strong>• We developed a health economic model, based on published data, to evaluate the cost-effectiveness of guideline-recommended ultrasound surveillance (USS) in patients with gallbladder polyps measuring less than 10 mm in the UK.• The analysis provides a transparent platform to explore potential numbers of trans-abdominal ultrasound studies and cholecystectomies that might be expected if USS protocols are adhered to and discovers important gaps in current evidence that could be filled by additional targeted research.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"693-700"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart and lung sparing with isocentric lateral decubitus positioning compared with dorsal decubitus positioning during adjuvant localized breast cancer radiotherapy.","authors":"Pierre Loap, Jeremi Vu Bezin, Alain Fourquet, Youlia Kirova","doi":"10.1093/bjr/tqaf049","DOIUrl":"10.1093/bjr/tqaf049","url":null,"abstract":"<p><strong>Objectives: </strong>The cardiac and pulmonary dosimetric benefit of alternative positioning in isocentric lateral decubitus compared with dorsal decubitus during adjuvant breast irradiation has yet to be proven, in spite of the relative long-standing use of isocentric lateral decubitus.</p><p><strong>Methods: </strong>Eight consecutive patients with an indication for adjuvant breast irradiation without boost or lymph node irradiation were scanned in both isocentric lateral and dorsal decubitus positions. For each patient, a plan delivering 40.05 Gy in 15 fractions in isocentric lateral decubitus and in dorsal decubitus using a field-in-field technique was calculated. Doses to the heart, to various cardiac substructures, and to the lungs were compared.</p><p><strong>Results: </strong>Mean dose to the heart, to various cardiac structures (left ventricle, left coronary, right coronary), to the homolateral lung, and to the contralateral lung were significantly lower in isocentric lateral decubitus than in dorsal decubitus. Average absolute mean dose reductions were -40 cGy for the heart, -27.5 cGy for the left ventricle, -56.5 cGy for the right coronary artery, -64.5 cGy for the left coronary artery, -45.5 cGy for the sinoatrial node, -74 cGy for the homolateral lung, and -4.5 cGy for the contralateral lung. For all organs at risk, median dose-volume histograms in isocentric lateral decubitus showed lower relative volumes than in dorsal decubitus.</p><p><strong>Conclusion: </strong>Lateral decubitus positioning significantly reduces dose to the heart, to various cardiac substructures, to the homolateral lung, and to the contralateral lung, compared with dorsal decubitus. This technique is easily implemented and can be widely recommended to reduce heart and lung doses to a minimum.</p><p><strong>Advances in knowledge: </strong>Lateral decubitus positioning significantly reduces dose to the heart, to various cardiac substructures, to the homolateral lung, and to the contralateral lung, compared with dorsal decubitus. This technique is easily implemented and can be widely recommended to reduce heart and lung doses to a minimum.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"679-685"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584834","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":"Radiomic phenotype of peri-coronary adipose tissue as a potential non-invasive imaging tool for detecting atrial fibrillation.","authors":"Jingping Wu, Xiao Meng, Dan Wu, Yuwei Li, Xinghua Zhang, Zhenping Wang, Xue Wang, Fan Zhang","doi":"10.1093/bjr/tqaf046","DOIUrl":"10.1093/bjr/tqaf046","url":null,"abstract":"<p><strong>Objectives: </strong>Epicardial adipose tissue (EAT) contributes to atrial fibrillation (AF). We sought to explore the role of fat attention index (FAI), volume, and fat radiomic profile (FRP) of peri-coronary artery adipose tissue (PCAT) on coronary computed tomography angiography (CCTA) in determining the presence of AF and differentiating its types.</p><p><strong>Methods: </strong>This study enrolled 300 patients who underwent CCTA retrospectively and divided them into AF (n = 137) and non-AF (n = 163) groups. The imaging parameters of FAI, volume, and FRP were excavated and measured after PCAT segmentation. Every coronary artery extracted 853 radiomics and a total of 2559 radiomics were collected. Significant and relevant FRP was screened by random forest algorithm based on machine learning, and then 3 models-VF (FAI and volume), FRP, and FRPC (FRP and clinical factors)-were then compared. Among AF individuals, the FRP and FRPC scores of persistent AF (PerAF, n = 44) and paroxysmal AF (PAF, n = 93) were compared with boxplot.</p><p><strong>Results: </strong>In the test cohort, FRP score demonstrated excellent distinctive ability in identifying AF, with an area under the curve (AUC) of 0.89, compared with the model incorporating FAI and volume (AUC = 0.83). The FRPC model, which combined FRP with clinical factors, showed an improved AUC of 0.98. Among AF types, FRP and FRPC scores are significantly higher in the PerAF than PAF patients (P < .001) and 20 most contributive features were selected in identifying AF.</p><p><strong>Conclusion: </strong>Textural radiomic features derived from PCAT on coronary CTA detect micro-pathophysiological information associated with AF, which may help identify and differentiate AF and provide a hopeful imaging target.</p><p><strong>Advances in knowledge: </strong>The analysis of epicardial tissue around coronary arteries helps identify and differentiate atrial fibrillation and its types. Fat radiomic profiles derived from peri-coronary arteries fat could provide a non-invasive tool for atrial fibrillation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"777-784"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566191","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 British Society of Gastrointestinal and Abdominal Radiology multi-centre audit of imaging investigations in inflammatory bowel disease.","authors":"Katherine Taylor, Elizabeth Robinson, Ravivarma Balasubramaniam, Gauraang Bhatnagar, Stuart A Taylor, Damian Tolan, Anita Wale, Ian Zealley, Kieran G Foley","doi":"10.1093/bjr/tqaf050","DOIUrl":"10.1093/bjr/tqaf050","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate current UK practice for inflammatory bowel disease (IBD) imaging against recommendations from published international literature.</p><p><strong>Methods: </strong>A retrospective multi-centre audit was undertaken evaluating imaging modalities, protocols, and pathways used to investigate IBD both in outpatient and inpatient settings during January-December 2022. Reporting practices and training provisions were also recorded.</p><p><strong>Results: </strong>Forty-one centres contributed: 35 centres provided complete data, whereas 6 centres provided incomplete data. Magnetic resonance enterography (MRE) was the most common modality for small bowel imaging across UK centres, comprising 13 099/18 784 (69.7%) investigations. There was regional variability in other modalities used, with 5 centres performing 81% of all intestinal ultrasound and 3 centres performing 65% of all small bowel follow-through. Compared with outpatients, inpatients with suspected IBD were significantly more likely to be imaged with techniques imparting ionising radiation whether scanned either in-hours (p = 0.005) or out-of-hours (p < 0.001). Non-ionising radiation imaging modalities were significantly less available out-of-hours (p < 0.0001). Sequences included in MRE protocols were variable. Disparity in imaging follow-up for patients prescribed biologic therapies was observed.</p><p><strong>Conclusions: </strong>Considerable variation in UK IBD imaging practice has been identified. Improvements must be made to reduce the regional inequality of patient access to different imaging modalities and decrease reliance on ionising radiation for inpatients. Further research to standardise and optimise imaging pathways should be undertaken to improve uniformity, with emphasis placed on training and education.</p><p><strong>Advances in knowledge: </strong>This multi-centre audit showed considerable IBD imaging practice variation between UK centres, particularly for imaging modalities used between inpatient and outpatient groups and in-hours versus out-of-hours.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"734-743"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilation of the left renal vein: an indicator of spontaneous splenorenal shunt in chronic liver disease patients.","authors":"Afak Durur Karakaya, Mine Sorkun, Murat Akyıldız, Turan Kanmaz, Bengi Gürses","doi":"10.1093/bjr/tqaf048","DOIUrl":"10.1093/bjr/tqaf048","url":null,"abstract":"<p><strong>Objectives: </strong>Spontaneous splenorenal shunts (SSS) in chronic liver disease (CLD) impact liver perfusion and prognosis post-liver transplantation. This study aims to identify radiological findings that predict the presence of SSS in CLD patients and to examine the relationship between SSS and left renal vein diameter.</p><p><strong>Methods: </strong>A retrospective study was conducted on 150 adult patients evaluated for liver transplants from June 2018 to April 2021. The study groups included healthy controls (Group 1), CLD patients without SSS (Group 2), and those with SSS (Group 3). Multidetector CT angiography was used to measure the diameters of renal veins, portal vein, spleen size, and SSS.</p><p><strong>Results: </strong>Significant differences were found between the groups for spleen size, splenic vein diameter, portal vein diameter, left renal vein diameter, and renal vein diameter difference, except for the right renal vein diameter. A left renal vein diameter of 10.5 mm or greater and both renal veins diameter difference of 0.5 mm or more favouring the left showed good diagnostic performance for predicting SSS, with area under the curve values of 0.828 and 0.833, respectively.</p><p><strong>Conclusion: </strong>Dilation of the left renal vein and a greater diameter difference between renal veins favouring the left are strong indicators of SSS in CLD patients. These findings can aid in pre-transplant assessments and potentially improve post-transplant outcomes.</p><p><strong>Advances in knowledge: </strong>This study establishes that an increased diameter of the left renal vein and a greater diameter difference between renal veins are reliable radiological indicators for predicting the presence of SSS in CLD patients.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"764-769"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}