British Journal of Radiology最新文献

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Clinical photon-counting CT increases CT number precision and reduces patient size dependence compared to single- and dual- energy CT.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-08 DOI: 10.1093/bjr/tqaf052
Jessica D Flores, Gavin Poludniowski, Adrian Szum, Georg Walther, Johan Lundberg, Patrik Nowik, Tobias Granberg
{"title":"Clinical photon-counting CT increases CT number precision and reduces patient size dependence compared to single- and dual- energy CT.","authors":"Jessica D Flores, Gavin Poludniowski, Adrian Szum, Georg Walther, Johan Lundberg, Patrik Nowik, Tobias Granberg","doi":"10.1093/bjr/tqaf052","DOIUrl":"https://doi.org/10.1093/bjr/tqaf052","url":null,"abstract":"<p><strong>Objectives: </strong>To study whether photon-counting computed tomography (PCCT) can improve CT number accuracy, precision and reduce patient size dependence compared to dual-energy CT (DECT) virtual monoenergetic imaging (VMI) and single-energy CT (SECT).</p><p><strong>Methods: </strong>Clinical PCCT, DECT and SECT scanners were used to image a multi-energy quality assurance phantom and tissue-equivalent inserts with/without an outer nested annulus, representing two object sizes (18 and 33 cm). CT numbers were converted to linear attenuation coefficients (LAC) and regions-of-interest applied. Theoretical monoenergetic LAC were calculated from known elemental compositions as a ground truth. Percent difference in mean LAC between phantom sizes, between mean and theoretical LAC, and its coefficient of variation (COV) were calculated.</p><p><strong>Results: </strong>Mean LAC percent differences between small and larger phantoms were highest in DECT (within -3% to 9%) and SECT (within 1% to 5%), particularly at higher calcium and iodine concentrations, while being relatively constant in PCCT over material concentrations and VMI energies (within ±2%). The COV in mean LAC was consistently lower (about 2 to 5 times) in PCCT relative to DECT and SECT for calcium in the large phantom. With consideration of the theoretical uncertainties of 2%, both PCCT and DECT showed comparable agreement to theoretical LAC.</p><p><strong>Conclusions: </strong>PCCT VMI produces CT numbers with less dependence on patient size and increased precision in large object sizes than DECT VMI and SECT.</p><p><strong>Advances in knowledge: </strong>Clinical PCCT provides less variable CT numbers than DECT and SECT with less sensitivity to the imaged object size.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584833","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}
引用次数: 0
The Impact of Plan Complexity on Dose Delivery Deviations Resulting from MLC Positioning Errors in Volumetric Modulated Arc Therapy.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-08 DOI: 10.1093/bjr/tqaf053
Qinghe Peng, Peng Fan, Xunyu Wang, Fali Tao, Ruijun Niu, Li Chen
{"title":"The Impact of Plan Complexity on Dose Delivery Deviations Resulting from MLC 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":"https://doi.org/10.1093/bjr/tqaf053","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effect of plan complexity on dosimetric alterations induced by multi-leaf collimator (MLC) misplacements in volumetric modulated arc therapy (VMAT).</p><p><strong>Methods: </strong>VMAT plans for 14 cervical and 10 lung cancer cases were reoptimized utilizing three distinct Aperture Shape Controller settings (none, very high, very low), resulting in three 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 three 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 millimeter 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 millimeter. 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 < 0.05).</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":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heart and lung sparing with isocentric lateral decubitus positioning compared with dorsal decubitus positioning during adjuvant localized breast cancer radiotherapy.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-08 DOI: 10.1093/bjr/tqaf049
Pierre Loap, Jeremi Vu Bezin, Alain Fourquet, Youlia Kirova
{"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":"https://doi.org/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 were 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 sino-atrial 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>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","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}
引用次数: 0
Vertebral Augmentation for Cancer Patients.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-08 DOI: 10.1093/bjr/tqaf032
Stefano Marcia, Stefano Marini, Giovanni Carlo Anselmetti, Matteo Bellini, Emanuele Piras, Salvatore Masala, Chiara Zini
{"title":"Vertebral Augmentation for Cancer Patients.","authors":"Stefano Marcia, Stefano Marini, Giovanni Carlo Anselmetti, Matteo Bellini, Emanuele Piras, Salvatore Masala, Chiara Zini","doi":"10.1093/bjr/tqaf032","DOIUrl":"10.1093/bjr/tqaf032","url":null,"abstract":"<p><p>Vertebral augmentation has emerged as a crucial intervention for cancer patients suffering from vertebral compression fractures (VCFs) due to metastatic spinal tumors. These fractures significantly compromise patients' quality of life and exacerbate pain, leading to increased morbidity and decreased functional status. This comprehensive review explores the efficacy, safety, and outcomes of vertebral augmentation techniques, including vertebroplasty and kyphoplasty, in cancer patients. It examines the underlying pathophysiology of VCFs in cancer, patient selection criteria, procedural techniques, complications, and future directions in research and clinical practice. The review emphasizes the importance of a multidisciplinary approach involving oncologists, interventional radiologists, and pain management specialists to optimize patient outcomes and improve overall well-being.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582172","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}
引用次数: 0
Thoracic applications of photon-counting CT: where are WE after three years of clinical implementation?
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-07 DOI: 10.1093/bjr/tqaf026
Martine Remy-Jardin, Thomas Flohr, Jacques Remy
{"title":"Thoracic applications of photon-counting CT: where are WE after three years of clinical implementation?","authors":"Martine Remy-Jardin, Thomas Flohr, Jacques Remy","doi":"10.1093/bjr/tqaf026","DOIUrl":"https://doi.org/10.1093/bjr/tqaf026","url":null,"abstract":"<p><p>Photon-counting CT has now entered the field of clinical practice, raising expectations on the advantages that could be derived for patient management. Two main directions are under scrutinity for the medical community at large. At the present time, most attention is directed toward the confirmation of the expected improvement in image quality and the evaluation of its consequences in terms of decision-making. In parallel, new perspectives in the field of functional imaging as well as for spectral imaging are topics of active research that have not been translated in clinical practice. This review article provides an update on the current use of this technology, based on the last three years of clinical investigations. Early clinical experience is summarized, focusing on adult respiratory indications.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575692","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}
引用次数: 0
Radiomic phenotype of peri-coronary adipose tissue as a potential non-invasive imaging tool for detecting atrial fibrillation.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-05 DOI: 10.1093/bjr/tqaf046
Wu Jingping, Meng Xiao, Wu Dan, Li Yuwei, Zhang Xinghua, Wang Zhenping, Wang Xue, Fan Zhang
{"title":"Radiomic phenotype of peri-coronary adipose tissue as a potential non-invasive imaging tool for detecting atrial fibrillation.","authors":"Wu Jingping, Meng Xiao, Wu Dan, Li Yuwei, Zhang Xinghua, Wang Zhenping, Wang Xue, Fan Zhang","doi":"10.1093/bjr/tqaf046","DOIUrl":"https://doi.org/10.1093/bjr/tqaf046","url":null,"abstract":"<p><strong>Objectives:: </strong>Epicardial adipose tissue (EAT) contribute to atrial fibrillation (AF). We sought to explore the role of FAI (fat attention index), volume, fat radiomic profile (FRP) from peri-coronary artery adipose tissue (PCAT) on coronary computed tomography angiography (CCTA) in determining the presence of AF and differentiating AF types.</p><p><strong>Methods: </strong>This study enrolled 300 patients underwent CCTA retrospectively and divided them into AF (n = 137) and non-AF groups (n = 163). 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 compared three models of VF (FAI and volume), FRP and FRPC (FRP and clinical factors). 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 performed excellent distinctive ability to identify AF with an AUC of 0.89 compared with the model enrolling FAI and volume (AUC = 0.83), and FRPC model showed improved AUC of 0.98 combining clinical factors. Among AF types, FPR and FRPC scores are significantly higher in the PerAF than PAF patients (p < 0.001). And twenty 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 help identify and differentiate atrial fibrillation and its types. Fat radiomic profiles derived from peri-coronary arteries fat could provide non-invasive tool for atrial fibrillation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","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}
引用次数: 0
Enhanced Blood Vessel Visualization and Accelerated Image Acquisition Using Spiral MRA in Moyamoya Disease: A Comparative Study with Cartesian MRA.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-04 DOI: 10.1093/bjr/tqaf038
Maoxue Wang, Yongbo Yang, Yujie Yu, Chuyue Chen, Kun Wang, Mahmud Mossa-Basha, Baochen Chu, Pin Lv, Mei Yao, Wen Zhang, Xin Zhang, Zhengyang Zhu, Xiance Zhao, Lei Zhou, Bing Zhang
{"title":"Enhanced Blood Vessel Visualization and Accelerated Image Acquisition Using Spiral MRA in Moyamoya Disease: A Comparative Study with Cartesian MRA.","authors":"Maoxue Wang, Yongbo Yang, Yujie Yu, Chuyue Chen, Kun Wang, Mahmud Mossa-Basha, Baochen Chu, Pin Lv, Mei Yao, Wen Zhang, Xin Zhang, Zhengyang Zhu, Xiance Zhao, Lei Zhou, Bing Zhang","doi":"10.1093/bjr/tqaf038","DOIUrl":"https://doi.org/10.1093/bjr/tqaf038","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the blood vessel visualization with spiral MRA (MRAspiral) and compressed SENSE accelerated Cartesian MRA (MRACS) in moyamoya disease (MMD) patients, with digital subtraction angiography (DSA) as the reference standard.</p><p><strong>Methods: </strong>We prospectively collected MRAspiral with different acquisition windows (τ = 4, 6, 10 ms), MRACS and DSA in MMD patients. Contrast-to-noise ratio (CNR) was measured in the M1, M2, M3, and M4 segments of the middle cerebral artery (MCA) for each MRA sequence. Vessel visualization of the distal MCA, leptomeningeal artery (LMA) collaterals, distal external carotid artery (ECA), and internal carotid artery (ICA) steno-occlusion was qualitatively analyzed using 3- and 4-point likert scales compared to DSA. A linear fixed-effects model was used to determine differences among the four sequences.</p><p><strong>Results: </strong>A total of 98 hemispheres from 55 MMD patients were included. CNR in the M2, M3 and M4 segments of the MCA was not significantly different between MRACS and MRAτ4 or MRAτ6, but it was significantly higher in MRACS than MRAτ10 (M2: P < 0.001, M3: P < 0.001, M4: P = 0.013). MRAspiral sequences provided better visualization of the distal MCA, LMA collaterals and distal ECA compared to MRACS (all P < 0.001).</p><p><strong>Conclusions: </strong>MRAspiral offers improved vessel visualization in distal arteries with adequate image quality for patients with MMD. Compared to MRACS, MRAspiral can reduce scan time by 32.31% when the τ value is set to 6 ms, while also providing superior image quality.</p><p><strong>Advances in knowledge: </strong>Spiral MRA performs well in visualizing collateral vessels in moyamoya disease with shorter scan time.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555900","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}
引用次数: 0
Dilation of the Left Renal Vein: An Indicator of Spontaneous Splenorenal Shunt in Chronic Liver Disease Patients.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-03-01 DOI: 10.1093/bjr/tqaf048
Afak Durur Karakaya, Mine Sorkun, Murat Akyıldız, Turan Kanmaz, Bengi Gürses
{"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":"https://doi.org/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 favoring the left showed good diagnostic performance for predicting SSS, with AUC 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 favoring 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":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidental breast cancer on CT: factors associated with detection and relationship to prognostics and treatment options.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-02-27 DOI: 10.1093/bjr/tqaf044
Ali Abougazia, Deepali Sharma, Omnia Abdelghani
{"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":"https://doi.org/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 and results: </strong>Out of the retrospectively included 56 scans in 42 patients, 38 reports (67.9%) missed the breast cancers. Missed cancers were found to be smaller (P = 0.0042), progressed more by the time they were diagnosed (P = 0.0011), and their initial treatment was delayed by a median of 3.4 years (P < 0.0001). Cancers were more likely to be missed out of hours (P = 0.0485), in an outpatient reporting session (P = 0.0397), when the cancer presented as a circumscribed mass (P = 0.0196), and when the breasts were dense (P = 0.0250).</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 minimising 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":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","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}
引用次数: 0
Enhancement of colorectal cancer liver metastases with gadoxetate-enhanced MRI at multiple time points is associated with disease free survival following hepatectomy.
IF 1.8 4区 医学
British Journal of Radiology Pub Date : 2025-02-26 DOI: 10.1093/bjr/tqaf040
Joshua Shur, Leila Kafaei, Angela Riddell, Ian Chau, Ricky Bhogal, Long Jiao, Dow-Mu Koh
{"title":"Enhancement of colorectal cancer liver metastases with gadoxetate-enhanced MRI at multiple time points is associated with disease free survival following hepatectomy.","authors":"Joshua Shur, Leila Kafaei, Angela Riddell, Ian Chau, Ricky Bhogal, Long Jiao, Dow-Mu Koh","doi":"10.1093/bjr/tqaf040","DOIUrl":"https://doi.org/10.1093/bjr/tqaf040","url":null,"abstract":"<p><strong>Aim: </strong>Investigate signal intensity of colorectal liver metastases (CRLM) at hepatobiliary phase (HBP) gadoxetate-enhanced MRI at two time points pre- (TP1) and post- chemotherapy (TP2) and association with disease-free survival (DFS) in patients undergoing curative liver resection.</p><p><strong>Methods: </strong>Retrospective study. Single largest tumours outlined and HBP T1 signal intensity measured, normalised to skeletal muscle at TP1 and TP2. Enhancement thresholds defined and risk groups at each TP and Kaplan-Meier survival curves compared using the log-rank test. Univariate and multivariate association of enhancement and 8 clinical features with risk of recurrence calculated using Cox proportional hazards.</p><p><strong>Results: </strong>82 patients (48 male, mean age 59 years) underwent 135 imaging studies, 58 at TP1, 77 at TP2 and 53 patients at TP1 + 2. Of 82 patients, 58 recurred with median time to recurrence 11.7 months. Enhancement of > =135 and > =15 at TP1 and TP2 respectively were predictive of reduced risk of recurrence (p < 0.05), although not when corrected for multiple testing (p = 0.33 and 0.20 respectively). Enhancement was not associated with recurrence in multivariate model including 8 clinical features (p > 0.05). Change in enhancement between TP was not associated with risk of recurrence however tumours that consistently exhibited low enhancement were 9 times more likely to recur.</p><p><strong>Conclusions: </strong>Increased CRLM enhancement in the HBP following gadoxetic acid at two TPs is associated with improved DFS in patients undergoing liver resection. This initial observation warrants further investigation of serial enhancement measurements as prognostic biomarkers.</p><p><strong>Advances in knowledge: </strong>Dual-timepoint signal assessment may be informative for clinical outcomes in CRLM undergoing resection.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555903","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}
引用次数: 0
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