Shimaa Abdalla Ahmed, Ahmed Elbadawy, Lamiaa M R Khalaf, Marwa Samy
{"title":"Iliac vein obstruction: accuracy of Direct Multidetector Computed Tomographic Venography and duplex ultrasound.","authors":"Shimaa Abdalla Ahmed, Ahmed Elbadawy, Lamiaa M R Khalaf, Marwa Samy","doi":"10.1093/bjr/tqae194","DOIUrl":"https://doi.org/10.1093/bjr/tqae194","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the accuracy of direct computed tomographic venography (DCTV) and duplex ultrasound (DUS) in the identification of iliac vein obstruction in highly symptomatic patients with severe chronic venous disease (CVD) compared with intravascular ultrasound (IVUS).</p><p><strong>Methods: </strong>this study involved patients who had advanced CVD (CEAP C3-6). All patients underwent DCTV, venous duplex scanning, and IVUS. The presence of iliac vein obstruction was detected, and degree of obstruction was classified into 3 grades (grade I, 0% to 49%; grade II, 50% to 79%; and grade III, 80% or greater). The sensitivity, specificity, PPV, NPV, and accuracy were calculated for each modality compared with IVUS. Inter-observer agreement was assessed using the κ coefficient.</p><p><strong>Results: </strong>of 94 patients with CVD, IVUS identified iliac vein obstruction in 55 (58.5%) patients (25.5% was grade 1, 27.3% was grade 2, 47.3% was grade 3). The sensitivity, specificity of DCTV in diagnosing obstruction was (96%, 95% in grade 1; 100%, 100% grade 2; 100%, 100% in grade 3, respectively). The sensitivity, specificity of DUS was (63.9%, 65% in grade 1; 68%, 82% in grade 2, and 70%, 85% in grade 3, respectively). The overall agreement of DUS was 0.73 (95% CI, 0.70-0.79), and DCTV was 0.96 (95% CI, 0.91- 0.97).</p><p><strong>Conclusions: </strong>DUS is a reasonable initial imaging modality for the identification of significant iliac vein obstruction. DCTV provides an accurate reproducible imaging for accurate estimation needed for treatment planning.</p><p><strong>Advances in knowledge: </strong>Direct CT Venography provides accurate reproducible radiological information required for treatment planning of patients with Iliac vein obstruction including accurate assessment of site of obstruction, its morphology, and degree of obstruction and it can replace the use of indirect CT venography using smaller amount of contrast media with accurate diagnosis.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458542","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}
Khanin Khanungwanitkul, Olga Sliwicka, Fides Regina Schwartz
{"title":"Abdominal Applications of Photon-Counting CT.","authors":"Khanin Khanungwanitkul, Olga Sliwicka, Fides Regina Schwartz","doi":"10.1093/bjr/tqae206","DOIUrl":"https://doi.org/10.1093/bjr/tqae206","url":null,"abstract":"<p><p>Photon-counting computed tomography (PCCT) has shown promising advancements in abdominal imaging in clinical use. Though more peer-reviewed primary literature is needed, this commentary explores PCCT's potential applications, focusing on enhancing diagnostic accuracy, optimizing radiation dose management, and improving patient care. PCCT offers improved spatial and contrast resolution, lower image noise, and reduced radiation dose. Increased spatial resolution provides better detail in abdominal imaging, aiding in the detection of small lesions and subtle pathological changes. However, this generates more images per scan, raising concerns about \"image overload\" in PACS, potentially leading to longer reading times and increased stress for radiologists. PCCT's improved contrast resolution enhances tissue differentiation, reducing the need for intravenous contrast agents. The technology's advanced tissue characterization provides several advantages, such as non-invasive and opportunistic liver disease evaluation and improved differentiation of renal and adrenal masses. PCCT's optimized radiation dose management is crucial for patients requiring frequent scans. Enhanced diagnostic accuracy through spectral information aids in tissue differentiation, improving confidence in diagnoses. Streamlined workflows, particularly in emergency settings, and oncologic imaging, are potential benefits, reducing the need for additional imaging studies. Future integration of PCCT into clinical practice requires collaboration, education, and research to fully harness its potential, ensuring optimized abdominal imaging and improved patient care.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406153","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":"Ultrasound strain elastography to improve diagnostic performance of breast lesions by reclassifying BI-RADS 3 and 4a lesions: a multicenter diagnostic study.","authors":"Yang Gu, Jiawei Tian, Haitao Ran, Weidong Ren, Cai Chang, Jianjun Yuan, Chunsong Kang, Youbin Deng, Hui Wang, Baoming Luo, Shenglan Guo, Qi Zhou, Ensheng Xue, Weiwei Zhan, Qing Zhou, Jie Li, Ping Zhou, Chunquan Zhang, Man Chen, Ying Gu, Jinfeng Xu, Wu Chen, Yuhong Zhang, Jianchu Li, Hongyan Wang, Yuxin Jiang","doi":"10.1093/bjr/tqae197","DOIUrl":"https://doi.org/10.1093/bjr/tqae197","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the added value of strain elastography (SE) by recategorizing ultrasound (US) Breast Imaging Reporting and Data System (BI-RADS) 3 and 4a lesions.</p><p><strong>Methods: </strong>A total of 4371 patients underwent US and SE with BI-RADS 2-5 categories solid breast lesions were included from thirty-two hospitals. We evaluated the elastographic images according to elasticity scores (ES) and strain ratios (SR). Three combined methods (BI-RADS+ES, BI-RADS+SR, BI-RADS+ES+SR) and two reclassified methods were used (method one: upgrading BI-RADS 3 and downgrading BI-RADS 4a, method two: downgrading BI-RADS 4a alone). The diagnostic performance and the potential reduction of unnecessary biopsies were evaluated.</p><p><strong>Results: </strong>Combining BI-RADS with SE had a higher area under the curve (AUC) than BI-RADS alone (0.822-0.898 vs. 0.794, P<0.01). For reclassified method one, the sensitivity, specificity, and accuracy were 99.36%, 66.70%, 78.36% for BI-RADS+ES and 98.01%, 66.45%, 77.72% for BI-RADS+SR, and 99.42%, 66.70%, 78.38% for BI-RADS+ES+SR, respectively. For reclassified method two, the sensitivity, specificity, and accuracy were 99.17%, 70.72%, 80.87% for BI-RADS+ES and 97.76%, 81.75%, 87.46% for BI-RADS+SR, and 99.23%, 69.83%, 80.32% for BI-RADS+ES+SR, respectively. Downgrading BI-RADS 4a alone had higher AUC, specificity, and accuracy (P<0.01) and similar sensitivity (P>0.05) to upgrading BI-RADS 3 and downgrading BI-RADS 4a. Combining SE with BI-RADS could help reduce unnecessary biopsies by 17.64%-55.20%.</p><p><strong>Conclusions: </strong>Combining BI-RADS with SE improved the diagnostic performance in distinguishing benign from malignant lesions and could decrease false-positive breast biopsy rates. Downgrading BI-RADS 4a lesions alone might be sufficient for achieving good diagnostic performance.</p><p><strong>Advances in knowledge: </strong>Downgrading BI-RADS category 4a lesions alone had higher AUC, specificity, and accuracy, and similar sensitivity to upgrading or downgrading BI-RADS category 3 and 4a lesions.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458545","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}
Xuetong Tao, Ziba Gandomkar, Tong Li, Patrick C Brennan, Warren M Reed
{"title":"Radiomic Analysis of Cohort-Specific Diagnostic Errors in Reading Dense Mammograms Using Artificial Intelligence.","authors":"Xuetong Tao, Ziba Gandomkar, Tong Li, Patrick C Brennan, Warren M Reed","doi":"10.1093/bjr/tqae195","DOIUrl":"https://doi.org/10.1093/bjr/tqae195","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate radiologists' interpretation errors when reading dense screening mammograms using a radiomics-based artificial intelligence approach.</p><p><strong>Methods: </strong>Thirty-six radiologists from China and Australia read 60 dense mammograms. For each cohort, we identified normal areas that looked suspicious of cancer and the malignant areas containing cancers. Then radiomic features were extracted from these identified areas and random forest models were trained to recognize the areas that were most frequently linked to diagnostic errors within each cohort. The performance of the model and discriminatory power of significant radiomic features were assessed.</p><p><strong>Results: </strong>We found that in the Chinese cohort, the AUC values for predicting false positives were 0.864 (CC) and 0.829 (MLO), while in the Australian cohort, they were 0.652 (CC) and 0.747 (MLO). For false negatives, the AUC values in the Chinese cohort were 0.677 (CC) and 0.673 (MLO), and in the Australian cohort, they were 0.600 (CC) and 0.505 (MLO). In both cohorts, regions with higher Gabor and maximum response filter outputs were more prone to false positives, while areas with significant intensity changes and coarse textures were more likely to yield false negatives.</p><p><strong>Conclusions: </strong>This cohort-based pipeline proves effective in identifying common errors for specific reader cohorts based on image-derived radiomic features.</p><p><strong>Advances in knowledge: </strong>This study demonstrates that radiomics-based AI can effectively identify and predict radiologists' interpretation errors in dense mammograms, with distinct radiomic features linked to false positives and false negatives in Chinese and Australian cohorts.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388225","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":"Evolving SPECT-CT technology.","authors":"Kathy P Willowson, Dale L Bailey","doi":"10.1093/bjr/tqae200","DOIUrl":"https://doi.org/10.1093/bjr/tqae200","url":null,"abstract":"<p><p>Both hardware and software developments have seen single photon emission computed tomography (SPECT)/X-ray computed tomography (CT) technology grow at a rapid rate. Such growth has been fuelled by the need for clinical applications and has provided inspiration for clinical developments, particularly with the expanding role of theranostics. Developments such as whole-body quantitative reconstructions, digital detectors, and recent multidetector 3D geometry have allowed SPECT to become comparable to PET on a number of fronts, with a particularly powerful role in biodistribution and dosimetry studies for both planning and evaluating radionuclide therapy. Whilst there remain fundamental challenges for SPECT such the limited spatial resolution and sensitivity, the unique opportunity to image long-lived radioisotopes and simultaneous multi-tracer studies, together with easily accessible equipment, makes SPECT/CT a valuable clinical asset. This review discusses developments in SPECT/CT technology and their clinical impact.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388195","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}
Cecília Vidal de Souza Torres, André de Freitas Secaf, David Freire Maia Vieira, Alexandre Souto de Moraes Morgado, Matheus de Moraes Palma, Gabriel Andrade Ramos, Jorge Elias, Rodolfo B Reis, Valdair F Muglia
{"title":"The incremental value of Histogram Analysis in the differentiation between hyperdense cysts and solid renal masses on unenhanced CT images.","authors":"Cecília Vidal de Souza Torres, André de Freitas Secaf, David Freire Maia Vieira, Alexandre Souto de Moraes Morgado, Matheus de Moraes Palma, Gabriel Andrade Ramos, Jorge Elias, Rodolfo B Reis, Valdair F Muglia","doi":"10.1093/bjr/tqae198","DOIUrl":"https://doi.org/10.1093/bjr/tqae198","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the utility of voxel histogram analysis (HA) for differentiating hyperdense renal cysts from small solid masses on unenhanced computed tomography (CT) scans.</p><p><strong>Methods: </strong>A retrospective analysis of 99 hyperdense cystic lesions and 28 solid malignant lesions was conducted using a radiological database (from 2015 to 2021) and a pathological database (from 2010 to 2020). The study investigated the distribution of voxel attenuation values using percentiles to establish reliable criteria for differentiation after drawing a region of interest (ROI) in the centre of the lesions. The standard of reference was a histopathological diagnosis for malignant masses and contrast-enhanced CT or magnetic resonance imaging (MRI) for cysts.</p><p><strong>Results: </strong>HA provided higher diagnostic accuracy than the conventional mean attenuation value of 70 Hounsfield Units (HU). For the 75th and 90th percentiles ± 1 standard deviation, accuracies of 77.2% (95% confidence interval 68.9-84.2%) for the 75th and 68.5% (59.7-76.4%) for the 90th were found, versus 37.0% (28.6-46.0%) for the 70 HU threshold criterion. A Gaussian distribution of voxel attenuation values was observed in 88.9% of the lesions, suggesting that it is feasible to calculate these parameters from a single measurement.</p><p><strong>Conclusion: </strong>The study underscores the potential of HA as a valuable tool for characterizing hyperdense cysts on unenhanced CT by using the same ROI for measuring lesion attenuation. HA could offer additional value beyond the 70 HU criterion and possibly influence clinical decisions. Multi-institutional studies are necessary for external validation to confirm its generalizability and more extensive applicability.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388226","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":"Multiparameter magnetic resonance imaging features of prostatic malakoplakia.","authors":"Han-Jiang Zeng, Ling Yang, Jin Yao","doi":"10.1093/bjr/tqae205","DOIUrl":"https://doi.org/10.1093/bjr/tqae205","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the multiparameter magnetic resonance imaging (mpMRI) features of prostatic malakoplakia.</p><p><strong>Methods: </strong>Eleven patients (median age 62 years; IQR 59-71 years) with pathologically confirmed prostatic malakoplakia were included in this study. MpMRI features of the lesions were retrospectively reviewed and summarized.</p><p><strong>Results: </strong>The Prostate Imaging-Reporting and Data System (PI-RADS) scores of the patients were 4 or 5, with a medium diameter of 3.7 cm (IQR 2.0-5.2 cm). All the lesions involved the peripheral zone, of which 3 cases (3/11, 27.3%) involved the transition zone simultaneously. A diffuse symmetrical distribution was found in 5 cases, a focal distribution in 5 cases, and a focal symmetrical distribution in 1 case. Both the surgical capsule and prostatic margin were bulged and compressed, but no signs of infiltration were found. Nearly all the lesions had moderate hypointensity on T2-weighted images and slightly higher signal intensity on T1-weighted images. Among the lesions, early enhancement occurred in all cases, prolonged enhancement occurred in 8 cases, and ring enhancement persisted in 1 case. All lesions displayed periprostatic enhancement in the delayed phase.</p><p><strong>Conclusions: </strong>Lesions distributed diffusely and symmetrically in the peripheral zone with preserved surgical capsule and margin are characteristic features of malakoplakia as opposed to cancer, especially in those with slightly high T1 signal intensity and delayed periprostatic enhancement. Those locally distributed lesions with the above signs should also be suspected.</p><p><strong>Advances in knowledge: </strong>Prostatic malakoplakia are more likely to distribute diffusely and symmetrically, with slightly high T1 signal intensity and delayed periprostatic enhancement.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388197","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}
Ali Husnain, Abdul Aziz Aadam, Rajesh Keswani, Jasmine Sinha, Juan Carlos Caicedo, Andres Duarte, Kristine Stiff, Allison Reiland, Daniel Borja Cacho, Riad Salem, Ahsun Riaz
{"title":"Outcomes of Percutaneous Endobiliary Radiofrequency Ablation in Managing Resistant Benign Biliary Strictures: A Retrospective Analysis.","authors":"Ali Husnain, Abdul Aziz Aadam, Rajesh Keswani, Jasmine Sinha, Juan Carlos Caicedo, Andres Duarte, Kristine Stiff, Allison Reiland, Daniel Borja Cacho, Riad Salem, Ahsun Riaz","doi":"10.1093/bjr/tqae204","DOIUrl":"https://doi.org/10.1093/bjr/tqae204","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the safety and effectiveness of percutaneous endobiliary radiofrequency ablation (EB-RFA) in the management of refractory benign biliary strictures.</p><p><strong>Materials and methods: </strong>Percutaneous EB-RFA was performed in 15 individuals (M/F = 8/7; median age: 57 [33-84]) for benign biliary strictures resistant to traditional methods (transhepatic cholangioplasty and biliary drains). All patients underwent ≥1 unsuccessful cholangioplasty session and upsizing of their transhepatic biliary drains pre-procedure. Technical and clinical success were defined as luminal gain with enhanced flow and a lack of clinically evident recurrent stricture on follow-up after drain/stent removal, respectively.</p><p><strong>Results: </strong>A total of 16 EB-RFA procedures were performed. Technical success rate was 100% (16/16). Procedure-related complications occurred in 1/16 cases (drain leakage with subsequent cellulitis). Clinical success rate was 87% (13/15) with a median follow-up of 17 (2-24) months. Drain/stent was not removed in one case (1/16) as the patient was lost to follow-up immediately post-procedure. The 1-year patency rate was 100%. A significant reduction was observed in the median number of IR visits (8 [1-51] to 1 [0-9]; p = 0.003) and drain insertion/exchange procedures (5 [1-45] to 0 [0-6]; p = 0.003) pre- and post-EB-RFA with a median follow-up of 18 (0-26) months.</p><p><strong>Conclusion: </strong>Percutaneous EB-RFA can safely and effectively treat refractory benign biliary strictures. However, larger prospective studies with extended follow-ups are needed to gather more robust data.</p><p><strong>Advances in knowledge: </strong>This study contributes to the limited evidence on the role of EB-RFA in addressing refractory benign biliary strictures, enhancing the understanding of its clinical utility.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388198","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}
Mahmoud Soliman, Islam H Metwally, Adel Denewer, Ahmed Abdallah, Fatmaelzahraa Abdelfattah Denewar, Nuala Healy, Laszlo Romics, Amit Agrawal
{"title":"Computed Tomographic Angiography in Planning Thoraco-dorsal Artery Perforator Flap in Breast and Soft Tissue Reconstruction: A Systematic Review.","authors":"Mahmoud Soliman, Islam H Metwally, Adel Denewer, Ahmed Abdallah, Fatmaelzahraa Abdelfattah Denewar, Nuala Healy, Laszlo Romics, Amit Agrawal","doi":"10.1093/bjr/tqae203","DOIUrl":"https://doi.org/10.1093/bjr/tqae203","url":null,"abstract":"<p><strong>Objectives: </strong>Thoraco-dorsal Artery Perforator (TDAP) flaps have been increasingly used in breast and soft tissue reconstruction. Perforator localization is often done using a hand-held doppler, however, false results are not uncommon. This study aimed to systematically review the literature on the value of preoperative Computed Tomographic Angiography (CTA) in TDAP flaps examining scanning protocol, mapping technique, concordance with operative findings and disadvantages.</p><p><strong>Methods: </strong>A PRISMA-compliant comprehensive search of Medline, Embase, Cochrane Library and CINAHL databases was conducted in November 2023. We included studies evaluating CTA mapping of free and pedicled TDAPs for breast or soft tissue reconstruction using The Joanna Briggs Institute (JBI) Critical Appraisal Tools.</p><p><strong>Results: </strong>Five studies were included and considered at high risk of bias. The studies included 72 patients with a mean age of 43.8 years. Concordance between CT findings and Doppler mapping or operative visualization was reported in two studies. In three studies, CTA was combined with Doppler flowmetry, whilst dynamic infrared thermography was used in one study. Standardized scanning protocol and patient positioning were lacking in all reports.</p><p><strong>Conclusions: </strong>This study highlights the paucity of evidence on the value of CTA in TDA perforator mapping with inconsistent outcomes and non-standardized scanning protocols. Despite difficult imaging acquisition and interpretation, 3D reconstructed images and detailed vascular anatomy may facilitate planning.</p><p><strong>Advances in knowledge: </strong>Further research is required to explore the practical value of CTA in TDAP planning and standardizing protocols.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388194","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}
Luigi Camera, Vincenzo D'Ambrosio, Lorenzo Pinto, Adriana Paludi, Raffaele Liuzzi, Rossella De Cicco, Andrea Ponsiglione, Maria Grazia Lagnese, Simone Maurea, Arturo Brunetti
{"title":"Fixed Rate vs Fixed Injection Duration In Single-Pass Contrast-Enhanced Abdominal Multi-Detector CT: Effects On Vascular Enhancement.","authors":"Luigi Camera, Vincenzo D'Ambrosio, Lorenzo Pinto, Adriana Paludi, Raffaele Liuzzi, Rossella De Cicco, Andrea Ponsiglione, Maria Grazia Lagnese, Simone Maurea, Arturo Brunetti","doi":"10.1093/bjr/tqae202","DOIUrl":"https://doi.org/10.1093/bjr/tqae202","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects on vascular enhancement of either a fixed rate (FR) or a fixed injection duration (FID) in single-pass (SP) contrast-enhanced abdominal multi-detector CT (CE-MDCT).</p><p><strong>Materials & methods: </strong>Ninety-nine (54M; 45F; aged 18-86 yrs) patients with nontraumatic acute abdomen underwent a SP CE-MDCT after i.v. injection of 1.7 cc/Kg of a nonionic iodinated contrast-media (370 mgI/ml) performed with either a FR (2 cc/sec; Group A) or a FID (55 sec; Group B). In both groups, patients were further stratified according to total body weight (Kg) as follows: 40-60 (L); 61-80 (M); 81-100 (H). Signal- (SNR) and contrast-to-noise ratios (CNR) were calculated for the liver and for both abdominal aorta (AA) and main portal vein (MPV). Statistical analysis was performed by Student's T or Chi-square test for continuous and categorical data, respectively, whereas post-hoc analysis was performed by the Mann-Whitney test (p < 0.05).</p><p><strong>Results: </strong>There were no significant differences in demographic and physical characteristics between Group A (n = 50; 53 ± 20 yrs; BMI = 23.4 ± 4.4) and B (n = 50; 51 ± 17 yrs; BMI 22.7 ± 4.2). Whereas overlapping findings were observed in the M sub-groups (n = 40), SNR and CNR were significantly higher (p < 0.01) in Group B for both AA and MPV in the high (H) weight sub-groups (n = 20) while not significant differences were observed in the low (L) weight sub-groups (n = 40) despite a significantly lower injection rate (1.6 ± 0.2 cc/sec, p < 0.01) in Group B.</p><p><strong>Conclusion: </strong>A FID results in an overall better vascular enhancement than a FR in SP CE-MDCT.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388196","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}