British Journal of Radiology最新文献

{"title":"Evaluating Amide Proton Transfer Imaging for Improved Glioma Assessment: Implications for RANO 2.0 Criteria.","authors":"Hua-Zhen Deng, Xing-Liang Liu, Wen-Jing Fan, Xue Hua, Yilinuer Yilihamu, Yongzhou Xu, Han-Wen Zhang, Xiao-Lei Liu, Fan Lin","doi":"10.1093/bjr/tqaf115","DOIUrl":"https://doi.org/10.1093/bjr/tqaf115","url":null,"abstract":"<p><strong>Objectives: </strong>The updated RANO 2.0 criteria acknowledge the limitations of conventional MRI in distinguish tumour progression (TP) from pseudoprogression (PsP) after surgery. Advanced imaging techniques, such as Amide Proton Transfer (APT) imaging, further validating its integration into the RANO 2.0 framework to enhance assessment accuracy.</p><p><strong>Methods: </strong>This study retrospectively analyzed 75 patients with high-grade gliomas who underwent MRI, including APT imaging. APT imaging was assessed for its ability to differentiate true tumor recurrence from PsP, using various regions of interest (ROIs) to analyze APT signal variations.</p><p><strong>Results: </strong>APT imaging significantly improved the diagnostic accuracy in distinguishing glioma TP from PsP when compared to conventional MRI alone. Metrics such as APTmax and APTmean demonstrated higher sensitivity and specificity compared to APTmin, validating the integration of APT imaging into the RANO 2.0 criteria by providing valuable insights into tumor metabolism and the microenvironment.</p><p><strong>Conclusions: </strong>APT imaging is a valuable addition to conventional MRI for postoperative glioma evaluation. supporting its integration into the RANO 2.0 criteria for a more accurate assessment of tumor status and potentially guiding better patient management. Further research is needed to confirm these findings and establish clinical protocols.</p><p><strong>Advances in knowledge: </strong>This study highlights the potential of APT imaging in enhancing the diagnostic accuracy for distinguishing TP from PsP, demonstrates that APT imaging, particularly when integrated with multimodal MRI (T1WI, T2WI, T2-FLAIR and contrast-enhanced T1WI), improves the sensitivity and specificity of diagnosis.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157028","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":"Development and external validation of a predictive model of nondiagnostic results in patients undergoing CT-guided percutaneous transthoracic needle lung biopsy.","authors":"Yonghao Du, Linyun Yang, Xuyin Zhang, Ting Liang, Shaonong Dang, Shanshan Liu, Rong Wang, Gang Niu","doi":"10.1093/bjr/tqaf110","DOIUrl":"https://doi.org/10.1093/bjr/tqaf110","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and validate a nomogram to predict nondiagnostic results in patients undergoing CT-guided percutaneous transthoracic needle biopsy (PTNB) of the lung.</p><p><strong>Methods: </strong>A total of 954 PTNBs in the training cohort and 186 PTNBs in the external validation cohort were retrospectively included. PTNB results were categorized as diagnostic or nondiagnostic. Logistic regression was used to identify independent predictors of nondiagnostic results. C-statistic, calibration curve, and decision curve analysis were used to evaluate discrimination, calibration, and clinical usefulness, respectively.</p><p><strong>Results: </strong>Of 954 PTNBs in the training cohort, 280 (29.4%) were nondiagnostic results. The model included six independent predictors: age at biopsy, lesion size, lobulation sign, air bronchogram, the number of samples, and pre-test probability. The C-statistics for the training and external validation cohorts were 0.752 and 0.734, respectively. Two risk groups were identified with low (<40%) and high (≥40%) probabilities of nondiagnostic results. For lesions of low risk with the number of samples ≤ 2, ≤2 samples should be obtained; for lesions of low risk with the number of samples ≥3, more samples should be obtained when appropriate; for lesions of high risk with the number of samples ≥3, PTNB needs to be reconsidered.</p><p><strong>Conclusions: </strong>The nomogram showed good performance in predicting the nondiagnostic results of PTNB of the lung. Suggestions for each risk group may facilitate clinical practice.</p><p><strong>Advances in knowledge: </strong>Pretest probability was a significant factor to predict nondiagnostic results of PTNB. The number of samples of PTNB should be different for different risk groups to avoid nondiagnostic results.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149485","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":"Machine Learning Model for Predicting Omicron Prognosis Based on CT and Clinical Variables.","authors":"Hassan Tariq, Daanyal Siddiqui","doi":"10.1093/bjr/tqaf072","DOIUrl":"https://doi.org/10.1093/bjr/tqaf072","url":null,"abstract":"","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149527","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":"Exploiting the endothelial-immune axis to improve radiotherapy efficacy.","authors":"Olivier Guipaud, Claire Lago, Lucie Portier, Vincent Paget, Agnès François, Stéphane Supiot, Fabien Milliat","doi":"10.1093/bjr/tqaf114","DOIUrl":"https://doi.org/10.1093/bjr/tqaf114","url":null,"abstract":"<p><p>The immune system is essential for controlling tumours and plays a crucial role in how normal and cancer tissues respond to radiotherapy. Lining the inner surface of vessels, the endothelium acts as a barrier that normally prevents the passage of cells from the bloodstream into tissues and promotes the recruitment of immune cells during stressful, injured or infected conditions. Profound changes in endothelial function occur in response to irradiation, determining the tumour response to radiotherapy and participating in the initiation and development of adverse effects. In both normal tissues and tumours, radiation makes endothelial cells more adhesive to circulating cells, stimulates transendothelial migration and promotes immune infiltration, possibly chronic and harmful to normal tissues. Considering the active role of endothelium in immune cell recruitment, targeting endothelial cells becomes an attractive strategy to improve the therapeutic gain of radiotherapy. To this end, it is crucial to better understand how endothelial cells respond to irradiation in vivo and to determine their role in regulating immune cell recruitment. Advanced analytical technologies, such as single-cell RNA sequencing and spatial transcriptomics, now enable to uncover the molecular responses of cells in living organisms and comprehend their interactions within an organ. Here, we present the latest findings regarding the impact of radiation on the vascular endothelium and its implications for normal tissues and tumours. We also explore current research using single-cell analysis to uncover new cell types, molecular pathways, and cell-cell interactions in irradiated animal models and human patients. Additionally, we highlight how endothelial cell-mediated immune recruitment may represent a potential target for modulating the immune response.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149505","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 contrast-enhanced agent on segmentation using a deep learning-based software \"Ai-Seg\" for head and neck cancer.","authors":"Sayaka Kihara, Yoshihiro Ueda, Shuichi Harada, Akira Masaoka, Naoyuki Kanayama, Toshiki Ikawa, Shoki Inui, Takashi Akagi, Teiji Nishio, Koji Konishi","doi":"10.1093/bjr/tqaf108","DOIUrl":"https://doi.org/10.1093/bjr/tqaf108","url":null,"abstract":"<p><strong>Objectives: </strong>In radiotherapy, auto-segmentation tools using deep learning assist in contouring organs-at-risk (OARs). We developed a segmentation model for head and neck (HN) OARs dedicated to contrast-enhanced (CE) computed tomography (CT) using the segmentation software, Ai-Seg, and compared the performance between CE and non-CE (nCE) CT.</p><p><strong>Methods: </strong>The retrospective study recruited 321 patients with HN cancers and trained a segmentation model using CE CT (CE model). The CE model was installed in Ai-Seg and applied to additional 25 patients with CE and nCE CT. The Dice similarity coefficient (DSC) and average Hausdorff distance (AHD) were calculated between the ground truth and Ai-Seg contours for brain, brainstem, chiasm, optic nerves, cochleae, oral cavity, parotid glands, pharyngeal constrictor muscle, and submandibular glands (SMGs). We compared the CE model and the existing model trained with nCE CT available in Ai-Seg for 6 OARs.</p><p><strong>Results: </strong>The CE model obtained significantly higher DSCs on CE CT for parotid and SMGs compared to the existing model. The CE model provided significantly lower DSC values and higher AHD values on nCE CT for SMGs than on CE CT, but comparable values for other OARs.</p><p><strong>Conclusions: </strong>The CE model achieved significantly better performance than the existing model and can be used on nCE CT images without significant performance difference, except SMGs. Our results may facilitate the adoption of segmentation tools in clinical practice.</p><p><strong>Advances in knowledge: </strong>We developed a segmentation model for HN OARs dedicated to CE CT using Ai-Seg and evaluated its usability on nCE CT.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149514","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":"Repeated ultraselective transcatheter arterial chemoembolization (rusTACE) for hepatocellular carcinoma with portal vein thrombus.","authors":"Akira Yamamoto, Ken Kageyama, Atsushi Jogo, Etsuji Sohgawa, Ryuichi Kita, Sawako Uchida-Kobayashi, Shigekazu Takemura, Akihiro Tamori, Toshio Kaminou, Yukio Miki","doi":"10.1093/bjr/tqaf112","DOIUrl":"https://doi.org/10.1093/bjr/tqaf112","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the safety and long-term effectiveness of repeated ultraselective transarterial chemoembolization (rusTACE) using a 1.7-Fr-tip microcatheter in HCC patients with portal vein tumor thrombus (PVTT).</p><p><strong>Methods: </strong>This retrospective analysis includes HCC patients with PVTT treated with rusTACE between May 2014 and July 2022. A 1.7-Fr-tip microcatheter was used to perform rusTACE for ultraselective embolization of the tumor-feeding artery. Treatment was repeated at least 2 times within 2 months. Treatment responses, survival rates, adverse event, liver function, and tumor-feeding arteries were assessed.</p><p><strong>Results: </strong>Twenty patients underwent rusTACE with a mean interval of 42 days between treatments. RusTACE was well-tolerated. Median survival time was 26.1 months, with 1-, 2-, 3-, and 5-year survival rates of 85.0%, 61.0%, 40.9%, and 24.6%, respectively. Complete response (CR) of PVTT was achieved in 75%. Among these, 35% maintained CR of PVTT throughout follow-up (mean, 25.0 months). Univariate analysis showed prognostic factors included Child-Pugh score 5, CR of PVTT, CR of systemic tumors at the end of rusTACE, and liver tumor burden <30%. In 17%, a peribiliary vascular plexus or communicating artery was identified as the tumor-feeding artery.</p><p><strong>Conclusions: </strong>RusTACE is a safe and effective treatment option for HCC with PVTT in selected patients (Child-Pugh class A). RusTACE showed a high CR rate and long overall survival. The short interval between treatments and ultraselective embolization of tumor-feeding arteries contributed to favorable outcomes.</p><p><strong>Advances in knowledge: </strong>RusTACE can be safely performed in HCC with PVTT and has a high local control rate.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149532","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":"Calculating Optic Nerve Planning Organ at Risk Volume Margins for Stereotactic Radiosurgery using optic nerve motion determined using MRI.","authors":"Sagar Sabharwal, Geoff Heyes, GeorgeS J Tudor, Robert Flintham, Swarupsinh Chavda, Paul Sanghera","doi":"10.1093/bjr/tqaf073","DOIUrl":"https://doi.org/10.1093/bjr/tqaf073","url":null,"abstract":"","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149460","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 deep inspiration breath-hold (DIBH) and fractionation on immune system exposure in breast radiotherapy.","authors":"Pierre Loap, Jeremi Vu-Bezin, Ludovic De Marzi, Youlia Kirova","doi":"10.1093/bjr/tqaf113","DOIUrl":"https://doi.org/10.1093/bjr/tqaf113","url":null,"abstract":"<p><strong>Objective: </strong>The immune system has been recognized as an organ-at-risk in esophageal and lung cancers. The potential impact of deep inspiration breath-hold (DIBH) and fractionation on immune system preservation in breast radiation therapy is presently unknown. The aim of this study was to assess the magnitude of the benefit of DIBH and hypofractionation on immune system exposure in adjuvant irradiation of right breast cancers.</p><p><strong>Methods: </strong>Ten consecutive patients treated volumetric-modulated arc therapy (VMAT)with DIBH for adjuvant locoregional irradiation of the right breast where included. The effective dose to the immune system (EDIC) was calculated for each patient (the absolute contribution of the lungs, heart, liver and total integral dose to the EDIC was evaluated) based on normofractionated and hypofractionated regimens, with or without DIBH.</p><p><strong>Results: </strong>EDIC was significantly lower in DIBH than in free breathing, both in standard fractionation (2.81 Gy [range: 2.44; 3.38] vs. 3.1 Gy [2.63; 3.94], p < 0. 01) and hypofractionation (2.15 Gy [1.87; 2.58] vs. 2.35 Gy [2.02; 2.96], p < 0.01), corresponding to a relative EDIC reduction of approximately 10% with DIBH. EDIC was lower with hypofractionation with free breathing than with conventional fractionation with DIBH (p < 0.01).</p><p><strong>Conclusion: </strong>DIBH significantly reduces the dose to the immune system by 10% in cases of locoregional irradiation of right breast cancers, and moderate hypofractionation results in an EDIC gain compared with any standard fractionation treatment. Pending formal demonstration of a relationship between dose to the immune system and survival, as is the case in other localizations, we suggest as a precaution the use of DIBH combined with hypofractionated treatment in cases where immune sparing seems most important, such as breast cancers with a poor response after preoperative immunotherapy.</p><p><strong>Advances in knowledge: </strong>DIBH significantly reduces the dose to the immune system by 10% in cases of locoregional irradiation of right breast cancers, and moderate hypofractionation results in an EDIC gain compared with any standard fractionation treatment. Pending formal demonstration of a relationship between dose to the immune system and survival, as is the case in other localizations, we suggest as a precaution the use of DIBH combined with hypofractionated treatment in cases where immune sparing seems most important, such as breast cancers with a poor response after preoperative immunotherapy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149526","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":"Letter to the editor regarding study design for diagnostic performance of S-detect in differentiating breast masses.","authors":"Jatin Naidu, Hitesh Muthyala","doi":"10.1093/bjr/tqaf109","DOIUrl":"https://doi.org/10.1093/bjr/tqaf109","url":null,"abstract":"","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136009","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":"Computed tomography angiography of the carotid body: bridging the gap between normal and neoplastic lesions.","authors":"Sezer Nil Yılmazer Zorlu, Çağlar Uzun, Ebru Düşünceli Atman, Ruhi Erdem Ergüden, Atilla Halil Elhan","doi":"10.1093/bjr/tqaf096","DOIUrl":"https://doi.org/10.1093/bjr/tqaf096","url":null,"abstract":"<p><strong>Objective: </strong>Sympathetic nervous system hyperactivation in chronic conditions, such as hypertension and metabolic syndrome, can lead to carotid body (CB) hyperplasia, potentially mimicking small carotid body tumors (CBTs) in radiological evaluations. This study aimed to investigate computed tomography angiography (CTA) findings to differentiate CBTs from non-neoplastic CBs.</p><p><strong>Methods: </strong>Patients were categorized into CBT and non-neoplastic CB groups. Demographics (smoking status, hypertension, diabetes mellitus), shape, dimensions, volume, and density (including standard deviations) were assessed. Density ratios were calculated using CB/CBT and ipsilateral common carotid artery density. Diagnostic performance was evaluated via ROC analysis, and logistic regression identified factors associated with increased CBT risk.</p><p><strong>Results: </strong>Significant differences between the CB and CBT groups were found in gender, smoking status, and shape (p < 0.01), while age, location, hypertension, and diabetes mellitus showed no association (p > 0.05). The CBT group had significantly higher density, standard deviation, and density ratios (p < 0.001). Multivariate analysis, adjusted for age, gender, and smoking, showed that saddle shape, standard deviation ≥21.5, and density ratio ≥0.5603 predicted CBT diagnosis with 92.6% sensitivity and 99.3% specificity.</p><p><strong>Conclusions: </strong>Saddle shape, along with increased density and standard deviation values, emerges as findings suggestive of a CBT diagnosis. The proposed imaging features may improve differentiation of small CBTs from non-neoplastic CBs, particularly in cases with enlarged CBs lacking typical tumor features.</p><p><strong>Advances in knowledge: </strong>Specific CTA findings, including saddle shape, increased density, and standard deviation, can effectively differentiate small CBTs from non-neoplastic CBs, offering a novel approach to improving radiological diagnostics in cases with CB hyperplasia.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953914","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}