British Journal of Radiology最新文献

{"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}

{"title":"Adding value in radiology-improved radiological diagnosis of osteoporotic vertebral fragility fractures following National UK Audit and Interventions.","authors":"David C Howlett, Hannah L Adams, Lamees Salman, Karl J Drinkwater","doi":"10.1093/bjr/tqaf054","DOIUrl":"10.1093/bjr/tqaf054","url":null,"abstract":"<p><p>Vertebral fragility fractures (VFFs) are the most common osteoporotic fracture, with significant associated morbidity, mortality, and risk of future fractures. Unfortunately, VFFs are frequently underdiagnosed and underreported. With this background, The Royal College of Radiologists (RCR), in collaboration with the Royal College of Physicians (RCP) and Royal Osteoporosis Society (ROS), undertook a UK-wide retrospective audit in 2019 to assess radiology reporting of incidental VFFs present on CT studies. The audit standards were not achieved; however, following a series of interventions, a re-audit in 2022 demonstrated generalized improvement in compliance with the audit parameters, in particular a 6-percentage point increase in moderate/severe VFFs reported. This article examines the potential benefits in terms of reductions in patient morbidity, mortality, and costs that could be expected if the improvements identified were translated to a national level, acknowledging and discussing other improvements that need to occur, with particular reference to onward referral pathways.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"650-652"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623540","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":"Using 18F-FDG PET/CT to predict programmed cell death ligand expression in non-small cell lung cancer via metabolic tumour heterogeneity.","authors":"Ruxi Chang, Liang Luo, Cong Shen, Weishan Zhang, Xiaoyi Duan","doi":"10.1093/bjr/tqaf034","DOIUrl":"10.1093/bjr/tqaf034","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study is to evaluate the effectiveness of using 18F-FDG PET/CT metabolic heterogeneity to assess the programmed cell death ligand (PD-L1) expression in primary tumours.</p><p><strong>Methods: </strong>Data from 103 non-small cell lung cancer (NSCLC) patients undergoing 18F-FDG PET/CT were collected. PD-L1 expression was verified via biopsy or surgical specimens. The coefficient of variation (COV) assessed metabolic heterogeneity of the primary tumour. ROC curves evaluated the predictive potential of metabolic metrics and defined thresholds. Logistic regression examined predictors of PD-L1 expression.</p><p><strong>Results: </strong>The study included 103 patients (mean age: 63.65 ± 9.28 years), of whom 60 were male. Sixty-four patients had positive PD-L1 expression, while 39 had negative PD-L1 expression. COV was significantly higher in the PD-L1-positive group (Z = -2.529, P = 0.011), while no significant differences were noted in other parameters between the groups (P > 0.05 for all). The optimal cut-off value was proposed as 28.9, with sensitivity and specificity of 46.9% (34.3%-59.8%) and 82.1% (66.5%-92.5%), respectively (AUC: 0.649 (0.549, 0.741)) which can more effectively identify PD-L1-negative patients. Other metabolic parameters are less effective than COV (AUC< 0.6). In addition, COV-defined metabolic heterogeneity outperformed other metabolic parameters in predicting PD-L1 expression (P = 0.049) and emerged as an independent predictor.</p><p><strong>Conclusion: </strong>Metabolic heterogeneity, described by the COV of the primary lesion, is a marker for predicting PD-L1 expression in NSCLC patients. Therefore, the COV of the primary tumour may complement conventional imaging in providing immunohistochemical information before biopsy.</p><p><strong>Advances in knowledge: </strong>COV of the primary tumour can predict PD-L1 expression, potentially complementing conventional imaging for immunohistochemical information prior to biopsy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"715-720"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466956","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":"Head and neck manifestations of extramedullary plasmacytomas and their differential diagnoses: a pictorial review.","authors":"Sophie Wilkinson, Susan Jawad, Xin-Ying Kowa","doi":"10.1093/bjr/tqaf031","DOIUrl":"10.1093/bjr/tqaf031","url":null,"abstract":"<p><p>Solitary plasmacytoma and multiple myeloma are plasma cell dyscrasias that typically present as bone tumour(s) due to abnormal and unregulated proliferation of plasma cells in the skeletal marrow. Both can manifest as soft tissue lesions within the head and neck region, and they may pose a diagnostic challenge given their relative rarity. This review aims to highlight the key multimodality imaging features of plasma cell neoplasms with an emphasis on extraosseous/extramedullary presentations in the anatomically complex head and neck region, as well as the relevant anatomy of various head and neck subsites and the main differential diagnoses that the radiologist should consider. Familiarity with these entities is crucial and will help the radiologist facilitate the timely diagnosis of plasma cell neoplasia using the arsenal of increasingly available and sensitive imaging techniques.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"640-649"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398298","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":"Natural history and long-term follow-up of incidental thyroid nodules on CT imaging.","authors":"Eda Lyuman, Claire McArthur","doi":"10.1093/bjr/tqaf002","DOIUrl":"10.1093/bjr/tqaf002","url":null,"abstract":"<p><strong>Objectives: </strong>Incidental thyroid nodules (ITNs) are found in up to 25% of CT scans. Increased use of cross-sectional imaging has contributed to the increased incidence of thyroid cancer worldwide. ITNs pose a management dilemma since nodule malignancy rate is 5%-15% but most cancers are indolent and prognosis in differentiated thyroid cancer is excellent. Study aims are to determine prevalence of ITNs ≥1 cm on CT scans, evaluate reporting practices, assess for emergence of clinically evident thyroid cancer during 13-year follow-up and assess interim nodule growth and clinical outcomes in nodules that were further investigated.</p><p><strong>Methods: </strong>Direct image review of 1499 consecutive CT scans that included the thyroid, performed during January 2009 in a large NHS health board was performed. Clinical data up to January 2022 was analysed in 150 patients with at least 1 ITN ≥1 cm.</p><p><strong>Results: </strong>ITN prevalence was 11% with mean patient age 70 years and mean nodule diameter 17.5 mm. 30% of ITNs were mentioned in the CT report. During the follow-up period 11% proceeded to thyroid ultrasound, 5% fine needle aspiration, and 2% diagnostic hemithyroidectomy with no thyroid malignancy found. One hundred twenty patients (80%) were deceased by the study endpoint, none from thyroid malignancy. No patients presented with clinically evident thyroid malignancy during follow-up.</p><p><strong>Conclusions: </strong>None of 150 ITN cases developed clinically evident thyroid malignancy in a 13-year follow-up period with 80% of patients deceased by the study endpoint from non-thyroid causes.</p><p><strong>Advances in knowledge: </strong>This would suggest that ITNs detected on CT do not require further investigation unless malignant appearances or significant clinical concern for thyroid malignancy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"686-692"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000549","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}