British Journal of Radiology最新文献

{"title":"The current state of imaging biomarker development and evaluation.","authors":"Steve Halligan, Sue Mallett","doi":"10.1093/bjr/tqaf027","DOIUrl":"https://doi.org/10.1093/bjr/tqaf027","url":null,"abstract":"<p><p>With a focus on imaging, this narrative review describes why biomarker research rarely culminates in anything clinically useful. We explain the difference between diagnostic and prognostic biomarkers and the different phases of their research. We describe what factors need consideration when designing research studies to generate evidence sufficient to translate a potential imaging biomarker into clinical practice. We emphasise the need to balance the number of biomarkers investigated with the number of available patient events, so that studies are not overwhelmed by false-positive results. We explain the need for rigorous evaluation, so that clinicians can be convinced the biomarker will work in their practice and benefit their patients. In particular, we explain why novel biomarkers should be evaluated alongside factors already known to be clinically useful, so that their incremental benefit, if any, can be determined.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398301","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":"Head and neck manifestations of extramedullary plasmacytomas and their differential diagnoses: a pictorial review.","authors":"S Wilkinson, S Jawad, X Kowa","doi":"10.1093/bjr/tqaf031","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging and Management of Lymphedema in the Era of Precision Oncology.","authors":"Pranjal Rai, Abhishek Mahajan, Shreya Shukla, Niyati Pokar","doi":"10.1093/bjr/tqaf029","DOIUrl":"https://doi.org/10.1093/bjr/tqaf029","url":null,"abstract":"<p><p>Lymphedema is a common complication of cancer treatment, leading to significant morbidity. Early and accurate diagnosis through the combined expertise of radiology and nuclear medicine is crucial for preventing lymphedema progression and improving patient outcomes. Imaging techniques such as lymphoscintigraphy, duplex ultrasound, MRI, and CT as well as newer modalities including near-infrared lymphangiography can diagnose and assess lymphedema severity. Bioimpedance spectroscopy (BIS) provides a non-invasive tool for early detection by measuring extracellular fluid changes, aiding in identifying lymphedema at its earliest stages. Pretreatment baseline measurements and prospective surveillance models (PSMs) are essential for tracking limb volume changes and mobility, enhancing early intervention outcomes. Recognizing the strengths and limitations of each imaging modality allows radiologists and nuclear medicine physicians to synergistically optimize lymphedema diagnosis and management. Effective management relies on multidisciplinary collaboration and includes conservative and surgical options tailored to disease severity. Advanced imaging modalities are pivotal for planning and monitoring interventional strategies. This review explores the development and management of secondary lymphedema in oncological patients, focusing chiefly on imaging and treatment strategies. It also briefly highlights the evolving role of artificial intelligence and machine learning in enhancing imaging precision and treatment outcomes.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398299","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":"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":"https://doi.org/10.1093/bjr/tqaf024","url":null,"abstract":"<p><strong>Objective: </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 <10mm, with cholecystectomy advised if polyp size increases. USS (including potential surgeries) 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 1,000 GBP patients with and without USS, stratified by initial size of GBP (<6mm and 6-9mm). We estimated USS resource and costs under alternate thresholds for surgery. Clinical data were extracted from a large-scale cohort study. TAUS and surgery 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 additional surgeries) were estimated between £213,441 (n = 50) and £750,045 (n = 253) in GBPs <6mm, and between £420,275 (n = 165) and £531,297 (n = 207) in GBPs 6-9mm, balanced against avoidance of 1.3 (<6mm) and 8.7 (6-9mm) 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 <10mm, 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>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Research Applications of FAPI Tracers: A Review.","authors":"Mélanie Desaulniers, Étienne Rousseau, Kim M Pabst","doi":"10.1093/bjr/tqaf020","DOIUrl":"https://doi.org/10.1093/bjr/tqaf020","url":null,"abstract":"<p><p>In the last decade, fibroblast activation protein-α inhibitors (FAPIs), which target the cancer-associated fibroblasts of the tumour microenvironment, have become a topic of great interest. In oncology, FAPI PET/CT imaging has repeatedly demonstrated a higher lesion detection rate than other conventional imaging modalities such as CT or 18F-FDG PET/CT for several tumours. In some cases, the initial staging and therapeutic management may even change. Some FAPI radioligands may also be labelled with therapeutic radionuclides for theranostic applications. It is thus possible to treat certain metastatic cancers with FAPI radioligand therapy (FAPI-RLT), which is generally well tolerated with little toxicity. Recently, new FAPIs have been developed with the particularity of having a higher binding affinity the target, which further improves the lesion detection rate on PET/CT and clinical outcomes following FAPI-RLT. This review provides recent updates in the clinical use of FAPI PET/CT and FAPI-RLT, and discusses potential emergent applications, including in inflammation imaging.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255006","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":"Electrochemotherapy in metastatic epidural spinal cord compression: a review and technical update.","authors":"F Deschamps, L Tselikas, R L Cazzato, G Facchini, V Granata, B Bonnet, V D'Alessio, R Fusco, A Zanasi, F De Terlizzi, A Gangi, T de Baere, L M Mir","doi":"10.1093/bjr/tqae219","DOIUrl":"https://doi.org/10.1093/bjr/tqae219","url":null,"abstract":"<p><p>This review aims to analyse the safety and clinical efficacy in terms of pain relief and local tumour control, in patients with metastatic epidural spinal cord compression undergoing electrochemotherapy (ECT). Moreover, a recommendation detailing optimal electrodes insertion is proposed with the intent of improving treatment planning. Clinical studies published between 2015 and 2023 were included since this time window is consistent with recent developments in the field of ECT of spinal metastases. In the whole, three articles were included. Results showed that percutaneous image-guided ECT provides effective pain relief with limited procedure-related morbidity, along with local tumour control (complete response 28.5%, 38% partial response, 24% stable disease) at 3- month follow-up in the largest published series so far. In conclusion, ECT should integrate the armamentarium of therapies that are currently being proposed to patients with painful metastatic epidural disease.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122199","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":"Revolutionising Osseous Biopsy: The Impact of Artificial Intelligence in the Era of Personalised Medicine.","authors":"Amanda Isaac, Michail E Klontzas, Danoob Dalili, Asli Irmak Akdogan, Mohamed Fawzi, Giuseppe Gugliemi, Dimitrios Filippiadis","doi":"10.1093/bjr/tqaf018","DOIUrl":"https://doi.org/10.1093/bjr/tqaf018","url":null,"abstract":"<p><p>In a rapidly evolving healthcare environment, artificial intelligence (AI) is transforming diagnostic techniques and personalised medicine. This is also seen in osseous biopsies. AI applications in radiomics, histopathology, predictive modelling, biopsy navigation, and interdisciplinary communication are reshaping how bone biopsies are conducted and interpreted. We provide a brief review of AI in image- guided biopsy of bone tumours (primary and secondary) and specimen handling, in the era of personalised medicine. This paper explores AI's role in enhancing diagnostic accuracy, improving safety in biopsies, and enabling more precise targeting in bone lesion biopsies, ultimately contributing to better patient outcomes in personalised medicine. We dive into various AI technologies applied to osseous biopsies, such as traditional machine learning, deep learning, radiomics, simulation and generative models. We explore their roles in tumour board meetings, communication between clinicians, radiologists, and pathologists. Additionally, we inspect ethical considerations associated with the integration of AI in bone biopsy procedures, technical limitations, and we delve into health equity, generalisability, deployment issues, and reimbursement challenges in AI-powered healthcare. Finally, we explore potential future developments and offer a list of open-source AI tools and algorithms relevant to bone biopsies, which we include to encourage further discussion and research.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058063","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":"Clinical Trials in Cancer Theranostics with Potential Near-Term Impact on Clinical Practice.","authors":"Hossein Jadvar, Abtin Doroudinia, Peter S Conti, Patrick M Colletti","doi":"10.1093/bjr/tqaf017","DOIUrl":"https://doi.org/10.1093/bjr/tqaf017","url":null,"abstract":"<p><p>Theranostics has its roots with the first radioiodine therapy for thyroid diseases in about 80 years ago. More recently the field has experienced a remarkable renascence with the regulatory approval of paired imaging and radiopharmaceutical therapy agents in gastroenteropancreatic neuroendocrine tumors and metastatic castration-resistant prostate cancer that are now employed in routine clinical practice. The momentum is strong for identification and testing of new theranostic agents for use in various cancers and finding new clinical incications of the available agents. There are currently numerous preclinical, first-in-human studies, large-scale prospective registries, and clinical trials including randomized trials underway in cancer theranostics that target a variety of germane biological targets. The results of these investigations, if successful, will undoubtedly impact the future of cancer management which is anticipated to improve patient outcome. Multi-targeted theranostics may also provide opportunities for synergistic efficacy to tackle the inherent complexities driven by the heterogeneity of cancer. In this article, we review the currently active recruiting phase 2 and phase 3 clinical trials in cancer theranostics that are targeted to the prostate-specific membrane antigen, gastrin-releasing peptide receptor, and fibroblast activation protein, with the anticipated potential near-term (<5 years) impact on clinical practice.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051790","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":"The value of ultrasound measured rectus femoris thickness, cross-sectional area and shear wave velocity in assessment of muscle in postmenopausal women with osteosarcopenia.","authors":"Zi-Tong Chen, Jia-Ying Ge, Feng-Shan Jin, Le-Hang Guo, Qiao Wang, Hui Zhao, Li-Ping Sun, Hui-Xiong Xu, Hui Sheng, Xiao-Long Li","doi":"10.1093/bjr/tqaf012","DOIUrl":"https://doi.org/10.1093/bjr/tqaf012","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the value of ultrasound (US) and shear wave velocity (SWV) to assess muscle in postmenopausal women with osteosarcopenia (OSP).</p><p><strong>Methods: </strong>This study included 145 postmenopausal women, comprising 115 osteopenia/osteoporosis participants without sarcopenia (OP alone) and 30 OSP participants. All received the evaluation of bone mineral density (BMD), appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-meter walking speed, and 5-time chair stand test. The cross-sectional area (RFcsa), thickness (RFthickness), and mean SWV of rectus femoris (RF) were measured by US and shear wave elastography. The clinical characteristics, RFcsa, RFthickness, and SWV, were compared between OP alone and OSP to determine the independent predictors of OSP. Receiver operating characteristic (ROC) curve analysis was used to evaluate the value of US and SWV for assessment of OSP.</p><p><strong>Results: </strong>The RFcsa, RFthickness, SWV, and BMD of OSP were lower than those of OP alone (all P < 0.05). Through multivariate analysis, the diagnostic performance of the prediction model (area under the ROC curve, AUC, 0.917) composed of RFcsa and SWV was superior to RFcsa (AUC, 0.847), RFthickness (AUC, 0.797), and SWV (AUC, 0.740) alone. Moreover, the prediction model achieved 70.0% sensitivity, 93.0% specificity, and 88.3% accuracy.</p><p><strong>Conclusions: </strong>The RFcsa, RFthickness, and SWV have potential value in assessing muscle in OSP and can be applied to routine clinical management of postmenopausal women.</p><p><strong>Advances in knowledge: </strong>US measured RF thickness, CSA and SWV could assist detection and clinical management of OSP in postmenopausal women.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032298","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":"18F-DCFPyL PET/MRI Radiomics for Intraprostatic Prostate Cancer Detection and Metastases Prediction Using Whole-Gland Segmentation.","authors":"Seyed Ali Mirshahvalad, Adriano Basso Dias, Claudia Ortega, Jorge Andres Abreu Gomez, Satheesh Krishna, Nathan Perlis, Alejandro Berlin, Theodorus van der Kwast, Kartik Jhaveri, Sangeet Ghai, Ur Metser, Anna Theresa Santiago, Patrick Veit-Haibach","doi":"10.1093/bjr/tqaf014","DOIUrl":"https://doi.org/10.1093/bjr/tqaf014","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate 18F-DCFPyL-PET/MRI whole-gland-derived radiomics for detecting clinically significant (cs) prostate cancer (PCa) and predicting metastasis.</p><p><strong>Methods: </strong>Therapy-naïve PCa patients who underwent 18F-DCFPyL PET/MRI were included. Whole-prostate-segmentation was performed. Feature extraction from each modality was done. The selection of potential variables was made through regularized binomial logistic regression. The oversampled training data were used to train binomial logistic regression for each outcome. The estimates of the models were calculated, and the mean accuracy was reported. The trained models were assessed on the test data for comparative evaluation of performance.</p><p><strong>Results: </strong>A total of 103 patients (mean age=65;mean PSA=23.4) were studied. Among them, 89 had csPCa, and 20 had metastatic disease. There were 5 radiomics variables selected for ISUP-GG≥2 from T2w, ADC and PET. To detect N1, five radiomics variables were selected from the T2w and PET. For M1, four radiomics variables were selected from T2w and ADC. Regarding the performance of models for the prediction of csPCa, the imaging-based hybrid model (T2w+PET) provided the highest AUC(0.98). The performance of N1 models showed the highest AUC(0.80) for T2w+PET. To predict M1, the T2w+ADC model showed the highest AUC(0.93).</p><p><strong>Conclusions: </strong>Whole-gland PET/MRI-radiomics may provide a reliable model to predict csPCa. Also, acceptable performance was reached for predicting metastatic disease in our limited population. Our findings may support the value of whole-gland radiomics for non-invasive csPCa detection and prediction of metastatic disease.</p><p><strong>Advances in knowledge: </strong>Whole-gland PET/MRI-radiomics, a less operator-dependent segmentation method, can be potentially used for treatment personalization in PCa patients.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028054","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}