British Journal of Radiology最新文献_第6页

Natural History and Long Term Follow-Up of Incidental Thyroid Nodules on Computed Tomography Imaging. 偶发性甲状腺结节的计算机断层成像的自然历史和长期随访。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-21 DOI: 10.1093/bjr/tqaf002

Eda Lyuman, Claire McArthur

{"title":"Natural History and Long Term Follow-Up of Incidental Thyroid Nodules on Computed Tomography Imaging.","authors":"Eda Lyuman, Claire McArthur","doi":"10.1093/bjr/tqaf002","DOIUrl":"https://doi.org/10.1093/bjr/tqaf002","url":null,"abstract":"Objectives: 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.Methods: 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 one ITN > =1cm.Results: 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. 120 patients (80%) were deceased by the study endpoint, none from thyroid malignancy. No patients presented with clinically evident thyroid malignancy during follow-up.Conclusions: None of150 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.Advances in knowledge: This would suggest that ITNs detected on CT do not require further investigation unless malignant appearances or significant clinical concern for thyroid malignancy.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bone lesion cryotherapy: pictorial review and review of current evidence. 骨损伤冷冻治疗：图像回顾和当前证据回顾。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-15 DOI: 10.1093/bjr/tqaf007

N Jenko, R D Henderson, A T Patel

引用次数: 0

An update on pancreatic cancer imaging, staging, and use of the PACT-UK radiology template pre- and post-neoadjuvant treatment. 胰腺癌成像、分期以及新辅助治疗前后 PACT-UK 放射学模板使用的最新情况。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae217

Carmelo Corallo, Abdullah S Al-Adhami, Nigel Jamieson, Juan Valle, Ganesh Radhakrishna, John Moir, Raneem Albazaz

{"title":"An update on pancreatic cancer imaging, staging, and use of the PACT-UK radiology template pre- and post-neoadjuvant treatment.","authors":"Carmelo Corallo, Abdullah S Al-Adhami, Nigel Jamieson, Juan Valle, Ganesh Radhakrishna, John Moir, Raneem Albazaz","doi":"10.1093/bjr/tqae217","DOIUrl":"10.1093/bjr/tqae217","url":null,"abstract":"Pancreatic ductal adenocarcinoma continues to have a poor prognosis, although recent advances in neoadjuvant treatments (NATs) have provided some hope. Imaging assessment of suspected tumours can be challenging and requires a specific approach, with pancreas protocol CT being the primary imaging modality for staging with other modalities used as problem-solving tools to facilitate appropriate management. Imaging assessment post NAT can be particularly difficult due to a current lack of robust radiological criteria to predict response and differentiate treatment induced fibrosis/inflammation from residual tumour. This review aims to provide an update of pancreatic ductal adenocarcinoma with particular focus on three points: tumour staging pre- and post-NAT including vascular assessment, structured reporting with introduction of the PAncreatic Cancer reporting Template-UK (PACT-UK) radiology template, and the potential future role of artificial intelligence in the diagnosis and staging of pancreatic cancer.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"13-26"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495544","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}

引用次数: 0

Calculating optic nerve planning organ at risk volume margins for stereotactic radiosurgery using optic nerve motion determined using MRI. 利用磁共振成像确定的视神经运动计算立体定向放射外科手术的视神经规划风险器官体积边缘。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae201

Sagar Sabharwal, Geoff Heyes, George S J Tudor, Robert Flintham, Swarupsinh Chavda, Paul Sanghera

{"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, George S J Tudor, Robert Flintham, Swarupsinh Chavda, Paul Sanghera","doi":"10.1093/bjr/tqae201","DOIUrl":"10.1093/bjr/tqae201","url":null,"abstract":"Objectives: The combination of sharp dose gradients in stereotactic radiosurgery (SRS) and minute optic nerve motion may significantly increase dose to the optic nerves when treating perioptic lesions. The aim of this study was to calculate optic nerve planning organ at risk volume (PRV) margins for CyberKnife SRS treatment planning.Methods: MRI scans were taken of 10 healthy volunteers looking left, right, up, down, and straight ahead to measure optic nerve motion. The measured optic nerve motion and the uncertainties in the technical accuracy of CyberKnife were used to calculate optic nerve PRV margins.Results: Two optic nerve PRV margins were calculated: a non-isotropic margin of mL/R,PRV=3 mm, mSup/Inf,PRV=2 mm, and mAnt/Post,PRV=1 mm which considers the full range of motion measured in a worst case scenario; and an isotropic margin of mPRV=1 mm which considers a scenario where patients are asked to look neutrally during imaging and treatment. Applying these PRVs to 8 historical sphenoid wing meningioma CyberKnife plans showed tolerance levels may be exceeded due to optic nerve motion.Conclusions: Optic nerve PRV margins may be needed in CyberKnife planning to reduce risk to the optic nerves. The use of a mPRV=1 mm PRV to account for organ motion, along with instructing patients to hold their gaze neutrally during imaging and treatment, may be a suitable organ sparing strategy.Advances in knowledge: Measured optic nerve motion and the technical accuracy of the CyberKnife system have been used to calculate optic nerve PRV margins.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"107-113"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375110","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}

引用次数: 0

Radiomic analysis of cohort-specific diagnostic errors in reading dense mammograms using artificial intelligence. 利用人工智能对阅读致密乳腺 X 线照片时的特定组群诊断错误进行放射学分析。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae195

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":"10.1093/bjr/tqae195","url":null,"abstract":"Objectives: This study aims to investigate radiologists' interpretation errors when reading dense screening mammograms using a radiomics-based artificial intelligence approach.Methods: 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.Results: 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.Conclusions: This cohort-based pipeline proves effective in identifying common errors for specific reader cohorts based on image-derived radiomic features.Advances in knowledge: 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.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"75-88"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652727/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of low-dose CT and MRI in enthesitis-related arthritis patients with sacroiliitis. 对骶髂关节炎相关关节炎患者进行低剂量计算机断层扫描和磁共振成像的比较。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae210

Yunus Emre Bayrak, Törehan Özer, Yonca Anık, Nihal Şahin, Hafize Emine Sönmez

{"title":"Comparison of low-dose CT and MRI in enthesitis-related arthritis patients with sacroiliitis.","authors":"Yunus Emre Bayrak, Törehan Özer, Yonca Anık, Nihal Şahin, Hafize Emine Sönmez","doi":"10.1093/bjr/tqae210","DOIUrl":"10.1093/bjr/tqae210","url":null,"abstract":"Objective: This study investigated the utility of low-dose CT (ldCT) compared with MRI in diagnosing sacroiliitis in enthesitis-related arthritis (ERA) patients.Methods: Thirty patients diagnosed with ERA were evaluated, with a median follow-up of 1.47 years. Images from patients were examined by two paediatric radiologists. For each patient, we assessed the density changes on ldCT at corresponding locations, employing the signal intensity observed on MRI across each joint surface as a reference. While measurements in areas without oedema on MRI showed relatively high density, measurements in areas with oedema on MRI showed relatively low density.Results: MRI revealed bilateral bone marrow oedema in 22 (73.3%) patients. During the ldCT evaluation of the right iliac crest, lower density was identified on ldCT in regions displaying heightened signal intensity on MRI in 20 (66.6%) patients. On the right sacral side, lower density was observed in the ldCT of 22 (73.3%) patients. Moving to the left iliac crest, 18 (60%) patients displayed a lower density. On the left sacral side, lower density was identified on ldCT in 22 (73.3%) patients. Erosion was detected in 23 patients on ldCT, whereas only 11 patients showed erosion on MRI.Conclusions: This study suggests that ldCT is superior to MRI for early structural change detection. Pixel-based density evaluation in ldCT aligns with MRI for bone marrow oedema.Advances in knowledge: The present study showed that ldCT is superior to MRI for early structural change detection. Pixel-based density evaluation in ldCT aligns with MRI findings for bone marrow oedema.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"143-149"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458539","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}

引用次数: 0

Sequencing microsphere selective internal radiotherapy after external beam radiotherapy for hepatocellular carcinoma: proof of concept of a synergistic combination. 肝细胞癌外照射放疗后的测序微球选择性内放疗：协同组合的概念验证。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae209

Carlos Huesa-Berral, Jack F Terry, Louis Kunz, Alejandro Bertolet

{"title":"Sequencing microsphere selective internal radiotherapy after external beam radiotherapy for hepatocellular carcinoma: proof of concept of a synergistic combination.","authors":"Carlos Huesa-Berral, Jack F Terry, Louis Kunz, Alejandro Bertolet","doi":"10.1093/bjr/tqae209","DOIUrl":"10.1093/bjr/tqae209","url":null,"abstract":"Objectives: This study aims to explore the synergistic effects of combining stereotactic body radiation therapy (SBRT) and selective internal radiation therapy (SIRT) in that specific sequence for treating hepatocellular carcinoma (HCC), particularly in patients at high risk of radiation-induced liver disease (RILD).Methods: We analysed a case of a patient with HCC who was treated with SBRT at our institution. A virtual 90Y dose distribution was added using our in-house MIDOS model to keep a minimum dose to the healthy liver tissue. BED and EUD metrics were calculated to harmonize the dose distributions of SBRT and SIRT.Results: Our radiation biology-based models suggest that the combination of SBRT and SIRT could maintain effective tumour control while reducing the dose to normal liver tissue. Specifically, an SBRT plan of 10 Gy×3 fractions combined with SIRT yielded comparable tumour control probability to an SBRT-only plan of 10 Gy×5 fractions.Conclusions: The combination of SBRT and SIRT is a promising treatment strategy for HCC patients at high risk of RILD. While the LQ model and associated formalisms provide a useful starting point, further studies are needed to account for factors beyond these models. Nonetheless, the potential for significant dose reduction to normal tissue suggests that this combination therapy could offer substantial clinical benefits.Advances in knowledge: This article presents a proposal to combine SBRT and SIRT, in this specific order, for HCC, discussing its advantages. A framework for future research into optimizing combination therapy for HCC is provided, utilizing a novel HCC vascular model to simulate 90Y doses.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"50-57"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458544","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}

引用次数: 0

Automated CT-based decoupling of the effects of airway narrowing and wall thinning on airway counts in chronic obstructive pulmonary disease. 基于 CT 自动解耦慢性阻塞性肺病气道狭窄和气道壁变薄对气道计数的影响。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae211

Syed Ahmed Nadeem, Xinyu Zhang, Prashant Nagpal, Eric A Hoffman, Kung-Sik Chan, Alejandro P Comellas, Punam K Saha

{"title":"Automated CT-based decoupling of the effects of airway narrowing and wall thinning on airway counts in chronic obstructive pulmonary disease.","authors":"Syed Ahmed Nadeem, Xinyu Zhang, Prashant Nagpal, Eric A Hoffman, Kung-Sik Chan, Alejandro P Comellas, Punam K Saha","doi":"10.1093/bjr/tqae211","DOIUrl":"10.1093/bjr/tqae211","url":null,"abstract":"Objective: We examine pathways of airway alteration due to wall thinning, narrowing, and obliteration in chronic obstructive pulmonary disease (COPD) using CT-derived airway metrics.Methods: Ex-smokers (N = 649; age mean ± std: 69 ± 6 years; 52% male) from the COPDGene Iowa cohort (September 2013-July 2017) were studied. Total airway count (TAC), peripheral TAC beyond 7th generation (TACp), and airway wall thickness (WT) were computed from chest CT scans using previously validated automated methods. Causal relationships among demographic, smoking, spirometry, COPD severity, airway counts, WT, and scanner variables were analysed using causal inference techniques including direct acyclic graphs to assess multi-pathway alterations of airways in COPD.Results: TAC, TACp, and WT were significantly lower (P < .0001) in mild, moderate, and severe COPD compared to the preserved lung function group. TAC (TACp) losses attributed to narrowing and obliteration of small airways were 4.59%, 13.29%, and 32.58% (4.64%, 17.82%, and 45.51%) in mild, moderate, and severe COPD, while the losses attributed to wall thinning were 8.24%, 17.01%, and 22.95% (12.79%, 25.66%, and 33.95%) in respective groups.Conclusions: Different pathways of airway alteration in COPD are observed using CT-derived automated airway metrics. Wall thinning is a dominant contributor to both TAC and TACp loss in mild and moderate COPD while narrowing and obliteration of small airways is dominant in severe COPD.Advances in knowledge: This automated CT-based study shows that wall thinning dominates airway alteration in mild and moderate COPD while narrowing and obliteration of small airways leads the alteration process in severe COPD.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"150-159"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495545","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}

引用次数: 0

Diagnostic accuracy of MRI for detecting nerve injury in brachial plexus birth injury. 磁共振成像检测臂丛神经产伤中神经损伤的诊断准确性。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae214

James Brooks, Claire Hardie, Ryckie Wade, Irvin Teh, Grainne Bourke

{"title":"Diagnostic accuracy of MRI for detecting nerve injury in brachial plexus birth injury.","authors":"James Brooks, Claire Hardie, Ryckie Wade, Irvin Teh, Grainne Bourke","doi":"10.1093/bjr/tqae214","DOIUrl":"10.1093/bjr/tqae214","url":null,"abstract":"Objectives: To determine the diagnostic accuracy of MRI for diagnosing nerve injury in brachial plexus birth injury (BPBI).Methods: Electronic databases were searched from inception to February 15, 2023 for studies reporting the accuracy of MRI (index test) compared to surgical exploration (reference standard) in detecting the target conditions of: root avulsion, any nerve abnormality, and pseudomeningocele (as a marker of root avulsion) in children with BPBI. Meta-analysis using a bivariate model was performed where data allowed.Results: Eight studies met the inclusion criteria. In total, 116 children with BPBI were included. All included studies were at risk of bias. The mean sensitivity and mean specificity of MRI for detecting root avulsion was 68% (95% CI: 55%, 79%) and 89% (95% CI: 78%, 95%), respectively. Pseudomeningocele was not a reliable marker of avulsion. Data were too sparse to determine the diagnostic accuracy of MRI for any nerve abnormality.Conclusions: At present, surgical exploration should remain as the diagnostic modality of choice for BPBI due to the modest diagnostic accuracy of MRI in detecting root avulsion. The diagnostic accuracy of MRI needs to be close to 100% as the results may determine whether a child undergoes invasive surgery.Advances in knowledge: Previous research regarding MRI in detecting BPBI is highly variable and prior to our study the overall diagnostic accuracy was unclear. Through conducting a systematic review and meta-analysis, we were able to reliably determine the overall sensitivity and specificity of MRI for detecting root avulsion.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"36-44"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458540","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}

引用次数: 0

Computed tomographic angiography in planning thoraco-dorsal artery perforator flap in breast and soft tissue reconstruction: a systematic review. 计算机断层扫描血管造影在规划乳房和软组织重建中的胸背动脉打孔器皮瓣中的应用：系统回顾。

IF 1.8 4区医学

British Journal of Radiology Pub Date : 2025-01-01 DOI: 10.1093/bjr/tqae203

Mahmoud Soliman, Islam H Metwally, Adel Denewer, Ahmed Abdallah, Fatmaelzahraa Abdelfattah Denewar, Nuala Ann 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 Ann Healy, Laszlo Romics, Amit Agrawal","doi":"10.1093/bjr/tqae203","DOIUrl":"10.1093/bjr/tqae203","url":null,"abstract":"Objectives: 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.Methods: 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.Results: 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.Conclusions: 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.Advances in knowledge: Further research is required to explore the practical value of CTA in TDAP planning and standardizing protocols.","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"27-35"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652726/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0