British Journal of Radiology最新文献

{"title":"Response to letter to editor.","authors":"Bobby Bhartia","doi":"10.1093/bjr/tqae257","DOIUrl":"https://doi.org/10.1093/bjr/tqae257","url":null,"abstract":"","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881328","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":"Diagnostic performance of axial T2-weighted MRI sequence for exclusion of brain tumour in paediatric patients with non-localizing symptoms.","authors":"Amy C Gerrish, Luqman Malik, Charlotte Swain, Adam G Thomas, Timothy Jaspan, Rob A Dineen","doi":"10.1093/bjr/tqae244","DOIUrl":"https://doi.org/10.1093/bjr/tqae244","url":null,"abstract":"<p><strong>Objective: </strong>To establish diagnostic performance of a single axial T2-weighted sequence for detection of brain tumours in children with non-localizing symptoms, compared to a standard MRI protocol.</p><p><strong>Methods: </strong>Retrospective analysis of children undergoing MRI brain imaging for suspected brain tumours with non-localizing symptoms over a 3-year period. Axial T2-weighted images were blindly reviewed by 2 experienced paediatric neuroradiologists. Primary analysis was calculation of diagnostic performance metrics for tumour identification using axial T2-weighted image only compared to the standard MRI protocol.</p><p><strong>Results: </strong>For 312 children undergoing MRI brain during the study period, sensitivity and specificity for brain tumour detection based on axial T2-weighted images in children with non-localizing symptoms were 1.000 (95% CIs 0.598, 1.000) and 0.998 (95% CI 0.990, 0.999), respectively. Based on T2-weighted images alone, 50 patients (16%) were flagged as needing recall for further imaging compared to 14 (4.5%) recalled after the standard protocol.</p><p><strong>Conclusions: </strong>Axial T2-weighted images have high sensitivity and specificity for detection of brain tumours in children with non-localizing symptoms but are associated with increased imaging recall rates. Prospective evaluation of this approach to identify patients requiring more comprehensive imaging is warranted.</p><p><strong>Advances in knowledge: </strong>A truncated MRI protocol with single axial T2-weighted sequence has high diagnostic performance for brain tumour detection in children with non-localizing features. Radiologists can be reassured that a child with this presentation who is unable to complete the full MRI scan protocol is very unlikely to have a brain tumour missed provided an axial T2-weighted sequence is obtained.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823782","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":"Striving for excellence: multicentre quality improvement project to optimize CT KUB technique in renal colic patients.","authors":"Aasma Nudrat Zafar, Hamza Rehman, Khalid Shakeel Babar, Humaira Anjum, Iqra Saeed, Nasrullah Yaqoob, Farzana Rahim, Ijaz Ahmed, Mahjabeen Mehmood Kamal, Naila Usmani, Ayesha Sharif Khan, Saerah Iffat Zafar, Maaz Khan, Ihsan Ali, Shumaila Arooj, Mehwish Zahra Alavi, Amber Goraya, Nazish Irfan, Muhammad Awais, Uzma Azmat","doi":"10.1093/bjr/tqae172","DOIUrl":"10.1093/bjr/tqae172","url":null,"abstract":"<p><strong>Objective: </strong>To perform audit of imaging practice in different hospitals to assess their adherence to guidelines on optimizing computerized tomography of kidneys, ureter, and bladder (CT KUB) technique in order to reduce unnecessary scan length. To assess improvement in adherence to guidelines after intervention, following education of the technologists.</p><p><strong>Material and methods: </strong>There were 12 participant radiology departments in 8 cities of Islamic Republic of Pakistan. Findings of first audit round were presented in respective departmental meetings, and technologists were educated. Second round was performed after 12 weeks. Our target was to achieve 100% compliance to standards. Comparison of adherence to guidelines before and after intervention was done. Total number of axial slices of KUB CT scan, images above upper pole of highest kidney (overscan/unnecessary slices), and percentage of unnecessary images were recorded. To calculate statistical significance of difference, Fischer exact and Chi-square tests were applied.</p><p><strong>Results: </strong>Percentage of patients with appropriate CT KUB technique according to RCR guidelines was far less in first round (0%-64%). It significantly improved after educating the technologists (35.57%-90.90%).</p><p><strong>Conclusion: </strong>By following standard practice of CT KUB scan, significant radiation dose reduction is achievable without compromising diagnostic details.</p><p><strong>Advances in knowledge: </strong>Standardization of CT KUB examination technique can valuably contribute to reduction in unessential radiation exposure.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1946-1949"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055019","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":"Does the risk of hypersensitivity reactions to iopromide differ by sex, race, or across regions/countries? An analysis of 152 233 patients from 4 observational studies and the company's pharmacovigilance database.","authors":"Jan Endrikat, Alexander Ullmann, Christoph Gerlinger, Aasia Bhatti, Philipp Lengsfeld, Alexander Michel","doi":"10.1093/bjr/tqae190","DOIUrl":"10.1093/bjr/tqae190","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the potential impact of patients' sex, race, and region/country on the risk of hypersensitivity reactions after intra-venous or intra-arterial administration of iopromide.</p><p><strong>Methods: </strong>Two analyses were performed. (1) The \"Phase-IV-Analysis\" evaluated an integrated pooled database of 4 non-interventional studies. (2) The \"GPV-Analysis\" evaluated case reports from the company's pharmacovigilance database. The Phase-IV-Analysis was a nested case-control analysis of patients who received an injection of iopromide 300/370 mg iodine/mL. Cases had typical/unequivocal HSRs as defined by the ACR Committee on Drugs and Contrast Media 2018. The global pharmacovigilance (GPV)-Analysis was based on HSR case reports in the company database. Exposure estimates were derived from sales/market research data.</p><p><strong>Results: </strong>The Phase-IV-Analysis comprised 152 233 patients from 37 countries. In the full-analysis set 145 033, 59 412, and 146 649 patients were included in the sex, race, and region/country cohort, respectively. The GPV-Analysis was based on 78.72 million administrations for sex and 118.56 million administrations for region/country. No GPV exposure data by race were available. Sex: Phase-IV-Analysis: The HSR incidence was significantly higher for women (0.72%) vs men (0.55%) (P ≤ .0001). The unadjusted odds ratio (OR) was 1.3 (95% CI, 1.154-1.499), the adjusted OR was 1.156 (95% CI, 1.006-1.328) (P = .04). GPV-Analysis: Reporting rates were 0.0102% for women and 0.0075% for men (P < .0001). OR: 1.36 (95% CI, 1.3-1.43). Race: Phase-IV-Analysis: No significantly different HSR incidences for white (0.70%) and Asian (0.61%) patients (P = .3094) were detected. Region/country: Phase-IV-Analysis: The overall world HSR-incidence was 0.62%. Europe: 0.52%, Asia: 0.70%, United States: 0.75%, Germany: 0.51%, China: 0.41%, South Korea: 0.76%. GPV-Analysis: The overall world HSR-reporting rate was 0.015%, varying across regions/countries.</p><p><strong>Conclusion: </strong>Women showed a slightly higher risk for HSRs than men. Impact of race was not found. HSR-reporting varied by region/country.</p><p><strong>Advances in knowledge: </strong>Risk for HSRs was increased by female sex but not by race or region/country.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"2004-2014"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307088","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":"Children's bone age development is delayed with increasing altitude: a multicentre study.","authors":"Qixing Liu, Cidan Wangjiu, Tudan Awang, Meijie Yang, Puqiong Qiongda, Huogen Wang, Hui Pan, Fengdan Wang","doi":"10.1093/bjr/tqae168","DOIUrl":"10.1093/bjr/tqae168","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the bone age (BA) characteristics of children living in high-altitude regions and determine the impact of altitude on the development of BA.</p><p><strong>Methods: </strong>From June 2014 to July 2022, 1318 children with left-hand-wrist radiographs were retrospectively enrolled from 3 different geographical altitudes (Beijing 43.5 m above sea level [asl], Lhasa 3650 m asl, and Nagqu 4500 m asl). The predicted age difference (PAD), defined as the difference between BA and chronologic age (CA), was considered the indicator for delayed or advanced growth. The PAD of children from the 3 regions in total and according to different age groups, genders, and ethnicities were compared. The linear regression model was used to assess the effect of altitude on PAD.</p><p><strong>Results: </strong>A total of 1284 children (CA: 12.00 [6.45-15.72] years; male: 837/1284, 65.2%) were included in the study with 407 from Beijing, 491 from Lhasa, and 386 from Nagqu. The PAD for Beijing, Lhasa, and Nagqu were 0.1 [-0.30 to 0.65], -0.40 [-1.20 to 0.27], and -1.42 [-2.32 to -0.51] years, respectively. A linear regression analysis showed that altitude significantly contributed to PAD (compared to Beijing, Lhasa coefficient = -0.57, P < .001; Nagqu coefficient = -1.55, P < .001).</p><p><strong>Conclusions: </strong>High altitude might be an independent contributor to the delayed BA development of children.</p><p><strong>Advances in knowledge: </strong>The impact of altitude on BA development was revealed for the first time, highlighting the necessity of considering the altitude of the area when evaluating BA development for children residing in high-altitude regions.ke.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1931-1938"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046398","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":"DynaCT biliary reconstruction via a 3D C-arm cholangiography system: clinical application in hepatolithiasis.","authors":"Ya-Wen Cao, Dong-Qiao Chen, Jie-Long Lin, Zhao-Wei Ding, Pei-Heng Li, Rong-Qi Li, Yong-Qing Ye","doi":"10.1093/bjr/tqae237","DOIUrl":"https://doi.org/10.1093/bjr/tqae237","url":null,"abstract":"<p><strong>Objective: </strong>Dyna computed tomography (DynaCT) is an innovative clinical imaging tool used to obtain three-dimensional (3D) images of biliary structures via the Artis Zee DSA system (SIEMENS Company, Germany). DynaCT is a type of 3D cone beam computed tomography (CBCT) reconstruction produced from a two-dimensional (2D) cholangiography system by rotating the C-arm without moving the patient. The aim of this study was to evaluate the technical approach and application value of DynaCT to diagnosis hepatolithiasis and biliary stenosis.</p><p><strong>Methods: </strong>This was a retrospective single-centre series of 37 hepatolithiasis patients with tubes receiving one-step percutaneous transhepatic cholangioscopic lithotripsy (one-step PTCSL) between October 2021 and October 2022: twenty-one patients were guided by CT (CT group) and sixteen by DynaCT biliary reconstruction (DynaCT group). We compared DynaCT biliary reconstruction technology with computed tomography (CT) in the application of bile ducts.</p><p><strong>Results: </strong>DynaCT biliary reconstruction was successfully performed in 37 patients. Biliary stenosis, including anatomy, morphology, and size, was visualized via DynaCT. Compared with the CT group, the DynaCT group was characterized by significantly more target biliary branches with stones (92 vs. 48, P < 0.05), a higher percentage of secondary stenosis (75.76% vs. 24.24%, p < 0.05), a greater percentage of biliary infection (37.5% vs. 9.5%, P = 0.041), a shorter overall stone clearance time (26.38 ± 13.49 vs. 52.67 ± 30.10, P = 0.001), and a lower rate of reoperation for residual stones (25.00% vs. 66.67%, P = 0.012). DynaCT had a lower contrast agent (25.61 ± 5.13 vs. 42.69 ± 11.15, p < 0.05). However, DynaCT increased radiation exposure (38.12 ± 10.59 vs. 25.79 ± 4.76, p < 0.05). There were no significant differences between the two groups regarding the clearance ratio of the calculus or several postoperative complications.</p><p><strong>Conclusion: </strong>DynaCT for biliary reconstruction has the potential to be a powerful evaluation tool for one-step PTCSL surgery and could lead to new possibilities for hepatobiliary surgery.</p><p><strong>Advances in knowledge: </strong>DynaCT was used for the first time in patients with hepatolithiasis and biliary stenosis. Compared with CT, DynaCT for biliary reconstruction results in higher-quality 3D biliary, blood vessel and liver images. On the basis of the DynaCT biliary model, one-step PTCSL has the potential to improve the stone clearance ratio and shorten the stone clearance time and reoperation ratio.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614797","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 Review of Applications of Photon-Counting Computed Tomography in Head and Neck Imaging.","authors":"Siddhant Dogra, Nitesh Shekhrajka, Gul Moonis","doi":"10.1093/bjr/tqae226","DOIUrl":"https://doi.org/10.1093/bjr/tqae226","url":null,"abstract":"<p><p>Photon-counting CT (PCCT), approved for clinical practice for over two years now, both improves on features of conventional energy-integrating detector (EID) CT and introduces new capabilities such as multienergy acquisition. PCCT is already transforming all domains of radiology, including head and neck imaging, and will become increasingly utilized in the approaching years. In this review, we first concisely explain the key physical principles distinguishing PCCT from EID-CT. We then discuss how the underlying physics leads to the novel features associated with PCCT, focusing on improved artifact reduction, spatial resolution, contrast-to-noise ratio, as well as multienergy acquisition and reduced contrast and radiation doses. Next, we review head and neck PCCT applications and comparison to EID-CT in dental imaging, sinus imaging, temporal bone, tumor imaging, and vascular imaging. Within the temporal bone applications, we explore normal anatomy, pathologic anatomy, and the appearance of protheses and implants. Representative imaging is provided to highlight differences between PCCT and EID-CT. Finally, we highlight areas of ongoing research in PCCT.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614399","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":"Patterns of metabolic response in patients receiving commercial CAR T-cells for relapsing/refractory aggressive B cells lymphoma.","authors":"Laetitia Vercellino, Siham Betterki, Estelle Blanc, Eric de Kerviler, Caterina Cristinelli, Pascal Merlet, Catherine Thieblemont, Véronique Meignin, Roberta Di Blasi","doi":"10.1093/bjr/tqae178","DOIUrl":"10.1093/bjr/tqae178","url":null,"abstract":"<p><p>CAR T-cells is an innovative treatment for relapsed/refractory aggressive B cell lymphomas, initially proposed as third-line therapy and beyond, now allowed as soon as second-line treatment for patients with early relapse after first-line treatment. FDG PET/CT remains the modality of choice to evaluate response to this therapeutic strategy, to detect or confirm treatment failure, and allow for salvage therapy if needed. Correct classification of patients regarding response is thus of the utmost importance. In many cases, metabolic response follows classical known patterns, and Deauville score and Lugano criteria yield accurate characterization of patient status. However, given its specific mode of action, it can result in delayed response or atypical patterns of response. We report here a few examples of response from our experience to illustrate the existence of tricky cases. These atypical cases require multidisciplinary management, with clinical, biological, imaging, and pathological work-up.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1755-1764"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139374","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":"Abdominal Applications of Photon-Counting CT.","authors":"Khanin Khanungwanitkul, Olga Sliwicka, Fides Regina Schwartz","doi":"10.1093/bjr/tqae206","DOIUrl":"https://doi.org/10.1093/bjr/tqae206","url":null,"abstract":"<p><p>Photon-counting computed tomography (PCCT) has shown promising advancements in abdominal imaging in clinical use. Though more peer-reviewed primary literature is needed, this commentary explores PCCT's potential applications, focusing on enhancing diagnostic accuracy, optimizing radiation dose management, and improving patient care. PCCT offers improved spatial and contrast resolution, lower image noise, and reduced radiation dose. Increased spatial resolution provides better detail in abdominal imaging, aiding in the detection of small lesions and subtle pathological changes. However, this generates more images per scan, raising concerns about \"image overload\" in PACS, potentially leading to longer reading times and increased stress for radiologists. PCCT's improved contrast resolution enhances tissue differentiation, reducing the need for intravenous contrast agents. The technology's advanced tissue characterization provides several advantages, such as non-invasive and opportunistic liver disease evaluation and improved differentiation of renal and adrenal masses. PCCT's optimized radiation dose management is crucial for patients requiring frequent scans. Enhanced diagnostic accuracy through spectral information aids in tissue differentiation, improving confidence in diagnoses. Streamlined workflows, particularly in emergency settings, and oncologic imaging, are potential benefits, reducing the need for additional imaging studies. Future integration of PCCT into clinical practice requires collaboration, education, and research to fully harness its potential, ensuring optimized abdominal imaging and improved patient care.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving SPECT-CT technology.","authors":"Kathy P Willowson, Dale L Bailey","doi":"10.1093/bjr/tqae200","DOIUrl":"https://doi.org/10.1093/bjr/tqae200","url":null,"abstract":"<p><p>Both hardware and software developments have seen single photon emission computed tomography (SPECT)/X-ray computed tomography (CT) technology grow at a rapid rate. Such growth has been fuelled by the need for clinical applications and has provided inspiration for clinical developments, particularly with the expanding role of theranostics. Developments such as whole-body quantitative reconstructions, digital detectors, and recent multidetector 3D geometry have allowed SPECT to become comparable to PET on a number of fronts, with a particularly powerful role in biodistribution and dosimetry studies for both planning and evaluating radionuclide therapy. Whilst there remain fundamental challenges for SPECT such the limited spatial resolution and sensitivity, the unique opportunity to image long-lived radioisotopes and simultaneous multi-tracer studies, together with easily accessible equipment, makes SPECT/CT a valuable clinical asset. This review discusses developments in SPECT/CT technology and their clinical impact.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}