Current problems in diagnostic radiology最新文献

{"title":"Disparities in MRI and TRUS for prostate cancer detection: A systematic review and meta-analysis of 94,020 cases.","authors":"Ashkan Bahrami, Long H Tu, Milad Ghanikolahloo, Zohreh Sadeghi, Armin Tafazolimoghadam, Mahan Farzan, Mobina Fathi, Yaser Khakpour, Arian Tavasol, Milad Alipour, Ahmad Shoja, Mobin Azami, Thomas Clifford, Ramtin Hajibeygi, Samra Iftikhar","doi":"10.1067/j.cpradiol.2025.08.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PC) is one of the most prevalent cancers and is the second leading cause of cancer death in men. Recent evidence has demonstrated racial disparities in imaging utilization and, as a result, PC diagnosis.</p><p><strong>Purpose: </strong>The goal of this systematic review and meta-analysis was to quantify the disparity in utilization of Magnetic Resonance Imaging (MRI) and Transrectal Ultrasound (TRUS) for PC diagnosis among different races (Whites, Blacks, Asians, Caucasians, Hispanics, and other races). Our study, however, focuses on disparities observed in the North American population, as most of the studies included were carried out in Canada and the United States.</p><p><strong>Materials and methods: </strong>We carried out a systematic search in Google Scholar, PubMed/Medline, Web of Science, Scopus, and EMBASE databases. A total of 33 relevant articles published before August 2024 were included. We used Stata version 15 for statistical analysis. I² statistics was employed to assess heterogeneity. Egger and Begg's tests evaluated any publication bias.</p><p><strong>Results: </strong>A total of 33 articles collectively contained 94,020 cases with a mean age of 77.9 across six defined races (African-American or Black, White, Asians, Caucasians, Hispanics, and other races). Analysis demonstrated greater utilization of MRI in White patients 66 % (95 % CI: 0.59-0.73; I2 = 99.5 %),19 % (95 % CI: 0.17-0.22; I2 = 98.95 %) in Blacks, 67 % (95 % CI: 0.56-0.78; I2 = 98.99 %) in Caucasians, 7 % (95 % CI: 0.04-0.09; I2 = 97.55 %) in Hispanics, 4 % (95 % CI: 0.03-0.05; I2 = 86.53 %) in Asians, and 24 % (95 % CI: 0.11-0.37; I2 = 99.94 %) in other races. Also, relatively low utilization of TRUS was demonstrated in Black patients at 30 % (95 % CI: 0.15-0.44, I2=99.75 %) CONCLUSION: This systematic review and meta-analysis demonstrate a higher utilization of MRI for PC diagnosis in White patients relative to Blacks, Hispanics, and Asians, respectively. In addition, the use of TRUS in the Black population is relatively limited. These outcomes indicate a need for a change in radiologic utilization and health policies.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbubble-Augmented Needle Visualization in Ultrasound-Guided Biopsy: A Promising Technique with Methodological Caveats.","authors":"Deniz Esin Tekcan Sanli, Ahmet Necati Sanli","doi":"10.1067/j.cpradiol.2025.08.003","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.08.003","url":null,"abstract":"","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric comparison of low-energy contrast-enhanced mammography and full-field digital mammography for image quality and lesion conspicuity using EUREF standards and Likert scoring.","authors":"Veenu Singla, Dollphy Garg, T Pallavi, N P Bhavith","doi":"10.1067/j.cpradiol.2025.08.001","DOIUrl":"10.1067/j.cpradiol.2025.08.001","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether low-energy (LE) images acquired during contrast-enhanced mammography (CEM) are diagnostically and technically comparable to full-field digital mammography (FFDM) using standardised image quality and lesion conspicuity metrics.</p><p><strong>Materials and methods: </strong>In this retrospective study, 268 women (mean age: 44.6 years) who underwent both FFDM and CEM imaging, were included. Three blinded radiologists independently assessed the FFDM and LE-CEM images using 20-point EUREF (European Reference Organisation for Quality Assured Breast Screening and Diagnostic Services) criteria and 5-point Likert scale for image quality, lesion conspicuity, margin clarity, and diagnostic adequacy. An analysis of the additional lesion detection rate was done. Additionally, technical metrics including posterior nipple line (PNL), compressed breast thickness (CBT), and average glandular dose (AGD) were also recorded. Statistical analysis included Wilcoxon signed-rank, McNemar's test, intraclass correlation coefficient (ICC), and Fleiss' kappa.</p><p><strong>Results: </strong>LE images scored significantly higher than FFDM in 11 of 20 EUREF parameters (p < 0.05) and were non-inferior in the remaining. Median Likert scores were significantly higher for LE images across all lesion parameters, including conspicuity against background (5 vs. 4), margin clarity (5 vs. 4), and overall lesion visibility (5 vs. 4) (all p < 0.001). LE images detected significantly more lesions per patient (0.557 vs. 0.314; p < 0.001) with excellent inter-reader agreement (κ > 0.80). PNL and CBT showed near-perfect positional reproducibility (ICC > 0.98), and all AGD values remained within EUREF safety limits.</p><p><strong>Conclusion: </strong>LE-CEM images match or rather exceed FFDM in image quality, lesion detection, and diagnostic adequacy, while maintaining technical reproducibility. These findings support omitting additional FFDM exposure in patients with indications for CEM, thereby reducing radiation dose and streamlining the workflow.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving pediatric sonographer visualization of the superior mesenteric vasculature: A local quality improvement initiative.","authors":"Jeffrey J Tutman, Michael Tchou, Kelly Harris, Colleen Violette, HaiThuy N Nguyen","doi":"10.1067/j.cpradiol.2025.07.004","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound is emerging as a viable first-line imaging modality in the assessment of midgut volvulus. However, successful transition to this technique can be challenging.</p><p><strong>Objective: </strong>The aim of our project was to increase sonographer visualization rates of the superior mesenteric artery and superior mesenteric vein (SMA/SMV) by >39 % from baseline over a 7-month period.</p><p><strong>Methods: </strong>We conducted a quality improvement project targeting the ultrasound department at a large academic children's hospital system. The study included 615 patients who underwent pyloric or volvulus ultrasounds. Interventions included implementation of a team goal, monthly review of deficient exams and radiologist to sonographer peer review. Our primary outcome measure was percentage of exams in which the SMA/SMV vascular pedicle was successfully visualized.</p><p><strong>Results: </strong>The average baseline rate of SMA/SMV visualization was 37 %. This rate increased to 72 % within one month of implementation, and an average of 83 % visualization was achieved over the 7-month period of observation. This improvement was sustained during the 2 months immediately following the conclusion of the formal observation period and remained evident 2 years post-completion.</p><p><strong>Conclusion: </strong>Our quality improvement initiative resulted in significant, rapid, and sustained improvement in sonographer visualization rates of the superior mesenteric vasculature. Given widespread interest in volvulus ultrasound, we provide a framework for successfully training sonographers to perform this exam. The approach we used may also have potential to be utilized in the implementation of other imaging protocols.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest CT findings of follicular bronchiolitis: Comparative analysis according to underlying lung diseases.","authors":"Mitulkumar Patel, Kyung Won Kim, Mark M Hammer","doi":"10.1067/j.cpradiol.2025.07.003","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.07.003","url":null,"abstract":"<p><p>Objectives Follicular bronchiolitis (FB) is a rare and often under-recognized small airway disease characterized by lymphoid hyperplasia in the bronchiolar walls. We aimed to compare chest CT findings in patients with FB by underlying disease: rheumatoid arthritis (RA), Other connective tissue diseases (CTDs), and those without CTD. Methods A retrospective cohort of patients with pathologically-proven follicular bronchiolitis was classified into three groups: RA (n = 9), Other CTDs (n = 6), and non-CTD (n = 13). Chest CT were reviewed for findings including tree-in-bud nodules and air trapping (small airway disease), ground glass opacities, fibrosis, and bronchiectasis. Chi-square test was performed to evaluate the frequency differences across three groups. Fisher's exact test was performed to compare RA group and non-RA group. Results In all patients, the most common CT finding was bronchiectasis (17/28, 61 %), followed by small airway disease features (14/28, 50.0 %), fibrosis (13/28, 46.4 %), and ground glass opacities (7/28, 25.0 %). In three-group comparison (RA vs. Other CTD vs. non-CTD), small airway disease was significantly more prevalent in other CTD (3/6, 50.0 %) and non-CTD (10/13, 76.9 %) groups compared to the RA group (1/9, 11.1 %) (p = 0.01). In two-group analysis (RA vs. non-RA), fibrosis (7/9, 77.8 % vs. 6/19, 31.6 %; p = 0.041) and bronchiectasis (8/9, 88.9 % vs. 9/19, 47.4 %; p = 0.049) were significantly more common in the RA group compared to non-RA patients. Conclusion Chest CT findings of FB vary significantly depending on the underlying disease. Small airway disease features predominate in non-RA patients, while patients with RA and FB more frequently show fibrosis and bronchiectasis, likely reflecting coexistent pulmonary manifestations of RA. Recognizing these imaging patterns may improve diagnostic accuracy and inform appropriate management.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique ultrasound contrast agent-coated needle biopsy technique in oncology patients.","authors":"Chandrashekhara S H, Sai Sangeetha P, Triveni G S","doi":"10.1067/j.cpradiol.2025.07.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.07.002","url":null,"abstract":"<p><p>Biopsy plays a pivotal role in the diagnosis and management of soft-tissue masses. Conventional ultrasound-guided biopsies offer advantages such as real-time imaging and avoidance of radiation exposure, yet they present challenges in precise targeting, operator experience, and complications. In response to these challenges, a novel technique, ultrasound contrast agent coated needle biopsy, has emerged, harnessing the power of microbubble contrast agents to enhance imaging. This technique was applied in five cases to address the difficulties encountered during routine ultrasound-guided biopsies. These cases encompassed a diverse range of clinical scenarios, including soft tissue tumors, bone metastasis, and post-treatment changes. Challenges included obscured needle visualization due to various factors such as rib shadows, fragmented bony fragments, and background fibrosis.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining CT subtypes in chronic obstructive pulmonary disease: real world daily practice does not meet guidelines.","authors":"Thomas FitzMaurice, Greta Jurkeviciute, Laurynas Kucinskas, Manuel Gutierrez, Linu Kuruvilla, John Holemans, Monika Radikė","doi":"10.1067/j.cpradiol.2025.07.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.07.001","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the quality and inter-rater reliability of CT-definable chronic obstructive pulmonary disease (COPD) subtype reporting in CT chest reports in a real-world setting, and assess concordance with Fleischner Society guidelines.</p><p><strong>Methods: </strong>We undertook a retrospective review of 100 randomly selected CT chest scans containing the terms 'emphysema' or 'COPD'. Existing reports were evaluated for the description of emphysema phenotype, severity, and location, as well as the presence of associated findings, benchmarked against the Fleischner Society guidelines for CT reporting. The scans were then read independently by two consultant thoracic radiologists and two radiology specialty residents, blinded to the original reports and each other's assessments. Inter-rater variability was assessed using Light's Kappa for categorical variables and intraclass correlation coefficient (ICC) for ordinal variables.</p><p><strong>Results: </strong>Emphysema phenotype was described in 51 % of the pre-existing reports, with centrilobular emphysema being the most frequently reported subtype. Only 26 % of reports included all three key descriptors of phenotype, severity and location. Inter-rater agreement was fair for emphysema phenotype (κ = 0.371) and moderate for the grading of paraseptal emphysema (ICC = 0.733), but was more variable for associated features such as large airways disease (κ = 0.0646) and bronchiectasis (κ = 0.0996).</p><p><strong>Conclusion: </strong>This study shows variability in the quality of CT reporting for COPD in a real-world setting, with frequent omissions of key descriptors and marked inter-rater variability. These findings highlight the need for standardisation in CT reporting, particularly in the context of increasing reliance on imaging for COPD diagnosis and management.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultimate frisbee related injury patterns: A decade long institutional experience.","authors":"Matthew Coulter, Brian Zhang, Jayesh Gupta, Shaun Johnson, Nathan Amann, Navid Faraji","doi":"10.1067/j.cpradiol.2025.06.011","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.06.011","url":null,"abstract":"<p><strong>Objective: </strong>The primary outcome of this investigation was to describe the frequency and types of ultimate frisbee-related injuries at a single institution over an 11-year period. The secondary outcomes were to report rates of radiographic utilization and surgical intervention.</p><p><strong>Materials and methods: </strong>TriNetX was utilized to identify patients with ultimate-frisbee related injuries from 2010 to 2021 at a single institution. Injured body parts were recorded and further classified by type of injury. Imaging utilization, including plain radiograph, computed tomography (CT), and magnetic resonance imaging (MRI) were recorded. Rate of subsequent surgery was also recorded.</p><p><strong>Results: </strong>A total of 187 distinct injury encounters were identified. The most common anatomic regions injured were the knee (23.5 %), shoulder (14.8 %), and ankle (12.2 %). Among knee injuries, anterior cruciate ligament (ACL) tear was the most common type of injury (20.5 %). Sprains were the most common type of injury to the shoulder (34.5 %) and the ankle (64 %). 71.1 % of patients were imaged with radiographs, 16.6 % were imaged with MRI, and 3.7 % of patients were imaged with CT. Additionally, 14.4 % of patients required surgery due to their ultimate frisbee-related injury.</p><p><strong>Conclusion: </strong>As ultimate frisbee increases in popularity among the general population so does the incidence of ultimate-related injuries. Although these injuries have many similarities with those associated with other non-contact team sports, knowledge of the gameplay and commonly associated injury patterns is integral to initiating effective treatment and management of these injuries.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging in Pott's spine: A review of typical and atypical imaging features and diagnostic challenges.","authors":"Dr Rashmi Dixit, Dr Sonali Garg, Dr Gaurav Shanker Pradhan","doi":"10.1067/j.cpradiol.2025.06.010","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.06.010","url":null,"abstract":"<p><p>Pott's spine is associated with high morbidity, long-term disabling sequelae and even mortality. The classical paradiscal form, where there is destruction of end plates of adjacent 2-3 vertebral bodies along with intervening disc involvement and associated paravertebral abscess is well recognized. However, due to its varied clinical and radiological presentations, it remains a diagnostic challenge often resulting in delay in diagnosis. This is especially true of countries where tuberculosis has been almost eliminated but now are witnessing increase in incidence both due to immigration and HIV infection. Overlooking tuberculosis as a differential diagnostic consideration is very likely when the radiological presentation is not classical and consequent delay in diagnosis may have devastating consequences for the patient. In this review, we aim to describe various typical and atypical imaging findings of Pott's spine with special emphasis on atypical presentations including single vertebral body involvement, isolated posterior element involvement, intraspinal epidural abscess without vertebral involvement and skip lesions along with differential diagnostic considerations like metastases, fractures and spinal infections. The major focus is on magnetic resonance imaging findings which is the imaging modality of choice in patients presenting with neurological symptoms referable to the spine. Radiographic and Computed tomography findings are also discussed in brief. We also describe treatment and post treatment imaging in brief. Radiologists need to be aware of these atypical presentations as they may be the first to raise the possibility of tuberculosis which can avoid disabling long term sequalae.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hierarchy of hazard controls in clinical magnetic resonance safety: an analysis of the American College of Radiology Manual on MR Safety.","authors":"Ives R Levesque, Véronique Fortier, Jorge Campos Pazmiño, Zaki Ahmed, Evan McNabb","doi":"10.1067/j.cpradiol.2025.06.007","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.06.007","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this work was to critically assess safety guidance and practices in clinical magnetic resonance (MR) using the hierarchy of hazard controls (HHC).</p><p><strong>Methods: </strong>Publicly available, widely used guidance documents for MR safety practice were gathered. The most recent guidance, the American College of Radiology (ACR) MR Safety Manual (2024) was selected for detailed analysis. A 5-point scale was assigned to the various levels in the hierarchy of hazard controls, from Elimination (score=5, most effective) to Personal Protective Equipment (score=1, least effective). MR safety practices recommended in the ACR MR Safety Manual were surveyed and scored using the 5-point scale. The safety practices were grouped by category of hazard addressed (e.g. main field, radio-frequency field, gradient field).</p><p><strong>Results: </strong>Overall, Administrative Controls were the most common controls, followed by Engineering Controls. Controls within each hazard category featured a range of HHC scores, and all categories were predominantly served by Administrative Controls.</p><p><strong>Conclusion: </strong>The analysis presented in this work could serve as a tool to analyze choices made in the deployment of safety measures, to motivate decision- or policy-making, as a tool for assessment of MR safety programs, or as an approach to motivate future work in the design of hazard controls for MR.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}