Insights Into Imaging

Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the "silo" of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information...

BACKGROUND: Liver cirrhosis-acute decompensation (LC-AD) has rapid short-term disease progression and difficult early risk stratification. The purpose is to develop and validate a model based on dual-energy CT quantification of extracellular liver volume (ECVIC-liver ) for predicting the occurrence of acute-on-chronic liver failure (ACLF) within 90 days in patients with hepatitis B (HBV) LC-AD. METHODS: The retrospective study included patients with HBV LC-AD who underwent dual-energy CT scans of the liver from January 2018 to March 2022 and were randomized to training group (215 patients) and validation group (92 patients)...

OBJECTIVE: To build a clinical-radiomics model based on noncontrast computed tomography images to identify the risk of hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) following intravenous thrombolysis (IVT). MATERIALS AND METHODS: A total of 517 consecutive patients with AIS were screened for inclusion. Datasets from six hospitals were randomly divided into a training cohort and an internal cohort with an 8:2 ratio. The dataset of the seventh hospital was used for an independent external verification...

PURPOSE: The field of radiology is currently underestimated by undergraduate medical students. The "Hands-on Radiology" summer school was established to improve radiology knowledge and interest among undergraduates. The purpose of this questionnaire survey was to analyze whether a radiological hands-on course is an effective tool to reach and motivate undergraduate students. MATERIALS AND METHODS: The three-day course held in August 2022 included lectures, quizzes, and small group hands-on workshops focusing on practical work with simulators...

OBJECTIVES: This study aimed to investigate the influence of microvascular impairment on myocardial characteristic alterations in remote myocardium at multiple time points, and its prognostic significance after acute ST-segment elevation myocardial infarction (STEMI). METHODS: Patients were enrolled prospectively and performed CMR at baseline, 30 days, and 6 months. The primary endpoint was major adverse cardiac events (MACE): death, myocardial reinfarction, malignant arrhythmia, and hospitalization for heart failure...

OBJECTIVE: To assess PI-RADSv2.1 and PI-RADSv2 descriptors across readers with varying experience. METHODS: Twenty-one radiologists (7 experienced (≥ 5 years) seniors, 7 less experienced seniors and 7 juniors) assessed 240 'predefined' lesions from 159 pre-biopsy multiparametric prostate MRIs. They specified their location (peripheral, transition or central zone) and size, and scored them using PI-RADSv2.1 and PI-RADSv2 descriptors. They also described and scored 'additional' lesions if needed...

OBJECTIVE: To investigate whether commercially available deep learning (DL) software improves the Prostate Imaging-Reporting and Data System (PI-RADS) scoring consistency on bi-parametric MRI among radiologists with various levels of experience; to assess whether the DL software improves the performance of the radiologists in identifying clinically significant prostate cancer (csPCa). METHODS: We retrospectively enrolled consecutive men who underwent bi-parametric prostate MRI at a 3 T scanner due to suspicion of PCa...

OBJECTIVES: We assessed the appropriateness of chest-abdominal-pelvis (CAP) CT scan use in the Emergency Department (ED), based on expert physicians and the ESR iGuide, a clinical decision support system (CDSS). METHODS: A retrospective cross-study was conducted. We included 100 cases of CAP-CT scans ordered at the ED. Four experts rated the appropriateness of the cases on a 7-point scale, before and after using the decision support tool. RESULTS: Before using the ESR iGuide the overall mean rating of the experts was 5...

BACKGROUND: This study aimed to explore whether there is an association between androgen receptor (AR) expression and ultrasound, clinicopathological features and prognosis of breast cancer. METHODS: A total of 141 breast cancer patients were included in this retrospective study. AR expression was analyzed by immunohistochemistry. The images of B-mode, color Doppler and strain elastography from 104 patients were collected continuously, and the corresponding ultrasound characteristics were obtained...

OBJECTIVES: Currently, a prostate biopsy is guided by transrectal ultrasound (US) alone. However, this biopsy cannot be performed in men without an anus. The aim of this study was to show the outcomes of a new transperineal US (TPUS)-guided biopsy technique in patients who underwent Miles' operation. METHODS: Between April 2009 and March 2022, TPUS-guided biopsy was consecutively conducted in 9 patients (median, 71 years; range, 61-78 years) with high prostate-specific antigen values (22...

BACKGROUND: Structured reporting (SR) is recommended in radiology, due to its advantages over free-text reporting (FTR). However, SR use is hindered by insufficient integration of speech recognition, which is well accepted among radiologists and commonly used for unstructured FTR. SR templates must be laboriously completed using a mouse and keyboard, which may explain why SR use remains limited in clinical routine, despite its advantages. Artificial intelligence and related fields, like natural language processing (NLP), offer enormous possibilities to facilitate the imaging workflow...

OBJECTIVE: We aimed to develop a deep learning artificial intelligence (AI) algorithm to detect impacted animal bones on lateral neck radiographs and to assess its effectiveness for improving the interpretation of lateral neck radiographs. METHODS: Lateral neck radiographs were retrospectively collected for patients with animal bone impaction between January 2010 and March 2020. Radiographs were then separated into training, validation, and testing sets. A total of 1733 lateral neck radiographs were used to develop the deep learning algorithm...

OBJECTIVES: To automatically segment prostate central gland (CG) and peripheral zone (PZ) on T2-weighted imaging using deep learning and assess the model's clinical utility by comparing it with a radiologist annotation and analyzing relevant influencing factors, especially the prostate zonal volume. METHODS: A 3D U-Net-based model was trained with 223 patients from one institution and tested using one internal testing group (n = 93) and two external testing datasets, including one public dataset (ETDpub , n = 141) and one private dataset from two centers (ETDpri , n = 59)...

OBJECTIVE: The aim of this study was to develop a model that combines clinically relevant features with radiomics signature based on magnetic-resonance imaging (MRI) for diagnosis of chronic cholangitis in pancreaticobiliary maljunction (PBM) children. METHODS: A total of 144 subjects from two institutions confirmed PBM were included in this study. Clinical characteristics and MRI features were evaluated to build a clinical model. Radiomics features were extracted from the region of interest manually delineated on T2-weighted imaging...

OBJECTIVES: To compare the performance of ultra-low-dose computed tomography (ULD-CT) with standard-dose computed tomography (SD-CT) for the diagnosis of non-displaced fractures of the shoulder, knee, ankle, and wrist. METHODS: This prospective study enrolled 92 patients receiving conservative treatment for limb joint fractures who underwent SD-CT followed by ULD-CT at a mean interval of 8.85 ± 1.98 days. Fractures were characterized as displaced or non-displaced...

BACKGROUND: Magnetic resonance elastography (MRE) has been used to stage liver fibrosis in adults. We aimed to assess the agreement between the Ishak scoring system and magnetic resonance elastography-measured liver stiffness (MRE-LS) in children. This study included all the children who underwent abdominal MRE and liver biopsies between February 2018 and January 2021. The correlation between MRE-LS and Ishak fibrosis stage, MRE parameters, and clinical and biochemical markers affecting this relationship was investigated...

OBJECTIVES: This study compared the accuracy of predicting transarterial chemoembolization (TACE) outcomes for hepatocellular carcinoma (HCC) patients in the four different classifiers, and comprehensive models were constructed to improve predictive performance. METHODS: The subjects recruited for this study were HCC patients who had received TACE treatment from April 2016 to June 2021. All participants underwent enhanced MRI scans before and after intervention, and pertinent clinical information was collected...

OBJECTIVES: Although diffusion tensor imaging (DTI) may facilitate the identification of cytoarchitectural changes associated with focal cortical dysplasia (FCD), the predominant aetiology of paediatric structural epilepsy, its potential has thus far remained unexplored in this population. Here, we investigated whether DTI indices can differentiate FCD from contralateral brain parenchyma (CBP) and whether clinical features affect these indices. METHODS: In this single-centre, retrospective study, we considered children and adolescents with FCD-associated epilepsy who underwent brain magnetic resonance (MRI), including DTI...

BACKGROUND: Education in radiology should be an integral aspect of undergraduate medical training given the essential role of imaging in patient management. Since the introduction of the European Society of Radiology undergraduate curriculum a decade ago, radiology education has evolved. OBJECTIVES: This survey aimed to assess the current status of undergraduate radiology education in Europe. METHODS: An electronic survey on undergraduate teaching was distributed by the European Society of Radiology to delegates of the European Society of Radiology education committee and presidents of national radiological societies from April 1 to May 31, 2022...

OBJECTIVE: The relatively long scan time has hampered the clinical use of whole-heart noncontrast coronary magnetic resonance angiography (NCMRA). The compressed sensitivity encoding (SENSE) technique, also known as the CS technique, has been found to improve scan times. This study aimed to identify the optimal CS acceleration factor for NCMRA. METHODS: Thirty-six participants underwent four NCMRA sequences: three sequences using the CS technique with acceleration factors of 4, 5, and 6, and one sequence using the conventional SENSE technique with the acceleration factor of 2...