Insights Into Imaging

OBJECTIVE: To construct and validate a prediction model based on dual-layer detector spectral CT (DLCT) and clinico-radiologic features to predict the microsatellite instability (MSI) status of gastric cancer (GC) and to explore the relationship between the prediction results and patient prognosis. METHODS: A total of 264 GC patients who underwent preoperative DLCT examination were randomly allocated into the training set (n = 187) and validation set (n = 80)...

OBJECTIVES: Lung carcinoids and atypical hamartomas may be difficult to differentiate but require different treatment. The aim was to differentiate these tumors using contrast-enhanced CT semantic and radiomics criteria. METHODS: Between November 2009 and June 2020, consecutives patient operated for hamartomas or carcinoids with contrast-enhanced chest-CT were retrospectively reviewed. Semantic criteria were recorded and radiomics features were extracted from 3D segmentations using Pyradiomics...

BACKGROUND: Written medical examinations consist of multiple-choice questions and/or free-text answers. The latter require manual evaluation and rating, which is time-consuming and potentially error-prone. We tested whether natural language processing (NLP) can be used to automatically analyze free-text answers to support the review process. METHODS: The European Board of Radiology of the European Society of Radiology provided representative datasets comprising sample questions, answer keys, participant answers, and reviewer markings from European Diploma in Radiology examinations...

BACKGROUND: The deep learning-based nodule detection (DLD) system improves nodule detection performance of observers on chest radiographs (CXRs). However, its performance in different pulmonary nodule (PN) locations remains unknown. METHODS: We divided the CXR intrathoracic region into non-danger zone (NDZ) and danger zone (DZ). The DZ included the lung apices, paramediastinal areas, and retrodiaphragmatic areas, where nodules could be missed. We used a dataset of 300 CXRs (100 normal and 200 abnormal images with 216 PNs [107 NDZ and 109 DZ nodules])...

OBJECTIVES: Posthepatectomy liver failure (PHLF) is a severe complication of liver resection. We aimed to develop and validate a model based on extracellular volume (ECV) and liver volumetry derived from computed tomography (CT) for preoperative predicting PHLF in resectable hepatocellular carcinoma (HCC) patients. METHODS: A total of 393 resectable HCC patients from two hospitals were enrolled and underwent multiphasic contrast-enhanced CT before surgery. A total of 281 patients from our hospital were randomly divided into a training cohort (n = 181) and an internal validation cohort (n = 100), and 112 patients from another hospital formed the external validation cohort...

BACKGROUND: Pulmonary solid pleura-attached nodules (SPANs) are not very commonly detected and thus not well studied and understood. This study aimed to identify the clinical and CT characteristics for differentiating benign and malignant SPANs. RESULTS: From January 2017 to March 2023, a total of 295 patients with 300 SPANs (128 benign and 172 malignant) were retrospectively enrolled. Between benign and malignant SPANs, there were significant differences in patients' age, smoking history, clinical symptoms, CT features, nodule-pleura interface, adjacent pleural change, peripheral concomitant lesions, and lymph node enlargement...

BACKGROUND: To explore the pathologic basis and prognostic value of tumor and liver stiffness measured pre-operatively by two-dimensional shear wave elastography (2D-SWE) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients who undergo hepatic resection. METHODS: A total of 191 HBV-infected patients with solitary resectable HCC were prospectively enrolled. The stiffness of intratumoral tissue, peritumoral tissue, adjacent liver tissue, and distant liver tissue was evaluated by 2D-SWE...

Endometriosis is a frequent pathology mostly affecting women of young age. When typical aspects are present, the diagnosis can easily be made at imaging, especially at MRI. Transformation of benign endometriosis to endometriosis-associated neoplasms is rare. The physiopathology is complex and remains controversial. Endometrioid carcinoma and clear cell carcinoma are the main histological subtypes. Our goal was to review the main imaging characteristics that should point to an ovarian or extra-ovarian endometriosis-related tumor, especially at MRI, as it may be relevant prior to surgical management...

OBJECTIVES: Imaging guidelines could play an important role in the training of radiologists, but the extent of their adoption in residency programs is unclear. With this survey, the European Society of Urogenital Radiology (ESUR) Junior Network aimed to assess the dissemination of the ESUR guidelines on endometrial cancer MRI staging (EC-ESUR guidelines) among young radiologists. METHODS: An online questionnaire targeted to last year radiology residents and radiologists in the first year of their career was designed...

OBJECTIVES: To develop and validate European entrustable professional activities (EPAs) for sub-specialised hepatobiliary and gastrointestinal (HB/GI) diagnostic imaging. MATERIALS AND METHODS: Both European Society of Radiology and national curricula in HB/GI diagnostic radiology were thoroughly reviewed, resulting in preliminary EPAs drafted by a pilot group of expert radiologists in 2 different countries. Each EPA was fully described with 7 components (Specification/limitations; Potential risks of failing; Relevant domains of competence; Required experience, knowledge, skills, attitude and behaviour; Assessment information sources to assess progress and ground a summative entrustment decision; Entrustment for which level of supervision is to be reached; and Expiration date)...

PURPOSE: This study focuses on assessing the performance of active learning techniques to train a brain MRI glioma segmentation model. METHODS: The publicly available training dataset provided for the 2021 RSNA-ASNR-MICCAI Brain Tumor Segmentation (BraTS) Challenge was used in this study, consisting of 1251 multi-institutional, multi-parametric MR images. Post-contrast T1, T2, and T2 FLAIR images as well as ground truth manual segmentation were used as input for the model...

Entrustable professional activity (EPA) is a tool for comprehensively evaluating the level of confidence in resident performances across various competencies in medicine. The application of and attitudes towards EPAs in radiology across the European Society of Radiology (ESR) national institutional member societies is still to be determined. An online survey was conducted among ESR national institutional member societies to assess the current use of EPAs and other resident assessment forms among different countries...

PURPOSE: In recent decades, diverse nomograms have been proposed to predict extraprostatic extension (EPE) in prostate cancer (PCa). We aimed to systematically evaluate the accuracy of MRI-inclusive nomograms and traditional clinical nomograms in predicting EPE in PCa. The purpose of this meta-analysis is to provide baseline summative and comparative estimates for future study designs. MATERIALS AND METHODS: The PubMed, Embase, and Cochrane databases were searched up to May 17, 2023, to identify studies on prediction nomograms for EPE of PCa...

OBJECTIVES: Entropy is a new late gadolinium enhanced (LGE) cardiac magnetic resonance (CMR)-derived parameter that is independent of signal intensity thresholds. Entropy can be used to measure myocardial tissue heterogeneity by comparing full pixel points of tissue images. This study investigated the incremental prognostic value of left ventricular (LV) entropy in patients with hypertrophic cardiomyopathy (HCM). METHODS: This study enrolled 337 participants with HCM who underwent 3...

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BACKGROUND: Preoperative assessment of the histological type of ovarian cancer is essential to determine the appropriate treatment strategy. Tumor location may be helpful in this regard. The purpose of this study was to compare the position of endometriosis-associated (EAOCs) and non-associated (non-EAOCs) ovarian cancer relative to the uterus using MRI. METHODS: This retrospective study included patients with pathologically confirmed malignant epithelial ovarian tumors who underwent MRI at our hospital between January 2015 and January 2023...

OBJECTIVE: Sound touch elastography (STE) and sound touch quantification (STQ) are novel imaging methods to evaluate tissue stiffness. This study aims to investigate renal stiffness in patients with chronic kidney disease (CKD) by STE and STQ, using renal biopsy as 'gold standard'. METHODS: Between 2019 January and 2022 June, 60 patients who underwent renal biopsy for proteinuria (cases) and 45 healthy volunteers (controls) at our hospital were included in this study...

OBJECTIVES: The numbers of computed tomography (CT) and magnetic resonance imaging (MRI) examinations per capita continue to increase in Sweden and in other parts of Europe. The appropriateness of CT and MRI examinations was audited using established European appropriateness criteria. Alternative modalities were also explored. The results were compared with those of a previous study performed in Sweden. METHODS: A semi-automatic retrospective evaluation of referrals from examinations performed in four healthcare regions using the European appropriateness criteria in ESR iGuide was undertaken...

BACKGROUND: This study provides a quantitative meta-analysis of pancreatic CT perfusion studies, investigating choice of study parameters, ability for quantitative discrimination of pancreatic diseases, and influence of acquisition and reconstruction parameters on reported results. METHODS: Based on a PubMed search with key terms 'pancreas' or 'pancreatic,' 'dynamic' or 'perfusion,' and 'computed tomography' or 'CT,' 491 articles published between 1982 and 2020 were screened for inclusion in the study...

BACKGROUND: Tumour hypoxia is a negative predictive and prognostic biomarker in colorectal cancer typically assessed by invasive sampling methods, which suffer from many shortcomings. This retrospective proof-of-principle study explores the potential of MRI-derived imaging markers in predicting tumour hypoxia non-invasively in patients with colorectal liver metastases (CLM). METHODS: A single-centre cohort of 146 CLMs from 112 patients were segmented on preoperative T2-weighted (T2W) images and diffusion-weighted imaging (DWI)...