Acta Radiologica Open

Background: Computed tomography (CT) contributes to 60% of the collective dose in medical imaging. Literature has demonstrated that patient dose varies across regions and countries. Establishing diagnostic reference levels (DRLs) contributes to the optimization of clinical practices and radiation protection. Purpose: To survey the dose indices (CTDIvol and dose-length product) for frequently performed CT examinations from the chosen hospitals in Norway and Canada and to determine local DRLs (LDRLs) based on the collected data...

Background: The differentiation between myxomas and myxoid liposarcomas (MLPS) often is a serious challenge for the radiologists. Magnetic resonance imaging (MRI) is the most useful imaging technique in characterization of the soft tissue tumors (STT). Purpose: To evaluate in a sample of myxomas and MLPS of the extremities, what morphological findings in conventional MRI allow us to differentiate these two types of myxoid tumors, in addition to analyzing the validity of the apparent diffusion coefficient (ADC) values of diffusion-weighted MRI (DW-MRI)...

We report here a case of sternoclavicular arthritis due to SAPHO syndrome in a 60-year-old female in which quantitative values determined using bone SPECT/CT were useful to evaluate response. After celecoxib and alendronate sodium hydrate therapy, the chief complaints were well relieved and post-treatment Tc-99m HMDP bone SPECT/CT examination showed decreased uptake. The maximum standardized uptake value (SUV), peak SUV, mean SUV, metabolic bone volume, and total bone uptake of the untreated lesion were 18, 16, 10, 17 mL, and 180, respectively, which were decreased to 8, 7, 5, 15 mL, and 75, respectively, after the treatment...

We report a rare case of retroperitoneal pseudotumor caused by Schistosoma japonicum that was diagnosed by computed tomography (CT) guided percutaneous biopsy in a 15-year-old Filipino male. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a mass lesion, including a mesenteric artery, in the right retroperitoneal space. His mother had a history of S. japonicum infection but his initial stool examination was negative. As schistosomiasis was suspected, cone-beam CT-guided biopsy was performed to enable transcatheter therapeutic arterial embolization to be performed immediately in the event of hemorrhage...

Background: Imaging of the portal vein prior to puncture for TIPS is essential. Purpose: With this study, we examined a modified retrograde portography with regard to the reliable representation of the portal vein. Material and Methods: Prospective evaluation of 65 TIPS interventions with regard to the delimitation of the portal vein and the exact parameters of retrograde portography such as catheter diameter and contrast medium volume per injection. Results: Retrograde portographies with a large-lumen catheter (10 F) and a large contrast medium volume (40 mL) were performed in 35/63 patients with significantly better delineation of the portal vein than when using 5 F catheters with 10 mL contrast medium...

Brown tumors are uncommon manifestations of hyperparathyroidism (HPT) that without awareness are easily misdiagnosed as metastases. This short report highlights the importance of clinical context and clear communication between medical specialties when interpreting complex radiologic findings.

Background: One major challenge when inserting a tunneled, cuffed central venous catheter (CVC) for hemodialysis under fluoroscopy is to accurately place the catheter tip by assessing its position in relation to the cardiac silhouette to approximate the right atrium (RA). Purpose: To investigate whether a weighted mean calculated from published results for two two-dimensional landmark reference distances may be useful in assessing CVC tip positions in relation to the RA...

Radioactive seed localization is a method widely used within breast cancer treatment. This case represents a 43-year-old male patient with a foreign body in his left axilla. We used radioactive seed localization for marking the foreign body, which made the subsequent surgery possible, quick, and minimal invasive.

Background: Dual-energy contrast-enhanced mammography (DECEM) is an advanced breast imaging technique of digital mammography. Purpose: To assess the total radiation dose received from complete DECEM using different combinations of exposure parameters for low- and high-energy images. Materials and methods: A dedicated phantom with three different concentrations of iodine inserts was used. Each iodine insert was 10 mm in diameter and concentration of 1...

Background: Cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR (>0.55) is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. Purpose: We propose a deep learning (DL)-based model for automatic CTR calculation to assist radiologists with rapid diagnosis of cardiomegaly and thus optimise the radiology flow...

Backgrounds: There is a lack of universally available biomarker to differentiate rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Purpose: to see if the size of the axillary lymphnodes (ALNs) and the frequency of lymphadenopathy are useful biomarker to differentiate RA and PsA. Material and Methods: Forty RA and 19 PsA patients without previous biologics usage were retrospectively included. Chest CT was assessed for the presence of lymphadenopathy and the size of the largest ALN...

We report a case of a locally invasive recurrent atypical meningioma in the temporal region with late onset of meningioma lung metastasis. The patient was diagnosed in early adolescence with an atypical meningioma believed to be radiotherapy induced following treatment of a benign pilocytic astrocytoma in the hypothalamus region at 6 years of age. Even though the patient underwent several surgical and radiotherapy treatments, the intracranial meningioma kept growing and was locally invasive. The patient received experimental treatment with bevacizumab, a vascular endothelial growth factor A (VEGF-A)-inhibitor, for 4 years from age 26...

Lumbar spinal stenosis is one of the most commonly diagnosed pathological conditions of the spine. Patients with lumbar spinal stenosis can be symptomatic or asymptomatic. Regardless of the clinical presentation, a combination of radiological imaging modalities including magnetic resonance imaging, CT, and dynamic X-rays can be used to evaluate the severity. An often underrecognized aspect of severe lumbar spinal stenosis is its effect on nerve roots. We propose coining the term "GatorSign" to describe nerve root edema above the area of severe central canal stenosis...

Background: The ideal approach to managing parastomal and small bowel ectopic varices (EVs) is yet to be established. Purpose: To evaluate outcomes following percutaneous antegrade transhepatic venous obliteration (PATVO) in patients presenting with bleeding from parastomal or small bowel EVs. Material and Methods: A case series of 12 patients presenting with active or recurrent bleeding from parastomal or small bowel EVs who underwent 17 PATVO interventions at our tertiary care institution was performed...

Background: Risk factors are traits or behaviors that have an influence on the development of breast cancer (BC). Awareness of the prevalent risk factors can guide in developing prevention interventions. Purpose: To evaluate the correlation between the breast density, body mass index, and the risk of breast cancer development in relation to the menopausal status in a native African-Arab population. Material and methods: The study included 30,443 screened females who were classified into cancer and non-cancer groups and each group was further sub-classified into pre- and postmenopausal groups...

Internal carotid artery (ICA) dissection is a dangerous condition that results from disruption of the intimal part of the wall of the internal carotid artery. It is a rare disease that may occur spontaneously or as a result of a trauma. Spontaneous dissections of the carotid artery are rare but important causes of ischemic stroke because they usually affect young and middle-aged patients. Up to date, only a few cases were described in the literature about ICA dissection causing isolated cranial nerve palsies, with the Hypoglossal nerve being the most affected...

Background: Systemic air embolism is a rare, however potentially fatal, low incidence, complication to CT-guided transthoracic needle biopsy of lung lesions. Purpose: The purpose of this review of case reports and series was to pool data about this rare complication and glance for a pattern or similarities in the patients' initial symptoms and course, as well as the management of the patients in relation to current guidelines. Material and methods: PubMed was searched for case reports and case series about systemic air embolisms following CT-guided transthoracic needle biopsy of lung lesions from inception to November 2021...

Background: Chronic nonbacterial osteomyelitis (CNO) is a pediatric autoinflammatory disorder presenting with sterile inflammatory bone lesions. Whole-body MRI (WBMRI) has most recently emerged for disease assessment, but data are limited. Purpose: The purpose is to evaluate the imaging findings and patterns of CNO on WBMRI in a series of Greek pediatric patients. Material and Methods: Whole-body magnetic resonance imaging studies of all children with documented CNO, performed in a single tertiary center, were retrospectively reviewed...

Background: Brain CT needs more attention to improve the extremely low image contrast and image texture. Purpose: To evaluate the performance of iterative progressive reconstruction with visual modeling (IPV) for the improvement of low-contrast detectability (IPV-LCD) compared with filtered backprojection (FBP) and conventional IPV. Materials and methods: Low-contrast and water phantoms were used. Helical scans were conducted with the use of a CT scanner with 64 detectors...

Background: Magnetic Resonance Imaging (MRI) is considered a vital in depicting multiple sclerosis (MS) lesions. Current studies demonstrate that proton density (PD) weighted images (WI) are superior to T2 WI in detecting MS lesions (plaques) in the spinal cord. Purpose: To evaluate the diagnostic value of filtered fused PD/T2 weighted images in detecting cervical spinal cord MS lesions. Material and Methods: In this retrospective study, we selected a sample size of 50 MS patients...