Publisher: Sage Publications   (Total: 1166 journals)

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Showing 1 - 200 of 1166 Journals sorted alphabetically
AADE in Practice     Hybrid Journal   (Followers: 6)
Abstracts in Anthropology     Full-text available via subscription   (Followers: 29)
Academic Pathology     Open Access   (Followers: 6)
Accounting History     Hybrid Journal   (Followers: 18, SJR: 0.527, CiteScore: 1)
Acta Radiologica     Hybrid Journal   (Followers: 1, SJR: 0.754, CiteScore: 2)
Acta Radiologica Open     Open Access   (Followers: 2)
Acta Sociologica     Hybrid Journal   (Followers: 39, SJR: 0.939, CiteScore: 2)
Action Research     Hybrid Journal   (Followers: 53, SJR: 0.308, CiteScore: 1)
Active Learning in Higher Education     Hybrid Journal   (Followers: 396, SJR: 1.397, CiteScore: 2)
Adaptive Behavior     Hybrid Journal   (Followers: 9, SJR: 0.288, CiteScore: 1)
Administration & Society     Hybrid Journal   (Followers: 18, SJR: 0.675, CiteScore: 1)
Adoption & Fostering     Hybrid Journal   (Followers: 25, SJR: 0.313, CiteScore: 0)
Adsorption Science & Technology     Open Access   (Followers: 9, SJR: 0.258, CiteScore: 1)
Adult Education Quarterly     Hybrid Journal   (Followers: 258, SJR: 0.566, CiteScore: 2)
Adult Learning     Hybrid Journal   (Followers: 51)
Advances in Dental Research     Hybrid Journal   (Followers: 11, SJR: 1.791, CiteScore: 4)
Advances in Developing Human Resources     Hybrid Journal   (Followers: 35, SJR: 0.614, CiteScore: 2)
Advances in Mechanical Engineering     Open Access   (Followers: 156, SJR: 0.272, CiteScore: 1)
Advances in Methods and Practices in Psychological Science     Full-text available via subscription   (Followers: 20)
Advances in Structural Engineering     Full-text available via subscription   (Followers: 51, SJR: 0.599, CiteScore: 1)
AERA Open     Open Access   (Followers: 14)
Affilia     Hybrid Journal   (Followers: 6, SJR: 0.496, CiteScore: 1)
Africa Spectrum     Open Access   (Followers: 17)
Agrarian South : J. of Political Economy     Hybrid Journal   (Followers: 3)
Air, Soil & Water Research     Open Access   (Followers: 13, SJR: 0.214, CiteScore: 1)
Alexandria : The J. of National and Intl. Library and Information Issues     Full-text available via subscription   (Followers: 68)
Allergy & Rhinology     Open Access   (Followers: 5)
AlterNative : An Intl. J. of Indigenous Peoples     Full-text available via subscription   (Followers: 39, SJR: 0.194, CiteScore: 0)
Alternative Law J.     Hybrid Journal   (Followers: 12, SJR: 0.176, CiteScore: 0)
Alternatives : Global, Local, Political     Hybrid Journal   (Followers: 12, SJR: 0.351, CiteScore: 1)
Alternatives to Laboratory Animals     Full-text available via subscription   (Followers: 11, SJR: 0.297, CiteScore: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 26, SJR: 0.982, CiteScore: 2)
American Economist     Hybrid Journal   (Followers: 7)
American Educational Research J.     Hybrid Journal   (Followers: 259, SJR: 2.913, CiteScore: 3)
American J. of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 23, SJR: 0.67, CiteScore: 2)
American J. of Cosmetic Surgery     Hybrid Journal   (Followers: 9)
American J. of Evaluation     Hybrid Journal   (Followers: 18, SJR: 0.646, CiteScore: 2)
American J. of Health Promotion     Hybrid Journal   (Followers: 35, SJR: 0.807, CiteScore: 1)
American J. of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 47, SJR: 0.65, CiteScore: 1)
American J. of Law & Medicine     Full-text available via subscription   (Followers: 12, SJR: 0.204, CiteScore: 1)
American J. of Lifestyle Medicine     Hybrid Journal   (Followers: 7, SJR: 0.431, CiteScore: 1)
American J. of Medical Quality     Hybrid Journal   (Followers: 13, SJR: 0.777, CiteScore: 1)
American J. of Men's Health     Open Access   (Followers: 9, SJR: 0.595, CiteScore: 2)
American J. of Rhinology and Allergy     Hybrid Journal   (Followers: 11, SJR: 0.972, CiteScore: 2)
American J. of Sports Medicine     Hybrid Journal   (Followers: 249, SJR: 3.949, CiteScore: 6)
American Politics Research     Hybrid Journal   (Followers: 36, SJR: 1.313, CiteScore: 1)
American Review of Public Administration     Hybrid Journal   (Followers: 28, SJR: 2.062, CiteScore: 2)
American Sociological Review     Hybrid Journal   (Followers: 356, SJR: 6.333, CiteScore: 6)
American String Teacher     Full-text available via subscription   (Followers: 3)
Analytical Chemistry Insights     Open Access   (Followers: 26, SJR: 0.224, CiteScore: 1)
Angiology     Hybrid Journal   (Followers: 5, SJR: 0.849, CiteScore: 2)
Animation     Hybrid Journal   (Followers: 15, SJR: 0.197, CiteScore: 0)
Annals of Clinical Biochemistry     Hybrid Journal   (Followers: 10, SJR: 0.634, CiteScore: 1)
Annals of Otology, Rhinology & Laryngology     Hybrid Journal   (Followers: 20, SJR: 0.807, CiteScore: 1)
Annals of Pharmacotherapy     Hybrid Journal   (Followers: 59, SJR: 1.096, CiteScore: 2)
Annals of the American Academy of Political and Social Science     Hybrid Journal   (Followers: 51, SJR: 1.225, CiteScore: 3)
Annals of the ICRP     Hybrid Journal   (Followers: 4, SJR: 0.548, CiteScore: 1)
Anthropocene Review     Hybrid Journal   (Followers: 8, SJR: 3.341, CiteScore: 7)
Anthropological Theory     Hybrid Journal   (Followers: 48, SJR: 0.739, CiteScore: 1)
Antitrust Bulletin     Hybrid Journal   (Followers: 14)
Antiviral Chemistry and Chemotherapy     Open Access   (Followers: 2, SJR: 0.635, CiteScore: 2)
Antyajaa : Indian J. of Women and Social Change     Hybrid Journal   (Followers: 1)
Applied Biosafety     Hybrid Journal   (Followers: 1, SJR: 0.131, CiteScore: 0)
Applied Psychological Measurement     Hybrid Journal   (Followers: 21, SJR: 1.17, CiteScore: 1)
Applied Spectroscopy     Full-text available via subscription   (Followers: 27, SJR: 0.489, CiteScore: 2)
Armed Forces & Society     Hybrid Journal   (Followers: 25, SJR: 0.29, CiteScore: 1)
Arthaniti : J. of Economic Theory and Practice     Full-text available via subscription  
Arts and Humanities in Higher Education     Hybrid Journal   (Followers: 49, SJR: 0.305, CiteScore: 1)
Asia Pacific Media Educator     Hybrid Journal   (Followers: 1, SJR: 0.23, CiteScore: 0)
Asia-Pacific J. of Management Research and Innovation     Full-text available via subscription   (Followers: 3)
Asia-Pacific J. of Public Health     Hybrid Journal   (Followers: 15, SJR: 0.558, CiteScore: 1)
Asia-Pacific J. of Rural Development     Hybrid Journal   (Followers: 2)
Asian and Pacific Migration J.     Full-text available via subscription   (Followers: 8, SJR: 0.324, CiteScore: 1)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2, SJR: 0.305, CiteScore: 0)
Asian J. of Comparative Politics     Hybrid Journal   (Followers: 5)
Asian J. of Legal Education     Full-text available via subscription   (Followers: 4)
Asian J. of Management Cases     Hybrid Journal   (Followers: 6, SJR: 0.101, CiteScore: 0)
ASN Neuro     Open Access   (Followers: 2, SJR: 1.534, CiteScore: 3)
Assessment     Hybrid Journal   (Followers: 19, SJR: 1.519, CiteScore: 3)
Assessment for Effective Intervention     Hybrid Journal   (Followers: 15, SJR: 0.578, CiteScore: 1)
Australasian J. of Early Childhood     Hybrid Journal   (Followers: 7, SJR: 0.535, CiteScore: 1)
Australasian Psychiatry     Hybrid Journal   (Followers: 18, SJR: 0.433, CiteScore: 1)
Australian & New Zealand J. of Psychiatry     Hybrid Journal   (Followers: 30, SJR: 1.801, CiteScore: 2)
Australian and New Zealand J. of Criminology     Hybrid Journal   (Followers: 546, SJR: 0.612, CiteScore: 1)
Australian J. of Career Development     Hybrid Journal   (Followers: 5)
Australian J. of Education     Hybrid Journal   (Followers: 51, SJR: 0.403, CiteScore: 1)
Australian J. of Management     Hybrid Journal   (Followers: 13, SJR: 0.497, CiteScore: 1)
Autism     Hybrid Journal   (Followers: 355, SJR: 1.739, CiteScore: 4)
Autism & Developmental Language Impairments     Open Access   (Followers: 16)
Avian Biology Research     Hybrid Journal   (Followers: 6, SJR: 0.401, CiteScore: 1)
Behavior Modification     Hybrid Journal   (Followers: 14, SJR: 0.877, CiteScore: 2)
Behavioral and Cognitive Neuroscience Reviews     Hybrid Journal   (Followers: 27)
Behavioral Disorders     Hybrid Journal   (Followers: 1)
Beyond Behavior     Hybrid Journal   (Followers: 1)
Bible Translator     Hybrid Journal   (Followers: 13)
Biblical Theology Bulletin     Hybrid Journal   (Followers: 24, SJR: 0.184, CiteScore: 0)
Big Data & Society     Open Access   (Followers: 55)
Biochemistry Insights     Open Access   (Followers: 7)
Bioinformatics and Biology Insights     Open Access   (Followers: 12, SJR: 1.141, CiteScore: 2)
Biological Research for Nursing     Hybrid Journal   (Followers: 7, SJR: 0.685, CiteScore: 2)
Biomarker Insights     Open Access   (Followers: 1, SJR: 0.81, CiteScore: 2)
Biomarkers in Cancer     Open Access   (Followers: 11)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 13)
Biomedical Informatics Insights     Open Access   (Followers: 8)
Bioscope: South Asian Screen Studies     Hybrid Journal   (Followers: 4, SJR: 0.235, CiteScore: 0)
BMS: Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique     Hybrid Journal   (Followers: 4, SJR: 0.226, CiteScore: 0)
Body & Society     Hybrid Journal   (Followers: 29, SJR: 1.531, CiteScore: 3)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Brain and Neuroscience Advances     Open Access  
Brain Science Advances     Open Access  
Breast Cancer : Basic and Clinical Research     Open Access   (Followers: 12, SJR: 0.823, CiteScore: 2)
British J. of Music Therapy     Hybrid Journal   (Followers: 9)
British J. of Occupational Therapy     Hybrid Journal   (Followers: 252, SJR: 0.323, CiteScore: 1)
British J. of Pain     Hybrid Journal   (Followers: 31, SJR: 0.579, CiteScore: 2)
British J. of Politics and Intl. Relations     Hybrid Journal   (Followers: 39, SJR: 0.91, CiteScore: 2)
British J. of Visual Impairment     Hybrid Journal   (Followers: 14, SJR: 0.337, CiteScore: 1)
British J.ism Review     Hybrid Journal   (Followers: 18)
BRQ Business Review Quarterly     Open Access   (Followers: 1)
Building Acoustics     Hybrid Journal   (Followers: 4, SJR: 0.215, CiteScore: 1)
Building Services Engineering Research & Technology     Hybrid Journal   (Followers: 3, SJR: 0.583, CiteScore: 1)
Bulletin of Science, Technology & Society     Hybrid Journal   (Followers: 9)
Business & Society     Hybrid Journal   (Followers: 15)
Business and Professional Communication Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.348, CiteScore: 1)
Business Information Review     Hybrid Journal   (Followers: 17, SJR: 0.279, CiteScore: 0)
Business Perspectives and Research     Hybrid Journal   (Followers: 3)
Cahiers Élisabéthains     Hybrid Journal   (Followers: 1, SJR: 0.111, CiteScore: 0)
Calcutta Statistical Association Bulletin     Hybrid Journal   (Followers: 1)
California Management Review     Hybrid Journal   (Followers: 37, SJR: 2.209, CiteScore: 4)
Canadian Association of Radiologists J.     Full-text available via subscription   (Followers: 2, SJR: 0.463, CiteScore: 1)
Canadian J. of Kidney Health and Disease     Open Access   (Followers: 8, SJR: 1.007, CiteScore: 2)
Canadian J. of Nursing Research (CJNR)     Hybrid Journal   (Followers: 15)
Canadian J. of Occupational Therapy     Hybrid Journal   (Followers: 166, SJR: 0.626, CiteScore: 1)
Canadian J. of Psychiatry     Hybrid Journal   (Followers: 28, SJR: 1.769, CiteScore: 3)
Canadian J. of School Psychology     Hybrid Journal   (Followers: 12, SJR: 0.266, CiteScore: 1)
Canadian Pharmacists J. / Revue des Pharmaciens du Canada     Hybrid Journal   (Followers: 3, SJR: 0.536, CiteScore: 1)
Cancer Control     Open Access   (Followers: 2)
Cancer Growth and Metastasis     Open Access   (Followers: 1)
Cancer Informatics     Open Access   (Followers: 4, SJR: 0.64, CiteScore: 1)
Capital and Class     Hybrid Journal   (Followers: 10, SJR: 0.282, CiteScore: 1)
Cardiac Cath Lab Director     Full-text available via subscription   (Followers: 1)
Cardiovascular and Thoracic Open     Open Access   (Followers: 1)
Career Development and Transition for Exceptional Individuals     Hybrid Journal   (Followers: 10, SJR: 0.44, CiteScore: 1)
Cartilage     Hybrid Journal   (Followers: 6, SJR: 0.889, CiteScore: 3)
Cell Transplantation     Open Access   (Followers: 5, SJR: 1.023, CiteScore: 3)
Cephalalgia     Hybrid Journal   (Followers: 8, SJR: 1.581, CiteScore: 3)
Cephalalgia Reports     Open Access   (Followers: 4)
Child Language Teaching and Therapy     Hybrid Journal   (Followers: 34, SJR: 0.501, CiteScore: 1)
Child Maltreatment     Hybrid Journal   (Followers: 11, SJR: 1.22, CiteScore: 3)
Child Neurology Open     Open Access   (Followers: 6)
Childhood     Hybrid Journal   (Followers: 19, SJR: 0.894, CiteScore: 2)
Childhood Obesity and Nutrition     Open Access   (Followers: 12)
China Information     Hybrid Journal   (Followers: 9, SJR: 0.767, CiteScore: 2)
China Report     Hybrid Journal   (Followers: 11, SJR: 0.221, CiteScore: 0)
Chinese J. of Sociology     Full-text available via subscription   (Followers: 5)
Christian Education J. : Research on Educational Ministry     Hybrid Journal   (Followers: 1)
Chronic Illness     Hybrid Journal   (Followers: 6, SJR: 0.672, CiteScore: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 12, SJR: 0.808, CiteScore: 2)
Chronic Stress     Open Access  
Citizenship, Social and Economics Education     Full-text available via subscription   (Followers: 6, SJR: 0.145, CiteScore: 0)
Cleft Palate-Craniofacial J.     Hybrid Journal   (Followers: 8, SJR: 0.757, CiteScore: 1)
Clin-Alert     Hybrid Journal   (Followers: 1)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32, SJR: 0.49, CiteScore: 1)
Clinical and Translational Neuroscience     Open Access   (Followers: 1)
Clinical Case Studies     Hybrid Journal   (Followers: 3, SJR: 0.364, CiteScore: 1)
Clinical Child Psychology and Psychiatry     Hybrid Journal   (Followers: 45, SJR: 0.73, CiteScore: 2)
Clinical EEG and Neuroscience     Hybrid Journal   (Followers: 8, SJR: 0.552, CiteScore: 2)
Clinical Ethics     Hybrid Journal   (Followers: 13, SJR: 0.296, CiteScore: 1)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3, SJR: 0.537, CiteScore: 2)
Clinical Medicine Insights : Blood Disorders     Open Access   (Followers: 1, SJR: 0.314, CiteScore: 2)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 8, SJR: 0.686, CiteScore: 2)
Clinical Medicine Insights : Case Reports     Open Access   (Followers: 1, SJR: 0.283, CiteScore: 1)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 4, SJR: 0.425, CiteScore: 2)
Clinical Medicine Insights : Ear, Nose and Throat     Open Access   (Followers: 2)
Clinical Medicine Insights : Endocrinology and Diabetes     Open Access   (Followers: 33, SJR: 0.63, CiteScore: 2)
Clinical Medicine Insights : Oncology     Open Access   (Followers: 3, SJR: 1.129, CiteScore: 3)
Clinical Medicine Insights : Pediatrics     Open Access   (Followers: 3)
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Medicine Insights : Reproductive Health     Open Access   (Followers: 1, SJR: 0.776, CiteScore: 0)
Clinical Medicine Insights : Therapeutics     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Medicine Insights : Women's Health     Open Access   (Followers: 4)
Clinical Nursing Research     Hybrid Journal   (Followers: 34, SJR: 0.471, CiteScore: 1)
Clinical Pathology     Open Access   (Followers: 5)
Clinical Pediatrics     Hybrid Journal   (Followers: 25, SJR: 0.487, CiteScore: 1)
Clinical Psychological Science     Hybrid Journal   (Followers: 16, SJR: 3.281, CiteScore: 5)
Clinical Rehabilitation     Hybrid Journal   (Followers: 78, SJR: 1.322, CiteScore: 3)
Clinical Risk     Hybrid Journal   (Followers: 5, SJR: 0.133, CiteScore: 0)
Clinical Trials     Hybrid Journal   (Followers: 22, SJR: 2.399, CiteScore: 2)
Clothing and Textiles Research J.     Hybrid Journal   (Followers: 28, SJR: 0.36, CiteScore: 1)
Collections : A J. for Museum and Archives Professionals     Full-text available via subscription   (Followers: 3)
Common Law World Review     Full-text available via subscription   (Followers: 17)
Communication & Sport     Hybrid Journal   (Followers: 8, SJR: 0.385, CiteScore: 1)
Communication and the Public     Hybrid Journal   (Followers: 2)
Communication Disorders Quarterly     Hybrid Journal   (Followers: 15, SJR: 0.458, CiteScore: 1)
Communication Research     Hybrid Journal   (Followers: 24, SJR: 2.171, CiteScore: 3)
Community College Review     Hybrid Journal   (Followers: 8, SJR: 1.451, CiteScore: 1)
Comparative Political Studies     Hybrid Journal   (Followers: 291, SJR: 3.772, CiteScore: 3)
Compensation & Benefits Review     Hybrid Journal   (Followers: 8)
Competition & Change     Hybrid Journal   (Followers: 12, SJR: 0.843, CiteScore: 2)

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Similar Journals
Journal Cover
Acta Radiologica
Journal Prestige (SJR): 0.754
Citation Impact (citeScore): 2
Number of Followers: 1  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0284-1851 - ISSN (Online) 1600-0455
Published by Sage Publications Homepage  [1166 journals]
  • Retrospective evaluation of routine in-hospital observation in 433
           patients after CT-guided biopsies

    • Free pre-print version: Loading...

      Authors: Tim Fischer, Yassir El Baz, Simon Wildermuth, Sebastian Leschka, Sabine Güsewell, Paul Martin Putora, Tobias Johannes Dietrich
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundAfter computed tomography (CT)-guided interventions, routine in-hospital observation is recommended by the Cardiovascular and Interventional Radiological Society of Europe.PurposeTo evaluate the frequency of delayed major complications or hospitalizations after CT-guided biopsies in patients with initially no or minor complications and to assess whether routine in-hospital observation is justified.Material and MethodsThis retrospective study included 433 outpatients after CT-guided biopsy of the thoracic (n = 176), abdominal (n = 129), or musculoskeletal (n = 128) region with subsequent in-hospital observation. Complications were graded according to the current Society of Interventional Radiology recommendations and grouped into minor or major. A complication that occurred during in-hospital observation was defined as delayed complication. A delayed major complication was a newly developed major complication or a progression from an initially minor to a major complication. Hospitalization frequencies were evaluated similarly. Occurrence, 95% confidence intervals (CI), and P values for significant differences between the three organ groups were calculated. If delayed major complications were more frequent than 1%, routine in-hospital observation was considered justified.ResultsDelayed, major complication frequencies were: thoracic, 8.2% (95% CI 4.6–13.4); abdominal, 0.0% (95% CI 0.0–2.9); and musculoskeletal, 0.0% (95% CI 0.0–2.9) (P 
      Citation: Acta Radiologica
      PubDate: 2021-05-04T04:32:43Z
      DOI: 10.1177/02841851211011564
       
  • Thrombectomy of symptomatic isolated occlusions of posterior cerebral
           arteries in segment P1 and P2 in acute stroke treatment

    • Free pre-print version: Loading...

      Authors: Jens Altenbernd, Michael Forsting, Werner Weber, Sebastian Fischer
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundInterventional stroke treatments for occlusions of the posterior circulation are established procedures. However, there are limited data on the treatment of isolated symptomatic P1 and P2 occlusions, which we have examined in this study.PurposeTo investigate the mechanical thrombectomy of distal posterior occlusionsMaterial and MethodsRetrospectively, data from patients with isolated P1 and P2 occlusions treated with MT were evaluated. Successful reperfusions have been defined as modified thrombolysis in cerebral infarct (mTICI) Grade 2b–3. A good clinical outcome was defined as a 90-day modified Rankin score 0–2.ResultsAll 79 treated patients were primarily aspirated. Stent retrievers were used secondarily in nine patients. Successful reperfusion was achieved in 95% of patients. Of the patients, 57% had a favorable clinical outcome after 90 days.ConclusionMechanical thrombectomy with first line aspiration of symptomatic P1 and P2 occlusions is a safe and effective procedure.
      Citation: Acta Radiologica
      PubDate: 2021-05-04T04:32:43Z
      DOI: 10.1177/02841851211014191
       
  • Magnetic resonance imaging characteristics of chronic prostatitis in
           patients under the age of 50: is it more than the eye can see'

    • Free pre-print version: Loading...

      Authors: Andrei Lebovici, Csaba Csutak, Paula Popa, Nicolae Crișan, Mihai Suciu, Bogdan Feciche, Iulia Andraș, Paul-Andrei Ștefan, Diana Sorina Feier
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThe magnetic resonance (MRI) diagnosis of chronic prostatitis (CP) is insufficiently evaluated.PurposeTo evaluate the MRI appearance of CP in young patients by comparing it to individuals with non-prostatic related pathology.Material and MethodsThe study included 47 patients with prostatitis‐like symptoms evaluated by urologists and referred to pelvic MRI examination (mean age=40.23±7 years; age range=23–49 years) and 93 age-matched individuals with non-prostatic related pathology (mean age=37.5±7 years; age range=21–49 years). All MRI examinations were performed on a 1.5-T machine using a prostate-specific protocol for the prostatitis group and different protocols that included high-resolution small field of view T2-weighted (T2WI) and diffusion-weighted imaging (DWI), for the control group, depending on the clinical indication.ResultsFour different T2WI intensity patterns were observed: hyperintense homogenous; slightly to moderate homogenous hypointense; inhomogeneous; and marked hypointense. We found statistically significant differences between the two analyzed groups regarding mean ADC values (P
      Citation: Acta Radiologica
      PubDate: 2021-05-04T04:32:42Z
      DOI: 10.1177/02841851211010397
       
  • Feasibility of ultrashort echo time (UTE) T2* cartilage mapping in the
           hip: a pilot study

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      Authors: Tony T Wong, Patrick Quarterman, Thomas S Lynch, Michael J Rasiej, Diego Jaramillo, Sachin R Jambawalikar
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundUltrashort echo time (UTE) T2* is sensitive to molecular changes within the deep calcified layer of cartilage. Feasibility of its use in the hip needs to be established to determine suitability for clinical use.PurposeTo establish feasibility of UTE T2* cartilage mapping in the hip and determine if differences in regional values exist.Material and MethodsMRI scans with UTE T2* cartilage maps were prospectively acquired on eight hips. Hip cartilage was segmented into whole and deep layers in anterosuperior, superior, and posterosuperior regions. Quantitative UTE T2* maps were analyzed (independent one-way ANOVA) and reliability was calculated (ICC).ResultsUTE T2* mean values (anterosuperior, superior, posterosuperior): full femoral layer (19.55, 18.43, 16.84 ms) (P=0.004), full acetabular layer (19.37, 17.50, 16.73 ms) (P=0.013), deep femoral layer (18.68, 17.90, 15.74 ms) (P=0.010), and deep acetabular layer (17.81, 16.18, 15.31 ms) (P=0.007). Values were higher in anterosuperior compared to posterosuperior regions (mean difference; 95% confidence interval [CI]): full femur layer (2.71 ms; 95% CI 0.91–4.51: P=0.003), deep femur layer (2.94 ms; 95% CI 0.69–5.19; P=0.009), full acetabular layer (2.63 ms 95% CI 0.55–4.72; P=0.012), and deep acetabular layer (2.50 ms; 95% CI 0.69–4.30; P=0.006). Intra-reader (ICC 0.89–0.99) and inter-reader reliability (ICC 0.63–0.96) were good to excellent for the majority of cartilage layers.ConclusionUTE T2* cartilage mapping was feasible in the hip with mean values in the range of 16.84–19.55 ms in the femur and 16.73–19.37 ms in the acetabulum. Significantly higher values were present in the anterosuperior region compared to the posterosuperior region.
      Citation: Acta Radiologica
      PubDate: 2021-04-30T04:43:46Z
      DOI: 10.1177/02841851211011563
       
  • T1 mapping is useful for staging deep venous thrombosis in the lower
           extremities

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      Authors: Gang Wu, Liangjin Liu, Ting Wang, Chu Pan
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThe discrimination of acute and chronic deep venous thrombosis (DVT) is of great importance. Quantitative imaging is an urgent requirement in reflecting intrinsic characteristics of thrombosis.PurposeTo investigate the feasibility of T1 mapping in staging DVT in the lower extremities.Material and MethodsA total of 57 patients with DVT in the lower extremities (26 men, 31 women; mean age = 53.3 years) underwent T1-weighted imaging and T1 mapping for obtaining T1 signal intensity (SI) and T1 time of thrombus. The relative SI (rSI) of DVT was obtained by calculating the ratio of thrombus SI to muscle SI. The Mann–Whitney U test was used to compare rSI and T1 time of DVT between acute group (patients with limb edema ≤ 2 weeks) and chronic group (patients with limb edema > 2 weeks). A receiver operator characteristic (ROC) curve was constructed for further evaluation.ResultsDVT rSI was significantly higher in the acute group versus the chronic group (2.8 ± 1.2 vs. 1.4 ± 0.6; P
      Citation: Acta Radiologica
      PubDate: 2021-04-29T04:33:00Z
      DOI: 10.1177/02841851211004425
       
  • Maintaining immobilization devices on trauma patients during chest and
           pelvic X-ray: a feasibility study

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      Authors: Pål Johan Stokkeland, Erlend Andersen, Maria Myhre Bjørndal, Anita Imeland Moen, Sindre Aslaksen, Chris Peter Grasaas-Albrecht, Per Kristian Hyldmo
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundMost trauma systems and traumatic spinal injury guidelines mandate spinal stabilization from the site of injury to a radiological confirmation or refutal of spinal injury. Vacuum mattresses have been advocated for patients in need of prehospital spinal stabilization.PurposeTo investigate the effect of different vacuum mattresses on standard resuscitation bay conventional radiography of chest and pelvis, especially regarding artefacts.Material and MethodsWe used a mobile X-ray machine to perform chest and pelvic conventional radiography on an anthropomorphic whole-body phantom with a trauma transfer board, three different vacuum mattresses, and without any stabilization device. The vacuum mattresses were investigated in activated, deactivated, and stretched after deactivated states. Two radiologists assessed the artefacts independently. Agreement was measured using kappa coefficient.ResultsAll radiographs were of good technical quality and fully diagnostic. With the exception of one disagreed occurrence, artefacts were seen to hamper clinical judgment exclusively with activated vacuum mattresses. There was substantial agreement on artefact assessment. The observed agreement was 0.82 with a kappa coefficient of 0.71. The first vacuum mattress caused no artefacts hampering with clinical judgment.ConclusionOur study concludes that it is feasible to maintain some vacuum mattresses through resuscitation bay conventional radiography of chest and pelvis. They do not result in artefacts hampering with clinical judgment. Our vacuum mattress No. 1 is recommendable for this purpose. Together with our previous findings our present results indicate that some vacuum mattresses may be used throughout the initial resuscitation bay assessment and CT examination.
      Citation: Acta Radiologica
      PubDate: 2021-04-28T04:47:32Z
      DOI: 10.1177/02841851211008386
       
  • Percutaneous transthoracic needle biopsies in immunocompromised hosts with
           suspicious pulmonary infection: diagnostic yields and complications

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      Authors: Woo Hyeon Lim, Chang Min Park
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPulmonary infection is a major cause of morbidity and mortality in immunocompromised patients, in whom diagnostic yields of cone-beam computed tomography (CBCT)-guided percutaneous transthoracic needle biopsies (PTNBs) have not been evaluated so far.PurposeTo evaluate diagnostic yields and complications of CBCT-guided PTNBs in immunocompromised patients.Material and MethodsFrom January 2015 to January 2018, 43 patients (25 men, 18 women; mean age 54.1 ± 16.4 years) who were suspected of having pulmonary infections were included in this retrospective study. Electronic medical records and radiologic studies were reviewed, including the underlying medical status, information on target lesions, PTNB procedural factors, and pathologic results. Logistic regression was performed to explore factors related with post-PTNB complications.ResultsAmong 43 patients, specific causative organisms or family of organisms were identified by PTNBs in 16 patients (37.2%). The most common causative organism was fungus (10/16, 62.5%), while bacterial infection was pathologically proven only in one patient (6.3%). Clinically significant change in management occurred in 12 of 43 patients (27.9%). Post-PTNB complications developed in 12 patients (27.9%; pneumothorax [n = 6] and hemoptysis [n = 6]) without PTNB-related mortality. Lower lobar location (odds ratio [OR] = 0.07, P = 0.006) was related with post-PTNB pneumothorax, while lower platelet counts (≤127 × 103/µL) were associated with post-PTNB hemoptysis (OR = 9.82, P = 0.025).ConclusionCBCT-guided PTNBs revealed microbiological pathogens in 37.2% of immunocompromised patients and led to subsequent clinical actions in 27.9% of patients. Post-PTNB complications occurred in 27.9% of patients, and it might be necessary to perform PTNBs more carefully in immunocompromised patients with lower platelet counts.
      Citation: Acta Radiologica
      PubDate: 2021-04-28T04:47:31Z
      DOI: 10.1177/02841851211005087
       
  • Occurrence of spontaneous fistulas detected by contrast filling during
           computed tomography-guided percutaneous drainage placement of splenic and
           perisplenic fluid collections

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      Authors: Wolf Bäumler, Marco Dollinger, Janine Rennert, Michael Beutl, Christian Stroszczynski, Andreas Schicho
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundFistulas are serious complications of splenic and perisplenic fluid accumulations, which are often difficult to detect by routine imaging methods.PurposeTo evaluate the occurrence of spontaneous fistulas detectable during computed tomography-guided percutaneous drainage placement (CTGDP) with contrast filling of splenic or perisplenic fluid collections and to assess characteristics in comparison with perihepatic or peripancreatic fluid accumulations, also being treated with CTGDP.Material and MethodsIn 127 CTGDP-procedures, pre-interventional CTs conducted with intravenous contrast agent were compared to post-interventional CTs including contrast filling of the drain to identify spontaneous fistulas. Patient and case characteristics were evaluated, and therapeutic consequences of fistula identification were analyzed.ResultsA total of 43 perisplenic, 40 peripancreatic, and 44 perihepatic drains were evaluated; 13 (30.2%) perisplenic, 7 (17.5%) peripancreatic, and 10 (22.7%) perihepatic fistulas were observed. Concerning the frequency of fistulas, no significant difference was found between the patient groups (P = 0.39). All fistulas were solely proven in CT scans including contrast filling of the drain. Seven fistulas (23.3%) required additional interventions. Perihepatic drains were significantly more often associated with recent surgery (P 
      Citation: Acta Radiologica
      PubDate: 2021-04-24T05:09:26Z
      DOI: 10.1177/02841851211010424
       
  • Patterns of aggressiveness: risk of progression to invasive breast cancer
           by mammographic features of calcifications in screen-detected ductal
           carcinoma in situ

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      Authors: Marie Lilleborge, Ragnhild S Falk, Tone Hovda, Marit M Holmen, Giske Ursin, Solveig Hofvind
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundMammographic features of calcifications on mammograms showing invasive breast cancer are associated with survival. Less is known about mammographic features and progression to invasive breast cancer among women treated for ductal carcinoma in situ (DCIS).PurposeTo investigate mammographic features of calcifications in screen-detected DCIS in women who later did and did not get diagnosed with invasive breast cancer.Material and MethodsThis registry-based nested case-control study analyzed data from women with screen-detected DCIS in BreastScreen Norway, 1995–2016. Within this cohort of women with DCIS, those who were later diagnosed with invasive breast cancer (cases) were matched (1:2) to women who were not diagnosed with invasive breast cancer (controls) after their DCIS and by the end of 2016. Information on mammographic features were collected by a national radiological review, where screening mammograms were reviewed locally at each of the 16 breast centers in Norway. We used conditional logistic regression analysis to estimate associations between mammographic features of calcifications in the DCIS mammogram and the risk of subsequent invasive breast cancer.ResultsWe found a higher risk of invasive breast cancer associated with fine linear branching (casting) morphology (odds ratio 20.0; 95% confidence interval [CI] 2.5–158.9) compared to fine linear or fine pleomorphic morphology. Regional or diffuse distribution showed an odds ratio of 2.8 (95% CI 1.0–8.2) compared to segmental or linear distribution.ConclusionMammographic features of calcifications in screen-detected DCIS were of influence on the risk of invasive breast cancer. Unfavorable characteristics of DCIS were fine linear branching morphology, and regional or diffuse distribution.
      Citation: Acta Radiologica
      PubDate: 2021-04-23T05:00:45Z
      DOI: 10.1177/02841851211006319
       
  • Accuracy of iodine quantification using dual-energy computed tomography
           with focus on low concentrations

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      Authors: Anders Ahnfelt, Pär Dahlman, Monica Segelsjö, Mats O Magnusson, Anders Magnusson
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundIodine quantification using dual-energy computed tomography (DECT) is helpful in characterizing, and follow-up after treatment of tumors. Some malignant masses, for instance papillary renal cell carcinomas (p-RCC), are hard to differentiate from benign lesions because of very low contrast enhancement. In these cases, iodine concentrations might be very low, and it is therefore important that iodine quantification is reliable even at low concentrations if this technique is used.PurposeTo examine the accuracy of iodine quantification and to determine whether it is also accurate for low iodine concentrations.Material and MethodsTwenty-six syringes with different iodine concentrations (0–30 mg I/mL) were scanned in a phantom model using a DECT scanner with two different kilovoltage and image reconstruction settings. Iodine concentrations were measured and compared to known concentration. Absolute and relative errors were calculated.ResultsFor concentrations of 1 mg I/mL or higher, there was an excellent correlation between true and measured iodine concentrations for all settings (R = 0.999–1.000; P 
      Citation: Acta Radiologica
      PubDate: 2021-04-23T05:00:45Z
      DOI: 10.1177/02841851211009462
       
  • Myocardium microcirculation study in a healthy Chinese population using
           3.0-T cardiac magnetic resonance intravoxel incoherent motion imaging

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      Authors: Shilan Li, Anna Mou, Xin Li, Yan Guo, Qingwei Song, Ailian Liu, Zhiyong Li
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundIntravoxel incoherent motion imaging (IVIM) can non-invasively evaluate diffusion and microvascular perfusion.PurposeTo explore the myocardium microcirculation of a healthy Chinese population by using cardiac magnetic resonance (CMR) IVIM.Material and MethodsA total of 80 healthy volunteers (44 men, 36 women) who underwent 3.0-T CMR examination were enrolled. All participants had cardiac cine imaging and short-axis CMR-IVIM of the left ventricle (LV) using multiple b-values. The consistency of the IVIM parameters was assessed by intraclass correlation coefficient (ICC) and the Bland–Altman test. Spearman correlation analysis was performed between IVIM parameters and age, and body mass index (BMI). The differences of IVIM parameters were analyzed between gender and different ages.ResultsLV end-diastolic volume (EDV), end-systolic volume (ESV), LVmass, cardiac output (CO), and BMI in the male group were higher than those in the female group (P
      Citation: Acta Radiologica
      PubDate: 2021-04-23T05:00:44Z
      DOI: 10.1177/02841851211006311
       
  • Association between cardiovascular risk factors and degenerative disc
           disease of the thoracolumbar spine in the general population: results from
           the KORA MRI Study

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      Authors: Elke Maurer, Christian Klinger, Roberto Lorbeer, Gerald Hefferman, Christopher L Schlett, Annette Peters, Konstantin Nikolaou, Fabian Bamberg, Mike Notohamiprodjo, Sven S Walter
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundLittle is known about the associations between cardiovascular risk factors (CRF) and disc degeneration (DD).PurposeTo evaluate the potential association between CRFs and intervertebral DD in a population-based sample.MethodsA total of 400 participants from the community-based KORA-study were assessed in terms of CRFs, specifically obesity, hypertension, diabetes, elevated LDL-c, low HDL-c, elevated triglycerides, smoking status, and alcohol consumption. The patients additionally underwent whole-body magnetic resonance imaging (MRI) using T2-weighted single-shot fast-spin-echo and T1 dual-echo gradient-echo Dixon pulse sequences. Thoracic and lumbar DD were assessed using the Pfirrmann score and for the presence of disc bulging/protrusion. Cross-sectional associations between CRFs and MR-based Pfirrmann score were then analyzed.ResultsA total of 385 individuals (58.2% men; mean age 56.3 ± 9.2 years) were included. Prevalence of DD was 76.4%. Older age (β = 0.18; 95% CI 0.12–0.25; P 
      Citation: Acta Radiologica
      PubDate: 2021-04-21T04:35:48Z
      DOI: 10.1177/02841851211010391
       
  • Transcatheter arterial embolization for hemorrhage after gynecologic
           hysterectomy: a multicenter study

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      Authors: Cheng Shi Chen, Young-Jong Cho, Ji Hoon Shin, Jeong Ho Kim, Suyoung Park, Gyeong Sik Jeon, Alrashidi Ibrahim, Hai-Liang Li, Boryeong Jeong
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundTranscatheter arterial embolization (TAE) is not common for hemorrhagic complications after gynecologic hysterectomy.PurposeTo evaluate the effectiveness and safety of TAE for hemorrhage after hysterectomy for gynecologic diseases.Material and MethodsThis is a retrospective, multicenter study, which investigated 11 patients (median age = 45 years) who underwent TAE for hemorrhage after gynecologic hysterectomy between 2004 and 2020.ResultsThe median interval between surgery and angiography was one day (range = 0–82 days). Hemodynamic instability and massive transfusion were present in 6 (54.5%) and 4 (36.4%) patients, respectively. CT scans (n = 7) showed contrast extravasation (n = 5), pseudoaneurysm (n = 1), or both (n = 1). On angiography, the bleeding arteries were the anterior division branches of the internal iliac artery (IIA) (n = 6), posterior division branch (lateral sacral artery, n = 1), and inferior epigastric artery (n = 1) in eight patients with active bleeding. In the remaining three patients, angiographic staining without active bleeding foci was observed at the vaginal stump, and the feeders for staining were all anterior division branches of the IIA. Technical and clinical success rates were 100% and 90.9% (10/11), respectively. In one patient, active bleeding focus was successfully embolized on angiography, but surgical hemostasis was performed for suspected bleeding on exploratory laparotomy. Postembolization syndrome occurred in one patient.ConclusionsTAE is effective and safe for hemorrhage after hysterectomy for gynecologic diseases. Angiographic findings are primarily active bleeding, but angiographic staining is not uncommon. A bleeding focus is possible in any branch of the IIA, as well as the arteries supplying the abdominal wall.
      Citation: Acta Radiologica
      PubDate: 2021-04-21T04:35:47Z
      DOI: 10.1177/02841851211010395
       
  • Can radiomic analysis of a single-phase dual-energy CT improve the
           diagnostic accuracy of differentiating enhancing from non-enhancing small
           renal lesions'

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      Authors: Yuqin Ding, Mathias Meyer, Peijie Lyu, Francesca Rigiroli, Juan Carlos Ramirez-Giraldo, Kyle Lafata, Siyun Yang, Daniele Marin
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThe value of dual-energy computed tomography (DECT)-based radiomics in renal lesions is unknown.PurposeTo develop DECT-based radiomic models and assess their incremental values in comparison to conventional measurements for differentiating enhancing from non-enhancing small renal lesions.Material and MethodsA total of 349 patients with 519 small renal lesions (390 non-enhancing, 129 enhancing) who underwent contrast-enhanced nephrographic phase DECT examinations between June 2013 and January 2020 on multiple DECT platforms were retrospectively recruited. Cohort A included all lesions, while cohort B included Bosniak II–IV and solid enhancing renal lesions. Radiomic models were built with features selected by the least absolute shrinkage and selection operator regression (LASSO). ROC analyses were performed to compare the diagnostic accuracy among conventional and radiomic models for predicting enhancing renal lesions.ResultsThe individual iodine concentration (IC), normalized IC, mean attenuation on 75-keV images, radiomic model of iodine images, 75-keV images and a combined model integrating all the above-mentioned features all demonstrated high AUCs for predicting renal lesion enhancement in cohort A (AUCs = 0.934–0.979) as well as in the test dataset (AUCs = 0.892–0.962) of cohort B (P values with Bonferroni correction >0.003). The AUC (0.864) of mean attenuation on 75-keV images was significantly lower than those of other models (all P values ≤0.001) except the radiomic model of 75-keV images (P = 0.038) in the training dataset of cohort B.ConclusionNo incremental value was found by adding radiomic and machine learning analyses to iodine images for differentiating enhancing from non-enhancing renal lesions.
      Citation: Acta Radiologica
      PubDate: 2021-04-21T04:35:47Z
      DOI: 10.1177/02841851211010396
       
  • Associations between clinical and imaging findings in posterior ankle
           impingement syndrome: a systematic review

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      Authors: Peta Baillie, Susan Mayes, Jason Lam, Katia Ferrar, Jill Cook
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPosterior ankle impingement syndrome (PAIS) is a common and debilitating condition, commonly affecting people who participate in activities that involve repetitive ankle plantarflexion. The relationship between clinical and imaging findings in PAIS has not been established.PurposeTo investigate the relationship between clinical and imaging features in PAIS by reviewing the literature comparing symptomatic patients to asymptomatic controls.Material and MethodsA systematic literature search was performed to identify all English-language articles that compared imaging features in patients diagnosed with PAIS to imaging in an asymptomatic control group.ResultsA total of 8394 articles were evaluated by title and abstract, and 156 articles were read in full text. No articles compared imaging findings to an asymptomatic control group, thus no articles met the inclusion criteria.ConclusionThis systematic review found no published research that compared the imaging findings of people diagnosed with PAIS to asymptomatic people. Until this information is available, imaging features in people with posterior ankle impingement should be interpreted with caution.
      Citation: Acta Radiologica
      PubDate: 2021-04-20T04:35:10Z
      DOI: 10.1177/02841851211008389
       
  • Non-invasive assessment of heterogeneity of gliomas using diffusion and
           perfusion MRI: correlation with spatially co-registered PET

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      Authors: Ying Zhang, Yu Lin, Zhen Xing, Shaobo Yao, Dairong Cao, Wei-bing Miao
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundHeterogeneity of gliomas challenges the neuronavigated biopsy and oncological therapy. Diffusion and perfusion magnetic resonance imaging (MRI) can reveal the cellular and hemodynamic heterogeneity of tumors. Integrated positron emission tomography (PET)/MRI is expected to be a non-invasive imaging approach to characterizing glioma.PurposeTo evaluate the value of apparent diffusion coefficient (ADC), cerebral blood volume (CBV), and spatially co-registered maximal standard uptake value (SUVmax) for tissue characterization and glioma grading.Material and MethodsThirty-seven consecutive patients with pathologically confirmed gliomas were retrospectively investigated. The relative minimum ADC (rADCmin), relative maximal ADC (rADCmax), relative maximal rCBV (rCBVmax), the relative minimum rCBV (rCBVmin), and the corresponding relative SUVmax (rSUVmax) were measured. The paired t-test was used to compare the quantitative parameters between different regions to clarify tumor heterogeneity. Imaging parameters between WHO grade IV and grade II/III gliomas were compared by t-test. The diagnostic efficiency of multiparametric PET/MRI was analyzed by receiver operating characteristic (ROC) curve.ResultsThe values of rSUVmax were significantly different between maximal diffusion/perfusion area and minimum diffusion/perfusion area (P 
      Citation: Acta Radiologica
      PubDate: 2021-04-16T06:27:55Z
      DOI: 10.1177/02841851211006913
       
  • Influence of diabetes on diagnostic performance of computed tomography
           angiography of the calf arteries in acute limb ischemia

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      Authors: Talha Butt, Leena Lehti, Jan Apelqvist, Anders Gottsäter, Stefan Acosta
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPatients with diabetes mellitus (DM) have a more extensive distal arterial occlusive disease compared to non-diabetic patients. Diagnostic imaging is a necessity to identify the location and extent of the arterial occlusion in acute limb ischemia (ALI). Computed tomography angiography (CTA) is the most commonly used modality and the diagnostic performance with CTA of calf arteries may be questioned.PurposeTo evaluate diagnostic performance of CTA of calf arteries in ALI and to compare patients with and without DM.Material and MethodsAll thrombolytic treatments performed during 2001–2008 in patients with ALI were included. Initial digital subtraction angiography (DSA) and CTA of all patients were classified according to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) below-the-knee arteries and compared to CTA. Two raters assessed the CTA images independently. Inter-rater reliability was expressed as intraclass correlation (ICC) with 95% confidence intervals (CI).ResultsPatients with (n = 23) and without (n = 85) DM had lower (P = 0.006) glomerular filtration rate. ICC between CTA and DSA was 0.33 (95% CI –0.22 to 0.56) and 0.71 (95% CI 0.38–0.68) in patients with and without DM, respectively. Sensitivity with CTA for TASC D lesions in patients with and without DM was 0.14 (95% CI –0.12 to 0.40) and 0.64 (95% CI 0.48–0.80), respectively.ConclusionThe sensitivity of CTA for assessment of infra-popliteal TASC D lesions in patients with ALI was not acceptable in patients with DM in contrast to those without DM. Another imaging option at present times should be considered for patients with DM.
      Citation: Acta Radiologica
      PubDate: 2021-04-15T08:04:08Z
      DOI: 10.1177/02841851211006918
       
  • Does the primary soft-tissue sarcoma configuration predict configuration
           of recurrent tumors on magnetic resonance imaging'

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      Authors: Sam Sedaghat, Mona Salehi Ravesh, Maya Sedaghat, Jens Meschede, Olav Jansen, Marcus Both
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundSoft-tissue sarcomas (STS) are rare malignancies of the soft tissue.PurposeTo assess whether the magnetic resonance imaging (MRI) configuration of primary STS can predict the configuration of a recurring tumor and whether the MRI configuration of multiple recurrences differs in one and the same patient.Material and MethodsThirty-nine patients with histologically proven recurrent STS were included in this retrospective study and underwent pre- and post-treatment MRI. Three main configurations of primary and recurrent tumors were identified: polycyclic/multilobulated; ovoid/nodular; and streaky.ResultsSixty recurrent lesions were detected: 34 ovoid/nodular; 15 polycyclic/multilobulated; and 11 streaky. Five recurrences were multifocal and eight were bifocal. Of 39 patients, 28 (71.8%) presented one recurrence within the MRI follow-up period (P = 0.006); in 10 patients (25.6%), up to three different configurations of recurring STS were identified in one patient. Recurrences of polycyclic/multilobulated primaries were mostly ovoid/nodular (48%; P = 0.003) or polycyclic/multilobulated (37%; P = 0.014), and recurring ovoid/nodular STS significantly most often showed the same configuration as the primary tumor (85%; P 
      Citation: Acta Radiologica
      PubDate: 2021-04-15T05:27:13Z
      DOI: 10.1177/02841851211008381
       
  • Diagnostic performance of computed tomography and diffusion-weighted
           imaging as first-line imaging modality according to the International
           Myeloma Working Group (IMWG) imaging algorithm for monoclonal plasma cell
           disorders

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      Authors: Min A Yoon, Choong Guen Chee, Hye Won Chung, Dong Hyun Lee, Kyung Won Kim
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThe latest International Myeloma Working Group (IMWG) guideline recommends low-dose whole-body (WB) computed tomography (CT) as the first-line imaging technique for the initial diagnosis of plasma cell disorders.PurposeTo evaluate diagnostic performances of CT and diffusion-weighted imaging (DWI) as the first-line imaging modalities and assess misclassification rates obtained following the guideline.Material and MethodsTwo independent radiologists analyzed CT (acquired as PET/CT) and DWI (3-T; b-values = 50 and 900 s/mm2) of patients newly diagnosed with plasma cell disorder, categorizing the number of bone lesions. Diagnostic performance of CT and DWI was compared using the McNemar test, and misclassification rates were calculated with a consensus WB-MRI reading as the reference standard. Differences in lesion number categories were assessed using marginal homogeneity and kappa statistics.ResultsOf 56 patients (36 men; mean age = 63.5 years), 39 had myeloma lesions. DWI showed slightly higher sensitivity for detecting myeloma lesions (97.4%) than CT (84.6%–92.3%; P > 0.05). CT showed significantly higher specificity (88.2%) than DWI (52.9%–58.8%; P
      Citation: Acta Radiologica
      PubDate: 2021-04-15T05:27:12Z
      DOI: 10.1177/02841851211008383
       
  • Percutaneous transcystic removal of gallbladder and common bile duct
           stones: a narrative review

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      Authors: Andrew MacCormick, Paul Jenkins, Nelofer Gafoor, David Chan
      Abstract: Acta Radiologica, Ahead of Print.
      The incidence of gallstone-related complications is rising, thus leading to increases in waiting list times for elective laparoscopic cholecystectomy (LC). Percutaneous cholecystostomy (PC) provides immediate biliary drainage and may be used as an emergency option in a critically unwell patient as a bridge to surgery, or as the management option of a patient who is not fit for surgery. However, a significant number of these patients may be readmitted after PC with recurrent acute cholecystitis or pancreatitis, leading to significant morbidity and mortality. The aim of the present review was to analyze the available literature surrounding the use of the transcystic approach, including the extraction and balloon expulsion method, in the management of patients with gallbladder stones and/or common bile duct (CBD) stones. The full text of 18 articles were reviewed, of which four were included in this review. Results showed an overall success rate of CBD stone extraction in 118 of 139 patients (84.9%), gallbladder stone extraction in 97 of 114 (85.0%), and CBD stone expulsion in 27 of 29 (93.1%). Percutaneous CBD and gallbladder stone extraction may be a safe management option for elderly or co-morbid patients who are not appropriate for surgical intervention. However, the evidence base surrounding this is very limited; therefore, further research is required in order to evaluate this in more detail.
      Citation: Acta Radiologica
      PubDate: 2021-04-13T05:20:27Z
      DOI: 10.1177/02841851211006915
       
  • International Scientific Prize 2020

    • Free pre-print version: Loading...

      Authors: Henrik S Thomsen
      Abstract: Acta Radiologica, Ahead of Print.

      Citation: Acta Radiologica
      PubDate: 2021-04-13T05:20:26Z
      DOI: 10.1177/02841851211009822
       
  • Different chest CT scoring systems in patients with COVID-19: could
           baseline CT be a helpful tool in predicting survival in patients with
           matched ages and co-morbid conditions'

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      Authors: Okan Dilek, Emin Demirel, Hüseyin Akkaya, Mehmet Cenk Belibagli, Gokhan Soker, Bozkurt Gulek
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundComputed tomography (CT) gives an idea about the prognosis in patients with COVID-19 lung infiltration.PurposeTo evaluate the success rates of various scoring methods utilized in order to predict survival periods, on the basis of the imaging findings of COVID-19. Another purpose, on the other hand, was to evaluate the agreements among the evaluating radiologists.Material and MethodsA total of 100 cases of known COVID-19 pneumonia, of which 50 were deceased and 50 were living, were included in the study. Pre-existing scoring systems, which were the Total Severity Score (TSS), Chest Computed Tomography Severity Score (CT-SS), and Total CT Score, were utilized, together with the Early Decision Severity Score (ED-SS), which was developed by our team, to evaluate the initial lung CT scans of the patients obtained at their initial admission to the hospital. The scans were evaluated retrospectively by two radiologists. Area under the curve (AUC) values were acquired for each scoring system, according to their performances in predicting survival times.ResultsThe mean age of the patients was 61 ± 14.85 years (age range = 18–87 years). There was no difference in co-morbidities between the living and deceased patients. The survival predicted AUC values of ED-SS, CT-SS, TSS, and Total CT Score systems were 0.876, 0.823, 0.753, and 0.744, respectively.ConclusionAlgorithms based on lung infiltration patterns of COVID-19 may be utilized for both survival prediction and therapy planning.
      Citation: Acta Radiologica
      PubDate: 2021-04-13T05:20:25Z
      DOI: 10.1177/02841851211006316
       
  • The prevalence of sacroiliitis on abdominal MRI examinations of patients
           with Takayasu arteritis

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      Authors: Iris Eshed, Amit Druyan, Myriam Stern, Michal Bordavka, Merav Lidar
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundTakayasu arteritis (TA), a systemic large-vessel vasculitis, was reported to have high incidence of spondyloarthropathy.PurposeTo evaluate the prevalence of inflammatory sacroiliitis in patients with TA that underwent abdominal/pelvic magnetic resonance imaging (MRI) examinations as part of their vasculitis work-up.Material and MethodsConsecutive abdominal/pelvic MRI examinations of 34 patients with TA fulfilling the 1990 ACR criteria and 34 age- and gender-matched controls performed between 2008 and 2020 were retrospectively reviewed for the presence sacroiliitis. The presence of active and structural lesions was scored twice (with a one-month interval between reads) by one reader. Structural lesions were also evaluated on computed tomography, when available, and correlated to MRI findings. Clinical data were extracted from the patients’ clinical files. MRI scores were compared between the study and control groups and correlated with the clinical data.ResultsSacroiliitis was evident in 11.7% of the TA group examinations compared to 0.3% in the control group (P = 0.6). Participants with TA had significantly more erosions and fat deposition compared to the control group (Study: 0.01/0.03, Control: 0/0, P = 0.03/0.003, respectively). However, mean sacroiliitis score was not significantly different (Study: 1.06, Control: 0.78, P = 0.015). Of the four patients with TA and sacroiliitis, 3 (75%) had a diagnosis of inflammatory bowel disease (IBD).ConclusionSacroiliitis was detected in 11.7% of abdominal MRI examinations of patients with TA, 75% of which had associated IBD, suggesting that both IBD and sacroiliitis should be routinely screened in the TA population as their presence may influence treatment decisions.
      Citation: Acta Radiologica
      PubDate: 2021-04-12T05:21:27Z
      DOI: 10.1177/0284185121996270
       
  • Percutaneous retrieval of intravascular foreign body in children: a case
           series and review

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      Authors: Lucas Vatanabe Pazinato, Tulio Fabiano de Oliveira Leite, Edgar Bortolini, Osvaldo Ignacio Pereira, Cesar Higa Nomura, Joaquim Mauricio da Motta-Leal-Filho
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPercutaneous retrieval of intravascular foreign bodies has recently increased as a treatment option.PurposeTo report our single-center experience of the percutaneous retrieval of 14 intravascular embolized catheter fragments in children and to conduct a literature review.Material and MethodsMEDLINE databases were searched for case reports and series including children and iatrogenic catheter fragments or guidewires retrieved through percutaneous techniques. We also conducted a retrospective analysis of 14 cases from our institution over a 14-year period. A total of 27 studies were selected comprising 74 children, plus our 14 unpublished cases. Statistical analyses were performed using Microsoft Excel version 2016.ResultsPort catheter fragments and peripherally inserted central catheters (PICCs) were the most embolized foreign bodies and the pulmonary artery was the most common site of embolization in 44.1% of cases. Analysis of the retrieval technique demonstrated a preference for extraction through the femoral vein (81.7%) and using snare techniques (93.5%). The success rate of percutaneous retrieval was 96.6% with only 1.1% of procedure-related complications. Patients were asymptomatic in 77.2% of cases, presented septic complications in 2.3%, and no deaths were reported. Median fluoroscopy time was 10 min (range = 1.7–80 min) and median procedure length was 60 min (range = 35–208 min).ConclusionPercutaneous retrieval of intravascular foreign bodies is a feasible, safe, and efficient technique in children and should be considered the preferred treatment option.
      Citation: Acta Radiologica
      PubDate: 2021-04-09T05:17:26Z
      DOI: 10.1177/02841851211006904
       
  • Effect of “drip-and-ship” and “drip-and-drive” on endovascular
           treatment of acute ischemic stroke with large vessel occlusion: a
           single-center retrospective study

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      Authors: Yu Hang, Zhen Yu Jia, Lin Bo Zhao, Yue Zhou Cao, Huang Huang, Hai-Bin Shi, Sheng Liu
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPatients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) were usually transferred from a primary stroke center (PSC) to a comprehensive stroke center (CSC) for endovascular treatment (drip-and-ship [DS]), while driving the doctor from a CSC to a PSC to perform a procedure is an alternative strategy (drip-and-drive [DD]).PurposeTo compare the efficacy and prognosis of the two strategies.Material and MethodsFrom February 2017 to June 2019, 62 patients with LVO received endovascular treatment via the DS and DD models and were retrospectively analyzed from the stroke alliance based on our CSC. Primary endpoint was door-to-reperfusion (DTR) time. Secondary endpoints included puncture-to-recanalization (PTR) time, modified Thrombolysis in Cerebral Infarction (mTICI) rates at the end of the procedure, and modified Rankin Scale (mRS) at 90 days.ResultsForty-one patients received the DS strategy and 21 patients received the DD strategy. The DTR time was significantly longer in the DS group compared to the DD group (315.5 ± 83.8 min vs. 248.6 ± 80.0 min; P 
      Citation: Acta Radiologica
      PubDate: 2021-04-08T04:49:46Z
      DOI: 10.1177/02841851211006897
       
  • Gunshot wounds to the head: a comparison of postmortem magnetic resonance
           imaging, computed tomography, and autopsy

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      Authors: Reto Ursprung, Sebastian Eggert, Garyfalia Ampanozi, Dominic Gascho, Michael Thali, Sabine Franckenberg
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPostmortem imaging has become a powerful diagnostic tool in forensics. Postmortem computed tomography (PMCT) is often used currently to complement and sometimes even replace an autopsy.PurposeTo compare PMCT, postmortem magnetic resonance imaging (PMMRI), and autopsy findings for gunshot wounds to the head.Material and MethodsCross-sectional study. We performed a retrospective analysis of 24 cases with gunshot wounds to the head that underwent both PMCT and PMMRI between 2011 and 2018 at the Institute of Forensic Medicine, University of Zurich (Switzerland).ResultsOur study confirms that PMCT and, to a slightly lesser degree, PMMRI provide additional information that is valuable when combined with autopsy findings. Air embolism was solely detected in PMCT (67% vs. 0% at autopsy). A retained bullet or projectile and bone fragments were diagnosed more frequently with PMCT (42%, 67%, and 92%) than at autopsy (33%, 42%, and 46%). Soft tissue lesions were more often detected with PMMRI than with PMCT. With regard to autopsy, subdural hemorrhage and ventricular hemorrhage were slightly more frequently diagnosed with PMMRI (63% and 75% vs. 38% and 58% at autopsy). Intracerebral hemorrhage was by far most often diagnosed with PMMRI (92%) compared with both PMCT (38%) and autopsy (14%).ConclusionAll three modalities should ideally be considered in cases of craniocerebral gunshot wounds. However, it might be conceivable that depending on the forensic query, PMCT and PMMRI may be an adequate replacement for an autopsy.
      Citation: Acta Radiologica
      PubDate: 2021-03-29T06:34:42Z
      DOI: 10.1177/0284185121999999
       
  • Musculoskeletal symptoms among radiation technologists in Saudi Arabia:
           prevalence and causative factors

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      Authors: Nasser Shubayr, Yazeed Alashban
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundRadiation technologists usually perform several physical tasks as part of their work routine that are related to imaging equipment and handling patients. These kinds of physical activities increase their risk of developing musculoskeletal symptoms (MSS).PurposeTo determine the prevalence and causative factors of MSS among radiation technologists in Saudi Arabia.Material and MethodsA previously validated and published questionnaire was sent electronically to 800 radiation technologists in Saudi Arabia. It focused on the presence and prior diagnosis of MSS. Questions to determine risk factors were included.ResultsA total of 381 responses were obtained. MSS were indicated by 326 responders (85.6%). Furthermore, it was reported that 309 responders (81.1%) spent more than 2 h per day in awkward postures. Of the responders, 164 (43%) stated that they worked 4 h per day on a personal computer or PACS. The most frequently selected reasons for MSS included patient transfer (50.6%), chairs (38.5%), lead aprons (25.6%), moving heavy equipment (23.1%), and fixed table height (19.4%). An association between work-related MSS and gender was observed (χ2(1) = 5.338; P = 0.021). Similarly, an association between work-related MSS and age was also observed (χ2(3) = 48.58; P = 0.000).ConclusionRadiation technologists in Saudi Arabia reported a fairly high incidence of MSS, more commonly among female and senior workers. To have a better and safer workplace for radiation technologists, this study suggests preventive measures on organizational and individual levels.
      Citation: Acta Radiologica
      PubDate: 2021-03-29T06:34:41Z
      DOI: 10.1177/02841851211004428
       
  • Value of energy spectrum CT parameters in the differential diagnosis of
           high-grade clear cell renal cell carcinoma and type II papillary renal
           cell carcinoma

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      Authors: Xiaohong Liang, Caiqiang Xue, Xiaoyu Huang, Jinyan Wei, Junlin Zhou
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundEnergy spectrum computed tomography (CT) has become a promising approach for the differential diagnosis of tumor subtypes.PurposeTo explore the value of energy spectrum CT parameters in the differential diagnosis of high-grade clear cell renal cell carcinoma (ccRCC) and type II papillary renal cell carcinoma (pRCC).Material and MethodsForty-two cases of high-grade ccRCC and 28 cases of type II pRCC were retrospectively reviewed. All region of interest (ROI) measurements were maintained consistently between the two-phase contrast-enhanced examinations. The ROIs encompassed as much of the enhancing areas of the lesions as possible. Energy spectrum CT parameters of all cases, including the 70 keV (HU) value, normalized iodine concentration (NIC), and energy spectrum curve slope were recorded by two radiologists with over 10 years of experience in abdominal CT diagnosis.ResultsIn the cortical phase (CP) and parenchymal phase (PP), the 70 keV (HU) value, NIC, and slope value of the energy spectrum curve of high-grade ccRCC were significantly higher than those of type II pRCC. In the CP, NIC showed the highest differential diagnosis efficiency for the two group tumors, with a sensitivity of 78.9% and a specificity of 77.0%. There was no statistical difference in tumor hemorrhage, tumor envelope, tumor morphology, tumor border, lymph node metastasis, embolism, renal pelvis invasion, or tumor calcification between the two tumor types. However, there was significant difference in the number of tumors (P = 0.019).ConclusionEnergy spectrum CT parameters are valuable for the differential diagnosis of high-grade ccRCC and type II pRCC.
      Citation: Acta Radiologica
      PubDate: 2021-03-29T05:07:50Z
      DOI: 10.1177/02841851211002830
       
  • Ultrasound-guided transperineal laser ablation for percutaneous treatment
           of benign prostatic hyperplasia: a new minimally invasive interventional
           therapy

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      Authors: Huai-Jie Cai, Jian-Hua Fang, Fan-Lei Kong, Chen-Ke Xu, Chuang-Hua Chen, Wei Wang, Bin Huang
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundAlthough there are different treatments for benign prostate hyperplasia, their efficacy and safety differ. We are currently exploring a new minimally invasive interventional therapy for benign prostatic hyperplasia (BPH).PurposeTo determine the feasibility, effectiveness, and safety of ultrasound-guided transperineal laser ablation (US-TPLA) for the treatment of BPH.Material and MethodsTwenty patients with BPH (mean age = 73.9 ± 9.2 years) who underwent US-TPLA from June 2018 to January 2020 with a subsequent six-month follow-up were retrospectively reviewed. After local anesthesia, a 21-G trocar was inserted into the prostate tissue under ultrasound monitoring, followed by 1064 nm diode laser irradiation. Changes in international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume, and complications were evaluated six months after surgery.ResultsAll patients underwent the operation successfully without serious complications. After six months, the average IPSS improved from 22.7 ± 5.3 to 9.1 ± 3.2 (P 
      Citation: Acta Radiologica
      PubDate: 2021-03-29T05:07:50Z
      DOI: 10.1177/02841851211003289
       
  • Diagnostic performance of T2-weighted imaging and intravoxel incoherent
           motion diffusion-weighted MRI for predicting metastatic axillary lymph
           nodes in T1 and T2 stage breast cancer

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      Authors: Yuanyuan Liu, Hongbing Luo, Chunhua Wang, Xiaoyu Chen, Min Wang, Peng Zhou, Jing Ren
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundNon-invasive modalities for assessing axillary lymph node (ALN) are needed in clinical practice.PurposeTo investigate the suspicious ALN on unenhanced T2-weighted (T2W) imaging and intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) for predicting ALN metastases (ALNM) in patients with T1–T2 stage breast cancer and clinically negative ALN.Material and MethodsTwo radiologists identified the most suspicious ALN or the largest ALN in negative axilla by T2W imaging features, including short axis (Size-S), long axis (Size-L)/S ratio, fatty hilum, margin, and signal intensity on T2W imaging. The IVIM parameters of these selected ALNs were also obtained. The Mann–Whitney U test or t-test was used to compare the metastatic and non-metastatic ALN groups. Finally, logistic regression analysis with T2W imaging and IVIM features for predicting ALNM was conducted.ResultsThis study included 49 patients with metastatic ALNs and 50 patients with non-metastatic ALNs. Using the above conventional features on T2W imaging, the sensitivity and specificity in predicting ALNM were not high. Compared with non-metastatic ALNs, metastatic ALNs had lower pseudo-diffusion coefficient (D*) (P = 0.043). Logistic regression analysis showed that the most useful features for predicting ALNM were signal intensity and D*. The sensitivity and specificity predicting ALNM that satisfied abnormal signal intensity and lower D* were 73.5% and 84%, respectively.ConclusionsThe abnormal signal intensity on T2W imaging and one IVIM feature (D*) were significantly associated with ALNM, with sensitivity of 73.5% and specificity of 84%.
      Citation: Acta Radiologica
      PubDate: 2021-03-27T09:03:39Z
      DOI: 10.1177/02841851211002834
       
  • Venous stent versus conventional stent for the treatment of central vein
           obstruction in hemodialysis patients: a retrospective study

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      Authors: Surasit Akkakrisee, Keerati Hongsakul
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundEndovascular treatment is a first-line treatment for upper thoracic central vein obstruction (CVO). Few studies using bare venous stents (BVS) in CVO have been conducted.PurposeTo evaluate the treatment performance of upper thoracic central vein stenosis between BVS and conventional bare stent (CBS) in hemodialysis patients.MethodsHemodialysis patients with upper thoracic central vein obstruction who underwent endovascular treatment at the interventional unit of our institution from 1 January 2008 to 31 December 2018 were enrolled in the present study. CBS was used to treat central vein obstruction in 43 patients and BVS in 34 patients. We compared the primary patency rates and complications between the two stent types. P values  0.05). There were no statistically significant differences of primary patency rates at three and six months between the BVS and CBS groups (94.1% vs. 86.0% and 73.5% vs. 58.1%, respectively; P > 0.05). The primary patency rate at 12 months in the BVS group was significantly higher than that in the CBS group (61.8% vs. 32.6%; P = 0.008).ConclusionEndovascular treatment of central vein obstruction with BVS provided a higher primary patency rate at 12 months than CBS.
      Citation: Acta Radiologica
      PubDate: 2021-03-27T09:03:38Z
      DOI: 10.1177/02841851211005163
       
  • A comparative study of four diffusion-weighted imaging models in the
           diagnosis of cervical cancer

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      Authors: Jiao Song, Yi Lu, Xue Wang, Wenwen Peng, Wenxiao Lin, Zujun Hou, Zhihan Yan
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundMost commonly used diffusion-weighted imaging (DWI) models include intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), stretched exponential model (SEM), and mono-exponential model (MEM). Previous studies of the four models were inconsistent on which model was more effective in distinguishing cervical cancer from normal cervical tissue.PurposeTo assess the performance of four DWI models in characterizing cervical cancer and normal cervical tissue.Material and MethodsForty-seven women with suspected cervical carcinoma underwent DWI using eight b-values before treatment. Imaging parameters, calculated using IVIM, SEM, DKI, and MEM, were compared between cervical cancer and normal cervical tissue. The diagnostic performance of the models was evaluated using independent t-test, Mann–Whitney U test, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression analysis.ResultsAll parameters except pseudo-diffusion coefficient (D*) differed significantly between cervical cancer and normal cervical tissue (P 
      Citation: Acta Radiologica
      PubDate: 2021-03-20T08:24:55Z
      DOI: 10.1177/02841851211002017
       
  • Radiation exposure and establishment of diagnostic reference levels of
           whole-body low-dose CT for the assessment of multiple myeloma with second-
           and third-generation dual-source CT

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      Authors: Sebastian Zensen, Denise Bos, Marcel Opitz, Johannes Haubold, Michael Forsting, Nika Guberina, Axel Wetter
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundIn the assessment of diseases causing skeletal lesions such as multiple myeloma (MM), whole-body low-dose computed tomography (WBLDCT) is a sensitive diagnostic imaging modality, which has the potential to replace the conventional radiographic survey.PurposeTo optimize radiation protection and examine radiation exposure, and effective and organ doses of WBLDCT using different modern dual-source CT (DSCT) devices, and to establish local diagnostic reference levels (DRL).Material and MethodsIn this retrospective study, 281 WBLDCT scans of 232 patients performed between January 2017 and April 2020 either on a second- (A) or third-generation (B) DSCT device could be included. Radiation exposure indices and organ and effective doses were calculated using a commercially available automated dose-tracking software based on Monte-Carlo simulation techniques.ResultsThe radiation exposure indices and effective doses were distributed as follows (median, interquartile range): (A) second-generation DSCT: volume-weighted CT dose index (CTDIvol) 1.78 mGy (1.47–2.17 mGy); dose length product (DLP) 282.8 mGy·cm (224.6–319.4 mGy·cm), effective dose (ED) 1.87 mSv (1.61–2.17 mSv) and (B) third-generation DSCT: CTDIvol 0.56 mGy (0.47–0.67 mGy), DLP 92.0 mGy·cm (73.7–107.6 mGy·cm), ED 0.61 mSv (0.52–0.69 mSv). Radiation exposure indices and effective and organ doses were significantly lower with third-generation DSCT (P 
      Citation: Acta Radiologica
      PubDate: 2021-03-20T08:24:55Z
      DOI: 10.1177/02841851211003287
       
  • Shear wave elastography evaluation of brachial plexus in multiple
           sclerosis

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      Authors: Enes Gürün, İsmail Akdulum, Melih Akyüz, Suna Özhan Oktar
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundMultiple sclerosis (MS) is a chronic neuroinflammatory disease characterized by inflammation involving the peripheral nerves. Shear wave elastography (SWE) is potentially a method of choice for detecting peripheral nerve involvement.PurposeTo compare the degree of thickening and nerve elasticity of brachial plexus (BP) nerve roots and evaluate the usefulness of sonoelastography in patients with clinically diagnosed MS without brachial plexopathy.Material and MethodsThirty-two patients with MS and 32 controls were included in the study. Bilateral C5, C6, and C7 mean nerve root diameters, and mean elasticity values in kiloPascal (kPa) were measured in the patient and control groups. The relationship between the age, height, and weight values and nerve diameter-elasticity values of the patient and control groups was compared.ResultsThe elasticity values of the C5 and C6 nerve roots were increased, and the nerve root thickness was decreased in the MS group compared to that in the control (P  0.05).ConclusionOur study showed an increase in the BP nerve root elasticity values (kPa) in patients with MS compared to that of the control group and a decrease in diameter values thought to be related to the possible chronic atrophic process. The results are consistent with the demyelinating process of the peripheral nervous system (PNS) due to MS.
      Citation: Acta Radiologica
      PubDate: 2021-03-18T05:13:04Z
      DOI: 10.1177/02841851211002828
       
  • Effects of tube voltage and iodine contrast medium on radiation dose of
           whole-body CT

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      Authors: Morikatsu Yoshida, Takeshi Nakaura, Seitaro Oda, Masafumi Kidoh, Yasunori Nagayama, Hiroyuki Uetani, M Azuma, Daisuke Sakabe, Toshinori Hirai, Yoshinori Funama
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThe low-tube-voltage scan generally needs a higher tube current than the conventional 120 kVp to maintain the image noise. In addition, the low-tube-voltage scan increases the photoelectric effect, which increases the radiation absorption in organs.PurposeTo compare the organ radiation dose caused by iodine contrast medium between low tube voltage with low contrast medium and that of conventional 120-kVp protocol with standard contrast medium.Material and MethodsAfter the propensity-matching analysis, 66 patients were enrolled including 33 patients with 120 kVp and 600 mgI/kg and 33 patients with 80 kVp and 300 mgI/kg (50% iodine reduction). The pre- and post-contrast phases were assessed in all patients. The Monte Carlo simulation tool was used to simulate the radiation dose. The computed tomography (CT) numbers for 10 organs and the organ doses were measured. The organ doses were normalized by the volume CT dose index, and the 120-kVp protocol was compared with the 80-kVp protocol.ResultsOn contrast-enhanced CT, there were no significant differences in the mean CT numbers of the organs between 80-kVp and 120-kVp protocols except for the pancreas, kidneys, and small intestine. The normalized organ doses at 80 kVp were significantly lower than those of 120 kVp in all organs (e.g. liver, 1.6 vs. 1.9; pancreas, 1.5 vs. 1.8; spleen, 1.7 vs. 2.0) on contrast-enhanced CT.ConclusionThe low tube voltage with low-contrast-medium protocol significantly reduces organ doses at the same volume CT dose index setting compared with conventional 120-kVp protocol with standard contrast medium on contrast-enhanced CT.
      Citation: Acta Radiologica
      PubDate: 2021-03-12T10:18:53Z
      DOI: 10.1177/02841851211001539
       
  • Prediction of residual tumor and overall survival after first-line surgery
           in patients with pancreatic ductal adenocarcinoma using preoperative
           magnetic resonance imaging findings

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      Authors: Jae Seok Bae, Jung Hoon Kim, Hyo-Jin Kang, Joon Koo Han
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundComplete resection is the only potentially curative treatment in patients with pancreatic ductal adenocarcinoma (PDA) and is associated with a longer overall survival (OS) than incomplete resection of tumor. Hence, prediction of the resection status after surgery would help predict the prognosis of patients with PDA.PurposeTo predict residual tumor (R) classification and OS in patients who underwent first-line surgery for PDA using preoperative magnetic resonance imaging (MRI).Material and MethodsIn this study, 210 patients with PDA who underwent MRI and first-line surgery were randomly categorized into a test group (n=150) and a validation group (n=60). The R classification was divided into R0 (no residual tumor) and R1/R2 (microscopic/macroscopic residual tumor). Preoperative MRI findings associated with R classification and OS were assessed by using logistic regression and Cox proportional hazard models. In addition, the prediction models for the R classification and OS were validated using calibration plots and C statistics.ResultsOn preoperative MRI, portal vein encasement (odds ratio 4.755) was an independent predictor for R1/R2 resection (P=0.040). Tumor size measured on MRI (hazard ratio [HR] per centimeter 1.539) was a predictor of OS, along with pathologic N1 and N2 stage (HR 1.944 and 3.243, respectively), R1/R2 resection (HR 3.273), and adjuvant chemoradiation therapy (HR 0.250) (P
      Citation: Acta Radiologica
      PubDate: 2021-03-08T01:23:15Z
      DOI: 10.1177/0284185121999998
       
  • Semi-quantitative scoring of imaging modalities in detecting soft tissue
           foreign bodies: an in vitro study

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      Authors: Abdulrahman M Alfuraih, Faisal N Almutairi, Sultan B Alotaibi, Abdullah A Alshmrani
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundAccurate identification of foreign bodies (FB) using medical imaging is essential for diagnosis and determining the suitable retrieval technique.PurposeTo compare the sensitivity of different imaging modalities for detecting various FB materials in soft tissue and assess the reproducibility of a scoring system for grading the conspicuity of FBs.Material and MethodsFive FB materials (plastic, wood, glass, aluminum, and copper) were embedded in a tissue-mimicking phantom. Computed radiography (CR), ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were compared using a semi-quantitative 5-point Likert scale scoring system. The intra- and inter-reader reproducibility of four independent readers was analyzed using Kendall’s coefficient of concordance (W).ResultsGlass was visible on all imaging modalities. Plastic was only visible in excellent detail using ultrasound. Wood was detected in excellent resolution using ultrasound and CT using the default window while plain X-ray failed to detect it. Ultrasound was the only modality that showed aluminum in excellent quality while CT showed it with good demarcation from the surroundings. Copper was detectable in excellent detail using CR, ultrasound, and CT. MRI performance was suboptimal, especially with the plastic FB. The scoring system showed excellent intra-reader (W = 0.91, P = 0.001) and inter-reader (W = 0.88, P 
      Citation: Acta Radiologica
      PubDate: 2021-03-06T05:49:26Z
      DOI: 10.1177/0284185121999654
       
  • Diagnostic accuracy of ultra-low-dose chest computed tomography in an
           emergency department

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      Authors: Maria Tækker, Björg Kristjánsdóttir, Michael B Andersen, Maja L Fransen, Pernille W Greisen, Christian B Laursen, Bo Mussmann, Stefan Posth, Ole Graumann
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThis study examined whether ultra-low-dose chest computed tomography (ULD-CT) could improve detection of acute chest conditions.PurposeTo determine (i) whether diagnostic accuracy of ULD-CT is superior to supine chest X-ray (sCXR) for acute chest conditions and (ii) the feasibility of ULD-CT in an emergency department.Material and MethodsFrom 1 February to 31 July 2019, 91 non-traumatic patients from the Emergency Department were prospectively enrolled in the study if they received an sCXR. An ULD-CT and a non-contrast chest CT (NCCT) scan were then performed. Three radiologists assessed the sCXR and ULD-CT examinations for cardiogenic pulmonary edema, pneumonia, pneumothorax, and pleural effusion. Resources and effort were compared for sCXR and ULD-CT to evaluate feasibility. Diagnostic accuracy was calculated for sCXR and ULD-CT using NCCT as the reference standard.ResultsThe mean effective dose of ULD-CT was 0.05±0.01 mSv. For pleural effusion and cardiogenic pulmonary edema, no difference in diagnostic accuracy between ULD-CT and sCXR was observed. For pneumonia and pneumothorax, sensitivities were 100% (95% confidence interval [CI] 69–100) and 50% (95% CI 7–93) for ULD-CT and 60% (95% CI 26–88) and 0% (95% CI 0–0) for sCXR, respectively. Median examination time was 10 min for ULD-CT vs. 5 min for sCXR (P
      Citation: Acta Radiologica
      PubDate: 2021-03-05T04:23:24Z
      DOI: 10.1177/0284185121995804
       
  • Development and evaluation of a computer-based decision support system for
           diffuse lung diseases at high-resolution computed tomography

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      Authors: Simon S Martin, Delina Kolaneci, Julian L Wichmann, Lukas Lenga, Doris Leithner, Thomas J Vogl, Volkmar Jacobi
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundHigh-resolution computed tomography (HRCT) is essential in narrowing the possible differential diagnoses of diffuse and interstitial lung diseases.PurposeTo investigate the value of a novel computer-based decision support system (CDSS) for facilitating diagnosis of diffuse lung diseases at HRCT.Material and MethodsA CDSS was developed that includes about 100 different illustrations of the most common HRCT signs and patterns and describes the corresponding pathologies in detail. The logical set-up of the software facilitates a structured evaluation. By selecting one or more CT patterns, the program generates a ranked list of the most likely differential diagnoses. Three independent and blinded radiology residents initially evaluated 40 cases with different lung diseases alone; after at least 12 weeks, observers re-evaluated all cases using the CDSS.ResultsIn 40 patients, a total of 113 HRCT patterns were evaluated. The percentage of correctly classified patterns was higher with CDSS (96.8%) compared to assessment without CDSS (90.3%; P 
      Citation: Acta Radiologica
      PubDate: 2021-03-04T05:40:58Z
      DOI: 10.1177/0284185121995799
       
  • Visualization of wrist ligaments with 3D and 2D magnetic resonance imaging
           at 3 Tesla

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      Authors: Simon Götestrand, Anders Björkman, Isabella M Björkman-Burtscher, Rana Ab-Fawaz, Ingvar Kristiansson, Björn Lundin, Mats Geijer
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundWrist ligaments are challenging to visualize using magnetic resonance imaging (MRI). Injuries involving the scapholunate ligament (SLL), the lunotriquetral ligament (LTL), and the triangular fibrocartilage complex (TFCC) are common and difficult to diagnose, often requiring diagnostic arthroscopy.PurposeTo compare the visualization of wrist ligaments on a three-dimensional (3D) sequence with two-dimensional (2D) sequences on 3-T MRI.Material and MethodsEighteen healthy volunteers were examined with a 3D SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) sequence and 2D coronal, axial, and sagittal proton density-weighted (PD) sequences. Four musculoskeletal radiologists graded the anatomical visibility of the SLL, LTL, TFCC, and the image quality, using five grades in a visual grading characteristics (VGC) evaluation. After Bonferroni correction, a P value ≤0.005 was considered statistically significant.ResultsThe 3D images were graded significantly better than the 2D images in the visualization of the dorsal and palmar parts of the SLL and the LTL. Regarding the TFCC, the 3D images were graded significantly better for visualization of the foveal attachment. 2D imaging was not found significantly superior to 3D imaging in any aspect.ConclusionThe 3D SPACE sequence was scored as superior to the 2D sequences at 3 T in the assessment of the SLL, the LTL, and the foveal attachment of the TFCC. Thus, 3D SPACE can replace 2D PD sequences when these ligaments need to be assessed.
      Citation: Acta Radiologica
      PubDate: 2021-03-04T05:40:57Z
      DOI: 10.1177/0284185121994044
       
  • Contrast medium protocols in routine chest CT: a survey study

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      Authors: Mette Karen Henning, Trond Mogens Aaløkken, Safora Johansen
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundAdministration of contrast medium (CM) is an important image quality factor in computed tomography (CT) of the chest. There is no clear evidence or guidelines on CM strategies for chest CT, thus a consensus approach is needed.PurposeTo survey the potential impact on differences in chest CT protocols, with emphasis on strategies for the administration of CM.Material and MethodsA total of 170 respondents were included in this survey, which used two different approaches: (i) an online survey was sent to the members of the European Society of Thoracic Imaging (ESTI); and (ii) an email requesting a copy of their CT protocol was sent to all hospitals in Norway, and university hospitals in Sweden and Denmark. The survey focused on factors affecting CM protocols and enhancement in chest CT.ResultsThe overall response rate was 24% (n = 170): 76% of the respondents used a CM concentration of ≥350 mgI/mL; 52% of the respondents used a fixed CM volume strategy. Fixed strategies for injection rate and delay were also the most common approach, practiced by 73% and 57% of the respondents, respectively. The fixed delay was in the range of 20–90 s. Of the respondents, 56% used flexible tube potential strategies (kV).ConclusionThe chest CT protocols and CM administration strategies employed by the respondents vary widely, affecting the image quality. The results of this study underline the need for further research and consensus guidelines related to chest CT.
      Citation: Acta Radiologica
      PubDate: 2021-03-02T07:52:13Z
      DOI: 10.1177/0284185121997111
       
  • Cognitive impairment in mild traumatic brain injury: a diffusion kurtosis
           imaging and volumetric study

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      Authors: Ming-Liang Wang, Xiao-Er Wei, Meng-Meng Yu, Wen-Bin Li
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundA significant number of patients with mild traumatic brain injury (mTBI) would experience cognitive deficit.PurposeTo investigate the brain structural changes in sub-acute mTBI by diffusion kurtosis imaging (DKI) and volumetric analysis, and to assess the relationship between brain structural changes and cognitive functions.Material and MethodsA total of 23 patients with sub-acute mTBI and 24 control participants were recruited. All the participants underwent examinations of neuropsychological tests, DKI, and magnetic resonance imaging (MRI)-based morphological scans. Images were investigated using whole brain-based analysis and further regions of interest-based analysis for subcortical nuclei. The neuropsychological tests were compared between the mTBI and the control group. Correlation analysis was performed to examine the relationship between gray matter (GM) volume, DKI parameters, and cognitive functions.ResultsCompared with control participants, mTBI patients performed worse in the domains of verbal memory, attention and executive function (P  0.05). Using DKI, patients with mTBI showed lower mean kurtosis (MK) in widespread white matter (WM) regions and several subcortical nuclei (P 
      Citation: Acta Radiologica
      PubDate: 2021-02-28T04:23:17Z
      DOI: 10.1177/0284185121998317
       
  • The diagnostic value of T2 map, diffusion tensor imaging, and diffusion
           kurtosis imaging in differentiating dermatomyositis from muscular
           dystrophy

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      Authors: Jun Ran, Bin Dai, Chanyuan Liu, Huayue Zhang, Yitong Li, Bowen Hou, Xiaoming Li
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundDermatomyositis (DM) and muscular dystrophy are clinically difficult to differentiate.PurposeTo confirm the feasibility and assess the accuracy of conventional magnetic resonance imaging (MRI), T2 map, diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI) in the differentiation of DM from muscular dystrophy.Material and MethodsForty-two patients with DM proven by diagnostic criteria were enrolled in the study along with 23 patients with muscular dystrophy. Conventional MR, T2 map, DTI, and DKI images were obtained in the thigh musculature for all patients. Intramuscular T2 value, apparent diffusion coefficient (ADC), fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK) values were compared between the patients with DM and muscular dystrophy. Student’s t-tests and receiver operating characteristic (ROC) curve analyses were performed for all parameters. P values 
      Citation: Acta Radiologica
      PubDate: 2021-02-28T04:23:17Z
      DOI: 10.1177/0284185121999006
       
  • Assessment of central cartilaginous tumor of the appendicular bone:
           inter-observer and intermodality agreement and comparison of diagnostic
           performance of CT and MRI

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      Authors: Seungbo Lee, Min A Yoon
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundDiagnostic performance, inter-observer agreement, and intermodality agreement between computed tomography (CT) and magnetic resonance imaging (MRI) in the depiction of the major distinguishing imaging features of central cartilaginous tumors have not been investigated.PurposeTo determine the inter-observer and intermodality agreement of CT and MRI in the evaluation of central cartilaginous tumors of the appendicular bones, and to compare their diagnostic performance.Material and MethodsTwo independent radiologists retrospectively reviewed preoperative CT and MRI. Inter-observer and intermodality agreement between CT and MRI in the assessment of distinguishing imaging features, including lesion size, deep endosteal scalloping, cortical expansion, cortical disruption, pathologic fracture, soft tissue extension, and peritumoral edema, were evaluated. The agreement with histopathology and the accuracy of the radiologic diagnoses made with CT and MRI were also analyzed.ResultsA total of 72 patients were included. CT and MRI showed high inter-observer and intermodality agreements with regard to size, deep endosteal scalloping, cortical expansion, cortical disruption, and soft tissue extension (ICC = 0.96–0.99, k = 0.60–0.90). However, for the evaluation of pathologic fracture, MRI showed only moderate inter-observer agreement (k = 0.47). Peritumoral edema showed only fair intermodality agreement (k = 0.28–0.33) and moderate inter-observer agreement (k = 0.46) on CT. Both CT and MRI showed excellent diagnostic performance, with high agreement with the histopathology (k = 0.89 and 0.87, respectively) and high accuracy (91.7% for both CT and MRI).ConclusionCT and MRI showed high inter-observer and intermodality agreement in the assessment of several distinguishing imaging features of central cartilaginous tumors of the appendicular bones and demonstrated comparable diagnostic performance.
      Citation: Acta Radiologica
      PubDate: 2021-02-28T04:23:16Z
      DOI: 10.1177/0284185121996268
       
  • Investigation of ligament, bone, synovial and plica pathologies
           accompanied by common extensor tendon in patients with lateral overuse
           syndrome of the elbow using magnetic resonance imaging

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      Authors: Sinem Aydoğmuş, Berna Dirim Mete, Hüseyin Aydoğmuş, Muhsin Engin Uluç, Özgür Tosun, Yusuf Kenan Çetinoğlu
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundTendinosis in the common extensor tendon and accompanying ligament, bone, and plica abnormalities can be observed on magnetic resonance imaging (MRI).PurposeTo determine whether there is a difference between accompanying abnormalities according to the degree of common extensor tendon injuryMaterial and MethodsPatients who underwent 1.5-T MRI tests with a prediagnosis of lateral overuse syndrome were retrospectively reviewed, and 56 patients who had an injury in the common extensor tendon (CET) were included. The degree of tendon and ligament injury, muscle signal change, bone marrow signal change, presence of joint effusion, and morphological features in the presence of plica were evaluated via MRI examinations of the elbow.ResultsOverall, 32, 16, and eight patients had mild, moderate, and severe CET damage, respectively. As the severity of CET damage increased, the presence of joint effusion, and the presence and degree of damage to the lateral ulnar collateral ligament (LUCL) and radial collateral ligament (RCL) increased. The radiohumeral (RH) plica area was significantly larger in the group with mild CET damage. There was no statistically significant correlation between the severity of CET damage and the end of RH plica with a blind-end, coverage of one-third or more of the radius, its signal, thickness, and presence of olecranon fold.ConclusionAs the severity of CET injury increases, damage to the LUCL, RCL, and the presence of effusion in the joint increases. RH plica should be evaluated in terms of concomitant pathology in patients with mild CET injuries on MRI.
      Citation: Acta Radiologica
      PubDate: 2021-02-26T05:10:45Z
      DOI: 10.1177/0284185121990797
       
  • CT findings and dynamic imaging changes of COVID-19 in 2908 patients: a
           systematic review and meta-analysis

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      Authors: Xiuxiu Zhou, Yu Pu, Di Zhang, Yi Xia, Yu Guan, Shiyuan Liu, Li Fan
      Abstract: Acta Radiologica, Ahead of Print.
      Quick screening patients with COVID-19 is the most important way of controlling transmission by isolation and medical treatment. Chest computed tomography (CT) has been widely used during the initial screening process, including pneumonia diagnosis, severity assessment, and differential diagnosis of COVID-19. The course of COVID-19 changes rapidly. Serial CT imaging could observe the distribution, density, and range of lesions dynamically, monitor the changes, and then guide towards appropriate treatment. The aim of the review was to explore the chest CT findings and dynamic CT changes of COVID-19 using systematic evaluation methods, instructing the clinical imaging diagnosis. A systematic literature search was performed. The quality of included literature was evaluated with a quality assessment tool, followed by data extraction and meta-analysis. Homogeneity and publishing bias were analyzed. A total of 109 articles were included, involving 2908 adults with COVID-19. The lesions often occurred in bilateral lungs (74%) and were multifocal (77%) with subpleural distribution (81%). Lesions often showed ground-glass opacity (GGO) (68%), followed by GGO with consolidation (48%). The thickening of small vessels (70%) and thickening of intralobular septum (53%) were also common. The dynamic changes of chest CT manifestations showed that lesions were absorbed and improved gradually after reaching the peak (80%), had progressive deterioration (55%), were absorbed and improved gradually (46%), fluctuated (22%), or remained stable (26%). The review showed the common and key CT features and the dynamic imaging change patterns of COVID-19, helping with timely management during COVID-19 pandemic.
      Citation: Acta Radiologica
      PubDate: 2021-02-26T05:10:45Z
      DOI: 10.1177/0284185121992655
       
  • Shear-wave elastography for detection of placenta percreta: a
           case-controlled study

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      Authors: Dilek Sen Dokumaci, Hacer Uyanikoglu
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPrenatal diagnosis of placenta percreta (PP) is important to be able to provide effective management and a multidisciplinary approach to minimize the complications.PurposeTo evaluate the role of shear-wave elastography (SWE) in the prenatal diagnosis of PP.Material and MethodsA total of 18 women with PP and 20 pregnant women with normal placenta in the second or third trimesters were included in this prospective study. SWE was used to determine the elasticities of the placenta (in the maternal edge of the placenta) and myometrium. The obstetric data regarding grayscale and Doppler ultrasonography, and perinatal outcomes were reviewed. A mean placental SW velocity (SWV) cut-off value was determined to predict the presence of placental adherence.ResultsThe SWV values of the PP group in the maternal edge of the placenta were significantly higher than those of the control group (1.95 ± 0.19 m/s and 1.69 ± 0.23 m/s; P = 0.001). Myometrial SWV was also higher in the PP group compared to the control group (2.25 ± 0.39 m/s and 1.90 ± 0.71 m/s; P = 0.002). A receiver operating characteristic (ROC) curve analysis was performed and the best cut-off value of placental SWV was determined as 1.92 m/s with sensitivity of 58% and specificity of 80%, to predict the placental adherence in patients with PP.ConclusionPlacental stiffness was significantly higher in patients with PP than in pregnant women with normally localized placenta. Thus, we thought that SWE of the placenta might be used as an alternative method in the diagnosis of PP.
      Citation: Acta Radiologica
      PubDate: 2021-02-25T05:14:06Z
      DOI: 10.1177/0284185121997768
       
  • Corrigendum to Ultrasensitive Doppler as a tool for the diagnosis of
           testicular ischemia during the Valsalva maneuver: a new way to explore
           varicoceles'

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      Abstract: Acta Radiologica, Ahead of Print.

      Citation: Acta Radiologica
      PubDate: 2021-02-25T03:43:07Z
      DOI: 10.1177/0284185121999119
       
  • Pirarubicin-loaded CalliSpheres® drug-eluting beads for the treatment of
           patients with stage III–IV lung cancer

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      Authors: Yonghua Bi, Xiaonan Shi, Mengfei Yi, Xinwei Han, Jianzhuang Ren
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundCalliSpheres® beads (CB) have been used recently for patients with hepatocellular carcinoma. However, the safety and effect of drug-eluting bead transarterial chemoembolization (DEB-TACE) in patients with stage III–IV lung cancer are still unknown.PurposeTo evaluate the safety and efficacy of DEB-TACE with pirarubicin-loaded CB for the treatment of stage III–IV lung cancer.Material and MethodsFrom July 2016 to April 2020, 29 patients with stage III–IV primary lung cancer underwent DEB-TACE with pirarubicin-loaded CB. The objective response rate (ORR) was the primary endpoint; the secondary endpoints were progression-free survival (PFS) and overall survival (OS).ResultsTwenty-nine patients received DEB-TACE with pirarubicin-loaded (median 60 mg) CB, with no severe adverse events or treatment-related deaths. After DEB-TACE, hemoptysis disappeared within 1–3 days in all patients, and the symptoms of cough or expectoration were significantly improved in 12 patients. ORR and disease control rate at one, three, and six months after DEB-TACE were 39.3% and 96.4%, 26.1% and 69.6%, and 29.4% and 58.8%, respectively. The median PFS was 6.3 months (range 1.1–30.1 months), and the three-, six-, and 12-month PFS rates were 70.2%, 50.1%, and 27.1%, respectively. The median OS was 10.2 months (range 1.1–44.6 months), and the three-, six, and 12-month OS rates were 87.9%, 68.6%, and 39.8%, respectively.ConclusionDEB-TACE with pirarubicin-loaded CB is safe, feasible, and well-tolerated for patients with stage III–IV lung cancer, and symptom control was a potential benefit of treatment.
      Citation: Acta Radiologica
      PubDate: 2021-02-21T03:42:52Z
      DOI: 10.1177/0284185121994298
       
  • Imaging features of rhinocerebral mucormycosis: from onset to vascular
           complications

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      Authors: Linda Mazzai, Mariagiulia Anglani, Chiara Giraudo, Matia Martucci, Giacomo Cester, Francesco Causin
      Abstract: Acta Radiologica, Ahead of Print.
      Rhinocerebral mucormycosis (RCM) may result in severe intracranial ischemic and hemorrhagic lesions. Both computed tomography (CT) and magnetic resonance imaging (MRI) play an essential role in the diagnosis of RCM, but whereas CT is better for assessing bone erosion, MRI is superior in evaluating soft tissue, intraorbital extension, and in assessing intracranial and vascular invasion. Specific CT and MRI techniques, such as CT angiography or enhanced MR angiography, and more advanced MRI sequences such as gadolinium-3D Black Blood imaging, contribute to the assessment of the extension of vascular invasion.In this pictorial review, we describe specific CT and MRI signs of RCM, mainly focusing on its life-threatening complications due to vascular involvement.
      Citation: Acta Radiologica
      PubDate: 2021-02-21T03:42:51Z
      DOI: 10.1177/0284185120988828
       
  • Evaluating intracranial artery dissection by using three-dimensional
           simultaneous non-contrast angiography and intra-plaque hemorrhage
           high-resolution magnetic resonance imaging: a retrospective study

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      Authors: Min Tang, Jinglong Gao, Jie Gao, Xuejiao Yan, Xin Zhang, Longchao Li, Zhe Xia, Xiaoyan Lei, Xiaoling Zhang
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThere was no previous report on the three-dimensional simultaneous non-contrast angiography and intra-plaque hemorrhage (3D-SNAP) magnetic resonance imaging (MRI) sequence to diagnose intracranial artery dissection (IAD).PurposeTo improve the diagnostic accuracy and guide the clinical treatment for IAD by elucidating its pathological features using 3D-SNAP MRI.Material and MethodsFrom January 2015 to September 2018, 113 patients with suspected IAD were analyzed. They were divided into IAD and non-IAD groups according to the spontaneous coronary artery dissection (SCAD) criteria. All patients underwent 3D-SNAP, 3D-TOF, T2W imaging, 3D-PD, 3D-T1W-VISTA, and 3D-T1WCE) using 3.0-T MRI; clinical data were collected. The IAD imaging findings (intramural hematoma, double lumen, intimal flap, aneurysmal dilatation, stenosis, or occlusion) in every sequence were analyzed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficiency of each sequence.ResultsThere was a significant difference in the probability of intramural hematoma, relative signal intensity of intramural hematoma, double lumen, stenosis, or occlusion signs on 3D-TOF, T2W, 3D-PD, 3D-T1W-VISTA, 3D-SNAP, and 3D-T1WCE sequences (P
      Citation: Acta Radiologica
      PubDate: 2021-02-19T05:38:38Z
      DOI: 10.1177/0284185121992235
       
  • Radiomics analysis enables fatal outcome prediction for hospitalized
           patients with coronavirus disease 2019 (COVID-19)

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      Authors: Zan Ke, Liang Li, Li Wang, Huan Liu, Xuefang Lu, Feifei Zeng, Yunfei Zha
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundIn December 2019, a rare respiratory disease named coronavirus disease 2019 (COVID-19) broke out, leading to great concern around the world.PurposeTo develop and validate a radiomics nomogram for predicting the fatal outcome of COVID-19 pneumonia.Material and MethodsThe present study consisted of a training dataset (n = 66) and a validation dataset (n = 30) with COVID-19 from January 2020 to March 2020. A radiomics signature was generated using the least absolute shrinkage and selection operator (LASSO) Cox regression model. A radiomics score (Rad-score) was developed from the training cohort. The radiomics model, clinical model, and integrated model were built to assess the association between radiomics signature/clinical characteristics and the mortality of COVID-19 cases. The radiomics signature combined with the Rad-score and the independent clinical factors and radiomics nomogram were constructed.ResultsSeven stable radiomics features associated with the mortality of COVID-19 were finally selected. A radiomics nomogram was based on a combined model consisting of the radiomics signature and the clinical risk factors indicating optimal predictive performance for the fatal outcome of patients with COVID-19 with a C-index of 0.912 (95% confidence interval [CI] 0.867–0.957) in the training dataset and 0.907 (95% CI 0.849–0.966) in the validation dataset. The calibration curves indicated optimal consistency between the prediction and the observation in both training and validation cohorts.ConclusionThe CT-based radiomics nomogram indicated favorable predictive efficacy for the overall survival risk of patients with COVID-19, which could help clinicians intensively follow up high-risk patients and make timely diagnoses.
      Citation: Acta Radiologica
      PubDate: 2021-02-19T05:37:40Z
      DOI: 10.1177/0284185121994695
       
  • Effect of formalin fixation on measured concentrations of deposited
           gadolinium in human tissue: an autopsy study

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      Authors: Makoto Hasegawa, Desiree A Marshall, Luis F Gonzalez-Cuyar, Daniel S Hippe, Shar Samy, Kenneth R Maravilla
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundGenerally, studies of gadolinium (Gd) deposition in humans measure concentration by analyzing formalin fixed postmortem tissue. However, the effect of formalin fixation on measured Gd concentration has not been well investigated.PurposeTo evaluate the effect of fixation by comparing Gd concentration in fresh versus formalin-fixed postmortem human tissues.Material and MethodsFresh samples of bone and skin were collected from autopsy cases with previous exposure to Gd-based contrast agents (GBCAs). The type of GBCA administered, dose, and estimated glomerular filtration rate were recorded. Each tissue sample was cut into three aliquots. Paired samples were stored fresh frozen while the remaining two were stored in 10% neutral buffered formalin for one and three months, respectively. Gd concentration was measured using ICP-MS.ResultsOf 18 autopsy cases studied, 12 were exposed to only macrocyclic GBCA, one to only linear agents, and five received both macrocyclic and linear agents. On average, Gd concentration for bone decreased 30.7% after one month of fixation (P = 0.043) compared to non-fixed values. There was minimal, if any, change in concentration between one and three months (average decrease 1.5%; P = 0.89). The findings were numerically similar for skin tissue with an average decrease of 36.9% after one month (P = 0.11) and 6.0% (P = 0.73) between one and three months.ConclusionFormalin fixation appears to decrease Gd concentration in bone and skin by approximately 30%–40% on average. The largest decrease occurs within the first 30 days of fixation followed by a considerably smaller decrease at 60 days.
      Citation: Acta Radiologica
      PubDate: 2021-02-16T04:43:22Z
      DOI: 10.1177/0284185121994047
       
  • Transcatheter arterial embolization for massive hemobilia with N-butyl
           cyanoacrylate (NBCA) Glubran 2

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      Authors: Yadong Shi, Liang Chen, Boxiang Zhao, Hao Huang, Zhaoxuan Lu, Haobo Su
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundMassive hemobilia is a life-threatening condition and therapeutic challenge. Few studies have demonstrated the use of N-butyl cyanoacrylate (NBCA) for massive hemobilia.PurposeTo investigate the efficacy and safety of transcatheter arterial embolization (TAE) using NBCA Glubran 2 for massive hemobilia.Material and MethodsBetween January 2012 and December 2019, the data of 26 patients (mean age 63.4 ± 12.6 years) with massive hemobilia were retrospectively evaluated for TAE using NBCA. The patients’ baseline characteristics, severities of hemobilia, and imaging findings were collected. Emergent TAE was performed using 1:2–1:4 mixtures of NBCA and ethiodized oil. Technical success, clinical success, procedure-related complications, and follow-up outcomes were assessed.ResultsPre-procedure arteriography demonstrated injuries to the right hepatic artery (n = 24) and cystic artery (n = 2). Initial coil embolization distal to the lesions was required in 5 (19.2%) patients to control high blood flow and prevent end-organ damage. After a mean treatment time of 11.2 ± 5.3 min, technical success was achieved in 100% of the patients without non-target embolization and catheter adhesion. Clinical success was achieved in 25 (96.2%) patients. Major complications were noted in 1 (3.8%) patient with gallbladder necrosis. During a median follow-up time of 16.5 months (range 3–24 months), two patients died due to carcinomas, whereas none of the patients experienced recurrent hemobilia, embolic material migration, or post-embolization complications.ConclusionNBCA embolization for massive hemobilia is associated with rapid and effective hemostasis, as well as few major complications. This treatment modality may be a promising alternative to coil embolization.
      Citation: Acta Radiologica
      PubDate: 2021-02-10T04:39:05Z
      DOI: 10.1177/0284185121992971
       
  • The utility of diffusion-weighted imaging and ADC values in the
           characterization of mumps orchitis and seminoma

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      Authors: Renwei Liu, Jianhua Li, Yixiang Jiang, Zhiqing Wu, Jiayin Ji, Aibo Li, Xiaoping Wang, Ruifeng Li
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundDiffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and quantitative analysis of a disease.PurposeTo characterize testicular lesions that present as a hypointense signal on magnetic resonance imaging (MRI) T2-weighted images using DWI.Material and MethodsStudy participants were divided into three groups. Group A were healthy controls (n = 35), group B included patients with mumps orchitis (n = 20), and group C included patients with seminoma (n = 15). DWI sequences used b-values of 0, 1000, and 2000 s/mm2. Apparent diffusion coefficient (ADC) values between 1000 and 2000 s/mm2 were calculated by MRI postprocessing software. The Kruskal–Wallis test and receiver operating characteristic analysis were performed to evaluate how well ADC values distinguished between mumps orchitis and seminoma.ResultsNormal testicular tissue showed a hyperintense signal on DWI and hypointensity on the ADC map: mean ADC value was 0.77 (0.69–0.85) ± 0.08 ×10−3 mm2/s. Mumps orchitis and seminoma showed slight hyperintensity on DWI: mean ADC values were 0.85 (0.71–0.99) ± 0.15 ×10−3 mm2/s and 0.43 (0.39–0.47) ± 0.04 × 10−3 mm2/s, respectively. There were statistically significant differences in mean ADC values between normal testicular tissue and seminoma and between mumps orchitis and seminoma. The cutoff ADC value for differentiating seminoma from mumps orchitis was 0.54 × 10−3 mm2/s. The sensitivity, specificity, and Youden Index for diagnosing seminoma were 99%, 31%, and 30%, respectively.ConclusionHigh b-value DWI has potential utility for differentiating mumps orchitis from seminoma in the clinical setting.
      Citation: Acta Radiologica
      PubDate: 2021-02-09T03:42:42Z
      DOI: 10.1177/0284185121991980
       
  • Role of MRI in idiopathic inflammatory myopathies: a review article

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      Authors: Khushboo Pilania, Bhavin Jankharia
      Abstract: Acta Radiologica, Ahead of Print.
      Idiopathic inflammatory myopathies are a rare heterogeneous group of chronic, autoimmune conditions characterized by the slow, progressive weakness of the skeletal muscles and inflammatory infiltrates in the muscle tissue. The predominant role of magnetic resonance imaging (MRI) in myositis imaging is to assess disease activity and to identify the target site for biopsy. Its role in phenotyping the disease is less explored. The aim of the present review was to examine the role of MRI in differentiating between the common inflammatory myopathies, i.e. dermatomyositis, polymyositis, and sporadic inclusion body myositis, and to describe the specific spectrum of MRI findings in various inflammatory myopathies.
      Citation: Acta Radiologica
      PubDate: 2021-02-08T06:26:29Z
      DOI: 10.1177/0284185121990305
       
  • 18F-FDG PET cannot predict expression of clinically relevant
           histopathological biomarkers in head and neck squamous cell carcinoma: a
           meta-analysis

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      Authors: Alexey Surov, Maciej Pech, Alexander Eckert, Christoph Arens, Oliver Grosser, Andreas Wienke
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundHead and neck squamous cell carcinoma (HNSCC) is a common cancer. Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) is a widely used imaging modality in HNSCC.PurposeTo provide evident data about associations between 18F-FDG PET and histopathology in HNSCC.Material and MethodsThe MEDLINE database was screened for associations between maximum standard uptake values (SUVmax) derived from 18F-FDG PET and histopathological features in HNSCC up to May 2020. Only papers containing correlation coefficients between SUVmax and histopathology were acquired. Overall, 23 publications were collected.ResultsThe following correlations were calculated: KI 67: 12 studies (345 patients), pooled correlation coefficient (PCC): 0.23 (95% confidence interval [CI] 0.06–0.40); hypoxia-inducible factor-1α: eight studies (240 patients), PCC: 0.24 (95% CI 0.06–0.42); microvessel density: three studies (64 patients), PCC: 0.33 (95% CI 0.02–0.65); vascular endothelial growth factor: two studies (59 cases), PCC: 0.27 (95% CI 0.02–0.51); tumor suppressor protein p53: four studies (159 patients), PCC: 0.05 (95% CI –0.41 to 0.51); epidermal growth factor receptor: two studies (124 patients), PCC: 0.21 (95% CI 0.05–0.37); tumor cell count: three studies (67 patients), PCC: 0.18 (95% CI –0.06 to 0.42); tumor cell apoptosis: two studies (40 patients), PCC: 0.07 (95% CI = –0.85 to 0.99); B-cell lymphoma-2 protein: two studies (118 patients); PCC: 0.04 (95% CI –0.65 to 0.74); glucose-transporter 1: 10 studies (317 patients), PCC: 0.20 (95% CI 0.10–0.30).ConclusionSUVmax derived from 18F-FDG PET cannot reflect relevant histopathological features in HNSCC.
      Citation: Acta Radiologica
      PubDate: 2021-02-05T05:21:15Z
      DOI: 10.1177/0284185121988973
       
  • Cerebral blood volume Alberta Stroke Program Early Computed Tomography
           Score predicts intracranial hemorrhage after thrombectomy in patients with
           acute ischemic stroke in an extended time window

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      Authors: Yue-Zhou Cao, Lin-Bo Zhao, Zhen-Yu Jia, Qiang-Hui Liu, Xiao-Quan Xu, Hai-Bin Shi, Sheng Liu
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundHigher baseline Alberta Stroke Program Early Computed Tomography Score (ASPECTS) was associated with a lower probability of hemorrhagic transformation in patients with acute ischemic stroke (AIS).PurposeTo investigate the predictive value of cerebral blood volume (CBV)-ASPECTS of intracranial hemorrhage (ICH) in AIS treated with thrombectomy selected by computed tomographic perfusion (CTP) in an extended time window.Material and MethodsA total of 91 consecutive patients with AIS with large vessel occlusion in the anterior circulation after thrombectomy in an extended time window were enrolled between January 2018 and September 2019. ICH was diagnosed according to Heidelberg Bleeding Classification. CBV-ASPECTS was assessed by evaluating each ASPECTS region for relatively low CBV value compared with the mirror region in the contralateral hemisphere. Demographic characteristics, clinical data, CBV-ASPECTS, and procedure process and results were compared between patients with ICH and those without.ResultsICH occurred in 31/91 (34.1%) patients with AIS. Symptomatic ICH (sICH) was observed in 4 (4.4%) patients, while asymptomatic ICH (aICH) was seen in 27 (29.7%). In univariate analysis, both ICH and aICH were associated with high admission NIHSS score (P
      Citation: Acta Radiologica
      PubDate: 2021-02-05T05:21:15Z
      DOI: 10.1177/0284185121990843
       
  • Diffusion kurtosis imaging assessment of the response to radiotherapy in a
           VX2 bone tumor model: an animal study

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      Authors: Jia Guo, Cheng Dong, Zengjie Wu, Weikai Sun, Xiaoli Li, Ruizhi Zhou, Wenjian Xu
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundNeoadjuvant radiotherapy plays a vital role in the treatment of malignant bone tumors, and non-invasive imaging methods are needed to evaluate the response to treatment.PurposeTo assess the value of diffusion kurtosis imaging (DKI) for monitoring early response to radiotherapy in malignant bone tumors.Material and MethodsTreatment response was evaluated in a rabbit VX2 bone tumor model (n = 35) using magnetic resonance imaging (MRI), DKI, and histopathologic examinations. Subjects were divided into three groups: pre-treatment, post-treatment, and control groups. The post-treatment group was subclassified into good response and poor response groups according to the results of histopathologic examination. Apparent diffusion coefficient (ADC) and DKI parameters (mean diffusion coefficient [MD] and mean kurtosis [MK]) were recorded. The relationship between ADC, DKI parameters, and histopathologic changes after radiotherapy was determined using Pearson’s correlation coefficient. The diagnostic performance of these parameters was assessed using receiver operating characteristic analysis.ResultsMD in the good response group was higher after treatment than before treatment (P 
      Citation: Acta Radiologica
      PubDate: 2021-02-04T05:39:38Z
      DOI: 10.1177/0284185121989519
       
  • Diagnostic yield and safety of percutaneous CT-guided biopsy of
           retroperitoneal lesions and analysis of imaging features

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      Authors: Anil Kumar Singh, Zafar Neyaz, Ritu Verma, Anshul Gupta, Richa Mishra, Prabhakar Mishra
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundComputed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels.PurposeTo assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories.Material and MethodsThis retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher’s exact tests.ResultsCT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma.ConclusionPercutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.
      Citation: Acta Radiologica
      PubDate: 2021-02-03T06:40:43Z
      DOI: 10.1177/0284185121990286
       
  • Multimodal ultrasound parameters aided carotid plaque risk stratification
           in patients with asymptomatic carotid stenosis

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      Authors: Yi Li, Shuai Zheng, Jinghan Zhang, Fumin Wang, Wen He
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundRisk stratification of asymptomatic carotid plaque remains an issue in stroke prevention in clinical practice.PurposeTo investigate whether a multimodal ultrasound (MMU) model would help plaque risk stratification in patients with asymptomatic carotid stenosis.Material and MethodsA prospective study was conducted of symptomatic and asymptomatic patients with > 50% proximal internal carotid artery (ICA) stenosis. All patients underwent MMU examination. Multivariable regression analyses were performed to identify parameters associated with ischemic vascular events (IVE). These parameters were used to develop a scoring nomogram to assess the probability of IVE. We elaborated the diagnostic performance of the MMU nomogram using receiver operating characteristic (ROC) curves.ResultsFrom December 2018 to December 2019, 98 patients (75 men, mean age 67 ± 8 years) were included; 50 were symptomatic and 48 were asymptomatic. Multivariable regression analyses revealed that plaque surface morphology (PSM) (odds ratio [OR] 2.99, 95% confidence interval [CI] 1.26–7.12, P = 0.013), intraplaque neovascularization (IPN) grades (OR 3.23, 95% CI 1.77–5.89, P 50%, PSM, IPN grades, and CSD were independent variables associated with IVE. The MMU nomogram provided favorable value to risk stratification of IVE. Future large-scale studies with long-term follow-up are needed to validate these findings.
      Citation: Acta Radiologica
      PubDate: 2021-02-02T04:26:05Z
      DOI: 10.1177/0284185121989189
       
  • Managing patients with suspected postpartum retained products of
           conception using a novel sonographic classification

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      Authors: Orna Levinsohn-Tavor, Nataly Zilberman Sharon, Noa Feldman, Ran Svirsky, Noam Smorgick, Arava Nir-Yoffe, Ron Maymon
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundSuspicion of retained products of conception (RPOC) often arises after delivery and still poses a diagnostic and management challenge.PurposeTo prospectively evaluate a sonographic classification for the management of patients with suspected RPOC after delivery.Material and MethodsBased on grayscale and Doppler ultrasound parameters, patients were classified into high, moderate, or low probability of RPOC. For the low and moderate probability groups, an ultrasound follow-up at the end of the puerperium was recommended. For the high probability group, a follow-up examination was conducted 10–14 days after the first ultrasound, and patients with persistent high probability findings were referred for surgical intervention.ResultsThe sample was composed of 215 patients at risk of RPOC. Of these, 100, 93, and 22 patients were classified as having a low, moderate, or high probability of RPOC, respectively. Rates of RPOC were 55%, 2%, and 2% in the high, moderate, and low probability categories, respectively. When the categorization was based on the most recent ultrasound obtained during the puerperium, the adjusted RPOC prevalence rates were 71% in the high, 6% in the moderate, and 0% in the low probability groups.ConclusionThis study confirms the effectiveness of our sonographic classification for managing patients with suspected RPOC after delivery. In all three categories, it is recommended to adhere to a conservative management protocol in clinically stable women until the end of the puerperium. This approach provides good predictability for RPOC and can reduce unnecessary surgical interventions.
      Citation: Acta Radiologica
      PubDate: 2021-02-01T05:45:47Z
      DOI: 10.1177/0284185121991464
       
  • Utility of intraoperative magnetic resonance imaging for giant cell tumor
           of bone after denosumab treatment: a pilot study

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      Authors: Taisuke Furuta, Tadahiko Kubo, Tomohiko Sakuda, Taiichi Saito, Kaoru Kurisu, Yoshihiro Muragaki, Nobuo Adachi
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundGiant cell tumor of bone (GCTB) is an intermediate but locally aggressive neoplasm. Current treatment of high-risk GCTB involves administration of denosumab, which inhibits bone destruction and promotes osteosclerosis. However, denosumab monotherapy is not a curative treatment for GCTB and surgical treatment remains required. Denosumab treatment complicates surgery, and the recurrence rate of GCTB is high (20%–30%).PurposeTo examine the utility of intraoperative magnetic resonance imaging (iMRI) for detection and reduction of residual tumor after denosumab treatment and to investigate the utility of iMRI, which is not yet widely used.Material and MethodsWe enrolled five patients who received denosumab for a median period of eight months (range 6–12 months). Surgery was performed when the degree of osteosclerosis around the articular surface was deemed appropriate. We performed iMRI using a modified operation table to identify residual tumor after initial curettage and evaluated the rate of detection of residual tumor by iMRI, intraoperative and postoperative complications, exposure time of iMRI, and operation time.ResultsSuspected residual tumor tissue was identified in all five cases and was confirmed by histopathology after additional curettage. The rate of detection of residual tumor by iMRI was 100%. Residual tumor was located in sites which were difficult to remove due to osteosclerosis. The iMRI was performed safely and without trouble. During the median follow-up period of 10 months (range 6–24 months), no adverse events or recurrences occurred.ConclusionIntraoperative MRI could contribute to the reduction of residual tumor tissue and it may prevent recurrence of GCTB after denosumab therapy.
      Citation: Acta Radiologica
      PubDate: 2021-02-01T05:45:46Z
      DOI: 10.1177/0284185121989515
       
  • Ultra-low-dose computed tomography and its utility in wrist trauma in the
           emergency department

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      Authors: Erdal Tekin, Kutsi Tuncer, Ibrahim Ozlu, Recep Sade, Rustem Berhan Pirimoglu, Gokhan Polat
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThe use and frequency of computed tomography (CT) are increasing day by day in emergency departments (ED). This increases the amount of radiation exposed.PurposeTo evaluate the image quality obtained by ultra-low-dose CT (ULDCT) in patients with suspected wrist fractures in the ED and to investigate whether it is an alternative to standard-dose CT (SDCT).Material and MethodsThis is a study prospectively examining 336 patients who consulted the ED for wrist trauma. After exclusion criteria were applied, the patients were divided into the study and control groups. Then, SDCT (120 kVp and 100 mAs) and ULDCT (80 kVp and 5 mAs) wrist protocols were applied simultaneously. The images obtained were evaluated for image quality and fracture independently by a radiologist and an emergency medical specialist using a 5-point scale.ResultsThe effective radiation dose calculated for the control group scans was 41.1 ± 2.1 µSv, whereas the effective radiation dose calculated for the study group scans was 0.5 ± 0.0 µSv. The effective radiation dose of the study group was significantly lower than that of the control group (P 
      Citation: Acta Radiologica
      PubDate: 2021-01-29T04:40:41Z
      DOI: 10.1177/0284185121989958
       
  • Usefulness of computed tomography in the diagnosis of acute pyelonephritis
           in older patients suspected of infection with unknown focus

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      Authors: Tetsuhiro Yano, Toshihiko Takada, Ryuto Fujiishi, Kotaro Fujii, Hiroshi Honjo, Masayuki Miyajima, Taro Takeshima, Michio Hayashi, Jun Miyashita, Teruhisa Azuma, Shunichi Fukuhara
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundIn older adults, the diagnosis of acute pyelonephritis is challenging because of non-specific symptoms and false-positive urine test results. Few studies have investigated the diagnostic performance of computed tomography (CT) signs.PurposeTo evaluate the diagnostic performance of CT signs for acute pyelonephritis in older patients suspected of infection with unknown focus.Material and MethodsThis cross-sectional study was conducted between 2015 and 2018. Patients aged ≥65 years who underwent blood cultures, urine culture, and non-contrast or contrast-enhanced CT on admission were included. Cases with clinically presumable infection focus before CT were excluded. Two radiologists blinded to clinical information independently reviewed five CT signs: perirenal fat stranding; pelvicalyceal wall thickening and enhancement; renal enlargement; thickening of Gerota’s fascia; and area(s) of decreased attenuation. The final diagnoses were made by a clinical expert panel.ResultsAmong 473 eligible patients, 61 were diagnosed with acute pyelonephritis. When the laterality of findings between the left and right kidneys were considered, the positive and negative likelihood ratios of perirenal fat stranding were 4.0 (95% confidence interval [CI] = 2.3–7.0) and 0.8 (95% CI = 0.7–0.9) in non-contrast CT, respectively. The other signs in non-contrast CT showed similar diagnostic performance with positive and negative likelihood ratios of 3.5–11.3 and 0.8–0.9, respectively.ConclusionCT signs can help physicians diagnose acute pyelonephritis in older patients suspected of infection with unknown focus.
      Citation: Acta Radiologica
      PubDate: 2021-01-29T04:40:39Z
      DOI: 10.1177/0284185120988817
       
  • Characterization of high-grade pineal region lesions: the usefulness of
           apparent diffusion coefficient volumetric values

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      Authors: Rosalinda Calandrelli, Fabio Pilato, Luca Massimi, Marco Gessi, Marco Panfili, Cesare Colosimo
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundHigh-grade pineal region tumors are rare and heterogeneous types of primary central nervous system neoplasms; radiological differential diagnosis is challenging but it is important because it has a therapeutic relevance.PurposeTo discriminate among high-grade pineal region tumors by combining apparent diffusion coefficient (ADC) volumetric values and qualitative features in order to predict their histology.Material and MethodsTwenty-two patients with high-grade pineal region tumors were assessed by qualitative and quantitative analysis. Margins, T2-weighted signal intensity, contrast enhancement, hemorrhage, calcifications, different volumetric ADC fractions (ADCmean, ADCmax, ADCmin) were evaluated and were compared to the histopathologic findings (cell count and proliferation index).ResultsOur qualitative imaging data showed that only margins were different among different tumors and each tumor type showed peculiar age onset. ADCmean was found the best quantitative value to discriminate high-grade tumors of the pineal region. ADCmean correlated with proliferation index but not with cell count. ADCmean values were lower in tumors with higher proliferation rate and a significant difference in ADCmean values were found between germinomas and pineoblastomas, between germinomas and papillary tumors and between papillary tumors and pineoblastomas. Moreover, the cut-off value of 0.865 × 10–3 mm2/s for ADCmean (ADC mean threshold value) could differentiate germinoma from pineoblastomas with the best combination of sensitivity and specificity.ConclusionThe ADCmean value measured on the whole tumor, reflecting tumor proliferative activity, may be a practical and non-invasive marker for predicting tumor histology in high-grade pineal region lesions and might be useful in preoperative assessment.
      Citation: Acta Radiologica
      PubDate: 2021-01-26T05:58:08Z
      DOI: 10.1177/0284185120986912
       
  • Olive oil effectively mitigates ovariectomy-induced marrow adiposity
           assessed by MR spectroscopy in estrogen-deficient rabbits

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      Authors: Yin Liu, Huayi Tan, Can Huang, Lifeng Li, Sijie Wu
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundPolyphenols in extra virgin olive oil (EVOO) have been found to reduce the expression of PPARγ2, inhibit adipocyte differentiation, and enhance the formation of osteoblasts from bone marrow stem cells. However, the underlying mechanisms of their action remain unknown.PurposeTo determine the sequential effects of EVOO on marrow fat expansion induced by estrogen deprivation using 3.0-T proton magnetic resonance (MR) spectroscopy in an ovariectomy (OVX) rabbit model of postmenopausal bone loss over a six-month period.Material and MethodsA total of 45 female New Zealand rabbits were equally divided into sham-operation, OVX controls, and OVX treated with EVOO for six months. Marrow fat fraction was measured by MR spectroscopy at baseline conditions, and three and six months postoperatively, respectively. Serum bone biomarkers, lumbar and femoral bone mineral density, microtomographic parameters, biomechanical properties, and quantitative parameters of marrow adipocytes were studied.ResultsOVX was associated with marrow adiposity in a time-dependent manner, accompanied with increased bone turnover and impaired bone mass and trabecular microarchitecture. In OVX rabbits, EVOO markedly alleviated trabecular bone loss and reduced the accumulation of lipid droplets including adipocyte size, density, and areas of fat deposits in the bone marrow. EVOO prevented such changes in terms of both marrow adiposity and bone remodeling.ConclusionEarly EVOO treatment may exert beneficial effects on bone by modulating marrow adiposity, which would support their protective effect against bone pathologies.
      Citation: Acta Radiologica
      PubDate: 2021-01-26T05:58:07Z
      DOI: 10.1177/0284185120986937
       
  • Delayed onset bleed after percutaneous kidney biopsy: is it the same as
           early bleed'

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      Authors: Dharmendra Bhadauria, Leena Jose, Ravi Kushwaha, Anupma Kaul, Raghu Nandan, Vivek Singh, Narayan Prasad
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundWhile the majority of bleeding complications after a percutaneous kidney biopsy (PKB) occur early (≤24 h), delayed onset bleeding complications (>24 h) have been rarely reported and can be catastrophic for the patient.PurposeTo describe the incidence, risk factors, and outcomes of delayed bleeding complications after PKB.Material and MethodsWe retrospectively studied native and graft kidney biopsies in patients who developed delayed bleeding complications (>24 h) after the biopsy performed in the Department of Nephrology and Renal Transplantation of a tertiary care medical institution in north India between January 2014 to December 2018.ResultsOf the 4912 renal biopsies reviewed, 20 patients (16 men, 4 women; 0.40%) had a delayed biopsy bleeding complication. Of these patients, 95% had major bleeding complications requiring blood transfusions and 85% needed intervention like gelfoam/coil embolization. Despite intervention, one patient (5%) had mortality due to complications of bleeding and sepsis. When compared to a control group of patients with early biopsy bleed, patients with the delayed biopsy bleed had similar demographic and clinical profiles except for higher pre-biopsy hemoglobin and lower systolic and diastolic blood pressure.ConclusionA post-PKB delayed onset bleed is not uncommon, and the vast majority of these patients had major bleeding complications requiring blood transfusions and/or intervention like embolization. They had a similar demographic and clinical profile presentation as early bleed patients. Meticulous outpatient monitoring and patient education after discharge may be useful to detect this complication promptly and to intervene early to have good patient outcome.
      Citation: Acta Radiologica
      PubDate: 2021-01-26T05:58:07Z
      DOI: 10.1177/0284185120988812
       
  • Differential diagnosis of renal oncocytoma and chromophobe renal cell
           carcinoma using CT features: a central scar-matched retrospective study

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      Authors: Xiaoli Li, Pei Nie, Jing Zhang, Feng Hou, Qianli Ma, Jiufa Cui
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundRenal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) have a common cellular origin and different clinical management and prognosis.PurposeTo explore the utility of computed tomography (CT) in the differentiation of RO and chRCC.Material and MethodsTwenty-five patients with RO and 73 patients with chRCC presenting with the central scar were included retrospectively. Two experienced radiologists independently reviewed the CT imaging features, including location, tumor size, relative density ratio, segmental enhancement inversion (SEI), necrosis, and perirenal fascia thickening, among others. Interclass correlation coefficient (ICC, for continuous variables) or Kappa coefficient test (for categorical variables) was used to determine intra-observer and inter-observer bias between the two radiologists.ResultsThe inter- and intra-reader reproducibility of the other CT imaging parameters were nearly perfect (>0.81) except for the measurements of fat (0.662). RO differed from chRCC in the cortical or medullary side (P = 0.005), relative density ratio (P = 0.020), SEI (P 
      Citation: Acta Radiologica
      PubDate: 2021-01-26T05:58:03Z
      DOI: 10.1177/0284185120988109
       
  • Efficiency of diffusion-weighted MRI for differentiating radiologically
           similar simple and type I hydatid cysts of the liver

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      Authors: Ilyas Dundar, Mesut Ozgokce, Fatma Durmaz, Sercan Ozkacmaz, Saim Turkoglu, Cemil Goya
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundDetermining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications.PurposeTo explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances.Material and MethodsThis single-center prospective study was conducted during 2016–2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test.ResultsOf 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5–82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2–7.6 cm) and ADCmean value was 3.03 ± 0.47 (range 2.64–5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8–14 cm) and ADCmean value was 2.99 ± 0.29 (range 2.36–3.83). There was no statistically significant difference in ADC values between type I HCs and SLCsConclusionSome studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.
      Citation: Acta Radiologica
      PubDate: 2021-01-22T06:12:12Z
      DOI: 10.1177/0284185120988131
       
  • Assessment of optic nerve vascularity in healthy eyes using superb
           microvascular imaging: a preliminary study

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      Authors: Abdussamet Batur, Muhammed Alpaslan, Sercan Özkaçmaz, M Sedat Durmaz
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundChanges in optic nerve vascularity are observed in many diseases. Superb microvascular imaging (SMI) has the potential to become the method of choice for detecting microvasculature in the optic nerves.PurposeTo evaluate optic nerve vascularity in healthy individuals through power Doppler sonography (PDUS) and SMI.Material and MethodsTwenty-seven healthy patients with 54 eyes were prospectively evaluated. The duration of the examination for optic nerve vascularity lasted until the posterior ciliary artery blood supply was observed in PDUS and SMI. The visibility of vascularity, as well as the ratio of the vascular structures to the optic nerves (vascular index [VI]), was evaluated.ResultsFifty-four eyes were evaluated from a total of 27 patients (mean age = 49.0 ± 19.42 years). The VI value for the right optic nerve was 29.58 ± 4.00 while for the left optic nerve, it was 31.21 ± 3.52. Vascularity was clearly observed in both eyes (n = 54) in all 27 cases in the evaluation performed with the SMI technique. However, with the power Doppler examination, vascular flow was not observed in 14 right eyes and in 10 left eyes within the specified timeframe.ConclusionThe results indicate that imaging of vascular structures can be done faster and better with SMI than PDUS examination. The normal VI values may provide important information about the blood supply of the optic nerve, which is of relevance in orbital pathologies and many systemic conditions.
      Citation: Acta Radiologica
      PubDate: 2021-01-21T04:34:57Z
      DOI: 10.1177/0284185120983279
       
  • Predicting ureteral status below the ureteral calculi in patients
           undergoing ureteroscopic lithotomy

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      Authors: Caipeng Qin, Huaqi Yin, Yiqing Du, Qing Li, Hijun Liu, Tao Xu
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundDuring ureteroscopy, severe ureter straightness or contortion may occur before the stone is passed.PurposeTo identify clinical factors associated with distal ureteral status below the ureteral calculi in patients before surgery.Material and MethodsFrom October 2016 to March 2017, 101 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients who lacked clinical data and underwent preoperative indwelling ureteral stent placement were excluded. Univariate and multivariate analyses were performed to determine the clinical factors associated with intraoperative findings.ResultsA total of 101 patients were enrolled in the study (mean age  =  54 years; mean stone size  =  7.9 ± 4.5 mm). Overall, 25 of the 101 patients (24.7%) were diagnosed with poor distal ureteral status defined as intraoperative ureterostenosis or contortion resulting in a ureteroscope being unable to pass during the initial attempt. Univariate analysis showed significant differences in renal parenchyma thickness, ureteral wall thickening on imaging, and stone location (all, P 
      Citation: Acta Radiologica
      PubDate: 2021-01-21T04:34:57Z
      DOI: 10.1177/0284185120988092
       
  • Effect of image quality on myocardial extracellular volume quantification
           using cardiac computed tomography: a phantom study

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      Authors: Yoshinori Funama, Seitaro Oda, Masafumi Kidoh, Daisuke Sakabe, Takeshi Nakaura
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThe image quality directly affects the accuracy of computed tomography (CT) extracellular volume (ECV) quantification.PurposeTo investigate the effects of image quality and acquisition protocol on the accuracy of ECV quantification.Material and MethodsOne-volume scans were performed on a 320-row multidetector CT volume scanner using a multi-energy CT phantom. To simulate the blood pool and myocardium, solid rods representing blood and soft tissue were used in precontrast CT. Moreover, the solid rods including different iodine concentrations were used in postcontrast CT. The tube voltage was set at 120 kVp, and the tube current was changed from 750 mA (100% dose) to 190 mA (25% dose). All images underwent full- and half-scan reconstructions based on model-based iterative reconstruction. The ECV was calculated from the CT numbers between pre- and postcontrast.ResultsThe mean ECV with full- and half-scan reconstructions at the central portion was 0.275 at 100% scan dose to 0.271 at 25% scan dose and 0.276 at 100% scan dose to 0.269 at 25% scan dose. Compared with that in the 100% scan dose, the variation in each ECV increased with decreasing radiation dose. The ECV at the center of the image along the z-axis had lower variation than that at outer portion of the images. On the reconstruction algorithm, there was no statistical difference in ECVs with full- and half-scan reconstructions.ConclusionFor stable ECV quantifications, excessive radiation dose reduction may be inappropriate, and it is better to consider the variations in ECV values depending on the slice location.
      Citation: Acta Radiologica
      PubDate: 2021-01-19T06:03:09Z
      DOI: 10.1177/0284185120986938
       
  • Standardize routine angiography assessment of leg vasculatures before
           fibular flap harvest: lessons of congenital and acquired vascular
           anomalies undetected by color Doppler and physical examinations

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      Authors: Chunyue Ma, Lei Wang, Zhuowei Tian, Xingjun Qin, Dan Zhu, Jinbao Qin, Yi Shen
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundFibular flaps have been widely used for mandibular and maxillary reconstructions. On occasion, anatomical variants of fibular arteries (FA) will be encountered.PurposeAlthough anatomical variants of FA during fibular harvest have been reported, controversy exists regarding whether simple color Doppler ultrasonography (CDU) and physical examinations (PE) are sufficient for early preoperative detection.Material and MethodsA 10-year retrospective analysis in our department was performed to find the patients with various FA anomalies confirmed by computed tomography angiography (CTA) or intraoperative findings.ResultsA total number of 19 FA anomalies were found either pre- or intraoperatively in 16 patients, in whom three cases were with bilateral FA variants. Type IIIC variants, also called arteria peronea magna (great peroneal artery), were confirmed in two legs, while the majority (13 legs) had type IIIA hypoplastic/aplastic posterior tibialis arteries (PTA). Four legs had new type IIID (low FA and PTA bifurcations). Preoperative CDU and PE only suspected anomalies in two legs. Six cases proceeded with using the affected fibulas, within whom vascular grafts were used in half of them for lengthening the FA pedicle. Local ischemia, partial soleus muscle necrosis, and claudication were reported in one.ConclusionsRoutine CTA before every fibular harvest, rather than simple PE and CDU, should be added for screening contraindications and ensuring safety for fibular flap harvest.
      Citation: Acta Radiologica
      PubDate: 2021-01-18T05:30:45Z
      DOI: 10.1177/0284185120980001
       
  • Retrosternal hematoma in sternal fracture for prediction of concomitant
           injury on chest CT

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      Authors: Ye Na Son, Jung Im Kim, Han Na Lee, So Youn Shin
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundIsolated sternal fracture, a benign injury, has been increasing in the pan-scan era, although one-third of patients with sternal fracture still has trouble with concomitant injury. The differentiation of these two entities is important to optimize patient management.PurposeTo evaluate correlation between retrosternal hematoma and concomitant injury in patients with sternal fracture and to identify predicting factors for concomitant injury in sternal fracture.Material and MethodsA total of 139 patients (84 men; mean age = 54.9 ± 15.3 years) with traumatic sternal fracture were enrolled in this study. We reviewed medical charts and multiplanar computed tomography (CT) images to evaluate cause, location, and degree of sternal fracture, retrosternal hematoma, and concomitant injury. Univariate and multivariate analysis were used to identify variables that were associated with concomitant injury.ResultsConcomitant injury on chest CT was observed in 85 patients with sternal fracture. Of the patients, 98 (70.5%) were accompanied by retrosternal hematoma. Multivariate analysis revealed that retrosternal hematoma (odds ratio [OR] = 5.350; P 
      Citation: Acta Radiologica
      PubDate: 2021-01-18T05:30:44Z
      DOI: 10.1177/0284185120981571
       
  • Variations ignored in routine wrist MRI reports: prevalence of the median
           nerve anatomical variations and persistent median artery

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      Authors: Fatih Dag, Berna Dirim Mete, Merve Gursoy, Muhsin Engin Uluc
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundIt is vital to know the anatomical variations of the wrist to avoid iatrogenic injuries during carpal tunnel (CT) surgery.PurposeTo determine the anatomical variations of the median nerve (MN) and the prevalence of persistent median artery (PMA) on wrist magnetic resonance imaging (MRI).Material and MethodsA total of 300 wrists evaluated by MRI during 2013–2015 were retrospectively identified. While branching of the MN distal to the CT is accepted as the normal anatomy, proximal to the tunnel and within the tunnel were considered as variations. The prevalence of PMA was also evaluated. The patients were assigned to groups according to age, gender, and wrist side and compared to determine whether there was any significant difference in terms of these variations. All evaluations were assessed with the shared decision of a musculoskeletal radiologist and a radiology resident.ResultsOf the 300 wrists, 38 (12.7%) and 34 (11.3%) had a bifid MN proximal to the CT and within the CT, respectively. Only one nerve trifurcation was seen within the CT. The MN exhibited branching distal to the CT in 227 (76%) patients. PMA was observed in 44 (14.7%) patients. Of the 44 PMA cases, 28 (63.6%) also had a coexisting MN variation. There was no significant difference in the prevalence of MN variations and PMA in the subgroups (P > 0.05).ConclusionNearly one in four patients (24.4%) have MN variations and 14.8% had PMA. Preoperative evaluation of these common anatomical variations with MRI will be protective against postoperative complications of CT surgery.
      Citation: Acta Radiologica
      PubDate: 2021-01-18T05:30:43Z
      DOI: 10.1177/0284185120985502
       
  • Effectiveness of epidural steroid injection in patients with lumbar
           herniated intervertebral disc under a “wait-and-see” policy

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      Authors: Bo Ram Kim, Joon Woo Lee, Eugene Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundThere are no consensus and guidelines on the optimal interval of repeat epidural steroid injections (ESI) for patients with lumbar herniated intervertebral disc (HIVD) who respond to initial ESI.PurposeTo evaluate the effectiveness of ESI in patients with HIVD under a “wait-and-see” policy, i.e. as-needed injections not on a predetermined schedule.Material and MethodsA total of 592 patients with lumbar HIVD received spine injections between January and December 2017. After excluding patients with excellent (no pain) or poor (>70% residual symptoms) response in the two- or three-week pain assessment, the data of 141 responders were analyzed (60 men, 73 women; age = 50.55±17.25 years). We divided patients into wait-and-see (n=124) and early repeat-ESI (n=17) groups, who received repeat ESIs within three weeks. Evaluations of characteristics and outcomes were performed with the chi-square test or independent Student’s t-test.ResultsSix patients (4.8%) in the wait-and-see group and 1 (5.9%) in the early repeat-ESI group underwent operation within one year (P=0.85). A mean of 1.52±0.82 ESIs was performed in the wait-and-see and a mean of 2.29±0.47 ESIs in the early repeat-ESI group over one year (P
      Citation: Acta Radiologica
      PubDate: 2021-01-13T04:41:56Z
      DOI: 10.1177/0284185120985500
       
  • Additional value of deep learning computed tomographic angiography-based
           fractional flow reserve in detecting coronary stenosis and predicting
           outcomes

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      Authors: Yang Li, Hong Qiu, Zhihui Hou, Jianfeng Zheng, Jianan Li, Youbing Yin, Runlin Gao
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundDeep learning (DL) has achieved great success in medical imaging and could be utilized for the non-invasive calculation of fractional flow reserve (FFR) from coronary computed tomographic angiography (CCTA) (CT-FFR).PurposeTo examine the ability of a DL-based CT-FFR in detecting hemodynamic changes of stenosis.Material and MethodsThis study included 73 patients (85 vessels) who were suspected of coronary artery disease (CAD) and received CCTA followed by invasive FFR measurements within 90 days. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristics curve (AUC) were compared between CT-FFR and CCTA. Thirty-nine patients who received drug therapy instead of revascularization were followed for up to 31 months. Major adverse cardiac events (MACE), unstable angina, and rehospitalization were evaluated and compared between the study groups.ResultsAt the patient level, CT-FFR achieved 90.4%, 93.6%, 88.1%, 85.3%, and 94.9% in accuracy, sensitivity, specificity, PPV, and NPV, respectively. At the vessel level, CT-FFR achieved 91.8%, 93.9%, 90.4%, 86.1%, and 95.9%, respectively. CT-FFR exceeded CCTA in these measurements at both levels. The vessel-level AUC for CT-FFR also outperformed that for CCTA (0.957 vs. 0.599, P 
      Citation: Acta Radiologica
      PubDate: 2021-01-11T04:30:28Z
      DOI: 10.1177/0284185120983977
       
  • Measuring functional connectivity in patients with strabismus using
           stationary functional magnetic resonance imaging: a resting-state network
           study

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      Authors: Kang Yu, Qi Lin, Qian-Min Ge, Chen-Yu Yu, Qiu-Yu Li, Yi-Cong Pan, Yi Shao
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundStrabismus (STR) is a common eye disease characterized by abnormal eye movements and stereo vision. Neuroimaging studies have revealed that STR patients have impaired functional connectivity (FC) in the visual cortex and sensorimotor cortex.PurposeTo investigate alterations in FC and connections within and between subnetworks of the visual network (VN), sensorimotor network (SMN), and default mode network (DMN) in patients with STR.Material and MethodsA total of 32 patients with STR (24 men, 8 women) and 32 age- and sex-matched healthy controls (HCs) (24 men, 8 women) were recruited. Participants underwent resting-state functional magnetic resonance imaging scans. The resting-state network (RSN) was examined by independent component analysis, and differences in RSN FC between STR and HC groups were evaluated with the t test. Functional network connectivity (FNC) analysis was performed for the three RSNs.ResultsCompared to the HC group, the STR group showed increased FC in the VN and SMN (voxel-level P 
      Citation: Acta Radiologica
      PubDate: 2021-01-11T04:30:28Z
      DOI: 10.1177/0284185120983978
       
  • MRI features of responsible contacts in vascular compressive trigeminal
           neuralgia and prediction modeling

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      Authors: Yufei Zhao, Jianhua Chen, Rifeng Jiang, Xue Xu, Lin Lin, Yunjing Xue, Qing Duan
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundMultiple neurovascular contacts in patients with vascular compressive trigeminal neuralgia often challenge the diagnosis of responsible contacts.PurposeTo analyze the magnetic resonance imaging (MRI) features of responsible contacts and establish a predictive model to accurately pinpoint the responsible contacts.Material and MethodsSixty-seven patients with unilateral trigeminal neuralgia were enrolled. A total of 153 definite contacts (45 responsible, 108 non-responsible) were analyzed for their MRI characteristics, including neurovascular compression (NVC) grading, distance from pons to contact (Dpons-contact), vascular origin of compressing vessels, diameter of vessel (Dvessel) and trigeminal nerve (Dtrigeminal nerve) at contact. The MRI characteristics of the responsible and non-responsible contacts were compared, and their diagnostic efficiencies were further evaluated using a receiver operating characteristic (ROC) curve. The significant MRI features were incorporated into the logistics regression analysis to build a predictive model for responsible contacts.ResultsCompared with non-responsible contacts, NVC grading and arterial compression ratio (84.44%) were significantly higher, Dpons-contact was significantly lower at responsible contacts (P 
      Citation: Acta Radiologica
      PubDate: 2021-01-08T04:47:20Z
      DOI: 10.1177/0284185120983971
       
  • Overnight radiology resident discrepancies at a large pediatric hospital:
           categorization by year of training, program, imaging modality, and report
           type

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      Authors: Mary L Dinh, Rana Yazdani, Nikhil Godiyal, Cory M Pfeifer
      Abstract: Acta Radiologica, Ahead of Print.
      BackgroundOvernight radiology resident discrepancies have been described in multiple studies; however, study of resident discrepancies specific to pediatric radiology is limited.PurposeTo examine radiology resident discrepancies as they pertain to a large pediatric hospital system.Material and MethodsA total of 21,560 preliminary reports issued by 39 residents over a one-year period were scored as agreement, minor discrepancy, or major discrepancy by faculty members using a modification of the 2009 RADPEER scoring system. Residents were trainees of three different diagnostic radiology programs: large university-based, medium-sized community-based, or small community-based. Discrepancy rates were evaluated based on resident postgraduate year, program, and imaging modality. The effect of a general pediatric radiology report versus pediatric neuroradiology report of a CT scan was also tested. CT was the only modality in which there were comparable numbers of studies scored by both general pediatric radiologists and neuroradiologists.ResultsThe rate of major resident to faculty assessment discrepancies was 1.01%, and the rate of minor resident to faculty assessment discrepancies was 4.47%. Major discrepancy rates by postgraduate years 3-5 were 1.08%, 0.75%, and 1.59%, respectively. Major discrepancy rates were highest for MR (11.22%), followed by CT (1.82%), radiographs (0.91%), and ultrasound (0.56%). There was no significant difference in discrepancy rate between residency programs and general pediatric radiology report of a CT versus pediatric neuroradiology report of a CT.ConclusionRadiology discrepancy rates for residents issuing preliminary reports at a large children’s hospital system are similar to those reported for adult procedures.
      Citation: Acta Radiologica
      PubDate: 2021-01-07T05:48:38Z
      DOI: 10.1177/0284185120981574
       
 
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