ACTA Radiologica (Test)

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SAGE Journals: Table of Contents Table of Contents for Acta Radiologica. List of articles from ahead of print issues.

  • PET/MR versus PET/CT for locoregional staging of oropharyngeal squamous cell cancer
    by Lennart Flygare on 5. december 2022 at 5:25

    Acta Radiologica, Ahead of Print. <br/>BackgroundThe value of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for TN staging in head and neck cancer (HNC) has been proven in numerous studies. A few studies have investigated the value of FDG-PET/magnetic resonance imaging (MRI) in the staging of HNC; the combined results indicate potential for FDG-PET/MRI, but the scientific evidence remains weak.PurposeTo compare performance of FDG-PET/CT and FDG-PET/MRI for locoregional staging in patients with oropharyngeal carcinomas.Material and MethodsTwo radiologists independently of each other retrospectively reviewed primary pre-therapeutic FDG-PET/CT and FDG-PET/MRI examinations from 40 individuals with oropharyngeal carcinomas. TN stage and primary tumor size were noted. The results were compared between observers and modalities and against TN stage set at a multidisciplinary conference.ResultsFor nodal staging, PET/MRI had slightly higher specificity and accuracy than PET/CT for the most experienced observer. Both methods demonstrated excellent sensitivity (≥ 0.97 and 1.00, respectively), as well as high negative predictive values (≥ 0.95 and 1.00, respectively). No significant differences were found for tumor staging or measurement of maximum tumor diameter. There was a weak agreement (κ = 0.35–0.49) between PET/CT and PET/MRI for T and N stages for both observers. Inter-observer agreement was higher for PET/MRI than for PET/CT, both for tumor staging (κ = 0.57 vs. 0.35) and nodal staging (κ = 0.69 vs. 0.55). The agreement between observers was comparable to the agreement between methods.ConclusionPET/MRI may be a viable alternative to PET/CT for locoregional staging (TN staging) and assessment of maximal tumor diameter in oropharyngeal squamous cell cancer.

  • The value of magnetic resonance blood oxygen level-dependent imaging in evaluating the efficacy of advanced cervical cancer combined with radiotherapy and chemotherapy
    by Liang Yin on 5. december 2022 at 3:22

    Acta Radiologica, Ahead of Print. <br/>BackgroundBlood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) is an imaging method used to analyze oxygenation status of the tumor.PurposeTo investigate the feasibility of BOLD-MRI in evaluating the efficacy of advanced cervical cancer combined with radiotherapy and chemotherapy.Material and MethodsThis prospective study included 85 patients with advanced cervical cancer who received BOLD-MRI examination before and after concurrent chemoradiotherapy from October 2020 to December 2021. To investigate the changes of baseline R2* values and △R2* values of cervical cancers before and after treatment.Results29 cases were complete response, 34 cases were partial response, and 22 cases showed progression. The baseline R2* values of the tumors were lower than that of the normal cervical muscle (P < 0.0001). After oxygen stimulation, the baseline R2* values of the tumors decreased (P = 0.012). After treatment, the baseline R2* values of the tumors increased (P = 0.007), and the dynamic △R2* values of the tumors decreased (P = 0.025). The baseline R2* value of the complete response was the highest (P = 0.000), the dynamic △R2* value of the complete response was the lowest (P = 0.017).ConclusionBOLD-MRI can evaluate the efficacy of concurrent chemoradiotherapy for advanced cervical cancer.

  • Erratum to “Feasibility of monitoring the resolution of acute pulmonary embolism with non-contrast-enhanced magnetic resonance imaging at one day, one week, one, three, and six months”
    on 3. december 2022 at 8:51

    Acta Radiologica, Ahead of Print. <br/>

  • Is acute appendicitis complicated or uncomplicated? Approaching the question via computed tomography
    by Mehmet Akçiçek on 1. december 2022 at 6:21

    Acta Radiologica, Ahead of Print. <br/>BackgroundThe distinction between complicated and uncomplicated appendicitis is very important for the selection of the treatment method.PurposeTo investigate the sensitivity and specificity of computed tomography (CT) in differentiating between complicated and uncomplicated appendicitis to demonstrate that false negativity in differentiating these cases can be reduced when CT findings are incorporated into the clinical evaluation of patients.Material and MethodsAll patients aged ≥18 years who underwent appendectomy at Malatya Training and Research Hospital in 2020 and 2021 were retrospectively screened. Of them, 283 patients were included in the study who had undergone CT before the operation. Patients with appendicitis were divided into two groups: complicated and uncomplicated, according to the results of their pathology tests. Demographic data, laboratory results, and CT images of the patients were evaluated.ResultsThe patients with complicated appendicitis had a significantly higher mean age (P<0.001). The most common CT findings in patients with complicated appendicitis were moderate or severe peri-appendiceal fat stranding (PFS) and appendix wall enhancement defect (AWD). The findings with the highest sensitivity were PFS (77.9%) and AWD (69.4%). Although abscess, phlegmon, and peri-appendiceal air had the highest specificity (100%), these findings were the ones with the lowest sensitivity. According to the scoring system was developed for the differential diagnosis, CT had a sensitivity of 83.3% and a specificity of 79.2%.ConclusionBased on the sensitivity and specificity values measured for CT according to the findings of our study, the scoring system may be useful for the differential diagnosis of complicated appendicitis.

  • Diagnostic accuracy of lower-dose cardiac CT in evaluating young infants with non-coronary complex congenital heart disease on a 64-slice multidetector CT scanner
    by Amal Abdelsattar Sakrana on 1. december 2022 at 6:19

    Acta Radiologica, Ahead of Print. <br/>BackgroundRedoable precise and non-invasive diagnostic imaging modality with the least radiation dose is essential for infants with congenital heart disease (CHD) .PurposeTo investigate the accuracy and estimate the radiation dose of our cardiac computed tomography (CCT) protocol.Material and MethodsA total of 82 infants with CHD underwent non-ECG-gated CCT without contrast timing scanning techniques and were retrospectively studied. The image quality and radiation dose were estimated. The radiation dose was compared statistically to virtual retrospective ECG-gated and prospective ECG-triggering scanning modes. The diagnostic accuracy was assessed assuming the surgical results as the diagnostic gold standard.ResultsMost exams showed a high quality with low radiation doses compared to previous studies. The mean effective dose (ED) was 0.39 ± 1.2, significantly lower than that of the virtual retrospective ECG-gated and prospective ECG-triggering scanning and lower than in previous studies. Our CCT protocol has achieved a diagnostic accuracy of 99.52% with a sensitivity of 94.83% and specificity of 99.91%.ConclusionNon-ECG-gated CCT without contrast timing techniques can detect the non-coronary cardiovascular defects of CHD in infants with an ultralow radiation dose and a high diagnostic accuracy.

  • Neurological manifestations of COVID-19: a retrospective observational study based on 1060 patients with a narrative review
    by Alberto Negro on 1. december 2022 at 6:17

    Acta Radiologica, Ahead of Print. <br/>BackgroundIn the past two decades, three coronavirus epidemics have been reported. Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome (SARS)-like coronavirus (SARS-CoV-2). In most patients, the disease is characterized by interstitial pneumonia, but features can affect other organs.PurposeTo document the radiological features of the patients and to perform a narrative review of the literature.Material and MethodsWe conducted a retrospective, single-center study on 1060 consecutive hospitalized patients with COVID-19 at our institution. According to the inclusion criteria, we selected patients to be studied in more radiological detail. All images were obtained as per standard of care protocols. We performed a statistic analysis to describe radiological features. We then presented a systematic review of the main and conventional neuroimaging findings in COVID-19.ResultsOf 1060 patients hospitalized for COVID-19 disease, 15% (159) met the eligibility criteria. Of these, 16 (10%) did not undergo radiological examinations for various reasons, while 143 (90%) were examined. Of these 143 patients, 48 (33.6%) had positive neuroimaging. We found that the most frequent pathology was acute ischemic stroke (n=16, 33.3%). Much less frequent were Guillain–Barre syndrome (n=9, 18.8%), cerebral venous thrombosis (n=7, 14.6%), encephalitis or myelitis (n=6, 12.5%), intracranial hemorrhage and posterior hemorrhagic encephalopathy syndrome (n=4, 8.3%), exacerbation of multiple sclerosis (n=4, 8.3%), and Miller–Fisher syndrome (n=2, 4.2%).ConclusionOur data are coherent with the published literature. Knowledge of these patterns will make clinicians consider COVID-19 infection when unexplained neurological findings are encountered.

  • Prognostic significance of 18F-FDG PET/CT indices in metastatic renal cell cancer and evaluation of revised IMDC risk model by including 18F-FDG PET-CT parameters
    by Rukiye Arikan on 30. november 2022 at 6:48

    Acta Radiologica, Ahead of Print. <br/>BackgroundPrognostic markers in metastatic renal cell cancer (mRCC) are still insufficient. Any prognostic model objectively determines disease burden.PurposeTo investigate the relationship between 18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters and outcomes in mRCC, and to define a revised International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model for the intermediate-risk group.Material and MethodsA retrospective study of mRCC was conducted. To investigate the prognostic significance of 18F-FDG PET/CT parameters, maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) were determined in pre-treatment images. Cutoff values were defined by ROC curve analyses and their association with outcomes was analyzed. Additionally, a TLG-adjusted IMDC model was created by stratifying intermediate-risk group patients according to TLG levels.ResultsThe study included 52 patients. The disease control rate (DCR) was 61.5% and median overall survival (OS) was 18 months (95% confidence interval=9.2–25.8). In the univariate analyses, IMDC score, MTV, and TLG were prognostic factors for Disease Control Rate (DCR), and Eastern Cooperative Oncology Group (ECOG)-Performance Status (PS), IMDC score, lactate dehydrogenase (LDH), treatment option, MTV, and TLG were prognostic factors for OS (P < 0.05 each). In the multivariate analyses, MTV was an independent prognostic factor for DCR, and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. According to the revised-IMDC model, the intermediate-favorable group showed longer OS than the intermediate-unfavorable group.ConclusionPretreatment MTV was independent prognostic factor for DCR and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. Revised-IMDC model could identify patients with a worse prognosis among the IMDC intermediate-risk group.

  • Comparing image quality of five breast tomosynthesis systems based on radiologists’ reviews of phantom data
    by Veli-Matti Sundell on 28. november 2022 at 8:04

    Acta Radiologica, Ahead of Print. <br/>BackgroundPrevious studies have shown differences in technical image quality between digital breast tomosynthesis (DBT) systems. However, quantitative image quality measurements may not necessarily fully reflect the clinical performance of DBT.PurposeTo study the subjective image quality of five DBT systems manufactured by Fujifilm, GE, Hologic, Planmed, and Siemens using phantom images.Material and MethodsA TOR MAM test object with polymethyl methacrylate plates was imaged on five DBT systems from different vendors. Three DBT acquisitions were performed at mean glandular doses of 1.0 mGy, 2.0 mGy, and 3.5 mGy while maintaining a constant phantom set-up. Eight DBT acquisitions with different test plate positions and phantom set-up thicknesses were performed at clinically applied dose levels. Additionally, three conventional two-dimensional mammogram images were acquired with different phantom thicknesses. Six radiologists ranked the systems based on the visibilities of the targets seen in the phantom images.ResultsIn the DBT acquisitions performed at comparable dose levels, one system differed significantly from all other systems in microcalcification scores. When using site-specific DBT protocols, significant differences were found between the devices for microcalcification, filament, and low-contrast targets. A strong correlation was observed between the reviewer scores and radiation doses in DBT acquisitions, whereas no such correlation was observed in the 2D acquisitions.ConclusionIn DBT acquisitions, dose level was found to be a major factor explaining image quality differences between the systems, regardless of other acquisition parameters. Most DBT systems performed equally well at similar dose levels.

  • Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies
    by Huaijie Cai on 28. november 2022 at 6:32

    Acta Radiologica, Ahead of Print. <br/>BackgroundThere are many ways to treat prostatic hyperplasia; these are currently more inclined to minimally invasive treatment. We mainly compared the differences between two treatment methods, ultrasound-guided transperineal laser ablation (US-TPLA) and prostatic artery embolization (PAE).PurposeTo evaluate the efficacy and safety of US-TPLA and PAE in the treatment of benign prostatic hyperplasia (BPH).Material and MethodsThe clinical information for 40 patients with BPH admitted to our hospital between June 2018 and January 2021 were retrospectively analyzed. The changes in International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume (PV), and the incidence of complications were compared between groups.ResultsThe IPSS (P < 0.001; P < 0.001), QoL (P < 0.001; P < 0.001), Qmax (P < 0.001; P < 0.001), PVR (P < 0.001; P < 0.001), and PV (P < 0.001; P < 0.001) at three and six months after US-TPLA and PAE improved with respect to those before surgery. There was no significant difference in IPSS (P = 0.235; P = 0.151), QoL (P = 0.527; P = 0.294), Qmax (P = 0.776; P = 0.420), PVR (P = 0.745; P = 0.607), and PV (P = 0.527; P = 0.573) between the groups at three and six months after surgery. No serious complications occurred in either group.ConclusionUS-TPLA and PAE seem to have a similar short-term efficacy. The efficacy of the two procedures is comparable, and neither is associated with serious complications. US-TPLA and PAE are both effective complementary measures for the treatment of BPH.

  • Simple changes to the reporting environment produce a large reduction in the frequency of interruptions to the reporting radiologist: an observational study
    by Carina Banziger on 28. november 2022 at 6:31

    Acta Radiologica, Ahead of Print. <br/>BackgroundInterruptions are a cause of discrepancy, errors, and potential safety incidents in radiology. The sources of radiological error are multifactorial and strategies to reduce error should include measures to reduce interruptions.PurposeTo evaluate the effect of simple changes in the reporting environment on the frequency of interruptions to the reporting radiologist of a hospital radiology department.Material and MethodsA prospective observational study was carried out. The number and type of potentially disruptive events (PDEs) to the radiologist reporting inpatient computed tomography (CT) scans were recorded during 20 separate 1-h observation periods during both pre- and post-intervention phases. The interventions were (i) relocation of the radiologist to a private, quiet room, and (ii) initial vetting of clinician enquiries via a separate duty radiologistResultsAfter the intervention there was an 82% reduction in the number of frank interruptions (PDEs that require the radiologist to abandon the reporting task) from a median 6 events per hour to 1 (95% confidence interval [CI] = 4–6; P < 0.00001). The overall number of PDEs was reduced by 56% from a median 11 events per hour to 5 (95% CI = 4.5–11: P < 0.00001).ConclusionRelocation of inpatient CT reporting to a private, quiet room, coupled with vetting of clinician enquiries via the duty radiologist, resulted in a large reduction in the frequency of interruptions, a frequently cited avoidable source of radiological error.