Abdominal Radiology

Muglia, Valdair Francisco; Laschena, Ludovica; Pecoraro, Martina; de Lion Gouvea, Gabriel; Colli, Leandro Machado; Panebianco, Valeria

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04412-7pmid: 39254707

Prostate cancer (PCa) relapse, defined either by persistent PSA levels (after RP) or biochemical recurrence (BCR), is a common occurrence. The imaging evaluation of patients experiencing PCa relapse has undergone significant advancements in the past decade, notably with the introduction of new Positron Emission Tomography (PET) tracers such as Prostate-specific membrane antigen (PSMA), and the progress in functional Magnetic Resonance Imaging (MRI). This article will explore the role of traditional imaging, the evolution of MRI towards the development of the Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR) scoring system, and how next-generation imaging is enhancing diagnostic accuracy in the setting of PCa relapse, which is essential for adopting personalized strategies that may ultimately impact outcomes.Graphical abstract[graphic not available: see fulltext]

Luo, Xiulan; Li, Xiaolu; Chen, Chaolin; Zheng, Hong

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04569-1pmid: 39269504

PurposeThis meta-analysis was conducted to assess the relative diagnostic effectiveness of [18F]FDG PET/CT and MRI in the initial detection of ovarian cancer.MethodsA thorough literature search was conducted using PubMed, Embase, and Web of Science databases to locate relevant studies published up to April 2024. The selected studies were those that evaluated diagnostic performance of [18F]FDG PET/CT and MRI for the initial detection of ovarian cancer. Sensitivity and specificity metrics were analyzed employing the DerSimonian and Laird random-effects model, with further transformation utilizing the Freeman-Tukey double arcsine method. The quality of included studies was appraised using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.ResultsThe meta-analysis included 23 articles encompassing a total of 1973 patients. The sensitivity of [18F]FDG PET/CT was found to be higher than that of MRI (0.94 vs. 0.87, P = 0.02). In terms of specificity, [18F]FDG PET/CT and MRI demonstrated similar values (0.87 vs. 0.86, P = 0.90). An assessment of publication bias using the funnel plot asymmetry test revealed no significant bias for any outcomes (Egger’s test: all P > 0.05).ConclusionsOur meta-analysis reveals that [18F]FDG PET/CT exhibits higher sensitivity while maintaining similar specificity compared to MRI for the initial detection of ovarian cancer. However, the substantial heterogeneity observed across studies may influence these findings. Consequently, larger-scale prospective studies are necessary to validate these results.

Li, Jing; Zhang, Hongkai; Bei, Tianxia; Wang, Yi; Ma, Fei; Wang, Shaoyu; Li, Haocheng; Qu, Jinrong

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04559-3pmid: 39254709

ObjectiveTo investigate the potential of six advanced diffusion-weighted imaging (DWI) models for preoperative prediction of lymph node metastasis (LNM) in resectable gastric cancer (GC).MethodsBetween Nov 2022 and Nov 2023, standard MRI scans were prospectively performed in consecutive patients with endoscopic pathology-confirmed gastric adenocarcinoma who were referred for direct radical gastrectomy. Six DWI models, including fractional order calculus (FROC), continuous-time random walk (CTRW), diffusion kurtosis imaging (DKI), intravoxel incoherent motion (IVIM), the mono-exponential model (MEM) and the stretched exponential model (SEM) were computed. Surgical pathologic diagnosis of LNM was the reference standard, and patients were classified into LNM-positive or LNM-negative groups accordingly. The morphological features and quantitative parameters of the DWI models in different LNM categories were analyzed and compared. Multivariable logistic regression was used to screen significant predictors. Receiver-operating characteristic curves and the area under the curve (AUC) were plotted to evaluate the performances, the Delong test was performed to compare the AUCs.ResultsIn the LNM-positive group, tumor thickness and kurtosis (DKI_K) were significantly higher, while anomalous diffusion coefficient (CTRW_D), diffusivity (DKI_D), diffusion coefficient (FROC_D), pseudodiffusion coefficient (IVIM_D*), perfusion fraction (IVIM_f), and ADC were lower compared to the LNM-negative group. Clinical tumor staging (cT) and CTRW_D were independent predictors. Their combination demonstrated a superior AUC of 0.930, significantly higher than that of individual parameters.ConclusionsTumor thickness, DKI_K, CTRW_D, DKI_D, FROC_D, IVIM_D*, IVIM_f and ADC were associated with LNM status. The combination of independent predictors of cT and CTRW_D further enhanced the performance.

Yamaguchi, Ruri; Oda, Tetsuro; Nagashima, Kengo

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04546-8pmid: 39240377

PurposeTo compare the diagnostic test accuracy (DTA) of shear wave elastography (SWE) to that of transient elastography (TE) for liver fibrosis grade assessment in nonalcoholic fatty liver disease adults.MethodsMEDLINE, The Cochrane Library, and Web of Science were searched. Inclusion criteria were primary studies examining DTA of TE, point SWE (pSWE), two-dimensional SWE (2D-SWE), or magnetic resonance elastography (MRE) with liver biopsy. Network meta-analysis was conducted using a Bayesian bivariate mixed-effects model.ResultsFor fibrosis grade 2 or higher, 15 studies with 25 observations (16 observations for TE, 1 for MRE, 4 for pSWE and 2D-SWE; 2,066 patients) were included; the pooled sensitivity and specificity were 0.79 (95% credible interval (CrI) 0.70–0.86; 95% prediction interval (PI) 0.36–0.96) and 0.73 (95% CrI 0.62–0.82; 95% PI 0.23–0.96) for TE, 0.68 (95% CrI 0.48–0.83; 95% PI 0.23–0.94) and 0.75 (95% CrI 0.53–0.88; 95% PI 0.24–0.97) for pSWE, 0.85 (95% CrI 0.70–0.93; 95% PI 0.40–0.98) and 0.72 (95% CrI 0.49–0.86; 95% PI 0.20–0.96) for 2D-SWE, respectively. The proportion of studies classified as unclear in QUADAS-2 was high, and the results were heterogeneous.Conclusion2D-SWE could be recommended as TE is for liver fibrosis assessment.The protocol of this systematic review and network meta-analysis has been registered in PROSPERO (CRD42022327249). All included primary papers have already been published and the information and data can be used freely.

Zhang, Jun; Yin, Xuemei; Wang, Kexin; Wang, Liang; Yang, Zhenghan; Zhang, Yaofeng; Wu, Pengsheng; Zhao, Chenglin

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04560-wpmid: 39225718

Al-Katib, Sayf; Dearden, Andrew; Al-Bassam, Noor; Ghannam, Jacob; Beydoun, Ali; Kolderman, Nathan; Nandalur, Reyna; Nandalur, Kiran

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04505-3pmid: 39276188

Remote work has been increasingly utilized in the profession of radiology over recent years. Setting up your individual workstation offers an opportunity to tailor it to suit your preferences without the restriction of a universal setup to accommodate multiple users. Important considerations when setting up a home workstation include selecting the optimal work location, choosing the proper desk and chair, and configuring an ideal computer monitor layout. The use of peripheral devices, such as programmable mice and hands-free dictation tools can improve efficiency and reduce repetitive strain injuries. This article also explores the use of smart home devices and programmable scripts using AutoHotKey to further streamline workflow and maximize the benefits of a remote workstation.

Ye, Rongping; Zheng, Yao; Pan, Feng; Wang, Huifang; Yan, Chuan; Li, Yueming

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04564-6pmid: 39276191

Jiang, Yang; Li, Qin; Hu, Qinqin; Fang, Yu; Yang, Huiping; Hu, Ran; Zhang, Qin; Zhao, Yirong; Fan, Longling; Yang, Hua; Zhang, Dechuan

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04540-0pmid: 39261321

PurposeTo compare the image quality of magnetic resonance cholangiopancreatography (MRCP) in the supine position and prone position under the conditions of the same equipment, the same sequence (3D Navigator Triggered Sampling Perfection with Application-Optimized Contrast Using Different Flip-angle Evolutions, 3D-NT-SPACE) and the same patient, and to explore the clinical application value of prone position in MRCP examination to suppress respiratory motion artifacts.Methods53 participants who underwent MRCP in our hospital from April 2020 to August 2022 were prospectively collected. The 3D-NT-SPACE sequence was used in these patients. The visibility of the common bile duct, common hepatic duct, main pancreatic duct, and first- and second- and third-level branches of the intrahepatic bile duct and the comfort of the participants in two positions were subjective-evaluated. The Signal-to-noise ratio (SNR) and contrast-to-noise ratio were objective-evaluated. Statistical analysis was performed using Shapiro–Wilk, Levene’s, Mann Whitney U test, Pearson chi-square test, and one-sample chi-square test.Results53 patients (51.92 years ± 2.02, 20 men) were evaluated. There were significant differences in the second- and third-level branches visibility score, the main pancreatic duct visibility score, the image quality score of the pancreaticobiliary tree, the blur and motion artifact score, the total image quality score, and SNR between the two positions (p < 0.05).ConclusionsThe overall image quality of the prone position was better than that of the supine position. The prone position is a useful complement to the supine position.

Zhou, Mi; Chen, Mengyuan; Chen, Meining; Yan, Xu; Yang, Guang; Huang, Hongyun

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04588-ypmid: 39276193

PurposeThis prospective study aimed to assess the predictive value of mono-exponential and multiple mathematical diffusion-weighted imaging (DWI) models in determining the response to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC).MethodsThe study included 103 LARC patients scheduled for preoperative chemoradiotherapy between December 2021 and June 2023 Magnetic resonance imaging (MRI) scans were performed using a 3.0-T MR scanner, encompassing sagittal, axial, and oblique coronal T2-weighted images without fat saturation, along with DWI perpendicular to the rectum’s long axis. Various DWI parameters, including apparent diffusion coefficient (ADC), stretched exponential model (SEM), continuous-time random-walk model (CTRW), and fractional-order calculus model (FROC), were measured. The pathologic complete response (pCR) rate and tumor downstaging (T-downstage) rate were determined.ResultsAfter nCRT, SEM-α, SEM-DDC, CTRW-α, CTRW-β, CTRW-D, FROC-β, and ADC values were significantly higher in the pCR group compared to the non-pCR group (all P < 0.05). SEM-DDC, CTRW-α, CTRW-D, FROC-β, FROC-µ, and ADC values were significantly higher in the T-downstage group (ypT0-1) than in the non-T-downstage group (ypT2-4) (P < 0.05). The combination of CTRW (α + β + D) exhibited the best diagnostic performance for assessing pCR after nCRT (AUC = 0.840, P < 0.001). Pre-nCRT CTRW (α + β) demonstrated a predictive AUC of 0.652 (95%CI: 0.552–0.743), 90.3% sensitivity, and 43.1% specificity for pCR. Regarding T-downstage assessment after nCRT, the combination of CTRW (α + D) yielded the best diagnostic performance (AUC = 0.877, P = 0.048).ConclusionIn LARC patients, imaging markers derived from CTRW show promise in predicting tumor response before nCRT and assessing pCR after nCRT.

Pontes Fernandez, Cicília Fraga Rocha; Oliveira, Brunna Clemente; Franco, Izabela Pires; Matteoni-Athayde, Luciana; Ferreira, Ingrid Almeida Gomes; Brandão, Alice; Chamié, Luciana Pardini

2024 Abdominal Radiology

doi: 10.1007/s00261-024-04541-zpmid: 39237820

Endometriosis impacts millions of women globally, making precise assessment essential for effective surgical planning and clinical management. Despite advances in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) for diagnosis and staging, many radiologists still overlook the evaluation of lateral pelvic anatomical structures. Understanding the lateral compartment's involvement is vital for accurate disease staging and achieving optimal surgical outcomes. This pictorial review provides a thorough examination of the lateral pelvic compartment anatomy using TVUS and MRI, complemented by surgical correlations. It offers detailed discussions on pelvic ligaments, parametrium, and adjacent structures, such as nerves, vessels, and ureters. The review provides practical guidance for identifying critical anatomical structures in imaging exams and emphasizes the importance of standardized terminology. Enhancing imaging precision and diagnostic accuracy for lateral compartment endometriosis is crucial for optimal surgical planning and improved patient outcomes.