1,721,125 research outputs found
ESR Essentials: diagnosis of hepatocellular carcinoma—practice recommendations by ESGAR
Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and a leading cause of cancer related death worldwide. Current guidelines for the noninvasive diagnosis of HCC are provided by the European Association for the Study of the Liver (EASL), the American Association for the Study of Liver Diseases (AASLD) which endorsed the Liver Imaging Reporting and Data System (LI-RADS) algorithm, the Korean Liver Cancer Association-National Cancer Center (KLCA-NCC), and the Asian-Pacific Association for the Study of the Liver (APASL). These allow the diagnosis of HCC in high-risk patients in the presence of typical imaging features on contrast-enhanced CT, MRI, or contrast-enhanced ultrasound. Size, non-rim arterial phase hyperenhancement, non-peripheral washout, enhancing capsule, and growth are major imaging features and they should be combined for the diagnosis of HCC. This article provides concise and relevant practice recommendations aimed at general radiologist audience, summarizing the best practice and informing on the essential imaging criteria for the diagnosis of HCC, while also discussing the high-risk population criteria, imaging modalities, and imaging features according to the current guidelines
Reply to “Standardizing diffusion-weighted imaging in LI-RADS for diagnosis of hepatocellular carcinoma”
Design and implementation of a World Wide Web teaching files database on diagnostic radiology
INTRODUCTION:
The aim of this project was to demonstrate the feasibility and effectiveness of a teaching files database on diagnostic radiology accessible via the Internet and the World Wide Web. The Italian experience in developing a national database named "RadioDB" is presented.
MATERIALS AND METHODS:
"RadioDB" is sponsored by the Italian Society of Radiology (SIRM) and is based on a multicenter academic collaboration. It constitutes a collection of multimedia case record and teaching files. "RadioDB" is based on a Pentium workstation running a Structured Query Language (SQL) database and a World Wide Web server. Each case record contains at least one radiological image and a text file for case comment with key words and codes from the American College of Radiology (ACR). In most cases, a complete teaching file is also available. Peer reviewed teaching files available on this server are contributed via anonymous file transfer protocol (FTP) through the Internet from various Italian academic Departments of Radiology.
RESULTS:
Worldwide users can easily access and search "RadioDB" database through a World Wide Web query interface and retrieve on-the-fly case record and teaching files. Users can search the database by author name, description, key words, free text or ACR codes.
CONCLUSIONS:
"RadioDB" enlarges the base of current off-line educational materials offering and it allows radiologists to improve their medical education
Ultrasonic evaluation with second harmonic imaging and SonoVue in the assessment of cerebral perfusion in diabetic patients: a case-control study
The purpose was to compare
human brain tissue perfusion
in diabetic patients and healthy subjects
with second harmonic imaging
ultrasound and SonoVue to test the
hypothesis that brain tissue perfusion
differences are present in these two
groups of patients. In a prospective
case-control study, second harmonic
examinations performed in 20 patients
with type II diabetes mellitus
and in 20 matched control patients
were compared. After administration
of 2.5 ml of SonoVue, 60 time-triggered
images were recorded. Timeintensity
curves, including peak intensity
and positive gradient normalized
to the middle cerebral artery,
were calculated to quantify ultrasound
intensity in a region of interest.
The Mann-Whitney U-test was
used to reveal any differences between
healthy and diabetic subjects.
Mean peak intensity was 0.64±0.1 Au
in healthy subjects and 0.53±0.09 Au
in diabetic patients. Mean positive
gradient was 0.04±0.007 Au/s in
healthy subjects and 0.04±0.008 Au/s
in diabetic patients. Peak intensity
and positive gradient were significantly
lower in diabetic patients than
in healthy subjects (P<0.05). Ultrasound
examination with second harmonic
imaging and SonoVue administration
is able to detect clinically
silent, reduced cerebral perfusion in
type II diabetic patients. Diabetic patients
have reduced cerebral perfusion
in comparison to healthy subjects
LI-RADS v2018 category and imaging features: inter-modality agreement between contrast-enhanced CT, gadoxetate disodium-enhanced MRI, and extracellular contrast-enhanced MRI
Purpose: To perform an intra-individual comparison of LI-RADS category and imaging features in patients at high risk of hepatocellular carcinoma (HCC) on contrast-enhanced CT, gadoxetate disodium-enhanced MRI (EOB-MRI), and extracellular agent-enhanced MRI (ECA-MRI) and to analyze the diagnostic performance of each imaging modality. Method: This retrospective study included cirrhotic patients with at least one LR-3, LR-4, LR-5, LR-M or LR-TIV observation imaged with at least two imaging modalities among CT, EOB-MRI, or ECA-MRI. Two radiologists evaluated the observations using the LI-RADS v2018 diagnostic algorithm. Reference standard included pathologic confirmation and imaging criteria according to LI-RADS v2018. Imaging features were compared between different exams using the McNemar test. Inter-modality agreement was calculated by using the weighted Cohen's kappa (k) test. Results: A total of 144 observations (mean size 34.0 ± 32.4 mm) in 96 patients were included. There were no significant differences in the detection of major and ancillary imaging features between the three imaging modalities. When considering all the observations, inter-modality agreement for category assignment was substantial between CT and EOB-MRI (k 0.60; 95%CI 0.44, 0.75), moderate between CT and ECA-MRI (k 0.46; 95%CI 0.22, 0.69) and substantial between EOB-MRI and ECA-MRI (k 0.72; 95%CI 0.59, 0.85). In observations smaller than 20 mm, inter-modality agreement was fair between CT and EOB-MRI (k 0.26; 95%CI 0.05, 0.47), moderate between CT and ECA-MRI (k 0.42; 95%CI -0.02, 0.88), and substantial between EOB-MRI and ECA-MRI (k 0.65; 95%CI 0.47, 0.82). ECA-MRI demonstrated the highest sensitivity (70%) and specificity (100%) when considering LR-5 as predictor of HCC. Conclusions: Inter-modality agreement between CT, ECA-MRI, and EOB-MRI decreases in observations smaller than 20 mm. ECA-MRI has the provided higher sensitivity for the diagnosis of HCC
An exploration of radiological signs in post-intervention liver complications
: The advent and progression of radiological techniques in the past few decades have revolutionized the diagnostic and therapeutic landscape for liver diseases. These minimally invasive interventions, ranging from biopsies to complex therapeutic procedures like transjugular intrahepatic portosystemic shunt placement and transarterial embolization, offer substantial benefits for the treatment of patients with liver diseases. They provide accurate tissue diagnosis, allow real-time visualization, and render targeted treatment for hepatic lesions with enhanced precision. Despite their advantages, these procedures are not without risks, with the potential for complications that can significantly impact patient outcomes. It is imperative for radiologists to recognize the signs of these complications promptly to mitigate further health deterioration. Ultrasound, CT, and MRI are widely utilized examinations for monitoring the complications. This article presents an overarching review of the most commonly encountered hepatobiliary complications post-radiological interventions, emphasizing their imaging characteristics to improve patient post-procedure management
Going Beyond Counting First Authors in Author Co-citation Analysis
The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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