Life | Special Issue : Feature Studies in Diagnostic Radiology

Research

11 pages, 703 KiB

Open AccessArticle

One-Day Interruption of NOAC Is Associated with Low Risk of Periprocedural Adverse Events during Pulmonary Vein Isolation If Combined with Left Atrial Thrombus Exclusion with Computed Tomography

by Katalin Piros, Adorján Vida, Nándor Szegedi, Péter Perge, Zoltán Salló, Arnold Béla Ferencz, Vivien Klaudia Nagy, Szilvia Herczeg, Pál Ábrahám, Csaba Csobay-Novák, Zsófia Drobni, Tamás Tahin, Györgyi Apponyi, Béla Merkely, László Gellér and István Osztheimer

Life 2024, 14(1), 133; https://doi.org/10.3390/life14010133 - 17 Jan 2024

Viewed by 705

Abstract

Background: Safety, efficacy, and patient comfort are the expectations during pulmonary vein isolation (PVI). We aimed to validate the combined advantages of pre- and periprocedural anticoagulation with non-vitamin K anticoagulants (NOACs) and rigorous left atrial appendage thrombus (LAAT) exclusion with computed tomography (CT). [...] Read more.

Background: Safety, efficacy, and patient comfort are the expectations during pulmonary vein isolation (PVI). We aimed to validate the combined advantages of pre- and periprocedural anticoagulation with non-vitamin K anticoagulants (NOACs) and rigorous left atrial appendage thrombus (LAAT) exclusion with computed tomography (CT). Methods: This study included a population of consecutive patients, between March 2018 and June 2020, who underwent cardiac CT within 24 h before PVI to guide the ablation and rule out LAAT. NOAC was omitted 24 h before the ablation. Results: A total of 187 patients (63% male) underwent CT before PVI. None of the patients experienced stroke during or after the procedure. The complication rate was low, with no thromboembolic events and 2.1% of patients experiencing a major bleeding event. Conclusions: Omitting NOAC 24 h before the ablation might be safe if combined with left atrial thrombus exclusion with computed tomography. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

14 pages, 3525 KiB

Open AccessArticle

Bilateral Carotid Artery Molecular Calcification Assessed by [¹⁸F] Fluoride PET/CT: Correlation with Cardiovascular and Thromboembolic Risk Factors

by Shiv Patil, Eric M. Teichner, Robert C. Subtirelu, Chitra Parikh, Omar Al-Daoud, Miraziz Ismoilov, Thomas Werner, Poul Flemming Høilund-Carlsen and Abass Alavi

Life 2023, 13(10), 2070; https://doi.org/10.3390/life13102070 - 17 Oct 2023

Cited by 1 | Viewed by 1125

Abstract

Atherosclerosis, a leading cause of mortality and morbidity worldwide, involves inflammatory processes that result in plaque formation and calcification. The early detection of the molecular changes underlying these processes is crucial for effective disease management. This study utilized positron emission tomography/computed tomography (PET/CT) [...] Read more.

Atherosclerosis, a leading cause of mortality and morbidity worldwide, involves inflammatory processes that result in plaque formation and calcification. The early detection of the molecular changes underlying these processes is crucial for effective disease management. This study utilized positron emission tomography/computed tomography (PET/CT) with [¹⁸F] sodium fluoride (NaF) as a tracer to visualize active calcification and inflammation at the molecular level. Our aim was to investigate the association between cardiovascular risk factors and [¹⁸F] NaF uptake in the left and right common carotid arteries (LCC and RCC). A cohort of 102 subjects, comprising both at-risk individuals and healthy controls, underwent [¹⁸F] NaF PET/CT imaging. The results revealed significant correlations between [¹⁸F] NaF uptake and cardiovascular risk factors such as age (β = 0.005, 95% CI 0.003–0.008, p < 0.01 in LCC and β = 0.006, 95% CI 0.004–0.009, p < 0.01 in RCC), male gender (β = −0.08, 95% CI −0.173–−0.002, p = 0.04 in LCC and β = −0.13, 95% CI −0.21–−0.06, p < 0.01 in RCC), BMI (β = 0.02, 95% CI 0.01–0.03, p < 0.01 in LCC and β = 0.02, 95% CI 0.01–0.03, p < 0.01 in RCC), fibrinogen (β = 0.006, 95% CI 0.0009–0.01, p = 0.02 in LCC and β = 0.005, 95% CI 0.001–0.01, p = 0.01), HDL cholesterol (β = 0.13, 95% CI 0.04–0.21, p < 0.01 in RCC only), and CRP (β = −0.01, 95% CI −0.02–0.001, p = 0.03 in RCC only). Subjects at risk showed a higher [¹⁸F] NaF uptake compared to healthy controls (one-way ANOVA; p = 0.02 in LCC and p = 0.04 in RCC), and uptake increased with estimated cardiovascular risk (one-way ANOVA, p < 0.01 in LCC only). These findings underscore the potential of [¹⁸F] NaF PET/CT as a sensitive tool for the early detection of atherosclerotic plaque, assessment of cardiovascular risk, and monitoring of disease progression. Further research is needed to validate the technique’s predictive value and its potential impact on clinical outcomes. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

13 pages, 876 KiB

Open AccessArticle

Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Parameters Could Predict International Society of Urological Pathology Risk Groups of Prostate Cancers on Radical Prostatectomy

by Chun-Bi Chang, Yu-Chun Lin, Yon-Cheong Wong, Shin-Nan Lin, Chien-Yuan Lin, Yu-Han Lin, Ting-Wen Sheng, Lan-Yan Yang and Li-Jen Wang

Life 2023, 13(9), 1944; https://doi.org/10.3390/life13091944 - 21 Sep 2023

Viewed by 788

Abstract

Background: The International Society of Urological Pathology (ISUP) grade and positive surgical margins (PSMs) after radical prostatectomy (RP) may reflect the prognosis of prostate cancer (PCa) patients. This study aimed to investigate whether DCE-MRI parameters (i.e., K^trans, k_ep, and [...] Read more.

Background: The International Society of Urological Pathology (ISUP) grade and positive surgical margins (PSMs) after radical prostatectomy (RP) may reflect the prognosis of prostate cancer (PCa) patients. This study aimed to investigate whether DCE-MRI parameters (i.e., K^trans, k_ep, and IAUC) could predict ISUP grade and PSMs after RP. Method: Forty-five PCa patients underwent preoperative DCE-MRI. The clinical characteristics and DCE-MRI parameters of the 45 patients were compared between the low- and high-risk (i.e., ISUP grades III-V) groups and between patients with or without PSMs after RP. Multivariate logistic regression analysis was used to identify the significant predictors of placement in the high-risk group and PSMs. Results: The DCE parameter K^trans-max was significantly higher in the high-risk group than in the low-risk group (p = 0.028) and was also a significant predictor of placement in the high-risk group (odds ratio [OR] = 1.032, 95% confidence interval [CI] = 1.005–1.060, p = 0.021). Patients with PSMs had significantly higher prostate-specific antigen (PSA) titers, positive biopsy core percentages, K^trans-max, k_ep-median, and k_ep-max than others (all p < 0.05). Of these, positive biopsy core percentage (OR = 1.035, 95% CI = 1.003–1.068, p = 0.032) and k_ep-ma_x (OR = 1.078, 95% CI = 1.012–1.148, p = 0.020) were significant predictors of PSMs. Conclusion: Preoperative DCE-MRI parameters, specifically K^trans-max and k_ep-max, could potentially serve as preoperative imaging biomarkers for postoperative PCa prognosis based on their predictability of PCa risk group and PSM on RP, respectively. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

18 pages, 1250 KiB

Open AccessArticle

Comparison of 116 Radiosurgery Treatment Plans for Multi-Leaf and Cone Collimator on a Varian Edge Linac: Are Cones Superior in the Daily Routine?

by Adlan Čehobašić, Josip Paladino, Hrvoje Kaučić, Ana Mišir-Krpan, Vanda Leipold, Mihaela Mlinarić, Domagoj Kosmina, Andreas Mack, Dragan Schwarz, Sunčana Divošević and Ivana Alerić

Life 2023, 13(4), 1020; https://doi.org/10.3390/life13041020 - 15 Apr 2023

Viewed by 1197

Abstract

Delivering focused radiation doses via linear accelerators is a crucial component of stereotactic radiosurgery (SRS) for brain metastases. The Varian Edge linear accelerator provides highly conformal radiation therapy through a high-definition multi-leaf collimator (HD120 MLC) and conical collimator (CC). HD120 MLC adapts to [...] Read more.

Delivering focused radiation doses via linear accelerators is a crucial component of stereotactic radiosurgery (SRS) for brain metastases. The Varian Edge linear accelerator provides highly conformal radiation therapy through a high-definition multi-leaf collimator (HD120 MLC) and conical collimator (CC). HD120 MLC adapts to the shape of the target volume using movable tungsten leaves, while CC has a block of conical shape (cones). CC in SRS treatments of small brain metastases is preferred due to its mechanical stability and steeper dose fall-off, potentially sparing organs at risk (OARs) and the brain better than HD120 MLC. This study aims to determine if CC offers significant advantages over HD120 MLC for SRS treatments. For 116 metastatic lesions, CC and HD120 MLC treatment plans were created in Varian Eclipse TPS and compared based on various dose parameters, robustness tests, and QA measurements. The results indicate that CC provides no significant advantages over HD120 MLC, except for slight, clinically insignificant benefits in brain sparing and dose fall-off for the smallest lesions. HD120 MLC outperforms CC in almost every aspect, making it a better choice for irradiating brain metastases with 0.1 cm³ or higher volumes. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

17 pages, 3288 KiB

Open AccessArticle

Predicting the Efficacy of SBRT for Lung Cancer with ¹⁸F-FDG PET/CT Radiogenomics

by Kuifei Chen, Liqiao Hou, Meng Chen, Shuling Li, Yangyang Shi, William Y. Raynor and Haihua Yang

Life 2023, 13(4), 884; https://doi.org/10.3390/life13040884 - 27 Mar 2023

Viewed by 1494

Abstract

Purpose: to develop a radiogenomic model on the basis of ¹⁸F-FDG PET/CT radiomics and clinical-parameter EGFR for predicting PFS stratification in lung-cancer patients after SBRT treatment. Methods: A total of 123 patients with lung cancer who had undergone ¹⁸F-FDG PET/CT examination [...] Read more.

Purpose: to develop a radiogenomic model on the basis of ¹⁸F-FDG PET/CT radiomics and clinical-parameter EGFR for predicting PFS stratification in lung-cancer patients after SBRT treatment. Methods: A total of 123 patients with lung cancer who had undergone ¹⁸F-FDG PET/CT examination before SBRT from September 2014 to December 2021 were retrospectively analyzed. All patients’ PET/CT images were manually segmented, and the radiomic features were extracted. LASSO regression was used to select radiomic features. Logistic regression analysis was used to screen clinical features to establish the clinical EGFR model, and a radiogenomic model was constructed by combining radiomics and clinical EGFR. We used the receiver operating characteristic curve and calibration curve to assess the efficacy of the models. The decision curve and influence curve analysis were used to evaluate the clinical value of the models. The bootstrap method was used to validate the radiogenomic model, and the mean AUC was calculated to assess the model. Results: A total of 2042 radiomics features were extracted. Five radiomic features were related to the PFS stratification of lung-cancer patients with SBRT. T-stage and overall stages (TNM) were independent factors for predicting PFS stratification. AUCs under the ROC curve of the radiomics, clinical EGFR, and radiogenomic models were 0.84, 0.67, and 0.86, respectively. The calibration curve shows that the predicted value of the radiogenomic model was in good agreement with the actual value. The decision and influence curve showed that the model had high clinical application values. After Bootstrap validation, the mean AUC of the radiogenomic model was 0.850(95%CI 0.849–0.851). Conclusions: The radiogenomic model based on ¹⁸F-FDG PET/CT radiomics and clinical EGFR has good application value in predicting the PFS stratification of lung-cancer patients after SBRT treatment. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

15 pages, 2521 KiB

Open AccessArticle

Relationship of FDG Uptake of the Reticuloendothelial System with Tumor Immune Microenvironment and Prognosis in Patients with Gastric Cancer

by Hyein Ahn, Geum Jong Song, Moon-Soo Lee, Ji-Hye Lee, Si-Hyong Jang, Mee-Hye Oh, Jong Hyuk Yun, Sang Mi Lee and Jeong Won Lee

Life 2023, 13(3), 771; https://doi.org/10.3390/life13030771 - 13 Mar 2023

Cited by 2 | Viewed by 1661

Abstract

2-deoxy-2-[¹⁸F]fluoro-D-glucose (FDG) uptake of the reticuloendothelial system, including the bone marrow (BM) and spleen, on positron emission tomography/computed tomography (PET/CT) has been shown to be a significant prognostic factor in diverse malignancies. However, the relationship between FDG uptake of the BM [...] Read more.

2-deoxy-2-[¹⁸F]fluoro-D-glucose (FDG) uptake of the reticuloendothelial system, including the bone marrow (BM) and spleen, on positron emission tomography/computed tomography (PET/CT) has been shown to be a significant prognostic factor in diverse malignancies. However, the relationship between FDG uptake of the BM and spleen and histopathological findings, including the tumor immune microenvironment, has not been fully evaluated. This study aimed to investigate the relationship of FDG uptake in the BM and spleen with histopathological findings and recurrence-free survival (RFS) in patients with gastric cancer. Seventy patients with gastric cancer who underwent pre-operative FDG PET/CT and subsequent curative surgery were retrospectively enrolled. On image analysis, the BM-to-liver uptake ratio (BLR) and spleen-to-liver uptake ratio (SLR) were measured from PET/CT images, and on immunohistochemical analysis, the densities of immune cell infiltration in the tumor tissue were graded. The BLR and SLR showed significant positive correlations with the grades of CD163 cell and CD8 cell infiltration in the tumor tissue, respectively (p < 0.05). In multivariate survival analysis, both BLR and SLR were significant predictors of RFS (p < 0.05). FDG uptake in the BM and spleen might be potential imaging biomarkers for evaluating tumor immune microenvironment conditions and predicting RFS in patients with gastric cancer. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

11 pages, 1138 KiB

Open AccessArticle

Efficacy and Failure Patterns of Early SBRT to the Primary Tumor in Advanced EGFR-Mutation-Positive Lung Cancer with EFGR-TKI Treatment: A Prospective, Single Arm, Phase II Study

by Yangyang Shi, Hailing Xu, William Y. Raynor, Jiapei Ding, Ling Lin, Chao Zhou, Wei Wang, Yinnan Meng, Xiaomai Wu, Xiaofeng Chen, Dongqing Lv and Haihua Yang

Life 2022, 12(12), 1954; https://doi.org/10.3390/life12121954 - 22 Nov 2022

Cited by 2 | Viewed by 1402

Abstract

Early stereotactic body radiation therapy (SBRT) to the primary tumor combined with epidermal growth factor receptor tyrosine kinase inhibitor (EFGR-TKI) treatment may increase progression-free survival (PFS) by delaying resistance in patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC). In this prospective, single [...] Read more.

Early stereotactic body radiation therapy (SBRT) to the primary tumor combined with epidermal growth factor receptor tyrosine kinase inhibitor (EFGR-TKI) treatment may increase progression-free survival (PFS) by delaying resistance in patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC). In this prospective, single arm, phase II study, patients with advanced NSCLC were treated with EGFR-TKI (icotinib 125 mg tid or gefitinib 250 mg qd) for one month followed by SBRT (40–60 Gy/5–8 F/5–10 d) to the primary tumor with concurrent EGFR-TKI until disease progression. The primary endpoint was PFS and the patterns of failure. Overall survival (OS) and adverse effects (AEs) were secondary endpoints. Overall, 41 advanced NSCLC patients with EGFR mutations received treatment with 24.42 months of median follow-up time. On average, SBRT was initiated 1.49 months after EGFR-TKI administration. Tumors were found to have an average shrinkage rate of 42.50%. Median PFS was 15.23 months (95% CI 13.10–17.36), while median OS was 27.57 months (95% CI 23.05–32.09). Thirty-three patients were found to have disease progression, of which new site failure (NF) (22 patients, 66.66%) was the most common pattern, followed by original site failure (OF) (7 patients, 21.21%) and simultaneous OF/NF (ONF) (4 patients, 12.12%). There were no Aes equal to or greater than grade 3, with the most frequent AE being radiation pneumonitis. Therefore, administering therapy targeted at the primary tumor using early SBRT after EGFR-TKI initiation is a new potentially safe and effective approach to treat EGFR-mutant advanced NSCLC. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

Review

Jump to: Research, Other

13 pages, 1227 KiB

Open AccessReview

A Global Review of the Impacts of the Coronavirus (COVID-19) Pandemic on Radiology Practice, Finances, and Operations

by Kishan Patel, Arnav Rashid, Luke Spear and Ali Gholamrezanezhad

Life 2023, 13(4), 962; https://doi.org/10.3390/life13040962 - 06 Apr 2023

Cited by 1 | Viewed by 1405

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic ushered in rapid changes in healthcare, including radiology, globally. This review discusses the impact of the pandemic on various radiology departments globally. We analyze the implications of the COVID-19 pandemic on the imaging volumes, finances, and clinical [...] Read more.

The Coronavirus Disease 2019 (COVID-19) pandemic ushered in rapid changes in healthcare, including radiology, globally. This review discusses the impact of the pandemic on various radiology departments globally. We analyze the implications of the COVID-19 pandemic on the imaging volumes, finances, and clinical operations of radiology departments in 2020. Studies from health systems and outpatient imaging centers were analyzed, and the activity throughout 2020 was compared to the pre-pandemic activity, including activity during similar timeframes in 2019. Imaging volumes across modalities, including MRI and CT scans, were compared, as were the Relative Value Units (RVUs) for imaging finances. Furthermore, we compared clinical operations, including staffing and sanitation procedures. We found that imaging volumes in private practices and academic centers decreased globally. The decreases in volume could be attributed to delayed patient screenings, as well as the implementation of protocols, such as the deep cleaning of equipment between patients. Revenues from imaging also decreased globally, with many institutions noting a substantial decline in RVUs and revenue compared with pre-COVID-19 levels. Our analysis thus found significant changes in the volumes, finances, and operations of radiology departments due to the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

Other

Jump to: Research, Review

11 pages, 5444 KiB

Open AccessBrief Report

Aging and Cerebral Glucose Metabolism: ¹⁸F-FDG-PET/CT Reveals Distinct Global and Regional Metabolic Changes in Healthy Patients

by Robert Christopher Subtirelu, Eric Michael Teichner, Yvonne Su, Omar Al-Daoud, Milan Patel, Shiv Patil, Milo Writer, Thomas Werner, Mona-Elisabeth Revheim, Poul Flemming Høilund-Carlsen and Abass Alavi

Life 2023, 13(10), 2044; https://doi.org/10.3390/life13102044 - 12 Oct 2023

Cited by 2 | Viewed by 1290

Abstract

Alterations in cerebral glucose metabolism can be indicative of both normal and pathological aging processes. In this retrospective study, we evaluated global and regional neurological glucose metabolism in 73 healthy individuals (mean age: 35.8 ± 13.1 years; 82.5% female) using 18F-Fluorodeoxyglucose (FDG) positron [...] Read more.

Alterations in cerebral glucose metabolism can be indicative of both normal and pathological aging processes. In this retrospective study, we evaluated global and regional neurological glucose metabolism in 73 healthy individuals (mean age: 35.8 ± 13.1 years; 82.5% female) using 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). This population exhibited a low prevalence of comorbidities associated with cerebrovascular risk factors. We utilized ¹⁸F-FDG-PET/CT imaging and quantitative regional analysis to assess cerebral glucose metabolism. A statistically significant negative correlation was found between age and the global standardized uptake value mean (SUVmean) of FDG uptake (p = 0.000795), indicating a decrease in whole-brain glucose metabolism with aging. Furthermore, region-specific analysis identified significant correlations in four cerebral regions, with positive correlations in the basis pontis, cerebellar hemisphere, and cerebellum and a negative correlation in the lateral orbital gyrus. These results were further confirmed via linear regression analysis. Our findings reveal a nuanced understanding of how aging affects glucose metabolism in the brain, providing insight into normal neurology. The study underscores the utility of ¹⁸F-FDG-PET/CT as a sensitive tool in monitoring these metabolic changes, highlighting its potential for the early detection of neurological diseases and disorders related to aging. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

12 pages, 1597 KiB

Open AccessSystematic Review

Role of Exendin-4 Functional Imaging in Diagnosis of Insulinoma: A Systematic Review

by Marko Magdi Abdou Sidrak, Maria Silvia De Feo, Ferdinando Corica, Joana Gorica, Miriam Conte, Luca Filippi, Laura Evangelista, Giuseppe De Vincentis and Viviana Frantellizzi

Life 2023, 13(4), 989; https://doi.org/10.3390/life13040989 - 11 Apr 2023

Viewed by 1787

Abstract

Background: Insulinomas are the most common neuroendocrine neoplasms of the pancreas. Diagnosis is made through patient clinical presentation with hypoglycemia symptoms and imaging, such as EUS, CT, MRI, and functional imaging. Exendin-4 PET/CT (and SPECT/CT) is a new prominent radiotracer developed to image [...] Read more.

Background: Insulinomas are the most common neuroendocrine neoplasms of the pancreas. Diagnosis is made through patient clinical presentation with hypoglycemia symptoms and imaging, such as EUS, CT, MRI, and functional imaging. Exendin-4 PET/CT (and SPECT/CT) is a new prominent radiotracer developed to image insulinomas. The aim of the study is to evaluate whether exendin-4 imaging is a useful tool in imaging for insulinoma patients when other imaging methods do not reach them. Methods: MEDLINE research conducted on PubMed, Scopus, and Web of Science gathered a total of 501 papers. Studies that evaluated exendin-4 SPECT and PET in insulinoma patients were screened and assessed through QUADAS-2 for risk of bias and applicability concerns’ assessment. Sensitivity, specificity, and accuracy were reported when available. Results: A total of 13 studies were deemed eligible for a QUADAS 2 review. Studies included ranged from 2009 to 2022. The most-used tracer was ⁶⁸Ga-DOTA-exendin-4 in PET and ¹¹¹In-DTPA-exendin-4 in SPECT. Exendin-4 labeled with ⁹⁹mTc was also reported. The QUADAS-2 risk of bias assessment was overall low, with some unclear reports in the reference and index domains. Only two domains were at high risk of bias because of an explicated non-blind imaging review. Applicability concerns for bias were low in all domains. Reported sensitivities ranged from 95% to 100% and specificities from 20% to 100%. Conclusions: exendin-4 imaging is a sensitive functional imaging tracer in both SPECT and PET applications, especially in suspicion of benign insulinomas located where endoscopic ultrasound cannot reach, being more sensitive than morfostructural imaging. Full article

(This article belongs to the Special Issue Feature Studies in Diagnostic Radiology)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Feature Studies in Diagnostic Radiology

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Published Papers (10 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI