A Multicenter Study of Needle Size and Safety for Splenic Biopsy.

Background Splenic biopsy is rarely performed because of the perceived risk of hemorrhagic complications. Purpose To evaluate the safety of large bore (≥18 gauge) image-guided splenic biopsy. Materials and Methods This retrospective study included consecutive adult patients who underwent US- or CT-guided splenic biopsy between March 2001 and March 2022 at eight academic institutions in the United States.

Can incorrect artificial intelligence (AI) results impact radiologists, and if so, what can we do about it? A multi-reader pilot study of lung cancer detection with chest radiography.

Objective: To examine whether incorrect AI results impact radiologist performance, and if so, whether human factors can be optimized to reduce error.

Methods: Multi-reader design, 6 radiologists interpreted 90 identical chest radiographs (follow-up CT needed: yes/no) on four occasions (09/20-01/22). No AI result was provided for session 1.

Ventriculogallbladder Shunt: Percutaneous Transhepatic Placement of the Distal Catheter.

Background: Ventriculogallbladder (VGB) shunts are currently placed as a salvage procedure in treatment of hydrocephalus when all other options are exhausted. Although VGB shunts work well when successfully implanted, they are still rarely used because of the technical challenges with the traditional surgical technique.

Objective: To implant VGB shunts using a minimally invasive technique that is safer and less technically challenging.

Review of CT-guided trans-osseous biopsies.

Percutaneous image-guided biopsy is an invaluable technique in the management of a myriad of different conditions; however, percutaneous access to some targets remains challenging. Trans-osseous biopsy provides safe, high-yield access to many challenging lesions in the chest, abdomen, and pelvis which might otherwise require more invasive procedures, such as mediastinoscopy or surgery to establish a histological diagnosis. Additionally, trans-osseous biopsy is well tolerated and may reduce the risk of injury to intervening vital structures as compared to other percutaneous techniques.

Unusual appearance of an adrenal ganglioneuroma.

Ganglioneuromas are rare tumors that occur spontaneously or arise from a poorly differentiated neuroblastic tumor. Although they are typically described in the pediatric population, they can occur in adults. Ganglioneuromas are often discovered incidentally and their typical imaging appearance, although non-specific, is that of a well-defined solid mass.

Liver Ultrasound Elastography: Review of Techniques and Clinical Applications.

Chronic liver disease remains a substantial worldwide problem. Accurate estimation of liver fibrosis is crucial for determining the stage of the disease, assessing the patient's prognosis and predicting treatment response. Staging hepatic fibrosis has traditionally been done with liver biopsy but clinical practice has been changing, partly because liver biopsy has several disadvantages: it is invasive; it is associated with rare but serious complications; and it is prone to sampling error representing a tiny portion of the total liver volume.

CT-guided biopsy of pulmonary nodules ≤10 mm: Diagnostic yield based on nodules' lobar and segmental distribution.

Purpose: The aim of our study is to evaluate the diagnostic performance of CT-guided biopsy of lung nodules ≤10 mm based on their lobar and segmental location.

Materials And Methods: This was a retrospective study performed on 193 CT-guided percutaneous transthoracic needle biopsies of lung nodules ≤10 mm in greatest dimension, between January 1, 2013 and April 30, 2019. Biopsies were classified as either diagnostic or non-diagnostic based on final cytology and surgical pathology reports.

Abdominal wall and pelvic hernias: classic and unusual hernias and their mimics.

Abdominal and pelvic wall hernias are classically defined as a weakness or opening of the muscular wall through which abdominal or pelvic tissues protrude. The aim of this manuscript is to review the imaging findings of abdominal and pelvic wall hernias and their mimics and to discuss pearls and pitfalls for accurately diagnosing and classifying these entities.

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging-based Diagnosis of Hepatocellular Carcinoma: A Systematic Review.

The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC.

Gallbladder opacification on gadoxetate disodium-enhanced CT scan.

This study aimed to evaluate the radiologist's ability to identify excreted gadoxetate disodium within the gallbladder on CT scan. Thirty three healthy adults underwent imaging of the liver during work-up for potential liver donation. Three patients had undergone prior cholecystectomy and therefore were excluded.

Cholecystostomy Treatment in an ICU Population: Complications and Risks.

Background: Percutaneous cholecystostomy tube placement has widely been used as an alternative treatment to cholecystectomy, especially in advanced disease or critically ill patients. Reported postprocedural complication rates have varied significantly over the last decade. The goal of this study is to evaluate the safety of percutaneous cholecystostomy tube treatment in critically ill patients.

Hepatocellular carcinoma recurrence pattern following liver transplantation and a suggested surveillance algorithm.

Purpose: This study aims to evaluate the recurrence pattern of hepatocellular carcinoma (HCC) following liver transplantation.

Materials And Methods: A total of 54 patients underwent liver transplantation for HCC; 9 patients developed biopsy-proven recurrent HCC (16.6%).

Metastatic Renal Cell Carcinoma in a Hepatic Hemangioma: A Case Report and Review of the Literature.

We report the case of 55-year-old female with biopsy-proven clear cell renal cell carcinoma with a suspicious lesion found in the liver who presented for right radical nephrectomy and partial hepatectomy. Histologic evaluation of the hepatic specimen demonstrated metastatic renal cell carcinoma within a hepatic hemangioma. Herein we provide a review of the literature for this uncommon scenario.

Effect of needle gauge and lobe laterality on parenchymal liver biopsy outcome: a retrospective analysis.

Purpose: To analyze the effect of lobe selection, needle gauge, and number of passes on procedure outcomes in terms of specimen length and post-procedure complications.

Methods: In this HIPAA-compliant, IRB-approved retrospective study, the data from 771 ultrasound-guided adult parenchymal liver biopsies were analyzed. Post-procedure complications were assigned a 3-point rating scale.

Delayed splenic rupture presenting 70 days following blunt abdominal trauma.

Delayed splenic rupture following conservative management of splenic injury is an extremely rare complication. We report a case of an adult patient who presented with delayed splenic rupture necessitating splenectomy, 2 months following blunt abdominal trauma. Imaging at the initial presentation demonstrated only minimal splenic contusion and the patient was discharge following 24 hours of observation.

Gadoxetate disodium-enhanced liver MRI: gallbladder opacification patterns during hepatobiliary phase.

Objective(s): To describe the different patterns of gallbladder lumen opacification on gadoxetate disodium-enhanced liver magnetic resonance imaging (MRI).

Methods: One hundred eighty-seven MRI examinations were reviewed by two abdominal imaging radiologists who described the different patterns of gallbladder opacification, based on comparing the post-contrast to the pre-contrast images.

Results: Four patterns of gallbladder opacification were identified, all based on the anti-dependent distribution of the excreted biliary contrast inside the gallbladder lumen.

Renal biopsy: comparative yield of cranial versus caudal needle trajectory. An ex vivo analysis.

Aim: To compare the diagnostic quality of tissue cores obtained using cranial and caudal angulation of the renal biopsy needle. Comparison was made in terms of the number of glomeruli and proportion of renal cortex with medulla on pathological analysis.

Methods: A total of 40 desktop, renal biopsies were performed on 10 ex vivo porcine kidneys using two different targeting angles.

Focused peer review: the end game of peer review.

Purpose: The aim of this report is to describe the authors' experience with expanding the routine peer-review process to include misdiagnoses from all sources and the use of focused peer review (FPR) in faculty accountability and management.

Methods: A department-wide routine peer review was conducted. Each radiologist was assigned 12 cases per month.

Incidentally detected misty mesentery on CT: risk of malignancy correlates with mesenteric lymph node size.

Objective: To determine the natural history of incidentally detected misty mesentery on computed tomography (CT) and to correlate the risk of malignancy with size of mesenteric lymph nodes.

Methods: A retrospective review of all CT abdomen/pelvic examinations from January 1, 2004 through December 31, 2008 identified cases of misty mesentery. The largest mesenteric lymph node was measured, and additional areas of lymphadenopathy were identified.

Determination of cystic duct patency using hepatobiliary MRI with gadoxetate disodium: is T1 precontrast imaging necessary?

Purpose: To determine the need for precontrast T1-weighted imaging in determining cystic duct patency using hepatobiliary phase imaging with gadoxetate disodium-enhanced magnetic resonance imaging (MRI).

Materials And Methods: MRI exams using gadoxetate disodium from October 4, 2008 to April 14, 2010 were reviewed in a retrospective fashion. Two reviewers independently reviewed only the 20-minute T1-weighted delayed postcontrast images to determine the presence of excreted contrast in the gallbladder lumen.

Addenda to the radiology report: what are we trying to convey?

Purpose: The aims of this paper are to describe addenda to radiology reports and to discuss the communication gaps in radiology addenda reaching referring physicians. The authors examine impediments to compliance with an addendum policy and suggest possible solutions.

Methods: A total of 62,500 radiology reports were reviewed to analyze the occurrence of report addenda.

Pneumothorax following ultrasound-guided jugular vein puncture for central venous access in interventional radiology: 4 years of experience.

Purpose: The purpose of our study was to review the rate of pneumothorax following central venous access, using real-time ultrasound guidance.

Materials And Methods: Data related to ultrasound-guided venous puncture, for central venous access, performed between July 1, 2004 and June 30, 2008 was retrospectively and prospectively collected. Access route, needle gauge, catheter type, and diagnosis of pneumothorax on the intraprocedure spot radiographs and or the postprocedure chest radiographs, were recorded.

Alcohol sclerosis of a giant liver cyst following failed deroofings.

Percutaneous alcohol sclerotherapy for simple liver cysts is an established and safe procedure. We report alcohol ablation of a very large (5.5 liters) liver cyst that had failed laparoscopic deroofing procedures twice.