Visceral fat area and subcutaneous fat area as measures of body composition in soft tissue sarcoma.

Background And Objectives: Soft tissue sarcomas (STS) are a heterogenous group of malignancies of mesenchymal origin. Given recent data linking obesity as well as the pattern of fat distribution with cancer outcomes, we sought to investigate the association of visceral fat area (VFA) and subcutaneous fat area (SFA) with oncologic outcomes in patients with STS undergoing surgery.

Methods: We analyzed data from 88 patients with STS diagnosed from 2008 to 2022.

Extremity radiographs derived from low-dose ultra-high-resolution CT: a phantom study.

Objective: To demonstrate the potential of low-dose ultra-high-resolution CT (UHRCT) images to generate high-quality radiographic images on extremity phantoms and to estimate the radiation dose required for this.

Materials And Methods: A hand and knee phantom containing real human bones was imaged on an UHRCT scanner at full-dose, half-dose, and quarter-dose levels using a high-resolution extremity protocol. The raw data was reconstructed using both filtered back projection (FBP) and an iterative reconstruction algorithm (AIDR3D).

Scrutinizing the use of contrasted chest CTs in extremity sarcoma staging and surveillance.

Background: Since 2015, the American College of Radiology (ACR) has recommended staging for lung metastasis via chest computed tomography (CT) without contrast for extremity sarcoma staging and surveillance. The purpose of this study was to determine our institutional compliance with this recommendation.

Methods: This was a retrospective chart review of patients diagnosed with sarcoma in the extremities who received CT imaging of the chest for pulmonary staging and surveillance at our institution from 2005 to 2023.

Recurrent chondroblastoma of the acetabulum in an adult.

Chondroblastoma is a rare, benign neoplasm of chondroblast cell origin, accounting for less than 1% of primary bone tumors. It is usually diagnosed in the second decade of life with most of the cases involving the long bones such as the femur and humerus. Furthermore, over 90% of cases are in individuals under 30 years of age.

A rare case of chondroblastoma involving the distal phalanx of the ring finger.

Chondroblastoma, a rare benign bone tumor, is typically found in the epiphysis of long bones, with hand involvement being particularly uncommon. We present a case of an 11-year-old female with chondroblastoma involving the fourth distal phalanx of the hand. Imaging revealed a lytic, expansile lesion with sclerotic margins and no soft tissue component.

AI-Based Automated Lipomatous Tumor Segmentation in MR Images: Ensemble Solution to Heterogeneous Data.

Deep learning (DL) has been proposed to automate image segmentation and provide accuracy, consistency, and efficiency. Accurate segmentation of lipomatous tumors (LTs) is critical for correct tumor radiomics analysis and localization. The major challenge of this task is data heterogeneity, including tumor morphological characteristics and multicenter scanning protocols.

Sarcopenia and frailty as predictors of surgical morbidity and oncologic outcomes in retroperitoneal sarcoma.

Background: Retroperitoneal sarcomas (RPS) are rare tumors for which surgical resection is the principal treatment. There is no established model to predict perioperative risks for RPS. We evaluated the association between preoperative sarcopenia, frailty, and hypoalbuminemia with surgical and oncological outcomes.

Ankle MRI and preceding radiographs: an evaluation of physician ordering practices.

Objective: Multiple guidelines have been published for appropriate imaging in patients with ankle-related symptoms which suggest radiographs as the initial imaging examination for both acute and chronic ankle abnormalities. Few studies have evaluated adherence to these imaging guidelines. This study retrospectively evaluated the utilization of ankle MRI and preceding radiographs based on ordering provider group and MRI indication.

Surgical and oncologic outcomes following arterial resection and reconstruction for advanced solid tumors.

Background And Objectives: Although arterial involvement for advanced tumors is rare, vascular resection may be indicated to achieve complete tumor resection. Given the potential morbidity of this approach, we sought to evaluate perioperative outcomes, vascular graft patency, and survival among patients undergoing tumor excision with en bloc arterial resection and reconstruction.

Methods: From 2010 to 2020, we identified nine patients with tumors encasing or extensively abutting major arterial structures for whom en bloc arterial resection and reconstruction was performed.

Polyostotic osteoid osteoma: A case report.

Osteoid osteomas are common, benign osteoblastic tumors that can occur in any bone in the body. They are almost always solitary, with only rare reports of multiple tumors in the same patient. When multiple, they typically are found within the same bone.

Real-time three-dimensional MRI for the assessment of dynamic carpal instability.

Background: Carpal instability is defined as a condition where wrist motion and/or loading creates mechanical dysfunction, resulting in weakness, pain and decreased function. When conventional methods do not identify the instability patterns, yet clinical signs of instability exist, the diagnosis of dynamic instability is often suggested to describe carpal derangement manifested only during the wrist's active motion or stress. We addressed the question: can advanced MRI techniques provide quantitative means to evaluate dynamic carpal instability and supplement standard static MRI acquisition? Our objectives were to (i) develop a real-time, three-dimensional MRI method to image the carpal joints during their active, uninterrupted motion; and (ii) demonstrate feasibility of the method for assessing metrics relevant to dynamic carpal instability, thus overcoming limitations of standard MRI.

The medial epicondyle of the distal femur is the optimal location for MRI measurement of semitendinosus and gracilis tendon cross-sectional area.

Purpose: Graft diameter ≥ 8 mm reduces the risk of failure after anterior cruciate ligament reconstruction (ALCR) with hamstring tendon autograft. Pre-operative measurement of gracilis (GT) and semitendinosus (ST) cross-sectional area using MRI has been utilized but the optimal location for measurement is unknown. The main purpose of this study was to examine the cross-sectional areas of GT + ST at different locations and develop a model to predict whether a doubled hamstring graft of GT + ST will be of sufficient cross-sectional area for ACLR.

Radiographic Evaluation of Meniscal Extrusion.

Background Magnetic resonance imaging (MRI) is well established as the preferred noninvasive tool for meniscal evaluation. To our knowledge, there has been no study examining the utility of diagnosing meniscal extrusion from radiography alone. We hypothesize that with appropriate window settings, meniscal extrusion may be diagnosed on radiography with high sensitivity and specificity.

Retroperitoneal extramedullary hematopoietic pseudotumor in ataxia-telangiectasia.

Ataxia-telangiectasia confers a significant increase in the development of several cancer types, most commonly leukemia and lymphoma. However, as the natural history for these patients is evolving and their lifespan is increasing, there is the potential for the development of additional uncommon tumors in an already rare patient population. We report the first case, to our knowledge, of an incidental retroperitoneal tumor in a 26-year-old woman undergoing evaluation for hepatic dysfunction.

CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality.

Objective: Our objective was to determine the association between muscle cross-sectional area and attenuation, as measured on routine CT scans, and mortality in older patients with hip fracture.

Materials And Methods: A retrospective 10-year study of patients with hip fracture was conducted with the following inclusion criteria: age 65 years or older, first-time hip fracture treated with surgery, and CT of the chest, abdomen, or pelvis. This yielded 274 patients (70.

"Knuckle Cracking": Can Blinded Observers Detect Changes with Physical Examination and Sonography?

Background: Voluntary knuckle cracking is a common habit, with a reported prevalence of 25% to 45%. Habitual knuckle cracking also is a frequent source of questions for physicians, and the largest study to date reported an association with functional hand impairments.

Questions/purposes: (1) When compared with subjects who are not habitual knuckle crackers, do habitual knuckle crackers have greater QuickDASH scores, swelling, weakness, joint laxity, or ROM? (2) In subjects who crack their knuckles, does cracking immediately increase ROM? (3) What are the characteristic sonographic findings in joints that crack?

Methods: A prospective, institutional review board-approved study was performed on 400 metacarpophalangeal joints (MPJs) in 40 asymptomatic adult subjects.

Influence of IV Contrast Administration on CT Measures of Muscle and Bone Attenuation: Implications for Sarcopenia and Osteoporosis Evaluation.

Objective: The objective of our study was to characterize enhancement of muscle and bone that occurs on standardized four-phase contrast-enhanced CT.

Materials And Methods: Two musculoskeletal radiologists reviewed standardized four-phase abdominal CT scans obtained with IV contrast material. The psoas area was measured, and the mean attenuation (in Hounsfield units) was recorded for the aorta, psoas muscles, posterior paraspinal muscles, and L4 vertebral body.

Delayed phlegmon with gallstone fragments masquerading as soft tissue sarcoma.

Complications from lost gallstones after cholecystectomy are rare but varied from simple perihepatic abscess to empyema and expectoration of gallstones. Gallstone complications have been reported in nearly every organ system, although reports of malignant masquerade of retained gallstones are few. We present the case of an 87-year-old woman with a flank soft tissue tumor 4 years after laparoscopic cholecystectomy.

The Notch of Harty (Pseudodefect of the Tibial Plafond): Frequency and Characteristic Findings at MRI of the Ankle.

Objective: The purpose of this study is to report the frequency and characteristic findings of the notch of Harty as seen on MRI.

Materials And Methods: One hundred six consecutive ankle MRI studies performed at 1.5 or 3 T were reviewed retrospectively by two radiologists.

MR Imaging of the Lumbosacral Plexus: A Review of Techniques and Pathologies.

The lumbosacral plexus is a complex anatomic area that serves as the conduit of innervation and sensory information to and from the lower extremities. It is formed by the ventral rami of the lumbar and sacral spine which then combine into larger nerves serving the pelvis and lower extremities. It can be a source of severe disability and morbidity for patients when afflicted with pathology.

Venous tumor thrombus from a pelvic osteosarcoma.

We present a case of pelvic osteosarcoma in an 18-year-old woman with a tumor thrombus in the left iliac vein, extending to the inferior vena cava. Tumor thrombus has been rarely described with osteosarcoma, with only 14 cases in the literature.

Pediatric radiology fellows' experience with intussusception reduction.

Background: Intussusception reduction allows young children to avoid surgery. However, graduating residents have had relatively little training in intussusception reduction and, for the most part, consider themselves ill-prepared to perform this procedure.

Objective: The goal of this study was to assess the extent of training in intussusception reduction during one year of a pediatric radiology fellowship and to determine whether graduating fellows consider themselves adequately trained in this technique.

Radiology residents' experience with intussusception reduction.

Background: Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure.

Objective: We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution.