Intra-practice Urologist-level Variation in Targeted Fusion Biopsy Outcomes.

Objective: To examine the extent to which the urologist performing biopsy contributes to variation in prostate cancer detection during fusion-guided prostate biopsy.

Methods: All men in the Michigan Urological Surgery Improvement Collaborative (MUSIC) clinical registry who underwent fusion biopsy at Michigan Medicine from August 2017 to March 2019 were included. The primary outcomes were clinically significant cancer detection rate (defined as Gleason Grade ≥2) in targeted cores and clinically significant cancer detection on targeted cores stratified by PI-RADS score.

MRI assessment of rectal cancer response to neoadjuvant therapy: a multireader study.

Objectives: A watch and wait strategy with the goal of organ preservation is an emerging treatment paradigm for rectal cancer following neoadjuvant treatment. However, the selection of appropriate patients remains a challenge. Most previous efforts to measure the accuracy of MRI in assessing rectal cancer response used a small number of radiologists and did not report variability among them.

Intra- and inter-operator variability in MRI-based manual segmentation of HCC lesions and its impact on dosimetry.

Purpose: The aim was to quantify inter- and intra-observer variability in manually delineated hepatocellular carcinoma (HCC) lesion contours and the resulting impact on radioembolization (RE) dosimetry.

Methods: Ten patients with HCC lesions treated with Y-90 RE and imaged with post-therapy Y-90 PET/CT were selected for retrospective analysis. Three radiologists contoured 20 lesions manually on baseline multiphase contrast-enhanced MRIs, and two of the radiologists re-contoured at two additional sessions.

Imaging of Metastatic Disease to the Ovary/Adnexa.

Ovarian metastases tend to arise in young women, either in patients with known cancer or as the first presentation of a previously occult extraovarian malignancy. Although imaging cannot always differentiate between secondary and primary ovarian neoplasms, and pathologic confirmation is generally required, it is important to recognize suggestive imaging features on pelvic MR imaging. Ovarian metastases are commonly described as bilateral, solid, heterogenous, and hypervascular.

A Pipeline for Automated Voxel Dosimetry: Application in Patients with Multi-SPECT/CT Imaging After Lu-Peptide Receptor Radionuclide Therapy.

Patient-specific dosimetry in radiopharmaceutical therapy (RPT) is impeded by the lack of tools that are accurate and practical for the clinic. Our aims were to construct and test an integrated voxel-level pipeline that automates key components (organ segmentation, registration, dose-rate estimation, and curve fitting) of the RPT dosimetry process and then to use it to report patient-specific dosimetry in Lu-DOTATATE therapy. An integrated workflow that automates the entire dosimetry process, except tumor segmentation, was constructed.

Gastric neuroendocrine neoplasms: a primer for radiologists.

Gastric neuroendocrine neoplasms are uncommon tumors with variable differentiation and malignant potential. Three main subtypes are recognized: type 1, related to autoimmune atrophic gastritis; type 2, associated with Zollinger-Ellison and MEN1 syndrome; and type 3, sporadic. Although endoscopy alone is often sufficient for diagnosis and management of small, indolent, multifocal type 1 tumors, imaging is essential for evaluation of larger, high-grade, and type 2 and 3 neoplasms.

Past, present, and future of abdominal radiology fellowship recruitment.

The authors provide a commentary on the current status of the Abdominal Radiology Fellowship recruitment process, which is not presently governed by a formal Match. Abdominal Radiology is the largest radiology subspecialty fellowship that remains outside of the Match. The Society of Abdominal Radiology convened a task force in 2019 to assess stakeholder viewpoints on a Match and found that the community was divided.

Ultrasound (US) LI-RADS: Outcomes of Category US-3 Observations.

The purpose of the study is to evaluate the outcomes of ultrasound (US) LI-RADS category US-3 observations detected at US performed for hepatocellular carcinoma (HCC) screening and surveillance on the basis of subsequently performed multi-phase MRI or CT or histopathology. In this retrospective analysis, 267 patients at high risk for HCC (161 men and 106 women; mean [± SD] age, 58.6 ± 12.

IgG4-related disease presenting as a solitary paratesticular fibrous pseudotumor.

Paratesticular fibrous pseudotumors (PFP) have long been described in the literature. Since the recognition of IgG4-related disease (IgG4-RD) as a distinct clinical entity, cases of PFP with similar pathological characteristics have been described. A case of IgG4-RD presenting as an isolated PFP is presented.

Cocaine nephropathy: A rare cause of abnormal nephrograms.

Cocaine use is associated with a variety of renal injuries. Although rhabdomyolysis is the most common cause of cocaine-induced nephropathy, cocaine can also cause renal vasculitis, acute interstitial nephritis, acute tubular necrosis, thrombotic microangiopathy, and renal infarction. We present a rare case of cocaine-induced nephropathy in a 30-year-old male who presented with acute kidney injury and abnormal nephrograms at contrast-enhanced computed tomography.

Multimodality imaging of pancreas-kidney transplants.

Simultaneous pancreas-kidney transplant remains a treatment option for patients with insulin-dependent diabetes mellitus type 1, aimed at restoring normoglycemia, alleviating insulin dependency, avoiding diabetic nephropathy, and thereby improving the quality of life. Imaging remains critical in the assessment of these transplant grafts. Ultrasound with Doppler remains the primary imaging modality for establishing baseline assessment of the graft as well as for evaluating vascular, parenchymal, and perigraft complications.

Ultrasound Liver Imaging Reporting and Data System (US LI-RADS): An Overview with Technical and Practical Applications.

The Ultrasound Liver Imaging Reporting and Data System (US LI-RADS), introduced in 2017 by the American College of Radiology, standardizes the technique, interpretation, and reporting of screening and surveillance ultrasounds intended to detect hepatocellular carcinoma in high-risk patients. These include patients with cirrhosis of any cause as well as subsets of patients with chronic hepatitis B viral infection. The US LI-RADS scheme is composed of an ultrasound category and a visualization score: ultrasound categories define the exam as negative, subthreshold, or positive and direct next steps in management; visualization scores denote the expected sensitivity of the exam, based on adequacy of liver visualization with ultrasound.

ACR Ultrasound Liver Reporting and Data System: Multicenter Assessment of Clinical Performance at One Year.

Purpose: The aim of this study was to evaluate the clinical performance of the ACR's Ultrasound Liver Reporting and Data System (US LI-RADS™) for detecting hepatocellular carcinoma (HCC) in patients at high risk for HCC.

Methods: In this retrospective, multicenter study, 2,050 patients at high risk for HCC (1,078 men and 972 women; mean age, 57.7 years) at five sites in the United States had undergone screening liver ultrasound from January 2017 to February 2018, and US LI-RADS observation categories and visualization scores were assigned on a clinical basis.

Multifocal Meningiomas Mimicking Dural-Based Intracranial Metastases at 18F-Fluciclovine PET/CT.

A 78-year-old man with biochemically recurrent prostate adenocarcinoma (prostate-specific antigen, 2.3 ng/mL) but without detectable disease in the chest, abdomen, or pelvis at conventional CT imaging or in the bones at Tc-MDP scintigraphy underwent F-fluciclovine (anti-1-amino-3-F-fluorocyclobutane-1-carboxylic acid) PET/CT to evaluate for occult recurrent or metastatic disease. Imaging identified intense radiotracer uptake within 3 dural-based lesions along the left cerebral convexity.

Inadvertent Injection of a Breast Implant During Lymphoscintigraphy.

A 34-year-old woman with history of bilateral saline implants, invasive ductal carcinoma of the right breast, and suspicious left breast calcifications was referred for left breast lymphoscintigraphy before bilateral mastectomy. A total of 3.2 mCi of Tc-filtered sulfur colloid was administered with 3 subdermal injections in the superior, lateral, and inferior periareolar left breast in the late afternoon preceding the day of surgery.

Association of advanced hepatic fibrosis and sonographic visualization score: a dual-center study using ACR US LI-RADS.

Purpose: To evaluate the association between imaging and clinical features and visualization scores, as specified by American College of Radiology (ACR) Ultrasound Liver Imaging Reporting and Data System (LI-RADS), on hepatocellular carcinoma (HCC) screening ultrasound examinations.

Methods: In this dual-center retrospective study, HCC screening ultrasound reports containing ultrasound elastography measurements (January to September, 2017) were reviewed. Ultrasound point shear wave elastography and 2-dimensional shear wave elastography were used to assess liver stiffness; median shear wave velocity was translated to METAVIR fibrosis scoring, per previously published data.

The utility of bone scintigraphy with SPECT/CT in the evaluation and management of frostbite injuries.

Objective:: Frostbite is a localized cold-thermal injury resulting from prolonged exposure of flesh to freezing and near freezing temperatures. The depth and extent of frostbite injuries are not easily assessed, from a clinical standpoint, at the time of injury making it challenging to plan appropriate management and treatment.

Methods:: A review of the literature of management of cold-related injuries and retrospective case review of the imaging and clinical course of frostbite injury.

Incisional Hernia Repair: What the Radiologist Needs to Know.

Objective: Incisional hernias are becoming more prevalent with increases in the obesity of the population and the complexity of abdominal surgeries. Radiologists' understanding of these hernias is limited. This article examines abdominal wall anatomy, surgical techniques, the role of imaging (current and emerging), and complications from the surgical perspective, to enhance to the role of the radiologist.

Sonographic Evaluation of Complications of Extracranial Carotid Artery Interventions.

Carotid endarterectomy and carotid artery stenting are among the most common peripheral vascular procedures performed worldwide. Sonography is the initial and often only imaging modality used in the evaluation of iatrogenic carotid arterial injuries. This pictorial essay provides an overview of the clinical and sonographic findings of complications after interventions in the extracranial carotid arteries, including dissection, fluid collections, pseudoaneurysm, thrombosis, thromboembolism, restenosis, and stent deformation.

Frostbite: Spectrum of Imaging Findings and Guidelines for Management.

Frostbite is a localized cold thermal injury that results from tissue freezing. Frostbite injuries can have a substantial effect on long-term limb function and mobility if not promptly evaluated and treated. Imaging plays a critical role in initial evaluation of frostbite injuries and in monitoring response to treatment.

SPECT/CT in the Evaluation of Frostbite.

Frostbite remains a challenging clinical scenario with multiple treatment algorithms and variable results. Currently, frostbite management often follows a conservative approach with rewarming followed by wound care and delayed amputation. We review seven patients where single-photon emission computed tomography (SPECT) fused with conventional computed tomography was used to evaluate tissue viability for earlier directed debridement and limb salvage.

Carotid stent deformation: sonographic findings and CT correlation.

Carotid artery dissection is a rare but potentially serious complication of endovascular procedures in the carotid arteries. Stent deformation or incomplete expansion may occur following endovascular repair of an iatrogenic carotid artery dissection and may mimic stent fracture. We report an unusual case of deformation of a common carotid artery open cell design stent following endovascular repair of an iatrogenic dissection, which resulted in persistent blood flow between the stent and the wall of the common carotid artery.