Image-guided percutaneous mesenteric biopsy: diagnostic yield and safety profile.

Purpose: To evaluate the diagnostic yield and safety profile of percutaneous image-guided biopsy of mesenteric lesions.

Materials, Methods, And Procedures: Image-guided percutaneous biopsies of the mesentery at a single institution from 2000 to 2022 were identified and reviewed. Relevant demographic and procedural data were abstracted from the medical record.

Noninvasive Quantitative CT for Diffuse Liver Diseases: Steatosis, Iron Overload, and Fibrosis.

Chronic diffuse liver disease continues to increase in prevalence and represents a global health concern. Noninvasive detection and quantification of hepatic steatosis, iron overload, and fibrosis are critical, especially given the many relative disadvantages and potential risks of invasive liver biopsy. Although MRI techniques have emerged as the preferred reference standard for quantification of liver fat, iron, and fibrosis, CT can play an important role in opportunistic detection of unsuspected disease and is performed at much higher volumes.

Percutaneous image-guided mesenteric biopsy: how we do it in a high-volume training center.

Lesions in the mesentery are unique from other potential biopsy targets in the abdomen or pelvis for several reasons. Mesenteric lesions are among the deepest in the abdomen and are often surrounded by or adjacent to small bowel or colon. Mesenteric vasculature is often crowded, and traversing the mesentery often involves crossing multiple vascular planes.

Spectrum of Heterotopic and Ectopic Splenic Conditions.

A spectrum of heterotopic and ectopic splenic conditions may be encountered in clinical practice as incidental asymptomatic detection or symptomatic diagnosis. The radiologist needs to be aware of these conditions and their imaging characteristics to provide a prompt correct diagnosis and avoid misdiagnosis as neoplasm or lymphadenopathy. Having a strong knowledge base of the embryologic development of the spleen improves understanding of the pathophysiologic basis of these conditions.

Fully Automated and Explainable Measurement of Liver Surface Nodularity in CT: Utility for Staging Hepatic Fibrosis.

Rationale And Objectives: In the United States, cirrhosis was the 12th leading cause of death in 2016. Despite end-stage cirrhosis being irreversible, earlier stages of hepatic fibrosis can be reversed via early diagnosis and intervention. The objective is to investigate the utility of a fully automated technique to measure liver surface nodularity (LSN) for staging hepatic fibrosis (stages F0-F4).

Spatial Resolution Fidelity Comparison Between Energy Integrating and Deep Silicon Photon Counting CT: Implications for Pulmonary Imaging.

Purpose: We investigated spatial resolution loss away from isocenter for a prototype deep silicon photon-counting detector (PCD) CT scanner and compare with a clinical energy-integrating detector (EID) CT scanner.

Materials And Methods: We performed three scans on a wire phantom at four positions (isocenter, 6.7, 11.

Percutaneous Microwave Ablation for Treatment of Retroperitoneal Tumors.

Purpose To determine if microwave ablation (MWA) of retroperitoneal tumors can safely provide high rates of local tumor control. Materials and Methods This retrospective study included 19 patients (median age, 65 years [range = 46-78 years]; 13 [68.4%] men and six [31.

Metabolic syndrome: imaging features and clinical outcomes.

Metabolic syndrome, which affects around a quarter of adults worldwide, is a group of metabolic abnormalities characterized mainly by insulin resistance and central adiposity. It is strongly correlated with cardiovascular and all-cause mortality. Early identification of the changes induced by metabolic syndrome in target organs and timely intervention (eg, weight reduction) can decrease morbidity and mortality.

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.

Comparison of MiraLAX and magnesium citrate for bowel preparation at CT colonography.

Purpose: To compare MiraLAX, a hypo-osmotic lavage, and magnesium citrate (MgC), a hyper-osmotic agent for bowel preparation at CTC.

Methods: 398 total screening CTC studies were included in this retrospective, single institution study. 297 underwent preparation with a double-dose MgC regimen (mean age, 61 ± 5.

A Comparison of Histotripsy and Percutaneous Cryoablation in a Chronic Healthy Swine Kidney Model.

Purpose: To compare the safety and efficacy of histotripsy with cryoablation in a chronic human-scale normal porcine kidney model.

Materials And Methods: Eighteen female domestic swine were divided evenly into histotripsy and cryoablation treatment arms. A planned 2-3 cm diameter treatment was performed under ultrasound (histotripsy) or ultrasound and computed tomography (CT) guidance (cryoablation).

Malignant Neoplasms of the Penis with Radiologic and Pathologic Correlation.

Penile malignancy is the third most common male-specific genitourinary malignancy, with squamous cell carcinoma representing the most common histologic type. Squamous cell carcinoma is an epithelial malignancy, frequently developing from the mucosal surfaces of the foreskin, glans, and coronal sulcus and manifesting as a distal infiltrative or ulcerated mass. This typically occurs in men from the 6th to 8th decades of life, and risk factors include human papillomavirus, phimosis, presence of foreskin and poor hygiene, chronic inflammatory conditions such as lichen sclerosus, trauma, and smoking.

Consumable Material Waste and Workflow Efficiency Comparison Between Multi-use Syringeless and Single-use Syringe-Based Injectors in Computed Tomography.

Rationale And Objectives: Syringeless power injectors obviate the need for reloading iodinated contrast media (ICM) and plastic consumable pistons between exams. This study evaluates the potential time and material waste (ICM, plastic, saline, and total) saved using a multi-use syringeless injector (MUSI) compared to a single-use syringe-based injector (SUSI).

Materials And Methods: Two observers recorded technologist time spent using a SUSI and a MUSI over three clinical workdays.

Automated Deep Learning Artificial Intelligence Tool for Spleen Segmentation on CT: Defining Volume-Based Thresholds for Splenomegaly.

Splenomegaly historically has been assessed on imaging by use of potentially inaccurate linear measurements. Prior work tested a deep learning artificial intelligence (AI) tool that automatically segments the spleen to determine splenic volume. The purpose of this study is to apply the deep learning AI tool in a large screening population to establish volume-based splenomegaly thresholds.

Stercoral colitis: CT imaging findings and clinical risk factors.

Purpose: To describe and update stercoral colitis clinical risk factors, relative frequency, location, and CT imaging features correlated with surgical and pathological results.

Methods: CT reports over a 5-year period (05/2017-05/2022) at a single medical center were searched. Main inclusion criteria were luminal distention with formed stool, wall thickening, and surrounding inflammation.

MRA as the Preferred Test for Pulmonary Embolism During the Iodinated Contrast Media Shortage of 2022: A Single-Center Experience.

Closure of a GE Healthcare facility in Shanghai, China, in 2022 disrupted the iodinated contrast media supply. Technologic advances have addressed limitations associated with the use of pulmonary MRA for diagnosis of pulmonary embolism (PE). The purpose of this study was to describe a single institution's experience in the use of pulmonary MRA as an alternative to CTA for the diagnosis of PE in the general population during the iodinated contrast media shortage in 2022.

CT Number Accuracy and Association With Object Size: A Phantom Study Comparing Energy-Integrating Detector CT and Deep Silicon Photon-Counting Detector CT.

Variable beam hardening based on patient size causes variation in CT numbers for energy-integrating detector (EID) CT. Photon-counting detector (PCD) CT more accurately determines effective beam energy, potentially improving CT number reliability. The purpose of the present study was to compare EID CT and deep silicon PCD CT in terms of both the effect of changes in object size on CT number and the overall accuracy of CT numbers.

How Do Cancer-Specific Computed Tomography Protocols Compare With the American College of Radiology Dose Index Registry? An Analysis of Computed Tomography Dose at 2 Cancer Centers.

Background: Little guidance exists on how to stratify radiation dose according to diagnostic task. Changing dose for different cancer types is currently not informed by the American College of Radiology Dose Index Registry dose survey.

Methods: A total of 9602 patient examinations were pulled from 2 National Cancer Institute designated cancer centers.

Understanding the Tumor Immune Microenvironment in Renal Cell Carcinoma.

Scientific understanding of how the immune microenvironment interacts with renal cell carcinoma (RCC) has substantially increased over the last decade as a result of research investigations and applying immunotherapies, which modulate how the immune system targets and eliminates RCC tumor cells. Clinically, immune checkpoint inhibitor therapy (ICI) has revolutionized the treatment of advanced clear cell RCC because of improved outcomes compared to targeted molecular therapies. From an immunologic perspective, RCC is particularly interesting because tumors are known to be highly inflamed, but the mechanisms underlying the inflammation of the tumor immune microenvironment are atypical and not well described.

Diagnostic performance of the "drooping" sign in CT diagnosis of exophytic renal angiomyolipoma.

Objective: To evaluate the prevalence of angular interface and the "drooping" sign in exophytic renal angiomyolipomas (AMLs) and the diagnostic performance in differentiating exophytic lipid-poor AMLs from other solid renal masses.

Methods: This IRB-approved, two-center study included 185 patients with 188 exophytic solid renal masses < 4 cm with histopathology and pre-operative CT within 30 days of surgical resection or biopsy. Images were reviewed for the presence of angular interface and the "drooping" sign qualitatively by three readers blinded to the final diagnosis, with majority rules applied.

Factors Contributing to Computed Tomography Trauma Scan Times at a Tertiary Center: Improving Emergency Department Trauma Imaging Workflow Through Targeted Interventions.

Purposes: The aims of the study are to identify factors contributing to computed tomography (CT) trauma scan turnaround time variation and to evaluate the effects of an automated intervention on time metrics.

Methods: Throughput metrics were captured via picture archiving and communication system from January 1, 2018, to December 16, 2019, and included 17,709 CT trauma scans from our institution. Initial data showed that imaging technologist variation played a significant role in trauma imaging turnaround time.

Electrocardiographic Gating and Cerebral Perfusion Computed Tomography Option-Set Prevalence and Utilization Data From 62 Institutions in the United States.

Objectives: To provide the radiology community with data to address the question: "Compared with peer institutions, is my institution efficiently using its electrocardiographic (ECG) gating and cerebral perfusion-capable computed tomography (CT) scanners?"

Methods: In this retrospective study, we analyze 6 months of scanner utilization data from 62 institutions (299 locations, 507 scanners) to identify scanners capable of performing ECG gating and perfusion CT studies. We report the number of ECG gating/perfusion-capable scanners and locations as a function of the total number of locations and scanners in each institution. We additionally regress the number of ECG-gated and perfusion examinations on (1) the number of locations/scanners capable of performing these examinations and (2) the fraction of the institution's CT examination volume that requires ECG gating or perfusion.

Ultrasound-guided transvaginal biopsies of pelvic lesions: diagnostic yield, safety profile, and technical considerations over a 20-year experience.

Purpose: To evaluate diagnostic yield, safety profile, and specific technical considerations of transvaginal ultrasound (TVUS) guided biopsy/aspiration.

Materials/methods: TVUS guided biopsy (core, FNA) procedures with pre-procedure CT/MRI imaging at a single institution between 2001 and 2021 were reviewed. Relevant patient demographic data was extracted via the Electronic Health Record (EMR), technical details of the biopsy procedure were collected, and distance to target via transvaginal and transabdominal biopsy approach was measured on pre-procedure imaging.