- Microcalcification-associated breast cancer: HER2-enriched molecular subtype is associated with mammographic features. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20170942
- CONCLUSIONS: Our study presents a prediction model that incorporates the mammographic features of tumor size, non-spiculated mass and calcification extent, which can potentially be used to preoperative predict breast cancer HER2-enriched subtype. Advancesinknowledge: Mammographic features can noninvasively visualize breast tumor phenotype characteristics.
- ADC histogram analysis of muscle lymphoma - Correlation with histopathology in a rare entity. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20180291
- CONCLUSIONS: This study identified significant correlations between cellularity and histogram parameters derived from ADC maps in muscle lymphoma. Thus, histogram analysis parameters reflect histopathology in muscle tumors. Advances in knowledge: Whole lesion ADC histogram analysis is able to reflect histopathology parameters in muscle lymphomas.
- Colon cancer screening with CT colonography: logistics, cost effectiveness, efficiency and progress. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20180307
- Colorectal cancer (CRC) incidence and mortality can be significantly reduced by population screening. Several different screening methods are currently in use, and this review focuses specifically on...
Colorectal cancer (CRC) incidence and mortality can be significantly reduced by population screening. Several different screening methods are currently in use, and this review focuses specifically on the imaging technique computed tomography colonography (CTC). The challenges and logistics of CTC screening, as well as the importance of test accuracy, uptake, quality assurance and cost-effectiveness will be discussed. With comparable advanced adenoma detection rates to colonoscopy (the most commonly used whole-colon investigation), CTC is a less invasive alternative, requiring less laxative, and with the potential benefit that it permits assessment of extra colonic structures. Three large-scale European trials have contributed valuable evidence supporting the use of CTC in population screening, and highlight the importance of selecting appropriate clinical management pathways based on initial CTC findings. Future research into CTC-screening will likely focus on radiologist training and CTC quality assurance, with identification of evidence-based key performance indicators that are associated with clinically-relevant outcomes such as the incidence of post-test interval cancers (CRC occurring after a presumed negative CTC). In comparison to other CRC screening techniques, CTC offers a safe and accurate option that is particularly useful when colonoscopy is contraindicated. Forthcoming cost-effectiveness analyses which evaluate referral thresholds, the impact of extra-colonic findings and real-world uptake will provide useful information regarding the feasibility of future CTC population screening.
- Breast compression across consecutive examinations among women participating in Breast screen Norway. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20180209
- CONCLUSIONS: We observed increasing values of breast compression parameters across consecutive screening examinations. Further research should investigate the effect of this variation on image quality and women's experiences of discomfort and pain. Advances in Knowledge: Breast compression force, compression pressure and compressed breast thickness increased across consecutive screening examinations, which might be of influence for the women's experiences of discomfort and pain during the examination and for image quality.
- Comparative effectiveness of 18F-FDG PET-CT and contrast-enhanced CT in the diagnosis of suspected large-vessel vasculitis. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20180247
- CONCLUSIONS: FDG PET-CT demonstrated excellent accuracy whilst CECT mural thickening showed good accuracy in the diagnosis of LVV. Both parameters showed a highly significant correlation. In hospitals without access to FDG PET-CT or in patients unsuitable for PET-CT (e.g., uncontrolled diabetes) CECT offers a viable alternative for the assessment LVV. Advances in knowledge: FDG PET-CT is a highly accurate test for the diagnosis of LVV. Aorta:liver SUVmax ratio is the most specific parameter for LVV. In hospitals without PET-CT or in unsuitable patients e.g. diabetics, CECT is a viable alternative.
- Detection of recurrent hepatocellular carcinoma after surgical resection: Non-contrast liver MR imaging with diffusion-weighted imaging versus gadoxetic acid-enhanced MR imaging. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20180177
- CONCLUSIONS: Non-contrast MR imaging may serve as an alternative follow up method which can potentially replace whole MR imaging at least in selected patients followed up ≥1 year after surgery who have relatively lower risk of HCC recurrence. Advances in knowledge: There is no consensus regarding the ideal imaging modality or follow up interval after resection of HCC. Non-contrast MR imaging had comparable performance to that of gadoxetic acid-enhanced MR imaging in the detection of HCC recurrence during surveillance ≥1 year after surgery.
- Imaging findings in essure related complications. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20170686
- Tubal sterilization with Essure inserts has become a prevalent alternative to laparoscopic sterilization because of its minimal invasiveness. It is a well-tolerated ambulatory procedure that provides...
Tubal sterilization with Essure inserts has become a prevalent alternative to laparoscopic sterilization because of its minimal invasiveness. It is a well-tolerated ambulatory procedure that provides reliable permanent contraception without the risks associated with laparoscopic surgery and general anesthesia. Correct positioning of the Essure device is necessary to achieve the fibrotic reaction induced by the polyethylene terephthalate fibers, subsequently resulting in tubal occlusion usually within 3 months. After uneventful procedures with satisfactory bilateral placement, only the correct position of the devices needs to be confirmed at follow-up. The imaging techniques used to asses Essure devices may vary depending on the country and its recommendations. The gold standard test to ascertain tubal occlusion remains the hysterosalpingography but after uneventful procedures, vaginal-ultrasound proved to be a reliable alternative to confirm the proper position of the inserts. Radiologists have been increasingly confronted to post procedural evaluations and despite the efficiency rate of the Essure device, its use still exposes to a low risk of complications and malfunctions such as unwanted pregnancies, device misplacement, tubal or uterine perforation, and chronic pelvic pain. Unintended pregnancies are mostly due to patient or physician non-compliance and misinterpretation of post procedural examinations by radiologists which emphasizes the importance of their training in Essure device assessment. This pictorial review discusses the imaging methods used to asses Essure implants and illustrates the possible complications related to them.
- Peripheral vision: abdominal pathology missed outside the centre of gaze. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20180142
- Radiology misses have been the subject of much debate on both sides of the Atlantic in recent years. There is now greater focus in trying to reduce radiology errors by continuous education and changi...
Radiology misses have been the subject of much debate on both sides of the Atlantic in recent years. There is now greater focus in trying to reduce radiology errors by continuous education and changing the working environment to try and protect the radiologist, and ultimately the patient from potential harm. Duty of candour is a relevant and sensitive area. Developing robust validated reporting pathways within the healthcare structure is very important so as to encourage a "learning from discrepancies" culture and to put the patient and their families at the center of reporting and acknowledging errors in radiology. Having reflected in our daily practice and while writing this pictorial review, we have concluded that during reporting magnetic resonance imaging (MRI) scans, routine assessment of the localizer images, focusing outside the area of interest and having a more structured approach to image interrogation are key actions which may help reduce the the number of omissions. We present a myriad of cases where pathology was "missed" outside the center of gaze in relation to the abdomen or outside the abdomen on abdominal MRI, and suggest key high yield sequence related review areas to minimize the chance of missing potentially significant pathology.
- Survival outcomes and patterns of failure after D2 dissection and adjuvant chemoradiotherapy for locally advanced gastric cancer: a retrospective study. [Journal Article]
- BJBr J Radiol 2018 Jun 21; :20170594
- CONCLUSIONS: Postoperative chemoradiotherapy has a potential effect on optimizing locoregional control, resulting in only 12.0% of locoregional failure. In patients after D2 resection and adjuvant CRT, peritoneal metastasis was the leading pattern of failure, followed by distant metastasis. Advances in knowledge: Peritoneal recurrence was the most common pattern of failure after D2 dissection and adjuvant CRT, followed by distant metastasis, whereas locoregional relapse was relatively rare. Selection of patients based on the predicted risk of each recurrence pattern may be a reasonable approach to the optimization of treatment strategies.
New Search Next
- Neuroarthropathy in diabetes: pathogenesis of Charcot arthropathy. [Journal Article]
- BJBone Joint Res 2018; 7(5):373-378
- Charcot neuroarthropathy is a rare but serious complication of diabetes, causing progressive destruction of the bones and joints of the foot leading to deformity, altered biomechanics and an increase...
Charcot neuroarthropathy is a rare but serious complication of diabetes, causing progressive destruction of the bones and joints of the foot leading to deformity, altered biomechanics and an increased risk of ulceration. Management is complicated by a lack of consensus on diagnostic criteria and an incomplete understanding of the pathogenesis. In this review, we consider recent insights into the development of Charcot neuroarthropathy. It is likely to be dependent on several interrelated factors which may include a genetic pre-disposition in combination with diabetic neuropathy. This leads to decreased neuropeptides (nitric oxide and calcitonin gene-related peptide), which may affect the normal coupling of bone formation and resorption, and increased levels of Receptor activator of nuclear factor kappa-B ligand, potentiating osteoclastogenesis. Repetitive unrecognized trauma due to neuropathy increases levels of pro-inflammatory cytokines (interleukin-1β, interleukin-6, tumour necrosis factor α) which could also contribute to increased bone resorption, in combination with a pre-inflammatory state, with increased autoimmune reactivity and a profile of monocytes primed to transform into osteoclasts - cluster of differentiation 14 (CD14). Increased blood glucose and loss of circulating Receptor for Advanced Glycation End-Products (AGLEPs), leading to increased non-enzymatic glycation of collagen and accumulation of AGLEPs in the tissues of the foot, may also contribute to the pathological process. An understanding of the relative contributions of each of these mechanisms and a final common pathway for the development of Charcot neuroarthropathy are still lacking. Cite this article: S. E. Johnson-Lynn, A. W. McCaskie, A. P. Coll, A. H. N. Robinson. Neuroarthropathy in diabetes: pathogenesis of Charcot arthropathy. Bone Joint Res 2018;7:373-378. DOI: 10.1302/2046-3758.75.BJR-2017-0334.R1.