- Improving diagnostic accuracy in clinically ambiguous paediatric appendicitis: a retrospective review of ultrasound and pathology findings with focus on the non-visualised appendix. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180585
- CONCLUSIONS: Ultrasound has the potential to improve diagnostic accuracy in clinically ambiguous appendicitis. Advances in knowledge: This paper furthers the evidence on the efficacy of ultrasound as a diagnostic tool in acute appendicitis in children, especially when the diagnosis is clinically equivocal. It also sheds further light on the "non-visualized appendix" with almost half of these patients having pathologically confirmed appendicitis; meaning advanced imaging with CT or MR may be indicated in this cohort.
- Clinical significance of the post-radiotherapy 18F-fluorodeoxyglucose positron emission tomography response in nasopharyngeal cancer. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180045
- CONCLUSIONS: In patients that have received definitive (chemo)radiotherapy for nasopharyngeal cancer, 18F-FDG PET within 6 months of completion of treatment has a high negative predictive value for predicting residual disease and is prognostic for long-term treatment outcomes. Patients with remaining focal increased uptake of 18F-FDG at lymph nodes may benefit from more aggressive treatments, and further studies are needed to validate the clinical significance of post-radiotherapy 18F-FDG PET. Advances in knowledge: We found that Post-radiotherapy 18F-FDG PET findings have a high negative predictive value for detecting residual disease and are a significant prognostic factor for treatment outcomes.
- National survey of imaging practice for suspected or confirmed plasma cell malignancies. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180462
- CONCLUSIONS: Significant challenges remain to standardisation of imaging practice in accordance with national best-practice guidelines. Advances in knowledge: This is the first publication to date evaluating current UK imaging practice for assessing myeloma since the publication of new guidelines recommending use of advanced cross-sectional imaging techniques. Skeletal survey remains the most commonly performed first-line imaging test in patients with suspected or confirmed myeloma and this is largely due to resource limitations within radiology departments.
- Congenital anomalies of the pulmonary arteries: an imaging overview. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180185
- Congenital pulmonary artery anomalies represent a diverse group of abnormalities, ranging from asymptomatic incidental findings to causes of sudden cardiac death. While some may be recognized in chil...
Congenital pulmonary artery anomalies represent a diverse group of abnormalities, ranging from asymptomatic incidental findings to causes of sudden cardiac death. While some may be recognized in childhood, others may be found incidentally in adulthood. We review the clinical and imaging findings in patients with congenital anomalies of the pulmonary arteries, including valvular and perivavular anomalies as well as abnormal narrowing, course and communications of the pulmonary arteries. We also discuss the role of various imaging modalities in the evaluation of these patients. It is vital to be aware of the key radiologic manifestations and associated haemodynamic consequences in these conditions in order to facilitate accurate diagnosis and prognostic stratification.
- Review of risk factors of secondary cancers among cancer survivors. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180390
- Improvements in cancer survival have made the long-term risks from treatments more important, in particular among the children, adolescents and young adults who are more at risk particularly due to a...
Improvements in cancer survival have made the long-term risks from treatments more important, in particular among the children, adolescents and young adults who are more at risk particularly due to a longer life expectancy and a higher sensitivity to treatments. Subsequent malignancies in cancer survivors now constitute 15 to 20% of all cancer diagnoses in the cancer registries. Lots of studies are published to determine risk factors, with some controversial findings. Just data from large cohorts with detailed information on individual treatments and verification of what is called "secondary cancers" can add some knowledge, because their main difficulty is that the number of events for most second cancer sites are low, which impact the statistical results. In this review of the literature, we distinguish second and secondary cancers and discuss the factors contributing to this increased risk of secondary cancers. The article concludes with a summary of current surveillance and screening recommendations.
- Theranostics in neuroendocrine tumours: somatostatin receptor imaging and therapy. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180108
- Theranostics and its principles: pre-treatment selection of patients who are most likely to benefit from treatment by the use of a related, specific diagnostic test are integral to the treatment of p...
Theranostics and its principles: pre-treatment selection of patients who are most likely to benefit from treatment by the use of a related, specific diagnostic test are integral to the treatment of patients with neuroendocrine tumours (NETs). This is due to NET's important, but variable, somatostatin receptor (SSTR) expression, their heterogeneity and variation in site of primary and rate of progression. Only patients whose tumours have sufficient expression of SSTRs will benefit from SSTR based radionuclide therapy and demonstrating this expression prior to therapy is essential. This article provides a relevant overview of NETs and the multiple facets of SSTR based theranostics, including imaging and therapy radionuclides; clinical efficacy and toxicity; patient selection and treatment and finally emerging radiopharmaceuticals and newer clinical applications.
- Ovarian cancerscreening-ultrasound; impact on ovarian cancer mortality. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20170571
- Although ovarian cancer (OC) is the most lethal of all female malignancies, debate still exists concerning the benefits and harms of the screening programs and their impact on long term survival and ...
Although ovarian cancer (OC) is the most lethal of all female malignancies, debate still exists concerning the benefits and harms of the screening programs and their impact on long term survival and mortality from the disease. The most widely tested screening strategies have focused on trans-vaginal ultrasound (TVU) and on algorithms that measure serum levels or interval changes of cancer antigen -125 (CA-125) either individually or in combination. TVU can identify size and morphology changes of the ovary that may signal a developing malignancy; yet, it is still accused of having a low specificity. There is preliminary evidence that screening can improve survival, but the impact of screening on mortality from OC is still unclear and warrants further validation. In spite of having many published prospective studies, up to-date, none have been able to demonstrate conclusively a reduction in mortality from OC both in the screened general or high-risk population. Data from the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial has not shown survival or mortality benefits in the general population. Most prospective trials have reported a decrease in stage at detection (with the exception of the PLCO trial), thereby allowing treatment to be initiated when the disease is most curable. Research is in progress to develop new diagnostic tests and novel biomarkers, which when used in combination can increase the accuracy and outcomes of screening. In this review article we will discuss the debate provoked on OC screening programs and the impact of using ultrasound on the reduction of ovarian cancer-related mortality.
- Transcatheter arterial embolization of acute bleeding as 24/7 service: predictors of outcome and mortality. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180516
- CONCLUSIONS: Our results provide no evidence for a subjectively perceived increase in TAEs during off-hours but rather appear to show that most TAEs are performed during regular hours. Prompt TAE to control acute bleeding is crucial to prevent a drop in Hb with shock and the need for transfusion, which may promote coagulopathy and rebleeding, all of which are risk factors for a negative outcome. Advances in knowledge: The presented analysis provides insights of occurrences and risk factors for success of transcatheter arterial embolization in acute bleeding in a large study population.
- Diagnostic value of iterative reconstruction algorithm in low kV CT angiography (CTA) with low contrast medium volume for transcatheter aortic valve implantation (TAVI) planning: image quality and radiation dose exposure. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20170802
- CONCLUSIONS: Low kV and low CM volume CTA protocols allow TAVI planning to be carried out with high quality images and a significant reduction in the radiation dose as compared to the standard CTA protocol. Advances in knowledge: Low-kV CTA for pre-operative assessment of patients candidates for TAVI, permits to achieve a significant reduction of radiation dose exposure and contrast medium volume, reducing the risk of contrast induced nephropathy.
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- Assessment of cartesian co-ordinates-based bladder and rectal dose and variability with tandem-ring angles first Nigerian experience in high-dose-rate brachytherapy. [Journal Article]
- BJBr J Radiol 2018 Aug 13; :20180258
- CONCLUSIONS: The baseline data obtained in this study served as guidelines for subsequently achieving acceptable values of bladder point dose and RPD at University College Hospital, Nigeria. Special attention should be paid to the application of 2 cm-tandems in relation to the RPD. Advances in knowledge: This is one of the few studies assessing the influence of T-R angles on organs-at-risk. The increase in RPD with the use of intrauterine tandem-2 cm is found to be most pronounced with T-R 300, and this trend reduced with larger angles.