Mccarthyblackwell0623

OBJECTIVE. The purpose of this study was to determine the quantification accuracy of virtual unenhanced images and establish the lower limit of iodine quantification as a function of dose. MATERIALS AND METHODS. A large elliptical and cylindric phantom mimicking the patient abdomen was scanned on two commercial dual-energy CT scanners, an IQon Spectral CT (Philips Healthcare) and a Revolution CT with Gemstone Spectral Imaging Xtream suite (GE Healthcare). The phantom contained simulated soft tissue, blood, and bone with known elemental composition. It also contained simulated iodine concentrations (0.2-15.0 mg/mL) and iodine-enhanced blood (0.5-5.0 mg/mL). The mean absolute error in CT value for virtual unenhanced images and mean absolute percent error in iodine, calcium, and fat-specific images were measured. RESULTS. For virtual unenhanced images, when excluding the simulated bone, the mean absolute error in CT value was 8.0 ± 5.0 (SD) HU and 9.0 ± 6.2 HU for the IQon and the Revolution CT, respectively (p = 0.61). The mean error in CT value of the simulated bone was -90.5 ± 111.6 HU and -98.5 ± 117.8 HU on the IQon and the Revolution CT, respectively (p = 0.08). For iodine-specific images, the mean absolute percent error was 13.7% and 8.3% for the IQon and the Revolution CT, respectively, above 0.5 mg/mL iodine concentration, and 150% and 100% at less than 0.5 mg/mL iodine concentration. The mean absolute percent error increased from 16.2% at 100% radiation dose to 18.9% and 24% at 75% and 50% dose, respectively, on the IQon; and from 8.8% at 100% dose to 11.1% and 17.8% at 75% and 50%, respectively, on the Revolution CT. CONCLUSION. Virtual unenhanced images are reasonably accurate for simulated soft tissues and contrast materials, except for simulated bone. The lower limit of iodine quantification is radiation-dose dependent. For typical dose levels, 0.5 mg/mL iodine concentration is the lower threshold for iodine detection accuracy.OBJECTIVE. Frequency of acute rejection (AR) after pediatric liver transplant remains high despite progress in immunosuppression. Liver biopsy (LB) is the reference standard for the diagnosis of AR despite its potential for morbidity. The purpose of our study was to evaluate the ability of acoustic radiation force impulse (ARFI) imaging to distinguish AR from other causes of short- and medium-term liver dysfunction and to identify liver transplant cases with normal liver function. MATERIALS AND METHODS. ARFI imaging was used to evaluate shear wave velocity (SWV) after liver transplant in young children. All pediatric liver grafts that had LB and ARFI examination between January 2014 and December 2017 were included in this retrospective study. Results of LB were compared with those of SWV. Collected data included age at biopsy and transplant, sex, weight, height, body mass index, interval between liver transplant and shear wave elastography and LB, kind of graft, type of donor, and diagnosis at transplant. ROCn place of LB in pediatric patients with liver dysfunction after liver transplant, restricting indication and risks of biopsy to selected cases.OBJECTIVE. The purpose of this study is to investigate the frequency of funded research published in major radiology journals and to determine whether funding is associated with the article citation rate. MATERIALS AND METHODS. A total of 600 consecutive original research articles published in three journals-AJR, Radiology, and European Radiology-were included. Linear regression analysis was performed to determine the association between research funding and the article citation rate, as adjusted for journal, continent of origin of the first author, subspecialty, study findings included in the article title, number of authors, immediate open access publication, and time since publication online. RESULTS. Funding was declared for 286 of 600 included articles (47.7%). Sources of funding were as follows federal sponsorship (29.4%), a nonprofit foundation (16.4%), both federal sponsorship and a nonprofit foundation (16.1%), private industry (10.1%), intramural institutional research funding (9.8%), and other fundndations, whereas only a minority of funded articles were supported by private industry. Funding was not associated with a higher citation rate.OBJECTIVE. Liver Imaging Reporting and Data System (LI-RADS) was updated in 2018 (LI-RADS version 2018 [LI-RADSv2018]) to facilitate integration into the American Association for the Study of Liver Diseases 2018 clinical practice guidelines and involved changes in LR-5 categorization and threshold growth definitions. There are also differences between the criteria for LI-RADSv2018 LR-5 category and the criteria for Organ Procurement and Transplantation Network (OPTN) class 5. The objective of our study was to compare the diagnostic performances of LI-RADSv2018, LI-RADS version 2017 (LI-RADSv2017), and OPTN criteria for diagnosing hepatocellular carcinoma (HCC) on MRI. MATERIALS AND METHODS. In this retrospective study, 122 patients with 159 observations were included who met LI-RADS criteria for at risk for HCC and had at least one hepatic observation on MRI performed between January 1, 2015, and January 1, 2018 and who had histopathology results (n = 104) or follow-up imaging (n = 55) as reference standards.I-RADSv2018 was significantly higher than the sensitivity of class 5 in OPTN criteria (63.9% vs 53.6%; p = 0.004) without a difference in specificity (97.3% vs 97.3%; p = 1.00). Reader agreement was moderate for overall LIRADSv2017 and LI-RADSv2018 categories (κ = 0.504 and 0.561, respectively); substantial for LR-5 and LR-TIV+5 categories as diagnostic of HCC versus other categories for both v2017 and v2018 (κ = 0.758 and 0.802, respectively); and substantial for OPTN class 5 criteria (κ = 0.756). CONCLUSION. The diagnostic performance of LI-RADSv2018 is higher, with higher sensitivity and similar specificity, than the diagnostic performance of LI-RADSv2017 and OPTN criteria for HCC.OBJECTIVE. Contrast-enhanced digital mammography (CEDM) combines the high spatial resolution of mammography with the improved enhancement provided by contrast medium. In this article, CEDM technique-the current and potential clinical applications and current challenges-will be reviewed. CONCLUSION. CEDM is a promising technique in the supplemental evaluation of patients with mammographically inconclusive findings and potentially in the screening of women with mammographically dense breasts. CEDM is emerging as a cost-effective alternative to dynamic contrast-enhanced MRI to stage newly diagnosed breast cancer and evaluate response to neoadjuvant chemotherapy.OBJECTIVE. Open access publishing has grown exponentially and can be a means of increasing availability of scientific knowledge to readers who cannot afford to pay for access. This article discusses problems that can occur with open access and offers suggestions for ameliorating the problems facing radiology research because of poor-quality journals. CONCLUSION. Open access literature has loosed an avalanche of information into the radiology world, much of which has not been validated by careful peer review. To maintain academic integrity and serve our colleagues and patients, radiologists need to guard against shoddy science published in deceptive journals.OBJECTIVE. The purpose of this article is to characterize the appearance on CT of e-cigarette or vaping product use-associated lung injury (EVALI) in a cohort with histopathologic evidence of this disorder. MATERIALS AND METHODS. Twenty-four patients with EVALI were identified. Chest CT examinations were reviewed by two radiologists for various chest CT findings. For comparison with pathologic findings, CT assessments were distilled into previously described patterns of EVALI seen on CT acute lung injury (ALI), chronic eosinophilic pneumonia (CEP) or organizing pneumonia (OP), acute eosinophilic pneumonia (AEP), alveolar hemorrhage, hypersensitivity pneumonitis (HP), lipoid pneumonia, and mixed or unclassifiable patterns. RESULTS. Sixteen of 24 (67%) patients were men; the mean age was 34.5 years (range, 17-67 years). The most common CT finding was ground-glass opacities, which was present in 23 of 24 (96%) patients and the dominant finding in 18 of 24 (75%) patients. Consolidation was the next most common finding in 42% of patients. Interlobular septal thickening was present in 29%. Lobular low attenuation was conspicuous in six patients. Distribution was multifocal in 54% of patients, peripheral in 17%, and centrally predominant in 8%. Subpleural sparing was seen in 45%. The predominant CT pattern was ALI (42%), concordant with histopathologic findings in 75%; the next most predominant pattern was ground-glass opacity centrilobular nodules resembling HP (33%). A CT pattern of CEP or OP was seen in 13% of patients, all showing ALI on lung biopsy. No patient showed macroscopic lung parenchymal fat. Two patients with CT ALI patterns showed OP on histopathologic examination. Of the eight patients with ground-glass opacity centrilobular nodules resembling HP at CT, none showed HP at histopathologic examination. CONCLUSION. EVALI manifests at CT as ALI with multifocal ground-glass opacity, often with organizing consolidation, and a small centrilobular nodular pattern resembling HP.OBJECTIVE. The purpose of this study was to prospectively evaluate Prostate Imaging Reporting and Data and System version 2.1 (PI-RADSv2.1), which was released in March 2019 to update version 2.0, for prostate cancer detection with transrectal ultrasound-MRI fusion biopsy and 12-core systematic biopsy. SUBJECTS AND METHODS. This prospective study included 110 consecutively registered patients who underwent multiparametric MRI evaluated with PI-RADSv2.1 criteria followed by fusion biopsy and systematic biopsy between April and September 2019. AZD3514 in vitro Lesion-based cancer detection rates (CDRs) were calculated for prostate cancer (Gleason grade group, > 0) and clinically significant prostate cancer (Gleason grade group, > 1). RESULTS. A total of 171 lesions (median size, 1.1 cm) in 110 patients were detected and evaluated with PI-RADSv2.1. In 16 patients no lesion was detected, and only systematic biopsy was performed. Lesions were categorized as follows PI-RADS category 1, 1 lesion; PI-RADS category 2, 34 lesions; PI-RADS category 3, 54 lesions; PI-RADS category 4, 52 lesions; and PI-RADS category 5, 30 lesions. Histopathologic analysis revealed prostate cancer in 74 of 171 (43.3%) lesions and clinically significant prostate cancer in 57 of 171 (33.3%) lesions. The CDRs of prostate cancer for PI-RADS 2, 3, 4, and 5 lesions were 20.0%, 24.1%, 51.9%, and 90.0%. The CDRs of clinically significant prostate cancer for PI-RADS 1, 2, 3, 4, and 5 lesions were 0%, 5.7%, 14.8%, 44.2%, and 80.0%. In 16 patients with normal multiparametric MRI findings (PI-RADS 1), the CDRs were 50.0% for PCa and 18.8% for clinically significant prostate cancer. CONCLUSION. This investigation yielded CDRs assessed with prospectively assigned PI-RADSv2.1 scores. CDRs increased with higher PI-RADSv2.1 scores. These results can be compared with previously published outcomes derived with PI-RADS version 2.0.