European radiology
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Differentiation of malignant and benign pancreatic lesions on anatomical imaging is difficult in some cases with overlapping features. Prostate-specific membrane antigen (PSMA) is overexpressed during angioneogenesis in many tumors. We aimed to evaluate the PSMA expression in pancreatic lesions to differentiate these lesions and explore the performance of Ga-68 PSMA-PET/CT vis-a-vis F-18 FDG-PET/CT. ⋯ • Conventional imaging such as CT and MRI are unable to reliably differentiate localized malignant pancreatic lesion from benign lesions mimicking malignancy such as mass-forming pancreatitis. • FDG PET/CT helps in detecting malignant foci in view of their increased glucose metabolism. However, it may be falsely positive in inflammatory lesions which may occasionally hinder its ability to differentiate between benign and malignant lesions. • Apart from prostatic malignancy, PSMA is overexpressed in neovasculature of many non-prostatic malignancies. The present study highlights that Ga68 PSMA PET/CT performed better in diagnosing malignancy non-invasively than FDG-PET/CT with a higher PPV (90.5% vs. 65.4%) and accuracy (92.5% vs. 72.5%).
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Why is there a major gap between the promises of AI and its applications in the domain of diagnostic radiology? To answer this question, we systematically review and critically analyze the AI applications in the radiology domain. ⋯ • Many AI applications are introduced to the radiology domain and their number and diversity grow very fast. • Most of the AI applications are narrow in terms of modality, body part, and pathology. • A lot of applications focus on supporting "perception" and "reasoning" tasks.
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Multicenter Study
Whole-body MRI versus an FDG-PET/CT-based reference standard for staging of paediatric Hodgkin lymphoma: a prospective multicentre study.
To assess the concordance of whole-body MRI (WB-MRI) and an FDG-PET/CT-based reference standard for the initial staging in children with Hodgkin lymphoma (HL) METHODS: Children with newly diagnosed HL were included in this prospective, multicentre, international study and underwent WB-MRI and FDG-PET/CT at staging. Two radiologists and a nuclear medicine physician independently evaluated all images. Discrepancies between WB-MRI and FDG-PET/CT were assessed by an expert panel. All FDG-PET/CT errors were corrected to derive the FDG-PET/CT-based reference standard. The expert panel corrected all reader errors in the WB-MRI DWI dataset to form the intrinsic MRI data. Inter-observer agreement for WB-MRI DWI was calculated using overall agreement, specific agreements and kappa statistics. Concordance for correct classification of all disease sites and disease stage between WB-MRI (without DWI, with DWI and intrinsic WB-MRI DWI) and the reference standard was calculated as primary outcome. Secondary outcomes included positive predictive value, negative predictive value and kappa statistics. Clustering within patients was accounted for using a mixed-effect logistic regression model with random intercepts and a multilevel kappa analysis. ⋯ • This study showed excellent agreement between WB-MRI DWI and an FDG-PET/CT-based reference standard for staging paediatric HL. • Diffusion-weighted imaging is a useful addition to WB-MRI in staging paediatric HL. • Inter-observer agreement for WB-MRI DWI was good for both nodal and extra-nodal staging and determining disease stage.
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To determine the prognostic value of CT-based splenic volume measurement in patients with compensated chronic liver disease (cCLD) from chronic hepatitis B (CHB). ⋯ • Spleen volume could be easily acquired from routine multiphasic liver CT scan using a semi-automated 3D volumetric software program with excellent inter-observer agreement. • A larger spleen volume was significantly associated with a higher rate of hepatocellular carcinoma occurrence, the development of decompensation, and poor overall survival in patients with compensated chronic liver disease from chronic hepatitis B.
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To determine CT's role in the early detection of COVID-19 infection and serial CT changes in the disease course in patients with COVID-19 pneumonia. ⋯ • The chest CT detection time of COVID-19 pneumonia was 2.61 days earlier than that of an initial RT-PCR positive result (t = - 7.31, p = 0.000). • The lung CT improvement time was significantly shorter than that of RT-PCR conversion to negative (t = - 4.72, p = 0.000). • At the early stage (0-3 days), the CT features of COVID-19 were predominantly GGO and small-vessel thickening; at stage 2 (4-7 days), GGO evolved to consolidation and crazy paving signs. At stage 3 (8-14 days and later), fibrotic lesions significantly increased, accompanied by consolidation, GGO, and crazy paving signs.