Vancouver Imaging Review: Head to Toe

Sep 28th, 2016Oct 1st, 2016
Vancouver, BC
CA
http://www.ubcradcme.com/vir
Phone:[email protected]
The UBC Vancouver Imaging Review is designed to provide participants with the necessary tools to enhance their interpretation skills utilizing the latest imaging technologies, including MR, MDCT, PET/CT, ultrasound, and radiography.
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Images of a 39-year-old who underwent screening mammography. Right craniocaudal (left) and mediolateral oblique (middle) views from preoperative mammography show suspicious grouped fine pleomorphic calcifications (arrows). After biopsy showed ductal carcinoma of situ (DCIS), patient underwent breast-conserving surgery, yielding final diagnosis of ductal carcinoma in situ (intermediate grade, hormone receptor positive). (Right) Screenshot of an output of a commercial AI tool applied to preoperative mammography. AI detected right breast lesion with score of 95% on both views (concentric colored circles). Present study’s reviewing radiologist deemed AI marking to correspond with site of DCIS.
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Axial contrast-enhanced CT scan in a 28-year-old premenopausal woman shows an incidentally detected solid-appearing left ovarian lesion (solid arrow) anterior to the uterus (U), associated with trace ascites in the right adnexa and cul de sac (dashed arrows). At pathologic analysis, this was shown to be ovarian dysgerminoma. Two readers misdiagnosed this lesion, one as a leiomyoma and one as an ovarian fibroma.
Clinicians, beware: CT diagnostic accuracy varies by adnexal lesion type
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Lower limb amputation is an increasingly common major complication of advanced peripheral arterial disease and diabetes mellitus.
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3D MRI technique helps plan treatment for pediatric heart conditions
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The method makes "heart muscle and heart valves visible while making blood and surrounding tissues transparent," researchers noted.
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Could AI scoring help with managing DCIS?
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An AI model showed associations with recurrence after DCIS surgery and performed comparably to established clinical risk models.
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Images of a 39-year-old who underwent screening mammography. Right craniocaudal (left) and mediolateral oblique (middle) views from preoperative mammography show suspicious grouped fine pleomorphic calcifications (arrows). After biopsy showed ductal carcinoma of situ (DCIS), patient underwent breast-conserving surgery, yielding final diagnosis of ductal carcinoma in situ (intermediate grade, hormone receptor positive). (Right) Screenshot of an output of a commercial AI tool applied to preoperative mammography. AI detected right breast lesion with score of 95% on both views (concentric colored circles). Present study’s reviewing radiologist deemed AI marking to correspond with site of DCIS.
Clinicians, beware: CT diagnostic accuracy varies by adnexal lesion type
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The modality correctly diagnoses dermoids and simple cysts, but is not as effective at identifying other types of adnexal lesions.
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Axial contrast-enhanced CT scan in a 28-year-old premenopausal woman shows an incidentally detected solid-appearing left ovarian lesion (solid arrow) anterior to the uterus (U), associated with trace ascites in the right adnexa and cul de sac (dashed arrows). At pathologic analysis, this was shown to be ovarian dysgerminoma. Two readers misdiagnosed this lesion, one as a leiomyoma and one as an ovarian fibroma.
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Images from two representative cases. (A-C) Images in an 82-year-old man with a calcified plaque in the proximal segment of the left anterior descending artery. (A, B) Curved planar reconstruction images from CCTA with (A) hybrid iterative reconstruction (HIR) and (B) super-resolution deep learning reconstruction (SR-DLR) show that the measured PDS was 66% for the HIR image and 42% for the SR-DLR image. (C) Quantitative analysis of the invasive coronary angiography (ICA) image (reference standard) revealed a PDS of 34% (arrow). (D-F) Images in a 37-year-old woman with a noncalcified plaque in the middle segment of the left circumflex artery. (D, E) Curved planar reconstruction images from CCTA with (D) HIR and (E) SR-DLR show that the measured PDS was 47% for the HIR image and 80% for the SR-DLR image. (F) Quantitative analysis of the ICA image revealed a PDS of 72% (arrow). Blue, red, and yellow lines in A, B, D, and E represent the proximal reference point, stenosed lesion, and distal reference point, respectively, and the insets show the corresponding cross-sectional images.
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Trends show that nonsurgical management of DCIS is rising, paving the way for imaging's role in active surveillance.
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F-18 sodium fluoride PET/CT scans can quantify changes in cardiac and aortic vascular calcifications.
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DBT-guided biopsies show practical advantages
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New research says DBT-guided biopsies lead to less procedure times and radiation exposure compared to mammography-guided biopsies.
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Radiology is at an inflection point
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Radiology is a cornerstone of modern medical diagnostics, but today is at an inflection point, said Civie CEO Dhruv Chopra in a new column.
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