Springer Science and Business Media LLC

To compare the visualization of hemodynamic imaging findings of hypervascular hepatocellular carcinoma (HCC) on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using radial volumetric imaging breath-hold examination with k-space-weighted image contrast reconstruction (r-VIBE-KWIC) versus dynamic computed tomography during hepatic arteriography (dyn-CTHA). We retrospectively reviewed the databases of preoperative DCE-MRI using r-VIBE-KWIC, dyn-CTHA, and postoperative pathology of resected specimens. Fourteen patients with 14 hypervascular HCCs underwent both DCE-MRI and dyn-CTHA. The imaging findings of the tumor and adjacent liver parenchyma were assessed on both modalities by two readers. The tumor enhancement time was also compared between the two modalities. On DCE-MRI/dyn-CTHA, early staining, peritumoral low-intensity or low-density bands, corona enhancement, and washout of HCC were observed in 14/14 (100%), 10/12 (83%), 11/14 (78%), and 4/14 (29%) patients, respectively. Pathologically, four HCCs with low-density bands on dyn-CTHA had no fibrous capsules. The median tumor enhancement time on DCE-MRI and dyn-CTHA was 24 (9–24) and 23 (8–35) s, respectively. The correlation coefficient between the two groups was 0.762 (P < 0.002). DCE-MRI using r-VIBE-KWIC has diagnostic potential comparable with that of dyn-CTHA in the hemodynamic evaluation of hypervascular HCC except for the washout phenomenon.

We have developed an in-house software equipped with partial image phase-only correlation (PIPOC) which can automatically quantify radiographic joint space narrowing (JSN) progression. The purpose of this study was to evaluate the software in phantom and clinical assessments. In the phantom assessment, the software's performance on radiographic images was compared to the joint space width (JSW) difference using a micrometer as ground truth. A phantom simulating a finger joint was scanned underwater. In the clinical assessment, 15 RA patients were included. The software measured the radiological progression of the finger joints between baseline and the 52nd week. The cases were also evaluated with the Genant-modified Sharp score (GSS), a conventional visual scoring method. We also quantitatively assessed these joints’ synovial vascularity (SV) on power Doppler ultrasonography (0, 8, 20 and 52 weeks). In the phantom assessment, the PIPOC software could detect changes in JSN with a smallest detectable difference of 0.044 mm at 0.1 mm intervals. In the clinical assessment, the JSW change of the joints with GSS progression detected by the software was significantly greater than those without GSS progression (p = 0.004). The JSW change of joints with positive SV at baseline was significantly higher than those with negative SV (p = 0.024). Our in-house software equipped with PIPOC can automatically and quantitatively detect slight radiographic changes of JSW in clinically inactive RA patients.

Horseshoe kidney (HSK) is the most common fusion anomaly of kidneys. Diagnosis of horseshoe kidneys is made by the demonstration of an isthmus or band of renal tissue between the lower poles of the kidneys. Connection between the upper poles of the kidneys is extremely rare. Several types of skeletal anomalies can be seen concomitantly with HSK. In our present case, where the patient was a 3-year-old male, the connection of renal tissue was located between the upper poles of the kidneys. Furthermore, there was an accompanying spina bifida and Gibbus deformity secondary to anterior hypoplasia of the T10 vertebral body.

Deep learning (DL) is a state-of-the-art technique for developing artificial intelligence in various domains and it improves the performance of natural language processing (NLP). Therefore, we aimed to develop a DL-based NLP model that classifies the status of bone metastasis (BM) in radiology reports to detect patients with BM. The DL-based NLP model was developed by training long short-term memory using 1,749 free-text radiology reports written in Japanese. We adopted five-fold cross-validation and used 200 reports for testing the five models. The accuracy, sensitivity, specificity, precision, and area under the receiver operating characteristics curve (AUROC) were used for the model evaluation. The developed model demonstrated classification performance with mean ± standard deviation of 0.912 ± 0.012, 0.924 ± 0.029, 0.901 ± 0.014, 0.898 ± 0.012, and 0.968 ± 0.004 for accuracy, sensitivity, specificity, precision, and AUROC, respectively. The proposed DL-based NLP model may help in the early and efficient detection of patients with BM.

The link between malignancy and venous thromboembolism (VTE) is well established; the risk has been shown to be higher in certain tumour types and in patients receiving platinum-based chemotherapy regimens. ‘Active’ cancer is often quoted as being a particular risk factor for VTE, but the definition varies widely and the supporting evidence is weak. This study was conceived to establish whether incidental pulmonary emboli are associated with an increased likelihood of progressive disease on a staging computed tomography (CT) scan. All CT scans containing incidental PEs over the course of a year in a large specialist cancer hospital were examined (n = 306). An age-matched control group was assembled. Multivariate logistic regression analysis was performed to establish the relationship of several independent variables, including progressive disease, with the dependent variable of the presence or absence of incidental pulmonary emboli. Progressive disease was present in 144 of 306 (47.1%) of the patients in the PE group but only 63 of 306 (20.6%) of the control group patients. Progressive disease on the staging CT scan was found to have an odds ratio for incidental PE of 3.46, with a 95% CI of 2.38–5.01. Receiving platinum-based chemotherapy resulted in an odds ratio of 3.89 (2.41–6.28) for PE. Receiving non-platinum-based systemic anti-cancer therapy (SACT) resulted in an odds ratio for PE of 1.71 (1.16–2.50). The detection of an incidental PE on a staging CT scan is associated with a very high risk of progressive malignant disease.

To evaluate the diagnostic performance of chest CT to differentiate coronavirus disease 2019 (COVID-19) pneumonia in non-high-epidemic area in Japan. This retrospective study included 21 patients clinically suspected COVID-19 pneumonia and underwent chest CT more than 3 days after the symptom onset: six patients confirmed COVID-19 pneumonia by real-time reverse-transcription polymerase chain reaction (RT-PCR) and 15 patients proved uninfected. Using a Likert scale and its receiver operating characteristic curve analysis, two radiologists (R1/R2) evaluated the diagnostic performance of the five CT criteria: (1) ground glass opacity (GGO)-predominant lesions, (2) GGO- and peripheral-predominant lesions, (3) bilateral GGO-predominant lesions; (4) bilateral GGO- and peripheral-predominant lesions, and (5) bilateral GGO- and peripheral-predominant lesions without nodules, airway abnormalities, pleural effusion, and mediastinal lymphadenopathy. All patients confirmed COVID-19 pneumonia had bilateral GGO- and peripheral-predominant lesions without airway abnormalities, mediastinal lymphadenopathy, and pleural effusion. The five CT criteria showed moderate to excellent diagnostic performance with area under the curves (AUCs) ranging 0.77–0.88 for R1 and 0.78–0.92 for R2. The criterion (e) showed the highest AUC. Chest CT would play a supplemental role to differentiate COVID-19 pneumonia from other respiratory diseases presenting with similar symptoms in a clinical setting.

The purpose of this study was to show the effectiveness of combining intra-arterial infusion and systemic chemotherapy with concurrent radiotherapy for treatment of stage IV mandibular gingival cancer. A total of 23 patients with mandibular gingival cancer were treated with either docetaxel by intra-arterial infusion followed by systemic chemoradiotherapy with cisplatinum and 5-fluorouracil as a monthly regimen, or with docetaxel and cisplatinum by intra-arterial infusion followed by systemic chemoradiotherapy with 5-fluorouracil as a weekly or biweekly regimen. Tumor responses, locoregional control, overall survival, disease-specific survival, and adverse events were evaluated. Of the 23 patients enrolled in the study, 22 completed the treatment. With regard to clinical stages, 82 % were diagnosed as IVA and 18 % IVB. Complete and partial response was observed in 82 and 18 %, respectively. Five-year overall survival, disease-specific survival, and locoregional control were 51, 70, and 72 %, respectively. No statistically significant difference was seen between the monthly regimen and the weekly plus biweekly regimen, although the latter resulted in longer survival and 88 % control. Combined intra-arterial infusion and systemic chemoradiotherapy may be an effective treatment for patients with stage IV mandibular gingival cancer.

The aim of this study was to evaluate the effectiveness of a worksheet for diagnosing postmortem computed tomography (PMCT) in emergency departments (EDs). A total of 49 cases of clinically diagnosed nontraumatic deaths in the ED who underwent total body PMCT were enrolled. PMCT images were prospectively evaluated by four radiologists: two radiologists with 1.5 and 3.5 years of residency and two board-certified radiologists with >20 years of experience. Readers were independently instructed to detect and interpret findings with reference to fatal findings, postmortem features, changes caused by cardiopulmonary resuscitation, and other pathological findings according to a worksheet that was composed of the possible findings previously reported. Agreement on detection and interpretation of findings between each reader was measured using Cohen’s kappa coefficients. For the detection of findings, there was substantial agreement among the four readers (kappa > 0.60, P < 0.0001). There was substantial (kappa > 0.60, P < 0.0001) and near-substantial (kappa = 0.60, P < 0.0001) agreement in the interpretation of the finding. Results of our study suggest equivalency on diagnosing PMCT regardless of the reader’s level of experience. We conclude that the worksheet is useful for diagnosing PMCT in emergency departments.