Notes

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To investigate the proportion of clinical scenarios covered by EURO-2000 Guidelines and ESR iGuide, and assess compliance with both guidelines.

The clinical indication on archived request forms for head, chest, abdomen-pelvis, and spine CT examinations performed in three hospitals in January 2018 was retrospectively matched with EURO-2000 Guidelines and ESR iGuide. For clinical scenarios addressed in the guidelines, the compliance with the guidelines was assessed. Analysis was performed on pooled data from the three centres and further stratified by centre, body region, and prescriber's specialisation. The differences in categorical data distributions between centres, body regions, and prescribers' specialisations were assessed with paired McNemar's χ
tests.

A total of 6,812 requests for 7,217 CT examinations were analysed. Sixty-five percent of clinical situations that lead to prescribing CT examinations were addressed in EURO-2000 Guidelines compared with 81% for ESR iGuide. Proportions of clinical served for different body regions and/or prescribers' subspecialties. • As referral guidelines are incomplete, any estimation of justified or unjustified CT requests is of relative significance.
• ESR iGuide performs better than earlier EURO-2000 Guidelines for the coverage of all possible clinical scenarios leading to CT referrals. • Differences in coverage of clinical scenarios by both referral guidelines are observed for different body regions and/or prescribers' subspecialties. • As referral guidelines are incomplete, any estimation of justified or unjustified CT requests is of relative significance.
The purpose of this study was to assess the radiological change patterns in skull base meningiomas after conventionally fractionated stereotactic radiotherapy (CFSRT) to determine a simple and valid method to assess the tumor response.

Forty-one patients with a benign skull base meningioma treated by CFSRT from March 2007 to August 2015 were retrospectively evaluated. We measured tumor volume(TV), long-axis diameter (LD), and short-axis diameter (SD) on both pre-treatment images and follow-up images of 1, 3, and 5 years after CFSRT, respectively. The paired t test was used to detect differences in the LD and SD change rates. Spearman's correlation coefficients were calculated to evaluate relationships between the TV and the diameters changes.

The number of available follow-up MRIs that was performed at 1, 3, and 5 years after the CFSRT was 41 (100%), 34 (83%), and 23 (56%), respectively. The change rates of SD were significantly higher than those of LD at every time point and more strongly correlated with the change rates of tumor volume at 3 and 5 years after CFSRT.

SD may be useful as a simple indicator of the tumor response for skull base meningioma after CFSRT.

• The change rate in short-axis diameter is a useful and simple indicator of the response of skull base meningioma to conventionally fractionated stereotactic radiotherapy. • Conventionally fractionated stereotactic radiotherapy for skull base meningioma achieved excellent 5-year local control.
• The change rate in short-axis diameter is a useful and simple indicator of the response of skull base meningioma to conventionally fractionated stereotactic radiotherapy. • Conventionally fractionated stereotactic radiotherapy for skull base meningioma achieved excellent 5-year local control.
To compare the diagnostic value of high frame rate contrast-enhanced ultrasound (H-CEUS) in distinguishing gallbladder adenomas from cholesterol polyp lesions with that of CEUS.

This study enrolled 94 patients with gallbladder polyp lesions (GPLs) who underwent laparoscopic cholecystectomy. CEUS and H-CEUS were performed before surgery. The perfusion features of GPLs and the final diagnosis as determined by both technologies were compared.

There were differences in vascular types between gallbladder adenomas and cholesterol polyp lesions observed on H-CEUS (p < 0.05), while there were no differences in vascular types between gallbladder adenomas and cholesterol polyp lesions observed on CEUS (p > 0.05). In the cholesterol polyp lesion group, there were no differences in vascular types between CEUS and H-CEUS (p > 0.05), while the vascular types were different between CEUS and H-CEUS in the gallbladder adenoma group (p < 0.05). The diagnostic value of H-CEUS in distinguishing gallbladder adenUS helps patients with gallbladder polyp lesions to choose the appropriate treatment means.
To develop and validate a multiparametric MRI-based radiomics nomogram for pretreatment predicting the axillary sentinel lymph node (SLN) burden in early-stage breast cancer.

A total of 230 women with early-stage invasive breast cancer were retrospectively analyzed. A radiomics signature was constructed based on preoperative multiparametric MRI from the training dataset (n = 126) of center 1, then tested in the validation cohort (n = 42) from center 1 and an external test cohort (n = 62) from center 2. Multivariable logistic regression was applied to develop a radiomics nomogram incorporating radiomics signature and predictive clinical and radiological features. The radiomics nomogram's performance was evaluated by its discrimination, calibration, and clinical use and was compared with MRI-based descriptors of primary breast tumor.

The constructed radiomics nomogram incorporating radiomics signature and MRI-determined axillary lymph node (ALN) burden showed a good calibration and outperformed the MRI-deredicting of SLN burden in patients with early-stage breast cancer.
• Radiomics nomogram incorporating radiomics signature and MRI-determined ALN burden outperforms the MRI-determined ALN burden alone for predicting SLN burden in early-stage breast cancer. • Radiomics nomogram might have a better predictive ability than the MRI-based breast tumor combined descriptors. • Multiparametric MRI-based radiomics nomogram can be used as a non-invasive tool for preoperative predicting of SLN burden in patients with early-stage breast cancer.
To evaluate whether the change in computed tomography pulmonary angiography (CTPA) metrics after balloon pulmonary angioplasty (BPA) can predict treatment effect in chronic thromboembolic pulmonary hypertension (CTEPH) patients.

This study included 82 CTEPH patients who underwent both CTPA and right heart catheterization (RHC) before and at the scheduled time of 6 months after BPA. The diameters of the main pulmonary artery (dPA), ascending aorta (dAA), right atrium (dRA), right ventricular free wall thickness (dRVW), and right and left ventricles (dRV, dLV) were measured on CTPA. The correlation of the New York Heart Association functional class (NYHA FC), 6-minute walking distance (6MWD), brain natriuretic peptide (BNP) level, and calculated CT metrics with a decrease in mean pulmonary artery pressure (ΔmPAP) using RHC (used as the reference for BPA effect) was investigated. Using multiple regression analysis, independent variables were also identified.

In univariate analysis, clinical indicators (NYHre after balloon pulmonary angioplasty in CTEPH patients was significantly correlated with the clinical indices improvement and CTPA parameter decrease. • The decreased diameter of the main pulmonary artery and the decreased diameter of the right atrium on CTPA were independent predictors of mean pulmonary artery pressure reduction.
• Radiology has developed into a central and important part of patient care.• A combination of technological developments, increasing workload and radiologists' behaviour run the risk of diminishing the visibility of radiologists to referrers and patientsRadiology has developed into a central and important part of patient care.• It is vital for the successful future of radiology that we remain conscious of the need to maintain visibility of who we are and what we contribute to patient care.
• Radiology has developed into a central and important part of patient care.• A combination of technological developments, increasing workload and radiologists' behaviour run the risk of diminishing the visibility of radiologists to referrers and patientsRadiology has developed into a central and important part of patient care.• It is vital for the successful future of radiology that we remain conscious of the need to maintain visibility of who we are and what we contribute to patient care.
To develop and compare several machine learning models to predict occult cervical lymph node (LN) metastasis in early-stage oral tongue squamous cell cancer (OTSCC) from preoperative MRI texture features.

We retrospectively enrolled 116 patients with early-stage OTSCC (cT1-2N0) who had been surgically treated by tumor excision and elective neck dissection (END). For each patient, we extracted 86 texture features from T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (ceT1WI), respectively. Dimension reduction was performed in three consecutive steps reproducibility analysis, collinearity analysis, and information gain algorithm. Models were created using six machine learning methods, including logistic regression (LR), random forest (RF), naïve Bayes (NB), support vector machine (SVM), AdaBoost, and neural network (NN). Their performance was assessed using tenfold cross-validation.

Occult LN metastasis was pathologically detected in 42.2% (49/116) of the patients. No significant assoc predict occult cervical node metastasis in early-stage OTSCC with no evidence of node involvement on conventional images. • Six texture features from T2WI and ceT1WI of preoperative MRI were selected to construct the predictive model. • After comparing six machine learning methods, naïve Bayes (NB) achieved the best performance by correctly identifying the node status in 74.1% of the patients, using tenfold cross-validation.
To summarise the CT findings of gastric poorly cohesive carcinoma (PCC) in the 40s late arterial phase and differentiate it from tubular adenocarcinoma (TAC) using an integrative nomogram.

A total of 241 patients including 59 PCCs, 109 TACs, and 73 other type gastric cancers were enrolled. Thirteen CT morphological characteristics of each lesion in the late arterial phase were evaluated. In addition, CT value-related parameters were extracted from ROIs encompassing the area of greatest enhancement on four-phase CT images. CVT-313 clinical trial Nomograms based on regression models were built to discriminate PCCs from TACs and from non-PCCs. ROC curve analysis was performed to assess the diagnostic efficiency.

Six morphological characteristics, 10 CT value-related parameters, and the enhanced curve types differed significantly among the above three groups in the primary cohort (all p < 0.05). The paired comparison revealed that 10 CT value-related parameters differed significantly between PCCs and TACs (all p < 0.05). Thom TACs. • More useful information can be derived from 40s late arterial phase CT images; thus, a more accurate evaluation can be made in clinical practice.
• Multiple morphological characteristics and CT value-related parameters differed significantly between gastric PCCs and TACs in the 40 s late arterial phase. • The nomogram integrating morphological characteristics and CT value-related parameters in the 40 s late arterial phase had favourable performance in discriminating PCCs from TACs. • More useful information can be derived from 40 s late arterial phase CT images; thus, a more accurate evaluation can be made in clinical practice.
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