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1.
Ultraschall Med ; 2024 Mar 21.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-38513687

RESUMO

Simulation-based training (SBT) is increasingly acknowledged worldwide and has become a popular tool for ultrasound education. Ultrasound simulation involves the use of technology and software to create a virtual training setting. Simulation-based training allows healthcare professionals to learn, practice, and improve their ultrasound imaging skills in a safe learning-based environment. SBT can provide a realistic and focused learning experience that creates a deep and immersive understanding of the complexity of ultrasound, including enhancing knowledge and confidence in specific areas of interest. Abdominal ultrasound simulation is a tool to increase patient safety and can be a cost-efficient training method. In this paper, we provide an overview of various types of abdominal ultrasound simulators, and the benefits, and challenges of SBT. We also provide examples of how to develop SBT programs and learning strategies including mastery learning. In conclusion, the growing demand for medical imaging increases the need for healthcare professionals to start using ultrasound simulators in order to keep up with the rising standards.

2.
Acta Radiol ; 64(5): 1765-1769, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36575645

RESUMO

BACKGROUND: Computed tomography (CT) is a widely used method for the staging of colon cancer. Accurate reports could lead to a better preoperative evaluation and planning of the treatment of colon cancer. PURPOSE: To evaluate the use of CT free-text reports and structured report templates when it comes to staging CT imaging of colon cancer. MATERIAL AND METHODS: A multiple choice questionnaire survey was conducted over four weeks. Online questionnaire software was used, and a link was shared to medical doctors with help from the Danish Colorectal Cancer Group (DCCG) and from a social media radiologist group. RESULTS: Clinicians preferred the template style (95%), whereas the level of support was lower among the radiologists (76%). All female responders preferred the template style, in contrast to only 84% of the male responders. Furthermore, the survey showed a slightly deficient level of the national CT reporting quality; only 7/13 questions and sub-questions, concerning CT report quality, achieved an approval rate >85%. The colorectal cancer multidisciplinary team consultants who always or usually work with template style reporting of CT scans of colon cancer tend to be more satisfied with the quality and content of the reports, compared to those who rarely use or read template reports. CONCLUSION: The following indicators were insufficiently reported: tumor invasion growth; number of hepatic metastases; segment location of hepatic metastasis; and retroperitoneal lymph node involvement. In the template reports group, nearly all participants found relevant information easily accessible.


Assuntos
Neoplasias do Colo , Neoplasias Hepáticas , Humanos , Masculino , Feminino , Neoplasias do Colo/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Radiologistas , Estadiamento de Neoplasias
3.
Orthod Craniofac Res ; 23(1): 102-109, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31550076

RESUMO

OBJECTIVE: To determine the influence of altered head or tongue posture on upper airway (UA) volumes using MRI imaging based on a new objective and validated UA evaluation protocol. SETTING AND SAMPLE POPULATION: One supine CBCT and five sagittal MRI scans were obtained from ten subjects in different head and tongue positions: (a) supine neutral head position (NHP) with the tongue in a natural resting position with the tip of the tongue in contact with the lingual aspect of the lower incisors (TRP); (b) head extension with TRP; (c) head flexion with TRP; (d) NHP with the tip of the tongue in contact with the posterior edge of the hard palate (THP); and (e) NHP with the tip of the tongue in contact with the floor of the mouth in contact with the caruncula sublingualis. MATERIAL AND METHODS: Based on a validated CBCT UA analysis, the retropalatal, oropharyngeal and the corresponding total volumes were measured from each MRI scan. Wilcoxon signed-rank test was applied to determine the statistically significant difference in mean volume between the baseline head and tongue posture (NHP with TRP) and the other postures. RESULTS: Five females and five males with a mean age of 46.5 ± 13.7 years volunteered for this pilot study. UA volumes, particularly the oropharyngeal volume, increased significantly with head extension and NHP with THP and decreased significantly with head flexion. CONCLUSION: Altered head and tongue posture proved to affect UA volumes, thus representing confounding variables during three-dimensional radiographic image acquisition.


Assuntos
Cabeça , Postura , Cefalometria , Feminino , Imageamento por Ressonância Magnética , Masculino , Faringe , Projetos Piloto , Língua
4.
Acta Radiol ; 60(4): 535-541, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29969051

RESUMO

BACKGROUND: Ultrasound elastography is increasingly available in clinical practice. Recent studies showed higher velocity stiffness in testicular tumors compared to normal testicles. PURPOSE: To evaluate ultrasound elastography in combination with the apparent diffusion coefficient measurements in diffusion weighted (DW) magnetic resonance imaging (MRI) in testicles. DW can be a useful tool in evaluating testicular malignancies. However, the relationship between velocity stiffness and MRI diffusion is not well established. MATERIAL AND METHODS: We prospectively included 132 patients with testicular microlithiasis (n = 53), or normal testicular tissue (n = 53), or suspected for testicular cancer (n = 26). All 132 patients underwent ultrasonography including shear wave elastography and MRI diffusion coefficient examination of the scrotum. RESULTS: No clinically relevant difference in velocity stiffness was found between normal and testicles with microlithiasis. There was a significant difference in stiffness between patients with testicular microlithiasis (0.78 m/s), normal testicular tissue (0.77 m/s), and patients with testicular cancer (1.95 m/s) ( P ≤ 0.001). Similarly, there was a statistically significant difference in MRI diffusion values between patients with testicular microlithiasis (0.978 × 10-3 mm2 s-1), normal testicular tissue (0.929 × 10-3 mm2 s-1), and testicular cancers (0.743 × 10-3 mm2 s-1) ( P < 0.01). CONCLUSION: Patients with testicular microlithiasis had no malignant characteristics measured with shear wave elastography or MRI diffusion. MRI diffusion and elastography may be useful to preoperatively differentiate benign from malignant testicular lesions.


Assuntos
Cálculos/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Técnicas de Imagem por Elasticidade/métodos , Doenças Testiculares/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Adulto , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Testículo/diagnóstico por imagem , Adulto Jovem
5.
World J Urol ; 35(10): 1489-1496, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28405762

RESUMO

PURPOSE: To correlate ureteral lesions visualized during ureteroscopy with histopathological findings. MATERIALS AND METHODS: Ureteral access sheaths (UAS) sized 13/15 Fr. were inserted bilaterally in 22 laboratory pigs. During retraction of the UAS with a semirigid ureteroscope inside, ureteral lesions were evaluated and registered using the Post-ureteroscopic lesion scale (PULS). Ureters were excised in vivo between the uretero-pelvic junction and the uretero-vesical junction. Embedded in paraffin, 4-µm thick sections were step sectioned at 250-300 µm intervals and haematoxylin and eosin (HE) stained. Histopathological scoring of ureteral wall lesions was subsequently performed according to PULS. RESULTS: In 72.1% of ureters, the highest histopathological score was at least 1 grade higher than the highest endoscopic PULS score. For 12 (27.9%) lesions, the difference was 2 scores higher, and for 1 (2.3%), it was 3 scores higher. The histopathological PULS grade was higher than the endoscopical PULS grade at all minimum, quartile, and maximum scores. There was a significant difference in the distribution of highest lesional scores between the endoscopic and histopathological PULS (p = 0.002). The calculated mean of the highest scores was 1.49 for endoscopic PULS and 2.51 for histopathological PULS (p < 0.0001). CONCLUSION: Histopathological evaluation of ureteral wall lesions after UAS placement revealed a significantly higher degree of severity than observed endoscopically. Thus, endoscopy underestimated the histopathological extent of the lesion in the majority of cases.


Assuntos
Ureter , Doenças Ureterais/diagnóstico , Ureteroscopia , Animais , Precisão da Medição Dimensional , Projetos de Pesquisa , Índice de Gravidade de Doença , Suínos , Ureter/diagnóstico por imagem , Ureter/patologia , Ureteroscópios , Ureteroscopia/instrumentação , Ureteroscopia/métodos
6.
Acta Radiol ; 57(6): 767-72, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26419255

RESUMO

BACKGROUND: Ultrasonography of the testis is a well-established diagnostic tool in detection of testicular microlithiasis (TML). Operator-dependent diagnostic variation related to skill, knowledge, and operator consistency are factors that influence detection of TML. PURPOSE: To determine inter- and intraobserver agreement for detection of TML using ultrasonography for a group of physicians with no or limited experience compared to a group of experience senior radiologists. MATERIAL AND METHODS: Between May and September 2014 a total of six observers evaluated 34 patients scrotal ultrasonography recorded from September to December 2013. The observers were blinded to patient history and previous ultrasonography. Three of the observers had no or limited experience with detection of TML, and three of the observers had more than 15 years of experience. Each observer reviewed all the scrotal ultrasonography recordings twice with a time interval of 3 months. RESULTS: The inter-observer agreement showed substantial agreement and up to almost perfect agreement (κ = 0.86). Both the experienced and less experienced observers had a higher agreement in detecting and grading TML in their second reading. CONCLUSION: The ultrasonography grading system of TML in this study showed to be reproducible, with an inter- and intraobserver agreement ranging between substantial agreement and up to almost perfect agreement with many years of experience not necessarily being essential.


Assuntos
Cálculos/diagnóstico por imagem , Doenças Testiculares/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador
7.
Diagnostics (Basel) ; 14(12)2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38928634

RESUMO

Ultrasound elastography is widely used to assess tissue stiffness for lesion characterization, including differentiation between benign and malignant lesions. This study focuses on the use of elastography in the male pelvis, including the prostate, testicles, and rectum, by comparing elastography types (shear wave and strain). This article provides a summary of the existing literature on the use of elastography in the male pelvic region and outlines the clinical perspective. Ultrasound elastography is a good technique for evaluating and monitoring lesions in the male pelvic region.

8.
J Imaging ; 10(3)2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38535146

RESUMO

This study aimed to test the accuracy of a magnetic resonance imaging (MRI)-based method to detect and characterise deep venous thrombosis (DVT) in the ilio-femoro-caval veins. Patients with verified DVT in the lower extremities with extension of the thrombi to the iliac veins, who were suitable for catheter-based venous thrombolysis, were included in this study. Before the intervention, magnetic resonance venography (MRV) was performed, and the ilio-femoro-caval veins were independently evaluated for normal appearance, stenosis, and occlusion by two single-blinded observers. The same procedure was used to evaluate digital subtraction phlebography (DSP), considered to be the gold standard, which made it possible to compare the results. A total of 123 patients were included for MRV and DSP, resulting in 246 image sets to be analysed. In total, 496 segments were analysed for occlusion, stenosis, or normal appearance. The highest sensitivity compared occlusion with either normal or stenosis (0.98) in MRV, while the lowest was found between stenosis and normal (0.84). Specificity varied from 0.59 (stenosis >< occlusion) to 0.94 (occlusion >< normal). The Kappa statistic was calculated as a measure of inter-observer agreement. The kappa value for MRV was 0.91 and for DSP, 0.80. In conclusion, MRV represents a sensitive method to analyse DVT in the pelvis veins with advantages such as no radiation and contrast and the possibility to investigate the anatomical relationship in the area.

9.
Radiol Case Rep ; 18(10): 3572-3576, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37577074

RESUMO

Testicular cancer is predominantly diagnosed in young men aged 15-35 years. However, there are some rare tumors such as spermatocytic tumors that are seen more often in the older male population. Spermatocytic tumors have previously been known as spermatocytic seminomas in the scientific literature. We report the cases of 2 patients aged 50 and 77 years both diagnosed with spermatocytic tumors. In this paper we will discuss the ultrasound and histopathology features of these tumors and review the literature of spermatocytic tumor cases.

10.
J Clin Imaging Sci ; 13: 39, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38205276

RESUMO

Objectives: Computed tomography (CT) of the wrist may be challenged, due to patients' inability to extend the arm for a "Superman pose" resulting in increased radiation dose due to scatter. Alternative positions and less dose administering modalities such as 3D Cone-beam CT (CBCT) and single-shot CT could be considered. This phantom study aimed to estimate scatter radiation dose in different phantom positions using helical and single-shot CT and 3D CBCT. Material and Methods: Wireless electronic dosimeters attached to the head and chest of an anthropomorphic phantom in various clinically relevant positions were used to measure scatter radiation. In helical CT, the following positions were used: Superman pose, semi-superman pose, wrist on the abdomen, and single-shot CT with the patient sitting in front of and behind the gantry. In 3D CBCT, the phantom was in a supine position with the arm extended laterally. Results: Helical CT using the Superman pose resulted in a total scattered radiation dose of 64.8 µGy. The highest total dose (269.7 µGy) was obtained with the wrist positioned on the abdomen while the lowest total dose was achieved in single-shot CT with the phantom sitting behind the gantry with the forearm placed inside the gantry (3.2 µGy). The total dose in 3D CBCT was 171.1 µGy. Conclusion: The commonly used semi-superman and wrist-on-abdomen positions in CT administer the highest scattered doses and should be avoided when either single-shot CT or 3D CBCT is available. Radiographers should carefully consider alternatives when a patient referred for wrist CT cannot comply with the Superman position.

11.
Cancers (Basel) ; 16(1)2023 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-38201571

RESUMO

PURPOSE: To assess the use of quantitative diffusion-weighted MRI (DW-MRI) as a diagnostic imaging biomarker in differentiating between benign colon adenoma, early, and advanced cancer of the colon, as well as predicting lymph node involvement, and finally comparing mucinous-producing colon cancer with adenomas and non-mucinous colon cancer. METHOD: Patients with a confirmed tumor on colonoscopy were eligible for inclusion in this study. Using a 3.0 Tesla MRI machine, the main tumor mean apparent diffusion coefficient (mADC) was obtained. Surgically resected tumor specimens served as an endpoint, except in mucinous colon cancers, which were classified based on T2 images. RESULTS: A total of 152 patients were included in the study population. The mean age was 71 years. A statistically significant mADC mean difference of -282 × 10-6 mm2/s [-419--144 95% CI, p < 0.001] was found between colon adenomas and early colon cancer, with an AUC of 0.80 [0.68-0.93 95% CI] and an optimal cut off value of 1018 × 10-6 mm2/s. Only a small statistically significant difference (p = 0.039) in mADC was found between benign tumors and mucinous colon cancer. We found no statistical difference in mADC mean values between early and advanced colon cancer, and between colon cancer with and without lymph node involvement. CONCLUSION: Quantitative DW-MRI is potentially useful for determining whether a colonic tumor is benign or malignant. Mucinous colon cancer shows less diffusion restriction when compared to non-mucinous colon cancer, a potential pitfall.

12.
J Med Imaging Radiat Sci ; 54(4): 692-698, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37838500

RESUMO

BACKGROUND: Ultrasonography measurement of the testicles and subsequent calculation of the testicular volume is recommended as a part of a standard scrotal ultrasound examination. The interobserver variability of testicular volume measurement has implications for surgical recommendations. Therefore, this study aimed to investigate the interobserver variability in the measurement of testicular volume. METHODS: Interobserver variability was established by comparing testicular measurements performed by two observers on the same patient during the same clinical appointment. The observers were blinded to each other's measurements. Testicular volume was calculated using the Lambert formula: length x width x height x 0.71. A total of three observers, A, B and C, participated in the study. The observers had between 4 to 20 years' experience with scrotal ultrasound examinations. RESULTS: In total, 24 patients' were included (48 testicles). The patient´s mean age was 43 years (range 19-75 years). The overall mean right testicular volume was 19.8 ml (range 7.3-31.6 ml), and the left was 20.1 ml (range 7.1-36.1 ml). The interclass correlation coefficient (ICC) between observer A and B was excellent (ICC= 0.98, CI:0.92-0.99), between observer A and C, was excellent (ICC=0.91, CI: 0.77-0.97) and between B and C good (ICC=0.82, CI:0.51-0.93). CONCLUSION: Variability in estimating testicular volume is low, with interobserver agreement ranging from good to excellent. Ultrasound provides a highly reproducible tool to determine testicular volume.


Assuntos
Testículo , Masculino , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Variações Dependentes do Observador , Ultrassonografia , Testículo/diagnóstico por imagem
13.
Healthcare (Basel) ; 11(20)2023 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-37893809

RESUMO

(1) Background: This study aims to comprehensively understand the motivations driving radiographers in five Arab countries to engage in research. (2) Methods: A cross-sectional study employing an anonymous online survey was conducted for 12 weeks from May to July 2023. The study sample consisted of 250 radiographers, with equal representation from Iraq, the Kingdom of Saudi Arabia, Palestine, Sudan, and the United Arab Emirates. (3) Results: Overall, the participants showed limited involvement in research-related activities in all five countries, particularly in presenting at conferences and publishing in peer-reviewed journals. Most participants believed research positively impacts their professional development (34.8%) and patient care and outcomes (40%). The participants perceived professional development (36.4%) as a key motivator for research engagement. A significant majority (81.6%) expressed motivation to start research in clinical practice. A total of 66.8% found research opportunities available during clinical practice. Barriers included time constraints (56%), limited resources (47.2%), and lack of support and skills (33.2% and 32%, respectively). (4) Conclusion: This study emphasises the need for targeted strategies to enhance research engagement among radiographers in the Arab region. Addressing barriers, such as time constraints and resource limitations, while leveraging intrinsic motivators, such as professional development, is crucial for fostering a culture of research-driven excellence in radiography.

14.
Endosc Ultrasound ; 12(1): 38-49, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36629173

RESUMO

Simulation has been shown to improve clinical learning outcomes, speed up the learning process and improve learner confidence, whilst initially taking pressure off busy clinical lists. The World Federation for Ultrasound in Medicine and Biology (WFUMB) state of the art paper on the use of simulators in ultrasound education introduces ultrasound simulation, its advantages and challenges. It describes different simulator types, including low and high-fidelity simulators, the requirements and technical aspects of simulators, followed by the clinical applications of ultrasound simulation. The paper discusses the role of ultrasound simulation in ultrasound clinical training, referencing established literature. Requirements for successful ultrasound simulation acceptance into educational structures are explored. Despite being in its infancy, ultrasound simulation already offers a wide range of training opportunities and likely holds the key to a broader point of care ultrasound education for medical students, practicing doctors, and other health care professionals. Despite the drawbacks of simulation, there are also many advantages, which are expanding rapidly as the technology evolves.

15.
Endosc Ultrasound ; 12(3): 311-318, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37693111

RESUMO

Simulation has been shown to improve clinical learning outcomes, speed up the learning process, and improve trainee confidence, while taking the pressure off initial face-to-face patient clinical areas. The second part of The World Federation for Ultrasound in Medicine and Biology state-of-the-art paper on the use of simulators provides a general approach on the practical implementation. The importance of needs assessment before developing a simulation-based training program is outlined. We describe the current practical implementation and critically analyze how simulators can be integrated into complex task scenarios to train small or large groups. A wide range of simulation equipment is available especially for those seeking interventional ultrasound training, ranging from animal tissue models, simple synthetic phantoms, to sophisticated high-fidelity simulation platforms using virtual reality. Virtual reality simulators provide feedback and thereby allow trainees to not only to practice their motor skills and hand eye coordination but also to interact with the simulator. Future developments will integrate more elements of automated assessment and artificial intelligence, thereby enabling enhanced realistic training experience and improving skill transfer into clinical practice.

16.
Cancers (Basel) ; 14(11)2022 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-35681783

RESUMO

Background: Colorectal cancer is the second most common cancer worldwide. The sigmoid takeoff is the landmark where the colon sigmoid curves toward the sacrum viewed from sagittal magnetic resonance imaging (MRI). The purpose of this study was to assess interobserver variability in the assessment of the anal verge and anorectal junction in patients diagnosed with rectal cancer on magnetic resonance imaging (MRI). Materials and Methods: The rectal MRI examinations were performed using a 1.5- or 3.0-tesla unit using an anterior coil and a standard scan protocol. Two senior radiologists assessed MRI scans from patients under investigation for rectal cancer. The two observers assessed the anal verge and takeoff in cm independently. Difference in agreement between the observers were evaluated using intraclass correlation (ICC) and graphically by Bland-Altman plots. Results: The study population (n = 122) included 68 (55.7%) female and 54 (44.3%) male subjects. The overall median age was 69.5 years (range 39-95 years). There was perfect agreement between the two observers when defining rectal tumor above or below the takeoff landmark. The reliability of measuring the distance from the anal verge to the sigmoid takeoff was 0.712. Conclusion: Overall, the study found a moderate reliability in assessing the location of the sigmoid takeoff, with a low difference in the distance measuring, as well as a good consensus concerning the determination of tumors in relation to the sigmoid takeoff. Routine implementation of this information within the report seems reasonable.

17.
Curr Oncol ; 29(2): 837-847, 2022 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-35200570

RESUMO

In general, magnetic resonance (MR) diffusion-weighted imaging (DWI) has shown potential in clinical settings. In testicles parenchyma, the DW imaging helps differentiate and characterize benign from malignant lesions. Placement and size of the region of interest (ROI) may affect the ADC value. Therefore, the aim of this study was to investigate the intra- and interobserver variability in testicular tumors when measuring ADC using various types of regions of interest (ROI). Two observers performed the ADC measurements in testicular lesions based on three ROI methods: (1) whole volume, (2) round, and (3) small sample groups. Intra- and interobserver variability was analyzed for all ROI methods using intraclass correlation coefficients (ICC) and bland-altman plots. The two observers performed the measurements twice, three months apart. A total of 26 malignant testicle tumors were included. Interobserver agreement was excellent in tumor length (ICC = 0.98) and tumor width (ICC = 0.98). In addition, intraobserver agreement was excellent in tumor length (ICC = 0.98) and tumor width (ICC = 0.99). The whole volume interobserver agreement in the first reading was excellent (ICC = 0.93). Round ADC had an excellent (ICC = 0.93) and fair (ICC = 0.58) interobserver agreement, in the first and second reading, respectively. Interobserver agreement in ADC small ROIs was good (ICC = 0.87), and good (ICC = 0.78), in the first and second reading, respectively. Intraobserver agreement varied from fair, good to excellent agreement. The ROI method showed varying inter- and intraobserver agreement in ADC measurement. Using multiple small ROI conceded the highest interobserver variability, and, thus, the whole volume or round seem to be the preferable methods.


Assuntos
Imagem de Difusão por Ressonância Magnética , Neoplasias Testiculares , Imagem de Difusão por Ressonância Magnética/métodos , Humanos , Imageamento por Ressonância Magnética , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Neoplasias Testiculares/diagnóstico por imagem
18.
Diagnostics (Basel) ; 12(9)2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36140566

RESUMO

Purpose: To investigate the diagnostic performance of endorectal ultrasound (ERUS), shear-wave elastography (SWE), and magnetic resonance imaging (MRI) in patients with a complex rectal adenoma or an early rectal cancer, i.e., T1 or T2 adenocarcinoma in a clinical setting, and to evaluate the association between SWE and stromal fraction (SF) and apparent diffusion coefficient (ADC) and SF. Method: This prospective study included patients undergoing ERUS and SWE for a rectal tumor subsequently confirmed by histopathology to be an adenoma or a T1 or T2 adenocarcinoma. The accuracy of the imaging methods was assessed by comparing the T category as determined by ERUS and MRI with histopathology, which served as the gold standard. SF was assessed on surgical specimens. Results: A total of 86 patients were included. Of these, 62 patients had adenomas and 24 patients had carcinomas, of which 11 were T1 tumors and 13 were T2 tumors. ERUS and MRI yielded sensitivity, specificity, and accuracy of 0.79 and 0.73, 0.95 and 0.90, and 0.86 and 0.78, respectively, for discrimination between benign and malignant lesions. The area under the receiver operating characteristics curve for SWE was 0.88, and with a cut-off value of 40 kPa the sensitivity, specificity, and accuracy were 0.79, 0.89, and 0.86, respectively. There was a positive correlation between SF and SWE with a p-value of <0.001 and a negative correlation between SF and ADC with a p-value of 0.011. Conclusion: Both ERUS and MRI classified T categories with a high accuracy; however, ERUS classified more adenomas correctly than MRI. In this small population, SWE could differentiate an adenoma from early carcinoma. SF was correlated with both SWE and ADC, as increasing SF tended to yield higher SWE and lower ADC values.

19.
Cancers (Basel) ; 14(11)2022 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-35681613

RESUMO

BACKGROUND: Endorectal ultrasound (ERUS) is an important tool when evaluating complex rectal adenomas and rectal cancer, and the accuracy is improved by adding elastography measurements. A high interobserver agreement is imperative in clinical practice. Therefore, the aim of this study was to evaluate interobserver agreement assessed on real-time images. Additionally, we investigated the intra- and interobserver agreement between experienced and inexperienced observers. MATERIALS AND METHODS: We prospectively included patients referred to an ERUS at the Department of Radiology with a complex rectal polyp or suspected rectal malignancy. Two operators independently scanned each patient in turn. Furthermore, four observers assessed previously obtained images using three different methods for placing the region of interest (ROI). Three months later, the four observers reassessed the images to assess intraobserver variability. RESULTS: A total of 19 patients were included for live assessment. Agreement of tumor classification was substantial for T stage (kappa: 0.86) and fair for N stage (kappa: 0.73), with an absolute agreement for T and N stages of 84% and 89%, respectively. Agreement of SWE was good for Emean (ICC 0.94, 95% CI 0.86-0.98) and fair for Emax (ICC 0.85, 95% CI 0.66-0.94). Intra- and interobserver agreement between inexperienced and experienced observers showed good to excellent agreement with all ROI methods. CONCLUSION: Interobserver agreement is high in SWE when performed in a clinical setting. We found the best agreement using the mean value of several ROIs. Intra- and interobserver agreement was high regardless of operator experience.

20.
Curr Oncol ; 29(2): 1069-1079, 2022 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-35200590

RESUMO

(1) Background: Computer tomography (CT) scanning is currently the standard method for staging of colon cancer; however, the CT based preoperative local staging is far from optimal. The purpose of this study was to investigate the sensitivity and specificity of magnetic resonance imaging (MRI) compared to CT in the T- and N-staging of colon cancer. (2) Methods: Patients underwent a standard contrast-enhanced CT examination. For the abdominal MRI scan, a 3 Tesla unit was used, including diffusion weighted imaging (DWI). Experienced radiologists reported the CT and MRI scans blinded to each other and the endpoint of the pathological report. (3) Results: From 2018 to 2021, 134 patients received CT and MRI scans. CT identified 118 of the 134 tumors, whereas MRI identified all tumors. For discriminating between stage T3ab and T3cd, the sensitivity of CT was 51.1% and of MRI 80.0% (p = 0.02). CT and MRI showed a sensitivity of 21.4% and 46.4% in detecting pT4 tumors and a specificity of 79.0% and 85.0%, respectively. (4) Conclusion: Compared to CT, the sensitivity of MRI was statistically significantly higher in staging advanced T3cd and T4 tumors. MRI has the potential to be used in the treatment planning of colon cancer.


Assuntos
Neoplasias do Colo , Imageamento por Ressonância Magnética , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/patologia , Computadores , Humanos , Imageamento por Ressonância Magnética/métodos , Estadiamento de Neoplasias , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodos
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