Imaging Features of Gastrointestinal Neoplasms Complicating Inflammatory Bowel Diseases.

Inflammatory bowel diseases (IBD) are chronic inflammatory diseases affecting the gastrointestinal (GI) tract. Patients with IBD, besides other non-neoplastic complications, are also at increased risk of GI malignancies such as colorectal cancer, small bowel adenocarcinoma and lymphoma. The principal purpose of imaging in patients with IBD to assess complications and to stage a clinically known cancer. In addition, the goal of imaging has expanded to include the diagnosis of GI malignancies in clinical situations where colonoscopy cannot be performed or is incomplete. In addition, imaging allows the detection of cancers in patients where the development of either disease-related or treatment-related neoplasia is clinically suspected. The purpose of this review is to present the different imaging techniques used to detect GI malignancies in IBD patients and describe the radiological appearances of GI malignancies in IBD patients.

Lead-Dust Contamination on Radiation Protection Apparel.

PURPOSE: To evaluate the prevalence of surface lead-dust contamination on radiation protection apparel (RPAs) in the radiology department and compare findings with those from other studies of RPA lead-dust contamination. MATERIALS AND METHODS: A survey of RPAs was conducted between June and December 2021 in radiology departments at a tertiary-care university hospital. A convenience sample of RPAs located on wall-mounted racks outside the angiography suite and emergency department was surveyed. Surface lead dust on RPAs was detected using a rapid qualitative test. RESULTS: A total of 69 RPAs included full-length frontal lead aprons (n = 11), full-length frontal lead aprons (n = 25) with thyroid collars (n = 25), and thyroid collars alone (n = 8). Garments consisted mainly of a lead/antimony composite core with a 0.5-mm lead equivalency. One RPA failed radiologic quality inspection, and 8 garments were in poor or worn condition. The overall prevalence of surface lead-dust contamination on RPAs was 60.9% (95% CI, 49.1%-71.5%) and was significantly (P = .0035) higher on thyroid collars (78.8% [95% CI, 62.2%-89.3%]) than on lead aprons (44.4% [95% CI, 29.5%-60.4%]). CONCLUSIONS: A high prevalence of surface lead-dust contamination was detected on RPAs using a rapid qualitative test. There is currently no established safe level of lead, and these findings suggest RPAs be monitored frequently not only for physical defects limiting radiation protection but also for lead-dust contamination.

Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study.

BACKGROUND: In rectal cancer surgery, larger mesorectal fat area has been shown to correlate with increased intraoperative difficulty. Prior studies were mostly in Asian populations with average body mass indices (BMIs) less than 25 kg/m2. This study aimed to define the relationship between radiological variables on pelvic magnetic resonance imaging (MRI) and intraoperative difficulty in a North American population. METHODS: This is a single-center retrospective cohort study analyzing all patients who underwent low anterior resection (LAR) or transanal total mesorectal excision (TaTME) for stage I-III rectal adenocarcinoma from January 2015 until December 2019. Eleven pelvic magnetic resonance imaging measures were defined a priori according to previous literature and measured in each of the included patients. Operative time in minutes and intraoperative blood loss in milliliters were utilized as the primary indicators of intraoperative difficulty. RESULTS: Eighty-three patients (39.8% female, mean age: 62.4 ± 11.6 years) met inclusion criteria. The mean BMI of included patients was 29.4 ± 6.2 kg/m2. Mean operative times were 227.2 ± 65.1 min and 340.6 ± 78.7 min for LARs and TaTMEs, respectively. On multivariable analysis including patient, tumor, and MRI factors, increasing posterior mesorectal thickness was significantly associated with increased operative time (p = 0.04). Every 1 cm increase in posterior mesorectal thickness correlated with a 26 min and 6 s increase in operative time. None of the MRI measurements correlated strongly with BMI. CONCLUSION: As the number of obese rectal cancer patients continues to expand, strategies aimed at optimizing their surgical management are paramount. While increasing BMI is an important preoperative risk factor, the present study identifies posterior mesorectal thickness on MRI as a reliable and easily measurable parameter to help predict operative difficulty. Ultimately, this may in turn serve as an indicator of which patients would benefit most from pre-operative resources aimed at optimizing operative conditions and postoperative recovery.

Antioxidants Taken Orally prior to Diagnostic Radiation Exposure Can Prevent DNA Injury.

PURPOSE: To evaluate efficacy of oral antioxidant treatment given to patients before radiologic procedures in reducing x-ray-induced DNA damage. MATERIALS AND METHODS: In a single-center prospective controlled trial, antioxidant treatment with 2 g ascorbate, 1.2 g N-acetylcysteine, 600 mg lipoic acid, and 30 mg beta carotene was given to 5 consecutive participants before undergoing clinically indicated technetium-99m methylene diphosphonate (99mTc MDP) bone scans for cancer staging. These participants were compared with 5 participants without antioxidant treatment. DNA damage was visualized in peripheral blood mononuclear cells (PBMCs) before and after bone scans using three-dimensional microscopy and fluorescently labeled gamma-H2AX protein. Wilcoxon rank sum test was used to determine whether there was a statistically significant difference in the radiation received between the control and antioxidant groups, the number of foci/cell before and after bone scan within groups, and foci/cell after bone scan between groups. RESULTS: There was a significantly higher number of gamma-H2AX foci/cell after ionization radiation in the control group compared with the antioxidant group (P = .009). There was no statistically significant difference in number of gamma-H2AX foci/cell before or after exposure in the antioxidant group; the number of gamma-H2AX foci/cell was statistically significantly higher (P = .009) in the control group after exposure to 99mTc MDP. CONCLUSIONS: In patients undergoing 99mTc MDP bone scans, treatment with oral antioxidants before scanning significantly prevented DNA damage in PBMCs. Antioxidants may provide an effective means to protect patients and health care professionals from radiation-induced DNA damage during imaging studies.

A study of inventiveness among Society of Interventional Radiology members and the impact of their social networks.

PURPOSE: To investigate the nature of inventiveness among members of the Society of Interventional Radiology (SIR) and learn what influenced the inventors and assisted their creativity. MATERIALS AND METHODS: The membership directory of the SIR was cross-referenced with filings at the United States Patent and Trademark Organization (USPTO) and the Patent Cooperation Treaty (PCT). The inventors were queried with an online survey to illuminate their institutions of training and practice as well as enabling or inhibiting factors to their inventiveness. Responses were analyzed through the construction of social network maps and thematic and graphical analysis. RESULTS: It was found that 457 members of the SIR held 2,492 patents or patent filings. After 1986, there was a marked and sustained increase in patent filings. The online survey was completed by 73 inventors holding 470 patents and patent filings. The social network maps show the key role of large academic interventional radiology departments and individual inventors in the formation of interconnectivity among inventors and the creation of the intellectual property (IP). Key inhibitors of the inventive process include lack of mentorship, of industry contacts, and of legal advice. Key enablers include mentorship, motivation, and industry contacts. CONCLUSIONS: Creativity and inventiveness in SIR members stem from institutions that are hubs of innovation and networks of key innovators; inventors are facilitated by personal motivation, mentorship, and strong industry contacts.

A literature review of findings in physical elder abuse.

PURPOSE: To review the medical literature for reports on the types of physical injuries in elder abuse with the aim of eliciting patterns that will aid its detection. MATERIALS AND METHODS: The databases of PubMed, CINAHL, EMBASE, and TRIP were searched from 1975 to March 2012 for articles that contained the following phrases: "physical elder abuse," "older adult abuse," "elder mistreatment," "geriatric abuse," "geriatric trauma," and "nonaccidental geriatric injury." Distribution and description of injuries in physical elder abuse from case-control studies, cross-sectional studies, case series, and case reports as seen at autopsy, in hospital emergency departments, or in medicolegal reports were tabulated and summarized. RESULTS: A review of 9 articles from a total of 574 articles screened yielded 839 injuries. The anatomic distribution in these was as follows: upper extremity, 43.98%; maxillofacial, dental, and neck, 22.88%; skull and brain, 12.28%; lower extremity, 10.61%; and torso, 10.25%. CONCLUSION: Two-thirds of injuries that occur in elder abuse are to the upper extremity and maxillofacial region. The social context in which the injuries takes place remains crucial to accurate identification of abuse. This includes a culture of violence in the family; a demented, debilitated, or depressed and socially isolated victim; and a perpetrator profile of mental illness, alcohol or drug abuse, or emotional and/or financial dependence on the victim.