BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with ...BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with the conventional energyintegrating detector CT.AIM To evaluate PCD CT in oncologic imaging,focusing on its role in tumor detection,staging,and treatment response assessment.METHODS We performed a systematic PubMed search from January 1,2017 to December 31,2024,using the keywords“photon-counting CT”,“cancer”,and“tumor”to identify studies on its use in oncologic imaging.We included experimental studies on humans or human phantoms and excluded reviews,commentaries,editorials,non-English,animal,and non-experimental studies.Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Out of 175 initial studies,39 met the inclusion criteria after screening and full-text review.Data extraction focused on study type,country of origin,and oncologic applications of photon-counting CT.No formal risk of bias assessment was performed,and the review was not registered in PROSPERO as it did not include a meta-analysis.RESULTS Key findings highlighted the advantages of PCD CT in imaging renal masses,adrenal adenomas,ovarian cancer,breast cancer,prostate cancer,pancreatic tumors,hepatocellular carcinoma,metastases,multiple myeloma,and lung cancer.Additionally,PCD CT has demonstrated improved lesion characterization and enhanced diagnostic accuracy in oncology.Despite its promising capabilities challenges related to data processing,storage,and accessibility remain.CONCLUSION As PCD CT technology evolves,its integration into routine oncologic imaging has the potential to significantly enhance cancer diagnosis and patient management.展开更多
BACKGROUND Cutaneous melanoma is an aggressive skin cancer with high metastatic potential.Accurate staging is critical to guide therapeutic strategies and improve prognosis.Whole-body magnetic resonance imaging(WB-MRI...BACKGROUND Cutaneous melanoma is an aggressive skin cancer with high metastatic potential.Accurate staging is critical to guide therapeutic strategies and improve prognosis.Whole-body magnetic resonance imaging(WB-MRI),particularly when combined with diffusion-weighted imaging(DWI),has emerged as promising tool for comprehensive,radiation-free assessment of metastatic spread.AIM To systematically review the diagnostic performance and clinical utility of WBMRI in the staging and restaging of cutaneous melanoma,with comparison to conventional imaging modalities such as computed tomography(CT)and positron emission tomography/CT(PET/CT).METHODS A systematic literature review was conducted using PubMed,Embase,Scopus and Web of Science databases for studies published in the last 10 years.Inclusion criteria focused on comparative diagnostic accuracy studies of WB-MRI vs CT and PET/CT for melanoma staging.The methodological quality of the studies was appraised using the QUADAS-2 tool.RESULTS Sixteen studies involving over 700 patients met the inclusion criteria.WB-MRI showed high sensitivity(73%-90%)and specificity(up to 98%)in detecting metastases,particularly in bone,liver and soft tissue.DWI enhanced lesion detection,and WB-MRI often influenced clinical management decisions.However,CT outperformed WB-MRI in identifying small pulmonary nodules.AI-assisted analysis and contrastenhanced sequences further improved diagnostic confidence.CONCLUSION WB-MRI represents a robust imaging modality for staging cutaneous melanoma,offering superior soft-tissue contrast and functional imaging without ionizing radiation.Its strengths lie in detecting bone,liver and brain metastases.Challenges include limited lung lesion detection,cost,and availability.Advances in artificial intelligence,Hybrid PET/MRY systems,and radiomics are poised to expand WB-MRI’s role in personalized melanoma management.展开更多
Medical imaging, such as computed tomography （CT）, magnetic resonance imaging （MRI） and positron emissiontomography （PET）, plays a vital role for the decision-making in oncologic management. In clinical practice...Medical imaging, such as computed tomography （CT）, magnetic resonance imaging （MRI） and positron emissiontomography （PET）, plays a vital role for the decision-making in oncologic management. In clinical practice, imaging-derivedtumor metrics are routinely applied in oncologic management as an imaging biomarker. For example, the ResponseEvaluation Criteria in Solid Tumors （RECIST） are commonly used for tumor treatment response evaluation based on thedynamic changes in tumor size. However, the current cross-sectional images are interpreted qualitatively for lesioncharacterization, treatment response evaluation and prognostic prediction by highly trained radiologists, which hasincreasingly apparent limitations. Therefore, there is a demanding shift toward more quantitative imaging interpretation.展开更多
In this editorial,we comment on the article by Lambert et al,published in the recent issue of the World Journal of Radiology.The focus of the editorial is to explore the advancements in whole-body magnetic resonance i...In this editorial,we comment on the article by Lambert et al,published in the recent issue of the World Journal of Radiology.The focus of the editorial is to explore the advancements in whole-body magnetic resonance imaging(WB-MRI)techno-logy,its current clinical applications,and the challenges that must be addressed to fully realize its potential in oncological imaging.WB-MRI has emerged as a pivotal tool in oncological imaging,offering comprehensive disease assessment without ionizing radiation.Its applications span the detection of bone metastases,evaluation of hematologic malignancies,and staging of a wide range of cancers,including lymphoma,prostate,and breast cancers.Advanced techniques such as diffusion-weighted imaging have enhanced its diagnostic performance by pro-viding superior lesion-to-background contrast and quantitative metrics.Despite its diagnostic strengths,WB-MRI faces challenges in standardization,patient acceptance,and integration into clinical workflows.Variability in acquisition pro-tocols,hardware differences,and patient-related factors,such as anxiety and motion artifacts,have limited widespread adoption.Emerging guidelines like MET-RADS-P and ONCO-RADS aim to address these issues by promoting stan-dardized protocols tailored to specific clinical needs.This editorial explores the advancements in WB-MRI technology,its current clinical applications,and the barriers that must be overcome to maximize its utility.By addressing these cha-llenges and embracing standardization,WB-MRI holds the potential to redefine the landscape of oncological imaging,aligning diagnostic precision with modern treatment goals of reducing long-term patient risk.展开更多
AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients...AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point scale.RESULTS Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P < 0.001), as SD values in liver and spleen(liver 16.81 vs 14.41). Volumetric-Computed-Tomographic-Dose-Index(CTDIvol) and Dose-Length-Product(DLP) were significantly lower in low-dose CT as compared to standard-dose(DLP 1025.6 m Gy*cm vs 1429.2 m Gy*cm, P < 0.001) with overall dose reduction of 28.9%. Qualitative analysis did not reveal significant differences in image noise and diagnostic quality.CONCLUSION Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.展开更多
AIM： To evaluate in a multicenter study whether the sonographic characterization of focal liver lesions can be improved using SonoVue-enhancement; and to compare this method with computed tomography （CT） and magnet...AIM： To evaluate in a multicenter study whether the sonographic characterization of focal liver lesions can be improved using SonoVue-enhancement; and to compare this method with computed tomography （CT） and magnetic resonance imaging （MRI）. METHODS： One hundred and thirty four patients withone focal liver lesion detected in baseline ultrasound （US） were examined with conventional US, contrastenhanced US （n = 134）, contrast-enhanced CT （n = 115） and/or dynamic contrast-enhanced MRI （n = 70）. The lesions were classified as malignant, benign or indeterminate and the type of lesion was determined. The final diagnosis based on the combined information of all imaging examinations, clinical information and histology （n = 32） was used. Comparisons were made to see whether the addition of contrast-enhanced US led to the improvement of the characterization of doubtful focal liver lesions.RESULTS： In comparison with unenhanced US, SonoVue markedly improves sensitivity and specificity for the characterization （malignant/benign） of focal liver lesions. In comparison with CT and/or dynamic MRI, SonoVue -enhanced sonography applied for characterization of focal liver lesions was 30.2% more sensitive in the recognition of malignancy and 16.1% more specific in the exclusion of malignancy and overall 22.9% more accurate. In the subgroup with confirmative histology available （n = 30）, sensitivity was 95.5% （CEUS）, 72.2% （CT） and 81.8% （MRI）, and specificity was 75.0% （CEUS）, 37.5% （CT） and 42.9% （MRI）. The sensitivity and specificity of CEUS for the identification of focal nodular hyperplasia （FNH） and hemangiomas was 100% and 87%, resulting in an accuracy of 94.5%.CONCLUSION： SonoVue-enhanced sonography emerges as the most sensitive, ost specific and thus most accurate imaging modality for the characterization of focal liver lesions.展开更多
The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without...The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.展开更多
Hepatocellular carcinoma(HCC)continues to be a diagnostic and therapeutic challenge for healthcare systems around the world in addition to being a significant contributor to oncologic mortality.To improve the standard...Hepatocellular carcinoma(HCC)continues to be a diagnostic and therapeutic challenge for healthcare systems around the world in addition to being a significant contributor to oncologic mortality.To improve the standard of life and the survival of patients,early diagnosis of the condition and subsequent appropriate treatment are essential.Hepatocellular carcinoma(HCC)observation,early detection,diagnosis,and follow-up all depend heavily on imaging modalities.They provide valuable information about the characteristics of HCC nodules,aiding in non-invasive diagnosis and staging.Imaging has evolved beyond simply confirming a suspected diagnosis in the management of hepatocellular carcinoma(HCC).Several traditional imaging modalities,including PET/CT,MRI,MR elastography,ultrasound(US),and endoscopy,along with next-generation imaging modalities such as photoacoustic imaging,and Cerenkov luminescence with the utilization of contrasting agents further enhance their diagnostic capabilities in HCC.The selection of the most appropriate imaging modality and contrasting agent depends on various factors,including the clinical scenario,patient characteristics,and availability of resources.In addition to these advancements,artificial intelligence(AI)has developed as a valuable tool in radiology for the management of HCC.In this review,we highlighted the most important imaging techniques for managing patients with a high risk of HCC.展开更多
Background The specificity and precision of lymphadenopathy assessment using US, CT and MRI are generally unsatisfactory, while fluorodeoxyglucose-positron emission tomography/computed tomography （18F-FDG PET/CT） ca...Background The specificity and precision of lymphadenopathy assessment using US, CT and MRI are generally unsatisfactory, while fluorodeoxyglucose-positron emission tomography/computed tomography （18F-FDG PET/CT） can support this process by providing additional information about the lymph node features. However, which image features of 18F-FDG PET/CT play the key role in the diagnosis and cutoffs of malignant cervical lymphadenopathy still needs to be determined by further studies. Our study aimed to identify 18F-FDG PET/CT abnormalities that would assist in making a reliable diagnosis of malignant cervical lymphadenopathy in enlarged cervical lymph nodes of patients with unknown primary diseases. Methods One hundred and ninety-one consecutive patients of cervical lymphadenopathy with unknown primary causes were examined by 18F-FDG PET/CT from May 2007 to October 2011 and a definite diagnosis was established by pathologic biopsy. 18F-FDG PET/CT images were evaluated to identify the relevant abnormalities. All image features were analyzed by optimal scale regression tests to determine the important factors that were predictive for the diagnosis of malignant cervical lymphadenopathy and the cutoffs. Results The factors studied in 18F-FDG PET/CT images for predicting malignant cervical lymphadenopathy were sex, age, node location, size, shape, margins, maximum standard uptake value （SUV）, mean SUV, FDG uptake pattern and number of nodes. It was found that mean SUV, maximum SUV, FDG uptake pattern, location, size and margins were the important risk factors of cervical lymph nodes that could predict malignant cervical lymphadenopathy. Signs of mean SUV〉2.5 （or maximum SUV〉3.5）, nodular FDG uptake pattern, location of IIA, III, IV, VB, VI and VII regions, size〉1.5 cm and vague margins had their optimal diagnostic accuracy （Ac） and Youden index （YI）, further, combination of any three factors of these six important risk factors would led to the best diagnosticAc of 96% and YI of 0.93. Conclusions Signs of mean SUV, maximum SUV, FDG uptake pattern, location, size and margins of node in ~SF-FDG PET/CT imaging are important predictive factors of malignant cervical lymphadenopathy. A combination of multiple factors may yield a higher diagnostic efficacy.展开更多
文摘BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with the conventional energyintegrating detector CT.AIM To evaluate PCD CT in oncologic imaging,focusing on its role in tumor detection,staging,and treatment response assessment.METHODS We performed a systematic PubMed search from January 1,2017 to December 31,2024,using the keywords“photon-counting CT”,“cancer”,and“tumor”to identify studies on its use in oncologic imaging.We included experimental studies on humans or human phantoms and excluded reviews,commentaries,editorials,non-English,animal,and non-experimental studies.Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Out of 175 initial studies,39 met the inclusion criteria after screening and full-text review.Data extraction focused on study type,country of origin,and oncologic applications of photon-counting CT.No formal risk of bias assessment was performed,and the review was not registered in PROSPERO as it did not include a meta-analysis.RESULTS Key findings highlighted the advantages of PCD CT in imaging renal masses,adrenal adenomas,ovarian cancer,breast cancer,prostate cancer,pancreatic tumors,hepatocellular carcinoma,metastases,multiple myeloma,and lung cancer.Additionally,PCD CT has demonstrated improved lesion characterization and enhanced diagnostic accuracy in oncology.Despite its promising capabilities challenges related to data processing,storage,and accessibility remain.CONCLUSION As PCD CT technology evolves,its integration into routine oncologic imaging has the potential to significantly enhance cancer diagnosis and patient management.
文摘BACKGROUND Cutaneous melanoma is an aggressive skin cancer with high metastatic potential.Accurate staging is critical to guide therapeutic strategies and improve prognosis.Whole-body magnetic resonance imaging(WB-MRI),particularly when combined with diffusion-weighted imaging(DWI),has emerged as promising tool for comprehensive,radiation-free assessment of metastatic spread.AIM To systematically review the diagnostic performance and clinical utility of WBMRI in the staging and restaging of cutaneous melanoma,with comparison to conventional imaging modalities such as computed tomography(CT)and positron emission tomography/CT(PET/CT).METHODS A systematic literature review was conducted using PubMed,Embase,Scopus and Web of Science databases for studies published in the last 10 years.Inclusion criteria focused on comparative diagnostic accuracy studies of WB-MRI vs CT and PET/CT for melanoma staging.The methodological quality of the studies was appraised using the QUADAS-2 tool.RESULTS Sixteen studies involving over 700 patients met the inclusion criteria.WB-MRI showed high sensitivity(73%-90%)and specificity(up to 98%)in detecting metastases,particularly in bone,liver and soft tissue.DWI enhanced lesion detection,and WB-MRI often influenced clinical management decisions.However,CT outperformed WB-MRI in identifying small pulmonary nodules.AI-assisted analysis and contrastenhanced sequences further improved diagnostic confidence.CONCLUSION WB-MRI represents a robust imaging modality for staging cutaneous melanoma,offering superior soft-tissue contrast and functional imaging without ionizing radiation.Its strengths lie in detecting bone,liver and brain metastases.Challenges include limited lung lesion detection,cost,and availability.Advances in artificial intelligence,Hybrid PET/MRY systems,and radiomics are poised to expand WB-MRI’s role in personalized melanoma management.
文摘Medical imaging, such as computed tomography （CT）, magnetic resonance imaging （MRI） and positron emissiontomography （PET）, plays a vital role for the decision-making in oncologic management. In clinical practice, imaging-derivedtumor metrics are routinely applied in oncologic management as an imaging biomarker. For example, the ResponseEvaluation Criteria in Solid Tumors （RECIST） are commonly used for tumor treatment response evaluation based on thedynamic changes in tumor size. However, the current cross-sectional images are interpreted qualitatively for lesioncharacterization, treatment response evaluation and prognostic prediction by highly trained radiologists, which hasincreasingly apparent limitations. Therefore, there is a demanding shift toward more quantitative imaging interpretation.
文摘In this editorial,we comment on the article by Lambert et al,published in the recent issue of the World Journal of Radiology.The focus of the editorial is to explore the advancements in whole-body magnetic resonance imaging(WB-MRI)techno-logy,its current clinical applications,and the challenges that must be addressed to fully realize its potential in oncological imaging.WB-MRI has emerged as a pivotal tool in oncological imaging,offering comprehensive disease assessment without ionizing radiation.Its applications span the detection of bone metastases,evaluation of hematologic malignancies,and staging of a wide range of cancers,including lymphoma,prostate,and breast cancers.Advanced techniques such as diffusion-weighted imaging have enhanced its diagnostic performance by pro-viding superior lesion-to-background contrast and quantitative metrics.Despite its diagnostic strengths,WB-MRI faces challenges in standardization,patient acceptance,and integration into clinical workflows.Variability in acquisition pro-tocols,hardware differences,and patient-related factors,such as anxiety and motion artifacts,have limited widespread adoption.Emerging guidelines like MET-RADS-P and ONCO-RADS aim to address these issues by promoting stan-dardized protocols tailored to specific clinical needs.This editorial explores the advancements in WB-MRI technology,its current clinical applications,and the barriers that must be overcome to maximize its utility.By addressing these cha-llenges and embracing standardization,WB-MRI holds the potential to redefine the landscape of oncological imaging,aligning diagnostic precision with modern treatment goals of reducing long-term patient risk.
文摘AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point scale.RESULTS Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P < 0.001), as SD values in liver and spleen(liver 16.81 vs 14.41). Volumetric-Computed-Tomographic-Dose-Index(CTDIvol) and Dose-Length-Product(DLP) were significantly lower in low-dose CT as compared to standard-dose(DLP 1025.6 m Gy*cm vs 1429.2 m Gy*cm, P < 0.001) with overall dose reduction of 28.9%. Qualitative analysis did not reveal significant differences in image noise and diagnostic quality.CONCLUSION Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.
文摘AIM： To evaluate in a multicenter study whether the sonographic characterization of focal liver lesions can be improved using SonoVue-enhancement; and to compare this method with computed tomography （CT） and magnetic resonance imaging （MRI）. METHODS： One hundred and thirty four patients withone focal liver lesion detected in baseline ultrasound （US） were examined with conventional US, contrastenhanced US （n = 134）, contrast-enhanced CT （n = 115） and/or dynamic contrast-enhanced MRI （n = 70）. The lesions were classified as malignant, benign or indeterminate and the type of lesion was determined. The final diagnosis based on the combined information of all imaging examinations, clinical information and histology （n = 32） was used. Comparisons were made to see whether the addition of contrast-enhanced US led to the improvement of the characterization of doubtful focal liver lesions.RESULTS： In comparison with unenhanced US, SonoVue markedly improves sensitivity and specificity for the characterization （malignant/benign） of focal liver lesions. In comparison with CT and/or dynamic MRI, SonoVue -enhanced sonography applied for characterization of focal liver lesions was 30.2% more sensitive in the recognition of malignancy and 16.1% more specific in the exclusion of malignancy and overall 22.9% more accurate. In the subgroup with confirmative histology available （n = 30）, sensitivity was 95.5% （CEUS）, 72.2% （CT） and 81.8% （MRI）, and specificity was 75.0% （CEUS）, 37.5% （CT） and 42.9% （MRI）. The sensitivity and specificity of CEUS for the identification of focal nodular hyperplasia （FNH） and hemangiomas was 100% and 87%, resulting in an accuracy of 94.5%.CONCLUSION： SonoVue-enhanced sonography emerges as the most sensitive, ost specific and thus most accurate imaging modality for the characterization of focal liver lesions.
文摘The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.
文摘Hepatocellular carcinoma(HCC)continues to be a diagnostic and therapeutic challenge for healthcare systems around the world in addition to being a significant contributor to oncologic mortality.To improve the standard of life and the survival of patients,early diagnosis of the condition and subsequent appropriate treatment are essential.Hepatocellular carcinoma(HCC)observation,early detection,diagnosis,and follow-up all depend heavily on imaging modalities.They provide valuable information about the characteristics of HCC nodules,aiding in non-invasive diagnosis and staging.Imaging has evolved beyond simply confirming a suspected diagnosis in the management of hepatocellular carcinoma(HCC).Several traditional imaging modalities,including PET/CT,MRI,MR elastography,ultrasound(US),and endoscopy,along with next-generation imaging modalities such as photoacoustic imaging,and Cerenkov luminescence with the utilization of contrasting agents further enhance their diagnostic capabilities in HCC.The selection of the most appropriate imaging modality and contrasting agent depends on various factors,including the clinical scenario,patient characteristics,and availability of resources.In addition to these advancements,artificial intelligence(AI)has developed as a valuable tool in radiology for the management of HCC.In this review,we highlighted the most important imaging techniques for managing patients with a high risk of HCC.
文摘Background The specificity and precision of lymphadenopathy assessment using US, CT and MRI are generally unsatisfactory, while fluorodeoxyglucose-positron emission tomography/computed tomography （18F-FDG PET/CT） can support this process by providing additional information about the lymph node features. However, which image features of 18F-FDG PET/CT play the key role in the diagnosis and cutoffs of malignant cervical lymphadenopathy still needs to be determined by further studies. Our study aimed to identify 18F-FDG PET/CT abnormalities that would assist in making a reliable diagnosis of malignant cervical lymphadenopathy in enlarged cervical lymph nodes of patients with unknown primary diseases. Methods One hundred and ninety-one consecutive patients of cervical lymphadenopathy with unknown primary causes were examined by 18F-FDG PET/CT from May 2007 to October 2011 and a definite diagnosis was established by pathologic biopsy. 18F-FDG PET/CT images were evaluated to identify the relevant abnormalities. All image features were analyzed by optimal scale regression tests to determine the important factors that were predictive for the diagnosis of malignant cervical lymphadenopathy and the cutoffs. Results The factors studied in 18F-FDG PET/CT images for predicting malignant cervical lymphadenopathy were sex, age, node location, size, shape, margins, maximum standard uptake value （SUV）, mean SUV, FDG uptake pattern and number of nodes. It was found that mean SUV, maximum SUV, FDG uptake pattern, location, size and margins were the important risk factors of cervical lymph nodes that could predict malignant cervical lymphadenopathy. Signs of mean SUV〉2.5 （or maximum SUV〉3.5）, nodular FDG uptake pattern, location of IIA, III, IV, VB, VI and VII regions, size〉1.5 cm and vague margins had their optimal diagnostic accuracy （Ac） and Youden index （YI）, further, combination of any three factors of these six important risk factors would led to the best diagnosticAc of 96% and YI of 0.93. Conclusions Signs of mean SUV, maximum SUV, FDG uptake pattern, location, size and margins of node in ~SF-FDG PET/CT imaging are important predictive factors of malignant cervical lymphadenopathy. A combination of multiple factors may yield a higher diagnostic efficacy.
