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Inadvertent retention of guidewire is an infrequent but well recognized complication with central line insertion and other interventional procedures. The fragment can either embolize within the vascular system or get retained in soft tissues adjacent to the vein. Occasionally, the guidewire may be stripped owing to forceful pulling over the puncture needle during the procedure. Retention of such stripped guidewire fragments in soft tissues may remain undetected unless the wire is carefully inspected. While removal of the intravascular guidewire fragments via snare devices is well documented in literature, surgical removal of the fragments lodged in soft tissues may not always be feasible owing to the close proximity to vascular structures or may require extensive exploration for deep-seated fragments, which necessitates using general anesthesia in the pediatric population. Image guided removal may be utilized as a useful alternative for overcoming such issues. We report a case of image guided removal of stripped femoral central line fragments embedded in the soft tissue in a pediatric patient., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The term "aspiration" describes lung injury that results from unintentional passage of contents other than air into the lungs and bronchial tree, commonly from the gastrointestinal and upper respiratory tracts. Only a small proportion of aspiration-related events are symptomatic, especially in predisposed individuals such as patients with diminished consciousness, impaired swallowing, oesophageal motility disorders, and reflux disease. Aspiration-related syndromes can be classified based on the onset of presentation, composition of the aspirated substance, and anatomic site of injury. When considering the injury site, the aspirated material can either obstruct the airways, thereby presenting with obstructive features (eg, atelectasis on radiographs); it can alternatively affect the lung parenchyma. Lung injury due to aspiration of noxious agents such as acid or lipids is termed chemical aspiration pneumonitis. The aspirated contents can alternatively lead to lung parenchymal infection when the contents are infected, which is termed aspiration pneumonia. We have reviewed the imaging manifestations of various entities related to aspiration and have classified the abnormalities based on the site of injury and the nature of the culprit agent. Differences between "aspiration pneumonitis" and "aspiration pneumonia" are also explored. This is followed by an illustration of a few specific situations related to aspiration in pediatric and adult patients., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To evaluate the performance of intravoxel incoherent motion and diffusion kurtosis imaging (IVIM- DKI) in response assessment of rectosigmoid carcinoma to chemo-radiotherapy (CRT) and compare with 18-FDG PET/CT parameters., Methods: A total of 30 patients of recto-sigmoid cancer on CRT underwent baseline staging and follow-up with IVIM - DKI. Out of this cohort, 20 patients underwent 18-FDG PET/CT. IVIM- DKI MRI and PET/CT parameters were noted from both pre and post-chemoradiotherapy (done at 6 weeks after completion) scans. Quantitative IVIM-DKI parameters, viz. apparent (ADC) and molecular (D) diffusion coefficient, perfusion coefficient (f), and kurtosis (K) were measured from non-necrotic areas and semi-quantitative PET parameters including SUV max, SUV ratio, metabolic tumor volume (MTV), total lesion glycolysis (TLG) were also measured. All these parameters correlated with the patient's response keeping RECIST 1.1 criteria as reference standard., Results: A statistically significant increase in D and ADC with a significant decline in K was noted after therapy in the entire cohort. These changes were observed in both responders as well as non-responders. No significant differences were observed in the percentage changes of these parameters post therapy amongst both groups. Among 20 patients with follow-up PET/CT imaging, a significant decline in all parameters of primary lesion was seen post-therapy. Responders (n = 12) showed a significant decline in MTV and TLG from baseline after therapy, whereas non-responders did not show any such decline. Change in TLG (ɗ TLG), followed by ɗ MTV had the strongest correlation with a positive response. A ɗ TLG value of ≥ 54.19 carried a 79% sensitivity and 83% specificity in differentiating responders from non responders., Conclusion: 18-FDG PET/CT is a more accurate single modality for assessing both response and tumor burden post therapy, while ADC and D from IVIM MRI are useful adjuncts to response assessment., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Owing to their inherent resistance to different classes of antifungals, early identification of Fusarium spp. is crucial. In this study, 10 clinical isolates were included from patients with invasive fusariosis involving lungs, sinuses, or both. Clinico-radiological data were collected. Samples were processed by standard laboratory procedures. Three gene regions (ITS, TEF1, and RPB2) were amplified by PCR for multilocus sequencing. Fusarium MLST, FUSARIUM-ID, and FUSARIOID-ID databases were used for final identification. Antifungal susceptibility testing was performed by broth microdilution following CLSI M38-A3 and Sensititre™ YeastOne™ YO9 plate. Pulmonary involvement was seen in all patients, and sino-nasal involvement was present in six. Radiologically, consolidations and cavitations were present in eight and six cases, respectively. Halo sign was present in six; reverse halo sign was also found in three of them. Direct microscopy showed septate hyphae that were morphologically different from those found in aspergillosis. Results of the molecular identification were as follows: two Fusarium irregulare, one Fusarium pernambucanum, one Fusarium incarnatum, one Fusarium sp. FIESC 30, two Fusarium keratoplasticum, one Fusarium falciforme, one Fusarium pseudonygamai, and one Fusarium delphinoides. For both Fusarium solani (FSSC) and Fusarium incarnatum-equiseti (FIESC) species complexes, amphotericin B had the lowest minimum inhibitory concentrations (MICs). Importantly, for terbinafine, all FIESC isolates had low MICs, while FSSC isolates had high MICs. In some cases, early identification of Fusarium spp. is possible by means of morphology of hyphae on direct microscopy and findings on radiology. Molecular identification, at least to the species complex level, is crucial for the choice of antifungals., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)

Chronic noninfectious osteomyelitis or chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis, is an autoinflammatory bone disorder primarily affecting the pediatric age group. Currently, it is diagnosed on the basis of clinical, laboratory, and imaging features. Imaging plays a crucial role in the diagnosis and follow-up of CNO with whole body magnetic resonance imaging (WBMRI) being the main modality. Radiographs assist in exclusion of common differential diagnoses like infections and malignancy. WBMRI aids in disease detection and exclusion of differential diagnoses, identifies additional lesions, and has a role in ascertaining the pattern of bony involvement which helps with prognostication and grading. Recent recognition of specific morphological and distribution patterns on WBMRI is increasingly allowing an upfront diagnosis of this entity to be made on imaging alone. It is also helpful for assessment of response to therapy during follow-up. This review aims to summarize the role of imaging in the evaluation of CNO, with special emphasis on WBMRI in its assessment., Competing Interests: Conflict of Interest None declared., (Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Objectives: The objective is to evaluate the efficacy of 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) computed tomography (CT) in the evaluation of tumor response to preoperative/palliative chemoradiotherapy (CRT) for advanced colorectal cancer; including metastatic cancer at primary presentation and recurrent cancers with local and/or distant metastasis., Materials and Methods: Fifty patients with advanced rectal cancer underwent two point imaging with 18 FDG PET-CT before and after 3 weeks of completion of preoperative/palliative CRT in between 2016 and 2022. Patients with locally recurrent cancer also underwent radical surgery. The assessment consisted of the evaluation of the following metabolic PET parameters: Maximum standardized uptake value (SUV max ), SUV ratio , metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Response was assessed among the followed patients using RECIST 1.1 criteria., Observations and Results: There was a significant decline in the mean post therapy SUV max and SUV ratio as compared to baseline ( P = 0.0001). Twenty-six out of 50 (52%) patients were classified as responders. A significant decrease in all parameters (SUV max , SUV ratio , TLG, and MTV) from baseline was observed in responders of the study when comparing with nonresponders ( P < 0.05). Besides SUV max and SUV ratio , the mean posttherapy TLG was significantly reduced in responders than nonresponders ( P = 0.0065)., Conclusion: PET-CT is a useful combined anatomic and functional imaging modality in monitoring tumor response to preoperative/palliative CRT in advanced rectal cancer, whether primary or recurrent, including metastatic cancers at presentation. Posttherapy SUV and TLG in particular are significantly associated with treatment response., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Nuclear Medicine.)

Three-year-old boy who presented with colicky abdominal pain, diarrhoea and vomiting was investigated with computed tomography which revealed a mass in the peripancreatic region. An imaging possibility of duodenal intramural hematoma was considered after reassessment with ultrasound which was subsequently confirmed by magnetic resonance imaging. The development of a spontaneous duodenal hematoma lead to further evaluation of the patient and revealed X linked hyper IgM syndrome., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Skeletal dysplasias or osteochondrodysplasias comprise a large heterogeneous group of genetic disorders and possess significant overlap on imaging, which adds to the dilemma of the reporting radiologist. These entities are routinely evaluated with a detailed skeletal survey and hand radiographs form a crucial part of a complete survey. Certain conditions have characteristic imaging findings that enable a diagnosis be made on hand radiograph alone. Additionally, hand radiographs may also demonstrate findings that may be suggestive of a particular diagnosis/differential diagnoses and would warrant further assessment for proving the same. We aim to demonstrate the use of hand radiographs in diagnosis of various such entities through this review. Although they cannot replace a complete skeletal survey in the diagnosis, hand radiographs performed for other indications might alert a radiologist to the diagnosis of an unsuspected skeletal dysplasia., Competing Interests: Conflict of Interest None declared., (Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

The objective of this research was to study the contrast enhancement patterns of the different molecular subtypes of breast cancer on contrast-enhanced ultrasound (CEUS) using both qualitative and quantitative parameters. This prospective study included females with a single breast mass which was histopathologically proven carcinoma. B mode ultrasound (USG) and CEUS were performed in all patients during baseline assessment. Qualitative CEUS assessment encompassed enhancement pattern, presence of fill-in and washout. Quantitative assessment included measurement of peak enhancement, time to peak; area under the curve and mean transit time. A p -value < 0.05 was considered statistically significant for differentiating the subtypes. The included thirty masses were categorised into two subtypes-triple negative breast cancer (TNBC) (36.7%) and non-TNBC (63.3%) subtypes. With B-mode USG, a statistically significant difference was observed between the two groups with respect to their shape and margins. TNBC lesions showed an oval shape, circumscribed margins and peripheral nodular enhancement on CEUS with the absence of fill-in even in the delayed phase ( p -value - 0.04). The two subtypes did not significantly differ in terms of quantitative perfusion parameters. The various subtypes of breast cancer therefore possess distinct contrast enhancement patterns. CEUS potentially allows differentiation amongst these molecular subtypes that may aid in radiology-pathology (rad-path) correlation and follow up of the patients., Competing Interests: All authors declare that no conflicts exist., (© the authors; licensee ecancermedicalscience.)

History: A 10-year-old North Indian boy presented with swelling of multiple joints in his hands for the past 3 years. This swelling involved the small joints of his hands and some restriction of joint movement, without any associated tenderness or morning stiffness. No other joints were symptomatically involved. Prior to visiting our hospital, he had received disease-modifying antirheumatoid drugs for suspected juvenile idiopathic arthritis, without any clinical benefit. On examination, the metacarpophalangeal and interphalangeal joints were nontender but had swelling and flexion deformities. He also had a short stature (below the third centile) for his age. Inflammatory markers, including erythrocyte sedimentation rate (7 mm per hour; normal range, 0-22 mm per hour) and C-reactive protein level (1.5 mg/L; normal level, <10 mg/L), were normal, and the rheumatoid factor test result was negative. A skeletal survey of the patient was performed.

Competing Interests: None

History: A 10-year-old North Indian boy presented with swelling of multiple joints in his hands for the past 3 years. This swelling involved the small joints of his hands and some restriction of joint movement, without any associated tenderness or morning stiffness. No other joints were symptomatically involved. Prior to visiting our hospital, he had received disease-modifying antirheumatoid drugs for suspected juvenile idiopathic arthritis, without any clinical benefit. On examination, the metacarpophalangeal and interphalangeal joints were nontender but had swelling and flexion deformities. He also had a short stature (below the third centile) for his age. Inflammatory markers, including erythrocyte sedimentation rate (7 mm per hour; normal range, 0-22 mm per hour) and C-reactive protein level (1.5 mg/L; normal level, <10 mg/L), were normal, and the rheumatoid factor test result was negative. A skeletal survey of the patient was performed and is shown in Figures 1-6.

Pulmonary intimal sarcoma (PAS) is a highly aggressive malignant mesenchymal tumor affecting the central pulmonary arteries. Similar clinical presentation and indeterminate laboratory parameters often result in misdiagnosis of this condition as pulmonary thromboembolism, which is a relatively common disease. Certain imaging features can however allow differentiation between these two diagnoses. We present one such case of PAS that was initially treated as pulmonary embolism; and briefly review the relevant imaging characteristics to avoid overlooking PAS especially in patients with an atypical clinical history for thromboembolism., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by Turkish Society of Nuclear Medicine Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

Diaphragmatic structure and function assessment can be performed using grayscale as well as M-mode ultrasound. This article discusses the application of M-mode ultrasound in the assessment of diaphragmatic dysfunction., Competing Interests: Conflict of Interest None declared., (Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Anorectal malformations (ARMs) encompass a complex spectrum of congenital anomalies and H/N type anorectal malformations are extremely rare. In the presence of colostomy, an augmented pressure colostogram with or without retrograde or micturating cystourethrogram is the investigation of choice. Transperineal ultrasound is an imaging technique that allows a fairly accurate morphological assessment of ARMs along with dynamic evaluation of the anorectal structures and pelvic floor anatomy. Here we describe the role of transperineal ultrasound as an adjunctive modality in diagnosis of one such complex anomaly., Competing Interests: Conflict of Interest None declared., (Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Myeloid sarcoma or chloroma is a localised tumour characterised by extramedullary proliferation of precursor myeloid cells. Commonly occurring in association with acute myeloid leukaemia, chloroma can occasionally be seen in myeloproliferative disorders with subsequent blastic transformation. Imaging plays an important role in the diagnosis and evaluation of this entity. A case of chloroma involving the dorso-lumbar vertebral region is presented in a patient with chronic myeloid leukaemia with subsequent blastic transformation., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2022. The Authors.)