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Symptomatic radiation cardiotoxicity affects up to 30% patients with lung cancer and several heart substructure doses are associated with reduced overall survival. A greater focus on minimising cardiotoxicity is now possible due to advancements in radiotherapy technology and the new discipline of cardio-oncology, but uptake of emerging data has not been ascertained. A global cross-sectional analysis of Radiation Oncologists who treat lung cancer was therefore conducted by the International Cardio-Oncology Society in order to establish the impact of recently published literature and guidelines on practice. A bespoke questionnaire was designed following an extensive review of the literature and from recurring relevant themes presented at Radiation Oncology and Cardio-Oncology research meetings. Six question domains were retained following consensus discussions among the investigators, comprising 55 multiple choice stems: guidelines, cardiovascular assessment, cardiology investigations, radiotherapy planning strategies, primary prevention prescribing and local cardio-oncology service access. An invitation was sent to all Radiation Oncologists registered with ICOS and to Radiation Oncology colleagues of the investigators. In total 118 participants were recruited and 92% were consultant physicians. The ICOS 2021 expert consensus statement was rated as the most useful position paper, followed by the joint ESC–ESTRO 2022 guideline. The majority (80%) of participants indicated that a detailed cardiovascular history was advisable. Although 69% of respondents deemed the availability of cardiac substructure auto-segmentation to be very/quite important, it was implemented by only a few, with the most common being the left anterior descending coronary artery V15. A distinct cardio-oncology service was available to 39% participants, while the remainder utilised general cardiology services. The uptake of recent guidelines on cardiovascular optimisation is good, but access to cardiology investigations and consultations, and auto-segmentation, represent barriers to modifying radiotherapy practices in lung cancer to reduce the risk of radiation cardiotoxicity. • Radiation cardiotoxicity is common following treatment for NSCLC. • Several guidelines and many clinical studies have been published recently. • Impact on emerging evidence on radiotherapy practice is unknown. • Uptake of guidelines is suboptimal and much supporting evidence is weak in NSCLC. • Greater collaboration between radiation oncology and cardio-oncology is warranted. [ABSTRACT FROM AUTHOR]

The National Palliative Care and Interventional Radiotherapy Study Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) carried out a survey whose aim was to obtain a "snapshot" of the real-world practice of nonmelanoma skin cancer (NMSC) treatments in Italy. The survey was conducted on SurveyMonkey's online interface and was sent via e-mail to our society Radiation Oncologists. Fifty-eight Italian radiation oncologists (ROs), representing 54 centers, answered the survey. Thirteen percent of the ROs declared they treat fewer than 10 NMSC lesions annually, 36% treat between 11 and 20, and 51% treat more than 20 lesions annually. Interventional radiotherapy (IRT) was offered by 25% of the ROs, and every case was reportedly discussed by a multidisciplinary team (71%). Electrons (74%), volumetric modulated arc therapy (V-MAT) (57%), three-dimensional conformal radiotherapy (3D-CRT) (43%), and IRT (26%) were the main treatment options. With external beam radiotherapy (EBRT), 46 and 53 different RT schedules were treated for curative and palliative intent, respectively; whereas for IRT, there were 21 and 7 for curative and palliative intent, respectively. The most popular EBRT curative options were 50–70.95/22–35 fractions (fx) and 50–70 Gy/16-20fx and for EBRT palliative settings, 30Gy/10fx, and 20–35Gy/5fx. For IRT, the most popular curative options were 32–50Gy/8-10fx and 30–54Gy/3-5fx, whereas 30Gy/6fz was the palliative option. Less than 10 re-RT cases were reported in one year in 42.5%, 11–20 cases in 42.5%, and >20 cases annually in 15%. Electrons (61%), VMAT (49%), and BRT (25%) were the most widely used approaches: 20–40Gy in 10fx and 20–25Gy in 5fx were the recommended fractionations. The survey shows a variegated reality. A national registry with more detailed data could help in undercover its causes. • The Italian Association of Radiotherapy and Clinical Oncology (AIRO) proposed a survey to verify the national radiotherapy practices for nonmelanoma skin cancer (NMSC). • The preferred treatment techniques were: electrons (74%) and volumetric modulated arc therapy (V-MAT) (57%). • Interventional radiotherapy (IRT) can only be offered as a therapeutic option in only 25% of Italian RT centers. • Differing RT schedules but mainly adhering to international recommendations. • Data show that the single center experience was likely to play a prevalent role. [ABSTRACT FROM AUTHOR]

Simple Summary: The O-RADS system demonstrates high diagnostic performance in distinguishing benign from malignant adnexal masses, even when used by inexperienced examiners. However, the false positive rate remains relatively high, mainly due to the over-interpretation of solid-appearing components in classic benign lesions. Despite this, inter-observer variability among non-expert raters was substantial. Incorporating O-RADS system training into residency programs is beneficial for inexperienced practitioners. This study could be an educational model for gynecologic residency training for other systems of sonographic features. Objective: To evaluate the accuracy of the O-RADS system in differentiating between benign and malignant adnexal masses, as assessed by inexperienced gynecologists. Methods: Ten gynecologic residents attended a 20 h training course on the O-RADS system conducted by experienced examiners. Following the training, the residents performed ultrasound examinations on patients admitted with adnexal masses under supervision, recording the data in a database that included videos and still images. The senior author later accessed this ultrasound database and presented the cases offline to ten residents for O-RADS rating, with the raters being blinded to the final diagnosis. The efficacy of the O-RADS system by the residents and inter-observer variability were assessed. Results: A total of 201 adnexal masses meeting the inclusion criteria were evaluated, consisting of 136 (67.7%) benign masses and 65 (32.3%) malignant masses. The diagnostic performance of the O-RADS system showed a sensitivity of 90.8% (95% CI: 82.2–96.2%) and a specificity of 86.8% (95% CI: 80.4–91.8%). Inter-observer variability in scoring was analyzed using multi-rater Fleiss Kappa analysis, yielding Kappa indices of 0.642 (95% CI: 0.641–0.643). The false positive rate was primarily due to the misclassification of solid components in classic benign masses as O-RADS-4 or O-RADS-5. Conclusions: The O-RADS system demonstrates high diagnostic performance in distinguishing benign from malignant adnexal masses, even when used by inexperienced examiners. However, the false positive rate remains relatively high, mainly due to the over-interpretation of solid-appearing components in classic benign lesions. Despite this, inter-observer variability among non-expert raters was substantial. Incorporating O-RADS system training into residency programs is beneficial for inexperienced practitioners. This study could be an educational model for gynecologic residency training for other systems of sonographic features. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, we compared two artificial intelligence (AI) tools, OncoStudio and Protégé AI, for their ability to automatically segment organs in Korean cancer patients undergoing radiation therapy. Manual contouring of organs is time-consuming and can vary among clinicians, potentially impacting treatment accuracy. We aimed to evaluate how well the aforementioned AI tools can assist clinicians by speeding up this process and ensuring precision. Our findings showed that OncoStudio, which was specifically developed for Korean patients, performed better in most cases than Protégé AI, a globally developed tool. These results suggest that population-specific AI tools can improve radiation therapy planning, ultimately enhancing patient outcomes and reducing clinician workload. Background: Accurate delineation of tumors and organs at risk (OARs) is crucial for intensity-modulated radiation therapy. This study aimed to evaluate the performance of OncoStudio, an AI-based auto-segmentation tool developed for Korean patients, compared with Protégé AI, a globally developed tool that uses data from Korean cancer patients. Methods: A retrospective analysis of 1200 Korean cancer patients treated with radiotherapy was conducted. Auto-contours generated via OncoStudio and Protégé AI were compared with manual contours across the head and neck and thoracic, abdominal, and pelvic organs. Accuracy was assessed using the Dice similarity coefficient (DSC), mean surface distance (MSD), and 95% Hausdorff distance (HD). Feedback was obtained from 10 participants, including radiation oncologists, residents, and radiation therapists, via an online survey with a Turing test component. Results: OncoStudio outperformed Protégé AI in 85% of the evaluated OARs (p < 0.001). For head and neck organs, OncoStudio achieved a similar DSC (0.70 vs. 0.70, p = 0.637) but significantly lower MSD and 95% HD values (p < 0.001). In thoracic organs, OncoStudio performed excellently in 90% of cases, with a significantly greater DSC (male: 0.87 vs. 0.82, p < 0.001; female: 0.95 vs. 0.87, p < 0.001). OncoStudio also demonstrated superior accuracy in abdominal (DSC 0.88 vs. 0.81, p < 0.001) and pelvic organs (male: DSC 0.95 vs. 0.85, p < 0.001; female: DSC 0.82 vs. 0.73, p < 0.001). Clinicians favored OncoStudio in 70% of cases, with 90% endorsing its clinical suitability for Korean patients. Conclusions: OncoStudio, which is tailored for Korean patients, demonstrated superior segmentation accuracy across multiple anatomical regions, suggesting its suitability for radiotherapy planning in this population. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer staging utilizing the TNM (Tumor, Node, Metastasis) classification system is fundamental in determining disease progression. The manual extraction and classification of TNM information from radiology reports presents significant challenges in clinical workflow efficiency and consistency. This study investigated the capability of GPT3.5, a large language model, to automate TNM classification from radiology reports in both English and Japanese languages. Our analysis demonstrated that when provided with comprehensive TNM definitions, the model achieved high accuracy rates, particularly in English reports (94% for M-stage classification). These findings indicate the potential of multilingual language models to enhance the efficiency and standardization of cancer staging processes across diverse healthcare environments. Background/Objectives: This study aimed to investigate the accuracy of Tumor, Node, Metastasis (TNM) classification based on radiology reports using GPT3.5-turbo (GPT3.5) and the utility of multilingual large language models (LLMs) in both Japanese and English. Methods: Utilizing GPT3.5, we developed a system to automatically generate TNM classifications from chest computed tomography reports for lung cancer and evaluate its performance. We statistically analyzed the impact of providing full or partial TNM definitions in both languages using a generalized linear mixed model. Results: The highest accuracy was attained with full TNM definitions and radiology reports in English (M = 94%, N = 80%, T = 47%, and TNM combined = 36%). Providing definitions for each of the T, N, and M factors statistically improved their respective accuracies (T: odds ratio [OR] = 2.35, p < 0.001; N: OR = 1.94, p < 0.01; M: OR = 2.50, p < 0.001). Japanese reports exhibited decreased N and M accuracies (N accuracy: OR = 0.74 and M accuracy: OR = 0.21). Conclusions: This study underscores the potential of multilingual LLMs for automatic TNM classification in radiology reports. Even without additional model training, performance improvements were evident with the provided TNM definitions, indicating LLMs' relevance in radiology contexts. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges of diagnosing and managing non-clear cell renal cell carcinoma (nccRCC), a heterogeneous and less-studied subtype of kidney cancer. Topics include the distinct subtypes of nccRCC, the prognostic and therapeutic implications of variant histology, and the development of evidence-based guidance for managing nccRCC, with a particular emphasis on papillary and chromophobe RCC.

External beam radiotherapy (EBRT) is essential to offer an effective cancer treatment, but it needs to be accessible, well-timed, and high-quality. There is a global lack of radiotherapy infrastructure and investment that compromises the cancer outcomes. The authors aim to quantify the future needs of EBRT until 2040 to cover the future demand. Based on the Global Cancer Observatory estimate for new cancer cases in Portugal for 2040 it was calculated the optimal number of EBRT courses. The OUP is the proportion of new cancer cases that should receive EBRT at least once. In line with the International Atomic Energy Agency (IAEA) DIrectory of RAdiotherapy Centres and European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology guidelines, we estimated the number of EBRT machines / Megavoltage (MV) units needed. Also, the authors followed the IAEA staffing guidelines. The calculated median increase in the optimal number of EBRT courses for the year 2040 was found to be 18% when compared to the requirements in 2020. The projected number of optimal EBRT courses for 2040 was estimated to be approximately 34.000. Consequently, a range of 18 to 30 new EBRT machines/ MV units will need to be installed to adequately address the growing demand. To meet this demand, it is anticipated that a total of 28 to 46 radiation oncologists, 22 to 36 medical physicists, and 61 to 102 radiation therapists will be required. The deficit of EBRT machines / MV units in Portugal will require a change in the cancer related – policies and an investment to offer full access to EBRT treatments. • Global lack of Radiotherapy infrastructure compromises cancer outcomes. • Authors quantify future EBRT needs in Portugal until 2040. • Authors estimate an 18% increase in optimal EBRT courses by 2040. • Estimated need for 18 to 30 new EBRT machines to meet growing demand. • Urgent policy changes and investment needed to address Portugal's EBRT deficit. [ABSTRACT FROM AUTHOR]

Purpose To explore the perceptions and current practices of radiologist assistants' peer-review process. Methods A 49-question, anonymous, online questionnaire was emailed to 133 radiologist assistants in the American Registry of Radiologic Technologists database. Descriptive statistics were used for data analyses. Results The survey response rate was 42.1% (56/133). Most respondents (62.5%) participated in peer review. Direct in-person observation (21.4%) was the most common process used for radiologist assistants. Radiologists (62.5%) and radiologist assistants (51.8%) were considered peers to perform peer review. Although respondents indicated individual feedback was given by letters or emails (16.1%), they preferred face-to-face or phone call discussions (39.3%). Most respondents (65.5%) did not have peer-review meetings for educational purposes. Most respondents (92.5%) agreed that participating in peer review would be beneficial to their professional and educational development (90%) and that learning from peer review would be worth their time (95%). Discussion Health care providers and organizations use peer review to identify practice variations, optimum care delivery, effective communication, and deficiencies in professionalism by comparing the peers' views on performance against accepted standards. In radiology, diagnostic and interventional radiologists routinely perform peer review, but no information exists on processes for radiology-specific advanced practice providers, particularly radiologist assistants. Conclusion Radiologist assistants were receptive to participating in peer review and saw it as beneficial for educational and professional development. Knowledge of current processes and perceptions allows for radiologist assistant--specific peerreview development. [ABSTRACT FROM AUTHOR]

Self-monitoring is essential for effectively regulating learning, but difficult in visual diagnostic tasks such as radiograph interpretation. Eye-tracking technology can visualize viewing behavior in gaze displays, thereby providing information about visual search and decision-making. We hypothesized that individually adaptive gaze-display feedback improves posttest performance and self-monitoring of medical students who learn to detect nodules in radiographs. We investigated the effects of: (1) Search displays, showing which part of the image was searched by the participant; and (2) Decision displays, showing which parts of the image received prolonged attention in 78 medical students. After a pretest and instruction, participants practiced identifying nodules in 16 cases under search-display, decision-display, or no feedback conditions (n = 26 per condition). A 10-case posttest, without feedback, was administered to assess learning outcomes. After each case, participants provided self-monitoring and confidence judgments. Afterward, participants reported on self-efficacy, perceived competence, feedback use, and perceived usefulness of the feedback. Bayesian analyses showed no benefits of gaze displays for post-test performance, monitoring accuracy (absolute difference between participants' estimated and their actual test performance), completeness of viewing behavior, self-efficacy, and perceived competence. Participants receiving search-displays reported greater feedback utilization than participants receiving decision-displays, and also found the feedback more useful when the gaze data displayed was precise and accurate. As the completeness of search was not related to posttest performance, search displays might not have been sufficiently informative to improve self-monitoring. Information from decision displays was rarely used to inform self-monitoring. Further research should address if and when gaze displays can support learning. [ABSTRACT FROM AUTHOR]

Although the rapid growth in the efficiency of medical imaging is undeniable, the expansion of health information technology (HIT) into medical imaging has not been as seamless or well-integrated as it was thought to be. The socio-technical complexities in medical imaging associated with HIT systems can cause risks to patient harm and inconvenience, both individually and collectively, often in new, unforeseen, and unexpected ways. This study reflects a retrospectively collected single incident report related to medical imaging HIT systems, aiming to develop a set of preventive and corrective strategies. A combination of multiple deductive approaches (existing frameworks), i.e., HIT Classification Systems and 18-step medical imaging process workflow and inductive method (content analysis), were used to analyze the incident. The incident was identified as a "system configuration"-related software issue, contributed by system upgrade-changes in hardware and software. The incident was determined to occur during steps 10-12, i.e., "study selection and retrieval," "calling up of patient's referral," and "image review and interpretation," causing severe disruptions in the clinical workflow for several weeks. We propose 16 preventive and corrective strategies grouped under four key areas based on the sociotechnical aspects associated with HIT systems. The key areas are (i) preparation and integration for upgraded systems, (ii) training for medical imaging specialists, (iii) contingency planning/immediate backup system, and (iv) system design and configuration. These strategies are expected to help healthcare staff, analysts, reporters, researchers, and relevant stakeholders improve care delivery and patient safety in medical imaging in the context of any system upgrades. [ABSTRACT FROM AUTHOR]

Verification of pregnancy status prior to initiating radiation treatment for cancer is important to preserve patient and fetal safety. However, many institutions lack clear guidelines for pregnancy screening prior to treatment initiation. A practice gap analysis conducted at an academic medical center revealed inconsistent pregnancy screening within the radiation oncology department, with 7% (N = 729) of eligible patients screened prior to initiating treatment. A nurse-driven policy was implemented based on recommendations from the American Society for Radiation Oncology and the National Comprehensive Cancer Network. Postimplementation, 78% (N = 364) of eligible patients received pregnancy screening prior to treatment. [ABSTRACT FROM AUTHOR]

Lapidus arthrodesis is one of the most commonly used techniques in the correction of moderate and severe hallux valgus. We analyzed the clinical and radiological outcomes after using the Phantom® Lapidus intramedullary nail to find an effective technique with low complications. We retrospectively analyzed data of 52 patients who underwent a modified Lapidus arthrodesis with an intramedullary nail at our center from November 2019 to September 2022. The mean follow-up period was 27 (range, 18–34) months. Clinical results were evaluated using the visual analog scale (VAS), the European Foot and Ankle Society score (EFAS) and the American Orthopaedic Foot and Ankle Society score (AOFAS); three different radiological measures were analyzed. The mean AOFAS score increased from 44.8 to 82 points. The mean EFAS score increased from 11.2 to 20.1 points. The mean VAS score decreased by 4.7 points. The mean EFAS Sport score was increased from 9.2 (SD 4.6) to 12.6 (SD 5.4) points. The intermetatarsal angle decreased from 15° to 6.9° and the hallux valgus angle by a mean of 17.9°. The forefoot width reduced from 93.6 to 84.7 mm. All results were statistically significant (p <.001). One case of nonunion was recorded. No implant-related complications were observed. This device was effective in correcting moderate to severe hallux valgus, with significant patient satisfaction. Its complication rate was not higher than that of other fixation devices. Correct compression of the arthrodesis, absence of extraosseous material, and multidirectional stability are important qualities of this implant for the correct treatment of this pathology. Level IV, retrospective case series [ABSTRACT FROM AUTHOR]

Introduction: Bladder cancer staging is pivotal for guiding therapeutic decisions. In this study, the primary objective was to assess the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI), The study aimed to classify bladder tumors as either nonmuscle-invasive bladder cancers or muscle-invasive bladder cancers (MIBC) using the Vesical Imaging Reporting and Data System (VI-RADS) scoring. A secondary objective of the study focused on the accuracy of biparametric magnetic resonance imaging (bpMRI) in comparison to mpMRI. Methods: Thirty-three patients with bladder tumors were enrolled and underwent both mpMRI and bpMRI scoring assessments. VI-RADS scores were assigned and subsequently compared with histopathological findings posttransurethral resection of bladder tumor., Statistical measures included sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for VI-RADS scores at cutoff thresholds of ≥4 and 5. Results: MpMRI at a VI-RADS cutoff of ≥4 yielded an 83.33% sensitivity and 100% specificity, with a diagnostic accuracy of 90.91%. At a cutoff of 5, sensitivity was 100%, specificity was 77.27%, and diagnostic accuracy was 84.85%. bpMRI at a cutoff of ≥4 showed an 80% sensitivity and 100% specificity, with diagnostic accuracy matching mpMRI at 90.91%. Conclusions: This prospective analysis demonstrates that VI-RADS scoring with mpMRI provides reliable diagnostic accuracy for bladder cancer staging. mpMRI exhibits high sensitivity and specificity at a cutoff of ≥ 4, making it a robust tool for MIBC detection. bpMRI is an effective alternative in select patients. The study validates the use of VI-RADS scoring in clinical practice for effective treatment planning. [ABSTRACT FROM AUTHOR]

Simple Summary: Liver transplantation (LT) is one of the primary treatments for hepatocellular carcinoma (HCC) and significantly improves patient survival. However, the application of LT for HCC faces challenges owing to advancements in cancer-specific treatments and increased patient comorbidities. This review explores the current controversies and advancements in LT for HCC, focusing on managing comorbidities, the impact of frailty, selection criteria, the role of radiology, and the potential use of immunotherapy. We emphasize the importance of immunosuppression management and surveillance for HCC recurrence. A multidisciplinary approach is crucial to optimize the outcomes of patients with HCC undergoing LT, ensuring comprehensive care and improved survival rates. Liver transplantation (LT) remains one of the most effective treatments for hepatocellular carcinoma (HCC) and significantly enhances patient survival. However, the application of LT for HCC faces challenges owing to advancements in cancer-specific treatment modalities and the increased burden of patients' comorbidities. This narrative review explores current controversies and advancements in LT for HCC. Key areas of focus include the management of comorbidities and patient education by advanced practice nurses, impacts of frailty on waitlists and post-LT outcomes, selection criteria for LT in the era of new downstaging tools, role of radiology in patient selection, and implications of potential immunotherapy use both before and after LT. Additionally, the importance of immunosuppression management with strategies aimed at minimizing rejection while considering the risk of HCC recurrence and the role of surveillance for HCC recurrence is highlighted. This review also underscores the importance of a multidisciplinary approach for optimizing outcomes in patients with HCC undergoing LT. [ABSTRACT FROM AUTHOR]

Simple Summary: There is still an overdiagnosis of indolent prostate cancer (iPCa) lesions using the Prostate Imaging-Reporting and Data System (PI-RADS), and radiomics has emerged as a promising tool to improve the diagnosis of clinically significant prostate cancer (csPCa) lesions. However, the current state and applicability of radiomics remains a challenge. This systematic review aims at evaluating the evidence of handcrafted and deep radiomics in differentiating lesions at risk of having csPCa from those with iPCa and benign pathology. The review highlighted a good performance of radiomics but without significant differences with radiologist assessment (PI-RADS), as well as several methodological limitations in the reported studies, which might induce bias. Future studies should improve methodological aspects to ensure the clinical applicability of radiomics, especially the need for clinical prospective studies and the comparison with PI-RADS. Early detection of clinically significant prostate cancer (csPCa) has substantially improved with the latest PI-RADS versions. However, there is still an overdiagnosis of indolent lesions (iPCa), and radiomics has emerged as a potential solution. The aim of this systematic review is to evaluate the role of handcrafted and deep radiomics in differentiating lesions with csPCa from those with iPCa and benign lesions on prostate MRI assessed with PI-RADS v2 and/or 2.1. The literature search was conducted in PubMed, Cochrane, and Web of Science databases to select relevant studies. Quality assessment was carried out with Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2), Radiomic Quality Score (RQS), and Checklist for Artificial Intelligence in Medical Imaging (CLAIM) tools. A total of 14 studies were deemed as relevant from 411 publications. The results highlighted a good performance of handcrafted and deep radiomics methods for csPCa detection, but without significant differences compared to radiologists (PI-RADS) in the few studies in which it was assessed. Moreover, heterogeneity and restrictions were found in the studies and quality analysis, which might induce bias. Future studies should tackle these problems to encourage clinical applicability. Prospective studies and comparison with radiologists (PI-RADS) are needed to better understand its potential. [ABSTRACT FROM AUTHOR]

Male breast cancer is rarely seen and peaks at the age of 71. Hyperestrogenism, gonadal dysfunction, obesity, and alcohol are among the risk factors for male breast cancer. In hereditary cases, BRCA2 mutation is often observed. The most common symptom is a painless mass that is palpable behind the nipple. Most male breast cancers are ductal carcinomas (81%), papillary carcinomas (13%), and mucinous carcinomas (6%). The invasive micropapillary carcinoma of the breast is important due to its high rate of lymphnode metastasis, recurrence, and distant metastasis. Mortality is 50% higher in men with lymphnode involvement compared to non-involved cases. Furthermore, as the number of affected lymphnodes increases, the prognos is worsens. In this study, we examined a case of invasive micropapillary type male breast cancer with clinical presentation as a palpable mass, lymphnode involvement, and aimed to highlight the radiological considerations that need attention. [ABSTRACT FROM AUTHOR]

Magnetic Resonance Imaging or MRI is a valuable diagnostic tool using strong magnets and radio waves to produce detailed three dimensional images of particularly soft tissue organs. MRI accidents are the least frequent among all medical accidents. However, if safety guidelines are not strictly followed, MRI can be dangerous for both the patient and staff. Strict protocols, patient screening and both patient and staff education are critical to ensure patient and staff safety. This article reviews risks related to MRI scanning and highlights the key information that all staff need to be vigilant about to ensure the safety of all people in the MRI environment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the perceptions of the coronavirus disease 2019 (COVID-19) initiated workplace strategies implemented in radiation oncology departments across Australia. Methods: A multidisciplinary team from Princess Alexandra Hospital developed a survey to address the impact of the pandemic strategies on areas such as patient care, staff education, well-being, flexible working arrangements, and research. The survey was conducted from November 2020 to April 2021. Results: Out of 210 respondents from seven institutions, 45% reported burnout and 57% experienced work work-related stress. A significant majority of respondents were in favour of continued remote work (86%, 131/153). Radiation oncologists identified administrative or non-clinical work (92%, 34/37), telehealth clinics (32%, 12/37), or radiation therapy planning (22%, 8/37) as suitable for remote work. Additionally, 54% (21/39) of the radiation oncologists plan to use telehealth more frequently, with 67% (26/39) feeling more confident with the technology. The majority (81%, 171/210) of participants favoured continuation of hybrid in-person and virtual meetings. Virtual solutions were adopted for quality assurance activities (72%, 118/165) and 52% (60/116) indicated preference for ongoing utility of virtual platforms. However, 38% (79/210) of the respondents expressed concerns about the negative impact on junior staff training. Conclusion: These findings reveal a strong inclination towards technological advancements and remote work arrangements to enable flexible working conditions. Our study suggests the need for ongoing reforms, focusing on improving clinical service delivery efficiencies and enhancing job satisfaction among clinicians. What is known about the topic? During the coronavirus disease 2019 (COVID-19) pandemic there were significant adaptations required to the delivery of clinical care. What does this paper add? There is a strong preference for ongoing work from home arrangements, especially for administrative and non-clinical work. Most radiation oncologists feel more confident using telehealth and favour its ongoing use post-pandemic. Burnout and stress remain prevalent within the workforce. What are the implications for practitioners? There is a high demand among the radiation oncology workforce for adoption of technological advances to improve work satisfaction including remote access to enable flexible work arrangements. [ABSTRACT FROM AUTHOR]

Simple Summary: Basal cell carcinoma (BCC) is the most prevalent type of skin cancer, accounting for a significant number of cases globally each year. Most BCCs develop on the face, and, therefore, the cosmetic outcome of excision is particularly important. Early diagnosis allows for easier removal of smaller lesions, while precise excision reduces the likelihood of recurrence. This study aimed to assess the utility of a novel non-invasive imaging approach, the ultraviolet-enhanced fluorescence dermoscopy (UVFD), for imaging of BCCs. Based on the analysis of a group of 163 BCCs, we found that UVFD may provide additional valuable clues, especially in the case of tumors located on the face, small BCCs (<5 mm), non-pigmented variants and nodular subtypes. Introduction: Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. The aim of the current study was to analyze the ultraviolet-enhanced fluorescence dermoscopy (UVFD) characteristics of BCCs. Methods: BCCs were evaluated under polarized dermoscopy (PD) and UVFD. The findings in PD were described using predefined parameters for dermoscopic evaluation in dermato-oncology. UVFD characteristics were determined based on personal observations, and included interrupted follicle pattern, absence of pink-orange or blue-green fluorescence, well-demarcated borders, and dark silhouettes. Results: In total, 163 BCCs were analyzed. Under UVFD, the interrupted follicle pattern (p < 0.001), absence of pink-orange fluorescence (p = 0.005) and well-demarcated borders (p = 0.031) were more frequently noted in BCCs < 5 mm than in bigger tumors. Lesions on the face showed clearly defined borders (p = 0.031) and interrupted follicle pattern (p < 0.001) more frequently than tumors located beyond the face. Nodular BCCs displayed interrupted follicle pattern (p = 0.001) and absence of pink-orange fluorescence (p < 0.001) more commonly than superficial subtypes. Non-pigmented BCCs more frequently showed lack of blue-green fluorescence (p = 0.007) and interrupted follicle pattern (p = 0.018) compared to pigmented variants. Conclusions: UVFD may be a valuable, complementary to PD, tool in the diagnosis of BCC, particularly in small tumors, lesions located on the face and nodular or non-pigmented subtypes. [ABSTRACT FROM AUTHOR]

Background: The advent and increased use of high-resolution ultrasonography has resulted in improved detection of thyroid nodules. Even with the use of various Thyroid Imaging–Reporting and Data System, accurate imaging diagnosis of malignant thyroid nodules has been suboptimal, which necessitated use of newer modalities like contrast-enhanced ultrasonography alone and in combination for this purpose. Although the combined use of various Thyroid Imaging–Reporting and Data System and contrast-enhanced ultrasonography has turned out to be accurate in many studies, the ideal way to integrate contrast-enhanced ultrasonography into the Thyroid Imaging–Reporting and Data System algorithm is under-investigated. Purpose: To estimate and compare the diagnostic accuracy of American College of Radiology Thyroid Imaging–Reporting and Data System and contrast-enhanced ultrasonography in differentiating benign and malignant nodules alone and in combination. To estimate the diagnostic accuracy of contrast-enhanced ultrasonography in re-categorisation of Thyroid Imaging–Reporting and Data System 3 and Thyroid Imaging–Reporting and Data System 4 thyroid nodules. Materials and methods: This was a prospective cohort study performed in a tertiary care university–based hospital for 3 years. Adult patients with clinical or previous sonographic diagnosis of thyroid nodules were selected. Each of the nodules were assessed using ultrasonography and categorised using American College of Radiology Thyroid Imaging–Reporting and Data System criteria. The lesion was then assessed for contrast-enhanced ultrasonography features. The final diagnosis of the nodules was made using fine needle aspiration cytology. The diagnostic accuracy in diagnosis of malignant thyroid nodules for each of the American College of Radiology Thyroid Imaging–Reporting and Data System and contrast-enhanced ultrasonography alone and in combination was assessed. The diagnostic accuracy of contrast-enhanced ultrasonography in diagnosis of malignant thyroid nodules categorised as Thyroid Imaging–Reporting and Data System 3 and Thyroid Imaging–Reporting and Data System 4 was also assessed. Results: American College of Radiology Thyroid Imaging–Reporting and Data System had a sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of 86.6%, 54.5%, 17.4%, 97.3% and 57.7%, respectively, in diagnosis of malignant thyroid nodules. Contrast-enhanced ultrasonography had a sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of 86.6%, 95.4%, 67.9%, 98.4% and 94.4%, respectively, in diagnosis of malignant thyroid nodules. Contrast-enhanced ultrasonography had sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of 93.3%, 100.0%, 100.0%, 99.2% and 99.3%, respectively, in re-categorisation of Thyroid Imaging–Reporting and Data System 3 and Thyroid Imaging–Reporting and Data System 4 nodules. Conclusion: Contrast-enhanced ultrasonography can play a key role in diagnosis of malignant thyroid nodules which are categorised as indeterminate on grey-scale ultrasound. [ABSTRACT FROM AUTHOR]

This is a pilot study reviewing patients undergoing ankle replacement with the 3-D printed INFINITY™ with ADAPTIS™ total ankle arthroplasty (TAA) system. A retrospective review was conducted of patients with a minimum two-year follow-up who underwent TAA with the INFINITY™ with ADAPTIS™ implant system. Outcome measures include implant survivorship, complications with subsequent reoperations, patient reported outcomes, and radiologic subsidence or radiolucency. Thirty patients were included with median follow-up of 26 months (range, 24–36). Implant survival rate was 90% (27/30). Two patients experienced linear radiolucency > 2 mm: one required a revision TAA secondary to tibial subsidence; the other patient was asymptomatic and nonprogressive on serial radiographs. No cystic radiolucencies > 5 mm were identified. VAS, PROMIS PF, and FADI scores improved significantly. TAA performed with the 3-D printed INFINITY™ with ADAPTIS™ implant technology led to ninety percent short term implant survivorship and improvement in patient reported outcomes with comparable results to other 4th generation arthroplasty systems as a treatment modality for end-stage ankle arthritis. Level III, Retrospective cohort study, Prognostic [ABSTRACT FROM AUTHOR]

Background Multi - modal neuroimaging examinations play a crucial role in the diagnosis and treatment of functional neurosurgery. However, there is currently a lack of effective management for these complex data in clinical practice. This study attempts to establish a feasible multimodal neuroimaging data information management system and evaluate its application effects. Methods By standardizing clinical diagnosis and treatment processes, analyzing the nodes where imaging data were generated, and streamlining data flow routes, establishing storage naming conventions, setting up storage servers, and training specialized personnel, we designed and applied a multi - modal neuroimaging data information management system. The primary evaluation indicators were the archiving rates of 5 types of data: structural sequences, other preoperative images, postoperative electrode CT, electrode reconstruction, and postoperative CT/MRI. The secondary evaluation indicators included the total man-hours consumed for data archiving and the average man-hours consumed per case. Results Without multi-modal neuroimaging data information management (control group, n = 64), the total manpower consumption was 192 man-hours, with an average of 3 man-hours per case. With multi-modal neuroimaging data information management (data management group, n = 50), the total manpower consumption was 84 man-hours, with an average of 1.68 man-hours per case. The data management group had higher archiving rates compared to the control group: structural sequences [100% (50/50) vs. 32.81% (21/64); χ² = 11.383, P = 0.001], other preoperative images [96% (48/50) vs. 26.56% (17/64); χ² = 13.839, P = 0.000], postoperative electrode CT [96% (48/50) vs. 32.81% (21/64); χ² = 10.409, P = 0.001], electrode reconstruction [96% (48/50) vs. 32.81% (21/64); χ² = 10.409, P = 0.001], postoperative CT/MRI [96% (48/50) vs. 15.63% (10/64); χ² = 22.169, P = 0.000]. Conclusions Designing a multi-modal neuroimaging data information management system that aligns with clinical practice and reasonably setting data collection and archiving nodes can effectively improve data archiving rates, save manpower resources, ensure the complete storage of clinical data, and ensure the smooth operation of clinical tasks, and enhance clinical diagnosis and treatment levels. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate the effects of ultraviolet (UV) treatment and alendronate immersion on the osseointegration of dental implants and mucosal attachment of dental implant abutments using a mongrel dog model. Materials and Methods: A total of 48 sandblasted, large-grit, acid-etched (SLA) titanium dental implants and 48 machined surface healing abutments in four male mongrel dogs were prepared. Implants and healing abutments were divided into four groups (n = 12 per group). The control (CON) group did not undergo additional surface treatments. The UV group was treated with UV for 15 minutes, and the alendronate-immersed (AN) group was soaked in 10-3 M alendronate for 24 hours. The UV treatment and alendronate soaking (UVAN) group was treated with alendronate, followed by UV irradiation. All implants were placed in the mandible of mongrel dogs, and the animals were sacrificed at 4 and 8 weeks postoperatively. Bone-to-implant contact (BIC), bone density, and connective tissue attachment were measured. Results: In cortical bone, the UV group exhibited significantly higher BIC compared to the CON and AN groups (P < .05). In contrast, the AN and UVAN groups did not have significantly higher BIC. In the trabecular bone, there was no statistical difference between the groups. No significant increase in bone density and connective tissue attachment was shown in any group. Conclusion: UV treatment of SLA surface implants significantly increased osseointegration in cortical bone. The alendronate immersion did not increase osseointegration, and there was no synergic effect with UV treatment. Further, UV treatment and alendronate immersion of machined healing abutments did not significantly increase connective tissue attachment. [ABSTRACT FROM AUTHOR]

Simple Summary: The European Thyroid Imaging and Reporting Data System (EU-TIRADS) aids clinicians in determining the necessity of fine-needle aspiration biopsy (FNAB) for thyroid nodules suspected of malignancy. This study evaluated the effectiveness of EU-TIRADS criteria in real-world surgical settings. Results indicated that the EU-TIRADS demonstrates reliable diagnostic accuracy in identifying thyroid cancer, facilitating improved clinical decision-making regarding patient management. Enhanced adherence to EU-TIRADS guidelines can mitigate the risk of an overdiagnosis and overtreatment, particularly for low-risk thyroid cancer cases, thereby optimizing patient care. Background: The European Thyroid Imaging and Reporting Data System (EU-TIRADS) aims to reduce the overdiagnosis of thyroid cancer (TC) by guiding the selection of nodules for fine-needle aspiration biopsy (FNAB). This study sought to validate EU-TIRADS nodule selection criteria using data from EUROCRINE, an extensive international endocrine surgery registry. Method: We reviewed indications for FNAB among patients with TC compared to those with benign disease who underwent surgery between March 2020 and March 2022, considering preoperative EU-TIRADS scores and dominant nodule size (FNAB is recommended in Category 5 (˃10 mm or ˂10 mm with suspicious lymph nodes), 4 (˃15 mm), and 3 (˃20 mm)). Patients were categorized into three risk groups: minimal risk (patients with papillary microcarcinoma), high risk (patients with pT3b stage or higher, pN1b, or pM1), and low–moderate risk (all other patients). We conducted a Receiver Operating Characteristic (ROC) analysis to assess the diagnostic accuracy of the EU-TIRADS. Results: We analyzed 32,008 operations. Approximately 68% of the surgical records included EU-TIRADS classifications. The EU-TIRADS exhibited diagnostic accuracy across high-volume sites, with a median ROC Area Under the ROC Curve (AUC) of 0.752, indicating its effectiveness in identifying malignancy. Among the cases, 7907 patients had TC. Notably, 55% of patients with TC underwent FNAB despite not initially meeting the EU-TIRADS criteria. These patients were distributed across the minimal- (58%), low–moderate- (36%), and high-risk (5.8%) categories. Of the patients with TC recommended for FNAB, 78% were deemed low–moderate risk, 21% high risk, and only 0.7% minimal risk. Conclusion: The EU-TIRADS offers effective preoperative malignancy risk stratification. Promoting the proper use of the EU-TIRADS in clinical practice is essential to mitigate the overdiagnosis and overtreatment of low-risk TC. [ABSTRACT FROM AUTHOR]

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient’s condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sensitive images represent a new challenge in enterprise imaging. These images, often containing nudity or gruesome content, have the potential to cause emotional harm to patients and people who view the images. Unfortunately, the interoperability standards used in imaging informatics have not yet addressed this issue. Because of this, the software solutions used in healthcare information technology are not able to offer patients and other viewers of image protections. In this Health Information Management Systems Society (HIMSS)/Society for Imaging Informatics in Medicine (SIIM) Enterprise Imaging Community Whitepaper, we define sensitive images, identify unique challenges related to their management, and provide recommendations for future solutions to protect our patients. [ABSTRACT FROM AUTHOR]

Microservices are a software development approach where an application is structured as a collection of loosely coupled, independently deployable services, each focusing on executing a specific purpose. The development of microservices could have a significant impact on radiology workflows, allowing routine tasks to be automated and improving the efficiency and accuracy of radiologic tasks. This technical report describes the development of several microservices that have been successfully deployed in a tertiary cancer center, resulting in substantial time savings for radiologists and other staff involved in radiology workflows. These microservices include the automatic generation of shift emails, notifying administrative staff and faculty about fellows on rotation, notifying referring physicians about outside examinations, and populating report templates with information from PACS and RIS. The report outlines the common thought process behind developing these microservices, including identifying a problem, connecting various APIs, collecting data in a database, writing a prototype and deploying it, gathering feedback and refining the service, putting it in production, and identifying staff who are in charge of maintaining the service. The report concludes by discussing the benefits and challenges of microservices in radiology workflows, highlighting the importance of multidisciplinary collaboration, interoperability, security, and privacy. [ABSTRACT FROM AUTHOR]

Simple Summary: This retrospective study focused on 23 patients diagnosed with Hepatocellular Carcinoma (HCC), utilizing the Liver Imaging Reporting and Data System (LI-RADS) for classification. This system aids in the non-invasive diagnosis of HCC, potentially eliminating the need for a diagnostic biopsy. Patients were selected based on their diagnosis, confirmed either via imaging methods that identified advanced liver nodules or via histopathological findings consistent with HCC, including specific protein markers. The study aimed to assess the histopathological changes resulting from prior local interventions, such as trans-arterial chemoembolization or radiofrequency ablation, and their impact on the tumor's response to subsequent immune therapies. Key findings indicated variations in alpha-fetoprotein levels and increased expression of the immune marker PD-L1 in untreated patients, suggesting a more aggressive cancer progression in these individuals. The study's conclusions support the use of liver biopsy in refining therapeutic approaches for HCC, particularly in recurrent cases post-intervention, to enhance personalized immune therapy strategies. Background: The Liver Imaging Reporting and Data System (LI-RADS) combines standardized terminology with a classification system for imaging findings in patients with HCC, therefore rendering diagnostic biopsy unnecessary in many cases. This retrospective study included 23 patients with a biopsy diagnosis of HCC, performed either before or after local interventional procedures, in order to evaluate the histopathologic changes induced by previous procedures and their potential influence on the response to immune therapy. Material and Methods: The study encompassed a cohort of patients diagnosed with Hepatocellular Carcinoma (HCC). Diagnosis was established via contrast-enhanced computer tomography or magnetic resonance imaging that identified LI-RADS-5 nodules in conjunction with historical liver disease and elevated alpha-fetoprotein (AFP) levels or via histological examination confirming positivity for glypican3, heat shock protein 70, and glutamine synthetase. The study detailed the liver disease etiology, LI-RADS scores, characteristics and dimensions of HCC nodules, serum AFP concentrations, Edmondson–Steiner grading, and the expression of programmed cell death ligand 1 (PD-L1) in the tumor cells. Results: Among the study's cohort of Hepatocellular Carcinoma (HCC) patients, a portion had not received any prior treatments, while the remainder experienced local HCC recurrence following trans-arterial chemoembolization or radiofrequency ablation. Observations indicated elevated alpha-fetoprotein (AFP) levels in those who had not undergone any previous interventions, showing statistical significance. The Edmondson–Steiner classification predominantly identified grade III differentiation across patients, irrespective of their treatment history. Furthermore, an increase in intra-tumoral programmed cell death ligand 1 (PD-L1) expression was noted in patients who had not been subjected to previous therapies. Conclusion: Liver biopsy offers valuable insights for patients with Hepatocellular Carcinoma (HCC), assisting in the tailoring of immune therapy strategies, particularly in cases of recurrence following prior local interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: In response to the COVID-19 pandemic, new evidence-based strategies have emerged for reducing transmission of respiratory infections through management of indoor air. OBJECTIVES: This paper reviews critical advances that could reduce the burden of disease from inhaled pathogens and describes challenges in their implementation. DISCUSSION: Proven strategies include assuring sufficient ventilation, air cleaning by filtration, and air disinfection by germicidal ultraviolet (UV) light. Layered intervention strategies are needed to maximize risk reduction. Case studies demonstrate how to implement these tools while also revealing barriers to implementation. Future needs include standards designed with infection resilience and equity in mind, buildings optimized for infection resilience among other drivers, new approaches and technologies to improve ventilation, scientific consensus on the amount of ventilation needed to achieve a desired level of risk, methods for evaluating new air-cleaning technologies, studies of their long-term health effects, workforce training on ventilation systems, easier access to federal funds, demonstration projects in schools, and communication with the public about the importance of indoor air quality and actions people can take to improve it [ABSTRACT FROM AUTHOR]

Copyright of Health Bulletin / Zdravstveni Glasnik is the property of Faculty of Health Studies, University of Mostar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: This research investigates the novel area of how Type 1 and Type 2 diabetic skin responds to ultraviolet (UV) radiation, compared to normal skin, a subject previously unexplored. By focusing on the well-documented carcinogenic effects of UV radiation on murine skin, the study compares these effects with those on diabetic murine skin. For the first time, our findings reveal that Type 1 diabetic skin shows reduced sensitivity in developing squamous cell carcinoma and nevi. This research could significantly impact the scientific community by enhancing our understanding of skin cancer's pathogenesis in diabetic mice and could potentially guide future research on skin carcinogenesis. This study explores the previously uncharted territory of the effects of ultraviolet (UV) radiation on diabetic skin, compared to its well-documented impact on normal skin, particularly focusing on carcinogenesis and aging. Employing hairless SKH-hr2, Type 1 and 2 diabetic, and nondiabetic male mice, the research subjected these to UV radiation thrice weekly for eight months. The investigation included comprehensive assessments of photoaging and photocarcinogenesis in diabetic versus normal skin, measuring factors such as hydration, trans-epidermal water loss, elasticity, skin thickness, melanin, sebum content, stratum corneum exfoliation and body weight, alongside photo documentation. Additionally, oxidative stress and the presence of hydrophilic antioxidants (uric acid and glutathione) in the stratum corneum were evaluated. Histopathological examination post-sacrifice provided insights into the morphological changes. Findings reveal that under UV exposure, Type 1 diabetic skin showed heightened dehydration, thinning, and signs of accelerated aging. Remarkably, Type 1 diabetic mice did not develop squamous cell carcinoma or pigmented nevi, contrary to normal and Type 2 diabetic skin. This unexpected resistance to UV-induced skin cancers in Type 1 diabetic skin prompts a crucial need for further research to uncover the underlying mechanisms providing this resistance. [ABSTRACT FROM AUTHOR]

Pulmonary thromboembolism (PTE) poses a significant risk of acute right-sided heart failure and mortality. Computed tomography pulmonary angiography (CTPA) serves as the gold standard for assessing acute pulmonary embolism (APE) risk. This study aims to determine the potential risk of acute right-sided heart failure in APE patients through semi-quantitative CTPA measurements, including the pulmonary arterial obstruction index (PAOI) and evaluation of right atrium (RA) dimensions, left atrium (LA) dimensions, RA/LA ratio, and inferior vena cava (IVC) contrast reflux. Method: This retrospective study involved 50 patients, undergoing initial and follow-up CTPA’s at the Institute of Radiology in Skopje, between January 2018 and January 2021, who were initially diagnosed with APE. They all exhibited varied degrees of pulmonary arterial obstruction index, constituting the study group, while their follow-up CT’s after treatment and resolution of emboli, comprised the control group. PAOI was semi-quantitatively correlated with RA and LA dimensions, RA/LA ratio, and IVC contrast reflux using axial CT scans on the initial and follow up CTPA’s. Results: Among the 50 APE patients, 31 were male and 19 were female. Significant positive correlations were observed between PAOI and RA short axis, RA/LA short and long axis ratio, and IVC contrast reflux. Conversely, negative correlations were found between PAOI and LA dimensions. Discussion: The correlations observed between PAOI measurements and cardiac dimensions in APE patients shed light on the condition's hemodynamic implications. A negative correlation with left atrium dimensions suggests reduced left ventricular preload with increasing pulmonary arterial obstruction. Conversely, positive correlations with right atrium dimensions and RA/LA ratio underscore the impact of elevated pulmonary vascular resistance on right heart strain, indicating a heightened risk of right-sided heart failure. The association between PAOI and IVC contrast reflux highlights the significance of venous congestion in APE, further exacerbating right heart strain. These findings emphasize the importance of assessing right heart dimensions and venous congestion in APE prognosis. PAOI, along with these parameters, serve as valuable prognostic indicators, aiding in risk stratification and guiding therapeutic decisions to minimize adverse outcomes in APE patients. Conclusion: PAOI measurements, IVC contrast reflux, RA short axis, and RA/LA short and long axis ratio serve as reliable CT prognostic markers for APE severity, risk of right-sided heart failure, and adverse outcomes. These markers aid in timely diagnosis and therapy selection for APE patients. [ABSTRACT FROM AUTHOR]

Background: The incidence of endometrial cancer is globally increasing. Aotearoa New Zealand is no exception with a 59% increase in cases over that last ten years. Aims: We report a sub‐set of themes which pertain to provider reflections of rising endometrioid‐type endometrial cancer incidence in individuals with high weight. Materials and Methods: Fifteen semi‐structured interviews with healthcare professionals experienced in providing care to women with endometrial cancer were audio‐recorded and transcribed. Interviews were analysed using reflexive thematic analysis. Results: Two main themes emerged: (1) concerns for the future; and (2) impact on fertility and treatment options. Healthcare professionals discussed rising incidence in younger people and a need for increased awareness about the association of excess weight as a risk factor for developing the disease. The concern extended to workforce and equipment shortfalls of meeting the needs of individuals with higher weight, which subsequently influenced treatment options, health outcomes and survivorship. Conclusions: Rising incidence of endometrial cancer in individuals with high weight presents multiple chances for inequitable access and health outcomes over the care continuum for endometrial cancer. Action is required to address incidence, awareness, access to equitable and inclusive treatment, and survivorship. [ABSTRACT FROM AUTHOR]

To understand perspective on breast cancer using a survey. Questionnaire was distributed to 304 Japanese radiation oncologists (RadOncs) (response rate: 64.1%). Result was compared with a similar US survey. In a scenario with an 81-year-old patient with comorbidities, while most US RadOncs chose to tell that radiation might not be necessary, 2% of Japanese chose it. In a scenario with a healthy 65-year-old breast cancer patient with lumpectomy, while most US RadOncs chose to discuss omission of radiation, 24.5% of Japanese chose it. Differences were observed on radiotherapy for older early-stage breast cancer. [ABSTRACT FROM AUTHOR]

Background Many different risk stratification systems have been formulated for thyroid nodules, differing in their fine-needle aspiration cytology (FNAC) indication, suggesting a lack of consensus around the world. Purpose This prospective study was conducted to find the best guideline for risk stratification, for a better malignancy yield, and with reduced rates of negative FNACs among three Thyroid Imaging, Reporting, and Data System (TIRADS) guidelines. Materials and Methods A total of 625 thyroid nodules with conclusive FNAC or histopathological diagnosis were included in the study. Various sonographic parameters were recorded. They were classified into categories as per the three guidelines and compared with FNAC diagnosis. The guidelines were evaluated in terms of sensitivity, specificity, predictive values, and diagnostic accuracy. Sensitivity and specificity were compared by McNemar's test. Results American College of Radiology (ACR) TIRADS had the highest diagnostic accuracy (56.8%), specificity (50.75%), positive predictive value (23.92%), lowest rates of negative FNACs (76.08%), and high negative predictive value (97.84 %). Korean (K) TIRADS had the maximum sensitivity (97.75%), highest negative predictive value (98.44%), and gross malignancy yield. European TIRADS was between the two other guidelines in most parameters with specificity like K TIRADS. Conclusion All the three guidelines are very good screening tools, with comparable high sensitivity. ACR TIRADS is better in terms of specificity and reduced rates of negative FNACs. Including the presence of a suspicious cervical lymph node as a criterion and more frequent follow-up might further improve the diagnostic performance of the guideline. [ABSTRACT FROM AUTHOR]

Similar to invasive breast cancer, ductal carcinoma in situ is also going through a phase of changes not only from a technical but also a conceptual standpoint. From prescribing radiotherapy to everyone to personalized approaches, including radiotherapy omission, there is still a lack of a comprehensive framework to guide radiation oncologists in decision making. Many pieces of the puzzle are finding their place as high-quality data mature and are disseminated, but very often, the interpretation of risk factors and the perception of risk remain very highly subjective. Sharing the therapeutic choice with patients requires effective communication for an understanding of risks and benefits, facilitating an informed decision that does not increase anxiety and concerns about prognosis. The purpose of this narrative review is to summarize the current state of knowledge to highlight the tools available to radiation oncologists for managing DCIS, with an outlook on future developments. [ABSTRACT FROM AUTHOR]

Access to radiology reports and images through a patient portal offers several advantages. The purpose of this study was to characterize patient's interactions with their radiology results. This was a retrospective study that evaluated radiography, ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography, exams performed between July 2020 and June 2021 for patients aged 12 and older. Exam information, access logs of radiology reports and images, and patient demographics were obtained from the electronic health record and image viewing software. Descriptive statistics were computed. The study included 1,685,239 exams. A total of 54.1% of reports were viewed. MRI and PET reports were viewed with the greatest frequency (70.2% and 67.6%, respectively); 25.5% of exam images were viewed, with the greatest frequency for MRI (40.1%). Exams were shared a total of 17,095 times and downloaded 8409 times; 64% of reports were viewed for patients aged 18–39 and 34% for patients aged 80 and greater. The rate of reports viewed was greater for patients with English as their preferred language (57.1%) compared to other languages (33.3%). Among those viewed, 56.5% of reports and 48.2% of images were viewed multiple times; 72.8% of images were viewed on smartphones, 25.8% on desktop computers, and 1.4% on tablets. Patients utilize a portal to view reports and view and share images. Continued efforts are warranted to promote the use of portals and create patient-friendly imaging results to help empower patients. [ABSTRACT FROM AUTHOR]

The article focuses on the HIMSS-SIIM Enterprise Imaging Community White Papers, reflecting on past achievements and future directions, highlighting the collaboration between HIMSS and SIIM in generating informative documents. It discusses the impact and future prospects of these white papers, marking the renaming of SIIM's Journal of Digital Imaging to the Journal of Imaging Informatics in Medicine (JIIM).

Strengthening the field of imaging informatics by further defining standards and advocating for continuous education are the cornerstones of the American Board of Imaging Informatics (ABII). ABII is the non-profit organization that governs the Imaging Informatics Professional certification program. ABII is responsible for awarding the Certified Imaging Informatics Professional (CIIP) designation to candidates who meet specified educational and experience-based criteria and pass a qualifying exam (1). For this paper, we analyzed Quality Improvement (QI) projects submitted to ABII for satisfaction of the 10-year requirements in 2017–2021. The project reports demonstrated a variety of interventions undertaken to ultimately improve patient care. A retrospective review of these reports exemplifies the critical role the Certified Imaging Informatics Professionals have in delivery of high quality, safe healthcare and their vital contributions to the healthcare industry and practice of medicine. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Low-dose-rate brachytherapy (LDR-BT) with 198Au grains and 192Ir pins is an essential treatment option for oral cancer due to its high rate of local control and low invasiveness. However, the radiation exposure of medical radiation workers is concerning. Thus, we aimed to determine the radiation dose delivered to medical radiation workers during LDR-BT using 198Au grains and 192Ir pins for oral cancer. Methods: Thirty-two patients with oral cancer underwent 198Au grain interstitial LDR-BT between June 2016 and May 2023, and 23 patients with tongue cancer underwent 192Ir pin interstitial LDR-BT between March 2015 and November 2017 at our hospital. Dosimetry was performed by attaching a dosimeter to the chest pocket of the operator and assistant during 198Au grain or 192Ir pin LDR-BT. Since the operator also loads 198Au grains into the implantation device, the operator's radiation dose includes the dose received during this preparation. Results: Mean radiation doses of the operators with 198Au grain and 192Ir pin LDR-BT were 165.8 and 211.2 μSv, respectively. Statistically significant differences between the radioactive sources of 198Au grain and 192Ir pin LDR-BT were observed (p = 0.0459). The mean radiation doses of the assistants with 198Au grain and 192Ir pin LDR-BT were 92.0 and 162.0 μSv, respectively. Statistically significant differences were observed between the radioactive sources of 198Au grains and 192Ir pin LDR-BT (p = 0.0003). Conclusions: Regarding radioactive source differences, 192Ir pin LDR-BT resulted in higher doses delivered to medical radiation workers than 198Au grain LDR-BT. [ABSTRACT FROM AUTHOR]

Refractory wounds present complex and serious clinical dilemmas in plastic and reconstructive surgeries. Currently, there are no standard guidelines for the treatment of refractory wounds. To observe the clinical effects of ultraviolet (UV) therapy combined with autologous platelet‐rich plasma (PRP) on chronic refractory wounds. Between January 2021 and December 2022, 60 inpatients with chronic refractory wounds were enrolled. Twenty patients were assigned to each of control groups 1 and 2 and treatment group according to whether they received PRP or UV treatment. All the patients underwent thorough debridement. Control group 2 received UV radiation. The treatment group underwent UV radiation combined with PRP gel covering the wound. Control group 1 underwent routine dressing changes after surgery, followed by skin grafting or skin key transfer if needed. One month later, we observed the wound healing in the two groups. After 2—4 PRP gel treatments, the wounds of patients in the treatment group healed. The healing time was 25.25 ± 4.93 days, and the dressings were changed 4.15 ± 3.30 times, both of which were better outcomes than in both control groups. In the treatment group, epidermal growth factor (EGF), insulin‐like growth factor (IGF), platelet‐derived growth factor (PGF), and transforming growth factor β (TGF‐β) were slightly higher, and the concentration of vascular endothelial growth factor (VEGF) was significantly higher than in the control group (p < 0.05). PRP combined with UV therapy significantly increased the concentration of wound growth factors, accelerated wound healing, shortened treatment time, reduced treatment costs, and alleviated pain in patients. [ABSTRACT FROM AUTHOR]

During the routine dissection classes for undergraduate medical students, we encountered a rare anatomical variation concerning the aberrant origin and course of the accessory splenic artery. The splenic artery is one of the direct branches of the coeliac trunk. During its tortuous course, it supplies the pancreas with greater curvature of the stomach and spleen. The accessory splenic artery originating from the main trunk of splenic artery, too, follows the same tortuous course while running through the lesser sac and supplies the posterior part of the spleen via the splenophrenic ligament. The accessory splenic artery is gaining clinical importance during various GI surgeries and some radiological procedures. The unnoticed accessory splenic artery damage may result in tremendous bleeding while performing GI-based surgery or radiological investigation like angiography. In our case report, the accessory splenic artery is an aberrant origin from the initial part of the actual splenic artery. Knowledge regarding the origin, course and termination is of utmost importance to GI surgeons, radiologists, and anatomists. [ABSTRACT FROM AUTHOR]