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Abstract Various processes, including benign or malignant (mostly metastasis) processes, contribute to the occurrence of multiple pulmonary nodules. For differential diagnosis, metastasis must be excluded as an etiological factor in patients who have multiple pulmonary nodules with a known primary malignancy. However, differential diagnosis of multiple pulmonary nodules caused by benign diseases and malignant processes is challenging. Multiple pulmonary nodules resulting from metastasis may mimic those resulting from infections, inflammatory processes, and rare benign diseases. Some rare diseases, such as pulmonary sclerosing pneumocytoma and pulmonary epithelioid hemangioendothelioma, or common diseases with a rare presentation of multiple nodules must be considered in the differential diagnosis of metastasis. In addition to the clinical and laboratory findings, radiological features are crucial for differential diagnosis. The size, density, location, and border characteristics (well-defined or poorly defined) of pulmonary nodules, as well as their internal structure (solid, subsolid, or ground glass nodule), growth rate during follow-up, and associated pulmonary and extrapulmonary findings are important for differential diagnosis along with clinical and laboratory data. This article summarizes the general features and imaging findings of these diseases, which less frequently present with multiple pulmonary nodules, and the clues that can be used to distinguish these diseases from metastasis. Critical relevance statement The radiological features, clinical findings, and temporal changes during follow-up are important in distinguishing non-metastatic causes of multiple pulmonary nodules from metastatic causes and guiding diagnosis and early treatment, especially in patients with primary malignancy. Key Points Multiple pulmonary nodules have a wide range of etiologies, including metastatic disease. Metastasis as an etiology must be excluded in patients with multiple pulmonary nodules. Correlation of radiological findings (nodule size, position, and associated findings) with clinical history is crucial for differential diagnosis. Graphical Abstract

PURPOSE: To evaluate the efficacy of interventional radiological (IR) procedures in iatrogenic urinary tract injury and investigate the factors affecting the outcome. METHODS: Fifty-eight patients (21 male) with a mean age of 50.3 ± 15.8 years referred for iatrogenic urinary tract injury were enrolled in this study. Technical success was defined as (i) successful placement of a nephrostomy catheter within the renal pelvis and/or (ii) successful antegrade ureteral stent placement (double J stent) between the renal pelvis and bladder lumen. Complete resolution was defined as maintained ureteral patency without an external drain and ureteral stent. The factors that may affect complete resolution [ureteral avulsion, ureterovaginal fistula (UVF), history of malignancy/radiotherapy, and time to IR management] were also investigated. The receiver operating characteristic analysis was performed to estimate the cut-off time point for the IR management timing affecting complete resolution. RESULTS: The technical success rate for nephrostomy and ureteral stent placement was 100% (n = 58/58) and 78% (n = 28/36), respectively. In 14 patients, non-dilated pelvicalyceal systems were evident. In 18 patients, no further intervention after percutaneous nephrostomy was performed due to (i) poor performance status (n = 6) and (ii) reconstruction surgery upon clinicians’ and/or patients’ request (n = 12). Reconstruction surgery was required in 11 of the remaining 40 patients due to failure of percutaneous treatment (n = 11/40, 27.5%). In six of the patients, ureteral stents could not be removed due to the development of benign ureteral strictures (n = 6/40, 15%). Our complete resolution rate was 57.5% (n = 23/40). Age, gender, type of surgery (endoscopic or open), side and location of the injury did not statistically affect the complete resolution rate. The presence of ureteral avulsion, history of malignancy and radiotherapy individually or in combination significantly affected the complete resolution rate negatively. The presence of UVF also had a negative effect on the complete resolution rate; however, it did not reach statistical significance. Delayed intervention was also a significant factor related to lower complete resolution. The optimal cut-off point of the time interval for favorable clinical outcome was found to be 0–19th day following the surgery. CONCLUSION: IR procedures are safe and effective in the management of iatrogenic urinary tract injuries. Antegrade ureteral stenting should be performed as soon as possible to establish ureteral integrity without the development of stricture.

Abstract Hydatid cyst caused by the larval form of Echinococcus is a worldwide zoonosis. The lungs and liver are the most common sites involved. While the lung parenchyma is the most common site within the thorax, it may develop in any extrapulmonary region including the pleural cavity, fissures, mediastinum, heart, vascular structures, chest wall, and diaphragm. Imaging plays a pivotal role not only in the diagnosis of hydatid cyst, but also in the visualization of the extent of involvement and complications. The aim of this pictorial review was to comprehensively describe the imaging findings of thoracic hydatid cyst including pulmonary and very unusual extrapulmonary involvements. An outline is also given for the findings of complications and differential diagnosis of thoracic hydatid cyst.

PurposeThe aim of this study was to evaluate visual and software-based quantitative assessment of parenchymal changes and normal lung parenchyma in patients with coronavirus disease 2019 (COVID-19) pneumonia. The secondary aim of the study was to compare the radiologic findings with clinical and laboratory data.MethodsPatients with COVID-19 who underwent chest computed tomography (CT) between March 11, 2020 and April 15, 2020 were retrospectively evaluated. Clinical and laboratory findings of patients with abnormal findings on chest CT and PCR-evidence of COVID-19 infection were recorded. Visual quantitative assessment score (VQAS) was performed according to the extent of lung opacities. Software-based quantitative assessment of the normal lung parenchyma percentage (SQNLP) was automatically quantified by a deep learning software. The presence of consolidation and crazy paving pattern (CPP) was also recorded. Statistical analyses were performed to evaluate the correlation between quantitative radiologic assessments, and clinical and laboratory findings, as well as to determine the predictive utility of radiologic findings for estimating severe pneumonia and admission to intensive care unit (ICU).ResultsA total of 90 patients were enrolled. Both VQAS and SQNLP were significantly correlated with multiple clinical parameters. While VQAS >8.5 (sensitivity, 84.2%; specificity, 80.3%) and SQNLP 9.5 (sensitivity, 93.3%; specificity, 86.5%) and SQNLP

PURPOSE To evaluate the efficacy of interventional radiological (IR) procedures in iatrogenic urinary tract injury and investigate the factors affecting the outcome. METHODS Fifty-eight patients (21 male) with a mean age of 50.3 ± 15.8 years referred for iatrogenic urinary tract injury were enrolled in this study. Technical success was defined as (i) successful placement of a nephrostomy catheter within the renal pelvis and/or (ii) successful antegrade ureteral stent placement (double J stent) between the renal pelvis and bladder lumen. Complete resolution was defined as maintained ureteral patency without an external drain and ureteral stent. The factors that may affect complete resolution [ureteral avulsion, ureterovaginal fistula (UVF), history of malignancy/ radiotherapy, and time to IR management] were also investigated. The receiver operating characteristic analysis was performed to estimate the cut-off time point for the IR management timing affecting complete resolution. RESULTS The technical success rate for nephrostomy and ureteral stent placement was 100% (n = 58/58) and 78% (n = 28/36), respectively. In 14 patients, non-dilated pelvicalyceal systems were evident. In 18 patients, no further intervention after percutaneous nephrostomy was performed due to (i) poor performance status (n = 6) and (ii) reconstruction surgery upon clinicians' and/or patients' request (n = 12). Reconstruction surgery was required in 11 of the remaining 40 patients due to failure of percutaneous treatment (n = 11/40, 27.5%). In six of the patients, ureteral stents could not be removed due to the development of benign ureteral strictures (n = 6/40, 15%). Our complete resolution rate was 57.5% (n = 23/40). Age, gender, type of surgery (endoscopic or open), side and location of the injury did not statistically affect the complete resolution rate. The presence of ureteral avulsion, history of malignancy and radiotherapy individually or in combination significantly affected the complete resolution rate negatively. The presence of UVF also had a negative effect on the complete resolution rate; however, it did not reach statistical significance. Delayed intervention was also a significant factor related to lower complete resolution. The optimal cut-off point of the time interval for favorable clinical outcome was found to be 0--19th day following the surgery. CONCLUSION IR procedures are safe and effective in the management of iatrogenic urinary tract injuries. Antegrade ureteral stenting should be performed as soon as possible to establish ureteral integrity without the development of stricture. [ABSTRACT FROM AUTHOR]

The article discusses a specific pattern of drug-induced lung disease called the centrilobular ground-glass nodule (GGN) pattern. This pattern has been observed in acute myeloid leukemia (AML) patients receiving cytosine arabinoside (Ara-C) chemotherapy. The authors highlight the importance of recognizing this pattern and differentiating it from other conditions, such as miliary tuberculosis. They emphasize the need for multidisciplinary meetings to establish a diagnosis and determine the best management plan for patients with suspected drug-induced lung disease. The article provides case examples and suggests that proper patient management is more crucial than achieving a definitive diagnosis. [Extracted from the article]

The article offers information on a 41-year-old female with human epidermal growth factor receptor 2 (HER2) (+) metastatic breast cancer experiencing cardiac complications. Topics include her medical history, presenting symptoms of exertional dyspnea and orthopnea, and physical examination findings such as bilateral crackles, S3 sound, and a murmur.

Purpose: The aim of this study was to evaluate visual and software-based quantitative assessment of parenchymal changes and normal lung parenchyma in patients with coronavirus disease 2019 (COVID-19) pneumonia. The secondary aim of the study was to compare the radiologic findings with clinical and laboratory data.Methods: Patients with COVID-19 who underwent chest computed tomography (CT) between March 11, 2020 and April 15, 2020 were retrospectively evaluated. Clinical and laboratory findings of patients with abnormal findings on chest CT and PCR-evidence of COVID-19 infection were recorded. Visual quantitative assessment score (VQAS) was performed according to the extent of lung opacities. Software-based quantitative assessment of the normal lung parenchyma percentage (SQNLP) was automatically quantified by a deep learning software. The presence of consolidation and crazy paving pattern (CPP) was also recorded. Statistical analyses were performed to evaluate the correlation between quantitative radiologic assessments, and clinical and laboratory findings, as well as to determine the predictive utility of radiologic findings for estimating severe pneumonia and admission to intensive care unit (ICU).Results: A total of 90 patients were enrolled. Both VQAS and SQNLP were significantly correlated with multiple clinical parameters. While VQAS >8.5 (sensitivity, 84.2%; specificity, 80.3%) and SQNLP <82.45% (sensitivity, 83.1%; specificity, 84.2%) were related to severe pneumonia, VQAS >9.5 (sensitivity, 93.3%; specificity, 86.5%) and SQNLP <81.1% (sensitivity, 86.5%; specificity, 86.7%) were predictive of ICU admission. Both consolidation and CPP were more commonly seen in patients with severe pneumonia than patients with nonsevere pneumonia (P = 0.197 for consolidation; P < 0.001 for CPP). Moreover, the presence of CPP showed high specificity (97.2%) for severe pneumonia.Conclusion: Both SQNLP and VQAS were significantly related to the clinical findings, highlighting their clinical utility in predicting severe pneumonia, ICU admission, length of hospital stay, and management of the disease. On the other hand, presence of CPP has high specificity for severe COVID-19 pneumonia. [ABSTRACT FROM AUTHOR]

Abstract Congenital lung diseases in adults are rare diseases that can present with symptoms or be detected incidentally. Familiarity with the imaging features of different types of congenital lung diseases helps both in correct diagnosis and management of these diseases. Congenital lung diseases in adults are classified into three main categories as bronchopulmonary anomalies, vascular anomalies, and combined bronchopulmonary and vascular anomalies. Contrast-enhanced computed tomography, especially 3D reconstructions, CT, or MR angiography, can show vascular anomalies in detail. The tracheobronchial tree, parenchymal changes, and possible complications can also be defined on chest CT, and new applications such as quantitative 3D reconstruction CT images, dual-energy CT (DECT) can be helpful in imaging parenchymal changes. In addition to the morphological assessment of the lungs, novel MRI techniques such as ultra-short echo time (UTE), arterial spin labeling (ASL), and phase-resolved functional lung (PREFUL) can provide functional information. This pictorial review aims to comprehensively define the radiological characteristics of each congenital lung disease in adults and to highlight differential diagnoses and possible complications of these diseases.

Amaç: Torasik ışınlamalarda koroner arterler (KA) radyasyona maruz kalır ve buna bağlı olarak kardiyovasküler toksisiteler oluşabilir. Bu toksisiteleri önlemek için, öncelikle bu yapıların sabit ve tekrarlanabilir bir şekilde tanımlanmaları gerekir. Bu yapılar konturlanırken ve risk altındaki organ marjları oluşturulurken kardiyopulmoner aktivitenin sebep olduğu hareketler dikkate alınmalıdır. Aksi takdirde hesaplanan ve uygulanan doz arasında farklılıklar olur. Bu çalışmanın amacı, elektrokardiyografi (EKG) kapılı bilgisayarlı tomografi (BT) görüntülerini kullanarak KA'nın hareketini ölçmek ve güvenlik marjlarının uygun bir şekilde oluşturulmasını sağlamaktır. Gereç ve Yöntem: Çalışma için gerekli etik kurul izinlerini takiben, hastanemiz Radyoloji bölümünde EKG kapılı BT ile koroner anjiografi yapılan 24 hasta retrospektif olarak değerlendirilmiştir. Çalışmamıza, 18 yaş üzerinde, kanser tanısı olmayan, 10 kadın (yaş: 58,10 ± 12,29) ve 14 erkek (yaş: 52,00 ± 18,46) hasta dahil edilmiştir. KA kalp üzerinde uzunca bir segmentte uzandıkları için değerlendirme kolaylığı açısından sol anterior desendan arter (LAD) 3 segmente, sol circumflex arter (Cx) 2 segmente ve sağ koroner arter (RCA) 2 segmete bölünmüş, sol ana koroner arter (LCA) kısa olduğundan dolayı tek segmentte bırakılarak hareketleri değerlendirilmiştir. Hastaların EKG kapılı intravenöz kontrastlı BT çekimleri Somatom Force SW VA50 CT X-Ray cihazında expiryumun sonunda yapılmış ve bu görüntüler RayStation® 8A planlama sistemlerine aktarılarak, maksimum hareketin olduğu sistol ve diastol fazlarındaki görüntülerde KA konturlanmış ve bu iki faz arasındaki yer değişimleri ölçülmüştür. Bulgular: Koroner arter çapları ve hareketleri değerlendirildiğinde yaş ve cinsiyet açısından farklılık izlenmemiştir. LCA, LAD'ın ilk segmenti (LAD1) ve RCA'nın ikinci segmenti (RCA2)'nin maksimum yer değiştirmelerinin radyal yönde olduğu dikkati çekmiştir. Cx'in ikinci segmenti (Cx2) ile LAD'ın ikinci segmenti (LAD2)'nin maksimum yer değiştirmelerinin kranokaudal yönde olduğu tespit edilmiştir. Diğer arter ve segmentlerde herhangi bir genelleme yapılamamıştır. Ölçülen yer değişimleri %95'lik güvenlik aralığıyla Tablo 1'de özetlenmiştir. Sonuç: Tüm KA'nın kalp hareketine bağlı olarak hareket ettiği tespit edilmiştir. Bu hareketlerin, arterin bulunduğu yere göre değişiklik gösterdiği dikkati çekmiştir. Koroner arter konturlamalarında, risk altındaki organ marjları verilirken kalp hareketinden kaynaklı emniyetler verilerek doz doğruluğu sağlanmalıdır. [ABSTRACT FROM AUTHOR]

Amaç: Torasik yerleşimli tümörlerin radyoterapisinde, doz-hacimsel parametreler olarak kardiyak ortalama doz ve maksimum kalp dozu, tedavi planı optimizasyonu için sıklıkla kullanılmıştır. Ancak bu parametreler, önemli kardiyak altyapılar tarafından alınan farklı dozları hesaba katmamaktadır. Bunun önüne geçebilmek için, Ramus interventricularis anterior (LAD) başta olmak üzere, bu yapıların aldıkları dozların hesaplanması son yıllarda önem kazanmıştır. Bu çalışmanın amacı, tedavi planlama sistemi (TPS)'nde, LAD'ın optimizasyona dahil edilmesi sonucu ortaya çıkan yeni tedavi planlarının, klinik hedefler açısından standart planlamalarla karşılaştırılmasıdır. Gereç ve Yöntem: Çalışma için gerekli etik kurul izinlerini takiben, hastanemiz Radyasyon Onkolojisi bölümünde Elekta Versa HD cihazlarıyla 6 MV enerjili foton ve volümetrik modülasyonlu ark terapisi (VMAT) ile tedavi görmüş olan, 18 yaşını doldurmuş; konvansiyonel fraksiyonizasyonda (2 Gy x 30 fx), planlanan hedef hacim (PTV) dozu 60 Gy olan, ardışık 10 küçük hücreli dışı akciğer kanseri hastası (yaş: 69,40 ± 9,26) ile konvansiyonel fraksiyonizasyonda (2 Gy x 25 fx) ve 10 Gy tümör yatağı boostuyla birlikte, toplam PTV dozu 60 Gy olan, ardışık 10 sol meme kanserli hastanın (yaş: 56,50 ± 9,77) halihazırda risk altındaki organ ve yapılar (OAR)'ı konturlanmış olan görüntülerine RayStation® 8A TPS'de, 3 segmente ayrılmış olan LAD'ın (LAD1, LAD2 ve LAD3) konturları da eklenerek tek bir LAD altında birleştirilmiştir. Optimizasyona LAD da dahil edilip, hedef ve OAR doz kısıtlamaları tarafından test edilerek daha önce yapılmış tedavi planları ile karşılaştırılmıştır. Bulgular: Yeni tedavi planlarında; hedeflerin ve diğer kritik organların aldıkları dozlarda anlamlı bir fark gözlenemezken, akciğer kanserli olgularda LAD V15 Gy, kalp ortalama doz, sol meme kanserli olgularda LAD V15 Gy, kalp V25 Gy, kalp V10 Gy anlamlı bir şekilde düşmüştür. Sonuç: LAD'ın tedavi planı yapılırken optimizasyona dahil edilmesi gerektiği sonucuna varılmıştır. [ABSTRACT FROM AUTHOR]

Abstract Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly and may be a component of the complex cardiac pathologies. While it is often asymptomatic, it can lead to significant problems such as arrhythmias and cyanosis. Besides, it can cause serious complications during vascular interventional procedures or the surgical treatment of cardiac anomalies (CA). The clinical significance of PLSVC depends on the drainage site and the accompanying CA. In this article, we will describe the epidemiology, embryology, and anatomic variations of PLSVC. Possible accompanying CA and heterotaxy spectrum will be reviewed with the help of multidetector computed tomography (MDCT) images. Radiological pitfalls, differential diagnoses, and the clinical importance of PLSVC will be highlighted.

An amendment to this paper has been published and can be accessed via the original article.

Masses or mass-like lesions located in proximity to mitral valve encompass a wide range of differential diagnoses including neoplasias, abscesses, thrombi, and rarely caseous calcification of mitral annulus. Due to asymptomatic presentation, its diagnosis is usually incidental. Echocardiography is the first choice of imaging in evaluation. Cardiac computed tomography (CT) is helpful in establishing diagnosis by showing dense calcifications while cardiac magnetic resonance imaging (MRI) is used primarily as a problem solving tool. Imaging in evaluation of mitral annulus caseous calcification is essential in order to prevent unnecessary operations.

Left images: Top: (A) Echocardiography shows a dilated pulmonary artery, large aortopulmonary window (dotted line), and abnormally positioned aortic arch. (B) MIP image reveals superior RV, inferior LV, and elongated arch vessels (arrows). Bottom: MinIP shows a thin left main bronchus and non-aerated RML (asterisk). Right images: VRT highlights superior RV, inferior LV, elongated arch vessels (arrows), and APW., (© 2025 Wiley Periodicals LLC.)