State of the Art of Abdominal Radiology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 7257

Special Issue Editor


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Guest Editor
Department of Medical Imaging and Nuclear Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
Interests: abdominal imaging; pelvic imaging; oncologic imaging; MRI of the liver
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Special Issue Information

Dear Colleagues,

In the last few decades, diagnostics in abdominal and pelvic pathology have vastly improved. Today, MRI is an indispensable tool in the diagnosis of liver or pancreatic pathology and in the local staging of pelvic cancers.

This issue of Diagnostics will specifically focus on novel MRI techniques in the diagnosis of both diffuse and focal liver pathology. Research papers that highlight progress achieved using ultrasound techniques in the diagnostics of diffuse liver disease are also welcome.

The pre- and postoperative evaluation of digestive cancer remains an important task of an abdominal radiologist. Qualitative imaging and radiomics can help predict the histopathological characteristics of a tumor and may offer additional tools in establishing the prognosis of a patient.

The aim of this Special Issue is to publish new advancements and trends in diagnostic and interventional abdominal radiology. Research and review articles regarding the presented and related topics are appropriate for submission to this Special Issue of Diagnostics.

Dr. Cosmin Caraiani
Guest Editor

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Keywords

  • abdominal imaging
  • pelvic imaging
  • liver MRI
  • liver ultrasound
  • digestive cancer imaging
  • radiomics

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Published Papers (5 papers)

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Research

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16 pages, 6995 KiB  
Article
Comparison of Ultrasound Attenuation Imaging Using a Linear versus a Conventional Convex Probe: A Volunteer Study
by Olivia Hänni, Lisa Ruby, Catherine Paverd, Thomas Frauenfelder, Marga B. Rominger and Alexander Martin
Diagnostics 2024, 14(9), 886; https://doi.org/10.3390/diagnostics14090886 - 24 Apr 2024
Viewed by 968
Abstract
The study aimed to investigate the feasibility of attenuation imaging (ATI) measurements using a linear probe on healthy volunteers and compare measurements with the conventional convex probe. Attenuation imaging measurements of the liver tissue were taken using ultrasound with a convex and a [...] Read more.
The study aimed to investigate the feasibility of attenuation imaging (ATI) measurements using a linear probe on healthy volunteers and compare measurements with the conventional convex probe. Attenuation imaging measurements of the liver tissue were taken using ultrasound with a convex and a linear probe in 33 volunteers by two examining doctors, and the measurements were repeated 4–5 weeks later by one of them. The ATI values for the linear probe were in the range of the values for the convex probe for both examiners. Measurements did not change significantly for 32 out of 33 volunteers after 4–5 weeks when using the linear probe. The size of the region of interest (ROI) only impacted the ATI values for the convex probe; it did not affect the values taken with the linear probe. Healthy volunteers were measured, and their attenuation values were compared to those from a convex probe, commonly used in steatosis evaluation. When both probes were positioned in the same liver area, they showed good agreement in attenuation values, though depth significantly affected the measurements, with both probes providing different values at different depths. The study’s results aligned with previous research using the same system. Operator A and B’s results were compared, demonstrating similar ranges of values for both probes. The linear probe has been demonstrated to allow for superficial measurements and attain ATI values in line with that of the convex probe in the liver. Full article
(This article belongs to the Special Issue State of the Art of Abdominal Radiology)
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14 pages, 6207 KiB  
Article
Confounders of Ultrasound Attenuation Imaging in a Linear Probe Using the Canon Aplio i800 System: A Phantom Study
by Olivia Hänni, Lisa Ruby, Catherine Paverd, Thomas Frauenfelder, Marga B. Rominger and Alexander Martin
Diagnostics 2024, 14(3), 271; https://doi.org/10.3390/diagnostics14030271 - 26 Jan 2024
Cited by 1 | Viewed by 1328
Abstract
There have been studies showing attenuation imaging (ATI) with ultrasound as an approach to diagnose liver diseases such as steatosis or cirrhosis. So far, this technique has only been used on a convex probe. The goal of the study was to investigate the [...] Read more.
There have been studies showing attenuation imaging (ATI) with ultrasound as an approach to diagnose liver diseases such as steatosis or cirrhosis. So far, this technique has only been used on a convex probe. The goal of the study was to investigate the feasibility of ATI measurements using the linear array on a canon Aplio i800 scanner on certified phantoms. Three certified liver tissue attenuation phantoms were measured in five different positions using a linear probe. The effects of positioning and depth were explored and compared. The values were compared to the certified expected value for each phantom as well as the different measurement values for each measurement position. The ATI measurements on phantoms showed significant effect for the different probe positions and region of interest (ROI) depths. Values taken in the center with the probe perpendicular to the phantom were closest to certified values. Median values at 2.5–4.5 cm depth for phantoms 1 and 2 and 0.5–2.5 cm for phantom 3 were comparable with certified values. Measurements taken at a depth greater than 6 cm in any position were the least representative of the certified values (p-value < 0.01) and had the widest range throughout the different sessions. ATI measurements can be performed with the linear probe in phantoms; however, careful consideration should be given to depth dependency, as it can significantly affect measurement values. Remaining measurements at various depths within the 0.5–6.0 cm range showed deviation from the certified values of approximately 25%. Full article
(This article belongs to the Special Issue State of the Art of Abdominal Radiology)
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14 pages, 1681 KiB  
Article
MRI Tumor Regression Grade Combined with T2-Weighted Volumetry May Predict Histopathological Response in Locally Advanced Rectal Cancer following Neoadjuvant Chemoradiotherapy—A New Scoring System Proposal
by Aleksandra Jankovic, Jelena Djokic Kovac, Marko Dakovic, Milica Mitrovic, Dusan Saponjski, Ognjen Milicevic, Aleksandra Djuric-Stefanovic and Goran Barisic
Diagnostics 2023, 13(20), 3226; https://doi.org/10.3390/diagnostics13203226 - 17 Oct 2023
Cited by 2 | Viewed by 1056
Abstract
Modern studies focus on the discovery of innovative methods to improve the value of post-treatment magnetic resonance imaging (MRI) in the prediction of pathological responses to preoperative neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). The aim of this study was [...] Read more.
Modern studies focus on the discovery of innovative methods to improve the value of post-treatment magnetic resonance imaging (MRI) in the prediction of pathological responses to preoperative neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). The aim of this study was to assess the potential benefits of combining magnetic resonance tumor regression grade (mrTRG) with T2-weighted volumetry in the prediction of pathological responses to nCRT in LARC. This was a cohort study conducted on patients with histopathologically confirmed LARC in a period from 2020 to 2022. After histopathological verification, all patients underwent initial MRI studies, while the follow-up MRI was performed after nCRT. Tumor characteristics, MRI estimated tumor regression grade (mrTRG) and tumor volumetry were evaluated both initially and at follow-up. All patients were classified into responders and non-responders according to pathological tumor regression grade (pTRG) and mrTRG. A total of 71 patients, mostly male (66.2%) were included in the study. The median tumor volume reduction rate was significantly higher in nCRT-responders compared to non-responders (79.9% vs. 63.3%) (p = 0.003). Based on ROC analysis, optimal cut-off value for tumor volume reduction rate was determined with an area under the curve (AUC) value of 0.724 (p = 0.003). Using the tumor volume reduction rate ≥75% with the addition of response to nCRT according to mrTRG, a new scoring system for prediction of pTRG to preoperative nCRT in LARC was developed. Diagnostic performance of prediction score was tested and the sensitivity, PPV, specificity, and NPV were 81.8%, 56.3%, 71.4%, and 89.7%, respectively. The combination of mrTRG and T2-weighted volumetry increases the MRI-based prediction of pTRG to preoperative nCRT in LARC. The proposed scoring system could aid in distinguishing responders to nCRT, as these patients could benefit from organ-preserving treatment and a “watch and wait” strategy. Full article
(This article belongs to the Special Issue State of the Art of Abdominal Radiology)
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11 pages, 2433 KiB  
Article
Obesity-Related Pitfalls of Virtual versus True Non-Contrast Imaging—An Intraindividual Comparison in 253 Oncologic Patients
by Henner Huflage, Andreas Steven Kunz, Robin Hendel, Johannes Kraft, Stefan Weick, Gary Razinskas, Stephanie Tina Sauer, Lenhard Pennig, Thorsten Alexander Bley and Jan-Peter Grunz
Diagnostics 2023, 13(9), 1558; https://doi.org/10.3390/diagnostics13091558 - 26 Apr 2023
Cited by 3 | Viewed by 1252
Abstract
Objectives: Dual-source dual-energy CT (DECT) facilitates reconstruction of virtual non-contrast images from contrast-enhanced scans within a limited field of view. This study evaluates the replacement of true non-contrast acquisition with virtual non-contrast reconstructions and investigates the limitations of dual-source DECT in obese patients. [...] Read more.
Objectives: Dual-source dual-energy CT (DECT) facilitates reconstruction of virtual non-contrast images from contrast-enhanced scans within a limited field of view. This study evaluates the replacement of true non-contrast acquisition with virtual non-contrast reconstructions and investigates the limitations of dual-source DECT in obese patients. Materials and Methods: A total of 253 oncologic patients (153 women; age 64.5 ± 16.2 years; BMI 26.6 ± 5.1 kg/m2) received both multi-phase single-energy CT (SECT) and DECT in sequential staging examinations with a third-generation dual-source scanner. Patients were allocated to one of three BMI clusters: non-obese: <25 kg/m2 (n = 110), pre-obese: 25–29.9 kg/m2 (n = 73), and obese: >30 kg/m2 (n = 70). Radiation dose and image quality were compared for each scan. DECT examinations were evaluated regarding liver coverage within the dual-energy field of view. Results: While arterial contrast phases in DECT were associated with a higher CTDIvol than in SECT (11.1 vs. 8.1 mGy; p < 0.001), replacement of true with virtual non-contrast imaging resulted in a considerably lower overall dose-length product (312.6 vs. 475.3 mGy·cm; p < 0.001). The proportion of DLP variance predictable from patient BMI was substantial in DECT (R2 = 0.738) and SECT (R2 = 0.620); however, DLP of SECT showed a stronger increase in obese patients (p < 0.001). Incomplete coverage of the liver within the dual-energy field of view was most common in the obese subgroup (17.1%) compared with non-obese (0%) and pre-obese patients (4.1%). Conclusion: DECT facilitates a 30.8% dose reduction over SECT in abdominal oncologic staging examinations. Employing dual-source scanner architecture, the risk for incomplete liver coverage increases in obese patients. Full article
(This article belongs to the Special Issue State of the Art of Abdominal Radiology)
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Review

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19 pages, 996 KiB  
Review
MRI-Based Radiomics in Bladder Cancer: A Systematic Review and Radiomics Quality Score Assessment
by Bianca Boca, Cosmin Caraiani, Teodora Telecan, Roxana Pintican, Andrei Lebovici, Iulia Andras, Nicolae Crisan, Alexandru Pavel, Laura Diosan, Zoltan Balint, Monica Lupsor-Platon and Mircea Marian Buruian
Diagnostics 2023, 13(13), 2300; https://doi.org/10.3390/diagnostics13132300 - 6 Jul 2023
Cited by 4 | Viewed by 1983
Abstract
(1): Background: With the recent introduction of vesical imaging reporting and data system (VI-RADS), magnetic resonance imaging (MRI) has become the main imaging method used for the preoperative local staging of bladder cancer (BCa). However, the VI-RADS score is subject to interobserver variability [...] Read more.
(1): Background: With the recent introduction of vesical imaging reporting and data system (VI-RADS), magnetic resonance imaging (MRI) has become the main imaging method used for the preoperative local staging of bladder cancer (BCa). However, the VI-RADS score is subject to interobserver variability and cannot provide information about tumor cellularity. These limitations may be overcome by using a quantitative approach, such as the new emerging domain of radiomics. (2) Aim: To systematically review published studies on the use of MRI-based radiomics in bladder cancer. (3) Materials and Methods: We performed literature research using the PubMed MEDLINE, Scopus, and Web of Science databases using PRISMA principles. A total of 1092 papers that addressed the use of radiomics for BC staging, grading, and treatment response were retrieved using the keywords “bladder cancer”, “magnetic resonance imaging”, “radiomics”, and “textural analysis”. (4) Results: 26 papers met the eligibility criteria and were included in the final review. The principal applications of radiomics were preoperative tumor staging (n = 13), preoperative prediction of tumor grade or molecular correlates (n = 9), and prediction of prognosis/response to neoadjuvant therapy (n = 4). Most of the developed radiomics models included second-order features mainly derived from filtered images. These models were validated in 16 studies. The average radiomics quality score was 11.7, ranging between 8.33% and 52.77%. (5) Conclusions: MRI-based radiomics holds promise as a quantitative imaging biomarker of BCa characterization and prognosis. However, there is still need for improving the standardization of image preprocessing, feature extraction, and external validation before applying radiomics models in the clinical setting. Full article
(This article belongs to the Special Issue State of the Art of Abdominal Radiology)
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