In recent years, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been increasingly used for the treatment of peritoneal metastases. Imaging examination plays an important role in the process of CRS+HIPEC in treatment of peritoneal metastasis. This article briefly introduces the preoperative imaging evaluation, postoperative imaging evaluation, and current limitations of CRS+HIPEC in the treatment of peritoneal metastases.
The radiology diagnosis report encapsulates radiologists’ comprehensive analytical insights and deep interpretive understanding of patients’ imaging data, serving as an essential basis for disease diagnosis, clinical treatment planning, and prognosis assessment. As the primary medium through which radiologists contribute substantively to patient’s care, traditional free-text reports represent subjective interpretations shaped by individual experience and stylistic preferences. Such reliance on personal factors can introduce inconsistencies and limitations in clinical applications. To address these challenges, structured radiology reporting has been developed. We present a concise overview of the origins, developmental trajectory, current landscape, and emerging trends of structured radiology reports, highlighting their role in advancing standardized.
ObjectiveTo summarize the common imaging features of liver cancer after local-regional therapy in order to more accurately evaluate the post-treatment response of it. MethodThe literatures of studies on imaging features after ablation, transcatheter therapy, and radiotherapy of liver cancer in recent years were searched and reviewed. ResultsIt was not accurate to evaluate the response of liver cancer after treatment only by comparing the size of tumor before and after treatment. We should follow up and observe the changes of enhancement components after tumor treatment, and pay attention to identify the normal features after treatment. ConclusionsImaging evaluation after local-regional therapy of liver cancer is of great significance in management and clinical decision-making of patients with liver cancer. Standard response evaluation systems such as EASL or mRECIST should be carefully applied after local-regional therapy of liver cancer. Treatment response of patients should be comprehensively evaluated in combination with the characteristics of local-regional therapy methods and timing, so as to avoid delaying timing of secondary treatment and causing excessive treatment.
Acute pancreatitis is a prevalent acute abdominal syndrome in clinical practice, characterized by a complex and variable course, numerous complications, high treatment challenges, and significant variability in prognosis. Imaging computed tomography (CT) plays an indispensable role in the diagnosis, classification, and severity assessment of acute pancreatitis. To ensure precise communication of the condition across departments and mutual recognition of imaging examination results among different medical institutions, there is an urgent need to establish standardized imaging reports for acute pancreatitis. We present the CT structured reporting for acute pancreatitis utilized at West China Hospital of Sichuan University, with the aim of promoting the standardization of CT report writing for acute pancreatitis.
ObjectiveTo summarize the status and progress of imaging studies of pancreatic neuroendocrine neoplasms (pNENs).MethodThe relevant literatures published recently at domestic and abroad about the imaging of pNENs were collected and reviewed.ResultsDue to poor visibility of pancreatic body and tail, the application of ultrasound (US) was limited. Compared with US, endoscopic ultrasound (EUS) and contrast-enhanced ultrasound (CEUS) could improve the detection rate of pNENs. The ability of plain CT scans to differentiate pathological grades was still controversial, but the value of enhanced scan was higher. CT texture analysis was feasible in the discrimination of nonhypervascular pNENs and pancreatic ductal adenocarcinoma (PDAC). Teta2 was the parameter with the highest diagnostic performance. The enhanced features of MRI were similar to CT. Combined with the apparent diffusion coefficient (ADC) value, the diagnostic and classification capabilities of MRI were improved, and the sensitivity and specificity of different ADC thresholds were also different. 68Ga-tetraazacyclododecane tetraacetic acid (68Ga-DOTA) peptide PET-CT had good preliminary diagnostic value for well-differentiated pNENs, and 18Fluoro-fluorodeoxyglucose (18F-FDG) PET-CT had limited diagnostic value.ConclusionsSomatostatin receptor imaging is of high diagnostic value and can guide clinical treatment and predict prognosis, but it has not been widely used in China. Conventional morphological images have advantages in the diagnosis and classification of pNENs. Therefore, it is important to choose a proper image inspection method.
ObjectiveTo summarize the application of magnetic resonance imaging (MRI) in the evaluation of pancreatic exocrine function.MethodIn this paper, we reviewed and summarized the related literatures about the application of MRI in the field of pancreatic exocrine function evaluation in recent years.ResultsA variety of MRI techniques could be used to detect the pancreatic exocrine function. In addition to conventional MRI techniques, there were also MRI stimulated by pancreatic secretions, cine (dynamic) cholangiopancreatography based on space selective reverse recovery pulse, and so on.ConclusionThe new MRI techniques have potential for semi-quantitative and quantitative evaluation of pancreatic exocrine function.
ObjectiveTo summarize the research progress of CT related to esophageal varices of cirrhotic patients complicated with portal hypertension.MethodsRelevant CT literatures of esophageal varices of cirrhotic patients complicated with portal hypertension were collected to make an review,then summarized the research status and progress of CT in the diagnosis and evaluation of lower esophageal varices.ResultCT had a good correlation with endoscopic diagnosis of esophageal varices, and CT was of great value in evaluating the presence, degree, and risk of esophageal varicose veins, especially in predicting the risk of esophageal varicose veins, which could be used as an effective modality to assist endoscopic examination to a certain extent.ConclusionsCT is an important examination method for esophageal varices, which has important value in diagnosis and evaluation. In the future, more further researches can be carried out to provide more strong and accurate support for the diagnosis and treatment of esophageal varices.
Objective To summary the principle of magnetic resonance spectroscopy imaging and its application progress in diagnosis and differential diagnosis of pancreatic cancer. Methods The newest related literatures of home and abroad were collected and reviewed. Results Magnetic resonance spectroscopy imaging was a technology using the magnetic resonance phenomena and chemical shift phenomena to measure molecular organization. The spectroscopy most commonly used in clinical and scientific research includes 1H， 31P， and 23Na. Conclusion Magnetic resonance spectroscopy as the only approach to noninvasive quantitative provding biochemical information in vivo， has an important significance to the diagnosis and differential diagnosis of pancreatic cancer.
ObjectiveTo summarize the current status and update of the use of medical imaging in risk prediction of pancreatic fistula following pancreaticoduodenectomy (PD).MethodA systematic review was performed based on recent literatures regarding the radiological risk factors and risk prediction of pancreatic fistula following PD.ResultsThe risk prediction of pancreatic fistula following PD included preoperative, intraoperative, and postoperative aspects. Visceral obesity was the independent risk factor for clinically relevant postoperative pancreatic fistula (CR-POPF). Radiographically determined sarcopenia had no significant predictive value on CR-POPF. Smaller pancreatic duct diameter and softer pancreatic texture were associated with higher incidence of pancreatic fistula. Besides the surgeons’ subjective intraoperative perception, quantitative assessment of the pancreatic texture based on medical imaging had been reported as well. In addition, the postoperative laboratory results such as drain amylase and serum lipase level on postoperative day 1 could also be used for the evaluation of the risk of pancreatic fistula.ConclusionsRisk prediction of pancreatic fistula following PD has considerable clinical significance, it leads to early identification and early intervention of the risk factors for pancreatic fistula. Medical imaging plays an important role in this field. Results from relevant studies could be used to optimize individualized perioperative management of patients undergoing PD.
Objective To assess the radiation dose and image quality with low-dose multi-detector row CT urography （CTU） for the evaluation of children patients with ureteropelvic junction stenosis （UJS）. Methods In this prospective study， 30 children patients with UJS underwent CTU were classified half-randomly through exam numbers into 3 groups （115 mA， 100 mA， and 75 mA）. Consecutive acquisitions including CT dose index weighted （CTDIw） and dose long product （DLP） were obtained in each patient and compared for each group. Three experienced chest radio-logists were unaware of the CT technique reviewed CT images for overall image quality using a 3-grade scale （excellent， good， and worst）. The data were analyzed using a parametric analysis of variance test and Wilcoxon’s signed rank test. Results The CTDIws of 115 mA group， 100 mA group， and 75 mA group were （7.63±0.83） mGy， （6.29±0.51） mGy， and （4.72±0.18） mGy， respectively， the difference was significant among three groups （F=36.445， P=0.000）. The mean CTDIw reduction was 38.2% in the 75 mA group as compared with 115 mA group （P＜0.001）. The DLPs of 115 mA group， 100 mA group， and 75 mA group were （173.89±29.88） mGy•cm， （145.96±26.21） mGy•cm， and （102.78±12.72） mGy•cm， respectively， the difference was significant among three groups （F=13.955， P=0.000）. The mean radiation dose reduction was 40.9% （75 mA group versus 115 mA group， P＜0.001）. The assessment of image quality was no significant difference with the same protocol and post-processing technique （Wilcoxon’s signed rank test， P＞0.05）. There was a good agreement for image quality scoring among the three reviewers （Kappa=0.736）. Conclusion Low-dose multi-detector row CTU should be considered as a promising technique for the evaluation of children patients with UJS because it could decrease radiation dose and obtain acceptable image quality.