Things We Do for No Reason: Overlooking incidental coronary artery calcification (iCAC).

A 58-year-old man with no significant medical history or prescribed medications, including coronary artery disease, presented to the emergency department with hypoxemia due to COVID-19. A non-contrast chest computed tomography (CT) ordered to evaluate for the cause of the patient's hypoxemia revealed mild ground-glass opacities and moderate incidental coronary artery calcium (iCAC), noted in the body of the report. The CT report impression only reads "Peripheral ground glass opacities in keeping with COVID-19 infection.

Beyond the norm: Exploring the diverse facets of adrenal lesions.

Radiological diagnosis of adrenal lesions can be challenging due to the overlap between benign and malignant imaging features. The primary challenge in managing adrenal lesions is to accurately identify and characterize them to minimize unnecessary diagnostic examinations and interventions. However, there are substantial risks of underdiagnosis and misdiagnosis.

ChatGPT-4's Accuracy in Estimating Thyroid Nodule Features and Cancer Risk From Ultrasound Images.

Objective: To evaluate the performance of GPT-4 and GPT-4o in accurately identifying features and categories from thyroid nodule ultrasound images following the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS).

Methods: This comparative validation study, conducted between October 2023 and May 2024, utilized 202 thyroid ultrasound images sourced from 3 open-access databases. Both complete and cropped versions of each image were independently evaluated by expert radiologists to establish a reference standard for TI-RADS features and categories.

Radiomics machine learning algorithm facilitates detection of small pancreatic neuroendocrine tumors on CT.

Purpose: The purpose of this study was to develop a radiomics-based algorithm to identify small pancreatic neuroendocrine tumors (PanNETs) on CT and evaluate its robustness across manual and automated segmentations, exploring the feasibility of automated screening.

Materials And Methods: Patients with pathologically confirmed T1 stage PanNETs and healthy controls undergoing dual-phase CT imaging were retrospectively identified. Manual segmentation of pancreas and tumors was performed, then automated pancreatic segmentations were generated using a pretrained neural network.

Tip of the iceberg: extracardiac CT findings in infective endocarditis.

Infective endocarditis (IE) is a disease with high morbidity and mortality rate, but diagnosis is confounded by diverse clinical presentations, which mimic other pathologies. A history of illicit intravenous drug use, previous cardiac valve surgery, and indwelling intracardiac devices increases the risk for developing infective endocarditis. The modified Duke criteria serve as the standard diagnostic tool, though its accuracy is reduced in certain cases.

Opportunistic Screening for Coronary Artery Disease: An Untapped Population Health Resource.

Background: Coronary artery disease is the leading cause of death in the United States. At-risk asymptomatic adults are eligible for screening with electrocardiogram-gated coronary artery calcium (CAC) CT, which aids in risk stratification and management decision-making. Incidental CAC (iCAC) is easily quantified on chest CT in patients imaged for noncardiac indications; however, radiologists do not routinely report the finding.

Tethered spinal cord tension assessed via ultrasound elastography in computational and intraoperative human studies.

Background: Tension in the spinal cord is a trademark of tethered cord syndrome. Unfortunately, existing tests cannot quantify tension across the bulk of the cord, making the diagnostic evaluation of stretch ambiguous. A potential non-destructive metric for spinal cord tension is ultrasound-derived shear wave velocity (SWV).

Rapid on-site evaluation (ROSE) of image-guided FNA specimens improves subsequent core biopsy adequacy in clinical trial patients: The impact of preanalytical factors and its correlation with survival.

Background: Sufficient tumor collection has become of utmost importance in therapeutic experimental protocols. Rapid on-site evaluation (ROSE) ensures adequate sampling for quantification of biomarkers, molecular analyses, and other ancillary studies. The objectives of this study were to evaluate the role of ROSE in trial-associated fine-needle aspiration (FNA) and to analyze predictors of adequacy and cumulative survival from in-house FNA cases used in clinical trials.

CT Evaluation of the Esophagus: The Role of CT Imaging and CT Imaging Findings in Diagnosing Esophageal Abnormalities.

Esophageal disorders are commonly encountered by radiologists on computed tomography. Characteristic computed tomography findings of various esophageal pathologies have been extensively described and are important for the radiologist to know to facilitate accurate and timely diagnosis. Esophageal disorders can be broadly classified as infectious and inflammatory, congenital/structural, or neoplastic.

Prevalence of Hepatic Steatosis in Adults Presenting to the Emergency Department Identified by Unenhanced Chest CT.

This study aimed to investigate the prevalence of hepatic steatosis in racially diverse adults presenting to the emergency department at a tertiary healthcare system in the United States using attenuation values on unenhanced computed tomography (CT) as the reference standard. The utility of known risk factors for predicting the presence of hepatic steatosis was assessed. Additionally, reporting of hepatic steatosis in original radiology reports was evaluated.

Impact of genetic testing and smoking on the distribution of risk factors in patients with recurrent acute and chronic pancreatitis.

Objective: The aim of the present study is to assess the impact of smoking dose and duration on the distribution of risk factor(s) in patients with RAP and CP, and the impact of genetic testing on the distribution of risk factor(s) in patients with idiopathic RAP and CP.

Methods: All adult patients with RAP and CP referred to a multidisciplinary pancreatitis clinic between 2010 and 2017 were evaluated. Risk factors included alcohol and smoking, hypertriglyceridemia, biliary, and other etiologies.

CT evaluation of self-induced and retained foreign bodies in the abdomen and pelvis.

Computed tomography (CT) can both locate and identify foreign bodies as well as pinpoint complications to help direct treatment. Retained foreign bodies in the abdomen and pelvis can lead to perforation, obstruction, intussusception, fistula formation, and abdominal abscess formation. This article reviews the imaging appearance of incidentally found common foreign bodies and the role of CT in identifying unsuspected foreign bodies.

Morphologic Severity of Acute Pancreatitis on Imaging Is Independently Associated with Opioid Dose Requirements in Hospitalized Patients.

Background: Prior studies have evaluated clinical characteristics associated with opioid dose requirements in hospitalized patients with acute pancreatitis (AP) but did not incorporate morphologic findings on CT imaging.

Aims: We sought to determine whether morphologic severity on imaging is independently associated with opioid dose requirements in AP.

Methods: Adult inpatients with a diagnosis of AP from 2006 to 2017 were reviewed.

Abdominal Vascular Complications in Neurofibromatosis Type 1.

Supplemental material is available for this article.

Adapting the modified barium swallow: modifications to improve safety in the setting of airborne respiratory illnesses like COVID-19.

No guidance exists on how to safely perform modified barium swallows (MBS) in the midst of the COVID-19 pandemic or other communicable airborne respiratory infections (C-ARI). MBS has the potential to become an aerosol generating procedure (AGP) as it may trigger a cough or necessitate suctioning which may result in transmission of C-ARI putting patients and health care workers at risk. Regulations and best practices from international and US governmental and commercial agencies were reviewed.

Low Serum Trypsin Levels Predict Deep Pancreatic Cannulation Failure During Endoscopic Retrograde Cholangiopancreatography in Patients With Symptomatic Obstructive Chronic Pancreatitis.

Objectives: Deep pancreatic cannulation (DPC) failure during endoscopic retrograde cholangiopancreatography (ERCP) in patients with chronic pancreatitis (CP) can occur in the presence of ductal obstruction due to strictures and/or stones. There are currently no simple preprocedure clinical or laboratory tests that can predict DPC failure during ERCP.

Methods: All adult patients with definite CP by M-ANNHEIM criteria referred to the pancreatitis clinic between 2010 and 2017 were evaluated.

Optimum lean body formulation for correction of standardized uptake value in PET imaging.

Unlabelled: Standardized uptake value (SUV) normalized by lean body mass ([LBM] SUL) is becoming a popular metric for quantitative assessment of clinical PET. Sex-specific quantitative effects of different LBM formulations on liver SUV have not been well studied.

Methods: (18)F-FDG PET/CT scans from 1,033 consecutive adult (501 women, 532 men) studies were reviewed.