Multidisciplinary collaboration and radiology-pathology correlation are key components to advancing our knowledge and understanding of musculoskeletal disease and improving clinical care. The ...International Skeletal Society was founded on this principle and in its 50-year history it has successfully cultivated a globally recognized and respected Annual Meeting and Refresher Course to foster interest and share expertise in musculoskeletal disorders. The Society’s consistent efforts for outreach and intersociety connections with MSK societies around the world have further strengthened its heritage. This look back on the Society’s first 50 years recounts how it all started, where it has been, and provides insights on its promising future, not only in its support for education and scientific discovery, but also in its enrichment of precision medicine.
The purpose of this study is to investigate the variation in attenuation values (expressed as Hounsfield units) for L1 vertebral body trabecular bone at different tube voltages used in dual-energy CT ...(DECT) and to remind physicians to consider changes in attenuation values when they approach opportunistic screening for osteoporosis.
Consecutive patients who underwent DECT examination of the abdomen and pelvis for suspected urolithiasis were included in the study. Attenuation noted on CT of the L1 trabecular bone performed with the use of tube voltages of 80, 100, and 140 kV was recorded. The correlation between the attenuation noted when the tube voltage was 140 kV and the attenuation noted when the tube voltage was either 80 or 100 kV was calculated, and differences in the mean CT attenuation values were compared.
The mean attenuation values from L1 trabecular bone measurement performed for 191 patients were analyzed. As expected, the mean attenuation values decreased as the tube voltage increased. There was a strong correlation between the attenuation values noted when tube voltages of 80 and 140 kV were used (r
= 0.97) and those noted when 100 and 140 kV were used (r
= 0.96). The mean attenuation value noted at 80 kV was 76.4 HU (65%) higher than that noted at 140 kV (p < 0.001). The mean attenuation value at 100 kV was 45.5 HU (39.9%) higher than that noted at 140 kV (p < 0.001).
We confirmed that attenuation values of L1 trabecular bone, unlike attenuation values of fat, fluid, or soft tissue, vary at different CT x-ray tube voltages. Therefore, standard reference attenuation values for trabecular bone seen at 120 kV cannot be applied to other single-energy settings, DECT, or CT examinations where dose modulation software automatically raises or lowers the tube voltage from 120 kV. Knowledge of the specific energy spectra used is essential before performing opportunistic CT evaluation for osteoporosis.
Multiple osteolytic lesions are a well-recognized and typical imaging feature of multiple myeloma as well as several other plasma cell disorders. Given the high volume of imaging studies obtained of ...multiple myeloma patients, radiologists will likely encounter a subset of multiple myeloma patients with less common or “atypical” findings during their practice. These atypical findings include osteosclerotic lesions, extramedullary lesions, and amyloid deposition. Similar imaging findings that are considered atypical for multiple myeloma can also be detected in other plasma cell disorders that are distinct from multiple myeloma. For instance, POEMS syndrome is a distinct plasma cell disorder from multiple myeloma, but also can present with osteosclerotic lesions. This article reviews the atypical findings associated with multiple myeloma and also reviews other plasma cell disorders that can have a similar spectrum of imaging findings. Special attention is paid to the musculoskeletal imaging findings.
Magnetic resonance imaging (MRI) is frequently obtained to assess for pathology in the setting of shoulder pain and dysfunction. MRI of the shoulder provides diagnostic information that helps ...optimize patient management and surgical planning. Both general and subspecialized orthopaedic surgeons routinely order and review shoulder MRIs in practice. Therefore, familiarity with the MRI appearance of common shoulder pathologies is important. This document reviews the most common shoulder pathologies using a standardized MRI interpretative approach. Instructional videos demonstrating a musculoskeletal radiologist interpreting normal and abnormal shoulder MRIs are also provided.
Artificial intelligence (AI) is increasingly used in clinical practice for musculoskeletal imaging tasks, such as disease diagnosis and image reconstruction. AI applications in musculoskeletal ...imaging have focused primarily on radiography, CT, and MRI. Although musculoskeletal ultrasound stands to benefit from AI in similar ways, such applications have been relatively underdeveloped. In comparison with other modalities, ultrasound has unique advantages and disadvantages that must be considered in AI algorithm development and clinical translation. Challenges in developing AI for musculoskeletal ultrasound involve both clinical aspects of image acquisition and practical limitations in image processing and annotation. Solutions from other radiology subspecialties (e.g., crowdsourced annotations coordinated by professional societies), along with use cases (most commonly rotator cuff tendon tears and palpable soft-tissue masses), can be applied to musculoskeletal ultrasound to help develop AI. To facilitate creation of high-quality imaging datasets for AI model development, technologists and radiologists should focus on increasing uniformity in musculoskeletal ultrasound performance and increasing annotations of images for specific anatomic regions. This Expert Panel Narrative Review summarizes available evidence regarding AI's potential utility in musculoskeletal ultrasound and challenges facing its development. Recommendations for future AI advancement and clinical translation in musculoskeletal ultrasound are discussed.
Radiologists have an integral role in the diagnosis of bone and soft-tissue tumors beyond image interpretation. Image-guided biopsies are used to diagnose and stage musculoskeletal tumors. This ...article reviews the steps of minimally invasive image-guided biopsies, from prebiopsy planning through postbiopsy pathology follow-up. Helpful techniques to perform and troubleshoot these procedures adequately and safely are detailed. Radiologists are also expanding the treatment options available for many benign and malignant bone and soft-tissue tumors. Some of these more frequently performed procedures include percutaneous thermal ablation and cementoplasty. The evidence, indications, and basic principles of these interventional procedures are also discussed.
Imaging of the Aging Spine Oei, Merrie W; Evens, Ashley L; Bhatt, Alok A ...
The Radiologic clinics of North America
60, Številka:
4
Journal Article
Recenzirano
Degeneration of the spine is a normal aspect of aging. The associated changes of spine degeneration seen on imaging are typically asymptomatic. However, distinguishing normal age-related change from ...symptomatic pathologic change can be challenging owing to the overlap in imaging features. Understanding the general prevalence, timing, and evolution of age-related change can aid in this differentiation and help prevent imaging overdiagnosis and unnecessary workup.
