The purpose of this study was to assess the utility of CT-based renal cortex volume to estimate split renal function (SRF) in pre-transplant living kidney donors and to evaluate its reliability to ...predict graft function in the recipients.
Our study recruited all adult potential donors who had both Tc-99m-diethylenetriamine pentacetate (DTPA) scintigraphy and CT angiography of the abdominal aorta done before donating their kidney. We compared the correlation between CT-based renal cortex volume combined with kidney function and DTPA scan as well as post-donation kidney function in the recipients.
The correlation between CT-based split cortex volume and DTPA-measured SRF before transplantation was strong (intraclass correlation coefficient = 0.954-0.968). The inter-rater reliability of two radiologists also showed substantial agreement (intraclass correlation coefficient = 0.97,
< 0.001). In contrast, the correlations between renal cortical volume of donated kidney adjusted to recipient body weight and recipient kidney function was poor at both 2 week and 2 year follow-up.
CT-based renal cortex volume combined with pre-operative kidney function appears to be precise and reproducible to evaluate pre-transplant SRF. Nevertheless, the prediction of recipient graft function needs to be further investigated to ensure a good outcome.
This method is practicable for all potential donors who undergo kidney transplantation in terms of streamline donor workup without compromising information.
Soft tissue sarcomas (STS) are a rare, heterogeneous tumour group. Radiotherapy improves local control. CT is used to plan radiotherapy, but has poor soft tissue definition. MRI has superior soft ...tissue definition. Contour variation amongst oncologists is an important factor in treatment failure. This study is the first to directly compare STS tumour contouring using CT
MRI.
Planning CT and
weighted MR images of eight patients with STS were distributed to four oncologists. Gross tumour volume was contoured on both imaging modalities using in-house software. Images were recontoured 6 weeks later. The mean distance to agreement (DTA), standard deviation of the DTA, dice similarity coefficient (DSC) and contour volume were calculated for each oncologist and compared to a median contour volume. Results for CT and MRI were compared using a pairwise Student's
-test.
When comparing MRI to CT, tumour volumes were significantly smaller, with a difference of 21.4 cm
across all patients (
= 0.008). There was not a statistically significant difference in the mean distance to agreement or dice similarity coefficient, but the standard deviation of the DTA showed a statistically significant improvement (
= 0.04). For intraobserver variation, there was no statistically significant improvement using MRI
CT.
Oncologists contour smaller tumour volumes using MRI, with reduced interobserver variation. Improving the reliability and consistency of contouring is needed for improved quality assurance.
With further experience, the use of MRI in STS radiotherapy planning may reduce variation between oncologists and contribute to improved local control and reduced treatment toxicities.
Junior doctors routinely request radiological investigations for patients. Prior studies have noted that among this group there is a lack of knowledge on radiation legislation and radiation exposure ...in common radiological investigations. However, no studies have compared this against radiology trainees and radiographers. We compared knowledge of radiation legislation and radiation exposure in common radiological investigations among final year medical students (FYMS), foundation year doctors (FY1, FY2) against specialist radiology trainees (SRT) and radiographers (RG).
A 12-question multiple choice questionnaire (MCQ) was distributed to FYMS, FY1, FY2, SRT and RG at a UK teaching hospital. Questions assessed knowledge of radiation legislation and radiation-dose estimates of common radiological investigations. Mean MCQ scores were compared using one-way ANOVA and Tukey post-test to determine statistical significance (
-value < 0.05).
127 participants were included in the study. Mean scores (%) for FYMS (49.3%), FY1 (52.6%) and FY2 (51.1%) were significantly lower compared to SRT (64.4%) and RG (66.3%) (
-value < 0.05). Mean test scores between FYMS, FY1 and FY2 did not significantly differ (
-value > 0.05).
FYMS, FY1 and FY2 knowledge of radiation legislation and radiation exposure in common radiological investigations was poor compared to SRT and RG. Patients require knowledge of radiation risk to provide informed consent as per IRMER regulations, thus we propose formal teaching on the subject matter to promote radiation safety culture among medical undergraduates and postgraduates.
First study to compare knowledge of radiation legislation and radiation exposure in common radiological investigations between medical students and junior doctors to radiology trainees and radiographers.
To describe the challenges inherent in diagnosing fibrosing lung diseases (FLD) on CT imaging and methodologies by which the diagnostic process may be simplified.
Extensive searches in online ...scientific databases were performed to provide relevant and contemporary evidence that describe the current state of knowledge related to FLD diagnosis. This includes descriptions of the utility of a working diagnosis for an individual case discussed in a multidisciplinary team (MDT) setting and challenges associated with the lack of consensus guidelines for diagnosing chronic hypersensitivity pneumonitis.
As well as describing imaging features that indicate the presence of a fibrosing lung disease, those CT characteristics that nuance a diagnosis of the various FLDs are considered. The review also explains the essential information that a radiologist needs to convey to an MDT when reading a CT scan. Lastly, we provide some insights as to the future directions the field make take in the upcoming years.
This review outlines the current state of FLD diagnosis and emphasizes areas where knowledge is limited, and more evidence is required. Fundamentally, however, it provides a guide for radiologists when tackling CT imaging in a patient with FLD.
This review encompasses advice from recent guideline statements and evidence from the latest studies in FLD to provide an up-to-date manual for radiologists to aid the diagnosis of FLD on CT imaging in an MDT setting.
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