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

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 17027

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Dr. Mandeep Garg

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Guest Editor

Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Interests: chest radiology; diagnostic radiology; lung infections; pulmonary aspergillosis; COVID-19; lung cancer
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Dr. Uma Debi

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Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Interests: radiodiagnosis & imaging

Dr. Nidhi Prabhakar

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Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Interests: radiodiagnosis & imaging

Dr. Amit Kumar Janu

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Co-Guest Editor

1. Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, India
2. Department of Health Sciences, Homi Bhabha National Institute, Mumbai, India
Interests: radiodiagnosis

Special Issue Information

Dear Colleagues,

This Special Issue, ‘Advances in Diagnostic and Interventional Radiology’, aims to publish high-quality research papers in the field of diagnostic and interventional radiology. Imaging plays a key role in the patient diagnostics and management of various diseases. Recently, there have been significant improvements in both hardware and software used in various imaging technologies such as X-rays, ultrasound, CT, and MRI. This has led to the growing utilization of these modalities in day-to-day practice and patient care.

Interventional radiology is a super specialty of radiology which can diagnose and treat various cancers and other diseases with minimal invasive or key-hole procedures, saving patients from the trauma of major surgeries. Interventional radiologists, with the help of different imaging techniques, insert needles, wires, catheters, or other small instruments into the targeted areas of body to diagnose and treat various cancers and other diseases.

In this context, original articles, review articles, systematic reviews, meta-analyses, and commentaries based on the scientific content and the novelty of research will be published in this Special Issue. Apart from this, priority should also be given to research papers based on artificial intelligence (AI).

Dr. Mandeep Garg
Dr. Uma Debi
Dr. Nidhi Prabhakar
Dr. Amit Kumar Janu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

imaging
CT scan
MRI
intervention radiology
biopsy
cancer

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Published Papers (11 papers)

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14 pages, 1938 KiB

Open AccessArticle

Cryoprobe Placement Using Electromagnetic Navigation System (IMACTIS® CT-Navigation™) for Cryoablation Treatment of Upper Kidney Pole Lesions and Adrenal Metastases: Experience from a Single-Center, 4-Year Study

by A. Michailidis, P. Kosmoliaptsis, G. Dimou, G. Mingou, S. Zlika, C. Giankoulof, S. Galanis and E. Petsatodis

Diagnostics 2024, 14(17), 1963; https://doi.org/10.3390/diagnostics14171963 - 5 Sep 2024

Viewed by 1266

Abstract

The aim of this study is to evaluate the safety and efficacy of the use of the IMACTIS^® CT-Navigation™-electromagnetic navigation system (EMNS) in cryoablation CT-guided procedures under local anesthesia for the treatment of upper kidney pole and adrenal lesions. We conducted a retrospective analysis of patients with upper kidney pole lesions and adrenal metastases who underwent cryoablation using the IMACTIS-CT^®-EMNS between January 2019 and April 2023. The EMNS was used to guide the placement of the cryoprobes with CT guidance under local anesthesia. The primary outcome was technical success, defined as the successful placement of the cryoprobes in the target lesion. A total of 31 patients were studied, of whom, 25 patients were treated with cryoablation for upper pole kidney masses, and 6 patients underwent the cryoablation of adrenal metastases during the study period. The mean age was 60 years (range, 36–82 years), and 21 patients were male. All the upper kidney pole lesions were renal cell carcinomas, and regarding adrenal metastases, the primary cancer sites were the lungs (n = 3), breast (n = 2), and the colon (n = 1). The median size of the lesions was 3,8 cm (range, 1.5–5 cm). All procedures were technically successful, with the cryoprobes accurately placed in the target lesions under CT guidance using the EMNS, avoiding the penetration of any other organs using an oblique trajectory. No major complications were reported, and local tumor control was achieved in all cases. Our initial experience using the EMNS for cryoprobe placement during CT-guided interventional procedures under local anesthesia for the cryoablation treatment of upper pole kidney lesions and adrenal metastases showed that it is safe and effective. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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17 pages, 4157 KiB

Open AccessArticle

A Cross-Sectional Validation of Horos and CoreSlicer Software Programs for Body Composition Analysis in Abdominal Computed Tomography Scans in Colorectal Cancer Patients

by Andrés Jiménez-Sánchez, María Elisa Soriano-Redondo, José Luis Pereira-Cunill, Antonio Jesús Martínez-Ortega, José Ramón Rodríguez-Mowbray, Irene María Ramallo-Solís and Pedro Pablo García-Luna

Diagnostics 2024, 14(15), 1696; https://doi.org/10.3390/diagnostics14151696 - 5 Aug 2024

Cited by 2 | Viewed by 1952

Abstract

Background: Body composition assessment using computed tomography (CT) scans may be hampered by software costs. To facilitate its implementation in resource-limited settings, two open-source segmentation programs (Horos and CoreSlicer) were transversally validated in colorectal cancer patients. Methods: Contrast-enhanced abdominal CT scans were analyzed following the Alberta protocol. The Cross-Sectional Area (CSA) and intensities of skeletal muscle tissue (MT), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and intramuscular adipose tissue (IMAT) were measured. The Skeletal Muscle Index (SMI) was calculated. Cutoff points were applied to the SMI, MT intensity, and VAT CSA to define muscle atrophy, myosteatosis, and abdominal obesity. The inter-software agreement was evaluated using different statistical tools. Results: A total of 68 participants were measured. The MT CSA and SMI displayed no differences. The MT CSA agreement was excellent, and both programs provided equal muscle atrophy prevalences. CoreSlicer underestimated the MT intensity, with a non-significant myosteatosis prevalence increase (+5.88% and +8.82%) using two different operative definitions. CoreSlicer overestimated the CSA and intensity in both VAT and SAT, with a non-significant increase (+2.94%) in the abdominal obesity prevalence. Conclusions: Both software programs were feasible tools in the study group. The MT CSA showed great inter-software agreement and no muscle atrophy misdiagnosis. Segmentation differences in the MT intensity and VAT CSA caused limited diagnostic misclassification in the study sample. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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12 pages, 2097 KiB

Open AccessArticle

Transarterial Embolization of Geniculate Arteries Reduces Pain and Improves Physical Function in Knee Osteoarthritis—A Prospective Cohort Study

by Louise Hindsø, Per Hölmich, Michael M. Petersen, Michael B. Nielsen, Søren Heerwagen, Mikkel Taudorf and Lars Lönn

Diagnostics 2024, 14(15), 1627; https://doi.org/10.3390/diagnostics14151627 - 27 Jul 2024

Cited by 2 | Viewed by 2109

Abstract

Knee osteoarthritis (OA) affects millions worldwide, leading to pain and reduced quality of life. Conventional treatments often fail to provide adequate relief, necessitating new therapeutic approaches. This study evaluated the efficacy and safety of genicular artery embolization (GAE) using permanent microspheres in patients with mild-to-moderate knee OA. In this prospective, single-center study, 17 participants underwent GAE. KOOS (Knee injury and Osteoarthritis Outcome Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index), and IPAQ (International Physical Activity Questionnaire) scores, along with physical performance tests, medication use, and dual-energy X-ray absorptiometry (DEXA) scans, were assessed at baseline and at multiple follow-up points over six months. The primary endpoint, VAS at six months, showed significant improvement (median reduction from 66 mm to 40 mm, p = 0.0004). All pain and function scores, as well as physical performance tests, improved significantly. No clinically relevant changes in medication use or DEXA parameters were observed after six months. Only minor, self-limiting adverse events occurred. This study indicates that GAE is a promising minimally invasive treatment for knee OA, providing significant pain relief and functional improvement. However, further long-term, randomized trials are needed to confirm these findings and establish optimal patient selection criteria. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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13 pages, 3357 KiB

Open AccessArticle

Comparison of the Efficacy of Percutaneous Microwave Ablation Therapy versus Laparoscopic Partial Nephrectomy for Early-Stage Renal Tumors

by Osman Kula, Yeliz Ateş, Hakkı Mete Çek, Atınç Tozsin, Burak Günay, Burak Akgül, Selçuk Korkmaz, Gökhan Karataş, Serdar Solak, Fethi Emre Ustabaşıoğlu and Ersan Arda

Diagnostics 2024, 14(14), 1574; https://doi.org/10.3390/diagnostics14141574 - 20 Jul 2024

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Abstract

This study aimed to compare the efficacy of percutaneous microwave ablation therapy (MWAT) and laparoscopic partial nephrectomy (LPN) in early-stage renal cell carcinoma (RCC) classified as T1a; a retrospective analysis was conducted on patients treated between January 2017 and November 2023. Oncological outcomes, radiological recurrence, length of stay (LOS), and costs were evaluated. The study included 110 patients, with no significant differences between the two groups regarding residual tumors, local tumor progression, and disease-free survival rates (p > 0.05). The LPN group showed significantly lower pre/postoperative serum urea and creatinine and higher estimated glomerular filtration rate values, whereas the MWA group experienced significantly lower mean costs, complication rates, LOS in the hospital, and procedure durations (p ≤ 0.05). However, post-procedure residual tumors and local tumor progression rates did not differ significantly between the LPN and MWAT groups (p > 0.05). MWAT is as effective as LPN for T1a RCC lesions. In addition, MWAT has lower costs than LPN and is a cost-effective treatment method. Therefore, MWAT minimizes hospital stay and complications and since the oncological results are similar to LPN, it might be considered as the first choice of treatment in young patients. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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19 pages, 2471 KiB

Open AccessArticle

Technical and Clinical Outcome of Low-Milliampere CT Fluoroscopy-Guided Percutaneous Drainage Placement in Abdominal Fluid Collections after Liver Transplantation: A 16-Year Retrospective Analysis of 50 Consecutive Patients

by Robert Stahl, Max Seidensticker, Helmut Arbogast, David Kuppinger, Veronika Greif, Alexander Crispin, Melvin D’Anastasi, Vera Pedersen, Robert Forbrig, Thomas Liebig, Tim Rutetzki and Christoph G. Trumm

Diagnostics 2024, 14(4), 353; https://doi.org/10.3390/diagnostics14040353 - 6 Feb 2024

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Abstract

Purpose: Evaluation of the effectiveness of CT-guided drainage (CTD) placement in managing symptomatic postoperative fluid collections in liver transplant patients. The assessment included technical success, clinical outcomes, and the occurrence of complications during the peri-interventional period. Methods: Analysis spanned the years 2005 to 2020 and involved 91 drain placement sessions in 50 patients using percutaneous transabdominal or transhepatic access. Criteria for technical success (TS) included (a) achieving adequate drainage of the fluid collection and (b) the absence of peri-interventional complications necessitating minor or prolonged hospitalization. Clinical success (CS) was characterized by (a) a reduction or normalization of inflammatory blood parameters within 30 days after CTD placement and (b) the absence of a need for surgical revision within 60 days after the intervention. Inflammatory markers in terms of C-reactive protein (CRP), leukocyte count and interleukin-6, were evaluated. The dose length product (DLP) for various intervention steps was calculated. Results: The TS rate was 93.4%. CS rates were 64.3% for CRP, 77.8% for leukocytes, and 54.5% for interleukin-6. Median time until successful decrease was 5.0 days for CRP and 3.0 days for leukocytes and interleukin-6. Surgical revision was not necessary in 94.0% of the cases. During the second half of the observation period, there was a trend (p = 0.328) towards a lower DLP for the entire intervention procedure (median: years 2013 to 2020: 623.0 mGy·cm vs. years 2005 to 2012: 811.5 mGy·cm). DLP for the CT fluoroscopy component was significantly (p = 0.001) lower in the later period (median: years 2013 to 2020: 31.0 mGy·cm vs. years 2005 to 2012: 80.5 mGy·cm). Conclusions: The TS rate of CT-guided drainage (CTD) placement was notably high. The CS rate ranged from fair to good. The reduction in radiation exposure over time can be attributed to advancements in CT technology and the growing expertise of interventional radiologists. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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14 pages, 5696 KiB

Open AccessArticle

Evaluation of Dynamic Contrast-Enhanced and Oxygen-Enhanced Functional Lung Magnetic Resonance Imaging in Chronic Obstructive Pulmonary Disease Patients

by Rohit K. Srinivas, Mandeep Garg, Uma Debi, Nidhi Prabhakar, Sahajal Dhooria, Ritesh Agarwal, Ashutosh Nath Aggarwal and Manavjit Singh Sandhu

Diagnostics 2023, 13(23), 3511; https://doi.org/10.3390/diagnostics13233511 - 23 Nov 2023

Cited by 2 | Viewed by 1338

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition characterized by obstruction of airways and emphysematous lung tissue damage, with associated hypoxic vasoconstriction in the affected lung parenchyma. In our study, we evaluate the role of oxygen-enhanced (OE) MRI and dynamic contrast enhanced (DCE)-MRI in COPD patients for assessment of ventilation and perfusion defects and compared their severity with clinical severity. A total of 60 patients with COPD (diagnosed based on clinical and spirometry findings) and 2 controls with normal spirometry and no history of COPD were enrolled. All patients underwent MRI within 1 month of spirometry. OE-MRI was performed by administering oxygen at 12 L/min for 4 min to look for ventilation defects. DCE-MRI was performed by injecting intravenous gadolinium contrast, and perfusion abnormalities were detected by subtracting the non-enhanced areas from the first pass perfusion contrast images. A total of 87% of the subjects demonstrated ventilation and perfusion abnormalities on MRI independently. The lobe-wise distribution of ventilation and perfusion abnormalities correlated well with each other and was statistically significant in all lobes (p < 0.05). The severity of ventilation-perfusion defects also correlated well with clinical severity, as their median value (calculated using a Likert rating scale) was significantly lower in patients in the Global initiative for chronic Obstructive Lung Disease (GOLD) I/II group (3.25) compared to the GOLD III/IV group (7.25). OE- and DCE-MRI provide functional information about ventilation-perfusion defects and their regional distribution, which correlates well with clinical severity in patients with COPD. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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11 pages, 4248 KiB

Open AccessArticle

Comparative Study of Ablation Zone of EMPRINT HP Microwave Device with Contemporary 2.4 GHz Microwave Devices in an Ex Vivo Porcine Liver Model

by Terrence C. H. Hui, Guo Yuan How, Michelle S. M. Chim and Uei Pua

Diagnostics 2023, 13(16), 2702; https://doi.org/10.3390/diagnostics13162702 - 18 Aug 2023

Cited by 3 | Viewed by 2436

Abstract

(1) Background: Percutaneous microwave ablation (MWA) is an accepted treatment of non-operative liver cancer. This study compares the ablation zones of four commercially available 2.45 GHz MWA systems (Emprint, Eco, Neuwave, and Solero) in an ex vivo porcine liver model. (2) Methods: Ex vivo porcine livers (n = 85) were obtained. Two ablation time setting protocols were evaluated, the manufacturer’s recommended maximum time and a 3 min time, performed at the manufacturer-recommended maximum power setting. A total of 236 ablation samples were created with 32 (13.6%) samples rejected. A total of 204 samples were included in the statistical analysis. (3) Results: For single-probe protocols, Emprint achieved ablation zones with the largest SAD. Significant differences were found in all comparisons for the 3 min time setting and for all comparisons at the 10 min time setting except versus Neuwave LK15 and Eco. Emprint produced ablation zones that were also significantly more spherical (highest SI) than the single-probe ablations from all other manufacturers. No statistical differences were found for ablation shape or SAD between the single-probe protocols for Emprint and the three-probe protocols for Neuwave. (4) Conclusions: The new Emprint HP system achieved large and spherical ablation zones relative to other 2.45 GHz MWA systems. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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7 pages, 19138 KiB

Open AccessInteresting Images

Liver Ischemia After Transarterial Embolization for Hepatic Trauma Injury

by Meng-Lin Han and Chia-Hsun Lu

Diagnostics 2024, 14(22), 2492; https://doi.org/10.3390/diagnostics14222492 - 7 Nov 2024

Viewed by 769

Abstract

Transarterial embolization (TAE) is a routine procedure performed by interventional radiologists to manage traumatic hepatic injuries. Hepatic super-selective TAE rarely results in ischemia within the embolized area. In this case, the initial CT scan revealed significant contrast extravasation, leading to an urgent TAE. Due to continued concerns about bleeding, a second TAE was performed two days later. Subsequent CT scans revealed localized ischemia and necrosis following increased abdominal pain and elevated liver functions. Further analysis identified a common hepatic artery variation in this case. Thus, the ischemia in segments 6 and 7 was determined to be unrelated to the embolization procedure. A detailed review of the CT images suggests that injury to the accessory right inferior hepatic veins (IHVs) likely caused ischemia and eventual necrosis in segments 6 and 7. While hepatic vein variations are not uncommon, this case highlights the importance of evaluating the condition of hepatic veins, in addition to the hepatic artery and portal vein, during preoperative planning. If no arterial extravasation is identified, conservative treatment may be an option for the patient. Further research on this topic is warranted. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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12 pages, 9950 KiB

Open AccessCase Report

Different Manifestations of Persistent Sciatic Artery and Possible Treatment Options: A Series of Four Cases

by Laura Maria Cacioppa, Marzia Rosati, Marco Macchini, Nicolo’ Rossini, Pietro Boscarato, Vincenzo Vento, Matteo Vocaturo, Andrea Coppola, Enrico Paci, Roberto Candelari and Chiara Floridi

Diagnostics 2024, 14(21), 2383; https://doi.org/10.3390/diagnostics14212383 - 25 Oct 2024

Cited by 2 | Viewed by 1086

Abstract

Persistent sciatic artery (PSA) is a rare vascular anomaly classified into five types according to the Pillet and Gauffre classification system. Although PSA may be detected as an incidental finding, symptomatic cases account for approximately 80% of all cases and have variable clinical presentations. Due to the frequent ischemic and aneurysmal complications, PSAs can lead to limb-threatening conditions requiring prompt identification and adequate treatment management. In this paper, we present a series of four cases of PSA with extremely different anatomical characteristics, patients’ ages, medical histories and clinical presentations. All cases were diagnosed in our institution and managed after multidisciplinary discussions involving vascular surgeons and interventional radiologists. The series included three women and one man. In two cases, one of which included gluteal and back pain, pulsatile masses were found. Two patients had lower-limb chronic ischemia, one with rest pain and one with IIb claudication. Whereas selective angiography was performed only in endovascular approaches, computed tomography angiography (CTA) was performed on all patients as the decisive diagnostic modality. In our series, treatment strategies were selected on the basis of clinical and anatomical factors, and after the evaluation of the potential risks and benefits of each technique. Treatment was medical in two cases, endovascular in one case and hybrid in one case. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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12 pages, 8897 KiB

Open AccessCase Report

Endovascular Stenting for Idiopathic Stenosis of the Superior Mesenteric Vein: A Case Report

by Mugur Cristian Grasu, Radu Lucian Dumitru, Gina-Ionela Rusu-Munteanu, Mariana Mihaila, Mircea Manuc and Ioana Gabriela Lupescu

Diagnostics 2024, 14(11), 1187; https://doi.org/10.3390/diagnostics14111187 - 5 Jun 2024

Cited by 1 | Viewed by 1361

Abstract

Idiopathic superior mesenteric vein (SMV) stenosis, where no clear causative factor is identifiable, remains a clinical rarity. We present a detailed case report of a patient with idiopathic stenosis of the SMV who underwent successful endovascular stenting. This report outlines the patient’s clinical presentation, diagnostic imaging findings, procedural approach by the interventional radiology team, and subsequent management. Endovascular stenting is a viable therapeutic option for patients with idiopathic SMV stenosis. This case demonstrates that with appropriate interventional and post-procedural management, long-term stent patency and thrombosis prevention can be achieved. The success of this case encourages further investigation into endovascular treatments for venous stenoses. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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5 pages, 1953 KiB

Open AccessInteresting Images

Use of Transradial Access to Install Two Sequential Stents for Pseudoaneurysms along the Celiac Artery and Common Hepatic Artery Axes

by Abheek Ghosh, Sean Lee, Christina Lim, Tanvir Agnihotri and Nabeel Akhter

Diagnostics 2023, 13(20), 3273; https://doi.org/10.3390/diagnostics13203273 - 21 Oct 2023

Cited by 1 | Viewed by 1221

Abstract

Transfemoral access is the most common method for stenting visceral aneurysms. Over the years, transradial access has gained tremendous traction in interventional procedures due to many reported benefits, including increased patient comfort, decreased procedural cost, and reduced rates of procedural complications, among others. Moreover, transradial access can serve as a valuable alternative when transfemoral access may be contraindicated. Here, we successfully utilized transradial access to sequentially place two stents for pseudoaneurysms in the celiac artery and common hepatic artery. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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