ARRS

This week's Point/Counterpoint focuses on access site for visceral arterial interventions.

Point: Transradial is the Future https://www.ajronline.org/doi/abs/10.2214/AJR.20.25175

Counterpoint: Transfemoral Remains the Way to Go https://www.ajronline.org/doi/abs/10.2214/AJR.20.25245

ARRS Case of the Week

Can you diagnose this woman who has architectural distortion without a central mass?

arrs.org 66-year-old woman with profuse bloody right nipple discharge 10 months after left lumpectomy for left breast cancer treated with lumpectomy.

Findings on Chest CT Performed in the Emergency Department in Patients on Immune Checkpoint Inhibitor Therapy: Single-Institution 8-Year Experience in 136 Patients : American Journal of Roentgenology : Ahead of Print (AJR)

This week's open-access Editor's Choice article finds most chest CT examinations in the ED in patients on ICI therapy exhibited worsening lung tumor burden, which was associated with worse survival.

ajronline.org Background. Patients undergoing immune checkpoint inhibitor (ICI) therapy may present to the emergency department (ED) with a wide range of immune-related adverse events. Objective. To evaluate che...

PET/MRI Characterization of Mucinous Versus Nonmucinous Components of Rectal Adenocarcinoma: A Comparison of Tumor Metabolism and Cellularity : American Journal of Roentgenology : Ahead of Print (AJR)

PET/MRI can be used to differentiate the mucinous and nonmucinous components within primary rectal adenocarcinoma on the basis of metabolic status.

ajronline.org OBJECTIVE. The purpose of this study was to evaluate whether FDG PET/MRI can be used to differentiate the mucinous from the nonmucinous components of primary rectal tumors and to compare the glycol...

Qualitative and Quantitative Assessment of Nonlocal Means Reconstruction Algorithm in a Flexible PET Scanner : American Journal of Roentgenology : Ahead of Print (AJR)

The modified NLM algorithm was clinically acceptable, yielding higher TNR and background SNR compared with conventional reconstruction. Image quality and the lesion detection rate were comparable in this population.

ajronline.org OBJECTIVE. Flexible PET (fxPET) was designed to fit existing MRI systems. The newly modified nonlocal means (NLM) algorithm is combined with the 3D dynamic row-action maximum likelihood algorithm (...

Beyond the AJR: “Cost-effectiveness of Breast Cancer Screening With Magnetic Resonance Imaging for Women at Familial Risk” : American Journal of Roentgenology : Ahead of Print (AJR)

Screening MRI substantially reduces breast cancer mortality for women with ≥20% familial lifetime breast cancer risk and could be cost-effective.

ajronline.org

Nipple Discharge: Current Clinical and Imaging Evaluation : American Journal of Roentgenology : Ahead of Print (AJR)

Although central duct excision is the current standard for evaluation of malignancy in patients with pathologic nipple discharge, studies suggest that, given the high negative predictive value of MRI, surveillance may be a reasonable alternative to surgery.

ajronline.org OBJECTIVE. Nipple discharge is a common complaint that is first evaluated with clinical assessment. Physiologic discharge does not require imaging other than routine screening mammography. Initial ...

Findings on Chest CT Performed in the Emergency Department in Patients on Immune Checkpoint Inhibitor Therapy: Single-Institution 8-Year Experience in 136 Patients : American Journal of Roentgenology : Ahead of Print (AJR)

This knowledge of pathologies detected on chest CT in patients on ICI therapy who present to the ED may guide radiologists in interpreting such imaging.

ajronline.org Background. Patients undergoing immune checkpoint inhibitor (ICI) therapy may present to the emergency department (ED) with a wide range of immune-related adverse events. Objective. To evaluate che...

Online Course: MRI Staging of Rectal Cancer Case Review

Gain insights into key staging features of rectal cancer on MRI, optimal image acquisition, using a standardized synoptic reporting template, and more!

arrs.org Using a case-based approach with 20 full examples and detailed histories, this Online Course will highlight the pearls and pitfalls of using MRI for staging and follow-up evaluation of patients with rectal cancer. In addition to MR pointers on technique and anatomy, esteemed faculty will discuss and...

ARRS Online Courses Sale

As we usher in the New Year, say farewell to 2020 with 20% off all Online Courses from now until the end of the year.

Use coupon code BYE2020 no later than Thursday, December 31 to receive your discount.

arrs.org Learn Online and On Demand ARRS has more Online Courses than ever—featuring lectures from leading experts across the spectrum of radiology. View all of our high-quality Online Courses below.

Current Status and Future of BI-RADS in Multimodality Breast Imaging, From the AJR Special Series on Radiology Reporting and Data Systems : American Journal of Roentgenology : Ahead of Print (AJR)

BI-RADS will continue to evolve because changes in technology and research provide new data points, including new breast imaging modalities.

ajronline.org The American College of Radiology (ACR) BI-RADS is a communication and data tracking system that has evolved since its inception as a brief mammography lexicon and reporting guide to become a robus...

Our new Point/Counterpoint examines management of high-risk breast lesions.

Point—Surveillance is a Change in Practice Preceding Evidence-Based Standardization https://www.ajronline.org/doi/abs/10.2214/AJR.20.25072

Counterpoint—Time for Personalized Surveillance https://www.ajronline.org/doi/abs/10.2214/AJR.20.25146

ARRS members get free access to this well-rounded overview on COVID-19 imaging findings.

https://www.arrs.org/ARRSLIVE/Education/Meetings/Symposia/COVID19/Homepage.aspx

Borderline Resectable and Locally Advanced Pancreas Cancer: FDG PET/MRI and CT Tumor Metrics for Assessment of Neoadjuvant Therapy Pathologic Response and Prediction of Survival : American Journal of Roentgenology : Ahead of Print (AJR)

This week's open access Editor's Choice article finds PET/MRI and CT metrics can help guide post-NAT pancreatic cancer treatment decisions.

ajronline.org Please see the Editorial Comment by Jean H. Lee discussing this article. Background: Imaging biomarkers of response to neoadjuvant therapy (NAT) in pancreatic ductal adenocarcinoma (PDA) are needed...

ARRS Case of the Week

Can you diagnose this woman with 6 months of left shoulder pain?

arrs.org 15-year-old boy with palmar mass that grew quickly over several months 1 year ago after a mallet injury to the long finger; has since been stable; underwent MRI at outside institution.

Through the Glass Portable Radiography of Patients in Isolation Units: Experience During the Coronavirus Disease (COVID-19) Pandemic : American Journal of Roentgenology : Ahead of Print (AJR)

To reduce staff exposure to infection and maintain operational efficiency, a protocol has been developed to image patients using portable chest radiographs through the glass of an isolation room.

ajronline.org Objective: To reduce staff exposure to infection and maintain operational efficiency, we have developed a protocol to image patients using portable chest radiographs through the glass of an isolati...

AJR Podcasts

Listen in as our team of senior resident and fellow Podcast Editors critique articles and provide synthesized overviews of timely research from the “Yellow Journal” for in-training and practicing radiologists.

arrs.org Borderline Resectable and Locally Advanced Pancreas Cancer: FDG PET/MRI and CT Tumor Metrics for Assessment of Neoadjuvant Therapy Pathologic Response and Prediction of Survival [critique of article by Panda et al.]

Application of Adaptive Image Receive Coil Technology for Whole-Brain Imaging : American Journal of Roentgenology : Ahead of Print (AJR)

On average, the prototype 16-channel head AIR coil outperformed a conventional 8-channel head coil but did not perform as well as a conventional 32-channel head coil.

ajronline.org OBJECTIVE. The Adaptive Image Receive (AIR) radiofrequency coil is an emergent technology that is lightweight and flexible and exhibits electrical characteristics that overcome many of the limitati...

MRI of the Carpal Tunnel 3 and 12 Months After Endoscopic Carpal Tunnel Release : American Journal of Roentgenology : Ahead of Print (AJR)

After ECTR, undue swelling and flattening of the median nerve persist as long as 12 months after surgery, even in patients with a good surgical outcome.

ajronline.org OBJECTIVE. The purpose of this study was to study changes in the median nerve, retinaculum, and carpal tunnel on MRI after successful endoscopic carpal tunnel release (ECTR). SUBJECTS AND METHODS. ...

Compared with cTACE, DEB-TACE was associated with more frequent hepatobiliary injuries and severe abdominal pain.

https://www.ajronline.org/doi/abs/10.2214/AJR.20.24708

Clinicopathologic and Imaging Features of Lung Cancer Associated with Cystic Airspaces - AJR Live

Lung cancer associated with cystic airspaces is an uncommon morphology that is under recognized on imaging. December's AJR Live will discuss their imaging findings and clinical course.

arrs.org AJR Live Webinars feature leading experts discussing some of AJR’s most controversial, cutting-edge articles—broadcasted each month live, online, with CME.

Imaging Changes and Clinical Complications After Drug-Eluting Beads Versus Conventional Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: Multicenter Study : American Journal of Roentgenology : Ahead of Print (AJR)

This week's open-access Editor's Choice finds that compared to cTACE, DEB-TACE for treatment-naïve HCC is associated with a higher frequency of hepatobiliary injury, although similar short-term local control.

ajronline.org Background: Drug-eluting beads transarterial chemoembolization (DEB-TACE) has emerged as an alternative to conventional transarterial chemoembolization (cTACE) for treatment of hepatocellular carci...

The Spectrum of Neuroimaging findings on CT and MRI in Adults with Coronavirus Disease (COVID-19) : American Journal of Roentgenology : Ahead of Print (AJR)

This article reviews the neuroimaging manifestations of COVID-19 on CT and MRI, presenting cases from the New York City metropolitan region encountered by the authors during the first surge of the pandemic.

ajronline.org Neurologic involvement is well-recognized in coronavirus disease (COVID-19). This article reviews the neuroimaging manifestations of COVID-19 on CT and MRI, presenting cases from the New York City ...

Give the gift of protected time to radiologists

Support essential clinical research and mentorship by contributing to The Roentgen Fund this Giving Tuesday. 100% of your donation goes to scholars and fellows.

https://www.arrs.org/RoentgenFund

ARRS Case of the Week

Can you diagnose this man with left pleural effusion?

arrs.org Axial (A) and coronal (B) contrast-enhanced CT images show a small left pleural effusion with high-attenuation material (arrows) within the dependent portions of the pleural space. Coronal FDG PET (C) and axial fused PET/CT (D) images show marked FDG uptake (arrow, C) corresponding to the high-atten...

Prevalence of Vas Deferens Calcifications on Abdominal CT Examinations and Association With Systemic Conditions : American Journal of Roentgenology : Vol. 215, No. 6 (AJR)

In the large cohort in this study, the prevalence of VD calcification was 1.61%. VD calcification was strongly associated with DM.

ajronline.org OBJECTIVE. The purpose of this study was to describe the prevalence of vas deferens (VD) calcifications on abdominal CT examinations and the associations between VD calcifications and several syste...

Precision Prospectus: Limiting Variability in PET Interpretation - ARRS InPractice

Daniel Sullivan on reproducible results in oncologic FDG-PET scans.

arrsinpractice.org Daniel Sullivan on reproducible results in oncologic FDG-PET scans.

Normalized Dual-Energy Iodine Ratio Best Differentiates Renal Cell Carcinoma Subtypes Among Quantitative Imaging Biomarkers From Perfusion CT and Dual-Energy CT : American Journal of Roentgenology : Vol. 215, No. 6 (AJR)

PCT and DECT had comparable and high diagnostic accuracy in differentiating RCC subtypes; however, because of the significantly lower radiation dose of DECT, iodine ratio may be used as the best independent predictor.

ajronline.org OBJECTIVE. The objective of our study was to assess and compare the diagnostic accuracy of perfusion CT (PCT) and dual-energy CT (DECT) in differentiating clear cell renal cell carcinoma (ccRCC) fr...

Extravasation Reporting: The Scientific Case for Regulatory Change - ARRS InPractice

David Townsend says follow the science for reporting faulty injections.

arrsinpractice.org David Townsend says follow the science for reporting faulty injections.

Stump Appendicitis: Clinical and CT Findings : American Journal of Roentgenology : Vol. 215, No. 6 (AJR)

Stump appendicitis has a characteristic CT appearance and may occur within the first year after appendectomy or many years later.

ajronline.org OBJECTIVE. Recurrent inflammation of the appendiceal stump after appendectomy is rare; published case series have included no more than six patients. The purpose of this study was to report the cli...

Join us online for our virtual symposium on machine learning and artificial intelligence in radiology participate live and on demand with credit.

Happy Thanksgiving!

MRI Ancillary Features for LI-RADS Category 3 and 4 Observations: Improved Categorization to Indicate the Risk of Hepatic Malignancy : American Journal of Roentgenology : Vol. 215, No. 6 (AJR)

Final categories determined with ancillary features, instead of categories determined by major features only, can help indicate malignancy risk in LR-3 and LR-4 observations on MRI.

ajronline.org OBJECTIVE. The purpose of this study was to investigate whether ancillary features can help stratify malignancy risk in Liver Imaging Reporting and Data System (LI-RADS) category 3 (LR-3) and 4 (LR...

A Practical Primer for Dual-Energy CT - ARRS InPractice

Mayur Virarkar and Priya Bhosale point out DECT’s latest clinical applications.

arrsinpractice.org Mayur Virarkar and Priya Bhosale point out DECT’s latest clinical applications.

CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients : American Journal of Roentgenology : Vol. 215, No. 6 (AJR)

This study with credit from the December issue characterizes the CT findings of 30 children from mainland China who had laboratory-confirmed COVID-19.

ajronline.org OBJECTIVE. The purpose of this study is to characterize the CT findings of 30 children from mainland China who had laboratory-confirmed coronavirus disease (COVID-19). Although recent American Coll...