Objectives: To determine the diagnostic accuracy and complication rate of percutaneous transthoracic needle biopsy (PTNB) for subsolid pulmonary nodules and sources of heterogeneity among reported results. Methods: We searched PubMed, EMBASE, and Cochrane libraries (until November 7, 2020) for studies measuring the diagnostic accuracy of PTNB for subsolid pulmonary nodules. Pooled sensitivity and specificity of PTNB were calculated using a bivariate random-effects model. Bivariate meta-regression analyses were performed to identify sources of heterogeneity. Pooled overall and major complication rates were calculated. Results: We included 744 biopsies from 685 patients (12 studies). The pooled sensitivity and specificity of PTNB for subsolid nodules were 90% (95% confidence interval [CI]: 85–94%) and 99% (95% CI: 92–100%), respectively. Mean age above 65 years was the only covariate significantly associated with higher sensitivity (93% vs 85%, p = 0.04). Core needle biopsy showed marginally higher sensitivity than fine-needle aspiration (93% vs 83%, p = 0.07). Pooled overall and major complication rate of PTNB were 43% (95% CI: 25–62%) and 0.1% (95% CI: 0–0.4%), respectively. Major complication rate was not different between fine-needle aspiration and core needle biopsy groups (p = 0.25). Conclusion: PTNB had acceptable performance and a low major complication rate in diagnosing subsolid pulmonary nodules. The only significant source of heterogeneity in reported sensitivities was a mean age above 65 years. Advances in knowledge: This is the first meta-analysis attempting to systemically determine the cause of heterogeneity in the diagnostic accuracy and complication rate of PTNB for subsolid pulmonary nodules.

To investigate the correlation between dyspeptic symptoms and gastric motility parameters measured by magnetic resonance imaging (MRI) using volumetry and motility indices in patients with Parkinson’s disease (PD). In this IRB-approved study, MRI datasets obtained from August 2014 to May 2016 in 38 PD patients were retrospectively analyzed. Patients underwent a 120-minute-long MRI study using a liquid test meal and 8 sets of scans. Gastric content volume (GCV) and total volume (TGV), gastric half emptying time (T_1/2), motility index (GMI), accommodation (GA), and emptying (GE) values were acquired. These measurements were compared between patients according to the presence of gastric symptoms: early satiety (n = 25), epigastric pain (n = 13), and dyspepsia (n = 28). Patients with early satiety showed significantly decreased GE of GCV and TGV (p < 0.001 and p = 0.017). Dyspeptic patients had significantly decreased GE of GCV and GMI (p = 0.001 and p = 0.029). GE of GCV at 90 and 120 minutes were significantly lower in patients with early satiety (p = 0.001 and p = 0.002). GE of GCV and GMI at 90 minutes were significantly decreased in patients with dyspepsia (p = 0.004 and p = 0.002). T_1/2 of GCV was prolonged in patients with early satiety, epigastric pain, and dyspepsia (p = 0.004, p = 0.041, and p = 0.023). T_1/2 of TGV also delayed in patients with early satiety (p = 0.023). GMI at 90 minutes was significantly correlated with dyspepsia on multivariable analysis (p = 0.028). Gastric motility can be quantitatively assessed by MRI, showing decreased GMI, delayed GE, and prolonged T_1/2 in PD patients with early satiety or dyspepsia.

Biparametric (bp) magnetic resonance imaging (MRI) could be an alternative MRI for the detection of the clinically significant prostate cancer (csPCa). To compare the accuracies of prostate cancer detection and localization between prebiopsy bpMRI and postbiopsy multiparametric MRI (mpMRI) taken on different days, using radical prostatectomy specimens as the reference standards. Data of 41 total consecutive patients who underwent the following examinations and procedures between September 2015 and March 2017 were collected: (1) magnetic resonance– and/or ultrasonography-guided biopsy after bpMRI; (2) postbiopsy mpMRI; and (3) radical prostatectomy with csPCa. Two radiologists scored suspected lesions on bpMRI and mpMRI independently using Prostate Imaging Reporting and Data System version 2. The diagnostic accuracy of detecting csPCa and the Dice similarity coefficient were obtained. Apparent diffusion coefficient (ADC) ratios were also obtained for quantitative comparison between bpMRI and mpMRI. Diagnostic accuracies on bpMRI and mpMRI were 0.83 and 0.82 for reader 1; 0.80 and 0.82 for reader 2. There are no significantly different values of diagnostic sensitivities or specificities between the readers or between MRI protocols. Intra-observer Dice similarity coefficient was significantly lower in reader 2, compared to that in reader 1 between the two MRI protocols. The range of mean ADC ratio was 0.281–0.635. There was no statistically significant difference in the ADC ratio between bpMRI and mpMRI. Diagnostic performance of bpMRI without dynamic contrast enhancement MRI is not significantly different from mpMRI with dynamic contrast enhancement MRI in the detection of csPCa.

We aimed to analyse the CT examinations of the previous screening round (CT_prev) in NLST participants with incidence lung cancer and evaluate the value of DL-CAD in detection of missed lung cancers. Thoracic radiologists reviewed CT_prev in participants with incidence lung cancer, and a DL-CAD analysed CT_prev according to NLST criteria and the lung CT screening reporting & data system (Lung-RADS) classification. We calculated patient-wise and lesion-wise sensitivities of the DL-CAD in detection of missed lung cancers. As per the NLST criteria, 88% (100/113) of CT_prev were positive and 74 of them had missed lung cancers. The DL-CAD reported 98% (98/100) of the positive screens as positive and detected 95% (70/74) of the missed lung cancers. As per the Lung-RADS classification, 82% (93/113) of CT_prev were positive and 60 of them had missed lung cancers. The DL-CAD reported 97% (90/93) of the positive screens as positive and detected 98% (59/60) of the missed lung cancers. The DL-CAD made false positive calls in 10.3% (27/263) of controls, with 0.16 false positive nodules per scan (41/263). In conclusion, the majority of CT_prev in participants with incidence lung cancers had missed lung cancers, and the DL-CAD detected them with high sensitivity and a limited false positive rate.

Adrenal nodules that were detected at staging CT in patients with otherwise resectable gastric cancers were rarely malignant. Background Guidelines recommending additional imaging for adrenal nodules lack relevant epidemiologic evidence. Purpose To measure the prevalence of adrenal nodules detected at staging CT in patien...

This study aims to evaluate the utility of texture analysis in predicting the outcome of stereotactic radiosurgery (SRS) for brain metastases from lung cancer. From 83 patients with lung cancer who underwent SRS for brain metastasis, a total of 118 metastatic lesions were included. Two neuroradiologists independently performed magnetic resonance imaging (MRI)-based texture analysis using the Imaging Biomarker Explorer software. Inter-reader reliability as well as univariable and multivariable analyses were performed for texture features and clinical parameters to determine independent predictors for local progression-free survival (PFS) and overall survival (OS). Furthermore, Harrell’s concordance index (C-index) was used to assess the performance of the independent texture features. The primary tumor histology of small cell lung cancer (SCLC) was the only clinical parameter significantly associated with local PFS in multivariable analysis. Run-length non-uniformity (RLN) and short-run emphasis were the independent texture features associated with local PFS. In the non-SCLC (NSCLC) subgroup analysis, RLN and local range mean were associated with local PFS. The C-index of independent texture features was 0.79 for the all-patients group and 0.73 for the NSCLC subgroup. In conclusion, texture analysis on pre-treatment MRI of lung cancer patients with brain metastases may have a role in predicting SRS response.