Post-embolisation syndrome (PES) is a prevalent complication that occurs in patients following uterine artery embolisation (UAE) for the treatment of uterine fibroids. The aetiology of PES remains incompletely understood, although postulated to result secondary to tissue infarction resulting in release of inflammatory mediators. We followed PRISMA guidelines and performed a systematic review of studies of PES following UAE from inception to October 2022. Our published protocol was prospectively registered. Our search yielded 54 results. We reviewed 22 full texts, and nine articles were included. Observational studies comprised 6/9 relevant studies, with 5/9 retrospective design. The rate of PES was documented in 5/8 studies (excluding case report) with a reported incidence ranging from 4–34.6%. Five of the nine studies studies postulated that the aetiological basis of PES is inflammatory related. Further research is necessary to advance our understanding of PES to define the biological basis of the syndrome with more certainty and gain a consensus on peri-procedure management to reduce incidence and improve patient outcomes.

Background: Opinions seem somewhat divided when considering the effect of artificial intelligence (AI) on medical imaging. The aim of this study was to characterise viewpoints presented online relating to the impact of AI on the field of radiology and to assess who is engaging in this discourse. Methods: Two search methods were used to identify online information relating to AI and radiology. Firstly, 34 terms were searched using Google and the first two pages of results for each term were evaluated. Secondly, a Rich Search Site (RSS) feed evaluated incidental information over 3 weeks. Webpages were evaluated and categorized as having a positive, negative, balanced, or neutral viewpoint based on study criteria. Results: Of the 680 webpages identified using the Google search engine, 248 were deemed relevant and accessible. 43.2% had a positive viewpoint, 38.3% a balanced viewpoint, 15.3% a neutral viewpoint, and 3.2% a negative viewpoint. Peer-reviewed journals represented the most common webpage source (48%), followed by media (29%), commercial sources (12%), and educational sources (8%). Commercial webpages had the highest proportion of positive viewpoints (66%). Radiologists were identified as the most common author group (38.9%). The RSS feed identified 177 posts of which were relevant and accessible. 86% of posts were of media origin expressing positive viewpoints (64%). Conclusion: The overall opinion of the impact of AI on radiology presented online is a positive one. Consistency across a range of sources and author groups exists. Radiologists were significant contributors to this online discussion and the results may impact future recruitment.

Purpose: Interstitial lung disease (ILD) is the most common non-musculoskeletal manifestation of idiopathic inflammatory myopathies (IIM). Identification of body composition change may enable early intervention to improve prognosis. We investigated muscle quantity and quality derived from cross-sectional imaging in IIM, and its relationship to ILD severity. Methods: A retrospective cohort study assessing IIM of ILD patients (n = 31) was conducted. Two datasets separated in time were collected, containing demographics, biochemical data, pulmonary function testing and thoracic CT data. Morphomic analysis of muscle quantity (cross-sectional area) and quality (density in Hounsfield Units) on thoracic CT were analysed utilising a web-based tool allowing segmentation of muscle and fat. Bilateral erector spinae and pectoralis muscle (ESM&PM) were measured at defined vertebral levels. Results: FVC and D_LCO decreased but within acceptable limits of treatment response (FVC: 83.7–78.7%, p < 0.05, D_LCO 63.4–60.6%, p < 0.05). The cross-sectional area of the PM and ESM increased (PM: 39.8 to 40.7 cm², p = 0.491; ESM: 35.2 to 39.5 cm², p = 0.098). Density significantly fell for both the PM and ESM (PM: 35.3–31 HU, p < 0.05; ESM: 38–33.7, p < 0.05). Subcutaneous fat area increased from 103.9 to 136.1 cm² (p < 0.05), while the visceral fat area increased but not reaching statistical significance. The change in PM density between time points demonstrated an inverse correlation with D_LCO (p < 0.05, R = − 0.49). Conclusion: Patients with IIM ILD demonstrated significant body composition changes on CT imaging unlikely to be detected by traditional measurement tools. An increase in muscle area with an inverse decrease in density suggests poor muscle quality.

Introduction: Chest ports are typically inserted via the right internal jugular vein with the left side being utilized in certain patient populations. The purpose of this study was to evaluate the dynamic position of the chest port and catheter tip, comparing a demographically matched cohort of female breast cancer patients with right‐ or left‐sided chest ports.Methods: 142 female patients with breast cancer requiring chest port insertion for chemotherapy and imaging confirming catheter tip position initially with supine fluoroscopy and follow‐up with erect chest radiography over a 5‐year period were identified. Data points analyzed were catheter tip‐to‐carina distance and the distance from the port to the ipsilateral infraclavicular border. Intraprocedural measurements were taken in the supine position during chest port insertion and compared with follow‐up erect chest radiography. The catheter tip position was also allocated a zone within the venous system on both image sets to assess for significant retraction to a more proximal zone in the erect position. Imaging within 12‐months of chest port insertion was also screened to identify port‐related complications.Results: The whole cohort showed significant retraction of the catheter tip (cephalad) (p < 0.001) and protraction of the port (caudal) (p < 0.001). The median tip‐to‐carina distance decreased from 38.3 mm to 28.6 mm and the port‐to‐clavicle distance increased from 31.3 mm to 64.6 mm. Right‐sided chest ports had increased tip‐to‐catheter retraction (15 mm) compared with left‐sided (6.9 mm) (p = 0.310). A complication was identified in 8.5% of the right‐sided and 11% of the left‐sided ports. Zone migration was significantly associated with the occurrence of a complication in left‐sided ports (p = 0.023).Conclusion: When assessing chest port catheter tip position between supine and erect radiographic studies in female patients with breast cancer, retraction cephalad will occur and this is more apparent in right‐sided ports. Change in catheter tip position was not associated with a significant increase in complication rate unless it occurred in left‐sided ports where zone migration was evident.

Computed tomography (CT) imaging has become indispensable in the management of medical oncology patients. Risks associated with high cumulative effective dose (CED) are relevant in testicular cancer patients. Split-bolus protocols, whereby the contrast medium injection is divided into two, followed by combining the required phase images in a single scan acquisition has been shown to provide images of comparable image quality and less radiation dose compared to single-bolus split-phase CT for various indications. We retrospectively evaluated the performance of split-bolus and single-bolus protocols in patients having follow-up CT imaging for testicular cancer surveillance. 45 patients with testicular cancer undergoing surveillance CT imaging of the thorax, abdomen, and pelvis who underwent split-bolus and single-bolus protocols were included. Quantitative image quality analysis was conducted by placing region of interests in pre-defined anatomical sub-structures within the abdominal cavity. The signal-to-noise ratio (SNR) and radiation dose in the form of dose length product (DLP) and effective dose (ED) were recorded. The DLP and ED for the single-bolus, split-phase acquisition was 506 ± 89 mGy cm and 7.59 ± 1.3 mSv, respectively. For the split-bolus, single-phase acquisition, 397 ± 94 mGy∗cm and 5.95 ± 1.4 mSv, respectively (p < 0.000). This represented a 21.5 % reduction in radiation dose exposure. The SNR for liver, muscle and fat for the single-bolus were 7.4, 4.7 and 8, respectively, compared to 5.5, 3.8 and 7.4 in the split-bolus protocol (p < 0.001). In a testicular cancer patient cohort undergoing surveillance CT imaging, utilization of a split-bolus single-phase acquisition CT protocol enabled a significant reduction in radiation dose whilst maintaining subjective diagnostic acceptability. Use of split-bolus, single-phase acquisition has the potential to reduce CED in surveillance of testicular cancer patients.

Rationale: In cystic fibrosis (CF), body composition alterations are observed. The prevalence of obesity in CF is increasing, with evidence suggesting a subsequent increase in cardiometabolic risk. We sought to assess body composition using analytic morphomics from ultra-low–dose thoracic computed tomography (CT) scans in patients with CF on the triple CFTR (cystic fibrosis transmembrane conductance regulator) modulator therapy elexacaftor/tezacaftor/ivacaftor (ETI). Objectives: Our objective was to use analytical morphomics on routine ultra-low–dose CTs to assess patterns of change in body composition in patients with CF on ETI therapy. Methods: Forty-two patients with CF on ETI who had baseline and follow-up ultra-low–dose thoracic CT imaging were retrospectively analyzed. The CTs were acquired at a radiation dose equivalent to two frontal chest X-rays using our previously published acquisition parameters. The Bhalla score was used as a marker of structural lung disease severity. Analytic morphomics variables, including cross-sectional area and attenuation of pectoralis muscle, visceral fat (epicardial and upper abdominal), and subcutaneous fat, were extracted using the validated image segmentation software CoreSlicer. Paired-samples mean testing (Wilcoxon matched-pairs signed-rank test) and Spearman rank correlation analyses were performed. Results: Total Bhalla scores significantly improved over time in patients on ETI (P < 0.0001). In addition, body composition also changed, with an increase in the cross-sectional area of subcutaneous and epicardial visceral fat (P < 0.0001 and P = 0.0062, respectively). In those with a normal BMI at follow-up, epicardial and subcutaneous fat had also increased significantly in the interval (P = 0.0066 and P = 0.0002, respectively). Conclusions: In CF, ETI produced a significant improvement in structural lung disease over time; however, it also resulted in an increase in visceral and subcutaneous fat. The analytic morphomics methodology presented herein may help identify those patients for aggressive primary prevention strategies and permit the creation of more personalized nutritional plans.