Article of the Week

THE PAIN CRISIS: INTERVENTIONAL RADIOLOGY’S ROLE IN PAIN MANAGEMENT
Austin Fletcher, MD, Kelli J. Moore, MD, James D. Stensby, MD, Anna Hulbert, MD, Arash M. Saemi, MD, Ryan M. Davis, MD, Ambarish Bhat, MD
This article reviews a wide range of minimally invasive procedures, including vertebral augmentation, sacroplasty, thermal ablation of osseous metastasis, nerve blocks, and gonadal vein embolization, that interventional radiologists are now using successfully to treat chronic pain.

PREDICTIVE VALUE OF CARDIAC CT ANGIOGRAPHY, CARDIAC MRI, AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR CARDIOEMBOLIC STROKE RECURRENCE
Georg Apfaltrer, MD, Francesco Lavra, Carlo N. De Cecco, Akos Varga-Szemes MD, PhD, Marly van Assen BS, Domenico Mastrodicasa, MD, Marco Scarabello, MD, Marwen H. Eid, MD, L. Parkwood Griffith, MD, John W. Nance, MD, Sheldon E. Litwin, MD, Luca Saba, MD, U. Joseph Schoepf, MD
Given their high negative predictive value, cardiac MRI and cardiac CT angiography are potential alternatives when echocardiography provides equivocal findings for cardioembolic stroke recurrence.

DIFFUSION-WEIGHTED MRI IN THE ASSESSMENT OF SACROILIITIS: IMPROVED IMAGE QUALITY AND DIAGNOSTIC PERFORMANCE WITH READOUT-SEGMENTED ECHO-PLANAR IMAGING COMPARED WITH CONVENTIONAL SINGLE-SHOT ECHO-PLANAR IMAGING
Hua Zhang, MD, Hongjie Huang, MD, Yuyang Zhang, MD, Zhandai Tu, MD, Zebin Xiao, MD, Jummin Chen, MD, PhD, Dairong Cao, MD
Readout-segmented EPI (rs-EPI) significantly improves the image quality and diagnostic confidence for DWI of the sacroiliac joints compared with single-shot-EPI (ss-EPI). ADC values from rs-EPI better differentiated among disease activity states in patients with axial spondyloarthritis than did ADC values from ss-EPI.

BEST PRACTICES FOR POST-TREATMENT SURVEILLANCE IMAGING IN HEAD AND NECK CANCER: APPLICATION OF THE NECK IMAGING REPORTING AND DATA SYSTEM (NI-RADS)
Sara B. Strauss, MD, Ashley H. Aiken, MD, Josua E. Lantos, MD, C. Douglas Phillips, MD
NI-RADS is a practical solution to the inconsistency in surveillance practices, both in terms of modality choice and surveillance schedule, as well as imaging description in post-treatment HNSCC.

TEMPORAL PATTERN OF RADIOGRAPHIC FINDINGS OF COSTOCHONDRAL JUNCTION RIB FRACTURES ON SERIAL SKELETAL SURVEYS IN SUSPECTED INFANT ABUSE
Andy Tsai, MD PhD, Jeannette Perez-Rossello, MD, Susan A. Connolly, MD, Kosuke Kawai, ScD, Paul K. Kleinman, MD
Costochondral junction fractures in suspected infant abuse show primary injury patterns on initial skeletal survey in 59% (most commonly bucket-handle pattern) and on 2-week follow-up in 6%; secondary healing patterns on initial survey in 89% (most commonly growth disturbance) and on 2-week follow-up in 80%.

DIAGNOSTIC ACCURACY OF QUANTITATIVE MULTI-CONTRAST 5-MINUTE KNEE MRI USING PROSPECTIVE ARTIFICIAL INTELLIGENCE IMAGE QUALITY ENHANCEMENT
Akshay S. Chaudhari, PhD, Murray J. Grissom, MD, Zhongman Fang, PhD, Bragi Sveinsson, PhD, Jin Hyung Lee, PhD, Garry E. Gold, MD, Brian A. Hargreaves, PhD, Kathryn J. Stevens, MD
A 5-minute quantitative double-echo steady-state (qDESS) sequence prospectively enhanced with deep learning had high agreement with conventional knee MRI findings and comparable accuracy as conventional knee MRI with respect to surgical findings. Automatic qDESS T2 relaxation time maps improve sensitivity for subtle cartilage lesions compared to conventional knee MRI.

MIXED-METHODS STUDY TO PREDICT UPSTAGING OF DCIS TO INVASIVE DISEASE ON MAMMOGRAPHY
Lars J. Grimm, MD, Benjamin Neely, MS, Rui Hou, MS, Vignesh Selvakumaran, BSE, Jay A. Baker, MD, Sora C. Yoon, MD, Sujata V. Ghate, MD, Ruth Walsh, MD, Tyler P. Litton, MD, Amrita Devalapalli, MD, Connie Kim, MD, Mary Scott Soo, MD, Terry Hyslop, PhD, E. Shelley Hwang, MD, MPH, Joseph Y. Lo, PhD
A mixed-methods two stage observer study demonstrated that radiologists can improve their ability to predict upstaging of DCIS to invasive disease. The performance of radiologists is currently superior to that achieved by deep learning and computer vision algorithms.

VESICLE IMAGING AND DATA REPORTING SYSTEM (VI-RADS): MULTI-INSTITUTIONAL MULTI-READER DIAGNOSTIC ACCURACY AND INTER-OBSERVER AGREEMENT STUDY
Yoshiko Ueno, MD, PhD, Tsutomo Tamada, MD, PhD, Mitsuru Takeuchi, MD, PhD, Keitaro Sofue, MD, PhD, Satoru Takahashi, MD, PhD, Yuki Kamishimi, MD, PhD, Yasuyo Urase, MD, Ayumu Kido, MD, PhD, Nobuyuki Hinata, MD, PhD, Kenichi Harada, MD, PhD, Masato Fujisawa, MD, PhD, Yoshiyuki Miyaji, MD, PhD, Takamichi Murakami, MD, PhD
Among seven radiologists with different levels of experience in bladder MRI interpretation, the Vesical Imaging-Reporting and Data System (VI-RADS) demonstrated moderate to substantial interobserver agreement (κ-value: 0.55-0.80) and a pooled AUC of 0.87 (range: 0.82-0.91) for diagnosing muscle-invasive bladder.

REAL WORLD LUNG CANCER CT SCREENING PERFORMANCE, SMOKING BEHAVIOR, AND ADHERENCE TO RECOMMENDATIONS: LUNG-RADS CATEGORY AND SMOKING STATUS PREDICT ADHERENCE
Eduardo Jose Mortani Barbosa, MD, Rochelle Yang, BA, Michelle Hershman, MD
Patient adherence to lung cancer screening recommendations is low (43.0%). However, adherence is higher in patients with an increased suspicion for lung cancer (i.e., a higher Lung-RADS category) and in former smokers.

DIAGNOSTIC ACCURACY OF 68Ga-PSMA PET/CT FOR INITIAL DETECTION IN PATIENTS WITH SUSPECTED PROSTATE CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS
Swayamjeet Satapathy, MBBS, Harmandeep Sing, MD, Rajender Kumar, MD, Bhagwant Rai Mittal, MD
68Ga-PSMA-PET/CT had high diagnostic accuracy for initial detection in patients with suspected prostate cancer and has potential application as a ‘rule-out’ test in this setting.

ADVANCED MUSCULOSKELETAL ULTRASOUND TECHNIQUES: WHAT ARE THE APPLICATIONS?
Marnix van Holsbeeck, MD, Steven Soliman, DO, Filip Van Kerkhove, MD, Joseph Craig, MD
This review covers technical advances in musculoskeletal ultrasound from the viewpoint of the user. The authors take a critical look at the recent literature to highlight progress and unsolved questions.

PREDICTORS OF ANESTHETIC EXPOSURE IN PEDIATRIC MRI
Fedel Machado-Rivas, MD, Ellen Leitman, MD, PhD, Camilo Jaimes, MD, John Conklin, MD, Paul A. Caruso, MD, Chang A. Liu, MD, Michael S. Gee, MD, PhD
A direct relationship between pediatric MRI scan time and dose of anesthetic exposure can be modeled using imaging and clinical variables.

PERCUTANEOUS MICROWAVE ABLATION OF STAGE T1A RENAL CELL CARCINOMA: INTERMEDIATE RESULTS ON SAFETY, TECHNICAL FEASIBILITY, AND CLINICAL OUTCOMES OF 119 TUMORS
Jianhai Guo, MD, Ronald S. Arellano, MD
CT-guided percutaneous microwave ablation is associated with high rates of technical success, excellent local progression-free survival and overall survival, and low complication rate for stage T1a renal cell carcinoma.

DIAGNOSTIC PERFORMANCE OF AMERICAN COLLEGE OF RADIOLOGY THYROID IMAGING REPORT AND DATA SYSTEM: A SYSTEMIC REVIEW AND META-ANALYSIS
Wei Li, MS, Yueming Wang, MS, Jing Wen, MS, Lanlan Zhang, MS, Yuan Sun, MS
When compared with ATA guidelines and Korean TI-RADS, ACR TIRADS could avoid a large number of unnecessary biopsies, with acceptable decline in sensitivity..