Corrigendum: Discovery of metastases in thyroid cancer and "benign metastasizing goiter": a historical note.

[This corrects the article DOI: 10.3389/fendo.2024.1354750.].

Transcending Language Barriers: Can ChatGPT Be the Key to Enhancing Multilingual Accessibility in Healthcare?

OBJECTIVE: To explore the capabilities of ChatGPT for the purpose of simplifying and translating radiology reports into Spanish, Hindi, and Russian languages, with comparisons to its performance in simplifying to the English language. METHODS: 50 deidentified abdomen-pelvis CT reports were fed to ChatGPT (4.0), instructing it to simplify and translate the report. The processed reports were rated on factual correctness (I), potential harmful errors (II), completeness (III), and explanation of medical terms (IV). The translated versions were also rated on the quality of translation (V). The scores in each category were compared between the translated versions and each translated version was compared with the English version in the first four categories. The original reports and the simplified English reports were rated on the Flesch Reading Ease Score (FRES) and the Flesch Kincaid Grade Level (FKRL). RESULTS: The Spanish translation outperformed the Hindi and Russian version significantly in categories I and III (p<0.05). All translated versions performed significantly worse compared to the English version in category IV (p<0.001). Notably, the Hindi translated version performed significantly worse in all 4 categories (p<0.05). The Russian translated version was also significantly worse in category III (p<0.05). In the first three categories, the Spanish translation, and the Russian translation in the first two categories demonstrated no statistically significant difference from the English version. No statistically significant difference was observed in the FRES and FKRL of the simplified English reports. Typographical errors in the original reports negatively affected the translation. CONCLUSION: ChatGPT demonstrates potential ability in translating reports and communicating pertinent clinical information with limited errors. More training and tailoring are required for languages that are not as commonly used in medical literature. LLMs can be used for translating and simplifying radiology reports, potentially improving access to healthcare, and helping reduce healthcare costs.

Discovery of metastases in thyroid cancer and "benign metastasizing goiter": a historical note.

At the beginning of the eighteenth century, most physicians recognized cancer as an aggressive process that gradually spreads, leading to cachexia and death. Thyroid malignancies had long been underestimated because the majority of the population of West Europe suffered from diffuse goiters that masked malignant processes in the neck. Moreover, the life expectancy at that time was very low (about 37-40 years), so the majority of people died of other causes before metastatic thyroid cancer could develop and manifest. Nevertheless, in 1817, French dermatologist Jean Louis Alibert described the first case of a malignant tumor involving the thyroid gland. From the 1820s the number of case reports describing thyroid cancer increased. Even though Jean Claude Recamier described metastases in 1829, secondary lesions on various organs in patients with thyroid malignancies were not themselves considered malignant until 1876.

Gallstones Detection on Dual-Energy Computerized Tomography-Is It Ready for Real-World Use? A Retrospective Observational Study.

AIMS: The aims of the study are to evaluate the performance of dual-energy computed tomography (DECT) imaging in the detection of noncalcified gallstones (GSs) and to assess its performance relative to transabdominal ultrasound (US) in identifying cholelithiasis. METHOD: This study is a retrospective review of radiology records and images to find all patients who had both US and DECT scans within a 6-month period and were found to have GSs. Patients who did not have GSs on US served as the control group. The CT scans were reviewed by 4 radiologists who did not have access to the US results when assessing the presence or absence of GSs on the DECT scans. In case of any discrepancies among the radiologists, the majority opinion was considered. If there was a split opinion, a fifth reviewer was consulted. The data were analyzed to calculate sensitivity, specificity, positive and negative predictive values, as well as overall accuracy and to evaluate interreader variability. The absolute Hounsfield unit (HU) differences of the GSs and bile were compared between polychromatic (PC), virtual noncontrast (VNC), and virtual monochromatic (VMC) images. RESULTS: Considering at least 3-reader agreement, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were found to be 92%, 96%, 96%, 92%, and 94%, respectively. Individual reader sensitivity varied between 87% and 92%. There was good interobserver agreement with a Fleiss' kappa of 0.76. Quantification of the whole data set showed that no significant difference was observed in the HU values for the stones between the PC images and the VNC images. A significant increase was observed on the 50-keV VMC images compared with the PC and VNC images. In the study group, 17% stones were visualized only on the VNC or/and 50-keV VMC images, and not on the PC images. On quantitative analysis of these cases, there was a significant increase of HU in the VNC images as compared with PC images and a significant decrease of HU in the 50-keV VMC images as compared with PC images. CONCLUSIONS: Low-keV images increase stone-bile contrast. Evaluation of cholelithiasis using VNC and 50-keV VMC images demonstrated a 14% increase in sensitivity relative to conventional CT.

The Brain Tumor Segmentation (BraTS-METS) Challenge 2023: Brain Metastasis Segmentation on Pre-treatment MRI.

Clinical monitoring of metastatic disease to the brain can be a laborious and timeconsuming process, especially in cases involving multiple metastases when the assessment is performed manually. The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) guideline, which utilizes the unidimensional longest diameter, is commonly used in clinical and research settings to evaluate response to therapy in patients with brain metastases. However, accurate volumetric assessment of the lesion and surrounding peri-lesional edema holds significant importance in clinical decision-making and can greatly enhance outcome prediction. The unique challenge in performing segmentations of brain metastases lies in their common occurrence as small lesions. Detection and segmentation of lesions that are smaller than 10 mm in size has not demonstrated high accuracy in prior publications. The brain metastases challenge sets itself apart from previously conducted MICCAI challenges on glioma segmentation due to the significant variability in lesion size. Unlike gliomas, which tend to be larger on presentation scans, brain metastases exhibit a wide range of sizes and tend to include small lesions. We hope that the BraTS-METS dataset and challenge will advance the field of automated brain metastasis detection and segmentation.

Diplopia and Ptosis: An Unusual Case of Prostate Cancer Metastasis to the Sphenoid Bone Treated With Palliative Radiotherapy.

We report a case of a 72-year-old male who presented to the hospital with a chief complaint of diplopia in the setting of a recent onset of urinary incontinence and right-sided back pain. He was subsequently diagnosed with prostate cancer, notably metastasizing to the right sphenoid bone, causing impingement of the oculomotor nerve. Our case is unique in that the patient's initial presentation of prostate cancer was oculomotor nerve palsy with subsequent histologic analysis of the primary tumor showing both small cell neuroendocrine carcinoma along with adenocarcinoma. Also, the initial routine stroke protocol MRI and computed tomography angiography (CTA) missed the lesion, while gadolinium-enhanced targeted MRI revealed lesions in both the spine and the orbit. This case emphasizes the need for enhanced contrast as well as focused imaging in patients presenting with diplopia with a negative initial workup for stroke. Ptosis can be a sign of metastasis from other cancers and it is important to have a broad differential including metastatic disease in patients' presenting with similar symptoms and negative initial workup who may otherwise be at risk of cancer.

Beyond the sacro-Iliac joints: Vertebral involvement in axial spondylarthritis.

Imaging plays a central role in the diagnosis of axial spondylarthritis (axSpA). Commonly the sacroiliac joints are involved but vertebral involvement can occur in isolation in 1 out of 4 patients. Recognizing vertebral involvement patterns in axSpA can help establishing a diagnosis early and initiate therapy before irreversible changes have occurred. Magnetic resonance imaging (MRI) is considered the reference standard for early detection of inflammatory changes of the disease. Aims of this review are to present an overview of the imaging findings of vertebral involvement in axSpA, and to detail the current recommendations on the role of imaging in the diagnosis of axSpA in patients with isolated vertebral involvement.

Impact of PTRIA (Patient Test Result Information Act) on patient follow up management.

OBJECTIVE: We aim to study if direct patient notification in accordance with the Patient Test Results Information Act (Act 112) in Pennsylvania leads to decreased loss to follow up and prompt management of actionable imaging findings. METHODS: For this IRB-approved study, radiology reports were randomly identified using the Nuance mPower™ search engine. The actionable finding group (prior to Act-112) contained 300 patients for which a voice notification was sent by radiologists to alert ordering physicians about significant imaging findings. The PTRIA group (after Act-112) contained 300 patients who were mailed a standardized letter one day after the final report was issued. The electronic medical records were reviewed to evaluate how patients were managed. RESULTS: There was no difference in loss to follow up rates and time to follow up completion between the two groups. In both groups, 34% of patients were lost to follow up in transition of care from generalists to specialists; 24% cases were lost to follow up when imaging findings were not in the area of the initial ordering provider expertise. CONCLUSION: The goal of Act 112 is to increase patients' role in the timely management of their significant medical conditions and prevent medical errors, specifically loss to follow up. Our study suggests that presumed patients' awareness does not contribute to improved follow up rates or decreased time to a follow up visit. 13% of patients are lost to follow up in both groups. A tracking system is required to prevent delayed management of the significant findings.

Protocol Optimization and Implementation of Dual-Energy and Dual-Source Computed Tomography in Clinical Practice: Field of View, Speed, or Material Separation?

Clinical use of dual-energy computed tomography (DECT) and dual-source computed tomography (DSCT) has been well established for more than a decade. Improved software and decreased postprocessing time have increased the advantages and availability of DECT and DSCT imaging. In this article, we will provide a practical guide for implementation of DECT and DSCT in clinical practice and discuss automated processing and selection of CT protocols in neurologic, cardiothoracic, vascular, body, and musculoskeletal imaging.

Percutaneous Vertebroplasty: A History of Procedure, Technology, Culture, Specialty, and Economics.

Percutaneous vertebroplasty (VP) progressed from a virtually unknown procedure to one performed on hundreds of thousands of patients annually. The development of VP provides a historically exciting case study into a rapidly adopted procedure. VP was the synthesis of information gained from spinal biopsy developments, the inception of biomaterials used in medicine, and the unique health care climate in France during the 1980s. It was designed as a revolutionary technique to treat vertebral body fractures with minimal side effects and was rapidly adopted and marketed in the United States. The impact of percutaneous vertebroplasty on spine surgery was profound.

Medullary Thyroid Carcinoma: An Update on Imaging.

Medullary thyroid carcinoma (MTC), arising from the parafollicular C cells of the thyroid, accounts for 1-2% of thyroid cancers. MTC is frequently aggressive and metastasizes to cervical and mediastinal lymph nodes, lungs, liver, and bones. Although a number of new imaging modalities for directing the management of oncologic patients evolved over the last two decades, the clinical application of these novel techniques is limited in MTC. In this article, we review the biology and molecular aspects of MTC as an important background for the use of current imaging modalities and approaches for this tumor. We discuss the modern and currently available imaging techniques-advanced magnetic resonance imaging (MRI)-based techniques such as whole-body MRI, dynamic contrast-enhanced (DCE) technique, diffusion-weighted imaging (DWI), positron emission tomography/computed tomography (PET/CT) with 18F-FDOPA and 18F-FDG, and integrated positron emission tomography/magnetic resonance (PET/MR) hybrid imaging-for primary as well as metastatic MTC tumor, including its metastatic spread to lymph nodes and the most common sites of distant metastases: lungs, liver, and bones.

Fibrous dysplasia for radiologists: beyond ground glass bone matrix.

Fibrous dysplasia (FD) is a congenital disorder arising from sporadic mutation of the α-subunit of the Gs stimulatory protein. Osseous changes are characterised by the replacement and distortion of normal bone with poorly organised, structurally unsound, fibrous tissue. The disease process may be localised to a single or multiple bones. In McCune-Albright syndrome (MAS), fibrous dysplasia is associated with hyperfunction of endocrine organs and overproduction of melanin in the skin, while Mazabraud syndrome FD is associated with intramuscular myxomas. In radiology, FD is very often automatically associated with the term "ground glass matrix". However, FD is a complex disease, and knowledge of its unique pathogenesis and course are crucial to understanding imaging findings and potential complications. This article aims to not only summarise the spectrum of radiological findings of osseous and extra-osseous abnormalities associated with FD but also to highlight the pathological base of the disease evolution, corresponding imaging changes and complications based on the disease distribution. We also have provided current recommendations for clinical management and follow-up of patients with FD. TEACHING POINTS: • FD is often a part of complex disease, involving not only bone but also multiple other organs. • FD lesions are characterised by age-related histological, radiographical and clinical transformations. • Radiologists play a crucial role in the identification of osseous complications associated with FD. • The craniofacial form of the disease is the most common type of FD and the most difficult form to manage. • Patients with McCune-Albright syndrome may have different extra-skeletal abnormalities, which often require follow-up.

Transseptal course of anomalous left main coronary artery originating from single right coronary orifice presenting as unstable angina.

Transseptal course of coronary artery has often been described as a benign entity; however, this report and literature analysis provides growing evidence of high risk of serious cardiovascular events in this anomaly. We present a case of unstable angina in a patient with anomalous common origin of left and right coronary arteries from a single coronary ostium at the right sinus of Valsalva, with subsequent transseptal course of the left main artery, review of relevant literature, and discussion of possible management options.

ABCs of the degenerative spine.

Degenerative changes in the spine have high medical and socioeconomic significance. Imaging of the degenerative spine is a frequent challenge in radiology. The pathogenesis of this degenerative process represents a biomechanically related continuum of alterations, which can be identified with different imaging modalities. The aim of this article is to review radiological findings involving the intervertebral discs, end plates, bone marrow changes, facet joints and the spinal canal in relation to the pathogenesis of degenerative changes in the spine. Findings are described in association with the clinical symptoms they may cause, with a brief review of the possible treatment options. The article provides an illustrated review on the topic for radiology residents. TEACHING POINTS: • The adjacent vertebrae, intervertebral disc, ligaments and facet joints constitute a spinal unit. • Degenerative change is a response to insults, such as mechanical or metabolic injury. • Spine degeneration is a biomechanically related continuum of alterations evolving over time.

Focal Hepatic Glycogenosis in a Patient With Uncontrolled Diabetes Mellitus Type 1.

Hepatomegaly and elevated liver enzymes in patients with diabetes are commonly associated with fatty liver disease. However, physicians often forget about another intrinsic substance that can cause a similar clinical picture-glycogen. Liver stores approximately one third of the total body glycogen and is responsible for blood glucose homeostasis. Excessive hepatocellular glycogen accumulation occurs not only in congenital glycogen storage diseases, but also in acquired conditions associated with hyperglycemic-hyperinsulinemic states such as uncontrolled diabetes mellitus, high-dose corticosteroid use, and dumping syndrome. All reported cases of acquired abnormal glycogen deposition described a diffuse form of hepatic glycogenosis with the entire liver involved in the accumulating process. To our knowledge, this is the first reported case of abnormal focal glycogen deposition in a patient with diabetes mellitus type 1 with imaging and pathologic correlation. Awareness of the imaging appearance of focal glycogen deposition can help to distinguish it from other pathologic conditions.

Intimal Problems: A Pictorial Review of Nontraumatic Aortic Disease at Multidetector Computed Tomography.

Nontraumatic aortic diseases include a spectrum of disorders, many of which result in high morbidity and mortality. This article highlights the multidetector computed tomography appearance of common and uncommon nontraumatic aortic entities: dissection, intramural hematoma, penetrating atherosclerotic ulcer, pseudoaneurysm, aneurysm, acute thrombus, chronic occlusion, and vasculitis. Additionally, classical imaging mimics and pitfalls are addressed. Radiologists should feel confident identifying these conditions and providing accurate diagnoses to expedite patient care and prevent devastating, even fatal outcomes.

Epidemiology of imaging-detected tendon abnormalities in athletes participating in the Rio de Janeiro 2016 Summer Olympics.

BACKGROUND: Tendon abnormalities are prevalent among both elite and non-elite athletes. Cross-sectional imaging modalities are used to confirm and evaluate the severity of such lesions. AIM: To describe the demographics, prevalence, anatomical location and characteristics of tendon abnormalities in athletes who participated in the Rio de Janeiro 2016 Summer Olympic Games. METHODS: We recorded all sports injuries reported by the National Olympic Committee (NOC) medical teams and the Organizing Committee medical staff during the Rio 2016 Summer Olympics. Diagnostic imaging was performed through the official IOC clinic within the Olympic Village, using digital ultrasound machines and 3T and 1.5T MR scanners. Image interpretation was performed centrally by board-certified musculoskeletal radiologists with expertise in sports injuries. RESULTS: In total, 11 274 athletes (5089 women (45%), 6185 men (55%)) from 207 NOCs were included. NOC and Rio de Janeiro 2016 medical staff reported 1101 injuries. Central review of radiological images revealed 156 tendon abnormalities in 109 athletes (51.2% male, mean age: 26.8, range 18-39). The supraspinatus tendon was the most commonly involved tendon (31 cases, 19.9%), followed by the Achilles tendon (20 cases, 12.8%) and patellar and infraspinatus tendons (12 cases, 7.7%). Tendon abnormalities were most commonly seen in track and field athletes (54 abnormalities, 34.6%). CONCLUSION: 156 tendon abnormalities were reported, most commonly in track and field athletes, and involving mainly the shoulder tendons, as well as Achilles and patellar tendons.

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions.

Chronic liver disease has multiple causes, many of which are increasing in prevalence. The final common pathway of chronic liver disease is tissue destruction and attempted regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis is important not only for diagnosis but also for management, prognostic evaluation, and follow-up of patients with chronic liver disease. Although liver biopsy has traditionally been considered the reference standard for assessment of liver fibrosis, noninvasive techniques are the emerging focus in this field. Ultrasound-based elastography and magnetic resonance (MR) elastography are gaining popularity as the modalities of choice for quantifying hepatic fibrosis. These techniques have been proven superior to conventional cross-sectional imaging for evaluation of fibrosis, especially in the precirrhotic stages. Moreover, elastography has added utility in the follow-up of previously diagnosed fibrosis, the assessment of treatment response, evaluation for the presence of portal hypertension (spleen elastography), and evaluation of patients with unexplained portal hypertension. In this article, a brief overview is provided of chronic liver disease and the tools used for its diagnosis. Ultrasound-based elastography and MR elastography are explored in depth, including a brief glimpse into the evolution of elastography. Elastography is based on the principle of measuring tissue response to a known mechanical stimulus. Specific elastographic techniques used to exploit this principle include MR elastography and ultrasonography-based static or quasistatic strain imaging, one-dimensional transient elastography, point shear-wave elastography, and supersonic shear-wave elastography. The advantages, limitations, and pitfalls of each modality are emphasized. ©RSNA, 2016.

Soft-Tissue Infections and Their Imaging Mimics: From Cellulitis to Necrotizing Fasciitis.

Infection of the musculoskeletal system can be associated with high mortality and morbidity if not promptly and accurately diagnosed. These infections are generally diagnosed and managed clinically; however, clinical and laboratory findings sometimes lack sensitivity and specificity, and a definite diagnosis may not be possible. In uncertain situations, imaging is frequently performed to confirm the diagnosis, evaluate the extent of the disease, and aid in treatment planning. In particular, cross-sectional imaging, including computed tomography and magnetic resonance imaging, provides detailed anatomic information in the evaluation of soft tissues due to their inherent high spatial and contrast resolution. Imaging findings of soft-tissue infections can be nonspecific and can have different appearances depending on the depth and anatomic extent of tissue involvement. Although many imaging features of infectious disease can overlap with noninfectious processes, imaging can help establish the diagnosis when combined with the clinical history and laboratory findings. Radiologists should be familiar with the spectrum of imaging findings of soft-tissue infections to better aid the referring physician in managing these patients. The aim of this article is to review the spectrum of soft-tissue infections using a systematic anatomic compartment approach. We discuss the clinical features of soft-tissue infections, their imaging findings with emphasis on cross-sectional imaging, their potential mimics, and clinical management. ©RSNA, 2016.

Uncommon Diseases of The Popliteal Artery: A Pictorial Review.

Uncommon diseases of the popliteal artery include cystic adventitial disease, popliteal artery entrapment syndrome (PAES) and popliteal artery aneurysm (PAA). Because all of these conditions may present with pain or intermittent claudication, imaging is crucial for differentiating them and directing management. Delayed diagnosis can lead to major complications, including acute limb ischemia. Our aim is to provide an illustrative overview of these conditions in order to make radiologists aware of them and avoid misdiagnosis for timely appropriate management. Teaching Points • Cystic adventitial disease diagnosis is based on evidence of cysts within artery walls. • A variety of anatomic variations may result in PAES. • PAES may be bilateral. • PAA is most commonly encountered in men. • Acute complications of PAA include acute thrombosis and distal embolization.