Alexander, Lauren F.

ABSTRACT Aim The supply of donor kidneys (living and deceased) has fallen far behind the need, while the number of patients with end stage kidney disease continues to rise, increasing their risk of cardiovascular mortality. Kidney transplant candidates frequently exhibit large artery calcification, a major contributor to cardiovascular death. This study aimed to evaluate the relationship between abdominal arterial calcification (AAC) and survival in patients awaiting kidney transplant. Methods We modified the coronary calcium scoring method (Modified Agatston Method) and applied it to quantify AAC. This retrospective study included all adult patients ( N = 4184) listed for kidney transplant from 2005 to 2023 who had undergone abdominal computed tomography (CT) scans. Patients were categorised into two groups: those who died while on the waiting list (DWL) and those who survived (SWL). Results Among 4184 candidates, 446 (10.7%) died while on the waiting list, and 3738 (89.3%) survived to transplant or study end. Patients in the DWL group had significantly higher AAC scores across all vascular sites. The median total AAC score was 3605.8 (IQR 780.1–9017.3) in the DWL group versus 940.1 (IQR 49.2–4915.0) in the SWL group. Each 1000‐point increase in total AAC was associated with a 5.1% increase in mortality risk (HR 1.051; p < 0.001). An AAC cutoff of > 1769 correlated with reduced 5‐year survival (45.4% vs. 77.4%, p < 0.001). Conclusion AAC scoring on non‐contrast abdominal CT represents a noninvasive biomarker of mortality in kidney transplant waitlist patients and may enhance risk stratification and personalised care.

Abstract Background Abdominal arterial calcification is a well-established predictor of cardiovascular events and mortality in kidney failure. Autosomal dominant polycystic kidney disease (ADPKD), a common genetic cause of kidney failure, presents with a distinct vascular profile. However, the burden of abdominal arterial calcification in ADPKD remains inadequately characterized. Clarifying these differences may improve cardiovascular risk stratification and transplant timing. Methods We conducted a retrospective cohort study of 4088 adult patients listed for kidney transplant at three Mayo Clinic sites (2005–2024). Patients were categorized by kidney failure cause: ADPKD vs. non-ADPKD. Abdominal arterial calcification was quantified on non-contrast computed tomography (CT) scans using a modified Agatston scoring method. Propensity score matching (1:1) adjusted for age, sex, race, lipid levels, left ventricular ejection fraction, dialysis exposure, coronary artery disease, neurovascular disease, and smoking history, was performed. Abdominal arterial calcification scores were compared between matched groups, and subgroup analyses evaluated abdominal arterial calcification severity across dialysis durations in ADPKD patients. Results After matching, 309 patients with ADPKD were compared with 309 non-ADPKD chronic kidney disease (CKD) controls. Abdominal arterial calcification scores were significantly lower in the ADPKD group (median: 425.3; IQR: 0.0–2033.5) than in the non-ADPKD group (median: 1256.8; IQR: 96.5–5033.8). Among ADPKD patients, abdominal arterial calcification scores increased with dialysis duration (P &lt; .001). Conclusion ADPKD patients exhibit lower abdominal arterial calcification scores than their non-ADPKD counterparts after adjusting for clinical variables. Abdominal arterial calcification progression with dialysis highlights the importance of early transplant evaluation. This study introduces a novel adaptation of coronary calcium scoring software for quantifying abdominal calcification, offering a standardized approach to vascular risk assessment in kidney transplant candidates.

CEUS is a safe and cost-effective means for characterization of indeterminate renal masses, with performance equal to or better than that of contrast-enhanced CT or MRI for stratification and surveillance of cystic renal masses and discrimination of benign avascular cysts from solid renal masses.

The interpretation of gynecologic pelvic MRI benefits from tailored MRI protocols, radiologists' knowledge of normal female pelvic anatomy, and a step-by-step approach focusing on lesion origin, lesion tissue composition, and solid tissue morphology, with findings presented in a structured report.

ABSTRACT Background Abdominal arterial calcification (AAC) is a common comorbidity in patients with end‐stage kidney disease (ESKD) and a predictor of cardiovascular events post‐kidney transplant. However, prior studies lacked a standardized approach to evaluate AAC and its impact on post‐transplant outcomes. This study aimed to correlate AAC score values with post‐kidney transplant outcomes using a modified scoring system traditionally applied to coronary artery calcification. Methods This retrospective study included 14 339 adult patients listed for kidney transplant between 2002 and 2023 at three transplant centers. Among them, 3683 patients met the criteria of undergoing a kidney transplant and an abdominal computed tomography (CT) scan pre‐transplant. We modified the coronary calcium score software by adjusting intake data points to quantify calcification in the abdominal aorta, common iliac, external iliac, and internal iliac arteries. Outcomes focused on post‐transplant mortality. Results In 3683 kidney transplant recipients, higher AAC scores were significantly associated with increased mortality. Each 1000‐unit increase in AAC score elevated hazard ratios (HRs) across arterial regions, including 1.116 for the aorta and 1.389 for the internal iliac (all p < 0.001). Adjusted analyses confirmed AAC as an independent risk factor for mortality. Kaplan–Meier curves demonstrated lower survival with increasing AAC quartiles. Conclusions AAC, measured by a standardized score, is a significant mortality risk factor in kidney transplant recipients. Integrating AAC scores into pre‐transplant evaluations could enhance risk stratification and improve outcomes. Prospective studies are needed to validate these findings and explore interventions to reduce AAC and improve survival.

Pancreas transplant is the standard treatment for restoring endocrine function and limiting complications from diabetes, and radiologists should understand the surgical techniques, normal imaging spectrum, and various complications associated with this surgical procedure.

This review examines the applications and challenges of large language models (LLMs), like OpenAI’s ChatGPT, in radiology research. ChatGPT can assist radiology researchers in generating new ideas, finding and summarizing research papers, designing studies, analyzing data, and facilitating manuscript writing. LLMs are powerful tools with numerous applications in radiology research. However, users should be mindful of potential pitfalls, such as producing incorrect or biased outputs and inconsistent responses, along with ethical and privacy concerns. We discuss approaches to optimize models and address these issues, including prompting techniques like chain-of-thought prompting, retrieval-augmented generation, and fine-tuning. For researchers, prompt engineering can be particularly effective. This review seeks to demonstrate how researchers can utilize ChatGPT for radiology research while offering strategies to mitigate associated risks. We aim to help researchers harness these potent tools to safely boost their productivity.

Objectives Endovascular aneurysm repair, though minimally invasive and has the benefit of relatively low perioperative complication rates, it is associated with significant long term reintervention rates related to endoleaks. Several variables have been studied to predict the outcomes of endovascular aneurysm repair, 1 of which is the calcium burden of the vasculature. This prompted us to study the association between calcium burden measured by the standardized Agatston scoring system and the outcomes of Endovascular aneurysm repair. Methods This is a retrospective study of patients who underwent Endovascular aneurysm repair from 2008 to 2020 at our institution and who had a non-contrast computerized tomography scan preoperatively, accounting for 87 patients. The calcium burden of the vasculature was measured by the Agatston scoring system allowing for better reproducibility, and the outcome variables included mortality and endoleaks. Results Patients with higher median total calcium scores (≥12966.9) had significantly lesser survival (79.8% vs 52.3% ( P = .002) at five years compared to patients with lower median total calcium score (<12966.9). Also, patients with type 2 endoleaks had higher calcium scores in above the aneurysm level ((1591.2 vs 688.2), P = .05)) compared to patients with no type 2 endoleaks. Conclusion Calcium score assigned using a standardized Agatston scoring system can be used as a predictor of mortality risk assisting in deciding the treatment of choice for patients.