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OuYang PY, Liu ZQ, Lin QG, He Y, Guo ZX, Yao WY, Xu SK, Peng QH, Xiao SM, Li J, Li A, Zhang BY, Yang SS, Fan W, Xie CM, Wu YS, Zhang X, Chen CY, Xie FY. Benefit of [ 18F] FDG PET/CT in the diagnosis and salvage treatment of recurrent nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging 2023; 50:881-891. [PMID: 36301324 DOI: 10.1007/s00259-022-06020-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/20/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE To compare PET/CT, MRI and ultrasonography in detecting recurrence of nasopharyngeal carcinoma and identify their benefit in staging, contouring and overall survival (OS). METHODS Cohort A included 1453 patients with or without histopathology-confirmed local recurrence, while cohort B consisted of 316 patients with 606 histopathology-confirmed lymph nodes to compare the sensitivities and specificities of PET/CT, MRI and ultrasonography using McNemar test. Cohorts C and D consisted of 273 patients from cohort A and 267 patients from cohort B, respectively, to compare the distribution of PET/CT-based and MRI-based rT-stage and rN-stage and the accuracy of rN-stage using McNemar test. Cohort E included 30 random patients from cohort A to evaluate the changes in contouring with or without PET/CT by related-samples T test or Wilcoxon rank test. The OS of 61 rT3-4N0M0 patients staged by PET/CT plus MRI (cohort F) and 67 MRI-staged rT3-4N0M0 patients (cohort G) who underwent similar salvage treatment were compared by log-rank test and Cox regression. RESULTS PET/CT had similar specificity to MRI but higher sensitivity (93.9% vs. 79.3%, P < 0.001) in detecting local recurrence. PET/CT, MRI and ultrasonography had comparable specificities, but PET/CT had greater sensitivity than MRI (90.9% vs. 67.6%, P < 0.001) and similar sensitivity to ultrasonography in diagnosing lymph nodes. According to PET/CT, more patients were staged rT3-4 (82.8% vs. 68.1%, P < 0.001) or rN + (89.9% vs. 69.3%, P < 0.001), and the rN-stage was more accurate (90.6% vs. 73.8%, P < 0.001). Accordingly, the contours of local recurrence were more precise (median Dice similarity coefficient 0.41 vs. 0.62, P < 0.001) when aided by PET/CT plus MRI. Patients staged by PET/CT plus MRI had a higher 3-year OS than patients staged by MRI alone (85.5% vs. 60.4%, P = 0.006; adjusted HR = 0.34, P = 0.005). CONCLUSION PET/CT more accurately detected and staged recurrence of nasopharyngeal carcinoma and accordingly complemented MRI, providing benefit in contouring and OS.
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Affiliation(s)
- Pu-Yun OuYang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Zhi-Qiao Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Qing-Guang Lin
- Department of Ultrasound, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, Guangdong, China
| | - Yun He
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, Guangdong, China
| | - Zhi-Xin Guo
- Department of Ultrasound, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, Guangdong, China
| | - Wen-Yan Yao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Sen-Kui Xu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Qing-He Peng
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Su-Ming Xiao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Jiajian Li
- CVTE Research, Guangzhou, Guangdong, China
| | - Anwei Li
- CVTE Research, Guangzhou, Guangdong, China
| | - Bao-Yu Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Shan-Shan Yang
- Department of Radiation Oncology, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wei Fan
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, Guangdong, China
| | - Chuan-Miao Xie
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, Guangdong, China
| | - Yi-Shan Wu
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong, China
| | - Xu Zhang
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, Guangdong, China
| | - Chun-Yan Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Fang-Yun Xie
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China.
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Hsu D, Rath TJ, Branstetter BF, Anzai Y, Phillips CD, Juliano AF, Mosier KM, Bazylewicz MP, Poliashenko SM, Kulzer MH, Rhyner PA, Risk B, Wiggins RH, Aiken AH. Interrater Reliability of NI-RADS on Posttreatment PET/Contrast-enhanced CT Scans in Head and Neck Squamous Cell Carcinoma. Radiol Imaging Cancer 2021; 3:e200131. [PMID: 34018845 DOI: 10.1148/rycan.2021200131] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Purpose To evaluate the interrater reliability among radiologists examining posttreatment head and neck squamous cell carcinoma (HNSCC) fluorodeoxyglucose PET/contrast-enhanced CT (CECT) scans using Neck Imaging Reporting and Data System (NI-RADS). Materials and Methods In this retrospective study, images in 80 patients with HNSCC who underwent posttreatment surveillance PET/CECT and immediate prior comparison CECT or PET/CECT (from June 2014 to July 2016) were uploaded to the American College of Radiology's cloud-based website, Cortex. Eight radiologists from seven institutions with variable NI-RADS experience independently evaluated each case and assigned an appropriate prose description and NI-RADS category for the primary site and the neck site. Five of these individuals were experienced readers (> 5 years of experience), and three were novices (< 5 years of experience). In total, 640 lexicon-based and NI-RADS categories were assigned to lesions among the 80 included patients by the eight radiologists. Light generalization of Cohen κ for interrater reliability was performed. Results Of the 80 included patients (mean age, 63 years ± 10 [standard deviation]), there were 58 men (73%); 60 patients had stage IV HNSCC (75%), and the most common tumor location was oropharynx (n = 32; 40%). Light κ for lexicon was 0.30 (95% CI: 0.23, 0.36) at the primary site and 0.31 (95% CI: 0.24, 0.37) at the neck site. Light κ for NI-RADS category was 0.55 (95% CI: 0.46, 0.63) at the primary site and 0.60 (95% CI: 0.48, 0.69) at the neck site. Percent agreement between lexicon and correlative NI-RADS category was 84.4% (540 of 640) at the primary site and 92.6% (593 of 640) at the neck site. There was no significant difference in interobserver agreement among the experienced versus novice raters. Conclusion Moderate agreement was achieved among eight radiologists using NI-RADS at posttreatment HNSCC surveillance imaging. Keywords: CT, PET/CT, Head/Neck, Neck, Neoplasms-Primary, Observer Performance Supplemental material is available for this article. © RSNA, 2021.
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Affiliation(s)
- Derek Hsu
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Tanya J Rath
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Barton F Branstetter
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Yoshimi Anzai
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - C Douglas Phillips
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Amy F Juliano
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Kristine M Mosier
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Michael P Bazylewicz
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Stan M Poliashenko
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Matthew H Kulzer
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Patricia A Rhyner
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Benjamin Risk
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Richard H Wiggins
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
| | - Ashley H Aiken
- From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.)
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