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SUMMARY Aldosterone-secreting adrenocortical carcinomas (ACCs) are rare and usually present as large tumors. The only potentially curative treatment for ACC is surgical resection. However, surgery may be unfeasible in some patients who have multiple comorbidities or decline the procedure. We describe herein the case of a 44-year-old man with aldosterone-secreting ACC who declined surgery because of religious convictions. As a Jehovah’s Witness, the patient was concerned about requiring blood transfusion during surgery. Treatment with mitotane was started but interrupted due to hepatotoxicity. Subsequently, the patient was successfully treated with stereotactic ablative radiotherapy (SABR). After SABR, the patient had progressive improvement of pain, reduction in antihypertensive drugs, control of blood pressure and hypokalemia, normalization of serum aldosterone and renin levels, and reduction in tumor size and weight. To our knowledge, this is the first report of a patient with a pure aldosterone-secreting ACC who received SABR. The patient’s response was substantial, showing that SABR could be considered as an alternative local treatment for aldosterone-secreting ACCs when surgery is unfeasible. Aldosteronesecreting Aldosterone secreting (ACCs tumors resection However procedure 44yearold yearold 44 year old aldosteronesecreting convictions Jehovahs Jehovah s Witness hepatotoxicity Subsequently . (SABR) pain drugs hypokalemia levels weight knowledge substantial 4 (SABR

https://doi.org/10.20945/2359-4292-2023-0441

Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging Brazil Surgery Association
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Pereira, Luiz Fernando Ferreira

; Santos, Ricardo Sales dos

; Bonomi, Daniel Oliveira

; Franceschini, Juliana

; Santoro, Ilka Lopes

; Miotto, André

; Sousa, Thiago Lins Fagundes de

; Chate, Rodrigo Caruso

; Hochhegger, Bruno

; Gomes Neto, Artur

; Schneider, Airton

; Araújo Neto, César Augusto de

; Escuissato, Dante Luiz

; Prado, Gustavo Faibischew

; Costa-Silva, Luciana

; Zamboni, Mauro Musa

; Ghefter, Mario Claudio

; Corrêa, Paulo César Rodrigues Pinto

; Torres, Pedro Paulo Teixeira e Silva

; Mussi, Ricardo Kalaf

; Muglia, Valdair Francisco

; Godoy, Irma de

; Bernardo, Wanderley Marques

Jornal Brasileiro de Pneumologia

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2024, Volume 50 N. 1 elocation e20230233

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS. LC (LC tumors 15 stage 85 cases (LCS lowdose low dose (LDCT LCrelated related 20 20% 38 cessation decade populationbased population recommendation incipient necessary Surgery Association literature studies reviews guidelines reviewed criteria findings lesions models acquisition team System 1 8 2 3

RESUMO O câncer de pulmão (CP) é uma das neoplasias mais comuns e letais no Brasil, e apenas 15% dos pacientes são diagnosticados nos estágios iniciais. O tabagismo persiste como o responsável por mais de 85% de todos os casos. O rastreamento do CP (RCP) por meio da TC de baixa dosagem de radiação (TCBD) reduz a mortalidade do CP em 20%, e, quando combinado com a cessação do tabagismo, essa redução chega a 38%. Na última década, diversos países adotaram o RCP como recomendação de saúde populacional. No Brasil, embora ainda incipiente, a discussão sobre o tema é cada vez mais ampla e necessária. Com o intuito de aumentar o conhecimento e estimular o debate sobre o RCP, a Sociedade Brasileira de Cirurgia Torácica, a Sociedade Brasileira de Pneumologia e Tisiologia e o Colégio Brasileiro de Radiologia e Diagnóstico por Imagem constituíram um painel de especialistas para elaborar as recomendações para o RCP. As recomendações aqui apresentadas foram baseadas em revisão narrativa da literatura, com ênfase em grandes estudos populacionais, em revisões sistemáticas e em recomendações de diretrizes internacionais, sendo construídas após ampla discussão pelo grupo de especialistas. Os temas revisados foram os seguintes: porque rastrear, considerações gerais sobre tabagismo, epidemiologia do CP, critérios de elegibilidade, achados incidentais, lesões granulomatosas, modelos probabilísticos, requisitos mínimos da TCBD, aquisições volumétricas, riscos do rastreamento, estrutura mínima e papel da equipe multidisciplinar, conduta segundo o Lung CT Screening Reporting and Data System (Lung-RADS), custos vs. benefícios e perspectivas do rastreamento. (CP Brasil 15 iniciais 85 casos (RCP TCBD (TCBD 20 20% 38 38% década populacional incipiente necessária Torácica literatura populacionais internacionais seguintes rastrear elegibilidade incidentais granulomatosas probabilísticos volumétricas multidisciplinar LungRADS, LungRADS RADS , (Lung-RADS) vs 1 8 2 3 (Lung-RADS

https://doi.org/10.36416/1806-3756/e20230233

Quantification of hepatic fat: evaluation of different magnetic resonance imaging measurement strategies in cases of homogeneous and heterogeneous distribution fat
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Noguerol, Eloa de Castro

; Souza, Luis Ronan Marquez Ferreira de

; Muglia, Valdair Francisco

; Elias Jr., Jorge

Radiologia Brasileira

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2024, Volume 57 elocation e20240009en

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Objective: To evaluate three different measurements strategies to quantify hepatic steatosis and to investigate the differences between homogeneous and heterogeneous forms of hepatic steatosis. Materials and Methods: Retrospective study conducted by magnetic resonance imaging review. We evaluated three different strategies measures for quantification of hepatic steatosis in two matched groups: homogeneous and heterogeneous steatosis. We considered p < 0.05 significance level in all made tests. Results: In heterogeneous steatosis group, the strategy with a region of interest (ROI) of 1 cm2 to measure the signal intensity in the most altered area showed significant variations in the quantification, while the average of four ROIs of 1 cm2 or representative target area in axial section did not vary significant. In diffuse hepatic steatosis, any strategy used showed no significant difference. The intraclass correlation coefficient ranged between 0.96 and 0.99, with 95% confidence interval of 0.93-0.99. Conclusion: The quantification of fat liver by magnetic resonance imaging using only one ROI is less representative, especially in heterogeneous steatosis. There was no significant difference between the average of four ROIs strategy and the strategy of representative segmentation area of parenchyma. Objective Methods review groups 005 0 05 0.0 tests Results group (ROI cm 096 96 0.9 099 99 0.99 95 0.930.99. 093099 0.93 0.99. 93 0.93-0.99 Conclusion parenchyma 00 0. 09 9 930 0.930.99 09309 093 0.93-0.9 0.930.9 0930 0.93-0. 0.930. 0.93-0 0.930 0.93-

Resumo Objetivo: Avaliar três estratégias diferentes de medidas para quantificação da esteatose hepática e verificar se existem diferenças entre as formas homogênea e heterogênea de esteatose. Materiais e Métodos: Estudo retrospectivo, realizado com base em revisão de exames de ressonância magnética. Foram avaliadas três diferentes estratégias de medidas para quantificação da esteatose hepática em dois grupos pareados: esteatose homogênea e esteatose heterogênea. Considerou-se nível de significância de p < 0,05 em todos os testes realizados. Resultados: No grupo de esteatose heterogênea, o uso de região de interesse (ROI) de 1 cm2 para medir a intensidade de sinal na área mais alterada apresentou variações significativas na quantificação, enquanto a média de quatro ROIs de 1 cm2 ou a segmentação de área representativa em corte axial não apresentaram variações significativas. Na esteatose hepática homogênea, qualquer estratégia utilizada não demonstrou diferença significativa. O coeficiente de correlação intraclasse variou entre 0,96 e 0,99, com intervalo de confiança 95% de 0,93-0,99. Conclusão: A quantificação da gordura hepática por ressonância magnética utilizando apenas uma ROI é menos representativa, principalmente na esteatose heterogênea. Não houve diferença significativa entre a obtenção da média de quatro ROIs e a segmentação de área representativa do parênquima. Objetivo Métodos retrospectivo pareados Considerouse Considerou 005 0 05 0,0 realizados Resultados (ROI cm 096 96 0,9 099 99 0,99 95 0,930,99. 093099 0,93 0,99. 93 0,93-0,99 Conclusão parênquima 00 0, 09 9 930 0,930,99 09309 093 0,93-0,9 0,930,9 0930 0,93-0, 0,930, 0,93-0 0,930 0,93-

https://doi.org/10.1590/0100-3984.2024.0009-en

Atualização da Recomendação para Avaliação da Doença das Artérias Carótidas e Vertebrais pela Ultrassonografia Vascular: DIC, CBR, SBACV – 2023 Vascular DIC CBR 202 20 2
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Albricker, Ana Cristina Lopes

; Freire, Claudia Maria Vilas

; Santos, Simone Nascimento dos

; Alcantara, Monica Luiza de

; Cantisano, Armando Luis

; Porto, Carmen Lucia Lascasas

; Amaral, Salomon Israel do

; Veloso, Orlando Carlos Glória

; Morais Filho, Domingos de

; Teodoro, José Aldo Ribeiro

; Petisco, Ana Cláudia Gomes Pereira

; Saleh, Mohamed Hassan

; Barros, Marcio Vinícius Lins de

; Barros, Fanilda Souto

; Engelhorn, Ana Luiza Dias Valiente

; Engelhorn, Carlos Alberto

; Nardino, Érica Patrício

; Silva, Melissa Andreia de Moares

; Biagioni, Luisa Ciucci

; Souza, Adriano José de

; Sarpe, Anna Karina Paiva

; Oliveira, Arthur Curtarelli de

; Moraes, Marcelo Rodrigo de Souza

; Francisco Neto, Miguel José

; Françolin, Peter Célio

; Rochitte, Carlos Eduardo

; Iquizli, Rogerio

; Santos, Alair Augusto Sarmet Moreira Damas dos

; Muglia, Valdair Francisco

; Naves, Bruno de Lima

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 10 elocation e20230695

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20230695

Communication in radiology: evaluation of terminology and TNM descriptor use at a cancer center
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Silva, Thiago Pereira Fernandes da

; Mendes, Gustavo Gomes

; Muglia, Valdair Francisco

; Chojniak, Rubens

; Barbosa, Paula Nicole Vieira Pinto

Radiologia Brasileira

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nov 2022, Volume 55 N. 6 Pages 353 - 358

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: O propósito do nosso estudo foi analisar a transmissão das informações de radiologistas para médicos assistentes, com foco no nível de certeza e uso de descritores de imagem do sistema de estadiamento tumor–nódulo–metástase (TNM). Materiais e Métodos: Radiologistas (n = 56) e médicos assistentes (n = 50) participaram neste estudo unicêntrico, baseado em questionários respondidos entre 20 de março de 2020 e 21 de janeiro de 2021. Os participantes ordenaram hierarquicamente termos comumente usados por radiologistas da instituição para descrever o nível de certeza utilizando uma escala que variou de 1 (mais contrário) a 10 (mais favorável). Em seguida, foram avaliados os descritores relacionados ao sistema TNM e sua interpretação. O teste t de Student e o coeficiente de correlação kappa foram empregados para comparar a classificação dos termos. Os itens relacionados aos estadiamentos T e N foram analisados pelo teste exato de Fisher. O nível de confança foi fixado em 97% (p < 0,03). Resultados: A concordância geral entre radiologistas e médicos assistentes na classificação hierárquica dos termos foi baixa (kappa = 0,10–0,35), porém, os valores médios e medianos dos dois grupos foram semelhantes. A maioria dos médicos (86%) e radiologistas (67%) foi receptiva à introdução de um léxico padronizado. Uma proposta de léxico foi elaborada com base nas respostas dos participantes e representada graficamente. Em relação aos descritores do sistema TNM, diferenças estatisticamente significativas foram observadas nos seguintes itens: forma de relatar o número de linfonodos; menção a características indicativas de ruptura capsular nodal; menção de irregularidades nas paredes vasculares; e preferência por descrições sucintas para comprometimento de estruturas vasculares. Conclusão: Falhas de comunicação e diferenças na interpretação de laudos entre radiologistas e médicos assistentes ainda são prevalentes em radiologia e oncologia. Esforços para melhor compreendê-los podem melhorar a objetividade do laudo radiológico e a qualidade do atendimento médico.

Abstract Objective: The purpose of our study was to evaluate the transmission of information from radiologists to physicians, focusing on the level of certainty and the use of imaging descriptors from the tumor–node–metastasis (TNM) staging system. Materials and Methods Radiologists (n = 56) and referring physicians (n = 50) participated in this questionnaire-based, single-center study, conducted between March 20, 2020, and January 21, 2021. Participants were presented with terms commonly used by the radiologists at the institution and were asked to order them hierarchically in terms of the level of certainty they communicate regarding a diagnosis, using a scale ranging from 1 (most contrary to) to 10 (most favoring). They then assessed TNM system descriptors and their interpretation. Student’s t-tests and the kappa statistic were used in order to compare the rankings of the terms of certainty. Items related to T and N staging were analyzed by Fisher’s exact test. The confdence level was set to 97% (p < 0.03). Results: Although overall agreement among the radiologists and referring physicians on term ranking was poor (kappa = 0.10–0.35), the mean and median values for the two groups were similar. Most of the radiologists and referring physicians (67% and 86%, respectively) approved of the proposal to establish a standard lexicon. Such a lexicon, based on the participant responses, was developed and graphically represented. Regarding the TNM system descriptors, there were significant differences between the two groups in the reporting of lymph node numbers, of features indicating capsular rupture, and of vessel wall irregularities, as well as in the preference for clear descriptions of vascular involvement. Conclusion: Our findings indicate that ineffective communication and differences in report interpretation between radiologists and referring physicians are still prevalent in the fields of radiology and oncology. Efforts to gain a better understanding of those impediments might improve the objectivity of reporting and the quality of care.

https://doi.org/10.1590/0100-3984.2022.0043

The dilemma of partial nephrectomy and surgical upstaging
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Reis, Rodolfo Borges dos

; Feres, Rafael Neuppmann

; Silva, Marcelo Cartapatti da

; Muglia, Valdair Francisco

; Rodrigues Junior, Antonio Antunes

International braz j urol

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oct 2022, Volume 48 N. 5 Pages 795 - 797

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2021.0859.1

VI-RADS score system - A primer for urologists
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Nicola, Refky

; Pecoraro, Martina

; Lucciola, Sara

; Reis, Rodolfo Borges dos

; Narumi, Yoshifumi

; Panebianco, Valeria

; Muglia, Valdair Francisco

International braz j urol

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aug 2022, Volume 48 N. 4 Pages 609 - 622

Abstract: En | Text: En | PDF: En

ABSTRACT Bladder cancer (BCa) is one of the most common cancers worldwide and is also considered to be one of the most relapsing and aggressive neoplasms. About 30% of patients will present with muscle invasive disease, which is associated with a higher risk for metastatic disease. The aim of this article is to review the state of art imaging in Radiology, while providing a complete guide to urologists, with case examples, for the rationale of the development of the Vesical Imaging Reporting and Data System (VI-RADS), a scoring system emphasizing a standardized approach to multiparametric Magnetic Resonance Imaging (mpMRI) acquisition, interpretation, and reporting for BCa. Also, we examine relevant external validation studies and the consolidated literature of mpMRI for bladder cancer. In addition, this article discusses some of the potential clinical implications of this scoring system for disease management and follow-up.

https://doi.org/10.1590/s1677-5538.ibju.2021.0560

Frequency of lipid-poor adrenal adenomas in magnetic resonance imaging examinations of the abdomen
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Martins, Victor Guerra

; Torres, Cecilia Vidal S

; Mermejo, Livia Mara

; Tucci Jr., Silvio

; Molina, Carlos Augusto Fernandes

; Elias Jr., Jorge

; Muglia, Valdair Francisco

Radiologia Brasileira

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may 2022, Volume 55 N. 3 Pages 145 - 150

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Estimar a frequência de adenomas pobres em lipídios (APLs) em exames de ressonância magnética (RM). Materiais e Métodos: Investigaram-se, retrospectivamente, as lesões adrenais em exames de RM realizados de janeiro de 2016 a dezembro de 2017. Um total de 2.014 pacientes foi submetido a exames abdominais e, após exclusões, 69 pacientes com 74 adenomas foram recuperados. Determinaram-se o tamanho da lesão, a lateralidade, a homogeneidade, a queda do sinal em imagens fora-de-fase (FF) e o índice de intensidade do sinal (IIS). Foram utilizadas as seguintes definições para APLs: sem queda de sinal nas imagens FF e IIS < 16,5%. Para 68 lesões, havia imagens de tomografia computadorizada (TC), com intervalo de até um ano da RM, que também foram analisadas. Resultados: Sessenta e nove pacientes foram incluídos, sendo 42 mulheres (60,8%) e 27 homens (39,2%). A média de idade foi 59,2 ± 14,1 anos. O tamanho médio do adenoma adrenal foi 18,5 ± 7,7 mm para o leitor 1 (7,0-56,0 mm) e 21,0 ± 8,3 mm (7,0-55,0 mm) para o leitor 2 (p = 0,055). A queda de sinal nas imagens FF mostrou que a frequência de APLs para ambos os leitores foi 6,8% (5/74). Para a análise quantitativa, a frequência foi 4,0% (3/74) para o leitor 1 e 5,4% (4/74) para o leitor 2. A frequência de APLs nas imagens de TC foi 21/68 lesões (30,8%). Conclusão: A prevalência de APLs em imagens de RM foi significativamente menor do que em exames de TC. Essa prevalência tende a ser ainda menor quando a definição de APL é baseada na análise quantitativa (IIS < 16,5%), em vez da análise visual.

Abstract Objective: To estimate the frequency of lipid-poor adenomas (LPAs) in magnetic resonance imaging (MRI) examinations. Materials and Methods: We retrospectively investigated adrenal lesions on MRI examinations performed in a total of 2,014 patients between January 2016 and December 2017. After exclusions, the sample comprised 69 patients with 74 proven adenomas. Two readers (reader 1 and reader 2) evaluated lesion size, laterality, homogeneity, signal drop on out-of-phase (OP) images, and the signal intensity index (SII). An LPA was defined as a lesion with no signal drop on OP images and an SII < 16.5%. For 68 lesions, computed tomography (CT) scans (obtained within one year of the MRI) were also reviewed. Results: Of the 69 patients evaluated, 42 (60.8%) were women and 27 (39.2%) were men. The mean age was 59.2 ± 14.1 years. Among the 74 confirmed adrenal adenomas evaluated, the mean lesion size was 18.5 ± 7.7 mm (range, 7.0-56.0 mm) for reader 1 and 21.0 ± 8.3 mm (range, 7.0-55.0 mm) for reader 2 (p = 0.055). On the basis of the signal drop in OP MRI sequences, both readers identified five (6.8%) of the 74 lesions as being LPAs. When determined on the basis of the SII, that frequency was three (4.0%) for reader 1 and four (5.4%) for reader 2. On CT, 21 (30.8%) of the 68 lesions evaluated were classified as LPAs. Conclusion: The prevalence of LPA was significantly lower on MRI than on CT. That prevalence tends to be even lower when the definition of LPA relies on a quantitative analysis rather than on a qualitative (visual) analysis.

https://doi.org/10.1590/0100-3984.2021.0083

Diretriz Conjunta sobre Tromboembolismo Venoso – 2022
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Albricker, Ana Cristina Lopes

; Freire, Cláudia Maria Vilas

; Santos, Simone Nascimento dos

; Alcantara, Monica Luiza de

; Saleh, Mohamed Hassan

; Cantisano, Armando Luis

; Teodoro, José Aldo Ribeiro

; Porto, Carmen Lucia Lascasas

; Amaral, Salomon Israel do

; Veloso, Orlando Carlos Gloria

; Petisco, Ana Cláudia Gomes Pereira

; Barros, Fanilda Souto

; Barros, Márcio Vinícius Lins de

; Souza, Adriano José de

; Sobreira, Marcone Lima

; Miranda, Robson Barbosa de

; Moraes, Domingos de

; Verrastro, Carlos Gustavo Yuji

; Mançano, Alexandre Dias

; Lima, Ronaldo de Souza Leão

; Muglia, Valdair Francisco

; Matushita, Cristina Sebastião

; Lopes, Rafael Willain

; Coutinho, Artur Martins Novaes

; Pianta, Diego Bromfman

; Santos, Alair Augusto Sarmet Moreira Damas dos

; Naves, Bruno de Lima

; Vieira, Marcelo Luiz Campos

; Rochitte, Carlos Eduardo

Arquivos Brasileiros de Cardiologia

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apr 2022, Volume 118 N. 4 Pages 797 - 857

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20220213

10.

Analysis of the use of educational materials by radiologists and radiology residents in Brazil: paradigm shift
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Chojniak, Letícia Motono

; Isberner, Rony Klaus

; Souza, Juliana de Oliveira

; Muglia, Valdair Francisco

; Bitencourt, Almir Galvão Vieira

; Chojniak, Rubens

Radiologia Brasileira

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mar 2022, Volume 55 N. 2 Pages 97 - 103

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Identificar o perfil de utilização dos recursos didáticos pelos médicos radiologistas e residentes em radiologia e diagnóstico por imagem brasileiros. Materiais e Métodos: Estudo observacional, transversal e descritivo, realizado por meio de questionário eletrônico contendo perguntas referentes ao perfil do médico, formação, local de atuação, perfil de acesso a recursos educacionais e tipos de recursos mais utilizados. Resultados: Responderam ao questionário 265 médicos com idade média de 38,2 anos, sendo a maioria radiologistas formados (170; 64,2%), do sexo masculino (166; 62,6%), trabalhando em instituições privadas (174; 65,7%), sem vínculo acadêmico (167; 63,0%), atuando principalmente nas áreas de ultrassonografia (212; 80,0%) e tomografia computadorizada (206; 77,7%). A carga horária média de estudo semanal foi de 9,6 horas (mediana: 6 horas), sendo maior no grupo dos médicos que estão em formação e nos que atuam em instituições públicas e acadêmicas. Quanto ao recurso para o acesso do material de estudo, observou-se uma tendência pela maior utilização do computador (65,3%). A maioria dos respondentes optou por acessar materiais didáticos sem custo (61,9%), sendo os sites da web, livros e revistas eletrônicas os mais pesquisados. Conclusão: Os radiologistas brasileiros utilizam recursos eletrônicos e digitais como principais materiais didáticos, sendo os sites da web, livros e revistas eletrônicas as fontes mais utilizadas.

Abstract Objective: To profile the use of educational materials by radiologists and radiology residents in Brazil. Materials and Methods: This was a cross-sectional, descriptive, observational study in which an electronic questionnaire was sent via email to physicians working in the field of radiology. The questionnaire contained questions regarding the profile, education, and place of work of the physicians, as well as their access to educational resources and the types of educational materials they used most. Results: The questionnaire was completed by 265 physicians. The mean age of the respondents was 38.2 years. Of the 265 respondents, 212 (80.0%) worked with ultrasound, 206 (77.7%) worked with computed tomography, 170 (64.2%) were board-certified, 166 (62.6%) were male, 174 (65.7%) worked at private facilities, and 167 (63.0%) had no academic affiliation. The mean weekly total study time was 9.6 h (median, 6 h), being higher among physicians in training, among those who worked at public facilities, and among those who worked at teaching hospitals. Regarding the device employed in order to access educational materials, there was a trend toward greater use of computers, which were employed by 65.3%. The majority of the respondents (61.9%) chose to access educational materials that were free of charge, the most common sources being websites, eBooks, and online journals. Conclusion: Electronic and digital resources are the main means of access to educational materials used by radiologists in Brazil, the most commonly used resources being web sites, eBooks, and online journals.

https://doi.org/10.1590/0100-3984.2021.0107

11.

Node dissection in prostate cancer: no answers for old questions
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Reis, Rodolfo Borges dos

; Rodrigues Junior, Antônio Antunes

; Feres, Rafael Neuppmann

; Silva, Marcelo Cartapatti da

; Muglia, Valdair Francisco

International braz j urol

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jan 2022, Volume 48 N. 1 Pages 67 - 69

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2021.1063.1

12.

The role of magnetic resonance imaging in active surveillance of prostate cancer
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Alagbe, Olayemi Atinuke

; Westphalen, Antonio Carlos

; Muglia, Valdair Francisco

Radiologia Brasileira

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aug 2021, Volume 54 N. 4 Pages 246 - 253

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo A vigilância ativa (VA) é uma estratégia importante para evitar o tratamento excessivo do câncer de próstata (CaP) e tornou-se o padrão de atendimento a pacientes de baixo risco. O papel da ressonância magnética (RM) na VA tem se expandido, devido à sua capacidade de estratificar o risco pacientes com CaP suspeito ou diagnosticado, tornando-se parte integrante dos protocolos de VA em várias instituições. Uma RM pré-biópsia negativa está associada a um valor preditivo negativo muito alto para o diagnóstico de Gleason ≥ 3+4. Um exame positivo em homens que são elegíveis para VA tem se mostrado associado à presença de CaP de alto grau e inelegibilidade para VA. A RM também pode ser usada para orientar e determinar o tempo ideal de uma biópsia, ou por protocolo, durante a VA. Há, no entanto, várias questões relacionadas à RM que permanecem não resolvidas. Estas incluem a falta de consenso ou diretrizes, preocupações com o depósito de gadolínio em vários tecidos e aumento da pressão por maior eficiência e produção. Da mesma forma, a necessidade de biópsia sistemática combinada à dirigida continua a ser uma questão controversa, quando as lesões são visíveis na RM. Revisaremos as atuais diretrizes de VA, os papéis consensualmente aceitos da RM na seleção e monitoramento dos pacientes, potenciais usos, ainda discutíveis, e as limitações do método.

Abstract Active surveillance (AS) is an important strategy to avoid overtreatment of prostate cancer (PCa) and has become the standard of care for low-risk patients. The role of magnetic resonance imaging (MRI) in AS has expanded due to its ability to risk stratify patients with suspected or known PCa, and MRI has become an integral part of the AS protocols at various institutions. A negative pre-biopsy MRI result is associated with a very high negative predictive value for a Gleason score ≥ 3+4. A positive MRI result in men who are otherwise eligible for AS has been shown to be associated with the presence of high-grade PCa and therefore with ineligibility. In addition, MRI can be used to guide and determine the timing of per-protocol biopsy during AS. However, there are several MRI-related issues that remain unresolved, including the lack of a consensus and guidelines; concerns about gadolinium deposition in various tissues; and increased demand for higher efficiency and productivity. Similarly, the need for the combined use of targeted and systematic sampling is still a matter of debate when lesions are visible on MRI. Here, we review the current AS guidelines, as well as the accepted roles of MRI in patient selection and monitoring, the potential uses of MRI that are still in question, and the limitations of the method.

https://doi.org/10.1590/0100-3984.2020.0069 353 downloads

13.

Editorial Comment: Evaluation of HIF-1α and VEGF-A expression in radiation-induced cystitis: A case-control study
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Reis, Rodolfo Borges dos

; Rodrigues Junior, Antonio Antunes

; Feres, Rafael Neuppmann

; Muglia, Valdair Francisco

International braz j urol

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mar 2021, Volume 47 N. 2 Pages 306 - 307

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2020.0054.1 318 downloads

14.

Editorial Comment: Endoclips as novel fiducial markers in trimodality bladder preserving therapy of muscle-invasive bladder carcinoma: feasibility and patient outcomes
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Reis, Rodolfo Borges dos

; Muglia, Valdair Francisco

; Rodrigues Júnior, Antônio Antunes

; Viani, Gustavo

International braz j urol

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feb 2021, Volume 47 N. 1 Pages 100 - 102

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2019.0713.1 293 downloads

15.

Pelvic floor muscles after prostate radiation therapy: morpho-functional assessment by magnetic resonance imaging, surface electromyography and digital anal palpation
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Ribeiro, Aline Moreira

; Nammur, Larissa Guerra

; Mateus-Vasconcelos, Elaine Cristine Lemes

; Ferreira, Cristine Homsi Jorge

; Muglia, Valdair Francisco

; Oliveira, Harley Francisco de

International braz j urol

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feb 2021, Volume 47 N. 1 Pages 120 - 130

Abstract: En | Text: En | PDF: En

ABSTRACT Aim: To evaluate the radiotherapy (RT) effect in the pelvic floor muscles (PFM) function in men with prostate cancer (PC). Materials and Methods: A cross-sectional study included three groups of patients with PC and RT indication: 1) Pre-RT group: evaluated before the beginning of RT; 2) Acute group: evaluated between six months and one year after RT; 3) Late Group: evaluated between two and a half years and four years post-RT. PFM assessment was divided into: a) functional assessment through the digital anal palpation (Modified Oxford Scale) and surface electromyography (sEMG) with anal probe; b) anatomical assessment by pelvic magnetic resonance imaging (MRI) with thickness measurements of levator ani muscle and pelvic specific parameters at rest and under Valsalva maneuver. We used Student t test, considering as significant p <0.05. Results: Thirty-three men were assessed: Pre-RT (n=12); Acute (n=10) and Late (n=11) groups. PFM functional assessment showed Late group with lower electromyographic activity, especially in the sustained contractions when compared to the Pre-RT (p=0.003) and Acute groups (p=0.006). There was no significant difference between groups in MRI. Conclusion: PFM functional assessment showed a decrease in sEMG activity in the Late group post-RT. Most of the sample (72.7%) did not know how to actively contract the PFM or had a weak voluntary contraction when assessed by digital anal palpation. Also, these patients presented higher prevalence of pelvic complaints. No changes were observed in the morpho-functional parameters evaluated by MRI, except the measurement of the membranous urethra length when comparing Pre-RT Group and Acute and Late Groups.

https://doi.org/10.1590/s1677-5538.ibju.2019.0765 615 downloads

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