A prominent subarachnoid space (SAS) in infants under 24 months is a very common finding and is a normal variant that can be associated with macrocephaly. This must be differentiated from various pathological conditions that also cause a prominent SAS, including a reduction in brain volume, obstruction to the cerebrospinal fluid (CSF) or malformations of the skull. The inappropriate labelling of normal SAS prominence as enlargement due to pathology and misrepresentation of published literature by some author groups has created confusion medicolegally, contributing to inappropriate conclusions that a normal prominent SAS may cause subdural haemorrhage (SDH) and brain injury. This paper aims to review the characteristics of the SAS in infants, the terminology relating to the prominence of the SAS and the possible association between the prominence of the SAS and SDH.

Pelvic Congestion Syndrome (PCS) is a condition characterised by chronic pelvic pain resulting from the dilation and reflux of veins within the pelvis. While pelvic pain is the primary symptom of PCS, other associated symptoms may vary among individuals. Bladder symptoms have been commonly observed in PCS, including increased urination frequency, urinary urgency, nocturia and rarely haematuria. This study aimed to investigate the prevalence of bladder symptoms in women with pelvic congestion syndrome and the effectiveness of Ovarian Vein Embolisation in alleviating these symptoms.

Prostate motion during external beam radiotherapy (EBRT) is common and typically managed using fiducial markers and cone beam CT (CBCT) scans for inter-fractional motion correction. However, real-time intra-fractional motion management is less commonly implemented. This study evaluated the extent of intra-fractional prostate motion using transperineal ultrasound (TPUS) and examined the impact of treatment time on prostate motion.

Patients aged > 85 years are under-represented in research that has established stereotactic body radiotherapy (SBRT) as the standard of care in early stage non-small cell lung cancer (NSCLC) not suitable for or refusing surgery. With an ageing population in Australia, it is important to assess SBRT and cause of death (COD) in elderly patients receiving curative intent lung SBRT.

Recent RANZCR studies have demonstrated gender disparity in research publication output of both radiation oncology (RO) trainees and specialists, favouring men. The purpose of this project was to examine success rates by gender of grant and prize (G&P) submissions to the RO Research Committee (RORC) to determine if anything needs to be done about the appraisal process to potentially address that disparity.

Climate change negatively impacts individual and population-level health through multiple pathways, including poor air quality, extreme heat and changes in infectious disease. These health effects will lead to higher health system and medical imaging utilisation. At the same time, the delivery of radiology services generates substantial greenhouse gas emissions. Mitigation strategies to reduce the environmental impact of medical imaging and adaptation strategies to build resiliency to current and future impacts of climate change in radiology should be centred on human health. A health-centred response in radiology reinforces the role of radiologists as physicians and emphasises the opportunity for medical imaging to promote health and advance our understanding of climate-related health effects. This review discusses the need for a health-centred focus on climate change in radiology, including the effects of climate change on human health and health systems, intersection of climate change with health equity, health benefits of climate action and opportunities to leverage medical imaging to improve human health.

Coronary computed tomography angiography (CCTA) is a well-established and reliable non-invasive imaging modality that provides a comprehensive assessment of coronary artery anatomy and luminal stenosis due to atherosclerosis. Owing to advances in CCTA software and technology, the composition and morphology of coronary plaque can be accurately evaluated. Adverse features which identify plaque as being high-risk or 'vulnerable' can provide a personalised cardiovascular risk assessment over and above stenosis severity. High-risk plaque features on CCTA include spotty calcification, low attenuation plaque, positive remodelling and the napkin ring sign. However, it can be challenging to characterise high-risk plaque accurately on CCTA, and as such, education and experience are required. In this pictorial essay, a comprehensive visual guide to high-risk plaque features on CCTA is provided, with clear examples and challenging cases that highlight common pitfalls. It is important for expert readers to properly identify these features given their association with adverse outcomes and potential future implications on intensive goal-directed medical therapy.

The LVIS EVO (MicroVention) is a braided stent designed to assist coil embolisation of intracranial aneurysms. It offers several structural innovations over previous and currently available braided, and laser-cut, stents that are theorised to improve procedural success. This retrospective audit aims to determine the success and complication rates of LVIS EVO-assisted coil embolisation in unruptured saccular aneurysms at a tertiary neurovascular referral centre in Queensland, Australia.

CT-guided percutaneous transthoracic needle biopsy is the primary method for diagnosing lung lesions. Widely accepted validated risk prediction models are yet to be developed. A recently published study conducted at Grampians Health Services (GHS) developed two risk prediction models for predicting pneumothorax and intercostal catheter (ICC) insertion. This study aims to validate these models.

Uterine leiomyomata, commonly known as fibroids, are prevalent benign tumours affecting a significant percentage of women of reproductive age. Although many patients remain asymptomatic, a substantial proportion experience severe symptoms, including abnormal uterine bleeding and adverse reproductive outcomes. Surgical intervention often becomes necessary for patients with symptomatic fibroids, despite advancements in medical therapies. This article explores the critical role of Magnetic Resonance Imaging (MRI) in the preoperative planning and management of fibroid surgeries. MRI has been proven superior to traditional imaging methods, such as transvaginal ultrasound (TVS), offering a more accurate evaluation of fibroid size, location, number, and characteristics. This enhanced imaging aids in surgical planning by providing detailed anatomical insights, helping gynaecologists choose the appropriate surgical techniques and predict potential complications. Moreover, MRI is instrumental in assessing the risk of malignancy, guiding decisions on whether to proceed with myomectomy or hysterectomy. Technological advancements, such as 3D MRI modelling and augmented reality, promise further improvements in surgical outcomes by enhancing anatomical understanding and precision. These innovations, along with artificial intelligence integration, show potential in reducing operation times and improving patient outcomes. This review underscores the essential role of MRI in contemporary fibroid management and highlights future directions in the field.

Characterisation of an indeterminate ovarian mass is important as it guides management and clinical outcomes. Ultrasound is the first-line modality in the assessment of ovarian tumours. When ovarian masses are indeterminate on ultrasound, MRI provides excellent resolution in tissue characterisation and enhancement patterns. Ovarian masses can be categorised based on risk-scoring systems such as the American College of Radiology (ACR) MRI Ovarian-Adnexal Reporting and Data System (O-RADS). The imaging features of non-neoplastic, benign, borderline and malignant neoplastic ovarian lesions are discussed in this review with a focus on the pathology process accounting for the MRI appearance. Characteristic findings and clues in differentiating a benign lesion from a malignancy are presented in this review.

Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension. We aimed to systematically evaluate published cases of PVOD to provide an overview of their clinical presentation, management and prognosis to assist early identification and treatment. We conducted a literature search of PubMed and Embase databases for adult cases of 'pulmonary veno-occlusive disease' and 'pulmonary capillary haemangiomatosis'. Data collected included baseline demographics, medical history, clinical presentation, investigations performed, treatment and outcome. Kaplan-Meier survival analysis was used for overall survival with Cox-hazards-regression model used to evaluate treatment outcomes and prognostic factors. A total of 257 cases of PVOD from 113 articles were included in our analysis (mean age 45 ± 17 years, 54% females). Most frequent associations were smoking (28%), systemic sclerosis (10%) and mitomycin exposure (9%). Cardinal CT chest findings included ground glass opacities (75%), interlobular septal thickening (74%) and lymphadenopathy (51%); however, all three features were only seen in 23% (35/151). Median overall survival was 12 months (interquartile range, 3-48 months). Lung transplantation was the only treatment associated with improved survival (P = 0.006). Right ventricular dilatation (P = 0.005), increased mean pulmonary artery pressure (P = 0.01) and reduced 6-minute walk distance (P = 0.04) were associated with poorer overall survival. This systematic review provides a clinically relevant overview of a rare and often fatal condition. There is need for early diagnosis and referral for consideration of lung transplantation, while recognising right ventricular dilatation and elevated pulmonary pressures portend poorer prognosis. PROSPERO international register CRD42024553829.

Chemoradiotherapy with MRI-guided brachytherapy boosts is the standard of care for locally advanced cervical cancer. Data from the RetroEMBRACE and EMBRACE I trials provide dose-response curves for target volumes and OAR. This study evaluated plan quality, safety and toxicity following escalation of the CTV_HR D90 prescription from 80-90 Gy to 85-95 Gy for two different applicator designs.

This study aims to examine and compare the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and Digital Subtraction Angiography (DSA) in evaluating hypervascular spinal metastases. A comprehensive literature review was conducted, utilizing top-tier databases such as PubMed, Scopus and Google Scholar, to compile an authoritative and up-to-date overview of the current advancements in the field. We synthesized key studies focusing on the advantages, limitations and efficacy of both imaging techniques. DCE-MRI provides a non-invasive method for evaluating tissue morphology, perfusion and vascularity, offering valuable information for cancer diagnosis and treatment monitoring. In contrast, DSA is an invasive procedure primarily used for embolization and diagnosing cerebrovascular events. Both modalities have distinct features regarding image acquisition, contrast agents, resolution and accessibility. DCE-MRI shows promise for cancer-related applications, offering advantages over conventional MRI by incorporating anatomical and hemodynamic parameters. While DSA remains important for cases requiring critical vascular information, further research is necessary to explore its potential therapeutic benefits in assessing vessel patency. Continued investigations are crucial to uncover additional insights and therapeutic applications for both DCE-MRI and DSA in medical imaging.

The purpose of this study was to address the gap in knowledge in the incidence, presentation and imaging features of PPGL in Fontan patients. It has been hypothesised in the literature that Fontan circulation patients have an increased incidence of these tumours. This study is the largest cohort of adult Fontan patients in North America. The Fontan procedure is a palliative procedure for single ventricle congenital heart disease where the systemic venous return is directed into the pulmonary circulation. Fontan patients are at increased risk of developing several extracardiac complications including phaeochromocytoma and paraganglioma (PPGL).

Climate change is a critical global issue, impacting ecosystems, economies and communities worldwide. The shift from paper-based to digital systems is becoming increasingly prevalent across industries, with downstream positive impacts on sustainability. In 2020, Austin Health, a public tertiary hospital in Victoria, Australia, adopted a web-based outpatient booking application, which succeeded the prior paper-based system. The application served as an integrated platform for administrative staff to access various Austin Information Technology platforms and replaced previous mail-based outpatient appointment notifications with Short Message Service-based notifications. This study aimed to assess the environmental impact and organisation-wide economic cost of a web-based outpatient booking application compared to the prior paper-based system across the same time period.

Visual perceptual artefacts are distortions or illusions in medical image interpretation arising from the human visual system rather than hardware or imaging acquisition processes. These artefacts, emerging at various visual processing stages, such as the retina, visual pathways, visual cortex, and cognitive interpretation stages, impact the interpretation of cardiothoracic images. This review discusses artefacts including Mach bands, Dark Rim, Background Effects, Ambiguous Figures, Subjective Contours, and the Parallax Effect. A thorough literature search was conducted using PubMed and Google Scholar. Search terms included 'visual perceptual artifacts', 'cardiothoracic imaging', 'Mach bands', 'dark rim artifact', 'stress cardiac MRI', and 'radiology visual illusions'. Inclusion criteria encompassed studies focusing on visual perceptual artefacts in cardiothoracic imaging published in peer-reviewed journals. Studies not addressing visual perceptual artefacts or those focusing on imaging technology, hardware, or software-related artefacts were excluded. Duplicate studies were removed, and a final selection of 32 studies was analysed. Several key visual perceptual artefacts relevant to cardiothoracic imaging were identified. Mach bands, caused by lateral inhibition in the retina, create false contrasts at object boundaries, potentially mimicking pathologies such as fractures or pneumothoraces. The dark rim artefact observed on stress cardiac MRI, resulting from Gibbs ringing or truncation artefacts, can simulate perfusion defects and complicate diagnosis. Lateral inhibition can possibly accentuate the appearance of the dark rim artefact. Artefacts also fall under illusions of sensation, perception, and image formation. These illusions present both risks and benefits to diagnostic radiology. Recognizing visual perceptual artefacts is crucial for improving diagnostic accuracy and developing strategies to mitigate their impact. A comprehensive understanding and training on these artefacts are essential for radiologists to enhance interpretive skills, reduce diagnostic errors, and ultimately improve patient care in radiology.

CT has replaced skull radiography as the gold standard for assessment of craniosynostosis in children. To minimise the risks of ionising radiation in this radiosensitive population, low-dose CT protocols are increasingly being adopted. This study evaluates the effectiveness of an ultra-low-dose CT protocol with a tin filter in reducing radiation exposure whilst maintaining diagnostic quality for craniosynostosis, and its utility in the evaluation of other findings not appreciable on skull radiography.