The Royal Hallamshire Hospital is a general and teaching hospital located in Sheffield, South Yorkshire, England. It is in the city's West End, facing Glossop Road and close to the main campus of University of Sheffield and the Collegiate Crescent campus of Sheffield Hallam University. The hospital is run by the Sheffield Teaching Hospitals NHS Foundation Trust.
Positron emission tomography combined with magnetic resonance imaging (PET/MR) has not yet achieved the level of adoption of PET/CT. This study aimed to harmonise PET imaging protocols across a national PET/MR network and to quantitatively assess whether PET/MR can achieve reliability comparable to PET/CT. While previous PET test-retest studies have demonstrated good repeatability, they have typically been limited to small cohorts or restricted site configurations. We conducted a multi-site harmonisation and rigorous test-retest study across the network of eight PET/MR scanners. Thirty-seven healthy older participants (65-90 years) underwent harmonised one-hour amyloid PET/MR scans using either [ ^18 F]flutemetamol or [ ^18 F]florbetaben on two occasions. Retest scans were performed under conditions of same-site repeatability or multi-site reproducibility. Harmonised acquisition and reconstruction protocols were applied, and amyloid burden was quantified on the Centiloid (CL) scale. CL values across 74 scans showed excellent test-retest agreement (ICC = 0.968), improving to 0.987 after exclusion of one attenuation correction related outlier. Mean test-retest variability was 2.58
Cadaveric comparative study. To assess the additional superior reach achievable using the pedicled pectoralis major (PM) flap with subclavicular tunnelling and clavicle osteotomy compared with the standard supraclavicular route. Ten hemi-thoraces from fresh-frozen cadavers without prior clavipectoral surgery were dissected. Each PM flap was passed sequentially through three routes: supraclavicular, subclavicular, and mid-shaft clavicle osteotomy. Maximum superior reach from the clavicle midpoint to the ipsilateral preauricular-temporal region was measured under a standardised manual traction technique. Two observers recorded distances, and their mean value was used for analysis. Comparisons between the three routes were performed using the Friedman test and Wilcoxon signed-rank tests with Bonferroni adjustment. In this cadaveric series, mean ± SD reach was 166.6 ± 42.3 mm (supraclavicular), 195.6 ± 37.6 mm (subclavicular), and 215.4 ± 28.5 mm (clavicular osteotomy). The corresponding mean gains were + 29 mm (p = 0.006) from supraclavicular to subclavicular, + 20 mm (p = 0.004) from subclavicular to osteotomy, and + 49 mm (p = 0.002) from supraclavicular to osteotomy. Each step gave a measurable improvement in reach, all of which proved statistically significant. Subclavicular tunnelling and clavicle osteotomy significantly increased PM flap reach by 20–50 mm. While these gains are modest, they may be clinically useful in salvage situations where free tissue transfer is not feasible.
BACKGROUND:D-dimer testing is widely integrated into diagnostic algorithms for venous thromboembolism (VTE). However, the lack of standardization across D-dimer assays and reporting may limit the comparability of study findings. OBJECTIVES:To summarize reporting of essential characteristics of D-dimer testing in VTE diagnostic management studies. METHODS:We systematically searched MEDLINE and Embase from January 1999 to August 2024 for VTE diagnostic management studies that evaluated diagnostic algorithms, including D-dimer testing, and followed patients for ≥ 4 weeks after VTE was excluded. The primary outcome was reporting of D-dimer assay characteristics. Secondary outcomes were reporting of patient numbers and failure rates per assay. RESULTS:Of 9670 articles screened, 58 studies were included: 36 (62%) enrolled patients with suspected pulmonary embolism, 21 (36%) with suspected deep vein thrombosis, and 1 with suspected VTE. Sample sizes ranged from 191 to 5400; follow-up was 1 to 6 months. Assay name was fully reported in 52 of 58 studies (90%), manufacturer in 49 of 58 (85%), unit magnitude in 42 of 46 (91%), and the unit type in 8/46 (17%). The detection limit was reported in 3 of 58 studies (5.2%); other analytical performance parameters were unreported. Nineteen quantitative assays were used across 19 combinations of thresholds and unit magnitudes. Of 17 studies using multiple assays, 9 reported patient numbers per assay, and 1 reported failure rate per assay. CONCLUSION:Key characteristics of D-dimer testing were inconsistently reported in VTE diagnostic management studies. While assay name, manufacturer, unit magnitude, and thresholds were often included, unit type and assay-specific data were frequently omitted. Minimum reporting standards for D-dimer testing are needed for VTE diagnostic management studies.
