Top

Published in:

01-10-2020 | Ultrasound | Review

Imaging findings in association with altered maternal alpha-fetoprotein levels during pregnancy

Authors: Hassan Aboughalia, Sarah Bastawrous, Margarita V. Revzin, Shani S. Delaney, Douglas S. Katz, Mariam Moshiri

Published in: Abdominal Radiology | Issue 10/2020

Abstract

Maternal serum alpha-fetoprotein is a valuable laboratory test used in pregnant women as an indicator to detect certain clinical abnormalities. These can be grouped into four main categories: fetal factors, pregnancy complications, placental abnormalities, and maternal factors. Imaging is an invaluable tool to investigate the various etiologies leading to altered maternal serum alpha-fetoprotein. By reading this article, the radiologist, sonologist, or other health care practitioner should be able to define the probable pathology leading to the laboratory detected abnormal maternal serum levels, thus helping the clinician to appropriately manage the pregnancy and counsel the patient.

Open neural tube defects: Risk factors, prenatal screening and diagnosis, and pregnancy management - UpToDate. https://www.uptodate.com/contents/open-neural-tube-defects-risk-factors-prenatal-screening-and-diagnosis-and-pregnancy-management?search=maternal serum alpha-fetoprotein, ovarian tumors&topicRef = 3201&source = see_link#H14. Accessed 4 Feb 2019

Crandall BF, Lebherz TB, Schroth PC, Matsumoto M (1983) Alpha-fetoprotein concentrations in maternal serum: relation to race and body weight. Clin Chem 29:531–3PubMed

Benn PA, Clive JM, Collins R (1997) Medians for second-trimester maternal serum α-fetoprotein, human chorionic gonadotropin, and unconjugated estriol; differences between races or ethnic groups. Clin Chem 43:333–337PubMed

American College of Obstetricians and Gynecologists (2016) Practice Bulletin No. 163: Screening for Fetal Aneuploidy. Obstet Gynecol 127:e123

Malone FD, Canick JA, Ball RH, et al (2005) First-Trimester or Second-Trimester Screening, or Both, for Down’s Syndrome. N Engl J Med 353:2001–2011PubMed

Bradley LA, Palomaki GE, McDowell GA Technical standards and guidelines: prenatal screening for open neural tube defects. Genet Med 7:355–69

Norem CT, Schoen EJ, Walton DL, Krieger RC, O’Keefe J, To TT, Ray GT (2005) Routine Ultrasonography Compared With Maternal Serum Alpha-fetoprotein for Neural Tube Defect Screening. Obstet Gynecol 106:747–752PubMed

American College of Obstetricians and Gynecologists (2017) Practice Bulletin 187: Neural tube defects. Obs Gynecol 130:e279-290

Wilkins-Haug L (1998) Unexplained elevated maternal serum alpha-fetoprotein: what is the appropriate follow-up? Curr Opin Obstet Gynecol 10:469–474PubMed

10.

Johnson JM, Harman CR, Evans JA, MacDonald K, Manning FA (1990) Maternal serum a-fetoprotein in twin pregnancy. Am J Obstet Gynecol 162:1020–1025PubMed

11.

Spencer K, Staboulidou I, Nicolaides KH (2010) First trimester aneuploidy screening in the presence of a vanishing twin: implications for maternal serum markers. Prenat Diagn 30:235–240PubMed

12.

R Resnik, CJ Lockwood, TR Moore, MF Greene, JA Copel, RM Silver, eds. Creasy And Resnik’s Maternal-fetal Medicine: Principles And Practice, 8th ed. Philadelphia, PA : Elsevier, 2019. ISBN-13: 978-0323479103

13.

Zaganjor I, Sekkarie A, Tsang BL, Williams J, Razzaghi H, Mulinare J, Sniezek JE, Cannon MJ, Rosenthal J (2016) Describing the Prevalence of Neural Tube Defects Worldwide: A Systematic Literature Review. PLoS One 11:e0151586PubMedPubMedCentral

14.

French BN (1983) The embryology of spinal dysraphism. Clin Neurosurg 30:295–340PubMed

15.

Kumar J, Afsal M, Garg A (2017) Imaging spectrum of spinal dysraphism on magnetic resonance: A pictorial review. World J Radiol 9:178–190PubMedPubMedCentral

16.

Greene NDE, Copp AJ (2014) Neural Tube Defects. Annu Rev Neurosci 37:221–242PubMedPubMedCentral

17.

Gupta P, Kumar A, Kumar A, Goel S (2013) Congenital Spinal Cord Anomalies: A Pictorial Review. Curr Probl Diagn Radiol 42:57–66PubMed

18.

Wang ZP, Li H, Hao LZ, Zhao ZT (2009) The effectiveness of prenatal serum biomarker screening for neural tube defects in second trimester pregnant women: A meta-analysis. Prenat Diagn. doi: https://doi.org/10.1002/pd.2325CrossRefPubMed

19.

Fong KW, Toi A, Okun N, Al-Shami E, Menezes RJ (2011) Retrospective review of diagnostic performance of intracranial translucency in detection of open spina bifida at the 11-13-week scan. Ultrasound Obstet Gynecol 38:630–634PubMed

20.

Hartge DR, Gembicki M, Rody A, Weichert J (2018) Neural Tube Defects in Embryonic Life: Lessons Learned From 340 Early Pregnancy Failures. J Ultrasound Med 37:2841–2847PubMed

21.

Meller C, Aiello H, Otaño L (2017) Sonographic detection of open spina bifida in the first trimester: review of the literature. Child’s Nerv Syst 33:1101–1106

22.

Engels AC, Joyeux L, Brantner C, De Keersmaecker B, De Catte L, Baud D, Deprest J, Van Mieghem T (2016) Sonographic detection of central nervous system defects in the first trimester of pregnancy. Prenat Diagn 36:266–273PubMed

23.

Zugazaga Cortazar A, Martín Martinez C, Duran Feliubadalo C, Bella Cueto MR, Serra L (2013) Magnetic resonance imaging in the prenatal diagnosis of neural tube defects. Insights Imaging 4:225–37PubMedPubMedCentral

24.

Bromley B (2003) Diagnostic Imaging of Fetal Anomalies. J Ultrasound Med 22:850–850

25.

Breau MA, Schneider-Maunoury S (2014) Mechanisms of cranial placode assembly. Int J Dev Biol 58:9–19PubMed

26.

Beuriat P-A, Szathmari A, Rousselle C, Sabatier I, Di Rocco F, Mottolese C (2017) Complete Reversibility of the Chiari Type II Malformation After Postnatal Repair of Myelomeningocele. World Neurosurg 108:62–68PubMed

27.

Moldenhauer JS, Adzick NS (2017) Fetal surgery for myelomeningocele: After the Management of Myelomeningocele Study (MOMS). Semin Fetal Neonatal Med 22:360–366PubMed

28.

Kabagambe SK, Jensen GW, Chen YJ, Vanover MA, Farmer DL (2017) Fetal Surgery for Myelomeningocele: A Systematic Review and Meta-Analysis of Outcomes in Fetoscopic versus Open Repair. Fetal Diagn Ther 43:161–174PubMed

29.

Breningstall GN, Marker SM, Tubman DE (1992) Hydrosyringomyelia and diastematomyelia detected by MRI in myelomeningocele. Pediatr Neurol 8:267–271PubMed

30.

Nagaraj UD, Bierbrauer KS, Peiro JL, Kline-Fath BM (2016) Differentiating Closed Versus Open Spinal Dysraphisms on Fetal MRI. Am J Roentgenol 207:1316–1323

31.

Torres US, Portela-Oliveira E, Braga FDCB, Werner H, Daltro PAN, Souza AS (2015) When Closure Fails: What the Radiologist Needs to Know About the Embryology, Anatomy, and Prenatal Imaging of Ventral Body Wall Defects. Semin Ultrasound, CT MRI 36:522–536

32.

Sadler TW (2010) The embryologic origin of ventral body wall defects. Semin Pediatr Surg 19:209–214PubMed

33.

Victoria T, Andronikou S, Bowen D, Laje P, Weiss DA, Johnson AM, Peranteau WH, Canning DA, Adzick NS (2018) Fetal anterior abdominal wall defects: prenatal imaging by magnetic resonance imaging. Pediatr Radiol 48:499–512PubMed

34.

Chen C-P (2007) Chromosomal Abnormalities Associated With Omphalocele. Taiwan J Obstet Gynecol 46:1–8PubMed

35.

Emanuel PG, Garcia GI, Angtuaco TL (1995) Prenatal detection of anterior abdominal wall defects with US. RadioGraphics 15:517–530PubMed

36.

Bruch SW, Adzick NS, Goldstein RB, Harrison MR (1996) Challenging the embryogenesis of cloacal exstrophy. J Pediatr Surg 31:768–70PubMed

37.

Austin PF, Homsy YL, Gearhart JP, Porter K, Guidi C, Madsen K, Maizels M (1998) The prenatal diagnosis of cloacal exstrophy. J Urol 160:1179–81PubMed

38.

Carey JC, Greenbaum B, Hall BD (1978) The OEIS complex (omphalocele, exstrophy, imperforate anus, spinal defects). Birth Defects Orig Artic Ser 14:253–63PubMed

39.

Keppler-Noreuil K, Gorton S, Foo F, Yankowitz J, Keegan C (2007) Prenatal ascertainment of OEIS complex/cloacal exstrophy—15 new cases and literature review. Am J Med Genet Part A 143A:2122–2128PubMed

40.

Goto S, Suzumori N, Obayashi S, Mizutani E, Hayashi Y, Sugiura-Ogasawara M (2012) Prenatal findings of omphalocele-exstrophy of the bladder-imperforate anus-spinal defects (OEIS) complex. Congenit Anom (Kyoto) 52:179–181

41.

Chauvin NA, Epelman M, Victoria T, Johnson AM (2012) Complex Genitourinary Abnormalities on Fetal MRI: Imaging Findings and Approach to Diagnosis. Am J Roentgenol 199:W222–W231

42.

CANTRELL JR, HALLER JA, RAVITCH MM (1958) A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart. Surg Gynecol Obstet 107:602–14PubMed

43.

Restrepo MS, Cerqua A, Turek JW (2014) Pentalogy of Cantrell with Ectopia Cordis Totalis, Total Anomalous Pulmonary Venous Connection, and Tetralogy of Fallot: A Case Report and Review of the Literature. Congenit Heart Dis 9:E129–E134PubMed

44.

Van Allen MI, Curry C, Gallagher L, Reynolds JF (1987) Limb body wall complex: I. Pathogenesis. Am J Med Genet 28:529–48PubMed

45.

Gajzer DC, Hirzel AC, Saigal G, Rojas CP, Rodriguez MM (2015) Possible Genetic Origin of Limb–body Wall Complex. Fetal Pediatr Pathol 34:257–70PubMedPubMedCentral

46.

Russo R, D’Armiento M, Angrisani P, Vecchione R (1993) Limb body wall complex: A critical review and a nosological proposal. Am J Med Genet 47:893–900PubMed

47.

Murphy A, Platt LD (2011) First-Trimester Diagnosis of Body Stalk Anomaly Using 2- and 3-Dimensional Sonography. J Ultrasound Med 30:1739–1743PubMed

48.

Kestilä M, Lenkkeri U, Männikkö M, et al (1998) Positionally Cloned Gene for a Novel Glomerular Protein—Nephrin—Is Mutated in Congenital Nephrotic Syndrome. Mol Cell 1:575–582PubMed

49.

Patrakka J, Martin P, Salonen R, et al (2002) Proteinuria and prenatal diagnosis of congenital nephrosis in fetal carriers of nephrin gene mutations. Lancet 359:1575–1577PubMed

50.

Carrera M, Kestilä M, de la Iglesia C, Ruiz J, Serra B, Baraibar R (1999) Maternal serum alpha-fetoprotein levels in congenital nephrotic syndrome carrier pregnancies. Prenat Diagn 19:489–90PubMed

51.

Männikkö M, Kestilä M, Lenkkeri U, et al (1997) Improved prenatal diagnosis of the congenital nephrotic syndrome of the Finnish type based on DNA analysis. Kidney Int 51:868–872PubMed

52.

Moore BS, Pretorius DH, Scioscia AL, Reznik VM (1992) Sonographic findings in a fetus with congenital nephrotic syndrome of the Finnish type. J Ultrasound Med 11:113–116PubMed

53.

Gitlin D, Perricelli A, Gitlin GM (1972) Synthesis of -fetoprotein by liver, yolk sac, and gastrointestinal tract of the human conceptus. Cancer Res 32:979–82PubMed

54.

Chodirker BN, Chudley AE, MacDonald KM, Harman CR, Evans JA (1994) MSAFP levels and oesophageal atresia. Prenat Diagn 14:1086–9PubMed

55.

Van Rijn M, Christaens GC, Hagenaars AM, Visser GH (1998) Maternal serum alpha-fetoprotein in fetal anal atresia and other gastro-intestinal obstructions. Prenat Diagn 18:914–21PubMed

56.

Morris JK, Mutton DE, Alberman E (2002) Revised estimates of the maternal age specific live birth prevalence of Down’s syndrome. J Med Screen 9:2–6PubMed

57.

Savva GM, Walker K, Morris JK (2010) The maternal age-specific live birth prevalence of trisomies 13 and 18 compared to trisomy 21 (Down syndrome). Prenat Diagn 30:57–64PubMed

58.

Merkatz IR, Nitowsky HM, Macri JN, Johnson WE (1984) An association between low maternal serum alpha-fetoprotein and fetal chromosomal abnormalities. Am J Obstet Gynecol 148:886–94PubMed

59.

Canick JA, Knight GJ, Palomaki GE, Haddow JE, Cuckle HS, Wald NJ (1988) Low second trimester maternal serum unconjugated oestriol in pregnancies with Down’s syndrome. Br J Obstet Gynaecol 95:330–3PubMed

60.

Aitken DA, Wallace EM, Crossley JA, Swanston IA, van Pareren Y, van Maarle M, Groome NP, Macri JN, Connor JM (1996) Dimeric inhibin A as a marker for Down’s syndrome in early pregnancy. N Engl J Med 334:1231–6PubMed

61.

Bogart MH, Pandian MR, Jones OW (1987) Abnormal maternal serum chorionic gonadotropin levels in pregnancies with fetal chromosome abnormalities. Prenat Diagn 7:623–30PubMed

62.

Lambert-Messerlian GM, Saller DN, Tumber MB, French CA, Peterson CJ, Canick JA (1998) Second-trimester maternal serum inhibin A levels in fetal trisomy 18 and Turner syndrome with and without hydrops. Prenat Diagn 18:1061–7PubMed

63.

Palomaki GE, Haddow JE, Knight GJ, Wald NJ, Kennard A, Canick JA, Saller DN, Blitzer MG, Dickerman LH, Fisher R (1995) Risk-based prenatal screening for trisomy 18 using alpha-fetoprotein, unconjugated oestriol and human chorionic gonadotropin. Prenat Diagn 15:713–23PubMed

64.

Breathnach FM, Malone FD, Lambert-Messerlian G, et al (2007) First- and second-trimester screening: detection of aneuploidies other than Down syndrome. Obstet Gynecol 110:651–7PubMed

65.

Hertzberg BS, Middleton WD, Preceded by: Middleton WD Ultrasound : the requisites.

66.

Lai S, Lau WL, Leung WC, Lai FK, Chin R (2010) Is ultrasound alone enough for prenatal screening of trisomy 18? A single centre experience in 69 cases over 10 years. Prenat Diagn 30:1094–1099PubMed

67.

Liau J, Romine L, Korty LA, Chao C, White K, Harmon S, Ho Y, Hull AD, Pretorius DH (2014) Simplifying the Ultrasound Findings of the Major Fetal Chromosomal Aneuploidies. Curr Probl Diagn Radiol 43:300–316PubMed

68.

Lakovschek IC, Streubel B, Ulm B (2011) Natural outcome of trisomy 13, trisomy 18, and triploidy after prenatal diagnosis. Am J Med Genet Part A 155:2626–2633

69.

Papp C, Szigeti Z, Tóth-Pál E, Hajdú J, Joó JG, Papp Z (2008) Ultrasonographic Findings of Fetal Aneuploidies in the Second Trimester – Our Experiences. Fetal Diagn Ther 23:105–113PubMed

70.

Guschmann M, Henrich W, Dudenhausen JW (2003) Chorioangiomas–new insights into a well-known problem. II. An immuno-histochemical investigation of 136 cases. J Perinat Med 31:170–175PubMed

71.

(2014) Placental chorioangioma: literature review. J Perinat Med 42:273

72.

Khong T, George K (1994) Maternal Serum Alpha-Fetoprotein Levels in Chorioangiomas. Am J Perinatol 11:245–248PubMed

73.

Kirkpatrick AD, Podberesky DJ, Gray AE, McDermott JH (2007) Best cases from the AFIP - Placental chorioangioma. RADIOGRAPHICS 27:1187–1190PubMed

74.

Jauniaux E, Ogle R (2000) Color Doppler imaging in the diagnosis and management of chorioangiomas. Ultrasound Obstet Gynecol 15:463–467PubMed

75.

Resta RG, Luthy DA, Mahony BS (1988) Umbilical cord hemangioma associated with extremely high alpha-fetoprotein levels. Obstet Gynecol 72:488–91PubMed

76.

Hara K, Fukumura Y, Saito T, Arakawa A, Okabe H, Takeda S, Yao T (2015) A giant cord hemangioma with extramedullary hematopoiesis and elevated maternal serum human chorionic gonadotropin: a case report and review of the literature. Diagn Pathol 10:154PubMedPubMedCentral

77.

Armstrong V, Hansen WF, Van Voorhis BJ, Syrop CH (2003) Detection of cesarean scars by transvaginal ultrasound. Obstet Gynecol 101:61–5PubMed

78.

Papadopoulos VG, Kourea HP, Adonakis GL, Decavalas GO (2009) A case of umbilical cord hemangioma: Doppler studies and review of the literature. Eur J Obstet Gynecol Reprod Biol 144:8–14PubMed

79.

Kellow ZS, Feldstein VA (2011) Ultrasound of the Placenta and Umbilical Cord. Ultrasound Q 27:187–197PubMed

80.

Jauniaux E, Collins S, Burton GJ. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. Am J Obstet Gynecol 218(1):75-87

81.

Lyell DJ, Blumenfeld YJ, Druzin ML, El-Sayed YY, et al. Maternal serum markers, characteristics and morbidly adherent placenta in women with previa. J Perinat 35:570-574

82.

Obstertic Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol 132(6): e259-e275

83.

Shaaban AM, Rezvani M, Elsayes KM, Baskin H, Mourad A, Foster BR, Jarboe EA, Menias CO (2014) Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features. RadioGraphics 34:777–801PubMed

84.

Elit L, Bocking A, Kenyon C, Natale R (1999) An Endodermal Sinus Tumor Diagnosed in Pregnancy: Case Report and Review of the Literature. Gynecol Oncol 72:123–127PubMed

85.

de la Motte Rouge T, Pautier P, Genestie C, et al (2016) Prognostic significance of an early decline in serum alpha-fetoprotein during chemotherapy for ovarian yolk sac tumors. Gynecol Oncol 142:452–457

86.

Smith HO, Berwick M, Verschraegen CF, Wiggins C, Lansing L, Muller CY, Qualls CR (2006) Incidence and survival rates for female malignant germ cell tumors. Obstet Gynecol 107:1075–85PubMed

87.

Saba L, Guerriero S, Sulcis R, Virgilio B, Melis G, Mallarini G (2009) Mature and immature ovarian teratomas: CT, US and MR imaging characteristics. Eur J Radiol 72:454–63PubMed

88.

Dehghani-Firouzabadi R, Tayebi N, Ghasemi N, Tahmasbi Z The association between second-trimester maternal serum alpha-fetoprotein in 14-22 weeks and adverse pregnancy outcome. Acta Med Iran 48:234–8

89.

Başbuğ D, Başbuğ A, Gülerman C (2017) Is unexplained elevated maternal serum alpha-fetoprotein still important predictor for adverse pregnancy outcome? Ginekol Pol 88:325–330PubMed

90.

Milunsky A, Jick SS, Bruell CL, MacLaughlin DS, Tsung Y-K, Jick H, Rothman KJ, Willett W (1989) Predictive values, relative risks, and overall benefits of high and low maternal serum α-fetoprotein screening in singleton pregnancies: New epidemiologic data. Am J Obstet Gynecol 161:291–297PubMed

91.

Bartha JL, Comino-Delgado R, Arce F (1997) Maternal serum alpha-fetoprotein in placental abruption associated with preterm labor. Int J Gynaecol Obstet 56:231–6PubMed

92.

Öztürk H, Erkaya S, Altınbaş S, Karadağ B, Vanlı Tonyalı N, Özkan D (2014) The role of unexplained high serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in the second trimester to determine poor obstetric outcomes. Turkish J Obstet Gynecol 11:142–147

93.

Ananth C V, Wapner RJ, Ananth S, D’Alton ME, Vintzileos AM (2017) First-Trimester and Second-Trimester Maternal Serum Biomarkers as Predictors of Placental Abruption. Obstet Gynecol 129:465–472PubMedPubMedCentral

94.

Bartkute K, Balsyte D, Wisser J, Kurmanavicius J (2017) Pregnancy outcomes regarding maternal serum AFP value in second trimester screening. J Perinat Med 45:817–820PubMed

95.

Räty R, Anttila L, Virtanen A, Koskinen P, Laitinen P, Mörsky P, Tiitinen A, Martikainen H, Ekblad U (2003) Maternal midtrimester free β-HCG and AFP serum levels in spontaneous singleton pregnancies complicated by gestational diabetes mellitus, pregnancy-induced hypertension or obstetric cholestasis. Prenat Diagn 23:1045–1048PubMed

96.

Maymon R, Meiri H, Svirski R, Weiner E, Cuckle H (2019) Maternal serum screening marker levels in twin pregnancies affected by gestational diabetes. Arch Gynecol Obstet 299:655–663PubMed

97.

Sprawka N, Lambert-Messerlian G, Palomaki GE, Eklund EE, Canick JA (2011) Adjustment of maternal serum alpha-fetoprotein levels in women with pregestational diabetes. Prenat Diagn 31:282–285PubMed

98.

Sharony R, Dayan D, Kidron D, Manor M, Berkovitz A, Biron-Shental T, Maymon R (2016) Is the ratio of maternal serum to amniotic fluid AFP superior to serum levels as a predictor of pregnancy complications? Arch Gynecol Obstet 293:767–770PubMed

99.

Gkogkos P, Androutsopoulos G, Vassilakos P, Panayiotakis G, Kourounis G, Decavalas G (2008) Mid-trimester maternal serum AFP levels in predicting adverse pregnancy outcome. Clin Exp Obstet Gynecol 35:208–10PubMed

100.

Cohen JL, Smilen KE, Bianco AT, Moshier EL, Ferrara LA, L. Stone J (2014) Predictive value of combined serum biomarkers for adverse pregnancy outcomes. Eur J Obstet Gynecol Reprod Biol 181:89–94PubMed

101.

Benn PA, Horne D, Briganti S, Rodis JF, Clive JM (1996) Elevated second-trimester maternal serum hcg alone or in combination with elevated alpha-fetoprotein. Obstet Gynecol 87:217–222PubMed

Title: Imaging findings in association with altered maternal alpha-fetoprotein levels during pregnancy
Authors: Hassan Aboughalia
Sarah Bastawrous
Margarita V. Revzin
Shani S. Delaney
Douglas S. Katz
Mariam Moshiri
Publication date: 01-10-2020
Publisher: Springer US
Keywords: Ultrasound
Ultrasound
Published in: Abdominal Radiology / Issue 10/2020
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-020-02499-2

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Imaging findings in association with altered maternal alpha-fetoprotein levels during pregnancy

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2020

The floating gallbladder

Radiologic serosal invasion sign as a new criterion of T4a gastric cancer on computed tomography: diagnostic performance and prognostic significance in patients with advanced gastric cancer

Improving the performance of IOTA simple rules: sonographic assessment of adnexal masses with resource-effective use of a magnetic resonance scoring (ADNEX MR scoring system)

Apical periurethral transition zone lesions: MRI and histology findings

Non-occlusive mesenteric ischemia (NOMI): evaluation of 2D-perfusion angiography (2D-PA) for early treatment response assessment

Adjunctive hydrodissection of the bare area of liver during percutaneous thermal ablation of sub-cardiac hepatic tumours

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page