Clinical radiology最新文献_第7页

Application of multidimensional diffusion-weighted magnetic resonance imaging in nasopharyngeal carcinoma: a prospective study. 磁共振成像在鼻咽癌诊断中的应用：一项前瞻性研究。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-13 DOI: 10.1016/j.crad.2025.107178

Y Chen, L Zou, Y Zhang, W Cui, Z Liu, D Luo

Aim: The microstructural diffusional heterogeneity of nasopharyngeal carcinoma (NPC) impacts outcome assessment. This study aims to investigate the potential of multidimensional diffusion-weighted magnetic resonance imaging (MDD-MRI) in evaluating microscopic diffusion characteristics of NPC.

Materials and methods: Sixty-six NPC patients underwent MDD-MRI to derive microscopic diffusion metrics, including anisotropic mean kurtosis (MK), isotropic MK, total MK, and microscopic fractional anisotropy (FA). Macroscopic metrics, such as the apparent diffusion coefficient (ADC), along with parameters from diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI), were also analysed for comparison. Differences between NPC and normal tissues, as well as among pathological subtypes, clinical stages, and Epstein-Barr virus infection statuses, were assessed. Receiver operating characteristic curve analysis evaluated the ability to distinguish NPC from normal tissue. Spearman's correlation analysis examined associations between diffusion metrics and primary tumour (T) stages.

Results: NPC tissues exhibited lower ADC (P<.001) and higher DKI-related MK (MK_K; P<.001) compared to normal nasopharyngeal tissues, with area under the curve values of 0.968 (95 % CI: 0.926-1) and 0.749 (95 % CI: 0.633-0.865) for ADC and MK_K, respectively. Microscopic metrics and ADC correlated with T stages: microscopic FA (rho = 0.52, P<.001), anisotropic MK (rho = 0.38, P=.002), isotropic MK (rho = 0.27, P=.03), total MK (rho = 0.32, P=.009), and ADC (rho = -0.36, P=.003).

Conclusion: MDD-MRI is a valuable tool for assessing NPC's microscopic characteristics, possibly improves T-stage evaluation beyond conventional ADC.

目的：鼻咽癌显微结构弥散异质性对预后评价的影响。本研究旨在探讨多维弥散加权磁共振成像（MDD-MRI）在评估鼻咽癌显微弥散特征方面的潜力。材料和方法：66例鼻咽癌患者通过MDD-MRI获得微观扩散指标，包括各向异性平均峰度（MK）、各向同性MK、总MK和微观分数各向异性（FA）。宏观指标，如表观扩散系数（ADC），以及扩散张量成像（DTI）和扩散峰度成像（DKI）的参数，也进行了分析以进行比较。评估鼻咽癌与正常组织之间、病理亚型、临床分期和eb病毒感染状态之间的差异。受试者工作特征曲线分析评估了区分鼻咽癌与正常组织的能力。Spearman的相关分析检验了扩散指标与原发性肿瘤(T)分期之间的关系。结果：鼻咽癌组织的ADC （PK）和PK分别较低。显微指标和ADC与T分期相关：显微FA （rho = 0.52, p）结论：MDD-MRI是评估鼻咽癌显微特征的一种有价值的工具，可能比传统ADC更好地评估T分期。

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引用次数: 0

Protocol and performance of coronary computed tomography angiography in patients with atrial fibrillation: a systematic review and meta-analysis 房颤患者冠状动脉ct血管造影的方案和效果：系统回顾和荟萃分析。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-12 DOI: 10.1016/j.crad.2025.107175

X.-Z. Yang , S. Hachaichi , J. Endrikat , A. Ullmann , L. Cao , G. Wang

Aim

The aim of this study was to systematically investigate protocols and performance of iopromide contrast-enhanced coronary computed tomography angiography (CCTA) for diagnosing coronary artery disease (CAD) in patients with atrial fibrillation (AF).

Materials and methods

We searched PubMed, Embase, Web of Science, and the Cochrane Library for eligible studies of iopromide contrast-enhanced CCTA in patients with AF from inception to February 2025. Using a random-effect model, we pooled the following diagnostic metrics of CCTAs from included studies: diagnostic segments, effective radiation dose, sensitivity, specificity, and receiver operating characteristic (ROC) curve for CAD diagnosis versus conventional angiography.

Results

We included 14 studies involving 601 patients with AF who underwent iopromide 370 mgI/ml contrast-enhanced CCTA. Most studies applied individualised contrast and voltage protocols. Pooled analysis in 11 of those 14 studies indicated 98% segments were diagnostic (95% confidence interval [CI]: 0.96–0.99) with consistent results in subgroups of patients with heart rate variation >50 beats per minute, patients with overweight status, and patients with heart valve diseases. Scanners with ≥128 slices or individualised protocols could further improve image quality. The per-patient ROC was 0.97 (95% CI: 0.95–0.98), while the per-segment ROC was 0.99 (95% CI: 0.98–0.99). In addition, prospective-triggered or individualised voltage protocols reduced radiation dose by approximately 50%.

Conclusion

Our meta-analysis showed that 370-mgI/ml iopromide contrast-enhanced CCTA delivers consistent image quality and accurate diagnosis of CAD in patients with AF. The use of high-performance scanners combined with individualised protocols and prospective acquisition could further enhance image quality while reducing radiation exposure.

目的：本研究的目的是系统地探讨碘丙胺增强冠状动脉计算机断层血管造影（CCTA）诊断心房颤动（AF）患者冠状动脉疾病（CAD）的方案和性能。材料和方法：我们检索了PubMed、Embase、Web of Science和Cochrane Library，检索了从一开始到2025年2月在房颤患者中进行碘丙胺对比剂增强CCTA的符合条件的研究。使用随机效应模型，我们从纳入的研究中汇总了ccta的以下诊断指标：诊断段，有效辐射剂量，敏感性，特异性和受试者工作特征（ROC）曲线，用于CAD诊断与传统血管造影。结果：我们纳入了14项研究，涉及601例房颤患者，他们接受了碘丙胺370 mgI/ml的造影增强CCTA。大多数研究采用个性化对比和电压方案。这14项研究中11项的汇总分析表明，98%的片段是诊断性的（95%可信区间[CI]: 0.96-0.99），在心率变化为每分钟50次的患者、超重状态的患者和心脏瓣膜疾病患者的亚组中结果一致。≥128片或个性化方案的扫描仪可以进一步提高图像质量。每例患者的ROC为0.97 (95% CI: 0.95-0.98)，而每段的ROC为0.99 （95% CI: 0.98-0.99）。此外，前瞻性触发或个体化电压方案可将辐射剂量降低约50%。结论：我们的荟萃分析显示，370 mgi /ml碘丙胺增强CCTA可以提供一致的图像质量和准确的AF患者CAD诊断。使用高性能扫描仪结合个性化方案和前瞻性采集可以进一步提高图像质量，同时减少辐射暴露。

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引用次数: 0

Temporal patterns of diastolic and systolic dysfunction in hypertrophic cardiomyopathy assessed by cardiac magnetic resonance (CMR) time-volume parameters 利用心脏磁共振（CMR）时间-体积参数评估肥厚性心肌病患者舒张和收缩功能障碍的时间模式

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-12 DOI: 10.1016/j.crad.2025.107176

S.S. Dereli Bulut , B. Akcayoz , Z. Sakci , N. Günay

AIM

Diastolic dysfunction (DD) is central to hypertrophic cardiomyopathy (HCM), yet comprehensive cardiac magnetic resonance (CMR)–based staging is limited. We evaluated a multiparametric CMR framework combining time-volume indices, left atrial volume index (LAVI), and phase-contrast magnetic resonance imaging (PC-MRI) flow analysis against echocardiographic staging and healthy controls.

MATERIALS AND METHODS

Fifty-four HCM patients and 65 matched controls underwent cine-CMR to derive peak filling rate (PFR), peak filling rate acceleration (PFRA), peak filling rate end time (PFRE), and peak ejection rate (PER). PC-MRI at the sinotubular junction yielded peak velocity, ejection time (ET), time to peak velocity (TPV), and TPV-to-ET ratio. LAVI was measured from 4-chamber cine. Serum N-terminal pro–B-type natriuretic peptide (NT-proBNP) and troponin I were analysed. DD was classified per American Society of Echocardiography / European Association of Cardiovascular Imaging (ASE/EACVI) early-to-late diastolic mitral inflow velocity ratio (E/A)-based criteria. Diagnostic performance was assessed by receiver operating characteristic (ROC) analysis; reproducibility was assessed by intraclass correlation coefficients (ICCs).

RESULTS

DD was present in 70% of HCM patients. In controls, HCM showed a lower PFR (286.4 vs 397.8 ml/s), reduced PFRA (0.91 vs 1.48 ml/s²), prolonged PFRE (321.3 vs 205.7 ms), and higher LAVI (48.3 vs 29.8 ml/m²) (all P<0.001). Obstructive HCM demonstrated delayed systolic acceleration with a lower TPV-to-ET ratio (0.55 vs 0.67). LAVI and TPV-to-ET ratio each achieved an area under the curve (AUC) of 0.85 for DD discrimination, exceeding isolated time-volume indices. NT-proBNP correlated with DD severity and PFRE (r=0.42, P=0.01). PER decline indicated subclinical systolic impairment despite preserved ejection fraction (EF). Reproducibility was excellent (ICC: 0.92–0.95).

CONCLUSION

A CMR framework integrating time-volume metrics, LAVI, and aortic flow kinetics enables accurate DD classification, detection of early systolic dysfunction, and characterisation of obstruction-related haemodynamics in HCM, supporting clinical application and longitudinal surveillance.

aim舒张功能障碍（DD）是肥厚性心肌病（HCM）的核心，但基于心脏磁共振（CMR）的综合分期是有限的。我们评估了一个多参数CMR框架，结合时间-体积指数、左心房容积指数（LAVI）和超声心动图分期和健康对照的相对比磁共振成像（PC-MRI）血流分析。材料与方法54例HCM患者和65例对照者进行了cine-CMR，获得了峰填充率（PFR）、峰填充率加速（PFRA）、峰填充率结束时间（PFRE）和峰射血率（PER）。在窦管交界处的PC-MRI得到了峰值速度、弹射时间（ET）、峰值速度时间（TPV）和TPV- ET比值。LAVI从4室cine测量。检测血清n端b型前利钠肽（NT-proBNP）和肌钙蛋白I。DD根据美国超声心动图学会/欧洲心血管成像协会（ASE/EACVI）早舒张晚期二尖瓣流入速度比（E/A）标准进行分类。采用受试者工作特征（ROC）分析评估诊断效能；用类内相关系数（ICCs）评价再现性。结果70% HCM患者存在dd。在对照组中，HCM表现出较低的PFR (286.4 vs 397.8 ml/s)，降低的PFRA (0.91 vs 1.48 ml/s2)，延长的PFRE （321.3 vs 205.7 ms）和较高的LAVI (48.3 vs 29.8 ml/m2)（所有P<；0.001）。阻塞性HCM表现为延迟收缩加速，tpv / et比较低（0.55 vs 0.67）。LAVI和TPV-to-ET的曲线下面积（AUC）均达到0.85，优于单独的时间-体积指数。NT-proBNP与DD严重程度、PFRE相关（r=0.42， P=0.01）。PER下降表明亚临床收缩期损伤，尽管射血分数（EF）保持不变。重现性极好（ICC: 0.92-0.95）。结论CMR框架整合了时间-容量指标、LAVI和主动脉血流动力学，可以准确地对HCM进行DD分类、早期收缩功能障碍检测和梗阻相关血流动力学表征，支持临床应用和纵向监测。

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引用次数: 0

Efficacy of autologous blood patch injection for the prevention of pneumothorax after transthoracic lung biopsy 自体血贴片注射预防经胸肺活检后气胸的疗效观察。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-12 DOI: 10.1016/j.crad.2025.107177

G. Gravel, A. Roussel, P.-A. Lampson, X. Belin, A. Guth, F. Mellot

Aim

Transthoracic computed tomography (CT)-guided lung biopsy (TLB) is associated with a risk of pneumothorax. Most studies evaluating the efficacy of blood patch injection for preventing pneumothorax also combined patient positioning techniques, making it difficult to evaluate the sealing effect. This study aimed to assess the efficacy of autologous blood patch sealing without specific patient positioning technique after TLB for preventing pneumothorax and chest tube insertion.

Material and Methods

In our single institution, from February 1^st, 2024, to January 31st, 2025, consecutive patients who underwent TLB with autologous blood patch injection were retrospectively compared with consecutive patients who underwent TLB from August 1^st, 2022, to July 30^th, 2023, with no blood patch injection.

Results

A total of 494 patients were included, with 245 patients in the blood patch group (group A) and 249 patients in the control group (group B). Blood patch injection was successfully performed in 235 of 245 (95.9%) patients in group A. The rate of pneumothorax was 32 of 245 patients in group A (13.1%) vs 78 of 249 patients in group B (31.3%) (P < .001). Seven (2.9%) patients required chest tube insertion in group A vs 20 (8.0%) in group B (P = .019). Five (2.0%) patients required a secondary chest radiograph for pneumothorax in group A vs 23 (9.2%) in group B (P = .001).

Conclusion

Sealing the biopsy tract with an autologous blood patch after TLB, without a specific patient positioning technique is safe and effective in preventing pneumothorax and chest tube insertion.

目的：经胸计算机断层扫描（CT）引导的肺活检（TLB）与气胸风险相关。大多数评价血贴片注射预防气胸疗效的研究还结合了患者体位技术，难以评价其密封效果。本研究旨在评估TLB术后自体血贴片封闭无特异性患者定位技术对预防气胸和胸管插入的效果。材料与方法：回顾性比较我院自2024年2月1日至2025年1月31日连续行TLB的自体血贴片注射患者与自2022年8月1日至2023年7月30日连续行TLB的未注射血贴片患者。结果：共纳入494例患者，其中血贴片组245例（A组），对照组249例（B组）。A组245例患者中有235例（95.9%）成功进行了血贴片注射。A组245例患者中气胸发生率为32例（13.1%），B组249例患者中有78例（31.3%）（P < 0.001）。A组7例（2.9%）患者需要插入胸管，B组20例（8.0%）（P = 0.019）。a组5例（2.0%）患者因气胸需要进行二次胸片检查，B组23例（9.2%）（P = 0.001）。结论：TLB术后用自体血贴片封闭活检道，无需特殊的患者定位技术，可安全有效地预防气胸和胸管插入。

{"title":"Efficacy of autologous blood patch injection for the prevention of pneumothorax after transthoracic lung biopsy","authors":"G. Gravel, A. Roussel, P.-A. Lampson, X. Belin, A. Guth, F. Mellot","doi":"10.1016/j.crad.2025.107177","DOIUrl":"10.1016/j.crad.2025.107177","url":null,"abstract":"<div><h3>Aim</h3><div>Transthoracic computed tomography (CT)-guided lung biopsy (TLB) is associated with a risk of pneumothorax. Most studies evaluating the efficacy of blood patch injection for preventing pneumothorax also combined patient positioning techniques, making it difficult to evaluate the sealing effect. This study aimed to assess the efficacy of autologous blood patch sealing without specific patient positioning technique after TLB for preventing pneumothorax and chest tube insertion.</div></div><div><h3>Material and Methods</h3><div>In our single institution, from February 1<sup>st</sup>, 2024, to January 31st, 2025, consecutive patients who underwent TLB with autologous blood patch injection were retrospectively compared with consecutive patients who underwent TLB from August 1<sup>st</sup>, 2022, to July 30<sup>th</sup>, 2023, with no blood patch injection.</div></div><div><h3>Results</h3><div>A total of 494 patients were included, with 245 patients in the blood patch group (group A) and 249 patients in the control group (group B). Blood patch injection was successfully performed in 235 of 245 (95.9%) patients in group A. The rate of pneumothorax was 32 of 245 patients in group A (13.1%) vs 78 of 249 patients in group B (31.3%) (<em>P</em> < .001). Seven (2.9%) patients required chest tube insertion in group A vs 20 (8.0%) in group B (<em>P</em> = .019). Five (2.0%) patients required a secondary chest radiograph for pneumothorax in group A vs 23 (9.2%) in group B (<em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>Sealing the biopsy tract with an autologous blood patch after TLB, without a specific patient positioning technique is safe and effective in preventing pneumothorax and chest tube insertion.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"92 ","pages":"Article 107177"},"PeriodicalIF":1.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The residual liver relative enhancement index: a quantitative tool from gadoxetic acid–enhanced magnetic resonance imaging for assessing liver function in hepatocellular carcinoma patients 残肝相对增强指数：加多西酸增强磁共振成像评估肝细胞癌患者肝功能的定量工具。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-12 DOI: 10.1016/j.crad.2025.107168

U. Eryuruk , M.N. Tasdemir , E. Cakir , S. Aslan

AIM

This study aimed to investigate the relationship between the residual liver relative enhancement index (RL-REI), which is derived from gadoxetic acid (GA)–enhanced magnetic resonance imaging (MRI), and albumin-bilirubin (ALBI) and Child-Pugh (CP) scores in assessing liver function in patients with hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

Patients with histopathologically confirmed HCC who underwent GA-enhanced MRI were retrospectively analysed. Receiver operating characteristic (ROC) curve analysis was conducted to identify the optimal cut-off values for the residual liver volume (RLV), the enhancement ratio (ER), and the RL-REI in predicting ALBI grades and CP classes. Spearman’s rank correlation was used to assess the relationships of the RLV, the ER, and the RL-REI with the ALBI and CP scores. Intraclass correlation coefficient (ICC) was applied to evaluate intrareader reliability and inter-reader agreement.

Results

Forty-one patients (mean age: 56.7 ± 11.5 years, 33 men) met the study criteria. The RL-REI showed high diagnostic performance (area under the curve [AUC] ≥ 0.945 and accuracy ≥ 85.3%) for both readers in differentiating ALBI grades and CP classes (P<0.001). The RL-REI demonstrated a strong correlation with the ALBI and CP scores (r=−0.852 and −0.766 for reader 1, r=−0.839 and −0.758 for reader 2) (p<0.001). Intrareader and inter-reader agreement was almost perfect for all measurements (ICC ≥ 0.922) (P<0.001).

Conclusion

The RL-REI demonstrated a strong correlation with ALBI and CP scores for assessing liver function in HCC patients and showed high accuracy in predicting ALBI grades and CP classes, highlighting its potential as a valuable radiological tool.

目的：本研究旨在探讨残肝相对增强指数（RL-REI）与白蛋白胆红素（ALBI）和Child-Pugh （CP）评分在评估肝细胞癌（HCC）患者肝功能中的关系。RL-REI由gadoxetic酸（GA）增强磁共振成像（MRI）获得。材料和方法：回顾性分析经组织病理学证实的肝细胞癌患者行ga增强MRI检查。采用受试者工作特征（ROC）曲线分析，确定残肝体积（RLV）、增强比（ER）和RL-REI预测ALBI分级和CP分级的最佳临界值。使用Spearman等级相关来评估RLV、ER和RL-REI与ALBI和CP评分的关系。用类内相关系数（Intraclass correlation coefficient， ICC）评价读者内信度和读者间一致性。结果：41例患者（平均年龄：56.7±11.5岁，男性33例）符合研究标准。RL-REI在鉴别ALBI分级和CP分级方面表现出较高的诊断效能（曲线下面积[AUC]≥0.945，准确率≥85.3%）。结论：RL-REI在评估HCC患者肝功能方面与ALBI和CP评分有很强的相关性，在预测ALBI分级和CP分级方面显示出较高的准确性，突出了其作为一种有价值的放射学工具的潜力。

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引用次数: 0

The diagnostic value of a subcoracoid effusion in ultrasound assessment of rotator cuff tears 喙下积液在肩袖撕裂超声诊断中的价值。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-08 DOI: 10.1016/j.crad.2025.107164

M. Charnock , N. Kotnis

AIM

The aim of this study was to assess the prevalence of a subcoracoid effusion and its association with rotator cuff tears at shoulder ultrasound.

MATERIALS AND METHODS

This was a prospective study involving 3,405 patients who underwent shoulder ultrasound referred from both primary and secondary care between January 2019 and January 2025. Demographic details, sonographic diagnosis including the size of a rotator cuff tear, and subcoracoid bursal distension was recorded. Details of further imaging studies and surgical outcomes were also documented.

RESULTS

Of the 3405 patients examined, ultrasound revealed a subcoracoid effusion in 132 patients. Four patients had a subcoracoid effusion and no rotator cuff tear on ultrasound, and six patients reported a subcoracoid effusion and a partial thickness tear on ultrasound. A total of 122 (4%) patients had a subcoracoid effusion and a full-thickness tear on ultrasound, with 64 patients having surgical correlation (Fisher’s exact test P<0.001).

CONCLUSION

While subcoracoid effusions are not common, this study confirms a strong association between subcoracoid effusions and full-thickness rotator cuff tears. Careful assessment of the rotator cuff is essential when subcoracoid effusions are identified on ultrasound.

目的：本研究的目的是评估喙下积液的患病率及其与肩袖撕裂的关系。材料和方法：这是一项前瞻性研究，涉及3405名患者，这些患者在2019年1月至2025年1月期间接受了初级和二级护理的肩部超声检查。记录了人口统计学细节、超声诊断包括肩袖撕裂的大小和喙下囊扩张。进一步影像学检查和手术结果的细节也被记录下来。结果：在3405例患者中，超声显示132例为喙下积液。4例患者有喙下积液，超声检查无肩袖撕裂，6例患者有喙下积液，超声检查有部分厚度撕裂。超声显示122例（4%）患者有喙下积液和全层撕裂，64例患者有手术相关性（Fisher精确检验p）。结论：虽然喙下积液并不常见，但本研究证实了喙下积液和全层肩袖撕裂之间有很强的相关性。当超声检查发现喙下积液时，对肩袖进行仔细评估是必要的。

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引用次数: 0

Radiomics in clinical radiology: advances, challenges, and future directions 临床放射学中的放射组学：进展、挑战和未来方向。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-08 DOI: 10.1016/j.crad.2025.107165

K. Linton-Reid , M. Chen , M.B. Martell , J.M. Posma , E.O. Aboagye

High-throughput extraction of quantitative image features, known as radiomics, has the potential to improve clinical radiology by revealing hidden features in medical images. In this review, we discuss the convergence of radiomics with artificial intelligence (AI), specifically the development of large language models (LLMs) and agentic AI models, alongside improvements in radiomics methods, standardisation, and clinical uptake pathways. Our aim is to summarise these developments, highlight current challenges, and suggest potential future directions for the widespread adoption of radiomics in clinical practice. The study conducted an extensive literature review, focusing on radiomics research, particularly investigations that examined validation frameworks, standardisation efforts, deep learning, LLMs, multi-centre studies, and the emerging library of agentic pipelines. The review compares key publications to outline common findings affecting diagnostic accuracy, prognostic performance, reproducibility, and integration into clinical workflows. Advances in AI, particularly LLMs that work with both text and images to enhance understanding, and agentic AI systems that tailor workflows to specific conditions, offer promising opportunities to improve radiomic analysis and its clinical applicability. Issues of reproducibility are being addressed through standardisation and robust validation, paving the way for broader clinical implementation. Radiomics has the potential to become an essential component of precision imaging in the coming years, though this will require resolving challenges related to reproducibility, interpretability, and seamless integration into clinical practice through cross-disciplinary collaboration.

Clinical Relevance

Radiologists and imaging scientists should anticipate the future use of radiomic AI solutions, potentially incorporating LLMs, to support diagnostic, prognostic, and therapeutic decision-making, ultimately enhancing precision medicine.

定量图像特征的高通量提取，被称为放射组学，有可能通过揭示医学图像中的隐藏特征来改善临床放射学。在这篇综述中，我们讨论了放射组学与人工智能（AI）的融合，特别是大型语言模型（llm）和人工智能代理模型的发展，以及放射组学方法、标准化和临床吸收途径的改进。我们的目的是总结这些发展，强调当前的挑战，并建议放射组学在临床实践中广泛采用的潜在未来方向。该研究进行了广泛的文献综述，重点关注放射组学研究，特别是对验证框架、标准化工作、深度学习、法学硕士、多中心研究和新兴代理管道库的调查。该综述比较了主要出版物，概述了影响诊断准确性、预后表现、可重复性和融入临床工作流程的常见发现。人工智能的进步，特别是同时处理文本和图像以增强理解的法学硕士，以及针对特定条件定制工作流程的人工智能代理系统，为改善放射学分析及其临床适用性提供了有希望的机会。可重复性问题正在通过标准化和强有力的验证得到解决，为更广泛的临床应用铺平道路。放射组学有可能在未来几年成为精确成像的重要组成部分，尽管这需要解决与重复性、可解释性相关的挑战，并通过跨学科合作无缝整合到临床实践中。临床意义：放射科医生和成像科学家应该预测未来使用放射学人工智能解决方案，可能会结合llm，以支持诊断、预后和治疗决策，最终增强精准医疗。

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引用次数: 0

Pain induced by platelet-rich plasma injections: reality or myth and short-medium term efficiency in a large retrospective cohort 富血小板血浆注射引起的疼痛：现实或神话和中短期效率在一个大型回顾性队列中。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-08 DOI: 10.1016/j.crad.2025.107166

S. Garaud , M. Hamard , K. Gorican , H. Bouredoucen, C. Knuchel, D. Ferreira Branco, P.-A. Poletti, S. Boudabbous

AIM

The aim of our study was to assess pain during PRP injections and to evaluate correlations with pathology, anatomical location and needle size. The second goal was to evaluate the improvement in pain in the short and medium term.

Materials and Methods

Overall, 389 (195 males and 194 females) consecutive patients addressed for PRP injections were prospectively included. Pain during infiltration was evaluated using a visual analogue scale (VAS). Correlations with pathology, anatomical location and needle size were analyzed. Pain response was assessed in the short term, (10–15 days), and in the medium term (3 months).

Results

A total of 215 patients suffered from tendinopathy and 174 from osteoarthritis. Median age was 47.7 years old for tendinopathy and 46.03 years old for osteoarthritis. During injections, a significant difference was noticed between the groups (Mann-Whitney: p=0.0124). But no significant influence of the needle size or the anatomical location on recorded pain during injection (p=0.222). Improvement of short-term or medium-term pain values compared with the day of injection was not significant (p=0.3992, p=0.1202 respectively).

Conclusion

Our study showed that PRP injections were associated with a higher level of pain in patients with tendinopathy than in those with arthritis, regardless of anatomical location or needle size. No improvement in pain was noticed in the short and medium term.

目的：我们研究的目的是评估PRP注射过程中的疼痛，并评估其与病理、解剖位置和针头大小的相关性。第二个目标是评估短期和中期疼痛的改善。材料和方法：前瞻性纳入389例连续接受PRP注射的患者（男195例，女194例）。采用视觉模拟评分法（VAS）评价浸润过程中的疼痛。分析其与病理、解剖位置和针径的相关性。在短期（10-15天）和中期（3个月）评估疼痛反应。结果：215例发生肌腱病变，174例发生骨关节炎。肌腱病变的中位年龄为47.7岁，骨关节炎的中位年龄为46.03岁。注射时，两组间差异有统计学意义（Mann-Whitney: p=0.0124）。但针的大小和解剖位置对记录的注射痛无显著影响（p=0.222）。与注射当日相比，短期和中期疼痛值的改善无统计学意义（p=0.3992, p=0.1202）。结论：我们的研究表明，与关节炎患者相比，PRP注射与肌腱病变患者更高程度的疼痛相关，无论其解剖位置或针头大小如何。短期和中期疼痛均未见改善。

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引用次数: 0

Spectral computed tomography (CT) in breast lesion evaluation: clinical utility and imaging spectrum—a pictorial review 光谱计算机断层扫描（CT）在乳腺病变评估中的应用：临床应用和成像光谱。

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-07 DOI: 10.1016/j.crad.2025.107161

K.R. Yong , S. Lee , A. Uppaluri, C.H.S. Lim, S. Ganti

Breast lesions constitute a significant proportion of women’s health imaging. While mammography, ultrasound, and magnetic resonance imaging (MRI) are well established methods of breast assessment, the radiation penalty associated with computed tomography (CT) limits its role mainly to incidental detection of breast lesions, oncological staging, and follow-up.

Spectral CT, including dual-energy CT and photon-counting CT enables advanced postprocessing techniques such as iodine maps, monoenergetic reconstructions, and material decomposition which may aid in lesion breast detection, characterisation, and oncological treatment response monitoring.

This article illustrates the utility of spectral CT in a range of benign and malignant breast lesions, with correlation to conventional breast imaging.

A series of benign and malignant breast lesions, alongside relevant iodine maps, monoenergetic reconstructions, and material decomposition will be demonstrated, with corresponding conventional breast imaging. The clinical applications in lesion detection, differentiation between benign and malignant lesions, staging, prognostication, and treatment response will be discussed.

Whilst spectral CT will not replace conventional breast imaging methods, it has a role as a valuable adjunct to aid the radiologist in routine clinical practice. Emerging functional and quantitative capabilities have the potential for objective lesion assessment and further integration of CT into breast imaging practice.

乳房病变在妇女健康成像中占很大比例。虽然乳房x线摄影、超声和磁共振成像（MRI）是公认的乳房评估方法，但与计算机断层扫描（CT）相关的辐射惩罚限制了它的作用，主要是偶然发现乳房病变、肿瘤分期和随访。光谱CT，包括双能CT和光子计数CT，实现了先进的后处理技术，如碘图、单能重建和物质分解，这可能有助于病灶乳腺检测、表征和肿瘤治疗反应监测。这篇文章说明了光谱CT在一系列乳腺良性和恶性病变中的应用，并与常规乳腺成像相关。一系列良性和恶性乳房病变，以及相关的碘图、单能重建和物质分解，将与相应的常规乳房影像学一起展示。临床应用在病变的检测，良恶性病变的区分，分期，预后和治疗反应将讨论。虽然光谱CT不会取代传统的乳房成像方法，但它作为辅助放射科医生在常规临床实践中的有价值的辅助手段。新兴的功能和定量能力有可能客观评估病变，并进一步将CT整合到乳房成像实践中。

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引用次数: 0

Assessment of tendon mechanical properties using virtual touch tissue imaging quantification: an elastography study of normal and injured supraspinatus tendons 使用虚拟触摸组织成像定量评估肌腱力学特性：正常和受伤冈上肌肌腱的弹性成像研究

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-11-07 DOI: 10.1016/j.crad.2025.107163

J. Yang , L. Kang , Z. Bao , X. Liu , H. Li , J. Xu , L. Chen

AIM

This study aimed to evaluate the shear wave velocity (SWV) of supraspinatus tendons (SST) using Virtual Touch Imaging Quantification (VTIQ) elastography, to analyse factors influencing SWV measurements in healthy individuals, and to characterise changes in SST stiffness during injury.

MATERIALS AND METHODS

Clinical data from 130 healthy volunteers and 51 patients with SST injuries were analysed. The SWV values in healthy volunteers were assessed by VTIQ across gender, age, body mass index (BMI), and SST thickness groups. Patients were categorised by age (group 1: ≤50 years; group 2: >50 years). SST thickness and SWV values were measured bilaterally, with healthy volunteers serving as controls. Two-dimensional (2D) ultrasound acoustic characteristics were evaluated for injured SSTs.

RESULTS

Bilateral SST SWV values showed no significant differences between sexes or SST thickness groups, but females had lower SWV values than males (P = 0.003). SWV values decreased with increasing age and BMI, with significant differences between age (P < 0.001) and BMI groups (P = 0.04). In individuals over 50 years old, right SST SWV values were lower than the left (P < 0.05). Injured SST in group 1 exhibited reduced echogenicity and significantly lower SWV values compared to controls (P < 0.05). Group 2 showed increased echogenicity with no significant difference in SWV values (P > 0.05).

CONCLUSION

VTIQ elastography effectively reflects SST stiffness changes. Age and BMI significantly influence SWV values, while SST injuries result in increased thickness and reduced stiffness mainly. Overall, VTIQ elastography serves as a valuable complement to conventional 2D ultrasound for diagnosing SST injuries.

目的本研究旨在利用虚拟触摸成像量化（VTIQ）弹性成像技术评估冈上肌腱（SST）的横波速度（SWV），分析影响健康个体横波速度测量的因素，并表征损伤期间冈上肌腱（SST）刚度的变化。材料与方法对130例健康志愿者和51例SST损伤患者的临床资料进行分析。采用VTIQ对健康志愿者的SWV值进行跨性别、年龄、体重指数（BMI）和SST厚度组的评估。患者按年龄分类（1组≤50岁；2组≤50岁）。双侧测量SST厚度和SWV值，健康志愿者作为对照。评估损伤SSTs的二维超声声学特征。结果双侧海温SWV值在性别和海温厚度组间无显著差异，但女性的SWV值低于男性（P = 0.003）。SWV值随年龄和BMI的增加而降低，年龄组（P < 0.001）与BMI组（P = 0.04）差异有统计学意义。在50岁以上个体中，右侧SST SWV值低于左侧（P < 0.05）。与对照组相比，1组损伤的SST表现出较低的回声性和显著降低的SWV值（P < 0.05）。组2回声增强，SWV值差异无统计学意义（P > 0.05）。结论vtiq弹性图能有效反映海温刚度变化。年龄和BMI显著影响SWV值，而SST损伤主要导致厚度增加和刚度降低。总的来说，VTIQ弹性成像是传统二维超声诊断SST损伤的宝贵补充。

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引用次数: 0