European Journal of Radiology最新文献

Multilingual feasibility of GPT-4o for automated Voice-to-Text CT and MRI report transcription. GPT-4o 用于自动语音转文本 CT 和 MRI 报告转录的多语言可行性。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-17 DOI: 10.1016/j.ejrad.2024.111827

Felix Busch, Philipp Prucker, Alexander Komenda, Sebastian Ziegelmayer, Marcus R Makowski, Keno K Bressem, Lisa C Adams

Purpose: Large language models (LLMs) promise to streamline radiology reporting. With the release of OpenAI's GPT-4o (Generative Pre-trained Transformers-4 omni), which processes not only text but also speech, multimodal LLMs might now also be used as medical speech recognition software for radiology reporting in multiple languages. This proof-of-concept study investigates the feasibility of using GPT-4o for automated voice-to-text transcription of radiology reports in English and German.

Methods: Three readers with varying levels of experience each dictated 100 synthetic radiology reports in both languages using GPT-4o via the ChatGPT iOS mobile application. Reports included CT and MRI scans of various anatomical regions. Evaluation metrics included error type, severity, and correction time. BERTScore and ROUGE metrics were calculated to assess semantic similarity and n-gram overlap between dictated and original reports.

Results: No significant differences in correction time between languages were found, but differences were observed between readers based on experience. Error rates were similar for both languages, with most errors being minor (92.68 %, n = 114/123 German; 94.74 %, n = 90/95 English) and technical (27.04 %, n = 43/159 German; 35.65 %, n = 41/115 English) or typographical (23.9 %, n = 38/159 German; 27.83 %, n = 32/115 English). BERTScore metrics were significantly higher for German, while ROUGE metrics showed no significant differences between languages.

Conclusion: This study demonstrates the potential of GPT-4o for multilingual transcription of radiology reports, effectively handling both English and German with minimal errors and high semantic understanding. Future research should compare GPT-4o with current radiology dictation tools, assessing performance, cost-effectiveness, and multilingual capabilities across diverse speaker populations.

目的：大型语言模型（LLM）有望简化放射学报告。OpenAI 的 GPT-4o（Generative Pre-trained Transformers-4 omni）不仅能处理文本，还能处理语音，随着它的发布，多模态 LLM 现在也可用作医学语音识别软件，以多种语言处理放射学报告。这项概念验证研究调查了使用 GPT-4o 自动将英语和德语的放射学报告语音转为文本的可行性：方法：三名具有不同经验水平的读者通过 ChatGPT iOS 移动应用程序使用 GPT-4o 分别口述了 100 份两种语言的合成放射学报告。报告包括不同解剖区域的 CT 和 MRI 扫描。评估指标包括错误类型、严重程度和纠正时间。通过计算 BERTScore 和 ROUGE 指标来评估听写报告和原始报告之间的语义相似性和 n-gram 重叠：结果：没有发现不同语言在校正时间上有明显差异，但根据经验观察到不同读者之间存在差异。两种语言的错误率相似，大多数错误为轻微错误（92.68%，n=114/123 德语；94.74%，n=90/95 英语）、技术错误（27.04%，n=43/159 德语；35.65%，n=41/115 英语）或排版错误（23.9%，n=38/159 德语；27.83%，n=32/115 英语）。德语的 BERTScore 指标明显更高，而 ROUGE 指标在不同语言之间没有明显差异：本研究证明了 GPT-4o 在放射学报告多语言转录方面的潜力，它能有效处理英语和德语，错误极少，语义理解能力强。未来的研究应将 GPT-4o 与当前的放射学听写工具进行比较，评估其性能、成本效益以及在不同说话人群中的多语言能力。

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引用次数: 0

Predicting functional outcome after open lumbar fusion surgery: A retrospective multicenter cohort study 开放式腰椎融合手术后功能预后的预测：回顾性多中心队列研究

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-14 DOI: 10.1016/j.ejrad.2024.111836

Ji Wu , Jian Li , Hao Zhang , Luyang Wu , Xiping Shen , Wei Lv

Purpose

We aimed to develop and externally validate a tool for predicting short-term functional outcome after lumbar fusion surgery.

Methods

Data of 1520 patients underwent lumbar fusion from three institutions was analyzed. A total of 855 and 1251 radiomics features from paraspinal muscles were extracted from preoperative CT and MRI scans, respectively. Multivariable logistic regression was used to identify independent risk factors of poor functional status after surgery. We developed and externally validated a combined model by integrating radiomics score and clinical features. We evaluated the clinical utility and stability of the model using decision curve and calibration curve analysis. SHAP plot was used for interpretation of predictive results.

Results

At multivariable analysis, radiomics score and 4 clinical features were identified as independent risk factors of poor functional outcome, and then a combined model was generated. This model had excellent performance, with AUCs of 0.85(95 %CI, 0.81–0.88), 0.82(95 %CI, 0.77–0.84), 0.79(95 %CI, 0.73–0.84) and 0.80(95 %CI, 0.76–0.83) in the derivation dataset and three independent test datasets, respectively. Moreover, this model showed great calibration and utility, outperforming the clinical model and radiomics score alone (both p < 0.05).

Conclusion

The combined model allows for accurate prediction of functional outcome after lumbar fusion surgery. The model could guide clinical decisions about the necessity of surgery for potential functional recovery.

目的我们旨在开发一种用于预测腰椎融合术后短期功能预后的工具，并对其进行外部验证。方法我们分析了三家机构的 1520 名腰椎融合术患者的数据。从术前 CT 和 MRI 扫描中分别提取了 855 个和 1251 个脊柱旁肌肉放射组学特征。我们使用多变量逻辑回归来识别术后功能状况不佳的独立风险因素。通过整合放射组学评分和临床特征，我们建立了一个综合模型，并进行了外部验证。我们利用决策曲线和校准曲线分析评估了模型的临床实用性和稳定性。结果在多变量分析中，放射组学评分和四个临床特征被确定为不良功能预后的独立风险因素，然后生成了一个组合模型。该模型表现出色，在衍生数据集和三个独立测试数据集中的AUC分别为0.85（95 %CI，0.81-0.88）、0.82（95 %CI，0.77-0.84）、0.79（95 %CI，0.73-0.84）和0.80（95 %CI，0.76-0.83）。此外，该模型还显示出很高的校准性和实用性，优于单独的临床模型和放射组学评分（均为 p < 0.05）。该模型可指导临床决定是否有必要进行手术以实现潜在的功能恢复。

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引用次数: 0

ECG, clinical and novel CT-imaging predictors of necessary pacemaker implantation after transfemoral aortic valve replacement 经胸主动脉瓣置换术后必须植入起搏器的心电图、临床和新型 CT 成像预测因素。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-13 DOI: 10.1016/j.ejrad.2024.111835

Konstantin Klambauer , Daniel Puhr-Westerheide , Matthias P. Fabritius , Wolfgang G. Kunz , Julien Dinkel , Christine Schmid-Tannwald , Christina Utz , Fabian Grathwohl , Nicola Fink , Konstantinos D. Rizas , Jens Ricke , Michael Ingrisch , Anna T. Stüber , Adrian Curta

Purpose

Newly onset conduction disturbances with the need for permanent pacemaker (PPM) implantation remain the most common complication of transcatheter aortic valve replacement (TAVR). The objective was to evaluate the predictive value of clinical, ECG and new pre-procedural CT-imaging parameters for the requirement of PPM-implantation after TAVR.

Methods

2105 consecutive patients receiving TAVR using a balloon expandable prosthesis (Sapien 3, Edwards Lifesciences, Irving, CA, USA) at our institution were enrolled. Patients receiving a valve-in-valve prosthesis, TAVR after surgical repair, with missing or non-diagnostic CT-scans, with pre-implanted PPM and after TAVR in mitral position were excluded. The most suitable classification model for the given dataset was first identified through benchmark testing and later applied for prediction analysis.

Results

312 eligible patients requiring PPM implantation were compared to an age- matched control group of 305 patients not requiring PPM implantation. A scaled LASSO model allowed for most accurate prediction with an AUC of 0.70. Right bundle branch block was the strongest predictor (OR 2.739), followed by atrioventricular block 1° (OR 2.091), prosthesis diameter (OR 1.351), atrial fibrillation (OR 1.255), arterial hypertension (OR 1.215), coronary artery disease (1.070), the angle of ventricle axis and aortic root (OR 1.030), sinotubular junction height (OR 1.014) and the calcification of the left coronary cuspid (OR 1.007).

Conclusions

ECG- and clinical outperform imaging parameters in predicting PPM-implantation following TAVR. Right bundle branch block emerged as the most significant predictor overall, while the angle of ventricle axis and aortic root as a novel imaging-based predictor.

目的：需要植入永久起搏器（PPM）的新发传导障碍仍然是经导管主动脉瓣置换术（TAVR）最常见的并发症。目的是评估临床、心电图和新的术前 CT 成像参数对 TAVR 后需要植入 PPM 的预测价值。方法：本机构连续登记了 2105 例使用球囊扩张假体（Sapien 3，Edwards Lifesciences，Irving，CA，USA）接受 TAVR 的患者。排除了接受瓣中瓣假体、手术修复后接受TAVR、CT扫描缺失或无诊断性、预先植入PPM和二尖瓣位置TAVR的患者。首先通过基准测试确定最适合给定数据集的分类模型，然后应用于预测分析：结果：312 名符合条件的需要植入 PPM 的患者与 305 名不需要植入 PPM 的患者组成的年龄匹配对照组进行了比较。缩放 LASSO 模型的 AUC 为 0.70，预测结果最为准确。右束支传导阻滞是最强的预测因子（OR 2.739），其次是房室传导阻滞 1°（OR 2.091）、假体直径（OR 1.351）、心房颤动（OR 1.255）、动脉高血压（OR 1.215）、冠状动脉疾病（1.070）、心室轴与主动脉根部夹角（OR 1.030）、窦管交界高度（OR 1.014）和左冠状动脉骤尖钙化（OR 1.007）：结论：在预测TAVR术后PPM植入方面，心电图和临床参数优于影像学参数。右束支传导阻滞是最重要的总体预测指标，而心室轴线与主动脉根部的夹角则是基于影像学的新型预测指标。

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引用次数: 0

Diagnostic performance of Photon-counting CT angiography in peripheral artery disease compared to DSA as gold standard 与作为金标准的 DSA 相比，光子计数 CT 血管造影在外周动脉疾病中的诊断性能

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-13 DOI: 10.1016/j.ejrad.2024.111834

Patrick Ghibes , Florian Hagen , Matthias Weissinger , Robin Wrazidlo , Konstantin Nikolaou , Abraham Levitin , Levester Kirksey , Christoph Artzner , Gerd Grözinger , Sasan Partovi

Background

Photon-counting (PC) CT has the potential to improve diagnostic confidence and image quality of CT angiography (CTA) in patients with peripheral artery disease (PAD).

Purpose

To retrospectively evaluate the diagnostic performance of Photon-counting CT angiography for the assessment of stenotic disease in patients with PAD compared to digital subtraction angiography (DSA) as gold standard.

Materials and Methods

All patients undergoing PC CTA followed by DSA between November 2021 and November 2023 were included in this institutional review board approved HIPAA compliant retrospective analysis. The arterial vasculature of the lower extremity was divided into 10 segments from the iliac vasculature to the calf arterial vasculature. The images were evaluated independently by two experienced readers. Inter-reader agreement was determined using Cohen’s kappa coefficient (κ). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) as well as accuracy were calculated for PC CTA and PC pure lumen reconstruction compared to DSA as gold standard.

Results

109 patients (mean age 74.68 ± 11.10 years; 77 males, 32 females) were included in the retrospective analysis. PC pure lumen reconstructions was available for 91 patients (83 %). A total of 933 vascular segments for PC CTA and 780 vascular segments for PC pure lumen reconstruction were evaluated. Good to perfect inter-reader agreement was found for PC CTA (κ = 0.791) and for PC pure lumen reconstruction (κ = 0.829). Sensitivity, Specificity and accuracy for PC CTA were 91 %; 95 % and 93 %, respectively. Sensitivity, Specificity and accuracy for PC pure lumen reconstruction were 85 %, 89 % and 88 %, respectively.

Conclusion

Photon-counting CTA demonstrates high sensitivity and specificity for the detection and diagnosis of stenotic lesions in PAD. PC non-calcium reconstruction does not further increase the accuracy compared to PC CTA.

背景光子计数（PC）CT 有可能提高外周动脉疾病（PAD）患者 CT 血管造影（CTA）的诊断信心和图像质量。目的回顾性评估光子计数 CT 血管造影与作为金标准的数字减影血管造影（DSA）相比，在评估 PAD 患者狭窄性疾病方面的诊断性能。材料和方法在2021年11月至2023年11月期间接受PC CTA和DSA检查的所有患者都纳入了这项经机构审查委员会批准、符合HIPAA标准的回顾性分析。下肢动脉血管被分为从髂动脉血管到小腿动脉血管的 10 个区段。图像由两名经验丰富的读者独立评估。使用科恩卡帕系数 (κ)确定阅读者之间的一致性。与作为金标准的 DSA 相比，计算了 PC CTA 和 PC 纯腔重建的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）以及准确性。91名患者（83%）获得了PC纯腔重建。PC CTA 共评估了 933 个血管节段，PC 纯腔重建共评估了 780 个血管节段。PC CTA（κ = 0.791）和 PC 纯管腔重建（κ = 0.829）的阅片师间一致性良好至完美。PC CTA 的敏感性、特异性和准确性分别为 91%、95% 和 93%。结论光子计数 CTA 对 PAD 狭窄病变的检测和诊断具有很高的灵敏度和特异性。与 PC CTA 相比，PC 非钙重建并不能进一步提高准确性。

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引用次数: 0

In-vivo cerebral artery pulsation assessment with Dynamic computed tomography angiography 利用动态计算机断层扫描血管造影术评估体内脑动脉搏动。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-13 DOI: 10.1016/j.ejrad.2024.111828

Lotte B. Stam , Sabine M.L. Linden , René Aquarius , Alessa Hering , Luuk J. Oostveen , Frederick J.A. Meijer , Hieronymus D. Boogaarts

Four-Dimensional Computed Tomography Angiography (4D CTA) seems a promising technique for capturing vessel motion of cerebral arteries, which may help to assess pathological conditions such as intracranial aneurysms. The goal of our current observational study is to capture the lumen diameter of cerebral arteries during three subsequent cardiac cycles with 4D CTA and to assess vessel motion, anticipating consistent expansion patterns within each cardiac cycle.

Eighteen adult patients with unruptured and untreated intracranial aneurysms were recruited at Radboud University Medical Center. Three cardiac cycles were captured, on a wide detector CT system, using ECG-gated 4D CTA. To reduce the impact of small head movements during the acquisition, a rigid-body registration was employed. Three 10 mm segments of cerebral arteries were selected. The total deformation of the vessel lumen was calculated using a deformable registration algorithm and was used as a substitute measure for vessel motion.

No pulsations could be registered, which was probably caused by pulsation motion below threshold of detection in combination with insufficient Signal-to-Noise Ratio. Further studies need to investigate if large intracranial structures can be evaluated and if using a novel scanner with a high spatial resolution would result in reproducible measurements of arteries this size.

四维计算机断层扫描血管造影术（4D CTA）似乎是一种捕捉脑动脉血管运动的有前途的技术，有助于评估颅内动脉瘤等病理情况。我们目前的观察性研究的目的是通过 4D CTA 捕捉脑动脉在随后三个心动周期中的管腔直径，并评估血管运动情况，预测每个心动周期中的一致扩张模式。研究人员在拉德布德大学医学中心招募了 18 名颅内动脉瘤未破裂和未治疗的成年患者。在宽探测器 CT 系统上，使用心电图门控 4D CTA 采集了三个心脏周期。为减少采集过程中头部微小移动的影响，采用了刚体配准。选取了三段 10 毫米长的脑动脉。使用可变形配准算法计算血管管腔的总变形量，并将其作为血管运动的替代指标。没有发现搏动，这可能是由于搏动运动低于检测阈值，再加上信噪比不足造成的。进一步的研究需要探讨是否能对大型颅内结构进行评估，以及使用具有高空间分辨率的新型扫描仪是否能对如此大小的动脉进行可重复的测量。

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引用次数: 0

Vascular abnormalities not to miss on routine chest CT: A pictorial review. 常规胸部 CT 不可错过的血管异常：图解回顾。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-13 DOI: 10.1016/j.ejrad.2024.111833

Rebecca Jamieson, Ahmed Kharabish, Monika Radikė

There is a wide and ever-increasing range of imaging indications for thoracic computed tomography (CT). Identifying and appropriately triaging cardiovascular findings is often challenging, especially in non-gated or unenhanced studies. The authors provide a pictorial review of clinically relevant abnormalities of the main intrathoracic vessels (aorta, superior vena cava, pulmonary arteries and coronary arteries), for radiologists reporting non-gated enhanced or unenhanced CT of the thorax.

胸部计算机断层扫描（CT）的成像适应症范围广泛且不断增加。识别和适当分流心血管检查结果往往具有挑战性，尤其是在非门控或非增强检查中。作者以图解的方式回顾了主要胸内血管（主动脉、上腔静脉、肺动脉和冠状动脉）与临床相关的异常，供放射科医生在报告胸部非门控增强或非增强 CT 时参考。

引用次数: 0

Corrigendum to “CT imaging using variable helical pitch scanning for lower extremity arterial disease: Reduced contrast medium dose, improved image quality and diagnostic accuracy” [Eur. J. Radiol. 184 (2024) 111792] 使用可变螺旋间距扫描对下肢动脉疾病进行 CT 成像：降低造影剂剂量，提高图像质量和诊断准确性" [Eur. J. Radiol.

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-12 DOI: 10.1016/j.ejrad.2024.111817

Xiao-Shi Li , Ji-Gang Geng , Yin-Hu Zhu , Li-Yao Liu , Yan Qiang Qiao , Yong-Li Ma , Lu Lu , Chang-Rui Song , Yue Qin , Guo-Ping Chen , Min Xu , Zi-rui Wang , Ya-Rong Wang

引用次数: 0

Discrimination of thrombus types in ischemic stroke using Dual-Energy CT 利用双能量 CT 鉴别缺血性中风的血栓类型。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-10 DOI: 10.1016/j.ejrad.2024.111832

Guisong Hou , Haoming Chen , Li’an Luo , Lin Hou , Tuanyu Lin , Yuan Liu

Objective

This study explores the clinical utility of dual-energy computed tomography (DECT) in discriminating thrombus types in ischemic stroke.

Methods

Patients with acute ischemic stroke who underwent brain DECT non-contrast scanning and brain CT perfusion (CTP) before thrombectomy were included, and the thrombus composition was analyzed by postoperative pathology. DECT data was conducted to reconstruct polychromatic images and effective atomic number images. Computed tomography (CT) values, effective atomic numbers, and spectral curve slopes of the thrombus were measured and calculated. Thrombus attenuation increase was obtained from CTP data. Parameters were compared between red blood cell (RBC)-dominant thrombi and fibrin/platelet (F/P)-dominant thrombi. Thresholds, sensitivity, specificity, and area under the curve (AUC) were analyzed to distinguish these thrombi. The associations between DECT parameters and proportion of RBCs were analyzed by Spearman’s correlation.

Results

Pathological analysis of 42 enrolled patients revealed 24 cases of RBC-dominant thrombi and 18 cases of F/P-dominant thrombi. Effective atomic numbers, spectral curve slopes, and polychromatic images CT values were significantly higher in the RBC-dominant thrombi group compared with the F/P-dominant thrombi group. Although the average thrombus attenuation increase was greater in the F/P-dominant thrombi group, this difference was not statistically significant. Among the DECT parameters, polychromatic images CT values had the greatest AUC at 0.924 (0.848–0.999) for discriminating RBC-dominant and F/P-dominant thrombi, with a threshold of 59 HU, sensitivity of 79.2 %, and specificity of 94.4 %. The combined diagnostic AUC reached 0.938 (0.863–1.012), with 87.5 % sensitivity and 94.4 % specificity. DECT polychromatic images CT values, effective atomic numbers, and spectral curve slopes were significantly correlated with proportion of RBCs (r = 0.673, 0.574, and 0.571, all p < 0.01).

Conclusion

DECT non-contrast scan parameters are associated with thrombus composition, which could be effective in distinguishing between RBC-dominant and F/P-dominant thrombi.

目的本研究探讨了双能计算机断层扫描（DECT）在缺血性脑卒中血栓类型判别中的临床应用：方法：纳入在血栓切除术前接受脑 DECT 非对比扫描和脑 CT 灌注（CTP）的急性缺血性脑卒中患者，并通过术后病理分析血栓构成。DECT 数据用于重建多色图像和有效原子序数图像。测量并计算血栓的计算机断层扫描（CT）值、有效原子数和光谱曲线斜率。血栓的衰减增加可从 CTP 数据中获得。对以红细胞（RBC）为主的血栓和以纤维蛋白/血小板（F/P）为主的血栓进行了参数比较。分析了区分这些血栓的阈值、灵敏度、特异性和曲线下面积（AUC）。通过斯皮尔曼相关性分析了 DECT 参数与红细胞比例之间的关系：结果：对 42 例入选患者进行病理分析后发现，24 例血栓以 RBC为主，18 例血栓以F/P为主。与 F/P 型血栓组相比，RBC 型血栓组的有效原子数、光谱曲线斜率和多色图像 CT 值明显更高。虽然F/P为主血栓组的血栓平均衰减增加较多，但这一差异在统计学上并不显著。在 DECT 参数中，多色图像 CT 值的 AUC 最大，为 0.924（0.848-0.999），用于区分 RBC 主导血栓和 F/P 主导血栓，阈值为 59 HU，灵敏度为 79.2%，特异性为 94.4%。综合诊断 AUC 达到 0.938（0.863-1.012），灵敏度为 87.5%，特异度为 94.4%。DECT 多色图像 CT 值、有效原子数和光谱曲线斜率与红细胞比例显著相关（r = 0.673、0.574 和 0.571，均为 p 结论：DECT 多色图像 CT 值、有效原子数和光谱曲线斜率与红细胞比例显著相关（r = 0.673、0.574 和 0.571，均为 p）：DECT 非对比扫描参数与血栓组成相关，可有效区分 RBC 主导型血栓和 F/P 主导型血栓。

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引用次数: 0

Diagnostic accuracy of ultrasound classifications – O-RADS US v2022, O-RADS US v2020, and IOTA SR – in distinguishing benign and malignant adnexal masses: Enhanced by combining O-RADS US v2022 with tumor marker HE4 O-RADS US v2022、O-RADS US v2020 和 IOTA SR 超声波分类在区分良性和恶性附件肿块方面的诊断准确性：将 O-RADS US v2022 与肿瘤标记物 HE4 结合使用可提高诊断准确性。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-09 DOI: 10.1016/j.ejrad.2024.111824

Yubo Liu , Lan Cao , Shengfu Chen , Jianhua Zhou

Purpose

To assess the diagnostic accuracy of O-RADS Ultrasound (O-RADS US) v2022, O-RADS US v2020, and IOTA SR, and to evaluate whether combining imaging findings with tumor markers enhances the diagnosis of adnexal masses.

Methods

This retrospective study, conducted between January 2018 and December 2023, included consecutive women with adnexal masses scheduled for surgery. Histopathologic results served as the reference standard. Risk factors for malignancy were identified using univariate and multivariate logistic regression analyses. ROC analysis was employed to assess diagnostic test performances, while Kappa statistics evaluated inter-reviewer agreement.

Results

A total of 613 women (mean age, 49.39 ± 12.81 years; range, 16–87 years) with pelvic masses were included. O-RADS US v2022 exhibited comparable performance to O-RADS US v2020, with areas under the curve (AUC) values of 0.940 and 0.937, respectively (p = 0.02, exceeding the adjusted significance level of 0.0167). Both O-RADS models outperformed the IOTA SR, which had an AUC of 0.862 (p < 0.0001 for both comparisons). Multivariate analysis revealed that O-RADS US v2022 [OR 9.148, 95 %CI (4.912–17.039), p < 0.001] and HE4 [OR 1.023, 95 %CI (1.010–1.036), p = 0.001] were significant factors associated with malignant lesions. Furthermore, the combination of O-RADS US v2022 and HE4 demonstrated an AUC of 0.98, significantly outperforming either O-RADS US v2022 alone (AUC = 0.94) or HE4 alone (AUC = 0.92). The Kappa values for O-RADS US v2022, O-RADS US v2020 and IOTA SR were 0.933, 0.891 and 0.923, respectively, indicating substantial inter-reader agreement.

Conclusions

The O-RADS US v2022 demonstrates comparable performance in predicting ovarian malignant lesions when compared to O-RADS US v2020, while surpassing the performance of IOTA SR. Additionally, the combination of O-RADS US v2022 and HE4 provides improved diagnostic effectiveness over using either O-RADS US v2022 or HE4 alone.

目的：评估O-RADS超声（O-RADS US）v2022、O-RADS US v2020和IOTA SR的诊断准确性，并评估将成像结果与肿瘤标志物相结合是否能增强附件肿块的诊断：这项回顾性研究在 2018 年 1 月至 2023 年 12 月期间进行，纳入了计划进行手术的患有附件肿块的连续女性。组织病理学结果作为参考标准。通过单变量和多变量逻辑回归分析确定了恶性肿瘤的风险因素。采用ROC分析评估诊断测试的性能，而Kappa统计则评估审查者之间的一致性：共纳入了 613 名患有盆腔肿块的女性（平均年龄为 49.39 ± 12.81 岁；年龄范围为 16-87 岁）。O-RADS US v2022 与 O-RADS US v2020 的性能相当，曲线下面积 (AUC) 值分别为 0.940 和 0.937（p = 0.02，超过调整后显著性水平 0.0167）。两个 O-RADS 模型的 AUC 值均为 0.862（p 结论），均优于 IOTA SR：与 O-RADS US v2020 相比，O-RADS US v2022 在预测卵巢恶性病变方面的表现相当，同时超过了 IOTA SR。此外，与单独使用 O-RADS US v2022 或 HE4 相比，联合使用 O-RADS US v2022 和 HE4 可提高诊断效果。

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引用次数: 0

Preparing radiology residents for breast MRI: A dual-site, resident-as-teacher feasibility project. 为放射科住院医师进行乳腺核磁共振成像做准备：双站点、住院医师即教师可行性项目。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-11-09 DOI: 10.1016/j.ejrad.2024.111831

L Cereser, F Sparascio, P Clauser, P Stelzer, G Agati, A Messner, R Girometti, C Zuiani

Purpose: To assess the impact of a faculty-mentored, resident-as-teacher theoretical-practical breast MRI (B-MRI) course on the reporting completeness and accuracy of "trainee" radiology residents (RRs) with basic or no experience in conventional breast imaging (CBI) and the personal skills and critical thinking of experienced, "teacher" RRs.

Methods: Six teacher-RRs from the Udine University residency program (URP) preliminarily selected and reported 55 B-MRI cases under faculty supervision. Twelve trainee-RRs (six from Udine URP and six from Vienna URP, with basic and no experience in CBI, respectively) underwent seven days of self-study on selected material, followed by a pre-training reporting test (pre-TRT) on 15 of the 55 B-MRI cases. Then, trainee-RRs attended a two-hour teaching session and reviewed the remaining 40 B-MRI cases supervised by teacher-RRs, followed by two post-training tests reporting the same pre-TRT cases, held immediately and 30 days later. We evaluated the trainee-RRs' reporting completeness and accuracy based on descriptors from the teacher-RRs' reports and assessed the teacher-RRs' self-evaluated personal skills and critical thinking through a 25-item questionnaire (Wilcoxon signed ranks test).

Results: Trainee-RRs showed significant post-course improvements in report completeness and accuracy, with Udine-trainee-RRs maintaining their progress and Vienna-trainee-RRs declining after 30 days. Index lesion metrics improved post-training but significantly declined over time. Teacher-RRs self-reported increased personal skills and critical thinking.

Conclusion: After attending the course, trainee-RRs from two URPs exhibited significantly higher completeness and accuracy in B-MRI reporting, particularly those with basic experience in CBI. Teacher-RRs perceived significant improvements in personal skills and critical thinking.

目的：评估由教师指导、住院医师即教师的理论-实践乳腺 MRI（B-MRI）课程对具有常规乳腺成像（CBI）基础或毫无经验的放射科住院医师（RR）报告完整性和准确性的影响，以及对经验丰富的 "教师 "RR的个人技能和批判性思维的影响：方法：来自乌迪内大学住院医师培训项目（URP）的六名教师住院医师在教师的指导下初步选择并报告了 55 个 B-MRI 病例。12 名受训 RR（6 名来自乌迪内大学住院医师培训项目，6 名来自维也纳大学住院医师培训项目，分别具有 CBI 基础经验和无 CBI 经验）对所选材料进行了为期 7 天的自学，然后对 55 个 B-MRI 病例中的 15 个进行了培训前报告测试（pre-TRT）。然后，受训注册研究员在教师注册研究员的指导下，参加了一个两小时的教学课程，复习了其余 40 个 B-MRI 病例，紧接着在 30 天后举行了两次培训后测试，分别报告了培训前和培训后的相同病例。我们根据教师-RRs 报告中的描述来评估受训者-RRs 报告的完整性和准确性，并通过一份 25 个项目的问卷来评估教师-RRs 的自我评估个人技能和批判性思维（Wilcoxon 符号行列检验）：30 天后，乌迪内受训人员在报告完整性和准确性方面均有显著提高，而维也纳受训人员则有所下降。指数病变指标在培训后有所改善，但随着时间的推移明显下降。教师注册研究员自我报告称个人技能和批判性思维得到提高：参加课程后，来自两个 URP 的受训 RR 在 B-MRI 报告的完整性和准确性方面都有明显提高，尤其是那些有 CBI 基本经验的受训 RR。教师注册研究员在个人技能和批判性思维方面也有显著提高。

{"title":"Preparing radiology residents for breast MRI: A dual-site, resident-as-teacher feasibility project.","authors":"L Cereser, F Sparascio, P Clauser, P Stelzer, G Agati, A Messner, R Girometti, C Zuiani","doi":"10.1016/j.ejrad.2024.111831","DOIUrl":"10.1016/j.ejrad.2024.111831","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of a faculty-mentored, resident-as-teacher theoretical-practical breast MRI (B-MRI) course on the reporting completeness and accuracy of \"trainee\" radiology residents (RRs) with basic or no experience in conventional breast imaging (CBI) and the personal skills and critical thinking of experienced, \"teacher\" RRs.</p><p><strong>Methods: </strong>Six teacher-RRs from the Udine University residency program (URP) preliminarily selected and reported 55 B-MRI cases under faculty supervision. Twelve trainee-RRs (six from Udine URP and six from Vienna URP, with basic and no experience in CBI, respectively) underwent seven days of self-study on selected material, followed by a pre-training reporting test (pre-TRT) on 15 of the 55 B-MRI cases. Then, trainee-RRs attended a two-hour teaching session and reviewed the remaining 40 B-MRI cases supervised by teacher-RRs, followed by two post-training tests reporting the same pre-TRT cases, held immediately and 30 days later. We evaluated the trainee-RRs' reporting completeness and accuracy based on descriptors from the teacher-RRs' reports and assessed the teacher-RRs' self-evaluated personal skills and critical thinking through a 25-item questionnaire (Wilcoxon signed ranks test).</p><p><strong>Results: </strong>Trainee-RRs showed significant post-course improvements in report completeness and accuracy, with Udine-trainee-RRs maintaining their progress and Vienna-trainee-RRs declining after 30 days. Index lesion metrics improved post-training but significantly declined over time. Teacher-RRs self-reported increased personal skills and critical thinking.</p><p><strong>Conclusion: </strong>After attending the course, trainee-RRs from two URPs exhibited significantly higher completeness and accuracy in B-MRI reporting, particularly those with basic experience in CBI. Teacher-RRs perceived significant improvements in personal skills and critical thinking.</p>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"111831"},"PeriodicalIF":3.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667159","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}

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