European Journal of Radiology最新文献

Radiomics-based histological grading of pancreatic ductal adenocarcinoma using 18F-FDG PET/CT: A two-center study

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

European Journal of Radiology

Pub Date : 2025-03-30 DOI: 10.1016/j.ejrad.2025.112070

Yang Xu , Yunmei Shi , Tao Jiang , Qingxia Wu , Ren Lang , Yuetao Wang , Minfu Yang

Objective

To explore the value of radiomics features derived from ¹⁸F-FDG PET/CT images in predicting the histological grade of pancreatic ductal adenocarcinoma (PDAC).

Materials and Methods

A retrospective analysis was conducted using data from patients with suspected pancreatic cancer, who histologically confirmed as PDAC within 14 days after ¹⁸F-FDG PET/CT scan in one of two hospitals. Tumors were divided into high-grade (undifferentiated or poorly differentiated), and low-grade (moderately or well differentiated). Two researchers independently used uRP to perform layer-by-layer tumor segmentation in both PET and CT images of each patient, and extract features. Model performance was evaluated using 5-fold cross-validation on the entire multi-center cohort, with results averaged across all folds. The least absolute shrinkage and selection was used for feature selection, and support vector machine (SVM), random forest (RF), and logistic regression (LR) were employed to distinguish the grade of PDAC. The performance of the model was evaluated using the receiver operating characteristic curve.

Results

This study comprised 111 patients (72 males and 39 females), comprising 52 patients with high-grade PDAC tumors and 59 patients with low-grade. A series of models were established by SVM, LR, and RF algorithms based on selected features. In the test set, the mean areas under the curve (AUCs) for PET image-based models using SVM, LR, and RF algorithms were 0.773, 0.772, and 0.760. For CT-based models, the mean AUCs were 0.764, 0.770, and 0.576. For PET/CT-based models, the mean AUCs were 0.840, 0.844, and 0.773.

Conclusion

Despite the lack of external validation, the PET/CT-derived radiomics model enables accurate preoperative histological grading of PDAC, offering a clinically actionable tool to neoadjuvant therapy stratification and further guide personalized medical decision-making.

{"title":"Radiomics-based histological grading of pancreatic ductal adenocarcinoma using 18F-FDG PET/CT: A two-center study","authors":"Yang Xu , Yunmei Shi , Tao Jiang , Qingxia Wu , Ren Lang , Yuetao Wang , Minfu Yang","doi":"10.1016/j.ejrad.2025.112070","DOIUrl":"10.1016/j.ejrad.2025.112070","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the value of radiomics features derived from <sup>18</sup>F-FDG PET/CT images in predicting the histological grade of pancreatic ductal adenocarcinoma (PDAC).</div></div><div><h3>Materials and Methods</h3><div>A retrospective analysis was conducted using data from patients with suspected pancreatic cancer, who histologically confirmed as PDAC within 14 days after <sup>18</sup>F-FDG PET/CT scan in one of two hospitals. Tumors were divided into high-grade (undifferentiated or poorly differentiated), and low-grade (moderately or well differentiated). Two researchers independently used uRP to perform layer-by-layer tumor segmentation in both PET and CT images of each patient, and extract features. Model performance was evaluated using 5-fold cross-validation on the entire multi-center cohort, with results averaged across all folds. The least absolute shrinkage and selection was used for feature selection, and support vector machine (SVM), random forest (RF), and logistic regression (LR) were employed to distinguish the grade of PDAC. The performance of the model was evaluated using the receiver operating characteristic curve.</div></div><div><h3>Results</h3><div>This study comprised 111 patients (72 males and 39 females), comprising 52 patients with high-grade PDAC tumors and 59 patients with low-grade. A series of models were established by SVM, LR, and RF algorithms based on selected features. In the test set, the mean areas under the curve (AUCs) for PET image-based models using SVM, LR, and RF algorithms were 0.773, 0.772, and 0.760. For CT-based models, the mean AUCs were 0.764, 0.770, and 0.576. For PET/CT-based models, the mean AUCs were 0.840, 0.844, and 0.773.</div></div><div><h3>Conclusion</h3><div>Despite the lack of external validation, the PET/CT-derived radiomics model enables accurate preoperative histological grading of PDAC, offering a clinically actionable tool to neoadjuvant therapy stratification and further guide personalized medical decision-making.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112070"},"PeriodicalIF":3.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768599","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

Image normalization techniques and their effect on the robustness and predictive power of breast MRI radiomics

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

European Journal of Radiology

Pub Date : 2025-03-30 DOI: 10.1016/j.ejrad.2025.112086

Florian Schwarzhans , Geevarghese George , Lorena Escudero Sanchez , Olgica Zaric , Jean E. Abraham , Ramona Woitek , Sepideh Hatamikia

Background and purpose

Radiomics analysis has emerged as a promising approach to aid in cancer diagnosis and treatment. However, radiomics research currently lacks standardization, and radiomics features can be highly dependent on acquisition and pre-processing techniques used. In this study, we aim to investigate the effect of various image normalization techniques on robustness of radiomics features extracted from breast cancer patient MRI scans.

Materials and methods

MRI scans from the publicly available MAMA-MIA dataset and an internal breast MRI test set depicting triple negative breast cancer (TNBC) were used. We compared the effect of commonly used image normalization techniques on radiomics feature robustness using Concordance-Correlation-Coefficient (CCC) between multiple combinations of normalization approaches. We also trained machine learning-based prediction models of pathologic complete response (pCR) on radiomics after different normalization techniques were used and compared their areas under the receiver operating characteristic curve (ROC-AUC).

Results

For predicting complete pathological response from pre-treatment breast cancer MRI radiomics, the highest overall ROC-AUC was achieved by using a combination of three different normalization techniques indicating their potentially powerful role when working with heterogeneous imaging data. The effect of normalization was more pronounced with smaller training data and normalization may be less important with increasing abundance of training data. Additionally, we observed considerable differences between MRI data sets and their feature robustness towards normalization.

Conclusion

Overall, we were able to demonstrate the importance of selecting and standardizing normalization methods for accurate and reliable radiomics analysis in breast MRI scans especially with small training data sets.

{"title":"Image normalization techniques and their effect on the robustness and predictive power of breast MRI radiomics","authors":"Florian Schwarzhans , Geevarghese George , Lorena Escudero Sanchez , Olgica Zaric , Jean E. Abraham , Ramona Woitek , Sepideh Hatamikia","doi":"10.1016/j.ejrad.2025.112086","DOIUrl":"10.1016/j.ejrad.2025.112086","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Radiomics analysis has emerged as a promising approach to aid in cancer diagnosis and treatment. However, radiomics research currently lacks standardization, and radiomics features can be highly dependent on acquisition and pre-processing techniques used. In this study, we aim to investigate the effect of various image normalization techniques on robustness of radiomics features extracted from breast cancer patient MRI scans.</div></div><div><h3>Materials and methods</h3><div>MRI scans from the publicly available MAMA-MIA dataset and an internal breast MRI test set depicting triple negative breast cancer (TNBC) were used. We compared the effect of commonly used image normalization techniques on radiomics feature robustnessusing Concordance-Correlation-Coefficient (CCC) between multiple combinations of normalization approaches. We also trained machine learning-based prediction models of pathologic complete response (pCR) on radiomics after different normalization techniques were used and compared their areas under the receiver operating characteristic curve (ROC-AUC).</div></div><div><h3>Results</h3><div>For predicting complete pathological response from pre-treatment breast cancer MRI radiomics, the highest overall ROC-AUC was achieved by using a combination of three different normalization techniques indicating their potentially powerful role when working with heterogeneous imaging data. The effect of normalization was more pronounced with smaller training data and normalization may be less important with increasing abundance of training data. Additionally, we observed considerable differences between MRI data sets and their feature robustness towards normalization.</div></div><div><h3>Conclusion</h3><div>Overall, we were able to demonstrate the importance of selecting and standardizing normalization methods for accurate and reliable radiomics analysis in breast MRI scans especially with small training data sets.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112086"},"PeriodicalIF":3.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preoperative identification of hepatocellular carcinoma from focal liver lesions ≤ 20 mm in high-risk patients using clinical and contrast-enhanced ultrasound features

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

European Journal of Radiology

Pub Date : 2025-03-30 DOI: 10.1016/j.ejrad.2025.112076

Xin-Yuan Hu , Yi-Kang Sun , Yao Miao , Xiao-Ling Chen , Dan Lu , Bo-Yang Zhou , Li-Fan Wang , Chong-Ke Zhao , Hao-Hao Yin , Xiao-Long Li , Zi-Tong Chen , Ya-Qin Zhang , Ming-Rui Zhu , Xin Guan , Er-Xuan Wu , Hong Han , Li-Ping Sun , Qing Lu , Hui-Xiong Xu

Objective

We aimed to develop and validate a prediction model to identify HCC in focal liver lesions (FLLs) ≤20 mm among patients at risk for HCC based on clinical and contrast-enhanced ultrasound (CEUS) features.

Methods

Between January 2022 and July 2023, 386 patients (mean age 58 ± 11 years; 277 male) at risk for HCC with FLLs ≤20 mm and clinical and preoperative CEUS data from three centers were retrospectively enrolled. Three prediction models based on clinical data (Cli-M), CEUS features (CEUS-M), and combined clinical and CEUS features (Com-M) were constructed using the training cohort (187 patients). Their predictive performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) in the internal and external validation cohorts. All patients were reclassified using the American College of Radiology CEUS Liver Imaging Reporting and Data System (CEUS LI-RADS) and combined with the best-performing model (modified LI-RADS).

Results

The AUCs of Com-M were 0.873–0.951 in the training, internal, and external validation cohorts, which were higher than those of Cli-M (0.749–0.795, all P < 0.05) and CEUS-M (0.848–0.899, all P < 0.05). The sensitivity of LR-5 of modified LI-RADS was significantly improved from 83.1 % to 88.9 % (p＜0.001) in the training, internal and external validation cohort while there was no statistical different on its specificity (82.6 %-94.7 % vs 95.7 %-97.6 %., p = 0.162–0.650).

Conclusions

The model based on clinical and CEUS features can help identify HCC in FLLs ≤ 20 mm in high-risk patients.

{"title":"Preoperative identification of hepatocellular carcinoma from focal liver lesions ≤ 20 mm in high-risk patients using clinical and contrast-enhanced ultrasound features","authors":"Xin-Yuan Hu , Yi-Kang Sun , Yao Miao , Xiao-Ling Chen , Dan Lu , Bo-Yang Zhou , Li-Fan Wang , Chong-Ke Zhao , Hao-Hao Yin , Xiao-Long Li , Zi-Tong Chen , Ya-Qin Zhang , Ming-Rui Zhu , Xin Guan , Er-Xuan Wu , Hong Han , Li-Ping Sun , Qing Lu , Hui-Xiong Xu","doi":"10.1016/j.ejrad.2025.112076","DOIUrl":"10.1016/j.ejrad.2025.112076","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to develop and validate a prediction model to identify HCC in focal liver lesions (FLLs) ≤20 mm among patients at risk for HCC based on clinical and contrast-enhanced ultrasound (CEUS) features.</div></div><div><h3>Methods</h3><div>Between January 2022 and July 2023, 386 patients (mean age 58 ± 11 years; 277 male) at risk for HCC with FLLs ≤20 mm and clinical and preoperative CEUS data from three centers were retrospectively enrolled. Three prediction models based on clinical data (Cli-M), CEUS features (CEUS-M), and combined clinical and CEUS features (Com-M) were constructed using the training cohort (187 patients). Their predictive performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) in the internal and external validation cohorts. All patients were reclassified using the American College of Radiology CEUS Liver Imaging Reporting and Data System (CEUS LI-RADS) and combined with the best-performing model (modified LI-RADS).</div></div><div><h3>Results</h3><div>The AUCs of Com-M were 0.873–0.951 in the training, internal, and external validation cohorts, which were higher than those of Cli-M (0.749–0.795, all <em>P</em> < 0.05) and CEUS-M (0.848–0.899, all <em>P</em> < 0.05). The sensitivity of LR-5 of modified LI-RADS was significantly improved from 83.1 % to 88.9 % (p＜0.001) in the training, internal and external validation cohort while there was no statistical different on its specificity (82.6 %-94.7 % vs 95.7 %-97.6 %., p = 0.162–0.650).</div></div><div><h3>Conclusions</h3><div>The model based on clinical and CEUS features can help identify HCC in FLLs ≤ 20 mm in high-risk patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112076"},"PeriodicalIF":3.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776484","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 Node Reporting and Data System (Node-RADS) for standardized MRI evaluation of lymph nodes in endometrial cancer, integrated with clinicopathological and molecular data

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

European Journal of Radiology

Pub Date : 2025-03-29 DOI: 10.1016/j.ejrad.2025.112079

Riccardi Sandrine , Ninkova Roberta Valerieva , Calabrese Alessandro , Curti Federica , Gennarini Marco , Miceli Valentina , Cupertino Angelica , Cutonilli Claudia , Di Donato Violante , Pernazza Angelina , Rizzo Stefania Maria Rita , Panebianco Valeria , Catalano Carlo , Manganaro Lucia

Objectives

To evaluate the diagnostic performance of Node-RADS score using magnetic resonance imaging (MRI) in predicting lymph node involvement (LNI) in patients with endometrial cancer (EC). Additionally, the applicability of the Node-RADS score was evaluated by three readers with different levels of experience in pelvic imaging. Finally, this study investigated the correlation between the Node-RADS score and the extent of myometrial invasion, histological type, lympho vascular invasion (LVI) and molecular subtype.

Methods

Out of 108 cases, 82 patients with histologically confirmed locally advanced EC met the inclusion criteria for retrospective analysis. LNI risk was assessed for each pelvic lymph node station using a Node-RADS score (1–5). Diagnostic accuracy was determined by comparing scores to histologic findings, considered as the gold standard. Three independent readers with different experience levels assigned scores.

Results

The Node-RADS score strongly correlated with histologically confirmed LNI (AUC: 0.832). A cutoff of Node-RADS ≥ 3 optimally detected metastatic lymph nodes, with 85.71 % sensitivity and 76.47 % specificity. Interobserver agreement was high, with κ values of 0.86 (senior vs. junior reader 1) and 0.70 (senior vs. junior reader 2). A significant positive correlation was found between Node-RADS score and myometrial invasion as well as LVI.

Conclusion

Node-RADS score is a reliable, standardized tool for assessing LN stations and enhancing diagnostic accuracy in locoregional staging of EC.

{"title":"The Node Reporting and Data System (Node-RADS) for standardized MRI evaluation of lymph nodes in endometrial cancer, integrated with clinicopathological and molecular data","authors":"Riccardi Sandrine , Ninkova Roberta Valerieva , Calabrese Alessandro , Curti Federica , Gennarini Marco , Miceli Valentina , Cupertino Angelica , Cutonilli Claudia , Di Donato Violante , Pernazza Angelina , Rizzo Stefania Maria Rita , Panebianco Valeria , Catalano Carlo , Manganaro Lucia","doi":"10.1016/j.ejrad.2025.112079","DOIUrl":"10.1016/j.ejrad.2025.112079","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the diagnostic performance of Node-RADS score using magnetic resonance imaging (MRI) in predicting lymph node involvement (LNI) in patients with endometrial cancer (EC). Additionally, the applicability of the Node-RADS score was evaluated by three readers with different levels of experience in pelvic imaging. Finally, this study investigated the correlation between the Node-RADS score and the extent of myometrial invasion, histological type, lympho vascular invasion (LVI) and molecular subtype.</div></div><div><h3>Methods</h3><div>Out of 108 cases, 82 patients with histologically confirmed locally advanced EC met the inclusion criteria for retrospective analysis. LNI risk was assessed for each pelvic lymph node station using a Node-RADS score (1–5). Diagnostic accuracy was determined by comparing scores to histologic findings, considered as the gold standard. Three independent readers with different experience levels assigned scores.</div></div><div><h3>Results</h3><div>The Node-RADS score strongly correlated with histologically confirmed LNI (AUC: 0.832). A cutoff of Node-RADS ≥ 3 optimally detected metastatic lymph nodes, with 85.71 % sensitivity and 76.47 % specificity. Interobserver agreement was high, with κ values of 0.86 (senior vs. junior reader 1) and 0.70 (senior vs. junior reader 2). A significant positive correlation was found between Node-RADS score and myometrial invasion as well as LVI.</div></div><div><h3>Conclusion</h3><div>Node-RADS score is a reliable, standardized tool for assessing LN stations and enhancing diagnostic accuracy in locoregional staging of EC.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112079"},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contrast enhanced ultrasound versus MRI for response assessment of extra-abdominal desmoid Fibromatosis- A feasibility study

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

European Journal of Radiology

Pub Date : 2025-03-29 DOI: 10.1016/j.ejrad.2025.112071

D.S. Dheeksha , Ekta Dhamija , Kalaivani Mani , Sameer Rastogi , Deepam Pushpam , Sameer Bakhshi , S.H. Chandrashekhara , Adarsh Barwad

Background

Desmoid Fibromatosis (DF) is a locally aggressive soft tissue tumor which was traditionally managed with surgical excision. However due to high rates of local recurrence and insights about its behavior, there is now a paradigm shift towards active surveillance and medical management. Imaging plays a crucial role in surveillance and treatment response; however, conventional RECIST criteria are not adequate for DF. MRI is the preferred modality but faces limitation in availability and uniformity. Although ultrasound (US) is not optimal for evaluation, contrast enhanced US has shown promising results in many solid tumors.

Objectives

To explore the role of Contrast Enhanced Ultrasound (CEUS) as a response assessment tool in DF.

Materials and Methods

This was a prospective study conducted between March 2022 and December 2023 and included 21 adults with DF who received medical line of treatment. A combination of clinical evaluation for symptom relief, and imaging modalities using MRI and CEUS, were utilized for response assessment. Statistical analysis was performed using non parametric tests.

Results

Out of 21, 19 patients underwent pre as well as post-treatment evaluation. Clinical improvement was reported by 73.68 % while MRI indicated response only in 41.18 %; whereas only 29.41 % met the criteria for partial response according to RECIST 1.1. All responders on MRI exhibited continued enhancement on CEUS with a significant decrease in Mean Transit Time (MTT, p = 0.047).

Conclusion

CEUS demonstrates potential as an effective treatment response tool in DF, providing real-time information of microvascular changes within the mass.

{"title":"Contrast enhanced ultrasound versus MRI for response assessment of extra-abdominal desmoid Fibromatosis- A feasibility study","authors":"D.S. Dheeksha , Ekta Dhamija , Kalaivani Mani , Sameer Rastogi , Deepam Pushpam , Sameer Bakhshi , S.H. Chandrashekhara , Adarsh Barwad","doi":"10.1016/j.ejrad.2025.112071","DOIUrl":"10.1016/j.ejrad.2025.112071","url":null,"abstract":"<div><h3>Background</h3><div>Desmoid Fibromatosis (DF) is a locally aggressive soft tissue tumor which was traditionally managed with surgical excision. However due to high rates of local recurrence and insights about its behavior, there is now a paradigm shift towards active surveillance and medical management. Imaging plays a crucial role in surveillance and treatment response; however, conventional RECIST criteria are not adequate for DF. MRI is the preferred modality but faces limitation in availability and uniformity. Although ultrasound (US) is not optimal for evaluation, contrast enhanced US has shown promising results in many solid tumors.</div></div><div><h3>Objectives</h3><div>To explore the role of Contrast Enhanced Ultrasound (CEUS) as a response assessment tool in DF.</div></div><div><h3>Materials and Methods</h3><div>This was a prospective study conducted between March 2022 and December 2023 and included 21 adults with DF who received medical line of treatment. A combination of clinical evaluation for symptom relief, and imaging modalities using MRI and CEUS, were utilized for response assessment. Statistical analysis was performed using non parametric tests.</div></div><div><h3>Results</h3><div>Out of 21, 19 patients underwent pre as well as post-treatment evaluation. Clinical improvement was reported by 73.68 % while MRI indicated response only in 41.18 %; whereas only 29.41 % met the criteria for partial response according to RECIST 1.1. All responders on MRI exhibited continued enhancement on CEUS with a significant decrease in Mean Transit Time (MTT, p = 0.047).</div></div><div><h3>Conclusion</h3><div>CEUS demonstrates potential as an effective treatment response tool in DF, providing real-time information of microvascular changes within the mass.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112071"},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768482","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

Advancements in diagnosing stiffness and vascularization of synovitis in hands and wrists using shear wave elastography and power doppler ultrasound in patients with systemic lupus erythematosus 利用剪切波弹性成像和功率多普勒超声诊断系统性红斑狼疮患者手部和腕部滑膜炎的僵硬度和血管化的进展

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

European Journal of Radiology

Pub Date : 2025-03-29 DOI: 10.1016/j.ejrad.2025.112072

Salvatore Marsico , Laura Tío , Irene Carrión-Barberà , Patricia Corzo , José María Maiques-Llácer , Albert Solano , Jordi Monfort , Tarek Carlos Salman-Monte

<div><h3>Rationale and Objectives</h3><div>This study aimed to compare synovial joint effusion stiffness and vascularization using shear wave elastography (SWE) and Power Doppler ultrasound (PDU) among systemic lupus erythematosus (SLE) patients with varying joint symptoms and healthy controls and to explore associations with patient characteristics.</div></div><div><h3>Methods</h3><div>This cross-sectional study, conducted between February 2021 and April 2023, included 60 SLE patients and a demographically matched healthy control group. The SLE patients were divided into three groups: those with active wrist/hand arthritis (G1), inflammatory arthralgia (G2), and no joint symptoms (G3). B-mode, SWE, and PDU assessments were performed on the non-dominant hand to evaluate synovial joint stiffness. Data on demographics, clinical presentations, serological markers, and patient-reported outcomes were analyzed.</div></div><div><h3>Results</h3><div>A total of 80 participants were included, with no significant demographic differences between groups. SLE patients exhibited significantly higher stiffness values than controls in the radiocarpal (p = 0.004), ulnocarpal (p = 0.051), and metacarpophalangeal joints (p = 0.038, p = 0.002). Among these, the ulnocarpal joint showed the highest differences in stiffness values. No significant differences in stiffness were observed among SLE groups. However, positive Doppler findings were associated with higher SLICC-SDI scores (p = 0.005), and a positive correlation was found between the number of Doppler-positive joints and SLICC-SDI scores (r = 0.438, p < 0.001). Importantly, subclinical synovitis was observed in asymptomatic patients (G3), as demonstrated by significantly elevated stiffness in key joints compared to controls.</div></div><div><h3>Conclusions</h3><div>SLE patients exhibited higher stiffness values compared to controls, indicating subclinical synovitis even in asymptomatic individuals. Key findings suggest that the radiocarpal and ulnocarpal joints are particularly affected and should be prioritized in imaging protocols. The integration of SWE and PDU into routine SLE assessments can facilitate earlier diagnosis, enabling prompt treatment and reducing the risk of cumulative joint damage. SWE and PDU are valuable for the early detection and treatment of musculoskeletal changes. By identifying subclinical synovitis, these techniques not only improve patient monitoring but also help tailor therapeutic strategies to individual disease activity.</div><div>The correlation with higher SLICC-SDI scores underscores the critical role of joint evaluation in preventing long-term damage and enhancing care management. Moving forward, refining imaging protocols to standardize SWE and PDU application in SLE is essential. Additionally, exploring the utility of these techniques in other joints, such as the knees and ankles, may provide further insights into the extent of subclinical involvement across the musculos

这项研究旨在使用剪切波弹性成像（SWE）和动力多普勒超声（PDU）比较具有不同关节症状的系统性红斑狼疮（SLE）患者和健康对照组的滑膜关节渗出僵硬度和血管化情况，并探讨与患者特征之间的关联。系统性红斑狼疮患者分为三组：活动性腕/手关节炎组（G1）、炎性关节痛组（G2）和无关节症状组（G3）。对非惯用手进行 B 型、SWE 和 PDU 评估，以评估滑膜关节僵硬程度。对人口统计学、临床表现、血清学标志物和患者报告结果等数据进行了分析。系统性红斑狼疮患者的桡腕关节（p = 0.004）、尺桡关节（p = 0.051）和掌指关节（p = 0.038，p = 0.002）的僵硬度值明显高于对照组。其中，尺指关节的硬度值差异最大。系统性红斑狼疮各组之间的关节僵硬度无明显差异。然而，多普勒阳性结果与较高的 SLICC-SDI 评分相关（p = 0.005），多普勒阳性关节数量与 SLICC-SDI 评分之间呈正相关（r = 0.438，p <0.001）。重要的是，在无症状的患者（G3）中观察到了亚临床滑膜炎，与对照组相比，关键关节的僵硬度明显升高。主要研究结果表明，桡腕关节和尺桡关节尤其受到影响，应在成像方案中优先考虑。将SWE和PDU纳入系统性红斑狼疮的常规评估中，可促进早期诊断、及时治疗并降低累积性关节损伤的风险。SWE和PDU对于早期发现和治疗肌肉骨骼病变很有价值。通过鉴别亚临床滑膜炎，这些技术不仅能改善对患者的监测，还有助于根据个体的疾病活动度制定治疗策略。SLICC-SDI评分较高的相关性强调了关节评估在预防长期损害和加强护理管理方面的关键作用。展望未来，完善成像方案以规范系统性红斑狼疮的 SWE 和 PDU 应用至关重要。此外，探索这些技术在其他关节（如膝关节和踝关节）中的应用，可进一步了解整个肌肉骨骼系统亚临床受累的程度。

{"title":"Advancements in diagnosing stiffness and vascularization of synovitis in hands and wrists using shear wave elastography and power doppler ultrasound in patients with systemic lupus erythematosus","authors":"Salvatore Marsico , Laura Tío , Irene Carrión-Barberà , Patricia Corzo , José María Maiques-Llácer , Albert Solano , Jordi Monfort , Tarek Carlos Salman-Monte","doi":"10.1016/j.ejrad.2025.112072","DOIUrl":"10.1016/j.ejrad.2025.112072","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>This study aimed to compare synovial joint effusion stiffness and vascularization using shear wave elastography (SWE) and Power Doppler ultrasound (PDU) among systemic lupus erythematosus (SLE) patients with varying joint symptoms and healthy controls and to explore associations with patient characteristics.</div></div><div><h3>Methods</h3><div>This cross-sectional study, conducted between February 2021 and April 2023, included 60 SLE patients and a demographically matched healthy control group. The SLE patients were divided into three groups: those with active wrist/hand arthritis (G1), inflammatory arthralgia (G2), and no joint symptoms (G3). B-mode, SWE, and PDU assessments were performed on the non-dominant hand to evaluate synovial joint stiffness. Data on demographics, clinical presentations, serological markers, and patient-reported outcomes were analyzed.</div></div><div><h3>Results</h3><div>A total of 80 participants were included, with no significant demographic differences between groups. SLE patients exhibited significantly higher stiffness values than controls in the radiocarpal (p = 0.004), ulnocarpal (p = 0.051), and metacarpophalangeal joints (p = 0.038, p = 0.002). Among these, the ulnocarpal joint showed the highest differences in stiffness values. No significant differences in stiffness were observed among SLE groups. However, positive Doppler findings were associated with higher SLICC-SDI scores (p = 0.005), and a positive correlation was found between the number of Doppler-positive joints and SLICC-SDI scores (r = 0.438, p < 0.001). Importantly, subclinical synovitis was observed in asymptomatic patients (G3), as demonstrated by significantly elevated stiffness in key joints compared to controls.</div></div><div><h3>Conclusions</h3><div>SLE patients exhibited higher stiffness values compared to controls, indicating subclinical synovitis even in asymptomatic individuals. Key findings suggest that the radiocarpal and ulnocarpal joints are particularly affected and should be prioritized in imaging protocols. The integration of SWE and PDU into routine SLE assessments can facilitate earlier diagnosis, enabling prompt treatment and reducing the risk of cumulative joint damage. SWE and PDU are valuable for the early detection and treatment of musculoskeletal changes. By identifying subclinical synovitis, these techniques not only improve patient monitoring but also help tailor therapeutic strategies to individual disease activity.</div><div>The correlation with higher SLICC-SDI scores underscores the critical role of joint evaluation in preventing long-term damage and enhancing care management. Moving forward, refining imaging protocols to standardize SWE and PDU application in SLE is essential. Additionally, exploring the utility of these techniques in other joints, such as the knees and ankles, may provide further insights into the extent of subclinical involvement across the musculos","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112072"},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783848","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

Accuracy of a deep neural network for automated pulmonary embolism detection on dedicated CT pulmonary angiograms

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

European Journal of Radiology

Pub Date : 2025-03-29 DOI: 10.1016/j.ejrad.2025.112077

Emese Zsarnoczay , Saikiran Rapaka , U.Joseph Schoepf , Chiara Gnasso , Milan Vecsey-Nagy , Thomas M. Todoran , Muhammad Taha Hagar , Dmitrij Kravchenko , Giuseppe Tremamunno , Joseph Parkwood Griffith , Nicola Fink , Sydney Derrick , Meredith Bowman , Henry Sam , Mikayla Tiller , Kathleen Godoy , Florin Condrea , Puneet Sharma , Jim O’Doherty , Pal Maurovich-Horvat , Akos Varga-Szemes

Purpose

To assess the performance of a Deep Neural Network (DNN)-based prototype algorithm for automated PE detection on CTPA scans.

Methods

Patients who had previously undergone CTPA with three different systems (SOMATOM Force, go.Top, and Definition AS; Siemens Healthineers, Forchheim, Germany) because of suspected PE from September 2022 to January 2023 were retrospectively enrolled in this study (n = 1,000, 58.8 % women). For detailed evaluation, all PE were divided into three location-based subgroups: central arteries, lobar branches, and peripheral regions. Clinical reports served as ground truth. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were determined to evaluate the performance of DNN-based PE detection.

Results

Cases were excluded due to incomplete data (n = 32), inconclusive report (n = 17), insufficient contrast detected in the pulmonary trunk (n = 40), or failure of the preprocessing algorithms (n = 8). Therefore, the final cohort included 903 cases with a PE prevalence of 12 % (n = 110). The model achieved a sensitivity, specificity, PPV, and NPV of 84.6, 95.1, 70.5, and 97.8 %, respectively, and delivered an overall accuracy of 93.8 %. Among the false positive cases (n = 39), common sources of error included lung masses, pneumonia, and contrast flow artifacts. Common sources of false negatives (n = 17) included chronic and subsegmental PEs.

Conclusion

The proposed DNN-based algorithm provides excellent performance for the detection of PE, suggesting its potential utility to support radiologists in clinical reading and exam prioritization.

{"title":"Accuracy of a deep neural network for automated pulmonary embolism detection on dedicated CT pulmonary angiograms","authors":"Emese Zsarnoczay , Saikiran Rapaka , U.Joseph Schoepf , Chiara Gnasso , Milan Vecsey-Nagy , Thomas M. Todoran , Muhammad Taha Hagar , Dmitrij Kravchenko , Giuseppe Tremamunno , Joseph Parkwood Griffith , Nicola Fink , Sydney Derrick , Meredith Bowman , Henry Sam , Mikayla Tiller , Kathleen Godoy , Florin Condrea , Puneet Sharma , Jim O’Doherty , Pal Maurovich-Horvat , Akos Varga-Szemes","doi":"10.1016/j.ejrad.2025.112077","DOIUrl":"10.1016/j.ejrad.2025.112077","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the performance of a Deep Neural Network (DNN)-based prototype algorithm for automated PE detection on CTPA scans.</div></div><div><h3>Methods</h3><div>Patients who had previously undergone CTPA with three different systems (SOMATOM Force, go.Top, and Definition AS; Siemens Healthineers, Forchheim, Germany) because of suspected PE from September 2022 to January 2023 were retrospectively enrolled in this study (n = 1,000, 58.8 % women). For detailed evaluation, all PE were divided into three location-based subgroups: central arteries, lobar branches, and peripheral regions. Clinical reports served as ground truth. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were determined to evaluate the performance of DNN-based PE detection.</div></div><div><h3>Results</h3><div>Cases were excluded due to incomplete data (n = 32), inconclusive report (n = 17), insufficient contrast detected in the pulmonary trunk (n = 40), or failure of the preprocessing algorithms (n = 8). Therefore, the final cohort included 903 cases with a PE prevalence of 12 % (n = 110). The model achieved a sensitivity, specificity, PPV, and NPV of 84.6, 95.1, 70.5, and 97.8 %, respectively, and delivered an overall accuracy of 93.8 %. Among the false positive cases (n = 39), common sources of error included lung masses, pneumonia, and contrast flow artifacts. Common sources of false negatives (n = 17) included chronic and subsegmental PEs.</div></div><div><h3>Conclusion</h3><div>The proposed DNN-based algorithm provides excellent performance for the detection of PE, suggesting its potential utility to support radiologists in clinical reading and exam prioritization.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112077"},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Very rare adverse reactions to intravascular contrast media: From Kounis to sweet syndrome

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

European Journal of Radiology

Pub Date : 2025-03-25 DOI: 10.1016/j.ejrad.2025.112066

Aart J. van der Molen , José J. Laguna , Annick A.J.M van de Ven , Francisco Vega

Intravascular administration of contrast media may inadvertently result in adverse drug reactions (ADR) including selected hypersensitivity reactions. This review highlights some very rare ADR, aiming to alert imaging physicians to these conditions and to prompt adequate management. This is particularly relevant for Kounis syndrome, an immediate hypersensitivity reaction involving the coronary arteries. The acute management of Kounis syndrome can be challenging, as it requires continued contrast media administration, while balancing the simultaneous coronary reperfusion that requires vasodilatation with anti-allergic treatment that may involve vasoconstrictor agents. For other adverse reactions, referral to a drug allergy specialist is highly recommended to assess causality and identify safe alternatives.

Clinical Relevance Statement

Cardiologists and radiologists must recognize the key symptoms of these very rare adverse reactions to contrast media to promptly initiate the appropriate therapy and refer patients for allergological evaluation, ideally within 1–6 months after the reaction.

{"title":"Very rare adverse reactions to intravascular contrast media: From Kounis to sweet syndrome","authors":"Aart J. van der Molen , José J. Laguna , Annick A.J.M van de Ven , Francisco Vega","doi":"10.1016/j.ejrad.2025.112066","DOIUrl":"10.1016/j.ejrad.2025.112066","url":null,"abstract":"<div><div>Intravascular administration of contrast media may inadvertently result in adverse drug reactions (ADR) including selected hypersensitivity reactions. This review highlights some very rare ADR, aiming to alert imaging physicians to these conditions and to prompt adequate management. This is particularly relevant for Kounis syndrome, an immediate hypersensitivity reaction involving the coronary arteries. The acute management of Kounis syndrome can be challenging, as it requires continued contrast media administration, while balancing the simultaneous coronary reperfusion that requires vasodilatation with anti-allergic treatment that may involve vasoconstrictor agents. For other adverse reactions, referral to a drug allergy specialist is highly recommended to assess causality and identify safe alternatives.</div></div><div><h3>Clinical Relevance Statement</h3><div>Cardiologists and radiologists must recognize the key symptoms of these very rare adverse reactions to contrast media to promptly initiate the appropriate therapy and refer patients for allergological evaluation, ideally within 1–6 months after the reaction.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112066"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The age and gender-dependent changes in pulmonary arterial flow distribution: A cardiac magnetic resonance flow study

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

European Journal of Radiology

Pub Date : 2025-03-24 DOI: 10.1016/j.ejrad.2025.112064

Gülbanu Güner, Safiye Sanem Dereli Bulut

Objective

To investigate whether the pulmonary artery blood flow distribution in the normal population changes depending on age and gender using the Cardiac Magnetic Resonance Phase Contrast Imaging method.

Materials and methods

A total of 62 healthy volunteers aged 20–60 years were included in the study between September 2020 and November 2021. Participants were first divided into two groups according to their age (group 120–40 years old, group 2: 40–60 years old). Then, each group was divided into two according to gender (groups 1A, 1B and groups 2A, 2B). After routine MR sequences of mediastinum and heart (True Fast Imaging with Steady State Free Precession, short axis for heart (SA), 4-chamber, 2-chamber and 3-chamber CINE sequence). Phase Contrast imaging was performed to Main Pulmonary Artery (MPA), right PA and left PA. On the phase contrast (PC) images obtained, flow velocity, forward flow, backward flow and net forward flow volume and gradient were calculated for each artery. With these data, the distribution ratio for both pulmonary arteries was calculated. Measurements were made simultaneously by two radiologists.

Results

In phase contrast sequence evaluation; No statistically significant correlation was found between RPA/LPA distribution ratio and Group 1 (p > 0.05). A moderate and positive correlation was found statistically between RPA/LPA distribution ratio and Group 2 (r:0.42, p:0.04). No statistically significant correlation was found between the RPA/LPA distribution ratio and the gender variable (p:0.59).

Conclusion

The distribution ratio of pulmonary blood flow to both lungs in healthy volunteers can be measured using PC-CMR without the need for invasive procedures. Knowing the normal distribution ratios according to age in the population can be used for the early diagnosis of pathological conditions.

{"title":"The age and gender-dependent changes in pulmonary arterial flow distribution: A cardiac magnetic resonance flow study","authors":"Gülbanu Güner, Safiye Sanem Dereli Bulut","doi":"10.1016/j.ejrad.2025.112064","DOIUrl":"10.1016/j.ejrad.2025.112064","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate whether the pulmonary artery blood flow distribution in the normal population changes depending on age and gender using the Cardiac Magnetic Resonance Phase Contrast Imaging method.</div></div><div><h3>Materials and methods</h3><div>A total of 62 healthy volunteers aged 20–60 years were included in the study between September 2020 and November 2021. Participants were first divided into two groups according to their age (group 120–40 years old, group 2: 40–60 years old). Then, each group was divided into two according to gender (groups 1A, 1B and groups 2A, 2B). After routine MR sequences of mediastinum and heart (True Fast Imaging with Steady State Free Precession, short axis for heart (SA), 4-chamber, 2-chamber and 3-chamber CINE sequence). Phase Contrast imaging was performed to Main Pulmonary Artery (MPA), right PA and left PA. On the phase contrast (PC) images obtained, flow velocity, forward flow, backward flow and net forward flow volume and gradient were calculated for each artery. With these data, the distribution ratio for both pulmonary arteries was calculated. Measurements were made simultaneously by two radiologists<strong>.</strong></div></div><div><h3>Results</h3><div>In phase contrast sequence evaluation; No statistically significant correlation was found between RPA/LPA distribution ratio and Group 1 (p > 0.05). A moderate and positive correlation was found statistically between RPA/LPA distribution ratio and Group 2 (r:0.42, p:0.04). No statistically significant correlation was found between the RPA/LPA distribution ratio and the gender variable (p:0.59).</div></div><div><h3>Conclusion</h3><div>The distribution ratio of pulmonary blood flow to both lungs in healthy volunteers can be measured using PC-CMR without the need for invasive procedures. Knowing the normal distribution ratios according to age in the population can be used for the early diagnosis of pathological conditions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112064"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715208","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

Prediction of postoperative pancreatic fistula based on multi-sequence MR imaging

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

European Journal of Radiology

Pub Date : 2025-03-22 DOI: 10.1016/j.ejrad.2025.112067

Xiaoyang Li , Kuinan Tong , Tianxin Cheng , Piao Yan , Hui Xu , Kun Liu , Rui Xu , Jun Lu , Zhenghan Yang , Hongwei Wu

Objective

To investigate the value of conventional MRI sequences in predicting the occurrence of postoperative pancreatic fistula (POPF) in patients undergoing pancreaticoduodenectomy (PD).

Methods

A total of 122 patients from August 2019 to April 2023 were enrolled. All patients underwent pancreatic histological evaluation, including fibrosis, fat deposition, and acinar cell atrophy. The preoperative image features of pancreas were obtained, including morphological features, pancreas-muscle signal intensity ratio, pancreatic fat fraction and multi-phase enhancement features. The patients were divided into two groups according to whether pancreatic fistula occurred after operation. The related risk factors of pancreatic fistula, the correlation between imaging and pathological changes were analyzed, and the value of preoperative imaging in predicting pancreatic fistula was evaluated.

Results

Of the 122 patients, 23(18.9 %) developed POPF. Pathological score showed that there was a significant difference in pancreatic fat deposition between the two groups (P = 0.006), the fat deposition score was higher in the POPF group. Pancreatic fat deposition was the only independent risk factor for POPF(OR,1.933; P = 0.018). MRI showed that proton density fat fraction(PDFF) (P = 0.001), pancreas-to-aorta signal intensity ratio(P-A SI ratio) of equilibrium phase(P = 0.023) and delay phase(P = 0.020) had significant differences. PDFF was positively correlated with fat deposition(r = 0.404, P < 0.001), P-A SI ratio of equilibrium phase and delay phase were positively correlated with fibrosis(r = 0.313, P = 0.002; r = 0.315, P = 0.002, respectively). ROC analysis showed that PDFF had the best efficacy in predicting postoperative pancreatic fistula (AUROC = 0.810), better than P-A SI ratio of equilibrium phase(AUROC = 0.752) and delayed phase(AUROC = 0.766).

Conclusions

Pancreatic fat deposition is a high risk factor for POPF, PDFF can reflect fat deposition and predict POPF.

{"title":"Prediction of postoperative pancreatic fistula based on multi-sequence MR imaging","authors":"Xiaoyang Li , Kuinan Tong , Tianxin Cheng , Piao Yan , Hui Xu , Kun Liu , Rui Xu , Jun Lu , Zhenghan Yang , Hongwei Wu","doi":"10.1016/j.ejrad.2025.112067","DOIUrl":"10.1016/j.ejrad.2025.112067","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the value of conventional MRI sequences in predicting the occurrence of postoperative pancreatic fistula (POPF) in patients undergoing pancreaticoduodenectomy (PD).</div></div><div><h3>Methods</h3><div>A total of 122 patients from August 2019 to April 2023 were enrolled. All patients underwent pancreatic histological evaluation, including fibrosis, fat deposition, and acinar cell atrophy. The preoperative image features of pancreas were obtained, including morphological features, pancreas-muscle signal intensity ratio, pancreatic fat fraction and multi-phase enhancement features. The patients were divided into two groups according to whether pancreatic fistula occurred after operation. The related risk factors of pancreatic fistula, the correlation between imaging and pathological changes were analyzed, and the value of preoperative imaging in predicting pancreatic fistula was evaluated.</div></div><div><h3>Results</h3><div>Of the 122 patients, 23(18.9 %) developed POPF. Pathological score showed that there was a significant difference in pancreatic fat deposition between the two groups (P = 0.006), the fat deposition score was higher in the POPF group. Pancreatic fat deposition was the only independent risk factor for POPF(OR,1.933; P = 0.018). MRI showed that proton density fat fraction(PDFF) (P = 0.001), pancreas-to-aorta signal intensity ratio(P-A SI ratio) of equilibrium phase(P = 0.023) and delay phase(P = 0.020) had significant differences. PDFF was positively correlated with fat deposition(r = 0.404, P < 0.001), P-A SI ratio of equilibrium phase and delay phase were positively correlated with fibrosis(r = 0.313, P = 0.002; r = 0.315, P = 0.002, respectively). ROC analysis showed that PDFF had the best efficacy in predicting postoperative pancreatic fistula (AUROC = 0.810), better than P-A SI ratio of equilibrium phase(AUROC = 0.752) and delayed phase(AUROC = 0.766).</div></div><div><h3>Conclusions</h3><div>Pancreatic fat deposition is a high risk factor for POPF, PDFF can reflect fat deposition and predict POPF.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"186 ","pages":"Article 112067"},"PeriodicalIF":3.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697973","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