European Journal of Radiology最新文献_第3页

Discrepancies in ASPECTS obtained by artificial intelligence and experts: Associated factors and prognostic implications 人工智能和专家获得的 ASPECTS 存在差异：相关因素和预后影响。

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

European Journal of Radiology

Pub Date : 2024-08-28 DOI: 10.1016/j.ejrad.2024.111708

Purpose

The differences between the Alberta Stroke Program Early CT Score (ASPECTS) obtained by experts and artificial intelligence (AI) software require elucidation. We aimed to characterize the discrepancies between the ASPECTS obtained by AI and experts and determine the associated factors and prognostic implications.

Methods

This multicenter, retrospective, observational cohort study included patients showing acute ischemic stroke caused by large-vessel occlusion in the anterior circulation. ASPECTS was determined by AI software (RAPID ASPECTS) and experts from the core laboratory. Interclass correlation coefficients (ICCs) and Bland–Altman plots were used to illustrate the consistency and discrepancies; logistic regression analyses were used to assess the correlates of inconsistency; and receiver operating characteristic analyses were performed to assess the diagnostic performance for predicting unfavorable clinical outcomes.

Results

The study population included 491 patients. The ICC for the expert and AI ASPECTS was 0.63 (95 % confidence interval [CI]: 0.25–0.79).The mean difference between expert and AI ASPECTS was 2.24. Chronic infarcts (odds ratio [OR], 1.9; 95 % CI, 1.1–3.4; P=0.021) and expert scores in the internal capsule (OR, 2.9; 95 % CI, 1.1–7.7; P=0.034) and lentiform (OR, 2.4; 95 % CI, 1.3–4.7; P=0.008) were significant correlates of inconsistency. The ASPECTS obtained by AI showed a significantly higher area under the curve for unfavorable outcomes (0.68 vs. 0.63, P=0.04).

Conclusions

In comparison with expert ASPECTS, AI ASPECTS overestimated the infarct extent. Future studies should aim to determine whether AI ASPECTS assessments should use a lower threshold to screen patients for endovascular therapy.

目的：专家和人工智能（AI）软件获得的阿尔伯塔省卒中计划早期 CT 评分（ASPECTS）之间的差异需要澄清。我们旨在描述人工智能和专家获得的 ASPECTS 之间的差异，并确定相关因素和预后影响：这项多中心、回顾性、观察性队列研究纳入了前循环大血管闭塞导致的急性缺血性卒中患者。ASPECTS 由人工智能软件（RAPID ASPECTS）和核心实验室的专家测定。类间相关系数（ICC）和Bland-Altman图用于说明一致性和差异；逻辑回归分析用于评估不一致性的相关因素；接受者操作特征分析用于评估预测不利临床结果的诊断性能：研究对象包括491名患者。专家和 AI ASPECTS 的 ICC 为 0.63（95 % 置信区间 [CI]：0.25-0.79）。慢性梗死（几率比[OR]，1.9；95 % CI，1.1-3.4；P=0.021）和专家在内囊（OR，2.9；95 % CI，1.1-7.7；P=0.034）和皮孔（OR，2.4；95 % CI，1.3-4.7；P=0.008）的评分不一致有显著相关性。通过人工智能获得的 ASPECTS 显示，不利结果的曲线下面积明显更高（0.68 vs. 0.63，P=0.04）：结论：与专家 ASPECTS 相比，AI ASPECTS 高估了梗死范围。未来的研究应旨在确定 AI ASPECTS 评估是否应使用较低的阈值来筛选接受血管内治疗的患者。

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引用次数: 0

The relationship between imaging-based body composition abnormalities and long-term mortality in patients with liver cirrhosis 肝硬化患者基于影像的身体成分异常与长期死亡率之间的关系

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

European Journal of Radiology

Pub Date : 2024-08-26 DOI: 10.1016/j.ejrad.2024.111707

Background

Emerging evidence on cirrhosis suggests a close correlation between abnormality in body composition characteristics and poor prognosis. This study aimed to evaluate the impact of dynamic changes in body composition on the prognostic outcomes in patients with cirrhosis.

Methods

This retrospective analysis included 158 patients diagnosed as cirrhosis from January 2018 to August 2023. Skeletal muscle mass, muscle quality, visceral and subcutaneous adiposity were evaluated using computed tomography (CT) imaging at the third lumbar vertebra level. Competing risk model was performed four different body composition status (i.e., normal, only sarcopenia, only myosteatosis, and combined status) for liver-related mortality. We also explored the relationship between the dynamic change in body composition and long-term prognosis by applying Gray’s test.

Results

Of the 158 cirrhotic patients (mean [SD] age, 57.1 [12.6] years), sarcopenia was present in 85 (60.1 %) patients, while 22 (13.9 %) patients had sarcopenic obesity and 68 (43.0 %) had myosteatosis. Patients solely diagnosed with sarcopenia exhibited a higher mortality rate compared to those with normal body composition (Gray’s test, P=0.006), while patients solely diagnosed with myosteatosis or with a combination of sarcopenia and myosteatosis did not reach statistical significance (Gray’s test, P=0.076; P=0.140). Multivariable analysis also revealed that VSR (HR=1.10 [1.01∼1.20]; P=0.028), sarcopenia (HR=2.73 [1.20∼6.22], P=0.017) and myosteatosis (HR=2.39 [1.10∼5.18], P=0.028) were significant independent predictors of liver-related deaths. Otherwise, patients exhibiting aggravating body composition during follow-up period were associated with a significantly higher mortality risk compared to those with normal or remission body composition status (HR=7.63 [1.12∼51.14]; P=0.036).

Conclusion

Progressive alterations in body composition status appears to be associated with liver-related mortality in individuals with liver cirrhosis. Focusing on the management of skeletal muscle, along with visceral and subcutaneous adiposity, may contribute to improving the prognosis of cirrhotic patients.

背景有关肝硬化的最新证据表明，身体成分特征异常与预后不良之间存在密切联系。本研究旨在评估身体成分的动态变化对肝硬化患者预后的影响。方法本回顾性分析纳入了 2018 年 1 月至 2023 年 8 月期间确诊为肝硬化的 158 例患者。使用第三腰椎水平的计算机断层扫描（CT）成像评估骨骼肌质量、肌肉质量、内脏和皮下脂肪含量。针对肝脏相关死亡率，我们建立了四种不同身体成分状态（即正常、仅肌少症、仅肌骨质疏松症和综合状态）的竞争风险模型。结果在 158 名肝硬化患者中（平均 [SD] 年龄为 57.1 [12.6] 岁），有 85 名患者（60.1%）患有肌肉疏松症，22 名患者（13.9%）患有肌肉疏松性肥胖症，68 名患者（43.0%）患有肌骨质疏松症。与身体成分正常的患者相比，单纯被诊断为肌少症的患者死亡率更高（格雷氏检验，P=0.006），而单纯被诊断为肌骨软化症的患者或同时患有肌少症和肌骨软化症的患者则没有统计学意义（格雷氏检验，P=0.076；P=0.140）。多变量分析还显示，VSR（HR=1.10 [1.01∼1.20]；P=0.028）、肌肉疏松症（HR=2.73 [1.20∼6.22]；P=0.017）和肌骨疏松症（HR=2.39 [1.10∼5.18]；P=0.028）是肝脏相关死亡的重要独立预测因素。此外，与身体成分状况正常或缓解的患者相比，随访期间身体成分状况恶化的患者的死亡风险明显更高（HR=7.63 [1.12∼51.14]；P=0.036）。关注骨骼肌以及内脏和皮下脂肪的管理可能有助于改善肝硬化患者的预后。

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引用次数: 0

Under pressure – Association of the arm position and leading circulatory structure behind the pressure point in cardiopulmonary resuscitation patients 压力下 - 心肺复苏患者手臂位置与受压点后主导循环结构的关联

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

European Journal of Radiology

Pub Date : 2024-08-25 DOI: 10.1016/j.ejrad.2024.111706

Background

Thoracic computed tomography scans (CT) are used by several study groups to investigate the circulatory structures (heart and vessels) located behind the pressure point for chest compressions. Yet, it remains unclear how the positioning of these structures is influenced by factors such as intubation, the respiratory cycle and arm positioning.

Methods

We retrospectively analyzed data of adult patients with in- or out-of-hospital cardiac arrest who underwent thoracic CT imaging within one year before or up to six months after arrest. A region of interest (ROI) behind the pressure point was defined. The largest structure within this region was defined as “leading circulatory structure”, which was the primary outcome. Airway status (intubated versus spontaneous breathing), respiratory cycle (inspiration, expiration, resting expiratory position), and arm position (up over the head versus down beside the trunk) served as covariates in an ordinal regression model.

Results

Among 500 initially screened patients, 411 (82.2 %) were included in the analysis. There was a significant association between the arm position and the leading circulatory structure behind the pressure point. However, no association was found with airway status or respiratory cycle. The most frequently identified leading circulatory structure was the left atrium (arms up: 41.8 %, down: 50.7 %), followed by the ascending aorta (up: 23.8 % vs. down: 16.7 %). The left ventricle was the leading structure in only one case (0.2 %, arms down).

Conclusion

This study shows that arm position is significantly associated with the leading circulatory structure behind the pressure point for chest compressions in cardiac arrest.

背景一些研究小组使用胸部计算机断层扫描（CT）来研究位于胸外按压压力点后方的循环结构（心脏和血管）。方法我们回顾性分析了院内或院外心脏骤停成年患者的数据，这些患者在心脏骤停前一年内或骤停后六个月内接受了胸部 CT 成像检查。我们定义了压力点后方的感兴趣区（ROI）。该区域内最大的结构被定义为 "主要循环结构"，这是主要结果。气道状态（插管与自主呼吸）、呼吸周期（吸气、呼气、静息呼气位置）和手臂位置（举过头顶与垂于躯干旁）是序数回归模型中的协变量。手臂位置与受压点后的主导循环结构之间存在明显关联。但与气道状态或呼吸周期没有关联。最常见的主导循环结构是左心房（手臂向上：41.8%，向下：50.7%），其次是升主动脉（向上：23.8%，向下：16.7%）。结论这项研究表明，手臂位置与心脏骤停时胸外按压压力点后的主要循环结构有显著关联。

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引用次数: 0

Quantitative diagnosis of carotid blowout syndrome with CT perfusion 利用 CT 灌注定量诊断颈动脉爆裂综合征

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

European Journal of Radiology

Pub Date : 2024-08-24 DOI: 10.1016/j.ejrad.2024.111705

Background and purpose

Carotid blowout syndrome (CBS) is a potentially fatal disease. The CBS diagnosis mainly relies on subjective observations and the quantitative diagnotic method was not well established. This study aimed to diagnose CBS severity by computed tomography perfusion (CTP) parameters with different region-of-interest (ROI) models.

Materials and Method

We prospectively recruited CBS patients between February 1, 2018 and July 31, 2023 in a tertiary medical center, and CTP was performed using the same 128-detector CT machine. Digital subtraction angiography (DSA) and elective endovascular intervention were performed within 3 days post-CTP for diagnosis confirmation and treatments. CBS severity was classified into ongoing (threatened + impending) or acute CBS based on DSA findings and clinical features. Pericarotid soft-tissue (PCST) CTP parameters, including blood flow (BF), blood volume (BV), mean transit time (MTT) and flow extraction product (FEP), were evaluated and correlated on DSA. We depicted models A, B and C for the small focal lesion in 1 cm of PCST, 1 cm around PCST and the whole PCST respectively.

Results

CTP images of 110 patients (77 ongoing (45 threatened + 32 impending); 33 acute) were analyzed. Pericarotid BV (1.8 ± 1.2vs.3.5 ± 2.0; p < 0.001) in Model A and BF in Model B (42.6 ± 11.0vs.50.9 ± 20.4; p = 0.031) were lower in acute-CBS than in ongoing-CBS patients. Subgroup analysis demonstrated lower BV in acute (1.8 ± 1.2) compared with threatened (3.7 ± 2.3; p < 0.001; p < 0.001) and impending (3.2 ± 1.6; p = 0.009) CBS patients in Model A.

Conclusion

CBS severity can be quantitatively diagnosed by pericarotid soft-tissue CTP parameters. In Model A (small focus), BV was capable of differentiating acute CBS from other subtypes, demonstrating its potential role as a CBS imaging biomarker.

背景和目的颈动脉爆裂综合征（CBS）是一种潜在的致命疾病。CBS 的诊断主要依靠主观观察，定量诊断方法尚未建立。本研究旨在通过不同感兴趣区（ROI）模型的计算机断层扫描灌注（CTP）参数诊断CBS的严重程度。材料与方法我们在2018年2月1日至2023年7月31日期间在一家三级医疗中心前瞻性地招募了CBS患者，并使用同一台128探测器CT机进行CTP检查。CTP后3天内进行数字减影血管造影（DSA）和选择性血管内介入治疗，以确诊和治疗。根据数字减影血管造影（DSA）结果和临床特征，CBS严重程度被分为持续性（威胁性+即将发生）或急性CBS。对 DSA 上的颈动脉周围软组织（PCST）CTP 参数（包括血流（BF）、血容量（BV）、平均通过时间（MTT）和血流提取乘积（FEP））进行了评估和关联。我们分别对 PCST 1 厘米、PCST 周围 1 厘米和整个 PCST 的小病灶模型 A、B 和 C 进行了描述。在模型 A 中，急性 CBS 患者的颈动脉周围 BV（1.8 ± 1.2vs.3.5 ± 2.0；p < 0.001）和模型 B 中的 BF（42.6 ± 11.0vs.50.9 ± 20.4；p = 0.031）均低于持续性 CBS 患者。亚组分析显示，在模型 A 中，急性 CBS 患者的 BV（1.8 ± 1.2）低于受威胁 CBS 患者的 BV（3.7 ± 2.3；p <；0.001；p <；0.001）和即将发生 CBS 患者的 BV（3.2 ± 1.6；p = 0.009）。在模型 A（小病灶）中，BV 能够将急性 CBS 与其他亚型区分开来，显示了其作为 CBS 影像生物标记物的潜在作用。

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引用次数: 0

[68 Ga]Ga-CXCR4 PET/CT imaging in high-grade glioma for assessment of CXCR4 receptor expression 用于评估高级别胶质瘤中 CXCR4 受体表达的[68 Ga]Ga-CXCR4 PET/CT 成像技术

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

European Journal of Radiology

Pub Date : 2024-08-23 DOI: 10.1016/j.ejrad.2024.111694

Purpose

Gliomas account for 75 % of primary malignant CNS tumors. High-grade glioma (CNS WHO grades 3 and 4) have an unfavorable treatment response and poor outcome. CXCR4 is a G protein-coupled receptor that plays an important part in the signaling pathway between cancer cells and tumor microenvironment. CXCR4 overexpression has been shown in a variety of cancers. In this study, we evaluate the potential value of [⁶⁸Ga]Ga-Pentixafor as a PET/CT CXCR4-probe for in vivo assessment of CXCR4 expression in patients with high-grade glioma and its correlation with tumor grade.

Materials and Methods

[⁶⁸Ga]Ga-CXCR4 PET/CT was performed in the prospective single-center study in treatment-naïve biopsy-proven patients with high-grade glioma. The acquired images were analyzed qualitatively and semi-quantitatively.

Result

A total of 26 patients (mean age: 53.3±14.4 years, 11 women, 15 men) were enrolled. CNS WHO grade 3 pathology was seen in 19 % (5/26) of the sample. The patient-based sensitivity of ⁶⁸Ga-CXCR4 was 96.2 %. Overall, 28 pathologic lesions were detected, leading to a lesion-based sensitivity of 96.4 %. The median (IQR) SUV_max of grade 4 lesions was substantially greater than the grade 3(3.03(2.5–3.7) vs. 1.51(1.2–1.8), p = 0.0145).). The highest tracer activity of organs −beside bladder as the main excretion reservoir-was in lymphoid tissue of Waldeyer’s ring (mean SUV_max: 7.41), and spleen (mean SUV_max: 6.62).

Conclusion

In conclusion, this new application for [⁶⁸Ga]Ga-Pentixafor PET tracer exhibits excellent visual and semi-quantitative diagnostic properties. Further studies are warranted.

目的胶质瘤占中枢神经系统原发性恶性肿瘤的 75%。高级别胶质瘤（中枢神经系统 WHO 3 级和 4 级）的治疗反应不佳，预后较差。CXCR4是一种G蛋白偶联受体，在癌细胞与肿瘤微环境之间的信号通路中发挥着重要作用。CXCR4 在多种癌症中都有过表达。在本研究中，我们评估了[68Ga]Ga-Pentixafor作为PET/CT CXCR4探针在体内评估高级别胶质瘤患者CXCR4表达的潜在价值及其与肿瘤分级的相关性。结果共有26名患者（平均年龄：53.3±14.4岁，11名女性，15名男性）入组。中枢神经系统 WHO 3 级病变占样本的 19%（5/26）。基于患者的 68Ga-CXCR4 敏感性为 96.2%。总体而言，共检测到 28 个病理病灶，基于病灶的敏感性为 96.4%。4 级病变的 SUVmax 中位数（IQR）远高于 3 级（3.03(2.5-3.7) vs. 1.51(1.2-1.8)，p = 0.0145）。结论：总之，[68Ga]Ga-Pentixafor PET示踪剂的这一新应用显示出卓越的视觉和半定量诊断特性。还需要进一步研究。

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引用次数: 0

Plaque enhancement of middle cerebral artery and pre-stroke diet are associated with prognosis of subacute ischemic stroke: A prospective high-resolution MR vessel wall imaging study 大脑中动脉斑块强化和卒中前饮食与亚急性缺血性卒中的预后有关：前瞻性高分辨率磁共振血管壁成像研究

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

European Journal of Radiology

Pub Date : 2024-08-23 DOI: 10.1016/j.ejrad.2024.111693

Objectives

To explore the value of middle cerebral artery (MCA) plaque characteristics in predicting the outcomes of subacute ischemic stroke and the incremental value of the previous diet on predictive performance.

Methods

One hundred and thirty-seven subacute ischemic stroke patients attributed to MCA plaques were included and analyzed in this prospective study. The National Institute of Health Stroke Scale (NIHSS) score, Mediterranean Diet Adherence Screener (MEDAS) score, and other clinical data were assessed. The plaque area, degree of stenosis, plaque burden, enhancement ratio, remodeling type, and intraplaque hemorrhage were measured using high-resolution MR vessel wall imaging (HR-VWI). Multivariable logistic regression analysis and receiver operating characteristic curve analysis were performed to assess the predictive performance of clinical and plaque characteristics for subacute ischemic stroke outcomes at 3 months.

Results

Patients with poor outcomes exhibited high NIHSS scores, and low MEDAS scores (P<0.001). Plaque burden, enhancement ratio, and degree of stenosis were significantly higher in patients with poor outcomes (P<0.001). Multivariate analyses further indicated that NIHSS score (P=0.001), MEDAS score (P=0.013), and enhancement ratio (P=0.011) were independent predictors of subacute ischemic stroke outcomes. The three models’ area under the curve (AUC) values were 0.811, 0.844, and 0.794. Combining these three factors resulted in an AUC of 0.908 (P<0.001).

Conclusions

The combination of NIHSS score, MEDAS score, and enhancement ratio showed significant superiority in the prognostic evaluation of subacute ischemic stroke. Clinical data combined with plaque characteristics improves the accuracy of 3-month outcome prediction on subacute ischemic stroke.

目的探讨大脑中动脉（MCA）斑块特征在预测亚急性缺血性卒中预后中的价值，以及之前的饮食对预测性能的增量价值。方法在这项前瞻性研究中，纳入并分析了 137 名归因于 MCA 斑块的亚急性缺血性卒中患者。对美国国立卫生研究院卒中量表（NIHSS）评分、地中海饮食坚持筛选器（MEDAS）评分和其他临床数据进行了评估。使用高分辨率磁共振血管壁成像（HR-VWI）测量了斑块面积、狭窄程度、斑块负担、增强比、重塑类型和斑块内出血。结果预后差的患者NIHSS评分高，MEDAS评分低（P<0.001）。预后不良患者的斑块负荷、增强比和狭窄程度明显更高（P<0.001）。多变量分析进一步表明，NIHSS 评分（P=0.001）、MEDAS 评分（P=0.013）和增强比（P=0.011）是亚急性缺血性卒中预后的独立预测因素。三个模型的曲线下面积（AUC）值分别为 0.811、0.844 和 0.794。结论 NIHSS 评分、MEDAS 评分和增强比值的组合在亚急性缺血性卒中的预后评估中显示出明显的优越性。临床数据与斑块特征相结合提高了亚急性缺血性卒中 3 个月预后预测的准确性。

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引用次数: 0

Functional liver imaging score (FLIS) can predict adverse events in HCC patients 肝脏功能成像评分（FLIS）可预测肝癌患者的不良事件

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

European Journal of Radiology

Pub Date : 2024-08-23 DOI: 10.1016/j.ejrad.2024.111695

Purpose

To assess the performance of FLIS in predicting adverse outcomes, namely post-hepatectomy liver failure (PHLF) and death, in patients who underwent liver surgery for malignancies.

Methods

All consecutive patients who underwent liver resection and 1.5 T gadoxetic acid MR were enrolled. PHLF and overall survival (OS) were collected. Two radiologists with 18 and 8 years of experience in abdominal imaging, blinded to clinical data, evaluated all images. Radiologists evaluated liver parenchymal enhancement (EnQS), biliary contrast excretion (ExQS), and signal intensity of the portal vein relative to the liver parenchyma (PVsQs). Reliability analysis was computed with Cohen’s Kappa. Cox regression analysis was calculated to determine which factors are associated with PHLF and OS. Area Under the Receiver Operating Characteristic curve (AUROC) was computed.

Results

150 patients were enrolled, 58 (38.7 %) in the HCC group and 92 (61.3 %) in the non-HCC group. The reliability analysis between the two readers was almost perfect (κ = 0.998). The multivariate Cox analysis showed that only post-surgical blood transfusions and major resection were associated with adverse events [HR=8.96 (7.98–9.88), p = 0.034, and HR=0.99 (0.781–1.121), p = 0.032, respectively] in the whole population. In the HCC group, the multivariable Cox analysis showed that blood transfusions, major resection and FLIS were associated with adverse outcomes [HR=13.133 (2.988–55.142), p = 0.009, HR=0.987 (0.244–1.987), p = 0.021, and HR=1.891 (1.772–3.471), p = 0.039]. The FLIS AUROC to predict adverse outcomes was 0.660 (95 %CIs = 0.484–0.836), with 87 % sensitivity and 33.3 % specificity (81.1–94.4 and 22.1–42.1).

Conclusions

FLIS can be considered a promising tool to preoperative depict patients at risk of PHLF and death.

目的评估FLIS在预测因恶性肿瘤接受肝脏手术的患者的不良预后（即肝切除术后肝功能衰竭（PHLF）和死亡）方面的性能。收集PHLF和总生存率（OS）。两名分别有 18 年和 8 年腹部成像经验的放射科医生对所有图像进行了评估，他们对临床数据保密。放射科医生评估了肝实质增强（EnQS）、胆汁造影剂排泄（ExQS）和门静脉相对于肝实质的信号强度（PVsQs）。可靠性分析采用科恩卡帕（Cohen's Kappa）计算。Cox回归分析用于确定哪些因素与PHLF和OS相关。结果 150 例患者中，HCC 组 58 例（38.7%），非 HCC 组 92 例（61.3%）。两位阅卷人之间的可靠性分析几乎完美（κ = 0.998）。多变量 Cox 分析显示，在所有人群中，只有手术后输血和大部切除与不良事件相关[分别为 HR=8.96 (7.98-9.88)，p = 0.034 和 HR=0.99 (0.781-1.121)，p = 0.032]。HCC组的多变量Cox分析显示，输血、大部切除和FLIS与不良预后相关[HR=13.133（2.988-55.142），P=0.009；HR=0.987（0.244-1.987），P=0.021；HR=1.891（1.772-3.471），P=0.039]。FLIS预测不良后果的AUROC为0.660（95 %CIs = 0.484-0.836），灵敏度为87%，特异度为33.3%（81.1-94.4和22.1-42.1）。

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引用次数: 0

Multivendor comparison of quantification accuracy of effective atomic number by Dual-Energy CT: A phantom study 双能 CT 有效原子序数量化准确性的多厂商比较：一项模型研究。

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

European Journal of Radiology

Pub Date : 2024-08-23 DOI: 10.1016/j.ejrad.2024.111690

Purpose

Our study aimed to compare the accuracy of the effective atomic number (Z_eff) of five dual-energy CT (DECT) from three vendors and different generations under different scanning parameters.

Methods

Z_eff accuracy of five DECT scanners with twelve tube voltage configurations was evaluated by using the TomoTherapy cheese phantom. The potential dose dependence of the Z_eff was investigated using three radiation dose (5, 15, and 25 mGy), and the robustness of Z_eff was simulated for different organs of the body by placing the inserts at different positional depths. Bias and mean absolute percentage error (MAPE) were used to characterize the accuracy of Zeff. Data underwent analysis using one-way ANOVA, followed by the Turky and LSD post hoc tests, simple linear regression, and linear mixed models.

Results

All tube voltage configurations had a bias of less than 1. Dual layer detector DECT (dl-DECT) −140 kV has the lowest MAPE (1.79 %±1.93 %). The third generation dual source DECT (ds-DECT) and the second generation rapid switch DECT (rs-DECT) have higher MAPE than their predecessor DECT. The results of the linear mixed model showed that tube voltage configuration (F=16.92, p < 0.001) and insert type (F=53.26, p < 0.001) significantly affect the MAPE. In contrast, radiation dose only has a significant effect on the MAPE of rs-DECT. The inserts position does not affect the final MAPE.

Conclusion

When scanning different inserts, Z_eff accuracy varies by vendor and DECT generation. Of all the scanners, dl-DECT had the highest Z_eff accuracy. Upgrading DECT generation doesn’t lead to higher accuracy, or even lower.

目的：我们的研究旨在比较在不同扫描参数下三个供应商和不同年代的五台双能 CT（DECT）的有效原子序数（Zeff）的准确性：方法：使用 TomoTherapy 奶酪模型评估了五种 DECT 扫描仪在十二管电压配置下的 Zeff 精确度。使用三种辐射剂量（5、15 和 25 mGy）对 Zeff 的潜在剂量依赖性进行了研究，并通过将插入物放置在不同的位置深度模拟了体内不同器官的 Zeff 稳定性。偏差和平均绝对百分比误差 (MAPE) 被用来描述 Zeff 的准确性。使用单因素方差分析、Turky 和 LSD 后检验、简单线性回归和线性混合模型对数据进行分析：双层探测器 DECT（dl-DECT）-140 kV 的 MAPE 最低（1.79 %±1.93 %）。第三代双源 DECT（ds-DECT）和第二代快速开关 DECT（rs-DECT）的 MAPE 高于其前身 DECT。线性混合模型的结果表明，管电压配置（F=16.92，p 结论：MAPE=0.01）比前一代 DECT 的 MAPE 高：在扫描不同插入物时，Zeff 精确度因供应商和 DECT 代而异。在所有扫描仪中，dl-DECT 的 Zeff 精度最高。新一代 DECT 的升级并不会带来更高的精度，甚至更低。

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引用次数: 0

Radiology staff perspectives are a key determinant for successful AI adoption in clinical practice 放射科员工的观点是在临床实践中成功采用人工智能的关键因素

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

European Journal of Radiology

Pub Date : 2024-08-22 DOI: 10.1016/j.ejrad.2024.111692

引用次数: 0

Photon-counting detector CT (PCD-CT) generated iodine maps to characterize parenchymal lung disease: A feasibility study 光子计数探测器 CT（PCD-CT）生成的碘图用于描述肺实质疾病：可行性研究。

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

European Journal of Radiology

Pub Date : 2024-08-22 DOI: 10.1016/j.ejrad.2024.111689

Background

With photon-counting CT, spectral imaging is always available, and iodine maps with high spatial and spectral resolution can be generated.

Objectives

The aim of this study was to investigate whether iodine uptake in different parenchymal patterns can be used to characterise parenchymal disease with increased lung attenuation.

Methods

325 patients were scanned with a photon-counting CT using four scan protocols, all with lung parenchymal contrast. Lesions were classified into three basic patterns: consolidation, ground-glass opacities (GGO), and reticular pattern. Lesion classification was performed by 2 of 3 radiologists who were blinded to the diagnosis. Classification was performed twice using a 5-point Likert scale (with and without iodine maps). In case of disagreement, a third reader was consulted, and the decision was made by consensus.

Results

206 lesions were found with a confirmed diagnosis (83 consolidations, 72 GGO, and 51 reticular). Diagnostic confidence improved when iodine maps were included in the evaluation. The mean Likert score increased significantly for all three basic patterns (consolidations: 3.3 vs. 3.9, GGO: 3.4 vs. 4.1, and reticular: 3.6 vs. 4.4, p < 0.001). However, the score for GGO and reticular pattern was downgraded in three and one cases, respectively. The downgrading occurred for morphologically uncertain GGO findings (3) and atelectasis (1) with inhomogeneous iodine uptake. In 29 lesions, the classification was changed when the iodine maps were included in the evaluation.

Conclusion

Including iodine maps adds contrast uptake information and improves the diagnostic confidence of radiologists in the characterization of parenchymal pathologies.

Clinical Impact

Iodine maps have the potential to provide complementary information for the interpretation of lung opacities with overlapping morphology.

背景：通过光子计数 CT，可随时进行光谱成像，并可生成具有高空间和光谱分辨率的碘图：方法：采用四种扫描方案对 325 名患者进行光子计数 CT 扫描，所有方案均使用肺实质对比剂。病变分为三种基本模式：合并、磨玻璃不透明（GGO）和网状模式。病变分类由 3 位放射科医生中的 2 位进行，他们对诊断结果都是盲法。使用 5 点李克特量表进行两次分类（含碘图和不含碘图）。结果：共发现 206 个确诊病灶（83 个合并病灶、72 个 GGO 病灶和 51 个网状病灶）。将碘图纳入评估后，诊断可信度有所提高。三种基本模式的平均 Likert 分值均有显著提高（合并症：3.3 分 vs. 3.9 分）：3.3 对 3.9，GGO：3.4 对 4.1，网状：3.6 对 4.4：3.6 vs. 4.4，P 结论：纳入碘图可增加对比摄取信息，提高放射科医生对实质病变特征的诊断信心：临床影响：碘图有可能为解释形态重叠的肺不张提供补充信息。

{"title":"Photon-counting detector CT (PCD-CT) generated iodine maps to characterize parenchymal lung disease: A feasibility study","authors":"","doi":"10.1016/j.ejrad.2024.111689","DOIUrl":"10.1016/j.ejrad.2024.111689","url":null,"abstract":"<div><h3>Background</h3><p>With photon-counting CT, spectral imaging is always available, and iodine maps with high spatial and spectral resolution can be generated.</p></div><div><h3>Objectives</h3><p>The aim of this study was to investigate whether iodine uptake in different parenchymal patterns can be used to characterise parenchymal disease with increased lung attenuation.</p></div><div><h3>Methods</h3><p>325 patients were scanned with a photon-counting CT using four scan protocols, all with lung parenchymal contrast. Lesions were classified into three basic patterns: consolidation, ground-glass opacities (GGO), and reticular pattern. Lesion classification was performed by 2 of 3 radiologists who were blinded to the diagnosis. Classification was performed twice using a 5-point Likert scale (with and without iodine maps). In case of disagreement, a third reader was consulted, and the decision was made by consensus.</p></div><div><h3>Results</h3><p>206 lesions were found with a confirmed diagnosis (83 consolidations, 72 GGO, and 51 reticular). Diagnostic confidence improved when iodine maps were included in the evaluation. The mean Likert score increased significantly for all three basic patterns (consolidations: 3.3 vs. 3.9, GGO: 3.4 vs. 4.1, and reticular: 3.6 vs. 4.4, p < 0.001). However, the score for GGO and reticular pattern was downgraded in three and one cases, respectively. The downgrading occurred for morphologically uncertain GGO findings (3) and atelectasis (1) with inhomogeneous iodine uptake. In 29 lesions, the classification was changed when the iodine maps were included in the evaluation.</p></div><div><h3>Conclusion</h3><p>Including iodine maps adds contrast uptake information and improves the diagnostic confidence of radiologists in the characterization of parenchymal pathologies.</p></div><div><h3>Clinical Impact</h3><p>Iodine maps have the potential to provide complementary information for the interpretation of lung opacities with overlapping morphology.</p></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145474","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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