European Journal of Radiology最新文献_第3页

Percutaneous treatment of bilioenteric anastomotic strictures: Comparison of long-term outcomes between temporary covered stents and balloon dilation 胆肠吻合口狭窄的经皮治疗：临时覆盖支架与球囊扩张术的长期疗效比较。

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

European Journal of Radiology

Pub Date : 2024-11-05 DOI: 10.1016/j.ejrad.2024.111816

Kun Yung Kim, Chang Jin Yoon, Jae Hwan Lee, Chong-Ho Lee

Purpose

To compare the long-term outcomes of percutaneous balloon dilation versus temporary covered stent placement in treating benign bilioenteric anastomotic strictures.

Materials and Methods

Eighty-three patients with benign bilioenteric anastomotic stricture from December 2014 to May 2023 were included in the study. Balloon dilation was performed up to 3 times in 46 patients (balloon group) and temporary covered stent placement aiming at spontaneous migration was performed in 23 patients (stent group). Technical and clinical success, primary patency rates, percutaneous transhepatic biliary drainage (PTBD) indwelling times, and complications were compared between the two groups.

Results

The median follow-up was 963 days for the balloon group and 1151 days for the stent group (p = 0.775). Short-term stricture resolution was achieved in 46 of 60 patients (76.7 %) in the balloon group and in all patients in the stent group. Clinical success was achieved in all patients with short-term stricture resolution. The stent group showed higher primary patency rates (90.2 %, 83.3 %, 74.0 %, and 74.0 % vs. 72.9 %, 56.8 %, 39.7 %, and 39.7 % at 1, 3 5, and 7 years; p = 0.033) and a shorter median PTBD indwelling time (4 days vs. 6 days; p = 0.031) compared to the balloon group. Spontaneous migration of the stent was found in 19 of 23 patients (82.6 %), with a median stent indwelling time of 3 months (range, 3–12 months).

Conclusion

Percutaneous temporary covered stent placement is an effective treatment option for patients with benign bilioenteric anastomotic strictures, offering higher primary patency rates and shorter PTBD indwelling times, compared to balloon dilation over a long-term period.

目的：比较经皮球囊扩张术与临时有盖支架置入术治疗良性胆肠吻合口狭窄的长期疗效：研究纳入了 2014 年 12 月至 2023 年 5 月的 83 例良性胆肠吻合口狭窄患者。46例患者（球囊组）最多进行了3次球囊扩张，23例患者（支架组）进行了临时有盖支架置入，以实现自发移位。对两组患者的技术和临床成功率、初次通畅率、经皮经肝胆管引流术（PTBD）留置时间和并发症进行了比较：结果：球囊组的中位随访时间为 963 天，支架组为 1151 天（P = 0.775）。球囊组 60 例患者中有 46 例（76.7%）短期内解决了狭窄问题，支架组所有患者都解决了狭窄问题。所有短期解决狭窄的患者都取得了临床成功。与球囊组相比，支架组的初次通畅率更高（1 年、3 年、5 年和 7 年分别为 90.2%、83.3%、74.0% 和 74.0% vs. 72.9%、56.8%、39.7% 和 39.7%；p = 0.033），PTBD 的中位留置时间更短（4 天 vs. 6 天；p = 0.031）。23例患者中有19例（82.6%）发现支架自发移位，中位支架留置时间为3个月（3-12个月）：结论：对于良性胆肠吻合口狭窄患者来说，经皮临时有盖支架置入术是一种有效的治疗方法，与球囊扩张术相比，它能提供更高的初次通畅率和更短的长期PTBD留置时间。

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引用次数: 0

Basal Ganglia’s influence on awake test in carotid endarterectomy 基底节对颈动脉内膜切除术清醒测试的影响

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

European Journal of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.ejrad.2024.111812

Barbara Roque-Carvalho , Juliana Pereira-Macedo , Mavilde Arantes , Jose Sousa , Lara Romana-Dias , Hugo Ribeiro , Piotr Myrcha , João Rocha-Neves

Background

White matter changes (WMC) have been associated with the underlying presence of chronic cerebral ischemia, such as in carotid stenosis and age-related white matter changes (ARWMC). A low attenuation on computed tomography (CT) characterizes these alterations. Patients undergoing carotid endarterectomy (CEA) with severe WMC may be at increased risk of intraoperative neurologic deficits (IND) during carotid clamping. This study aims to determine the potential role of ARWMC as a predictor of IND during CEA with regional anesthesia (RA).

Methods

Patients undergoing CEA under RA at a tertiary referral center, who presented with IND during CEA were prospectively and consecutively recruited between January 2011 and December 2023. The control group comprised the immediately consecutive patient who underwent the same procedure without IND. From this sample, patients with preoperative CT were selected and compared based on ARWMC score (≤ 1 and 2). Differences in demographics and comorbidities were assessed between the groups. A multivariable logistic regression was performed.

Results

One hundred and twenty-one patients were enrolled. Patients with IND had a significantly higher ARWMC score in basal ganglia (ARWMC-BG ≥ 2) and posterior circulation disease was more frequent (27.8 %). No significant differences were observed in anatomical variations of the circle of Willis.

For patients with ARWMC-BG ≥ 2, a significant burden of other comorbidities was associated, such as chronic kidney disease, coronary disease, and atrial fibrillation. After multivariable logistic regression analysis, ARWMC-BG score ≥ 2 was an independent risk factor for IND (aOR 3.472).

Conclusion

An ARWMC-BG score above 2 predicts positive intraoperative “awake tests” in CEA with RA, constituting a reliable tool to stratify patients according to their risk of adverse events. However, larger prospective cohorts are needed to validate these findings and offer a better selection and management of this subset of patients.

背景：白质改变（WMC）与慢性脑缺血的潜在存在有关，如颈动脉狭窄和与年龄相关的白质改变（ARWMC）。计算机断层扫描（CT）上的低衰减是这些改变的特征。接受颈动脉内膜切除术（CEA）的重度白质病变患者在颈动脉钳夹过程中可能会增加术中神经功能缺损（IND）的风险。本研究旨在确定 ARWMC 在区域麻醉（RA）下进行 CEA 期间作为 IND 预测因子的潜在作用：2011年1月至2023年12月期间，在一家三级转诊中心接受RA下CEA手术并在CEA过程中出现IND的患者被连续招募。对照组由接受相同手术但未出现 IND 的连续患者组成。根据 ARWMC 评分（≤ 1 分和 2 分），从样本中挑选出术前有 CT 的患者并进行比较。评估了两组患者在人口统计学和合并症方面的差异。结果：结果：共招募了121名患者。IND患者基底节的ARWMC评分明显更高（ARWMC-BG≥2），后循环疾病更常见（27.8%）。在威利斯环的解剖变异方面没有观察到明显差异。对于 ARWMC-BG ≥ 2 的患者，其他合并症的负担也很重，如慢性肾病、冠心病和心房颤动。经过多变量逻辑回归分析，ARWMC-BG评分≥2是IND的独立危险因素（aOR 3.472）：结论：ARWMC-BG评分超过2分可预测伴有RA的CEA术中 "清醒试验 "阳性，是根据不良事件风险对患者进行分层的可靠工具。然而，需要更大规模的前瞻性队列来验证这些发现，并为这部分患者提供更好的选择和管理。

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引用次数: 0

Ultra-high-resolution photon-counting detector CT for visualization of the brachial plexus 用于臂丛显像的超高分辨率光子计数探测器 CT

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

European Journal of Radiology

Pub Date : 2024-10-30 DOI: 10.1016/j.ejrad.2024.111810

Masahiro Nakashima , Tatsuya Kawai , Kazuhisa Matsumoto , Takatsune Kawaguchi , Misugi Urano , Nobuo Kitera , Toshihide Itoh , Akio Hiwatashi

Objectives

To investigate the use of photon-counting detector CT (PCD-CT) to improve brachial plexus depiction.

Materials and Methods

This retrospective study included patients who underwent neck CT from March to December 2023. To assess the optimal reconstruction condition in PCD-CT, the signal-to-noise ratios (SNRs) on images using various quantitative regular (Qr) kernels and strengths of quantum iterative reconstruction (QIR) were evaluated. Next, images obtained by ultra-high-resolution mode in PCD-CT (PCD-UHR), standard mode in PCD-CT (PCD-STD), and standard mode in energy-integrating detector CT (EID-STD) of 20 patients each were compared regarding brachial plexus depiction. A qualitative evaluation was performed using a 5-point Likert scale regarding sharpness, noise, and overall image quality. The standard deviations (SDs), SNRs, and contrast-to noise ratios (CNRs) were quantitatively evaluated.

Results

Overall, 60 patients (mean age, 63 years ± 18; 30 males) were included. The SNRs for the Qr40 and QIR4 (means ± SDs) were 3.6 ± 1.1 and 4.1 ± 1.2, respectively, significantly higher than others (P < 0.05). The scores for overall image quality were 4 [4–5], 3 [3–4], and 2 [2–3], and those for sharpness were 4 [3–5], 3 [3–3], and 2 [1–3] for PCD-UHR, PCD-STD, and EID-STD, respectively (all, P < 0.05). Those for noise were 3 [3–4], 4 [3–4], and 2 [2–2], the SDs were 6.6 ± 1.6, 5.4 ± 0.8, and 8.8 ± 1.7, SNRs were 5.0 ± 1.4, 6,1 ± 1.2, and 3.5 ± 1.6, and CNRs were 5.6 ± 1.9, 7.9 ± 1.7, and 4.4 ± 1.8, respectively (between either of the PCD groups and EID-STD, P < 0.05).

Conclusion

PCD-CT showed superior delineation for brachial plexus to EID-CT.

材料与方法这项回顾性研究纳入了 2023 年 3 月至 12 月期间接受颈部 CT 检查的患者。为了评估 PCD-CT 的最佳重建条件，研究人员评估了使用各种定量正则（Qr）核和量子迭代重建（QIR）强度的图像的信噪比（SNR）。然后，比较了 PCD-CT 超高分辨率模式（PCD-UHR）、PCD-CT 标准模式（PCD-STD）和能量积分探测器 CT 标准模式（EID-STD）下各 20 名患者的臂丛描绘图像。在清晰度、噪声和整体图像质量方面，采用 5 点李克特量表进行定性评估。对标准偏差（SD）、信噪比（SNR）和对比度与噪声比（CNR）进行了定量评估。Qr40和QIR4的信噪比（平均值±标度）分别为3.6±1.1和4.1±1.2，明显高于其他（P <0.05）。PCD-UHR、PCD-STD 和 EID-STD 的总体图像质量得分分别为 4 [4-5]、3 [3-4] 和 2 [2-3]，清晰度得分分别为 4 [3-5]、3 [3-3] 和 2 [1-3]（均为 P <0.05）。噪声分别为 3 [3-4]、4 [3-4] 和 2 [2-2]，SD 分别为 6.6 ± 1.6、5.4 ± 0.8 和 8.8 ± 1.7，SNR 分别为 5.0 ± 1.4、6,1 ± 1.2 和 3.5 ± 1.6，CNR 分别为 5.6 ± 1.结论 PCD-CT 对臂丛神经的划分优于 EID-CT。

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引用次数: 0

Training the next generation of onco-radiologists: The Hong Kong experience 培训下一代放射科医师：香港的经验。

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

European Journal of Radiology

Pub Date : 2024-10-29 DOI: 10.1016/j.ejrad.2024.111809

Wan Hang Keith Chiu , Kai-yan Kwok , Oi Ling Chan , Yee Tak Alta Lai , Lik Fai Cheng , Wai Lun Poon

Oncologic Radiology (OR) is a new higher subspecialty training programme developed by the Hong Kong College of Radiologists. Instead of the traditional organ-centric approach, the curriculum ensures exposure in a wide spectrum of cancers to trainees who wish to pursue a career in cancer imaging and interventions. The OR training is hands-on and trainees will learn to interpret and report many imaging modalities including ultrasound, mammography, computed tomography and magnetic resonance. Aside from diagnostic training, trainees will also acquire basic knowledge and skills in Interventional Oncology. Specific emphasis is put on inter-disciplinary collaboration with input from Medical Physicists and Clinical Oncologists during their training. The curriculum aims to provide comprehensive knowledge and necessary skills in radiological findings, clinical aspects, pathology, treatment options of oncologic diseases in different organ systems to meet the demand of modern Oncology.

肿瘤放射学（OR）是香港放射科医学院开发的一个新的高级亚专科培训课程。与传统的以器官为中心的方法不同，该课程确保有志于从事癌症成像和介入治疗的学员能够接触到各种癌症。手术室的培训以实际操作为主，学员将学习如何解读和报告多种成像模式，包括超声波、乳腺X光造影、计算机断层扫描和磁共振。除了诊断培训，学员还将学习介入肿瘤学的基本知识和技能。在培训期间，医学物理学家和临床肿瘤学家会提供意见，特别强调跨学科合作。课程旨在提供有关不同器官系统肿瘤疾病的放射学发现、临床方面、病理学和治疗方案的全面知识和必要技能，以满足现代肿瘤学的需求。

引用次数: 0

Early prediction of radiotherapy outcomes in pharyngeal cancer using deep learning on baseline [18F]Fluorodeoxyglucose positron emission Tomography/Computed tomography 利用对基线[18F]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描的深度学习，早期预测咽癌的放疗效果。

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

European Journal of Radiology

Pub Date : 2024-10-29 DOI: 10.1016/j.ejrad.2024.111811

Kuo-Chen Wu , Shang-Wen Chen , Ruey-Feng Chang , Te-Chun Hsieh , Kuo-Yang Yen , Chao-Jen Chang , Zong-Kai Hsu , Yi-Chun Yeh , Yuan-Yen Chang , Chia-Hung Kao

Objectives

This study aimed to develop an integrated segmentation-free deep learning (DL) framework to predict multiple aspects of radiotherapy outcome in pharyngeal cancer patients by analyzing pretreatment 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT).

Methods

We utilized baseline 18F-FDG-PET/CT scans from patients newly diagnosed with oropharyngeal or hypopharyngeal cancer. The study cohort comprised 162 patients for training and 32 for validation, all of whom completed definitive chemoradiotherapy or radiotherapy for organ-preservation. Following image augmentation, fused PET and CT images were used to train three distinct DL models. An ensemble voting classifier was then employed to predict local recurrence (LR), neck lymph node relapse (NR), and distant metastases (DM). Model performance was evaluated using receiver operating characteristic curve analysis.

Results

With a median follow-up of 36 months, the training cohort experienced, LR in 45 (27.8 %), NR in 32 (19.8 %), and DM in 21 (13.0 %) patients. By optimizing single models and finalizing with an ensemble voting classifier, the area under the curve for the occurrence of LR, NR, and DM was 0.850, 0.878, and 0.893, whereas the accuracy for the three endpoints were 87.5 %, 68.8 %, and 78.1 %, respectively.

Conclusions

By utilizing baseline 18F-FDG-PET/CT, our proposed DL models can provide a supplemental prediction for various therapeutic outcome in patients with pharyngeal cancer undergoing radiotherapy-based treatment. The accuracy for NR and DM predictions requires further optimization through additional technological breakthrough or combing clinical parameters. External validation is an important future step to confirm the model’s generalizability and clinical utility.

研究目的本研究旨在开发一种集成的无分割深度学习（DL）框架，通过分析治疗前的 18F- 氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描-计算机断层扫描（PET/CT），预测咽癌患者放疗结果的多个方面：我们利用了新诊断为口咽癌或下咽癌患者的基线18F-FDG-PET/CT扫描结果。研究队列包括162名训练患者和32名验证患者，他们都完成了明确的化学放疗或器官保留放疗。图像增强后，融合 PET 和 CT 图像被用于训练三种不同的 DL 模型。然后采用集合投票分类器预测局部复发（LR）、颈部淋巴结复发（NR）和远处转移（DM）。利用接收器操作特征曲线分析评估了模型的性能：中位随访时间为 36 个月，训练队列中有 45 例（27.8%）患者出现局部复发，32 例（19.8%）患者出现颈部淋巴结复发，21 例（13.0%）患者出现远处转移。通过优化单一模型并最终使用集合投票分类器，LR、NR 和 DM 发生率的曲线下面积分别为 0.850、0.878 和 0.893，而三个终点的准确率分别为 87.5%、68.8% 和 78.1%：通过利用基线18F-FDG-PET/CT，我们提出的DL模型可以对接受放疗的咽癌患者的各种治疗结果进行补充预测。NR和DM预测的准确性需要通过更多的技术突破或结合临床参数来进一步优化。外部验证是未来确认模型通用性和临床实用性的重要步骤。

{"title":"Early prediction of radiotherapy outcomes in pharyngeal cancer using deep learning on baseline [18F]Fluorodeoxyglucose positron emission Tomography/Computed tomography","authors":"Kuo-Chen Wu , Shang-Wen Chen , Ruey-Feng Chang , Te-Chun Hsieh , Kuo-Yang Yen , Chao-Jen Chang , Zong-Kai Hsu , Yi-Chun Yeh , Yuan-Yen Chang , Chia-Hung Kao","doi":"10.1016/j.ejrad.2024.111811","DOIUrl":"10.1016/j.ejrad.2024.111811","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to develop an integrated segmentation-free deep learning (DL) framework to predict multiple aspects of radiotherapy outcome in pharyngeal cancer patients by analyzing pretreatment 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT).</div></div><div><h3>Methods</h3><div>We utilized baseline 18F-FDG-PET/CT scans from patients newly diagnosed with oropharyngeal or hypopharyngeal cancer. The study cohort comprised 162 patients for training and 32 for validation, all of whom completed definitive chemoradiotherapy or radiotherapy for organ-preservation. Following image augmentation, fused PET and CT images were used to train three distinct DL models. An ensemble voting classifier was then employed to predict local recurrence (LR), neck lymph node relapse (NR), and distant metastases (DM). Model performance was evaluated using receiver operating characteristic curve analysis.</div></div><div><h3>Results</h3><div>With a median follow-up of 36 months, the training cohort experienced, LR in 45 (27.8 %), NR in 32 (19.8 %), and DM in 21 (13.0 %) patients. By optimizing single models and finalizing with an ensemble voting classifier, the area under the curve for the occurrence of LR, NR, and DM was 0.850, 0.878, and 0.893, whereas the accuracy for the three endpoints were 87.5 %, 68.8 %, and 78.1 %, respectively.</div></div><div><h3>Conclusions</h3><div>By utilizing baseline 18F-FDG-PET/CT, our proposed DL models can provide a supplemental prediction for various therapeutic outcome in patients with pharyngeal cancer undergoing radiotherapy-based treatment. The accuracy for NR and DM predictions requires further optimization through additional technological breakthrough or combing clinical parameters. External validation is an important future step to confirm the model’s generalizability and clinical utility.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111811"},"PeriodicalIF":3.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568237","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

Evaluating ten years of breast cancer screening with contrast enhanced mammography in women with Intermediate-high risk 评估中高风险妇女使用对比增强型乳腺 X 射线照相术进行乳腺癌筛查的十年情况

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

European Journal of Radiology

Pub Date : 2024-10-28 DOI: 10.1016/j.ejrad.2024.111807

Vera Sorin , Nisim Rahman , Nitsan Halabi , Yiftach Barash , Eyal Klang , Miri Sklair-Levy

Purpose

While mammography is considered the gold standard for screening women for breast cancer, its accuracy declines in women with dense breasts. The purpose of the study is to evaluate the diagnostic accuracy of contrast enhanced mammography (CEM) for detecting breast cancer in intermediate and high-risk women, including those with genetic predispositions, over a decade-long cohort at a tertiary center.

Methods

We retrospectively analyzed all CEM examinations performed for screening purposes at a tertiary center between 2012 and 2023. Data were extracted from imaging reports and from medical records. All biopsies performed up to one year following CEM examinations, and all breast cancer cases were extracted. BI-RADS scores from CEM reports were compared to biopsy results and to imaging follow-up. Sensitivity, specificity, positive and negative predictive values, area under the ROC curve (AUC), and cumulative cancer detection rate were calculated.

Results

Overall 5,424 screening CEM examinations were analyzed. The mean age was 54.8 ± 8.9 years. Family history of breast cancer was recorded in 1,134/5,424 (20.9 %) women. Most women (4,606/5,424, 84.9 %) had dense breasts (BI-RADS C-D). Overall, 628 biopsies were performed within one year of screening, and 74 cancers were detected. CEM had sensitivity 95.9 % (71/74), specificity 81.8 % (4378/5350), positive predictive value 6.8 % (71/1043), negative predictive value 99.9 % (4378/4381). The cancer detection rate for CEM was 13.1 per 1,000 cases, and the AUC was 0.923.

Conclusions

CEM is a viable breast cancer screening method for women with dense breasts. Future prospective studies are needed to evaluate the long-term prognostic impact of CEM screening.

目的虽然乳腺 X 射线照相术被认为是筛查妇女乳腺癌的黄金标准，但其准确性在乳房致密的妇女中有所下降。本研究旨在评估造影剂增强型乳腺 X 光造影术（CEM）对中高危女性（包括有遗传倾向的女性）乳腺癌的诊断准确性。数据提取自成像报告和病历。提取了所有在CEM检查后一年内进行的活组织检查和所有乳腺癌病例。将CEM报告中的BI-RADS评分与活检结果和影像学随访结果进行比较。计算了灵敏度、特异性、阳性和阴性预测值、ROC 曲线下面积（AUC）和累积癌症检出率。平均年龄为 54.8 ± 8.9 岁。1,134/5,424 名妇女（20.9%）有乳腺癌家族史。大多数女性（4,606/5,424，84.9%）患有致密乳房（BI-RADS C-D）。总体而言，在筛查后一年内进行了 628 例活检，发现了 74 例癌症。CEM的灵敏度为95.9%（71/74），特异性为81.8%（4378/5350），阳性预测值为6.8%（71/1043），阴性预测值为99.9%（4378/4381）。CEM 的癌症检出率为 13.1‰，AUC 为 0.923。未来需要进行前瞻性研究，以评估 CEM 筛查对长期预后的影响。

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引用次数: 0

Impact of deep Learning-enhanced contrast on diagnostic accuracy in stroke CT angiography 深度学习增强对比对中风 CT 血管造影诊断准确性的影响。

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

European Journal of Radiology

Pub Date : 2024-10-28 DOI: 10.1016/j.ejrad.2024.111808

Sebastian Steinmetz , Mario Alberto Abello Mercado , Sebastian Altmann , Antoine Sanner , Andrea Kronfeld , Marius Frenzel , Dongok Kim , Sergiu Groppa , Timo Uphaus , Marc A. Brockmann , Ahmed E. Othman

Purpose

To examine the impact of deep learning-augmented contrast enhancement on image quality and diagnostic accuracy of poorly contrasted CT angiography in patients with suspected stroke.

Methods

This retrospective single-centre study included 102 consecutive patients who underwent CT imaging for suspected stroke between 01/2021 and 12/2022, including whole brain volume perfusion CT (VPCT) and, specifically, a poorly contrasted CT angiography (defined as < 350HU in the proximal MCA). CT angiography imaging data was reconstructed using i.) an iterative reconstruction kernel (conventional CTA, c-CTA) as well as ii.) an iodine-based contrast boosting deep learning model (Deep Learning-enhanced CTA, DLe-CTA). For quantitative analysis, the slope, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were determined. Qualitative image analysis was conducted by three readers, rating image quality and vessel-specific parameters on a 4-point Likert scale. Readers evaluated both datasets for cerebral vessel occlusion presence. VPCT served as the reference standard for calculating sensitivity and specificity.

Results

102 patients were evaluated (mean age 69 ± 13 years; 70 men). DLe-CTA outperformed c-CTA in quantitative (all items p < 0.001) and qualitative image analysis (all items p < 0.05). VPCT revealed 58/102 patients with vascular occlusion. DLe-CTA resulted in significantly higher sensitivity compared to c-CTA (p < 0.001); (all readers put together: c-CTA: 142/174 [81.6 %; 95 % CI: 75.0 %-87.1 %] vs. DLe-CTA 163/174 [94 %; 95 % CI: 89.0 %-96.8 %]). One false positive finding occurred on DLe-CTA (specificity 1/132) [99.2 %; 95 % CI: 95.9 %-100 %].

Conclusions

Deep learning-augmented contrast enhancement improves the image quality and increases the sensitivity of detection vessel occlusions in poorly contrasted CTA.

目的：研究深度学习增强对比度对疑似中风患者对比度差的 CT 血管造影的图像质量和诊断准确性的影响：这项回顾性单中心研究纳入了 102 名在 2021 年 1 月至 2022 年 12 月期间因疑似中风而接受 CT 成像检查的连续患者，包括全脑容积灌注 CT（VPCT），特别是对比度差的 CT 血管造影（定义为结果：102 名患者（平均年龄为 65 岁，男性）接受了评估：102 名患者接受了评估（平均年龄 69 ± 13 岁；70 名男性）。DLe-CTA在定量（所有项目的P）方面优于c-CTA：深度学习增强对比度可改善图像质量，提高对比度差的 CTA 检测血管闭塞的灵敏度。

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引用次数: 0

Symptomology of celiac artery compression: Classifying patients by the degree of celiac artery stenosis and secondary changes in collateral branches on computed tomography angiogram 腹腔动脉压迫症状：根据腹腔动脉狭窄程度和计算机断层扫描血管造影上侧支的继发性变化对患者进行分类。

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

European Journal of Radiology

Pub Date : 2024-10-26 DOI: 10.1016/j.ejrad.2024.111805

Lili Xu , Yongfei Wu , Jiahui Zhang , Xiaoxiao Zhang , Xin Bai , Li Chen , Qianyu Peng , Erjia Guo , Gumuyang Zhang , Zhengyu Jin , Hao Sun

Purpose

This study aimed to analyze the correlation between the degree of celiac artery (CA) stenosis and the secondary changes in collateral branches in patients with CA compression (CAC) by CT and to classify patients by the combination of the two imaging features.

Methods

Patients with CAC identified by contrast-enhanced CT from January 2012 to December 2013 were retrospectively enrolled and divided into the symptomatic group and asymptomatic group. CA stenosis was categorized as mild, moderate, or severe, and collateral circulation as invisible, visible, or prominent. The correlation between the imaging features was analyzed with Kendall’s Tau-b. Multivariate regression identified risk factors for symptomatic CAC. And patients were further classified into three subtypes (Type A to C) based on CA stenosis and collateral circulation.

Results

This study included 150 patients (79 men, 71 women), with 49 (32.7 %) symptomatic. The collateral circulation classification correlated with the CA stenosis (Tau-b = 0.295, p < 0.001). And both imaging features were proven to be independent risk factors for the symptomatic CAC (all p < 0.05). Of the three subtypes of patients, only one patient with Type A (1/26 [3.8 %]) was symptomatic; a small proportion of patients with Type B (23/99 [23.2 %]) were symptomatic; and all patients with Type C (25/25 [100 %]) were symptomatic.

Conclusions

The development of collateral circulation is positively correlated with the degree of CA stenosis. Our proposed classification system based on the combination of the degree of CA stenosis and collateral circulation helps to identify patients with symptomatic CAC.

目的：本研究旨在分析腹腔动脉（CA）狭窄程度与腹腔动脉压迫（CAC）患者CT侧支继发性变化之间的相关性，并根据这两种影像学特征对患者进行分类：回顾性纳入2012年1月至2013年12月通过对比增强CT发现的CAC患者，将其分为有症状组和无症状组。CA狭窄分为轻度、中度和重度，侧支循环分为不可见、可见和突出。用 Kendall's Tau-b 分析了成像特征之间的相关性。多变量回归确定了无症状 CAC 的风险因素。根据CA狭窄和侧支循环情况，将患者进一步分为三个亚型（A型至C型）：该研究共纳入 150 名患者（79 名男性，71 名女性），其中 49 人（32.7%）有症状。侧支循环分类与 CA 狭窄程度相关（Tau-b = 0.295，p 结论：侧支循环的发展与 CA 狭窄程度呈正相关：侧支循环的发展与 CA 狭窄程度呈正相关。我们提出的基于 CA 狭窄程度和侧支循环的分类系统有助于识别有症状的 CAC 患者。

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引用次数: 0

Image quality of virtual monochromatic and material density iodine images for evaluation of head and neck neoplasms using deep learning-based CT image reconstruction – A retrospective observational study 利用基于深度学习的 CT 图像重建评估头颈部肿瘤的虚拟单色和物质密度碘图像的图像质量 - 一项回顾性观察研究。

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

European Journal of Radiology

Pub Date : 2024-10-25 DOI: 10.1016/j.ejrad.2024.111806

Florian Bürckenmeyer, Stephanie Gräger, Lucja Mlynska, Felix Güttler, Maja Ingwersen, Ulf Teichgräber, Martin Krämer

Purpose

To compare the quality of deep learning image reconstructed (DLIR) virtual monochromatic images (VMI) and material density (MD) iodine images from dual-energy computed tomography (DECT) for the evaluation of head and neck neoplasms with CT scans from a conventional single-energy protocol.

Method

A total of 294 head and neck CT scans (98 VMIs operated at 60 keV, 102 MD iodine images, and 94 images from a 120 kVp single-energy CT (SECT) protocol) were retrospectively evaluated. VMIs and MD iodine images were generated using the Gemstone Spectral Imaging (GSI) mode using DLIR and metal artifact reduction (MAR) algorithms. SECT images were generated using adaptive statistical iterative reconstruction (ASIR-V). Images were scored by two independent readers on a 6-point Likert-type scale for overall image quality, vessel contrast, soft tissue contrast, noise texture, noise intensity, artifact reduction, and sharpness.

Results

Subjective overall image quality was rated as superior or excellent in 98 % of DLIR-based MD iodine images and VMIs, but only in 55 % of ASIR-V-based SECT images. For each individual quality criterion, image quality of VMIs and MD iodine images was rated as better than that of SECT images (p < 0.001 in each case). Noise texture and intensity were rated better in MD iodine images than in VMIs.

Conclusion

DECT using both DLIR and MAR for the generation of VMIs and MD iodine images resulted in higher subjective quality of oncologic head and neck images than ASIR-V-based SECT. Noise reduction and noise texture were best achieved with DLIR-based MD iodine images.

目的：比较双能量计算机断层扫描（DECT）的深度学习图像重建（DLIR）虚拟单色图像（VMI）和物质密度（MD）碘图像与传统单能量方案CT扫描的头颈部肿瘤评估质量：方法：对总计 294 例头颈部 CT 扫描（98 例在 60 keV 下操作的 VMI、102 例 MD 碘图像和 94 例来自 120 kVp 单能量 CT (SECT) 方案的图像）进行了回顾性评估。VMI 和 MD 碘图像是使用宝石光谱成像（GSI）模式、DLIR 和金属伪影减少（MAR）算法生成的。SECT 图像使用自适应统计迭代重建（ASIR-V）生成。图像由两名独立阅读者根据整体图像质量、血管对比度、软组织对比度、噪点纹理、噪点强度、伪影减少和清晰度进行 6 点李克特式评分：在基于 DLIR 的 MD 碘图像和 VMI 中，98% 的主观整体图像质量被评为优或良，但在基于 ASIR-V 的 SECT 图像中，只有 55% 的主观整体图像质量被评为优或良。就每项质量标准而言，VMI 和 MD 碘图像的图像质量均优于 SECT 图像（p 结论）：与基于 ASIR-V 的 SECT 相比，使用 DLIR 和 MAR 生成 VMI 和 MD 碘值图像的 DECT 可获得更高的头颈部肿瘤图像主观质量。基于 DLIR 的 MD 碘图像的降噪和噪点纹理效果最佳。

{"title":"Image quality of virtual monochromatic and material density iodine images for evaluation of head and neck neoplasms using deep learning-based CT image reconstruction – A retrospective observational study","authors":"Florian Bürckenmeyer, Stephanie Gräger, Lucja Mlynska, Felix Güttler, Maja Ingwersen, Ulf Teichgräber, Martin Krämer","doi":"10.1016/j.ejrad.2024.111806","DOIUrl":"10.1016/j.ejrad.2024.111806","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the quality of deep learning image reconstructed (DLIR) virtual monochromatic images (VMI) and material density (MD) iodine images from dual-energy computed tomography (DECT) for the evaluation of head and neck neoplasms with CT scans from a conventional single-energy protocol.</div></div><div><h3>Method</h3><div>A total of 294 head and neck CT scans (98 VMIs operated at 60 keV, 102 MD iodine images, and 94 images from a 120 kVp single-energy CT (SECT) protocol) were retrospectively evaluated. VMIs and MD iodine images were generated using the Gemstone Spectral Imaging (GSI) mode using DLIR and metal artifact reduction (MAR) algorithms. SECT images were generated using adaptive statistical iterative reconstruction (ASIR-V). Images were scored by two independent readers on a 6-point Likert-type scale for overall image quality, vessel contrast, soft tissue contrast, noise texture, noise intensity, artifact reduction, and sharpness.</div></div><div><h3>Results</h3><div>Subjective overall image quality was rated as superior or excellent in 98 % of DLIR-based MD iodine images and VMIs, but only in 55 % of ASIR-V-based SECT images. For each individual quality criterion, image quality of VMIs and MD iodine images was rated as better than that of SECT images (p < 0.001 in each case). Noise texture and intensity were rated better in MD iodine images than in VMIs.</div></div><div><h3>Conclusion</h3><div>DECT using both DLIR and MAR for the generation of VMIs and MD iodine images resulted in higher subjective quality of oncologic head and neck images than ASIR-V-based SECT. Noise reduction and noise texture were best achieved with DLIR-based MD iodine images.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111806"},"PeriodicalIF":3.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582624","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

CT imaging using variable helical pitch scanning for lower extremity arterial disease: Reduced contrast medium dose, improved image quality and diagnostic accuracy 使用可变螺旋间距扫描进行下肢动脉疾病的 CT 成像：降低造影剂剂量，提高图像质量和诊断准确性。

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

European Journal of Radiology

Pub Date : 2024-10-25 DOI: 10.1016/j.ejrad.2024.111792

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 , Ya-Rong Wang

Objectives

This study aimed to explore the feasibility of reducing contrast medium (CM) volume, improving image quality and diagnostic accuracy using variable helical pitch (VHP) scanning for patients with lower extremity arterial disease (LEAD).

Materials and methods

Eighty patients who underwent lower extremity CT angiography (CTA) were prospectively enrolled and randomly assigned to either the VHP group (n = 40) or the conventional group (n = 40). Quantitative parameters and qualitative scores were compared between the two groups. Additionally, out of these patients, 72 arteries from 18 patients had DSA as the reference standard, and the diagnostic accuracy for the degree of vessel stenosis was assessed and compared.

Results

In the VHP group, the contrast volume was significantly lower than in the conventional group (79.55 ± 11.87 mL vs. 89.63 ± 10.03 mL, p < 0.001), showing a reduction of 12.7 %. For all image quality characteristics, scores in VHP group were significantly superior to those in the conventional groups (all p < 0.05). Quantitative analysis revealed that images from the VHP group exhibited superior CT enhancement, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the anterior tibial arteries (ATA) and dorsali pedis arteries (DPA) compared to the conventional group (all p < 0.001). Moreover, segment-based analysis showed the VHP group had significantly higher positive predictive value (PPV) and accuracy than the conventional group (PPV: 100 % vs. 76.19 %, p = 0.01; accuracy: 100 % vs. 84.38 %, p = 0.01, respectively).

Conclusions

The implementation of the VHP protocol led to a 12.7 % decrease in contrast medium dosage compared to the conventional lower extremity CTA scanning protocol. Furthermore, it improved image quality and diagnostic accuracy, particularly for arteries below the knee.

目的：本研究旨在探讨对下肢动脉疾病（LEAD）患者使用可变螺旋间距（VHP）扫描减少造影剂（CM）用量、提高图像质量和诊断准确性的可行性：80名接受下肢CT血管造影术（CTA）的患者被纳入前瞻性研究，并随机分配到VHP组（40人）或传统组（40人）。两组患者的定量参数和定性评分进行了比较。此外，在这些患者中，18 名患者的 72 条动脉以 DSA 作为参考标准，对血管狭窄程度的诊断准确性进行了评估和比较：结果：VHP 组的造影剂用量明显低于常规组（79.55 ± 11.87 mL vs. 89.63 ± 10.03 mL，P 结论：VHP 组的造影剂用量明显低于常规组（79.55 ± 11.87 mL vs. 89.63 ± 10.03 mL，P 结论）：与传统的下肢 CTA 扫描方案相比，VHP 方案的实施使造影剂用量减少了 12.7%。此外，它还提高了图像质量和诊断准确性，尤其是膝下动脉。

{"title":"CT imaging using variable helical pitch scanning for lower extremity arterial disease: Reduced contrast medium dose, improved image quality and diagnostic accuracy","authors":"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 , Ya-Rong Wang","doi":"10.1016/j.ejrad.2024.111792","DOIUrl":"10.1016/j.ejrad.2024.111792","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to explore the feasibility of reducing contrast medium (CM) volume, improving image quality and diagnostic accuracy using variable helical pitch (VHP) scanning for patients with lower extremity arterial disease (LEAD).</div></div><div><h3>Materials and methods</h3><div>Eighty patients who underwent lower extremity CT angiography (CTA) were prospectively enrolled and randomly assigned to either the VHP group (n = 40) or the conventional group (n = 40). Quantitative parameters and qualitative scores were compared between the two groups. Additionally, out of these patients, 72 arteries from 18 patients had DSA as the reference standard, and the diagnostic accuracy for the degree of vessel stenosis was assessed and compared.</div></div><div><h3>Results</h3><div>In the VHP group, the contrast volume was significantly lower than in the conventional group (79.55 ± 11.87 mL vs. 89.63 ± 10.03 mL, p < 0.001), showing a reduction of 12.7 %. For all image quality characteristics, scores in VHP group were significantly superior to those in the conventional groups (all p < 0.05). Quantitative analysis revealed that images from the VHP group exhibited superior CT enhancement, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the anterior tibial arteries (ATA) and dorsali pedis arteries (DPA) compared to the conventional group (all p < 0.001). Moreover, segment-based analysis showed the VHP group had significantly higher positive predictive value (PPV) and accuracy than the conventional group (PPV: 100 % vs. 76.19 %, p = 0.01; accuracy: 100 % vs. 84.38 %, p = 0.01, respectively).</div></div><div><h3>Conclusions</h3><div>The implementation of the VHP protocol led to a 12.7 % decrease in contrast medium dosage compared to the conventional lower extremity CTA scanning protocol. Furthermore, it improved image quality and diagnostic accuracy, particularly for arteries below the knee.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111792"},"PeriodicalIF":3.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544602","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