European Journal of Radiology最新文献_第3页

Ccta-based AI for Diagnosing ≥ 50 % coronary Stenosis: A patient- and Vessel-Level meta-analysis 基于ccta的AI诊断≥50%冠状动脉狭窄：一项患者和血管水平的荟萃分析

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112634

Yiqiao Yan , Xinyuan Zhang , Chuan Liu , Hang Fu , Ke Xu , Huayan Xu

Background

To investigate the diagnostic performance of CCTA-based artificial intelligence (AI) in detecting ≥ 50 % coronary stenosis of coronary artery disease (CAD) at both the patient and vessel levels.

Methods

A systematic search of PubMed, Embase, and Web of Science databases (from inception to March 2025) was conducted to identify diagnostic studies evaluating CCTA-based AI methods for detecting CAD. Studies of ≥ 50 % coronary stenosis were enrolled. Data for diagnostic performance was extracted and meta analysis was performed. Statistical analyses were performed using RevMan 5.4, Meta-Disc 1.4, and Stata 16.0. This study was designed and reported following the PRISMA-DTA statement.

Results

The systematic search yielded 2,211 potentially relevant records. Following multi-stage screening, 11 eligible studies (1506 patients; 2896 vessels) were included. At the patient level, AI based assistant tools demonstrated pooled sensitivity of 0.95 [95 % CI (0.93–0.97)], specificity of 0.73 [95 % CI (0.61–0.82)], and AUC of 0.96 [95 % CI (0.94–0.97)] for CAD with ≥ 50 % stenosis diagnosis. The positive likelihood ratio (+LR) was 3.5 [95 % CI (2.4–5.2)] and negative likelihood ratio (−LR) was 0.07 [95 % CI (0.05–0.10)], with a pooled DOR of 52 [31–86]. At the vessel level of diagnosing ≥ 50 % stenosis diagnosis, AI-based assistant diagnostic tool showed pooled sensitivity of 0.87 [95 % CI (0.83–0.90)], specificity of 0.89 [95 % CI (0.82–0.93)], +LR of 7.7 [95 % CI (4.8–12.5)], −LR of 0.15 [95 % CI (0.11–0.19)], DOR of 53 [35–79], and AUC of 0.93 [95 % CI (0.90–0.95)].

Conclusion

When pooled across diverse deep-learning systems, AI-assisted CCTA demonstrates high sensitivity and solid diagnostic performance for detecting ≥ 50 % coronary stenosis. However, this reflects aggregated results from heterogeneous models rather than the capability of any single AI tool, limiting direct generalizability to specific systems or vendors.

研究基于ccta的人工智能（AI）在患者和血管水平检测冠心病（CAD）冠状动脉狭窄≥50%的诊断性能。方法系统检索PubMed、Embase和Web of Science数据库（从创建到2025年3月），以确定评估基于ccta的人工智能方法检测CAD的诊断研究。纳入了冠状动脉狭窄≥50%的研究。提取诊断表现数据并进行meta分析。采用RevMan 5.4、Meta-Disc 1.4和Stata 16.0进行统计分析。本研究的设计和报告遵循PRISMA-DTA声明。结果系统检索得到2211条可能相关的记录。经过多阶段筛选，纳入了11项符合条件的研究（1506例患者，2896条血管）。在患者水平上，基于人工智能的辅助工具对狭窄程度≥50%的CAD诊断的总敏感性为0.95 [95% CI(0.93-0.97)]，特异性为0.73 [95% CI (0.61-0.82)]， AUC为0.96 [95% CI(0.94-0.97)]。阳性似然比（+LR）为3.5 [95% CI(2.4-5.2)]，阴性似然比（- LR）为0.07 [95% CI(0.05-0.10)]，合并DOR为52[31-86]。在诊断≥50%狭窄的血管水平上，人工智能辅助诊断工具的总灵敏度为0.87 [95% CI(0.83-0.90)]，特异性为0.89 [95% CI (0.82-0.93)]， +LR为7.7 [95% CI (4.8% - 12.5)]， - LR为0.15 [95% CI (0.11-0.19)]， DOR为53 [35-79]，AUC为0.93 [95% CI(0.90-0.95)]。结论：人工智能辅助CCTA在多种深度学习系统中对冠状动脉狭窄的检测具有较高的灵敏度和可靠的诊断性能。然而，这反映了来自异构模型的聚合结果，而不是任何单个AI工具的能力，限制了对特定系统或供应商的直接推广。

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引用次数: 0

Diagnostic performance of Angio-Based fractional flow for hemodynamic assessment in intracranial Atherosclerosis 基于血管的分数血流在颅内动脉粥样硬化血流动力学评估中的诊断价值

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112635

Yongsheng Liu , Fengyi Zhang , Guiwen Shao, Yuxiang Liu, Yongjian Liu, Peng Ge, Feng Wang

Objectives

To evaluate the diagnostic performance of Angio-based fractional flow (Angio-FF), a computational fluid dynamics technique, for identifying hemodynamically significant intracranial atherosclerotic stenosis (ICAS) compared with the degree of stenosis (DS).

Materials and methods

This retrospective study included 348 patients with unilateral ICAS. Angio-FF was calculated using AccuFFicas V1.0 software. Diagnostic accuracy, sensitivity, specificity, and area under the ROC curve (AUC) were compared between Angio-FF and DS, stratified by stenosis severity, vascular territory, and Angio-FF gray zone.

Results

Symptomatic lesions exhibited lower Angio-FF (median 0.46 vs. 0.83, P < 0.001) and higher DS (69.5 % vs. 62.5 %, P < 0.001). Angio-FF showed superior AUC (0.884 vs. 0.664, P < 0.001) than DS. Angio-FF, using a cutoff value of 0.69, demonstrated significantly higher sensitivity (81.4 % vs. 50.0 %), specificity (88.9 % vs. 68.9 %), accuracy (83.3 % vs. 54.9 %), positive predictive value (PPV) (95.5 % vs. 82.2 %), and negative predictive value (NPV) (62.5 % vs. 32.5 %) compared to DS (≥ 70 % stenosis) for identifying culprit lesions (P < 0.001). Diagnostic performance was significantly better in anterior circulation lesions than in posterior ones, with higher sensitivity (91.8 % vs. 60.9 %), accuracy (89.5 % vs. 73.1 %), and NPV (73.1 % vs. 55.3 %) (all P < 0.05), while specificity and PPV remained high in both regions. Within the Angio-FF gray zone (0.64–0.74), diagnostic performance was lower than outside the zone, with reduced sensitivity (67.4 % vs. 84.4 %), accuracy (72.4 % vs. 85.5 %), and NPV (42.3 % vs. 67.6 %) (all P < 0.05), yet it still outperformed DS, with a higher AUC (0.795 vs. 0.524, P = 0.003).

Conclusions

Angio-FF outperformed conventional DS assessment in identifying hemodynamically significant ICAS, with particularly high accuracy in lesions with < 70 % stenosis. Despite reduced performance within the gray zone, it remained more reliable than DS.

Abbreviations: ICAS, intracranial atherosclerotic stenosis; TIA, transient ischemic attack; DS, degree of stenosis; FF, fractional flow; Angio-FF, Angio-based fractional flow; CFD, computational fluid dynamics; DSA, digital subtraction angiography; AUC, area under the curve; ROC, receiver operating characteristic; PPV, positive predictive value; NPV, negative predictive value; DCA, decision curve analysis; MCA, middle cerebral artery; BA, basilar artery; VA, vertebral artery; IQR, interquartile range; MRA, magnetic resonance angiography; Pa, proximal arterial pressure; Pd, distal arterial pressure; TIMI, Thrombolysis In Myocardial Infarction.

目的评价基于血管的分数血流（angiobased fractional flow，简称Angio-FF）作为一种计算流体动力学技术，对血流动力学意义显著的颅内动脉粥样硬化性狭窄（ICAS）和狭窄程度（DS）的诊断价值。材料与方法本研究纳入348例单侧ICAS患者。使用AccuFFicas V1.0软件计算血管内皮素水平。通过狭窄严重程度、血管范围和Angio-FF灰色区进行分层，比较了Angio-FF和DS的诊断准确性、敏感性、特异性和ROC曲线下面积（AUC）。结果有症状的病变表现为较低的Angio-FF（中位数0.46比0.83,P < 0.001）和较高的DS（中位数69.5%比62.5%,P < 0.001）。Angio-FF的AUC（0.884比0.664,P < 0.001）优于DS。与DS（狭窄度≥70%）相比，使用截断值0.69的Angio-FF在识别罪魁祸首病变方面表现出更高的敏感性（81.4%比50.0%）、特异性（88.9%比68.9%）、准确性（83.3%比54.9%）、阳性预测值（PPV）（95.5%比82.2%）和阴性预测值（NPV）（62.5%比32.5%）（P < 0.001）。前循环病变的诊断表现明显优于后循环病变，敏感性（91.8%比60.9%）、准确性（89.5%比73.1%）和NPV（73.1%比55.3%）均较高（P < 0.05），特异性和PPV在两个区域均保持较高水平。在Angio-FF灰色区域（0.64-0.74）内，诊断性能低于该区域外，敏感性（67.4% vs. 84.4%）、准确性（72.4% vs. 85.5%）和NPV (42.3% vs. 67.6%)（均P <； 0.05），但仍优于DS， AUC较高（0.795 vs. 0.524, P = 0.003）。结论sangio - ff在识别血流动力学意义显著的ICAS方面优于传统DS评估，在狭窄<； 70%的病变中准确率特别高。尽管在灰色区域内性能下降，但它仍然比DS更可靠。缩写：ICAS，颅内动脉粥样硬化性狭窄；TIA，短暂性脑缺血发作；DS：狭窄程度；FF，分流；Angio-FF，血管分流；计算流体力学；DSA，数字减影血管造影；AUC：曲线下面积；ROC，接收机工作特性；PPV，阳性预测值；NPV，负预测值；DCA，决策曲线分析；MCA，大脑中动脉；BA，基底动脉；VA，椎动脉；IQR，四分位间距；磁共振血管造影；Pa，近端动脉压；Pd，远端动脉压；TIMI，心肌梗死中的溶栓。

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引用次数: 0

Head position matters: Position‑dependent vestibular flow void artifacts in inner ear MRI and their clinical implications 头部位置问题：内耳MRI中位置依赖的前庭血流空洞伪影及其临床意义

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejrad.2025.112638

Domagoj Javor , Markus Leyer , Bryan K. Ward , Barbara Bennani-Baiti , Elisabeth Ranharter , Michael Bauer , Margit Kirschbaum , Markus Brunner , Bela Büki

It has been shown that static magnetic fields from high-strength magnetic resonance imaging (MRI) machines induce nystagmus in all humans with intact inner ear function. This effect can be explained by the magneto-hydrodynamic Lorentz force, which arises from the interaction of endolymphatic ionic currents and the strong static magnetic field of an MRI machine. Prior experiments demonstrated that MRI-induced nystagmus and vertigo vary with head pitch relative to the magnetic field, being reduced when the head is pitched forward and increased when extended. In another study it has been suggested that signal void artefacts reflected Lorentz-force-induced endolymph movement caused by the interaction between ionic currents flowing through the utricular macula and the static magnetic field of the MRI scanner. Based on these findings the present authors proposed that if the hypointensities are flow voids caused by Lorentz forces, their visibility should also vary with head pitch. In this case, both nystagmus and vestibular hypointensities would share a common mechanism. Twenty healthy volunteers (8 males and 12 females) were recruited to undergo a non-contrast 3 Tesla (T) MRI scan in one of two head pitch positions: chin up (head extension, pitched backward) and chin down (head flexion, pitched forward). A statistically significant increase in hypointensities was observed between the pitched forward and pitched backward positions for both ears (p < 0.01), while no significant differences were detected between corresponding positions of the left and right ears. These findings not only support a Lorentz‑force origin of vestibular hypointensities but also have immediate clinical applicability, with direct implications for radiological interpretation and protocol design to reduce misinterpretation and patient vertigo.

研究表明，来自高强度磁共振成像（MRI）机器的静态磁场会诱发所有内耳功能完好的人的眼球震颤。这种效应可以用磁流体动力学洛伦兹力来解释，洛伦兹力是由内淋巴离子电流和核磁共振成型机的强静态磁场相互作用产生的。先前的实验表明，mri诱发的眼球震颤和眩晕随着头部相对于磁场的俯仰而变化，当头部向前倾时减少，当头部向前伸时增加。在另一项研究中，有人认为信号空洞伪影反映了洛伦兹力诱导的内淋巴运动，这是由流过核斑的离子电流与MRI扫描仪的静态磁场之间的相互作用引起的。基于这些发现，本文作者提出，如果低强度是由洛伦兹力引起的流动空洞，它们的可见性也应该随头部间距而变化。在这种情况下，眼球震颤和前庭低血压可能有一个共同的机制。招募了20名健康志愿者（8名男性和12名女性），在两种头部俯仰姿势中的一种进行了非对比特斯拉(T) MRI扫描：下巴向上（头部伸展，向后倾斜）和下巴向下（头部弯曲，向前倾斜）。双耳前倾和后倾位置之间的低强度有统计学意义的增加（p < 0.01），而左右耳相应位置之间无统计学意义的差异。这些发现不仅支持前庭低血压的洛伦兹力起源，而且具有直接的临床适用性，对放射学解释和方案设计具有直接意义，以减少误解和患者眩晕。

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引用次数: 0

Hitting the Bull’s AI: Artificial Intelligence-derived Imaging Features and their Association with Outcomes in CT-guided Lung Biopsy, a Retrospective Study 击中公牛的人工智能：人工智能衍生的成像特征及其与ct引导下肺活检结果的关联，一项回顾性研究

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejrad.2025.112642

Christian Roller , Till Ittermann , Annika Syperek , Matthias Mühler , Mark O Wielpütz , Jens-Peter Kühn , Sophia FU Blum , Felix Schön , Patrick Winter , Susanne Schnell , Marie-Luise Kromrey

Purpose

This study aims to evaluate whether quantitative imaging features analyzed by an artificial intelligence (AI) tool are associated with success rate, histopathological results, and complication risks of CT-guided lung biopsies.

Methods

A retrospective study was conducted on 120 CT-guided biopsies of suspicious pulmonary lesions with pathology reports. Associations between technical success, histopathology, occurrence of peri-interventional complications, as well as intervention-related factors such as lesion diameter and biopsy pathway and the AI-derived parameters lesion volume, malignancy probability and emphysema ratio were assessed using t-test for continuous data and Chi-square test for categorical data. Adjusted multivariate logistic regression models and predictive performance of AI parameters were calculated.

Results

Ninety-eight of 120 biopsies (81.7 %) were technically successful. Peri-interventional pneumothorax occurred in 65 % of cases, 26.7 % needed drainage. Alveolar hemorrhage was documented in 53.3 %, high-grade hemorrhage in 30.8 %. Adjusted regression models showed significant association of AI-derived lesion volume with technical success (OR = 1.30, CI 1.00; 1.69), AI malignancy chance with histopathologically confirmed malignancy (OR = 1.17, CI 1.08; 1.28) and AI emphysema ratio with increased risk of pneumothorax requiring chest tube insertion (OR = 1.29, CI 1.12; 1.48). For alveolar hemorrhage, only AI lesion volume (p = 0.011) showed a significant inverse correlation in unadjusted models, while adjusted models identified emphysema ratio as the relevant AI feature.

Conclusions

AI derived imaging features show significant association with complication risks in CT-guided lung biopsies, like pneumothorax and alveolar hemorrhage. This may allow stricter patient selection and better execution of biopsies, which may lead to improved outcomes and patient safety. Additionally, software’s high association with histopathological malignancy supports reconsideration of its role in guiding the indication for lung biopsy in the assessment of pulmonary lesions.

Clinical Relevance Statement

With the advancing integration of AI tools into radiological workflows, this study highlights AI’s potential to provide pre-interventional risk stratification and outcome predictions for CT-guided lung biopsies, which are the gold standard for sampling peripheral lung lesions.

目的本研究旨在评估人工智能（AI）工具分析的定量影像学特征是否与ct引导下肺活检的成功率、组织病理学结果和并发症风险相关。方法对120例ct引导下的可疑肺病变活检病例进行回顾性分析。连续资料采用t检验，分类资料采用卡方检验，评估技术成功、组织病理学、介入周并发症发生、病变直径、活检路径等干预相关因素与人工智能衍生参数病变体积、恶性肿瘤概率、肺气肿率之间的关系。计算调整后的多元逻辑回归模型和人工智能参数的预测性能。结果120例活检中98例（81.7%）技术成功。65%的病例发生介入期气胸，26.7%需要引流。53.3%的患者有肺泡出血，30.8%的患者有重度出血。调整后的回归模型显示，人工智能病变体积与技术成功相关（OR = 1.30, CI 1.00; 1.69），人工智能恶性肿瘤发生率与组织病理学证实的恶性肿瘤相关（OR = 1.17, CI 1.08; 1.28），人工智能肺气肿发生率与需要插入胸管的气胸风险增加相关（OR = 1.29, CI 1.12; 1.48）。对于肺泡出血，在未调整的模型中，只有AI病变体积（p = 0.011）与肺气肿呈显著负相关，而调整后的模型将肺气肿比例确定为相关的AI特征。结论ct引导下肺活检的影像学特征与气胸、肺泡出血等并发症风险有显著相关性。这可能允许更严格的患者选择和更好的活检执行，这可能导致改善的结果和患者的安全。此外，软件与组织病理学恶性肿瘤的高度关联支持重新考虑其在肺病变评估中指导肺活检指征的作用。随着人工智能工具与放射工作流程的不断整合，本研究强调了人工智能在为ct引导的肺活检提供介入前风险分层和结果预测方面的潜力，而ct引导的肺活检是周围肺病变采样的金标准。

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引用次数: 0

Evaluation of multi-keV PureCalcium images from photon-counting CT for abdominal imaging: A comparison with true and conventional virtual non-contrast images 基于光子计数CT的多键纯钙图像对腹部成像的评价：与真实和传统虚拟非对比图像的比较。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejrad.2025.112640

Liming Li , Yang Yao , Kehui Nie , Mengchen Yuan , Songmei Fan , Jianbo Gao

Purpose

To determine which keV PureCa images can effectively substitute TNC images for abdominal imaging.

Methods

A total of 50 consecutive patients who underwent thoracoabdominal scans on Photon-Counting CT from January to April 2025 were included. A true non-contrast (TNC), arterial (CTA) and venous (CTV) phase images were analyzed. Conventional virtual non-contrast (VNC) and 5 PureCa images were reconstructed from each contrast phase. Attenuation values and noise on 12 regions of interest were measured. Overall image quality, contrast removal and calcium preservation were analyzed using a 5-point scale. The paired t-tests and Friedman tests were applied to compare objective and subjective results.

Results

70 keV yielded the smallest HUerror in the majority of abdominal tissues during the arterial and venous phase. The overall trend demonstrated a plateau in noise reduction beyond 65 keV. Compared with VNC images, PureCa demonstrated significantly lower HUerror in key soft tissues: Liver: 2 (1–6) HU vs 5 (3–8) HU (P = 0.001), Muscle: 2 (1–4) HU vs 10 (7–14) HU (P < 0.001), subcutaneous adipose tissue: 2.5 (1–4) HU vs 39 (33–42) HU (P < 0.001). All patients had a subjective score of 3 or above. 65–70 keV PureCa images were rated significantly higher than 50–60 keV images, and comparable to VNC, but still inferior to TNC (P < 0.05).

Conclusions

PureCa images reconstructed at 70 keV on photon-counting CT systems provide accurate attenuation values and satisfactory image quality for abdominal tissues.

目的：确定哪些keV PureCa图像可以有效地替代TNC图像进行腹部成像。方法：选取自2025年1月至4月连续50例行光子计数CT胸腹扫描的患者。对真实无对比期（TNC）、动脉期（CTA）和静脉期（CTV）图像进行分析。从每个对比阶段重建常规虚拟非对比（VNC）和5张PureCa图像。测量了12个感兴趣区域的衰减值和噪声。整体图像质量、对比度去除和钙保存采用5分制进行分析。采用配对t检验和Friedman检验比较客观和主观结果。结果：在动脉和静脉期，70 keV在大多数腹部组织中产生最小的HUerror。总体趋势表明，在65 keV以上，降噪趋于平稳。与VNC图像相比，PureCa显示关键软组织的HUerror明显降低：肝脏：2 (1-6)HU vs 5 (3-8) HU (P = 0.001)，肌肉：2 (1-4)HU vs 10 (7-14) HU (P < 0.001)，皮下脂肪组织：2.5 (1-4)HU vs 39 (33-42) HU （P < 0.001）。所有患者主观评分均在3分及以上。65-70 keV的PureCa图像评分明显高于50-60 keV的图像，与VNC相当，但仍低于TNC (P)结论：在光子计数CT系统上重建的PureCa图像在70 keV下可以提供准确的衰减值和令人满意的图像质量。

{"title":"Evaluation of multi-keV PureCalcium images from photon-counting CT for abdominal imaging: A comparison with true and conventional virtual non-contrast images","authors":"Liming Li , Yang Yao , Kehui Nie , Mengchen Yuan , Songmei Fan , Jianbo Gao","doi":"10.1016/j.ejrad.2025.112640","DOIUrl":"10.1016/j.ejrad.2025.112640","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine which keV PureCa images can effectively substitute TNC images for abdominal imaging.</div></div><div><h3>Methods</h3><div>A total of 50 consecutive patients who underwent thoracoabdominal scans on Photon-Counting CT from January to April 2025 were included. A true non-contrast (TNC), arterial (CTA) and venous (CTV) phase images were analyzed. Conventional virtual non-contrast (VNC) and 5 PureCa images were reconstructed from each contrast phase. Attenuation values and noise on 12 regions of interest were measured. Overall image quality, contrast removal and calcium preservation were analyzed using a 5-point scale. The paired t-tests and Friedman tests were applied to compare objective and subjective results.</div></div><div><h3>Results</h3><div>70 keV yielded the smallest HUerror in the majority of abdominal tissues during the arterial and venous phase. The overall trend demonstrated a plateau in noise reduction beyond 65 keV. Compared with VNC images, PureCa demonstrated significantly lower HUerror in key soft tissues: Liver: 2 (1–6) HU vs 5 (3–8) HU (P = 0.001), Muscle: 2 (1–4) HU vs 10 (7–14) HU (P < 0.001), subcutaneous adipose tissue: 2.5 (1–4) HU vs 39 (33–42) HU (P < 0.001). All patients had a subjective score of 3 or above. 65–70 keV PureCa images were rated significantly higher than 50–60 keV images, and comparable to VNC, but still inferior to TNC (P < 0.05).</div></div><div><h3>Conclusions</h3><div>PureCa images reconstructed at 70 keV on photon-counting CT systems provide accurate attenuation values and satisfactory image quality for abdominal tissues.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112640"},"PeriodicalIF":3.3,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910798","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

ChatGPT-5–Based large language model analysis versus an FDA-approved AI-CAD system for thyroid nodule ultrasound evaluation 基于chatgpt -5的大语言模型分析与fda批准的用于甲状腺结节超声评估的AI-CAD系统。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejrad.2025.112639

Ziman Chen , Mengting Ye , Jieyi Liang , Fei Chen , Michael Tin Cheung Ying

Purpose

Recent advances in multimodal large language models (LLMs) have demonstrated promising potential for medical image analysis, yet their diagnostic capability in thyroid ultrasound remains unverified. This study explored the feasibility of ChatGPT-5, the latest multimodal LLM, for thyroid nodule classification and contextualized its diagnostic performance against S-Detect, an FDA-approved commercial computer-aided diagnosis system.

Methods

In this prospective study, 141 patients with 186 nodules who underwent preoperative ultrasound and subsequent surgery were enrolled. For S-Detect, the largest transverse grayscale ultrasound image of each nodule was analyzed with automated contouring for binary classification. For ChatGPT-5, cropped transverse and longitudinal nodule ultrasound images were analyzed using a standardized diagnostic prompt for binary classification. Agreement with histopathology was assessed using Kappa statistics; sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) were calculated.

Results

Both systems showed statistically significant ability to distinguish benign from malignant nodules (P < 0.05). Agreement with histopathology was fair for ChatGPT-5 (Kappa = 0.224) and moderate for S-Detect (Kappa = 0.579). ChatGPT-5 demonstrated sensitivity 50.8 %, specificity 75.8 %, and accuracy 59.1 %, whereas S-Detect achieved higher sensitivity (91.9 %) and accuracy (82.3 %) but lower specificity (62.9 %). The AUC for S-Detect (77.4 %) was significantly greater than that for ChatGPT-5 (63.3 %, P < 0.001).

Conclusions

ChatGPT-5 demonstrated feasibility for thyroid nodule classification but showed lower diagnostic performance than the licensed, pre-trained S-Detect system and is not yet adequate for medical imaging applications.

目的：多模态大语言模型（LLMs）在医学图像分析方面的最新进展显示出了良好的潜力，但其在甲状腺超声诊断方面的能力仍未得到证实。本研究探讨了ChatGPT-5（最新的多模态LLM）用于甲状腺结节分类的可行性，并将其诊断性能与fda批准的商用计算机辅助诊断系统S-Detect进行了对比。方法：在这项前瞻性研究中，141例186个结节患者接受了术前超声检查和随后的手术。对于S-Detect，对每个结节的最大横向灰度超声图像进行自动轮廓分析，进行二值分类。对于ChatGPT-5，使用标准化的诊断提示进行二值分类，分析裁剪的横向和纵向结节超声图像。采用Kappa统计法评估与组织病理学的一致性；计算灵敏度、特异度、准确度和受试者工作特征曲线下面积。结果：两种系统鉴别良恶性结节的能力均有统计学意义（P < 0.05）。ChatGPT-5与组织病理学的一致性为一般（Kappa = 0.224）， S-Detect与组织病理学的一致性为中等（Kappa = 0.579）。ChatGPT-5的灵敏度为50.8%，特异性为75.8%，准确性为59.1%，而S-Detect的灵敏度（91.9%）和准确性（82.3%）更高，但特异性较低（62.9%）。S-Detect的AUC（77.4%）显著高于ChatGPT-5的AUC （63.3%, P < 0.001）。结论：ChatGPT-5显示了甲状腺结节分类的可行性，但其诊断性能低于许可的预训练S-Detect系统，尚不足以用于医学成像应用。

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引用次数: 0

Evaluation of two software programs for cross‐sectional body composition analysis on abdominal computed tomography scans of patients with cirrhosis 两种软件程序对肝硬化患者腹部计算机断层扫描的横断面身体成分分析的评价

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejrad.2025.112637

Francesca D’Arcangelo , Alberto Zanetto , Abha Dunichand-Hoedl , Maryam Motamedrad , Patrizia Burra , Aldo J. Montano-Loza

The impact of body composition abnormalities and clinical outcomes in patients with cirrhosis is well established. Abdominal computed tomography (CT) evaluation is the technique that is better evaluated; however, agreements are not well known. Fifty patients were randomly selected from two centers, and two observers independently evaluated their CT. The cross-sectional muscle area (CSMA), skeletal muscle index (SMI), muscle attenuation (MA), visceral adipose tissue area (VAT), visceral adipose tissue index (VATI), subcutaneous adipose tissue area (SAT), and subcutaneous adipose tissue area (SATI) were analyzed using SliceOmatic©V.5.0 (Magog, Canada), and Synapse 3D, Fujifilm. The interobserver and intersoftware intra-class correlation coefficients (ICCs) were highly equivalent for CSMA, SMI, MA, VAT, VATI, SAT, and SATI (Range 0.984–0.999, P < 0.001), and excellent Pearson’s correlation coefficients were found for all comparisons (Range 0.970–0.998). Using different software programs to evaluate body composition in patients with cirrhosis showed excellent agreement for measuring muscle mass and adipose depots.

机体成分异常对肝硬化患者临床预后的影响已得到充分证实。腹部计算机断层扫描（CT）评估是更好的评估技术；然而，协议并不广为人知。从两个中心随机选择50例患者，由两名观察员独立评估他们的CT。使用SliceOmatic©V.5.0 （Magog, Canada）和Synapse 3D， Fujifilm分析横断肌面积（CSMA）、骨骼肌指数（SMI）、肌肉衰减（MA）、内脏脂肪组织面积（VAT）、内脏脂肪组织指数（VATI）、皮下脂肪组织面积（SAT）和皮下脂肪组织面积（SATI）。CSMA、SMI、MA、VAT、VATI、SAT和SATI的观察者间和软件间类内相关系数（ICCs）高度相等（范围0.984-0.999,P < 0.001），所有比较的Pearson相关系数都很好（范围0.970-0.998）。使用不同的软件程序来评估肝硬化患者的身体成分，在测量肌肉质量和脂肪储备方面显示出极好的一致性。

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引用次数: 0

Development and characterization of new contrast agents for Photon-Counting CT 新型光子计数CT造影剂的研制与表征

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejrad.2025.112643

Mika Donabauer , Stefan Sawall , Isabelle Ayx , Carmen Wängler , Stefan O. Schoenberg , Björn Wängler

Purpose

The development of novel contrast agents is a critical step in unleashing the full potential of Photon-Counting Computed Tomography (PCCT), as clinically approved iodine contrast agents do not exhibit optimal spectral properties to harness the full potential of photon-counting detectors. Moreover, material decomposition requires the application of different contrast agents with differing X-ray attenuation characteristics at different photon energies. However, the development of contrast agents being suitable for this purpose is in its infancy, limiting the imaging options of PCCT. In this study, we investigated which of the elements lanthanum, gadolinium, ytterbium, lead, bismuth and gold are suitable for use as the basis of contrast agents in PCCT as these should exhibit highly interesting X-ray attenuation characteristics at different tube voltages for this application.

Methods

New contrast agents based on the aforementioned elements were synthesized and characterized in terms of stability. Further, these substances were characterized by phantom studies on the first FDA-approved clinical PCCT Naeotom Alpha scanner with regard to contrast generation at different tube voltages of 70, 90, 120, and 140 kV in comparison to the approved iodine-based contrast agent Gastrolux to determine their general potential for PCCT imaging.

Results

We found that at lower tube voltages of 70 kV, iodine (48.1 ± 0.8 HU/(mg/mL)) and gadolinium (43.5 ± 1.0 HU/(mg/mL)) demonstrated the highest attenuation rates, whereas lanthanum, gold, ytterbium, and lead showed lower X-ray attenuation efficiency under these conditions (35.7 ± 0.7, 28.1 ± 0.6, 25.8 ± 0.2, and 25.3 ± 0.1 HU/(mg/mL), respectively). At a higher tube voltage of 120 kV, the situation changed, showing the highest attenuation rates for gadolinium, ytterbium, and iodine (33.4 ± 0.4, 28.1 ± 0.1, and 24.6 ± 0.3 HU/(mg/mL), respectively), followed by gold, bismuth, lanthanum, and lead (23.5 ± 0.3, 21.7 ± 0.2, 19.7 ± 0.3, and 18.1 ± 0.1 HU/(mg/mL), respectively).

Conclusions

Although all elements investigated showed a general suitability for implementation in contrast-enhanced CT imaging, iodine, gadolinium and ytterbium demonstrated the highest potential in this regard. However, also gold and bismuth could in general be suitable for material decomposition studies in combination with the aforementioned elements in cases necessitating a strongly varying contrasting behavior at chosen tube voltages.

新型造影剂的开发是释放光子计数计算机断层扫描（PCCT）潜力的关键一步，因为临床批准的碘造影剂没有表现出最佳的光谱特性来充分利用光子计数检测器的潜力。此外，材料分解需要应用不同的造影剂，在不同的光子能量下具有不同的x射线衰减特性。然而，适合这一目的的造影剂的发展尚处于起步阶段，限制了PCCT的成像选择。在这项研究中，我们研究了哪些元素镧、钆、镱、铅、铋和金适合作为PCCT造影剂的基础，因为这些元素在不同的管电压下应该表现出非常有趣的x射线衰减特性。方法合成以上述元素为基础的新型造影剂，并对其稳定性进行表征。此外，在fda批准的首台临床PCCT Naeotom Alpha扫描仪上对这些物质进行了模拟研究，以确定它们在不同管电压（70、90、120和140千伏）下的造影剂生成情况，并与已批准的碘基造影剂Gastrolux进行了比较，以确定它们在PCCT成像中的总体潜力。结果在较低的管电压为70 kV时，碘（48.1±0.8 HU/(mg/mL)）和钆（43.5±1.0 HU/(mg/mL)）的x射线衰减率最高，而镧、金、镱和铅的衰减率较低（分别为35.7±0.7、28.1±0.6、25.8±0.2和25.3±0.1 HU/(mg/mL)）。在120 kV较高的管电压下，衰减率最高的是钆、镱和碘（分别为33.4±0.4、28.1±0.1和24.6±0.3 HU/(mg/mL)），其次是金、铋、镧和铅（分别为23.5±0.3、21.7±0.2、19.7±0.3和18.1±0.1 HU/(mg/mL)）。结论虽然所研究的元素在CT增强成像中表现出一般的适用性，但碘、钆和镱在这方面表现出最高的潜力。然而，在需要在选定的管电压下产生强烈变化的对比行为的情况下，金和铋通常也适用于与上述元素结合的材料分解研究。

{"title":"Development and characterization of new contrast agents for Photon-Counting CT","authors":"Mika Donabauer , Stefan Sawall , Isabelle Ayx , Carmen Wängler , Stefan O. Schoenberg , Björn Wängler","doi":"10.1016/j.ejrad.2025.112643","DOIUrl":"10.1016/j.ejrad.2025.112643","url":null,"abstract":"<div><h3>Purpose</h3><div>The development of novel contrast agents is a critical step in unleashing the full potential of Photon-Counting Computed Tomography (PCCT), as clinically approved iodine contrast agents do not exhibit optimal spectral properties to harness the full potential of photon-counting detectors. Moreover, material decomposition requires the application of different contrast agents with differing X-ray attenuation characteristics at different photon energies. However, the development of contrast agents being suitable for this purpose is in its infancy, limiting the imaging options of PCCT. In this study, we investigated which of the elements lanthanum, gadolinium, ytterbium, lead, bismuth and gold are suitable for use as the basis of contrast agents in PCCT as these should exhibit highly interesting X-ray attenuation characteristics at different tube voltages for this application.</div></div><div><h3>Methods</h3><div>New contrast agents based on the aforementioned elements were synthesized and characterized in terms of stability. Further, these substances were characterized by phantom studies on the first FDA-approved clinical PCCT Naeotom Alpha scanner with regard to contrast generation at different tube voltages of 70, 90, 120, and 140 kV in comparison to the approved iodine-based contrast agent Gastrolux to determine their general potential for PCCT imaging.</div></div><div><h3>Results</h3><div>We found that at lower tube voltages of 70 kV, iodine (48.1 ± 0.8 HU/(mg/mL)) and gadolinium (43.5 ± 1.0 HU/(mg/mL)) demonstrated the highest attenuation rates, whereas lanthanum, gold, ytterbium, and lead showed lower X-ray attenuation efficiency under these conditions (35.7 ± 0.7, 28.1 ± 0.6, 25.8 ± 0.2, and 25.3 ± 0.1 HU/(mg/mL), respectively). At a higher tube voltage of 120 kV, the situation changed, showing the highest attenuation rates for gadolinium, ytterbium, and iodine (33.4 ± 0.4, 28.1 ± 0.1, and 24.6 ± 0.3 HU/(mg/mL), respectively), followed by gold, bismuth, lanthanum, and lead (23.5 ± 0.3, 21.7 ± 0.2, 19.7 ± 0.3, and 18.1 ± 0.1 HU/(mg/mL), respectively).</div></div><div><h3>Conclusions</h3><div>Although all elements investigated showed a general suitability for implementation in contrast-enhanced CT imaging, iodine, gadolinium and ytterbium demonstrated the highest potential in this regard. However, also gold and bismuth could in general be suitable for material decomposition studies in combination with the aforementioned elements in cases necessitating a strongly varying contrasting behavior at chosen tube voltages.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112643"},"PeriodicalIF":3.3,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879948","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

Clarifying the practical interpretation of the CAD-RADS “N” modifier in routine coronary CT angiography 阐明CAD-RADS“N”修饰符在常规冠状动脉CT血管造影中的实际意义

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejrad.2025.112627

Yigit Can Kartal, Hakan Ayyildiz, Sercin Ozkok

引用次数: 0

Magnetic resonance imaging of penile Prostheses: A pictorial review of normal appearances and complications 阴茎假体的磁共振成像：正常外观和并发症的图像回顾

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2025-12-30 DOI: 10.1016/j.ejrad.2025.112625

Francesco Verde , Vincenzo Iossa , Costanza Camillo , Dario Grimaldi , Roberto Ronza , Francesca Iacobellis , Francesco Muto , Marco Fasbender Jacobitti , Luigi Pucci , Enrico Scarano , Maurizio Carrino , Marco Di Serafino

Penile prostheses represent the definitive treatment option for erectile dysfunction refractory to conservative management, and recognition of their imaging appearances and potential complications is essential for radiologists. Magnetic resonance imaging (MRI) has emerged as the optimal imaging modality for post-implantation evaluation, offering superior soft tissue contrast and multiplanar capabilities compared to ultrasound and computed tomography. This review provides a comprehensive overview of penile prosthesis types, including semi-rigid and two- and three-piece inflatable devices, with emphasis on the imaging-relevant anatomical considerations of different surgical approaches. We present standardised MRI protocols for prosthesis evaluation, detailing recommended sequences, imaging planes, and technical parameters. The normal MRI appearances of each prosthesis component are described, including cylinders, pump, reservoir, and connecting tubing. The review illustrates the MRI findings of mechanical complications (fluid leakage, cylinder fracture, aneurysm formation), malpositioning abnormalities (erosion, cylinder crossover, buckling, floppy glans syndrome), and infectious complications, supported by a comprehensive pictorial collection. The complementary roles of computed tomography and ultrasound are also discussed. This pictorial review aims to familiarise radiologists with the expected post-surgical appearances and the spectrum of complications detectable on imaging, enabling accurate diagnosis and timely clinical management.

阴茎假体是难以保守治疗的勃起功能障碍的最终治疗选择，认识到其影像学表现和潜在的并发症对放射科医生至关重要。磁共振成像（MRI）已成为植入后评估的最佳成像方式，与超声和计算机断层扫描相比，它提供了优越的软组织对比和多平面成像能力。这篇综述提供了阴茎假体类型的全面概述，包括半刚性和两件和三件充气装置，重点是不同手术入路的成像相关解剖学考虑。我们提出了用于假体评估的标准化MRI方案，详细介绍了推荐的序列、成像平面和技术参数。描述了每个假体部件的正常MRI外观，包括圆柱体、泵、储层和连接管。这篇综述阐述了机械并发症（液体泄漏、椎体骨折、动脉瘤形成）、定位异常（侵蚀、椎体交叉、屈曲、龟头松弛综合征）和感染性并发症的MRI表现，并提供了全面的图片收集。计算机断层扫描和超声的互补作用也进行了讨论。这篇图片综述旨在使放射科医生熟悉预期的术后表现和成像可检测的并发症谱，从而实现准确的诊断和及时的临床管理。

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引用次数: 0