Introduction: Bronchiectasis, closely associated with nontuberculous mycobacterial pulmonary disease (NTM-PD), exhibits unevenly distributed lesions, yet their spatial features remain unclear. We hypothesized that upright CT, which may better depict distal airways due to gravity-induced lung expansion, might more accurately reflect disease severity and its relationship with pulmonary function tests (PFTs).
Methods: In this prospective study, twenty patients underwent low-dose inspiratory and expiratory CT scans in standing and supine positions. Airways were segmented with Vincent® software and classified as bronchiectatic or non-bronchiectatic. Generation-specific quantitative CT (QCT) parameters, including inspiratory airway total area (ITA), inspiratory airway lumen area (ILA), wall thickness, and wall area percentage (WA%), were measured and correlated with PFTs.
Results: Bronchiectatic lesions were primarily identified in the 8th-10th generation airways (anatomically the 7th-9th generations), the transition from distal bronchi to proximal bronchioles. Standing CT detected more distal airways than supine CT. Mixed-effect models revealed significantly larger ITA and higher WA% in bronchiectatic airways (8th-10th generations) on standing CT. In non-bronchiectatic airways (trachea to 6th generation), ITA and ILA were significantly larger in the standing position, except for the main bronchus ITA. ITA, ILA, and WA% were moderate to strongly correlated with %FVC, %FEV1, and FEF25-75%, reflecting airway obstruction, with stronger correlations in the standing position. ITA in bronchiectatic airways was moderately negatively correlated with diffusing capacity of the lungs for carbon monoxide, indicating potential alveolar disease.
Conclusion: Upright CT offers useful structural biomarkers associated with airflow limitation and possible alveolar impairment in bronchiectasis with NTM-PD.
Registration: University Hospital Medical Information Network (UMIN 000026587). URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000030456.
{"title":"Quantitative airway evaluation using supine and upright computed tomography in patients with non-cystic fibrosis bronchiectasis and nontuberculous mycobacterial pulmonary disease.","authors":"Masanori Kaji, Takanori Asakura, Yoshitake Yamada, Hiromu Tanaka, Ho Namkoong, Shotaro Chubachi, Minoru Yamada, Takuya Ozawa, Yoichi Yokoyama, Shin Iizuka, Keiichi Narita, Genta Nagao, Ryoichi Kato, Naoki Fukunaga, Shunsuke Nakamura, Shuhei Azekawa, Sayaka Miyazaki, Kensuke Nakagawara, Hirofumi Kamata, Richard C Boucher, Koichi Fukunaga, Naoki Hasegawa, Masahiro Jinzaki","doi":"10.1016/j.ejrad.2025.112626","DOIUrl":"https://doi.org/10.1016/j.ejrad.2025.112626","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchiectasis, closely associated with nontuberculous mycobacterial pulmonary disease (NTM-PD), exhibits unevenly distributed lesions, yet their spatial features remain unclear. We hypothesized that upright CT, which may better depict distal airways due to gravity-induced lung expansion, might more accurately reflect disease severity and its relationship with pulmonary function tests (PFTs).</p><p><strong>Methods: </strong>In this prospective study, twenty patients underwent low-dose inspiratory and expiratory CT scans in standing and supine positions. Airways were segmented with Vincent® software and classified as bronchiectatic or non-bronchiectatic. Generation-specific quantitative CT (QCT) parameters, including inspiratory airway total area (ITA), inspiratory airway lumen area (ILA), wall thickness, and wall area percentage (WA%), were measured and correlated with PFTs.</p><p><strong>Results: </strong>Bronchiectatic lesions were primarily identified in the 8th-10th generation airways (anatomically the 7th-9th generations), the transition from distal bronchi to proximal bronchioles. Standing CT detected more distal airways than supine CT. Mixed-effect models revealed significantly larger ITA and higher WA% in bronchiectatic airways (8th-10th generations) on standing CT. In non-bronchiectatic airways (trachea to 6th generation), ITA and ILA were significantly larger in the standing position, except for the main bronchus ITA. ITA, ILA, and WA% were moderate to strongly correlated with %FVC, %FEV<sub>1</sub>, and FEF<sub>25-75%</sub>, reflecting airway obstruction, with stronger correlations in the standing position. ITA in bronchiectatic airways was moderately negatively correlated with diffusing capacity of the lungs for carbon monoxide, indicating potential alveolar disease.</p><p><strong>Conclusion: </strong>Upright CT offers useful structural biomarkers associated with airflow limitation and possible alveolar impairment in bronchiectasis with NTM-PD.</p><p><strong>Registration: </strong>University Hospital Medical Information Network (UMIN 000026587). URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000030456.</p>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"112626"},"PeriodicalIF":3.3,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965760","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}
Pub Date : 2025-12-28DOI: 10.1016/j.ejrad.2025.112624
Ural Koç , Yasin Celal Güneş , Mehmet Numan Çolakoğlu , Nazım Coşkun , Vural Dere , Mustafa Özdemir , Elif Özdemir
Objectives
To evaluate whether ChatGPT-generated informed consent forms improve comprehension, attitudinal responses, and readability compared with standard informed consent forms in two interventional radiology procedures.
Materials and methods
This prospective, single blind, randomized controlled study was conducted at a tertiary-care interventional radiology department between March and August 2025. A total of 122 participants with no prior exposure to the procedures were randomly assigned (1:1) to receive either a web-based Chat Generative Pre-trained Transformer (GPT)-4o-generated or a standard informed consent form for transarterial radioembolization (TARE) or percutaneous hydatid cyst treatment (PHCT). All participants completed a ten-item comprehension test and a four-item attitudinal survey. Readability was analyzed using multiple indices (Flesch–Kincaid, Gunning Fog, Coleman–Liau, SMOG, Automated Readability Index, and Ateşman) and the Patient Education Materials Assessment Tool (PEMAT).
Results
Participants who read ChatGPT-generated consent forms achieved higher comprehension scores than those who read standard forms (82.9 % vs. 77.3 %, p = 0.04). The benefit was consistent across procedures and education levels, with the greatest relative improvement among participants with lower educational attainment (p = 0.04). Readability analysis showed that ChatGPT-generated forms had shorter sentences and lower linguistic complexity (Flesch 39.2; Ateşman 53.9) than standard forms. Test–retest results indicated better knowledge retention for ChatGPT-generated forms, particularly in the TARE subgroup. No significant attitudinal differences were observed between groups.
Conclusion
ChatGPT-generated informed consent forms demonstrated superior comprehension and equivalent attitudinal responses compared with standard documents, supporting their potential as communication tools to enhance clarity and engagement in interventional radiology.
目的评估在两种介入放射治疗过程中，与标准知情同意书相比，chatgpt生成的知情同意书是否能提高患者的理解力、态度反应和可读性。材料和方法本前瞻性、单盲、随机对照研究于2025年3月至8月在一家三级保健介入放射科进行。共有122名之前没有接触过该程序的参与者被随机分配（1:1），接受基于网络的Chat -generated Pre-trained Transformer (GPT)- 40生成或标准的经动脉放射栓塞（TARE）或经皮包囊治疗（PHCT）的知情同意书。所有参与者都完成了一个包含10个项目的理解测试和一个包含4个项目的态度调查。采用多种指标（Flesch-Kincaid、Gunning Fog、Coleman-Liau、SMOG、Automated Readability Index和ate man）和患者教育材料评估工具（PEMAT）分析可读性。结果阅读chatgpt生成的知情同意书的参与者的理解得分高于阅读标准表格的参与者（82.9% vs. 77.3%, p = 0.04）。在不同的程序和教育水平中，获益是一致的，在受教育程度较低的参与者中，相对改善最大（p = 0.04）。可读性分析表明，chatgpt生成的表单比标准表单句子更短，语言复杂性更低（Flesch 39.2; ate man 53.9）。重测结果表明，chatgpt生成的表单的知识保留率更高，尤其是在TARE子组中。两组之间的态度差异不显著。结论：与标准文件相比，chatgpt生成的知情同意表表现出更好的理解能力和同等的态度反应，支持其作为沟通工具的潜力，以提高介入放射学的清晰度和参与度。
{"title":"ChatGPT-generated informed consent forms in interventional radiology: A randomized controlled evaluation of comprehension, attitudinal responses, and readability","authors":"Ural Koç , Yasin Celal Güneş , Mehmet Numan Çolakoğlu , Nazım Coşkun , Vural Dere , Mustafa Özdemir , Elif Özdemir","doi":"10.1016/j.ejrad.2025.112624","DOIUrl":"10.1016/j.ejrad.2025.112624","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate whether ChatGPT-generated informed consent forms improve comprehension, attitudinal responses, and readability compared with standard informed consent forms in two interventional radiology procedures.</div></div><div><h3>Materials and methods</h3><div>This prospective, single blind, randomized controlled study was conducted at a tertiary-care interventional radiology department between March and August 2025. A total of 122 participants with no prior exposure to the procedures were randomly assigned (1:1) to receive either a web-based Chat Generative Pre-trained Transformer (GPT)-4o-generated or a standard informed consent form for transarterial radioembolization (TARE) or percutaneous hydatid cyst treatment (PHCT). All participants completed a ten-item comprehension test and a four-item attitudinal survey. Readability was analyzed using multiple indices (Flesch–Kincaid, Gunning Fog, Coleman–Liau, SMOG, Automated Readability Index, and Ateşman) and the Patient Education Materials Assessment Tool (PEMAT).</div></div><div><h3>Results</h3><div>Participants who read ChatGPT-generated consent forms achieved higher comprehension scores than those who read standard forms (82.9 % vs. 77.3 %, p = 0.04). The benefit was consistent across procedures and education levels, with the greatest relative improvement among participants with lower educational attainment (p = 0.04). Readability analysis showed that ChatGPT-generated forms had shorter sentences and lower linguistic complexity (Flesch 39.2; Ateşman 53.9) than standard forms. Test–retest results indicated better knowledge retention for ChatGPT-generated forms, particularly in the TARE subgroup. No significant attitudinal differences were observed between groups.</div></div><div><h3>Conclusion</h3><div>ChatGPT-generated informed consent forms demonstrated superior comprehension and equivalent attitudinal responses compared with standard documents, supporting their potential as communication tools to enhance clarity and engagement in interventional radiology.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112624"},"PeriodicalIF":3.3,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880225","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}
To identify clinical, environmental, and lifestyle-related risk factors for transient osteoporosis of the hip (TOH) in men, compared with a control group of men without TOH and peripartum women with TOH.
Method
This retrospective cross-sectional study included men aged ≥ 18 years who underwent pelvic/hip MRI for hip pain at a tertiary care center between 2010 and 2023. Among 231 men, 31 (13.4 %) were diagnosed with TOH. Prospective data were collected via telephone questionnaire. Controls included 190 men without TOH (questionnaires administered to an age-matched subgroup of 31) and a previously described cohort of 34 women with peripartum TOH. Data on demographics, medical history, physical activity, occupation, vitamin D/calcium supplement use, and corticosteroid exposure were analyzed.
Results
Men with TOH were significantly younger than controls (45.4 vs. 57.3 years; P = 0.006) with higher BMI (29.62 vs. 28.24p = 0.03) and more frequently reported vitamin D/calcium use (58.1 % vs. 10 %; P < 0.001). They tended to have more physically demanding occupations, higher activity levels, and more childhood dental issues (P > 0.05). Compared to women with peripartum TOH, men were older, had a similar BMI at symptom onset, a greater corticosteroid use, and a lower prevalence of family history of osteoporosis. Patients consulted an average of 3.7 physicians before diagnosis. Symptoms resolved within 3–6 months in most cases, and MRI findings normalized within 2–11 months.
Conclusions
TOH in men is underrecognized and may be associated with mechanical overload and altered bone turnover. Identifying potential risk factors may aid in earlier diagnosis and management.
{"title":"Unveiling risk factors for transient osteoporosis of the hip in Middle-Aged Men: Insights from a Cross-Sectional study","authors":"Yosi Eithan Sarusi , Mordechay Dulitzky , Omri Segal , Shlomi Toussia-Cohen , Iris Eshed","doi":"10.1016/j.ejrad.2025.112621","DOIUrl":"10.1016/j.ejrad.2025.112621","url":null,"abstract":"<div><h3>Objective</h3><div>To identify clinical, environmental, and lifestyle-related risk factors for transient osteoporosis of the hip (TOH) in men, compared with a control group of men without TOH and peripartum women with TOH.</div></div><div><h3>Method</h3><div>This retrospective cross-sectional study included men aged ≥ 18 years who underwent pelvic/hip MRI for hip pain at a tertiary care center between 2010 and 2023. Among 231 men, 31 (13.4 %) were diagnosed with TOH. Prospective data were collected via telephone questionnaire. Controls included 190 men without TOH (questionnaires administered to an age-matched subgroup of 31) and a previously described cohort of 34 women with peripartum TOH. Data on demographics, medical history, physical activity, occupation, vitamin D/calcium supplement use, and corticosteroid exposure were analyzed.</div></div><div><h3>Results</h3><div>Men with TOH were significantly younger than controls (45.4 vs. 57.3 years; P = 0.006) with higher BMI (29.62 vs. 28.24p = 0.03) and more frequently reported vitamin D/calcium use (58.1 % vs. 10 %; P < 0.001). They tended to have more physically demanding occupations, higher activity levels, and more childhood dental issues (P > 0.05). Compared to women with peripartum TOH, men were older, had a similar BMI at symptom onset, a greater corticosteroid use, and a lower prevalence of family history of osteoporosis. Patients consulted an average of 3.7 physicians before diagnosis. Symptoms resolved within 3–6 months in most cases, and MRI findings normalized within 2–11 months.</div></div><div><h3>Conclusions</h3><div>TOH in men is underrecognized and may be associated with mechanical overload and altered bone turnover. Identifying potential risk factors may aid in earlier diagnosis and management.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112621"},"PeriodicalIF":3.3,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855149","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}
Pub Date : 2025-12-22DOI: 10.1016/j.ejrad.2025.112623
Walaa M. Saad , Omnia Ezz Eldin , Ashraf N. Ettaby , Khaled E. El Noauaem , Hebatallah H.M. Hassan , Ahmed Oshiba , Samar Eshiba
Background
Persistent urogenital sinus (UGS) is a rare but complex congenital anomaly that poses significant challenges in pediatric reconstructive surgery. Accurate preoperative visualization of the urogenital anatomy is essential for optimal surgical planning. This study aims to evaluate the diagnostic utility of magnetic resonance imaging (MRI) in assessing persistent UGS, specifically the site of confluence, common channel length, urethral length, and to correlate MRI findings with the preoperative cystoscopy and surgical outcomes.
Objectives
To evaluate role of MRI in evaluation of urogenital sinus and associated anomalies helping in pre operative planning for surgical decision making and post operative evaluation.
Materials and methods
This prospective study included 29 female pediatric patients with UGS anomalies who underwent pelvic MRI as part of their preoperative assessment. MRI findings were compared with intraoperative data. Parameters assessed included the length of the urethra, the common urogenital channel, and vaginal length, in addition to the identification of associated anomalies. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were calculated.
Results
MRI identified UGS in 89.7 % of surgically confirmed cases, with radiological-surgical concordance observed in 25 out of 29 patients. Discordance was noted in 4 cases, including one misclassified “high” type UGS and three “very low” types not visualized on MRI. MRI showed a sensitivity of 89.7 % and an overall accuracy of 89.7 %. Significant correlations were found between UGS type and both common channel length (P = 0.005) and urethral length (P = 0.011). Associated anomalies were present in 68.9 % of patients, most commonly involving genital, spinal, and rectal systems.
Conclusion
MRI is a highly sensitive and accurate modality for the preoperative evaluation of UGS, offering detailed anatomical insights and enabling the detection of associated anomalies. Its integration into diagnostic workflows can improve surgical planning and patient outcomes.
{"title":"Role of magnetic resonance imaging in evaluation of urogenital sinus malformations","authors":"Walaa M. Saad , Omnia Ezz Eldin , Ashraf N. Ettaby , Khaled E. El Noauaem , Hebatallah H.M. Hassan , Ahmed Oshiba , Samar Eshiba","doi":"10.1016/j.ejrad.2025.112623","DOIUrl":"10.1016/j.ejrad.2025.112623","url":null,"abstract":"<div><h3>Background</h3><div>Persistent urogenital sinus (UGS) is a rare but complex congenital anomaly that poses significant challenges in pediatric reconstructive surgery. Accurate preoperative visualization of the urogenital anatomy is essential for optimal surgical planning. This study aims to evaluate the diagnostic utility of magnetic resonance imaging (MRI) in assessing persistent UGS, specifically the site of confluence, common channel length, urethral length, and to correlate MRI findings with the preoperative cystoscopy and surgical outcomes.</div></div><div><h3>Objectives</h3><div>To evaluate role of MRI in evaluation of urogenital sinus and associated anomalies helping in pre operative planning for surgical decision making and post operative evaluation<strong>.</strong></div></div><div><h3>Materials and methods</h3><div>This prospective study included 29 female pediatric patients with UGS anomalies who underwent pelvic MRI as part of their preoperative assessment. MRI findings were compared with intraoperative data. Parameters assessed included the length of the urethra, the common urogenital channel, and vaginal length, in addition to the identification of associated anomalies. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were calculated.</div></div><div><h3>Results</h3><div>MRI identified UGS in 89.7 % of surgically confirmed cases, with radiological-surgical concordance observed in 25 out of 29 patients. Discordance was noted in 4 cases, including one misclassified “high” type UGS and three “very low” types not visualized on MRI. MRI showed a sensitivity of 89.7 % and an overall accuracy of 89.7 %. Significant correlations were found between UGS type and both common channel length (<em>P</em> = 0.005) and urethral length (<em>P</em> = 0.011). Associated anomalies were present in 68.9 % of patients, most commonly involving genital, spinal, and rectal systems.</div></div><div><h3>Conclusion</h3><div>MRI is a highly sensitive and accurate modality for the preoperative evaluation of UGS, offering detailed anatomical insights and enabling the detection of associated anomalies. Its integration into diagnostic workflows can improve surgical planning and patient outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112623"},"PeriodicalIF":3.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827263","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}
DNA polymerase epsilon (POLE) exonuclease domain-mutated endometrial cancer (EC) is associated with a favorable prognosis and significant immune cell infiltration. Cancers with significant immune cell infiltration often exhibit higher maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT). This study aimed to evaluate the correlation between POLE status and FDG-PET/CT imaging in patients with EC.
Methods
This retrospective study enrolled 102 patients (mean age, 56.2 ± 11.8 years) with EC who underwent preoperative FDG-PET/CT between July 2018 and August 2023. Patients were categorized into molecular subtypes based on molecular profiling. SUVmax of the primary tumor and lymph nodes was measured, and correlations with molecular subtypes were examined.
Results
The SUVmax in the primary tumor of POLE-mutated ECs was higher than that in non-POLE-mutated ECs (mean ± SD, 13.21 ± 4.78 vs 9.82 ± 3.78; p = 0.001). Multiple regression analysis showed that POLE status was associated with SUVmax in primary tumors (B = 2.30, p = 0.031). The SUVmax in non-metastatic lymph nodes of POLE-mutated ECs was higher than that in non-POLE-mutated ECs (median SUVmax, 1.31 [IQR, 1.05–2.21] vs. 1.06 [IQR, 0.91–1.20]; p = 0.003). Multiple regression analysis revealed that POLE status was the only factor associated with SUVmax in non-metastatic lymph nodes (B = 0.339, p = 0.046), while age, BMI, blood glucose level, histological type, and primary tumor size showed no significant association.
Conclusion
Patients with POLE-mutated EC exhibit high SUVmax in primary tumors and also tend to show elevated uptake in non-metastatic lymph nodes.
目的：DNA聚合酶epsilon （POLE）外切酶结构域突变的子宫内膜癌（EC）与良好的预后和显著的免疫细胞浸润有关。具有显著免疫细胞浸润的癌症通常在18f -氟脱氧葡萄糖(FDG)-正电子发射断层扫描/计算机断层扫描（PET/CT）上表现出更高的最大标准化摄取值（SUVmax）。本研究旨在评估EC患者的POLE状态与FDG-PET/CT成像的相关性。方法：本回顾性研究纳入102例EC患者（平均年龄56.2±11.8岁），于2018年7月至2023年8月接受术前FDG-PET/CT检查。根据分子谱将患者分为分子亚型。测定原发肿瘤和淋巴结的SUVmax，并检测与分子亚型的相关性。结果：原发性肿瘤中pole突变ECs的SUVmax高于非pole突变ECs（平均±SD， 13.21±4.78 vs 9.82±3.78;p = 0.001）。多元回归分析显示，原发性肿瘤中POLE状态与SUVmax相关（B = 2.30, p = 0.031）。pol -突变ECs非转移性淋巴结的SUVmax高于非pole -突变ECs（中位SUVmax， 1.31 [IQR, 1.05-2.21]比1.06 [IQR, 0.91-1.20]; p = 0.003）。多元回归分析显示，POLE状态是与非转移性淋巴结SUVmax相关的唯一因素（B = 0.339, p = 0.046），而年龄、BMI、血糖水平、组织学类型和原发肿瘤大小无显著相关性。结论：pole突变的EC患者在原发肿瘤中表现出较高的SUVmax，并且在非转移性淋巴结中也倾向于表现出较高的摄取。
{"title":"Elevated 18F-FDG uptake in non-metastatic lymph nodes of POLE-mutated endometrial cancer on PET/CT","authors":"Maho Kurihara , Yu Iwabuchi , Yoshitake Yamada , Atsushi Shimizu , Takuma Yoshimura , Kensuke Sakai , Tatsuyuki Chiyoda , Kohei Nakamura , Hiroshi Nishihara , Wataru Yamagami , Masahiro Jinzaki","doi":"10.1016/j.ejrad.2025.112620","DOIUrl":"10.1016/j.ejrad.2025.112620","url":null,"abstract":"<div><h3>Purpose</h3><div>DNA polymerase epsilon (<em>POLE</em>) exonuclease domain-mutated endometrial cancer (EC) is associated with a favorable prognosis and significant immune cell infiltration. Cancers with significant immune cell infiltration often exhibit higher maximum standardized uptake value (SUVmax) on <sup>18</sup>F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT). This study aimed to evaluate the correlation between <em>POLE</em> status and FDG-PET/CT imaging in patients with EC.</div></div><div><h3>Methods</h3><div>This retrospective study enrolled 102 patients (mean age, 56.2 ± 11.8 years) with EC who underwent preoperative FDG-PET/CT between July 2018 and August 2023. Patients were categorized into molecular subtypes based on molecular profiling. SUVmax of the primary tumor and lymph nodes was measured, and correlations with molecular subtypes were examined.</div></div><div><h3>Results</h3><div>The SUVmax in the primary tumor of <em>POLE</em>-mutated ECs was higher than that in non-<em>POLE</em>-mutated ECs (mean ± SD, 13.21 ± 4.78 vs 9.82 ± 3.78; <em>p</em> = 0.001). Multiple regression analysis showed that <em>POLE</em> status was associated with SUVmax in primary tumors (B = 2.30, <em>p</em> = 0.031). The SUVmax in non-metastatic lymph nodes of <em>POLE</em>-mutated ECs was higher than that in non<em>-POLE-</em>mutated ECs (median SUVmax, 1.31 [IQR, 1.05–2.21] vs. 1.06 [IQR, 0.91–1.20]; <em>p</em> = 0.003). Multiple regression analysis revealed that <em>POLE</em> status was the only factor associated with SUVmax in non-metastatic lymph nodes (B = 0.339, p = 0.046), while age, BMI, blood glucose level, histological type, and primary tumor size showed no significant association.</div></div><div><h3>Conclusion</h3><div>Patients with <em>POLE</em>-mutated EC exhibit high SUVmax in primary tumors and also tend to show elevated uptake in non-metastatic lymph nodes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112620"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818168","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}
Pub Date : 2025-12-17DOI: 10.1016/j.ejrad.2025.112615
Jiaqi Yao , Lijie Zhang , Sihong Huang , Shirui Cao , Xinjia Xu , Junjie Yang , Yule Zeng , Jun Liu
Background
COVID-19 patients often experience cognitive deficits and sleep disorders, potentially linked to cerebral glymphatic system (GS) dysfunction. Long-term progression remains unclear.
Methods
A prospective follow-up study was conducted on 17 COVID-19 patients at 1(V1), 2 (V2), and 5 years (V5) post-discharge. Multimodal MRI was used to assess the Analysis Along the Perivascular Space (ALPS) index, White Matter Free Water (WM-FW), Choroid Plexus Volume (CPV), and Global Blood-Oxygen-Level-Dependent–Cerebrospinal Fluid (gBOLD–CSF) Coupling, alongside comprehensive neuropsychological tests. Data were analyzed using Linear Mixed-Effects Models (LME), correlation, and regression analyses (P < 0.05), with Minimal Clinically Important Difference (MCID) and Receiver Operating Characteristic (ROC) analyses applied to evaluate clinical significance and discriminative performance.
Results
COVID-19 patients exhibited persistent declines in cognitive and sleep functions, as measured by the Logical Memory Test-B (V5: P < 0.001) and the Pittsburgh Sleep Quality (V1: P < 0.001, V5: P = 0.004). The ALPS index remained reduced (V1L:P = 0.026; V2L:P = 0.011; V5R: P = 0.025), while WM-FW fluctuated nonlinearly (V1:P = 0.028; V5:P = 0.045) and CPV was stable (L: χ2 = 0.36, P = 0.83; R: χ2 = 0.27, P = 0.87). gBOLD–CSF showed significant recovery (χ2 = 24.95, P < 0.001), exceeding the MCID and correlating with word fluency (β = –0.754, P < 0.001) and sleep quality; ROC analysis confirmed high discriminative power (AUC = 0.853).
Conclusion
Structural GS impairment may persist up to 5 years, while gBOLD–CSF shows reversible, clinically meaningful recovery. Integrating four imaging markers, this study outlines a “persistent damage–partial recovery–nonlinear fluctuation” trajectory, offering mechanistic insights into SARS-CoV-2 infection and a potential biomarker for long-term monitoring.
背景：COVID-19患者经常出现认知缺陷和睡眠障碍，这可能与脑淋巴系统（GS）功能障碍有关。长期进展尚不清楚。方法：对17例COVID-19患者在出院后1年（V1）、2年（V2）和5年（V5）进行前瞻性随访研究。采用多模态MRI评估沿血管周围间隙（ALPS）指数、白质游离水（WM-FW）、脉络膜丛体积（CPV）和全血氧水平依赖性脑脊液（gBOLD-CSF）耦合分析，并进行综合神经心理测试。采用线性混合效应模型（LME）、相关性和回归分析对数据进行分析(P结果：通过逻辑记忆测试b （V5: P L:P = 0.026; V2L:P = 0.011; V5R: P = 0.025）测量，COVID-19患者表现出持续的认知和睡眠功能下降，而WM-FW呈非线性波动（V1:P = 0.028; V5:P = 0.045）， CPV稳定（L: χ2 = 0.36, P = 0.83; R: χ2 = 0.27, P = 0.87）。结论：结构性GS损伤可持续长达5年，而gBOLD-CSF的恢复是可逆的，具有临床意义。该研究整合了四种成像标志物，概述了“持续损伤-部分恢复-非线性波动”的轨迹，为SARS-CoV-2感染提供了机制见解，并为长期监测提供了潜在的生物标志物。
{"title":"Changes in the cerebral glymphatic system after rehabilitation of COVID-19 patients: A five-year follow-up study","authors":"Jiaqi Yao , Lijie Zhang , Sihong Huang , Shirui Cao , Xinjia Xu , Junjie Yang , Yule Zeng , Jun Liu","doi":"10.1016/j.ejrad.2025.112615","DOIUrl":"10.1016/j.ejrad.2025.112615","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 patients often experience cognitive deficits and sleep disorders, potentially linked to cerebral glymphatic system (GS) dysfunction. Long-term progression remains unclear.</div></div><div><h3>Methods</h3><div>A prospective follow-up study was conducted on 17 COVID-19 patients at 1(V1), 2 (V2), and 5 years (V5) post-discharge. Multimodal MRI was used to assess the Analysis Along the Perivascular Space (ALPS) index, White Matter Free Water (WM-FW), Choroid Plexus Volume (CPV), and Global Blood-Oxygen-Level-Dependent–Cerebrospinal Fluid (gBOLD–CSF) Coupling, alongside comprehensive neuropsychological tests. Data were analyzed using Linear Mixed-Effects Models (LME), correlation, and regression analyses (<em>P</em> < 0.05), with Minimal Clinically Important Difference (MCID) and Receiver Operating Characteristic (ROC) analyses applied to evaluate clinical significance and discriminative performance.</div></div><div><h3>Results</h3><div>COVID-19 patients exhibited persistent declines in cognitive and sleep functions, as measured by the Logical Memory Test-B (V5: <em>P</em> < 0.001) and the Pittsburgh Sleep Quality (V1: <em>P</em> < 0.001, V5: <em>P</em> = 0.004). The ALPS index remained reduced (V1<sub>L</sub>:<em>P</em> = 0.026; V2<sub>L</sub>:<em>P</em> = 0.011; V5<sub>R</sub>: <em>P</em> = 0.025), while WM-FW fluctuated nonlinearly (V1:<em>P</em> = 0.028; V5:<em>P</em> = 0.045) and CPV was stable (L: χ<sup>2</sup> = 0.36, <em>P</em> = 0.83; R: χ<sup>2</sup> = 0.27, <em>P</em> = 0.87). gBOLD–CSF showed significant recovery (χ<sup>2</sup> = 24.95, <em>P</em> < 0.001), exceeding the MCID and correlating with word fluency (β = –0.754, <em>P</em> < 0.001) and sleep quality; ROC analysis confirmed high discriminative power (AUC = 0.853).</div></div><div><h3>Conclusion</h3><div>Structural GS impairment may persist up to 5 years, while gBOLD–CSF shows reversible, clinically meaningful recovery. Integrating four imaging markers, this study outlines a “persistent damage–partial recovery–nonlinear fluctuation” trajectory, offering mechanistic insights into SARS-CoV-2 infection and a potential biomarker for long-term monitoring.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112615"},"PeriodicalIF":3.3,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827211","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}
Pub Date : 2025-12-17DOI: 10.1016/j.ejrad.2025.112616
Mengjie Li , Mengnan Yu , Wenli Hu , Lu Li , Xing Zhong , Jiahui Huang , Xi Liu , Xiaozhou Fan
Objective
To examine the ultrasonographic parameters and diagnostic efficacy of nutcracker syndrome (NCS) in two positions and thus to ensure accurate recruitment.
Materials and methods
According to the presence or absence of left varicocele, 184 teenagers from Air Force medical selection in 2024 were classified into the NCS-positive group or the control. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of ultrasound parameters in the seated anteversion and supine position. Independent predictors were determined via regression analysis. Individual and combined diagnostic prediction models were developed based on these independent predictors through nomogram and the calibration curve.
Results
ROC curve analysis showed the superior diagnostic efficacy for NCS in the seated anteversion position. Regression analysis identified two independent diagnostic predictors: the diameter ratio between the dilatation and stenosis of the left renal vein (D2/D1) and the peak velocity (V1) at the stenosis. And the combination of these two diagnostic parameters (the cutoff value of D2/D1: 2.38 and the cutoff value of V1: 69.5 cm/s) achieved an AUC of 0.821 with a sensitivity of 68.3 % and a specificity of 84.3 %. The calibration curve demonstrated good consistency between the predictions made by the nomogram and actual clinical observations.
Conclusions
This study established the diagnostic criteria at the seated anteversion position for NCS, indicating that D2/D1 and V1 of left renal vein serve as independent diagnostic parameters. In the future, these criteria can enhance accuracy in aviation recruitment medical examinations.
{"title":"Diagnostic value of ultrasound in different positions for detecting nutcracker syndrome during physical examination of flying cadets","authors":"Mengjie Li , Mengnan Yu , Wenli Hu , Lu Li , Xing Zhong , Jiahui Huang , Xi Liu , Xiaozhou Fan","doi":"10.1016/j.ejrad.2025.112616","DOIUrl":"10.1016/j.ejrad.2025.112616","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the ultrasonographic parameters and diagnostic efficacy of nutcracker syndrome (NCS) in two positions and thus to ensure accurate recruitment.</div></div><div><h3>Materials and methods</h3><div>According to the presence or absence of left varicocele, 184 teenagers from Air Force medical selection in 2024 were classified into the NCS-positive group or the control. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of ultrasound parameters in the seated anteversion and supine position. Independent predictors were determined via regression analysis. Individual and combined diagnostic prediction models were developed based on these independent predictors through nomogram and the calibration curve.</div></div><div><h3>Results</h3><div>ROC curve analysis showed the superior diagnostic efficacy for NCS in the seated anteversion position. Regression analysis identified two independent diagnostic predictors: the diameter ratio between the dilatation and stenosis of the left renal vein (D2/D1) and the peak velocity (V1) at the stenosis.<!--> <!-->And the combination of these two diagnostic parameters (the cutoff value of D2/D1: 2.38 and the cutoff value of V1: 69.5 cm/s) achieved an AUC of 0.821 with a sensitivity of 68.3 % and a specificity of 84.3 %. The calibration curve demonstrated good consistency between the predictions made by the nomogram and actual clinical observations.</div></div><div><h3>Conclusions</h3><div>This study established the diagnostic criteria at the seated anteversion position for NCS, indicating that D2/D1 and V1 of left renal vein serve as independent diagnostic parameters. In the future, these criteria can enhance accuracy in aviation recruitment medical examinations.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112616"},"PeriodicalIF":3.3,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833681","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}
Pub Date : 2025-12-16DOI: 10.1016/j.ejrad.2025.112618
Ilse Huijberts , Bart A.J.M. Wagemans , Florentina M.E. Pinckaers , M.M.Quirien Robbe , Wim H. van Zwam , Robert J. van Oostenbrugge , Alida A. Postma
Purpose
The visualisation of lenticulostriate arteries (LSA) using CT-techniques has not been extensively studied. Currently, digital subtraction angiography (DSA) is the preferred imaging modality for LSA visualisation. The new photon-counting detector CT (PCD-CT) may offer a non-invasive alternative. This study evaluates PCD-CT for LSA visualisation compared to DSA and energy-integrating detector CT-angiography (EID-CTA).
Methods
We assessed imaging data from subarachnoid haemorrhage (SAH) patients, as they are expected to have intact LSA and routinely undergo DSA. From 2021 to 2024, adult SAH-patients who underwent both DSA and either EID-CTA or PCD-CT were enrolled. PCD-CT was acquired in UHR mode. For LSA > 5 mm from the middle cerebral artery (MCA) origin, only the length of the largest branch was measured, whereas for LSA < 5 mm all individual branches were assessed. LSA presence, length and subjective image quality were assessed across PCD-CT, EID-CTA, and DSA by two radiologists. Cohen’s kappa and the Intraclass Correlation Coefficient were used to evaluate inter-rater agreement.
Results
159 patients were included. No differences were found between DSA and PCD-CT in LSA detection and length < 5 mm from the MCA origin. At > 5 mm from the MCA origin, the measured length of LSA was significantly longer on DSA. PCD-CT outperformed EID-CTA for LSA detection and length measurements. Observer 1 rated PCD-CT quality lower than DSA, while observer 2 found no difference. EID-CTA quality was rated significantly lower than both PCD-CT and DSA. Inter-rater agreement ranged from poor to moderate across modalities.
Conclusion
PCD-CT holds promise as a method for non-invasive LSA visualisation and requires further evaluation in prospective studies and clinical settings.
{"title":"Visualisation of lenticulostriate arteries using photon counting detector CT angiography: A retrospective cohort study","authors":"Ilse Huijberts , Bart A.J.M. Wagemans , Florentina M.E. Pinckaers , M.M.Quirien Robbe , Wim H. van Zwam , Robert J. van Oostenbrugge , Alida A. Postma","doi":"10.1016/j.ejrad.2025.112618","DOIUrl":"10.1016/j.ejrad.2025.112618","url":null,"abstract":"<div><h3>Purpose</h3><div>The visualisation of lenticulostriate arteries (LSA) using CT-techniques has not been extensively studied. Currently, digital subtraction angiography (DSA) is the preferred imaging modality for LSA visualisation. The new photon-counting detector CT (PCD-CT) may offer a non-invasive alternative. This study evaluates PCD-CT for LSA visualisation compared to DSA and energy-integrating detector CT-angiography (EID-CTA).</div></div><div><h3>Methods</h3><div>We assessed imaging data from subarachnoid haemorrhage (SAH) patients, as they are expected to have intact LSA and routinely undergo DSA. From 2021 to 2024, adult SAH-patients who underwent both DSA and either EID-CTA or PCD-CT were enrolled. PCD-CT was acquired in UHR mode. For LSA > 5 mm from the middle cerebral artery (MCA) origin, only the length of the largest branch was measured, whereas for LSA < 5 mm all individual branches were assessed. LSA presence, length and subjective image quality were assessed across PCD-CT, EID-CTA, and DSA by two radiologists. Cohen’s kappa and the Intraclass Correlation Coefficient were used to evaluate inter-rater agreement.</div></div><div><h3>Results</h3><div>159 patients were included. No differences were found between DSA and PCD-CT in LSA detection and length < 5 mm from the MCA origin. At > 5 mm from the MCA origin, the measured length of LSA was significantly longer on DSA. PCD-CT outperformed EID-CTA for LSA detection and length measurements. Observer 1 rated PCD-CT quality lower than DSA, while observer 2 found no difference. EID-CTA quality was rated significantly lower than both PCD-CT and DSA. Inter-rater agreement ranged from poor to moderate across modalities.</div></div><div><h3>Conclusion</h3><div>PCD-CT holds promise as a method for non-invasive LSA visualisation and requires further evaluation in prospective studies and clinical settings.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112618"},"PeriodicalIF":3.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793680","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}
Pub Date : 2025-12-16DOI: 10.1016/j.ejrad.2025.112619
Stacy Ruther , Eric Jackson , Eric vanSonnenberg
Background
Mindfulness-Based Stress Reduction (MBSR) is an evidence-based program that integrates meditation, bodily awareness, and yoga to manage stress and reduce anxiety. Neuroimaging studies suggest that MBSR modulates brain networks involved in emotion regulation, self-awareness, and attention, though findings remain inconsistent. Structural and functional MRI (fMRI) have been used to investigate these effects, focusing on default mode, salience, limbic, and central executive networks.
Objective
To synthesize MRI and fMRI research on the effects of MBSR on brain structure, neural activation, and functional connectivity, with emphasis on networks related to emotion and attention regulation.
Materials & Methods
A narrative review was conducted using PubMed, Embase, and Scopus to identify studies published between 2009–2024 on MBSR and neuroimaging. Search terms included yoga, mindfulness-based stress reduction, MRI, fMRI, and neuroimaging. Of 586 articles screened, 27 met inclusion criteria, comprising 9 structural MRI, 10 neural activation, and 11 functional connectivity studies.
Results
Structural MRI findings were inconsistent; most studies reported no significant gray matter changes. Small studies noted modest increases in hippocampal and amygdala volume. In contrast, fMRI consistently demonstrated functional changes across key networks. Neural activation studies showed increased activity in the superior parietal lobule, posterior cingulate cortex, and prefrontal regions. Functional connectivity studies reported enhanced coupling between the medial prefrontal cortex and amygdala.
Conclusion
MBSR appears to influence brain function more than structure, with consistent enhancement of activity and connectivity in networks that support emotion regulation, self-referential processing, and attention. Findings suggest improved top-down regulation of emotion, though study heterogeneity limits conclusions.
{"title":"Mindfulness on the brain: a review of structural and functional MRI findings in mindfulness-based stress reduction","authors":"Stacy Ruther , Eric Jackson , Eric vanSonnenberg","doi":"10.1016/j.ejrad.2025.112619","DOIUrl":"10.1016/j.ejrad.2025.112619","url":null,"abstract":"<div><h3>Background</h3><div>Mindfulness-Based Stress Reduction (MBSR) is an evidence-based program that integrates meditation, bodily awareness, and yoga to manage stress and reduce anxiety. Neuroimaging studies suggest that MBSR modulates brain networks involved in emotion regulation, self-awareness, and attention, though findings remain inconsistent. Structural and functional MRI (fMRI) have been used to investigate these effects, focusing on default mode, salience, limbic, and central executive networks.</div></div><div><h3>Objective</h3><div>To synthesize MRI and fMRI research on the effects of MBSR on brain structure, neural activation, and functional connectivity, with emphasis on networks related to emotion and attention regulation.</div></div><div><h3>Materials & Methods</h3><div>A narrative review was conducted using PubMed, Embase, and Scopus to identify studies published between 2009–2024 on MBSR and neuroimaging. Search terms included yoga, mindfulness-based stress reduction, MRI, fMRI, and neuroimaging. Of 586 articles screened, 27 met inclusion criteria, comprising 9 structural MRI, 10 neural activation, and 11 functional connectivity studies.</div></div><div><h3>Results</h3><div>Structural MRI findings were inconsistent; most studies reported no significant gray matter changes. Small studies noted modest increases in hippocampal and amygdala volume. In contrast, fMRI consistently demonstrated functional changes across key networks. Neural activation studies showed increased activity in the superior parietal lobule, posterior cingulate cortex, and prefrontal regions. Functional connectivity studies reported enhanced coupling between the medial prefrontal cortex and amygdala.</div></div><div><h3>Conclusion</h3><div>MBSR appears to influence brain function more than structure, with consistent enhancement of activity and connectivity in networks that support emotion regulation, self-referential processing, and attention. Findings suggest improved top-down regulation of emotion, though study heterogeneity limits conclusions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112619"},"PeriodicalIF":3.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797201","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}
Pub Date : 2025-12-16DOI: 10.1016/j.ejrad.2025.112609
Alexandru Barb , Christian Uhl , Louisa Bornhak , Edris El-Sanosy , Matthias Fink , Dittmar Böckler , Johannes Hatzl
Objective
To externally validate the accuracy of deep learning-based iliac artery tortuosity assessment (PRAEVAorta 2, Bordeaux, France) in computed tomography angiography of patients with abdominal aortic aneurysms.
Design
Retrospective, multi-center validation study.
Methods
Data from the ZEnith alPHa for aneurYsm Repair Registry (ZEPHYR) were used. Tortuosity measurements from PRAEVAorta 2 were benchmarked against manual reference measurements from an internationally recognized core laboratory (Syntactx, New York, USA). All PRAEVAorta 2 reports were visually inspected by two observers for plausibility of the segmentation of the iliac arteries. Scans with obvious segmentation errors were excluded. Qualitative and quantitative analysis of potential risk factors for segmentation failures were conducted. The core laboratory performed manual tortuosity measurements using standard multiplanar reconstructions.
Results
In total, 270 CTA scans from the ZEPHYR database fulfilled the inclusion criteria and were available for analysis. 21.1 % of scans demonstrated obvious segmentation errors upon initial review and were excluded from this analysis. Most common risk factors for segmentation failure were internal iliac artery occlusions and overlapping aneurysms in the distal infrarenal aorta and proximal common iliac arteries. In the remaining 213 scans, the median iliac tortuosity measured by the core laboratory was 1.34 (IQR 1.23–1.45) while PRAEVAorta 2 reported a median tortuosity of 1.25 (IQR 1.19–1.33). The analysis showed an excellent Pearson correlation of 0.95 (95 % CI: 0.94–0.96) with a moderate to good Intraclass Correlation (ICC) of 0.73 (95 % CI: 0.69–0.77) and a bias of −0.09 in Bland-Altman analysis.
Conclusion
PRAEVAorta 2 successfully provided fully automated measurements of the iliac artery tortuosity in most cases, highlighting its potential as a valuable tool for both research and clinical applications. However, a critical review of automatically provided reports by an experienced observer remains essential.
{"title":"Accuracy of fully automated iliac artery tortuosity measurements in patients with abdominal aortic aneurysm using deep learning","authors":"Alexandru Barb , Christian Uhl , Louisa Bornhak , Edris El-Sanosy , Matthias Fink , Dittmar Böckler , Johannes Hatzl","doi":"10.1016/j.ejrad.2025.112609","DOIUrl":"10.1016/j.ejrad.2025.112609","url":null,"abstract":"<div><h3>Objective</h3><div>To externally validate the accuracy of deep learning-based iliac artery tortuosity assessment (PRAEVAorta 2, Bordeaux, France) in computed tomography angiography of patients with abdominal aortic aneurysms.</div></div><div><h3>Design</h3><div>Retrospective, multi-center validation study.</div></div><div><h3>Methods</h3><div>Data from the ZEnith alPHa for aneurYsm Repair Registry (ZEPHYR) were used. Tortuosity measurements from PRAEVAorta 2 were benchmarked against manual reference measurements from an internationally recognized core laboratory (Syntactx, New York, USA). All PRAEVAorta 2 reports were visually inspected by two observers for plausibility of the segmentation of the iliac arteries. Scans with obvious segmentation errors were excluded. Qualitative and quantitative analysis of potential risk factors for segmentation failures were conducted. The core laboratory performed manual tortuosity measurements using standard multiplanar reconstructions.</div></div><div><h3>Results</h3><div>In total, 270 CTA scans from the ZEPHYR database fulfilled the inclusion criteria and were available for analysis. 21.1 % of scans demonstrated obvious segmentation errors upon initial review and were excluded from this analysis. Most common risk factors for segmentation failure were internal iliac artery occlusions and overlapping aneurysms in the distal infrarenal aorta and proximal common iliac arteries. In the remaining 213 scans, the median iliac tortuosity measured by the core laboratory was 1.34 (IQR 1.23–1.45) while PRAEVAorta 2 reported a median tortuosity of 1.25 (IQR 1.19–1.33). The analysis showed an excellent Pearson correlation of 0.95 (95 % CI: 0.94–0.96) with a moderate to good Intraclass Correlation (ICC) of 0.73 (95 % CI: 0.69–0.77) and a bias of −0.09 in Bland-Altman analysis.</div></div><div><h3>Conclusion</h3><div>PRAEVAorta 2 successfully provided fully automated measurements of the iliac artery tortuosity in most cases, highlighting its potential as a valuable tool for both research and clinical applications. However, a critical review of automatically provided reports by an experienced observer remains essential.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112609"},"PeriodicalIF":3.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796691","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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