European Journal of Radiology最新文献_第5页

Relationship between resource utilization and diagnostic accuracy of large language models for efficient multimodal reasoning in radiologic image interpretation 资源利用与多模态推理大语言模型诊断准确性的关系

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

European Journal of Radiology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejrad.2026.112677

Taewon Han , Jeong Hyun Lee , Woo Kyoung Jeong, Jaeseung Shin, Yun Hwa Roh, Min Je Kim

Objectives

We evaluated the diagnostic performance and resource efficiency of three multimodal-reasoning-models for radiological image interpretation.

Methods

Using three multimodal-reasoning-models, we analyzed 73 cases under different conditions (Imaging-Only and Combined-Descriptive-Text) with three system prompt types (basic [without system prompt], original [specialized-role], and chain-of-thought [CoT] prompts). Quiz cases were extracted from the Korean Society of Ultrasound in Medicine Website, along with corresponding human benchmark data. Diagnostic performance was assessed through Multiple-Choice (MCQ) and Differential-Diagnosis (DDx) outputs. Resource utilization was measured by token consumption for each case across all scenarios. Pearson correlation coefficients were calculated to evaluate associations between token usage and diagnostic accuracy.

Results

For imaging-only input, under CoT prompt, o1 demonstrated superior accuracy of 56.2 %, surpassing the 55.9 % human benchmark compared to Claude-3.7-Sonnet (49.3 %) and Gemini-2.0-Flash-Thinking-Experimental (37 %) for MCQ. The integration of descriptive-text inputs substantially increased performance across all models, with o1 achieving the highest accuracy (71.2 %, with basic and original). This performance advantage was most pronounced in DDx. Original prompts utilized fewer output tokens while maintaining comparable accuracy for o1 (Imaging-Only with DDx: original vs. basic, CoT prompts, all p < 0.01). Intra-model analysis revealed a negative correlation between accuracy and output token for o1 (r = -0.41), while inter-model analysis showed strong positive correlations between total token and accuracy (r = 0.93 for Imaging-Only with MCQ).

Conclusion

The paradoxical relationship between resource utilization and diagnostic accuracy suggests that model architecture fundamentally determines baseline performance, while prompt optimization influences efficiency within architectural constraints on multimodal-reasoning-models.

目的评价三种多模态推理模型在影像学判读中的诊断性能和资源效率。方法采用3种多模态推理模型，对73例不同情况下（仅图像和组合描述文本）的系统提示类型（基本[无系统提示]、原始[专业角色]和思维链[CoT]提示）进行分析。测试案例提取自韩国超声医学学会网站，以及相应的人类基准数据。通过多项选择（MCQ）和鉴别诊断（DDx）输出评估诊断表现。通过所有场景中每个案例的令牌消耗来衡量资源利用率。计算Pearson相关系数以评估标记使用与诊断准确性之间的关联。结果在CoT提示下，仅图像输入，01的准确率为56.2%，超过了MCQ的Claude-3.7-Sonnet（49.3%）和Gemini-2.0-Flash-Thinking-Experimental（37%）的人类基准55.9%。描述性文本输入的集成大大提高了所有模型的性能，其中01达到了最高的准确率（基本和原始准确率为71.2%）。这种性能优势在DDx中最为明显。原始提示使用更少的输出标记，同时保持与01相当的准确性（仅使用DDx成像：原始与基本，CoT提示，所有p <； 0.01）。模型内分析显示准确率与输出令牌之间呈负相关（r = -0.41），而模型间分析显示总令牌与准确率之间呈强正相关（r = 0.93）。结论资源利用率与诊断准确性之间的矛盾关系表明，模型架构从根本上决定了基线性能，而在多模态推理模型的架构约束下，快速优化影响效率。

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引用次数: 0

Ultrashort echo time MRI radiomics as a predictor of clinical outcomes in patellar tendinopathy: Insights from a large prospective clinical trial 超短回波时间MRI放射组学作为髌腱病临床结果的预测因子：来自一项大型前瞻性临床试验的见解。

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

European Journal of Radiology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejrad.2026.112675

Yijie Fang , Jie Deng , Stephan J. Breda , Robert-Jan de Vos , Edwin H.G. Oei , Jukka Hirvasniemi

Purpose

To evaluate the predictive utility of radiomic features extracted from ultrashort echo time (UTE) MRI in comparison to conventional proton density (PD) sequences for short-term (24-week) and long-term (5-year) clinical outcomes in patients with patellar tendinopathy (PT) receiving exercise therapy.

Materials and methods

This prospective study of 76 PT patients undergoing 24-week exercise therapy underwent baseline 3D UTE and PD MRI at 3.0 T. The patellar tendon segmentation used nnU-Net, evaluated with Dice coefficient. Six predictive models consisting of clinical covariates and radiomic features from UTE and PD were developed using Elastic Net with 10-fold cross-validation. Model performance in predicting responsiveness of the patient-reported Victorian Institute of Sports Assessment (VISA-P) score was evaluated using the area under the receiver operating characteristic curve (ROC AUC) and the precision-recall curve (PR AUC), with 95% confidence intervals.

Results

The mean Dice similarity coefficient for the automatic segmentation of the patellar tendon from 3D-PD was 0.92 (SD: 0.02) and from 3D-UTE-Cones 0.89 (SD: 0.03). The UTE-based radiomics model demonstrated the highest predictive performance at 24 weeks (ROC AUC: 0.714 [95% CI: 0.701–0.727]; PR AUC: 0.848 [0.837–0.858]), while the PD-based model showed the lowest (ROC AUC: 0.569 [0.553–0.584]; PR AUC: 0.710 [0.692–0.727]). At the 5-year follow-up, UTE radiomics maintained robust performance (ROC AUC: 0.692 [0.677–0.706]; PR AUC: 0.822 [0.810–0.834]), whereas PD radiomics remained limited (ROC AUC: 0.578 [0.561–0.594]; PR AUC: 0.694 [0.676–0.713]).

Conclusions

Radiomics features extracted from UTE MRI demonstrate the highest predictive performance for clinical outcomes.

目的：评估从超短回波时间（UTE） MRI中提取的放射学特征与传统质子密度（PD）序列相比，对接受运动治疗的髌骨肌腱病（PT）患者短期（24周）和长期（5年）临床结果的预测效用。材料和方法：本前瞻性研究对76例接受24周运动治疗的PT患者在3.0 t时进行基线3D UTE和PD MRI，使用nnU-Net进行髌骨肌腱分割，用Dice系数进行评估。使用Elastic Net建立了6个预测模型，包括临床协变量和来自UTE和PD的放射学特征，并进行了10倍交叉验证。模型在预测患者报告的维多利亚体育评估研究所（VISA-P）评分的反应性方面的表现采用受试者工作特征曲线（ROC AUC）和精确召回曲线（PR AUC）下的面积进行评估，置信区间为95%。结果：3D-PD自动分割髌骨肌腱的Dice相似系数均值为0.92 (SD: 0.02)， 3d - ute - cone自动分割髌骨肌腱的Dice相似系数均值为0.89 （SD: 0.03）。基于ute的放射组学模型在24周时表现出最高的预测性能（ROC AUC: 0.714 [95% CI: 0.701-0.727]; PR AUC: 0.848[0.837-0.858]），而基于pd的模型表现出最低的预测性能（ROC AUC: 0.569 [0.553-0.584]; PR AUC: 0.710[0.692-0.727]）。在5年随访中，UTE放射组学保持了良好的表现（ROC AUC: 0.692 [0.677-0.706]; PR AUC: 0.822[0.810-0.834]），而PD放射组学仍然有限（ROC AUC: 0.578 [0.561-0.594]; PR AUC: 0.694[0.676-0.713]）。结论：从UTE MRI中提取的放射组学特征对临床结果具有最高的预测性能。

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引用次数: 0

Artificial intelligence-assisted CCTA for coronary stenosis detection: Diagnostic promise, methodological nuances, and directions for clinical translation 人工智能辅助CCTA检测冠状动脉狭窄：诊断前景、方法上的细微差别和临床翻译方向

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

European Journal of Radiology

Pub Date : 2026-01-13 DOI: 10.1016/j.ejrad.2026.112670

Weihao Cheng , Zekai Yu

引用次数: 0

VIPs outperforms established models for predicting post-TIPS prognosis in viral hepatitis-dominant cirrhosis VIPs在预测病毒性肝炎主导型肝硬化tips后预后方面优于现有模型

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

European Journal of Radiology

Pub Date : 2026-01-13 DOI: 10.1016/j.ejrad.2026.112672

Zhongsong Gao , Kun Zhang , Bo Li , Zhaogang Zhang , Hengtao Zhang , Xin Zhang , Bo Feng , Ruihang Wang , Wen Shen , Kefeng Jia

Background

Transjugular intrahepatic portosystemic shunt (TIPS) manages portal hypertension complications in cirrhosis, but predicting post-TIPS outcomes remains challenging, especially in viral hepatitis-dominated populations.

Purpose

To systematically evaluate the predictive performance of the novel Viral-Associated Index of Post-TIPS Score (VIPs) for post-TIPS prognosis. We also comprehensively compare it with six established clinical prognostic models and one imaging-based model (the spleen volume-based model, SvBM).

Materials and methods

We retrospectively analyzed 247 cirrhotic patients undergoing TIPS (56.7 % viral hepatitis). Baseline data calculated prognostic scores (VIPs, MELD, MELD-Na, FIPS, Child-Pugh, ALBI, MOTS, and SvBM). The primary endpoint was transplant-free survival (TFS). Discrimination was assessed by the area under the receiver operating characteristic curve (AUROC) at 6, 12, 36, and 60 months post-TIPS. Calibration (Brier score), explanatory power (R²), and decision curve analysis (DCA) were also evaluated.

Results

VIPs demonstrated good-to-moderate discrimination for TFS, with AUROCs (95 % CI) of 0.794 (0.689–0.899), 0.753 (0.649–0.858), 0.721 (0.645–0.797), and 0.692 (0.617–0.767) at 6, 12, 36, and 60 months, respectively. This advantage was most pronounced in the viral hepatitis subgroup, with AUROCs ranging from 0.699 (0.603–0.796) to 0.822 (0.715–0.930) across follow-up. VIPs significantly outperformed Child-Pugh, ALBI, FIPS, MOTS and SvBM at all timepoints (all p < 0.05), and surpassed MELD and MELD-Na for long-term predictions (36/60 months, both p < 0.05). It also exhibited the best calibration (lowest Brier scores: 0.076–0.217) and the highest explanatory power (R² = 0.121–0.142). Subgroup analyses further confirmed robust performance in females and patients with variceal bleeding.

Conclusions

VIPs demonstrates superior predictive accuracy for post-TIPS survival in a viral hepatitis-dominated cohort and may serve as a preferred prognostic tool to guide individualized decision-making.

背景：经颈静脉肝内门静脉系统分流术（TIPS）可治疗肝硬化门静脉高压并发症，但预测TIPS后的预后仍然具有挑战性，特别是在病毒性肝炎为主的人群中。目的系统评价新型tips后病毒相关指数评分（VIPs）对tips后预后的预测效果。我们还将其与六种已建立的临床预后模型和一种基于影像学的模型（脾体积模型，SvBM）进行了综合比较。材料和方法回顾性分析247例接受TIPS治疗的肝硬化患者（56.7%为病毒性肝炎）。基线数据计算预后评分（vip、MELD、MELD- na、FIPS、Child-Pugh、ALBI、MOTS和SvBM）。主要终点是无移植生存期（TFS）。在tips后6、12、36和60个月，通过受试者工作特征曲线下面积（AUROC）来评估辨别力。校正（Brier评分）、解释能力（R2）和决策曲线分析（DCA）也进行了评估。结果vip对TFS表现出良好到中度的区分，在6、12、36和60个月时，auroc （95% CI）分别为0.794（0.689-0.899）、0.753（0.649-0.858）、0.721（0.645-0.797）和0.692（0.617-0.767）。这一优势在病毒性肝炎亚组中最为明显，随访期间auroc范围为0.699（0.603-0.796）至0.822（0.715-0.930）。VIPs在所有时间点上的表现都明显优于Child-Pugh、ALBI、FIPS、MOTS和SvBM（均p <； 0.05），并且在长期预测方面超过MELD和MELD- na（36/60个月，均p <； 0.05）。其校正效果最佳（最低Brier评分为0.076 ~ 0.217），解释能力最高（R2 = 0.121 ~ 0.142）。亚组分析进一步证实了在女性和静脉曲张出血患者中的良好表现。结论：在病毒性肝炎为主的队列中，vip对tips后患者的生存具有优越的预测准确性，可作为指导个体化决策的首选预后工具。

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引用次数: 0

Cortical vein opacification measurement using hounsfield unit values is a predictor for outcome in anterior circulation acute ischemic stroke 皮质静脉混浊测量使用霍斯菲尔德单位值是预测预后的前循环急性缺血性卒中。

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

European Journal of Radiology

Pub Date : 2026-01-13 DOI: 10.1016/j.ejrad.2026.112671

Erling Wang , Yueyan Bian , Xiaoxu Yang , Huihui Xie , Xiuqin Jia , Qi Yang

Objectives

In acute ischemic stroke (AIS) patients, the cortical vein opacification on computed tomographic angiography (CTA) imaging is usually asymmetric. We aimed to explore the correlation between CT perfusion parameters and cortical vein opacification evaluated by Hounsfield unit (HU) values, which is more accurately, and compare the predictive ability between them for outcome in AIS.

Methods

Patients with AIS obtained within 24 h after onset from June 2023 to January 2024 were reviewed. Opacification of the cortical vein of Labbé, sphenoparietal sinus, and the Trolard vein was measured on CTA imaging using HU. Then HU ratio (rHU) was calculated by dividing the affected side by the controlateral side (rHU = HU-affected/HU-control). The sum of rHU of three cortical veins opacification (CVOR, CVOR = rHU_Labbé+ rHU_{sphenoparietal sinus} + rHU _{Trolard vein}) was calculated. The correlations between CVOR and CT perfusion parameters, hypoperfusion and ischemic core volume, were explored. Outcome was assessed at 90 days using the modified Rankin Scale (mRS), a standardized measure of disability ranging from 0 (no symptoms) to 6 (death). An mRS score of 2 or less is considered as functional outcome.

Results

A total of 143 patients (mean age, 67.3 ± 12.5 years; 106 men) were included. We found that CVOR had a strong negative correlation with hypoperfusion volume (r = -0.759, P < 0.001) and had a moderate negative correlation with ischemic core volume (r = -0.517, P < 0.001). Receiver operating characteristic curve analysis revealed CVOR performed better than hypoperfusion volume (area under the curve [AUC], 0.784 vs 0.711; P = 0.008) and ischemic core volume (AUC, 0.784 vs 0.693; P = 0.02) in predicting the favorable 90-day mRS. Multivariable analysis showed CVOR was an independent predictor for poor outcome after adjusting for confounding factors [odds ratio 0.06 (0.02–0.32), p < 0.001].

Conclusion

Cortical vein opacification evaluated by HU values, had a strong negative correlation with hypoperfusion volume, and was also a novel independent predictor for clinical outcome.

目的：在急性缺血性脑卒中（AIS）患者中，计算机断层血管成像（CTA）上的皮质静脉混浊通常是不对称的。我们旨在探讨CT灌注参数与更准确的Hounsfield unit （HU）值评价的皮质静脉混浊的相关性，并比较两者对AIS预后的预测能力。方法：回顾性分析2023年6月至2024年1月发病后24 h内的AIS患者。采用HU在CTA成像上测量labb皮质静脉、蝶顶窦和特罗德静脉的混浊情况。然后用患病侧除以对照组（rHU =患病侧/对照组）计算HU比（rHU）。计算3条皮质静脉混浊（CVOR, CVOR = rhulabb + rhusphenopartal sinus + rHU Trolard静脉）的rHU之和。探讨CVOR与CT灌注参数、灌注不足及缺血核体积的相关性。在90天时，使用改进的Rankin量表（mRS）评估结果，这是一种标准化的残疾衡量标准，范围从0（无症状）到6（死亡）。mRS评分为2分或更低被认为是功能性预后。结果：共纳入143例患者，平均年龄67.3±12.5岁，男性106例。我们发现CVOR与低灌注量有很强的负相关（r = -0.759， P）。结论：用HU值评价皮质静脉混浊与低灌注量有很强的负相关，也是临床预后的一个新的独立预测指标。

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引用次数: 0

Impact of DSA-based postoperative cerebral blood flow cascades on outcomes in acute ischemic stroke patients undergoing successful endovascular thrombectomy 基于dsa的术后脑血流级联对成功进行血管内血栓切除术的急性缺血性卒中患者预后的影响

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

European Journal of Radiology

Pub Date : 2026-01-11 DOI: 10.1016/j.ejrad.2026.112664

Jin Liu , Chen Gong , Yuetao Wen , Jing Guo , Junling Fu , You Wang , Jinxian Yuan , Tao Xu , Lina Zhang , Shuyu Jiang

Background

Half of patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO) fail to achieve functional independence after endovascular treatment (EVT), which may be related to the ineffective restoration of cerebral blood flow in ischemic brain tissue despite revascularization. Therefore, a comprehensive model to assess postoperative cerebral blood flow cascade (pCBF) may provide additional information for treatment.

Methods

This was a retrospective cohort study. All patients underwent standard cerebral angiography immediately after EVT. pCBF consisted of expanded Thrombolysis in Cerebral Infarction, microvascular cerebral circulation time, and Cortical Vein Opacification Score based on immediate DSA images after EVT. The primary outcome was functional independence at 90 days, defined as an mRS score of 0–2.

Results

156 patients were enrolled in this study after strict screening. In multivariate regression analysis, compared with the unfavorable pCBF group, the favorable pCBF group had a higher rate of functional independence at 90 days (82.1 % vs 26.0 %, aOR 12.94, 95 % CI 5.28–31.73, P < 0.001). In addition, the pCBF demonstrated good discrimination and calibration in this cohort, as well as the fivefold cross-validation.

Conclusion

Favorable pCBF may better reflect true reperfusion in AIS-LVO patients after achieving successful recanalization and was associated with functional outcomes.

背景大血管闭塞（AIS-LVO）所致急性缺血性脑卒中患者中，有一半患者在血管内治疗（EVT）后未能实现功能独立，这可能与尽管进行了血运重建，但缺血脑组织的脑血流未能恢复有关。因此，一个综合的模型来评估术后脑血流级联（pCBF）可能为治疗提供额外的信息。方法回顾性队列研究。所有患者在EVT后立即接受标准脑血管造影。pCBF包括脑梗死扩大溶栓、微血管脑循环时间、EVT后即刻DSA图像皮质静脉混浊评分。主要终点是90天的功能独立性，定义为mRS评分0-2。结果156例患者经严格筛选入组。多因素回归分析显示，与不良pCBF组相比，不良pCBF组90天功能独立率更高（82.1% vs 26.0%, aOR 12.94, 95% CI 5.28-31.73, P < 0.001）。此外，pCBF在该队列中表现出良好的判别和校准，以及五倍交叉验证。结论良好的pCBF能更好地反映AIS-LVO患者再通成功后的真实再灌注情况，并与功能预后相关。

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引用次数: 0

Shap-interpretable predictive modeling of microvascular invasion and early recurrence in hepatocellular carcinoma using MRI habitat imaging combined with clinical features 利用MRI栖息地成像结合临床特征对肝细胞癌微血管侵袭和早期复发进行形状可解释的预测建模。

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

European Journal of Radiology

Pub Date : 2026-01-11 DOI: 10.1016/j.ejrad.2026.112667

Hongmei Yu , Min Chen , Depeng Kong , Xiang Qiu , Jingang Yang , Fa Wu , Yi Huang , Rui Jiang

Objective

To develop and validate an integrated model combining Gd-EOB-DTPA–enhanced MRI habitat imaging with clinical features for preoperative prediction of microvascular invasion (MVI) and early recurrence in hepatocellular carcinoma (HCC).

Methods

This retrospective study enrolled 230 pathologically confirmed HCC patients, classified as MVI-positive or −negative. Radiomics features were extracted from the total tumor volume and a 3-mm peritumoral region. Tumor regions were segmented into three spatial habitats via K-means clustering, and habitat-specific features were obtained. Key features were selected using least absolute shrinkage and selection operator (LASSO) regression. Seven machine learning algorithms were trained; the intratumoral heterogeneity (ITH) score model showed optimal performance. Four models were developed: Clinical, Peritumoral Radiomics, ITH Score, and Combined (ITH + Peritumoral Radiomics + Clinical). Performance was assessed with ROC analysis, calibration, decision curve analysis (DCA), and SHapley Additive exPlanations (SHAP). A prognostic model was developed using the DeepSurv network to assess early recurrence-free survival (RFS) following HCC resection, with Kaplan-Meier curves plotted for evaluation.

Results

Extreme Gradient Boosting (XGBoost) achieved the best performance for ITH and traditional radiomics models. The ITH score model outperformed the Peritumoral Radiomics model. The Combined model achieved the highest performance on the training set (AUC: 0.925; sensitivity: 0.926; specificity: 0.785; accuracy: 0.863; F1-score: 0.882). Calibration and DCA confirmed reliability and clinical benefit. SHAP analysis clarified feature contributions.The HCC prognostic model-defined MVI-High risk patients, who exhibited significantly different risk scores, also had a significantly poorer early RFS per Kaplan-Meier analysis (P < 0.001).

Conclusion

The integrated MRI habitat–clinical model outperformed standalone approaches, showing promise for individualized surgical planning and recurrence risk stratification in HCC.

目的：建立并验证gd - eob - dtpa增强MRI栖息地成像与临床特征相结合的肝细胞癌（HCC）微血管侵袭（MVI）及早期复发术前预测模型。方法：本回顾性研究纳入230例病理证实的HCC患者，分为mvi阳性或阴性。从肿瘤总体积和肿瘤周围3mm区域提取放射组学特征。通过K-means聚类方法将肿瘤区域划分为3个空间生境，得到肿瘤的生境特异性特征。使用最小绝对收缩和选择算子（LASSO）回归选择关键特征。训练了7种机器学习算法；肿瘤内异质性（ITH）评分模型表现最佳。建立了临床、肿瘤周围放射组学、ITH评分和联合（ITH +肿瘤周围放射组学+临床）四种模型。采用ROC分析、校准、决策曲线分析（DCA）和SHapley加性解释（SHAP）评估绩效。使用DeepSurv网络建立预后模型，评估HCC切除术后的早期无复发生存（RFS），绘制Kaplan-Meier曲线进行评估。结果：极限梯度增强（XGBoost）在ITH和传统放射组学模型中获得了最佳性能。ITH评分模型优于肿瘤周围放射组学模型。组合模型在训练集上的表现最高（AUC: 0.925，灵敏度：0.926，特异性：0.785，准确率：0.863,F1-score: 0.882）。校准和DCA证实了可靠性和临床效益。SHAP分析澄清了特征的贡献。根据Kaplan-Meier分析，HCC预后模型定义的mvi -高风险患者表现出明显不同的风险评分，其早期RFS也明显较差（P < 0.001）。结论：综合MRI栖息地-临床模型优于单独的方法，显示出HCC个体化手术计划和复发风险分层的希望。

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引用次数: 0

Economic evaluation of bulk packaging and single-dose packaging of contrast media for contrast-enhanced CT 增强CT造影剂散装包装和单剂量包装的经济评价

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

European Journal of Radiology

Pub Date : 2026-01-10 DOI: 10.1016/j.ejrad.2026.112665

Jie Jia , Yuxin Peng , Zhixu Zhu , Dunming Xiao , Yingyao Chen , Yan Wei

Objective

To conduct an economic evaluation of bulk-packaged contrast media in the CT rooms from multiple perspectives, assess its economic benefits, and provide a evidence to support hospital cost control and pharmacy management.

Methods

Based on on-site investigations and the database constructed by the hospital management information system, information from 1,169 patients regarding contrast media utilization and medical insurance reimbursements was analyzed. We assessed the impact of different contrast media packaging formats on the hospital’s scanning volume and waste disposal costs using descriptive statistical methods and a decision-tree mode. In addition, cost-minimization analysis was conducted for the economic evaluation.

Results

Based on the average number of scans per hospital (49,807 per year), the 500 ml (400 mg/ml) vial saved an average of 29.60 s per patient compared with the 100 ml (400 mg/ml) vial, resulting in an annual increase of 3,890 patients scanned and potentially generating additional hospital revenue of approximately US$424,163, assuming sufficient appointment availability and operational capacity. In addition, the 500 ml (400 mg/ml) vial reduced medical insurance expenditures by US$1,701,280 to US$1,804,260 annually per hospital (a reduction of 52.19%–55.38%). The switch to bulk packaging also reduced medical waste by an average of 3,832 kg per year, corresponding to savings of US$1,904 in waste disposal costs. Qualitative interview indicated that imaging bulk-packaged contrast media can simultaneously reduce hospital costs and maintain patient safety under current technological conditions.

Conclusion

The use of bulk-packaged contrast media in contrast-enhanced CT was shown to be more effective in controlling hospital costs compared with single-dose packaging.

目的从多个角度对CT室散装包装造影剂进行经济评价，评价其经济效益，为医院成本控制和药房管理提供依据。方法通过现场调查和医院管理信息系统建立的数据库，对1169例患者的造影剂使用情况和医保报销情况进行分析。我们使用描述性统计方法和决策树模型评估了不同造影剂包装格式对医院扫描量和废物处理成本的影响。并进行了成本最小化分析，进行了经济性评价。结果：根据每家医院的平均扫描次数（每年49,807次），500毫升（400毫克/毫升）小瓶比100毫升（400毫克/毫升）小瓶平均每位患者节省29.60秒，导致每年增加3,890名扫描患者，并可能产生约424,163美元的额外医院收入，假设有足够的预约可用性和运营能力。此外，500毫升（400毫克/毫升）小瓶使每家医院每年的医疗保险支出减少1 701 280至1 804 260美元（减少52.19%-55.38%）。改用散装包装还使医疗废物平均每年减少3 832公斤，相当于节省1 904美元的废物处理费用。定性访谈表明，在目前的技术条件下，成像散装包装造影剂可以同时降低医院成本和维护患者安全。结论在增强CT中使用散装包装造影剂比单剂量包装更能有效控制医院费用。

{"title":"Economic evaluation of bulk packaging and single-dose packaging of contrast media for contrast-enhanced CT","authors":"Jie Jia , Yuxin Peng , Zhixu Zhu , Dunming Xiao , Yingyao Chen , Yan Wei","doi":"10.1016/j.ejrad.2026.112665","DOIUrl":"10.1016/j.ejrad.2026.112665","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct an economic evaluation of bulk-packaged contrast media in the CT rooms from multiple perspectives, assess its economic benefits, and provide a evidence to support hospital cost control and pharmacy management.</div></div><div><h3>Methods</h3><div>Based on on-site investigations and the database constructed by the hospital management information system, information from 1,169 patients regarding contrast media utilization and medical insurance reimbursements was analyzed. We assessed the impact of different contrast media packaging formats on the hospital’s scanning volume and waste disposal costs using descriptive statistical methods and a decision-tree mode. In addition, cost-minimization analysis was conducted for the economic evaluation.</div></div><div><h3>Results</h3><div>Based on the average number of scans per hospital (49,807 per year), the 500 ml (400 mg/ml) vial saved an average of 29.60 s per patient compared with the 100 ml (400 mg/ml) vial, resulting in an annual increase of 3,890 patients scanned and potentially generating additional hospital revenue of approximately US$424,163, assuming sufficient appointment availability and operational capacity. In addition, the 500 ml (400 mg/ml) vial reduced medical insurance expenditures by US$1,701,280 to US$1,804,260 annually per hospital (a reduction of 52.19%–55.38%). The switch to bulk packaging also reduced medical waste by an average of 3,832 kg per year, corresponding to savings of US$1,904 in waste disposal costs. Qualitative interview indicated that imaging bulk-packaged contrast media can simultaneously reduce hospital costs and maintain patient safety under current technological conditions.</div></div><div><h3>Conclusion</h3><div>The use of bulk-packaged contrast media in contrast-enhanced CT was shown to be more effective in controlling hospital costs compared with single-dose packaging.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112665"},"PeriodicalIF":3.3,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975425","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

Navigating the complexities of recall rates in breast cancer screening: Insights from the Irish national breast cancer screening programme 导航乳腺癌筛查中召回率的复杂性：来自爱尔兰国家乳腺癌筛查计划的见解

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

European Journal of Radiology

Pub Date : 2026-01-08 DOI: 10.1016/j.ejrad.2026.112663

Nuala A. Healy

引用次数: 0

Letter to the Editor regarding “Allergological evaluation of hypersensitivity reactions after administration of contrast agents: What the radiologist needs to know” – The role of polyethylene glycol in contrast-induced hypersensitivity 致编辑的关于“造影剂使用后超敏反应的过敏学评估：放射科医生需要知道的”的信-聚乙二醇在造影剂引起的超敏反应中的作用

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

European Journal of Radiology

Pub Date : 2026-01-08 DOI: 10.1016/j.ejrad.2025.112650

Igor Rubinić , Dominik Strikić , Marija Kurtov , Viktorija Erdeljić Turk

引用次数: 0