European Journal of Radiology最新文献_第5页

Synovitis mediates the association between medial meniscal extrusion and subchondral bone denudation in knee osteoarthritis: Data from the FNIH OA biomarkers consortium 滑膜炎介导膝关节骨性关节炎中半月板内侧挤压和软骨下骨脱落之间的关联：来自FNIH OA生物标志物联盟的数据。

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

European Journal of Radiology

Pub Date : 2026-01-16 DOI: 10.1016/j.ejrad.2026.112669

Dongfan Liu , Yingwei Sun , Lunhao Bai , Chunbo Deng

Background

Medial meniscal extrusion (MME) accelerates structural progression in knee osteoarthritis (KOA). While its biomechanical impact has been established, its relationship with subchondral bone denudation and the potential mediating role of synovitis remain unclear.

Purpose

This study aimed to investigate the association between MME in the absence of medial meniscal posterior root tears and the size of denuded areas of subchondral bone (dABs), and to evaluate whether synovitis mediates this relationship.

Methods

Data from the Foundation for the National Institutes of Health (FNIH) Osteoarthritis Biomarkers Consortium were analyzed. MME and synovitis (effusion-synovitis and Hoffa-synovitis) were assessed semi-quantitatively using the MRI Osteoarthritis Knee Score (MOAKS) system. The size of medial tibiofemoral dABs was quantified at baseline and 24-month follow-up. Linear regression models evaluated cross-sectional and longitudinal associations. Causal mediation analysis was conducted to quantify the proportion of the total effect of MME on dABs mediated by synovitis.

Results

A total of 520 participants were included. Cross-sectionally, both baseline MME (β = 2.03,95 % CI: 0.67, 3.38) and synovitis score (β = 0.97,95 % CI: 0.48, 1.46) were significantly associated with central medial femoral (cMF) dABs. Longitudinal analysis revealed significant correlations between MME and both 24-month cMF dABs (β = 3.41,95 % CI: 1.49,5.33) and 24-month medial tibial (MT) dABs (β = 0.98,95 % CI: 0.47,1.87). Furthermore, the 24-month synovitis score showed significant associations with both cMF dABs (β = 2.06,95 % CI: 1.38,2.74) and MT dABs (β = 0.88,95 % CI: 0.55,1.21). Mediation analysis indicated that synovitis mediated 20.1 % (95 % CI: 6.6, 71.1) of the effect of MME on baseline cMF dABs. 24-month synovitis mediated 20.38 % (95 % CI: 6.61, 44.50) of the effect of MME on 24-month cMF dABs and 16.86 % (95 % CI: 2.71, 42.16) of its effect on 24-month MT dABs.

Conclusion

MME and dABs showed significant correlations in both cross-sectional and longitudinal studies. Synovitis acted as a mediator between MME and dABs, suggesting that inflammatory pathways may be involved in the pathological mechanisms of MME promoting KOA progression.

背景：内侧半月板挤压（MME）加速膝关节骨关节炎（KOA）的结构进展。虽然其生物力学影响已经确立，但其与软骨下骨剥落的关系以及滑膜炎的潜在介导作用仍不清楚。目的：本研究旨在探讨无内侧半月板后根撕裂时MME与软骨下骨脱落区（dABs）大小的关系，并评估滑膜炎是否介导了这种关系。方法：分析来自美国国立卫生研究院（FNIH）骨关节炎生物标志物联盟基金会的数据。使用MRI骨关节炎膝关节评分（MOAKS）系统对MME和滑膜炎（积液-滑膜炎和hoffa -滑膜炎）进行半定量评估。在基线和24个月的随访中，对内侧胫股dab的大小进行量化。线性回归模型评估了横断面和纵向关联。进行因果中介分析，量化MME对滑膜炎介导的dABs的总影响比例。结果：共纳入受试者520人。横断面上，基线MME （β = 2.03, 95% CI: 0.67, 3.38）和滑膜炎评分（β = 0.97, 95% CI: 0.48, 1.46）与股骨中央内侧（cMF） dABs显著相关。纵向分析显示，MME与24个月cMF dABs （β = 3.41, 95% CI: 1.49,5.33）和24个月胫骨内侧（MT） dABs （β = 0.98, 95% CI: 0.47,1.87）具有显著相关性。此外，24个月滑膜炎评分与cMF dABs （β = 2.06, 95% CI: 1.38,2.74）和MT dABs （β = 0.88, 95% CI: 0.55,1.21）均有显著相关性。中介分析表明，滑膜炎介导了20.1% （95% CI: 6.6, 71.1）的MME对基线cMF dABs的影响。24个月滑膜炎介导的MME对24个月cMF抗体的影响为20.38% (95% CI: 6.61, 44.50)，对24个月MT抗体的影响为16.86% （95% CI: 2.71, 42.16）。结论：MME和dABs在横断面和纵向研究中均具有显著相关性。滑膜炎在MME和dABs之间起中介作用，提示炎症途径可能参与了MME促进KOA进展的病理机制。

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引用次数: 0

Utilizing baseline multiregional MRI radiomics for prediction of tumor deposition and prognosis following neoadjuvant therapy in resectable rectal cancer 利用基线多区域MRI放射组学预测可切除直肠癌新辅助治疗后的肿瘤沉积和预后

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.2026.112676

Bingjie Wu , Lingwei Wang , Yang Wang , Fan Liu , Xujie Gao , Wenpeng Wang , Bohan Xiao , Ying Liu

Objective

To investigate whether pre-treatment T2WI-based multiregional radiomics can predict the probability of post-treatment tumor deposit (TD) and prognostic outcomes in patients with resectable rectal cancer after neoadjuvant therapy.

Materials and methods

This retrospective study included 159 patients with pathologically confirmed rectal cancer who received neoadjuvant therapy and then underwent surgery from March 2013 to March 2024. Radiomics features were extracted from the intratumoral region, a 3-mm-region straddling the tumor margin, and peritumoral 3 mm region on pre-treatment T2WI images. Clinical-radiomics nomogram was developed based on the most predictive radiomics signatures and clinical risk factors. Prognostic model for 5-year recurrence-free survival (RFS) was constructed by Cox regression analysis.

Results

The nomogram integrating clinical risk factors (Tumor distance to anal margin and MRI-reported extramural vascular invasion (EMVI)) with an intra-straddle 3 mm radiomics signature score (radscore) demonstrated optimal predictive performance with area under the receiver operating characteristic curve (AUC) of 0.953 (95% CI: 0.877–0.988), 0.810 (95% CI: 0.629–0.928) and 0.952 (95% CI: 0.857–0.992) in the training cohort, validation cohort and test cohort, respectively. The prognostic model constructed by intra-straddle 3 mm radscore (hazard ratio [HR] = 3.60, 95% CI: 1.59–8.16) and MRI-reported EMVI (HR = 6.07, 95% CI: 2.51–14.63) showed good performance for predicting 5‑year RFS with AUC of 0.827 (95% CI: 0.772–0.890) in the entire cohort.

Conclusion

The nomogram, incorporating pre-treatment MRI-based intra-straddle 3 mm radscore along with clinical risk factors, facilitates noninvasive assessment of the likelihood of TD positivity following neoadjuvant therapy, and has the power to predict 5-year RFS in patients with resectable rectal cancer.

目的探讨t2wi多区域放射组学对可切除直肠癌患者新辅助治疗后肿瘤沉积（TD）发生概率及预后的预测作用。材料与方法回顾性研究2013年3月至2024年3月，159例经病理证实的直肠癌患者接受新辅助治疗后行手术治疗。在治疗前T2WI图像上提取肿瘤内区域、横跨肿瘤边缘的3mm区域和肿瘤周围3mm区域的放射组学特征。临床放射组学图是基于最具预测性的放射组学特征和临床危险因素而开发的。采用Cox回归分析建立5年无复发生存期（RFS）预后模型。结果将临床危险因素（肿瘤到肛门边缘的距离和mri报告的外血管侵犯（EMVI））与跨骑3 mm放射组学特征评分（radscore）相结合的nomogram预测效果最佳，训练队列、验证队列和测试队列的受试者工作特征曲线下面积（AUC）分别为0.953 （95% CI: 0.877 ~ 0.988）、0.810 （95% CI: 0.629 ~ 0.928）和0.952 （95% CI: 0.857 ~ 0.992）。由跨骑3 mm radscore（风险比[HR] = 3.60, 95% CI: 1.59-8.16）和mri报告的EMVI（风险比[HR] = 6.07, 95% CI: 2.51-14.63）构建的预后模型在预测整个队列的5年RFS方面表现良好，AUC为0.827 （95% CI: 0.772-0.890）。该成像结合了治疗前基于mri的跨骑3mm radscore以及临床危险因素，有助于对新辅助治疗后TD阳性可能性进行无创评估，并具有预测可切除直肠癌患者5年RFS的能力。

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引用次数: 0

Association between cognitive status and structural brain changes in Alzheimer’s disease: Clinical implication of lightweight deep learning-aided diagnosis 阿尔茨海默病认知状态与大脑结构变化之间的关系：轻量级深度学习辅助诊断的临床意义

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.2026.112678

Po-Hsuan Hsieh , Ya-Fang Chen , Ta-Fu Chen , Wen-Chau Wu , for the Alzheimer’s Disease Neuroimaging Initiative

Background

The complex brain changes involved in Alzheimer’s disease (AD) development constitute a high-dimensional nonlinear feature space where deep learning (DL) classification/diagnosis may be advantageous over classical non-learning methods. However, the practicality of DL remains under debate among healthcare professionals, largely because many models are computationally expensive and operate without explicit interpretability. This study aimed to construct a lightweight DL model to disclose the association between cognitive status and structural brain changes in AD.

Methods

By using the data obtained from the Alzheimer’s Disease Neuroimaging Initiative database, 418 AD patients and 418 age-matched cognitively normal (CN) subjects were included for DL model construction based on their T1-weighted magnetic resonance images at baseline visit. A lightweight design was achieved by incorporating group convolution, global pooling, and efficient channel attention.

Results

The accuracy rate of our model was 90.6 %, competitive with previous models built with up-to-ten times more parameters. The occlusion maps showed that the medial temporal area and thalamus accounted the most for our model’s differentiation between AD and CN, in line with current knowledge of the pathological trajectory. Hierarchical regression further revealed that the logit of the DL model output explained a significant amount of variance in the mini mental state examination score, above and beyond the clinical indices including age, sex, and education duration (R² change = 0.341, F(1, 91) = 57.623, p < 0.001).

Conclusions

Lightweight DL can be clinically practicable for AD diagnosis by focusing on pathologically interpretable structural changes and offering image-based assessment of cognitive status.

背景：阿尔茨海默病（AD）发展过程中涉及的复杂大脑变化构成了一个高维非线性特征空间，深度学习（DL）分类/诊断可能比经典的非学习方法更有优势。然而，深度学习的实用性在医疗保健专业人员中仍然存在争议，主要是因为许多模型在计算上很昂贵，并且没有明确的可解释性。本研究旨在构建轻量级DL模型，揭示AD患者认知状态与大脑结构变化之间的关系。方法：利用从阿尔茨海默病神经影像学倡议数据库获得的数据，根据基线就诊时的t1加权磁共振图像，纳入418例AD患者和418例年龄匹配的认知正常（CN）受试者进行DL模型构建。通过结合群体卷积、全局池化和有效的信道关注，实现了轻量级设计。结果：该模型的准确率为90.6%，优于以往参数增加10倍以上的模型。闭塞图显示内侧颞区和丘脑是我们的模型区分AD和CN的主要原因，这与目前对病理轨迹的了解一致。层次回归进一步显示，DL模型输出的logit解释了迷你精神状态检查分数的显著差异，超出了年龄、性别和受教育程度等临床指标（R2变化= 0.341，F(1,91) = 57.623, p）。结论：轻量级DL可以通过关注病理可解释的结构变化和基于图像的认知状态评估来诊断AD。

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引用次数: 0

Performance analysis of liver segmentation using nn-UNet TotalSegmentator: Focus on atypical livers, pathologies, and variants 使用nn-UNet TotalSegmentator进行肝脏分割的性能分析：关注非典型肝脏、病理和变异

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.2026.112674

Joy-Marie Kleiß , Sebastian Arndt , Lisa Sommerfeld , Maximilian Schmidt MD , Florian Putz , Teresa Graetz , Leonard Stepansky , Kaan Türkan , Simon Mayr , Michael Uder , Matthias S May

Rationale and Objectives

This study evaluates the accuracy of the nn-UNet TotalSegmentator (TS) by Wasserthal et al. (2023) in segmenting atypical livers with pathologies and variants in CT scans.

Materials and Methods

CT scans were retrospectively collected from our RIS and divided into two cohorts: a reference group (67 healthy livers) and a study group (55 scans across eleven pathology and variant subgroups). TS performed automatic segmentation for all groups. For reference, the images were then manually segmented, with corrections reviewed by two radiologists. Accuracy was assessed using Dice similarity score, Hausdorff distance (HD), mean surface distance (MSD), volume difference, and clinical ratings.

Results

Automatic segmentation underestimated liver volume by a mean of 48.11 ml (3.1%) in the reference group and overestimated it in 84% of study group cases by 79.09 ml (4%).

The average Dice score was 0.980 ± 0.007 for the reference group and 0.933 ± 0.113 for the study group. Hepatomegaly achieved the highest score (0.979 ± 0.006), Polycystic liver disease (PLD) the lowest (0.656 ± 0.230). Cirrhosis with Ascites, Beavertail, and PLD had significantly lower Dice scores than the reference group. Clinical ratings were often lower than Dice scores suggested, especially in Beavertail, Cirrhosis with Ascites, Ablation defects, Metastases, and Hemihepatectomy.

Conclusion

TS performs excellently on healthy and well on most pathological livers. Despite high Dice scores in many pathological cases, clinical ratings reveal limitations. Clinical evaluation remains essential. Inclusion of PLD and Beavertail cases in training data may reduce bias and improve performance.

理由和目的本研究评估了Wasserthal等人（2023）使用nn-UNet TotalSegmentator （TS）对CT扫描中病理和变异的非典型肝脏进行分割的准确性。材料和方法回顾性收集RIS的sct扫描，并将其分为两组：参照组（67个健康肝脏）和研究组（11个病理和变异亚组的55个扫描）。TS对所有组进行自动分割。作为参考，这些图像随后被手动分割，并由两名放射科医生进行校正。使用Dice相似度评分、Hausdorff距离（HD）、平均表面距离（MSD）、体积差和临床评分来评估准确性。结果自动分割在参照组中平均低估了48.11 ml(3.1%)，在84%的研究组中平均高估了79.09 ml（4%）。参照组的平均Dice评分为0.980±0.007，研究组的平均Dice评分为0.933±0.113。肝肿大评分最高（0.979±0.006），多囊性肝病评分最低（0.656±0.230）。肝硬化合并腹水、海狸尾和PLD的Dice评分明显低于对照组。临床评分通常低于Dice评分，特别是在海狸尾、肝硬化合并腹水、消融缺陷、转移和半肝切除术中。结论ts对健康肝脏治疗效果良好，对多数病理肝脏治疗效果良好。尽管在许多病理病例中Dice得分很高，但临床评分显示出局限性。临床评估仍然是必要的。在训练数据中加入PLD和Beavertail案例可以减少偏差并提高性能。

{"title":"Performance analysis of liver segmentation using nn-UNet TotalSegmentator: Focus on atypical livers, pathologies, and variants","authors":"Joy-Marie Kleiß , Sebastian Arndt , Lisa Sommerfeld , Maximilian Schmidt MD , Florian Putz , Teresa Graetz , Leonard Stepansky , Kaan Türkan , Simon Mayr , Michael Uder , Matthias S May","doi":"10.1016/j.ejrad.2026.112674","DOIUrl":"10.1016/j.ejrad.2026.112674","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>This study evaluates the accuracy of the nn-UNet TotalSegmentator (TS) by Wasserthal et al. (2023) in segmenting atypical livers with pathologies and variants in CT scans.</div></div><div><h3>Materials and Methods</h3><div>CT scans were retrospectively collected from our RIS and divided into two cohorts: a reference group (67 healthy livers) and a study group (55 scans across eleven pathology and variant subgroups). TS performed automatic segmentation for all groups. For reference, the images were then manually segmented, with corrections reviewed by two radiologists. Accuracy was assessed using Dice similarity score, Hausdorff distance (HD), mean surface distance (MSD), volume difference, and clinical ratings.</div></div><div><h3>Results</h3><div>Automatic segmentation underestimated liver volume by a mean of 48.11 ml (3.1%) in the reference group and overestimated it in 84% of study group cases by 79.09 ml (4%).</div><div>The average Dice score was 0.980 ± 0.007 for the reference group and 0.933 ± 0.113 for the study group. Hepatomegaly achieved the highest score (0.979 ± 0.006), Polycystic liver disease (PLD) the lowest (0.656 ± 0.230). Cirrhosis with Ascites, Beavertail, and PLD had significantly lower Dice scores than the reference group. Clinical ratings were often lower than Dice scores suggested, especially in Beavertail, Cirrhosis with Ascites, Ablation defects, Metastases, and Hemihepatectomy.</div></div><div><h3>Conclusion</h3><div>TS performs excellently on healthy and well on most pathological livers. Despite high Dice scores in many pathological cases, clinical ratings reveal limitations. Clinical evaluation remains essential. Inclusion of PLD and Beavertail cases in training data may reduce bias and improve performance.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112674"},"PeriodicalIF":3.3,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035336","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

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。

{"title":"Relationship between resource utilization and diagnostic accuracy of large language models for efficient multimodal reasoning in radiologic image interpretation","authors":"Taewon Han , Jeong Hyun Lee , Woo Kyoung Jeong, Jaeseung Shin, Yun Hwa Roh, Min Je Kim","doi":"10.1016/j.ejrad.2026.112677","DOIUrl":"10.1016/j.ejrad.2026.112677","url":null,"abstract":"<div><h3>Objectives</h3><div>We evaluated the diagnostic performance and resource efficiency of three multimodal-reasoning-models for radiological image interpretation.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112677"},"PeriodicalIF":3.3,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035636","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

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。

{"title":"VIPs outperforms established models for predicting post-TIPS prognosis in viral hepatitis-dominant cirrhosis","authors":"Zhongsong Gao , Kun Zhang , Bo Li , Zhaogang Zhang , Hengtao Zhang , Xin Zhang , Bo Feng , Ruihang Wang , Wen Shen , Kefeng Jia","doi":"10.1016/j.ejrad.2026.112672","DOIUrl":"10.1016/j.ejrad.2026.112672","url":null,"abstract":"<div><h3>Background</h3><div>Transjugular intrahepatic portosystemic shunt (TIPS) manages portal hypertension complications in cirrhosis, but predicting post-TIPS outcomes remains challenging, especially in viral hepatitis-dominated populations.</div></div><div><h3>Purpose</h3><div>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).</div></div><div><h3>Materials and methods</h3><div>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 (R<sup>2</sup>), and decision curve analysis (DCA) were also evaluated.</div></div><div><h3>Results</h3><div>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 <em>p</em> < 0.05), and surpassed MELD and MELD-Na for long-term predictions (36/60 months, both <em>p</em> < 0.05). It also exhibited the best calibration (lowest Brier scores: 0.076–0.217) and the highest explanatory power (R<sup>2</sup> = 0.121–0.142). Subgroup analyses further confirmed robust performance in females and patients with variceal bleeding.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112672"},"PeriodicalIF":3.3,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975733","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

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。

{"title":"Impact of DSA-based postoperative cerebral blood flow cascades on outcomes in acute ischemic stroke patients undergoing successful endovascular thrombectomy","authors":"Jin Liu , Chen Gong , Yuetao Wen , Jing Guo , Junling Fu , You Wang , Jinxian Yuan , Tao Xu , Lina Zhang , Shuyu Jiang","doi":"10.1016/j.ejrad.2026.112664","DOIUrl":"10.1016/j.ejrad.2026.112664","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Favorable pCBF may better reflect true reperfusion in AIS-LVO patients after achieving successful recanalization and was associated with functional outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112664"},"PeriodicalIF":3.3,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975351","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