Pub Date : 2026-01-11DOI: 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}
Pub Date : 2026-01-11DOI: 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.
{"title":"Shap-interpretable predictive modeling of microvascular invasion and early recurrence in hepatocellular carcinoma using MRI habitat imaging combined with clinical features","authors":"Hongmei Yu , Min Chen , Depeng Kong , Xiang Qiu , Jingang Yang , Fa Wu , Yi Huang , Rui Jiang","doi":"10.1016/j.ejrad.2026.112667","DOIUrl":"10.1016/j.ejrad.2026.112667","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>The integrated MRI habitat–clinical model outperformed standalone approaches, showing promise for individualized surgical planning and recurrence risk stratification in HCC.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112667"},"PeriodicalIF":3.3,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009433","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 : 2026-01-10DOI: 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.
{"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}
Pub Date : 2026-01-08DOI: 10.1016/j.ejrad.2026.112663
Nuala A. Healy
{"title":"Navigating the complexities of recall rates in breast cancer screening: Insights from the Irish national breast cancer screening programme","authors":"Nuala A. Healy","doi":"10.1016/j.ejrad.2026.112663","DOIUrl":"10.1016/j.ejrad.2026.112663","url":null,"abstract":"","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112663"},"PeriodicalIF":3.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975421","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 : 2026-01-08DOI: 10.1016/j.ejrad.2025.112650
Igor Rubinić , Dominik Strikić , Marija Kurtov , Viktorija Erdeljić Turk
{"title":"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","authors":"Igor Rubinić , Dominik Strikić , Marija Kurtov , Viktorija Erdeljić Turk","doi":"10.1016/j.ejrad.2025.112650","DOIUrl":"10.1016/j.ejrad.2025.112650","url":null,"abstract":"","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112650"},"PeriodicalIF":3.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975422","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 update the Italian Diagnostic Reference Levels (NDRLs) in interventional neuroradiology, the Istituto Superiore di Sanità coordinated a working group with consolidated expertise in this field. Establishing DRLs in interventional procedures is particularly challenging due to the complexity influenced by clinical and technical factors. For this reason, aim of this work is to provide DRLs that also take into account procedure complexity.
Material and methods
Data were collected from 20 Italian hospitals concerning cerebral angiography(CA), embolization of cerebral aneurysms (ECA), and Mechanical Thrombectomy (MT). For each procedure, Air-Kerma (Ka,r), Kerma-Area-Product(PKA), and Fluoroscopy Time(FT) were recorded.
Data related to patient age, sex, and radiological equipment were registered. Additionally, for CA number of arteries evaluated, diagnostic priority (elective or emergency), and study type were documented. For ECA, aneurysm status, dome-to-neck ratio, aneurysm size, aneurysm location, and aneurysm morphology were recorded. For MT, collected data included occlusion type, thrombus location, and use of a stent retriever.
Results
PKA distributions were analysed with non-parametric tests and generalized linear regression models to identify clinical and technical factors affecting dosimetry. Log transformations helped develop a complexity score to classify procedures. The new NDRLs are 191 Gy.cm2 for CA (71 Gy.cm2 for simple, 117 Gy.cm2 for medium, 198 Gy.cm2 for complex), 252 Gy.cm2 for ECA (136 Gy.cm2 for simple, 174 Gy.cm2 medium, 268 Gy.cm2 complex) and 169 Gy.cm2 for MT (71 Gy.cm2 for simple, 132 Gy.cm2 for medium, 169 Gy.cm2 for complex).
Conclusion
This study establishes updated national diagnostic reference levels for interventional neuroradiology in Italy through a comprehensive complexity-stratified approach. The research demonstrates the critical importance of regular DRL updates to reflect evolving practice patterns and technological advances, offering a more nuanced framework that recognizes the inherent variability of neuro interventional procedures across different complexity tiers.
{"title":"Establishing updated diagnostic reference levels for interventional radiology: a national Italian survey incorporating procedure complexity indices – Part II: interventional neuroradiology","authors":"Monica Cavallari , Loredana D’Ercole , Sveva Grande , Catherine Klersy , Renato Padovani , Antonio Orlacchio , Gaetano Compagnone , Antonella Rosi , Alessandra Palma","doi":"10.1016/j.ejrad.2026.112662","DOIUrl":"10.1016/j.ejrad.2026.112662","url":null,"abstract":"<div><h3>Introduction</h3><div>To update the Italian Diagnostic Reference Levels (NDRLs) in interventional neuroradiology, the Istituto Superiore di Sanità coordinated a working group with consolidated expertise in this field. Establishing DRLs in interventional procedures is particularly challenging due to the complexity influenced by clinical and technical factors. For this reason, aim of this work is to provide DRLs that also take into account procedure complexity.</div></div><div><h3>Material and methods</h3><div>Data were collected from 20 Italian hospitals concerning cerebral angiography(CA), embolization of cerebral aneurysms (ECA), and Mechanical Thrombectomy (MT). For each procedure, Air-Kerma (K<sub>a,r</sub>), Kerma-Area-Product(P<sub>KA</sub>), and Fluoroscopy Time(FT) were recorded.</div><div>Data related to patient age, sex, and radiological equipment were registered. Additionally, for CA number of arteries evaluated, diagnostic priority (elective or emergency), and study type were documented. For ECA, aneurysm status, dome-to-neck ratio, aneurysm size, aneurysm location, and aneurysm morphology were recorded. For MT, collected data included occlusion type, thrombus location, and use of a stent retriever.</div></div><div><h3>Results</h3><div>P<sub>KA</sub> distributions were analysed with non-parametric tests and generalized linear regression models to identify clinical and technical factors affecting dosimetry. Log transformations helped develop a complexity score to classify procedures. The new NDRLs are 191 Gy.cm<sup>2</sup> for CA (71 Gy.cm<sup>2</sup> for simple, 117 Gy.cm<sup>2</sup> for medium, 198 Gy.cm<sup>2</sup> for complex), 252 Gy.cm<sup>2</sup> for ECA (136 Gy.cm<sup>2</sup> for simple, 174 Gy.cm<sup>2</sup> medium, 268 Gy.cm<sup>2</sup> complex) and 169 Gy.cm<sup>2</sup> for MT (71 Gy.cm<sup>2</sup> for simple, 132 Gy.cm<sup>2</sup> for medium, 169 Gy.cm<sup>2</sup> for complex).</div></div><div><h3>Conclusion</h3><div>This study establishes updated national diagnostic reference levels for interventional neuroradiology in Italy through a comprehensive complexity-stratified approach. The research demonstrates the critical importance of regular DRL updates to reflect evolving practice patterns and technological advances, offering a more nuanced framework that recognizes the inherent variability of neuro interventional procedures across different complexity tiers.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112662"},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009466","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 : 2026-01-07DOI: 10.1016/j.ejrad.2026.112661
Charles Mayard , Salim Si-Mohamed , Angèle Houmeau , Cyril Prieur , Jean-Nicolas Dacher , Loic Boussel , Philippe Douek , Sara Boccalini
Objectives
Systematic data about whether photon counting detector CT (PCD-CT) could improve the assessment of native heart valves is lacking. Thus, the aim of this study was to assess the performances of PCD-CT for the evaluation of native heart valves as compared to energy integrating detector CT (EID-CT).
Methods
Patients necessitating coronary artery CT were prospectively included (February 2021 to December 2022) to undergo an ECG-gated PCD-CT and EID-CT. A subjective assessment of the sharpness and conspicuity of each of the components of the four valves was performed with a 4-point scale. The number of small structures of the valvular apparati was calculated. The number of calcifications per leaflet and their localization within the thickness of the aortic leaflets were noted. The volume of the calcifications and the full width at mid weight (FWMH) of the aortic valve were calculated.
Results
Thirty-three patients (62 ± 13 years; 88 % men) were included. Conspicuity of aortic, mitral, and pulmonary valvular structures was increased with PCD-CT (all < 0.05) except for the aortic right-non-coronary commissure and the pulmonary right-left commissure (p = 0.06 and p = 0.07). Sharpness was superior for all the borders and the commissures of the aortic and mitral valve (all p < 0.05). More fine structures (nodules, chordae) and calcifications were visible with PCD-CT. The precise localization of the calcifications could be assessed with PCD-CT in most cases (70 %) while the volumes were similar (p = 0.07). FWMH was lower with PCD-CT (1.7(IQ = 1.1) vs 2.5 mm (IQ = 1.3); p < 0.01).
Conclusions
PCD-CT yielded better subjective and objective image quality of native aortic, mitral and pulmonary valves and allowed for more structures to be detected compared to EID-CT. This might result in earlier, improved diagnosis of valve pathologies.
{"title":"Benefits of photon counting CT for the assessment of native heart valves","authors":"Charles Mayard , Salim Si-Mohamed , Angèle Houmeau , Cyril Prieur , Jean-Nicolas Dacher , Loic Boussel , Philippe Douek , Sara Boccalini","doi":"10.1016/j.ejrad.2026.112661","DOIUrl":"10.1016/j.ejrad.2026.112661","url":null,"abstract":"<div><h3>Objectives</h3><div>Systematic data about whether photon counting detector CT (PCD-CT) could improve the assessment of native heart valves is lacking. Thus, the aim of this study was to assess the performances of PCD-CT for the evaluation of native heart valves as compared to energy integrating detector CT (EID-CT).</div></div><div><h3>Methods</h3><div>Patients necessitating coronary artery CT were prospectively included (February 2021 to December 2022) to undergo an ECG-gated PCD-CT and EID-CT. A subjective assessment of the sharpness and conspicuity of each of the components of the four valves was performed with a 4-point scale. The number of small structures of the valvular apparati was calculated. The number of calcifications per leaflet and their localization within the thickness of the aortic leaflets were noted. The volume of the calcifications and the full width at mid weight (FWMH) of the aortic valve were calculated.</div></div><div><h3>Results</h3><div>Thirty-three patients (62 ± 13 years; 88 % men) were included. Conspicuity of aortic, mitral, and pulmonary valvular structures was increased with PCD-CT (all < 0.05) except for the aortic right-non-coronary commissure and the pulmonary right-left commissure (p = 0.06 and p = 0.07). Sharpness was superior for all the borders and the commissures of the aortic and mitral valve (all p < 0.05). More fine structures (nodules, chordae) and calcifications were visible with PCD-CT. The precise localization of the calcifications could be assessed with PCD-CT in most cases (70 %) while the volumes were similar (p = 0.07). FWMH was lower with PCD-CT (1.7(IQ = 1.1) vs 2.5 mm (IQ = 1.3); p < 0.01).</div></div><div><h3>Conclusions</h3><div>PCD-CT yielded better subjective and objective image quality of native aortic, mitral and pulmonary valves and allowed for more structures to be detected compared to EID-CT. This might result in earlier, improved diagnosis of valve pathologies.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112661"},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051150","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 : 2026-01-07DOI: 10.1016/j.ejrad.2025.112636
Chih-Chien Tsai , Chia-Ling Chen , Chih-Hua Yeh , Yao-Liang Chen , Yu-Chun Lin , Jur-Shan Cheng , Jiun-Jie Wang
Purpose
To examine the white matter integrity in participants with cerebral palsy (CP) and among its different subtypes through diffusion MRI.
Methods
34 participants with CP (19 boys, 15 girls; mean age: 13.9 ± 3.6 years) and 27 typically developing (TD) participants (14 boys, 13 girls; mean age: 14.5 ± 3.2 years) were enrolled. Diffusion-weighted and T2-weighted images were obtained. Clinical assessments included Gross Motor Function Classification System, Manual Ability Classification System, and Bimanual Fine Motor Function test. Diffusion-weighted images were analyzed by fixel-based analysis and Tract-based spatial statistics. Lesion map was calculated from the T2-weighted images.
Differences in fixel-based metrics between CP or its subtype to TD participants, and among different subtypes, were evaluated through connectivity-based fixel enhancement and non-parametric permutation testing. The association of fixel-based metrics with clinical assessment scores was examined through general linear model.
Results
White matter damage can be noticed in CP participants, including corpus callosum, corticospinal tract, thalamic radiation, and optic radiation, when compared to TD participants. Fixel-based analysis detected additional regions in genu of corpus callosum. Fixel-based metrics in thalamic radiation and corticospinal tract were related to the severity of the motor impairment. Participants with diplegia had damage in the body of the corpus callosum and optic radiation when compared to those with hemiplegia.
Conclusion
Fixel-based analysis is sensitive to identify subtle white matter alterations that vary by CP subtype. The microstructural and macrostructural integrity of the corticospinal tract and thalamic radiation could be considered as promising image-based biomarkers to enhance clinical assessment.
{"title":"Exploring white matter abnormalities in different subtypes of spastic cerebral palsy using fixel-based analysis","authors":"Chih-Chien Tsai , Chia-Ling Chen , Chih-Hua Yeh , Yao-Liang Chen , Yu-Chun Lin , Jur-Shan Cheng , Jiun-Jie Wang","doi":"10.1016/j.ejrad.2025.112636","DOIUrl":"10.1016/j.ejrad.2025.112636","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the white matter integrity in participants with cerebral palsy (CP) and among its different subtypes through diffusion MRI.</div></div><div><h3>Methods</h3><div>34 participants with CP (19 boys, 15 girls; mean age: 13.9 ± 3.6 years) and 27 typically developing (TD) participants (14 boys, 13 girls; mean age: 14.5 ± 3.2 years) were enrolled. Diffusion-weighted and T2-weighted images were obtained. Clinical assessments included Gross Motor Function Classification System, Manual Ability Classification System, and Bimanual Fine Motor Function test. Diffusion-weighted images were analyzed by fixel-based analysis and Tract-based spatial statistics. Lesion map was calculated from the T2-weighted images.</div><div>Differences in fixel-based metrics between CP or its subtype to TD participants, and among different subtypes, were evaluated through connectivity-based fixel enhancement and non-parametric permutation testing. The association of fixel-based metrics with clinical assessment scores was examined through general linear model.</div></div><div><h3>Results</h3><div>White matter damage can be noticed in CP participants, including corpus callosum, corticospinal tract, thalamic radiation, and optic radiation, when compared to TD participants. Fixel-based analysis detected additional regions in genu of corpus callosum. Fixel-based metrics in thalamic radiation and corticospinal tract were related to the severity of the motor impairment. Participants with diplegia had damage in the body of the corpus callosum and optic radiation when compared to those with hemiplegia.</div></div><div><h3>Conclusion</h3><div>Fixel-based<!--> <!-->analysis is sensitive to identify subtle white matter alterations that vary by CP<!--> <!-->subtype. The microstructural and macrostructural integrity of the corticospinal<!--> <!-->tract and thalamic<!--> <!-->radiation could be considered as promising image-based biomarkers to enhance clinical assessment.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112636"},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017580","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 : 2026-01-07DOI: 10.1016/j.ejrad.2026.112659
Christer Ruff , Till-Karsten Hauser , Paula Bombach , Daniel Vogl , Constantin Roder , Frank Paulsen , Deborah Staber , Vivien Richter , Leonie Zerweck , Ulrike Ernemann , Georg Gohla
Purpose
Postoperative MRI plays a pivotal role in assessing residual disease and planning therapy after intracranial tumor resection. As acute perioperative infarction may mimic enhancing and non-enhancing tumor tissue in follow-up imaging, the initial postoperative MRI examination is essential for this purpose. However, conventional DWI techniques like RESOLVE are often impaired by artifacts from intracranial air. This study compares RESOLVE DWI with TGSE-BLADE DWI within early postoperative scans to improve diagnostic confidence in identifying ischemic changes.
Method
In a retrospective, institutional review board–approved study, 33 patients (mean age 52.3 ± 25.1 years) underwent a 1.5-Tesla MRI within 48 h of resection. RESOLVE and TGSE-BLADE DWI sequences were acquired in the same orientation and slice thickness of 5 mm. Two neuroradiologists blindly evaluated geometric distortion, susceptibility artifacts, overall image quality, and diagnostic confidence. Quantitative analysis included measuring signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), apparent diffusion coefficient (ADC) values, image quality metrics and resection defect dimensions against T1-weighted images.
Results
TGSE-BLADE DWI exhibited significantly reduced geometric distortions and susceptibility artifacts near the resection site compared with RESOLVE DWI, producing superior qualitative image quality and diagnostic confidence (p < 0.001). Conversely, RESOLVE DWI yielded slightly higher SNR and CNR. Measurements of the resection defect on TGSE-BLADE DWI closely matched those on T1-weighted images (p = 0.974), while RESOLVE DWI showed a significant discrepancy (p < 0.001).
Conclusions
TGSE-BLADE DWI significantly minimizes artifacts and geometric distortions in intracranial postoperative imaging, thereby improving the detection of perioperative ischemic changes. This robust technique serves as an effective alternative to conventional EPI-based sequences in challenging settings with pronounced B0 inhomogeneities, ultimately enhancing diagnostic confidence and patient care.
{"title":"A comprehensive quantitative and qualitative assessment of TGSE-BLADE DWI in postoperative imaging following intracranial tumor resection","authors":"Christer Ruff , Till-Karsten Hauser , Paula Bombach , Daniel Vogl , Constantin Roder , Frank Paulsen , Deborah Staber , Vivien Richter , Leonie Zerweck , Ulrike Ernemann , Georg Gohla","doi":"10.1016/j.ejrad.2026.112659","DOIUrl":"10.1016/j.ejrad.2026.112659","url":null,"abstract":"<div><h3>Purpose</h3><div>Postoperative MRI plays a pivotal role in assessing residual disease and planning therapy after intracranial tumor resection. As acute perioperative infarction may mimic enhancing and non-enhancing tumor tissue in follow-up imaging, the initial postoperative MRI examination is essential for this purpose. However, conventional DWI techniques like RESOLVE are often impaired by artifacts from intracranial air. This study compares RESOLVE DWI with TGSE-BLADE DWI within early postoperative scans to improve diagnostic confidence in identifying ischemic changes.</div></div><div><h3>Method</h3><div>In a retrospective, institutional review board–approved study, 33 patients (mean age 52.3 ± 25.1 years) underwent a 1.5-Tesla MRI within 48 h of resection. RESOLVE and TGSE-BLADE DWI sequences were acquired in the same orientation and slice thickness of 5 mm. Two neuroradiologists blindly evaluated geometric distortion, susceptibility artifacts, overall image quality, and diagnostic confidence. Quantitative analysis included measuring signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), apparent diffusion coefficient (ADC) values, image quality metrics and resection defect dimensions against T1-weighted images.</div></div><div><h3>Results</h3><div>TGSE-BLADE DWI exhibited significantly reduced geometric distortions and susceptibility artifacts near the resection site compared with RESOLVE DWI, producing superior qualitative image quality and diagnostic confidence (p < 0.001). Conversely, RESOLVE DWI yielded slightly higher SNR and CNR. Measurements of the resection defect on TGSE-BLADE DWI closely matched those on T1-weighted images (p = 0.974), while RESOLVE DWI showed a significant discrepancy (p < 0.001).</div></div><div><h3>Conclusions</h3><div>TGSE-BLADE DWI significantly minimizes artifacts and geometric distortions in intracranial postoperative imaging, thereby improving the detection of perioperative ischemic changes. This robust technique serves as an effective alternative to conventional EPI-based sequences in challenging settings with pronounced B<sub>0</sub> inhomogeneities, ultimately enhancing diagnostic confidence and patient care.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112659"},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975350","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 : 2026-01-07DOI: 10.1016/j.ejrad.2026.112660
Ruo-Yu Wang , Xiao-Dan Mu , Yu-Jin Zhang , Yi-Fei Peng , Yue Liu , Zi-Bo Wang , Wei Yan , Li Zhang
Objective
To investigate the predictive value of MOLLI T1 mapping imaging for the longitudinal changes in Minimal Clinical Important Difference (MCID) after surgery for patients with Cervical Spondylotic Myelopathy (CSM).
Methods
A prospective study enrolled 163 surgically treated CSM patients (October 2022–October 2023). All underwent preoperative conventional MRI and MOLLI T1 mapping. The MCID was determined based on the difference in Modified Japanese Orthopedic Association (m JOA) scores before and at 3, 6, and 12 months after surgery. Patients with an MCID less than 2 were defined as the poor prognosis group, while those with an MCID of 2 or higher were defined as the good prognosis group. Patients were classified into the good prognosis and poor prognosis groups at 3, 6,12 months postoperatively. The differences in conventional MRI features and T1 values between the two groups at these time points were compared. Univariate and multivariate logistic regression identified recovery predictors, with forest plots generated. Receiver operating characteristic (ROC) curve analysis assessed diagnostic performance.
Results
At 3 months, (27 good vs 136 poor). Only T2WI hyperintensity differed between groups [Area under the receiver operating characteristic curve (AUC)=0.597, cut off = 0.1942; sensitivity = 40.74 %, specificity = 78.68 %]. At 6 months (60 good vs 103 poor), T1 values showed significance (AUC = 0.690, cut off = 0.3091; sensitivity = 83.33 %, specificity = 47.57 %). At 12 months (100 good vs 63 poor), T1 values demonstrated superior prediction (AUC = 0.875,cut off = 0.6389; sensitivity = 75.00 %, specificity = 88.89 %).
Conclusion
MOLLI T1 mapping effectively predicts CSM recovery at 6,12 months postoperatively, with optimal diagnostic performance at 12 months.
Critical relevance statement
This study first employs MRI T1 mapping to predict MCID outcomes in CSM patients, demonstrating its high predictive value for favorable postoperative prognosis and providing a reliable imaging parameter for outcome assessment.
目的：探讨MOLLI T1成像对脊髓型颈椎病（CSM）患者术后最小临床重要差异（MCID）纵向变化的预测价值。方法：一项前瞻性研究，纳入163例手术治疗的CSM患者（2022年10月至2023年10月）。所有患者术前均行常规MRI和MOLLI T1制图。MCID是根据手术前、术后3个月、6个月和12个月修正日本骨科协会（m JOA）评分的差异来确定的。MCID小于2定义为预后不良组，MCID大于等于2定义为预后良好组。术后3、6、12个月分为预后良好组和预后不良组。比较两组在这些时间点的常规MRI特征和T1值的差异。单变量和多变量逻辑回归确定了恢复预测因子，并生成了森林样地。受试者工作特征（ROC）曲线分析评估诊断效果。结果：3个月时，27例良好，136例不良。两组间仅有T2WI高信号差异[受试者工作特征曲线下面积（Area under receiver operating characteristic curve， AUC）=0.597, cut off = 0.1942；敏感性= 40.74%，特异性= 78.68%。6个月时，T1值具有显著性（AUC = 0.690, cut off = 0.3091；敏感性= 83.33%，特异性= 47.57%）。在12个月时，T1值显示出较好的预测（AUC = 0.875,cut off = 0.6389；敏感性= 75.00%，特异性= 88.89%）。结论：MOLLI T1映射能有效预测术后6、12个月的CSM恢复情况，12个月时诊断效果最佳。关键相关性声明：本研究首次采用MRI T1定位预测CSM患者的MCID结局，显示了其对术后良好预后的高预测价值，为结局评估提供了可靠的影像学参数。
{"title":"Longitudinal predictive value of MOLLI T1 mapping imaging for minimal clinically important difference after surgery for cervical spondylotic myelopathy","authors":"Ruo-Yu Wang , Xiao-Dan Mu , Yu-Jin Zhang , Yi-Fei Peng , Yue Liu , Zi-Bo Wang , Wei Yan , Li Zhang","doi":"10.1016/j.ejrad.2026.112660","DOIUrl":"10.1016/j.ejrad.2026.112660","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the predictive value of MOLLI T<sub>1</sub> mapping imaging for the longitudinal changes in Minimal Clinical Important Difference (MCID) after surgery for patients with Cervical Spondylotic Myelopathy (CSM).</div></div><div><h3>Methods</h3><div>A prospective study enrolled 163 surgically treated CSM patients (October 2022–October 2023). All underwent preoperative conventional MRI and MOLLI T<sub>1</sub> mapping. The MCID was determined based on the difference in Modified Japanese Orthopedic Association (m JOA) scores before and at 3, 6, and 12 months after surgery. Patients with an MCID less than 2 were defined as the poor prognosis group, while those with an MCID of 2 or higher were defined as the good prognosis group. Patients were classified into the good prognosis and poor prognosis groups at 3, 6,12 months postoperatively. The differences in conventional MRI features and T<sub>1</sub> values between the two groups at these time points were compared. Univariate and multivariate logistic regression identified recovery predictors, with forest plots generated. Receiver operating characteristic (ROC) curve analysis assessed diagnostic performance.</div></div><div><h3>Results</h3><div>At 3 months, (27 good vs 136 poor). Only T<sub>2</sub>WI hyperintensity differed between groups [Area under the receiver operating characteristic curve (AUC)=0.597, cut off = 0.1942; sensitivity = 40.74 %, specificity = 78.68 %]. At 6 months (60 good vs 103 poor), T<sub>1</sub> values showed significance (AUC = 0.690, cut off = 0.3091; sensitivity = 83.33 %, specificity = 47.57 %). At 12 months (100 good vs 63 poor), T<sub>1</sub> values demonstrated superior prediction (AUC = 0.875,cut off = 0.6389; sensitivity = 75.00 %, specificity = 88.89 %).</div></div><div><h3>Conclusion</h3><div>MOLLI T<sub>1</sub> mapping effectively predicts CSM recovery at 6,12 months postoperatively, with optimal diagnostic performance at 12 months.</div></div><div><h3>Critical relevance statement</h3><div>This study first employs MRI T<sub>1</sub> mapping to predict MCID outcomes in CSM patients, demonstrating its high predictive value for favorable postoperative prognosis and providing a reliable imaging parameter for outcome assessment.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112660"},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951523","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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