European Journal of Radiology最新文献

{"title":"A nomogram based on multiparametric magnetic resonance imaging improves the diagnostic performance of breast lesions diagnosed as BI-RADS category 4: A comparative study with the Kaiser score","authors":"Xiao Yang ,&nbsp;Zhou Lu ,&nbsp;Xiaoying Tan ,&nbsp;Lin Shao ,&nbsp;Jie Shi ,&nbsp;Weiqiang Dou ,&nbsp;Zongqiong Sun","doi":"10.1016/j.ejrad.2025.111920","DOIUrl":"10.1016/j.ejrad.2025.111920","url":null,"abstract":"<div><h3>Purpose</h3><div>To construct a nomogram combining Kaiser score (KS), synthetic MRI (syMRI) parameters, apparent diffusion coefficient (ADC), and clinical features to distinguish benign and malignant breast lesions better.</div></div><div><h3>Methods</h3><div>From December 2022 to February 2024, a retrospective cohort of 168 patients with breast lesions diagnosed as Breast Imaging Reporting and Data System (BI-RADS) category 4 by ultrasound and/or mammography was included. The research population was divided into the training set (n = 117) and the validation set (n = 51) by random sampling with a ratio of 7:3. Breast lesions’ KS, ADC, relaxation time of syMRI, and clinical and imaging features were statistically analyzed and compared between malignant and benign groups. Two experienced radiologists independently assigned KS, and measured quantitative values of ADC and parameters of syMRI, and the intraclass correlation coefficient (ICC) was calculated. Independent predictors were identified by univariable and multivariable logistic regression analysis. Then, a nomogram was established, and its performance was evaluated by the area under the curve (AUC), calibration curve, and decision curve.</div></div><div><h3>Results</h3><div>There were 168 lesions (118 malignant and 50 benign) in 168 female patients confirmed by histopathology. The interobserver agreement for each quantitative parameter was excellent. Older patient (OR = 1.091, 95 % confidence interval [CI]: 1.017–1.170, P = 0.014), higher lesions’ KS (OR = 288.431, 95 % CI: 34.930–2381.654, P &lt; 0.001), lower ADC (OR = 0.077, 95 % CI: 0.011–0.558, P = 0.011), and lower T2 relaxation time (OR = 0.918, 95 % CI: 0.868–0.972, P = 0.003) were independent predictors of breast malignancies and utilized to establish the nomogram. The accuracy of KS, ADC, T2, and patient age in predicting malignant breast lesions was 88.89 %, 79.48 %, 82.05 %, and 58.97 %, respectively. No significant differences in AUCs of KS, ADC and T2 were observed in distinguishing benign from malignant breast lesions. The nomogram yielded higher AUCs of 0.968 (0.934–0.996) and 0.959 (0.863–0.995) in training and validation sets than KS, ADC, T2, and patient age (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Although there were no significant differences among the AUCs of KS, ADC, and T2, the constructed nomogram incorporating these parameters significantly improves diagnostic performance for distinguishing benign and malignant BI-RADS 4 breast lesions. Future external validation is needed in practical applications.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111920"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964298","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}

{"title":"Pelvic insufficiency fractures in locally advanced cervical cancer: the diagnostic yield of post-treatment MRI in a tertiary centre","authors":"Consolato Gullì ,&nbsp;Luca Russo ,&nbsp;Diana Gavrila ,&nbsp;Matteo Mangialardi ,&nbsp;Giorgio Mazzotta ,&nbsp;Matteo Mancino ,&nbsp;Rosa Autorino ,&nbsp;Evis Sala ,&nbsp;Antonio Leone ,&nbsp;Benedetta Gui","doi":"10.1016/j.ejrad.2025.111918","DOIUrl":"10.1016/j.ejrad.2025.111918","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the incidence of pelvic insufficiency fractures (PIFs) after concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical cancer (LACC), their time of onset and risk factors. We also analysed the inter-observer agreement between gynaecologic radiologists (GYN readers) and radiologists expert in musculoskeletal imaging (MSK reader) in detecting PIFs in our tertiary care centre.</div></div><div><h3>Methods</h3><div>Patients with confirmed LACC who underwent concurrent chemoradiation (CCRT) at our institution from June 2019 to November 2022 were retrospectively included. These patients underwent follow-up pelvic MRI every 3–6 months after CCRT. Cohen’s kappa statistics was employed to assess the inter-observer agreement between GYN and MSK readers.<!--> <!-->Logistic regression analysis was performed calculating odds ratios (OR) to identify risk factors for PIFs, such as age, body mass index (BMI), diabetes, smoking, hypertension, renal function and tumour size.</div></div><div><h3>Results</h3><div>Eighty-seven patients were included. PIFs were diagnosed in 21/87 (24.1 %) patients with a median onset time of 7.4 months from the end of EBRT. Among risk factors, age was statistically associated with PIFs (OR = 1.057, 95 % CI: 1.005–1.118, <em>p</em> = 0.033) with median age in the fracture group of 61.1 years (range: 52.0–71.5) and 53.8 years (range: 43.8–63.3). BMI was a significant predictor of PIFs (OR = 1.134; 95 % CI: 1.013–1.285; <em>p</em> = 0.027), with a higher median BMI among patients with PIFs (26.5; range: 21.5–31.2) compared to non-fractured patients (23.1; range: 20.2–25.1). Also patients with reduced renal function (eGFR &lt; 60 mL/min) had 3.437 times higher odds of experiencing fractures compared to those with normal eGFR. The GYN readers correctly identified PIFs in 2/21 cases and agreed with the MSK reader in 68/87 cases. The interobserver agreement was poor to fair (K = 0.138; 95 % CI: 0–0.311).</div></div><div><h3>Conclusions</h3><div>PIFs are a common complication of CCRT. Their identification on post-CCRT MRI may decrease the need for further targeted investigations and invasive treatments.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111918"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of very low iodine dose aortoiliac CT angiography using dual-source photon-counting detector CT","authors":"Tim Oechsner ,&nbsp;Martin Soschynski ,&nbsp;Christopher L. Schlett ,&nbsp;Tobias Krauss ,&nbsp;Christopher Schupppert ,&nbsp;Katharina Müller-Peltzer ,&nbsp;Milán Vecsey-Nagy ,&nbsp;Dmitrij Kravchenko ,&nbsp;Ákos Varga-Szemes ,&nbsp;Tilman Emrich ,&nbsp;Raphael Scheu ,&nbsp;Jana Taron ,&nbsp;Fabian Bamberg ,&nbsp;Muhammad Taha Hagar","doi":"10.1016/j.ejrad.2025.111919","DOIUrl":"10.1016/j.ejrad.2025.111919","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the feasibility of aortoiliac CT-Angiography (CTA) using dual-source photon-counting detector (PCD)-CT with minimal iodine dose.</div></div><div><h3>Methods</h3><div>This IRB-approved, single-center prospective study enrolled patients with indications for aortoiliac CTA from December 2022 to March 2023. All scans were performed using a first-generation dual-source PCD-CT. Images were acquired with fast pitch and full spectral capabilities (collimation 144 × 0.4 mm). The contrast protocol included a mixture of sodium chloride and iodinated contrast agent (Iopromide, total iodine dose: 9.5–9.8 g). Virtual monoenergetic images (VMIs) were reconstructed at 40, 50, 60, and 68 keV. Two blinded radiologists evaluated image quality on a 4-point scale. Attenuation was measured across eight regions in the aorta and iliac arteries, and contrast-to-noise ratio (CNR) was calculated. Statistical comparisons were performed using repeated measures ANOVA and Bonferroni post-hoc tests.</div></div><div><h3>Results</h3><div>The final cohort consisted of 39 subjects (mean age: 69.6 ± 9.6 years; 30.8 % female). VMI at 40 keV provided significantly higher attenuation: 478 ± 114 HU, compared to 50 keV (331 ± 74 HU), 60 keV (241 ± 51 HU), and 68 keV (190 ± 48 HU) (p &lt; 0.01). This translated in increased CNR for 40 keV reconstructions (11.8 ± 3.9), followed by 50 keV (9.1 ± 3.0), 60 keV (7.0 ± 2.3), and 68 keV (6.1 ± 1.9) (p &lt; 0.01). Subjective image quality was rated excellent at 40 keV (4 [3,4]), though associated with highest noise (38 ± 7.4 HU, p = 0.02).</div></div><div><h3>Conclusion</h3><div>Aortoiliac CTA using dual-source PCD-CT at 40 keV achieved high attenuation and CNR, enabling effective imaging with only 9.8 g of iodine.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111919"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast imaging readers’ performance in the PERFORMS test-set based assessment scheme within the MyPeBS international randomised study","authors":"Eleni Michalopoulou ,&nbsp;Iain Darker ,&nbsp;Valentina Iotti ,&nbsp;Efrat Slonim ,&nbsp;Harry J. de Koning ,&nbsp;Rodrigo Alcantara Souza ,&nbsp;Jean-Benoit Burrion ,&nbsp;Sandrine De Montgolfier ,&nbsp;Cécile Vissac-Sabatier ,&nbsp;Michal Guindy ,&nbsp;Pierpaolo Pattacini ,&nbsp;Suzette Delaloge ,&nbsp;Fiona J. Gilbert ,&nbsp;Yan Chen ,&nbsp;the MyPeBS Consortium","doi":"10.1016/j.ejrad.2025.111938","DOIUrl":"10.1016/j.ejrad.2025.111938","url":null,"abstract":"<div><h3>Purpose</h3><div>A survey conducted by the European Society of Breast Imaging (EUSOBI) in 2023 revealed significant variations in Quality Assurance (QA) practices across Europe. The UK encourages regular performance monitoring for screen readers. This study aimed to assess the variability in diagnostic performance among readers participating in a wider prospective randomised trial across multiple countries.</div></div><div><h3>Method</h3><div>In this retrospective multinational study, breast imaging readers from the MyPeBS clinical trial examined a test set of 40 challenging breast screening cases using the PERFORMS software, from March 2021 to February 2022. The challenging set, enriched with biopsy-proven cancers, aimed to differentiate readers by their level of diagnostic performance. Cancer detection and correct return to screen rates were calculated for each participant.</div></div><div><h3>Results</h3><div>A total of 110 readers from 6 countries completed the PERFORMS test set, while 88 also completed an accompanying questionnaire collecting information about their breast screening work and experience. The study revealed variability in cancer detection rates (M = 73.6 %, SD = 19.7 %, range 0.0 %–100.0 %) and correct return to screen rates (M = 79.7 %, SD = 10.5 %, range 46.4 %–100.0 %). Outliers with extremely low cancer detection (2.7 % of participants) and correct return to screen rates (1.8 % of participants) were also identified.</div></div><div><h3>Conclusions</h3><div>Breast imaging readers’ performance in test set-based assessments like PERFORMS can reflect real-world screening proficiency. The presence of outlier readers with low diagnostic performance on the test highlights the need for double reading and for standardised QA protocols to ensure patient safety and service efficiency.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111938"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of intravenous CT contrast agents on internal calibration techniques to determine trabecular BMD of the lumbar spine","authors":"Stefan Bartenschlager ,&nbsp;Alexander Cavallaro ,&nbsp;Tobias Pogarell ,&nbsp;Michael Uder ,&nbsp;Oliver Chaudry ,&nbsp;Georg Schett ,&nbsp;Klaus Engelke","doi":"10.1016/j.ejrad.2025.111923","DOIUrl":"10.1016/j.ejrad.2025.111923","url":null,"abstract":"<div><h3>Objectives</h3><div>Contrast agents are frequently administered in computed tomography (CT) scans used for opportunistic screening of osteoporosis. The objective of this study is to compare the impact of contrast-related bone mineral density (BMD) increase between phantom-based and internal CT calibration techniques.</div></div><div><h3>Materials and Methods</h3><div>Phantom-based and internal CT calibration techniques were used to determine trabecular BMD in 93 existing clinical CT scans of the lumbar spine of 34 subjects, scanned before and after administration of contrast agents. BMD differences between native (Nat) and contrast-enhanced scans in arterial (Art) and portal venous (PV) phases were compared among calibration methods. Three pairs of internal reference materials were investigated: blood/air, subcutaneous adipose tissue (SAT)/air and muscle tissue/air.</div></div><div><h3>Results</h3><div>Contrast agents increased CT values of blood in the aorta and the inferior vena cava in the Art phase by 210 ± 99HU and 47 ± 35HU, respectively and in the PV phase by 110 ± 49HU and 73 ± 28HU, respectively. Effects on CT values of muscle and SAT were &lt; 5HU in the Art phase and &lt; 10HU in the PV phase.</div><div>BMD obtained with phantom calibration increased significantly (p &lt; 0.01) in Art and PV phases by 8.6 ± 14.7 mg/cm³ and 14.4 ± 16.3 mg/cm³, respectively. If SAT/air or muscle/air were used as internal reference materials, increases in internally calibrated BMD (&lt;12 mg/cm³ in AT phase and &lt; 17 mg/cm³ in PV phase) did not significantly differ (p &gt; 0.1 for Art and PV phases) from increases of phantom-calibrated BMD.</div></div><div><h3>Conclusions</h3><div>Although CT values of internal reference materials increased following the administration of contrast, internal calibration was unable to mitigate the contrast-related BMD increases observed in phantom-based calibration.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111923"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The added value of b0-DWI analysis in the diagnosis of cavitating lacunes when T2-weighted spin-echo is unavailable","authors":"Céline Leung Kune Chong ,&nbsp;Andreea Aignatoaie ,&nbsp;Alexandre Salem ,&nbsp;Canan Ozsancak ,&nbsp;Christophe Magni ,&nbsp;Grégoire Boulouis ,&nbsp;Héloïse Ifergan ,&nbsp;Jean-Philippe Cottier ,&nbsp;Marco Pasi ,&nbsp;Pascal Auzou ,&nbsp;Gilles Metrard ,&nbsp;Clara Cohen","doi":"10.1016/j.ejrad.2025.111924","DOIUrl":"10.1016/j.ejrad.2025.111924","url":null,"abstract":"<div><h3>Purpose</h3><div>Silent brain infarcts, sometimes appearing as incidental lacunes in patients with unknown history of vascular event, are linked to dementia, gait disturbances and depression. We observed that some cavitating lacunes were only visible on b0-diffusion-weighted-imaging (b0-DWI: T2-weighted without diffusion gradients) when T2-weighted-spin-echo (T2-SE) was unavailable. We aimed to evaluate the additional value of b0-DWI in detecting cavitating lacunes.</div></div><div><h3>Methods</h3><div>We retrospectively included patients aged ≥ 65 years who underwent brain MRI (1.5 T or 3 T) for various indications, with FLAIR (Fluid Attenuated Inversion Recovery) and b0-DWI, without T2-SE. Patients with multiple sclerosis, lacking b0-DWI or with low-quality MRI were excluded. Vascular risk factors, white matter lesions (Fazekas scale) and mention of lacune in the radiology report were inquired. Two radiologists independently analyzed all b0-DWI sequences, followed by FLAIR.</div></div><div><h3>Results</h3><div>Among 306 subjects, at least one lacune was observed in 149 (48.7 %): 54 (36.2 %) supratentorial, 32 (21.5 %) infratentorial and 63 (42.3 %) both. Of these, 119 (79.9 %) had vascular risk factors and 135 (90.6 %) had white matter lesions. 33 (10.8 %) were exclusively detected on b0-DWI (b0-DWI-lacunes), of which 5 (1.6 %) without vascular factor, and 20 (6.5 %) were unmentioned in the report. Among b0-DWI-lacunes, 15 (45.5 %) were supratentorial, 9 (27.3 %) infratentorial and 9 (27.3 %) both, with 28 (84.8 %) associated with white matter lesions. Inter-rater reliability for b0-DWI-lacunes diagnosis was good (95.6 % agreement, kappa = 0.717, CI_95% [0.568–0.869]).</div></div><div><h3>Conclusion</h3><div>In our study, 10.8% b0-DWI-lacunes were not visible on FLAIR, and 6.5% were unmentioned in the neuroradiology report. Examining FLAIR alongside b0-DWI improves diagnostic performance for cavitating lacune detection and contributes to vascular prevention.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111924"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using evidence-based imaging referral guidelines to facilitate appropriate imaging: Are they all the same?","authors":"Yi Xiang Tay ,&nbsp;Shane J. Foley ,&nbsp;Marcus EH Ong ,&nbsp;Robert Chun Chen ,&nbsp;Lai Peng Chan ,&nbsp;Ronan Killeen ,&nbsp;Eu Jin Tan ,&nbsp;May San Mak ,&nbsp;Jonathan P. McNulty","doi":"10.1016/j.ejrad.2025.111933","DOIUrl":"10.1016/j.ejrad.2025.111933","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Countries worldwide have selected, adopted, adapted, and translated evidence-based imaging referral guidelines from radiology professional bodies. This study establishes the concordance of three imaging referral guidelines from the ACR, ESR, and RCR, and examines the emergency department cervical spine imaging appropriateness rates.</div></div><div><h3>Materials and Methods</h3><div>A retrospective analysis of the electronic medical records was performed between October 1st to December 31st, 2022, evaluating 452 radiography and 153 CT imaging referrals. For each case, the initial clinical diagnosis was integrated with the corresponding clinical notes for analysis. Evaluation of the appropriateness rating was dichotomised to either ‘indicated’ or ‘not indicated’ for analytical and practical purposes. The inter-rater agreement for the imaging referral guidelines was calculated using Fleiss’ Kappa and Cohen’s Kappa.</div></div><div><h3>Results</h3><div>The overall appropriateness rate of X-ray cervical spine imaging referrals was 13.3 % −75.2 %, depending on the imaging referral guidelines utilised. The appropriateness rate of CT cervical spine was 90.8 %, which was an identical rate for all three of the guidelines. Fleiss’ Kappa indicated the guidelines for X-ray of the cervical spine had slight agreement (κ = 0.135 (95 % CI, 0.088 to 0.183), p &lt; 0.001) and almost perfect agreement amongst guidelines for CT cervical spine (κ = 1.000 (95 % CI, 0.909 to 1.091), p &lt; 0.001). For pairwise comparison, ACR AC and ESR iGuide for X-ray demonstrated moderate agreement (κ = 0.765, p &lt; 0.001); however, RCR iRefer had no level of agreement with both. For CT, there was almost perfect agreement between all the guidelines.</div></div><div><h3>Conclusion</h3><div>The guidelines demonstrated slight agreement for X-ray cervical spine and almost perfect agreement for CT cervical spine, complicating audit process and influencing audit output. Multidisciplinary buy-in positively impacts CT cervical spine appropriateness rates. Harmonising and prioritising guideline development for commonly encountered clinical scenarios is required.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111933"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare delayed hypersensitivity reactions to contrast media: Severe cutaneous adverse reactions","authors":"Aart J. van der Molen ,&nbsp;Annick A.J.M. van de Ven ,&nbsp;Francisco Vega ,&nbsp;Ilona A. Dekkers ,&nbsp;José J. Laguna","doi":"10.1016/j.ejrad.2024.111908","DOIUrl":"10.1016/j.ejrad.2024.111908","url":null,"abstract":"<div><div>The risk of developing a severe delayed cutaneous reaction (SCAR) is very low following iodine-based contrast medium (ICM) administration and extremely low following gadolinium-based contrast agent (GBCA) administration. However, SCAR can be very severe and potentially life-threatening. It is crucial for the imaging physician to recognize danger signals: bullous skin eruption, skin erosion and detachment, mucosal involvement, systemic symptoms, and laboratory abnormalities. Patients suspected of having a SCAR should be urgently referred to a drug allergy specialist or dermatologist. To prevent recurrence, consider exploring alternative imaging modalities and avoid administering the same type of contrast medium involved: if the culprit is a ICM, avoid all ICM and if the culprit is a GBCA, avoid all GBCA. In an allergy centre with experience in SCAR evaluation a careful allergologic analysis may be performed safely several months after the patient has recovered from SCAR. However, allergologic analysis is challenging due to the lack of reliable <em>in vitro</em> diagnostic tests and the risks of <em>in vivo</em> diagnostic tests, particularly drug provocation tests.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111908"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143159528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of AI-driven measurements for hip morphology assessment","authors":"Louis Lassalle ,&nbsp;Nor-eddine Regnard ,&nbsp;Marion Durteste ,&nbsp;Jeanne Ventre ,&nbsp;Vincent Marty ,&nbsp;Lauryane Clovis ,&nbsp;Zekun Zhang ,&nbsp;Nicolas Nitche ,&nbsp;Alexis Ducarouge ,&nbsp;Alexia Tran ,&nbsp;Jean-Denis Laredo ,&nbsp;Ali Guermazi","doi":"10.1016/j.ejrad.2024.111911","DOIUrl":"10.1016/j.ejrad.2024.111911","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Accurate assessment of hip morphology is crucial for the diagnosis and management of hip pathologies. Traditional manual measurements are prone to mistakes and inter- and intra-reader variability. Artificial intelligence (AI) could mitigate such issues by providing accurate and reproducible measurements. The aim of this study was to compare the performance of BoneMetrics (Gleamer, Paris, France) in measuring pelvic and hip parameters on anteroposterior (AP) and false profile radiographs to expert manual measurements.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study included AP and false profile pelvic radiographs collected from private practices in France. Pelvic and hip measurements included the femoral neck shaft angle, lateral center edge angle, acetabular roof angle, pelvic obliquity, and vertical center anterior angle. AI measurements were compared to a ground truth established by two expert radiologists. Performance metrics included mean absolute error (MAE), Bland-Altman analysis, and intraclass correlation coefficients (ICC).</div></div><div><h3>Results</h3><div>AI measurements were performed on AP views from 88 patients and on false profile views from 60 patients. They demonstrated high accuracy, with MAE values inferior to 0.5 mm for pelvic obliquity and inferior to 4.2° for all pelvic angles on both views. ICC values indicated good to excellent agreement between AI measurements and the ground truth (0.78–0.99). Notably, no significant differences were found in AI measurement accuracy between patients with normal and abnormal acetabular coverage.</div></div><div><h3>Conclusion</h3><div>The application of AI in measuring pelvic and hip parameters on AP and false profile radiographs demonstrates promising outcomes. The results reveal that these AI-powered measurements provide accurate estimations and show strong agreement with expert manual measurements. Ultimately, the use of AI has the potential to enhance the reproducibility of measurements as part of comprehensive hip assessments, thereby improving diagnostic accuracy.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111911"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160927","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}

{"title":"MRI-based multiregional radiomics for desmoplastic reaction classification and prognosis stratification in stage II rectal cancer: A bicenter study","authors":"Shuxuan Fan ,&nbsp;Jing Wang ,&nbsp;Yan Hou ,&nbsp;Xiaonan Cui ,&nbsp;Ziwei Feng ,&nbsp;Lisha Qi ,&nbsp;Jiaxin Liu ,&nbsp;Keyi Bian ,&nbsp;Jing Liang ,&nbsp;Zhaoxiang Ye ,&nbsp;Sunyi Zheng ,&nbsp;Wenjuan Ma","doi":"10.1016/j.ejrad.2024.111888","DOIUrl":"10.1016/j.ejrad.2024.111888","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop an MRI-based multiregional radiomics model for the noninvasive desmoplastic reaction (DR) classification and prognosis stratification in stage II rectal cancer (RC) patients.</div></div><div><h3>Materials and Methods</h3><div>This study retrospectively involved 336 patients with RC from two centers, with 239 from Center 1 divided into training (n = 191) and internal validation (n = 48) datasets at an 8:2 ratio, and 97 from Center 2 serving as external validation dataset. Radiomics features were extracted, and a multiregional radiomics DR (M−RDR) signature was established using multi-level feature selection procedure. The cut-off value for M−RDR was determined using Youden’s index. We further evaluated the predictive values of M−RDR on prognosis and adjuvant chemotherapy stratification. The primary outcome was 3-year disease-free survival (DFS), and cox model performance was assessed using AUCs and 95 % confidence intervals.</div></div><div><h3>Results</h3><div>M−RDR demonstrated a high accuracy in DR classification with AUCs of 0.778 and 0.798 in the training and internal validation datasets. Multivariable analysis confirmed M−RDR as an independent prognostic factor after adjusting for clinicopathological factors.<!--> <!-->The combined model incorporating M−RDR and clinicopathological factors showed good performance in predicting 3-year DFS, with AUCs of 0.923, 0.908, and 0.891 in the training, internal validation and external validation datasets, respectively. Additionally, patients in the M−RDR−high group who received adjuvant chemotherapy had significantly better DFS compared with those who did not (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The MRI-based multiregional radiomics model could effectively improve non-invasive DR classification, and was able to enhance postoperative risk stratification and treatment decision-making in stage II RC patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111888"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871790","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}