European Journal of Radiology最新文献_第6页

Usefulness of metal artifact reduction on CT angiography after massive coil embolization in peripheral AVM 金属伪影复位在周围型AVM大线圈栓塞后CT血管造影中的应用。

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

European Journal of Radiology

Pub Date : 2025-12-09 DOI: 10.1016/j.ejrad.2025.112606

Jihwan Choi , Sang Yub Lee , Kwang Bo Park , Joon Kee Park , Shin Seok Yang , Chang Hoon Oh , Taejun Jeon , Dong-Ik Kim , Young Soo Do

Purpose

To evaluate the image quality of three reconstruction methods—filtered back projection (FBP), adaptive statistical iterative reconstruction (AR50), and deep learning–based reconstruction (DL-M)—processed with the Smart Metal Artifact Reduction (SMAR) technique for post-embolization assessment of peripheral arteriovenous malformations (AVMs).

Materials and methods

In this prospective single-center study, 30 patients who underwent coil embolization for AVM were included. Post-embolization CT angiography was performed using dual-energy CT. Virtual monoenergetic images at 50 and 70 keV were reconstructed using FBP, AR50, and DL-M. All were processed with SMAR, and DL-M without SMAR served as the baseline. Artifact severity was objectively assessed using the standard deviation (SD) around the AVM, artifact index (AI), and contrast-to-noise ratio (CNR). Two readers (a resident and a staff radiologist) subjectively graded artifact severity, vessel visualization, and new artifacts using 4-point scales.

Results

At both energy levels, average SD and AI were significantly lower in SMAR-processed images than in baseline DL-M (all p < 0.001). Subjective scores for artifact reduction and visualization of adjacent vessels were also significantly improved (p < 0.001). There were no significant differences among the three SMAR-processed methods. New artifacts appeared in three cases but had minimal effect on interpretability.

Conclusions

SMAR-processed FBP, AR50, and DL-M reconstructions significantly reduced metal artifacts and improved visualization after AVM coil embolization, supporting their value for post-treatment evaluation and clinical decision-making.

目的：评价三种重建方法——滤波反投影（FBP）、自适应统计迭代重建（AR50）和基于深度学习的重建（DL-M）——与智能金属伪影还原（SMAR）技术一起用于外周动静脉畸形（AVMs）栓塞后评估的图像质量。材料和方法：在这项前瞻性单中心研究中，纳入了30例因AVM接受线圈栓塞治疗的患者。栓塞后行双能CT血管造影。利用FBP、AR50和DL-M重建50和70 keV下的虚拟单能图像。所有患者均经SMAR处理，不经SMAR处理的DL-M作为基线。使用AVM周围的标准差（SD）、伪影指数（AI）和噪声对比比（CNR）客观评估伪影严重程度。两位读者（一位住院医师和一位放射科医生）主观地用4分制对伪影严重程度、血管可视化和新伪影进行评分。结果：在两种能量水平下，smart处理图像的平均SD和AI均显著低于基线DL-M（均p）。结论：smart处理的FBP、AR50和DL-M重建显著减少了AVM线圈栓塞后的金属伪影，改善了可视化，支持其对治疗后评估和临床决策的价值。

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引用次数: 0

Treatment of non-severe hemoptysis: A retrospective propensity score-matched comparison between conservative management and bronchial artery embolization 非严重咯血的治疗：保守治疗和支气管动脉栓塞的回顾性倾向评分匹配比较

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

European Journal of Radiology

Pub Date : 2025-12-09 DOI: 10.1016/j.ejrad.2025.112604

Kun Yung Kim, Chang Jin Yoon, Jae Hwan Lee, Chong-Ho Lee, Hooney Daniel Min

Objective

This study aimed to compare the effectiveness of hemoptysis control between patients managed conservatively and early bronchial artery embolization (BAE), and to identify clinical factors associated with recurrence.

Methods

Patients with underlying malignancy, massive hemoptysis, or incomplete clinical data were excluded. 320 patients with non-severe hemoptysis were included (210 conservative, 110 BAE). Propensity scores were estimated using baseline variables including age, sex, comorbidities, and radiologic findings. Hemoptysis-free survival (HFS) was the primary outcome. Cox proportional hazards regression was used to assess associations between clinical and radiological factors and HFS.

Results

Before PSM, radiological finding of post-tuberculous residual changes and cavitary lesion were more prevalent in the BAE group (22.7 % vs. 13.3 %, p = 0.032; 12.7 % vs. 5.7 %, p = 0.029, respectively). After PSM, 110 matched pairs showed balanced baseline variables. Clinical success rates were 94.5 % in the conservative group and 97.3 % in the BAE group (p = 0.496). In the PSM cohort, HFS did not differ significantly between groups (p = 0.304). Diabetes mellitus (DM) was the only independent predictor of recurrence (HR 2.615, 95 % CI 1.288–5.306, p = 0.008). Patients with DM had significantly shorter HFS (p = 0.003).

Conclusion

Conservative management and BAE showed comparable outcomes in non-severe hemoptysis of benign etiology. Diabetes mellitus was an independent predictor of recurrence, and BAE served effectively as rescue therapy after conservative treatment failure.

目的比较保守治疗与早期支气管动脉栓塞（BAE）对咯血的控制效果，并探讨与咯血复发相关的临床因素。方法排除有潜在恶性肿瘤、大咯血或临床资料不完整的患者。纳入320例非严重咯血患者（保守210例，BAE 110例）。使用基线变量包括年龄、性别、合并症和放射学结果来估计倾向得分。无咯血生存（HFS）是主要终点。采用Cox比例风险回归评估临床和放射学因素与HFS之间的关系。结果PSM治疗前，BAE组结核后残留病变和空洞病变的影像学表现更为普遍（22.7%比13.3%,p = 0.032； 12.7%比5.7%,p = 0.029）。经PSM后，110对配对配对的基线变量平衡。保守组的临床成功率为94.5%，BAE组为97.3% （p = 0.496）。在PSM队列中，各组间HFS无显著差异（p = 0.304）。糖尿病（DM）是复发的唯一独立预测因子（HR 2.615, 95% CI 1.288 ~ 5.306, p = 0.008）。DM患者的HFS明显缩短（p = 0.003）。结论保守治疗与BAE治疗良性非严重咯血疗效相当。糖尿病是复发的独立预测因子，BAE作为保守治疗失败后的有效抢救治疗。

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引用次数: 0

Hepatic steatosis can accurately be measured during free breathing using ultrasound-guided attenuation parameter (UGAP) technology. Technical note 使用超声引导衰减参数（UGAP）技术可以在自由呼吸期间准确测量肝脏脂肪变性。技术报告

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

European Journal of Radiology

Pub Date : 2025-12-09 DOI: 10.1016/j.ejrad.2025.112602

Marie Byenfeldt , Patrik Nasr , Anna Lindam , Christer Grönlund , Mattias Ekstedt , Peter Lundberg , Johan Kihlberg

Aim

Hitherto, breathing phases impact on hepatic steatosis measurements with quantitative ultrasound method in patients with liver fibrosis is not well known. The aim of the study was to evaluate different breathing phases for the ultrasound guided attenuation parameter (UGAP) technology for hepatic steatosis in patients with liver fibrosis.

Material and methods

Healthy controls and a cohort with steatosis and fibrosis was prospectively enrolled between September 2022 and October 2024. Presence of hepatic steatosis (≥ S1) with UGAP was defined as magnetic resonance imaging ≥ 5 % proton density fat fraction (PDFF), and presence of fibrosis was evaluated with magnetic resonance elastography. In a group with N = 55 measurements were sampled during normal breath hold, peak-inspiration and end-expiration phases. In a group with n = 37 free breathing phase was added during recorded volume sampling for measurements after examination. The diagnostic performance of UGAP for all four breathing methods were evaluated based on area under the receiver operating characteristic curve (AUROC) with PDFF.

Results

In group N = 55 no difference in diagnostic performance was seen between AUC for normal breath hold 0.79 (95 %CI: 0.66–0.92), inspiration 0.78 (95 %CI: 0.64–0.91) and expiration 0.77 (95 %CI: 0.64–0.91). In group n = 37 no difference was seen between AUC for normal breath hold 0.71 (95 %CI: 0.53–0.89), inspiration 0.66 (0.47–0.85), expiration 0.67 (95 %CI: 0.49–0.86) and free breathing 0.72 (95 %CI: 0.55–0.90). No difference between normal breath-hold UGAP mean values dB/cm/MHz and all tested breathing phases mean values (n = 37, NS).

Conclusion

Patients with liver fibrosis and inability to hold their breath during measurements for hepatic steatosis can be measured using UGAP technology with sustained diagnostic accuracy.

目的迄今为止，呼吸相对肝纤维化患者定量超声测量肝脂肪变性的影响尚不清楚。本研究的目的是评估超声引导衰减参数（UGAP）技术在肝纤维化患者肝脂肪变性中的不同呼吸阶段。材料和方法在2022年9月至2024年10月期间前瞻性纳入健康对照和脂肪变性和纤维化队列。磁共振成像≥5%质子密度脂肪分数（PDFF）定义为肝脂肪变性（≥S1），磁共振弹性成像评估肝纤维化的存在。在N = 55的组中，在正常屏气、吸气高峰和呼气末阶段进行测量。在n = 37的一组中，在记录体积取样时加入自由呼吸期，用于检查后测量。基于PDFF的受试者工作特征曲线下面积（AUROC）评估四种呼吸方式的UGAP诊断性能。结果N = 55组正常屏气的AUC为0.79 (95% CI: 0.66 ~ 0.92)，吸气为0.78 (95% CI: 0.64 ~ 0.91)，呼气为0.77 （95% CI: 0.64 ~ 0.91）。在n = 37组中，正常屏气的AUC为0.71 (95% CI: 0.53-0.89)，吸气为0.66(0.47-0.85)，呼气为0.67 (95% CI: 0.49-0.86)，自由呼吸为0.72 （95% CI: 0.55-0.90）。正常屏气UGAP平均值dB/cm/MHz与所有测试呼吸阶段平均值无差异（n = 37， NS）。结论在肝脂肪变性检测中出现肝纤维化和不能屏气的患者可使用UGAP技术进行检测，诊断准确性持续提高。

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引用次数: 0

Tumor and Perirenal Adipose Tissue Radiomic Models for Pathological T-Stage Prediction and Biological Exploration in Clear Cell Renal Cell Carcinoma 透明细胞肾细胞癌病理t期预测和生物学探索的肿瘤和肾周脂肪组织放射组学模型

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

European Journal of Radiology

Pub Date : 2025-12-04 DOI: 10.1016/j.ejrad.2025.112592

Chenchen Wang , Xiaoni Wang , Ning Mao , Yuanshan Cui , Zhongyi Wang , Yumei Zhang , Xiaoming Xi , Xiao Kang , Xinru Ba , Lei Zhang , Xin Jiang , Rui Xu , Jiahui Wang , Letong Wang , Heng Ma , Hao Guo

Rationale and Objectives

Prediction of pathological T stage can assist in guiding treatment approaches for clear cell renal cell carcinoma (ccRCC). The objectives of this research were to assess the value of radiomic models based on tumor and perirenal adipose tissue (PRAT) for preoperative prediction of pathological T-stage of ccRCC and to conduct radiogenomic correlation analysis.

Materials and methods

Patients recruited were randomly stratified into the training set and the internal test set in a 7:3 proportion. A total of 50 patients from The Cancer Imaging Archive (TCIA) were included as an external test set. Radiomics features were derived from the volume of interest within tumors and PRATs to generate the tumor model, the PRAT model, and the combined model. The T-stage was independently assessed by two experienced radiologists. Subsequently, analysis of biological functions was performed utilizing RNA-seq data obtained from The Cancer Genome Atlas (TCGA) database.

Results

A total of 251 patients were divided into the training set (n = 139), internal test set (n = 62), and external test set (n = 50). The AUC values of the tumor, PRAT, and combined models were 0.84, 0.82, and 0.88 in the external test set, respectively. The combined model achieved the highest AUC value among all models and was notably superior to radiologists in both internal and external test sets. Signaling pathways associated with tumor progression and neural signal transduction were found to be activated in the TCGA set.

Conclusion

The CT-based combined radiomics model demonstrated superior classification performance in predicting the pathological T stage.

目的病理T分期的预测有助于指导透明细胞肾细胞癌（ccRCC）的治疗。本研究的目的是评估基于肿瘤和肾周脂肪组织（PRAT）的放射组学模型在ccRCC病理性t期术前预测中的价值，并进行放射组学相关性分析。招募的患者按7:3的比例随机分为训练集和内部测试集。来自癌症影像档案（TCIA）的50例患者作为外部测试组。放射组学特征从肿瘤和PRAT内感兴趣的体积中导出，以生成肿瘤模型、PRAT模型和组合模型。t期由两名经验丰富的放射科医生独立评估。随后，利用从癌症基因组图谱（TCGA）数据库中获得的RNA-seq数据进行生物学功能分析。结果251例患者分为训练集（n = 139）、内部测试集（n = 62）和外部测试集（n = 50）。肿瘤模型、PRAT模型和联合模型在外部测试集中的AUC值分别为0.84、0.82和0.88。在所有模型中，联合模型的AUC值最高，在内部和外部测试集上都明显优于放射科医生。发现与肿瘤进展和神经信号转导相关的信号通路在TCGA组中被激活。结论基于ct的联合放射组学模型在预测病理T分期方面具有较好的分类性能。

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引用次数: 0

Predictive role of muscle MRI in juvenile dermatomyositis: A tertiary center experience 肌肉MRI对青少年皮肌炎的预测作用：三级中心经验

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

European Journal of Radiology

Pub Date : 2025-12-03 DOI: 10.1016/j.ejrad.2025.112599

Sevtap Arslan , Adalet Elcin Yildiz , Yagmur Bayindir , Erdal Sag , Yelda Bilginer , Seza Ozen , Goknur Haliloglu

Objectives

To investigate muscle MRI findings in juvenile dermatomyositis (JDM) and assess their relationship with clinical parameters and myositis-specific autoantibody (MSA) profile.

Methods

59 MRI scans from 42 cases with JDM were analyzed retrospectively. Distribution and pattern of myositis, symmetricity, fascial and/or subcutaneous involvement, and presence of calcinosis, were evaluated. Clinical features, serum creatine kinase (CK) levels, and MSA profile were recorded.

Results

Myositis was detected in 71.4 % of cases (n = 30), with 8/30 (26.6 %) being clinically inactive at the time of MRI. The most common dominant distribution and pattern types of myositis were diffuse (n = 15; 50 %) and foggy (n = 21; 70 %), respectively. Fascial and subcutaneous involvement were observed in 86.7 % and 73.3 % of cases and were significantly associated with the presence of calcinosis (p = 0.016 and 0.004, respectively). The dominant pattern of myositis was significantly associated with MSA profile, with the honeycomb pattern being more frequent in MSA-negative cases, and the foggy pattern in MSA-positive cases (p = 0.029 and 0.04, respectively). No significant associations were found between MRI findings and clinical features or serum CK levels.

Conclusions

Muscle MRI is a valuable tool for detecting subclinical disease activity in JDM, suggesting that disease activity and qualitative MRI findings may not always align with each other. Fascial and subcutaneous involvement were associated with the presence of calcinosis, suggesting a potential role of MRI in identifying cases at risk for developing calcinosis. Of note, the presence of foggy pattern on MRI was associated with the presence of MSAs.

目的探讨青少年皮肌炎（JDM）的肌肉MRI表现，并评价其与临床参数和肌炎特异性自身抗体（MSA）谱的关系。方法回顾性分析42例JDM患者59例MRI扫描资料。评估肌炎的分布和类型、对称性、筋膜和/或皮下受累以及钙质沉着的存在。记录临床特征、血清肌酸激酶（CK）水平和MSA谱。结果30例患者中有71.4% （n = 30）检出肌炎，其中8/30 (26.6%)MRI时临床无活动。肌炎最常见的主要分布和模式类型分别为弥漫性（n = 15; 50%）和雾性（n = 21; 70%）。在86.7%和73.3%的病例中观察到筋膜和皮下受损伤，并且与钙沉着的存在显著相关（p分别= 0.016和0.004）。肌炎的主要形态与MSA有显著的相关性，MSA阴性者以蜂窝状形态多见，MSA阳性者以雾状形态多见（p值分别为0.029和0.04）。MRI结果与临床特征或血清CK水平无显著相关性。结论肌肉MRI是检测JDM亚临床疾病活动的一种有价值的工具，提示疾病活动和定性MRI结果可能并不总是一致的。筋膜和皮下受损伤与钙质沉着症的存在有关，这表明MRI在识别有发生钙质沉着症风险的病例中具有潜在的作用。值得注意的是，MRI上雾状模式的存在与msa的存在有关。

{"title":"Predictive role of muscle MRI in juvenile dermatomyositis: A tertiary center experience","authors":"Sevtap Arslan , Adalet Elcin Yildiz , Yagmur Bayindir , Erdal Sag , Yelda Bilginer , Seza Ozen , Goknur Haliloglu","doi":"10.1016/j.ejrad.2025.112599","DOIUrl":"10.1016/j.ejrad.2025.112599","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate muscle MRI findings in juvenile dermatomyositis (JDM) and assess their relationship with clinical parameters and myositis-specific autoantibody (MSA) profile.</div></div><div><h3>Methods</h3><div>59 MRI scans from 42 cases with JDM were analyzed retrospectively. Distribution and pattern of myositis, symmetricity, fascial and/or subcutaneous involvement, and presence of calcinosis, were evaluated. Clinical features, serum creatine kinase (CK) levels, and MSA profile were recorded.</div></div><div><h3>Results</h3><div>Myositis was detected in 71.4 % of cases (n = 30), with 8/30 (26.6 %) being clinically inactive at the time of MRI. The most common dominant distribution and pattern types of myositis were diffuse (n = 15; 50 %) and foggy (n = 21; 70 %), respectively. Fascial and subcutaneous involvement were observed in 86.7 % and 73.3 % of cases and were significantly associated with the presence of calcinosis (p = 0.016 and 0.004, respectively). The dominant pattern of myositis was significantly associated with MSA profile, with the honeycomb pattern being more frequent in MSA-negative cases, and the foggy pattern in MSA-positive cases (p = 0.029 and 0.04, respectively). No significant associations were found between MRI findings and clinical features or serum CK levels.</div></div><div><h3>Conclusions</h3><div>Muscle MRI is a valuable tool for detecting subclinical disease activity in JDM, suggesting that disease activity and qualitative MRI findings may not always align with each other. Fascial and subcutaneous involvement were associated with the presence of calcinosis, suggesting a potential role of MRI in identifying cases at risk for developing calcinosis. Of note, the presence of foggy pattern on MRI was associated with the presence of MSAs.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112599"},"PeriodicalIF":3.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691113","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

MRI‑based scoring system to predict spondylodiscitis: The SPONDY-Score 基于MRI的评分系统预测脊椎炎：SPONDY-Score。

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

European Journal of Radiology

Pub Date : 2025-12-03 DOI: 10.1016/j.ejrad.2025.112600

Domenico Albano , Caterina Beatrice Monti , Giulia Blanda , Simone Pansa , Carmelo Messina , Salvatore Gitto , Francesca Serpi , Moreno Zanardo , Francesco Rizzetto , Chiara Silvia Vismara , Maria Cristina Moioli , Massimo Puoti , Angelo Vanzulli , Luca Maria Sconfienza

Objective

To evaluate the diagnostic performance of a MRI-based scoring system to differentiate endplate edema related to spondylodiscitis and degenerative spine disease (DSD).

Methods

This retrospective study included 126 patients with spondylodiscitis and 162 with DSD. MRI scans were reviewed by two raters to report 12 features. Excluding collections, which were deemed pathognomonic of spondylodiscitis, the top five most significant features were selected and used for logistic regression. The dataset was randomly split into training and testing sets (75:25). We used the coefficients deriving from logistic regression to construct a clinical score (SPONDY-Score), which would assign said points to each included variable and chose the best threshold for such score. Reproducibility of MRI features was evaluated by calculating Cohen κ and raw concordance.

Results

The SPONDY-Score involved the assignment of 1 point for the involvement of posterior elements by bone edema, 15 points for vertebral bodies destruction, 5 points for the presence of paravertebral edema, −4 points for the presence of T2 hypointensity of the disc, 1 point for the presence of non-anatomical T2 hyperintensity of the disc. The best threshold was set at 5 points. When the SPONDY-Score was applied to the testing set, combined with the presence of paravertebral collections as indicator of spondylodiscitis, the model obtained 89 % accuracy, 95 % sensitivity and 85 % specificity. Regarding inter-observer reproducibility, κ values and concordance ranged from 0.61 to 0.90 and from 85 % to 98 %, respectively.

Conclusion

The SPONDY-Score demonstrated excellent diagnostic performance, providing an accurate and standardized method for clinical decision-making.

目的：评价基于mri评分系统对椎间盘炎相关终板水肿和退行性脊柱疾病（DSD）的诊断性能。方法：回顾性研究126例脊柱炎患者和162例DSD患者。MRI扫描由两名评分员评估，报告12个特征。排除被认为是脊椎椎间盘炎的病理特征的集合，选择前五个最显著的特征并用于逻辑回归。数据集随机分为训练集和测试集（75:25）。我们使用从逻辑回归得出的系数来构建临床评分（SPONDY-Score），该评分将为每个包含的变量分配所述点数，并为该评分选择最佳阈值。通过计算Cohen κ和原始一致性来评估MRI特征的可重复性。结果：SPONDY-Score评分为骨水肿累及后椎体1分，椎体破坏15分，椎旁水肿5分，椎间盘T2低密度-4分，椎间盘非解剖性T2高强度1分。最佳阈值设为5点。当将SPONDY-Score应用于测试集，并结合椎旁收集物作为椎间盘炎的指标时，该模型获得了89%的准确性，95%的敏感性和85%的特异性。关于观察者间再现性，κ值和一致性分别在0.61 ~ 0.90和85% ~ 98%之间。结论：SPONDY-Score具有良好的诊断效果，为临床决策提供了准确、规范的方法。

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引用次数: 0

Prediction of IDH-mutation and 1p19q-codeletion status in adult-type diffuse gliomas using three-class radiomics models 利用三级放射组学模型预测成人型弥漫性胶质瘤中idh突变和1p19q编码状态

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

European Journal of Radiology

Pub Date : 2025-12-03 DOI: 10.1016/j.ejrad.2025.112601

Yanhua Li , Mingxiao Wang , Jun Zhang , Xinyue Zhang , Yahong Tan , Guoli Liu , Lin Ma

Purpose

To predict the genetic subtypes of adult-type diffuse gliomas with three-class MRI radiomics.

Material and Methods

Four hundred and eighty patients with pathologically proved diffuse gliomas from our institution were randomly divided into training set (n = 336) and internal validation set (n = 144) according to a ratio of 7 to 3, and 105 patients from the cancer imaging archive (TCIA) were utilized as an external validation set. All patients were classified into IDH wild-type (IDHwt), IDH-mutant with 1p19q-noncodeleted (IDHmut-intact) and IDH-mutant with 1p19q-codeleted (IDHmut-codel) subtypes, and all the patients underwent conventional MR imaging and diffusion weighted imaging (DWI) scans. Two regions of interest (ROI) segmentation schemes (tumor ROI and tumor with peritumoral edema ROI) and MRI sequences with and without apparent diffusion coefficient (ADC) maps were tested with 6 machine learning classifiers to filter the optimal models.

Results

Support vector machine (SVM) classifier combined with conventional MR sequences based on tumor ROI was proved to be the best diagnostic model, with the area under the curve (AUC) of 0.963, 0.964, and 0.929, and accuracy of 0.902, 0.929, and 0.890 for IDHwt, IDHmut-intact, and IDHmut-codel prediction, respectively, and overall accuracy (micro average accuracy) of 0.860. The model was validated in both internal and external validation sets.

Conclusions

Three-class MRI radiomics can be used preoperatively in predicting the molecular subtype of adult diffuse gliomas with satisfactory performance and show potential value for the diagnosis and risk stratification in glioma patients. This retrospective study received ethics approval with a waiver of informed consent.

目的：应用MRI三级放射组学技术预测成人型弥漫性胶质瘤的遗传亚型。材料与方法：我院病理证实的弥漫性胶质瘤患者480例，按7比3的比例随机分为训练集（n = 336）和内部验证集（n = 144），其中肿瘤影像档案（TCIA）患者105例作为外部验证集。将所有患者分为IDH野生型（IDHwt）、IDH突变型(1p19q-非编码型（idhmut -完整型）和IDH突变型（1p19q-编码型）亚型，并对所有患者进行常规MR成像和弥散加权成像（DWI）扫描。用6个机器学习分类器对两种感兴趣区域（ROI）分割方案（肿瘤ROI和肿瘤周围水肿ROI）以及有和没有表观扩散系数（ADC）图的MRI序列进行了测试，以过滤最优模型。结果：基于肿瘤ROI的支持向量机（SVM）分类器与常规MR序列相结合是最佳的诊断模型，IDHwt、idhmut -完好无损、IDHmut-codel预测的曲线下面积（AUC）分别为0.963、0.964、0.929，准确率分别为0.902、0.929、0.890，总体准确率（微平均准确率）为0.860。该模型在内部和外部验证集中进行了验证。结论：MRI三级放射组学可以术前预测成人弥漫性胶质瘤的分子亚型，效果满意，对胶质瘤患者的诊断和危险分层具有潜在价值。这项回顾性研究获得了伦理批准，并放弃了知情同意。

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引用次数: 0

Carotid perivascular adipose tissue in CT before and after treatment for severe internal carotid artery stenosis 颈动脉血管周围脂肪组织治疗前后的CT表现。

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

European Journal of Radiology

Pub Date : 2025-12-03 DOI: 10.1016/j.ejrad.2025.112598

Francesco Secchi , Caterina Beatrice Monti , Irene Baroni , Vlasta Bari , Noemi Perillo , Michele Conti , Paolo Righini , Alexis Elias Malavazos , Domenico Tuttolomondo , Giovanni Nano , Daniela Mazzaccaro

Purpose

The study aim is to assess how surgical or endovascular treatments can impact carotid perivascular inflammation in patients affected by severe carotid artery stenosis.

Methods

Seventy consecutive patients with unilateral carotid stenosis from the BAROX trial were included in this study. CT angiography (CTA) exams were conducted on a dual-source CT system before and after the carotid endarterectomy (CEA) or stenting.

Perivascular adipose tissue (PVAT) CT attenuation measurement in a 40 mm proximal segment of the internal carotid artery was measured as carotid PVAT (CPVAT). CT attenuation was calculated as the mean attenuation of all voxels in the range of −30 to −190 HU, thresholds used for identifying adipose tissue.

Results

The median CPVAT measurements before and after both surgical and percutaneous procedures in the stenotic side was −60 (−66, −57) before and −61 (−66, −56) after procedure (p = 0.046). The median CPVAT measurements before and after the surgical procedures was −59 (−66, −57) before and −59 (−62, −54) after procedure (p = 0.006). As well as before- and after stent placement was −60 (−65, −55) before and −65 (−70, −60) after procedure (p = 0.103).

A correlation analysis showed a positive correlation between post-procedure CPVAT and the occurrence of the procedure (ρ = 0.403, p = 0.003), as well as a positive correlation between pre- and post-procedure CPVAT on the untreated side and the degree of stenosis (pre-procedure: ρ = 0.328, p = 0.007; post-procedure: ρ = 0.271, p = 0.027).

Conclusion

We found an increase in CPVAT following CEA, indicating that an inflammatory process occurs during treatment.

目的：研究目的是评估手术或血管内治疗对颈动脉严重狭窄患者颈动脉血管周围炎症的影响。方法：本研究纳入BAROX试验中连续70例单侧颈动脉狭窄患者。在颈动脉内膜切除术（CEA）或支架植入术前后在双源CT系统上进行CT血管造影（CTA）检查。测量颈内动脉近段40mm血管周围脂肪组织（PVAT）的CT衰减量为颈动脉PVAT （CPVAT）。CT衰减计算为所有体素在-30至-190 HU范围内的平均衰减，这是用于识别脂肪组织的阈值。结果：手术和经皮手术前后狭窄侧CPVAT的中位值术前为-60(-66,-57)，术后为-61 (-66,-56)（p = 0.046）。手术前后的中位CPVAT测量值术前为-59(-66,-57)，术后为-59 (-62,-54)（p = 0.006）。支架置入术前后的血管内皮细胞密度分别为-60（-65,-55）和-65 (-70,-60)（p = 0.103）。相关分析显示，术后CPVAT与手术发生呈正相关（ρ = 0.403, p = 0.003），术前和术后未治疗侧CPVAT与狭窄程度呈正相关（术前：ρ = 0.328, p = 0.007；术后：ρ = 0.271, p = 0.027）。结论：我们发现CEA后CPVAT增加，表明在治疗过程中发生了炎症过程。

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引用次数: 0

Quantitative susceptibility mapping for the comprehensive assessment of adult-type diffuse gliomas 成人型弥漫性胶质瘤的定量易感性图谱综合评价

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

European Journal of Radiology

Pub Date : 2025-12-02 DOI: 10.1016/j.ejrad.2025.112595

Pengxin Shen , Yangyang Li , Wenji Xu , Zhiyi Zhang , Xiaochun Wang , Guoqiang Yang , Jiangfeng Du , Hui Zhang , Yan Tan

Objectives

To comprehensively evaluate the value of intratumoral susceptibility signals (ITSS) and regional susceptibility values on quantitative susceptibility mapping (QSM) for adult-type diffuse glioma grading, molecular typing, prognosis, and recurrence prediction based on the 2021 World Health Organization classification of central nervous system tumors (WHO CNS).

Methods

A total of 70 pathologically confirmed adult-type diffuse glioma patients were retrospectively analyzed. The number of ITSS was evaluated on QSM, and susceptibility measurements were performed in regions of relatively high susceptibility, and relatively low susceptibility within the tumor. The associations of ITSS and regional susceptibility values with glioma WHO grade, isocitrate dehydrogenase (IDH) status, O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, telomerase reverse transcriptase (TERT) mutation, Ki67 expression, prognosis, and recurrence were evaluated.

Results

ITSS grading was significantly associated with glioma WHO grade, IDH status, 1-year survival, and recurrence (p < 0.001, p < 0.001, p = 0.049, p = 0.005, respectively). Relatively high tumor susceptibility was significantly correlated with glioma WHO grade, IDH status, MGMT promoter methylation, and Ki67 labeling index (p < 0.001, p < 0.001, p = 0.034, p = 0.025, respectively). Relatively low tumor susceptibility had limited value in evaluating the WHO grade, molecular markers, prognosis, and recurrence of gliomas. Kaplan-Meier analysis showed significantly better overall survival for ITSS grade 0 compared to grades 1–3 (p = 0.01), and multivariate analysis identified it as an independent prognostic factor (p = 0.042).

Conclusions

Noninvasive imaging parameters extracted from QSM images can reflect glioma WHO grade, molecular markers, prognosis, and recurrence risk. These preliminary findings showed that the QSM might be a noninvasive imaging biomarker for comprehensive evaluation of adult-type diffuse gliomas.

目的基于2021年世界卫生组织中枢神经系统肿瘤分类（WHO CNS），综合评价肿瘤内易感信号（ITSS）和区域易感值在成人型弥漫性胶质瘤分级、分子分型、预后和复发预测中的定量易感作图（QSM）价值。方法对70例经病理证实的成人型弥漫性胶质瘤患者进行回顾性分析。在QSM上评估ITSS的数量，并在肿瘤内相对高易感性区域和相对低易感性区域进行敏感性测量。评估ITSS和区域易感价值与胶质瘤WHO分级、异柠檬酸脱氢酶（IDH）状态、o6 -甲基鸟嘌呤- dna甲基转移酶（MGMT）启动子甲基化、端粒酶逆转录酶（TERT）突变、Ki67表达、预后和复发的关系。结果sitss分级与胶质瘤WHO分级、IDH状态、1年生存率和复发率显著相关（p < 0.001, p < 0.001, p = 0.049, p = 0.005）。相对较高的肿瘤易感性与胶质瘤WHO分级、IDH状态、MGMT启动子甲基化、Ki67标记指数显著相关（p < 0.001, p < 0.001, p = 0.034, p = 0.025）。相对较低的肿瘤易感性在评价胶质瘤的WHO分级、分子标志物、预后和复发方面价值有限。Kaplan-Meier分析显示，与1-3级相比，ITSS 0级患者的总生存率显著提高（p = 0.01），多因素分析确定其为独立预后因素（p = 0.042）。结论从QSM图像中提取的无创影像参数能反映胶质瘤WHO分级、分子标志物、预后及复发风险。这些初步研究结果表明，QSM可能是一种非侵入性成像生物标志物，可用于成人型弥漫性胶质瘤的综合评估。

{"title":"Quantitative susceptibility mapping for the comprehensive assessment of adult-type diffuse gliomas","authors":"Pengxin Shen , Yangyang Li , Wenji Xu , Zhiyi Zhang , Xiaochun Wang , Guoqiang Yang , Jiangfeng Du , Hui Zhang , Yan Tan","doi":"10.1016/j.ejrad.2025.112595","DOIUrl":"10.1016/j.ejrad.2025.112595","url":null,"abstract":"<div><h3>Objectives</h3><div>To comprehensively evaluate the value of intratumoral susceptibility signals (ITSS) and regional susceptibility values on quantitative susceptibility mapping (QSM) for adult-type diffuse glioma grading, molecular typing, prognosis, and recurrence prediction based on the 2021 World Health Organization classification of central nervous system tumors (WHO CNS).</div></div><div><h3>Methods</h3><div>A total of 70 pathologically confirmed adult-type diffuse glioma patients were retrospectively analyzed. The number of ITSS was evaluated on QSM, and susceptibility measurements were performed in regions of relatively high susceptibility, and relatively low susceptibility within the tumor. The associations of ITSS and regional susceptibility values with glioma WHO grade, isocitrate dehydrogenase (IDH) status, O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, telomerase reverse transcriptase (TERT) mutation, Ki67 expression, prognosis, and recurrence were evaluated.</div></div><div><h3>Results</h3><div>ITSS grading was significantly associated with glioma WHO grade, IDH status, 1-year survival, and recurrence (<em>p</em> < 0.001, <em>p</em> < 0.001, <em>p</em> = 0.049, <em>p</em> = 0.005, respectively). Relatively high tumor susceptibility was significantly correlated with glioma WHO grade, IDH status, MGMT promoter methylation, and Ki67 labeling index (<em>p</em> < 0.001, <em>p</em> < 0.001, <em>p</em> = 0.034, <em>p</em> = 0.025, respectively). Relatively low tumor susceptibility had limited value in evaluating the WHO grade, molecular markers, prognosis, and recurrence of gliomas. Kaplan-Meier analysis showed significantly better overall survival for ITSS grade 0 compared to grades 1–3 (<em>p</em> = 0.01), and multivariate analysis identified it as an independent prognostic factor (<em>p</em> = 0.042).</div></div><div><h3>Conclusions</h3><div>Noninvasive imaging parameters extracted from QSM images can reflect glioma WHO grade, molecular markers, prognosis, and recurrence risk. These preliminary findings showed that the QSM might be a noninvasive imaging biomarker for comprehensive evaluation of adult-type diffuse gliomas.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112595"},"PeriodicalIF":3.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748712","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

Performance of CT-based Node-RADS for assessing cervical regional lymph node metastasis in papillary thyroid carcinoma 基于ct的淋巴结- rads评估甲状腺乳头状癌颈部区域淋巴结转移的价值。

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

European Journal of Radiology

Pub Date : 2025-12-01 DOI: 10.1016/j.ejrad.2025.112593

Ying Xiang , Dandan Huang , Yuelang Zhang , Xiaohui Li , Le Liu , Kang Zhu , Ying He , Haiqiao Sun , Tuo He , Xuan Su , Jiamin Kang , Weiguo Xu , Xiaoyong Ren

Objectives

The Node Reporting and Data System (Node-RADS) score system was recently proposed to better characterize lymph node metastasis (LNM). The study aimed to explore the diagnostic performance of Node-RADS score system for predicting LNM on CECT (contrast-enhanced CT) scans in patients with papillary thyroid carcinoma (PTC).

Methods

In total, 191 PTC patients (61 males and 130 females, average age: 45.37 ± 13.22 years), who underwent preoperative CECT, US examinations and lymph nodes (LNs) dissection, were retrospectively analyzed through Node-RADS CECT score system. Moreover, the area under the curve (AUC), sensitivity, specificity, and Youden’s index were calculated for Node-RADS CECT score and individual criteria.

Results

Overall, 191 patients with a total of 300 LNs (204 metastatic and 96 benign) were assessed. At the LNs level, best performance was found for Node-RADS CECT score ≥ 2 and ≥ 4 of central LNs and lateral LNs (AUC: 0.772 and 0.756), respectively. Node-RADS CECT score was shown to be an independent predictor of LNM (odds ratio [OR] = 2.41, p < 0.05). Among all criteria, combined with Node-RADS CECT score and US achieved the best diagnostic efficiency in evaluation of LNM, with AUCs of 0.846 in central group and 0.872 in lateral group (Delong test: p < 0.05).

Conclusions

The Node-RADS CECT score system provides a standardized LNM assessment. Combined Node-RADS CECT score and US would lead to an enhancement in predictive accuracy. Whereas, the rates of LNM ranged from 15.32% to 35.48% at the node level for score 1 and 2, which should be validated in the future research.

目的：最近提出了淋巴结报告和数据系统（Node- rads）评分系统，以更好地表征淋巴结转移（LNM）。本研究旨在探讨Node-RADS评分系统对甲状腺乳头状癌（PTC）患者CECT（对比增强CT） LNM的诊断价值。方法：采用Node-RADS CECT评分系统对191例术前行CECT、US检查及淋巴结清扫的PTC患者（男61例，女130例，平均年龄45.37±13.22岁）进行回顾性分析。此外，计算Node-RADS CECT评分和个体标准的曲线下面积（AUC）、敏感性、特异性和约登指数。结果：总共评估了191例患者共300例LNs（204例转移性，96例良性）。在LNs水平上，Node-RADS CECT评分≥2和≥4的中央LNs和侧LNs表现最佳（AUC分别为0.772和0.756）。Node-RADS CECT评分被证明是LNM的独立预测因子（优势比[OR] = 2.41, p）。结论：Node-RADS CECT评分系统提供了标准化的LNM评估。结合Node-RADS CECT评分和US可提高预测准确性。而在1分和2分的节点水平上，LNM的检出率在15.32% ~ 35.48%之间，有待于进一步的研究验证。

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引用次数: 0