European Journal of Radiology最新文献_第8页

Safety and preliminary efficacy of percutaneous co-ablation system under local anesthesia for the treatment of malignant lung tumors: A retrospective cohort study 局麻下经皮共消融系统治疗恶性肺肿瘤的安全性和初步疗效：一项回顾性队列研究。

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

European Journal of Radiology

Pub Date : 2026-01-02 DOI: 10.1016/j.ejrad.2025.112645

Linling Zhang , Shuo Yang , Jizhong Yin , Bin Chen

Background

Lung cancer is a common malignancy with the highest mortality rate. Currently, Image-guided thermal ablation (IGTA) therapy has been widely applied in lung cancer. This study aimed to evaluate the safety and preliminary efficacy of co-ablation therapy in the treatment of malignant pulmonary tumors. The co-ablation system is a novel ablation device that integrates the technical advantages of both cryoablation and high-intensity thermal ablation.

Methods

From February 2022 to May 2024, 194 patients (182 with primary lung cancer and 12 with metastatic lung tumor) underwent percutaneous co-ablation for the treatment of malignant lung tumors at our institution. A retrospective study was conducted to analyze the adverse events (AEs), and preliminary efficacy in 205 treatment sessions targeting 224 lesions.

Results

The median diameter of the targeted tumor was 1.3 cm. All co-ablation procedures were performed under local anesthesia. 55 sessions (26.83 %) experienced AEs (grade 2 or higher), with pneumothorax being the most common (44 sessions, 21.46 %). Grade 3 AEs occurred in 7 sessions (3.41 %), with pneumothorax and pleural effusion being the most common. In multivariate analysis, independent predictors of AEs included severe emphysema [odds ratio (OR) = 3.14; 95 % confidence interval (CI): 1.55–4.74], tumor size (OR = 1.09; 95 % CI: 0.0642–2.11), and number of tumors (OR = 4.60; 95 % CI: 2.83–6.38). Median follow-up time was 6 months. Follow-up assessments of local tumor control (LTC) rates at 3, 6, and 12 months post-ablation revealed that smaller tumor size was associated with higher LTC rates. There was statistical difference for progress-free survival(PFS) between group ≤ 3 cm and group＞3cm of tumor size [NR vs 6 (95 %CI:4.1–7.9) months, P = 0.0045].

Conclusion

Co-ablation is a safe treatment for malignant lung tumors with acceptable AEs rates. The incidence of pneumothorax was comparable to that of conventional cryoablation, whereas pleural effusion and hemoptysis rates were significantly lower. Furthermore, the procedure achieved favorable local control rates and prolonged progression-free survival, particularly for small (≤3 cm) lesions.

背景：肺癌是一种常见的恶性肿瘤，死亡率最高。目前，影像引导热消融（IGTA）治疗已广泛应用于肺癌。本研究旨在评价联合消融治疗肺部恶性肿瘤的安全性和初步疗效。共烧蚀系统是一种集低温烧蚀和高强度热烧蚀技术优点于一体的新型烧蚀装置。方法：2022年2月至2024年5月，194例患者（原发肺癌182例，转移性肺癌12例）行经皮联合消融术治疗恶性肺肿瘤。回顾性分析了针对224个病灶的205次治疗的不良事件（ae）和初步疗效。结果：肿瘤中位直径为1.3 cm。所有联合消融手术均在局部麻醉下进行。55例（26.83%）出现不良反应（2级或以上），其中气胸最为常见（44例，21.46%）。7例（3.41%）发生3级ae，以气胸和胸腔积液最为常见。在多因素分析中，ae的独立预测因素包括严重肺气肿[比值比(OR) = 3.14；95%可信区间（CI）： 1.55 ~ 4.74]、肿瘤大小（OR = 1.09; 95% CI: 0.0642 ~ 2.11）、肿瘤数量（OR = 4.60; 95% CI: 2.83 ~ 6.38）。中位随访时间为6个月。消融后3、6和12个月的局部肿瘤控制率随访评估显示，较小的肿瘤大小与较高的LTC率相关。肿瘤大小≤3cm组与bbb3cm组无进展生存期（PFS）比较，差异有统计学意义[NR vs 6 （95% CI:4.1 ~ 7.9）个月，P = 0.0045]。结论：联合消融术治疗恶性肺肿瘤安全可靠，不良事件发生率可接受。气胸的发生率与常规冷冻消融术相当，而胸腔积液和咯血发生率明显较低。此外，该手术获得了良好的局部控制率和延长的无进展生存期，特别是对于小（≤3cm）病变。

{"title":"Safety and preliminary efficacy of percutaneous co-ablation system under local anesthesia for the treatment of malignant lung tumors: A retrospective cohort study","authors":"Linling Zhang , Shuo Yang , Jizhong Yin , Bin Chen","doi":"10.1016/j.ejrad.2025.112645","DOIUrl":"10.1016/j.ejrad.2025.112645","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is a common malignancy with the highest mortality rate. Currently, Image-guided thermal ablation (IGTA) therapy has been widely applied in lung cancer. This study aimed to evaluate the safety and preliminary efficacy of co-ablation therapy in the treatment of malignant pulmonary tumors. The co-ablation system is a novel ablation device that integrates the technical advantages of both cryoablation and high-intensity thermal ablation.</div></div><div><h3>Methods</h3><div>From February 2022 to May 2024, 194 patients (182 with primary lung cancer and 12 with metastatic lung tumor) underwent percutaneous co-ablation for the treatment of malignant lung tumors at our institution. A retrospective study was conducted to analyze the adverse events (AEs), and preliminary efficacy in 205 treatment sessions targeting 224 lesions.</div></div><div><h3>Results</h3><div>The median diameter of the targeted tumor was 1.3 cm. All co-ablation procedures were performed under local anesthesia. 55 sessions (26.83 %) experienced AEs (grade 2 or higher), with pneumothorax being the most common (44 sessions, 21.46 %). Grade 3 AEs occurred in 7 sessions (3.41 %), with pneumothorax and pleural effusion being the most common. In multivariate analysis, independent predictors of AEs included severe emphysema [odds ratio (OR) = 3.14; 95 % confidence interval (CI): 1.55–4.74], tumor size (OR = 1.09; 95 % CI: 0.0642–2.11), and number of tumors (OR = 4.60; 95 % CI: 2.83–6.38). Median follow-up time was 6 months. Follow-up assessments of local tumor control (LTC) rates at 3, 6, and 12 months post-ablation revealed that smaller tumor size was associated with higher LTC rates. There was statistical difference for progress-free survival(PFS) between group ≤ 3 cm and group＞3cm of tumor size [NR vs 6 (95 %CI:4.1–7.9) months, P = 0.0045].</div></div><div><h3>Conclusion</h3><div>Co-ablation is a safe treatment for malignant lung tumors with acceptable AEs rates. The incidence of pneumothorax was comparable to that of conventional cryoablation, whereas pleural effusion and hemoptysis rates were significantly lower. Furthermore, the procedure achieved favorable local control rates and prolonged progression-free survival, particularly for small (≤3 cm) lesions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112645"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899613","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

Acceleration of chemical shift encoding-based water-fat imaging for pancreatic proton density fat fraction mapping in a single breath-hold: Data from the LION study 基于化学位移编码的水-脂肪成像在单次屏气中加速胰腺质子密度脂肪分数成像：来自LION研究的数据。

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

European Journal of Radiology

Pub Date : 2026-01-02 DOI: 10.1016/j.ejrad.2025.112641

Selina Rupp , Jessie Han , Stella Marlene Naebauer , Kilian Weiss , Johannes M. Peeters , Marcus M. Makowski , Anna Reik , Hans Hauner , Christina Holzapfel , Daniela Junker , Egon Burian , Dimitrios C. Karampinos , Mingming Wu

Purpose

With the rising prevalence of obesity and metabolic syndrome, there is an increasing need for noninvasive quantification of pancreatic fat as a marker of metabolic risk. Chemical shift encoding (CSE)-based water–fat separation enables pancreatic proton density fat fraction (PDFF) mapping. This study evaluates techniques for accelerating high-resolution, single-breath-hold PDFF mapping using sparse sampling with compressed sensing with sensitivity encoding (C-SENSE) and a deep learning (DL)-assisted reconstruction algorithm, focusing on reproducibility, precision, and clinical applicability.

Methods

104 abdominal MRI datasets were obtained from 71 adults (58 % female; age 18–65 years; body mass index (BMI) 30.0–39.9 kg/m²; without diabetes) enrolled in a lifestyle intervention trial. Imaging was performed at 3 T (Ingenia Elition X, Philips) using two six-echo gradient-echo acquisitions (2 × 2 × 3 mm³, identical TR/TE/echo spacing). Acceleration factors of R = 6 (16.9 s) and R = 10 (10.3 s) were reconstructed using vendor compressed sensing (C-SENSE6, C-SENSE10); the DL-assisted reconstruction (C-SENSE AI10) was applied only to R = 10 to evaluate denoising of higher-acceleration data. PDFF maps were analyzed using three regional regions of interest (ROIs) (head, body, tail) and whole-pancreas segmentation.

Results

A Mean pancreatic PDFF measured with C-SENSE6 was 15.0 [10.9 – 23.0] % at baseline (V1) and 8.2 [7.1 – 11.4] % after one year (V3). Across all reconstructions, PDFF ranged 3.5 – 47.6 %. Strong linearity was observed between C-SENSE10 and C-SENSE AI10 compared with C-SENSE6 (R² ≥ 0.99). Whole-pancreas analysis showed high reproducibility (intraclass correlation coefficient = 0.87 – 1.00 across methods). The DL-assisted reconstruction reduced map noise compared with conventional C-SENSE10 without affecting PDFF accuracy.

Conclusion

Accelerated CSE-based pancreatic PDFF mapping enables precise, reproducible, and clinically feasible single-breath-hold fat quantification. The approach provides a robust tool for evaluating pancreatic steatosis in obesity and metabolic disease research.

目的：随着肥胖和代谢综合征患病率的上升，越来越需要无创量化胰腺脂肪作为代谢风险的标志。基于化学位移编码（CSE）的水-脂肪分离实现了胰腺质子密度脂肪分数（PDFF）的映射。本研究评估了使用稀疏采样、压缩感知和敏感编码（C-SENSE）和深度学习（DL）辅助重建算法加速高分辨率、单屏气PDFF映射的技术，重点关注可重复性、精度和临床适用性。方法：71例成人(女性58%，年龄18-65岁，体重指数（BMI） 30.0-39.9 kg/m2；没有糖尿病)参加了一项生活方式干预试验。成像在3t （Ingenia Elition X, Philips）使用两个六回波梯度回波采集（2 × 2 × 3 mm3，相同的TR/TE/回波间隔）进行。利用供应商压缩感知（C-SENSE6、C-SENSE10）重构R = 6 （16.9 s）和R = 10 （10.3 s）的加速因子；仅在R = 10时应用dl辅助重建（C-SENSE AI10）来评估高加速度数据的去噪。PDFF图使用三个感兴趣区域（roi）（头、体、尾）和全胰腺分割进行分析。结果：C-SENSE6测量的平均胰腺PDFF在基线时（V1）为15.0[10.9 - 23.0]%，一年后（V3）为8.2[7.1 - 11.4]%。在所有重建中，PDFF范围为3.5 - 47.6%。与C-SENSE6相比，C-SENSE10与c - senseai10呈强线性关系（R2≥0.99）。全胰腺分析显示高重复性（各方法的类内相关系数= 0.87 - 1.00）。与传统的C-SENSE10相比，dl辅助重建在不影响PDFF精度的情况下降低了地图噪声。结论：基于cse的胰腺PDFF加速制图能够实现精确、可重复、临床可行的单次屏气脂肪定量。该方法为肥胖和代谢性疾病研究中评估胰腺脂肪变性提供了强有力的工具。

{"title":"Acceleration of chemical shift encoding-based water-fat imaging for pancreatic proton density fat fraction mapping in a single breath-hold: Data from the LION study","authors":"Selina Rupp , Jessie Han , Stella Marlene Naebauer , Kilian Weiss , Johannes M. Peeters , Marcus M. Makowski , Anna Reik , Hans Hauner , Christina Holzapfel , Daniela Junker , Egon Burian , Dimitrios C. Karampinos , Mingming Wu","doi":"10.1016/j.ejrad.2025.112641","DOIUrl":"10.1016/j.ejrad.2025.112641","url":null,"abstract":"<div><h3>Purpose</h3><div>With the rising prevalence of obesity and metabolic syndrome, there is an increasing need for noninvasive quantification of pancreatic fat as a marker of metabolic risk. Chemical shift encoding (CSE)-based water–fat separation enables pancreatic proton density fat fraction (PDFF) mapping. This study evaluates techniques for accelerating high-resolution, single-breath-hold PDFF mapping using sparse sampling with compressed sensing with sensitivity encoding (C-SENSE) and a deep learning (DL)-assisted reconstruction algorithm, focusing on reproducibility, precision, and clinical applicability.</div></div><div><h3>Methods</h3><div>104 abdominal MRI datasets were obtained from 71 adults (58 % female; age 18–65 years; body mass index (BMI) 30.0–39.9 kg/m<sup>2</sup>; without diabetes) enrolled in a lifestyle intervention trial. Imaging was performed at 3 T (Ingenia Elition X, Philips) using two six-echo gradient-echo acquisitions (2 × 2 × 3 mm<sup>3</sup>, identical TR/TE/echo spacing). Acceleration factors of R = 6 (16.9 s) and R = 10 (10.3 s) were reconstructed using vendor compressed sensing (C-SENSE6, C-SENSE10); the DL-assisted reconstruction (C-SENSE AI10) was applied only to R = 10 to evaluate denoising of higher-acceleration data. PDFF maps were analyzed using three regional regions of interest (ROIs) (head, body, tail) and whole-pancreas segmentation.</div></div><div><h3>Results</h3><div>A Mean pancreatic PDFF measured with C-SENSE6 was 15.0 [10.9 – 23.0] % at baseline (V1) and 8.2 [7.1 – 11.4] % after one year (V3)<strong>.</strong> Across all reconstructions, PDFF ranged 3.5 – 47.6 %<strong>.</strong> Strong linearity was observed between C-SENSE10 and C-SENSE AI10 compared with C-SENSE6 (R<sup>2</sup> ≥ 0.99). Whole-pancreas analysis showed high reproducibility (intraclass correlation coefficient = 0.87 – 1.00 across methods). The DL-assisted reconstruction reduced map noise compared with conventional C-SENSE10 without affecting PDFF accuracy.</div></div><div><h3>Conclusion</h3><div>Accelerated CSE-based pancreatic PDFF mapping enables precise, reproducible, and clinically feasible single-breath-hold fat quantification. The approach provides a robust tool for evaluating pancreatic steatosis in obesity and metabolic disease research.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112641"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917425","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

Research progress and clinical utility of multi-parameter orbital MRI in thyroid-associated ophthalmopathy 多参数眼眶MRI在甲状腺相关性眼病中的研究进展及临床应用

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

European Journal of Radiology

Pub Date : 2026-01-02 DOI: 10.1016/j.ejrad.2025.112644

Xinyi Gou , Jin Cheng , Tianyuan Li , Wei Zhao , Yi Wang , Xiuying Zhang , Nan Hong

Thyroid-associated ophthalmopathy (TAO), the most common orbital disease in adults, is a specific autoimmune condition closely associated with thyroid dysfunction, primarily affecting orbital fat and extraocular muscles. Multiparametric magnetic resonance imaging (MRI) holds unique value in diagnosing TAO, staging disease activity and progression evaluation by providing multidimensional information on tissue morphology, edema, fat infiltration, and fibrosis. This review examines conventional and advanced MRI techniques—such as T1WI, T2WI, diffusion-weighted imaging, dynamic contrast-enhanced MRI and magnetization transfer imaging—for their research progress and clinical utility. Recent advances in artificial intelligence (AI) applications for orbital MRI in TAO are also discussed. AI-enhanced multiparametric orbital MRI facilitates the comprehensive evaluation of TAO, covering image acquisition, quantification of metrics, and the establishment of predictive assessment models. Despite these advancements, challenges persist, such as the need to standardize quantitative parameters, validate findings through larger multicenter studies, and develop more efficient scanning protocols. Future research should prioritize parameter standardization, automated analysis workflows, and integration of multiparametric data to advance personalized TAO management.

甲状腺相关性眼病（TAO）是成人最常见的眼眶疾病，是一种与甲状腺功能障碍密切相关的特异性自身免疫性疾病，主要影响眼眶脂肪和眼外肌。多参数磁共振成像（MRI）通过提供组织形态、水肿、脂肪浸润和纤维化的多维信息，在诊断TAO、分期疾病活动和进展评估方面具有独特的价值。本文综述了传统和先进的MRI技术，如T1WI、T2WI、弥散加权成像、动态对比增强MRI和磁化转移成像的研究进展和临床应用。本文还讨论了人工智能（AI）在眼眶MRI中的应用进展。人工智能增强的多参数眼眶MRI促进了TAO的综合评估，包括图像采集、指标量化和预测评估模型的建立。尽管取得了这些进步，但挑战仍然存在，例如需要标准化定量参数，通过更大的多中心研究验证发现，以及开发更有效的扫描协议。未来的研究应优先考虑参数标准化、自动化分析工作流和多参数数据集成，以推进个性化的TAO管理。

{"title":"Research progress and clinical utility of multi-parameter orbital MRI in thyroid-associated ophthalmopathy","authors":"Xinyi Gou , Jin Cheng , Tianyuan Li , Wei Zhao , Yi Wang , Xiuying Zhang , Nan Hong","doi":"10.1016/j.ejrad.2025.112644","DOIUrl":"10.1016/j.ejrad.2025.112644","url":null,"abstract":"<div><div>Thyroid-associated ophthalmopathy (TAO), the most common orbital disease in adults, is a specific autoimmune condition closely associated with thyroid dysfunction, primarily affecting orbital fat and extraocular muscles. Multiparametric magnetic resonance imaging (MRI) holds unique value in diagnosing TAO, staging disease activity and progression evaluation by providing multidimensional information on tissue morphology, edema, fat infiltration, and fibrosis. This review examines conventional and advanced MRI techniques—such as T1WI, T2WI, diffusion-weighted imaging, dynamic contrast-enhanced MRI and magnetization transfer imaging—for their research progress and clinical utility. Recent advances in artificial intelligence (AI) applications for orbital MRI in TAO are also discussed. AI-enhanced multiparametric orbital MRI facilitates the comprehensive evaluation of TAO, covering image acquisition, quantification of metrics, and the establishment of predictive assessment models. Despite these advancements, challenges persist, such as the need to standardize quantitative parameters, validate findings through larger multicenter studies, and develop more efficient scanning protocols. Future research should prioritize parameter standardization, automated analysis workflows, and integration of multiparametric data to advance personalized TAO management.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112644"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921025","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

Preoperative MRI for non-invasive assessment of pancreatic acinar cell composition 术前MRI无创评估胰腺腺泡细胞组成。

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

European Journal of Radiology

Pub Date : 2026-01-02 DOI: 10.1016/j.ejrad.2025.112649

Sevde Nur Emir , Aylin Acar , Ali Koyuncuer , Servet Emir , Abdulbaki Ağaçkıran , Tolga Canbak

Objective

This study explores the predictive power of preoperative MRI in evaluating pancreatic acinar cell composition. We aimed to determine whether MRI-derived signal intensity ratios could serve as reliable biomarkers for preoperative assessment.

Methods

In this retrospective study, 47 patients (30 males, 17 females; mean age: 64.6 years) who underwent pancreatoduodenectomy between January 2022 and May 2024 were included. Preoperative MRI signal intensities from T1-weighted sequences, dynamic contrast-enhanced phases, and diffusion-weighted imaging were quantified. The acinar cell ratio was determined via histopathological analysis of the pancreatic resection margin. Pearson and Spearman correlation tests assessed associations between MRI parameters and acinar cell content, while a logistic regression model evaluated their predictive accuracy.

Results

A significant correlation was observed between various MRI parameters and pancreatic acinar cell ratio. The strongest association was found for the pre-contrast pancreas T1-weighted to venous phase signal intensity ratio (Ratio-3), which yielded a correlation coefficient of 0.696 (p < 0.0001). ROC analysis demonstrated that Ratio-3 had an area under the curve (AUC) of 0.91, with 94 % sensitivity and 80 % specificity in predicting an acinar cell ratio exceeding 40 %.

Conclusion

Ratio-3 (Pre-contrast pancreas T1W/Venous phase signal) shows strong potential as a non-invasive biomarker for assessing pancreatic acinar cell composition. These findings may improve preoperative risk stratification, aiding in pancreatic fistula prediction and surgical planning.

目的：探讨术前MRI对胰腺腺泡细胞组成的预测能力。我们的目的是确定mri衍生的信号强度比是否可以作为术前评估的可靠生物标志物。方法：回顾性研究纳入2022年1月至2024年5月期间行胰十二指肠切除术的47例患者（男性30例，女性17例，平均年龄64.6岁）。术前量化t1加权序列、动态增强期和弥散加权成像的MRI信号强度。通过胰腺切除边缘的组织病理学分析确定腺泡细胞比例。Pearson和Spearman相关检验评估MRI参数与腺泡细胞含量之间的关系，而逻辑回归模型评估其预测准确性。结果：各MRI参数与胰腺腺泡细胞比例有显著相关性。对比前胰腺t1加权与静脉相信号强度比（ratio -3）相关性最强，相关系数为0.696 (p)。结论：ratio -3（对比前胰腺T1W/静脉相信号）具有很强的潜力，可作为评估胰腺腺泡细胞组成的无创生物标志物。这些发现可以改善术前风险分层，帮助胰瘘的预测和手术计划。

{"title":"Preoperative MRI for non-invasive assessment of pancreatic acinar cell composition","authors":"Sevde Nur Emir , Aylin Acar , Ali Koyuncuer , Servet Emir , Abdulbaki Ağaçkıran , Tolga Canbak","doi":"10.1016/j.ejrad.2025.112649","DOIUrl":"10.1016/j.ejrad.2025.112649","url":null,"abstract":"<div><h3>Objective</h3><div>This study explores the predictive power of preoperative MRI in evaluating pancreatic acinar cell composition. We aimed to determine whether MRI-derived signal intensity ratios could serve as reliable biomarkers for preoperative assessment.</div></div><div><h3>Methods</h3><div>In this retrospective study, 47 patients (30 males, 17 females; mean age: 64.6 years) who underwent pancreatoduodenectomy between January 2022 and May 2024 were included. Preoperative MRI signal intensities from T1-weighted sequences, dynamic contrast-enhanced phases, and diffusion-weighted imaging were quantified. The acinar cell ratio was determined via histopathological analysis of the pancreatic resection margin. Pearson and Spearman correlation tests assessed associations between MRI parameters and acinar cell content, while a logistic regression model evaluated their predictive accuracy.</div></div><div><h3>Results</h3><div>A significant correlation was observed between various MRI parameters and pancreatic acinar cell ratio. The strongest association was found for the pre-contrast pancreas T1-weighted to venous phase signal intensity ratio (Ratio-3), which yielded a correlation coefficient of 0.696 (p < 0.0001). ROC analysis demonstrated that Ratio-3 had an area under the curve (AUC) of 0.91, with 94 % sensitivity and 80 % specificity in predicting an acinar cell ratio exceeding 40 %.</div></div><div><h3>Conclusion</h3><div>Ratio-3 (Pre-contrast pancreas T1W/Venous phase signal) shows strong potential as a non-invasive biomarker for assessing pancreatic acinar cell composition. These findings may improve preoperative risk stratification, aiding in pancreatic fistula prediction and surgical planning.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112649"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910867","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

Establishing updated diagnostic reference levels for interventional radiology: a national Italian survey incorporating procedure complexity Indices 为介入放射学建立更新的诊断参考水平：一项纳入程序复杂性指数的意大利全国调查

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

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112648

Monica Cavallari , Sveva Grande , Alessandra Palma , Catherine Klersy , Renato Padovani , Antonio Orlacchio , Gaetano Compagnone , Antonella Rosi , Loredana D’Ercole

Background and Purpose

The implementation of Euratom Council Directive 2013/59 into Italian legislation (D. Lgs 101/2020) requires the Ministry of Health, in collaboration with the Istituto Superiore di Sanità (ISS) and relevant scientific organizations, to facilitate the evaluation and regular updating of Diagnostic Reference Levels (DRLs) for procedures in diagnostic and interventional radiology.

Materials and methods

This study presents the update of the Italian Diagnostic Reference Levels derived from a survey conducted between 2019 and 2022 by a Working Group (WG) organized by ISS. A total of 53 hospitals across Italy were involved, of which 38 contributed to data collection related to body procedures. The survey concerned the collection of data related to different interventional radiology procedures: Trans-Arterial Chemo Embolization (TACE), EndoVascular Aneurysms Repair (EVAR), Transjugular Intrahepatic Porto-systemic Shunt (TIPS), Angioplasty and stenting for peripheral arterial disease of the lower limbs (LL), Percutaneous Biliary Interventions (PBI), Endoscopic Retrograde Cholangio-Pancreatography (ERCP), PTA (Percutaneous Transluminal Angioplasty) and/or Carotid stenting and Vertebroplasty. For each procedure, Air Kerma AT REFERENCE POINT(K_a,r), Kerma Area Product (P_KA) and Fluoroscopy Time (FT) were collected. Clinical parameters were obtained for TACE, EVAR, PBI, LL and Vertebroplasty, too. A P_KA multivariable analysis was performed to identify which parameters significantly influence the dosimetric data and to derive DRL related to procedure complexity.

Results

New DRL values were derived for each of these procedures, except for TIPS, for which the typical value was used: 45 Gy.cm² for PBI, 24 Gy.cm² for LL, 62 Gy.cm² for PTA and/or Carotid stenting, 252 Gy.cm² for TIPS, 18 Gy.cm² for ERCP, 134 Gy.cm² for EVAR, 91 Gy.cm² for Vertebroplasty and 255 Gy.cm² for TACE. DRL were also established according to the complexity of the procedure for TACE and EVAR.

Conclusion

This national survey successfully established diagnostic reference levels (DRLs) for seven interventional body procedures (TACE, EVAR, TIPS, LL, PBI, ERCP, PTA, Vertebroplasty) across Italian hospitals, providing facilities with systematic tools to optimize patient radiation exposure through comparison with national values and complexity-stratified reference levels.

背景和目的为在意大利立法中落实欧洲原子能共同体理事会第2013/59号指令（D. Lgs 101/2020），要求卫生部与高等卫生研究所（ISS）和相关科学组织合作，促进诊断和介入放射学程序的诊断参考水平（drl）的评估和定期更新。材料和方法本研究介绍了由ISS组织的工作组（WG）在2019年至2022年期间进行的一项调查得出的意大利诊断参考水平的更新。意大利共有53家医院参与其中，其中38家医院协助收集与人体手术有关的数据。这项调查收集了与不同介入放射治疗程序有关的数据：经动脉化疗栓塞（TACE）、血管内动脉瘤修复（EVAR）、经颈静脉肝内门静脉-全身分流术（TIPS）、下肢外周动脉疾病血管成形术和支架植入术（LL）、经皮胆道介入术（PBI）、内镜逆行胆道-胰腺造影（ERCP）、PTA（经皮腔内血管成形术）和/或颈动脉支架植入术和椎体成形术。每个手术收集Air Kerma AT参考点（Ka,r）、Kerma面积积（PKA）和透视时间（FT）。获得TACE、EVAR、PBI、LL和椎体成形术的临床参数。进行PKA多变量分析，以确定哪些参数显著影响剂量学数据，并得出与程序复杂性相关的DRL。结果除TIPS外，每种方法均获得了新的DRL值，其典型值为45 Gy。PBI为cm2, 24gy。l的平方厘米是62gy。PTA和/或颈动脉支架植入术，252gy。TIPS为cm2, 18 Gy。ERCP为134gy。EVAR的平方厘米是91 Gy。cm2椎体成形术，255 Gy。cm2为TACE。根据TACE和EVAR程序的复杂性，建立了DRL。结论：这项全国性调查成功建立了意大利各医院7种介入性身体手术（TACE、EVAR、TIPS、LL、PBI、ERCP、PTA、椎体成形术）的诊断参考水平（drl），通过与国家标准和复杂性分层参考水平的比较，为优化患者辐射暴露提供了系统工具。

{"title":"Establishing updated diagnostic reference levels for interventional radiology: a national Italian survey incorporating procedure complexity Indices","authors":"Monica Cavallari , Sveva Grande , Alessandra Palma , Catherine Klersy , Renato Padovani , Antonio Orlacchio , Gaetano Compagnone , Antonella Rosi , Loredana D’Ercole","doi":"10.1016/j.ejrad.2025.112648","DOIUrl":"10.1016/j.ejrad.2025.112648","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The implementation of Euratom Council Directive 2013/59 into Italian legislation (D. Lgs 101/2020) requires the Ministry of Health, in collaboration with the Istituto Superiore di Sanità (ISS) and relevant scientific organizations, to facilitate the evaluation and regular updating of Diagnostic Reference Levels (DRLs) for procedures in diagnostic and interventional radiology.</div></div><div><h3>Materials and methods</h3><div>This study presents the update of the Italian Diagnostic Reference Levels derived from a survey conducted between 2019 and 2022 by a Working Group (WG) organized by ISS. A total of 53 hospitals across Italy were involved, of which 38 contributed to data collection related to body procedures. The survey concerned the collection of data related to different interventional radiology procedures: Trans-Arterial Chemo Embolization (TACE), EndoVascular Aneurysms Repair (EVAR), Transjugular Intrahepatic Porto-systemic Shunt (TIPS), Angioplasty and stenting for peripheral arterial disease of the lower limbs (LL), Percutaneous Biliary Interventions (PBI), Endoscopic Retrograde Cholangio-Pancreatography (ERCP), PTA (Percutaneous Transluminal Angioplasty) and/or Carotid stenting and Vertebroplasty. For each procedure, Air Kerma AT REFERENCE POINT(K<sub>a,r</sub>), Kerma Area Product (P<sub>KA</sub>) and Fluoroscopy Time (FT) were collected. Clinical parameters were obtained for TACE, EVAR, PBI, LL and Vertebroplasty, too. A P<sub>KA</sub> multivariable analysis was performed to identify which parameters significantly influence the dosimetric data and to derive DRL related to procedure complexity.</div></div><div><h3>Results</h3><div>New DRL values were derived for each of these procedures, except for TIPS, for which the typical value was used: 45 Gy.cm<sup>2</sup> for PBI, 24 Gy.cm<sup>2</sup> for LL, 62 Gy.cm<sup>2</sup> for PTA and/or Carotid stenting, 252 Gy.cm<sup>2</sup> for TIPS, 18 Gy.cm<sup>2</sup> for ERCP, 134 Gy.cm<sup>2</sup> for EVAR, 91 Gy.cm<sup>2</sup> for Vertebroplasty and 255 Gy.cm<sup>2</sup> for TACE. DRL were also established according to the complexity of the procedure for TACE and EVAR.</div></div><div><h3>Conclusion</h3><div>This national survey successfully established diagnostic reference levels (DRLs) for seven interventional body procedures (TACE, EVAR, TIPS, LL, PBI, ERCP, PTA, Vertebroplasty) across Italian hospitals, providing facilities with systematic tools to optimize patient radiation exposure through comparison with national values and complexity-stratified reference levels.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112648"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921118","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

Contrast enhanced ultrasound at first month: A feasible predictor for retreatment after benign thyroid nodule thermal ablation 第一个月造影增强超声：良性甲状腺结节热消融后再治疗的可行预测指标。

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

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112628

Tinghui Yin , Yifei Leng , Bowen Zheng , Jinfen Wang, Lei Tan, Yuting He, Yufan Lian, Yanping Ma, Ge Tong, Xiuling Chen, Tao Wu, Jie Ren

Objectives

To determine the clinical values of contrast enhanced ultrasound (CEUS) at the first follow-up for predicting retreatment in benign thyroid nodules (BTNs) after thermal ablation (TA).

Materials and methods

A total of 176 BTNs from 155 patients who underwent TA with a median follow-up period of 32.5 months (range 7 to 83 months) were enrolled in this study. Initial ablation ratio (IAR) and CEUS base IAR (CIAR) was calculated by conventional US and CEUS at 1-month after TA. The predicting performances for retreatment of quantitative and qualitative CEUS at 1-month after TA were analyzed by receiver operating characteristic (ROC) curves and Kaplan-Meier survival analysis.

Results

The median final volume reduction rate (VRR) of all nodules was 96.9% (range 31.4% to 100%). The areas under curves (AUCs) of quantitative and qualitative CEUS at 1-month for nodular retreatment were 0.986 and 0.981. Correspondingly, the sensitivity, negative predictive value (NPV) and negative likelihood ratio (LR) were 100%, 100% and 0 for both quantitative and qualitative CEUS.

Conclusion

CEUS at 1-month is a feasible predictor for nodular retreatment after BTNs TA. According to our results, CEUS is recommended as routine at the first follow-up for BTNs underwent TA.

目的：探讨超声造影（CEUS）在热消融（TA）后首次随访时预测良性甲状腺结节（BTNs）再治疗的临床价值。材料和方法：155例接受TA治疗的患者共176例BTNs，中位随访期为32.5个月（7 ~ 83个月）。在TA术后1个月分别用常规超声和超声计算初始消融比（IAR）和基础消融比（CIAR）。采用受试者工作特征（ROC）曲线和Kaplan-Meier生存分析分析TA术后1个月定量和定性超声造影再治疗的预测性能。结果：所有结节的中位最终体积缩小率（VRR）为96.9%（范围为31.4%至100%）。再治疗1个月时定量和定性超声曲线下面积（auc）分别为0.986和0.981。定量和定性CEUS的敏感性、阴性预测值（NPV）和阴性似然比（LR）分别为100%、100%和0。结论：1个月的超声造影是BTNs TA术后结节再治疗的可行预测指标。根据我们的研究结果，超声造影推荐作为btn行TA的第一次随访常规。

{"title":"Contrast enhanced ultrasound at first month: A feasible predictor for retreatment after benign thyroid nodule thermal ablation","authors":"Tinghui Yin , Yifei Leng , Bowen Zheng , Jinfen Wang, Lei Tan, Yuting He, Yufan Lian, Yanping Ma, Ge Tong, Xiuling Chen, Tao Wu, Jie Ren","doi":"10.1016/j.ejrad.2025.112628","DOIUrl":"10.1016/j.ejrad.2025.112628","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the clinical values of contrast enhanced ultrasound (CEUS) at the first follow-up for predicting retreatment in benign thyroid nodules (BTNs) after thermal ablation (TA).</div></div><div><h3>Materials and methods</h3><div>A total of 176 BTNs from 155 patients who underwent TA with a median follow-up period of 32.5 months (range 7 to 83 months) were enrolled in this study. Initial ablation ratio (IAR) and CEUS base IAR (CIAR) was calculated by conventional US and CEUS at 1-month after TA. The predicting performances for retreatment of quantitative and qualitative CEUS at 1-month after TA were analyzed by receiver operating characteristic (ROC) curves and Kaplan-Meier survival analysis.</div></div><div><h3>Results</h3><div>The median final volume reduction rate (VRR) of all nodules was 96.9% (range 31.4% to 100%). The areas under curves (AUCs) of quantitative and qualitative CEUS at 1-month for nodular retreatment were 0.986 and 0.981. Correspondingly, the sensitivity, negative predictive value (NPV) and negative likelihood ratio (LR) were 100%, 100% and 0 for both quantitative and qualitative CEUS.</div></div><div><h3>Conclusion</h3><div>CEUS at 1-month is a feasible predictor for nodular retreatment after BTNs TA. According to our results, CEUS is recommended as routine at the first follow-up for BTNs underwent TA.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112628"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916531","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

Evaluation of Age-Related compositional changes in the infrapatellar fat pad using MRI-Derived PDFF and T2* at 1.5 T 利用mri衍生PDFF和1.5 T时T2*评估髌下脂肪垫年龄相关成分变化。

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

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112632

Kecheng Yuan , Qingyun Liu , Weijie Zheng , Xiaoqiong Tang , Chuang Zhang , Jiantai Zhou , Penghui Luo , Fulang Qi , Lin Chen , Bensheng Qiu

Purpose

To investigate age-related compositional changes in the infrapatellar fat pad (IFP) using chemical shift-encoded MRI-derived proton density fat fraction (PDFF) and T₂* at 1.5 T, and to evaluate their associations with clinical symptoms and structural abnormalities.

Methods

A cross-sectional study was performed in 100 adults (mean age: 44 ± 14 years; 54 men, 46 women) who underwent 1.5 T MRI using a six-echo spoiled gradient-echo sequence for quantitative assessment of PDFF and T₂* in the IFP. Clinical symptoms were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and structural abnormalities were evaluated using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Spearman correlation and mediation analyses were performed.

Results

Age showed a strong negative correlation with IFP PDFF (r = − 0.46, p < 0.001) and a moderate inverse association with T₂* (r = − 0.30, p = 0.003). Lower PDFF was associated with worse WOMAC pain (r = − 0.33, p = 0.001) and WORMS scores (r = − 0.41, p < 0.001). The mediation analysis revealed a significant indirect pathway linking age to both pain (ACME = 0.19, 95 % CI: 0.02–0.38) and WORMS scores (ACME = 0.24, 95 % CI: 0.06–0.45) through PDFF. In contrast, the indirect pathway through T₂* was weaker and less precise (ACME = 0.12, 95 % CI: 0.01–0.28).

Conclusions

PDFF and T₂* reflect age-related compositional and microstructural changes in the IFP, with PDFF demonstrating stronger associations with clinical symptoms and joint degeneration. These findings indicate PDFF as a superior imaging biomarker for early detection, monitoring, and potential therapeutic targeting in age-related musculoskeletal degeneration.

目的：利用化学位移编码mri衍生质子密度脂肪分数（PDFF）和T2*在1.5 T时研究年龄相关的髌下脂肪垫（IFP）组成变化，并评估其与临床症状和结构异常的关系。方法：对100名成年人（平均年龄：44±14岁；男性54名，女性46名）进行横断面研究，这些成年人接受1.5 T MRI检查，使用六回波破坏梯度回波序列定量评估IFP中的PDFF和T2*。临床症状采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）进行评估，结构异常采用全器官磁共振成像评分（WORMS）进行评估。进行Spearman相关分析和中介分析。结果：年龄与IFP PDFF呈显著负相关(r = - 0.46, p 2* (r = - 0.30, p = 0.003)。较低的PDFF与较差的WOMAC疼痛（r = - 0.33, p = 0.001）和WORMS评分(r = - 0.41， p 2*较弱且较不精确（ACME = 0.12, 95% CI: 0.01-0.28）相关。结论：PDFF和T2*反映了IFP中与年龄相关的组成和微观结构变化，其中PDFF与临床症状和关节退变有更强的相关性。这些发现表明PDFF是一种优越的成像生物标志物，可用于年龄相关性肌肉骨骼变性的早期检测、监测和潜在的治疗靶点。

{"title":"Evaluation of Age-Related compositional changes in the infrapatellar fat pad using MRI-Derived PDFF and T2* at 1.5 T","authors":"Kecheng Yuan , Qingyun Liu , Weijie Zheng , Xiaoqiong Tang , Chuang Zhang , Jiantai Zhou , Penghui Luo , Fulang Qi , Lin Chen , Bensheng Qiu","doi":"10.1016/j.ejrad.2025.112632","DOIUrl":"10.1016/j.ejrad.2025.112632","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate age-related compositional changes in the infrapatellar fat pad (IFP) using chemical shift-encoded MRI-derived proton density fat fraction (PDFF) and T<sub>2</sub>* at 1.5 T, and to evaluate their associations with clinical symptoms and structural abnormalities.</div></div><div><h3>Methods</h3><div>A cross-sectional study was performed in 100 adults (mean age: 44 ± 14 years; 54 men, 46 women) who underwent 1.5 T MRI using a six-echo spoiled gradient-echo sequence for quantitative assessment of PDFF and T<sub>2</sub>* in the IFP. Clinical symptoms were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and structural abnormalities were evaluated using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Spearman correlation and mediation analyses were performed.</div></div><div><h3>Results</h3><div>Age showed a strong negative correlation with IFP PDFF (r = − 0.46, p < 0.001) and a moderate inverse association with T<sub>2</sub>* (r = − 0.30, p = 0.003). Lower PDFF was associated with worse WOMAC pain (r = − 0.33, p = 0.001) and WORMS scores (r = − 0.41, p < 0.001). The mediation analysis revealed a significant indirect pathway linking age to both pain (ACME = 0.19, 95 % CI: 0.02–0.38) and WORMS scores (ACME = 0.24, 95 % CI: 0.06–0.45) through PDFF. In contrast, the indirect pathway through T<sub>2</sub>* was weaker and less precise (ACME = 0.12, 95 % CI: 0.01–0.28).</div></div><div><h3>Conclusions</h3><div>PDFF and T<sub>2</sub>* reflect age-related compositional and microstructural changes in the IFP, with PDFF demonstrating stronger associations with clinical symptoms and joint degeneration. These findings indicate PDFF as a superior imaging biomarker for early detection, monitoring, and potential therapeutic targeting in age-related musculoskeletal degeneration.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112632"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959128","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

CEM in women prospectively assessed for screening recalls: Per-breast diagnostic performance with 3-year or longer follow-up 前瞻性评估筛查回忆的女性CEM：每乳房3年或更长时间随访的诊断表现。

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

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112652

Sara Marziali , Andrea Cozzi , Veronica Magni , Laura Menicagli , Adrienn Benedek , Andrea Cisarri , Alessandra Marrocco , Giuseppe Di Giulio , Francesco Sardanelli

Objectives

To evaluate the performance of contrast-enhanced mammography (CEM) for the assessment of screening recalls at ≥ 3-year follow-up.

Materials and methods

Women recalled after screening mammography at two Italian centers were prospectively enrolled to undergo CEM alongside standard assessment (SA) through additional views, tomosynthesis, and/or ultrasound. SA and CEM were independently evaluated, recommending biopsy or referral to a subsequent screening round. Per-breast diagnostic performance of CEM (low-energy plus recombined images) was calculated by taking histopathology and/or ≥ 3-year follow-up as the reference standard.

Results

Of the original 414 breasts (from 207 women), 393 (from 198 women) had available biopsy or follow-up data for the purposes of this analysis, being negative either at the original biopsy or at follow-up (316/393, 80.4%), or having a malignant finding at the original biopsy (74/393, 18.8%), or an interval cancer during follow-up (3/393, 0.8%, two at 1-year, one at 3-year). These interval cancers were 1 DCIS, two node-negative invasive (one 5-mm mixed no special type/lobular; one 6-mm mucinous). Per-breast analysis of the 393 breasts yielded a 96.1% sensitivity (74/77, 95% confidence interval 89.3–98.8%), 94.9% specificity (300/316, 92.0–96.9%), 95.2% accuracy (374/393, 92.6–97.1%), 82.2% positive predictive value (74/90, 73.2–88.8%), 99.0% negative predictive value (300/303, 97.2–99.7%).

Conclusions

In a cohort of women undergoing screening recall with CEM, when considering ≥ 3-year follow-up, per-breast sensitivity was about 96 %, specificity 95 %, negative predictive value 99 %.

目的：评价对比增强乳房x线摄影（CEM）在评估筛查召回≥3年随访中的表现。材料和方法：在意大利两家中心进行乳房x光筛查后被召回的女性，前瞻性地接受了CEM和标准评估（SA），包括额外的视图、断层合成和/或超声。SA和CEM独立评估，建议活检或转诊到后续筛查轮。以组织病理学和/或≥3年随访为参考标准，计算CEM的每乳诊断效能（低能量加重组图像）。结果：在最初的414个乳房（来自207名女性）中，393个（来自198名女性）有本分析目的的活检或随访数据，在最初的活检或随访中为阴性（316/393,80.4%），或在最初的活检中发现恶性（74/393,18.8%），或在随访期间发现间隔癌（3/393,0.8%，1年2例，3年1例）。间期癌1例DCIS， 2例浸润性淋巴结阴性（1例5mm混合型，无特殊类型/小叶；1例6mm黏液性）。对393个乳房进行单乳分析，敏感性为96.1%(74/77,95%置信区间89.3-98.8%)，特异性为94.9%(300/316,92.0-96.9%)，准确性为95.2%(374/393,92.6-97.1%)，阳性预测值为82.2%(74/90,73.2-88.8%)，阴性预测值为99.0%（300/303,97.2-99.7%）。结论：在接受CEM筛查回忆的女性队列中，当考虑≥3年的随访时，每个乳房的敏感性约为96%，特异性为95%，阴性预测值为99%。

{"title":"CEM in women prospectively assessed for screening recalls: Per-breast diagnostic performance with 3-year or longer follow-up","authors":"Sara Marziali , Andrea Cozzi , Veronica Magni , Laura Menicagli , Adrienn Benedek , Andrea Cisarri , Alessandra Marrocco , Giuseppe Di Giulio , Francesco Sardanelli","doi":"10.1016/j.ejrad.2025.112652","DOIUrl":"10.1016/j.ejrad.2025.112652","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the performance of contrast-enhanced mammography (CEM) for the assessment of screening recalls at ≥ 3-year follow-up.</div></div><div><h3>Materials and methods</h3><div>Women recalled after screening mammography at two Italian centers were prospectively enrolled to undergo CEM alongside standard assessment (SA) through additional views, tomosynthesis, and/or ultrasound. SA and CEM were independently evaluated, recommending biopsy or referral to a subsequent screening round. Per-breast diagnostic performance of CEM (low-energy plus recombined images) was calculated by taking histopathology and/or ≥ 3-year follow-up as the reference standard.</div></div><div><h3>Results</h3><div>Of the original 414 breasts (from 207 women), 393 (from 198 women) had available biopsy or follow-up data for the purposes of this analysis, being negative either at the original biopsy or at follow-up (316/393, 80.4%), or having a malignant finding at the original biopsy (74/393, 18.8%), or an interval cancer during follow-up (3/393, 0.8%, two at 1-year, one at 3-year). These interval cancers were 1 DCIS, two node-negative invasive (one 5-mm mixed no special type/lobular; one 6-mm mucinous). Per-breast analysis of the 393 breasts yielded a 96.1% sensitivity (74/77, 95% confidence interval 89.3–98.8%)<strong>,</strong> 94.9% specificity (300/316, 92.0–96.9%)<strong>,</strong> 95.2% accuracy (374/393, 92.6–97.1%)<strong>,</strong> 82.2% positive predictive value (74/90, 73.2–88.8%)<strong>,</strong> 99.0% negative predictive value (300/303, 97.2–99.7%)<strong>.</strong></div></div><div><h3>Conclusions</h3><div>In a cohort of women undergoing screening recall with CEM, when considering ≥ 3-year follow-up, per-breast sensitivity was about 96 %, specificity 95 %, negative predictive value 99 %.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112652"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917375","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

Ccta-based AI for Diagnosing ≥ 50 % coronary Stenosis: A patient- and Vessel-Level meta-analysis 基于ccta的AI诊断≥50%冠状动脉狭窄：一项患者和血管水平的荟萃分析

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

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112634

Yiqiao Yan , Xinyuan Zhang , Chuan Liu , Hang Fu , Ke Xu , Huayan Xu

Background

To investigate the diagnostic performance of CCTA-based artificial intelligence (AI) in detecting ≥ 50 % coronary stenosis of coronary artery disease (CAD) at both the patient and vessel levels.

Methods

A systematic search of PubMed, Embase, and Web of Science databases (from inception to March 2025) was conducted to identify diagnostic studies evaluating CCTA-based AI methods for detecting CAD. Studies of ≥ 50 % coronary stenosis were enrolled. Data for diagnostic performance was extracted and meta analysis was performed. Statistical analyses were performed using RevMan 5.4, Meta-Disc 1.4, and Stata 16.0. This study was designed and reported following the PRISMA-DTA statement.

Results

The systematic search yielded 2,211 potentially relevant records. Following multi-stage screening, 11 eligible studies (1506 patients; 2896 vessels) were included. At the patient level, AI based assistant tools demonstrated pooled sensitivity of 0.95 [95 % CI (0.93–0.97)], specificity of 0.73 [95 % CI (0.61–0.82)], and AUC of 0.96 [95 % CI (0.94–0.97)] for CAD with ≥ 50 % stenosis diagnosis. The positive likelihood ratio (+LR) was 3.5 [95 % CI (2.4–5.2)] and negative likelihood ratio (−LR) was 0.07 [95 % CI (0.05–0.10)], with a pooled DOR of 52 [31–86]. At the vessel level of diagnosing ≥ 50 % stenosis diagnosis, AI-based assistant diagnostic tool showed pooled sensitivity of 0.87 [95 % CI (0.83–0.90)], specificity of 0.89 [95 % CI (0.82–0.93)], +LR of 7.7 [95 % CI (4.8–12.5)], −LR of 0.15 [95 % CI (0.11–0.19)], DOR of 53 [35–79], and AUC of 0.93 [95 % CI (0.90–0.95)].

Conclusion

When pooled across diverse deep-learning systems, AI-assisted CCTA demonstrates high sensitivity and solid diagnostic performance for detecting ≥ 50 % coronary stenosis. However, this reflects aggregated results from heterogeneous models rather than the capability of any single AI tool, limiting direct generalizability to specific systems or vendors.

研究基于ccta的人工智能（AI）在患者和血管水平检测冠心病（CAD）冠状动脉狭窄≥50%的诊断性能。方法系统检索PubMed、Embase和Web of Science数据库（从创建到2025年3月），以确定评估基于ccta的人工智能方法检测CAD的诊断研究。纳入了冠状动脉狭窄≥50%的研究。提取诊断表现数据并进行meta分析。采用RevMan 5.4、Meta-Disc 1.4和Stata 16.0进行统计分析。本研究的设计和报告遵循PRISMA-DTA声明。结果系统检索得到2211条可能相关的记录。经过多阶段筛选，纳入了11项符合条件的研究（1506例患者，2896条血管）。在患者水平上，基于人工智能的辅助工具对狭窄程度≥50%的CAD诊断的总敏感性为0.95 [95% CI(0.93-0.97)]，特异性为0.73 [95% CI (0.61-0.82)]， AUC为0.96 [95% CI(0.94-0.97)]。阳性似然比（+LR）为3.5 [95% CI(2.4-5.2)]，阴性似然比（- LR）为0.07 [95% CI(0.05-0.10)]，合并DOR为52[31-86]。在诊断≥50%狭窄的血管水平上，人工智能辅助诊断工具的总灵敏度为0.87 [95% CI(0.83-0.90)]，特异性为0.89 [95% CI (0.82-0.93)]， +LR为7.7 [95% CI (4.8% - 12.5)]， - LR为0.15 [95% CI (0.11-0.19)]， DOR为53 [35-79]，AUC为0.93 [95% CI(0.90-0.95)]。结论：人工智能辅助CCTA在多种深度学习系统中对冠状动脉狭窄的检测具有较高的灵敏度和可靠的诊断性能。然而，这反映了来自异构模型的聚合结果，而不是任何单个AI工具的能力，限制了对特定系统或供应商的直接推广。

{"title":"Ccta-based AI for Diagnosing ≥ 50 % coronary Stenosis: A patient- and Vessel-Level meta-analysis","authors":"Yiqiao Yan , Xinyuan Zhang , Chuan Liu , Hang Fu , Ke Xu , Huayan Xu","doi":"10.1016/j.ejrad.2025.112634","DOIUrl":"10.1016/j.ejrad.2025.112634","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the diagnostic performance of CCTA-based artificial intelligence (AI) in detecting ≥ 50 % coronary stenosis of coronary artery disease (CAD) at both the patient and vessel levels.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and Web of Science databases (from inception to March 2025) was conducted to identify diagnostic studies evaluating CCTA-based AI methods for detecting CAD. Studies of ≥ 50 % coronary stenosis were enrolled. Data for diagnostic performance was extracted and meta analysis was performed. Statistical analyses were performed using RevMan 5.4, Meta-Disc 1.4, and Stata 16.0. This study was designed and reported following the PRISMA-DTA statement.</div></div><div><h3>Results</h3><div>The systematic search yielded 2,211 potentially relevant records. Following multi-stage screening, 11 eligible studies (1506 patients; 2896 vessels) were included. At the patient level, AI based assistant tools demonstrated pooled sensitivity of 0.95 [95 % CI (0.93–0.97)], specificity of 0.73 [95 % CI (0.61–0.82)], and AUC of 0.96 [95 % CI (0.94–0.97)] for CAD with ≥ 50 % stenosis diagnosis. The positive likelihood ratio (+LR) was 3.5 [95 % CI (2.4–5.2)] and negative likelihood ratio (−LR) was 0.07 [95 % CI (0.05–0.10)], with a pooled DOR of 52 [31–86]. At the vessel level of diagnosing ≥ 50 % stenosis diagnosis, AI-based assistant diagnostic tool showed pooled sensitivity of 0.87 [95 % CI (0.83–0.90)], specificity of 0.89 [95 % CI (0.82–0.93)], +LR of 7.7 [95 % CI (4.8–12.5)], −LR of 0.15 [95 % CI (0.11–0.19)], DOR of 53 [35–79], and AUC of 0.93 [95 % CI (0.90–0.95)].</div></div><div><h3>Conclusion</h3><div>When pooled across diverse deep-learning systems, AI-assisted CCTA demonstrates high sensitivity and solid diagnostic performance for detecting ≥ 50 % coronary stenosis. However, this reflects aggregated results from heterogeneous models rather than the capability of any single AI tool, limiting direct generalizability to specific systems or vendors.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112634"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921116","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

Diagnostic performance of Angio-Based fractional flow for hemodynamic assessment in intracranial Atherosclerosis 基于血管的分数血流在颅内动脉粥样硬化血流动力学评估中的诊断价值

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

European Journal of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112635

Yongsheng Liu , Fengyi Zhang , Guiwen Shao, Yuxiang Liu, Yongjian Liu, Peng Ge, Feng Wang

Objectives

To evaluate the diagnostic performance of Angio-based fractional flow (Angio-FF), a computational fluid dynamics technique, for identifying hemodynamically significant intracranial atherosclerotic stenosis (ICAS) compared with the degree of stenosis (DS).

Materials and methods

This retrospective study included 348 patients with unilateral ICAS. Angio-FF was calculated using AccuFFicas V1.0 software. Diagnostic accuracy, sensitivity, specificity, and area under the ROC curve (AUC) were compared between Angio-FF and DS, stratified by stenosis severity, vascular territory, and Angio-FF gray zone.

Results

Symptomatic lesions exhibited lower Angio-FF (median 0.46 vs. 0.83, P < 0.001) and higher DS (69.5 % vs. 62.5 %, P < 0.001). Angio-FF showed superior AUC (0.884 vs. 0.664, P < 0.001) than DS. Angio-FF, using a cutoff value of 0.69, demonstrated significantly higher sensitivity (81.4 % vs. 50.0 %), specificity (88.9 % vs. 68.9 %), accuracy (83.3 % vs. 54.9 %), positive predictive value (PPV) (95.5 % vs. 82.2 %), and negative predictive value (NPV) (62.5 % vs. 32.5 %) compared to DS (≥ 70 % stenosis) for identifying culprit lesions (P < 0.001). Diagnostic performance was significantly better in anterior circulation lesions than in posterior ones, with higher sensitivity (91.8 % vs. 60.9 %), accuracy (89.5 % vs. 73.1 %), and NPV (73.1 % vs. 55.3 %) (all P < 0.05), while specificity and PPV remained high in both regions. Within the Angio-FF gray zone (0.64–0.74), diagnostic performance was lower than outside the zone, with reduced sensitivity (67.4 % vs. 84.4 %), accuracy (72.4 % vs. 85.5 %), and NPV (42.3 % vs. 67.6 %) (all P < 0.05), yet it still outperformed DS, with a higher AUC (0.795 vs. 0.524, P = 0.003).

Conclusions

Angio-FF outperformed conventional DS assessment in identifying hemodynamically significant ICAS, with particularly high accuracy in lesions with < 70 % stenosis. Despite reduced performance within the gray zone, it remained more reliable than DS.

Abbreviations: ICAS, intracranial atherosclerotic stenosis; TIA, transient ischemic attack; DS, degree of stenosis; FF, fractional flow; Angio-FF, Angio-based fractional flow; CFD, computational fluid dynamics; DSA, digital subtraction angiography; AUC, area under the curve; ROC, receiver operating characteristic; PPV, positive predictive value; NPV, negative predictive value; DCA, decision curve analysis; MCA, middle cerebral artery; BA, basilar artery; VA, vertebral artery; IQR, interquartile range; MRA, magnetic resonance angiography; Pa, proximal arterial pressure; Pd, distal arterial pressure; TIMI, Thrombolysis In Myocardial Infarction.

目的评价基于血管的分数血流（angiobased fractional flow，简称Angio-FF）作为一种计算流体动力学技术，对血流动力学意义显著的颅内动脉粥样硬化性狭窄（ICAS）和狭窄程度（DS）的诊断价值。材料与方法本研究纳入348例单侧ICAS患者。使用AccuFFicas V1.0软件计算血管内皮素水平。通过狭窄严重程度、血管范围和Angio-FF灰色区进行分层，比较了Angio-FF和DS的诊断准确性、敏感性、特异性和ROC曲线下面积（AUC）。结果有症状的病变表现为较低的Angio-FF（中位数0.46比0.83,P < 0.001）和较高的DS（中位数69.5%比62.5%,P < 0.001）。Angio-FF的AUC（0.884比0.664,P < 0.001）优于DS。与DS（狭窄度≥70%）相比，使用截断值0.69的Angio-FF在识别罪魁祸首病变方面表现出更高的敏感性（81.4%比50.0%）、特异性（88.9%比68.9%）、准确性（83.3%比54.9%）、阳性预测值（PPV）（95.5%比82.2%）和阴性预测值（NPV）（62.5%比32.5%）（P < 0.001）。前循环病变的诊断表现明显优于后循环病变，敏感性（91.8%比60.9%）、准确性（89.5%比73.1%）和NPV（73.1%比55.3%）均较高（P < 0.05），特异性和PPV在两个区域均保持较高水平。在Angio-FF灰色区域（0.64-0.74）内，诊断性能低于该区域外，敏感性（67.4% vs. 84.4%）、准确性（72.4% vs. 85.5%）和NPV (42.3% vs. 67.6%)（均P <； 0.05），但仍优于DS， AUC较高（0.795 vs. 0.524, P = 0.003）。结论sangio - ff在识别血流动力学意义显著的ICAS方面优于传统DS评估，在狭窄<； 70%的病变中准确率特别高。尽管在灰色区域内性能下降，但它仍然比DS更可靠。缩写：ICAS，颅内动脉粥样硬化性狭窄；TIA，短暂性脑缺血发作；DS：狭窄程度；FF，分流；Angio-FF，血管分流；计算流体力学；DSA，数字减影血管造影；AUC：曲线下面积；ROC，接收机工作特性；PPV，阳性预测值；NPV，负预测值；DCA，决策曲线分析；MCA，大脑中动脉；BA，基底动脉；VA，椎动脉；IQR，四分位间距；磁共振血管造影；Pa，近端动脉压；Pd，远端动脉压；TIMI，心肌梗死中的溶栓。

{"title":"Diagnostic performance of Angio-Based fractional flow for hemodynamic assessment in intracranial Atherosclerosis","authors":"Yongsheng Liu , Fengyi Zhang , Guiwen Shao, Yuxiang Liu, Yongjian Liu, Peng Ge, Feng Wang","doi":"10.1016/j.ejrad.2025.112635","DOIUrl":"10.1016/j.ejrad.2025.112635","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the diagnostic performance of Angio-based fractional flow (Angio-FF), a computational fluid dynamics technique, for identifying hemodynamically significant intracranial atherosclerotic stenosis (ICAS) compared with the degree of stenosis (DS).</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 348 patients with unilateral ICAS. Angio-FF was calculated using AccuFFicas V1.0 software. Diagnostic accuracy, sensitivity, specificity, and area under the ROC curve (AUC) were compared between Angio-FF and DS, stratified by stenosis severity, vascular territory, and Angio-FF gray zone.</div></div><div><h3>Results</h3><div>Symptomatic lesions exhibited lower Angio-FF (median 0.46 vs. 0.83,P < 0.001) and higher DS (69.5 % vs. 62.5 %,P < 0.001). Angio-FF showed superior AUC (0.884 vs. 0.664,P < 0.001) than DS. Angio-FF, using a cutoff value of 0.69, demonstrated significantly higher sensitivity (81.4 % vs. 50.0 %), specificity (88.9 % vs. 68.9 %), accuracy (83.3 % vs. 54.9 %), positive predictive value (PPV) (95.5 % vs. 82.2 %), and negative predictive value (NPV) (62.5 % vs. 32.5 %) compared to DS (≥ 70 % stenosis) for identifying culprit lesions (P < 0.001). Diagnostic performance was significantly better in anterior circulation lesions than in posterior ones, with higher sensitivity (91.8 % vs. 60.9 %), accuracy (89.5 % vs. 73.1 %), and NPV (73.1 % vs. 55.3 %) (all P < 0.05), while specificity and PPV remained high in both regions. Within the Angio-FF gray zone (0.64–0.74), diagnostic performance was lower than outside the zone, with reduced sensitivity (67.4 % vs. 84.4 %), accuracy (72.4 % vs. 85.5 %), and NPV (42.3 % vs. 67.6 %) (all P < 0.05), yet it still outperformed DS, with a higher AUC (0.795 vs. 0.524, P = 0.003).</div></div><div><h3>Conclusions</h3><div>Angio-FF outperformed conventional DS assessment in identifying hemodynamically significant ICAS, with particularly high accuracy in lesions with < 70 % stenosis. Despite reduced performance within the gray zone, it remained more reliable than DS.</div><div>Abbreviations: ICAS, intracranial atherosclerotic stenosis; TIA, transient ischemic attack; DS, degree of stenosis; FF, fractional flow; Angio-FF, Angio-based fractional flow; CFD, computational fluid dynamics; DSA, digital subtraction angiography; AUC, area under the curve; ROC, receiver operating characteristic; PPV, positive predictive value; NPV, negative predictive value; DCA, decision curve analysis; MCA, middle cerebral artery; BA, basilar artery; VA, vertebral artery; IQR, interquartile range; MRA, magnetic resonance angiography; Pa, proximal arterial pressure; Pd, distal arterial pressure; TIMI, Thrombolysis In Myocardial Infarction.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112635"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880227","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