European Journal of Radiology最新文献_第9页

Brain-tumor interface-based MRI radiomics models to predict Ki-67 proliferation status of meningiomas: A multi-center study 基于脑肿瘤界面的MRI放射组学模型预测脑膜瘤Ki-67增殖状态：一项多中心研究。

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

European Journal of Radiology

Pub Date : 2025-11-25 DOI: 10.1016/j.ejrad.2025.112577

Ping Gao , Jiaxin Wei , Wei Wang , Xiuan Xu

Objective

To evaluate the potential of brain-tumor interface (BTI) radiomics for predicting the Ki-67 proliferation index in meningiomas and to construct and validate a nomogram integrating radiomics with clinical features for this purpose.

Materials and Methods

This multicenter retrospective study enrolled 300 patients from two distinct centers. Patients diagnosed with meningioma were stratified into low (<5%) and high (≥5%) Ki-67 expression groups based on immunohistochemistry. Clinical data were collected, and independent predictors were identified via univariate and multivariate logistic regression analyses. Radiomics features from the tumor parenchyma and the 4 mm BTI region were extracted from T1-CE and T2WI images to construct single-region and combined-region radiomics models. A nomogram integrating the radiomics scores (Radscore) from the optimal radiomics model and clinical predictors was developed and validated.

Results

In the internal validation cohort, the tumor radiomics model achieved an AUC of 0.754, the BTI radiomics model achieved an AUC of 0.702, and the combined Radiomics model performed better with an AUC of 0.780, significantly outperforming both single-region models. In the external test cohort, corresponding AUCs were 0.681 for the tumor radiomics model, 0.682 for the BTI radiomics model, and 0.709 for the combined Radiomics model, again showing the combined model’s superiority. Univariate and multivariate analyses identified tumor volume and maximum diameter as independent clinical predictors of Ki-67 proliferation status. The clinical model incorporating these features reached an AUC of 0.741 in the internal validation cohort and 0.688 in the external test cohort. The nomogram integrating radiomics scores with clinical predictors achieved the highest diagnostic performance (AUC of 0.846 in the internal validation cohort, 0.752 in external test cohort), significantly outperforming all other evaluated models.

Conclusions

The BTI region shows the potential for predicting meningioma Ki-67 proliferation. The nomogram developed in this study provides an effective tool for this prediction, supporting personalized treatment strategies.

目的：评价脑肿瘤界面放射组学（BTI）在脑膜瘤中Ki-67增殖指数预测中的应用潜力，构建并验证将放射组学与临床特征相结合的脑膜瘤影像学图。材料和方法：本多中心回顾性研究纳入了来自两个不同中心的300例患者。结果：在内部验证队列中，肿瘤放射组学模型的AUC为0.754，BTI放射组学模型的AUC为0.702，联合放射组学模型的AUC为0.780，明显优于单区域模型。在外部测试队列中，肿瘤放射组学模型对应的auc为0.681，BTI放射组学模型对应的auc为0.682，联合放射组学模型对应的auc为0.709，再次显示了联合放射组学模型的优越性。单因素和多因素分析发现肿瘤体积和最大直径是Ki-67增殖状态的独立临床预测因子。纳入这些特征的临床模型在内部验证队列中的AUC为0.741，在外部测试队列中的AUC为0.688。将放射组学评分与临床预测因子相结合的nomogram诊断性能最高（内部验证队列的AUC为0.846，外部测试队列的AUC为0.752），显著优于所有其他评估模型。结论：BTI区具有预测脑膜瘤Ki-67增殖的潜力。本研究开发的nomogram为这种预测提供了有效的工具，支持个性化的治疗策略。

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引用次数: 0

Safety and efficacy of Yttrium-90 transarterial radioembolization of neuroendocrine liver metastasis – A retrospective single-institution study 钇-90经动脉放射栓塞治疗神经内分泌肝转移的安全性和有效性-一项回顾性单机构研究。

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

European Journal of Radiology

Pub Date : 2025-11-25 DOI: 10.1016/j.ejrad.2025.112570

Gavin Yuan , Elena N. Petre , Harry Marquis , Adam Kesner , Steven Lundi , Lee Rodriguez , Chaya S. Moskowitz , Charlie White , Ken Zhao , Vlasios Sotirchos , Diane Reidy-Lagunes , Nitya Raj , Etay Ziv , Erica S. Alexander

Purpose

To determine safety and efficacy of Yttrium-90 transarterial radioembolization (TARE) for neuroendocrine liver metastases (NLM).

Materials and Methods

Retrospective analysis of 39 patients [17 male; mean age 65.5 years (SD ± 12.25)] who underwent 57 TARE treatments with glass/resin microspheres from 4/2012–12/2022. Primary site included: pancreas (n = 16), small bowel (n = 7), rectum (n = 4), lung (n = 5), NET of unknown origin (n = 4), colon (n = 1), kidney (n = 1), and stomach (n = 1). Overall survival (OS) and time to ascites development were estimated via Kaplan-Meier method. Cox proportional hazards models assessed association between patient characteristics and OS. Local tumor progression (LTP) was analyzed using a competing risks framework with death without local progression treated as the competing risk. Complications were graded via: Common Terminology Criteria for Adverse Events.

Results

Cumulative incidence of LTP was 45 % (95 % CI: 31 %–59 %) at 1-year among all procedures. Ki-67 index was significantly associated with local progression; tumors with a Ki-67 index of more than 20 % had increased risk of recurrence vs those with Ki-67 ≤20 % (HR = 2.82, 95 % CI (1.24, 6.39); p = 0.013).

Median OS was 31 months (95 %CI: 20-NR). Patients with tumor burden ≥50 % vs <50 % of liver volume had an increased risk of death, though this was not statistically significant (HR = 2.24, 95 %CI (0.92, 5.44); p = 0.075). Two patients (3.5 %, 95 % CI: 0.4 %, 12.1 %) developed complications within 30 days requiring hospitalization: fatigue, nausea, and pain (grade 1); spinal infarct with motor and sensory losses (grade 3).

Conclusion

TARE is safe for NLM. LTP was better in patients with lower Ki-67 index.

目的：探讨经动脉放射栓塞治疗神经内分泌性肝转移瘤（NLM）的安全性和有效性。材料与方法：回顾性分析39例患者[男17例；平均年龄65.5岁（SD±12.25）]，于2012年4月至2022年12月接受了57例玻璃/树脂微球TARE治疗。原发部位包括：胰腺（n = 16）、小肠（n = 7）、直肠（n = 4）、肺（n = 5）、不明来源NET （n = 4）、结肠（n = 1）、肾脏（n = 1）、胃（n = 1）。通过Kaplan-Meier法估计总生存期（OS）和腹水发展时间。Cox比例风险模型评估了患者特征与OS之间的关系。采用竞争风险框架分析局部肿瘤进展（LTP），无局部进展的死亡被视为竞争风险。并发症通过不良事件通用术语标准进行分级。结果：在所有手术中，1年LTP的累积发生率为45% （95% CI: 31% - 59%）。Ki-67指数与局部进展显著相关；Ki-67指数大于20%的肿瘤复发风险高于Ki-67指数≤20%的肿瘤(HR = 2.82, 95% CI (1.24, 6.39)；p = 0.013)。中位OS为31个月（95% CI: 20-NR）。结论：TARE治疗NLM是安全的。Ki-67指数越低，LTP越好。

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引用次数: 0

Virtual non-calcium imaging to detect bone marrow edema in patients with arthritis: a feasibility study with MRI as standard of reference 虚拟非钙成像检测关节炎患者骨髓水肿：以MRI为参考标准的可行性研究

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

European Journal of Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.ejrad.2025.112571

Laura Büttner , Torsten Diekhoff , Katharina Ziegeler , Jürgen Mews , Sarah Ohrndorf , Fabian Proft , Denis Poddubnyy , Sevtap Tugce Ulas

Objective

To evaluate the diagnostic performance of virtual non-calcium (VNCa) imaging derived from dual-energy CT (DECT) for the detection of bone marrow edema (BME) in patients with suspected hand arthritis using magnetic resonance imaging (MRI) as standard of reference.

Materials and methods

In this post-hoc analysis, 68 patients ((50 women) with a mean age of 55 (SD 13.1)) were included. All patients underwent DECT and MRI of the hand. VNCa images were reconstructed using three-material decomposition. Two radiologists scored the VNCa images and MRI datasets in consensus for BME. Specificity, sensitivity, and diagnostic accuracy of VNCa were calculated. The sum score was calculated by adding all region-based BME scores per patient, providing an aggregated measure for correlation with MRI findings.

Results

MRI was positive in 21 patients and VNCa in 15 patients. VNCa achieved a high specificity (96.7 %), moderate sensitivity (61.9 %), and an overall accuracy of 85.3 %. The sum score in VNCa was strongly correlated with MRI (r = 0.77; p < 0.001).

Conclusion

VNCa imaging showed excellent specificity, albeit only moderate sensitivity for detecting BME in patients with suspected hand arthritis. These results underscore the clinical utility of DECT for arthritis imaging, adding to known strengths such as sensitivity for structural damage and ease of acquisition.

目的评价双能CT （DECT）虚拟无钙（VNCa）成像以磁共振成像（MRI）为参比标准对疑似手关节炎患者骨髓水肿（BME）的诊断价值。材料和方法在这项事后分析中，纳入了68例患者（50例女性），平均年龄为55岁（SD 13.1）。所有患者均行手部DECT和MRI检查。采用三材料分解方法重建VNCa图像。两名放射科医生对VNCa图像和MRI数据集进行评分，一致认为BME。计算VNCa的特异性、敏感性和诊断准确性。总得分是通过将每个患者的所有基于区域的BME评分相加来计算的，提供了与MRI结果相关的汇总测量。结果smri阳性21例，VNCa阳性15例。VNCa具有高特异性（96.7%），中等敏感性（61.9%），总体准确率为85.3%。VNCa的总评分与MRI有很强的相关性（r = 0.77; p < 0.001）。结论vnca影像学对疑似手关节炎患者的BME检测具有良好的特异性，但仅为中等敏感性。这些结果强调了DECT在关节炎成像中的临床应用，增加了已知的优势，如对结构损伤的敏感性和易于获取。

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引用次数: 0

Deep learning-reconstructed hepatobiliary MRI: Enhancing biliary delineation, lesion margin sharpness, and small lesion detection 深度学习重建的肝胆MRI：增强胆道的描绘、病变边缘的清晰度和小病变的检测

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

European Journal of Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.ejrad.2025.112574

Haoran Dai , Jili Chen , Kai Liu , Ming Zhang , Caixia Fu , Dominik Nickel , Wei Sun , Bin Feng , Caizhong Chen , Chun Yang , Xuhao Song , Mengsu Zeng

Objective

To evaluate the comparative performance of a deep learning-reconstructed T1-weighted volumetric interpolated breath-hold examination (DL VIBE) on hepatobiliary phase MRI against the conventional T1 VIBE in biliary tree visualization, lesion detection, and artifact suppression.

Materials and methods

This retrospective study included 94 patients with suspected hepatic lesions (145 lesions, March-May 2025). All underwent gadoxetic acid-enhanced MRI at hepatobiliary phase using DL-VIBE (1.5 mm slice thickness) and conventional VIBE (3.0 mm). Blinded evaluations assessed biliary anatomy, lesion margins, and image quality through quantitative metrics (edge rise distance [ERD], CNR) and qualitative scoring.

Results

DL-VIBE demonstrated superior biliary visualization with 163 % higher tertiary duct detection (2.45 vs. 0.93 branches, p < 0.001) and improved continuity scores (2.97 vs. 2.60, p < 0.001). Lesion margins showed significantly improved sharpness (ERD: 0.93 ± 0.50 mm vs. 1.51 ± 0.10 mm; P < 0.001), while lesion detection rates were significantly higher overall (97.2 % vs. 91.0 %; P = 0.005) and particularly for micro lesions (96.3 % vs. 87.6 %; P = 0.004). DL-VIBE reduced image noise (3.82 vs. 2.25, p < 0.001) and suppressed ringing artifacts (3.55 vs. 2.30, p < 0.001) while maintaining bile duct CNR gains (230.50 vs. 135.14, p < 0.001), though with marginally lower texture naturalness (2.85 vs. 3.45, p = 0.001).

Conclusion

DL-VIBE improves biliary microanatomy delineation, lesion margin resolution, and small lesion detection in gadoxetic acid-enhanced hepatobiliary MRI, suggesting clinical utility for precision imaging within standard breath-hold durations.

Clinical relevance statement

DL-reconstructed 1.5-mm HBP VIBE serves as an improved alternative to conventional 3-mm VIBE, offering enhanced tertiary bile duct visualization and subcentimeter lesion detection for better clinical decision-making.

目的评价深度学习重建的T1加权容积内插式憋气检查（DL VIBE）在肝胆期MRI上与常规T1 VIBE在胆道树显示、病变检测和伪影抑制方面的比较性能。材料与方法回顾性研究94例疑似肝脏病变患者（145个病变，时间：2025年3月- 5月）。所有患者均在肝胆期行加多etic酸增强MRI，采用DL-VIBE （1.5 mm切片厚度）和常规VIBE （3.0 mm）。盲法评估通过定量指标（边缘上升距离[ERD]、CNR）和定性评分来评估胆道解剖、病变边缘和图像质量。结果dl - vibe显示出更优越的胆道显像，三级胆管检出率提高163%(2.45比0.93支，p < 0.001)，连续性评分提高（2.97比2.60,p < 0.001）。病变边缘的清晰度明显提高（ERD: 0.93±0.50 mm vs. 1.51±0.10 mm; P < 0.001），病变检出率总体上明显提高（97.2% vs. 91.0%; P = 0.005），特别是微病变（96.3% vs. 87.6%; P = 0.004）。DL-VIBE降低了图像噪声（3.82 vs. 2.25, p < 0.001）并抑制了环形伪影（3.55 vs. 2.30, p < 0.001），同时保持了胆管CNR增益（230.50 vs. 135.14, p < 0.001），尽管纹理自然度略低（2.85 vs. 3.45, p = 0.001）。结论dl - vibe改善了加多etic酸增强肝胆MRI的胆道显微解剖描绘、病变边缘分辨率和小病变检测，提示在标准憋气时间内进行精确成像的临床应用。临床相关性声明dl重建的1.5 mm HBP VIBE可作为传统3-mm VIBE的改进替代方案，提供增强的三级胆管可视化和亚厘米病变检测，以更好地进行临床决策。

{"title":"Deep learning-reconstructed hepatobiliary MRI: Enhancing biliary delineation, lesion margin sharpness, and small lesion detection","authors":"Haoran Dai , Jili Chen , Kai Liu , Ming Zhang , Caixia Fu , Dominik Nickel , Wei Sun , Bin Feng , Caizhong Chen , Chun Yang , Xuhao Song , Mengsu Zeng","doi":"10.1016/j.ejrad.2025.112574","DOIUrl":"10.1016/j.ejrad.2025.112574","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the comparative performance of a deep learning-reconstructed T1-weighted volumetric interpolated breath-hold examination (DL VIBE) on hepatobiliary phase MRI against the conventional T1 VIBE in biliary tree visualization, lesion detection, and artifact suppression.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 94 patients with suspected hepatic lesions (145 lesions, March-May 2025). All underwent gadoxetic acid-enhanced MRI at hepatobiliary phase using DL-VIBE (1.5 mm slice thickness) and conventional VIBE (3.0 mm). Blinded evaluations assessed biliary anatomy, lesion margins, and image quality through quantitative metrics (edge rise distance [ERD], CNR) and qualitative scoring.</div></div><div><h3>Results</h3><div>DL-VIBE demonstrated superior biliary visualization with 163 % higher tertiary duct detection (2.45 vs. 0.93 branches, p < 0.001) and improved continuity scores (2.97 vs. 2.60, p < 0.001). Lesion margins showed significantly improved sharpness (ERD: 0.93 ± 0.50 mm vs. 1.51 ± 0.10 mm; <em>P</em> < 0.001), while lesion detection rates were significantly higher overall (97.2 % vs. 91.0 %; <em>P</em> = 0.005) and particularly for micro lesions (96.3 % vs. 87.6 %; <em>P</em> = 0.004). DL-VIBE reduced image noise (3.82 vs. 2.25, p < 0.001) and suppressed ringing artifacts (3.55 vs. 2.30, p < 0.001) while maintaining bile duct CNR gains (230.50 vs. 135.14, p < 0.001), though with marginally lower texture naturalness (2.85 vs. 3.45, p = 0.001).</div></div><div><h3>Conclusion</h3><div>DL-VIBE improves biliary microanatomy delineation, lesion margin resolution, and small lesion detection in gadoxetic acid-enhanced hepatobiliary MRI, suggesting clinical utility for precision imaging within standard breath-hold durations.</div></div><div><h3>Clinical relevance statement</h3><div>DL-reconstructed 1.5-mm HBP VIBE serves as an improved alternative to conventional 3-mm VIBE, offering enhanced tertiary bile duct visualization and subcentimeter lesion detection for better clinical decision-making.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112574"},"PeriodicalIF":3.3,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622728","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 the TARGET score for MRI-based detection of prostate cancer recurrence in patients treated with HIFU hemiablation HIFU半消融术患者前列腺癌复发mri检测的TARGET评分评价

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

European Journal of Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.ejrad.2025.112572

Constantin Ehrengut , Nilüfer Deniz Alberalar , Toni Franz , Lars-Christian Horn , Andreas Blana , Boris Hadaschik , Jens-Uwe Stolzenburg , Heinz Peter Schlemmer , Sebastian Ebel , Timm°Denecke , Roman Ganzer , Alexander Schaudinn

Purpose

To evaluate diagnostic performance and inter-reader agreement of the Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET).

Methods

This retrospective, multi-center study included patients who underwent high-intensity focused ultrasound (HIFU) hemiablation for localized prostate cancer (PCa), with follow-up multiparametric MRI (mpMRI) at 12 months and subsequent biopsy (reference standard). Three radiologists independently assessed the mpMRIs using the TARGET score (treated prostate side) and the PI-RADS score (v2.1, untreated side). Diagnostic performance metrics and area under the receiver operating characteristic curves (AUC) were computed for any-/clinically significant-PCa (cs-PCa) and two scoring thresholds (3 vs. 4). Inter-reader-agreement was analyzed using Fleiss к.

Results

Of all 40 patients included, 23 had biopsy-proven recurrent PCa in 26 lesions, with seven lesions harboring cs-PCa (5/7 on the treated side). TARGET showed moderate to high sensitivity (Reader 1–3: 60–100 %), high NPV (91–100 %) but lower specificity (54–69 %) and PPV (16–27 %) in the detection of cs-PCa, given a scoring threshold of ≥ 3. The diagnostic performance for cs-PCa (AUC: 0.57–0.79) exceeded that of any-PCa (0.54–0.64). PI-RADS showed an overall moderate efficacy in any-/cs-PCa-detection (untreated prostate side, AUC: 0.52–0.60). Overall inter-reader agreement was moderate (TARGET к = 0.60–0.64, PI-RADS к = 0.54–0.55).

Conclusions

The strength of the TARGET score was its high NPV, implying its potential to rule out cs-PCa. However, the moderate sensitivity and specificity, low PPV and moderate inter-reader agreement indicate a limited reliability of TARGET to consistently identify cs-PCa recurrence. The generalizability of these findings is restricted by the overall small sample size.

目的评价《跨大西洋前列腺病灶治疗后MRI评估指南》（TARGET）的诊断效果和读者间一致性。方法本研究是一项回顾性、多中心研究，纳入了接受高强度聚焦超声（HIFU）半消融术治疗局限性前列腺癌（PCa）的患者，随访12个月后进行多参数MRI （mpMRI）检查和活检（参考标准）。三位放射科医生使用TARGET评分（前列腺治疗侧）和PI-RADS评分（v2.1，未治疗侧）独立评估mpmri。对任意/临床显著性pca （cs-PCa）和两个评分阈值（3 vs. 4）计算诊断性能指标和受试者工作特征曲线下面积（AUC）。用fliss分析了读者间一致性。结果在所有40例患者中，23例在26个病变中活检证实复发性PCa，其中7个病变含有cs-PCa（5/7在治疗侧）。TARGET在cs-PCa检测中表现出中高灵敏度（Reader 1-3: 60 - 100%），高NPV(91 - 100%)，但较低的特异性（54 - 69%）和PPV(16 - 27%)，评分阈值≥3。cs-PCa的诊断效能（AUC: 0.57 ~ 0.79）高于any-PCa（0.54 ~ 0.64）。PI-RADS在任何-/cs- pca检测中显示总体中等疗效（未经治疗的前列腺侧，AUC: 0.52-0.60）。总体读者间一致性为中等（TARGET = 0.60-0.64, PI-RADS = 0.54-0.55）。结论TARGET评分的优势在于其较高的净现值，这意味着它有可能排除cs-PCa。然而，中等的敏感性和特异性、较低的PPV和中等的解读间一致性表明，TARGET在一致识别cs-PCa复发方面的可靠性有限。这些发现的普遍性受到总体样本量小的限制。

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引用次数: 0

T1-weighted subtraction maps improve the detection of contrast-enhancing lesions in multiple sclerosis t1加权减影图提高了多发性硬化症增强病变的检出率。

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

European Journal of Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.ejrad.2025.112576

Mirjam Beyrle , Dominik Sepp , Paul Eichinger , Mark Mühlau , Achim Berthele , Christina Engl , Bernhard Hemmer , Claus Zimmer , Benedikt Wiestler , Jan S. Kirschke , Olivia Kertels

In multiple sclerosis (MS), detection of contrast-enhancing lesions (T1c + L) by magnetic resonance imaging (MRI) provides valuable information for initial diagnosis and supports monitoring of acute disease activity. We investigated the added value of subtraction maps from T1-weighted images (T1_sub) for correctly detecting T1c + L.

Methods

Magnetic resonance images of 555 scans in 286 MS patients were normalized into [0;1] range and co-registered for T1_sub calculation. Ground truth (GT) assessment of T1c + L was established through consensus readings using all available sequences, particularly T1_sub images. Detection accuracy was compared to GT by three independent neuroradiologists, one with and two without available T1_sub.

Results

GT identified 1109 T1c + L, of which 1037 were detected with subtraction maps. Without subtraction maps, approximately half of these lesions were missed. Lesions overlooked without T1_sub were smaller, less hyperintense in post-contrast scans, and more frequently located infratentorial. Without T1_sub, about one contrast-enhancing lesion remained undetected per scan; however, including T1_sub reduced the relative risk of missing a lesion by nearly 80 %. Furthermore, almost a third of examinations were falsely interpreted as free of any T1c + L. In contrast, by T1_sub implementation, the proportion of inconspicuous reports was reduced by nearly 90 %.

Conclusion

In a clinically meaningful way, subtraction maps improve detection of contrast-enhancing MS lesions, particularly when smaller, less intense, and infratentorial.

在多发性硬化症（MS）中，通过磁共振成像（MRI）检测对比增强病变（T1c + L）为初步诊断提供了有价值的信息，并支持监测急性疾病活动。我们研究了t1加权图像（t1 - sub）的减法图对正确检测T1c + l的附加价值。方法：将286例MS患者555次扫描的磁共振图像归一化为[0；1]范围，并共同注册用于T1_sub计算。T1c + L的Ground truth （GT）评估是通过使用所有可用序列，特别是T1_sub图像的共识读数建立的。检测精度由三名独立的神经放射学家与GT进行比较，其中一名有t1 - sub，两名没有t1 - sub。结果：GT检出T1c + L 1109例，其中减法图谱检出1037例。如果没有减法图，大约一半的病变被遗漏。没有t1 - sub而被忽视的病变在造影后扫描中更小，低强度，更常位于幕下。如果没有t1 - sub，每次扫描约有一个增强病灶未被发现；然而，包括t1 - sub可将缺失病变的相对风险降低近80%。此外，几乎三分之一的检查被错误地解释为没有任何T1c + l。相比之下，通过实施T1_sub，不明显报告的比例减少了近90%。结论：减影图提高了对比增强MS病变的检测，特别是当MS病变更小、强度更低和幕下病变时，减影图具有临床意义。

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引用次数: 0

Superselective embolization of the medial calcaneal artery: a minimally invasive and novel solution for rapid pain relief in plantar fasciitis 超选择性跟内侧动脉栓塞：一种快速缓解足底筋膜炎疼痛的微创新方法

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

European Journal of Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.ejrad.2025.112573

Mehmet Tonkaz , Tumay Bekci

Purpose

This study evaluated the efficacy and safety of superselective embolization of the medial calcaneal artery using imipenem/cilastatin in patients with chronic, treatment-resistant plantar fasciitis.

Materials and methods

In this single-center prospective study, 32 patients (17 females, 15 males; mean age: 47.3 ± 9.1 years) with chronic plantar fasciitis unresponsive to conservative treatments underwent superselective embolization of the medial calcaneal artery using imipenem/cilastatin. In 31 patients (96.9 %), the target artery originated from the posterior tibial artery or lateral plantar artery; in one patient (3.1 %), it originated from the peroneal artery due to anatomical variations. Pain severity was assessed using the Visual Analog Scale (VAS), functional status with the Foot Function Index (FFI), and plantar fascia thickness using ultrasound imaging. Technical success, complications, and recurrence were recorded.

Results

All procedures were technically successful, with no major or minor complications. The mean VAS score decreased from 7.3 ± 0.7 at baseline to 1.3 ± 0.5 at six months (p < 0.001), while the mean FFI score improved from 55.5 ± 4.9 to 20.4 ± 6.3 (p < 0.001). Plantar fascia thickness decreased from 5.2 ± 0.6 mm to 3.7 ± 0.3 mm at six months (p < 0.001). Minimal recurrence was observed in five patients (15.6 %) with physically demanding occupations and orthopedic heel insoles were recommended; however, no repeat embolization was required.

Conclusion

Superselective embolization of the medial calcaneal artery using imipenem/cilastatin represents a novel, safe, and minimally invasive strategy for rapid and sustained pain relief in patients with chronic plantar fasciitis.

目的：本研究评价亚胺培南/西司他汀超选择性栓塞跟内侧动脉治疗慢性难治性足底筋膜炎的疗效和安全性。材料和方法在这项单中心前瞻性研究中，32例慢性足底筋膜炎患者（女性17例，男性15例，平均年龄：47.3±9.1岁）采用亚胺培南/西司他汀超选择性栓塞跟内侧动脉。31例（96.9%）患者的靶动脉起源于胫骨后动脉或足底外侧动脉；在1例（3.1%）患者中，由于解剖变异，它起源于腓动脉。采用视觉模拟量表（VAS）评估疼痛严重程度，采用足功能指数（FFI）评估功能状态，采用超声成像评估足底筋膜厚度。记录手术成功、并发症和复发率。结果所有手术技术成功，无大、小并发症。平均VAS评分从基线时的7.3±0.7下降到6个月时的1.3±0.5 (p < 0.001)，而平均FFI评分从55.5±4.9提高到20.4±6.3 （p < 0.001）。6个月时足底筋膜厚度由5.2±0.6 mm降至3.7±0.3 mm （p < 0.001）。5例患者（15.6%）在体力要求高的职业中观察到最小的复发，并建议使用矫形鞋垫；然而，不需要重复栓塞。结论：亚胺培南/西司他汀超选择性栓塞跟内侧动脉是一种新颖、安全、微创的治疗慢性足底筋膜炎的方法。

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引用次数: 0

MR imaging with 15-channel dental coil compared with standard 20-channel coil in patients with head and neck tumours and suspected bone invasion 头颈部肿瘤疑似骨侵犯患者使用15通道牙圈与标准20通道牙圈的磁共振成像比较

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

European Journal of Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.ejrad.2025.112575

Iris Burck , Xinyi Liu , Scherwin Mahmoudi , Jan-Erik Scholtz , Neelam Lingwal , Simon Martin , Vitali Koch , Maximilian Fleischmann , Jennifer Gotta , Ria Winkelmann , Philipp Thoenissen , Timo Stöver , Thomas J. Vogl , Daniel Pinto dos Santos

Purpose

To compare the diagnostic accuracy of a 15-channel dental coil with that of a standard 20-channel coil in the evaluation of head and neck tumours with suspected bone invasion.

Methods and Materials

A total of 40 patients (18 females, mean age 67.0 ± 15.1 years) with head and neck cancer and clinical suspicion of bone invasion underwent MRI using both coils. Two radiologists retrospectively evaluated the images for signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), subjectively for bone infiltration, image quality, metal artefacts and tumour delineation using a 5-point grading scale. The sensitivity and specificity of both coils in detecting bone invasion were calculated in histopathological correlation. Interobserver agreement was assessed using Cohen’s kappa.

Results

SNR and CNR values of tumours were significantly higher with the 15-channel coil (SNR: 12.1 vs. 9.9; CNR: 3.6 vs. 1.5). The 15-channel coil was superior in image quality, metal artifacts, lesion delineation, and assessment of bone infiltration. Interobserver agreement was very good for bone infiltration assessment, overall image quality and artefact reduction, and substantial for lesion delineation. The 15-channel coil was found to be more sensitive (100% vs. 76%) and more specific (97% vs. 82%) in detecting bone invasion. Twenty-three histopathologically confirmed tumours with bone invasion were correctly detected with the 15-channel coil, whereas sixteen were detected with the standard coil.

Conclusions

MRI with the 15-channel coil provides significantly better image quality and accuracy in the assessment of head and neck cancer, particularly in cases of bone invasion, compared with the standard coil.

Clinical Relevance Statement

The use of a 15-channel coil enhances diagnostic accuracy in the detection and characterization of head and neck cancer especially regarding bone infiltration and contributes to more individualized cancer treatment.

目的比较15通道牙线圈与标准20通道牙线圈对疑似骨侵犯的头颈部肿瘤的诊断准确性。方法与材料对40例临床怀疑有骨侵犯的头颈癌患者（女性18例，平均年龄67.0±15.1岁）行双线圈MRI检查。两名放射科医生回顾性评估图像的信噪比（SNR）和对比噪声比（CNR），主观上评估骨浸润、图像质量、金属伪影和肿瘤描绘，采用5分制评分。通过组织病理学相关性计算两种线圈检测骨侵犯的敏感性和特异性。观察员间协议使用Cohen的kappa进行评估。结果15通道线圈组肿瘤的SNR和CNR值明显高于15通道线圈组（SNR: 12.1 vs. 9.9; CNR: 3.6 vs. 1.5）。15通道线圈在图像质量，金属伪影，病变描绘和骨浸润评估方面具有优势。观察者之间的一致性对于骨浸润评估、整体图像质量和伪影减少以及病变描绘都非常好。发现15通道线圈在检测骨侵犯方面更敏感（100%对76%），更特异（97%对82%）。15通道线圈正确检测到23例组织病理学证实的骨浸润肿瘤，而标准线圈检测到16例。结论与标准线圈相比，带有15通道线圈的smri在评估头颈癌，特别是骨侵犯的情况下提供了更好的图像质量和准确性。临床相关性声明15通道线圈的使用提高了头颈癌的诊断准确性，特别是在骨浸润方面，有助于更个性化的癌症治疗。

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引用次数: 0

Timing of MRI for early treatment response prediction of chemoradiotherapy in uterine cervical cancer MRI对宫颈癌放化疗早期疗效预测的时机

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

European Journal of Radiology

Pub Date : 2025-11-23 DOI: 10.1016/j.ejrad.2025.112566

Susanne Fridsten , Kristina Hellman , Anders Sundin , Lennart Nedar

Aim

To explore the optimal use of MRI including time point to predict early treatment response during definitive chemoradiotherapy in cervical carcinoma.

Methods

Pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) scheduled for chemoradiotherapy. All patients underwent four MRI examinations (at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment start). Maximum tumor size, size change (Δsize), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) mean and change in ADC (ΔADC) at the different time points were recorded.

Results

7/15 patients relapsed during the study period, referred to as “poor prognosis” (PP) and the remaining 8/15 are referred to as “good prognosis” (GP). At all four time points, the tumors in the PP patients were larger than in the GP patients. Tumor size did change between the time point but this was not significant between the groups. Visible tumor on high b-value DWI reached a sensitivity and specificity for predicting prognostic group being highest at 5 weeks, 83 % (5/6) and 63 % (5/8), respectively. The combination of tumor size at baseline and visible tumor on DWI at 5 weeks, resulted in an area under the curve (AUC) = 0.83. At 12 weeks, no GP patients, but 2/7 PP patients showed visible tumor on DWI. Addition of ADC-values in the analysis did not improve the predictive value at any time point.

Conclusion

This pilot study indicates that the tumor size on baseline MRI, combined with tumor visibility on DWI at 5 weeks, may predict outcome of chemoradiotherapy.

目的探讨包括时间点在内的MRI在宫颈癌晚期放化疗早期疗效预测中的最佳应用。方法选取15例计划放化疗的IIB-IIIB期宫颈癌患者（FIGO 2009）为研究对象。所有患者均接受4次MRI检查（治疗开始后基线、3周、5周和12周）。记录不同时间点最大肿瘤大小、大小变化（Δsize）、扩散加权成像（DWI）可见性、表观扩散系数（ADC）平均值及ADC变化（ΔADC）。结果7/15例患者在研究期间复发，称为“预后差”（PP），其余8/15例称为“预后好”（GP）。在所有四个时间点，PP患者的肿瘤均大于GP患者。肿瘤大小在不同时间点之间确实发生了变化，但这在两组之间并不显著。高b值DWI可见肿瘤预测预后组的敏感性和特异性在5周时最高，分别为83%（5/6）和63%（5/8）。结合基线时肿瘤大小和5周时DWI可见肿瘤，曲线下面积(AUC) = 0.83。12周时，无GP患者，但2/7 PP患者在DWI上可见肿瘤。在分析中加入adc值并没有提高任何时间点的预测值。结论本初步研究表明，基线MRI上的肿瘤大小，结合5周DWI上的肿瘤可见性，可以预测放化疗的结果。

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引用次数: 0

Knowledge-guided gadolinium-free MRI radiomics predict 1p/19q co-deletion in IDH-mutant adult-type diffuse gliomas: A dual-center study 知识引导的无钆MRI放射组学预测idh突变成人型弥漫性胶质瘤的1p/19q共缺失：一项双中心研究

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

European Journal of Radiology

Pub Date : 2025-11-22 DOI: 10.1016/j.ejrad.2025.112569

Wenle He , Liting Chen , Xi Leng , Xiaole Fan , Chunhong Qin

Purpose

By integrating visual knowledge into radiomics, we aim to develop an interpretable and robust radiomic model based on Gadolinium-free MRI for preoperative identification of 1p/19q co-deletion in IDH-mutant adult-type diffuse gliomas.

Materials and methods

MRI from 215 surgically confirmed IDH-mutant Adult-type Diffuse Glioma patients were collected from two centers and split into training, internal and external validation set. For knowledge-guided radiomics, features driven from T1WI, T2WI, and FLAIR demonstrating high interreader stability were extracted from the training set. Features significantly associated with four visual features (T2-FLAIR mismatch, homogeneity, enhancement, and calcification) were identified, and hierarchical clustering and Max-Relevance and Min-Redundancy were used to eliminate multicollinearity and redundancy. Stability selection using Lasso was performed for robust feature selection. Two classifiers (Support Vector Machines and Extreme Gradient Boosting) were trained with nested cross-validation for 1p/19q co-deletion prediction. For comparison, regular radiomic models without visual guidance were developed to evaluate the superiority of the knowledge-guided radiomics. This retrospective study was approved by the institutional review board of the centers and the requirement for informed consent was waived.

Results

The knowledge-guided Support Vector Machines model achieved AUCs of 0.893 (95 %CI: 0.859–0.928) and 0.839 (95 % CI: 0.794–0.885) in the internal and external validation sets. The two regular radiomics models demonstrated various performance degradation, especially in the external set (AUCs: 0.681–0.767). The knowledge-guided radiomics model of either classifier outperformed corresponding regular radiomics across most performance metrics (p < 0.01) in the validation sets.

Conclusions

The knowledge-guided radiomic framework improves preoperative prediction of 1p/19q co-deletion in IDH-mutant adult-type diffuse gliomas, offering enhanced model interpretability and cross-center generalizability.

目的通过将视觉知识整合到放射组学中，我们旨在建立一个基于无钆MRI的可解释且稳健的放射组学模型，用于idh突变成人型弥漫性胶质瘤的1p/19q共缺失的术前识别。材料和方法收集来自两个中心的215例手术确诊的idh突变成人型弥漫性胶质瘤患者的smri，分为训练组、内部验证组和外部验证组。对于知识引导的放射组学，从训练集中提取具有高解读器稳定性的T1WI， T2WI和FLAIR驱动的特征。识别出与四种视觉特征（T2-FLAIR不匹配、均匀性、增强和钙化）显著相关的特征，并使用分层聚类和最大相关性和最小冗余来消除多重共线性和冗余。利用Lasso进行稳定性选择，实现鲁棒性特征选择。两个分类器（支持向量机和极端梯度增强）使用嵌套交叉验证进行1p/19q共缺失预测。为了比较，我们开发了没有视觉引导的规则放射组学模型来评估知识引导放射组学的优越性。这项回顾性研究得到了中心机构审查委员会的批准，并免除了知情同意的要求。结果知识引导的支持向量机模型在内部和外部验证集中的auc分别为0.893 （95% CI: 0.859 ~ 0.928）和0.839 （95% CI: 0.794 ~ 0.885）。两种常规放射组学模型表现出不同程度的性能下降，特别是在外部组（auc: 0.681-0.767）。在验证集中，任一分类器的知识引导放射组学模型在大多数性能指标上都优于相应的常规放射组学（p < 0.01）。结论知识引导的放射学框架提高了idh突变成人型弥漫性胶质瘤1p/19q共缺失的术前预测，提高了模型的可解释性和跨中心的通用性。

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引用次数: 0