Journal of Computer Assisted Tomography最新文献

Objectives: To evaluate the feasibility of generating high-resolution CT-like bone images from shoulder 3D-VIBE CAIPIRINHA Dixon MRI using vendor-independent deep-learning reconstruction.

Methods: This IRB-approved retrospective study included patients who underwent shoulder MRI and CT between January 2023 and 2024. MRI was performed on a 3.0-T system with a dedicated coil. Patients with study dates >6 months apart or poor image quality were excluded. A 3D multiecho VIBE CAIPIRINHA-Dixon sequence was postprocessed with a DL-based tool. In-phase and opposed-phase images before (Ori-In, Ori-Op) and after DL processing (DL-In, DL-Op) were evaluated by 2 musculoskeletal radiologists for pathology, anatomic visibility, artifacts, and glenoid dimensions, using a Likert scale. CT served as the gold standard. Relative contrast-to-noise (rCNR) and signal-to-noise ratios (rSNR) were assessed by radiologists and a computer scientist. Statistical tests included Friedman, Wilcoxon Rank, Kruskal-Wallis, and intraclass correlation coefficients.

Results: Ninety-nine patients (52 males, 47 females; age range: 17-87) were included. Cortical visibility score of humerus was significantly higher in DL-Op [median value: 2.75, interquartile range (IQR): 1.5 to 3.5 than Ori: 2 (1.5 to 2.44), P<0.001]. Trabecular score was higher on DL-In and Op (2.63 and 2.75) than Ori (2, P<0.001). DL-In images had the minimal artifacts [2 (1.5 to 2.38)] with the best rSNR (humerus: 110.82; glenoid: 92.14) and rCNR (humerus: 39.45; glenoid: 21.40). Ori-In underestimated longitudinal diameter compared with CT (P=0.046); transverse diameters were similar across sequences. The median DL-in and DL-op scores of rotator cuff calcification were 2.38 (IQR: 2.5 to 3.06) and 2.25 (2.06 to 2.94), significantly higher compared with the 1.25 (1 to 2.75) of fat-saturated T2WI. Inter-reader agreement ranged from 0.62 to 0.82 (P<0.001).

Conclusions: DL-3D-VIBE CAIPIRINHA Dixon MRI can generate high-quality CT-like images of shoulder joint, providing a potential for a radiation-free bone imaging.

Objectives: This study aims to evaluate various large language models (LLMs) for their effectiveness in answering Japan Radiology Board Examination (JRBE).

Materials and methods: A total of 315 examination questions from 2021 to 2023 JRBE were administered to 14 LLMs, comprising 7 open-source and 7 closed-source models. Each model processed the questions in their original Japanese language and after translating them into English by LLMs themselves. Performance metrics, including median scores, interquartile ranges (IQR), P-values, and correlation coefficients, were analyzed using Python.

Results: Closed-source models achieved a higher median correct response rate of 44.28% (IQR: 32.38%-53.02%) compared with open-source models at 29.52% (IQR: 24.76%-36.67%), exhibiting a 50.2% improvement (P < 0.001). Translating questions to English improved performance, with median scores increasing from 33.02% (IQR: 27.86%-43.65%) to 40.00% (IQR: 27.54%-46.27%), representing a 21.1% increase (P = 0.005). A positive correlation was observed between the cost per 1M tokens and accuracy (Japanese: r = 0.623, P = 0.017; English: r = 0.613, P = 0.020). No significant correlation was found between model release dates and performance. Only the high-cost closed-source models, GPT-4 and Claude-3-Opus, surpassed the 60% passing threshold by Japanese Medical Specialty Board when using English translation. Among open-source models, LLama-3-70B demonstrated notable performance improvements compared with its predecessors.

Conclusions: Closed-source, high-end LLMs exhibit superior performance in JRBE, and translating questions into English by themselves further enhances their accuracy. There is a significant positive correlation between the cost of LLMs and their performance, whereas the release date does not significantly influence their performance.

Objectives: At present, the study of bronchiolar adenoma (BA) mainly focuses on its pathologic characteristics, but there is limited understanding of its clinical manifestations and imaging signs. This article aims to summarize the clinical manifestations and imaging features of 80 cases of BA, with the goal of achieving a comprehensive and systematic understanding of BA.

Materials and methods: We retrospectively analyzed 80 patients with BA confirmed by surgical pathology in our hospital. All subjects underwent thin-slice CT examination. The basic information, tumor history, clinical manifestations, and CT imaging features of the lesions were collected. The subjects' age, maximum diameter of BA, and shortest distance from the pleura were analyzed by t -test or 1-way ANOVA, while other clinical and radiologic characteristics were compared for differences among different BA types by the χ 2 test or Fisher exact probability method.

Results: The majority of the 80 patients were female, with an average age of 59.08±10.16 years. The majority of them do not manifest any clinical symptoms. All lesions are located in the subpleural area, including 63 cases in the lower lobe of the lungs. The average size of the tumors was 10.31±5.01 mm. The majority of the lesions exhibited irregular morphology (53 cases, 66.25%) and predominantly comprised solid nodules (46 cases, 57.50%). There were statistically significant differences in lesion morphology, boundary, and pseudocavity among pure ground-glass nodular BA, mixed ground-glass nodular BA, and solid density nodular BA. Compared with pure ground-glass density BA (1 case, 1.25%) and mixed ground-glass density BA (7 cases, 8.75%), the boundary of solid nodules BA (42 cases, 52.50%) was significantly clearer ( P <0.001). The presence of pseudocavity was found to be significantly higher in individuals with solid nodules compared with those with pure ground-glass nodules ( P <0.0167). Compared with BA without pseudocavity, BA with pseudocavity exhibited a clearer lung interface ( P <0.001), more abnormal vessel signs ( P =0.007), and a higher incidence of malignant preoperative diagnosis ( P =0.020).

Conclusions: BA mostly occurs in middle-aged and elderly women without any clinical symptoms. The imaging manifestations of BA are diverse, mainly presenting as irregular solid nodules. The interface between the tumor and lung is clear, and pseudocavity formation is common. In addition, BA with pseudocavity often exhibits abnormal vascular signs, which can lead to misdiagnosis as malignancy before surgery.

Objectives: This study aimed to develop a multiregional radiomics-based model using multisequence MRI to predict microvascular invasion in hepatocellular carcinoma.

Methods: We enrolled 141 patients with hepatocellular carcinoma, including 61 with microvascular invasion, who were diagnosed between March 2017 and July 2022. Clinical data were compared using the Wilcoxon rank-sum test or χ 2 test. Patients were randomly divided into training (n=112, 80%) and test (n=29, 20%) data sets. Four MRI sequences-including T2-weighted imaging, T2-weighted imaging with fat suppression, arterial phase-contrast enhancement, and portal venous phase contrast enhancement-were used to build the radiomics model. The tumor volumes of interest were manually delineated, and the expand-5 mm and expand-10 mm volumes of interest were automatically generated. A total of 1409 radiomic features were extracted from each volume of interest. Feature selection was performed using the least absolute shrinkage and selection operator and Spearman correlation analysis. Three logistic regression models (Tumor, Tumor-Expand5, and Tumor-Expand10) were established based on the radiomic features. Model performance was assessed using receiver operating characteristic analysis and Delong's test.

Results: Maximum tumor diameter, hepatitis B virus DNA, and aspartate aminotransferase levels were significantly different between the groups. The Tumor-Expand5mm model exhibited the best performance among the 3 models, with areas under the curve of 0.90 and 0.84 in the training and test data sets.

Conclusions: The Tumor-Expand5 model based on multisequence MRI shows great potential for predicting microvascular invasion in patients with hepatocellular carcinoma, and may further contribute to personal clinical decision-making.

Objective: This study aimed to compare computed tomography (CT)/magnetic resonance imaging (MRI) characteristics of acute pancreatitis (AP) between patients with cholecystectomy and non-cholecystectomy and to validate the effect of prior cholecystectomy on the severity of subsequent pancreatitis.

Methods: This retrospective study included 384 inpatients with AP at our hospital from January 1, 2020 to December 31, 2023. Based on their history of cholecystectomy, the patients were split into cholecystectomy and non-cholecystectomy groups. propensity score matching was applied, considering age and sex, in a 1:3 ratio. Demographic, clinical, laboratory, and CT/MRI parameters of each group were analyzed.

Results: There were 200 (52.1%) males and 184 (47.9%) females, with a mean age of 53.55 ± 13.86 years (range: 18-98 y). Ninety-six patients were in the cholecystectomy group that had previously undergone cholecystectomy, and 288 in the non-cholecystectomy group. Creatinine and C-reactive protein levels were lower in the patients with cholecystectomy than in patients with non-cholecystectomy ( P 1 = 0.001, P 2 = 0.049). In the prevalence of biliary pancreatitis, the cholecystectomy patients are 27.1%, whereas the non-cholecystectomy patients are 45.8% ( P = 0.005). The non-cholecystectomy patients had a significantly higher mean CT/MRI severity index score (3.57 ± 1.72 points) than the cholecystectomy group (3.00 ± 1.58 points; P < 0.001). Regarding local complications, In the groups that underwent cholecystectomy and those that did not, the prevalence of acute peripancreatic fluid collection was 40.4% and 21.9%, respectively. ( P < 0.001).

Conclusions: AP following cholecystectomy exhibits unique imaging characteristics. Cholecystectomy reduces the severity and acute peripancreatic fluid collection rate of subsequent pancreatitis on CT/MRI.

Objective: Incomplete partition type II (IP-II) is one of the most common inner ear malformations that necessitates cochlear implantation. It is characterized by a cystic cochlear apex resulting from the coalescence of middle and apical turns due to modiolar hypoplasia and distal interscalar septal defect. Radiologic diagnosis of IP-II anomaly could be difficult with equivocal changes in tiny labyrinthine structures, especially with inexperienced observers. In our study, we aimed to determine pertinent quantitative radioanatomical measurements of inner ear structures (lateral interscalar notch angle, lateral interscalar notch depth, and lateral height) that may contribute to the diagnosis of IP-II anomaly using temporal bone high-resolution computed tomography (HRCT).

Methods: Our study was a retrospective case-control study approved by the institutional review board. We retrospectively reviewed temporal bone HRCT examinations for the preoperative assessment of cochlear implantation of patients with sensorineural hearing loss (SNHL), using the diagnosis code of IP-II anomaly. Patients with SNHL and a radiologic diagnosis of IP-II anomaly according to the Sennaroglu classification were recruited. Thirty-four SNHL patients with IP-II anomaly (66 ears) and 24 patients without SNHL (48 ears) who underwent temporal CT imaging for inflammatory conditions or trauma not involving labyrinthine structures were included in the study. The lateral interscalar notch angle, lateral interscalar notch depth, and lateral height were independently measured by 2 observers (a senior head and neck radiologist and a novice radiologist). The parameters measured in patient and control groups were compared using the Mann-Whitney U test, and interobserver reliability was calculated.

Results: Lateral interscalar notch angle and lateral height values were found to be significantly larger, while lateral interscalar notch depth value was significantly smaller in the IP-II group ( P <0.05). The agreement between the observers in all measurements, evaluated separately in IP-II and control groups, was excellent ( P <0.05). The cutoff values for determining the IP-II anomaly were found to be consistent between the 2 observers, with high sensitivity and specificity.

Conclusions: CT measurements of inner ear structures in SNHL could help to diagnose IP-II anomalies, especially in patients with equivocal audiological and radiologic findings. This study validates CT measurements in the evaluation of IP-II anomaly conducted by histologic specimens and MRI in previous studies. Lateral cochlear measurements with an angle of >130 degrees, a depth of ≤0.35 mm, and a height of >3.15 mm could support the diagnosis of the IP-II anomaly. These measurements are also reproducible.

Objective: This study investigated novel radiomic features derived from apparent diffusion coefficient (ADC) maps for diagnosing Sjögren syndrome (SS) in patients without visible magnetic resonance morphologic changes.

Materials and methods: This study prospectively analyzed 119 consecutive patients with SS and 95 healthy volunteers using 3.0 T magnetic resonance imaging, including diffusion-weighted imaging with b values of 0 and 1000 s/mm 2 . Regions of interest (ROIs) were manually delineated along the margins of the largest parotid gland slice on ADC maps, from which 838 quantitative features were automatically extracted. Based on the intraclass correlation coefficient and absolute correlation coefficient, 45 radiomic parameters were selected for analysis. The differentiation between patients with SS and healthy controls was evaluated using univariate analysis and receiver operating characteristic analysis. Multiple radiomic features were integrated using binary logistic regression analysis. Through machine learning algorithms, 4 predictive models were developed, and each was thoroughly evaluated for predictive performance. The Shapley Additive exPlanations (SHAP) approach was employed to elucidate the predictive factors influencing the model.

Results: Twenty-two radiomic parameters demonstrated significant differences between SS and control groups. The AUCs were 0.681 ± 0.100 (0.559~0.878). The optimal diagnostic combination for SS consisted of 6 parameters: 0.975Quantile, 180dr_D(4)_Cluster Prominence, 225dr_D(7)_Entropy, 315dr_D(7)_Entropy, Compactness2, and Max3D Diameter, achieving an AUC of 0.956. The SVM, GBM, and XGBoost models were effectively distinguished SS from healthy controls. Among all the parameters, Max3DDiameter demonstrated the strongest predictive power in the model.

Conclusions: Radiomic features derived from ADC maps demonstrate significant potential in facilitating the early diagnosis of SS.

Purpose: To evaluate the accuracy of statistical parametric mapping (SPM) and Scenium in the differential diagnosis of Parkinson disease (PD) and atypical Parkinsonian syndromes based on 18 F-fluoro-deoxy-glucose ( 18 F-FDG) imaging, and to explore the application of these 2 software programs in analyzing patients with Parkinson disease of varying severity, as well as to construct and evaluate the metabolic profiles of PD patients using Scenium.

Methods: A total of 64 patients with Parkinsonian syndrome who met the diagnostic criteria were included in this study. PET images were used for disease diagnosis with SPM and Scenium based on diagnostic charts, and the diagnostic accuracy of both software programs was assessed through consistency analysis. Meanwhile, an in-depth analysis was performed to compare the sensitivity, specificity, positive predictive value, and negative predictive value of the 2 software programs. In addition, Scenium was used to construct a diagnostic model for PD.

Results: SPM demonstrated greater accuracy in distinguishing between PD and APS, with a significantly higher Kappa value (K_spm=0.704) compared with Scenium (K_scenium=0.440). The sensitivity and specificity of SPM were 82.5% and 91.7%, respectively. Further, a PD diagnostic model was constructed by incorporating PET parameters from the contralateral central region and basal ganglia, achieving a diagnostic accuracy of 82.9%.

Conclusions: SPM can more accurately differentiate the diagnosis of Parkinson disease from atypical Parkinson syndrome compared with Scenium.

Objective: To evaluate the effectiveness of the new-generation snapshot freeze (SSF2) algorithm combined with Deep Learning Image Reconstruction (DLIR) in improving the image quality of coronary artery calcifications (CAC) and their quantification.

Methods: Coronary artery calcification score (CACS) scans were performed on 69 patients using ECG-triggered noncontrast CT. Four groups of images were reconstructed with SSF2 or without (STD), combined with ASIR-V (Adaptive Statistical Iterative Reconstruction-V) and DLIR: STD ASIR-V , STD DLIR , SSF2 ASIR-V , and SSF2 DLIR . CAC image quality was compared, and inter-observer consistency was evaluated among reconstruction groups. CACS, including the Agatston score (AS), volume score (VS), mass score (MS), and the risk stratification based on AS among groups, were compared.

Results: The consistencies of the inter-observer image quality scores were excellent or good (kappa=0.705 to 0.837). SSF2 ASIR-V and SSF2 DLIR had significantly higher scores than STD ASIR-V and STD DLIR in reducing motion artifacts of calcified plaques ( P <0.05), while no significant differences between SSF2 ASIR-V and SSF2 DLIR , or between STD ASIR-V and STD DLIR ( P >0.05). There was no significant difference in CT values of vessels, subcutaneous fat, and muscle in CAC images, but the noises of SSF2 ASIR-V and STD ASIR-V images were significantly higher than those of SSF2 DLIR and STD DLIR images ( P >0.05). STD ASIR-V had the highest CACS values, while SSF2 DLIR had the lowest. Using AS in STD ASIR-V as the reference, 9 patients (13.04%) in SSF2 DLIR and 7 patients (10.14%) in SSF2 ASIR-V had a risk stratification reduced, while no change in STD DLIR .

Conclusions: SSF2 and DLIR significantly reduce motion artifacts and image noise in non-contrast CACS CT, respectively. SSF2 reduces CACS values and risk stratification.

Obstructive sleep apnea (OSA) can result from various causes of partial or complete obstruction of the upper airway. CT is amenable to quantitative analysis of the upper airway and surrounding structures. CT is also useful for identifying abnormalities that could be attributed to the patient's symptoms and is relevant for surgical planning. There are various surgical procedures that can be performed for OSA that can also be encountered on CT. The relevant anatomic measurements, imaging features of various pathologies that can affect the upper airway, and postoperative imaging for OSA are reviewed in this article.