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The prognostic value of CT-measured body composition combined with radiomics in predicting the survival of patients with resectable colon cancer. ct测量体成分结合放射组学预测可切除结肠癌患者生存的预后价值。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-07 DOI: 10.1007/s11547-025-02135-3
Xiaoling Zhi, Tong Nie, Mingming Song, Zhihao Liu, Yixin Heng, Jiaxin Xu, Xiaoyu Wu, Yinghao Cao, Feihong Wu, Chuansheng Zheng

Objective: To explore the prognostic value of body compositions and radiomics in patients with resectable colon cancer, and to develop and validate a clinical-radiomics model for predicting the postoperative overall survival of patients with resectable colon cancer.

Methods: This study included 296 patients (43 months of median follow-up) with resectable colon cancer. Non-contrast CT images were used to quantify the body composition at the level of the third lumbar vertebra. Radiomics features were extracted from portal venous-phase CT scans. The recursive feature elimination and the least absolute shrinkage and selection operator regression were used for feature selection and construction of radiomic signatures. Univariate and multivariate Cox regression analysis were used to identify body composition. Combined with radiomics features, clinical-radiomics prediction model was constructed and plotted by nomogram, with performance metrics including the area under the receiver operating characteristic curve, calibration curves, decision curve analysis, and integrated discrimination improvement index.

Result: Low skeletal muscle density (HR = 0.398, 95%CI = 0.168-0.939, P = 0.035) and low visceral fat area (HR = 0.238, 95%CI = 0.108-0.524, P < 0.001) were significantly associated with poor OS. The integrated clinical-radiomics model achieved C-index of 0.802 and 0.786 in the training and test cohorts, with superior 3-year OS AUC values of 0.804 and 0.828. Furthermore, clinical-radiomics model has a significant improvement in performance compared with radiomics model (IDI: 23.2%, P < 0.001) and clinical model (IDI:5.2%, P = 0.008).

Conclusion: Nomogram combining body composition and tumor radiomics features can help predict the long-term prognosis of patients with resectable colon cancer and may serve as an effective tool to promote individualized treatment.

目的:探讨体成分和放射组学对可切除结肠癌患者的预后价值,建立并验证预测可切除结肠癌患者术后总生存的临床-放射组学模型。方法:本研究纳入296例可切除结肠癌患者(中位随访时间为43个月)。使用非对比CT图像来量化第三腰椎水平的身体组成。从门静脉期CT扫描中提取放射组学特征。采用递归特征消去、最小绝对收缩和选择算子回归进行特征选择和构建。采用单因素和多因素Cox回归分析确定体成分。结合放射组学特征,构建临床-放射组学预测模型,并采用nomogram方法绘制其性能指标,包括受试者工作特征曲线下面积、校准曲线、决策曲线分析、综合判别改善指数等。结果:骨骼肌密度低(HR = 0.398, 95%CI = 0.168 ~ 0.939, P = 0.035),内脏脂肪面积低(HR = 0.238, 95%CI = 0.108 ~ 0.524, P)。结论:结合机体组成和肿瘤放射组学特征的Nomogram预后预测可切除结肠癌患者的远期预后,可作为促进个体化治疗的有效工具。
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引用次数: 0
Evaluating double-reading mammography for long-term surveillance in breast cancer survivors: a retrospective exploratory analysis from a single center. 评估双读乳房x光检查对乳腺癌幸存者的长期监测:来自单一中心的回顾性探索性分析。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-06 DOI: 10.1007/s11547-025-02117-5
Giulia Vatteroni, Rubina Manuela Trimboli, Federica Fici, Isabella Bolengo, Giulia Pinna, Giulia Pruneddu, Elisa Salpietro, Paola Nardi, Nicolò Turri, Damiano Gentile, Corrado Tinterri, Daniela Bernardi

Purpose: This exploratory analysis aims to assess the clinical feasibility of transitioning breast cancer (BC) survivors from intensive follow-up to a long-term surveillance strategy based on double-reading mammography within a population-based screening model.

Material and methods: Women who underwent BC surgery in 2013 and were followed for 10 years at a tertiary cancer center in Italy were retrospectively included. Recurrence rates and time to relapse were analyzed using the Kruskal-Wallis test and Chi-square test. Available follow-up mammograms were independently reviewed by three experienced radiologists, blinded to clinical information, using a positive/negative binary scale. Pathology served as the reference standard. Sensitivity, positive predictive value (PPV), and inter-reader agreement (Cohen's and Fleiss' κ) were calculated. Simulated double reading was analyzed using McNemar's test. A p value < 0.05 was considered statistically significant.

Results: Among 505 women, 46 (9.1%) experienced BC recurrence: 19/271 (7.0%) in Luminal A, 6/84 (7.1%) in Luminal B, 3/28 (10.7%) in triple-negative (TN), 7/57 (12.3%) in HER2-positive (HER2 +) cancers, and 11/65 (16.9%) in ductal carcinoma in situ (DCIS), which showed the highest recurrence rate (p = 0.0024). Median time to relapse ranged from 4.7 years (TN) to 8.1 years (Luminal A), with no statistically significant difference among the subtypes (p = 0.190). Individual reader sensitivity ranged from 67.7 to 74.2%, increasing to 77.4-83.9% with double reading. PPVs ranged from 95.4 to 100% for single reading and from 96.0% to 96.2% for double reading. Differences in sensitivity and PPV between single and double reading were not statistically significant (p = 1.0). Five recurrences (16.1%) were mammographically occult and clinically detected. Inter-reader agreement was moderate to good (Cohen's κ = 0.38-0.69; Fleiss' κ = 0.57).

Conclusions: Double-reading mammography showed a higher detection rate of BC recurrences compared to single reading in this exploratory setting, suggesting its potential role as a long-term surveillance strategy for BC survivors. However, the occurrence of relapses outside the mammographic field of view warrants careful consideration.

目的:本探索性分析旨在评估在基于人群的筛查模型中,将乳腺癌(BC)幸存者从强化随访转变为基于双读乳房x光检查的长期监测策略的临床可行性。材料和方法:回顾性纳入2013年在意大利三级癌症中心接受BC手术并随访10年的女性。采用Kruskal-Wallis检验和卡方检验分析复发率和复发时间。可用的后续乳房x光片由三名经验丰富的放射科医生独立审查,不了解临床信息,使用阳性/阴性二元量表。病理为参考标准。计算敏感性、阳性预测值(PPV)和读者间一致性(Cohen’s和Fleiss’k)。采用McNemar试验对模拟双读进行分析。结果:505例女性中,46例(9.1%)发生BC复发率,其中管腔A 19/271(7.0%),管腔B 6/84(7.1%),三阴性(TN) 3/28 (10.7%), HER2阳性(HER2 +) 7/57(12.3%),导管原位癌(DCIS) 11/65(16.9%)复发率最高(p = 0.0024)。中位复发时间为4.7年(TN) ~ 8.1年(Luminal A),各亚型间差异无统计学意义(p = 0.190)。个体读者敏感度为67.7 ~ 74.2%,双读时为77.4 ~ 83.9%。单次阅读的ppv为95.4 ~ 100%,双次阅读的ppv为96.0% ~ 96.2%。单读和双读的敏感性和PPV差异无统计学意义(p = 1.0)。5例(16.1%)复发为乳腺x线检查隐匿,临床发现。读者间一致性为中等至良好(Cohen’s κ = 0.38-0.69; Fleiss’s κ = 0.57)。结论:在这个探索性的环境中,双读乳房x线摄影显示出比单读更高的BC复发检出率,提示其作为BC幸存者的长期监测策略的潜在作用。然而,乳房x线摄影视野之外复发的发生值得仔细考虑。
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引用次数: 0
Intratumoral calcifications in pancreatic neoplasms on unenhanced CT: frequency and diagnostic implications. 非增强CT显示胰腺肿瘤内钙化的频率和诊断意义。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-03 DOI: 10.1007/s11547-025-02142-4
Riccardo De Robertis, Maria Chiara Brunese, Nicolò Cardobi, Flavio Spoto, Francesca Pasquazzo, Beatrice Mascarin, Fabrizio Urraro, Alfonso Reginelli, Luca Brunese, Salvatore Cappabianca, Mirko D'Onofrio

Purpose: Serous cystadenomas (SCAs), solid pseudopapillary neoplasms (SPNs), neuroendocrine neoplasms (NENs), and mucinous cystic neoplasms (MCNs) are pancreatic tumors that frequently develop calcifications. Identifying the presence and pattern of calcifications on unenhanced CT scans can significantly aid radiologists in differential diagnosis.

Methods: Patients were included if they had a confirmed diagnosis through pathology or endoscopic ultrasound and MRI follow-up for at least one year. Exclusion criteria were the absence of CT imaging and multiple pancreatic lesions. Two radiologists independently reviewed unenhanced CT scans to assess lesion location, size, presence of calcifications, and calcification patterns, categorized as Type 1 (punctate), Type 2 (curvilinear/elongated), and Type 3 (coarse). Statistical analysis was performed using Fisher's test for categorical variables, Kruskal-Wallis and Mann-Whitney tests for numerical variables, and logistic regression models to assess the impact of calcification patterns on diagnosis. Sensitivity, specificity, accuracy, and AUC-ROC were calculated for predictive models.

Results: 311 patients (mean age 61 ± 14 years; 56.9% female) were included. Calcifications were present in 27.7% of cases. Calcified NENs and SPNs were more frequently in the body/tail (p = 0.003), and calcified NENs were larger than non-calcified ones (p < 0.001). Punctate calcifications were most common in NENs, while coarse calcifications predominated in SCAs, decreasing the likelihood of a NEN diagnosis and increasing the probability of SCA. The AUC-ROC values were 0.891 for NENs and 0.986 for SCAs.

Conclusions: Approximately 30% of pancreatic tumors exhibit calcifications. Punctate intratumoral calcifications are more indicative of NENs, whereas coarse calcifications strongly suggest SCAs, influencing the differential diagnosis.

目的:浆液性囊腺瘤(SCAs)、实性假乳头状瘤(SPNs)、神经内分泌瘤(NENs)和粘液囊性瘤(MCNs)是胰腺肿瘤,常发生钙化。在非增强CT扫描上识别钙化的存在和模式可以显著地帮助放射科医生进行鉴别诊断。方法:通过病理或内窥镜超声和MRI随访至少一年确诊的患者纳入。排除标准为无CT影像及多发胰腺病变。两名放射科医生独立审查了未增强CT扫描,以评估病变的位置、大小、钙化的存在和钙化模式,分为1型(点状)、2型(曲线/拉长)和3型(粗糙)。统计分析采用分类变量的Fisher检验,数值变量的Kruskal-Wallis和Mann-Whitney检验,以及逻辑回归模型来评估钙化模式对诊断的影响。计算预测模型的敏感性、特异性、准确性和AUC-ROC。结果:纳入311例患者,平均年龄61±14岁,女性56.9%。27.7%的病例存在钙化。钙化的NENs和spn多见于体尾(p = 0.003),钙化的NENs大于未钙化的NENs (p结论:约30%的胰腺肿瘤表现为钙化。点状瘤内钙化更提示NENs,而粗钙化强烈提示SCAs,影响鉴别诊断。
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引用次数: 0
Proposal and clinical application of a structured standardized report for lumbosacral MRI integrated with a comprehensive grading system for lumbar stenosis. 结合腰椎管狭窄综合分级系统的腰骶MRI结构化标准化报告的提出及临床应用
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-03 DOI: 10.1007/s11547-025-02145-1
Valerio D'Agostino, George Robert Matcuk, Maria Luisa Barretta, Anna Maria Chiesa, Paolo Spinnato

Purpose: Creation and evaluation of a structured report (SR) for lumbar spine magnetic resonance imaging (MRI), with the implementation of a previously clinically validated grading system that differentiates lumbar stenosis based on the location and underlying causes, with particular attention to the often underestimated aspect of spinal epidural lipomatosis (SEL).

Material and methods: This prospective single-center study enrolled all the MRIs of the lumbar spine performed at our institution within one month. A (SR) was created using the RSNA's platform "RadReport.org" and submitted to radiologists of our center. Both free-text reports and SR were then evaluated by referring clinicians. The radiologists' intra- (after 2 months) and inter-operator agreement on the new grading system in a SR was assessed using Cohen's Kappa index. Subsequently, an evaluation survey was carried out among the 12 radiologists and 16 clinicians in our hospital, using a five-point Likert scale.

Results: In a period of 1 month, a total of 150 structured reports were generated (86 women, average age 58 ± 22 years). An almost perfect intra-operator (Kc = 0.955) and inter-operator (Kc = 0.838) agreement was detected. The survey showed almost complete satisfaction (89%) and perception of ease of use (83%) of the SR. The new grading system was preferred over the previous ones by 96% of clinicians and 81% of radiologists.

Conclusion: An MRI SR of the lumbar spine could be a valid and appreciated tool to improve communication between specialists, allowing a better multidisciplinary evaluation.

目的:创建和评估腰椎磁共振成像(MRI)的结构化报告(SR),实施先前临床验证的分级系统,根据位置和潜在原因区分腰椎狭窄,特别注意经常被低估的脊髓硬膜外脂肪瘤病(SEL)方面。材料和方法:这项前瞻性单中心研究纳入了在我院一个月内进行的所有腰椎mri检查。A (SR)是通过RSNA的RadReport.org平台创建的,并提交给我中心的放射科医生。然后由转诊临床医生对自由文本报告和SR进行评估。放射科医师内部(2个月后)和操作员之间对SR新分级系统的协议使用Cohen's Kappa指数进行评估。随后,对我院12名放射科医师和16名临床医生进行了评估调查,采用李克特五分制。结果:在1个月的时间内,共生成结构化报告150份(女性86份,平均年龄58±22岁)。检测到几乎完美的算子内(Kc = 0.955)和算子间(Kc = 0.838)一致性。调查显示,sr几乎完全满意(89%),并且易于使用(83%)。96%的临床医生和81%的放射科医生更喜欢新的分级系统。结论:腰椎MRI SR是一种有效的、值得赞赏的工具,可以改善专家之间的沟通,从而更好地进行多学科评估。
{"title":"Proposal and clinical application of a structured standardized report for lumbosacral MRI integrated with a comprehensive grading system for lumbar stenosis.","authors":"Valerio D'Agostino, George Robert Matcuk, Maria Luisa Barretta, Anna Maria Chiesa, Paolo Spinnato","doi":"10.1007/s11547-025-02145-1","DOIUrl":"https://doi.org/10.1007/s11547-025-02145-1","url":null,"abstract":"<p><strong>Purpose: </strong>Creation and evaluation of a structured report (SR) for lumbar spine magnetic resonance imaging (MRI), with the implementation of a previously clinically validated grading system that differentiates lumbar stenosis based on the location and underlying causes, with particular attention to the often underestimated aspect of spinal epidural lipomatosis (SEL).</p><p><strong>Material and methods: </strong>This prospective single-center study enrolled all the MRIs of the lumbar spine performed at our institution within one month. A (SR) was created using the RSNA's platform \"RadReport.org\" and submitted to radiologists of our center. Both free-text reports and SR were then evaluated by referring clinicians. The radiologists' intra- (after 2 months) and inter-operator agreement on the new grading system in a SR was assessed using Cohen's Kappa index. Subsequently, an evaluation survey was carried out among the 12 radiologists and 16 clinicians in our hospital, using a five-point Likert scale.</p><p><strong>Results: </strong>In a period of 1 month, a total of 150 structured reports were generated (86 women, average age 58 ± 22 years). An almost perfect intra-operator (Kc = 0.955) and inter-operator (Kc = 0.838) agreement was detected. The survey showed almost complete satisfaction (89%) and perception of ease of use (83%) of the SR. The new grading system was preferred over the previous ones by 96% of clinicians and 81% of radiologists.</p><p><strong>Conclusion: </strong>An MRI SR of the lumbar spine could be a valid and appreciated tool to improve communication between specialists, allowing a better multidisciplinary evaluation.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Navigating discordant findings in multimodality imaging of prostate cancer in the MRI and PSMA-PET era. 磁共振成像和PSMA-PET时代前列腺癌多模态成像的不一致发现。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-03 DOI: 10.1007/s11547-025-02140-6
Sungmin Woo, Benedetta Masci, Anton S Becker, Angela Tong, Kent P Friedman, Felipe de Galiza Barbosa, Damiano Caruso, Andrea Laghi, Hebert Alberto Vargas

Various imaging modalities play key roles throughout the different stages of prostate cancer. Each imaging modality has different strengths and weaknesses and various scoring systems or frameworks are used to interpret their findings. Discordances between imaging modalities or interpretation frameworks, and even with clinicopathological findings are not uncommon. Discordances often lead to challenges in the decision-making process, especially with dynamically changing indications for newer imaging modalities. While more research is needed on harmonizing interpretations across different modalities, multidisciplinary team discussion is key to optimizing management of patients with prostate cancer when such discordances are present. In this comprehensive review, we take a deep dive in to these various discordances seen in clinical practice and explore their clinical implications.

不同的成像方式在前列腺癌的不同阶段起着关键作用。每种成像方式都有不同的优点和缺点,并且使用不同的评分系统或框架来解释他们的发现。影像方式或解释框架之间的不一致,甚至与临床病理发现并不罕见。不一致常常导致决策过程中的挑战,特别是随着新成像方式的动态变化适应症。虽然需要更多的研究来协调不同方式的解释,但多学科团队讨论是优化前列腺癌患者管理的关键,当这种不一致存在时。在这篇综合综述中,我们将深入探讨临床实践中出现的各种不协调现象,并探讨其临床意义。
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引用次数: 0
Predictive model development and validation of functional liver imaging score for prognosis of patients with hepatocellular carcinoma after surgical resection: a multicenter study. 肝功能影像学评分对肝细胞癌术后患者预后预测模型的建立和验证:一项多中心研究
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-02 DOI: 10.1007/s11547-025-02110-y
Feier Ding, Takashi Ota, Shuo Cai, Hui Ma, Masahiro Yanagawa, Atsushi Nakamoto, Noriyuki Tomiyama, Yidi Chen, Bin Song, Xinya Zhao

Purpose: This study aimed to develop and validate a prognostic model for hepatocellular carcinoma (HCC) patients undergoing liver resection, using the functional liver imaging score (FLIS) derived from hepatobiliary-specific contrast-enhanced magnetic resonance imaging (MRI).

Material and methods: A total of 694 pathologically confirmed HCC patients who underwent hepatobiliary-specific MRI with either gadoxetic acid or gadobenate dimeglumine and subsequent liver resection were included. FLIS was calculated by assigning 0-2 points to three hepatobiliary-phase MRI features: hepatic enhancement, biliary excretion, and portal vein signal intensity. Multivariable Cox regression identified AFP level, tumor size, and extent of resection as independent predictors of overall survival (OS).

Results: FLIS ≤ 2, alpha-fetoprotein (AFP) > 400 ng/mL, tumor size > 5 cm, and major resection were identified as independent predictors of worse OS. A predictive model combining these factors demonstrated excellent prognostic performance, with Harrell's concordance indices of 0.91 in the training cohort and 0.96 internal validation cohort, and 0.94 in external validation cohort. The FLIS-based model significantly outperformed FLIS alone and conventional clinical models (p < 0.05). Kaplan-Meier survival analysis showed that low-risk patients had significantly better OS and recurrence-free survival (RFS) compared to high-risk patients across all cohorts (p < 0.05).

Conclusion: FLIS is a simple, non-invasive imaging biomarker for evaluating liver function and predicting outcomes in HCC patients. When integrated with key clinical variables, the FLIS-based model demonstrates excellent discrimination and calibration for OS and RFS, providing accurate postoperative prognostic stratification and showing great potential for guiding surveillance and improving long-term survival outcomes in future clinical applications.

目的:本研究旨在建立和验证肝细胞癌(HCC)患者肝切除术的预后模型,使用肝胆特异性对比增强磁共振成像(MRI)得出的肝脏功能成像评分(FLIS)。材料和方法:共纳入694例经病理证实的肝细胞癌患者,这些患者接受了肝胆道特异性MRI检查,并接受了加多己酸或加多苯酸二聚胺,随后进行了肝切除术。FLIS是通过给三个肝胆期MRI特征(肝脏增强、胆汁排泄和门静脉信号强度)分配0-2分来计算的。多变量Cox回归发现AFP水平、肿瘤大小和切除程度是总生存期(OS)的独立预测因子。结果:FLIS≤2,甲胎蛋白(AFP) > 400 ng/mL,肿瘤大小> 5 cm,主要切除是OS恶化的独立预测因素。综合这些因素的预测模型表现出良好的预后效果,训练组和内部验证组的Harrell一致性指数为0.91,内部验证组为0.96,外部验证组为0.94。结论:FLIS是HCC患者评估肝功能和预测预后的一种简单、无创的成像生物标志物。当与关键临床变量相结合时,基于flis的模型对OS和RFS表现出良好的区分和校准,提供准确的术后预后分层,在未来的临床应用中具有指导监测和改善长期生存结果的巨大潜力。
{"title":"Predictive model development and validation of functional liver imaging score for prognosis of patients with hepatocellular carcinoma after surgical resection: a multicenter study.","authors":"Feier Ding, Takashi Ota, Shuo Cai, Hui Ma, Masahiro Yanagawa, Atsushi Nakamoto, Noriyuki Tomiyama, Yidi Chen, Bin Song, Xinya Zhao","doi":"10.1007/s11547-025-02110-y","DOIUrl":"https://doi.org/10.1007/s11547-025-02110-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop and validate a prognostic model for hepatocellular carcinoma (HCC) patients undergoing liver resection, using the functional liver imaging score (FLIS) derived from hepatobiliary-specific contrast-enhanced magnetic resonance imaging (MRI).</p><p><strong>Material and methods: </strong>A total of 694 pathologically confirmed HCC patients who underwent hepatobiliary-specific MRI with either gadoxetic acid or gadobenate dimeglumine and subsequent liver resection were included. FLIS was calculated by assigning 0-2 points to three hepatobiliary-phase MRI features: hepatic enhancement, biliary excretion, and portal vein signal intensity. Multivariable Cox regression identified AFP level, tumor size, and extent of resection as independent predictors of overall survival (OS).</p><p><strong>Results: </strong>FLIS ≤ 2, alpha-fetoprotein (AFP) > 400 ng/mL, tumor size > 5 cm, and major resection were identified as independent predictors of worse OS. A predictive model combining these factors demonstrated excellent prognostic performance, with Harrell's concordance indices of 0.91 in the training cohort and 0.96 internal validation cohort, and 0.94 in external validation cohort. The FLIS-based model significantly outperformed FLIS alone and conventional clinical models (p < 0.05). Kaplan-Meier survival analysis showed that low-risk patients had significantly better OS and recurrence-free survival (RFS) compared to high-risk patients across all cohorts (p < 0.05).</p><p><strong>Conclusion: </strong>FLIS is a simple, non-invasive imaging biomarker for evaluating liver function and predicting outcomes in HCC patients. When integrated with key clinical variables, the FLIS-based model demonstrates excellent discrimination and calibration for OS and RFS, providing accurate postoperative prognostic stratification and showing great potential for guiding surveillance and improving long-term survival outcomes in future clinical applications.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Residual myocardial hyperemia in regadenoson stress/rest quantitative perfusion cardiac magnetic resonance. 心脏磁共振摄心腺苷应激/休息定量灌注的残余心肌充血。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 Epub Date: 2025-08-23 DOI: 10.1007/s11547-025-02062-3
Gorka Bastarrika, Ana Ezponda, Javier Muñiz-Sáenz-Diez, Marta Vidorreta, Amaia Ochoa González, Juan José Gavira, Nahikari Salterain

Purpose: This study sought to investigate the presence of residual myocardial hyperemia on the recovery phase in patients undergoing stress CMR.

Material and methods: Fifty patients with clinical indication for stress CMR underwent quantitative perfusion imaging in resting conditions, after regadenoson-induced hyperemia (400 mcg, 5 mL), and 10 min after recovery with euphylline. Studies showing hypoperfusion due to ischemia and/or prior myocardial infarction were excluded. Global myocardial blood flow during rest (MBFrest), stress (MBFstress) and recovery (MBFrecovery) and MPR indices (MPRstress/rest and MPRstress/recovery) were calculated using automated pixel-wise quantitative myocardial perfusion mapping.

Results: A total of 30 patients (22 males, mean age of 62.7 ± 1 years) were included in the analysis. Global MBFrest and MBFstress were 0.83 ± 0.2 mL/g/min and 2.1 ± 0.6 mL/g/min, respectively. After recovery with euphylline, myocardial perfusion did not return to the resting values (MBFrecovery of 0.92 ± 0.3 mL/g/min) and statistically differed from MBFrest (p < 0.01), suggesting residual myocardial hyperemia. This resulted in an abnormally low MPRstress/recovery (2.43 ± 0.7) with respect to MPRstress/rest (2.56 ± 0.7) (p = 0.03). A linear mixed-effects model accounting for repeated measures revealed statistically significant group differences over time in global MBF (mean difference 0.1, 95% CI 0.02-0.17, p = 0.01) and global MPR (mean difference -0.13, 95% CI -0.25 to -0.02, p = 0.02).

Conclusion: Despite the use of euphylline to counteract the vasodilator effect, MBF does not completely revert to resting values and MBFrecovery cannot be used as a substitute for MBFrest when regadenoson is used. Consequently, a rest/stress protocol is advised for quantitative CMR perfusion to obtain accurate MBF and MPR parameters.

目的:本研究旨在探讨应激性CMR患者恢复期残余心肌充血的存在。材料与方法:50例有应激性CMR临床指征的患者,分别在静息状态、再腺苷酸诱导充血(400 mcg, 5 mL)后和用euphyline恢复后10分钟进行定量灌注成像。排除了因缺血和/或既往心肌梗死导致的灌注不足的研究。使用自动逐像素定量心肌灌注制图计算休息(MBFrest)、应激(mbfrstress)和恢复(mbfrerecovery)期间的心肌血流和MPR指数(MPRstress/rest和MPRstress/recovery)。结果:共纳入30例患者,其中男性22例,平均年龄62.7±1岁。Global MBFrest和mbstress分别为0.83±0.2 mL/g/min和2.1±0.6 mL/g/min。经euphyline恢复后,心肌灌注未恢复到静息值(mbfrerecovery为0.92±0.3 mL/g/min),与MBFrest (p stress/recovery(2.43±0.7))相比,与MPRstress/rest(2.56±0.7)相比,差异有统计学意义(p = 0.03)。考虑重复测量的线性混合效应模型显示,随着时间的推移,全球MBF(平均差值0.1,95% CI 0.02-0.17, p = 0.01)和全球MPR(平均差值-0.13,95% CI -0.25至-0.02,p = 0.02)的组间差异具有统计学意义。结论:尽管使用了euphyline来抵消血管舒张作用,但MBF并不能完全恢复到静息值,并且当使用regadenoson时,MBFrecovery不能替代MBFrecovery。因此,建议采用休息/应激方案进行定量CMR灌注,以获得准确的MBF和MPR参数。
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引用次数: 0
Unlocking the potential of radiomics in identifying fibrosing and inflammatory patterns in interstitial lung disease. 释放放射组学在鉴别间质性肺疾病纤维化和炎症模式方面的潜力
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 Epub Date: 2025-08-22 DOI: 10.1007/s11547-025-02067-y
Leonardo Colligiani, Chiara Marzi, Vincenzo Uggenti, Sara Colantonio, Laura Tavanti, Francesco Pistelli, Greta Alì, Emanuele Neri, Chiara Romei

Purpose: To differentiate interstitial lung diseases (ILDs) with fibrotic and inflammatory patterns using high-resolution computed tomography (HRCT) and a radiomics-based artificial intelligence (AI) pipeline.

Materials and methods: This single-center study included 84 patients: 50 with idiopathic pulmonary fibrosis (IPF)-representative of fibrotic pattern-and 34 with cellular non-specific interstitial pneumonia (NSIP) secondary to connective tissue disease (CTD)-as an example of mostly inflammatory pattern. For a secondary objective, we analyzed 50 additional patients with COVID-19 pneumonia. We performed semi-automatic segmentation of ILD regions using a deep learning model followed by manual review. From each segmented region, 103 radiomic features were extracted. Classification was performed using an XGBoost model with 1000 bootstrap repetitions and SHapley Additive exPlanations (SHAP) were applied to identify the most predictive features.

Results: The model accurately distinguished a fibrotic ILD pattern from an inflammatory ILD one, achieving an average test set accuracy of 0.91 and AUROC of 0.98. The classification was driven by radiomic features capturing differences in lung morphology, intensity distribution, and textural heterogeneity between the two disease patterns. In differentiating cellular NSIP from COVID-19, the model achieved an average accuracy of 0.89. Inflammatory ILDs exhibited more uniform imaging patterns compared to the greater variability typically observed in viral pneumonia.

Conclusion: Radiomics combined with explainable AI offers promising diagnostic support in distinguishing fibrotic from inflammatory ILD patterns and differentiating inflammatory ILDs from viral pneumonias. This approach could enhance diagnostic precision and provide quantitative support for personalized ILD management.

目的:利用高分辨率计算机断层扫描(HRCT)和基于放射组学的人工智能(AI)管道鉴别纤维化和炎症模式的间质性肺疾病(ILDs)。材料和方法:这项单中心研究包括84例患者:50例特发性肺纤维化(IPF)-纤维化模式的代表,34例继发于结缔组织病(CTD)的细胞性非特异性间质性肺炎(NSIP) -作为主要炎症模式的例子。作为次要目标,我们分析了另外50例COVID-19肺炎患者。我们使用深度学习模型对ILD区域进行半自动分割,然后进行手动审查。从每个分割的区域中提取103个放射性特征。使用具有1000次引导重复的XGBoost模型进行分类,并使用SHapley加性解释(SHAP)来识别最具预测性的特征。结果:该模型准确区分了纤维化ILD与炎性ILD,平均测试集准确率为0.91,AUROC为0.98。该分类是由两种疾病模式之间肺形态、强度分布和质地异质性的放射学特征驱动的。在区分细胞NSIP和COVID-19时,该模型的平均准确率为0.89。与病毒性肺炎相比,炎性ild表现出更均匀的成像模式。结论:放射组学结合可解释的AI在区分纤维化与炎症性ILD模式以及区分炎症性ILD与病毒性肺炎方面提供了有希望的诊断支持。该方法可提高诊断精度,并为ILD的个性化管理提供定量支持。
{"title":"Unlocking the potential of radiomics in identifying fibrosing and inflammatory patterns in interstitial lung disease.","authors":"Leonardo Colligiani, Chiara Marzi, Vincenzo Uggenti, Sara Colantonio, Laura Tavanti, Francesco Pistelli, Greta Alì, Emanuele Neri, Chiara Romei","doi":"10.1007/s11547-025-02067-y","DOIUrl":"10.1007/s11547-025-02067-y","url":null,"abstract":"<p><strong>Purpose: </strong>To differentiate interstitial lung diseases (ILDs) with fibrotic and inflammatory patterns using high-resolution computed tomography (HRCT) and a radiomics-based artificial intelligence (AI) pipeline.</p><p><strong>Materials and methods: </strong>This single-center study included 84 patients: 50 with idiopathic pulmonary fibrosis (IPF)-representative of fibrotic pattern-and 34 with cellular non-specific interstitial pneumonia (NSIP) secondary to connective tissue disease (CTD)-as an example of mostly inflammatory pattern. For a secondary objective, we analyzed 50 additional patients with COVID-19 pneumonia. We performed semi-automatic segmentation of ILD regions using a deep learning model followed by manual review. From each segmented region, 103 radiomic features were extracted. Classification was performed using an XGBoost model with 1000 bootstrap repetitions and SHapley Additive exPlanations (SHAP) were applied to identify the most predictive features.</p><p><strong>Results: </strong>The model accurately distinguished a fibrotic ILD pattern from an inflammatory ILD one, achieving an average test set accuracy of 0.91 and AUROC of 0.98. The classification was driven by radiomic features capturing differences in lung morphology, intensity distribution, and textural heterogeneity between the two disease patterns. In differentiating cellular NSIP from COVID-19, the model achieved an average accuracy of 0.89. Inflammatory ILDs exhibited more uniform imaging patterns compared to the greater variability typically observed in viral pneumonia.</p><p><strong>Conclusion: </strong>Radiomics combined with explainable AI offers promising diagnostic support in distinguishing fibrotic from inflammatory ILD patterns and differentiating inflammatory ILDs from viral pneumonias. This approach could enhance diagnostic precision and provide quantitative support for personalized ILD management.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1797-1807"},"PeriodicalIF":4.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conventional vs. DEB vs. DSM: Which technique for palliative TACE in intermediate-stage HCC? Results on 70 patients in terms of efficacy and tolerance. 传统、DEB和DSM:哪一种技术可用于中期HCC的姑息性TACE ?结果70例患者的疗效和耐受性。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 Epub Date: 2025-08-06 DOI: 10.1007/s11547-025-02069-w
Francesco Giurazza, Claudio Carrubba, Ernesto Punzi, Raffaella Tortora, Marco Guarracino, Fiorella Brangi, Federica Falaschi, Carla Migliaccio, Fabio Corvino, Giovanni Vennarecci, Giuseppe Giovanni Di Costanzo, Giulio Lombardi, Raffaella Niola

Purpose: This study aims to compare palliative cTACE, DEB-TACE and DSM-TACE in patients affected by HCC in intermediate BCLC stage in terms of efficacy and patient tolerance.

Materials and methods: Patients treated with palliative TACE were prospectively enrolled in two centers during 9 months. Procedures were performed superselectively in all patients. Inclusion criteria were: HCC diagnosis, intermediate BCLC stage, portal tree patency, preserved hepatic-renal-coagulation functions, palliative procedural aim, follow-up available up to 6-month post-TACE intervention. Exclusion criteria were: previous TACE treatments, alone or in combination with ablation in the same session, ascites, bilirubin > 2mg/dL, age < 18years, bridge to transplant procedural aim, concomitant infectious diseases. Primary endpoint was to compare efficacy and patients tolerance among the 3 different TACE techniques; secondary endpoint was to compare post-procedural complications occurrence.

Results: Seventy patients were included and divided into three groups according to the TACE technique: 24 were treated with cTACE, 25 with DEB-TACE, 21 with DSM-TACE. According to mRECIST criteria at 1-, 3- and 6-month follow-up, DEB-TACE presented better local response rates but without statistically significant differences. Patients treated with DSM-TACE showed significantly better tolerance, considering post-procedural transaminases and INR values together with clinical adverse events occurrence monitored up to 7 days. There were no differences in post-procedural complications and no major complications occurred.

Conclusions: In this study, in patients with intermediate-stage HCC undergoing palliative treatments, no significant differences emerged comparing cTACE, DEB-TACE and DSM-TACE in terms of procedural efficacy; however, patients treated with DSM-TACE showed significant better procedural tolerance.

目的:本研究旨在比较姑息性cace、DEB-TACE和DSM-TACE在BCLC中期HCC患者中的疗效和患者耐受性。材料和方法:接受姑息性TACE治疗的患者在两个中心前瞻性入选,为期9个月。所有患者的手术都是超选择性的。纳入标准为:HCC诊断,BCLC中期分期,门静脉树通畅,保留肝肾凝血功能,姑息性手术目的,tace干预后随访至6个月。排除标准为:既往TACE治疗,单独或同期联合消融,腹水,胆红素bbb20 2mg/dL,年龄。结果:纳入70例患者,根据TACE技术分为三组:cTACE治疗24例,DEB-TACE治疗25例,DSM-TACE治疗21例。根据mRECIST随访1个月、3个月和6个月的标准,DEB-TACE具有更好的局部缓解率,但无统计学差异。考虑到术后转氨酶和INR值以及长达7天的临床不良事件发生监测,DSM-TACE治疗的患者耐受性明显更好。两组术后并发症无明显差异,无重大并发症发生。结论:在本研究中,在姑息治疗的中期HCC患者中,cTACE、DEB-TACE和DSM-TACE在程序疗效方面没有显著差异;然而,接受DSM-TACE治疗的患者表现出明显更好的程序耐受性。
{"title":"Conventional vs. DEB vs. DSM: Which technique for palliative TACE in intermediate-stage HCC? Results on 70 patients in terms of efficacy and tolerance.","authors":"Francesco Giurazza, Claudio Carrubba, Ernesto Punzi, Raffaella Tortora, Marco Guarracino, Fiorella Brangi, Federica Falaschi, Carla Migliaccio, Fabio Corvino, Giovanni Vennarecci, Giuseppe Giovanni Di Costanzo, Giulio Lombardi, Raffaella Niola","doi":"10.1007/s11547-025-02069-w","DOIUrl":"10.1007/s11547-025-02069-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare palliative cTACE, DEB-TACE and DSM-TACE in patients affected by HCC in intermediate BCLC stage in terms of efficacy and patient tolerance.</p><p><strong>Materials and methods: </strong>Patients treated with palliative TACE were prospectively enrolled in two centers during 9 months. Procedures were performed superselectively in all patients. Inclusion criteria were: HCC diagnosis, intermediate BCLC stage, portal tree patency, preserved hepatic-renal-coagulation functions, palliative procedural aim, follow-up available up to 6-month post-TACE intervention. Exclusion criteria were: previous TACE treatments, alone or in combination with ablation in the same session, ascites, bilirubin > 2mg/dL, age < 18years, bridge to transplant procedural aim, concomitant infectious diseases. Primary endpoint was to compare efficacy and patients tolerance among the 3 different TACE techniques; secondary endpoint was to compare post-procedural complications occurrence.</p><p><strong>Results: </strong>Seventy patients were included and divided into three groups according to the TACE technique: 24 were treated with cTACE, 25 with DEB-TACE, 21 with DSM-TACE. According to mRECIST criteria at 1-, 3- and 6-month follow-up, DEB-TACE presented better local response rates but without statistically significant differences. Patients treated with DSM-TACE showed significantly better tolerance, considering post-procedural transaminases and INR values together with clinical adverse events occurrence monitored up to 7 days. There were no differences in post-procedural complications and no major complications occurred.</p><p><strong>Conclusions: </strong>In this study, in patients with intermediate-stage HCC undergoing palliative treatments, no significant differences emerged comparing cTACE, DEB-TACE and DSM-TACE in terms of procedural efficacy; however, patients treated with DSM-TACE showed significant better procedural tolerance.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1888-1896"},"PeriodicalIF":4.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Simultaneous generation of color-coded arteriography, venography, and dynamic angiography: methodology and clinical applications in stroke. 同时生成彩色动脉造影、静脉造影和动态血管造影:方法和在中风中的临床应用。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1007/s11547-025-02074-z
Heekyung Kim, Hong Gee Roh, Jin Tae Kwak, Hee Jong Ki, In Seong Kim, Sumin Jung, Hyun Yang, Jeong Jin Park, Yoo Sung Jeon, Hyun Jeong Kim

Cerebrovascular accident is a leading cause of death and disability. Early detection of cerebrovascular diseases is crucial for timely treatment. This study introduces a novel method for the simultaneous generation of color-coded arteriography, venography, and dynamic angiography derived from dynamic contrast-enhanced magnetic resonance angiography and computed tomography perfusion. By realigning source images into time series volume data, this approach enables the classification of five dynamic phases, allowing for the creation of detailed angiographic images and facilitating a comprehensive evaluation of cerebrovascular accidents in the emergency room. The method enables rapid assessment of ischemic strokes, improving patient selection for recanalization therapy, and aids in the early diagnosis of other cerebrovascular diseases, including cerebral venous thrombosis and arteriovenous shunts. We demonstrate the clinical applications of this technique, highlighting its potential to enhance the accuracy and speed of cerebrovascular imaging, making it a valuable first-line diagnostic tool for stroke patients.

脑血管意外是造成死亡和残疾的主要原因。脑血管疾病的早期发现对于及时治疗至关重要。本研究介绍了一种同时生成彩色动脉造影、静脉造影和动态血管造影的新方法,该方法来源于动态对比增强磁共振血管造影和计算机断层扫描灌注。通过将源图像重新调整为时间序列体积数据,该方法可以对五个动态阶段进行分类,从而创建详细的血管造影图像,并促进对急诊室脑血管事故的全面评估。该方法可以快速评估缺血性中风,改善患者对再通治疗的选择,并有助于早期诊断其他脑血管疾病,包括脑静脉血栓形成和动静脉分流。我们展示了该技术的临床应用,强调了其提高脑血管成像准确性和速度的潜力,使其成为中风患者有价值的一线诊断工具。
{"title":"Simultaneous generation of color-coded arteriography, venography, and dynamic angiography: methodology and clinical applications in stroke.","authors":"Heekyung Kim, Hong Gee Roh, Jin Tae Kwak, Hee Jong Ki, In Seong Kim, Sumin Jung, Hyun Yang, Jeong Jin Park, Yoo Sung Jeon, Hyun Jeong Kim","doi":"10.1007/s11547-025-02074-z","DOIUrl":"10.1007/s11547-025-02074-z","url":null,"abstract":"<p><p>Cerebrovascular accident is a leading cause of death and disability. Early detection of cerebrovascular diseases is crucial for timely treatment. This study introduces a novel method for the simultaneous generation of color-coded arteriography, venography, and dynamic angiography derived from dynamic contrast-enhanced magnetic resonance angiography and computed tomography perfusion. By realigning source images into time series volume data, this approach enables the classification of five dynamic phases, allowing for the creation of detailed angiographic images and facilitating a comprehensive evaluation of cerebrovascular accidents in the emergency room. The method enables rapid assessment of ischemic strokes, improving patient selection for recanalization therapy, and aids in the early diagnosis of other cerebrovascular diseases, including cerebral venous thrombosis and arteriovenous shunts. We demonstrate the clinical applications of this technique, highlighting its potential to enhance the accuracy and speed of cerebrovascular imaging, making it a valuable first-line diagnostic tool for stroke patients.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1820-1826"},"PeriodicalIF":4.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
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Radiologia Medica
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