首页 > 最新文献

Radiologia Medica最新文献

英文 中文
Feasibility study on QSM and R2* mapping for quantitative evaluation of iron deposition and ovarian function assessment in endometriotic ovarian cysts. QSM和R2*作图定量评价子宫内膜异位性卵巢囊肿铁沉积及卵巢功能的可行性研究。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-13 DOI: 10.1007/s11547-025-02152-2
Dawei Ding, Lingyu Chang, Xuemei Wang, Ying Xu, Bo Yang, Dmytro Pylypenko, Tianyong Xu, Jingtao Wang, Dexin Yu, Fang Wang

Objectives: To evaluate the feasibility of quantitative susceptibility mapping (QSM) and R2* mapping in assessing iron deposition in endometriotic ovarian cysts (EMO) and their potential implications for ovarian reserve.

Materials and methods: This prospective study included 28 patients (33 lesions) with histopathologically confirmed EMO who underwent preoperative MRI examinations, including R2* mapping and QSM. Cyst fluid iron concentration ([Fe]) was measured via inductively coupled plasma optical emission spectrometry. Serum anti-Müllerian hormone (AMH) levels were quantified as a marker of ovarian reserve. Pearson correlation and regression analyses were performed to assess associations among AMH, [Fe], R2*, and QSM values.

Results: In Group All Ages, AMH was negatively correlated with age (r = -0.74, p < 0.001) and [Fe] (r = -0.35, p = 0.048), while [Fe] showed moderate positive correlations with R2* (r = 0.55, p < 0.001) and QSM (r = 0.56, p < 0.001). In Group < 40 years, AMH exhibited moderate negative correlations with [Fe] (r = -0.45, p = 0.031), R2* (r = -0.48, p = 0.019), QSM (r = -0.49, p = 0.018). Multiple regression analyses confirmed that [Fe], R2*, QSM were significant predictors of AMH levels (p < 0.05). R2* and QSM were highly correlated (r = 0.72, p < 0.001), validating their consistency in assessing iron content.

Conclusion: R2* mapping and QSM reliably quantify iron deposition in EMO, with in vitro validation supporting their accuracy. Moreover, the potential link between iron deposition and ovarian reserve highlights the preliminary value of these methods in assessing ovarian function.

目的:评价定量易感性作图(QSM)和R2*作图评估子宫内膜异位性卵巢囊肿(EMO)铁沉积的可行性及其对卵巢储备的潜在意义。材料和方法:本前瞻性研究纳入28例经组织病理学证实的EMO患者(33个病灶),术前行MRI检查,包括R2*作图和QSM。采用电感耦合等离子体发射光谱法测定囊液铁浓度[Fe]。测定血清抗勒氏激素(AMH)水平,作为卵巢储备的标志。采用Pearson相关分析和回归分析评估AMH、[Fe]、R2*和QSM值之间的相关性。结果:在所有年龄组中,AMH与年龄呈负相关(r = -0.74, p)。结论:R2*制图和QSM能可靠地定量EMO中的铁沉积,体外验证支持其准确性。此外,铁沉积与卵巢储备之间的潜在联系突出了这些方法在评估卵巢功能方面的初步价值。
{"title":"Feasibility study on QSM and R2* mapping for quantitative evaluation of iron deposition and ovarian function assessment in endometriotic ovarian cysts.","authors":"Dawei Ding, Lingyu Chang, Xuemei Wang, Ying Xu, Bo Yang, Dmytro Pylypenko, Tianyong Xu, Jingtao Wang, Dexin Yu, Fang Wang","doi":"10.1007/s11547-025-02152-2","DOIUrl":"https://doi.org/10.1007/s11547-025-02152-2","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility of quantitative susceptibility mapping (QSM) and R2* mapping in assessing iron deposition in endometriotic ovarian cysts (EMO) and their potential implications for ovarian reserve.</p><p><strong>Materials and methods: </strong>This prospective study included 28 patients (33 lesions) with histopathologically confirmed EMO who underwent preoperative MRI examinations, including R2* mapping and QSM. Cyst fluid iron concentration ([Fe]) was measured via inductively coupled plasma optical emission spectrometry. Serum anti-Müllerian hormone (AMH) levels were quantified as a marker of ovarian reserve. Pearson correlation and regression analyses were performed to assess associations among AMH, [Fe], R2*, and QSM values.</p><p><strong>Results: </strong>In Group All Ages, AMH was negatively correlated with age (r = -0.74, p < 0.001) and [Fe] (r = -0.35, p = 0.048), while [Fe] showed moderate positive correlations with R2* (r = 0.55, p < 0.001) and QSM (r = 0.56, p < 0.001). In Group < 40 years, AMH exhibited moderate negative correlations with [Fe] (r = -0.45, p = 0.031), R2* (r = -0.48, p = 0.019), QSM (r = -0.49, p = 0.018). Multiple regression analyses confirmed that [Fe], R2*, QSM were significant predictors of AMH levels (p < 0.05). R2* and QSM were highly correlated (r = 0.72, p < 0.001), validating their consistency in assessing iron content.</p><p><strong>Conclusion: </strong>R2* mapping and QSM reliably quantify iron deposition in EMO, with in vitro validation supporting their accuracy. Moreover, the potential link between iron deposition and ovarian reserve highlights the preliminary value of these methods in assessing ovarian function.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506339","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
Clinical MRI-radiomics model based on support vector machine to predict the efficacy of first transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma. 基于支持向量机的临床mri放射组学模型预测首次经动脉化疗栓塞治疗不可切除肝内胆管癌的疗效。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-08 DOI: 10.1007/s11547-025-02141-5
Ze Zhang, Anhui Xu, Yi Zhang, Nan Jiang, Yonghong Hao, Ruibing Zhou, Ketao Mu, Xiaoxv Yin

Background: Transarterial chemoembolization (TACE) is an effective treatment for patients with unresectable intrahepatic cholangiocarcinoma (iCCA), but tumor heterogeneity affects the efficacy of treatment. This study aimed to construct a Clinical-Radiomics (CR) model for predicting tumor response after the first TACE in patients with unresectable iCCA.

Methods: A total of 107 unresectable iCCA patients who received TACE as the first treatment with available contrast-enhanced MRI (CEMRI) were retrospectively enrolled. Patients were randomly assigned to the training (N = 75) and validation cohorts (N = 32) in a 7:3 ratio. Radiomics features were extracted from CEMRI (arterial, portal venous, and delayed phases) for tumor, peritumor 5 mm, and peritumor 10 mm, respectively, and then the features were selected by random forest before constructing the radiomics model. Radiomics model score and clinical variables were analyzed using univariate and multivariate logistic regression to construct the CR model. Kaplan-Meier method was utilized to assess OS.

Results: The radiomics model constructed based on the tumor plus peritumor 10 mm demonstrated the best performance. The CR model developed by combining with CA19.9 showed excellent performance in both the training (AUC = 0.941) and the validation cohorts (AUC = 0.903). Dividing groups based on the model predicted tumor responses, the Kaplan-Meier curves demonstrated a significant difference in OS between the two groups (P < 0.011). The main limitations of this study include the use of a single-center cohort, which lacks external validation, and the inherent characteristics of a retrospective design, leading to an unavoidable selection bias.

Conclusion: The model in this study demonstrated excellent performance in predicting tumor response after first TACE in patients with unresectable iCCA. The model could support clinicians to make more scientific guidance on the treatment of patients.

背景:经动脉化疗栓塞(TACE)是治疗不可切除肝内胆管癌(iCCA)的有效方法,但肿瘤异质性影响治疗效果。本研究旨在建立一个临床放射组学(CR)模型,用于预测不可切除iCCA患者首次TACE后的肿瘤反应。方法:回顾性纳入107例首次接受TACE治疗的不可切除iCCA患者,使用现有的对比增强MRI (CEMRI)。患者按7:3的比例随机分配到训练组(N = 75)和验证组(N = 32)。分别从肿瘤、肿瘤周围5 mm和肿瘤周围10 mm的CEMRI(动脉期、门静脉期和延迟期)中提取放射组学特征,然后通过随机森林选择特征,构建放射组学模型。采用单因素和多因素logistic回归分析放射组学模型评分和临床变量,构建CR模型。采用Kaplan-Meier法评价OS。结果:基于肿瘤+瘤周10mm构建的放射组学模型效果最佳。结合CA19.9建立的CR模型在训练队列(AUC = 0.941)和验证队列(AUC = 0.903)上均表现优异。根据预测肿瘤反应的模型进行分组,Kaplan-Meier曲线显示两组患者的OS有显著差异(P)。结论:本研究中的模型在预测不可切除iCCA患者首次TACE后的肿瘤反应方面表现出色。该模型可以支持临床医生对患者的治疗做出更科学的指导。
{"title":"Clinical MRI-radiomics model based on support vector machine to predict the efficacy of first transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma.","authors":"Ze Zhang, Anhui Xu, Yi Zhang, Nan Jiang, Yonghong Hao, Ruibing Zhou, Ketao Mu, Xiaoxv Yin","doi":"10.1007/s11547-025-02141-5","DOIUrl":"https://doi.org/10.1007/s11547-025-02141-5","url":null,"abstract":"<p><strong>Background: </strong>Transarterial chemoembolization (TACE) is an effective treatment for patients with unresectable intrahepatic cholangiocarcinoma (iCCA), but tumor heterogeneity affects the efficacy of treatment. This study aimed to construct a Clinical-Radiomics (CR) model for predicting tumor response after the first TACE in patients with unresectable iCCA.</p><p><strong>Methods: </strong>A total of 107 unresectable iCCA patients who received TACE as the first treatment with available contrast-enhanced MRI (CEMRI) were retrospectively enrolled. Patients were randomly assigned to the training (N = 75) and validation cohorts (N = 32) in a 7:3 ratio. Radiomics features were extracted from CEMRI (arterial, portal venous, and delayed phases) for tumor, peritumor 5 mm, and peritumor 10 mm, respectively, and then the features were selected by random forest before constructing the radiomics model. Radiomics model score and clinical variables were analyzed using univariate and multivariate logistic regression to construct the CR model. Kaplan-Meier method was utilized to assess OS.</p><p><strong>Results: </strong>The radiomics model constructed based on the tumor plus peritumor 10 mm demonstrated the best performance. The CR model developed by combining with CA19.9 showed excellent performance in both the training (AUC = 0.941) and the validation cohorts (AUC = 0.903). Dividing groups based on the model predicted tumor responses, the Kaplan-Meier curves demonstrated a significant difference in OS between the two groups (P < 0.011). The main limitations of this study include the use of a single-center cohort, which lacks external validation, and the inherent characteristics of a retrospective design, leading to an unavoidable selection bias.</p><p><strong>Conclusion: </strong>The model in this study demonstrated excellent performance in predicting tumor response after first TACE in patients with unresectable iCCA. The model could support clinicians to make more scientific guidance on the treatment of patients.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471786","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
Impact of whole-brain radiation therapy on neurocognitive functions, alopecia and hearing loss: a systematic review and meta-analysis endorsed by the Palliative Care and Neuro-Oncology Study Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO). 全脑放射治疗对神经认知功能、脱发和听力损失的影响:一项由意大利放射治疗和临床肿瘤协会(AIRO)姑息治疗和神经肿瘤研究组批准的系统综述和荟萃分析。
IF 4.8 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-11-08 DOI: 10.1007/s11547-025-02143-3
Rossella Di Franco, Donato Pezzulla, Silvia Chiesa, Francesco Cellini, Ettore Rocchi, Sara Peluso, Francesca Maurizi, Valentina Borzillo, Esmeralda Scipilliti, Elisabetta Bonzano, Sara Colombo, Alberto Cacciola, Giovanni Carlo Mazzola, Luca Bergamaschi, Sara Lillo, Luigi De Cicco, Angela Argenone, Fabio Arcidiacono, Paolo Muto, Francesco Deodato, Valentina Pinzi, Ernesto Maranzano

Aims: We search the literature on data regarding the role of whole-brain radiation therapy on neurocognitive functions, hearing, and alopecia, through the use of hippocampal-, scalp-, and cochlea-sparing radiotherapy (RT).

Methods: Prospective and retrospective studies with at least five patients were included in this analysis, following PRISMA recommendations.

Results: Eighteen works were selected for hippocampal sparing, published between 2015 and 2025 with 1736 patients. Neurocognitive functions were evaluated with a heterogeneous range of tests (mainly HVLT-R, TMT-A and TMT-B, Cowa test, and MME). For scalp-sparing RT, only three papers were selected, published between 2014 and 2015, for a total of 65 patients. There was an important heterogeneity in terms of scalp definitions, CTV prescriptions, used techniques and doses, and methods and scales adopted to evaluate the clinical efficacy of scalp-sparing RT. Regarding cochlea-sparing RT, no citation was selected. A meta-analysis could only be performed for the papers focusing on hippocampal-sparing procedures. Only nine papers meet the criteria, showing a high heterogeneity (chi-square = 229.96, df 8, p < 0.001, with the I2 index (96.52%) and the H2M index (27.75)). For this reason, we opted for random effect models DerSimonian Laird, maximum likelihood, and profile likelihood, which provided widely overlapping results. Although the data show an average protective effect of hippocampal avoidance on cognitive performance, the meta-analysis, based on the available studies, is unable to demonstrate its significance.

Conclusions: A high heterogeneity in terms of hippocampal-, cochlear-, and scalp-sparing RT was registered as well as different and difficult to compare data. Our findings indicate the need for further studies to explore this issue.

目的:我们通过使用海马、头皮和耳蜗保留放射治疗(RT),检索有关全脑放射治疗对神经认知功能、听力和脱发的作用的文献资料。方法:根据PRISMA的建议,本分析纳入了至少5例患者的前瞻性和回顾性研究。结果:选取2015 - 2025年间发表的文献18篇,共1736例患者进行海马保留研究。神经认知功能评估采用异质测试(主要是HVLT-R、TMT-A和TMT-B、Cowa测试和MME)。对于保留头皮的RT,仅选择了3篇论文,发表于2014年至2015年,共65例患者。在头皮定义、CTV处方、使用的技术和剂量、评估保留头皮RT临床疗效的方法和量表等方面存在重要的异质性。关于保留耳蜗RT,未选择文献。一项荟萃分析只能对关注海马保留程序的论文进行。只有9篇论文符合标准,异质性较高(χ 2 = 229.96, df 8, p)。结论:海马、耳蜗和头皮保留RT具有较高异质性,且数据不同且难以比较。我们的发现表明需要进一步的研究来探讨这个问题。
{"title":"Impact of whole-brain radiation therapy on neurocognitive functions, alopecia and hearing loss: a systematic review and meta-analysis endorsed by the Palliative Care and Neuro-Oncology Study Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO).","authors":"Rossella Di Franco, Donato Pezzulla, Silvia Chiesa, Francesco Cellini, Ettore Rocchi, Sara Peluso, Francesca Maurizi, Valentina Borzillo, Esmeralda Scipilliti, Elisabetta Bonzano, Sara Colombo, Alberto Cacciola, Giovanni Carlo Mazzola, Luca Bergamaschi, Sara Lillo, Luigi De Cicco, Angela Argenone, Fabio Arcidiacono, Paolo Muto, Francesco Deodato, Valentina Pinzi, Ernesto Maranzano","doi":"10.1007/s11547-025-02143-3","DOIUrl":"https://doi.org/10.1007/s11547-025-02143-3","url":null,"abstract":"<p><strong>Aims: </strong>We search the literature on data regarding the role of whole-brain radiation therapy on neurocognitive functions, hearing, and alopecia, through the use of hippocampal-, scalp-, and cochlea-sparing radiotherapy (RT).</p><p><strong>Methods: </strong>Prospective and retrospective studies with at least five patients were included in this analysis, following PRISMA recommendations.</p><p><strong>Results: </strong>Eighteen works were selected for hippocampal sparing, published between 2015 and 2025 with 1736 patients. Neurocognitive functions were evaluated with a heterogeneous range of tests (mainly HVLT-R, TMT-A and TMT-B, Cowa test, and MME). For scalp-sparing RT, only three papers were selected, published between 2014 and 2015, for a total of 65 patients. There was an important heterogeneity in terms of scalp definitions, CTV prescriptions, used techniques and doses, and methods and scales adopted to evaluate the clinical efficacy of scalp-sparing RT. Regarding cochlea-sparing RT, no citation was selected. A meta-analysis could only be performed for the papers focusing on hippocampal-sparing procedures. Only nine papers meet the criteria, showing a high heterogeneity (chi-square = 229.96, df 8, p < 0.001, with the I2 index (96.52%) and the H2M index (27.75)). For this reason, we opted for random effect models DerSimonian Laird, maximum likelihood, and profile likelihood, which provided widely overlapping results. Although the data show an average protective effect of hippocampal avoidance on cognitive performance, the meta-analysis, based on the available studies, is unable to demonstrate its significance.</p><p><strong>Conclusions: </strong>A high heterogeneity in terms of hippocampal-, cochlear-, and scalp-sparing RT was registered as well as different and difficult to compare data. Our findings indicate the need for further studies to explore this issue.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477256","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
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。
{"title":"The prognostic value of CT-measured body composition combined with radiomics in predicting the survival of patients with resectable colon cancer.","authors":"Xiaoling Zhi, Tong Nie, Mingming Song, Zhihao Liu, Yixin Heng, Jiaxin Xu, Xiaoyu Wu, Yinghao Cao, Feihong Wu, Chuansheng Zheng","doi":"10.1007/s11547-025-02135-3","DOIUrl":"https://doi.org/10.1007/s11547-025-02135-3","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Result: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459534","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
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。
{"title":"Evaluating double-reading mammography for long-term surveillance in breast cancer survivors: a retrospective exploratory analysis from a single center.","authors":"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","doi":"10.1007/s11547-025-02117-5","DOIUrl":"https://doi.org/10.1007/s11547-025-02117-5","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Material and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452803","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
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。
{"title":"Intratumoral calcifications in pancreatic neoplasms on unenhanced CT: frequency and diagnostic implications.","authors":"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","doi":"10.1007/s11547-025-02142-4","DOIUrl":"https://doi.org/10.1007/s11547-025-02142-4","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</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":"145438962","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
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。
{"title":"Navigating discordant findings in multimodality imaging of prostate cancer in the MRI and PSMA-PET era.","authors":"Sungmin Woo, Benedetta Masci, Anton S Becker, Angela Tong, Kent P Friedman, Felipe de Galiza Barbosa, Damiano Caruso, Andrea Laghi, Hebert Alberto Vargas","doi":"10.1007/s11547-025-02140-6","DOIUrl":"https://doi.org/10.1007/s11547-025-02140-6","url":null,"abstract":"<p><p>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.</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":"145439044","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
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。
{"title":"Residual myocardial hyperemia in regadenoson stress/rest quantitative perfusion cardiac magnetic resonance.","authors":"Gorka Bastarrika, Ana Ezponda, Javier Muñiz-Sáenz-Diez, Marta Vidorreta, Amaia Ochoa González, Juan José Gavira, Nahikari Salterain","doi":"10.1007/s11547-025-02062-3","DOIUrl":"10.1007/s11547-025-02062-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to investigate the presence of residual myocardial hyperemia on the recovery phase in patients undergoing stress CMR.</p><p><strong>Material and methods: </strong>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 (MBF<sub>rest</sub>), stress (MBF<sub>stress</sub>) and recovery (MBF<sub>recovery</sub>) and MPR indices (MPR<sub>stress/rest</sub> and MPR<sub>stress/recovery</sub>) were calculated using automated pixel-wise quantitative myocardial perfusion mapping.</p><p><strong>Results: </strong>A total of 30 patients (22 males, mean age of 62.7 ± 1 years) were included in the analysis. Global MBF<sub>rest</sub> and MBF<sub>stress</sub> 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 (MBF<sub>recovery</sub> of 0.92 ± 0.3 mL/g/min) and statistically differed from MBF<sub>rest</sub> (p < 0.01), suggesting residual myocardial hyperemia. This resulted in an abnormally low MPR<sub>stress/recovery</sub> (2.43 ± 0.7) with respect to MPR<sub>stress/rest</sub> (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).</p><p><strong>Conclusion: </strong>Despite the use of euphylline to counteract the vasodilator effect, MBF does not completely revert to resting values and MBF<sub>recovery</sub> cannot be used as a substitute for MBF<sub>rest</sub> when regadenoson is used. Consequently, a rest/stress protocol is advised for quantitative CMR perfusion to obtain accurate MBF and MPR parameters.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1777-1785"},"PeriodicalIF":4.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966426","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
期刊
Radiologia Medica
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1