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Hypersensitivity Pneumonitis on Thin-Section Chest CT Scans: Diagnostic Performance of the ATS/JRS/ALAT versus ACCP Imaging Guidelines. 薄层胸部 CT 扫描显示的超敏性肺炎:ATS/JRS/ALAT与ACCP成像指南的诊断性能对比。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230068
Lydia Chelala, Ayodeji Adegunsoye, Mary Strek, Cathryn T Lee, Renea Jablonski, Aliya N Husain, Inemesit Udofia, Jonathan H Chung

Purpose To compare the diagnostic performance of the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax (ATS/JRS/ALAT) versus the American College of Chest Physicians (ACCP) imaging classifications for hypersensitivity pneumonitis (HP). Materials and Methods Patients in the institutional review board-approved Interstitial Lung Disease (ILD) registry referred for multidisciplinary discussion (MDD) at the authors' institution (January 1, 2006-April 1, 2021) were included in this retrospective study when ILD was diagnosed at MDD. MDD diagnoses included HP, connective tissue disease-ILD, and idiopathic pulmonary fibrosis. Retrospective review of thin-section CT images was performed in consensus by two cardiothoracic radiologists blinded to the diagnosis. Diagnostic patterns were determined for thin-section CT images using both classifications. Discordance rates were determined. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were assessed using MDD diagnosis as the reference standard. Results A total of 297 patients were included in the study: 200 (67%) with HP, 49 (16%) with connective tissue disease-ILD, and 48 (16%) with idiopathic pulmonary fibrosis at MDD. The discordance rate between the two classifications was 21%. Assuming low HP prevalence (10%), ATS/JRS/ALAT classification outperformed ACCP classification, with greater accuracy (92.3% vs 87.6%) and greater positive predictive value (60.7% vs 42.9%). Assuming high prevalence (50%), accuracy and negative predictive value were superior using ACCP classification (81.7% vs 79.7% and 77.7% vs 72.6%, respectively), and positive predictive value was superior using ATS/JRS/ALAT classification (93.3% vs 87.1%). Conclusion Accuracy of the ATS/JRS/ALAT and ACCP HP classifications was greater in settings with low and high HP prevalence, respectively. Diagnostic performance of both classifications was discordant in a minority of cases. Keywords: CT, Thorax, Hypersensitivity Pneumonitis, Interstitial Lung Disease Supplemental material is available for this article. © RSNA, 2024.

目的 比较美国胸科学会、日本呼吸学会和拉丁美洲肺病协会 (ATS/JRS/ALAT) 与美国胸科医师学会 (ACCP) 对超敏性肺炎 (HP) 的影像学分类的诊断效果。材料与方法 作者所在机构经机构审查委员会批准的间质性肺病(ILD)登记处(2006 年 1 月 1 日至 2021 年 4 月 1 日)中转诊进行多学科讨论(MDD)的患者在 MDD 诊断为 ILD 时被纳入本回顾性研究。MDD 诊断包括 HP、结缔组织病-ILD 和特发性肺纤维化。薄层 CT 图像的回顾性审查由两名对诊断结果保密的心胸放射科医生共同完成。使用两种分类方法确定了薄层 CT 图像的诊断模式。确定了不一致率。以 MDD 诊断为参考标准,评估敏感性、特异性、阳性预测值、阴性预测值和准确性。结果 共有 297 名患者被纳入研究:其中 200 人(67%)患有 HP,49 人(16%)患有结缔组织病-ILD,48 人(16%)患有 MDD 特发性肺纤维化。两种分类的不一致率为 21%。假设肺纤维化发病率较低(10%),ATS/JRS/ALAT 分类的准确率(92.3% 对 87.6%)和阳性预测值(60.7% 对 42.9%)均高于 ACCP 分类。假设发病率较高(50%),使用 ACCP 分类法的准确性和阴性预测值更高(分别为 81.7% vs 79.7% 和 77.7% vs 72.6%),而使用 ATS/JRS/ALAT 分类法的阳性预测值更高(93.3% vs 87.1%)。结论 ATS/JRS/ALAT 和 ACCP HP 分类在 HP 发病率低和高的环境中分别具有更高的准确性。在少数病例中,两种分类的诊断性能不一致。关键词CT、胸部、过敏性肺炎、间质性肺病 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Enabling Reliable Visual Detection of Chronic Myocardial Infarction with Native T1 Cardiac MRI Using Data-Driven Native Contrast Mapping. 利用数据驱动的原位对比度映射,通过原位 T1 心脏 MRI 对慢性心肌梗死进行可靠的视觉检测。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230338
Khalid Youssef, Xinheng Zhang, Ghazal Yoosefian, Yinyin Chen, Shing Fai Chan, Hsin-Jung Yang, Keyur Vora, Andrew Howarth, Andreas Kumar, Behzad Sharif, Rohan Dharmakumar

Purpose To investigate whether infarct-to-remote myocardial contrast can be optimized by replacing generic fitting algorithms used to obtain native T1 maps with a data-driven machine learning pixel-wise approach in chronic reperfused infarct in a canine model. Materials and Methods A controlled large animal model (24 canines, equal male and female animals) of chronic myocardial infarction with histologic evidence of heterogeneous infarct tissue composition was studied. Unsupervised clustering techniques using self-organizing maps and t-distributed stochastic neighbor embedding were used to analyze and visualize native T1-weighted pixel-intensity patterns. Deep neural network models were trained to map pixel-intensity patterns from native T1-weighted image series to corresponding pixels on late gadolinium enhancement (LGE) images, yielding visually enhanced noncontrast maps, a process referred to as data-driven native mapping (DNM). Pearson correlation coefficients and Bland-Altman analyses were used to compare findings from the DNM approach against standard T1 maps. Results Native T1-weighted images exhibited distinct pixel-intensity patterns between infarcted and remote territories. Granular pattern visualization revealed higher infarct-to-remote cluster separability with LGE labeling as compared with native T1 maps. Apparent contrast-to-noise ratio from DNM (mean, 15.01 ± 2.88 [SD]) was significantly different from native T1 maps (5.64 ± 1.58; P < .001) but similar to LGE contrast-to-noise ratio (15.51 ± 2.43; P = .40). Infarcted areas based on LGE were more strongly correlated with DNM compared with native T1 maps (R2 = 0.71 for native T1 maps vs LGE; R2 = 0.85 for DNM vs LGE; P < .001). Conclusion Native T1-weighted pixels carry information that can be extracted with the proposed DNM approach to maximize image contrast between infarct and remote territories for enhanced visualization of chronic infarct territories. Keywords: Chronic Myocardial Infarction, Cardiac MRI, Data-Driven Native Contrast Mapping Supplemental material is available for this article. © RSNA, 2024.

目的 研究在犬模型的慢性再灌注心肌梗死中,用数据驱动的机器学习像素法取代用于获得原始 T1 图的通用拟合算法,是否能优化梗死与远端心肌的对比度。材料与方法 研究了一种慢性心肌梗死的对照大型动物模型(24 只犬科动物,雌雄各半),其组织学证据表明梗死组织的组成不均匀。使用自组织图和 t 分布随机邻域嵌入的无监督聚类技术来分析和可视化原生 T1 加权像素强度模式。对深度神经网络模型进行了训练,以便将原生 T1 加权图像系列中的像素强度模式映射到晚期钆增强(LGE)图像上的相应像素上,从而生成视觉增强的非对比度映射图,这一过程被称为数据驱动的原生映射(DNM)。采用皮尔逊相关系数和布兰-阿尔特曼分析法将 DNM 方法的结果与标准 T1 地图进行比较。结果 原位 T1 加权图像在梗死区和偏远区之间显示出不同的像素强度模式。颗粒模式可视化显示,与原始 T1 图相比,LGE 标记的梗死区与偏远区的分离度更高。DNM 的表观对比噪声比(平均值为 15.01 ± 2.88 [标度])与原始 T1 地图(5.64 ± 1.58;P < .001)有显著差异,但与 LGE 对比噪声比(15.51 ± 2.43;P = .40)相似。与原始 T1 地图相比,基于 LGE 的梗死区域与 DNM 的相关性更强(原始 T1 地图与 LGE 相比,R2 = 0.71;DNM 与 LGE 相比,R2 = 0.85;P < .001)。结论 原位 T1 加权像素所携带的信息可通过建议的 DNM 方法提取出来,从而最大限度地提高梗死区和远端区域的图像对比度,增强慢性梗死区的可视化。关键词慢性心肌梗死 心脏 MRI 数据驱动的原位对比度映射 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Safety Net Reconstruction to Catch Low-Density and Low-Volume Calcifications at Photon-Counting Detector CT Using Virtual Noncontrast Imaging. 利用虚拟非对比成像进行安全网重建,捕捉光子计数探测器 CT 上的低密度和低容积钙化。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.240266
Prabhakar Shantha Rajiah, Kishore Rajendran
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引用次数: 0
Coronary Plaque Characterization with T1-weighted MRI and Near-Infrared Spectroscopy to Predict Periprocedural Myocardial Injury. 利用 T1 加权磁共振成像和近红外光谱分析冠状动脉斑块特征,预测围手术期心肌损伤。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230339
Koji Isodono, Hidenari Matsumoto, Debiao Li, Piotr J Slomka, Damini Dey, Sebastien Cadet, Daisuke Irie, Satoshi Higuchi, Hiroki Tanisawa, Motoki Nakazawa, Yoshiaki Komori, Hidefumi Ohya, Ryoji Kitamura, Tetsuichi Hondera, Ikumi Sato, Hsu-Lei Lee, Anthony G Christodoulou, Yibin Xie, Toshiro Shinke

Purpose To clarify the predominant causative plaque constituent for periprocedural myocardial injury (PMI) following percutaneous coronary intervention: (a) erythrocyte-derived materials, indicated by a high plaque-to-myocardium signal intensity ratio (PMR) at coronary atherosclerosis T1-weighted characterization (CATCH) MRI, or (b) lipids, represented by a high maximum 4-mm lipid core burden index (maxLCBI4 mm) at near-infrared spectroscopy intravascular US (NIRS-IVUS). Materials and Methods This retrospective study included consecutive patients who underwent CATCH MRI before elective NIRS-IVUS-guided percutaneous coronary intervention at two facilities. PMI was defined as post-percutaneous coronary intervention troponin T values greater than five times the upper reference limit. Multivariable analysis was performed to identify predictors of PMI. Finally, the predictive capabilities of MRI, NIRS-IVUS, and their combination were compared. Results A total of 103 lesions from 103 patients (median age, 72 years [IQR, 64-78]; 78 male patients) were included. PMI occurred in 36 lesions. In multivariable analysis, PMR emerged as the strongest predictor (P = .001), whereas maxLCBI4 mm was not a significant predictor (P = .07). When PMR was excluded from the analysis, maxLCBI4 mm emerged as the sole independent predictor (P = .02). The combination of MRI and NIRS-IVUS yielded the largest area under the receiver operating curve (0.86 [95% CI: 0.64, 0.83]), surpassing that of NIRS-IVUS alone (0.75 [95% CI: 0.64, 0.83]; P = .02) or MRI alone (0.80 [95% CI: 0.68, 0.88]; P = .30). Conclusion Erythrocyte-derived materials in plaques, represented by a high PMR at CATCH MRI, were strongly associated with PMI independent of lipids. MRI may play a crucial role in predicting PMI by offering unique pathologic insights into plaques, distinct from those provided by NIRS. Keywords: Coronary Plaque, Periprocedural Myocardial Injury, MRI, Near-Infrared Spectroscopy Intravascular US Supplemental material is available for this article. © RSNA, 2024.

目的 明确经皮冠状动脉介入术后围术期心肌损伤(PMI)的主要致病斑块成分:(a) 红细胞衍生物质,表现为冠状动脉粥样硬化 T1 加权磁共振成像(CATCH)上斑块与心肌信号强度比(PMR)较高;或 (b) 脂质,表现为近红外光谱血管内超声(NIRS-IVUS)上最大 4 mm 脂质核心负荷指数(maxLCBI4 mm)较高。材料与方法 这项回顾性研究纳入了在两家医院接受 NIRS-IVUS 引导的经皮冠状动脉介入治疗前接受 CATCH MRI 的连续患者。PMI定义为经皮冠状动脉介入治疗后肌钙蛋白T值超过参考上限的五倍。进行了多变量分析以确定 PMI 的预测因素。最后,比较了 MRI、NIRS-IVUS 及其组合的预测能力。结果 共纳入 103 名患者(中位年龄 72 岁 [IQR,64-78];78 名男性患者)的 103 个病灶。36 个病灶出现 PMI。在多变量分析中,PMR 是最强的预测因子(P = .001),而 maxLCBI4 mm 并非显著的预测因子(P = .07)。当分析中排除 PMR 时,maxLCBI4 mm 成为唯一的独立预测因子(P = .02)。MRI 和 NIRS-IVUS 的组合产生了最大的接收器工作曲线下面积(0.86 [95% CI: 0.64, 0.83]),超过了 NIRS-IVUS 单独使用时的面积(0.75 [95% CI: 0.64, 0.83]; P = .02)或 MRI 单独使用时的面积(0.80 [95% CI: 0.68, 0.88]; P = .30)。结论斑块中的红细胞衍生物质在 CATCH MRI 中表现为高 PMR,与 PMI 密切相关,与血脂无关。核磁共振成像可对斑块提供不同于近红外光谱的独特病理学见解,从而在预测 PMI 方面发挥关键作用。关键词:冠状动脉斑块冠状动脉斑块 围手术期心肌损伤 MRI 近红外光谱血管内超声 这篇文章有补充材料。© RSNA, 2024.
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引用次数: 0
Erratum for: MRI in Patients with Cardiovascular Implantable Electronic Devices and Fractured or Abandoned Leads. 勘误:心血管植入式电子设备及导线断裂或脱落患者的核磁共振成像。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.249004
Mark J Greenhill, Pooja Rangan, Wilber Su, J Peter Weiss, Michael Zawaneh, Samuel Unzek, Balaji Tamarappoo, Julia Indik, Roderick Tung, Michael F Morris
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引用次数: 0
Leveraging Serial Low-Dose CT Scans in Radiomics-based Reinforcement Learning to Improve Early Diagnosis of Lung Cancer at Baseline Screening. 在基于放射组学的强化学习中利用连续低剂量 CT 扫描改善基线筛查中的肺癌早期诊断。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-01 DOI: 10.1148/ryct.230196
Yifan Wang, Chuan Zhou, Lei Ying, Elizabeth Lee, Heang-Ping Chan, Aamer Chughtai, Lubomir M Hadjiiski, Ella A Kazerooni

Purpose To evaluate the feasibility of leveraging serial low-dose CT (LDCT) scans to develop a radiomics-based reinforcement learning (RRL) model for improving early diagnosis of lung cancer at baseline screening. Materials and Methods In this retrospective study, 1951 participants (female patients, 822; median age, 61 years [range, 55-74 years]) (male patients, 1129; median age, 62 years [range, 55-74 years]) were randomly selected from the National Lung Screening Trial between August 2002 and April 2004. An RRL model using serial LDCT scans (S-RRL) was trained and validated using data from 1404 participants (372 with lung cancer) containing 2525 available serial LDCT scans up to 3 years. A baseline RRL (B-RRL) model was trained with only LDCT scans acquired at baseline screening for comparison. The 547 held-out individuals (150 with lung cancer) were used as an independent test set for performance evaluation. The area under the receiver operating characteristic curve (AUC) and the net reclassification index (NRI) were used to assess the performances of the models in the classification of screen-detected nodules. Results Deployment to the held-out baseline scans showed that the S-RRL model achieved a significantly higher test AUC (0.88 [95% CI: 0.85, 0.91]) than both the Brock model (AUC, 0.84 [95% CI: 0.81, 0.88]; P = .02) and the B-RRL model (AUC, 0.86 [95% CI: 0.83, 0.90]; P = .02). Lung cancer risk stratification was significantly improved by the S-RRL model as compared with Lung CT Screening Reporting and Data System (NRI, 0.29; P < .001) and the Brock model (NRI, 0.12; P = .008). Conclusion The S-RRL model demonstrated the potential to improve early diagnosis and risk stratification for lung cancer at baseline screening as compared with the B-RRL model and clinical models. Keywords: Radiomics-based Reinforcement Learning, Lung Cancer Screening, Low-Dose CT, Machine Learning © RSNA, 2024 Supplemental material is available for this article.

目的 评估利用连续低剂量 CT(LDCT)扫描开发基于放射组学的强化学习(RRL)模型的可行性,以改善基线筛查中肺癌的早期诊断。材料与方法 在这项回顾性研究中,2002 年 8 月至 2004 年 4 月期间,从全国肺筛查试验中随机抽取了 1951 名参与者(女性患者 822 名;中位年龄 61 岁 [范围 55-74 岁])(男性患者 1129 名;中位年龄 62 岁 [范围 55-74 岁])。利用来自1404名参与者(372名肺癌患者)的数据(包含2525张3年前的序列LDCT扫描),对使用序列LDCT扫描的RRL模型(S-RRL)进行了训练和验证。基线 RRL(B-RRL)模型仅使用基线筛查时获得的 LDCT 扫描数据进行训练和对比。547名被排除在外的患者(150名肺癌患者)被用作独立的测试集进行性能评估。接受者操作特征曲线下面积(AUC)和净再分类指数(NRI)用于评估模型在筛查出的结节分类中的性能。结果 对保留的基线扫描结果显示,S-RRL 模型的测试 AUC(0.88 [95% CI: 0.85, 0.91])明显高于 Brock 模型(AUC, 0.84 [95% CI: 0.81, 0.88]; P = .02)和 B-RRL 模型(AUC, 0.86 [95% CI: 0.83, 0.90]; P = .02)。与肺CT筛查报告和数据系统(NRI,0.29;P < .001)和布洛克模型(NRI,0.12;P = .008)相比,S-RRL模型能显著改善肺癌风险分层。结论 与 B-RRL 模型和临床模型相比,S-RRL 模型显示了在基线筛查时改进肺癌早期诊断和风险分层的潜力。关键词基于放射组学的强化学习 肺癌筛查 低剂量 CT 机器学习 © RSNA, 2024 本文有补充材料。
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引用次数: 0
Sex Differences in Aging-related Myocardial Stiffening Quantitatively Measured with MR Elastography. 用磁共振弹性成像技术定量测量与衰老相关的心肌僵化的性别差异
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-01 DOI: 10.1148/ryct.230140
Arvin Arani, Matthew C Murphy, Huzefa Bhopalwala, Shivaram P Arunachalam, Phillip J Rossman, Joshua D Trzasko, Kevin Glaser, Yi Sui, Tina Gunderson, Adelaide M Arruda-Olson, Armando Manduca, Kejal Kantarci, Richard L Ehman, Philip A Araoz

Purpose To investigate the feasibility of using quantitative MR elastography (MRE) to characterize the influence of aging and sex on left ventricular (LV) shear stiffness. Materials and Methods In this prospective study, LV myocardial shear stiffness was measured in 109 healthy volunteers (age range: 18-84 years; mean age, 40 years ± 18 [SD]; 57 women, 52 men) enrolled between November 2018 and September 2019, using a 5-minute MRE acquisition added to a clinical MRI protocol. Linear regression models were used to estimate the association of cardiac MRI and MRE characteristics with age and sex; models were also fit to assess potential age-sex interaction. Results Myocardial shear stiffness significantly increased with age in female (age slope = 0.03 kPa/year ± 0.01, P = .009) but not male (age slope = 0.008 kPa/year ± 0.009, P = .38) volunteers. LV ejection fraction (LVEF) increased significantly with age in female volunteers (0.23% ± 0.08 per year, P = .005). LV end-systolic volume (LVESV) decreased with age in female volunteers (-0.20 mL/m2 ± 0.07, P = .003). MRI parameters, including T1, strain, and LV mass, did not demonstrate this interaction (P > .05). Myocardial shear stiffness was not significantly correlated with LVEF, LV stroke volume, body mass index, or any MRI strain metrics (P > .05) but showed significant correlations with LV end-diastolic volume/body surface area (BSA) (slope = -3 kPa/mL/m2 ± 1, P = .004, r2 = 0.08) and LVESV/BSA (-1.6 kPa/mL/m2 ± 0.5, P = .003, r2 = 0.08). Conclusion This study demonstrates that female, but not male, individuals experience disproportionate LV stiffening with natural aging, and these changes can be noninvasively measured with MRE. Keywords: Cardiac, Elastography, Biological Effects, Experimental Investigations, Sexual Dimorphisms, MR Elastography, Myocardial Shear Stiffness, Quantitative Stiffness Imaging, Aging Heart, Myocardial Biomechanics, Cardiac MRE Supplemental material is available for this article. Published under a CC BY 4.0 license.

目的 探讨使用定量磁共振弹性成像(MRE)来描述年龄和性别对左心室剪切硬度影响的可行性。材料和方法 在这项前瞻性研究中,对2018年11月至2019年9月期间入组的109名健康志愿者(年龄范围:18-84岁;平均年龄为40岁±18[SD];57名女性,52名男性)进行了左心室心肌剪切刚度测量,在临床MRI方案中增加了5分钟的MRE采集。线性回归模型用于估算心脏 MRI 和 MRE 特征与年龄和性别的关系;模型还用于评估潜在的年龄-性别交互作用。结果 女性(年龄斜率 = 0.03 kPa/year ± 0.01,P = .009)而非男性(年龄斜率 = 0.008 kPa/year ± 0.009,P = .38)志愿者的心肌剪切硬度随着年龄的增长而显著增加。女性志愿者的左心室射血分数(LVEF)随着年龄的增长而显著增加(每年 0.23% ± 0.08,P = .005)。女性志愿者的左心室收缩末期容积(LVESV)随着年龄的增长而下降(-0.20 mL/m2 ± 0.07,P = .003)。磁共振成像参数,包括 T1、应变和左心室质量,并未显示出这种相互作用(P > .05)。心肌剪切僵硬度与 LVEF、LV 搏出量、体重指数或任何 MRI 应变指标无明显相关性(P > .05),但与 LV 舒张末期容积/体表面积 (BSA) (斜率 = -3 kPa/mL/m2±1,P = .004,r2 = 0.08)和 LVESV/BSA (-1.6 kPa/mL/m2±0.5,P = .003,r2 = 0.08)有明显相关性。结论 该研究表明,女性(而非男性)会随着自然衰老而经历不成比例的左心室僵化,而这些变化可通过 MRE 进行无创测量。关键词心脏 弹性成像 生物效应 实验研究 性二态性 磁共振弹性成像 心肌剪切僵硬度 定量僵硬度成像 衰老的心脏 心肌生物力学 心脏MRE 本文有补充材料。以 CC BY 4.0 许可发布。
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引用次数: 0
Seeing between Time: Higher Frame Rate Cardiac Cine MRI using Deep Learning. 时空穿梭:利用深度学习实现更高帧速率的心脏动态磁共振成像。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-01 DOI: 10.1148/ryct.240140
Ioannis Koktzoglou
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引用次数: 0
Intraindividual Comparison of Dose Reduction and Coronary Calcium Scoring Accuracy Using Kilovolt-independent and Tin Filtration CT Protocols. 使用独立于千伏和锡滤 CT 方案的剂量降低和冠状动脉钙化评分准确性的个体内比较。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-01 DOI: 10.1148/ryct.230246
Salma Zook, Bhupendar Tayal, Kristian Kragholm, Ola Abdelkarim, Diana Tran, Myra Cocker, Juan Carlos Ramirez-Giraldo, Kristina Hallam, Colleen Sexton, Stephanie Johnson, Su Min Chang

Purpose To investigate the ability of kilovolt-independent (hereafter, kV-independent) and tin filter spectral shaping to accurately quantify the coronary artery calcium score (CACS) and radiation dose reductions compared with the standard 120-kV CT protocol. Materials and Methods This prospective, blinded reader study included 201 participants (mean age, 60 years ± 9.8 [SD]; 119 female, 82 male) who underwent standard 120-kV CT and additional kV-independent and tin filter research CT scans from October 2020 to July 2021. Scans were reconstructed using a Qr36f kernel for standard scans and an Sa36f kernel for research scans simulating artificial 120-kV images. CACS, risk categorization, and radiation doses were compared by analyzing data with analysis of variance, Kruskal-Wallis test, Mann-Whitney test, Bland-Altman analysis, Pearson correlations, and κ analysis for agreement. Results There was no evidence of differences in CACS across standard 120-kV, kV-independent, and tin filter scans, with median CACS values of 1 (IQR, 0-48), 0.6 (IQR, 0-58), and 0 (IQR, 0-51), respectively (P = .85). Compared with standard 120-kV scans, kV-independent and tin filter scans showed excellent correlation in CACS values (r = 0.993 and r = 0.999, respectively), with high agreement in CACS risk categorization (κ = 0.95 and κ = 0.93, respectively). Standard 120-kV scans had a mean radiation dose of 2.09 mSv ± 0.84, while kV-independent and tin filter scans reduced it to 1.21 mSv ± 0.85 and 0.26 mSv ± 0.11, cutting doses by 42% and 87%, respectively (P < .001). Conclusion The kV-independent and tin filter research CT acquisition techniques showed excellent agreement and high accuracy in CACS estimation compared with standard 120-kV scans, with large reductions in radiation dose. Keywords: CT, Cardiac, Coronary Arteries, Radiation Safety, Coronary Artery Calcium Score, Radiation Dose Reduction, Low-Dose CT Scan, Tin Filter, kV-Independent Supplemental material is available for this article. © RSNA, 2024.

目的 研究千伏独立型(以下简称千伏独立型)和锡滤波器频谱整形与标准 120 千伏 CT 方案相比,准确量化冠状动脉钙化评分 (CACS) 和减少辐射剂量的能力。材料和方法 这项前瞻性、盲人阅读研究纳入了 201 名参与者(平均年龄为 60 岁 ± 9.8 [SD];119 名女性,82 名男性),他们在 2020 年 10 月至 2021 年 7 月期间接受了标准 120-kV CT 以及额外的 kV 独立型和锡滤波研究 CT 扫描。标准扫描使用 Qr36f 内核重建,研究扫描使用 Sa36f 内核模拟人工 120-kV 图像。通过方差分析、Kruskal-Wallis 检验、Mann-Whitney 检验、Bland-Altman 分析、Pearson 相关性和 κ 一致性分析分析数据,比较 CACS、风险分类和辐射剂量。结果 没有证据表明标准 120-kV、独立 kV 和锡滤波器扫描的 CACS 存在差异,CACS 中位值分别为 1(IQR,0-48)、0.6(IQR,0-58)和 0(IQR,0-51)(P = .85)。与标准 120-kV 扫描相比,kV 独立扫描和锡滤波器扫描的 CACS 值显示出极好的相关性(r = 0.993 和 r = 0.999),CACS 风险分类的一致性也很高(κ = 0.95 和 κ = 0.93)。标准 120 kV 扫描的平均辐射剂量为 2.09 mSv ± 0.84,而独立 kV 扫描和锡滤波器扫描的平均辐射剂量则分别降至 1.21 mSv ± 0.85 和 0.26 mSv ± 0.11,剂量分别减少了 42% 和 87%(P < .001)。结论 与标准 120-kV 扫描相比,独立于 kV 和锡滤波研究 CT 采集技术在 CACS 估算方面显示出极佳的一致性和高准确性,并大幅降低了辐射剂量。关键词CT,心脏,冠状动脉,辐射安全,冠状动脉钙化评分,辐射剂量减少,低剂量CT扫描,锡滤波器,独立于kV的CT扫描 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Infracardiac Total Anomalous Pulmonary Venous Connection. 心下全异常肺静脉连接。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-01 DOI: 10.1148/ryct.240018
Lucas de Pádua Gomes de Farias, Luciana de Pádua Silva Baptista, Márcio Campos Sampaio
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引用次数: 0
期刊
Radiology. Cardiothoracic imaging
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