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Activation patterns of rotator-cuff muscles from quantitative IVIM DWI after physical testing. 通过定量 IVIM DWI 分析物理测试后旋肩袖肌肉的激活模式。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-26 DOI: 10.1186/s41747-024-00487-5
Adrian Alexander Marth, Georg Ralph Spinner, Constantin von Deuster, Stefan Sommer, Reto Sutter, Daniel Nanz

Background: The diagnostic value of clinical rotator cuff (RC) tests is controversial, with only sparse evidence available about their anatomical specificity. We prospectively assessed regional RC muscle activation patterns by means of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) after the execution of common clinical RC tests.

Methods: Ten healthy subjects (five males, five females) underwent three sessions of diffusion-weighted 3-T shoulder MRI before and after testing the supraspinatus (SSP, Jobe test, session 1), subscapularis (SSC, lift-off test, session 2, at least 1 week later), and infraspinatus muscle (ISP, external rotation test, session 3, another week later). IVIM parameters (perfusion fraction, f; pseudo-diffusion coefficient. D*; and their product, fD*) were measured in regions of interest placed in images of the SSP, SSC, ISP, and deltoid muscle. The Wilcoxon signed-rank test was used for group comparisons; p-values were adjusted using the Bonferroni correction.

Results: After all tests, fD* was significantly increased in the respective target muscles (SSP, SSC, or ISP; p ≤ 0.001). After SSP testing, an additional significant increase of fD* was observed in the deltoid, the SSC, and the ISP muscle (p < 0.001). After the SSC and ISP tests, no significant concomitant increase of any parameter was observed in the other RC muscles.

Conclusion: IVIM revealed varying activation patterns of RC muscles for different clinical RC tests. For SSP testing, coactivation of the deltoid and other RC muscles was observed, implying limited anatomical specificity, while the tests for the SSC and ISP specifically activated their respective target muscle.

Relevance statement: Following clinical RC tests, IVIM MRI revealed that SSP testing led to shoulder muscle coactivation, while the SSC and ISP tests specifically activated the target muscles.

Key points: In this study, intravoxel incoherent motion MRI depicted muscle activation following clinical rotator cuff tests. After supraspinatus testing, coactivation of surrounding shoulder girdle muscles was observed. Subscapularis and infraspinatus tests exhibited isolated activation of their respective target muscles.

背景:临床肩袖(RC)测试的诊断价值尚存争议,有关其解剖特异性的证据也很稀少。我们通过体细胞内不连贯运动(IVIM)弥散加权磁共振成像(MRI)前瞻性地评估了进行常见临床肩袖测试后的区域肩袖肌激活模式:十名健康受试者(五名男性,五名女性)在冈上肌(SSP,Jobe 试验,第 1 次)、肩胛下肌(SSC,提举试验,第 2 次,至少一周后)和冈下肌(ISP,外旋试验,第 3 次,一周后)测试前后接受了三次 3 T 肩部弥散加权磁共振成像。IVIM 参数(灌注分数,f;假扩散系数,D*;及其乘积,f)的变化情况。D*;以及它们的乘积 fD*)。组间比较采用 Wilcoxon 符号秩检验;P 值采用 Bonferroni 校正:结果:所有测试后,各目标肌肉(SSP、SSC 或 ISP;p ≤ 0.001)的 fD* 均显著增加。在 SSP 测试后,三角肌、SSC 和 ISP 肌肉中的 fD* 也有明显增加(p):IVIM 揭示了不同临床 RC 测试中 RC 肌肉的不同激活模式。在 SSP 测试中,观察到三角肌和其他 RC 肌肉的共同激活,这意味着解剖特异性有限,而在 SSC 和 ISP 测试中,则特别激活了各自的目标肌肉:在临床 RC 测试后,IVIM 核磁共振成像显示,SSP 测试会导致肩部肌肉共同激活,而 SSC 和 ISP 测试会特异性激活目标肌肉:本研究中,体素内不连贯运动磁共振成像描绘了临床肩袖测试后的肌肉激活情况。冈上肌测试后,可观察到周围肩周肌肉的共同激活。肩胛下肌和冈下肌测试显示了各自目标肌肉的孤立激活。
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引用次数: 0
Correction: Effect of emphysema on AI software and human reader performance in lung nodule detection from low-dose chest CT. 更正:肺气肿对人工智能软件和人类阅读器从低剂量胸部 CT 检测肺结节性能的影响。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-16 DOI: 10.1186/s41747-024-00494-6
Nikos Sourlos, GertJan Pelgrim, Hendrik Joost Wisselink, Xiaofei Yang, Gonda de Jonge, Mieneke Rook, Mathias Prokop, Grigory Sidorenkov, Marcel van Tuinen, Rozemarijn Vliegenthart, Peter M A van Ooijen
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引用次数: 0
Reproducibility of a single-volume dynamic CT myocardial blood flow measurement technique: validation in a swine model. 单容积动态 CT 心肌血流测量技术的再现性:在猪模型中的验证。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-14 DOI: 10.1186/s41747-024-00498-2
Negin Hadjiabdolhamid, Yixiao Zhao, Logan Hubbard, Sabee Molloi

Background: We prospectively assessed the reproducibility of a novel low-dose single-volume dynamic computed tomography (CT) myocardial blood flow measurement technique.

Methods: Thirty-four pairs of measurements were made under rest and stress conditions in 13 swine (54.3 ± 12.3 kg). One or two acquisition pairs were acquired in each animal with a 10-min delay between each pair. Contrast (370 mgI/mL; 0.5 mL/kg) and a diluted contrast/saline chaser (0.5 mL/kg; 30:70 contrast/saline) were injected peripherally at 5 mL/s, followed by bolus tracking and acquisition of a single volume scan (100 kVp; 200 mA) with a 320-slice CT scanner. Bolus tracking and single volume scan data were used to derive perfusion in mL/min/g using a first-pass analysis model; the coronary perfusion territories of the left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA) were automatically assigned using a previously validated minimum-cost path technique. The reproducibility of CT myocardial perfusion measurement within the LAD, LCx, RCA, and the whole myocardium was assessed via regression analysis. The average CT dose index (CTDI) of perfusion measurement was recorded.

Results: The repeated first (Pmyo1) and second (Pmyo2) single-volume CT perfusion measurements were related by Pmyo2 = 1.01Pmyo1 - 0.03(ρ = 0.96; RMSE = 0.08 mL/min/g; RMSE = 0.07 mL/min/g) for the whole myocardium, and by Preg2 = 0.86Preg1 + 0.13(ρ = 0.87; RMSE = 0.31 mL/min/g; RMSE = 0.29 mL/min/g) for the LAD, LCx, and RCA perfusion territories. The average CTDI of the single-volume CT perfusion measurement was 10.5 mGy.

Conclusion: The single-volume CT blood flow measurement technique provides reproducible low-dose myocardial perfusion measurement using only bolus tracking data and a single whole-heart volume scan.

Relevance statement: The single-volume CT blood flow measurement technique is a noninvasive tool that reproducibly measures myocardial perfusion and provides coronary CT angiograms, allowing for simultaneous anatomic-physiologic assessment of myocardial ischemia.

Key points: A low-dose single-volume dynamic CT myocardial blood flow measurement technique is reproducible. Motion misregistration artifacts are eliminated using a single-volume CT perfusion technique. This technique enables combined anatomic-physiologic assessment of coronary artery disease.

背景:我们对新型低剂量单容积动态计算机断层扫描(CT)心肌血流测量技术的重现性进行了前瞻性评估:我们对新型低剂量单容积动态计算机断层扫描(CT)心肌血流测量技术的可重复性进行了前瞻性评估:方法:对 13 头猪(54.3 ± 12.3 千克)进行了 34 对静息和应激条件下的测量。每只动物采集一或两对数据,每对数据之间延迟 10 分钟。以 5 mL/s 的速度向外周注射对比剂(370 mgI/mL;0.5 mL/kg)和稀释的对比剂/盐水追逐液(0.5 mL/kg;对比剂/盐水的比例为 30:70),然后使用 320 排 CT 扫描仪进行栓剂跟踪和单容积扫描(100 kVp;200 mA)。利用栓剂跟踪和单次容积扫描数据,采用一次通过分析模型得出以 mL/min/g 为单位的灌注量;采用先前验证的最小成本路径技术自动分配左前降支 (LAD)、左环挠 (LCx) 和右冠状动脉 (RCA) 的冠状动脉灌注区域。通过回归分析评估了 LAD、LCx、RCA 和整个心肌内 CT 心肌灌注测量的再现性。结果显示,重复第一次(Pmyo1)和重复第二次(Pmyo2)的心肌灌注测量结果均优于重复第三次(Pmyo3)和重复第三次(Pmyo4):结果:重复的第一次(Pmyo1)和第二次(Pmyo2)单容积 CT 灌注测量值的相关性为 Pmyo2 = 1.01Pmyo1 - 0.03(ρ = 0.96;RMSE = 0.08 mL/min/g;RMSE = 0.07毫升/分钟/克),LAD、LCx 和 RCA 灌注区域的 Preg2 = 0.86Preg1 + 0.13(ρ = 0.87;RMSE = 0.31 毫升/分钟/克;RMSE = 0.29 毫升/分钟/克)。单容积 CT 灌注测量的平均 CTDI 为 10.5 mGy:结论:单容积 CT 血流测量技术只需使用药栓跟踪数据和单次全心容积扫描,就能进行可重复的低剂量心肌灌注测量:单容积 CT 血流测量技术是一种无创工具,可重复测量心肌灌注并提供冠状动脉 CT 血管造影,从而同时对心肌缺血进行解剖学和生理学评估:要点:低剂量单容积动态 CT 心肌血流测量技术具有可重复性。使用单容积 CT 灌注技术可消除运动失准伪影。该技术可对冠状动脉疾病进行解剖学和生理学联合评估。
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引用次数: 0
Automated cardiovascular MR myocardial scar quantification with unsupervised domain adaptation. 利用无监督领域适应性自动进行心血管磁共振心肌瘢痕量化。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-14 DOI: 10.1186/s41747-024-00497-3
Richard Crawley, Sina Amirrajab, Didier Lustermans, Robert J Holtackers, Sven Plein, Mitko Veta, Marcel Breeuwer, Amedeo Chiribiri, Cian M Scannell

Quantification of myocardial scar from late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) images can be facilitated by automated artificial intelligence (AI)-based analysis. However, AI models are susceptible to domain shifts in which the model performance is degraded when applied to data with different characteristics than the original training data. In this study, CycleGAN models were trained to translate local hospital data to the appearance of a public LGE CMR dataset. After domain adaptation, an AI scar quantification pipeline including myocardium segmentation, scar segmentation, and computation of scar burden, previously developed on the public dataset, was evaluated on an external test set including 44 patients clinically assessed for ischemic scar. The mean ± standard deviation Dice similarity coefficients between the manual and AI-predicted segmentations in all patients were similar to those previously reported: 0.76 ± 0.05 for myocardium and 0.75 ± 0.32 for scar, 0.41 ± 0.12 for scar in scans with pathological findings. Bland-Altman analysis showed a mean bias in scar burden percentage of -0.62% with limits of agreement from -8.4% to 7.17%. These results show the feasibility of deploying AI models, trained with public data, for LGE CMR quantification on local clinical data using unsupervised CycleGAN-based domain adaptation. RELEVANCE STATEMENT: Our study demonstrated the possibility of using AI models trained from public databases to be applied to patient data acquired at a specific institution with different acquisition settings, without additional manual labor to obtain further training labels.

通过基于人工智能(AI)的自动分析,可以对晚期钆增强(LGE)心血管磁共振(CMR)图像中的心肌瘢痕进行量化。然而,人工智能模型容易受到领域偏移的影响,当应用于与原始训练数据具有不同特征的数据时,模型的性能就会下降。在本研究中,对 CycleGAN 模型进行了训练,以将本地医院数据转换为公共 LGE CMR 数据集的外观。经过领域适应后,在外部测试集(包括 44 名临床评估为缺血性瘢痕的患者)上评估了之前在公共数据集上开发的人工智能瘢痕量化管道,包括心肌分割、瘢痕分割和瘢痕负担计算。所有患者的人工分段与人工智能预测分段之间的平均±标准偏差骰子相似系数与之前报告的相似:心肌为 0.76 ± 0.05,瘢痕为 0.75 ± 0.32,在有病理结果的扫描中,瘢痕为 0.41 ± 0.12。Bland-Altman分析显示,瘢痕负荷百分比的平均偏差为-0.62%,一致性范围为-8.4%至7.17%。这些结果表明,利用基于 CycleGAN 的无监督领域自适应技术,在本地临床数据上部署使用公共数据训练的 LGE CMR 定量人工智能模型是可行的。相关性声明:我们的研究证明了使用公共数据库训练的人工智能模型应用于特定机构以不同采集设置获取的患者数据的可能性,而无需额外的人工劳动来获取进一步的训练标签。
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引用次数: 0
Accuracy of 3D real-time MRI temperature mapping in gel phantoms during microwave heating. 微波加热期间凝胶模型中三维实时磁共振成像温度绘图的准确性。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-14 DOI: 10.1186/s41747-024-00479-5
Olaf Dietrich, Sergio Lentini, Osman Öcal, Pierre Bour, Thibaut L Faller, Valéry Ozenne, Jens Ricke, Max Seidensticker

Background: Interventional magnetic resonance imaging (MRI) can provide a comprehensive setting for microwave ablation of tumors with real-time monitoring of the energy delivery using MRI-based temperature mapping. The purpose of this study was to quantify the accuracy of three-dimensional (3D) real-time MRI temperature mapping during microwave heating in vitro by comparing MRI thermometry data to reference data measured by fiber-optical thermometry.

Methods: Nine phantom experiments were evaluated in agar-based gel phantoms using an in-room MR-conditional microwave system and MRI thermometry. MRI measurements were performed for 700 s (25 slices; temporal resolution 2 s). The temperature was monitored with two fiber-optical temperature sensors approximately 5 mm and 10 mm distant from the microwave antenna. Temperature curves of the sensors were compared to MRI temperature data of single-voxel regions of interest (ROIs) at the sensor tips; the accuracy of MRI thermometry was assessed as the root-mean-squared (RMS)-averaged temperature difference. Eighteen neighboring voxels around the original ROI were also evaluated and the voxel with the smallest temperature difference was additionally selected for further evaluation.

Results: The maximum temperature changes measured by the fiber-optical sensors ranged from 7.3 K to 50.7 K. The median RMS-averaged temperature differences in the originally selected voxels ranged from 1.4 K to 3.4 K. When evaluating the minimum-difference voxel from the neighborhood, the temperature differences ranged from 0.5 K to 0.9 K. The microwave antenna and the MRI-conditional in-room microwave generator did not induce relevant radiofrequency artifacts.

Conclusion: Accurate 3D real-time MRI temperature mapping during microwave heating with very low RMS-averaged temperature errors below 1 K is feasible in gel phantoms.

Relevance statement: Accurate MRI-based volumetric real-time monitoring of temperature distribution and thermal dose is highly relevant in clinical MRI-based interventions and can be expected to improve local tumor control, as well as procedural safety by extending the limits of thermal (e.g., microwave) ablation of tumors in the liver and in other organs.

Key points: Interventional MRI can provide a comprehensive setting for the microwave ablation of tumors. MRI can monitor the microwave ablation using real-time MRI-based temperature mapping. 3D real-time MRI temperature mapping during microwave heating is feasible. Measured temperature errors were below 1 °C in gel phantoms. The active in-room microwave generator did not induce any relevant radiofrequency artifacts.

背景:介入性磁共振成像(MRI)可为肿瘤的微波消融提供一个全面的环境,利用基于磁共振成像的温度测绘对能量输送进行实时监测。本研究的目的是通过比较核磁共振测温数据和光纤测温测量的参考数据,量化微波体外加热过程中三维(3D)实时核磁共振测温的准确性:方法:使用室内磁共振条件微波系统和磁共振测温仪,在琼脂凝胶模型中进行了九次模型实验评估。核磁共振成像测量持续了 700 秒(25 个切片;时间分辨率为 2 秒)。温度由两个光纤温度传感器监测,分别距离微波天线约 5 毫米和 10 毫米。传感器的温度曲线与传感器顶端单体素感兴趣区(ROI)的 MRI 温度数据进行了比较;MRI 测温的准确性根据均方根(RMS)平均温差进行评估。还对原始 ROI 周围的 18 个相邻体素进行了评估,并选择温差最小的体素进行进一步评估:微波天线和磁共振成像条件下的室内微波发生器没有引起相关的射频伪影:结论:在凝胶模型中,微波加热过程中精确的三维实时磁共振成像温度绘图是可行的,且均方根温度误差非常低,低于 1 K:基于磁共振成像对温度分布和热剂量进行精确的容积实时监测与基于磁共振成像的临床介入治疗高度相关,有望通过扩大肝脏和其他器官肿瘤热(如微波)消融的范围来改善局部肿瘤控制和手术安全性:要点:介入磁共振成像可为肿瘤的微波消融提供全面的环境。磁共振成像可利用基于磁共振成像的实时温度图监测微波消融。在微波加热过程中进行三维实时磁共振成像温度测绘是可行的。在凝胶模型中测得的温度误差低于1 °C。室内有源微波发生器没有诱发任何相关的射频伪影。
{"title":"Accuracy of 3D real-time MRI temperature mapping in gel phantoms during microwave heating.","authors":"Olaf Dietrich, Sergio Lentini, Osman Öcal, Pierre Bour, Thibaut L Faller, Valéry Ozenne, Jens Ricke, Max Seidensticker","doi":"10.1186/s41747-024-00479-5","DOIUrl":"10.1186/s41747-024-00479-5","url":null,"abstract":"<p><strong>Background: </strong>Interventional magnetic resonance imaging (MRI) can provide a comprehensive setting for microwave ablation of tumors with real-time monitoring of the energy delivery using MRI-based temperature mapping. The purpose of this study was to quantify the accuracy of three-dimensional (3D) real-time MRI temperature mapping during microwave heating in vitro by comparing MRI thermometry data to reference data measured by fiber-optical thermometry.</p><p><strong>Methods: </strong>Nine phantom experiments were evaluated in agar-based gel phantoms using an in-room MR-conditional microwave system and MRI thermometry. MRI measurements were performed for 700 s (25 slices; temporal resolution 2 s). The temperature was monitored with two fiber-optical temperature sensors approximately 5 mm and 10 mm distant from the microwave antenna. Temperature curves of the sensors were compared to MRI temperature data of single-voxel regions of interest (ROIs) at the sensor tips; the accuracy of MRI thermometry was assessed as the root-mean-squared (RMS)-averaged temperature difference. Eighteen neighboring voxels around the original ROI were also evaluated and the voxel with the smallest temperature difference was additionally selected for further evaluation.</p><p><strong>Results: </strong>The maximum temperature changes measured by the fiber-optical sensors ranged from 7.3 K to 50.7 K. The median RMS-averaged temperature differences in the originally selected voxels ranged from 1.4 K to 3.4 K. When evaluating the minimum-difference voxel from the neighborhood, the temperature differences ranged from 0.5 K to 0.9 K. The microwave antenna and the MRI-conditional in-room microwave generator did not induce relevant radiofrequency artifacts.</p><p><strong>Conclusion: </strong>Accurate 3D real-time MRI temperature mapping during microwave heating with very low RMS-averaged temperature errors below 1 K is feasible in gel phantoms.</p><p><strong>Relevance statement: </strong>Accurate MRI-based volumetric real-time monitoring of temperature distribution and thermal dose is highly relevant in clinical MRI-based interventions and can be expected to improve local tumor control, as well as procedural safety by extending the limits of thermal (e.g., microwave) ablation of tumors in the liver and in other organs.</p><p><strong>Key points: </strong>Interventional MRI can provide a comprehensive setting for the microwave ablation of tumors. MRI can monitor the microwave ablation using real-time MRI-based temperature mapping. 3D real-time MRI temperature mapping during microwave heating is feasible. Measured temperature errors were below 1 °C in gel phantoms. The active in-room microwave generator did not induce any relevant radiofrequency artifacts.</p>","PeriodicalId":36926,"journal":{"name":"European Radiology Experimental","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reproducibility of CT-based opportunistic vertebral volumetric bone mineral density measurements from an automated segmentation framework. 基于 CT 的自动分割框架椎体体积骨矿密度测量的再现性。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1186/s41747-024-00483-9
Jannis Bodden, Philipp Prucker, Anjany Sekuboyina, Malek El Husseini, Katharina Grau, Sebastian Rühling, Egon Burian, Claus Zimmer, Thomas Baum, Jan S Kirschke

Background: To investigate the reproducibility of automated volumetric bone mineral density (vBMD) measurements from routine thoracoabdominal computed tomography (CT) assessed with segmentations by a convolutional neural network and automated correction of contrast phases, on diverse scanners, with scanner-specific asynchronous or scanner-agnostic calibrations.

Methods: We obtained 679 observations from 278 CT scans in 121 patients (77 males, 63.6%) studied from 04/2019 to 06/2020. Observations consisted of two vBMD measurements from Δdifferent reconstruction kernels (n = 169), Δcontrast phases (n = 133), scan Δsessions (n = 123), Δscanners (n = 63), or Δall of the aforementioned (n = 20), and observations lacking scanner-specific calibration (n = 171). Precision was assessed using root-mean-square error (RMSE) and root-mean-square coefficient of variation (RMSCV). Cross-measurement agreement was assessed using Bland-Altman plots; outliers within 95% confidence interval of the limits of agreement were reviewed.

Results: Repeated measurements from Δdifferent reconstruction kernels were highly precise (RMSE 3.0 mg/cm3; RMSCV 1.3%), even for consecutive scans with different Δcontrast phases (RMSCV 2.9%). Measurements from different Δscan sessions or Δscanners showed decreased precision (RMSCV 4.7% and 4.9%, respectively). Plot-review identified 12 outliers from different scan Δsessions, with signs of hydropic decompensation. Observations with Δall differences showed decreased precision compared to those lacking scanner-specific calibration (RMSCV 5.9 and 3.7, respectively).

Conclusion: Automatic vBMD assessment from routine CT is precise across varying setups, when calibrated appropriately. Low precision was found in patients with signs of new or worsening hydropic decompensation, what should be considered an exclusion criterion for both opportunistic and dedicated quantitative CT.

Relevance statement: Automated CT-based vBMD measurements are precise in various scenarios, including cross-session and cross-scanner settings, and may therefore facilitate opportunistic screening for osteoporosis and surveillance of BMD in patients undergoing routine clinical CT scans.

Key points: Artificial intelligence-based tools facilitate BMD measurements in routine clinical CT datasets. Automated BMD measurements are highly reproducible in various settings. Reliable, automated opportunistic osteoporosis diagnostics allow for large-scale application.

背景:目的:研究常规胸腹部计算机断层扫描(CT)通过卷积神经网络分割和造影剂相位自动校正进行的自动容积骨密度(vBMD)测量的可重复性:我们从2019年4月至2020年6月对121名患者(77名男性,63.6%)进行的278次CT扫描中获得了679个观察结果。观察结果包括来自Δ不同重建内核(n = 169)、Δ对比阶段(n = 133)、扫描Δ时段(n = 123)、Δ扫描仪(n = 63)或Δ上述所有(n = 20)的两次vBMD测量,以及缺乏扫描仪特定校准的观察结果(n = 171)。精度采用均方根误差(RMSE)和均方根变异系数(RMSCV)进行评估。交叉测量的一致性采用 Bland-Altman 图进行评估;对一致性界限 95% 置信区间内的异常值进行审查:不同重建内核的Δ重复测量结果非常精确(RMSE 3.0 mg/cm3;RMSCV 1.3%),即使是不同Δ对比阶段的连续扫描结果也是如此(RMSCV 2.9%)。来自不同Δ扫描时段或Δ扫描仪的测量结果显示精确度下降(RMSCV 分别为 4.7% 和 4.9%)。Plot-review 从不同的扫描Δ时段中发现了 12 个异常值,有水肿分解的迹象。与缺乏特定扫描仪校准的观测结果相比,存在Δ所有差异的观测结果显示精度下降(RMSCV分别为5.9和3.7):结论:如果校准得当,通过常规 CT 自动评估 vBMD 在不同的设置下都是精确的。在有新的或恶化的水肿失代偿迹象的患者中,精确度较低,这应被视为机会性和专用定量 CT 的排除标准:基于 CT 的自动 vBMD 测量在各种情况下都很精确,包括跨疗程和跨扫描仪设置,因此有助于对接受常规临床 CT 扫描的患者进行骨质疏松症的机会性筛查和 BMD 监测:基于人工智能的工具有助于在常规临床 CT 数据集中进行 BMD 测量。自动 BMD 测量在各种环境下都具有很高的可重复性。可靠的自动机会性骨质疏松症诊断可大规模应用。
{"title":"Reproducibility of CT-based opportunistic vertebral volumetric bone mineral density measurements from an automated segmentation framework.","authors":"Jannis Bodden, Philipp Prucker, Anjany Sekuboyina, Malek El Husseini, Katharina Grau, Sebastian Rühling, Egon Burian, Claus Zimmer, Thomas Baum, Jan S Kirschke","doi":"10.1186/s41747-024-00483-9","DOIUrl":"10.1186/s41747-024-00483-9","url":null,"abstract":"<p><strong>Background: </strong>To investigate the reproducibility of automated volumetric bone mineral density (vBMD) measurements from routine thoracoabdominal computed tomography (CT) assessed with segmentations by a convolutional neural network and automated correction of contrast phases, on diverse scanners, with scanner-specific asynchronous or scanner-agnostic calibrations.</p><p><strong>Methods: </strong>We obtained 679 observations from 278 CT scans in 121 patients (77 males, 63.6%) studied from 04/2019 to 06/2020. Observations consisted of two vBMD measurements from Δdifferent reconstruction kernels (n = 169), Δcontrast phases (n = 133), scan Δsessions (n = 123), Δscanners (n = 63), or Δall of the aforementioned (n = 20), and observations lacking scanner-specific calibration (n = 171). Precision was assessed using root-mean-square error (RMSE) and root-mean-square coefficient of variation (RMSCV). Cross-measurement agreement was assessed using Bland-Altman plots; outliers within 95% confidence interval of the limits of agreement were reviewed.</p><p><strong>Results: </strong>Repeated measurements from Δdifferent reconstruction kernels were highly precise (RMSE 3.0 mg/cm<sup>3</sup>; RMSCV 1.3%), even for consecutive scans with different Δcontrast phases (RMSCV 2.9%). Measurements from different Δscan sessions or Δscanners showed decreased precision (RMSCV 4.7% and 4.9%, respectively). Plot-review identified 12 outliers from different scan Δsessions, with signs of hydropic decompensation. Observations with Δall differences showed decreased precision compared to those lacking scanner-specific calibration (RMSCV 5.9 and 3.7, respectively).</p><p><strong>Conclusion: </strong>Automatic vBMD assessment from routine CT is precise across varying setups, when calibrated appropriately. Low precision was found in patients with signs of new or worsening hydropic decompensation, what should be considered an exclusion criterion for both opportunistic and dedicated quantitative CT.</p><p><strong>Relevance statement: </strong>Automated CT-based vBMD measurements are precise in various scenarios, including cross-session and cross-scanner settings, and may therefore facilitate opportunistic screening for osteoporosis and surveillance of BMD in patients undergoing routine clinical CT scans.</p><p><strong>Key points: </strong>Artificial intelligence-based tools facilitate BMD measurements in routine clinical CT datasets. Automated BMD measurements are highly reproducible in various settings. Reliable, automated opportunistic osteoporosis diagnostics allow for large-scale application.</p>","PeriodicalId":36926,"journal":{"name":"European Radiology Experimental","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abdominal aneurysm sac thrombus CT density and volume after EVAR: which association with underlying endoleak? EVAR 后腹部动脉瘤囊血栓 CT 密度和体积:与潜在内漏有何关联?
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1186/s41747-024-00489-3
Matthias Lembrechts, Lucas Desauw, Walter Coudyzer, Annouschka Laenen, Inge Fourneau, Geert Maleux

Background: Our aim was to analyse abdominal aneurysm sac thrombus density and volume on computed tomography (CT) after endovascular aneurysm repair (EVAR).

Methods: Patients who underwent EVAR between January 2005 and December 2010 and had at least four follow-up CT exams available over the first five years of follow-up were included in this retrospective single-centre study. Thrombus density and aneurysm sac volume were calculated on unenhanced CT scans. Linear mixed models were used for data analysis.

Results: Out of 82 patients, 44 (54%) had an endoleak on post-EVAR contrast-enhanced CT. Thrombus density significantly increased over time in both the endoleak and non-endoleak groups, with a slope of 0.159 UH/month (95% confidence interval [CI] 0.115-0.202), p < 0.0001) and 0.052 UH/month (95% CI 0.002-0.102, p = 0.041). In patients without endoleak, a significant decrease in aneurysm sac volume was identified over time (slope -0.891 cc/month, 95% CI -1.200 to -0.581); p < 0.001) compared to patients with endoleak (slope 0.284 cc/month, 95% CI -0.031 to 0.523, p = 0.082). The association between thrombus density and aneurysm sac volume was positive in the endoleak group (slope 1.543 UH/cc, 95% CI 0.948-2.138, p < 0.001) and negative in the non-endoleak group (slope -1.450 UH/cc, 95% CI -2.326 to -0.574, p = 0.001).

Conclusion: We observed a progressive increase in thrombus density of the aneurysm sac after EVAR in patients with and without endoleak, more pronounced in patients with endoleak. The association between aneurysm volume and thrombus density was positive in patients with and negative in those without endoleak.

Relevance statement: A progressive increase in thrombus density and volume of abdominal aortic aneurysm sac on unenhanced CT might suggest underlying endoleak lately after EVAR.

Key points: Thrombus density of the aneurysm sac after EVAR increased over time. Progressive increase in thrombus density was significantly associated to the underlying endoleak. The association between aneurysm volume and thrombus density was positive in patients with and negative in those without endoleak.

背景:我们的目的是分析腹部动脉瘤囊血栓密度和体积:我们的目的是分析血管内动脉瘤修补术(EVAR)后计算机断层扫描(CT)上腹部动脉瘤囊血栓的密度和体积:这项回顾性单中心研究纳入了 2005 年 1 月至 2010 年 12 月间接受 EVAR 的患者,这些患者在随访的前五年中至少接受过四次 CT 随访。通过未增强 CT 扫描计算血栓密度和动脉瘤囊体积。数据分析采用线性混合模型:82名患者中,44人(54%)在EVAR术后造影剂增强CT检查中出现内漏。随着时间的推移,内漏组和非内漏组的血栓密度均明显增加,斜率为 0.159 UH/月(95% 置信区间 [CI] 0.115-0.202),P 结论:我们观察到血栓密度逐渐增加:我们观察到,在有内漏和无内漏的患者中,EVAR 后动脉瘤囊血栓密度逐渐增加,有内漏的患者更为明显。动脉瘤体积与血栓密度之间的关系在有内膜渗漏的患者中呈正相关,而在无内膜渗漏的患者中呈负相关:未增强 CT 显示的腹主动脉瘤囊血栓密度和体积逐渐增大,可能提示 EVAR 术后存在潜在的内漏:EVAR术后动脉瘤囊血栓密度随时间增加。要点:EVAR 术后动脉瘤囊血栓密度会随着时间的推移而增加,血栓密度的逐渐增加与潜在的内漏密切相关。有内漏的患者动脉瘤体积与血栓密度呈正相关,无内漏的患者则呈负相关。
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引用次数: 0
In vitro and in vivo optimized reconstruction for low-keV virtual monoenergetic photon-counting detector CT angiography of lower legs. 用于小腿低 kEV 虚拟单能光子计数探测器 CT 血管造影的体外和体内优化重建。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1186/s41747-024-00481-x
Dirk Graafen, Willi Bart, Moritz C Halfmann, Lukas Müller, Lukas Hobohm, Yang Yang, Achim Neufang, Christine Espinola-Klein, Michael B Pitton, Roman Kloeckner, Akos Varga-Szemes, Tilman Emrich

Background: Lower extremity peripheral artery disease frequently presents with calcifications which reduces the accuracy of computed tomography (CT) angiography, especially below-the-knee. Photon-counting detector (PCD)-CT offers improved spatial resolution and less calcium blooming. We aimed to identify the optimal reconstruction parameters for PCD-CT angiography of the lower legs.

Methods: Tubes with different diameters (1-5 mm) were filled with different iodine concentrations and scanned in a water container. Images were reconstructed with 0.4 mm isotropic resolution using a quantitative kernel at all available sharpness levels (Qr36 to Qr76) and using different levels of quantum iterative reconstruction (QIR-2-4). Noise and image sharpness were determined for all reconstructions. Additionally, CT angiograms of 20 patients, reconstructed with a medium (Qr44), sharp (Qr60), and ultrasharp (Qr72) kernel at QIR-2-4, were evaluated by three readers assessing noise, delineation of plaques and vessel walls, and overall quality.

Results: In the phantom study, increased kernel sharpness led to higher image noise (e.g., 16, 38, 77 HU for Qr44, Qr60, Qr72, and QIR-3). Image sharpness increased with increasing kernel sharpness, reaching a plateau at the medium-high level 60. Higher QIR levels decreased image noise (e.g., 51, 38, 25 HU at QIR-2-4 and Qr60) without reducing vessel sharpness. The qualitative in vivo results confirmed these findings: the sharp kernel (Qr60) with the highest QIR yielded the best overall quality.

Conclusion: The combination of a sharpness level optimized reconstruction kernel (Qr60) and the highest QIR level yield the best image quality for PCD-CT angiography of the lower legs when reconstructed at 0.4-mm resolution.

Relevance statement: Using high-resolution PCD-CT angiography with optimized reconstruction parameters might improve diagnostic accuracy and confidence in peripheral artery disease of the lower legs.

Key points: Effective exploitation of the potential of PCD-CT angiography requires optimized reconstruction parameters. Too soft or too sharp reconstruction kernels reduce image quality. The highest level of quantum iterative reconstruction provides the best image quality.

背景:下肢外周动脉疾病常伴有钙化,这降低了计算机断层扫描(CT)血管造影的准确性,尤其是膝关节以下部位。光子计数探测器(PCD)-CT 可提高空间分辨率,减少钙化。我们的目的是确定 PCD-CT 小腿血管造影的最佳重建参数:方法:在不同直径(1-5 毫米)的管子中注入不同浓度的碘,并在水容器中进行扫描。使用所有可用清晰度级别(Qr36 至 Qr76)的定量核和不同级别的量子迭代重建(QIR-2-4),以 0.4 毫米各向同性分辨率重建图像。对所有重建的噪声和图像清晰度进行了测定。此外,20 位患者的 CT 血管造影分别使用中等(Qr44)、锐利(Qr60)和超锐利(Qr72)核在 QIR-2-4 下进行重建,由三位读者对噪声、斑块和血管壁的划分以及整体质量进行评估:在模型研究中,内核锐度增加会导致图像噪声增加(例如,Qr44、Qr60、Qr72 和 QIR-3 的噪声分别为 16、38 和 77 HU)。图像清晰度随着内核清晰度的增加而增加,在中高水平 60 时达到高点。更高的 QIR 水平会降低图像噪声(例如,QIR-2-4 和 Qr60 分别为 51、38 和 25 HU),但不会降低血管的清晰度。活体定性结果证实了这些发现:具有最高 QIR 的锐利内核(Qr60)能获得最佳的整体质量:结论:在 0.4 毫米分辨率下重建小腿 PCD-CT 血管造影时,锐利度级别优化的重建内核(Qr60)和最高 QIR 级别的组合可获得最佳图像质量:使用具有优化重建参数的高分辨率 PCD-CT 血管造影可提高小腿外周动脉疾病的诊断准确性和可信度:要点:有效发挥 PCD-CT 血管造影术的潜力需要优化的重建参数。过软或过尖的重建内核都会降低图像质量。最高级别的量子迭代重建可提供最佳图像质量。
{"title":"In vitro and in vivo optimized reconstruction for low-keV virtual monoenergetic photon-counting detector CT angiography of lower legs.","authors":"Dirk Graafen, Willi Bart, Moritz C Halfmann, Lukas Müller, Lukas Hobohm, Yang Yang, Achim Neufang, Christine Espinola-Klein, Michael B Pitton, Roman Kloeckner, Akos Varga-Szemes, Tilman Emrich","doi":"10.1186/s41747-024-00481-x","DOIUrl":"10.1186/s41747-024-00481-x","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity peripheral artery disease frequently presents with calcifications which reduces the accuracy of computed tomography (CT) angiography, especially below-the-knee. Photon-counting detector (PCD)-CT offers improved spatial resolution and less calcium blooming. We aimed to identify the optimal reconstruction parameters for PCD-CT angiography of the lower legs.</p><p><strong>Methods: </strong>Tubes with different diameters (1-5 mm) were filled with different iodine concentrations and scanned in a water container. Images were reconstructed with 0.4 mm isotropic resolution using a quantitative kernel at all available sharpness levels (Qr36 to Qr76) and using different levels of quantum iterative reconstruction (QIR-2-4). Noise and image sharpness were determined for all reconstructions. Additionally, CT angiograms of 20 patients, reconstructed with a medium (Qr44), sharp (Qr60), and ultrasharp (Qr72) kernel at QIR-2-4, were evaluated by three readers assessing noise, delineation of plaques and vessel walls, and overall quality.</p><p><strong>Results: </strong>In the phantom study, increased kernel sharpness led to higher image noise (e.g., 16, 38, 77 HU for Qr44, Qr60, Qr72, and QIR-3). Image sharpness increased with increasing kernel sharpness, reaching a plateau at the medium-high level 60. Higher QIR levels decreased image noise (e.g., 51, 38, 25 HU at QIR-2-4 and Qr60) without reducing vessel sharpness. The qualitative in vivo results confirmed these findings: the sharp kernel (Qr60) with the highest QIR yielded the best overall quality.</p><p><strong>Conclusion: </strong>The combination of a sharpness level optimized reconstruction kernel (Qr60) and the highest QIR level yield the best image quality for PCD-CT angiography of the lower legs when reconstructed at 0.4-mm resolution.</p><p><strong>Relevance statement: </strong>Using high-resolution PCD-CT angiography with optimized reconstruction parameters might improve diagnostic accuracy and confidence in peripheral artery disease of the lower legs.</p><p><strong>Key points: </strong>Effective exploitation of the potential of PCD-CT angiography requires optimized reconstruction parameters. Too soft or too sharp reconstruction kernels reduce image quality. The highest level of quantum iterative reconstruction provides the best image quality.</p>","PeriodicalId":36926,"journal":{"name":"European Radiology Experimental","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intra-arterial PSMA injection using hepatic arterial infusion pump in intrahepatic cholangiocarcinoma: a proof-of-concept study. 使用肝动脉输注泵对肝内胆管癌进行动脉内 PSMA 注射:概念验证研究。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1186/s41747-024-00496-4
Mara Marieke Katrien Veenstra, Erik Vegt, Marcel Segbers, Stijn Franssen, Bas Groot Koerkamp, Frederik Anton Verburg, Maarten Guillaume Josephus Thomeer

Prostate-specific membrane antigen (PSMA) targeted tracers show increased uptake in several malignancies, indicating a potential for peptide radioligand therapy. Intra-arterial injection of radiotracers can increase the therapeutic window. This study aimed to evaluate the feasibility of intra-arterial injection of [68Ga]Ga-PSMA-11 for intrahepatic cholangiocarcinoma and compare tracer uptake after intrahepatic arterial injection and intravenous injection. Three patients with intrahepatic cholangiocarcinoma received [68Ga]Ga-PSMA-11 through a hepatic arterial infusion pump, followed by positron emission tomography/computed tomography (PET/CT). Two-three days later, patients underwent PET/CT after intravenous [68Ga]Ga-PSMA-11 injection. All tumours showed higher uptake on the intra-arterial scan compared with the intravenous scan: the intra-arterial / intravenous standardised uptake value normalised by lean body mass ratios were 1.40, 1.46, and 1.54. Local intra-arterial PSMA injection is possible in patients with intrahepatic cholangiocarcinoma. Local injection increases tumour-to-normal tissue ratios, increasing the therapeutic window for theranostic applications. RELEVANCE STATEMENT: Intra-arterial Prostate specific membrane antigen (PSMA) injection increases the therapeutic window for potential theranostic application in intrahepatic cholangiocarcinoma. KEY POINTS: Three patients with intrahepatic cholangiocarcinoma underwent PET/CT after intra-arterial and intravenous injection of [68Ga]Ga-PSMA-11. Intra-arterial injection showed higher uptake than intravenous injection. PSMA-targeted imaging could be valuable for a subset of intrahepatic cholangiocarcinoma patients.

前列腺特异性膜抗原(PSMA)靶向示踪剂在几种恶性肿瘤中的摄取量增加,表明肽类放射性配体疗法具有潜力。放射性示踪剂的动脉内注射可增加治疗窗口期。本研究旨在评估动脉内注射[68Ga]Ga-PSMA-11治疗肝内胆管癌的可行性,并比较肝内动脉注射和静脉注射后的示踪剂摄取情况。三名肝内胆管癌患者通过肝动脉输注泵接受了[68Ga]Ga-PSMA-11,随后进行了正电子发射断层扫描/计算机断层扫描(PET/CT)。两三天后,患者在静脉注射[68Ga]Ga-PSMA-11后接受PET/CT检查。与静脉扫描相比,所有肿瘤在动脉内扫描中的摄取量都更高:动脉内/静脉内标准化摄取值(按瘦体重比归一化)分别为 1.40、1.46 和 1.54。肝内胆管癌患者可进行局部动脉内 PSMA 注射。局部注射可提高肿瘤与正常组织的比率,从而增加治疗应用的治疗窗口。相关性声明:动脉内注射前列腺特异性膜抗原(PSMA)增加了肝内胆管癌潜在治疗应用的治疗窗口。要点:三名肝内胆管癌患者在动脉内和静脉注射[68Ga]Ga-PSMA-11后接受了PET/CT检查。动脉内注射比静脉注射显示出更高的摄取率。PSMA靶向成像对部分肝内胆管癌患者很有价值。
{"title":"Intra-arterial PSMA injection using hepatic arterial infusion pump in intrahepatic cholangiocarcinoma: a proof-of-concept study.","authors":"Mara Marieke Katrien Veenstra, Erik Vegt, Marcel Segbers, Stijn Franssen, Bas Groot Koerkamp, Frederik Anton Verburg, Maarten Guillaume Josephus Thomeer","doi":"10.1186/s41747-024-00496-4","DOIUrl":"10.1186/s41747-024-00496-4","url":null,"abstract":"<p><p>Prostate-specific membrane antigen (PSMA) targeted tracers show increased uptake in several malignancies, indicating a potential for peptide radioligand therapy. Intra-arterial injection of radiotracers can increase the therapeutic window. This study aimed to evaluate the feasibility of intra-arterial injection of [<sup>68</sup>Ga]Ga-PSMA-11 for intrahepatic cholangiocarcinoma and compare tracer uptake after intrahepatic arterial injection and intravenous injection. Three patients with intrahepatic cholangiocarcinoma received [<sup>68</sup>Ga]Ga-PSMA-11 through a hepatic arterial infusion pump, followed by positron emission tomography/computed tomography (PET/CT). Two-three days later, patients underwent PET/CT after intravenous [<sup>68</sup>Ga]Ga-PSMA-11 injection. All tumours showed higher uptake on the intra-arterial scan compared with the intravenous scan: the intra-arterial / intravenous standardised uptake value normalised by lean body mass ratios were 1.40, 1.46, and 1.54. Local intra-arterial PSMA injection is possible in patients with intrahepatic cholangiocarcinoma. Local injection increases tumour-to-normal tissue ratios, increasing the therapeutic window for theranostic applications. RELEVANCE STATEMENT: Intra-arterial Prostate specific membrane antigen (PSMA) injection increases the therapeutic window for potential theranostic application in intrahepatic cholangiocarcinoma. KEY POINTS: Three patients with intrahepatic cholangiocarcinoma underwent PET/CT after intra-arterial and intravenous injection of [<sup>68</sup>Ga]Ga-PSMA-11. Intra-arterial injection showed higher uptake than intravenous injection. PSMA-targeted imaging could be valuable for a subset of intrahepatic cholangiocarcinoma patients.</p>","PeriodicalId":36926,"journal":{"name":"European Radiology Experimental","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Automated evaluation of diaphragm configuration based on chest CT in COPD patients. 根据胸部 CT 自动评估慢性阻塞性肺病患者的膈肌结构。
IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1186/s41747-024-00491-9
Jens T Bakker, Jorine E Hartman, Karin Klooster, David A Lynch, Marieke C van der Molen, Jean-Paul Charbonnier, Michail Tsiaousis, Rozemarijn Vliegenthart, Dirk-Jan Slebos

Background: Severe chronic obstructive pulmonary disease (COPD) often results in hyperinflation and flattening of the diaphragm. An automated computed tomography (CT)-based tool for quantifying diaphragm configuration, a biomarker for COPD, was developed in-house and tested in a large cohort of COPD patients.

Methods: We used the LungQ platform to extract the lung-diaphragm intersection, as direct diaphragm segmentation is challenging. The tool computed the diaphragm index (surface area/projected surface area) as a measure of diaphragm configuration on inspiratory scans in a COPDGene subcohort. Visual inspection of 250 randomly selected segmentations served as a quality check. Associations between the diaphragm index, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, forced expiratory volume in 1 s (FEV1) % predicted, and CT-derived emphysema scores were explored using analysis of variance and Pearson correlation.

Results: The tool yielded incomplete segmentation in 9.2% (2.4% major defect, 6.8% minor defect) of 250 randomly selected cases. In 8431 COPDGene subjects (4240 healthy; 4191 COPD), the diaphragm index was increasingly lower with higher GOLD stages (never-smoked 1.83 ± 0.16; GOLD-0 1.79 ± 0.18; GOLD-1 1.71 ± 0.15; GOLD-2: 1.67 ± 0.16; GOLD-3 1.58 ± 0.14; GOLD-4 1.54 ± 0.11) (p < 0.001). Associations were found between the diaphragm index and both FEV1% predicted (r = 0.44, p < 0.001) and emphysema score (r = -0.36, p < 0.001).

Conclusion: We developed an automated tool to quantify the diaphragm configuration in chest CT. The diaphragm index was associated with COPD severity, FEV1%predicted, and emphysema score.

Relevance statement: Due to the hypothesized relationship between diaphragm dysfunction and diaphragm configuration in COPD patients, automatic quantification of diaphragm configuration may prove useful in evaluating treatment efficacy in terms of lung volume reduction.

Key points: Severe COPD changes diaphragm configuration to a flattened state, impeding function. An automated tool quantified diaphragm configuration on chest-CT providing a diaphragm index. The diaphragm index was correlated to COPD severity and may aid treatment assessment.

背景:严重的慢性阻塞性肺病(COPD)通常会导致膈肌过度充气和扁平。我们在内部开发了一种基于计算机断层扫描(CT)的自动工具,用于量化横膈膜的形态,这是慢性阻塞性肺病的一种生物标志物:我们使用 LungQ 平台提取肺-膈交点,因为直接分割膈具有挑战性。该工具计算了膈肌指数(表面积/投影表面积),以此衡量 COPDGene 亚队列中吸气扫描的膈肌构型。对随机选取的 250 个切片进行目视检查作为质量检查。使用方差分析和皮尔逊相关性分析探讨了横膈膜指数、慢性阻塞性肺病全球倡议(GOLD)分期、1 秒内用力呼气容积(FEV1)预测百分比和 CT 导出的肺气肿评分之间的关联:在随机抽取的 250 个病例中,有 9.2% 的病例(2.4% 的病例有重大缺陷,6.8% 的病例有轻微缺陷)使用该工具进行了不完全分割。在 8431 名 COPDGene 受试者(4240 名健康人;4191 名 COPD 患者)中,膈肌指数随着 GOLD 阶段的升高而越来越低(从未吸烟者 1.83 ± 0.16;GOLD-0 1.79 ± 0.18;GOLD-1 1.71 ± 0.15;GOLD-2:1.67 ± 0.16;GOLD-3 1.58 ± 0.14;GOLD-4 1.54 ± 0.11)(p 结论:我们开发了一种自动工具来量化膈肌指数:我们开发了一种自动工具来量化胸部 CT 中的横膈膜结构。横膈膜指数与慢性阻塞性肺病严重程度、预测 FEV1% 和肺气肿评分相关:由于假设 COPD 患者的横膈膜功能障碍与横膈膜构型之间存在关系,因此自动量化横膈膜构型可能有助于评估肺容积缩小的治疗效果:要点:严重的慢性阻塞性肺疾病会使横膈膜结构变平,从而阻碍功能的发挥。一种自动工具可量化胸部 CT 上的横膈膜结构,从而得出横膈膜指数。横膈膜指数与慢性阻塞性肺病的严重程度相关,可帮助进行治疗评估。
{"title":"Automated evaluation of diaphragm configuration based on chest CT in COPD patients.","authors":"Jens T Bakker, Jorine E Hartman, Karin Klooster, David A Lynch, Marieke C van der Molen, Jean-Paul Charbonnier, Michail Tsiaousis, Rozemarijn Vliegenthart, Dirk-Jan Slebos","doi":"10.1186/s41747-024-00491-9","DOIUrl":"10.1186/s41747-024-00491-9","url":null,"abstract":"<p><strong>Background: </strong>Severe chronic obstructive pulmonary disease (COPD) often results in hyperinflation and flattening of the diaphragm. An automated computed tomography (CT)-based tool for quantifying diaphragm configuration, a biomarker for COPD, was developed in-house and tested in a large cohort of COPD patients.</p><p><strong>Methods: </strong>We used the LungQ platform to extract the lung-diaphragm intersection, as direct diaphragm segmentation is challenging. The tool computed the diaphragm index (surface area/projected surface area) as a measure of diaphragm configuration on inspiratory scans in a COPDGene subcohort. Visual inspection of 250 randomly selected segmentations served as a quality check. Associations between the diaphragm index, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, forced expiratory volume in 1 s (FEV1) % predicted, and CT-derived emphysema scores were explored using analysis of variance and Pearson correlation.</p><p><strong>Results: </strong>The tool yielded incomplete segmentation in 9.2% (2.4% major defect, 6.8% minor defect) of 250 randomly selected cases. In 8431 COPDGene subjects (4240 healthy; 4191 COPD), the diaphragm index was increasingly lower with higher GOLD stages (never-smoked 1.83 ± 0.16; GOLD-0 1.79 ± 0.18; GOLD-1 1.71 ± 0.15; GOLD-2: 1.67 ± 0.16; GOLD-3 1.58 ± 0.14; GOLD-4 1.54 ± 0.11) (p < 0.001). Associations were found between the diaphragm index and both FEV1% predicted (r = 0.44, p < 0.001) and emphysema score (r = -0.36, p < 0.001).</p><p><strong>Conclusion: </strong>We developed an automated tool to quantify the diaphragm configuration in chest CT. The diaphragm index was associated with COPD severity, FEV1%predicted, and emphysema score.</p><p><strong>Relevance statement: </strong>Due to the hypothesized relationship between diaphragm dysfunction and diaphragm configuration in COPD patients, automatic quantification of diaphragm configuration may prove useful in evaluating treatment efficacy in terms of lung volume reduction.</p><p><strong>Key points: </strong>Severe COPD changes diaphragm configuration to a flattened state, impeding function. An automated tool quantified diaphragm configuration on chest-CT providing a diaphragm index. The diaphragm index was correlated to COPD severity and may aid treatment assessment.</p>","PeriodicalId":36926,"journal":{"name":"European Radiology Experimental","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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European Radiology Experimental
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