European Journal of Radiology Open最新文献

Feasibility of single-phase DECT as an alternative to triple-phase CT for imaging-defined risk factors assessment in neuroblastoma for dose reduction 在减少剂量的神经母细胞瘤中，作为影像学确定的危险因素评估替代三相CT的单相DECT的可行性

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-29 DOI: 10.1016/j.ejro.2026.100732

Ruifang Sun , Haoyan Li , Bei Wang , Huiying Kang , Runtong Lu , Zhenpeng Chen , Yun Peng , Jihang Sun

Objective

To investigate the feasibility of evaluating Imaging-Defined Risk Factors (IDRFs) in Neuroblastoma (NB) patients using venous-phase (VP)-only images in dual-energy CT for radiation dose reduction and examination workflow optimization, compared with conventional triple-phase CECT.

Materials and methods

Ninety-four pediatric NB patients (ages 4.92 ± 3.45 y, range 0–17 y), who underwent triple-phase DECT were included. The standard 68 keV images reconstructed using 50 % adaptive statistical iterative reconstruction-V (ASIR-V) served as the control group. The 40 keV images in VP with deep learning image reconstruction (DLIR) were used as the study group. Objective measurements included CT values and standard deviations of the aorta, back muscles, NB lesions; contrast-to-noise ratio (CNR) of the aorta, and edge-rise slope (ERS) of NB lesions and compared by using paired Wilcoxon tests. Two pediatric radiologists independently reviewed images for IDRFs and used a 5-point scale to assess images quality. Weighted Cohen's kappa was generated to analyze the inter-rater differences.

Results

The study group had higher arterial CT values (440.81 ± 79.93 HU vs. 340.35 ± 61.14 HU, p < 0.001), similar CNR (30.43 ± 10.91 vs. 28.17 ± 10.05, p = 0.110), and higher ERS (129.31 ± 41.32 vs. 114.06 ± 36.33, p = 0.002). Two radiologists showed no difference in IDRFs assessment with good intra-group consistency, and all images met diagnostic needs with image quality scores exceeded 3. The single-phase DECT reduced radiation dose to 108.84 ± 50.49 mGy-cm, over 60 % lower than the triple-phase CECT.

Conclusion

Single venous-phase 40 keV-DECT images demonstrate feasibility for evaluating IDRFs in pediatric NB patients, saving about 60 % radiation dose and optimizing the examination workflow compared to the conventional triple-phase approach.

目的探讨双能CT静脉期影像评估神经母细胞瘤（NB）患者影像学定义危险因素（IDRFs）的可行性，以降低辐射剂量和优化检查流程，并与常规三期CT进行比较。材料与方法94例行三期DECT的NB患儿（年龄4.92 ± 3.45 y，范围0-17 y）。采用50% %自适应统计迭代重建- v （ASIR-V）重建的标准的68张 keV图像作为对照组。采用深度学习图像重建（deep learning image reconstruction， DLIR）的40张VP中的 keV图像作为研究组。客观测量包括主动脉、背部肌肉、NB病变的CT值及标准差；主动脉的噪声比（CNR）和NB病变的边缘上升斜率（ERS），并采用配对Wilcoxon检验进行比较。两名儿科放射科医生独立审查了idrf图像，并使用5分制评估图像质量。生成加权科恩kappa来分析评分者之间的差异。两名放射科医师IDRFs评分无差异，组内一致性好，图像质量评分均在3分以上，均满足诊断需要。单相DECT降低辐射剂量为108.84 ± 50.49 mGy-cm，比三相CECT降低60 %以上。结论单静脉期40 kv - dect图像评估小儿NB患者IDRFs是可行的，与传统的三期方法相比，可节省约60% %的放射剂量，优化检查工作流程。

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引用次数: 0

Impact of high-iodine concentration contrast material for dual-energy CT angiography on arterial visualization: A single-blind, randomized controlled trial 双能CT血管造影中高碘浓度造影剂对动脉显像的影响：一项单盲、随机对照试验

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-27 DOI: 10.1016/j.ejro.2026.100733

Yoshifumi Noda , Shoma Nagata , Taketo Suto , Masashi Asano , Takuma Ishihara , Takeshi Iwata , Toshiharu Miyoshi , Nobuyuki Kawai , Tetsuro Kaga , Masayuki Matsuo

Purpose

To investigate the effect of high-iodine concentration contrast material for dual-energy CT angiography (DECTA) on arterial visualizations by comparing it with medium-iodine concentration.

Method

This prospective, single-blind, randomized controlled trial included 100 consecutive participants undergoing DECTA from November 2023 to February 2025. The participants were randomly assigned into two protocols: receiving high-iodine concentration contrast material of 370 mgI/mL (Group A, n = 51) and receiving medium-iodine concentration of 300 mgI/mL (Group B, n = 49). The axial, coronal, and volume-rendered (VR) images were reconstructed at 40 keV in both groups. Two radiologists reviewed three image types and assessed the arterial visualizations using a five-point scale. The primary outcome was the score for the iliolumbar artery on the VR images, whereas secondary outcomes were the scores for all others. The Wilcoxon rank sum test was conducted to compare the outcomes between the two groups.

Results

No statistical significance in terms of the score for the iliolumbar artery on the VR images was found between the two groups; however, the median score was higher in Group A than in Group B (3.5 vs. 3.0; P = .05). The scores for secondary outcomes in Group A were equal to or greater than that in Group B, and significant differences were observed, especially in the small arteries, including the bronchial, internal thoracic, intercostal, left gastric, and inferior phrenic arteries (P < .05).

Conclusion

In small arteries, the protocol with high-iodine concentration contrast material exhibited better arterial visualizations compared with medium-iodine concentration in DECTA at 40 keV.

目的通过与中碘对比，探讨高碘双能CT血管造影（DECTA）造影剂对动脉显像的影响。该前瞻性、单盲、随机对照试验包括100名连续受试者，于2023年11月至2025年2月接受DECTA治疗。参与者被随机分配到两个方案：接受高碘浓度造影剂370 mgI/mL （A组，n = 51）和接受中碘浓度300 mgI/mL （B组，n = 49）。在40 keV下重建两组的轴状、冠状和体渲染（VR）图像。两名放射科医生回顾了三种图像类型，并使用五分制评估了动脉显像。主要结果是髂腰动脉在VR图像上的得分，而次要结果是所有其他的得分。采用Wilcoxon秩和检验比较两组结果。结果两组患者髂腰动脉在VR图像上的评分差异无统计学意义；但A组的中位评分高于B组（3.5 vs. 3.0; P = .05）。A组的次要结局评分均等于或大于B组，且差异有统计学意义，特别是在支气管、胸内动脉、肋间动脉、胃左动脉、膈下动脉等小动脉方面，差异有统计学意义（P <； .05）。结论在小动脉中，高碘造影剂方案在40 keV时比中等碘浓度的DECTA显示出更好的动脉显像。

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引用次数: 0

Muscle and fat matter: Automated CT-based body composition analysis predicts survival in Hepatocellular carcinoma patients undergoing radioembolization 肌肉和脂肪物质：基于自动ct的身体成分分析预测肝细胞癌患者接受放射栓塞治疗的生存率

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-19 DOI: 10.1016/j.ejro.2025.100721

Hannah L. Steinberg-Vorhoff , Anneke Ketelsen , Tabea Schuch , Jens M. Theysohn , Benedikt M. Schaarschmidt , Johannes Haubold , Farroch Vahidi Noghani , Matthias Jeschke , Leonie Jochheim , Johannes M. Ludwig

Purpose

This study aimed to assess the prognostic significance of pretreatment CT-based body composition markers in patients with Hepatocellular carcinoma (HCC) treated with radioembolization.

Material and methods

Automated analysis of baseline CT scans was performed to retrospectively evaluate body composition (BCA) parameters in 198 patients from a prospective registry database, including skeletal muscle (SM) and bone (B) volumes. BCA parameters and ratios were dichotomized using a maximally selected log-rank approach. Kaplan-Meier and uni- (UVA) and multivariate (MVA) Cox-proportional-hazard ratio (HR) survival analyses were performed.

Results

The median survival time was 18.5 months. In UVA, lower BCLC stage, ≦ 70 years of age, normal serum albumin, non-elevated C-reactive protein, normal aspartate aminotransferase (ASAT), normal alkaline phosphatase, normal gamma-glutamyl transaminase (GGT), absence of portal vein thrombosis and various BCA parameters were statistically significant with the skeletal muscle to bone ratio (SM/B) demonstrating the strongest survival discrimination with a median survival of 23.6 months for high and 12.0 months for low SM/B (HR: 0.65, 95 %CI: 0.46–0.9; p = 0.0001). In MVA, SM/B, BCLC stage, ASAT, and GGT remained independently significant. Patients with higher SM/B ratios demonstrated a significantly higher disease control rate during the initial imaging follow-up after three months (74.4 % vs. 54.0 %, p = 0.017).

Conclusion

These findings suggest that fully automated, CT-based measurement of BCA parameters — particularly the SM/B ratio — can serve as an independent prognostic factor for survival and disease control in patients with Hepatocellular carcinoma (HCC) undergoing radioembolization. This could potentially facilitate the identification of patients who would benefit most from this treatment.

目的本研究旨在评估基于ct预处理的体成分标志物在肝细胞癌（HCC）放射栓塞治疗中的预后意义。材料和方法对基线CT扫描进行自动分析，从前瞻性注册数据库中回顾性评估198例患者的身体成分（BCA）参数，包括骨骼肌（SM）和骨(B)体积。BCA参数和比率使用最大选择的log-rank方法进行二分类。进行Kaplan-Meier、单因素（UVA）和多因素（MVA） Cox-proportional-hazard ratio （HR）生存分析。结果中位生存期为18.5个月。UVA中，低BCLC分期、≦ 70岁、血清白蛋白、c反应蛋白、谷草转氨酶（ASAT）、碱性磷酸酶、γ -谷氨酰转氨酶（GGT）、门静脉血栓形成及BCA各项参数正常均有统计学意义，骨骼肌与骨量比（SM/B）表现出最强的生存差异，高SM/B组中位生存为23.6个月，低SM/B组中位生存为12.0个月(HR: 0.65, 95 %CI：0.46 - -0.9; = 0.0001页)。在MVA中，SM/B、BCLC分期、ASAT和GGT保持独立显著。SM/B比值较高的患者在3个月后的初始影像学随访中疾病控制率明显较高（74.4 % vs. 54.0% %,p = 0.017）。这些研究结果表明，全自动、基于ct的BCA参数测量，特别是SM/B比值，可以作为肝细胞癌（HCC）放射栓塞患者生存和疾病控制的独立预后因素。这可能有助于识别从这种治疗中获益最多的患者。

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引用次数: 0

The value of virtual non-contrast images derived from dual-energy spectral CT in the short-term efficacy assessment of hepatocellular carcinoma after TACE 双能谱CT虚拟非对比图像在肝细胞癌TACE术后短期疗效评估中的价值

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-17 DOI: 10.1016/j.ejro.2026.100730

Mingzi Gao , Taoming Du , Kai Zhang , Cheng Yan , Changchun Liu , Can Su , Jingwen Zhang , Yingxuan Wang , Jing Han , Mingxin Zhang , Yujie Chen , Jinghui Dong , Liqin Zhao

Purpose

To explore the clinical utility of virtual non-contrast (VNC) images from dual-energy spectral CT (DEsCT) in short-term follow-up of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).

Methods

66 HCC patients with DEsCT 4–6 weeks post-TACE were retrospectively enrolled. VNC images were generated from arterial (VNC_AP) and portal venous phase (VNC_PVP) images. Beam-hardening artifacts surrounding lipiodol were assessed on true non-contrast (TNC) and both VNC images. Lipiodol removal degree was classified into 4 grades at 25 % intervals on both VNC images. Residual viable tumor (RVT) was diagnosed using contrast-enhanced CT or MRI. CT attenuation values of RVT, adjacent normal hepatic parenchyma (ANHP), and lipiodol removal area (LRA) were compared among TNC and VNC images. Diagnostic performance of CT attenuation values on VNC images was compared for the three areas.

Results

34 patients showed beam-hardening artifacts surrounding lipiodol on TNC images, which were reduced or eliminated on VNC_AP and VNC_PVP images in 28 and 26 cases. All HCCs showed good lipiodol removal on both VNC images, with 7 lesions at Grade 3 and 59 lesions at Grade 4. On TNC images, significant CT attenuation value differences were found between LRA and ANHP, and LRA and RVT (P < 0.001), but not between RVT and ANHP (P > 0.05). Both VNC images showed good diagnostic efficacy for these three areas, with LRA having the lowest value.

Conclusion

VNC images demonstrate superior lipiodol removal efficacy and beam-hardening artifacts reduction, facilitating precise RVT delineation and TACE-induced necrosis assessment, complementing contrast-enhanced CT for TACE efficacy assessment in HCC.

目的探讨双能谱CT （DEsCT）虚拟非对比成像（VNC）在肝细胞癌经动脉化疗栓塞（TACE）术后短期随访中的临床应用价值。方法回顾性分析肝细胞癌tace术后4 ~ 6周行DEsCT的患者66例。VNC图像由动脉期（VNCAP）和门静脉期（VNCPVP）图像生成。在真实非对比（TNC）和两个VNC图像上评估脂醇周围的波束硬化伪影。在两个VNC图像上，以25 %的间隔将脂醇去除程度分为4个等级。残余活肿瘤（RVT）通过增强CT或MRI诊断。比较TNC与VNC影像中RVT、邻近正常肝实质（ANHP）、脂醇去除区（LRA）的CT衰减值。比较三个区域的CT衰减值对VNC图像的诊断性能。结果34例患者在TNC图像上出现脂醇周围的束硬化伪影，28例在VNCAP和VNCPVP图像上减少或消除脂醇周围的束硬化伪影。所有hcc在两张VNC图像上均显示良好的脂醇去除，其中7个病变为3级，59个病变为4级。在TNC图像上，LRA与ANHP、LRA与RVT的CT衰减值差异有统计学意义（P <； 0.001），而RVT与ANHP的CT衰减值差异无统计学意义（P <； 0.05）。两个VNC图像对这三个区域的诊断效果都很好，其中LRA的值最低。结论vnc图像显示出较好的去脂效果和减少束硬化伪影，有助于精确描绘RVT和评估TACE诱导的坏死，补充了对比增强CT对肝癌TACE疗效的评估。

{"title":"The value of virtual non-contrast images derived from dual-energy spectral CT in the short-term efficacy assessment of hepatocellular carcinoma after TACE","authors":"Mingzi Gao , Taoming Du , Kai Zhang , Cheng Yan , Changchun Liu , Can Su , Jingwen Zhang , Yingxuan Wang , Jing Han , Mingxin Zhang , Yujie Chen , Jinghui Dong , Liqin Zhao","doi":"10.1016/j.ejro.2026.100730","DOIUrl":"10.1016/j.ejro.2026.100730","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the clinical utility of virtual non-contrast (VNC) images from dual-energy spectral CT (DEsCT) in short-term follow-up of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).</div></div><div><h3>Methods</h3><div>66 HCC patients with DEsCT 4–6 weeks post-TACE were retrospectively enrolled. VNC images were generated from arterial (VNC<sub>AP</sub>) and portal venous phase (VNC<sub>PVP</sub>) images. Beam-hardening artifacts surrounding lipiodol were assessed on true non-contrast (TNC) and both VNC images. Lipiodol removal degree was classified into 4 grades at 25 % intervals on both VNC images. Residual viable tumor (RVT) was diagnosed using contrast-enhanced CT or MRI. CT attenuation values of RVT, adjacent normal hepatic parenchyma (ANHP), and lipiodol removal area (LRA) were compared among TNC and VNC images. Diagnostic performance of CT attenuation values on VNC images was compared for the three areas.</div></div><div><h3>Results</h3><div>34 patients showed beam-hardening artifacts surrounding lipiodol on TNC images, which were reduced or eliminated on VNC<sub>AP</sub> and VNC<sub>PVP</sub> images in 28 and 26 cases. All HCCs showed good lipiodol removal on both VNC images, with 7 lesions at Grade 3 and 59 lesions at Grade 4. On TNC images, significant CT attenuation value differences were found between LRA and ANHP, and LRA and RVT (P < 0.001), but not between RVT and ANHP (P > 0.05). Both VNC images showed good diagnostic efficacy for these three areas, with LRA having the lowest value.</div></div><div><h3>Conclusion</h3><div>VNC images demonstrate superior lipiodol removal efficacy and beam-hardening artifacts reduction, facilitating precise RVT delineation and TACE-induced necrosis assessment, complementing contrast-enhanced CT for TACE efficacy assessment in HCC.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100730"},"PeriodicalIF":2.9,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of preoperative co-occurring intervertebral disc-related degenerative features with one-year lumbar discectomy outcomes: A proposal for and preliminary testing of a novel MRI-based criterion 术前共同发生的椎间盘相关退行性特征与一年腰椎间盘切除术结果的关联：一种基于mri的新标准的建议和初步测试

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-17 DOI: 10.1016/j.ejro.2026.100729

Tero Korhonen , Jyri Järvinen , Juha Pesälä , Marianne Haapea , Pietari Kinnunen , Jaakko Niinimäki

Purpose

This study developed a criterion for preoperative co-occurring intervertebral disc (IVD)-related degenerative features and evaluated its association with one-year outcomes following single-level lumbar discectomy.

Methods

The novel literature-based criterion, termed “Advanced Preoperative Degeneration” (APD), required the operated segment to exhibit preoperatively at least two advanced-level phenotypes from endplate damage (EPD), Modic changes (MC), and IVD degeneration. Subsequently, a retrospective single-center register-based study of patients treated with single-level micro- or endoscopic lumbar discectomy at a tertiary-level hospital between 2017 and 2022 was performed. The patients were categorized into three groups, APD-positive, APD1/3, and APD0, based on the presence of two or more, one, or none of the required phenotypes, respectively. A mixed-effects model was employed to assess between-group differences in improvement of LBP and leg pain (0–100 VAS), disability (ODI), and quality of life (EQ-5D-3L) from baseline to the one-year postoperative time point.

Results

The cohort consisted of 140 patients (mean age: 45.3 years; 81 [57.9 %] male). Overall, the patients exhibited significant improvements in all PROMs after discectomy. However, at the one-year follow-up, the APD-positive group exhibited significantly higher leg pain and disability levels than the APD0 group, with mean scores of 31.4 versus 19.6 for leg pain and 20.6 versus 12.0 for ODI, respectively.

Conclusion

This study introduces a novel approach by integrating preoperative co-occurring IVD-related degenerative features into a composite APD criterion. Meeting the APD criterion was associated with significantly poorer one-year outcomes for leg pain and disability following lumbar discectomy.

目的：本研究建立了术前共发生椎间盘（IVD）相关退行性特征的标准，并评估其与单节段腰椎间盘切除术后一年预后的关系。方法基于文献的新标准，称为“术前晚期退变”（APD），要求手术节段术前表现出至少两种高级表型，即终板损伤（EPD）、modc改变（MC）和IVD退变。随后，对2017年至2022年在三级医院接受单节段显微或内窥镜腰椎间盘切除术的患者进行了一项基于单中心登记的回顾性研究。根据是否存在两种或两种以上、一种或不存在所需表型，将患者分为apd阳性、APD1/3和APD0三组。采用混合效应模型评估组间从基线至术后1年时间点LBP和腿部疼痛改善（0-100 VAS）、残疾（ODI）和生活质量（EQ-5D-3L）的差异。结果140例患者（平均年龄45.3岁，男性81例[57.9 %]）。总体而言，椎间盘切除术后患者的所有prom均有显著改善。然而，在一年的随访中，apd阳性组的腿部疼痛和残疾水平明显高于APD0组，腿部疼痛和ODI的平均得分分别为31.4分和19.6分，ODI平均得分分别为20.6分和12.0分。结论本研究引入了一种新的方法，将术前共同发生的ivd相关退行性特征整合到综合APD标准中。满足APD标准与腰椎间盘切除术后下肢疼痛和残疾的1年预后明显较差相关。

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引用次数: 0

Eye tracking as a tool to quantify the effects of CAD display on radiologists’ interpretation of chest radiographs 眼动追踪作为量化CAD显示对放射科医生解释胸片的影响的工具

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-15 DOI: 10.1016/j.ejro.2026.100731

Daisuke Matsumoto , Tomohiro Kikuchi , Yusuke Takagi , Soichiro Kojima , Ryoma Kobayashi , Daiju Ueda , Kohei Yamamoto , Sho Kawabe , Harushi Mori

Background:

Computer-aided detection (CAD) systems for chest radiographs are widely used; however, concurrent reader displays such as bounding-box (BB) highlights may influence interpretation. This pilot study used eye tracking to examine which aspects of visual search were affected by these factors.

Methods:

We sampled 180 chest radiographs from the VinDR-CXR dataset: 120 with solitary pulmonary nodules or masses and 60 without. BBs were configured for 80 % display sensitivity and specificity. Three radiologists (with 11, 5, and 1 years of experience) interpreted each case twice—once with BBs visible and once without—after a ≥ 2-week washout. Eye movements were recorded using an EyeTech VT3 Mini. Metrics included interpretation time, time to first fixation, lesion dwell time, total gaze-path length, and lung-field coverage. Outcomes were modeled using a linear mixed model with the reading condition set as a fixed effect and case and reader as random intercepts. Primary analysis was restricted to true positives (n = 96).

Results:

Concurrent BB display prolonged interpretation time by 4.9 s (p < 0.001) and increased lesion dwell time by 1.3 s (p < 0.001). Total gaze-path length increased by 2076 pixels (p < 0.001), and lung-field coverage increased by 10.5 % (p < 0.001). The time to first fixation was reduced by 1.3 s (p < 0.001).

Conclusion:

Eye tracking revealed measurable changes in search behavior associated with concurrent BB display during chest radiograph interpretation. These findings support this approach and highlight the need for larger studies across modalities and clinical contexts.

背景：胸片计算机辅助检测（CAD）系统被广泛应用；然而，并发阅读器显示，如边界框（BB）高光可能会影响解释。这项初步研究使用眼动追踪来检查视觉搜索的哪些方面受到这些因素的影响。方法：我们从vdr - cxr数据集中抽取180张胸片：120张有孤立性肺结节或肿块，60张没有。BBs配置为80 %的显示灵敏度和特异性。三名放射科医生（分别有11年、5年和1年的经验）在≥ 2周洗脱期后对每个病例进行两次解释——一次有可见的BBs，一次没有。使用EyeTech VT3 Mini记录眼球运动。指标包括解释时间、首次固定时间、病变停留时间、总注视路径长度和肺视野覆盖范围。结果采用线性混合模型建模，其中阅读条件集为固定效应，病例和读者为随机截点。初步分析仅限于真阳性（n = 96）。结果：并发BB显示延长解释时间4.9 s (p <； 0.001)，延长病变停留时间1.3 s （p <； 0.001）。总注视路径长度增加了2076个像素（p <； 0.001），肺场覆盖率增加了10. % （p <； 0.001）。首次固定时间缩短了1.3 s （p <； 0.001）。结论：眼动追踪揭示了胸片解释期间与并发BB显示相关的搜索行为的可测量变化。这些发现支持了这种方法，并强调了跨模式和临床背景进行更大规模研究的必要性。

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引用次数: 0

Automated diagnosis of usual interstitial pneumonia on chest CT via the mean curvature of isophotes 通过同凸点平均曲率在胸部CT上自动诊断常见间质性肺炎

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-10 DOI: 10.1016/j.ejro.2025.100723

Peter Savadjiev , Morteza Rezanejad , Sahir Bhatnagar , David Camirand , Claude Kauffmann , Kaleem Siddiqi , Ronald J. Dandurand , Patrick Bourgouin , Carl Chartrand-Lefebvre , Alexandre Semionov

Purpose

To test whether the mean curvature of isophotes (MCI), a geometric image transformation, can be used to improve automatic detection on chest CT of Usual Interstitial Pneumonia (UIP), a determining radiological pattern in the diagnosis of Interstitial Lung Diseases (ILD).

Materials and methods

This retrospective study included chest CT scans from 234 patients (123 female,111 male; mean age: 61.6 years; age range: 18–90 years) obtained at two independent institutions between 2007 and 2024.

Three different classification models were trained on the original CT images and separately on MCI-transformed CT images: (1) a previously published deep learning model for classifying fibrotic lung disease on chest CT, (2) a classification pipeline based on the EfficientNet-V2 convolutional neural network architecture, and (3) a non-deep-learning model based on the functional principal component analysis (FPCA) of density functions of voxel intensity.

All models were trained on data from the first institution and evaluated on data from the second institution with the recall-macro, precision-macro and F1-macro scores. Performance difference between classifier pairs was tested with the Stuart-Maxwell marginal homogeneity test.

Results

For a fixed model architecture and training algorithm, MCI-transformed images yield comparable or better classification performance than the original CT images. The best performance improvement achieved with MCI compared to CT was: recall-macro 0.83 vs 0.57, precision-macro 0.81 vs 0.50, F1-macro 0.80 vs 0.49, p = 4.2e-5.

Conclusion

MCI may be a valuable addition to existing AI systems for screening for UIP on chest CT.

目的探讨异ophotes平均曲率（MCI）的几何图像变换能否提高常规间质性肺炎（UIP）的胸部CT自动检测水平，这是诊断间质性肺疾病（ILD）的一种决定性影像学模式。材料和方法本回顾性研究包括2007年至2024年间在两个独立机构获得的234例患者的胸部CT扫描（123例女性，111例男性，平均年龄：61.6岁，年龄范围：18-90岁）。在原始CT图像和mci转换后的CT图像上分别训练了三种不同的分类模型：(1)先前发表的用于胸部CT上纤维化肺病分类的深度学习模型，(2)基于EfficientNet-V2卷积神经网络架构的分类管道，(3)基于体素强度密度函数的功能主成分分析（FPCA）的非深度学习模型。所有模型都使用第一所机构的数据进行训练，并使用第二所机构的数据进行recall-macro、precision-macro和F1-macro评分。使用Stuart-Maxwell边际均匀性检验检验分类器对之间的性能差异。结果在固定的模型架构和训练算法下，mci变换后的图像与原始CT图像的分类性能相当或更好。与CT相比，MCI获得的最佳性能改善为：召回宏0.83 vs 0.57，精度宏0.81 vs 0.50， f1宏0.80 vs 0.49, p = 4.25 -5。结论mci可能是现有AI系统在胸部CT上筛查UIP的一个有价值的补充。

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引用次数: 0

Artificial intelligence in breast cancer screening: A systematic review and meta-analysis of integration strategies 人工智能在乳腺癌筛查中的应用：整合策略的系统回顾和荟萃分析

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-10 DOI: 10.1016/j.ejro.2026.100727

Eloïse Sossavi, Catherine Roy, Sébastien Molière

Objective

To compare AI-augmented and conventional double reading in organised breast-cancer screening with respect to cancer-detection rate (CDR), recall rate, and radiologist workload.

Methods

We conducted a systematic review and random-effects meta-analysis of 13 prospective and retrospective studies (1.03 million screens) from 2017 to 2024 that embedded commercial or research AI into population-based digital mammography or tomosynthesis programmes. Eligible studies included ≥ 10,000 screens (or ≥100 cancers) and reported CDR, recalls, and/or workload metrics. We extracted cancer and recall counts and calculated risk ratios (RRs) for AI-augmented versus double reading, overall and by integration model: independent second reader, gate-keeper/decision-referral triage, and concurrent overlay.

Results

Overall, AI-augmented protocols achieved CDR parity (RR 1.01; 95 % CI 0.96–1.07) and no significant change in recalls (RR 1.00; 95 % CI 0.88–1.15). Triage models preserved CDR (RR 1.02; 95 % CI 0.98–1.07) while reducing recalls by 11 % (RR 0.89; 95 % CI 0.82–0.96) and cutting initial reads by 44–70 %. Independent-reader workflows maintained CDR (RR 0.98; 95 % CI 0.92–1.05) but showed variable recall effects (RR 1.12; 95 % CI 0.90–1.39) driven by arbitration logic and threshold choices. Concurrent overlay (two studies) indicated possible sensitivity gains (RR 1.31; 95 % CI 0.90–1.91) without higher recall rates, though precision was limited.

Conclusions

AI integration can match conventional double reading in detection performance, but its impact on workflow depends on the chosen model. Triage-based approaches consistently lower radiologist workload and recalls without compromising sensitivity, whereas replacing a second reader may simply shift effort to arbitration. Future implementation should focus on workflow-aware metrics and prospective threshold validation.

目的比较人工智能增强双读与常规双读在组织乳腺癌筛查中的癌症检出率、召回率和放射科医生工作量。方法：我们对2017年至2024年期间将商业或研究性人工智能嵌入基于人群的数字乳房x光检查或断层合成计划的13项前瞻性和回顾性研究（103万例筛查）进行了系统回顾和随机效应荟萃分析。符合条件的研究包括≥ 10,000个筛查（或≥100个癌症）和报告的CDR、召回和/或工作量指标。我们提取了癌症和召回计数，并计算了人工智能增强与双重读取的风险比（rr），总体上和通过集成模型：独立的第二读取器、看门人/决策-推荐分诊和并发叠加。结果总体而言，人工智能增强方案实现了CDR奇偶性（RR 1.01; 95% CI 0.96-1.07），召回率无显著变化（RR 1.00; 95% CI 0.88-1.15）。分诊模型保留了CDR (RR 1.02; 95% CI 0.98-1.07)，同时减少了11%的召回（RR 0.89; 95% CI 0.82-0.96），并减少了44 - 70%的初始读数。独立读者工作流程保持CDR (RR 0.98; 95% CI 0.92-1.05)，但在仲裁逻辑和阈值选择的驱动下显示出可变的召回效应（RR 1.12; 95% CI 0.90-1.39）。同时叠加（两项研究）表明可能的灵敏度提高（RR 1.31; 95% CI 0.90-1.91）没有更高的召回率，尽管精度有限。结论ai集成在检测性能上可与传统双读相媲美，但对工作流程的影响取决于所选择的模型。基于分诊的方法持续降低放射科医生的工作量和召回，而不影响灵敏度，而更换第二个阅读器可能只是将工作转移到仲裁。未来的实现应该关注工作流感知度量和预期阈值验证。

{"title":"Artificial intelligence in breast cancer screening: A systematic review and meta-analysis of integration strategies","authors":"Eloïse Sossavi, Catherine Roy, Sébastien Molière","doi":"10.1016/j.ejro.2026.100727","DOIUrl":"10.1016/j.ejro.2026.100727","url":null,"abstract":"<div><h3>Objective</h3><div>To compare AI-augmented and conventional double reading in organised breast-cancer screening with respect to cancer-detection rate (CDR), recall rate, and radiologist workload.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and random-effects meta-analysis of 13 prospective and retrospective studies (1.03 million screens) from 2017 to 2024 that embedded commercial or research AI into population-based digital mammography or tomosynthesis programmes. Eligible studies included ≥ 10,000 screens (or ≥100 cancers) and reported CDR, recalls, and/or workload metrics. We extracted cancer and recall counts and calculated risk ratios (RRs) for AI-augmented versus double reading, overall and by integration model: independent second reader, gate-keeper/decision-referral triage, and concurrent overlay.</div></div><div><h3>Results</h3><div>Overall, AI-augmented protocols achieved CDR parity (RR 1.01; 95 % CI 0.96–1.07) and no significant change in recalls (RR 1.00; 95 % CI 0.88–1.15). Triage models preserved CDR (RR 1.02; 95 % CI 0.98–1.07) while reducing recalls by 11 % (RR 0.89; 95 % CI 0.82–0.96) and cutting initial reads by 44–70 %. Independent-reader workflows maintained CDR (RR 0.98; 95 % CI 0.92–1.05) but showed variable recall effects (RR 1.12; 95 % CI 0.90–1.39) driven by arbitration logic and threshold choices. Concurrent overlay (two studies) indicated possible sensitivity gains (RR 1.31; 95 % CI 0.90–1.91) without higher recall rates, though precision was limited.</div></div><div><h3>Conclusions</h3><div>AI integration can match conventional double reading in detection performance, but its impact on workflow depends on the chosen model. Triage-based approaches consistently lower radiologist workload and recalls without compromising sensitivity, whereas replacing a second reader may simply shift effort to arbitration. Future implementation should focus on workflow-aware metrics and prospective threshold validation.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100727"},"PeriodicalIF":2.9,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Machine learning-based multi-class classification of bladder pathologies using fused 3D CT radiomic and 3D auto-encoder deep features 基于机器学习的膀胱病理多分类融合三维CT放射学和三维自编码器深度特征

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-09 DOI: 10.1016/j.ejro.2026.100728

Hongwei Xiao , Weihao Liu , Huancheng Yang , Zexin Huang , Yangguang Yuan , Tianyu Wang , Hanlin Liu , Kai Wu

Objective

To develop an automated analytical framework that integrates hybrid radiomics and deep learning features from non-contrast CT images for the multi-class classification of bladder pathologies.

Methods

This retrospective study analyzed 902 CT scans (584 normal, 142 calculi, 66 cancers, 110 cystitis). An integrated pipeline was implemented, comprising: 1) automatic bladder segmentation using a 3D-UNet, 2) hybrid feature extraction combining 100 radiomics features and 256 deep features from a 3D convolutional autoencoder, 3) feature selection via variance thresholding and LASSO regression, and 4) final classification using an XGBoost classifier. The dataset was split into training (80 %) and validation (20 %) sets. Performance was evaluated using the area under the receiver operating characteristic curve (AUROC) with a one-vs-rest strategy for multi-class classification. Model stability was assessed via stratified five-fold cross-validation, and interpretability was analyzed with SHapley Additive exPlanations (SHAP).

Results

The framework achieved one-vs-rest AUROCs of 0.94 (95 % CI: 0.89–0.99) for calculi, 0.92 (0.85–0.99) for cancer, 0.90 (0.84–0.95) for normal bladder, and 0.83 (0.75–0.91) for cystitis. The micro-average AUROC for four-class discrimination was 0.94 (0.92–0.96). Binary normal/abnormal classification demonstrated stable performance across cross-validation folds (AUROC range: 0.89–0.92). SHAP analysis revealed that radiomic features dominated decisions for calculi/normal differentiation, while deep features were critical for distinguishing cancer and cystitis.

Conclusion

The proposed hybrid CT analysis framework achieves clinically relevant performance in the automated, multi-class classification of bladder pathologies, excelling particularly in calculi detection. The complementary roles of radiomic and deep features provide an interpretable diagnostic aid, demonstrating potential for integration into clinical workflows to support differential diagnosis.

目的开发一种结合非对比CT图像放射组学和深度学习特征的自动分析框架，用于膀胱病理的多类别分类。方法回顾性分析902例CT扫描（正常584例，结石142例，癌66例，膀胱炎110例）。实现了一个集成的管道，包括：1)使用3D- unet自动膀胱分割，2)结合100个放射组学特征和来自3D卷积自编码器的256个深度特征的混合特征提取，3)通过方差阈值和LASSO回归进行特征选择，4)使用XGBoost分类器进行最终分类。数据集被分成训练集（80 %）和验证集（20 %）。使用接收者工作特征曲线下面积（AUROC）对性能进行评估，并采用一对休息策略进行多类别分类。通过分层五重交叉验证评估模型稳定性，并使用SHapley加性解释（SHAP）分析可解释性。结果该框架的auroc为：结石0.94(95 % CI: 0.89-0.99)，癌症0.92(0.85-0.99)，正常膀胱0.90(0.84-0.95)，膀胱炎0.83（0.75-0.91）。四类鉴别的微平均AUROC为0.94（0.92 ~ 0.96）。二元正常/异常分类在交叉验证折叠中表现稳定（AUROC范围：0.89-0.92）。SHAP分析显示，放射学特征主导了结石/正常分化的决定，而深部特征对区分癌症和膀胱炎至关重要。结论本文提出的混合CT分析框架在膀胱病理的自动、多类别分类中达到了临床相关的性能，尤其在结石检测方面表现突出。放射学和深部特征的互补作用提供了可解释的诊断辅助，展示了整合到临床工作流程以支持鉴别诊断的潜力。

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引用次数: 0

Myocardial transit time mapping by CMR: A novel potential parameter of microcirculatory dysfunction in hypertrophic cardiomyopathy with and without atrial fibrillation CMR心肌传递时间映射：伴有和不伴有房颤的肥厚性心肌病微循环功能障碍的新潜在参数

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2026-01-08 DOI: 10.1016/j.ejro.2026.100726

Junlin Yang , Yong Cheng , Jinxiu Yang , Yuncheng Li , Zhen Wang , Shutian An , Jun Wang , Yongqiang Yu , Ren Zhao , Xiaohu Li

Purpose

This study aimed to explore myocardial transit time (MyoTT) by cardiovascular magnetic resonance (CMR) as a potential parameter of coronary microvascular dysfunction (CMD) in hypertrophic cardiomyopathy (HCM) with and without atrial fibrillation (AF).

Materials and Methods

This study enrolled 50 patients with HCM and 50 healthy control subjects to assess cardiac function, native T1, extracellular volume (ECV), myocardial strain, and MyoTT. Factors associated with HCM status were estimated by logistic regression analyses, adjusting for potential confounders. Meanwhile, we evaluated the discriminative performance of the aforementioned parameters for HCM (vs control) and for AF status among HCM patients.

Results

In the HCM and control groups, the HCM group exhibited significant reductions in LV-GLS, RV-EDVI, and RV-ESVI (all P < 0.05) and significant increases in LVMI, LVGPWT, native T1 values, ECV values, absolute MyoTT values and presence of LGE (all P < 0.05). Logistic regression analysis revealed HCM was significantly associated with MyoTT, native T1, ECV and LV-GLS. In HCM with and without AF, the HCM with AF group showed nominally higher native T1 values and absolute MyoTT values before correction. Logistic regression analysis revealed HCM with AF was significantly associated with MyoTT and native T1. The AUCs for ECV, MyoTT, LV-GLS, and native T1 were 0.828, 0.848, 0.708, and 0.862, respectively (P < 0.05). The AUCs for discriminating HCM with AF from HCM without AF for MyoTT and native T1 were 0.740 and 0.681, respectively (P < 0.05).

Conclusion

MyoTT levels are elevated in patients with HCM, particularly when AF is present. This suggests that MyoTT may reflect CMD-related alterations in HCM, especially in those with AF.

目的探讨心肌传递时间（MyoTT）作为肥厚性心肌病（HCM）伴心房颤动（AF）和不伴心房颤动（AF）患者冠状动脉微血管功能障碍（CMD）的潜在参数。材料与方法本研究招募了50例HCM患者和50例健康对照者，评估心功能、原生T1、细胞外体积（ECV）、心肌应变和MyoTT。通过逻辑回归分析估计与HCM状态相关的因素，调整潜在的混杂因素。同时，我们评估了上述参数对HCM（对照）和HCM患者房颤状态的判别性能。结果在HCM组和对照组中，HCM组的LV-GLS、RV-EDVI和RV-ESVI均显著降低（P均 <； 0.05），LVMI、LVGPWT、原生T1值、ECV值、绝对MyoTT值和LGE的存在均显著升高（P均 <； 0.05）。Logistic回归分析显示HCM与MyoTT、原生T1、ECV和LV-GLS显著相关。在伴有和不伴有房颤的HCM中，伴有房颤的HCM组在校正前的T1值和MyoTT绝对值名义上更高。Logistic回归分析显示HCM合并AF与MyoTT和原生T1显著相关。ECV、MyoTT、LV-GLS、原生T1的auc分别为0.828、0.848、0.708、0.862 （P <； 0.05）。MyoTT和原生T1区分有AF的HCM和无AF的HCM的auc分别为0.740和0.681 （P <； 0.05）。结论HCM患者myott水平升高，尤其是房颤患者。这表明MyoTT可能反映了HCM中与cd相关的改变，尤其是房颤患者。

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引用次数: 0