European Journal of Radiology Open最新文献_第10页

Prediction of lymph node metastasis in papillary thyroid carcinoma using non-contrast CT-based radiomics and deep learning with thyroid lobe segmentation: A dual-center study 基于非对比ct的放射组学和甲状腺叶分割的深度学习预测甲状腺乳头状癌淋巴结转移：一项双中心研究

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-02-24 DOI: 10.1016/j.ejro.2025.100639

Hao Wang , Xuan Wang , Yusheng Du , You Wang , Zhuojie Bai , Di Wu , Wuliang Tang , Hanling Zeng , Jing Tao , Jian He

Objectives

This study aimed to develop a predictive model for lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) patients by deep learning radiomic (DLRad) and clinical features.

Methods

This study included 271 thyroid lobes from 228 PTC patients who underwent preoperative neck non-contrast CT at Center 1 (May 2021–April 2024). LNM status was confirmed via postoperative pathology, with each thyroid lobe labeled accordingly. The cohort was divided into training (n = 189) and validation (n = 82) cohorts, with additional temporal (n = 59 lobes, Center 1, May–August 2024) and external (n = 66 lobes, Center 2) test cohorts. Thyroid lobes were manually segmented from the isthmus midline, ensuring interobserver consistency (ICC ≥ 0.8). Deep learning and radiomics features were selected using LASSO algorithms to compute DLRad scores. Logistic regression identified independent predictors, forming DLRad, clinical, and combined models. Model performance was evaluated using AUC, calibration, decision curves, and the DeLong test, compared against radiologists' assessments.

Results

Independent predictors of LNM included age, gender, multiple nodules, tumor size group, and DLRad. The combined model demonstrated superior diagnostic performance with AUCs of 0.830 (training), 0.799 (validation), 0.819 (temporal test), and 0.756 (external test), outperforming the DLRad model (AUCs: 0.786, 0.730, 0.753, 0.642), clinical model (AUCs: 0.723, 0.745, 0.671, 0.660), and radiologist evaluations (AUCs: 0.529, 0.606, 0.620, 0.503). It also achieved the lowest Brier scores (0.167, 0.184, 0.175, 0.201) and the highest net benefit in decision-curve analysis at threshold probabilities > 20 %.

Conclusions

The combined model integrating DLRad and clinical features exhibits good performance in predicting LNM in PTC patients.

目的通过深度学习放射学（DLRad）和临床特征，建立甲状腺乳头状癌（PTC）患者淋巴结转移（LNM）的预测模型。方法本研究纳入228例PTC患者的271个甲状腺叶，这些患者于2021年5月至2024年4月在中心1行术前颈部非对比CT检查。术后病理证实LNM状态，并相应标记每个甲状腺叶。该队列分为训练队列（n = 189）和验证队列（n = 82），另外还有时间队列（n = 59个叶，中心1,2024年5 - 8月）和外部测试队列（n = 66个叶，中心2）。手动从峡中线分割甲状腺叶，确保观察者之间的一致性（ICC≥0.8）。使用LASSO算法选择深度学习和放射组学特征来计算DLRad分数。逻辑回归确定了独立的预测因子，形成了DLRad、临床和联合模型。使用AUC、校准、决策曲线和DeLong测试对模型性能进行评估，并与放射科医生的评估进行比较。结果LNM的独立预测因素包括年龄、性别、多发结节、肿瘤大小组和DLRad。该组合模型的auc值分别为0.830（训练）、0.799（验证）、0.819（时间检验）和0.756（外部检验），优于DLRad模型（auc值分别为0.786、0.730、0.753、0.642）、临床模型（auc值分别为0.723、0.745、0.671、0.660）和放射科医师评价模型（auc值分别为0.529、0.606、0.620、0.503）。在阈值概率>； 20 %的决策曲线分析中，它也获得了最低的Brier分数（0.167,0.184,0.175,0.201）和最高的净效益。结论将DLRad与临床特征相结合的联合模型对PTC患者的LNM有较好的预测效果。

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引用次数: 0

Prediction of plaque progression using different machine learning models of pericoronary adipose tissue radiomics based on coronary computed tomography angiography 基于冠状动脉计算机断层血管造影的不同冠状动脉周围脂肪组织放射组学机器学习模型预测斑块进展

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-02-15 DOI: 10.1016/j.ejro.2025.100638

Jingjing Pan , Qianyu Huang , Jiangming Zhu , Wencai Huang , Qian Wu , Tingting Fu , Shuhui Peng , Jiani Zou

Objectives

To develop and validate the value of different machine learning models of pericoronary adipose tissue (PCAT) radiomics based on coronary computed tomography angiography (CCTA) for predicting coronary plaque progression (PP).

Methods

This retrospective study evaluated 97 consecutive patients (with 127 plaques: 40 progressive and 87 nonprogressive) who underwent serial CCTA examinations. We analyzed conventional parameters and PCAT radiomics features. PCAT radiomics models were constructed using logistic regression (LR), K-nearest neighbors (KNN), and random forest (RF). Logistic regression analysis was applied to identify variables for developing conventional parameter models. Model performances were assessed by metrics including area under the curve (AUC), accuracy, sensitivity, and specificity.

Results

At baseline CCTA, 93 radiomics features were extracted from CCTA images. After dimensionality reduction and feature selection, two radiomics features were deemed valuable. Among radiomics models, we selected the RF as the optimal model in the training and validation sets (AUC = 0.971, 0.821). At follow-up CCTA, logistic regression analysis showed that increase in fat attenuation index (FAI) and decrease in PCAT volume were independent predictors of PP. The predictive capability of the combined model (increase in FAI + decrease in PCAT volume) was the best in the training and validation sets (AUC = 0.907, 0.882).

Conclusions

At baseline CCTA, the RF-based PCAT radiomics model demonstrated excellent predictive ability for PP. Furthermore, at follow-up CCTA, our results indicated that both increase in FAI and decrease in PCAT volume can independently predict PP, and their combination provided enhanced predictive ability.

目的建立并验证基于冠状动脉ct血管造影（CCTA）的不同冠状动脉周围脂肪组织（PCAT）放射组学机器学习模型在预测冠状动脉斑块进展（PP）方面的价值。方法本回顾性研究评估了连续行CCTA检查的97例患者（127个斑块：40例进展性，87例非进展性）。我们分析了常规参数和PCAT放射组学特征。使用逻辑回归（LR）、k近邻（KNN）和随机森林（RF）构建PCAT放射组学模型。采用Logistic回归分析识别变量，建立常规参数模型。通过曲线下面积（AUC）、准确性、灵敏度和特异性等指标评估模型的性能。结果在基线CCTA中提取了93个放射组学特征。经过降维和特征选择，两个放射组学特征被认为是有价值的。在放射组学模型中，我们选择射频作为训练集和验证集的最优模型（AUC = 0.971, 0.821）。在随访CCTA时，logistic回归分析显示，脂肪衰减指数（FAI）升高和PCAT体积减小是PP的独立预测因子，在训练集和验证集中，联合模型（FAI升高+ PCAT体积减小）的预测能力最好（AUC = 0.907, 0.882）。结论在基线CCTA中，基于rf的PCAT放射组学模型对PP具有出色的预测能力。此外，在后续CCTA中，我们的结果表明FAI的增加和PCAT体积的减少都可以独立预测PP，并且它们的组合增强了预测能力。

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引用次数: 0

MRI and CT radiomics for the diagnosis of acute pancreatitis MRI与CT放射组学对急性胰腺炎的诊断价值

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-31 DOI: 10.1016/j.ejro.2025.100636

Caterina Tartari , Fabio Porões , Sabine Schmidt , Daniel Abler , Thomas Vetterli , Adrien Depeursinge , Clarisse Dromain , Naïk Vietti Violi , Mario Jreige

Purpose

To evaluate the single and combined diagnostic performances of CT and MRI radiomics for diagnosis of acute pancreatitis (AP).

Materials and methods

We prospectively enrolled 78 patients (mean age 55.7 ± 17 years, 48.7 % male) diagnosed with AP between 2020 and 2022. Patients underwent contrast-enhanced CT (CECT) within 48–72 h of symptoms and MRI ≤ 24 h after CECT. The entire pancreas was manually segmented tridimensionally by two operators on portal venous phase (PVP) CECT images, T2-weighted imaging (WI) MR sequence and non-enhanced and PVP T1-WI MR sequences. A matched control group (n = 77) with normal pancreas was used. Dataset was randomly split into training and test, and various machine learning algorithms were compared. Receiver operating curve analysis was performed.

Results

The T2WI model exhibited significantly better diagnostic performance than CECT and non-enhanced and venous T1WI, with sensitivity, specificity and AUC of 73.3 % (95 % CI: 71.5–74.7), 80.1 % (78.2–83.2), and 0.834 (0.819–0.844) for T2WI (p = 0.001), 74.4 % (71.5–76.4), 58.7 % (56.3–61.1), and 0.654 (0.630–0.677) for non-enhanced T1WI, 62.1 % (60.1–64.2), 78.7 % (77.1–81), and 0.787 (0.771–0.810) for venous T1WI, and 66.4 % (64.8–50.9), 48.4 % (46–50.9), and 0.610 (0.586–0.626) for CECT, respectively.

The combination of T2WI with CECT enhanced diagnostic performance compared to T2WI, achieving sensitivity, specificity and AUC of 81.4 % (80–80.3), 78.1 % (75.9–80.2), and 0.911 (0.902–0.920) (p = 0.001).

Conclusion

The MRI radiomics outperformed the CT radiomics model to detect diagnosis of AP and the combination of MRI with CECT showed better performance than single models. The translation of radiomics into clinical practice may improve detection of AP, particularly MRI radiomics.

目的探讨CT和MRI放射组学在急性胰腺炎（AP）诊断中的单独和联合诊断价值。材料和方法我们前瞻性地纳入了2020年至2022年间诊断为AP的78例患者（平均年龄55.7 ± 17岁，男性48.7 %）。患者在出现症状48-72 h内行对比增强CT （CECT）检查，CECT后MRI≤ 24 h。由两名操作员对门静脉期（PVP） CECT图像、t2加权成像（WI） MR序列以及非增强和PVP T1-WI MR序列进行全胰腺三维人工分割。对照组（n = 77）胰腺正常。将数据集随机分为训练和测试两部分，比较不同的机器学习算法。进行受试者工作曲线分析。结果T2WI模型的诊断效果明显优于CECT、非增强和静脉T1WI，敏感性、特异性和AUC为73.3 %(95% % CI： % 71.5 - -74.7),80.1(78.2 - -83.2),和0.834 (0.819 - -0.844)T2WI (p = 0.001),74.4 %(71.5 - -76.4),58.7 %(56.3 - -61.1),和0.654 (0.630 - -0.677)non-enhanced T1WI, 62.1 %(60.1 - -64.2),78.7 % -81(77.1),和0.787(0.771 - -0.810)静脉T1WI,和66.4 %(64.8 - -50.9),48.4 %(46 - 50.9),和0.610(0.586 - -0.626),摄影,分别。与T2WI相比，T2WI联合CECT提高了诊断性能，达到了81.4 %（80-80.3）、78.1 %（75.9-80.2）和0.911 (0.902-0.920)（p = 0.001）的敏感性、特异性和AUC。结论MRI放射组学在诊断AP方面优于CT放射组学模型，且MRI与CECT联合应用优于单一模型。放射组学转化为临床实践可以提高AP的检测，特别是MRI放射组学。

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引用次数: 0

Low KV-low contrast medium dose one-stop dual source CT high pitch integrated coronary-carotid-cerebral-aortic CTA improves image quality and reduces both radiation and contrast medium doses 低kv -低造影剂剂量一站式双源CT高音高一体化冠-颈-脑-主动脉CTA提高图像质量，降低辐射和造影剂剂量

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-29 DOI: 10.1016/j.ejro.2025.100637

Meng Wang, Chao Zheng, Lin Yang, Juan Su, Bo Wang, JieXin Sheng

Rationale and objectives

To evaluate the impact of low dose-low contrast medium injection protocol on radiation dose and image quality of one-stop dual source high pitch integrated coronary -carotid -cerebral- aortic CTA.

Methods

A total of 211 non-obese patients, consisting of 44 females with an average age of 59 years, were split into two groups: low dose group (LD group n = 136) and routine dose group (RD group n = 75). Noise, attenuation, signal to noise ratio (SNR), and contrast to noise ratio (CNR) were compared between the groups by setting region of interest (ROI) in target vessels to evaluate objective image quality. Two radiologists assessed subjective image quality using the 5-point scale. volumetric CT dose index (CTDIvol), dose length production (DLP), and effective radiation dose (ED) were compared, while contrast medium (CM) dose was assessed by CM volume and iodine uptake (IU).

Results

Both radiation and CM dose were significantly reduced in the LD group compared with the RD group, DLP and ED were reduced by 51 %, and CM volume and IU were reduced by 13 % (all p < 0.05). Attenuation and noise were higher, while SNR and CNR were close to or slightly higher in the LD group compared with the RD group. The LD group had higher subjective image quality scores while all scores in the two groups satisfied the diagnostic requirements.

Conclusion

Low-kV, low-CM one-stop dual-source high-pitch integrated coronary-carotid-cerebral-aortic CTA can ensure image quality while significantly reducing the doses of contrast medium and radiation

目的探讨低剂量-低造影剂注射方案对一站式双源高音高综合冠状动脉-颈动脉-脑主动脉CTA放射剂量和图像质量的影响。方法211例非肥胖患者，女性44例，平均年龄59岁，随机分为低剂量组（LD组n = 136）和常规剂量组（RD组n = 75）。通过设定目标血管的感兴趣区域（ROI），比较各组间的噪声、衰减、信噪比（SNR）和噪比（CNR），评价客观图像质量。两名放射科医生使用5分制评估主观图像质量。对比体积CT剂量指数（CTDIvol）、剂量长度产生（DLP）和有效辐射剂量（ED），对比造影剂（CM）剂量通过CM体积和碘摄取（IU）评估。结果与RD组相比，LD组放疗和CM剂量均显著降低，DLP和ED减少51 %，CM体积和IU减少13 % （p均为 <； 0.05）。与RD组相比，LD组的衰减和噪声更高，而信噪比和CNR接近或略高。LD组主观影像质量评分较高，两组均满足诊断要求。结论低kv、低cm一站式双源高音高一体化冠-颈-脑-主动脉CTA在保证图像质量的同时，可显著降低造影剂剂量和辐射剂量

{"title":"Low KV-low contrast medium dose one-stop dual source CT high pitch integrated coronary-carotid-cerebral-aortic CTA improves image quality and reduces both radiation and contrast medium doses","authors":"Meng Wang, Chao Zheng, Lin Yang, Juan Su, Bo Wang, JieXin Sheng","doi":"10.1016/j.ejro.2025.100637","DOIUrl":"10.1016/j.ejro.2025.100637","url":null,"abstract":"<div><h3>Rationale and objectives</h3><div>To evaluate the impact of low dose-low contrast medium injection protocol on radiation dose and image quality of one-stop dual source high pitch integrated coronary -carotid -cerebral- aortic CTA.</div></div><div><h3>Methods</h3><div>A total of 211 non-obese patients, consisting of 44 females with an average age of 59 years, were split into two groups: low dose group (LD group n = 136) and routine dose group (RD group n = 75). Noise, attenuation, signal to noise ratio (SNR), and contrast to noise ratio (CNR) were compared between the groups by setting region of interest (ROI) in target vessels to evaluate objective image quality. Two radiologists assessed subjective image quality using the 5-point scale. volumetric CT dose index (CTDIvol), dose length production (DLP), and effective radiation dose (ED) were compared, while contrast medium (CM) dose was assessed by CM volume and iodine uptake (IU).</div></div><div><h3>Results</h3><div>Both radiation and CM dose were significantly reduced in the LD group compared with the RD group, DLP and ED were reduced by 51 %, and CM volume and IU were reduced by 13 % (all p < 0.05). Attenuation and noise were higher, while SNR and CNR were close to or slightly higher in the LD group compared with the RD group. The LD group had higher subjective image quality scores while all scores in the two groups satisfied the diagnostic requirements.</div></div><div><h3>Conclusion</h3><div>Low-kV, low-CM one-stop dual-source high-pitch integrated coronary-carotid-cerebral-aortic CTA can ensure image quality while significantly reducing the doses of contrast medium and radiation</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"14 ","pages":"Article 100637"},"PeriodicalIF":1.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101133","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

Real-time shear wave elastography in measuring normal ileocolon intestinal wall stiffness using colonoscopy as reference: A single-center research 以结肠镜为参考，实时剪切波弹性成像测量正常回肠肠壁刚度：单中心研究

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-25 DOI: 10.1016/j.ejro.2024.100632

Shuo Wang , Shihui Li , Shuling Chen , Manying Li , Xiaoyan Xie , Mao Ren , Yujun Chen

Purpose

To investigate the feasibility of real-time shear wave elastography (SWE) in evaluating intestinal wall stiffness, and to establish the threshold SWE value of normal intestinal wall and explore the influencing factors of intestinal SWE.

Method

659 subjects who underwent intestinal SWE and colonoscopy were retrospectively enrolled. The wall elasticity of colonoscopy-confirmed normal/abnormal intestinal segment was measured by transabdominal SWE. Measurement reliability was evaluated by the intraclass correlation coefficient (ICC). The threshold value of SWE in differentiating normal and abnormal intestine was determined using ROC curve analysis with the largest Youden index, and the diagnostic performance of this threshold was evaluated. We explored the effects of gender, age, depth and type of the targeted intestinal segment on the intestinal wall elasticity by t test and logistic linear regression analysis.

Results

The technical success rate of SWE examination is 95.3 % (628/659). The mean SWE value of normal intestinal walls is (5.45 ± 1.34) kPa, which was significantly lower than that of abnormal ones (15.38 kPa±7.22, P < 0.001). Using 8.1 kPa as the threshold， the sensitivity and specificity were 93.5 % and 96.0 % with an AUC of 94.8 %. The overall ICC for SWE measurements was 0.933. Gender (ß=0.278, P = 0.013), depth (ß=0.220, P = 0.043) and type of the targeted segment (ß=0.522, P < 0.001) was associated with the SWE value of intestinal wall, but age was not (ß=0.050, P = 0.484).

Conclusions

SWE is feasible in evaluating the stiffness of intestinal wall with high reliability. The SWE threshold value differentiating normal intestinal wall and abnormal intestinal wall is 8.1 kPa.

目的探讨实时剪切波弹性成像（SWE）评价肠壁刚度的可行性，建立正常肠壁的SWE阈值，探讨肠道SWE的影响因素。方法回顾性分析659例接受小肠SWE和结肠镜检查的患者。经腹SWE测定结肠镜下正常/异常肠段肠壁弹性。采用类内相关系数（ICC）评价测量信度。采用最大约登指数的ROC曲线分析确定SWE区分正常与异常肠道的阈值，并评价该阈值的诊断效能。我们通过t检验和logistic线性回归分析探讨了性别、年龄、目标肠段深度和类型对肠壁弹性的影响。结果SWE检查的技术成功率为95.3 %（628/659）。正常肠壁SWE平均值为（5.45 ± 1.34）kPa，显著低于异常肠壁SWE平均值（15.38 kPa±7.22,P <； 0.001）。以8.1 kPa为阈值，灵敏度为93.5 %，特异度为96.0 %，AUC为94.8 %。SWE测量的总体ICC为0.933。性别（ß=0.278, P = 0.013）、深度（ß=0.220, P = 0.043）和目标节段类型（ß=0.522, P <； 0.001）与肠壁SWE值相关，而年龄（ß=0.050, P = 0.484）与SWE值无关。结论sswe评价肠壁硬度是可行的，可靠性高。区分正常与异常肠壁的SWE阈值为8.1 kPa。

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引用次数: 0

Ultra-fast biparametric MRI in prostate cancer assessment: Diagnostic performance and image quality compared to conventional multiparametric MRI 超快速双参数MRI在前列腺癌评估中的应用：与常规多参数MRI相比的诊断性能和图像质量

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-21 DOI: 10.1016/j.ejro.2025.100635

Antonia M. Pausch , Vivien Filleböck , Clara Elsner , Niels J. Rupp , Daniel Eberli , Andreas M. Hötker

Purpose

To compare the diagnostic performance and image quality of a deep-learning-assisted ultra-fast biparametric MRI (bpMRI) with the conventional multiparametric MRI (mpMRI) for the diagnosis of clinically significant prostate cancer (csPCa).

Methods

This prospective single-center study enrolled 123 biopsy-naïve patients undergoing conventional mpMRI and additionally ultra-fast bpMRI at 3 T between 06/2023–02/2024. Two radiologists (R1: 4 years and R2: 3 years of experience) independently assigned PI-RADS scores (PI-RADS v2.1) and assessed image quality (mPI-QUAL score) in two blinded study readouts. Weighted Cohen’s Kappa (κ) was calculated to evaluate inter-reader agreement. Diagnostic performance was analyzed using clinical data and histopathological results from clinically indicated biopsies.

Results

Inter-reader agreement was good for both mpMRI (κ = 0.83) and ultra-fast bpMRI (κ = 0.87). Both readers demonstrated high sensitivity (≥94 %/≥91 %, R1/R2) and NPV (≥96 %/≥95 %) for csPCa detection using both protocols. The more experienced reader mostly showed notably higher specificity (≥77 %/≥53 %), PPV (≥62 %/≥45 %), and diagnostic accuracy (≥82 %/≥65 %) compared to the less experienced reader. There was no significant difference in the diagnostic performance of correctly identifying csPCa between both protocols (p > 0.05). The ultra-fast bpMRI protocol had significantly better image quality ratings (p < 0.001) and achieved a reduction in scan time of 80 % compared to conventional mpMRI.

Conclusion

Deep-learning-assisted ultra-fast bpMRI protocols offer a promising alternative to conventional mpMRI for diagnosing csPCa in biopsy-naïve patients with comparable inter-reader agreement and diagnostic performance at superior image quality. However, reader experience remains essential for diagnostic performance.

目的比较深度学习辅助下的超快速双参数MRI （bpMRI）与常规多参数MRI （mpMRI）对临床显著性前列腺癌（csPCa）的诊断性能和图像质量。方法本前瞻性单中心研究纳入123例biopsy-naïve患者，于2023年6月至2024年2月期间在3 T接受常规mpMRI和超快速bpMRI。两名放射科医生（R1: 4年经验，R2: 3年经验）在两项盲法研究中独立分配PI-RADS评分（PI-RADS v2.1）并评估图像质量（mPI-QUAL评分）。计算加权科恩Kappa （κ）来评估读者间的一致性。诊断性能分析使用临床数据和组织病理学结果从临床指示活检。结果mpMRI和超快速bpMRI的读间一致性均较好（κ = 0.83）。两种读卡器均表现出高灵敏度（≥94 %/≥91 %,R1/R2）和NPV（≥96 %/≥95 %）。与经验不足的读者相比，经验丰富的读者大多表现出更高的特异性（≥77 %/≥53 %），PPV（≥62 %/≥45 %）和诊断准确性（≥82 %/≥65 %）。两种方案在正确识别csPCa的诊断性能上无显著差异（p >； 0.05）。超高速bpMRI方案具有更好的图像质量评级（p <； 0.001），与传统mpMRI相比，扫描时间减少了80% %。结论深度学习辅助的超快速bpMRI方案在诊断biopsy-naïve患者的csPCa方面具有相当的读者间一致性和更高的图像质量的诊断性能，是传统mpMRI的一个有希望的替代方案。然而，读者体验仍然是诊断性能的关键。

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引用次数: 0

Comparison of objective quality parameters between CTA and CTP angiographic reconstructions in ischemic stroke patients 缺血性脑卒中患者CTA与CTP血管造影重建客观质量参数的比较。

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-14 DOI: 10.1016/j.ejro.2025.100634

M.M.Q. Robbe , F.M.E. Pinckaers , A.H.H. Dirx , P.H.M. Voorter , W.H. van Zwam , B.A.J.M. Wagemans , A.A. Postma

Introduction

CT perfusion-angiographic reconstructions (CTP-AR) may be used for occlusion detection in ischemic stroke patients. Objective image quality of CTP-AR needs to be evaluated before implementation as it may affect occlusion detection. In this study, we aimed to assess the objective image quality, by means of contrast to noise ratio (CNR) and signal to noise ratio (SNR), of both CT-angiography and CT perfusion-angiographic reconstructions (CTP-AR).

Methods

Patients with an ischemic stroke between September 2020 up to and including September 2021 who underwent both CT perfusion and CTA at baseline were included. CTP-AR was reconstructed from 1 mm CTP series at the peak arterial enhancement. Per patient, five ipsilateral and five contralateral regions of interest (ROI) were placed. Attenuation and standard deviation per ROI were used to calculate CNR and SNR. Differences in CNR and SNR between CTA and CTP-AR were tested using paired-sample t-tests.

Results

In total, 195/239 patients were included. Both on the ipsilateral and contralateral side, the CNR was significantly higher on CTP-AR compared to CTA (P < .001 and P < .001, respectively). The SNR measured in the M1 was not significantly different between CTA and CTP-AR (ipsilateral: P = .68; contralateral: P = .63). The SNR, both on the ipsilateral and contralateral side, was significantly lower on CTP-AR compared to CTA in all parenchyma regions; the caudate nucleus (P < .001), lentiform nucleus (P < .001), centrum semiovale (P < .001), and the parenchyma adjacent to the M1 (P < .001).

Conclusion

Image quality measures of CTP-derived angiographic reconstructions indicate higher CNR compared to CTA, but a lower SNR in non-angiographic structures.

简介：CT灌注血管造影重建（CTP-AR）可用于缺血性脑卒中患者的闭塞检测。CTP-AR的客观图像质量在实施前需要进行评估，因为它可能会影响遮挡检测。在本研究中，我们旨在通过对比CT血管造影和CT灌注血管造影重建（CTP-AR）的噪声比（CNR）和信噪比（SNR）来评估客观图像质量。方法：纳入2020年9月至2021年9月期间接受CT灌注和CTA基线治疗的缺血性卒中患者。CTP- ar重建从1 mm CTP系列在动脉增强峰值。每个患者放置5个同侧和5个对侧感兴趣区（ROI）。每个ROI的衰减和标准差用于计算CNR和SNR。CTA与CTP-AR的CNR和SNR差异采用配对样本t检验。结果：共纳入195/239例患者。在同侧和对侧，CTP-AR的CNR均显著高于CTA (P P P = .68；侧:P = 点)。与CTA相比，CTP-AR在所有实质区域的信噪比均显著低于同侧和对侧；结论：ctp衍生血管造影重建的图像质量指标显示，与CTA相比，CTA的CNR更高，但非血管造影结构的信噪比更低。

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引用次数: 0

Assessment of hemodynamic disturbances and impaired ventricular filling in asymptomatic fontan patients: A 4D flow CMR study 无症状fontan患者血流动力学紊乱和心室充盈受损的评估：4D血流CMR研究。

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-08 DOI: 10.1016/j.ejro.2024.100631

Li-Wei Hu , Xiaodan Zhao , Shuang Leng , RongZhen Ouyang , Qian Wang , Ai-Min Sun , Yi-Man Liu , Wei Dong , Liang Zhong , Yu-Min Zhong

Background

The Fontan procedure is a surgical intervention designed for patients with single ventricle physiology, wherein the systemic venous return is redirected into the pulmonary circulation, thereby facilitating passive pulmonary blood flow without the assistance of ventricular propulsion. Consequently, long-term follow-up of individuals who have undergone the asymptomatic Fontan procedure is essential.

Objectives

The aims of this investigation were to: 1) examine the impact of flow components and kinetic energy (KE) parameters on hemodynamic disturbances in asymptomatic Fontan patients and control group; 2) Assess left ventricular diastolic dysfunction through the analysis of 4D flow parameters across different Fontan sub-groups; 3) Compare intracardiac flow parameters among Fontan sub-groups based on morphological features of the left ventricle (LV) and right ventricle (RV).

Methods

Twenty-five Fontan patients (mean age: 10 ± 3 years, male/female: 15/10) and fourteen control subjects (mean age: 10 ± 2 years, male/female: 8/6) were recruited retrospectively for the study. The Fontan patients were further categorized into three groups based on their ventricular function: left ventricular (LV), right ventricular (RV), and biventricular (BiV). Each participant underwent cardiovascular magnetic resonance (CMR) imaging, including cine and 4D flow sequences on a 3.0 T scanner. Ventricular flow components and KE were assessed using 4D flow. The study utilized cine images to analyze cardiac function and inter-ventricular mechanical dyssynchrony. Echocardiography evaluated functional ventricular diastolic dysfunction.

Results

Fontan patients had a higher median functional single ventricle (FSV) residual volume compared to controls (28 % vs. 23 %, P = 0.034), with lower median FSV direct flow (32 % vs. 40 %, P = 0.005) and delayed ejection flow (17 % vs. 24 %, P = 0.024). The parameters of FSV normalized to the ventricular end-diastolic volume (KEi_EDV) were found to be significantly lower in Fontan patients (all P < 0.05). In both left ventricle (LV) and biventricular (BiV) Fontan subgroups, direct flow was identified as an independent predictor of LV diastolic dysfunction (AUC=0.76, Sensitivity=86 %, Specificity=70 %). Furthermore, residual volume and E-wave KEi_EDV were observed to be significantly different between LV and right ventricle (RV) Fontan subgroups.

Conclusions

The altered flow pattern and reduced kinetic energy observed in Fontan patients may indicate hemodynamic disturbances and compromised ventricular filling. Reduced direct flow is associated with LV diastolic dysfunction in LV and BiV Fontan subgroups. Systemic LV exhibited a more efficient intracardiac flow pattern compare with systemic RV in Fontan patients.

背景：Fontan手术是一种专为单心室生理患者设计的手术干预，其中全身静脉回流被重定向到肺循环，从而促进被动肺血流量，而无需心室推进的帮助。因此，对接受无症状Fontan手术的个体进行长期随访是必要的。目的：本研究的目的是：1)研究血流成分和动能（KE）参数对无症状Fontan患者和对照组血流动力学紊乱的影响；2)通过分析Fontan不同亚组的4D血流参数评估左室舒张功能障碍；3)根据左心室（LV）和右心室（RV）的形态学特征，比较Fontan亚组心内血流参数。方法：回顾性招募25例Fontan患者（平均年龄：10 ± 3岁，男/女：15/10）和14例对照组（平均年龄：10 ± 2岁，男/女：8/6）进行研究。Fontan患者根据心室功能进一步分为三组：左心室（LV）、右心室（RV）和双心室（BiV）。每位参与者都接受了心血管磁共振（CMR）成像，包括3.0 T扫描仪上的电影和4D血流序列。采用4D血流法评估心室血流成分和KE。该研究利用电影图像分析心功能和心室间机械非同步化。超声心动图评估功能性心室舒张功能不全。结果:Fontan患者有较高的平均功能性单心室(FSV)残余体积相比控制(28 %和23 % P = 0.034),较低的平均FSV直接流(32 %和40 % P = 0.005)和延迟喷射流(17 %与24 % P = 0.024)。FSV归一化到心室舒张末期容积（KEiEDV）的参数在Fontan患者中显著降低(所有P EDV在左心室和右心室（RV） Fontan亚组之间观察到显著差异。结论：Fontan患者血流模式改变和动能降低可能提示血流动力学紊乱和心室充盈受损。在左室和BiV Fontan亚组中，直接血流减少与左室舒张功能障碍有关。Fontan患者的全身性左室比全身性右室表现出更有效的心内血流模式。

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引用次数: 0

Peroneus brevis split tear – A challenging diagnosis: A pictorial review of magnetic resonance and ultrasound imaging. Part 1. Anatomical basis and clinical insights 腓骨短肌撕裂-一个具有挑战性的诊断：磁共振和超声成像的图像回顾。第1部分。解剖学基础和临床见解。

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-08 DOI: 10.1016/j.ejro.2024.100633

Katarzyna Bokwa-Dąbrowska , Rafał Zych , Dan Mocanu , Michael Huuskonen , Dawid Dziedzic , Pawel Szaro

Diagnosing peroneus brevis split tears is a significant challenge, as many cases are missed both clinically and on imaging. Anatomical variations within the superior peroneal tunnel can contribute to peroneus brevis split tears or instability of the peroneal tendons. However, determining which anatomical variations predispose patients to these injuries remains challenging due to conflicting data in the literature. In this review, we present the current understanding of the role of anatomical variants in the development of peroneus brevis split tears. Many studies emphasize the significance of the retromalleolar groove and retromalleolar tubercle, the impact of a low-lying muscle belly, and the presence of accessory muscles within the superior peroneal tunnel as contributors to peroneal pathology. Hypertrophy of the peroneal tubercle or post-traumatic irregularities in the surface of the retromalleolar groove can accelerate degenerative changes in the peroneal tendons, potentially leading to peroneus brevis split tears. The topographic anatomy of the superior peroneal tunnel is essential for systematically performing ultrasound and interpreting magnetic resonance imaging of the ankle. The first part of this review focuses on the anatomical foundations of imaging diagnostics for peroneus brevis pathology. In the second part, we will examine the radiological spectrum of peroneal tendon injuries, offering a framework to enhance diagnostic confidence in this frequently underdiagnosed pathology.

诊断腓骨短肌撕裂是一个重大的挑战，因为许多病例在临床和影像学上都被遗漏了。腓骨上隧道内的解剖变异可导致腓骨短肌撕裂或腓骨肌腱不稳定。然而，由于文献中相互矛盾的数据，确定哪些解剖变异使患者易患这些损伤仍然具有挑战性。在这篇综述中，我们介绍了目前对解剖变异在腓骨短肌撕裂发展中的作用的理解。许多研究强调踝后沟和踝后结节的重要性，低肌腹的影响，以及腓上管内存在的副肌是腓骨病理的因素。腓骨结节肥大或创伤后踝后沟表面不规则可加速腓骨肌腱的退行性改变，可能导致腓骨短肌撕裂。腓骨上隧道的地形解剖对于系统地进行超声和解释踝关节的磁共振成像是必不可少的。本综述的第一部分着重于腓骨短肌病理成像诊断的解剖学基础。在第二部分，我们将检查腓骨肌腱损伤的放射谱，提供一个框架，以提高对这种经常被误诊的病理的诊断信心。

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引用次数: 0

CT-based intratumoral and peritumoral radiomics nomogram to predict spread through air spaces in lung adenocarcinoma with diameter ≤ 3 cm: A multicenter study 基于ct的瘤内和瘤周放射组学图预测直径≤ 3 cm的肺腺癌通过空气间隙扩散：一项多中心研究。

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-01-02 DOI: 10.1016/j.ejro.2024.100630

Yangfan Su , Junli Tao , Xiaosong Lan , Changyu Liang , Xuemei Huang , Jiuquan Zhang , Kai Li , Lihua Chen

Purpose

The aim of this study was to explore and develop a preoperative and noninvasive model for predicting spread through air spaces (STAS) status in lung adenocarcinoma (LUAD) with diameter ≤ 3 cm.

Methods

This multicenter retrospective study included 640 LUAD patients. Center I included 525 patients (368 in the training cohort and 157 in the validation cohort); center II included 115 patients (the test cohort). We extracted radiomics features from the intratumor, extended tumor and peritumor regions. Multivariate logistic regression and boruta algorithm were used to select clinical independent risk factors and radiomics features, respectively. We developed a clinical model and four radiomics models (the intratumor model, extended tumor model, peritumor model and fusion model). A nomogram based on prediction probability value of the optimal radiomics model and clinical independent risk factors was developed to predict STAS status.

Results

Maximum diameter and nodule type were clinical independent risk factors. The extended tumor model achieved satisfactory STAS status discrimination performance with the AUC of 0.74, 0.71 and 0.80 in the three cohorts, respectively, performed better than other radiomics models. The integrated discrimination improvement value revealed that the nomogram outperformed compared to the clinical model with the value of 12 %. Patients with high nomogram score (≥ 77.31) will be identified as STAS-positive.

Conclusions

Peritumoral information is significant to predict STAS status. The nomogram based on the extended tumor model and clinical independent risk factors provided good preoperative prediction of STAS status in LUAD with diameter ≤ 3 cm, aiding surgical decision-making.

目的：本研究的目的是探索和建立一种预测直径≤ 3 cm的肺腺癌（LUAD）通过空气间隙扩散（STAS）状态的术前无创模型。方法：对640例LUAD患者进行多中心回顾性研究。中心1纳入525例患者（368例在培训队列，157例在验证队列）；第二中心纳入115例患者（试验队列）。我们从肿瘤内、肿瘤扩展和肿瘤周围区域提取放射组学特征。采用多变量logistic回归和boruta算法分别选择临床独立危险因素和放射组学特征。我们建立了一个临床模型和四个放射组学模型（肿瘤内模型、扩展肿瘤模型、肿瘤周围模型和融合模型）。建立基于最佳放射组学模型预测概率值和临床独立危险因素的nomogram预测STAS状态。结果：最大直径和结节类型是临床独立的危险因素。扩展肿瘤模型获得了令人满意的STAS状态识别性能，三个队列的AUC分别为0.74、0.71和0.80，优于其他放射组学模型。综合判别改进值显示nomogram优于临床模型，其值为12 %。nomogram评分高（≥77.31）的患者为stas阳性。结论：肿瘤周围信息对预测STAS状态有重要意义。基于扩展肿瘤模型和临床独立危险因素的nomogram术前预测直径≤ 3 cm的LUAD的STAS状态，有助于手术决策。

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引用次数: 0