Pub Date : 2025-12-01DOI: 10.1016/j.ejro.2025.100711
Jing-Yi Liu , Qi Wang , Yi-Tong Lu , Yue-Luan Jiang , Dominik Nichel , Robert Grimm , Liang Zhu , Meng-Hua Dai
Objectives
Pancreatic ductal adenocarcinoma (PDAC) has a high recurrence risk after R0 resection. This study aimed to evaluate the prognostic value of preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters, including volume transfer constant (Ktrans), rate constant (kep), extracellular extravascular volume fraction (ve), and MRI-derived extracellular volume (ECV) fraction, for predicting early recurrence and survival after surgery.
Methods
In this retrospective cohort study, 61 patients (mean age 60.7 ± 9.7 years; 35 males) with histologically confirmed PDAC underwent preoperative 3 T MRI between January 2017 and May 2024, including DCE-MRI and dual-time-point T1 mapping. Two radiologists independently measured Ktrans, kep, ve, and ECV. Inter-observer agreement (ICC), associations with pathological features, and prognostic value for recurrence-free survival (RFS) and overall survival (OS) were analyzed using Cox regression, Kaplan–Meier analysis with log-rank tests, and time-dependent ROC curves.
Results
ECV demonstrated excellent reproducibility (ICC = 0.99) and independently predicted shorter RFS (HR = 1.020; 95 % CI: 1.003–1.038; p = 0.022). An optimal ECV cutoff of 31.99 % effectively stratified patients into high- and low-risk groups with significantly different median RFS (10.9 vs. 17.4 months, p = 0.012). However, other DCE-MRI parameters (Ktrans, kep, ve) showed poor reproducibility and lacked independent prognostic value for RFS or OS.
Conclusion
MRI-derived tumor ECV is a robust, reproducible biomarker for predicting early recurrence after R0 resection in PDAC patients, potentially assisting in preoperative risk stratification.
{"title":"MRI-derived extracellular volume fraction as a prognostic biomarker for early recurrence after R0 resection of pancreatic ductal adenocarcinoma","authors":"Jing-Yi Liu , Qi Wang , Yi-Tong Lu , Yue-Luan Jiang , Dominik Nichel , Robert Grimm , Liang Zhu , Meng-Hua Dai","doi":"10.1016/j.ejro.2025.100711","DOIUrl":"10.1016/j.ejro.2025.100711","url":null,"abstract":"<div><h3>Objectives</h3><div>Pancreatic ductal adenocarcinoma (PDAC) has a high recurrence risk after R0 resection. This study aimed to evaluate the prognostic value of preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters, including volume transfer constant (K<sup>trans</sup>), rate constant (k<sub>ep</sub>), extracellular extravascular volume fraction (v<sub>e</sub>), and MRI-derived extracellular volume (ECV) fraction, for predicting early recurrence and survival after surgery.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 61 patients (mean age 60.7 ± 9.7 years; 35 males) with histologically confirmed PDAC underwent preoperative 3 T MRI between January 2017 and May 2024, including DCE-MRI and dual-time-point T1 mapping. Two radiologists independently measured K<sup>trans</sup>, k<sub>ep</sub>, v<sub>e</sub>, and ECV. Inter-observer agreement (ICC), associations with pathological features, and prognostic value for recurrence-free survival (RFS) and overall survival (OS) were analyzed using Cox regression, Kaplan–Meier analysis with log-rank tests, and time-dependent ROC curves.</div></div><div><h3>Results</h3><div>ECV demonstrated excellent reproducibility (ICC = 0.99) and independently predicted shorter RFS (HR = 1.020; 95 % CI: 1.003–1.038; p = 0.022). An optimal ECV cutoff of 31.99 % effectively stratified patients into high- and low-risk groups with significantly different median RFS (10.9 vs. 17.4 months, p = 0.012). However, other DCE-MRI parameters (K<sup>trans</sup>, k<sub>ep</sub>, v<sub>e</sub>) showed poor reproducibility and lacked independent prognostic value for RFS or OS.</div></div><div><h3>Conclusion</h3><div>MRI-derived tumor ECV is a robust, reproducible biomarker for predicting early recurrence after R0 resection in PDAC patients, potentially assisting in preoperative risk stratification.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100711"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614350","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}
Pub Date : 2025-11-20DOI: 10.1016/j.ejro.2025.100710
D. Samaras , G. Agrotis , D. Tsivaka , M. Vakalopoulou , K. Vassiou , V. Tzortzis , M. Vlychou , I. Tsougos
Background
Multiparametric Magnetic Resonance Imaging (mpMRI), including diffusion-weighted imaging (DWI), plays a key role in detecting and stratifying prostate cancer (PCa). The Apparent Diffusion Coefficient (ADC) aids in tissue characterization and may assist in distinguishing between Gleason score 7 subgroups (GS 3 +4 and GS 4 +3). This study aimed to evaluate mean ADC and ADCratio (ratio of tumor-to-normal ADC) in differentiating these subgroups and to assess the influence of magnetic field strength (1.5 T vs. 3.0 T) on diagnostic performance.
Methods
This retrospective study included 48 patients with histologically confirmed GS 7 PCa who underwent mpMRI at 1.5 T or 3.0 T. Two experienced radiologists independently and blindly delineated tumor and reference ROIs. Inter-observer agreement was evaluated using the intraclass correlation coefficient (ICC). Correlation, t-tests, and receiver operating characteristic (ROC) analyses were used to assess relationships, group differences, and optimal cut-off values.
Results
Excellent inter-observer agreement was found for both mean ADC and ADCratio (ICC0.9). At 3.0 T, mean ADC (10.9 ×10⁻⁴ mm²/s vs 8.55 ×10⁻⁴ mm²/s, p = 0.011) and ADCratio (0.68 vs 0.54, p = 0.003) significantly distinguished GS 3 + 4 from GS 4 + 3, while no differences were observed at 1.5 T. Spearman’s ρ confirmed stronger correlations at 3.0 T (ADCratio ρ=−0.510; p = 0.004). For the combined (3.0 T + 1.5 T) dataset, ADCratio achieved an AUC of 0.748 and mean ADC an AUC of 0.718 (p > 0.05).
Conclusion
ADCratio demonstrated high reproducibility and stable diagnostic performance across scanners, supporting its potential as a reliable imaging biomarker for prostate cancer grading.
多参数磁共振成像（mpMRI），包括弥散加权成像（DWI），在前列腺癌（PCa）的检测和分层中起着关键作用。表观扩散系数（ADC）有助于组织表征，并有助于区分Gleason评分7个亚组（GS 3 +4和GS 4 +3）。本研究旨在评估这些亚组的平均ADC和adratio（肿瘤与正常ADC之比），并评估磁场强度（1.5 T vs. 3.0 T）对诊断性能的影响。方法回顾性研究48例组织学证实的GS - 7型前列腺癌患者，在1.5 T或3.0 T行mpMRI检查。两位经验丰富的放射科医生独立、盲目地描绘肿瘤和参考roi。使用类内相关系数（ICC）评估观察者间的一致性。使用相关性、t检验和受试者工作特征（ROC）分析来评估相关性、组间差异和最佳临界值。结果平均ADC和ADCratio的观察者间一致性很好（ICC>0.9）。在3.0 T时，平均ADC （10.9 ×10⁻⁴mm²/s vs 8.55 ×10⁻⁴mm²/s, p = 0.011）和ADCratio （0.68 vs 0.54, p = 0.003）显着区分了GS 3 + 4和GS 4 + 3，而在1.5 T时没有观察到差异。Spearman 's ρ在3.0 T时证实了更强的相关性（ADCratio ρ= - 0.510; p = 0.004）。对于组合（3.0 T + 1.5 T）数据集，adcreatio的AUC为0.748，平均ADC和AUC为0.718 （p > 0.05）。结论adcratio具有高重复性和稳定的诊断性能，支持其作为前列腺癌分级的可靠成像生物标志物的潜力。
{"title":"Comparative evaluation of ADC and ADC ratio in differentiating Gleason Score 7 in prostate cancer imaging","authors":"D. Samaras , G. Agrotis , D. Tsivaka , M. Vakalopoulou , K. Vassiou , V. Tzortzis , M. Vlychou , I. Tsougos","doi":"10.1016/j.ejro.2025.100710","DOIUrl":"10.1016/j.ejro.2025.100710","url":null,"abstract":"<div><h3>Background</h3><div>Multiparametric Magnetic Resonance Imaging (mpMRI), including diffusion-weighted imaging (DWI), plays a key role in detecting and stratifying prostate cancer (PCa). The Apparent Diffusion Coefficient (ADC) aids in tissue characterization and may assist in distinguishing between Gleason score 7 subgroups (GS 3 +4 and GS 4 +3). This study aimed to evaluate mean ADC and ADC<sub>ratio</sub> (ratio of tumor-to-normal ADC) in differentiating these subgroups and to assess the influence of magnetic field strength (1.5 T vs. 3.0 T) on diagnostic performance.</div></div><div><h3>Methods</h3><div>This retrospective study included 48 patients with histologically confirmed GS 7 PCa who underwent mpMRI at 1.5 T or 3.0 T. Two experienced radiologists independently and blindly delineated tumor and reference ROIs. Inter-observer agreement was evaluated using the intraclass correlation coefficient (ICC). Correlation, t-tests, and receiver operating characteristic (ROC) analyses were used to assess relationships, group differences, and optimal cut-off values.</div></div><div><h3>Results</h3><div>Excellent inter-observer agreement was found for both mean ADC and ADC<sub>ratio</sub> (ICC<span><math><mo>></mo></math></span>0.9). At 3.0 T, mean ADC (10.9 ×10⁻⁴ mm²/s vs 8.55 ×10⁻⁴ mm²/s, p = 0.011) and ADC<sub>ratio</sub> (0.68 vs 0.54, p = 0.003) significantly distinguished GS 3 + 4 from GS 4 + 3, while no differences were observed at 1.5 T. Spearman’s ρ confirmed stronger correlations at 3.0 T (ADCratio ρ=−0.510; p = 0.004). For the combined (3.0 T + 1.5 T) dataset, ADC<sub>ratio</sub> achieved an AUC of 0.748 and mean ADC an AUC of 0.718 (p > 0.05).</div></div><div><h3>Conclusion</h3><div>ADC<sub>ratio</sub> demonstrated high reproducibility and stable diagnostic performance across scanners, supporting its potential as a reliable imaging biomarker for prostate cancer grading.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100710"},"PeriodicalIF":2.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568665","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}
Pub Date : 2025-11-20DOI: 10.1016/j.ejro.2025.100709
Ru Ding , Kun An , Fen Wang , Zirui Cao , Yan Zeng , Lili Guo
Background and objectives
Acute ischemic stroke (AIS) remains the primary cause of mortality and disability among adults in China. Different etiologies of acute ischemic stroke (AIS) are considered important factors affecting neurological function. The accurate etiological classification of AIS prior to surgery is crucial. To investigate and explore the predictive value of a clot-based combined radiomics model for identifying the etiological subtypes of acute ischemic stroke.
Materials and methods
A total of 263 patients with acute ischemic stroke caused by anterior circulation large artery occlusion were retrospectively enrolled. These were grouped into training (180), testing (45), and external validation cohorts (38). NCCT and CTA scans were adopted to segment region of interest (ROI) of clots. Feature selection was conducted to establish Clinical model, radiomics models (NCCT, CTA, and NCCT&CTA), and combined model.
Results
The AUCs of the clinical model and radiomics models (NCCT, CTA and NCCT&CTA) in the testing cohort were 0.8288(95 % CI: 0.7174–0.9403), 0.8133(95 % CI:0.6853–0.9414), 0.8075(95 % CI:0.6844–0.9307) and 0.8535(95 % CI:0.6774–1), respectively. The combined model achieved a greater AUC than the other four models in the testing cohort (0.9077 [95 % CI: 0.821–0.9944]). Clinical decision curve analysis (DCA) demonstrated that the radiomics (NCCT&CTA) model and combined model show better net benefits within a relatively wide range of threshold probabilities.
Conclusion
The combined radiomics model achieved good predictive efficacy for distinguishing the etiological subtypes of acute ischemic stroke and can provide valuable information for the precise selection of recanalization strategies in clinical practice.
{"title":"Analysis of a clot-based combined radiomics model for predicting embolic etiology in acute ischemic stroke patients","authors":"Ru Ding , Kun An , Fen Wang , Zirui Cao , Yan Zeng , Lili Guo","doi":"10.1016/j.ejro.2025.100709","DOIUrl":"10.1016/j.ejro.2025.100709","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Acute ischemic stroke (AIS) remains the primary cause of mortality and disability among adults in China<strong>.</strong> Different etiologies of acute ischemic stroke (AIS) are considered important factors affecting neurological function. The accurate etiological classification of AIS prior to surgery is crucial. To investigate and explore the predictive value of a clot-based combined radiomics model for identifying the etiological subtypes of acute ischemic stroke.</div></div><div><h3>Materials and methods</h3><div>A total of 263 patients with acute ischemic stroke caused by anterior circulation large artery occlusion were retrospectively enrolled. These were grouped into training (180), testing (45), and external validation cohorts (38). NCCT and CTA scans were adopted to segment region of interest (ROI) of clots. Feature selection was conducted to establish Clinical model, radiomics models (NCCT, CTA, and NCCT&CTA), and combined model.</div></div><div><h3>Results</h3><div>The AUCs of the clinical model and radiomics models (NCCT, CTA and NCCT&CTA) in the testing cohort were 0.8288(95 % CI: 0.7174–0.9403), 0.8133(95 % CI:0.6853–0.9414), 0.8075(95 % CI:0.6844–0.9307) and 0.8535(95 % CI:0.6774–1), respectively. The combined model achieved a greater AUC than the other four models in the testing cohort (0.9077 [95 % CI: 0.821–0.9944]). Clinical decision curve analysis (DCA) demonstrated that the radiomics (NCCT&CTA) model and combined model show better net benefits within a relatively wide range of threshold probabilities.</div></div><div><h3>Conclusion</h3><div>The combined radiomics model achieved good predictive efficacy for distinguishing the etiological subtypes of acute ischemic stroke and can provide valuable information for the precise selection of recanalization strategies in clinical practice.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100709"},"PeriodicalIF":2.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568669","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}
Pub Date : 2025-11-18DOI: 10.1016/j.ejro.2025.100708
Francesco Arrigoni , Federico Bruno , Pierpaolo Palumbo , Luigi Rinvenuto , Mario Muselli , Roberto Calbi , Carmine Zoccali , Luigi Zugaro , Alessandra Splendiani , Antonio Barile , Ernesto Di Cesare
Osteoid Osteoma (OO) is a benign but extremely painful bone lesion, mostly treated using Radiofrequency Ablation with needle (RFA). Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is an alternative technique able to ablate without using needles or skin incisions. Given the scarcity of literature in this field, the purpose of this paper is to retrospectively analyze long-term results of MRgFUS treatments of OO and to investigate technical limits. This is a retrospective analysis of all the MRgFUS procedures performed in our institution to treat OOs. Demographic, clinical data, and morphological features were analyzed, looking for correlation between the clinical results and the morphological features. Sixty-seven procedures were analyzed. The success rate – intended as complete pain relief - was 91 %. Almost all the patients (60 out of 67) were followed up to 4 years. A thick bone cortex above the nidus (p.014) and a short distance between the nidus and the ultrasound source (p.002) were statistically linked to failure. No complications were recorded. This is the largest series of OO treated using MRgFUS even reported. The main strength of this study lies in its large sample size and the extended follow-up period for nearly all patients (4 years for 90 % of patients) which allow us to clearly confirm the safety and efficacy of this ablative technique. Moreover, exclusion criteria for this treatment modality are proposed, based on two causes of treatment failure identified during our procedures.
{"title":"Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) for ablation of osteoid osteoma: Long-term results from 10 years of experience","authors":"Francesco Arrigoni , Federico Bruno , Pierpaolo Palumbo , Luigi Rinvenuto , Mario Muselli , Roberto Calbi , Carmine Zoccali , Luigi Zugaro , Alessandra Splendiani , Antonio Barile , Ernesto Di Cesare","doi":"10.1016/j.ejro.2025.100708","DOIUrl":"10.1016/j.ejro.2025.100708","url":null,"abstract":"<div><div>Osteoid Osteoma (OO) is a benign but extremely painful bone lesion, mostly treated using Radiofrequency Ablation with needle (RFA). Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is an alternative technique able to ablate without using needles or skin incisions. Given the scarcity of literature in this field, the purpose of this paper is to retrospectively analyze long-term results of MRgFUS treatments of OO and to investigate technical limits. This is a retrospective analysis of all the MRgFUS procedures performed in our institution to treat OOs. Demographic, clinical data, and morphological features were analyzed, looking for correlation between the clinical results and the morphological features. Sixty-seven procedures were analyzed. The success rate – intended as complete pain relief - was 91 %. Almost all the patients (60 out of 67) were followed up to 4 years. A thick bone cortex above the nidus (p.014) and a short distance between the nidus and the ultrasound source (p.002) were statistically linked to failure. No complications were recorded. This is the largest series of OO treated using MRgFUS even reported. The main strength of this study lies in its large sample size and the extended follow-up period for nearly all patients (4 years for 90 % of patients) which allow us to clearly confirm the safety and efficacy of this ablative technique. Moreover, exclusion criteria for this treatment modality are proposed, based on two causes of treatment failure identified during our procedures.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100708"},"PeriodicalIF":2.9,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568663","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}
Pub Date : 2025-11-17DOI: 10.1016/j.ejro.2025.100707
Robin F. Gohmann , Fyn Kaiser , Batuhan Temiz , Sebastian Gottschling , Christian Krieghoff , Christian Lücke , Matthias Horn , Matthias Gutberlet
Purpose
Segmentation of visceral and subcutaneous adipose tissue in computed tomography (CT) datasets has shown much promise in research and for medical applications, e.g. for risk stratification and guiding therapies. This study evaluates the influence of iterative reconstruction (IR) and filtered back projection (FBP) techniques on 2D- and 3D-segmentation of adipose tissue in CT images with and without contrast medium.
Methods
We retrospectively analyzed 31 patients to compare adipose tissue density and quantity between IR and FBP across different compartments and contrast phases. Segmentation was performed using a fixed threshold (-190 to -30 HU).
Results
Significant differences were observed in 2D-segmentation, particularly for visceral adipose tissue in non-enhanced scans (-0.54 ± 1.4 HU; p = 0.04) and subcutaneous adipose tissue in venous scans (-0.48 ± 1.2 HU; p = 0.03). In 3D-segmentation, subcutaneous adipose tissue density in venous scans was also lower with IR compared to FBP (-0.67 ± 1.2 HU; p = 0.004).
Conclusion
Adipose tissue segmentation between IR and FBP revealed minimal and only occasionally yields statistically significant differences in density and quantity across adipose tissue compartments and contrast phases. The observed differences were very small, casting doubt on their clinical relevance at the level of individual patients. However, even subtle systematic variations may warrant consideration in population-based studies or longitudinal research where methodological consistency is critical.
目的在计算机断层扫描（CT）数据集中分割内脏和皮下脂肪组织在研究和医学应用中显示出很大的前景，例如用于风险分层和指导治疗。本研究评估了迭代重建（IR）和滤波后投影（FBP）技术对有造影剂和无造影剂的CT图像中脂肪组织的2D和3d分割的影响。方法回顾性分析31例患者，比较IR和FBP在不同室室和对比期的脂肪组织密度和数量。使用固定阈值（-190至-30 HU）进行分割。结果两组在2d分割方面存在显著差异，尤其是非增强扫描时内脏脂肪组织（-0.54 ± 1.4 HU; p = 0.04）和静脉扫描时皮下脂肪组织（-0.48 ± 1.2 HU; p = 0.03）。在3d分割中，静脉扫描的皮下脂肪组织密度也比FBP低（-0.67 ± 1.2 HU; p = 0.004）。结论IR和FBP之间的脂肪组织分割显示，脂肪组织间隔和对比期的密度和数量差异很小，只是偶尔出现统计学意义上的差异。观察到的差异非常小，使人怀疑其在个体患者水平上的临床相关性。然而，在基于人群的研究或纵向研究中，即使是细微的系统变化也可能需要考虑，因为方法的一致性是至关重要的。
{"title":"Segmentation of visceral and subcutaneous adipose tissue in abdominal CT-datasets with and without contrast medium: Influence of iterative reconstruction on 2D- and 3D-segmentation","authors":"Robin F. Gohmann , Fyn Kaiser , Batuhan Temiz , Sebastian Gottschling , Christian Krieghoff , Christian Lücke , Matthias Horn , Matthias Gutberlet","doi":"10.1016/j.ejro.2025.100707","DOIUrl":"10.1016/j.ejro.2025.100707","url":null,"abstract":"<div><h3>Purpose</h3><div>Segmentation of visceral and subcutaneous adipose tissue in computed tomography (CT) datasets has shown much promise in research and for medical applications, e.g. for risk stratification and guiding therapies. This study evaluates the influence of iterative reconstruction (IR) and filtered back projection (FBP) techniques on 2D- and 3D-segmentation of adipose tissue in CT images with and without contrast medium.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 31 patients to compare adipose tissue density and quantity between IR and FBP across different compartments and contrast phases. Segmentation was performed using a fixed threshold (-190 to -30 HU).</div></div><div><h3>Results</h3><div>Significant differences were observed in 2D-segmentation, particularly for visceral adipose tissue in non-enhanced scans (-0.54 ± 1.4 HU; <em>p</em> = 0.04) and subcutaneous adipose tissue in venous scans (-0.48 ± 1.2 HU; <em>p</em> = 0.03). In 3D-segmentation, subcutaneous adipose tissue density in venous scans was also lower with IR compared to FBP (-0.67 ± 1.2 HU; <em>p</em> = 0.004).</div></div><div><h3>Conclusion</h3><div>Adipose tissue segmentation between IR and FBP revealed minimal and only occasionally yields statistically significant differences in density and quantity across adipose tissue compartments and contrast phases. The observed differences were very small, casting doubt on their clinical relevance at the level of individual patients. However, even subtle systematic variations may warrant consideration in population-based studies or longitudinal research where methodological consistency is critical.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100707"},"PeriodicalIF":2.9,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568664","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}
Pub Date : 2025-11-14DOI: 10.1016/j.ejro.2025.100705
Yang Zi, Baoqi Shi
This study investigates the effect of pulmonary artery invasion on bronchial artery embolization (BAE) for the treatment of hemoptysis caused by lung cancer. A single-center retrospective analysis was conducted on the clinical data of 58 lung cancer patients who underwent BAE treatment for hemoptysis between July 2019 and July 2023. Based on preoperative CT angiography results, patients were divided into two groups: the pulmonary artery invasion group (n = 40) and the non-pulmonary artery invasion group (n = 18). The clinical characteristics, technical success rate, clinical success rate, complication rate, hemoptysis recurrence rate, and other factors were compared between the two groups. The prognostic factors for hemoptysis-free survival were analyzed using the Cox proportional hazards model. The results showed that, compared with the non-pulmonary artery invasion group, there was no significant difference in age (65.6 ± 8.2 vs. 67.2 ± 9.0, P = 0.52), gender (P = 0.67), Maximal tumor size (59.7 ± 26.0 vs. 51.6 ± 21.1, P = 0.25), the clinical success rate (85.0 % vs. 100.0 %, P = 0.16), the postoperative complication rate (15.0 % vs. 22.2 %) and so on between the two groups. However, the recurrence rate of hemoptysis one month after BAE was significantly higher in the pulmonary artery invasion group (60.0 % vs. 11.1 %, P < 0.01). The median hemoptysis-free survival time in the pulmonary artery invasion group was 28.5 days (IQR 54.3 days), which was significantly lower than 420.0 days (IQR 637.5 days) in the non-pulmonary artery invasion group (P < 0.01). Multivariate analysis showed that pulmonary artery invasion was an independent risk factor for hemoptysis recurrence after BAE (OR=18.46, 95 % CI: 6.37–53.49, P < 0.01). The study concluded that pulmonary artery invasion has a significant impact on hemoptysis recurrence after BAE in lung cancer.
本研究探讨肺动脉侵犯对支气管动脉栓塞治疗肺癌咯血的影响。对2019年7月至2023年7月间58例因咯血接受BAE治疗的肺癌患者的临床资料进行单中心回顾性分析。根据术前CT血管造影结果将患者分为肺动脉侵犯组（n = 40）和非肺动脉侵犯组（n = 18）。比较两组患者的临床特点、技术成功率、临床成功率、并发症发生率、咯血复发率等因素。使用Cox比例风险模型分析无咯血生存的预后因素。结果表明,与肺动脉入侵组相比,年龄没有显著差异(65.6 ±8.2 vs 67.2 ± 9.0,P = 0.52),性别(P = 0.67),最大肿瘤大小( 59.7±26.0 vs 51.6 ± 21.1,P = 0.25),临床成功率(85.0 % 100.0 vs % P = 0.16),术后并发症率(15.0 %与22.2 %)等两组之间。而肺动脉侵犯组咯血复发率1个月明显高于肺动脉侵犯组（60.0 % vs 11.1 %,P <； 0.01）。肺动脉侵犯组无溶血生存时间中位数为28.5天（IQR 54.3天），明显低于非肺动脉侵犯组420.0天（IQR 637.5天）（P <； 0.01）。多因素分析显示，肺动脉侵犯是BAE术后咯血复发的独立危险因素（OR=18.46, 95 % CI: 6.37 ~ 53.49, P <； 0.01）。本研究认为肺动脉侵犯对肺癌BAE术后咯血复发有显著影响。
{"title":"The impact of pulmonary artery invasion on bronchial artery embolization in treating hemoptysis in lung cancer","authors":"Yang Zi, Baoqi Shi","doi":"10.1016/j.ejro.2025.100705","DOIUrl":"10.1016/j.ejro.2025.100705","url":null,"abstract":"<div><div>This study investigates the effect of pulmonary artery invasion on bronchial artery embolization (BAE) for the treatment of hemoptysis caused by lung cancer. A single-center retrospective analysis was conducted on the clinical data of 58 lung cancer patients who underwent BAE treatment for hemoptysis between July 2019 and July 2023. Based on preoperative CT angiography results, patients were divided into two groups: the pulmonary artery invasion group (n = 40) and the non-pulmonary artery invasion group (n = 18). The clinical characteristics, technical success rate, clinical success rate, complication rate, hemoptysis recurrence rate, and other factors were compared between the two groups. The prognostic factors for hemoptysis-free survival were analyzed using the Cox proportional hazards model. The results showed that, compared with the non-pulmonary artery invasion group, there was no significant difference in age (65.6 ± 8.2 vs. 67.2 ± 9.0, P = 0.52), gender (P = 0.67), Maximal tumor size (59.7 ± 26.0 vs. 51.6 ± 21.1, P = 0.25), the clinical success rate (85.0 % vs. 100.0 %, P = 0.16), the postoperative complication rate (15.0 % vs. 22.2 %) and so on between the two groups. However, the recurrence rate of hemoptysis one month after BAE was significantly higher in the pulmonary artery invasion group (60.0 % vs. 11.1 %, P < 0.01). The median hemoptysis-free survival time in the pulmonary artery invasion group was 28.5 days (IQR 54.3 days), which was significantly lower than 420.0 days (IQR 637.5 days) in the non-pulmonary artery invasion group (P < 0.01). Multivariate analysis showed that pulmonary artery invasion was an independent risk factor for hemoptysis recurrence after BAE (OR=18.46, 95 % CI: 6.37–53.49, P < 0.01). The study concluded that pulmonary artery invasion has a significant impact on hemoptysis recurrence after BAE in lung cancer.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100705"},"PeriodicalIF":2.9,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519282","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}
Pub Date : 2025-11-08DOI: 10.1016/j.ejro.2025.100706
Patrick Ghibes , Florian Hagen , Petros Martirosian , Stephan Ursprung , Konstantin Nikolaou , Daniel Raskin , Abraham Levitin , Levester Kirksey , Sasan Partovi
Purpose
To evaluate the diagnostic quality and detection of anatomical variants in branching patterns of the renal arteries for non-contrast quiescent-interval slice-selective (QISS) MR Angiography (MRA) compared to CT Angiography (CTA).
Methods
Patients who underwent a QISS MRA of the renal arteries as well as CTA as reference standard were included in this retrospective study. Signal-to-noise ratio (SNR), contrast-to-noise ratio (SNR), and vessel diameter were determined in the left and right renal arterial systems. Image quality and diagnostic confidence were assessed with a standardized five-point Likert scale. Sensitivity, specificity and accuracy for the detection of anatomical variants in branching patterns (accessory renal artery, aberrant renal artery and early branching) of the renal arterial system were determined compared to CTA as reference standard.
Results
30 patients (59 renal arteries) were included in this retrospective study. CTA reached significantly higher median SNR compared to QISS MRA (10.96, inter-quartile range (IQR) 6.70–16.11 vs. 5.65, IQR 4.38–8.76, respectively, p < 0.001). Median CNR was significantly higher in QISS MRA (16.75, IQR 13.09–20.96) compared to CTA (13.22, IQR 7.49–18.57), p = 0.006. Diameters of the renal arteries were similar between QISS MRA and CTA (5.8 mm, IQR 4.90–6.60 versus 5.8 mm, IQR 4.75, 6.70, p = 0.893). Diagnostic confidence was rated excellent for both, though significantly higher for CTA (5, IQR 5–5,) compared to QISS MRA (5, IQR 4–5), p = 0.003). 19 of 20 variants in branching pattern could be detected successfully by QISS.
Conclusion
QISS MRA offers similar diagnostic confidence and image quality to CTA as reference standard. Further, QISS MRA demonstrates excellent diagnostic accuracy in detecting anatomical variants of branching patterns of the renal arterial vasculature.
目的评价非对比静止间隔切片选择（QISS） MR血管造影（MRA）与CT血管造影（CTA）对肾动脉分支形态解剖变异的诊断质量和检测效果。方法回顾性研究采用肾动脉QISS MRA和CTA作为参考标准的患者。测定左、右肾动脉系统的信噪比（SNR）、信噪比（SNR）和血管直径。用标准化的李克特五点量表评估图像质量和诊断可信度。对比CTA作为参考标准，检测肾动脉系统分支形态（副肾动脉、异常肾动脉和早期分支）解剖变异的敏感性、特异性和准确性。结果30例患者（59条肾动脉）纳入回顾性研究。与QISS MRA相比，CTA的中位信噪比明显更高（10.96，四分位间距（IQR） 6.70-16.11 vs. 5.65, IQR 4.38-8.76, p <； 0.001）。QISS MRA的中位CNR （16.75, IQR 13.09-20.96）显著高于CTA (13.22, IQR 7.49-18.57), p = 0.006。肾动脉直径在QISS MRA和CTA之间相似（5.8 mm, IQR 4.90-6.60 vs 5.8 mm, IQR 4.75, 6.70, p = 0.893）。两者的诊断可信度都被评为优秀，尽管CTA （5, IQR 5 - 5,）与QISS MRA （5, IQR 4-5）相比显着更高，p = 0.003)。20个分支型变异中有19个可以通过QISS检测到。结论作为参考标准，qiss MRA的诊断置信度和图像质量与CTA相当。此外，QISS MRA在检测肾动脉血管分支模式的解剖变异方面表现出出色的诊断准确性。
{"title":"Diagnostic performance of non-contrast quiescent-interval slice-selective (QISS) magnetic resonance angiography for evaluation of the renal arterial vasculature compared to computed tomography angiography (CTA) as reference standard","authors":"Patrick Ghibes , Florian Hagen , Petros Martirosian , Stephan Ursprung , Konstantin Nikolaou , Daniel Raskin , Abraham Levitin , Levester Kirksey , Sasan Partovi","doi":"10.1016/j.ejro.2025.100706","DOIUrl":"10.1016/j.ejro.2025.100706","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the diagnostic quality and detection of anatomical variants in branching patterns of the renal arteries for non-contrast quiescent-interval slice-selective (QISS) MR Angiography (MRA) compared to CT Angiography (CTA).</div></div><div><h3>Methods</h3><div>Patients who underwent a QISS MRA of the renal arteries as well as CTA as reference standard were included in this retrospective study. Signal-to-noise ratio (SNR), contrast-to-noise ratio (SNR), and vessel diameter were determined in the left and right renal arterial systems. Image quality and diagnostic confidence were assessed with a standardized five-point Likert scale. Sensitivity, specificity and accuracy for the detection of anatomical variants in branching patterns (accessory renal artery, aberrant renal artery and early branching) of the renal arterial system were determined compared to CTA as reference standard.</div></div><div><h3>Results</h3><div>30 patients (59 renal arteries) were included in this retrospective study. CTA reached significantly higher median SNR compared to QISS MRA (10.96, inter-quartile range (IQR) 6.70–16.11 vs. 5.65, IQR 4.38–8.76, respectively, p < 0.001). Median CNR was significantly higher in QISS MRA (16.75, IQR 13.09–20.96) compared to CTA (13.22, IQR 7.49–18.57), p = 0.006. Diameters of the renal arteries were similar between QISS MRA and CTA (5.8 mm, IQR 4.90–6.60 versus 5.8 mm, IQR 4.75, 6.70, p = 0.893). Diagnostic confidence was rated excellent for both, though significantly higher for CTA (5, IQR 5–5,) compared to QISS MRA (5, IQR 4–5), p = 0.003). 19 of 20 variants in branching pattern could be detected successfully by QISS.</div></div><div><h3>Conclusion</h3><div>QISS MRA offers similar diagnostic confidence and image quality to CTA as reference standard. Further, QISS MRA demonstrates excellent diagnostic accuracy in detecting anatomical variants of branching patterns of the renal arterial vasculature.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100706"},"PeriodicalIF":2.9,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464875","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}
Pub Date : 2025-11-07DOI: 10.1016/j.ejro.2025.100704
Jade Baars , Thijs Urlings , Edwin van der Linden , Ilia Panfilov , Lodewijk Cobben , Willem-Jan de Jong , Joost van der Vorst , Jaap Hamming , Ayoub Charehbili
Background
Computed tomography angiography (CTA) of below the knee (BTK) arteries in patients with peripheral arterial disease (PAD) is often challenging due to reduced contrast enhancement and the presence of arterial wall calcifications. Several studies have been published using dual energy (DE) techniques to improve image quality and diagnostic performance of CTA. This systematic review aims to assess diagnostic performance of dual energy CTA (DECTA) in BTK arteries of patients with PAD.
Methods
A systematic literature search was conducted to identify studies reporting on DECTA of BTK arteries. Studies were included if they assessed imaging quality using qualitative or objective parameters, or provided data on diagnostic accuracy. The search was performed in Pubmed, Embase and Cochrane Library.
Results
The initial search yielded original 440 articles. 15 studies were included in the final analysis, with 10 studies using bone removal software and 5 studies using virtual monochromatic imaging (VMI+). Pooled sensitivity and specificity for bone removal software for detecting significant stenosis below the knee was 94.8 % (95 % CI 88.1–97.8 %) and 59.3 % (95 % CI 43.3–73.6 %), respectively. All studies on VMI+ reported an increase in signal-to-noise ratio and contrast-to-noise ratio as the energy level decreased. Low energy VMI+ images had consistently higher qualitative imaging scores compared to both high energy and 120 kV blended reconstructions.
Conclusion
DECTA provides high sensitivity and moderate specificity for detecting significant stenosis below the knee using bone removal software. Based on available literature, optimal imaging of BTK arteries can be achieved by using low energy VMI+ reconstructions.
外周动脉疾病（PAD）患者膝下动脉（BTK）的计算机断层血管造影（CTA）通常具有挑战性，因为对比度增强降低和动脉壁钙化的存在。利用双能量（DE）技术提高CTA图像质量和诊断性能的研究已经发表。本系统综述旨在评估双能量CTA （DECTA）对PAD患者BTK动脉的诊断效果。方法系统检索有关BTK动脉DECTA的文献。如果研究使用定性或客观参数评估成像质量，或提供诊断准确性的数据，则纳入研究。检索在Pubmed、Embase和Cochrane图书馆进行。最初的搜索产生了440篇原创文章。最终分析纳入15项研究，其中10项研究使用去骨软件，5项研究使用虚拟单色成像（VMI+）。骨移除软件检测膝关节以下明显狭窄的总敏感性和特异性分别为94.8 %（95 % CI 88.1 - 97.8% %）和59.3 %（95 % CI 43.3-73.6 %）。所有关于VMI+ 的研究都表明，随着能量水平的降低，信噪比和噪比都有所增加。与高能和120 kV混合重建相比，低能量VMI+ 图像始终具有更高的定性成像评分。结论应用去骨软件，decta检测膝关节以下明显狭窄具有较高的灵敏度和中等的特异性。根据现有文献，使用低能量VMI+ 重建可以实现BTK动脉的最佳成像。
{"title":"The diagnostic value of dual-energy CTA for visualising below the knee arteries in peripheral arterial disease: A systematic review","authors":"Jade Baars , Thijs Urlings , Edwin van der Linden , Ilia Panfilov , Lodewijk Cobben , Willem-Jan de Jong , Joost van der Vorst , Jaap Hamming , Ayoub Charehbili","doi":"10.1016/j.ejro.2025.100704","DOIUrl":"10.1016/j.ejro.2025.100704","url":null,"abstract":"<div><h3>Background</h3><div>Computed tomography angiography (CTA) of below the knee (BTK) arteries in patients with peripheral arterial disease (PAD) is often challenging due to reduced contrast enhancement and the presence of arterial wall calcifications. Several studies have been published using dual energy (DE) techniques to improve image quality and diagnostic performance of CTA. This systematic review aims to assess diagnostic performance of dual energy CTA (DECTA) in BTK arteries of patients with PAD.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted to identify studies reporting on DECTA of BTK arteries. Studies were included if they assessed imaging quality using qualitative or objective parameters, or provided data on diagnostic accuracy. The search was performed in Pubmed, Embase and Cochrane Library.</div></div><div><h3>Results</h3><div>The initial search yielded original 440 articles. 15 studies were included in the final analysis, with 10 studies using bone removal software and 5 studies using virtual monochromatic imaging (VMI+). Pooled sensitivity and specificity for bone removal software for detecting significant stenosis below the knee was 94.8 % (95 % CI 88.1–97.8 %) and 59.3 % (95 % CI 43.3–73.6 %), respectively. All studies on VMI+ reported an increase in signal-to-noise ratio and contrast-to-noise ratio as the energy level decreased. Low energy VMI+ images had consistently higher qualitative imaging scores compared to both high energy and 120 kV blended reconstructions.</div></div><div><h3>Conclusion</h3><div>DECTA provides high sensitivity and moderate specificity for detecting significant stenosis below the knee using bone removal software. Based on available literature, optimal imaging of BTK arteries can be achieved by using low energy VMI+ reconstructions.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100704"},"PeriodicalIF":2.9,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464876","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}
Pub Date : 2025-11-07DOI: 10.1016/j.ejro.2025.100703
Jiayi Bao , Yuanqing Liu , Yang Yu , Ximing Wang , Chunhong Hu , Su Hu
Background
To explore the value of MRI radiomics-based machine learning models for predicting the pathological grade of pancreatic cancer preoperatively.
Methods
125 patients with pathologically confirmed pancreatic cancer who underwent preoperative MRI were retrospectively enrolled. The primary cohort was randomized in an 8:2 ratio into a training cohort (n = 100) and a validation cohort (n = 25). 1316 radiomics features were extracted from contrast-enhanced T1WI arterial phase (AP) or portal venous phase (PVP) images, respectively. After feature reduction and filtering, the best features were selected to construct machine learning models (K-nearest neighbor, KNN; support vector machine, SVM; logistic regression, LR; random forest, RF). Finally, the performance of these models was evaluated using the receiver operating characteristic curve (ROC).
Results
There were no statistical differences in clinical characteristics between the low-grade and high-grade cohorts (P > 0.05). The best radiomics features selected from the AP, PVP and AP+PVP images were 6, 6 and 10, respectively. Among the four models, the LR machine learning model achieved the best predictive performance. The distribution of the Radscore values was clinically significant between the low-grade and high-grade groups both in the training cohort (median, 0.26 vs 0.99; P < 0.001) and validation cohort (median, 0.63 vs 1.48; P = 0.011). LR model of AP+PVP performed the best with AUC value of 0.81 (95 % CI: 0.72–0.91) for the training cohort and 0.82 (95 % CI: 0.62–1.00) for the validation cohort.
Conclusions
MRI radiomics-based machine learning model is a potential non-invasive method to predict the pathological grade of pancreatic cancer.
目的探讨基于MRI放射学的机器学习模型在胰腺癌术前病理分级预测中的应用价值。方法回顾性分析术前行MRI检查的经病理证实的胰腺癌患者125例。主要队列按8:2的比例随机分为训练队列（n = 100）和验证队列（n = 25）。分别从增强T1WI动脉期（AP）或门静脉期（PVP）图像中提取1316个放射组学特征。经过特征约简和滤波，选择最优特征构建机器学习模型（K-nearest neighbor， KNN; support vector machine， SVM; logistic regression， LR; random forest， RF）。最后，使用受试者工作特征曲线（ROC）评估这些模型的性能。结果低分级组与高分级组临床特征比较，差异无统计学意义（P >； 0.05）。AP、PVP和AP+PVP图像的放射组学特征值分别为6、6和10。在四种模型中，LR机器学习模型的预测性能最好。在训练队列（中位数，0.26 vs 0.99; P <； 0.001）和验证队列（中位数，0.63 vs 1.48; P = 0.011）中，低分级组和高分级组之间的Radscore值分布具有临床意义。AP+PVP的LR模型表现最好，训练组的AUC值为0.81(95 % CI: 0.72-0.91)，验证组的AUC值为0.82（95 % CI: 0.62-1.00）。结论基于smri放射组学的机器学习模型是一种潜在的无创预测胰腺癌病理分级的方法。
{"title":"Magnetic resonance imaging radiomics-based machine learning model for preoperative prediction of pathological grade in pancreatic cancer: A preliminary study","authors":"Jiayi Bao , Yuanqing Liu , Yang Yu , Ximing Wang , Chunhong Hu , Su Hu","doi":"10.1016/j.ejro.2025.100703","DOIUrl":"10.1016/j.ejro.2025.100703","url":null,"abstract":"<div><h3>Background</h3><div>To explore the value of MRI radiomics-based machine learning models for predicting the pathological grade of pancreatic cancer preoperatively.</div></div><div><h3>Methods</h3><div>125 patients with pathologically confirmed pancreatic cancer who underwent preoperative MRI were retrospectively enrolled. The primary cohort was randomized in an 8:2 ratio into a training cohort (n = 100) and a validation cohort (n = 25). 1316 radiomics features were extracted from contrast-enhanced T<sub>1</sub>WI arterial phase (AP) or portal venous phase (PVP) images, respectively. After feature reduction and filtering, the best features were selected to construct machine learning models (K-nearest neighbor, KNN; support vector machine, SVM; logistic regression, LR; random forest, RF). Finally, the performance of these models was evaluated using the receiver operating characteristic curve (ROC).</div></div><div><h3>Results</h3><div>There were no statistical differences in clinical characteristics between the low-grade and high-grade cohorts (<em>P</em> > 0.05). The best radiomics features selected from the AP, PVP and AP+PVP images were 6, 6 and 10, respectively. Among the four models, the LR machine learning model achieved the best predictive performance. The distribution of the Radscore values was clinically significant between the low-grade and high-grade groups both in the training cohort (median, 0.26 vs 0.99; <em>P</em> < 0.001) and validation cohort (median, 0.63 vs 1.48; <em>P</em> = 0.011). LR model of AP+PVP performed the best with AUC value of 0.81 (95 % CI: 0.72–0.91) for the training cohort and 0.82 (95 % CI: 0.62–1.00) for the validation cohort.</div></div><div><h3>Conclusions</h3><div>MRI radiomics-based machine learning model is a potential non-invasive method to predict the pathological grade of pancreatic cancer.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100703"},"PeriodicalIF":2.9,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464879","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}
Pub Date : 2025-11-05DOI: 10.1016/j.ejro.2025.100700
Yidan Zhu , Ke Xu , Han Jia , Wangyan Liu , Xiaoxuan Sun , Qiang Wang , Yi Xu , Yinsu Zhu
Objectives
To evaluate the prognostic value of cardiovascular magnetic resonance (CMR) parameters in patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH).
Materials and methods
This retrospective cohort study involved 135 patients with documented CTD-PAH. Cardiac functional parameters including right ventricle end-diastolic volume index (RVEDVI), end-systolic volume index (RVESVI), stroke volume index (RVSVI), ejection fraction (RVEF), and SV/ESV; the volumetric parameter; T1 mapping and late gadolinium enhancement (LGE) parameters; strain parameters like RV global longitudinal strain(GLS); and hemodynamics parameters like mean velocity at the pulmonary artery (mvPA) and PA relative area change (PA RAC) were calculated from CMR images. Survival analysis was conducted using Kaplan–Meier and Cox regression. The endpoint was the occurrence of clinical deterioration events.
Results
The median follow-up time was 22.27 months (interquartile range: 11.5–31.9 months).RVIP ECV, RVGLS, RVEDVI, RVESVI, RVMI, and RAA, as well as mvPA, SV/ESV, RVEF, and PA RAC, were associated with adverse outcomes. SV/ESV ≤ 0.55, RV GLS > -12.1 %, and PA RAC≤ 16.1 % were significant independent predictors of prognosis. The combined parameters provided incremental prognostic value over COMPERA 2.0 (area under the curve (AUC) from 0.771 to 0.899; P = 0.001).And time-dependent ROC curve confirmed the predictive efficiency of the combined parameters in year 3, with the AUC reaching 0.821(95 % CI: 0.698–0.945).
Conclusion
Multiparametric CMR provides a non-invasive, efficient method to assess prognosis in CTD-PAH patients. Key parameters including SV/ESV, RV GLS, and PA RAC significantly predicted survival and confer incremental prognostic utility over COMPERA 2.0, offering reliable prognostic markers for clinical interventions.
{"title":"Cardiac MRI-derived ventricular-pulmonary arterial coupling predicts outcomes in connective tissue disease-associated pulmonary arterial hypertension patients","authors":"Yidan Zhu , Ke Xu , Han Jia , Wangyan Liu , Xiaoxuan Sun , Qiang Wang , Yi Xu , Yinsu Zhu","doi":"10.1016/j.ejro.2025.100700","DOIUrl":"10.1016/j.ejro.2025.100700","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the prognostic value of cardiovascular magnetic resonance (CMR) parameters in patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH).</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study involved 135 patients with documented CTD-PAH. Cardiac functional parameters including right ventricle end-diastolic volume index (RVEDVI), end-systolic volume index (RVESVI), stroke volume index (RVSVI), ejection fraction (RVEF), and SV/ESV; the volumetric parameter; T1 mapping and late gadolinium enhancement (LGE) parameters; strain parameters like RV global longitudinal strain(GLS); and hemodynamics parameters like mean velocity at the pulmonary artery (mvPA) and PA relative area change (PA RAC) were calculated from CMR images. Survival analysis was conducted using Kaplan–Meier and Cox regression. The endpoint was the occurrence of clinical deterioration events.</div></div><div><h3>Results</h3><div>The median follow-up time was 22.27 months (interquartile range: 11.5–31.9 months).RVIP ECV, RVGLS, RVEDVI, RVESVI, RVMI, and RAA, as well as mvPA, SV/ESV, RVEF, and PA RAC, were associated with adverse outcomes. SV/ESV ≤ 0.55, RV GLS > -12.1 %, and PA RAC≤ 16.1 % were significant independent predictors of prognosis. The combined parameters provided incremental prognostic value over COMPERA 2.0 (area under the curve (AUC) from 0.771 to 0.899; P = 0.001).And time-dependent ROC curve confirmed the predictive efficiency of the combined parameters in year 3, with the AUC reaching 0.821(95 % CI: 0.698–0.945).</div></div><div><h3>Conclusion</h3><div>Multiparametric CMR provides a non-invasive, efficient method to assess prognosis in CTD-PAH patients. Key parameters including SV/ESV, RV GLS, and PA RAC significantly predicted survival and confer incremental prognostic utility over COMPERA 2.0, offering reliable prognostic markers for clinical interventions.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100700"},"PeriodicalIF":2.9,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464877","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}
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