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Development of a hybrid 2.5D deep learning model for glioma survival prediction using T1-weighted MRI from the CGGA database 开发混合2.5D深度学习模型，利用CGGA数据库的t1加权MRI预测胶质瘤生存
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-10-26 DOI: 10.1016/j.ejro.2025.100697
Kai Jin, Caixing Sun, Liang Xia

Background

Current glioma survival prediction relies on invasive molecular profiling. To overcome this, a non-invasive deep learning framework using T1-weighted contrast-enhanced MRI (T1CE) was developed to predict overall survival. This framework addresses computational limitations associated with the volumetric analysis while preserving important spatial information.

Methods

We designed a hybrid 2.5D convolutional neural network to process multi-slice inputs, including the center slice and its adjacent slices, from 217 patients in the CGGA database. Transfer learning using ResNet and DenseNet architectures were employed to initialize the models. These models were subsequently fine-tuned with the Cox proportional hazards loss function. After the fine-tuning process was completed, the imaging signature was combined with clinical and molecular variables, including IDH and 1p19q status, to build an integrated model. Performance was evaluated via C-index, time-dependent AUC, and Kaplan-Meier analysis in independent training (70 %) and testing (30 %) cohorts.

Results

The Combined model achieved superior discrimination, with a training C-index of 0.819 (95 % CI: 0.758–0.880) and a testing C-index of 0.804 (95 % CI: 0.708–0.900). It significantly outperformed the isolated Radiomic, deep learning (2D and 2.5D), and Clinical models (all p < 0.05). Moreover, time-dependent ROC analysis demonstrated consistent model performance over 1–5 years, with AUC values ranging from 0.851 to 0.906. The stratified survival curves clearly revealed distinct prognostic groups (log-rank p < 0.001).

Conclusions

The 2.5D multi-source framework provides a clinically feasible, non-invasive tool for preoperative survival prediction, enabling personalized therapeutic strategies for glioma patients.
目前的胶质瘤生存预测依赖于侵入性分子谱分析。为了克服这一问题，研究人员开发了一种使用t1加权对比增强MRI （T1CE）的非侵入性深度学习框架来预测总生存率。该框架解决了与体积分析相关的计算限制，同时保留了重要的空间信息。方法设计一种混合2.5D卷积神经网络，对217例CGGA患者的中心切片及其相邻切片进行多片输入处理。使用ResNet和DenseNet架构进行迁移学习来初始化模型。这些模型随后用Cox比例风险损失函数进行微调。在微调过程完成后，结合临床和分子变量，包括IDH和1p19q状态，构建集成模型。在独立训练（70 %）和测试（30 %）队列中，通过c指数、时间相关AUC和Kaplan-Meier分析来评估表现。结果联合模型的训练c -指数为0.819(95 % CI: 0.758 ~ 0.880)，检验c -指数为0.804(95 % CI: 0.708 ~ 0.900)，具有较好的判别性。它明显优于孤立的Radiomic、深度学习（2D和2.5D）和临床模型（均p <； 0.05）。此外，时间相关的ROC分析显示，模型在1-5年内的表现一致，AUC值在0.851 ~ 0.906之间。分层生存曲线清楚地显示了不同的预后组（log-rank p <； 0.001）。结论2.5D多源框架为胶质瘤患者的术前生存预测提供了一种临床可行的、无创的工具，可为胶质瘤患者提供个性化的治疗策略。
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引用次数: 0
Enhancing accuracy of detecting left atrial dilatation on CT pulmonary angiography 提高CT肺血管造影检测左房扩张的准确性
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-10-15 DOI: 10.1016/j.ejro.2025.100696
Louis Tapper , Samer Alabed , Ahmed Maiter , Andrzej Lejawka , Mahan Salehi , Krit Dwivedi , Pankaj Garg , David G. Kiely , Peter Metherall , Rob J. van der Geest , Kavita Karunasaagarar , Michael Sharkey , Andrew J. Swift

Introduction

Left atrial (LA) dilatation predicts several cardiovascular disorders. Identifying LA dilatation on computed tomography pulmonary angiography (CTPA) could aid diagnosis of cardiovascular disease. This study assessed an artificial intelligence (AI) segmentation model’s performance at detecting LA dilatation on CTPA.

Methods

Patients with suspected pulmonary hypertension (PH) who underwent CTPA and cardiac MRI (CMR) were retrospectively identified from a single centre registry. The LA was segmented by an AI tool for CTPA and a validated AI tool for CMR. LA volume measurements were categorised for LA dilatation based on existing threshold values. The expert radiologist's reports of the CTPA studies were also categorised for LA dilatation. Automated CTPA LA volumes and corresponding radiologist reports were compared against the reference standard of CMR.

Results

451 patients were included (mean age 64 ± 13 years, 62.5 % female, 85.8 % white). Automated LA volume measurements on CTPA showed strong positive correlation with those on CMR (ρ = 0.92, p < 0.001) with minimal bias on Bland-Altman analysis (-4 mL, 95 %CI −39 to +31 mL). Automated LA measurements on CTPA showed higher agreement with those on CMR (κ = 0.80) than the radiologist reports (κ = 0.62). Automated LA measurements on CTPA showed higher accuracy metrics (sensitivity 81.0 %, specificity 96.8 %, positive predictive value (PPV) 88.5 %, negative predictive value (NPV) 94.4 %) than the radiologist reports (sensitivity 66.7 %, specificity 93.1 %, PPV 74.5 %, NPV 90.2 %).

Conclusion

Deep learning increases the accuracy of LA volume measurements on non-ECG gated CTPA, improving radiologist performance in detecting LA dilatation.
左心房（LA）扩张可预测几种心血管疾病。通过ct肺血管造影（CTPA）识别LA扩张有助于心血管疾病的诊断。本研究评估了人工智能（AI）分割模型在检测CTPA上LA扩张方面的性能。方法回顾性分析单中心登记的疑似肺动脉高压（PH）患者行CTPA和心脏MRI （CMR）检查。LA通过CTPA的人工智能工具和CMR的经过验证的人工智能工具进行分割。根据现有阈值对LA扩张的容积测量进行分类。放射科专家的CTPA研究报告也被归类为LA扩张。自动CTPA LA体积和相应的放射科医生报告与CMR参考标准进行比较。结果纳入451例患者（平均年龄64岁 ± 13岁，女性62.5% %，白人85.8% %）。CTPA的自动LA体积测量与CMR的体积测量显示出很强的正相关（ρ = 0.92, p <； 0.001），Bland-Altman分析的偏差最小（-4 mL， 95% %CI - 39至+31 mL）。CTPA的自动LA测量值与CMR的一致性（κ = 0.80）高于放射科医生报告的一致性（κ = 0.62）。自动LA测量CTPA的准确性指标（敏感性81.0 %，特异性96.8 %，阳性预测值（PPV） 88.5 %，阴性预测值（NPV） 94.4 %）高于放射科医生报告的准确性指标（敏感性66.7 %，特异性93.1 %,PPV 74.5 %,NPV 90.2 %）。结论深度学习提高了非ecg门控CTPA左室容积测量的准确性，提高了放射科医生检测左室扩张的能力。
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引用次数: 0
A systematic review and meta-analysis of imaging characteristics and upgrade rates in noninvasive lobular neoplasia of the breast 对乳腺非侵袭性小叶瘤的影像学特征和升级率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 : 2025-10-15 DOI: 10.1016/j.ejro.2025.100691
Fatemeh Shakki Katouli , Negin Salehi , Faezeh Soveyzi , Mina Abedi , Parya Valizadeh , Hamed Ghorani , Seyedeh Melika Hashemi , Jayran Zebardast , Madjid Shakiba , Sadaf Alipour

Background

Non-invasive lobular neoplasia (NLN) encompasses a range of lobular breast lesions that may precede invasive breast cancer. Microcalcifications detected through mammography play a crucial role in evaluating breast lesions and are often associated with NLN. This study focuses on the prevalence and significance of microcalcifications in NLN, noting that they can be the sole radiographic finding in many cases. While mammography is highly sensitive for detecting microcalcifications, it has limitations in diagnosing NLN, as some lesions may not show up on scans. Advanced imaging techniques like magnetic resonance imaging (MRI) offer improved diagnostic accuracy, particularly in dense breast tissue, but more research is needed for their routine use. Additionally, the risk of NLN progressing to malignant lesions highlights the importance of vigilant monitoring and management. This study aims to analyze the relationship between microcalcifications and NLN, addressing progression risks and implications for clinical practice.

Method

This systematic review and meta-analysis (CRD42022346891) involved a comprehensive search of databases such as PubMed and Scopus from 2000 to 2023, using keywords related to lobular carcinoma and mammography. Eligible English-language studies included those reporting mammographic findings of pure NLN lesions confirmed by histopathologic evaluation and surgical excision. Exclusion criteria involved studies without surgical results or definitive imaging findings. Two independent reviewers assessed titles and abstracts, resolving discrepancies as needed. Data were systematically extracted using a standardized form, with the selection process depicted in a PRISMA flow diagram.

Result

Meta-analysis of included studies revealed that the pooled proportion of any mammographic microcalcification among all NLN lesions was 0.70 (95 % CI: 0.63–0.76). Pure microcalcification (without an associated mass or distortion) was the most common presentation, with a pooled proportion of 0.67 (95 % CI: 0.60–0.74) among all lesions and 0.99 (95 % CI: 0.96–1.00) among lesions presenting with any microcalcification. The overall pooled upgrade rate to malignancy was 0.18 (95 % CI: 0.11–0.25), with a significantly higher rate for lobular carcinoma in situ (LCIS) at 0.22 (95 % CI: 0.15–0.30) compared to atypical lobular hyperplasia (ALH) at 0.06 (95 % CI: 0.01–0.14). Microcalcifications were present in the majority of upgraded lesions (pooled proportion: 0.78, 95 % CI: 0.69–0.87). A small but significant proportion of lesions (0.08, 95 % CI: 0.03–0.17) had no mammographic findings. All pooled estimates showed high heterogeneity. Sensitivity analysis confirmed the robustness of the results, while Egger's test indicated potential publication bias.

Conclusion

In conclusion this study highlights the significant prevalence of microcalcifications i
背景：非浸润性乳腺小叶瘤（NLN）包括一系列可能发生于浸润性乳腺癌的乳腺小叶病变。通过乳房x线摄影检测到的微钙化在评估乳腺病变中起着至关重要的作用，通常与NLN相关。本研究的重点是NLN中微钙化的患病率和意义，注意到它们在许多病例中可能是唯一的影像学发现。虽然乳房x光检查对检测微钙化非常敏感，但它在诊断NLN方面有局限性，因为一些病变可能无法在扫描中显示出来。像磁共振成像（MRI）这样的先进成像技术提高了诊断的准确性，特别是在致密的乳腺组织中，但需要更多的研究才能将其常规使用。此外，NLN发展为恶性病变的风险突出了警惕监测和管理的重要性。本研究旨在分析微钙化与NLN之间的关系，解决进展风险及其对临床实践的影响。方法本系统综述和荟萃分析（CRD42022346891）对2000 - 2023年PubMed、Scopus等数据库进行综合检索，检索关键词为小叶癌和乳腺x线摄影。符合条件的英语研究包括那些经组织病理学评估和手术切除证实的纯NLN病变的乳房x光检查结果。排除标准包括没有手术结果或明确影像学发现的研究。两名独立审稿人评估标题和摘要，根据需要解决差异。使用标准化表格系统地提取数据，并在PRISMA流程图中描述选择过程。结果纳入研究的荟萃分析显示，所有NLN病变中任何乳房x线摄影微钙化的总比例为0.70（95 % CI: 0.63-0.76）。纯微钙化（无相关肿块或扭曲）是最常见的表现，在所有病变中合并比例为0.67(95 % CI: 0.60-0.74)，在任何微钙化病变中合并比例为0.99（95 % CI: 0.96-1.00）。总体合并恶性升级率为0.18(95 % CI: 0.11-0.25)，小叶原位癌（LCIS）的发生率为0.22(95 % CI: 0.15-0.30)，而非典型小叶增生（ALH）的发生率为0.06（95 % CI: 0.01-0.14）。大多数升级病变存在微钙化（合并比例：0.78,95 % CI: 0.69-0.87）。一小部分但有意义的病变（0.08,95 % CI: 0.03-0.17）没有乳房x线检查结果。所有汇总估计均显示高度异质性。敏感性分析证实了结果的稳健性，而Egger的检验表明了潜在的发表偏倚。总之，本研究强调了NLN病例中微钙化的显著患病率及其作为诊断特征的关键作用。尽管它们与疾病进展有关，但微钙化并不是恶性肿瘤升级的可靠预测因子。进一步的评估是必要的，以了解其临床意义，并改善对NLN患者的管理策略。
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引用次数: 0
Photon counting CT improves coronary stent imaging and fat attenuation index assessment across reconstruction modes 光子计数CT改善冠状动脉支架成像和脂肪衰减指数评估跨重建模式
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-10-13 DOI: 10.1016/j.ejro.2025.100695
Yujie Gao , Yaru Yang , Qiuju Hu , Yane Zhao , Yong Yuan , Jiliang Chen , Bangjun Guo , Dongsheng Jin , song luo , Guangming Lu

Objectives

To investigate the effect of photon counting CT (PCCT) ultra–high resolution (UHR) mode on coronary stent visualization and fat attenuation index (FAI) assessment in individuals with percutaneous coronary intervention (PCI).

Methods

Patients who underwent PCI with stent placement and following coronary CT angiography (CCTA) by using a PCCT system were enrolled during January to August 2024. Simulated energy integrating detector CT (EID-CT) images (0.8 mm) were reconstructed with kernel Bv48, while UHR images (0.2 mm) were reconstructed using kernel Bv60 and Bv72. Objective and subjective image quality, stent-specific FAI and peri-stent FAI was evaluated.

Results

A total of 41 patients with 51 isolated stents (69.76 ± 8.75 years; 34 men) were included. Compared to simulated EID-CT, 0.2 mm Bv72 images showed larger in-stent diameters and reduced blooming artifacts (all p < 0.001). Subjective image quality scores for 0.2 mm UHR images were superior to those for simulated EID-CT (all p < 0.01). The stent-specific FAI and peri-stent FAI of 51 isolated stents was lower in the 0.2 mm UHR images than in simulated EID-CT (all p < 0.05). The reconstruction mode of 0.2 mm Bv72 showed the ability of stent-specific FAI and peri-stent FAI to distinguish stents with in-stent restenosis (ISR) < 50 % in diameter from stents without ISR, with cut-off value of −98HU and −99.5HU, respectively.

Conclusions

PCCT UHR mode improved the image quality of coronary stents, reduced the FAI values and provided cut-off values based on stent-specific FAI and peri-stent FAI.
目的探讨光子计数CT （PCCT）超高分辨率（UHR）模式对经皮冠状动脉介入治疗（PCI）患者冠脉支架显像及脂肪衰减指数（FAI）评估的影响。方法于2024年1月至8月，采用PCCT系统行PCI支架置入术及冠状动脉CT血管造影（CCTA）的患者入组。模拟能量积分检测器CT （EID-CT）图像（0.8 mm）用内核Bv48重建，UHR图像（0.2 mm）用内核Bv60和Bv72重建。评估客观和主观图像质量、支架特异性FAI和支架周围FAI。结果共纳入51例孤立支架患者41例（69.76 ± 8.75岁，男性34例）。与模拟EID-CT相比，0.2 mm Bv72图像显示支架内直径更大，假影减少（p均 <； 0.001）。0.2 mm UHR图像的主观图像质量评分优于模拟EID-CT （p均 <； 0.01）。51个离体支架在0.2 mm UHR图像上的支架特异性FAI和支架周围FAI均低于模拟reid - ct （p均 <； 0.05）。重建模式为0.2 mm Bv72，表明支架特异性FAI和支架周围FAI能够区分支架内再狭窄（ISR） <； 50 %直径的支架与无ISR的支架，截断值分别为- 98HU和- 99.5HU。结论spcct UHR模式提高了冠状动脉支架的图像质量，降低了FAI值，并提供了基于支架特异性FAI和支架周围FAI的截断值。
{"title":"Photon counting CT improves coronary stent imaging and fat attenuation index assessment across reconstruction modes","authors":"Yujie Gao ,&nbsp;Yaru Yang ,&nbsp;Qiuju Hu ,&nbsp;Yane Zhao ,&nbsp;Yong Yuan ,&nbsp;Jiliang Chen ,&nbsp;Bangjun Guo ,&nbsp;Dongsheng Jin ,&nbsp;song luo ,&nbsp;Guangming Lu","doi":"10.1016/j.ejro.2025.100695","DOIUrl":"10.1016/j.ejro.2025.100695","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the effect of photon counting CT (PCCT) ultra–high resolution (UHR) mode on coronary stent visualization and fat attenuation index (FAI) assessment in individuals with percutaneous coronary intervention (PCI).</div></div><div><h3>Methods</h3><div>Patients who underwent PCI with stent placement and following coronary CT angiography (CCTA) by using a PCCT system were enrolled during January to August 2024. Simulated energy integrating detector CT (EID-CT) images (0.8 mm) were reconstructed with kernel Bv48, while UHR images (0.2 mm) were reconstructed using kernel Bv60 and Bv72. Objective and subjective image quality, stent-specific FAI and peri-stent FAI was evaluated.</div></div><div><h3>Results</h3><div>A total of 41 patients with 51 isolated stents (69.76 ± 8.75 years; 34 men) were included. Compared to simulated EID-CT, 0.2 mm Bv72 images showed larger in-stent diameters and reduced blooming artifacts (all p &lt; 0.001). Subjective image quality scores for 0.2 mm UHR images were superior to those for simulated EID-CT (all p &lt; 0.01). The stent-specific FAI and peri-stent FAI of 51 isolated stents was lower in the 0.2 mm UHR images than in simulated EID-CT (all p &lt; 0.05). The reconstruction mode of 0.2 mm Bv72 showed the ability of stent-specific FAI and peri-stent FAI to distinguish stents with in-stent restenosis (ISR) &lt; 50 % in diameter from stents without ISR, with cut-off value of −98HU and −99.5HU, respectively.</div></div><div><h3>Conclusions</h3><div>PCCT UHR mode improved the image quality of coronary stents, reduced the FAI values and provided cut-off values based on stent-specific FAI and peri-stent FAI.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100695"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319584","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
Deep learning for Three‐Class Classification of ground-glass nodules on non-enhanced chest CT: A multicenter comparative study of CNN architectures 深度学习在非增强胸部CT磨玻璃结节三级分类中的应用：CNN架构的多中心对比研究
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-10-08 DOI: 10.1016/j.ejro.2025.100690
Meihua Shao , Jian Wang , Lin Zhu , Jianfei Tu , Guohua Cheng , Linyang He , Hengfeng Shi , Cui Zhang , Hong Yu

Objective

To develop, validate, and compare four three-dimensional (3D) convolutional neural network (CNN) models for differentiating ground-glass nodules (GGNs) on non-contrast chest computed tomography (CT) scans, specifically classifying them as adenomatous hyperplasia (AAH)/adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (IA).

Materials and methods

This multi-center study retrospectively enrolled 4284 consecutive patients with surgically resected and pathologically confirmed AAH/AIS, MIA, or IA from four hospitals between January 2015 and December 2023. GGNs were randomly partitioned into a training set (n = 3083, 72 %) and a validation set (n = 1277, 28 %). Four 3D deep learning models (Res2Net 3D, DenseNet3D, ResNet50 3D, Vision Transformer 3D) were implemented for GGN segmentation and three-class classification. Additionally, variants of the Res2Net 3D model were developed by incorporating clinical and CT features: Res2Net 3D_w2 (sex, age), Res2Net 3D_w6 (adding lesion size, location, and smoking history), and Res2Net 3D_w10 (sex, age, location, the mean, maximum, and standard deviation of CT attenuation, nodule volume, volume ratio, volume ratio within the left/right lung, and the maximum CT value of the entire lung). Model performance was evaluated using accuracy, recall, precision, F1-score, and area under the receiver operating characteristic curve (AUC).

Results

Res2Net 3D outperformed others, achieving AUCs of 0.91 (AAH/AIS), 0.88 (MIA), and 0.92 (IA). Its F1-scores were 0.416, 0.500, and 0.929, respectively. All Res2Net variants achieved accuracies between 0.83–0.84.

Conclusion

The Res2Net 3D model accurately differentiates GGN subtypes using non-contrast CT, showing high performance, especially for invasive adenocarcinoma.
目的建立、验证并比较4种三维（3D）卷积神经网络（CNN）模型在非对比胸部计算机断层扫描（CT）上鉴别毛玻璃结节（ggn），并将其分类为腺瘤性增生(AAH)/原位腺癌（AIS）、微创腺癌（MIA）和浸润性腺癌（IA）。材料和方法本多中心研究回顾性纳入了2015年1月至2023年12月间4家医院4284例手术切除并病理证实的AAH/AIS、MIA或IA患者。将ggn随机划分为训练集（n = 3083,72 %）和验证集（n = 1277,28 %）。采用Res2Net 3D、DenseNet3D、ResNet50 3D、Vision Transformer 3D四个三维深度学习模型对GGN进行分割和三类分类。此外，通过结合临床和CT特征，开发了Res2Net 3D模型的不同版本：Res2Net 3D_w2（性别、年龄），Res2Net 3D_w6（添加病变大小、位置和吸烟史），Res2Net 3D_w10（性别、年龄、位置、CT衰减平均值、最大值和标准差、结节体积、体积比、左右肺体积比、全肺最大CT值）。通过准确性、召回率、精密度、f1评分和受试者工作特征曲线（AUC）下面积来评估模型的性能。结果res2net 3D的auc分别为0.91 （AAH/AIS）、0.88 （MIA）和0.92 （IA）。其f1得分分别为0.416、0.500和0.929。所有Res2Net变体的准确率都在0.83-0.84之间。结论Res2Net三维模型在非对比CT上能准确鉴别GGN亚型，对浸润性腺癌具有较高的鉴别价值。
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引用次数: 0
Weight-bearing MRI of the cervical spine: A scoping review of clinical utility and emerging applications 颈椎负重MRI：临床应用和新兴应用的范围综述
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-10-08 DOI: 10.1016/j.ejro.2025.100694
Jonathan Verderame , Muhammad Shakib Arslan , Farhan Mukhtar , Zaheer Abbas

Objective

Weight-bearing magnetic resonance imaging enables assessment of the cervical spine and craniocervical junction under physiological load, potentially revealing pathology that is occult on conventional supine imaging. This scoping review synthesizes current evidence, maps clinical and emerging applications, and identifies key gaps requiring further investigation.

Methods

A structured search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and Semantic Scholar (July 2025). Eligible studies were reviewed for diagnostic utility, technical considerations, clinical indications, and outcomes. Methodological quality was appraised descriptively in line with Joanna Briggs Institute guidance.

Results

Nine studies, published between 2008 and 2025, met inclusion criteria. Upright and dynamic MRI detected posture-dependent changes including spinal canal narrowing, cord compression, foraminal stenosis, ligamentous buckling, cerebellar tonsillar descent, altered sagittal alignment, and CSF flow differences. Findings were more pronounced in flexion extension and upright postures compared with supine imaging. Normative studies established reference metrics for CCJ motion and prevertebral soft tissue width. Preliminary evidence also highlights applications in connective tissue disorders, Chiari malformation, and upper cervical chiropractic practice, although most studies were feasibility reports with small sample sizes and heterogeneous protocols.

Conclusion

Emerging evidence suggests that WBMRI provides added diagnostic value in selected cervical spine and CCJ conditions by revealing dynamic or load-sensitive pathology not captured on standard supine imaging. While current evidence remains preliminary, standardized protocols, higher-field technologies, and large multicenter outcome-based studies are essential to validate diagnostic thresholds, improve reproducibility, and define the role of WBMRI in routine clinical care.
目的负重磁共振成像能够评估生理负荷下的颈椎和颅颈交界处，潜在地揭示传统仰卧位成像所隐藏的病理。这一范围审查综合了目前的证据，绘制了临床和新兴应用地图，并确定了需要进一步调查的关键差距。方法在PubMed、Scopus、Web of Science、b谷歌Scholar、Semantic Scholar（2025年7月）中进行结构化检索。对符合条件的研究进行了诊断效用、技术考虑、临床适应症和结果的审查。方法质量按照乔安娜布里格斯研究所的指导进行描述性评价。结果2008年至2025年间发表的9项研究符合纳入标准。直立和动态MRI检测到姿势依赖性变化，包括椎管狭窄、脊髓压迫、椎间孔狭窄、韧带屈曲、小脑扁桃体下降、矢状面排列改变和脑脊液流量差异。与仰卧位相比，屈伸位和直立位的影像学表现更为明显。规范研究建立了CCJ运动和椎前软组织宽度的参考指标。初步证据也强调了结缔组织疾病、Chiari畸形和上颈椎捏脊术的应用，尽管大多数研究都是小样本量和异质方案的可行性报告。结论：越来越多的证据表明，WBMRI通过揭示标准仰卧位成像未捕获的动态或负荷敏感病理，为选定的颈椎和CCJ疾病提供了额外的诊断价值。虽然目前的证据仍然是初步的，但标准化的方案、更高领域的技术和基于结果的大型多中心研究对于验证诊断阈值、提高可重复性和确定WBMRI在常规临床护理中的作用至关重要。
{"title":"Weight-bearing MRI of the cervical spine: A scoping review of clinical utility and emerging applications","authors":"Jonathan Verderame ,&nbsp;Muhammad Shakib Arslan ,&nbsp;Farhan Mukhtar ,&nbsp;Zaheer Abbas","doi":"10.1016/j.ejro.2025.100694","DOIUrl":"10.1016/j.ejro.2025.100694","url":null,"abstract":"<div><h3>Objective</h3><div>Weight-bearing magnetic resonance imaging enables assessment of the cervical spine and craniocervical junction under physiological load, potentially revealing pathology that is occult on conventional supine imaging. This scoping review synthesizes current evidence, maps clinical and emerging applications, and identifies key gaps requiring further investigation.</div></div><div><h3>Methods</h3><div>A structured search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and Semantic Scholar (July 2025). Eligible studies were reviewed for diagnostic utility, technical considerations, clinical indications, and outcomes. Methodological quality was appraised descriptively in line with Joanna Briggs Institute guidance.</div></div><div><h3>Results</h3><div>Nine studies, published between 2008 and 2025, met inclusion criteria. Upright and dynamic MRI detected posture-dependent changes including spinal canal narrowing, cord compression, foraminal stenosis, ligamentous buckling, cerebellar tonsillar descent, altered sagittal alignment, and CSF flow differences. Findings were more pronounced in flexion extension and upright postures compared with supine imaging. Normative studies established reference metrics for CCJ motion and prevertebral soft tissue width. Preliminary evidence also highlights applications in connective tissue disorders, Chiari malformation, and upper cervical chiropractic practice, although most studies were feasibility reports with small sample sizes and heterogeneous protocols.</div></div><div><h3>Conclusion</h3><div>Emerging evidence suggests that WBMRI provides added diagnostic value in selected cervical spine and CCJ conditions by revealing dynamic or load-sensitive pathology not captured on standard supine imaging. While current evidence remains preliminary, standardized protocols, higher-field technologies, and large multicenter outcome-based studies are essential to validate diagnostic thresholds, improve reproducibility, and define the role of WBMRI in routine clinical care.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100694"},"PeriodicalIF":2.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264883","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
Glymphatic dysfunction as an imaging biomarker for cognitive impairment in patients with β-thalassemia major: A multimodal MRI study 淋巴功能障碍作为β-地中海贫血患者认知障碍的成像生物标志物：一项多模态MRI研究
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-10-06 DOI: 10.1016/j.ejro.2025.100692
Xingye Yang , Meiru Bu , Xi Deng , Haifeng Zheng , Chengli Wu , Wei Cui , Muliang Jiang , Bihong T. Chen

Background and purpose

Cerebral lymphatic abnormalities have been associated with neurodegenerative processes. However, brain glymphatic system and its role in cognitive impairment in β-thalassemia major (β-TM) remain unknown. This study assessed brain glymphatic alterations in β-TM using advanced neuroimaging and their correlation with cognitive deficits.

Method

Thirty-five β-TM patients and forty matched healthy controls (HC) underwent standardized cognitive assessment and diffusion tensor imaging (DTI). Automated segmentation derived glymphatic parameters: Analysis Along the Perivascular Space index (DTI-ALPS index), choroid plexus volume fraction (CPVF), perivascular space volume fraction (PVSVF), and fractional volume of free water in white matter (FW-WM) and were compared between groups. Correlations with cognitive scores were analyzed.

Result

Compared with the HC, β-TM patients showed significantly lower DTI-ALPS index values in the left hemisphere (1.4527vs1.5275,P = 0.003), the right hemisphere (1.3648vs1.4492,P = 0.004) and bilateral hemispheres (1.4087vs1.4884,P = 0.001), alongside higher CPVF values in the left hemisphere (0.5426vs0.4655,P = 0.034), the right hemisphere (0.5296vs0.4439,P = 0.018) and bilateral hemispheres (1.0731vs0.9095,P = 0.01). The patient group also had higher PVSVF values in the white matter (0.2848vs0.2488,P = 0.841), the subcortical regions (0.1718vs0.1470,P = 0.349) and whole brain (0.4566vs0.3958,P = 0.678), and had higher FW-WM value (0.1580vs0.1557,P = 0.384). Lower DTI-ALPS index and higher FW-WM value was associated with poorer cognitive performance in the β-TM patients (P < 0.05).

Conclusions

The DTI-ALPS index is a potential neuroimaging biomarker for glymphatic dysfunction and cognitive impairment in β-TM. Increased CP volume implicated underlying glymphatic alterations, supporting integration of glymphatic MRI metrics into clinical cognitive assessment for this population.
背景和目的脑淋巴异常与神经退行性病变有关。然而，脑淋巴系统及其在β-地中海贫血（β-TM）认知障碍中的作用尚不清楚。本研究利用先进的神经成像技术评估了β-TM的脑淋巴改变及其与认知缺陷的相关性。方法对35例β-TM患者和40例健康对照（HC）进行标准化认知评估和弥散张量成像（DTI）。自动分割得到的淋巴参数：分析沿血管周围空间指数（DTI-ALPS指数）、脉络膜丛体积分数（CPVF）、血管周围空间体积分数（PVSVF）和白质游离水分数体积（FW-WM），并比较两组间的差异。分析与认知评分的相关性。ResultCompared HC,βtm病人显示显著降低DTI-ALPS索引值的左半球(1.4527 vs1.5275 P = 0.003),右脑(1.3648 vs1.4492 = 0.004页)和双边半球(1.4087 vs1.4884 P = 0.001),与高CPVF值左半球(0.5426 vs0.4655 P = 0.034),右脑(0.5296 vs0.4439 = 0.018页)和双边半球(1.0731 vs0.9095 = 0.01页)。患者组脑白质PVSVF值（0.2848vs0.2488,P = 0.841）、皮质下区PVSVF值（0.1718vs0.1470,P = 0.349）、全脑PVSVF值（0.4566vs0.3958,P = 0.678）、FW-WM值（0.1580vs0.1557,P = 0.384）均较高。β-TM患者DTI-ALPS指数越低，FW-WM值越高，认知表现越差（P <； 0.05）。结论DTI-ALPS指数是β-TM淋巴功能障碍和认知功能障碍的潜在神经影像学生物标志物。CP体积增加暗示了潜在的淋巴改变，支持将淋巴MRI指标整合到该人群的临床认知评估中。
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引用次数: 0
Exercise-related changes in knee articular structures detected using magnetic resonance imaging T1ρ and T2 mapping 使用磁共振成像T1ρ和T2映射检测膝关节结构的运动相关变化
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-10-02 DOI: 10.1016/j.ejro.2025.100693
Keita Nagawa , Hirokazu Shimizu , Saki Tsuchihashi , Kaiji Inoue , Shinji Kakemoto , Taira Shiratori , Akane Kaizu , Masahiro Koyama , Yuya Yamamoto , Masami Yoneyama , Naoki Sugita , Eito Kozawa

Purpose

To evaluate the changes in various knee joint structures before and after physical activities using magnetic resonance imaging (MRI) T1ρ and T2 mapping.

Methods

MRI of the right knee was performed for 12 healthy volunteers before and after jumping rope, flexion and extension, and at rest. Different parts of articular cartilage, anterior and posterior cruciate ligaments, medial and lateral meniscus, gastrocnemius muscle and Hoffa’s fat pad were quantitatively assessed based on T1ρ and T2 values. A paired t-test was performed to determine whether the effects of various activities on different parts of the knee articular structures were statistically different.

Results

The T1ρ values for the lateral meniscus decreased, while both T1ρ and T2 values for the gastrocnemius muscle increased after jumping rope. No statistically significant differences were observed in the other parts of the meniscus, cruciate ligaments, and Hoffa’s fat pad. The T1ρ and T2 values for the weight-bearing cartilages of the femur and tibia were both reduced after jumping rope. However, no statistically significant differences were observed in the cartilage after flexion and extension or at rest.

Conclusions

MRI T1ρ and T2 mapping can be used to evaluate the changes in various joint structures before and after physical activities. These changes in knee tissue were hypothesized to reflect variations in tissue fluid, collagen fibers, and proteoglycan content. Further studies are required to investigate the influence of exercise on articular structures using MRI mapping techniques.
目的应用磁共振成像（MRI） T1ρ和T2成像评价运动前后膝关节各种结构的变化。方法对12名健康志愿者在跳绳、屈伸和静止前后进行右膝mri检查。根据T1ρ和T2值定量评估关节软骨、前后交叉韧带、内侧和外侧半月板、腓肠肌和Hoffa脂肪垫的不同部位。采用配对t检验来确定各种活动对不同部位膝关节结构的影响是否有统计学差异。结果跳绳后外侧半月板的T1ρ值降低，腓肠肌的T1ρ值和T2值均升高。在半月板、交叉韧带和Hoffa脂肪垫的其他部位无统计学差异。跳绳后股骨和胫骨承重软骨的T1ρ和T2值均降低。然而，在屈伸和静止后的软骨中，没有观察到统计学上的显著差异。结论smri T1ρ和T2测图可用于评价运动前后各关节结构的变化。膝关节组织的这些变化被推测为反映了组织液、胶原纤维和蛋白多糖含量的变化。需要进一步的研究来研究运动对关节结构的影响，使用MRI成像技术。
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引用次数: 0
High performance of low/ultralow-dose photon-counting CT for pulmonary metastasis in young musculoskeletal malignancy patients 低/超低剂量光子计数CT对年轻肌肉骨骼恶性肿瘤肺转移的高效诊断
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-09-27 DOI: 10.1016/j.ejro.2025.100689
Shanshui Zhou , Qiyuan Bao , Haipeng Dong , Jiqiang Li , Zhihan Xu , Lianjun Du , Wenjie Yang , Yong Lu , Weibin Zhang , Fuhua Yan , Le Qin

Purpose

To investigate the performance of chest photon-counting CT (PCCT) at low-dose (LD) and ultralow-dose (ULD) in young musculoskeletal malignancy patients with pulmonary metastasis and compare with prior standard-dose energy-integrating CT (EICT).

Materials and methods

From August to November 2023, this prospective study recruited consecutive participants with prior EICT images and grouped them into LD and ULD groups to receive PCCT examination. Two observers independently and blindly evaluated the image quality using a five-point Likert scale. Intraindividual differences between PCCT and EICT were compared using the Wilcoxon signed-rank test or paired samples t-test.

Results

The LD and ULD groups included 50 (19 [16; 21] years; 33 males) and 50 participants (19 [14; 21] years; 30 males), respectively. The interval between EICT and PCCT examinations was 116 (88.5; 194) days. Compared with EICT, PCCT obtained median effective dose reduction rates of 87.62 % (3.78 [3.15; 5.18] vs. 0.43 [0.39; 0.58] mSv; p < 0.001) and 92.58 % (3.92 [2.96; 4.95] vs. 0.27 [0.22; 0.34] mSv; p < 0.001) in the LD and ULD groups, respectively. For subjective assessments, PCCT has superior overall image quality (5 [5; 5] vs. 5 [4; 5]) and lung nodule visualization (5 [5; 5] vs. 5 [4; 5]) to EICT (all p-values <0.001).

Conclusion

PCCT provided higher image quality and lung nodule visualization with significant dose reduction compared to EICT in these young musculoskeletal malignancy patients.
目的探讨低剂量（LD）和超低剂量（ULD）胸部光子计数CT （PCCT）在年轻肌肉骨骼恶性肿瘤合并肺转移患者中的表现，并与既往标准剂量能量积分CT （EICT）进行比较。材料与方法本前瞻性研究于2023年8月至11月连续招募有EICT影像的受试者，将其分为LD组和ULD组接受PCCT检查。两名观察员独立和盲目评估图像质量使用五点李克特量表。PCCT和EICT的个体差异采用Wilcoxon符号秩检验或配对样本t检验进行比较。结果LD组50例（19[16；21]岁，男性33例），ULD组50例（19[14；21]岁，男性30例）。EICT与PCCT检查间隔116（88.5;194）天。与EICT相比，PCCT在LD组和ULD组的中位有效剂量减少率分别为87.62 %（3.78[3.15；5.18]比0.43 [0.39;0.58]mSv; p <； 0.001）和92.58 %（3.92[2.96；4.95]比0.27 [0.22;0.34]mSv; p <； 0.001）。在主观评价方面，PCCT具有优于EICT的整体图像质量（5 [5;5]vs. 5[4; 5]）和肺结节显示（5 [5;5]vs. 5[4; 5]）（所有p值<；0.001）。结论与EICT相比，pcct在年轻肌肉骨骼恶性肿瘤患者中具有更高的图像质量和更清晰的肺结节显示，且剂量明显降低。
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引用次数: 0
Spectral computer-tomography and the ability to detect occult femoral neck and scaphoid fractures – A systematic review and exploratory meta-analysis 光谱计算机断层扫描和检测隐匿性股骨颈和舟状骨骨折的能力-系统回顾和探索性荟萃分析
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Journal of Radiology Open
Pub Date : 2025-09-24 DOI: 10.1016/j.ejro.2025.100686
Camilla Thøgersen Buxbom , Amalie Braithwaite , Søren Hess , Lars Lykke Hermansen , Martin Weber Kusk

Objective

This systematic review aims to describe the ability of spectral computed tomography (SCT) to identify bone marrow oedema (BME) in the scaphoid bone and the femoral neck compared to magnetic resonance images (MRI).

Materials and methods

PubMed, Embase and Cochrane Library were searched from the 1st of October 2024; eligible studies had patients over 15 years of age, underwent SCT and had MRI as a gold standard. Sensitivities, specificities, negative predictive values (NPV) and positive predictive values (PPV) were noted or calculated from available information. Bias and applicability were assessed using QUADAS-2 tools. A random-effects model was used in the meta-analysis, and heterogeneity was assessed using I2 statistics.

Results

1061 studies were identified and screened by title/abstract. Twenty-two studies underwent full-text assessment. A total of four were included, of which three were suitable for meta-analysis regarding the scaphoid bone. Pooled sensitivity was 93 %, specificity was 98 %, PPV was 92 % and NPV was 98 %. A single study concerning the femoral neck was located, with sensitivity, specificity, PPV and NPV of 87 %, 94 %, 93 % and 89 % respectively.

Conclusions

Data regarding the ability of SCT to detect BME in the femoral neck and scaphoid bone are promising, but limited, with only small studies available. There is a need for larger prospective studies, regarding both the detection of occult fractures in the femoral neck and the scaphoid bone.
目的：本系统综述旨在描述光谱计算机断层扫描（SCT）识别舟状骨和股骨颈骨髓水肿（BME）的能力，并与磁共振成像（MRI）进行比较。资料与方法检索自2024年10月1日起的spubmed、Embase和Cochrane Library；符合条件的研究有15岁以上的患者，接受了SCT和MRI作为金标准。敏感性、特异性、阴性预测值（NPV）和阳性预测值（PPV）被记录或从现有信息中计算。使用QUADAS-2工具评估偏倚和适用性。meta分析采用随机效应模型，采用I2统计量评估异质性。结果通过标题/摘要对1061项研究进行了筛选。22项研究进行了全文评估。共纳入4例，其中3例适合用于舟状骨的meta分析。敏感性为93 %，特异性为98 %，PPV为92 %，NPV为98 %。我们找到了一项关于股骨颈的研究，其敏感性、特异性、PPV和NPV分别为87 %、94 %、93 %和89 %。结论：关于SCT检测股骨颈和舟状骨BME的能力的数据是有希望的，但有限，只有少量的研究可用。对于股骨颈和舟状骨隐匿性骨折的检测，需要进行更大规模的前瞻性研究。
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引用次数: 0
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