European Journal of Radiology Open最新文献_第5页

Investigation in image quality and immediate patient safety using pre-dual-flow injection for low-contrast dose spectral pulmonary artery CT angiography 在低对比剂量频谱肺动脉 CT 血管造影术中使用预双流注射技术对图像质量和患者即时安全性的研究

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-05-22 DOI: 10.1016/j.ejro.2024.100571

Liwei Xue , Qing Zhong , Nianjie Xu , Yanping Zheng , Yuanfen Liu

Purpose

The patient safety of iodine contrast-enhanced pulmonary artery CT angiography (CTPA) is widely concerned. This study aimed to investigate the image quality and immediate patient safety of spectral CTPA using a lower-contrast dose pre-dual-flow injection method.

Methods

This retrospective study included 120 patients with suspected pulmonary embolisms who received spectral CTPA between February and December 2022. Patients were divided into normal contrast injection (Group A, n=60) and pre-dual-flow group (Group B, n=60). CT values of pulmonary arteries (PAs) at different levels, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), arteriovenous separation performance, and beam hardening artifact (BHA) index of two sets of images were measured or calculated. The subjective image quality and immediate patient safety were also scored using the three-point method.

Results

Group B had a contrast dose reduction by 42.5 % (60 vs. 34.5 mL). Radiation exposure dose was not statistically different between the two groups (P>0.05). CT values of different-level PAs on group B images were higher than those on group A images (P<0.05). Group B images had higher SNR and CNR, better arteriovenous separation between PA trunk and pulmonary vein, and lower BHA index on soft tissue and PA (all P<0.05). For subjective evaluation of image quality, group B had a better score in beam hardening artifact (P<0.05). For immediate patient safety, the score in comfortability was statistically higher in group B, with P<0.05.

Conclusions

Comparing with the normal injection method, pre-dual-flow spectral CTPA with a lower contrast dose injected results in better image quality and shows potential in patient-safety promotion.

目的碘对比剂增强肺动脉 CT 血管造影（CTPA）的患者安全性受到广泛关注。这项回顾性研究纳入了 2022 年 2 月至 12 月间接受光谱 CTPA 的 120 例疑似肺栓塞患者。患者被分为正常对比剂注射组（A 组，n=60）和双流前注射组（B 组，n=60）。测量或计算两组图像的不同水平肺动脉（PA）CT值、信噪比（SNR）和对比度-信噪比（CNR）、动静脉分离性能和束流硬化伪影（BHA）指数。结果 B 组造影剂量减少了 42.5%（60 mL 对 34.5 mL）。两组的辐射剂量无统计学差异（P>0.05）。B 组图像上不同层次 PA 的 CT 值高于 A 组图像（P<0.05）。B 组图像的 SNR 和 CNR 更高，PA 干与肺静脉之间的动静脉分离度更好，软组织和 PA 的 BHA 指数更低（均为 P<0.05）。在图像质量的主观评价方面，B 组在束流硬化伪影方面得分更高（P<0.05）。结论与普通注射方法相比，注射对比剂剂量较低的预双流频谱 CTPA 可获得更好的图像质量，并显示出促进患者安全的潜力。

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引用次数: 0

Insertional Achilles tendinopathy: A radiographic cross-sectional comparison between symptomatic and asymptomatic heel of 71 patients 插入性跟腱病：71 名患者有症状和无症状足跟的影像学横断面比较

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-05-10 DOI: 10.1016/j.ejro.2024.100568

Kenichiro Nakajima

Purpose

This retrospective study aimed to investigate whether the standard radiographic indicators for Haglund's syndrome are applicable to insertional Achilles tendinopathy.

Methods

Patients who underwent surgery for insertional Achilles tendinopathy in one heel and experienced no pain in the other heel were enrolled in this study. Preoperative calibrated radiographs of the lateral view of the calcaneus were assessed using (1) calcaneal pitch angle, (2) Fowler-Phillip angle, (3) posterior calcaneal angle, (4) Chauveau-Liet angle, (5) X/Y ratio, (6) Haglund’s deformity height, (7) Haglund’s deformity peak angle, (8) calcification length, (9) calcification width, (10) parallel pitch test, and (11) presence of free body. The Wilcoxon signed rank test and McNemar’s test were used for statistical analyses.

Results

Seventy-one patients (52 males; mean age, 57.2; mean body mass index, 27.1) were included. Mean values for each index in the symptomatic and asymptomatic heels were as follows, respectively: (1) 23.5, 23.0 (p = 0.30); (2) 58.9, 57.8 (p < 0.05); (3) 7.6, 9.2 (p < 0.05); (4) 15.8, 13.9 (p < 0.05); (5) 2.8, 2.8 (p = 0.87); (6) 5.4, 5.0 (p < 0.05); (7) 99.6, 99.0 (p = 0.44); (8) 10.5, 7.6 (p < 0.001); and (9) 5.1, 4.4 (p < 0.05). The sensitivity, specificity, and area under curve of significant indicators were as follows, respectively: (2) 0.78, 0.37, 0.55; (3) 0.45, 0.72, 0.58; (4) 0.63, 0.54, 0.57; (6) 0.45, 0.69, 0.59; (8) 0.48, 0.80, 0.66; and (9) 0.63, 0.54, 0.59. The presence of free body also showed a significant difference between both heels (p < 0.05).

Conclusion

Some radiographic indicators for Haglund's syndrome are applicable to the diagnosis of insertional Achilles tendinopathy. A comparison of the parameters of Haglund’s syndrome with those of insertional Achilles tendinopathy may illuminate the etiology and pathology of insertional Achilles tendinopathy and lead to novel treatments.

目的本回顾性研究旨在探讨 Haglund's 综合征的标准影像学指标是否适用于插入性跟腱病。方法本研究选取了因一侧跟腱插入性跟腱病接受手术且另一侧跟腱无疼痛的患者。术前校准的小跟骨侧视X光片采用以下指标进行评估：(1) 小跟骨俯仰角；(2) Fowler-Phillip角；(3) 小跟骨后角；(4) Chauveau-Liet角；(5) X/Y比值；(6) Haglund畸形高度；(7) Haglund畸形峰角；(8) 钙化长度；(9) 钙化宽度；(10) 平行俯仰试验；(11) 是否存在游离体。统计分析采用 Wilcoxon 符号秩检验和 McNemar 检验。有症状和无症状高跟鞋的各项指数平均值分别为：（1）23.5，23.0（P = 0.30）；（2）58.9，57.8（P <；0.05）；（3）7.6，9.2（P <；0.05）；（4）15.8，13.9（p <；0.05）；（5）2.8，2.8（p = 0.87）；（6）5.4，5.0（p <；0.05）；（7）99.6，99.0（p = 0.44）；（8）10.5，7.6（p <；0.001）；以及（9）5.1，4.4（p <；0.05）。重要指标的灵敏度、特异性和曲线下面积分别为：(2) 0.78，0.37，0.55；(3) 0.45，0.72，0.58；(4) 0.63，0.54，0.57；(6) 0.45，0.69，0.59；(8) 0.48，0.80，0.66；(9) 0.63，0.54，0.59。结论Haglund综合征的一些影像学指标适用于插入性跟腱病的诊断。将 Haglund's 综合征的参数与插入性跟腱病的参数进行比较，可能会揭示插入性跟腱病的病因和病理，从而找到新的治疗方法。

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引用次数: 0

Advanced deep learning-based image reconstruction in lumbar spine MRI at 0.55 T – Effects on image quality and acquisition time in comparison to conventional deep learning-based reconstruction 0.55 T 下腰椎磁共振成像中基于深度学习的高级图像重建--与基于深度学习的传统重建相比对图像质量和采集时间的影响

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-04-30 DOI: 10.1016/j.ejro.2024.100567

Felix Schlicht , Jan Vosshenrich , Ricardo Donners , Alina Carolin Seifert , Matthias Fenchel , Dominik Nickel , Markus Obmann , Dorothee Harder , Hanns-Christian Breit

Objectives

To evaluate an optimized deep leaning-based image post-processing technique in lumbar spine MRI at 0.55 T in terms of image quality and image acquisition time.

Materials and methods

Lumbar spine imaging was conducted on 18 patients using a 0.55 T MRI scanner, employing conventional (CDLR) and advanced (ADLR) deep learning-based post-processing techniques. Two musculoskeletal radiologists visually evaluated the images using a 5-point Likert scale to assess image quality and resolution. Quantitative assessment in terms of signal intensities (SI) and contrast ratios was performed by region of interest measurements in different body-tissues (vertebral bone, intervertebral disc, spinal cord, cerebrospinal fluid and autochthonous back muscles) to investigate differences between CDLR and ADLR sequences.

Results

The images processed with the advanced technique (ADLR) were rated superior to the conventional technique (CDLR) in terms of signal/contrast, resolution, and assessability of the spinal canal and neural foramen. The interrater agreement was moderate for signal/contrast (ICC = 0.68) and good for resolution (ICC = 0.77), but moderate for spinal canal and neuroforaminal assessability (ICC = 0.55). Quantitative assessment showed a higher contrast ratio for fluid-sensitive sequences in the ADLR images. The use of ADLR reduced image acquisition time by 44.4%, from 14:22 min to 07:59 min.

Conclusions

Advanced deep learning-based image reconstruction algorithms improve the visually perceived image quality in lumbar spine imaging at 0.55 T while simultaneously allowing to substantially decrease image acquisition times.

Clinical relevance

Advanced deep learning-based image post-processing techniques (ADLR) in lumbar spine MRI at 0.55 T significantly improves image quality while reducing image acquisition time.

材料和方法使用 0.55 T MRI 扫描仪对 18 名患者进行了腰椎成像，采用了基于深度学习的传统（CDLR）和高级（ADLR）后处理技术。两名肌肉骨骼放射科医生使用 5 点李克特量表对图像进行目测评估，以评估图像质量和分辨率。通过对不同的身体组织（椎骨、椎间盘、脊髓、脑脊液和自体背部肌肉）进行感兴趣区测量，对信号强度（SI）和对比度比率进行定量评估，以研究 CDLR 和 ADLR 序列之间的差异。结果使用高级技术（ADLR）处理的图像在信号/对比度、分辨率以及椎管和神经孔的可评估性方面均优于传统技术（CDLR）。在信号/对比度（ICC = 0.68）和分辨率（ICC = 0.77）方面，检查者之间的一致性为中等，但在椎管和神经孔的可评估性（ICC = 0.55）方面，检查者之间的一致性为中等。定量评估显示，ADLR图像中流体敏感序列的对比度更高。结论基于深度学习的高级图像重建算法提高了 0.55 T 腰椎成像的视觉感知图像质量，同时大幅缩短了图像采集时间。临床相关性基于深度学习的高级图像后处理技术（ADLR）在 0.55 T 腰椎 MRI 中的应用显著提高了图像质量，同时缩短了图像采集时间。

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引用次数: 0

Comparing 2-dimensional versus 3-dimensional MR myelography for cerebrospinal fluid leak detection 比较二维与三维磁共振脊髓造影在脑脊液漏检测中的应用

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-04-25 DOI: 10.1016/j.ejro.2024.100565

Iichiro Osawa , Takashi Mitsufuji , Keita Nagawa , Yuki Hara , Toshimasa Yamamoto , Nobuo Araki , Eito Kozawa

Purpose

We compared cerebrospinal fluid (CSF) leak conspicuity and image quality as visualized using 3D versus 2D magnetic resonance (MR) myelography in patients with spinal CSF leaks.

Methods

Eighteen patients underwent spinal MR imaging at 3 Tesla. Three board-certified radiologists independently evaluated CSF leak conspicuity and image quality on a 4-point scale; the latter assessed by scoring fat suppression, venous visualization, and severity of CSF flow artifacts. Additionally, the evaluators ranked the overall performances of 2D versus 3D MR myelography upon completing side-by-side comparisons of CSF leak conspicuity. Inter-reader agreement was determined using the Gwet’s AC1.

Results

The quality of 3D MR myelography images was significantly better than that of 2D MR myelography with respect to CSF leak conspicuity (mean scores: 3.3 vs. 1.9, p < 0.0001) and severity of CSF flow artifacts on the axial view (mean scores: 1.0 vs. 2.5, p = 0.0001). Inter-reader agreement was moderate to almost perfect for 2D MR myelography (AC1 = 0.55–1.00), and almost perfect for 3D MR myelography (AC1 = 0.85–1.00). Moreover, 3D MR myelography was judged to be superior to 2D acquisition in 78 %, 83 %, and 83 % of the samples per readers 1, 2 and 3, respectively; the inter-reader agreement was almost perfect (AC1: reader 1 vs. 2; 0.98, reader 2 vs. 3; 0.96, reader 3 vs. 1; 0.98).

Conclusion

CSF leaks are more conspicuous when using 3D MR myelography than when using its 2D counterpart; therefore, the former is more reliable for identifying such leaks.

目的我们比较了脊髓脑脊液（CSF）漏患者使用三维与二维磁共振（MR）髓核造影所观察到的脑脊液（CSF）漏的清晰度和图像质量。三位经委员会认证的放射科医生以 4 分制独立评估 CSF 漏的明显程度和图像质量；后者通过对脂肪抑制、静脉显像和 CSF 流伪影的严重程度进行评分来评估。此外，评估人员在完成脑脊液漏显影并排比较后，对二维与三维 MR 髓造影的整体性能进行了排名。结果在CSF漏的清晰度（平均分：3.3 vs. 1.9，p <0.0001）和轴向视图上CSF血流伪影的严重程度（平均分：1.0 vs. 2.5，p = 0.0001）方面，三维MR髓核造影图像的质量明显优于二维MR髓核造影。二维磁共振脊髓造影的读片者间一致性为中等至几乎完美（AC1 = 0.55-1.00），三维磁共振脊髓造影的读片者间一致性为几乎完美（AC1 = 0.85-1.00）。此外，三维磁共振髓核造影在读者1、2和3的样本中分别有78%、83%和83%被判定优于二维采集；读者间的一致性几乎完美（AC1：读者1 vs. 2；0.98，读者2 vs. 3；0.96，读者3 vs. 1；0.98）。

{"title":"Comparing 2-dimensional versus 3-dimensional MR myelography for cerebrospinal fluid leak detection","authors":"Iichiro Osawa , Takashi Mitsufuji , Keita Nagawa , Yuki Hara , Toshimasa Yamamoto , Nobuo Araki , Eito Kozawa","doi":"10.1016/j.ejro.2024.100565","DOIUrl":"https://doi.org/10.1016/j.ejro.2024.100565","url":null,"abstract":"<div><h3>Purpose</h3><p>We compared cerebrospinal fluid (CSF) leak conspicuity and image quality as visualized using 3D versus 2D magnetic resonance (MR) myelography in patients with spinal CSF leaks.</p></div><div><h3>Methods</h3><p>Eighteen patients underwent spinal MR imaging at 3 Tesla. Three board-certified radiologists independently evaluated CSF leak conspicuity and image quality on a 4-point scale; the latter assessed by scoring fat suppression, venous visualization, and severity of CSF flow artifacts. Additionally, the evaluators ranked the overall performances of 2D versus 3D MR myelography upon completing side-by-side comparisons of CSF leak conspicuity. Inter-reader agreement was determined using the Gwet’s AC1.</p></div><div><h3>Results</h3><p>The quality of 3D MR myelography images was significantly better than that of 2D MR myelography with respect to CSF leak conspicuity (mean scores: 3.3 vs. 1.9, <em>p</em> < 0.0001) and severity of CSF flow artifacts on the axial view (mean scores: 1.0 vs. 2.5, <em>p</em> = 0.0001). Inter-reader agreement was moderate to almost perfect for 2D MR myelography (AC1 = 0.55–1.00), and almost perfect for 3D MR myelography (AC1 = 0.85–1.00). Moreover, 3D MR myelography was judged to be superior to 2D acquisition in 78 %, 83 %, and 83 % of the samples per readers 1, 2 and 3, respectively; the inter-reader agreement was almost perfect (AC1: reader 1 vs. 2; 0.98, reader 2 vs. 3; 0.96, reader 3 vs. 1; 0.98).</p></div><div><h3>Conclusion</h3><p>CSF leaks are more conspicuous when using 3D MR myelography than when using its 2D counterpart; therefore, the former is more reliable for identifying such leaks.</p></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352047724000200/pdfft?md5=df7496bb249ecf4943a1c38acd785ecd&pid=1-s2.0-S2352047724000200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140643968","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

Machine learning approaches in the prediction of positive axillary lymph nodes post neoadjuvant chemotherapy using MRI, CT, or ultrasound: A systematic review 使用 MRI、CT 或超声波预测新辅助化疗后腋窝淋巴结阳性的机器学习方法：系统综述

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-04-24 DOI: 10.1016/j.ejro.2024.100561

Shirin Yaghoobpoor , Mobina Fathi , Hamed Ghorani , Parya Valizadeh , Payam Jannatdoust , Arian Tavasol , Melika Zarei , Arvin Arian

Background and objective

Neoadjuvant chemotherapy is a standard treatment approach for locally advanced breast cancer. Conventional imaging modalities, such as magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound, have been used for axillary lymph node evaluation which is crucial for treatment planning and prognostication. This systematic review aims to comprehensively examine the current research on applying machine learning algorithms for predicting positive axillary lymph nodes following neoadjuvant chemotherapy utilizing imaging modalities, including MRI, CT, and ultrasound.

Methods

A systematic search was conducted across databases, including PubMed, Scopus, and Web of Science, to identify relevant studies published up to December 2023. Articles employing machine learning algorithms to predict positive axillary lymph nodes using MRI, CT, or ultrasound data after neoadjuvant chemotherapy were included. The review follows the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, encompassing data extraction and quality assessment.

Results

Seven studies were included, comprising 1502 patients. Four studies used MRI, two used CT, and one applied ultrasound. Two studies developed deep-learning models, while five used classic machine-learning models mainly based on multiple regression. Across the studies, the models showed high predictive accuracy, with the best-performing models combining radiomics and clinical data.

Conclusion

This systematic review demonstrated the potential of utilizing advanced data analysis techniques, such as deep learning radiomics, in improving the prediction of positive axillary lymph nodes in breast cancer patients following neoadjuvant chemotherapy.

背景和目的新辅助化疗是局部晚期乳腺癌的标准治疗方法。磁共振成像（MRI）、计算机断层扫描（CT）和超声波等常规成像模式已被用于腋窝淋巴结评估，这对治疗计划和预后至关重要。本系统性综述旨在全面考察当前利用机器学习算法预测新辅助化疗后腋窝淋巴结阳性的研究，这些算法利用的成像模式包括核磁共振成像、计算机断层扫描和超声。纳入了采用机器学习算法利用新辅助化疗后的 MRI、CT 或超声数据预测腋窝淋巴结阳性的文章。综述遵循系统综述和荟萃分析（PRISMA）指南的首选报告项目，包括数据提取和质量评估。四项研究使用了核磁共振成像，两项使用了 CT，一项使用了超声波。两项研究开发了深度学习模型，五项研究使用了主要基于多元回归的经典机器学习模型。结论这项系统性综述展示了利用深度学习放射组学等先进数据分析技术改善新辅助化疗后乳腺癌患者腋窝淋巴结阳性预测的潜力。

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引用次数: 0

Diagnostic performance of different imaging modalities for splenic malignancies: A comparative meta-analysis 不同成像模式对脾脏恶性肿瘤的诊断效果：比较荟萃分析

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-04-22 DOI: 10.1016/j.ejro.2024.100566

Parya Valizadeh , Payam Jannatdoust , Mohammadreza Tahamtan , Hamed Ghorani , Soroush Soleimani Dorcheh , Khashayar Farnoud , Faeze Salahshour

Background and objectives

The spleen hosts both benign and malignant lesions. Despite multiple imaging modalities, the distinction between these lesions poses a diagnostic challenge, marked by varying diagnostic accuracy levels across methods. In this study, we aimed to evaluate and compare the diagnostic performance of various imaging techniques for detecting malignant splenic lesions.

Methods

Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Sciences databases for studies evaluating imaging techniques in detecting malignant splenic lesions. Data extraction included diagnostic accuracy metrics, and methodological quality was assessed using QUADAS-2. Diagnostic Test Accuracy meta-analyses were conducted using R (version: 4.2.1). Subgroup analyses and meta-regression were performed to compare different modalities and clinical settings.

Results

Our study included 28 studies (pooled sample size: 2358), primarily using retrospective designs with histopathology as the reference standard. PET scan demonstrated the highest diagnostic accuracy (AUC: 92 %), demonstrating a sensitivity of 93 % (95 % CI: 80.4 % - 97.7 %) and a specificity of 82.8 % (95 % CI: 71.1 % - 90.4 %). Contrast-enhanced ultrasound (CEUS), Contrast-enhanced CT scan, and contrast-enhanced MRI also showed impressive performance with AUCs of 91.4 %, 90.9 %, and 85.3 %, respectively. Differences among these modalities were not statistically significant, but they outperformed non-contrast-enhanced methods. PET and CEUS exhibited higher specificity for lymphoma cases compared to studies including other malignancies.

Conclusion and clinical implications

Overall, PET emerges as the best modality for splenic malignancies, and CEUS and CE-MRI show promise as potential alternatives, notably due to their reduced radiation exposure. Further research is essential for precise malignancy differentiation.

背景和目的脾脏同时存在良性和恶性病变。尽管有多种成像模式，但如何区分这些病变仍是一个诊断难题，不同方法的诊断准确率也不尽相同。在本研究中，我们旨在评估和比较各种成像技术在检测恶性脾脏病变方面的诊断性能。方法按照 PRISMA 指南，我们检索了 PubMed、Scopus 和 Web of Sciences 数据库中评估成像技术在检测恶性脾脏病变方面的研究。数据提取包括诊断准确性指标，方法学质量采用 QUADAS-2 进行评估。诊断测试准确性荟萃分析使用 R（版本：4.2.1）进行。我们的研究纳入了 28 项研究（汇总样本量：2358 个），主要采用回顾性设计，以组织病理学为参考标准。PET 扫描的诊断准确率最高（AUC：92%），灵敏度为 93%（95% CI：80.4% - 97.7%），特异性为 82.8%（95% CI：71.1% - 90.4%）。对比增强超声波 (CEUS)、对比增强 CT 扫描和对比增强 MRI 的 AUC 分别为 91.4%、90.9% 和 85.3%，同样表现出色。这些模式之间的差异没有统计学意义，但它们都优于非对比增强方法。与包括其他恶性肿瘤的研究相比，PET 和 CEUS 对淋巴瘤病例具有更高的特异性。进一步的研究对于精确区分恶性肿瘤至关重要。

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引用次数: 0

Narrow band imaging-based radiogenomics for predicting radiosensitivity in nasopharyngeal carcinoma 基于窄带成像的放射基因组学预测鼻咽癌的放射敏感性

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-04-20 DOI: 10.1016/j.ejro.2024.100563

Cheng-Wei Tie , Xin Dong , Ji-Qing Zhu , Kai Wang , Xu-Dong Liu , Yu-Meng Liu , Gui-Qi Wang , Ye Zhang , Xiao-Guang Ni

Objectives

This study aims to assess the efficacy of narrow band imaging (NBI) endoscopy in utilizing radiomics for predicting radiosensitivity in nasopharyngeal carcinoma (NPC), and to explore the associated molecular mechanisms.

Materials

The study included 57 NPC patients who were pathologically diagnosed and underwent RNA sequencing. They were categorized into complete response (CR) and partial response (PR) groups after receiving radical concurrent chemoradiotherapy. We analyzed 267 NBI images using ResNet50 for feature extraction, obtaining 2048 radiomic features per image. Using Python for deep learning and least absolute shrinkage and selection operator for feature selection, we identified differentially expressed genes associated with radiomic features. Subsequently, we conducted enrichment analysis on these genes and validated their roles in the tumor immune microenvironment through single-cell RNA sequencing.

Results

After feature selection, 54 radiomic features were obtained. The machine learning algorithm constructed from these features showed that the random forest algorithm had the highest average accuracy rate of 0.909 and an area under the curve of 0.961. Correlation analysis identified 30 differential genes most closely associated with the radiomic features. Enrichment and immune infiltration analysis indicated that tumor-associated macrophages are closely related to treatment responses. Three key NBI differentially expressed immune genes (NBI-DEIGs), namely CCL8, SLC11A1, and PTGS2, were identified as regulators influencing treatment responses through macrophages.

Conclusion

NBI-based radiomics models introduce a novel and effective method for predicting radiosensitivity in NPC. The molecular mechanisms may involve the functional states of macrophages, as reflected by key regulatory genes.

本研究旨在评估窄带成像（NBI）内窥镜在利用放射组学预测鼻咽癌（NPC）放射敏感性方面的功效，并探讨相关的分子机制。他们在接受根治性同期放化疗后被分为完全反应组（CR）和部分反应组（PR）。我们使用 ResNet50 对 267 幅 NBI 图像进行了特征提取分析，每幅图像获得了 2048 个放射学特征。我们使用 Python 进行深度学习，并使用最小绝对收缩和选择算子进行特征选择，从而确定了与放射学特征相关的差异表达基因。随后，我们对这些基因进行了富集分析，并通过单细胞 RNA 测序验证了它们在肿瘤免疫微环境中的作用。根据这些特征构建的机器学习算法显示，随机森林算法的平均准确率最高，为 0.909，曲线下面积为 0.961。相关性分析确定了 30 个与放射学特征最密切相关的差异基因。富集和免疫浸润分析表明，肿瘤相关巨噬细胞与治疗反应密切相关。三个关键的 NBI 差异表达免疫基因（NBI-DEIGs），即 CCL8、SLC11A1 和 PTGS2，被确定为通过巨噬细胞影响治疗反应的调节因子。其分子机制可能涉及关键调控基因所反映的巨噬细胞功能状态。

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引用次数: 0

Modified respiratory-triggered SPACE sequences for magnetic resonance cholangiopancreatography 用于磁共振胰胆管造影的改良呼吸触发 SPACE 序列

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-04-20 DOI: 10.1016/j.ejro.2024.100564

Dayong Jin , Xin Li , Yifan Qian, Yanqiang Qiao, Liyao Liu, Juan Tian, Lei Wang, Yongli Ma, Yue Qin, Yinhu Zhu

Background

Respiratory-triggered (RT) and breath-hold are the most common acquisition modalities for magnetic resonance cholangiopancreatography (MRCP). The present study compared the three different acquisition modalities for optimizing the use of MRCP in patients with diseases of the pancreatic and biliary systems.

Materials and methods

Three MRCP acquisition modalities were used in this study: conventional respiratory-triggered sampling perfection with application-optimized contrasts using different flip evolutions (RT-SPACE), modified RT-SPACE, and breath-hold (BH)-SPACE. Fifty-eight patients with clinically suspected pancreatic and biliary system disease were included. All image data were acquired on a 1.5 T MR. Scan time and image quality were compared between the three acquisition modalities. Friedman test, which was followed by post-hoc analysis, was performed among triple-scan protocol.

Results

There was a significant difference in the mean acquisition time among conventional RT-SPACE, modified RT-SPACE, and BH-SPACE (167.41±32.11 seconds vs 50.84±73.78 seconds vs 18.00 seconds, P <0.001). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also significantly different among the three groups (P <0.001). The SNR and CNR were higher in the RT-SPACE group than in the BH-SPACE group (P <0.05). However, there were no statistically significant differences (P >0.05) among the 3 groups regarding quality of overall image, image clarity, background inhibition, and visualization of the pancreatic and biliary system.

Conclusions

MRCP acquisition with the modified RT-SPACE sequence greatly shortens the acquisition time with comparable quality images. The MRCP acquisition modality could be designed based on the patient's situation to improve the examination pass rate and obtain excellent images for diagnosis.

背景吸气触发（RT）和屏气是磁共振胰胆管造影（MRCP）最常用的采集模式。本研究比较了三种不同的采集模式，以优化 MRCP 在胰腺和胆道系统疾病患者中的应用。材料和方法本研究使用了三种 MRCP 采集模式：传统的呼吸触发采样完善模式，并使用不同的翻转演化（RT-SPACE）进行应用优化对比度；改良的 RT-SPACE 和屏气（BH）-SPACE。研究对象包括 58 名临床疑似胰腺和胆道系统疾病患者。所有图像数据均通过 1.5 T MR 采集。比较了三种采集模式的扫描时间和图像质量。结果传统 RT-SPACE、改良 RT-SPACE 和 BH-SPACE 的平均采集时间有显著差异（167.41±32.11 秒 vs 50.84±73.78 秒 vs 18.00 秒，P <0.001）。三组的信噪比（SNR）和对比度-信噪比（CNR）也有显著差异（P <0.001）。RT-SPACE 组的 SNR 和 CNR 均高于 BH-SPACE 组（P <0.05）。结论使用改良的 RT-SPACE 序列进行 MRCP 采集大大缩短了采集时间，但图像质量相当。可以根据患者的情况设计 MRCP 采集模式，以提高检查通过率，获得优质的诊断图像。

{"title":"Modified respiratory-triggered SPACE sequences for magnetic resonance cholangiopancreatography","authors":"Dayong Jin , Xin Li , Yifan Qian, Yanqiang Qiao, Liyao Liu, Juan Tian, Lei Wang, Yongli Ma, Yue Qin, Yinhu Zhu","doi":"10.1016/j.ejro.2024.100564","DOIUrl":"https://doi.org/10.1016/j.ejro.2024.100564","url":null,"abstract":"<div><h3>Background</h3><p>Respiratory-triggered (RT) and breath-hold are the most common acquisition modalities for magnetic resonance cholangiopancreatography (MRCP). The present study compared the three different acquisition modalities for optimizing the use of MRCP in patients with diseases of the pancreatic and biliary systems.</p></div><div><h3>Materials and methods</h3><p>Three MRCP acquisition modalities were used in this study: conventional respiratory-triggered sampling perfection with application-optimized contrasts using different flip evolutions (RT-SPACE), modified RT-SPACE, and breath-hold (BH)-SPACE. Fifty-eight patients with clinically suspected pancreatic and biliary system disease were included. All image data were acquired on a 1.5 T MR. Scan time and image quality were compared between the three acquisition modalities. Friedman test, which was followed by post-hoc analysis, was performed among triple-scan protocol.</p></div><div><h3>Results</h3><p>There was a significant difference in the mean acquisition time among conventional RT-SPACE, modified RT-SPACE, and BH-SPACE (167.41±32.11 seconds vs 50.84±73.78 seconds vs 18.00 seconds, <em>P</em> <0.001). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also significantly different among the three groups (<em>P</em> <0.001). The SNR and CNR were higher in the RT-SPACE group than in the BH-SPACE group (<em>P</em> <0.05). However, there were no statistically significant differences (<em>P</em> >0.05) among the 3 groups regarding quality of overall image, image clarity, background inhibition, and visualization of the pancreatic and biliary system.</p></div><div><h3>Conclusions</h3><p>MRCP acquisition with the modified RT-SPACE sequence greatly shortens the acquisition time with comparable quality images. The MRCP acquisition modality could be designed based on the patient's situation to improve the examination pass rate and obtain excellent images for diagnosis.</p></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352047724000194/pdfft?md5=8f0fdf9ade75eed9c21ff5242b0a3319&pid=1-s2.0-S2352047724000194-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140622315","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

Reproducing RECIST lesion selection via machine learning: Insights into intra and inter-radiologist variation 通过机器学习再现 RECIST 病灶选择：透视放射医师内部和医师之间的差异

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-04-17 DOI: 10.1016/j.ejro.2024.100562

Teresa M. Tareco Bucho , Liliana Petrychenko , Mohamed A. Abdelatty , Nino Bogveradze , Zuhir Bodalal , Regina G.H. Beets-Tan , Stefano Trebeschi

Background

The Response Evaluation Criteria in Solid Tumors (RECIST) aims to provide a standardized approach to assess treatment response in solid tumors. However, discrepancies in the selection of measurable and target lesions among radiologists using these criteria pose a significant limitation to their reproducibility and accuracy. This study aimed to understand the factors contributing to this variability.

Methods

Machine learning models were used to replicate, in parallel, the selection process of measurable and target lesions by two radiologists in a cohort of 40 patients from an internal pan-cancer dataset. The models were trained on lesion characteristics such as size, shape, texture, rank, and proximity to other lesions. Ablation experiments were conducted to evaluate the impact of lesion diameter, volume, and rank on the selection process.

Results

The models successfully reproduced the selection of measurable lesions, relying primarily on size-related features. Similarly, the models reproduced target lesion selection, relying mostly on lesion rank. Beyond these features, the importance placed by different radiologists on different visual characteristics can vary, specifically when choosing target lesions. Worth noting that substantial variability was still observed between radiologists in both measurable and target lesion selection.

Conclusions

Despite the successful replication of lesion selection, our results still revealed significant inter-radiologist disagreement. This underscores the necessity for more precise guidelines to standardize lesion selection processes and minimize reliance on individual interpretation and experience as a means to bridge existing ambiguities.

背景实体瘤反应评估标准（RECIST）旨在提供一种评估实体瘤治疗反应的标准化方法。然而，放射科医生在使用这些标准选择可测量病灶和靶病灶时存在差异，严重限制了这些标准的可重复性和准确性。本研究旨在了解造成这种差异的因素。方法使用机器学习模型平行复制两位放射科医生从内部泛癌症数据集中的 40 位患者中选择可测量病灶和靶病灶的过程。这些模型是根据病灶特征（如大小、形状、纹理、等级以及与其他病灶的接近程度）进行训练的。进行了消融实验，以评估病灶直径、体积和等级对选择过程的影响。结果模型成功地再现了对可测量病灶的选择，主要依赖于与大小相关的特征。同样，模型重现了目标病变的选择，主要依赖于病变的等级。除了这些特征外，不同放射科医生对不同视觉特征的重视程度也会有所不同，特别是在选择目标病灶时。值得注意的是，在可测量病灶和目标病灶的选择上，放射科医生之间仍然存在很大的差异。这突出表明，有必要制定更精确的指南来规范病灶选择过程，并尽量减少对个人解释和经验的依赖，以此来消除现有的模糊性。

{"title":"Reproducing RECIST lesion selection via machine learning: Insights into intra and inter-radiologist variation","authors":"Teresa M. Tareco Bucho , Liliana Petrychenko , Mohamed A. Abdelatty , Nino Bogveradze , Zuhir Bodalal , Regina G.H. Beets-Tan , Stefano Trebeschi","doi":"10.1016/j.ejro.2024.100562","DOIUrl":"https://doi.org/10.1016/j.ejro.2024.100562","url":null,"abstract":"<div><h3>Background</h3><p>The Response Evaluation Criteria in Solid Tumors (RECIST) aims to provide a standardized approach to assess treatment response in solid tumors. However, discrepancies in the selection of measurable and target lesions among radiologists using these criteria pose a significant limitation to their reproducibility and accuracy. This study aimed to understand the factors contributing to this variability.</p></div><div><h3>Methods</h3><p>Machine learning models were used to replicate, in parallel, the selection process of measurable and target lesions by two radiologists in a cohort of 40 patients from an internal pan-cancer dataset. The models were trained on lesion characteristics such as size, shape, texture, rank, and proximity to other lesions. Ablation experiments were conducted to evaluate the impact of lesion diameter, volume, and rank on the selection process.</p></div><div><h3>Results</h3><p>The models successfully reproduced the selection of measurable lesions, relying primarily on size-related features. Similarly, the models reproduced target lesion selection, relying mostly on lesion rank. Beyond these features, the importance placed by different radiologists on different visual characteristics can vary, specifically when choosing target lesions. Worth noting that substantial variability was still observed between radiologists in both measurable and target lesion selection.</p></div><div><h3>Conclusions</h3><p>Despite the successful replication of lesion selection, our results still revealed significant inter-radiologist disagreement. This underscores the necessity for more precise guidelines to standardize lesion selection processes and minimize reliance on individual interpretation and experience as a means to bridge existing ambiguities.</p></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352047724000170/pdfft?md5=af783b599123985e9f85386304718a03&pid=1-s2.0-S2352047724000170-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140558728","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

Evaluation of multi-parameter MRI in preoperative staging of endometrial carcinoma 评估多参数磁共振成像在子宫内膜癌术前分期中的应用

IF 2 Q2 Medicine

European Journal of Radiology Open

Pub Date : 2024-03-23 DOI: 10.1016/j.ejro.2024.100559

Lianbi Zhang, Liqiong Liu

Background

Endometrial carcinoma (EC) is a prevalent gynecological malignancy, necessitating accurate preoperative staging for effective treatment planning. This study explores the application value of multi-parameter MRI in diagnosing and staging endometrial cancer.

Methods

Seventy-six patients diagnosed with endometrial cancer underwent 3.0 T pelvic MRI within two weeks before surgery. Imaging data were analyzed based on FIGO clinical staging criteria. The study assessed the sensitivity, specificity, positive predictive value, and negative predictive value of MRI for each stage.

Results

Postoperative pathology confirmed 71 cases of endometrial adenocarcinoma, 3 serous adenocarcinoma, and 2 clear cell carcinomas. MRI staging showed a high consistency (Kappa value = 0.786) with postoperative pathology. The overall accuracy of MRI diagnosis was 86.8%. Sensitivity and specificity varied for each stage: IA (91.3%, 96.2%), IB (88.6%, 93.8%), II (97.4%, 89.2%), and III (84.2%, 100%).

Conclusion

While there was a slight misdiagnosis rate, the overall accuracy of preoperative MRI for endometrial cancer was high, aiding in precise diagnosis and clinical staging. MRI effectively identified myometrial infiltration, cervical involvement, paracentral extension, and lymph node metastasis. Further research with larger sample sizes is recommended for enhanced reliability.

背景子宫内膜癌（EC）是一种常见的妇科恶性肿瘤，需要准确的术前分期以制定有效的治疗计划。本研究探讨了多参数磁共振成像在子宫内膜癌诊断和分期中的应用价值。方法76例确诊为子宫内膜癌的患者在术前两周内接受了3.0 T盆腔磁共振成像。根据 FIGO 临床分期标准对成像数据进行分析。研究评估了磁共振成像对每个分期的敏感性、特异性、阳性预测值和阴性预测值。结果术后病理证实 71 例子宫内膜腺癌、3 例浆液性腺癌和 2 例透明细胞癌。核磁共振分期与术后病理结果显示高度一致（Kappa值=0.786）。MRI 诊断的总体准确率为 86.8%。各分期的敏感性和特异性各不相同：IA（91.3%，96.2%）、IB（88.6%，93.8%）、II（97.4%，89.2%）和III（84.2%，100%）。磁共振成像能有效识别子宫肌层浸润、宫颈受累、宫旁延伸和淋巴结转移。建议进一步开展样本量更大的研究，以提高可靠性。

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引用次数: 0