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

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。

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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

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

Automatic measurement of Caton index on knee X-ray images using a key point detection model 基于关键点检测模型的膝关节x线图像卡顿指数自动测量

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-09-20 DOI: 10.1016/j.ejro.2025.100687

Ting Li , Nadeer M. Gharaibeh , Gang Wu

Purpose

To explore the feasibility of the You Only Look Once (YOLO) algorithm in the measurement of Carton index.

Methods

1156 knee X-ray images were collected from two centers (960 and 196). Five key points at patella and tibia on knee X-ray were labeled using the software of Labelme. YOLO11 pose models (including YOLO11n, YOLO11m and YOLO11x) were refined by labeled images from center A, and was then used to detect keypoints on images from center B. A line was the line between anterior edge of the tibial plateau and the lower pole of patellar articular surface, and B line was patellar articular surface. Carton index (A/B ratio) of 196 cases was obtained by senior radiologist, junior radiologist and YOLO respectively. The Bland Altman plot, Pearson Correlation test, Mean Absolute Error (MAE) and Intra-class correlation coefficient (ICC) were used to evaluate the agreement in measurement.

Results

Carton index of 196 images were automatically obtained with YOLO11n-pose, YOLO11m-pose and YOLO11x-pose. The ICC between senior and junior radiologists was 0.89. Pearson correlation coefficients were 0.23, 0.43 and 0.73 respectively for YOLO11n, YOLO11m and YOLO11x. ICC were 0.23, 0.42 and 0.72 respectively for YOLO11n, YOLO11m and YOLO11x. MAE were 0.20, 0.17 and 0.10 respectively for YOLO11n, YOLO11m and YOLO11x.

Conclusions

YOLO11x-pose model shows promise in the automatic measurement of Carton index on the knee X-ray image.

目的探讨“You Only Look Once （YOLO）”算法在纸箱指标测量中的可行性。方法从两个中心（960和196）采集膝关节x线片1156张。采用Labelme软件标记膝关节x线髌骨和胫骨的5个关键点。通过A中心的标记图像对YOLO11位姿模型（包括YOLO11n、YOLO11m和YOLO11x）进行精细处理，然后检测B中心图像上的关键点。A线为胫骨平台前缘与髌骨关节面下极之间的直线，B线为髌骨关节面。196例患者分别由高级放射科医师、初级放射科医师和YOLO获得卡尔顿指数（A/B比）。采用Bland Altman图、Pearson相关检验、平均绝对误差（MAE）和类内相关系数（ICC）评价测量一致性。结果采用YOLO11n-pose、YOLO11m-pose和YOLO11x-pose自动获取196幅图像的卡尔顿指数。高级和初级放射科医师之间的ICC为0.89。YOLO11n、YOLO11m和YOLO11x的Pearson相关系数分别为0.23、0.43和0.73。YOLO11n、YOLO11m和YOLO11x的ICC分别为0.23、0.42和0.72。YOLO11n、YOLO11m和YOLO11x的MAE分别为0.20、0.17和0.10。结论syolo11x -pose模型在膝关节x线图像的卡尔顿指数自动测量中具有较好的应用前景。

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引用次数: 0

A quantitative CT perfusion-derived online dynamic nomogram for predicting hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke 预测急性缺血性脑卒中静脉溶栓后出血转化的定量CT灌注衍生在线动态图

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-09-16 DOI: 10.1016/j.ejro.2025.100685

Yanping Zheng , Peirong Jiang , Xiuzhu Xu , Liwei Xue , Jialin Chen , Yunjing Xue

Purpose

To evaluate the diagnostic value of cerebral perfusion and its predictive ability of hemorrhagic transformation (HT) in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT) using CT perfusion (CTP).

Methods

Retrospective cohort of 55 AIS patients who underwent CTP before IVT was included. Clinical information, such as the National Institutes of Health Stroke Scale (NIHSS) score and history of atrial fibrillation (AF), were collected. CTP parameters, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), permeability surface area product (PS), time-to-maximum (Tmax), time to peak (TTP), were measured in pathological hemispheres. Relative values (rCBV, rCBF, rMTT, rPS, rTmax, rTTP) were calculated as pathological-to-asymptomatic hemisphere ROI ratios. Comparisons between HT and non-HT groups were conducted using Student’s t-Test and Mann-Whitney U test. ROC curve and Logistic regression analysis were used to evaluate model predictive values. Delong's test compared AUC differences among parameters. Dynamic nomogram model was constructed with R-shiny and evaluated.

Results

NIHSS score at admission, NIHSS score before IVT, NIHSS score after IVT, NIHSS score at discharge, AF, PS and rPS were significantly higher than those in the non-HT group (p < 0.005). ROC curve and logistic regression analyses revealed that the combined model including NIHSS score before IVT, AF, and rPS displayed the highest AUC of 0.899 (95 % CI:0.814,0.984; p < 0.001).

Conclusion

Dynamic nomogram model combined NIHSS score before IVT, AF and rPS may act as a real-time visualization tool in the prediction of HT risk after IVT in patients with AIS.

目的探讨CT灌注（CTP）对急性缺血性脑卒中（AIS）静脉溶栓（IVT）后脑灌注的诊断价值及其对出血转化（HT）的预测能力。方法回顾性分析55例IVT前行CTP的AIS患者。收集临床信息，如美国国立卫生研究院卒中量表（NIHSS）评分和房颤（AF）史。在病理半球测量CTP参数，包括脑血流量（CBF）、脑血容量（CBV）、平均传递时间（MTT）、通透性表面积积（PS）、到达最大时间（Tmax）、到达峰值时间（TTP）。相对数值（rCBV, rCBF, rMTT, rPS, rTmax, rTTP）计算为病理与无症状半球ROI比率。HT组与非HT组的比较采用Student’s t检验和Mann-Whitney U检验。采用ROC曲线和Logistic回归分析评价模型预测值。Delong的测试比较了参数之间的AUC差异。用R-shiny建立动态模态图模型并进行评价。结果入院时NIHSS评分、IVT前NIHSS评分、IVT后NIHSS评分、出院时NIHSS评分、AF、PS、rPS均显著高于非ht组（p <； 0.005）。ROC曲线和logistic回归分析显示，包括IVT、AF和rPS前NIHSS评分的联合模型的AUC最高，为0.899（95 % CI:0.814,0.984; p <； 0.001）。结论动态图模型结合IVT前NIHSS评分、AF和rPS可作为预测AIS患者IVT后HT风险的实时可视化工具。

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引用次数: 0

Value of dynamic contrast-enhanced MRI in the diagnosis of acute radiation-induced rectal injury in patients with rectal cancer: A comparison with endoscopy 动态增强MRI在直肠癌急性放射性直肠损伤诊断中的价值：与内镜的比较

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-09-08 DOI: 10.1016/j.ejro.2025.100684

Wen-jie Fan , Yu-ru Ma , Quan-meng Liu , Ning Zhang , Yi-yan Liu , Zi-qiang Wen , Bao-lan Lu , Jian-peng Yuan , Shen-ping Yu , Yan Chen

Objectives

To investigate the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) quantitative parameters in acute radiation-induced rectal injury (RRI) among patients with rectal cancer.

Methods

This retrospective study included patients confirmed to rectal cancer who underwent rectal MRI (including a DCE-MRI sequence) and endoscopy after neoadjuvant chemoradiotherapy from November 2014 to July 2022. The enrolled patients were divided into an acute RRI group and a non-acute RRI group based on Vienna rectoscopy score. Two radiologists independently measured DCE-MRI quantitative parameters (including the forward volume transfer constant [K^trans], rate constant [k_ep], and fractional extravascular extracellular space volume [v_e]) and thickness of rectal wall. Receiver operating characteristic curve analysis was performed to analyze statistically significant parameters.

Results

Forty-nine patients (median age, 58 years; interquartile range, 14 years; 34 men) were enrolled, 28 of whom were in the acute RRI group. K^trans in patients with acute RRI was significantly lower compared to those without acute RRI (0.049 min⁻¹ vs 0.107 min⁻¹; P < 0.001). The area under the receiver operating characteristic curve of K^trans was 0.80. With a K^trans cutoff value of 0.079 min⁻¹, the sensitivity and specificity were 93 % and 67 %, respectively.

Conclusion

K^trans demonstrated moderate performance in diagnosing acute RRI, providing a non-invasive and objective basis for managing and treating rectal cancer patients with acute RRI.

目的探讨动态对比增强MRI （DCE-MRI）定量参数对直肠癌急性放射性直肠损伤（RRI）的诊断价值。方法回顾性研究纳入2014年11月至2022年7月新辅助放化疗后行直肠MRI（包括DCE-MRI序列）和内镜检查的确诊直肠癌患者。根据维也纳直肠镜评分将入组患者分为急性RRI组和非急性RRI组。两名放射科医师独立测量了DCE-MRI定量参数（包括正向体积传递常数[Ktrans]、速率常数[keep]、血管外细胞外空间体积分数[ve]）和直肠壁厚度。进行受试者工作特征曲线分析，分析具有统计学意义的参数。结果纳入49例患者（中位年龄58岁，四分位间距14岁，男性34例），其中28例为急性RRI组。急性RRI患者的Ktrans明显低于非急性RRI患者（0.049 min−1 vs 0.107 min−1;P <； 0.001）。Ktrans的受者工作特性曲线下面积为0.80。Ktrans截止值为0.079 min−1，敏感性和特异性分别为93 %和67 %。结论ktrans在诊断急性RRI方面表现中等，为直肠癌急性RRI患者的管理和治疗提供了无创、客观的依据。

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引用次数: 0

Non-invasive diagnostic value of pericoronary fat attenuation index for identifying culprit lesions in acute coronary syndrome 冠状动脉脂肪衰减指数对急性冠状动脉综合征罪魁祸首病变的无创诊断价值

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-09-05 DOI: 10.1016/j.ejro.2025.100682

Fengfeng Yang , Zhengyang Li , Haoran Cai, Jing Zhu, Huijia Liu, Yang Zhao

Objectives

This study aimed to determine the efficacy of fat attenuation index (FAI) as a non-invasive diagnostic tool in the precise identification of culprit lesions in individuals diagnosed with acute coronary syndrome (ACS).

Methods

A retrospective analysis of 230 patients with non-ST-segment elevation ACS. PCAT attenuation (FAI_standard) was measured in the proximal 40-mm segment of each major coronary artery. Furthermore, the average PCAT attenuation of the identified lesions was designated as FAI_lesion. The average PCAT attenuation across the complete length of coronary artery, referred to as FAI_average, was computed. Plaque characteristics (volume, composition) were analyzed via coronary computed tomography angiography. Multivariable logistic regression identified predictors of culprit lesions, and diagnostic performance was assessed using area under the curve (AUC) and decision curve analysis.

Results

Culprit lesions exhibited significantly elevated levels of PCAT attenuation across the parameters of FAI_standard, FAI_average, and FAI_lesion. FAI_lesion demonstrated superior diagnostic accuracy versus FAI_standard and FAI_average, and also emerged as the strongest independent predictor (Odds ratio = 2.598, P < 0.001). In training and test sets, a composite model integrating FAI_lesion with additional indices demonstrated enhanced diagnostic efficacy for the detection of culprit lesions in patients with ACS (AUC = 0.960, 0.803). Low-attenuation plaque volume (<30 HU) was independently associated with culprit lesions (OR = 3.12, P = 0.002).

Conclusion

FAI_lesion, a superior non-invasive biomarker for high-risk ACS lesions compared to traditional FAI, enables earlier precise risk stratification through clinical integration.

目的本研究旨在确定脂肪衰减指数（FAI）作为一种非侵入性诊断工具在诊断为急性冠脉综合征（ACS）的个体中精确识别罪魁祸首病变的有效性。方法对230例非st段抬高ACS患者进行回顾性分析。在每条主要冠状动脉近40mm段测量PCAT衰减（FAIstandard）。此外，确定病变的平均PCAT衰减被指定为FAIlesion。计算冠状动脉全长度的平均PCAT衰减，称为FAIaverage。通过冠状动脉ct血管造影分析斑块特征（体积、组成）。多变量逻辑回归确定了罪魁祸首病变的预测因素，并使用曲线下面积（AUC）和决策曲线分析评估了诊断效果。结果在FAIstandard、FAIaverage和FAIlesion参数中，sculprit病变的PCAT衰减水平均显著升高。与FAIstandard和FAIaverage相比，FAIlesion表现出更高的诊断准确性，并且也是最强的独立预测因子（优势比= 2.598,P <； 0.001）。在训练集和测试集中，将FAIlesion与其他指标相结合的复合模型对ACS患者的罪魁祸首病变的诊断效果增强（AUC = 0.960, 0.803）。低衰减斑块体积（<30 HU）与罪魁祸首病变独立相关（OR = 3.12, P = 0.002）。结论与传统FAI相比，failesion是一种更好的非侵入性ACS高危病变生物标志物，通过临床整合，可以更早地进行精确的风险分层。

{"title":"Non-invasive diagnostic value of pericoronary fat attenuation index for identifying culprit lesions in acute coronary syndrome","authors":"Fengfeng Yang , Zhengyang Li , Haoran Cai, Jing Zhu, Huijia Liu, Yang Zhao","doi":"10.1016/j.ejro.2025.100682","DOIUrl":"10.1016/j.ejro.2025.100682","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to determine the efficacy of fat attenuation index (FAI) as a non-invasive diagnostic tool in the precise identification of culprit lesions in individuals diagnosed with acute coronary syndrome (ACS).</div></div><div><h3>Methods</h3><div>A retrospective analysis of 230 patients with non-ST-segment elevation ACS. PCAT attenuation (FAI<sub>standard</sub>) was measured in the proximal 40-mm segment of each major coronary artery. Furthermore, the average PCAT attenuation of the identified lesions was designated as FAI<sub>lesion</sub>. The average PCAT attenuation across the complete length of coronary artery, referred to as FAI<sub>average</sub>, was computed. Plaque characteristics (volume, composition) were analyzed via coronary computed tomography angiography. Multivariable logistic regression identified predictors of culprit lesions, and diagnostic performance was assessed using area under the curve (AUC) and decision curve analysis.</div></div><div><h3>Results</h3><div>Culprit lesions exhibited significantly elevated levels of PCAT attenuation across the parameters of FAI<sub>standard</sub>, FAI<sub>average</sub>, and FAI<sub>lesion</sub>. FAI<sub>lesion</sub> demonstrated superior diagnostic accuracy versus FAI<sub>standard</sub> and FAI<sub>average</sub>, and also emerged as the strongest independent predictor (Odds ratio = 2.598, P < 0.001). In training and test sets, a composite model integrating FAI<sub>lesion</sub> with additional indices demonstrated enhanced diagnostic efficacy for the detection of culprit lesions in patients with ACS (AUC = 0.960, 0.803). Low-attenuation plaque volume (<30 HU) was independently associated with culprit lesions (OR = 3.12, P = 0.002).</div></div><div><h3>Conclusion</h3><div>FAI<sub>lesion</sub>, a superior non-invasive biomarker for high-risk ACS lesions compared to traditional FAI, enables earlier precise risk stratification through clinical integration.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100682"},"PeriodicalIF":2.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996333","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

Combined predictive model for prostate cancer screening: Development and validation study 前列腺癌筛查的联合预测模型：开发和验证研究

IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open

Pub Date : 2025-09-04 DOI: 10.1016/j.ejro.2025.100683

Yu Li , Fang Yang , Xuebin Liu , Jiping Luo , Siyu Dan , Xiuli He , Guihao Hu , Ling He , Xiachuan Qin , Tao Wu , Wensheng Yue

Background

Early detection of prostate cancer (PCa) remains challenging, as prostate-specific antigen (PSA) testing and digital rectal examination (DRE) offer limited specificity. Transrectal ultrasound (TRUS) is routinely used for biopsy guidance, but its diagnostic potential for PCa screening is underexplored. We aimed to evaluate TRUS-derived morphological features and develop a nomogram that integrates clinical and TRUS characteristics to improve PCa risk stratification.

Methods

Consecutive patients with suspected PCa were enrolled from two tertiary centers (training cohort: n = 154, October 2021–January 2023; validation cohort: n = 51, December 2021–June 2022). Demographic data, laboratory-derived PSA indices (including PSA density), and TRUS parameters (independently assessed by two blinded sonographers) were collected and analyzed. A predictive nomogram was constructed using multivariate logistic regression and externally validated.

Results

In the training cohort (mean age 70.9 ± 8.0 years; 72 PCa, 82 benign), independent predictors of PCa included elevated PSA density (OR=3.86, 95 % CI: 1.30–11.40, P = 0.015), abnormal DRE (OR=3.06, 95 % CI: 1.09–8.60, P = 0.034), TRUS-defined ill-defined zone boundaries (OR=9.61, 95 % CI: 3.37–39.02, P = 0.002), and hyper-enhancement (OR=7.07, 95 % CI: 2.69–21.89, P < 0.001). The nomogram achieved strong discrimination (training C-index=0.933, 95 % CI: 0.881–0.986; validation C-index=0.907, 95 % CI: 0.792–0.970) with 84.7 % sensitivity, 87.8 % specificity, and 86.4 % accuracy. Pathological concordance was high (kappa=0.726).

Conclusion

TRUS-derived features (ill-defined zones, hyper-enhancement) significantly enhance PCa detection when combined with clinical parameters. Our nomogram provides a practical, visual tool to guide biopsy decisions and demonstrates robust performance across cohorts.

背景前列腺癌（PCa）的检测仍然具有挑战性，因为前列腺特异性抗原（PSA）检测和直肠指检（DRE）的特异性有限。经直肠超声（TRUS）通常用于活检指导，但其在前列腺癌筛查中的诊断潜力尚未得到充分探索。我们的目的是评估TRUS衍生的形态学特征，并开发一个整合临床和TRUS特征的nomogram，以改善PCa的风险分层。方法从两个三级中心连续招募疑似PCa患者（培训队列：n = 154,2021年10月- 2023年1月；验证队列：n = 51,2021年12月- 2022年6月）。收集和分析人口统计数据、实验室衍生的PSA指数（包括PSA密度）和TRUS参数（由两名盲法超声医师独立评估）。采用多元逻辑回归构建预测模态图，并进行外部验证。ResultsIn训练队列(平均年龄70.9 ± 8.0年;72 PCa, 82良性),PCa的独立预测因子包括高PSA密度(或= 3.86,95 % CI: 1.30 - -11.40, P = 0.015),异常DRE(或= 3.06,95 % CI: 1.09 - -8.60, P = 0.034),TRUS-defined模糊区边界(或= 9.61,95 % CI: 3.37 - -39.02, P = 0.002),和hyper-enhancement(或= 7.07,95 % CI: 2.69 - -21.89, P & lt; 0.001)。nomogram具有较强的判别性（training C-index=0.933, 95 % CI: 0.881-0.986; validation C-index=0.907, 95 % CI: 0.792-0.970）， sensitivity为84.7 %，specificity为87.8 %，accuracy为86.4 %。病理一致性高（kappa=0.726）。结论trus衍生特征（区域不清、超增强）结合临床参数可显著提高前列腺癌的检出率。我们的图提供了一个实用的、可视化的工具来指导活检的决定，并在队列中展示了强大的性能。

{"title":"Combined predictive model for prostate cancer screening: Development and validation study","authors":"Yu Li , Fang Yang , Xuebin Liu , Jiping Luo , Siyu Dan , Xiuli He , Guihao Hu , Ling He , Xiachuan Qin , Tao Wu , Wensheng Yue","doi":"10.1016/j.ejro.2025.100683","DOIUrl":"10.1016/j.ejro.2025.100683","url":null,"abstract":"<div><h3>Background</h3><div>Early detection of prostate cancer (PCa) remains challenging, as prostate-specific antigen (PSA) testing and digital rectal examination (DRE) offer limited specificity. Transrectal ultrasound (TRUS) is routinely used for biopsy guidance, but its diagnostic potential for PCa screening is underexplored. We aimed to evaluate TRUS-derived morphological features and develop a nomogram that integrates clinical and TRUS characteristics to improve PCa risk stratification.</div></div><div><h3>Methods</h3><div>Consecutive patients with suspected PCa were enrolled from two tertiary centers (training cohort: n = 154, October 2021–January 2023; validation cohort: n = 51, December 2021–June 2022). Demographic data, laboratory-derived PSA indices (including PSA density), and TRUS parameters (independently assessed by two blinded sonographers) were collected and analyzed. A predictive nomogram was constructed using multivariate logistic regression and externally validated.</div></div><div><h3>Results</h3><div>In the training cohort (mean age 70.9 ± 8.0 years; 72 PCa, 82 benign), independent predictors of PCa included elevated PSA density (OR=3.86, 95 % CI: 1.30–11.40, <em>P</em> = 0.015), abnormal DRE (OR=3.06, 95 % CI: 1.09–8.60, <em>P</em> = 0.034), TRUS-defined ill-defined zone boundaries (OR=9.61, 95 % CI: 3.37–39.02, <em>P</em> = 0.002), and hyper-enhancement (OR=7.07, 95 % CI: 2.69–21.89, <em>P</em> < 0.001). The nomogram achieved strong discrimination (training C-index=0.933, 95 % CI: 0.881–0.986; validation C-index=0.907, 95 % CI: 0.792–0.970) with 84.7 % sensitivity, 87.8 % specificity, and 86.4 % accuracy. Pathological concordance was high (kappa=0.726).</div></div><div><h3>Conclusion</h3><div>TRUS-derived features (ill-defined zones, hyper-enhancement) significantly enhance PCa detection when combined with clinical parameters. Our nomogram provides a practical, visual tool to guide biopsy decisions and demonstrates robust performance across cohorts.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100683"},"PeriodicalIF":2.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996474","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