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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 Pub Date : 2025-12-01 Epub 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 [Ktrans], rate constant [kep], and fractional extravascular extracellular space volume [ve]) 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. Ktrans 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 Ktrans was 0.80. With a Ktrans cutoff value of 0.079 min−1, the sensitivity and specificity were 93 % and 67 %, respectively.

Conclusion

Ktrans 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。
{"title":"Value of dynamic contrast-enhanced MRI in the diagnosis of acute radiation-induced rectal injury in patients with rectal cancer: A comparison with endoscopy","authors":"Wen-jie Fan ,&nbsp;Yu-ru Ma ,&nbsp;Quan-meng Liu ,&nbsp;Ning Zhang ,&nbsp;Yi-yan Liu ,&nbsp;Zi-qiang Wen ,&nbsp;Bao-lan Lu ,&nbsp;Jian-peng Yuan ,&nbsp;Shen-ping Yu ,&nbsp;Yan Chen","doi":"10.1016/j.ejro.2025.100684","DOIUrl":"10.1016/j.ejro.2025.100684","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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 [<em>K</em><sup>trans</sup>], rate constant [<em>k</em><sub>ep</sub>], and fractional extravascular extracellular space volume [<em>v</em><sub>e</sub>]) and thickness of rectal wall. Receiver operating characteristic curve analysis was performed to analyze statistically significant parameters.</div></div><div><h3>Results</h3><div>Forty-nine patients (median age, 58 years; interquartile range, 14 years; 34 men) were enrolled, 28 of whom were in the acute RRI group. <em>K</em><sup>trans</sup> in patients with acute RRI was significantly lower compared to those without acute RRI (0.049 min<sup>−1</sup> vs 0.107 min<sup>−1</sup>; <em>P</em> &lt; 0.001). The area under the receiver operating characteristic curve of <em>K</em><sup>trans</sup> was 0.80. With a <em>K</em><sup>trans</sup> cutoff value of 0.079 min<sup>−1</sup>, the sensitivity and specificity were 93 % and 67 %, respectively.</div></div><div><h3>Conclusion</h3><div><em>K</em><sup>trans</sup> demonstrated moderate performance in diagnosing acute RRI, providing a non-invasive and objective basis for managing and treating rectal cancer patients with acute RRI.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100684"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018466","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
Cardiac MRI-derived ventricular-pulmonary arterial coupling predicts outcomes in connective tissue disease-associated pulmonary arterial hypertension patients 心脏mri衍生的心室-肺动脉耦合预测结缔组织病相关肺动脉高压患者的预后
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-01 Epub Date: 2025-11-05 DOI: 10.1016/j.ejro.2025.100700
Yidan Zhu , Ke Xu , Han Jia , Wangyan Liu , Xiaoxuan Sun , Qiang Wang , Yi Xu , Yinsu Zhu

Objectives

To evaluate the prognostic value of cardiovascular magnetic resonance (CMR) parameters in patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH).

Materials and methods

This retrospective cohort study involved 135 patients with documented CTD-PAH. Cardiac functional parameters including right ventricle end-diastolic volume index (RVEDVI), end-systolic volume index (RVESVI), stroke volume index (RVSVI), ejection fraction (RVEF), and SV/ESV; the volumetric parameter; T1 mapping and late gadolinium enhancement (LGE) parameters; strain parameters like RV global longitudinal strain(GLS); and hemodynamics parameters like mean velocity at the pulmonary artery (mvPA) and PA relative area change (PA RAC) were calculated from CMR images. Survival analysis was conducted using Kaplan–Meier and Cox regression. The endpoint was the occurrence of clinical deterioration events.

Results

The median follow-up time was 22.27 months (interquartile range: 11.5–31.9 months).RVIP ECV, RVGLS, RVEDVI, RVESVI, RVMI, and RAA, as well as mvPA, SV/ESV, RVEF, and PA RAC, were associated with adverse outcomes. SV/ESV ≤ 0.55, RV GLS > -12.1 %, and PA RAC≤ 16.1 % were significant independent predictors of prognosis. The combined parameters provided incremental prognostic value over COMPERA 2.0 (area under the curve (AUC) from 0.771 to 0.899; P = 0.001).And time-dependent ROC curve confirmed the predictive efficiency of the combined parameters in year 3, with the AUC reaching 0.821(95 % CI: 0.698–0.945).

Conclusion

Multiparametric CMR provides a non-invasive, efficient method to assess prognosis in CTD-PAH patients. Key parameters including SV/ESV, RV GLS, and PA RAC significantly predicted survival and confer incremental prognostic utility over COMPERA 2.0, offering reliable prognostic markers for clinical interventions.
目的评价心血管磁共振(CMR)参数对结缔组织病相关性肺动脉高压(CTD-PAH)患者的预后价值。材料和方法本回顾性队列研究纳入135例有记录的CTD-PAH患者。心功能参数包括右心室舒张末期容积指数(RVEDVI)、收缩末期容积指数(RVESVI)、卒中容积指数(RVSVI)、射血分数(RVEF)和SV/ESV;体积参数;T1成像和晚期钆增强(LGE)参数;RV整体纵向应变(GLS)等应变参数;根据CMR图像计算肺动脉平均流速(mvPA)、肺动脉相对面积变化(PA RAC)等血流动力学参数。生存率分析采用Kaplan-Meier和Cox回归。终点是临床恶化事件的发生。结果中位随访时间为22.27个月(四分位数差为11.5 ~ 31.9个月)。RVIP、ECV、RVGLS、RVEDVI、RVESVI、RVMI和RAA,以及mvPA、SV/ESV、RVEF和PA RAC与不良结局相关。SV/ESV≤ 0.55,RV GLS >; -12.1 %,PA RAC≤ 16.1 %是预后的显著独立预测因子。综合参数在COMPERA 2.0上提供了增量预后价值(曲线下面积(AUC)从0.771到0.899; = 0.001页)。随时间变化的ROC曲线证实了联合参数在第3年的预测效率,AUC达到0.821(95 % CI: 0.698-0.945)。结论多参数CMR是一种无创、有效的评估CTD-PAH患者预后的方法。关键参数包括SV/ESV、RV GLS和PA RAC显著预测生存,并赋予比COMPERA 2.0更大的预后效用,为临床干预提供可靠的预后指标。
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引用次数: 0
Diagnostic accuracy of MRI radiomics in predicting lymph node metastasis in prostate cancer: A systematic review MRI放射组学预测前列腺癌淋巴结转移的诊断准确性:系统综述
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-01 Epub Date: 2025-07-28 DOI: 10.1016/j.ejro.2025.100673
Alireza Teymouri , Mohammad Saeid Khonji , Parisa Alaghi , Sina Azadnajafabad , Ava Teymouri , Sina Delazar

Purpose

Prostate cancer (PCa) is frequently associated with pelvic lymph node metastasis (PLNM), which may be missed by conventional imaging, particularly in micrometastatic disease. MRI-based radiomics offers potential to improve detection. This review evaluates recent advancements and diagnostic accuracy of MRI radiomics for predicting PLNM in PCa patients.

Methods

PubMed, Embase, and Web of Science were systematically searched through January 1, 2025, using terms like “prostate cancer,” “radiomics,” and “pelvic lymph node metastasis.” Eligible studies were assessed using the Radiomics Quality Score (RQS). Study characteristics and performance metrics were narratively synthesized. Pooled area under the receiver operating characteristic curve (AUC) was calculated for PLNM prediction in studies using prostate as regions of interest (ROI), reported with 95 % confidence intervals (CI); p-value < 0.05 was considered significant.

Results

Nine studies (2021–2024) involving 2344 PCa patients were included. Radiomics models using prostate as ROI achieved a pooled AUC of 0.78 (95 %CI: 0.72–0.84) with mild heterogeneity (I² = 19.81 %, p < 0.38). Models with lymph nodes as ROI showed AUCs of 0.93–0.95. Integrating imaging reports and clinical data often improved diagnostic accuracy. Radiomics outperformed clinical nomograms in five studies, although the difference was insignificant in one study (p > 0.05). Median RQS was 16/36; studies lacked prospective design and cost-effectiveness analysis.

Conclusion

MRI radiomics predicts PLNM with moderate accuracy, particularly when using pelvic lymph nodes as ROI. Standardized protocols, feature extraction, and clinical data integration are crucial for consistency. Prospective studies with larger cohorts are needed to validate these findings.
目的前列腺癌(PCa)常与盆腔淋巴结转移(PLNM)相关,这可能被常规影像学所遗漏,特别是在微转移性疾病中。基于核磁共振的放射组学提供了改进检测的潜力。本文综述了MRI放射组学预测PCa患者PLNM的最新进展和诊断准确性。方法使用“前列腺癌”、“放射组学”和“盆腔淋巴结转移”等术语,系统地检索到2025年1月1日的spubmed、Embase和Web of Science。使用放射组学质量评分(RQS)对符合条件的研究进行评估。叙述性地综合了研究特点和绩效指标。在使用前列腺作为感兴趣区域(ROI)的研究中,计算受试者工作特征曲线(AUC)下的汇总面积,以95% %置信区间(CI)进行PLNM预测;p值<; 0.05被认为是显著的。结果纳入9项研究(2021-2024),涉及2344例PCa患者。使用前列腺作为ROI的放射组学模型的合并AUC为0.78(95 %CI: 0.72-0.84),具有轻度异质性(I²= 19.81 %,p <; 0.38)。以淋巴结为ROI的模型auc为0.93 ~ 0.95。将影像学报告和临床资料相结合通常可以提高诊断的准确性。放射组学在五项研究中优于临床形态图,尽管其中一项研究的差异不显著(p >; 0.05)。中位RQS为16/36;研究缺乏前瞻性设计和成本-效果分析。结论mri放射组学预测PLNM具有中等准确性,特别是当使用盆腔淋巴结作为ROI时。标准化的协议、特征提取和临床数据整合对于一致性至关重要。需要更大规模的前瞻性研究来验证这些发现。
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引用次数: 0
Improvement of machine learning models for predicting high-grade subtypes of lung adenocarcinoma based on delta radiomics: A multicenter cohort study 基于放射组学的预测肺腺癌高级别亚型的机器学习模型的改进:一项多中心队列研究
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-01 Epub Date: 2025-11-01 DOI: 10.1016/j.ejro.2025.100699
Feiyang Zhong , Ting Li , Wenping Li , Lijun Wu , Pengju Zhang , Pengxin Yu , Yuan Fang , Meiyan Liao , Shaohong Zhao

Objectives

To evaluate the effectiveness of delta radiomics in predicting high-grade components in lung adenocarcinoma and to develop a robust machine learning model for clinical application.

Methods

This retrospective multi-center cohort study included lung cancer patients from three hospitals who had pre-surgery CT follow-up scans. Training (n = 491) and validation (n = 210) were performed using cases from Center 1, and testing was conducted using cases from Centers 2 and 3 (n = 92). Radiomic features were extracted from baseline and follow-up CT images, and delta radiomic features were calculated. The LASSO algorithm was used for radiomic feature selection, and rad-score and delta rad-score were constructed. Significant clinical and radiomic features were combined to build the final machine learning model. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), DeLong test, decision curve analysis (DCA), and integrated discrimination improvement (IDI) analysis.

Results

In the external test cohort, the integrated machine learning model constructed based on clinical features (CTR, smoking status, maximum diameter of the solid component), rad-score, and delta rad-score showed that the random forest model performed the best, with an AUC of 0.91. The random forest model outperformed the clinical model (AUC = 0.80), rad-score (AUC = 0.79), and delta rad-score (AUC = 0.81). DCA and IDI indicated that the random forest model provides superior clinical benefit and improvement.

Conclusion

Delta radiomics significantly aids in identifying high-grade subtypes of lung adenocarcinoma. The integrated machine learning model offers an effective approach for prediction of high-grade components, with potential clinical implications.

Clinical Relevance Statement

This study presents a novel application of delta radiomics to predict high-grade lung adenocarcinoma, which may influence surgical management and improve patient outcomes.
目的评估δ放射组学在预测肺腺癌高级别成分中的有效性,并为临床应用开发一个强大的机器学习模型。方法回顾性多中心队列研究纳入三家医院的肺癌患者术前CT随访扫描。使用中心1的病例进行训练(n = 491)和验证(n = 210),使用中心2和3的病例进行测试(n = 92)。从基线和随访CT图像中提取放射学特征,并计算δ放射学特征。采用LASSO算法进行放射学特征选择,并构造rad-score和delta rad-score。将重要的临床和放射学特征结合起来构建最终的机器学习模型。采用受试者工作特征曲线下面积(AUC)、DeLong检验、决策曲线分析(DCA)和综合判别改进(IDI)分析对模型性能进行评价。结果在外部测试队列中,基于临床特征(CTR、吸烟状况、实体成分最大直径)、rad-score和delta rad-score构建的综合机器学习模型显示随机森林模型表现最好,AUC为0.91。随机森林模型优于临床模型(AUC = 0.80)、rad-score (AUC = 0.79)和delta rad-score (AUC = 0.81)。DCA和IDI表明随机森林模型具有较好的临床疗效和改善效果。结论delta放射组学在鉴别肺腺癌高级别亚型中具有重要的辅助作用。集成的机器学习模型为预测高级成分提供了有效的方法,具有潜在的临床意义。临床相关性声明本研究提出了delta放射组学预测高级别肺腺癌的新应用,这可能会影响手术治疗并改善患者预后。
{"title":"Improvement of machine learning models for predicting high-grade subtypes of lung adenocarcinoma based on delta radiomics: A multicenter cohort study","authors":"Feiyang Zhong ,&nbsp;Ting Li ,&nbsp;Wenping Li ,&nbsp;Lijun Wu ,&nbsp;Pengju Zhang ,&nbsp;Pengxin Yu ,&nbsp;Yuan Fang ,&nbsp;Meiyan Liao ,&nbsp;Shaohong Zhao","doi":"10.1016/j.ejro.2025.100699","DOIUrl":"10.1016/j.ejro.2025.100699","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effectiveness of delta radiomics in predicting high-grade components in lung adenocarcinoma and to develop a robust machine learning model for clinical application.</div></div><div><h3>Methods</h3><div>This retrospective multi-center cohort study included lung cancer patients from three hospitals who had pre-surgery CT follow-up scans. Training (n = 491) and validation (n = 210) were performed using cases from Center 1, and testing was conducted using cases from Centers 2 and 3 (n = 92). Radiomic features were extracted from baseline and follow-up CT images, and delta radiomic features were calculated. The LASSO algorithm was used for radiomic feature selection, and rad-score and delta rad-score were constructed. Significant clinical and radiomic features were combined to build the final machine learning model. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), DeLong test, decision curve analysis (DCA), and integrated discrimination improvement (IDI) analysis.</div></div><div><h3>Results</h3><div>In the external test cohort, the integrated machine learning model constructed based on clinical features (CTR, smoking status, maximum diameter of the solid component), rad-score, and delta rad-score showed that the random forest model performed the best, with an AUC of 0.91. The random forest model outperformed the clinical model (AUC = 0.80), rad-score (AUC = 0.79), and delta rad-score (AUC = 0.81). DCA and IDI indicated that the random forest model provides superior clinical benefit and improvement.</div></div><div><h3>Conclusion</h3><div>Delta radiomics significantly aids in identifying high-grade subtypes of lung adenocarcinoma. The integrated machine learning model offers an effective approach for prediction of high-grade components, with potential clinical implications.</div></div><div><h3>Clinical Relevance Statement</h3><div>This study presents a novel application of delta radiomics to predict high-grade lung adenocarcinoma, which may influence surgical management and improve patient outcomes.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100699"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416106","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
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 Pub Date : 2025-12-01 Epub 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
<div><h3>Background</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Result</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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。
{"title":"A systematic review and meta-analysis of imaging characteristics and upgrade rates in noninvasive lobular neoplasia of the breast","authors":"Fatemeh Shakki Katouli ,&nbsp;Negin Salehi ,&nbsp;Faezeh Soveyzi ,&nbsp;Mina Abedi ,&nbsp;Parya Valizadeh ,&nbsp;Hamed Ghorani ,&nbsp;Seyedeh Melika Hashemi ,&nbsp;Jayran Zebardast ,&nbsp;Madjid Shakiba ,&nbsp;Sadaf Alipour","doi":"10.1016/j.ejro.2025.100691","DOIUrl":"10.1016/j.ejro.2025.100691","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In conclusion this study highlights the significant prevalence of microcalcifications i","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100691"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319583","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
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 Pub Date : 2025-12-01 Epub 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
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 Pub Date : 2025-12-01 Epub 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":"2025-12-01","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
Segmentation of visceral and subcutaneous adipose tissue in abdominal CT-datasets with and without contrast medium: Influence of iterative reconstruction on 2D- and 3D-segmentation 有和没有造影剂的腹部ct数据集中内脏和皮下脂肪组织分割:迭代重建对二维和三维分割的影响
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-01 Epub Date: 2025-11-17 DOI: 10.1016/j.ejro.2025.100707
Robin F. Gohmann , Fyn Kaiser , Batuhan Temiz , Sebastian Gottschling , Christian Krieghoff , Christian Lücke , Matthias Horn , Matthias Gutberlet

Purpose

Segmentation of visceral and subcutaneous adipose tissue in computed tomography (CT) datasets has shown much promise in research and for medical applications, e.g. for risk stratification and guiding therapies. This study evaluates the influence of iterative reconstruction (IR) and filtered back projection (FBP) techniques on 2D- and 3D-segmentation of adipose tissue in CT images with and without contrast medium.

Methods

We retrospectively analyzed 31 patients to compare adipose tissue density and quantity between IR and FBP across different compartments and contrast phases. Segmentation was performed using a fixed threshold (-190 to -30 HU).

Results

Significant differences were observed in 2D-segmentation, particularly for visceral adipose tissue in non-enhanced scans (-0.54 ± 1.4 HU; p = 0.04) and subcutaneous adipose tissue in venous scans (-0.48 ± 1.2 HU; p = 0.03). In 3D-segmentation, subcutaneous adipose tissue density in venous scans was also lower with IR compared to FBP (-0.67 ± 1.2 HU; p = 0.004).

Conclusion

Adipose tissue segmentation between IR and FBP revealed minimal and only occasionally yields statistically significant differences in density and quantity across adipose tissue compartments and contrast phases. The observed differences were very small, casting doubt on their clinical relevance at the level of individual patients. However, even subtle systematic variations may warrant consideration in population-based studies or longitudinal research where methodological consistency is critical.
目的在计算机断层扫描(CT)数据集中分割内脏和皮下脂肪组织在研究和医学应用中显示出很大的前景,例如用于风险分层和指导治疗。本研究评估了迭代重建(IR)和滤波后投影(FBP)技术对有造影剂和无造影剂的CT图像中脂肪组织的2D和3d分割的影响。方法回顾性分析31例患者,比较IR和FBP在不同室室和对比期的脂肪组织密度和数量。使用固定阈值(-190至-30 HU)进行分割。结果两组在2d分割方面存在显著差异,尤其是非增强扫描时内脏脂肪组织(-0.54 ± 1.4 HU; p = 0.04)和静脉扫描时皮下脂肪组织(-0.48 ± 1.2 HU; p = 0.03)。在3d分割中,静脉扫描的皮下脂肪组织密度也比FBP低(-0.67 ± 1.2 HU; p = 0.004)。结论IR和FBP之间的脂肪组织分割显示,脂肪组织间隔和对比期的密度和数量差异很小,只是偶尔出现统计学意义上的差异。观察到的差异非常小,使人怀疑其在个体患者水平上的临床相关性。然而,在基于人群的研究或纵向研究中,即使是细微的系统变化也可能需要考虑,因为方法的一致性是至关重要的。
{"title":"Segmentation of visceral and subcutaneous adipose tissue in abdominal CT-datasets with and without contrast medium: Influence of iterative reconstruction on 2D- and 3D-segmentation","authors":"Robin F. Gohmann ,&nbsp;Fyn Kaiser ,&nbsp;Batuhan Temiz ,&nbsp;Sebastian Gottschling ,&nbsp;Christian Krieghoff ,&nbsp;Christian Lücke ,&nbsp;Matthias Horn ,&nbsp;Matthias Gutberlet","doi":"10.1016/j.ejro.2025.100707","DOIUrl":"10.1016/j.ejro.2025.100707","url":null,"abstract":"<div><h3>Purpose</h3><div>Segmentation of visceral and subcutaneous adipose tissue in computed tomography (CT) datasets has shown much promise in research and for medical applications, e.g. for risk stratification and guiding therapies. This study evaluates the influence of iterative reconstruction (IR) and filtered back projection (FBP) techniques on 2D- and 3D-segmentation of adipose tissue in CT images with and without contrast medium.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 31 patients to compare adipose tissue density and quantity between IR and FBP across different compartments and contrast phases. Segmentation was performed using a fixed threshold (-190 to -30 HU).</div></div><div><h3>Results</h3><div>Significant differences were observed in 2D-segmentation, particularly for visceral adipose tissue in non-enhanced scans (-0.54 ± 1.4 HU; <em>p</em> = 0.04) and subcutaneous adipose tissue in venous scans (-0.48 ± 1.2 HU; <em>p</em> = 0.03). In 3D-segmentation, subcutaneous adipose tissue density in venous scans was also lower with IR compared to FBP (-0.67 ± 1.2 HU; <em>p</em> = 0.004).</div></div><div><h3>Conclusion</h3><div>Adipose tissue segmentation between IR and FBP revealed minimal and only occasionally yields statistically significant differences in density and quantity across adipose tissue compartments and contrast phases. The observed differences were very small, casting doubt on their clinical relevance at the level of individual patients. However, even subtle systematic variations may warrant consideration in population-based studies or longitudinal research where methodological consistency is critical.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"15 ","pages":"Article 100707"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) for ablation of osteoid osteoma: Long-term results from 10 years of experience 磁共振引导聚焦超声手术(MRgFUS)消融类骨瘤:10年经验的长期结果
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-01 Epub Date: 2025-11-18 DOI: 10.1016/j.ejro.2025.100708
Francesco Arrigoni , Federico Bruno , Pierpaolo Palumbo , Luigi Rinvenuto , Mario Muselli , Roberto Calbi , Carmine Zoccali , Luigi Zugaro , Alessandra Splendiani , Antonio Barile , Ernesto Di Cesare
Osteoid Osteoma (OO) is a benign but extremely painful bone lesion, mostly treated using Radiofrequency Ablation with needle (RFA). Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is an alternative technique able to ablate without using needles or skin incisions. Given the scarcity of literature in this field, the purpose of this paper is to retrospectively analyze long-term results of MRgFUS treatments of OO and to investigate technical limits. This is a retrospective analysis of all the MRgFUS procedures performed in our institution to treat OOs. Demographic, clinical data, and morphological features were analyzed, looking for correlation between the clinical results and the morphological features. Sixty-seven procedures were analyzed. The success rate – intended as complete pain relief - was 91 %. Almost all the patients (60 out of 67) were followed up to 4 years. A thick bone cortex above the nidus (p.014) and a short distance between the nidus and the ultrasound source (p.002) were statistically linked to failure. No complications were recorded. This is the largest series of OO treated using MRgFUS even reported. The main strength of this study lies in its large sample size and the extended follow-up period for nearly all patients (4 years for 90 % of patients) which allow us to clearly confirm the safety and efficacy of this ablative technique. Moreover, exclusion criteria for this treatment modality are proposed, based on two causes of treatment failure identified during our procedures.
骨样骨瘤(OO)是一种良性但极其痛苦的骨病变,主要采用针射频消融(RFA)治疗。磁共振引导聚焦超声手术(MRgFUS)是一种替代技术,能够在不使用针头或皮肤切口的情况下消融。鉴于该领域文献匮乏,本文的目的是回顾性分析MRgFUS治疗OO的长期结果,并调查技术限制。这是一个回顾性分析在我们机构进行的所有MRgFUS程序来治疗OOs。分析人口学、临床资料和形态学特征,寻找临床结果与形态学特征之间的相关性。对67例手术进行了分析。成功率-预期完全缓解疼痛-为91 %。几乎所有患者(67例中有60例)随访4年。病灶上方较厚的骨皮质(p.014)和病灶与超声源之间较短的距离(p.002)在统计学上与失败有关。无并发症记录。这是有报道的使用MRgFUS治疗OO的最大系列。本研究的主要优势在于其大样本量和对几乎所有患者的延长随访期(90% %的患者为4年),这使我们能够清楚地确认这种消融技术的安全性和有效性。此外,根据在我们的程序中确定的治疗失败的两个原因,提出了这种治疗方式的排除标准。
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引用次数: 0
Clinical and MRI variables associated with close or positive margins during breast-conserving surgery using MRI projection mapping in breast carcinoma with nonmass enhancement 在非肿块增强的乳腺癌保乳手术中,MRI投影成像与边缘闭合或阳性相关的临床和MRI变量
IF 2.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-01 Epub Date: 2025-09-01 DOI: 10.1016/j.ejro.2025.100681
Maki Amano , Jun Ozeki , Yumi Koyama , Xiaoyan Tang , Fumi Nozaki , Mayumi Tani , Yasuo Amano

Purpose

To evaluate the utility of a magnetic resonance imaging (MRI) projection mapping system (PMS) for determining the resection lines during breast-conserving surgery (BCS) in patients with breast cancer presenting with nonmass enhancement (NME) and identify the clinical or MRI variables associated with close or positive margins.

Materials and methods

Forty-one patients with breast cancer exhibiting NME were enrolled. In the operating room, a maximum intensity projection image generated from supine MRI was projected onto the breast using a PMS, which employed a structured light method to measure the surface of the breast. Cancer contours delineated on the MRI-PMS, with an additional safety margin, served as the resection lines for cylindrical BCS. Margins were pathologically categorized as negative (> 2 mm), close (≤ 2 mm), or positive. The association between margin status and clinical or MRI variables was analyzed.

Results

Surgical margins were negative in 24 patients (58.5 %), close in 15 (36.6 %), and positive in 2 (4.9 %). There were significant differences in the maximum diameter of nonmass components (NMCs) shown by pathology, that of NME on MRI, and the discrepancy between the two diameters between patients with negative margin and those with close or positive margin (< 0.05 for all). Receiver operating characteristics revealed that threshold of 40 mm for NMEs provided high specificity of 91.7 %.

Conclusion

The MRI-PMS led to a low rate of positive margins during BCS in patients with breast cancer with NMEs. Large NMCs and NMEs are associated with positive or close margin.
目的评估磁共振成像(MRI)投影成像系统(PMS)在乳腺癌保乳手术(BCS)期间确定非肿块增强(NME)患者切除线的效用,并确定与边缘闭合或阳性相关的临床或MRI变量。材料与方法入选41例表现为NME的乳腺癌患者。在手术室中,使用PMS将仰卧位MRI产生的最大强度投影图像投影到乳房上,PMS采用结构光法测量乳房表面。在MRI-PMS上划定的肿瘤轮廓,具有额外的安全裕度,作为圆柱形BCS的切除线。切缘病理分类为阴性(≤2 mm)、接近(≤2 mm)或阳性。分析了切缘状态与临床或MRI变量之间的关系。结果手术切缘阴性24例(58.5% %),闭合15例(36.6 %),阳性2例(4.9 %)。病理显示的非肿块成分(NMCs)最大直径与MRI显示的NME最大直径、切缘阴性患者与切缘相近或阳性患者的最大直径差异均有统计学意义(均为0.05)。接受者工作特征显示,NMEs的阈值为40 mm,特异性为91.7 %。结论MRI-PMS可导致合并NMEs的乳腺癌患者BCS阳性切缘率低。大型nmc和NMEs与正边际或近边际相关。
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引用次数: 0
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European Journal of Radiology Open
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