Pub Date : 2025-12-01DOI: 10.1016/j.diii.2025.07.005
Steven P. Rowe , Linda C. Chu
{"title":"Volumetric tumor burden and liquid biopsy metrics as emerging biomarkers in solid cancer","authors":"Steven P. Rowe , Linda C. Chu","doi":"10.1016/j.diii.2025.07.005","DOIUrl":"10.1016/j.diii.2025.07.005","url":null,"abstract":"","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":"106 12","pages":"Pages 409-410"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this study was to evaluate baseline tumor burden from liquid biopsy (LB) and computed tomography (CT) as prognostic biomarkers and whether their combination refines stratification in metastatic solid cancers.
Materials and methods
This retrospective cohort study included 1065 patients. Eligible patients underwent LB and chest-abdomen-pelvis CT examination at baseline. Radiologists outlined lesions on the largest axial slice, and total tumor volume (TTV) was approximated in three dimensions. LB Tumor fraction (TF) ≥ 10 % was considered high. To assess combined prognostic power of LB and TTV, patients were divided into three groups according to LB (circulating tumor deoxyribonucleic acid [ctDNA] detectability and TF) and each group was further divided into two subgroups using TTV thresholds determined by Youden’s index. Overall survival (OS) analyses were performed using Cox proportional hazard models and Kaplan-Meier curves.
Results
A total of 560 patients (290 women and 270 men; median age, 61 years) with 31,314 annotated lesions were selected. The median OS was 11.28 months, and the median TTV was 96.68 cm3. The LB groups included patients with undetectable ctDNA (n = 102), patients with detectable ctDNA and low TF (n = 251), and patients with high TF (n = 207). Integrating TTV thresholds (18.7 cm3, 44.9 cm3, and 159.94 cm3) to LB groups significantly stratified the population on OS. Patients with undetectable ctDNA and TTV ≥ 18.7 cm3 had significantly shorter OS (median OS, 24.8 months) than those with TTV < 18.7 cm3 (median OS, > 35 months).
Conclusion
Combining baseline CT tumor burden with LB could be a valuable prognostic tool for stratifying patients with metastatic solid cancer.
{"title":"Baseline CT-derived tumor burden and liquid biopsy as biomarkers to predict survival in patients with metastatic solid cancer","authors":"Ghina Jardali , Littisha Lawrance , Lama Dawi , Jules Dupont , Othilie Gautier , Michèle Kind , Samy Ammari , Joya Hadchiti , Aurélie Choucair , Arnaud Bayle , Paul-Henry Cournède , Isabelle Borget , Serge Muller , François Bidault , Corinne Balleyguier , Antoine Hollebecque , Yohann Loriot , Filippo Gustavo Dall-Olio , Benjamin Besse , Ludovic Lacroix , Nathalie Lassau","doi":"10.1016/j.diii.2025.06.002","DOIUrl":"10.1016/j.diii.2025.06.002","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to evaluate baseline tumor burden from liquid biopsy (LB) and computed tomography (CT) as prognostic biomarkers and whether their combination refines stratification in metastatic solid cancers.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study included 1065 patients. Eligible patients underwent LB and chest-abdomen-pelvis CT examination at baseline. Radiologists outlined lesions on the largest axial slice, and total tumor volume (TTV) was approximated in three dimensions. LB Tumor fraction (TF) ≥ 10 % was considered high. To assess combined prognostic power of LB and TTV, patients were divided into three groups according to LB (circulating tumor deoxyribonucleic acid [ctDNA] detectability and TF) and each group was further divided into two subgroups using TTV thresholds determined by Youden’s index. Overall survival (OS) analyses were performed using Cox proportional hazard models and Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>A total of 560 patients (290 women and 270 men; median age, 61 years) with 31,314 annotated lesions were selected. The median OS was 11.28 months, and the median TTV was 96.68 cm<sup>3</sup>. The LB groups included patients with undetectable ctDNA (<em>n</em> = 102), patients with detectable ctDNA and low TF (<em>n</em> = 251), and patients with high TF (<em>n</em> = 207). Integrating TTV thresholds (18.7 cm<sup>3</sup>, 44.9 cm<sup>3</sup>, and 159.94 cm<sup>3</sup>) to LB groups significantly stratified the population on OS. Patients with undetectable ctDNA and TTV ≥ 18.7 cm<sup>3</sup> had significantly shorter OS (median OS, 24.8 months) than those with TTV < 18.7 cm<sup>3</sup> (median OS, > 35 months).</div></div><div><h3>Conclusion</h3><div>Combining baseline CT tumor burden with LB could be a valuable prognostic tool for stratifying patients with metastatic solid cancer.</div></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":"106 12","pages":"Pages 430-437"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.diii.2025.07.003
Jorge D. Oldan , Anurag Anugu , Md Zobaer Islam , Alireza Amindarolzarbi , Rudolf A. Werner , Martin G. Pomper , Lilja B. Solnes , Frankis Almaguel , Stergios Moschos , Benjamin L Viglianti , Steven P. Rowe
To date, prospective, pivotal clinical trials in the theranostic space have focused on specific disease states. Those include leveraging positron emission tomography (PET) findings to optimize the second-line use of 177Lu-DOTATATE in patients with metastatic and progressive neuroendocrine tumors or the use of prostate-specific membrane antigen (PSMA) PET findings to select patients with metastatic castration-resistant prostate cancer for treatment with 177Lu-PSMA-617. However, we are entering an era where a broader understanding of the expression patterns of a wide variety of targets is beginning to be understood. As an example, PSMA PET has shown potential utility in the imaging of clear cell renal cell carcinoma and other malignancies with high rates of neovascularity. Many of the theranostic agents in the pipeline are designed to bind against "pan-cancer" targets such as fibrinogen-activating protein or the C-X-C motif chemokine receptor 4, or targets that become over-expressed in a broad variety of cancer states, such as those that target carbonic anhydrase IX. Artificial intelligence methods will assist us in appropriately selecting patients and in delivering predictive and prognostic imaging biomarkers. Given the wide potential applicability of emerging theranostic agents, it will be incumbent upon the field to carefully design clinical trials that will lead to regulatory approvals that will, in turn, permit broad use across a number of cancer types. In our future clinical practices, we will evolve to leverage precision medicine to identify target expression and deliver appropriate theranostic agents that are not limited to a specific cell of origin or disease state.
{"title":"Theranostics 2.0: Target-driven, artificial intelligence-enabled cancer therapy across tumor types","authors":"Jorge D. Oldan , Anurag Anugu , Md Zobaer Islam , Alireza Amindarolzarbi , Rudolf A. Werner , Martin G. Pomper , Lilja B. Solnes , Frankis Almaguel , Stergios Moschos , Benjamin L Viglianti , Steven P. Rowe","doi":"10.1016/j.diii.2025.07.003","DOIUrl":"10.1016/j.diii.2025.07.003","url":null,"abstract":"<div><div>To date, prospective, pivotal clinical trials in the theranostic space have focused on specific disease states. Those include leveraging positron emission tomography (PET) findings to optimize the second-line use of <sup>177</sup>Lu-DOTATATE in patients with metastatic and progressive neuroendocrine tumors or the use of prostate-specific membrane antigen (PSMA) PET findings to select patients with metastatic castration-resistant prostate cancer for treatment with <sup>177</sup>Lu-PSMA-617. However, we are entering an era where a broader understanding of the expression patterns of a wide variety of targets is beginning to be understood. As an example, PSMA PET has shown potential utility in the imaging of clear cell renal cell carcinoma and other malignancies with high rates of neovascularity. Many of the theranostic agents in the pipeline are designed to bind against \"pan-cancer\" targets such as fibrinogen-activating protein or the C-X-C motif chemokine receptor 4, or targets that become over-expressed in a broad variety of cancer states, such as those that target carbonic anhydrase IX. Artificial intelligence methods will assist us in appropriately selecting patients and in delivering predictive and prognostic imaging biomarkers. Given the wide potential applicability of emerging theranostic agents, it will be incumbent upon the field to carefully design clinical trials that will lead to regulatory approvals that will, in turn, permit broad use across a number of cancer types. In our future clinical practices, we will evolve to leverage precision medicine to identify target expression and deliver appropriate theranostic agents that are not limited to a specific cell of origin or disease state.</div></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":"106 12","pages":"Pages 413-420"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.diii.2025.07.001
Christian Alejandro Hernandez-Fajardo , François Lux , Tristan Doussineau , Sandrine Dufort , Jean-Baptiste Langlois , Angele Houmeau , Agnieszka Gutwinska , Ramata Seydou Coulibaly , Antoine Robert , Geraldine Le Duc , Olivier Tillement , Philippe Douek , Salim Si-Mohamed
Purpose
The purpose of this study was to investigate the feasibility of using a gadolinium (Gd)-based ultrasmall rigid platform (USRP) for angiography imaging using color K-edge imaging with spectral photon-counting CT technology in a rabbit model.
Materials and methods
Ten atherosclerotic rabbits with a mean weight of 3.1 ± 0.5 (standard deviation) kg, underwent intravenous administration of an USRP solution (15 mL; 2.5 mL/s; 0.27 mol Gd3+/L). A sub-group of six rabbits also received gadoteric acid (7.8 mL; 1.4 mL/s; 0.5 mol Gd3+/L) for paired comparisons. Rabbits were imaged using a clinical SPCCT prototype (120 kVp; 100 mAs; 0.5-s rotation time; 1.17 pitch). The whole aorta was scanned 6 s post-injection (first pass), followed by abdominal scanning at 30 s, 1-, 3- and 10 min. Two-readers assigned aneurysm grades (expressed as a % vessel dilatation). Median, 25th, and 75th percentiles were used to compare first-pass signals. Mean signal differences in biodistribution for both agents were compared in the aorta, vena cava, and renal pelvis using t-test or Wilcoxon signed-rank test. Signals from both conventional CT and color K-edge images were analyzed.
Results
Mean aneurysm grades for both image types were 45 %. A matching first-pass signal was achieved for both agents (P = 0.98), with median concentrations of 7.8 mg/mL (6.9, 8.4) vs. 7.6 mg/mL (6.4, 8.6) for USRP and gadoteric acid, respectively. Following timepoints showed similar blood pool signal among agents, but a minimal increase in average signal (mean signal difference = 17 Hounsfield unit or 0.2 mg/mL; P < 0.05) for both vessels in favor of USRP. High Gd concentrations in the renal pelvis for both agents indicated similar renal excretion profiles (mean signal difference of 0.9 mg/mL; P > 0.05).
Conclusion
Gd-based USRPs can be used for color K-edge angiography imaging, representing viable contrast media candidates for emerging spectral photon-counting CT applications.
{"title":"Color K-edge angiography with a dedicated gadolinium-based contrast agent for spectral photon-counting computed tomography","authors":"Christian Alejandro Hernandez-Fajardo , François Lux , Tristan Doussineau , Sandrine Dufort , Jean-Baptiste Langlois , Angele Houmeau , Agnieszka Gutwinska , Ramata Seydou Coulibaly , Antoine Robert , Geraldine Le Duc , Olivier Tillement , Philippe Douek , Salim Si-Mohamed","doi":"10.1016/j.diii.2025.07.001","DOIUrl":"10.1016/j.diii.2025.07.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to investigate the feasibility of using a gadolinium (Gd)-based ultrasmall rigid platform (USRP) for angiography imaging using color K-edge imaging with spectral photon-counting CT technology in a rabbit model.</div></div><div><h3>Materials and methods</h3><div>Ten atherosclerotic rabbits with a mean weight of 3.1 ± 0.5 (standard deviation) kg, underwent intravenous administration of an USRP solution (15 mL; 2.5 mL/s; 0.27 mol Gd<sup>3+</sup>/L). A sub-group of six rabbits also received gadoteric acid (7.8 mL; 1.4 mL/s; 0.5 mol Gd<sup>3+</sup>/L) for paired comparisons. Rabbits were imaged using a clinical SPCCT prototype (120 kVp; 100 mAs; 0.5-s rotation time; 1.17 pitch). The whole aorta was scanned 6 s post-injection (first pass), followed by abdominal scanning at 30 s, 1-, 3- and 10 min. Two-readers assigned aneurysm grades (expressed as a % vessel dilatation). Median, 25<sup>th</sup>, and 75<sup>th</sup> percentiles were used to compare first-pass signals. Mean signal differences in biodistribution for both agents were compared in the aorta, vena cava, and renal pelvis using <em>t</em>-test or Wilcoxon signed-rank test. Signals from both conventional CT and color K-edge images were analyzed.</div></div><div><h3>Results</h3><div>Mean aneurysm grades for both image types were 45 %. A matching first-pass signal was achieved for both agents (<em>P</em> = 0.98), with median concentrations of 7.8 mg/mL (6.9, 8.4) <em>vs</em>. 7.6 mg/mL (6.4, 8.6) for USRP and gadoteric acid, respectively. Following timepoints showed similar blood pool signal among agents, but a minimal increase in average signal (mean signal difference = 17 Hounsfield unit or 0.2 mg/mL; <em>P</em> < 0.05) for both vessels in favor of USRP. High Gd concentrations in the renal pelvis for both agents indicated similar renal excretion profiles (mean signal difference of 0.9 mg/mL; <em>P</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>Gd-based USRPs can be used for color K-edge angiography imaging, representing viable contrast media candidates for emerging spectral photon-counting CT applications.</div></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":"106 12","pages":"Pages 421-429"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-29DOI: 10.1016/j.diii.2025.11.010
Bouchra Habib Geryes, Salma Moalla, Esteban De Saint Etienne, Aurélie Moussier, François Pontana, Nathalie Boddaert, Valérie Pontvianne, Volodia Dangouloff-Ros
Purpose: The purpose of this study was to provide protocol guidance and evaluate radiation dose levels in pediatric photon-counting computed tomography (PCCT) applications.
Materials and methods: This multi-institutional, retrospective study included data from PCCT examinations performed between January 2024 and May 2025 in three medical institutions. Protocols were developed through expert consensus to optimize image quality and minimize motion artifacts and radiation exposure in children. Volume CT dose indexes (CTDIvol, in mGy) and dose-length products (DLP, in mGy·cm) were collected across ten body regions and stratified into five weight groups.
Results: A total of 4772 patients who underwent a total of 6464 pediatric PCCT examinations were included. There were 2719 male (56.97 %) and 2053 female (43.02 %) pediatric patients with a mean age of 7.9 ± 5.5 (standard deviation [SD]) years (range: 4 days-17.9 years), and a mean weight of 29.6 ± 20.3 (SD) kg (range: 2-79 kg). A total of 2110 PCCT examinations (32.64 %) involved children up to preschool age (< 15 kg and < 4 years). The chest (33.54 %; 2168/6464) and head (25.91 %; 1675/6464) were the most frequent regions examined, followed by the ear, nose and throat (11.36 %; 736/6464), the heart (8.65 %; 559/6464) and the abdomen/pelvis (5.09 %; 329/6464). Median CTDIvol for non-contrast head PCCT ranged from 16.1 to 24.0 mGy and DLP from 311 to 608 mGy·cm, while for non-contrast chest PCCT, median CTDIvol ranged from 0.3 to 0.8 mGy and DLP from 7 to 27 mGy·cm. CTDIvol and DLP increased with patient body weight.
Conclusion: This multi-institutional study provides practical protocol guidance for PCCT and updated dose benchmarks adapted to pediatric patients. These findings support the safe integration of PCCT into clinical practice and offer a flexible reference framework that centers can adapt to optimize image quality and radiation protection in children.
{"title":"Photon-counting CT in pediatric patients: A multi-institutional evaluation of protocols and radiation exposure in 4,772 patients.","authors":"Bouchra Habib Geryes, Salma Moalla, Esteban De Saint Etienne, Aurélie Moussier, François Pontana, Nathalie Boddaert, Valérie Pontvianne, Volodia Dangouloff-Ros","doi":"10.1016/j.diii.2025.11.010","DOIUrl":"10.1016/j.diii.2025.11.010","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to provide protocol guidance and evaluate radiation dose levels in pediatric photon-counting computed tomography (PCCT) applications.</p><p><strong>Materials and methods: </strong>This multi-institutional, retrospective study included data from PCCT examinations performed between January 2024 and May 2025 in three medical institutions. Protocols were developed through expert consensus to optimize image quality and minimize motion artifacts and radiation exposure in children. Volume CT dose indexes (CTDIvol, in mGy) and dose-length products (DLP, in mGy·cm) were collected across ten body regions and stratified into five weight groups.</p><p><strong>Results: </strong>A total of 4772 patients who underwent a total of 6464 pediatric PCCT examinations were included. There were 2719 male (56.97 %) and 2053 female (43.02 %) pediatric patients with a mean age of 7.9 ± 5.5 (standard deviation [SD]) years (range: 4 days-17.9 years), and a mean weight of 29.6 ± 20.3 (SD) kg (range: 2-79 kg). A total of 2110 PCCT examinations (32.64 %) involved children up to preschool age (< 15 kg and < 4 years). The chest (33.54 %; 2168/6464) and head (25.91 %; 1675/6464) were the most frequent regions examined, followed by the ear, nose and throat (11.36 %; 736/6464), the heart (8.65 %; 559/6464) and the abdomen/pelvis (5.09 %; 329/6464). Median CTDIvol for non-contrast head PCCT ranged from 16.1 to 24.0 mGy and DLP from 311 to 608 mGy·cm, while for non-contrast chest PCCT, median CTDIvol ranged from 0.3 to 0.8 mGy and DLP from 7 to 27 mGy·cm. CTDIvol and DLP increased with patient body weight.</p><p><strong>Conclusion: </strong>This multi-institutional study provides practical protocol guidance for PCCT and updated dose benchmarks adapted to pediatric patients. These findings support the safe integration of PCCT into clinical practice and offer a flexible reference framework that centers can adapt to optimize image quality and radiation protection in children.</p>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-28DOI: 10.1016/j.diii.2025.11.007
Joël Greffier, Cécile Salvat, Maxime Pastor, Valérie Bousson, Salim Si-Mohamed, Jean-Paul Beregi, Lama Hadid-Beurrier, Djamel Dabli
Purpose: The purpose of this study was to compare the spectral performance of three dual-energy CT (DECT) scanners and one photon-counting CT (PCCT) scanner on virtual monoenergetic images (VMIs) at low-energy levels and on iodine maps.
Materials and methods: A spectral phantom was scanned using one PCCT scanner and three different DECT scanners that included a rapid kV-switching CT (R-KVSCT), an ultrafast kV-switching (U-KVSCT) and a dual-layer CT (DLCT) scanner. Acquisitions were obtained with each CT system using classical abdominal and pelvic examination parameters, as well as a volume CT dose index at 11 mGy. VMI at 40/50/60/70 keV and iodine maps were reconstructed for each scanner. Noise power spectrum (NPS) and task-based transfer function (TTF) were evaluated. Detectability indexes (d') were computed to model the detection task of two contrast-enhanced lesions.
Results: Noise magnitude decreased from 40 to 70 keV for all DECT scanners and this decrease was greater for R-KVSCT (-80.0 ± 0.1 [standard deviation (SD)] %) and less pronounced for DLCT (-14.4 ± 0.8 [SD] %) scanners. The average NPS spatial frequency (fav) values decreased from 40 to 70 keV (0.26 to 0.17 mm-1) for R-KVSCT, increased for DLCT (0.18 to 0.25 mm-1) but were similar for U-KVSCT (0.19 ± 0.002 [SD] mm-1) and PCCT (0.21 ± [SD] 0.008 mm-1) scanner. For R-KVSCT and PCCT scanners, TTF at 50 % (f50) values increased from 40 to 70 keV for both inserts. For U-KVSCT and DLCT scanners, similar f50 values were found according to energy level for both inserts. For both contrast-enhanced lesions, d' values decreased from 40 to 70 keV for PCCT, DLCT and U-KVSCT scanners. For R-KVSCT scanner, d' values peaked at 60 keV. At 40 and 50 keV, the greatest d' values were found with DLCT and PCCT scanners.
Conclusion: At 40 or 50 keV, the best combined results (objective and subjective assessments) are obtained with DLCT and PCCT scanners.
{"title":"Comparison of spectral performance of three dual-energy CT scanners equipped with a deep-learning image reconstruction algorithm and one photon counting CT scanner: A phantom study.","authors":"Joël Greffier, Cécile Salvat, Maxime Pastor, Valérie Bousson, Salim Si-Mohamed, Jean-Paul Beregi, Lama Hadid-Beurrier, Djamel Dabli","doi":"10.1016/j.diii.2025.11.007","DOIUrl":"https://doi.org/10.1016/j.diii.2025.11.007","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare the spectral performance of three dual-energy CT (DECT) scanners and one photon-counting CT (PCCT) scanner on virtual monoenergetic images (VMIs) at low-energy levels and on iodine maps.</p><p><strong>Materials and methods: </strong>A spectral phantom was scanned using one PCCT scanner and three different DECT scanners that included a rapid kV-switching CT (R-KVSCT), an ultrafast kV-switching (U-KVSCT) and a dual-layer CT (DLCT) scanner. Acquisitions were obtained with each CT system using classical abdominal and pelvic examination parameters, as well as a volume CT dose index at 11 mGy. VMI at 40/50/60/70 keV and iodine maps were reconstructed for each scanner. Noise power spectrum (NPS) and task-based transfer function (TTF) were evaluated. Detectability indexes (d') were computed to model the detection task of two contrast-enhanced lesions.</p><p><strong>Results: </strong>Noise magnitude decreased from 40 to 70 keV for all DECT scanners and this decrease was greater for R-KVSCT (-80.0 ± 0.1 [standard deviation (SD)] %) and less pronounced for DLCT (-14.4 ± 0.8 [SD] %) scanners. The average NPS spatial frequency (f<sub>av</sub>) values decreased from 40 to 70 keV (0.26 to 0.17 mm<sup>-1</sup>) for R-KVSCT, increased for DLCT (0.18 to 0.25 mm<sup>-1</sup>) but were similar for U-KVSCT (0.19 ± 0.002 [SD] mm<sup>-1</sup>) and PCCT (0.21 ± [SD] 0.008 mm<sup>-1</sup>) scanner. For R-KVSCT and PCCT scanners, TTF at 50 % (f<sub>50</sub>) values increased from 40 to 70 keV for both inserts. For U-KVSCT and DLCT scanners, similar f<sub>50</sub> values were found according to energy level for both inserts. For both contrast-enhanced lesions, d' values decreased from 40 to 70 keV for PCCT, DLCT and U-KVSCT scanners. For R-KVSCT scanner, d' values peaked at 60 keV. At 40 and 50 keV, the greatest d' values were found with DLCT and PCCT scanners.</p><p><strong>Conclusion: </strong>At 40 or 50 keV, the best combined results (objective and subjective assessments) are obtained with DLCT and PCCT scanners.</p>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-28DOI: 10.1016/j.diii.2025.11.008
Hugo Perez, Bastien Chalamet, Sylvain Grange, Anthony Viste, Joris Lavigne, Jean-Baptiste Pialat, Nicolas Stacoffe
Purpose: The purpose of this study was to assess the technical success, intervention duration, radiation exposure, and safety of cone-beam computed tomography (CBCT)-guided percutaneous screw fixation in treating traumatic pelvic ring and acetabular fractures.
Materials and methods: All consecutive patients with unstable pelvic ring (Tile B/C) or acetabular fractures treated by CBCT-guided percutaneous osteosynthesis between March 2023 and September 2025 were included. All interventions were performed using CBCT navigation with bull's eye guidance. Outcomes were technical success (i.e., fully intraosseous screw trajectory without cortical breach), intervention duration, dose-area product (DAP), and perioperative complications, and their associations or correlations with fracture classification, screw count, and body mass index .
Results: Sixty-seven patients underwent CBCT-guided fixation. There were 45 men and 22 women, with a mean age of 50.8 ± 18.5 (standard deviation) years (range: 17-91 years) and a median body mass index of 24.8 kg/m² (Q1, 22.3; Q3, 27.2; range: 16.7-42.2 kg/m²). Overall, 102 out of 103 screws (99.0 %) followed the planned intraosseous trajectory. No intraoperative complications were observed. One patient (1/67; 1.5 %) developed immediate postoperative nervous pain requiring screw adjustment with rapid pain relief. Median intervention duration was 43 min (first quartile [Q1], 30; third quartile [Q3], 54.5; range, 19-107 min) with a moderate correlation with the number of screws (ρ = 0.496). Median DAP was 81.6 Gy·cm² (Q1, 59.1; Q3, 101.5; range, 11.8-226.5 Gy·cm²) with a weak correlation with body mass index (ρ = 0.311).
Conclusion: CBCT-guided percutaneous pelvic fixation is safe and effective in the management of traumatic pelvic fractures and may represent a minimally invasive alternative to open surgery or conventional fluoroscopy for patients with this condition.
{"title":"Cone-beam CT-guided osteosynthesis of traumatic pelvic fractures: An analysis of 67 patients.","authors":"Hugo Perez, Bastien Chalamet, Sylvain Grange, Anthony Viste, Joris Lavigne, Jean-Baptiste Pialat, Nicolas Stacoffe","doi":"10.1016/j.diii.2025.11.008","DOIUrl":"https://doi.org/10.1016/j.diii.2025.11.008","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the technical success, intervention duration, radiation exposure, and safety of cone-beam computed tomography (CBCT)-guided percutaneous screw fixation in treating traumatic pelvic ring and acetabular fractures.</p><p><strong>Materials and methods: </strong>All consecutive patients with unstable pelvic ring (Tile B/C) or acetabular fractures treated by CBCT-guided percutaneous osteosynthesis between March 2023 and September 2025 were included. All interventions were performed using CBCT navigation with bull's eye guidance. Outcomes were technical success (i.e., fully intraosseous screw trajectory without cortical breach), intervention duration, dose-area product (DAP), and perioperative complications, and their associations or correlations with fracture classification, screw count, and body mass index .</p><p><strong>Results: </strong>Sixty-seven patients underwent CBCT-guided fixation. There were 45 men and 22 women, with a mean age of 50.8 ± 18.5 (standard deviation) years (range: 17-91 years) and a median body mass index of 24.8 kg/m² (Q1, 22.3; Q3, 27.2; range: 16.7-42.2 kg/m²). Overall, 102 out of 103 screws (99.0 %) followed the planned intraosseous trajectory. No intraoperative complications were observed. One patient (1/67; 1.5 %) developed immediate postoperative nervous pain requiring screw adjustment with rapid pain relief. Median intervention duration was 43 min (first quartile [Q1], 30; third quartile [Q3], 54.5; range, 19-107 min) with a moderate correlation with the number of screws (ρ = 0.496). Median DAP was 81.6 Gy·cm² (Q1, 59.1; Q3, 101.5; range, 11.8-226.5 Gy·cm²) with a weak correlation with body mass index (ρ = 0.311).</p><p><strong>Conclusion: </strong>CBCT-guided percutaneous pelvic fixation is safe and effective in the management of traumatic pelvic fractures and may represent a minimally invasive alternative to open surgery or conventional fluoroscopy for patients with this condition.</p>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1016/j.diii.2025.11.006
Paul Calame, Christine Hoeffel, Stéphanie Nougaret
{"title":"Dual-energy CT for peritoneal metastases: When the right question meets the right technology.","authors":"Paul Calame, Christine Hoeffel, Stéphanie Nougaret","doi":"10.1016/j.diii.2025.11.006","DOIUrl":"https://doi.org/10.1016/j.diii.2025.11.006","url":null,"abstract":"","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-23DOI: 10.1016/j.diii.2025.11.003
Aurore Sajust de Bergues de Escalup, Augustin Lecler, Émilie Poirion, Caroline Papeix, Romain Deschamps, Dan Milea, Julien Savatovsky, Loïc Duron, Emma O'Shaughnessy
Purpose: The purpose of this study was to assess the benefit of a deep learning-based image reconstruction (DLBIR) for improving image quality in orbital magnetic resonance imaging (MRI) at 3 Tesla (T).
Materials and methods: Seventy-one patients (48 women and 23 men) with a mean age of 52 ± 19.5 (standard deviation [SD]) years (age range: 7-90 years) who underwent MRI examination of the orbit at 3 T between January and June of 2024, were included in the study. Coronal T2-weighted MR images obtained in 70 patients and post-contrast fat-saturated (FS) coronal T1-weighted MR images obtained in 25 patients, were reconstructed with and without DLBIR, resulting in four imaging sets. Two radiologists independently and blindly measured the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the optic nerves on the four imaging sets. Image quality and orbital abnormalities were assessed using a standardized 5-point Likert scale. Comparisons between MR images obtained with and without DLBIR were performed using Wilcoxon test for ordinal and quantitative variables and McNemar test for paired binary data.
Results: SNR and CNR of coronal T2-weighted MR images were significantly greater using DLBIR (26.67 ± 9.03 [SD], and 14.87 ± 10.31 [SD], respectively) than without DLBIR (18.91 ± 7.28 [SD], and 9.78 ± 8.47 [SD], respectively) (P < 0.001). There were no differences in SNR and CNR between post-contrast FS T1-weighted images obtained with DLBIR (85.56 ± 63.13 [SD], and 64 ± 41.38 [SD], respectively) and those obtained without DLBIR (91.36 ± 48.49 [SD], and 43.25 ± 20.4 [SD], respectively) (P = 0.35, and P = 0.14, respectively). Qualitatively, good-to-excellent image quality was obtained more frequently with DLBIR than without DLBIR for T2-weighted and post-contrast FS T1-weighted images with respect to optic nerve sharpness (67 % vs. 16 %, and 8 % vs. 0 %, respectively), brain sharpness (90 % vs. 6 %, and 68 % vs. 4 %, respectively), and overall image quality (73 % vs. 1 % and 36 % vs. 0 %, respectively) (all P ≤ 0.001). No significant differences in the detection rates of orbital abnormalities were found between MR images obtained with and without DLBIR, including optic nerve hyperintensity (34 % vs. 31 %, respectively; P = 0.16) and optic nerve atrophy (33 % for both) on T2-weighted images, and optic nerve enhancement on post-contrast FS T1-weighted images (16 % for both).
Conclusion: DLBIR significantly improves image quality of MRI examinations of the orbit at 3 T, without losing clinically relevant information.
目的：本研究的目的是评估基于深度学习的图像重建（DLBIR）对改善3tesla (T)轨道磁共振成像（MRI）图像质量的益处。材料与方法：选取于2024年1 - 6月行3t眶部MRI检查的患者71例，其中女性48例，男性23例，平均年龄52±19.5（标准差[SD]）岁，年龄范围7-90岁。70例患者获得冠状t2加权MR图像，25例患者获得对比后脂肪饱和（FS）冠状t1加权MR图像，在有和没有DLBIR的情况下重建，得到4组成像。两名放射科医师在4台成像机上分别独立、盲测视神经的信噪比（SNR）和比噪比（CNR）。使用标准化的5点李克特量表评估图像质量和眼眶异常。采用有序变量和定量变量的Wilcoxon检验和成对二进制数据的McNemar检验对有DLBIR和没有DLBIR的MR图像进行比较。结果：DLBIR组冠状面t2加权MR图像的信噪比（SNR）和CNR （CNR）分别为26.67±9.03 [SD]和14.87±10.31 [SD]，显著高于无DLBIR组（18.91±7.28 [SD]和9.78±8.47 [SD]） （P < 0.001）。经DLBIR处理后的t1加权图像的信噪比（85.56±63.13 [SD], 64±41.38 [SD]）与未经DLBIR处理后的t1加权图像的信噪比（91.36±48.49 [SD], 43.25±20.4 [SD]）比较，两者差异无统计学意义（P = 0.35, P = 0.14）。定性地说，与没有DLBIR相比，在t2加权和对比后的FS t1加权图像中，DLBIR在视神经清晰度（分别为67% vs. 16%和8% vs. 0%）、脑清晰度（分别为90% vs. 6%和68% vs. 4%）和整体图像质量（分别为73% vs. 1%和36% vs. 0%）方面获得良至优图像质量的频率更高（所有P≤0.001）。在有DLBIR和没有DLBIR的MR图像中，眼眶异常的检出率没有显著差异，包括t2加权图像上的视神经高信号（分别为34%和31%，P = 0.16）和视神经萎缩（两者均为33%），以及对比后FS t1加权图像上的视神经增强（两者均为16%）。结论：DLBIR在不丢失临床相关信息的情况下，显著提高了眼眶MRI检查的图像质量。
{"title":"Deep learning-based image reconstruction significantly improves image quality of MRI examinations of the orbit at 3 Tesla.","authors":"Aurore Sajust de Bergues de Escalup, Augustin Lecler, Émilie Poirion, Caroline Papeix, Romain Deschamps, Dan Milea, Julien Savatovsky, Loïc Duron, Emma O'Shaughnessy","doi":"10.1016/j.diii.2025.11.003","DOIUrl":"https://doi.org/10.1016/j.diii.2025.11.003","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the benefit of a deep learning-based image reconstruction (DLBIR) for improving image quality in orbital magnetic resonance imaging (MRI) at 3 Tesla (T).</p><p><strong>Materials and methods: </strong>Seventy-one patients (48 women and 23 men) with a mean age of 52 ± 19.5 (standard deviation [SD]) years (age range: 7-90 years) who underwent MRI examination of the orbit at 3 T between January and June of 2024, were included in the study. Coronal T2-weighted MR images obtained in 70 patients and post-contrast fat-saturated (FS) coronal T1-weighted MR images obtained in 25 patients, were reconstructed with and without DLBIR, resulting in four imaging sets. Two radiologists independently and blindly measured the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the optic nerves on the four imaging sets. Image quality and orbital abnormalities were assessed using a standardized 5-point Likert scale. Comparisons between MR images obtained with and without DLBIR were performed using Wilcoxon test for ordinal and quantitative variables and McNemar test for paired binary data.</p><p><strong>Results: </strong>SNR and CNR of coronal T2-weighted MR images were significantly greater using DLBIR (26.67 ± 9.03 [SD], and 14.87 ± 10.31 [SD], respectively) than without DLBIR (18.91 ± 7.28 [SD], and 9.78 ± 8.47 [SD], respectively) (P < 0.001). There were no differences in SNR and CNR between post-contrast FS T1-weighted images obtained with DLBIR (85.56 ± 63.13 [SD], and 64 ± 41.38 [SD], respectively) and those obtained without DLBIR (91.36 ± 48.49 [SD], and 43.25 ± 20.4 [SD], respectively) (P = 0.35, and P = 0.14, respectively). Qualitatively, good-to-excellent image quality was obtained more frequently with DLBIR than without DLBIR for T2-weighted and post-contrast FS T1-weighted images with respect to optic nerve sharpness (67 % vs. 16 %, and 8 % vs. 0 %, respectively), brain sharpness (90 % vs. 6 %, and 68 % vs. 4 %, respectively), and overall image quality (73 % vs. 1 % and 36 % vs. 0 %, respectively) (all P ≤ 0.001). No significant differences in the detection rates of orbital abnormalities were found between MR images obtained with and without DLBIR, including optic nerve hyperintensity (34 % vs. 31 %, respectively; P = 0.16) and optic nerve atrophy (33 % for both) on T2-weighted images, and optic nerve enhancement on post-contrast FS T1-weighted images (16 % for both).</p><p><strong>Conclusion: </strong>DLBIR significantly improves image quality of MRI examinations of the orbit at 3 T, without losing clinically relevant information.</p>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.diii.2025.11.001
Charles Roux, Romain Chauvet, Farha Tessier, Louis Meyblum, Jonathan Cortese, Maxime Baudouin, Fan Sun, Graciela Pavon-Djavid, Yun Luo, Claire Mangeney, Geraud Forestier, Frederic Clarencon, Aymeric Rouchaud
Remarkable progress has been made in the endovascular management of atherosclerotic lesions in recent decades. Despite initial challenges, such as arterial dissection and acute thrombosis, successive technological innovations have led to the development of stents designed to minimize the risk of restenosis and occlusion. Percutaneous transluminal angioplasty, combined with antiplatelet regimens and management of cardiovascular risk factors, is now at the forefront of symptomatic arteriosclerotic lesion treatment. However, a persistent limitation of percutaneous transluminal angioplasty is the permanent implantation of metallic stents. The long-term presence of metallic stents requires prolonged antiplatelet therapy, creates artifacts on imaging, and is associated with late or very late stent failure. All these conditions are linked to significant morbidity and mortality. The purpose of this review was to provide interventional practitioners with a comprehensive overview of the need for bioresorbable stents in interventional radiology practice by briefly reviewing the vascular healing process, and the factors contributing to stent failure, including patient- and stent-related factors, and by exploring the emergence of bioresorbable stents as the next frontier in endovascular therapy. This article illustrates and discusses how bioresorbable scaffolds could transform the landscape of endovascular interventional radiology from head to toe by retracing the major milestones in bioresorbable scaffold development, outlining future technical improvements, and highlighting current clinical evidence and future perspectives.
{"title":"Bioresorbable scaffolds in interventional radiology: Current concepts and future direction.","authors":"Charles Roux, Romain Chauvet, Farha Tessier, Louis Meyblum, Jonathan Cortese, Maxime Baudouin, Fan Sun, Graciela Pavon-Djavid, Yun Luo, Claire Mangeney, Geraud Forestier, Frederic Clarencon, Aymeric Rouchaud","doi":"10.1016/j.diii.2025.11.001","DOIUrl":"https://doi.org/10.1016/j.diii.2025.11.001","url":null,"abstract":"<p><p>Remarkable progress has been made in the endovascular management of atherosclerotic lesions in recent decades. Despite initial challenges, such as arterial dissection and acute thrombosis, successive technological innovations have led to the development of stents designed to minimize the risk of restenosis and occlusion. Percutaneous transluminal angioplasty, combined with antiplatelet regimens and management of cardiovascular risk factors, is now at the forefront of symptomatic arteriosclerotic lesion treatment. However, a persistent limitation of percutaneous transluminal angioplasty is the permanent implantation of metallic stents. The long-term presence of metallic stents requires prolonged antiplatelet therapy, creates artifacts on imaging, and is associated with late or very late stent failure. All these conditions are linked to significant morbidity and mortality. The purpose of this review was to provide interventional practitioners with a comprehensive overview of the need for bioresorbable stents in interventional radiology practice by briefly reviewing the vascular healing process, and the factors contributing to stent failure, including patient- and stent-related factors, and by exploring the emergence of bioresorbable stents as the next frontier in endovascular therapy. This article illustrates and discusses how bioresorbable scaffolds could transform the landscape of endovascular interventional radiology from head to toe by retracing the major milestones in bioresorbable scaffold development, outlining future technical improvements, and highlighting current clinical evidence and future perspectives.</p>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号