Background: Obstructive coronary disease remains a leading cause of sudden cardiac death (SCD). The management of SCD therefore involves coronary angiography. Our aim was to evaluate whether the non-hyperemic angiography-derived microcirculatory resistance index (NH-IMRangio) could be an easy-to-use tool for identifying patients with electrical heart disease (EHD) from patients with other causes of SCD.
Methods: A retrospective study was carried out on 30 patients who survived from SCD with no significant coronary lesions on coronary angiography. Etiological investigations enabled the classification of patients with myocardial disease (Group 1, n=20) and those with EHD without myocardial disease (Group 2, n=10). Myocardial disease was investigated by cardiac magnetic resonance imaging (CMR). NH-IMRangio was determined based on standard coronary angiographic views with 3-dimensional-modeling and computational analysis of the coronary flow.
Results: Patients were 46.4±15.9 years old and mostly male (73%). Group 1 included patients with dilated cardiomyopathy (n=7), non-dilated left ventricular cardiomyopathy (n=6), hypertrophic cardiomyopathy (n=2), arrhythmogenic right ventricular cardiomyopathy (n=1), myocardial infarction with non-obstructive coronary arteries (MINOCA) disease due to vasospastic angina (n=1), myocarditis (n=2), chemotherapy-induced cardiomyopathy (n=1). Group 1 presented a significantly higher NH-IMR angio compared to group 2 (46.5±13.1 vs. 34.1±10.8, P<0.02). An NH-IMR angio cut-off of 41.5 enabled an optimal classification of patients with or without myocardial disease.
Conclusions: A high NH-IMRangio could represent a useful tool for guiding the etiological diagnosis of SCD towards myocardial disease rather than EHD.
{"title":"Diagnostic relevance of angiography-derived coronary microcirculatory resistance in sudden cardiac death.","authors":"Bahia Sedoud, Benoit Caullery, Merwan Aouati, Stephanie Marliere, Estelle Vautrin, Nicolas Piliero, Olivier Ormezzano, Helene Bouvaist, Lea Ruez Lantuejoul, Gerald Vanzetto, Laurent Riou, Gilles Barone-Rochette","doi":"10.21037/qims-2025-1601","DOIUrl":"https://doi.org/10.21037/qims-2025-1601","url":null,"abstract":"<p><strong>Background: </strong>Obstructive coronary disease remains a leading cause of sudden cardiac death (SCD). The management of SCD therefore involves coronary angiography. Our aim was to evaluate whether the non-hyperemic angiography-derived microcirculatory resistance index (NH-IMRangio) could be an easy-to-use tool for identifying patients with electrical heart disease (EHD) from patients with other causes of SCD.</p><p><strong>Methods: </strong>A retrospective study was carried out on 30 patients who survived from SCD with no significant coronary lesions on coronary angiography. Etiological investigations enabled the classification of patients with myocardial disease (Group 1, n=20) and those with EHD without myocardial disease (Group 2, n=10). Myocardial disease was investigated by cardiac magnetic resonance imaging (CMR). NH-IMRangio was determined based on standard coronary angiographic views with 3-dimensional-modeling and computational analysis of the coronary flow.</p><p><strong>Results: </strong>Patients were 46.4±15.9 years old and mostly male (73%). Group 1 included patients with dilated cardiomyopathy (n=7), non-dilated left ventricular cardiomyopathy (n=6), hypertrophic cardiomyopathy (n=2), arrhythmogenic right ventricular cardiomyopathy (n=1), myocardial infarction with non-obstructive coronary arteries (MINOCA) disease due to vasospastic angina (n=1), myocarditis (n=2), chemotherapy-induced cardiomyopathy (n=1). Group 1 presented a significantly higher NH-IMR angio compared to group 2 (46.5±13.1 <i>vs.</i> 34.1±10.8, P<0.02). An NH-IMR angio cut-off of 41.5 enabled an optimal classification of patients with or without myocardial disease.</p><p><strong>Conclusions: </strong>A high NH-IMRangio could represent a useful tool for guiding the etiological diagnosis of SCD towards myocardial disease rather than EHD.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"234"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Background: </strong>Porto-sinusoidal vascular disorder (PSVD) is often misdiagnosed as liver cirrhosis due to overlapping clinical presentations and imaging features. This study conducted a blinded, independent imaging review to identify and compare the distinct imaging features between the two diseases, and to develop and validate a predictive model for differentiating PSVD from cirrhosis.</p><p><strong>Methods: </strong>Patients with histologically and clinically confirmed PSVD or cirrhosis and available contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) scans were retrospectively enrolled in the study. Imaging features were independently and systematically analyzed by two abdominal radiologists, who were blinded to the case grouping. Inter-reader discrepancies were resolved by consensus. The key features for analysis included liver surface nodularity (LSN), regenerative nodules (RNs), signs of portal hypertension (PH), and reticular delayed enhancement of the hepatic parenchyma. CT, MRI, and combined predictive models were developed to identify the top performing model, which was then selected and validated on an independent test cohort. Model performance was evaluated based on the area under the curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>In total, 106 patients with PSVD and 104 patients with cirrhosis were included for imaging evaluation and model development. The data of an additional 36 patients with PSVD and 51 patients with cirrhosis were collected for independent model testing. PSVD exhibited the same pronounced PH imaging features as cirrhosis, including grade 1-3 splenomegaly (77/106, 72.6% <i>vs.</i> 67/104, 64.4%; P>0.05), collateral vessels (103/106, 97.2% <i>vs.</i> 94/104, 90.4%; P>0.05), and ascites (35/106, 33.0% <i>vs.</i> 32/104, 30.8%; P>0.05). In addition, PSVD showed more increased small branches of intrahepatic blood vessels than cirrhosis (79/106, 74.5% <i>vs.</i> 41/104, 39.4%; P<0.001). Conversely, PSVD exhibited fewer cirrhosis-specific imaging features, such as reticular delayed enhancement of the hepatic parenchyma (10/48, 20.8% <i>vs.</i> 50/53, 94.3%; P<0.001), RNs (3/48, 6.3% <i>vs.</i> 29/53, 54.7%; P<0.001), and LSN (27/106, 25.5% <i>vs.</i> 75/104, 72.1%; P<0.001). In the validation set, the MRI model [AUC: 0.970, 95% confidence interval (CI): 0.912-1.0], which incorporated four imaging features (reticular delayed enhancement, RNs, LSN and increased small intrahepatic vascular branches), showed superior discriminatory performance compared to the CT model (AUC: 0.825, 95% CI: 0.646-1.0), with a sensitivity of 0.818 and a specificity of 0.889. While the combined model (AUC: 0.97, 95% CI: 0.912-1.0) did not improve upon the performance of the MRI model alone, with sensitivity of 0.821 and specificity of 0.889. Thus, we recommend the MRI model as the preferred modality for diagnosing PSVD. The MRI model also achieved optimal performance in the
背景：门窦血管病变（PSVD）由于临床表现和影像学特征重叠，常被误诊为肝硬化。本研究进行了一项独立的盲法影像学回顾，以识别和比较两种疾病的不同影像学特征，并建立和验证区分PSVD与肝硬化的预测模型。方法：回顾性纳入经组织学和临床证实的PSVD或肝硬化患者，并进行CT或MRI扫描。影像学特征由两名腹部放射科医生独立系统地分析，他们对病例分组不知情。读者之间的差异经协商一致解决。分析的主要特征包括肝表面结节（LSN）、再生结节（RNs）、门静脉高压（PH）征象和网状延迟性肝实质强化。开发了CT、MRI和联合预测模型，以确定表现最佳的模型，然后选择该模型并在独立的测试队列中进行验证。根据曲线下面积（AUC）、敏感性和特异性评估模型的性能。结果：共纳入106例PSVD患者和104例肝硬化患者进行影像学评价和模型制作。另外收集36例PSVD患者和51例肝硬化患者的数据进行独立模型检验。PSVD表现出与肝硬化相同的明显的PH影像特征，包括1-3级脾肿大（77/106,72.6% vs. 67/104, 64.4%; P >.05）、侧支血管（103/106,97.2% vs. 94/104, 90.4%; P >.05）和腹水（35/106,33.0% vs. 32/104, 30.8%; P b>.05）。此外，PSVD表现为肝内血管小分支增加多于肝硬化（79/106,74.5% vs. 41/104, 39.4%; Pvs. 50/53, 94.3%; Pvs. 29/53, 54.7%; Pvs. 75/104, 72.1%）。结论：有严重PH影像学特征但缺乏典型肝硬化影像学特征的PSVD患者应进行彻底检查。MRI是首选的成像方式。我们基于mri的预测模型可靠地区分PSVD和肝硬化，为增强PSVD的怀疑提供了一种非侵入性方法。
{"title":"Imaging features of porto-sinusoidal vascular disorder in a case-control study: diagnostic value for differentiation from liver cirrhosis.","authors":"Fengxiang Song, Haoxiang Zhu, Lijun Qian, Zhiyu Zeng, Meng Li, Jinyu Wang, Meilin Zhu, Li Li, Min Yuan, Yunfei Lu, Yang He, Long Chen, Nannan Shi, Xiong Ma, Chenyi Jiang, Dongliang Li, Jing Lv, Chenghai Liu, Weifeng Zhao, Meng Zhang, Ying Yuan, Fei Shan, Jiawen Zhang, Jiming Zhang, Qingchun Fu, Yuxin Shi","doi":"10.21037/qims-2025-1775","DOIUrl":"https://doi.org/10.21037/qims-2025-1775","url":null,"abstract":"<p><strong>Background: </strong>Porto-sinusoidal vascular disorder (PSVD) is often misdiagnosed as liver cirrhosis due to overlapping clinical presentations and imaging features. This study conducted a blinded, independent imaging review to identify and compare the distinct imaging features between the two diseases, and to develop and validate a predictive model for differentiating PSVD from cirrhosis.</p><p><strong>Methods: </strong>Patients with histologically and clinically confirmed PSVD or cirrhosis and available contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) scans were retrospectively enrolled in the study. Imaging features were independently and systematically analyzed by two abdominal radiologists, who were blinded to the case grouping. Inter-reader discrepancies were resolved by consensus. The key features for analysis included liver surface nodularity (LSN), regenerative nodules (RNs), signs of portal hypertension (PH), and reticular delayed enhancement of the hepatic parenchyma. CT, MRI, and combined predictive models were developed to identify the top performing model, which was then selected and validated on an independent test cohort. Model performance was evaluated based on the area under the curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>In total, 106 patients with PSVD and 104 patients with cirrhosis were included for imaging evaluation and model development. The data of an additional 36 patients with PSVD and 51 patients with cirrhosis were collected for independent model testing. PSVD exhibited the same pronounced PH imaging features as cirrhosis, including grade 1-3 splenomegaly (77/106, 72.6% <i>vs.</i> 67/104, 64.4%; P>0.05), collateral vessels (103/106, 97.2% <i>vs.</i> 94/104, 90.4%; P>0.05), and ascites (35/106, 33.0% <i>vs.</i> 32/104, 30.8%; P>0.05). In addition, PSVD showed more increased small branches of intrahepatic blood vessels than cirrhosis (79/106, 74.5% <i>vs.</i> 41/104, 39.4%; P<0.001). Conversely, PSVD exhibited fewer cirrhosis-specific imaging features, such as reticular delayed enhancement of the hepatic parenchyma (10/48, 20.8% <i>vs.</i> 50/53, 94.3%; P<0.001), RNs (3/48, 6.3% <i>vs.</i> 29/53, 54.7%; P<0.001), and LSN (27/106, 25.5% <i>vs.</i> 75/104, 72.1%; P<0.001). In the validation set, the MRI model [AUC: 0.970, 95% confidence interval (CI): 0.912-1.0], which incorporated four imaging features (reticular delayed enhancement, RNs, LSN and increased small intrahepatic vascular branches), showed superior discriminatory performance compared to the CT model (AUC: 0.825, 95% CI: 0.646-1.0), with a sensitivity of 0.818 and a specificity of 0.889. While the combined model (AUC: 0.97, 95% CI: 0.912-1.0) did not improve upon the performance of the MRI model alone, with sensitivity of 0.821 and specificity of 0.889. Thus, we recommend the MRI model as the preferred modality for diagnosing PSVD. The MRI model also achieved optimal performance in the ","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"212"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Preoperative localization of pulmonary nodules requires multiple computed tomography (CT) scans, making it an urgent problem to address how to effectively reduce radiation damage while maintaining image quality. Artificial intelligence iterative reconstruction (AIIR) can significantly improve the image quality of ultra-low-dose CT (ULDCT). This study aimed to examine the feasibility of using ULDCT-AIIR for the preoperative localization of pulmonary nodules.
Methods: This prospective study enrolled 40 consecutive patients with pulmonary nodules who underwent preoperative hook-wire localization under low-dose CT (LDCT). Immediately following the LDCT, an additional ULDCT scan was performed. Images were reconstructed using filtered back projection (FBP) and a hybrid iterative reconstruction (HIR) for both LDCT and ULDCT scans; additionally, AIIR was applied solely to the ULDCT images. Objective parameters measured included image noise, contrast-to-noise ratio (CNR), and the distances between nodules and reference. Subjective image quality was assessed using a 5-point Likert scale, evaluating the visualization of pulmonary nodules, localization grids, needle tips, hook-wires, and complications. Quantitative and qualitative metrics were compared across the reconstruction groups using the Kruskal-Wallis test.
Results: The volume CT dose index of ULDCT was 90% lower than that of LDCT (0.22 vs. 2.20 mGy). ULDCT-AIIR showed comparable lung parenchyma noise and CNRnodule-lung to LDCT-HIR (P>0.05), and significantly outperformed other reconstructions (P<0.01). The subjective visualization scores for nodules, localization grids, needle tips, hook-wires, and complications with ULDCT-AIIR were non-inferior to those with LDCT-HIR and significantly superior to most other reconstruction groups (P<0.01). Distance measurements demonstrated no significant differences between ULDCT-AIIR and other reconstruction methods (P>0.05).
Conclusions: ULDCT-AIIR achieves image quality comparable to LDCT-HIR with significantly reduced radiation doses, suggesting its potential as an alternative to LDCT for preoperative pulmonary nodule localization.
{"title":"Preoperative localization of pulmonary nodules using ultra-low-dose CT based on artificial intelligence iterative reconstruction.","authors":"Huixiang Lan, Xiaobin Liu, Danlin Ou, Sihua Zhong, Hongcheng Zhong, Mingzhu Liang","doi":"10.21037/qims-2025-1544","DOIUrl":"https://doi.org/10.21037/qims-2025-1544","url":null,"abstract":"<p><strong>Background: </strong>Preoperative localization of pulmonary nodules requires multiple computed tomography (CT) scans, making it an urgent problem to address how to effectively reduce radiation damage while maintaining image quality. Artificial intelligence iterative reconstruction (AIIR) can significantly improve the image quality of ultra-low-dose CT (ULDCT). This study aimed to examine the feasibility of using ULDCT-AIIR for the preoperative localization of pulmonary nodules.</p><p><strong>Methods: </strong>This prospective study enrolled 40 consecutive patients with pulmonary nodules who underwent preoperative hook-wire localization under low-dose CT (LDCT). Immediately following the LDCT, an additional ULDCT scan was performed. Images were reconstructed using filtered back projection (FBP) and a hybrid iterative reconstruction (HIR) for both LDCT and ULDCT scans; additionally, AIIR was applied solely to the ULDCT images. Objective parameters measured included image noise, contrast-to-noise ratio (CNR), and the distances between nodules and reference. Subjective image quality was assessed using a 5-point Likert scale, evaluating the visualization of pulmonary nodules, localization grids, needle tips, hook-wires, and complications. Quantitative and qualitative metrics were compared across the reconstruction groups using the Kruskal-Wallis test.</p><p><strong>Results: </strong>The volume CT dose index of ULDCT was 90% lower than that of LDCT (0.22 <i>vs.</i> 2.20 mGy). ULDCT-AIIR showed comparable lung parenchyma noise and CNR<sub>nodule-lung</sub> to LDCT-HIR (P<i>></i>0.05), and significantly outperformed other reconstructions (P<i><</i>0.01). The subjective visualization scores for nodules, localization grids, needle tips, hook-wires, and complications with ULDCT-AIIR were non-inferior to those with LDCT-HIR and significantly superior to most other reconstruction groups (P<0.01). Distance measurements demonstrated no significant differences between ULDCT-AIIR and other reconstruction methods (P>0.05).</p><p><strong>Conclusions: </strong>ULDCT-AIIR achieves image quality comparable to LDCT-HIR with significantly reduced radiation doses, suggesting its potential as an alternative to LDCT for preoperative pulmonary nodule localization.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"236"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.21037/qims-2025-1794
Yuyang Ou, Dan Li, Yun-Nan Li, Chong Shi, Shi-Liang Li
Background: Cervicogenic headache (CEH) is a chronic secondary headache syndrome originating from the upper cervical spine. Although conventional treatments such as pharmacological management, nerve blocks, and radiofrequency ablation are effective for many patients, a subset remains refractory to standard therapies. Soft tissue adhesions around the atlas (C1) are a potential but often overlooked pain generator. This report describes the successful management of intractable CEH through use of ultrasound-guided needle-knife release targeting the transverse process of the atlas.
Case description: A 32-year-old male presented with a 15-year history of persistent, left-sided pulsatile headache following cervical trauma. The patient had previously undergone extensive treatments, including oral analgesics, C2 nerve blocks, pulsed radiofrequency, and "blind" (nonvisualized) needle-knife therapy, all of which failed to provide sustained relief. Physical examination revealed distinct tenderness at the posterior arch of the atlas. Under high-frequency ultrasound guidance, we identified the transverse process of the atlas and performed precise needle-knife release on the adherent soft tissues attached to the bone surface. This visualized approach allowed for the safe avoidance of critical neurovascular structures such as the vertebral artery. Following a course of six weekly sessions, the patient reported a 90% reduction in pain intensity. At the 6-month follow-up, the therapeutic effect was sustained without recurrence, and the patient's quality of life and daily functioning were significantly improved.
Conclusions: This case highlights that soft tissue pathology around the C1 transverse process can be a critical etiology in refractory CEH. Conventional "blind" needle-knife therapy may fail due to safety concerns limiting the depth of release. Ultrasound-guided needle-knife therapy offers a visualized, safe, and precise minimally invasive alternative for patients unresponsive to traditional C2-targeted therapies, allowing for the effective release of deep soft tissue adhesions.
{"title":"Ultrasound-guided needle-knife release for treatment-refractory cervicogenic headache: a case report.","authors":"Yuyang Ou, Dan Li, Yun-Nan Li, Chong Shi, Shi-Liang Li","doi":"10.21037/qims-2025-1794","DOIUrl":"https://doi.org/10.21037/qims-2025-1794","url":null,"abstract":"<p><strong>Background: </strong>Cervicogenic headache (CEH) is a chronic secondary headache syndrome originating from the upper cervical spine. Although conventional treatments such as pharmacological management, nerve blocks, and radiofrequency ablation are effective for many patients, a subset remains refractory to standard therapies. Soft tissue adhesions around the atlas (C1) are a potential but often overlooked pain generator. This report describes the successful management of intractable CEH through use of ultrasound-guided needle-knife release targeting the transverse process of the atlas.</p><p><strong>Case description: </strong>A 32-year-old male presented with a 15-year history of persistent, left-sided pulsatile headache following cervical trauma. The patient had previously undergone extensive treatments, including oral analgesics, C2 nerve blocks, pulsed radiofrequency, and \"blind\" (nonvisualized) needle-knife therapy, all of which failed to provide sustained relief. Physical examination revealed distinct tenderness at the posterior arch of the atlas. Under high-frequency ultrasound guidance, we identified the transverse process of the atlas and performed precise needle-knife release on the adherent soft tissues attached to the bone surface. This visualized approach allowed for the safe avoidance of critical neurovascular structures such as the vertebral artery. Following a course of six weekly sessions, the patient reported a 90% reduction in pain intensity. At the 6-month follow-up, the therapeutic effect was sustained without recurrence, and the patient's quality of life and daily functioning were significantly improved.</p><p><strong>Conclusions: </strong>This case highlights that soft tissue pathology around the C1 transverse process can be a critical etiology in refractory CEH. Conventional \"blind\" needle-knife therapy may fail due to safety concerns limiting the depth of release. Ultrasound-guided needle-knife therapy offers a visualized, safe, and precise minimally invasive alternative for patients unresponsive to traditional C2-targeted therapies, allowing for the effective release of deep soft tissue adhesions.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"253"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.21037/qims-2025-100
Xiaofan Hu, Hongyu Wang, Fan Sun, Hongping Sun, Li Sun, Shuhang Xu, Yongxin Hu
{"title":"Ultrasound-guided microwave ablation for primary hyperparathyroidism in a pregnancy patient with medullary sponge kidney: a case description and literature analysis.","authors":"Xiaofan Hu, Hongyu Wang, Fan Sun, Hongping Sun, Li Sun, Shuhang Xu, Yongxin Hu","doi":"10.21037/qims-2025-100","DOIUrl":"https://doi.org/10.21037/qims-2025-100","url":null,"abstract":"","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"264"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.21037/qims-2025-1704
Tingting Li, Mingyuan Wu, Man Lu
Background: Color Doppler ultrasonography technology has demonstrated excellent diagnostic performance across diverse clinical scenarios; however, research on its use in rectal tumor evaluation remains underexplored. This study aimed to evaluate the diagnostic value of transrectal ultrasound (TRUS)-derived vascular features in differentiating between malignant and benign rectal lesions, preoperative tumor staging, and monitoring the neoadjuvant therapy (NT) response.
Methods: A retrospective cohort of 452 patients with TRUS-detected gastrointestinal lesions was analyzed. Vascular parameters, including peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were recorded. Histopathological findings served as the diagnostic gold standard.
Results: Of the 452 cases, 428 (94.7%) were pathologically confirmed as malignant, while 24 (5.3%) were benign. The malignant group exhibited significantly higher PSV and RI values than the benign group (P<0.05). An RI threshold of >0.67 for malignancy detection resulted in a sensitivity of 78% and a specificity of 80%. Grade 3 (G3) tumors had higher PSV than grade 2 (G2) tumors, and G2 tumors had higher PSV than grade 1 (G1) tumors. Among the three tumor grades (P<0.05), the G3 tumors had the highest RI value (0.77), while the G1 tumors had the lowest RI value (0.68). In the pathology nodal stage (pN-stage) cases, pN2-stage cases exhibited a significantly higher PSV (20.1 cm/s) compared to both the pN0 (16.7 cm/s) and pN1 (15.9 cm/s) cases (P<0.001). In pathology tumor stage (pT-stage) cases, only pT4-stage cases showed higher RI than pT1-stage cases. After NT, the PSV and RI values decreased significantly (18.3 vs. 13.7 cm/s and 0.75 vs. 0.67) (P<0.05). The partial response (PR) group showed greater decreases in both the PSV and RI values after NT than the stable disease (SD) group.
Conclusions: TRUS vascular parameters, particularly PSV and RI, demonstrate strong diagnostic value in differentiating between malignant and benign rectal lesions, and differ significantly across some tumor differentiation grades and pN-/pT-stages. Additionally, these parameters can serve as effective biomarkers for monitoring NT efficacy.
{"title":"The role of transrectal doppler ultrasound in the evaluation of rectal lesions: a large-sample analysis of 400+ cases.","authors":"Tingting Li, Mingyuan Wu, Man Lu","doi":"10.21037/qims-2025-1704","DOIUrl":"https://doi.org/10.21037/qims-2025-1704","url":null,"abstract":"<p><strong>Background: </strong>Color Doppler ultrasonography technology has demonstrated excellent diagnostic performance across diverse clinical scenarios; however, research on its use in rectal tumor evaluation remains underexplored. This study aimed to evaluate the diagnostic value of transrectal ultrasound (TRUS)-derived vascular features in differentiating between malignant and benign rectal lesions, preoperative tumor staging, and monitoring the neoadjuvant therapy (NT) response.</p><p><strong>Methods: </strong>A retrospective cohort of 452 patients with TRUS-detected gastrointestinal lesions was analyzed. Vascular parameters, including peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were recorded. Histopathological findings served as the diagnostic gold standard.</p><p><strong>Results: </strong>Of the 452 cases, 428 (94.7%) were pathologically confirmed as malignant, while 24 (5.3%) were benign. The malignant group exhibited significantly higher PSV and RI values than the benign group (P<0.05). An RI threshold of >0.67 for malignancy detection resulted in a sensitivity of 78% and a specificity of 80%. Grade 3 (G3) tumors had higher PSV than grade 2 (G2) tumors, and G2 tumors had higher PSV than grade 1 (G1) tumors. Among the three tumor grades (P<0.05), the G3 tumors had the highest RI value (0.77), while the G1 tumors had the lowest RI value (0.68). In the pathology nodal stage (pN-stage) cases, pN2-stage cases exhibited a significantly higher PSV (20.1 cm/s) compared to both the pN0 (16.7 cm/s) and pN1 (15.9 cm/s) cases (P<0.001). In pathology tumor stage (pT-stage) cases, only pT4-stage cases showed higher RI than pT1-stage cases. After NT, the PSV and RI values decreased significantly (18.3 <i>vs.</i> 13.7 cm/s and 0.75 <i>vs.</i> 0.67) (P<0.05). The partial response (PR) group showed greater decreases in both the PSV and RI values after NT than the stable disease (SD) group.</p><p><strong>Conclusions: </strong>TRUS vascular parameters, particularly PSV and RI, demonstrate strong diagnostic value in differentiating between malignant and benign rectal lesions, and differ significantly across some tumor differentiation grades and pN-/pT-stages. Additionally, these parameters can serve as effective biomarkers for monitoring NT efficacy.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"238"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increase the risk of cardiovascular disease. This study evaluated the impact of MetS on myocardial fibrosis, left heart function, and postoperative reverse remodeling in hypertrophic obstructive cardiomyopathy (HOCM) patients undergoing septal myectomy (SM).
Methods: A total of 305 consecutive patients with HOCM (120 with MetS and 185 without MetS) who underwent SM with comprehensive pre- and postoperative cardiac magnetic resonance (CMR) evaluations between April 2022 and December 2024 were included in this study. CMR-derived structural, functional, and fibrosis-related parameters were analyzed. Multivariable linear regression identified determinants of the rate of change in global longitudinal strain (GLS) and left atrial (LA) strain.
Results: Compared with the HOCM patients without MetS, those with MetS exhibited lower global radial strain (GRS), GLS, and left ventricular global function index (LVGFI) values, along with higher left ventricular mass index (LVMI), left ventricular remodeling index (LVRI), and myocardial fibrosis burden values (all P<0.05). Regarding LA function, the HOCM patients with MetS had larger left atrial volume index (LAVI) and left atrioventricular coupling index (LACI) values, lower total left atrial emptying fraction (LAEF), and impaired LA total and passive strain (all P<0.05). The multivariable analysis identified the presence of MetS as an independent determinant of postoperative changes in GLS (β=0.264, P<0.001) and total strain (εs; β=0.135, P=0.030).
Conclusions: The presence of MetS worsens left heart dysfunction and myocardial fibrosis in HOCM patients, and independently impairs myocardial recovery and reverse remodeling following SM. These findings highlight the importance of the early detection and comprehensive management of metabolic risk factors to improve surgical outcomes in HOCM patients with MetS.
{"title":"Impact of metabolic syndrome on cardiac function and myocardial fibrosis in hypertrophic obstructive cardiomyopathy following septal myectomy assessed by cardiac magnetic resonance.","authors":"Ziyi Pan, Zhaoxia Yang, Yun Zhao, Jinyang Wen, Lingping Ran, Dazhong Tang, Lu Huang, Liming Xia","doi":"10.21037/qims-2025-1631","DOIUrl":"https://doi.org/10.21037/qims-2025-1631","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increase the risk of cardiovascular disease. This study evaluated the impact of MetS on myocardial fibrosis, left heart function, and postoperative reverse remodeling in hypertrophic obstructive cardiomyopathy (HOCM) patients undergoing septal myectomy (SM).</p><p><strong>Methods: </strong>A total of 305 consecutive patients with HOCM (120 with MetS and 185 without MetS) who underwent SM with comprehensive pre- and postoperative cardiac magnetic resonance (CMR) evaluations between April 2022 and December 2024 were included in this study. CMR-derived structural, functional, and fibrosis-related parameters were analyzed. Multivariable linear regression identified determinants of the rate of change in global longitudinal strain (GLS) and left atrial (LA) strain.</p><p><strong>Results: </strong>Compared with the HOCM patients without MetS, those with MetS exhibited lower global radial strain (GRS), GLS, and left ventricular global function index (LVGFI) values, along with higher left ventricular mass index (LVMI), left ventricular remodeling index (LVRI), and myocardial fibrosis burden values (all P<0.05). Regarding LA function, the HOCM patients with MetS had larger left atrial volume index (LAVI) and left atrioventricular coupling index (LACI) values, lower total left atrial emptying fraction (LAEF), and impaired LA total and passive strain (all P<0.05). The multivariable analysis identified the presence of MetS as an independent determinant of postoperative changes in GLS (β=0.264, P<0.001) and total strain (εs; β=0.135, P=0.030).</p><p><strong>Conclusions: </strong>The presence of MetS worsens left heart dysfunction and myocardial fibrosis in HOCM patients, and independently impairs myocardial recovery and reverse remodeling following SM. These findings highlight the importance of the early detection and comprehensive management of metabolic risk factors to improve surgical outcomes in HOCM patients with MetS.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"197"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.21037/qims-2025-1952
Yingcheng Zhao, Zhenzhen You, Lanfen Chen, Zhenghao Shi, Lin Wang, Yuanlin Zhang, Lu Sun, Xiaowei He, Xiaoli Wang
<p><strong>Background: </strong>Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) demonstrates significant potential for early disease detection, yet encounters challenges in lesion analysis due to interference from concomitant effects during imaging. Although machine learning-based unsupervised anomaly detection (UAD) methods offer feasible solutions for identifying subtle lesions in contaminated images, current UAD approaches primarily dependent on convolutional neural network (CNN) or Transformer architectures to process image-level data from conventional imaging modalities, exhibit limitations when applied to CEST data characterized by spectral information. This study aimed to propose a novel UAD framework tailored for CEST spectral data to overcome these limitations, enabling precise pixel-wise anomaly detection for early-stage lesions.</p><p><strong>Methods: </strong>The proposed framework named Mamba-AE employs a multi-layers encoder-decoder architecture with stacked Mamba blocks as the core component. Each Mamba block integrates three key modules: selective state-space models (SSMs) to dynamically adjust parameters based on input sequences, enabling adaptive long-range dependency modeling of CEST spectral data; Gated Multi-Layer Perceptron with Sigmoid Linear Unit (SiLU) activation and residual connections to enhance non-linear feature learning and stability; Multi-Scale Feature Alignment that aligns hierarchical encoder-decoder features via cosine similarity, preserving physiological semantics across scales. The framework adopts a dual-domain reconstruction strategy: data-space reconstruction minimizes pixel-wise spectral errors through Huber loss, while feature-space reconstruction enforces consistency between paired encoder-decoder layer features via cosine similarity loss. Anomaly scores are generated by combining normalized residuals from data-space errors and discrepancies in feature-space alignment, enabling precise pixel-level lesion localization in early-stage CEST data. For quantitative evaluation of lesion detection performance, the area under the curve (AUC) and Dice similarity coefficient are employed as core metrics. The framework was trained exclusively on CEST spectra from healthy rat brain tissue and validated on an independent dataset from a rat model of transient focal cerebral ischemia induced by middle cerebral artery occlusion (MCAO) with reperfusion.</p><p><strong>Results: </strong>The proposed method has been validated on ischemic stroke rat datasets at 2, 6, and 24 hours post-occlusion. Mamba-AE demonstrated superior performance across all stages. At the critical 2-hour time point, it achieved the highest performance among all methods, with an AUC of 95.91% and a Dice score of 88.43% (sensitivity >89%, specificity >92%). The advantage remained substantial at 6 hours (AUC: 92.19%, Dice: 85.23%) and 24 hours (AUC: 94.64%, Dice: 87.79%), consistently outperforming other approaches. Further
背景：化学交换饱和转移（CEST）磁共振成像（MRI）显示出早期疾病检测的巨大潜力，但由于成像过程中伴随效应的干扰，在病变分析方面遇到了挑战。尽管基于机器学习的无监督异常检测（UAD）方法为识别污染图像中的细微病变提供了可行的解决方案，但目前的UAD方法主要依赖于卷积神经网络（CNN）或Transformer架构来处理来自传统成像模式的图像级数据，当应用于以光谱信息为特征的CEST数据时，存在局限性。本研究旨在提出一种针对CEST光谱数据量身定制的新型UAD框架，以克服这些限制，实现对早期病变进行精确的逐像素异常检测。方法：提出的Mamba- ae框架采用以堆叠的Mamba块为核心组件的多层编码器-解码器架构。每个Mamba块集成了三个关键模块：选择性状态空间模型（SSMs），根据输入序列动态调整参数，实现CEST光谱数据的自适应远程依赖建模；采用Sigmoid线性单元（SiLU）激活和残差连接的门控多层感知器增强非线性特征学习和稳定性多尺度特征对齐，通过余弦相似性对齐分层编码器-解码器特征，保持跨尺度的生理语义。该框架采用双域重构策略：数据空间重构通过Huber损失最小化像素频谱误差，而特征空间重构通过余弦相似度损失增强配对编码器-解码器层特征之间的一致性。异常评分是通过结合数据空间误差和特征空间对齐差异的归一化残差生成的，可以在早期CEST数据中实现精确的像素级病变定位。为了定量评价病灶检测性能，采用曲线下面积（area under the curve， AUC）和Dice相似系数作为核心指标。该框架仅在健康大鼠脑组织的CEST谱上进行训练，并在大脑中动脉闭塞（MCAO）再灌注引起的短暂局灶性脑缺血大鼠模型的独立数据集上进行验证。结果：该方法在缺血性脑卒中大鼠闭塞后2、6和24小时的数据集上得到了验证。Mamba-AE在所有阶段都表现出优异的性能。在关键的2小时时间点，该方法的AUC为95.91%，Dice评分为88.43%（灵敏度>为89%，特异性>为92%），在所有方法中表现最佳。6小时（AUC: 92.19%, Dice: 85.23%）和24小时（AUC: 94.64%, Dice: 87.79%）的优势仍然很大，始终优于其他方法。此外，异常热图显示了精确的病变定位能力，其空间精度与组织病理学地面真值测量结果密切相关。结论：Mamba-AE为CEST MRI的早期疾病检测提供了一种计算效率高且可靠的解决方案。它整合了光谱特征学习和结构保存，突出了它在临床应用中的潜力，需要对细微的病理变化有很高的敏感性。
{"title":"Mamba-AE: pixel-wise anomaly detection auto-encoder in chemical exchange saturation transfer magnetic resonance imaging.","authors":"Yingcheng Zhao, Zhenzhen You, Lanfen Chen, Zhenghao Shi, Lin Wang, Yuanlin Zhang, Lu Sun, Xiaowei He, Xiaoli Wang","doi":"10.21037/qims-2025-1952","DOIUrl":"https://doi.org/10.21037/qims-2025-1952","url":null,"abstract":"<p><strong>Background: </strong>Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) demonstrates significant potential for early disease detection, yet encounters challenges in lesion analysis due to interference from concomitant effects during imaging. Although machine learning-based unsupervised anomaly detection (UAD) methods offer feasible solutions for identifying subtle lesions in contaminated images, current UAD approaches primarily dependent on convolutional neural network (CNN) or Transformer architectures to process image-level data from conventional imaging modalities, exhibit limitations when applied to CEST data characterized by spectral information. This study aimed to propose a novel UAD framework tailored for CEST spectral data to overcome these limitations, enabling precise pixel-wise anomaly detection for early-stage lesions.</p><p><strong>Methods: </strong>The proposed framework named Mamba-AE employs a multi-layers encoder-decoder architecture with stacked Mamba blocks as the core component. Each Mamba block integrates three key modules: selective state-space models (SSMs) to dynamically adjust parameters based on input sequences, enabling adaptive long-range dependency modeling of CEST spectral data; Gated Multi-Layer Perceptron with Sigmoid Linear Unit (SiLU) activation and residual connections to enhance non-linear feature learning and stability; Multi-Scale Feature Alignment that aligns hierarchical encoder-decoder features via cosine similarity, preserving physiological semantics across scales. The framework adopts a dual-domain reconstruction strategy: data-space reconstruction minimizes pixel-wise spectral errors through Huber loss, while feature-space reconstruction enforces consistency between paired encoder-decoder layer features via cosine similarity loss. Anomaly scores are generated by combining normalized residuals from data-space errors and discrepancies in feature-space alignment, enabling precise pixel-level lesion localization in early-stage CEST data. For quantitative evaluation of lesion detection performance, the area under the curve (AUC) and Dice similarity coefficient are employed as core metrics. The framework was trained exclusively on CEST spectra from healthy rat brain tissue and validated on an independent dataset from a rat model of transient focal cerebral ischemia induced by middle cerebral artery occlusion (MCAO) with reperfusion.</p><p><strong>Results: </strong>The proposed method has been validated on ischemic stroke rat datasets at 2, 6, and 24 hours post-occlusion. Mamba-AE demonstrated superior performance across all stages. At the critical 2-hour time point, it achieved the highest performance among all methods, with an AUC of 95.91% and a Dice score of 88.43% (sensitivity >89%, specificity >92%). The advantage remained substantial at 6 hours (AUC: 92.19%, Dice: 85.23%) and 24 hours (AUC: 94.64%, Dice: 87.79%), consistently outperforming other approaches. Further","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"218"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.21037/qims-2025-1766
Jiehan Hong, Zhengjie Wu, Zeping Gao, Hairong Zheng, Benpeng Zhu, Teng Ma
<p><strong>Background: </strong>Acute coronary syndrome (ACS) is triggered by the rupture or erosion of unstable atherosclerotic plaques in coronary arteries, which induces thrombosis and ultimately results in myocardial hypoperfusion. In current clinical practice, treatment strategies for ACS are predominantly guided by the assessment of vascular stenosis severity, while the key indicator of plaque vulnerability (i.e., plaque nature) is largely overlooked. This oversight may lead to suboptimal therapeutic decisions and adversely affect patient outcomes. This study thus aimed to develop an ultrasound technology-based system capable of imaging intravascular structures and analyzing plaque characteristics.</p><p><strong>Methods: </strong>In this study, two ultrasound transducers with different frequencies were integrated into a single microcatheter: a low-frequency-focused transducer for generating a sufficient acoustic radiation force to induce shear waves in tissue and a high-frequency imaging transducer for acquiring high-resolution structural images. Structural imaging data were analyzed to determine the shear wave propagation speed, enabling calculation of tissue stiffness and simultaneous imaging of both the morphological and mechanical properties for comprehensive tissue characterization. The safety of the dual-frequency system was confirmed through precise acoustic output measurements and calculations, and compliance with established safety standards was established. To evaluate the feasibility of simultaneously assessing coronary artery morphology and functional properties in the context of coronary artery disease, three sets of experiments were performed: elastomeric phantom tests with varying stiffness, <i>ex vivo</i> porcine coronary artery experiments, and <i>in vivo</i> rabbit abdominal aortic plaque studies.</p><p><strong>Results: </strong>The acoustic performance of the dual-frequency ultrasound transducers was characterized via echo measurements and spectral analysis, yielding center frequencies of 9.78 and 36.35 MHz and corresponding peak-to-peak echo amplitudes of 1,682 and 380.4 mV, respectively. Based on peak displacement and shear-wave velocity measurements in phantom imaging, the lateral and axial resolutions of the low-frequency driving transducer were determined to be 440.3 and 320.3 µm, respectively, whereas those of the high-frequency imaging transducer were 369.2 and 312.2 µm, respectively. Through the comparison of the mechanical properties of porcine coronary arteries before and 20 minutes after formalin fixation, the Young modulus of the vessels in the native state was determined to be 69.6±6.3 kPa, which increased to 140.3±16.3 kPa after fixation. These results further confirmed the system's ability to detect tissues of varying stiffness levels. <i>In vivo</i> measurements revealed a significant stiffness contrast between atherosclerotic plaques (4.9±0.3 kPa) and normal vessel walls (39.6±2.5 kPa). These results demo
{"title":"Miniaturized dual-element transducer-based intravascular ultrasonic elastography: a preliminary <i>in vivo</i> study.","authors":"Jiehan Hong, Zhengjie Wu, Zeping Gao, Hairong Zheng, Benpeng Zhu, Teng Ma","doi":"10.21037/qims-2025-1766","DOIUrl":"https://doi.org/10.21037/qims-2025-1766","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) is triggered by the rupture or erosion of unstable atherosclerotic plaques in coronary arteries, which induces thrombosis and ultimately results in myocardial hypoperfusion. In current clinical practice, treatment strategies for ACS are predominantly guided by the assessment of vascular stenosis severity, while the key indicator of plaque vulnerability (i.e., plaque nature) is largely overlooked. This oversight may lead to suboptimal therapeutic decisions and adversely affect patient outcomes. This study thus aimed to develop an ultrasound technology-based system capable of imaging intravascular structures and analyzing plaque characteristics.</p><p><strong>Methods: </strong>In this study, two ultrasound transducers with different frequencies were integrated into a single microcatheter: a low-frequency-focused transducer for generating a sufficient acoustic radiation force to induce shear waves in tissue and a high-frequency imaging transducer for acquiring high-resolution structural images. Structural imaging data were analyzed to determine the shear wave propagation speed, enabling calculation of tissue stiffness and simultaneous imaging of both the morphological and mechanical properties for comprehensive tissue characterization. The safety of the dual-frequency system was confirmed through precise acoustic output measurements and calculations, and compliance with established safety standards was established. To evaluate the feasibility of simultaneously assessing coronary artery morphology and functional properties in the context of coronary artery disease, three sets of experiments were performed: elastomeric phantom tests with varying stiffness, <i>ex vivo</i> porcine coronary artery experiments, and <i>in vivo</i> rabbit abdominal aortic plaque studies.</p><p><strong>Results: </strong>The acoustic performance of the dual-frequency ultrasound transducers was characterized via echo measurements and spectral analysis, yielding center frequencies of 9.78 and 36.35 MHz and corresponding peak-to-peak echo amplitudes of 1,682 and 380.4 mV, respectively. Based on peak displacement and shear-wave velocity measurements in phantom imaging, the lateral and axial resolutions of the low-frequency driving transducer were determined to be 440.3 and 320.3 µm, respectively, whereas those of the high-frequency imaging transducer were 369.2 and 312.2 µm, respectively. Through the comparison of the mechanical properties of porcine coronary arteries before and 20 minutes after formalin fixation, the Young modulus of the vessels in the native state was determined to be 69.6±6.3 kPa, which increased to 140.3±16.3 kPa after fixation. These results further confirmed the system's ability to detect tissues of varying stiffness levels. <i>In vivo</i> measurements revealed a significant stiffness contrast between atherosclerotic plaques (4.9±0.3 kPa) and normal vessel walls (39.6±2.5 kPa). These results demo","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"222"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.21037/qims-2025-1860
Zifan Lin, Yuchao Shi, Hongying Hu, Meng You
Background: Age-related degeneration of parotid glands impacts oral and systemic health, yet non-invasive assessment remains limited. This study characterizes parotid gland aging using computed tomography (CT)-based radiomics for the early detection of glandular dysfunction or diseases.
Methods: This retrospective study included 320 healthy individuals (aged 12-84 years), stratified into four age groups (adolescent: <25, young adult: 25-44, middle-aged: 45-59, elderly: >59 years) with balanced sex distribution. Axial medial-lateral diameter (AMLD) and mean Hounsfield unit (HU) attenuation were manually measured on axial CT slices. Three-dimensional (3D) radiomic features were extracted from automatically segmented glands via PyRadiomics platform. Dimensionality reduction was performed by probabilistic principal component analysis (PCA) and unsupervised K-means clustering was applied to shape-, first-order-, and texture-related features to identify age-associated patterns.
Results: AMLD increased significantly with age from 32.1±3.5 mm in the adolescent group to 40.3±4.1 mm in the elderly group (P<0.05). Similarly, gland volume enlarged significantly, with males exhibiting larger volumes than females across all groups (P<0.05). In contrast, mean HU declined with age from -2.5±6.8 to -15.7±10.2 HU (P<0.05), indicating reduced tissue density and homogeneity. Radiomic uniformity also decreased significantly in adults compared to adolescents (P<0.05). Unsupervised clustering revealed a marked age-dependent shift: Cluster 1 (small, spherical glands) comprised 55.6% of adolescent glands but only 8.8% of elderly glands (P<0.05), whereas Clusters 3 and 4 (large, irregular glands) increased from 10.9% to 48.8% (P<0.05).
Conclusions: CT-based radiomics captured age-related morphological and structural changes in parotid glands. These findings support the application of CT as a non-invasive tool for monitoring parotid gland aging and may inform the early detection of age-associated glandular dysfunction.
{"title":"Age-related changes in the parotid gland: a computed tomography-based radiomics study.","authors":"Zifan Lin, Yuchao Shi, Hongying Hu, Meng You","doi":"10.21037/qims-2025-1860","DOIUrl":"https://doi.org/10.21037/qims-2025-1860","url":null,"abstract":"<p><strong>Background: </strong>Age-related degeneration of parotid glands impacts oral and systemic health, yet non-invasive assessment remains limited. This study characterizes parotid gland aging using computed tomography (CT)-based radiomics for the early detection of glandular dysfunction or diseases.</p><p><strong>Methods: </strong>This retrospective study included 320 healthy individuals (aged 12-84 years), stratified into four age groups (adolescent: <25, young adult: 25-44, middle-aged: 45-59, elderly: >59 years) with balanced sex distribution. Axial medial-lateral diameter (AMLD) and mean Hounsfield unit (HU) attenuation were manually measured on axial CT slices. Three-dimensional (3D) radiomic features were extracted from automatically segmented glands via PyRadiomics platform. Dimensionality reduction was performed by probabilistic principal component analysis (PCA) and unsupervised K-means clustering was applied to shape-, first-order-, and texture-related features to identify age-associated patterns.</p><p><strong>Results: </strong>AMLD increased significantly with age from 32.1±3.5 mm in the adolescent group to 40.3±4.1 mm in the elderly group (P<0.05). Similarly, gland volume enlarged significantly, with males exhibiting larger volumes than females across all groups (P<0.05). In contrast, mean HU declined with age from -2.5±6.8 to -15.7±10.2 HU (P<0.05), indicating reduced tissue density and homogeneity. Radiomic uniformity also decreased significantly in adults compared to adolescents (P<0.05). Unsupervised clustering revealed a marked age-dependent shift: Cluster 1 (small, spherical glands) comprised 55.6% of adolescent glands but only 8.8% of elderly glands (P<0.05), whereas Clusters 3 and 4 (large, irregular glands) increased from 10.9% to 48.8% (P<0.05).</p><p><strong>Conclusions: </strong>CT-based radiomics captured age-related morphological and structural changes in parotid glands. These findings support the application of CT as a non-invasive tool for monitoring parotid gland aging and may inform the early detection of age-associated glandular dysfunction.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"16 3","pages":"248"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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