Acta radiologica最新文献

BackgroundArtificial intelligence (AI)-based systems have the potential to increase the efficiency and effectiveness of breast cancer screening programs but need to be carefully validated before clinical implementation.PurposeTo retrospectively evaluate an AI system to safely reduce the workload of a double-reading breast cancer screening program.Material and MethodsAll digital mammography (DM) screening examinations of women aged 40-74 years between August 2021 and January 2022 in Östergötland, Sweden were included. Analysis of the interval cancers (ICs) was performed in 2024. Each examination was double-read by two breast radiologists and processed by the AI system, which assigned a score of 1-10 to each examination based on increasing likelihood of cancer. In a retrospective simulation, the AI system was used for triaging; low-risk examinations (score 1-7) were selected for single reading and high-risk examinations (score 8-10) for double reading.ResultsA total of 15,468 DMs were included. Using an AI triaging strategy, 10,473 (67.7%) examinations received scores of 1-7, resulting in a 34% workload reduction. Overall, 52/53 screen-detected cancers were assigned a score of 8-10 by the AI system. One cancer was missed by the AI system (score 4) but was detected by the radiologists. In total, 11 cases of IC were found in the 2024 analysis.ConclusionReplacing one reader in breast cancer screening with an AI system for low-risk cases could safely reduce workload by 34%. In total, 11 cases of IC were found in the 2024 analysis; of them, three were identified correctly by the AI system at the 2021-2022 examination.

BackgroundComputed tomography (CT)-derived acetabular angles are commonly used in the diagnosis of hip dysplasia, but the measurements are labor-intensive, with higher inter- and intra-operator variation, necessitating an automated method.PurposeTo develop and validate an automatic method for segmenting the acetabular lunate surface and measure diagnostic angles using CT images to improve diagnosis and preoperative planning for patients with hip dysplasia.Material and MethodsWe developed a method to segment the acetabular lunate surface, automatically identify five landmark points (center, anterior, posterior, lateral, and medial) and calculate diagnostic angles for center-edge (CE), anterior-sector (AASA), posterior-sector (PASA), acetabular anteversion (AcAV), and acetabular-index (AI). The method was validated against repeated manual measurements by three raters on a dataset of 18 patients (36 hips).ResultsNo differences between raters and the automatic method for the center (P = 0.18), anterior (P = 0.55), posterior (P = 0.18), lateral (P = 0.13), and medial (P = 0.12) landmarks. No statistically significant differences were observed between raters and the automatic method for the AASA (P = 0.01) and PASA (P = 0.08) angles. Statistically significant differences were found between the automatic method and rater 3 for the CE and AI angles, and between the automatic method and rater 2 for the AcAV angle. The ICC for all angle measurements by raters and the automated method was in the range of 0.90-0.99.ConclusionWith similar agreement between manual and automatic measurements, the automatic method provides important information that may be used for both diagnosis and surgical planning, with the potential to greatly reduce the time used for analysis per patient.

BackgroundEmbolization plays a significant role in interventional radiology and modern medicine, intersecting with several specialties. The technological advancement of embolic agents has contributed to successful outcomes in the treatment of a wide range of diseases.PurposeTo compare the histomorphological effects of Embosoft microspheres and Embosphere microspheres in uterine artery embolization (UAE) in sheep.Material and MethodsSuperselective and bilateral UAE was performed with Embosoft and Embosphere microspheres in 10 adult non-pregnant sheep. Embosoft microspheres with a diameter of 500-700 μm were compared with Embosphere microspheres of a similar diameter in two groups of five sheep each. One sheep was embolized only with non-ionic iodinated contrast solution and saline (SF0.9%). The evaluation was based on histopathological examination of the uterus, performed 7 days after embolization. Necrosis scores, the diameter of occluded arteries, and the number of particles were assessed. ANOVA test and Student's t-test were used to determine the differences between the study groups.ResultsThe mean volume of embolic agents was 18.35 mL in the Embosphere group and 19.1 mL in the Embosoft group, with no statistically significant difference (P = 0.62). No significant difference was observed between the corresponding sides in the two groups. In addition, there were no significant differences in the thickness of the surface epithelium (Embosphere 21.26 μm vs. 19.72 μm Embosoft; P = 0.56) and glandular area between the groups (Embosphere 12.20% vs. 17.77% Embosoft; P = 0.18).ConclusionEmbosoft micropheres were associated with a greater inflammatory response and a smaller area of degeneration compared to Embosphere microspheres.

BackgroundThis study examines the correlation between magnetic resonance imaging (MRI)-derived volume parameters, surgical outcomes, and renal function in adults undergoing ureteropelvic junction (UPJ) obstruction surgery. Understanding these relationships can improve surgical planning, patient selection, and postoperative prognosis.PurposeTo assess the correlation between anatomical parameters and surgical outcomes in adult patients with UPJ obstruction.Material and MethodsA prospective cross-sectional study was conducted on 60 patients with UPJ obstruction, selected via simple random sampling. The hydronephrosis volume (HV) to renal volume (RV) ratio was calculated using MR urography (MRU). Preoperative diethylene triamine pentaacetic acid (DTPA) differential renal function (DRF) and creatinine levels were also recorded. Patients requiring surgery were followed up after 6 months, measuring pelvis/RV ratio, creatinine, and DTPA DRF. Statistical analyses were performed to find correlations.ResultsOperated patients had a higher preoperative HV/RV ratio (AUC=0.914, 95% confidence interval [CI]=0.829-1.000; P <0.001) and higher DTPA DRF values (AUC=0.936, 95% CI=0.860-1.000; P <0.001). Patients with greater preoperative HV/RV ratios were less likely to achieve anatomical normalization. Significant correlations were found between HV/RV ratios with DTPA DRF and creatinine (P <0.05). DeLong's test showed no significant differences between HV/RV ratios and DTPA DRF in predicting surgical need.ConclusionQuantitative volumetric analysis using MRU can effectively predict the need for surgery and renal function deterioration in patients with UPJ obstruction. The HV/RV ratio plays a crucial role in guiding surgical decisions and predicting outcomes. This study emphasizes and tests the hypothesis that higher degree of hydronephrosis correlates with higher degree of deterioration of renal function and need for surgical intervention.

BackgroundHigher-resolution magnetic resonance imaging sequences are needed for the early detection of pancreatic cancer.PurposeTo compare the quality of our novel T2-weighted, high-contrast, thin-slice imaging sequence, with an improved spatial resolution and deep learning-based reconstruction (three-shot turbo spin-echo with deep learning-based reconstruction [3S-TSE-DLR]), for imaging the pancreas with imaging using three conventional sequences (half-Fourier acquisition single-shot turbo spin-echo [HASTE], fat-suppressed 3D T1-weighted [FS-3D-T1W] imaging, and magnetic resonance cholangiopancreatography [MRCP]).Material and MethodsPancreatic images of 50 healthy volunteers acquired with 3S-TSE-DLR, HASTE, FS-3D-T1W imaging, and MRCP were compared by two diagnostic radiologists. A 5-point scale was used for assessing motion artifacts, pancreatic margin sharpness, and the ability to identify the main pancreatic duct (MPD) on 3S-TSE-DLR, HASTE, and FS-3D-T1W imaging, respectively. The ability to identify MPD via MRCP was also evaluated.ResultsArtifact scores (the higher the score, the fewer the artifacts) were significantly higher for 3S-TSE-DLR than for HASTE, and significantly lower for 3S-TSE-DLR than for FS-3D-T1W imaging, for both radiologists. Sharpness scores were significantly higher for 3S-TSE-DLR than for HASTE and FS-3D-T1W imaging, for both radiologists. The rate of identification of MPD was significantly higher for 3S-TSE-DLR than for FS-3D-T1W imaging, for both radiologists, and significantly higher for 3S-TSE-DLR than for HASTE for one radiologist. The rate of identification of MPD was not significantly different between 3S-TSE-DLR and MRCP.Conclusion3S-TSE-DLR provides better image sharpness than conventional sequences, can identify MPD equally as well or better than HASTE, and shows identification performance comparable to that of MRCP.

BackgroundRadiofrequency ablation (RFA) is a first-line therapy for early-stage, single, small (≤3 cm) hepatocellular carcinoma (HCC) tumors; however, adequate control of subcapsular HCC by RFA remains challenging due to the higher risk of major complications and local tumor recurrence than non-subcapsular HCC.PurposeTo compare safety and efficacy of conventional transarterial chemoembolization (cTACE) and RFA as treatments for single, small (≤3 cm) HCC with a subcapsular location.Material and MethodsBetween 2008 and 2017, 717 treatment-naïve patients who underwent cTACE (n = 362) or RFA (n = 355) as a first-line treatment for single, small (≤3 cm), subcapsular HCC were enrolled. Propensity score analysis using inverse probability weighting (IPW) was applied to reduce the effect of potential confounding factors.ResultsThe median follow-up time was 87 months. After propensity score analysis using IPW, the 15-year overall survival rates in the cTACE and RFA groups were 47% and 45%, respectively (P = 0.89). The 15-year time to local tumor recurrence rates were 55% and 71%, respectively (P <0.001), and the 15-year time to recurrence rates were 29% and 30%, respectively (P = 0.18). The rates of major complication associated with cTACE and RFA after IPW were 1% and 4%, respectively (P = 0.01).ConclusioncTACE is a viable alternative to RFA for treating subcapsular HCCs measuring ≤3 cm, with a comparable overall survival rate and fewer major complications.

BackgroundIntensity-modulated radiotherapy targeting areas of active bone marrow effectively reduces hematological toxicity; consequently, it is important to determine whether the bone marrow is active.PurposeTo explore diffusion-weighted imaging (DWI) signal as a potential tool for assessing bone marrow function in middle-aged and elderly patients with rectal cancer.Material and MethodsA retrospective study investigated clinical and magnetic resonance imaging (MRI) data from middle-aged and elderly patients with rectal cancer. Pelvic bone marrow DWI signals (b = 800 s/mm²) were classified as high and iso-low signal groups. Factors influencing the DWI signal were analyzed individually in a multifactorial analysis. Subsequently, a comparison was made of the intravoxel incoherent motion (IVIM) parameters between the high and iso-low signal groups.ResultsThe study involved 73 patients, with 32 in the high-signal and 41 in the iso-low-signal groups. The multifactorial analysis showed that anemia (odds ratio [OR] = 5.264; P = 0.025) and proton density fat fraction (PDFF) (OR = 0.872; P <0.001) were independent factors influencing the DWI signal. In addition, the high-signal group demonstrated significantly lower values of the standard apparent diffusion coefficient (ADC) (median = 0.466 ×10^-3 mm²/s, interquartile range = 0.413-0.550 vs. 0.534 ×10^-3 mm²/s, interquartile range = 0.495-0.594; P <0.01) and the mean diffusion coefficient (D) (0.423 ± 0.065 vs. 0.482 ± 0.090, × 10^-3 mm²/s; P <0.01).ConclusionThe evaluation of pelvic bone marrow function through DWI signals is feasible in middle-aged and elderly patients with rectal cancer. A high DWI signal in the pelvic bone marrow correlates with post-anemic cellular proliferation, indicating active hematopoiesis.

BackgroundVoiding cystourethrography (VCUG) remains the best method to diagnose and to determine vesicoureteral reflux (VUR) grade.PurposeTo determine necessity and indications of VCUG and to investigate high-grade VUR predictors.Material and MethodsWe retrospectively reviewed data. The patients were sorted into three age groups: 0-12 months; 13-24 months; and above 24 months. Student t-test, Mann-Whitney U test, ANOVA, and Kruskal Wallis test were used to compare the means between groups. Pearson's correlation test was used for correlation analysis. Risk factors were determined by multivariate regression analysis.ResultsThe most common indication for VCUG was recurrent urinary tract infections (UTIs). VCUG revealed VUR in 96 (18.4%) patients, posterior urethral valve (PUV) in 13 (2.5%) patients, and bladder anomalies in 14 (2.6%) patients. Neither sex nor age was statistically significantly associated with presence or grades of VUR. Multivariate analysis showed that a history of recurrent UTI (P = 0.008), a presence of high-grade hydronephrosis (HN) on renal-bladder ultrasound (RBUS) (P = 0.001), and a presence of scarring on dimercaptosuccinic acid renal cortical scintigraphy (DMSA) (P < 0.001) were strongly associated with high-grade VUR. In addition, female sex, renal dysfunction, high-grade VUR, history of recurrent UTIs, and older age at diagnosis were identified as risk factors for renal scarring.ConclusionWe highlight that the most common indication for VCUG is recurrent UTIs, which is associated with higher renal damage and high-grade VUR. If a VCUG should be considered for children with recurrent UTIs, high-grade HN and renal scaring, which are the predictors of high-grade VUR.

BackgroundAbbreviated protocol (AP) of magnetic resonance imaging (MRI) possesses substantial diagnostic accuracy in detecting breast cancer; however, multiple studies have found that the sensitivity of original AP is reduced in non-mass enhancement (NME) lesions.PurposeTo evaluate the diagnostic value of the different AP protocols of MRI for detecting breast cancer with different morphologic patterns.Material and MethodsA retrospective study was performed on 193 lesions from 186 patients who underwent breast MRI with pathological confirmation. The lesions were divided into mass and NME groups. Three protocols were used for interpretation, including standard full diagnostic protocol (FDP), AP1 and AP2 (AP1 using the first-phase enhancement, AP2 using the first- and second-phase enhancements). The scan and interpretation time, sensitivity, specificity, and area under the curve (AUC) of three protocols in two groups were compared.ResultsThere were 124 and 69 lesions in the mass and NME groups, respectively. The scan and interpretation time of AP1 and AP2 were shorter than those of FDP (all P <0.001). In the mass group, the sensitivity and specificity of the three protocols did not significantly differ (all P >0.05); however, in the NME group, the sensitivity of AP1 was lower than that of FDP and AP2 (P1 = 0.007, P2 = 0.000). The AUC did not significantly differ among three protocols in two groups (all P >0.05), but the NME group had the lowest mean AUC for API (0.864 ± 0.049).ConclusionThe application of the second-phase post-enhancement scan as the AP2 can reduce the missed diagnoses of breast cancer with NME.

BackgroundThere is a lack of unified standard and effective methods for the diagnosis and treatment of postoperative cerebral edema.PurposeTo test the effectiveness of a predictive model in the diagnostic and treatment strategies for postoperative cerebral edema in patients with a meningioma.Material and MethodsA prediction model was constructed based on the data of 300 patients with a meningioma. The predictive model was used to evaluate the diagnosis and treatment effectiveness among another 100 patients. The 100 patients were randomly divided into a control group (n = 50) and an intervention group (n = 50). The control group received conventional diagnosis and treatment, and the intervention group was evaluated, diagnosed, and treated under the instruction of the prediction model.ResultsThe calibration curves, decision curves, and receiver operating characteristic curves showed that the model had good calibration and good utility performance. A significant and effective rate of cerebral edema treatment was higher in the intervention group compared to the control group. In addition, a shorter time to cerebral edema regression, shorter hospital stay, lower cost, and lower incidence of postoperative complications characterized the intervention group compared to the control group (P <0.05).ConclusionThe prediction model based on radiomics and clinical features has a high classification performance and clinical utility. The diagnostic and therapeutic decision under this model can improve the therapeutic effect and outcome of patients with postoperative cerebral edema and reduce the hospitalization time and cost.