Acta radiologica最新文献

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.

BackgroundQuantitative parameters derived from synthetic magnetic resonance imaging (SyMRI) have shown potential in diagnosing clinically significant prostate cancer (csPCa). Histogram analysis enhances diagnostic accuracy by evaluating spatial heterogeneity.PurposeTo assess the performance of histogram analysis models utilizing relaxation maps from SyMRI in diagnosing csPCa.Material and MethodsA total of 124 men with a clinical suspicion of csPCa were enrolled prospectively between April 2018 and December 2019. From 124 patients, 224 ROIs were analyzed, including 97 csPCa lesions, 11 insignificant PCa, 59 non-cancerous peripheral zone (PZ) lesions, and 57 benign prostatic hyperplasia. The lesions were randomly divided into a training group and a validation group, in a ratio of 7:3. Histogram analysis models were constructed using SyMRI relaxation maps, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), and their combination. We compared these with mean-value-based models using the same modalities. The diagnostic accuracy of these models in distinguishing csPCa from clinically insignificant disease (CIS) was evaluated.ResultsHistogram analysis models outperformed mean-value-based models in both training and validation groups. SyMRI-based histogram analysis models demonstrated diagnostic effectiveness comparable to DWI and ADC models. The combined model achieved the highest area under the curve values in the PZ (0.898; 95% confidence interval [CI]=0.763-0.999) and transition zone (TZ) (0.944; 95% CI=0.874-0.999). In the TZ, the combined model significantly outperformed the Prostate Imaging Reporting and Data System (P = 0.019).ConclusionHistogram analysis of SyMRI relaxation maps is a valuable tool for differentiating csPCa from CIS. Combining SyMRI with DWI and ADC further improved diagnostic accuracy.

BackgroundLiver iron overload is the most common cause of magnetic resonance elastography (MRE) failure.PurposeTo determine a threshold of R2*, a surrogate of liver iron concentration (LIC), which predicts the failure of liver MRE for either 2D gradient-recalled echo (GRE) or spin-echo echo-planar imaging (SE-EPI) MRE sequence at 3 T.Material and MethodsThis single-center retrospective study included 247 patients who underwent GRE MRE, SE-EPI MRE sequences for fibrosis evaluation and 2D multi-echo GRE sequence for R2* quantification using MRQuantif software. The ability of R2* to predict the failed MRE related to liver iron accumulation was estimated by the area under the receiver operating characteristic curve (AUC).ResultsAfter excluding 26 exams for technical failure, we evaluated 221 patients (52 women; mean age = 56 ± 13) with R2* values in the range of 37-1665 s^-1. The iron-related failure rates of GRE MRE and SE-EPI MRE were 62.9% (139/221) and 10.0% (22/221), respectively. The best cutoff of R2* to predict failure exam due to liver iron deposition with GRE MRE was 101 s^-1 with a sensitivity of 79.1% and specificity of 97.6% (AUC = 0.97; 95% confidence interval [CI] = 0.95-0.99). This cutoff for SE-EPI MRE was 289 s^-1 with a sensitivity of 82.8% and specificity of 99.5% (AUC = 0.89; 95% CI = 0.78-1).ConclusionLiver R2* is a good predictor of MRE examination failure related to iron deposition for MRE at 3 T.

BackgroundOsteoporosis is a significant global health issue, particularly in aging populations. Dual-energy X-ray absorptiometry (DXA) is the gold standard for osteoporosis diagnosis; however, its limitations have driven research into alternative methods.PurposeTo explore the diagnostic potential of cervical MRI-derived vertebral bone quality (VBQ) scores in predicting osteoporosis, in comparison to lumbar vertebra measurements.Material and MethodsThis retrospective study included patients who had DXA scans between 2020 and 2023 and underwent cervical MRI within 6 months. A total of 213 patients were classified into normal (n = 72), osteopenia (n = 82), and osteoporosis (n = 59) groups based on their DXA T-scores. T1-weighted MRI images were used to measure vertebral body signal intensity (SI) and cerebrospinal fluid (CSF) SI, which were then used to calculate VBQ scores. Both cervical and lumbar VBQ scores were compared to DXA results to evaluate diagnostic efficacy.ResultsCervical VBQ scores, particularly the C4:posterior fossa CSF SI ratio, demonstrated significant correlations with DXA T-scores (P = 1.7 × 10^-5). The study found that the C4:posterior fossa CSF SI ratio had a high diagnostic accuracy (AUC = 0.81) for distinguishing between normal bone density and osteopenia/osteoporosis. Furthermore, cervical VBQ scores showed stronger correlations with bone density than lumbar scores, suggesting that the cervical spine may serve as a more effective diagnostic region.ConclusionCervical MRI-derived VBQ scores, especially the C4:posterior fossa CSF SI ratio, offer a promising non-invasive tool for osteoporosis diagnosis. This method may provide a complementary or alternative diagnostic approach to DXA, particularly in cases where lumbar imaging is insufficient.

BackgroundIt remains unclear whether a torn meniscus loses significantly more fat content than a normal meniscus and consequently shows a lower signal drop on opposed-phase (OP) images using the multi-point Dixon (mDixon) technique.PurposeTo evaluate meniscal injuries by performing a quantitative analysis of internal fat content using a signal drop.Material and MethodsA total of 99 patients who underwent knee magnetic resonance imaging (MRI) with the mDixon technique was included in this retrospective study. We measured the mean signal intensity of the meniscus from the in-phase (IP) and OP mDixon images with sagittal reconstruction. The proportional decrease of signal intensity (signal drop) was calculated. The median value with 25th (Q1) and 75th (Q3) percentiles of signal drop was reported for each meniscus. The Mann-Whitney U-test was used to compare the signal drop between meniscal tear and normal groups.ResultsIn the lateral meniscus (LM) and medial meniscus posterior horn (MMPH) tear groups, the median values of signal drop were significantly lower than in the normal group (P <0.05). Although the MM anterior horn (MMAH) tear group had a lower median signal drop than the normal group, there was no significant difference (P = 0.116 and 0.283, readers 1 and 2, respectively).ConclusionThe signal drop in torn menisci was lower than in normal menisci across all tear types, with statistical significance observed in LM and MMPH tears. We believe that these results may be explained by a reduced intracellular lipid content in torn menisci compared to normal menisci.

BackgroundThe relationship between serum inflammatory biomarkers, carotid atherosclerotic plaque characteristics, and the recurrence of ischemic events remains a subject of ongoing debate.PurposeTo investigate whether the combination of carotid atherosclerotic plaque burden and serum inflammatory biomarkers could help predict ipsilateral ischemic stroke recurrence.Material and MethodsPatients with cerebral infarction were prospectively recruited and received three-dimensional vessel wall imaging (VWI). Baseline serum level of high-sensitivity C-reactive protein (hs-CRP) and the neutrophil-to-lymphocyte ratio (NLR) was recorded. Plaque burden was independently measured by two trained readers. Stroke recurrence was assessed at 1 year after discharge. Factors associated with stroke recurrence were analyzed. Receiver operating characteristic curves were used to calculate areas under the curve (AUCs) of inflammatory biomarkers and plaque burden for predicting stroke recurrence.ResultsA total of 56 patients were included, with recurrence in nine patients. hs-CRP (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.17-2.19; P = 0.017) and carotid normalized wall index (NWI) (OR = 1.08, 95% CI = 1.01-1.16; P = 0.023) were found associated with stroke recurrence. Multivariate logistic regression showed that hs-CRP (OR = 1.67, 95% CI = 1.17-2.38; P = 0.005) and NWI (OR = 1.10, 95% CI = 1.01-1.20, P = 0.023) remained associated with stroke recurrence. Hs-CRP (AUC = 0.806; P = 0.002) and NWI (AUC = 0.738; P <0.001) were predictors of stroke recurrence. The combination of hs-CRP with NWI (AUC = 0.811, P <0.001) demonstrated the best performance in terms of predicting stroke recurrence.ConclusionBoth hs-CRP and NWI were independently associated with stroke recurrence. The combination of hs-CRP and NWI may be a good predictor of 1-year stroke recurrence.

BackgroundIn routine clinical practice, incidental solitary bone lesions are commonly seen on various imaging modalities. 18F-FDG-positron emission tomography (PET)/computed tomography (CT) imaging provides functional and morphological information in oncology patients, and incidental bone lesions are often detected during the scan.PurposeTo evaluate the metabolic characteristics and CT morphological findings of incidental bone lesions detected in patients undergoing 18F-FDG-PET/CT imaging.Material and MethodsSUVmax values and CT characteristics of incidental osseous lesions reported in 86 patients undergoing 18F-FDG-PET/CT imaging between 2019 and 2023 were evaluated. In addition, the SUVmax values of the lesions were compared with bone areas without adjacent/contralateral density/FDG changes. CT characteristics of incidental osseous lesions were evaluated.ResultsThe study group included 52 women and 34 men (age range = 26-89 years). CT identified typical bone haemangioma lesions in 45/86 (52%) cases. Non-haemangioma lesions were mainly benign bone pathologies: fibrous dysplasia; Paget's disease; perineural cyst; osteonecrosis; and osteoma. The mean SUVmax value of 41 non-haemangioma bone lesions (4.27 ± 3.71) was significantly higher than that in adjacent/contralateral normal density areas (2.31 ± 1.27; P = 0.01).Conclusion18F-FDG-PET/CT imaging shows varying FDG uptake in incidental osseous lesions. Morphological features on CT play a critical role in diagnosis and avoiding unnecessary imaging or interventions.

Breast cancer screening (BCS) is a prevention strategy for breast cancer (BC) facilitating early detection and treatment. BCS has been shown to be effective in reducing BC mortality and minimizing the need for more extensive invasive treatments. Immigrant women's participation rate to BSC is lower than that of native women. Interventions to support their informed decision-making could make a difference to this. The aim of this review was to investigate the current evidence of interventions for supporting informed decision-making on attendance to BCS by immigrant women. An integrative review was conducted by searching online databases (Medline, PubMed, PsycInfo, CINAHL, Scopus). A quality appraisal of the articles was performed using Joanna Briggs Institute quality appraisal checklists and mixed method appraisal tool. Data were extracted and synthesized using narrative analysis. A total of 25 articles were included in the study. Interventional strategies for supporting informed decision-making on attendance to BCS by immigrants were home visits, personal navigation service support, education sessions, and media-led information. In summary, to ensure the effective adoption of interventions for immigrants, it is imperative to consider cultural and linguistic tailored interventions, involve family members, especially husbands, offer free BCS and navigation services to those with limited financial resources, and, most importantly, uphold women's autonomy in their decision to participate in BCS.

BackgroundAcute findings of patellar dislocation in magnetic resonance imaging (MRI) can diminish with time; therefore, additional findings may help diagnosis of chronic patellofemoral instability.PurposeTo define a previously undescribed MRI finding-medial parapatellar triangle (MPT)-and to examine the diagnostic value of the disruption of MPT in chronic patellofemoral instability.Material and MethodsOur study was performed on 24 knees that underwent medial patellofemoral ligament reconstruction for chronic patellofemoral instability and 48 knees of patients with similar age and sex as control group. MPT was defined as an acute-angled triangle delineated by patellar cartilage, medial retinaculum, and medial femoral condyle in the section passing through the upper third of the patella on axial proton-density weighted with fat saturation (PD fat-sat) MRI scans. Disruption of MPT was assessed by two authors blinded to the diagnosis. Inter- and intra-observer reliability was assessed using Cohen's κ test. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each observer and observation.ResultsIn the study group, the triangular structure was disrupted in 18 knees for the first observer's first observation, and 17 knees for the second observation; for the second observer, it was 15 knees and 17 knees, respectively. In the control group, the numbers were 2, 6, 1, and 3, respectively. Mean Cohen's κ statistic was 0.81 (range=0.73-0.87). Sensitivity, specificity, PPV, and NPV were 66.7%-75%, 87.5%-97.9%, 72.7%-94.4%, and 84%-88.5%. respectively.ConclusionDisruption of MPT is an additional finding that may help the diagnosis of chronic patellofemoral instability.