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Reliability, reproducibility, and potential pitfalls of the O-RADS scoring with non-dynamic MRI. 使用非动态磁共振成像进行 O-RADS 评分的可靠性、可重复性和潜在缺陷。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-09-30 DOI: 10.1177/02841851241279897
Gulsum Kılıçkap, Betül Akdal Dölek, Serhat Kaya, Numan Ilteriş Çevik

Background: The O-RADS scoring has been proposed to standardize the reporting of adnexal lesions using magnetic resonance imaging (MRI).

Purpose: To assess intra- and inter-observer agreement of the O-RADS scoring using non-dynamic MRI and its agreement with pathologic diagnosis, and to provide the pitfalls in the scoring based on discordant ratings.

Material and methods: Adnexal lesions that were diagnosed using non-dynamic MRI at two centers were scored using O-RADS. Intra- and inter-observer agreements were assessed using kappa statistics. Cross-tabulations were made for intra- and inter-observer ratings and for O-RADS scores and pathological findings.

Results: Intra- and inter-observer agreements were assessed for 404 lesions in 339 patients who were admitted to center 1. Intra-observer agreement was almost perfect (97.8%, kappa = 0.963) and inter-observer agreement was substantial (83.2%, kappa = 0.730). The combined data from center 1 and center 2 included 496 patients; of them, 295 (59.5%) were operated. There was no borderline or malignant pathology for the lesions with O-RADS 1 or 2. Of those with an O-RADS score of 3, 3 (4.1%) lesions were borderline and none were malignant. The O-RADS scoring in discriminating borderline/malignant lesions from benign lesions was outstanding (area under the ROC curve 0.950, 95% CI = 0.923-0.971). Sensitivity, specificity, positive, and negative predictive values of O-RADS 4/5 lesions for borderline/malignant lesions were 96.2%, 87.1%, 72.8%, and 98.4%, respectively.

Conclusion: The O-RADS scoring using non-dynamic MRI is a reproducible method and has good discrimination for borderline/malignant lesions. Potential factors that may lead to discordant ratings are provided here.

背景:目的:评估使用非动态 MRI 的 O-RADS 评分在观察者内部和观察者之间的一致性及其与病理诊断的一致性,并根据不一致的评分提供评分中的误区:在两个中心使用非动态 MRI 诊断的附件病变均使用 O-RADS 进行评分。使用卡帕统计法评估观察者内部和观察者之间的一致性。对观察者内部和观察者之间的评分以及 O-RADS 评分和病理结果进行交叉分析:对第一中心收治的 339 名患者的 404 个病灶进行了观察者内部和观察者之间的一致性评估。观察者内部几乎完全一致(97.8%,kappa = 0.963),观察者之间也非常一致(83.2%,kappa = 0.730)。中心1和中心2的合并数据包括496名患者,其中295人(59.5%)接受了手术。O-RADS为1或2的病变没有边界或恶性病变。在 O-RADS 评分为 3 分的病灶中,3 个(4.1%)病灶为边缘病变,无恶性病变。O-RADS 评分在区分边缘/恶性病变和良性病变方面表现突出(ROC 曲线下面积为 0.950,95% CI = 0.923-0.971)。O-RADS 4/5 病变对边缘/恶性病变的敏感性、特异性、阳性和阴性预测值分别为 96.2%、87.1%、72.8% 和 98.4%:结论:使用非动态磁共振成像进行O-RADS评分是一种可重复的方法,对边缘/恶性病变具有良好的辨别能力。本文提供了可能导致评分不一致的潜在因素。
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引用次数: 0
A survey of bridging bone on chest radiography shows a greater than expected prevalence of marginal syndesmophytes. 对胸片上桥骨的调查显示,边缘联合骨赘的发病率高于预期。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-11-06 DOI: 10.1177/02841851241289562
Ankur Srivastava, Timothy Miao, Yi Yan, Artur Wozniak, Joanne Howey, Michael Roth, Gregory J Garvin

Background: The recognition of thin marginal spinal syndesmophytes is important, in part due to their association with non-traumatic or mildly traumatic vertebral fractures.

Purpose: To determine a lower limit on the prevalence of marginal spinal syndesmophytes using chest radiographs.

Material and methods: We conducted a retrospective analysis of 500 chest radiographs, assessing the prevalence of thin marginal syndesmophytes, bridging or near-bridging osteophytes, and flowing paravertebral ossifications in the thoracic intervertebral discs among individuals aged 16 years and older in a North American city.

Results: Among the 500 participants, we observed that thin vertical marginal syndesmophytes were present in 17 (3.4%) cases, bridging or near-bridging osteophytes were present in 126 (25.2%) cases, and flowing paravertebral ossifications were present in 37 (7.4%) cases. Out of the 17 participants with thin marginal syndesmophytes, 10 exhibited a bamboo-like spine appearance, defined as the presence of ≥4 contiguous levels of bridging marginal syndesmophytes. Analysis of syndesmophyte distribution per vertebral level indicated a higher frequency of involvement in the mid to lower thoracic spine, maximal at T9/10.

Conclusions: The presence of thin marginal syndesmophytes in the thoracic spine on routine chest radiographs is substantially more prevalent than would be anticipated based on the existing literature. The feasibility of reliably identifying these syndesmophytes in the spine and the impact of this on morbidity should be further investigated due to their association with advanced ankylosing spondylitis and their susceptibility to fractures.

背景:目的:利用胸部X光片确定脊柱边缘骨赘患病率的下限。材料与方法:我们对500张胸部X光片进行了回顾性分析,评估了脊柱边缘骨赘、桥接或近桥接骨赘以及椎旁流动骨赘的患病率:我们对500张胸片进行了回顾性分析,评估了北美某城市16岁及以上人群胸椎椎间盘薄边缘联合骨赘、桥接或近似桥接骨赘以及流动椎旁骨化的患病率:在 500 名参与者中,我们发现有 17 例(3.4%)存在薄型垂直边缘联合骨赘,126 例(25.2%)存在桥状或近桥状骨质增生,37 例(7.4%)存在流动性椎旁骨化。在 17 例边缘骨赘较薄的患者中,有 10 例表现出竹节状脊柱外观,其定义为存在≥4 层连续的桥状边缘骨赘。对每个椎体水平的联合鞘状突起分布进行的分析表明,中下胸椎的联合鞘状突起受累频率较高,T9/10椎体的联合鞘状突起最多:结论:在常规胸片上发现胸椎薄缘联合骨赘的发生率远高于现有文献的预期。由于它们与晚期强直性脊柱炎及其骨折易感性有关,因此应进一步研究在脊柱中可靠识别这些联合骨赘的可行性及其对发病率的影响。
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引用次数: 0
Dynamic susceptibility contrast-enhanced MRI with USPIO in evaluating angiogenesis of the peri-infarction zones in subacute ischemic stroke in a permanent middle cerebral artery occlusion rat model. 用 USPIO 动态感性对比增强磁共振成像评估永久性大脑中动脉闭塞大鼠模型亚急性缺血性中风梗死周围区域的血管生成。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-10-24 DOI: 10.1177/02841851241290646
Yuanchao Li, Fang Lu, Cheng Zhang, Huihui Xu, Shuohui Yang

Background: Dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI) can reflect the angiogenesis of ischemic stroke.

Purpose: To investigate the value of DSC-MRI with ultrasmall superparamagnetic particles of iron oxides (USPIO) in evaluating angiogenesis in the peri-infarction zones in subacute ischemic stroke in a permanent middle cerebral artery occlusion (pMCAO) rat model.

Material and methods: A total of 21 Sprague-Dawley rats were randomly divided into the pMCAO and sham operation groups. Every rat in each group underwent DSC-MRI with USPIO at 3, 5, and 7 days. DSC-MRI parameters of the relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), relative mean transit time (rMTT), and relative time to peak (rTTP) were measured, calculated, and compared among the different times. Sequential correlations were analyzed among the histopathological indexes with the microvascular density (MVD) and percentage of vascular area (%VA), the serum factors with vascular endothelial growth factor (VEGF), vascular cell adhesion molecule 1 (VCAM-1), and perfusion parameters, respectively.

Results: The rCBV and rCBF in the peri-infarction area of pMCAO rats were significantly higher on day 7 than on day 3, whereas no significant changes in rMTT and rTTP were observed at 3, 5, and 7 days. Significantly positive correlations were found between rCBV and MVD, %VA, VEGF, VCAM-1, between rCBF and MVD, %VA, VEGF, and VCAM-1 at 3, 5, and 7 days in the pMCAO group.

Conclusion: The rCBV and rCBF deriving from USPIO-DSC may be potentially useful for evaluating the angiogenesis of the peri-infarction zones in the subacute phase of ischemic stroke.

背景:目的:在永久性大脑中动脉闭塞(pMCAO)大鼠模型中,研究超小型超顺磁性氧化铁颗粒(USPIO)DSC-MRI在评估亚急性缺血性卒中梗死周围血管生成中的价值:将 21 只 Sprague-Dawley 大鼠随机分为 pMCAO 组和假手术组。每组的每只大鼠都在 3 天、5 天和 7 天时接受了 USPIO 的 DSC-MRI 检查。DSC-MRI参数包括相对脑血容量(rCBV)、相对脑血流量(rCBF)、相对平均通过时间(rMTT)和相对达峰时间(rTTP),这些参数在不同时间进行测量、计算和比较。分析了组织病理学指标与微血管密度(MVD)和血管面积百分比(%VA)之间的序列相关性,血清因子与血管内皮生长因子(VEGF)、血管细胞粘附分子1(VCAM-1)和灌注参数之间的序列相关性:pMCAO大鼠梗死周围区域的rCBV和rCBF在第7天显著高于第3天,而rMTT和rTTP在第3、5和7天均无显著变化。在 pMCAO 组中,rCBV 与 MVD、%VA、VEGF 和 VCAM-1 之间,rCBF 与 MVD、%VA、VEGF 和 VCAM-1 之间在 3、5 和 7 天内均呈显著正相关:结论:USPIO-DSC 得出的 rCBV 和 rCBF 可能有助于评估缺血性中风亚急性阶段梗死周围区域的血管生成情况。
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引用次数: 0
Inter-reader agreement of LI-RADS treatment response algorithm among three readers with different seniorities for hepatocellular carcinoma after locoregional therapy. 三位不同资历的读者对局部区域治疗后肝细胞癌的 LI-RADS 治疗反应算法的读者间一致性。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-11-03 DOI: 10.1177/02841851241289130
Yuxin Wang, Himeko Asayo, Wei Wang, Hui Xu, Dawei Yang, Lixue Xu, Siwei Yang, Zhenghan Yang

Background: The accurate evaluation of tumor response after locoregional therapy is crucial for adjusting therapeutic strategy and guiding individualized follow-up.

Purpose: To determine the inter-reader agreement of the LR-TR algorithm for hepatocellular carcinoma treated with locoregional therapy among radiologists with different seniority.

Material and methods: A total of 275 treated observations on 249 MRI scans from 99 patients were retrospectively collected. Three readers of different seniorities (senior, intermediate, and junior with 10, 6, and 2 years of experience in hepatic imaging, respectively) analyzed the presence or absence of features (arterial-phase hyperenhancement and washout) and evaluated LR-TR category.

Results: There were substantial inter-reader agreements for overall LR-TR categorization (kappa = 0.704), LR-TR viable (kappa = 0.715), and LR-TR non-viable (kappa = 0.737), but fair inter-reader agreement for LR-TR equivocal (kappa = 0.231) among three readers. The inter-reader agreement was substantial for arterial-phase hyperenhancement (kappa = 0.725), but moderate for washout (kappa = 0.443) among three readers. The inter-reader agreements between two readers were substantial for overall LR-TR categorization (kappa = 0.734, 0.727, 0.652), LR-TR viable (kappa = 0.719, 0.752, 0.678), and LR-TR non-viable (kappa = 0.758, 0.760, 0.694), which were at the same level as the inter-reader agreements among three readers. In addition, the inter-reader agreements between two readers were substantial for arterial-phase hyperenhancement (kappa = 0.733, 0.766, 0.678), but moderate for washout (kappa = 0.473, 0.422, 0.446), which were at the same level as the inter-reader agreements among three readers.

Conclusion: LR-TR algorithm demonstrated overall substantial inter-reader agreement among radiologists with different seniority.

背景:准确评估局部治疗后的肿瘤反应对于调整治疗策略和指导个体化随访至关重要:目的:确定不同资历的放射科医生对肝细胞癌局部治疗后LR-TR算法的阅片者间一致性:回顾性收集了99名患者的249次核磁共振扫描共275个治疗观察结果。三位不同资历的读者(高级、中级和初级,分别有 10 年、6 年和 2 年的肝脏成像经验)分析了有无特征(动脉期高增强和冲刷)并评估了 LR-TR 类别:三位读者在LR-TR总体分类(kappa = 0.704)、LR-TR存活(kappa = 0.715)和LR-TR不存活(kappa = 0.737)方面的读者间一致性很高,但在LR-TR等效(kappa = 0.231)方面的读者间一致性一般。三位读者在动脉期高增强方面的读数一致性很好(kappa = 0.725),但在冲洗方面的读数一致性一般(kappa = 0.443)。在整体 LR-TR 分类(kappa = 0.734、0.727、0.652)、LR-TR 可行(kappa = 0.719、0.752、0.678)和 LR-TR 不可行(kappa = 0.758、0.760、0.694)方面,两名读者之间的读数差异很大,与三名读者之间的读数差异处于同一水平。此外,在动脉期高增强方面,两名读者之间的读数一致性很好(kappa = 0.733, 0.766, 0.678),但在冲洗方面,读数一致性一般(kappa = 0.473, 0.422, 0.446),与三名读者之间的读数一致性处于同一水平:结论:LR-TR 算法在不同资历的放射科医生之间表现出了很高的读片者间一致性。
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引用次数: 0
Development of a radiomic model for cervical cancer staging based on pathologically verified, retrospective metastatic lymph node data. 根据病理验证的回顾性转移淋巴结数据,开发宫颈癌分期的放射学模型。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-11-21 DOI: 10.1177/02841851241291931
Bin Zhang, Liang Liu, Deyue Meng, Chin Siang Kue

Background: Cervical cancer is a major cause of morbidity and mortality among gynecological malignancies. Diagnostic imaging of lymph node (LN) metastasis for prognosis and staging is used; however, the accuracy in classifying the stage needs to improve.

Purpose: To examine the accuracy of AI-based radiomics in diagnosis, prognosis assessment and predicting the diagnostic value of radiomics for pelvic LN metastasis in cervical cancer patients.

Material and methods: The study included 118 female patients with 660 LNs and 118 merged LNs. Four imaging histology models-decision tree, random forest, logistic regression, and support vector machine (SVM)-were created in this study. The imaging histology features were extracted from both the independent and merged LN groups. The AUC values for the test sets and the training sets of the four imaging histology models were compared for the independent LN group and the merged LN group. The DeLong test was used to compare the models.

Result: The imaging histology prediction model developed in the merged LN group outperformed the independent LN group in terms of test set AUC (0.668 vs. 0.535 for decision tree, 0.841 vs. 0.627 for logistic regression, 0.785 vs. 0.637 for random forest, 0.85 vs. 0.648 for SVM) and accuracy (0.754 vs. 0.676 for decision tree, 0.780 vs. 0.671 for random forest, 0.848 vs. 0.685 for logistic regression, 0.822 vs. 0.657 for SVM).

Conclusion: The constructed SVM imaging histology model for the merged LN group might be advantageous in predicting pelvic LN metastasis in cervical cancer.

背景:宫颈癌是妇科恶性肿瘤中发病率和死亡率的主要原因。目的:研究基于人工智能的放射组学在诊断、预后评估方面的准确性,并预测放射组学对宫颈癌患者盆腔 LN 转移的诊断价值:研究纳入了 118 名女性患者,其中有 660 个 LN 和 118 个合并的 LN。本研究创建了四种影像组学模型--决策树、随机森林、逻辑回归和支持向量机(SVM)。成像组织学特征是从独立 LN 组和合并 LN 组中提取的。比较了独立 LN 组和合并 LN 组四个成像组学模型的测试集和训练集的 AUC 值。使用 DeLong 检验对模型进行比较:结果:在合并 LN 组中开发的成像组织学预测模型的测试集 AUC 优于独立 LN 组(决策树为 0.668 vs. 0.535,逻辑回归为 0.841 vs. 0.627,Logistic 回归为 0.785 vs. 0.637 for random forest, 0.85 vs. 0.648 for SVM)和准确率(0.754 vs. 0.676 for decision tree, 0.780 vs. 0.671 for random forest, 0.848 vs. 0.685 for logistic regression, 0.822 vs. 0.657 for SVM).结论:结论:针对合并 LN 组构建的 SVM 影像组织学模型在预测宫颈癌盆腔 LN 转移方面可能具有优势。
{"title":"Development of a radiomic model for cervical cancer staging based on pathologically verified, retrospective metastatic lymph node data.","authors":"Bin Zhang, Liang Liu, Deyue Meng, Chin Siang Kue","doi":"10.1177/02841851241291931","DOIUrl":"10.1177/02841851241291931","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is a major cause of morbidity and mortality among gynecological malignancies. Diagnostic imaging of lymph node (LN) metastasis for prognosis and staging is used; however, the accuracy in classifying the stage needs to improve.</p><p><strong>Purpose: </strong>To examine the accuracy of AI-based radiomics in diagnosis, prognosis assessment and predicting the diagnostic value of radiomics for pelvic LN metastasis in cervical cancer patients.</p><p><strong>Material and methods: </strong>The study included 118 female patients with 660 LNs and 118 merged LNs. Four imaging histology models-decision tree, random forest, logistic regression, and support vector machine (SVM)-were created in this study. The imaging histology features were extracted from both the independent and merged LN groups. The AUC values for the test sets and the training sets of the four imaging histology models were compared for the independent LN group and the merged LN group. The DeLong test was used to compare the models.</p><p><strong>Result: </strong>The imaging histology prediction model developed in the merged LN group outperformed the independent LN group in terms of test set AUC (0.668 vs. 0.535 for decision tree, 0.841 vs. 0.627 for logistic regression, 0.785 vs. 0.637 for random forest, 0.85 vs. 0.648 for SVM) and accuracy (0.754 vs. 0.676 for decision tree, 0.780 vs. 0.671 for random forest, 0.848 vs. 0.685 for logistic regression, 0.822 vs. 0.657 for SVM).</p><p><strong>Conclusion: </strong>The constructed SVM imaging histology model for the merged LN group might be advantageous in predicting pelvic LN metastasis in cervical cancer.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"1548-1559"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of pediatric breast ultrasound less is more: a practical imaging approach. 小儿乳腺超声评估少即是多:实用成像方法。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-10-15 DOI: 10.1177/02841851241287924
Elisabetta Giannotti, Rachel Sun, Nuala Healy, Fleur Kilburn-Toppin, Carmelo Sofia, Andrew Hs Lee, Maria Adele Marino

Background: Breast cancer in pediatric patients is rare, but ultrasound (US) is widely utilized for symptomatic cases.

Purpose: To determine biopsy and cancer detection rates of pediatric patients and to assess if breast US can be omitted.

Material and methods: A retrospective review of a 5-year period was conducted of single-center breast US performed in patients aged <19 years. Data regarding presentation, clinical opinion (P1-5 score), and US (U1-5 score) were collected. If biopsy or surgery was performed, pathology was reviewed (B1-5 score).

Results: In total, 579 patients were included (19 boys, 560 girls; mean age=16.2±1.9 years; age range=0-18 years). Clinical examination was normal or benign (P1/P2) in all boys (100%) and 557/560 (99.5%) girls, and P3 in 3 (0.5%) girls. Of US, 52% demonstrated normal findings (U1) for both sexes (300/579); in the remaining cases, the most frequent findings were gynecomastia in 12/19 boys and well-defined breast masses in 208/560 girls. Of the 560 girls, 6 (1%) underwent US-guided biopsy, with final histology of fibroadenoma (B2) in all cases, while 27 (5%) had a surgical excision, with final histology of fibroadenoma (22/27, 81.5%), hamartoma (2/27, 7.4%), benign phyllodes tumor (2/27, 7.4%), and angiomyxoma skin lesion (1/27, 3.7%). No malignant lesions were diagnosed at the time of clinical referral or during the 18-month follow-up in patients with a well-defined mass on US.

Conclusion: Breast malignancy is extremely rare in pediatric population. US can be safely omitted if clinical examination is normal; this approach would have avoided breast US in 52% of patients in this study.

背景:目的:确定儿童患者的活检率和癌症检出率,并评估是否可以省略乳腺超声检查:材料和方法:对单中心乳腺 US 进行了为期 5 年的回顾性审查:共纳入579名患者(19名男孩,560名女孩;平均年龄=16.2±1.9岁;年龄范围=0-18岁)。所有男孩(100%)和 557/560 名女孩(99.5%)的临床检查结果均为正常或良性(P1/P2),3 名女孩(0.5%)的临床检查结果为 P3。在 US 检查中,52% 的男女受检者(300/579)的检查结果均为正常(U1);在其余受检者中,最常见的检查结果是 12/19 名男孩患有妇科炎症,208/560 名女孩患有轮廓清晰的乳房肿块。在 560 名女孩中,有 6 人(1%)在 US 引导下进行了活组织检查,所有病例的最终组织学结果均为纤维腺瘤(B2),有 27 人(5%)进行了手术切除,最终组织学结果为纤维腺瘤(22/27,81.5%)、火腿肠瘤(2/27,7.4%)、良性植物瘤(2/27,7.4%)和血管瘤皮损(1/27,3.7%)。在临床转诊时或18个月的随访中,US检查发现肿块轮廓清晰的患者均未确诊恶性病变:结论:乳腺恶性肿瘤在儿童中极为罕见。结论:乳腺恶性肿瘤在儿童人群中极为罕见,如果临床检查结果正常,可以放心地省略 US 检查;在本研究中,52% 的患者可以通过这种方法避免乳腺 US 检查。
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引用次数: 0
Machine learning and radiomics for ventricular tachyarrhythmia prediction in hypertrophic cardiomyopathy: insights from an MRI-based analysis. 肥厚型心肌病室性心动过速预测的机器学习和放射组学:基于核磁共振成像的分析见解。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-10-01 DOI: 10.1177/02841851241283041
Emine Sebnem Durmaz, Mert Karabacak, Burak Berksu Ozkara, Osman Aykan Kargın, Bilal Demir, Damla Raimoglou, Ahmet Atil Aygun, Ibrahim Adaletli, Ahmet Bas, Eser Durmaz

Background: Myocardial fibrosis is often detected in patients with hypertrophic cardiomyopathy (HCM), which causes left ventricular (LV) dysfunction and tachyarrhythmias.

Purpose: To evaluate the potential value of a machine learning (ML) approach that uses radiomic features from late gadolinium enhancement (LGE) and cine images for the prediction of ventricular tachyarrhythmia (VT) in patients with HCM.

Material and methods: Hyperenhancing areas of LV myocardium on LGE images were manually segmented, and the segmentation was propagated to corresponding areas on cine images. Radiomic features were extracted using the PyRadiomics library. The least absolute shrinkage and selection operator (LASSO) method was employed for radiomic feature selection. Our model development employed the TabPFN algorithm, an adapted Prior-Data Fitted Network design. Model performance was evaluated graphically and numerically over five-repeat fivefold cross-validation. SHapley Additive exPlanations (SHAP) were employed to determine the relative importance of selected radiomic features.

Results: Our cohort consisted of 60 patients with HCM (73.3% male; median age = 51.5 years), among whom 17 had documented VT during the follow-up. A total of 1612 radiomic features were extracted for each patient. The LASSO algorithm led to a final selection of 18 radiomic features. The model achieved a mean area under the receiver operating characteristic curve of 0.877, demonstrating good discrimination, and a mean Brier score of 0.119, demonstrating good calibration.

Conclusion: Radiomics-based ML models are promising for predicting VT in patients with HCM during the follow-up period. Developing predictive models as clinically useful decision-making tools may significantly improve risk assessment and prognosis.

背景:目的:评估一种机器学习(ML)方法的潜在价值,该方法利用晚期钆增强(LGE)和电影图像的放射学特征来预测肥厚型心肌病(HCM)患者的室性快速性心律失常(VT)。材料和方法:手动分割 LGE 图像上左心室心肌的高增强区域,并将分割结果传播到 cine 图像上的相应区域。使用 PyRadiomics 库提取放射组学特征。采用最小绝对收缩和选择算子(LASSO)方法进行放射体特征选择。我们的模型开发采用了 TabPFN 算法,这是一种经过调整的先验数据拟合网络设计。通过五次重复五倍交叉验证,对模型性能进行了图形和数值评估。采用了SHAPLEY Additive exPlanations(SHAP)来确定所选放射学特征的相对重要性:我们的队列由 60 名 HCM 患者组成(73.3% 为男性;中位年龄 = 51.5 岁),其中 17 人在随访期间有 VT 记录。每位患者共提取了 1612 个放射学特征。通过 LASSO 算法,最终选择了 18 个放射学特征。该模型的接收者操作特征曲线下的平均面积为 0.877,显示了良好的分辨能力,平均 Brier 分数为 0.119,显示了良好的校准能力:结论:基于放射组学的 ML 模型有望在随访期间预测 HCM 患者的 VT。开发预测模型作为临床有用的决策工具,可显著改善风险评估和预后。
{"title":"Machine learning and radiomics for ventricular tachyarrhythmia prediction in hypertrophic cardiomyopathy: insights from an MRI-based analysis.","authors":"Emine Sebnem Durmaz, Mert Karabacak, Burak Berksu Ozkara, Osman Aykan Kargın, Bilal Demir, Damla Raimoglou, Ahmet Atil Aygun, Ibrahim Adaletli, Ahmet Bas, Eser Durmaz","doi":"10.1177/02841851241283041","DOIUrl":"10.1177/02841851241283041","url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is often detected in patients with hypertrophic cardiomyopathy (HCM), which causes left ventricular (LV) dysfunction and tachyarrhythmias.</p><p><strong>Purpose: </strong>To evaluate the potential value of a machine learning (ML) approach that uses radiomic features from late gadolinium enhancement (LGE) and cine images for the prediction of ventricular tachyarrhythmia (VT) in patients with HCM.</p><p><strong>Material and methods: </strong>Hyperenhancing areas of LV myocardium on LGE images were manually segmented, and the segmentation was propagated to corresponding areas on cine images. Radiomic features were extracted using the PyRadiomics library. The least absolute shrinkage and selection operator (LASSO) method was employed for radiomic feature selection. Our model development employed the TabPFN algorithm, an adapted Prior-Data Fitted Network design. Model performance was evaluated graphically and numerically over five-repeat fivefold cross-validation. SHapley Additive exPlanations (SHAP) were employed to determine the relative importance of selected radiomic features.</p><p><strong>Results: </strong>Our cohort consisted of 60 patients with HCM (73.3% male; median age = 51.5 years), among whom 17 had documented VT during the follow-up. A total of 1612 radiomic features were extracted for each patient. The LASSO algorithm led to a final selection of 18 radiomic features. The model achieved a mean area under the receiver operating characteristic curve of 0.877, demonstrating good discrimination, and a mean Brier score of 0.119, demonstrating good calibration.</p><p><strong>Conclusion: </strong>Radiomics-based ML models are promising for predicting VT in patients with HCM during the follow-up period. Developing predictive models as clinically useful decision-making tools may significantly improve risk assessment and prognosis.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"1473-1481"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morphological remodeling of the repaired sigmoid sinus bone wall in patients with pulsatile tinnitus after successful surgical reconstruction: an ultra-high-resolution CT study. 搏动性耳鸣患者手术重建成功后修复的乙状窦骨壁形态重塑:超高分辨率 CT 研究。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-11-11 DOI: 10.1177/02841851241279544
Chihang Dai, Pengfei Zhao, Guopeng Wang, Heyu Ding, Han Lv, Shusheng Gong, Zhenchang Wang

Background: Sigmoid sinus wall reconstruction (SSWR) is an effective treatment for pulsatile tinnitus (PT). However, follow-up postoperative imaging manifestations have not been extensively reported.

Purpose: To evaluate the morphological changes in patients with PT after successful SSWR using ultra-high-resolution computed tomography (U-HRCT).

Material and methods: Data were retrospectively analyzed from 10 patients with PT who underwent successful SSWR primarily with autologous bone powder. U-HRCT scans were performed within 3 days of surgery and repeated 6 months later. The integrity, relative density, extent, and shape of the repaired wall were analyzed. The chi-square test was used to compare the categorical variables and the Phi (φ) coefficient was used to represent the magnitude of the correlation.

Results: Among the 10 patients with PT, 1 (10%) achieved complete coverage of the defect with the residual bone, 8 (80%) had partial coverage, and 1 (10%) showed complete separation. A gap between the repaired wall and residual bone in the initial U-HRCT was linked to incomplete defect coverage in the subsequent U-HRCT scan (P < 0.001, φ = 0.903). The repaired wall shrank from the periphery to the center and the density increased. The repaired wall compressed into the sigmoid sinus retracts over time, reshaping into a naturally curved sigmoid sinus sulcus.

Conclusion: Morphological remodeling is a typical characteristic of the repaired sigmoid sinus wall in patients with PT. Short-term incomplete repair may imply incomplete coverage of the defect in the future, but this is not correlated with recurrence.

背景:乙状窦壁重建术(SSWR)是治疗搏动性耳鸣(PT)的有效方法。目的:使用超高分辨率计算机断层扫描(U-HRCT)评估成功接受乙状窦壁重建术(SSWR)后 PT 患者的形态学变化:对主要使用自体骨粉成功进行SSWR的10例PT患者的数据进行回顾性分析。术后 3 天内进行 U-HRCT 扫描,6 个月后重复扫描。对修复壁的完整性、相对密度、范围和形状进行了分析。采用卡方检验比较分类变量,并用腓系数(φ)表示相关性的大小:在 10 位 PT 患者中,1 位(10%)实现了缺损与残余骨的完全覆盖,8 位(80%)实现了部分覆盖,1 位(10%)出现了完全分离。在初次 U-HRCT 扫描中,修复后的壁与残留骨之间存在间隙,这与随后的 U-HRCT 扫描中缺损覆盖不完全有关(P 结论:缺损覆盖不完全与缺损形态重塑有关:形态重塑是 PT 患者修复后乙状窦壁的典型特征。短期的不完全修复可能意味着未来缺损的不完全覆盖,但这与复发无关。
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引用次数: 0
Deep-learning reconstruction enhances image quality of Adamkiewicz Artery in low-keV dual-energy CT. 深度学习重建提高了低keV双能CT中Adamkiewicz动脉的图像质量。
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-10-22 DOI: 10.1177/02841851241288507
Fuminari Tatsugami, Toru Higaki, Ikuo Kawashita, Chikako Fujioka, Yuko Nakamura, Shinya Takahashi, Kazuo Awai

Background: Low-keV virtual monoenergetic images (VMIs) of dual-energy computed tomography (CT) enhances iodine contrast for detecting small arteries like the Adamkiewicz artery (AKA), but image noise can be problematic. Deep-learning image reconstruction (DLIR) effectively reduces noise without sacrificing image quality.

Purpose: To evaluate whether DLIR on low-keV VMIs of dual-energy CT scans improves the visualization of the AKA.

Material and methods: We enrolled 29 patients who underwent CT angiography before aortic repair. VMIs obtained at 70 and 40 keV were reconstructed using hybrid iterative reconstruction (HIR), and 40 keV VMIs were reconstructed using DLIR. The image noise of the spinal cord, the maximum CT values of the anterior spinal artery (ASA), and the contrast-to-noise ratio (CNR) of the ASA were compared. The overall image quality and the delineation of the AKA were evaluated on a 4-point score (1 = poor, 4 = excellent).

Results: The mean image noise of the spinal cord was significantly lower on 40-keV DLIR than on 40-keV HIR scans; they were significantly higher than on 70-keV HIR images. The CNR of the ASA was highest on the 40-keV DLIR images among the three reconstruction images. The mean image quality scores for 40-keV DLIR and 70-keV HIR scans were comparable, and higher than of 40-keV HIR images. The mean delineation scores for 40-keV HIR and 40-keV DLIR scans were significantly higher than for 70-keV HIR images.

Conclusion: Visualization of the AKA was significantly better on low-keV VMIs subjected to DLIR than conventional HIR images.

背景:双能计算机断层扫描(CT)的低keV虚拟单能图像(VMI)增强了碘对比度,可用于检测小动脉,如Adamkiewicz动脉(AKA),但图像噪声可能是个问题。深度学习图像重建(DLIR)可在不影响图像质量的情况下有效降低噪声。目的:评估双能 CT 扫描的低 KeV VMI 上的 DLIR 是否能改善 AKA 的可视化:我们招募了 29 名在主动脉修复前接受 CT 血管造影术的患者。使用混合迭代重建(HIR)对 70 和 40 keV 的 VMI 进行重建,使用 DLIR 对 40 keV 的 VMI 进行重建。比较了脊髓的图像噪声、脊髓前动脉(ASA)的最大 CT 值和 ASA 的对比-噪声比(CNR)。对整体图像质量和 AKA 的划分进行了 4 级评分(1 = 差,4 = 优):结果:脊髓的平均图像噪声在 40-keV DLIR 扫描中明显低于 40-keV HIR 扫描;在 70-keV HIR 图像中则明显高于 40-keV DLIR 扫描。在三种重建图像中,40-keV DLIR 图像的 ASA CNR 最高。40-keV DLIR 和 70-keV HIR 扫描的平均图像质量得分相当,且高于 40-keV HIR 图像。40-keV HIR 和 40-keV DLIR 扫描的平均划分分数明显高于 70-keV HIR 图像:结论:与传统的 HIR 图像相比,采用 DLIR 的低 keV VMI 对 AKA 的可视化效果明显更好。
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引用次数: 0
Can the second phase of contrast-enhanced MRA of the neck provide additional information in the acute stroke setting? 颈部对比增强 MRA 的第二阶段能否为急性卒中提供更多信息?
IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-12-01 Epub Date: 2024-11-05 DOI: 10.1177/02841851241290728
P Shah, H Kale, M Shrivastava, D Sanghvi, M Munshi, G Sangani, K Mundada

Background: Double-concentration magnetic resonance imaging (MRI) contrast agents are frequently used in contrast-enhanced MR angiography (CE-MRA) of the head and neck. To avoid mistiming the peak concentration of intraluminal contrast (due to shorter duration of peak), a second acquisition is sometimes performed.

Purpose: To evaluate additional information from the second acquisition of CE-MRA and compare the collateral scoring to the hypoperfusion index obtained on MR perfusion, and to investigate presence of pseudo-occlusion using the second phase of CE-MRA.

Material and methods: A retrospective study was conducted. CE-MRA of the brain/neck, dynamic susceptibility contrast (DSC) MR perfusion scan (in majority) and subsequent digital subtraction angiography (DSA) were evaluated in patients with previous acute internal carotid artery (ICA)/middle cerebral artery (MCA) occlusion. Evaluation of CE-MRA/MR perfusion and DSA was performed by three experienced neuroradiologists and one neurointerventionist, respectively.

Results: The site of ICA occlusion was seen to be distal to the site noted on early arterial phase (pseudo-occlusion of ICA) in 28.5% of patients. A significant negative correlation was seen between a higher HIR and collateral score.

Conclusion: Evaluation of second phase CE-MRA can provide valuable information that may be otherwise lost if only the early arterial phase is evaluated.

背景:双浓度磁共振成像(MRI)造影剂经常用于头颈部造影剂增强磁共振血管成像(CE-MRA)。目的:评估 CE-MRA 第二次采集的额外信息,并将侧支评分与 MR 灌注获得的低灌注指数进行比较,同时利用 CE-MRA 的第二阶段调查是否存在假性闭塞:材料和方法:进行了一项回顾性研究。对既往患有急性颈内动脉(ICA)/大脑中动脉(MCA)闭塞的患者进行了脑/颈部 CE-MRA、动态感性对比(DSC)磁共振灌注扫描(多数)和随后的数字减影血管造影(DSA)评估。CE-MRA/MR灌注和DSA的评估分别由三位经验丰富的神经放射学专家和一位神经介入专家完成:结果:28.5% 的患者的 ICA 闭塞部位位于早期动脉期发现的部位的远端(ICA 假性闭塞)。HIR较高与侧支评分之间呈明显负相关:结论:对第二阶段 CE-MRA 的评估可以提供有价值的信息,而如果只评估早期动脉阶段,这些信息可能会丢失。
{"title":"Can the second phase of contrast-enhanced MRA of the neck provide additional information in the acute stroke setting?","authors":"P Shah, H Kale, M Shrivastava, D Sanghvi, M Munshi, G Sangani, K Mundada","doi":"10.1177/02841851241290728","DOIUrl":"10.1177/02841851241290728","url":null,"abstract":"<p><strong>Background: </strong>Double-concentration magnetic resonance imaging (MRI) contrast agents are frequently used in contrast-enhanced MR angiography (CE-MRA) of the head and neck. To avoid mistiming the peak concentration of intraluminal contrast (due to shorter duration of peak), a second acquisition is sometimes performed.</p><p><strong>Purpose: </strong>To evaluate additional information from the second acquisition of CE-MRA and compare the collateral scoring to the hypoperfusion index obtained on MR perfusion, and to investigate presence of pseudo-occlusion using the second phase of CE-MRA.</p><p><strong>Material and methods: </strong>A retrospective study was conducted. CE-MRA of the brain/neck, dynamic susceptibility contrast (DSC) MR perfusion scan (in majority) and subsequent digital subtraction angiography (DSA) were evaluated in patients with previous acute internal carotid artery (ICA)/middle cerebral artery (MCA) occlusion. Evaluation of CE-MRA/MR perfusion and DSA was performed by three experienced neuroradiologists and one neurointerventionist, respectively.</p><p><strong>Results: </strong>The site of ICA occlusion was seen to be distal to the site noted on early arterial phase (pseudo-occlusion of ICA) in 28.5% of patients. A significant negative correlation was seen between a higher HIR and collateral score.</p><p><strong>Conclusion: </strong>Evaluation of second phase CE-MRA can provide valuable information that may be otherwise lost if only the early arterial phase is evaluated.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"1540-1547"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Acta radiologica
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