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Spatial distribution of cerebral microbleeds and FLAIR hyperintensities on follow-up MRI after radiotherapy for lower grade glioma 低级别胶质瘤放疗后MRI脑微出血和FLAIR高信号的空间分布
Pub Date : 2023-09-01 DOI: 10.1016/j.redii.2023.100033
Justyna Kłos , Reina W. Kloet , Hiska L. van der Weide , Kelvin Ng Wei Siang , Peter F. Sinnige , Miranda C.A. Kramer , Rudi A.J.O. Dierckx , Ronald J.H. Borra , Anouk van der Hoorn

Background and purpose

Cerebral microbleeds (CMBs) and fluid-attenuated-inversion recovery (FLAIR) hyperintensities on brain MRI scans after radiotherapy (RT) are considered markers for microvascular damage and related cognitive changes. However, the spatial distribution using existing scoring systems as well as colocation of these imaging biomarkers remain unclear, hampering clinical interpretation. This study aims to elucidate the distribution and colocation of these markers in patients with lower grade glioma (LGG).

Materials and methods

CMBs were spatially classified on retrospective 1.5 T susceptibility weighted MRI scans according to the existing Microbleed Anatomical Rating Scale (MARS) and were additionally scored for being located in hippocampus, amygdala, cortex, white matter (WM), grey matter (GM), WM/GM junction and for their spatial relation to FLAIR hyperintensities. Scoring was performed for whole, ipsilateral and contralateral cerebrum (with respect to tumour bulk).

Results

Fifty-one scans were included of which 28 had at least one CMB. The majority of CMBs were localized in the lobar area and in deep and periventricular white matter (DPWM) - generally in WM. Only few CMBs were found in GM. In scans obtained up to 7 years after RT completion the majority of CMBs were not colocalized with FLAIR hyperintensities.

Conclusion

CMBs and FLAIR hyperintensities appear to be separate imaging biomarkers for radiation therapy induced microvascular damage, as they are not colocalized in patients with LGG, especially not early on after completion of RT.

背景和目的脑微出血(CMBs)和液体衰减反转恢复(FLAIR)在放射治疗(RT)后的脑MRI扫描中的高信号被认为是微血管损伤和相关认知变化的标志物。然而,使用现有评分系统的空间分布以及这些成像生物标志物的位置仍然不清楚,阻碍了临床解释。本研究旨在阐明这些标志物在低级别胶质瘤(LGG)患者中的分布和位置。材料和方法根据现有的微出血解剖评分量表(MARS),在回顾性1.5T磁化率加权MRI扫描中对脑胶质瘤进行空间分类,并对其位于海马、杏仁核、皮层、白质(WM),以及它们与FLAIR高信号的空间关系。对整个大脑、同侧大脑和对侧大脑(肿瘤体积)进行评分。结果共51次扫描,其中28次至少有一次CMB。大多数CMBs局限于肺叶区、深部和室周白质(DPWM),通常在WM中。在GM中仅发现少数CMBs。在RT完成后7年的扫描中,大多数CMBs未与FLAIR高信号共定位。结论CMBs和FLAIR高信号似乎是放射治疗诱导的微血管损伤的独立成像生物标志物,因为它们在LGG患者中没有共同定位,尤其是在RT完成后的早期。
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引用次数: 0
Role of abbreviated non-contrast-enhanced MR-enterography in the evaluation of Crohn's disease activity and complications as an alternative for full protocol contrast-enhanced study: A systematic review and meta-analysis 短时间非增强磁共振肠造影在评价克罗恩病活动性和并发症中作为全方案增强造影研究的替代方法的作用:一项系统回顾和荟萃分析
Pub Date : 2023-06-01 DOI: 10.1016/j.redii.2023.100030
Payam Jannatdoust , Parya Valizadeh , Mahshad Razaghi , Maedeh Rouzbahani , Amirbahador Abbasi , Arvin Arian

Background

Crohn's disease (CD) is a chronic disorder that often starts at a young age and involves periods of remission and relapse. Prompt diagnosis of relapses through screening is crucial due to the potential morbid complications of untreated active inflammation. Magnetic resonance enterography (MRE) is a noninvasive technique to screen for active inflammation. The standard protocol involves intravenous injection of contrast agents with potential side effects. Some abbreviated non-contrast-enhanced MRE protocols are proposed as alternatives for conventional MRE to identify active inflammation. Currently, there is controversy regarding the applicability and accuracy of these protocols. This study aims to describe and compare these protocols and evaluate their accuracy in detecting active inflammation and CD complications.

Methods

Results from a systematic search of three databases in August 2022 were queried and screened by abstract and full text. Eligible studies were qualitatively and quantitatively analyzed by diagnostic test accuracy meta-analysis.

Results

59 studies entered the systematic review, and 37 were eligible for meta-analysis. Diffusion-weighted imaging (DWI) and fast T2-weighted (T2w) sequences were most frequently used in abbreviated protocols and showed non-inferior accuracy compared to the full protocol in detecting active inflammation. ADC and qualitative DWI had pooled sensitivity of 90% (CI: 82–95%) and 89% (CI:82–93%) and pooled specificity of 94% (CI: 88–97%) and 89% (CI: 79–94%), respectively for detecting active inflammation. Moreover, T2w and combined T2w+DWI sequences had pooled sensitivity of 80% (CI: 64–90%) and 76% (CI: 61–86%) and pooled specificity of 90% (CI: 80–95%) and 87% (CI: 74 – 94%), respectively. Unenhanced protocols show relatively poor diagnostic accuracy in detecting penetrating complications of CD. Magnetization transfer imaging (MTI) has demonstrated excellent accuracy in detecting fibrosis. High heterogeneity was observed in all subgroups, and accuracy was reported to be highly operator dependent in most studies.

Conclusion

An abbreviated protocol consisting of DWI and fast T2w imaging can potentially replace the full protocol MRE. Full protocol MRE will still have its role in identifying penetrating complications. MTI should be indicated in case of suspected fibrostenotic disease.

背景克罗恩病(CD)是一种慢性疾病,通常在很小的时候就开始了,并经历了一段时间的缓解和复发。通过筛查及时诊断复发是至关重要的,因为未经治疗的活动性炎症可能会出现并发症。磁共振肠造影(MRE)是一种非侵入性技术,用于筛查活动性炎症。标准方案包括静脉注射有潜在副作用的造影剂。提出了一些缩写的非对比增强MRE方案作为常规MRE的替代方案,以识别活动性炎症。目前,关于这些协议的适用性和准确性存在争议。本研究旨在描述和比较这些方案,并评估其在检测活动性炎症和CD并发症方面的准确性。方法对2022年8月系统检索三个数据库的结果进行摘要和全文查询和筛选。通过诊断测试准确性荟萃分析对符合条件的研究进行定性和定量分析。结果59项研究进入系统综述,37项符合条件进行荟萃分析。扩散加权成像(DWI)和快速T2加权(T2w)序列在缩写方案中最常使用,并且在检测活动性炎症方面显示出与完整方案相比不差的准确性。ADC和定性DWI在检测活动性炎症方面的合并敏感性分别为90%(CI:82-95%)和89%(CI:82-33%),合并特异性分别为94%(CI:88-97%)和89%。此外,T2w和T2w+DWI组合序列的合并敏感性分别为80%(CI:64-90%)和76%(CI:61-86%),合并特异性分别为90%(CI:80-95%)和87%(CI:74-94%)。未强化的方案在检测CD穿透性并发症方面显示出相对较差的诊断准确性。磁化转移成像(MTI)在检测纤维化方面显示出优异的准确性。在所有亚组中都观察到高度异质性,据报道,在大多数研究中,准确性高度依赖于操作者。结论由DWI和快速T2w成像组成的简化方案有可能取代完整方案的MRE。完整方案MRE仍将在识别穿透并发症方面发挥作用。如果怀疑患有纤维狭窄性疾病,应提示MTI。
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引用次数: 0
Effect of scan duration on CT perfusion values in metastases from renal cell carcinoma 肾细胞癌转移灶扫描时间对CT灌注值的影响
Pub Date : 2023-06-01 DOI: 10.1016/j.redii.2023.100028
Chaan S. Ng , Adam G. Chandler , Yanwen Chen , Wei Wei , Nizar M. Tannir , Brian P. Hobbs

Objective

CT perfusion (CTp) values are affected by CT scan acquisition duration (tacq); their reproducibility is adversely affected by uncertainty in their measurement. The objectives were to assess the effects of tacq on CTp parameter values in metastases from renal cell carcinoma (mRCC) in thoracic and abdominal locations.

Materials and Methods

131 CTp evaluations in 53 patients with mRCC were retrospectively analyzed by distributed parameter modeling to yield tissue blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PS), and also hepatic arterial perfusion (HAP) and hepatic arterial fraction (HAF) for liver metastases and normal liver, with tacq from 25 to 590 s. Penalized piecewise polynomial regression (SPLINE) characterized functional relationships between CTp parameters and acquisition duration, tacq. Evidence for time-invariance was evaluated for each parameter at multiple time points by conducting inference on the fitted derivative to assess its proximity to zero as a function of acquisition time. Equivalence testing was implemented with three levels of confidence (low (20%), moderate (70%), high (95%)).

Results

Systematic and non-systematic variability was observed for CTp parameter values with limited tacq. All parameters in all locations approached increasing stability with increasing tacq. PS, HAP and HAF required longer acquisition times than BF, BV and MTT to attain comparable levels of stability. Stabilization tended to require longer acquisition in liver than other tissues. tacq=380 s was required to obtain at least moderate level of confidence for all parameters and organs.

Conclusion

Increasing tacq yields increasingly more stable CT perfusion parameters, and thereby better reproducibility.

目的CT灌注(CTp)值受CT扫描采集时间(tacq)的影响;它们的再现性受到测量不确定性的不利影响。目的是评估tacq对肾细胞癌(mRCC)胸部和腹部转移的CTp参数值的影响。材料与方法通过分布参数模型对53例mRCC患者的131项CTp评估进行回顾性分析,得出肝转移和正常肝的组织血流量(BF)、血容量(BV)、平均转运时间(MTT)、通透性(PS)、肝动脉灌注(HAP)和肝动脉分数(HAF),tacq为25至590 s。惩罚分段多项式回归(SPLINE)表征了CTp参数和采集持续时间tacq之间的函数关系。通过对拟合的导数进行推断,评估其作为采集时间的函数接近零的程度,来评估多个时间点上每个参数的时间不变性证据。采用三个置信水平(低(20%)、中(70%)、高(95%))进行等价性检验。所有位置的所有参数都接近随着tacq的增加而增加的稳定性。PS、HAP和HAF需要比BF、BV和MTT更长的采集时间才能达到可比的稳定性水平。与其他组织相比,稳定往往需要在肝脏中获得更长的时间。需要tacq=380s来获得所有参数和器官的至少中等水平的置信度。结论增加tacq可获得越来越稳定的CT灌注参数,从而获得更好的再现性。
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引用次数: 1
Diagnosing sarcopenia with semi-automated skeletal muscle computed tomography cutoff values and the association of these muscle metrics with long-term physical exercise 用半自动骨骼肌计算机断层扫描临界值诊断肌萎缩,以及这些肌肉指标与长期体育锻炼的相关性
Pub Date : 2023-06-01 DOI: 10.1016/j.redii.2023.100026
Robert Janiszewski , Nathan Law , Ryan Walters , Tami DenOtter
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引用次数: 0
Elbow trauma in children: development and evaluation of radiological artificial intelligence models 儿童肘部创伤:放射学人工智能模型的建立与评价
Pub Date : 2023-06-01 DOI: 10.1016/j.redii.2023.100029
Clémence ROZWAG , Franck VALENTINI , Anne COTTEN , Xavier DEMONDION , Philippe PREUX , Thibaut JACQUES

Rationale and Objectives

To develop a model using artificial intelligence (A.I.) able to detect post-traumatic injuries on pediatric elbow X-rays then to evaluate its performances in silico and its impact on radiologists’ interpretation in clinical practice.

Material and Methods

A total of 1956 pediatric elbow radiographs performed following a trauma were retrospectively collected from 935 patients aged between 0 and 18 years. Deep convolutional neural networks were trained on these X-rays. The two best models were selected then evaluated on an external test set involving 120 patients, whose X-rays were performed on a different radiological equipment in another time period. Eight radiologists interpreted this external test set without then with the help of the A.I. models .

Results

Two models stood out: model 1 had an accuracy of 95.8% and an AUROC of 0.983 and model 2 had an accuracy of 90.5% and an AUROC of 0.975. On the external test set, model 1 kept a good accuracy of 82.5% and AUROC of 0.916 while model 2 had a loss of accuracy down to 69.2% and of AUROC to 0.793. Model 1 significantly improved radiologist's sensitivity (0.82 to 0.88, P = 0.016) and accuracy (0.86 to 0.88, P = 0,047) while model 2 significantly decreased specificity of readers (0.86 to 0.83, P = 0.031).

Conclusion

End-to-end development of a deep learning model to assess post-traumatic injuries on elbow X-ray in children was feasible and showed that models with close metrics in silico can unpredictably lead radiologists to either improve or lower their performances in clinical settings.

原理和目的使用人工智能(a.I.)开发一个模型,该模型能够在儿童肘部X光片上检测创伤后损伤,然后评估其在计算机上的表现及其对放射科医生在临床实践中的解释的影响。材料和方法回顾性收集935名年龄在0至18岁之间的儿童在创伤后进行的1956张肘部x线片。在这些X射线上训练了深度卷积神经网络。选择两个最佳模型,然后在一个涉及120名患者的外部测试集上进行评估,这些患者在另一个时间段内在不同的放射设备上进行X光检查。8名放射科医生在人工智能模型的帮助下对该外部测试集进行了解释。在外部测试集上,模型1保持了82.5%的良好精度和0.916的AUROC,而模型2的精度下降到69.2%,AUROC下降到0.793。模型1显著提高了放射科医生的敏感性(0.82~0.88,P=0.016)和准确性(0.86~0.88,P=0.047),而模型2显著降低了读者的特异性(0.86~ 0.83,P=0.031)不可预测地导致放射科医生在临床环境中提高或降低他们的表现。
{"title":"Elbow trauma in children: development and evaluation of radiological artificial intelligence models","authors":"Clémence ROZWAG ,&nbsp;Franck VALENTINI ,&nbsp;Anne COTTEN ,&nbsp;Xavier DEMONDION ,&nbsp;Philippe PREUX ,&nbsp;Thibaut JACQUES","doi":"10.1016/j.redii.2023.100029","DOIUrl":"10.1016/j.redii.2023.100029","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><p>To develop a model using artificial intelligence (A.I.) able to detect post-traumatic injuries on pediatric elbow X-rays then to evaluate its performances in silico and its impact on radiologists’ interpretation in clinical practice.</p></div><div><h3>Material and Methods</h3><p>A total of 1956 pediatric elbow radiographs performed following a trauma were retrospectively collected from 935 patients aged between 0 and 18 years. Deep convolutional neural networks were trained on these X-rays. The two best models were selected then evaluated on an external test set involving 120 patients, whose X-rays were performed on a different radiological equipment in another time period. Eight radiologists interpreted this external test set without then with the help of the A.I. models .</p></div><div><h3>Results</h3><p>Two models stood out: model 1 had an accuracy of 95.8% and an AUROC of 0.983 and model 2 had an accuracy of 90.5% and an AUROC of 0.975. On the external test set, model 1 kept a good accuracy of 82.5% and AUROC of 0.916 while model 2 had a loss of accuracy down to 69.2% and of AUROC to 0.793. Model 1 significantly improved radiologist's sensitivity (0.82 to 0.88, <em>P</em> = 0.016) and accuracy (0.86 to 0.88, <em>P</em> = 0,047) while model 2 significantly decreased specificity of readers (0.86 to 0.83, <em>P</em> = 0.031).</p></div><div><h3>Conclusion</h3><p>End-to-end development of a deep learning model to assess post-traumatic injuries on elbow X-ray in children was feasible and showed that models with close metrics in silico can unpredictably lead radiologists to either improve or lower their performances in clinical settings.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"6 ","pages":"Article 100029"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49070855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BERT-based natural language processing analysis of French CT reports: Application to the measurement of the positivity rate for pulmonary embolism 基于BERT的法语CT报告自然语言处理分析:在肺栓塞阳性率测量中的应用
Pub Date : 2023-06-01 DOI: 10.1016/j.redii.2023.100027
Émilien Jupin-Delevaux , Aissam Djahnine , François Talbot , Antoine Richard , Sylvain Gouttard , Adeline Mansuy , Philippe Douek , Salim Si-Mohamed , Loïc Boussel

Rationale and objectives

To develop a Natural Language Processing (NLP) method based on Bidirectional Encoder Representations from Transformers (BERT) adapted to French CT reports and to evaluate its performance to calculate the diagnostic yield of CT in patients with clinical suspicion of pulmonary embolism (PE).

Materials and methods

All the CT reports performed in our institution in 2019 (99,510 reports, training and validation dataset) and 2018 (94,559 reports, testing dataset) were included after anonymization. Two BERT-based NLP sentence classifiers were trained on 27.700, manually labeled, sentences from the training dataset. The first one aimed to classify the reports’ sentences into three classes (“Non chest”, “Healthy chest”, and "Pathological chest" related sentences), the second one to classify the last class into eleven sub classes pathologies including "pulmonary embolism". F1-score was reported on the validation dataset. These NLP classifiers were then applied to requested CT reports for pulmonary embolism from the testing dataset. Sensitivity, specificity, and accuracy for detection of the presence of a pulmonary embolism were reported in comparison to human analysis of the reports.

Results

The F1-score for the 3-Classes and 11-SubClasses classifiers was 0.984 and 0.985, respectively. 4,042 examinations from the testing dataset were requested for pulmonary embolism of which 641 (15.8%) were positively evaluated by radiologists. The sensitivity, specificity, and accuracy of the NLP network for identifying pulmonary embolism in these reports were 98.2%, 99.3% and 99.1%, respectively.

Conclusion

BERT-based NLP sentences classifier enables the analysis of large databases of radiological reports to accurately determine the diagnostic yield of CT screening.

原理和目的开发一种基于变压器双向编码器表示(BERT)的自然语言处理(NLP)方法,该方法适用于法国CT报告,并评估其性能,以计算临床怀疑肺栓塞(PE)患者的CT诊断率。材料和方法2019年在我院进行的所有CT报告(99510份报告,培训和验证数据集)和2018年(94559份报告,测试数据集)在匿名化后被纳入。两个基于BERT的NLP句子分类器在来自训练数据集的27.700个手动标记的句子上进行训练。第一个是将报告的句子分为三类(“非胸部”、“健康胸部”和“病理性胸部”相关句子),第二个是将最后一类分为11个子类,包括“肺栓塞”。在验证数据集中报告了F1分数。然后将这些NLP分类器应用于来自测试数据集的肺栓塞CT报告。与人类对报告的分析相比,报告了检测肺栓塞存在的敏感性、特异性和准确性。结果3类分类器和11个子类分类器的F1得分分别为0.984和0.985。要求从测试数据集中进行4042次肺栓塞检查,其中641次(15.8%)得到放射科医生的积极评价。在这些报告中,NLP网络识别肺栓塞的敏感性、特异性和准确性分别为98.2%、99.3%和99.1%。结论基于BERT的NLP语句分类器能够对大型放射学报告数据库进行分析,准确地确定CT筛查的诊断率。
{"title":"BERT-based natural language processing analysis of French CT reports: Application to the measurement of the positivity rate for pulmonary embolism","authors":"Émilien Jupin-Delevaux ,&nbsp;Aissam Djahnine ,&nbsp;François Talbot ,&nbsp;Antoine Richard ,&nbsp;Sylvain Gouttard ,&nbsp;Adeline Mansuy ,&nbsp;Philippe Douek ,&nbsp;Salim Si-Mohamed ,&nbsp;Loïc Boussel","doi":"10.1016/j.redii.2023.100027","DOIUrl":"10.1016/j.redii.2023.100027","url":null,"abstract":"<div><h3>Rationale and objectives</h3><p>To develop a Natural Language Processing (NLP) method based on Bidirectional Encoder Representations from Transformers (BERT) adapted to French CT reports and to evaluate its performance to calculate the diagnostic yield of CT in patients with clinical suspicion of pulmonary embolism (PE).</p></div><div><h3>Materials and methods</h3><p>All the CT reports performed in our institution in 2019 (99,510 reports, training and validation dataset) and 2018 (94,559 reports, testing dataset) were included after anonymization. Two BERT-based NLP sentence classifiers were trained on 27.700, manually labeled, sentences from the training dataset. The first one aimed to classify the reports’ sentences into three classes (“Non chest”, “Healthy chest”, and \"Pathological chest\" related sentences), the second one to classify the last class into eleven sub classes pathologies including \"pulmonary embolism\". F1-score was reported on the validation dataset. These NLP classifiers were then applied to requested CT reports for pulmonary embolism from the testing dataset. Sensitivity, specificity, and accuracy for detection of the presence of a pulmonary embolism were reported in comparison to human analysis of the reports.</p></div><div><h3>Results</h3><p>The F1-score for the 3-Classes and 11-SubClasses classifiers was 0.984 and 0.985, respectively. 4,042 examinations from the testing dataset were requested for pulmonary embolism of which 641 (15.8%) were positively evaluated by radiologists. The sensitivity, specificity, and accuracy of the NLP network for identifying pulmonary embolism in these reports were 98.2%, 99.3% and 99.1%, respectively.</p></div><div><h3>Conclusion</h3><p>BERT-based NLP sentences classifier enables the analysis of large databases of radiological reports to accurately determine the diagnostic yield of CT screening.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"6 ","pages":"Article 100027"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44997288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Radiation dose in CT-based active surveillance of small renal masses may be reduced by 75%: A retrospective exploratory multiobserver study 基于CT的肾小肿块主动监测中的辐射剂量可减少75%:一项回顾性探索性多观察者研究
Pub Date : 2023-03-01 DOI: 10.1016/j.redii.2022.100019
Jens Borgbjerg , Nis Elbrønd Larsen , Ivar Mjåland Salte , Niklas Revold Grønli , Elise Klæstrup , Anne Negård
{"title":"Radiation dose in CT-based active surveillance of small renal masses may be reduced by 75%: A retrospective exploratory multiobserver study","authors":"Jens Borgbjerg ,&nbsp;Nis Elbrønd Larsen ,&nbsp;Ivar Mjåland Salte ,&nbsp;Niklas Revold Grønli ,&nbsp;Elise Klæstrup ,&nbsp;Anne Negård","doi":"10.1016/j.redii.2022.100019","DOIUrl":"10.1016/j.redii.2022.100019","url":null,"abstract":"","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"5 ","pages":"Article 100019"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49336767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
(18F)-PSMA-1007PET/CT in patients with biochemical recurrence after radical prostatectomy: Diagnostic performance and impact on treatment management 18 F-PSMA-1007PET/CT在根治性前列腺切除术后生化复发患者中的诊断表现及对治疗管理的影响
Pub Date : 2023-03-01 DOI: 10.1016/j.redii.2022.100021
Jia Jiang , Lei Chen , Xiaowei Ji , Xuan Zheng , Junjie Hong , Kun Tang , Xiangwu Zheng

Objective

To evaluate the diagnostic performance of (18F)-PSMA-1007 PET/CT in prostate cancer patients with biochemical recurrence (BCR) after radical prostatectomy and the effect of (18F)-PSMA-1007 PET/CT on treatment strategy.

Methods

A total of 114 patients with BCR after radical prostatectomy who performed (18F)-PSMA-1007 PET/CT were retrospectively analyzed. The Gleason scores (GS), maximum standardized uptake values (SUVmax) and the diagnostic performance were compared according to different prostate-specific antigen (PSA) groups. To evaluate the impact of (18F)-PSMA-1007 PET/CT on treatment management, we also collected subjects’ therapy before and after PET/CT. The PSA value was monitored to evaluate the biochemical response.

Results

(18F)-PSMA-1007PET/CT was positive in 92/114 patients (80.7%). The detection rates were 20/34 (58.8%), 13/17 (76.5%), 15/17 (88.2%) and 44/46 (95.7%) for PSA levels of 0.2-<0.5, 0.5-<1, 1-<2, ≥2 ng/ml. The positive lesions on PET/CT revealed local recurrence in 24/114 (21.1%) patients, lymph nodes metastases in 54/114 (47.4%) and metastatic sites in bone, lung, and others in 75/114 (65.8%). A significant positive correlation was observed between the GS/ SUVmax and PSA level (r1 = 0.375, r2 = 0.336, P<0.001). As a result of the (18F)-PSMA-1007 PET/CT, therapeutic decision-making changed in 60/114 (52.6%) patients. With a follow-up of 11.0 ± 6.4 months, 81/114 PSA were collected after treatment guided by (18F)-PSMA-1007 PET/CT, and in 42/81 (51.9%) of patients, serum PSA levels decreased of more than 60%.

Conclusion

(18F)-PSMA-1007 PET/CT has a high lesion detection rate for recurrent prostate cancer (PCa) and could have significant implications in decision-making treatment plan for the majority of PCa patients.

目的评价(18F)-PSMA-1007 PET/CT对癌症前列腺癌根治术后生化复发(BCR)患者的诊断价值及对治疗策略的影响。方法对114例前列腺癌根治术后行(18F)-PSMA-1007 PET/CT的BCR患者进行回顾性分析。根据不同的前列腺特异性抗原(PSA)组比较Gleason评分(GS)、最大标准化摄取值(SUVmax)和诊断性能。为了评估(18F)-PSMA-1007 PET/CT对治疗管理的影响,我们还收集了受试者在PET/CT前后的治疗情况。监测PSA值以评估生化反应。结果(18F)-PSMA-1007PET/CT阳性率为80.7%(92/114),对0.2-<;0.5、0.5-<;1、1-<;2,≥2 ng/ml。PET/CT上的阳性病变显示,24/114(21.1%)患者局部复发,54/114(47.4%)患者有淋巴结转移,75/114(65.8%)患者有骨、肺和其他部位的转移。在GS/SUVmax和PSA水平之间观察到显著的正相关(r1=0.375,r2=0.336,P<;0.001)。作为(18F)-PSMA-1007 PET/CT的结果,114例患者中有60例(52.6%)改变了治疗决策。随访11.0±6.4个月,在(18F)-PSMA-1007 PET/CT引导下治疗后收集了81/114例PSA,其中42/81例(51.9%)患者,结论(18F)-PSMA-1007PET/CT对复发性癌症(PCa)有较高的病灶检出率,对大多数前列腺癌患者的治疗方案决策具有重要意义。
{"title":"(18F)-PSMA-1007PET/CT in patients with biochemical recurrence after radical prostatectomy: Diagnostic performance and impact on treatment management","authors":"Jia Jiang ,&nbsp;Lei Chen ,&nbsp;Xiaowei Ji ,&nbsp;Xuan Zheng ,&nbsp;Junjie Hong ,&nbsp;Kun Tang ,&nbsp;Xiangwu Zheng","doi":"10.1016/j.redii.2022.100021","DOIUrl":"10.1016/j.redii.2022.100021","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the diagnostic performance of (<sup>18</sup>F)-PSMA-1007 PET/CT in prostate cancer patients with biochemical recurrence (BCR) after radical prostatectomy and the effect of (<sup>18</sup>F)-PSMA-1007 PET/CT on treatment strategy.</p></div><div><h3>Methods</h3><p>A total of 114 patients with BCR after radical prostatectomy who performed (<sup>18</sup>F)-PSMA-1007 PET/CT were retrospectively analyzed. The Gleason scores (GS), maximum standardized uptake values (SUV<sub>max</sub>) and the diagnostic performance were compared according to different prostate-specific antigen (PSA) groups. To evaluate the impact of (<sup>18</sup>F)-PSMA-1007 PET/CT on treatment management, we also collected subjects’ therapy before and after PET/CT. The PSA value was monitored to evaluate the biochemical response.</p></div><div><h3>Results</h3><p>(<sup>18</sup>F)-PSMA-1007PET/CT was positive in 92/114 patients (80.7%). The detection rates were 20/34 (58.8%), 13/17 (76.5%), 15/17 (88.2%) and 44/46 (95.7%) for PSA levels of 0.2-&lt;0.5, 0.5-&lt;1, 1-&lt;2, ≥2 ng/ml. The positive lesions on PET/CT revealed local recurrence in 24/114 (21.1%) patients, lymph nodes metastases in 54/114 (47.4%) and metastatic sites in bone, lung, and others in 75/114 (65.8%). A significant positive correlation was observed between the GS/ SUV<sub>max</sub> and PSA level (r<sub>1</sub> = 0.375, r<sub>2</sub> = 0.336, <em>P</em>&lt;0.001). As a result of the (<sup>18</sup>F)-PSMA-1007 PET/CT, therapeutic decision-making changed in 60/114 (52.6%) patients. With a follow-up of 11.0 ± 6.4 months, 81/114 PSA were collected after treatment guided by (<sup>18</sup>F)-PSMA-1007 PET/CT, and in 42/81 (51.9%) of patients, serum PSA levels decreased of more than 60%.</p></div><div><h3>Conclusion</h3><p>(<sup>18</sup>F)-PSMA-1007 PET/CT has a high lesion detection rate for recurrent prostate cancer (PCa) and could have significant implications in decision-making treatment plan for the majority of PCa patients.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"5 ","pages":"Article 100021"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41492858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Improved image quality with deep learning reconstruction – a study on a semi-anthropomorphic upper-abdomen phantom 通过深度学习重建提高图像质量——对半拟人化上腹部体模的研究
Pub Date : 2023-03-01 DOI: 10.1016/j.redii.2023.100022
Tormund Njølstad MD , Anselm Schulz MD PhD , Kristin Jensen PhD , Hilde K. Andersen MSc , Anne Catrine T. Martinsen PhD

Purpose

To assess image quality of a deep learning reconstruction (DLR) algorithm across dose levels using a semi-anthropomorphic upper-abdominal phantom, and compare with filtered back projection (FBP) and hybrid iterative reconstruction (IR).

Material and methods

CT scans obtained at five dose levels (CTDIvol 5, 10, 15, 20 and 25 mGy) were reconstructed with FBP, hybrid IR (IR50, IR70 and IR90) and DLR of low (DLL), medium (DLM) and high strength (DLH) in 0.625 mm and 2.5 mm slices. CT number, homogeneity, noise, contrast, contrast-to-noise ratio (CNR), noise texture deviation (NTD; a measure of IR-specific artifacts), noise power spectrum (NPS) and task-based transfer function (TTF) were compared between reconstruction algorithms.

Results

CT numbers were highly consistent across reconstruction algorithms. Image noise was significantly reduced with higher levels of DLR. Noise texture (NPS and NTD) was with DLR maintained at comparable levels to FBP, contrary to increasing levels of hybrid IR. Images reconstructed with DLR of low and high strength in 0.625 mm slices showed similar noise characteristics to 2.5 mm slice FBP and IR50, respectively. Dose-reduction potential based on image noise with IR50 as reference was estimated to 35% for DLM and 74% for DLH.

Conclusions

The novel DLR algorithm demonstrates robust noise reduction with maintained noise texture characteristics despite higher algorithm strength, and may have overcome important limitations of IR. There may be potential for dose reduction and additional benefit from thin-slice reconstruction.

目的使用半拟人化上腹部体模评估深度学习重建(DLR)算法在不同剂量水平下的图像质量,并与滤波反投影(FBP)和混合迭代重建(IR)进行比较。材料和方法用FBP、混合IR(IR50、IR70和IR90)和低(DLL)、中(DLM)和高强度(DLH)的DLR在0.625mm和2.5mm的切片中重建在5个剂量水平(CTDIvol 5、10、15、20和25mGy)下获得的CT扫描。比较了重建算法之间的CT数量、均匀性、噪声、对比度、对比噪声比(CNR)、噪声纹理偏差(NTD;IR特异性伪影的测量)、噪声功率谱(NPS)和基于任务的传递函数(TTF)。结果不同重建算法的CT数字高度一致。DLR水平越高,图像噪声显著降低。噪声纹理(NPS和NTD)与混合IR水平的增加相反,DLR保持在与FBP相当的水平。在0.625mm切片中用低强度和高强度DLR重建的图像分别显示出与2.5mm切片FBP和IR50相似的噪声特性。基于以IR50为参考的图像噪声的剂量减少潜力估计DLM为35%,DLH为74%。结论新的DLR算法表现出稳健的降噪效果,尽管算法强度较高,但仍保持了噪声纹理特性,并可能克服了IR的重要局限性。薄层重建可能具有降低剂量的潜力和额外的好处。
{"title":"Improved image quality with deep learning reconstruction – a study on a semi-anthropomorphic upper-abdomen phantom","authors":"Tormund Njølstad MD ,&nbsp;Anselm Schulz MD PhD ,&nbsp;Kristin Jensen PhD ,&nbsp;Hilde K. Andersen MSc ,&nbsp;Anne Catrine T. Martinsen PhD","doi":"10.1016/j.redii.2023.100022","DOIUrl":"10.1016/j.redii.2023.100022","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess image quality of a deep learning reconstruction (DLR) algorithm across dose levels using a semi-anthropomorphic upper-abdominal phantom, and compare with filtered back projection (FBP) and hybrid iterative reconstruction (IR).</p></div><div><h3>Material and methods</h3><p>CT scans obtained at five dose levels (CTDI<sub>vol</sub> 5, 10, 15, 20 and 25 mGy) were reconstructed with FBP, hybrid IR (IR50, IR70 and IR90) and DLR of low (DLL), medium (DLM) and high strength (DLH) in 0.625 mm and 2.5 mm slices. CT number, homogeneity, noise, contrast, contrast-to-noise ratio (CNR), noise texture deviation (NTD; a measure of IR-specific artifacts), noise power spectrum (NPS) and task-based transfer function (TTF) were compared between reconstruction algorithms.</p></div><div><h3>Results</h3><p>CT numbers were highly consistent across reconstruction algorithms. Image noise was significantly reduced with higher levels of DLR. Noise texture (NPS and NTD) was with DLR maintained at comparable levels to FBP, contrary to increasing levels of hybrid IR. Images reconstructed with DLR of low and high strength in 0.625 mm slices showed similar noise characteristics to 2.5 mm slice FBP and IR50, respectively. Dose-reduction potential based on image noise with IR50 as reference was estimated to 35% for DLM and 74% for DLH.</p></div><div><h3>Conclusions</h3><p>The novel DLR algorithm demonstrates robust noise reduction with maintained noise texture characteristics despite higher algorithm strength, and may have overcome important limitations of IR. There may be potential for dose reduction and additional benefit from thin-slice reconstruction.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"5 ","pages":"Article 100022"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48644660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Dose variations for biopsy, puncture and drainage under CT guidance: A national survey in 1709 patients CT引导下活检、穿刺和引流的剂量变化:一项全国1709例患者的调查
Pub Date : 2023-03-01 DOI: 10.1016/j.redii.2023.100025
Laure Berny , Joël Greffier , Chris Serrand , Djamel Dabli , Fabien De Oliveira , Hélène de Forges , Jean-Paul Beregi , Julien Frandon

Background

A nation-wide study recently published the dose reference levels for the main CT-guided interventional procedures in 5001 patients. We assessed the impact of patient's age, sex and targeted organ on the patient dose during thoracic and abdominopelvic biopsies and punctures/drainages.

Patients and methods

Data were extracted from the previous nationwide study. All biopsies, punctures and drainages for thoracic or abdominopelvic locations performed between January 2017 and June 2019 in all participating centers were included in the study. Multivariable analyses were carried out using a linear regression of the dose-length product (DLP) log, adjusted to age, sex, anatomical location, number of helical acquisitions and inclusion center.

Results

Of the 5001 patients of the initial study, 2383 benefited from thoracic or abdominopelvic procedures, including 674 percutaneous destructions excluded. 1709 patients (44 centers), 1045 men, 664 women, median age 64.4 ± 14.0 years were included. The mean DLP was 751.2 ± 642.7mGy.cm. It was significantly higher in men than women (p = 0.0005) and higher for abdominopelvic procedures than for thoracic locations (p<0.0001).

Conclusion

Doses delivered to patients for abdominal and thoracic biopsies and punctures/drainages performed under CT guidance depend on gender and location. Furthers studies taking into account the patient's morphology and anatomical location of the procedure would allow proposing finer dose reference levels.

背景最近一项全国性研究公布了5001名患者在CT引导下进行主要介入治疗的剂量参考水平。我们评估了患者的年龄、性别和靶器官对胸腹盆腔活检和穿刺/引流过程中患者剂量的影响。患者和方法数据取自先前的全国性研究。2017年1月至2019年6月期间,在所有参与中心进行的所有胸部或腹部骨盆部位的活检、穿刺和引流都包括在研究中。使用剂量-长度乘积(DLP)对数的线性回归进行多变量分析,并根据年龄、性别、解剖位置、螺旋采集次数和纳入中心进行调整。结果在最初研究的5001名患者中,2383人受益于胸部或腹部骨盆手术,其中674例经皮破坏除外。1709名患者(44个中心),1045名男性,664名女性,中位年龄64.4±14.0岁。平均DLP为751.2±642.7mGy.cm。男性的DLP显著高于女性(p=0.0005),腹盆腔手术的DLP明显高于胸部手术(p<0.0001)。结论在CT指导下进行腹部和胸部活检和穿刺/引流的患者剂量取决于性别和位置。进一步的研究考虑了患者的形态和手术的解剖位置,可以提出更精细的剂量参考水平。
{"title":"Dose variations for biopsy, puncture and drainage under CT guidance: A national survey in 1709 patients","authors":"Laure Berny ,&nbsp;Joël Greffier ,&nbsp;Chris Serrand ,&nbsp;Djamel Dabli ,&nbsp;Fabien De Oliveira ,&nbsp;Hélène de Forges ,&nbsp;Jean-Paul Beregi ,&nbsp;Julien Frandon","doi":"10.1016/j.redii.2023.100025","DOIUrl":"10.1016/j.redii.2023.100025","url":null,"abstract":"<div><h3>Background</h3><p>A nation-wide study recently published the dose reference levels for the main CT-guided interventional procedures in 5001 patients. We assessed the impact of patient's age, sex and targeted organ on the patient dose during thoracic and abdominopelvic biopsies and punctures/drainages.</p></div><div><h3>Patients and methods</h3><p>Data were extracted from the previous nationwide study. All biopsies, punctures and drainages for thoracic or abdominopelvic locations performed between January 2017 and June 2019 in all participating centers were included in the study. Multivariable analyses were carried out using a linear regression of the dose-length product (DLP) log, adjusted to age, sex, anatomical location, number of helical acquisitions and inclusion center.</p></div><div><h3>Results</h3><p>Of the 5001 patients of the initial study, 2383 benefited from thoracic or abdominopelvic procedures, including 674 percutaneous destructions excluded. 1709 patients (44 centers), 1045 men, 664 women, median age 64.4 ± 14.0 years were included. The mean DLP was 751.2 ± 642.7mGy.cm. It was significantly higher in men than women (<em>p</em> = 0.0005) and higher for abdominopelvic procedures than for thoracic locations (<em>p</em>&lt;0.0001).</p></div><div><h3>Conclusion</h3><p>Doses delivered to patients for abdominal and thoracic biopsies and punctures/drainages performed under CT guidance depend on gender and location. Furthers studies taking into account the patient's morphology and anatomical location of the procedure would allow proposing finer dose reference levels.</p></div>","PeriodicalId":74676,"journal":{"name":"Research in diagnostic and interventional imaging","volume":"5 ","pages":"Article 100025"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45522997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Research in diagnostic and interventional imaging
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