BMC Medical Imaging最新文献

Background: Preterm birth (< 37 weeks' gestation) alters cerebrovascular development due to the premature transition from a foetal to postnatal circulatory system, with potential implications for future cerebrovascular health. This study aims to explore potential differences in the Circle of Willis (CoW), a key arterial ring that perfuses the brain, of healthy adults born preterm.

Methods: A total of 255 participants (108 preterm, 147 full-term) were included in the analysis. High-resolution three-dimensional Time-of-Flight Magnetic Resonance Angiography (3D TOF MRA) datasets were analysed, measuring vessel diameters and classifying segments into different groups of CoW anatomical variations. Statistical comparisons assessed the prevalence of each variant group between preterm and full-term populations, as well as the relationship between CoW variability, sex, and degree of prematurity.

Results: We identified 164 participants with variant CoW configurations. Unilateral segment hypoplasia (30%) and unilateral segment absence (29%) were the most common variations, with over 50% related to the posterior communicating artery (PComA). However, the incidence of absent segments was lower in preterm adults, who were more likely to exhibit variants associated with complete CoW configurations compared to full-term adults (p = 0.025). Preterm males had a higher probability of a group 1 variant (circles with one or more hypoplastic segments only) than the full-term group (p = 0.024). In contrast, preterm females showed higher odds of a group 4a variant (circles with one or more accessory segments, without any absent segments) in comparison to their full-term counterparts (p = 0.020).

Conclusions: Preterm birth is linked to a distinct vascular phenotype of CoW in adults born preterm, with a higher likelihood of a CoW configuration with hypoplastic segments but a lower likelihood of absent segments. Future work should focus on larger prospective studies and explore the implications of these findings for normal development and cerebrovascular disease. Furthermore, TOF MRA might be a useful adjunct in the neurovascular assessment of preterm-born individuals.

Background: Beta thalassemia major (β-TM) is a severe genetic anemia with considerable phenotypic heterogeneity. This study investigated whether genotype correlates with distinct myocardial iron overload patterns, assessed by cardiovascular magnetic resonance (CMR) T2* values.

Methods: CMR data for cardiac iron deposition evaluation, which recruited pediatric participants between January 2021 and December 2024, were analyzed with CVI42. The patients were classified into three genetic subgroups of β⁰/β⁰, β⁰/β⁺, and β⁺/β⁺ based on their genetic outcomes. The CMR results classified patients into normal myocardial T2* value and myocardial iron overload groups. Qualitative and quantitative factors were subsequently compared by groups using comparative statistics.

Results: The study included 145 pediatric β-TM patients, with 24 (17%) exhibiting cardiac iron deposition based on CMR T2* values. There were significant differences in iron chelation treatment strategies across genotypes, with the β⁰/β⁰ genotype accounting for 54% (13/24) of patients in the cardiac iron deposition group. Regardless of genotype, the mid-inferolateral segment consistently showed the lowest CMR T2* values and the highest prevalence of iron deposition.

Conclusion: The risk of cardiac iron deposition increases as age progresses, and the mid-inferolateral segment is more susceptible to iron accumulation. The β⁰/β⁰ genotype is more likely to suffer from cardiac iron overload, emphasizing the need for closer clinical monitoring and regular cardiac MRI evaluations.

Background: Interstitial lung abnormalities (ILA) are a proposed imaging concept. Fibrous ILA have a higher risk of progression and death. Clinically, computed tomography (CT) examination is a frequently used and convenient method compared with pulmonary function tests. This study aimed to correlate quantitative CT airway parameters with pulmonary function parameters in patients with fibrous ILA, with the goal of establishing a prediction model for abnormal pulmonary function parameters in patients with fibrous ILA.

Methods: Ninety-five cases of fibrous ILA including CT images and 64 normal control cases were collected. All patients completed pulmonary function tests within one week. The airway parameters of the CT images of the two groups of cases were measured using a commercial software (Aview). Differences in airway parameters and lung function parameters between the two groups were analyzed by logistic multifactorial regression. The correlation between airway parameters and lung function parameters among 95 patients with fibrous ILA and a prediction model was determined for the decreased percentage forced vital capacity to predicted normal value (FVC%pred) in patients with fibrous ILA.

Results: Logistic multifactorial regression correlated FVC%pred and bronchial wall thickness (WT) were correlated with fibrous ILA. The 95 patients with fibrous ILA were divided into normal FVC%pred (n = 69) and decreased FVC%pred (n = 26) groups at the 80% cut-off. Logistic multifactorial regression revealed that FVC%pred decline in patients with fibrous ILA was effectively predicted by age (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.02-1.21, p = 0.014), gender (OR: 4.16,95% CI: 1.27-13.71, p = 0.019), luminal area of the sixth generation brochi (LA₆; OR: 0.87, 95%CI: 0.78-0.970,p = 0.015), and airway wall area (WA; OR: 1.12, 95%CI: 1.02-1.24, p = 0.020) were effective predictors of. The area under the curve of the prediction model based on the four parameters was 0.8428.

Conclusion: WT is a quantitative CT biomarker and FVC%pred is a valid lung function parameter in fibrous ILA patients. Age, gender, LA₆, and WA are effective predictors of FVC%pred decline in fibrous ILA patients. The combined model has good predictive value.

Clinical trial number: 2024K249.

Background: Langerhans cell histiocytosis (LCH) is a rare disease, most prevalent in children. Ultrasound is a noninvasive, cheap, and widely available technique. However, systematic elucidation of sonographic features of LCH and treatment related follow-up are relatively few, resulting in overall underestimation of the clinical value of ultrasound in diagnosing and monitoring LCH.

Objective: This study aimed to observe the sonographic features of Langerhans Cell Histiocytosis (LCH) comparing with other imaging examinations, and to evaluate the changes of ultrasonography in the follow-up of LCH in children.

Materials and methods: Forty-four children (female:male, 19/25; median age, 60 months; range, 8 to 192 months) with LCH were included in this retrospective study. Thirty-one had single-system involvement (SS-LCH), and 13 had multisystem involvement (MS-LCH) among the 44 children. We analyzed the clinical characteristics, ultrasound (US) images, and images from other modalities, including X-ray, computed tomography (CT), and magnetic resonance imaging (MRI). The sonographic characteristics of the various involved organs, particularly bone, thyroid, and liver were analyzed, and the percentage of LCH cases correctly identified by the various imaging modalities were evaluated.

Results: Localized worm-like bone defects solid hypoechoic lesions were found in 38 patients with a total of 43 skeletal lesions, which showed solid hypoechoic lesions on US. Five patients showed hypoechoic or hyperechoic areas in the liver. Two patients showed scattered or diffuse irregular hypoechoic areas in the thyroid. Two patients with skeletal and 1 with thyroid involvement showed smaller lesions and lower blood flow after chemotherapy, and 6 lesions involving the liver resolved or were smaller in US review. The percentage of LCH cases correctly identified of US (65.38%) was higher than that of X-ray (21.05%) (P = 0.026) for skeletal lesions, which was comparable to that of CT and MRI. The overall correctly identified percentage of US for LCH was not significantly different from that of other imaging modalities.

Conclusion: LCH can be detected and suspected based on sonographic features. US may be an excellent tool for the diagnosis and follow-up of LCH in children.

Background: Quantitative molecular imaging via single-photon emission computed tomography-derived standardised uptake value (SPECT/CT-SUV) is used to assess the response of metastatic castration-resistant prostate cancer (mCRPC) patients to targeted radionuclide therapy (TRT) with [¹⁷⁷Lu]Lu-PSMA. This imaging technique determines the radiopharmaceutical distribution and internal dosimetry in patients who receive TRT. However, there is limited evidence regarding the role of image quantification in monitoring changes induced by [¹⁷⁷Lu]Lu-PSMA. This systematic examines the role of quantitative SPECT/CT-SUV during [¹⁷⁷Lu]Lu-PSMA TRT and assesses whether SUV changes correlate with quantitative imaging and biomarkers.

Methods: A systematic review was conducted in accordance with the PRISMA guidelines. The MEDLINE/PubMed databases were searched from January 2016 to July 2024 to identify relevant articles. The inclusion criterion was the use of quantitative SPECT/CT-SUV during [¹⁷⁷Lu]Lu-PSMA TRT for patients with mCRPC. The records were screened to determine their eligibility. The abstracts of 62 records were screened, and 28 were excluded because they were not relevant; the full texts of 34 original papers were retrieved and assessed for eligibility.

Results: A total of five studies were included in this systematic review (two prospective studies and three retrospective studies). The sample sizes of the studies ranged from 6 to 73 patients. The highest number of lesions analysed was 144. Three studies reported the SPECT/CT-SUV following cycle 1, and only one study reported the correlation with pretherapy PET/CT (r = 0.9, p = 0.005). SPECT/CT-SUV changes between the first two to three cycles were reported in one study. None of the studies reported the SPECT/CT-SUV for normal organs. One study reported correlations between SPECT/CT-derived SUV and PET/CT-derived SUV in target and nontarget tissues.

Conclusion: Quantitative SPECT/CT-SUV can be used to predict responses to subsequent PSMA-TRT cycles. Disease burden and tumour heterogeneity are the leading causes of TRT individualisation.

Objectives: This study aims to develop and validate nomograms that utilize morphological and radiomics features derived from computed tomography enterography (CTE) to evaluate inflammatory activity in patients with ileocolonic Crohn's disease (CD).

Methods: A total of 54 CD patients (237 bowel segments) with clinically confirmed CD were retrospectively analyzed. The Simple Endoscopic Score for Crohn's Disease (SES-CD) was used as a reference standard to quantify the degree of mucosal inflammation and assess disease severity. We extracted morphological and radiomics features in the training cohort to create a morphological model (M-score) and a radiomics model (Rad-score). A combined nomogram was generated by integrating the M-score and Rad-score. The predictive performance of each model was evaluated using receiver operating characteristic (ROC) curve analysis. Additionally, calibration curve and decision curve analysis (DCA) were employed to assess the accuracy and clinical applicability of the nomogram in the testing cohort.

Results: The area under the ROC curve (AUC) for the nomogram, which included stenosis, comb sign, and Rad-score, was 0.834 [95% confidence interval (CI): 0.728-0.940] for distinguishing between active and remissive disease. Furthermore, the nomogram created using comb sign and Rad-score achieved a satisfactory AUC of 0.781 (95% CI: 0.611-0.951) in differentiating mild activity from moderate-to-severe activity. The calibration curve and DCA confirmed both nomograms' accuracy and clinical utility.

Conclusions: Nomograms that combined CTE-based radiomics and morphological features could serve as valuable tools for assessing inflammatory activity, thereby supporting clinical decision-making in managing CD.

Keypoints: 1. Radiomics features from CTE could predict the inflammatory activity of CD.

Neoadjuvant chemotherapy (NAC) is a systemic and systematic chemotherapy regimen for breast cancer patients before surgery. However, NAC is not effective for everyone, and the process is excruciating. Therefore, accurate early prediction of the efficacy of NAC is essential for the clinical diagnosis and treatment of patients. In this study, a novel convolutional neural network model with bimodal layer-wise feature fusion module (BLFFM) and temporal hybrid attention module (THAM) is proposed, which uses multistage bimodal ultrasound images as input for early prediction of the efficacy of neoadjuvant chemotherapy in locally advanced breast cancer (LABC) patients. The BLFFM can effectively mine the highly complex correlation and complementary feature information between gray-scale ultrasound (GUS) and color Doppler blood flow imaging (CDFI). The THAM is able to focus on key features of lesion progression before and after one cycle of NAC. The GUS and CDFI videos of 101 patients collected from cooperative medical institutions were preprocessed to obtain 3000 sets of multistage bimodal ultrasound image combinations for experiments. The experimental results show that the proposed model is effective and outperforms the compared models. The code will be published on the https://github.com/jinzhuwei/BLTA-CNN .

Objective: This study aimed to evaluate the diagnostic value of ColorViz fused images from multi-phase computed tomography angiography (mCTA) using GE Healthcare's FastStroke software for newly diagnosed cerebral infarctions in patients with acute ischemic stroke (AIS).

Methods: A total of 106 AIS patients with unilateral anterior circulation occlusion were prospectively enrolled. All patients underwent mCTA scans during the arterial peak phase, venous peak phase, and venous late phase. The vascular information from these mCTA phases was combined into a time-varying color-coded image using GE Healthcare's FastStroke software. All participants also underwent magnetic resonance diffusion-weighted imaging (MR-DWI) within three days. The diagnostic capability of the mCTA ColorViz fusion images for identifying newly diagnosed intracranial infarction was assessed using MR-DWI as the gold standard, focusing on the degree of delayed vascular perfusion and the number of visible blood vessels.

Results: The mCTA ColorViz fusion images revealed ischemic changes in brain tissue, demonstrating a sensitivity of 88.7% for superficial infarctions and 48.5% for deep infarctions. Additionally, the subjective vascular grading score of the mCTA ColorViz fusion images showed a strong negative correlation with the infarct area identified by MR-DWI (r = - 0.6, P < 0.001).

Conclusion: The mCTA ColorViz fusion images produced by FastStroke software provide valuable diagnostic insights for newly diagnosed cerebral infarction in AIS patients. The sensitivity of these images is notably higher for superficial infarctions compared to deep ones. This technique allows for relatively accurate detection of the ischemic extent and the likelihood of infarction in the superficial regions where lesions are located.

Background: PSMA PET/CT emerges as a pivotal technology in the diagnostic landscape of prostate cancer (PCa). It offers a suite of imaging interpretation criteria, notably the maximum standardized uptake value (SUVmax), the molecular imaging prostate-specific membrane antigen score (miPSMA score), and the PSMA reporting and data system (PSMA-RADS). Identifying the most valuable criteria for diagnosing PCa and standardizing imaging interpretation across various tracers is an unresolved question. Our study endeavors to pinpoint the most optimal criteria to enhance the precision of PCa diagnosis, encompassing clinically significant PCa (csPCa), by evaluating the consistency and diagnostic accuracy of these three criteria using two [¹⁸F]-labeled PSMA tracers.

Method: This retrospective analysis spans a five-year period, focusing on patients with clinically suspected or newly diagnosed, treatment-naïve PCa who underwent ¹⁸F-PSMA PET/CT. The study is bifurcated into two segments: 1.A direct comparison assessing the consistency in SUVmax, miPSMA scores, and PSMA-RADS among PSMA PET/CT tracers ([¹⁸F]DCFPyL and [¹⁸F]PSMA-1007) for prostate foci in 24 patients. 2. An analysis of the diagnostic accuracy of these three criteria for both PCa and csPCa across 55 [¹⁸F]DCFPyL and 65 [¹⁸F]PSMA-1007 PET/CT scans, respectively.

Results: 1.Our head-to-head study reveals that SUVmax and miPSMA score exhibit near-perfect consistency, with PSMA-RADS demonstrating substantial consistency. 2. The diagnostic accuracy ranking, considering both PCa and csPCa, stands as miPSMA score ≈ SUVmax > PSMA-RADS for [¹⁸F]DCFPyL PET/CT, contrasting with miPSMA score > SUVmax ≈ PSMA-RADS for [¹⁸F]PSMA-1007 PET/CT.

Conclusion: The miPSMA score outperforms SUVmax and PSMA-RADS in terms of inter-tracer consistency and diagnostic accuracy for the detection of PCa, including csPCa, when comparing [¹⁸F]DCFPyL and [¹⁸F]PSMA-1007 PET/CT scans. This underscores the miPSMA score's potential as a robust criterion for PCa and csPCa diagnosis, holding substantial promise for refining clinical decision-making and patient management strategies.

Clinical trial number: not applicable.

Background: The purpose of our study was to investigate the association between non-alcoholic fatty liver disease (NAFLD) and abdominal aortic aneurysms (AAA) progression using non-enhanced computed tomography (CT) and CT angiography (CTA).

Methods: Patients with AAA and age- and sex-matched healthy subjects who underwent abdominal CTA and non-enhanced CT examination between January 2015 and January 2023 from four hospitals were retrospectively analyzed. Patients with AAA were divided into progression (growth rate > 10 mL/year) and non-progression groups, as well as those with NAFLD and without NAFLD, based on abdominal CT results. The Kaplan-Meier and Cox regression were used to investigate the association between NAFLD and AAA progression.

Results: A total of 151 patients with AAA (mean age: 69.1 ± 10.5 years old, 133 men) were included, among which 66 patients (43.7%) had NAFLD. During a median of 10.7 months (6.0-76.0 months), 57 patients (37.7%) had AAA progression. The prevalence of NAFLD was significantly higher in the AAA group compared to the control group (43.7% vs. 31.1%, p = 0.024). Multivariable regression analysis revealed that the NAFLD was independently associated with AAA progression (HR, 4.28; 95% CI, 2.20-8.31; p < 0.001). The area under curve of combined NAFLD and AAA maximal diameter was 0.857 for predicting AAA progression.

Conclusions: NAFLD on non-enhanced CT is an independent predictor of AAA progression. It can improve the diagnostic efficacy of predicting the progression of abdominal aortic aneurysms.

Clinical trial number: Not applicable. This research is a retrospective analysis.