Clinical radiology最新文献

{"title":"Seven-year trends in computed tomography (CT) pulmonary angiography utilisation and predictors of positivity in a large emergency department","authors":"C.M. Hood ,&nbsp;C. Vo ,&nbsp;A.H. King ,&nbsp;S. Prasad ,&nbsp;M.D. Weintraub ,&nbsp;M.H. Lev ,&nbsp;A.D. Sodickson ,&nbsp;S. Saini ,&nbsp;M.S. Gee ,&nbsp;M.D. Succi","doi":"10.1016/j.crad.2025.106953","DOIUrl":"10.1016/j.crad.2025.106953","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate trends in computed tomography pulmonary angiography (CTPA) utilisation in an emergency department (ED) and identify factors associated with pulmonary embolism (PE) detection.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study analysed CTPA exams from 2017–2023 at a quaternary urban ED. CTPA volumes were normalised to total ED visits and ED CTs. Logistic regression assessed predictors of positivity. CTPA-per-visit trends were modelled with negative-binomial regression.</div></div><div><h3>Results</h3><div>CTPA volume rose 49% from 2,467 in 2017 to 3,684 in 2023. Positivity rates remained stable (mean 9.1%, range 8.3%–10.6%, p=0.55). CTPA use peaked at 10.0% of ED CTs in 2021, declining to 8.3% by 2023 (p=0.30). CTPAs per 1,000 ED visits increased from ∼22 in 2017 to ∼40 in 2021, then fell to ∼31 in 2023 (p=0.75). Male patients had higher odds of a positive result (aOR 1.222, 95% CI: 1.115–1.339), as did Black (aOR 1.222, CI: 1.058–1.412) vs White patients. Asian patients had lower odds (aOR 0.647, CI 0.489–0.857). Overnight exams were less likely to yield PE (aOR 0.830, CI 0.730–0.945). Higher body mass index (BMI) (aOR 1.014, CI 1.006–1.022) and cancer history (aOR 1.185, CI 1.039–1.352) were also predictive. Ordering provider training level (MD/DO, NP, PA) did not affect diagnostic yield.</div></div><div><h3>Conclusion</h3><div>Over a seven-year period (2017–2023), annual CTPA volume and utilisation rate increased, but the positivity rate remained stable at ∼9%. Male sex, Black race, higher BMI, cancer history, and daytime imaging were associated with higher odds of PE. Provider training level was not associated with diagnostic yield.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106953"},"PeriodicalIF":2.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elucidating the biological function of computed tomography (CT)-based radiomics biomarkers in serous ovarian cancer","authors":"M. Kishi ,&nbsp;D. Kawahara ,&nbsp;R. Nishioka ,&nbsp;I. Koh ,&nbsp;K. Tomono ,&nbsp;Y. Sato ,&nbsp;I. Nishibuchi ,&nbsp;Y. Murakami","doi":"10.1016/j.crad.2025.106952","DOIUrl":"10.1016/j.crad.2025.106952","url":null,"abstract":"<div><h3>AIM</h3><div>This study aims to elucidate the biological mechanisms in the tumour microenvironment as read from images by comprehensive Gene Set Enrichment Analysis (GSEA) based on radiomic features that predict survival. Furthermore, this study enables biological interpretation of survival prediction using radiomic features, which in turn allows for optimal treatment feedback to improve clinical outcomes.</div></div><div><h3>MATERIAL AND METHODS</h3><div>This retrospective study included serous ovarian cancer patients with pretreatment computed tomography (CT) images. Prognostic radiomic features were selected using least absolute shrinkage and selection operator (LASSO)-Cox regression and calculated as a Rad-score. Patients were classified into low- and high-risk groups (HRGs), and a survival prediction model was constructed. Model performance was evaluated with Kaplan–Meier curves, the log-rank test, and the C-index. GSEA identified gene sets associated with radiomic features linked to survival.</div></div><div><h3>RESULTS</h3><div>The Kaplan–Meier curve using the log-rank test (p&lt;0.01) and C-index values (0.768; 95% CI: 0.694–0.842) of the predictive models showed significant differences. GSEA was performed on the low- and HRGs, and the results identified a set of genes associated with cell proliferation, including the G2M checkpoint (p=0.006, FDR=0.138), mitotic spindle (p=0.006, FDR=0.156), and E2F targets (p=0.032, FDR=0.133).</div></div><div><h3>CONCLUSION</h3><div>This study revealed the biological functions underlying imaging features crucial for survival prediction and introduced an innovative approach to radiogenomics. This comprehensive approach promises to provide novel insights into the tumour microenvironment and potentially contribute to advancements in ovarian cancer treatment.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106952"},"PeriodicalIF":2.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac magnetic resonance imaging to predict left ventricular reverse remodelling in non-ischaemic dilated cardiomyopathy: a systematic review and meta-analysis","authors":"B.S. Berdibekov,&nbsp;S.A. Alexandrova,&nbsp;N.I. Bulaeva,&nbsp;E.Z. Golukhova","doi":"10.1016/j.crad.2025.106950","DOIUrl":"10.1016/j.crad.2025.106950","url":null,"abstract":"<div><h3>AIM</h3><div>This systematic review and meta-analysis aimed to evaluate the predictive value of cardiac magnetic resonance (CMR) imaging parameters for left ventricular reverse remodelling (LVRR) in patients with nonischaemic dilated cardiomyopathy (DCM).</div></div><div><h3>MATERIALS AND METHODS</h3><div>Electronic databases were searched for studies examining late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV). A random-effect meta-analysis was conducted, with heterogeneity assessed using the I² statistic.</div></div><div><h3>RESULTS</h3><div>Seventeen studies involving 1,465 participants (mean age: 54.3 years; LGE prevalence: 31%-69%) were included, with an average follow-up of 18.6 months. LGE was a strong univariate predictor of LVRR (pooled odds ratio [OR]: 3.65; 95% confidence interval [CI]: 2.45 to 5.45). A meta-analysis of three studies showed that LGE remained predictive after adjustment for baseline characteristics (pooled adjusted OR: 2.84; 95% CI: 1.50-5.37). Patients without LVRR had a greater LGE extent (weighted mean difference [MD]: 4.19%; 95% CI: 2.40%-5.97%), longer native T1 times (weighted MD: 44.84 ms; 95% CI: 25.92-63.76 ms), and higher ECV (weighted MD: 4.33%; 95% CI: 2.40%-6.26%).</div></div><div><h3>CONCLUSION</h3><div>The absence of LGE is a robust predictor of LVRR, even after adjustment for baseline characteristics. Patients with LVRR demonstrated lower LGE extent, shorter T1 times, and lower ECV, underscoring the utility of these CMR markers as indicators of myocardial recovery. Future research should focus on incorporating CMR parameters into clinical decision-making algorithms to enhance the management and outcomes of patients with DCM.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106950"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-Sylvian versus intracerebral haematoma associated with ruptured middle cerebral artery aneurysm: initial and follow-up imaging features","authors":"J.I. Hwang ,&nbsp;D.Y. Yoon ,&nbsp;E.S. Kim ,&nbsp;H.J. Jeon ,&nbsp;J.Y. Lee ,&nbsp;Y.L. Seo ,&nbsp;E.J. Yun","doi":"10.1016/j.crad.2025.106951","DOIUrl":"10.1016/j.crad.2025.106951","url":null,"abstract":"<div><h3>AIM</h3><div>The aim of this study was to evaluate and compare the initial and follow-up imaging features of intra-Sylvian haematoma (ISH) and intracerebral haematoma (ICH) from a ruptured middle cerebral artery (MCA) aneurysm.</div></div><div><h3>MATERIALS AND METHODS</h3><div>We retrospectively evaluated and compared the imaging features of 24 patients with ISH and 46 with ICH from ruptured MCA aneurysms. The following features in initial computed tomography, computed tomography angiography, and magnetic resonance (MR) imaging were investigated: density (Hounsfield unit) and margin of the haematoma, low density surrounding the haematoma, morphological parameters of the aneurysm, early severe vasospasm of M1 and M2 segments, active rebleeding, and high b1000 signal intensity and low apparent diffusion coefficient (ADC) surrounding the haematoma on MR diffusion-weighted imaging (DWI). Additionally, we assessed delayed severe vasospasm and the distribution of cerebromalacia on follow-up imaging examinations.</div></div><div><h3>RESULTS</h3><div>Compared to the ICH group, the ISH group showed a more frequent haematoma with serrated margins (100% vs 21.7%, <em>P</em>=0.000), absent or uniform thickness low density surrounding the haematoma (75.0% vs 15.2%, <em>P</em>=0.000), early severe vasospasm of M1 and M2 segments (83.3% vs 41.3%, <em>P</em>=0.001), thick (&gt;5 mm) high b1000 signal intensity and low ADC surrounding the haematoma on MR DWI (100% vs 27.8%, <em>P</em>=0.001), delayed severe vasospasm at days 7 (±1) (100% vs 61.5%, <em>P</em>&lt;0.05), and cerebromalacia involving brain surrounding the Sylvian fissure at 3 to 12 months (71.4% vs 0%, <em>P</em>=0.000).</div></div><div><h3>CONCLUSION</h3><div>Initial and follow-up imaging features can help differentiate between ISH and ICH associated with ruptured MCA aneurysm, facilitating appropriate treatment in the course of the disease.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106951"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of thyroid-associated ophthalmopathy activity using corrected standardised uptake value maximum (SUVmax) and uptake ratios from 99Tcm-diethylene triamine pentaacetic acid single photon emission computed tomography/computed tomography (99Tcm-DTPA SPECT/CT) imaging","authors":"J. Sun ,&nbsp;L. Ma ,&nbsp;M. Wang ,&nbsp;X. Yuan","doi":"10.1016/j.crad.2025.106946","DOIUrl":"10.1016/j.crad.2025.106946","url":null,"abstract":"<div><h3>Aim</h3><div>This study evaluated the utility of corrected maximum standardized uptake value (SUVmax) in assessing thyroid-associated ophthalmopathy (TAO) activity through 99Tcm-diethylene triamine pentaacetic acid (99Tcm-DTPA) SPECT/CT imaging.</div></div><div><h3>Materials and Methods</h3><div>A total of 166 orbits from 83 TAO patients were analyzed, alongside 22 orbits from 11 healthy controls. Participants were cate gorized into active (CAS ≥ 3), inactive (CAS &lt;3), and control groups based on the clinical activity score (CAS). Corrected SUVmax and uptake ratios (UR) were quantitatively measured using Q.Metrix software. Statistical analyses, including Kruskale-Wallis tests, Spearman correlations, and ROC curve evaluations, were employed to examine group differences and diagnostic performance.</div></div><div><h3>Results</h3><div>The corrected SUVmax and UR values were significantly higher in the active group compared to inactive and control groups (P&lt;0.001). Corrected SUVmax demonstrated strong reproducibility (ICC = 0.958) and a positive correlation with CAS (rs = 0.537, P&lt;0.001), outperforming UR in consistency (ICC = 0.632). ROC analysis revealed that the corrected SUVmax threshold of 10.440 offered 70.7% sensitivity and 82.1% specificity for predicting TAO activity. UR exhibited comparable diagnostic performance but with reduced reproducibility.</div></div><div><h3>Conclusion</h3><div>These findings highlight corrected SUVmax as a robust and reliable parameter for quantifying TAO inflammatoryactivity. Its strong correlation with CAS and high interobserver agreement establish its potential for clinical use in guiding TAO treatment and monitoring disease progression. Further multicenter studies are warranted to validate these findings and expand clinical applications.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106946"},"PeriodicalIF":2.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction of radiation dose and contrast medium volume in computed tomography pulmonary angiography: adaptation of dual-energy computed tomography (CT) protocols to the body mass index","authors":"X. Zhang ,&nbsp;H. Huang ,&nbsp;Y. Huang ,&nbsp;Y. Sun ,&nbsp;Z. Chen ,&nbsp;M. Chen ,&nbsp;J. Xu","doi":"10.1016/j.crad.2025.106944","DOIUrl":"10.1016/j.crad.2025.106944","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the image quality and diagnostic value of a body mass index (BMI)-based dual-energy computed tomography (CT) protocol in computed tomography pulmonary angiography (CTPA) for reduction of radiation dose and contrast medium (CM) volume.</div></div><div><h3>Materials and Methods</h3><div>Patients suspected of having pulmonary embolism were prospectively included and randomly assigned to one of three protocols: Protocol A (a standard protocol, 100 kV/140 mAs/50 mL iodinated CM), B (a conventional dual-energy protocol, 80–140 kV switching/automatic tube current/weight-dependent CM volume) and C (a BMI-based dual-energy protocol, 80–140 kV switching/BMI-based tube current/weight-dependent CM volume, BMI-based CM injection rate). Subjective and objective image analysis were performed by two radiologists independently. Diagnostic accuracy of pulmonary embolism were evaluated. Inter-group comparison was performed.</div></div><div><h3>Results</h3><div>Ninety patients (mean age 54.1 ± 13.3 years, 57 men) were included, with 30 patients in each group. The CT values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the pulmonary arteries in group C were significantly higher than those in group B (358.2 ± 50.5 vs 324.9 ± 57.2, <em>p</em>=0.047, 17.8 ± 3.2 vs 15.3 ± 2.9, <em>p</em>=0.010, 19.2 ± 4.1 vs 15.7 ± 3.8, <em>p</em>=0.014). The dose length product (DLP) and CM volume were significantly reduced in groups B and C (A vs B vs C, DLP, 287.9 ± 34.0 vs 177.2 ± 39.2 vs 183.8 ± 23.1 mGy·cm), <em>p</em>&lt;0.001, CM, 50.0 ± 0.0 vs 22.1 ± 3.0 vs 23.2 ± 4.0 ml, <em>p</em>&lt;0.001). There were no significant differences in diagnostic accuracy or subjective image quality among the three groups.</div></div><div><h3>Conclusion</h3><div>The BMI-based dual-energy CT protocol can reduce radiation exposure and iodine burden compared to routine CTPA without affecting the image quality and diagnostic accuracy in patients with a BMI under 30 kg/m².</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106944"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal function and iodinated contrast media: a National Institute for Health and Care Excellence update","authors":"R.D. Proctor ,&nbsp;W.S. McKane ,&nbsp;F. Awan ,&nbsp;T. Oates ,&nbsp;J.A. Stephenson ,&nbsp;T. Sands ,&nbsp;A. Morris ,&nbsp;M. Brady ,&nbsp;A.J.P. Lewington ,&nbsp;J.S. Murray","doi":"10.1016/j.crad.2025.106940","DOIUrl":"10.1016/j.crad.2025.106940","url":null,"abstract":"","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106940"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of benign, intermediate, and malignant soft-tissue tumours by using multiple diffusion-weighted imaging models","authors":"K. Zhang ,&nbsp;Y. Dai ,&nbsp;C. Yu ,&nbsp;J. Liu ,&nbsp;Y. Cheng ,&nbsp;Y. Zhou ,&nbsp;Y. Liu ,&nbsp;J. Tao ,&nbsp;L. Zhang ,&nbsp;S. Wang","doi":"10.1016/j.crad.2025.106942","DOIUrl":"10.1016/j.crad.2025.106942","url":null,"abstract":"<div><h3>AIM</h3><div>The aim of this study was to determine whether intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) can differentiate benign, intermediate, and malignant soft-tissue tumours (STTs) of the extremities and trunk.</div></div><div><h3>MATERIALS AND METHODS</h3><div>We prospectively recruited 100 STT patients (32, 15, and 53 patients with benign, intermediate, and malignant tumours, respectively). The patients underwent IVIM and DKI, and the following parameters were measured: standard apparent diffusion coefficient (ADC), perfusion fraction (<em>f</em>), true diffusion coefficient (D_slow), pseudo-diffusion coefficient (D_fast), water diffusion heterogeneity index (α), distributed diffusion coefficient (DDC), mean diffusivity (MD), and mean kurtosis (MK). Statistical analyses were performed using receiver operating characteristic curves, the Kruskal-Wallis H test, and post hoc test with Bonferroni correction.</div></div><div><h3>RESULTS</h3><div>Standard ADC, D_slow, DDC, and MD values gradually decreased from benign to intermediate and malignant STTs. Intermediate STTs displayed a lower <em>f</em> value than benign tumours (<em>P</em>=0.029). The MK value was higher in malignant tumours than in intermediate and benign tumours (<em>P</em>=0.021 and &lt;0.001, respectively). The DDC value best differentiated benign tumours from nonbenign (intermediate and malignant) tumours (area under the curve [AUC] = 0.884, 0853, and 0.892, respectively). The optimal MK cut-off value for differentiating intermediate and malignant tumours was 0.65 (sensitivity: 73.33%, specificity: 81.13%, accuracy: 79.41%).</div></div><div><h3>CONCLUSION</h3><div>IVIM and DKI parameters were helpful for differentiating benign, intermediate, and malignant STTs and can complement conventional MRI, with DDC and MK values showing high diagnostic efficacy.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106942"},"PeriodicalIF":2.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the correlation between high-risk coronary plaque and hepatic fat fraction in non-alcoholic fatty liver disease using spectral computed tomography (CT)","authors":"Q. Li ,&nbsp;T. Cui ,&nbsp;H. Ding ,&nbsp;X. Shi ,&nbsp;Y. Zhang ,&nbsp;P. Jiang ,&nbsp;J. Han ,&nbsp;J. Li ,&nbsp;J. Liu","doi":"10.1016/j.crad.2025.106943","DOIUrl":"10.1016/j.crad.2025.106943","url":null,"abstract":"<div><h3>Aim</h3><div>To quantitatively assess the fat volume fraction (FVF) in nonalcoholic fatty liver disease (NAFLD) using the spectral computed tomography (CT) multimaterial decomposition (MMD) algorithm and to investigate its association with high-risk coronary plaques (HRP).</div></div><div><h3>Materials and Methods</h3><div>This retrospective study included patients diagnosed with coronary artery disease (CAD) from August 2023 to August 2024 who underwent coronary CT angiography and abdominal enhanced spectral CT imaging. Patients were categorised into three groups based on HRP imaging features (positive remodelling, low-density plaques, spotty calcification, and napkin ring sign): no plaque (n = 57), non-HRP (n = 54), and HRP (n = 48) groups. FVF was measured using the spectral CT MMD algorithm to quantify liver fat content. Clinical characteristics, biochemical markers, and imaging differences among the groups were analysed. Univariate and multivariate logistic regression analyses were performed to determine the association between FVF and HRP.</div></div><div><h3>Results</h3><div>FVF values were significantly higher in the HRP group (13.2%) compared to the non-HRP group (9.2%) and the no plaque group (6.5%) (P&lt;0.001). Multivariate binary logistic regression analysis identified FVF as an independent risk factor for HRP (odds ratio [OR]: 2.55, P&lt;0.001), along with high-sensitivity C-reactive protein (hs-CRP) (OR: 1.94, P=0.025) and diabetes mellitus (OR: 9.83, P=0.002). Additionally, FVF correlated epicardial and pericoronary adipose tissue (PCAT) volume and CT attenuation (P&lt;0.001).</div></div><div><h3>Conclusion</h3><div>The spectral CT MMD algorithm enables quantitative assessment of FVF, which is independently associated with coronary HRP formation in NAFLD patients. Elevated FVF serves as a risk factor for CAD in patients with NAFLD.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106943"},"PeriodicalIF":2.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast tumour classification in DCE-MRI via cross-attention and discriminant correlation analysis enhanced feature fusion","authors":"F. Pan ,&nbsp;B. Wu ,&nbsp;X. Jian ,&nbsp;C. Li ,&nbsp;D. Liu ,&nbsp;N. Zhang","doi":"10.1016/j.crad.2025.106941","DOIUrl":"10.1016/j.crad.2025.106941","url":null,"abstract":"<div><h3>Aim</h3><div>Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has proven to be highly sensitive in diagnosing breast tumours, due to the kinetic and volumetric features inherent in it. To utilise the kinetics-related and volume-related information, this paper aims to develop and validate a classification for differentiating benign and malignant breast tumours based on DCE-MRI, though fusing deep features and cross-attention-encoded radiomics features using discriminant correlation analysis (DCA).</div></div><div><h3>Materials and methods</h3><div>Classification experiments were conducted on a dataset comprising 261 individuals who underwent DCE-MRI including those with multiple tumours, resulting in 137 benign and 163 malignant tumours. To improve the strength of correlation between features and reduce features’ redundancy, a novel fusion method that fuses deep features and encoded radiomics features based on DCA (eFF-DCA) is proposed. The eFF-DCA includes three components: (1) a feature extraction module to capture kinetic information across phases, (2) a radiomics feature encoding module employing a cross-attention mechanism to enhance inter-phase feature correlation, and (3) a DCA-based fusion module that transforms features to maximise intra-class correlation while minimising inter-class redundancy, facilitating effective classification.</div></div><div><h3>Results</h3><div>The proposed eFF-DCA method achieved an accuracy of 90.9% and an area under the receiver operating characteristic curve of 0.942, outperforming methods using single-modal features.</div></div><div><h3>Conclusion</h3><div>The proposed eFF-DCA utilises DCE-MRI kinetic-related and volume-related features to improve breast tumour diagnosis accuracy, but non–end-to-end design limits multimodal fusion. Future research should explore unified end-to-end deep learning architectures that enable seamless multimodal feature fusion and joint optimisation of feature extraction and classification.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"86 ","pages":"Article 106941"},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}