Diagnostic and interventional radiology最新文献

{"title":"Evaluating the reference accuracy of large language models in radiology: a comparative study across subspecialties.","authors":"Yasin Celal Güneş, Turay Cesur, Eren Çamur","doi":"10.4274/dir.2025.253101","DOIUrl":"https://doi.org/10.4274/dir.2025.253101","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare six large language models (LLMs) [Chat Generative Pre-trained Transformer (ChatGPT)o1-preview, ChatGPT-4o, ChatGPT-4o with canvas, Google Gemini 1.5 Pro, Claude 3.5 Sonnet, and Claude 3 Opus] in generating radiology references, assessing accuracy, fabrication, and bibliographic completeness.</p><p><strong>Methods: </strong>In this cross-sectional observational study, 120 open-ended questions were administered across eight radiology subspecialties (neuroradiology, abdominal, musculoskeletal, thoracic, pediatric, cardiac, head and neck, and interventional radiology), with 15 questions per subspecialty. Each question prompted the LLMs to provide responses containing four references with in-text citations and complete bibliographic details (authors, title, journal, publication year/month, volume, issue, page numbers, and PubMed Identifier). References were verified using Medline, Google Scholar, the Directory of Open Access Journals, and web searches. Each bibliographic element was scored for correctness, and a composite final score [(FS): 0-36] was calculated by summing the correct elements and multiplying this by a 5-point verification score for content relevance. The FS values were then categorized into a 5-point Likert scale reference accuracy score (RAS: 0 = fabricated; 4 = fully accurate). Non-parametric tests (Kruskal-Wallis, Tamhane's T2, Wilcoxon signed-rank test with Bonferroni correction) were used for statistical comparisons.</p><p><strong>Results: </strong>Claude 3.5 Sonnet demonstrated the highest reference accuracy, with 80.8% fully accurate references (RAS 4) and a fabrication rate of 3.1%, significantly outperforming all other models (<i>P</i> < 0.001). Claude 3 Opus ranked second, achieving 59.6% fully accurate references and a fabrication rate of 18.3% (<i>P</i> < 0.001). ChatGPT-based models (ChatGPT-4o, ChatGPT-4o with canvas, and ChatGPT o1-preview) exhibited moderate accuracy, with fabrication rates ranging from 27.7% to 52.9% and <8% fully accurate references. Google Gemini 1.5 Pro had the lowest performance, achieving only 2.7% fully accurate references and the highest fabrication rate of 60.6% (<i>P</i> < 0.001). Reference accuracy also varied by subspecialty, with neuroradiology and cardiac radiology outperforming pediatric and head and neck radiology.</p><p><strong>Conclusion: </strong>Claude 3.5 Sonnet significantly outperformed all other models in generating verifiable radiology references, and Claude 3 Opus showed moderate performance. In contrast, ChatGPT models and Google Gemini 1.5 Pro delivered substantially lower accuracy with higher rates of fabricated references, highlighting current limitations in automated academic citation generation.</p><p><strong>Clinical significance: </strong>The high accuracy of Claude 3.5 Sonnet can improve radiology literature reviews, research, and education with dependable references. The poor performance of other models, with h","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987792","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}

{"title":"Comparison of the novel simultaneous biplane versus in-plane imaging technique in ultrasound-guided biopsy: a prospective randomized multi-operator cross-over phantom study.","authors":"Baki Akca, Florian Vafai-Tabrizi, Michel Bielecki, Georg-Christian Funk","doi":"10.4274/dir.2025.253191","DOIUrl":"https://doi.org/10.4274/dir.2025.253191","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare the in-plane and novel biplane imaging techniques in ultrasound-guided biopsies (USBx). USBx are effective for obtaining tissue samples in suspected malignancy or infection. The in-plane technique is the gold standard, offering continuous needle visualization. The biplane technique enables simultaneous in-plane and out-of-plane visualization, potentially improving biopsy outcomes. A study was conducted using gel phantoms to simulate USBx, with the goal of determining whether one technique offers distinct advantages over the other.</p><p><strong>Methods: </strong>A total of 30 participants (mean age: 30 ± 7 years; 20 men) were recruited, primarily consisting of physicians in training with varying levels of experience. Each participant performed biopsies on gel phantoms using both the in-plane and biplane techniques in a randomized order after watching a standardized tutorial video. Procedure-related parameters were analyzed, and post-intervention questionnaires, including the NASA task load index (NASA-TLX), were collected to assess cognitive workload and personal preferences.</p><p><strong>Results: </strong>All participants achieved successful biopsies with both techniques. The first-puncture success rate was significantly higher with the biplane technique (83% vs. 63%; <i>P</i> = 0.01). The biplane technique required significantly fewer biopsy attempts than the in-plane approach (37 vs. 43; <i>P</i> = 0.03). Although the biplane technique had a longer \"mean time to first successful biopsy\" (120 seconds vs. 72 seconds), this difference was not statistically significant (<i>P</i> = 0.09), likely due to high variability. No significant differences were found in safety-related parameters, including the number of skin punctures, needle retractions, percentage of time the needle tip was visible, and the number of biopsy attempts without needle tip visualization. The NASA-TLX indicated higher mental demand with the biplane technique (<i>P</i> = 0.013), but other dimensions showed no significant differences. Overall, 83% of participants, including 88% of more experienced operators, preferred the biplane technique, citing enhanced visualization and perceived safety.</p><p><strong>Conclusion: </strong>In this study, the biplane technique in USBx was substantially superior in terms of total biopsy attempts and first-puncture success rate compared with the in-plane approach. It may offer safety and efficiency advantages, particularly for less-experienced operators. Further studies with larger sample sizes and experienced operators, especially in clinical settings, are needed to determine clear superiority.</p><p><strong>Clinical significance: </strong>These findings suggest that biplane imaging may be especially beneficial for training less-experienced operators and in cases with elevated complication risk.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962513","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}

{"title":"Pix2Pix generative-adversarial network in improving the quality of T2-weighted prostate magnetic resonance imaging: a multi-reader study.","authors":"Yeliz Başar, Mustafa Said Kartal, Mustafa Ege Seker, Deniz Alis, Delal Seker, Müjgan Orman, Sabri Şirolu, Serpil Kurtcan, Aydan Arslan, Nurper Denizoğlu, İlkay Öksüz, Ercan Karaarslan","doi":"10.4274/dir.2025.243102","DOIUrl":"https://doi.org/10.4274/dir.2025.243102","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the performance and feasibility of generative deep learning in enhancing the image quality of T2-weighted (T2W) prostate magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>Axial T2W images from the prostate imaging: cancer artificial intelligence dataset (n = 1,476, biologically males; n = 1,500 scans) were used, partitioned into training (n = 1300), validation (n = 100), and testing (n = 100) sets. A Pix2Pix model was trained on original and synthetically degraded images, generated using operations such as motion, Gaussian noise, blur, ghosting, spikes, and bias field inhomogeneities to enhance image quality. The efficacy of the model was evaluated by seven radiologists using the prostate imaging quality criteria to assess original, degraded, and improved images. The evaluation also included tests to determine whether the images were original or synthetically improved. Additionally, the model's performance was tested on the in-house external testing dataset of 33 patients. The statistical significance was assessed using the Wilcoxon signedrank test.</p><p><strong>Results: </strong>Results showed that synthetically improved images [median score (interquartile range) 4.71 (1)] were of higher quality than degraded images [3.36 (3), <i>P</i> = 0.0001], with no significant difference from original images [5 (1.14), <i>P</i> > 0.05]. Observers equally identified original and synthetically improved images as original (52% and 53%), proving the model's ability to retain realistic attributes. External testing on a dataset of 33 patients confirmed a significant improvement (<i>P</i> = 0.001) in image quality, from a median score of 4 (2.286)-4.71 (1.715).</p><p><strong>Conclusion: </strong>The Pix2Pix model, trained on synthetically degraded data, effectively improved prostate MRI image quality while maintaining realism and demonstrating both applicability to real data and generalizability across various datasets.</p><p><strong>Clinical significance: </strong>This study critically assesses the efficacy of the Pix2Pix generative-adversarial network in enhancing T2W prostate MRI quality, demonstrating its potential to produce high-quality, realistic images indistinguishable from originals, thereby potentially advancing radiology practice by improving diagnostic accuracy and image reliability.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977174","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}

{"title":"Reporting checklists: from a tool after publication to a tool before submission.","authors":"Jingyu Zhong","doi":"10.4274/dir.2025.253314","DOIUrl":"https://doi.org/10.4274/dir.2025.253314","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981993","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}

{"title":"Quality of reporting of studies on artificial intelligence in radiology: what is the current state of the field?","authors":"Ahmed Maiter","doi":"10.4274/dir.2025.253315","DOIUrl":"https://doi.org/10.4274/dir.2025.253315","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959172","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}

{"title":"Detection of common bile duct dilatation on magnetic resonance cholangiopancreatography by deep learning.","authors":"Hilal Er Ulubaba, Rukiye Çiftçi, İpek Atik, Osman Furkan Karakuş","doi":"10.4274/dir.2025.253218","DOIUrl":"https://doi.org/10.4274/dir.2025.253218","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to detect common bile duct (CBD) dilatation using deep learning methods from artificial intelligence algorithms.</p><p><strong>Methods: </strong>To create a convolutional neural network (CNN) model, 77 magnetic resonance cholangiopancreatography (MRCP) images without CBD dilatation and 70 MRCP images with CBD dilatation were used. The system was developed using coronal maximum intensity projection reformatted 3D-MRCP images. The ResNet50, DenseNet121, and visual geometry group models were selected for training, and detailed training was performed on each model.</p><p><strong>Results: </strong>In the study, the DenseNet121 model showed the best performance, with a 97% accuracy rate. The ResNet50 model ranked second, with a 96% accuracy rate.</p><p><strong>Conclusion: </strong>CBD dilatation was detected with high performance using the DenseNet CNN model. Once validated in multicenter studies with larger datasets, this method may help in diagnosis and treatment decision-making.</p><p><strong>Clinical significance: </strong>Deep learning algorithms can aid clinicians and radiologists in the diagnostic process once technical, ethical, and financial limitations are addressed. Fast and accurate diagnosis is crucial for accelerating treatment, reducing complications, and shortening hospital stays.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981989","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}

{"title":"Possible use of digital variance angiography in uterine fibroid embolization: a retrospective observational study.","authors":"Viktor Bérczi, Szuzina Fazekas, István Góg, Marcell Gyánó, Ambrus Tóth, Ákos Bérczi, Osama Habeeballah, Krzysztof Pyra, Zoltán Harmat, Dat Tin Nguyen","doi":"10.4274/dir.2025.243042","DOIUrl":"https://doi.org/10.4274/dir.2025.243042","url":null,"abstract":"<p><strong>Purpose: </strong>Digital variance angiography (DVA), a recently developed image processing technology, provides a higher contrast-to-noise ratio (CNR) and better image quality during lower limb interventions than digital subtraction angiography (DSA). Our aim was to investigate whether the quality reserve of DVA can also be observed in uterine fibroid embolization (UFE).</p><p><strong>Methods: </strong>In this retrospective observational study, the CNR and image quality of DSA and DVA images from 56 patients (mean ± standard deviation age: 44.2 ± 5.3 years) who underwent UFE at our institution were assessed. For the visual evaluation of the same image pairs, the visibility of large vessels, small vessels, tissue blush, and background noise was compared by three experienced readers using a four-grade Likert scale. Data were analyzed using the Wilcoxon signed-rank test or the one-sample Wilcoxon test.</p><p><strong>Results: </strong>DVA provided significantly higher CNR than DSA (the median CNR_DVA/CNR_DSA was 1.96). In the visual comparison of DVA and DSA images, Likert scores did not significantly differ from zero (equal quality level) in any evaluated categories. The median (interquartile range) values were 0.00 (1.00) for large vessels, -0.33 (1.33) for small vessels, 0.00 (0.67) for tissue blush, and 0.00 (0.75) for background noise.</p><p><strong>Conclusion: </strong>Although the visual image quality of DSA and DVA was identical, DVA provided a twofold CNR in UFE, indicating a significant quality advantage for this technology.</p><p><strong>Clinical significance: </strong>The observed quality reserve may allow for dose management (reduction of applied radiation dose and/or contrast media), enhancing the safety of UFE for both patients and personnel.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988981","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}

{"title":"Comparing ultrasound-guided intra-articular injection and medial branch block for lumbar facet joint pain: a clinical study.","authors":"Hui Zhao, Yun-Long Hou, Le-Hang Guo, Qiao Wang, Tian He, Guang-Fei Gu, Li-Ping Sun, Feng-Shan Jin","doi":"10.4274/dir.2024.242765","DOIUrl":"10.4274/dir.2024.242765","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the effectiveness of ultrasound-guided intra-articular (IA) injections with medial branch nerve blocks in treating lumbar facet joint pain.</p><p><strong>Methods: </strong>This retrospective study enrolled 94 patients clinically diagnosed with lumbar facet joint pain. Diagnostic blocks confirmed the diagnosis in 82 patients, evidenced by a pain visual analog score (VAS) reduction of at least 50% immediately following the injection. Of these, 42 were treated with ultrasound-guided IA injections (group 1), and 40 received ultrasound-guided medial branch blocks (group 2). Effective pain relief was defined as a VAS reduction of at least 50%.</p><p><strong>Results: </strong>Group 1 showed significantly higher pain relief rates compared with group 2 at both 1-month (54.76% versus 2.5%, <i>P</i> < 0.001) and 3-month (26.19% versus 5%, <i>P</i> = 0.014) follow-ups. Within group 1, patients aged 21-50 years experienced higher relief rates (81.25% at 1-month and 56.25% at 3-month follow-ups) compared with those over 50 (38.46% at 1-month and 7.69% at 3-month follow-ups), which was statistically significant (<i>P</i> = 0.007 at 1-month and <i>P</i> = 0.001 at 3-month follow-ups). Furthermore, in group 1, patients with sedentary jobs reported significantly greater pain relief (90.91% at 1-month and 81.82% at 3-month follow-ups) compared with those with non-sedentary jobs (41.94% at 1-month and 6.45% at 3-month follow-ups) (<i>P</i> = 0.005 at 1-month and <i>P</i> < 0.001 at 3-month follow-ups).</p><p><strong>Conclusion: </strong>Ultrasound-guided IA injection provides better pain relief compared with medial branch nerve blocks. This method serves as a viable alternative for patients, especially younger and middle-aged patients with lumbar facet pain due to sedentary lifestyles.</p><p><strong>Clinical significance: </strong>This study compared and analyzed the therapeutic effects of two different ultrasound intervention blockade methods on patients with lumbar facet joint pain, demonstrating that IA injection has a better pain relief effect and can be used as a pain relief method for patients who refuse radiofrequency therapy.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"259-263"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of the O-RADS MRI system for magnetic resonance imaging in discriminating benign and malignant adnexal lesions: a systematic review, meta-analysis, and meta-regression.","authors":"Gülsüm Kılıçkap","doi":"10.4274/dir.2024.242784","DOIUrl":"10.4274/dir.2024.242784","url":null,"abstract":"<p><strong>Purpose: </strong>After the introduction of the Ovarian-Adnexal Reporting and Data System (O-RADS) for magnetic resonance imaging (MRI), several studies with diverse characteristics have been published to assess its diagnostic performance. This systematic review and meta-analysis aimed to assess the diagnostic performance of O-RADS MRI scoring for adnexal masses, accounting for the risk of selection bias.</p><p><strong>Methods: </strong>The PubMed, Scopus, Web of Science, and Cochrane databases were searched for eligible studies. Borderline or malignant lesions were considered malignant. All O-RADS MRI scores ≥4 were considered positive. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The pooled sensitivity, specificity, and likelihood ratio (LR) values were calculated, considering the risk of selection bias.</p><p><strong>Results: </strong>Fifteen eligible studies were found, and five of them had a high risk of selection bias. Between-study heterogeneity was low-to-moderate for sensitivity but substantial for specificity (I2 values were 35.5% and 64.7%, respectively). The pooled sensitivity was significantly lower in the studies with a low risk of bias compared with those with a high risk of bias (93.0% and 97.5%, respectively; <i>P</i> = 0.043), whereas the pooled specificity was not different (90.4% for the overall population). The negative and positive LRs were 0.08 [95% confidence interval (CI) 0.05–0.11] and 10.0 (95% CI 7.7–12.9), respectively, for the studies with low risk of bias and 0.03 (95% CI 0.01–0.10) and 10.3 (95% CI 3.8–28.3), respectively, for those with high risk of bias.</p><p><strong>Conclusion: </strong>The overall diagnostic performance of the O-RADS system is very high, particularly for ruling out borderline/malignant lesions, but with a moderate ruling-in potential. Studies with a high risk of selection bias lead to an overestimation of sensitivity.</p><p><strong>Clinical significance: </strong>The O-RADS system demonstrates considerable diagnostic performance, particularly in ruling out borderline or malignant lesions, and should routinely be used in practice. The high between-study heterogeneity observed for specificity suggests the need for improvement in the consistent characterization of the benign lesions to reduce false positive rates.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"171-179"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of dual-energy computed tomography angiography-based virtual monoenergetic imaging for evaluations after cerebral aneurysm clipping.","authors":"Zhihua Lu, Suying Wu, Feijian Wu, Qingdong Jin, Qingjing Huang, Baoteng Zhang","doi":"10.4274/dir.2024.242975","DOIUrl":"10.4274/dir.2024.242975","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to research the optimal energy range of dual-energy computed tomography angiography (DECTA)-based virtual monoenergetic imaging (VMI) for evaluations after cerebral aneurysm clipping.</p><p><strong>Methods: </strong>Sixty patients who underwent DECTA after cerebral aneurysm clipping were analyzed retrospectively. Conventional computed tomography angiography (CTA) was compared with VMIs at 60, 70, 80, 90, and 100 keV. The mean attenuation and standard deviation values within the regions of interest placed in the brain parenchyma and arteries with the worst artifact were measured, respectively. The ΔCT and artifact index (AI) values were calculated to assess the artifact severity. The contrast-to-noise ratio (CNR) was calculated to assess vascular contrast. Two radiologists assessed brain parenchyma and cerebrovascular scores qualitatively using a five-point Likert scale.</p><p><strong>Results: </strong>Quantitative analysis showed that the artifacts of VMIs were significantly reduced compared with conventional CTA (<i>P</i> ≤ 0.014), except for the ΔCT and AI of 60 keV and the ΔCT of 70 keV. However, there was no significant difference in the vascular contrast on VMIs compared with conventional CTA, except for the CNR of 60 keV (<i>P</i> = 0.008). In qualitative analysis, the proportions of brain parenchyma scores and cerebrovascular scores ≥4 on the VMIs of 70 and 80 keV were higher than those of conventional CTA and other VMIs.</p><p><strong>Conclusion: </strong>For the patients who underwent DECTA after cerebral aneurysm clipping, the 70-80 keV VMIs are expected to be the optimal energy range for balancing clip artifacts and visibility of adjacent vessels.</p><p><strong>Clinical significance: </strong>Studying the optimal energy range of DECTA-based VMI for post-operative assessment of aneurysm clipping can reduce metal artifacts in images and increase vascular contrast. This facilitates the follow-up of patients after aneurysm clipping, offers timely and accurate detection of postoperative complications, provides assistance to clinicians in diagnosis and treatment, and improves patient prognosis.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"264-273"},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}