Diagnostic and interventional radiology最新文献

{"title":"AI agents in radiology: toward autonomous and adaptive intelligence.","authors":"Burak Koçak, İsmail Meşe","doi":"10.4274/dir.2025.253470","DOIUrl":"https://doi.org/10.4274/dir.2025.253470","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575056","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":"Combined therapy with microwave ablation and conventional transarterial chemoembolization for hepatocellular carcinoma tumors larger than five centimetres: a prospective study.","authors":"Hui Liu, Zhuoyang Fan, Ranying Zhang, Xingwei Zhang, Jianhua Wang","doi":"10.4274/dir.2025.253308","DOIUrl":"https://doi.org/10.4274/dir.2025.253308","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the safety and efficacy of a combined therapy involving microwave ablation (MWA) and transarterial chemoembolization (TACE) versus only TACE for the treatment of hepatocellular carcinoma (HCC) tumors ≥5 cm.</p><p><strong>Methods: </strong>This prospective study enrolled 186 patients with HCC tumors ≥5 cm. Patients were divided into a test group (TACE + MWA) and a control group (TACE only). The average tumor size was 9.2 ± 3.7 cm, ranging from 5 to 19 cm. Forty-five patients (27.4%) had Barcelona Clinic Liver Cancer class A disease, and 119 (72.6%) had class B disease. The viable tumor volume was quantified utilizing ITK-SNAP, a free and open-source software package for medical image segmentation and visualization, along with contrast-enhanced magnetic resonance imaging. The tumor response was assessed according to the modified response evaluation criteria in solid tumors rules. Serum alpha-fetoprotein (AFP) levels were monitored, and the tumor necrosis ratio and AFP variation rate were calculated.</p><p><strong>Results: </strong>The final analysis of 164 patients (median age 57 years, range 26-80 years; 19 women, 145 men) showed that the test group exhibited a significantly higher tumor necrosis ratio than the control group (87.5% vs. 76.1%, <i>P</i> = 0.002). The serum AFP levels were markedly reduced in the test group relative to the control group 30 days after surgery (<i>P</i> = 0.001). The AFP variation rate in the test group (79.5%) was significantly greater than that observed in the control group (47.5%) (<i>P</i> < 0.001). A significant positive correlation existed between the tumor necrosis ratio and AFP variation rate (<i>P</i> < 0.001). Compared with the control group, the test group demonstrated a significantly higher partial response rate (68.6% vs. 51.3%, <i>P</i> < 0.05), a lower rate of progressive disease (17.4% vs. 35.9%, <i>P</i> < 0.05), an increased overall response rate (70.9% vs. 55.1%, <i>P</i> = 0.036), and an enhanced disease control rate (82.6% vs. 64.1%, <i>P</i> = 0.007). Post-MWA, 3 patients experienced hemorrhage and 2 developed arteriovenous fistulae, all of which were treated with embolization.</p><p><strong>Conclusion: </strong>The combination of TACE and MWA demonstrated safety, good tolerability, and greater efficacy compared with TACE alone for HCC tumors ≥5 cm.</p><p><strong>Clinical significance: </strong>The combination of TACE and MWA offers new possibilities for improving tumor necrosis rates, reducing AFP levels, and enhancing short-term prognosis. These findings not only provide new treatment options for clinical doctors but also promote the application of three-dimensional quantitative assessment technology and provide important references for future research and clinical practice.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575057","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":"Impact of a computed tomography-based artificial intelligence software on radiologists' workflow for detecting acute intracranial hemorrhage.","authors":"Jimin Kim, Jinhee Jang, Se Won Oh, Ha Young Lee, Eun Jeong Min, Jin Wook Choi, Kook-Jin Ahn","doi":"10.4274/dir.2025.253301","DOIUrl":"https://doi.org/10.4274/dir.2025.253301","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of a commercially available computed tomography (CT)-based artificial intelligence (AI) software for detecting acute intracranial hemorrhage (AIH) on radiologists' diagnostic performance and workflow in a real-world clinical setting.</p><p><strong>Methods: </strong>This retrospective study included a total of 956 non-contrast brain CT scans obtained over a 70-day period, interpreted independently by 2 board-certified general radiologists. Of these, 541 scans were interpreted during the initial 35 days before the implementation of AI software, and the remaining 415 scans were interpreted during the subsequent 35 days, with reference to AIH probability scores generated by the software. To assess the software's impact on radiologists' performance in detecting AIH, performance before and after implementation was compared. Additionally, to evaluate the software's effect on radiologists' workflow, Kendall's Tau was used to assess the correlation between the daily chronological order of CT scans and the radiologists' reading order before and after implementation. The early diagnosis rate for AIH (defined as the proportion of AIH cases read within the first quartile by radiologists) and the median reading order of AIH cases were also compared before and after implementation.</p><p><strong>Results: </strong>A total of 956 initial CT scans from 956 patients [mean age: 63.14 ± 18.41 years; male patients: 447 (47%)] were included. There were no significant differences in accuracy [from 0.99 (95% confidence interval: 0.99-1.00) to 0.99 (0.98-1.00), <i>P</i> = 0.343], sensitivity [from 1.00 (0.99-1.00) to 1.00 (0.99-1.00), <i>P</i> = 0.859], or specificity [from 1.00 (0.99-1.00) to 0.99 (0.97-1.00), <i>P</i> = 0.252] following the implementation of the AI software. However, the daily correlation between the chronological order of CT scans and the radiologists' reading order significantly decreased [Kendall's Tau, from 0.61 (0.48-0.73) to 0.01 (0.00-0.26), <i>P</i> < 0.001]. Additionally, the early diagnosis rate significantly increased [from 0.49 (0.34-0.63) to 0.76 (0.60-0.93), <i>P</i> = 0.013], and the daily median reading order of AIH cases significantly decreased [from 7.25 (Q1-Q3: 3-10.75) to 1.5 (1-3), <i>P</i> < 0.001] after the implementation.</p><p><strong>Conclusion: </strong>After the implementation of CT-based AI software for detecting AIH, the radiologists' daily reading order was considerably reprioritized to allow more rapid interpretation of AIH cases without compromising diagnostic performance in a real-world clinical setting.</p><p><strong>Clinical significance: </strong>With the increasing number of CT scans and the growing burden on radiologists, optimizing the workflow for diagnosing AIH through CT-based AI software integration may enhance the prompt and efficient treatment of patients with AIH.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575059","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":"Readout-segmented echo-planar imaging and conventional single-shot echo-planar imaging for determining cervical cancer image quality, lymphovascular space invasion, and lymph node metastasis status: a comparative study.","authors":"Huizhen Song, Jiao Bai, Yu Wang, Juan Xie, Yunzhu Wu, Jian Shu","doi":"10.4274/dir.2025.253283","DOIUrl":"10.4274/dir.2025.253283","url":null,"abstract":"<p><strong>Purpose: </strong>Diffusion-weighted imaging (DWI) using single-shot echo-planar imaging (ss-EPI) is prone to artifacts, geometric distortion, and T2* blurring. Readout-segmented echo-planar imaging (rs-EPI) may improve image quality in the DWI of cervical cancer (CC). This study aimed to compare the image quality between rs-EPI and ss-EPI DWI in CC and to evaluate whether the apparent diffusion coefficient (ADC) values of ss-EPI (ssADC) and rs-EPI (rsADC) can differentiate the status of lymphovascular space invasion (LVSI) and lymph node metastasis (LNM).</p><p><strong>Methods: </strong>This prospective study included 69 patients with CC who underwent ss-EPI and rs-EPI DWI before surgery. Qualitative reader scores, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and ADC values derived from ss-EPI and rs-EPI were compared. The differences in ADC values were analyzed in patients who were (a) LNM-positive (LNM+, n = 17) and LNM-negative (LNM-, n = 52); (b) LVSI-positive (LVSI+, n = 33) and LVSI-negative (LVSI-, n = 36).</p><p><strong>Results: </strong>The rs-EPIs of CC had higher subjective image quality scores and a lower SNR than ss-EPI (all <i>P</i> < 0.001); no significant differences existed between rs-EPI and ss-EPI for either CNR or ADC (CNR, <i>P</i> = 0.313; ADC, <i>P</i> = 0.949; <i>P</i> > 0.05 for all). The rsADC and ssADC of the LNM+ group were substantially lower than those of the LNM- group (rsADC, <i>P</i> = 0.000; ssADC, <i>P</i> = 0.000; <i>P</i> < 0.001 for all); the areas under the receiver operating characteristic curve were 0.855 and 0.851, respectively. However, there were no differences in ADC values between the LVSI+ and LVSI- groups (rsADC, <i>P</i> = 0.271; ssADC, <i>P</i> = 0.200; <i>P</i> > 0.05 for all).</p><p><strong>Conclusion: </strong>Over a similar scan time, rs-EPI improves the qualitative image quality of DWI significantly more than ss-EPI and has good diagnostic accuracy for LNM status in CC. However, neither could predict the LVSI status.</p><p><strong>Clinical significance: </strong>Readout-segmented EPI improves the qualitative image quality of DWI and has good diagnostic accuracy for LNM status in CC, compared with conventional ss-EPI. It is more inclined to qualitative analysis of CC foci and provides a better scheme when choosing the DWI sequence scanning strategy for CC.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368694","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":"Multiparametric magnetic resonance imaging, diffusion-weighted magnetic resonance imaging, and magnetic resonance elastography: differentiating benign and malignant liver lesions.","authors":"Avaz Jabiyev, Muşturay Karçaaltıncaba, Ali Devrim Karaosmanoğlu, Deniz Akata, Mustafa Nasuh Özmen, İlkay Sedakat İdilman","doi":"10.4274/dir.2025.253324","DOIUrl":"https://doi.org/10.4274/dir.2025.253324","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the accuracy of multiparametric magnetic resonance imaging (mpMRI), diffusion-weighted imaging (DWI), and magnetic resonance elastography (MRE) in differentiating benign and malignant liver lesions.</p><p><strong>Methods: </strong>This retrospective study included patients with focal liver lesions who underwent MRI and MRE between 2018 and 2022. Based on histopathologic analyses or follow-up imaging findings, 70 solid liver lesions were retrospectively evaluated as benign (n = 20) or malignant (n = 50).</p><p><strong>Results: </strong>There was no statistically significant difference between the benign and malignant liver lesions in pre-contrast T1 relaxation times (<i>P</i> > 0.05). Malignant liver lesions had a significantly lower T2 value, contrast-enhancement ratio (CER), T1 relaxation time reduction (T1D), T1D percentage [T1D (%)], and apparent diffusion coefficient (ADC), along with a significantly higher stiffness value (<i>P</i> < 0.05). In receiver operating characteristic analysis, the following cut-off values were determined for differentiating malignant from benign lesions: a CER of 1.99 [area under the curve (AUC): 0.828, sensitivity 78.6%, specificity 73.2%], a T1D of 749.5 ms (AUC: 0.817, sensitivity 71.4%, specificity 78%), a T1D (%) reduction of 49.71% (AUC: 0.831, sensitivity 78.6%, specificity 73.2%), a T2 relaxation time of 74 ms (AUC: 0.705, sensitivity 65%, specificity 76.6%), an ADC of 1.275 × 10^-3 mm²/s (AUC: 0.861, sensitivity 89.5%, specificity 81.2%), and a stiffness of 3.77 kPa (AUC: 0.848, sensitivity 85%, specificity 75%).</p><p><strong>Conclusion: </strong>Combined mpMRI, DWI, and MRE provide high diagnostic accuracy, with ADC and MRE offering superior performance in differentiating malignant from benign liver lesions.</p><p><strong>Clinical significance: </strong>This article highlights the accuracy of mpMRI, MRE, and DWI in distinguishing between malignant and benign liver lesions. These findings support the integration of mpMRI, DWI, and MRE into clinical practice for non-invasive liver lesion characterization.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207925","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":"When AI reviews your work: author-centered reflections on LLMs in peer review.","authors":"Burak Koçak, Mehmet Ruhi Onur","doi":"10.4274/dir.2025.253449","DOIUrl":"https://doi.org/10.4274/dir.2025.253449","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198533","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":"The AI Act: responsibilities and obligations for healthcare professionals and organizations.","authors":"Kicky Gerhilde van Leeuwen, Leon Doorn, Erik Gelderblom","doi":"10.4274/dir.2025.252851","DOIUrl":"https://doi.org/10.4274/dir.2025.252851","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173055","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":"Reply: evaluating text and visual diagnostic capabilities of large language models on questions related to the Breast Imaging Reporting and Data System (BI-RADS) Atlas 5^th edition.","authors":"Yasin Celal Güneş, Turay Cesur, Eren Çamur, Leman Günbey Karabekmez","doi":"10.4274/dir.2025.253360","DOIUrl":"https://doi.org/10.4274/dir.2025.253360","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110124","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":"Retrieval-augmented generation for answering Breast Imaging Reporting and Data System (BI-RADS)-related questions with large language models.","authors":"Esat Kaba","doi":"10.4274/dir.2025.253272","DOIUrl":"https://doi.org/10.4274/dir.2025.253272","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110128","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":"The role of T1 hyperintensity in differentiating granulomatous prostatitis from prostate cancer: a retrospective analysis of 31 lesions.","authors":"Selahattin Durmaz, Mert Kılıç, Bilgen Coşkun, Sergin Akpek, Barış Bakır, Tarık Esen, Metin Vural, Emre Altınmakas","doi":"10.4274/dir.2025.253242","DOIUrl":"https://doi.org/10.4274/dir.2025.253242","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To investigate the multiparametric magnetic resonance imaging (mpMRI) characteristics of granulomatous prostatitis (GP) and share our experience with 31 pathologically confirmed GP lesions in 19 patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This two-center retrospective study reviewed the pathological and imaging data of 856 patients who underwent prostate biopsy between January 2012 and April 2024. Of these, 19 patients with available prebiopsy mpMRI and a pathologically confirmed diagnosis of GP were included. Additionally, 280 biopsy-naïve patients diagnosed with clinically significant prostate cancer (csPCa) were included as a control group for comparative analysis. Prebiopsy mpMR images of patients with GP were assessed by consensus between two of three radiologists (M.V., B.C., S.D.), evaluating lesion location, size, shape, multifocality, extraprostatic extension (EPE), signal characteristics on T1-, T2-, and diffusion-weighted imaging (DWI), the mean apparent diffusion coefficient (ADC&lt;sub&gt;mean&lt;/sub&gt;) value, enhancement patterns, and prostate imaging reporting and data system (PI-RADS) scores. Statistical analyses were conducted using SPSS version 30.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 19 patients, 31 pathologically confirmed GP lesions were identified on prebiopsy mpMRI. Twenty-six lesions were located in the peripheral zone and five in the transitional zone. Multifocal involvement was observed in nine patients (47.3%). Thirty of 31 lesions were hypointense on T2-WI, and seven showed capsular bulging and/or irregularity, suggesting EPE. DWI revealed markedly impeded diffusion in all lesions. The median ADC&lt;sub&gt;mean&lt;/sub&gt; value was 825 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s (IQR: 230 × 10&lt;sup&gt;-3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s). On dynamic contrast-enhanced sequences, 25 lesions showed early enhancement, five showed prolonged enhancement, and one showed prolonged ring enhancement. Based on mpMRI findings, 17 lesions were assigned a PI-RADS score of 4, and 13 lesions were assigned a PI-RADS score of 5. Notably, 22 lesions (71%) in 14 patients with GP (73.7%) exhibited hyperintensity on T1-WI despite no prior prostate biopsy history. Statistical analysis comparing the GP and csPCa groups revealed that hyperintensity on T1-WI was significantly more frequent in GP, both on a per-patient basis (73.7% vs. 3.2%) and a per-lesion basis (71.0% vs. 3.1%) (&lt;i&gt;P&lt;/i&gt; &lt; 0.0001 for both).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;GP shares overlapping imaging features with prostate cancer on mpMRI. However, hyperintensity on T1-WI may serve as a distinguishing feature, potentially reducing unnecessary prostate interventions. Radiologists should consider GP in PI-RADS ≥4 lesions exhibiting T1-WI hyperintensity. Furthermore, given the high incidence of GP following intravesical Bacillus Calmette-Guérin (BCG) therapy, a thorough history of BCG treatment should be obtained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical significance: &lt;/strong&gt;GP is recognized for its tenden","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110166","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}