Diagnostic and interventional radiology最新文献

{"title":"Validation of R2* magnetic resonance imaging for quantifying secondary iron overload in pediatric patients.","authors":"Tahani M Ahmad, Fareed Khdair Ahmad, Mohamed Abdolell, Olfat Ahmad, Matthew T Rogers","doi":"10.4274/dir.2025.253282","DOIUrl":"10.4274/dir.2025.253282","url":null,"abstract":"<p><strong>Purpose: </strong>Non-invasive assessment of iron deposition is the standard of care for guiding chelation therapy in patients with iron overload. Several magnetic resonance imaging (MRI)-based techniques have been developed. This study compares the MRI-based R2* method with the standard R2-based method for quantifying iron levels in the liver and heart in children and young adults with secondary iron overload.</p><p><strong>Methods: </strong>A single-center prospective study was conducted over 2.5 years involving 14 patients aged 4-22 years with secondary iron overload. These patients underwent 40 MRI scans using both R2 and R2* methods at same time. A total of 36 scans were analyzed, comparing the two methods using linear regression analysis and Bland-Altman plots.</p><p><strong>Results: </strong>The study shows a significant correlation between liver iron concentration measurements obtained using the R2* method and those obtained using the R2-based method (adjusted R² = 0.77128). The agreement was even stronger for R2* values in the cardiac septum (adjusted R² = 0.93483).</p><p><strong>Conclusion: </strong>The R2* method for assessing iron deposition in the liver and cardiac septum is comparable to the R2-based method and is suitable for clinical use. However, due to slight differences in measurements between the two techniques, it is advisable to consistently use one method for monitoring treatment in each patient. Further research is needed to refine the calibration equations.</p><p><strong>Clinical significance: </strong>This study highlights the MRI-based R2* method as a reliable, non-invasive, and cost-effective alternative to the R2-based method for monitoring iron overload in pediatric patients, with no additional costs for institutions or third parties.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"399-404"},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207926","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":"Evaluating the prognostic impact of inflammatory markers on treatment outcomes in patients with intrahepatic cholangiocarcinoma undergoing radioembolization","authors":"Sinan Sözütok, Ferhat Can Pişkin, Hüseyin Tuğsan Ballı, Berkay Dik","doi":"10.4274/dir.2024.242929","DOIUrl":"10.4274/dir.2024.242929","url":null,"abstract":"<p><strong>Purpose: </strong>Intrahepatic cholangiocarcinoma (iCCA) is a rare and aggressive malignancy with limited treatment options, often diagnosed at advanced stages. Radioembolization has emerged as a promising therapy, but its efficacy varies among patients, necessitating reliable biomarkers to predict treatment response. This study evaluates the prognostic impact of systemic inflammatory response markers on treatment outcomes in patients with iCCA undergoing radioembolization.</p><p><strong>Methods: </strong>This retrospective study included 70 patients with iCCA treated with radioembolization between January 2016 and December 2023. Inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were measured from peripheral blood samples. Treatment response was assessed using the modified RECIST criteria, and survival analyses were performed using the Kaplan–Meier method and Cox proportional hazards regression.</p><p><strong>Results: </strong>Patients with lower NLR, PLR, and SII values exhibited significantly higher objective response rates (<i>P</i> = 0.032, <i>P</i> = 0.016, and <i>P</i> = 0.001, respectively). High levels of NLR, PLR, and SII were associated with shorter overall survival (12 vs. 16 months, <i>P</i> = 0.007; 12 vs. 16 months, <i>P</i> = 0.004; and 10 vs. 22 months, <i>P</i> < 0.001, respectively) and progression-free survival (3 vs. 7 months, <i>P</i> = 0.046 for SII). Multivariate analysis identified high SII (<i>P</i> = 0.040), lymph node metastasis (<i>P</i> = 0.042), and high serum total bilirubin (<i>P</i> = 0.013) as significant independent prognostic factors.</p><p><strong>Conclusion: </strong>Systemic inflammatory markers such as NLR, PLR, and SII are valuable prognostic indicators for patients with iCCA undergoing radioembolization. These markers can aid in identifying patients likely to benefit from personalized treatment strategies, potentially improving clinical outcomes.</p><p><strong>Clinical significance: </strong>The clinical significance of this study lies in its demonstration that systemic inflammatory markers (NLR, PLR, and SII) serve as valuable prognostic indicators for predicting treatment outcomes in patients with iCCA undergoing radioembolization, thus aiding in the identification of patients who may benefit from personalized treatment strategies and potentially improving clinical outcomes.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"377-383"},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709137","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":"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":"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}