European Journal of Radiology最新文献

{"title":"Absence of T2 flow voids in the vertebral arteries on cervical spine MRI in patients with trauma","authors":"Tae Ran Ahn ,&nbsp;Jun Seong Kim ,&nbsp;Jiyoung Yoon ,&nbsp;Jungbok Lee","doi":"10.1016/j.ejrad.2025.112163","DOIUrl":"10.1016/j.ejrad.2025.112163","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate patients with cervical spine trauma with absence of T2 flow voids in the vertebral arteries (VAs) on cervical spine MRI, assess the proportion of VA occlusion and subsequent brain infarction, and identify injury patterns associated with brain infarction.</div></div><div><h3>Methods</h3><div>Patients with absence of T2 flow voids in the VA on cervical spine MRI for acute trauma in a regional trauma center between 2019 and 2023 were retrospectively evaluated. Injury characteristics were assessed, and the absence of T2 flow voids, an indicator of VA injury and brain infarction, was confirmed by angiography and brain MRI. Univariate exact logistic regression was employed to evaluate the association of cervical spine injury characteristics with the presence of brain infarction in the VA territory.</div></div><div><h3>Results</h3><div>Of 683 patients, 42 (6.1 %) showed VA T2 flow void absence. The absence of T2 flow voids was predominantly unilateral (95.2 %). Coexisting transverse foramen fractures, discoligamentous complex (DLC) disruptions, and cord injuries were recorded in 61.9 %, 38.1 %, and 57.1 % of patients, respectively. Overall, 45.2 % and 26.2 % of patients had VA occlusion and brain infarction, respectively, with 14.3 % having both. Brain infarction was significantly associated with DLC disruptions (OR = 8.26, <em>p</em> = 0.040) and spinal cord injuries (OR = 12.09, <em>p</em> = 0.014). Two patients with bilateral VA involvement both developed brain infarction.</div></div><div><h3>Conclusion</h3><div>In patients with cervical spine trauma and an absence of T2 flow voids in the VAs on MRI, VA occlusion and subsequent brain infarction were frequently observed. Brain infarction<!--> <!-->in these cases was associated with DLC disruptions or spinal cord injuries.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112163"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927569","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":"Impact of spectrum bias on deep learning–based stroke MRI analysis","authors":"Christian Hedeager Krag ,&nbsp;Felix Christoph Müller ,&nbsp;Karen Lind Gandrup ,&nbsp;Louis Lind Plesner ,&nbsp;Malini Vendela Sagar ,&nbsp;Michael Brun Andersen ,&nbsp;Mads Nielsen ,&nbsp;Christina Kruuse ,&nbsp;Mikael Boesen","doi":"10.1016/j.ejrad.2025.112161","DOIUrl":"10.1016/j.ejrad.2025.112161","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate spectrum bias in stroke MRI analysis by excluding cases with uncertain acute ischemic lesions (AIL) and examining patient, imaging, and lesion factors associated with these cases.</div></div><div><h3>Materials and Methods</h3><div>This single-center retrospective observational study included adults with brain MRIs for suspected stroke between January 2020 and April 2022. Diagnostic uncertain AIL were identified through reader disagreement or low certainty grading by a radiology resident, a neuroradiologist, and the original radiology report consisting of various neuroradiologists. A commercially available deep learning tool analyzing brain MRIs for AIL was evaluated to assess the impact of excluding uncertain cases on diagnostic odds ratios. Patient-related, MRI acquisition-related, and lesion-related factors were analyzed using the Wilcoxon rank sum test, χ2 test, and multiple logistic regression. The study was approved by the National Committee on Health Research Ethics.</div></div><div><h3>Results</h3><div>In 989 patients (median age 73 (IQR: 59–80), 53% female), certain AIL were found in 374 (38%), uncertain AIL in 63 (6%), and no AIL in 552 (56%). Excluding uncertain cases led to a four-fold increase in the diagnostic odds ratio (from 68 to 278), while a simulated case-control design resulted in a six-fold increase compared to the full disease spectrum (from 68 to 431). Independent factors associated with uncertain AIL were MRI artifacts, smaller lesion size, older lesion age, and infratentorial location.</div></div><div><h3>Conclusion</h3><div>Excluding uncertain cases leads to a four-fold overestimation of the diagnostic odds ratio. MRI artifacts, smaller lesion size, infratentorial location, and older lesion age are associated with uncertain AIL and should be accounted for in validation studies.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112161"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937256","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":"Visualization of the middle meningeal artery on photon-counting detector CT: Comparison with energy-integrating detector CT","authors":"Kazuhisa Matsumoto ,&nbsp;Masahiro Nakashima ,&nbsp;Tatsuya Kawai ,&nbsp;Takatsune Kawaguchi ,&nbsp;Wataru Sugihara ,&nbsp;Misugi Urano ,&nbsp;Yusuke Nishikawa ,&nbsp;Nobuo Kitera ,&nbsp;Seita Watanabe ,&nbsp;Toshihide Itoh ,&nbsp;Akio Hiwatashi","doi":"10.1016/j.ejrad.2025.112155","DOIUrl":"10.1016/j.ejrad.2025.112155","url":null,"abstract":"<div><h3>Purpose</h3><div>The middle meningeal artery (MMA) is the target arteries for the treatment of intracranial diseases. The purpose of this study was to investigate the ability of photon-counting detector CT (PCD-CT) to improve the visualization of the MMA compared to energy-integrated detector CT (EID-CT).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed head CT angiography images from patients who underwent PCD-CT with ultra-high-resolution (UHR) mode between April 2023 and July 2024. We compared the images reconstructed with a slice thickness 0.2 mm and the matrix sizes 1024 × 1024 (’PCD-1024’) and 512 × 512 (’PCD-512’) with the same-patient images previously obtained by EID-CT with 0.75- or 1.0- mm slice thickness and the matrix size 512 × 512 (’EID-512’). Quantitatively, a region of interest (ROI) was placed on the maxillary artery near the origin of the MMA, and the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast ratio (CR) were measured. Image sharpness was evaluated by measuring the full width at half maximum (FWHM) and the maximum intensity from the MMA vessel line profile. Qualitatively, the overall image quality, sharpness, and artifacts were evaluated using four-point Likert scales. The same evaluation was performed using PCD-CT with 0.2 mm (’0.2 mm’) and virtual monoenergetic images (VMIs) (’45 keV’, ’55 keV’, and ’70 keV’).</div></div><div><h3>Results</h3><div>30 patients (19 males, 11 females; median age 65 years) were included. Quantitatively, the SNR (mean ± SD) for PCD-1024, PCD-512, and EID-512 were 16.9 ± 5.6, 20.3 ± 6.2, and 23.2 ± 7.8, respectively (P &lt; 0.01 for PCD-1024 vs. EID-512). The CNR were 16.6 ± 4.5, 20.2 ± 5.5, and 44.4 ± 13.9. The CR were 0.74 ± 0.06, 0.74 ± 0.06, and 0.68 ± 0.08. The FWHM were 1.41 ± 0.17, 1.48 ± 0.15, and 1.77 ± 0.12, and the maximum intensity were 407.5 ± 71.7, 386.0 ± 72.5, and 218.2 ± 58.2 (P &lt; 0.001 for PCD-1024 vs. EID-512 and PCD-512 vs. EID-512, respectively). Qualitatively, significant differences (P &lt; 0.05) were identified among the PCD-1024, PCD-512, and EID-512 groups regarding the respective scores (median [IQR]) for overall image quality (4 [3–4], 3 [3–4], and 2 [2–3]), sharpness (4 [3–4], 3 [3–3], and 2 [2–3]), and artifacts (3 [3–3], 3 [2–3], and 2 [2–2]). In VMI analysis, quantitatively, 45 keV showed the highest values for SNR, CNR, CR, and maximum intensity; however, there were no differences in FWHM among the groups. Qualitatively, 0.2 mm was superior to the other groups in all evaluated aspects (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>PCD-1024 visualized the MMA better than both PCD-512 and EID-512. The 0.2 mm reconstruction was visually superior to the VMIs.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112155"},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941090","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":"Comparison of unilateral and bilateral percutaneous transhepatic biliary drainage for management of malignant hilar biliary obstruction: Effects on inflammation and outcomes","authors":"Çağrı Erdim ,&nbsp;Rabia Deniz ,&nbsp;Mehmet Hamza Türkcanoğlu ,&nbsp;Sezgi Karabulut Gök ,&nbsp;Hatice Kübra Yerişenoğlu Demir ,&nbsp;Ceren Tansu Yavuz ,&nbsp;Ebranur Kocabaş Göktaş ,&nbsp;Mustafa Fatih Arslan ,&nbsp;Mehmet Cingöz ,&nbsp;Özgür Kılıçkesmez","doi":"10.1016/j.ejrad.2025.112131","DOIUrl":"10.1016/j.ejrad.2025.112131","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective study aimed to compare the effects of unilateral and bilateral percutaneous transhepatic biliary drainage (PTBD) procedures on inflammatory markers and clinical outcomes in patients with malignant hilar biliary obstruction (MHBO).</div></div><div><h3>Methods</h3><div>The study included 102 patients with MHBO who underwent PTBD at our institution. Patients were divided into unilateral (n = 46) and bilateral (n = 56) groups based on the drainage method. Demographic information and laboratory parameters were collected, and inflammatory markers were measured at baseline and follow-up intervals (24 h, 1 week, and 1 month). Statistical analyses were conducted to compare clinical and laboratory outcomes between the two groups.</div></div><div><h3>Results</h3><div>In both groups all types of bilirubin levels showed significant decreaese after succesful cathetarization of at least one biliary duct and obervation of biliary drainage in all patients. Both unilateral and bilateral PTBD groups showed significant improvements in hepatic and cholestatic enzymes (ALT, AST, ALP, GGT), coagulation parameters (INR, APTT), and CRP levels over time (p &lt; 0.05). However, most inflammatory markers, including CRP and procalcitonin, showed no significant differences between the two groups. Notably, only unilateral group exhibited significant improvements in platelet and lymphocyte counts from baseline to 1 month (p = 0.05 and p = 0.028, respectively). Correlation analysis revealed a strong negative association between CRP and albumin in the unilateral group (r = -0.713, p &lt; 0.001), whereas the bilateral group showed a positive correlation between CRP and procalcitonin (r = 0.783, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that there were no significant differences between unilateral and bilateral PTBD in recovery of hyperbilirubinemia. However, some inflammatory markers were adversely affected in the bilateral group. Based on these findings, unilateral PTBD may suffice as a first-line approach in patients with MHBO due to its less invasive nature and lower cost. Bilateral drainage should be reserved for cases where sufficient bilirubin reduction cannot be achieved.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112131"},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937253","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":"Ultra-high resolution photon-counting detector coronary CT minimizes overestimation bias compared to invasive reference","authors":"Gerald Siegfried Laux ,&nbsp;Moritz C. Halfmann ,&nbsp;Larissa Kavermann ,&nbsp;Stefanie Bockius ,&nbsp;Maike Knorr ,&nbsp;Tommaso Gori ,&nbsp;Pal Maurovich-Horvat ,&nbsp;Akos Varga-Szemes ,&nbsp;Philipp Lurz ,&nbsp;Tobias Bäuerle ,&nbsp;Michaela M. Hell ,&nbsp;Tilman Emrich","doi":"10.1016/j.ejrad.2025.112154","DOIUrl":"10.1016/j.ejrad.2025.112154","url":null,"abstract":"<div><h3>Background</h3><div>Photon-counting detector (PCD) coronary CT angiography (CCTA) at ultra-high-resolution (UHR) is a promising tool for the detailed evaluation of the coronary arteries. However, correlation with invasive quantitative coronary angiography (QCA) has not been thoroughly investigated. We here evaluated the efficacy of UHR-CCTA against invasive QCA in patients suspected of coronary artery disease (CAD).</div></div><div><h3>Methods</h3><div>Retrospectively, patients suggestive of CAD were included if they had undergone UHR-CCTA on a PCD-CT system showing coronary stenosis which clinically indicated subsequent invasive coronary angiography and no prior coronary interventions. CCTA datasets were reconstructed in 0.6 mm, 0.4 mm, and UHR 0.2 mm slice thicknesses. The extent of stenosis was compared between QCA and CCTA using univariate analysis of variance with post-hoc testing and Bland-Altman plots. Diagnostic performance was assessed based on the detection of relevant coronary stenosis (≥50 %) as confirmed by QCA.</div></div><div><h3>Results</h3><div>Forty-nine patients (71 ± 9 years; 37 % male) were included. Stenosis evaluation for 103 segments revealed decreasing mean stenosis diameter with improving spatial resolution (61.4 % for 0.6 mm, 55.3 % for 0.4 mm, 50.9 % for UHR 0.2 mm; p ≤ 0.001). Bias between CCTA and QCA decreased with increasing resolution (13.2 %, limits of agreement [LoA] 30 vs. 9.4 %, 28.1 vs. 5.2 %, 23). UHR-CCTA reconstructions showed superior diagnostic accuracy and positive predictive value (PPV) for detecting relevant CAD compared to lower resolutions (61.2 vs. 61.2 % vs. 71.4 and 53.7 % vs. 53.9 vs. 61.8 %, respectively).</div></div><div><h3>Conclusions</h3><div>UHR-CCTA with photon-counting detector CT demonstrated a decrease in overestimation bias and an increase in PPV.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112154"},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927568","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":"The Association between opportunistic DECT-derived bone values and vertebral fracture status","authors":"Philipp Reschke ,&nbsp;Vitali Koch ,&nbsp;Christof M Sommer ,&nbsp;Jennifer Gotta ,&nbsp;Elena Höhne ,&nbsp;Christian Booz ,&nbsp;Tommaso D’Angelo ,&nbsp;Katrin Eichler ,&nbsp;Thomas J. Vogl ,&nbsp;Leon D. Gruenewald","doi":"10.1016/j.ejrad.2025.112159","DOIUrl":"10.1016/j.ejrad.2025.112159","url":null,"abstract":"<div><h3>Introduction</h3><div>Osteoporosis is a major cause of spinal insufficiency fractures but often remains underdiagnosed. Dual-energy CT (DECT) enables reliable assessment of bone mineral density (BMD), but its limited accessibility highlights the need for alternative metrics. This study investigates the association between vertebral fracture status, DECT-derived BMD and alternative bone quality assessments, including Hounsfield Unit (HU)-based assessment and cortical thickness ratio.</div></div><div><h3>Methods</h3><div>A total of 180 patients who underwent non-contrast DECT of the spine between January 2016 and December 2021 were retrospectively analyzed. All imaged vertebrae were assessed for acute insufficiency fractures. DECT-based BMD was assessed using a dedicated postprocessing software that applies material decomposition and compared with HU-based assessment and cortical thickness ratio. Statistical analysis included correlation analysis, logistic regression adjusted for age and sex, ROC and PR curve analyses.</div></div><div><h3>Results</h3><div>Among 180 patients (97 females, median age of 65 years), 126 subjects (70 %) were confirmed to have insufficiency fractures. Patients with fractures had significantly lower values for DECT-based BMD (98.3 vs. 123.7 mg/cm³, <em>p</em> &lt; 0.001), trabecular HU (93.5 vs. 159.5 HU, <em>p</em> &lt; 0.001), and cortical thickness ratio (1.065 vs. 1.05, <em>p</em> &lt; 0.001). Cortical HU showed no significant difference between patients with and without fractures (<em>p</em> = 0.35). DECT-based BMD provided the highest diagnostic accuracy for detecting insufficiency fractures, yielding an AUC of 0.8 for the ROC curve and an AUC of 0.9 for the PR curve. HU-based measurements (trabecular HU: Spearman ρ = 0.17; cortical HU: ρ = 0.2) and the cortical thickness ratio (ρ = -0.01) demonstrated only weak correlations with the reference standard, DECT-derived BMD.</div></div><div><h3>Conclusion</h3><div>DECT-based BMD demonstrated the highest diagnostic accuracy for insufficiency fractures. HU-based assessments and cortical thickness ratio showed only weak correlations with DECT-based BMD, limiting their reliability as alternatives.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112159"},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947049","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":"DWI/ADC in response assessment after local-regional treatment of HCC – Pearls and Pitfalls","authors":"Liang Meng Loy,&nbsp;Guo Yuan How,&nbsp;Hsien Min Low,&nbsp;Uei Pua,&nbsp;Lawrence Han Hwee Quek,&nbsp;Cher Heng Tan","doi":"10.1016/j.ejrad.2025.112156","DOIUrl":"10.1016/j.ejrad.2025.112156","url":null,"abstract":"<div><div>Many patients with hepatocellular carcinoma (HCC) present with advanced-stage disease or multifocal tumors which make them unsuitable for radical treatment options. In such cases, locoregional therapy (LRT) such as transarterial chemoembolization (TACE), transarterial radioembolization (TARE) can be used as a bridge to liver transplantation or to downstage borderline tumors. However, post treatment response assessment can be very difficult, especially in the case of TARE.</div><div>The recently updated Liver Imaging Reporting and Data System treatment response algorithm (LI-RADS TRA) 2024 guidelines has included ancillary features of mild-moderate T2 signal intensity and diffusion restriction into the assessment algorithm. Diffusion-weighted imaging (DWI) would be particularly important in post-TARE assessment as early response assessment using traditional size and enhancement criteria can be challenging following TARE. However, the interpretation of restricted diffusion in post-treatment imaging can be challenging as DWI can be affected by various factors such as inflammatory changes, haemorrhage, or T2-relaxation time of the surrounding parenchyma. In this review article, we provide an overview of the advantages and challenges in the use of DWI to interpret treatment response after LRT.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112156"},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923265","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":"Accuracy of CT colonography with mannitol preparation for detecting synchronous lesions in obstructive colorectal cancer","authors":"Angela H.M. Caiado ,&nbsp;Sergio C. Nahas ,&nbsp;Ilka R.S. Oliveira ,&nbsp;Serli K.N. Ueda ,&nbsp;Caio S.R. Nahas ,&nbsp;Manoel S. Rocha ,&nbsp;Ulysses S. Torres ,&nbsp;Carlos A. Buchpiguel","doi":"10.1016/j.ejrad.2025.112151","DOIUrl":"10.1016/j.ejrad.2025.112151","url":null,"abstract":"<div><h3>Objective</h3><div>Preoperative detection of advanced neoplasms is essential for surgical planning in colorectal cancer (CRC). CT colonography (CTC) has emerged as a reliable alternative when obstructive CRC prevents complete optical colonoscopy (OC). Mannitol, commonly used for OC preparation in some countries, offers potential advantages over polyethylene glycol (PEG), including low cost, reduced ingestion volume, fast action, and a more palatable sweet taste. We evaluated the diagnostic accuracy of mannitol-based CTC for detecting synchronous lesions in CRC, hypothesizing that this low-volume preparation could maintain high accuracy while improving patient tolerability.</div></div><div><h3>Methods</h3><div>Of 150 CRC patients with incomplete OC who underwent preoperative CTC following cathartic preparation with mannitol, 62 were retrospectively analyzed. Their CTC findings were compared with postoperative surgical and pathological results and follow-up OC. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were assessed for lesions ≥6 mm. In addition, the quality of bowel preparation with mannitol (amount of liquid and solid residue) was compared with historical data from published studies.</div></div><div><h3>Results</h3><div>In 62 patients (372 segments), 26 synchronous lesions were identified (9 ≥ 10 mm, 17 sized 6–9 mm). For lesions ≥6 mm, CTC achieved a sensitivity of 92.3 % (95 % CI: 74.9–99.1 %), specificity of 99.1 % (95 % CI: 97.5–99.8 %), PPV of 88.9 % (95 % CI: 70.8–97.6 %), and NPV of 99.4 % (95 % CI: 97.9–99.9 %). Bowel cleansing was adequate, with 82.8 % of segments showing no or minimal residual fluid and 96.3 % with no or minimal solid residue.</div></div><div><h3>Conclusion</h3><div>CTC with a mannitol-based preparation demonstrated high accuracy in detecting synchronous neoplasms among patients with obstructive CRC and incomplete OC. These findings suggest that mannitol is a feasible alternative to PEG, maintaining excellent diagnostic performance while possibly improving tolerability. Additionally, it could streamline surgical planning and improve overall outcomes in modern CRC management.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112151"},"PeriodicalIF":3.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923263","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":"Peripheral vs. central parametric mapping of the liver in single ventricle patients: Measurement location matters","authors":"Anna Yanovskiy ,&nbsp;Tiina Ojala ,&nbsp;Alma Kormi ,&nbsp;Reetta Kivisaari ,&nbsp;Juha Peltonen ,&nbsp;Laura Martelius","doi":"10.1016/j.ejrad.2025.112158","DOIUrl":"10.1016/j.ejrad.2025.112158","url":null,"abstract":"<div><h3>Background</h3><div>Fontan circulation often results in Fontan-associated liver disease, typically challenging to detect early. MRI liver parametric mapping shows potential for tissue characterization, but institution-specific reference values hinder comparability. This study investigates whether the peripheral-to-central mapping ratio can serve as a surrogate for absolute mapping values.</div></div><div><h3>Methods</h3><div>The retrospective single tertiary center cohort study included 68 pediatric patients with single ventricle anomalies and 25 healthy controls. Parametric mapping values were measured in three liver regions, comparing central region and peripheral areas of both liver lobes.</div></div><div><h3>Results</h3><div>There was a strong positive correlation between the T1 ratio and T1 mean (r = 0.68, p &lt; 0.001), and a moderate positive correlation between the T2 ratio and T2 mean (r = 0.46, p &lt; 0.001). T1 and T2 mapping ratios exhibited the highest values in post-total cavopulmonary connection (TCPC) patients (p &lt; 0.05). Post-TCPC patients had significantly higher T1 and T2 mapping, and ECV values in the right lobe compared to the left lobe (p &lt; 0.05). T1 mean showed significant weak associations with duration of post-TCPC follow-up (r = 0.3, p = 0.029), ejection fraction (r = −0.36, p = 0.006), oxygen saturation (r = −0.31, p = 0.022), and univentricular end-diastolic volume (r = 0.27, p = 0.043), and severe lymphatic collaterals were linked to higher T1 mean values (p = 0.024) in post-TCPC patients. Absolute T1 values were significantly higher in cirrhosis across all tested regions (p &lt; 0.05). The T1 ratio was significantly associated with the duration of post-TCPC follow-up (r = 0.27, p = 0.041).</div></div><div><h3>Conclusions</h3><div>Measurement location influences liver parametric mapping values. The T1 ratio shows the most promise among the peripheral-to-central ratios, though its associations with hemodynamics are weaker than those of absolute values.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112158"},"PeriodicalIF":3.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906131","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":"MRI characteristics of FIGO stage IA epithelial ovarian cancer (EOC)","authors":"Wang Yilin,&nbsp;Chen Yan,&nbsp;Zhao Xinming,&nbsp;Xu Xiaojuan,&nbsp;Wang Yichen,&nbsp;Sun Yuying","doi":"10.1016/j.ejrad.2025.112157","DOIUrl":"10.1016/j.ejrad.2025.112157","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the MRI characteristics of FIGO stage IA EOC with different pathologic subtypes in order to improve the radiologists’ understanding of these diseases.</div></div><div><h3>Methods</h3><div>In this retrospective study, we recruited patients who underwent surgery due to EOC at our hospital and were staged as FIGO IA from January 2013 to May 2024. The MR imaging and clinical features were evaluated by radiologists specialized in gynecology. Kruskal-Wallis test and Chi-squared test were performed to assess the difference between groups.</div></div><div><h3>Results</h3><div>A total of 34 patients with a mean age of 56 years included serous carcinoma 9 cases (26 %), endometrioid carcinoma 9 cases (26 %), clear cell carcinoma 10 cases (29 %), mucinous carcinoma 6 cases (18 %). 2 patients synchronously developed ovarian cancer and uterus endometrial cancer. The median CA125 level was 65.6 U/ml (95 % CI, 21.6 to 92.8) and laterality ratio was 17:18 (left: right). Median diameter of tumor was 10.9 cm (95 % CI, 8.0 to 11.8). There were 6 cases of pure solid tumor, 5 cases of unilocular cystic-solid tumor and 23 multilocular cystic-solid tumor. 17 cases appeared hemorrhage signal and 6 of which had mixed signals in the loculi. As for enhancement pattern, total 10 cases of type I, 11 cases of type II and 13 cases of type III. Solid tissue in 33 (97 %) cases demonstrated restricted diffusion in DWI sequence. 9 cases presented ascites. There were 5 factors showed significant differences among different pathologic subtypes (<em>p</em> &lt; 0.05), including maximum diameter, general morphology, growth pattern of solid tissue, grouped septa and presence of mixed signals in the loculi.</div></div><div><h3>Conclusion</h3><div>The imaging performance of FIGO stage IA EOC were variable, and there were differences in imaging characteristics among different pathological subtypes, which can improve current understanding of FIGO stage IA EOC and reduce clinical diagnostic omissions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"188 ","pages":"Article 112157"},"PeriodicalIF":3.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941089","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}