European Journal of Radiology最新文献

{"title":"Development and application of AI assisted automatic reconstruction of axial lumbar disc CT images and diagnosis of lumbar disc herniation","authors":"Lidi Wan ,&nbsp;Xiaolian Su ,&nbsp;Zuogang Xiong ,&nbsp;Zhijun Cui ,&nbsp;Guangyu Tang ,&nbsp;Haiying Zhang ,&nbsp;Lin Zhang","doi":"10.1016/j.ejrad.2025.112003","DOIUrl":"10.1016/j.ejrad.2025.112003","url":null,"abstract":"<div><div>Rationale and Objectives.</div><div>To evaluate the value of artificial intelligence (AI) assisted diagnostic system in reconstructing axial lumbar disc CT images and diagnosing lumbar disc herniation.</div></div><div><h3>Materials and Methods</h3><div>440 patients with lumbar disc herniation were included, with 400 cases of spiral data (320 training, 40 validations, and 40 testing) and 40 cases of axial data (testing). V-Net was used to reconstruct the axial lumbar disc images. U-Net was used to segment the herniated discs and perform MSU classification. The Dice coefficient was used to evaluate the accuracy of AI in lumbar vertebras and discs segmentation. The quality of axial CT images reconstructed by AI and radiology technician was compared. The diagnostic accuracy of AI, radiologist, and AI + radiologist for the MSU classification of lumbar disc herniation in spiral and axial data was evaluated.</div></div><div><h3>Results</h3><div>The Dice coefficients of AI for segmenting the sacral, lumbar, and lumbar discs were 0.953, 0.940, and 0.926, respectively. The quality of the axial CT images reconstructed by AI and radiographer had non-significant difference (P＞0.05). In both the spiral and axial data, the accuracy of AI, radiologist, and AI + radiologist in diagnosing the MSU classification was significantly different (P &lt; 0.01). The diagnostic accuracy of the AI system in MSU classification was higher in the spiral data than that of the axial data (P = 0.003).</div></div><div><h3>Conclusion</h3><div>The AI system is feasible and satisfactory for segmentation of lumbar CT image, reconstruction of axial lumbar disc CT images, and diagnosis of lumbar disc herniation.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"185 ","pages":"Article 112003"},"PeriodicalIF":3.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420614","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":"Correlation between tibial tubercle-trochlear groove and 3D shiftactive extension in patellar dislocation: An active extension analysis based on three-dimensional measurements","authors":"Mao Yuan ,&nbsp;Wei Tian ,&nbsp;Bo Sheng ,&nbsp;Jia Li ,&nbsp;Haitao Yang ,&nbsp;Furong Lv ,&nbsp;Yurou Chen","doi":"10.1016/j.ejrad.2025.111999","DOIUrl":"10.1016/j.ejrad.2025.111999","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the correlation between 3D shift_{active extension} (lateral patellar shift in active extension position based on newly established 3D measurement method) and static tibial tubercle-trochlear groove (TT-TG) distance in full knee extension with muscle relaxation.</div></div><div><h3>Methods</h3><div>42 knees of 24 patients with recurrent patellar dislocation were included in the study group and 38 knees of 30 subjects were included in the control group. TT-TG distance, bisect offset index_{muscle relaxation}, bisect offset index_{active extension} and 3D shift_{active extension} were measured to investigate the correlation between patellar lateral shift measurements and TT-TG distance.</div></div><div><h3>Results</h3><div>In the recurrent patellar dislocation group, the correlation between TT-TG distance and 3D shift_{active extension} (r = 0.76 [95 % CI, 0.61 to 0.86]) was significantly higher than correlation between TT-TG distance and bisect offset index_{active extension} (r = 0.61 [95 % CI, 0.32 to 0.79]) and correlation between TT-TG distance and bisect offset index_{muscle relaxation} (r = 0.6 [95 % CI, 0.32 to 0.80]), with p = 0.01 and p = 0.03, respectively.</div></div><div><h3>Conclusion</h3><div>Significantly stronger correlation between TT-TG distance and 3D shift_{active extension} in patients with patellar dislocation was observed in this study. 3D shift_{active extension} could be considered as a preoperative evaluation for tibial tubercle osteotomy to both characterize the patellar lateral shift and estimate tibial tubercle lateralization to simplify the preoperative assessment procedures. The 3D shift_{active extension} obtained under muscle contraction conditions both simulated the functional state of the patellofemoral joint and improved the limitations of the 2D measurements, helping to improve surgical decision-making for functional rehabilitation.</div><div>Level of Evidence: Level III</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"185 ","pages":"Article 111999"},"PeriodicalIF":3.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420616","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":"Image quality and diagnostic performance of deep learning reconstruction for diffusion- weighted imaging in 3 T breast MRI","authors":"Eun Ji Lee ,&nbsp;Yun-Woo Chang ,&nbsp;Eun Hye Lee ,&nbsp;Jang Gyu Cha ,&nbsp;Shin Young Kim ,&nbsp;Nami Choi ,&nbsp;Munyoung Paek ,&nbsp;Omar Darwish","doi":"10.1016/j.ejrad.2025.111997","DOIUrl":"10.1016/j.ejrad.2025.111997","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the image quality and the diagnostic value of deep learning reconstruction (DLR) for diffusion-weighted imaging (DWI) compared with conventional single-shot echo-planar imaging (ss-EPI) in 3 T breast MRI.</div></div><div><h3>Methods</h3><div>Between January and July 2023, this single-center prospective study involved patients who underwent both clinical breast MRI and additional DWIs including accelerated (fast DLR) and high-resolution (HR DLR) for the research purpose. Two radiologists independently evaluated image quality, including fat suppression homogeneity, image blurring, artifacts, and lesion conspicuity. The optimal cutoff value of the ADC value was determined based on a separate dataset comprising 98 breast lesions in 81 patients from a previous retrospective study. ADC values from 62 breast lesions (55 malignant, 7 benign) in 50 patients were analyzed to compare diagnostic performance across three DWI datasets.</div></div><div><h3>Results</h3><div>The study cohort included 50 patients (median age, 55.3 years). Fast DLR and HR DLR showed significantly better image quality compared to ss-EPI (<em>P</em> &lt; 0.05), with no significant difference between two DLR methods (<em>P</em> &gt; 0.05). DLR protocols consistently outperform ss-EPI for reducing artifacts across all lesion types and lesion size (<em>P</em> &lt; 0.05). Mean ADC values measured in the phantom and clinical images were not significantly different across DWI protocols (<em>P</em> &gt; 0.05). No significant difference in the diagnostic performance with the AUC of 0.846 in ss-EPI, 0.828 in fast DLR and 0.855 in HR DLR (<em>P</em> &gt; 0.05). Fast DLR showed a significantly lower standard deviation of ADC values compared to ss-EPI in malignant, mass-type lesions and those smaller than 2 cm (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>DLR DWI in 3T breast MRI improves image quality in both accelerated and high-resolution acquisition settings without compromising diagnostic performance. The use of DLR in DWI of breast MRI could enhance the efficiency and versatility of imaging protocols, offering significant clinical value.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"185 ","pages":"Article 111997"},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438261","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":"Temporal Evolution of multiparametric magnetic resonance imaging findings following lesion-targeted focal microwave tissue coagulation for localized prostate cancer","authors":"Bunta Tokuda ,&nbsp;Kaori Yamada ,&nbsp;Nana Kozawa ,&nbsp;Akiko Takahata ,&nbsp;Yayoi Iwami ,&nbsp;Toshiko Ito-Ihara ,&nbsp;Atsuko Fujihara ,&nbsp;Takumi Shiraishi ,&nbsp;Takashi Ueda ,&nbsp;Munehiro Ohashi ,&nbsp;Osamu Ukimura ,&nbsp;Kei Yamada","doi":"10.1016/j.ejrad.2025.111995","DOIUrl":"10.1016/j.ejrad.2025.111995","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate temporal changes in multiparametric MRI (mpMRI) findings following lesion-targeted focal therapy with microwave tissue coagulation (MTC) for localized prostate cancer (PCa).</div></div><div><h3>Methods</h3><div>This retrospective study included 33 patients (34 procedures) with localized PCa who underwent lesion-targeted focal therapy with MTC between June 2019 and March 2024. Post-treatment mpMRI, including T2-weighted imaging (T2WI), T1-weighted imaging (T1WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI), was evaluated by three radiologists to analyze signal changes and enhancement patterns in the treated area. Inter-reader agreement for each MRI sequence was also assessed.</div></div><div><h3>Results</h3><div>The median PSA reduction following treatment was 82 % (range, 18 %–99 %). The average post-treatment observation period was 16.5 months (range, 2.8–51.6 months), with a total of 97 post-treatment mpMRI scans conducted. In the early post-treatment period (3–6 months), the treated area exhibited heterogeneous hypointensity with a hypointense rim on T2WI, hyperintensity or isointensity on T1WI, and heterogeneous mixed signal intensity on DWI. Over time, these patterns diminished, with all lesions demonstrating hypointensity on T2WI, T1WI, and DWI by 17, 28, and 22 months, respectively. On DCE-MRI, rim enhancement predominated in the early post-treatment period, while all lesions showed no enhancement during later follow-up.</div></div><div><h3>Conclusion</h3><div>After lesion-targeted focal therapy with MTC for localized PCa, MRI findings in the treated area exhibited dynamic changes during the early post-treatment period, ultimately stabilizing as hypointensity across all sequences and no enhancement during late follow-up.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"185 ","pages":"Article 111995"},"PeriodicalIF":3.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420615","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":"Role of breast MRI BI-RADS descriptors in discrimination of non-mass enhancement lesion: A systematic review & meta-analysis","authors":"Arvin Arian ,&nbsp;Mohammad Mobin Teymouri Athar ,&nbsp;Shadi Nouri ,&nbsp;Hamed Ghorani ,&nbsp;Fattaneh Khalaj ,&nbsp;Seyyed Sina Hejazian ,&nbsp;Shiva Shaghaghi ,&nbsp;Rasa Beheshti","doi":"10.1016/j.ejrad.2025.111996","DOIUrl":"10.1016/j.ejrad.2025.111996","url":null,"abstract":"<div><h3>Objectives:</h3><div>To evaluate the association of BI-RADS 5th edition distribution and type of enhancement descriptors with the malignancy of non-mass enhancement (NME) lesions.</div></div><div><h3>Methods:</h3><div>Medline via PubMed, Scopus, Web of Science, ProQuest, and Embase databases were systematically searched from January 2013 to July 2022 for original studies, written in English, reporting the positive predictive value (PPV) of individual BI-RADS 5th edition descriptors (distribution and type of enhancement) of NME lesions. Risk of bias and quality of included studies were assessed by QUADAS 2 appraisal tool. Odds ratio (OR) of pathologically confirmed malignant results in each distribution and internal enhancement were pooled in a <em>meta</em>-analysis.</div></div><div><h3>Results:</h3><div>Eight studies for a total of 1095 lesions were included. The pooled OR of malignancy for linear, focal, segmental, regional, multiple region, and diffuse distributions are 0.70 (95%CI: 0.44–1.14), 0.37 (95% CI: 0.26–0.54), 2.42 (95% CI: 1.62–3.62), 0.56 (95% CI: 0.11–2.79), 2.80 (95% CI: 0.96–8.21), and 3.35 (95% CI: 0.59–19.04), respectively. The pooled OR of malignancy for homogenous, heterogeneous, clustered ring enhancement, and clumped enhancement are 0.39 (95% CI: 0.23–0.67), 0.59 (95% CI: 0.40–0.85), 2.92 (95% CI: 1.86–4.57), and 1.49 (95% CI: 0.96–2.32), respectively.</div></div><div><h3>Conclusion:</h3><div>Based on a <em>meta</em>-analysis of 8 studies and more than one thousand non-mass enhancing lesions, diffuse, multiple regions and clustered ring descriptors of enhancement have the highest pooled OR for malignancy.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"185 ","pages":"Article 111996"},"PeriodicalIF":3.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444446","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":"Diffusion tensor imaging changes along the perivascular spaces may serve as a prognostic factor for high-grade glioma","authors":"Lang Wang ,&nbsp;Lu Liu ,&nbsp;Hongjing Zhang ,&nbsp;Qiang Yue","doi":"10.1016/j.ejrad.2025.111993","DOIUrl":"10.1016/j.ejrad.2025.111993","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the alteration of glymphatic activity in high-grade glioma (HGG) using the diffusion tensor image (DTI) analysis along perivascular spaces (ALPS) method and assess its prognostic performance.</div></div><div><h3>Methods</h3><div>Data of HGG and volunteer were retrieved from The Cancer Imaging Archive and Consortium for Reliability and Reproducibility databases, respectively. Image features including multicenter, cystic change, tumor location, midline structure, lateral ventricle compression, and nerve fiber involvement were evaluated for HGG. The ALPS-index was calculated, and the <em>difference of ALPS-index</em> (D_ALPS), was defined to represent the difference of bilateral ALPS-index.</div></div><div><h3>Results</h3><div>In total, 236 HGG and 61 volunteers were included. The ALPS-index of the tumor-side hemisphere was larger than that of the normal-side, but it was smaller than that of volunteers. The ALPS-index of the normal-side showed a decreasing trend for HGG cases presenting a compressed lateral ventricle, deviated midline structure, and peritumor edema-involved association and projection fibers, but increased in gross total resection. The D_ALPS increased for isocitrate dehydrogenase mutation. The normal-side ALPS-index negatively correlated with edema and tumor volume. The D_ALPS positively correlated with edema volume. Univariable and multivariable Cox analysis revealed smaller D_ALPS as independent factors for poor prognosis. Survival analysis showed that high D_ALPS corresponded to longer survival times compared to low D_ALPS.</div></div><div><h3>Conclusions</h3><div>The glymphatic activity in HGG individuals is lower compared with that of healthy volunteers, with a potential compensation in the tumor side. Many clinical–radiological characteristics affect the glymphatic activity. The defined D_ALPS shows potential as an independent prognostic factor in HGG.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"184 ","pages":"Article 111993"},"PeriodicalIF":3.2,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420807","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":"CT-guided transthoracic needle biopsy: How we do it","authors":"Maurizio Balbi ,&nbsp;Luisella Righi ,&nbsp;Noemi Cristina Culasso ,&nbsp;Marta Bignoli ,&nbsp;Rouslan Senkeev ,&nbsp;Ludwig Federico Garello ,&nbsp;Damiano Carota ,&nbsp;Simona Sobrero ,&nbsp;Silvia Novello ,&nbsp;Andrea Veltri","doi":"10.1016/j.ejrad.2025.111994","DOIUrl":"10.1016/j.ejrad.2025.111994","url":null,"abstract":"<div><div>CT-guided transthoracic needle biopsy is a well-established method for diagnosing pulmonary lesions. However, despite extensive literature on the subject, many aspects of the procedure remain unexamined in large controlled trials. Consequently, practices vary across centers due to differences in local facilities, operators’ preferences, and experience. This article summarizes the essential steps of CT-guided transthoracic needle biopsy, covering patient selection to technical tips and tricks, complication management, and rapid onsite cytology evaluation. The techniques described here are based on years of clinical practice, research findings, and close collaboration with colleagues from various specialties, aiming to maximize tissue retrieval while minimizing complications. Moreover, given the growing importance of molecular analyses in the diagnosis and management of lung cancer, this article provides a concise and practical guide on proper biopsy specimen handling.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"184 ","pages":"Article 111994"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of radiomic and deep features to reliably differentiate benign renal lesions from renal cell carcinoma","authors":"Shuanbao Yu ,&nbsp;Ruochen Hao ,&nbsp;Jinshan Cui ,&nbsp;Yang Yang ,&nbsp;Zeyuan Wang ,&nbsp;Haoke Zheng ,&nbsp;Minglin Li ,&nbsp;Xinfei Li ,&nbsp;Wei Chen ,&nbsp;Wendong Jia ,&nbsp;Meng Wang ,&nbsp;Bo Chen ,&nbsp;Pokhrel Gaurab ,&nbsp;Yuhong Li ,&nbsp;Dapeng Wu ,&nbsp;Xuesong Li ,&nbsp;Xuepei Zhang","doi":"10.1016/j.ejrad.2025.111989","DOIUrl":"10.1016/j.ejrad.2025.111989","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate differentiation of benign renal lesions from renal cell carcinoma (RCC) is crucial for optimized management, particularly for small renal lesions (≤4 cm in diameter). This study aimed to integrate clinical data, radiomic features, and deep features to improve diagnostic performance in distinguishing benign renal lesions from RCC.</div></div><div><h3>Methods</h3><div>In this retrospective study, radiomic and deep scores were constructed using the AutoGluon-Tabular classifier based on radiomic and deep features extracted from the whole region of CT imaging. These scores were combined with clinical score, derived from clinical data, to create a multimodal score. The multimodal score was developed using a training cohort of 1,030 patients, validated in a cohort of 448 patients, and tested in a cohort of 680 patients from two independent institutions.</div></div><div><h3>Results</h3><div>A total of 2,158 patients with renal lesions were evaluated, including 1,739 (80.6 %) diagnosed with RCC, 419 (19.4 %) with benign renal lesions, and 1,340 (62.1 %) with small renal lesions. The multimodal score demonstrated higher diagnostic performance for both overall renal lesions (AUC: 0.949–0.906 vs 0.926–0.765) and small renal lesions (AUC: 0.929–0.880 vs 0.901–0.657) compared to the clinical score, radiomic score, deep score, and radiologists’ interpretations in the validation and test cohorts. The multimodal score also showed satisfactory concordance and the highest net benefit across threshold probabilities exceeding 60 %. The AUC values for subgroup with predicted risk below or above cutoff values for 99 % sensitivity or specificity were 0.964 and 0.897 for overall and small renal lesions in the external test cohort, respectively.</div></div><div><h3>Conclusions</h3><div>The multimodal score is a reliable predictor for distinguishing benign renal lesions from RCC in both overall and small renal lesions, and has the potential to spare patients from unnecessary biopsies or surgeries and can aid in guiding the management for renal lesions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"184 ","pages":"Article 111989"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388496","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":"Differentiating atypical hepatocellular carcinoma from focal nodular Hyperplasia: The value of Kupffer phase imaging with Sonazoid-Contrast-Enhanced ultrasound compared to Gadodiamide-Enhanced MRI","authors":"Zhe Huang,&nbsp;Xiao-jing Lin,&nbsp;Shan-shan Li,&nbsp;Hong-Chang Luo,&nbsp;Kai-Yan Li","doi":"10.1016/j.ejrad.2025.111991","DOIUrl":"10.1016/j.ejrad.2025.111991","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the value of Kupffer phase imaging with Sonazoid-Contrast-Enhanced Ultrasound (CEUS) in differentiating atypical Hepatocellular Carcinoma (HCC) from Focal Nodular Hyperplasia (FNH), compared to the efficacy of Gadodiamide-Enhanced Magnetic Resonance Imaging (CEMRI).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed a total of 56 focal liver lesions, comprising 36 atypical HCC and 20 FNH lesions, which were examined pre-operatively using both CEUS and CEMRI. Features were extracted from the images obtained from both modalities. The diagnostic performance of these features was evaluated using the Area Under the Receiver Operating Characteristic Curve (AUC).</div></div><div><h3>Results</h3><div>In the multivariate analysis, HBsAg-positive status (OR = 8.395, p = 0.021) and hypo-enhancement in the Kupffer phase (OR = 5.276, p = 0.042) were identified as independent predictors of atypical HCC. The specificity and sensitivity of HBsAg-positive for diagnosing atypical HCC are 65.0 % and 91.7 %, respectively. The specificity and sensitivity of hypo-enhancement in the Kupffer phase for diagnosing atypical HCC are 95.0 % and 63.9 %, respectively. Significantly, by integrating CEUS diagnostic characteristics to distinguish atypical HCC from FNH, we attained a specificity of 100.0 %, a sensitivity of 63.9 %, and a diagnostic accuracy of 76.8 %. Similarly, the combination of CEMRI diagnostic features resulted in a specificity of 100.0 %, a sensitivity of 47.2 %, and an overall diagnostic accuracy of 66.1 %. CEUS’s diagnostic accuracy is superior to CEMRI and this difference is statistically significant (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Sonazoid-CEUS demonstrates significant clinical potential and is a viable tool for the differential diagnosis of atypical HCC and FNH.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"184 ","pages":"Article 111991"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420794","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":"Frequency and risk factors of contrast media extravasation in 378,082 intravenous contrast-enhanced CT scans","authors":"Lijian Wang ,&nbsp;Qinlan Chen ,&nbsp;Haipeng Liu ,&nbsp;Xiaomi Wang ,&nbsp;Qian Qian ,&nbsp;Mengxi Xu ,&nbsp;Linlin Ma ,&nbsp;Xinhong Wang","doi":"10.1016/j.ejrad.2025.111992","DOIUrl":"10.1016/j.ejrad.2025.111992","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the occurrence and risk factors of contrast media extravasation (CME) during contrast-enhanced computed tomography (CECT).</div></div><div><h3>Methods</h3><div>This is an observational retrospective study. 378,082 cases who underwent CECT scans between January 2017 and December 2023 were initially included. The total and annual incidence of CME were examined. Subsequently, 155,547 cases with sufficient information were finally included for risk analysis. Risk factors of CME were investigated using logistic regression with generalized estimating equation analyses. Besides, risk factors of large-volume (≥50 ml) CME were also surveyed.</div></div><div><h3>Results</h3><div>The incidence of CME decreased steadily from 0.18 % in 2017 to 0.07 % in 2023, with an overall rate of 0.11 % (431/378,082). Multivariate analysis revealed that female [odds ratio (OR) = 1.683; <em>P</em> &lt; 0.001], age (OR = 1.017; <em>P</em> &lt; 0.001), BMI &lt; 18.5 (OR = 2.083; <em>P</em> &lt; 0.001), emergency patient (OR = 1.950; <em>P</em> &lt; 0.001), diabetes mellitus (OR = 2.650; <em>P</em> = 0.001), iohexol injection (OR = 1.721; <em>P</em> = 0.006), iopamidol injection (OR = 1.640; <em>P</em> = 0.006), and without saline flush (OR = 3.336; <em>P</em> &lt; 0.001) were the risk factors of CME. 24 ≤ BMI &lt; 28 (OR = 0.686; <em>P</em> = 0.002) was a protective factor for CME. In addition, male, BMI ≥ 28, 18-gauge injection, elbow fossa injection, and upper-arm injection were the risk factors for large-volume CME.</div></div><div><h3>Conclusions</h3><div>CME was uncommon during CECT. Several risk factors identified for CME and large-volume CME may have the potential to reduce the occurrence and severity of CME.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"184 ","pages":"Article 111992"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394914","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}