European Radiology最新文献

{"title":"Reply to letter to the Editor: Current role of [18F] FDG-PET/CT in pulmonary sarcoidosis: a meta-analysis.","authors":"Ryan Donnelly, Cormac McCarthy, David J Murphy","doi":"10.1007/s00330-024-11194-5","DOIUrl":"10.1007/s00330-024-11194-5","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2235-2236"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"So many countries, so many customs, so many ways of using CT.","authors":"Zsolt Szucs-Farkas","doi":"10.1007/s00330-025-11356-z","DOIUrl":"10.1007/s00330-025-11356-z","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1913-1914"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative MRI distinguishes different leukodystrophies and correlates with clinical measures.","authors":"Menno D Stellingwerff, Murtadha L Al-Saady, Kwok-Shing Chan, Adam Dvorak, José P Marques, Shannon Kolind, Daphne H Schoenmakers, Romy van Voorst, Stefan D Roosendaal, Frederik Barkhof, Nicole I Wolf, Johannes Berkhof, Petra J W Pouwels, Marjo S van der Knaap","doi":"10.1007/s00330-024-11089-5","DOIUrl":"10.1007/s00330-024-11089-5","url":null,"abstract":"<p><strong>Objectives: </strong>The leukodystrophy \"vanishing white matter\" (VWM) and \"metachromatic leukodystrophy\" (MLD) affect the brain's white matter, but have very different underlying pathology. We aim to determine whether quantitative MRI reflects known neuropathological differences and correlates with clinical scores in these leukodystrophies.</p><p><strong>Methods: </strong>VWM and MLD patients and controls were prospectively included between 2020 and 2023. Clinical scores were recorded. MRI at 3 T included multi-compartment relaxometry diffusion-informed myelin water imaging (MCR-DIMWI) and multi-echo T2-relaxation imaging with compressed sensing (METRICS) to determine myelin water fractions (MWF). Multi-shell diffusion-weighted data were used for diffusion tensor imaging measures and neurite orientation dispersion and density imaging (NODDI) analysis, which estimates neurite density index, orientation dispersion index, and free water fraction. As quantitative MRI measures are age-dependent, ratios between actual and age-expected MRI measures were calculated. We performed the multilevel analysis with subsequent post-hoc and correlation tests to assess differences between groups and clinico-radiological correlations.</p><p><strong>Results: </strong>Sixteen control (age range: 2.3-61.3 years, 8 male), 37 VWM (2.4-56.5 years, 20 male), and 14 MLD (2.2-41.7 years, 6 male) subjects were included. Neurite density index and MWF were lower in patients than in controls (p < 0.001). Free water fraction was highest in VWM (p = 0.01), but similar to controls in MLD (p = 0.99). Changes in diffusion tensor imaging measures relative to controls were generally more pronounced in VWM than in MLD. In both patient groups, MCR-DIMWI MWF correlated strongest with clinical measures.</p><p><strong>Conclusion: </strong>Quantitative MRI correlates to clinical measures and yields differential profiles in VWM and MLD, in line with differences in neuropathology.</p><p><strong>Key points: </strong>Question Can quantitative MRI reflect known neuropathological differences and correlate with clinical scores for these leukodystrophies? Finding Quantitative MRI measures, e.g., MWF, neurite density index, and free water fraction differ between leukodystrophies and controls, in correspondence to known histological differences. Clinical relevance MRI techniques producing quantitative, biologically-specific, measures regarding the health of myelin and axons deliver more comprehensive information regarding pathological changes in leukodystrophies than current approaches, and are thus viable tools for monitoring patients and providing clinical trial outcome measures.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1845-1857"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of coronary calcification on the assessment of plaque pathology: a comparison of computed tomography and multimodality intravascular imaging.","authors":"Nathan Angelo Lecaros Yap, Anantharaman Ramasamy, Ibrahim Halil Tanboga, Xingwei He, Murat Cap, Retesh Bajaj, Medeni Karaduman, Ajay Jain, Pieter Kitslaar, Alexander Broersen, Xiaotong Zhang, Hessam Sokooti, Johan H C Reiber, Jouke Dijkstra, Mick Ozkor, Patrick W Serruys, James C Moon, Anthony Mathur, Andreas Baumbach, Ryo Torii, Francesca Pugliese, Christos V Bourantas","doi":"10.1007/s00330-024-10996-x","DOIUrl":"10.1007/s00330-024-10996-x","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the impact of calcific (Ca) on the efficacy of coronary computed coronary angiography (CTA) in evaluating plaque burden (PB) and composition with near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) serving as the reference standard.</p><p><strong>Materials and methods: </strong>Sixty-four patients (186 vessels) were recruited and underwent CTA and 3-vessel NIRS-IVUS imaging (NCT03556644). Expert analysts matched and annotated NIRS-IVUS and CTA frames, identifying lumen and vessel wall borders. Tissue distribution was estimated using NIRS chemograms and the arc of Ca on IVUS, while in CTA Hounsfield unit cut-offs were utilized to establish plaque composition. Plaque distribution plots were compared at segment-, lesion-, and cross-sectional-levels.</p><p><strong>Results: </strong>Segment- and lesion-level analysis showed no effect of Ca on the correlation of NIRS-IVUS and CTA estimations. However, at the cross-sectional level, Ca influenced the agreement between NIRS-IVUS and CTA for the lipid and Ca components (p-heterogeneity < 0.001). Proportional odds model analysis revealed that Ca had an impact on the per cent atheroma volume quantification on CTA compared to NIRS-IVUS at the segment level (p-interaction < 0.001). At lesion level, Ca affected differences between the modalities for maximum PB, remodelling index, and Ca burden (p-interaction < 0.001, 0.029, and 0.002, respectively). Cross-sectional-level modelling demonstrated Ca's effect on differences between modalities for all studied variables (p-interaction ≤ 0.002).</p><p><strong>Conclusion: </strong>Ca burden influences agreement between NIRS-IVUS and CTA at the cross-sectional level and causes discrepancies between the predictions for per cent atheroma volume at the segment level and maximum PB, remodelling index, and Ca burden at lesion-level analysis.</p><p><strong>Clinical relevance statement: </strong>Coronary calcification affects the quantification of lumen and plaque dimensions and the characterization of plaque composition coronary CTA. This should be considered in the analysis and interpretation of CTAs performed in patients with extensive Ca burden.</p><p><strong>Key points: </strong>Coronary CT Angiography is limited in assessing coronary plaques by resolution and blooming artefacts. Agreement between dual-source CT angiography and NIRS-IVUS is affected by a Ca burden for the per cent atheroma volume. Advanced CT imaging systems that eliminate blooming artefacts enable more accurate quantification of coronary artery disease and characterisation of plaque morphology.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1745-1760"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-based prediction of the need for wide resection margins in patients with single hepatocellular carcinoma.","authors":"Yanshu Wang, Yali Qu, Chongtu Yang, Yuanan Wu, Hong Wei, Yun Qin, Jie Yang, Tianying Zheng, Jie Chen, Roberto Cannella, Federica Vernuccio, Maxime Ronot, Weixia Chen, Bin Song, Hanyu Jiang","doi":"10.1007/s00330-024-11043-5","DOIUrl":"10.1007/s00330-024-11043-5","url":null,"abstract":"<p><strong>Objectives: </strong>To develop an MRI-based score that enables individualized predictions of the survival benefit of wide over narrow resection margins.</p><p><strong>Materials and methods: </strong>This single-center retrospective study (December 2011 to May 2022) included consecutive patients who underwent curative-intent resection for single Barcelona Clinic Liver Cancer (BCLC) 0/A HCC and preoperative contrast-enhanced MRI. In patients with narrow resection margins, preoperative demographic, laboratory, and MRI variables independently associated with early recurrence-free survival (RFS) were identified using Cox regression analyses, which were employed to develop a predictive score (named \"MARGIN\"). Survival outcomes were compared between wide and narrow resection margins in a propensity-score matched cohort for the score-stratified low- and high-risk groups, respectively.</p><p><strong>Results: </strong>Four hundred nineteen patients (median age, 54 years; 361 men) were included, 282 (67.3%) undergoing narrow resection margins. In patients with narrow resection margins, age, alpha-fetoprotein (AFP) > 400 ng/mL, protein induced by vitamin K absence or antagonist-II (PIVKA-II) > 200 mAU/mL, radiological involvement of liver capsule, and infiltrative appearance were associated with early RFS (p values, 0.002-0.04) and formed the MARGIN score with a testing dataset C-index of 0.75 (95% CI: 0.65-0.84). In the matched cohort, wide resection margin was associated with improved early RFS rate for the high-risk group (MARGIN score ≥ - 1.3; 71.1% vs 41.0%; p = 0.02), but not for the low-risk group (MARGIN score < - 1.3; 79.7% vs 76.1%; p = 0.36).</p><p><strong>Conclusion: </strong>In patients with single BCLC 0/A HCC, the MARGIN score may serve as promising decision-making to indicate the need for wide resection margins.</p><p><strong>Clinical relevance statement: </strong>The MARGIN score has the potential to identify patients who would benefit more from wide resection margins than narrow resection margins, improving the postoperative survival of patients with single BCLC 0/A hepatocellular carcinoma (HCC).</p><p><strong>Key points: </strong>Age, AFP, PIVKA-II, radiological involvement of liver capsule, and infiltrative appearance were associated with early RFS and formed the MARGIN score. The MARGIN score achieved a testing dataset C-index of 0.75. Wide resection margins were associated with improved early RFS for the high-risk group, but not for the low-risk group.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1772-1784"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced breast diffusion-weighted imaging: what are the next steps? A proposal from the EUSOBI International Breast Diffusion-weighted Imaging working group.","authors":"Maya Honda, Eric E Sigmund, Denis Le Bihan, Katja Pinker, Paola Clauser, Dimitrios Karampinos, Savannah C Partridge, Eva Fallenberg, Laura Martincich, Pascal Baltzer, Ritse M Mann, Julia Camps-Herrero, Mami Iima","doi":"10.1007/s00330-024-11010-0","DOIUrl":"10.1007/s00330-024-11010-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study by the EUSOBI International Breast Diffusion-weighted Imaging (DWI) working group aimed to evaluate the current and future applications of advanced DWI in breast imaging.</p><p><strong>Methods: </strong>A literature search and a comprehensive survey of EUSOBI members to explore the clinical use and potential of advanced DWI techniques and a literature search were involved. Advanced DWI approaches such as intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), and diffusion tensor imaging (DTI) were assessed for their current status and challenges in clinical implementation.</p><p><strong>Results: </strong>Although a literature search revealed an increasing number of publications and growing academic interest in advanced DWI, the survey revealed limited adoption of advanced DWI techniques among EUSOBI members, with 32% using IVIM models, 17% using non-Gaussian diffusion techniques for kurtosis analysis, and only 8% using DTI. A variety of DWI techniques are used, with IVIM being the most popular, but less than half use it, suggesting that the study identified a gap between the potential benefits of advanced DWI and its actual use in clinical practice.</p><p><strong>Conclusion: </strong>The findings highlight the need for further research, standardization and simplification to transition advanced DWI from a research tool to regular practice in breast imaging. The study concludes with guidelines and recommendations for future research directions and clinical implementation, emphasizing the importance of interdisciplinary collaboration in this field to improve breast cancer diagnosis and treatment.</p><p><strong>Clinical relevance statement: </strong>Advanced DWI in breast imaging, while currently in limited clinical use, offers promising improvements in diagnosis, staging, and treatment monitoring, highlighting the need for standardized protocols, accessible software, and collaborative approaches to promote its broader integration into routine clinical practice.</p><p><strong>Key points: </strong>Increasing number of publications on advanced DWI over the last decade indicates growing research interest. EUSOBI survey shows that advanced DWI is used primarily in research, not extensively in clinical practice. More research and standardization are needed to integrate advanced DWI into routine breast imaging practice.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2130-2140"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESR Essentials: role of PET/CT in neuroendocrine tumors-practice recommendations by the European Society for Hybrid, Molecular and Translational Imaging.","authors":"Ricarda Ebner, Gabriel T Sheikh, Matthias Brendel, Jens Ricke, Clemens C Cyran","doi":"10.1007/s00330-024-11095-7","DOIUrl":"10.1007/s00330-024-11095-7","url":null,"abstract":"<p><p>Neuroendocrine neoplasms (NEN) originate from the secretory cells of the neuroendocrine system, with the majority arising in the gastrointestinal tract and pancreas. Given the heterogeneity in the biological behavior and morphological differentiation of these tumors, advanced imaging techniques are crucial for supporting the suspected diagnosis, accurate staging, and monitoring therapy. As most well-differentiated NEN demonstrate overexpression of somatostatin receptors (SSR) on the cell surface, SSR-directed PET/CT is considered the reference standard for imaging of this particular entity. SSR-PET/CT should be the imaging method of choice in every NEN G1 or G2 and considered for re-staging after both potentially curative and non-curative surgeries. The extent of SSR expression is also crucial for determining a patient's eligibility for peptide receptor radionuclide therapy (PRRT). PRRT utilizes [¹⁷⁷Lu]Lu-DOTA-TATE to target the SSR receptor and can significantly prolong progression-free survival in patients with advanced, progressive neuroendocrine tumor of the gastroenteropancreatic system (GEP-NET). PET/CT is a central component of the multidisciplinary management of NEN. Variable follow-up intervals are recommended, considering that tumors with higher proliferation rates or advanced metastatic disease require more frequent assessments. The combination with other imaging modalities, like MRI, complements SSR-PET/CT, further enhancing overall diagnostic accuracy. KEY POINTS: Somatostatin receptor-PET/CT (SSR-PET/CT) is the guideline-recommended reference standard for imaging well-differentiated neuroendocrine tumors (NET). SSR-PET/CT should be the diagnostic imaging of choice for staging and post-therapy re-staging of grade 1 or 2 NET (G1 or G2). Variable follow-up intervals are recommended for NET G1 and G2. Tumors with higher proliferation rates or advanced metastatic disease necessitate more frequent assessments.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1903-1912"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESR Essentials: imaging in fibrotic lung diseases-practice recommendations by the European Society of Thoracic Imaging.","authors":"Anna Rita Larici, Juergen Biederer, Giuseppe Cicchetti, Tomas Franquet Casas, Nick Screaton, Martine Remy-Jardin, Anagha Parkar, Helmut Prosch, Cornelia Schaefer-Prokop, Thomas Frauenfelder, Benoit Ghaye, Nicola Sverzellati","doi":"10.1007/s00330-024-11054-2","DOIUrl":"10.1007/s00330-024-11054-2","url":null,"abstract":"<p><p>Fibrotic lung diseases (FLDs) represent a subgroup of interstitial lung diseases (ILDs), which can progress over time and carry a poor prognosis. Imaging has increased diagnostic discrimination in the evaluation of FLDs. International guidelines have stated the role of radiologists in the diagnosis and management of FLDs, in the context of the interdisciplinary discussion. Chest computed tomography (CT) with high-resolution technique is recommended to correctly recognise signs, patterns, and distribution of individual FLDs. Radiologists may be the first to recognise the presence of previously unknown interstitial lung abnormalities (ILAs) in various settings. A systematic approach to CT images may lead to a non-invasive diagnosis of FLDs. Careful comparison of serial CT exams is crucial in determining either disease progression or supervening complications. This 'Essentials' aims to provide radiologists a concise and practical approach to FLDs, focusing on CT technical requirements, pattern recognition, and assessment of disease progression and complications. Hot topics such as ILAs and progressive pulmonary fibrosis (PPF) are also discussed. KEY POINTS: Chest CT with high-resolution technique is the recommended imaging modality to diagnose pulmonary fibrosis. CT pattern recognition is central for an accurate diagnosis of fibrotic lung diseases (FLDs) by interdisciplinary discussion. Radiologists are to evaluate disease behaviour by accurately comparing serial CT scans.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2245-2255"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of radiomics research: comprehensive analysis of 1574 unique publications from 89 reviews.","authors":"Burak Kocak, Ali Keles, Fadime Kose, Abdurrezzak Sendur","doi":"10.1007/s00330-024-11057-z","DOIUrl":"10.1007/s00330-024-11057-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to comprehensively evaluate the quality of radiomics research by examining unique papers from reviews using the radiomics quality score (RQS).</p><p><strong>Methods: </strong>A literature search was conducted in PubMed (last search date: April 14, 2024). Systematic or non-systematic reviews using the RQS to evaluate radiomic studies were potentially included. Exclusion was applied at two levels: first, at the review level, and second, at the study level (i.e., for the individual articles previously evaluated within the reviews). Score-wise and item-wise analyses were performed, along with trend, multivariable, and subgroup analyses based on baseline study characteristics and validation methods.</p><p><strong>Results: </strong>A total of 1574 unique papers (published online between 1999 and 2023) from 89 reviews were included in the final analysis. The median RQS percentage was 31% with an IQR of 25% (25th-75th percentiles, 14-39%). A positive correlation between median RQS percentage and publication year (2014-2023) was found, with Kendall's tau coefficient of 0.908 (p < 0.001), suggesting an improvement in quality over time. The quality of radiomics publications significantly varied according to different subfields of radiology (p < 0.001). Around one-third of the publications (32%) lacked a separate validation set. Papers with internal validation (54%) dominated those with external validation (14%). Higher-quality validation practices were significantly associated with better RQS percentage scores, independent of the validation's effect on the final score. Item-wise analysis revealed significant shortcomings in several areas.</p><p><strong>Conclusion: </strong>Radiomics research quality is low but improving according to RQS. Significant variation exists across radiology subfields. Critical areas were identified for targeted improvement.</p><p><strong>Clinical relevance statement: </strong>Our study shows that the quality of radiomics research is generally low but improving over time, with item-wise analysis highlighting critical areas needing improvement. It also reveals that the quality of radiomics research differs across subfields and validation methods.</p><p><strong>Key points: </strong>Overall quality of radiomics research remains low and highly variable, although a significant positive trend suggests an improvement in quality over time. Considerable variations exist in the quality of radiomics publications across different subfields of radiology and validation types. The item-wise analysis highlights several critical areas requiring attention, emphasizing the need for targeted improvements.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1980-1992"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of novel cardiovascular magnetic resonance transit times beyond the pulmonary circulation in patients with ventricular dysfunction.","authors":"Teresa Sevilla, Carlos Baladrón, María de Miguel-Álava, Gino Rojas-Lavado, Esther González-Bartol, Ana Revilla-Orodea, Cristhian Aristizabal-Duque, Manuel Carrasco-Moraleja, Miguel Fernández-Garrote, J Alberto San Román","doi":"10.1007/s00330-024-11045-3","DOIUrl":"10.1007/s00330-024-11045-3","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prognostic value of transit time (TT) assessment in the systemic circulation and organ perfusion in patients with ventricular dysfunction (VD). The primary endpoint was defined as death, heart failure admission, or ventricular arrhythmias, and the secondary endpoint was worsening renal function.</p><p><strong>Methods: </strong>A retrospective study on 139 patients who underwent cardiac magnetic resonance for VD evaluation and 50 controls. TT was measured as peak-to-peak time in signal intensity over time curves obtained at different stages of circulation (right cavities, left cavities, aorta, and peripheral organs) from first-pass perfusion images. Outcomes were monitored over a median follow-up of 15 months.</p><p><strong>Results: </strong>A total of 139 patients were included (84% male, age 63 [57-70] years). Patients exhibited significantly prolonged TT compared to controls, with in-patients showing longer times than outpatients. Among the 29 patients reaching the primary endpoint, both PTT and STT were significantly prolonged (PTT: 9.75 s vs 13.4 s, p < 0.01; STT: 4.77 s vs 7.00 s, p < 0.01). Concurrent prolongation of PTT (> 10 s) and STT (> 5 s) was associated with a higher event probability (42.3%), compared to isolated abnormalities (6.3% for PTT, 6.7% for STT). Multivariate analysis revealed that combined PTT and STT alteration independently predicted the combined endpoint (HR IC 95%: 8.685 (2.415-31.236), p = 0.001). Prolonged RPT was independently associated with renal function deterioration (OR IC 95%: 1.129 (1.015-1.256), p = 0.024).</p><p><strong>Conclusions: </strong>Evaluation of TT beyond pulmonary circulation provides prognostic insights into VD. Simultaneous assessment of PTT and STT enhances specificity compared to isolated PTT evaluation, predicting combined adverse events. RPT is independently associated with renal impairment.</p><p><strong>Clinical relevance statement: </strong>For the first time, it is described that transit time can be evaluated in systemic circulation and in peripheral organs and that this assessment can be easily made from conventional CMR perfusion images and holds significant prognostic value.</p><p><strong>Key points: </strong>Pulmonary transit time is a valuable hemodynamic parameter; systemic transit time may also be valuable. Transit time can be measured in the systemic circulation, and is longer in patients with ventricular dysfunction. Systemic transit time assessed by magnetic resonance imaging identifies patients with ventricular dysfunction who will experience events during follow-up.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2180-2188"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}