European Radiology最新文献

{"title":"Muscle atrophy and organ enlargement associated with quality of life during systemic therapy for melanoma: findings from an AI-based body composition analysis.","authors":"Itske Fraterman, Laura Estacio Cerquin, Kelly M de Ligt, Iris van der Loo, Sofie Wilgenhof, Lonneke V van de Poll-Franse, Regina G H Beets-Tan, Renaud L M Tissier, Stefano Trebeschi","doi":"10.1007/s00330-024-11289-z","DOIUrl":"https://doi.org/10.1007/s00330-024-11289-z","url":null,"abstract":"<p><strong>Introduction: </strong>Health-related quality of life (HRQoL) is emerging as an endpoint, adjunct to survival, in cancer treatment. For this reason, the European Organization for Research and Treatment of Cancer (EORTC) has developed standardized quality-of-life questionnaires to collect patient-reported outcome measurement (PROM), which so far have been widely used in clinical trials to evaluate the impact of new drugs on cancer patients. However, while these questionnaires comprehensively describe patient functions, little is known about their association with patient characteristics. This study aims to bridge this gap and investigate the association between patient body composition and HRQoL.</p><p><strong>Materials and methods: </strong>A retrospective cohort of melanoma patients treated with systemic therapy who completed HRQoL questionnaires and had regular imaging follow-ups was included. The primary endpoint was the association between n = 116 AI-measured longitudinal volumes of thoracic and abdominal organs, subcutaneous and visceral fat, skeleton and muscles (estimated by TotalSegmentator), and physical functioning (PF), role functioning (RF) and fatigue (FA) (estimated by the EORTC-QLQ-C30).</p><p><strong>Results: </strong>The n = 358 patients were included. Our findings show larger liver, spleen, and gallbladder volumes associated with decreased PF and RF and an increase in FA (p < 0.05). Furthermore, larger muscle volumes were associated with an increase in PF and RF and a decrease in FA (p < 0.01).</p><p><strong>Discussion: </strong>Our findings show significant associations between AI-measured body and organ analysis and HRQoL in patients with melanoma on systemic treatment. Future research is needed to understand the underlying cause and determine the possible predictive ability of these imaging features.</p><p><strong>Key points: </strong>Question Are changes in body composition associated with changes in HRQoL in melanoma patients undergoing systemic therapy? Findings AI-based body composition analysis shows that larger muscle volumes are linked to improved HRQoL, while organ enlargement is associated with a decline in it. Clinical relevance Our findings indicate new imaging biomarkers that can help monitor patients and evaluate treatment responses. These biomarkers link patient function to physical changes during treatment, offering insights for creating response evaluation criteria that also consider improvements in quality of life.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863798","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":"Reply to the Letter to the Editor: \"Brain Tumor-Radiology and Data System (BT-RADS)-an imperfect system but a worthwhile start\".","authors":"Teodoro Martín-Noguerol, Alberto Cabrera-Zubizarreta, Antonio Luna","doi":"10.1007/s00330-024-11271-9","DOIUrl":"https://doi.org/10.1007/s00330-024-11271-9","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852936","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":"Exploring the value of multiparametric quantitative MRI in the assessment of pancreatic ductal adenocarcinoma fibrosis grading.","authors":"Fangqing Wang, Xinghua Xu, Jianwei Xu, Feng Li, Hui Zhang, Lei Wang, Dexin Yu","doi":"10.1007/s00330-024-11246-w","DOIUrl":"https://doi.org/10.1007/s00330-024-11246-w","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the performance of multiparametric magnetic resonance imaging (MRI) in quantification of pancreatic ductal adenocarcinoma (PDAC) fibrosis grading.</p><p><strong>Method: </strong>This prospective study enrolled 79 patients with PDAC confirmed by pathology. Multiparametric MRI including native T1 mapping, intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), diffusion kurtosis imaging diffusion-weighted imaging (DKI-DWI), and enhanced T1 mapping were performed before surgery. Masson staining was used to evaluate intratumoral fibrosis content and classified into low- and high-fibrosis groups. MRI parameters were compared between the two groups using multivariable logistic regression analysis. The correlations between fibrosis content and MRI parameters were evaluated using Pearson's correlation.</p><p><strong>Results: </strong>D, f, mean diffusion (MD), and enhanced T1 mapping were lower in the high-fibrosis group than in the low-fibrosis group (p < 0.001, p < 0.001, p < 0.001, p = 0.026, respectively). Native T1 mapping and extracellular volume (ECV) were opposite (All p < 0.001). No significant differences in the rest. Multivariable logistic regression revealed that native T1 mapping, MD, and ECV were independent discriminators for PDAC fibrosis grading (p = 0.037, p = 0.031, p = 0.014, respectively); the area under the curve (AUC) of native T1 mapping, MD and ECV was 0.863, 0.798, and 0.929. Among them, ECV had an extremely strong positive correlation with intratumoral fibrosis content. Native T1 mapping and MD were correlated strongly with fibrosis content (positive and negative, respectively).</p><p><strong>Conclusions: </strong>ECV had the highest assessing performance for grading fibrosis in PDAC compared to other MRI parameters, and has the potential to be an imaging biomarker for predicting the fibrosis content of PDAC.</p><p><strong>Key points: </strong>Question The relationship between fibrosis grade of PDAC and quantitative MRI parameters based on T1 mapping and diffusion imaging has not been fully investigated. Findings ECV performed the best in distinguishing between fibrosis grade and increased as interstitial fibrosis increased; clinical indicators offered no added value. Clinical relevance Quantitative MRI parameters provide significant value in evaluating the fibrosis grade of PDAC, which bears significant implications for preoperative risk stratification and the selection of personalized treatment strategies for patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853597","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":"The radiohumeral synovial plica: anatomy, histology, and implications in chronic lateral epicondylitis.","authors":"Jianing Cui, Ping Wang, Wenting Li, Zhanhua Qian, Naili Wang, Lihua Gong, Huili Zhan, Wei Ye, Yuming Yin, Rongjie Bai","doi":"10.1007/s00330-024-11293-3","DOIUrl":"https://doi.org/10.1007/s00330-024-11293-3","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aimed to elucidate synovial plica (SP) of the elbow histological characteristics and the anatomical relationship with adjacent structures. Subsequently, we sought to assess the relationship between SP and clinical symptoms as well as magnetic resonance imaging (MRI) features in patients with chronic lateral epicondylitis.</p><p><strong>Methods: </strong>MRI was performed on eight cadaveric elbows specimens. The MRI findings were compared with those in anatomic sections and histologic preparations. In addition, ninety-nine patients with chronic lateral epicondylitis who underwent preoperative elbow MRI and arthroscopic surgery were included. The patients were divided into SP and without SP groups. The differences in clinical symptoms and MRI features between the two groups were compared.</p><p><strong>Results: </strong>SP is located proximal to the annular ligament that extends into the joint cavity, then moves to the lateral collateral ligament (LCL) complex, and finally attaches to the lateral epicondyle of the elbow along with the common extensor tendon (CET). The SP, ligament, and tendon blend imperceptibly without distinct boundaries. Furthermore, in a study of patients with chronic lateral epicondylitis, we found that compared to the without SP group, patients in the SP group had higher preoperative and 3-week postoperative VAS scores and more severe abnormalities in LCL complex and CET.</p><p><strong>Conclusion: </strong>The SP is distinct from the annular ligament and closely correlates with the LCL complex and CET enthesis at the lateral epicondyle. Chronic lateral epicondylitis patients with SP have more severe abnormalities of the LCL complex and CET, more severe pain, and longer postoperative recovery times.</p><p><strong>Key points: </strong>Question Synovial plica (SP) cause lateral elbow pain, but few studies regarding histological and imaging features of SP and its relationship to chronic lateral epicondylitis exist. Findings The presence of SP leads to more severe common extensor tendon abnormalities and higher visual analog scale scores in patients with chronic lateral epicondylitis. Clinical relevance The combination of magnetic resonance imaging and clinical symptoms to further understand the effect of SP on the clinical symptoms and postoperative recovery in chronic lateral epicondylitis can help refine treatment strategies and improve the prognosis of patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853070","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":"Comparative effectiveness of four techniques for identifying vertebral fragility fractures among elderly patients.","authors":"Hui-Ya Ma, Ren-Jie Zhang, Lu-Ping Zhou, Yan-Xin Wang, Jia-Qi Wang, Cai-Liang Shen, Xiu-Jun Zhang","doi":"10.1007/s00330-024-11292-4","DOIUrl":"https://doi.org/10.1007/s00330-024-11292-4","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of vertebral fragile fractures peaked among the elderly population, and identifying individuals at high risk of vertebral fractures and promptly instituting preventions are of critical importance. This study aims to determine the efficacy and values of Hounsfield unit (HU) values, vertebral bone quality (VBQ) scores, bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), and quantitative computed tomography (QCT) to discriminate between patients with and without vertebral fractures.</p><p><strong>Methods: </strong>A thorough search was conducted across PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, and Wan Fang Database to identify potential studies that met the eligibility criteria. Studies that evaluated the utility of HU values, VBQ scores, QCT-measured BMD, and DXA-measured BMD in discriminating vertebral fractures were qualified.</p><p><strong>Results: </strong>The combined results showed that there were significant differences in HU values, VBQ scores, QCT-measured BMD, and DXA-measured BMD between the fracture and non-fracture groups. Moreover, the pooled sensitivity, specificity, and AUC of HU values were 0.82, 0.67, and 0.76, respectively; the pooled sensitivity, specificity, and AUC of VBQ scores were 0.70, 0.75, and 0.78; the pooled sensitivity, specificity, and AUC of QCT-measured BMD were 0.85, 0.76 and 0.88.</p><p><strong>Conclusion: </strong>All four methods, namely HU values, VBQ scores, QCT-measured BMD, and DXA-measured BMD can effectively distinguish between patients with and without vertebral fragile fractures. Among these, QCT-measured BMD exhibited a relatively high efficacy in discriminating vertebral fractures. VBQ scores and HU values demonstrated comparable efficacy for discriminating vertebral fractures among elderly patients.</p><p><strong>Key points: </strong>Question Can four different imaging modalities effectively discriminate vertebral fragility fracture status among elderly patients? Findings These methods can effectively distinguish vertebral fractures status among elderly patients, and quantitative computed tomography (QCT)-measured bone mineral density (BMD) exhibited a relatively high efficacy. Clinical relevance The clinical applications of Hounsfield unit values, vertebral bone quality scores, and BMD measured by dual-energy X-ray absorptiometry and QCT show promising outcomes in identifying individuals at high risk of vertebral fractures.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853534","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":"Diagnostic accuracy of late iodine enhancement on cardiac CT for myocardial tissue characterization: a systematic review and meta-analysis.","authors":"Marco Gatti, Ovidio De Filippo, Gaia Cura Curà, Veronica Dusi, Umberto Di Vita, Guglielmo Gallone, Arianna Morena, Anna Palmisano, Elettra Pasinato, Andrea Solano, Gaetano Maria De Ferrari, Antonio Esposito, Paolo Fonio, Riccardo Faletti, Fabrizio D'Ascenzo","doi":"10.1007/s00330-024-11283-5","DOIUrl":"https://doi.org/10.1007/s00330-024-11283-5","url":null,"abstract":"<p><strong>Purpose: </strong>to evaluate the diagnostic accuracy of late iodine enhancement (LIE) in cardiac computed tomography (CCT) compared to late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) for myocardial tissue characterization.</p><p><strong>Materials and methods: </strong>EMBASE, PubMed/MEDLINE, and CENTRAL were searched for studies reporting the accuracy of LIE with LGE as the gold standard of reference. QUADAS-2 tool was used to assess the risk of bias. A bivariate random-effects model was used to analyze, pool, and plot the diagnostic performance measurements across studies. Pooled sensitivity, specificity, positive (+LR) and negative (-LR) likelihood ratio, diagnostic odds ratio (DOR), and hierarchical summary ROC curve (HSROC) were computed. Prospero registration number: CRD42023484045.</p><p><strong>Results: </strong>Fourteen studies involving 526 patients and 5758 myocardial segments were included. At the patient level, LIE in CCT showed a pooled sensitivity of 0.96 (95% CI: 0.88-0.99), specificity of 0.95 (95% CI: 0.88-0.98) and the HSROC AUC of 0.98 (95% CI: 0.97-0.99). The +LR was 20.97 (95% CI: 7.54-58.38) and the -LR was 0.04 (95% CI: 0.01-0.13), resulting in a DOR of 535 (95% CI: 94-3024). At the segment level, sensitivity was 0.86 (95% CI: 0.79-0.91), specificity was 0.98 (95% CI: 0.96-0.99), and the HSROC AUC was 0.97 (95% CI:0.95-0.98). The +LR was 55.08 (95% CI: 19.94-152.16) and the -LR was 0.14 (95% CI: 0.09-0.22) with a DOR of 388 (95% CI: 113-1333). Dual-energy CCT improved segment-level sensitivity to 0.93 (95% CI: 0.88-0.96).</p><p><strong>Conclusion: </strong>LIE in CCT shows excellent diagnostic accuracy when compared to LGE in CMR for myocardial tissue characterization, suggesting its potential as a promising alternative to CMR.</p><p><strong>Key points: </strong>Question How does myocardial tissue characterization by late iodine enhancement (LIE) on cardiac CT (CCT) compare to late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR)? Findings LIE in CCT demonstrates excellent diagnostic accuracy, with high sensitivity and specificity at both patient and segment levels, using LGE in CMR as the reference. Clinical relevance LIE in CCT provides a reliable alternative to LGE in CMR, especially for patients for whom CMR is not available or feasible or is contraindicated, thus improving access to myocardial tissue characterization.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863610","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":"Deep learning-based intratumoral and peritumoral features for differentiating ocular adnexal lymphoma and idiopathic orbital inflammation.","authors":"Huachen Zhang, Li Xu, Lijuan Yang, Zhiming Su, Haobei Kang, Xiaoyang Xie, Xuelei He, Hui Zhang, Qiufang Zhang, Xin Cao, Xiaowei He, Tao Zhang, Fengjun Zhao","doi":"10.1007/s00330-024-11275-5","DOIUrl":"https://doi.org/10.1007/s00330-024-11275-5","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the value of deep-learning-based intratumoral and peritumoral features for differentiating ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI).</p><p><strong>Methods: </strong>Nighty-seven patients with histopathologically confirmed OAL (n = 43) and IOI (n = 54) were randomly divided into training (n = 79) and test (n = 18) groups. DL-based intratumoral and peritumoral features were extracted to characterize the differences in heterogeneity and tissue invasion between different lesions, respectively. Subsequently, an attention-based fusion model was employed to fuse the features extracted from intra- and peritumoral regions and multiple MR sequences. A comprehensive comparison was conducted among different methods for extracting intratumoral, peritumoral, and fused features. Area under the curve (AUC) was used to evaluate the performance under a 10-fold cross-validation and independent test. Chi-square and student's t-test were used to compare discrete and continuous variables, respectively.</p><p><strong>Results: </strong>Fused intra-peritumoral features achieved AUC values of 0.870-0.930 and 0.849-0.924 on individual MR sequences in the validation and test sets, respectively. This was significantly higher than those using intratumoral features (p < 0.05), but not significantly different than those using peritumoral features (p > 0.05). By combining multiple MR sequences, AUC values of the intra-peritumoral features were boosted to 0.943 and 0.940, higher than those obtained from each sequence alone. Moreover, intra-peritumoral features yielded higher AUC values compared to entire orbital cone features extracted by either the intra- or the peritumoral DL model, although no significant difference was found from the latter (p > 0.05).</p><p><strong>Conclusion: </strong>DL-based intratumoral, peritumoral, and especially fused intra-peritumoral features may help differentiate between OAL and IOI.</p><p><strong>Key points: </strong>Question What is the diagnostic value of the peritumoral region and its combination with the intratumoral region for radiomic analysis of orbital lymphoproliferative disorders? Findings Fused intra- and peritumoral features achieved significantly higher performance than intratumoral features, but had no significant difference to the peritumoral features. Clinical relevance Peritumoral contextual features, which characterize the invasion patterns of orbital lesions within the surrounding areas of the entire orbital cone, might serve as an independent imaging marker for differentiating between OAL and IOI.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863679","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":"Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2024: imaging immediately after neoadjuvant therapy in soft tissue sarcoma, soft tissue tumor surveillance, and the role of interventional radiology.","authors":"Iris-Melanie Noebauer-Huhmann, Joan C Vilanova, Olympia Papakonstantinou, Marc-André Weber, Radhesh K Lalam, Violeta Vasilevska Nikodinovska, Hatice T Sanal, Frédéric E Lecouvet, Ana Navas, José Martel-Villagrán, Jacky W J de Rooy, Jan Fritz, Koenraad Verstraete, Thomas Grieser, Pavol Szomolanyi, Snehansh Chaudhary, Luca Maria Sconfienza, Alberto S Tagliafico, P Diana Afonso, Omar M Albtoush, Giacomo Aringhieri, Remide Arkun, Gunnar Aström, Alberto Bazzocchi, Rajesh Botchu, Martin Breitenseher, Danoob Dalili, Mark Davies, Milko C de Jonge, Berna D Mete, Jan L M A Gielen, Geoff Hide, Amanda Isaac, Slavcho Ivanoski, Ramy M Mansour, Catherine Mccarthy, Lorenzo Muntaner-Gimbernat, Paul O'Donnell, Şebnem Örgüç, Winston J Rennie, Santiago Resano, Philip Robinson, Simone A J Ter Horst, Kirsten van Langevelde, Klaus Wörtler, Marita Koelz, Joannis Panotopoulos, Reinhard Windhager, Barbara J Fueger, Maximilian Schmid, Filip M Vanhoenacker","doi":"10.1007/s00330-024-11242-0","DOIUrl":"https://doi.org/10.1007/s00330-024-11242-0","url":null,"abstract":"<p><strong>Objectives: </strong>An update of the first European Society of Musculoskeletal Radiology (ESSR) consensus on soft tissue tumor imaging in 2015 became necessary due to technical advancements, further insights into specific entities, and the revised WHO classification (2020) and AJCC staging system (2017). The third part of the revised guidelines covers algorithms and techniques beyond initial imaging: (1) Imaging after neoadjuvant therapy in soft tissue sarcoma, (2) sarcoma surveillance, and (3) special aspects, including surveillance of non-malignant entities and the role of interventional radiology.</p><p><strong>Materials and methods: </strong>A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements that had undergone interdisciplinary revision were scored online by level of agreement (0 to 10) during two iterative rounds that could result in either 'group consensus,' 'group agreement,' or 'lack of agreement.'</p><p><strong>Results: </strong>The three sections contain 47 statements with comments. Group consensus was reached in 91.5%, group agreement in 6.4%, lack of agreement in 2.1%. In sarcoma, imaging immediately after neoadjuvant therapy is pivotal for determining the therapy effects and for resection-planning; surveillance should include imaging at fixed grade- and type-dependent intervals. In general, MRI is the method of choice for loco-regional surveillance of soft tissue sarcomas, and chest CT to assess metastatic disease. Interventional radiology has a role, especially in oligometastatic disease, palliative tumor control and local recurrences.</p><p><strong>Conclusion: </strong>Strategies for standardized soft tissue tumor imaging regarding therapy control, surveillance, and useful interventional procedures are provided.</p><p><strong>Key points: </strong>Question An ESSR consensus update on soft tissue tumor imaging regarding surveillance became necessary due to technical advancements, further entity-specific insights, and revised WHO- and AJCC-classifications. Findings Imaging immediately after neoadjuvant therapy in soft tissue sarcoma is pivotal. Post-therapeutic surveillance should include imaging at regular intervals, stratified for tumor grade and type. Clinical relevance The updated ESSR soft tissue tumor imaging guidelines aim to provide best practice expert consensus for standardized imaging, to support radiologists in their decision-making, and to improve examination comparability, both in individual patients and in future studies on individualized strategies.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852977","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":"Comparison of radiation exposure from dual- and single-energy CT imaging protocols resulting in equivalent contrast-to-noise ratio of lesions for adults and children: a phantom study.","authors":"Nikos Ntoufas, Maria Raissaki, John Damilakis, Kostas Perisinakis","doi":"10.1007/s00330-024-11273-7","DOIUrl":"https://doi.org/10.1007/s00330-024-11273-7","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the radiation exposure from single-energy CT (SECT) against rapid kV-switching dual-energy CT (DECT) imaging in both adults and children when resulting image data offer equivalent lesion identification power.</p><p><strong>Materials and methods: </strong>Lesions in an adult and a 10-year-old-child body phantom were imitated using iodine solutions of different concentrations. Phantoms were subjected to several SECT and DECT thoracic and abdominal scans using a rapid kV-switching DECT scanner. The contrast-to-noise ratio (CNR) of each lesion was measured on resulting SECT images and virtual monoenergetic images (VMI) available from DECT. The SECT scans that resulted in CNR values similar to the maximum CNR observed in VMIs derived from corresponding DECT scans were identified. SECT and DECT scans with equivalent lesion-discriminating power were compared regarding the associated radiation dose burden. Doses to the lung, breast, and esophagus from thoracic imaging and doses to the liver, kidneys, and stomach from abdominal imaging were determined through Monte Carlo simulations of SECT and DECT exposures.</p><p><strong>Results: </strong>Compared to SECT imaging of the adult body phantom, organ doses from DECT were found to be 5-11% lower in thoracic imaging and 44-45% lower in abdominal imaging. Compared to SECT imaging of the 10-year-old body phantom, organ doses from DECT were found to be 2.8-3.4 times higher in thoracic imaging and 1.5-1.6 times higher in abdominal imaging.</p><p><strong>Conclusion: </strong>The use of rapid kV-switching DECT instead of SECT imaging may be associated with a similar or lower dose burden in adults but a noticeably higher dose burden in children.</p><p><strong>Key points: </strong>Question How does the radiation exposure from single-energy and dual-energy CT imaging compare when both techniques provide equivalent lesion identification power? Findings Rapid kV-switching dual-energy CT compared to single-energy CT may result in a similar or lower radiation dose in adults, but higher radiation dose in children. Clinical relevance Rapid kV-switching dual-energy CT imaging in children should be preferred over single-energy CT imaging only in cases where the additional information provided is crucial for an effective diagnosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853546","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":"Optimizing prone CT use for suspected interstitial lung abnormalities.","authors":"Jiyoung Song, Kum Ju Chae, Jong Eun Lee, Masahiro Yanagawa, Jonathan H Chung, David A Lynch, Myoung-Jin Jang, Jin Mo Goo, Soon Ho Yoon","doi":"10.1007/s00330-024-11259-5","DOIUrl":"https://doi.org/10.1007/s00330-024-11259-5","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated whether supine chest CT alone suffices for diagnosing ILAs, thereby reducing the need for prone chest CT.</p><p><strong>Materials and methods: </strong>Patients who underwent prone chest CT for suspected ILAs from January 2021 to July 2023, with matching supine CT within 1 year, were retrospectively evaluated. Five multinational thoracic radiologists independently rated ILA suspicion and fibrosis scores (1 to 5-point) and ILA extent (1-100%) using supine CT first, then combined supine-prone CT after a 1-month washout. We categorized ILA suspicion and fibrosis scores into four diagnostic groups; normal, non-fibrotic, indeterminate-type, and fibrotic ILAs. The areas under the receiver operating characteristic curve (AUCs) of ILA suspicion scores, inter-reader agreement on diagnostic categories, and intra-reader/inter-reader reliability for ILA extent were evaluated.</p><p><strong>Results: </strong>This study included 69 patients (mean age 67.2 ± 7.2 years; 36 women), with 23 age- and sex-matched patients in each group: normal, non-fibrotic ILAs, and fibrotic ILAs. The pooled AUC for ILA suspicion and inter-reader agreement on diagnostic categories improved for non-fibrotic ILAs with prone CT (AUC 0.76 to 0.92, p < 0.001; Fleiss kappa 0.25 to 0.51, p = 0.004), but not for fibrotic ILAs (AUC 0.94 to 0.99, p = 0.06; Fleiss kappa 0.63 to 0.72, p = 0.08). ILA extent was 1-2% smaller with prone CT for both ILA types (p < 0.001).</p><p><strong>Conclusion: </strong>For fibrotic ILAs, supine CT alone exhibited substantial diagnostic accuracy and inter-reader agreement, while the diagnosis of non-fibrotic ILAs benefited from adding prone CT. Supine CT alone slightly overestimated extent regardless of ILA type.</p><p><strong>Key points: </strong>Question Prone CT is recommended when interstitial lung abnormalities (ILAs) are suspected on supine CT, but its benefits remain underexplored. Findings Supine CT alone sufficed for diagnosing fibrotic ILAs, while prone CT improved non-fibrotic ILA diagnosis and reduced extent overestimation for both types. Clinical relevance Omitting prone CT reduces extra time, space, and radiation exposure without compromising the diagnosis of fibrotic ILAs, which have higher rates of progression and mortality risks, enhancing patient comfort and simplifying patient management.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853612","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}