European Radiology最新文献

{"title":"ESR Bridges: imaging of cancers in pregnancy-a multidisciplinary view.","authors":"Gabriele Masselli, Martina Derme, Giuseppe Rizzo, Carlo Catalano","doi":"10.1007/s00330-025-11598-x","DOIUrl":"https://doi.org/10.1007/s00330-025-11598-x","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208024","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":"Automatic patient centering in computed tomography: a systematic review and meta-analysis.","authors":"Yasser H Hadi, Lauren Keaney, Andrew England, Niamh Moore, Mark McEntee","doi":"10.1007/s00330-024-11170-z","DOIUrl":"10.1007/s00330-024-11170-z","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively examine the influence of auto-patient centering technologies on positioning accuracy, radiation dose, image quality, and time efficiency of computed tomography (CT) scans.</p><p><strong>Materials and methods: </strong>A systematic search of peer-reviewed English publications was performed between January 2000 and November 2023 in PubMed, Embase, CINAHL, Scopus, and Web of Science. Two postgraduate students and an academic lecturer independently reviewed the articles to verify adherence to the inclusion criteria. The QUADAS-2 tool was employed to evaluate study quality. We derived summary estimates on positioning accuracy, radiation dose reduction, image quality, and time efficiency using proportion and meta-analysis methodologies.</p><p><strong>Results: </strong>Nine studies were identified comparing automatic and manual CT positioning. Automatic positioning improved accuracy by reducing vertical offsets to 7 mm and 4 mm for thorax and abdominal CTs, compared to 19 mm and 18 mm with manual methods. Most studies showed significant reductions in radiation dose, ranging from 5.71 to 31%. Image quality results were mixed, automatic methods generally produced images with less noise, but differences were minimal. Time efficiency was better, with automatic positioning reducing preparation time from 0.48 min versus 0.67 min for manual positioning.</p><p><strong>Conclusions: </strong>This review confirms that automatic patient-centering technologies enhance positioning accuracy and decrease preparation times in CT scans. While reductions in radiation doses and some improvements in image quality were observed, the evidence remains mixed. Findings support integrating these technologies into clinical practice to optimize patient care.</p><p><strong>Key points: </strong>Question Does automatic patient centering in CT enhance positioning accuracy, reduce radiation exposure, and improve image quality? Findings Findings indicate that automatic centering can optimize image quality, reduce examination times and contribute to overall improvements in imaging efficiency. Clinical relevance Automatic patient centering in CT improves positioning accuracy, minimizes radiation exposure, enhances image quality, and accelerates imaging workflows, contributing to safer, more efficient imaging procedures that benefit patient care.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3486-3498"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681309","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":"ESR Bridges: renal cell carcinoma-a multidisciplinary view.","authors":"Rebeca Mirón Mombiela, Frederik Ferløv Thomsen, Dan Fuglø, Thomas Hasselager, Anne Kirstine Møller","doi":"10.1007/s00330-024-11270-w","DOIUrl":"10.1007/s00330-024-11270-w","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3107-3109"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806089","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":"ESR Essentials: how to get to valuable radiology AI: the role of early health technology assessment-practice recommendations by the European Society of Medical Imaging Informatics.","authors":"Erik H M Kemper, Hendrik Erenstein, Bart-Jan Boverhof, Ken Redekop, Anna E Andreychenko, Matthias Dietzel, Kevin B W Groot Lipman, Merel Huisman, Michail E Klontzas, Frans Vos, Maarten IJzerman, Martijn P A Starmans, Jacob J Visser","doi":"10.1007/s00330-024-11188-3","DOIUrl":"10.1007/s00330-024-11188-3","url":null,"abstract":"<p><p>AI tools in radiology are revolutionising the diagnosis, evaluation, and management of patients. However, there is a major gap between the large number of developed AI tools and those translated into daily clinical practice, which can be primarily attributed to limited usefulness and trust in current AI tools. Instead of technically driven development, little effort has been put into value-based development to ensure AI tools will have a clinically relevant impact on patient care. An iterative comprehensive value evaluation process covering the complete AI tool lifecycle should be part of radiology AI development. For value assessment of health technologies, health technology assessment (HTA) is an extensively used and comprehensive method. While most aspects of value covered by HTA apply to radiology AI, additional aspects, including transparency, explainability, and robustness, are unique to radiology AI and crucial in its value assessment. Additionally, value assessment should already be included early in the design stage to determine the potential impact and subsequent requirements of the AI tool. Such early assessment should be systematic, transparent, and practical to ensure all stakeholders and value aspects are considered. Hence, early value-based development by incorporating early HTA will lead to more valuable AI tools and thus facilitate translation to clinical practice. CLINICAL RELEVANCE STATEMENT: This paper advocates for the use of early value-based assessments. These assessments promote a comprehensive evaluation on how an AI tool in development can provide value in clinical practice and thus help improve the quality of these tools and the clinical process they support. KEY POINTS: Value in radiology AI should be perceived as a comprehensive term including health technology assessment domains and AI-specific domains. Incorporation of an early health technology assessment for radiology AI during development will lead to more valuable radiology AI tools. Comprehensive and transparent value assessment of radiology AI tools is essential for their widespread adoption.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3432-3441"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784787","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":"Loss of pulmonary capillaries in idiopathic pulmonary arterial hypertension with low diffusion capacity is accompanied by early diffuse emphysema detected by ¹²⁹Xe MRI.","authors":"Agilo Luitger Kern, Da-Hee Park, Jan Fuge, Jens M Hohlfeld, Frank Wacker, Marius M Hoeper, Karen M Olsson, Jens Vogel-Claussen","doi":"10.1007/s00330-024-11209-1","DOIUrl":"10.1007/s00330-024-11209-1","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies suggest the existence of an idiopathic pulmonary arterial hypertension (IPAH) phenotype affecting mostly patients with a smoking history, characterised by low diffusion capacity for carbon monoxide (D_LCO) without clinically significant emphysema. This study's objective was to test the hypothesis of a loss of pulmonary capillaries as an underlying mechanism by comparison to other patient groups with and without pulmonary hypertension (PH).</p><p><strong>Materials and methods: </strong>Between March 2019 and June 2023, patients of four groups were recruited for this observational study: IPAH with preserved (1) and low D_LCO (2), combined pulmonary fibrosis and emphysema with PH (3), and emphysema without PH (4). Patients underwent clinical CT and ¹²⁹Xe MRI including dissolved-phase imaging yielding the ratio of ¹²⁹Xe in red blood cells and membrane tissues (RBC-M), chemical shift saturation recovery for determining RBC fraction η and diffusion-weighted imaging yielding surface-volume ratio. Kruskal-Wallis tests were used for statistical analysis.</p><p><strong>Results: </strong>Twenty-nine participants were recruited, of which 22 (age 64 ± 10, 11 male, 5/5/7/5 for the individual groups) could be included in the analysis. RBC-M and η were reduced in IPAH with low versus preserved D_LCO and emphysema groups (p ≤ 0.01). CT low-attenuation area percentage was not increased in IPAH with low D_LCO compared to any group. ¹²⁹Xe MRI-derived surface-volume ratio was reduced in IPAH with low versus preserved D_LCO (p = 0.04).</p><p><strong>Conclusion: </strong>Results are consistent with a loss of pulmonary capillaries in patients with IPAH and low D_LCO along with destruction of alveolar tissue, likely due to early diffuse emphysema.</p><p><strong>Key points: </strong>Question A loss of pulmonary capillaries has been suggested in patients with IPAH and low diffusion capacity without clinically significant emphysema on CT. Findings ¹²⁹Xe uptake in red blood cells and lung surface-volume ratio were reduced in IPAH patients with low compared to preserved diffusion capacity. Clinical relevance This study furthers the understanding of the underlying pathological mechanisms in IPAH with low diffusion capacity, providing evidence that loss of pulmonary capillaries is accompanied by alveolar tissue destruction despite near-normal CT.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3010-3020"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791456","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":"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":"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":"3324-3335"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081562/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic T2 signal intensity loss on MRI is associated with disease burden in multiple myeloma.","authors":"Christian Neelsen, Christos Sachpekidis, Lukas John, Peter Neher, Elias Mai, Martin Grözinger, Daniel Paech, Antonia Dimitrakopoulou-Strauss, Felix T Kurz, Sandra Sauer, Marc S Raab, Heinz-Peter Schlemmer, Markus Wennmann, Niels Weinhold","doi":"10.1007/s00330-024-11191-8","DOIUrl":"10.1007/s00330-024-11191-8","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate correlations between spleen signal changes in different MRI sequences and bone marrow plasma cell infiltration as potential indicator of disease burden in multiple myeloma (MM) patients.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 45 patients with newly diagnosed MM that underwent whole-body MRI with axial DWI at b-values 50 (b50) and 800 (b800), and coronal T1 and T2 fast spin-echo (T2-TSE) imaging. A subcohort of 39 patients had concomitant [¹⁸F]FDG PET/CT. The spleen was segmented in all MRI sequences and signal intensities were normalized. MR signal intensities and ADC values were correlated with bone marrow plasma cell infiltration from biopsy, laboratory markers (Beta 2-microglobulin, M-Protein, Red blood count (RBC), Hemoglobin, Hematocrit, Total protein, Creatinine), clinical data (ISS stages, high-risk chromosomal aberrations), and standardized uptake value (SUV) in the spleen as well as spleen-to-liver and spleen-to-blood pool SUV ratios on [¹⁸F]FDG PET-CT.</p><p><strong>Results: </strong>Bone marrow plasma cell infiltration was negatively correlated with (normalized) mean splenic signal intensity on DWI-b50, DWI-b800, and T2-TSE images (r = -0.64, p < 0.001, r = -0.58, p < 0.001, and r = -0.66, p < 0.001, respectively) while there was no correlation with the apparent diffusion coefficient or spleen size (p = 0.52). In the subgroup analysis of 39 patients with concomitant [¹⁸F]FDG PET-CT, there was no correlation of normalized splenic [¹⁸F]FDG uptake either with MR spleen signal (for T2 p = 0.64) or with bone marrow plasma cell infiltration (p = 0.37).</p><p><strong>Conclusions: </strong>Our findings reveal a significant association between spleen signal intensity especially on normalized T2-weighted images and tumor burden.</p><p><strong>Key points: </strong>Question What changes occur in spleen signal on MRI as tumor load marker changes in multiple myeloma (MM)? Findings Spleen signal intensity, particularly on T2-weighted MRI, negatively correlates with bone marrow plasma cell infiltration and laboratory markers of tumor burden. Clinical relevance Standardized quantification of splenic T2 signal is proposed as a new marker for MM disease burden.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3576-3586"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738823","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":"PI-QUAL version 2 image quality categorisation and inter-reader agreement compared to version 1.","authors":"Kang-Lung Lee, Iztok Caglic, Po-Hsiang Liao, Dimitri A Kessler, Chao-Yu Guo, Tristan Barrett","doi":"10.1007/s00330-024-11233-1","DOIUrl":"10.1007/s00330-024-11233-1","url":null,"abstract":"<p><strong>Objectives: </strong>Prostate imaging quality (PI-QUAL) was developed to standardise the evaluation of prostate MRI quality and has recently been updated to version 2. This study aims to assess inter-reader agreement for PI-QUAL v1 and v2 scores and investigates changes in MRI quality score categories.</p><p><strong>Materials and methods: </strong>The study retrospectively analysed 350 multiparametric MRI (mpMRI) scans. Two expert uroradiologists independently assessed mpMRI quality using PI-QUAL v1 and v2 guidelines. Biparametric MRI (bpMRI) categorisation based on PI-QUAL v2 included only T2WI and diffusion-weighted imaging (DWI) results. Inter-reader agreement was determined using percentage agreement and kappa, and categorisation comparisons were made using the chi-square test.</p><p><strong>Results: </strong>Substantial inter-reader agreement was observed for the overall PI-QUAL v1 score (κ = 0.64) and moderate agreement for v2 mpMRI (κ = 0.54) and v2 bpMRI scores (κ = 0.57). Inter-reader agreements on individual sequences were similar between v1 and v2 (kappa for individual sequences: T2WI, 0.46 and 0.49; DWI, 0.66 and 0.70; DCE, 0.71 and 0.61). Quality levels shifted from predominantly \"optimal\" in v1 (65%) down to \"acceptable\" using v2 (55%); p < 0.001. The addition of DCE increased the proportion of cases with at least \"adequate\" quality at mpMRI (64%) compared to bpMRI (30%); p < 0.001.</p><p><strong>Conclusion: </strong>This study shows consistent inter-reader agreement between PI-QUAL v1 and v2, encompassing overall and individual sequence categorisation. A notable shift from \"optimal\" to \"acceptable\" quality was demonstrated when moving from v1 to v2, with DCE tending improving quality from \"inadequate\" (bpMRI) to \"acceptable\" (mpMRI).</p><p><strong>Key points: </strong>Question What are the agreement levels of image quality of prostate MRI by using PI-QUAL v1 and v2? Findings Inter-reader agreement based on PI-QUAL v1 and v2 is comparable. Dynamic contrast enhancement (DCE) enables an overall shift from inadequate quality (at bpMRI) to acceptable quality (mpMRI). Clinical relevance The inter-reader agreement on PI-QUAL v1 and v2 is equivalent. PI-QUAL v2 assesses prostate bpMRI as well as mpMRI quality. Transitioning from inadequate to acceptable between v2-bpMRI and v2-mpMRI highlights the role of DCE as an \"image quality safety net.\"</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3096-3104"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749590","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":"3-Tesla amide proton transfer-weighted imaging (APT-WI): elevated signal also in tumor mimics.","authors":"Guillaume Hamon, Augustin Lecler, Jean-Christophe Ferré, Pierre Bourdillon, Loïc Duron, Julien Savatovsky","doi":"10.1007/s00330-024-11202-8","DOIUrl":"10.1007/s00330-024-11202-8","url":null,"abstract":"<p><strong>Objectives: </strong>To explore amide proton transfer-weighted imaging (APTwi) for the initial classification of brain masses in clinical practice by systematically reporting APTwi signal intensity (APT-SI) in tumor mimics and brain tumors.</p><p><strong>Materials and methods: </strong>Single-center retrospective analysis (2017-2020) of APTwi in 156 patients (84 men, mean age: 50.9 ± 20) who underwent characterization imaging of a brain mass prior to any treatment, using 3-Tesla MRI. 125/156 (80%) patients presented with brain tumor and 31/156 (20%) with tumor mimics. Regions of interest were manually drawn on 2D axial slices by two readers on APTwi map in lesional and perilesional areas and APT-SI, corresponding to the Magnetization Transfer Ratio asymmetry at 3.5 ppm, was systematically reported. Student's t-test or Wilcoxon-test were used to compare groups of patients.</p><p><strong>Results: </strong>The mean APT-SI in lesional and perilesional areas were significantly higher in tumors compared to tumor mimics: 3% [2.10-4] (median [Q1-Q3]) vs 1.7% [0.80-2.55] (p < 0.001) and 1.9% [1.2-2.80] vs. 1.0% [0.55-2.3] (p < 0.01). There were no differences in mean APT-SI in the tumor core between low and high-grade tumors: 2.5% [1.80-4.0] vs. 3.25% [2.5-4.0]. The mean APT-SI was significantly higher in high-grade glioma compared to low-grade glioma: 3.4% [2.7-4] vs. 2.1% [1.7-2.5] (p < 0.001). Highest mean APT-SI in tumor core were found in mesenchymal tumors (5.83% ± 1.45, mean ± SD), embryonal tumors (5.27% ± 3.5) and meningiomas (4.28% ± 0.70). In tumor mimics, highest mean APT-SI was found in the core of infectious lesions (3.52% ± 0.67).</p><p><strong>Conclusion: </strong>High signal on ATPwi is not exclusive to high-grade brain tumors but can be observed in some tumor mimics and subtypes of low-grade tumors.</p><p><strong>Key points: </strong>Question What is the value of amide proton transfer-weighted imaging (APTwi) in the setting of brain mass classification? Findings High APT-signal intensity in the tumor core of a brain mass could correspond to a high- or low-grade tumor or tumor mimic. Clinical relevance In patients presenting for the initial classification of brain masses, APTwi findings should be interpreted with caution and in conjunction with other MRI parameters, as a high APTwi signal does not necessarily indicate a high-grade tumor.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3558-3567"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727266","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":"Radiomic features add incremental benefit to conventional radiological feature-based differential diagnosis of lung nodules.","authors":"Zhou Liu, Long Yang, JiuPing Liang, Binbin Wen, Zikun He, Yongsheng Xie, Honghong Luo, Qian Yang, Lijian Liu, Dehong Luo, Li Li, Na Zhang","doi":"10.1007/s00330-024-11221-5","DOIUrl":"10.1007/s00330-024-11221-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incremental benefit of adding radiomic features to conventional semantic radiological feature-based differential diagnosis between benign and malignant lung nodules.</p><p><strong>Methods: </strong>From May 2017 to March 2021, 393 patients with 465 pathologically confirmed lung nodules were enrolled with 54 patients with 54 lung nodules as external testing. Based on manually segmented lung nodules, 1409 radiomics features were extracted. Sixteen radiological features were obtained. The least absolute shrinkage and selection operator (LASSO) was used to select the most informative features from the two features set separately. Support vector machine (SVM) and logistic regression (LR) were used to build the models (radiomics model, radiological model, and combined model) with performance compared using the DeLong test.</p><p><strong>Results: </strong>After feature selection, six radiological features, including shape, vascular convergence sign (type III), margin, density, pleural traction sign, and spiculation, and nine radiomics features were selected. In the independent testing and external testing, combined models had significantly higher AUCs than the corresponding radiomic models for both the SVM classifier (AUC: 0.871 vs. 0.773, p = 0.029; 0.810 vs. 0.706, p = 0.037) and LR classifier (AUC: 0.871 vs. 0.742, p = 0.008; 0.828 vs. 0.712, p = 0.044), and the corresponding radiological model for both the SVM classifier (AUC: 0.871 vs. 0.803, p = 0.015; 0.810 vs. 0.730, p = 0.045) and LR classifier (AUC: 0.871 vs. 0.818, p = 0.034; 0.828 vs. 0.756, p = 0.040).</p><p><strong>Conclusion: </strong>Radiomics features could add incremental benefits to the conventional radiological feature-based differential diagnosis.</p><p><strong>Key points: </strong>Question Conventional semantic radiological feature-based differential diagnosis between benign and malignant lung nodules needs further improvement. Findings The model combining radiological features and radiomic features significantly outperforms a radiomic model and a radiological model. Clinical relevance Radiomic features could complement conventional radiological features to improve the differential diagnosis of lung nodules in the clinical setting.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2968-2978"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738819","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}