European Radiology最新文献

{"title":"Computer vision-based personal identification using 2D maximum intensity projection CT images.","authors":"Andreas Heinrich, Michael Hubig, Gita Mall, Ulf Teichgräber","doi":"10.1007/s00330-025-11630-0","DOIUrl":"10.1007/s00330-025-11630-0","url":null,"abstract":"<p><strong>Objectives: </strong>Computer vision (CV) mimics human vision, enabling the automatic comparison of radiological images from recent examinations with a vast image database for unique identification. This method offers significant potential in emergencies involving unknown individuals. This study assesses whether maximum intensity projection (MIP) images from thoracic computed tomography (CT) examinations are suitable for automated CV-based personal identification.</p><p><strong>Methods: </strong>The study analyzed 12,465 native CT examinations of the thorax from 8177 individuals, focusing on MIP images to assess their potential for CV-based personal identification in 300 cases. CV automatically identifies and describes features in images, which are then matched to reference images. The number of matching points was used as an indicator of identification accuracy.</p><p><strong>Results: </strong>The identification rate was 98.67% (296/300) at rank 1 and 99.67% (299/300) at rank 10, among over 8177 potential identities. Matching points were higher for images of the same individual (7.43 ± 5.83%) compared to different individuals (0.16 ± 0.14%), with 100% representing the maximum possible matching points. Reliable matching points were mainly found in the thoracic skeleton, sternum, and spine. Challenges arose when the patient was curved on the table or when medical equipment was present in the image.</p><p><strong>Conclusion: </strong>Unambiguous identification based on MIP images from thoracic CT examinations is highly reliable, even for large CV databases. This method is applicable to various 2D reconstructions, provided anatomical structures are comparably represented. Radiology offers extensive reference images for CV databases, enhancing automated personal identification in emergencies.</p><p><strong>Key points: </strong>Question Computer vision-based personal identification holds great potential, but it remains unclear whether maximum intensity projection images from thoracic-CT scans are suitable for this purpose. Findings Maximum intensity projection images of the thorax are highly individual, with computer vision-based identification achieving nearly 100% rank-1 accuracy across a potential 8177 identities. Clinical relevance Radiology holds a vast collection of reference images for a computer vision database, enabling automated personal identification in emergency examinations. This improves patient care and communication with relatives by providing access to medical history.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5900-5910"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980581","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":"Preoperative breast MRI for invasive ductal carcinoma with or without a DCIS component at needle biopsy: influence on surgical outcomes in the MIPA study.","authors":"Andrea Cozzi, Giovanni Di Leo, Nehmat Houssami, Fiona J Gilbert, Thomas H Helbich, Marina Álvarez Benito, Corinne Balleyguier, Massimo Bazzocchi, Peter Bult, Massimo Calabrese, Julia Camps Herrero, Francesco Cartia, Enrico Cassano, Paola Clauser, Marcos F de Lima Docema, Catherine Depretto, Valeria Dominelli, Gábor Forrai, Rossano Girometti, Steven E Harms, Sarah Hilborne, Raffaele Ienzi, Marc B I Lobbes, Claudio Losio, Ritse M Mann, Stefania Montemezzi, Inge-Marie Obdeijn, Umit Aksoy Ozcan, Federica Pediconi, Katja Pinker, Heike Preibsch, José L Raya Povedano, Carolina Rossi Saccarelli, Daniela Sacchetto, Gianfranco P Scaperrotta, Margrethe Schlooz, Botond K Szabó, Donna B Taylor, Sıla Ö Ulus, Mireille Van Goethem, Jeroen Veltman, Stefanie Weigel, Evelyn Wenkel, Chiara Zuiani, Francesco Sardanelli","doi":"10.1007/s00330-025-11572-7","DOIUrl":"10.1007/s00330-025-11572-7","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse the impact of preoperative breast MRI on surgical outcomes of patients diagnosed with pure invasive ductal carcinoma (IDC) or IDC with an associated in situ component (IDC + ductal carcinoma in situ [DCIS]) at needle biopsy.</p><p><strong>Methods: </strong>Patients aged 18-80 years referred for upfront surgery after a diagnosis of pure IDC or IDC + DCIS at needle biopsy were retrieved from the Multicenter International Prospective Analysis (MIPA) database. In each subgroup, patients who underwent preoperative MRI (MRI groups) were matched 1:1 to those who did not (noMRI groups) according to eight confounding covariates. Surgical outcomes were compared with non-parametric statistics after calculating odds ratios (ORs).</p><p><strong>Results: </strong>Among 1051 patients with IDC + DCIS, 510 were retained after matching (255 in each group): in comparison to the noMRI group, the MRI group had significantly higher rates of first-line mastectomy (13.3% vs 6.3%; OR 2.30, p = 0.011) and of overall mastectomy (14.5% vs 7.5%; OR 2.11, p = 0.016), without significantly lowering the reoperation rate (9.4% vs 10.6%, OR 0.88, p = 0.768). Among 2459 patients with pure IDC, 1638 were retained after matching (819 in each group): the first-line mastectomy rate was not significantly higher in the MRI group (12.9% vs 12.1% in the noMRI group; OR 1.08, p = 0.654). Instead, the reoperation rate was significantly lower (2.6% vs 7.9%; OR 3.28 for avoiding reoperation, p < 0.001) with no increase in overall mastectomies (13.6% vs 13.7%: OR 0.99, p = 1.000).</p><p><strong>Conclusions: </strong>In patients with IDC + DCIS, preoperative MRI did not reduce reoperations and increased mastectomies. Conversely, in patients with pure IDC, preoperative MRI reduced reoperations without increasing mastectomies.</p><p><strong>Key points: </strong>Question The impact of preoperative breast MRI on surgical outcomes of patients with IDC at needle biopsy is controversial and lacks large-scale investigations. Findings For pure IDC at needle biopsy, MRI reduced reoperations without increasing mastectomies; for IDC + DCIS, MRI did not reduce reoperations and increased mastectomies. Clinical relevance In patients with IDC at needle biopsy, the decision to perform preoperative breast MRI should take into account the presence of associated DCIS, as the benefits of MRI on surgical outcomes were observed only in patients with pure IDC.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6433-6443"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004966","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":"Intelligent extraction of CT image landmarks for improving cam-type femoroacetabular impingement assessment.","authors":"Sareh Tayyebinezhad, Mansoor Fatehi, Hossein Arabalibeik, Hossein Ghadiri","doi":"10.1007/s00330-025-11901-w","DOIUrl":"https://doi.org/10.1007/s00330-025-11901-w","url":null,"abstract":"<p><strong>Objectives: </strong>Femoroacetabular impingement (FAI) with cam-type morphology is a common hip disorder that can result in groin pain and eventually osteoarthritis. The pre-operative assessment is based on parameters obtained from x-ray or computed tomography (CT) scans, namely alpha angle (AA) and femoral head-neck offset (FHNO). The goal of our study was to develop a computer-aided detection (CAD) system to automatically select the hip region and measure diagnostic parameters from CT scans to overcome the limitations of the tedious and time-consuming process of subjectively selecting CT image slices to obtain parameters.</p><p><strong>Materials and methods: </strong>271 cases of ordinary abdominopelvic CT examination were collected retrospectively from two hospitals between 2018 and 2022, each equipped with a distinct CT scanner. First, a convolution neural network (CNN) was designed to select hip region slices among abdominopelvic CT scan image series. This CNN was trained using 80 CT scans divided into 50%, 20%, and 30% for training, validation and testing groups, respectively. Second, the most appropriate oblique slice passing through the femoral head-neck complex was selected, and AA and FHNO landmarks were calculated using image-processing algorithms. The best oblique slices were selected/measured manually for each hip as ground truth and its related parameters.</p><p><strong>Results: </strong>CT hip-region selection using CNN yielded 99.34% accuracy. Pearson correlation coefficient between manual and automatic parameters measurement were 0.964 and 0.856 for AA and FHNO, respectively.</p><p><strong>Conclusion: </strong>The results of this study are promising for future development of a CAD software application for screening CT scans that may aid physicians to assess FAI.</p><p><strong>Key points: </strong>Question Femoroacetabular impingement is a common, underdiagnosed hip disorder requiring time-consuming image-based measurements. Can AI improve the efficiency and consistency of its radiologic assessment? Findings Automated slice selection and landmark detection using a hybrid AI method improved measurement efficiency and accuracy, with minimal bias confirmed through Bland-Altman analysis. Clinical relevance An AI-based method enables faster, more consistent evaluation of cam-type femoroacetabular impingement in routine CT images, supporting earlier identification and reducing dependency on operator experience in clinical workflows.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198696","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":"Hepatic arterial infusion chemotherapy versus transarterial chemoembolization in patients with unresectable intrahepatic cholangiocarcinoma: a multicenter retrospective cohort study.","authors":"Yi Zhang, Ze Zhang, Xiaoxv Yin, Anhui Xu, Yonghong Hao, Nan Jiang, Ruibing Zhou, Ketao Mu","doi":"10.1007/s00330-025-11557-6","DOIUrl":"10.1007/s00330-025-11557-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with unresectable intrahepatic cholangiocarcinoma (ICC) have poor overall survival (OS). Hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE), including conventional TACE (c-TACE) and drug-eluting bead TACE (DEB-TACE), are widely used to treat ICC, but the efficacy of these therapies has not been fully demonstrated. This study aimed to compare the efficacy of HAIC and TACE in unresectable ICC patients.</p><p><strong>Methods: </strong>This retrospective cohort study included unresectable ICC patients who received HAIC, c-TACE or DEB-TACE as initial treatment between June 2016 and October 2023 at three hospitals. The median OS (mOS), tumor response, and incidence of adverse events (AEs) were compared and propensity score matching (PSM) was used to reduce selection bias.</p><p><strong>Results: </strong>A total of 181 patients with unresectable ICC received HAIC (n = 24), c-TACE (n = 73) and DEB-TACE (n = 84). The HAIC group had significantly higher mOS (10.3 vs. 5.1 months, p = 0.0042), objective response rate (ORR) (29.2% vs. 4.1%, p = 0.002) and disease control rate (DCR) (95.8% vs. 43.8%, p < 0.001) than the c-TACE group. There was no significant difference between the HAIC and DEB-TACE groups in improving mOS (10.3 vs. 12.5 months, p = 0.61). Results remained consistent after PSM. The c-TACE and DEB-TACE groups had a higher incidence of AEs compared with the HAIC group. After matching, there was no significant difference in the incidence of AEs between groups.</p><p><strong>Conclusion: </strong>HAIC improves ICC patient prognosis better than c-TACE. Both HAIC and DEB-TACE are superior treatment options for unresectable ICC.</p><p><strong>Key points: </strong>Question The evidence of comparative effectiveness between hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE) is insufficient. Findings HAIC significantly improved median overall survival, tumor response, and prognosis while reducing adverse events compared to convention TACE (c-TACE) in unresectable intrahepatic cholangiocarcinoma (ICC) patients. Clinical relevance HAIC significantly improves OS and tumor response in patients with unresectable ICC compared to c-TACE, but HAIC shows no significant difference from drug-eluting bead-TACE. Notably, HAIC shows no significant difference in adverse events compared to both c-TACE and DEB-TACE.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6564-6574"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993466","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":"Predicting postresection outcomes in solitary small hepatocellular carcinoma via pretreatment MR imaging features: subgroup analysis according to alpha-fetoprotein expression.","authors":"Wenlong Song, Yang Xu, Jun Zhou, Jiayi Yu, Xiaojing He, Caiming Jiang, Dajing Guo","doi":"10.1007/s00330-025-11558-5","DOIUrl":"10.1007/s00330-025-11558-5","url":null,"abstract":"<p><strong>Objectives: </strong>To develop models including MRI features for predicting recurrence-free survival (RFS) in patients with solitary small hepatocellular carcinoma (SHCC) following curative resection according to alpha-fetoprotein (AFP) expression and for achieving risk stratification.</p><p><strong>Materials and methods: </strong>A total of 201 solitary SHCC patients diagnosed pathologically who underwent MRI were enrolled retrospectively and divided into AFP-negative (n = 85) and AFP-positive (n = 116) SHCC groups. Clinicopathological factors, imaging features, and geometric parameters associated with RFS were determined by univariate and multivariate Cox analyses. Two prognostic models predicting postresection RFS were developed by multivariate Cox proportional hazard model, and their discriminatory ability was evaluated by the concordance index (C-index) and conducted internal validation. Kaplan‒Meier analysis with RFS as the endpoint was used to assess model performance.</p><p><strong>Results: </strong>The predictors of RFS in AFP-negative SHCC included mosaic architecture, portal-venous phase tumor-to-right erector spinae muscle signal intensity ratio, and sphericity, whereas those in AFP-positive SHCC were liver cirrhosis, tumor growth subtype, and asphericity. The C-indexes of the models in predicting RFS in AFP-negative and AFP-positive SHCC were 0.700 and 0.717, respectively. The risk probability calculated with the models stratified the two patient subgroups into two risk groups with significantly different survival outcomes (p < 0.001).</p><p><strong>Conclusion: </strong>Our two prognostic models may assist physicians in stratifying risk and monitoring relapses in patients with AFP-negative or AFP-positive solitary SHCCs.</p><p><strong>Key points: </strong>Question This study explored the predictors of the postresection outcomes of patients with small hepatocellular carcinoma according to the level of alpha-fetoprotein expression. Findings Pretreatment MRI and geometric features can serve as prognostic markers for predicting postoperative recurrence-free survival of small hepatocellular carcinoma with different alpha-fetoprotein expression. Clinical relevance Our models guide clinicians in administering appropriate therapeutic decisions and implementing proper postoperative monitoring regimens in different alpha-fetoprotein expression small hepatocellular carcinoma patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6527-6540"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989878","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 value of MR neurography in assessing lesions of the thoracic dorsal root ganglia in patients with zoster-associated pain.","authors":"Dejun She, Yalan Yan, Junhuan Hong, Dongmei Jiang, Hao Jiang, Ying Zou, Xiance Zhao, Dairong Cao","doi":"10.1007/s00330-025-11575-4","DOIUrl":"10.1007/s00330-025-11575-4","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the imaging characteristics of the thoracic dorsal root ganglia (DRG) in patients with zoster-associated pain (ZAP) using magnetic resonance neurography (MRN) and its correlation with disease stages and serological marker.</p><p><strong>Methods: </strong>Twenty-six consecutive ZAP patients with different disease stages (acute herpes neuralgia, subacute herpes neuralgia, and postherpetic neuralgia) and thirteen healthy subjects were scanned on a 3-T MR scanner for thoracic DRG visualization. The T₁-T₁₂ DRG for each ZAP patient were divided into three groups (prominent affected segment, rash distribution segment, and non-rash distribution segment). The volume and T2 signal intensity (SI) of thoracic DRG were measured and compared. The visual analog scale (VAS) and serological data were also recorded.</p><p><strong>Results: </strong>The volume ratio of prominent affected thoracic DRG in ZAP patients was larger than that in non-rash distribution segment of ZAP patients and that in the healthy group, respectively (both p < 0.05). The volume ratio of affected DRG in the acute herpes neuralgia and subacute herpes neuralgia group was both higher than that in the postherpetic neuralgia group (both p < 0.05). For T2 SI, no differences were found among three disease stages. The ESR index was the only parameter associated with volume ratio of prominent affected DRG segment (r = 0.48, p = 0.01).</p><p><strong>Conclusion: </strong>MRN is able to visualize and identify morphological changes of thoracic DRG of ZAP patients. The imaging characteristics of affected thoracic DRG exhibit differences across different disease stages, which was associated with ESR index in ZAP patients.</p><p><strong>Key points: </strong>Question Magnetic resonance neurography is able to detect the abnormal imaging features of dorsal root ganglia (DRG) in zoster-associated pain patients. Findings Magnetic resonance neurography (MRN) demonstrates a difference in the volume ratio of affected DRG among three disease stages in zoster-associated pain (ZAP) patients. Clinical relevance Combining serological parameter with observed thoracic DRG volume changes on MRN may serve as a viable predictor for ZAP development.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6207-6216"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986269","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":"Effects of antiplatelet therapy on reducing stroke risk in patients with moyamoya disease: the role of postcontrast MR vessel wall imaging.","authors":"Mingming Lu, Hongtao Zhang, Shitong Liu, Yuan Liu, Baobao Li, Fangbin Hao, Peng Peng, Fugeng Sheng, Xihai Zhao, Fei Yuan, Cong Han, Jianming Cai","doi":"10.1007/s00330-025-11562-9","DOIUrl":"10.1007/s00330-025-11562-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of vessel wall enhancement in the efficacy of antiplatelet therapy (APT) on reducing the stroke risk in patients with Moyamoya disease (MMD) based on postcontrast MR vessel wall imaging.</p><p><strong>Methods: </strong>Consecutive patients with MMD underwent postcontrast MR vessel wall imaging and were divided into APT and non-APT groups according to the prescribed antiplatelet agents. Kaplan-Meier survival and Cox regression analyses were performed to determine the association between APT and stroke risk of patients with MMD, and subgroup analysis was performed to determine the role of vessel wall enhancement in reducing stroke risk after APT.</p><p><strong>Results: </strong>A total of 1262 patients (mean age: 42.6 ± 11.1 years) were finally included for analysis. Compared with patients without APT, those with APT were older (p = 0.023) and had a higher incidence of hypertension (p = 0.015), and with advanced Suzuki stage (≥ IV) (p < 0.001). During an average follow-up of 37.9 months, patients without APT had a marginally greater incidence of cerebrovascular events (12.9% vs. 9.7%; HR p = 0.069) than those who underwent APT before and after propensity score matching. The subgroup analyses revealed that vessel wall enhancement had a significant interaction effect on the association between APT and stroke outcomes, and APT could significantly reduce stroke risk in MMD patients with vessel wall enhancement (HR =  0.43; 95% CI: 0.23-0.79, interaction p  = 0.038).</p><p><strong>Conclusion: </strong>APT may significantly reduce stroke risk in patients with MMD with vessel wall enhancement.</p><p><strong>Key points: </strong>Question The effect of antiplatelet therapy (APT) varies in patients with moyamoya disease (MMD). Findings APT may significantly reduce stroke risk for MMD patients with vessel wall enhancement. Clinical relevance Post-contrast high-resolution MRI may help identify MMD patients who would mostly benefit from APT; APT should be highly recommended in MMD patients with vessel wall enhancement.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5911-5921"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963540","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":"Longitudinal MRI in comparison to low-dose CT for follow-up of incidental pulmonary nodules in patients with COPD-a nationwide multicenter trial.","authors":"Lin Zhu, Qian Li, Oyunbileg von Stackelberg, Simon M F Triphan, Jürgen Biederer, Oliver Weinheimer, Monika Eichinger, Claus F Vogelmeier, Rudolf A Jörres, Hans-Ulrich Kauczor, Claus P Heußel, Bertram J Jobst, Hong Yu, Mark O Wielpütz","doi":"10.1007/s00330-025-11567-4","DOIUrl":"10.1007/s00330-025-11567-4","url":null,"abstract":"<p><strong>Purpose: </strong>This multicenter trial was conducted to evaluate MRI for the longitudinal management of incidental pulmonary nodules in heavy smokers.</p><p><strong>Materials and methods: </strong>239 participants (63.9 ± 8.4 years, 43-82 years) at risk of or with COPD GOLDI-IV from 16 centers prospectively underwent two rounds of same-day low-dose computed tomography (LDCT1&2) and MRI1&2 at an interval of three years in the nationwide COSYCONET trial. All exams were independently assessed for incidental pulmonary nodules in a standardized fashion by two blinded readers, incl. axis measurements and Lung-RADS categorization, with consensual LDCT results serving as the standard of reference. A change in diameter ≥ 2 mm was rated as progress. 11 patients underwent surgery for suspicious nodules after the first round.</p><p><strong>Results: </strong>Two hundred twenty-four of two hundred forty nodules (93.3%) persisted from LDCT1 to LDCT2, with a sensitivity of MRI2 of 82.8% and 81.5% for readers 1 and 2, respectively. Agreement in Lung-RADS categories between LDCT2 and MRI2 was substantial in per-nodule (κ = 0.62-0.70) and excellent in a per-patient (κ = 0.86-0.88) approach for both readers, respectively. Concordance between LDCT2 and MRI2 for growth was excellent to almost perfect (κ = 0.88-1.0). The accuracy of LDCT1 and MRI1 for lung cancer was 87.5%. Lung-RADS ≥ 3 category on MRI1 had higher accuracy for predicting progress (23.1% and 21.4%, respectively) than LDCT1 (15.8%).</p><p><strong>Conclusion: </strong>Compared to LDCT, MRI shows similar capabilities for the longitudinal evaluation of incidental nodules in heavy smokers. Decision-making for nodule management guided by Lung-RADS seems feasible based on longitudinal MRI.</p><p><strong>Key points: </strong>Question Can MRI serve as an alternative to low-dose CT (LDCT) for the longitudinal management of pulmonary nodules in heavy smokers, addressing concerns over radiation exposure? Findings MRI demonstrated substantial agreement with LDCT in detecting nodule growth, accurately categorizing Lung-RADS, and comparable accuracy in identifying malignancy over a three-year follow-up. Clinical relevance Longitudinal MRI demonstrates high consistency with LDCT in assessing the growth of incidental pulmonary nodules and categorizing per-patient Lung-RADS, offering a reliable, radiation-free alternative for monitoring and early malignancy detection in high-risk populations.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6336-6349"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974797","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":"Influence of imaging method on fat fraction estimation for assessing bone marrow in metastatic prostate cancer.","authors":"Yassine N Azma, Nada Boci, Katarzyna Abramowicz, Luca Russo, Matthew R Orton, Nina Tunariu, Dow-Mu Koh, Geoffrey Charles-Edwards, David J Collins, Jessica M Winfield","doi":"10.1007/s00330-025-11564-7","DOIUrl":"10.1007/s00330-025-11564-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the accuracy of fat fraction estimation with clinically available Dixon sequences in normal-appearing marrow and bone metastases in the pelvis of metastatic prostate cancer patients.</p><p><strong>Methods: </strong>A prospective single-centre study was conducted with metastatic prostate cancer patients and healthy volunteers. Linearity and bias of fat fraction estimates from clinically available Dixon sequences were assessed against a 6-point PDw gradient echo (q-Dixon) sequence measuring the reference standard proton density fat fraction. Lesion fat fraction estimates were cross-compared using the Friedman test. Repeatability in volunteers was evaluated with Bland-Altman plots. Sensitivity of fat fraction estimates using TSE-Dixon sequences to specific absorption rate (SAR) related modifications were evaluated with correlation plots.</p><p><strong>Results: </strong>Thirty-three patients were recruited for this study. Significant (p < 0.05) absolute bias (12.4%) was demonstrated in the T1-weighted (T1w) Dixon measurements against the q-Dixon. Significant differences (p < 0.05) between fat fraction estimates provided by the T1w Dixon and PDw Dixon sequences were observed in 13 active and 6 treated lesions. Repeatability coefficients for fat fraction estimates ranged from 5.9 to 9.0% in the pelvic tissues of healthy volunteers. Reduction of slice number with repetition time for SAR had the greatest effect, reaching a maximum difference in fat fraction of 14.7% from the q-Dixon for the T2w-TSE Dixon in bone marrow.</p><p><strong>Conclusions: </strong>T1w Dixon methods can detect post-treatment changes but remain confounded by relaxation time biases. While all Dixon methods showed good repeatability, careful choice of SAR-related modifications is critical to maintaining accuracy for PD- and T2-weighted TSE sequences.</p><p><strong>Key points: </strong>Question The clinical validity of signal-weighted fat fraction estimates versus proton density fat fraction for characterising metastatic bone lesions has not been fully assessed. Findings T1-weighted Dixon sequences in line with whole-body MRI international guidelines demonstrate significant fat fraction bias, particularly in lesions and muscle. Clinical relevance Fat fraction estimation using T1-weighted Dixon sequences recommended in international guidelines are highly sensitive to relaxation time biases, making underlying physiological changes potentially ambiguous.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6039-6051"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985882","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":"User requirements for quantitative radiological reports in multiple sclerosis.","authors":"David R van Nederpelt, Zoe C Mendelsohn, Lonneke Bos, Rozemarijn M Mattiesing, Olga Ciccarelli, Jaume Sastre-Garriga, Ferran Prados Carrasco, Joost P A Kuijer, Hugo Vrenken, Joep Killestein, Menno M Schoonheim, Bastiaan Moraal, Tarek Yousry, Giuseppe Pontillo, Àlex Rovira, Eva M M Strijbis, Bas Jasperse, Frederik Barkhof","doi":"10.1007/s00330-025-11544-x","DOIUrl":"10.1007/s00330-025-11544-x","url":null,"abstract":"<p><strong>Objectives: </strong>Quantitative radiological reports (QReports) can enhance clinical management of multiple sclerosis (MS) by including quantitative data from MRI scans. However, the lack of consensus on the specific information to include, on and clinicians' preferences, hinders the adoption of these imaging analysis tools. This study aims to facilitate the clinical implementation of QReports by determining clinicians' requirements regarding their use in MS management.</p><p><strong>Materials and methods: </strong>A four-phase Delphi panel approach was employed, involving neurologists and (neuro)radiologists across Europe. Initial interviews with experts helped develop a questionnaire addressing various QReport aspects. This questionnaire underwent refinement based on feedback and was distributed through the MAGNIMS network. A second questionnaire, incorporating additional questions, was circulated following a plenary discussion at the MAGNIMS workshop in Milan in November 2023. Responses from both questionnaire iterations were collected and analyzed, with adjustments made based on participant feedback.</p><p><strong>Results: </strong>The study achieved a 49.6% response rate, involving 78 respondents. Key preferences and barriers to QReport adoption were identified, highlighting the importance of integration into clinical workflows, cost-effectiveness, educational support for interpretation, and validation standards. Strong consensus emerged on including detailed lesion information and specific brain and spinal cord volume measurements. Concerns regarding report generation time, data protection, and reliability were also raised.</p><p><strong>Conclusion: </strong>While QReports show potential for improving MS management, incorporation of the key metrics and addressing the identified barriers related to cost, validation, integration, and clinician education is crucial for practical implementation. These recommendations for developers to refine QReports could enhance their utility and adoption in clinical practice.</p><p><strong>Key points: </strong>Question A lack of consensus on essential features for quantitative magnetic resonance imaging reports limits their integration into multiple sclerosis management. Findings This study identified key preferences, including detailed lesion information, specific brain and spinal cord measurements, and rigorous validation for effective quantitative reports. Clinical relevance This study identified essential features and barriers for implementing quantitative radiological reports in multiple sclerosis management, aiming to enhance clinical workflows, improve disease monitoring, and ultimately provide better, data-driven care for patients through tailored imaging solutions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5967-5978"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974899","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}