European Radiology最新文献

{"title":"Site effects in multisite fetal brain MRI: morphological insights into early brain development.","authors":"Xinyi Xu, Cong Sun, Hong Yu, Guohui Yan, Qingqing Zhu, Xianglei Kong, Yibin Pan, Haoan Xu, Tianshu Zheng, Chi Zhou, Yutian Wang, Jiaxin Xiao, Ruike Chen, Mingyang Li, Songying Zhang, Hongjie Hu, Yu Zou, Jingshi Wang, Guangbin Wang, Dan Wu","doi":"10.1007/s00330-024-11084-w","DOIUrl":"10.1007/s00330-024-11084-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate multisite effects on fetal brain MRI. Specifically, to identify crucial acquisition factors affecting fetal brain structural measurements and developmental patterns, while assessing the effectiveness of existing harmonization methods in mitigating site effects.</p><p><strong>Materials and methods: </strong>Between May 2017 and March 2022, T2-weighted fast spin-echo sequences in-utero MRI were performed on healthy fetuses from retrospectively recruited pregnant volunteers on four different scanners at four sites. A generalized additive model (GAM) was used to quantitatively assess site effects, including field strength (FS), manufacturer (M), in-plane resolution (R), and slice thickness (ST), on subcortical volume and cortical morphological measurements, including cortical thickness, curvature, and sulcal depth. Growth models were selected to elucidate the developmental trajectories of these morphological measurements. Welch's test was performed to evaluate the influence of site effects on developmental trajectories. The comBat-GAM harmonization method was applied to mitigate site-related biases.</p><p><strong>Results: </strong>The final analytic sample consisted of 340 MRI scans from 218 fetuses (mean GA, 30.1 weeks ± 4.4 [range, 21.7-40 weeks]). GAM results showed that lower FS and lower spatial resolution led to overestimations in selected brain regions of subcortical volumes and cortical morphological measurements. Only the peak cortical thickness in developmental trajectories was significantly influenced by the effects of FS and R. Notably, ComBat-GAM harmonization effectively removed site effects while preserving developmental patterns.</p><p><strong>Conclusion: </strong>Our findings pinpointed the key acquisition factors in in-utero fetal brain MRI and underscored the necessity of data harmonization when pooling multisite data for fetal brain morphology investigations.</p><p><strong>Key points: </strong>Question How do specific site MRI acquisition factors affect fetal brain imaging? Finding Lower FS and spatial resolution overestimated subcortical volumes and cortical measurements. Cortical thickness in developmental trajectories was influenced by FS and in-plane resolution. Clinical relevance This study provides important guidelines for the fetal MRI community when scanning fetal brains and underscores the necessity of data harmonization of cross-center fetal studies.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1830-1842"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282502","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":"Low dose optimization for total-body 2-[¹⁸F]FDG PET/CT imaging: a single-center study on feasibility based on body mass index stratification.","authors":"Taoying Gu, Siwei Liu, Xiaoguang Hou, Liwei Zhao, Yee Ling Ng, Jingyi Wang, Hongcheng Shi","doi":"10.1007/s00330-024-11039-1","DOIUrl":"10.1007/s00330-024-11039-1","url":null,"abstract":"<p><strong>Objectives: </strong>Implementing personalization protocol in clinical routine necessitates diverse low-dose PET/CT scan protocols. This study explores the clinical feasibility of one-third (1/3) dose regimen and evaluates the diagnostic image quality and lesion detectability of BMI-based 1/3-injection doses for 2-[¹⁸F]FDG PET/CT imaging.</p><p><strong>Methods: </strong>Seventy-four cancer patients underwent total-body 2-[¹⁸F]FDG PET/CT examination, with 37 retrospectively enrolled as full-dose group (3.7 MBq/kg) and 37 prospectively enrolled as the 1/3-dose group (1.23 MBq/kg). The 1/3-dose group was stratified by BMI, with an acquisition time of 5 min (G5), 6 min (G6), and 8 min (G8) for BMI < 25, 25 ≤ BMI ≤ 29, and BMI > 29, respectively. Image quality was subjectively and objectively assessed, and lesion detectability was quantitatively analyzed.</p><p><strong>Results: </strong>Subjective assessments of 1/3-dose and full-dose PET images showed strong agreement among readers (κ > 0.88). In the 1/3-dose group, the Likert scores were above 4. G5, G6, and G8 showed comparable image quality, with G5 demonstrating higher lesion conspicuity than G6 and G8 (p = 0.045). Objective evaluation showed no significant differences in SUV_max, liver SUV_mean and TBR between 1/3- and full-dose groups (p > 0.05). No statistical differences were observed in the SUV_max of primary tumor, SUV_mean of liver and TBR across all BMI categories between the 1/3-dose and full-dose groups. Lesion detection rates showed no significant difference between the 1/3-dose (93.24%, 193/207) and full-dose groups (94.73%, 198/209) (p = 0.520).</p><p><strong>Conclusion: </strong>A BMI-stratified 1/3-dose regimen is a feasible low-dose alternative with clinically acceptable lesion detectability equivalent to full-dose protocol, potentially expanding the applicability of personalized protocols.</p><p><strong>Clinical relevance statement: </strong>This study demonstrated that BMI-stratified 1/3-dose regimens for [¹⁸F]FDG total-body PET/CT yielded equivalent outputs compared to the full-dose regimen, which aligns with clinical needs for personalization in dose and BMI.</p><p><strong>Key points: </strong>Currently, limited personalized low-dose total-body PET/CT protocols are available, particularly for patients with varied BMI. Reducing the radiotracer dose to 1/3 the standard demonstrated comparable image quality and lesion detectability equivalent to full dose. BMI-stratified 1/3-dose regimen is a clinically feasible low-dose alternative.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1881-1893"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105760","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: advanced MR safety in vulnerable patients-practice recommendations by the European Society for Magnetic Resonance in Medicine and Biology.","authors":"Francesco Santini, Michele Pansini, Xeni Deligianni, Maria Eugenia Caligiuri, Edwin H G Oei","doi":"10.1007/s00330-024-11055-1","DOIUrl":"10.1007/s00330-024-11055-1","url":null,"abstract":"<p><p>For every patient, the MR safety evaluation should include the assessment of risks in three key areas, each corresponding to a specific hazard posed by the electromagnetic fields generated by the MR scanner: ferromagnetic attraction and displacement by the static field; stimulation, acoustic noise, and device interaction by the gradient fields; and bulk and focal heating by the radiofrequency field. MR safety guidelines and procedures are typically designed around the \"average\" patient: adult, responsive, and of typical habitus. For this type of patient, we can safely expect that a detailed history can identify metallic objects inside and outside the body, verbal contact during the scan can detect signs of discomfort from heating or acoustic noise, and safety calculations performed by the scanner can prevent hyperthermia. However, for some less common patient categories, these assumptions do not hold. For instance, patients with larger habitus, febrile patients, or pregnant people are more subject to bulk heating and require more conservative MR protocols, while at the same time presenting challenges during positioning and preparation. Other vulnerable categories are infants, children, and patients unable to communicate, who might require screening for ferromagnetic objects with other imaging modalities or dedicated equipment. This paper will provide guidance to implement appropriate safety margins in the workflow and scanning protocols in various vulnerable patient categories that are sometimes overlooked in basic MR safety guidance documents. CLINICAL RELEVANCE STATEMENT: Special care in the implementation of MR safety procedures is of paramount importance in the handling of patients. While most institutions have streamlined operations in place, some vulnerable patient categories require specific considerations to obtain images of optimal quality while minimizing the risks derived by exposure to the MR environment. KEY POINTS: Patients unable to effectively communicate need to be carefully screened for foreign objects. Core temperature management is important in specific patient categories. There are no hard quantitative criteria that make a patient fall into a specific vulnerable category. Protocols and procedures need to be adaptable.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1785-1793"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139713","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":"Speed and efficiency: evaluating pulmonary nodule detection with AI-enhanced 3D gradient echo imaging.","authors":"Sebastian Ziegelmayer, Alexander W Marka, Maximilian Strenzke, Tristan Lemke, Hannah Rosenkranz, Bernadette Scherer, Thomas Huber, Kilian Weiss, Marcus R Makowski, Dimitrios C Karampinos, Markus Graf, Joshua Gawlitza","doi":"10.1007/s00330-024-11027-5","DOIUrl":"10.1007/s00330-024-11027-5","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluating the diagnostic feasibility of accelerated pulmonary MR imaging for detection and characterisation of pulmonary nodules with artificial intelligence-aided compressed sensing.</p><p><strong>Materials and methods: </strong>In this prospective trial, patients with benign and malignant lung nodules admitted between December 2021 and December 2022 underwent chest CT and pulmonary MRI. Pulmonary MRI used a respiratory-gated 3D gradient echo sequence, accelerated with a combination of parallel imaging, compressed sensing, and deep learning image reconstruction with three different acceleration factors (CS-AI-7, CS-AI-10, and CS-AI-15). Two readers evaluated image quality (5-point Likert scale), nodule detection and characterisation (size and morphology) of all sequences compared to CT in a blinded setting. Reader agreement was determined using the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Thirty-seven patients with 64 pulmonary nodules (solid n = 57 [3-107 mm] part-solid n = 6 [ground glass/solid 8 mm/4-28 mm/16 mm] ground glass nodule n = 1 [20 mm]) were analysed. Nominal scan times were CS-AI-7 3:53 min; CS-AI-10 2:34 min; CS-AI-15 1:50 min. CS-AI-7 showed higher image quality, while quality remained diagnostic even for CS-AI-15. Detection rates of pulmonary nodules were 100%, 98.4%, and 96.8% for CS-AI factors 7, 10, and 15, respectively. Nodule morphology was best at the lowest acceleration and was inferior to CT in only 5% of cases, compared to 10% for CS-AI-10 and 23% for CS-AI-15. The nodule size was comparable for all sequences and deviated on average < 1 mm from the CT size.</p><p><strong>Conclusion: </strong>The combination of compressed sensing and AI enables a substantial reduction in the scan time of lung MRI while maintaining a high detection rate of pulmonary nodules.</p><p><strong>Clinical relevance statement: </strong>Incorporating compressed sensing and AI in pulmonary MRI achieves significant time savings without compromising nodule detection or characteristics. This advancement holds clinical promise, enhancing efficiency in lung cancer screening without sacrificing diagnostic quality.</p><p><strong>Key points: </strong>Lung cancer screening by MRI may be possible but would benefit from scan time optimisation. Significant scan time reduction, high detection rates, and preserved nodule characteristics were achieved across different acceleration factors. Integrating compressed sensing and AI in pulmonary MRI offers efficient lung cancer screening without compromising diagnostic quality.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2237-2244"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995559","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":"Survey of CT radiation doses and iodinated contrast medium administration: an international multicentric study.","authors":"Lina Karout, Mannudeep K Kalra","doi":"10.1007/s00330-024-11017-7","DOIUrl":"10.1007/s00330-024-11017-7","url":null,"abstract":"<p><strong>Objective: </strong>To assess the relationship between intravenous iodinated contrast media (ICM) administration usage and radiation doses for contrast-enhanced (CE) CT of head, chest, and abdomen-pelvis (AP) in international, multicenter settings.</p><p><strong>Methods: </strong>Our international (n = 16 countries), multicenter (n = 43 sites), and cross-sectional (ConRad) study had two parts. Part 1: Redcap survey with questions on information related to CT and ICM manufacturer/brand and respective protocols. Part 2: Information on 3,258 patients (18-96 years; M:F 1654:1604) who underwent CECT for a routine head (n = 456), chest (n = 528), AP (n = 599), head CT angiography (n = 539), pulmonary embolism (n = 599), and liver CT examinations (n = 537) at 43 sites across five continents. The following information was recorded: hospital name, patient age, gender, body mass index [BMI], clinical indications, scan parameters (number of scan phases, kV), IV-contrast information (concentration, volume, flow rate, and delay), and dose indices (CTDIvol and DLP).</p><p><strong>Results: </strong>Most routine chest (58.4%) and AP (68.7%) CECT exams were performed with 2-4 scan phases with fixed scan delay (chest 71.4%; AP 79.8%, liver CECT 50.7%) following ICM administration. Most sites did not change kV across different patients and scan phases; most CECT protocols were performed at 120-140 kV (83%, 1979/2685). There were no significant differences between radiation doses for non-contrast (CTDIvol 24 [16-30] mGy; DLP 633 [414-702] mGy·cm) and post-contrast phases (22 [19-27] mGy; 648 [392-694] mGy·cm) (p = 0.142). Sites that used bolus tracking for chest and AP CECT had lower CTDIvol than sites with fixed scan delays (p < 0.001). There was no correlation between BMI and CTDIvol (r² ≤ - 0.1 to 0.1, p = 0.931).</p><p><strong>Conclusion: </strong>Our study demonstrates up to ten-fold variability in ICM injection protocols and radiation doses across different CT protocols. The study emphasizes the need for optimizing CT scanning and contrast protocols to reduce unnecessary contrast and radiation exposure to patients.</p><p><strong>Clinical relevance statement: </strong>The wide variability and lack of standardization of ICM media and radiation doses in CT protocols suggest the need for education and optimization of contrast usage and scan factors for optimizing image quality in CECT.</p><p><strong>Key points: </strong>There is a lack of patient-centric CT protocol optimization taking into consideration mainly patients' size. There is a lack of correlation between ICM volume and CT radiation dose across CT protocol. A ten-fold variation in iodine-load for the same CT protocol in sites suggests a lack of standardization.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1915-1932"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055311","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: arterial vascular access and closure devices-practice recommendations by the Cardiovascular and Interventional Radiological Society of Europe.","authors":"Stavros Spiliopoulos, Spyridon Prountzos, Stavros Grigoriadis, Athanasios Diamantopoulos, Ioannis Paraskevopoulos","doi":"10.1007/s00330-024-11053-3","DOIUrl":"10.1007/s00330-024-11053-3","url":null,"abstract":"<p><p>Vascular access is the initial, very important, step of endovascular procedures. Various access sites include the common femoral artery, brachial artery, radial artery, popliteal artery, and distal tibial vessels (pedal arteries). Successful arterial access requires advanced knowledge of anatomy, as well as proper training and experience. Today, vascular access should be obtained using real-time, ultrasound guidance to reduce access time, patient discomfort, and puncture-related complications including dissection, arteriovenous communication, and bleeding. Nevertheless, high-level evidence to support this recommendation in peripheral procedures is limited and level A data are mainly derived from randomized cardiac trials investigating only radial and femoral access. Vascular closure devices (VCDs) for femoral access can be broadly categorized as active closure devices, compression assist devices, and external/topical hemostasis devices. There is high-level evidence demonstrating that their use is related to less time for ambulation and increased patient satisfaction. However, available data failed to clearly demonstrate a benefit in complications compared to standard manual compression in peripheral endovascular arterial procedures, and thrombotic and infectious complications reported following VCD use remain an issue. Heterogeneity noted in the literature, caused by the vast variety of devices, access sites, sheath sizes, clinical scenarios, and procedures, poses difficulties in data analysis and future study design. As a result, an individualized VCD use is currently suggested for ≥ 5 Fr femoral artery access not only to reduce time to hemostasis and ambulation and to improve patient comfort, but also to reduce bleeding complications in cases of femoral access with increased bleeding risk, deranged coagulation, and large-bore access, though a high level of evidence to support this later recommendation is limited. KEY POINTS: US guidance is strongly recommended for femoral access and is mandatory to obtain more challenging access. The use of VCDs for femoral hemostasis is generally safe, effective, and currently supported by level I evidence. Proper training and correct VCD choice, based on the patient's individual characteristics, are imperative to optimize outcomes.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1858-1867"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119337","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":"Ligamentum teres lesions are associated with compositional and structural hip cartilage degenerative change: region-specific cartilage degeneration.","authors":"Zehra Akkaya, Paula J Giesler, Koren E Roach, Gabby B Joseph, Charles E McCulloch, Upasana U Bharadwaj, Richard B Souza, Sharmila Majumdar, Thomas M Link","doi":"10.1007/s00330-024-11030-w","DOIUrl":"10.1007/s00330-024-11030-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the association between magnetic resonance imaging (MRI)-based ligamentum teres lesions (LTL) and structural hip degeneration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Bilateral 3-T hip MRIs of participants (n = 93 [36 men]; mean age ( ± SD) 51 years ± 15.4) recruited from the community and the orthopedic clinic of a single medical center were included. Clinical and imaging data acquired included hip disability and osteoarthritis outcome scores, semi-quantitative scoring of hip osteoarthritis on MRI (SHOMRI) scores on fluid-sensitive sequences, and cartilage T&lt;sub&gt;1ρ&lt;/sub&gt;/T&lt;sub&gt;2&lt;/sub&gt; compositional sequences. An MRI-based LTL scoring system, incorporating continuity, thickening, and signal intensity, ranging from 0 (normal) to 4 (complete tear) was constructed. Hip morphological features associated with LTL, based on functional or anatomical relationships to LT, were defined. Relationships between MRI-LT scores and SHOMRI, global/regional cartilage T&lt;sub&gt;1ρ&lt;/sub&gt;/T&lt;sub&gt;2&lt;/sub&gt;, and proposed morphological abnormalities and LTL were explored by mixed effects linear and logistic regression models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 82 (46.1%) hips, no pain was documented; 118 (63.4%) and 68 (36.6%) hips were graded as KL-grade ≤ 1 and ≥ 2, respectively. Compared to MRI-LT score = 0 (normal), score = 4 (complete tear) revealed significantly worse subchondral bony degenerative changes for bone marrow lesions (SHOMRI-BML) and subchondral cysts (SHOMRI-sc) (p &lt; 0.001, p = 0.015, respectively). Global acetabular T&lt;sub&gt;1ρ&lt;/sub&gt;, femoral T&lt;sub&gt;2&lt;/sub&gt; were significantly increased for abnormal MRI-LT scores (p-range = 0.005-0.032). Regional analyses revealed significantly increased T&lt;sub&gt;1ρ&lt;/sub&gt;/T&lt;sub&gt;2&lt;/sub&gt; in central acetabular/increased T&lt;sub&gt;2&lt;/sub&gt; in off-central femoral regions (p-range = 0.005-0.046). Pulvinar effusion-synovitis, shallow fovea, and foveal osteophytes were significantly associated with abnormal LT MRI findings (p-range = &lt; 0.001-0.044).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;MRI abnormalities of LT are associated with worse SHOMRI-sc/BML scores, indicative of hip osteoarthritis and higher T&lt;sub&gt;1ρ&lt;/sub&gt; and T&lt;sub&gt;2&lt;/sub&gt; that differ by region. Pulvinar effusion-synovitis and changes in femoral head morphology are associated with LTL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance statement: &lt;/strong&gt;Abnormal ligamentum teres findings identified via MRI are associated with structural degenerative changes of the hip joint and alterations in acetabular and femoral cartilage compositions show spatial differences in relation to LTL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;The clinical significance of common ligamentum teres lesions (LTL) on MRI is not well understood. LTL identified by an MRI-based scoring system is associated with worse biomarkers, indicating more advanced degenerative hip changes. Effusion-synovitis signal at pulvinar, shallow fovea capitis, and foveal osteophytes are associated with LTL on imaging.&lt;/p","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2275-2286"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035595","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":"Reducing energy consumption in musculoskeletal MRI using shorter scan protocols, optimized magnet cooling patterns, and deep learning sequences.","authors":"Saif Afat, Julian Wohlers, Judith Herrmann, Andreas S Brendlin, Sebastian Gassenmaier, Haidara Almansour, Sebastian Werner, Jan M Brendel, Alexander Mika, Christoph Scherieble, Mike Notohamiprodjo, Sergios Gatidis, Konstantin Nikolaou, Thomas Küstner","doi":"10.1007/s00330-024-11056-0","DOIUrl":"10.1007/s00330-024-11056-0","url":null,"abstract":"<p><strong>Objectives: </strong>The unprecedented surge in energy costs in Europe, coupled with the significant energy consumption of MRI scanners in radiology departments, necessitates exploring strategies to optimize energy usage without compromising efficiency or image quality. This study investigates MR energy consumption and identifies strategies for improving energy efficiency, focusing on musculoskeletal MRI. We assess the potential savings achievable through (1) optimizing protocols, (2) incorporating deep learning (DL) accelerated acquisitions, and (3) optimizing the cooling system.</p><p><strong>Materials and methods: </strong>Energy consumption measurements were performed on two MRI scanners (1.5-T Aera, 1.5-T Sola) in practices in Munich, Germany, between December 2022 and March 2023. Three levels of energy reduction measures were implemented and compared to the baseline. Wilcoxon signed-rank test with Bonferroni correction was conducted to evaluate the impact of sequence scan times and energy consumption.</p><p><strong>Results: </strong>Our findings showed significant energy savings by optimizing protocol settings and implementing DL technologies. Across all body regions, the average reduction in energy consumption was 72% with DL and 31% with economic protocols, accompanied by time reductions of 71% (DL) and 18% (economic protocols) compared to baseline. Optimizing the cooling system during the non-scanning time showed a 30% lower energy consumption.</p><p><strong>Conclusion: </strong>Implementing energy-saving strategies, including economic protocols, DL accelerated sequences, and optimized magnet cooling, can significantly reduce energy consumption in MRI scanners. Radiology departments and practices should consider adopting these strategies to improve energy efficiency and reduce costs.</p><p><strong>Clinical relevance statement: </strong>MRI scanner energy consumption can be substantially reduced by incorporating protocol optimization, DL accelerated acquisition, and optimized magnetic cooling into daily practice, thereby cutting costs and environmental impact.</p><p><strong>Key points: </strong>Optimization of protocol settings reduced energy consumption by 31% and imaging time by 18%. DL technologies led to a 72% reduction in energy consumption of and a 71% reduction in time, compared to the standard MRI protocol. During non-scanning times, activating Eco power mode (EPM) resulted in a 30% reduction in energy consumption, saving 4881 € ($5287) per scanner annually.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1993-2004"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145458","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 performance of radiologists in distinguishing post-COVID-19 residual abnormalities from interstitial lung abnormalities.","authors":"Jong Eun Lee, Hyo-Jae Lee, Gyeryeong Park, Kum Ju Chae, Kwang Nam Jin, Eva Castañer, Benoit Ghaye, Jane P Ko, Helmut Prosch, Scott Simpson, Anna Rita Larici, Jeffrey P Kanne, Thomas Frauenfelder, Yeon Joo Jeong, Soon Ho Yoon","doi":"10.1007/s00330-024-11075-x","DOIUrl":"10.1007/s00330-024-11075-x","url":null,"abstract":"<p><strong>Objective: </strong>Distinguishing post-COVID-19 residual abnormalities from interstitial lung abnormalities (ILA) on CT can be challenging if clinical information is limited. This study aimed to evaluate the diagnostic performance of radiologists in distinguishing post-COVID-19 residual abnormalities from ILA.</p><p><strong>Methods: </strong>This multi-reader, multi-case study included 60 age- and sex-matched subjects with chest CT scans. There were 40 cases of ILA (20 fibrotic and 20 non-fibrotic) and 20 cases of post-COVID-19 residual abnormalities. Fifteen radiologists from multiple nations with varying levels of experience independently rated suspicion scores on a 5-point scale to distinguish post-COVID-19 residual abnormalities from fibrotic ILA or non-fibrotic ILA. Interobserver agreement was assessed using the weighted κ value, and the scores of individual readers were compared with the consensus of all readers. Receiver operating characteristic curve analysis was conducted to evaluate the diagnostic performance of suspicion scores for distinguishing post-COVID-19 residual abnormalities from ILA and for differentiating post-COVID-19 residual abnormalities from both fibrotic and non-fibrotic ILA.</p><p><strong>Results: </strong>Radiologists' diagnostic performance for distinguishing post-COVID-19 residual abnormalities from ILA was good (area under the receiver operating characteristic curve (AUC) range, 0.67-0.92; median AUC, 0.85) with moderate agreement (κ = 0.56). The diagnostic performance for distinguishing post-COVID-19 residual abnormalities from non-fibrotic ILA was lower than that from fibrotic ILA (median AUC = 0.89 vs. AUC = 0.80, p = 0.003).</p><p><strong>Conclusion: </strong>Radiologists demonstrated good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA, but careful attention is needed to avoid misdiagnosing them as non-fibrotic ILA.</p><p><strong>Key points: </strong>Question How good are radiologists at differentiating interstitial lung abnormalities (ILA) from changes related to COVID-19 infection? Findings Radiologists had a median AUC of 0.85 in distinguishing post-COVID-19 abnormalities from ILA with moderate agreement (κ = 0.56). Clinical relevance Radiologists showed good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA; nonetheless, caution is needed in distinguishing residual abnormalities from non-fibrotic ILA.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2265-2274"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282501","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 analysis of GPT-4-based ChatGPT's diagnostic performance with radiologists using real-world radiology reports of brain tumors.","authors":"Yasuhito Mitsuyama, Hiroyuki Tatekawa, Hirotaka Takita, Fumi Sasaki, Akane Tashiro, Satoshi Oue, Shannon L Walston, Yuta Nonomiya, Ayumi Shintani, Yukio Miki, Daiju Ueda","doi":"10.1007/s00330-024-11032-8","DOIUrl":"10.1007/s00330-024-11032-8","url":null,"abstract":"<p><strong>Objectives: </strong>Large language models like GPT-4 have demonstrated potential for diagnosis in radiology. Previous studies investigating this potential primarily utilized quizzes from academic journals. This study aimed to assess the diagnostic capabilities of GPT-4-based Chat Generative Pre-trained Transformer (ChatGPT) using actual clinical radiology reports of brain tumors and compare its performance with that of neuroradiologists and general radiologists.</p><p><strong>Methods: </strong>We collected brain MRI reports written in Japanese from preoperative brain tumor patients at two institutions from January 2017 to December 2021. The MRI reports were translated into English by radiologists. GPT-4 and five radiologists were presented with the same textual findings from the reports and asked to suggest differential and final diagnoses. The pathological diagnosis of the excised tumor served as the ground truth. McNemar's test and Fisher's exact test were used for statistical analysis.</p><p><strong>Results: </strong>In a study analyzing 150 radiological reports, GPT-4 achieved a final diagnostic accuracy of 73%, while radiologists' accuracy ranged from 65 to 79%. GPT-4's final diagnostic accuracy using reports from neuroradiologists was higher at 80%, compared to 60% using those from general radiologists. In the realm of differential diagnoses, GPT-4's accuracy was 94%, while radiologists' fell between 73 and 89%. Notably, for these differential diagnoses, GPT-4's accuracy remained consistent whether reports were from neuroradiologists or general radiologists.</p><p><strong>Conclusion: </strong>GPT-4 exhibited good diagnostic capability, comparable to neuroradiologists in differentiating brain tumors from MRI reports. GPT-4 can be a second opinion for neuroradiologists on final diagnoses and a guidance tool for general radiologists and residents.</p><p><strong>Clinical relevance statement: </strong>This study evaluated GPT-4-based ChatGPT's diagnostic capabilities using real-world clinical MRI reports from brain tumor cases, revealing that its accuracy in interpreting brain tumors from MRI findings is competitive with radiologists.</p><p><strong>Key points: </strong>We investigated the diagnostic accuracy of GPT-4 using real-world clinical MRI reports of brain tumors. GPT-4 achieved final and differential diagnostic accuracy that is comparable with neuroradiologists. GPT-4 has the potential to improve the diagnostic process in clinical radiology.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1938-1947"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092549","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}