European Radiology最新文献

{"title":"Diagnostic accuracy and inter-reader agreement of the nacVI-RADS for bladder cancer treated with neoadjuvant chemotherapy: a prospective validation study.","authors":"Ailin Dehghanpour, Martina Pecoraro, Emanuele Messina, Ludovica Laschena, Antonella Borrelli, Simone Novelli, Daniele Santini, Giuseppe Simone, Rossano Girometti, Valeria Panebianco","doi":"10.1007/s00330-024-11327-w","DOIUrl":"10.1007/s00330-024-11327-w","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim was to determine the performance of neoadjuvant chemotherapy VI-RADS (nacVI-RADS) in predicting response to systemic therapy in patients with MIBC and to evaluate its inter-reader agreement.</p><p><strong>Materials and methods: </strong>Prospective study, including patients with non-metastatic muscle-invasive bladder cancer (MIBC) who underwent neoadjuvant chemotherapy before radical cystectomy (RC). Patients underwent pre- and post-treatment MRI. Radiological response was evaluated by two experienced radiologists using nacVI-RADS scoring system. Reference standard was defined using histopathological findings. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were calculated to assess nacVI-RADS performance for each reader. Inter-reader agreement was determined with Cohen's k statistics.</p><p><strong>Results: </strong>Fifty-five patients with non-metastatic MIBC, 46 males (84%) and 9 females (16%) with a median age of 69 (interquartile range (IQR) 66-72 years) were enrolled. Diagnostic performance of nacVI-RADS in detecting complete response to neoadjuvant chemotherapy showed a sensitivity of 76.5-85.3% and specificity of 76.2-81%. The area under the curve was 0.93 (95% CI: 0.86-0.99) for detecting any residual tissue, for the more experienced reader. Inter-reader agreement was optimal with a K of 0.85. In the multivariable logistic regression model, the variables showing independent correlation with response prediction to neoadjuvant therapy were nacVI-RADS score (p = 0.01 for the more experienced reader) and tumor regression grade (TRG; p < 0.001).</p><p><strong>Conclusion: </strong>NacVI-RADS scoring system offers a reliable and reproducible approach, employing a well-structured and easily interpretable method, to assess the response to systemic therapy in patients with MIBC.</p><p><strong>Key points: </strong>Question There is a lack of a standardized approach to distinguish between responders and non-responders to neoadjuvant chemotherapy for muscle-invasive bladder cancer. Findings The neoadjuvant chemotherapy VI-RADS (nacVI-RADS) score diagnostic performance for detecting complete response to neoadjuvant chemotherapy showed 85.3% sensitivity, 81% specificity, and an AUC of 0.93. Clinical relevance NacVI-RADS score represents a valid predictor of response to neoadjuvant systemic therapy, impacting therapeutic decision-making and improving overall patients' management.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4016-4026"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909473","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":"Discordance between prostate MRI and PSMA-PET/CT: the next big challenge for primary prostate tumor assessment?","authors":"Sungmin Woo, Anton S Becker, Doris Leithner, Marius E Mayerhoefer, Kent P Friedman, Angela Tong, David R Wise, Samir S Taneja, Michael J Zelefsky, Hebert A Vargas","doi":"10.1007/s00330-025-11358-x","DOIUrl":"10.1007/s00330-025-11358-x","url":null,"abstract":"<p><strong>Objectives: </strong>An increasing number of patients with prostate cancer (PCa) undergo assessment with magnetic resonance imaging (MRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT). This offers comprehensive multimodality staging but can lead to discrepancies. The objective was to assess the rates and types of discordance between MRI and PSMA-PET/CT for primary PCa assessment.</p><p><strong>Materials and methods: </strong>Consecutive men diagnosed with intermediate and high-risk PCa who underwent MRI and PSMA-PET/CT in 2021-2023 were retrospectively included. MRI and PSMA-PET/CT were interpreted using PI-RADS v2.1 and PRIMARY scores. Discordances between the two imaging modalities were categorized as \"minor\" (larger or additional lesion seen on one modality) or \"major\" (positive on only one modality or different index lesions between MRI and PSMA-PET/CT) and reconciled using radical prostatectomy or biopsy specimens.</p><p><strong>Results: </strong>Three hundred and nine men (median age 69 years, interquartile range (IQR) 64-75) were included. Most had Gleason Grade Group ≥ 3 PCa (70.9% (219/309)). Median PSA was 9.0 ng/mL (IQR 5.6-13.6). MRI and PSMA-PET/CT were concordant in 157/309 (50.8%) and discordant in 152/309 (49.1%) patients; with 39/152 (25.7%) major and 113/152 (74.3%) minor discordances. Of 27 patients with lesions only seen on MRI, 85.2% (23/27) were clinically significant PCa (csPCa). Of 23 patients with lesions only seen on PSMA-PET/CT, 78.3% (18/23) were csPCa. Altogether, lesions seen on only one modality were csPCa in 80.0% (36/45).</p><p><strong>Conclusion: </strong>MRI and PSMA-PET/CT were discordant in half of patients for primary PCa evaluation, with major discrepancies seen in roughly one out of eight patients.</p><p><strong>Key points: </strong>Question While both MRI and PSMA-PET/CT can be used for primary tumor assessment, the discordances between them are not well established. Findings MRI and PSMA-PET/CT were discordant in about half of the patients. Most prostate lesions seen on only one modality were significant cancer. Clinical relevance MRI and PSMA-PET/CT are often discordant for assessing the primary prostate tumor. Using both modalities for primary prostate tumor evaluation can provide complementary information that may substantially impact treatment planning.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4043-4054"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032708","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":"Repeatability of AI-based, automatic measurement of vertebral and cardiovascular imaging biomarkers in low-dose chest CT: the ImaLife cohort.","authors":"Iris Hamelink, Marcel van Tuinen, Thomas C Kwee, Peter M A van Ooijen, Rozemarijn Vliegenthart","doi":"10.1007/s00330-024-11328-9","DOIUrl":"10.1007/s00330-024-11328-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the repeatability of AI-based automatic measurement of vertebral and cardiovascular markers on low-dose chest CT.</p><p><strong>Methods: </strong>We included participants of the population-based Imaging in Lifelines (ImaLife) study with low-dose chest CT at baseline and 3-4 month follow-up. An AI system (AI-Rad Companion chest CT prototype) performed automatic segmentation and quantification of vertebral height and density, aortic diameters, heart volume (cardiac chambers plus pericardial fat), and coronary artery calcium volume (CACV). A trained researcher visually checked segmentation accuracy. We evaluated the repeatability of adequate AI-based measurements at baseline and repeat scan using Intraclass Correlation Coefficient (ICC), relative differences, and change in CACV risk categorization, assuming no physiological change.</p><p><strong>Results: </strong>Overall, 632 participants (63 ± 11 years; 56.6% men) underwent short-term repeat CT (mean interval, 3.9 ± 1.8 months). Visual assessment showed adequate segmentation in both baseline and repeat scan for 98.7% of vertebral measurements, 80.1-99.4% of aortic measurements (except for the sinotubular junction (65.2%)), and 86.0% of CACV. For heart volume, 53.5% of segmentations were adequate at baseline and repeat scans. ICC for adequately segmented cases showed excellent agreement for all biomarkers (ICC > 0.9). Relative difference between baseline and repeat measurements was < 4% for vertebral and aortic measurements, 7.5% for heart volume, and 28.5% for CACV. There was high concordance in CACV risk categorization (81.2%).</p><p><strong>Conclusion: </strong>In low-dose chest CT, segmentation accuracy of AI-based software was high for vertebral, aortic, and CACV evaluation and relatively low for heart volume. There was excellent repeatability of vertebral and aortic measurements and high concordance in overall CACV risk categorization.</p><p><strong>Key points: </strong>Question Can AI algorithms for opportunistic screening in chest CT obtain an accurate and repeatable result when applied to multiple CT scans of the same participant? Findings Vertebral and aortic analysis showed accurate segmentation and excellent repeatability; coronary calcium segmentation was generally accurate but showed modest repeatability due to a non-electrocardiogram-triggered protocol. Clinical relevance Opportunistic screening for diseases outside the primary purpose of the CT scan is time-consuming. AI allows automated vertebral, aortic, and coronary artery calcium (CAC) assessment, with highly repeatable outcomes of vertebral and aortic biomarkers and high concordance in overall CAC categorization.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3833-3841"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946749","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":"Left atrial functional impairment as a predictor of atrial fibrillation: insights from cardiac CT.","authors":"Doron Aronson, Daniel Perlow, Sobhi Abadi, Jonathan Lessick","doi":"10.1007/s00330-025-11348-z","DOIUrl":"10.1007/s00330-025-11348-z","url":null,"abstract":"<p><strong>Objectives: </strong>A strong association exists between left atrial (LA) structural remodeling and the development of atrial fibrillation (AF). The role of LA function in AF prediction remains unclear. We studied the relationship between LA function and incident AF using cardiac CT.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed patients who underwent multiphasic cardiac CT. LA volumes and parameters of LA global, reservoir and booster function were calculated. The association between measures of LA function and incident AF was analyzed using multivariable Cox regression adjusting for clinical variables, LA volume and left ventricular function.</p><p><strong>Results: </strong>1025 patients (age 64 years ± 14) were evaluated. Over a median of 3.9 years, 90 patients developed AF. There was a significant association between LA total emptying fraction (adjusted hazard ratio (HR) 1.05; 95% CI: 1.02-1.05 per 1% decrease, p < 0.001), LA reservoir function (HR 1.04; 95% CI: 1.02-1.06 per 1 mL/m² decrease in LA expansion index, p < 0.001) and passive LA emptying (HR 1.08; 95% CI: 1.03-1.13 per 1% decrease in LA passive emptying fraction, p < 0.001) with incident AF, but no association with LA booster function. Incorporating LA function into predictive models improved risk stratification beyond clinical variables and LA volume. Mediation analysis demonstrated that 46% of the effect of LA volume on AF was mediated via LA dysfunction.</p><p><strong>Conclusion: </strong>LA functional impairment is common even in patients with normal LA volume and provides additional prognostic information for AF risk. The findings underscore the significance of LA mechanical dysfunction in the pathogenesis of AF.</p><p><strong>Key points: </strong>Question A strong association exists between left atrial structural remodeling and incident atrial fibrillation. The role of left atrial function in atrial fibrillation prediction remains unclear. Findings Left atrial reservoir and passive emptying function (but not booster function) predict incident atrial fibrillation independent of left atrial volume and clinical risk factors. Clinical relevance Left atrial functional impairment precedes the development of atrial fibrillation. Measures of left atrial reservoir and passive emptying function are independent predictors of incident atrial fibrillation.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3907-3916"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI features that predict progression of residual disease after ablation of extra-abdominal desmoid fibromatosis.","authors":"Daniel M Düx, Yosef Chodakiewitz, Rachelle Bitton, Sharmila Sewell, Vipul R Sheth, Pejman Ghanouni, Ryan L Brunsing","doi":"10.1007/s00330-024-11319-w","DOIUrl":"10.1007/s00330-024-11319-w","url":null,"abstract":"<p><strong>Objective: </strong>To identify MRI features of desmoid tumors (DTs) that predict the growth of residual disease following ablation.</p><p><strong>Methods: </strong>Patients who underwent MRI-guided ablation for DTs between February 2013 and April 2021 were included in this single-center IRB-approved retrospective study. MRI scans assessed three suspicious tissue features: intermediate T2 signal [+iT2], nodular appearance [+NOD], and contrast enhancement [+ENH]. Percent-monthly change in diameter (PMCD) of suspicious foci determined growth (PMCD > 1%), unchanged (PMCD between -1% and +1%), or regression (PMCD < -1%). Statistical tests compared mean PMCD between groups and evaluated sensitivity and specificity.</p><p><strong>Results: </strong>Thirty-three patients (32 years ± 13.3; 22 females) with 34 DTs underwent 47 MRI-guided ablations, with a median follow-up of 269 days (IQR 147). Of 93 suspicious foci, 62 (67%) grew (PMCD: +5.6% IQR: 5.8), 13 (14%) remained unchanged (PMCD: -0.1% IQR: 0.6), and 18 (19%) regressed (PMCD: -3.9% IQR: 4.2). Features [+iT2], [+ENH], and [+NOD] were associated with PMCDs of +5.2% IQR: 6.0, +3.4% IQR: 6.0, and +3.4% IQR: 6.5, respectively, compared to -1.5% IQR: 4.7 (p < 0.0001), -0.5% IQR: 0.8 (p = 0.003), and +0.4% IQR: 7.5 (p = 0.0056) for their respective negative counterparts. Sensitivity, specificity, and accuracy for distinguishing growth were [+iT2]: 0.95, 0.71, 0.87, [+ENH]: 1.00, 0.32, 0.77, and [+NOD]: 0.84, 0.42, 0.70. Combining [+iT2 + NOD + ENH] yielded PMCD +5.9% IQR: 6.2 and the best performance for distinguishing growth (sensitivity 0.81, specificity 0.94, accuracy 0.85).</p><p><strong>Discussion: </strong>MRI features reliably predict the growth of residual or recurrent DTs post-ablation, with [+iT2] being the most accurate. Adding nodular enhancement to [+iT2] improved specificity without sacrificing accuracy.</p><p><strong>Key points: </strong>Question Post-ablation imaging of desmoids is challenging due to tumor heterogeneity and treatment-related inflammation. This study evaluates MRI features for assessing future tumor growth. Findings Foci of intermediate T2 signal post-ablation predicted desmoid growth with high sensitivity (0.95), while T2 signal, nodularity, and enhancement combined offer high specificity (0.94). Clinical relevance Intermediate T2 signal predicts desmoid tumor growth post-ablation with high sensitivity and accuracy but moderate specificity. Combining nodularity and enhancement improves specificity and predictive value, helping clinicians in managing desmoid tumor patients post-ablation.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4161-4170"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002371","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":"Baseline PSMA PET/CT parameters predict overall survival and treatment response in metastatic castration-resistant prostate cancer patients.","authors":"Fleur Kleiburg, Lioe-Fee de Geus-Oei, Romy Spijkerman, Wyanne A Noortman, Floris H P van Velden, Srirang Manohar, Frits Smit, Frank A J Toonen, Saskia A C Luelmo, Tom van der Hulle, Linda Heijmen","doi":"10.1007/s00330-025-11360-3","DOIUrl":"10.1007/s00330-025-11360-3","url":null,"abstract":"<p><strong>Objective: </strong>Metastatic castration-resistant prostate cancer (mCRPC) is a heterogeneous disease with varying survival outcomes. This study investigated whether baseline PSMA PET/CT parameters are associated with survival and treatment response.</p><p><strong>Methods: </strong>Sixty mCRPC patients underwent [¹⁸F]PSMA-1007 PET/CT before treatment with androgen receptor-targeted agents (ARTAs) or chemotherapy. Intensity-based parameters, volumetric parameters, metastatic sites and DmaxVox (distance between the two outermost voxels) from baseline PSMA PET/CT were collected, as well as age, Gleason score and laboratory parameters. Cox regression analysis evaluated their prognostic value for overall survival (OS). Additionally, a preliminary lesion-level analysis was done (n = 241 lesions) with lesion location and twelve radiomic features selected from previous literature. Logistic regression evaluated their association with PSMA PET/CT-based lesion progression after 3-4 months of treatment.</p><p><strong>Results: </strong>Total tumour volume (PSMA-TV) (HR = 1.41 per doubling [1.17-1.70]), total lesion uptake (TL-PSMA) (HR = 1.40 per doubling [1.16-1.69]) and DmaxVox (HR = 1.31 per 10 cm increase [1.07-1.62]) were prognostic for OS, each independent of baseline PSA level (HR = 0.82 per doubling [0.68-0.98]), haemoglobin level (HR = 0.68 per mmol/L increase [0.49-0.95]) and line of treatment. On lesion-level, location (prostate vs bone OR = 0.23 [0.06-0.83]) and SUV_mean (OR = 1.72 per doubling [1.08-2.75]) were independent prognostic markers for lesion progression, morphological and texture-based radiomic features were not.</p><p><strong>Conclusion: </strong>Baseline PSMA PET/CT scans have prognostic value in mCRPC patients and can potentially aid in treatment decision-making. DmaxVox can serve as a simpler alternative to PSMA-TV when automated segmentation software is not available. When combined with PSMA-TV, lower PSA levels indicated worse OS, which may be a marker of tumour dedifferentiation. Further research is needed to validate these models in larger patient cohorts.</p><p><strong>Key points: </strong>Question mCRPC is a highly heterogeneous disease, requiring good prognostic markers. Findings PSMA-TV was the best independent prognostic marker for OS; maximum distance between lesions (DmaxVox) can be used as a simpler alternative. Clinical relevance Baseline PSMA PET/CT parameters representing tumour burden were independently associated with OS in mCRPC patients, providing prognostic insights for clinical decision-making. Although PSMA-TV was the best prognostic marker, DmaxVox can serve as an easier to obtain alternative.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4223-4232"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022588","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":"Deep learning for forensic age estimation using orthopantomograms in children, adolescents, and young adults.","authors":"Rahel Mara Koch, Hans-Joachim Mentzel, Andreas Heinrich","doi":"10.1007/s00330-025-11373-y","DOIUrl":"10.1007/s00330-025-11373-y","url":null,"abstract":"<p><strong>Objectives: </strong>Forensic age estimation from orthopantomograms (OPGs) can be performed more quickly and accurately using convolutional neural networks (CNNs), making them an ideal extension to standard forensic age estimation methods. This study evaluates improvements in forensic age prediction for children, adolescents, and young adults by training a custom CNN from a previous study, using a larger, diverse dataset with a focus on dental growth features.</p><p><strong>Methods: </strong>21,814 OPGs from 13,766 individuals aged 1 to under 25 years were utilized. The custom CNN underwent 1000 epochs of training and validation using 16,000 and 4000 OPGs, respectively. The best model was chosen by the least mean absolute error (MAE) and evaluated with an additional test dataset of 1814 independent OPGs. Furthermore, the CNN was applied to OPGs from 15 available forensic age estimations conducted by experts certified by the Study Group on Forensic Age Diagnostics (AGFAD), and the results were compared.</p><p><strong>Results: </strong>A MAE of 0.93 ± 0.81 years and a mean-signed error (MSE) of -0.06 ± 1.23 years were achieved in the test dataset. 63% of predictions were accurate within 1 year, and 95% within 2.5 years. Results of the CNN were comparable to those obtained by experts, effectively highlighting discrepancies in the reported ages of individuals.</p><p><strong>Conclusion: </strong>Using a large and diverse dataset along with custom deep learning techniques, forensic age estimation can be significantly improved, often providing predictions accurate to within 1 year. This approach offers a reliable, robust, and objective complement to standard forensic age estimation methods.</p><p><strong>Key points: </strong>Question The potential of custom convolutional neural networks for forensic age estimation, along with a large, diverse dataset, warrants further investigation, offering valuable support to experts. Findings For 1814 test-orthopantomograms, 63% of predictions were accurate within 1 year and 95% within 2.5 years, similar to expert estimates in 15 forensic cases. Clinical relevance Many individuals' fates depend on accurate age estimation. Forensic age estimation can benefit from applying CNN-based methods to further enhance reliability and accuracy.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4191-4202"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037715","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":"Reproducibility of liver iron concentration measured by R2* method based on 1.5-T MRI: a meta-analysis.","authors":"Sue Cao, Jie Zhang, Chenyu Dong, Yutao Que, Xin Gao, Ruomi Guo","doi":"10.1007/s00330-024-11334-x","DOIUrl":"10.1007/s00330-024-11334-x","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the reproducibility of the 1.5-T MR imaging (MRI)-based R2* method in measuring the liver iron concentration (LIC) across different MRI scanners, scan parameters, and postprocessing techniques.</p><p><strong>Materials and methods: </strong>We performed a systematic search of the PubMed, Embase, Medline, Cochrane Library, and Web of Science databases and identified studies that used the 1.5-T MRI-based R2* method to measure the LIC. The original data were extracted from the selected studies. Reproducibility was assessed in terms of the ability to replicate the measured LIC with the 1.5-T MRI-based R2* method across different scanning instruments, scan parameters, and postprocessing techniques. We used the scanner equipment, scan parameters, and postprocessing technique as random effects to determine whether the R2* values obtained in the different studies were significantly different after the effects of the measured LIC were excluded. The calibration curve that best fit the R2* value to the LIC was estimated via univariate regression.</p><p><strong>Results: </strong>Twenty-one studies (1147 participants) were included. The seven studies (435 participants) in which the initial TE was ≤ 1.0 ms and the TE spacing was ≤ 1.4 ms did not have significant differences in the measured R2* value in pairwise comparisons (p > 0.05). Calibration of R2* to LIC was as follows: LIC (mg/g) = 0.042 + 2.85 × 10^-2 R2* (s^-¹) (R² = 0.79).</p><p><strong>Conclusion: </strong>The 1.5-T MRI-based R2* method in estimating LIC was reproducible across different MRI scanners, scan parameters, and postprocessing techniques.</p><p><strong>Key points: </strong>Question The R2* method is widely used to quantify LIC, but the reproducibility of R2*-based LIC estimation remains unknown. Findings In scan sequences with an initial echo time (TE) ≤ 1.0 ms and a TE spacing ≤ 1.4 ms, the R2*-based LIC quantification at 1.5 T achieved good reproducibility. Clinical relevance The 1.5-T MRI-based R2* method enables reproducible quantification of the LIC; its reproducibility spares patients from unnecessary trauma and economic burdens while promoting the extensive clinical dissemination of R2*-based LIC quantification methods.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3768-3780"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of preoperative MRI in assessing macrotrabecular-massive subtype of hepatocellular carcinoma: a systematic review and meta-analysis.","authors":"Tingwen Zhou, Xiaorui Han, Chuyin Xiao, Xiaoxiao Lei, Xinxin Lan, Xinhua Wei, Yingying Liang, Hongzhen Wu","doi":"10.1007/s00330-024-11344-9","DOIUrl":"10.1007/s00330-024-11344-9","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the value of preoperative magnetic resonance imaging (MRI) in predicting macrotrabecular-massive hepatocellular carcinoma (MTM-HCC).</p><p><strong>Materials and methods: </strong>A search was conducted on PubMed, Web of Science, Cochrane Library databases, and Embase for studies evaluating the performance of MRI in assessing MTM-HCC. The quality assessment of diagnostic studies (QUADAS-2) tool was used to assess the risk of bias. Diagnostic accuracy measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR), were pooled. Summary receiver operating characteristic (SROC) curves with the area under the curve (AUC) were generated. Meta-regression analysis was performed to explore potential sources of heterogeneity.</p><p><strong>Results: </strong>A total of ten eligible studies including 2074 lesions in 2053 patients were analyzed. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.65 (0.52, 0.76), 0.88 (0.80, 0.94), 5.6 (3.70, 8.60), 0.40 (0.30, 0.53), 14 (10, 20), and 0.84 (0.81, 0.87), respectively. High heterogeneity was observed (I² was 78.61% and 90.95% for sensitivity and specificity, respectively) along with a threshold effect (Spearman's correlation coefficient = 0.927, p < 0.001). Meta-regression analysis demonstrated that the MRI method (radiomics or non-radiomics) affected the heterogeneity.</p><p><strong>Conclusion: </strong>MRI has diagnostic value for MTM-HCC due to its higher specificity and moderate sensitivity, but its clinical application remains suboptimal due to significant heterogeneity. Thus, further prospective studies with large sample sizes are needed to confirm these results.</p><p><strong>Key points: </strong>Question What is the value of MRI for preoperatively predicting MTM-HCC? Findings Meta-regression analyses revealed that the MRI method (radiomics or non-radiomics) is a significant factor contributing to heterogeneity. Clinical relevance This study demonstrates the high diagnostic accuracy of MRI for early detection of MTM-HCC, which can assist in guiding individualized management.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4111-4120"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002789","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":"Abdominopelvic imaging in the follow-up of testicular germ-cell tumors in adults: recommendations of the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology.","authors":"Pieter De Visschere, Michele Bertolotto, Jane Belfield, Irene Campo, Beniamino Corcioni, Lorenzo Derchi, Vikram Dogra, Caterina Gaudiano, Dean Y Huang, Oliwia Kozak, Francesco Lotti, Karolina Markiet, Olivera Nikolic, Nicola Pavan, Vassiliki Pasoglou, Subramaniyan Ramanathan, Jonathan Richenberg, Laurence Rocher, Camilla Sachs, Paul S Sidhu, Katarzyna Skrobisz, Michal Studniarek, Athina Tsili, Mustafa Secil","doi":"10.1007/s00330-025-11380-z","DOIUrl":"10.1007/s00330-025-11380-z","url":null,"abstract":"<p><strong>Objectives: </strong>The Scrotal and Penile Imaging Working Group (SPIWG) of the European Society of Urogenital Radiology (ESUR) aimed to formulate recommendations on the imaging modalities and minimal technical requirements for abdominopelvic imaging in the follow-up of adult patients treated for testicular germ-cell tumors (TGCT).</p><p><strong>Methods: </strong>The SPIWG members performed an extensive literature search, reviewed the current clinical practice, and reached a consensus based on the opinions of experts in the field.</p><p><strong>Results: </strong>Recurrence in patients treated for TGCT mainly occurs in retroperitoneal lymph nodes (LNs). Abdominopelvic CT and MRI are equivalent assessing retroperitoneal LNs. MRI has the advantage of avoiding radiation exposure, and moreover, diffusion-weighted images (DWI) may increase the detection rates without the need for contrast administration. In patients treated for stage I TGCT, the ESUR-SPIWG recommends MRI over CT for the detection of retroperitoneal LNs during the follow-up after treatment. CT, however, remains the follow-up imaging of choice in patients with advanced disease. When MRI is used, the recommended minimal requirements are at least one high-quality anatomical sequence (T1-WI or T2-WI) in axial and coronal planes, and DWI in the same axial plane, ≤ 4 mm contiguous slices from the diaphragm to the perineum. When CT is used, the recommended minimal requirement is a standard-dose contrast-enhanced CT in the portal-venous phase, scanned from the diaphragm to the perineum.</p><p><strong>Conclusions: </strong>In this paper, the ESUR-SPIWG provides recommendations on the imaging modalities and minimal technical requirements for abdominopelvic imaging in the follow-up of adult patients treated for TGCT.</p><p><strong>Key points: </strong>Question There are no recommendations on the preferred imaging modality or scan sequences required for abdominopelvic imaging in the follow-up after treatment for testicular cancers. Findings The European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) provides recommendations for abdominopelvic imaging in follow-up after treatment for testicular cancers. Clinical relevance Recurrence of testicular germ-cell tumors mainly occurs in retroperitoneal lymph nodes. Both CT and MRI provide similar morphological assessments, but radiation exposure can be avoided by using MRI instead of CT.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4057-4067"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037710","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}