European Radiology最新文献

{"title":"Age-dependent changes in CT vertebral attenuation values in opportunistic screening for osteoporosis: a nationwide multi-center study.","authors":"Youngjune Kim, Hae Young Kim, Sungsoo Lee, Sehyun Hong, Joon Woo Lee","doi":"10.1007/s00330-024-11263-9","DOIUrl":"10.1007/s00330-024-11263-9","url":null,"abstract":"<p><strong>Objectives: </strong>To examine how vertebral attenuation changes with aging, and to establish age-adjusted CT attenuation value cutoffs for diagnosing osteoporosis.</p><p><strong>Materials and methods: </strong>This multi-center retrospective study included 11,246 patients (mean age ± standard deviation, 50 ± 13 years; 7139 men) who underwent CT and dual-energy X-ray absorptiometry (DXA) in six health-screening centers between 2022 and 2023. Using deep-learning-based software, attenuation values of L1 vertebral bodies were measured. Segmented linear regression in women and simple linear regression in men were used to assess how attenuation values change with aging. A multivariable linear regression analysis was performed to determine whether age is associated with CT attenuation values independently of the DXA T-score. Age-adjusted cutoffs targeting either 90% sensitivity or 90% specificity were derived using quantile regression. Performance of both age-adjusted and age-unadjusted cutoffs was measured, where the target sensitivity or specificity was considered achieved if a 95% confidence interval encompassed 90%.</p><p><strong>Results: </strong>While attenuation values declined consistently with age in men, they declined abruptly in women aged > 42 years. Such decline occurred independently of the DXA T-score (p < 0.001). Age adjustment seemed critical for age ≥ 65 years, where the age-adjusted cutoffs achieved the target (sensitivity of 91.5% (86.3-95.2%) when targeting 90% sensitivity and specificity of 90.0% (88.3-91.6%) when targeting 90% specificity), but age-unadjusted cutoffs did not (95.5% (91.2-98.0%) and 73.8% (71.4-76.1%), respectively).</p><p><strong>Conclusion: </strong>Age-adjusted cutoffs provided a more reliable diagnosis of osteoporosis than age-unadjusted cutoffs since vertebral attenuation values decrease with age, regardless of DXA T-scores.</p><p><strong>Key points: </strong>Question How does vertebral CT attenuation change with age? Findings Independent of dual-energy X-ray absorptiometry T-score, vertebral attenuation values on CT declined at a constant rate in men and abruptly in women over 42 years of age. Clinical relevance Age adjustments are needed in opportunistic osteoporosis screening, especially among the elderly.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3519-3527"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805566","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":"MR elastography-based detection of impaired skull-brain mechanical decoupling performance in response to repetitive head impacts.","authors":"Xiang Shan, Matthew C Murphy, Yi Sui, Keni Zheng, Emi Hojo, Armando Manduca, Richard L Ehman, John Huston, Ziying Yin","doi":"10.1007/s00330-024-11265-7","DOIUrl":"10.1007/s00330-024-11265-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate MR elastography (MRE)-assessed biomarkers for detecting changes in skull-brain mechanical decoupling performance induced by repetitive head impacts (RHIs).</p><p><strong>Methods: </strong>This prospective single-center study enrolled 80 asymptomatic participants (2017-2023) divided into three groups: no exposure (RHI(-)), low-impact (low RHI(+)), and high-impact (high RHI(+)). Four MRE-based parameters were evaluated to analyze the skull-brain decoupling performance: brain-to-skull rotational transmission ratio (Rtr), cortical shear strain (normalized OSS (octahedral shear strain)), cortical volumetric strain (normalized ONS (octahedral normal strain)), and the OSS-to-ONS ratio. Confounding factors (age/skull-brain distance, sex) were controlled with a linear regression model. One-way ANOVA with Tukey's post-hoc test was used for group comparisons.</p><p><strong>Results: </strong>The high RHI(+) showed a significantly increased adjusted Rtr compared to the RHI(-) and low RHI(+) (p < 0.001). Higher adjusted OSS-to-ONS ratios were found in the high RHI(+) in the frontal (q < 0.05), parietal (q < 0.001), and occipital (q < 0.05) lobes compared to the RHI(-), and in all regions compared to the low RHI(+) (q < 0.05). The high RHI(+) exhibited lower adjusted normalized ONS and OSS in the temporal lobe (q < 0.05) compared to the low RHI(+). These findings suggest that recent and prolonged RHI exposures may impair the skull-brain decoupling performance, affecting the capacity of the interface to isolate the brain by dampening skull-to-brain motion transmission and modulating brain surface deformation.</p><p><strong>Conclusion: </strong>This study reveals evidence of impaired decoupling function at the skull-brain interface resulting from RHI exposure and demonstrates MRE-based biomarkers for early detection of this impairment.</p><p><strong>Key points: </strong>Question The skull-brain interface is crucial for brain protection under impact, but its early mechanical responses to repetitive head impacts (RHIs) remain largely unknown. Findings Mechanical changes (more rotation and a shift in shear relative to volumetric strain) across the skull-brain interface were observed in participants under high RHI exposure. Clinical relevance Our study developed MR elastography (MRE)-based measurements to detect changes in the skull-brain interface caused by RHI, suggesting that MRE holds promise for noninvasively quantifying cumulative injury and potential future clinical interventions for individuals with high RHI exposure.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3613-3624"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800050","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":"Inferior vena cava-splenic vein shunt for the treatment of complete portal trunk occlusion and portal cavernoma in liver cirrhosis.","authors":"Maoyuan Mu, Yuzhe Cao, Zixiong Chen, Xiaobo Fu, Pengyi Chen, Han Qi, Fei Gao","doi":"10.1007/s00330-025-11571-8","DOIUrl":"10.1007/s00330-025-11571-8","url":null,"abstract":"<p><strong>Objectives: </strong>The transjugular intrahepatic portosystemic shunt procedure remains technically challenging in cases involving occlusion of the portal trunk. This study aimed to evaluate the feasibility, efficacy, and safety of utilizing the inferior vena cava-splenic vein shunt (IVCSS) as a new treatment option in cirrhotic patients with complete portal trunk occlusion and portal cavernoma.</p><p><strong>Methods: </strong>The IVCSS procedure was performed on twelve patients, involving the creation of a shunt using a covered stent between the inferior vena cava and the proximal end of the splenic vein to reduce distal portal pressure.</p><p><strong>Results: </strong>Technical success was achieved in all patients, with a mean procedure duration of 71.7 ± 44.2 min. The portosystemic gradient was reduced by a mean of 11.0 ± 5.6 mmHg after the procedure. After a median follow-up of 6.7 [2.8-11.4] months, clinical symptoms improved in all patients. Stent dysfunction occurred in 1 patient, the recurrence rates for variceal bleeding and ascites were 8.3% and 16.7%, respectively. One patient (8.3%) experienced a procedure-related complication of retroperitoneal hemorrhage. Three patients (25%) had an episode of hepatic encephalopathy, which improved after conservative treatment.</p><p><strong>Conclusion: </strong>IVCSS effectively reduced distal portal pressure, which contributed to an improvement of the patients' clinical symptoms with an acceptable procedure-related complication rate. IVCSS may serve as an alternative strategy to manage symptomatic portal hypertension for patients with complete portal trunk occlusion and portal cavernoma.</p><p><strong>Key points: </strong>Question What is an alternative treatment for cirrhotic patients with symptomatic portal hypertension caused by chronic portal vein occlusion other than TIPS? Findings Inferior vena cava-splenic vein shunt (IVCSS) is feasible for reducing distal portal pressure and effectively improving clinical symptoms. Clinical relevance For cirrhotic patients with complete portal trunk occlusion and portal cavernoma, the IVCSS approach seemed to be a promising alternative treatment for symptomatic portal hypertension.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3249-3255"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999041","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":"Head-to-head comparison among FAST, MAST, and multiparametric MRI-based new score in diagnosing at-risk MASH.","authors":"Kento Imajo, Yusuke Saigusa, Takashi Kobayashi, Koki Nagai, Shinya Nishida, Nobuyoshi Kawamura, Hiroyoshi Doi, Michihiro Iwaki, Asako Nogami, Yasushi Honda, Takaomi Kessoku, Yuji Ogawa, Hiroyuki Kirikoshi, Shigehiro Kokubu, Daisuke Utsunomiya, Hirokazu Takahashi, Shinichi Aishima, Yoshio Sumida, Satoru Saito, Masato Yoneda, Andrea Dennis, Stella Kin, Anneli Andersson, Atsushi Nakajima","doi":"10.1007/s00330-024-11215-3","DOIUrl":"10.1007/s00330-024-11215-3","url":null,"abstract":"<p><strong>Objectives: </strong>New scores were developed to identify at-risk metabolic dysfunction-associated steatohepatitis (MASH) using multiparametric MRI (mpMRI).</p><p><strong>Materials and methods: </strong>A prospective study was conducted on 176 patients with suspected or diagnosed metabolic dysfunction-associated steatotic liver disease (MASLD) paired with an MR scan, vibration-controlled transient elastography (VCTE), and liver biopsy. Liver stiffness measurement (LSM) using magnetic resonance elastography (MRE), proton density fat fraction (PDFF), and mpMRI-based corrected T1 (cT1) were combined to develop a one-step strategy, named MPcT (MRE + PDFF + cT1, combined score), and a two-step strategy-MRE-based LSM followed by PDFF with cT1 (M-PcT, paired score) for diagnosing at-risk MASH. Each model was categorized using rule-in and rule-out criteria (three categorized analyses). To avoid overfitting, the diagnostic accuracies were evaluated based on 5-fold cross-validation.</p><p><strong>Results: </strong>PDFF + cT1 (PcT) had the highest diagnostic performance for severe activity (hepatic inflammation plus ballooning grade ≥ 3) and for NAS ≥ 4 (active MASH). Areas under receiver operating characteristic curves (AUROCs) of M-PcT (0.832) for detecting at-risk MASH were significantly higher than those of Fibroscan-AST (FAST) (0.744, p = 0.017), MRI-AST (MAST) (0.710, p = 0.002), and MPcT (0.695, p < 0.001) in three categorized analysis. Following the rule-in criteria, positive predictive values of M-PcT (84.5%) were higher than those of FAST (73.5%), MAST (70.0%), and MPcT (66.7%). Following the rule-out criteria, negative predictive values of M-PcT (88.7%) were higher than those of FAST (84.0%), MAST (73.9%), and MPcT (84.9%).</p><p><strong>Conclusions: </strong>The two-step strategy, M-PcT (paired score), showed the reliability of rule-in/-out for at-risk MASH, with better predictive performance compared with FAST and MAST (combined score).</p><p><strong>Clinical trial registration: </strong>This study is registered with ClinicalTrials.gov (number, UMIN000012757).</p><p><strong>Key points: </strong>Question There is no mpMRI-based method for detecting as-risk MASH (NAFLD activity score ≥ 4 with fibrosis stage ≥ 2) like FAST and MAST scores. Findings MRE-based LSMs followed by PDFF with cT1 (M-PcT) were more useful in detecting at-risk MASH than the combined score (FAST and MAST). Clinical relevance By combining MRE and PDFF with cT1, it becomes possible to evaluate the pathology of MASH without the need for a liver biopsy, assisting in prognosis prediction and decision-making for treatment options.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3599-3609"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784794","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":"Restoring mobility: roles of percutaneous consolidation for pelvic ring bone lesions-a multicenter study.","authors":"Emmanuel Dien, Nicolas Stacoffe, Luca-Jacopo Pavan, Federico Torre, Paul-Alexis Ranc, Thomas Vivarrat-Perrin, Bastien Chalamet, Jean-Baptiste Pialat, Adrian Kastler, Nicolas Amoretti","doi":"10.1007/s00330-024-11193-6","DOIUrl":"10.1007/s00330-024-11193-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the early functional rehabilitation outcomes following percutaneous consolidation for pelvic ring tumor lesions.</p><p><strong>Materials and methods: </strong>In this multicenter retrospective study, patients with pelvic bone tumor lesions, whether primitive or metastatic, underwent percutaneous consolidation (cementoplasty, screw fixation, or both). The primary outcome was postoperative weight-bearing ambulation. Secondary outcomes included hospitalization duration, procedural complications, and long-term consolidation. Inclusion criteria were patients treated for prophylactic consolidation or pathological fractures. Kaplan-Meier analysis was used for the primary outcome and hospital stay, with p-values < 0.05 indicating significance.</p><p><strong>Results: </strong>A total of 143 consecutive procedures were performed in 138 patients (mean age, 65 years ± 13; 68 men) who underwent percutaneous screw fixation, cementoplasty, or both. Postoperative weight-bearing ambulation was achieved in 142/143 cases (99%). In total, 117/143 (82%) of these were in the first 24 h. 81/143 (57%) were discharged within 24 h (median, one day; Q3, one day; Q4, 112 days). 133/138 (96.5%) patients achieved long-term consolidation. The most common pattern was isolated acetabular involvement (N = 40; 28%). Of the 19 adverse events, 10 were asymptomatic. Three patients had delayed infections and one required screw removal.</p><p><strong>Conclusion: </strong>Percutaneous consolidation effectively achieved postoperative weight-bearing ambulation and represents a safe and durable treatment option for patients with pelvic bone lesions.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov: NCT06155890.</p><p><strong>Key points: </strong>Question How can radiology continue to help improve care for patients with metastatic pelvic ring lesions? Findings 99% of patients achieved postoperative weight-bearing, with 82% doing so within 24 h. Clinical relevance Percutaneous consolidation enabled rapid functional rehabilitation of oncology patients, allowing short hospital stays with low complication rates, and demonstrating the expanding role of radiologists in diagnosis, risk assessment, and treatment planning, thereby enhancing patient care.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3270-3281"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681228","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":"Impact of deep learning reconstruction on radiation dose reduction and cancer risk in CT examinations: a real-world clinical analysis.","authors":"Naoki Kobayashi, Takeshi Nakaura, Naofumi Yoshida, Yasunori Nagayama, Masafumi Kidoh, Hiroyuki Uetani, Daisuke Sakabe, Yuki Kawamata, Yoshinori Funama, Takashi Tsutsumi, Toshinori Hirai","doi":"10.1007/s00330-024-11212-6","DOIUrl":"10.1007/s00330-024-11212-6","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to estimate the extent to which the implementation of deep learning reconstruction (DLR) may reduce the risk of radiation-induced cancer from CT examinations, utilizing real-world clinical data.</p><p><strong>Methods: </strong>We retrospectively analyzed scan data of adult patients who underwent body CT during two periods relative to DLR implementation at our facility: a 12-month pre-DLR phase (n = 5553) using hybrid iterative reconstruction and a 12-month post-DLR phase (n = 5494) with routine CT reconstruction transitioning to DLR. To ensure comparability between two groups, we employed propensity score matching 1:1 based on age, sex, and body mass index. Dose data were collected to estimate organ-specific equivalent doses and total effective doses. We assessed the average dose reduction post-DLR implementation and estimated the Lifetime Attributable Risk (LAR) for cancer per CT exam pre- and post-DLR implementation. The number of radiation-induced cancers before and after the implementation of DLR was also estimated.</p><p><strong>Results: </strong>After propensity score matching, 5247 cases from each group were included in the final analysis. Post-DLR, the total effective body CT dose significantly decreased to 15.5 ± 10.3 mSv from 28.1 ± 14.0 mSv pre-DLR (p < 0.001), a 45% reduction. This dose reduction significantly lowered the radiation-induced cancer risk, especially among younger women, with the estimated annual cancer incidence from 0.247% pre-DLR to 0.130% post-DLR.</p><p><strong>Conclusion: </strong>The implementation of DLR has the possibility to reduce radiation dose by 45% and the risk of radiation-induced cancer from 0.247 to 0.130% as compared with the iterative reconstruction.</p><p><strong>Key points: </strong>Question Can implementing deep learning reconstruction (DLR) in routine CT scans significantly reduce radiation dose and the risk of radiation-induced cancer compared to hybrid iterative reconstruction? Findings DLR reduced the total effective body CT dose by 45% (from 28.1 ± 14.0 mSv to 15.5 ± 10.3 mSv) and decreased estimated cancer incidence from 0.247 to 0.130%. Clinical relevance Adopting DLR in clinical practice substantially lowers radiation exposure and cancer risk from CT exams, enhancing patient safety, especially for younger women, and underscores the importance of advanced imaging techniques.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3499-3507"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754919","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":"Muscle atrophy and organ enlargement associated with quality of life during systemic therapy for melanoma: findings from an AI-based body composition analysis.","authors":"Itske Fraterman, Laura Estacio Cerquin, Kelly M de Ligt, Iris van der Loo, Sofie Wilgenhof, Lonneke V van de Poll-Franse, Regina G H Beets-Tan, Renaud L M Tissier, Stefano Trebeschi","doi":"10.1007/s00330-024-11289-z","DOIUrl":"10.1007/s00330-024-11289-z","url":null,"abstract":"<p><strong>Introduction: </strong>Health-related quality of life (HRQoL) is emerging as an endpoint, adjunct to survival, in cancer treatment. For this reason, the European Organization for Research and Treatment of Cancer (EORTC) has developed standardized quality-of-life questionnaires to collect patient-reported outcome measurement (PROM), which so far have been widely used in clinical trials to evaluate the impact of new drugs on cancer patients. However, while these questionnaires comprehensively describe patient functions, little is known about their association with patient characteristics. This study aims to bridge this gap and investigate the association between patient body composition and HRQoL.</p><p><strong>Materials and methods: </strong>A retrospective cohort of melanoma patients treated with systemic therapy who completed HRQoL questionnaires and had regular imaging follow-ups was included. The primary endpoint was the association between n = 116 AI-measured longitudinal volumes of thoracic and abdominal organs, subcutaneous and visceral fat, skeleton and muscles (estimated by TotalSegmentator), and physical functioning (PF), role functioning (RF) and fatigue (FA) (estimated by the EORTC-QLQ-C30).</p><p><strong>Results: </strong>The n = 358 patients were included. Our findings show larger liver, spleen, and gallbladder volumes associated with decreased PF and RF and an increase in FA (p < 0.05). Furthermore, larger muscle volumes were associated with an increase in PF and RF and a decrease in FA (p < 0.01).</p><p><strong>Discussion: </strong>Our findings show significant associations between AI-measured body and organ analysis and HRQoL in patients with melanoma on systemic treatment. Future research is needed to understand the underlying cause and determine the possible predictive ability of these imaging features.</p><p><strong>Key points: </strong>Question Are changes in body composition associated with changes in HRQoL in melanoma patients undergoing systemic therapy? Findings AI-based body composition analysis shows that larger muscle volumes are linked to improved HRQoL, while organ enlargement is associated with a decline in it. Clinical relevance Our findings indicate new imaging biomarkers that can help monitor patients and evaluate treatment responses. These biomarkers link patient function to physical changes during treatment, offering insights for creating response evaluation criteria that also consider improvements in quality of life.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3476-3485"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryoablation for treatment of peripheral lung metastases from colorectal cancer: a bicenter retrospective study.","authors":"Jean Izaaryene, Rémi Grange, Vincent Habouzit, Sylvain Grange, Bastien Orsini, Michael Dassa, Nassima Daidj, Louis Thierry, Marjorie Ferre, Jean Marc Phelip, Bernard Lelong, Cécile De Chaisemartin, Emmanuel Mitry, Gilles Piana","doi":"10.1007/s00330-024-11153-0","DOIUrl":"10.1007/s00330-024-11153-0","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the oncological efficacy and complications of cryoablation (CA) in treating lung metastases from colorectal cancer (CRC) at the lung periphery.</p><p><strong>Materials and methods: </strong>The inclusion criteria for this bicenter retrospective study included patients with histologically confirmed CRC, with radiologically confirmed lung metastases at the periphery of the lung (distance of less than or equal to 2 cm from the costal, diaphragmatic, or cervical pleura) treated with CA between January 2017 and June 2022. Patients with intra-parenchymal metastases or metastases close to the mediastinal pleura and patients without follow-up were excluded.</p><p><strong>Results: </strong>Seventy-three patients were included (median age: 69 years, range 47.0-83.0; 38 males, 52.0%) with 113 metastases and 89 procedures. Technical success was achieved in all procedures. During follow-up (median 22 months), on a per metastasis basis, local recurrence occurred for 8/113 (7%) of the metastases in 7 patients at a median time of 19 months; 7 had concomitant distant recurrence. Local progression-free survival rates were 95% at 1 year and 89% at 2, 3, and 4 years. Distant progression occurred in 41/73 (56.2%) patients, significantly associated with a history of liver metastasis and synchronous lung metastasis (p < 0.05). The median chemotherapy-free survival was 14 (IQR (5.0-21.5)) months. Complications were predominantly mild or moderate, with a low incidence of severe complications.</p><p><strong>Conclusion: </strong>CA demonstrates high rate of local control and appears well-tolerated in the treatment of peripheral lung metastases from CRC. The procedure offers a viable therapeutic option, allowing patients a significant period without chemotherapy.</p><p><strong>Key points: </strong>Question Despite its advantages over surgery, data on cryoablation of metastases from colorectal cancer at the periphery of the lung are lacking. Findings Cryoablation enabled very good local control, with local progression-free survival rates of 95% at 1 year and 89% at 2, 3, and 4 years. Clinical relevance Cryoablation is an effective treatment for local tumor control of lung metastases from colorectal cancer at the periphery of the lung. The treatment is well tolerated and can provide patients with substantial relief from chemotherapy.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3282-3293"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686517","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 post-hepatectomy liver failure with T1 mapping-based whole-liver histogram analysis on gadoxetic acid-enhanced MRI: comparison with the indocyanine green clearance test and albumin-bilirubin scoring system.","authors":"Jun Li, Yi Li, Yuan-Yuan Chen, Xiao-Ying Wang, Cai-Xia Fu, Robert Grimm, Ying Ding, Meng-Su Zeng","doi":"10.1007/s00330-024-11238-w","DOIUrl":"10.1007/s00330-024-11238-w","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the value of T1 mapping-based whole-liver histogram analysis on gadoxetic acid-enhanced MRI for predicting post-hepatectomy liver failure (PHLF).</p><p><strong>Methods: </strong>Consecutive patients from March 2016 to March 2018 who underwent gadoxetic acid-enhanced MRI in our hospital were retrospectively analyzed, and 37 patients were enrolled. Whole-liver T1 mapping-based histogram analysis was performed. The indocyanine green (ICG) clearance tests were performed, and albumin-bilirubin (ALBI) scores were calculated. Univariate and multivariate binary logistic analyses were performed to identify independent predictors for PHLF. Diagnostic performance was evaluated with ROC analysis. Histogram-extracted parameters were also associated with the ICG test and ALBI scoring system.</p><p><strong>Results: </strong>In enrolled 37 patients (age 57.19 ± 12.28 years), 28 were male. 35.1% (13/37) of patients developed PHLF. For univariate analysis, pre-contrast T1 relaxation time (T1pre) mean, T1pre 95th percentile, the standard deviation (SD) of T1 relaxation time in hepatobiliary phase (T1HBP SD), T1HBP 95th percentile, T1HBP kurtosis, and ICG percentage retained at 15 min (ICG-R15) showed significant differences between the PHLF and non-PHLF groups (all p < 0.05), whereas the ALBI scores showed no significant differences between the two groups (p = 0.937). Multivariate analysis showed that a higher T1HBP 95th percentile was the independent predictor for PHLF (p < 0.05; odds ratio (OR) = 1.014). In addition, most of the histogram-extracted parameters showed significant correlations to the ICG test.</p><p><strong>Conclusions: </strong>T1 mapping-based whole-liver histogram analysis on gadoxetic acid-enhanced MRI is valuable for PHLF prediction and risk stratification, which outperformed the ICG clearance test and ALBI scoring system.</p><p><strong>Key points: </strong>Question What is the value of T1 mapping-based whole-liver histogram analysis on gadoxetic acid-enhanced MRI for PHLF? Findings The histogram parameters extracted from gadoxetic acid-enhanced T1 mapping manifested potential for grading liver function preoperatively. Clinical relevance T1 mapping-based whole-liver histogram analysis on gadoxetic acid-enhanced MRI can serve as a convenient one-station radiological tool to help identify potential PHLF risks within the preoperative clinical decision-making framework.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3587-3598"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754786","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":"Volumetric histogram analysis of amide proton transfer-weighted imaging for predicting complete tumor response to neoadjuvant chemoradiotherapy in locally advanced rectal adenocarcinoma.","authors":"Wenjing Yuan, Xia Lv, Jiaxin Zhao, Ziqi Jia, Qianling Zhou, Hanliang Zhang, Jianhao Dai, Jieping Feng, Weicui Chen, Wei Jiang, Xian Liu","doi":"10.1007/s00330-024-11220-6","DOIUrl":"10.1007/s00330-024-11220-6","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the potential of histogram analysis applied to pre-treatment amide proton transfer-weighted (APTw) imaging in predicting complete pathological regression (pCR) in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (nCRT).</p><p><strong>Materials and methods: </strong>This retrospective study enrolled LARC patients who underwent preoperative rectal magnetic resonance imaging (MRI). Based on histologic assessment, the patients were divided into a pathological complete response (pCR) group or a non-pCR group. APTw histogram features, apparent diffusion coefficient (ADC), and clinical parameters were analyzed. Mann-Whitney U-test, Spearman rank correlation, and univariate and multivariate logistic regression were used for statistical analysis. The predictive performances of different models were evaluated by the receiver operating characteristic curve (ROC).</p><p><strong>Results: </strong>One-hundred forty-five patients were included (mean age, 61.6 years ± 11.8 [SD]; 87 men). pCR patients exhibited lower pre-treatment ADC value, higher pre-treatment APTw-10%, APTw-90%, minimum, maximum, median, mean, range, and root mean square (RMS) of the primary tumor compared to non-pCR patients (all p < 0.05). APTw-10%, APTw-90%, maximum, mean, median, minimum, range, and RMS showed negative correlations with the tumor regression grade (TRG) category (r ranged between -0.457 and -0.173; all p < 0.005). Skewness, kurtosis, and entropy exhibited positive correlations with the TRG category (r = 0.278, 0.319, and 0.324, respectively; all p < 0.05). The combined model had a higher AUC of 0.930, with 93.9% sensitivity and 83.9% specificity.</p><p><strong>Conclusion: </strong>Histogram analysis of pre-treatment APTw may hold promise as a novel approach for predicting the response of LARC patients to nCRT.</p><p><strong>Key points: </strong>Question Predicting response to nCRT is crucial for early stratified management of LARC patients; however, current radiological studies remain inconclusive. Finding LARC patients with pCR is correlated with higher pre-treatment APTw intensity-related and lower shape-related histogram features. Clinical relevance The APTw-histogram model and the APTw-clinical combined model demonstrated strong diagnostic efficacy and clinical practicality in predicting LARC patients' responsiveness to nCRT, offering new insights for early clinical decision-making.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3158-3168"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767299","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}