European Radiology最新文献

{"title":"Ultrafast sequence-based prediction model and nomogram to differentiate additional suspicious lesions on preoperative breast MRI.","authors":"Haejung Kim, Sang Ah Chi, Kyunga Kim, Boo-Kyung Han, Eun Young Ko, Ji Soo Choi, Jeongmin Lee, Myoung Kyoung Kim, Eun Sook Ko","doi":"10.1007/s00330-024-10931-0","DOIUrl":"10.1007/s00330-024-10931-0","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether ultrafast sequence improves the diagnostic performance of conventional dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating additional suspicious lesions (ASLs) on preoperative breast MRI.</p><p><strong>Materials and methods: </strong>A retrospective database search identified 668 consecutive patients who underwent preoperative breast DCE-MRI with ultrafast sequence between June 2020 and July 2021. Among these, 107 ASLs from 98 patients with breast cancer (36 multifocal, 42 multicentric, and 29 contralateral) were identified. Clinical, pathological, conventional MRI findings, and ultrafast sequence-derived parameters were collected. A prediction model that adds ultrafast sequence-derived parameters to clinical, pathological, and conventional MRI findings was developed and validated internally. Decision curve analysis and net reclassification index statistics were performed. A nomogram was constructed.</p><p><strong>Results: </strong>The ultrafast model adding time to peak enhancement, time to enhancement, and maximum slope showed a significantly increased area under the receiver operating characteristic curve compared with the conventional model which includes age, human epidermal growth factor receptor 2 expression of index cancer, size of index cancer, lesion type of index cancer, location of ASL, and size of ASL (0.92 vs. 0.82; p = 0.002). The decision curve analysis showed that the ultrafast model had a higher overall net benefit than the conventional model. The net reclassification index of ultrafast model was 23.3% (p = 0.001).</p><p><strong>Conclusion: </strong>A combination of ultrafast sequence-derived parameters with clinical, pathological, and conventional MRI findings can aid in the differentiation of ASL on preoperative breast MRI.</p><p><strong>Clinical relevance statement: </strong>Our prediction model and nomogram that was based on ultrafast sequence-derived parameters could help radiologists differentiate ASLs on preoperative breast MRI.</p><p><strong>Key points: </strong>Ultrafast MRI can diminish background parenchymal enhancement and possibly improve diagnostic accuracy for additional suspicious lesions (ASLs). Location of ASL, larger size of ASL, and higher maximum slope were associated with malignant ASL. The ultrafast model and nomogram can help preoperatively differentiate additional malignancies.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"188-201"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626471","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":"Synthetic temporal bone CT generation from UTE-MRI using a cycleGAN-based deep learning model: advancing beyond CT-MR imaging fusion.","authors":"Sung-Hye You, Yongwon Cho, Byungjun Kim, Jeeho Kim, Gi Jung Im, Euyhyun Park, InSeong Kim, Kyung Min Kim, Bo Kyu Kim","doi":"10.1007/s00330-024-10967-2","DOIUrl":"10.1007/s00330-024-10967-2","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to develop a deep-learning model to create synthetic temporal bone computed tomography (CT) images from ultrashort echo-time magnetic resonance imaging (MRI) scans, thereby addressing the intrinsic limitations of MRI in localizing anatomic landmarks in temporal bone CT.</p><p><strong>Materials and methods: </strong>This retrospective study included patients who underwent temporal MRI and temporal bone CT within one month between April 2020 and March 2023. These patients were randomly divided into training and validation datasets. A CycleGAN model for generating synthetic temporal bone CT images was developed using temporal bone CT and pointwise encoding-time reduction with radial acquisition (PETRA). To assess the model's performance, the pixel count in mastoid air cells was measured. Two neuroradiologists evaluated the successful generation rates of 11 anatomical landmarks.</p><p><strong>Results: </strong>A total of 102 patients were included in this study (training dataset, n = 54, mean age 58 ± 14, 34 females (63%); validation dataset, n = 48, mean age 61 ± 13, 29 females (60%)). In the pixel count of mastoid air cells, no difference was observed between synthetic and real images (679 ± 342 vs 738 ± 342, p = 0.13). For the six major anatomical sites, the positive generation rates were 97-100%, whereas those of the five major anatomical structures ranged from 24% to 83%.</p><p><strong>Conclusion: </strong>We developed a model to generate synthetic temporal bone CT images using PETRA MRI. This model can provide information regarding the major anatomic sites of the temporal bone using MRI.</p><p><strong>Clinical relevance statement: </strong>The proposed algorithm addresses the primary limitations of MRI in localizing anatomic sites within the temporal bone.</p><p><strong>Key points: </strong>CT is preferred for imaging the temporal bone, but has limitations in differentiating pathology there. The model achieved a high success rate in generating synthetic images of six anatomic sites. This can overcome the limitations of MRI in visualizing key anatomic sites in the temporal skull.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"38-48"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723378","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":"Standardized reporting of spine and sacroiliac joints in axial spondyloarthritis MRI: from the ESSR-Arthritis Subcommittee.","authors":"Winston J Rennie, Anne Cotten, Anne Grethe Jurik, Frederic Lecouvet, Lennart Jans, Patrick Omoumi, Filippo Del Grande, Danoob Dalili, Alberto Bazzocchi, Fabio Becce, Dennis K Bielecki, Mikael Boesen, Torsten Diekhoff, Andrew Grainger, Giuseppe Guglielmi, Robert Hemke, Kay Geert A Hermann, Nele Herregods, Amanda Isaac, Gordana Ivanac, Franz Kainberger, Andrea Klauser, Salvatore Marsico, Vasco Mascarenhas, Philip O'Connor, Edwin Oei, Vittorio Pansini, Olympia Papakonstantinou, Anna Zejden, Monique Reijnierse, Andrea B Rosskopf, Amit Shah, Iwona Sudol-Szopinska, Frederiek Laloo, Chiara Giraudo","doi":"10.1007/s00330-024-10926-x","DOIUrl":"10.1007/s00330-024-10926-x","url":null,"abstract":"<p><strong>Objectives: </strong>Apply a modified Delphi-based approach and produce a practical, radiology-specific set of definitions for interpretation and standardization of the multiple MRI findings in axial spondyloarthritis (ax-SpA), specifically to aid the general radiologist with a musculoskeletal interest, working with gold standard basic MRI protocols.</p><p><strong>Materials and methods: </strong>We report the results of a modified Delphi-based consensus of 35 experts from 13 countries in the Arthritis Subcommittee of the European Society of Musculoskeletal Radiology (ESSR). Seventeen definitions were created (i.e., nine for the spine and eight for the sacroiliac joint) and two Delphi rounds were conducted on an electronic database, collated and revised by the project leader with agreement. Group leads were appointed for each definition following the first round. Final definitions included only those that reached a consensus > 80%; if > 50% agreed on exclusion consensus, definitions were excluded. Final results have been shared during the Arthritis meeting at the Annual ESSR Congress.</p><p><strong>Results: </strong>Fourteen definitions, eight for the spine and six for the sacroiliac joint were agreed for standardized reporting. Andersson's, anterior corner sclerotic and costovertebral joint inflammatory lesions of the spine, with active and non-active erosions, and fat metaplasia of the sacroiliac joint reaching the highest consensus (≥ 95%). More than 50% of the experts agreed to exclude joint space inflammation in the sacroiliac joint and tissue backfill. Syndesmophytes reached 76% agreement.</p><p><strong>Conclusions: </strong>Agreed definitions by expert radiologists using a modified Delphi process, should allow standardized actionable radiology reports and clarity in reporting terminology of ax-SpA.</p><p><strong>Clinical relevance statement: </strong>The proposed definitions will support reporting from musculoskeletal and general radiologists working with gold-standard basic MRI, improve confidence in lesion assessment, and standardize terminology to provide actionable reports on MRI in patients with ax-SpA.</p><p><strong>Key points: </strong>Experts applied a modified Delphi method to optimize the definitions of MRI findings of ax-SpA. After two Delphi rounds and one in-person meeting, fourteen definitions reached the agreement threshold. These consensus-based definitions will aid in actionable reporting specifically for the general radiologist with a musculoskeletal interest.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"360-369"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727083","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":"Temporal changes in CT-derived fractional flow reserve in patients after heart transplantation.","authors":"Simran P Sharma, Javier Sanz, Alexander Hirsch, Richa Patel, Alina A Constantinescu, Maya Barghash, Donna M Mancini, Jasper J Brugts, Kadir Caliskan, Yannick J H J Taverne, Olivier C Manintveld, Ricardo P J Budde","doi":"10.1007/s00330-024-10932-z","DOIUrl":"10.1007/s00330-024-10932-z","url":null,"abstract":"<p><strong>Background: </strong>Adding functional information by CT-derived fractional flow reserve (FFRct) to coronary CT angiography (CCTA) and assessing its temporal change may provide insight into the natural history and physiopathology of cardiac allograft vasculopathy (CAV) in heart transplantation (HTx) patients. We assessed FFRct changes as well as CAV progression over a 2-year period in HTx patients undergoing serial CT imaging.</p><p><strong>Methods: </strong>HTx patients from Erasmus MC and Mount Sinai Hospital, who had consecutive CCTAs 2 years apart were evaluated. FFRct analysis was performed for both scans. FFRct values at the most distal point in the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) were measured after precisely matching the anatomical locations in both analyses. Also, the number of anatomical coronary stenoses of > 30% was scored.</p><p><strong>Results: </strong>In total, 106 patients (median age 57 [interquartile range 47-67] years, 67% male) at 9 [6-13] years after HTx at the time of the baseline CCTA were included. Median distal FFRct values significantly decreased from baseline to follow-up for the LAD from 0.85 [0.79-0.90] to 0.84 [0.76-0.90] (p = 0.001), LCX from 0.92 [0.88-0.96] to 0.91 [0.85-0.95] (p = 0.009), and RCA from 0.92 [0.86-0.95] to 0.90 [0.86-0.94] (p = 0.004). The number of focal anatomical stenoses of > 30% increased from a median of 1 [0-2] at baseline to 2 [0-3] at follow-up (p = 0.009).</p><p><strong>Conclusions: </strong>The distal coronary FFRct values in post-HTX patients in each of the three major coronary arteries decreased, and the number of focal coronary stenoses increased over a 2-year period. Temporal FFRct change rate may become an additional parameter in the follow-up of HTx patients, but more research is needed to elucidate its role.</p><p><strong>Clinical relevance statement: </strong>CT-derived fractional flow reserve (FFRct) is important post-heart transplant because of additional information on coronary CT angiography for cardiac allograft vasculopathy (CAV) detection. The decrease and degree of reduction in distal FFRct value may indicate progression in anatomic CAV burden.</p><p><strong>Key points: </strong>CT-derived fractional flow reserve (FFRct) is important for monitoring cardiac allograft vasculopathy (CAV) in heart transplant patients. Over time, transplant patients showed a decrease in distal FFRct and an increase in coronary stenoses. Temporal changes in FFRct could be crucial for transplant follow-up, aiding in CAV detection.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"232-243"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626469","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 in pulmonary nodule detection and segmentation: a systematic review.","authors":"Chuan Gao, Linyu Wu, Wei Wu, Yichao Huang, Xinyue Wang, Zhichao Sun, Maosheng Xu, Chen Gao","doi":"10.1007/s00330-024-10907-0","DOIUrl":"10.1007/s00330-024-10907-0","url":null,"abstract":"<p><strong>Objectives: </strong>The accurate detection and precise segmentation of lung nodules on computed tomography are key prerequisites for early diagnosis and appropriate treatment of lung cancer. This study was designed to compare detection and segmentation methods for pulmonary nodules using deep-learning techniques to fill methodological gaps and biases in the existing literature.</p><p><strong>Methods: </strong>This study utilized a systematic review with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching PubMed, Embase, Web of Science Core Collection, and the Cochrane Library databases up to May 10, 2023. The Quality Assessment of Diagnostic Accuracy Studies 2 criteria was used to assess the risk of bias and was adjusted with the Checklist for Artificial Intelligence in Medical Imaging. The study analyzed and extracted model performance, data sources, and task-focus information.</p><p><strong>Results: </strong>After screening, we included nine studies meeting our inclusion criteria. These studies were published between 2019 and 2023 and predominantly used public datasets, with the Lung Image Database Consortium Image Collection and Image Database Resource Initiative and Lung Nodule Analysis 2016 being the most common. The studies focused on detection, segmentation, and other tasks, primarily utilizing Convolutional Neural Networks for model development. Performance evaluation covered multiple metrics, including sensitivity and the Dice coefficient.</p><p><strong>Conclusions: </strong>This study highlights the potential power of deep learning in lung nodule detection and segmentation. It underscores the importance of standardized data processing, code and data sharing, the value of external test datasets, and the need to balance model complexity and efficiency in future research.</p><p><strong>Clinical relevance statement: </strong>Deep learning demonstrates significant promise in autonomously detecting and segmenting pulmonary nodules. Future research should address methodological shortcomings and variability to enhance its clinical utility.</p><p><strong>Key points: </strong>Deep learning shows potential in the detection and segmentation of pulmonary nodules. There are methodological gaps and biases present in the existing literature. Factors such as external validation and transparency affect the clinical application.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"255-266"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563121","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":"A visual marker for early atrophy of the supraspinatus muscle on conventional MRI: introduction of the blackbird sign.","authors":"Georg C Feuerriegel, Roy P Marcus, Sophia S Goller, Adrian A Marth, Karl Wieser, Samy Bouaicha, Reto Sutter","doi":"10.1007/s00330-024-10946-7","DOIUrl":"10.1007/s00330-024-10946-7","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to introduce the blackbird sign as a fast, qualitative measure of early supraspinatus (SSP) muscle atrophy and to correlate the sign with quantitatively assessed muscle volume and intramuscular fat fraction (FF) in patients with full-thickness SSP tears.</p><p><strong>Materials and methods: </strong>The blackbird sign describes the asymmetric pattern of early SSP atrophy: on sagittal MR images, the supero-posterior contour of the muscle becomes concave, resembling the shape of a blackbird. MRIs of patients with full-thickness SSP tears were retrospectively reviewed for the presence of the blackbird and tangent signs. Patients were then divided into group 1: negative tangent sign and negative blackbird sign (n = 67), group 2: negative tangent sign and positive blackbird sign (n = 31), and group 3: positive tangent sign (n = 32). A 2-point Dixon sequence was acquired in all patients from which quantitative FF and muscle volumes were calculated.</p><p><strong>Results: </strong>In total 130 patients (mean age 67 ± 11 years) were included. Mean SSP volume was significantly smaller in group 3 (15.8 ± 8.1 cm³) compared to group 2 (23.9 ± 7.0 cm³, p = 0.01) and group 1 (29.7 ± 9.1 cm³, p < 0.01). Significantly lower muscle volumes were also found in group 2 compared to group 1 (p = 0.02), confirming that the blackbird sign is able to identify early SSP atrophy. Mean FF in the SSP was significantly higher in group 3 (18.5 ± 4.4%) compared to group 2 (10.9 ± 4.7%, p < 0.01) and group 1 (6.1 ± 2.6%, p < 0.01).</p><p><strong>Conclusion: </strong>Visual assessment of early muscle atrophy of the SSP is feasible and reproducible using the blackbird sign, allowing the diagnosis of early SSP atrophy.</p><p><strong>Clinical relevance statement: </strong>In routine clinical practice, the blackbird sign may be a useful tool for assessing early muscle degeneration before the risk of postoperative rotator cuff re-tears increases with progressive muscle atrophy and fatty infiltration.</p><p><strong>Key points: </strong>Quantitative measurements of rotator cuff injuries require time, limiting clinical practicality. The proposed blackbird sign is able to identify early SSP atrophy. Reader agreement for the blackbird sign was substantial, demonstrating reproducibility and ease of implementation in the clinical routine.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"313-322"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590016","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":"Radiation exposure and screening yield by digital breast tomosynthesis compared to mammography: results of the TOSYMA Trial breast density related.","authors":"Alexander Sommer, Stefanie Weigel, Hans-Werner Hense, Joachim Gerß, Veronika Weyer-Elberich, Laura Kerschke, Elke Nekolla, Horst Lenzen, Walter Heindel","doi":"10.1007/s00330-024-10847-9","DOIUrl":"10.1007/s00330-024-10847-9","url":null,"abstract":"<p><strong>Objectives: </strong>The randomized TOmosynthesis plus SYnthesized MAmmography (TOSYMA) screening trial has shown that digital breast tomosynthesis plus synthesized mammography (DBT + SM) is superior to digital mammography (DM) in invasive breast cancer detection varying with breast density. On the other hand, the overall average glandular dose (AGD) of DBT is higher than that of DM. Comparing the DBT + SM and DM trial arm, we analyzed here the mean AGD and their determinants per breast density category and related them to the respective invasive cancer detection rates (iCDR).</p><p><strong>Methods: </strong>TOSYMA screened 99,689 women aged 50 to 69 years. Compression force, resulting breast thickness, the calculated AGD obtained from each mammography device, and previously published iCDR were used for comparisons across breast density categories in the two trial arms.</p><p><strong>Results: </strong>There were 196,622 exposures of 49,227 women (DBT + SM) and 197,037 exposures of 49,132 women (DM) available for analyses. Mean breast thicknesses declined from breast density category A (fatty) to D (extremely dense) in both trial arms. However, while the mean AGD in the DBT + SM arm declined concomitantly from category A (2.41 mGy) to D (1.89 mGy), it remained almost unchanged in the DM arm (1.46 and 1.51 mGy, respectively). In relative terms, the AGD elevation in the DBT + SM arm (64.4% (A), by 44.5% (B), 27.8% (C), and 26.0% (D)) was lowest in dense breasts where, however, the highest iCDR were observed.</p><p><strong>Conclusion: </strong>Women with dense breasts may specifically benefit from DBT + SM screening as high cancer detection is achieved with only moderate AGD elevations.</p><p><strong>Clinical relevance statement: </strong>TOSYMA suggests a favorable constellation for screening with digital breast tomosynthesis plus synthesized mammography (DBT + SM) in dense breasts when weighing average glandular dose elevation against raised invasive breast cancer detection rates. There is potential for density-, i.e., risk-adapted population-wide breast cancer screening with DBT + SM.</p><p><strong>Key points: </strong>Breast thickness declines with visually increasing density in digital mammography (DM) and digital breast tomosynthesis (DBT). Average glandular doses of DBT decrease with increasing density; digital mammography shows lower and more constant values. With the smallest average glandular dose difference in dense breasts, DBT plus SM had the highest difference in invasive breast cancer detection rates.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"166-176"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619627","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-based 3D quantitative total tumor burden predicts early recurrence of BCLC A and B HCC after resection.","authors":"Hong Wei, Tianying Zheng, Xiaolan Zhang, Chao Zheng, Difei Jiang, Yuanan Wu, Jeong Min Lee, Mustafa R Bashir, Emily Lerner, Rongbo Liu, Botong Wu, Hua Guo, Yidi Chen, Ting Yang, Xiaoling Gong, Hanyu Jiang, Bin Song","doi":"10.1007/s00330-024-10941-y","DOIUrl":"10.1007/s00330-024-10941-y","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the potential of deep learning (DL)-assisted automated three-dimensional quantitative tumor burden at MRI to predict postoperative early recurrence (ER) of hepatocellular carcinoma (HCC).</p><p><strong>Materials and methods: </strong>This was a single-center retrospective study enrolling patients who underwent resection for BCLC A and B HCC and preoperative contrast-enhanced MRI. Quantitative total tumor volume (cm³) and total tumor burden (TTB, %) were obtained using a DL automated segmentation tool. Radiologists' visual assessment was used to ensure the quality control of automated segmentation. The prognostic value of clinicopathological variables and tumor burden-related parameters for ER was determined by Cox regression analyses.</p><p><strong>Results: </strong>A total of 592 patients were included, with 525 and 67 patients assigned to BCLC A and B, respectively (2-year ER rate: 30.0% vs. 45.3%; hazard ratio (HR) = 1.8; p = 0.007). TTB was the most important predictor of ER (HR = 2.2; p < 0.001). Using 6.84% as the threshold of TTB, two ER risk strata were obtained in overall (p < 0.001), BCLC A (p < 0.001), and BCLC B (p = 0.027) patients, respectively. The BCLC B low-TTB patients had a similar risk for ER to BCLC A patients and thus were reassigned to a BCLC A_n stage; whilst the BCLC B high-TTB patients remained in a BCLC B_n stage. The 2-year ER rate was 30.5% for BCLC A_n patients vs. 58.1% for BCLC B_n patients (HR = 2.8; p < 0.001).</p><p><strong>Conclusions: </strong>TTB determined by DL-based automated segmentation at MRI was a predictive biomarker for postoperative ER and facilitated refined subcategorization of patients within BCLC stages A and B.</p><p><strong>Clinical relevance statement: </strong>Total tumor burden derived by deep learning-based automated segmentation at MRI may serve as an imaging biomarker for predicting early recurrence, thereby improving subclassification of Barcelona Clinic Liver Cancer A and B hepatocellular carcinoma patients after hepatectomy.</p><p><strong>Key points: </strong>Total tumor burden (TTB) is important for Barcelona Clinic Liver Cancer (BCLC) staging, but is heterogenous. TTB derived by deep learning-based automated segmentation was predictive of postoperative early recurrence. Incorporating TTB into the BCLC algorithm resulted in successful subcategorization of BCLC A and B patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"127-139"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723375","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":"Optimizing coronary CT angiography quality with motion-compensated reconstruction for second-generation dual-layer spectral detector CT.","authors":"Shengmei Liu, Linyan Huang, Shen Gui, Xueting Pang, Jing Liu, Xue Li, Yinqiu Wang, Wenzhang He, Xiaodi Zhang, Liqing Peng","doi":"10.1007/s00330-024-10908-z","DOIUrl":"10.1007/s00330-024-10908-z","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of motion-compensated reconstruction (MCR) algorithm on improving the image quality of coronary computed tomography angiography (CCTA) using second-generation dual-layer spectral detector computed tomography (DLCT), and to evaluate the influence of heart rate (HR) on the motion-correction efficacy of this algorithm.</p><p><strong>Materials and methods: </strong>We retrospectively enrolled 127 patients who underwent CCTA for suspected coronary artery disease using second-generation DLCT. We divided the patients into two subgroups according to their average HR during scanning: the \"HR < 75 bpm\" group and the \"HR ≥ 75 bpm\" group. All images were reconstructed by the standard (STD) algorithm and MCR algorithm. Subjective image quality (4-point Likert scale), interpretability, and objective image quality between the STD and MCR in the whole population and within each subgroup were compared.</p><p><strong>Results: </strong>MCR showed significantly higher Likert scores and interpretability than STD on the per-segment (3.58 ± 0.69 vs. 2.82 ± 0.93, 98.4% vs. 91.9%), per-vessel (3.12 ± 0.81 vs. 2.12 ± 0.74, 96.3% vs. 78.7%) and per-patient (2.57 ± 0.76 vs. 1.62 ± 0.55, 90.6% vs. 59.1%) levels (all p < 0.001). In the analysis of HR subgroups on a per-vessel basis of interpretability, significant differences were observed only in the right coronary artery in the low HR group, whereas significant differences were noted in three major coronary arteries in the high HR group. For objective image quality assessment, MCR significantly improved the SNR (13.22 ± 4.06 vs. 12.72 ± 4.06) and the contrast-to-noise ratio (15.84 ± 4.82 vs. 15.39 ± 4.38) compared to STD (both p < 0.001).</p><p><strong>Conclusion: </strong>MCR significantly improves the subjective image quality, interpretability, and objective image quality of CCTA, especially in patients with higher HRs.</p><p><strong>Clinical relevance statement: </strong>The motion-compensated reconstruction algorithm of the second-generation dual-layer spectral detector computed tomography is helpful in improving the image quality of coronary computed tomography angiography in clinical practice, especially in patients with higher heart rates.</p><p><strong>Key points: </strong>Motion artifacts from cardiac movement affect the quality and interpretability of coronary computed tomography angiography (CCTA). This motion-compensated reconstruction (MCR) algorithm significantly improves the image quality of CCTA in clinical practice. Image quality improvement by using MCR was more significant in the high heart rate group.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"381-392"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579354","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":"Letter to the Editor: \"Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where?\"","authors":"William Dana Middleton, Jon A Jacobson, Nirvikar Dahiya","doi":"10.1007/s00330-024-10878-2","DOIUrl":"10.1007/s00330-024-10878-2","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"323-324"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590025","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}