European Radiology最新文献

{"title":"A randomised controlled trial comparing three clinical administration strategies in spectral detector CT pulmonary angiography with low contrast medium dose.","authors":"Cathrine Helgestad Kristiansen, Owen Thomas, Anton Bengt Nyquist, Audun Sanderud, Joao Boavida, Jonn Terje Geitung, Thien Trung Tran, Peter Mæhre Lauritzen","doi":"10.1007/s00330-025-11420-8","DOIUrl":"https://doi.org/10.1007/s00330-025-11420-8","url":null,"abstract":"<p><strong>Objectives: </strong>To compare vascular attenuation (VA) with three strategies for administering a low contrast medium (CM) dose in dual-layer spectral detector CT pulmonary angiography (CTPA).</p><p><strong>Methods: </strong>Patients were prospectively randomised into control- or one of two experimental groups. Control group patients received CM (350 mgI/mL) diluted 1:1 with saline. Experimental group B received CM (350 mgI/mL) with low flow. Experimental group C received CM with low concentration (140 mgI/mL). Virtual monoenergetic images at 40 and 55 kiloelectron Volt (keV) were reconstructed. Objective examination quality (OEQ) i.e., VA, noise, and signal-to-noise ratio, was measured and subjective examination quality (SEQ) was rated at three anatomical levels: in the pulmonary trunk (PT), the interlobar arteries and the posterior basal segmental arteries.</p><p><strong>Primary outcome: </strong>VA in PT at 40 keV.</p><p><strong>Secondary outcomes: </strong>OEQ and SEQ across all anatomic levels.</p><p><strong>Results: </strong>A total of 328 patients were randomised. 112 vs 115 and 101 were analysed in the control (A) vs experimental groups (B and C), respectively. There were no differences in VA in PT between the groups: A vs B (p = 0.96), B vs C (p = 0.14), and A vs C (p = 0.18). Group C showed higher VA across all anatomical levels. There were no differences in SEQ.</p><p><strong>Conclusion: </strong>There was no difference in the attenuation in the PT between the dilution-, low flow-, and low concentration groups. However, the low concentration group showed higher attenuation in the pulmonary arteries when all anatomical levels were assessed.</p><p><strong>Key points: </strong>Question Contrast medium reduction may be accomplished with dilution, low flow, or low concentration. However, the effect of the different strategies on vascular attenuation is unknown. Findings There was no difference in pulmonary trunk attenuation between the three strategies on spectral detector CT pulmonary angiography. Clinical relevance Low contrast medium dose spectral detector CT pulmonary angiography may be implemented with the administration strategy of the unit's own choice.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448647","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 the COVID-19 pandemic on cardiac magnetic resonance imaging practices: insights from the MRCT registry.","authors":"Lukas J Moser, Costanza Lisi, Matthias Gutberlet, Sara Boccalini, Ricardo P J Budde, Marco Francone, Maja Hrabak Paar, Christian Loewe, Giuseppe Muscogiuri, Luigi Natale, Konstantin Nikolaou, Maja Pirnat, Rodrigo Salgado, Rozemarijn Vliegenthart, Michelle C Williams, Matthias Eberhard, Hatem Alkadhi","doi":"10.1007/s00330-025-11464-w","DOIUrl":"https://doi.org/10.1007/s00330-025-11464-w","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the relationship between the COVID-19 pandemic and the spectrum of indications for cardiac magnetic resonance imaging (MRI) with a focus on myocarditis.</p><p><strong>Materials and methods: </strong>This was a retrospective analysis of data from the MRCT registry of the European Society of Cardiovascular Radiology (ESCR). Data regarding indications and diagnoses of myocarditis between January 1, 2018, and April 30, 2024, were extracted. Data was analyzed for the periods before and after the beginning (i.e., March 11, 2020) of the COVID-19 pandemic.</p><p><strong>Results: </strong>Data from 112,361 cardiac MRI examinations was analyzed (63.5% male, median age 58 [IQR 44-69]). Over the entire period, assessment of myocarditis was the most common indication for cardiac MRI (31%, n = 34,906/112,361). Before the pandemic, this indication comprised 28% of examinations and increased to a maximum of 41% in 2022 after the onset of the pandemic. Simultaneously, the positivity rate of these examinations decreased from 21% before the pandemic to 14% in 2022. Male patients had a higher positivity rate than female patients both before and during the pandemic, with mirroring trends between sexes. The proportion of cardiac MRI examinations performed for suspected and known coronary artery disease showed an inverse relationship with those performed for myocarditis and decreased from 24% and 17% pre-pandemic to a minimum of 21% and 13% during the pandemic.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic considerably influenced the pattern of referrals for cardiac MRI examinations in Europe, leading to a higher proportion of examinations for suspected myocarditis but a reduced positivity rate, suggesting a lower referral threshold for this indication. At the same time, proportionally fewer examinations were performed for suspected and known coronary artery disease.</p><p><strong>Key points: </strong>Question The COVID-19 pandemic may have influenced the spectrum and positivity rates of indications for cardiac MRI, especially examinations for myocarditis. Findings The COVID-19 pandemic led to a higher proportion of cardiac MRI examinations for suspected myocarditis but a reduced positivity rate. Clinical relevance The spectrum and proportions of indications for cardiac MRI give important information on the historical and current trends in cardiac imaging and provide insight into resource deployment.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448656","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":"Two independent studies, one goal, one conclusion: radiomics research quality under the microscope.","authors":"Burak Kocak, Nathaniel Barry","doi":"10.1007/s00330-025-11457-9","DOIUrl":"https://doi.org/10.1007/s00330-025-11457-9","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448672","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":"Important radiological and clinicopathological risk factors for the recurrence of intraductal papillary mucinous neoplasms after surgical resection.","authors":"Junghoan Park, Jung Hoon Kim, Rae Rim Ryu, Sungjun Hwang","doi":"10.1007/s00330-025-11431-5","DOIUrl":"https://doi.org/10.1007/s00330-025-11431-5","url":null,"abstract":"<p><strong>Objectives: </strong>To assess significant radiological and clinicopathological risk factors for post-surgery recurrence in patients with intraductal papillary mucinous neoplasm (IPMN).</p><p><strong>Materials and methods: </strong>Patients with IPMNs who underwent surgery from 2011 to 2021 at a single center were retrospectively included. Two reviewers evaluated CT findings according to international guidelines. Clinicopathological data were collected from medical records and surgical pathology reports. Patients were monitored for recurrence with contrast-enhanced CT or MRI up to 2023. Univariable Cox regression analysis included potential risk factors: all high-risk stigmata and worrisome features in the international guidelines, age, sex, tumor location, type, carcinoembryonic antigen, surgery type, postsurgical residual cyst, adjuvant treatment, pathologic grade, type, size, margin status, lymph node metastasis, gland type, and pancreatic intraepithelial neoplasia. Variables with p < 0.2 were included in multivariate analysis.</p><p><strong>Results: </strong>Among 332 patients (mean age, 66.3 ± 9.0 years; 212 men), recurrence occurred in 39 (11.7%) over a median follow-up of 3.2 years (range: 0.1-12.3 years). Two- and five-year recurrence-free survival rates were 91.2% and 86.4%, respectively. Significant radiological risk factors included enhancing mural nodule (EMN) presence (hazard ratio [HR] 5.088, p = 0.007) and lymphadenopathy (HR 2.837, p = 0.01). Associated invasive carcinoma (HR 25.030), lymph node metastasis (HR 27.562), adjuvant treatment (HR 0.203), and history of pancreatitis (HR 2.608) were also significant. Most imaging features showed moderate to excellent interobserver agreement, except for thickened/enhancing cyst walls (κ, 0.25).</p><p><strong>Conclusion: </strong>The presence of EMNs and lymphadenopathy, along with several clinicopathologic factors, were significantly associated with IPMN recurrence.</p><p><strong>Key points: </strong>Question Understanding postoperative recurrence risk in IPMN patients is crucial for determining surveillance strategies; however, research on radiologic risk factors remains limited. Findings The presence of EMNs and lymphadenopathy were identified as significant radiologic risk factors for the postoperative recurrence of IPMN, along with clinicopathologic factors. Clinical relevance IPMN recurrence is significantly associated with imaging findings like EMNs and lymphadenopathy, as well as clinical and pathologic factors. It can guide the development of tailored postoperative surveillance strategies for IPMN patients in further studies.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457404","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":"Improving image quality and diagnostic usability in photon-counting coronary CT angiography using a novel reconstruction algorithm.","authors":"Nina P Haag, Julius H Niehoff, Iram Shahzadi, Christoph Panknin, Marcus Wiemer, Sven Kaese, Roman Johannes Gertz, Lenhard Pennig, Ole Inuk Platte, Alexey Surov, Jan Borggrefe, Jan Robert Kroeger","doi":"10.1007/s00330-025-11429-z","DOIUrl":"https://doi.org/10.1007/s00330-025-11429-z","url":null,"abstract":"<p><strong>Purpose: </strong>Qualitative comparison of image quality and diagnostic usability of the recently introduced ZeeFree (ZF) reconstruction algorithm for photon-counting coronary CT angiography (cCTA) with Standard (SD) and TrueStack (TS) reconstruction algorithms.</p><p><strong>Methods and materials: </strong>This retrospective single-center study included 59 patients (mean age 62.5 ± 13.7, 37 males) who were referred for cCTA on a clinical photon-counting CT scanner between July and December 2023. Curved planar reformations were reconstructed for coronary arteries using ZF, SD, and TS algorithms. Three blinded radiologists individually evaluated image quality on a 5-point Likert scale (5 = excellent; median and interquartile range). Differences were evaluated using Friedman's test with pair-wise post-hoc testing. Readers were advised to assess the image quality to be diagnostic using a dichotomous yes/no question, with results being presented as percentages and significance evaluated by the Pearson Chi-Square test. Interrater reliability for image quality used Gwet's AC2 coefficient with ordinal weights, and Gwet's AC1 coefficient for diagnostic usability.</p><p><strong>Results: </strong>ZF showed superior quality (4 (2)) compared to SD (4 (2), p = 0.03) and TS (4 (1), p < 0.001) while a substantial inter-rater agreement was observed for all algorithms (0.70-0.74). Furthermore, ZF obtained the highest diagnostic usability compared to SD (82.5% vs. 77.0%, p < 0.001) and TS (75.5%, p < 0.001) while yielding an almost perfect inter-rater agreement (0.84).</p><p><strong>Conclusion: </strong>Compared to SD and TS, the novel ZF image reconstruction algorithm for photon-counting cCTA provides improved image quality and diagnostic usability, suggesting its primary use for clinical assessment.</p><p><strong>Key points: </strong>Question How well does the novel ZeeFree algorithm address motion artifacts in photon-counting coronary CT angiography? Findings ZeeFree significantly outperformed Standard and TrueStack reconstruction algorithms for image quality and diagnostic usability. Clinical relevance Enhanced image quality with ZeeFree could improve the diagnosis of coronary artery disease.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448663","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":"Three-dimensional MR elastography-based stiffness for assessing the status of Ki67 proliferation index and Cytokeratin-19 in hepatocellular carcinoma.","authors":"Lina Zhang, Yuanqiang Xiao, Mengshi Dong, Mengsi Li, Haimei Chen, Jin Wang","doi":"10.1007/s00330-025-11375-w","DOIUrl":"https://doi.org/10.1007/s00330-025-11375-w","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the potential diagnostic value of MR elastography (MRE)-based stiffness to noninvasively predict the status of Ki67 proliferation index (PI) and Cytokeratin-19 (CK19) in hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>Two hundred and nineteen patients with histologically proven HCCs (high/low Ki67 PI, N = 134/85; +/-CK19, N = 47/172) who underwent preoperative MRI and MRE examinations were retrospectively enrolled. Imaging features and clinical information were analyzed to develop the clinical-radiologic models. Logistic regression and area under the receiver operating characteristic curve (AUC) analyses were used to evaluate the status of Ki67 PI and CK19, and their model performances.</p><p><strong>Results: </strong>Tumor stiffness (TS) (p = 0.004) and TS/liver stiffness (LS) (p < 0.001) were significantly independent predictors of high Ki67 PI and positive CK19, respectively. By incorporating TS or TS/LS value, the AUCs of the clinical-radiological models have been improved for identifying high Ki67 PI from 0.796 to 0.819 (p = 0.113), and positive CK19 from 0.817 to 0.852 (p = 0.026). Patients with predicted high Ki67 PI/positive CK19 based on the combined models had worse recurrence-free survival (RFS) and overall survival (OS) than those with low Ki67 PI/negative CK19 (all p < 0.05), respectively. The combined statuses of predicted Ki67 PI and CK19 stratified patients into three distinct subgroups with significantly different RFS and OS (all p < 0.05). Notably, patients with predicted high Ki67 PI and positive CK19 had the worst prognosis.</p><p><strong>Conclusions: </strong>Three-dimensional MRE could be a promising tool for evaluating and stratifying the prognosis of HCC patients by predicting the status of Ki67 PI and CK19 preoperatively.</p><p><strong>Key points: </strong>Question Can MRE-based stiffness predict Ki67 PI and Cytokeratin 19 (CK19) in HCC? Findings MRE-based stiffness is an independent predictor of high Ki67 PI and CK19-positive and improves the diagnostic performance of clinical-radiological models predicting Ki67 PI and CK19 status. Clinical relevance MRE-based stiffness is a noninvasive predictor of high Ki67 PI and CK19-positive, and in combination with clinical-radiological models can be used for prognostic analysis, which could refine patients' selection for adjuvant therapy or surveillance.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440266","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":"Leptomeningeal metastases at recurrence in IDH-wildtype glioblastomas: incidence, risk factors, and prognosis based on postcontrast FLAIR imaging.","authors":"Yae Won Park, Geon Jang, Si Been Kim, Kyunghwa Han, Na-Young Shin, Sung Soo Ahn, Jong Hee Chang, Se Hoon Kim, Rajan Jain, Seung-Koo Lee","doi":"10.1007/s00330-025-11447-x","DOIUrl":"https://doi.org/10.1007/s00330-025-11447-x","url":null,"abstract":"<p><strong>Objectives: </strong>To comprehensively investigate the incidence, risk factors, and prognosis of leptomeningeal metastases (LM) diagnosed at recurrence in IDH-wildtype glioblastoma patients.</p><p><strong>Materials and methods: </strong>A total of 734 IDH-wildtype glioblastoma patients were enrolled between 2005 and 2022. LM at recurrence was diagnosed with MRI including postcontrast FLAIR. Logistic analysis for development of LM at recurrence was performed with clinical, molecular, imaging (including tumor volume and distance to subventricular zone via automatic segmentation), and surgical data including extent of resection and ventricular entry. The overall survival (OS) was compared between patients with and without LM at recurrence.</p><p><strong>Results: </strong>The incidence of LM at recurrence based on postcontrast FLAIR was 10.8% (79 patients). On multivariable analysis, younger age at diagnosis (odds ratio (OR) = 0.98, p = 0.011) and ventricular entry (OR = 3.15, p < 0.001) were independent predictors of LM at recurrence. However, patients with LM at recurrence showed no significant difference in OS from patients without LM (log-rank test; p = 0.461), with median OS of 18.0 (95% confidence interval (CI) 16.2-19.8) and 18.5 (95% CI 16.4-20.7) months in patients with and without LM at recurrence, respectively.</p><p><strong>Conclusion: </strong>The incidence of LM at recurrence is relatively high in IDH-wildtype glioblastoma patients. Younger age and ventricular entry during surgery warrant imaging surveillance for LM at recurrence. As LM at recurrence showed no significant OS compromise and larger extent of resection (EOR) is associated with survival benefits, ventricular entry during maximal safe resection may be acceptable.</p><p><strong>Key points: </strong>Question The incidence, risk factors, and prognosis of leptomeningeal metastases (LM) diagnosed at recurrence in IDH-wildtype glioblastoma patients are currently unknown. Findings LM at recurrence occurred in 10.8% of cases, with younger age and ventricular entry as risk factors, but no significant difference in survival outcomes between groups. Clinical relevance The incidence, risk factors, and prognosis of LM at recurrence were investigated in IDH-wildtype glioblastoma patients with postcontrast FLAIR. Younger age and ventricular entry warrant surveillance of LM at recurrence, while the overall survival is not as discouraging as expected.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448664","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":"Early detection of left atrial function alterations across the heart failure spectrum by feature tracking-cardiac magnetic resonance.","authors":"Yufan Gao, Boxin Li, Yanhe Ma, Shuo Liang, Anhong Yu, Minghui Hua, Hong Zhang, Zhigang Guo","doi":"10.1007/s00330-025-11453-z","DOIUrl":"https://doi.org/10.1007/s00330-025-11453-z","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess left atrial (LA) structure and phasic function in patients with heart failure (HF) with preserved ejection fraction (HFpEF), HF with mid-range ejection fraction (HFmrEF), and HF with reduced ejection fraction (HFrEF) as well as to explore abnormal atrioventricular interaction in HF patients.</p><p><strong>Methods: </strong>The LA structure and function of 49 controls without HF (24 males, mean age, 57 ± 7 years) and 142 HF patients (98 males, mean age, 59 ± 13 years) were evaluated by LA volumetric and strain analysis using cardiac magnetic resonance, complemented by T1 and left ventricular (LV) strain measurements. Reservoir, conduit, and booster pump LA function was analyzed by LA strain, strain rate, and emptying fraction.</p><p><strong>Results: </strong>The HF patients included 50 HFpEF, 31 HFmrEF, and 61 HFrEF cases. Compared with controls, HF patients displayed increased LA volumes. LA phasic functions were impaired in all HF groups, even in patients with normal LA size. The LA reservoir strain and strain rate decreased from HFpEF through HFmrEF to HFrEF (all p < 0.05). The worse LA strain parameters were associated with worse LV strains, higher native T1, higher extracellular volume, and higher brain natriuretic peptide levels (all p < 0.05). LA phasic strains and strain rates showed better performance in differentiating HF categories compared to LA volumetric analysis.</p><p><strong>Conclusions: </strong>LA phasic function was impaired to varying degrees in HFpEF, HFmrEF, and HFrEF patients compared to controls. LA strain plays a valuable role in identifying early LA function alterations and different LA function states in HF entities.</p><p><strong>Key points: </strong>Question Information left atrial (LA) structure and phasic function changes across the heart failure spectrum, especially alterations in LA strains before LA enlargement, remain limited. Findings Compared to controls, LA phasic strains assessed by cardiac MR were impaired to varying degrees in all heart failure subtypes, even with normal LA size. Clinical relevance LA strain plays a valuable role in identifying early LA function alterations and different LA function states in heart failure entities, with implications for monitoring dynamic LA function changes in routine practice.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440317","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":"Multimodal deep learning: tumor and visceral fat impact on colorectal cancer occult peritoneal metastasis.","authors":"Shidi Miao, Mengzhuo Sun, Beibei Zhang, Yuyang Jiang, Qifan Xuan, Guopeng Wang, Mingxuan Wang, Yuxin Jiang, Qiujun Wang, Zengyao Liu, Xuemei Ding, Ruitao Wang","doi":"10.1007/s00330-025-11450-2","DOIUrl":"https://doi.org/10.1007/s00330-025-11450-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study proposes a multimodal deep learning (DL) approach to investigate the impact of tumors and visceral fat on occult peritoneal metastasis in colorectal cancer (CRC) patients.</p><p><strong>Methods: </strong>We developed a DL model named Multi-scale Feature Fusion Network (MSFF-Net) based on ResNet18, which extracted features of tumors and visceral fat from the longest diameter tumor section and the third lumbar vertebra level (L3) in preoperative CT scans of CRC patients. Logistic regression analysis was applied to patients' clinical data that integrated with DL features. A random forest (RF) classifier was established to evaluate the MSFF-Net's performance on internal and external test sets and compare it with radiologists' performance.</p><p><strong>Results: </strong>The model incorporating fat features outperformed the single tumor modality in the internal test set. Combining clinical information with DL provided the best diagnostic performance for predicting peritoneal metastasis in CRC patients. The AUCs were 0.941 (95% CI: [0.891, 0.986], p = 0.03) for the internal test set and 0.911 (95% CI: [0.857, 0.971], p = 0.013) for the external test set. CRC patients with peritoneal metastasis had a higher visceral adipose tissue index (VATI) compared to those without. Maximum tumor diameter and VATI were identified as independent prognostic factors for peritoneal metastasis. Grad-CAM decision regions corresponded with the independent prognostic factors identified by logistic regression analysis.</p><p><strong>Conclusion: </strong>The study confirms the network features of tumors and visceral fat significantly enhance predictive performance for peritoneal metastasis in CRC. Visceral fat is a meaningful imaging biomarker for peritoneal metastasis's early detection in CRC patients.</p><p><strong>Key points: </strong>Question Current research on predicting colorectal cancer with peritoneal metastasis mainly focuses on single-modality analysis, while studies based on multimodal imaging information are relatively scarce. Findings The Multi-scale Feature Fusion Network, constructed based on ResNet18, can utilize CT images of tumors and visceral fat to detect occult peritoneal metastasis in colorectal cancer. Clinical relevance This study identified independent prognostic factors for colorectal cancer peritoneal metastasis and combines them with tumor and visceral fat network features, aiding early diagnosis and accurate prognostic assessment.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440264","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":"PI-CAI: a landmark AI study for prostate cancer detection on MRI.","authors":"Masoom A Haider","doi":"10.1007/s00330-025-11454-y","DOIUrl":"https://doi.org/10.1007/s00330-025-11454-y","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440265","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}