Insights into Imaging最新文献

{"title":"Automatic grading of knee osteoarthritis with a plain radiograph radiomics model: combining anteroposterior and lateral images.","authors":"Wei Li, Jin Liu, Zhongli Xiao, Dantian Zhu, Jianwei Liao, Wenjun Yu, Jiaxin Feng, Baoxin Qian, Yijie Fang, Shaolin Li","doi":"10.1186/s13244-024-01719-3","DOIUrl":"10.1186/s13244-024-01719-3","url":null,"abstract":"<p><strong>Objectives: </strong>To establish a radiomics-based automatic grading model for knee osteoarthritis (OA) and evaluate the influence of different body positions on the model's effectiveness.</p><p><strong>Materials and methods: </strong>Plain radiographs of a total of 473 pairs of knee joints from 473 patients (May 2020 to July 2021) were retrospectively analyzed. Each knee joint included anteroposterior (AP) and lateral (LAT) images which were randomly assigned to the training cohort and the testing cohort at a ratio of 7:3. First, an assessment of knee OA severity was done by two independent radiologists with Kallgren-Lawrence grading scale. Then, another two radiologists independently delineated the region of interest for radiomic feature extraction and selection. The radiomic classification features were dimensionally reduced and a machine model was conducted using logistic regression (LR). Finally, the classification efficiency of the model was evaluated using receiver operating characteristic curves and the area under the curve (AUC).</p><p><strong>Results: </strong>The AUC (macro/micro) of the model using a combination of AP and LAT (AP&LAT) images were 0.772/0.778, 0.818/0.799, and 0.864/0.879, respectively. The radiomic features from the combined images achieved better classification performance than the individual position image (p < 0.05). The overall accuracy of the radiomic model with AP&LAT images was 0.727 compared to 0.712 and 0.417 for radiologists with 4 years and 2 years of musculoskeletal diagnostic experience.</p><p><strong>Conclusions: </strong>A radiomic model constructed by combining the AP&LAT images of the knee joint can better grade knee OA and assist clinicians in accurate diagnosis and treatment.</p><p><strong>Critical relevance statement: </strong>A radiomic model based on plain radiographs accurately grades knee OA severity. By utilizing the LR classifier and combining AP&LAT images, it improves accuracy and consistency in grading, aiding clinical decision-making, and treatment planning.</p><p><strong>Key points: </strong>Radiomic model performed more accurately in K/L grading of knee OA than junior radiologists. Radiomic features from the combined images achieved better classification performance than the individual position image. A radiomic model can improve the grading of knee OA and assist in diagnosis and treatment.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11169124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310622","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":"Qualitative and quantitative MRI analysis of alveolar soft part sarcoma: correlation with histological grade and Ki-67 expression.","authors":"Junhui Yuan, Deshun Xie, Shaobo Fang, Fan Meng, Yue Wu, Dongqiu Shan, Nannan Shao, Bangmin Wang, Zhichao Tian, Yuanyuan Wang, Chunmiao Xu, Xuejun Chen","doi":"10.1186/s13244-024-01687-8","DOIUrl":"10.1186/s13244-024-01687-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between MRI findings and histological features for preoperative prediction of histological grading and Ki-67 expression level in alveolar soft part sarcoma (ASPS).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 63 ASPS patients (Jan 2017-May 2023). All patients underwent 3.0-T MRI examinations, including conventional sequences, dynamic contrast-enhanced scans with time-intensity curve analysis, and diffusion-weighted imaging with apparent diffusion coefficient (ADC) measurements. Patients were divided into low-grade (histological Grade I) and high-grade (histological Grade II/III) groups based on pathology. Immunohistochemistry was used to assess Ki-67 expression levels in ASPS. Statistical analysis included chi-square tests, Wilcoxon rank-sum test, binary logistic regression analysis, Spearman correlation analysis, and receiver operating characteristic curve analysis of various observational data.</p><p><strong>Results: </strong>There were 29 low-grade and 34 high-grade patients (26 males and 37 females) and a wide age range (5-68 years). Distant metastasis, tumor enhancement characteristics, and ADC values were independent predictors of high-grade ASPS. High-grade ASPS had lower ADC values (p = 0.002), with an area under the curve (AUC), sensitivity, and specificity of 0.723, 79.4%, and 58.6%, respectively, for high-grade prediction. There was a negative correlation between ADC values and Ki-67 expression (r = -0.526; p < 0.001). When the cut-off value of ADC was 0.997 × 10^-3 mm²/s, the AUC, sensitivity, and specificity for predicting high Ki-67 expression were 0.805, 65.6%, and 83.9%, respectively.</p><p><strong>Conclusion: </strong>Qualitative and quantitative MRI parameters are valuable for predicting histological grading and Ki-67 expression levels in ASPS.</p><p><strong>Critical relevance statement: </strong>This study will help provide a more nuanced understanding of ASPS and guide personalized treatment strategies.</p><p><strong>Key points: </strong>There is limited research on assessing ASPS prognosis through MRI. Metastasis, enhancement, and ADC correlated with histological grade; ADC related to Ki-67 expression. MRI provides clinicians with valuable information on ASPS grading and proliferation activity.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11169322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310623","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":"Reduced field-of-view DWI based on deep learning reconstruction improving diagnostic accuracy of VI-RADS for evaluating muscle invasion.","authors":"Xinxin Zhang, Xiaojuan Xu, Yichen Wang, Jie Zhang, Mancang Hu, Jin Zhang, Lianyu Zhang, Sicong Wang, Yi Li, Xinming Zhao, Yan Chen","doi":"10.1186/s13244-024-01686-9","DOIUrl":"10.1186/s13244-024-01686-9","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether reduced field-of-view (rFOV) diffusion-weighted imaging (DWI) with deep learning reconstruction (DLR) can improve the accuracy of evaluating muscle invasion using VI-RADS.</p><p><strong>Methods: </strong>Eighty-six bladder cancer participants who were evaluated by conventional full field-of-view (fFOV) DWI, standard rFOV (rFOV_STA) DWI, and fast rFOV with DLR (rFOV_DLR) DWI were included in this prospective study. Tumors were categorized according to the vesical imaging reporting and data system (VI-RADS). Qualitative image quality scoring, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and ADC value were evaluated. Friedman test with post hoc test revealed the difference across the three DWIs. Receiver operating characteristic analysis was performed to calculate the areas under the curve (AUCs).</p><p><strong>Results: </strong>The AUC of the rFOV_STA DWI and rFOV_DLR DWI were higher than that of fFOV DWI. rFOV_DLR DWI reduced the acquisition time from 5:02 min to 3:25 min, and showed higher scores in overall image quality with higher CNR and SNR, compared to rFOV_STA DWI (p < 0.05). The mean ADC of all cases of rFOV_STA DWI and rFOV_DLR DWI was significantly lower than that of fFOV DWI (all p < 0.05). There was no difference in mean ADC value and the AUC for evaluating muscle invasion between rFOV_STA DWI and rFOV_DLR DWI (p > 0.05).</p><p><strong>Conclusions: </strong>rFOV DWI with DLR can improve the diagnostic accuracy of fFOV DWI for evaluating muscle invasion. Applying DLR to rFOV DWI reduced the acquisition time and improved overall image quality while maintaining ADC value and diagnostic accuracy.</p><p><strong>Critical relevance statement: </strong>The diagnostic performance and image quality of full field-of-view DWI, reduced field-of-view (rFOV) DWI with and without DLR were compared. DLR would benefit the wide clinical application of rFOV DWI by reducing the acquisition time and improving the image quality.</p><p><strong>Key points: </strong>Deep learning reconstruction (DLR) can reduce scan time and improve image quality. Reduced field-of-view (rFOV) diffusion-weighted imaging (DWI) with DLR showed better diagnostic performances than full field-of-view DWI. There was no difference of diagnostic accuracy between rFOV DWI with DLR and standard rFOV DWI.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295922","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":"The value of apparent diffusion coefficient values in predicting Gleason grading of low to intermediate-risk prostate cancer.","authors":"Xu Yan, Ke Ma, Li Zhu, Yiqi Pan, Yuting Wang, Jiong Shi, Xiaoli Mai","doi":"10.1186/s13244-024-01684-x","DOIUrl":"10.1186/s13244-024-01684-x","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the diagnostic performance of the apparent diffusion coefficient (ADC) for low to intermediate-risk prostate cancer (PCa), as well as its correlation with the prognostic Gleason score (GS).</p><p><strong>Materials and methods: </strong>Retrospective analysis of MRI images and relevant clinical data from patients with prostate disease. The differences in ADC between different GS groups were compared, and the efficacy of ADC in PCa diagnosis were analyzed. Furthermore, the diagnostic performance of the mean ADC (ADC_mean) and minimum ADC (ADC_min) values was compared.</p><p><strong>Results: </strong>There were 1414 patients with 1631 lesions. In terms of GS, both ADC_min and ADC_mean values of the GS 4 + 3 group were significantly lower than those of the GS 3 + 4 group, GS 3 + 3 group, and the benign group, with all differences being statistically significant (p < 0.01). The AUC values for diagnosing PCa based on ADC_min and ADC_mean were 0.914 and 0.944, respectively. The corresponding diagnostic thresholds were 0.703 × 10^-³ mm²/s for ADC_min and 0.927 × 10^-3 mm²/s for ADC_mean. The magnitudes of ADC_min and ADC_mean values exhibited a negative correlation with GS values (ρ = -0.750, p < 0.001; ρ = -0.752, p < 0.001).</p><p><strong>Conclusions: </strong>ADC values demonstrate an inverse relationship with the invasiveness of PCa, indicating that higher invasiveness is associated with lower ADC values. Additionally, ADC values exhibit high diagnostic potential, sensitivity, and specificity for distinguishing between GS 3 + 4 and GS 4 + 3 lesions. Moreover, the diagnostic value of ADC_mean is even more significant, highlighting its crucial role in the diagnosis of low to intermediate-risk PCa.</p><p><strong>Critical relevance statement: </strong>ADC values are a valuable tool for distinguishing different levels of aggressiveness in PCa. They help in the preoperative assessment of the biological characteristics of PCa, allowing clinicians to develop personalized treatment strategies, effectively mitigating the risk of unnecessary interventions.</p><p><strong>Key points: </strong>The preoperative GS is crucial for planning the clinical treatment of PCa. The invasiveness of PCa is inversely correlated with ADC values. ADC values play a crucial role in the accurate preoperative evaluation of low to intermediate-risk PCa, thus aiding clinicians in developing tailored treatment plans.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295925","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":"Unlocking the potential: T1-weighed MRI as a powerful predictor of levodopa response in Parkinson's disease.","authors":"Junyi Yan, Xufang Luo, Jiahang Xu, Dongsheng Li, Lili Qiu, Dianyou Li, Peng Cao, Chencheng Zhang","doi":"10.1186/s13244-024-01690-z","DOIUrl":"10.1186/s13244-024-01690-z","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of levodopa, the most crucial metric for Parkinson's disease diagnosis and treatment, is traditionally gauged through the levodopa challenge test, which lacks a predictive model. This study aims to probe the predictive power of T1-weighted MRI, the most accessible modality for levodopa response.</p><p><strong>Methods: </strong>This retrospective study used two datasets: from the Parkinson's Progression Markers Initiative (219 records) and the external clinical dataset from Ruijin Hospital (217 records). A novel feature extraction method using MedicalNet, a pre-trained deep learning network, along with three previous approaches was applied. Three machine learning models were trained and tested on the PPMI dataset and included clinical features, imaging features, and their union set, using the area under the curve (AUC) as the metric. The most significant brain regions were visualized. The external clinical dataset was further evaluated using trained models. A paired one-tailed t-test was performed between the two sets; statistical significance was set at p < 0.001.</p><p><strong>Results: </strong>For 46 test set records (mean age, 62 ± 9 years, 28 men), MedicalNet-extracted features demonstrated a consistent improvement in all three machine learning models (SVM 0.83 ± 0.01 versus 0.73 ± 0.01, XgBoost 0.80 ± 0.04 versus 0.74 ± 0.02, MLP 0.80 ± 0.03 versus 0.70 ± 0.07, p < 0.001). Both feature sets were validated on the clinical dataset using SVM, where MedicalNet features alone achieved an AUC of 0.64 ± 0.03. Key responsible brain regions were visualized.</p><p><strong>Conclusion: </strong>The T1-weighed MRI features were more robust and generalizable than the clinical features in prediction; their combination provided the best results. T1-weighed MRI provided insights on specific regions responsible for levodopa response prediction.</p><p><strong>Critical relevance statement: </strong>This study demonstrated that T1w MRI features extracted by a deep learning model have the potential to predict the levodopa response of PD patients and are more robust than widely used clinical information, which might help in determining treatment strategy.</p><p><strong>Key points: </strong>This study investigated the predictive value of T1w features for levodopa response. MedicalNet extractor outperformed all other previously published methods with key region visualization. T1w features are more effective than clinical information in levodopa response prediction.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295926","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":"Non-Gaussian diffusion metrics with whole-tumor histogram analysis for bladder cancer diagnosis: muscle invasion and histological grade.","authors":"Zhichang Fan, Junting Guo, Xiaoyue Zhang, Zeke Chen, Bin Wang, Yueluan Jiang, Yan Li, Yongfang Wang, Guoqiang Yang, Xiaochun Wang","doi":"10.1186/s13244-024-01701-z","DOIUrl":"10.1186/s13244-024-01701-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the performance of histogram features of non-Gaussian diffusion metrics for diagnosing muscle invasion and histological grade in bladder cancer (BCa).</p><p><strong>Methods: </strong>Patients were prospectively allocated to MR scanner1 (training cohort) or MR2 (testing cohort) for conventional diffusion-weighted imaging (DWI_conv) and multi-b-value DWI. Metrics of continuous time random walk (CTRW), diffusion kurtosis imaging (DKI), fractional-order calculus (FROC), intravoxel incoherent motion (IVIM), and stretched exponential model (SEM) were simultaneously calculated using multi-b-value DWI. Whole-tumor histogram features were extracted from DWI_conv and non-Gaussian diffusion metrics for logistic regression analysis to develop diffusion models diagnosing muscle invasion and histological grade. The models' performances were quantified by area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>MR1 included 267 pathologically-confirmed BCa patients (median age, 67 years [IQR, 46-82], 222 men) and MR2 included 83 (median age, 65 years [IQR, 31-82], 73 men). For discriminating muscle invasion, CTRW achieved the highest testing AUC of 0.915, higher than DWI_conv's 0.805 (p = 0.014), and similar to the combined diffusion model's AUC of 0.885 (p = 0.076). For differentiating histological grade of non-muscle-invasion bladder cancer, IVIM outperformed a testing AUC of 0.897, higher than DWI_conv's 0.694 (p = 0.020), and similar to the combined diffusion model's AUC of 0.917 (p = 0.650). In both tasks, DKI, FROC, and SEM failed to show diagnostic superiority over DWI_conv (p > 0.05).</p><p><strong>Conclusion: </strong>CTRW and IVIM are two potential non-Gaussian diffusion models to improve the MRI application in assessing muscle invasion and histological grade of BCa, respectively.</p><p><strong>Critical relevance statement: </strong>Our study validates non-Gaussian diffusion imaging as a reliable, non-invasive technique for early assessment of muscle invasion and histological grade in BCa, enhancing accuracy in diagnosis and improving MRI application in BCa diagnostic procedures.</p><p><strong>Key points: </strong>Muscular invasion largely determines bladder salvageability in bladder cancer patients. Evaluated non-Gaussian diffusion metrics surpassed DWI_conv in BCa muscle invasion and histological grade diagnosis. Non-Gaussian diffusion imaging improved MRI application in preoperative diagnosis of BCa.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295921","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":"Soft tissue vascular tumor-like lesions in adults: imaging and pathological analysis pitfalls per ISSVA classification.","authors":"C Marcelin, J Dubois, V Kokta, M F Giroux, M A Danino, S Mottard, G Soulez","doi":"10.1186/s13244-024-01712-w","DOIUrl":"10.1186/s13244-024-01712-w","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) findings with the pathological findings of soft tissue vascular tumors (STVTs) according to the 2018 ISSVA (International Society for the Study of Vascular Anomalies) classification to differentiate vascular tumors from vascular malformations.</p><p><strong>Methods: </strong>This retrospective study included patients with STVTs who underwent contrast-enhanced MRI and pathological analysis at our hospital between 2010 and 2020. The presumptive diagnosis based on the on-site imaging and histological analysis was compared with imaging and histological analysis conducted off-site utilizing the ISSVA criteria.</p><p><strong>Results: </strong>This study included 31 patients with 31 vascular tumors located in the head and neck (n = 3), trunk (n = 2), and extremities (n = 26). The off-site pathological analysis confirmed benign vascular tumors in 54.8% of cases (non-involuting congenital hemangioma: 35.5%; epithelioid hemangioma: 13%; pyogenic granuloma: 3%; and spindle cell hemangioma: 3%). Based on the off-site histological analysis, 25.8% were reclassified as having a vascular malformation whereas three had other benign lesions. Only phleboliths were associated with a vascular malformation (p = 0.03). The concordance between off-site MRI and pathological findings was fair (k = 0.3902 (0.0531-0.7274)), whereas that between on-site and off-site pathological analyses was poor (k = -0.0949 (-0.4661 to 0.2763)).</p><p><strong>Conclusion: </strong>Benign vascular tumors have non-specific imaging features on imaging with some overlap with atypical vascular malformations. Therefore, histological analysis is recommended. Imaging and pathological analyses should be performed in accordance with the ISSVA classification to minimize inter-observer discrepancies.</p><p><strong>Critical relevance statement: </strong>Imaging features of benign vascular tumors on MRI are non-specific, leading to discrepancies with pathological findings and potential overlap with atypical vascular malformations. Imaging and histological analyses should be performed in accordance with ISSVA guidelines to improve patient management.</p><p><strong>Key points: </strong>The imaging features of benign vascular tumors are non-specific. Histological analysis is recommended for soft tissue vascular tumors in adults. Analyses of soft tissue vascular tumors should be performed in accordance with ISSVA guidelines.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295923","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":"Temporal evolution of primary angiitis of the central nervous system (PACNS) on MRI following immunosuppressant treatment.","authors":"Franca Wagner, Gonçalo G Almeida, Erik P Willems, Johannes Weber, Johannes Geiss, Thomas Hundsberger, Pasquale Mordasini, Simon Wildermuth, Sebastian Leschka, Stephan Waelti, Tobias Johannes Dietrich, Tim Steffen Fischer","doi":"10.1186/s13244-024-01710-y","DOIUrl":"10.1186/s13244-024-01710-y","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically analyse the time course of vessel wall enhancement and associated stenosis in patients with primary angiitis of the central nervous system (PACNS) following immunosuppressive therapy.</p><p><strong>Material and methods: </strong>Two neuroradiologists retrospectively analysed MRIs of patients with PACNS seen at the Bern University Hospital and the St. Gallen Cantonal Hospital between 2015 and 2020. MRIs were examined for the presence of vessel wall enhancement, length of vessel wall enhancement (mm), circumferential extent of enhancement (degree) and degree of stenosis (%). Descriptive statistics and measurements of interobserver reliability were obtained. To investigate the temporal profiles of the variables following the commencement of immunosuppressant treatment, four series of Bayesian generalised multi-level models were generated.</p><p><strong>Results: </strong>A total of 23 patients with 43 affected vessels identified from 209 MRI exams were evaluated (mean follow-up: 715 days, standard deviation ± 487 days), leading to a complete dataset of 402 entries. Vessel wall enhancement and circumferential extent of enhancement decreased for approximately 1 year after the initiation of immunosuppressant therapy. Changes were more pronounced in younger patients. Disappearance of vessel wall enhancement (in at least one vessel) was seen in about half of patients after a median of 172 days interquartile range 113-244, minimum 54 days, maximum 627 days.</p><p><strong>Conclusions: </strong>This study evaluated the typical time course of vessel wall enhancement in patients with PACNS. Our results could be a useful reference for radiologists and clinicians interpreting follow-up imaging in patients with PACNS.</p><p><strong>Critical relevance statement: </strong>Routine clinical exams can be interpreted with more confidence when radiologists are aware of the typical temporal evolution of vessel wall enhancement in patients with primary angiitis of the central nervous system after initiation of immunosuppressive therapy.</p><p><strong>Key points: </strong>Few data exist for vessel wall imaging of primary angiitis of the central nervous system. Following immunosuppressant therapy, vessel wall enhancement decreases for approximately one year. These results may serve as a reference for radiologists performing follow-up imaging.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295924","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":"Dixon MRI-based quantitative parameters of extraocular muscles, intraorbital fat, and lacrimal glands for staging thyroid-associated ophthalmopathy.","authors":"Xiong-Ying Pu, Lu Chen, Hao Hu, Qian Wu, Wen-Hao Jiang, Jin-Ling Lu, Huan-Huan Chen, Xiao-Quan Xu, Fei-Yun Wu","doi":"10.1186/s13244-024-01693-w","DOIUrl":"10.1186/s13244-024-01693-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the value of Dixon magnetic resonance imaging (MRI)-based quantitative parameters of extraocular muscles (EOMs), intraorbital fat (IF), and lacrimal glands (LGs) in staging patients with thyroid-associated ophthalmopathy (TAO).</p><p><strong>Methods: </strong>Two hundred patients with TAO (211 active and 189 inactive eyes) who underwent Dixon MRI for pretreatment evaluation were retrospectively enrolled and divided into training (169 active and 151 inactive eyes) and validation (42 active and 38 inactive eyes) cohorts. The maximum, mean, and minimum values of the signal intensity ratio (SIR), fat fraction (FF), and water fraction (WF) of EOMs, IF, and LGs were measured and compared between the active and inactive groups in the training cohort. Binary logistic regression analysis, receiver operating characteristic curve analysis, and the Delong test were used for further statistical analyses, as appropriate.</p><p><strong>Results: </strong>Compared with inactive TAOs, active TAOs demonstrated significantly greater EOM-SIR_max, EOM-SIR_mean, EOM-SIR_min, IF-SIR_max, IF-SIR_mean, LG-SIR_max, LG-SIR_mean, EOM-WF_mean, EOM-WF_min, IF-WF_max, IF-WF_mean, and LG-WF_mean and lower EOM-FF_max, EOM-FF_mean, IF-FF_mean, IF-FF_min, and LG-FF_mean values (all p < 0.05). The EOM-SIR_mean, LG-SIR_mean, and LG-FF_mean values were independently associated with active TAO (all p < 0.05). The combination of the EOM-SIR_mean, LG-SIR_mean, and LG-FF_mean values showed better performance than the EOM-SIR_mean value alone in staging TAO in both the training (AUC, 0.820 vs 0.793; p = 0.016) and validation (AUC, 0.751 vs 0.733, p = 0.341) cohorts.</p><p><strong>Conclusion: </strong>Dixon MRI-based parameters of EOMs, LGs, and IF are useful for differentiating active from inactive TAO. The integration of multiple parameters can further improve staging performance.</p><p><strong>Critical relevance statement: </strong>In this study, the authors explored the combined value of quantitative parameters of EOMs, IF, and LGs derived from Dixon MRI in staging TAO patients, which can support the establishment of a proper therapeutic plan.</p><p><strong>Key points: </strong>The quantitative parameters of EOMs, LGs, and IF are useful for staging TAO. The EOM-SIR_mean, LG-SIR_mean, and LG-FF_mean values were found to independently correlate with active TAO. Joint evaluation of orbital tissue improved the ability to assess TAO activity.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295920","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":"Intrauterine chilled saline instillation reduces endometrial impairment on MRI after ultrasound-guided percutaneous microwave ablation of uterine adenomyosis.","authors":"Hui-Li Zhang, Er-Ya Deng, Jing-E Zhu, Jia-Xin Li, Le Fu, Li-Ping Sun, Cheng-Zhong Peng, Xiao-Long Li, Song-Yuan Yu, Hui-Xiong Xu","doi":"10.1186/s13244-024-01707-7","DOIUrl":"10.1186/s13244-024-01707-7","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether intrauterine chilled saline can reduce endometrial impairment during US-guided percutaneous microwave ablation (PMWA) of adenomyosis.</p><p><strong>Methods: </strong>An open-label, randomized trial was conducted with sixty symptomatic adenomyosis patients who were randomly assigned (1:1) to receive PMWA treatment assisted by intrauterine saline instillation (study group) or traditional PMWA treatment alone (control group). The primary endpoint was endometrial perfusion impairment grade on post-ablation contrast-enhanced MRI. The secondary endpoints were endometrial dehydration grade, ablation rate, and intra-ablation discomfort.</p><p><strong>Results: </strong>The baseline characteristics of the two groups were similar. The incidence rates of endometrial perfusion impairment on MRI in the study and control groups were 6.7% (2/30) and 46.7% (14/30), respectively (p < 0.001). There were 28 (93.3%), 2 (6.7%), 0, and 0 patients in the study group and 16 (53.3%), 7 (23.3%), 5 (16.7%), and 2 (6.7%) in the control group (p < 0.001) who had grade 0, 1, 2, and 3 perfusion impairment, respectively. Additionally, there were 27 (90%), 3 (10%), and 0 patients in the study group and 19 (63.3%), 10 (33.3%), and 1 (3.3%) in the control group who had grade 0, 1, and 2 endometrial dehydration (p = 0.01). The ablation rates achieved in the study and control groups were 93.3 ± 17% (range: 69.2-139.6%) and 99.7 ± 15.7% (range: 71.5-129.8%), and they were not significantly different (p = 0.14). No significant difference was found in the intra-ablation discomfort.</p><p><strong>Conclusion: </strong>Intrauterine chilled saline can effectively reduce endometrial impairment after PMWA treatment for adenomyosis.</p><p><strong>Critical relevance statement: </strong>This trial demonstrated that the instillation of intrauterine chilled saline reduced endometrial impairment on MRI during PMWA of adenomyosis. This approach allows more precise and safe ablation in clinical practice.</p><p><strong>Key points: </strong>Endometrial impairment occurs in the PMWA treatment of adenomyosis. Intrauterine chilled saline can reduce endometrial impairment during PMWA for adenomyosis. An intrauterine catheter is a practical endometrial protecting method during thermal ablation.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2100053582. Registered 24 November 2021, www.chictr.org.cn/showproj.html?proj=141090 .</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247902","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}