Investigative Radiology最新文献

{"title":"Elastin-Specific Molecular Magnetic Resonance Imaging Reveals Spatiotemporal Extracellular Matrix Remodeling at the Tumor-Stroma Interface During Prostate Cancer Progression.","authors":"Avan Kader, Dilyana B Mangarova, Hannes Gödde, Marie L H H Ranner-Hafferl, Julia Brangsch, Jennifer L Heyl, Jana Moeckel, Felix Reuter, Jannis Marchand, Jennifer Mein, Miriam Fichtner, Keno K Bressem, Uwe Karst, Lisa C Adams, Marcus R Makowski","doi":"10.1097/RLI.0000000000001302","DOIUrl":"10.1097/RLI.0000000000001302","url":null,"abstract":"<p><strong>Objectives: </strong>Extracellular matrix (ECM) remodeling is a hallmark of tumor progression, yet the longitudinal dynamics of elastin accumulation during prostate cancer (PCa) development remain unknown. This study aimed to longitudinally track elastin remodeling during PCa progression using elastin-specific molecular MRI (ESMA) in an orthotopic mouse model and to characterize the spatial heterogeneity of elastin deposition at the tumor-stroma interface.</p><p><strong>Materials and methods: </strong>Human PC3 prostate cancer cells were orthotopically implanted into the ventral prostate lobe of SCID mice (n=6). Weekly MRIs were performed over 6 weeks at 3.0 Tesla using the gadolinium-based elastin-specific probe ESMA (0.2 mmol/kg intravenous weekly). Signal intensity (SI) was quantified before and after contrast administration. Findings were validated by Elastica-van Gieson staining, immunofluorescence, Western blot analysis, and laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) for spatial gadolinium mapping.</p><p><strong>Results: </strong>Postcontrast SI increased progressively from 1517±151 at baseline to 3400±411 at week 6 (2.2-fold increase, P <0.001), with the most pronounced enhancement between weeks 2 and 3. Elastin distribution was spatially heterogeneous: peripheral tumor regions contained significantly more elastin (2.95±1.63%) than central areas (1.00±0.40%, P <0.008), indicating preferential ECM remodeling at the tumor-stroma interface. LA-ICP-MS demonstrated a strong correlation between gadolinium concentration and histologic elastin content ( R2 =0.88, P <0.001), and Western blot detected tropoelastin expression in all tumors.</p><p><strong>Conclusion: </strong>ESMA-enhanced molecular MRI captures the longitudinal dynamics of elastin accumulation during PCa progression. Progressive elastin deposition, concentrated at the tumor periphery, is consistent with active ECM remodeling at the invasive front and suggests elastin as a candidate imaging biomarker for monitoring matrix-driven tumor progression.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vessel Wall Imaging in 1.5 T MRI Using Deep Learning Reconstruction: Prospective Evaluation of Interchangeability With Standard 3 T MRI.","authors":"Arwed Elias Michael, Haidara Almansour, Roman Paul, Dominik Nickel, Ralph Strecker, Alexander Brockmann, Vanessa Schoeffling, Sebastian Altmann, Ahmed E Othman","doi":"10.1097/RLI.0000000000001290","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001290","url":null,"abstract":"<p><strong>Objectives: </strong>Vessel wall magnetic resonance imaging is important in the diagnosis of intracranial vascular diseases. Until now, adequate clinical implementation has required the use of 3 T scanners, which limits wider availability. This study aims to evaluate the interchangeability of a 3D turbo spin echo sequence with variable flip angle MRI sequence (T1 3D Sampling Perfection with Application optimized Contrast using different flip angle Evolution, SPACE) with deep learning image reconstruction for a 1.5 T scanner, with an established sequence (T1 3D SPACE) for a 3 T scanner. In addition, image quality parameters and diagnostic confidence are to be compared.</p><p><strong>Materials and methods: </strong>Patients were prospectively examined using a T1-weighted turbo spin echo with variable flip angle at 3 T and a similar newly developed sequence with deep learning-based image reconstruction at 1.5 T. The images were read by 3 experienced radiologists regarding the presence of pathologic enhancement of the vessel wall for the interchangeability analysis. Image quality and diagnostic confidence were evaluated using 5-point Likert scales. Interreader and intrareader reliability were calculated for all parameters.</p><p><strong>Results: </strong>A total of 50 participants (42.6 ± 21.2 y, 26 males) were included. Regarding the presence of pathologic vessel wall enhancement, there was a high interreader agreement [Fleiss kappa = 0.72 (95% CI: 0.62; 0.81) for 1.5T, 0.78 (0.69; 0.88) for 3 T]. The sequences at 1.5 T and 3 T were interchangeable (IEI = 0.008). Image quality at 1.5 T was diagnostic in all cases, but rated superior at 3 T (P < 0.001). Diagnostic confidence was also slightly but significantly higher at 3 T (P < 0.001).</p><p><strong>Conclusions: </strong>The utilization of deep learning reconstruction enables vessel wall imaging in 1.5 T MRI. This new MRI sequence was interchangeable with established sequences at 3 T for the detection of pathologic vessel wall enhancement. This development could significantly improve the availability of vessel wall imaging in the clinical routine.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated Deep-Learning-Based Image Reconstruction for 3D T2 Dark-Fluid in Imaging of Multiple Sclerosis.","authors":"Sebastian Altmann, Mario A A Mercado, Arwed Elias Michael, Mariya Kondova, Roman H Paul, Marcel Dominik Nickel, Vanessa Ines Schöffling, Vinzenz Fleischer, Marc A Brockmann, Ahmed E Othman","doi":"10.1097/RLI.0000000000001300","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001300","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Deep-learning (DL)-accelerated MRI can significantly reduce acquisition times. Studies evaluating interchangeability with conventional 3D data sets, particularly for monitoring disease activity in multiple sclerosis (MS), are lacking. This study investigated interchangeability and comparability between conventional fluid-attenuated 3D-T2-SPACE dark-fluid (c-3D-T2) and accelerated DL-based fluid-attenuated 3D-T2-SPACE dark-fluid (DL-3D-T2) in detecting new white matter lesions lesions on brain MRIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this prospective study, 94 patients with confirmed MS (n=77) or suspected chronic inflammatory CNS disease (n=17), underwent clinically indicated brain MRI at 1.5T. Each participant underwent both c-3D-T2 (5:01 min) and DL-3D-T2 (2:48 min) imaging. Primary endpoint was interchangeability of both sequences for detecting new white matter lesions defined according to the 2024 revised McDonald criteria. Furthermore, comparability regarding total lesion count and image quality was evaluated. Lesions were assessed in 3 anatomic regions (periventricular, cortical/juxtacortical, and infratentorial) by 3 independent readers and 1 experienced neuroradiologist using an established, certified lesion-detection software. Equivalence margin for interchangeability was predefined at 5%. Gwet's AC1 and AC2 determined inter-reader reliability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study comprised of 70 women and 24 men, with a mean age of 44.9 years (range: 24 to 72 y). In 73 patients, a comparable prior examination was available and met the technical requirements for AI-based lesion-detection software. In 13 patients new lesions were confirmed. Interchangeability for the primary endpoint was demonstrated for all readers and the experienced neuroradiologist, using certified lesion-detection software. Individual equivalence indices remained within the 5% margin. Detection of new white matter lesions demonstrated almost perfect inter-method agreement with overall Gwet's AC2 values between 0.85 [0.74; 0.96] and 0.98 [0.95; 1.00], and excellent inter-reader reliability, with overall new lesions of 0.85 [0.76; 0.94]. Total number of infratentorial and periventricular lesions demonstrated almost perfect agreement [(≥0.93 (0.91; 0.96)] and good agreement for cortical/juxtacortical lesions [0.71 (0.65; 0.77)]. Subjective analysis revealed that 2 readers rated c-3D-T2 as significantly superior in image quality (P&lt;0.001) and 1 reader rated c-3D-T2 as significantly superior in diagnostic confidence (P=0.003).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;DL-accelerated 3D-T2-weighted imaging is interchangeable with conventional 3D imaging for detecting new white matter lesions, while reducing acquisition time by nearly 50%. This acceleration supports more efficient MRI protocols for routine MS surveillance, enabling inclusion of additional advanced sequences. However, as subjective image evaluation was slightly in","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion-weighted Imaging Distortion in Prostate MRI: A Cross-sectional Study Comparing Supine and Prone Positioning.","authors":"Kang-Lung Lee, Andrew B Gill, Dimitri A Kessler, Po-Hsiang Liao, Wellington Chishaya, Christopher Shepherd, Chao-Yu Guo, Iztok Caglic, Tristan Barrett","doi":"10.1097/RLI.0000000000001245","DOIUrl":"10.1097/RLI.0000000000001245","url":null,"abstract":"<p><strong>Objectives: </strong>Diffusion weighted imaging (DWI) is a key component of multiparametric (mp) prostate MRI. DWI using echo-planar techniques is susceptible to distortion at the recto-prostatic air-tissue interface. This study was to determine whether prone patient positioning reduces adjacent rectal air and DW image distortion when compared with standard-of-care supine positioning.</p><p><strong>Materials and methods: </strong>This prospective study included consecutive patients undergoing mpMRI for suspected PCa between 2023 and 2024. Prostate segmentation was performed on DW and contrast-enhanced images. DWI distortion was measured quantitatively. Qualitative image quality of DWI and T2-weighted imaging (T2WI) was evaluated using PI-QUAL version 2; a separate 5-point clinically based Likert scale was employed to evaluate the volume of rectal air adjacent to the prostate.</p><p><strong>Results: </strong>Fifty-two patients were enrolled. In total, 58% of patients expressed a preference for supine imaging versus 20% for prone imaging. Qualitative DWI image quality improved significantly in the prone position [median: 4 (3 to 4)] versus supine [3 (1 to 4)]; P < 0.001. In contrast, prone T2WI quality [1 (1 to 1)] was significantly inferior than supine T2WI [3 (3-4)]; P < 0.001. Quantitative measures of rectal air were significantly lower for prone [1.13 cm 3 (0.34-2.43)] compared with supine imaging [1.96 cm 3 (0.47 to 5.81); P = 0.005]. There was no significant difference in distortion between prone [3.21 mm (2.42 to 3.82) and supine [2.95 mm (2.25 to 4.21)] positioning across all patients ( P = 0.80); however, in patients with >4 cm 3 of supine rectal air (n = 19), distortion was significantly reduced by prone imaging [3.49 mm (2.84 to 4.03)] compared with supine [4.60 mm (3.17 to 5.95)]; P = 0.02. The mean additional scanning time for the necessary prone imaging was 8 minutes 18 seconds.</p><p><strong>Conclusions: </strong>Prone positioning significantly reduces DWI distortion artefact when rectal air is present, but consistently results in degraded T2WI quality.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"467-476"},"PeriodicalIF":7.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13232692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Contrast-enhanced Ultrasound Evaluation of Hepatocellular Carcinoma Radioembolization.","authors":"Corinne E Wessner, Weelic Chong, Gil Berreby, Lauren J Delaney, Flemming Forsberg, Andrej Lyshchik, Patrick O'Kane, Ji-Bin Liu, Kevin Anton, Stephen R Topper, Jesse Civan, Warren Maley, Scott W Keith, Colette M Shaw, John R Eisenbrey","doi":"10.1097/RLI.0000000000001255","DOIUrl":"10.1097/RLI.0000000000001255","url":null,"abstract":"<p><strong>Objective: </strong>Contrast-enhanced ultrasound (CEUS) can be used to effectively monitor hepatocellular carcinoma (HCC) treatment response to percutaneous ablation and transarterial chemoembolization. Here, we performed a supplementary analysis of a prospective study to evaluate HCC participants treated with yttrium-90 transarterial radioembolization (Y90-TARE). We evaluated the utility of quantifiable parameters obtained from CEUS up to 2 weeks posttreatment for predicting treatment response compared with the standard of care cross-sectional imaging performed 2 to 6 months posttreatment (reference standard).</p><p><strong>Materials and methods: </strong>In this IRB-approved, prospective clinical trial, participants with HCC scheduled for Y90-TARE underwent 3 CEUS sessions. These sessions occurred 1 to 4 hours post-Y90-TARE, 1 week, and 2 weeks posttreatment. Each CEUS examination involved a 10-minute infusion of Optison (GE HealthCare) using an Acuson Sequoia 2.0 or a HELX S3000 scanner (Siemens Healthineers) with 6C1 transducer. During each CEUS examination, flash-replenishment sequences were performed at the tumor midline for CEUS replenishment imaging. Changes between baseline and 1 or 2 weeks were used for quantitative analyses. Fractional tumor vascularity (FTV in %), perfusion (in mL/s*mg), peak enhancement (au), and time to peak (TTP in seconds) were calculated offline using Matlab (MathWorks) to quantitatively evaluate TARE response. Two abdominal radiologists read the reference standard MRI or CT obtained post-Y90-TARE and characterized the tumor as nonviable (complete response) or viable (partial response/stable disease). Unpaired t tests were performed to evaluate differences in nonviable versus viable disease. ROC analysis and logistic regression were evaluated to determine diagnostic performance and disease prediction.</p><p><strong>Results: </strong>Final analysis included 38 participants. Of these, 22 had nonviable disease (58%, 22/38) and 16 had viable disease (42%, 16/38). FTV showed a difference between nonviable and viable tumors at 2 weeks post-Y90-TARE (38% ± 24% vs 62% ± 28%, P = 0.008). In addition, there was a statistically significant difference in the change in FTV from immediately post-Y90-TARE to 2 weeks after treatment between participants with viable and nonviable disease (41% ± 31% vs 11% ± 26%, P = 0.006). No significant difference was found between viable and nonviable disease across examinations for any of the other variables ( P > 0.13).</p><p><strong>Conclusions: </strong>Quantitative CEUS appears to provide an early indicator of treatment response ∼2 weeks post-Y90-TARE.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"486-494"},"PeriodicalIF":7.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iodinated Contrast Media Hypersensitivity in 115,966 Patients: Risk Factors, Severity Profiles, and the Impact of Iodine Concentration on Reaction Risk.","authors":"Cherry Kim, Suk Keu Yeom, Young Hen Lee, Minseo Lee, Jae Young Park, Jae Hyun Bae, Bum Sik Tae","doi":"10.1097/RLI.0000000000001301","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001301","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the prevalence, severity profiles, and risk factors of hypersensitivity reactions (HSRs) to iodinated contrast media (ICM) in a nationwide cohort, and to evaluate the association between iodine concentration and HSR risk, including outcomes in patients receiving premedication, in the context of evolving contrast safety guidelines.</p><p><strong>Materials and methods: </strong>This retrospective cohort study used Korean National Health Insurance Service data from 2016 to 2018. Among 577,115 eligible individuals, 115,966 received ICM. HSRs within 7 days after ICM administration were identified using ICD-10-CM codes and classified as mild, moderate, or severe based on treatment intensity and hospitalization status. Multivariable Cox proportional hazards models and 3:1 propensity score matching were used to identify independent risk factors. Subgroup analyses were performed in 45,885 patients who received corticosteroid and/or antihistamine premedication. Additional analyses stratified by iodine concentration (≤300 vs. >300 mg I/mL; ≤350 vs. >350 mg I/mL) were performed in the full cohort.</p><p><strong>Results: </strong>HSRs occurred in 667 of 115,966 patients (0.58%); 72.4% were mild, 17.1% moderate, and 10.5% severe (severe, 0.06% of all ICM users). Independent risk factors included prior ICM exposure [hazard ratio (HR): 6.168; 95% CI: 4.896, 7.770], prior HSR (HR: 16.675; 95% CI: 3.689, 75.382), asthma (HR: 1.732), allergy (HR: 1.82), and malignancy (HR: 1.804). In the premedication subgroup, prior ICM exposure (HR: 8.362), asthma (HR: 2.03), diabetes mellitus (HR: 1.911), and autoimmune disease (HR: 1.836) were significant predictors. Higher iodine concentrations were associated with modestly higher overall HSR prevalence [eg, 0.64% (>300 mg I/mL) vs. 0.50% (≤300 mg I/mL); P=0.001, and 0.63% (>350 mg I/mL) vs. 0.53% (≤350 mg I/mL); P=0.046], mainly due to increased mild‑to‑moderate reactions, while severe reactions remained stable at 0.06%.</p><p><strong>Conclusions: </strong>ICM-related HSRs were uncommon and usually mild, and severe reactions were rare in this nationwide cohort. Prior ICM exposure, prior HSR, asthma, allergy, and malignancy were key risk factors for HSRs. Prior ICM exposure, asthma, diabetes mellitus, and autoimmune disease further characterized high-risk patients receiving premedication. Higher iodine concentrations were associated with a modestly higher frequency of mild-to-moderate HSRs, without affecting severe reaction rates. These findings suggest that iodine concentration may represent a potentially modifiable factor in individualized contrast agent selection for high-risk patients.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Lung Nodule Volumetric Accuracy with Photon-counting Computed Tomography Over Energy-integrating Computed Tomography in Low-dose Screening: A Phantom Study.","authors":"Joost F Hop, Marcel J W Greuter, Mark van Dijk, Geertruida H de Bock, Rozemarijn Vliegenthart","doi":"10.1097/RLI.0000000000001299","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001299","url":null,"abstract":"<p><strong>Objectives: </strong>To compare lung nodule volumetric accuracy and precision between photon-counting detector (PCD) computed tomography (CT) and energy-integrating detector (EID) CT using low-dose lung cancer screening protocols, and to optimize reconstruction parameters for lung nodule volumetry.</p><p><strong>Materials and methods: </strong>An anthropomorphic chest phantom with 12 artificial lung nodules of varying size, shape, and radiodensity was scanned using EID-CT and PCD-CT with reference and optimized low-dose lung cancer screening protocols. PCD-CT reconstruction parameters (slice thickness, matrix size, kernel, iterative reconstruction, and virtual monoenergetic imaging energy) were varied. Each protocol was scanned 3 times with nodule repositioning. Nodule volumes were independently measured semiautomatically by 2 observers. Interobserver agreement and test-retest reliability were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Volumetric accuracy and precision were calculated relative to ground-truth volumes. Volumetric accuracy was compared between PCD-CT and EID-CT using one-way analysis of variance, and across PCD-CT reconstructions using univariable linear regression. Volumetric precision was assessed based on the SD of mean volume differences. Noise was compared across scanners and reconstructions using one-way analysis of variance.</p><p><strong>Results: </strong>A total of 1224 nodule measurements demonstrated excellent volumetric interobserver agreement (ICC: 0.99) and test-retest reliability (ICCs of 0.96 for both observers). Volumetric accuracy improved from -16.6% and -15.2% with the reference and optimized EID-CT protocols to -12.5% and -10.2% with the reference and optimized PCD-CT protocols (P < 0.05). Volumetric precision remained comparable between reference and optimized EID-CT (6.3 and 8.2 mm3) and PCD-CT (6.4 and 6.2 mm3) protocols. On PCD-CT, ultra-thin slices (0.2 mm) and an ultra-sharp kernel (Qr76) worsened volumetric accuracy by 2.9% and 2.8%, respectively (P < 0.05). Image noise was lower on PCD-CT than on EID-CT (P < 0.05) and varied significantly across reconstruction settings on PCD-CT.</p><p><strong>Conclusions: </strong>PCD-CT improved lung nodule volumetric accuracy and reduced volume underestimation by up to 6% compared with EID-CT using low-dose screening protocols, while maintaining similar volumetric precision. Ultra-thin slices and an ultra-sharp kernel worsened volumetric accuracy. By reducing volume underestimation, PCD-CT may shift a larger proportion of nodules to higher baseline risk categories, potentially increasing the number of screening participants requiring clinical referral or short-term follow-up CT.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photon-counting CT in Anterior Cervical Discectomy and Fusion: Improved Metal Artifact Reduction and Impact on Bone Fusion Assessment.","authors":"Frederik Abel, Marco Curti, Thomas Marth, Roy P Marcus, Mazda Farshad, Reto Sutter","doi":"10.1097/RLI.0000000000001298","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001298","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the impact of tin-filtered photon-counting detector (PCD) computed tomography (CT) in combination with high-energy virtual monoenergetic imaging (VMI) and iterative metal artifact reduction (iMAR) on metal artifact reduction, image quality, and assessment of intragraft and extragraft bone fusion, in patients after anterior cervical discectomy and fusion (ACDF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Patients who underwent ACDF and postoperative tin-filtered PCD-CT between 2023 and 2026 were retrospectively analyzed. Metal artifacts were quantitatively and qualitatively assessed in standard polychromatic (T3D), iMAR (T3DiMAR), VMI at 120 keV (VMI120), and combined VMI120 + iMAR (VMI120+iMAR) reconstructions. Quantitative analysis included measurement of hypodense and hyperdense artifact attenuation and corrected noise. Three musculoskeletal radiologists independently scored 5 imaging features on 4-point Likert scales and assessed the presence of secondary artifacts. Subgroup analyses were performed for polyetheretherketone (PEEK)-tantalum versus titanium cages and for 140 versus 100 kVp acquisitions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-four patients (23 with PEEK-tantalum cages, 21 with titanium cages) were included. VMI120+iMAR achieved the strongest metal artifact reduction with hypodense artifacts from -362.5 Hounsfield Units (HU) to -38 HU and hyperdense artifacts from 218.5 to 83.5 HU, as well as significant noise improvements compared with T3D (all P&lt;0.001); effects were most pronounced near titanium cages. T3DiMAR provided comparable artifact reduction to VMI120+iMAR in PEEK-tantalum cages (P=0.55 to 0.83) but inferior artifact reduction in titanium cages (P&lt;0.001). Bone-metal interface conspicuity improved significantly with VMI120 and VMI120+iMAR (P≤0.01). Intragraft and extragraft bone fusion visibility was rated highest with standard T3D images (median 3 to 4), whereas the most pronounced impairments were observed for VMI120+iMAR (median 2 to 3, P≤0.01). iMAR-based techniques introduced secondary artifacts, including pseudo-osteolysis (20.5% to 38.6%), and white zone artifacts (50% to 56.8%), while dark zone and silhouette artifacts were less common (4.5% to 6.8%). White zone artifacts were significantly more frequent at 140 versus 100 kVp (P&lt;0.05), while dark zone and silhouette artifacts were exclusively observed at 100 kVp. Inter-reader agreement was substantial to almost perfect (κ=0.62 to 0.94).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Tin-filtered PCD-CT with VMI120+iMAR offers the most effective metal artifact reduction after ACDF and improves bone-metal interface conspicuity, particularly near titanium cages, followed by T3DiMAR. However, these advanced reconstructions may impair diagnostic accuracy for bone fusion assessment due to reconstruction-induced artifacts. iMAR-based reconstructions introduced pseudo-osteolysis that may simulate pseudoarthrosis, as well as white zone artif","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Synthetic MRI in Body Imaging: Technical Basis, Current Applications, and Future Directions.","authors":"Javkhlan Maikhuu, Akifumi Hagiwara, Katsuhiro Sano, Shohei Fujita, Andica Christina, Junko Kikuta, Hideo Kawasaki, Koji Kamagata","doi":"10.1097/RLI.0000000000001297","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001297","url":null,"abstract":"<p><p>Quantitative synthetic MRI (SyMRI) enables simultaneous acquisition of quantitative T1, T2, and proton density maps and retrospective generation of multiple contrast-weighted images from a single acquisition. By moving beyond conventional qualitative MRI, SyMRI may improve workflow efficiency while providing objective tissue biomarkers. Although most extensively studied in neuroimaging, its application to body MRI has expanded rapidly. This narrative review summarizes the technical basis of body SyMRI, focusing on the predominant 2-dimensional QRAPMASTER/multidynamic multiecho (MDME) framework and the newer 3-dimensional quantification using an interleaved Look-Locker acquisition sequence with T2 preparation pulse (QALAS) approach, and discusses current evidence across breast, prostate, gynecologic, rectal, head and neck, and musculoskeletal imaging. Available studies indicate that SyMRI is technically feasible across these applications and shows promise for lesion characterization, tumor grading, prognostic assessment, treatment-response evaluation, and quantitative analysis of normal and diseased tissues. In several settings, SyMRI-derived parameters provide additional value when combined with diffusion-weighted imaging, dynamic contrast-enhanced MRI, clinicopathologic variables, histogram analysis, radiomics, and predictive modeling. However, current evidence remains limited by small, single-center, and methodologically heterogeneous studies, and most body applications still rely on two-dimensional implementations. Future progress will depend on multicenter prospective validation, standardization of quantitative workflows, and broader evaluation of newer three-dimensional methods.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonclinical Safety Assessment of Digadoglucitol, a Novel Magnetic Resonance Imaging Contrast Agent for the Central Nervous System.","authors":"Roberta Bonafè, Alessandra Coppo, Roberta Queliti, Silvia Rossi, Simona Bussi, Luisa Poggi","doi":"10.1097/RLI.0000000000001296","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001296","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Digadoglucitol is a new macrocyclic gadolinium-based contrast agent for magnetic resonance imaging, intended to be used in central nervous system (CNS) and whole body clinical indications. The product features a unique dimeric structure with Gd(III) complexed by 2 macrocyclic chelators, setting it apart from other macrocyclic gadolinium-based contrast agents on the market. The safety profile of digadoglucitol in the context of single diagnostic use in humans was examined using a range of nonclinical studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;All safety pharmacology and toxicology studies, excluding dose-ranging investigations, were conducted in accordance with Good Laboratory Practice principles. Safety pharmacology evaluations focused on key physiological systems, including the central nervous (in rats), the cardiovascular (assessed in vitro and in monkeys), the respiratory (in rats) systems, and blood compatibility (in vitro). Pharmacokinetic studies were also performed to characterize systemic exposure (in rats); moreover, plasma protein binding, metabolic stability (in vitro), excretion and possible tissue retention of gadolinium (Gd) in rats were evaluated. An extensive toxicological assessment was conducted, including acute toxicity (in rats and mice), extended single-dose and repeated-dose toxicity (in rats and monkeys), as well as reproductive and developmental toxicity (in rats and rabbits), and juvenile toxicity (in rats). Additional studies addressed genotoxic potential (through in vitro assays and in vivo studies in mice), and local tolerance (in rats and monkeys).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Digadoglucitol was well tolerated after single or repeated intravenous administrations in rodents and nonrodents. The core battery of safety pharmacology studies showed that digadoglucitol had no adverse effects on the central nervous system and on cardiovascular or respiratory parameters. In vitro, digadoglucitol was found to be compatible with human whole blood and plasma at concentrations up to 0.25 M. The pharmacokinetics of digadoglucitol and the pattern and levels of Gd retention and clearance from brain and body tissues were very similar to those reported for other approved macrocyclic GBCAs widely used for MRI of the central nervous system. At the tested doses, digadoglucitol was rapidly eliminated from the rat plasma and excreted almost exclusively through urine and mainly in the first 8 hours after administration. The extent of plasma protein binding was low in all the tested species (mouse, rat, monkey, and human). Digadoglucitol was shown to be metabolically stable in mouse, rat, monkey, and human liver microsomes. Single-dose and repeated-dose toxicity studies demonstrated no-observed-adverse-effect levels that were, respectively, 10 to 16 times and 5 to 10 times higher than the highest anticipated effective imaging dose in humans (0.1 mmol Gd/kg). Toxicokinetic parameters showed consist","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}