Investigative Radiology最新文献

{"title":"Photon-Counting Detector CT Applications in Musculoskeletal Radiology.","authors":"Jan-Peter Grunz, Henner Huflage","doi":"10.1097/RLI.0000000000001108","DOIUrl":"10.1097/RLI.0000000000001108","url":null,"abstract":"<p><strong>Abstract: </strong>Photon-counting detectors (PCDs) have emerged as one of the most influential technical developments for medical imaging in recent memory. Surpassing conventional systems with energy-integrating detector technology in many aspects, PCD-CT scanners provide superior spatial resolution and dose efficiency for all radiological subspecialities. Demanding detailed display of trabecular microarchitecture and extensive anatomical coverage frequently within the same scan, musculoskeletal (MSK) imaging in particular can be a beneficiary of PCD-CT's remarkable performance. Since PCD-CT provides users with a plethora of customization options for both image acquisition and reconstruction, however, MSK radiologists need to be familiar with the scanner to unlock its full potential. From filter-based spectral shaping for artifact reduction over full field-of-view ultra-high-resolution scans to postprocessing of single- or dual-source multienergy data, almost every imaging task can be met with an optimized approach in PCD-CT. The objectives of this review were to give an overview of the most promising applications of PCD-CT in MSK imaging to date, to state current limitations, and to highlight directions for future research and developments.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"198-204"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859720","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":"Decoding Brain Development and Aging: Pioneering Insights From MRI Techniques.","authors":"Akifumi Hagiwara, Satoru Kamio, Junko Kikuta, Moto Nakaya, Wataru Uchida, Shohei Fujita, Stikov Nikola, Toshiaki Akasahi, Akihiko Wada, Koji Kamagata, Shigeki Aoki","doi":"10.1097/RLI.0000000000001120","DOIUrl":"10.1097/RLI.0000000000001120","url":null,"abstract":"<p><strong>Abstract: </strong>The aging process induces a variety of changes in the brain detectable by magnetic resonance imaging (MRI). These changes include alterations in brain volume, fluid-attenuated inversion recovery (FLAIR) white matter hyperintense lesions, and variations in tissue properties such as relaxivity, myelin, iron content, neurite density, and other microstructures. Each MRI technique offers unique insights into the structural and compositional changes occurring in the brain due to normal aging or neurodegenerative diseases. Age-related brain volume changes encompass a decrease in gray matter and an increase in ventricular volume, associated with cognitive decline. White matter hyperintensities, detected by FLAIR, are common and linked to cognitive impairments and increased risk of stroke and dementia. Tissue relaxometry reveals age-related changes in relaxivity, aiding the distinction between normal aging and pathological conditions. Myelin content, measurable by MRI, changes with age and is associated with cognitive and motor function alterations. Iron accumulation, detected by susceptibility-sensitive MRI, increases in certain brain regions with age, potentially contributing to neurodegenerative processes. Diffusion MRI provides detailed insights into microstructural changes such as neurite density and orientation. Neurofluid imaging, using techniques like gadolinium-based contrast agents and diffusion MRI, reveals age-related changes in cerebrospinal and interstitial fluid dynamics, crucial for brain health and waste clearance. This review offers a comprehensive overview of age-related brain changes revealed by various MRI techniques. Understanding these changes helps differentiate between normal aging and pathological conditions, aiding the development of interventions to mitigate age-related cognitive decline and other symptoms. Recent advances in machine learning and artificial intelligence have enabled novel methods for estimating brain age, offering also potential biomarkers for neurological and psychiatric disorders.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"162-174"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893965","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":"Focused Ultrasound: Noninvasive Image-Guided Therapy.","authors":"Chrit T W Moonen, Joseph P Kilroy, Alexander L Klibanov","doi":"10.1097/RLI.0000000000001116","DOIUrl":"10.1097/RLI.0000000000001116","url":null,"abstract":"<p><strong>Abstract: </strong>Invasive open surgery used to be compulsory to access tumor mass to perform excision or resection. Development of minimally invasive laparoscopic procedures followed, as well as catheter-based approaches, such as stenting, endovascular surgery, chemoembolization, brachytherapy, which minimize side effects and reduce the risks to patients. Completely noninvasive procedures bring further benefits in terms of reducing risk, procedure time, recovery time, potential of infection, or other side effects. Focusing ultrasound waves from the outside of the body specifically at the disease site has proven to be a safe noninvasive approach to localized ablative hyperthermia, mechanical ablation, and targeted drug delivery. Focused ultrasound as a medical intervention was proposed decades ago, but it only became feasible to plan, guide, monitor, and control the treatment procedures with advanced radiological imaging capabilities. The purpose of this review is to describe the imaging capabilities and approaches to perform these tasks, with the emphasis on magnetic resonance imaging and ultrasound. Some procedures already are in clinical practice, with more at the clinical trial stage. Imaging is fully integrated in the workflow and includes the following: (1) planning, with definition of the target regions and adjacent organs at risk; (2) real-time treatment monitoring via thermometry imaging, cavitation feedback, and motion control, to assure targeting and safety to adjacent normal tissues; and (3) evaluation of treatment efficacy, via assessment of ablation and physiological parameters, such as blood supply. This review also focuses on sonosensitive microparticles and nanoparticles, such as microbubbles injected in the bloodstream. They enable ultrasound energy deposition down to the microvascular level, induce vascular inflammation and shutdown, accelerate clot dissolution, and perform targeted drug delivery interventions, including focal gene delivery. Especially exciting is the ability to perform noninvasive drug delivery via opening of the blood-brain barrier at the desired areas within the brain. Overall, focused ultrasound under image guidance is rapidly developing, to become a choice noninvasive interventional radiology tool to treat disease and cure patients.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"205-219"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008851","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":"Hot Topics in Diagnostic Imaging-Encompassing Advances in MR, Photon-Counting CT, and Ultrasound.","authors":"Val M Runge, Johannes T Heverhagen","doi":"10.1097/RLI.0000000000001124","DOIUrl":"10.1097/RLI.0000000000001124","url":null,"abstract":"","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"161"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390500","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":"What Is the Added Value of DWI Compared With Structured Assessment of BI-RADS Criteria by the Kaiser Score? A Systematic Review and Meta-analysis.","authors":"Matthias Dietzel, Giulia Vatteroni, Pascal A T Baltzer","doi":"10.1097/RLI.0000000000001123","DOIUrl":"10.1097/RLI.0000000000001123","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis investigated the added value of DWI compared with the structured assessment of BI-RADS criteria using the Kaiser score.</p><p><strong>Materials and methods: </strong>Articles published in English until May 2024 were included. Two independent reviewers extracted data on the characteristics of studies evaluating the added value of DWI to distinguish benign from malignant breast lesions compared with structured assessment of the BI-RADS criteria. Using bivariate random-effects models, the sensitivity and specificity were calculated. I2 statistics, Deek's funnel plot asymmetry test for publication bias, and meta-regression were applied for the data analysis.</p><p><strong>Results: </strong>Five studies comprising 1005 malignant and 846 benign lesions were eligible for data synthesis. The pooled sensitivity and specificity estimates of structured BI-RADS assessment were 95.7% (95% confidence interval [CI], 92.6%-97.5%) and 68.7% (95% CI, 60.9%-75.6%), respectively. Adding DWI to the structured BI-RADS assessment achieved a pooled sensitivity of 94.4% (95% CI, 90.5%-96.7%) and a pooled specificity of 74.9% (95% CI, 68.8%-80.2%). Adding DWI to the structured BI-RADS assessment significantly changed neither the sensitivity ( P = 0.52) nor the specificity ( P = 0.20).</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis revealed only a limited, statistically nonsignificant added value of DWI compared with the structured assessment of BI-RADS criteria using the Kaiser score.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"175-183"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894300","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":"Three-Dimensional Magnetic Resonance Imaging in the Musculoskeletal System: Clinical Applications and Opportunities to Improve Imaging Speed and Resolution.","authors":"Shivani Ahlawat, Neil M Kumar, Ali Ghasemi, Laura M Fayad","doi":"10.1097/RLI.0000000000001133","DOIUrl":"10.1097/RLI.0000000000001133","url":null,"abstract":"<p><strong>Abstract: </strong>Although conventional 2-dimensional magnetic resonance (MR) sequences have traditionally comprised the foundational imaging strategy for visualization of musculoskeletal anatomy and pathology, the emergence of isotropic volumetric 3-dimensional sequences offers to advance musculoskeletal evaluation with comparatively similar image quality and diagnostic performance, shorter acquisition times, and the added advantages of improved spatial resolution and multiplanar reformation capability. The purpose of this review article is to summarize the available 3-dimensional MR sequences and their role in the management of patients with musculoskeletal disorders, including sports imaging, rheumatologic conditions, peripheral nerve imaging, bone and soft tissue tumor imaging, and whole-body MR imaging.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"184-197"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500569","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 Detector CT Iodine Maps Versus SPECT/CT: Advancing Lung Perfusion Imaging in Chronic Thromboembolic Pulmonary Hypertension.","authors":"Bjarne Kerber, Martin Hüllner, Alexander Maurer, Thomas Flohr, Silvia Ulrich, Mona Lichtblau, Thomas Frauenfelder, Sabine Franckenberg","doi":"10.1097/RLI.0000000000001163","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001163","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare the accuracy of photon-counting detector computed tomography (PCD-CT) iodine maps of the lung parenchyma with perfusion scintigraphy for detection and extent estimation of pulmonary perfusion defects.</p><p><strong>Materials and methods: </strong>This institutional review board-approved retrospective study included 26 subjects (11 male, aged 57.2 ± 15.8 years; 15 female, aged 55.2 ± 15.7 years) who underwent clinically indicated PCD-CT and perfusion SPECT/CT to assess for chronic thromboembolic pulmonary hypertension (CTEPH). Two blinded radiologists used CT iodine maps and corresponding sharp-kernel CT reconstructions in lung window to evaluate presence and extent of lobar perfusion defects and detect patients with CTEPH (or CTEPH overlap with other causes of PH). Accordingly, 2 blinded nuclear medicine physicians/radiologists evaluated perfusion SPECT/CT scans. The clinical diagnosis was reviewed in an interdisciplinary clinical setting. Quantitative analyses were calculated for both modalities. Perfusion defect estimation was compared with right heart catheter measurements.</p><p><strong>Results: </strong>Of the 26 subjects included, 10 were diagnosed with CTEPH or CTEPH overlap, 12 were diagnosed with PH associated with other pathologic mechanisms, 3 had no PH, and 1 had previous acute pulmonary embolism, which resolved. Radiation dose was greatly reduced for PCD-CT compared with SPECT/CT (1.19 [±0.33] mSv; 6.34 [±1.68] mSv, respectively, P < 0.001). Both PCD-CT readers (R1, R2) showed a trend toward higher accuracy, sensitivity, and specificity for CTEPH diagnosis compared with the scintigraphy consensus (SC) (accuracy: R1 0.85, R2 0.88, SC 0.73; sensitivity: R1 0.90, R2 0.90, SC 0.80; specificity: R1 0.81, R2 0.88, SC 0.69), although there was no significant difference observed (P > 0.688). There was good to excellent agreement between both PCD-CT readers for perfusion defect estimation. Moderate intermodality agreement was observed for CTEPH diagnosis certainty and perfusion defect estimation. The quantitative evaluation showed strong to excellent correlation between PCD-CT and SPECT/CT relative perfusion. There was a significant moderate correlation between PCD-CT perfusion defect estimations and mean pulmonary artery pressure (R1: r = 0.49, P = 0.020; R2: r = 0.49, P = 0.021), pulmonary vascular resistance (R1: r = 0.60, P = 0.003; R2: r = 0.52, P = 0.013), and cardiac index (R1: r = -0.45, P = 0.042).</p><p><strong>Conclusions: </strong>PCD-CT iodine maps allow for accurate CTEPH detection and are comparable to perfusion SPECT/CT with good quantitative correlation, but only moderate qualitative agreement, at greatly reduced radiation dose. Furthermore, visual PCD-CT perfusion defect extent was associated with prognostic right heart catheter measurements.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523457","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":"Pros and Cons of High-Performance Gradient Enabled Short-TE Prostate DWI: A Prospective Study.","authors":"Maximilian Bachl, Dominika Skwierawska, Dominique Hadler, Hannes Schreiter, Michael Uder, Rolf Janka, Frederik B Laun, Sebastian Bickelhaupt","doi":"10.1097/RLI.0000000000001171","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001171","url":null,"abstract":"<p><strong>Objectives: </strong>Recent advances in high-performance gradient technology have enabled shorter echo times (TEs) for diffusion-weighted prostate MRI. Short TE may improve the conspicuity of the usually T2 hypointense lesions but may also influence the diagnostic performance of the apparent diffusion coefficient (ADC) due to a changed weighting of subcompartments, including prostate fluid and tissues. The purpose of this study was to evaluate the influence of TE on prostate diffusion-weighted images with respect to lesion conspicuity and diagnostic performance of the ADC.</p><p><strong>Materials and methods: </strong>This institutional review board-approved prospective monocentric study included n = 55 (mean age 69 ± 9 years) patients undergoing clinically indicated prostate MRI on two 3 T MRI scanners with high-performance gradients. Diffusion-weighted imaging (DWI) was performed with an echo-planar sequence at 2 different TEs, 41 ms and 70 ms, with b-values of 50 s/mm2 and 800 s/mm2. Computed DWI was generated for a b-value of 1400 s/mm2. The lesion conspicuity and image quality were rated by 3 independent readers with a 5-point Likert scale and tested with the Wilcoxon rank sum test. Lesion ADCs were recorded, and their ability to detect significant lesions (Gleason score >6) was assessed with a receiver operator curve analysis.</p><p><strong>Results: </strong>Among the participants, n = 24 had clinically significant prostate cancer. The image quality at b = 1400 s/mm2 was rated significantly higher at TE = 41 ms than at TE = 70 ms (mean Likert score ± standard deviation for TE = 41 ms vs TE = 70 ms: R1: 4.06 ± 0.68 vs 3.02 ± 0.59; R2: 4.09 ± 0.82 vs 3.26 ± 0.67; R3: 4.16 ± 0.71 vs 3.18 ± 0.70; for all P's < 0.001). The lesion conspicuity at b = 1400 s/mm2 was rated higher at TE = 41 ms than at TE = 70 ms (mean Likert score ± standard deviation for TE = 41 ms vs TE = 70 ms: R1: 4.55 ± 0.66 vs 4.46 ± 0.72, P = 0.17; R2: 4.64 ± 0.59 vs 4.53 ± 0.63, P = 0.03; R3: 4.53 ± 0.66 vs 4.28 ± 0.80, P = 0.01). However, the ADC-based area under the curve for lesion characterization decreased from 0.80 at TE = 70 ms to 0.70 at TE = 41 ms (P = 0.07).</p><p><strong>Conclusions: </strong>Shortening TE to 41 ms in prostate DWI increases lesion conspicuity on high b-value images; however, it negatively impacts the diagnostic performance of the ADC.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523463","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":"Effect of Reconstruction Kernel and Virtual Monoenergetic Imaging on Segmentation-Based Measurement of Coronary Plaque Volume With Photon-Counting CT.","authors":"Susann Skoog, Elin Good, Lilian Henriksson, Mårten Sandstedt, Anders Persson, Erik Tesselaar","doi":"10.1097/RLI.0000000000001167","DOIUrl":"10.1097/RLI.0000000000001167","url":null,"abstract":"<p><strong>Objectives: </strong>Coronary computed tomography angiography is the primary modality for noninvasive assessment of coronary artery disease. Photon-counting computed tomography (PCCT) offers superior spatial resolution and spectral imaging for detailed characterization of atherosclerotic plaques. This study aimed to evaluate the impact of virtual monoenergetic imaging (VMI) energy levels and reconstruction kernels on segmentation-based measurement of plaque volume in individuals with coronary atherosclerosis using PCCT.</p><p><strong>Materials and methods: </strong>Fifty study participants underwent coronary computed tomography angiography with ultra-high-resolution PCCT. Both polyenergetic, 120 kVp (T3D) images and spectral images at varying VMI energy levels were reconstructed using different kernels. Plaque volumes were measured using semiautomated attenuation-based segmentation, adjusting segmentation thresholds for each VMI energy level. In addition, absolute plaque volume measurements were conducted using a coronary phantom simulating different plaque types.</p><p><strong>Results: </strong>Using a sharper kernel (Bv64 vs Bv48) significantly increased noncalcified plaque volume measurements ( P < 0.005) in study participants, whereas a 0.2-mm slice thickness reduced calcified plaque volumes compared with 0.4 mm ( P < 0.005). VMI energy level had no impact on measured volumes. Phantom measurements confirmed significant variability in measured volumes of calcified and noncalcified plaques depending on reconstruction method, as well as a minor effect of VMI level.</p><p><strong>Conclusions: </strong>In PCCT, the reconstruction kernel predominantly affects noncalcified coronary plaque quantification, whereas slice thickness mainly impacts calcified plaque volumes. In study participants, measured plaque volumes were not affected by VMI energy level when energy-specific segmentation thresholds were used, although a minor effect of VMI was observed in the phantom model.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515482","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":"Influence of Reader Expertise on Myocardial Infarction Detection: A Comparative Study of Dark-Blood and Bright-Blood Late Gadolinium Enhancement MRI.","authors":"Bibi Martens, Lara R van der Meulen, Richard J Crawley, Yvonne J M van Cauteren, Martijn W Smulders, Sebastian Streukens, Babs M F Hendriks, Ivo P L Houben, Suzanne Gommers, Simon M Frey, Lloyd Brandts, Joachim E Wildberger, Amedeo Chiribiri, Robert J Holtackers","doi":"10.1097/RLI.0000000000001161","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001161","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the influence of reader training and experience on the detection of (small) myocardial infarctions (MIs) and the assessment of ischemic scar transmurality using dark-blood late gadolinium enhancement (LGE) and bright-blood LGE magnetic resonance imaging. It was hypothesized that dark-blood LGE simplifies the detection of (small) MIs for less experienced readers, compared with bright-blood LGE imaging.</p><p><strong>Materials and methods: </strong>One hundred patients referred for cardiac magnetic resonance imaging for suspected ischemic scar were retrospectively included. Dark-blood LGE was performed first, followed by bright-blood LGE. Nine clinicians, grouped into three levels based on their training and experience, assessed the LGE images for the presence of MI and ischemic scar transmurality. Their assessment was subsequently compared with a European Association of Cardiovascular Imaging level 3 consultant. Reader confidence was evaluated with a 4-point Likert scale. Multilevel logistic regression was used to compare the 2 LGE methods and assess differences in myocardial infarction detection and transmurality among the 3 experience levels. Wilcoxon signed rank tests were performed to compare the reader confidence between the 2 LGE methods, whereas Friedman omnibus tests were conducted to assess differences in reader confidence among the 3 experience levels.</p><p><strong>Results: </strong>Dark-blood LGE resulted in increased correct detection of MIs compared with bright-blood LGE for both level 1 (87.3% vs 82.7%, odds ratio [OR]: 1.55 [95% confidence interval (CI): 0.94-2.54], P = 0.083) and level 2 readers (89.7% vs 83.0%, OR: 2.05 [95% CI: 1.20-3.51], P = 0.009). There was no significant difference observed between dark-blood LGE and bright-blood LGE for level 3 readers (88.7% vs 87.0%, OR: 1.20 [95% CI: 0.70-2.06], P = 0.495). Level 2 readers significantly detected more small MIs correctly when using dark-blood LGE compared with bright-blood LGE (66.7% vs 50.8%, OR: 2.40 [95% CI: 1.03-5.60], P = 0.042). All experience levels showed significantly increased confidence in presence of ischemic scar and transmurality with dark-blood LGE.</p><p><strong>Conclusions: </strong>Readily available dark-blood LGE can assist less experienced readers in correctly detecting and assessing (small) MIs compared with conventional bright-blood LGE. Regardless of experience level, dark-blood LGE improves reader confidence in assessing the presence and transmurality of MIs.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472474","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}