Investigative Radiology最新文献

{"title":"Whole-body Dual-source Photon-counting CT in Multiple Myeloma-The Value of Virtual Monoenergetic Imaging for Lesion Vitality Assessment.","authors":"Anke Heidemeier, Henner Huflage, Leo Rasche, Klaus Martin Kortuem, Johannes M Waldschmidt, Hermann Einsele, Wiebke Schlötelburg, Thorsten Alexander Bley, Jan-Peter Grunz","doi":"10.1097/RLI.0000000000001228","DOIUrl":"10.1097/RLI.0000000000001228","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Dual-source photon-counting CT (DS-PCCT) facilitates an unprecedented combination of spectral information and ultra-high resolution in whole-body imaging of multiple myeloma. This study explored the distinct characteristics of soft tissue, fat, and calcium in virtual monoenergetic images (VMI) with low photon energy, aiming to identify criteria of lesion vitality.</p><p><strong>Materials and methods: </strong>This retrospective study included 51 patients with multiple myeloma (67.1±10.1 y, 36 men) who underwent unenhanced whole-body DS-PCCT between October 2024 and February 2025. Three board-certified radiologists measured CT numbers within 169 osteolytic lesions (85 active) and their surrounding tissues. Differences between 40 and 70 keV were compared among active and inactive lesions. In addition, the presence of intralesional fat, calcifications, hypodense rims, homogeneity, and highlighting in color-coded virtual non-calcium maps was assessed subjectively.</p><p><strong>Results: </strong>The attenuation difference between 40 and 70 keV VMI was markedly larger in active than inactive lesions [median 19.3 (interquartile range: 12.7-27.0) vs. -3.8 (-26.1 to 17.0) HU; P <0.001]. Homogenous density (86.3% vs. 2.4%) and conspicuous color-coding (94.9 vs. 68.7%) were more common in active myeloma, whereas intralesional fat (10.6 vs. 72.2%), calcifications (1.6% vs. 40.1%), and hypodense rims (0 vs. 37.3%) were more frequent in inactive lesions (all P <0.001). Interrater measurement reliability was excellent (intraclass correlation coefficient ≥0.95), and agreement for all qualitative criteria was high (Krippendorff α ≥0.85).</p><p><strong>Conclusions: </strong>This investigation on whole-body DS-PCCT demonstrated a significant difference in attenuation changes from 70 to 40 keV VMI across multiple myeloma patients with a therapy response versus initial diagnosis and disease progression. Qualitative characteristics of medullary lesions, such as heterogeneity, partial recalcification, or a hypodense rim (\"halo sign\"), can serve as additional indicators of therapy response.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649445","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":"Synthetic MRI for Detecting Abnormal Signals in the Optic Nerves: An Exploratory Study.","authors":"Aurore Sajust de Bergues de Escalup, Loïc Duron, Patricia Koskas, Émilie Poirion, Caroline Papeix, Romain Deschamps, Dan Milea, Emma O'Shaughnessy, Julien Savatovsky, Laure Fournier, Augustin Lecler","doi":"10.1097/RLI.0000000000001226","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001226","url":null,"abstract":"<p><strong>Objectives: </strong>Synthetic magnetic resonance imaging (MRI) is a quantitative imaging technique that has shown promise in brain imaging but has not yet been evaluated for assessing the optic nerves. Our study aimed to investigate its diagnostic performance in this context.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated synthetic MRI's performance in detecting optic nerve hypersignals in 65 patients who underwent synthetic MRI covering the optic nerves from March 2023 to February 2025 in a single tertiary center. Diagnostic performance for optic nerve hypersignals was assessed using conventional T2 and/or FLAIR-weighted images with fat saturation as the reference standard. Quantitative T2 and proton density (PD) values were compared between optic nerves exhibiting hypersignals on synthetic MRI and those without any hypersignals. The detection rate of optic nerve hypersignals in patients with a diagnosis of acute optic neuritis was evaluated using synthetic MRI, both overall and for each individual synthetic contrast. For the qualitative analysis, sensitivity, specificity, and accuracy were each calculated with a 95% CI using the exact binomial (Clopper-Pearson) method. Quantitative differences in T2 and PD values were assessed using the Cohen d to evaluate effect size, and statistical significance was determined by the Wilcoxon rank-sum test.</p><p><strong>Results: </strong>Synthetic MRI showed good overall diagnostic performance for optic nerve hypersignals, with sensitivity, specificity, and accuracy of 71.4% [0.513-0.868], 97.1% [0.916-0.994], and 91.5% [0.854-0.957], respectively. Quantitative analysis revealed significantly higher median T2 (66.29 vs. 72.4 ms) and proton density (72.22 vs. 86.51) values in optic nerves exhibiting hypersignals compared with those without (P<0.001 for both). For acute optic neuritis specifically, 6 out of 7 (85.7%) were correctly identified in synthetic MRI. Confidence scores did not significantly differ between patients with optic nerve hypersignals and those without.</p><p><strong>Conclusions: </strong>Synthetic MRI showed promising results in detecting abnormal signals in the optic nerves, suggesting its potential role in their clinical evaluation.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642556","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":"Clinical Safety of Gadoxetate Disodium: Insights From 20 Years of Use and More Than 12 Million Administrations.","authors":"Jan Endrikat, Bojana Bogosavljev, Aasia Bhatti, Sebastiano Forgia, Moshe S Fuksbrumer, SoYeon Kim","doi":"10.1097/RLI.0000000000001224","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001224","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively analyze worldwide safety data of gadoxetate disodium after 20 years of use and to review its reclassification from group III to group II on the American College of Radiology (ACR) nephrogenic systemic fibrosis (NSF)-risk classification scheme.</p><p><strong>Materials and methods: </strong>Two safety data sets were analyzed: 23 clinical phase I to IV studies and Bayer pharmacovigilance database (PV) from 2004 to 2024. In addition, a literature review on NSF reports with special focus on patients with different degrees of renal impairment was performed. Patients' exposure was based on the assumption that one vial or prefilled syringe was given to each patient for each procedure, with an estimated total of over 12 million administrations. The primary target variable was the number, frequency and characteristics of unrelated/related adverse events (AEs) in clinical studies and adverse drug reactions (ADRs) reported to PV. Incidence and reporting rates were analyzed by descriptive statistical methods.</p><p><strong>Results: </strong>A total of 10,282 patients were included in clinical phase I to IV studies. Drug-related AEs were reported in 6% and 1.7% in phase III and IV studies, respectively. Nine (0.11%) related serious adverse events (SAEs) were recorded in phase IV, none in phase III. The most frequently recorded AEs (related or unrelated to drug) in phases I to III were nausea (1.4%) and headache (1.2%). All other AEs were reported ≤ 1.0%. In phase IV, dyspnea (0.34%) and nausea (0.28%) (related or unrelated) were most frequently reported. More than 12 million doses of gadoxetate were administered according to sales data. Most frequently reported ADRs from the PV were hypersensitivity reactions (reporting rate 0.0147%), nausea (0.0029%) and pain (0.0019%). Exposure increased steadily from 16,578 administrations in 2006 to 1,289,979 per year by December 31, 2024. Conversely, the ADR rate decreased from 0.21% in 2006 to ≤0.05% in 2011 through 2024. No report diagnostic of or consistent with NSF was documented, even in patients with renal impairment.</p><p><strong>Conclusion: </strong>Liver-specific gadoxetate disodium demonstrated a favorable safety profile in patients independent of their renal function. No report diagnostic of or consistent with NSF has been reported with over 20 years of use. The well-established benefit/risk profile of gadoxetate disodium prompted the ACR to reclassify it from group III to group II as of April 2024.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637034","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":"Breast Cancer Screening: A Decade of Progress.","authors":"Elene Iordanishvili, Maike Bode, Stephanie Morscheid, Teresa Lemainque, Christiane K Kuhl","doi":"10.1097/RLI.0000000000001216","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001216","url":null,"abstract":"<p><p>This review is dedicated to the 60th anniversary of Investigative Radiology and focuses on significant development made in the field of breast cancer screening in the past decade since the last anniversary article, and builds on it. The special focus of this article will be on selected landmark clinical trials that shape our current thinking.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575489","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":"Artifact Reduction in Interventional Devices Using Virtual Monoenergetic Images and Iterative Metal Artifact Reduction on Photon-Counting Detector CT.","authors":"Yannik Christian Layer, Sebastian Faby, Viktor Haase, Bernhard Schmidt, Narine Mesropyan, Patrick A Kupczyk, Alexander Isaak, Tatjana Dell, Julian A Luetkens, Daniel Kuetting","doi":"10.1097/RLI.0000000000001149","DOIUrl":"10.1097/RLI.0000000000001149","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to assess the impact of an iterative metal artifact reduction (iMAR) algorithm combined with virtual monoenergetic images (VMIs) for artifact reduction in photon-counting detector computed tomography (PCDCT) during interventions.</p><p><strong>Materials and methods: </strong>Using an abdominal phantom, we conducted evaluations on the efficacy of iMAR and VMIs for mitigating image artifacts during interventions on a PCDCT. Four different puncture devices were employed under 2 scan modes (QuantumSn at 100 kV, Quantumplus at 140 kV) to simulate various clinical scenarios. Image reconstructions were initially performed without iMAR and subsequently with iMAR settings. The latter was tested with 7 different metal presets for each case. Furthermore, iMAR-reconstructed images were paired with VMIs at energy levels of 70 keV, 110 keV, 150 keV, and 190 keV. Qualitative assessments were conducted to evaluate image quality, artifact expression, and the emergence of new artifacts using a Likert scale. Image quality was rated on a scale of 1 (nondiagnostic) to 5 (excellent), whereas artifact severity was rated from 0 (none) to 5 (massive). Preferences for specific iMAR presets were documented. Quantitative analysis involved calculating Hounsfield unit (HU) differences between artifact-rich and artifact-free tissues.</p><p><strong>Results: </strong>Overall, 96 different scanning series were evaluated. The optimal combination for artifact reduction was found to be iMAR neurocoils with VMIs at 150 keV and 190 keV, showcasing the most substantial reduction in artifacts with a median rating of 1 (standard: 4). VMIs at higher keV levels, such as 190 keV, resulted in reduced image quality, as indicated by a median rating of 3 (compared with 70 keV with a median of 5). Newly emerged artifact expression related to reconstructions varied among intervention devices, with iMAR thoracic coils exhibiting the least extent of artifacts (median: 2) and iMAR neurocoils displaying the most pronounced artifacts (median: 4). Qualitative analysis favored the combination of iMAR neurocoils with VMIs at 70 keV, showcasing the best results. Conversely, quantitative analysis revealed that the combination of iMAR neurocoils with VMIs at 190 keV yielded the best results, with an average artifact expression of 20.06 HU (standard: 167.98 HU; P < 0.0001).</p><p><strong>Conclusions: </strong>The study underscores a substantial reduction in artifacts associated with intervention devices during PCDCT scans through the synergistic application of VMI and iMAR techniques. Specifically, the combination of VMIs at 70 keV with iMAR neurocoils was preferred, leading to enhanced diagnostic assessability of surrounding tissues and target lesions. The study demonstrates the potential of iMAR and VMIs for PCDCT-guided interventions. These advancements could improve accuracy, safety, efficiency, and patient outcomes in clinical practice.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"463-469"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921310","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":"Audiovisual Breathing Guidance for Improved Image Quality and Scan Efficiency of T2- and Diffusion-Weighted Liver MRI.","authors":"Narine Mesropyan, Christoph Katemann, Annerieke Heuvelink-Marck, Can Yüksel, Alexander Isaak, Asadeh Lakghomi, Leon Bischoff, Tatjana Dell, Dmitrij Kravchenko, Daniel Kuetting, Claus C Pieper, Julian A Luetkens","doi":"10.1097/RLI.0000000000001150","DOIUrl":"10.1097/RLI.0000000000001150","url":null,"abstract":"<p><strong>Objectives: </strong>Impaired image quality and long scan times frequently occur in respiratory-triggered sequences in liver magnetic resonance imaging (MRI). We evaluated the impact of an in-bore active breathing guidance (BG) application on image quality and scan time of respiratory-triggered T2-weighted (T2) and diffusion-weighted imaging (DWI) by comparing sequences with standard triggering (T2 S and DWI S ) and with BG (T2 BG and DWI BG ).</p><p><strong>Materials and methods: </strong>In this prospective study, random patients with clinical indications for liver MRI underwent 3 T MRI with standard and BG acquisitions. The audiovisual BG application received the respiratory signal from the scanner, and animated breathing instructions were displayed using a mirror and screen behind the MRI bore. Prior to the DWI BG and T2 BG acquisition, patients received a short video instruction about MRI with BG. Suitable parameters for desired breathing pattern for T2 BG and DWI BG were set individually for each patient based on the patient's physical respiratory ability (ie, 4 seconds breathing followed by 4.5 seconds breath holding). Artifacts, sharpness, lesion conspicuity, and overall image quality were assessed using a Likert scale from 1 (nondiagnostic) to 5 (excellent). Scan time, apparent contrast-to-noise ratio, and apparent signal-to-noise ratio (aSNR) for all sequences were analyzed. Paired t test and Wilcoxon test were used for statistical analysis.</p><p><strong>Results: </strong>Thirty-two patients (mean age: 55 ± 13 years, 13 female) were included. T2 BG showed less artifacts (4.5 ± 0.7 vs 4.1 ± 0.8, P < 0.001) and better sharpness, lesion conspicuity, and overall image quality (eg, overall image quality 4.6 ± 0.7 vs 4.4 ± 0.7, P = 0.004) compared with T2 S . DWI BG demonstrated improved image quality in all categories compared with DWI S (eg, overall image quality 4.5 ± 0.5 vs 4.3 ± 0.5, P = 0.005) and less artifacts (4.1 ± 0.5 vs 3.8 ± 0.7, P = 0.007). Scan times of T2 BG (286 ± 23 vs 345 ± 68 seconds, P < 0.001) and DWI BG (160 ± 4 vs 252 ± 70 seconds, P < 0.001) were reduced by 17% and 37%, respectively. aSNR and apparent contrast-to-noise ratio (eg, aSNR: 23.45 ± 11.31 [T2 BG ] vs 25.84 ± 10.76 [T2 S ]; P = 0.079) were similar for both sequences for both approaches.</p><p><strong>Conclusions: </strong>Active BG for respiratory-triggered liver T2w and DWI sequences led to significant reduction of breathing artifacts, improved image quality, and shorter scan time compared with standard acquisitions.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"470-477"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977747","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":"High-Resolution Free-Breathing Chemical-Shift-Encoded MRI for Characterizing Lymph Nodes in the Upper Abdomen.","authors":"Ivo T Maatman, Marnix C Maas, Sjoerd Ypma, Tobias K Block, Rik van den Elshout, Andor Veltien, Ewoud J Smit, John J Hermans, Tom W J Scheenen","doi":"10.1097/RLI.0000000000001147","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001147","url":null,"abstract":"<p><strong>Objectives: </strong>Accurate lymph node (LN) staging is crucial for managing upper abdominal cancers. Ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging effectively distinguishes healthy and metastatic LNs through fat/water and -weighted imaging. However, respiratory motion artifacts complicate detection of abdominal LNs. This study evaluates if a free-breathing radial stack-of-stars acquisition can match or outperform Cartesian reference scans to visualize LNs and depict uptake of USPIO nanoparticles.</p><p><strong>Materials and methods: </strong>Five volunteers with USPIO and 20 patients without USPIO were scanned using radial stack-of-stars, Cartesian dual-echo, and fat-saturated Cartesian multiecho sequences for fat/water imaging and estimation. Reconstructed images from radial and Cartesian patient data underwent qualitative comparison by 2 radiologists. LNs were identified in all fat/water images, LN short-axis sizes were measured, and relaxation rates were analyzed using linear correlations and Bland-Altman plots.</p><p><strong>Results: </strong>Radial imaging provided better image quality than the Cartesian reference standard, according to both readers. Substantially, more LNs were identified in radial compared with Cartesian datasets (349 vs 202). Median short-axis diameters showed a significant difference, measuring 2.7 mm (interquartile range [IQR]: 2.7-4.6 mm) for radial images and 4.5 mm (IQR: 3.7-5.6 mm) for Cartesian images ( P < 0.0001). Relaxation rates measured in radial data showed a significant linear correlation with the Cartesian reference (Pearson correlation coefficient: 0.90 with P < 0.0001). Bland-Altman plots indicated a slight bias with a mean difference (MD) of 3.9 s -1 and limits of agreement at MD ± 16.4 s -1 .</p><p><strong>Conclusions: </strong>This work presents a promising magnetic resonance imaging method to depict upper abdominal LNs and to visualize their USPIO uptake. Instead of multiple Cartesian breath-hold scans, all relevant contrasts and parameters are obtained from a single free-breathing radial acquisition. The proposed method yielded higher image quality and more sensitive detection of small LNs. value analysis showed a strong linear correlation with the reference, albeit with minimal biases.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":"60 7","pages":"434-443"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234021","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":"Clinical Evaluation of 3D Motion-Correction Via Scout Accelerated Motion Estimation and Reduction Framework Versus Conventional T1-Weighted MRI at 1.5 T in Brain Imaging.","authors":"Laura S Leukert, Katya Hoffmannbeck Heitkötter, Andrea Kronfeld, Roman H Paul, Daniel Polak, Daniel Nicolas Splitthoff, Marc A Brockmann, Sebastian Altmann, Ahmed E Othman","doi":"10.1097/RLI.0000000000001156","DOIUrl":"10.1097/RLI.0000000000001156","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the occurrence of motion artifacts and image quality of brain magnetic resonance imaging (MRI) T1-weighted imaging applying 3D motion correction via the Scout Accelerated Motion Estimation and Reduction (SAMER) framework compared with conventional T1-weighted imaging at 1.5 T.</p><p><strong>Materials and methods: </strong>A preliminary study involving 14 healthy volunteers assessed the impact of the SAMER framework on induced motion during 3 T MRI scans. Participants performed 3 different motion patterns: (1) step up, (2) controlled breathing, and (3) free motion. The patient study included 82 patients who required clinically indicated MRI scans. 3D T1-weighted images (MPRAGE) were acquired at 1.5 T. The MRI data were reconstructed using either regular product reconstruction (non-Moco) or the 3D motion correction SAMER framework (SAMER Moco), resulting in 145 image sequences. For the preliminary and the patient study, 3 experienced radiologists evaluated the image data using a 5-point Likert scale, focusing on overall image quality, artifact presence, diagnostic confidence, delineation of pathology, and image sharpness. Interrater agreement was assessed using Gwet's AC 2 , and an exploratory analysis (non-Moco vs SAMER Moco) was performed.</p><p><strong>Results: </strong>Compared with non-Moco, the preliminary study demonstrated significant improvements across all imaging parameters and motion patterns with SAMER Moco ( P < 0.001). Odds ratios favoring SAMER Moco were >999.999 for freedom of artifact and overall image quality ( P < 0.0001). Excellent or good ratings for freedom of artifact were 52.4% with SAMER Moco, compared with 21.4% for non-Moco. Similarly, 66.7% of SAMER Moco images were rated excellent or good for overall image quality versus 21.4% for non-Moco. Multireader interrater agreement was excellent across all parameters.The patient study confirmed that SAMER Moco provided significantly superior image quality across all evaluated imaging parameters, particularly in the presence of motion ( P < 0.001). Diagnostic confidence was rated as excellent or good in 95.1% of SAMER Moco cases, compared with 78.1% for non-Moco cases. Similarly, overall image quality was rated as excellent or good in 89.8% of SAMER Moco cases versus 65.9% for non-Moco cases. The odds ratios for diagnostic confidence and for overall image quality were 6.698 and 6.030, respectively, both favoring SAMER Moco ( P < 0.0001). Multireader interrater agreement was excellent across all parameters.</p><p><strong>Conclusions: </strong>The application of SAMER in T1-weighted imaging datasets is feasible in clinical routine and significantly increases image quality and diagnostic confidence in 1.5 T brain MRI by effectively reducing motion artifacts.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"478-485"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023467","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":"Intraindividual Comparison of Image Quality Between Low-Dose and Ultra-Low-Dose Abdominal CT With Deep Learning Reconstruction and Standard-Dose Abdominal CT Using Dual-Split Scan.","authors":"Tae Young Lee, Jeong Hee Yoon, Jin Young Park, So Hyun Park, HeeSoo Kim, Chul-Min Lee, Yunhee Choi, Jeong Min Lee","doi":"10.1097/RLI.0000000000001151","DOIUrl":"10.1097/RLI.0000000000001151","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to intraindividually compare the conspicuity of focal liver lesions (FLLs) between low- and ultra-low-dose computed tomography (CT) with deep learning reconstruction (DLR) and standard-dose CT with model-based iterative reconstruction (MBIR) from a single CT using dual-split scan in patients with suspected liver metastasis via a noninferiority design.</p><p><strong>Materials and methods: </strong>This prospective study enrolled participants who met the eligibility criteria at 2 tertiary hospitals in South Korea from June 2022 to January 2023. The criteria included ( a ) being aged between 20 and 85 years and ( b ) having suspected or known liver metastases. Dual-source CT scans were conducted, with the standard radiation dose divided in a 2:1 ratio between tubes A and B (67% and 33%, respectively). The voltage settings of 100/120 kVp were selected based on the participant's body mass index (<30 vs ≥30 kg/m 2 ). For image reconstruction, MBIR was utilized for standard-dose (100%) images, whereas DLR was employed for both low-dose (67%) and ultra-low-dose (33%) images. Three radiologists independently evaluated FLL conspicuity, the probability of metastasis, and subjective image quality using a 5-point Likert scale, in addition to quantitative signal-to-noise and contrast-to-noise ratios. The noninferiority margins were set at -0.5 for conspicuity and -0.1 for detection.</p><p><strong>Results: </strong>One hundred thirty-three participants (male = 58, mean body mass index = 23.0 ± 3.4 kg/m 2 ) were included in the analysis. The low- and ultra-low- dose had a lower radiation dose than the standard-dose (median CT dose index volume: 3.75, 1.87 vs 5.62 mGy, respectively, in the arterial phase; 3.89, 1.95 vs 5.84 in the portal venous phase, P < 0.001 for all). Median FLL conspicuity was lower in the low- and ultra-low-dose scans compared with the standard-dose (3.0 [interquartile range, IQR: 2.0, 4.0], 3.0 [IQR: 1.0, 4.0] vs 3.0 [IQR: 2.0, 4.0] in the arterial phase; 4.0 [IQR: 1.0, 5.0], 3.0 [IQR: 1.0, 4.0] vs 4.0 [IQR: 2.0, 5.0] in the portal venous phases), yet within the noninferiority margin ( P < 0.001 for all). FLL detection was also lower but remained within the margin (lesion detection rate: 0.772 [95% confidence interval, CI: 0.727, 0.812], 0.754 [0.708, 0.795], respectively) compared with the standard-dose (0.810 [95% CI: 0.770, 0.844]). Sensitivity for liver metastasis differed between the standard- (80.6% [95% CI: 76.0, 84.5]), low-, and ultra-low-doses (75.7% [95% CI: 70.2, 80.5], 73.7 [95% CI: 68.3, 78.5], respectively, P < 0.001 for both), whereas specificity was similar ( P > 0.05).</p><p><strong>Conclusions: </strong>Low- and ultra-low-dose CT with DLR showed noninferior FLL conspicuity and detection compared with standard-dose CT with MBIR. Caution is needed due to a potential decrease in sensitivity for metastasis ( clinicaltrials.gov/NCT05324046 ).</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"454-462"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058900","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":"Different Glymphatic-Lymphatic Coupling in the Nasal Mucosa and Parasagittal Dura.","authors":"Horst Urbach, Murat Kavus, Niklas Lützen, Charlotte Zander, Theo Demerath, Alexander Rau, Katharina Wolf, Jürgen Beck, Ikram Eda Duman","doi":"10.1097/RLI.0000000000001220","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001220","url":null,"abstract":"<p><strong>Background: </strong>Glymphatic-lymphatic coupling is difficult to visualize in humans.</p><p><strong>Purpose: </strong>To evaluate the transport from the basal subarachnoid space to lymphatic vessels in the nasal mucosa and in the parasagittal dura, respectively.</p><p><strong>Methods: </strong>A highly resolved 3D compressed sensing black blood sequence with almost isotropic resolution (0.5 ×0.5 ×0.6 mm3) was acquired in 26 patients before and 2 to 4, 6 to 8, 24 to 48, and 72 to 96 hours after intrathecal injection of 0.5 mL gadobutrol. T1 signal intensities were measured in CSF spaces (perisylvian, above cribriform plate, midsylvian, and parasagittal), in the olfactory bulbs, fila olfactoria, and nasal mucosa, as well as in the cortex, white matter, and parasagittal dura.</p><p><strong>Results: </strong>In the perisylvian CSF, in the CSF above the cribriform plate, in the olfactory bulbs, fila olfactoria, nasal mucosa, and in the cortex, percentage T1 signal intensities showed a rapid increase, peaking at 2 to 4 hours and 6 to 8 hours, respectively. The midsylvian and parasagittal CSF exhibited a slower increase with peak enhancement at 24 to 48 hours. Similarly, in the white matter of the temporal lobe, T1 signal intensities increased gradually, reaching their peak at 24 to 48 hours, followed by a decline after 72 to 96 hours. In the parasagittal dura, T1 signal intensities continued to rise even beyond 72 to 96 hours.</p><p><strong>Conclusions: </strong>Intrathecally injected gadolinium reaches the lymphatic vessels in the nasal mucosa earlier than those in the parasagittal dura. Transport to the nasal mucosa takes place directly via the subarachnoid space. For the transport to the parasagittal dura, findings are compatible with a trans-parenchymal transport route.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527975","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}