Investigative Radiology最新文献

{"title":"Ultra-high Resolution Photon Counting Detector Computed Tomography Imaging for Quantitative Lung Assessment: An Anthropomorphic Phantom Study.","authors":"Jessica C Sieren, Kimberly E Schroeder, Jacob Kitzmann, Kevin Knoernschild, Jarron Atha, Natally Alarab, Junfeng Guo, Sean B Fain, Eric A Hoffman","doi":"10.1097/RLI.0000000000001227","DOIUrl":"10.1097/RLI.0000000000001227","url":null,"abstract":"<p><strong>Background: </strong>Quantitative lung imaging is utilized to understand, characterize, and monitor lung disease and response to interventions. X-ray computed tomography has remained the modality of choice for clinical lung assessment, and photon counting detector-computed tomography (PCD-CT) is the latest advancement. PCD-CT provides increased spatial and contrast resolution, decreased image noise and artifacts (such as beam hardening) and, thus, a potential for enhanced image quality for equivalent or reduced radiation dose levels. However, evaluation of the ultra-high resolution capabilities of PCD-CT for quantitative lung imaging has not yet been systematically investigated.</p><p><strong>Purpose: </strong>This study aims to evaluate 2 ultra-high resolution acquisition modes and 4 reconstruction kernels for optimal quantitative chest imaging at high radiation dose (9 mGy). We assess the stability of measurements across different scan modes and reconstruction kernels when the radiation dose level is reduced.</p><p><strong>Methods: </strong>A customized anthropomorphic chest phantom, containing standardized insert materials, including air, water, various density foam inserts, and a modulation transfer function (MTF) cube, was repeatedly scanned with PCD-CT (NAEOTOM Alpha; Siemens Healthineers). Two ultra-high resolution acquisition modes, quantum plus (UHRQ+) and quantum with tin filtering (UHRQSn), and 4 reconstruction kernels (Br64, Bl60, Qr60, and Qr40, all with iterative reconstruction level 3) were examined with acquisitions at 3 radiation dose levels (9.1 mGy, 6.8 mGy, and 3.2 mGy). Quantitative density measures, airway measurements, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and MTF values were compared, along with the percentage change in measurement values from high to low radiation dose levels.</p><p><strong>Results: </strong>At the highest radiation dose levels, UHRQ+ acquisition resulted in lower density values with higher SD compared with UHRQSn. UHRQ+ mode demonstrated higher CNR, SNR, and MTF values. Only UHRQ+ with Qr40 reconstruction provided accurate air measurements, both inside and outside the phantom, across all radiation dose levels. Quantitative density measurements remained highly stable (<2% change) as the radiation dose was reduced from 9.1 to 3.2 mGy. Airway wall thickness, diameter, and lumen area measurements were all larger with UHRQ+ acquisition compared with UHRQSn for the high radiation dose level. At low radiation dose levels, the UHRQ+ acquisition with Br64 reconstruction maintained the highest consistency in airway metrics compared with the values from the high dose acquisition, with <5% measurement percentage change.</p><p><strong>Conclusion: </strong>The UHRQ+ mode is recommended for quantitative lung assessment, leveraging the PCD-CT voxel size potential (1024×1024 in plane matrix with 0.2 mm slice thickness). The choice of reconstruction kernel at ultra-high resolution should b","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"288-296"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760019","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":"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":"279-287"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959581/pdf/","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":"OA","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":"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":"261-271"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","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":"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":"272-278"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959591/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the rNOE-CEST Contrast for Breast Cancer MRI Using the FATLESS Approach.","authors":"Philip S Boyd, Petr Menshchikov, Lisa Loi, Neele Kempa, Mark E Ladd, Heinz-Peter Schlemmer, Peter Bachert, Daniel Paech, Andreas Korzowski","doi":"10.1097/RLI.0000000000001222","DOIUrl":"10.1097/RLI.0000000000001222","url":null,"abstract":"<p><strong>Objectives: </strong>Quantitative chemical exchange saturation transfer (CEST) breast imaging is limited by pronounced fat-induced artifacts. The strongest fat artifact, appearing between [-2, -4] ppm in the Z-spectrum, directly overlaps the signal of the exchange-relayed nuclear Overhauser effect (rNOE) at around -3.5 ppm, a key biomarker for protein content and cellularity, making accurate rNOE-CEST evaluation extremely challenging. The aim of this study is to evaluate rNOE-CEST contrast corrected for fat-related artifacts using a novel, fully software-based fat correction method in breast cancer patients.</p><p><strong>Materials and methods: </strong>FATLESS (Fat Attenuation Technique using Lipid signal Estimation and Simulated Saturations in postprocessing) was developed for correcting fat-related artifacts across the entire Z-spectrum in CEST MRI. The FATLESS method estimates fat signals from residual signals at the direct water saturation offset (0 ppm) while accounting for partial saturation of fat resonances. FATLESS was retrospectively applied to 7T CEST data from breast cancer patients (acquired September 2018 to May 2019). Resulting fat-corrected rNOE, amide, and guanidino MTR Rex contrast values were quantified from 2D snapshot GRE CEST with low saturation power (B 1 =0.6, 0.9 μT). Kruskal-Wallis tests and Pearson correlation analyses were used to compare MTR Rex values between tumor and normal-appearing fibroglandular tissue and assess correlations with Ki-67, a tumor proliferation marker.</p><p><strong>Results: </strong>Nine biopsy-confirmed breast cancer patients [mean age, 50 y ± 10 (SD)] and 7 healthy controls [mean age, 25 y ± 4 (SD)] were included. Fat-corrected MTR Rex rNOE maps were validated in phantom and in vivo data, confirming independence from fat artifacts using the FATLESS method. Tumor regions showed significantly higher fat-corrected MTR Rex rNOE values than healthy tissue (+140% mean increase, P <0.001). A strong positive correlation was found between fat-corrected MTR Rex rNOE values and Ki-67 ( R ² = 0.71).</p><p><strong>Conclusions: </strong>The developed FATLESS fat correction method enables full utilization of all CEST MRI contrasts in the human breast. The observed significant rNOE contrast elevation and strong correlation with tumor proliferation highlight its potential as a non-invasive imaging biomarker for breast cancer characterization.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"241-250"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674779","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":"Cardiac Magnetic Resonance Imaging at Lower Field Strength: A Comparison of Biventricular Cine and Quantitative T1 and T2 Maps at 0.55T and 1.5T.","authors":"Simon Mayr, Stefan Zicha, Daniel Giese, Markus Kopp, Sandy Schmidt, Sebastian Arndt, Lisa Sommerfeld, Joy-Marie Kleiß, Michael Uder, Matthias S May","doi":"10.1097/RLI.0000000000001225","DOIUrl":"10.1097/RLI.0000000000001225","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare biventricular cine measurements and quantitative maps of myocardial T1 and T2 relaxation times at field strengths ranging from 0.55T to 1.5T in patients with a clinical indication for cardiac magnetic resonance imaging (CMR). Establishing the feasibility of low-field CMR may improve accessibility due to easier siting and lower cost of the low-field systems.</p><p><strong>Materials and methods: </strong>Thirteen patients underwent same-day comparative CMR at 0.55T and on a commercial scanner at 1.5T. We examined all individuals with breath-held segmented bSSFP cine sequences for volumetric assessment of the left ventricle (LV), right ventricle (RV), and visual assessment of wall motion abnormalities (WMA) and valve pathologies. The quantitative T1 and T2 maps were acquired in 3 short-axis views for tissue characterization. Blinded readers scored the image quality on a 3-point Likert scale. Ten healthy volunteers were additionally examined at 0.55T to obtain reference values for the parametric maps.</p><p><strong>Results: </strong>Functional analysis of both ventricles at low-field CMR has a reasonable correlation (r=0.94 to 0.99) with conventional 1.5T measurements. LV ejection fraction (EF) ( P =0.62) and RV measurements (all P >0.05) were highly reproducible, but LV absolute volumetric measurements were slightly lower at the low-field strength (all P <0.05). T1 and T2 relaxation times correlated strongly between field strengths (r=0.79; P <0.01 and r=0.63; P =0.02). Reference values from the volunteers were 678.6±13.5 ms (T1) and 66.5±4.1 ms (T2). Overall, good image quality was achieved, and visual assessment showed excellent agreement with 1.5T. Trigger artifacts occurred more frequently during 0.55T scans compared with 1.5T. Correct clinical stratification of volumetric parameters, WMA, valve pathologies, and parametric maps was possible in 94% of all cases.</p><p><strong>Conclusions: </strong>CMR at 0.55T provides a comprehensive assessment of function, structure, and tissue characterization comparable to that of 1.5T. The diagnostic accuracy in this clinical cohort is high. Identification of the specific trigger problems and optimization of the trigger technique could help to overcome the slight inaccuracies in the LV absolute volumetric measurements. Low-field CMR holds promise for expanding access to this valuable diagnostic tool, benefiting patients worldwide and on an individual level.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"251-260"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682627","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":"Efficacy of a Novel Dimeric Macrocyclic Gadolinium Chelate With High Relaxivity in Preclinical Models of Neurological and Oncological Pathologies.","authors":"Francesca La Cava, Sonia Colombo Serra, Alessia Cordaro, Luigi Miragoli, Chiara Brioschi, Claudia Cabella, Luisa Poggi, Alberto Fringuello Mingo","doi":"10.1097/RLI.0000000000001287","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001287","url":null,"abstract":"<p><strong>Background: </strong>Gadolinium-based contrast agents (GBCAs) are crucial for enhancing MRI contrast, especially in neurological and oncological imaging. Achieving high relaxivity is a primary focus in contrast media research. Recently, digadoglucitol, the first dimeric macrocyclic gadolinium complex, was introduced, offering significantly higher relaxivity compared with first-generation commercial macrocyclic GBCAs.</p><p><strong>Purpose: </strong>This study assesses the performance of digadoglucitol in preclinical models of neurological and oncological diseases. It explores whether digadoglucitol provides comparable diagnostic efficacy at half the dose and superior contrast enhancement at the full standard dose compared with gadoterate meglumine and gadobutrol.</p><p><strong>Material and methods: </strong>All animal experiments and preclinical procedures adhered to national and international regulations. The study involved models of glioma, meningioma, ischemia, and breast adenocarcinoma, for a total of 112 animals. Digadoglucitol was administered at doses of 0.1 mmol Gd/kg and 0.05 mmol Gd/kg, whereas gadoterate meglumine and gadobutrol were given at 0.1 mmol Gd/kg. MRI sessions assessed signal enhancement and contrast-to-noise ratio (CNR) before and after contrast-agent administration.</p><p><strong>Results: </strong>All pathologic models were accurately localized with consistent volumes across treatment groups. Tumour malignancy and ischemic lesions were confirmed by histologic analysis using standard haematoxylin-eosin staining and established pathologic criteria. Quantitative analysis revealed that both half and full doses of digadoglucitol produced significant signal enhancement and CNR in glioma, meningioma, ischemia, and breast models. The enhancement and CNR values were comparable (at half-dose) or exceeded (at full-dose) those achieved with gadoterate meglumine and gadobutrol. Statistical analysis confirmed the significance of these results.</p><p><strong>Conclusion: </strong>Digadoglucitol shows high diagnostic efficacy in preclinical models of neurological and oncological diseases. It delivers comparable effectiveness at half the dose and superior contrast enhancement at the full standard dose compared with established GBCAs. These preclinical findings suggest that digadoglucitol is a promising contrast agent to be considered for clinical translation, potentially allowing for reduced dosage while maintaining or improving diagnostic accuracy.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499042","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":"Dixon-Based Water T1 Mapping for Fat-Corrected Assessment of Hepatic Fibrosis in Chronic Liver Disease.","authors":"Narine Mesropyan, Elizabeth Huaroc Moquillaza, Johannes Chang, Philipp Lutz, Christoph Katemann, Kilian Weiss, Oliver M Weber, Johannes M Peeters, Tatjana Dell, Daniel Kuetting, Claus C Pieper, Can Yueksel, Mariya Doneva, Dimitrios C Karampinos, Julian A Luetkens, Alexander Isaak","doi":"10.1097/RLI.0000000000001212","DOIUrl":"10.1097/RLI.0000000000001212","url":null,"abstract":"<p><strong>Objectives: </strong>The diagnostic value of conventional T1 mapping for noninvasive assessment of liver fibrosis is limited in the presence of hepatic steatosis. To evaluate the diagnostic value of water T1 (wT1) with continuous inversion-recovery Look-Locker (CIR-LL) method, integrating spiral readout, Dixon, and dictionary-based processing, for the fat-corrected assessment of hepatic fibrosis in patients with chronic liver disease (CLD).</p><p><strong>Materials and methods: </strong>In this prospective study, consecutive participants with CLD underwent liver magnetic resonance imaging (MRI), which included assessment of MR-elastography (MRE)-derived liver stiffness, proton density fat fraction (PDFF), T1 relaxation times using modified Look-Locker inversion recovery (T1-MOLLI) and extracellular volume fraction (ECV), and wT1 relaxation times. MRE served as the reference standard to evaluate the diagnostic performance of MRI-based mapping parameters. Significant fibrosis (≥F2) was defined as MRE-derived liver stiffness >3.66 kPa in patients with PDFF≤5%, or >3.14 kPa in patients with PDFF>5%. Statistical analysis included Student t test, receiver operating characteristic (ROC) analysis, and Spearman correlation coefficient.</p><p><strong>Results: </strong>A total of 81 CLD patients (mean age, 50±14 y; 32 female; 40 patients with PDFF>5%) were included. All measured mapping values were significantly higher in patients with significant fibrosis compared with those without (eg, wT1: 628±82 vs. 546±41 ms, P <0.001). wT1 showed a strong correlation with MRE-derived liver stiffness, outperforming T1-MOLLI and ECV mapping [whole cohort: r =0.67 (wT1) vs. 0.53 (T1-MOLLI) vs. 0.48 (ECV); cohort with PDFF>5%: r =0.69 (wT1) vs. 0.44 (T1) vs. 0.49 (ECV); P <0.05 in each case, respectively]. wT1 had a superior diagnostic performance for the detection of significant fibrosis [whole cohort, area under the curve (AUC): 0.82 (wT1); 0.77 (T1-MOLLI); 0.73 (ECV), P <0.001 in each case; cohort with PDFF>5%, AUC: 0.84, P =0.002 (wT1), 0.70, P =0.04 (T1-MOLLI), 0.70, P =0.04 (ECV)].</p><p><strong>Conclusion: </strong>Compared with T1-MOLLI and ECV mapping, the proposed fat-corrected CIR-LL wT1 method proved to be a more robust marker of hepatic fibrosis in CLD, also in the presence of hepatic steatosis.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"84-91"},"PeriodicalIF":8.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234020","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":"Validation of a Pretrained Artificial Intelligence Model for Pancreatic Cancer Detection on Diagnosis and Prediagnosis Computed Tomography Scans.","authors":"Laura Degand, Clément Abi-Nader, Alexandre Bône, Rebeca Vetil, Davide Placido, Piotr Chmura, Marc-Michel Rohé, Federico De Masi, Søren Brunak","doi":"10.1097/RLI.0000000000001209","DOIUrl":"10.1097/RLI.0000000000001209","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate PANCANAI, a previously developed AI model for pancreatic cancer (PC) detection, on a longitudinal cohort of patients. In particular, aiming for PC detection on scans acquired before histopathologic diagnosis was assessed.</p><p><strong>Materials and methods: </strong>The model has been previously trained to predict PC suspicion on 2134 portal venous CTs. In this study, the algorithm was evaluated on a retrospective cohort of Danish patients with biopsy-confirmed PC and with CT scans acquired between 2006 and 2016. The sensitivity was measured, and bootstrapping was performed to provide median and 95% CI.</p><p><strong>Results: </strong>The study included 1083 PC patients (mean age: 69 y ± 11, 575 men). CT scans were divided into 2 groups: (1) concurrent diagnosis (CD): 1022 CT scans acquired within 2 months around histopathologic diagnosis, and (2) prediagnosis (PD): 198 CT scans acquired before histopathologic diagnosis (median 7 months before diagnosis). The sensitivity was 91.8% (938 of 1022; 95% CI: 89.9-93.5) and 68.7% (137 of 198; 95% CI: 62.1-75.3) on the CD and PD groups, respectively. Sensitivity on CT scans acquired 1 year or more before diagnosis was 53.9% (36 of 67; 95% CI: 41.8-65.7). Sensitivity on CT scans acquired at stage I was 82.9% (29 of 35; 95% CI: 68.6-94.3).</p><p><strong>Conclusion: </strong>PANCANAI showed high sensitivity for automatic PC detection on a large retrospective cohort of biopsy-confirmed patients. PC suspicion was detected in more than half of the CT scans that were acquired at least a year before histopathologic diagnosis.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"75-83"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12736417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475251","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":"Assignment of the Biological Identity of Breast Masses in Contrast-enhanced Spectral Computed Tomography Examinations of Chest Carried Out in Clinical Routine Diagnostics.","authors":"Kathrin Barbara Krug, Darius G Schafigh, Andra-Iza Iuga, Mathilda Weisthoff, Jean-Philip Weber, Wolfram Malter, David Maintz, Pascal A T Baltzer, Mathew G Wallis, Martin Hellmich, Konstantin Klein","doi":"10.1097/RLI.0000000000001215","DOIUrl":"10.1097/RLI.0000000000001215","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Focal breast lesions are observed in up to 5.8% of CT examinations performed in female patients for a wide variety of indications not affecting the breast. To simplify and standardize the further procedure in the case of breast masses visualized by computed tomography (CT), an easy and robust diagnostic approach in assigning surely benign findings, uncertain findings and probably malignant findings is warranted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed (1) to determine the diagnostic gain of quantitative measurements of the iodine content in breast masses visualized in contrast-enhanced dual energy (DE) CT examinations additional to the assessment of qualitative image features; and (2) to generate an interactive hierarchical decision tree allowing to assess the individual probability of benign or malignant findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;All contrast-enhanced DECT examinations performed in adult females from January 2018 to December 2020 were retrospectively screened for solid breast masses. Subsequently, the DECT images with confirmed breast masses were evaluated independently by 3 radiologists experienced in breast imaging using a structured questionnaire. First, the image characteristics of the ACR-BIRADS atlas on MRI were queried, and an assessment of the probability of benignancy or malignancy was requested. Second, the iodine content in the breast masses was interactively measured, and the readers were asked to provide a further assessment of the biological identity. Third, a decision tree was developed using a nonparametric supervised (machine) learning algorithm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the survey period, 5.591 contrast-enhanced DECT examinations of the chest were carried out in adult female patients. Six hundred eighty-seven DECTs (12.3%) displayed breast masses. The study group comprised 415 female patients (7.4%) with a benign or malignant breast mass confirmed by histology (155, 37.4%), a constant CT-course of ≥2 years without interfering therapy (202, 48.8%) and/or noninvasive breast imaging (57, 13.8%). Neither in the first step nor in the second step of the evaluations a cancer confirmed in the reference standard was classified as certainly benign. Subgroup analyses showed that the combined qualitative and quantitative approach was diagnostically superior compared with the sole descriptor-based assessments in 757 assessments of DECT evaluations with ACR 1+2 breast densities (AUC = 0.961 vs 0.924, lower bound 0.940 vs 0.893, upper bounds 0.982 vs 0.956, P = 0.001) and for the 541 assessments of DECT examinations visualizing masses in denser ACR 3+4 parenchyma (AUC = 0.972 vs 0.948, lower bound 0.953 vs 0.923, upper bound 0.991 vs 0.974, P = 0.043). Including iodine content into the descriptive image evaluations proved to be superior to the solely descriptor-based assessments in 456 assessments of lesions with &gt;5 to 10 mm diameter and in 370 assessments of lesio","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"92-102"},"PeriodicalIF":8.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730951","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}