Investigative Radiology最新文献

{"title":"Dual-Source Dual-Energy Imaging Using Photon-Counting Detector CT for Bone Edema Detection: Leveraging Tin Prefiltration for Improved Spectral Performance.","authors":"Kishore Rajendran, Andrea Ferrero, Elisabeth R Shanblatt, Cynthia H McCollough, Francis I Baffour","doi":"10.1097/RLI.0000000000001201","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001201","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of the study were to evaluate the spectral performance of an investigational dual-source (DS) scan mode using a tin (Sn) filter on the B-subsystem of a clinical photon-counting detector (PCD) CT system and to demonstrate improved material decomposition performance using clinical examples of bone imaging tasks.</p><p><strong>Materials and methods: </strong>Calcium inserts (Ca 100, 200 and 300 mg/cc) were placed in water phantoms (30-, 40-, and 50-cm lateral diameter) and scanned on clinical PCD-CT (NAEOTOM Alpha, Siemens) using DS spectral scan mode (QuantumPeak). Two tube potential configurations (70/Sn150 kV and 90/Sn150 kV) were used to scan the phantoms (11 mGy to 41 mGy volume CT dose index). The phantoms were also scanned using the single-source (SS) PCD-CT scan mode at 120 kV and 140 kV tube potential, and on a DS energy-integrating detector (EID) CT (SOMATOM Force, Siemens) for quantitative comparison. CT images (from SS-PCD-CT, DS-PCD-CT, and DS-EID-CT) were reconstructed using a quantitative kernel (Qr40) at a 2-mm section thickness using iterative reconstruction strength 1. Spectral separation was quantified using the dual-energy ratio (DER) of Ca inserts and using mean absolute percent error (MAPE) of Ca mass density obtained from Ca/water material decomposition. To demonstrate clinical feasibility, 4 patients were scanned using DS-PCD-CT under an institutional review board-approved study. Bone edema maps were reconstructed from DS-PCD-CT and compared with the corresponding clinical imaging exam of the same patients (MRI or DS-EID-CT).</p><p><strong>Results: </strong>DS-PCD-CT at 70/Sn150 kV for Ca 100 mg/cc showed the highest mean DER (2.49 and 2.56 at 30 and 40 cm, respectively) among all scan configurations. For the 50-cm phantom at Ca 100 mg/cc, DS-PCD-CT at 90/Sn150 kV showed highest mean DER (1.88), followed by DS-EID-CT at 90/Sn 150 kV (1.87) and SS-PCD-CT at 140 kV (1.78). The MAPE values for DS-PCD-CT were consistently lower across all phantom sizes (MAPE max. of 1.44%) compared to SS-PCD-CT (MAPE max. 3.97%) and DS-EID-CT (MAPE max. 3.68%). Qualitatively, patient images illustrated bone edema depiction on DS-PCD-CT comparable to clinical MR images, and more precise edema depiction compared to DS-EID-CT images at the site of fractures and intramedullary lesions, and with fewer artifacts.</p><p><strong>Conclusions: </strong>DS-PCD-CT showed superior spectral performance for calcium imaging tasks compared to SS-PCD-CT and DS-EID-CT.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010127","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":"Myocardial Late Enhancement With Photon-Counting Detector CT in Spontaneous Coronary Artery Dissection: Prospective Comparison With Cardiac MRI.","authors":"Konstantin Klambauer, Ernst Klotz, Lukas J Moser, Tobias Kälin, Andrea Biondo, Victor Schweiger, Victor Mergen, Costanza Lisi, Michael Würdinger, Rabea Schlenker, Davide Di Vece, Alexander Gotschy, Martin Reiner, Jelena-R Ghadri, Verena C Wilzeck, Matthias Eberhard, Christian Templin, Robert Manka, Hatem Alkadhi","doi":"10.1097/RLI.0000000000001203","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001203","url":null,"abstract":"<p><strong>Objectives: </strong>Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and myocardial infarction. Accurate diagnosis is crucial for appropriate management. This study aimed to compare late enhancement (LE) imaging using photon-counting detector (PCD)-CT with cardiac MRI in patients with SCAD in the acute phase and during follow-up and to introduce a novel approach for visualizing myocardial extracellular volume (ECV) distribution in the myocardium.</p><p><strong>Materials and methods: </strong>This single-center prospective study enrolled patients with SCAD diagnosed with invasive coronary angiography. LE iodine imaging with spectral dual-source PCD-CT and cardiac MRI was performed early after symptom onset and at short-term follow-up. CT included coronary angiography and LE imaging (5 minutes after contrast). LE CT was assessed using the combination of conventional LE images, overlay images, polar maps, and with newly developed atlas maps. Atlas maps represent 2-dimensional maps with prefiltering applied to enable a simpler and more intuitive reading of ECV distribution across the myocardium. Cardiac MRI served as the reference standard for identifying pathologic myocardial segments based on late gadolinium enhancement (LGE) and edema on T2-weighted and T2-mapping images. Agreement between modalities was evaluated using Cohen's κ.</p><p><strong>Results: </strong>Seventeen patients (median age, 44 years [interquartile range, 36-52]; 11 women) underwent 24 LE CT and cardiac MRI scans. Sixteen patients (median age, 44 years; 10 women) underwent acute phase imaging (median 6 days after symptom onset), and 8 patients (median age, 45 years; 6 women) underwent follow-up imaging (median 120 days after symptom onset). Atlas maps were helpful in detecting segments with pathological ECV and to adjudicate corresponding myocardial segments. Agreement between LE CT with LGE cardiac MRI was strong in the acute phase (κ = 0.832), improving to almost perfect when comparing LE-CT with both LGE and edema in cardiac MRI (κ = 0.944). At follow-up imaging, agreement further improved as edema resolved (κ = 0.956).</p><p><strong>Conclusions: </strong>LE imaging with PCD-CT demonstrated strong agreement with cardiac MRI for detecting myocardial injury in SCAD, which further improved at follow-up when edema resolved. Newly introduced atlas maps proved useful for a simple and intuitive visualization of myocardial injury.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063810","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":"Balanced Steady-State Free Precession Enables High-Resolution Dynamic 3D Deuterium Metabolic Imaging of the Human Brain at 7T.","authors":"Sabina Frese, Bernhard Strasser, Lukas Hingerl, Elton Montrazi, Lucio Frydman, Stanislav Motyka, Viola Bader, Anna Duguid, Aaron Osburg, Martin Krssak, Rupert Lanzenberger, Thomas Scherer, Wolfgang Bogner, Fabian Niess","doi":"10.1097/RLI.0000000000001196","DOIUrl":"10.1097/RLI.0000000000001196","url":null,"abstract":"<p><strong>Objectives: </strong>Deuterium (2H) metabolic imaging (DMI) is an emerging magnetic resonance technique to non-invasively map human brain glucose (Glc) uptake and downstream metabolism following oral or intravenous administration of 2H-labeled Glc. The achievable spatial resolution is limited due to inherently low sensitivity of DMI. This hinders potential clinical translation. The purpose of this study was to improve the signal-to-noise ratio (SNR) of 3D DMI via a balanced steady-state free precession (bSSFP) acquisition scheme combined with fast non-Cartesian spatial-spectral sampling to enable high-resolution dynamic imaging of neural Glc uptake and glutamate+glutamine (Glx) synthesis of the human brain at 7T.</p><p><strong>Materials and methods: </strong>Six healthy volunteers (2 f/4 m) were scanned after oral administration of 0.8 g/kg [6,6']-2H-Glc using a novel density-weighted bSSFP acquisition scheme combined with fast 3D concentric ring trajectory (CRT) k-space sampling at 7T. Time-resolved whole brain DMI datasets were acquired for approximately 80 minutes (7 minutes per dataset) after oral 2H-labeled Glc administration with 0.75 mL and 0.36 mL isotropic spatial resolution and results were compared to conventional spoiled Free Induction Decay (FID) 2H-MRSI with CRT readout at matched nominal spatial resolution. Dynamic DMI measurements of the brain were accompanied by simultaneous systemic Glc measurements of the interstitial fluid using a continuous Glc monitoring (CGM) sensor (on the upper arm). The correlation between brain and interstitial Glc levels was analyzed using linear mixed models.</p><p><strong>Results: </strong>The bSSFP-CRT approach achieved SNRs that were up to 3-fold higher than conventional spoiled FID-CRT 2H-MRSI. This enabled a 2-fold higher spatial resolution. Seventy minutes after oral tracer uptake comparable 2H-Glc, 2H-Glx, and 2H-water concentrations were detected using both acquisition schemes at both, regular and high spatial resolutions (0.75 ml and 0.36 mL isotropic). The mean Areas Under the Curve (AUC) for interstitial fluid Glc measurements obtained using a CGM sensor was 509 ± 65 mM·min. This is 3.4 times higher than the mean AUC of brain Glc measurements of 149 ± 43 mM·min obtained via DMI. The linear mixed models fitted to assess the relationship between CGM measures and brain 2H-Glc yielded statistically significant slope estimates in both GM (β1 = 0.47, P = 0.01) and WM (β1 = 0.36, P = 0.03).</p><p><strong>Conclusions: </strong>In this study we successfully implemented a balanced steady-state free precession (bSSFP) acquisition scheme for dynamic whole-brain human DMI at 7T. A 3-fold SNR increase compared to conventional spoiled acquisition allowed us to double the spatial resolution achieved using conventional FID-CRT DMI. Systemic continuous glucose measurements, combined with dynamic DMI, demonstrate significant potential for clinical applications. This could help improve our understan","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010149","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":"Commercially Available Ultrasound Contrast Agents: Factors Contributing to Favorable Outcomes With Ultrasound-Mediated Drug Delivery and Ultrasound Localization Microscopy Imaging.","authors":"Joshua J Hawley, Sophie L Allen, David M Thompson, Adam J Schwarz, François J M Tranquart","doi":"10.1097/RLI.0000000000001197","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001197","url":null,"abstract":"<p><strong>Abstract: </strong>Ultrasound contrast agents (UCAs) are microbubbles comprising an inert gas core stabilized by an encapsulating shell, which serves to increase the signal-to-noise ratio of blood-to-tissue in diagnostic ultrasound imaging. More recently, research has investigated the use of UCAs to combine both diagnostics and therapeutic outcomes in an amalgamated approach, designated 'theranostics.' Two examples of theranostic based approaches include the use of super-resolution imaging with ultrasound localized microscopy (ULM) and ultrasound-mediated drug delivery (UMDD). Both ULM and UMDD have been shown to have the potential to improve both patient care and clinical outcomes. Currently, there are 4 commercially available global UCAs licensed for clinical use. The physico-chemical properties of each of these UCAs influence its potential theranostic efficacy. Because of differences in their composition and/or manufacturing processes, each UCA has different characteristics that contribute to different in vivo resonance behavior, which in turn influences their effective clinical applications. This review highlights the key physico-chemical characteristic differences of the 4 commercially available contrast agents, with specific emphasis on their gaseous core, shell composition, and microbubble volume distribution, while providing novel insights into their benefits for supporting emerging clinical technologies, specifically ULM and UMDD.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011525","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 Neuroimaging Over the Last Decade: Achievements and What Lies Ahead.","authors":"Shohei Fujita, Akifumi Hagiwara, Koji Kamagata, Shigeki Aoki","doi":"10.1097/RLI.0000000000001192","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001192","url":null,"abstract":"<p><strong>Abstract: </strong>The past decade has witnessed notable advancements in clinical neuroimaging facilitated by technological innovations and significant scientific discoveries. In conjunction with Investigative Radiology's 60th anniversary, this review examines key contributions from the past 10 years, emphasizing the journal's most accessed articles and their impact on clinical practice and research. Advances in imaging technologies, including photon-counting computed tomography, and innovations in low-field and high-field magnetic resonance imaging systems have expanded diagnostic capabilities. Progress in the development and translation of contrast media and rapid quantitative imaging techniques has further improved diagnostic accuracy. Additionally, the integration of advanced data analysis methods, particularly deep learning and medical informatics, has improved image interpretation and operational efficiency. Beyond technological developments, this review highlights basic neuroscience findings, such as the discovery and characterization of the glymphatic system. These insights have provided a deeper understanding of central nervous system physiology and pathology, bridging the gap between research and clinical applications. This review integrates these advancements to provide an overview of the progress and ongoing challenges in clinical neuroimaging, offering insights into its current state and potential future directions within the broader field of radiology.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002277","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 Computed Tomography-Based Hepatic iron Quantification Using a Tungsten-Based Contrast Agent.","authors":"Jonas Neumann, Johannes Haubold, Felix Jergas, Gregor Jost, Hubertus Pietsch, Bernhard Schmidt, Tristan Nowak, Joachim von Zanthier","doi":"10.1097/RLI.0000000000001189","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001189","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the potential of quantifying hepatic iron in computed tomography (CT) scans in the presence of iodine (I)- or tungsten (W)-based contrast media (CM).</p><p><strong>Materials and methods: </strong>Experimental work was performed on a commercial photon-counting CT system able to simultaneously acquire up to 4 spectral data sets in a single scan. We examined 2 anthropomorphic abdominal phantoms with material samples of liquid liver tissue surrogate, fat, iron, and I- or W-based CM to mimic different liver compositions in an enhanced CT scan. Iron was quantified by material decomposition of reconstructed spectral CT images.</p><p><strong>Results: </strong>Two-material decomposition based on 2 spectral data sets provided material images of iron and liver with an accuracy of 1.4 mg/mL in the iron image of CM-free samples. The presence of W affected the iron quantification: For 2 and 4 mgW/mL in the material samples, the iron concentration was overestimated (P < 0.05) with accuracies of 2.7 and 4.7 mg/mL, respectively. Three-material decomposition based on 4 spectral data sets provided material images of iron, liver, and W, with an accuracy of 1.4 mg/mL in the images without W and 1.5 (nonsignificant difference, P > 0.07) and 1.6 mg/mL (overestimation, P > 0.03) in the iron image at 2 and 4 mgW/mL, respectively. The presence of I affected the iron quantification more than W in both 2- and 3-material decomposition: For 2 and 4 mgI/mL in the material samples, the measured iron concentration was even higher (P < 0.05), with accuracies >18 and >37 mg/mL, respectively.</p><p><strong>Conclusions: </strong>The accuracy of iron quantification from a 3-material decomposition suggested clinically feasible detection and quantification of critical hepatic iron levels in enhanced CT scans with suitable CM. In a 2-material decomposition, severe pathology is required to detect an iron liver. W-based CM was superior to I-based CM.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015742","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":"Single-Energy, Dual-Energy, and Photon-Counting Computed Tomography of the Liver: Current Development and Clinical Utility for the Assessment of Focal Liver Lesions.","authors":"Shintaro Ichikawa, Keitaro Sofue, Yuko Nakamura, Toru Higaki, Hiroyuki Morisaka, Tomoko Hyodo, Takamichi Murakami, Kazuo Awai, Masahiro Jinzaki, Satoshi Goshima","doi":"10.1097/RLI.0000000000001187","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001187","url":null,"abstract":"<p><strong>Abstract: </strong>Advancements in computed tomography (CT) technology, particularly the emergence of dual-energy CT (DE-CT) and photon-counting detector CT (PCD-CT), can improve detection, characterization, and treatment monitoring of focal liver lesions. DE-CT, through its ability to differentiate tissues with similar densities and produce diverse datasets, has enhanced lesion visibility and diagnostic precision. PCD-CT further advances imaging with superior spatial resolution and material decomposition capabilities, offering potential for complex diagnostic scenarios. This review aimed to highlight the role of CT in hepatic imaging and its application to focal liver lesions.DE-CT improves lesion detectability using low-energy virtual monochromatic images, which enhance iodine contrast and reduce radiation and contrast agent doses. It also facilitates treatment response evaluation after locoregional therapies for hepatocellular carcinoma by quantifying biomarkers, such as the extracellular volume fraction. This review underscores the transformative impact of DE-CT and PCD-CT on liver imaging, emphasizing their complementary roles alongside magnetic resonance imaging. These innovations have paved the way for more precise diagnostics, improved treatment planning, and enhanced patient outcomes in the management of liver diseases.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035252","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":"Assessment of Emphysema on X-ray Equivalent Dose Photon-Counting Detector CT: Evaluation of Visual Scoring and Automated Quantification Algorithms.","authors":"Bjarne Kerber, Falko Ensle, Jonas Kroschke, Cecilia Strappa, Anna Rita Larici, Thomas Frauenfelder, Lisa Jungblut","doi":"10.1097/RLI.0000000000001128","DOIUrl":"10.1097/RLI.0000000000001128","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to evaluate the feasibility and efficacy of visual scoring, low-attenuation volume (LAV), and deep learning methods for estimating emphysema extent in x-ray dose photon-counting detector computed tomography (PCD-CT), aiming to explore future dose reduction potentials.</p><p><strong>Methods: </strong>One hundred one prospectively enrolled patients underwent noncontrast low- and chest x-ray dose CT scans in the same study using PCD-CT. Overall image quality, sharpness, and noise, as well as visual emphysema pattern (no, trace, mild, moderate, confluent, and advanced destructive emphysema; as defined by the Fleischner Society), were independently assessed by 2 experienced radiologists for low- and x-ray dose images, followed by an expert consensus read. In the second step, automated emphysema quantification was performed using an established LAV algorithm with a threshold of -950 HU and a commercially available deep learning model for automated emphysema quantification. Automated estimations of emphysema extent were converted and compared with visual scoring ratings.</p><p><strong>Results: </strong>X-ray dose scans exhibited a significantly lower computed tomography dose index than low-dose scans (low-dose: 0.66 ± 0.16 mGy, x-ray dose: 0.11 ± 0.03 mGy, P < 0.001). Interreader agreement between low- and x-ray dose for visual emphysema scoring was excellent (κ = 0.83). Visual emphysema scoring consensus showed good agreement between low-dose and x-ray dose scans (κ = 0.70), with significant and strong correlation (Spearman ρ = 0.79). Although trace emphysema was underestimated in x-ray dose scans, there was no significant difference in the detection of higher-grade (mild to advanced destructive) emphysema ( P = 0.125) between the 2 scan doses. Although predicted emphysema volumes on x-ray dose scans for the LAV method showed strong and the deep learning model excellent significant correlations with predictions on low-dose scans, both methods significantly overestimated emphysema volumes on lower quality scans ( P < 0.001), with the deep learning model being more robust. Further, deep learning emphysema severity estimations showed higher agreement (κ = 0.65) and correlation (Spearman ρ = 0.64) with visual scoring for low-dose scans than LAV predictions (κ = 0.48, Spearman ρ = 0.45).</p><p><strong>Conclusions: </strong>The severity of emphysema can be reliably estimated using visual scoring on CT scans performed with x-ray equivalent doses on a PCD-CT. A deep learning algorithm demonstrated good agreement and strong correlation with the visual scoring method on low-dose scans. However, both the deep learning and LAV algorithms overestimated emphysema extent on x-ray dose scans. Nonetheless, x-ray equivalent radiation dose scans may revolutionize the detection and monitoring of disease in chronic obstructive pulmonary disease patients.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"291-298"},"PeriodicalIF":7.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893695","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":"Recent Developments and Future Perspectives in Magnetic Resonance Imaging and Computed Tomography Contrast Media.","authors":"Thomas Frenzel, Thomas Wels, Hubertus Pietsch, Laura Schöckel, Peter Seidensticker, Jan Endrikat","doi":"10.1097/RLI.0000000000001180","DOIUrl":"https://doi.org/10.1097/RLI.0000000000001180","url":null,"abstract":"<p><strong>Abstract: </strong>This review provides a comprehensive analysis of recent advancements in computed tomography (CT) and magnetic resonance imaging (MRI) contrast media, offering a critical evaluation of current trends and exploring future directions in the field. New clinical developments within the last 5-8 years are considered as well as clinical efficacy and safety aspects.For CT, the general safety of low- and iso-osmolar iodinated contrast agents and their effect on renal and thyroid function are reviewed. Special attention is given to contrast-enhanced mammography and a short outlook to photon-counting CT is provided.For MRI, a brief update on general safety, nephrogenic systemic fibrosis and the presence of gadolinium in the brain is given. The 2 new high-relaxivity gadolinium-based contrast agents, gadopiclenol and gadoquatrane (in late-stage clinical development), are highlighted.The review also describes targeted gadolinium-based contrast agents, superparamagnetic iron oxide particles, and developments of manganese-based contrast agents. It also introduces the emerging field of glymphatic imaging.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752697","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":"A Quantitative Comparison Between Human and Artificial Intelligence in the Detection of Focal Cortical Dysplasia.","authors":"Lennart Walger, Tobias Bauer, David Kügler, Matthias H Schmitz, Fabiane Schuch, Christophe Arendt, Tobias Baumgartner, Johannes Birkenheier, Valeri Borger, Christoph Endler, Franziska Grau, Christian Immanuel, Markus Kölle, Patrick Kupczyk, Asadeh Lakghomi, Sarah Mackert, Elisabeth Neuhaus, Julia Nordsiek, Anna-Maria Odenthal, Karmele Olaciregui Dague, Laura Ostermann, Jan Pukropski, Attila Racz, Klaus von der Ropp, Frederic Carsten Schmeel, Felix Schrader, Aileen Sitter, Alexander Unruh-Pinheiro, Marilia Voigt, Martin Vychopen, Philip von Wedel, Randi von Wrede, Ulrike Attenberger, Hartmut Vatter, Alexandra Philipsen, Albert Becker, Martin Reuter, Elke Hattingen, Josemir W Sander, Alexander Radbruch, Rainer Surges, Theodor Rüber","doi":"10.1097/RLI.0000000000001125","DOIUrl":"10.1097/RLI.0000000000001125","url":null,"abstract":"<p><strong>Objectives: </strong>Artificial intelligence (AI) is thought to improve lesion detection. However, a lack of knowledge about human performance prevents a comparative evaluation of AI and an accurate assessment of its impact on clinical decision-making. The objective of this work is to quantitatively evaluate the ability of humans to detect focal cortical dysplasia (FCD), compare it to state-of-the-art AI, and determine how it may aid diagnostics.</p><p><strong>Materials and methods: </strong>We prospectively recorded the performance of readers in detecting FCDs using single points and 3-dimensional bounding boxes. We acquired predictions of 3 AI models for the same dataset and compared these to readers. Finally, we analyzed pairwise combinations of readers and models.</p><p><strong>Results: </strong>Twenty-eight readers, including 20 nonexpert and 5 expert physicians, reviewed 180 cases: 146 subjects with FCD (median age: 25, interquartile range: 18) and 34 healthy control subjects (median age: 43, interquartile range: 19). Nonexpert readers detected 47% (95% confidence interval [CI]: 46, 49) of FCDs, whereas experts detected 68% (95% CI: 65, 71). The 3 AI models detected 32%, 51%, and 72% of FCDs, respectively. The latter, however, also predicted more than 13 false-positive clusters per subject on average. Human performance was improved in the presence of a transmantle sign ( P < 0.001) and cortical thickening ( P < 0.001). In contrast, AI models were sensitive to abnormal gyration ( P < 0.01) or gray-white matter blurring ( P < 0.01). Compared with single experts, expert-expert pairs detected 13% (95% CI: 9, 18) more FCDs ( P < 0.001). All AI models increased expert detection rates by up to 19% (95% CI: 15, 24) ( P < 0.001). Nonexpert+AI pairs could still outperform single experts by up to 13% (95% CI: 10, 17).</p><p><strong>Conclusions: </strong>This study pioneers the comparative evaluation of humans and AI for FCD lesion detection. It shows that AI and human predictions differ, especially for certain MRI features of FCD, and, thus, how AI may complement the diagnostic workup.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"253-259"},"PeriodicalIF":7.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500556","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}