Investigative Radiology最新文献

{"title":"Multiparametric Cardiovascular MRI Assessment of Post-COVID Syndrome in Children in Comparison to Matched Healthy Individuals.","authors":"Jan Eckstein, Valentina Skeries, Gesa Pöhler, Nigar Babazade, Till Kaireit, Marcel Gutberlet, Norman Kornemann, Susanne Hellms, Alexander Pfeil, Andreas Michael Bucher, Georg Hansmann, Philipp Beerbaum, Gesine Hansen, Frank Wacker, Jens Vogel-Claussen, Martin Wetzke, Diane Miriam Renz","doi":"10.1097/RLI.0000000000001048","DOIUrl":"10.1097/RLI.0000000000001048","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID syndrome (PCS) can adversely affect the quality of life of patients and their families. In particular, the degree of cardiac impairment in children with PCS is unknown.</p><p><strong>Objective: </strong>The aim of this study was to identify potential cardiac inflammatory sequelae in children with PCS compared with healthy controls.</p><p><strong>Methods: </strong>This single-center, prospective, intraindividual, observational study assesses cardiac function, global and segment-based strains, and tissue characterization in 29 age- and sex-matched children with PCS and healthy children using a 3 T magnetic resonance imaging (MRI).</p><p><strong>Results: </strong>Cardiac MRI was carried out over 36.4 ± 24.9 weeks post-COVID infection. The study cohort has an average age of 14.0 ± 2.8 years, for which the majority of individuals experience from fatigue, concentration disorders, dyspnea, dizziness, and muscle ache. Children with PSC in contrast to the control group exhibited elevated heart rate (83.7 ± 18.1 beats per minute vs 75.2 ± 11.2 beats per minute, P = 0.019), increased indexed right ventricular end-diastolic volume (95.2 ± 19.2 mlm -2 vs 82.0 ± 21.5 mlm -2 , P = 0.018) and end-systolic volume (40.3 ± 7.9 mlm -2 vs 34.8 ± 6.2 mlm -2 , P = 0.005), and elevated basal and midventricular T1 and T2 relaxation times ( P < 0.001 to P = 0.013). Based on the updated Lake Louise Criteria, myocardial inflammation is present in 20 (69%) children with PCS. No statistically significant difference was observed for global strains.</p><p><strong>Conclusions: </strong>Cardiac MRI revealed altered right ventricular volumetrics and elevated T1 and T2 mapping values in children with PCS, suggestive for a diffuse myocardial inflammation, which may be useful for the diagnostic workup of PCS in children.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"472-478"},"PeriodicalIF":7.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795045","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":"BOA: A CT-Based Body and Organ Analysis for Radiologists at the Point of Care.","authors":"Johannes Haubold, Giulia Baldini, Vicky Parmar, Benedikt Michael Schaarschmidt, Sven Koitka, Lennard Kroll, Natalie van Landeghem, Lale Umutlu, Michael Forsting, Felix Nensa, René Hosch","doi":"10.1097/RLI.0000000000001040","DOIUrl":"10.1097/RLI.0000000000001040","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to develop the open-source body and organ analysis (BOA), a comprehensive computed tomography (CT) image segmentation algorithm with a focus on workflow integration.</p><p><strong>Methods: </strong>The BOA combines 2 segmentation algorithms: body composition analysis (BCA) and TotalSegmentator. The BCA was trained with the nnU-Net framework using a dataset including 300 CT examinations. The CTs were manually annotated with 11 semantic body regions: subcutaneous tissue, muscle, bone, abdominal cavity, thoracic cavity, glands, mediastinum, pericardium, breast implant, brain, and spinal cord. The models were trained using 5-fold cross-validation, and at inference time, an ensemble was used. Afterward, the segmentation efficiency was evaluated on a separate test set comprising 60 CT scans. In a postprocessing step, a tissue segmentation (muscle, subcutaneous adipose tissue, visceral adipose tissue, intermuscular adipose tissue, epicardial adipose tissue, and paracardial adipose tissue) is created by subclassifying the body regions. The BOA combines this algorithm and the open-source segmentation software TotalSegmentator to have an all-in-one comprehensive selection of segmentations. In addition, it integrates into clinical workflows as a DICOM node-triggered service using the open-source Orthanc research PACS (Picture Archiving and Communication System) server to make the automated segmentation algorithms available to clinicians. The BCA model's performance was evaluated using the Sørensen-Dice score. Finally, the segmentations from the 3 different tools (BCA, TotalSegmentator, and BOA) were compared by assessing the overall percentage of the segmented human body on a separate cohort of 150 whole-body CT scans.</p><p><strong>Results: </strong>The results showed that the BCA outperformed the previous publication, achieving a higher Sørensen-Dice score for the previously existing classes, including subcutaneous tissue (0.971 vs 0.962), muscle (0.959 vs 0.933), abdominal cavity (0.983 vs 0.973), thoracic cavity (0.982 vs 0.965), bone (0.961 vs 0.942), and an overall good segmentation efficiency for newly introduced classes: brain (0.985), breast implant (0.943), glands (0.766), mediastinum (0.880), pericardium (0.964), and spinal cord (0.896). All in all, it achieved a 0.935 average Sørensen-Dice score, which is comparable to the one of the TotalSegmentator (0.94). The TotalSegmentator had a mean voxel body coverage of 31% ± 6%, whereas BCA had a coverage of 75% ± 6% and BOA achieved 93% ± 2%.</p><p><strong>Conclusions: </strong>The open-source BOA merges different segmentation algorithms with a focus on workflow integration through DICOM node integration, offering a comprehensive body segmentation in CT images with a high coverage of the body volume.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"433-441"},"PeriodicalIF":7.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138295205","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":"Differentiating Macrovascular and Microvascular Ischemia Using Fractal Analysis of Dynamic Myocardial Perfusion Stress-CT.","authors":"Florian Michallek, Satoshi Nakamura, Tairo Kurita, Hideki Ota, Kensuke Nishimiya, Ryo Ogawa, Takehito Shizuka, Hitoshi Nakashima, Yi-Ning Wang, Tatsuro Ito, Hajime Sakuma, Marc Dewey, Kakuya Kitagawa","doi":"10.1097/RLI.0000000000001027","DOIUrl":"10.1097/RLI.0000000000001027","url":null,"abstract":"<p><strong>Objectives: </strong>Fractal analysis of dynamic myocardial stress computed tomography perfusion imaging (4D-CTP) has shown potential to noninvasively differentiate obstructive coronary artery disease (CAD) and coronary microvascular disease (CMD). This study validates fractal analysis of 4D-CTP in a multicenter setting and assesses its diagnostic accuracy in subgroups with ischemia and nonobstructed coronary arteries (INOCA) and with mild to moderate stenosis.</p><p><strong>Materials and methods: </strong>From the AMPLIFiED multicenter trial, patients with suspected or known chronic myocardial ischemia and an indication for invasive coronary angiography were included. Patients underwent dual-source CT angiography, 4D-CTP, and CT delayed-enhancement imaging. Coronary artery disease, CMD, and normal perfusion were defined by a combined reference standard comprising invasive coronary angiography with fractional flow reserve, and absolute or relative CT-derived myocardial blood flow. Nonobstructed coronary arteries were defined as ≤25% stenosis and mild to moderate stenosis as 26%-80%.</p><p><strong>Results: </strong>In 127 patients (27% female), fractal analysis accurately differentiated CAD (n = 61, 23% female), CMD (n = 23, 30% female), and normal perfusion (n = 34, 35% female) with a multiclass area under the receiver operating characteristic curve (AUC) of 0.92 and high agreement (multiclass κ = 0.89). In patients with ischemia (n = 84), fractal analysis detected CAD (n = 61) over CMD (n = 23) with sensitivity of 95%, specificity of 74%, accuracy of 89%, and AUC of 0.83. In patients with nonobstructed coronary arteries (n = 33), INOCA (n = 15) was detected with sensitivity of 100%, specificity of 78%, accuracy of 88%, and AUC of 0.94. In patients with mild to moderate stenosis (n = 27), fractal analysis detected CAD (n = 19) over CMD with sensitivity of 84%, specificity of 100%, accuracy of 89%, and AUC of 0.95.</p><p><strong>Conclusions: </strong>In this multicenter study, fractal analysis of 4D-CTP accurately differentiated CAD and CMD including subgroups with INOCA and with mild to moderate stenosis.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"413-423"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111479","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":"3D Acoustic Wave Sparsely Activated Localization Microscopy With Phase Change Contrast Agents.","authors":"Kai Riemer, Qingyuan Tan, Sophie Morse, Luca Bau, Matthieu Toulemonde, Jipeng Yan, Jingwen Zhu, Bingxue Wang, Laura Taylor, Marcelo Lerendegui, Qiang Wu, Eleanor Stride, Christopher Dunsby, Peter D Weinberg, Meng-Xing Tang","doi":"10.1097/RLI.0000000000001033","DOIUrl":"10.1097/RLI.0000000000001033","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to demonstrate 3-dimensional (3D) acoustic wave sparsely activated localization microscopy (AWSALM) of microvascular flow in vivo using phase change contrast agents (PCCAs).</p><p><strong>Materials and methods: </strong>Three-dimensional AWSALM using acoustically activable PCCAs was evaluated on a crossed tube microflow phantom, the kidney of New Zealand White rabbits, and the brain of C57BL/6J mice through intact skull. A mixture of C 3 F 8 and C 4 F 10 low-boiling-point fluorocarbon gas was used to generate PCCAs with an appropriate activation pressure. A multiplexed 8-MHz matrix array connected to a 256-channel ultrasound research platform was used for transmitting activation and imaging ultrasound pulses and recording echoes. The in vitro and in vivo echo data were subsequently beamformed and processed using a set of customized algorithms for generating 3D super-resolution ultrasound images through localizing and tracking activated contrast agents.</p><p><strong>Results: </strong>With 3D AWSALM, the acoustic activation of PCCAs can be controlled both spatially and temporally, enabling contrast on demand and capable of revealing 3D microvascular connectivity. The spatial resolution of the 3D AWSALM images measured using Fourier shell correlation is 64 μm, presenting a 9-time improvement compared with the point spread function and 1.5 times compared with half the wavelength. Compared with the microbubble-based approach, more signals were localized in the microvasculature at similar concentrations while retaining sparsity and longer tracks in larger vessels. Transcranial imaging was demonstrated as a proof of principle of PCCA activation in the mouse brain with 3D AWSALM.</p><p><strong>Conclusions: </strong>Three-dimensional AWSALM generates volumetric ultrasound super-resolution microvascular images in vivo with spatiotemporal selectivity and enhanced microvascular penetration.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"379-390"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235227","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 Efficacy of Gadobutrol: Review of Over 25 Years of Use Exceeding 100 Million Administrations.","authors":"Jan Endrikat, Matthias Gutberlet, Jörg Barkhausen, Laura Schöckel, Aasia Bhatti, Cornelia Harz, Karl-Titus Hoffmann","doi":"10.1097/RLI.0000000000001041","DOIUrl":"10.1097/RLI.0000000000001041","url":null,"abstract":"<p><strong>Background: </strong>Gadobutrol has been administered more than 100 million times worldwide, since February 1998, that is, over the last 25 years. Numerous clinical studies in a broad range of indications document the long-term experience with gadobutrol.</p><p><strong>Objective: </strong>The aim of this study was to provide a literature-based overview on gadobutrol's efficacy in 9 approved indications and use in children.</p><p><strong>Materials and methods: </strong>Efficacy results in patients of all age groups including sensitivity, specificity, accuracy, and positive/negative predictive values were identified by a systematic literature search on Embase until December 31, 2022. Nine approved indications were considered: central nervous system (CNS), magnetic resonance angiography (MRA), breast, heart, prostate, kidney, liver, musculoskeletal, whole body, and various indications in children.</p><p><strong>Results: </strong>Sixty-five publications (10 phase III, 2 phase IV, 53 investigator-initiated studies) reported diagnostic efficacy results obtained from 7806 patients including 271 children, at 369 centers worldwide. Indication-specific sensitivity ranges were 59%-98% (CNS), 53%-100% (MRA), 80%-100% (breast), 64%-90% (heart), 64%-96% (prostate), 71-85 (kidney), 79%-100% (liver), 53%-98% (musculoskeletal), and 78%-100% (children). Indication-specific specificity ranges were 75%-100% (CNS), 64%-99% (MRA), 58%-98% (breast), and 47%-100% (heart).</p><p><strong>Conclusions: </strong>The evaluated body of evidence, consisting of 65 studies with 7806 patients, including 271 children and 7535 adults, showed that gadobutrol is an efficacious magnetic resonance imaging contrast agent for all age groups in various approved indications throughout the whole body.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"345-358"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136397347","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":"Physics-Informed Discretization for Reproducible and Robust Radiomic Feature Extraction Using Quantitative MRI.","authors":"Walter Zhao, Zheyuan Hu, Anahita Fathi Kazerooni, Gregor Körzdörfer, Mathias Nittka, Christos Davatzikos, Satish E Viswanath, Xiaofeng Wang, Chaitra Badve, Dan Ma","doi":"10.1097/RLI.0000000000001026","DOIUrl":"10.1097/RLI.0000000000001026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Given the limited repeatability and reproducibility of radiomic features derived from weighted magnetic resonance imaging (MRI), there may be significant advantages to using radiomics in conjunction with quantitative MRI. This study introduces a novel physics-informed discretization (PID) method for reproducible radiomic feature extraction and evaluates its performance using quantitative MRI sequences including magnetic resonance fingerprinting (MRF) and apparent diffusion coefficient (ADC) mapping.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A multiscanner, scan-rescan dataset comprising whole-brain 3D quantitative (MRF T1, MRF T2, and ADC) and weighted MRI (T1w MPRAGE, T2w SPACE, and T2w FLAIR) from 5 healthy subjects was prospectively acquired. Subjects underwent 2 repeated acquisitions on 3 distinct 3 T scanners each, for a total of 6 scans per subject (30 total scans). First-order statistical (n = 23) and second-order texture (n = 74) radiomic features were extracted from 56 brain tissue regions of interest using the proposed PID method (for quantitative MRI) and conventional fixed bin number (FBN) discretization (for quantitative MRI and weighted MRI). Interscanner radiomic feature reproducibility was measured using the intraclass correlation coefficient (ICC), and the effect of image sequence (eg, MRF T1 vs T1w MPRAGE), as well as image discretization method (ie, PID vs FBN), on radiomic feature reproducibility was assessed using repeated measures analysis of variance. The robustness of PID and FBN discretization to segmentation error was evaluated by simulating segmentation differences in brainstem regions of interest. Radiomic features with ICCs greater than 0.75 following simulated segmentation were determined to be robust to segmentation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;First-order features demonstrated higher reproducibility in quantitative MRI than weighted MRI sequences, with 30% (n = 7/23) features being more reproducible in MRF T1 and MRF T2 than weighted MRI. Gray level co-occurrence matrix (GLCM) texture features extracted from MRF T1 and MRF T2 were significantly more reproducible using PID compared with FBN discretization; for all quantitative MRI sequences, PID yielded the highest number of texture features with excellent reproducibility (ICC &gt; 0.9). Comparing texture reproducibility of quantitative and weighted MRI, a greater proportion of MRF T1 (n = 225/370, 61%) and MRF T2 (n = 150/370, 41%) texture features had excellent reproducibility (ICC &gt; 0.9) compared with T1w MPRAGE (n = 148/370, 40%), ADC (n = 115/370, 32%), T2w SPACE (n = 98/370, 27%), and FLAIR (n = 102/370, 28%). Physics-informed discretization was also more robust than FBN discretization to segmentation error, as 46% (n = 103/222, 46%) of texture features extracted from quantitative MRI using PID were robust to simulated 6 mm segmentation shift compared with 19% (n = 42/222, 19%) of weighted MRI texture features extracted usin","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"359-371"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41142946","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":"Uptake of Gadolinium-Based Contrast Agents by Blood Cells During Contrast-Enhanced MRI Examination.","authors":"Nico Ruprecht, Dixy Parakkattel, Lukas Hofmann, Peter Broekmann, Nicola Lüdi, Christoph Kempf, Johannes Thomas Heverhagen, Hendrik von Tengg-Kobligk","doi":"10.1097/RLI.0000000000001029","DOIUrl":"10.1097/RLI.0000000000001029","url":null,"abstract":"<p><strong>Objectives: </strong>Gadolinium-based contrast agents (GBCAs) are routinely used in magnetic resonance imaging (MRI) examinations. However, there is limited knowledge about the interaction with and distribution of the drug in human cells. This lack of knowledge is surprising, given that the first interaction of the drug occurs with blood cells. Moreover, recent studies reported gadolinium (Gd) deposition within organs, such as the brain. Hence, this study is aiming to determine the uptake of GBCA in blood cells of patients undergoing contrast-enhanced MRI (ce-MRI) examination.</p><p><strong>Materials and methods: </strong>Human blood was exposed to either gadoterate meglumine (Gd-DOTA) or Eu-DOTA in vitro or was collected from patients undergoing ce-MRI with Gd-DOTA. Uptake of contrast agents (CAs) by blood cells was quantified by Gd measurements using single-cell inductively coupled plasma mass spectrometry (SC-ICP-MS) or, to confirm Gd-DOTA uptake, by a complementary method using Eu-DOTA by time-resolved fluorescence spectroscopy, respectively.</p><p><strong>Results: </strong>Uptake of Gd-DOTA or Eu-DOTA into white blood cells (WBCs) ex vivo was detectable by SC-ICP-MS and time-resolved fluorescence spectroscopy. The intracellular concentrations were estimated to be in the range of 1-3 μM. However, no CA uptake into erythrocytes was detected with either method. In total, 42 patients between 30 and 84 years old (24 men, 18 women) were enrolled. White blood cells' uptake of Gd was measured by SC-ICP-MS. Isolated WBCs from patients who underwent ce-MRI examination showed substantial Gd uptake; however, the studied patient group showed an inhomogeneous distribution of Gd uptake. Measurements immediately after MRI examination indicated 21-444 attogram/WBC, corresponding to an intracellular Gd concentration in the range from 0.2 to 5.5 μM.</p><p><strong>Conclusions: </strong>This study confirms the ex vivo uptake of GBCA by WBCs and provides the first evidence that GBCA is indeed taken up by WBCs in vivo by patients undergoing ce-MRI examination. However, the observed Gd uptake in WBCs does not follow a log-normal distribution commonly observed in the fields of environmental studies, biology, and medicine. Whether cellular uptake of GBCA is linked to the observed deposition of Gd remains unclear. Therefore, studying the interaction between GBCA and human cells may clarify crucial questions about the effects of Gd on patients after MRI examinations.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"372-378"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41201167","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":"Implementing Artificial Intelligence for Emergency Radiology Impacts Physicians' Knowledge and Perception: A Prospective Pre- and Post-Analysis.","authors":"Boj Friedrich Hoppe, Johannes Rueckel, Yevgeniy Dikhtyar, Maurice Heimer, Nicola Fink, Bastian Oliver Sabel, Jens Ricke, Jan Rudolph, Clemens C Cyran","doi":"10.1097/RLI.0000000000001034","DOIUrl":"10.1097/RLI.0000000000001034","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the impact of implementing an artificial intelligence (AI) solution for emergency radiology into clinical routine on physicians' perception and knowledge.</p><p><strong>Materials and methods: </strong>A prospective interventional survey was performed pre-implementation and 3 months post-implementation of an AI algorithm for fracture detection on radiographs in late 2022. Radiologists and traumatologists were asked about their knowledge and perception of AI on a 7-point Likert scale (-3, \"strongly disagree\"; +3, \"strongly agree\"). Self-generated identification codes allowed matching the same individuals pre-intervention and post-intervention, and using Wilcoxon signed rank test for paired data.</p><p><strong>Results: </strong>A total of 47/71 matched participants completed both surveys (66% follow-up rate) and were eligible for analysis (34 radiologists [72%], 13 traumatologists [28%], 15 women [32%]; mean age, 34.8 ± 7.8 years). Postintervention, there was an increase that AI \"reduced missed findings\" (1.28 [pre] vs 1.94 [post], P = 0.003) and made readers \"safer\" (1.21 vs 1.64, P = 0.048), but not \"faster\" (0.98 vs 1.21, P = 0.261). There was a rising disagreement that AI could \"replace the radiological report\" (-2.04 vs -2.34, P = 0.038), as well as an increase in self-reported knowledge about \"clinical AI,\" its \"chances,\" and its \"risks\" (0.40 vs 1.00, 1.21 vs 1.70, and 0.96 vs 1.34; all P 's ≤ 0.028). Radiologists used AI results more frequently than traumatologists ( P < 0.001) and rated benefits higher (all P 's ≤ 0.038), whereas senior physicians were less likely to use AI or endorse its benefits (negative correlation with age, -0.35 to 0.30; all P 's ≤ 0.046).</p><p><strong>Conclusions: </strong>Implementing AI for emergency radiology into clinical routine has an educative aspect and underlines the concept of AI as a \"second reader,\" to support and not replace physicians.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"404-412"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235228","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":"Novel Clinically Translatable Iron Oxide Nanoparticle for Monitoring Anti-CD47 Cancer Immunotherapy.","authors":"Raheleh Roudi, Laura Pisani, Fabrizio Pisani, Louise Kiru, Heike E Daldrup-Link","doi":"10.1097/RLI.0000000000001030","DOIUrl":"10.1097/RLI.0000000000001030","url":null,"abstract":"<p><strong>Objectives: </strong>A novel clinically translatable iron oxide nanoparticle (IOP) is currently being tested in phase 2 clinical trials as a magnetic resonance imaging (MRI) contrast agent for hepatocellular carcinoma diagnosis. The purpose of our study is to evaluate if this IOP can detect activation of tumor-associated macrophages (TAMs) due to CD47 mAb-targeted immunotherapy in 2 mouse models of osteosarcoma.</p><p><strong>Materials and methods: </strong>The toxicity, biodistribution, and pharmacokinetics of IOP were evaluated in 77 female and 77 male rats. Then, 24 female BALB/c mice with intratibial murine K7M2 tumors and 24 female NOD scid gamma mice with intratibial human 143B osteosarcoma xenografts were treated with either CD47 mAb (n = 12) or control antibody (n = 12). In each treatment group, 6 mice underwent MRI scans before and after intravenous infusion of either IOP or ferumoxytol (30 mg Fe/kg). Tumor T2* values and TAM markers F4/80, CD80, CD206, and Prussian blue staining were compared between different experimental groups using exact 2-sided Wilcoxon rank sum tests.</p><p><strong>Results: </strong>Biodistribution and safety evaluations of IOP were favorable for doses of less than 50 mg Fe/kg body weight in female and male rats. Both IOP and ferumoxytol caused negative enhancement (darkening) of the tumor tissue. Both murine and human osteosarcoma tumors treated with CD47 mAb demonstrated significantly shortened T2* relaxation times after infusion of IOP or ferumoxytol compared with controls (all P 's < 0.05). Higher levels of F4/80 + CD80 + were found in murine and human osteosarcomas treated with CD47 mAb compared with sham-treated controls (all P 's < 0.05). In addition, murine CD47 mAb-treated tumors after infusion of either IOP or ferumoxytol showed significantly higher numbers of Prussian blue-positive cells compared with controls ( P < 0.05). There was no significant difference of F4/80 + CD206 + cells among any of the groups (all P 's > 0.05).</p><p><strong>Conclusions: </strong>Iron oxide nanoparticle-enhanced MRI can be used to diagnose CD47 mAb-mediated TAM-activation in osteosarcomas.</p>","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":" ","pages":"391-403"},"PeriodicalIF":7.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144116","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":"Toward Precision Diagnosis: Machine Learning in Identifying Malignant Orbital Tumors With Multiparametric 3 T MRI.","authors":"Emma O'Shaughnessy, Lucile Senicourt, Natasha Mambour, Julien Savatovsky, Loïc Duron, Augustin Lecler","doi":"10.1097/rli.0000000000001076","DOIUrl":"https://doi.org/10.1097/rli.0000000000001076","url":null,"abstract":"Orbital tumors present a diagnostic challenge due to their varied locations and histopathological differences. Although recent advancements in imaging have improved diagnosis, classification remains a challenge. The integration of artificial intelligence in radiology and ophthalmology has demonstrated promising outcomes.","PeriodicalId":14486,"journal":{"name":"Investigative Radiology","volume":"2013 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140566364","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}