Japanese Journal of Radiology最新文献

{"title":"Contrast-enhanced CT-based habitat radiomics for distinguishing low-risk thymomas from high-risk thymomas: a multicenter study.","authors":"Jian Kang, Xing Liu, Xuwen Yang, Yijia Xiong, Kai Sheng, Fan Xiao, Jingxuan Jiang","doi":"10.1007/s11604-025-01854-x","DOIUrl":"https://doi.org/10.1007/s11604-025-01854-x","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this research was to evaluate the effectiveness of contrast-enhanced computed tomography (CECT)-based habitat radiomics in differentiating low-risk thymomas from high-risk thymomas prior to surgery.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted involving patients with thymomas who had undergone CECT at three medical centers. The patients were divided into two cohorts: a training cohort comprising 134 patients from Centers A and B, and a validation cohort consisting of 41 patients from Center C. The k-means clustering algorithm was employed to segment the CECT images into distinct tumor habitats. Radiomic features were extracted from the entire tumor and the specific habitats identified. After feature selection, logistic regression (LR) model was developed to distinguish between low-risk and high-risk thymomas.</p><p><strong>Results: </strong>A total of 175 patients were enrolled in the study, with 106 diagnosed with low-risk thymomas and 69 with high-risk thymomas. In the validation cohort, the area under the receiver operating characteristic curve (AUC) values for the models derived from the whole tumor, habitat_1, habitat_2, and habitat_3 were 0.806 (95% CI 0.675-0.938), 0.946 (95% CI 0.861-1.000), 0.620 (95% CI 0.446-0.794), and 0.946 (95% CI 0.885-1.000), respectively. The habitats model demonstrated superior predictive performance compared to the whole tumor model.</p><p><strong>Conclusion: </strong>CECT-based habitat radiomics represents a promising diagnostic approach for distinguishing between low-risk and high-risk thymomas in the preoperative setting, highlighting its potential for enhanced diagnostic accuracy.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responce to comprehensive review of pulmonary embolism imaging: past, present and future innovations in computed tomography and other diagnostic techniques.","authors":"Kardos Marek","doi":"10.1007/s11604-025-01855-w","DOIUrl":"https://doi.org/10.1007/s11604-025-01855-w","url":null,"abstract":"","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing radiosensitivity of boron neutron capture therapy for liver cancer with homologous recombination repair inhibitor.","authors":"Zih-Yin Lai, Yu-Hsuan Huang, Ting-Yu Zhou, Chi-Ying Lee, Yu-Ming Shiao, Yi-Wei Chen, Fong-In Chou, Jen-Kun Chen, Yung-Jen Chuang","doi":"10.1007/s11604-025-01852-z","DOIUrl":"https://doi.org/10.1007/s11604-025-01852-z","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC), particularly in recurrent or treatment-refractory cases, often exhibits poor responsiveness to radiation therapy, increasing the risk of radiation-induced liver disease, necessitating innovative treatment approaches. Boric acid-mediated boron neutron capture therapy (BA-BNCT) has emerged as a promising approach for liver cancer. This study aims to improve BA-BNCT efficacy for radioresistant HCC by exploring sensitization agents, enhancing treatment while minimizing irradiation doses and side effects.</p><p><strong>Methods: </strong>We targeted the DNA homologous recombination repair (HRR) protein RAD51. Before neutron irradiation, a RAD51 inhibitor, B02, was administered to evaluate its sensitization effect on both HepG2 and the radioresistant HepG2R cells. We examined the cell death mechanism, focusing on the expression profile of LC3B after BA-BNCT, to investigate its impact on DNA repair responses, especially on autophagy and apoptosis.</p><p><strong>Results: </strong>We observed that inhibition of RAD51 led to increased γH2AX, the DNA double-strand break marker. Additionally, combining the RAD51 inhibitor B02 with BA-BNCT resulted in tumor cell arrest in the G₀/G₁ phase, indicating altered cell cycle regulation. In exploring cell death mechanisms, we observed increased autophagy following BNCT, potentially as a response to cellular stress induced by DNA damage in tumor cells. The combination of B02 and BA-BNCT significantly disrupted autophagic flux and promoted apoptosis in the tumor cells.</p><p><strong>Conclusions: </strong>Combining a RAD51 inhibitor with BA-BNCT significantly enhances the anti-tumor efficacy against radioresistant HCC and parental HCC cells. This proof-of-concept study suggests that the combination treatment can achieve comparable or superior therapeutic effects using lower radiation doses, thereby reinforcing the potential of BNCT for treating recurrent HCC.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a predictive model for healing of clinically relevant pancreatic fistulas post-pancreatoduodenectomy based on clinical and imaging nutritional status.","authors":"Yuan Xu, Bo Liu, Hong Liu, Rui Xu, Jiachen Sun, Yufeng Li, Tiezhu Ren, Jianli Liu, Hao Liu, Junlin Zhou","doi":"10.1007/s11604-025-01847-w","DOIUrl":"https://doi.org/10.1007/s11604-025-01847-w","url":null,"abstract":"<p><strong>Background: </strong>Clinically relevant pancreatic fistula (CR-PF) is a common complication following pancreaticoduodenectomy, and delayed healing (DH) of the fistula can lead to poor prognosis. We aimed to predict DH of CR-PF based on postoperative clinical and imaging-related inflammation and nutritional status in patients.</p><p><strong>Methods: </strong>We retrospectively collected data from 121 patients who developed grade B CR-PF following pancreaticoduodenectomy (PD) at two centers between 2018 and 2023. Patients were categorized into early and delayed healing groups based on the median healing time. Postoperative contrast-enhanced CT was used to measure pancreatic thickness (PT), main pancreatic duct diameter (DPD), and psoas muscle index (PMI). Logistic regression analysis was used to identify risk factors associated with delayed healing and to construct a predictive model. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Postoperative neutrophil-to-lymphocyte ratio, prognostic nutritional index, PMI, PT, and pancreatic texture (soft) were identified as independent risk factors for DH in patients with Grade B CR-PF. A comprehensive model was constructed based on these independent predictors. In the validation group, the model demonstrated an AUC of 0.840 (95% CI 0.711-0.969), and DCA and calibration curve indicated good predictive consistency and clinical utility.</p><p><strong>Conclusion: </strong>The model constructed based on dual-center data can accurately predict DH of Grade B CR-PF, providing reference value for clinicians in nutritional support and surgical interventions for CR-PF.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated evaluation of Nigrosome 1 sign, neuromelanin-sensitive MR and iron deposition.","authors":"Yasutaka Fushimi, Kiarash Ghassaban, Sean K Sethi, Satoshi Nakajima, Sachi Okuchi, Akihiko Sakata, Takayuki Yamamoto, Sayo Otani, Satoshi Ikeda, Yuta Terada, Atsushi Shima, Nobukatsu Sawamoto, Yuji Nakamoto","doi":"10.1007/s11604-025-01858-7","DOIUrl":"https://doi.org/10.1007/s11604-025-01858-7","url":null,"abstract":"<p><strong>Purpose: </strong>To differentiate between Parkinson's Disease (PD) and healthy controls by using integrated analysis of PD-specific MR findings including deformation of the substantia nigra pars compacta (SNpc), signal loss in neuromelanin (NM) sensitive MRI, and iron deposition in the deep gray matter (DGM) structures.</p><p><strong>Materials and methods: </strong>Patients with PD and healthy controls were recruited between August 2022 and December 2023. All subjects underwent 3 T MRI including a magnetization transfer contrast (MTC) and a double flip angle multi-echo protocol as part of Strategically Acquired Gradient Echo (STAGE). The data analysis included detecting the presence of Nigrosome-1 (N1) sign in the SNpc, signal intensity and volume of NM content and iron quantification through quantitative susceptibility mapping (QSM) in DGMs. The 3D regions of interest were manually demarcated on QSM maps. Mean susceptibility values from global analysis (whole structure) as well as regional high iron analysis (age-based threshold) were extracted for each individual structure. Univariate and multivariate analyses were performed using these parameters.</p><p><strong>Results: </strong>Nineteen patients with PD (68.0 ± 8.0 years, 10 males, Hoehn and Yahr scale 1 (n = 1), 2 (n = 13), 3 (n = 4), 4 (n = 1)) and 21 healthy controls (68.3 ± 8.6 years, 12 males) were enrolled. Discriminating PD from controls was successful using each method: N1 sign (P < 0.001), NM volume (P < 0.001), susceptibility values of global analysis (caudate, P < 0.001; putamen, P < 0.001; pulvinar, P = 0.006), regional analysis (putamen, P < 0.001; pulvinar, P = 0.009, thalamus, P = 0.008). Stepwise logistic regression analyses were performed, and the best model was created using N1 sign, NM volume, regional analysis (putamen, red nucleus and thalamus) (area under the curve of 0.99).</p><p><strong>Conclusions: </strong>Integrated analysis of PD specific MR findings including N1 sign, NM volume, and iron content in the DGM structures robustly discriminates between PD and healthy controls.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-tube-potential ultra-high-resolution coronary CTA with photon-counting detector CT for stent evaluation: a comparative feasibility study.","authors":"Suguru Araki, Satoshi Nakamura, Shiko Okabe, Masafumi Takafuji, Yasutaka Ichikawa, Hajime Sakuma, Kakuya Kitagawa","doi":"10.1007/s11604-025-01846-x","DOIUrl":"https://doi.org/10.1007/s11604-025-01846-x","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the feasibility of low-tube-potential ultra-high-resolution (UHR) coronary CT angiography (CCTA) using photon-counting detector CT (PCD-CT) in comparison to low-tube-potential CCTA using energy-integrating detector CT (EID-CT), with a specific focus on the evaluation of coronary stents.</p><p><strong>Materials and methods: </strong>This retrospective study included 54 patients (88 stents) who underwent CCTA in UHR mode on PCD-CT at low tube potential (PCD_UHR-low; 27 patients [45 stents]) or CCTA with EID-CT at low tube potential (EID-low; 27 patients [43 stents]). The EID-low cohort was selected by propensity score matching to the PCD_UHR-low cohort. Image quality of in-stent lumen was assessed using a 4-point Likert scale, with a score of 4 indicating \"excellent.\" Quantitative assessment of stents included stent-induced blooming, edge sharpness, stent full width at half maximum (FWHM) and ΔHU_in-stent which quantifies the increase in CT attenuation within the stent lumen. Radiation dose was evaluated using CT dose index volume (CTDIvol) and dose-length product (DLP).</p><p><strong>Results: </strong>PCD_UHR-low had higher image quality scores than EID-low (scores of 3 and 4, 82.2% vs. 53.5%; p = 0.02). PCD_UHR-low showed reduced stent-induced blooming, superior edge sharpness, smaller stent FWHM and smaller ΔHU_in-stent than EID-low (all, p < 0.01). CTDIvol and DLP in PCD_UHR-low (9.3 ± 4.4 mGy and 107.1 ± 50.4 mGy・cm) were comparable to those of EID-low (10.5 ± 5.9 mGy and 118.2 ± 74.9 mGy・cm), respectively. (p = 0.26 and 0.47).</p><p><strong>Conclusion: </strong>CCTA using UHR mode in PCD-CT at low tube potential achieved superior image quality for implanted stent visualization as compared to EID-CT at low tube potential, while maintaining comparable radiation doses.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing motion artifacts in the aorta: super-resolution deep learning reconstruction with motion reduction algorithm.","authors":"Koichiro Yasaka, Rin Tsujimoto, Rintaro Miyo, Osamu Abe","doi":"10.1007/s11604-025-01849-8","DOIUrl":"https://doi.org/10.1007/s11604-025-01849-8","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy of super-resolution deep learning reconstruction (SR-DLR) with motion reduction algorithm (SR-DLR-M) in mitigating aorta motion artifacts compared to SR-DLR and deep learning reconstruction with motion reduction algorithm (DLR-M).</p><p><strong>Materials and methods: </strong>This retrospective study included 86 patients (mean age, 65.0 ± 14.1 years; 53 males) who underwent contrast-enhanced CT including the chest region. CT images were reconstructed with SR-DLR-M, SR-DLR, and DLR-M. Circular or ovoid regions of interest were placed on the aorta, and the standard deviation of the CT attenuation was recorded as quantitative noise. From the CT attenuation profile along a line region of interest that intersected the left common carotid artery wall, edge rise slope and edge rise distance were calculated. Two readers assessed the images based on artifact, sharpness, noise, structure depiction, and diagnostic acceptability (for aortic dissection).</p><p><strong>Results: </strong>Quantitative noise was 7.4/5.4/8.3 Hounsfield unit (HU) in SR-DLR-M/SR-DLR/DLR-M. Significant differences were observed between SR-DLR-M vs. SR-DLR and DLR-M (p < 0.001). Edge rise slope and edge rise distance were 107.1/108.8/85.8 HU/mm and 1.6/1.5/2.0 mm, respectively, in SR-DLR-M/SR-DLR/DLR-M. Statistically significant differences were detected between SR-DLR-M vs. DLR-M (p ≤ 0.001 for both). Two readers scored artifacts in SR-DLR-M as significantly better than those in SR-DLR (p < 0.001). Scores for sharpness, noise, and structure depiction in SR-DLR-M were significantly better than those in DLR-M (p ≤ 0.005). Diagnostic acceptability in SR-DLR-M was significantly better than that in SR-DLR and DLR-M (p < 0.001).</p><p><strong>Conclusions: </strong>SR-DLR-M provided significantly better CT images in diagnosing aortic dissection compared to SR-DLR and DLR-M.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning barium enema preparation protocols to CT colonography in the modern imaging era.","authors":"Daisuke Tsurumaru, Yusuke Nishimuta, Katsuya Nanjo, Yutaro Shimomura, Kousei Ishigami","doi":"10.1007/s11604-025-01848-9","DOIUrl":"https://doi.org/10.1007/s11604-025-01848-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of applying a barium enema-style bowel preparation protocol to CT colonography (CTC) in clinical practice.</p><p><strong>Materials and methods: </strong>11 patients underwent CTC using a simplified bowel preparation protocol based on magnesium citrate, similar to that used for barium enema. Two radiologists assessed the homogeneity of fluid tagging, volume of residual fluid, and degree of colonic distension in six colonic segments (cecum, ascending, transverse, descending, sigmoid, rectum) in both supine and prone positions. Each parameter was rated on a 4-point Likert scale (0 = optimal, 3 = inadequate). The mean score and proportion of segments achieving a score of 0 were calculated.</p><p><strong>Results: </strong>More than 85% of segments received a score of 0 for tagging uniformity and colonic distension, and over 90% for residual fluid. Mean scores were below 0.3 for all three parameters. These findings indicate that the preparation protocol provided sufficient colonic cleansing and distension comparable to previously reported standard protocols.</p><p><strong>Conclusion: </strong>A simplified bowel preparation protocol adapted from barium enema practice can be effectively applied to CT colonography, achieving clinically acceptable image quality.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of perivascular adipose tissue attenuation using dual-layer spectral-detector CTA for identification of symptomatic carotid plaques.","authors":"Tong Chen, Jia Zhang, Sijia Li, Yuanbin Zhao, Xue Zhang, Xun Pei, Jiahui Lv, Yayuan Geng, Xiaomei Lu, Yinan Zhou, Xinyi Leng, Shengjun Sun, Xingquan Zhao, Binbin Sui","doi":"10.1007/s11604-025-01850-1","DOIUrl":"https://doi.org/10.1007/s11604-025-01850-1","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the attenuation of perivascular adipose tissue (PVAT) around carotid plaques on Dual-layer spectral-detector dual-energy computed tomography angiography (DLCTA) and explore its application values for the identification of symptomatic carotid plaques.</p><p><strong>Materials and methods: </strong>Patients with carotid plaques were enrolled and underwent DLCTA. The PVAT surrounding carotid plaques was outlined and the attenuation was measured on virtual monoenergetic images (40 keV and 70 keV) and polyenergetic imaging (PI). The PVAT attenuation was compared between symptomatic and asymptomatic plaques. The diagnostic performances of PVAT attenuation in differentiating symptomatic plaques were analyzed using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>A total of 73 patients (65.3 ± 7.9 years, 61 males) were included (symptomatic group, n = 29; asymptomatic group, n = 44). On monoenergetic 40 keV, 70 keV, and PI, PVAT attenuation was found significantly higher in the symptomatic plaques compared to the asymptomatic plaques (P < 0.001, P < 0.001, and P = 0.002 respectively). The area under the curves (AUCs) of PVAT_{40 keV}, PVAT_{70 keV}, and PVAT_PI for distinguishing the symptomatic plaques were 0.864, 0.750, and 0.714 respectively. With the cut-off value of - 86.2 HU, PVAT_{40 keV} showed the best diagnostic performance with a sensitivity of 89.7% and a specificity of 72.7%.</p><p><strong>Conclusions: </strong>DLCTA-derived PVAT attenuation might serve as a good imaging marker of symptomatic carotid plaques. Including PVAT attenuation on 40 keV images in clinical assessment, may help improve the abilities in the detection and identification of symptomatic carotid plaques.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary arterial morphological markers on non-contrast CT predicted acute exacerbations and disease progression in chronic obstructive pulmonary disease: a longitudinal cohort study.","authors":"Xiaohe Yu, Ziqi Xiong, Jingxue Cao, Fang Wang, Xiao Bao, Jingyun Shi","doi":"10.1007/s11604-025-01841-2","DOIUrl":"https://doi.org/10.1007/s11604-025-01841-2","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the predictive value of pulmonary artery quantitative CT (qCT) parameters for acute exacerbations of COPD (AECOPD) and explore their longitudinal changes in relation to pulmonary function decline.</p><p><strong>Materials and methods: </strong>This retrospective study included 507 COPD patients from XXX Hospital (2012-2024). Non-contrast CT images were analyzed using the FACT-Digital system to derive qCT parameters: arterial blood volume for vessels ≤ 5 mm² (BV5), total airway count (TAC), low attenuation area at -950 HU (LAA-950%), and total lung volume (TLV). ROC curves assessed predictive performance for AECOPD. Multivariable Cox regression evaluated associations between longitudinal qCT changes and outcomes (GOLD progression, FEV1 decline > 30/50 mL/year).</p><p><strong>Results: </strong>Four qCT parameters (TLV, LAA-950%, TAC, and arterial BV5) were used to build predictive models for AE within 1 year and frequent AE. For AE within 1 year prediction, CT model achieved an AUC of 0.817 (95% CI 0.762-0.872), integration with clinical parameters model improved AUC to 0.839 (95% CI 0.803-0.875). Arterial BV5 < 23.715 ml and TAC < 131 emerged as independent predictors. For frequent AE prediction, CT model showed an AUC of 0.767 (95% CI 0.704-0.830), integration with clinical parameters model improved AUC to 0.867 (95% CI 0.825-0.909). Arterial BV5 < 18 ml and TAC < 135 were identified as independent predictors. Arterial BV5 decline was identified as a marginal independent risk factor for GOLD stage progression (P = 0.051, HR = 2.286, 95% CI 0.995-5.252), FEV1 decline > 30 mL/year (P = 0.008, HR = 2.256, 95% CI 1.237-4.115) and FEV1 decline > 50 mL/year (P = 0.001, HR = 2.943, 95% CI 1.525-5.680).</p><p><strong>Conclusions: </strong>The study demonstrated that reduced small pulmonary arterial volume (BV5) is an independent risk factor for AECOPD and disease progression. Furthermore, during follow-up, decline in small pulmonary arterial volume independently predicted progression of GOLD stages and accelerated decline in lung function.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}