Journal of Computer Assisted Tomography最新文献

{"title":"Enhancing Coronary Revascularization Prediction: Insights From Fat Attenuation Index (FAI) of Pericoronary Adipose Tissue and CT-derived Fractional Flow Reserve (CT-FFR).","authors":"Jie Dong, Jinxin Yu, Yang Zhao, Yang Fengfeng","doi":"10.1097/RCT.0000000000001749","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001749","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the clinical value of the fat attenuation index (FAI) of pericoronary adipose tissue (PCAT) and fractional flow reserve derived from coronary computed tomography angiography (CT-FFR) in predicting coronary revascularization.</p><p><strong>Methods: </strong>Patients with known or suspected acute coronary syndrome (ACS) who underwent coronary computed tomography angiography (CCTA) and subsequent invasive coronary angiography (ICA) were screened. FAI, lesion-specific CT-FFR, and distal-tip CT-FFR were analyzed by core laboratories blinded to patient management. Per-vessel and per-patient logistic univariable and multivariable analyses were performed to predict revascularization. Three multivariable logistic regression models were compared, with ROC curves generated for each model and AUCs compared. Incremental predictive value between models 2 and 3 was also measured using continuous net reclassification improvement (NRI).</p><p><strong>Results: </strong>A total of 94 patients who received CCTA followed by ICA were identified and analyzed; 282 vessels were included. Overall, 54 (57.4%) patients with 72 (25.5%) vessels underwent revascularization. Lesion-specific CT-FFR, FAI, and significant stenosis were significantly associated with revascularization in both univariable and multivariable analyses. Lesion-specific CT-FFR, FAI, and significant stenosis were independent predictors of coronary revascularization. In the per-vessel analysis, those with 2 or 3 risk factors had a markedly higher revascularization rate [50 of 69 (72.5%) vs. 22 of 213 (10.3%); P < 0.001]. In the per-patient analysis, those with 2 or 3 risk factors had a markedly higher revascularization rate [35 of 42 (83.3%) vs. 19 of 52 (36.5%); P < 0.001]. The continuous net reclassification improvement (NRI) for the addition of FAI and CT-FFR to standard CCTA analysis (model 3 over model 2) was 0.273 (95% CI, 0.166-0.379, P < 0.0001).</p><p><strong>Conclusions: </strong>This study demonstrated the application value of CT-FFR and FAI in predicting coronary revascularization in patients with documented ACS. CT-FFR and FAI obtained from quantitative CCTA improved the prediction of future revascularization. These parameters can potentially identify patients likely to receive revascularization upon referral for cardiac catheterization. However, the clinical use of FAI may be limited by the lack of standardization in PCAT values and the absence of a clear established cutoff for clinical relevance.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585392","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":"Altered White Matter Microstructure and Cerebral Spontaneous Activity in Early Neurosyphilis Without Human Immunodeficiency Virus Infection.","authors":"Wen-Ting Ma, Sheng-Juan Yao, Yu Cao, Xiao-Di Zhang, Jun-Qi Chang, Yue Cheng, Xiao-Dong Zhang","doi":"10.1097/RCT.0000000000001743","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001743","url":null,"abstract":"<p><strong>Objective: </strong>To investigate white matter microstructure and spontaneous cerebral activity in early neurosyphilis using tract-based spatial statistics and amplitude of low-frequency fluctuation (ALFF).</p><p><strong>Methods: </strong>Twenty patients with early neurosyphilis and 20 matched healthy controls underwent diffusion tensor imaging and resting-state blood oxygen level-dependent imaging. Neuropsychological tests were performed before each magnetic resonance imaging. Fractional anisotropy (FA), mean diffusivity (MD), and ALFF values were compared between the 2 groups. Diffusion tensor imaging-derived metrics and ALFF values were correlated with the neuropsychiatric and laboratory indices.</p><p><strong>Results: </strong>Tract-based spatial statistics revealed decreased FA and increased MD values in early neurosyphilis, affecting regions such as the forceps minor, bilateral cingulum (hippocampus), left inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, corticospinal tract, right cingulum (cingulate gyrus), and anterior thalamic radiation. Decreased FA and increased MD values were observed in nonoverlapping fibers. Moreover, reduced ALFF values were observed in the left precuneus, superior frontal cortex, and right inferior parietal cortex in early neurosyphilis. In addition, the FA, MD, and ALFF values were significantly correlated with specific clinical data and questionnaires.</p><p><strong>Conclusion: </strong>Disrupted white matter microstructural integrity and spontaneous brain activity were observed in early neurosyphilis using advanced magnetic resonance imaging. Analysis of subtle cerebral structures and functions is potentially helpful for understanding the neural basis of neurosyphilis. Future longitudinal studies with larger sample sizes are warranted.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585247","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":"Benign, but Ominous, Pseudotumor in the Post-Sleeve Gastrectomy Hiatal Hernia: A Case Series.","authors":"Nikita Consul, Monica Cheng, Francis J Scholz","doi":"10.1097/RCT.0000000000001678","DOIUrl":"10.1097/RCT.0000000000001678","url":null,"abstract":"<p><strong>Abstract: </strong>We have incidentally observed a finding not yet described in the literature, on both cross-sectional imaging and fluoroscopy, to correlate with increased obstructive symptoms in our post sleeve gastrectomy patients. This case series aims to show postsurgical imaging cases with the common underlying finding of a pseudotumor associated with hiatal herniae and obstructive symptoms. Because this clinical presentation may, in some cases, warrant postsurgical revision, knowledge of the imaging findings and their potential clinical significance is useful to radiologists who interpret routine cross-sectional imaging examinations as well as fluoroscopic evaluations of these post sleeve gastrectomy patients.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 2","pages":"234-238"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663615","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":"Prostate Cancer Risk Prediction Model Using Clinical and Magnetic Resonance Imaging-Related Findings: Impact of Combining Lesions' Locations and Apparent Diffusion Coefficient Values.","authors":"Hirotsugu Nakai, Hiroaki Takahashi, Jordan D LeGout, Akira Kawashima, Adam T Froemming, Jason R Klug, Panagiotis Korfiatis, Derek J Lomas, Mitchell R Humphreys, Chandler Dora, Naoki Takahashi","doi":"10.1097/RCT.0000000000001679","DOIUrl":"10.1097/RCT.0000000000001679","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of the study are to develop a prostate cancer risk prediction model that combines clinical and magnetic resonance imaging (MRI)-related findings and to assess the impact of adding Prostate Imaging-Reporting and Data System (PI-RADS) ≥3 lesions-level findings on its diagnostic performance.</p><p><strong>Methods: </strong>This 3-center retrospective study included prostate MRI examinations performed with clinical suspicion of clinically significant prostate cancer (csPCa) between 2018 and 2022. Pathological diagnosis within 1 year after the MRI was used to diagnose csPCa. Seven clinical, 3 patient-level MRI-related, and 4 lesion-level MRI-related findings were extracted. After feature selection, 2 logistic regression models with and without lesions-level findings were created using data from facility I and II (development cohort). The area under the receiver operating characteristic curve (AUC) between the 2 models was compared in the PI-RADS ≥3 population in the development cohort and Facility III (validation cohort) using the Delong test. Interfacility differences of the selected predictive variables were evaluated using the Kruskal-Wallis test or chi-squared test.</p><p><strong>Results: </strong>Selected lesion-level features included the peripheral zone involvement and apparent diffusion coefficient (ADC) values. The model with lesions-level findings had significantly higher AUC than the model without in 655 examinations in the development cohort (0.81 vs 0.79, respectively, P  = 0.005), but not in 553 examinations in the validation cohort (0.77 vs 0.76, respectively). Large interfacility differences were seen in the ADC distribution ( P  < 0.001) and csPCa proportion in PI-RADS 3-5 ( P  < 0.001).</p><p><strong>Conclusions: </strong>Adding lesions-level findings improved the csPCa discrimination in the development but not the validation cohort. Interfacility differences impeded model generalization, including the distribution of reported ADC values and PI-RADS score-level csPCa proportion.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 2","pages":"247-257"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663620","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":"Beyond Do No Harm: Introduction to Green Radiology.","authors":"Elizabeth M Hecht, Daniel J A Margolis, Natasha E Wehrli, Brooke Cascella, Justine Pogorzelski, Elefterios Trikantzopoulos, Keith D Hentel","doi":"10.1097/RCT.0000000000001698","DOIUrl":"10.1097/RCT.0000000000001698","url":null,"abstract":"<p><strong>Abstract: </strong>In 2021, the Human Rights Council declared that having a clean, healthy, and sustainable environment is a human right. According to the WHO, 24% of deaths are attributable to environmental health risks and are largely preventable. Current predictions show that rising emissions will be linked to an enormous healthcare burden, especially for high-risk populations and historically disadvantaged communities. The US healthcare industry accounts for nearly 18% of its GDP and is a major consumer of resources. The largest healthcare-related source of greenhouse gas emissions is from the supply chain, including pharmaceuticals, other chemicals, food, and the transportation required to mobilize them accounting for 80% of emissions, with only 20% of emissions from purchased energy and the facilities directly. As a field, radiology has historically monitored its impact in terms of radiation exposure and thermal effects but has not focused on other pollutants, greenhouse gas emissions, or waste. Although tackling large issues such as climate change and pollution seems daunting, we can start by raising awareness through education, investigation, and advocacy. In this review, we discuss a systems-based approach to addressing climate change from the federal to the local level focusing on the potential role of the radiologist.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"169-179"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813373","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":"Imaging Features Differentiating Between Cardiac Sarcomas and Hematologic Neoplasms.","authors":"Aparna Singh, Mark M Hammer","doi":"10.1097/RCT.0000000000001672","DOIUrl":"10.1097/RCT.0000000000001672","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study is to assess the efficacy of computed tomography (CT) and positron emission tomography (PET)/CT findings in differentiating between cardiac sarcoma and cardiac hematologic neoplasms, which are rare but potentially lethal primary cardiac malignancies.</p><p><strong>Materials and methods: </strong>We searched the electronic medical record for pathology-proven cases from 2012 to 2023, finding 69 patients (46 sarcomas, 23 cardiac hematologic neoplasms). Imaging features including tumor size, atrioventricular (AV) groove involvement, right coronary artery (RCA) encasement by 180°, pericardial effusion, lymphadenopathy, and metabolic activity on fluorodeoxyglucose PET were reviewed by a radiology fellow. Statistical analysis was performed using Fisher exact test and Wilcoxon test.</p><p><strong>Results: </strong>Cardiac sarcoma patients were younger (median age 49 years) compared to patients with cardiac hematologic malignancies (66 years, P  = 0.006). While tumor size and chamber involvement were similar between the 2 categories, hematologic malignancies exhibited a notable predilection for AV groove involvement (70% vs 43%, P  = 0.04) and RCA encasement (52% vs 26%, P  = 0.02). Pulmonary metastases were more frequent in sarcoma cases (33% vs 4%, P  = 0.006). There was no significant difference in fluorodeoxyglucose uptake. Lymphadenopathy was similar between the 2 disease groups. A decision tree constructed using AV groove involvement and patient age achieved 75% accuracy in predicting the diagnosis of the mass.</p><p><strong>Conclusions: </strong>Overall, there is a substantial overlap in imaging features of cardiac sarcomas and hematologic malignancies involving the heart. Involvement of the AV groove and RCA encasement can allow a radiologist to favor hematologic malignancy. Ultimately, biopsy is required to establish a diagnosis.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"281-287"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390921","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":"Invited Commentary: The Academic Mission in Radiology: Is It Still a Viable Option?","authors":"Elliot K Fishman, Linda C Chu","doi":"10.1097/RCT.0000000000001714","DOIUrl":"10.1097/RCT.0000000000001714","url":null,"abstract":"","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"165-166"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949468","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":"Frequency and Distribution of Perinatal Arterial Ischemic Stroke in a Cohort of Patients With Cerebral Palsy Using Delayed MRI.","authors":"Mohammad Jalloul, Shyam Sunder B Venkatakrishna, Cesar Augusto P Alves, Jelena Curic, Savvas Andronikou","doi":"10.1097/RCT.0000000000001668","DOIUrl":"10.1097/RCT.0000000000001668","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the occurrence and MRI characteristics of perinatal arterial ischemic stroke (PAIS) in children with cerebral palsy (CP) and suspected term hypoxic-ischemic injury (HII).</p><p><strong>Methods: </strong>A retrospective review of brain MRI scans was conducted on children with CP and suspected term HII in South Africa.</p><p><strong>Results: </strong>Out of 1620 children with CP included in the study, 15 (0.9%) had PAIS. The most common site of infarct was the left middle cerebral artery. The majority of infarcts were unilateral, and 67% of cases exhibited cystic changes. Among children with PAIS, 47% exhibited concurrent HII, with the predominant patterns being basal-ganglia-thalamus (BGT) and watershed (WS). In cases of isolated PAIS (53%), network injuries were prevalent in 88% of children, most commonly involving the posterior limbs of the internal capsule, cerebral peduncles, thalami, and corpus callosum.</p><p><strong>Conclusions: </strong>The study highlights that PAIS is a relatively rare condition in children with CP, predominantly occurring in the left middle cerebral artery.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 2","pages":"327-331"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663616","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 the Energy Consumption of Magnetic Resonance Imaging and Computed Tomography Scanners: Integrating Ecodesign and Sustainable Operations.","authors":"Andrew M Hernandez, Anthony F Chen, Omkar Ghatpande, Reed A Omary, Sean Woolen, Youngkyoo Jung, Ghaneh Fananapazir","doi":"10.1097/RCT.0000000000001700","DOIUrl":"10.1097/RCT.0000000000001700","url":null,"abstract":"<p><strong>Abstract: </strong>This review aims to provide valuable insights into how energy consumption in magnetic resonance imaging (MRI) and computed tomography (CT) scanners can be effectively monitored, managed, and reduced, thereby contributing to more sustainable medical imaging practices. Demand for advanced imaging technologies such as MRI and CT scanners continues to increase, and understanding the resultant impact on greenhouse gas emissions requires a thorough evaluation of their energy consumption. This review examines the energy monitoring and consumption characteristics of MRI and CT scanners, highlighting potential approaches for energy savings. An overview of MRI and CT principles, hardware components, and their associated energy consumption is provided. After addressing the technical aspects, the hardware and software requirements essential for accurate energy metering are detailed. Baseline measurements of energy consumption data are then provided as a foundation to understand current usage patterns and identify areas for improvement. Ongoing efforts to reduce energy consumption are categorized into 3 main strategies: operations, scanner design enhancements, and active scanning techniques, including accelerated MRI protocols. Ultimately, we emphasize that achieving sustainability in medical imaging requires collaboration across disciplines. By incorporating eco-friendly design in new imaging equipment, we can reduce the environmental impact, promote sustainability, and set a health care industry standard for a healthier planet.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"191-202"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780224","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":"Musculoskeletal Computed Tomography: How to Add Value When Reporting Adult Lower Limb Trauma.","authors":"Yacer Asran, Thomas Mutungi, Kapil Shirodkar, Ganesh Hegde, Sameer Shamshuddin, Robin Proctor, Jawad Naqvi, David Knowles, Imran Ali","doi":"10.1097/RCT.0000000000001675","DOIUrl":"10.1097/RCT.0000000000001675","url":null,"abstract":"<p><strong>Abstract: </strong>Computed tomography plays an ever-increasing role in the management of fractures and dislocations due to its capability in efficiently providing multiplanar reformats and 3-dimensional volume rendered images. It can reveal findings that are occult on plain radiography and therefore allow for more accurate decision making with regard to fracture classification and management. Clinical radiologists play a critical role in facilitating the processing of imaging to provide adequate image reformats in the desired planes, producing 3 dimensional images but most crucially identifying pertinent findings, which will contribute between the selection of nonoperative and operative management and potentially influence surgical technique. In an earlier article we have outlined the key findings that the radiologist should search for in major upper limb fractures and dislocations. In this second article we focus on the pelvis, acetabulum, femur, tibia, ankle, and foot and through a case-based approach provide a succinct overview of radiological findings that can play an important role in determining patient management.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":"49 2","pages":"313-326"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663618","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}