Journal of Computer Assisted Tomography最新文献

{"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":"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":"825-832"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","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":"Altered Interhemispheric Functional Connectivity in Patients With Diabetic Retinopathy: A Resting-State Functional MRI Study.","authors":"Weiqi Ji, Yaqi Song, Fei Liu, Yu Lu, Xiaoqiang Fei, Jinhua Chen, Hongxia Zhang, Jianguo Xia, Weizhong Tian","doi":"10.1097/RCT.0000000000001740","DOIUrl":"10.1097/RCT.0000000000001740","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment is a prevalent complication among patients with diabetes mellitus. It tends to be more prominent in patients with diabetic retinopathy (DR) compared with patients with diabetes without DR (NDR). However, the functional connectivity (FC) between bilateral cerebral hemispheres in both remains poorly understood. This study aimed to investigate altered brain connectivity in patients with DR and NDR.</p><p><strong>Subjects and methods: </strong>We selected 26 patients with DR, 30 patients with NDR, and 30 healthy controls (HCs) to participate in resting-state functional magnetic resonance imaging (rs-fMRI) and high-resolution T1-weighted structural scans. We employed the DPABI toolbox in MATLAB to preprocess the acquired images and applied voxel-mirrored homotopic connectivity (VMHC) and FC analysis methods to estimate differences among the 3 groups. The patients also underwent neuropsychological assessment scales. We utilized partial correlation analysis to explore the associations between aberrant connections and clinical variables as well as neuropsychological characteristics in patients with DR. Receiver operating characteristic (ROC) analysis was conducted to assess the diagnostic performance of VMHC values in distinct brain regions for differentiating DR patients from NDR patients.</p><p><strong>Results: </strong>The results showed significantly altered VMHC values across the 3 groups, including bilateral lingual gyrus (LING_B), superior temporal gyrus (STG_B), and postcentral gyrus (PoCG_B). Significant differences in FC values were found across the LING_B, right cuneus (CUN_R), STG_R, PoCG_B, right precentral gyrus (PreCG_R), right precuneus (PCUN_R), and middle temporal gyrus (MTG_L) among the 3 groups. Moreover, a negative correlation was noted between the VMHC values of LING_B and disease duration in patients with DR. Positive correlations were detected between FC values in PoCG_B and fasting blood glucose (FBG) levels. Furthermore, ROC analysis of the VMHC values demonstrated that combining all the differential regions achieved the highest area under the curve of 0.826.</p><p><strong>Conclusions: </strong>Significant alterations in VMHC and FC may reflect the underlying neuropathology of cognitive dysfunction in DR and NDR. These altered connectivity patterns could serve as neuroimaging biomarkers, offering insights into the early diagnosis and intervention of cognitive impairments in DR patients.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"800-807"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752967","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":"Association Between Sarcopenia Measurement in Pectoral Region and Immediate Complications Following Percutaneous Transthoracic Lung Biopsy.","authors":"Aşık Murat, Bilgi Zeynep, Güney Ramazan, Tekin Zeynep Nilüfer, Muhammed Furkan Tapan","doi":"10.1097/RCT.0000000000001735","DOIUrl":"10.1097/RCT.0000000000001735","url":null,"abstract":"<p><strong>Purpose: </strong>Measurement of the skeletal muscle area (SMA) at the T4 vertebra level on thoracic computed tomography (CT) has emerged as a novel marker for predicting sarcopenia. This study aimed to investigate the association between complications following percutaneous transthoracic lung biopsy and sarcopenia.</p><p><strong>Materials and methods: </strong>Patients who underwent CT-guided percutaneous transthoracic lung biopsy to make a definitive diagnosis of suspected lung cancer were included in this study. The factors that are effective in predicting pneumothorax and parenchymal hemorrhage, which are the most common complications that may occur after lung biopsy, were investigated. For this purpose, statistically evaluated the relationship between the incidence of pneumothorax and parenchymal hemorrhage postbiopsy and factors including age, sex, lesion localization, lesion size, procedure duration, depth of lesion, number of pleural insertions of the biopsy needle, method of biopsy (fine needle aspiration biopsy or core needle biopsy ), and sarcopenia. The effects of these factors on complications occurring after biopsy were evaluated by univariate and multivariate regression analysis.</p><p><strong>Results: </strong>Three hundred twenty patients (M/F: 226/94) were enrolled in this retrospective study conducted between January 2016 and August 2023. The average age of the patients included was 65.18±12.62 SD (range: 43 to 88 y). The most common complications after CT-guided biopsy were pneumothorax (n=58, 18.1%) and parenchymal hemorrhage (n=21, 6.6%). Statistically significant associations were found between the incidence of complications and factors such as lesion size, distance from the pleura, and the most important factor as thoracic skeletal muscle area.</p><p><strong>Conclusion: </strong>The findings suggest that sarcopenia, along with certain clinical and procedural factors, may play a role in the prediction of complications following transthoracic lung biopsy. Further research is warranted to elucidate these associations' mechanisms and optimize patient care strategies.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"769-776"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742225","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":"Cyclic Characteristics of Perfusion and Diffusion in Normal Uterus: A Mono-Exponential and Bi-Exponential DWI Evaluation.","authors":"Yajie Li, Yujia Shen, Yu Mao, Shiman Wu, Caixia Fu, Qing Li, Hanqiu Liu, Qi Zhang","doi":"10.1097/RCT.0000000000001800","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001800","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of intravoxel incoherent motion (IVIM) MRI for noninvasive assessment of uterine perfusion and diffusion characteristics across different phases of the menstrual cycle.</p><p><strong>Methods: </strong>This prospective study included 27 volunteers with regular menstrual cycles (28±7 d) from December 2020 to May 2023. A zoomed field-of-view single-shot spin-echo echo-planar imaging (SE-EPI) sequence was used to obtain multi-b DWI images. Mono-exponential DWI derived apparent diffusion coefficient (ADC) and IVIM-derived parameters including diffusion D, pseudo diffusion D* and perfusion fraction f in the uterine corpus and cervix were analyzed during the menstrual cycle. Statistics analysis was performed by 1-way analysis of variance (ANOVA).</p><p><strong>Results: </strong>A total of 21 healthy female participants (mean age: 26.64±4.72 y) were recruited for analysis. Both D and ADC values in each layer of the uterine corpus were lowest during the menstrual phase. However, there was no statistically significant difference in ADC of myometrium between the menstrual and ovulatory phases (P=0.177). The D values of the 3 layers of the uterine corpus gradually increase from the menstrual phase to the luteal phase, whereas the 3-zone structure of the cervix has the highest D value in the ovulatory phase. During the luteal phase, the D* and f values of the endometrium and cervical mucus layer were lower than those of the other 2 layers (P<0.05).</p><p><strong>Conclusions: </strong>IVIM MRI enables noninvasive quantification of uterine perfusion and diffusion dynamics and reveals characteristic variations in the uterine corpus and cervix throughout the menstrual cycle.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069786","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":"Four-dimensional Computed Tomography Imaging in Primary Hyperparathyroidism: Multireader Multicase Study of Both Neuroradiologists and General Radiologists of Imaging Approaches With Less Phases.","authors":"Jorian P Krol, Robin J A Duteweert, Laura N Deden, Marie Louise E Bernsen, Cornelis H Slump, Wim J G Oyen","doi":"10.1097/RCT.0000000000001794","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001794","url":null,"abstract":"<p><strong>Objective: </strong>Primary hyperparathyroidism (PHPT) is commonly caused by parathyroid adenomas (PAs), and four-dimensional computed tomography (4DCT) is increasingly used for localising PAs due to its high sensitivity and specificity. However, the relative high radiation dose of 4DCT may limit its widespread use as first line imaging in some settings. A reduced phase protocol and enhancement maps, which highlight relative enhancement differences between the nonenhanced and arterial phases, have been proposed as ways to reduce radiation exposure without compromising diagnostic accuracy. This study aims to assess whether reduced 4DCT protocols can maintain diagnostic performance and if the enhancement map can further assist in adenoma localisation.</p><p><strong>Methods: </strong>This retrospective study included 27 PHPT patients, with both single and double adenomas, and some ectopic cases and 3 secondary HPT patients. Five-phase combinations derived from our institution's 4-phase protocol were evaluated using a multireader, multicase approach involving experienced neuroradiologists and general radiologists. The phases tested included combinations of nonenhanced, arterial, venous, and delayed venous phases. An enhancement map was introduced as one of the phases. Readers were asked to identify adenomas and assign confidence levels. Performance metrics, including sensitivity, specificity, and area under the curve (AUC), were calculated, and noninferiority tests compared the results to the current 4-phase protocol.</p><p><strong>Results: </strong>Sensitivity of the total group was between 0.64 and 0.70 with a specificity between 0.94 and 0.97. AUC were between 0.80 and 0.84. All reduced phase combinations were noninferior to the 4-phase protocol. Neuroradiologists achieved noninferior results with 1-phase to 3-phase protocols, while general radiologists required at least 3-phases. The enhancement map did not improve sensitivity or specificity, although readers found it useful as a supplementary tool for identifying lesions. Artefacts, especially in ectopic locations, reduced its effectiveness.</p><p><strong>Conclusions: </strong>This study supports the use of reduced 4DCT protocols for PHPT. A 1-phase or 2-phase protocol is recommended for experienced radiologists, while a 3-phase protocol is suitable for less experienced radiologists.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955797","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":"Intraindividual Comparison of Photon-Counting Versus Energy-Integrating CT of the Ophthalmic Artery.","authors":"Haijia Mao, Haijuan Wu, Xuzhong Ying, Zhenhua Zhao, Jianfeng Yang, Lv Sangying","doi":"10.1097/RCT.0000000000001796","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001796","url":null,"abstract":"<p><strong>Purpose: </strong>To conduct an intraindividual comparative analysis of ophthalmic artery imaging quality between photon-counting detector CT (PCD-CT) and energy-integrating detector CT (EID-CT), evaluating both objective and subjective assessments.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed patients undergoing carotid artery imaging with both PCD-CT and EID-CT systems. Quantitative analysis involved objective measurements of vascular attenuation (Hounsfield units, HU), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) using standardized region-of-interest (ROI) placements. For qualitative assessment, 2 blinded radiologists independently evaluated subjective image quality through 5-point Likert scales.</p><p><strong>Results: </strong>The cohort [n=26; mean age 65.6±12.6 y; 16 males (61.5%)] demonstrated significantly enhanced performance with PCD-CT. Compared with EID-CT, SNR, CNR, and attenuation values from the PCD-CT system were all significantly higher than values from EID-CT (all P<0.05). Qualitative assessments revealed superior PCD-CT scores across all parameters (all P<0.0001).</p><p><strong>Conclusions: </strong>PCD-CT provides significant improvements in both objective and subjective measurements of ophthalmic artery imaging compared with EID-CT, suggesting its potential as the preferred modality for vascular visualization.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069710","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":"Effect of Contrast Prewarming on Vascular Enhancement at Cardiac CTA-An Observational Study.","authors":"Kieran D Paddock, Pamela Mager, Usama Jazzar, Muhammad Akram, Kihoon Bohle, Adnan Khan, James Zhang, Sejal Mistry-Patel, Jett Brady, John W Nance, Nakul Gupta","doi":"10.1097/RCT.0000000000001784","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001784","url":null,"abstract":"<p><strong>Objective: </strong>We hypothesize that contrast warming, which reduces the viscosity of iodinated contrast media, is associated with fewer pressure-limited injections and greater arterial enhancement in the left ventricle, aortic root, left coronary artery, and right coronary artery, which would reflect improved image quality.</p><p><strong>Methods: </strong>We conducted a retrospective review of cardiac CTA studies performed with iohexol 350 mg/mL solution either prewarmed to body temperature (37 °C, N=591) or at room temperature (24 °C, N=59). χ2 test was used to compare the rate of pressure-limited injections (pressure limit 325 psi) between prewarmed and nonwarmed studies. Hounsfield unit (HU) attenuation was measured from regions of interest in the left ventricle, aortic root, left coronary artery, and right coronary artery. The Mann-Whitney U test was used to compare enhancement between prewarmed and nonwarmed exams. Linear regression was used to further examine the enhancement between contrast groups.</p><p><strong>Results: </strong>Cardiac CTA studies using prewarmed contrast had a significantly lower rate of pressure-limited injections (22/591 vs. 42/59, χ21=275.1; P<0.001). Prewarmed contrast resulted in significantly greater enhancement on cardiac CTA in the left ventricle (488 vs. 400 HU; P<0.001), aortic root (494 vs. 400 HU; P<0.001), left coronary artery (467 vs. 387 HU; P<0.001), and right coronary artery (449 vs. 377 HU; P<0.001). With linear regression, prewarmed contrast use was associated with greater enhancement in the left ventricle (R2=0.220, F7, 602=24.211, P<0.001), aortic root (R2=0.228, F7, 602=25.467, P<0.001), left coronary artery (R2=0.216, F8, 587=20.274, P<0.001), and right coronary artery (R2=0.221, F8, 571=20.302, P<0.001).</p><p><strong>Conclusions: </strong>The results support our hypothesis that prewarming of iodinated contrast media to body temperature results in fewer pressure-limited injections and improved vascular enhancement.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069740","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":"Renal Lesion Assessment at Portal Venous Phase Photon Counting Computed Tomography: Iodine Concentration and Attenuation Analysis.","authors":"Samantha Platt, Bhavik Bansal, Barun Bagga, Bari Dane","doi":"10.1097/RCT.0000000000001797","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001797","url":null,"abstract":"<p><strong>Objective: </strong>To determine the optimal iodine concentration (IC) to differentiate enhancing from nonenhancing renal lesions at venous phase photon-counting CT (PCCT).</p><p><strong>Materials and methods: </strong>Sixty-seven patients [41 males, mean (SD) age: 68 (13) y] who underwent contrast-enhanced venous phase abdominal PCCT and contrast-enhanced MRI were retrospectively identified. MRI characterization of renal lesions as simple cysts, hemorrhagic/proteinaceous cysts or masses was the reference standard. Two radiologists, blinded to MRI characterization, independently drew region-of-interests (ROI) within each renal lesion and the aorta to determine IC, iodine concentration normalized to aortic enhancement (NIC), postcontrast and virtual noncontrast attenuation. These variables were compared using nonparametric tests, and intraclass correlation coefficient was assessed. ROC analysis for IC, NIC, and attenuation difference was performed using mean measurements.</p><p><strong>Results: </strong>Median (IQR) IC was 0.015 (0.00 to 0.20) mg/mL for cysts (n = 41) and 3.00 (1.59 to 4.10) mg/mL for masses (n = 26; P < 0.001). NIC was 2 (-1 to 4)% for cysts and 58 (33 to 81)% for masses (P < 0.001). For differentiating cysts from masses, 0.6 mg/mL IC had 100% sensitivity and 95% specificity [AUC = 1.00 (0.99, 1.00)] and 14.1%. NIC had 100% sensitivity and 98% specificity [AUC = 1.00 (0.99, 1.00)]. For differentiating cysts from enhancing masses, a 20 HU attenuation change from VNC to postcontrast images demonstrated a sensitivity of 96% and specificity of 95% [AUC = 1.00 (0.99, 1.00)]. IC was 0.13 (-0.11 to 0.20) mg/mL for hemorrhagic cysts (n = 16) and 1.63 (1.31 to 1.89) mg/mL for papillary neoplasms (n = 8; P < 0.001). NIC was 2 (-1 to 5)% and 32 (22 to 40)%, respectively (P < 0.001). For differentiating hemorrhagic cysts from papillary neoplasms, 0.53 mg/mL IC had 100% sensitivity and 88% specificity [AUC = 0.98 (0.93, 1.00)] and 14.1% NIC had 100% sensitivity and 94% specificity [AUC = 0.98 (0.95, 1.00)]. A 20 HU change had 88% sensitivity and specificity. For differentiating hemorrhagic cysts from papillary neoplasms, a 20 HU attenuation change had 88% sensitivity and 88% specificity [AUC = 0.98 (0.93, 1.00)].</p><p><strong>Conclusions: </strong>PCCT iodine concentration showed outstanding diagnostic performance to differentiate renal cysts from neoplasms. A 20 HU change in attenuation from VNC to postcontrast imaging on PCCT remains a reliable threshold for enhancing lesion, similar to conventional CT. Iodine concentration demonstrated superior sensitivity and specificity compared with 20 HU change when identifying renal cysts versus masses.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069564","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":"Response Assessment in Hepatocellular Carcinoma: A Primer for Radiologists.","authors":"Nayla Mroueh, Jinjin Cao, Shravya Srinivas Rao, Soumyadeep Ghosh, Ok Kyu Song, Sasiprang Kongboonvijit, Anuradha Shenoy-Bhangle, Avinash Kambadakone","doi":"10.1097/RCT.0000000000001789","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001789","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide, necessitating accurate and early diagnosis to guide therapy, along with assessment of treatment response. Response assessment criteria have evolved from traditional morphologic approaches, such as WHO criteria and Response Evaluation Criteria in Solid Tumors (RECIST), to more recent methods focused on evaluating viable tumor burden, including European Association for Study of Liver (EASL) criteria, modified RECIST (mRECIST) and Liver Imaging Reporting and Data System (LI-RADS) Treatment Response (LI-TR) algorithm. This shift reflects the complex and evolving landscape of HCC treatment in the context of emerging systemic and locoregional therapies. Each of these criteria have their own nuanced strengths and limitations in capturing the detailed characteristics of HCC treatment and response assessment. The emergence of functional imaging techniques, including dual-energy CT, perfusion imaging, and rising use of radiomics, are enhancing the capabilities of response assessment. Growth in the realm of artificial intelligence and machine learning models provides an opportunity to refine the precision of response assessment by facilitating analysis of complex imaging data patterns. This review article provides a comprehensive overview of existing criteria, discusses functional and emerging imaging techniques, and outlines future directions for advancing HCC tumor response assessment.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799249","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":"A Clinical and Imaging-based Model for Distinguishing Mild From Moderately Severe/Severe Hypertriglyceridemic Acute Pancreatitis: Development and Validation.","authors":"Yixiu Hao, Jiajun Feng, Wenjuan He, Yongshun Wu, Ying Ma, Honggang Xu","doi":"10.1097/RCT.0000000000001791","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001791","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemic acute pancreatitis (HTG-AP) is a distinct subtype of acute pancreatitis with a wide spectrum of clinical severity, ranging from mild to moderately severe or severe disease. Timely identification of patients at higher risk is essential for informing early clinical decisions and improving outcomes. However, reliable tools specifically designed to stratify HTG-AP severity remain limited.</p><p><strong>Objective: </strong>To develop and validate a predictive model for distinguishing mild from moderately severe/severe hypertriglyceridemic acute pancreatitis (HTG-AP) using routine clinical and imaging parameters.</p><p><strong>Methods: </strong>This retrospective study included 106 patients diagnosed with HTG-AP at Guangzhou First People's Hospital from January 2018 to April 2023. Patients were categorized into mild (HTG-MAP) and moderately severe/severe (HTG-MSAP/SAP) groups based on the revised Atlanta classification. Clinical data, laboratory results, and imaging findings, including peak C-reactive protein (CRP), serum calcium levels, and Modified CT Severity Index (MCTSI) scores, were analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of disease severity. Model performance was assessed through 10-fold cross-validation and bootstrap calibration.</p><p><strong>Results: </strong>Among the 106 patients (median age: 38 y; 82.1% male), 46 had HTG-MAP and 60 had HTG-MSAP/SAP. Multivariate analysis identified peak CRP (OR: 1.0082, P=0.011), serum calcium (OR: 0.05, P=0.014), and MCTSI score ≥6 (OR: 4.91, P=0.008) as independent predictors of severe disease. The final logistic regression model demonstrated excellent discrimination, with an AUC of 0.900 in the overall cohort and a mean cross-validated AUC of 0.87. Calibration was satisfactory (Hosmer-Lemeshow P=0.774), and overall diagnostic accuracy reached 84.91%.</p><p><strong>Conclusions: </strong>The proposed model, incorporating peak CRP, serum calcium, and MCTSI score, effectively distinguishes between HTG-MAP and HTG-MSAP/SAP. Compared with conventional scoring systems such as Bedside Index for Severity in Acute Pancreatitis (BISAP), it demonstrates superior specificity and overall diagnostic accuracy, providing clinicians with a practical tool for risk stratification and clinical decision-making in HTG-AP.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794543","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}