Journal of Computer Assisted Tomography最新文献

{"title":"Diagnostic Value of HRCT and Non-EPI DWI-MRI in Middle Ear Cholesteatoma: Accuracy and Preoperative Impact.","authors":"Xu Huimin, Gao Gang, Lu Xinhong, Hu Songqun, Jin Jiaxin, Wang Yaojun","doi":"10.1097/RCT.0000000000001854","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001854","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic performance of high-resolution computed tomography (HRCT) and non-echo-planar diffusion-weighted magnetic resonance imaging (non-EPI DWI-MRI) for middle ear cholesteatoma and to assess the added value of their combined use in preoperative evaluation.</p><p><strong>Methods: </strong>Imaging data sets from 85 subjects (65 with surgically or histopathologically confirmed cholesteatoma, 20 controls) were retrospectively analyzed. HRCT, non-EPI DWI-MRI, and combined HRCT+DWI-MRI interpretations were compared against reference standards. Diagnostic metrics included sensitivity, specificity, accuracy, localization error, and interobserver agreement (κ).</p><p><strong>Results: </strong>HRCT demonstrated high sensitivity (95.4%) for detecting bony erosions and ossicular abnormalities, whereas non-EPI DWI-MRI showed greater specificity (85.0%) in distinguishing cholesteatoma from other soft tissues. The combined approach yielded optimal diagnostic performance (sensitivity 93.8%, specificity 92.0%, accuracy 93.2%) and the lowest localization error (mean 1.8 mm). Interobserver agreement was excellent (κ=0.88).</p><p><strong>Conclusion: </strong>High-resolution computed tomography and non-echo-planar diffusion-weighted MRI provide complementary diagnostic information in the evaluation of middle ear cholesteatoma. Their combined interpretation may improve diagnostic confidence and radiologic assessment of lesion extent; however, the direct impact on surgical outcomes requires further prospective validation.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678462","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":"Prevalence and Imaging Characteristics of Chronic Calcific Pancreatitis in Patients With Newly Diagnosed Pancreatic Ductal Adenocarcinoma.","authors":"Rubab F Malik, Zahra Yousefli, Mahya Faghih, Hana Tujjar, Merve Gurakar, Jin He, Richard Burkhart, Khadija Sami, Thomas McPhaul, Javad R Azadi, Satomi Kawamoto, Venkata S Akshintala, Elham Afghani, Vikesh K Singh, Atif Zaheer","doi":"10.1097/RCT.0000000000001916","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001916","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pancreatitis (CP) is a risk factor for pancreatic ductal adenocarcinoma (PDAC), with a cumulative risk of ~4% over 20 years. Most prior studies have evaluated the risk of PDAC among patients with CP. The frequency and imaging characteristics of chronic calcific pancreatitis (CCP) in patients presenting with PDAC are unknown.</p><p><strong>Methods: </strong>A retrospective review of the clinical history and staging computed tomography (CT) scans of patients diagnosed with resectable or borderline resectable/locally advanced PDAC between 2011 and 2022 was conducted. CCP and ductal dilatation were defined by the presence of pancreatic calcifications and a maximal pancreatic ductal diameter >5 mm on CT, respectively. Two independent radiologists reviewed all imaging studies, and discrepancies were adjudicated by a third radiologist.</p><p><strong>Results: </strong>Among 1008 patients with PDAC, CCP was found in 34 (3.4%), with a mean age of 69.9±8 years, 50% men, 91% White, and 59% with a history of smoking, with 26.95±18.5 pack-years. Only 7 (21%) patients had a documented history of chronic abdominal pain before PDAC diagnosis. The presence of ductal dilation, pseudocysts, or pancreatic atrophy was observed in nearly 40%, 10%, and 40% of patients, respectively, and 7 (21%) showed none of these features. Ductal dilation was associated with higher levels of CA 19-9 (349.8 U/mL [IQR; 238.3, 455.0] vs. 90.0 U/mL [IQR; 58.3, 162.2], P=0.003). Intratumoral and extratumoral-only calcifications were found in 14 (41%) and 20 (59%) patients, respectively. Extratumoral-only calcifications were associated with pancreatic atrophy (P=0.02). Radiologist inter-rater agreement was highest for tumor location, calcification location, maximal size, and number, and side branch dilatation, and was lowest for the percentage of pancreas with abnormal findings and PD contour.</p><p><strong>Conclusion: </strong>CCP is found in 3% of patients presenting with PDAC, and most have primary painless disease. Further studies are required to determine optimal PDAC screening strategies and surveillance in patients found to have primary painless CCP.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678454","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 to Distinguish Intralobar Versus Extralobar Bronchopulmonary Sequestration.","authors":"Kenneth O'Riordan, Mark M Hammer","doi":"10.1097/RCT.0000000000001917","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001917","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the CT characteristics of bronchopulmonary sequestration (BPS) and determine the imaging features in predicted hybrid lesions and sequestration subtypes (intralobar vs. extralobar sequestration).</p><p><strong>Materials and methods: </strong>This was a multicenter retrospective study in which all surgical pathology specimens of lung sequestration performed in a tertiary hospital system were reviewed from January 2008 to January 2026. In total, 52 pathologic samples of lung sequestrations were analyzed and compared with preoperative imaging features. Imaging features including anatomic and vascular anatomy, parenchymal changes and relationship to the pleural were noted. BPS with coexistingcongenital pulmonary airway malformation, also called a hybrid lesion, on pathology was correlated with imaging findings.</p><p><strong>Results: </strong>Venous drainage patterns differed significantly between the intralobar sequestration (ILS) and extralobar sequestration (ELS) groups, with 11% of the ILS group draining to the systemic venous system versus 57% of the ELS group (P=0.013). In addition, 98% of ILS were inseparable from the surrounding lung, whereas 57% were separate from the normal lung (P<0.001). Cystic changes were common; 7/12 cases of hybrid lesions had cystic abnormalities on CT, whereas 17 out of the 40 cases without pathologic evidence of hybrid lesions had cystic changes on CT.</p><p><strong>Conclusion: </strong>Distinguishing intralobar from extralobar sequestration is imperfect based on venous drainage and separability from the normal lung parenchyma. Our data also showed a discrepancy between cystic abnormalities on CT and pathologically proven hybrid lesions, with a higher proportion of sequestrations with cystic changes on CT than were reported on pathologic analysis. Thus, hybrid lesions may be underdiagnosed on pathologic analysis.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620419","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":"Complementary Role of Whole-Body MRI and CT in Hematologic Malignancies and Bone Marrow Disorders.","authors":"Elena Ghotbi, Matthew Frick, Joselle Cook, Francis Baffour","doi":"10.1097/RCT.0000000000001918","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001918","url":null,"abstract":"<p><p>Whole-body cross-sectional imaging has largely replaced skeletal survey as the standard for evaluating hematologic malignancies and bone marrow disorders, but the practical choice between whole-body low-dose CT (WBCT) and whole-body MRI (WBMRI) remains incompletely resolved. This clinical review provides a practical, scenario-based comparison of WBCT and WBMRI across diagnosis, staging, treatment response, and surveillance. We emphasize real-world practical considerations, including scanner access, expertise, patient tolerance, radiation considerations, and cost. In multiple myeloma, with available comparative evidence, we include a focused research synthesis of 3 studies (152 patients) demonstrating high pooled CT-MRI concordance of 0.895 (95% CI: 0.834-0.935) with no detectable heterogeneity (I2=0%), supporting either modality as a reasonable first-line depending on the clinical question. Across all included disease categories, the broader pooled concordance estimate was 0.797 (95% CI: 0.667-0.885) with substantial heterogeneity reflecting variability in clinical context, reference standard, and protocol. WBMRI dominates in non-neoplastic marrow disorders where marrow characterization is essential. In lymphoma, FDG-PET/CT remains the standard for adult disease, with WBMRI most indicated in pediatrics and adolescents. Emerging CT techniques, including dual-energy CT with virtual noncalcium images and photon-counting detector CT, are extending CT into the marrow imaging space and narrowing the historical gap with MRI. Modality selection should be guided by the specific clinical scenario, available resources, and patient factors rather than by global judgments of modality superiority.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549344","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":"Effects of Antiangiogenic Agents on CT Perfusion Parameters in Liver Metastases From Renal Cell Carcinoma and Normal Liver.","authors":"Chaan S Ng, Yanwen Chen, Adam G Chandler, Nizar M Tannir","doi":"10.1097/RCT.0000000000001911","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001911","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of targeted antiangiogenic agents on CT perfusion parameter values in liver metastases from renal cell carcinoma (mRCC) and on normal liver, before and after initiation of therapy.</p><p><strong>Methods: </strong>CT perfusion parameter values of liver metastases from RCC and adjacent normal liver were evaluated before and after 8 weeks of bevacizumab and pazopanib. Perfusion parameters blood flow (BF), blood volume (BV), mean transit time (MTT), permeability surface area product (PS), portal venous perfusion (PVP), hepatic arterial perfusion (HAP), and hepatic arterial fraction (HAF) were derived from General Electric CT Perfusion (4D) software. Differences between tissues at baseline and percent changes (Δ) in perfusion values after therapy were evaluated by the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>There were 9 patients in the study (6 bevacizumab, 3 pazopanib). BF, HAP, and HAF were significantly higher, and MTT significantly lower, in untreated metastases than normal liver (all P<0.02); and PS was borderline significantly higher (P=0.058). For the liver metastases 8 weeks after therapy, there were significant reductions in ΔBF, ΔBV, ΔHAP and ΔHAF compared with baseline: -27.4% (P=0.05), -54.9% (P=0.008), -80.6% (P=0.004), and -46.6% (P=0.019), respectively. No significant changes after 8 weeks of therapy were observed in normal liver for any of the 7 perfusion parameters.</p><p><strong>Conclusion: </strong>This small preliminary data set suggests that targeted antiangiogenic agents might have significant effects on tumor perfusion, which can be detected by CT perfusion just 8 weeks after initiation of therapy. The agents have differential effects on tumor and normal liver. CT perfusion may assist in monitoring therapies and offer insights into pathophysiological aspects of tumors.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548878","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":"Prognostic Value of Anatomic and Hemodynamic Analysis Based on Coronary Computed Tomography Angiography in Type 2 Diabetes Mellitus Patients With Stable Coronary Artery Disease.","authors":"Xinying Fu, Kaiyue Zhi, Yan Deng, Xiangling Lin, Xinxin Yu, Shuo Zhang, He Zhu, Pei Nie","doi":"10.1097/RCT.0000000000001915","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001915","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the additional prognostic value of anatomic and hemodynamic parameters derived from coronary computed tomography angiography (CCTA) over clinical characteristics in type 2 diabetes mellitus (T2DM) patients with stable coronary artery disease (CAD).</p><p><strong>Materials and methods: </strong>A multicenter cohort of 798 T2DM patients with stable CAD (training/test cohort: 478/320) was retrospectively included. The endpoints were major adverse cardiovascular events (MACE). Univariate and multivariate Cox regression analyses were used to identify independent clinical and CCTA-derived predictors. These independent predictors were subsequently used to construct the clinical model and the imaging model, respectively. The Coronary Artery Disease-Reporting and Data System (CAD-RADS) was used in combination with significant clinical and CCTA features to establish the combined model. The performance of the 3 models was evaluated with concordance index (C-index) and time-dependent area under the curve (time-AUC). Net reclassification improvement (NRI) was used to assess the additional prognostic value of CCTA parameters.</p><p><strong>Results: </strong>In the test cohort, the clinical model, which incorporated previous myocardial infarction (prior MI) and hyperlipidemia, achieved a C-index of 0.631 (95% CI, 0.503-0.760). The imaging model constructed by the change in CT-derived fractional flow reserve (ΔCT-FFR) achieved a C-index of 0.744 (95% CI, 0.623-0.866). The combined model obtained the highest C-index of 0.755 (95% CI, 0.562-0.849). Compared with the clinical model, the combined model demonstrated superior diagnostic performance (P = 0.014; P = 0.042) in the test cohort, achieving time-AUC values of 0.683 and 0.637 for 1-year and 5-year MACE, respectively.</p><p><strong>Conclusions: </strong>The combined model based on prior MI, hyperlipidemia, ∆CT-FFR and CAD-RADS can effectively predict the risk of MACE in T2DM patients with stable CAD. CCTA-based anatomic and hemodynamic parameters have additional value in predicting MACE compared with clinical characteristics.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549197","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":"Validation of Feature-Tracking Cardiac CT for Left Ventricular Strain Assessment in Pediatric Acute Myocarditis: Comparison With Cardiac MRI.","authors":"Lixin Yang, Yongli Cao, Yun Peng","doi":"10.1097/RCT.0000000000001898","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001898","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to validate feature-tracking cardiac CT (FT-CCT) for left ventricular (LV) strain assessment against cardiac MRI (CMR) in pediatric acute myocarditis, evaluating its potential as a pragmatic solution when CMR is delayed after a clinically indicated coronary CT angiography (CCTA).</p><p><strong>Materials and methods: </strong>Forty-five children with acute myocarditis underwent CCTA and CMR. Global longitudinal (GLS), circumferential (GCS), and radial strain were measured. Intermodality agreement (Bland-Altman, ICC), diagnostic performance for detecting late gadolinium enhancement (LGE) (ROC analysis, DeLong test), and heart rate influence were assessed.</p><p><strong>Results: </strong>FT-CCT showed excellent agreement with CMR for LV ejection fraction (bias: -0.1%) and strain (ICCs: 0.750-0.854), independent of heart rate. For detecting LGE, CCTA-derived GCS and GLS demonstrated diagnostic performance equivalent to CMR (AUCs: 0.716 vs. 0.718, P=0.974; 0.705 vs. 0.703, P=0.972). CCTA-derived GLS provided high specificity (93.1%) and PPV (77.8%), serving as a robust \"rule-in\" tool. Measurements were highly reproducible (ICCs: 0.746-0.809).</p><p><strong>Conclusion: </strong>FT-CCT applied to clinically indicated CCTA provides a heart rate-robust, reproducible alternative to CMR for LV strain assessment in pediatric myocarditis. Its high specificity and diagnostic equivalence support its role as a complementary tool for initial myocardial injury detection and risk stratification when CMR is not immediately available.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549203","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":"Editors' Recognition of Reviewers' Service and Awards for Distinction for Reviewing in 2025.","authors":"","doi":"10.1097/RCT.0000000000001914","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001914","url":null,"abstract":"","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706812","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":"Objective Assessment of a Step Artifact Correction Algorithm in Sequential Coronary CT Angiography on Dual-Layer CT.","authors":"Lennart R Koetzier, Philip M Tetteroo, Eran Langzam, Dominika Suchá, Niels R van der Werf, Birgitta K Velthuis","doi":"10.1097/RCT.0000000000001912","DOIUrl":"10.1097/RCT.0000000000001912","url":null,"abstract":"<p><p>Prospectively ECG-triggered sequential coronary CT angiography (CCTA) is prone to step artifacts between cardiac segments imaged during different heartbeats, which can obscure plaque and impair automated tools such as CT-fractional flow reserve. We evaluated a vendor-specific step artifact reduction (SAR) algorithm, alone and combined with motion-compensated reconstruction (MCR), in sequential CCTA. We retrospectively analyzed 79 patients scanned on a 128-slice dual-layer spectral CT system. Reconstructions compared were clinical standard, SAR, and SAR+MCR. Lumen continuity across the step interface in the left anterior descending (LAD) and right coronary arteries (RCA) was quantified by the Jaccard index (JI), and whole-heart continuity by histogram entropy of subtraction images; Cohen d is reported for effect sizes. Across 165 coronary step segments, SAR increased mean JI from 0.38 to 0.58 (+0.20; 95% CI: 0.16-0.23; P <0.01; d =0.84), similar in both vessels (LAD +0.20, d =0.82; RCA +0.19, d =0.87). Entropy decreased from 3.81 to 3.51 (-0.30; P <0.01; d =-3.12), indicating fewer step-related structures. In 25 motion-affected RCA segments, SAR alone increased the JI from 0.35 to 0.49, and adding MCR raised it to 0.70 (+0.22 vs. SAR alone; P <0.01; d =0.89). SAR improved vessel and whole-heart continuity on dual-layer spectral CT, with additional benefit from MCR in motion-affected segments.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471046","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":"Editors' Recognition of Reviewers' Service and Awards for Distinction for Reviewing in 2025.","authors":"","doi":"10.1097/RCT.0000000000001914","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001914","url":null,"abstract":"","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471130","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}