Journal of Computer Assisted Tomography最新文献

{"title":"The Clinical Value of Distinguishing Benign and Malignant Thyroid Micronodules With Intratumoral and Peritumoral CT Radiomic Models.","authors":"Dan Kong, Fen Wang, Wenli Shan, Yingying Zhuang, Yan Zeng, Lili Guo","doi":"10.1097/RCT.0000000000001909","DOIUrl":"10.1097/RCT.0000000000001909","url":null,"abstract":"<p><strong>Objective: </strong>To study the utility of intratumoral and peritumoral radiomic models in distinguishing between benign and malignant thyroid micronodules.</p><p><strong>Methods: </strong>CT-enhanced images of 607 patients with thyroid micronodules were obtained, and an additional 100 patients with micronodules were collected as an independent test group on the basis of the sequence of their examination times. The peritumoral region of interest (ROI) was delineated by expanding outward by 1 and 2 mm. Radiomics features were extracted from the 3-dimensional volume of interest (VOI), which included intratumoral, peritumoral 1 mm, peritumoral 2 mm, intratumoral+peritumoral 1 mm and 2 mm in the arterial phase, venous phase, and combined arteriovenous phase. All of the data were randomly divided into training and validation groups at an 8:2 ratio. The minimum redundancy maximum relevance (mRMR) and the least absolute shrinkage and selection operator (LASSO) method was utilized for regression dimension reduction. Radscore, clinical, and combined models were constructed. A nomogram was used to assess the performance of the fusion model, and an external test group was utilized to test the model's performance.</p><p><strong>Results: </strong>The intratumoral+peritumoral 1 mm radiomic model based on arterial-venous phase fusion had the best prediction performance (AUC training group 0.838; 95% CI: 0.802-0.873; validation group 0.827; 95% CI: 0.755-0.899; external test group 0.770; 95% CI: 0675-0.864). The combined model constructed with the radscore and clinical model was the optimal model (AUC training group 0.859; 95% CI: 0.826-0.892; validation group 0.876; 95% CI: 0817-0.935; external test group 0.810; 95% CI: 0.723-0.897).</p><p><strong>Conclusion: </strong>Both the intratumoral and peritumoral radiomic models had good diagnostic efficacy in differentiating benign and malignant thyroid micronodules.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471079","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":"CT-Guided Intervention: Reduction of Metal Artifact Using an Off-Axis Reconstruction Method.","authors":"Ali Mutlu, Allison B Couillard, Adrienne L Kisting, Meridith A Kisting, Annie M Zlevor, Aria M Salyapongse, Anna M Sorensen, Gretchen M Foltz, J Louis Hinshaw, Timothy P Szczykutowicz, Fred T Lee, Martin G Wagner","doi":"10.1097/RCT.0000000000001904","DOIUrl":"10.1097/RCT.0000000000001904","url":null,"abstract":"<p><strong>Objective: </strong>Needle artifact redistribution technique (Needle-ART) is a recently developed image artifact-reduction method for CT-guided needle procedures. The principle of this technique is to create an angle between the needle and imaging plane by tilting the CT gantry, then reformatting images along the needle plane, thus redistributing the artifact out of the viewing plane. The purpose of this study is to evaluate the feasibility, artifact reduction, and clinical applicability of Needle-ART for the placement of biopsy introducer needles into the liver, kidneys, and lungs of a deceased animal model.</p><p><strong>Methods: </strong>A paired before-and-after study was performed in 2 deceased swine to evaluate the effectiveness of Needle-ART in reducing metal artifacts during CT-guided interventions. A 17G co-axial needle was inserted into the liver, kidney, and lung at 6 sites per organ and scanned at each site with both 0-degree gantry tilt (standard axial as the control group) and 6-degree tilted gantry on Needle-ART. A total of 48 scans with 24 control and 24 Needle-ART were collected. Images were reformatted to align with the needle trajectory. Collected images were evaluated for overall artifact severity by 3 blinded radiologists.</p><p><strong>Results: </strong>Needle-ART significantly reduced metal artifacts across all quantitative metrics, which was consistent with blinded reader assessments. Mean artifact length was reduced by 35.5% ( P =0.0019) in liver, 65.9% ( P =0.003) in kidney, and 59.4% ( P =0.0021) in lung. Median artifact width decreased by 30% ( P =0.028) in liver, 24.3% ( P =0.028) in kidney, and 8.3% ( P =0.017) in lung. Median artifact intensity was reduced by 38.8% ( P =0.011) in liver, 35.4% ( P =0.028) in kidney, and 23.6% ( P =0.021) in lung. The radiologists scored conventional CT images (with non-tilted gantry) significantly worse artifacts compared with Needle-ART (with tilted gantry) ( P =0.000041).</p><p><strong>Conclusions: </strong>The off-axis reconstruction method is a novel technique that effectively reduces artifacts by acquiring scans with the CT gantry tilted 6 degrees relative to the plane containing the needle and target.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470984","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":"Consolidation-to-Tumor Ratio (CTR) Versus Tumor Disappearance Rate (TDR) for the Differential Diagnosis of Minimally Invasive and Invasive Pulmonary Adenocarcinoma Arising From Part-Solid Nodules.","authors":"Wei Guo, Yao Yao","doi":"10.1097/RCT.0000000000001910","DOIUrl":"10.1097/RCT.0000000000001910","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the diagnostic performance of consolidation-to-tumor ratio (CTR) and tumor disappearance rate (TDR) for differentiating minimally invasive adenocarcinoma (MIA) from invasive adenocarcinoma (IAC) in patients with part-solid nodules (PSNs), and to identify their optimal cutoff values as well as clinical application value.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 206 patients with pathologically confirmed pulmonary adenocarcinoma from PSNs who underwent chest CT and surgical resection between January 2023 and December 2025. They were divided into the MIA group and IAC group based on postoperative pathology. Two experienced radiologists independently measured and calculated CTR and TDR on 1-mm-thick CT images. ICC evaluated interobserver consistency; independent-samples t test or Mann-Whitney U test compared group differences; ROC curve analyzed diagnostic efficacy; multivariate Logistic regression identified independent diagnostic factors.</p><p><strong>Results: </strong>CTR and TDR had excellent interobserver consistency (ICC=0.912 and 0.905, both P <0.001). IAC group had significantly higher CTR [(0.60±0.13) vs. (0.32±0.11), P <0.001] and lower TDR [(0.34±0.16) vs. (0.65±0.14), P <0.001] than MIA group. ROC analysis showed AUC of CTR was 0.893 (95% CI: 0.857-0.935, cutoff=0.48, sensitivity=85.7%, specificity=83.5%) and TDR was 0.902 (95% CI: 0.862-0.938, cutoff=0.52, sensitivity=85.8%, specificity=87.6%), with no significant AUC difference ( P =0.375). Both CTR (OR=18.785, P <0.001) and TDR (OR=0.126, P <0.001) were independent diagnostic factors.</p><p><strong>Conclusion: </strong>TDR and CTR have comparable diagnostic efficacy in differentiating minimally invasive adenocarcinoma (MIA) from invasive adenocarcinoma (IAC) in part-solid pulmonary nodules. Both TDR and CTR are independent diagnostic factors for distinguishing MIA from IAC.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446959","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":"Postmortem CT Gas Distribution in Pediatric Cases With a History of Perimortem Cardiopulmonary Resuscitation.","authors":"Safa Hoodeshenas, Howard T Harcke, Courtney L Wallace, Mary P Harty, Sharon Gould","doi":"10.1097/RCT.0000000000001907","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001907","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the frequency, anatomic distribution, and potential mechanisms of postmortem gas formation identified on postmortem computed tomography (PMCT) in infants and young children, with emphasis on the association between postmortem gas and perimortem cardiopulmonary resuscitation (CPR).</p><p><strong>Methods: </strong>This retrospective study included 63 pediatric decedents (age range: birth to 25 mo) who underwent PMCT as part of medicolegal investigations, followed by autopsy. Two radiologists independently reviewed PMCT images, reports, and autopsy findings to determine the presence, location, and likely cause of postmortem gas. The presence of CPR was established based on documented history, autopsy findings, and imaging indicators. Descriptive statistics were used to characterize the cohort, and Fisher exact and t tests were applied for group comparisons with statistical significance set at P<0.05.</p><p><strong>Results: </strong>Postmortem gas was detected in 56 of 63 cases (89%). Among 61 cases with known CPR status, 57 had received CPR, and 4 had not. Gas was significantly more frequent in those with CPR (89%, 51/57) than in those without (25%, 1/4; P=0.008). The most commonly affected regions were the heart (64%) and liver (61%). Gas in the heart, liver, or brain was associated with a longer mean interval between death and imaging (7.4 vs. 3.9 h), although this difference did not reach statistical significance (P=0.06). Gas formation was observed as early as 0.5 hours postmortem.</p><p><strong>Conclusions: </strong>PMCT frequently demonstrates postmortem gas in pediatric deaths, most notably in cases with prior CPR. The distribution pattern-favoring the heart and liver-and early appearance within hours of death suggest a major contribution from resuscitation-related mechanisms rather than decomposition only. Recognition of these CPR-related imaging patterns is essential for distinguishing physiological postintervention findings from decomposition or pathologic processes and may improve the forensic interpretive value of PMCT in pediatric death investigations.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412032","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":"Deep Learning-Based Deblurring for Computed Tomography and a Phantom Evaluation for Coronary Artery Calcium Detectability.","authors":"Niels R van der Werf, Nathan R Huber, Tim Leiner, Dominika Suchá, Christian Wuelker, Nikolas D Schnellbaecher, Marcel J W Greuter, Michael Grass","doi":"10.1097/RCT.0000000000001897","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001897","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to develop and evaluate a deep learning (DL) deblurring algorithm for computed tomography (CT). Phantom testing assessed whether DL deblurring could improve CT image quality and coronary artery calcium (CAC) detectability.</p><p><strong>Materials and methods: </strong>The algorithm consisted of 2 sequential convolutional neural networks (CNNs): one for denoising and one for deblurring. After deblurring, the estimated noise from the first model was reintroduced to preserve image texture. The CNN denoising model was trained to map high-noise images to routine low-noise ones. The CNN deblurring model was trained using natural images-blurred inputs paired with sharp targets. To assess performance, an anthropomorphic phantom with 100 small calcifications was scanned on a CT system using a CAC scoring protocol. Data were acquired at clinical and high doses, then reconstructed with and without DL deblurring, using 25% of the maximum denoising strength. Detectability was defined as the ability to calculate an Agatston score (≥3 adjacent voxels >130 HU).</p><p><strong>Results: </strong>At high dose, CAC detectability increased from 39% (standard reconstruction) to 48% with deblurring. Similar detectability (39%) was achieved at the routine dose with deblurring, representing a 6% improvement compared with the original routine dose data.</p><p><strong>Discussion: </strong>Quantitative results from phantom testing demonstrate that DL deblurring can improve image quality, based on a clinically relevant, task-based CAC detection metric at clinical dose levels.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404933","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":"Radiomics Based on Dual-Layer Detector Spectral Computed Tomography for Predicting Histologic Subtypes and Ki-67 Expression in Non-Small Cell Lung Cancer.","authors":"Xiaoqiong Ni, Yiqing Bao, Chenxia Zhou, Jialu Ni, Liang Xu, Xin Wang, Guohua Fan, Dan Jin","doi":"10.1097/RCT.0000000000001894","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001894","url":null,"abstract":"<p><strong>Background: </strong>To develop a combined radiomics nomogram model and a clinical model based on dual-layer detector spectral computed tomography (DLCT) for predicting pathologic subtypes and Ki-67 index status in patients with non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>A total of 405 patients with NSCLC who underwent DLCT scans and Ki-67 testing from 2 medical centers were enrolled in the study. Patients from center 1 were divided into training (n=233) and internal validation (n=83) sets, while center 2 (n=89) formed the external validation dataset. The most valuable radiomics features from dual-phase enhanced CT images and their corresponding iodine images were extracted to construct radiomics models. Clinical factors were screened by univariate and multivariate logistic regression analysis for the construction of clinical models. Subsequently, 2 nomograms that incorporated the radiomics score and clinical factors were established and tested for the 2 tasks, respectively.</p><p><strong>Results: </strong>For type classification, the clinical model, radiomics model, and nomogram had AUCs of 0.863, 0.853, and 0.931, respectively, in the internal validation datasets and 0.862, 0.832, and 0.910, respectively, in the external validation datasets. For Ki-67 classification, the clinical model, radiomics model, and nomogram were available in the internal validation datasets at 0.718, 0.724, and 0.808, respectively, and the AUCs in the external validation dataset were 0.734, 0.721, and 0.791, respectively. Decision curve analysis demonstrated that the nomogram had greater net benefits than did the clinical model and the radiomics model in both terms of type classification and Ki-67 classification.</p><p><strong>Conclusion: </strong>The nomograms integrating clinical models and radiomics models all showed good performance not only for type classification but also for Ki-67 classification in NSCLC patients, which could facilitate clinical decision-making.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471063","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":"Diagnostic Performance of Routine Abdominal MRI for Detecting Left Ventricular Hypertrophy in ADPKD.","authors":"Yin Wang, Mengjun Shen, Qing Xiong, Jon D Blumenfeld, Chenglin Zhu, Vahid Bazojoo, Vahid Davoudi, Zhongxiu Hu, Martin R Prince","doi":"10.1097/RCT.0000000000001885","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001885","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of left ventricular (LV) volumetric parameters derived from routine abdominal MRI for detecting left ventricular hypertrophy (MRI-LVH) in patients with autosomal dominant polycystic kidney disease (ADPKD) who were previously diagnosed with LVH by echocardiography (Echo-LVH).</p><p><strong>Methods: </strong>This retrospective study reviewed 156 ADPKD patients (27 with LVH). The LV wall (LVW) and cavity were manually segmented on T2-weighted abdominal MRI images to calculate 3 height-adjusted parameters: LV wall volume (ht-LVWV), LV cavity volume (ht-LVCV), and total LV volume (ht-LVV). Diagnostic performance was assessed using receiver operating characteristic curve analysis, with Echo-LVH as the reference standard. Subgroup analyses were performed across sex, chronic kidney disease stage, Mayo Imaging Classification, and blood pressure status. Sensitivity analysis was adjusted for body surface area, age, sex, and systolic blood pressure.</p><p><strong>Results: </strong>Ht-LVWV demonstrated high diagnostic accuracy for Echo-LVH, with an area under the curve (AUC) of 0.82 (95% CI: 0.74-0.90), sensitivity=92%, and specificity=64% at a threshold of 60 mL/m. Ht-LVV also showed good performance (AUC=0.70), while ht-LVCV had inadequate diagnostic performance (AUC=0.61). Ht-LVWV maintained robust performance across all clinical subgroups. After adjusting for confounders, the AUC for ht-LVWV improved to 0.92 (95% CI: 0.85-0.98).</p><p><strong>Conclusion: </strong>Ht-LVWV measured on routine abdominal MRI is a promising biomarker for detecting LVH in ADPKD patients, with performance independent of key clinical variables. These findings support the potential for a diagnosis of MRI-LVH from standard ADPKD abdominal imaging protocols that are obtained routinely in the evaluation of ADPKD for renal and cardiovascular risk assessment in ADPKD.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368607","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":"On the Concordance Between Cardiac Magnetic Resonance and Computed Tomography for Left Heart Function Assessment.","authors":"James W Goldfarb","doi":"10.1097/RCT.0000000000001855","DOIUrl":"10.1097/RCT.0000000000001855","url":null,"abstract":"<p><strong>Objective: </strong>To assess the agreement between cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR) for measuring left ventricular (LV) and left atrial (LA) function, and to evaluate the influence of segmentation approach and volume calculation method.</p><p><strong>Methods: </strong>This retrospective study included 24 patients (mean age 74.2±10.9 y; 54% male) who underwent CMR and multiphase CCT within 14 days. LV and LA end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), and LV mass were measured using CCT voxel-based volumetry with papillary-inclusion (PIS) and exclusion (PES) segmentations and then compared with CMR. Simulations of Simpson's Area-Length (AL) and Disk-Summation (DS) techniques were performed on reformatted CCT images using increasing slice spacings (1 to 32 mm). Agreement was evaluated using correlation coefficients, intraclass correlation coefficients (ICC), percent error, and Bland-Altman analysis.</p><p><strong>Results: </strong>CCT demonstrated excellent correlation with CMR for LV-EDV, ESV, EF, and mass (r=0.82 to 0.98; ICC=0.72 to 0.94). PES yielded no EF bias, while PIS overestimated EF by 7.0%. LV mass was consistently overestimated by 39 to 52 g ( P <0.01). LA volumes showed moderate-to-strong correlation (r=0.70 to 0.90), but poor-to-moderate agreement (ICC=0.21 to 0.55). Simulated LA Simpson-DS measurements with slice spacings ≤8 mm preserved agreement with voxel-based values (ICC ≥0.99).</p><p><strong>Conclusions: </strong>CCT can accurately assess LV function when compared with CMR when using voxel-based methods and consistent papillary segmentation approaches. Biplane and measurements with wide slice spacings reduce agreement, warranting standardization for clinical interchangeability.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"606-615"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276410","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":"Neuroendocrine Malignancies of the Cervix: What Radiologists Need to Know.","authors":"Anu P Gayathri, Anand Patel, Love Shah, Thanchanok Chaiprasit, Elizabeth M Jensen, Xianzhong Ding, Margaret R Liotta, Jeanne Horowitz","doi":"10.1097/RCT.0000000000001862","DOIUrl":"10.1097/RCT.0000000000001862","url":null,"abstract":"<p><p>Neuroendocrine malignancies of the cervix (NEM) are an aggressive tumor with early metastasis and recurrence, resulting in poor prognosis and 5-year mortality ranging from 10% to 25% for later stages of disease. These are a rare malignancy of middle-aged and elderly women with an incidence of <2%. The clinical presentation is like the common cervical cancer-squamous cell carcinoma, presenting with nonspecific vaginal bleeding. Pap smear has very low sensitivity and accuracy for NEM, leading to delayed diagnosis. Due to its low incidence, the lack of specific clinical findings, and the limited sensitivity of Pap smears for diagnosing NEM, delays in diagnosis are common, contributing to a higher number of late-stage presentations. Hence, diagnosis by imaging using features such as intratumoral necrosis and hemorrhage, lower ADC values with a cutoff of 0.9×10 -3  mm 2 /s, lymphadenopathy, parametrial and vascular invasion, infiltrative features, and pathologic sampling with immunohistochemical staining is crucial and of paramount importance. We aim to discuss the clinical, imaging, and pathologic findings of NEM and describe the current management options for patients with this aggressive malignancy.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"566-576"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443943","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":"MRI Evaluation of Indeterminate Pulmonary Nodules.","authors":"Mark M Hammer, Rachna Madan","doi":"10.1097/RCT.0000000000001844","DOIUrl":"10.1097/RCT.0000000000001844","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate MRI features for differentiating pulmonary hamartomas from other nodule pathologies, including carcinoid tumors and non-small cell lung cancer (NSCLC).</p><p><strong>Materials and methods: </strong>This retrospective study analyzed chest MRIs of 48 patients with pulmonary nodules from 2017 to 2025. Patients had either pathologic diagnosis or stable follow-up confirming hamartoma. Two blinded radiologists reviewed images and recorded enhancement pattern (solid, rim, or speckled/mesh). The signal intensity index (SII) was calculated using chemical shift imaging.</p><p><strong>Results: </strong>Hamartomas (n=19, 40%), carcinoids (n=17, 35%), and adenocarcinomas (n=9, 19%) were the most common diagnoses. Rim and speckled/mesh enhancement patterns were nearly exclusive to hamartomas (22% and 39% vs. 0% and 4%, respectively, P <0.001). An SII >10% showed 61% sensitivity and 100% specificity for hamartomas. Combining rim or speckled/mesh enhancement patterns and SII >10% yielded 79% sensitivity and 96.6% specificity for hamartomas.</p><p><strong>Conclusions: </strong>Although chemical shift imaging is diagnostic for hamartomas, signal dropout is present in just over half of cases. Rim or speckled/mesh enhancement patterns are also highly suggestive. Combining these MRI features significantly improves diagnostic accuracy for pulmonary hamartomas, potentially reducing further follow-up or invasive procedures for indeterminate nodules.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"650-655"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756782","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}