Journal of Computer Assisted Tomography最新文献

{"title":"Acute Biliary Disorders and Complications.","authors":"Carlos Gonzalez Baerga, Manuel Menendez Santos, Ruben G Ortiz Cordero, Oswaldo A Guevara Tirado, Naciye Turan, Mayur Virarkar","doi":"10.1097/RCT.0000000000001901","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001901","url":null,"abstract":"<p><p>Hepatobiliary emergencies include both traumatic and nontraumatic pathologies that can affect the gallbladder, bile ducts, and liver. Due to the complexity and urgency of these conditions, advanced imaging techniques are required for rapid, accurate diagnosis. Traumatic liver emergencies were historically treated surgically; however, with the implementation of contrast-enhanced computed tomography (CT), management options have evolved. Contrast-enhanced CT imaging can provide additional insight into the extent and severity of injuries, enabling clinicians to decide between operative and nonoperative management with greater confidence. Furthermore, nontraumatic biliary emergencies present diagnostic challenges due to the diversity in their clinical presentations. When biliary pathology is suspected, the use of ultrasound, CT, and magnetic resonance imaging (MRI) aids in differentiating between conditions such as acute cholecystitis, acalculous cholecystitis, gangrenous cholecystitis, and emphysematous cholecystitis, thereby directing management strategies. Moreover, liver pathologies such as liver abscesses, hemorrhagic liver lesions, and vascular disorders demand integrated imaging assessments. The combination of ultrasound, CT, and MRI facilitates the differentiation between pyogenic and parasitic abscesses, evaluation of spontaneous liver ruptures, and diagnosis of portal vein thrombosis and Budd-Chiari syndrome, guiding clinical interventions. In addition, biloma and cholangitis, while less frequent, require precise diagnosis. The use of multimodality imaging enables early detection and intervention while mitigating potential complications. In conclusion, this review highlights the key role of advanced imaging in hepatobiliary emergencies and provides a comprehensive overview to help clinicians navigate complex scenarios effectively.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329907","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":"From Magnetic Resonance Imaging Radiomics to the Prediction of Regional Nodal Metastasis in Laryngeal Cancer.","authors":"Elif Dilara Topcuoglu, Onur Tuncer","doi":"10.1097/RCT.0000000000001900","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001900","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential of magnetic resonance imaging (MRI) radiomics-based machine learning (ML) models in predicting local lymph node metastasis (LNM) at initial diagnosis in patients with laryngeal squamous cell carcinoma (LSCC).</p><p><strong>Methods: </strong>This retrospective single-center study included 192 patients with pathologically confirmed LSCC who underwent preoperative contrast-enhanced T1-weighted neck MRI followed by curative surgical resection and lymphadenectomy. Tumor volumes were manually segmented, and 107 standardized radiomic features, along with clinical variables, were extracted. After collinearity reduction and feature selection, the most predictive features were used to train a random forest classifier. Model robustness was assessed through repeated cross-validation, and diagnostic performance was evaluated on an independent test set using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy.</p><p><strong>Results: </strong>LNM was present in 78 patients (40.6%). T stage and supraglottic involvement showed significant associations with LNM (P<0.001 and P=0.020, respectively). Feature selection consistently identified 6 radiomic features, with \"Sphericity\" emerging as the most predictive across all runs. The final radiomics model achieved a mean AUC of 0.90 (95% CI: 0.85-0.94), with sensitivities of 0.96, specificities of 0.82, and an accuracy of 0.87.</p><p><strong>Conclusions: </strong>MRI-based radiomics demonstrates potential for the preoperative prediction of regional LNM in laryngeal cancer by capturing quantitative imaging features related to tumor heterogeneity, shape, and morphology. However, these findings should be interpreted with caution, given the retrospective single-center design and lack of external validation, and require confirmation in larger multicenter studies.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308210","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":"Temporal Evolution of Sternal Healing on Chest CT Following Median Sternotomy: A Retrospective Analysis of Patterns of Fat Stranding, Lymphadenopathy, and Callus Formation.","authors":"Blake D Sarrazin, Maaz Hassan, Samuel Hund, Brian Everist, Vince Galate, Foyez Ahmmed, Christopher M Walker","doi":"10.1097/RCT.0000000000001905","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001905","url":null,"abstract":"<p><strong>Objective: </strong>Outline the expected course of normal sternal healing at different timepoints after surgery.</p><p><strong>Materials and methods: </strong>A total of 270 chest CT examinations in 228 unique patients performed between January 2018 and 2022 were retrospectively identified in patients who had undergone a first-time median sternotomy for elective surgery within the preceding 18 months. These examinations were divided into 4 intervals based on time since surgery-0 to 2 months, 2 to 6 months, 6 to 12 months, and >12 months. Basic patient data, surgery type, and imaging findings and measurements for the sternum and mediastinum were characterized and summarized.</p><p><strong>Results: </strong>Osseous callus was initially rare (manubrium 5.1%, sternal body 7.8% to 8.7%) but increased over time, reaching 87.2% in the manubrium and 78.7% to 85.1% in the sternal body beyond 12 months, with consistently lower prevalence in the manubrium at intermediate timepoints. The sternal gap measurements were widest at 2 to 6 months and smallest at 0 to 2 months and >12 months. Pneumomediastinum was exclusively seen at 0 to 2 months (36.2% of examinations). Mediastinal fat stranding (95.7%) and lymphadenopathy (23.3%) were most common at 0 to 2 months and persisted in a minority of patients at later timepoints.</p><p><strong>Conclusions: </strong>Post-sternotomy healing is prolonged and variable, with the manubrium demonstrating slower callus formation and persistently wider sternal gaps than the sternal body. Early postoperative findings such as mediastinal fat stranding, lymphadenopathy, and osseous resorptive changes are common and may reflect normal healing rather than pathology, with callus typically evident after 6 months.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308214","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":"Accuracy and Variability of Spatial Localization of Infarct Core Predicted by CT Perfusion.","authors":"Inka K Berglar, Levin M Moser, Shervin Kamalian, Justin Vranic, Shahmir Kamalian, Sam Payabvash, Rehab N Khalid, Aman Patel, Christopher Stapleton, Aneesh B Singhal, Natalia S Rost, Ramon G Gonzalez, Pamela W Schaefer, Michael H Lev, Robert W Regenhardt, Rajiv Gupta","doi":"10.1097/RCT.0000000000001884","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001884","url":null,"abstract":"<p><strong>Objective: </strong>In patients with acute ischemic stroke, CT perfusion (CTP)-derived infarct core is valuable for prognostication, triage and transfer decision-making, and for informing studies of emerging therapeutic targets. In this study, we compare the accuracy and variability of the infarct core predicted by 2 FDA-cleared CTP programs, using diffusion-weighted MRI (DWI) as the reference standard.</p><p><strong>Methods: </strong>We analyzed 61 stroke patients who underwent admission CTP and DWI within 90 minutes. Infarct core was estimated using relative cerebral blood flow thresholds and compared with DWI-derived ground truth. After coregistration of CTP and DWI, Dice similarity coefficients were calculated to quantify the topographic concordance of the infarct core.</p><p><strong>Results: </strong>The CTP-determined infarct core volumes were significantly correlated with DWI but demonstrated substantial variability and bias. Our results showed limited topographic overlap, with median dice scores of 0.367 (CTP-A) and 0.289 (CTP-B). However, in patients with larger infarcts (volumes ≥50 mL), CTP provides more reliable estimates of spatial agreement, reaching median Dice scores of 0.61 (CTP-A) and 0.47 (CTP-B).</p><p><strong>Conclusions: </strong>Although these findings show a generally low accuracy of CTP estimation, they suggest that CTP may offer clinically meaningful insights for decision-making in the large-core setting and inform the design of future trials.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338750","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":"Texture Analysis of Subsolid Nodules Detected on Computed Tomography for Differentiating Minimally Invasive From Invasive Adenocarcinoma.","authors":"Shih-Min Lin, Yi-Ching Chen, Jao Perng Lin, Wan-Ling Chang","doi":"10.1097/RCT.0000000000001874","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001874","url":null,"abstract":"<p><strong>Objective: </strong>Lung cancer is the leading cause of cancer-related deaths worldwide, and lung nodules serve as early indicators. This study aimed to evaluate computed tomography (CT) texture features to differentiate minimally invasive adenocarcinoma (MIA) from invasive adenocarcinoma (IAC) in subsolid nodules (SSNs).</p><p><strong>Methods: </strong>This retrospective study included patients with lung adenocarcinoma presenting as subsolid nodules. Based on preoperative pathologic findings, patients were categorized into MIA and IAC groups. Morphologic characteristics-including location, size, density, shape, and lobulation-were extracted from preoperative thin-section CT scans. CT texture features were quantified using MaZda software through histogram parameters (mean, standard deviation, skewness, and kurtosis) and gray-level co-occurrence matrix metrics (contrast, entropy, inverse difference moment, and autocorrelation).</p><p><strong>Results: </strong>Among 298 patients, 134 had MIA and 164 had IAC. Significant differences were found in CT morphologic features: IAC demonstrated larger size (11.65±3.17 mm vs. 9.32±2.41 mm, P<0.001), a higher prevalence of mixed ground-glass nodules (58.56% vs. 21.35%, P<0.001), more irregular shapes (64.86% vs. 32.58%, P<0.001), and more frequent lobulation (54.95% vs. 20.22%, P<0.001). Key texture features distinguishing IAC from MIA included higher mean attenuation (-448.69±46.52 HU vs. -562.47±145.28 HU, P<0.001) and entropy (6.95±0.22 vs. 6.66±0.38, P<0.001). The predictive nomogram integrating these features achieved an area under the curve of 0.831 in the training set and 0.893 in the validation set.</p><p><strong>Conclusion: </strong>Quantitative CT texture analysis-particularly entropy and mean attenuation-serves as a valuable tool for differentiating MIA from IAC in SSNs. This noninvasive approach enhances preoperative risk stratification and supports personalized surgical planning.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295149","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 Feature Analysis of HHV8-Associated Multicentric Castleman Disease: A Comparative Study With HIV-Related Diseases and Idiopathic MCD.","authors":"Noriyo Yanagawa, Takanori Inui, Akifumi Imamura, Kazuaki Fukushima, Masaru Tanaka, Taiichiro Kobayashi, Seowoong Jung, Ryoko Sekiya, Saori Ikeda, Emi Handa, Keigo Setoguchi","doi":"10.1097/RCT.0000000000001893","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001893","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate differences in the imaging features of human immunodeficiency virus (HIV)-associated Kaposi sarcoma (KS), HIV-associated lymphoma (HAL), and human herpesvirus 8-associated multicentric Castleman disease (hMCD) and clarify the differences between idiopathic MCD-not otherwise specified (iMCD-NOS) and hMCD.</p><p><strong>Methods: </strong>This single-center retrospective study included 39 episodes of KS, 13 of HAL, 11 of hMCD, and 25 of iMCD-NOS. Pulmonary lesions were divided into 5 patterns: pulmonary nodules/masses; perihilar opacity; centrilobular nodules with or without ground glass opacity (GGO)/consolidation; focal GGO; and pleural masses. The frequencies of pulmonary computed tomography patterns and the prevalence of lymph node enlargement, hepatomegaly, and splenomegaly were compared between the HIV-associated groups (KS, HAL, and hMCD) and between the hMCD and iMCD-NOS groups.</p><p><strong>Results: </strong>The most frequent imaging patterns of lung involvement in KS, HAL, and iMCD-NOS were perihilar opacity (64.3%), pulmonary nodules/masses (83.3%), and centrilobular nodules with or without GGO/consolidation patterns (60.0%), respectively. No hMCD-derived pulmonary lesions were observed in any patient. The prevalence of lymphadenopathy, hepatomegaly, and splenomegaly significantly differed between the 3 HIV-associated groups (P<0.05). The incidence of lesions occurring in 4 or more sites was significantly higher in the iMCD-NOS group with pulmonary lesions than in the group without pulmonary lesions (P<0.01). The incidences of imaging findings were comparable between the hMCD and iMCD-NOS with pulmonary lesions groups; however, the prevalences of enlarged abdominal lymph nodes (P<0.01), hepatomegaly (P<0.01), and splenomegaly (P<0.05) were significantly higher in patients with hMCD than in those with iMCD-NOS without pulmonary lesions.</p><p><strong>Conclusions: </strong>The frequency of pulmonary lesions is lower in hMCD than in KS and HAL. Observation of masses in the lungs should prompt suspicion of the concurrent presence of HAL, even when hMCD has been confirmed. While iMCD-NOS primarily affects the lymph nodes and, as the condition worsens, tends to cause lesions in the liver, spleen, and lungs, hMCD tends to cause lesions in the lymph nodes, liver, and spleen over a short period of time; however, the frequency of pulmonary lesions in hMCD is generally lower than in iMCD-NOS.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258254","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":"Utility of Single-Shot Fast Spin-Echo T2-Weighted MRI With Deep Learning Reconstruction for Assessing Myometrial Invasion in Endometrial Cancer.","authors":"Kengo Kiso, Takahiro Tsuboyama, Shohei Matsumoto, Hiromitsu Onishi, Atsushi Nakamoto, Mitsuaki Tatsumi, Takashi Ota, Hideyuki Fukui, Toru Honda, Noriyuki Tomiyama","doi":"10.1097/RCT.0000000000001896","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001896","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical feasibility of single-shot fast spin-echo T2-weighted MRI with deep learning reconstruction (SSFSE-DL-T2WI) for assessing myometrial invasion in endometrial cancer, compared with standard T2WI.</p><p><strong>Materials and methods: </strong>This retrospective study included 72 patients with endometrial cancer who underwent preoperative contrast-enhanced (CE) MRI. Standard T2WI was acquired using a para-axial fast spin-echo (FSE) sequence and a para-sagittal periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) sequence (mean acquisition time: 383 s). Para-axial and para-sagittal SSFSE-DL-T2WI were obtained with a mean acquisition time of 47 seconds. Signal-to-noise ratio (SNR) and tumor contrast were measured by one radiologist, whereas image quality was assessed by 2 radiologists. Comparisons between standard T2WI and SSFSE-DL-T2WI were performed using paired t tests or Wilcoxon signed-rank tests. Myometrial invasion was evaluated using T2WI alone and in combination with CE-T1WI. Diagnostic performance was evaluated using pathologic myometrial invasion in the surgical specimens as the reference standard and was compared between the 2 T2WI methods using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>SSFSE-DL-T2WI demonstrated significantly higher SNR but lower tumor-to-junctional zone contrast compared with FSE-T2WI (P<0.01). No significant differences in SNR or contrast were observed between SSFSE-DL-T2WI and PROPELLER-T2WI. Both readers rated SSFSE-DL-T2WI significantly better than standard T2WI with respect to noise, artifacts, and tumor visibility (P<0.01). The areas under the ROC curve (AUCs) for detecting any and deep myometrial invasion did not differ significantly between SSFSE-DL-T2WI (mean: 0.77 and 0.86, respectively) and standard T2WI (mean: 0.72 and 0.80, respectively). Similarly, when combined with CE-T1WI, AUCs were comparable between SSFSE-DL-T2WI (mean: 0.83 and 0.91, respectively) and standard T2WI (mean: 0.80 and 0.89, respectively).</p><p><strong>Conclusions: </strong>SSFSE-DL-T2WI provides superior image quality and comparable diagnostic accuracy for assessing myometrial invasion in endometrial cancer, while requiring substantially shorter acquisition time compared with standard T2WI.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258249","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":"Interlobular Septal Thickening: A Pictorial Review.","authors":"Courtney E Walters, Liane Ruddy, Amar S Shah, Evan Hasson, Clinton E Jokerst, Matthew T Stib, Michael B Gotway, Prasad M Panse, Carlos A Rojas","doi":"10.1097/RCT.0000000000001891","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001891","url":null,"abstract":"<p><p>Interlobular septal thickening (ILST) is a feature on chest computed tomography (CT) that is characterized by abnormal widening of the interlobular septa, which are thin connective tissues that separate secondary pulmonary lobules within the lung parenchyma. They contain pulmonary venules and lymphatic vessels. On CT, these septa are normally not visible in healthy patients. However, various pulmonary pathologic conditions can lead to ILST. If present, ILST can be categorized into 3 different patterns based on its morphologic appearance: smooth, nodular, and irregular/fibrotic. Each pattern occurs from different disease processes with little overlap. In this pictorial essay, we review common and rare etiologies for each type of ILST. For each disease, we discuss relevant pathophysiology, epidemiology, risk factors, symptoms, physical exam findings, labs, and management. Subsequently, we present the ILST features along with the distribution (eg, unilateral, bilateral, central, peripheral) and ancillary imaging findings that can support the diagnosis. Finally, characteristic and high-resolution figures are presented.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156711","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 Staging MRI: Prospective Value of Structured Reports With Defined Extraprostatic Extension Grading System.","authors":"Yu-Hui Huang, Ayca Ozutemiz, Andrew Mason, Lin Zhang, Paari Murugan, Subodh Regmi, Benjamin Spilseth","doi":"10.1097/RCT.0000000000001889","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001889","url":null,"abstract":"<p><strong>Objective: </strong>Accurate preoperative staging of extraprostatic extension (EPE) in prostate cancer using prostate MRI is essential for treatment planning but remains variable in practice. We evaluate the diagnostic accuracy and reporting clarity of a structured MRI reporting template and compare its performance with prior similar systems and subjective staging reports.</p><p><strong>Materials and methods: </strong>In this retrospective study, 621 consecutive men who underwent 3T prostate MRI before radical prostatectomy between 2013 and 2021 were evaluated. Of these, 183 prospectively interpreted MRI reports utilized a structured staging template incorporating a 7-point EPE scoring system based on a previously published model, modified to include additional intermediate-length capsular abutment categories. The remaining 438 reports used subjective staging. Report clarity was analyzed for the inclusion of EPE assessment and likelihood. Radical prostatectomy histopathology served as the reference standard. Diagnostic accuracy for EPE detection was assessed using the area under the receiver operating characteristic curve (AUC), and report clarity was analyzed for inclusion of EPE assessment and likelihood.</p><p><strong>Results: </strong>Structured reports were significantly more likely than subjective reports to describe EPE likelihood [100% vs. 52%, (P < 0.001)]. The structured EPE template yielded progressively higher positive predictive value with higher scores, in line with corresponding standardized verbal assessments of EPE probability, yielding an EPE prediction AUC of 0.76 (95% CI: 0.69-0.83).</p><p><strong>Conclusions: </strong>Structured prostate MRI reports prospectively interpreted using a structured EPE grading system significantly enhanced staging communication clarity over subjective interpretations. The structured template maintained predictable diagnostic accuracy similar to prior retrospective studies. Structured staging report templates can be successfully integrated into clinical practice and improve interdisciplinary communication, offering a scalable and reproducible approach to standardizing prostate MRI staging.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156697","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":"Biomechanical Characterization of the Pelvic Floor in Patients With Organ Prolapse: A Finite Element Analysis Based on MRI and Defecography.","authors":"Zhen Yu, Taipeng Zeng, Chengkun Hong, Miyang Yang, Xiaoyang Wang, Hao Huang, Yonggang Liang, Liyuan Fu","doi":"10.1097/RCT.0000000000001892","DOIUrl":"https://doi.org/10.1097/RCT.0000000000001892","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic organ prolapse (POP) is a prevalent condition with complex biomechanical mechanisms. This retrospective observational study aimed to quantitatively evaluate pelvic floor biomechanics in healthy and POP subjects using subject-specific finite element (FE) models derived from high-resolution MRI and dynamic magnetic resonance defecography (MRD).</p><p><strong>Methods: </strong>Subject-specific 3D FE models of the pelvic floor were reconstructed for a healthy control and patients with anterior, apical, and posterior POP. To ensure anatomic representativeness, cases closest to the median levator ani muscle (LAM) volume of each cohort were selected. Nonlinear hyperelastic properties were assigned, and physiological intra-abdominal pressures (eg, Valsalva) were simulated to analyze mechanical responses.</p><p><strong>Results: </strong>Under Valsalva loading, the LAM acted as the primary load-bearing structure. In the healthy model, maximum stress was concentrated at the puborectalis region (1.43 kPa). Conversely, POP models exhibited pathologic remodeling (increased LAM volume and surface area) and significantly altered biomechanics. The posterior POP model demonstrated the most severe mechanical deterioration, with peak stress reaching 5.34 kPa and broader stress concentration zones compared with the control. Furthermore, maximum structural deformation in POP models was substantially greater under identical loads, aligning with clinically observed macroscopic injury patterns.</p><p><strong>Conclusions: </strong>MRD-driven FE modeling effectively quantifies the biomechanical deterioration in POP. The pathologic stress concentration at the puborectalis and the progressive loss of the LAM's load-dispersing capacity provide crucial imaging-based biomechanical evidence to guide individualized surgical planning and pelvic rehabilitation.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150102","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}