Journal of Magnetic Resonance Imaging最新文献

{"title":"Investigation of ASL MRI Brain Perfusion Changes in Patients With Intracranial Dural Arteriovenous Fistula Following Embolization and Their Correlation With Cognitive Status Improvement.","authors":"Dewansh Mishra, Sajith Rajamani, Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Jithin Sivan Sulaja, Asish Vijayaraghavan, C Kesavadas, Bejoy Thomas","doi":"10.1002/jmri.29826","DOIUrl":"https://doi.org/10.1002/jmri.29826","url":null,"abstract":"<p><strong>Background: </strong>Dural arteriovenous fistulas (dAVFs) are anomalous connections between the meningeal arteries supplying the dura and the brain venous system. dAVFs are known to cause thalamic dementia, with studies showing its reversible nature post treatment.</p><p><strong>Purpose: </strong>To assess changes in brain perfusion following embolization in dAVF patients using quantitative arterial spin labeling (ASL) MRI and to investigate their correlation with changes in post-embolization cognitive status.</p><p><strong>Study type: </strong>Prospective study.</p><p><strong>Population: </strong>Twenty patients with angiographically diagnosed intracranial dAVF (mean age = 45.2 years, 70% males) who underwent cognitive assessment and ASL perfusion MRI pre and post embolization.</p><p><strong>Field strength/sequence: </strong>3D phase contrast pseudo-continuous arterial spin labeling (pcASL), 3D T2 fluid attenuated inversion recovery, and 3D T1 fast spoiled gradient recalled brain volume (BRAVO) sequences at 3 T.</p><p><strong>Assessment: </strong>Baseline and 1 month post embolization, cerebral blood flow was assessed in the left and right thalamus, precuneus, posterior cingulate, and parahippocampal regions, with averaged bilateral values to account for laterality. Baseline and post-embolization Addenbrooke's cognitive examination (ACE) scores were obtained in five domains (attention, memory, fluency, language, and visual orientation) and in total.</p><p><strong>Statistical tests: </strong>Paired t tests and Wilcoxon signed rank tests were performed to assess changes in brain perfusion and cognitive scores, respectively. Spearman correlation analysis was performed to assess the correlation between changes in brain perfusion and cognitive scores. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Post-embolization, significant increases were observed in left (35.16-42.92 mL/100 g/min) and averaged thalamic perfusion (35.25 to 40.74 mL/100 g/min). Median total ACE score (75-80), visuospatial (10-11.5), and language (20-21.5) domains also improved significantly. Positive correlations were found between increased averaged and right thalamic perfusion and improvements in memory and language scores (r = 0.55-0.58).</p><p><strong>Data conclusion: </strong>Improved thalamic perfusion post-embolization was positively correlated with cognitive gains, especially in language and memory. ASL MRI brain perfusion has the potential to be a marker for neurocognitive status and may help in the treatment planning of intracranial dAVF.</p><p><strong>Level of evidence: 2: </strong></p><p><strong>Technical efficacy: </strong>Stage 3.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping PTSD-Related Brain Dysregulation With Connectome Gradient Analysis.","authors":"Meirong He, Hongru Zhu, Xiaoyan Wang, Lijun Zhou, Junran Zhang","doi":"10.1002/jmri.29829","DOIUrl":"https://doi.org/10.1002/jmri.29829","url":null,"abstract":"<p><strong>Background: </strong>Hierarchical architecture is a fundamental organizational principle of the human brain. Previous studies have suggested that posttraumatic stress disorder (PTSD) may be characterized as disorders in the cerebral hierarchical organization. However, the specific abnormalities and underlying mechanisms are unclear.</p><p><strong>Purpose: </strong>To investigate whether there are disorders of cerebral hierarchical organization in patients with PTSD and their underlying mechanisms of alteration.</p><p><strong>Study type: </strong>Prospective, case control.</p><p><strong>Filed strength/sequence: </strong>3.0T, gradient echo echo-planar imaging sequence.</p><p><strong>Subjects: </strong>Forty-nine patients with PTSD (11 males and 38 females; Clinician-Administered PTSD Scale (CAPS) score > 40) and 38 trauma-exposed controls (TEC) (13 males and 25 females; CAPS score < 40).</p><p><strong>Assessment: </strong>Connectome gradient analysis was used to systematically examine disorders of cerebral hierarchical organization. Gradient metrics included range and variance of gradient scores. Graph theory analysis was also employed to explore underlying mechanisms of gradient abnormalities, and system segregation (quantifying the degree of separation between functional networks) and participation coefficients (PC) (quantifying the degree of connectivity that a given node has to other networks) were calculated.</p><p><strong>Statistical tests: </strong>Two-sample t-tests were used to compare differences in gradient and graph theory metrics between groups. The association between gradient scores and CAPS scores was assessed using partial correlation analysis. p < 0.05 was set as the statistical significance threshold, with false discovery rate (FDR) correction.</p><p><strong>Results: </strong>Compared with TEC, patients with PTSD showed significantly increased global gradient variance and altered gradient indicators in networks. At global and network levels, patients with PTSD exhibited significantly increased system segregation and significantly reduced PC, which were significantly associated with gradient variance (global system segregation: r = 0.84, global PC: r = 0.93, system segregation in SMN: r = 0.59, PC in DAN: r = -0.62 and PC in FPN: r = -0.53). Moreover, gradient scores in DAN (r = 0.319) and some regions of DMN (ANG.L: r = 0.294), SMN (PreCG.L: r = 0.319), and LIM (HIP.R: r = 0.319) were significantly correlated with CAPS score.</p><p><strong>Data conclusion: </strong>This study, integrating connectome gradient analysis with graph theory, showed hierarchical disruptions across multilevel brain networks in PTSD, potentially explaining clinical symptoms such as hypervigilance and dissociation.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 1.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Glycine-Targeted In Vivo Magnetic Resonance Spectroscopy for Quantifying Glycine in Glioma.","authors":"Kai Huang, Xiao-Zhu Hao, Cai-Xia Fu, Zhong Yang, Yan Ren, Xue Yang, Shi-Ji Zhang, Mei-Lin Zhu, Zhen-Wei Yao, Da-Xiu Wei, Ye-Feng Yao","doi":"10.1002/jmri.29824","DOIUrl":"https://doi.org/10.1002/jmri.29824","url":null,"abstract":"<p><strong>Background: </strong>Glycine (Gly) is a key metabolic intermediate in the proliferation of tumor cells. Monitoring the concentration of Gly in tumor tissues is of great importance for understanding the growth status of tumors. At present, magnetic resonance spectroscopy (MRS) is the only method to non-invasively measure Gly concentration in human tissues. However, in conventional MR spectra the ¹H signal of Gly overlaps with those of other molecules. This makes conventional MRS difficult to accurately measure the Gly concentration in human tissues.</p><p><strong>Purpose: </strong>To develop a pulse sequence, Gly-MRS, which can accurately measure Gly concentrations without the influence of the signal overlapping from other molecules in subjects with glioma.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects/phantoms: </strong>A phantom of the glycine (Gly), myo-inositol (MI) and glutamate (Glu) mixture aqueous solution and 6 phantoms of Gly aqueous solution (pH = 7.2 ± 0.1), 6 subjects with glioma (3 females and 3 males, BMI: 20 ± 4 kg/m², age: 50 ± 10 years).</p><p><strong>Field strength/sequence: </strong>3 Tesla/A Gly-targeted magnetic resonance spectroscopy pulse sequence, Gly-MRS, using Point-RESolved Spectroscopy (PRESS) for single voxel signal selection.</p><p><strong>Assessment: </strong>By applying the developed pulse sequences to the phantoms and the subjects with glioma, the Gly ¹H signals were successfully selectively probed. Quantification of the signals yields the concentrations of Gly in the regions of the tumor tissues of the subjects with glioma.</p><p><strong>Statistical tests: </strong>Numerical data only.</p><p><strong>Results: </strong>The Gly ¹H signals were detected in the tumor regions of 6 subjects with glioma, at a mean concentration of 5.20 mM (standard deviation, ± 3.29 mM). One subject exhibited a clear spatial distribution in the Gly concentrations in the tumor regions.</p><p><strong>Data conclusion: </strong>The Gly-MRS pulse sequence developed in this work might be useful for the accurate in vivo detection of the ¹H signal of Gly in gliomas of human beings.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 3.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial for \"A Glycine-Targeted In Vivo Magnetic Resonance Spectroscopy for Quantifying Glycine in Glioma\".","authors":"Jiaji Mao, Yutong Ji, Jun Shen","doi":"10.1002/jmri.29827","DOIUrl":"https://doi.org/10.1002/jmri.29827","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial for \"MRI Assessment of Lung Water Density in Individuals Previously Infected With COVID-19: A Cross-Sectional Study\".","authors":"Laura C Saunders, A A Roger Thompson, Jim M Wild","doi":"10.1002/jmri.29821","DOIUrl":"https://doi.org/10.1002/jmri.29821","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Federated Learning for Renal Tumor Segmentation and Classification on Multi-Center MRI Dataset.","authors":"Dat-Thanh Nguyen, Maliha Imami, Lin-Mei Zhao, Jing Wu, Ali Borhani, Alireza Mohseni, Mihir Khunte, Zhusi Zhong, Victoria Shi, Sophie Yao, Yuli Wang, Nicolas Loizou, Alvin C Silva, Paul J Zhang, Zishu Zhang, Zhicheng Jiao, Ihab Kamel, Wei-Hua Liao, Harrison Bai","doi":"10.1002/jmri.29819","DOIUrl":"https://doi.org/10.1002/jmri.29819","url":null,"abstract":"<p><strong>Background: </strong>Deep learning (DL) models for accurate renal tumor characterization may benefit from multi-center datasets for improved generalizability; however, data-sharing constraints necessitate privacy-preserving solutions like federated learning (FL).</p><p><strong>Purpose: </strong>To assess the performance and reliability of FL for renal tumor segmentation and classification in multi-institutional MRI datasets.</p><p><strong>Study type: </strong>Retrospective multi-center study.</p><p><strong>Population: </strong>A total of 987 patients (403 female) from six hospitals were included for analysis. 73% (723/987) had malignant renal tumors, primarily clear cell carcinoma (n = 509). Patients were split into training (n = 785), validation (n = 104), and test (n = 99) sets, stratified across three simulated institutions.</p><p><strong>Field strength/sequence: </strong>MRI was performed at 1.5 T and 3 T using T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CE-T1WI) sequences.</p><p><strong>Assessment: </strong>FL and non-FL approaches used nnU-Net for tumor segmentation and ResNet for its classification. FL-trained models across three simulated institutional clients with central weight aggregation, while the non-FL approach used centralized training on the full dataset.</p><p><strong>Statistical tests: </strong>Segmentation was evaluated using Dice coefficients, and classification between malignant and benign lesions was assessed using accuracy, sensitivity, specificity, and area under the curves (AUCs). FL and non-FL performance was compared using the Wilcoxon test for segmentation Dice and Delong's test for AUC (p < 0.05).</p><p><strong>Results: </strong>No significant difference was observed between FL and non-FL models in segmentation (Dice: 0.43 vs. 0.45, p = 0.202) or classification (AUC: 0.69 vs. 0.64, p = 0.959) on the test set. For classification, no significant difference was observed between the models in accuracy (p = 0.912), sensitivity (p = 0.862), or specificity (p = 0.847) on the test set.</p><p><strong>Data conclusion: </strong>FL demonstrated comparable performance to non-FL approaches in renal tumor segmentation and classification, supporting its potential as a privacy-preserving alternative for multi-institutional DL models.</p><p><strong>Evidence level: </strong>4.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Pathologic Results of Foci on Breast Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis.","authors":"Chenyu Zhang, Quankun Lin, Wei Zhai, Feng Cheng, Lu Sen, Baosan Han","doi":"10.1002/jmri.29811","DOIUrl":"https://doi.org/10.1002/jmri.29811","url":null,"abstract":"<p><strong>Background: </strong>Although T2-weighted imaging (T2WI) hypointensity, delayed enhancement washout pattern, interval growth, and new appearance of a focus have been associated with malignancy, the results are not consistent.</p><p><strong>Purpose: </strong>To investigate the malignancy rate and identify the clinical and imaging characteristics associated with malignancy among foci in breast MRI.</p><p><strong>Study type: </strong>Meta-analysis.</p><p><strong>Subjects: </strong>32 articles with 2645 foci.</p><p><strong>Field strength/sequence: </strong>1.5 T and 3.0 T. T1WI, T2WI, and DCE-MRI.</p><p><strong>Assessment: </strong>PubMed, Embase, Scopus, and Cochrane databases were searched for articles published from January 2013 to December 2023, using the search terms: \"focus,\" \"foci,\" \"small mass,\" \"size,\" \"breast magnetic resonance imaging,\" and \"breast MRI.\" Extracted data included the reference standard, number of benign/malignant foci, size criterion, BI-RADS categories, amount of fibroglandular tissue, background parenchymal enhancement, T2WI signal intensity, delayed enhancement pattern.</p><p><strong>Statistical tests: </strong>Pooled data were analyzed using Revman 5.4 software. Between-study heterogeneity was investigated with I²-statistics. If I² < 50% (reflecting no substantial heterogeneity), a fixed effects model was used for analysis. If I² > 50%, random effects model analysis was used. For continuous variables, the standardized mean difference (SMD) and 95% confidence interval (CI) were used to represent the results. Malignancy rate of each study was transformed via the Freeman-Tukey Doublearcsine method. Odds ratios (OR) with 95% CIs were calculated for dichotomous variables. p values ≤ 0.05 were considered significant.</p><p><strong>Results: </strong>The pooled malignancy rate of 2645 foci was 16% (95% CI: 13%-19%). There was a significant association between malignant foci and older age (OR = 5.82, 95% CI: 2.08-9.56), T2WI hypointensity (OR = 2.28, 95% CI: 1.19-4.35) and delayed enhancement washout pattern (OR = 2.78, 95% CI: 1.87-4.12). Hyperintense foci were significantly more likely to be benign (OR = 0.41, 95% CI: 0.21-0.79).</p><p><strong>Data conclusion: </strong>An enhancing focus with T2WI hypointensity and a washout pattern, especially in older patients, is significantly more likely to be malignant. Therefore, careful attention should be paid to it and could justify consideration of biopsy.</p><p><strong>Evidence level: </strong>3.</p><p><strong>Technical efficacy: </strong>Stage 3.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Inter-Individual Differences in Cognitive Decline Using the Brain Connectome in Osteoporosis.","authors":"Chao Li, Xiaoping Ren, Kechong Zhou, Quan Sun, Ziwei Liao, Tianlun Gong, Yang Wang","doi":"10.1002/jmri.29820","DOIUrl":"https://doi.org/10.1002/jmri.29820","url":null,"abstract":"<p><strong>Background: </strong>Osseous structures have been recognized as an endocrine organ that bidirectionally interacts with the brain. Osteoporosis (OP) is a systemic endocrine disorder linked to neurodegenerative disorders. This bone-brain axis interdependence highlights the necessity of cognitive monitoring in OP management to detect early neurodegeneration markers, particularly given individual variability in brain reserve that may predispose patients to accelerated cognitive decline.</p><p><strong>Purpose: </strong>To investigate the individual differences in functional connectome and its association with cognitive ability in OP.</p><p><strong>Study design: </strong>Longitudinal human study.</p><p><strong>Subjects: </strong>A total of 31 OP patients (Age: 56.7 ± 13.2, 17 Male) and 31 healthy controls (HC, age: 55.1 ± 11.3, 15 male).</p><p><strong>Field strength/sequence: </strong>3 T, gradient-echo EPI sequence, MP2RAGE sequence.</p><p><strong>Assessment: </strong>Individual identification analyses were performed to investigate the individual-specific pattern of brain functional connectome in both OP and HC by leveraging longitudinal test-retest fMRI data to map individual variabilities in brain functional connectomes. Cognitive abilities were assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE).</p><p><strong>Statistical tests: </strong>Two-sample t tests, support vector regression, permutation tests, and Bonferroni correction. A p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Significant inter-individual variability (SD_OP = 3.27, SD_HC = 2.35) and robust intra-individual stability (P_OP = 0.17, P_HC = 0.59) in cognitive performance for both OP and HC groups were observed. In addition, functional connectivity profiles could reliably identify individuals across sessions (SuccessRate, SR_OP = 85%, SR_HC = 92%). The support vector regression model revealed that connectivity profiles could predict cognitive ability both within (r_MoCA-OP = 0.63, r_MMSE-OP = 0.54, r_MoCA-HC = 0.58, r_MMSE-HC = 0.61) and between sessions (r_MoCA-OP = 0.47, r_MMSE-OP = 0.41, r_MoCA-HC = 0.53; r_MMSE-HC = 0.54), with the medial-frontal and default-mode networks emerging as the most predictive contributors.</p><p><strong>Conclusion: </strong>These findings underscore the potential of resting-state functional connectomes characterizing individual variability for cognitive ability in OP patients.</p><p><strong>Evidence level: </strong>4.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial for \"T1-Hyperintense Cystic Renal Masses: MR Subtraction Imaging May Improve Interobserver Agreement and Diagnostic Performance in the Bosniak Classification\".","authors":"Mohammad Abd Alkhalik Basha, Yassir Edrees Almalki","doi":"10.1002/jmri.29823","DOIUrl":"https://doi.org/10.1002/jmri.29823","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T1-Hyperintense Cystic Renal Masses: MR Subtraction Imaging May Improve Interobserver Agreement and Diagnostic Performance in the Bosniak Classification.","authors":"Huanhuan Kang, Huiping Guo, Xueyi Ning, Wei Xu, Haili Liu, Zhe Liu, Xiaohui Ding, Xu Bai, Chaobo Li, Xuewei Wen, Sicheng Yi, Mengqiu Cui, Jian Zhao, Lin Li, Xiaojing Zhang, Qingbo Huang, Huiyi Ye, Xin Ma, Haiyi Wang","doi":"10.1002/jmri.29822","DOIUrl":"https://doi.org/10.1002/jmri.29822","url":null,"abstract":"<p><strong>Background: </strong>T1-hyperintensity in cystic renal masses (CRMs) complicates Bosniak classification assessment due to inherent signal interference from hemorrhage and proteinaceous content, potentially obscuring enhancement visibility.</p><p><strong>Purpose: </strong>To investigate whether MR subtraction imaging improves interobserver agreement and diagnostic performance in the Bosniak classification of T1-hyperintense CRMs.</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Population: </strong>A total of 139 consecutive patients (mean age, 50 ± 12 years; 97 males) with 141 T1-hyperintense CRMs were included, consisting of surgically confirmed 133 lesions and clinically diagnosed 8 benign CRMs that were stable during follow-up (≥ 5 years).</p><p><strong>Field strength/sequence: </strong>1.5/3 T. fat-saturated T2-weighted imaging, diffusion-weighted imaging, unenhanced, and triphasic dynamic contrast-enhanced T1-weighted imaging (T1WI). Subtraction images were generated automatically by subtracting unenhanced from triphasic contrast-enhanced T1WI.</p><p><strong>Assessment: </strong>Six radiologists (half less experienced) independently classified all T1-hyperintense CRMs using the Bosniak classification (v2019) in two sessions, with and without subtraction imaging. A 1-month washout period was implemented between sessions, and the order of cases was re-randomized. Interobserver agreement and diagnostic performance were evaluated in all experienced and less experienced readers.</p><p><strong>Statistical tests: </strong>Weighted κ statistics assessed interobserver agreement. Diagnostic performance (the area under the curve [AUC], sensitivity, specificity) was compared using Delong and McNemar tests. Statistical significance was defined as p < 0.05.</p><p><strong>Results: </strong>Subtraction imaging significantly improved interobserver agreement in all radiologists (weighted κ = 0.62 vs. 0.46), and less experienced radiologists (3-5 years of experience, weighted κ = 0.63 vs. 0.42), though not significantly among experienced radiologists (10-15 years of experience, weighted κ = 0.61 vs. 0.52; p = 0.051). Less experienced radiologists showed significantly higher AUC (0.865 vs. 0.804), sensitivity (88.9% vs. 75.5%), and specificity (88.2% vs. 72.5%) with MR subtraction imaging.</p><p><strong>Data conclusion: </strong>MR subtraction imaging may improve overall interobserver agreement in the Bosniak classification of T1-hyperintense CRMs. Furthermore, it could improve diagnostic accuracy and interobserver agreement among less experienced radiologists.</p><p><strong>Evidence level: </strong>4.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}