Journal of Magnetic Resonance Imaging最新文献

{"title":"Editorial for \"Pre-Imaging Clinical Factors Associated With Cardiac MR Image Quality Using Large Language Model-Enabled Data Extraction\".","authors":"Xiaoyan Wang, Jing Zhou, Haifeng Wang","doi":"10.1002/jmri.70346","DOIUrl":"https://doi.org/10.1002/jmri.70346","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773845","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 \"3D Brachial Plexus Neurography With Variable-Rate Selective Excitation RF Pulses\".","authors":"Falko Ensle, Fabio Zecca","doi":"10.1002/jmri.70347","DOIUrl":"https://doi.org/10.1002/jmri.70347","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773734","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 \"Chronic Liver Disease: Assessing Inflammation and Fibrosis Using Three-Dimensional MR Elastography With Same-Day Biopsy in a Prospective Cohort\".","authors":"Gwenaël Pagé","doi":"10.1002/jmri.70348","DOIUrl":"https://doi.org/10.1002/jmri.70348","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773810","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 \"Prognostic Value of MRI-Based Treatment Response Assessment Criteria in Hepatocellular Carcinoma After Stereotactic Body Radiotherapy: A Comparative Analysis of mRECIST, LI-RADS TRA Version 2017, and LI-RADS Radiation TRA Version 2024\".","authors":"Jason Yao, Amer Alaref, Christian B van der Pol","doi":"10.1002/jmri.70337","DOIUrl":"https://doi.org/10.1002/jmri.70337","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773824","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":"Free-Breathing 3D Whole Heart and Aorta Cine MRI Without Contrast Agent-Comparison to Clinical Standard.","authors":"Ruixin Chen, Huangling Lu, Alexandru Cernicanu, Jos Westenberg, Merlijn Sevenster, Jochen Keupp, Jakob Meineke, Hildo J Lamb","doi":"10.1002/jmri.70343","DOIUrl":"https://doi.org/10.1002/jmri.70343","url":null,"abstract":"<p><strong>Background: </strong>The demand for cardiac MRI is increasing with the growing burden of cardiovascular disease. However, conventional protocols require sequential acquisitions for multi-breath-hold 2D cine and 3D MR angiography (MRA), which is time-consuming. In addition, breath-hold 2D cine can be challenging for patients with limited breath-hold capacity.</p><p><strong>Purpose: </strong>To further develop and evaluate a free-breathing 3D whole-heart cine MRI technique for simultaneous assessment of cardiac function and aortic anatomy in a single non-contrast acquisition at 1.5 T.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects: </strong>Twenty-four healthy volunteers (mean age 31.8 ± 9.9 years, 50% female).</p><p><strong>Field strength/sequences: </strong>1.5 T; A cartesian spiral (CASPR) bSSFP 3D cine, 2D cine and 3D mDixon MRA.</p><p><strong>Assessment: </strong>Acquisition and reconstruction times were assessed for 3D cine at 2.5 and 2.0 mm. LV mass, LVEF, and RVEF were assessed by two observers (5 and 32 years of experience) and compared with 2D cine. Aortic root and ascending aortic areas were compared with 3D MRA. Image quality was evaluated using blood pool-to-myocardium contrast ratio and endocardial/epicardial edge sharpness. Qualitative image preference was assessed by three observers (5, 32, and 33 years of experience).</p><p><strong>Statistical tests: </strong>One-way ANOVA with Tukey post hoc tests and Bland-Altman analysis with paired t-tests were used. Intraclass correlation coefficient (ICC) assessed inter- and intra-observer agreement. p < 0.05 was considered significant.</p><p><strong>Results: </strong>Acquisition time was 5 min (2.5 mm) and 7 min (2 mm), versus 11 min for 2D cine and 8 min for 3D MRA. Reconstruction time was approximately 5 min. LV mass showed no differences versus 2D cine. LVEF showed small but significant bias (2.5 mm: 1.38%, p = 0.005; 2.0 mm: 1.39%, p < 0.001). RVEF showed no significant differences. Ascending aorta areas showed significant differences (0.28mm² and 0.25mm², p < 0.001), while aortic root areas showed no difference versus 3D MRA. Reproducibility was at least moderate (ICC 0.75-0.998). 3D cine showed lower contrast and edge sharpness than 2D cine (p < 0.001). Observers preferred 2.0 mm (ICC = 0.64).</p><p><strong>Data conclusion: </strong>Free-breathing 3D cine MRI enables operator-independent, time-efficient, and accurate assessment of cardiac function and aortic anatomy in healthy volunteers in a single non-contrast acquisition at 1.5 T, compared to conventional 2D cine and 3D MRA.</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":3.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729255","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":"5T-Based Glutamate Chemical Exchange Saturation Transfer Imaging for Adult Diffuse Glioma Stratification.","authors":"Yinwei Ying, Qihang Yu, Yan Ren, Yajing Zhao, Dongdong Wang, Nan Mei, Zhuoying Ruan, Yuxi Xie, Jie Chen, Jin Cui, Jiayun Pan, Kai Lu, Zhiwei Qin, Yiping Lu, Bo Yin","doi":"10.1002/jmri.70340","DOIUrl":"https://doi.org/10.1002/jmri.70340","url":null,"abstract":"<p><strong>Background: </strong>Glutamate chemical exchange saturation transfer (GLU-CEST) is a non-invasive in vivo approach for glutamate detection, but its performance for glioma evaluation at 5T remains incompletely defined.</p><p><strong>Purpose: </strong>To investigate factors influencing 5T GLU-CEST and its diagnostic value in glioma stratification.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Phantom and population: </strong>Five phantom series (pH 6.2-7.4; glutamate 8-20 mM) and 40 adult-type diffuse glioma patients (49.00 ± 12.26 years; 23 males).</p><p><strong>Fieldstrength/sequence: </strong>5 T, fast spin-echo GLU-CEST and amide proton transfer (APT)-CEST.</p><p><strong>Assessment: </strong>Phantoms and patients underwent MRI scans; GLU-CEST, APT-CEST, and normalized values (ΔGLU-CEST, ΔAPT-CEST) were quantified. Gliomas were graded by WHO 2-4; IDH status was determined.</p><p><strong>Statistical tests: </strong>Spearman correlation, Kruskal-Wallis tests, Mann-Whitney U tests, and weighted DeLong tests; two-sided p < 0.05 was significant.</p><p><strong>Results: </strong>GLU-CEST signals positively correlated with glutamate and negatively with pH (ρ ≥ 0.893). Significant differences were found in all effects between WHO Grade 2 and 4 gliomas (ΔGLU-CEST: 2.006 [1.143, 2.799] vs. 4.365 [2.974, 5.299]; GLU-CEST: 7.424 [6.679, 7.649] vs. 10.155 [8.098, 11.550]; ΔAPT-CEST: 1.918 [1.258, 2.461] vs. 3.386 [2.682, 4.805]; APT-CEST: 1.961 [1.425, 2.715] vs. 3.333 [2.478, 4.632]), whereas only ΔGLU-CEST and GLU-CEST exhibited significant disparities between Grade 3 and 4 gliomas (ΔGLU-CEST: 2.171 [1.895, 2.862] vs. 4.365 [2.974, 5.299]; GLU-CEST: 7.102 [6.475, 7.259] vs. 10.155 [8.098, 11.550]). In the solid tumor region, all effects demonstrated significant differences between IDH-mutant and IDH wild-type gliomas (ΔGLU-CEST: 2.111 [1.614, 3.110] vs. 4.333 [2.964, 5.405]; GLU-CEST: 7.259 [6.577, 7.726] vs. 10.291 [8.097, 11.634]; ΔAPT-CEST: 2.017 [1.355, 2.718] vs. 3.235 [2.670, 4.735]; APT-CEST: 2.122 [1.680, 2.889] vs. 3.270 [2.450, 4.262]), whereas GLU-CEST outperformed APT-CEST and ΔAPT-CEST in diagnostic efficacy (AUC difference = 0.073 and 0.101).</p><p><strong>Data conclusion: </strong>5 T GLU-CEST is capable of differentiating between grade 2 and grade 4, as well as grade 3 and grade 4 adult diffuse gliomas, and demonstrates superior performance to APT-CEST in the classification of IDH status.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722985","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":"Pre-Imaging Clinical Factors Associated With Cardiac MR Image Quality Using Large Language Model-Enabled Data Extraction.","authors":"Hong Yu, Masha Bondarenko, Ali Nowroozi, Yoo Jin Lee, Adrian Serapio, Punita Kaveti, Jae Ho Sohn","doi":"10.1002/jmri.70336","DOIUrl":"https://doi.org/10.1002/jmri.70336","url":null,"abstract":"<p><strong>Background: </strong>Poor cardiac MR image quality can prompt repeat examinations and hinder clinical decision-making.</p><p><strong>Purpose: </strong>To evaluate whether pre-imaging clinical information, extracted using a large language model (LLM), is independently associated with cardiac MR image quality.</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Population: </strong>1006 adults undergoing clinical cardiac MR examinations.</p><p><strong>Field strength/sequence: </strong>1.5 T and 3 T scanners with cine, black blood, MR angiogram, or late gadolinium enhancement protocols.</p><p><strong>Assessment: </strong>Image quality was categorized per study as excellent, slightly limited, severely limited, or nondiagnostic using institutional reporting conventions finalized by radiologists and cardiologists. A HIPAA-compliant LLM assigned image quality labels based on radiology reports through an iteratively refined prompt, with reliability confirmed by two radiologists. Labels were binarized as Good (excellent and slightly limited) versus Poor (severely limited and nondiagnostic). A repeat-imaging-adjusted image quality label was used in a sensitivity analysis. Pre-imaging clinical and patient variables were extracted from electronic health records. Associations between variables and image quality labels were investigated.</p><p><strong>Statistical tests: </strong>Cohen's kappa (κ) for label agreement. Chi-square and t-tests for univariate analysis. Variance inflation factor (VIF) and multivariable logistic regression. Significance level: p < 0.05.</p><p><strong>Results: </strong>Binarized image quality labels showed substantial agreement with interpreters' assessments for both the primary dataset (κ = 0.689) and the repeat-adjusted dataset (κ = 0.879). There was no significant multicollinearity (VIF = 1.01-1.39). Cognitive and communication impairment (OR 1.81, 95% CI [1.30-2.54], p < 0.001) and respiratory issues (1.57 [1.14-2.17], p = 0.006) were independently associated with poor image quality. These associations remained significant in the repeat-adjusted sensitivity analysis (cognitive and communication impairment (OR 1.75, 95% CI [1.27-2.44], p < 0.001) and respiratory compromise (OR 1.37, 95% CI [1.04-1.82], p = 0.027)). Other clinical variables were not independently associated after adjustment.</p><p><strong>Data conclusion: </strong>Cognitive/communication impairment and respiratory compromise were independently associated with poor cardiac MR image quality.</p><p><strong>Level of evidence: 3: </strong></p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722959","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":"Hypointensity on Carotid Plaque MRI and Its Relationship to Calcification: Histopathologic Validation With Quantitative Susceptibility Mapping.","authors":"Ayano Ishiyama, Hideki Ishimaru, Shinji Okano, Yohei Ikebe, Tsuyoshi Izumo, Yoichi Morofuji, Minoru Morikawa, Reiko Ideguchi, Ryo Toya","doi":"10.1002/jmri.70335","DOIUrl":"https://doi.org/10.1002/jmri.70335","url":null,"abstract":"<p><strong>Background: </strong>On conventional carotid plaque MRI, calcification is commonly defined as a region that is hypointense across multiple contrast weightings. However, iron-containing components such as hemosiderin may exhibit similar signal characteristics, raising concerns regarding substrate specificity.</p><p><strong>Purpose: </strong>To evaluate whether quantitative susceptibility mapping (QSM) can distinguish hemosiderin from calcification in carotid atherosclerotic plaques using ex vivo MRI with direct histopathologic correlation.</p><p><strong>Study type: </strong>Ex vivo specimen study.</p><p><strong>Specimen: </strong>Twenty-four carotid endarterectomy specimens obtained between October 2017 and August 2021.</p><p><strong>Field strength/sequence: </strong>3T MRI including spin-echo T1-weighted, spin-echo T2-weighted, time-of-flight-equivalent gradient-echo (FLASH) imaging, and multi-echo FLASH-based QSM reconstruction.</p><p><strong>Assessment: </strong>Histologic sections were stained with hematoxylin-eosin, von Kossa (calcification), and Berlin blue (hemosiderin). With histopathologic findings as reference, two radiologists defined corresponding regions of interest on MRI for substrate-level signal characterization. Contrast-to-noise ratios (CNR) were measured on conventional sequences, and relative susceptibility values (rSV) were measured on QSM.</p><p><strong>Statistical test: </strong>Group comparisons were performed using the Wilcoxon rank-sum test. A two-sided p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Seventy-nine matched cross-sections yielded 41 calcifications and 25 hemosiderin deposits, including 16 sections with both components. On T1-, T2-, and FLASH imaging, CNR values did not differ significantly between calcification and hemosiderin (p = 0.12, p = 0.096, and p = 0.67, respectively), with substantial signal overlap. On QSM, hemosiderin exhibited positive rSVs (mean ± SD: 506.8 ± 320.5 ppb), whereas calcification exhibited negative rSVs (-440.5 ± 296.3 ppb), without polarity overlap in this dataset and with a significant group difference. Hemosiderin deposition was identified in 25 of 79 matched sections, and calcification and hemosiderin coexisted in 16 sections.</p><p><strong>Data conclusions: </strong>Hypointensity on conventional carotid plaque MRI may not reliably indicate calcification at the substrate level. QSM enables robust differentiation between diamagnetic calcium and paramagnetic iron with histopathologic validation.</p><p><strong>Level of evidence: 2: </strong></p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716926","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":"Prognostic Value of MRI-Based Treatment Response Assessment Criteria in Hepatocellular Carcinoma After Stereotactic Body Radiotherapy: A Comparative Analysis of mRECIST, LI-RADS TRA Version 2017, and LI-RADS Radiation TRA Version 2024.","authors":"Fan Zhou, Lidi Ma, Jiaqi Wei, Shuting Liao, Yuquan Zheng, Zhijun Geng, Chuanmiao Xie","doi":"10.1002/jmri.70334","DOIUrl":"https://doi.org/10.1002/jmri.70334","url":null,"abstract":"<p><strong>Background: </strong>Accurate imaging assessment of hepatocellular carcinoma (HCC) after stereotactic body radiotherapy (SBRT) remains challenging. Although LI-RADS CT/MRI Radiation Treatment Response Assessment (TRA v2024) was developed for this purpose, its prognostic value for survival stratification after SBRT remains to be validated.</p><p><strong>Purpose: </strong>To compare the prognostic performance of mid-term (3-6 months) and late-term (9-12 months) MRI-based treatment response assessed using modified RECIST (mRECIST), LI-RADS TRA v2017, and LI-RADS Radiation TRA v2024 in patients with HCC.</p><p><strong>Study type: </strong>Retrospective cohort study.</p><p><strong>Population: </strong>125 patients with HCC underwent SBRT (111 males; mean age, 56.4 ± 10.8 years).</p><p><strong>Field strength/sequence: </strong>3.0 T; axial fat-suppressed fast spin-echo T2-weighted imaging, diffusion-weighted imaging, pre-contrast gradient recalled echo T1-weighted imaging, and contrast-enhanced late arterial phase, portal venous phase, and delayed/transitional phase.</p><p><strong>Assessment: </strong>Tumor response was independently evaluated by three radiologists using three treatment assessment methods. Ancillary features (AFs) were additionally recorded to assess their incremental prognostic value. Overall survival (OS) and progression-free survival (PFS) were analyzed according to response categories.</p><p><strong>Statistical tests: </strong>Kolmogorov-Smirnov test, Intraclass correlation coefficients, Cohen's κ, Variance inflation factor analysis, Kaplan-Meier method, Log-rank tests with Bonferroni correction, Univariate and multivariable Cox regression analyses. Statistical significance was defined as p < 0.05.</p><p><strong>Results: </strong>At mid-term follow-up, LI-RADS Radiation TRA v2024 showed greater discrimination for PFS than mRECIST and LI-RADS TRA v2017, with no OS difference (p > 0.999). Across all three criteria, late-term response assessment yielded better prognostic stratification for PFS and OS than did mid-term evaluation. At the late-term follow-up, LI-RADS Radiation TRA v2024 was strongly associated with OS (HR = 15.80, 95% CI: 3.34-75.00) and PFS (HR = 6.31, 95% CI: 2.68-14.90). Adding AFs provided no further prognostic improvement.</p><p><strong>Data conclusion: </strong>LI-RADS Radiation TRA v2024 demonstrates strong prognostic stratification after SBRT, particularly at late-term MRI evaluation.</p><p><strong>Evidence level: </strong>3.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716940","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":"Comparison of Diagnostic Performance Between Standard Susceptibility Map-Weighted Imaging and Susceptibility Map-Weighted Imaging Reconstructed From Clinical SWI and Neuromelanin MRI in Early Parkinson's Disease.","authors":"Seon Lee, Yongsik Sim, Jinyoung Youn, Eung Yeop Kim, Seung Hwan Moon, Sun-Young Baek, Beomseok Sohn","doi":"10.1002/jmri.70332","DOIUrl":"https://doi.org/10.1002/jmri.70332","url":null,"abstract":"<p><strong>Background: </strong>Susceptibility map-weighted imaging (SMwI) provides high accuracy for early Parkinson's disease (ePD) by enhancing nigral hyperintensity. However, standard SMwI requires dedicated acquisition; reconstruction from routinely acquired sequences may offer a practical alternative.</p><p><strong>Purpose: </strong>To compare the diagnostic performance of standard SMwI with SWI- and neuromelanin (NM)-driven SMwI for differentiating ePD from disease controls (DC).</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Subjects: </strong>One hundred and eighty-seven drug-naïve ePD (age: 67.5 ± 9.4 years, 102 male) and 43 DC (age: 67.1 ± 9.2 years, 12 male).</p><p><strong>Field strength/sequence: </strong>3 T, multi-echo gradient-echo (GRE) for standard SMwI; GRE-based NM imaging: multi-echo GRE for SWI.</p><p><strong>Assessment: </strong>Nigral hyperintensity was assessed by three neuroradiologists (4-, 2-, and 1-year experience). Diagnostic performance was evaluated using clinical diagnosis for all subjects and PET for 106 subjects (98 ePD, 8 DC). PET-based assessment included side-based analyses accounting for PET laterality and patient-based analyses regardless of direction.</p><p><strong>Statistical tests: </strong>Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and area under the curve (AUC) were assessed using clinical diagnosis as reference; sensitivity, specificity, and accuracy using PET. Significance was set at p < 0.05.</p><p><strong>Results: </strong>Using clinical diagnosis as reference, standard SMwI showed highest diagnostic performance (sensitivity 0.856; specificity 1.000; PPV 1.000; AUC 0.928). SWI-driven SMwI maintained similar sensitivity (p = 0.355) but showed significantly reduced specificity, PPV, accuracy, AUC. In the PET subgroup, side- and patient-based analyses showed no differences in sensitivity (p = 0.261, p = 0.670), specificity (p = 1.000, p = 1.000) and accuracy (p = 0.268, p = 0.695) between standard and SWI-driven SMwI.</p><p><strong>Data conclusion: </strong>SWI-driven SMwI approached the diagnostic performance of standard SMwI with PET reference but showed inferior performance with clinical diagnosis, suggesting a fallback option when dedicated SMwI is unavailable.</p><p><strong>Evidence level: </strong>3.</p><p><strong>Technical efficacy: </strong>Stage 1.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690526","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}