Radiologia Medica最新文献

{"title":"Advanced radiomic prediction of osteoporosis in primary hyperparathyroidism: a machine learning-based analysis of CT images.","authors":"Antonio Adarve-Castro, Virginia Soria-Utrilla, José Miguel Castro-García, María Dolores Domínguez-Pinos, Francisco Sendra-Portero, Miguel J Ruiz-Gómez, José Algarra-García","doi":"10.1007/s11547-025-02004-z","DOIUrl":"https://doi.org/10.1007/s11547-025-02004-z","url":null,"abstract":"<p><p>This study aims to assess the proficiency of supervised machine learning techniques in discriminating between normal and abnormal bone mineral density (BMD) by leveraging clinical features and texture analysis of spinal bone tissue in patients diagnosed with primary hyperparathyroidism (PHP). From a total of 219 patients diagnosed with PHP, the 58 who had undergone both DXA and abdominal CT scan were included in this study. BMD was assessed by quantifying the Hounsfield units (HU) and performing texture analysis on every CT scan. The first lumbar vertebral body texture features were extracted by using LifeX 7.3.0 software. Initial classification into normal or abnormal BMD was performed with different machine learning techniques by training a model with the variables obtained from the texture analysis. Differentiating osteopenia from osteoporosis was evaluated by creating two models, one including the variables obtained from the texture analysis and HU and another one which only included the HU. Their performance was evaluated in the validation and test groups by calculating the accuracy, precision, recall, F1 score, and AUC. Bayes demonstrated higher performance for discerning individuals with normal and abnormal BMD, with an AUC of 0.916. The results from the second analysis showed a better performance for the model including the variables obtained from the texture analysis compared to the model that was solely trained with the HU (AUC in the training group of 0.77 vs. 0.65 in the test groups, respectively). In conclusion, analysis of BMD obtained from abdominal CT scans including texture analysis provide a better classification of normal density, osteopenia and osteoporosis in patients with PHP.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple cystic lesions of the pancreas: image quality and diagnostic accuracy of photon-counting detector computed tomography.","authors":"Stephan Rau, Thomas Stein, Alexander Rau, Caroline Wilpert, Fabian Pallasch, Balazs Bogner, Sebastian Faby, Fabian Bamberg, Jakob Weiss","doi":"10.1007/s11547-025-02015-w","DOIUrl":"https://doi.org/10.1007/s11547-025-02015-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate image quality and diagnostic accuracy of photon-counting detector (PCD) CT for the detection of pancreatic cystic lesions (PCLs) compared to energy-integrating detector (EID) CT with MRI serving as reference standard.</p><p><strong>Material and methods: </strong>We included consecutive patients who underwent contrast-enhanced PCD-CT of the abdomen and for whom an additional abdominal EID-CT was available. Multiparametric MRI served as the reference standard. CT images were assessed for the presence of PCLs by three radiologists independently in a blinded reading. Image quality, lesion conspicuity, and diagnostic confidence were rated on a 5-point Likert scale (5 = excellent). The coefficient of variation (CV) and the density difference between PCLs and visually normal pancreatic parenchyma were calculated as quantitative imaging measures. Radiation dose was assessed using CTDIvol [mGy].</p><p><strong>Results: </strong>Among 106 included patients (age 62.7 ± 12.6 years; 45 [42.5%] male), 46 had MRI-confirmed cystic lesions (mean size 8.7 ± 7.4 mm; range 2-45 mm). Diagnostic accuracy for PCLs was significantly higher for PCD-CT vs. EID-CT (area under the curve: 0.81 vs. 0.74; p = 0.002; sensitivity: 76.8% vs. 59.4%). Image quality, lesion conspicuity, and diagnostic confidence were rated superior for PCD-CT vs. EID-CT (all p < 0.001). Quantitative analyses revealed a significantly lower CV (0.19 vs. 0.24; p = 0.002) and a higher density difference (94.1 HU vs. 76.6 HU p < 0.001) between PCLs and visually normal pancreatic parenchyma at lower radiation doses (7.13 vs. 8.68 mGy; p < 0.001) for PCD-CT vs. EID-CT.</p><p><strong>Conclusion: </strong>PCD-CT provided significantly higher diagnostic accuracy and superior image quality for the detection of PCLs compared to conventional EID-CT at lower radiation dose.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic role of 2-[¹⁸F]FDG PET/CT in critically ill patients with suspected infection of unknown origin: a real-world experience.","authors":"Domenico Albano, Carlo Rodella, Anna Calabrò, Andor W J M Glaudemans, Giorgio Treglia, Francesco Bertagna","doi":"10.1007/s11547-025-02005-y","DOIUrl":"https://doi.org/10.1007/s11547-025-02005-y","url":null,"abstract":"<p><strong>Purpose: </strong>2-Deoxy-2-[¹⁸F]-fluoro-D-glucose (2-[¹⁸F]FDG) positron emission tomography/computed tomography (PET/CT) is a hybrid imaging tool with an emerging role in the study of several infectious and inflammatory diseases. Its role in critically ill patients admitted to the intensive care unit (ICU) is only marginally investigated. This study aimed to investigate the diagnostic performance and the clinical impact of 2-[¹⁸F]FDG PET/CT in the management of critically ill patients with suspected infections of unknown origin.</p><p><strong>Methods: </strong>We retrospectively included 47 ICU patients (mean age 63.6 years, 33 males) who underwent a 2-[¹⁸F]FDG PET/CT to look for infection foci. We calculated the diagnostic performance of PET/CT expressed as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. As reference standard, final diagnosis based on microbiological/pathologic data or on clinical follow-up was taken. Moreover, we investigated the impact of PET/CT on clinical management and the association of PET/CT with the main clinical, epidemiological and biochemical parameters.</p><p><strong>Results: </strong>The overall 2-[¹⁸F]FDG PET/CT sensitivity in detecting infectious foci was 80% (95%CI 64-91%), specificity 75% (95%CI 35-97%), PPV 94% (95%CI 83-93%), NPV 43% (95%CI 26-61%) and accuracy 79% (95%CI 65-90%). The absence of kidney failure, increase leukocyte count and low glucose level at the time of PET were significantly associated with true positive PET/CT. No adverse events during the transport and PET/CT procedure were registered.</p><p><strong>Conclusion: </strong>PET/CT demonstrated to be an accurate toll for the study of critically ill ICU patients with suspected infections. Kidney failure, leukocyte count and blood glucose were associated with true positive PET/CT.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First clinical application of Comprehensive Motion Management with 1.5T MR-linac on prostate cancer patients treated with radiotherapy: technical aspects and suggested workflow recommendations.","authors":"Luca Nicosia, Michele Rigo, Roberto Giuseppe Pellegrini, Andrea Gaetano Allegra, Chiara De-Colle, Niccolò Giaj-Levra, Edoardo Pastorello, Francesco Ricchetti, Ruggero Ruggieri, Filippo Alongi","doi":"10.1007/s11547-025-02014-x","DOIUrl":"https://doi.org/10.1007/s11547-025-02014-x","url":null,"abstract":"<p><strong>Purpose: </strong>MR-guided radiotherapy (MRgRT) on the MR-linac (MRL) with daily online plan adaptation enables better control of inter-fraction variability. Recently, Comprehensive Motion Management (CMM) was introduced for the 1.5T MRL. CMM halts dose delivery when the target moves outside its defined position and allows for target drift corrections, compensating for intra-fraction variability. This study aims to report the first clinical experience with prostate MRgRT using CMM, focusing on intra-fraction motion management and treatment delivery time.</p><p><strong>Material and methods: </strong>Sixty patients with low- to intermediate-risk prostate cancer were treated with the 1.5T MRL using CMM. PTV margins were 5 mm in all directions, with a 3-mm margin posteriorly. Fifty patients received ultra-hypofractionated radiotherapy (SBRT), and 10 received hypofractionated radiotherapy (hypoRT). The CMM threshold was set to 100% of the GTV volume.</p><p><strong>Results: </strong>A total of 450 treatment fractions were administered. The median beam-on time was 10.3 min, with a median duty cycle of 98.9% (95% CI 98.6-99.2%). Beam hold occurred in 158 fractions (35%), with an average of 24.5 instances per fraction (95% CI 16-32). Thirty-two baseline shift replans were performed. Both acute and late toxicities were low, with no Grade 3 or higher toxicities.</p><p><strong>Conclusions: </strong>CMM has been successfully implemented in MRgRT. In-treatment corrections and baseline shift replanning did not significantly impact treatment time, enhancing treatment quality without compromising patient compliance or treatment feasibility. The low incidence of beam-hold events suggests that CMM could potentially allow for a safe reduction in PTV margins.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transarterial embolization for acute lower gastrointestinal bleeding: a retrospective bicentric study.","authors":"Francesco Tiralongo, Daniele Perini, Luca Crimi, Makoto Taninokuchi Tomassoni, Lorenzo Braccischi, Davide Giuseppe Castiglione, Francesco Modestino, Francesco Vacirca, Daniele Falsaperla, Federica Maria Rosaria Libra, Stefano Palmucci, Pietro Valerio Foti, Francesco Lionetti, Cristina Mosconi, Antonio Basile","doi":"10.1007/s11547-025-02012-z","DOIUrl":"10.1007/s11547-025-02012-z","url":null,"abstract":"<p><p>Transcatheter arterial embolization (TAE) represents an effective treatment option for acute lower gastrointestinal bleeding (LGIB). This retrospective, bicentric study evaluated the safety and efficacy of TAE in 77 patients with LGIB. The mean patient age was 68.39 ± 17.54 years, and the mean pre-procedural hemoglobin was 7.87 ± 1.89 g/dL. The most common cause of LGIB was angiodysplasia (36.2%). Pre-procedural computed tomography angiography (CTA) detected active bleeding in 83% of cases. Technical success was achieved in 98.7% of patients, and 30-day clinical success was achieved in 87%. The rebleeding rate was 13%, and the ischemic complication rate was 11.7%. There were no significant associations between clinical success and sex, age, coagulopathy, first-line management, active bleeding signs, culprit vessel, superior mesenteric artery, or time between CTA and digital subtraction angiography. TAE is a safe and effective procedure for LGIB, with high technical and acceptable clinical success rates. It should be considered a standard procedure in select patients, especially when endoscopic treatment is contraindicated or not feasible.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 a fully automated AI algorithm for lesion detection and PI-RADS classification in patients with suspected prostate cancer.","authors":"Hannes Engel, Andrea Nedelcu, Robert Grimm, Heinrich von Busch, August Sigle, Tobias Krauss, Christopher L Schlett, Jakob Weiss, Matthias Benndorf, Benedict Oerther","doi":"10.1007/s11547-025-02003-0","DOIUrl":"https://doi.org/10.1007/s11547-025-02003-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of a fully automated, commercially available AI algorithm for detecting prostate cancer and classifying lesions according to PI-RADS.</p><p><strong>Material and methods: </strong>In this retrospective single-center cohort study, we included consecutive patients with suspected prostate cancer who underwent 3T MRI between May 2017 and May 2020. Histopathological ground truth was targeted transperineal ultrasound-fusion guided biopsy and extensive systematic biopsy. We compared the results of the AI algorithm to those of human readers on both the lesion and patient level and determined the diagnostic performance.</p><p><strong>Results: </strong>A total of 272 patients with 436 target lesions were evaluated. Of these patients, 135 (49.6%) had clinically significant prostate cancer (sPCa), 35 (12.9%) had clinically insignificant prostate cancer (ISUP = 1), and 102 (37.5%) were benign. On patient level, the cancer detection rates of sPCa for AI versus human readers were 11% versus 18% for PI-RADS ≤ 2, 27% versus 11% for PI-RADS 3, 54% versus 41% for PI-RADS 4, and 74% versus 92% for PI-RADS 5. The AI showed significantly higher accuracy: 74% versus 63% for PI-RADS ≥ 4 (p < 0.01) and 70% versus 52% for PI-RADS ≥ 3 (p < 0.01). Additionally, the AI correctly classified 62 patients with human reading PI-RADS ≥ 3 as true negatives.</p><p><strong>Conclusion: </strong>The AI algorithm proved to be a reliable and robust tool for lesion detection and classification. Its cancer detection rates and PI-RADS category distribution align with the results of recent meta-analyses, indicating precise risk stratification.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing hepatocellular carcinoma diagnosis in non-high-risk patients: a customized ChatGPT model integrating contrast-enhanced ultrasound.","authors":"Meng-Fei Xian, Wen-Tong Lan, Zhe Zhang, Ming-De Li, Xin-Xin Lin, Yang Huang, Hui Huang, Li-Da Chen, Qing-Hua Huang, Wei Wang","doi":"10.1007/s11547-025-01994-0","DOIUrl":"https://doi.org/10.1007/s11547-025-01994-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to improve hepatocellular carcinoma (HCC) diagnostic accuracy in non-high-risk populations by utilizing GPTs that incorporate integrated risk coefficients, and to explore its feasibility.</p><p><strong>Material and methods: </strong>Between August 2016 and June 2019, patients with focal liver lesions (FLLs) in non-high-risk populations, confirmed by histopathology or clinical/imaging evidence, were retrospectively included. A logistic regression model was developed using baseline characteristics and contrast-enhanced ultrasound (CEUS) features to identify independent HCC risk factors. Three ChatGPT-based models were evaluated: ChatGPT 4o (a general-purpose model developed by OpenAI), BaseGPT (a customized model with HCC diagnostic knowledge), and RiskGPT (a further customized model integrating HCC knowledge and identified risk factors). Their intra-agreement and diagnostic performance were compared.</p><p><strong>Results: </strong>Logistic regression identified male, obesity, HBcAb or HBeAb positivity, elevated alpha-fetoprotein, and mild washout on CEUS as associated with HCC. RiskGPT achieved the highest area under a receiver operating characteristic curve (AUC) (0.89) and demonstrated superior accuracy (90.3%) in HCC identification; significantly outperforming both ChatGPT 4o (AUC 0.79, P = 0.002; accuracy 83.1%, P = 0.02) and BaseGPT (AUC 0.81, P = 0.008; accuracy 80.6%, P = 0.002). RiskGPT demonstrated superior sensitivity compared to ChatGPT 4o (85.5% vs. 66.3%) and outperformed BaseGPT in specificity (92.7% vs. 80.6%) and positive predictive value (85.5% vs. 67.7%) (all P < 0.001). Additionally, RiskGPT showed substantial intra-consistency in diagnosing FLLs, with a κ value of 0.78.</p><p><strong>Conclusion: </strong>RiskGPT improves HCC diagnostic accuracy in non-high-risk patients by integrating clinical, imaging features, and risk coefficients, demonstrating significant diagnostic potential.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of gravitational effects and pre-puncture techniques in reducing pneumothorax during CT-guided lung biopsies.","authors":"Michael P Brönnimann, Maria C Barroso, Leonie Manser, Bernhard Gebauer, Timo A Auer, Federico Collettini, Patrick Dorn, Adrian T Huber, Johannes T Heverhagen, Martin H Maurer","doi":"10.1007/s11547-025-02007-w","DOIUrl":"https://doi.org/10.1007/s11547-025-02007-w","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate whether the relative height (RH) of the entry point (EP) during CT-guided lung biopsies, adjusted for patient positioning, can predict the risk of pneumothorax during the intervention, leveraging the gravitational effects on pleural pressure.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 128 percutaneous CT-guided lung biopsies performed at a single center between January 2018 and December 2023. Patients were grouped based on pneumothorax occurrence. Various measurement methods indirectly assessed the influence of gravitational force on pleural pressure, focusing on the RH at the EP with prone positioning adjustments (PP). Other confounding factors like patient demographics, lesion characteristics, pre-puncture fluid administration and other procedural details were assessed. Test performance metrics were compared using Chi-Square, Fisher's exact, and Mann-Whitney U tests. Univariate and binomial logistic regression assessed the influence of different parameters on pneumothorax occurrence.</p><p><strong>Results: </strong>All measurements of lower RH at EP and pre-puncture fluid administration were significantly associated with a reduced incidence of peri-interventional pneumothorax (p < 0.01). The RH at EP adjusted for the prone position demonstrated the best predictive performance (AUC = 0.844). After adjusting for various confounding factors, both lower RH at EP adjusted for the prone position (OR 110.114, p < 0.001) and pleural fluid administration (OR 0.011, p = 0.011) remained independently associated with a lower risk of pneumothorax.</p><p><strong>Conclusion: </strong>Strategic use of gravity by selecting the lowest possible entry point, ideally positioning the patient laterally, combined with pre-puncture pleural fluid administration, could be the key to reducing pneumothorax in CT-guided lung biopsies.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric ¹⁸F-FDG PET/MRI based on restrictive spectrum imaging and amide proton transfer-weighted imaging facilitates the assessment of lymph node metastases in non-small cell lung cancer.","authors":"Nan Meng, Xue Liu, Yihang Zhou, Xuan Yu, Yaping Wu, Fangfang Fu, Jianmin Yuan, Yang Yang, Zhe Wang, Meiyun Wang","doi":"10.1007/s11547-025-01992-2","DOIUrl":"https://doi.org/10.1007/s11547-025-01992-2","url":null,"abstract":"<p><strong>Background: </strong>To investigate the value of multiparametric ¹⁸F-FDG PET/MRI based on tri-compartmental restrictive spectrum imaging (RSI), amide proton transfer-weighted imaging (APTWI), and diffusion-weighted imaging (DWI) in the assessment of lymph node metastasis (LNM) of non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>A total of 152 patients (LNM-positive, 86 cases; LNM-negative, 66 cases) with NSCLC underwent chest multiparametric ¹⁸F-FDG PET/MRI were enrolled. ¹⁸F-FDG PET- derived parameter (SUV_max), RSI-derived parameters (f₁, f₂, and f₃), APTWI-derived parameter (MTRasym(3.5 ppm)), DWI-derived parameter (ADC), and were calculated and compared. Logistic regression analysis was used to identify independent predictors, and combined diagnostics. Area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analysis (DCA) were employed to assess the performance of the combined diagnostics.</p><p><strong>Results: </strong>MTRasym(3.5 ppm), SUV_max, f₂, and f₃ were higher and ADC and f₁ were lower in LNM-positive group than in LNM-negative group (all P < 0.05). Maximum lesion diameter, f₁, MTRasym(3.5 ppm), SUV_max, and ADC were independent predictors of LNM status in NSCLC patients, and the combination of them had an optimal diagnostic efficacy (AUC = 0.978; sensitivity = 95.35%; specificity = 90.91%), which was significantly higher than maximum lesion diameter, f₁, MTRasym(3.5 ppm), SUV_max, and ADC (AUC = 0.774, 0.810, 0.832, 0.834, and 0.783, respectively, and all P < 0.01). The combined diagnosis showed a good performance (AUC = 0.968) in the bootstrap (1000 samples)-based internal validation. Calibration curves and DCA demonstrated that the combined diagnosis not only provided better stability, but also resulted in a higher net benefit for the patients involved.</p><p><strong>Conclusion: </strong>Multiparametric ¹⁸F-FDG PET/MRI based on RSI, APTWI, and DWI is beneficial for the non-invasive assessment of LNM status in NSCLC.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of progressive pulmonary fibrosis by visual scoring of HRCT images: recommendations from Italian chest radiology experts.","authors":"Elisa Baratella, Andrea Borghesi, Lucio Calandriello, Giancarlo Cortese, Giovanni Della Casa, Chiara Giraudo, Emanuele Grassedonio, Anna Rita Larici, Stefano Palmucci, Chiara Romei, Ubaldo Romeo Plastina, Nicola Sverzellati","doi":"10.1007/s11547-025-01985-1","DOIUrl":"https://doi.org/10.1007/s11547-025-01985-1","url":null,"abstract":"<p><p>Interstitial lung diseases (ILD) constitute a large and heterogeneous group of disorders affecting the lung parenchyma. While idiopathic pulmonary fibrosis (IPF), the most common type of ILD, is the prototype of progressive fibrosis, other forms, collectively termed \"progressive pulmonary fibrosis\" (PPF), can show a similar clinical course. Detecting chronic fibrosing ILD progression necessitates radiological evidence using high-resolution computed tomography (HRCT), which determines eligibility for treatment. However, assessing the extent of fibrosis and progression on HRCT images is difficult and lacks specific guidelines. Therefore, expert oversight and high-quality visual assessment/scoring of complex disease patterns is essential to monitor disease changes. Twelve Italian chest radiologists deliberated on the current state of quantifying lung fibrosis using existing literature to develop practice-oriented consensus statements to assist radiologists in visually assessing/scoring lung fibrosis on HRCT images in patients with PPF. The resulting statements cover three key areas: (1) technical requirements necessary for accurate HRCT image assessment; (2) an easy-to-use quantification protocol for routine clinical practice; and (3) a multiple specialist approach by combining radiological, clinical, and histopathological findings for the correct diagnosis, prompt detection of PPF, and timely start of antifibrotic treatment. In future, automated quantitative HRCT evaluation will lead to new clinical assessment tools.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}