Radiologia MedicaPub Date : 2025-01-20DOI: 10.1007/s11547-025-01954-8
Sinan Orkut, Pierre De Marini, Alexander Sheng Ming Tan, Julien Garnon, Guillaume Koch, Thibault Tricard, Hervé Lang, Roberto Luigi Cazzato, Afshin Gangi
{"title":"Profile and methodology of ancillary protective measures employed during percutaneous renal cryoablation in a single high-volume centre.","authors":"Sinan Orkut, Pierre De Marini, Alexander Sheng Ming Tan, Julien Garnon, Guillaume Koch, Thibault Tricard, Hervé Lang, Roberto Luigi Cazzato, Afshin Gangi","doi":"10.1007/s11547-025-01954-8","DOIUrl":"https://doi.org/10.1007/s11547-025-01954-8","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the at-risk organs that require protection during percutaneous cryoablation (PCA) of renal tumours and the correlation with patient and target lesion characteristics, type of protective measure used and postoperative outcomes.</p><p><strong>Materials and methods: </strong>Single-centre retrospective review of patients with renal tumours who underwent PCA between 2008 and 2020. Final analysis included 374 tumours. Patient, tumour, and procedure technical details were extracted and analysed. At-risk organs were classified according to tumour location relative to kidney side, pyelic axis, and polar lines.</p><p><strong>Results: </strong>There were 171 (46.0%) tumours in the left kidney, and 194 (52.0%) in the right. Cryoprotection was required for 272 (272/374; 73.0%) tumours, with hydrodissection (216/374; 58.0%) being the most common technique. Protective measures were used for 82 (82/93; 88.0%) tumours in under/normal-weight patients and 143 (143/196; 73.0%) in overweight/obese ones (P = 0.004). In the left kidney, colon was the most common at-risk organ (63/171; 37.0%), followed by spleen (21/171; 12.3%), small bowel (21/171; 12.3%), ureter (19/171; 11.1%), abdominal wall (15/171; 8.8%), psoas muscle (10/171; 5.8%), and pancreas (9/171; 5.3%). In the right kidney, common at-risk organs were the colon (67/194; 35.0%), liver (50/194; 25.7%), ureter (15/194; 15.5%), diaphragm (16/194; 8.2%), abdominal wall (14/194; 7.2%), and duodenum (12/194; 6.1%). No cryoinjuries to at-risk organs occurred.</p><p><strong>Conclusion: </strong>Hydrodissection is the most common cryoprotective measure used for renal tumour PCA. Under/normal-weight patients are more likely to require cryoprotection. The colon is the most common adjacent at-risk organ requiring protection for both right- and left-sided tumours.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010637","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":"Deep learning-based MVIT-MLKA model for accurate classification of pancreatic lesions: a multicenter retrospective cohort study.","authors":"Hongfan Liao, Cheng Huang, Chunhua Liu, Jiao Zhang, Fengming Tao, Haotian Liu, Hongwei Liang, Xiaoli Hu, Yi Li, Shanxiong Chen, Yongmei Li","doi":"10.1007/s11547-025-01949-5","DOIUrl":"https://doi.org/10.1007/s11547-025-01949-5","url":null,"abstract":"<p><strong>Background: </strong>Accurate differentiation between benign and malignant pancreatic lesions is critical for effective patient management. This study aimed to develop and validate a novel deep learning network using baseline computed tomography (CT) images to predict the classification of pancreatic lesions.</p><p><strong>Methods: </strong>This retrospective study included 864 patients (422 men, 442 women) with confirmed histopathological results across three medical centers, forming a training cohort, internal testing cohort, and external validation cohort. A novel hybrid model, Multi-Scale Large Kernel Attention with Mobile Vision Transformer (MVIT-MLKA), was developed, integrating CNN and Transformer architectures to classify pancreatic lesions. The model's performance was compared with traditional machine learning methods and advanced deep learning models. We also evaluated the diagnostic accuracy of radiologists with and without the assistance of the optimal model. Model performance was assessed through discrimination, calibration, and clinical applicability.</p><p><strong>Results: </strong>The MVIT-MLKA model demonstrated superior performance in classifying pancreatic lesions, achieving an AUC of 0.974 (95% CI 0.967-0.980) in the training set, 0.935 (95% CI 0.915-0.954) in the internal testing set, and 0.924 (95% CI 0.902-0.945) in the external validation set, outperforming traditional models and other deep learning models (P < 0.05). Radiologists aided by the MVIT-MLKA model showed significant improvements in diagnostic accuracy and sensitivity compared to those without model assistance (P < 0.05). Grad-CAM visualization enhanced model interpretability by effectively highlighting key lesion areas.</p><p><strong>Conclusion: </strong>The MVIT-MLKA model efficiently differentiates between benign and malignant pancreatic lesions, surpassing traditional methods and significantly improving radiologists' diagnostic performance. The integration of this advanced deep learning model into clinical practice has the potential to reduce diagnostic errors and optimize treatment strategies.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010631","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}
Radiologia MedicaPub Date : 2025-01-15DOI: 10.1007/s11547-025-01950-y
Apurva B Challa, Monika Radike, Asim Rizvi, Nikkole M Weber, Malgorzata Wamil, Shivaram Poigai Arunachalam, Emily Sheedy, Shuai Leng, Eric E Williamson
{"title":"Interobserver and intraobserver variability among different vendors for mitral valve assessment: implications for transcatheter mitral valve repair.","authors":"Apurva B Challa, Monika Radike, Asim Rizvi, Nikkole M Weber, Malgorzata Wamil, Shivaram Poigai Arunachalam, Emily Sheedy, Shuai Leng, Eric E Williamson","doi":"10.1007/s11547-025-01950-y","DOIUrl":"https://doi.org/10.1007/s11547-025-01950-y","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-procedural imaging is critical for transcatheter mitral valve repair planning in patients with mitral valve disease. As differences among various measurement techniques for valve evaluation are still poorly understood, we sought to assess the intra- and interobserver agreement of complex measurements derived from a prototype mitral evaluation tool (Siemens) and a commercially available tool (CVI42) using both saddle- and D-shaped mitral annulus techniques.</p><p><strong>Materials and methods: </strong>Multiphasic cardiac computed tomography angiography data were loaded into each software. Three expert readers independently measured the annuli on systolic- and diastolic-phase images using both tools. Measurement agreement between the tools was assessed with t tests, with p ≤ 0.05 considered statistically significant. Intraclass correlation coefficient (ICC) was used for interobserver agreement. Bland-Altman plots were used to assess for systematic differences.</p><p><strong>Results: </strong>Ten patients (mean age: 61.9 ± 9.9 years, 70%males) were included, with either normal mitral valve (n = 5) or with primary mitral regurgitation (n = 5). The intraobserver comparison showed statistically significantly different circumference and planar surface areas only for one reader in each group. However, there was significant difference (p ≤ 0.05) between measurements for intercommissural distance, septolateral distance, and intertrigone distance. The interobserver agreement was good (ICC, 0.60-0.74) to excellent (ICC, 0.75-1.00). There were systematic differences in mitral annulus area parameters for both saddle- and D-shaped annulus.</p><p><strong>Conclusion: </strong>Both tools effectively assess mitral annulus with good-to-excellent interobserver agreement. As there were systematic differences in the annular area and distance, use of the same software should be considered in clinical and research workflows.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010634","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}
Radiologia MedicaPub Date : 2025-01-07DOI: 10.1007/s11547-024-01925-5
Fuqing Zhou, Zhizheng Zhuo, Lin Wu, Yuxin Li, Ningnannan Zhang, Xuemei Han, Chun Zeng, Lei Wang, Xiaoya Chen, Muhua Huang, Yanyan Zhu, Haiqing Li, Guanmei Cao, Jie Sun, Yongmei Li, Yunyun Duan
{"title":"Complexity of intrinsic brain activity in relapsing-remitting multiple sclerosis patients: patterns, association with structural damage, and clinical disability.","authors":"Fuqing Zhou, Zhizheng Zhuo, Lin Wu, Yuxin Li, Ningnannan Zhang, Xuemei Han, Chun Zeng, Lei Wang, Xiaoya Chen, Muhua Huang, Yanyan Zhu, Haiqing Li, Guanmei Cao, Jie Sun, Yongmei Li, Yunyun Duan","doi":"10.1007/s11547-024-01925-5","DOIUrl":"https://doi.org/10.1007/s11547-024-01925-5","url":null,"abstract":"<p><p>Functional plasticity has been demonstrated in multiple sclerosis (MS) studies. However, the intrinsic brain activity complexity alterations remain unclear. Here, using a coarse-graining time-series procedure algorithm, we obtained multiscale entropy (MSE) from a retrospective multi-centre dataset (208 relapsing-remitting MS patients and 228 healthy controls). By linear mixed model analysis, we demonstrated (1) increased entropy at scale 1 and decreased entropy at scale 6, indicating that regional brain activity shifted towards randomness in the stable MS subgroups (n = 159), and (2) decreased entropy across scales 1-6, trending towards regularity in the acute MS subgroups (n = 49). The main results of the correlation analysis included the following: (1) Decreased entropy was associated with lesion volume and brain volume specifically on longer time scales (scale 3-5), and (2) increased entropy of scale 3 was associated with clinical disability scores. These findings reflect the critical role of structural disruption in the brain activity complexity of BOLD signals in MS patients.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953996","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":"Metastasis-directed ablation of hepatocellular carcinoma with pulmonary oligometastases: a long-term multicenter study.","authors":"Qunfang Zhou, Ruixia Li, Songsong Wu, Yanyang Zhang, Wei Wang, Kangshun Zhu, Murong Wang, Zhimei Huang, Feng Duan","doi":"10.1007/s11547-024-01907-7","DOIUrl":"10.1007/s11547-024-01907-7","url":null,"abstract":"<p><strong>Purpose: </strong>Ablation is a promising approach for eliminating intrathoracic metastases. We compared the effectiveness of a combination of metastasis-directed ablation and systemic therapy with that of systemic therapy alone for patients with hepatocellular carcinoma (HCC) having pulmonary oligometastases.</p><p><strong>Materials and methods: </strong>We analyzed 679 patients with HCC and pulmonary oligometastases from seven tertiary hospitals. A total of 372 patients received systemic therapy (System group), whereas 307 patients received the combination therapy of pulmonary oligometastases ablation and systemic therapy (Ablation + System group).</p><p><strong>Results: </strong>The median progression-free survival (PFS) was 9.7 ± 0.6 and 11.5 ± 0.6 months in the System and Ablation + System groups, respectively. The Ablation + System group exhibited significantly better PFS (hazard ratio [HR], 0.71; 95% confidence interval [CI] 0.60-0.85; P < 0.001) and overall survival (OS) (HR, 0.65; 95% CI 0.52-0.81; P < 0.001) than the System group. The subgroup analysis revealed that OS (HR, 0.91; 95% CI 0.65-1.28; P = 0.590) and PFS (HR, 0.81; 95% CI 0.62-1.05; P = 0.100) did not differ between tyrosine kinase inhibitor (TKI) and TKI plus programmed cell death protein-1 (PD-1) inhibitor therapies in the Ablation + system group. In addition, PFS (HR, 0.53; 95% CI 0.38-0.74; P < 0.001) and OS (HR, 0.66; 95% CI 52-0.84; P < 0.001) showed obviously different for intrahepatic tumors with partial response (PR) status.</p><p><strong>Conclusion: </strong>The application of a combination of ablation of pulmonary oligometastases and systemic therapy resulted in longer PFS and OS than systemic therapy alone.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"25-36"},"PeriodicalIF":9.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626992","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 detection of high-level axillary lymph node metastasis after neoadjuvant therapy in breast cancer patients with nodal involvement: a combined approach of axilla ultrasound and breast elastography.","authors":"Jia-Xin Huang, Feng-Tao Liu, Yu-Ting Tan, Xue-Yan Wang, Jia-Hui Huang, Shi-Yang Lin, Gui-Ling Huang, Yu-Ting Zhang, Xiao-Qing Pei","doi":"10.1007/s11547-024-01936-2","DOIUrl":"10.1007/s11547-024-01936-2","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a combined approach using shear wave elastography (SWE) and conventional ultrasound (US) to determine the extent of positive axillary lymph nodes (LNs) following neoadjuvant therapy (NAT) in breast cancer patients with nodal involvement.</p><p><strong>Methods: </strong>This prospective, multicenter study was registered on the Chinese Clinical Trial Registry (ChiCTR2400085035). From October 2018 to February 2024, a total of 303 breast cancer patients with biopsy-proven positive LN were enrolled. The conventional US features of axillary LNs and SWE characteristics of breast lesions after NAT were analyzed. The diagnostic performances of axilla US, breast SWE, and their combination in detecting residual metastasis in axillary level III after NAT were assessed.</p><p><strong>Results: </strong>Pathologically positive LN(s) in axilla level III were detected in 13.75% of cases following NAT. The kappa value for the axilla level with positive LN confirmed by surgical pathology and detected by US is 0.39 (p < 0.001). The AUC of conventional axilla US to determine the status of axilla level III LNs after NAT was 0.67, with a sensitivity of 51.52%, a specificity of 74.36%. The breast SWE displayed moderate performance for detecting residual metastasis in axilla level III following NAT, with an AUC of 0.79, sensitivity of 84.85%, and specificity of 74.36%. Compared to axilla US and breast SWE alone, the combination of axilla US with breast SWE achieved a stronger discriminatory ability (AUC, 0.86 vs 0.67 vs 0.79, p < 0.05, Delong's test) and precise calibration (X<sup>2</sup> = 13.90, p = 0.085, HL test), with an improved sensitivity of 93.94% and a comparable specificity of 75.64%%.</p><p><strong>Conclusions: </strong>SWE outperformed conventional US in identifying the axilla levels with nodal metastasis following NAT in patients with initially diagnosed positive axilla. Furthermore, combining breast SWE with axilla US showed good diagnostic performance for detecting residual metastasis in axilla level III after NAT.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"121-131"},"PeriodicalIF":9.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radiologia MedicaPub Date : 2025-01-01Epub Date: 2024-11-18DOI: 10.1007/s11547-024-01924-6
So Yeong Jeong, Jung Hwan Baek
{"title":"Long-term clinical outcomes of thermal ablation for benign thyroid nodules and unresolved issues: a comprehensive systematic review.","authors":"So Yeong Jeong, Jung Hwan Baek","doi":"10.1007/s11547-024-01924-6","DOIUrl":"10.1007/s11547-024-01924-6","url":null,"abstract":"<p><p>Thermal ablation is widely accepted as an effective and safe method for treating benign thyroid nodules. Many studies reporting short-term results have consistently demonstrated the efficacy and safety of thermal ablation. However, as the clinical application of thermal ablation grows and follow-up periods extend, long-term clinical outcomes of thermal ablation have revealed several issues, including regrowth and diagnosis of malignancy in ablated lesions. In this systematic review, we analyze the long-term clinical outcomes of thyroid thermal ablation, focusing on regrowth, delayed surgery, and the potential for malignancy after thermal ablation and propose solutions to address these unresolved issues and enhance the management of benign thyroid nodules through thermal ablation.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"111-120"},"PeriodicalIF":9.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669059","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}
Radiologia MedicaPub Date : 2025-01-01Epub Date: 2024-11-14DOI: 10.1007/s11547-024-01919-3
Tianchen Luo, Meng Yan, Meng Zhou, Andre Dekker, Ane L Appelt, Yongling Ji, Ji Zhu, Dirk de Ruysscher, Leonard Wee, Lujun Zhao, Zhen Zhang
{"title":"Improved prognostication of overall survival after radiotherapy in lung cancer patients by an interpretable machine learning model integrating lung and tumor radiomics and clinical parameters.","authors":"Tianchen Luo, Meng Yan, Meng Zhou, Andre Dekker, Ane L Appelt, Yongling Ji, Ji Zhu, Dirk de Ruysscher, Leonard Wee, Lujun Zhao, Zhen Zhang","doi":"10.1007/s11547-024-01919-3","DOIUrl":"10.1007/s11547-024-01919-3","url":null,"abstract":"<p><strong>Background: </strong>Accurate prognostication of overall survival (OS) for non-small cell lung cancer (NSCLC) patients receiving definitive radiotherapy (RT) is crucial for developing personalized treatment strategies. This study aims to construct an interpretable prognostic model that combines radiomic features extracted from normal lung and from primary tumor with clinical parameters. Our model aimed to clarify the complex, nonlinear interactions between these variables and enhance prognostic accuracy.</p><p><strong>Methods: </strong>We included 661 stage III NSCLC patients from three multi-national datasets: a training set (N = 349), test-set-1 (N = 229), and test-set-2 (N = 83), all undergoing definitive RT. A total of 104 distinct radiomic features were separately extracted from the regions of interest in the lung and the tumor. We developed four predictive models using eXtreme gradient boosting and selected the top 10 features based on the Shapley additive explanations (SHAP) values. These models were the tumor radiomic model (Model-T), lung radiomic model (Model-L), a combined radiomic model (Model-LT), and an integrated model incorporating clinical parameters (Model-LTC). Model performance was evaluated through Harrell's concordance index, Kaplan-Meier survival curves, time-dependent area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. Interpretability was assessed using the SHAP framework.</p><p><strong>Results: </strong>Model-LTC exhibited superior performance, with notable predictive accuracy (C-index: training set, 0.87; test-set-2, 0.76) and time-dependent AUC above 0.75. Complex nonlinear relationships and interactions were evident among the model's variables.</p><p><strong>Conclusion: </strong>The integration of radiomic and clinical factors within an interpretable framework significantly improved OS prediction. The SHAP analysis provided insightful interpretability, enhancing the model's clinical applicability and potential for aiding personalized treatment decisions.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"96-109"},"PeriodicalIF":9.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626984","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":"Prediction of tumor response to neoadjuvant chemotherapy in high-grade osteosarcoma using clustering-based analysis of magnetic resonance imaging: an exploratory study.","authors":"Giovanni Benvenuti, Simona Marzi, Antonello Vidiri, Jacopo Baldi, Serena Ceddia, Federica Riva, Renato Covello, Irene Terrenato, Vincenzo Anelli","doi":"10.1007/s11547-024-01921-9","DOIUrl":"10.1007/s11547-024-01921-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the ability of magnetic resonance imaging (MRI)-based clustering analysis to predict the pathological response to neoadjuvant chemotherapy (NACT) in patients with primary high-grade osteosarcoma.</p><p><strong>Materials and methods: </strong>Twenty-two patients were included in this retrospective study. All patients underwent MRIs before and after NACT. The entire tumor volume was manually delineated on post-contrast T1-weighted images and subsegmented into three clusters using the K-means algorithm. Histogram-based parameters were calculated for each lesion. The response to NACT was obtained from the histopathological assessment of the tumor necrosis rate following resection. The Mann-Whitney test was used to compare poor and fair-to-good responders. The receiver operating characteristic curve was used to evaluate the diagnostic performance of the optimal parameters.</p><p><strong>Results: </strong>At baseline, poor responders showed a significantly larger volume of cluster1 (Vol1) than fair-to-good responders (p = 0.038). After NACT, they exhibited a lower 10th percentile (P10) and kurtosis (p = 0.038 and 0.002, respectively). Vol1 at baseline and P10 after NACT had an AUC of 77% (95% CI 56-98%). The kurtosis after NACT had the best discriminative power, with an AUC of 89.7% (95% CI 75-100%).</p><p><strong>Conclusion: </strong>The MRI-based histogram and clustering analysis provided a good ability to differentiate between poor and fair-to-good responders before and after NACT. Further investigations using larger datasets are required to corroborate our findings.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"13-24"},"PeriodicalIF":9.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626995","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}