Radiology最新文献

{"title":"Recent Advances in Compact Portable Platforms and Gradient Hardware for Brain MRI.","authors":"Kuan Zhang, Ali Ganjizadeh, Sanaz Vahdati, John Huston, Matt A Bernstein, Bradley J Erickson, Yunhong Shu","doi":"10.1148/radiol.241904","DOIUrl":"https://doi.org/10.1148/radiol.241904","url":null,"abstract":"<p><p>While pivotal in modern radiology for brain imaging, conventional whole-body MRI scanners face challenges related to their size, cost, and technical limitations, restricting accessibility for a wide range of patients. This article explores recent advances aiming to address these issues, with a focus on compact MRI scanners, portable low-field-strength MRI systems, and high-performance gradient inserts. Compact MRI scanners, specifically those at field strengths ranging from 0.5 to 7 T, in contrast to their whole-body counterparts, improve gradient performance and simplify installation. These compact scanners are typically fixed systems designed for cost reduction, space saving, and easy siting while also requiring much less cryogen yet supporting the use of high-performance gradients. Portable low-field-strength MRI systems (<0.5 T) provide flexible and cost-effective on-site imaging solutions. These portable systems are designed for mobility and increased accessibility, albeit with some quality trade-offs. All these compact scanners and portable systems have smaller physical footprints than conventional scanners due to reduced magnet size and bore width. Many are designed mainly for brain imaging. High-performance gradient inserts enhance existing MRI systems by providing superior spatial resolution or imaging speed, crucial for advanced neuroimaging. These innovations collectively promise to make MRI more accessible or versatile, transforming radiology practices across diverse clinical settings.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e241904"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258902","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":"Contributing to Carrying LI-RADS Onward.","authors":"Sarah Johnson","doi":"10.1148/radiol.251498","DOIUrl":"https://doi.org/10.1148/radiol.251498","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e251498"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258895","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":"Evolution of Subclinical Carotid Atherosclerotic Plaque Composition Using Serial MRI in the Rotterdam Study.","authors":"Luoshiyuan Zuo, Maryam Kavousi, Hyunho Mo, Meike W Vernooij, Daniel Bos","doi":"10.1148/radiol.242248","DOIUrl":"https://doi.org/10.1148/radiol.242248","url":null,"abstract":"<p><p>Background The co-occurrence of carotid plaque components within the same plaque could be a determinant of subclinical plaque evolution, which has largely been ignored. Purpose To investigate associations between pre-existing plaque compositions and new components within the same subclinical carotid plaque and describe the evolution of plaque compositions, focusing on age- and sex-specific patterns. Materials and Methods This prospective study, embedded within the Rotterdam Study, included participants aged 45 years and over with carotid intima-media thickness greater than 2.5 mm and two MRI examinations at baseline (October 2007 to November 2012) and 6-year follow-up (August 2014 to May 2017). All MRI examinations were performed at the Rotterdam Study research center on the same scanner. Plaque components, including calcification, intraplaque hemorrhage (IPH), and lipid-rich necrotic core, were evaluated by designated radiologists. To examine associations of baseline plaque compositions (combinations of individual components) with incident new components, generalized estimating equations were used to model longitudinal cluster data, calculate odds ratios (ORs) and 95% CIs, and adjust for confounders. Age-specific probabilities of changes in plaque compositions during follow-up were calculated, and a 30-year evolution of plaque compositions was simulated based on the Chapman-Kolmogorov equation. Results In total, 802 participants were included (mean age, 68.5 years ± 8.2 [SD]; 461 male), with only 2.9% of plaques (43 of 1460) having carotid stenosis exceeding 50%. Carotid plaques with calcification were independently associated with a higher incidence of IPH (adjusted OR, 2.00 [95% CI: 1.26, 3.16]; <i>P</i> = .003). In the simulated plaque evolution, multicomponent plaques represented 10% at age 55 years and increased to over 50% after age 70 years. Compared with women, men were more likely to have plaques with no component or a single component evolve to multicomponent plaques with IPH (men, 21% [116 of 558]; women, 13% [61 of 468]; <i>P</i> < .001). Conclusion Subclinical carotid plaques with pre-existing calcification are more likely to evolve into IPH than calcification-free plaques. Most subclinical carotid plaques progressed to multicomponent plaques in the simulated 30-year continuous plaque evolution, and men are more likely to develop multicomponent plaques with IPH. © RSNA, 2025 <i>Supplemental material is available for this article.</i></p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e242248"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209338","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":"Cumulative Effect of Targeted Interventions on Radiologist Recommendations for Additional Imaging.","authors":"Nooshin Abbasi, Neena Kapoor, Ronilda Lacson, Jeffrey P Guenette, Sonali Desai, David Lucier, Sanjay Saini, Rachel Sisodia, Ali S Raja, David W Bates, Ramin Khorasani","doi":"10.1148/radiol.243750","DOIUrl":"https://doi.org/10.1148/radiol.243750","url":null,"abstract":"<p><p>Background Ambiguous or unnecessary radiologist recommendations for additional imaging (RAIs) can lead to excessive imaging use and diagnostic errors. Purpose To determine the cumulative impacts of multifaceted technology-enabled interventions aimed at optimizing RAI on RAI rate, actionability, and resolution over an 8-year period. Materials and Methods In this retrospective cohort study, conducted from January 2015 to December 2022, radiology reports from two tertiary hospitals (study site and control site) were analyzed. A series of quality improvement interventions, including radiologist education, electronic communication tools for tracking RAIs, and performance reports, were implemented at the study site but not at the control site. The RAI rate trend over time was compared between the sites using linear regression. Mixed-effects logistic regression was performed to assess the intervention impact on the RAI rate. RAI actionability and resolution were compared between the sites using the Fisher exact test. <i>P</i> values were corrected using the Bonferroni method. Results Among 7 502 521 total radiology reports (1 323 459 patients) (study site, 3 608 977 reports and 660 051 patients; control site, 3 893 544 reports and 690 115 patients), the RAI rate of the study site decreased by 44%, from 10% (8202 of 81 586) to 5.6% (8972 of 159 599), but remained unchanged at the control site, at 10.9% (8757 of 80 030) vs 11% (16 978 of 153 711) (regression coefficient, -0.09; 95% CI: -0.1, -0.09; <i>P</i> < .001). RAI rates declined with each successive intervention at the study site (<i>P</i> < .001), with regression coefficients decreasing progressively from -0.12 (95% CI: -0.14, -0.10) for the initial intervention to -0.81 (95% CI: -0.83, -0.78) for the final intervention. Recommendation actionability at the study site increased 7.6-fold (from 5.6% [19 of 340] to 42.3% [144 of 340]; <i>P</i> < .001) but remained unchanged at the control site (from 15.0% [51 of 340] to 13.8% [47 of 340]; <i>P</i> = .73). Actionable RAIs were more frequently resolved at the study site than at the control site (84.7% [122 of 144] vs 59.6% [28 of 47]; <i>P</i> < .001). Conclusion Multifaceted interventions to optimize RAI improved the rate, actionability, and resolution of RAI. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Russell in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e243750"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209337","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":"Bilateral Partial Anomalous Pulmonary Venous Return.","authors":"Limin Lei, Yuhan Zhou","doi":"10.1148/radiol.242606","DOIUrl":"https://doi.org/10.1148/radiol.242606","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e242606"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258894","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":"Cost-Effectiveness and Efficacy of Noninvasive Colorectal Cancer Screening: An Important Step Toward Widespread Adoption of CT Colonography.","authors":"Samuel J Galgano, Elainea N Smith","doi":"10.1148/radiol.251493","DOIUrl":"https://doi.org/10.1148/radiol.251493","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e251493"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258896","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":"CT Colonography versus Multitarget Stool DNA Test for Colorectal Cancer Screening: A Cost-Effectiveness Analysis.","authors":"Perry J Pickhardt, Loredana Correale, Cesare Hassan","doi":"10.1148/radiol.243775","DOIUrl":"https://doi.org/10.1148/radiol.243775","url":null,"abstract":"<p><p>Background Colorectal cancer (CRC) is largely preventable or curable with effective screening. Purpose To compare both the clinical efficacy and cost effectiveness of CRC screening with CT colonography (CTC) with those of multitarget stool DNA (mt-sDNA) testing. Materials and Methods A state-transition Markov model was constructed using updated natural history evidence for colorectal polyps applied to a hypothetical 10 000-person cohort representative of the 45-year-old U.S. population. Three screening strategies were modeled with these data: mt-sDNA testing every 3 years, the conventional CTC (CTC_conv) strategy of immediate polypectomy for all polyps measuring at least 6 mm every 5 years, and the surveillance CTC (CTC_surv) strategy of 3-year CTC follow-up for small polyps (6-9 mm) and polypectomy for large polyps (≥10 mm). Multifaceted model validation was performed to confirm robustness. A detailed sensitivity analysis was performed in addition to the base-case scenario. Results Without screening, the cumulative incidence of CRC was 7.5% (<i>n</i> = 752), which was reduced by 59% (<i>n</i> = 310) with mt-sDNA, 75% (<i>n</i> = 190) with CTC_conv, and 70% (<i>n</i> = 223) with CTC_surv screening. The estimated programmatic costs per person for no screening, mt-sDNA, CTC_conv, and CTC_surv were $4955, $6011, $4422, and $3913, respectively. The estimated cost per quality-adjusted life year (QALY) gained for mt-sDNA testing was $8878, whereas both CTC strategies resulted in cost savings. Accordingly, CTC strategies dominated over both mt-sDNA and no screening (ie, more clinically efficacious and more cost-effective [cost-saving]). However, the CTC_conv strategy was not as cost-effective as the CTC_surv strategy, as costs related to more optical colonoscopies did not offset the corresponding small gains in QALYs. The results were similar when CRC screening began at 50 and 65 years of age. Conclusion Both CTC screening strategies dominated over mt-sDNA screening and no screening, yielding cost savings and increased clinical efficacy. The CTC strategy consisting of 3-year surveillance for small colorectal polyps and colonoscopy referral for large polyps achieved the best overall balance of cost and clinical efficacy. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Galgano and Smith in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e243775"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258897","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":"Adaptive Breast MRI Scanning Using AI.","authors":"Sarah Eskreis-Winkler, Arka Bhowmik, Lori H Kelly, Roberto Lo Gullo, Donna D'Alessio, Kristin Belen, Molly P Hogan, Nicole B Saphier, Varadan Sevilimedu, Janice S Sung, Christopher E Comstock, Elizabeth J Sutton, Katja Pinker","doi":"10.1148/radiol.242924","DOIUrl":"https://doi.org/10.1148/radiol.242924","url":null,"abstract":"<p><p>Background MRI protocols typically involve many imaging sequences and often require too much time. Purpose To simulate artificial intelligence (AI)-directed stratified scanning for screening breast MRI with various triage thresholds and evaluate its diagnostic performance against that of the full breast MRI protocol. Materials and Methods This retrospective reader study included consecutive contrast-enhanced screening breast MRI examinations performed between January 2013 and January 2019 at three regional cancer sites. In this simulation study, an in-house AI tool generated a suspicion score for subtraction maximum intensity projection images during a given MRI examination, and the score was used to determine whether to proceed with the full MRI protocol or end the examination early (abbreviated breast MRI [AB-MRI] protocol). Examinations with suspicion scores under the 50th percentile were read using both the AB-MRI protocol (ie, dynamic contrast-enhanced MRI scans only) and the full MRI protocol. Diagnostic performance metrics for screening with various AI triage thresholds were compared with those for screening without AI triage. Results Of 863 women (mean age, 52 years ± 10 [SD]; 1423 MRI examinations), 51 received a cancer diagnosis within 12 months of screening. The diagnostic performance metrics for AI-directed stratified scanning that triaged 50% of examinations to AB-MRI versus full MRI protocol scanning were as follows: sensitivity, 88.2% (45 of 51; 95% CI: 79.4, 97.1) versus 86.3% (44 of 51; 95% CI: 76.8, 95.7); specificity, 80.8% (1108 of 1372; 95% CI: 78.7, 82.8) versus 81.4% (1117 of 1372; 95% CI: 79.4, 83.5); positive predictive value 3 (ie, percent of biopsies yielding cancer), 23.6% (43 of 182; 95% CI: 17.5, 29.8) versus 24.7% (42 of 170; 95% CI: 18.2, 31.2); cancer detection rate (per 1000 examinations), 31.6 (95% CI: 22.5, 40.7) versus 30.9 (95% CI: 21.9, 39.9); and interval cancer rate (per 1000 examinations), 4.2 (95% CI: 0.9, 7.6) versus 4.9 (95% CI: 1.3, 8.6). Specificity decreased by no more than 2.7 percentage points with AI triage. There were no AI-triaged examinations for which conducting the full MRI protocol would have resulted in additional cancer detection. Conclusion AI-directed stratified MRI decreased simulated scan times while maintaining diagnostic performance. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Strand in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e242924"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209334","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":"Closing the Loop: Improving Patient Care When Imaging Follow-up is Needed.","authors":"Eric J Russell","doi":"10.1148/radiol.251369","DOIUrl":"https://doi.org/10.1148/radiol.251369","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e251369"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209336","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":"Future Applications of Cardiothoracic CT.","authors":"Mark L Schiebler, Masahiro Jinzaki, Masahiro Yanagawa, Amir Pourmorteza, Yoshitake Yamada, Yoko Kato, Noriaki Wada, Cornelia Schaefer-Prokop, Vincent Dousset, Noriyuki Tomiyama, Mathias Prokop, João A Lima, Hiroto Hatabu","doi":"10.1148/radiol.240085","DOIUrl":"https://doi.org/10.1148/radiol.240085","url":null,"abstract":"<p><p>Radiologists are witnessing astonishing innovation and advancement of CT technologies and their clinical applications. This review highlights how photon-counting CT (PCCT), upright CT, and artificial intelligence (AI) may impact cardiothoracic CT applications for imaging and diagnosis. PCCT relies on new detectors that can bin the separate photon energies and allow for lower radiation dose and better spatial resolution. The clinical applications of PCCT in the coronary arteries are becoming the new standard for cardiac CT imaging. New upright CT has shown the benefits of imaging in the upright position and offers new insight into how the upright position affects biomechanics and physiology. Four-dimensional CT, which can be used to directly image perfusion, is challenging MRI and MR angiography for primacy in this area. The burgeoning role of AI and informatics is changing the way radiologists interpret and report many imaging examinations. The future is bright and promises lower radiation and intravenous contrast agent doses and higher spatial resolution, and will further incorporate deep learning to improve the effectiveness of CT.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e240085"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258899","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}