Radiology最新文献

{"title":"Stent-Assisted Angioplasty in Symptomatic Intracranial Stenosis without Adjacent Branch Atheromatous Disease: A Randomized Trial with Patients Selected by Using Three-Dimensional Rotational Angiography.","authors":"Bonaventure Y Ip,Sze Ho Ma,Wai Ting Lui,Sangqi Pan,Vincent H L Ip,Lisa Au,Anne Chan,Charlie Chan,Joseph Choi,Ho Ko,Andrew Kwok,Howard Hiu Wo Chan,Florence Fan,Karen Ma,Alexander Lau,Bonnie Lam,Jill Abrigo,Tom Cheung,Jeffrey K T Wong,Trista Hung,Xinyi Leng,Yannie Soo,Wing Chi Fong,Tak Hong Tsoi,Ping Wing Ng,Siu Hung Li,Ning Ma,Zhongrong Miao,Vincent C T Mok,Lawrence Wong,Thomas W Leung,Simon C H Yu","doi":"10.1148/radiol.243860","DOIUrl":"https://doi.org/10.1148/radiol.243860","url":null,"abstract":"Background Use of stents for symptomatic intracranial atherosclerotic stenosis (ICAS) was found to be harmful in previous randomized trials, in which perforator stroke was a notable procedural complication. It was unclear if excluding patients with concurrent branch atheromatous disease (BAD) adjacent to the target intracranial stenosis may reduce perforator jailing. Purpose To compare the safety and efficacy of intracranial stent placement (hereafter, stenting) versus medical therapy in participants with high-grade symptomatic ICAS and adjacent BAD excluded with three-dimensional rotational angiography (3DRA). Materials and Methods In this single-center, prospective, randomized, open-label, blinded end-point trial conducted in Hong Kong from 2006 to 2022, participants with transient ischemic attack (TIA) or ischemic stroke attributed to severe ICAS (70%-99%) were randomized to intracranial stenting under local anesthesia or medical therapy within 6 weeks of a qualifying event. Participants underwent 3DRA, and participants with severe BAD adjacent to the target stenosis were excluded. The primary end point was a composite of TIA, ischemic stroke, intracranial hemorrhage, and death within 30 days or any ischemic stroke from 30 days to 1 year. The secondary end points were ischemic stroke or TIA in the same artery territory (SIT), any strokes, and percentage of stenosis at 1 year. Cumulative incidences of end points were compared using Cox proportional hazard models. Results A total of 150 participants (mean age, 61 years ± 9.5 [SD], 45 female participants) were randomized into stenting (n = 74) and medical therapy (n = 76) groups. There was no evidence of between-group differences in the cumulative incidence of the primary end point (stenting vs medical therapy, respectively: 12 of 74 [16%] vs 18 of 76 [24%]; hazard ratio [HR], 0.66 [95% CI: 0.32, 1.36]; P = .26), SIT (nine of 74 [12%] vs 15 of 76 [20%]; HR, 0.59 [95% CI: 0.26, 1.35]; P = .21), or any strokes at 1 year (10 of 74 [14%] vs 17 of 76 [22%]; HR, 0.57 [95% CI: 0.27, 1.24]; P = .16). Percentage stenosis at 1 year was lower with intracranial stenting (33% ± 22 vs 67% ± 18, respectively; P < .001). Conclusion In participants with symptomatic ICAS without BAD adjacent to the target stenosis, intracranial stenting did not result in a reduction in the cumulative incidence of stroke or death at 30 days or stroke from 30 days to 1 year. Center for Clinical Research and Biostatistics Clinical Trial Registry (The Chinese University of Hong Kong)/Chinese Clinical Trials Registry Identifier: CUHK-CCT00116 Published under a CC BY 4.0 license. Supplemental material is available for this article. See also the editorial by Wojak in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"104 1","pages":"e243860"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533474","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":"Acupuncture Improves MRI Brain Microstructure with Postconcussion Symptoms in Mild TBI: A Randomized Controlled Trial.","authors":"Zhuo-Nan Wang, Jie-Rui Ding, Xuan Li, Lei Shi, Bo Yin, Guang-Hui Bai, Min Fang, Li-Xing Lao, Jie Tian, Li-Jun Bai","doi":"10.1148/radiol.250315","DOIUrl":"https://doi.org/10.1148/radiol.250315","url":null,"abstract":"<p><p>Background Mild traumatic brain injury (mTBI) accounts for 80%-90% of all traumatic brain injury cases, with the heterogeneity of postconcussion syndrome (PCS) limiting effective interventions. With minimal invasiveness and few adverse effects, acupuncture is emerging as a potential treatment option. Purpose To evaluate the efficacy of acupuncture in managing acute PCS symptoms and long-term neurologic impairments. Materials and Methods This prospective, randomized, controlled trial enrolled patients with mTBI from August 2016 to September 2020, and participants were stratified into three groups: verum acupuncture, sham acupuncture, and waiting-list controls. Acupuncture therapy was provided in 14 sessions over 4 weeks. PCS was assessed at baseline, after therapy, and at 6-12-month follow-up. MRI scans were acquired both at baseline and after therapy. Healthy controls were included and scanned twice for comparison. Repeated-measures analysis of variance was performed to assess changes in PCS ratings and imaging metrics. Correlations between imaging metrics and PCS scores were conducted. Results Sixty-six participants (mean age, 41.2 years ± 12.7 [SD]; 32 [48%] male and 34 [52%] female) were included in the study. The PCS score was reduced in the verum acupuncture group (<i>n</i> = 22; -5.2 ± 6.9; <i>P</i> = .002) but not in the sham acupuncture (<i>n</i> = 22; -1.2 ± 6.4) or waiting-list control (<i>n</i> = 22; -1.5 ± 5.0) (both <i>P</i> > .05) groups. After 6-12 months of therapy, a stable effect was observed only in the verum acupuncture group (-8.1 ± 8.6; <i>P</i> < .001). Compared with the waiting-list control group, all participants with mTBI had decreased fractional anisotropy in the right cerebral peduncle, anterior limb of the internal capsule, posterior corona radiata (PCR), and cingulum-hippocampus. Greater improvements in the fractional anisotropy of the right PCR after verum acupuncture were correlated with persistent therapeutic effects of acupuncture at 6-12-month follow-up (<i>r</i> = 0.723; <i>P</i> < .001). Conclusion In this sample of participants with mTBI, acupuncture improved the white matter integrity at MRI, which was associated with relief of long-term postconcussion symptoms. Clinical trial registration no. NCT02868671 Published under a CC BY 4.0 license. <i>Supplemental material is available for this article.</i> See also the editorial by Narayana in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 1","pages":"e250315"},"PeriodicalIF":12.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691364","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":"Efficacy of Acupuncture in Treating Mild Traumatic Brain Injury.","authors":"Ponnada Aswadha Narayana","doi":"10.1148/radiol.251873","DOIUrl":"https://doi.org/10.1148/radiol.251873","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 1","pages":"e251873"},"PeriodicalIF":12.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691367","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":"Precision Imaging in Breast Cancer: Neoadjuvant Chemotherapy Monitoring with Advanced Diffusion MRI.","authors":"Sunitha B Thakur, Almir G V Bitencourt","doi":"10.1148/radiol.251723","DOIUrl":"https://doi.org/10.1148/radiol.251723","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 1","pages":"e251723"},"PeriodicalIF":12.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691371","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":"Behavioral Research Will Help Us Understand When AI Will Help Radiologists.","authors":"Jeremy M Wolfe","doi":"10.1148/radiol.251564","DOIUrl":"https://doi.org/10.1148/radiol.251564","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"692 1","pages":"e251564"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578627","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":"Current State of Fibrotic Interstitial Lung Disease Imaging.","authors":"Lydia Chelala,Anupama G Brixey,Stephen B Hobbs,Jeffrey P Kanne,Seth J Kligerman,David A Lynch,Jonathan H Chung","doi":"10.1148/radiol.242531","DOIUrl":"https://doi.org/10.1148/radiol.242531","url":null,"abstract":"Interstitial lung disease (ILD) diagnosis is complex, continuously evolving, and increasingly reliant on thin-section chest CT. Multidisciplinary discussion aided by a thorough radiologic review can achieve a high-confidence diagnosis of ILD in the majority of patients and is currently the reference standard for ILD diagnosis. CT also allows the early recognition of interstitial lung abnormalities, possibly reflective of unsuspected ILD and progressive in a substantial proportion of patients. Beyond diagnosis, CT has also become essential for ILD prognostication and follow-up, aiding the identification of fibrotic and progressive forms. The presence of fibrosis is a critical determinant of prognosis, particularly when typical features of usual interstitial pneumonia (UIP) are identified. The UIP-centric imaging approach emphasized in this review is justified by the prognostic significance of UIP, the prevalence of UIP in idiopathic pulmonary fibrosis, and its strong radiologic-pathologic correlation. In nonidiopathic pulmonary fibrosis ILD, progressive pulmonary fibrosis carries clinically significant prognostic and therapeutic implications. With growing evidence and the emergence of novel ILD-related concepts, recent updates of several imaging guidelines aim to optimize the approach to ILD. Artificial intelligence tools are promising adjuncts to the qualitative CT assessment and will likely augment the role of CT in the ILD realm.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"3 1","pages":"e242531"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533468","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":"To Be UIP, or Not to Be UIP, That is the Question as Always: Time to Reconsider the Concept of UIP.","authors":"Ryoko Egashira","doi":"10.1148/radiol.251370","DOIUrl":"https://doi.org/10.1148/radiol.251370","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"47 1","pages":"e251370"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533466","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 Value of Swallow Tail Sign at Brain MRI in Patients with Clinically Uncertain Parkinsonian Syndrome.","authors":"Yue Xing,Saadnah Naidu,Antonio Martín-Bastida,Marta Gennaro,Andreas A Roussakis,Abdul Halim Sapuan,Tayyib T A Hayat,James Birchall,Rob Skelly,Nin Bajaj,Gillian Sare,Jonathan Evans,Christopher R Tench,Paola Piccini,Stefan T Schwarz,Dorothee P Auer","doi":"10.1148/radiol.240680","DOIUrl":"https://doi.org/10.1148/radiol.240680","url":null,"abstract":"Background Striatal dopaminergic deficits, established with iodine 123-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropan (123I-FP-CIT) SPECT, support the diagnosis of Parkinson disease (PD) or atypical parkinsonian syndrome in clinical uncertainty. The swallow tail sign (STS) at susceptibility-weighted (SW) MRI helps differentiate patients with PD from controls, but its utility in clinically uncertain parkinsonian syndromes remains unclear. Purpose To compare the diagnostic performance of STS absence at SW MRI in diagnosing PD with that of 123I-FP-CIT SPECT in participants with clinically uncertain parkinsonian syndrome. Materials and Methods This prospective, multicenter study included participants with clinically uncertain parkinsonian syndrome between May 2016 and May 2019. Imaging modality specialists independently assessed images from SW MRI and 123I-FP-CIT SPECT while blinded to clinical findings. Diagnostic performance was assessed against diagnosis at clinical follow-up as the reference standard. Performance metrics were compared between modalities and post hoc subgroups split by diagnostic confidence and motor severity using Z tests. Cohen κ was computed for intrarater, interrater, and intermodality reliability. Results A total of 106 participants with clinically uncertain parkinsonian syndrome and diagnostic 3-T SW MRI examinations were included in the study sample (median age, 69 years [IQR, 14 years]; 59 male). STS assessment showed substantial agreement within (κ = 0.69; 95% CI: 0.55, 0.83) and between (κ = 0.70; 95% CI: 0.56, 0.84) raters. STS absence demonstrated a sensitivity of 81% (95% CI: 70, 90) and specificity of 75% (95% CI: 58, 88) in predicting PD. Post hoc analysis demonstrated better diagnostic performance in the subgroup with high (60 of 106 participants) versus low diagnostic confidence, with 91% sensitivity (95% CI: 79, 98; Z = 2.8; P = .005), 87% specificity (95% CI: 60, 98; Z = 1.4; P = .17), and 90% accuracy (95% CI: 79, 96; Z = 3.1; P = .002). 123I-FP-CIT SPECT yielded higher sensitivity than STS (98% [95% CI: 91, 100]; Z = 3.3; P = .001) but only 55% specificity (95% CI: 39, 70; Z = -1.9; P = .06). Conclusion In participants with clinically uncertain parkinsonian syndrome, STS absence on 3-T brain SW MRI scans supported the diagnosis of PD with high accuracy overall and greater accuracy when the diagnostic confidence of STS assessment was high. Clinical trial registration no. NCT03022357 © RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"11 1","pages":"e240680"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578624","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":"Impact of LI-RADS CT and MRI Ancillary Features on Diagnostic Performance: An Individual Participant Data Meta-Analysis.","authors":"Nicole Abedrabbo,Eric T Lam,Matthew D F McInnes,Haben Dawit,Diana Kadi,Christian B van der Pol,Jean-Paul Salameh,Brooke Levis,Haresh Naringrekar,Emily Lerner,Robert G Adamo,Mostafa Alabousi,Adam Polikoff,Alessandro Furlan,An Tang,Andrea S Kierans,Amit G Singal,Ashwini Arvind,Ayman Alhasan,Bin Song,Brian C Allen,Caecilia S Reiner,Christopher Clarke,Daniel R Ludwig,Federico Diaz Telli,Federico Piñero,Grzegorz Rosiak,Hanyu Jiang,Heejin Kwon,Hong Wei,Hyo-Jin Kang,Ijin Joo,Jeong Ah Hwang,Ji Hye Min,Ji Soo Song,Jin Wang,Joanna Podgórska,John R Eisenbrey,Krzysztof Bartnik,Li-Da Chen,Maxime Ronot,Milena Cerny,Nieun Seo,Sheng-Xiang Rao,Roberto Cannella,Sang Hyun Choi,So Yeon Kim,Tyler J Fraum,Wentao Wang,Woo Kyoung Jeong,Xiang Jing,Yeun-Yoon Kim,Zhen Kang,Mustafa R Bashir,Andreu F Costa","doi":"10.1148/radiol.242278","DOIUrl":"https://doi.org/10.1148/radiol.242278","url":null,"abstract":"Background A recent meta-analysis showed independent associations between most Liver Imaging Reporting and Data System (LI-RADS) ancillary features (AFs) and hepatocellular carcinoma (HCC), malignancy, and benignity. However, the impact of AFs on the diagnostic performance of LI-RADS remains unclear. Purpose To evaluate the impact of applying individual AFs on the diagnostic performance of CT and MRI LI-RADS using an individual participant data (IPD) meta-analysis. Materials and Methods Databases were searched for studies published from January 2014 to February 2023 that evaluated the diagnostic accuracy of CT and MRI for HCC in adults at risk for HCC using LI-RADS version 2014, 2017, or 2018. Observations were categorized according to LI-RADS major features, applying threshold growth when available, and excluding those previously treated or not meeting the composite reference standard (histopathologic analysis or imaging). Using a one-step approach, the IPD were pooled via bivariate mixed-effects models, accounting for clustering in participant-level and study-level random effects. The area under the receiver operator characteristic curve (AUC) for LI-RADS categories 1-5 and the positive predictive value (PPV), sensitivity, and specificity for LI-RADS category 5 (LR-5) observations were derived using three strategies: (a) major features only; (b) major features with each individual AF applied; and (c) similar to strategy 2 but allowing AFs favoring HCC in particular or malignancy in general to upgrade category LR-4 to category LR-5 when present. Comparisons were made using two-tailed z tests. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies 2. Results Forty-six studies comprising 9257 observations (1098 CT, 8159 MRI) in 7811 adult participants (6792 male; mean age, 58.7 years ± 10.7 [SD]) were included. For all AFs, there were no differences in AUCs of LI-RADS categories 1-5 among strategies 1-3 (P value range, .65 to >.99). For category LR-5, there were also no differences among strategies 1-3 in the PPV, sensitivity, and specificity (P value range, .11 to >.99). Sensitivity analysis of only low-risk bias studies (nine of 46) yielded results consistent with primary analysis. Conclusion The application of individual AFs did not impact the overall diagnostic performance of CT and MRI LI-RADS compared with major features alone. © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Searleman in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"198 1","pages":"e242278"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578626","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":"How I Do It: Three-Dimensional MR Neurography and Zero Echo Time MRI for Rendering of Peripheral Nerve and Bone.","authors":"Yenpo Lin,Ek T Tan,Gracyn Campbell,Ryan E Breighner,Maggie Fung,Scott W Wolfe,John A Carrino,Darryl B Sneag","doi":"10.1148/radiol.241604","DOIUrl":"https://doi.org/10.1148/radiol.241604","url":null,"abstract":"MR neurography sequences provide excellent nerve-to-background soft tissue contrast, whereas a zero echo time (ZTE) MRI sequence provides cortical bone contrast. By demonstrating the spatial relationship between nerves and bones, a combination of rendered three-dimensional (3D) MR neurography and ZTE sequences provides a roadmap for clinical decision-making, particularly for surgical intervention. In this article, the authors describe the method for fused rendering of peripheral nerve and bone by combining nerve and bone structures from 3D MR neurography and 3D ZTE MRI, respectively. The described method includes scanning acquisition, postprocessing that entails deep learning-based reconstruction techniques, and rendering techniques. Representative case examples demonstrate the steps and clinical use of these techniques. Challenges in nerve and bone rendering are also discussed.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"19 1","pages":"e241604"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533467","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}