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":"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":"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}

{"title":"Connecting Ambient Air Pollution and Myocardial Fibrosis.","authors":"Davis M Vigneault","doi":"10.1148/radiol.251801","DOIUrl":"https://doi.org/10.1148/radiol.251801","url":null,"abstract":"\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in Radiology. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"11 1","pages":"e251801"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533346","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":"ANCA-associated Vasculitis with Bilateral Renal Ruptures.","authors":"Xiaolong Liu,Zhanguo Sun","doi":"10.1148/radiol.243414","DOIUrl":"https://doi.org/10.1148/radiol.243414","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"35 1","pages":"e243414"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533475","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":"Association between Long-term Exposure to Ambient Air Pollution and Myocardial Fibrosis Assessed with Cardiac MRI.","authors":"Jacques Du Plessis,Chloe DesRoche,Scott Delaney,Rachel C Nethery,Rachel Hong,Paaladinesh Thavendiranathan,Heather Ross,Felipe Castillo,Kate Hanneman","doi":"10.1148/radiol.250331","DOIUrl":"https://doi.org/10.1148/radiol.250331","url":null,"abstract":"Background Poor air quality is associated with cardiovascular morbidity. However, the underlying pathophysiologic mechanisms are unclear. Purpose To determine the relationship between long-term exposure to ambient fine particulate matter with 2.5-µm or smaller aerodynamic diameter (PM2.5) and the extent of diffuse myocardial fibrosis quantified with cardiac MRI. Materials and Methods In this single-center retrospective study, patients with dilated cardiomyopathy (DCM) or controls with normal cardiac MRI findings were included (January 2018 to December 2022). Diffuse myocardial fibrosis was quantified using cardiac MRI native T1 mapping z scores. Residence-specific ambient PM2.5 concentration was assessed as the mean of daily exposure concentration in the year before cardiac MRI using direct measurements from the nearest monitoring station. Multivariable models were adjusted for clinically relevant covariates. Results A total of 694 patients (mean age, 47 years ± 16 [SD]; 443 men; 493 with DCM, 201 controls) were included. In multivariable models, each 1-µg/m3 increase in 1-year mean PM2.5 exposure was associated with a 0.30 higher native T1 z score in patients with DCM (adjusted β coefficient: 0.30; 95% CI: 0.13, 0.47; P < .001) and 0.27 higher native T1 z score in controls (adjusted β coefficient: 0.27; 95% CI: 0.04, 0.51; P = .02). For absolute values, each 1-µg/m3 increase in 1-year mean PM2.5 exposure was associated with 9.1 msec higher native T1 at 1.5 T (β coefficient: 9.1; 95% CI: 2.04, 15.97; P = .01) and 12.1 msec higher native T1 at 3 T (β coefficient: 12.1; 95% CI: 5.74, 18.52; P < .001). Stratified models indicated the largest effect sizes for the association of PM2.5 exposure with native T1 z scores in women (β coefficient: 0.49; 95% CI: 0.23, 0.76; P < .001), smokers (β coefficient: 0.43; 95% CI: 0.02, 0.84; P = .04), and patients with hypertension (β coefficient: 0.48; 95% CI: 0.16, 0.80; P = .004). Conclusion Higher long-term exposure to ambient fine particulate air pollution is associated with greater diffuse myocardial fibrosis at cardiac MRI native T1 mapping in patients with DCM and healthy controls. © RSNA, 2025 See also the editorial by Vigneault in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"7 1","pages":"e250331"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533470","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":"Lack of Transparency Regarding Role of AI in Ultra-High-field Coronary MR Angiography.","authors":"Shi-Hai Zhao","doi":"10.1148/radiol.243424","DOIUrl":"https://doi.org/10.1148/radiol.243424","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"648 1","pages":"e243424"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533347","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":"Breast MRI for Assessing Triple-Negative Breast Cancer after Neoadjuvant Chemoimmunotherapy.","authors":"Natsuko Onishi","doi":"10.1148/radiol.251503","DOIUrl":"https://doi.org/10.1148/radiol.251503","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"70 1","pages":"e251503"},"PeriodicalIF":19.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533464","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":"Posttreatment MRI to Predict Pathologic Complete Response of Triple-Negative Breast Cancer to Neoadjuvant Chemoimmunotherapy.","authors":"Toulsie Ramtohul, Derek Lollivier, Justine Spriet, Maxime Jin, Lounes Djerroudi, Thomas Gaillard, Claire Bonneau, Delphine Loirat, Diana Bello-Roufai, Youlia Kirova, Pierre Loap, Caroline Malhaire, Anne Vincent Salomon, François-Clément Bidard, Anne Tardivon, Audrey Maillez, Lauren Wallaert, Luc Ceugnart, Caroline Nhy, Luc Cabel","doi":"10.1148/radiol.243824","DOIUrl":"https://doi.org/10.1148/radiol.243824","url":null,"abstract":"<p><p>Background Neoadjuvant chemoimmunotherapy (NACI) has substantially improved pathologic complete response (pCR) rates in early triple-negative breast cancer (TNBC). However, the predictive accuracy of posttreatment MRI remains unexplored. Purpose To assess the performance of posttreatment MRI in the prediction of pCR in participants with TNBC treated with NACI. Materials and Methods In this prospective multicenter study (August 2021-June 2024), women with early TNBC were recruited from three centers (training set: Institut Curie; test set: Institut Godinot and Institut Oscar Lambret). Post-NACI dynamic contrast-enhanced MRI scans from multiple vendors were analyzed. Radiologic complete response (rCR)-defined as no enhancement in the tumor bed-was evaluated for predicting pCR. A multivariable logistic regression model incorporating rCR, nodal involvement, and Ki-67 index was developed and externally validated. In cases with residual enhancement (non-rCR), a radiomic score using shape and first-order features was tested. Results A total of 175 women were included in the training set (mean age, 49 years ± 11 [SD]) and 84 women in the external test set (mean age, 52 years ± 12). The rCR at MRI was predictive of pCR, with an area under the receiver operating characteristic curve (AUC) of 0.83 (95% CI: 0.75, 0.92). The combined model (rCR + nodal status + Ki-67) yielded an AUC of 0.88 (95% CI: 0.81, 0.96) in the test set. In node-negative patients with Ki-67 greater than 30%, the rCR false-discovery rate (ie, the proportion of rCR cases that were actually non-pCR or residual disease missed at breast MRI) was 3.6% (two of 56) in the training set and 3.5% (one of 29) in the test set; all cancers were limited to residual cancer burden I. In non-rCR cases, a model incorporating the radiomics score and lesion count achieved an AUC of 0.80 (95% CI: 0.69, 0.90). Conclusion Posttreatment rCR at MRI demonstrated strong predictive value for pCR in early TNBC following NACI. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Onishi in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 1","pages":"e243824"},"PeriodicalIF":12.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541984","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}