Radiology最新文献

{"title":"CT/MRI LI-RADS 2024 Update: Treatment Response Assessment.","authors":"Anum Aslam, Victoria Chernyak, Frank H Miller, Mustafa Bashir, Richard Do, Claude Sirlin, Robert J Lewandowski, Charles Y Kim, Ania Zofia Kielar, Avinash R Kambadakone, Hooman Yarmohammadi, Edward Kim, Dawn Owen, Resmi A Charalel, Anuradha Shenoy-Bhangle, Lauren M Burke, Mishal Mendiratta-Lala","doi":"10.1148/radiol.232408","DOIUrl":"https://doi.org/10.1148/radiol.232408","url":null,"abstract":"<p><p>With the rising incidence of hepatocellular carcinoma, there has been increasing use of local-regional therapy (LRT) to downstage or bridge to transplant, for definitive treatment, and for palliation. The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Assessment (TRA) algorithm provides guidance for step-by-step tumor assessment after LRT and standardized reporting. Current evidence suggests that the algorithm performs well in the assessment of tumor response to arterial embolic and loco-ablative therapies and fair when assessing response to radiation-based therapies, with limited data to validate the latter. Both evidence-based and expert-based refinements of the algorithm are needed to improve its diagnostic accuracy after varying types of LRT. This review provides an overview of the challenges and limitations of the LI-RADS TRA algorithm version 2017 and discusses the refinements introduced in the updated 2024 LI-RADS algorithm for CT/MRI.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e232408"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626431","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 Treasure Trove Hidden in Plain Sight: The Utility of GPT-4 in Chest Radiograph Evaluation.","authors":"Soroosh Tayebi Arasteh, Robert Siepmann, Marc Huppertz, Mahshad Lotfinia, Behrus Puladi, Christiane Kuhl, Daniel Truhn, Sven Nebelung","doi":"10.1148/radiol.233441","DOIUrl":"https://doi.org/10.1148/radiol.233441","url":null,"abstract":"<p><p>Background Limited statistical knowledge can slow critical engagement with and adoption of artificial intelligence (AI) tools for radiologists. Large language models (LLMs) such as OpenAI's GPT-4, and notably its Advanced Data Analysis (ADA) extension, may improve the adoption of AI in radiology. Purpose To validate GPT-4 ADA outputs when autonomously conducting analyses of varying complexity on a multisource clinical dataset. Materials and Methods In this retrospective study, unique itemized radiologic reports of bedside chest radiographs, associated demographic data, and laboratory markers of inflammation from patients in intensive care from January 2009 to December 2019 were evaluated. GPT-4 ADA, accessed between December 2023 and January 2024, was tasked with autonomously analyzing this dataset by plotting radiography usage rates, providing descriptive statistics measures, quantifying factors of pulmonary opacities, and setting up machine learning (ML) models to predict their presence. Three scientists with 6-10 years of ML experience validated the outputs by verifying the methodology, assessing coding quality, re-executing the provided code, and comparing ML models head-to-head with their human-developed counterparts (based on the area under the receiver operating characteristic curve [AUC], accuracy, sensitivity, and specificity). Statistical significance was evaluated using bootstrapping. Results A total of 43 788 radiograph reports, with their laboratory values, from University Hospital RWTH Aachen were evaluated from 43 788 patients (mean age, 66 years ± 15 [SD]; 26 804 male). While GPT-4 ADA provided largely appropriate visualizations, descriptive statistical measures, quantitative statistical associations based on logistic regression, and gradient boosting machines for the predictive task (AUC, 0.75), some statistical errors and inaccuracies were encountered. ML strategies were valid and based on consistent coding routines, resulting in valid outputs on par with human specialist-developed reference models (AUC, 0.80 [95% CI: 0.80, 0.81] vs 0.80 [95% CI: 0.80, 0.81]; <i>P</i> = .51) (accuracy, 79% [6910 of 8758 patients] vs 78% [6875 of 8758 patients], respectively; <i>P</i> = .27). Conclusion LLMs may facilitate data analysis in radiology, from basic statistics to advanced ML-based predictive modeling. © RSNA, 2024 <i>Supplemental material is available for this article.</i></p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e233441"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626498","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":"Interstitial Lung Abnormalities at Clinical CT: Insights and Implications from a Large-Scale Study.","authors":"Akinori Hata","doi":"10.1148/radiol.243020","DOIUrl":"https://doi.org/10.1148/radiol.243020","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e243020"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669068","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":"Myocardial Fibrosis Assessment at 3-T versus 5-T Myocardial Late Gadolinium Enhancement MRI: Early Results.","authors":"Yubo Guo, Lu Lin, Shihai Zhao, Gan Sun, Yuyan Chen, Ke Xue, Yuxin Yang, Shuo Chen, Yan Zhang, Guobin Li, Yanjie Zhu, Rozemarijn Vliegenthart, Yining Wang","doi":"10.1148/radiol.233424","DOIUrl":"https://doi.org/10.1148/radiol.233424","url":null,"abstract":"<p><p>Background Cardiac MRI at 5 T has recently become available and potentially improves tissue contrast enhancement at gadolinium chelate-enhanced T1-weighted imaging. Purpose To evaluate the feasibility of 5-T myocardial late gadolinium enhancement (LGE) MRI in assessing myocardial fibrosis by comparing image quality and LGE quantification with reference-standard 3-T myocardial LGE MRI. Materials and Methods Consecutive patients with confirmed myocardial fibrosis on previous 3-T MRI scans between January 2023 and July 2023 prospectively underwent follow-up imaging from August 2023 to November 2023. Each participant underwent follow-up 5-T imaging using an identical dose of contrast agent. Radiologist scoring of image quality using a Likert scale (range, 1-5), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contrast ratio, and semiautomatic quantitative LGE assessment were obtained and reported as medians and IQRs. Paired Wilcoxon signed rank tests were used to compare characteristics derived at 3-T and 5-T imaging. Results A total of 18 participants (mean age, 49 years ± 17 [SD]; nine male participants) were included, with a mean interval of 6.2 months ± 2.3 between undergoing 3-T and 5-T MRI. Median image quality scores were 4.0 (IQR, 3.0-4.2) at 3 T and 4.0 (IQR, 3.0-4.4) at 5 T (<i>P</i> = .45). SNR at 5 T was higher than at 3 T (183.7 [IQR, 147.2-255.9] vs 125.8 [IQR, 108.2-171.6], respectively; <i>P</i> = .002). Median CNR at 5 T was higher than at 3 T in normal myocardium (50.8 [IQR, 35.4-67.9] vs 16.5 [IQR, 11.3-24.6], respectively) and pericardial fat (21.4 [IQR, 7.1-29.3] vs -5.0 [IQR, -16.4 to -2.3], respectively) (both <i>P</i> < .001). There was no evidence of a difference in the percentage of LGE quantified between 5 T and 3 T (median, 11.8% [IQR, 7.7%-20.5%] vs 12.6% [IQR, 6.6%-20.4%], respectively; <i>P</i> = .81). Conclusion Myocardial LGE MRI at 5 T was found to be feasible, with no evidence of differences in subjective image quality and myocardial fibrosis quantification compared with 3-T myocardial LGE MRI. Furthermore, with use of identical contrast agent doses, SNRs and CNRs were improved at 5 T. Published under a CC BY 4.0 license. <i>Supplemental material is available for this article.</i> See also the editorial by Czum in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e233424"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626369","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":"Venturing Further into Ultrahigh-Field-Strength MRI: Myocardial Late Gadolinium Enhancement at 5 T.","authors":"Julianna M Czum","doi":"10.1148/radiol.242935","DOIUrl":"https://doi.org/10.1148/radiol.242935","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e242935"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626528","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":"Plasma Glial Fibrillary Acid Protein and Phosphorated Tau 181 Association with Presynaptic Density-Dependent Tau Pathology at ¹⁸F-SynVesT-1 Brain PET Imaging.","authors":"Junhao Wu, Binyin Li, Jie Wang, Qi Huang, Xing Chen, Zhiwen You, Kun He, Qihao Guo, Songye Li, Yiyun Henry Huang, Tengfei Guo, Wenlin Dai, Weiwei Xiang, Weihuang Chen, Dake Yang, Jun Zhao, Yihui Guan, Fang Xie","doi":"10.1148/radiol.233019","DOIUrl":"https://doi.org/10.1148/radiol.233019","url":null,"abstract":"<p><p>Background Synaptic loss is an important factor in Alzheimer disease (AD); however, blood assays that conveniently and rapidly reflect changes in synaptic density are lacking. Purpose To correlate multiple potential synaptic blood markers with synaptic density measured using ¹⁸F-SynVesT-1, a fluorine 18 (¹⁸F)-labeled radiotracer, brain PET and to explore the independent associations between these markers and synaptic density. Materials and Methods This prospective study included 50 cognitively unimpaired (mean age, 65.0 years ± 8.3 [SD]; 37 female) participants and 70 participants with cognitive impairment (mean age, 69.5 years ± 7.9; 43 female) from the Memory Clinic of Shanghai Jiao Tong University Affiliated Ruijin Hospital and communities in Shanghai. Amyloid-β (Aβ) and tau were assessed using ¹⁸F-florbetapir and ¹⁸F-MK6240 PET/CT. Synaptic density was evaluated with ¹⁸F-SynVesT-1 PET/MRI. Pearson correlation analysis was used to investigate relationships of plasma (Aβ42/40 ratio, phosphorylated tau 181 [p-tau-181], glial fibrillary acid protein [GFAP], neurofilament light) and serum (C-reactive protein, tumor necrosis factor-α, α-synuclein, neurogranin, active plasminogen activator inhibitor-1, tissue plasminogen activator) biomarkers with synaptic density. Linear regression models and mediation analysis were used to explore effects of other AD-related pathologies on these relationships. Results Correlations were observed between increased p-tau-181 and GFAP and decreased synaptic density in global cortex (<i>r</i>_p-tau-181 = -0.352, <i>r</i>_GFAP = -0.386; both <i>P</i> < .001) and hippocampus (<i>r</i>_p-tau-181 = -0.361, <i>r</i>_GFAP = -0.369; both <i>P</i> < .001) at ¹⁸F-SynVesT-1 PET/MRI. The relationships between p-tau-181 and GFAP with ¹⁸F-SynVesT-1 PET/MRI persisted after controlling for plasma Aβ42/40 ratio, Aβ PET, or cortical thickness (<i>P</i> value range, <.001-.01). This association disappeared after controlling for tau PET (<i>P</i> value range, .08-.83). Conclusion Plasma p-tau-181 and GFAP are closely associated with synaptic density measured using ¹⁸F-SynVesT-1 PET/MRI, with the relationship primarily influenced by tau accumulation rather than Aβ deposition or cortical thickness. © RSNA, 2024 <i>Supplemental material is available for this article.</i> See also the editorial by Giannakopoulos in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e233019"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668229","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":"Aquaporin-4 Immunoglobulin G-seropositive Neuromyelitis Optica Spectrum Disorder MRI Characteristics: Data Analysis from the International Real-World PAMRINO Study Cohort.","authors":"Claudia Chien, Vera Cruz E Silva, Emanuel Geiter, Dominik Meier, Hanna Zimmermann, Denis B Bichuetti, Marcos I Idagawa, Ayse Altintas, Uygur Tanriverdi, Sasitorn Siritho, Lehka Pandit, Anitha Dcunha, Maria J Sá, Rita Figueiredo, Peiqing Qian, Caryl Tongco, Itay Lotan, Vadim Khasminsky, Mark A Hellmann, Hadas Stiebel-Kalish, Dalia L Rotstein, Lindsay Waxman, Daniel Ontaneda, Kunio Nakamura, Hesham Abboud, M Omar Subei, Yang Mao-Draayer, Joachim Havla, Nasrin Asgari, Pernille B Skejø, Ilya Kister, Marius Ringelstein, Simon Broadley, Simon Arnett, Brie Marron, Anna M Jolley, Michael Wunderlich, Sean Green, Lawrence J Cook, Michael R Yeaman, Terry J Smith, Alexander U Brandt, Jens Wuerfel, Friedemann Paul","doi":"10.1148/radiol.233099","DOIUrl":"https://doi.org/10.1148/radiol.233099","url":null,"abstract":"<p><p>Background Patients with neuromyelitis optica spectrum disorder (NMOSD) are often seropositive for antibodies against aquaporin-4 (AQP4). The importance of MRI monitoring in this disease requires evaluation. Purpose To profile MRI features from a large international cohort with AQP4 immunoglobulin G (IgG)-seropositive NMOSD (from the Parallel MRI in NMOSD [PAMRINO] study) and to evaluate and confirm existing knowledge regarding the incidence, location, and longitudinal development of characteristic lesions in the central nervous system associated with AQP4-IgG-seropositive NMOSD. Materials and Methods In this retrospective study (from August 2016 to January 2019), MRI and clinical data were collected from 17 NMOSD expert sites in 11 countries across four continents. Clinical features and lesions identified at cross-sectional and longitudinal MRI were assessed. No formal statistical tests were used to compare observations; however, means, SDs, and 95% CIs are reported when evaluating lesion frequencies. Results Available T1-weighted and T2-weighted MRI scans in patients with AQP4-IgG-seropositive NMOSD (<i>n</i> = 525) were read. Among the 525 patients, 320 underwent cerebral MRI examinations with T2-weighted hyperintense cerebral (264 of 320; 82.5%), cerebellar (44 of 320; 13.8%), and brainstem (158 of 321 [49.2%], including one lesion observed at cervical spinal cord [SC] MRI) lesions. Lesions in the optic nerves, analyzed from 152 MRI examinations, were mainly found in the central (81 of 92; 88%) and posterior (79 of 92; 86%) sections (bilaterally in 39 of 92; 42%). Longitudinally extensive transverse myelitis was the predominant SC lesion pattern (upper compartment from 322 MRI examinations, 133 of 210 [63.3%]; and lower compartment from 301 MRI examinations, 149 of 212 [70.3%]). However, nonlongitudinal extensive transverse myelitis lesions were also observed frequently (105 of 210; 50.0%) in the cervical SC. Clinical data (<i>n</i> = 349; mean age, 44 years ± 14 [SD]; 202 female patients) and acute lesions at contrast-enhanced (CE) MRI (<i>n</i> = 58, performed within 30 days of the last attack) were evaluated. CE lesions were detected in the cerebrum (eight of 13; 62%), optic nerves (14 of 19; 74%), or chiasm (three of four; 75%) within 15 days of any relapse. In the upper SC (29 of 44; 66%), CE lesions were frequently observed up to 20 days after a clinical myelitis event. Conclusion A high incidence of abnormal brain MRI examinations and nonlongitudinal extensive SC lesions was found in patients in PAMRINO with AQP4-IgG-seropositive NMOSD. © RSNA, 2024 <i>Supplemental material is available for this article.</i></p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e233099"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626007","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":"In Vivo Imaging of Synaptic Loss and Plasma Biomarkers in Alzheimer Disease.","authors":"Panteleimon Giannakopoulos","doi":"10.1148/radiol.242867","DOIUrl":"https://doi.org/10.1148/radiol.242867","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e242867"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669066","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":"Cerebrofacial Arteriovenous Metameric Syndrome.","authors":"Dhairya A Lakhani, Majid Khan","doi":"10.1148/radiol.241156","DOIUrl":"https://doi.org/10.1148/radiol.241156","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e241156"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626118","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":"Navigating the Role of Radiology in the Climate Crisis.","authors":"Jan Vosshenrich","doi":"10.1148/radiol.243165","DOIUrl":"https://doi.org/10.1148/radiol.243165","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 2","pages":"e243165"},"PeriodicalIF":12.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667768","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}