Radiology最新文献

{"title":"Impact of Background Parenchymal Enhancement on Diagnostic Performance of Breast MRI: A Systematic Review and Meta-Analysis.","authors":"Sonja Bechyna, Pascal A T Baltzer","doi":"10.1148/radiol.241919","DOIUrl":"10.1148/radiol.241919","url":null,"abstract":"<p><p>Background Breast MRI is the most sensitive modality for detecting breast cancer, but its diagnostic performance can be reduced by background parenchymal enhancement (BPE). However, the implications of the degree of BPE in diagnostic evaluation remain controversial due to conflicting evidence. Purpose To conduct a systematic review and meta-analysis to determine whether the presence of moderate or marked BPE in women undergoing breast MRI negatively affects diagnostic performance compared with minimal or mild BPE. Materials and Methods On May 6, 2024, a systematic review of PubMed and Google Scholar was conducted on studies assessing the diagnostic performance of contrast-enhanced MRI in detecting breast cancer. Studies published until May 2024 were included if they provided raw data to extract or calculate true-positive, false-positive, true-negative, and false-negative results. Data were integrated using a bivariate random-effects model, and the sensitivity and specificity were compared between minimal or mild and moderate or marked BPE. Sources of heterogeneity were explored using meta-regression analysis. Summary receiver operating characteristic analysis was performed to compare overall diagnostic performance at different BPE levels by using a <i>Z</i> test. Results Eight studies of 6044 women (mean age, 52 years) were included. Minimal or mild BPE was associated with higher sensitivity (95.3% vs 84.1%; <i>P</i> = .02) and higher specificity (89.0% vs 78.7%; <i>P</i> = .02) compared with moderate or marked BPE. Diagnostic performance was higher for minimal or mild BPE (area under the receiver operating characteristic curve [AUC], 0.95; 95% CI: 0.92, 0.96) compared with moderate or marked BPE (AUC, 0.91; 95% CI: 0.88,0.93; <i>Z</i> score, 2.69; <i>P</i> = .007). Moderate or marked BPE and publication year in cases of moderate or marked BPE were covariates influencing the diagnostic odds ratio. Moderate or marked BPE remained an independent predictor of the diagnostic performance at multivariable analysis (diagnostic odds ratio, -1.33; <i>P</i> = .002). Conclusion The degree of BPE influences the diagnostic performance of breast MRI, with minimal or mild BPE being associated with higher sensitivity and specificity and moderate or marked BPE being associated with lower diagnostic performance. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Bahl in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e241919"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151488","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":"Assessment of the Rotator Cuff Muscles: State-of-the-Art MRI and Clinical Implications.","authors":"Georg C Feuerriegel,Benjamin Fritz,Adrian A Marth,Stefan Sommer,Karl Wieser,Reto Sutter","doi":"10.1148/radiol.242131","DOIUrl":"https://doi.org/10.1148/radiol.242131","url":null,"abstract":"Rotator cuff (RC) tears are a common cause of shoulder pain and, depending on the tear pattern, can substantially limit daily activities and affect quality of life. After a tendon tear, the RC muscle undergoes degenerative changes, including fatty degeneration and volume atrophy. The extent of fatty muscle degeneration has been associated with poorer functional and surgical outcomes after RC reconstruction, and the evaluation of the RC muscles is one of the most important factors for deciding whether to perform an RC repair. A variety of qualitative and quantitative methods are available to assess RC fatty muscle degeneration and volume atrophy based on MRI. This review provides a detailed overview of the RC muscle assessment, including qualitative measurements to assess the RC muscles, such as Goutallier grading, tangent sign, and fish backbone sign. Another focus is state-of-the-art quantitative MRI techniques, including chemical shift-based techniques such as single-voxel MR spectroscopy, multipoint water-fat separation, and MR relaxometry. Furthermore, the clinical relevance of qualitative and quantitative intramuscular fat assessment is addressed, and its potential importance for treatment planning and patient outcomes is discussed.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"13 1","pages":"e242131"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914843","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":"Cinematic Rendering of Superior Mesenteric Arteriovenous Fistula.","authors":"Wendi Kang,Jijun Zhang","doi":"10.1148/radiol.242237","DOIUrl":"https://doi.org/10.1148/radiol.242237","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"53 1","pages":"e242237"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914851","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":"Anatomy-derived 3D Aortic Hemodynamics Using Fluid Physics-informed Deep Learning.","authors":"Haben Berhane,Anthony Maroun,David Dushfunian,Justin Baraboo,Gabriela Martinez,Tyler Jacobson,Ulas Bagci,Bradley D Allen,Michael Markl","doi":"10.1148/radiol.240714","DOIUrl":"https://doi.org/10.1148/radiol.240714","url":null,"abstract":"Background Four-dimensional (4D) flow MRI provides assessment of thoracic aorta hemodynamic measures that are increasingly recognized as important biomarkers for risk assessment. However, long acquisition times and cumbersome data analysis limit widespread availability. Purpose To evaluate the feasibility and accuracy of a generative artificial intelligence (AI) approach (fluid physics-informed cycle generative adversarial network [FPI-CycleGAN]) in quantifying aorta hemodynamics directly from anatomic input as an alternative to 4D flow MRI. Materials and Methods Patients were retrospectively identified from a dataset of clinical cardiothoracic MRI examinations performed between November 2011 and July 2020. All patients underwent aortic 4D flow MRI, which served as a reference standard for training and testing of FPI-CycleGANs. A three-dimensional (3D) segmentation of the aortic geometry was used as the only input to predict systolic aortic hemodynamics, with separate networks for bicuspid aortic valve (BAV) (994 in the training set and 248 in the test set) and tricuspid aortic valve (TAV) (419 in the training set and 104 in the test set). Voxel-by-voxel and regional analyses were used to quantify and compare (AI vs the reference standard, 4D flow) systolic velocity vector fields, peak velocity, wall shear stress (WSS), and classification of aortic valve stenosis. Results In total, 1765 patients (median age, 53 years [IQR, 41-63 years]; 1242 patients had BAV and 523 had TAV) were included. Mean AI computation time was 0.15 second ± 0.11 (SD), and total training was 1500 and 3600 minutes for the TAV and BAV networks, respectively. The FPI-CycleGAN predicted systolic 3D velocity vector fields accurately, with low bias (<0.01 m/sec) and excellent limits of agreements (±0.06-0.08 m/sec). For peak velocities and WSS, there was strong agreement between FPI-CycleGAN and 4D flow (r2 = 0.930-0.957 [P < .001], with relative differences of 6.2%-9.8%). AI accurately classified aortic valve stenosis severity in 85.8% of patients (302 of 352) (κ = 0.80 [95% CI: 0.71, 0.89]). The FPI-CycleGAN was robust to one- and two-voxel dilation and erosion (bias, -0.05 to 0.1 m/sec) and ±5° rotation (bias, -0.02 to 0.03 m/sec) of the input data. The application of the trained FPI-CycleGAN in an external test set with contrast-enhanced MR angiography (n = 60 patients) as AI input data demonstrated strong to excellent performance for peak velocities and WSS (r2 = 0.944-0.965 [P < .001], with relative differences of 6.2%-9.2%). Conclusion Aorta 3D hemodynamics can be derived from anatomic input in less than 1 second using an FPI-CycleGAN and demonstrate strong agreement with in vivo 4D flow MRI systolic hemodynamics. © RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"115 1","pages":"e240714"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914861","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":"Is AI for CAD-RADS 2.0 Ready for Prime Time?","authors":"Marly van Assen, Carlo N De Cecco","doi":"10.1148/radiol.251210","DOIUrl":"https://doi.org/10.1148/radiol.251210","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e251210"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005870","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":"Erratum for: 2024 International Expert Consensus on US-guided Thermal Ablation for T1N0M0 Papillary Thyroid Cancer.","authors":"Zhen-Long Zhao, Shu-Rong Wang, Jennifer Kuo, Bülent Çekiç, Lei Liang, Hossam Arafa Ghazi, Shu-Hang Xu, Gerardo Amabile, Song-Song Wu, Ajit Yadav, Gang Dong, Ingo Janssen, Bo-Qiang Fan, Nobuhiro Fukunari, Jun-Feng He, Le Thanh Dung, Song-Yuan Yu, Sum Leong, Jian-Jun Yu, Yi-Hong Chou, Rafael De Cicco, Ying Che, Kai-Lun Cheng, Emad Kandil, Wei-Che Lin, Dong Xu, Jonathon Russell, Man Lu, Ralph P Tufano, Lin-Xue Qian, Gregory W Randolph, Jian-Qiao Zhou, Giovanni Mauri, Hong-Hui Su, Marika Russell, Amr H Abdelhamid Ahmed, Kaustubh Patel, Jung Hwan Baek, Ji-Hoon Kim, Ying Wei, Ming-An Yu","doi":"10.1148/radiol.259009","DOIUrl":"https://doi.org/10.1148/radiol.259009","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e259009"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151477","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":"Management and Prevention of Hypersensitivity Reactions to Radiocontrast Media: A Consensus Statement from the American College of Radiology and the American Academy of Allergy, Asthma & Immunology.","authors":"Carolyn Wang,Allison Ramsey,David Lang,Ana Maria Copaescu,Pranay Krishnan,Merin Kuruvilla,Benjamin Mervak,Jeffrey Newhouse,Alisa Sumkin,Rebecca Saff","doi":"10.1148/radiol.240100","DOIUrl":"https://doi.org/10.1148/radiol.240100","url":null,"abstract":"Intravenous iodinated contrast media (ICM) is widely used in the United States, and it is imperative to provide guidance on the management of adverse reactions to ICM as well as the preparation, planning, and potential premedication for patients with previous reactions. Currently there is a discordance between the American College of Radiology Contrast Manual, which recommends premedication to prevent repeat hypersensitivity reactions to ICM, and the Anaphylaxis 2020 Practice Parameters Update, which recommends against routine administration of glucocorticoids and/or antihistamines to prevent anaphylaxis with prior ICM hypersensitivity reactions. A task force of experts from radiology who are also members of the American College of Radiology Committee on Drugs and Contrast Media and expert allergists/immunologists including members of the Adverse Reactions to Drugs, Biologics and Latex Committee of American Academy of Allergy, Asthma & Immunology evaluated the scientific evidence to develop consensus recommendations that are endorsed by both organizations. The task force took into account the strength of evidence and balanced the potential risks of recurrent reactions with those of premedication and product avoidance when making these recommendations to improve and standardize the care of patients who experience or have a history of reaction to ICM. © Radiological Society of North America and American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc on behalf of American Academy of Allergy, Asthma & Immunology and by Radiological Society of North America. All rights are reserved, including those for text and data mining, AI training, and similar technologies. This paper was jointly developed by The Journal of Allergy and Clinical Immunology: In Practice, Radiology and jointly published by Elsevier Inc and Radiological Society of North America. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article. Keywords: Contrast allergy, Contrast hypersensitivity, Iodinated contrast allergy, Iodinated contrast hypersensitivity, Anaphylaxis, Contrast skin testing, Contrast switching, Contrast reaction, Delayed contrast reaction, Immediate contrast reaction.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"24 1","pages":"e240100"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914844","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":"Idarubicin versus Epirubicin in Transarterial Chemoembolization for Barcelona Clinic Liver Cancer Stage B Hepatocellular Carcinoma: An Open-label, Randomized, Phase IV Trial.","authors":"Haikuan Liu,Wenzhe Fan,Haiqing Li,Liangliang Qiao,Zhilong Liu,Bowen Zhu,Jian Guo,Kun Huang,Yiyang Tang,Jie Wen,Miao Xue,Yanqin Wu,Yue Zhao,Yang Jiang,Kangshou Liu,Junjie Liang,Mingrong Cao,Jiaping Li","doi":"10.1148/radiol.242315","DOIUrl":"https://doi.org/10.1148/radiol.242315","url":null,"abstract":"Background Transarterial chemoembolization (TACE) is regarded as the first-line treatment for patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC). However, the optimal chemotherapeutic agent loaded in TACE remains controversial. Purpose To compare the efficacy and safety of idarubicin and epirubicin as loaded drugs in drug-eluting bead (DEB)-TACE in patients with BCLC stage B HCC. Materials and Methods In this open-label, phase IV trial, patients with BCLC stage B HCC were recruited from four centers from August 2020 to October 2022 and randomly assigned (at a one-to-one ratio) to undergo idarubicin DEB-TACE or epirubicin DEB-TACE. The primary end point was progression-free survival (PFS), which was measured from the time of randomization to the time of progression or death from any cause. The efficacy analysis was conducted on an intention-to-treat basis, and only participants who received treatment were included in the safety analysis. Results A total of 239 participants (median age, 57 years; IQR, 50-66 years; 210 male) were randomly assigned to the idarubicin group (n = 120) or the epirubicin group (n = 119). The primary analysis cutoff for PFS was March 1, 2023, with 167 events observed (70%; idarubicin group, 85 events; epirubicin group, 82 events). The median PFS was 10.8 months and 8.7 months in the idarubicin and epirubicin groups, respectively (hazard ratio [HR], 0.61; 95% CI: 0.44, 0.84; P = .002). The HR for median overall survival (OS) was 0.53 (95% CI: 0.31, 0.88), with OS rates of 81.5% and 77.3% at 12 months and 71.8% and 54.0% at 24 months for the idarubicin and epirubicin groups, respectively. The objective response rates were 70.8% and 57.1% for the idarubicin and epirubicin groups, respectively (P = .03). There was no evidence of a between-group difference in incidence of adverse events, including hematologic toxicity. No treatment-related deaths were observed. Conclusion Idarubicin DEB-TACE increased survival in participants with BCLC stage B HCC, without an increase in the incidence of any adverse events. Clinical trial registration no. ChiCTR2000034758 © RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"3 1","pages":"e242315"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914850","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":"Tackling Moral Distress in Radiology: Root Causes and Systemic Solutions.","authors":"Kate Hanneman, Mina S Makary","doi":"10.1148/radiol.250273","DOIUrl":"https://doi.org/10.1148/radiol.250273","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e250273"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111724","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 Bias and Fairness in AI.","authors":"Melissa A Davis","doi":"10.1148/radiol.250081","DOIUrl":"https://doi.org/10.1148/radiol.250081","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e250081"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111794","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}