Radiology最新文献

{"title":"Intraindividual Comparison of Ultrafast versus Standard Two-dimensional Dynamic Contrast-enhanced Breast MRI.","authors":"Maike Bode,Stephanie Morscheid,Elene Iordanishvili,Luisa C Huck,Shuo Zhang,Teresa Lemainque,Christiane K Kuhl","doi":"10.1148/radiol.241371","DOIUrl":"https://doi.org/10.1148/radiol.241371","url":null,"abstract":"Background Ultrafast breast MRI promises to improve conspicuity of cancers by avoiding masking due to background parenchymal enhancement (BPE) and to improve classification of enhancing lesions. However, published studies systematically penalized standard dynamic contrast-enhanced (DCE) MRI because they integrated ultrafast MRI into existing DCE protocols, such that postcontrast acquisitions of DCE MRI began only after completion of ultrafast MRI. Purpose To perform an intraindividual comparison of conspicuity and classification of enhancing breast lesions with ultrafast MRI versus standard DCE MRI, where both methods included the early postcontrast phase. Materials and Methods This was a retrospective analysis of 31 women (median age, 48 years [IQR, 39-51 years]) from September 2021 to January 2023. Women underwent DCE MRI at 1.5 T and, within 2 days, a second contrast-enhanced examination using ultrafast MRI, for further diagnostic assessment of difficult-to-interpret enhancing lesions and/or BPE. For DCE MRI, a two-dimensional gradient-echo series (0.61 × 0.61 × 3.0-mm spatial resolution, 60 seconds per dynamic frame) was obtained once before and four times after injection of 0.1 mmol/kg gadobutrol. For ultrafast MRI, a compressed-sense accelerated three-dimensional gradient-echo series (0.92 × 0.97 × 2.5-mm spatial resolution, 4 seconds per keyhole dynamic frame) was obtained over 90 seconds before, during, and after injection of 0.1 mmol/kg gadobutrol. Two breast radiologists independently rated BPE, image quality, and conspicuity and morphology of enhancing lesions, and enhancement kinetics were analyzed (ultrafast MRI: maximum slope and time to enhancement; DCE MRI: wash-in rate and time course pattern). Results A total 59 enhancing lesions were reported in the 62 breasts of the 31 patients. BPE ratings were on average 0.8 points lower at ultrafast versus DCE MRI (mean, 2.5 ± 1.2 [SD] vs 3.3 ± 1.2; P < .001). Despite this mild reduction in BPE, lesion conspicuity was rated lower at ultrafast than at DCE MRI (mean, 3.5 ± 1.3 vs 4.1 ± 1.0; P = .001), as was image quality (mean, 2.3 ± 0.9 vs 4.1 ± 0.8; P < .001). Lesion morphology (shape, margin, internal architecture) was less assessable at ultrafast MRI (all P < .05). Kinetic parameters derived from ultrafast MRI did not improve classification of enhancing lesions compared with those derived from DCE MRI: At ultrafast MRI, time to enhancement was shorter for malignant versus benign lesions (P = .01), but maximum slope did not differ, whereas at DCE MRI, both wash-in rate and time course pattern differed between malignant and benign lesions (both P = .01). Conclusion In this enriched cohort in which ultrafast MRI was expected to provide diagnostic advantages over DCE MRI, ultrafast MRI in fact led to reduced lesion conspicuity and did not improve lesion classification. © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Cotes and Jacobs in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"115 1","pages":"e241371"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914856","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":"Case 337: Venous Vascular Malformation.","authors":"Brian H Mu, Faris Galambo, Hadeer W Al-Ali, Sumeet G Dua, Chanae D Dixon, Xinhai R Zhang, Mustafa A Mafraji","doi":"10.1148/radiol.241910","DOIUrl":"https://doi.org/10.1148/radiol.241910","url":null,"abstract":"<p><strong>History: </strong>A 38-year-old previously healthy male patient presented with left-sided facial pain over the prior 5 weeks. He first noticed the pain while washing and applying pressure to his face. The pain was described as shock-like, sharp and shooting, and radiating along the left cheek and temple. It began as 1-2-second episodes occurring two to three times per day, sometimes spontaneously, progressing in severity and frequency over time. Mild progressive left facial weakness also developed a few weeks after initial symptoms. Physical examination demonstrated reproducible pain in the distribution of the maxillary division of the trigeminal nerve (V2), with normal motor and sensory function. A recent routine dental examination demonstrated healthy teeth and gums, and there was no history of dental procedures or trauma. The rest of the physical and neurologic examinations revealed no abnormalities. The patient was afebrile with normal vital signs. Findings of routine laboratory testing, including complete blood count, metabolic panel with electrolytes, kidney and liver function, and inflammatory markers such as C-reactive protein, were all within normal limits. Following the neurologic and otolaryngologic evaluations, imaging was recommended. The patient was also started on treatment with carbamazepine for trigeminal neuralgia, with modest improvement of symptoms. He initially underwent MRI of the temporal bones at an outside hospital. After subsequent referral to our hospital, follow-up concomitant MRI and CT were performed approximately 3 months after the initial imaging.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e241910"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151317","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":"Radiomic Parenchymal Phenotypes of Breast Texture from Mammography and Association with Risk of Breast Cancer.","authors":"Stacey J Winham, Anne Marie McCarthy, Christopher G Scott, Aimilia Gastounioti, Hannah Horng, Aaron D Norman, Walter C Mankowski, Lauren Pantalone, Matthew R Jensen, Raymond J Acciavatti, Andrew D A Maidment, Eric A Cohen, Kathleen R Brandt, Emily F Conant, Karla M Kerlikowske, Despina Kontos, Celine M Vachon","doi":"10.1148/radiol.240281","DOIUrl":"10.1148/radiol.240281","url":null,"abstract":"<p><p>Background Parenchymal phenotypes reflect the intrinsic heterogeneity of both tissue structure and distribution on mammograms. Purpose To define parenchymal phenotypes on the basis of radiomic texture features derived from full-field digital mammography (FFDM) in breast screening populations and assess associations of parenchymal phenotypes with future risk of breast cancer and masking (false-negative [FN] findings or interval cancers), beyond breast density, and by race and ethnicity Materials and Methods A two-stage study design included a retrospective cross-sectional study of 30 000 randomly selected women with four-view FFDM (mean age, 57.4 years) and a nested case-control study of 1055 women with invasive breast cancer (151 Black and 893 White women) matched to 2764 women without breast cancer (411 Black and 2345 White women) (mean age, 60.4 years) sampled from April 2008 to September 2019 from three diverse breast screening practices. Radiomic features (<i>n</i> = 390) were extracted and standardized using an automated pipeline and adjusted for age and practice. Variation was classified using hierarchical clustering and principal component (PC) analysis. The resulting clusters and PCs were examined for association with invasive breast cancer risk, FN findings on mammograms, and symptomatic interval cancers beyond radiologist-reported Breast Imaging Reporting and Data System (BI-RADS) breast density using conditional logistic regression and likelihood ratio tests. Discrimination for breast cancer was assessed with area under the receiver operating characteristic curve (AUC). Results Six clusters and six PCs were defined, replicated, and associated with a higher risk of invasive breast cancer (<i>P</i> = .01 and <i>P</i> < .001, respectively) after adjustment for age, body mass index (calculated as weight in kilograms divided by height in meters squared), and BI-RADS breast density. PCs showed similar associations among Black and White women (<i>P</i> = .23). PCs were also positively associated with FN findings (<i>P</i> = .004) and symptomatic interval cancers (<i>P</i> = .006). AUC improved for all breast cancer end points when incorporating PCs, with the greatest improvement shown in prediction of FN findings (AUC with vs without PCs, 0.73 [95% CI: 0.68, 0.78] vs 0.66 [95% CI: 0.61, 0.71] , respectively; <i>P</i> = .004) and symptomatic interval cancers (AUC with vs without PCs, 0.77 [95% CI: 0.71, 0.82] vs 0.68 [95% CI: 0.62, 0.74], respectively; <i>P</i> = .006). Conclusion Parenchymal phenotypes based on radiomic features extracted from FFDM were associated with a higher risk of invasive breast cancer, specifically for FN findings and symptomatic interval cancer. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Mesurolle and El Khoury in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e240281"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Malignancy in Cystic Lung Lesions in a Lung Cancer CT Screening Program.","authors":"Suzanne C Byrne, Andetta R Hunsaker, Mark M Hammer","doi":"10.1148/radiol.243166","DOIUrl":"10.1148/radiol.243166","url":null,"abstract":"<p><p>Background There is currently a lack of consensus regarding the risk of malignancy and the natural history of cystic lung lesions. Purpose To evaluate imaging characteristics associated with the risk of malignancy of cystic lung lesions in a lung cancer screening program. Materials and Methods This retrospective study included all CT lung cancer screening examinations performed from January 2015 to July 2023 in a large health care network. Radiology reports were queried for cystic lesions. Baseline CT images were reviewed, and lesion morphologic characteristics and size were recorded. All follow-up CT scans were evaluated for changes in the lesion. The risk of growth and diagnosis of cancer over time were analyzed with Kaplan-Meier curves. Results Among 15 762 patients, 235 were found to have cystic lung lesions; 33 (14%) of these patients were diagnosed with lung cancer arising from the cystic lesion. Increased risk of cancer was associated with nodular wall thickening (odds ratio [OR], 11; <i>P</i> = .002) and presence of a solid nodule (OR, 5.3; <i>P</i> < .001) alone or in combination with a ground-glass component (OR, 24; <i>P</i> < .001). Multilocularity was not associated with an increased risk of cancer (OR, 1.7; <i>P</i> > .2). There were no cases of malignancy in unilocular cystic lesions without wall thickening (<i>n</i> = 46). Lesion growth or increase in complexity over time was associated with an increased risk of malignancy (<i>P</i> < .001). The median time to lesion growth was 636 days. The median time to cancer diagnosis was 482 days, and 28 (85%) of the cancers were stage 0 or I. Conclusion Cystic lung lesions with nodular wall thickening had an increased risk of malignancy. Conversely, unilocular lesions without wall thickening had essentially no risk of malignancy. Most malignant cystic lung lesions exhibited indolent behavior, with slow growth and diagnosis at early stages. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Zagurovskaya in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e243166"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-articular Knee Injections and Progression of Knee Osteoarthritis: Data from the Osteoarthritis Initiative.","authors":"Upasana U Bharadwaj, John A Lynch, Gabby B Joseph, Zehra Akkaya, Michael C Nevitt, Nancy E Lane, Charles E McCulloch, Thomas M Link","doi":"10.1148/radiol.233081","DOIUrl":"10.1148/radiol.233081","url":null,"abstract":"<p><p>Background At least 10% of all patients with knee osteoarthritis (OA) undergo treatment with injectable corticosteroids or hyaluronic acid (HA). Although both have been shown to help with symptomatic pain relief, their long-term effects on knee OA progression remain inconclusive. Purpose To investigate the association between intra-articular knee injections, specifically corticosteroids and HA, and OA progression using a detailed whole-joint semiquantitative MRI evaluation and clinical outcomes for a period of 2 years. Materials and Methods This secondary analysis uses data from the Osteoarthritis Initiative (OAI), a multicenter, longitudinal, prospective study (February 2004 to January 2015). Participants who received a reported injection of corticosteroid or HA and propensity-score-matched controls (on age, sex, body mass index [calculated as weight in kilograms divided by height in meters squared], and clinical variables) were analyzed. Using the Whole-Organ MRI Score (WORMS) system for cartilage, bone marrow lesions, and meniscus, 3-T MRI performed at the time of injection, 2 years prior, and 2 years after were semiquantitatively graded. Postinjection progression was quantified using WORMS difference between time of injection and the 2-year follow-up. Associations with injection type were analyzed using repeated measures of analysis of covariance. Results There were 210 participants analyzed (mean age, 64 years ± 7.9 years [SD]; 126 female participants). Corticosteroids were associated with greater WORMS progression compared with controls (mean difference, 0.39; 95% CI: 0.05, 0.75; <i>P</i> = .02) and HA (0.42; 95% CI: 0.01, 0.84; <i>P</i> = .04). HA was associated with decreased WORMS progression compared with the injection-concurrent time frame (mean difference, -0.42; 95% CI: -1.34, -0.28; <i>P</i> = .003). Both corticosteroids (mean difference in Western Ontario and McMaster Universities Osteoarthritis Index scores, -5.20; 95% CI: -6.91, -3.48; <i>P</i> = .001) and HA injections (-2.15; 95% CI: -4.42, -0.13; <i>P</i> = .04) were associated with reduced pain after injection. Conclusion Corticosteroid injections were associated with higher OA progression than HA injections and controls, whereas HA was associated with decreased progression at MRI for up to 2 years after injection. ClinicalTrials.gov Identifier: NCT00080171 © RSNA, 2025.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e233081"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum for: MRI-based Deep Learning Assessment of Amyloid, Tau, and Neurodegeneration Biomarker Status across the Alzheimer Disease Spectrum.","authors":"Christopher O Lew, Longfei Zhou, Maciej A Mazurowski, P Murali Doraiswamy, Jeffrey R Petrella","doi":"10.1148/radiol.259008","DOIUrl":"10.1148/radiol.259008","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e259008"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Field-Cycling MRI for Identifying Minor Ischemic Stroke.","authors":"Ajay Malhotra,Dheeraj Gandhi","doi":"10.1148/radiol.242774","DOIUrl":"https://doi.org/10.1148/radiol.242774","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"2 1","pages":"e242774"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914791","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":"Digital Breast Tomosynthesis and Digital Mammography Associated with Similar Rates of Advanced Cancer.","authors":"Karla Kerlikowske,Jeffrey A Tice","doi":"10.1148/radiol.242837","DOIUrl":"https://doi.org/10.1148/radiol.242837","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"11 1","pages":"e242837"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914841","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":"Floating Aortic Thrombus and Acute Myocardial Infarction.","authors":"Lihua Yu, Jiayin Zhang","doi":"10.1148/radiol.242582","DOIUrl":"https://doi.org/10.1148/radiol.242582","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e242582"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111775","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":"Pediatric Imaging 2040.","authors":"Nathan C Hull, Donald P Frush, Winnie C W Chu, Carlos F Ugas Charcape, Joanna Kasznia-Brown, Edward Y Lee","doi":"10.1148/radiol.250378","DOIUrl":"https://doi.org/10.1148/radiol.250378","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 2","pages":"e250378"},"PeriodicalIF":12.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151506","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}