Radiology最新文献

{"title":"The Importance of Clinical History in the Evaluation of Lumbar Spine Imaging.","authors":"Masis Isikbay, Vinil Shah","doi":"10.1148/radiol.242556","DOIUrl":"https://doi.org/10.1148/radiol.242556","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 1","pages":"e242556"},"PeriodicalIF":12.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522829","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 QIBA Profile for Diffusion-Weighted MRI: Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker.","authors":"Michael A Boss,Dariya Malyarenko,Savannah Partridge,Nancy Obuchowski,Amita Shukla-Dave,Jessica M Winfield,Clifton D Fuller,Kevin Miller,Virendra Mishra,Michael Ohliger,Lisa J Wilmes,Raj Attariwala,Trevor Andrews,Nandita M deSouza,Daniel J Margolis,Thomas L Chenevert","doi":"10.1148/radiol.233055","DOIUrl":"https://doi.org/10.1148/radiol.233055","url":null,"abstract":"The apparent diffusion coefficient (ADC) provides a quantitative measure of water mobility that can be used to probe alterations in tissue microstructure due to disease or treatment. Establishment of the accepted level of variance in ADC measurements for each clinical application is critical for its successful implementation. The Diffusion-Weighted Imaging Biomarker Committee of the Quantitative Imaging Biomarkers Alliance (QIBA) has recently advanced the ADC Profile from the consensus to clinically feasible stage for the brain, liver, prostate, and breast. This profile distills multiple studies on ADC repeatability and describes detailed procedures to achieve stated performance claims on an observed ADC change within acceptable confidence limits. In addition to reviewing the current ADC Profile claims, this report has used recent literature to develop proposed updates for establishing metrology benchmarks for mean lesion ADC change that account for measurement variance. Specifically, changes in mean ADC exceeding 8% for brain lesions, 27% for liver lesions, 27% for prostate lesions, and 15% for breast lesions are claimed to represent true changes with 95% confidence. This report also discusses the development of the ADC Profile, highlighting its various stages, and describes the workflow essential to achieving a standardized implementation of advanced quantitative diffusion-weighted MRI in the clinic. The presented QIBA ADC Profile guidelines should enable successful clinical application of ADC as a quantitative imaging biomarker and ensure reproducible ADC measurements that can be used to confidently evaluate longitudinal changes and treatment response for individual patients.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"40 1","pages":"e233055"},"PeriodicalIF":19.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385520","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":"MRI-based Zero Echo Time and Black Bone Pseudo-CT Compared with Whole-Body CT to Detect Osteolytic Lesions in Multiple Myeloma.","authors":"Frederic E Lecouvet,Deniz Zan,Darius Lepot,Caroline Chabot,Marie-Christiane Vekemans,Gaëtan Duchêne,Ophélye Chiabai,Perrine Triqueneaux,Thomas Kirchgesner,Lokmane Taihi,Julie Poujol,Olivier Gheysens,Nicolas Michoux","doi":"10.1148/radiol.231817","DOIUrl":"https://doi.org/10.1148/radiol.231817","url":null,"abstract":"Background MRI is highly sensitive for assessing bone marrow involvement in multiple myeloma (MM) but does not enable detection of osteolysis. Purpose To assess the diagnostic accuracy, repeatability, and reproducibility of pseudo-CT MRI sequences (zero echo time [ZTE], gradient-echo black bone [BB]) in detecting osteolytic lesions in MM using whole-body CT as the reference standard. Materials and Methods In this prospective study, consecutive patients were enrolled in our academic hospital between June 2021 and December 2022. Inclusion criteria were newly diagnosed MM, monoclonal gammopathy of undetermined significance at high risk for MM, or suspicion of progressive MM. Participants underwent ZTE and BB sequences covering the lumbar spine, pelvis, and proximal femurs as part of 3-T whole-body MRI examinations, as well as clinically indicated fluorine 18 fluorodeoxyglucose PET/CT examination within 1 month that included optimized whole-body CT. Ten bone regions and two scores (categorical score = presence/absence of osteolytic lesion; semiquantitative score = osteolytic lesion count) were assessed by three radiologists (two experienced and one unfamiliar with pseudo-CT reading) on the ZTE, BB, and whole-body CT images. The accuracy, repeatability, and reproducibility of categorical scores (according to Gwet agreement coefficients AC1 and AC2) and differences in semiquantitative scores were assessed at the per-sequence, per-region, and per-patient levels. Results A total of 47 participants (mean age, 67 years ± 11 [SD]; 27 male) were included. In experienced readers, BB and ZTE had the same high accuracy (98%) in the per-patient analysis, while BB accuracy ranged 83%-100% and ZTE accuracy ranged 74%-94% in the per-region analysis. An increase of false-negative (FN) findings in the spine ranging from +17% up to +23%, according to the lumbar vertebra, was observed using ZTE (P < .013). Regardless of the region (except coxal bones), differences in the BB score minus the ZTE score were positively skewed (P < .021). Regardless of the sequence or region, repeatability was very good (AC1 ≥0.87 for all), while reproducibility was at least good (AC2 ≥0.63 for all). Conclusion Both MRI-based ZTE and BB pseudo-CT sequences of the lumbar spine, pelvis, and femurs demonstrated high diagnostic accuracy in detecting osteolytic lesions in MM. Compared with BB, the ZTE sequence yielded more FN findings in the spine. ClinicalTrials.gov Identifier: NCT05381077 Published under a CC BY 4.0 license. Supplemental material is available for this article.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"30 1","pages":"e231817"},"PeriodicalIF":19.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385659","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 Ovarian-Adnexal Reporting and Data System (O-RADS) US Score Effect on Surgical Resection Rate.","authors":"Luyao Shen,Elizabeth A Sadowski,Akshya Gupta,Katherine E Maturen,Krupa K Patel-Lippmann,Hanna M Zafar,Aya Kamaya,Neha Antil,Yang Guo,Lisa M Barroilhet,Priyanka Jha","doi":"10.1148/radiol.240044","DOIUrl":"https://doi.org/10.1148/radiol.240044","url":null,"abstract":"Background The Ovarian-Adnexal Imaging Reporting and Data System (O-RADS) US risk score can be used to accurately stratify ovarian lesions based on morphologic characteristics. However, there are no large multicenter studies assessing the potential impact of using O-RADS US version 2022 risk score in patients referred for surgery for an ovarian or adnexal lesion. Purpose To retrospectively determine the proportion of patients with ovarian or adnexal lesions without acute symptoms who may have been managed conservatively by using the O-RADS US version 2022 risk score. Materials and Methods This multicenter retrospective study included patients with ovarian cystic lesions and nonacute symptoms who underwent surgical resection after US before the introduction of O-RADS US between January 2011 and December 2014. Investigators blinded to the final diagnoses recorded lesion imaging features and O-RADS US risk scores. The frequency of malignancy and the diagnostic performance of the risk score were calculated. The Mann-Whitney test and Fisher exact test were performed, with P < .05 indicating a statistically significant difference. Results A total of 377 patients with surgically resected lesions were included. Among the resected lesions, 42% (157 of 377) were assigned an O-RADS US risk score of 2. Of the O-RADS US 2 lesions, 54% (86 of 157) were nonneoplastic, 45% (70 of 157) were dermoids or other benign tumors, and less than 1% (one of 157) were malignant. Using O-RADS US 4 as the optimal threshold for malignancy prediction yielded a 94% (68 of 72) sensitivity, 64% (195 of 305) specificity, 38% (68 of 178) positive predictive value, and 98% (195 of 199) negative predictive value. Conclusion In patients without acute symptoms who underwent surgery for ovarian and adnexal lesions before the O-RADS US risk score was published, nearly half (42%) of surgically resected lesions retrospectively met the O-RADS US 2 version 2022 criteria. In these patients, imaging follow-up or conservative management could have been offered. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Fournier in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"98 1","pages":"e240044"},"PeriodicalIF":19.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385531","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":"Clinical Effectiveness of Automated Coronary CT-derived Fractional Flow Reserve: A Chinese Randomized Controlled Trial.","authors":"Bangjun Guo, Wei Xing, Chunhong Hu, Yunfei Zha, Xindao Yin, Yongsheng He, Shudong Hu, Yibing Shi, Fajin Lv, Rongpin Wang, Xiaohu Li, Hongmei Gu, Wei Cao, Jinhua Zhang, Yunfeng Zhou, Yi Xu, Meng Chun Jiang, Jian Zhong, Jinggang Zhang, Meng Chen, Baojun Xie, Qian Chen, Wenqiang Diao, Hongyan Qiao, Ying Zhang, Rui Xia, Xinfeng Liu, Shu Min Tao, Tao Zhang, Chang Qing Yin, Wenjun Li, Mengmeng Zhu, Chang Sheng Zhou, Jian Hua Li, Fan Zhou, Chun Yu Liu, Xiao Lei Zhang, Peng Peng Xu, Wen Zhang, Meng Jie Lu, Yu Xiu Liu, Yongyue Wei, Yueqin Chen, Chun Xiang Tang, Guang Ming Lu, Long Jiang Zhang","doi":"10.1148/radiol.233354","DOIUrl":"10.1148/radiol.233354","url":null,"abstract":"<p><p>Background Coronary CT-derived fractional flow reserve (CT-FFR) has been used in patients with suspected coronary artery disease (CAD); however, whether it decreases invasive coronary angiography (ICA) use and affects prognosis remains insufficiently evidenced. Purpose To explore the effectiveness of adding CT-FFR to routine coronary CT angiography (CCTA) on short-term ICA rate and major adverse cardiovascular events (MACE) in a Chinese setting. Materials and Methods A multicenter randomized controlled trial was conducted in 17 Chinese centers, with patient inclusion from May 2021 to September 2021. Eligible individuals with 25%-99% stenosis at CCTA were randomly assigned 1:1 to a strategy of CCTA plus automated CT-FFR or CCTA alone for guiding downstream care. The primary end point was the ICA rate 90 days after enrollment. Secondary end points included 90-day and 1-year MACE rates (comprised of all-cause mortality, nonfatal myocardial infarction, and urgent revascularization) and 1-year cardiac events (comprised of cardiac death, nonfatal myocardial infarction, and urgent revascularization). The Cox proportional hazards model with center effect adjustment was used for survival comparisons. Results A total of 5297 participants (mean age, 63.5 years ± 10.8 [SD]; 3178 male) were included. During the 90-day follow-up, ICA was performed in 263 of 2633 participants (10.0%) in the CCTA plus CT-FFR group and 327 of 2640 participants (12.4%) in the CCTA-alone group (absolute rate difference: -2.40%; 95% CI: -4.10, -0.70; <i>P</i> = .006). The MACE rates at 90 days (0.5% [12 of 2633 participants] vs 0.8% [21 of 2640 participants]; <i>P</i> = .12) and 1 year (2.9% [74 of 2546 participants] vs 2.8% [72 of 2531 participants]; <i>P</i> = .90) were similar for both groups. At 1-year follow-up, fewer cardiac events were observed in the CCTA plus CT-FFR group compared with the CCTA-alone group (0.5% vs 1.1%; adjusted hazard ratio: 0.52; 95% CI: 0.27, 0.99; <i>P</i> = .047). Conclusion CT-FFR added to CCTA led to a lower 90-day ICA rate and similar 1-year MACE rate in a Chinese real-world setting. Further follow-up is warranted to demonstrate the long-term prognostic value of this management approach. © RSNA, 2024 <i>Supplemental material is available for this article.</i> See also the editorial by Pundziute-do Prado in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 1","pages":"e233354"},"PeriodicalIF":12.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473348","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 Delays, Worse Prognosis: The Importance of Prompt Follow-up in Stage I Lung Cancer.","authors":"Chang Min Park, Taehee Lee","doi":"10.1148/radiol.242622","DOIUrl":"10.1148/radiol.242622","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 1","pages":"e242622"},"PeriodicalIF":12.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473350","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":"Meta-Analysis of Interobserver Agreement in Assessment of Interstitial Lung Disease Using High-Resolution CT.","authors":"Liam Delaney, Samer Alabed, Ahmed Maiter, Mahan Salehi, Marcus Goodlad, Hassan Shah, Elliot Checkley, Sue Matthews, Mohamed Kamil, Oscar Evans, Smitha Rajaram, Christopher Johns, Nicholas J Screaton, Andrew J Swift, Krit Dwivedi","doi":"10.1148/radiol.240016","DOIUrl":"10.1148/radiol.240016","url":null,"abstract":"<p><p>Background High-resolution CT (HRCT) is central to the assessment of interstitial lung disease (ILD), and accurate classification of disease has important implications for patients. Evaluation of imaging features can be challenging, even for experienced thoracic radiologists. Previous work has provided equivocal evidence on the interpretation of HRCT features at ILD-related imaging. Purpose To perform a meta-analysis to assess the level of agreement among expert thoracic radiologists in interpreting ILD-related imaging. Materials and Methods A systematic literature search from January 2000 to October 2023 of the Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases was performed for articles reporting assessments of interobserver agreement between thoracic radiologists for evaluation of ILD findings, such as severity and progression of disease, presence of features such as honeycombing and ground-glass opacification, and classification based on the 2011 and 2018 American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Asociación Latinoamericana del Tórax (ATS/ERS/JRS/ALAT) guidelines for idiopathic pulmonary fibrosis (IPF). Meta-analysis was performed using a random-effects model to obtain pooled κ or intraclass correlation coefficient (ICC) values as measures of interobserver agreement. Results The final analysis included 13 studies consisting of 6943 images and 146 radiologists. In 10 studies assessing agreement of specific radiologic findings in ILD, the pooled κ value was 0.56 (95% CI: 0.43, 0.70). In eight studies, the assessed interobserver agreement of the ATS/ERS/JRS/ALAT diagnostic guidelines for IPF based on usual interstitial pneumonia (UIP) patterns, the pooled κ value was 0.61 (95% CI: 0.48, 0.74). One study reported a κ value of 0.87 for ILD progression. Seven studies assessing ILD severity could not be pooled; the individual κ values for ILD severity ranged from 0.64 to 0.90, and ICC values ranged from 0.63 to 0.96. Conclusion There was moderate agreement between thoracic radiologists when assessing ILD features and UIP pattern diagnosis but little evidence on agreement of disease severity, extent, or progression. Meta-analysis registry no. PROSPERO CRD42022361803 © RSNA, 2024 <i>Supplemental material is available for this article</i>. See also the editorial by Humbert in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 1","pages":"e240016"},"PeriodicalIF":12.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473359","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":"Evaluation of GPT Large Language Model Performance on RSNA 2023 Case of the Day Questions.","authors":"Pritam Mukherjee, Benjamin Hou, Abhinav Suri, Yan Zhuang, Christopher Parnell, Nicholas Lee, Oana Stroie, Ravi Jain, Kenneth C Wang, Komal Sharma, Ronald M Summers","doi":"10.1148/radiol.240609","DOIUrl":"10.1148/radiol.240609","url":null,"abstract":"<p><p>Background GPT-4V (GPT-4 with vision, ChatGPT; OpenAI) has shown impressive performance in several medical assessments. However, few studies have assessed its performance in interpreting radiologic images. Purpose To assess and compare the accuracy of GPT-4V in assessing radiologic cases with both images and textual context to that of radiologists and residents, to assess if GPT-4V assistance improves human accuracy, and to assess and compare the accuracy of GPT-4V with that of image-only or text-only inputs. Materials and Methods Seventy-two Case of the Day questions at the RSNA 2023 Annual Meeting were curated in this observer study. Answers from GPT-4V were obtained between November 26 and December 10, 2023, with the following inputs for each question: image only, text only, and both text and images. Five radiologists and three residents also answered the questions in an \"open book\" setting. For the artificial intelligence (AI)-assisted portion, the radiologists and residents were provided with the outputs of GPT-4V. The accuracy of radiologists and residents, both with and without AI assistance, was analyzed using a mixed-effects linear model. The accuracies of GPT-4V with different input combinations were compared by using the McNemar test. <i>P</i> < .05 was considered to indicate a significant difference. Results The accuracy of GPT-4V was 43% (31 of 72; 95% CI: 32, 55). Radiologists and residents did not significantly outperform GPT-4V in either imaging-dependent (59% and 56% vs 39%; <i>P</i> = .31 and .52, respectively) or imaging-independent (76% and 63% vs 70%; both <i>P</i> = .99) cases. With access to GPT-4V responses, there was no evidence of improvement in the average accuracy of the readers. The accuracy obtained by GPT-4V with text-only and image-only inputs was 50% (35 of 70; 95% CI: 39, 61) and 38% (26 of 69; 95% CI: 27, 49), respectively. Conclusion The radiologists and residents did not significantly outperform GPT-4V. Assistance from GPT-4V did not help human raters. GPT-4V relied on the textual context for its outputs. © RSNA, 2024 <i>Supplemental material is available for this article.</i> See also the editorial by Katz in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 1","pages":"e240609"},"PeriodicalIF":12.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352740","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":"Clarifications on the Differentiation of Vertebral Fractures Using Deep Learning Models.","authors":"Shannon L Walston, Shingo Sato, Yasuhito Mitsuyama, Hirotaka Takita, Daiju Ueda","doi":"10.1148/radiol.241162","DOIUrl":"https://doi.org/10.1148/radiol.241162","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 1","pages":"e241162"},"PeriodicalIF":12.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352723","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":"Recurrent Ischemic Strokes Due to Anatomic Variation of the Hyoid Bone and Thyroid Cartilage.","authors":"Chunchao Xia, Zhenlin Li","doi":"10.1148/radiol.241186","DOIUrl":"https://doi.org/10.1148/radiol.241186","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"313 1","pages":"e241186"},"PeriodicalIF":12.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473371","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}