Radiology. Cardiothoracic imaging最新文献

{"title":"Evaluation of Wideband Pulse Sequences for Suppressing Image Artifacts in Children with Cardiac Implantable Electronic Devices.","authors":"Oluyemi Aboyewa, Andrada Popescu, Simon Lee, Joseph Camarda, KyungPyo Hong, Dhaivat Shah, Christina Laternser, Laleh Golestanirad, Daniel Kim, Gregory Webster","doi":"10.1148/ryct.250310","DOIUrl":"10.1148/ryct.250310","url":null,"abstract":"<p><p>Purpose To determine whether wideband late gadolinium enhancement (LGE) and wideband perfusion pulse sequences suppress image artifacts in children in the presence of a cardiac implantable electronic device (CIED). Materials and Methods In the first experiment of this prospective study, unenhanced cardiac MRI was performed at 1.5 T in 18 healthy pediatric participants (median age, 12 years [range, 10-15 years]; 12 [67%] female) with and without a CIED generator taped in the subclavicular and abdominal positions. LGE and perfusion scans were performed with standard and wideband sequences in each state. Three clinical raters adjudicated the presence or absence of clinically relevant image artifacts. Image artifacts were also quantified. In the second experiment, wideband perfusion and LGE MRI scans with gadolinium-based contrast material administration were performed on four pediatric participants (median age, 15 years [range, 15-19 years]; three [75%] female) with CIEDs in situ. Image quality was graded on a five-point Likert scale by clinical raters (3 = clinically acceptable). Myocardial blood flow was also quantified. Results In the participant experiments, standard LGE produced image artifacts in 61.81% (178 of 288) and 37.15% (107 of 288) of myocardial segments for subclavicular and abdominal IPGs, respectively, and were significantly different (<i>P</i> < .001) from wideband LGE (14.68% [42 of 288] and 0%, respectively) for both positions. Quantitative analysis results were consistent with expert adjudication. Wideband cardiac MRI in four children with CIEDs achieved high image quality (median score ≥ 4.0) and mean resting myocardial blood flow value of 1.06 mL/min/g (<i>n</i> = 3). Conclusion Compared with standard LGE and perfusion MRI, wideband LGE and perfusion MRI produced significantly fewer image artifacts induced by CIEDs in pediatric participants. <b>Keywords:</b> Wideband, Pediatric, Late Gadolinium Enhancement, Perfusion, Pacemaker, Defibrillator <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250310"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dark-Field Chest Radiography for Pneumothorax Detection: A Prospective Study.","authors":"Florian T Gassert, Henriette Bast, Theresa Urban, Rafael Schick, Maximilian E Lochschmidt, Lennard Kaster, Thomas Koehler, Alexandra Karrer, Ariane Keppler, Manuel Steinhardt, Alexander W Marka, Lisa Steinhelfer, Andreas P Sauter, Marcus R Makowski, Franz Pfeiffer, Daniela Pfeiffer","doi":"10.1148/ryct.240560","DOIUrl":"10.1148/ryct.240560","url":null,"abstract":"<p><p>Purpose To evaluate the potential of dark-field chest radiography to improve the detection and assessment of pneumothorax. Materials and Methods This prospective study was conducted between March 2022 and September 2023. Participants with or without pneumothorax underwent chest radiography using a prototype system that acquires attenuation-based and dark-field images simultaneously. Five blinded readers independently assessed attenuation-only radiographs and then, after a 4-week interval, assessed dark-field overlay images. Sensitivity, specificity, accuracy, reading time, and diagnostic confidence for pneumothorax detection were compared between the two approaches using appropriate statistical tests. Results The sample included 100 participants (median age, 62 years; IQR, 52-71 years; 61 male participants), including 36 individuals with clinically confirmed pneumothorax and 64 healthy controls. A nonsignificant increase in sensitivity for pneumothorax detection was observed with dark-field overlays (87.4% [95% CI: 67.5, 95.8]) compared with attenuation-based radiographs (84.2% [95% CI: 73.2, 91.2], <i>P</i> = .61), whereas specificity was nearly identical (97.6% [95% CI: 94.0, 99.1] vs 97.5 [95% CI: 95.7, 98.6], <i>P</i> = .89). The median reading time decreased from 30.8 seconds to 10.3 seconds (<i>P</i> < .001), and diagnostic confidence improved across all readers (median score: 3 vs 4; <i>P</i> < .001). Conclusion The addition of dark-field radiography to conventional chest radiography improves pneumothorax detection, substantially reduces reading time, and enhances diagnostic confidence without loss of sensitivity and specificity. <b>Keywords:</b> Pneumothorax, Radiography, Dark-Field © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e240560"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Photon-counting CT-based Virtual Monoenergetic Imaging on Detecting Myocardial Late Iodine Enhancement Compared to Cardiac MRI.","authors":"Chiara Gnasso, Milán Vecsey-Nagy, Muhammad Taha Hagar, U Joseph Schoepf, Daniel Alfonso Pinos Sanchez, Emese Zsarnóczay, Dmitrij Kravchenko, Giuseppe Tremamunno, Robert J Holtackers, Moritz C Halfmann, Tilman Emrich, Akos Varga-Szemes","doi":"10.1148/ryct.250072","DOIUrl":"10.1148/ryct.250072","url":null,"abstract":"<p><p>Purpose To investigate the image quality and diagnostic performance of photon-counting detector CT-based delayed enhancement (DE) at different virtual monoenergetic imaging (VMI) levels in detecting and characterizing myocardial fibrosis, using MRI as the reference. Materials and Methods This post hoc subanalysis of a prospective research cohort included participants who underwent late gadolinium enhancement MRI between July 2021 and January 2022 and same-day research CT DE on a photon-counting detector CT system. CT DE scans at different VMI levels (40-90 keV) were evaluated by two blinded readers in terms of subjective and objective image quality and presence and distribution of myocardial fibrosis. Diagnostic performance measures were calculated, and agreement with MRI was evaluated with Cohen κ statistics. Results The CT DE scans of 27 participants (mean age, 52.9 years ± 17.2 [SD]; 14 female) were analyzed. Twelve of 27 (44%) participants and 87 of 459 (19%) segments had a positive late gadolinium enhancement MRI. VMI at 50 keV demonstrated an adequate trade-off between objective (image noise and contrast-to-noise ratio) and subjective (image noise and sharpness and overall quality) image quality, exhibiting the highest sensitivity, specificity, and accuracy in focal fibrosis detection, in per-segment analyses (87.4% [95% CI: 80.4, 94.3], 97.8% [95% CI: 96.4, 99.3], and 95.9% [95% CI: 94.0, 97.7], respectively), with a strong agreement with MRI (κ = 0.86). These reconstructions showed the highest concordance in discriminating fibrosis patterns. Conclusion Photon-counting detector myocardial CT DE with VMI reconstructions at 50 keV represents a valuable tool for myocardial fibrosis detection and characterization, with best diagnostic performance and agreement with MRI when compared with other kiloelectron volt levels. <b>Keywords:</b> Virtual Monoenergetic Images, Late Iodine Enhancement, Myocardial Fibrosis, Photon-counting Detector CT <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250072"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-derived Right Ventricular Global Longitudinal Strain Predicts Heart Failure.","authors":"Sucharitha Chadalavada, Adil Mahmood, Janek Salatzki, Kerrick Hesse, Kenneth Fung, Mohammed Y Khanji, Zahra Raisi-Estabragh, Nay Aung, Steffen E Petersen","doi":"10.1148/ryct.240493","DOIUrl":"10.1148/ryct.240493","url":null,"abstract":"<p><p>Purpose To evaluate the association of right ventricular (RV) strain metrics derived from feature-tracking cardiac MRI with incident heart failure (HF). Materials and Methods This retrospective analysis included data of 45 700 participants (23 764 female) from the UK Biobank Imaging Study between August 2006 and July 2010. Cardiac MRI scans were performed using standardized UK Biobank protocols and equipment. Image analysis was performed with feature-tracking module of a certified postprocessing software (cvi42 prototype version 5.13.7). Biologically implausible and statistical outliers were excluded. The association of each RV global strain marker (global longitudinal strain [GLS], global circumferential strain [GCS], and global radial strain [GRS]) with incident HF was assessed using univariable and multivariable Cox regression models adjusted for established clinical features and RV imaging markers with known prognostic values. Results The mean age ± SD of the 45 700 study participants (23 764 female) was 65 years ± 7.7, and median follow-up was 3 years. Lower absolute RV GLS, RV GCS, and RV GRS were associated with increased HF risk (hazard ratio [HR]: 1.34, 1.37, and 0.71, respectively; <i>P</i> < .001 for all). According to multivariable analyses adjusted for conventional RV imaging markers and clinical covariates, only RV GLS independently predicted HF (HR: 1.16; 95% CI: 1.02, 1.33; <i>P</i> = .04). Conclusion In the general population, RV GLS, RV GCS, and RV GRS are independently predictive of HF after accounting for clinical features. RV GLS demonstrated independent predictive value against conventionally used RV imaging markers and clinical features. <b>Keywords:</b> Cardiac MRI, Right Ventricle, Myocardial Strain, Heart Failure, Survival Analysis <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e240493"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Diagnostic Parameters Using Cardiac CT-derived Aortic Valve Area and Aortic Valve Calcium Scores for Low-Gradient Aortic Stenosis.","authors":"Syed Ahmad, HangYu Watson, Maan Awad, Philippe Pibarot, Jonathon Leipsic, Seher Berzingi, Kunal Patel, Sameh Nassar, Basel Abdelazeem, Sudarshan Balla, Irfan Zeb","doi":"10.1148/ryct.250071","DOIUrl":"10.1148/ryct.250071","url":null,"abstract":"<p><p>Purpose To compare the performance of cardiac CT-derived hybrid aortic valve area (AVA) and planimetry, in combination with aortic valve calcium (AVC) or AVC density (AVCd), for assessing low-gradient aortic stenosis (LGAS). Materials and Methods This retrospective analysis included patients with LGAS (mean gradient < 40 mm Hg) who underwent echocardiography and cardiac CT from November 2018 to March 2022. The performance of absolute and indexed hybrid AVA and planimetry, combined with either absolute AVC or AVCd, was compared by time-to-event analysis and outcome classification ability. Results A total of 215 patients (mean age, 79.2 years ± 8.4 [SD]; 118 male patients) were included in the study. Of these, 74.4% (160 of 215) experienced a composite outcome of valve intervention or all-cause mortality during follow-up. Specifically, 11% (23 of 215) underwent surgical aortic valve replacement, 59% (126 of 215) underwent transcatheter aortic valve replacement, and 15% (32 of 215) died. The median follow-up duration was 478 days (IQR, 283-716 days). Indexed AVA measures performed better than absolute AVA. All models showed comparable discrimination, as measured by Harrell C statistic. The highest performing model was indexed AVA calculated using left ventricular outflow tract area derived from minimum CT diameter combined with absolute AVC (hazard ratio, 2.29; 95% CI: 1.66, 3.15; <i>P</i> < .001; C statistic, 0.60). The lowest performing model was absolute AVA planimetry with AVCd (hazard ratio, 1.62; 95% CI: 1.19, 2.22; <i>P</i> = .002; C statistic, 0.55). Conclusion Diagnostic strategies involving hybrid AVA and AVC or AVCd demonstrated comparable performance in LGAS assessment. Indexed hybrid AVA measures performed better alone or in combination with AVC compared with the absolute AVA measures. <b>Keywords:</b> Aortic Valve Calcium, Cardiac CT, Low-Gradient Aortic Stenosis <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250071"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Fourth Universal Definition ECG Criteria for Identifying Prior Myocardial Infarction.","authors":"Martin Segeroth, Patrick Badertscher, Ivo Strebel, Jan Gerrit van der Stouwe, Jude Formambuh, Federico Caobelli, Antonio Madaffari, Gregor Sommer, Pedro Lopez-Ayala, Simon M Frey, Michael Kuehne, Christian Sticherling, Maurice Pradella, Michael J Zellweger, Christian Mueller, Jens Bremerich, Philip Haaf","doi":"10.1148/ryct.250082","DOIUrl":"10.1148/ryct.250082","url":null,"abstract":"<p><p>Purpose To assess the diagnostic accuracy of 12-lead electrocardiography (ECG) in detecting, quantifying, and localizing prior myocardial infarction (pMIs) using cardiac MRI as the reference standard. Materials and Methods In this retrospective study, consecutive patients referred for cardiac MRI and their recorded digital ECGs were evaluated between January 2018 and August 2020. Patients underwent cardiac MRI assessment for coronary artery disease or cardiomyopathy. Late gadolinium enhancement was assessed across a 17-segment heart model for patients with and without ischemia. Two blinded cardiologists independently applied the fourth universal definition of myocardial infarction ECG criteria to identify pMIs. Diagnostic accuracy of ECG in detecting pMI was assessed by calculating accuracy, sensitivity, and specificity; χ² test was used to assess the independence of observed frequencies. Results Among 1038 patients (median age, 63 years; IQR, 52-75 years, 405 female patients), ECG detection accuracy for pMI was 78.6% (88.4% specificity and 39.4% sensitivity). Using ECG, 40.2% of all transmural pMIs and 12.3% of all subendocardial pMIs were detected. ECG did not detect pMIs in 126 of 208 (60.6%) patients, particularly in the lateral (69.3%) and inferior (52.3%) regions. ECG did not detect 72.6% and 48.0% of subendocardial and transmural pMIs, respectively. Detection rates decreased further in the presence of complete left or right bundle branch block. Nonspecific conduction disturbances were more common in patients with pMIs (5.3% vs 1.6%, <i>P</i> = .003), especially those with transmural pMIs (6.9% vs 1.6%, <i>P</i> = .002). Conclusion The Fourth Universal Definition of Myocardial Infarction ECG criteria provided high specificity but limited sensitivity for detecting pMI, particularly subendocardial and lateral infarcts. <b>Keywords:</b> Electrocardiogram, Cardiovascular Magnetic Resonance, Myocardial Infarction, Late Gadolinium Enhancement, Fourth Universal Definition of Myocardial Infarction <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250082"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular MRI-based Biventricular Perfusion Assessment in Two Patients with Chronic Thromboembolic Pulmonary Hypertension Undergoing Pulmonary Thromboendarterectomy.","authors":"Lexiaozi Fan, María Davó-Jiménez, Brandon C Benefield, Nour Beydoun, David Dushfunian, Sebastian Cohn, Michael Cuttica, Ruben Mylvaganam, S Chris Malaisrie, Stephen Chiu, Li-Yueh Hsu, Ryan Avery, Daniel Schimmel, Yasmin Raza, Jordyn Durkin, Donny Nieto, Michael Markl, Daniel C Lee, Daniel Kim, Benjamin H Freed","doi":"10.1148/ryct.250296","DOIUrl":"10.1148/ryct.250296","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) can lead to right ventricular (RV) ischemia and dysfunction due to chronic pulmonary artery obstruction and increased afterload. While cardiovascular MRI (CMR) enables noninvasive assessment of myocardial perfusion, its role in CTEPH remains unclear. The authors report adenosine stress perfusion CMR findings from two patients with CTEPH before and after pulmonary thromboendarterectomy (PTE). Both showed reduced biventricular perfusion before PTE; one demonstrated post-PTE improvement. Perfusion findings aligned with invasive hemodynamics, suggesting that CMR-derived myocardial perfusion reserve may serve as a valuable tool for assessing treatment response and RV pathophysiologic characteristics in CTEPH. <b>Keywords:</b> Cardiac, Pulmonary Arteries, Chronic Thromboembolic Pulmonary Hypertension, Pulmonary Thromboendarterectomy, Quantitative Perfusion Cardiovascular MRI, Myocardial Blood Flow, Myocardial Perfusion Reserve <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250296"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning R-Wave Detection for Electrocardiographic Gating in Cardiac MRI.","authors":"Amin Mahmoodi, Melina Hosseiny, Vladimir Ermakov, Samira Masoudi, Albert Hsiao","doi":"10.1148/ryct.250104","DOIUrl":"10.1148/ryct.250104","url":null,"abstract":"<p><p>Purpose To measure the frequency of electrocardiographic (ECG) gating errors and to assess whether convolutional neural networks (CNNs) can reduce such errors. Materials and Methods ECG tracings from 120 patients who underwent cine cardiac MRI at 1.5 T and 3.0 T, along with an external dataset of ECG tracings from 47 patients, were retrospectively collected (August 2022-April 2023). The frequency of arrhythmias and ECG-gating errors was determined by manual annotation of R waves. A CNN was developed for R-wave detection using data from 79 MRI and six external patients; the remaining data were used for testing. CNN performance was compared using signal processing algorithms, including vectorcardiographic (VCG) gating and the Hamilton algorithm. Results The mean age of the 120 patients undergoing cardiac MRI was 53.7 years ± 19.8 (SD), with 72 male patients. ECG-gating errors were observed in 8.1% of patients at 1.5 T and 15.2% at 3.0 T. At 1.5 T, CNN achieved a higher F1 score (99.1%) than did VCG (98.1%; <i>P</i> = .048). At 3.0 T, CNN achieved a higher F1 score (99.1%) than did the Hamilton algorithm (92.4%; <i>P</i> = .049) and was not statistically different than VCG (95.1%; <i>P</i> = .68). The CNN demonstrated a lower false-positive rate (0.1%) than did the Hamilton algorithm (7.4%; <i>P</i> = .02) at 3.0 T and was not statistically different than VCG (4.5%; <i>P</i> = .28). The feasibility of retrospective image reconstruction to improve cardiac MRI quality was also demonstrated. Conclusion CNNs offer a robust method for ECG R-wave detection, particularly in the presence of MRI-induced artifacts at 3.0 T. These findings support the potential of CNNs to enhance ECG gating and improve cardiac MR image quality. <b>Keywords:</b> Convolutional Neural Network, ECG Gating, Deep Learning R-Wave Detection, Cardiac MRI Reconstruction <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250104"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of the 2020 Society for Vascular Surgery/Society of Thoracic Surgeons Reporting Standards for Uncomplicated Type B Aortic Dissection.","authors":"Apichaya Sriprachyakul, Domenico Mastrodicasa, Martin J Willemink, Gabriel Mistelbauer, Jody Shen, Issac Yang, Richard L Hallett, Sachin B Malik, Mohammad H Madani, Kendrick M Lai, Virginia Hinostroza, Jordan R Stern, Kenneth Tran, Jason T Lee, A Claire Watkins, John W MacArthur, R Scott Mitchell, D Craig Miller, Dominik Fleischmann","doi":"10.1148/ryct.240325","DOIUrl":"10.1148/ryct.240325","url":null,"abstract":"<p><p>Purpose To assess the inter- and intrareader agreement of the 2020 Society for Vascular Surgery/Society of Thoracic Surgeons (SVS/STS) reporting standards in patients with acute uncomplicated type B aortic dissection (uTBAD). Materials and Methods CT angiograms, obtained between January 2001 and December 2013, from 37 patients (mean age ± SD, 48.5 years ± 15.6; 24 male) with uTBAD were retrospectively reviewed by 14 cardiovascular radiologists and surgeons. The entry tear and proximal and distal extent of each dissection were allocated to aortic zones according to the 2020 SVS/STS reporting standards. Inter- and intrareader agreement was assessed using Cohen κ. Causes of discrepant classifications were analyzed. Results Interreader agreement among all 14 readers (eight radiologists, four cardiothoracic surgeons, and two vascular surgeons) were fair for the entry tear (к = 0.33, 0.40, 0.22, and 0.40), poor to moderate for the proximal extent (к = 0.30, 0.37, 0.20, and 0.41), and moderate to substantial for the distal dissection extent (к = 0.65, 0.80, 0.41, and 0.77). Interreader agreement between individuals was poor to substantial for the entry tear (к = 0.04-0.71; 78% discrepancy) and proximal extent (к = 0.00-0.62; 68% discrepancy), and fair to excellent for the distal extent (к = 0.33-0.92; 35% discrepancy). The causes for discrepancies were unclear definitions of aortic zones, anatomic complexity of lesions, and poor image quality. Intrareader agreement was moderate for the entry tear (к = 0.41-0.57), fair to moderate for the proximal extent (к = 0.37-0.58), and substantial to excellent for the distal extent (к = 0.66-0.92). Conclusion The 2020 SVS/STS reporting standards for acute uTBAD were poorly reproducible among experienced cardiovascular radiologists and surgeons. <b>Keywords:</b> Vascular, Aorta, Dissection, Aortic Dissection, SVS/STS Reporting Standards, CT Angiography, Interobserver Study, Intraobserver Study <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e240325"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-derived Noncardiovascular Calcifications May Improve Coronary Heart Disease Prediction in Chronic Kidney Disease: The Multi-Ethnic Study of Atherosclerosis.","authors":"Elena Ghotbi, Quincy A Hathaway, David A Bluemke, Hamza Ahmed Ibad, Mahsima Shabani, Sepehr Akhtarkhavari, R Graham Barr, Wendy S Post, Matthew Budoff, Aarti Mathur, João A C Lima, Shadpour Demehri","doi":"10.1148/ryct.240546","DOIUrl":"10.1148/ryct.240546","url":null,"abstract":"<p><p>Purpose To evaluate whether adding costal cartilage calcification (CCC) to coronary artery calcium (CAC) scores from chest CT improves coronary heart disease (CHD) prediction in patients with chronic kidney disease (CKD). Materials and Methods This study was a secondary analysis of the Multi-Ethnic Study of Atherosclerosis. Participants (April 2010 to January 2012) were stratified into low- and high-risk CKD groups based on Kidney Disease Improving Global Outcomes staging. CAC and CCC were measured from noncontrast CT scans. The primary outcome was incident CHD. Cox proportional hazards regression was performed for each group, with clinical risk factors and CAC (conventional CAC model), and with the addition of CCC (CCC model). Discriminative power was assessed using the area under the receiver operating characteristic curve (AUC). Results A total of 2355 participants (1314 female; median age, 68 years; IQR, 62-76) were included. Median baseline CAC scores were 22 (IQR, 0-183) and 133 (IQR, 20-649), and median CCC scores were 2055 (IQR, 900-4405) and 3187 (IQR, 1370-6516), for low- and high-risk CKD groups, respectively (<i>P</i> < .001 for CAC and <i>P</i> < .05 for CCC). The conventional CAC model showed lower discriminative power for CHD among the high-risk group (AUC, 0.70; 95% CI: 0.56, 0.84) versus the low-risk group (AUC, 0.74; 95% CI: 0.70, 0.78). Adding CCC improved the AUC to 0.75 (95% CI: 0.61, 0.89) in the high-risk group (<i>P</i> = .04), although there was no evidence of improved discrimination in the low-risk group (AUC, 0.74; 95% CI: 0.69, 0.78). Conclusion Clinical and conventional CAC models showed lower discriminative power for predicting CHD in the high-risk CKD group versus the low-risk group. In the high-risk group, adding CCC improved prediction over clinical models. <b>Keywords:</b> CT, Cardiac, Coronary Arteries, Coronary Artery Calcium Score, Costal Cartilage Calcification, Chronic Kidney Disease, Cardiovascular Disease, Coronary Heart Disease ClinicalTrials.gov identifier: NCT00005487 © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e240546"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}