Radiology. Cardiothoracic imaging最新文献

{"title":"Heart Failure Outcome Prediction Using Artificial Intelligence-enabled Coronary Artery Calcium CT Chamber Volumetry Compared to American Heart Association PREVENT and the Agatston Score for Heart Failure Risk Stratification.","authors":"Eshan Momin, Jaret Barr, Gabrielle Gershon, Brian Zhou, Saikiran Rapaka, Athira Jacob, Ran Xiao, Austin J Rim, Carlo N De Cecco, Marly van Assen","doi":"10.1148/ryct.250406","DOIUrl":"https://doi.org/10.1148/ryct.250406","url":null,"abstract":"<p><p>Purpose To evaluate whether artificial intelligence (AI)-derived chamber volumetry from coronary artery calcium (CAC) CT improves heart failure (HF) risk prediction. Materials and Methods This retrospective study included asymptomatic patients without known cardiac disease undergoing CAC CT between 2010 and 2023. CAC CT images were analyzed using a validated AI model to calculate chamber volumes. HF events were identified based on <i>International Classification of Diseases, Ninth and Tenth Revisions</i> codes. Cox proportional hazard regression models incorporating chamber volumes, adjusted for Predicting Risk of cardiovascular disease EVENTs-Heart Failure (PREVENT-HF) score, were used to assess the association with HF. Time-dependent areas under the receiver operating characteristic curve (AUCs) at 3, 5, 8, and 10 years were calculated to compare the performance of volumetry, PREVENT-HF, CAC scoring, and their combination. Results A total of 5892 patients were included (mean age ± SD, 58.2 years ± 9.4; 3258 male). During a mean follow-up of 4 years ± 3, 377 patients (6.3%) developed HF. Larger left atrial, left ventricular, right atrial, and left ventricular myocardial volumes were associated with increased HF risk (<i>P</i> < .001). The composite, multivariable Cox regression model incorporating all chamber volumes, CAC score, and PREVENT-HF scores outperformed PREVENT-HF (AUC, 0.80 vs 0.76; ΔAUC, 0.04; <i>P</i> < .001) and CAC scores (AUC, 0.80 vs 0.70; ΔAUC, 0.10; <i>P</i> < .001) alone in predicting 10-year HF risk. A phase-volume interaction effect was identified, indicating that diastolic volumes were independently associated with higher HF risk than were systolic volumes (<i>P</i> < .001), adjusted for PREVENT-HF. Conclusion AI-derived cardiac chamber volumetry obtained from CAC CT improved HF risk prediction compared with PREVENT-HF or CAC scores alone. <b>Keywords:</b> Applications-CT, Deep Learning, Cardiac <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250406"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679639","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":"Registration-guided GAN Synthesis of Virtual Contrast-enhanced Thoracic CT for Hilar and Mediastinal Lymph Node Detection.","authors":"Motohiko Yamazaki, Kanako Oyanagi, Yuma Fuzawa, Kyoryoku You, Tetsuya Nomura, Takuya Yagi, Naoya Koizumi, Akiko Tasaki, Masaki Tominaga, Ibuki Namihira, Satoru Kobayashi, Hiroyuki Ishikawa","doi":"10.1148/ryct.250521","DOIUrl":"10.1148/ryct.250521","url":null,"abstract":"<p><p>Purpose To develop and evaluate a registration-guided generative adversarial network (Reg-GAN) that synthesizes virtual contrast-enhanced CT (vCECT) from noncontrast CT (NCCT) images and to assess its utility in detecting enlarged hilar and mediastinal lymph nodes. Materials and Methods In this retrospective study, data from 700 patients for training, 100 patients for internal testing, and 63 patients for external testing were used to construct Reg-GAN, which aligns synthesized vCECT with true CECT (tCECT) images during training. Image quality was compared among Reg-GAN, Non-Reg-GAN, and a publicly available GAN (Public GAN). Enlarged lymph nodes were defined by a 10-mm short-axis diameter threshold, and their detectability was evaluated. Wilcoxon signed rank and DeLong tests were used. Results In both the internal and external test sets, Reg-GAN-generated vCECT images were most similar to tCECT, as indicated by lower median values of the mean absolute error than Non-Reg-GAN and Public GAN (internal test, 13.60 vs 17.84 and 15.52, respectively, both <i>P</i> < .001; external test, 14.91 vs 19.49 and 16.37, respectively, both <i>P</i> < .001). In the reader study using the external test set, adding vCECT to NCCT improved area under the receiver operating characteristic curve values for detecting enlarged lymph nodes, particularly for the two most experienced radiologists, from 0.81 to 0.90 and from 0.74 to 0.88 (both <i>P</i> < .05). Conclusion Reg-GAN synthesized higher-quality vCECT images from NCCT images than Non-Reg-GAN and Public GAN. Adding vCECT images improved the detectability of enlarged lymph nodes, supporting the potential utility of vCECT in patients contraindicated for contrast agent administration or screening settings. <b>Keywords:</b> Generative Adversarial Network, Virtual Contrast-enhanced CT, Registration-guided GAN, Hilar and Mediastinal Lymph Nodes, Noncontrast CT, Deep Learning <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250521"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797648","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":"Prognostic Value of Cardiac MRI-derived Left-to-Right Global Longitudinal Strain Ratio in ST-Elevation Myocardial Infarction.","authors":"Yun Zhao, Jing-Ping Wu, Si-Ying Cao, Jin-Yi Xiang, Guo-Jun Zhu, Chong-Wen Wu, Xing-Yu Chen, Simran Qureshi, Jiani Hu, Lei Zhao, Yan Zhou, Jun Pu, Lian-Ming Wu","doi":"10.1148/ryct.250492","DOIUrl":"10.1148/ryct.250492","url":null,"abstract":"<p><p>Purpose To investigate the association between biventricular imbalance, as reflected by the left ventricular (LV) and right ventricular (RV) global longitudinal strain (GLS) ratio derived from cardiac MRI feature tracking, and all-cause death in isolated left ventricular myocardial infarction. Materials and Methods In this multicenter retrospective study, the primary end point was all-cause mortality. The GLS ratio was defined as the ratio of LVGLS and RVGLS. Long-axis (two, three, and four chambers) and short-axis cine sequences were used for strain analysis. Kaplan-Meier curves, Cox proportional hazards regression, and the C statistic were used for statistical analysis. Results In the internal testing set (919 patients; median age, 59 years [IQR, 51-66 years]; 769 [83.7%] male), 90 (9.8%) patients died over a median follow-up period of 60.9 months (IQR, 47.7-83.6 months). The GLS ratio was the strongest independent predictor for all-cause death (adjusted hazard ratio [HR], 1.69; 95% CI: 1.45, 1.97; <i>P</i> < .001). The model, along with clinical conventional imaging, RVGLS, and GLS ratio, demonstrated improved discrimination (C statistic, 0.82; 95% CI: 0.76, 0.87) and calibration (χ², 71.88). A GLS ratio of more than 0.95 was responsible for a fourfold death risk after multivariable adjustment. In those with normal RVGLS (HR, 2.43; 95% CI: 1.15, 5.10; <i>P</i> = .02), reserved LVGLS (HR, 5.38; 95% CI: 2.46, 11.79; <i>P</i> < .001), and both (HR, 7.76; 95% CI: 2.16, 11.90; <i>P</i> = .002), a high GLS ratio (>0.95) still predicted all-cause death. Conclusion In isolated LV myocardial infarction, an elevated GLS ratio may provide additional prognostic information for all-cause death.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250492"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723468","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":"Radiomic Feature Stability in Low-Dose CT and 3D Segmentation for Pulmonary Nodules: Phantom and Multicenter Evaluation.","authors":"Bonan Zhang, Yaoyao Zhuo, Yi Zhan, Fengxiang Song, Zhiyong Zhang, Fei Shan","doi":"10.1148/ryct.250464","DOIUrl":"10.1148/ryct.250464","url":null,"abstract":"<p><p>Purpose To identify a stable radiomic feature (RF) subset for pulmonary nodules by analyzing test-retest and acquisition parameter variability using phantoms and to evaluate its clinical utility. Materials and Methods CT scanners at multiple centers were used to scan a chest phantom embedded with artificial pulmonary nodules under varied doses and scanning and reconstruction parameters. An artificial intelligence-based, fully automated three-dimensional segmentation method was used. Three sources of variability were examined: test-retest, inter-CT scanner, and intra-CT scanner. RF stability was assessed using the concordance correlation coefficient (CCC), dynamic range, and intraclass correlation coefficient (ICC). Statistical tests were used to analyze the impact of these factors, with stable RFs identified through UpSet plots. Multiple radiomic models were constructed and validated using multicenter clinical ground-glass nodule data. Results In terms of test-retest variability, repeatable RFs represented 1715 of 2264 features (76%, CCC > 0.9). The reproducibility rate for inter-CT variability was 64% (1439 of 2264 features, ICC > 0.9). Variance component analysis identified section thickness/interval (24.9%), low-dose scanning (24.3%), inter-CT scanner variation (17.5%), and field of view (FOV, 14.9%) as the largest contributors to radiomic feature variability, with consistent influence patterns across all acquisition parameters. A stable subset of 466 RFs was used to construct six radiomics models, which, compared with prescreening RF models, demonstrated greater clinical efficacy and predictive performance on the validation sets (AUC range, 0.86 [95% CI: 0.81, 0.91] to 0.90 [95% CI: 0.86, 0.94)]. Conclusion Variations in section thickness, FOV, interscanner differences, and low-dose settings significantly affected RF stability. A stable RF subset for pulmonary nodules was identified and demonstrated clinical utility. <b>Keywords:</b> Phantom Studies, Applications-CT, Clinical Testing, Machine Learning, Model Training, Model Validation, Radiomics, Pulmonary, Lung, Pulmonary Nodule, Computed Tomography, Repeatability, Reproducibility <i>Supplemental material is available for this article.</i> © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250464"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831962","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":"First-Pass Perfusion and T1-weighted Dixon Imaging as Emerging Biomarkers of Pericardial Disease.","authors":"André Vaz, Danilo de Oliveira Santana Ramos, Júlia Tupinambá Del Rey Crusoé, Kevin Rafael De Paula Morales, Ludmila Mintzu Young, Camila Pietroski Reifegerste, Lucas Rodrigues Araújo, Paulo Sampaio Gutierrez, Léa Maria Macruz Ferreira Demarchi, José Rodrigues Parga Filho","doi":"10.1148/ryct.250565","DOIUrl":"https://doi.org/10.1148/ryct.250565","url":null,"abstract":"<p><p>Pericardial assessment with cardiac MRI relies on three complementary pillars: anatomic evaluation, functional characterization, and tissue characterization. Tissue characterization traditionally depends on T2-weighted triple inversion recovery imaging for helping to detect edema and late gadolinium enhancement for helping to identify inflammation or fibrosis. However, these techniques have important limitations, including the susceptibility of T2-weighted triple inversion recovery to motion artifacts and the potential overestimation of pericardial enhancement on conventional, non-fat-suppressed late gadolinium enhancement images due to adjacent epicardial and epipericardial fat. This imaging essay demonstrates the added value of two complementary and widely available sequences, first-pass perfusion and postcontrast T1-weighted Dixon, for pericardial tissue characterization. First-pass perfusion depicts early contrast media uptake which reflects microvascular hyperemia, a physiologic hallmark of active inflammation, and thus may help differentiate active from inactive disease and support clinical decision-making. Although previously applied to detect subepicardial hyperemia in myocarditis, the potential role of first-pass perfusion in pericardial evaluation remains incompletely explored. T1-weighted Dixon imaging provides robust fat suppression through chemical shift reconstruction, increasing the specificity of pericardial enhancement and reducing misinterpretation caused by adjacent adipose tissue. The aim of this imaging essay is to present the potential role of first-pass perfusion and T1-weighted Dixon imaging in improving pericardial tissue characterization and differentiating active inflammatory, chronic, and inactive (\"burned-out\") stages of pericardial disease, thereby aligning imaging findings more closely with clinically relevant phenotypes. <b>Keywords:</b> MR Imaging, MR Perfusion, Cardiac, Mediastinum, Pericardium <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250565"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831877","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":"Association between Cardiac MRI-derived Global Longitudinal Strain and Clinical Outcomes in Chronic Aortic Regurgitation.","authors":"Go Hashimoto, Maurice Enriquez-Sarano, Hideki Koike, Miho Fukui, Larissa I Stanberry, Paul Sorajja, Vinayak N Bapat, John Lesser, João L Cavalcante","doi":"10.1148/ryct.250239","DOIUrl":"10.1148/ryct.250239","url":null,"abstract":"<p><p>Purpose To examine the prognostic value of cardiac MRI-assessed left ventricular (LV) global longitudinal strain (GLS) in patients with moderate to severe chronic aortic regurgitation (AR). Materials and Methods This was a multicenter retrospective study of patients with isolated chronic moderate to severe AR who underwent cardiac MRI between January 2012 and February 2020, within 90 days of the baseline echocardiographic diagnosis. LV volumes, LV ejection fraction (LVEF), and LV GLS were measured with cardiac cine MRI with feature tracking. The end point was all-cause death or heart failure-related hospitalization. Statistical analyses included multivariable Cox proportional hazards regression to assess the association of LV GLS with outcomes, adjusting for age, sex, symptoms, and log EuroSCORE II. Results The study included 175 patients (median age, 58 years [IQR, 44-69 years]; 118 male). Median LVEF and LV GLS were 57% (IQR, 49%-64%) and -14.1% (IQR, -16.1% to -11.4%), respectively. During median follow-up of 3.4 years (IQR, 1.7-5.8 years), aortic valve replacement (AVR) was performed in 64 patients (37%). Composite end point occurred in 23% of patients (<i>n</i> = 41: 11 deaths and 30 heart failure-related hospitalizations). Multivariable analysis revealed that LV GLS ≥ -14% was independently associated with primary outcome in patients receiving medical management (adjusted hazard ratio, 8.70 [95% CI: 2.5, 30]; <i>P</i> < .001), after adjustment for age, sex, symptoms, and log EuroSCORE II. After AVR, patients with LV GLS < -14% had better outcomes (<i>P</i> = .02). In the overall cohort, LV GLS ≥ -14% was independently associated with outcomes (adjusted hazard ratio, 2.47 [95% CI: 1.38-4.43]; <i>P</i> = .002) after adjusting for age, sex, time-dependent AVR, and log EuroSCORE II. Conclusion Cardiac MRI-derived LV GLS was associated with clinical end points in patients with chronic AR. <b>Keywords:</b> Aortic Regurgitation, Aortic Valve, Cardiac MRI, Echocardiography, Left Ventricular Global Longitudinal Strain, MR-Functional Imaging, Cardiac <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250239"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621126","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":"Three-dimensional Mapping of Fibrosis Distribution in Desmoplakin Cardiomyopathy from Cardiac MRI.","authors":"Javiera Jilberto, Brennen McManus, Ahmad Moghrabi, Prachi Agarwal, Eric D Smith, Adam S Helms, David Nordsletten","doi":"10.1148/ryct.260010","DOIUrl":"10.1148/ryct.260010","url":null,"abstract":"<p><p>Purpose To generate high-resolution fibrosis maps using universal ventricular coordinates for spatial characterization of fibrotic patterns across disease severity in desmoplakin cardiomyopathy. Materials and Methods This retrospective study included patients with desmoplakin cardiomyopathy who underwent cardiac MRI between March 2012 and October 2024. Three-dimensional ventricular models were reconstructed from cine MRI acquisitions. Fibrosis identified at late gadolinium enhancement MRI was mapped to ventricular geometry using universal ventricular coordinates, enabling analysis within a common reference framework. Patients were classified as having mild, moderate, or severe disease based on fibrosis extent. Associations between fibrosis burden and left ventricular structural and functional metrics were evaluated using Tukey and Wald tests. Results Twenty-nine patients (mean age, 37.39 years [range, 10-77 years]; 20 female patients) were included. In mild disease, fibrosis was primarily located in the subepicardial midinferior region. With increasing fibrosis burden, moderate and severe disease demonstrated subepicardial circumferential involvement with a ringlike pattern in severe cases. Fibrosis burden correlated negatively with left ventricular ejection fraction (<i>r =</i> -0.80, <i>P</i> < .001) and positively with left ventricular end-diastolic volume index (<i>r =</i> 0.54, <i>P</i> = .002). Group comparisons showed significant differences between moderate and severe disease groups across all metrics (<i>P</i> < .05) but not between mild and moderate groups. Conclusion Use of universal ventricular coordinates enabled high-resolution mapping of fibrosis and demonstrated characteristic spatial patterns across disease severity in desmoplakin cardiomyopathy. Fibrosis was observed in nondilated ventricles, whereas higher fibrosis burden was associated with left ventricular dilatation and impaired systolic function. <b>Keywords:</b> Cardiomyopathies, Left Ventricle, Computer Applications-3D, MR Imaging <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e260010"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472364","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":"Comparison of Local Investigator and Core Laboratory Assessment of Cardiac MRI-derived Left Ventricular Ejection Fraction in the MyocarditIRM Study.","authors":"Hichem Sakhi, Claire Bouleti, Arshid Azarine, Mohamed Zarai, Alban Redheuil, Phalla Ou, Virgile Chevance","doi":"10.1148/ryct.260071","DOIUrl":"https://doi.org/10.1148/ryct.260071","url":null,"abstract":"","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e260071"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679567","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":"Lung Cancer in the Collapsed Lobe Following Successful Bronchoscopic Lung Volume Reduction.","authors":"Daniel B Green, Lauren K Groner, James F Gruden, Eugene Shostak","doi":"10.1148/ryct.250601","DOIUrl":"10.1148/ryct.250601","url":null,"abstract":"<p><p>In bronchoscopic lung volume reduction (BLVR), one-way endobronchial valves induce atelectasis of a target lobe, resulting in lung volume reduction in patients with severe chronic obstructive pulmonary disease. Despite improvement in overall quality of life, these patients remain at high risk for lung cancer, including within the collapsed lobe, where nodule detection is particularly challenging. This article presents a case of lung cancer arising in a collapsed lobe after BLVR and highlights imaging features suggestive of a growing malignancy. Although a nodule may be visible at noncontrast CT, contrast-enhanced chest CT can improve nodule conspicuity in this setting. <b>Keywords:</b> Pulmonary, CT, Lung, Tracheobronchial Tree, Chronic Obstructive Pulmonary Disease, Neoplasms-Primary <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250601"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562773","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":"Effects of a Fasting-mimicking Diet on MRI-assessed Cardiac Structure and Function in Participants with Type 2 Diabetes.","authors":"Ruixin Chen, Jos J M Westenberg, Elske L van den Burg, Marjolein P Schoonakker, Saskia le Cessie, Petra G van Peet, Hanno Pijl, Hildo J Lamb","doi":"10.1148/ryct.250547","DOIUrl":"10.1148/ryct.250547","url":null,"abstract":"<p><p>Purpose To evaluate the effects of a monthly 5-day fasting-mimicking diet (FMD) for 1 year on left ventricular (LV) geometry and function in individuals with type 2 diabetes (T2D). Materials and Methods This secondary analysis of the prospective Fasting In diabetes Treatment trial (ClinicalTrials.gov identifier no. NCT03811587) included individuals with T2D randomized to monthly 5-day FMD or usual care for 12 months (November 2018-July 2020). MRI (3.0 T) was performed at baseline, 6 months, and 12 months. LV geometry and systolic function were assessed from two-dimensional cine images, and diastolic function was assessed from four-dimensional flow MRI. Intention-to-treat linear mixed models and linear regression were used to evaluate treatment effects and LV-metabolic associations. Results A total of 82 participants (mean age, 62.9 years ± 8.5 [SD]; 43 female) were included. FMD reduced LV mass at 6 months (mean difference, -5.47 g [95% CI: -9.19, -1.75]; <i>P</i> = .005) but not at 12 months (<i>P</i> = .83). End-diastolic volume remained stable in the FMD group versus controls (mean difference, 7.75 mL [95% CI: 0.19, 15.32]; <i>P</i> = .045). Both the early-to-late peak filling ratio (E/A) (mean difference, 0.27 [95% CI: 0.04, 0.50]; <i>P</i> = .02) and the mitral annular early peak velocity (Ea) (mean difference, 0.84 cm/sec [95% CI: -0.02, 1.67]; <i>P</i> = .04) increased at 12 months. No other treatment effects were observed (all <i>P</i> > .05). ∆E/A was positively associated with change in hemoglobin A_1c (HbA_1c) level (standardized β = 0.47, <i>P</i> = .01) and negatively associated with changes in high-density lipoprotein cholesterol levels (standardized β = -0.55, <i>P</i> = .01). Conclusion FMD positively influenced LV diastolic function by increasing E/A and Ea in participants with T2D; E/A improvements were associated with reduced HbA_1c levels. <b>Keywords:</b> MR Imaging, Cardiac, Left Ventricle, Outcomes Analysis, Metabolic Disorders, Diet, Fasting-mimicking Diet, Left Ventricle Function, Type 2 Diabetes, Cardiac Magnetic Resonance ClinicalTrials.gov identifier number NCT03811587 <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 4","pages":"e250547"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621087","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}