Radiology. Cardiothoracic imaging最新文献

{"title":"Right Ventricular Impairment Prevalence in Takotsubo Syndrome and Associated Clinical Characteristics and Outcomes: EVOLUTION Registry Results.","authors":"Riccardo Cau, Luca Arcari, Gianluca Pontone, Giuseppe Muscogiuri, Marco Gatti, Roberta Montisci, Julian Luetkens, Sebastien Normant, Federica Catapano, Tommaso D'Angelo, Riccardo Faletti, Leon Bischoff, Antonio Esposito, Antonella Meloni, Federica Ciolina, Francesco Negri, Costanza Lisi, Massimo Imazio, Anna Palmisano, Maria Francesca Marchetti, Nicola Galea, Alessandra Volpe, Alfredo Blandino, Giacomo Pambianchi, Alberto Clemente, Jean Nicolas Dacher, Luca Saba","doi":"10.1148/ryct.250494","DOIUrl":"10.1148/ryct.250494","url":null,"abstract":"<p><p>Purpose To evaluate the prevalence, clinical correlates, and long-term prognostic impact of right ventricular (RV) impairment at cardiac MRI in patients with Takotsubo syndrome (TS). Materials and Methods Patients with TS were included in this secondary analysis of the Exploring the eVolution in PrognOstic capabiLity of mUltisequence Cardiac MagneTIc ResOnance in patieNts Affected by Takotsubo Cardiomyopathy (EVOLUTION) registry (ClinicalTrials.gov identifier no. NCT06277297) (November 2007-December 2024). RV impairment was defined as an RV ejection fraction <44% in male patients and <47% in female patients at cardiac MRI. Median follow-up was 13 months (IQR, 2.2-37 months). The primary end point was a composite of death due to any cause and major cardiovascular or cerebrovascular adverse events. Event-free survival was evaluated using Kaplan-Meier estimates, and univariable and multivariable Cox regression analysis identified predictors of the primary end point. Results Overall, 419 patients with TS (mean age, 69.9 years ± 12 [SD]; 383 female) were included. RV impairment was observed in 18.1% (76 of 419) of patients. Patients with RV impairment had longer hospitalization (13.7 days ± 20.5 vs 9.0 days ± 5.8, <i>P</i> = .016) and lower left ventricular ejection fraction (34.6% vs 50.3%, <i>P</i> = .001) and less frequently had emotional triggers (29% vs 42%, <i>P</i> = .026). RV impairment was associated with increased incidence of in-hospital (32% vs 18%, <i>P</i> = .005) and out-of-hospital complications (30% vs 15%, <i>P</i> = .001). Event-free survival was lower in patients with RV impairment (log-rank, <i>P</i> < .001). RV impairment (hazard ratio, 1.88 [95% CI: 1.20, 2.92]; <i>P</i> = .005) emerged as an independent predictor of the primary end point. Conclusion In patients with TS, the presence of RV impairment identified a high-risk subgroup with worse clinical course and increased risk of in-hospital and long-term complications. <b>Keywords:</b> MR Imaging, Cardiac, Volume Analysis, Takotsubo Syndrome, Cardiovascular Magnetic Resonance, Right Ventricle, Prognosis ClinicalTrials.gov identifier no. NCT06277297 <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250494"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699633","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":"Precise Lung Density Quantification with a Physics-based CT Harmonizer.","authors":"Saman Sotoudeh-Paima, David A Lynch, Stephen M Humphries, Ehsan Samei, Ehsan Abadi","doi":"10.1148/ryct.250124","DOIUrl":"10.1148/ryct.250124","url":null,"abstract":"<p><p>Purpose To develop a physics-based image harmonization method that transforms images into a reference quality index of noise, spatial resolution, and lung volume and to evaluate its performance for improving reproducibility of lung density measurement. Materials and Methods This retrospective analysis of Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) study data included participants who underwent chest CT with full-dose (200 mAs) and reduced-dose (40-80 mAs) protocols during the same visit between November 2014 and July 2017. A harmonization algorithm was developed to reduce variations in lung density by adjusting spatial resolution, noise, and lung volume in sequence, aligning scans to a reference condition based on full-dose, soft-kernel reconstruction. The percentage of lung voxels less than -950 HU (LAA-950) and the 15th percentile of the lung density histogram (Perc15) were calculated from scans. Improvements in bias, limits of agreement, and reproducibility coefficients were evaluated, and harmonizer performance was compared with that of two existing techniques: volume-adjusted lung density (VALD) and median filtering followed by VALD (MF-VALD). Results A total of 1159 participants (mean age ± SD, 65 years ± 9; 586 male) were studied. Across all imaging conditions, the harmonization technique improved the Perc15 reproducibility coefficient 4.8-fold, from 35.6 HU ± 0.7 to 7.4 HU ± 0.2. The harmonizer outperformed VALD and MF-VALD across the full-dose and reduced-dose scans, with reproducibility coefficients improving from 32.4 HU ± 0.7 before harmonization to 30.1 HU ± 0.3 with VALD, 10.3 HU ± 0.3 with MF-VALD, and 7.7 HU ± 0.2 with the harmonizer. Conclusion This physics-based technique harmonized CT images to a reference quality index, improving the reproducibility of lung density metrics. <b>Keywords:</b> CT, Thorax, Lung, Physics, Chronic Obstructive Pulmonary Disease Clinical trial registration no. NCT00608764 <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250124"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434935","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":"Clinical Feasibility, Efficiency, and Diagnostic Concordance of Full Free-breathing Cardiac MRI Compared with Breath-holding Techniques.","authors":"Wenli Zhou, Gang Yin, Jing An, Kai Yang, Fei Teng, Jing Xu, Xiaoming Bi, Jianing Pang, Kelvin Chow, Arlene Sirajuddin, Andrew Arai, Shihua Zhao, Minjie Lu","doi":"10.1148/ryct.250258","DOIUrl":"10.1148/ryct.250258","url":null,"abstract":"<p><p>Purpose To evaluate the feasibility, efficiency, and diagnostic concordance of a full comprehensive free-breathing cardiac MRI protocol. Materials and Methods In this prospective study conducted between June 2024 and August 2024, free-breathing and breath-holding MRI acquisitions were compared across all sequences using a 3.0-T scanner. Outcomes included scanning time, image quality, left ventricular (LV) functional parameters, and tissue characterization. Paired comparisons between free-breathing and breath-holding acquisitions were performed using matched-pairs Wilcoxon tests or <i>t</i> tests as appropriate. Results In this analysis of 605 participants (mean age ± SD, 48 years ± 17; 422 male), the full free-breathing cardiac MRI protocol reduced scanning duration compared with breath-holding techniques (20.9 minutes ± 3.1 vs 34.4 minutes ± 7.5; <i>P</i> < .001); free-breathing cine, T1 mapping, and late gadolinium enhancement (LGE) acquisitions achieved 54%, 28%, and 33% time reductions, respectively. Free-breathing cardiac MRI consistently achieved diagnostic image quality: Cine had a slightly lower score (4 [IQR, 4-4] vs 5 [IQR, 4-5]; <i>P</i> < .001), whereas T1/T2 mapping and flow showed similar scores of 5 (<i>P</i> > .05). LGE scores were higher with free-breathing (5 [IQR, 5-5] vs 5 [IQR, 4-5]; <i>P</i> < .001). Interobserver agreement was strong (κ = 0.80-0.93). Compared with the breath-holding measurement, free-breathing LV end-diastolic volume and LV end-systolic volume were higher (189.94 mL ± 84.74 vs 192.92 mL ± 86.32, <i>P</i> < .001; 104.99 mL ± 83.14 vs 108.52 mL ± 84.45, <i>P</i> < .001, respectively), whereas LV ejection fraction was lower (50.01% ± 17.93 vs 48.92% ± 17.66, <i>P</i> < .001), with excellent agreement between methods (intraclass correlation coefficient, 0.98-0.99). Native T1 values and LGE mass were slightly higher with free-breathing (<i>P</i> ≤ .001) but remained in excellent agreement with breath-holding methods. Conclusion Full free-breathing cardiac MRI reduced scanning duration while maintaining diagnostic image quality and strong agreement with breath-holding techniques across all sequences. <b>Keywords:</b> Cardiac MRI, Free-breathing, Breath-holding, Cardiac Imaging <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250258"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699656","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 Photon-Counting and Energy-Integrating Detector CT for Evaluation of Myocardial Late Iodine Enhancement.","authors":"Jordan H Chamberlin, Zain Gowani, Mohamed Hamouda, Sydney Carmain DiBona, Sameer Abrol, Brendan McNeal, Michael Gillespie, Dhiraj Baruah, Jeremy R Burt, Jeffrey Winterfield, Ismail M Kabakus","doi":"10.1148/ryct.250340","DOIUrl":"10.1148/ryct.250340","url":null,"abstract":"<p><p>Purpose To compare photon-counting detector (PCD) CT and energy-integrating detector (EID) CT for the evaluation of myocardial late iodine enhancement (LIE), a CT marker of myocardial fibrosis. Materials and Methods This retrospective cohort study included patients undergoing preprocedural evaluation for ventricular ablation from April 2022 to March 2024. Quantitative region of interest measurements and qualitative Likert scale ratings were compared between modalities. Primary outcome metrics included signal intensity ratio, signal-to-noise ratio, and contrast-to-noise ratio (CNR). A secondary analysis in a subset of 51 patients with MRI as the reference evaluated sensitivity and balanced accuracy relative to late gadolinium enhancement. Results A total of 150 patients (74 PCD CT, 76 EID CT) were included. PCD CT demonstrated higher CNR for both LIE to myocardium (4.2 [IQR, 1.7] vs 2.6 [IQR, 1.5]; <i>P</i> < .001) and blood pool to myocardium (4.0 [IQR, 1.7] vs 2.6 [IQR, 1.5]; <i>P</i> = .001) compared with EID CT. Mean qualitative image quality scores were higher for PCD CT than for EID CT (3.1 [IQR, 0.8] vs 2.5 [IQR, 0.8]; <i>P</i> < .001). PCD CT also showed lower rates of qualitatively degrading streak artifact (37.3% vs 55.3%; <i>P</i> = .04) and photon starvation (13.3% vs 32.9%; <i>P</i> = .008). In the subset of patients with MRI as a reference, per-segment sensitivity (80.1% vs 49.4%) and balanced accuracy (86.3% vs 72.9%; <i>P</i> < .001) were higher for PCD CT than for EID CT. Conclusion PCD CT improved image quality metrics, reduced suboptimal examination rate, and provided higher per-segment sensitivity for LIE compared with EID CT. <b>Keywords:</b> CT-Photon Counting, CT-Angiography, Cardiac <i>Supplemental material is available online for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250340"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356159","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":"Effect of CT Section Thickness on Aortic Valve Calcium Scoring via Photon-counting Detector CT.","authors":"Kazuma Murai, Masaya Kisohara, Toshihide Itoh, Tsuyoshi Ito, Nobuo Kitera, Seita Watanabe, Haruna Sagoh, Tatsuya Kawai, Akio Hiwatashi","doi":"10.1148/ryct.250221","DOIUrl":"10.1148/ryct.250221","url":null,"abstract":"<p><p>Purpose To evaluate the effect of section thickness on aortic valve calcification quantification via photon-counting detector (PCD) CT. Materials and Methods This retrospective study included patients who underwent electrocardiography-gated PCD CT from March 2023 to October 2024. The aortic valve Agatston score (AVAS), aortic valve calcium volume (AVCV), and aortic valve calcium mass (AVCM) were measured at 3-mm, 1-mm, and 0.4-mm sections. Linear mixed model and regression analyses were performed. Sex-specific AVAS thresholds were used for aortic stenosis (AS) severity classification (≥2000 for male patients, ≥1300 for female patients). Results Eighty-four patients (median age: 84 years [IQR: 80-88 years], 58 female) were included. AVAS at 70 keV decreased with thinner sections: 3-mm section, 2141 (95% CI: 1931, 2351); 1-mm section, 1900 (95% CI: 1690, 2110), and 0.4-mm section, 1791 (95% CI: 1581, 2001) (<i>P</i> < .001). AVCV decreased similarly: 1806 mm³ (95% CI: 1640, 1972), 1496 mm³ (95% CI: 1330, 1661), and 1373 mm³ (95% CI: 1207, 1538) (<i>P</i> < .001). AVCM differed minimally: 518 mg (95% CI: 452, 585), 525 mg (95% CI: 459, 592), and 527 mg (95% CI: 461, 594) (<i>P</i> < .001 except for 1 mm vs 0.4 mm, <i>P</i> = .24). Compared with 3-mm sections, seven of 84 (8.3%) and eight of 84 (9.5%) patients were reclassified from CT-severe to CT-nonsevere with 1- and 0.4-mm sections, respectively (<i>P</i> < .001). Regression-based equivalent thresholds were 1770 (male patients) and 1154 (female patients) at 1 mm and 1675 (male patients) and 1087 (female patients) at 0.4 mm. Conclusion Thin-section PCD CT decreased AVAS and AVCV, resulting in AS severity reclassification in 8%-9% of patients. <b>Keywords:</b> Applications-CT, CT-Photon Counting, Cardiac, Aortic Valve, Calcifications/Calculi <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250221"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514373","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":"Deep Learning-based Monoenergetic Imaging for Calcified Coronary Stenosis Assessment at Energy-integrating Detector CT.","authors":"Shaojie Chang, Emily K Koons, Hao Gong, Jamison E Thorne, Eric E Williamson, Thomas A Foley, Cynthia H McCollough, Shuai Leng","doi":"10.1148/ryct.250230","DOIUrl":"10.1148/ryct.250230","url":null,"abstract":"<p><p>Purpose To develop and evaluate a Deep learnIng-bAsed MONoenergetic imaging at Different energies (DIAMOND) framework for generating virtual monoenergetic images (VMIs) from conventional energy-integrating detector (EID) CT, aiming to reduce blooming artifacts and improve stenosis assessment in coronary CT angiography (CCTA) with heavily calcified plaques. Materials and Methods This study (August 2022-September 2023) used a combination of retrospective and prospective imaging data. DIAMOND was trained using a simplified U-Net architecture on a retrospective dataset of 10 CCTA examinations performed with ultrahigh-resolution (UHR) photon-counting detector (PCD) CT; 70-keV PCD VMIs (energy equivalent to 120-kV single-energy EID CT) served as inputs and 100-keV PCD VMIs as targets. The trained model was then applied to a prospective dataset of participants with heavily calcified plaques who underwent EID CT at 120 kV followed by same-day PCD CT. Percent diameter stenosis (PDS) was quantified for a phantom and participants by using commercial software and compared across EID CT, DIAMOND, and PCD CT using Bland-Altman analysis. Changes in stenosis severity categorization based on PDS were evaluated. Results DIAMOND reduced blooming artifacts and improved lumen visualization, with image quality resembling PCD CT. In 23 participants (mean age, 69 years ± 8 [SD]; 18 male), average PDS decreased from 35.65% (EID CT) to 25.19% (DIAMOND, <i>P</i> < .05), approaching 24.27% with UHR PCD CT (<i>P</i> < .05). Relative to EID CT, DIAMOND led to Coronary Artery Disease Reporting and Data System reclassification in 11 of 26 (42%) lesions, mainly in mild to moderate stenosis ranges. Processing time was approximately 0.21 second per axial section on a standard graphics processing unit. Conclusion This study demonstrated the feasibility of using DIAMOND to generate high-kiloelectron volt VMIs from single-energy EID CT, providing artifact-reduced coronary imaging and improved stenosis quantification for heavily calcified plaques comparable to PCD CT without hardware upgrades. <b>Keywords:</b> Coronary CT Angiography, Coronary Artery Stenosis, Energy-Integrating Detector CT, Photon-Counting Detector CT, Deep Learning, CT-Photon Counting, Angiography, Coronary Arteries <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250230"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487172","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":"Explainable Biological Age from Automated Chest Radiography-based Organ Quantifications: qCXR-bioage.","authors":"Yoosoo Chang, Suntae Park, Hyungjin Kim, Soon Ho Yoon, Hyun-Suk Jung, Jong-Min Kim, Samuel Cho, Ria Kwon, Ga-Young Lim, Dong Gil Kang, Kyunga Kim, Seungho Ryu","doi":"10.1148/ryct.250327","DOIUrl":"10.1148/ryct.250327","url":null,"abstract":"<p><p>Purpose To develop an explainable biologic age model using quantitative organ metrics from chest radiographs and evaluate the model's prognostic value for mortality. Materials and Methods In this retrospective cohort study of Korean adults (January 2006-December 2020), the authors developed a biologic age model, called qCXR-bioage, using deep learning segmentation software to extract quantitative chest radiograph biomarkers (lung area, emphysema probability, aortic diameter, heart area, and bone density). Automated measurements and XGBoost-derived clinical variables were integrated using the Klemera-Doubal method and multivariable ridge regression for 65 980 healthy adults, and the model was independently validated in 257 004 individuals. Predictive performance was assessed using <i>R²</i> and root mean squared error for chronological age and the Harrell concordance index (C-index) for mortality. The age gap (difference between radiographic and chronological age) was analyzed for all-cause and cause-specific mortality using multivariable Cox and Fine-Gray models. Results A total of 257 004 participants (mean age, 40.7 years ± 9.1 [±SD]; 141 778 male [55.2%]) were included. qCXR-bioage strongly correlated with chronological age (<i>R²</i> = 0.991 in male participants, 0.981 in female participants; root mean squared error < 2). After a median follow-up of 8.1 years, 1948 deaths were recorded. qCXR-bioage outperformed chronological age in predicting all-cause mortality (C-index in male participants, 0.769 vs 0.768 [<i>P</i> = .04]; C-index in female participants, 0.767 vs 0.761 [<i>P</i> = .001]). Accelerated aging (qCXR-bioage ≥ 0.5 year above chronological age) was associated with greater all-cause mortality (adjusted hazard ratio, 1.28 [95% CI: 1.11, 1.48; <i>P</i> = .001] in male participants and 1.28 [95% CI: 1.06, 1.56; <i>P</i> = .01] in female participants) after adjustment for chronological age and clinical confounders, with the strongest associations for cardiovascular mortality (hazard ratio, 1.73 [95% CI: 1.24, 2.41; <i>P</i> = .001] in male participants and 3.04 [95% CI: 1.37, 6.78; <i>P</i> = .006] in female participants). Conclusion Chest radiograph-based qCXR-bioage helped predict all-cause and cause-specific mortality. <b>Keywords:</b> Lung, Conventional Radiography, Thorax <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250327"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639593","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 Performance of Low-Dose Chest Photon-counting Detector CT for Assessing Lumbar Osteoporosis.","authors":"Bei Chen, Qing Zhang, Bangjun Guo, Jiliang Chen, Bowen Shi, Chen Cao, Yingqian Ge, Dongsheng Jin, Guangming Lu, Song Luo, Xiaojun Ouyang","doi":"10.1148/ryct.250164","DOIUrl":"10.1148/ryct.250164","url":null,"abstract":"<p><p>Purpose To investigate the diagnostic performance of virtual calcium imaging (VCI) parameters from photon-counting detector (PCD) CT for assessing lumbar vertebral osteoporosis. Materials and Methods A phantom study was first conducted using standard- and low-dose PCD CT to assess the stability and reproducibility of VCI parameters. Participants who underwent dual-energy x-ray absorptiometry (DXA), the reference standard for osteoporosis assessment, and standard- or low-dose PCD CT were prospectively enrolled. Partial correlation coefficients were used to assess associations between VCI parameters and DXA-derived T-scores. Measurements were obtained from anterior, middle, and posterior vertebral subregions. Diagnostic performance for osteoporosis was evaluated using receiver operating characteristic analysis. Results In the phantom study, VCI parameters from standard- and low-dose PCD CT showed strong positive correlations with known bone density (<i>r</i> = 0.94-0.95; <i>P</i> < .001). A total of 94 participants (mean age, 69.82 years ± 9.39 [SD]; 55 female) in the low-dose group and 91 participants (mean age, 69.52 years ± 9.32; 53 female) in the standard-dose group were included in the analysis. In the low-dose group, CT attenuation for calcium (Cal), calcium density, and virtual monoenergetic 70 keV (ME70) attenuation values were significantly correlated with T-scores after adjustment for sex and body mass index (<i>r</i> = 0.64, 0.67, and 0.62, respectively; all <i>P</i> < .001). These parameters differed significantly across vertebral subregions and bone mass categories (normal, reduced, and osteoporosis; <i>P</i> < .001). Using thresholds of Cal of 133.70 HU or less, calcium density of 4.93 mg/cm³ or less, and ME70 of 112.43 HU or less, receiver operating characteristic analysis demonstrated good diagnostic performance for osteoporosis (areas under the receiver operating characteristic curve, 0.90, 0.91, and 0.89, respectively), with sensitivities of 85%, 87%, and 82% and specificities of 83%, 79%, and 84%, respectively. Similar results were observed in the standard-dose group. Conclusion VCI parameters from PCD CT showed strong correlations with DXA T-scores and demonstrated high diagnostic performance for osteoporosis, suggesting a promising opportunistic screening tool for lumbar vertebral bone density assessment. <b>Keywords:</b> CT Photon Counting, CT Dual Energy, Thorax, Spine <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250164"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594227","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":"Right Ventricular Assist Devices: Radiographic and CT Findings with Illustrations.","authors":"Wei Li, Tannaz Rajabi, Swati P Deshmane, Maria Clara N Lorca, Farhan A Bajwa, Frederick S Ling, Susan K Hobbs, Abhishek Chaturvedi","doi":"10.1148/ryct.250113","DOIUrl":"10.1148/ryct.250113","url":null,"abstract":"<p><p>Right ventricular dysfunction is a critical predictor of mortality, often progressing to right heart failure, contributing to 3%-9% of heart failure admissions. Acute right heart failure is the primary cause of death in conditions such as right ventricular myocardial infarction and massive pulmonary embolism. Mechanical circulatory support with right ventricular assist devices (RVADs) has become essential in managing both acute and chronic right heart failure. Such devices provide hemodynamic support by assisting the failing right ventricle. This review outlines the mechanisms, clinical indications, and complications of these RVADs. Chest radiography and echocardiography are the primary modalities used for confirming the correct positioning of these devices, and CT is useful for evaluating intra- and extracardiac complications. These imaging modalities are vital for identifying complications and ensuring optimal device performance. As the use of RVADs grows, radiology's role in optimizing outcomes will continue to expand. <b>Keywords:</b> Right Ventricle, Cardiac Assist Devices, Conventional Radiography, CT, Echocardiography <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250113"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356157","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 Interaction between Emphysema and Interstitial Lung Abnormalities for Mortality in a Korean National Lung Cancer Screening Cohort.","authors":"Hyungjin Kim, Eunseo Jo, Jinseob Kim, Jin Mo Goo","doi":"10.1148/ryct.250376","DOIUrl":"10.1148/ryct.250376","url":null,"abstract":"<p><p>Purpose To investigate the prognostic interaction between emphysema and interstitial lung abnormalities (ILAs) in relation to mortality among individuals undergoing lung cancer screening (LCS). Materials and Methods This retrospective cohort study included individuals screened in the Korean National Lung Cancer Screening Program between August 2019 and December 2020. Emphysema and ILAs were identified from CT study reports found in the program records. The primary study outcomes were mortality after a lung cancer diagnosis and mortality without a lung cancer diagnosis, analyzed using Fine-Gray subdistribution hazard models. Results Among 124 121 LCS participants (mean age, 61.6 years ± 5.3; 121 876 male), 13.8% (17 082) and 2.6% (3275) had emphysema and ILAs, respectively, with ILAs present in 7.0% (1200 of 17 082) of those with emphysema. The association between emphysema and mortality after a lung cancer diagnosis differed based on ILA status (<i>P</i> for interaction = .003). Emphysema was associated with increased mortality only in the absence of ILAs (adjusted subdistribution hazard ratio [sHR], 2.32; 95% CI: 1.97, 2.73; <i>P</i> < .001). In contrast, ILAs were associated with elevated mortality regardless of emphysema status, although the association was attenuated in the presence of emphysema (adjusted sHR without emphysema, 5.29 [95% CI: 4.12, 6.78]; with emphysema, 3.04 [95% CI: 2.32, 3.96]; both <i>P</i> < .001). The combined presence of ILAs and emphysema conferred the highest mortality risk (adjusted sHR: 7.04; 95% CI: 5.42, 9.15), albeit not significantly higher than ILAs alone (<i>P</i> = .09), suggesting that ILAs drive the increased risk when the conditions coexist. Similar patterns were observed for mortality without a preceding lung cancer diagnosis. Conclusion ILAs diminished the prognostic significance of emphysema and were the primary driver of mortality risk when both conditions were present. <b>Keywords:</b> Lung Cancer Screening, Low-Dose CT, Interstitial Lung Abnormalities, Interstitial Lung Diseases, Emphysema <i>Supplemental material is available for this article.</i> © RSNA, 2026.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"8 2","pages":"e250376"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514557","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}