Radiology. Cardiothoracic imaging最新文献

{"title":"Quantitative CT Evaluation of Bronchiectasis Improvement in Cystic Fibrosis after CFTR-Modulator Therapy.","authors":"Amel Imene Hadj Bouzid, Daphné Pasche, Ilyes Benlala, Stéphanie Bui, Julie Macey, Jean Delmas, Fabien Beaufils, Baudouin Denis de Senneville, Patrick Berger, Gaël Dournes","doi":"10.1148/ryct.250116","DOIUrl":"10.1148/ryct.250116","url":null,"abstract":"<p><p>Purpose To assess whether elexacaftor-tezacaftor-ivacaftor (ETI) therapy improves bronchiectasis in cystic fibrosis at CT and to identify associated factors. Materials and Methods This retrospective study included consecutive patients with cystic fibrosis (CF) from two reference centers (between January 2020 and January 2025). Pulmonary function testing was performed, including forced expiratory volume in 1 second as percentage predicted (FEV₁%p), and CT was performed at three time points: 2 years before ETI (Y-2), at initiation of ETI (Y0), and 1 year after ETI (Y1). Bronchiectasis was assessed quantitatively and visually for shape and regional extent. Comparisons of paired medians were done using the Friedman test. Results A total of 106 patients were included (median age, 19 years [IQR, 12-29]; 59 male patients; median FEV₁%p, 80% [IQR, 55-99]). Of these 106 patients, 101 (95.3%) had mild-to-moderate disease severity, with FEV₁%p greater than 40%. Bronchiectasis normalized volumes increased between Y-2 (7.6 [IQR, 2-19]) and Y0 (15.3 [IQR, 5.6-32]) but decreased at Y1 (3.6 [IQR, 0.6-25]; <i>P</i> < .001). Bronchiectasis improved in 74 of 106 patients (69.8%), including 18 of 106 (16.9%) with complete resolution and 56 of 106 (52.9%) with partial reduction, with a median volume reduction of 64% and six resolved segments per patient. Bronchiectasis improvement was associated with younger age (<i>P</i> < .001), cylindric CT pattern (<i>P</i> < .001), fewer CT abnormalities (<i>P</i> < .001), and greater FEV1%p increase (<i>P</i> = .03). Younger age, lower <i>Pseudomonas aeruginosa</i> colonization, and lower CT mucus volume were independent predictors of bronchiectasis improvement (<i>R²</i> = 0.50; <i>P</i> < .001). Conclusion Bronchiectasis improvement occurred after ETI treatment in a substantial fraction of patients with predominantly mild-to-moderate CF. Improvement was linked to younger age and better disease status at ETI initiation, supporting early intervention. <b>Keywords:</b> CT-Quantitative, Tracheobronchial Tree, Chronic Obstructive Pulmonary Disease <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250116"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565084","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":"Common and Uncommon Imaging Manifestations of Thoracic and Disseminated Coccidioidomycosis Infection.","authors":"Sandhya R Nagarakanti, Matthew T Stib, Janis E Blair, Prasad M Panse, Michael B Gotway, Carlos A Rojas","doi":"10.1148/ryct.250269","DOIUrl":"10.1148/ryct.250269","url":null,"abstract":"<p><p>Coccidioidomycosis is caused by the dimorphic fungus <i>Coccidioides</i>, endemic to the southwestern United States. Most infected patients are asymptomatic or recover uneventfully, but a small proportion will develop chronic infection or dissemination. Diagnosis typically rests on organism demonstration in tissue or serology, but knowledge of <i>Coccidioides</i> infection imaging findings becomes important when tissue examination is not possible and serologic results are unclear. Acute coccidioidal pneumonia manifests at chest imaging with consolidation and lymphadenopathy, resolving completely or evolving into a nodule or cavity. Chronic coccidioidomycosis manifests with nodules or cavities that may persist. Uncommon coccidioidomycosis manifestations may simulate malignancy, including nodular pleural effusions, extrathoracic dissemination, and osseous disease. Thoracic coccidioidomycosis complications include pleural space cavity rupture causing bronchopleural fistula, cavity enlargement necessitating surgical intervention, and development of superinfection. Disseminated coccidioidomycosis affects the skin, central nervous system, and musculoskeletal system. Central nervous system coccidioidomycosis often manifests with basilar meningitis, with or without spinal leptomeningeal disease. Paraspinous fluid collections and discitis/vertebral body osteomyelitis simulating pyogenic infection occur, sometimes with relative disc space narrowing and slow disease progression. Musculoskeletal coccidioidomycosis manifests with lytic bone lesions and may produce peripherally enhancing fluid collections. Gastrointestinal coccidioidomycosis is uncommon, manifesting as peritonitis of unclear cause or peritoneal abscesses, rarely with solid organ low-attenuation lesions. Genitourinary coccidioidomycosis manifests as pyelonephritis or pelvic abscesses. Disseminated coccidioidomycosis diagnosis is facilitated through recognition of the common clinical context of immunocompromise coupled with travel to, or residence within, an endemic area. <b>Keywords:</b> Thorax, Lung, Mediastinum, Pleura, Tracheobronchial Tree, Fungus, Coccidioidomycosis, Spherules, Cavity, Nodule, Endemic, Dissemination <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250269"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669650","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":"Constructing a Unified Vision-Language Model for Chest Radiograph-based Diagnostics, Medical Education, and Data Augmentation.","authors":"Ling Yang, Xinyu Liang, Zhanyu Wang, Ziyu Diao, Xuan Huang, Die Shen, Xin Tan, Haifeng Li, Zhenghao Chen, Shijun Qiu, Luping Zhou","doi":"10.1148/ryct.250033","DOIUrl":"10.1148/ryct.250033","url":null,"abstract":"<p><p>Purpose To develop MedXChat, a large language model (LLM) capable of integrating radiology report generation, visual question answering (VQA), and text-to-image synthesis and evaluate its performance via computational metrics and expert radiologist assessments. Materials and Methods In this retrospective study, MedXChat was trained on the MIMIC Chest X-ray (MIMIC-CXR) database, comprising 270 790 chest radiograph-report pairs, 54 138 VQA samples, and 7500 text-to-image instruction pairs. Data were collected from 2011 to 2016. Computational evaluations of MedXChat performance were conducted using the F1 score, area under the receiver operating characteristic curve (AUC), and Fréchet inception distance (FID). Radiologist evaluations involved six experts-three junior, two senior, and one supervisor-who assessed 50 random MedXChat outputs for accuracy, consistency, and alignment with clinical standards. Results In the chest radiograph-to-report test set, MedXChat achieved an AUC of 0.67 (95% CI: 0.61, 0.75), higher than UniXGen (AUC, 0.54; <i>P</i> < .001) and LLM-CXR (AUC, 0.63; <i>P</i> = .02). Its F1 score was 0.44 versus 0.26 (<i>P</i> < .001) and 0.41 (<i>P</i> = .04), respectively. In chest radiograph-VQA, MedXChat showed higher accuracy for edema (73% vs 54% for LLM-CXR and 60% for LLaVA-Med) and pleural effusion (80% vs 53% for LLM-CXR and 61% for LLaVA-Med; all <i>P</i> ≤ .01). In text-to-image synthesis, it achieved the lowest FID (43.46 vs 73.29 and 106.17; <i>P</i> < .001) and the highest classification accuracy (71.5% vs 68.6% and 67.2%; <i>P</i> ≤ .05), producing high-quality images including lateral views. Conclusion MedXChat integrated report generation, VQA, and image synthesis within a unified framework, achieving state-of-the-art performance. MedXChat may support future professional applications and enhance radiologic workflows, education, and data augmentation. <b>Keywords:</b> Computer Aided Diagnosis (CAD), Applications - Decision Support, Applications - Multimodal, Outcomes Analysis, Technology Assessment, Comparative Studies <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250033"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775316","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":"Highly Accelerated Real-time Cine MRI Pulse Sequence for Cardiac Implantable Electronic Devices and Arrhythmias.","authors":"Dima Bishara, Kyungpyo Hong, María Davó-Jiménez, Jeremy D Collins, Cagdas Topel, Lexiaozi Fan, Roberto Sarnari, Bradley K Knight, Daniel C Lee, Daniel Kim","doi":"10.1148/ryct.240554","DOIUrl":"10.1148/ryct.240554","url":null,"abstract":"<p><p>Purpose To compare the image quality and temporal resolution of a 32-fold accelerated real-time cine MRI pulse sequence (19.3-msec temporal resolution) with those of a previously described 16-fold accelerated Cartesian real-time cine sequence (39.8-msec temporal resolution) in patients with cardiac implantable electronic devices (CIEDs) and arrhythmias. Materials and Methods This retrospective study included patients with CIEDs and arrhythmias scanned using both radial and Cartesian real-time cine MRI pulse sequences with gradient-recalled echo readouts at 1.5 T from March 2022 to March 2024. Image quality was assessed visually by clinical raters using a five-point Likert scale for each of four categories (namely, conspicuity, temporal fidelity of wall motion, artifact, and noise) and quantitatively using the signal-to-noise-and-artifact ratio metric. The authors used the Wilcoxon signed rank test and paired <i>t</i> test to compare differences for non-normally and normally distributed variables, respectively. Results The study included 23 patients with CIEDs and arrhythmias (nine female and 14 male patients; mean age, 66.5 years ± 13.3 [SD]). The radial real-time cine sequence yielded significantly higher median summed visual scores than the Cartesian real-time cine sequence across all myocardial segments (radial, 17.5-18, Cartesian, 14.5-16; <i>P</i> < .001). The mean signal-to-noise-and-artifact ratio was significantly higher for radial than for Cartesian (radial, 18.3 ± 5.6, Cartesian, 9.4 ± 4.1; <i>P</i> < .001). Conclusion The proposed 32-fold accelerated radial real-time cine MRI pulse sequence provided higher temporal resolution and superior image quality than the 16-fold accelerated Cartesian real-time cine pulse sequence in patients with CIEDs and arrhythmias. <b>Keywords:</b> MR Imaging, Cardiac, Heart, Left Ventricle, Right Ventricle, Artifacts, Cardiac Assist Devices, Imaging Sequences, Radial K-Space, CIED, Arrhythmia, GRASP, Compressed Sensing, Real-Time, Freebreathing <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e240554"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506659","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":"Quantitative Imaging for Interstitial Lung Disease.","authors":"Cody M Anderson, Roshan Singh, Chi Wan Koo","doi":"10.1148/ryct.250041","DOIUrl":"10.1148/ryct.250041","url":null,"abstract":"<p><p>Quantitative imaging has emerged as a promising tool for the diagnosis, classification, and prognostication of interstitial lung disease (ILD). Both global and regional lung abnormalities can be objectively and reproducibly measured using quantitative imaging, which is particularly useful for early disease evaluation and assessment of subtle changes. Accurate ILD classification and identification of inconspicuous changes allow for more personalized treatment decisions and, ultimately, improved patient outcomes. Because CT is the primary imaging modality for ILD evaluation, most of the computer-aided support systems have been developed for this modality and are referred to as <i>quantitative CT</i>. While CT continues to advance with functional capability using dual-energy technology, new MRI techniques are being developed that offer the ability to further improve ILD evaluation. Recent advancements in the field of artificial intelligence underly the development of these new quantitative imaging tools. As quantitative imaging for ILD evaluation becomes more common, it will likely play an increasingly important role in the general clinical radiology workflow, necessitating a familiarity of its use for the general radiologist. This review summarizes current applications of quantitative CT in the evaluation of fibrotic ILDs, including idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, and connective tissue disease-related ILD, and highlights emerging quantitative MRI techniques for ILD assessment. <b>Keywords:</b> Applications-CT, Deep Learning, Machine Learning, Radiomics, CT-Quantitative, Thorax, Lung © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250041"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669615","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":"Delayed Cardiac Herniation after Partial Thymectomy.","authors":"Marissa Borgese, Justin D Blasberg, Cristina Fuss, Anna S Bader","doi":"10.1148/ryct.250206","DOIUrl":"10.1148/ryct.250206","url":null,"abstract":"<p><p>Cardiac herniation describes displacement of the heart from its expected location through a defect in the pericardium that is congenital, traumatic, or iatrogenic in origin. While rare, early recognition and treatment are essential to minimize morbidity and mortality. The authors present a case of cardiac herniation in a 29-year-old patient with a history of thymectomy who presented to the emergency department for chest pain. Coronary CT angiography and cardiac MRI played critical roles in the timely diagnosis of cardiac herniation by demonstrating waistlike ventricular narrowing. Intraoperative inspection confirmed a significant circumferential pericardial defect with protrusion of the left ventricle. <b>Keywords:</b> Cardiac, Pericardium, Complications <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250206"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725746","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":"Opportunistic Lung Cancer Screening during Coronary Artery Calcium Scoring and CT Angiography.","authors":"Sandro Bertani, Gabriele Carra Forte, Rubens Gabriel Feijó Andrade, Hiren Mehta, João Martins da Fonseca, Edson Marchiori, Alysson Roncally Carvalho, Rosana Souza Rodrigues, Bruno Hochhegger","doi":"10.1148/ryct.250086","DOIUrl":"10.1148/ryct.250086","url":null,"abstract":"<p><p>Purpose To evaluate the feasibility, diagnostic yield, and radiation impact of additional ultra-low-dose CT (ULDCT) covering the entire thorax during coronary CT angiography (CCTA) and coronary artery calcium scoring (CACS) for lung cancer screening. Materials and Methods This prospective multicenter cohort study enrolled asymptomatic participants undergoing either CACS alone or CACS with CCTA between August 2018 and January 2024. Participants with contraindications to iodinated contrast material or who were pregnant were excluded. All participants underwent additional ULDCT for lung cancer screening. Pulmonary nodules were monitored for 2 years with follow-up low-dose CT. Primary outcomes were lung cancer detection rate, radiation exposure, and detection rate of noncancerous findings. Descriptive and multivariable analyses evaluated predictors of lung cancer, assessing calibration, discrimination, and significance. Results Among 2750 participants (mean age, 57 years ± 9.5 [SD]; 2090 men) who underwent coronary assessment, 1353 (49.2%) met U.S. Preventive Services Task Force lung cancer screening eligibility. ULDCT depicted pulmonary nodules in 1045 (38%) participants, with an average diameter of 4.57 mm ± 4.00. A total of 222 of 254 (87%) nodules larger than 6 mm were noncancerous lesions. Lung cancer was ultimately diagnosed in 32 of 2750 (1.16%) participants, including 12 participants with lung cancer that was undetectable within the cardiac field of view. Early-stage disease was identified in 23 of 32 (72%) participants. Additional ULDCT increased radiation dose by 2.03% ± 0.31 for CCTA and 17.12% ± 0.65 for CACS. Conclusion Additional full-chest ULDCT with CCTA and CACS enabled early lung cancer detection with modest radiation dose increase. <b>Keywords:</b> CT, Coronary CT Angiography, Cardiac, Thorax, Lung, Primary Neoplasms, Epidemiology <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e250086"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565008","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":"Rapid Late Gadolinium Enhancement Cardiac MRI in Real-World Clinical Practice: A Prospective Clinical Trial.","authors":"Huihui Kong, Jiali Zhou, Jinshui Li, Zhaozhao Wang, Ying Yuan, Jing An, Xiaoming Bi, Yi He","doi":"10.1148/ryct.240477","DOIUrl":"10.1148/ryct.240477","url":null,"abstract":"<p><p>Purpose To compare two rapid late gadolinium enhancement (LGE) cardiac MRI sequences-phase-sensitive inversion recovery (PSIR) single-shot true fast imaging with steady-state precession (TrueFISP) and motion-corrected TrueFISP PSIR (moco PSIR)-with the PSIR turbo fast low-angle shot (turboFLASH) sequence regarding image quality, localization, and quantification of LGE. Materials and Methods This prospective study included consecutive participants who underwent contrast-enhanced cardiac MRI with three LGE sequences between March 2022 and April 2023. TurboFLASH was the reference standard and was compared with the TrueFISP PSIR and moco PSIR sequences. Primary outcomes were overall image quality scores and contrast-to-noise ratios. Secondary outcomes included qualitative and quantitative assessments of LGE and microvascular obstruction. Statistical analyses included <i>t</i> tests, Wilcoxon signed rank tests, Bland-Altman analysis, and intraclass correlation coefficient. Results A total of 187 participants (mean age, 56.7 years ± 15.1 [SD]; 125 male participants) successfully underwent imaging using all three LGE sequences. All 112 LGE-positive (60%) and 67 LGE-negative (36%) participants undergoing turboFLASH sequencing showed identical results using both TrueFISP and moco PSIR. Overall image quality scores and contrast-to-noise ratios were higher for moco PSIR and TrueFISP than for turboFLASH (<i>P</i> < .001). In participants with ischemic heart disease (<i>n</i> = 94), we found no evidence of difference among the three sequences in LGE-positive layers or segment counts, LGE mass, or microvascular obstruction quantification. Bland-Altman and intraclass correlation coefficient analyses showed a strong agreement across sequences (intraclass correlation coefficient, 0.99). Conclusion Good image quality was achieved with the two rapid sequences in a single breath hold or free-breathing state, in addition to accurate LGE localization and quantification in participants with ischemic heart disease. <b>Keywords:</b> MR-Contrast Agent, Cardiac <i>Supplemental material is available for this article.</i> © The Author(s) 2025. Published by the Radiological Society of North America under a CC BY 4.0 license.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 6","pages":"e240477"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506666","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":"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}