European Journal of Radiology Open最新文献

{"title":"Myocardial transit time mapping by CMR: A novel potential parameter of microcirculatory dysfunction in hypertrophic cardiomyopathy with and without atrial fibrillation","authors":"Junlin Yang ,&nbsp;Yong Cheng ,&nbsp;Jinxiu Yang ,&nbsp;Yuncheng Li ,&nbsp;Zhen Wang ,&nbsp;Shutian An ,&nbsp;Jun Wang ,&nbsp;Yongqiang Yu ,&nbsp;Ren Zhao ,&nbsp;Xiaohu Li","doi":"10.1016/j.ejro.2026.100726","DOIUrl":"10.1016/j.ejro.2026.100726","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to explore myocardial transit time (MyoTT) by cardiovascular magnetic resonance (CMR) as a potential parameter of coronary microvascular dysfunction (CMD) in hypertrophic cardiomyopathy (HCM) with and without atrial fibrillation (AF).</div></div><div><h3>Materials and Methods</h3><div>This study enrolled 50 patients with HCM and 50 healthy control subjects to assess cardiac function, native T1, extracellular volume (ECV), myocardial strain, and MyoTT. Factors associated with HCM status were estimated by logistic regression analyses, adjusting for potential confounders. Meanwhile, we evaluated the discriminative performance of the aforementioned parameters for HCM (vs control) and for AF status among HCM patients.</div></div><div><h3>Results</h3><div>In the HCM and control groups, the HCM group exhibited significant reductions in LV-GLS, RV-EDVI, and RV-ESVI (all P &lt; 0.05) and significant increases in LVMI, LVGPWT, native T1 values, ECV values, absolute MyoTT values and presence of LGE (all P &lt; 0.05). Logistic regression analysis revealed HCM was significantly associated with MyoTT, native T1, ECV and LV-GLS. In HCM with and without AF, the HCM with AF group showed nominally higher native T1 values and absolute MyoTT values before correction. Logistic regression analysis revealed HCM with AF was significantly associated with MyoTT and native T1. The AUCs for ECV, MyoTT, LV-GLS, and native T1 were 0.828, 0.848, 0.708, and 0.862, respectively (P &lt; 0.05). The AUCs for discriminating HCM with AF from HCM without AF for MyoTT and native T1 were 0.740 and 0.681, respectively (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>MyoTT levels are elevated in patients with HCM, particularly when AF is present. This suggests that MyoTT may reflect CMD-related alterations in HCM, especially in those with AF.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100726"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939568","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":"Eye tracking as a tool to quantify the effects of CAD display on radiologists’ interpretation of chest radiographs","authors":"Daisuke Matsumoto ,&nbsp;Tomohiro Kikuchi ,&nbsp;Yusuke Takagi ,&nbsp;Soichiro Kojima ,&nbsp;Ryoma Kobayashi ,&nbsp;Daiju Ueda ,&nbsp;Kohei Yamamoto ,&nbsp;Sho Kawabe ,&nbsp;Harushi Mori","doi":"10.1016/j.ejro.2026.100731","DOIUrl":"10.1016/j.ejro.2026.100731","url":null,"abstract":"<div><h3><em>Background:</em></h3><div>Computer-aided detection (CAD) systems for chest radiographs are widely used; however, concurrent reader displays such as bounding-box (BB) highlights may influence interpretation. This pilot study used eye tracking to examine which aspects of visual search were affected by these factors.</div></div><div><h3><em>Methods:</em></h3><div>We sampled 180 chest radiographs from the VinDR-CXR dataset: 120 with solitary pulmonary nodules or masses and 60 without. BBs were configured for 80 % display sensitivity and specificity. Three radiologists (with 11, 5, and 1 years of experience) interpreted each case twice—once with BBs visible and once without—after a ≥ 2-week washout. Eye movements were recorded using an EyeTech VT3 Mini. Metrics included interpretation time, time to first fixation, lesion dwell time, total gaze-path length, and lung-field coverage. Outcomes were modeled using a linear mixed model with the reading condition set as a fixed effect and case and reader as random intercepts. Primary analysis was restricted to true positives (n = 96).</div></div><div><h3><em>Results:</em></h3><div>Concurrent BB display prolonged interpretation time by 4.9 s (p &lt; 0.001) and increased lesion dwell time by 1.3 s (p &lt; 0.001). Total gaze-path length increased by 2076 pixels (p &lt; 0.001), and lung-field coverage increased by 10.5 % (p &lt; 0.001). The time to first fixation was reduced by 1.3 s (p &lt; 0.001).</div></div><div><h3><em>Conclusion:</em></h3><div>Eye tracking revealed measurable changes in search behavior associated with concurrent BB display during chest radiograph interpretation. These findings support this approach and highlight the need for larger studies across modalities and clinical contexts.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100731"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977585","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":"TotalSegmentator-AI for aortic segmentation in CT: Reliable performance in normal anatomy but limited utility in pathological aortic disease","authors":"Dania El Rahal,&nbsp;Chiara Pozzessere,&nbsp;Marianna Gulizia,&nbsp;David C. Rotzinger ,&nbsp;Guillaume Fahrni","doi":"10.1016/j.ejro.2026.100772","DOIUrl":"10.1016/j.ejro.2026.100772","url":null,"abstract":"<div><h3>Introduction</h3><div>Accurate aortic segmentation on computed tomography angiography (CTA) is essential for diagnosing aortic disease, cardiovascular risk assessment, and surgical planning. Deep learning algorithms, such as TotalSegmentator-AI, offer fully automated multi-organ segmentation, yet their performance in pathological aortic conditions remains uncertain. This study performs a clinical stress-test of TotalSegmentator-AI, mapping its boundaries and structural failure modes across a spectrum of normal and pathological cases.</div></div><div><h3>Methods</h3><div>In this monocentric, retrospective study, 60 CTA scans from 2014 to 2024 were categorized into six groups: young, elderly, aneurysm, dissection, venous phase, and non-contrast phase. TotalSegmentator-AI was applied without manual correction. Two radiologists independently rated six aortic segments per scan using a five-point qualitative scale. Quantitative segmentation errors were correlated with qualitative scores using Spearman’s correlation, and inter-reader agreement was assessed with weighted Cohen’s kappa.</div></div><div><h3>Results</h3><div>All scans were successfully processed, yielding 360 aortic segments. Median segmentation quality was 4 [IQR 4–5], with 77% rated good or excellent. Performance was consistent across segments (p = 0.16) but varied by category (p &lt; 0.001): best in young patients (5 [IQR 4–5]) and adequate in non-contrast and venous-phase scans (4 [IQR 4–5]), poorest in dissections (3 [IQR 3–4]) and aneurysms (4 [IQR 3–4]). A strong negative correlation was observed between qualitative scores and quantitative errors (ρ = –1, p = 0.017). Inter-reader agreement was substantial (κ = 0.72).</div></div><div><h3>Conclusion</h3><div>TotalSegmentator-AI achieves accurate aortic segmentation in normal anatomy but is inadequate for unsupervised clinical use in complex pathologies like aneurysms and dissections. Comprehensive human-in-the-loop quality control or dedicated pathology-inclusive models are mandatory before AI-based segmentation can be safely integrated into vascular clinical workflows.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100772"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241456","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":"Patient-specific timing acquisition for coronary CT angiography: A retrospective patient validation study","authors":"Sabee Molloi ,&nbsp;Shiva Mostafavi ,&nbsp;Alireza Shojazadeh ,&nbsp;Kyrillos Grace ,&nbsp;Connor Edwards Miles All Leska-Kent ,&nbsp;Justin Truong ,&nbsp;Katherine Hyde ,&nbsp;Liqiang Ren ,&nbsp;Cecelia Brewingtown","doi":"10.1016/j.ejro.2026.100773","DOIUrl":"10.1016/j.ejro.2026.100773","url":null,"abstract":"<div><h3>Purpose</h3><div>To retrospectively validate a patient-specific post-trigger delay technique for coronary CT angiography (CCTA) and compare it with the conventional fixed-delay approach using true peak arterial enhancement as the reference standard.</div></div><div><h3>Methods</h3><div>Thirty-seven patients (mean age 63 ± 9 years; 35% male) who underwent dynamic CT perfusion imaging were retrospectively analyzed. Serial volumetric acquisitions were obtained during and after intravenous administration of 40–50 mL iodinated contrast. Time–attenuation curves from the descending aorta and major coronary arteries (LAD, LCx, RCA) were modeled using a gamma variate function to determine true time-to-peak enhancement (TTP), peak attenuation, and contrast-to-noise ratio (CNR). Coronary enhancement was simulated using (1) a fixed 5-second post-trigger delay and (2) a patient-specific delay defined as half the injection duration plus a dispersion constant. True peak enhancement was used as the reference standard. Timing accuracy and enhancement differences were evaluated using paired statistical analyses.</div></div><div><h3>Results</h3><div>The patient-specific delay predicted peak coronary enhancement with a mean deviation of −0.80 ± 0.85 s, maintaining enhancement and CNR within 10% of peak values. The fixed 5-second delay showed a larger deviation (−2.11 ± 0.82 s; p &lt; 0.001) and reduced coronary enhancement (−37%) and CNR (−27%) relative to peak (p &lt; 0.05). Improvements were consistent across all coronary arteries.</div></div><div><h3>Conclusion</h3><div>Injection-duration–based patient-specific timing more accurately predicts peak coronary enhancement than a fixed-delay strategy and improves CCTA contrast enhancement and CNR without increasing radiation dose or workflow complexity.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100773"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241461","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":"The value of virtual non-contrast images derived from dual-energy spectral CT in the short-term efficacy assessment of hepatocellular carcinoma after TACE","authors":"Mingzi Gao ,&nbsp;Taoming Du ,&nbsp;Kai Zhang ,&nbsp;Cheng Yan ,&nbsp;Changchun Liu ,&nbsp;Can Su ,&nbsp;Jingwen Zhang ,&nbsp;Yingxuan Wang ,&nbsp;Jing Han ,&nbsp;Mingxin Zhang ,&nbsp;Yujie Chen ,&nbsp;Jinghui Dong ,&nbsp;Liqin Zhao","doi":"10.1016/j.ejro.2026.100730","DOIUrl":"10.1016/j.ejro.2026.100730","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the clinical utility of virtual non-contrast (VNC) images from dual-energy spectral CT (DEsCT) in short-term follow-up of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).</div></div><div><h3>Methods</h3><div>66 HCC patients with DEsCT 4–6 weeks post-TACE were retrospectively enrolled. VNC images were generated from arterial (VNC_AP) and portal venous phase (VNC_PVP) images. Beam-hardening artifacts surrounding lipiodol were assessed on true non-contrast (TNC) and both VNC images. Lipiodol removal degree was classified into 4 grades at 25 % intervals on both VNC images. Residual viable tumor (RVT) was diagnosed using contrast-enhanced CT or MRI. CT attenuation values of RVT, adjacent normal hepatic parenchyma (ANHP), and lipiodol removal area (LRA) were compared among TNC and VNC images. Diagnostic performance of CT attenuation values on VNC images was compared for the three areas.</div></div><div><h3>Results</h3><div>34 patients showed beam-hardening artifacts surrounding lipiodol on TNC images, which were reduced or eliminated on VNC_AP and VNC_PVP images in 28 and 26 cases. All HCCs showed good lipiodol removal on both VNC images, with 7 lesions at Grade 3 and 59 lesions at Grade 4. On TNC images, significant CT attenuation value differences were found between LRA and ANHP, and LRA and RVT (P &lt; 0.001), but not between RVT and ANHP (P &gt; 0.05). Both VNC images showed good diagnostic efficacy for these three areas, with LRA having the lowest value.</div></div><div><h3>Conclusion</h3><div>VNC images demonstrate superior lipiodol removal efficacy and beam-hardening artifacts reduction, facilitating precise RVT delineation and TACE-induced necrosis assessment, complementing contrast-enhanced CT for TACE efficacy assessment in HCC.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100730"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977584","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":"Acute and chronic complications of cesarean delivery: An update for the general radiologist","authors":"Silvia Gazzotti ,&nbsp;Maria Segata ,&nbsp;Matteo Laruccia ,&nbsp;Franco Demaria ,&nbsp;Michele Imbriani ,&nbsp;Elena Siopis","doi":"10.1016/j.ejro.2026.100766","DOIUrl":"10.1016/j.ejro.2026.100766","url":null,"abstract":"<div><div>Cesarean section has become a frequent mode of delivery in the last few decades. While generally regarded as a safe procedure, it is not free of potential complications, often requiring imaging for proper diagnosis with a variety of modalities encompassing mainly ultrasound (transabdominal or transvaginal), computed tomography, and magnetic resonance imaging. It is fundamental for radiologists to be familiar with the expected post-operative changes that may be encountered following cesarean section in order not to misinterpret them for pathology. In general, complications may be subdivided into acute and chronic. Acute complications comprise mainly infections (including endometritis and abscess formation), hemorrhage and hematomas (which tend to occur in predictable locations, such as within the rectus sheath or at the level of the bladder flap), uterine dehiscence or rupture, and injury to adjacent structures (namely the urinary tract). Chronic complications may present years after surgery and include postoperative adhesions, incisional hernias, cesarean scar defects, placenta accreta spectrum disorders, cesarean scar ectopic pregnancy, cesarean scar retained products of conception, and abdominal wall endometriosis. MRI has a pivotal role in the characterization of such chronic complications in adjunct to ultrasound. This review article first discusses normal imaging findings following cesarean section and then provides an update on manifestations of its various possible complications, in both the acute and chronic setting, with the aim of serving as a general vademecum for radiologists who are not specialized in gynecologic imaging, in light of the increasing likelihood of encountering these entities in routine practice.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100766"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158572","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":"Airway segmentation on CT – A systematic review of machine learning tools","authors":"Nada Lsloum ,&nbsp;Ahmed Maiter ,&nbsp;Turki Alnasser ,&nbsp;Ahod Albylwi ,&nbsp;Khalid Alghamdi ,&nbsp;Michael Sharkey ,&nbsp;Alireza Hokmabadi ,&nbsp;Mahan Salehi ,&nbsp;Krit Dwivedi ,&nbsp;Chris Johns ,&nbsp;Andrew J. Swift ,&nbsp;Samer Alabed","doi":"10.1016/j.ejro.2026.100764","DOIUrl":"10.1016/j.ejro.2026.100764","url":null,"abstract":"<div><h3>Background</h3><div>Airway assessment on computed tomography (CT) can yield clinically useful information for diagnosis, treatment planning and monitoring in respiratory diseases. Manual airway segmentation is time-consuming, prone to error and poorly reproducible. This systematic review aimed to appraise machine learning (ML) methods for fully automated airway segmentation in chest CT imaging.</div></div><div><h3>Methods</h3><div>EMBASE, MEDLINE and CENTRAL were searched on October 28, 2025, for studies which used fully automated ML methods for airway segmentation on CT and reported quantitative performance metrics. The quality of included studies was assessed by the Must AI Criteria-10 (MAIC-10) checklist. PROSPERO [CRD42025635504]</div></div><div><h3>Results</h3><div>Thirty-two studies (28 used deep learning (DL)) published between 2010 and 2025 were included. Airway segmentation was performed on non-contrast CT scans in most studies. Voxel-wise accuracy metrics were generally high with Dice similarity coefficient (DSC) values ranging between 83% and 96%. Airway-specific topological metrics: branch detection rate (BD) and tree length detection rate (TD) showed broader variability (60–95% and 54–95% respectively), with DL methods consistently outperforming classical ML approaches. Fifteen studies conducted external validation (EXACT’09 test set used in 9/15). MAIC-10 was moderate and ranged from 6 to 8 out of 10, with lowest reporting in safety/privacy (31%), explainability (31%) and transparency (53%).</div></div><div><h3>Conclusion</h3><div>ML models achieved strong airway segmentation accuracy but showed considerable variation in topological completeness. Standardised evaluation frameworks and the adoption of more diverse datasets are needed to strengthen model generalisability and support translation into clinical practice.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100764"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177909","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":"Classifying diagnostic pitfalls in juxtapleural CT lesions: A root cause","authors":"Kunquan Lai ,&nbsp;Xinhuan Huang ,&nbsp;Huan Lai ,&nbsp;Huixian Chen ,&nbsp;Suiqiao Huang ,&nbsp;Honggang Xu ,&nbsp;Yongshun Wu","doi":"10.1016/j.ejro.2026.100769","DOIUrl":"10.1016/j.ejro.2026.100769","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop and assess the feasibility of a root-cause analysis (RCA) framework for classifying diagnostic pitfalls in the computed tomography (CT) interpretation of juxtapleural lesions.</div></div><div><h3>Methods</h3><div>This single-center, retrospective, exploratory taxonomy-development study was approved by our Institutional Review Board with a waiver of informed consent. To focus on the underlying mechanisms of diagnostic failure rather than overall institutional performance, we analyzed a cohort deliberately enriched for diagnostic difficulty. We analyzed 20 patients (mean age, 55.1 ± 16.9 years; 11 women) from a county-level hospital whose examinations were performed between December 2021 and March 2024. All patients had a definitive diagnosis established by histopathology/microbiology (n = 18) or conclusive clinical diagnosis (n = 2). Non-concordant cases (n = 18) were subjected to a structured RCA. Two radiologists independently categorized errors into three pitfall types.</div></div><div><h3>Results</h3><div>In this difficulty-enriched, intentionally selected cohort—which is not representative of general diagnostic performance—major or moderate diagnostic discordance was identified in 18 of 20 cases (90.0%; 95% CI: 68.3%, 98.8%). These errors converged into three distinct pitfalls: (1) Interpretive Errors due to Misleading Features, representing the most common type (12/18, 66.7%); (2) Perceptual Errors (3/18, 16.7%); and (3) Errors of Integration (3/18, 16.7%). Inter-rater reliability for this categorization showed substantial agreement (Cohen's κ = 0.68; 95% CI: 0.41, 0.95), though the wide confidence interval reflects the limited sample size.</div></div><div><h3>Conclusion</h3><div>In diagnostically challenging scenarios, errors in the CT interpretation of juxtapleural lesions exhibit systematic and classifiable patterns. Our novel three-pitfall taxonomy provides a preliminary yet promising framework for analyzing these errors, demonstrating feasibility and initial inter-rater reliability. External validation in larger, multicenter, prospective studies is required before this framework can be recommended for clinical implementation, educational deployment, or assessment of impact on diagnostic performance.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100769"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241366","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 of preoperative co-occurring intervertebral disc-related degenerative features with one-year lumbar discectomy outcomes: A proposal for and preliminary testing of a novel MRI-based criterion","authors":"Tero Korhonen ,&nbsp;Jyri Järvinen ,&nbsp;Juha Pesälä ,&nbsp;Marianne Haapea ,&nbsp;Pietari Kinnunen ,&nbsp;Jaakko Niinimäki","doi":"10.1016/j.ejro.2026.100729","DOIUrl":"10.1016/j.ejro.2026.100729","url":null,"abstract":"<div><h3>Purpose</h3><div>This study developed a criterion for preoperative co-occurring intervertebral disc (IVD)-related degenerative features and evaluated its association with one-year outcomes following single-level lumbar discectomy.</div></div><div><h3>Methods</h3><div>The novel literature-based criterion, termed “Advanced Preoperative Degeneration” (APD), required the operated segment to exhibit preoperatively at least two advanced-level phenotypes from endplate damage (EPD), Modic changes (MC), and IVD degeneration. Subsequently, a retrospective single-center register-based study of patients treated with single-level micro- or endoscopic lumbar discectomy at a tertiary-level hospital between 2017 and 2022 was performed. The patients were categorized into three groups, APD-positive, APD1/3, and APD0, based on the presence of two or more, one, or none of the required phenotypes, respectively. A mixed-effects model was employed to assess between-group differences in improvement of LBP and leg pain (0–100 VAS), disability (ODI), and quality of life (EQ-5D-3L) from baseline to the one-year postoperative time point.</div></div><div><h3>Results</h3><div>The cohort consisted of 140 patients (mean age: 45.3 years; 81 [57.9 %] male). Overall, the patients exhibited significant improvements in all PROMs after discectomy. However, at the one-year follow-up, the APD-positive group exhibited significantly higher leg pain and disability levels than the APD0 group, with mean scores of 31.4 versus 19.6 for leg pain and 20.6 versus 12.0 for ODI, respectively.</div></div><div><h3>Conclusion</h3><div>This study introduces a novel approach by integrating preoperative co-occurring IVD-related degenerative features into a composite APD criterion. Meeting the APD criterion was associated with significantly poorer one-year outcomes for leg pain and disability following lumbar discectomy.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100729"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977545","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 coronary CTA versus exercise electrocardiography in acute chest pain: A propensity score-matched study in the emergency department","authors":"Alessandro Marchetti ,&nbsp;Eleonora Moliterno ,&nbsp;Giuseppe Rovere ,&nbsp;Lorenzo Giarletta ,&nbsp;Alessio Perazzolo ,&nbsp;Domenico Amatulli ,&nbsp;Antonio De Vita ,&nbsp;Massimo Muciaccia ,&nbsp;Francesco Lauriero ,&nbsp;Giancarlo Savino ,&nbsp;Anna Rita Larici ,&nbsp;Biagio Merlino ,&nbsp;Marcello Covino ,&nbsp;Gaetano Antonio Lanza ,&nbsp;Giovanna Liuzzo ,&nbsp;Francesco Franceschi ,&nbsp;Francesco Burzotta ,&nbsp;Luigi Natale ,&nbsp;Riccardo Marano","doi":"10.1016/j.ejro.2026.100734","DOIUrl":"10.1016/j.ejro.2026.100734","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the clinical impact and operational efficiency of exercise electrocardiography (ex-ECG) and coronary CT angiography (CCTA) in the diagnostic-therapeutic care pathway of patients presenting to the Emergency Department (ED) with acute chest pain (ACP) and suspected non-ST-elevation acute coronary syndrome (NSTE-ACS).</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study enrolled 428 consecutive patients presenting with ACP between January 2022 and December 2023. After propensity score matching (PSM) for age, sex, Heart Score, and triage code, two balanced groups of 214 patients each underwent either -ex-ECG or CCTA. Primary outcomes included diagnostic test positivity, hospital admission rate, and ED length-stay. Secondary outcomes included need for invasive coronary angiography (ICA) and revascularization rates.</div></div><div><h3>Results</h3><div>No statistically significant differences were found in test positivity (42 vs 31 patients, p = 0.157) or hospital admission rates (42 vs 30 patients, p = 0.121) between ex-ECG and CCTA groups. The ICA rates were similar (36 vs 32 patients, p = 0.597), as were revascularization rates (13 patients each, p = 1.000). However, discharged patients undergoing CCTA had significantly shorter total ED length-stay compared to ex-ECG (1710 vs 1841 min, p &lt; 0.001), representing a 7.12 % reduction.</div></div><div><h3>Conclusion</h3><div>Both ex-ECG and CCTA demonstrate comparable clinical impact and operational efficiency in patients with ACP and suspected NSTE-ACS. CCTA offers effective advantages with significantly reduced ED length-stay for a safe discharge of the patients, improving resource management without compromising diagnostic quality. These findings support the increasing adoption of CCTA in the diagnostic pathway for ACP and suspected NSTE-ACS in the ED setting.</div></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":"16 ","pages":"Article 100734"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167238","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}