Journal of Medical Imaging and Radiation Sciences最新文献

{"title":"Enhancing child-friendly paediatric radiography: Our experiences in Hong Kong Children’s Hospital","authors":"Tin Hang Maxwell Lai, Tsan-pun Lam","doi":"10.1016/j.jmir.2026.102514","DOIUrl":"10.1016/j.jmir.2026.102514","url":null,"abstract":"<div><h3>Background / Purpose</h3><div>Paediatric patients undergoing radiographic examinations often experience significant stress and anxiety due to unfamiliar environments and limited understanding of procedures, influenced by their cognitive developmental stage. This can lead to reduced cooperation, emotional distress, and avoidance of future care. At Hong Kong Children’s Hospital, radiographers play a pivotal role in mitigating these challenges through tailored strategies that prioritize the child’s comfort, engagement, and involvement, transforming potentially frightening experiences into positive ones.</div></div><div>Paediatric patients undergoing radiographic examinations often experience significant stress and anxiety due to unfamiliar environments and limited understanding of procedures, influenced by their cognitive developmental stage. This can lead to reduced cooperation, emotional distress, and avoidance of future care. At Hong Kong Children’s Hospital, radiographers play a pivotal role in mitigating these challenges through tailored strategies that prioritize the child’s comfort, engagement, and involvement, transforming potentially frightening experiences into positive ones.</div><div><h3>Approach / Interventions</h3><div>Our team employs age-appropriate, child-centered techniques informed by developmental considerations. For infants, we use blanket-covered detectors to avoid cold surfaces and warmers during general and fluoroscopic imaging. For toddlers (1-3 years), who are often fearful of strangers, we guide parents in positioning and incorporate tablet-based distractions (e.g., for fluoroscopy). Preschoolers (3-6 years) benefit from playful elements, firm but positive instructions, and compliments. School-aged children (7-11 years) respond well to clear, logical explanations, while adolescents (12+ years) receive mature, privacy-respecting communication, including options for discussions without parents. Key strategies include pre-procedural preparation (e.g., examination room setup), eye-level interaction, parental involvement (as primary comfort source), distraction tools, positive reinforcement, promise-keeping (e.g., stickers post-exam), and creating a welcoming, game-like department atmosphere.</div></div><div>Our team employs age-appropriate, child-centered techniques informed by developmental considerations. For infants, we use blanket-covered detectors to avoid cold surfaces and warmers during general and fluoroscopic imaging. For toddlers (1-3 years), who are often fearful of strangers, we guide parents in positioning and incorporate tablet-based distractions (e.g., for fluoroscopy). Preschoolers (3-6 years) benefit from playful elements, firm but positive instructions, and compliments. School-aged children (7-11 years) respond well to clear, logical explanations, while adolescents (12+ years) receive mature, privacy-respecting communication, including options for discussions without parents. Key strategies include p","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102514"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004004","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 lumbar vertebral trabecular core segmentation for opportunistic CT","authors":"Ka Cheuk Fan, Chun Wai Lee, Ka Ho Leung, Tsan Pun Lam","doi":"10.1016/j.jmir.2026.102505","DOIUrl":"10.1016/j.jmir.2026.102505","url":null,"abstract":"<div><h3>Background / Purpose</h3><div>Opportunistic Computed Tomography (CT) represents a paradigm shift in medical imaging analysis, leveraging diagnostic scans obtained for unrelated indications such as abdominal pain or trauma to screen for secondary conditions like osteoporosis without additional radiation exposure or cost. A critical application of this approach is the assessment of bone mineral density (BMD) using the Hounsfield Unit (HU) attenuation values of the lumbar spine. Specifically, the L1 vertebral body is widely established as the reference standard for these measurements. However, accurate assessment requires isolating the trabecular bone (the spongy interior) from the cortical bone (the dense outer shell), as the latter can artificially inflate density readings.</div></div><div>Opportunistic Computed Tomography (CT) represents a paradigm shift in medical imaging analysis, leveraging diagnostic scans obtained for unrelated indications such as abdominal pain or trauma to screen for secondary conditions like osteoporosis without additional radiation exposure or cost. A critical application of this approach is the assessment of bone mineral density (BMD) using the Hounsfield Unit (HU) attenuation values of the lumbar spine. Specifically, the L1 vertebral body is widely established as the reference standard for these measurements. However, accurate assessment requires isolating the trabecular bone (the spongy interior) from the cortical bone (the dense outer shell), as the latter can artificially inflate density readings.</div><div><h3>Methods</h3><div>A robust, platform-agnostic workflow was developed to automate segmentation and analysis. The core segmentation utilizes TotalSegmentator (Wasserthal, et al., 2023), a deep learning-based tool that identifies lumbar vertebrae (L1-L5). Following L1 vertebral body segmentation, a morphological erosion of 2.5mm is applied to remove the cortical layer, generating a mask corresponding exclusively to the trabecular core. Statistical metrics (mean HU intensity and volume) are calculated for the trabecular region and output in standardized formats for direct correlation with Dual-Energy X-ray Absorptiometry (DEXA) scans—the clinical gold standard.</div></div><div>A robust, platform-agnostic workflow was developed to automate segmentation and analysis. The core segmentation utilizes TotalSegmentator (Wasserthal, et al., 2023), a deep learning-based tool that identifies lumbar vertebrae (L1-L5). Following L1 vertebral body segmentation, a morphological erosion of 2.5mm is applied to remove the cortical layer, generating a mask corresponding exclusively to the trabecular core. Statistical metrics (mean HU intensity and volume) are calculated for the trabecular region and output in standardized formats for direct correlation with Dual-Energy X-ray Absorptiometry (DEXA) scans—the clinical gold standard.</div><div><h3>Conclusion</h3><div>By automating the transition from raw DICOM images to granul","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102505"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004365","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":"Effectiveness of a Population-Based Low-Dose CT Lung Cancer Screening Program in Taiwan","authors":"Chen-Ting Chang","doi":"10.1016/j.jmir.2026.102535","DOIUrl":"10.1016/j.jmir.2026.102535","url":null,"abstract":"<div><h3>Background / Purpose</h3><div>Lung cancer is the leading cause of cancer-related mortality in Taiwan, with a high proportion of cases occurring in never-smokers. To address this unique epidemiological pattern, a population-based low-dose computed tomography (LDCT) screening program was implemented. This study aimed to evaluate the clinical effectiveness and screening performance of this nationwide program.</div></div><div>Lung cancer is the leading cause of cancer-related mortality in Taiwan, with a high proportion of cases occurring in never-smokers. To address this unique epidemiological pattern, a population-based low-dose computed tomography (LDCT) screening program was implemented. This study aimed to evaluate the clinical effectiveness and screening performance of this nationwide program.</div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 58,948 individuals who underwent LDCT screening between January and June 2025 under a standardized protocol. Key screening performance indicators, including positive rate, positive predictive value (PPV), and cancer detection rate, were analyzed. Subgroup analysis was performed based on risk factors, including family history of lung cancer and smoking status.</div></div><div>A retrospective analysis was conducted on 58,948 individuals who underwent LDCT screening between January and June 2025 under a standardized protocol. Key screening performance indicators, including positive rate, positive predictive value (PPV), and cancer detection rate, were analyzed. Subgroup analysis was performed based on risk factors, including family history of lung cancer and smoking status.</div><div><h3>Results</h3><div>A total of 290 lung cancer cases were identified, with more than 90% detected at early stages (stage 0–1), indicating effective early detection. The overall positive rate was 7.92%, PPV was 6.33%, and the cancer detection rate was 0.50%. Notably, individuals with a family history of lung cancer demonstrated higher PPV compared to heavy smokers. These findings highlight the importance of incorporating non-smoking-related risk factors into screening strategies in Asian populations.</div></div><div>A total of 290 lung cancer cases were identified, with more than 90% detected at early stages (stage 0–1), indicating effective early detection. The overall positive rate was 7.92%, PPV was 6.33%, and the cancer detection rate was 0.50%. Notably, individuals with a family history of lung cancer demonstrated higher PPV compared to heavy smokers. These findings highlight the importance of incorporating non-smoking-related risk factors into screening strategies in Asian populations.</div><div><h3>Conclusion</h3><div>The population-based LDCT screening program in Taiwan demonstrates effective early detection and favorable screening performance. Incorporating family history as a risk factor may improve screening efficiency in populations with a high prevalence of never-smokers. These findings","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102535"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004506","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":"Clinical Audit: Bleeding Management after Breast Core Needle Biopsy","authors":"Lok Ching Chan, Miu Yung Sze","doi":"10.1016/j.jmir.2026.102522","DOIUrl":"10.1016/j.jmir.2026.102522","url":null,"abstract":"<div><h3>Background</h3><div>Core needle biopsy is a minimally invasive procedure to extract a cylinder of suspicious breast abnormality for histological analysis. Continuation of anticoagulant therapy may induce prolonged bleeding time and hematoma formation post-breast core needle biopsy.</div></div><div>Core needle biopsy is a minimally invasive procedure to extract a cylinder of suspicious breast abnormality for histological analysis. Continuation of anticoagulant therapy may induce prolonged bleeding time and hematoma formation post-breast core needle biopsy.</div><div><h3>Objective</h3><div>This audit assesses the efficiency of bleeding management post-breast core needle biopsy under the influence of anticoagulant therapy.</div></div><div>This audit assesses the efficiency of bleeding management post-breast core needle biopsy under the influence of anticoagulant therapy.</div><div><h3>Methods</h3><div>Electronic patient records and drug orders of all patients who underwent ultrasound-guided breast core needle biopsy from September 2024 to February 2025 were studied. Patients with or without anticoagulant therapy were included, forming two patient groups: non-antithrombotic and antithrombotic. Localized manual compression on wounds with ice packs for 30 minutes and 45 minutes was routinely performed, respectively. Duration of compression until complete bleeding cessation and reasons for prolonged compression duration were recorded.</div></div><div>Electronic patient records and drug orders of all patients who underwent ultrasound-guided breast core needle biopsy from September 2024 to February 2025 were studied. Patients with or without anticoagulant therapy were included, forming two patient groups: non-antithrombotic and antithrombotic. Localized manual compression on wounds with ice packs for 30 minutes and 45 minutes was routinely performed, respectively. Duration of compression until complete bleeding cessation and reasons for prolonged compression duration were recorded.</div><div><h3>Results</h3><div>A total of 183 breast ultrasound-guided core needle biopsies were recorded during the review period. More patients from the antithrombotic group required extended compression time (antithrombotic group: 8 out of 20 patients [40%], non-antithrombotic group: 43 out of 163 patients [26%], extra time ranged from 5 to 20 minutes). Poor manual compression technique was the major reason for prolonged bleeding time in both groups. Unavailability of nursing staff for wound assessment at designated time frame was another influencing factor for the audit due to engagement in other procedures.</div></div><div>A total of 183 breast ultrasound-guided core needle biopsies were recorded during the review period. More patients from the antithrombotic group required extended compression time (antithrombotic group: 8 out of 20 patients [40%], non-antithrombotic group: 43 out of 163 patients [26%], extra time ranged from 5 to 20 minutes). Poor manual compres","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102522"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003885","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":"Investigate ultrasound-detected morphological differences in the metacarpophalangeal joints between healthy male and female","authors":"Ching Hui","doi":"10.1016/j.jmir.2026.102503","DOIUrl":"10.1016/j.jmir.2026.102503","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis (OA) is a complex musculoskeletal condition disproportionately affecting females. Gender-related variations in hand joint structure and their potential relevance to osteoarthritis remain an area of limited exploration. This study investigated structural differences in the metacarpophalangeal joints (MCPJ) of healthy young adults to establish baseline data and explore potential predispositions to joint pathology.</div></div><div>Osteoarthritis (OA) is a complex musculoskeletal condition disproportionately affecting females. Gender-related variations in hand joint structure and their potential relevance to osteoarthritis remain an area of limited exploration. This study investigated structural differences in the metacarpophalangeal joints (MCPJ) of healthy young adults to establish baseline data and explore potential predispositions to joint pathology.</div><div><h3>Method</h3><div>A cross-sectional study was conducted on a sample of 50 healthy young adults. Ultrasound scanning of the dominant hand’s MCPJs was used to measure cartilage thickness, synovial area and vascular index of synovium. Data were analysed by independent t-test and Mann-Whitney test to identify sex-based variations.</div></div><div>A cross-sectional study was conducted on a sample of 50 healthy young adults. Ultrasound scanning of the dominant hand’s MCPJs was used to measure cartilage thickness, synovial area and vascular index of synovium. Data were analysed by independent t-test and Mann-Whitney test to identify sex-based variations.</div><div><h3>Results</h3><div>The study discovered significant gender-related differences in cartilage thickness, with males showing thicker cartilage in MCPJs 2, 3, 4 compared to female participants with a high intra-observer reliability (ICC range: 0.977-0.979). In contrast, no statistically significant sex-based differences were observed in synovial area or vascular index. Notably, synovial area measurements showed lower intra-observer reliability (ICC range: 0.054-0.979).</div></div><div>The study discovered significant gender-related differences in cartilage thickness, with males showing thicker cartilage in MCPJs 2, 3, 4 compared to female participants with a high intra-observer reliability (ICC range: 0.977-0.979). In contrast, no statistically significant sex-based differences were observed in synovial area or vascular index. Notably, synovial area measurements showed lower intra-observer reliability (ICC range: 0.054-0.979).</div><div><h3>Discussion</h3><div>The study indicated that there are gender-related disparities in MCPJ cartilage thickness in healthy young adults with females demonstrating thinner cartilages. This may represent a structural predisposition to the degenerative processes of OA in females. The lack of statistically significant sex-based differences in synovial area and vascular index in this cohort suggests these markers may not exhibit sex-based variations in early adulth","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102503"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004363","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":"Editorial Board/Masthead","authors":"","doi":"10.1016/S1939-8654(26)00414-5","DOIUrl":"10.1016/S1939-8654(26)00414-5","url":null,"abstract":"","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102600"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003931","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":"Subscription","authors":"","doi":"10.1016/S1939-8654(26)00415-7","DOIUrl":"10.1016/S1939-8654(26)00415-7","url":null,"abstract":"","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102601"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003932","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":"New generation low‑dose biplanar X‑ray imaging for orthopedic patient","authors":"Yu Hin Lam","doi":"10.1016/j.jmir.2026.102513","DOIUrl":"10.1016/j.jmir.2026.102513","url":null,"abstract":"<div><h3>Background</h3><div>EOSedge is a next‑generation low‑dose biplanar X‑ray system capable of acquiring full‑body images within seconds—typically under 15 seconds for adults and under 5 seconds for children. In a pediatric hospital setting, however, young patients often experience fear of unfamiliar environments and have limited tolerance for positioning, which can compromise image quality and workflow efficiency. Our team, The Hong Kong Children’s Hospital, Department of Radiology, collaborated closely with the EOS manufacturer to address these challenges and optimize the system for pediatric use.</div></div><div>EOSedge is a next‑generation low‑dose biplanar X‑ray system capable of acquiring full‑body images within seconds—typically under 15 seconds for adults and under 5 seconds for children. In a pediatric hospital setting, however, young patients often experience fear of unfamiliar environments and have limited tolerance for positioning, which can compromise image quality and workflow efficiency. Our team, The Hong Kong Children’s Hospital, Department of Radiology, collaborated closely with the EOS manufacturer to address these challenges and optimize the system for pediatric use.</div><div><h3>Methods</h3><div>Through a series of technical meetings, we worked with the vendor to refine imaging protocols and explore hardware modifications tailored to young children and patients with physical limitations. Two major challenges were targeted: (1) anxious young children who require parental presence for reassurance, and (2) children with spinal muscular atrophy (SMA) who cannot stand and have difficulty maintaining upright sitting posture.</div></div><div>Through a series of technical meetings, we worked with the vendor to refine imaging protocols and explore hardware modifications tailored to young children and patients with physical limitations. Two major challenges were targeted: (1) anxious young children who require parental presence for reassurance, and (2) children with spinal muscular atrophy (SMA) who cannot stand and have difficulty maintaining upright sitting posture.</div><div><h3>Results</h3><div>Although initial use revealed issues such as unforeseeable situation that triggered the machine safety guard which terminated the exam, further collaboration with vendor led to the release of an updated version with manual X‑ray tube control, significantly improving operator flexibility and patient positioning safety. New feature that allows a parent to remain within a controlled safe zone and hold the child’s hand during acquisition, while ensuring that only the child is captured in the final image. For SMA patients, an enhanced seating system was provided to support safe upright positioning.</div></div><div>Although initial use revealed issues such as unforeseeable situation that triggered the machine safety guard which terminated the exam, further collaboration with vendor led to the release of an updated version with manual X‑ray t","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102513"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004003","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":"Transforming paediatric IR patient education: A comparative study of Gemini 3.0 and 2.0 flash models","authors":"Chun Wai Will Lee, Kin Fen Kevin Fung, Yee Ling Elaine Kan","doi":"10.1016/j.jmir.2026.102517","DOIUrl":"10.1016/j.jmir.2026.102517","url":null,"abstract":"<div><h3>Background / Purpose</h3><div>Age-appropriate patient education is vital in paediatric Interventional Radiology (IR) to reduce anxiety and improve cooperation. Large Language Models (LLMs) offer a potential solution for simplifying complex medical text. This study evaluates and compares the efficacy of the next-generation Gemini 3.0 Flash versus its predecessor, Gemini 2.0 Flash, in rendering CIRSE patient information materials into developmentally appropriate language, focusing specifically on readability metrics.</div></div><div>Age-appropriate patient education is vital in paediatric Interventional Radiology (IR) to reduce anxiety and improve cooperation. Large Language Models (LLMs) offer a potential solution for simplifying complex medical text. This study evaluates and compares the efficacy of the next-generation Gemini 3.0 Flash versus its predecessor, Gemini 2.0 Flash, in rendering CIRSE patient information materials into developmentally appropriate language, focusing specifically on readability metrics.</div><div><h3>Methods</h3><div>Standardized patient information for six common paediatric IR procedures (biopsy, drainage, sclerotherapy, port insertion, gastrostomy, and gastrojejunostomy) was processed using Gemini 2.0 Flash and Gemini 3.0 Flash. Materials were adapted for four age groups: 5-8, 9-12, 13-18, and >18 years using a consistent minimalist prompt. Quantitative analysis evaluated readability using Flesch Reading Ease (FRE) and the SMOG Index. Statistical differences were assessed using the Friedman Test followed by Post-hoc Wilcoxon signed-rank tests with Bonferroni correction (n=28 paired observations).</div></div><div>Standardized patient information for six common paediatric IR procedures (biopsy, drainage, sclerotherapy, port insertion, gastrostomy, and gastrojejunostomy) was processed using Gemini 2.0 Flash and Gemini 3.0 Flash. Materials were adapted for four age groups: 5-8, 9-12, 13-18, and >18 years using a consistent minimalist prompt. Quantitative analysis evaluated readability using Flesch Reading Ease (FRE) and the SMOG Index. Statistical differences were assessed using the Friedman Test followed by Post-hoc Wilcoxon signed-rank tests with Bonferroni correction (n=28 paired observations).</div><div><h3>Results</h3><div>Both models significantly improved readability across all age groups compared to the original texts (Friedman Statistic=49.143 for FRE, 39.586 for SMOG; p<0.0001). The original text had a mean FRE of 42.93 and SMOG of 13.46. Gemini 2.0 Flash achieved the highest readability scores (Mean FRE: 73.41, Mean SMOG: 9.53), significantly outperforming the original text (p<0.001). Gemini 3.0 Flash also showed substantial improvement (Mean FRE: 68.58, Mean SMOG: 10.40, p<0.001 vs Original). Comparative analysis revealed that Gemini 2.0 Flash produced statistically simpler text than Gemini 3.0 Flash, with higher reading ease (p<0.001) and lower grade levels (p=0.0042).</div></div><di","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102517"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004044","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":"Using Decision Tree-Based Machine Learning to Identify Predictors of Contrast Extravasation in CT Imaging: A Radiographer-Led Analysis","authors":"Syahir Nizam Ismail, Cheang Tze Cong","doi":"10.1016/j.jmir.2026.102532","DOIUrl":"10.1016/j.jmir.2026.102532","url":null,"abstract":"<div><h3>Background / Purpose</h3><div>Contrast extravasation is a recognized complication during computed tomography (CT) contrast administration and may lead to patient discomfort, delayed imaging, and increased clinical workload. Although extravasation events are relatively uncommon, identifying patients or procedural factors that increase risk remains important for improving patient safety. In many institutions, radiographers are responsible for assessing intravenous cannula suitability prior to contrast injection, yet these assessments are often based on clinical judgement rather than objective evidence. This study aimed to explore the use of machine learning (ML), specifically decision tree modelling, to identify key predictors of contrast extravasation and provide data-driven insights that may support radiographer practice.</div></div><div>Contrast extravasation is a recognized complication during computed tomography (CT) contrast administration and may lead to patient discomfort, delayed imaging, and increased clinical workload. Although extravasation events are relatively uncommon, identifying patients or procedural factors that increase risk remains important for improving patient safety. In many institutions, radiographers are responsible for assessing intravenous cannula suitability prior to contrast injection, yet these assessments are often based on clinical judgement rather than objective evidence. This study aimed to explore the use of machine learning (ML), specifically decision tree modelling, to identify key predictors of contrast extravasation and provide data-driven insights that may support radiographer practice.</div><div><h3>Methods</h3><div>A retrospective analysis of CT contrast extravasation records was conducted. The dataset included variables such as cannula site, cannula size, contrast injection flow rate, and recorded extravasation volume. Decision tree and random forest machine learning models were developed using the Scikit-learn library to analyse feature importance and rank potential predictors of extravasation events. Cross-validation techniques will be considered to enhance model reliability and mitigate bias associated with a relatively small dataset.</div></div><div>A retrospective analysis of CT contrast extravasation records was conducted. The dataset included variables such as cannula site, cannula size, contrast injection flow rate, and recorded extravasation volume. Decision tree and random forest machine learning models were developed using the Scikit-learn library to analyse feature importance and rank potential predictors of extravasation events. Cross-validation techniques will be considered to enhance model reliability and mitigate bias associated with a relatively small dataset.</div><div><h3>Results</h3><div>Model development and analysis are currently in progress. It is hypothesized that cannula insertion site and contrast injection flow rate will emerge as significant predictors of contrast ext","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 5","pages":"Article 102532"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004452","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}