Journal of Thoracic Imaging最新文献

{"title":"Comparison of Lung Perfusion Using X-Ray Pulsatility Index With Pulmonary Angiography in Chronic Thromboembolic Pulmonary Hypertension.","authors":"Matthew Smith, Jared Grice, Jared O'Leary, Gary T Smith","doi":"10.1097/RTI.0000000000000885","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000885","url":null,"abstract":"<p><strong>Purpose: </strong>We compared lung perfusion abnormalities using non-contrast X-ray pulsatility index (XPI) to pulmonary angiography in patients with suspected CTEPH.</p><p><strong>Materials and methods: </strong>Volunteers suspected of CTEPH between April 2023 and May 2024 were enrolled and provided consent for the IRB-approved prospective study, resulting in 13 patients (6 male; 7 female) and 18 independent lungs. Fluoroscopic acquisition (70 kV, 30 frames/s) was acquired over an 8-second breath-hold. The temporal signal from each pixel was decomposed into individual frequency components using spectral analysis. Signal oscillating at the heart rate was isolated using a band-pass filter and the amplitude (XPI) mapped to form an image. Immediately after each fluoroscopic acquisition for XPI, digital subtraction pulmonary angiography was performed using catheter-injected contrast in the same projection for comparison. Both XPI and DSA perfusion maps were segmented using a semi-automated technique. Segmentation maps were compared using the Dice similarity score, a statistical measurement of overlap.</p><p><strong>Results: </strong>Non-contrast fluoroscopy and contrast DSA images were obtained in 18 lungs. All patients were able to perform satisfactory breath-hold, despite several with moderate to severe CTEPH. Direct comparison of segmentation maps revealed an average Dice score of 0.70, suggesting excellent agreement between XPI and pulmonary angiography in depicting regions of blood flow and perfusion defects.</p><p><strong>Conclusions: </strong>XPI is a non-contrast method to evaluate and monitor pulmonary perfusion, producing maps with excellent agreement to pulmonary angiography, which is confirmatory for CTEPH. This technique could improve clinical efficiency as a screening or diagnostic test to augment clinical pulmonary function assessment.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Condensed Imaging Review of Thoracic Tuberculosis.","authors":"Naomi Pygott, Reem Bedir, Judith L Babar, Maria T A Wetscherek","doi":"10.1097/RTI.0000000000000884","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000884","url":null,"abstract":"<p><p>Tuberculosis (TB) remains a challenging global health issue and is considered the leading cause of death from infectious disease. Imaging plays a pivotal role in the diagnosis and management of tuberculosis. This review aims to provide a comprehensive overview of the disease mechanisms and associated radiologic features in active thoracic TB, including dissemination routes, covering pulmonary and extrapulmonary thoracic TB (lymph node, pleural, cardiovascular, and musculoskeletal involvement). We highlight TB complications, diagnostic challenges including post-tuberculous lung disease, imaging correlations with sputum smear positivity, and diagnostic mimics. The review emphasises special clinical scenarios that may pose diagnostic challenges, such as immunocompromised patients with human immunodeficiency virus infection, organ transplantation, and autoimmune disorders treated with biological agents, and drug-resistant TB. We discuss the imaging modalities used in the assessment of thoracic TB and the radiographic monitoring recommendations. A good understanding and recognition of the whole spectrum of disease patterns is crucial for individual patient care as well as for controlling TB spread in the community.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing Deep Learning-based Computed Tomography Fractional Flow Reserve on Coronary Artery Disease Diagnosis and Treatment: 1-year Clinical Application From a Chinese Major Hospital.","authors":"Ziyu An, Chenchen Tu, Zhao Ma, Shipan Wang, Jinfan Tian, Haoran Xing, Min Zhang, Mingduo Zhang, Feng Xu, Yanlong Ren, Lijun Zhang, Lei Xu, Xiantao Song, Hongjia Zhang","doi":"10.1097/RTI.0000000000000881","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000881","url":null,"abstract":"<p><strong>Purpose: </strong>Machine learning-based coronary computed tomography fractional flow reserve (CT-FFR) holds great potential for assessing coronary ischemic status. The current literature lacks a comprehensive description of the routine implementation of CT-FFR in real world. To investigate the clinical characteristics and acceptance of CT-FFR in clinical decision-making among Chinese patients and subsequently assess the diagnostic accuracy of invasive coronary angiography as the reference.</p><p><strong>Materials and methods: </strong>In this retrospective single-center study, 4564 patients were included. In the first part, we conducted a baseline analysis of patients and their epicardial coronary arteries. Then, we analyzed hospitalization and revascularization in the context of application of CT-FFR, using logistic regression and Sankey diagrams. Finally, we performed a diagnostic analysis of 2718 vessels in 906 patients.</p><p><strong>Results: </strong>The baseline analysis included a total of 4564 patients. A statistically significant distinction was observed in the traditional risk factors for coronary heart disease between 2 groups with CT-FFR 0.8 cutoff values. Logistic regression analysis and Sankey plots revealed a association between CT-FFR ≤0.8 and subsequent hospitalization. Finally, a diagnostic analysis was performed on 2718 vessels, and the optimal diagnostic model efficacy was achieved by using a CT-FFR cutoff value of 0.8 in conjunction with stenosis ≥70% for CCTA.</p><p><strong>Conclusions: </strong>Our study provides evidence that machine learning-based CT-FFR values exhibit a probably positive correlation with individuals presenting high-risk factors for coronary artery disease. Furthermore, we observed a influence of CT-FFR on the clinical decisions made by physicians. The integration of CT-FFR and CCTA has the potential to enhance diagnostic efficacy.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic IgG4-related Disease: Revealing the Diverse Imaging Manifestations.","authors":"Kyubin Kim, Gong Yong Jin, Myoung Ja Chung, Won Gi Jeong, Jong Eun Lee, Se Ri Kang, Hee Kang, Yeon Joo Jeong","doi":"10.1097/RTI.0000000000000887","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000887","url":null,"abstract":"<p><p>IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition characterized by IgG4-positive plasma cells, storiform fibrosis, obliterative phlebitis, and elevated serum IgG4 levels. Thoracic involvement commonly presents with mediastinal lymphadenopathy and peribronchovascular thickening, along with pulmonary abnormalities (nodules or masses, ground-glass opacities, fibrosis, consolidation, or cavities or cysts), pleural effusion or thickening, mediastinal or chest wall masses, and thoracic arteritis. Given the imaging overlap with other entities, a pattern-based approach is essential to narrow the differential diagnosis. Comprehensive radiologic evaluation across thoracic organs plays a pivotal role in early detection, timely treatment, and prevention of irreversible fibrosis.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Thoracic Radiology 2026 Annual Meeting Abstracts.","authors":"","doi":"10.1097/RTI.0000000000000888","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000888","url":null,"abstract":"","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Sporadic Lymphangioleiomyomatosis in a Male Patient Diagnosed Following Pneumothorax.","authors":"Satoshi Nakamura, Hiroshi Hirakawa, Katsunori Oikado, Daisuke Ito, Tomohiko Masumoto, Atsushi Miyamoto, Meiyo Tamaoka, Sakashi Fujimori, Hironori Uruga, Takeshi Fujii","doi":"10.1097/RTI.0000000000000883","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000883","url":null,"abstract":"<p><p>We report a rare case of sporadic lymphangioleiomyomatosis (LAM) in a 51-year-old male patient presenting with pneumothorax. High-resolution CT revealed multiple thin-walled cysts throughout both lungs. A history of renal angiomyolipoma and histopathologic findings confirmed the diagnosis. Immunohistochemical staining was positive for HMB-45 and α-smooth muscle actin. This case underscores the importance of including sporadic LAM in the differential diagnosis of cystic lung disease in men, despite its rarity. Early radiologic recognition and tissue confirmation are essential for accurate diagnosis and appropriate management.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECG-Gated Retrospective Coronary CT Angiography With Deep Learning Reconstruction on 8-cm Detector CT Scanners: Pushing Radiation Dose Towards Prospective Acquisition on 16-cm Wide-Detector Scanners.","authors":"Leilei Zhou, Shaoqing Zheng, Yixuan Zou, Guozhi Zhang, Qian Chen, Hongtao Huang, Xinying Wu","doi":"10.1097/RTI.0000000000000879","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000879","url":null,"abstract":"<p><strong>Purpose: </strong>Although 16-cm wide-detector CT scanners with prospective ECG-gating enable coronary artery imaging within a single cardiac cycle at a low radiation dose, many institutions still rely on scanners with detector widths <16 cm. These scanners typically use retrospective scanning, resulting in higher radiation exposure. This study tests the feasibility of lowering the radiation dose of ECG-gated retrospective CCTA on 8-cm detector scanners to the level of prospective acquisition on 16-cm ones, using deep learning reconstruction (DLR).</p><p><strong>Materials and methods: </strong>This study involved 83 low-dose (group A) and 62 routine-dose (group B) retrospective CCTA cases on an 8-cm detector scanner, with the low-dose protocol targeting a radiation level comparable to prospective acquisitions on 16-cm scanners. Groups Ref1 and Ref2 were used as the dose and image quality benchmarks. They consisted of prospective CCTA cases acquired on 16-cm scanners from a shared vendor, and were extracted from published studies. Specific subsets (A1/B1 and A2/B2) were selected from group A/B based on weight (55 to 75 kg) and HR (<75 bpm) to match Ref1 and Ref2. DLR was used for group A. Image quality was evaluated using signal-to-noise ratio (SNR) and subjective scoring.</p><p><strong>Results: </strong>No significant differences in demographics were noted among Ref1/A1/B1 or Ref2/A2/B2 (all P>0.05). CTDIvol for A1 was comparable to Ref1 (median: 13.6 mGy vs. 13.2 mGy, P>0.999), whereas A2 had lower CTDIvol than Ref2 (median: 13.3 mGy vs. 16.1 mGy, P=0.018). DLR improved SNRs in group A, with higher values than Ref and B (all P<0.05). With DLR, image quality scores were comparable between groups A and B (all P>0.05).</p><p><strong>Conclusion: </strong>DLR can lower the radiation dose in retrospective CCTA on 8-cm detector scanners to that of prospective CCTA on 16-cm ones, with non-inferior image quality.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editors' Recognition for Reviewing in 2025.","authors":"Jeffrey P Kanne, Dorith Shaham, Prabhakar Rajiah","doi":"10.1097/RTI.0000000000000880","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000880","url":null,"abstract":"","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiview 2.5D Deep Learning Outperforms 2D and 3D Models for Preoperative Prediction of Visceral Pleural Invasion in Stage IA Lung Adenocarcinoma.","authors":"Jiabi Zhao, Tingting Wang, Bin Wang, Lumin Ding, Xiwen Sun, Caizhong Chen","doi":"10.1097/RTI.0000000000000876","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000876","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the predictive performance of 2 novel 2.5-dimensional (2.5D) deep learning (DL) models for visceral pleural invasion (VPI) in clinical stage IA lung adenocarcinoma, comparing them with traditional 2D and 3D models.</p><p><strong>Materials and methods: </strong>A multicenter retrospective analysis included 804 patients from 2 Chinese hospitals with pathologically confirmed stage IA lung adenocarcinoma. The cohort was divided into training (n=360), internal validation (n=155), and external test sets (n=289). Two 2.5D models were developed: a multiview model integrating the largest tumor sections from coronal, sagittal, and axial planes, and a context model incorporating the largest axial slice with adjacent slices. Model performance was assessed using pathological diagnosis as the reference standard, with discriminative abilities evaluated via area under the curve (AUC), accuracy, and predictive values.</p><p><strong>Results: </strong>The 2.5D multiview model achieved an AUC of 0.73 in external validation, outperforming 2D (axial: 0.66, coronal: 0.64, sagittal: 0.63), 2.5D context (0.67), and 3D models (0.66). It demonstrated 67% accuracy, 48% positive predictive value (PPV), and 85% negative predictive value (NPV). Grad-CAM visualization highlighted tumor-pleura contact zones and peritumoral regions as critical predictors of VPI.</p><p><strong>Conclusion: </strong>The 2.5D multiview DL model enhances preoperative VPI prediction in stage IA lung adenocarcinoma, offering superior accuracy and interpretable insights to guide surgical decisions.</p><p><strong>Advances in knowledge: </strong>This study is the first to validate 2.5D DL models, particularly the multiview approach, for VPI prediction, demonstrating improved performance over 2D/3D models while revealing spatially relevant biomarkers through interpretable visualization.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Global Perspective on Viral Pneumonia.","authors":"Maya Vella, Brett M Elicker","doi":"10.1097/RTI.0000000000000874","DOIUrl":"https://doi.org/10.1097/RTI.0000000000000874","url":null,"abstract":"<p><p>There is growing global recognition of the importance of viruses as a cause of lower respiratory tract infections (LRIs) from widespread outbreaks such as the recent COVID-19 pandemic, to seasonal viruses such as those caused by influenza and adenovirus. Worldwide, viruses are a common cause of respiratory infections and mortality due to LRIs. Advances in rapid virus detection have led to a greater understanding of their prevalence and importance as etiological agents of illness. With multiple epidemics and pandemics of viral pneumonia over the past several decades, there is an increasing need to understand the global variations and impacts of these viruses. This review summarizes recent global trends in viral pneumonias and provides an overview of current diagnostic, treatment, and imaging challenges in the setting of viral infections.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}