Academic Radiology最新文献

{"title":"Magnetic Resonance Elastography Derived Stiffness to Predict Postoperative Pancreatic Fistula After Partial Pancreatectomy.","authors":"Dingxia Liu, Jiejun Chen, Yunfei Zhang, Yajia Gu, Xiuzhong Yao","doi":"10.1016/j.acra.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.acra.2025.03.028","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>To investigate the magnetic resonance elastography (MRE)-derived pancreatic stiffness for predicting the occurrence of clinically relative postoperative pancreatic fistula (CR-POPF) in patients with partial pancreatectomy, and establish a predictive model for POPF before surgery.</p><p><strong>Background: </strong>Pancreatic stiffness reflects fibrosis and fat infiltration, which are associated with CR-POPF. But preoperative prediction remains a challenge. MRE was proven to evaluate pancreatic stiffness accurately, potentially being a predictive imaging biomarker of POPF.</p><p><strong>Methods: </strong>This prospective study included adult patients who underwent magnetic resonance imaging with MRE sequence and subsequent partial pancreatectomy between August 2021 and December 2023. The relationships of MRE stiffness and main pancreatic duct diameter (MPD) with the risk of POPF were analyzed using logistic regression. Independent risk factors were identified to construct the nomogram prediction model. The predictive performance of each parameter and the model was conducted by calculating the area under the ROC curve (AUC).</p><p><strong>Results: </strong>A total of 73 patients (age 58.99±12.55 years; 30 pancreatoduodenectomy and 43 distal pancreatectomy) were enrolled, among whom 15 developed CR-POPF and 58 did not. After conducting uni- and multivariate logistic regression analyses, high BMI was found to be an independent risk factor for the occurrence of POPF (OR=2.916, 95% CI: 1.472-9.394, P=0.02), while high pancreatic MRE stiffness (OR=0.0633, 95% CI: 0.0022-0.5273, P=0.04) and large MPD (OR=0.0728, 95% CI: 0.003-0.5165, P=0.04) were independent protective factors. A preoperative prediction model for POPF was constructed by combining the three indicators, which has excellent predictive performance with an AUC of 0.97.</p><p><strong>Conclusion: </strong>MRE can quantitatively evaluate the mechanical property of pancreas, which is a reliable indicator for predicting the risk of POPF. The POPF prediction model established by combining BMI, pancreatic stiffness value, and MPD has promising clinical application prospects.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A CT-Based Clinical-Radiomics Nomogram for Predicting the Overall Survival to TACE Combined with Camrelizumab and Apatinib in Patients with Advanced Hepatocellular Carcinoma","authors":"Guangyao Ding,&nbsp;Kailang Li","doi":"10.1016/j.acra.2024.10.052","DOIUrl":"10.1016/j.acra.2024.10.052","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>To construct a computed tomography (CT)-based clinical-radiomics nomogram for estimating overall survival (OS) in advanced hepatocellular carcinoma (HCC) patients receiving transcatheter arterial chemoembolization (TACE) in combination with camrelizumab and apatinib.</div></div><div><h3>Methods</h3><div>A retrospective recruitment of 150 patients with clinically or pathologically confirmed HCC was conducted, followed by their division into training cohort (<em>n</em> = 105) and test cohort (<em>n</em> = 45). To generate the radiomics score (Rad-score), a series of analyses were performed, including Pearson correlation analysis, univariate Cox analysis, and least absolute shrinkage and selection operator Cox regression analysis. Subsequently, a clinical-radiomics nomogram was constructed using the Rad-score combined with independent clinical prognostic factors, followed by assessments of its calibration, discrimination, reclassification, and clinical utility.</div></div><div><h3>Results</h3><div>Five CT radiomics features were selected. The Rad-score showed a significant correlation with OS (<em>P</em> &lt; 0.001). The clinical-radiomics nomogram demonstrated superior performance in estimating OS, with a concordance index (C-index) of 0.840, compared to the radiomics nomogram (C-index: 0.817) and the clinical nomogram (C-index: 0.661). It also exhibited high 1-year and 2-year area under the curves of 0.936 and 0.946, respectively. Additionally, the clinical-radiomics nomogram markedly enhanced classification accuracy for OS outcomes, as evidenced by net reclassification improvement and integrated discrimination improvement. Decision curve analysis confirmed its clinical utility.</div></div><div><h3>Conclusion</h3><div>A CT-based clinical-radiomics nomogram exhibits strong potential for predicting OS in advanced HCC patients undergoing TACE combined with camrelizumab and apatinib.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 1993-2004"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-guided Preoperative Localization via Adjacent Microcoil Implantation Prior to Laparoscopic Partial Nephrectomy for Totally Endophytic Renal Masses Reduces Operative Time: A CaseControl Study","authors":"Zhiyuan Zhang MD ,&nbsp;Tianhao Su MD ,&nbsp;Siwei Yang MS ,&nbsp;Xuanhao Li MD ,&nbsp;Wei Wei ,&nbsp;Jian Song MD ,&nbsp;Kelei Mao ,&nbsp;Long Jin MD, PhD","doi":"10.1016/j.acra.2024.10.032","DOIUrl":"10.1016/j.acra.2024.10.032","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>This retrospective case<img>control study evaluated the efficacy and safety of CT-guided preoperative localization via adjacent microcoil implantation for reducing the operative time of laparoscopic partial nephrectomy (LPN) in patients with endophytic renal masses.</div></div><div><h3>Methods</h3><div>Data from patients who underwent LPN for completely endophytic treatment (three points for the ‘‘E’’ domain of the R.E.N.A.L. score) renal masses were collected from Beijing Friendship Hospital, Capital Medical University, between January 2020 and May 2023. Microcoils were placed adjacent to the renal masses under CT guidance prior to LPN. The head of the microcoil was pinpointed adjacent to the target endophytic renal mass, and its end tail remained outside the renal surface. Baseline characteristics and clinical, surgical, and postoperative outcomes were compared.</div></div><div><h3>Results</h3><div>Forty patients (microcoil localization, N = 8; standard LPN, N = 32) were included in the analysis. The median clinical tumor size was 15 mm (IQR: 10–22). In all patients in the microcoil localization group, the microcoil was successfully visualized laparoscopically by the surgeons. The microcoil localization technique demonstrated a significantly shorter operative time under general anesthesia (150 vs. 195 min, <em>P</em> = 0.012) and a nonsignificant trend towards a shorter hospital stay (8.6 vs. 11.7 days, <em>P</em> = 0.079). The microcoil localization technique showed a nonsignificant trend toward a reduced total operative time (189 vs. 195 min, <em>P</em> = 0.012). No significant differences were observed in histopathological findings, surgical approach, postoperative eGFR levels, eGFRs, or complication rates were observed between the groups.</div></div><div><h3>Conclusion</h3><div>This study suggested the use of a local microcoil on the surface of the kidney to locate the tumor accurately, which offers a more patient-centered surgical approach and can serve as a standard approach for treating totally endophytic renal masses that require localization.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 2073-2080"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral Distress and the Necessity of Purpose","authors":"Benjamin R. Gray MD MA ,&nbsp;J. Mark Mutz JD ,&nbsp;Richard B. Gunderman MD PhD","doi":"10.1016/j.acra.2024.11.057","DOIUrl":"10.1016/j.acra.2024.11.057","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 2270-2271"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Evaluation of Chemokine Receptor-4 (CXCR4) Overexpression in High-grade Glioma Using 68Ga-Pentixafor (Pars-Cixafor™) PET/CT Imaging","authors":"Habibollah Dadgar ,&nbsp;Nasim Norouzbeigi ,&nbsp;Majid Assadi ,&nbsp;Esmail Jafari ,&nbsp;Batool Al-Balooshi ,&nbsp;Akram Al-Ibraheem ,&nbsp;Abdulredha A. Esmail ,&nbsp;Fahad Marafi ,&nbsp;Mohamad Haidar ,&nbsp;Haider Muhsin Al-Alawi ,&nbsp;Yehia Omar ,&nbsp;Sharjeel Usmani ,&nbsp;Andrea Cimini ,&nbsp;Maria Ricci ,&nbsp;Hossein Arabi ,&nbsp;Habib Zaidi Ph.D","doi":"10.1016/j.acra.2024.11.064","DOIUrl":"10.1016/j.acra.2024.11.064","url":null,"abstract":"<div><h3>Background</h3><div>While magnetic resonance imaging (MRI) remains the gold standard for morphological imaging, its ability to differentiate between tumor tissue and treatment-induced changes on the cellular level is insufficient. Notably, glioma cells, particularly glioblastoma multiforme (GBM), demonstrate overexpression of chemokine receptor-4 (CXCR4). This study aims to evaluate the feasibility of non-invasive ⁶⁸Ga-Cixafor™ PET/CT as a tool to improve diagnostic accuracy in patients with high-grade glioma.</div></div><div><h3>Methods</h3><div>In this retrospective analysis, a database of histopathology-confirmed glioma patients with MRI findings consistent with high-grade gliomas was utilized. Within 2 weeks of their MRI, these patients underwent ⁶⁸Ga-Cixafor™ PET/CT scans to assess CXCR4 expression. Both visual scoring based on established criteria and semi-quantitative measures including maximum standardized uptake value (SUV_max) and tumor-to-background ratios (TBR) were calculated to analyze the PET/CT data.</div></div><div><h3>Results</h3><div>Our retrospective study enrolled 29 histologically confirmed glioma patients with MRI findings consistent with high-grade gliomas. All patients underwent ⁶⁸Ga-Cixafor™ PET/CT scans within 2 weeks of their MRI, specifically at one-hour post-injection time point. Visual assessment based on a standardized scoring system identified 27 positive scans out of 29 (93.1%). Median SUV_max was 2.31 (range: 0.49–9.96) and median TBR was 20 (range: 6.12–124.5). Pathological analysis revealed 5 grade III (17.24%) and 24 grade IV (82.75%) lesions among the 29 patients. Notably, the median SUV_max of grade IV lesions (2.85) was significantly higher than grade III lesions (1.27) (P<!--> <!-->=<!--> <!-->0.02). Conversely, there was no significant difference in median TBR between grade IV (20) and grade III (22.37). These findings support the correlation between high CXCR4 expression, particularly in high-grade gliomas, and elevated uptake of ⁶⁸Ga-Pentixafor. While areas with high uptake showed CXCR4 expression, areas with low uptake did not exhibit noticeable expression (data not shown).</div></div><div><h3>Conclusion</h3><div>This study demonstrated that ⁶⁸Ga-Cixafor™ PET exhibits a TBR with minimal cortical uptake, significantly enhancing glioma detection compared to conventional imaging methods. This, combined with the potential therapeutic capabilities of CXCR4-targeting radiopharmaceuticals, highlights the promise of ⁶⁸Ga-Cixafor™ as a valuable tool for not only improved glioma diagnosis but also personalized treatment strategies.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 2247-2256"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning Using One-stop-shop CT Scan to Predict Hemorrhagic Transformation in Stroke Patients Undergoing Reperfusion Therapy: A Multicenter Study","authors":"Huanhuan Ren ,&nbsp;Haojie Song ,&nbsp;Jiayang Liu ,&nbsp;Shaoguo Cui ,&nbsp;Meilin Gong ,&nbsp;Yongmei Li PhD","doi":"10.1016/j.acra.2024.09.052","DOIUrl":"10.1016/j.acra.2024.09.052","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Hemorrhagic transformation (HT) is one of the most serious complications in patients with acute ischemic stroke (AIS) following reperfusion therapy. The purpose of this study is to develop and validate deep learning (DL) models utilizing multiphase computed tomography angiography (CTA) and computed tomography perfusion (CTP) images for the fully automated prediction of HT.</div></div><div><h3>Materials and Methods</h3><div>In this multicenter retrospective study, a total of 229 AIS patients who underwent reperfusion therapy from June 2019 to May 2022 were reviewed. Data set 1, comprising 183 patients from two hospitals, was utilized for training, tuning, and internal validation. Data set 2, consisting of 46 patients from a third hospital, was employed for external testing. DL models were trained to extract valuable information from multiphase CTA and CTP images. The DenseNet architecture was used to construct the DL models. We developed single-phase, single-parameter models, and combined models to predict HT. The models were evaluated using receiver operating characteristic curves.</div></div><div><h3>Results</h3><div>Sixty-nine (30.1%) of 229 patients (mean age, 66.9 years ± 10.3; male, 144 [66.9%]) developed HT. Among the single-phase models, the arteriovenous phase model demonstrated the highest performance. For single-parameter models, the time-to-peak model was superior. When considering combined models, the CTA-CTP model provided the highest predictive accuracy.</div></div><div><h3>Conclusions</h3><div>DL models for predicting HT based on multiphase CTA and CTP images can be established and performed well, providing a reliable tool for clinicians to make treatment decisions.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 2141-2149"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Patient Volume on Iodinated Contrast Material Waste with Multidose Contrast Injectors","authors":"Niloufar Rafiei Alavi,&nbsp;Julie Limfueco,&nbsp;Randall Yamamoto,&nbsp;James Shi,&nbsp;Roozbeh Houshyar,&nbsp;Vahid Yaghmai","doi":"10.1016/j.acra.2024.12.013","DOIUrl":"10.1016/j.acra.2024.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Multidose iodinated contrast media (ICM) injectors have shown promise in reducing ICM waste. This study aims to evaluate the impact of patient volume on ICM waste reduction in multidose injectors.</div></div><div><h3>Methods</h3><div>CT studies performed over one-year period with a multidose injector at our emergency CT unit. We recorded the ICM volume, time, and date for each injection and calculated total annual ICM use, accounting for the 500 mL ICM containers' 8-hour window usage limit. We then calculated the ICM waste for the same patient cohort assuming single-dose vials used with single-dose injectors were used instead, without the 8-hour window for usage. To assess the impact of patient volume, we evaluated six subgroups based on daily injected patient counts: Group 1 (&lt;<!--> <!-->10 patients/day), Group 2 (10–19 patients/day), Group 3 (20–29 patients/day), Group 4 (30–39 patients/day), Group 5 (40–49 patients/day), Group 6 (≥<!--> <!-->50 patients/day). Annual and mean per patient ICM waste was calculated for both injector types and compared among all subgroups.</div></div><div><h3>Results</h3><div>In total, across 12,290 scans, multidose injectors reduced annual ICM waste by 86.1% compared to single-use injectors. Annual ICM waste was zero on days with 50 or more patients and was minimal (253 mL) for days with 40–49 patients. A significant negative correlation between patient volume and ICM waste was observed (r<!--> <!-->=<!--> <!-->−0.365, p<!--> <!-->&lt;<!--> <!-->0.0001). Mean ICM waste per patient was 2.5 times higher in Group 1 and 71.4% higher in Group 2 with multidose injector compared to single-dose injector. Conversely, in groups with at least 20 patients per day, mean ICM waste per patient was lower with multidose injectors compared to single-dose injectors. Mean ICM waste per patient was reduced by 53.9% in Group 3, 88.9% in Group 4 and 100% in Group 6.</div></div><div><h3>Conclusion</h3><div>High patient throughput centers with over 40 patients per day can nearly eliminate ICM waste with multidose injectors. However, using multidose injectors in centers with lower patient volumes (&lt;20 patients per day) may lead to increased ICM waste compared to single-dose injectors, underscoring the importance of aligning injector choice with patient volume to optimize resource utilization and minimize waste.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 2111-2120"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between the Thickness of the Hypoechoic Halo of Thyroid Nodules and Thyroid Cancer: A Retrospective Study","authors":"Weizhen Shi ,&nbsp;Ming Zhang ,&nbsp;Weiyi Tang ,&nbsp;Kui Tang","doi":"10.1016/j.acra.2024.12.009","DOIUrl":"10.1016/j.acra.2024.12.009","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>The association between hypoechoic halos and thyroid cancer in patients with thyroid nodules remains a contentious issue. The objective of this study was to examine the potential correlation between the thickness of hypoechoic halos and the presence of thyroid cancer in individuals with thyroid nodules.</div></div><div><h3>Methods</h3><div>The study retrospectively analyzed a cohort of 320 patients with thyroid nodules presenting hypoechoic halos from January 2019 to December 2022. Logistic regression models, both univariate and multivariate, were applied to investigate the association between hypoechoic halo thickness and thyroid cancer, with adjustments for potential confounding variables. Interaction and stratified analyses were conducted to assess the influence of demographic and tumor-specific characteristics, such as age, sex, halo thickness, tumor size, and tumor location, on the relationship between halo thickness and thyroid cancer risk.</div></div><div><h3>Results</h3><div>After adjusting for multiple covariates, the odds ratios (ORs) (95% confidence intervals (CIs)) of thyroid cancer for participants with a halo thickness ≥1 mm were 3.99 (2.4–6.62), 3.73 (2.09–6.67), and 3.16 (1.61–6.19), compared to those with a thickness &lt;1 mm. The association between thyroid cancer and the thickness of the halo remained stable across different subgroups (all P for interaction &gt; 0.05). The area under the curve (AUC) for the hypoechoic halo in nodules for diagnosing thyroid cancer was 0.821 (95% CI: 0.774–0.868), with the highest sensitivity and specificity observed at a thickness cutoff value of 1.29 mm.</div></div><div><h3>Conclusion</h3><div>Our single-center study on adults reveals a positive correlation between halo thickness and thyroid cancer risk, indicating that halo thickness may potentially serve as a valuable predictor for thyroid cancer incidence.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 1906-1917"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Noninvasive Diagnostics for Hepatic Steatosis in MASLD: The Pivotal Role of UDFF","authors":"Jinrong Qu MD","doi":"10.1016/j.acra.2025.02.013","DOIUrl":"10.1016/j.acra.2025.02.013","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 1958-1960"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Three Ultrasound-Based Techniques for Diagnosing and Grading Hepatic Steatosis in Metabolic Dysfunction-Associated Steatotic Liver Disease","authors":"Pingping Wang ,&nbsp;Danlei Song ,&nbsp;JiaHao Han,&nbsp;Jing Zhang,&nbsp;Huihui Chen,&nbsp;Ruixia Gao,&nbsp;Huiming Shen,&nbsp;Jia Li","doi":"10.1016/j.acra.2024.09.002","DOIUrl":"10.1016/j.acra.2024.09.002","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>To compare the diagnostic accuracy and grading ability of ultrasound-derived fat fraction (UDFF), controlled attenuation parameters (CAP), and hepatic/renal ratio (HRR) for hepatic steatosis in metabolic dysfunction-associated steatotic liver disease (MASLD) using magnetic resonance imaging proton density fat fraction (PDFF) as the gold standard.</div></div><div><h3>Methods</h3><div>Patients suspected of having MASLD in our hospital between October 2023 and May 2024 were divided into the MASLD group and the control group. All patients underwent UDFF, CAP, and PDFF examinations. HRR was measured during routine ultrasound examination. In statistical analysis, we initially assessed the correlation between UDFF, CAP, HRR, and general characteristics of subjects with PDFF. Subsequently, receiver operating characteristic curve were employed to evaluate and compare the diagnostic performance of UDFF, CAP, and HRR for different grades of hepatic steatosis in MASLD. Their area under the curve, optimal cut-off value, sensitivity, and specificity were also determined. Finally, predictive factors determined hepatic steatosis in MASLD (PDFF<!--> <!-->≥<!--> <!-->6%) were identified through binary logistic regression analysis.</div></div><div><h3>Results</h3><div>115 individuals were ultimately included in the MASLD group, while 102 were included in the control group. UDFF, CAP, and HRR were all positively correlated with PDFF. Among them, UDFF exhibited the strongest correlation with PDFF (ρ = 0.91). Furthermore, in the comparison of diagnostic efficacy among different grades of hepatic steatosis, UDFF outperformed CAP and HRR (p &lt; 0.05). However, there were no statistically significant differences in AUCs between CAP and HRR across all three grades. The AUCs for UDFF in ≥<!--> <!-->S1, ≥<!--> <!-->S2, and ≥<!--> <!-->S3 were 0.99 (95% CI 0.97 to 1.00), 0.96 (95% CI 0.93 to 0.98), and 0.97 (95% CI 0.94 to 0.99), respectively. The optimal thresholds for UDFF are determined as follows: ≥ 6% for grade S1; ≥ 15% for grade S2; and ≥ 23% for grade S3. Multivariate analysis revealed that only age, UDFF, and CAP were important influencing factors for hepatic steatosis in MASLD.</div></div><div><h3>Conclusion</h3><div>The diagnostic accuracy of UDFF surpassed that of CAP and HRR in the detection and grading of hepatic steatosis in MASLD.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 4","pages":"Pages 1949-1957"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}