Academic Radiology最新文献

{"title":"CT-Based Habitat Model for Predicting Tumor Response and Survival in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization Combining Molecular Targeted Agents and Immune Checkpoint Inhibitors.","authors":"Xiao Shen, Jin-Xing Zhang, Hai-Tao Yan, Jin Liu, Sheng Liu, Hai-Bin Shi, Qing-Quan Zu","doi":"10.1016/j.acra.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.acra.2025.09.022","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>To develop and validate a CT-based habitat model for predicting tumor response and overall survival (OS) in patients with unresectable hepatocellular carcinoma (uHCC) undergoing transarterial chemoembolization, combined with molecular-targeted agents, and immune checkpoint inhibitors (TACE-MTAs-ICIs).</p><p><strong>Materials and methods: </strong>A total of 200 patients treated with TACE-MTAs-ICIs between June 2019 and August 2024 were retrospectively included. Voxel-level radiomic features were extracted from contrast-enhanced CT images, and tumor habitats were identified using K-means clustering. Radiomic features were extracted from both habitat subregions and the entire tumor volume (conventional radiomics). A support vector machine (SVM) model was developed to predict tumor response, with SHapley Additive exPlanations (SHAP) analysis applied for interpretability. In parallel, a Cox proportional hazards model was constructed to predict OS. Independent clinical risk factors were incorporated with radiomic features to build a combined model. Model performance was evaluated and compared using multiple statistical metrics.</p><p><strong>Results: </strong>In the test cohort, the habitat model achieved strong performance for tumor response prediction (AUC: 0.881) and OS stratification (C-index: 0.703; 1-year AUC: 0.788; 2-year AUC: 0.806), outperforming the conventional radiomics model. Notably, the integrated model combining habitat features and clinical variables further improved predictive accuracy, yielding an AUC of 0.884 for response prediction and superior OS discrimination (C-index: 0.749; 1-year AUC: 0.831; 2-year AUC: 0.841).</p><p><strong>Conclusion: </strong>The proposed CT-based habitat model enables a more accurate and interpretable assessment of treatment response and OS in HCC, offering valuable noninvasive biomarkers that reflect intra-tumor heterogeneity. This approach holds promise for improving individualized treatment planning and clinical outcomes.</p><p><strong>Data availability statement: </strong>The data that support the findings of this study are available from the corresponding author upon reasonable request.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245790","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":"Ischiofemoral Impingement: Morphologic Associations, Pelvic Asymmetry, and Clinical Correlates in a Retrospective Observational Study.","authors":"Gizem Timoçin Yığman, Hande Özen Atalay, Erol Erinç Dokuyucu","doi":"10.1016/j.acra.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.acra.2025.09.023","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>To investigate the association between quadratus femoris edema (QFE) and pelvic morphometric measurements, pathological findings, and pain in adults with narrowed ischiofemoral space (IFS), and to evaluate whether right-left asymmetry in pelvic morphology influences QFE development.</p><p><strong>Methods: </strong>This retrospective single-center study included 116 adults (mean age: 54.2 years; 88.8% female) who underwent bony pelvis MRI between January 2020-June 2025 and had IFS < 15 mm. Exclusion criteria included hip surgery, femoral avascular necrosis, pediatric hip disorders, post-traumatic deformities, and nondiagnostic examinations. MRI assessments included QFE, IFS, quadratus femoris space (QFS), ischial angle, intertuberous distance, femoral neck angle, and hamstring tendon area, as well as the presence of femoroacetabular impingement, labral tears, hamstring tendinosis.</p><p><strong>Results: </strong>QFE was present in 97 patients (83.6%). IFS and QFS were significantly smaller in edema-positive patients (p<0.001), with large-to-moderate effect sizes. Left femoral neck angle was modestly but significantly higher in the edema group (p=0.016), while other morphometrics showed no significant differences. Left-sided hamstring tendinosis was the only pathological finding associated with QFE (p=0.019). Pain was common (86.2%) but not correlated with QFE (p>0.05). Right-left asymmetry was significantly greater for QFS (p=0.005) and ischial angle (p=0.012) in patients with QFE compared to those without QFE.</p><p><strong>Conclusion: </strong>QFE is strongly linked to reduced IFS, QFS and to asymmetries of QFS, ischial angle, but not consistently to pain. This is the first study to explore the correlation between hip pain and QFE in adults as well as role of morphometric asymmetry in QFE development highlighting the value of bilateral assessment.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234022","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 Impact of Critical Results Notification with Documentation in the Electronic Medical Record.","authors":"Adam C Zoga","doi":"10.1016/j.acra.2025.09.035","DOIUrl":"https://doi.org/10.1016/j.acra.2025.09.035","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234035","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":"Application of Idarubicin loaded Equalspheres in the TACE procedure for Rabbit Liver Tumor Model.","authors":"Huibin Lu, Zeyi Yao, Yahua Li, Xiaoyong Ge, Zongming Li, Zihe Zhou, Yifan Li, Tengfei Jin, Yao Ge, Yangduan Yao, Jianzhuang Ren, Xinwei Han, Kewei Ren","doi":"10.1016/j.acra.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.acra.2025.09.013","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>To investigate the in vitro drug loading and release effects of uniformly sized beads Equalspheres (ES) for idarubicin (IDA) and its application in rabbit liver VX₂ tumor model.</p><p><strong>Material and methods: </strong>The ES sizes of 70 µm and 100 µm were divided into three groups according to different IDA and ES ratios and different IDA concentrations for the drug loading experiment. The optimal concentration group was selected for the drug release experiment. The diameter and Zeta potential of the ES was measured, and the shrinkage rate was calculated. The rabbit liver VX₂ tumor model was divided into a control group, a TACE group, and an IDA-TACE group. The HE and IHC staining data were compared and analyzed.</p><p><strong>Results: </strong>The shrinkage of 70 and 100 µm ES with IDA loaded exceeds 20%. Both 70 µm and 100 µm ES can rapidly load IDA, and ES's loading efficiency with 10mg/ml IDA is higher than that with 5mg/ml. The encapsulation rate of 70 µm ES with IDA concentrations of 10mg/ml and 5mg/ml after 5 min of drug administration were (90.75±3.57)% and (83.97±2.34)%, respectively. The encapsulation rates of 100 µm ES with IDA concentrations of 10mg/ml and 5mg/ml after 5 min of drug administration were (93.66±2.19)% and (89.92±1.52)%, respectively. The 1 h and 24 h release rates of 70 µm ES were (62.64±1.88)% and (88.77±7.27)%, respectively. The 1 h and 24 h release rates of 100 µm ES were (80.74±4.90)% and (96.42±9.48)%, respectively. The 70 µm ES was chosen to perform TACE and IDA-TACE. Pathological results suggested that the expression of PCNA in the tumor after IDA-TACE was significantly downregulated, while the expression of VEGF, CD31, and HIF-1 was increased after embolization in 1w and significantly decreased in 2w.</p><p><strong>Conclusion: </strong>This study demonstrated that ES can rapidly load IDA and achieve sustained release. The shrinkage of ES needs to be a concern in clinical applications. The IDA-TACE is an effective procedure for achieving hepatic tumor locoregional treatment.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228287","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":"Predictive Value of Nomogram-Based Clinicopathological Biomarkers Combined with Multiparametric MRI for Tumour-Infiltrating Lymphocyte Expression in Breast Cancer.","authors":"Zhe Zhou, Zhanguo Sun, Fan Zhao, Yuan Jin, Yueqin Chen, Laimin Zhu, Yanji Guo, Weiwei Wang","doi":"10.1016/j.acra.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.acra.2025.09.017","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>To investigate the value of clinicopathological features and multiparametric magnetic resonance imaging (MRI) in predicting tumour-infiltrating lymphocyte (TIL) levels in breast cancer.</p><p><strong>Materials and methods: </strong>A total of 171 patients diagnosed with invasive ductal carcinoma who underwent preoperative MRI (2023-2025) were included. The analysis focused on the clinicopathological characteristics alongside conventional MRI features and a range of quantitative parameters. Multiple logistic regression analysis identified independent predictors of high and low TIL levels. A nomogram was constructed based on the multivariable logistic regression model results.</p><p><strong>Results: </strong>Logistic regression analysis identified histological grade, D, D*, Ktrans, and Kep as independent factors in the training cohort. The nomogram's C-index was 0.944 in the training cohort and 0.964 in the validation cohort. The area under the curve (AUC) of the nomogram model was 0.954 (85.1% sensitivity, 91.1% specificity, and 87.4% accuracy) in the training cohort and 0.974 (96.7% sensitivity, 92.1% specificity, and 92.6% accuracy) in the validation cohort, both significantly higher than those of the individual models in the corresponding cohorts (Z=3.018-6.653, all P<0.05 and Z=2.546-5.668, all P<0.05).</p><p><strong>Conclusion: </strong>Combining clinicopathological characteristics with multiparametric MRI parameters significantly improves prediction accuracy for TIL levels in breast cancer. This integrated model holds considerable clinical potential, providing robust support for personalised treatment strategies.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228339","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":"Thermal Ablation for T1N0M0 Papillary Thyroid Carcinoma: A Long-term Multicenter Comparative Study with Subgroup Analysis.","authors":"Han-Xiao Zhao, Shu-Rong Wang, Li-Hong Liu, Zhi-Bin Cong, Song-Song Wu, Jin-Ke Li, Lu Zhou, Sheng-Nan Huo, Li-Li Shi, Zhong-Hua Wang, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Ming-An Yu","doi":"10.1016/j.acra.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.acra.2025.09.019","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term efficacy of thermal ablation (TA) for T1N0M0 papillary thyroid carcinoma (PTC) and compare outcomes between unifocal T1a PTC and unifocal T1b PTC and between unifocal T1a PTC and multifocal (≤3 nodules) T1a PTC.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study included 495 patients with T1N0M0 PTC from eight hospitals with a median follow-up of 79 months, including 397 unifocal T1a, 49 unifocal T1b, and 49 multifocal T1a patients. The primary outcomes were disease progression and disease-free survival. Secondary outcomes included the technical success rate, volume reduction rate (VRR), complete disappearance rate, and complications. Univariate and multivariate Cox regression analyses were performed to identify risk factors for disease progression.</p><p><strong>Results: </strong>The disease progression rates were 4.3% (17/397) for unifocal T1a, 8.2% (4/49) for unifocal T1b, and 14.3% (7/49) for multifocal T1a PTC, with median follow-up durations of 81, 75, and 64 months, respectively. No significant differences were observed between the unifocal T1a and T1b groups (p=0.394), whereas progression was significantly higher for patients with multifocal T1a PTC than for patients with unifocal T1a PTC (p=0.010). New tumor development (4.4%) was more common than lymph node metastasis (LNMs) (1.8%) in the overall cohort. Among the 28 patients with disease progression, 25 underwent a second TA, with successful disease control in 96% (24/25) of the patients during a median follow-up of 40 months after retreatment. Multifocal tumors were the only independent risk factor for disease progression (HR: 5.601; p=0.001). Secondary outcomes included a 100% technical success rate, a 100% median VRR, and 99.0% complete tumor disappearance. The overall complication rate was 2.8%, with transient hoarseness being the most common major complication (2.2%).</p><p><strong>Conclusion: </strong>This long-term multicenter study demonstrated that TA is a safe and effective treatment for T1N0M0 PTC. Although multifocality was identified as an independent risk factor for disease progression, second ablation therapy can effectively control new tumors or LNM.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228285","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":"Pure Radial Scars Only Detected on Digital Breast Tomosynthesis: Additional Perspectives.","authors":"Deniz Esin Tekcan Sanli, Ahmet Necati Sanli","doi":"10.1016/j.acra.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.acra.2025.09.021","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226279","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":"CAP-Net: Carotid Artery Plaque Segmentation System Based on Computed Tomography Angiography","authors":"Xiao Luo ,&nbsp;Bin Hu ,&nbsp;Shuyi Zhou ,&nbsp;Qiuwen Wu ,&nbsp;Chen Geng ,&nbsp;Lingxiao Zhao ,&nbsp;Yuxin Li ,&nbsp;Ruoyu Di ,&nbsp;Jian Pu ,&nbsp;Daoying Geng ,&nbsp;Liqin Yang PhD","doi":"10.1016/j.acra.2025.07.009","DOIUrl":"10.1016/j.acra.2025.07.009","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Diagnosis of carotid plaques from head and neck CT angiography (CTA) scans is typically time-consuming and labor-intensive, leading to limited studies and unpleasant results in this area. The objective of this study is to develop a deep-learning-based model for detection and segmentation of carotid plaques using CTA images.</div></div><div><h3>Materials and Methods</h3><div>CTA images from 1061 patients (765 male; 296 female) with 4048 carotid plaques were included and split into a 75% training-validation set and a 25% independent test set. We built a workflow involving three modified deep learning networks: a plain U-Net for coarse artery segmentation, an Attention U-Net for fine artery segmentation, a dual-channel-input ConvNeXt-based U-Net architecture for plaque segmentation, and post-processing to refine predictions and eliminate false positives. The models were trained on the training-validation set using five-fold cross-validation and further evaluated on the independent test set using comprehensive metrics for segmentation and plaque detection.</div></div><div><h3>Results</h3><div>The proposed workflow was evaluated in the independent test set (261 patients with 902 carotid plaques) and achieved a mean dice similarity coefficient (DSC) of 0.91±0.04 in artery segmentation, and 0.75±0.14/0.67±0.15 in plaque segmentation per artery/patient. The model detected 95.5% (861/902) plaques, including 96.6% (423/438), 95.3% (307/322), and 92.3% (131/142) of calcified, mixed, and soft plaques, with less than one (0.63±0.93) false positive plaque per patient on average.</div></div><div><h3>Conclusion</h3><div>This study developed an automatic detection and segmentation deep learning-based CAP-Net for carotid plaques using CTA, which yielded promising results in identifying and delineating plaques.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 10","pages":"Pages 6194-6204"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709763","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":"Radiomics with Machine Learning Improves the Prediction of Microscopic Peritumoral Small Cancer Foci and Early Recurrence in Hepatocellular Carcinoma","authors":"Wenjie Zou ,&nbsp;Mengting Gu ,&nbsp;Huilin Chen ,&nbsp;Ruilin He ,&nbsp;Xingyu Zhao ,&nbsp;Ningyang Jia ,&nbsp;Peijun Wang ,&nbsp;Wanmin Liu","doi":"10.1016/j.acra.2025.07.018","DOIUrl":"10.1016/j.acra.2025.07.018","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>This study aimed to develop an interpretable machine learning model using magnetic resonance imaging (MRI) radiomics features to predict preoperative microscopic peritumoral small cancer foci (MSF) and explore its relationship with early recurrence in hepatocellular carcinoma (HCC) patients.</div></div><div><h3>Methods</h3><div>A total of 1049 patients from three hospitals were divided into a training set (Hospital 1: 614 cases), a test set (Hospital 2: 248 cases), and a validation set (Hospital 3: 187 cases). Independent risk factors from clinical and MRI features were identified using univariate and multivariate logistic regression to build a clinicoradiological model. MRI radiomics features were then selected using methods like least absolute shrinkage and selection operator (LassoCV) and modeled with various machine learning algorithms, choosing the best-performing model as the radiomics model. The clinical and radiomics features were combined to form a fusion model. Model performance was evaluated by comparing receiver operating characteristic (ROC) curves, area under the curve (AUC) values, calibration curves, and decision curve analysis (DCA) curves. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) values assessed improvements in predictive efficacy. The model's prognostic value was verified using Kaplan–Meier analysis. SHapley Additive exPlanations (SHAP) was used to interpret how the model makes predictions.</div></div><div><h3>Results</h3><div>Three models were developed as follows: Clinical Radiology, XGBoost, and Clinical XGBoost. XGBoost was selected as the final model for predicting MSF, with AUCs of 0.841, 0.835, and 0.817 in the training, test, and validation sets, respectively. These results were comparable to the Clinical XGBoost model (0.856, 0.826, 0.837) and significantly better than the Clinical Radiology model (0.688, 0.561, 0.613). Additionally, the XGBoost model effectively predicted early recurrence in HCC patients.</div></div><div><h3>Conclusion</h3><div>This study successfully developed an interpretable XGBoost machine learning model based on MRI radiomics features to predict preoperative MSF and early recurrence in HCC patients.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 10","pages":"Pages 5774-5788"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745890","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":"Intrinsic Brain Activity Mediates the Relationship Between Depressive Symptoms and Subjective Cognitive Complaints in Young Adults in Higher Education: A Resting-State fMRI Study Based on Amplitude of Low-frequency Fluctuation","authors":"Ying Cui ,&nbsp;Ruoxi Lu ,&nbsp;Xinyu Liang ,&nbsp;Jianyu Li ,&nbsp;Hanyue Zhang ,&nbsp;Danian Li ,&nbsp;Yan Guo ,&nbsp;Jing Wang ,&nbsp;Baohua Cheng ,&nbsp;Yanting Zheng ,&nbsp;Shijun Qiu ,&nbsp;Yujie Liu","doi":"10.1016/j.acra.2025.07.031","DOIUrl":"10.1016/j.acra.2025.07.031","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Depression is a prevalent mental health issue among young adults in higher education, often accompanied by subjective cognitive complaints, which can further exacerbate the impact of the disorder. However, the underlying neurobiological mechanisms linking depressive symptoms to cognitive complaints remain poorly understood. This study aims to explore alterations in intrinsic brain activity, assessed through amplitude of low-frequency fluctuation (ALFF), in young adults in higher education with depression. It also examines the mediating role of these alterations in the relationship between depressive symptoms and subjective cognitive complaints.</div></div><div><h3>Methods</h3><div>Resting-state fMRI data were collected from 108 participants, including 45 young adults in higher education with depression and 63 healthy controls (HCs). ALFF was calculated and compared between groups, followed by correlation and mediation analyses to explore the associations among ALFF alterations, depressive symptom severity (assessed by 17 item-Hamilton Depression Rating Scale, HAMD-17), and subjective cognitive complaints (assessed by Perceived Deficits Questionnaire-Depression, PDQ-D).</div></div><div><h3>Results</h3><div>Young adults in higher education with depression exhibited higher PDQ-D scores and increased ALFF in the left cerebellar lobule VIII, right cerebellar lobule IX, and right superior temporal gyrus, alongside decreased ALFF in the left postcentral gyrus compared to HCs. ALFF in the left cerebellar lobule VIII was positively correlated with the score of PDQ-D and significantly mediated the relationship between depressive symptom severity and subjective cognitive complaints (<em>β</em> = 0.126, <em>p</em> &lt; 0.01). Although mediation effects in the right superior temporal gyrus and right cerebellar lobule IX were not statistically significant, their large effect sizes suggested potential relevance.</div></div><div><h3>Conclusion</h3><div>These findings highlight the critical role of specific brain regions, particularly the cerebellum, in mediating cognitive and emotional disturbances in depression. Future research should explore the longitudinal and multimodal dynamics of these neural mechanisms to better understand depression's cognitive and emotional manifestations in young adults.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 10","pages":"Pages 6158-6168"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796045","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}