Radiology advances最新文献

{"title":"Estimating time-to-total knee replacement on radiographs and MRI: a multimodal approach using self-supervised deep learning.","authors":"Ozkan Cigdem, Shengjia Chen, Chaojie Zhang, Kyunghyun Cho, Richard Kijowski, Cem M Deniz","doi":"10.1093/radadv/umae030","DOIUrl":"10.1093/radadv/umae030","url":null,"abstract":"<p><strong>Purpose: </strong>Accurately predicting the expected duration of time until total knee replacement (time-to-TKR) is crucial for patient management and health care planning. Predicting when surgery may be needed, especially within shorter windows like 3 years, allows clinicians to plan timely interventions and health care systems to allocate resources more effectively. Existing models lack the precision for such time-based predictions. A survival analysis model for predicting time-to-TKR was developed using features from medical images and clinical measurements.</p><p><strong>Methods: </strong>From the Osteoarthritis Initiative dataset, all knees with clinical variables, MRI scans, radiographs, and quantitative and semiquantitative assessments from images were identified. This resulted in 895 knees that underwent TKR within the 9-year follow-up period, as specified by the Osteoarthritis Initiative study design, and 786 control knees that did not undergo TKR (right-censored, indicating their status beyond the 9-year follow-up is unknown). These knees were used for model training and testing. Additionally, 518 and 164 subjects from the Multi-Center Osteoarthritis Study and internal hospital data were used for external testing, respectively. Deep learning models were utilized to extract features from radiographs and MR scans. Extracted features, clinical variables, and image assessments were used in survival analysis with Lasso Cox feature selection and a random survival forest model to predict time-to-TKR.</p><p><strong>Results: </strong>The proposed model exhibited strong discrimination power by integrating self-supervised deep learning features with clinical variables (eg, age, body mass index, pain score) and image assessment measurements (eg, Kellgren-Lawrence grade, joint space narrowing, bone marrow lesion size, cartilage morphology) from multiple modalities. The model achieved an area under the curve of 94.5 (95% CI, 94.0-95.1) for predicting the time-to-TKR.</p><p><strong>Conclusions: </strong>The proposed model demonstrated the potential of self-supervised learning and multimodal data fusion in accurately predicting time-to-TKR that may assist physicians to develop personalize treatment strategies.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 4","pages":"umae030"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916814","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":"Magnetic particle imaging enables nonradioactive quantitative sentinel lymph node identification: feasibility proof in murine models.","authors":"Olivia C Sehl, Kelvin Guo, Abdul Rahman Mohtasebzadeh, Petrina Kim, Benjamin Fellows, Marcela Weyhmiller, Patrick W Goodwill, Max Wintermark, Stephen Y Lai, Paula J Foster, Joan M Greve","doi":"10.1093/radadv/umae024","DOIUrl":"10.1093/radadv/umae024","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) is an important cancer diagnostic staging procedure. Conventional SLNB procedures with ^99mTc radiotracers and scintigraphy are constrained by tracer half-life and, in some cases, insufficient image resolution. Here, we explore an alternative magnetic (nonradioactive) image-guided SLNB procedure.</p><p><strong>Purpose: </strong>To demonstrate that magnetic particle imaging (MPI) lymphography can sensitively, specifically, and quantitatively identify and map sentinel lymph modes (SLNs) in murine models in multiple regional lymphatic basins.</p><p><strong>Materials and methods: </strong>Iron oxide nanoparticles were administered intradermally to healthy C57BL/6 mice (male, 12-week-old, n = 5). The nanoparticles (0.675 mg Fe/kg) were injected into the tongue, forepaw, base of tail, or hind footpad, then detected by 3-dimensional MPI at multiple timepoints between 1 hour and 4 to 6 days. In this mouse model, the SLN is represented by the first lymph node draining from the injection site. SLNs were extracted to verify the MPI signal ex vivo and processed using Perl's Prussian iron staining. Paired <i>t</i>-test was conducted to compare MPI signal from SLNs in vivo vs. ex vivo and considered significant if <i>P</i> < .05.</p><p><strong>Results: </strong>MPI lymphography identified SLNs in multiple lymphatic pathways, including the cervical SLN draining the tongue, axillary SLN draining the forepaw, inguinal SLN draining the tail, and popliteal SLN draining the footpad. MPI signal in lymph nodes was present after 1 hour and stable for the duration of the study (4-6 days). Perl's Prussian iron staining was identified in the subcapsular space of excised SLNs.</p><p><strong>Conclusion: </strong>Our data support the use of MPI lymphography to specifically detect SLN(s) using a magnetic tracer for a minimum of 4 to 6 days, thereby providing information required to plan the SLN approach in cancer surgery. As clinical-scale MPI is developed, translation will benefit from a history of using iron-oxide nanoparticles in human imaging and recent regulatory-approvals for use in SLNB.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 3","pages":"umae024"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690348","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":"Different sodium concentrations of noncancerous and cancerous prostate tissue seen on MRI using an external coil.","authors":"Josephine L Tan, Vibhuti Kalia, Stephen E Pautler, Glenn Bauman, Lena V Gast, Max Müller, Armin M Nagel, Jonathan D Thiessen, Timothy J Scholl, Alireza Akbari","doi":"10.1093/radadv/umae023","DOIUrl":"10.1093/radadv/umae023","url":null,"abstract":"<p><strong>Background: </strong>Sodium (²³Na) MRI of prostate cancer (PCa) is a novel but underdocumented technique conventionally acquired using an endorectal coil. These endorectal coils are associated with challenges (e.g., a nonuniform sensitivity profile, limited prostate coverage, patient discomfort) that could be mitigated with an external ²³Na MRI coil.</p><p><strong>Purpose: </strong>To quantify tissue sodium concentration (TSC) differences within the prostate of participants with PCa and healthy volunteers using an external ²³Na MRI radiofrequency coil at 3 T.</p><p><strong>Materials and methods: </strong>A prospective study was conducted from January 2022 to June 2024 in healthy volunteers and participants with biopsy-proven PCa. Prostate ²³Na MRI was acquired on a 3-T PET/MRI scanner using a custom-built 2-loop (diameter, 18 cm) butterfly surface coil tuned for the ²³Na frequency (32.6 MHz). The percent difference in TSC (ΔTSC) between prostate cancer lesions and surrounding noncancerous prostate tissue of the peripheral zone (PZ) and transition zone (TZ) was evaluated using a 1-sample <i>t</i>-test. TSC was compared to apparent diffusion coefficient (ADC) measurements as a clinical reference.</p><p><strong>Results: </strong>Six healthy volunteers (mean age, 54.5 years ± 12.7) and 20 participants with PCa (mean age, 70.7 years ± 8.3) were evaluated. A total of 31 lesions were detected (21 PZ, 10 TZ) across PCa participants. Compared to noncancerous prostate tissue, prostate cancer lesions had significantly lower TSC (ΔTSC, -14.1% ± 18.2, <i>P</i> = .0002) and ADC (ΔADC, -26.6% ± 18.7, <i>P</i> < .0001).</p><p><strong>Conclusion: </strong>We used an external ²³Na MRI coil for whole-gland comparison of TSC in PCa and noncancerous prostate tissue at 3 T. PCa lesions presented with lower TSC compared to surrounding noncancerous PZ and TZ tissue. These findings demonstrate the feasibility of an external ²³Na MRI coil to quantify TSC in the prostate and offer a promising, noninvasive approach to PCa diagnosis and management.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 3","pages":"umae023"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690346","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":"Platelet-Rich Plasma for Patellar Tendinopathy: A randomized controlled trial correlating clinical outcomes and quantitative imaging","authors":"R. A. van der Heijden, Zachary Stewart, Robert Moskwa, Fang Liu, John Wilson, Scott J Hetzel, D. Thelen, Bryan C Heiderscheit, Richard Kijowski, Kenneth Lee","doi":"10.1093/radadv/umae017","DOIUrl":"https://doi.org/10.1093/radadv/umae017","url":null,"abstract":"\u0000 \u0000 \u0000 Patellar tendinopathy (PT) is a common overuse injury in active individuals, often with incomplete recovery. Recently, platelet-rich plasma (PRP) treatment has shown promising results. Traditional qualitative markers are not reliable indicators of treatment response. Advanced quantitative imaging, such as Ultrashort-TE (UTE) MRI and ultrasound (US) shear-wave elastography (SWE) may be valuable adjuncts.\u0000 \u0000 \u0000 \u0000 To investigate the clinical outcomes and quantitative imaging changes in adults with symptomatic patellar tendinopathy treated with PRP, needle tenotomy (NT) or sham injection (SH).\u0000 \u0000 \u0000 \u0000 Single-blinded prospective randomized controlled trial from April 2017 until July 2022 with three parallel interventions in athletes with symptomatic PT: PRP, NT and SH. VAS pain, VISA-P function, conventional US, shear wave speed (SWS), UTE T2* relaxation time (T2*single) and T2* fraction of fast-relaxing macromolecular-bound water (FF) were acquired at 0, 16 and 52-weeks. Longitudinal analyses were used to compare intra- and inter-group differences over time. Correlations were assessed by Pearson’s correlation coefficient.\u0000 \u0000 \u0000 \u0000 29 subjects (mean age, 26.1±5.3 years; 82.8% men) were randomized. At 52-weeks all groups demonstrated a significant improvement in pain, though most pronounced within the PRP group (ΔVAS=-5.9, 95% confidence interval (CI) [-7.8, -3.9], p<.001). SWS increased significantly only in the PRP group (Δ+2.3, [0.8, 3.9], p=.003). Change in SWS was moderately correlated with change in pain across all groups (r=-.52, [-.76, -.15], p=.009). FF significantly increased in all groups (Δ=0.10-0.11, p=.024-0.046); a significant decrease in T2*single was only seen in the PRP group (Δ=-8.07, [-14.6, -1.55], p=.014).\u0000 \u0000 \u0000 \u0000 Clinical improvement was evident irrespective of treatment but was greatest with PRP. SWS correlated with improvement in pain and may represent an adjunctive measure to assess healing in patellar tendinopathy. Correlative changes in T2* UTE quantitative markers suggest their potential for response assessment, but further research is needed to clarify their clinical applicability.\u0000","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":" 652","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141669604","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 Generative Model of the Distal Tibial Classic Metaphyseal Lesion in Infants: Assessment of Synthetic Images","authors":"Shaoju Wu, Sila Kurugol, Paul K Kleinman, Kirsten Ecklund, Michele Walters, Susan A Connolly, Patrick Johnston, Andy Tsai","doi":"10.1093/radadv/umae018","DOIUrl":"https://doi.org/10.1093/radadv/umae018","url":null,"abstract":"\u0000 \u0000 \u0000 The classic metaphyseal lesion (CML) is a distinctive fracture highly specific to infant abuse. To increase the size and diversity of the training CML database for automated deep-learning detection of this fracture, we developed a mask conditional diffusion model (MaC-DM) to generate synthetic images with and without CMLs.\u0000 \u0000 \u0000 \u0000 To objectively and subjectively assess the synthetic radiographic images with and without CMLs generated by MaC-DM.\u0000 \u0000 \u0000 \u0000 For retrospective testing, we randomly chose 100 real images (50 normals and 50 with CMLs; 39 infants, male = 22, female = 17; mean age = 4.1 months; SD = 3.1 months) from an existing distal tibia dataset (177 normal, 73 with CMLs), and generated 100 synthetic distal tibia images via MaC-DM (50 normals and 50 with CMLs). These test images were shown to three blinded radiologists. In the 1st session, radiologists determined if the images were normal or had CMLs. In the 2nd session, they determined if the images were real or synthetic. We analyzed the radiologists’ interpretations, and employed t-distributed stochastic neighbor embedding (t-SNE) technique to analyze the data distribution of the test images.\u0000 \u0000 \u0000 \u0000 When presented with the 200 images (100 synthetic, 100 with CMLs), radiologists reliably and accurately diagnosed CMLs (kappa = 0.90, 95% CI = [0.88, 0.92]; accuracy = 92%, 95% CI = [89%, 97%]). However, they were inaccurate in differentiating between real and synthetic images (kappa = 0.05, 95% CI = [0.03, 0.07]; accuracy = 53%, 95% CI = [49%, 59%]). The t-SNE analysis showed substantial differences in the data distribution between normal images and those with CMLs (AUC = 0.996, 95% CI = [0.992, 1.000], P < 0.01), but minor differences between real and synthetic images (AUC = 0.566, 95% CI = [0.486, 0.647], P = 0.11).\u0000 \u0000 \u0000 \u0000 Radiologists accurately diagnosed images with distal tibial CMLs but were unable to distinguish real from synthetically generated ones, indicating that our generative model could synthesize realistic images. Thus, MaC-DM holds promise as an effective strategy for data augmentation in training machine-learning models for diagnosis of distal tibial CMLs.\u0000","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677609","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":"Atrial Anatomical Variations on Computed Tomography Angiography Associated with Atrial Fibrillation and Those Predicting Recurrence Following Pulmonary Vein Isolation","authors":"R. Abazid, Osama Smettie, J. Romsa, J. Warrington, C. Akincioglu, Nikolaos Tzemos, W. Vezina, H. Khan","doi":"10.1093/radadv/umae016","DOIUrl":"https://doi.org/10.1093/radadv/umae016","url":null,"abstract":"\u0000 \u0000 \u0000 We aim to investigate the atrial anatomical variations in patients with and without atrial fibrillation (AF) using cardiac computed tomography angiography (CCTA) and identify features associated with AF recurrence following pulmonary vein isolation.\u0000 \u0000 \u0000 \u0000 We retrospectively reviewed 502 CCTAs of patients with AF performed prior to a pulmonary vein isolation procedure with 1058 CCTAs of patients without AF performed to rule out coronary artery disease between 2014 and 2017. Anatomical variations of both atria including left atrial diverticula (LAD), right atrial diverticula (RAD), Bachmann bundle shunt (BBS) and pulmonary vein anatomy were assessed.\u0000 \u0000 \u0000 \u0000 We found that patients with AF were older (67±14 vs. 63±13 years, P = 0.039), had a higher prevalence of diabetes (24.4%) vs (14.7%), P = 0.006, and cerebrovascular accidents (3.8%) vs. (0.9%), P = 0.044 when compared with patients without AF. Furthermore, on CCTAs patients with AF demonstrated a significantly higher prevalence of BBS (11% vs. 4.1%, P < 0.001), LAD (19% vs. 7.7%, P < 0.001), and RAD (9.8% vs. 2.1%, P < 0.001) when compared to patients without AF. Logistic multivariable regression analyses of CCTA findings demonstrated increased Odd Ratios (OR) in those with AF of BBS (OR = 3.51, 95% confidence interval (CI) = 2.32–5.35, P < 0.001), LAD (OR = 2.94, 95% CI = 2.12–4.07, P < 0.001), RAD (OR = 1.54, 95% CI = 1.19–2.11, P = 0.03), LA diameter (OR = 2.42, 95% CI = 1.65-3.39, P < 0.001). Importantly, multivariate Cox regression showed that the LA dimension is a predictor of AF recurrence (HR = 1.019, 95% CI = 1.001-1.051, P = 0.02).\u0000 \u0000 \u0000 \u0000 AF patients have a higher prevalence of BBS, LAD, and RAD in comparison to patients without AF. Mean LA diameter predicts AF recurrence after the pulmonary vein isolation procedure.\u0000","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706482","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":"Seven tesla knee MRI T2*-mapping detects intrasubstance meniscus degeneration in patients with posterior root tears.","authors":"Abdul Wahed Kajabi, Štefan Zbýň, Jesse S Smith, Eisa Hedayati, Karsten Knutsen, Luke V Tollefson, Morgan Homan, Hasan Abbasguliyev, Takashi Takahashi, Gregor J Metzger, Robert F LaPrade, Jutta M Ellermann","doi":"10.1093/radadv/umae005","DOIUrl":"10.1093/radadv/umae005","url":null,"abstract":"<p><strong>Background: </strong>Medial meniscus root tears often lead to knee osteoarthritis. The extent of meniscal tissue changes beyond the localized root tear is unknown.</p><p><strong>Purpose: </strong>To evaluate if 7 Tesla 3D T2*-mapping can detect intrasubstance meniscal degeneration in patients with arthroscopically verified medial meniscus posterior root tears (MMPRTs), and assess if tissue changes extend beyond the immediate site of the posterior root tear detected on surface examination by arthroscopy.</p><p><strong>Methods: </strong>In this prospective study we acquired 7 T knee MRIs from patients with MMPRTs and asymptomatic controls. Using a linear mixed model, we compared T2* values between patients and controls, and across different meniscal regions. Patients underwent arthroscopic assessment before MMPRT repair. Changes in pain levels before and after repair were calculated using Knee Injury & Osteoarthritis Outcome Score (KOOS). Pain changes and meniscal extrusion were correlated with T2* using Pearson correlation (<i>r</i>).</p><p><strong>Results: </strong>Twenty patients (mean age 53 ± 8; 16 females) demonstrated significantly higher T2* values across the medial meniscus (anterior horn, posterior body and posterior horn: all <i>P </i><<i> </i>.001; anterior body: <i>P </i>=<i> </i>.007), and lateral meniscus anterior (<i>P </i>=<i> </i>.024) and posterior (<i>P </i><<i> </i>.001) horns when compared to the corresponding regions in ten matched controls (mean age 53 ± 12; 8 females). Elevated T2* values were inversely correlated with the change in pain levels before and after repair. All patients had medial meniscal extrusion of ≥2 mm. Arthroscopy did not reveal surface abnormalities in 70% of patients (14 out of 20).</p><p><strong>Conclusions: </strong>Elevated T2* values across both medial and lateral menisci indicate that degenerative changes in patients with MMPRTs extend beyond the immediate vicinity of the posterior root tear. This suggests more widespread meniscal degeneration, often undetected by surface examinations in arthroscopy.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 1","pages":"umae005"},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11159571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297758","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}