Radiology advances最新文献

{"title":"Cardiac MRI T₂ mapping with heart phase acquisition and improved motion-sensitized driven equilibrium blood suppression.","authors":"Ebtihal Raheem Hammood, Shapoor Shirani, Sahar Asl Fallah, Farzad Maleki, Sadegh Dehghani","doi":"10.1093/radadv/umae013","DOIUrl":"10.1093/radadv/umae013","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) imaging relies on T₂ mapping to assess myocardial tissue properties. However, T₂ maps are subject to motion artifacts and signal interference, prompting exploration of techniques such as gradient-spin-echo (GraSE) sequences, heart phase acquisition, and dark blood (DB) imaging to improve image quality and reliability.</p><p><strong>Purpose: </strong>This prospective study evaluates the T₂ relaxation time (T₂) variability and the image quality of T₂ maps obtained in end-systole and end-diastole with and without fat saturation (FS), using GraSE sequence in CMR imaging. Furthermore, improved motion-sensitized driven-equilibrium (iMSDE) was compared with double inversion recovery (DIR) as an alternative DB technique.</p><p><strong>Materials and methods: </strong>Five variants of the DB GraSE sequence were developed and performed on a 1.5 Tesla MRI scanner. Forty-four healthy volunteers prospectively underwent the following sequences: GraSE in end-diastole (GraSE-ED), GraSE-ED with FS (GraSE-ED-FS), GraSE in end-systole (GraSE-ES), GraSE-ES with FS (GraSE-ES-FS), and commercial GraSE-ED (GraSE-CO). Four GraSE variants utilized iMSDE technique, while GraSE-CO used DIR for blood suppression. T₂, image quality, and visual artifacts were measured.</p><p><strong>Results: </strong>Ten volunteers were excluded due to image artifacts or missing datasets. Among the remaining 34 participants, the mean global T₂ was measured. No significant differences were seen among all variants (<i>P</i> > .05 for all comparisons). Intra- and inter-reader agreement of global T₂ values for all GraSE sequence were very good (<i>r</i> > 0.8 for both). Image quality was rated moderate or good for all variants of GraSE sequences. A lower incidence of artifacts was observed in end-systolic compared to end-diastolic imaging.</p><p><strong>Conclusion: </strong>All variants of GraSE sequence are highly reproducible and myocardial T₂ values did not significantly differ with heart phase. iMSDE is feasible as an alternative DB technique for T₂ mapping enabling acquisition in systole, which shows a lower incidence of artifacts compared to diastole.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 2","pages":"umae013"},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246192","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":"Cerenkov luminescence imaging and flexible autoradiography for specimen margin assessment during breast-conserving cancer surgery.","authors":"Aaditya Sinha, Zhane Peterson, Belul Shifa, Hannah Jeffery, Patriek Jurrius, Sarah Allen, Eugene Lee, Mohammed Azmat, Rachel Barrass, Damion Bailey, Jessica Johnson, Kathryn Adamson, Vasileios Karydakis, Elina Shaari, Mangesh Thorat, Hisham Hamed, Georgina Bitsakou, Sarah Pinder, Padma Menon, Wen Ng, Gary Cook, John Joemon, Armidita Jacob, Sofia Pereira, Jocelyn Thomas, Ruheana Begum, Karim El-Boghdadly, Mieke Van Hemelrijck, Ashutosh Kothari, Arnie Purushotham","doi":"10.1093/radadv/umae015","DOIUrl":"10.1093/radadv/umae015","url":null,"abstract":"<p><strong>Background: </strong>Among women with breast cancer who undergo breast-conserving surgery (BCS), 20% to 25% require further surgery because of close or involved margins. Improved techniques are needed to assess resection margins.</p><p><strong>Purpose: </strong>The study aims were to assess the feasibility of the combined techniques of Cerenkov luminescence imaging-flexible autoradiography (CLI-FAR) to assess excision specimen margins in women undergoing BCS and to determine the diagnostic performance of intraoperative CLI-FAR imaging with postoperative histopathology as the reference standard.</p><p><strong>Materials and methods: </strong>Women undergoing BCS were recruited prospectively at a single center over 13 months. Patients were injected with 250 MBq ± 10 MBq of 18F-fluorodeoxyglucose, 145 minutes before surgery; the excised specimens were imaged intraoperatively. The surgically excised tumor was initially imaged using conventional x-ray, and margins suspected to be involved by tumor were then imaged using CLI-FAR. CLI-FAR imaging was performed using the LightPath system (Lightpoint), an in vitro diagnostic device designed to identify and locate positron-emitting radionuclides. Any suspicious margin underwent an immediate reexcision in the form of cavity shavings. Sensitivity, specificity, and positive and negative predictive values while considering histopathological assessment as the golden standard were used to assess the performance of CLI-FAR.</p><p><strong>Results: </strong>In all, 54 specimens were imaged in 52 patients, with a total of 104 margins reviewed using CLI-FAR. The results showed a specificity of 97.8% (89/91; 95% confidence interval [CI], 95.0-100.6), sensitivity of 76.9% (10/13; 95% CI, 68.3-85.0), positive predictive value of 83.3% (10/12; 95% CI, 76.2-90.5), and negative predictive value of 96.7% (89/92; 95% CI, 93.3-100.2). In all, 8 patients had 10 positive margins on CLI-FAR imaging and were treated accordingly. CLI-FAR imaging reduced the reexcision rate by 69% (17.3/25).</p><p><strong>Conclusion: </strong>CLI-FAR imaging is a promising technique for intraoperative margin assessment in women undergoing BCS for invasive breast cancer.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 2","pages":"umae015"},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246204","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":"Deep learning-based liver cyst segmentation in MRI for autosomal dominant polycystic kidney disease.","authors":"Mina Chookhachizadeh Moghadam, Mohit Aspal, Xinzi He, Dominick J Romano, Arman Sharbatdaran, Zhongxiu Hu, Kurt Teichman, Hui Yi Ng He, Usama Sattar, Chenglin Zhu, Hreedi Dev, Daniil Shimonov, James M Chevalier, Akshay Goel, George Shih, Jon D Blumenfeld, Mert R Sabuncu, Martin R Prince","doi":"10.1093/radadv/umae014","DOIUrl":"10.1093/radadv/umae014","url":null,"abstract":"<p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) can lead to polycystic liver disease (PLD), characterized by liver cysts. Although majority of the patients are asymptomatic, massively enlarged liver secondary to PLD can cause discomfort, and compression on adjacent structures requiring cyst aspiration/fenestration, partial liver resection, or liver transplantation. Monitoring PLD by measuring liver volume fails to track the early stages when liver cyst volume is too small to affect liver volume.</p><p><strong>Purpose: </strong>To improve PLD assessment in the early stages by automating detection and segmentation of liver cysts using deep learning (DL) models.</p><p><strong>Materials and methods: </strong>A self-configured UNet-based platform (nnU-Net) was trained with 40 ADPKD subjects with liver cysts annotated by a radiologist. Internal (n = 7), External (n = 10), and test-retest reproducibility (n = 17) validations included macro- and micro-level performance metrics: patient-level Dice scores (PDice), along with voxel-level true positive rates (VTPR), as well as analysis of time saved in a model-assisted scenario. Additionally, we assessed human-level reliability in liver cyst segmentation and evaluated the model's test-retest reproducibility. We further compared liver volume vs cyst volume for tracking disease in a subject with 16+ years follow-up.</p><p><strong>Results: </strong>The model achieved an 82% ± 11% PDice and a 75% ± 15% VTPR on the internal test sets (n = 7 patients), and 80% ± 12% Dice score and a 91% ± 7% VTPR on the external test sets (n = 10 patients). It excelled particularly in detecting small liver cysts, a challenging task for manual annotation. This efficiency translated to a median of 91% (IQR: 14%) reduction in annotation time compared to manual labeling. Test-retest assessment demonstrated excellent reproducibility, with coefficients of variation of 94% for liver cyst fraction and 92% for cyst count.</p><p><strong>Conclusion: </strong>DL automation of liver cyst segmentations demonstrates potential to improve tracking of liver cyst volume in polycystic liver disease.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 2","pages":"umae014"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246153","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":"Photon counting detector computed tomography in pediatric cardiothoracic CT imaging.","authors":"Marilyn J Siegel, Juan C Ramirez-Giraldo","doi":"10.1093/radadv/umae012","DOIUrl":"10.1093/radadv/umae012","url":null,"abstract":"<p><p>Photon-counting detector computed tomography (PCD-CT) is the most recent advancement in CT technology and has the potential to change clinical practice. Unlike conventional energy-integrated-detector (EID) that uses a two-step process to convert X-rays into a digital signal, PCD-CT directly converts photon energies into electronic signal. The advantages of PCD-CT over EID-CT are higher spatial resolution, electronic noise reduction, higher contrast-to-noise ratio, improved radiation dose efficiency, and intrinsic spectral imaging. Successful implementation into clinical practice requires adaptations in CT protocols. In this review, we summarize the basic principles of PCD-CT and technical scanning factors followed by a discussion of its clinical benefits in pediatric pulmonary and cardiovascular imaging.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 2","pages":"umae012"},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246163","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":"Pathologic outcome of incidentally detected tracer-avid lesions in ⁶⁸Ga-PSMA-11 PET/CT for prostate cancer.","authors":"Darryl Mar, Devan Diwanji, Blair Lowery, Li Zhang, Thomas A Hope, Spencer C Behr, Robert R Flavell","doi":"10.1093/radadv/umae008","DOIUrl":"10.1093/radadv/umae008","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA) PET is effective in identifying prostate cancer metastases. However, PSMA PET uptake has also been described in other lesions, including nonprostate malignancies and benign processes.</p><p><strong>Purpose: </strong>To identify causes of unexpected radiopharmaceutical accumulation on PSMA PET.</p><p><strong>Materials and methods: </strong>A total of 2,054 study reports representing 1,873 unique patients who had undergone ⁶⁸Ga-PSMA-11 PET/CT scans at a single large academic center from December 2015 to April 2022 were retrospectively reviewed for the mention of unexpected PSMA uptake not initially thought to represent metastatic prostate cancer. Scans with pathologic outcome were reviewed by 2 blinded readers for scan indication and lesion location and quantitative parameters.</p><p><strong>Results: </strong>In 48 patients, the PSMA ligand-avid incidental lesions revealed 19 cases of second malignancies, 17 cases of prostate cancer, and 13 cases of benign lesions. The most common lesion locations were lung (14), thyroid (14), lymph nodes (8), and bowel (4). Benign lesions exhibited lower molecular imaging PSMA scores (median: 1; interquartile range [IQR]: 1.00-1.25; <i>P</i> = .017) than metastatic prostate lesions (median: 2; IQR: 1-3). Second malignancies were larger (median: 34 mm; IQR: 27-39 mm) than metastatic prostate cancer (median: 14 mm; IQR: 12-19 mm; <i>P</i> = .001) and benign lesions (median: 19 mm; IQR: 13.00-31.00 mm; <i>P</i> = .03). PSMA ligand-avid lesions in scans performed in the initial staging for prostate cancer were more commonly associated with a diagnosis of a secondary malignancy than with metastatic prostate cancer (0 vs 8 lesions, <i>P</i> = .008). Higher standardized uptake value maximum was observed for metastatic prostate cancer and second malignancy when compared with benign outcome.</p><p><strong>Conclusion: </strong>Features that influence the probability of an incidental lesion representing a malignancy include lesion location, reason for the PSMA PET/CT study, and associated imaging features (size, standardized uptake value maximum, and molecular imaging PSMA score).</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 1","pages":"umae008"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246321","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":"Incidental pulmonary embolism in abdominal CT: detection rate and characteristics with artificial intelligence.","authors":"Peder Wiklund, Koshiar Medson","doi":"10.1093/radadv/umae009","DOIUrl":"10.1093/radadv/umae009","url":null,"abstract":"<p><strong>Background: </strong>Abdominal CT is a mainstay in the evaluation of abdominal infections, trauma, oncology, and postoperative complications. Pulmonary embolism is a common complication, but there is a risk that these ancillary findings are overlooked. In addition, data on detection rate and characteristics of incidental pulmonary embolism (iPE) on abdominal CT are lacking.</p><p><strong>Purpose: </strong>The current study compared the period before and after implementing an artificial intelligence (AI) algorithm for iPE detection regarding detection rate and characteristics.</p><p><strong>Material and methods: </strong>A retrospective cross-sectional study was performed on abdominal CTs between August 1, 2019, and January 31, 2021 (before AI implementation, 8026 studies) and August 1, 2021, and January 31, 2023 (after AI implementation, 8765 studies). iPE cases were identified through text search and manually confirmed. Study indication and urgency were recorded for iPE patients, and the most proximal iPE level was assessed. A total of 1000 cases after AI implementation were randomly selected and manually reviewed for AI accuracy analysis.</p><p><strong>Results: </strong>A total of 5876 patients with a mean age of 63.6 ± 17.7 years were included before AI implementation, and 6310 patients with a mean age of 63.2 ± 18.3 years after AI implementation. The iPE detection rate was higher after AI implementation, 0.57% (50/8765 studies) vs 0.12% (10/8026), <i>P</i> < .001. The most common study indications were abdominal pain (25%, 15/60 cases) and infection (30%, 18/60 cases). There were no differences in CT pulmonary angiography usage or the most proximal extent of the iPE between the periods before or after AI implementation, <i>P</i> > .05. AI identified 46/50 of the reported iPE with 7 AI false-positive cases for a positive predictive value of 87% (95% confidence interval: 75-93%). In the manually reviewed randomly selected subset, iPE prevalence was 1.7% (15/874, 95% confidence interval: 1.0-2.8%) with AI having 40% sensitivity (95% CI, 16-68) and 100% specificity (95% CI, 99.5-100).</p><p><strong>Conclusion: </strong>Implementing AI for iPE detection and triage increased the iPE detection rate in abdominal CT. The AI sensitivity was moderate, with very few AI false positives.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 1","pages":"umae009"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246304","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":"Awake pediatric brain-MRI: a fast multi-sequence scan augmented with motion compensated single-shot 2D acquisitions.","authors":"Adam van Niekerk, Jan Svoboda, Åsa Aspelin, Tim Sprenger, Henric Rydén, Ola Norbeck, Enrico Avventi, Katarina Johansson, Natalie Rygaard, Peter Lindberg, Ronny Wickström, Anna Falk Delgado, Stefan Skare","doi":"10.1093/radadv/umae010","DOIUrl":"10.1093/radadv/umae010","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) is susceptible to motion artifacts, a particular challenge in pediatric imaging. External motion tracking devices and navigator techniques have been previously explored, but challenges persist necessitating sedation.</p><p><strong>Purpose: </strong>To establish a new awake brain-MRI exam tolerated by children with diagnostic quality images.</p><p><strong>Materials and methods: </strong>Participants were prospectively recruited and investigated using an in-house developed multi-sequence scan called NeuroMix that produces T1-weighted, T2-weighted, T2*-weighted, T2-FLAIR, and diffusion-weighted images in under 3 minutes. Additionally, a self-created motion tracking device was attached to participants' foreheads to perform prospective motion correction (PMC) on 2D single-shot sequences that produce higher resolution images of the same contrasts as NeuroMix.Three neuroradiologists scored the completed series for artifacts. The effects of age group (<5 vs ≥5 years) and sequence type (NeuroMix vs PMC) were evaluated with a Chi²-test.</p><p><strong>Results: </strong>Of the 64 participants recruited (mean age 6.7 years [2.7 standard deviation]) 58 completed their examination. Head motion recorded during PMC sequences revealed prevalent superior-inferior displacements [25% (67/293) exceeding 13.2 mm], and chin-up/down rotations [25% (67/293) exceeding 13.7°]. Sequence redundancy through NeuroMix and PMC scans resulted in 93% (54/58) of completed examinations having all series essential for producing an MRI-report rated as artifact-free, and therefore a report of high confidence in 84% (54/64) of participants. 22% (13/58) of completed exam reports could have been written using NeuroMix alone, the remaining required PMC- T2-weighted or T2-FLAIR sequences.</p><p><strong>Conclusion: </strong>This protocol reliably provided diagnostic quality images and reports with high radiologist confidence and could reduce the use of procedure sedation in children.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"1 1","pages":"umae010"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246292","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}