Quantitative Imaging in Medicine and Surgery最新文献

{"title":"Enhancing postoperative recurrence assessment in gastric and colorectal cancer patients with intraperitoneal fluorouracil implants: overcoming the diagnostic challenge of fluorouracil implant-related tumor-like lesions.","authors":"Luwen Hao, Xin Chen, Sijia Zhou, Xuemei Hu, Daoyu Hu, Zhen Li, Yaqi Shen","doi":"10.21037/qims-24-2033","DOIUrl":"10.21037/qims-24-2033","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative intraperitoneal chemotherapy using sustained-release fluorouracil implants has been used to reduce the recurrence of gastrointestinal tumors. However, these implants may persist and present as tumor-like lesions in imaging studies, potentially leading to false-positive interpretations as metastatic sites, affecting patient management. Our study aimed to enhance the diagnostic accuracy of radiologists in assessing gastric and colorectal cancer patients with fluorouracil implants.</p><p><strong>Methods: </strong>This retrospective study comprised a summary of fluorouracil implant-related lesion characteristics by a multidisciplinary team (MDT), and a three-stage evaluation of tumor-like lesions by two radiologists. In total, 240 computed tomography (CT) examinations were randomly selected from all the available CT examinations of all patients, whom were then further divided evenly into three groups. Two radiologists independently assessed the implant-related tumor-like lesions across the following three stages: stage 1: pre-training without surgical information; stage 2: post-training without surgical information; and stage 3: post-training with surgical details provided. The training was based on the characteristics of the lesions identified earlier by the MDT. The radiologists evaluated the malignancy or benignity of each lesion, and rated their diagnostic confidence using a three-point scale. The reference standard was determined by the MDT. Diagnostic accuracy and diagnostic confidence were compared using Pearson's Chi-squared test and the Wilcoxon rank-sum test.</p><p><strong>Results: </strong>A total of 168 fluorouracil implants were confirmed in the subdiaphragmatic regions, paracolic gutters, and tumor beds of 164 patients. Imaging features such as a typical foreign body reaction (85.71%), no contrast enhancement on CT/magnetic resonance imaging, and no diffusion restriction on diffusion-weighted imaging were important for differentiating between fluorouracil implant-related lesions and malignant lesions. Follow-up CT scans showed a size reduction in 67.26% of the lesions and density changes in 52.98%. The diagnostic accuracy and confidence of the radiologists were improved in stage 2 (accuracy: 91.25%; confidence: most often classified as medium) compared to stage 1 (accuracy: 67.5%; confidence: most often classified as low; both P<0.001). When surgical information was available, the diagnostic accuracy and confidence of the radiologists were improved in stage 3 (accuracy: 100%; confidence most often classified as high) compared to stage 2 (accuracy: P=0.007; confidence: P<0.001).</p><p><strong>Conclusions: </strong>The diagnostic accuracy and confidence of radiologists can be improved by providing them with training on implant imaging characteristics and precise surgical record documentation on the implant location and quantity.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"7774-7787"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978638","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":"Unveiling the unexpected: spontaneous ruptured pancreaticoduodenal artery pseudoaneurysm with retroperitoneal hematoma requiring pancreaticoduodenectomy.","authors":"Aarohi Parikh, Trishna Parikh, Ismail Hader","doi":"10.21037/qims-2025-212","DOIUrl":"10.21037/qims-2025-212","url":null,"abstract":"","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8674-8677"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978648","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":"Exploring non-invasive diagnostic tools for deep gluteal syndrome: a multimodal approach integrating clinical and imaging techniques.","authors":"Simona Kurková, Martin Kynčl, Ibrahim Ibrahim, Hynek Lachman, Kristina Sakmárová, Stanislav Machač","doi":"10.21037/qims-2025-241","DOIUrl":"10.21037/qims-2025-241","url":null,"abstract":"<p><strong>Background: </strong>Deep gluteal syndrome (DGS) involves extrapelvic entrapment or irritation of the sciatic nerve (SN) within the deep gluteal space, often mimicking S1 radicular syndrome. Accurate differentiation between DGS and true nerve root pathology is essential for effective treatment. This study aimed to distinguish DGS from nerve root affections and identify the causes of symptoms in individuals with suspected DGS using a comprehensive multi-modal evaluation, including advanced diagnostic techniques.</p><p><strong>Methods: </strong>Nineteen subjects (13 females, 6 males, mean age of 36.8±10.9 years, range 23-65 years) with unilateral gluteal pain radiating to the S1 dermatome for at least three months and symptoms exacerbated by prolonged sitting were evaluated. All underwent 3T magnetic resonance imaging (MRI) (Siemens MAGNETOM VIDA) for standard spine and pelvis imaging, diffusion tensor imaging (DTI) of the lumbosacral plexus (LSP) and SN, electromyography (EMG) of the H-reflex circuit with positional maneuvers, and clinical tests targeting DGS.</p><p><strong>Results: </strong>Nerve root contact was demonstrated in only two subjects on the pathology side. Morphological findings on standard MRI with the potential to cause DGS symptoms were inconsistent. Surprisingly, narrowing between the ischium and lesser trochanter of the femur was found in 42% on the symptomatic side. Statistically significant higher mean diffusivity (MD) (P=0.023), radial diffusivity (RD) (P=0.038), and axial diffusivity (AD) (P=0.026) values were observed on the symptomatic side of the SN, indicating edema and microstructural changes. No significant differences were noted in fractional anisotropy (FA) (P=0.913) and normalized quantitative anisotropy (NQA) values (P=0.778). No changes in diffusivity were observed at the LSP level. Twelve subjects (63%) showed increased latency (>1.2 ms) or complete disappearance of the H-reflex when using modified muscle position/activation on the symptomatic side. Clinical tests showed inconclusive results.</p><p><strong>Conclusions: </strong>Advanced diagnostic tools such as DTI and EMG combined with positional maneuvers can help identify DGS when standard imaging and clinical tests are inconclusive. Elevated diffusivity values in the symptomatic SN suggest possible edema and structural changes, supporting the utility of a multimodal approach for accurate diagnosis and treatment of DGS.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8409-8422"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978618","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":"Management of bilateral molar deep overbite with buccal crossbite using bracket-free clear aligners: a case description.","authors":"Miao He, Yang-Dong Lin, Bo Zhao","doi":"10.21037/qims-2025-110","DOIUrl":"10.21037/qims-2025-110","url":null,"abstract":"","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8693-8702"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978680","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":"Minimizing radiation dose in coronary CT angiography using dual single-cardiac phase acquisition with a whole-heart motion correction technology: a prospective randomized study on image quality.","authors":"Xin Fang, Shuang Li, Ping Xie, Huanrui Hu, Wenyu Ting, Yongchun You, Jianying Li, Kaiyue Diao, Wanjiang Li","doi":"10.21037/qims-2025-287","DOIUrl":"10.21037/qims-2025-287","url":null,"abstract":"<p><strong>Background: </strong>Coronary computed tomography angiography (CCTA) plays an increasingly important role in coronary artery disease (CAD) evaluation, but radiation dose remains a clinical concern. Conventional multi-cardiac phase (CMP) scanning covers wide R-R intervals to ensure optimal image quality, leading to higher radiation exposure. Recent advances in motion correction technology, particularly whole-heart motion correction algorithms, offer potential solutions for dose reduction. This study aimed to evaluate the feasibility of using dual single-cardiac phase (DSP) acquisition (end-systole: 45% R-R interval and end-diastole: 75% R-R interval) in CCTA with a whole-heart motion correction (SnapShot Freeze 2, SSF2) technology to minimize radiation dose and maintain image quality in comparison with CMP scanning.</p><p><strong>Methods: </strong>In this prospective randomized study, 140 patients were randomly assigned to either DSP (n=70) or CMP (n=70) scanning groups. All examinations were performed on a 256-row wide-detector computed tomography (CT) scanner with similar data acquisition parameters and reconstruction algorithms except cardiac phase range selections. Image quality was assessed both objectively [signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)] and subjectively (5-point scale). Image quality, diagnostic confidence, and acceptability between the two groups and across different heart rates were evaluated.</p><p><strong>Results: </strong>DSP scanning achieved 29% radiation dose reduction [volume CT dose index (CTDIvol): 19.24±4.59 <i>vs.</i> 27.01±6.02 mGy, P<0.001] with comparable image quality scores in both systolic {5, [interquartile range (IQR), 5.0-5.0] <i>vs.</i> 5 (IQR, 5.0-5.0), Reader 1: P=0.591, Reader 2: P=0.587} and diastolic phases [5 (IQR, 4.0-5.0) <i>vs.</i> 5 (IQR, 4.0-5.0), Reader 1: P=0.908, Reader 2: P=0.951]. All scans in our study cohort were diagnostically acceptable (100%) when both phases were available. Using only systolic or diastolic phases reduced acceptability to 97.1% and 94.3%, respectively.</p><p><strong>Conclusions: </strong>DSP scanning with SSF2 technology achieves significant radiation dose reduction while maintaining comparable image quality to CMP, with 100% diagnostic acceptability when both phases are available.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8205-8218"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978683","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":"The value of percutaneous contrast-enhanced ultrasound in the detection and diagnosis of sentinel lymph nodes in breast cancer: comparison with pathological features.","authors":"Caixin Huang, Jia Luo, Manying Li, Zhen Shan, Tiantian Zhen, Jiaping Li, Jinyu Liang, Xiaoyan Xie, Yanling Zheng","doi":"10.21037/qims-2024-2631","DOIUrl":"10.21037/qims-2024-2631","url":null,"abstract":"<p><strong>Background: </strong>The diagnostic performance of percutaneous contrast-enhanced ultrasound (P-CEUS) in classifying sentinel lymph nodes (SLNs) in breast cancer varies. This study aimed to evaluate the diagnostic value of P-CEUS in identifying SLNs and to explore the correlation between P-CEUS patterns and pathological characteristics of SLNs.</p><p><strong>Methods: </strong>This retrospective study included consecutive breast cancer patients who underwent preoperative or axillary surgery between June 2019 and March 2021. Each patient underwent conventional ultrasound of the ipsilateral breast and axilla, and SLNs were localized and diagnosed via P-CEUS. Histopathological examination served as the gold standard to assess the diagnostic accuracy of P-CEUS classification based on lymph node structure. The relationship between P-CEUS patterns and pathological characteristics of SLNs was also examined.</p><p><strong>Results: </strong>A total of 238 breast cancer patients (including 1 male) with a mean age of 51.0±11.3 years were included. Five patients with bilateral breast cancer underwent P-CEUS on both sides. The SLN detection rate by P-CEUS was 96.29% (234/243). Pathology results indicated that 64 SLNs (21.8%) were metastatic and 229 SLNs (78.2%) were non-metastatic. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of P-CEUS in detecting SLNs were 76.56% (49/64), 97.38% (223/229), 89.09% (49/55), 93.70% (223/238), and 92.83% (272/293), respectively. SLNs with different P-CEUS patterns exhibited varying pathological characteristics. Pathology sections of non-metastatic lymph nodes revealed varying degrees of adipose tissue and fibrous tissue hyperplasia. The different enhancement patterns of metastatic lymph nodes were closely associated with the distribution of metastatic lesions within the lymph nodes.</p><p><strong>Conclusions: </strong>The P-CEUS pattern of SLNs was closely correlated with their pathological characteristics. The P-CEUS classification of SLNs based on lymph node structure could aid in the diagnosis of SLNs in breast cancer.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8309-8319"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978715","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":"Disruptions of morphological brain networks and their associations with multi-symptoms in children with spastic cerebral palsy.","authors":"Chunfeng Zhao, Xiaofan Qiu, Xinyu Luo, Ying Peng, Yu Yin, Lisha Nie, Jinhui Wang, Heng Liu","doi":"10.21037/qims-2024-2949","DOIUrl":"10.21037/qims-2024-2949","url":null,"abstract":"<p><strong>Background: </strong>Spastic cerebral palsy (SCP) is associated with extensive alterations in regional cortical morphology. However, the specific effects of SCP on the topological organization of morphological brain networks remain largely unknown. This study aimed to investigate these effects and explore their potential correlations with clinical manifestations in SCP children.</p><p><strong>Methods: </strong>Structural magnetic resonance imaging and clinical data were collected from 31 children with SCP and 29 sex- and age-matched children with typical development. Single-subject morphological brain networks were constructed separately based on four different morphological indices [i.e., the cortical thickness (CT), fractal dimension, gyrification index, and sulcus depth], which were further characterized using graph-based network approaches. Permutation tests were used to examine between-group differences in regional morphology, interregional morphological connectivity (MC), and graph-based network properties. For magnetic resonance imaging (MRI)-based features showing significant between-group differences, Spearman partial correlations were used to examine their relationships with the clinical variables in the patients.</p><p><strong>Results: </strong>Compared with the control group, the SCP group only showed alterations in the CT-based morphological brain networks. Specifically, the SCP group displayed an increased characteristic path length (t=3.909, P=4.0×10^-4), which was negatively correlated with the verbal comprehension index (rho=-0.435, P=0.023), processing speed index (rho=-0.452, P=0.018), and full-scale intelligence quotient (rho=-0.471, P=0.013) of the SCP children, and positively correlated with the Gross Motor Function Classification System (rho=0.399, P=0.039) and Manual Ability Classification System (rho=0.459, P=0.016). Further, the SCP group showed decreased MC for 161 connections. These connections were mainly linked to the right area 25 (a part of the anterior cingulate cortex) at the nodal level and to regions in the default mode network at the subnetwork level. Among these, the MC between the right area 11l, part of the orbital and polar frontal cortex, and the right medial belt complex, part of the early auditory cortex, was positively correlated with the Communication Function Classification System in the SCP children (rho=0.662, P=1.7×10^-4). These results remained unchanged after excluding preterm children from the SCP group.</p><p><strong>Conclusions: </strong>SCP is associated with abnormal morphological brain network topology, which may contribute to disturbances in motor and cognition in patients.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"7749-7760"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978369","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":"Prenatal ultrasound diagnosis of a rare diffuse placental chorioangioma with fetal edema: a case description and prognostic analysis.","authors":"Pujuan Jia, Xuelu Feng, Xiaxia Cheng, Yanzhao Wang, Tiangang Li, Bin Ma","doi":"10.21037/qims-2025-499","DOIUrl":"10.21037/qims-2025-499","url":null,"abstract":"","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8746-8750"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978631","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":"Dual-energy computed tomography-derived electron density in the differential diagnosis of focal hepatic lesions: initial experience.","authors":"Takashi Ohtani, Kumi Ozaki, Tomokazu Ishida, Kouki Takahashi, Masato Shimada, Satomi Kanai, Tasuku Wakabayashi, Kenji Takata, Toshiki Tateishi, Tetsuya Tsujikawa","doi":"10.21037/qims-2024-2592","DOIUrl":"10.21037/qims-2024-2592","url":null,"abstract":"<p><strong>Background: </strong>The clinical utility of electron density (ED), obtained by non-contrast dual-energy computed tomography, has been demonstrated for the diagnosis of brain tumors and bone lesions; however, the clinical utility of ED in the liver has not been adequately reported. This study aimed to compare ED between hepatocellular carcinomas (HCCs), liver metastases, hepatic hemangiomas, and hepatic cysts and assess the differential diagnostic performance of ED between malignant tumors and benign lesions.</p><p><strong>Methods: </strong>Eighty-nine patients (53 men and 36 women; mean age, 67.2±13.2 years) were included. EDs were measured for 24 HCCs, 19 liver metastases, 28 hepatic hemangiomas, and 18 hepatic cysts. The relative ED (rED), normalized by the ED of the background liver parenchyma, was calculated. The ED and rED of the focal hepatic lesions (FHLs) were statistically analyzed. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of ED and rED in differentiating malignant tumors from benign lesions.</p><p><strong>Results: </strong>The ED and rED were higher in malignant tumors than in benign lesions. Significant differences in ED were observed among all lesions (P<0.05) except liver metastases and hepatic hemangiomas. Significant differences in rED were observed among all lesions (P<0.05) except HCCs and liver metastases. The area under the curve of rED for distinguishing between malignant tumors and benign lesions was significantly larger than that of ED (0.88 <i>vs.</i> 0.80, P<0.05).</p><p><strong>Conclusions: </strong>ED aids in the differential diagnosis of FHLs. The use of rED further improves diagnostic performance.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8219-8229"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978635","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":"Feasibility of fully automatic assessment of cervical canal stenosis using MRI via deep learning.","authors":"Xiaochen Feng, Yaying Zhang, Minming Lu, Chao Ma, Xiaoqiang Miao, Jiacheng Yang, Lina Lin, Yueyi Zhang, Kai Zhang, Ning Zhang, Yan Kang, Yu Luo, Kai Cao","doi":"10.21037/qims-2025-67","DOIUrl":"10.21037/qims-2025-67","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is no fully automated tool available for evaluating the degree of cervical spinal stenosis. The aim of this study was to develop and validate the use of artificial intelligence (AI) algorithms for the assessment of cervical spinal stenosis.</p><p><strong>Methods: </strong>In this retrospective multi-center study, cervical spine magnetic resonance imaging (MRI) scans obtained from July 2020 to June 2023 were included. Studies of patients with spinal instrumentation or studies with suboptimal image quality were excluded. Sagittal T2-weighted images were used. The training data from the Fourth People's Hospital of Shanghai (Hos. 1) and Shanghai Changzheng Hospital (Hos. 2) were annotated by two musculoskeletal (MSK) radiologists following Kang's system as the standard reference. First, a convolutional neural network (CNN) was trained to detect the region of interest (ROI), with a second Transformer for classification. The performance of the deep learning (DL) model was assessed on an internal test set from Hos. 2 and an external test set from Shanghai Changhai Hospital (Hos. 3), and compared among six readers. Metrics such as detection precision, interrater agreement, sensitivity (SEN), and specificity (SPE) were calculated.</p><p><strong>Results: </strong>Overall, 795 patients were analyzed (mean age ± standard deviation, 55±14 years; 346 female), with 589 in the training (75%) and validation (25%) sets, 206 in the internal test set, and 95 in the external test set. Four tasks with different clinical application scenarios were trained, and their accuracy (ACC) ranged from 0.8993 to 0.9532. When using a Kang system score of ≥2 as a threshold for diagnosing central cervical canal stenosis in the internal test set, both the algorithm and six readers achieved similar areas under the receiver operating characteristic curve (AUCs) of 0.936 [95% confidence interval (CI): 0.916-0.955], with a SEN of 90.3% and SPE of 93.8%; the AUC of the DL model was 0.931 (95% CI: 0.917-0.946), with a SEN in the external test set of 100%, and a SPE of 86.3%. Correlation analysis comparing the DL method, the six readers, and MRI reports between the reference standard showed a moderate correlation, with R values ranging from 0.589 to 0.668. The DL model produced approximately the same upgrades (9.2%) and downgrades (5.1%) as the six readers.</p><p><strong>Conclusions: </strong>The DL model could fully automatically and reliably assess cervical canal stenosis using MRI scans.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 9","pages":"8457-8470"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978621","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}