Abdominal Radiology最新文献

{"title":"Using interpretable rule-learning artificial intelligence to optimally differentiate adrenal pheochromocytomas from adenomas with CT radiomics.","authors":"Daniel I Glazer, Melissa Viator, Andrew Sharp, Jay B Patel, Borna E Dabiri, Christopher P Bridge, Justine A Barletta, Oleg S Pianykh, William W Mayo-Smith","doi":"10.1007/s00261-025-04893-0","DOIUrl":"https://doi.org/10.1007/s00261-025-04893-0","url":null,"abstract":"<p><strong>Purpose: </strong>To identify interpretable CT-based radiomics features that can differentiate adrenal pheochromocytomas from adenomas.</p><p><strong>Methods: </strong>An institutional database was used to identify patients with pathologically proven adrenal pheochromocytomas 5/1/05-5/1/23. To be included, patients needed to have a contrast-enhanced abdominal CT with an adrenal mass within 12 months of pathology (n = 95). For comparison, 57 adenomas were identified from a set of consecutive CT examinations. The final dataset included 152 adrenal masses (95 pheochromocytomas; 57 adenomas) with 121 used in the development set and 31 in the test set. Following confirmation of accurate automated segmentation, 463 radiomic features were evaluated and used to create an interpretable artificial intelligence (AI) rule-learning model. Model performance was reported using F1 score.</p><p><strong>Results: </strong>The study included 146 patients (age 59 years +/- 21; 89 females). A three-feature rule, High Gray Level Zone Emphasis > 184, Roundness > 0.35, and Boundary Low Gray Level Emphasis < 0.021 produced an F1 score of 0.97 on the train set (95% confidence interval [CI]: 0.94, 0.99) and 0.96 on the test set (95% CI: 0.89, 1.00). The rule-learning model determined that the rule most predictive of pheochromocytoma was Maximum Pixel Attenuation > 125 HU resulting in an F1 score of 0.89 (95% CI: 0.83, 0.94) on the training set and 0.93 (95% CI: 0.83, 0.99) on the test set.</p><p><strong>Conclusion: </strong>A rule-learning AI model identified the smallest optimal set of interpretable CT radiomics features, sufficient to achieve 96% accuracy in differentiating adrenal pheochromocytomas from adenomas on contrast enhanced CT.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion tensor imaging and diffusion kurtosis imaging of the pancreas - feasibility, robustness and protocol comparison in a healthy population.","authors":"Carlos Bilreiro, Luisa Andrade, Rafael Henriques, Nuno Loução, Celso Matos, Noam Shemesh","doi":"10.1007/s00261-025-04889-w","DOIUrl":"https://doi.org/10.1007/s00261-025-04889-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to determine the feasibility, image quality, intra-subject repeatability and inter-reader variability of Diffusion tensor (DTI) and Diffusion kurtosis imaging (DKI) for pancreatic imaging using different protocols and report normative values in healthy individuals.</p><p><strong>Methods: </strong>Single-institution prospective study performed on healthy volunteers in a clinical 3T scanner, using two different protocols (6/16 diffusion directions). Acquisitions were repeated twice to assess intra-subject repeatability. To assess inter-reader variability, Mean diffusivity (MD), Axial diffusivity (AD), Radial diffusivity (RD), Apparent diffusion coefficient (ADC) and Mean kurtosis (MK) values were extracted from segmented pancreas by two radiologists. A Likert scale was used by both readers to assess subjective image quality.</p><p><strong>Results: </strong>Twelve healthy volunteers were recruited for each MRI protocol. The 6 diffusion directions protocol was shorter: 7 min vs. 14 min (corresponding to 4 min vs. 7.5 min for a DTI only reconstruction). No differences in image quality were found between protocols. Only MK maps showed implausible estimates, leading to the exclusion of median 16% and 17.7% pixels for the 6- and 16-direction protocols, respectively. Intra-subject repeatability was determined with negligible coefficients of repeatability for DTI; however, MK presented slightly higher values. Inter-reader agreement was excellent for all maps (ICC > 0.9).</p><p><strong>Conclusions: </strong>DTI and DKI of the pancreas are feasible in clinical settings, with excellent inter-observer agreement and good image quality. Intra-subject repeatability is excellent for DTI, but some variability was observed with DKI. A 6-directions protocol may be preferred due to faster acquisition without quantitatively compromising estimates. MK inaccuracies prompt further research for improving artifact correction.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crizotinib-associated hepatic and renal cysts: a case report with MRI findings.","authors":"Saki Yamamoto, Toshimi Kawahata, Sota Masuoka, Ayako Takigami, Hiroyuki Fujii, Toshikazu Takasaki, Mizuho Saito, Mitsuru Matsuki, Makoto Maemondo, Harushi Mori","doi":"10.1007/s00261-025-04894-z","DOIUrl":"https://doi.org/10.1007/s00261-025-04894-z","url":null,"abstract":"<p><p>We report a case of a man in his 60s with ROS1 fusion-positive lung adenocarcinoma who developed multiple cystic lesions in both the kidneys and liver during crizotinib treatment. The patient presented with fever, abdominal pain, and oliguria. Contrast-enhanced CT revealed new cystic lesions in both the kidneys and liver, with some showing thick walls, septa, and hyperdense contents. MRI demonstrated heterogeneous signal intensities on T2-weighted images and mixed low to high signal intensities on T1-weighted images. Some cysts displayed T2 hypointense and T1 hyperintense areas along the cyst walls, with diffusion restriction predominantly at the periphery of the masses. Percutaneous drainage of the cysts was performed, and cytology revealed an increase in the number of cells, including neutrophils. However, no malignant cells or microorganisms were detected. Based on these imaging findings and laboratory results, the patient was diagnosed with crizotinib-associated renal and hepatic cysts. Symptoms improved after crizotinib discontinuation, and follow-up imaging showed cyst regression. This is the first report describing MRI findings for crizotinib-associated hepatic cysts. Characteristic MRI findings, such as T2 hypointensity/T1 hyperintensity along the cyst walls and diffusion restriction predominantly at the periphery of the masses, suggesting hemorrhagic components, may help differentiate crizotinib-associated cysts from other lesions, including metastases and abscesses.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-enhanced ultrasound in pregnancy.","authors":"Stephanie A Nguyen, David P Burrowes, Christina Merrill, Stephanie R Wilson","doi":"10.1007/s00261-025-04869-0","DOIUrl":"https://doi.org/10.1007/s00261-025-04869-0","url":null,"abstract":"<p><p>There are complex problems related to diagnostic imaging of the pregnant patient Cross sectional imaging with computed tomography (CT) tends to be avoided to due to the risk radiation poses to the fetus and magnetic resonance imaging (MRI) may be limited due to avoidance of gadolinium contrast.While ultrasound (US) is the primary test for imaging in pregnancy, there is limited awareness of contrast-enhanced US (CEUS) as a safe and accurate option for providing similar vascular information to that which is usually provided with contrast-enhanced CT and MRI. Microbubble contrast agents do not cross the placental barrier and have been shown in animal studies to pose no harm to the fetus at doses far above the human dose.The literature on CEUS in pregnancy will be reviewed and the utility and diagnostic accuracy of CEUS for the assessment of acute and chronic maternal conditions and evaluation of neoplastic masses will be demonstrated with case examples.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Impact of anatomical features of non-thrombotic left iliac venous compression on the development of venous leg ulcers based on CT venography.","authors":"Fandong Li, Xiaojie Lian, Mengtao Wu, Deqing Zhang, Dianjun Tang, Qiang Sun","doi":"10.1007/s00261-025-04850-x","DOIUrl":"https://doi.org/10.1007/s00261-025-04850-x","url":null,"abstract":"","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient satisfaction rates and tolerance of free-hand ultrasound-guided transperineal prostate biopsy in an outpatient setting.","authors":"Jack W Power, Philip J Dempsey, Andrew Yates, Nisha Soman, Mercy D'Souza, Catherine McGarvey, Kiaran J O'malley, David J Galvin, Barry D Hutchinson, John G Murray, Michelle M McNicholas, Carmel G Cronin","doi":"10.1007/s00261-025-04867-2","DOIUrl":"https://doi.org/10.1007/s00261-025-04867-2","url":null,"abstract":"<p><strong>Purpose: </strong>Transperineal ultrasound-guided prostate biopsy (TPPBx) under local anesthesia is becoming increasingly utilized due to its lower infection risk compared to transrectal ultrasound-guided prostate biopsy. Despite its increasing utilization, patient experience with this procedure remains an area requiring further investigation. This study aims to evaluate patient satisfaction and tolerance of outpatient free-hand ultrasound-guided transperineal prostate biopsy (TPPBx), focusing on patient experiences during and after the procedure, and its impact on quality of life.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 120 men undergoing TPPBx, using 2 standardized questionnaires; the day after the procedure and at follow-up 3-4 weeks later. Data on pain, post-procedural symptoms, and overall satisfaction were collected.</p><p><strong>Results: </strong>Of the 120 participants, 97 completed both questionnaires (81% response rate). The mean age was 65 years, with a median of 66. Satisfaction with care was high, with 100% of patients satisfied and 89% willing to undergo the procedure again. Mean pain scores were as follows: probe insertion 3/10 (median 2, IQR 1-5), local anesthetic administration 3/10 (median 2, IQR 1-4), and biopsy sampling 2/10 (median 1, IQR 0-3). Post-procedural symptoms included hematuria (63%) and hematospermia (49%), with the latter distressing for 17% of patients. No infections or hospital admissions were reported.</p><p><strong>Conclusion: </strong>TPPBx is a safe, effective, and tolerable method for prostate biopsy, with minimal complications and high satisfaction rates. Enhanced patient education and communication will be crucial as its adoption increases.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous management of iatrogenic ureteral injuries using a multistep approach: clinical, functional and long-term outcomes.","authors":"Emanuele Barabino, Arianna Nivolli, Michele Tosques, Diego Ivaldi","doi":"10.1007/s00261-025-04902-2","DOIUrl":"https://doi.org/10.1007/s00261-025-04902-2","url":null,"abstract":"<p><strong>Purpose: </strong>Iatrogenic ureteral injuries, while uncommon, are increasingly recognized as a significant source of morbidity and mortality following surgical or medical procedures. The aim of our study is to present a multi-step anterograde approach to treating these injuries, discuss the outcomes, and attempt to classify the injuries based on the mechanisms that caused them.</p><p><strong>Materials and methods: </strong>In this monocentric retrospective study, we evaluated patients who were treated for an IUI using a multistep, anterograde approach involving percutaneous nephrostomy, nephro-ureteral stenting, and anterograde stenting. Injuries were categorized as leakage, occlusive or mixed. Clinical success, drainage dependency, time-to-recanalization, ureteral recanalization rate, ureteral patency and kidney function post-intervention were evaluated as outcome measures.</p><p><strong>Results: </strong>The study included 38 patients who underwent 44 procedures, with a mean follow-up of 4.2 years. The clinical success rate was 89.5%. The ureteral recanalization rate was 72.7% and, after 6 months, 16 lesions (66.7%) were stent-free. The outcome was significantly better in lesions recanalized within 5 days (p < 0.0001, OR 45.5). Leakage injuries had a higher chance of being recanalized (p = 0.0067, OR 0.1) and better kidney function (p = 0.009, OR 35.3) compared to non-leakage ones. A time to diagnosis < 5 days was associated with preserved kidney function (p = 0.0031, OR = 0.025).</p><p><strong>Conclusion: </strong>Iatrogenic injuries can be effectively managed with a percutaneous anterograde approach, yielding favorable long-term outcomes. The type of injury and the time to diagnosis are critical factors that influence clinical results.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent endometriosis: clinical insights and imaging considerations.","authors":"Brooke S Lampl, Cara R King, Marjan Attaran, Myra K Feldman","doi":"10.1007/s00261-025-04870-7","DOIUrl":"https://doi.org/10.1007/s00261-025-04870-7","url":null,"abstract":"<p><p>Endometriosis is a gynecologic disorder characterized by endometrial-like tissue in ectopic locations, outside of the uterine cavity. In the adolescent population, the diagnosis of endometriosis is often overlooked as a cause of pelvic pain because of limited awareness by both patients and providers and a tendency to undervalue the complaints of pain by both families and caregivers. Although historically diagnosed by laparoscopy, there has been a shift in recent years towards imaging diagnosis. Transvaginal ultrasound is considered the first-line imaging technique for endometriosis in the adult population; however, this minimally invasive procedure is commonly avoided in adolescents, with MRI often used instead. Here, we discuss the clinical presentation and imaging considerations and treatment options involved in adolescents with suspected endometriosis.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LI-RADS for diagnosing hepatocellular carcinoma by contrast-enhanced US with SonoVue and Sonazoid-a single center prospective study.","authors":"Chen Lin, Xiao-Huan Yang, Hong-Yan Zhai, Xin-Yuan Zhu, Gui-Ming Zhou","doi":"10.1007/s00261-025-04881-4","DOIUrl":"https://doi.org/10.1007/s00261-025-04881-4","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the diagnostic performance of two algorithms for HCC diagnosis: SonoVue-CEUS based on CEUS LI-RADS version 2017 and a modified algorithm incorporating Kupffer-phase findings for Sonazoid-CEUS.</p><p><strong>Methods: </strong>This single center prospective study enrolled high-risk patients for HCC. Each participant underwent SonoVue-CEUS and Sonazoid-CEUS. Each liver observation was assigned two LI-RADS categories according to each algorithm: SonoVue-CEUS LI-RADS and modified Sonazoid-CEUS LI-RADS. For the latter method, observations at least 10 mm with non-rim arterial phase hyperenhancement were upgraded LR-4 to LR-5 if there was no washout with a Kupffer defect and were reassigned LR-M to LR-5 if there was early washout with mild Kupffer defect. The reference standard was pathologic confirmation.</p><p><strong>Results: </strong>Overall, 66 patients (mean age, 61.2 years ± 10.9; 54 male patients, 12 female patients) with 66 observations (mean size, 31 mm ± 16) were eventually enrolled. The results of Sonazoid-CEUS LI-RADS showed significant changes in sensitivity (82% vs. 65%, p < 0.001), accuracy (85% vs. 71%, p < 0.001) compared with the SonoVue-CEUS LI-RADS. There was no significant difference in specificity (93% vs. 87%, p = 0.26).</p><p><strong>Conclusion: </strong>When incorporating Kupffer-phase findings, Sonazoid-CEUS LI-RADS had higher sensitivity without loss of specificity compared with SonoVue-CEUS LI-RADS.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian masses suggested for MRI examination: assessment of deep learning models based on non-contrast-enhanced MRI sequences for predicting malignancy.","authors":"Meijiao Jiang, Chui Kong, Siwei Lu, Qingwan Li, Caiting Chu, Wenhua Li","doi":"10.1007/s00261-025-04891-2","DOIUrl":"https://doi.org/10.1007/s00261-025-04891-2","url":null,"abstract":"<p><strong>Purpose: </strong>We aims to assessed and compare four deep learning(DL) models using non-contrast-enhanced magnetic resonance imaging(MRI) to differentiate benign from malignant ovarian tumors, considering diagnostic efficacy and associated development costs.</p><p><strong>Methods: </strong>526 patients (327 benign lesions vs 199 malignant lesions) who were recommended for MRI due to suspected ovarian masses, confirmed with histopathology, were included in this retrospective study. A training cohort (n=367) and a validation cohort (n=159) were constructed. Based on the images of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), we evaluated the diagnostic performance of four DL models (ConvNeXt, FBNet, GhostNet, ResNet50) in distinguishing between benign and malignant ovarian tumors. Two radiologists with varying levels of experience independently reviewed all original non-contrast-enhanced MR images from the validation cohort to determine if each case was benign or malignant. The area under the receiver operating characteristic curve (AUC), confusion matrices, accuracy, sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) were used to compare performance.</p><p><strong>Results: </strong>The study of 526 ovarian mass patients (ages 1-92) evaluated four DL models for predicting malignant tumors, with AUCs ranging from 0.8091 to 0.8572 and accuracy between 81.1% and 85.5%. An experienced radiologist achieved 86.2% accuracy, slightly surpassing the DL models, while a less experienced radiologist had 69.2% accuracy. Resnet50 had the highest sensitivity (78.3%) and NPV (87.3%), while ConvNeXt excelled in specificity and PPV (100%). GhostNet and FBNet are more parameter-efficient than other models.</p><p><strong>Conclusion: </strong>The four DL models effectively distinguished between benign and malignant ovarian tumors using non-contrast MRI. These models outperformed less experienced radiologists and were slightly less accurate than experienced ones. ResNet50 had the best predictive performance, while GhostNet was highly accurate with fewer parameters. Our study indicates that DL models based on non-contrast-enhanced MRI have the potential to assist in diagnosis.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}