Radiologie (Heidelberg, Germany)最新文献

{"title":"Radiomics-based diagnosis of patellar chondromalacia using sagittal T2-weighted images.","authors":"Ying Shu","doi":"10.1007/s00117-024-01413-x","DOIUrl":"10.1007/s00117-024-01413-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore and evaluate a novel method for diagnosing patellar chondromalacia using radiomic features from patellar sagittal T2-weighted images (T2WI).</p><p><strong>Methods: </strong>The experimental data included sagittal T2WI images of the patella from 40 patients with patellar chondromalacia and 40 healthy volunteers. The training set comprised 30 cases of chondromalacia and 30 healthy volunteers, while the test set included 10 cases of each. A machine learning algorithm was used to train the classification model, which was then evaluated using standard performance metrics.</p><p><strong>Results: </strong>In the training set, the model achieved 24 true negatives (TN), 18 true positives (TP), 12 false negatives (FN), and six false positives (FP). Sensitivity, specificity, accuracy, and F1 score for the training set were 0.6, 0.8, 0.7, and 0.667, respectively. The model achieved six true negatives, eight true positives, two false negatives, and four false positives in the test set. Sensitivity, specificity, accuracy, and F1 score for the test set were 0.8, 0.6, 0.7, and 0.727, respectively.</p><p><strong>Conclusion: </strong>The radiomic analysis method based on patellar sagittal fat-suppressed T2WI images demonstrates good diagnostic capability for patellar bone marrow edema.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"32-36"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017566","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":"[Pathological spine fractures].","authors":"Josef Mohamad","doi":"10.1007/s00117-025-01514-1","DOIUrl":"10.1007/s00117-025-01514-1","url":null,"abstract":"<p><strong>Clinical issue: </strong>Pathological vertebral body fractures are nontraumatic fractures caused by metabolic diseases, tumor infiltration, inflammatory processes or other pathological changes. They often represent the first manifestation of an undiagnosed underlying condition. The clinical presentation is variable, most commonly involving acute back pain and, in some cases, neurological deficits up to paraplegia. Tumor-related fractures are often progressive and resistant to conservative treatment.</p><p><strong>Standard radiological methods: </strong>Diagnostic evaluation is stepwise, beginning with X‑ray (basic assessment), followed by computed tomography (detailed fracture and bone analysis), and magnetic resonance imaging (differentiation between benign vs. malignant causes, tumor infiltration, and spinal cord compression).</p><p><strong>Practical recommendations: </strong>Pathological vertebral body fractures should always be regarded as a potential first symptom of a serious underlying disease and must be promptly evaluated. This includes a thorough medical history, clinical examination, and appropriate stepwise imaging diagnostics. Therapeutic management depends on the underlying condition and the extent of the fracture, ranging from conservative treatment to surgical intervention.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"854-858"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071261","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":"[Options in nuclear medicine for advanced prostate cancer in practice].","authors":"Sophie Carina Siegmund, Philipp M Kazmierczak, Adrien Holzgreve, Christian G Stief, Jozefina Casuscelli, Marcus Unterrainer, Lena M Unterrainer","doi":"10.1007/s00117-025-01527-w","DOIUrl":"10.1007/s00117-025-01527-w","url":null,"abstract":"<p><p>Over the last few years diagnostic and therapeutic advances have contributed to the significant relevance of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) and PSMA radioligand therapy in patients with advanced prostate cancer (PCa). The PSMA-PET/CT has a higher accuracy for the detection of PCa metastases than the combination of CT and bone scintigraphy. Based on the theranostic approach, PSMA radioligand therapy can be performed in the castration-resistant stage in patients with sufficient PSMA expression of the tumor lesions in PSMA PET/CT and progression of PCa after chemotherapy and therapy with abiraterone or an androgen receptor signalling pathway inhibitor. Over the next few years, a large number of studies on the effectiveness of PSMA radioligand therapy in earlier stages of PCa and as part of combination therapies with other drugs will be conducted.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"877-886"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338278","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":"[Residency training in clinical practice].","authors":"Mina Soltani, Isabel Molwitz, Mike Notohamoprodjo","doi":"10.1007/s00117-025-01517-y","DOIUrl":"10.1007/s00117-025-01517-y","url":null,"abstract":"","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"872-876"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12552368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115413","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":"[Myelography-still up to date?]","authors":"Wolfgang Reith, Anne Kettner, Michael Kettner","doi":"10.1007/s00117-025-01524-z","DOIUrl":"10.1007/s00117-025-01524-z","url":null,"abstract":"<p><p>Myelography is used to visualize the spinal cord and its nerve roots either after intrathecal (IT) injection of contrast media into the spinal subarachnoid space (SAS) or noninvasively using heavily T2-weighted magnetic resonance (MRI) sequences. An IT injection can be image-guided (e.g., x‑ray fluoroscopy-guided or computed tomography (CT)-guided). Before the introduction of CT and MR imaging, fluoroscopic myelography was the predominant technique and the gold standard for neuroradiological examination of the contents of the spinal SAS. MR-myelography has not completely replaced fluoroscopic or CT-myelographic examination, and surgeons occasionally request supplemental myelography to resolve unclear MRI findings. Furthermore, the growing interest of neuroradiologists in accurately diagnosing and treating cerebrospinal fluid leaks has created a renewed need for this imaging modality. Spontaneous intracranial hypotension (SIH) is a cause of secondary headache resulting from the leakage of cerebrospinal fluid (CSF) from the spine. The typical presentation is an orthostatic headache that worsens in the upright position; however, over time, the orthostatic quality may be absent, and other headache types may occur. When conservative treatment or epidural blood patching are not effective, it may be necessary to localize the site of a spinal CSF leak to provide surgical treatment. Dynamic CT-myelography (CTM), digital subtraction-myelography (DSM), or dynamic fluoroscopic myelography are necessary to visualize the CSF leak.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"826-833"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314211","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":"[Postoperative imaging following spinal surgery for traumatic injuries].","authors":"A Haußmann, U Yilmaz","doi":"10.1007/s00117-025-01515-0","DOIUrl":"10.1007/s00117-025-01515-0","url":null,"abstract":"<p><strong>Background: </strong>The number of surgically treated fractures has increased significantly in recent years and requires solid neuroradiological expertise.</p><p><strong>Objective: </strong>This article provides an overview of the most common early and late complications associated with surgical procedures, as well as their appropriate imaging-based diagnosis.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"859-865"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115258","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":"Value of enhanced CT machine learning models combined with clinicoradiological characteristics in predicting lymphatic tissue metastasis in colon cancer.","authors":"Xinyi Li, Ziwei Tang, Yong Liu, Yanni Du, Yuxue Xing, Zixin Zhang, Ruming Xie","doi":"10.1007/s00117-024-01412-y","DOIUrl":"10.1007/s00117-024-01412-y","url":null,"abstract":"<p><p>This study aimed to assess the effectiveness of various machine learning models in identifying lymph node metastasis in colon cancer patients and to explore the potential benefits of combining clinicoradiological and radiomics features for improved diagnosis. A total of 260 patients with pathologically confirmed colon cancer were retrospectively included in study center 1 and study center 2 from January 2015 to August 2024. A total of 198 patients with colon cancer in center 1 were randomly divided into a training set (n = 138) and an internal testing set (n = 60) at a ratio of 7:3. Patients in center 2 were included in the external testing set (n = 62). Five clinical radiological features were used to establish a clinical model. Radiomics features were extracted from the computed tomography venous phase images, and four classifiers, including logistic regression, support vector machine, decision tree, and k‑nearest neighbor, were used to build machine learning models. In addition, a combined model was constructed by joining clinical, radiological, and radiogenomic features. The performance of these models was evaluated in terms of accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating curve (ROC) and calibration curves in the training set, internal testing set, and external testing set to determine the diagnostic model with the highest predictive efficiency and to evaluate the stability of the model. Among the four machine learning models, the SVM model had the best predictive performance, with an area under the ROC (AUC) of 0.813, 0.724, and 0.721 for the training set, internal testing set, and external testing set, respectively. The clinical model, radiomics model, and combined model had an AUC of 0.823, 0.813, 0.817, 0.508, 0.724, 0.751, 0.582, 0.721, and 0.744 in the training set, internal testing set, and external testing set, respectively. In conclusion, the combined model performed significantly better than the clinical model (p = 0.017, 0.038), but there was no significant difference between the radiomics model and the combined model (p = 0.556, 0.614).</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"21-31"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191499","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":"Diffusion tensor imaging features of white matter pathways in the brain after COVID-19 infection.","authors":"Serdar Balsak, Bahar Atasoy, Fatma Yabul, Ahmet Akcay, Ismail Yurtsever, Hayrettin Daskaya, Yasemin Akkoyunlu, Zeynep Donmez, Aslı Yaman Kula, Ozlem Toluk, Alpay Alkan","doi":"10.1007/s00117-024-01414-w","DOIUrl":"10.1007/s00117-024-01414-w","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether there is a difference in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in white matter pathways in the subacute period after COVID-19 infection and to evaluate the correlation between diffusion tensor imaging (DTI) metrics and laboratory findings.</p><p><strong>Material and methods: </strong>The study included 64 healthy controls and 91 patients. Patients were classified as group 1 (all patients, n = 91), group 2 (outpatients, n = 58), or group 3 (inpatients, n = 33). The ADC and FA values were calculated from 10 distinct neuroanatomic localizations; DTI values were compared between groups.</p><p><strong>Results: </strong>Decreased FA values in the cingulum, corpus callosum splenium and genu (CCS-CCG), forceps major, inferior fronto-occipital fasciculus (IFOF), and middle cerebellar peduncle (MCP) observed in group 1 compared with the control group. Group 1 showed elevated ADC values in CCG. Lower FA and higher ADC values in CCG were shown in group 3. The FA values for CCS, IFOF, and MCP in group 3 were lower than those in the control group. Group 3 had the highest ADC values in the CCS. Additionally, the FA values of the CCG were lower in group 3 than in group 2. Oxygen saturation levels and FA values in the CCG and SFOF exhibited a positive correlation.</p><p><strong>Conclusion: </strong>We speculate that DTI changes in white matter pathways may be associated with axonal damage and demyelination due to impaired white matter integrity following COVID-19 infection during the subacute period.</p><p><strong>Clinical significance: </strong>Our study showed with DTI findings that there is microstructural damage in white matter pathways in the subacute period of COVID-19 infection and that this damage is related to oxygen saturation levels. Many studies in the literature show that microstructural damage in white matter pathways can lead to clinical neurocognitive dysfunction. We suggest that these cases require more comprehensive studies investigating whether chronic white matter damage is reversible and examining its relationship with neurocognitive dysfunctions in the future.</p><p><strong>Main points: </strong>Neurological involvement is not rare in COVID-19 infection. We examined various white matter pathways with DTI during the subacute period of COVID-19 infection. We showed changes in DTI parameters indicating a decrease in white matter integrity and microstructural damage in the subacute period follow-up of cases with COVID-19. We found that there was a positive correlation between oxygen saturation levels and decreased FA values in white matter tracts.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"37-43"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054551","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":"Assessment of variability in pulmonary fissures using multidetector computed tomography: a short review.","authors":"Berin Tuğtağ Demir, Engin Çiftçioğlu, Fatih Çankal","doi":"10.1007/s00117-025-01436-y","DOIUrl":"10.1007/s00117-025-01436-y","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the variability in pulmonary fissures, focusing on their presence, absence, or incompleteness, and how these variations contribute to the formation of accessory lobes.</p><p><strong>Objective: </strong>Using multidetector computed tomography (MDCT), the study aimed to define lung morphology in terms of major, minor, and accessory fissures.</p><p><strong>Material and methods: </strong>A descriptive analysis was conducted of MDCT images from 576 lungs (288 individuals). The study group comprised 162 male (56.3%) and 126 female (43.8%) patients.</p><p><strong>Results: </strong>In the right lung, 35.1% of cases exhibited an incomplete horizontal fissure, while in the left lung, accessory horizontal fissures were complete in 8.3% and incomplete in 10.2% of cases. Accessory fissures were present in 81.59% of right lungs and 47.22% of left lungs. The most common accessory fissures were located between the medial basal-anterior basal segments (44.4%), superior and basal segments (19.4%), and anterior basal-lateral basal segments (19.4%) of the lower lobe. No significant gender or lung-side differences were noted in the occurrence of fissures (p > 0.05).</p><p><strong>Conclusion: </strong>The study revealed significant variability in the frequency of major, minor, and accessory pulmonary fissures. Understanding these variations is crucial in shedding light on unusual clinical presentations in lung pathologies and in facilitating an accurate diagnosis and surgical planning.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"59-66"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058006","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":"Added value of sodium MRI in multiparametric MRI for WHO grade II astrocytoma surveillance during \"watchful waiting\": initial experience.","authors":"Daniel Cantré, Ioan Gemescu, Lars Gerigk, Armin M Nagel, Marco Essig, Sönke Langner, Marc-André Weber","doi":"10.1007/s00117-025-01531-0","DOIUrl":"10.1007/s00117-025-01531-0","url":null,"abstract":"<p><strong>Background: </strong>Unresectable WHO grade II astrocytomas require continuous imaging surveillance. To evaluate whether sodium MRI (²³Na-MRI) adds diagnostic value to multiparametric MRI and helps predict progressive disease (PD), patients monitored under a \"watchful waiting\" strategy were repeatedly examined.</p><p><strong>Materials and methods: </strong>Overall, 18 patients with biopsy-proven WHO grade II astrocytoma (10 female, mean age 42 ± 15 years) were prospectively included after baseline imaging. The imaging protocol comprised morphological MRI (T2 TSE, T2 FLAIR, pre- and post-contrast T1 SE), DSC perfusion MRI (n = 17), and ²³Na-MRI (n = 9) at 3 T. At baseline, evaluable ²³Na-MRI was available for six patients. The Response Assessment in Neuro-Oncology criteria were used to define PD. Semiquantitative ROI analysis was performed on DSC- and ²³Na-MRI. Data were analyzed using the Cox regression model.</p><p><strong>Results: </strong>In 14 patients (78%), PD was found after a mean of 420 ± 354 days. For the endpoint time to progression, univariate Cox regression revealed a hazard ratio (HR) of 1.39 for relative regional cerebral blood volume (rrCBV) in the tumor at baseline, and an HR of 1.29 for relative regional cerebral blood flow (rrCBF) at baseline. The ²³Na signal in tumor tissue at baseline, normalized to sodium phantoms, revealed an HR of 0.91.</p><p><strong>Conclusion: </strong>Elevation of rrCBV and rrCBF in the tumor indicates poor prognosis, in line with the literature. ²³Na-MRI can be used for WHO grade II astrocytoma surveillance. In some treatment-naïve WHO grade II astrocytomas, an initially high sodium signal seems to be prognostically favorable, contrary to the literature on ²³Na-MRI in postoperative aftercare. However, due to the small cohort size with evaluable ²³Na-MRI at baseline, evidence is limited. In future, ²³Na-MRI may help selecting patients for a \"watchful waiting\" strategy.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"126-132"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497737","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}