Radiologie (Heidelberg, Germany)最新文献

{"title":"[Personalized profiling in the field of senology].","authors":"Annika S Behrens, Matthias W Beckmann, Peter A Fasching, Hanna Huebner, Julius Emons","doi":"10.1007/s00117-024-01410-0","DOIUrl":"10.1007/s00117-024-01410-0","url":null,"abstract":"<p><strong>Background: </strong>The concept of personalized medicine is becoming increasingly important. The possibilities of diagnostics include not only genetic and molecular tumor profiles, but also the use of precise and individual imaging techniques.</p><p><strong>Objectives: </strong>The development and implementation of suitable diagnostic procedures with high sensitivity and specificity, which are at the same time tailored to the individual risk factors and biological characteristics of the patient, remain a challenge.</p><p><strong>Materials and methods: </strong>To enable personalized profiling, comprehensive diagnostics must be established that take into account all parameters such as imaging, molecular and genetic markers as well as real-world data and the use of artificial intelligence. This article sheds light on different approaches to personalized diagnostics in breast cancer and highlights the current clinical standard, innovative areas of research and the resulting challenges.</p><p><strong>Conclusion: </strong>The highest hurdles for newer imaging techniques are the standardization of image analysis and the validation of these techniques in large clinical trials. The use of artificial intelligence requires not only appropriate technical and medical expertise, but also a sensitive approach to issues such as data protection and patient privacy. Real-world registries offer insights into real world treatment situations and are therefore of great importance.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"194-200"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026090","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":"[Artificial intelligence in breast imaging : Hopes and challenges].","authors":"Matthias Dietzel, Alexandra Resch, Pascal A T Baltzer","doi":"10.1007/s00117-024-01409-7","DOIUrl":"10.1007/s00117-024-01409-7","url":null,"abstract":"<p><strong>Clinical/methodical issue: </strong>Artificial intelligence (AI) is being increasingly integrated into clinical practice. However, the specific benefits are still unclear to many users.</p><p><strong>Standard radiological methods: </strong>In principle, AI applications are available for all imaging modalities, with a particular focus on mammography in breast diagnostics.</p><p><strong>Methodical innovations: </strong>AI promises to filter examinations into negative and clearly positive findings, and thereby reduces part of the radiological workload. Other applications are not yet as widely established.</p><p><strong>Performance: </strong>AI methods for mammography, and to a lesser extent tomosynthesis, have already reached the diagnostic quality of radiologists.</p><p><strong>Achievements: </strong>Except for second-opinion applications/triage in mammography, most methods are still under development.</p><p><strong>Practical recommendations: </strong>Currently, most AI applications must be critically evaluated by potential users regarding their maturity and practical benefits.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"187-193"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366426","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":"[Importance of parametric and molecular imaging for therapeutic management of breast cancer].","authors":"C C Hack, M Wetzl, D Schmidt, M W Beckmann","doi":"10.1007/s00117-024-01394-x","DOIUrl":"10.1007/s00117-024-01394-x","url":null,"abstract":"<p><strong>Background: </strong>In recent years, various magnetic resonance (MRI) and positron emission tomography (PET) parameters have been investigated in breast cancer. Parametric imaging focuses on the visualization and quantification of biological, physiological, and pathological processes at the cellular and molecular level. It therefore provides important insights into the key processes in carcinogenesis and tumor progression. This article aims to illustrate the importance for the management of breast cancer.</p><p><strong>Materials and methods: </strong>Based on the current literature, an overview of the current state of parametric breast imaging and its importance in therapy management is given. Moreover, future opportunities and challenges are highlighted.</p><p><strong>Results: </strong>Parametric imaging in breast cancer includes MRI, nuclear medicine procedures such as PET, the combination of different techniques (PET-CT, PET-MRI) and the use of specific radiotracers. Parametric MRI of the breast mainly uses T2 and diffusion-weighted imaging (DWI) as well as dynamic contrast-enhanced MRI (CM-MRI). Quantitative and qualitative imaging biomarkers provide insights into tumor biology and allow conclusions to be drawn about the molecular subtype or prognosis.</p><p><strong>Conclusions: </strong>Recently, parametric imaging has become established in breast diagnostics. It is constantly evolving and will continue to gain in importance in the forthcoming years. It offers the opportunity to improve the diagnosis and treatment management of breast cancer.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"154-161"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792958","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":"[Multiparametric magnetic resonance imaging of the breast : What can we expect from the future?]","authors":"Daniela Prinz, Silvester J Bartsch, Viktoria Ehret, Joachim Friske, Katja Pinker, Thomas H Helbich","doi":"10.1007/s00117-024-01390-1","DOIUrl":"10.1007/s00117-024-01390-1","url":null,"abstract":"<p><strong>Background: </strong>The combination of different MRI methods is described as multiparametric MRI (mpMRI) and plays a significant role in breast cancer diagnostics. Currently, mpMRI includes contrast-enhanced and diffusion-weighted MRI. For a more comprehensive characterization of the key processes involved in cancer development, additional MRI methods that capture functional processes at the cellular and molecular levels are necessary. In the context of preclinical studies, MRI methods that enable contrast-free evaluation of key processes at the metabolic and molecular levels are being developed for future clinical applications.</p><p><strong>Objectives: </strong>What does multiparametric MRI in breast cancer look like in the future?</p><p><strong>Methods: </strong>Systematic literature analysis focusing on preclinical research with regard to mpMRI as well as development and modification of noninvasive MRI methods.</p><p><strong>Results: </strong>Some of the most promising MRI methods for the evaluation of breast cancer that can answer functional and metabolic questions are BOLD (blood oxygen level dependent), IVIM (intravoxel incoherent motion), DMI (deuterium metabolic imaging) and CEST (chemical exchange saturation transfer). A combination and, therefore, a multiparametric approach allows for a noninvasive differentiation of breast cancer subtypes and early detection of treatment response which is crucial for the future development of the disease.</p><p><strong>Conclusion: </strong>Standardization of quantification methods as well as improvement and expansion of MRI methods enable such a multiparametric, functional, and metabolic evaluation of the tumor. Many of these are initially developed in preclinical settings before they can be translated into clinical practice.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"162-169"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752614","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":"[New innovations in cross-sectional imaging diagnostics of the aorta].","authors":"Claudius Melzig, Dittmar Böckler, Hans-Ulrich Kauczor, Mark O Wielpütz, Moritz S Bischoff","doi":"10.1007/s00117-025-01424-2","DOIUrl":"10.1007/s00117-025-01424-2","url":null,"abstract":"<p><p>Imaging, particularly computed tomography (CT) and magnetic resonance imaging (MRI), plays a central role in the diagnostics, treatment planning and follow-up of aortic diseases. While ultrasound is often used for the initial assessment, CT enables rapid and comprehensive imaging of the aorta. The MRI is a radiation-free and when necessary, contrast agent-free alternative and provides functional imaging methods. Positron emission tomography (PET) is particularly relevant for inflammatory vascular diseases. Cross-sectional imaging has recently undergone significant development, particularly with respect to image quality and the required doses of ionizing radiation and contrast agents, spatial resolution and newer methods, such as material decomposition and functional imaging. This article provides an overview of current developments in CT angiography (CTA) and magnetic resonance angiography (MRA) and their use in selected aortic diseases in the context of the latest guidelines.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"201-214"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411973","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":"[Parametric imaging in breast diagnostics : Computed tomography].","authors":"R Schulz-Wendtland, T Wacker","doi":"10.1007/s00117-024-01392-z","DOIUrl":"10.1007/s00117-024-01392-z","url":null,"abstract":"<p><strong>Background: </strong>The complementary breast diagnostics (CMD) include the clinical examination, ultrasound, mammography and magnetic resonance imaging (MRI) of the breast and the assessment of conspicuous findings by interventional methods.</p><p><strong>Objective: </strong>In recent years special breast computed tomography (BCT) systems have been developed and the question arises as to what significance this technology has in comparison to the established MRI procedure.</p><p><strong>Material and methods: </strong>Presentation of the two dedicated BCT systems with different concepts, which are currently commercially available.</p><p><strong>Results: </strong>In comparison to the Koning® (San Jose, CA, USA) BCT (CBBCT) system there are advantages to the SBCT system from AB-CT® (Erlangen, Germany) such as: 1) direct conversion of the photons at the detector resulting in a reduction of possible data loss, which eliminates an intermediate step as with scintillation imaging, 2) higher resolution, 3) lower patient dose and 4) more precise diagnostics of microcalcification.</p><p><strong>Conclusion: </strong>Based on the CMD the SBCT system includes the indications for MRI in the assessment and opens up new perspectives in terms of recognition and three-dimensional visualization of microcalcification, which is not possible with MRI. It remains to be seen whether SBCT will complement or replace MRI in the clarification or assessment of findings.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"178-186"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808839","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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","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":"[Endovascular thrombectomy of medium vessel occlusions].","authors":"Frederik Fries","doi":"10.1007/s00117-024-01402-0","DOIUrl":"10.1007/s00117-024-01402-0","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke is a leading cause of disability and dependency in daily life. While endovascular therapy has become the standard treatment for large vessel occlusions, its benefit for medium vessel occlusions has not yet been clearly established.</p><p><strong>Objective: </strong>This article provides an overview of the current evidence, epidemiology, and clinical challenges of thrombectomy in distal medium vessel occlusions (DMVOs).</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"110-114"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840173","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":"[Management of acute ischemic stroke : Bridging vs. mothership].","authors":"Alena Haußmann","doi":"10.1007/s00117-024-01397-8","DOIUrl":"10.1007/s00117-024-01397-8","url":null,"abstract":"<p><strong>Clinical issue: </strong>Acute ischemic stroke remains one of the most common causes of death in Germany and affects around 16,000 people every year. With the begin of using of i.v. lysis therapy in the mid-1990s and endovascular thrombectomy (after publication of randomized studies) in 2015, these two procedures represent the two most important pillars in acute therapy. In the absence of neuroradiology centers with endovascular treatment options, there are two principles for triaging of stroke patients-the drip-and-ship or mothership model. The question repeatedly arises as to whether and exactly when bridging i.v. lysis therapy should be used.</p><p><strong>Results: </strong>The S2 guideline for the treatment of acute stroke offers an evidence-based treatment decision for treating physicians and has been extended until 2026, with the exception of a few updates, due to its proven effectiveness.</p><p><strong>Conclusion: </strong>Every stroke patient should receive i.v. lysis therapy, taking into account the onset of neurological symptoms and possible contraindications, regardless of the planned triaging principle.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"115-117"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856887","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":"[How to: correctly read scientific articles : Research design and methodology].","authors":"Katharina Fetz, Johanna Rutetzki, Rolf Lefering","doi":"10.1007/s00117-025-01417-1","DOIUrl":"10.1007/s00117-025-01417-1","url":null,"abstract":"<p><p>Criteria for assessment of the significance of scientific articles are presented. The focus is on research design and methodology, illustrated by the classical study on prehospital volume treatment of severely injured individuals with penetrating torso injuries by Bickell et al. (1994). A well-thought out research design is crucial for the success of a scientific study and is documented in a study protocol beforehand. A hypothesis is a provisional explanation or prediction and must be testable, falsifiable, precise, and relevant. There are various types of randomization methods, with the randomized controlled trial being the gold standard for clinical interventional studies. When reading a scientific article it is important to verify whether the research design and setting align with the research question and whether potential sources of error have been considered and controlled. Critical scrutiny should also be applied to references, the funding and expertise of the researchers.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"131-140"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960059","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}