BMC Medical Imaging最新文献

{"title":"Pedal acceleration time as a diagnostic and prognostic tool in peripheral artery disease: systematic review and meta-analysis.","authors":"Mariana Rosado-Fonseca, Eduardo Silva, Tiago Ribeiro, Antónia Rocha-Melo, Daniela Santos-Silva, Mário Marques-Vieira, Piotr Myrcha, Hugo Ribeiro, João Rocha-Neves","doi":"10.1186/s12880-026-02493-y","DOIUrl":"10.1186/s12880-026-02493-y","url":null,"abstract":"<p><strong>Background: </strong>Wound healing in chronic limb-threatening ischaemia in peripheral artery disease (PAD) remains clinically challenging. Accurate perfusion assessment may predict limb outcomes. Standard measures ankle-brachial index (ABI) and transcutaneous oxygen pressure have limitations. The ABI, the guideline-recommended first-line diagnostic tool, has well-recognised limitations in patients. Pedal acceleration time (PAT), measured by duplex ultrasound from onset to peak arterial systole in the pedal arteries, shows promise as a prognostic marker, though its diagnostic and prognostic performance has not been fully validated. This study aimed to perform a systematic review and meta-analysis evaluating PAT's diagnostic accuracy compared with ABI in detecting lower-limb ischaemia. Secondary objectives included assessing PAT's prognostic value for wound healing and amputation risk.</p><p><strong>Methods: </strong>Three electronic databases MEDLINE, Scopus, and Web of Science, were systematically searched for studies evaluating PAT values and wound healing in PAD patients. Wound healing incidence and PAT-ABI correlations were pooled according to Preferred Reporting Items for Systematic reviews and Meta-Analyses of Diagnostic Test Accuracy studies (PRISMA-DTA) guidelines. Pooled diagnostic indices, including sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio with 95% confidence intervals were calculated. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Study Quality Assessment Tool for observational cohort and cross-sectional designs.</p><p><strong>Results: </strong>Seventeen studies (1749 patients) were included as following: 8 cross-sectional, 1 observational prospective, 3 observational retrospective, 4 cohort (3 retrospective, 1 prospective), and 1 case-control study. PAT demonstrated good diagnostic accuracy with pooled 0.72 (95% CI 0.68-0.76) sensitivity, 0.84 (95% CI 0.79-0.88) specificity, 4.38 (95% CI 3.35-5.73) positive likelihood ratio, 0.25 (95% CI 0.19-0.33) negative likelihood ratio, and 14.85 (95% CI 10.02-22.01) diagnostic odds ratio, indicating robust discrimination compared to ABI. The selected studies, referring to the period 2019-2025, reported an association between higher PAT values and worse wound healing outcomes and increased amputation risk. Due to insufficient and non-standardised data, PAT's prognostic pooled analysis for wound healing was not feasible.</p><p><strong>Conclusion: </strong>PAT accurately detected clinically significant lower-limb ischaemia compared to ABI. Faster PAT values correlated to higher ABI and favorable wound healing outcomes, whereas prolonged PAT indicated higher risk of non-healing wounds and major amputation. These results support PAT as a useful duplex-based complement to existing perfusion tests.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal bilateral parotid delta-radiomic kinetics and variance signatures for prediction of late xerostomia following radiotherapy.","authors":"Damilola Oluwafemi Samson, Mahayu Ismail, Mohd Ariff Mohamed Hanifa, Eznal Izwadi Mohd Mahidin, Hanani Abdul Manan, Noorazrul Yahya","doi":"10.1186/s12880-026-02573-z","DOIUrl":"10.1186/s12880-026-02573-z","url":null,"abstract":"<p><strong>Background and purpose: </strong>Radiation-induced xerostomia remains a significant concern in head-and-neck cancer radiotherapy, inadequately predicted, with unidentified kinetic signatures of parotid injury. This study aimed to identify predictive metrics and reproducible bilateral parotid delta-radiomic kinetics and variance features for late xerostomia.</p><p><strong>Materials and methods: </strong>This retrospective study included 131 HNC patients treated with VMAT-based radiochemotherapy. Weekly CBCT images (weeks 1-7) were collected (2020-2023). Twelve-month xerostomia was graded using CTCAE v5.0. IBSI-compliant bilateral parotid radiomics were extracted and converted to delta-radiomic kinetics. Patient-level data were split (training n: 91; testing n: 40), and feature selection combined univariate filtering with recursive feature elimination. Machine-learning models with stratified 5-fold cross-validation integrated clinical-dosimetric (CD), clinical-dosimetric + delta-radiomic (CDR), and clinical-dosimetric + delta-radiomic + kinetics (CDRK). Performance was evaluated using AUC (95% CI) and other metrics, with SHAP interpretability. Reliability (ICC, CCC, R²), multicollinearity, and bilateral asymmetry were assessed.</p><p><strong>Results: </strong>The prevalence of 12-month grade ≥ 2 xerostomia was nearly identical between cohorts (76.9%, 77.5%; SMD: 0.014), with no significant difference observed. Predictive performance enhanced with feature incorporation and peaked mid-treatment. Clinical-dosimetric models demonstrated limited early discrimination (AUC 0.38-0.45). Delta-radiomics improved performance at week-3, while combined kinetic models achieved optimal predictive performance at week-4 (SVM-CDRK AUC 0.81, p: 0.002, sensitivity 100%, specificity 86%, Brier score 0.06, F1-score 91%). LASSO- and MLP-CDRK yielded AUCs of 0.75 (p: 0.009) and 0.73 (p: 0.011) and F1-score (86%; 79%). Texture-based GLCM features (AUC 0.79, p: 0.003) outperformed first-order and morphological descriptors. S_norm-, AUC_lc-, and variance-based kinetics showed high longitudinal reliability (ICC/CCC > 0.86; R² 0.78-0.83), revealing week-4 as a potentially informative treatment phase.</p><p><strong>Conclusions: </strong>Longitudinal bilateral parotid delta-radiomic kinetics significantly enhance late xerostomia prediction, identify mid-treatment as the optimal risk-stratification window, and support adaptive radiotherapy and personalized toxicity mitigation.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualization of coronary small branch at ultra-high field 5T Noncontrast Dixon Whole-Heart Coronary MR Angiography: compared with 3T MRI.","authors":"Runzhi Zhang, Chuangwei Wei, Yan Xu, Jiahuan Dai, Nan Zhang, Jiayi Liu, Lei Xu, Zhaoying Wen","doi":"10.1186/s12880-026-02559-x","DOIUrl":"10.1186/s12880-026-02559-x","url":null,"abstract":"<p><strong>Background: </strong>Detection of the small coronary branches using 5T Dixon (5TDixon) sequence, analysis of visualization and performance comparison with 3T Dixon (3TDixon) sequence.</p><p><strong>Materials and methods: </strong>A prospective study was conducted involving 22 healthy adult volunteers (mean age, 25 years ± 3 [SD]; twelve male participants) who underwent navigator-gated three-dimensional MR angiography at both 5TDixon and 3TDixon. The visualization rates, image quality scores and visualized lengths of the small coronary branches were quantitatively compared between 5TDixon and 3TDixon sequences.</p><p><strong>Results: </strong>The 5TDixon sequence demonstrated superior performance to the 3TDixon sequence, yielding a significantly shorter scan time (10.01 ± 3.17 min vs. 13.71 ± 3.36 min, P = 0.002), a significantly higher SNR_RCA-pro (76.08 ± 13.68 vs. 29.08 ± 6.63, P < 0.001) and a significantly higher CNR_RCA-pro (72.25 ± 14.48 vs. 24.72 ± 5.72, P < 0.001).The visualization rates of the right anterior ventricular branch, acute marginal branch, and atrioventricular nodal artery were significant higher at 5TDixon compared with 3TDixon, whereas no statistically significant differences were observed for the conus branch, sinoatrial nodal artery and the anterior septal artery. Score of image quality of small coronary branches was higher for 5TDixon compared with 3TDixon (all P < 0.05). Among paired visible branches, 5TDixon generally demonstrated longer visualized vessel segments than 3TDixon, while length result for atrioventricular nodal artery was reported descriptively because of very small paired sample sizes.</p><p><strong>Conclusion: </strong>5T Non-contrast Dixon Whole-Heart Coronary MR Angiography provides an effective tool for visualizing small coronary branches and demonstrates superior performance compared with 3T.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular-aware mixture-of-experts with a texture-enhanced decoder for accurate X-ray vessel segmentation.","authors":"Zhongjian Ju, Qingnan Wu, Wanqiang Cai, Zidong Liu, Ruigang Ge, Yimeng Li, Jinyuan Wang, Zaichao Lu, Zeping Cui, Jiasong Wu, Baolin Qu","doi":"10.1186/s12880-026-02542-6","DOIUrl":"10.1186/s12880-026-02542-6","url":null,"abstract":"<p><strong>Background: </strong>Accurate vessel segmentation in X-ray angiography (XRA) is essential for diagnosing coronary artery disease and supporting interventional procedures. However, low contrast, complex backgrounds, and substantial variation in vessel caliber make accurate segmentation challenging, especially for thin vessels.</p><p><strong>Methods: </strong>We propose a Vascular-Aware Mixture-of-Experts (VA-MoE) framework for XRA vessel segmentation. The model incorporates Dynamic Snake Convolution (DSnC) to capture the elongated and curved morphology of vessels and a Texture-Enhanced Decoder (TED) to recover fine spatial details and suppress background noise during upsampling. The proposed framework was evaluated on three representative datasets: ARCADE, DCA1, and XCAD.</p><p><strong>Results: </strong>VA-MoE achieved an IoU of 87.80% and a Dice coefficient of 93.08% on ARCADE, an IoU of 65.18% and a Dice coefficient of 78.03% on DCA1, and an IoU of 67.52% and a Dice coefficient of 79.93% on XCAD. Compared with the strongest baseline methods, VA-MoE improved IoU and Dice by 2.77 and 1.21 percentage points on ARCADE, by 2.40 and 2.10 percentage points on DCA1, and by 2.89 and 1.50 percentage points on XCAD, respectively. Qualitative results further suggested improved topological continuity and better preservation of thin peripheral vessels compared with competing methods.</p><p><strong>Conclusion: </strong>The proposed VA-MoE framework provides a promising solution for XRA vessel segmentation. By jointly enhancing vascular structural modeling and texture recovery, it may support automated cardiovascular image analysis.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸F-FDG PET/CT radiomics combined with double-expressor status enhances prognostication and high-risk stratification in DLBCL.","authors":"Qi Jiang, Silu Cui, Panpan Luan, Faquan Ji, Yuxiao Hu","doi":"10.1186/s12880-026-02552-4","DOIUrl":"10.1186/s12880-026-02552-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the R-CHOP era, the IPI score has reduced efficacy in identifying high-risk diffuse large B-cell lymphoma (DLBCL) patients. Precise prognostic biomarkers and scoring systems are urgently needed to achieve refined stratification of this high-risk population. This study aimed to clarify the combined prognostic significance of &lt;sup&gt;18&lt;/sup&gt;F-fluorodeoxyglucose positron emission tomography/computed tomography (&lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT) radiomics and double-expressor status in DLBCL patients (DEL) receiving first-line R-CHOP therapy, and to evaluate their incremental value over the the International Prognostic Index (IPI) score in identifying high-risk DLBCL patients and predicting their prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study included 210 real-world patients with newly diagnosed DLBCL treated with R-CHOP. Radiomic parameters including maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and maximum lesion diameter (Dmax) were extracted from &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT, with lesion segmentation performed at a 41% SUV threshold. With PFS as the primary endpoint and OS as the secondary endpoint, optimal cutoffs were identified by the max-stat method. Survival analysis and Cox regression were applied to construct a prognostic risk score model. Model validation was performed using five-fold cross-validation and 1000 bootstrap resamplings. Predictive performance was evaluated by AIC, c-index and AUC, with AUC differences compared via multiple statistical tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Multivariate analysis identified MTV, Dmax and DEL status as independent predictors of progression-free survival (PFS) and overall survival (OS), leading to the development of the MDE prognostic model. Five-fold cross-validation confirmed significant PFS/OS risk stratification across all training and validation cohorts (all P &lt; 0.05). MDE was a significant independent PFS predictor (P &lt; 0.0001), outperforming the IPI (P = 0.205). The MDE model showed superior predictive performance over IPI: for PFS, mean AIC (536.564 vs. 575.546) and C-index (0.778 vs. 0.677); for OS, mean AIC (424.227 vs. 445.86) and C-index (0.775 vs. 0.724). Its AUC (0.797) was significantly higher than IPI (0.700, all P &lt; 0.05) per DeLong's test, bootstrap method and Venkatraman's permutation test. Compared with IPI high-risk patients (5-year PFS: 34.6%, OS: 32.6%), MDE identified a higher-risk subgroup (5-year PFS: 22.4%, OS: 29.7%) and improved discriminatory capacity across IPI subgroups (all P &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The MDE scoring system integrates baseline &lt;sup&gt;18&lt;/sup&gt;F-FDG-PET/CT radiomic features and DEL status. It identifies higher-risk DLBCL patients more effectively than the IPI, exhibits superior prognostic predictive value for treatment-naive DLBCL patients, and demonstrates excellent reproducibility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The research","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-based evidence of rectus capitis posterior minor hypertrophy and its correlation with disease duration in Parkinson's disease.","authors":"Xin-Ting Liu, Cong Liu, Xin Fang, Chen-Xu Zhao, Sheng-Bo Yu, Jian-Fei Zhang, Nan Zheng, Qiang Xu, Hong-Jin Sui","doi":"10.1186/s12880-026-02571-1","DOIUrl":"10.1186/s12880-026-02571-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Recent research in Parkinson's disease (PD) has increasingly focused on alterations in cerebrospinal fluid (CSF) dynamics and glymphatic system (GS) function. The myodural bridge (MDB), a structure connecting the suboccipital muscles to the spinal dura mater, is involved in the regulation of CSF dynamics. The rectus capitis posterior minor (RCPmi) is a core component of the myodural bridge complex (MDBC). This study employed magnetic resonance imaging (MRI) to evaluate morphological changes in the RCPmi in PD patients and to explore their potential association with CSF dynamics and disease duration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This retrospective MRI study included 349 participants: 156 patients with PD and 193 healthy controls (HC). The occiput-C2 angle (OC2A) was measured on mid-sagittal T2-weighted images. Standardized cross-sectional area (CSA) ratios of MDBC constituent muscles (RCPmi, RCPma, OCI) and non-constituent muscles (OCS, RCL) were quantified on axial images. In 51 PD patients with complete disease duration records (range 1-14 years), the correlation between RCPmi CSA and disease duration was analyzed. From the overall cohort, 277 participants with well-defined occipito-atlantal cistern (OAC) morphology (114 PD, 163 HC) were selected for measurement of OAC parameters (D-FM, D-C1, D-C2) and concurrent anteroposterior diameters of the medulla oblongata and upper cervical spinal cord at the corresponding anatomical levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No significant differences were observed between the PD and HC groups in OC2A or atlas posterior arch CSA (P &gt; 0.05), indicating that subsequent muscle comparisons were not biased by head position or individual anatomical variation. Compared with the HC group, the PD group exhibited significantly larger CSAs of all MDBC constituent muscles (P &lt; 0.05), with the most pronounced difference noted for RCPmi (PD: 1.97 ± 1.35 vs. HC: 1.58 ± 1.07, P = 0.003). No significant differences were found for non-constituent muscles (P &gt; 0.05). Within the PD group, RCPmi CSA showed a moderate positive correlation with disease duration (r = 0.47, P &lt; 0.001). Analysis of OAC parameters revealed significantly larger D-C1 and D-C2 distances in the PD group compared with the HC group (D-C1: 3.96 ± 1.29 mm vs. 3.60 ± 1.29 mm, P = 0.020; D-C2: 2.75 ± 0.88 mm vs. 2.45 ± 0.82 mm, P = 0.004), whereas D-FM did not differ significantly (P &gt; 0.05). Concurrent measurements of neural tissue anteroposterior diameters at the same anatomical levels as the OAC parameters showed no significant differences between PD group and HC group (P &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrates selective hypertrophy of the RCPmi in patients with PD, with the degree of hypertrophy significantly correlated with both disease duration and OAC enlargement. These morphological findings provide a cross‑sectional imaging correlate of disease chronicity. The study did not ","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of preoperative CT-derived fractional flow reserve after transcatheter or surgical aortic valve replacement in patients with severe aortic stenosis.","authors":"Xirui Duan, Xudong Jin, Shiying Tang, Shuaiyan Zuo, Wan Shen, Lei Yang, Ting Yang, Xiaolan Du, Feifei Zhou, Xinyan Zhou, Rong Qian, Na Tan, Guifang Sun, Chengde Liao","doi":"10.1186/s12880-026-02561-3","DOIUrl":"10.1186/s12880-026-02561-3","url":null,"abstract":"<p><strong>Background: </strong>Patients with aortic stenosis (AS) often have concomitant coronary artery disease (CAD), and coronary CTA (CCTA) is performed for anatomical evaluation to inform coronary revascularization decision-making prior to aortic valve replacement (AVR). However, the role of coronary hemodynamic assessment in pre-AVR is not well established. We aim to evaluate the prognostic value of preoperative CT angiography-derived fractional flow reserve (CT-FFR) in patients with severe AS undergoing transcatheter (TAVR) or surgical aortic valve replacement (SAVR).</p><p><strong>Methods: </strong>This consecutive retrospective observational cohort (July 2023-January 2025) included patients with severe AS referred to TAVR or SAVR. CT-FFR was obtained fully-automatic using an on-site machine learning algorithm, and a low value was defined as CT-FFR ≤ 0.80. The composite endpoint was a patient-oriented composite of all-cause mortality and major adverse cardiac events (MACE) (nonfatal myocardial infarction, unstable angina, cardiac death, cardiovascular-driven admission or heart failure admission).</p><p><strong>Results: </strong>Among 329 patients (mean age 61.4 ± 13.1 years), composite endpoint occurred in 14.3% and all-cause mortality in 4.0% over a median follow-up of 17 months. After adjustment, CT-FFR ≤ 0.80 remained independently associated with the composite endpoint (HR 3.83; 95% CI 2.04-7.20; P < 0.001) and with MACE (HR 4.84; 95% CI 2.40-9.78; P < 0.001), but was not independently associated with all-cause mortality (P = 0.071). Adding CT-FFR to clinical models substantially improved risk discrimination for MACE (C-index 0.74) and significantly improved reclassification (NRI 0.346; P < 0.001), whereas adding anatomical CCTA alone provided minimal incremental value.</p><p><strong>Conclusion: </strong>In patients with severe AS undergoing TAVR or SAVR, preoperative CT-FFR was associated with an increased risk of post-AVR adverse cardiac events. The prognostic value of CT-FFR was consistent across both TAVR and SAVR populations and may improve individual-level risk reclassification.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a prognostic model for colorectal cancer based on clinical parameters and quantitative body composition using CT imaging.","authors":"Zhihao Liu, Mingming Song, Yixin Heng, Tong Nie, Jiaxin Xu, Xiaoyu Wu, Liming Shen, Yinghao Cao, Feihong Wu, Le Qin","doi":"10.1186/s12880-026-02563-1","DOIUrl":"10.1186/s12880-026-02563-1","url":null,"abstract":"<p><strong>Objectives: </strong>In colorectal cancer (CRC) patients, body composition (BC) has been recognized as a patient-specific imaging biomarker associated with prognosis. This study aims to construct a joint prediction model based on computed tomography (CT) quantitative body composition and clinical parameters using the Least Absolute Shrinkage and Selection Operator (LASSO) regression model and evaluate its prognostic value in patients undergoing curative surgery for CRC.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study analyzed 377 CRC patients who underwent surgical resection from 2017 to 2022. The cohort was split into a training set and a validation set. CT images at the L3 and umbilical levels within 3 months pre-surgery were used to quantify body composition. LASSO regression and COX proportional hazard regression identified independent prognostic factors and developed nomogram prediction models. Model performance was assessed using C-index, receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA), and external validation.</p><p><strong>Results: </strong>LASSO regression identified 7 clinical indicators strongly associated with OS and DFS, respectively. Nomogram prediction models were then created incorporating body composition indicators. ROC curves showed the area under the curve (AUC) of 0.915 and 0.882 for 5 years OS and DFS, respectively. The combined model significantly outperformed TNM staging alone, with AUCs of 0.915 vs. 0.788 for 5 years OS in the training set, and 0.910 vs. 0.735 in the validation set. Calibration and DCA curves indicated strong predictive ability and clinical effectiveness.</p><p><strong>Conclusion: </strong>The combined prediction model based on CT-quantified body composition and clinical indicators effectively predicts CRC prognosis, outperforming the single TNM stage model.</p><p><strong>Clinical trial number: </strong>Retrospective study, not applicable.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of multiphasic CT-based delta-radiomics model for predicting postoperative recurrence risk in bladder cancer.","authors":"Weiwei Liu, Bingxin Gong, Guilin Zhang, Yusheng Guo, Xiaona Fu, Jie Lou, Peng Sun, Yi Li, Shanshan Jiang, Chao Huang, Lian Yang","doi":"10.1186/s12880-026-02554-2","DOIUrl":"10.1186/s12880-026-02554-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a CT-based delta-radiomics model for personalized prediction of postoperative prognosis in bladder cancer patients and identification of differentially expressed genes associated with tumour recurrence.</p><p><strong>Materials and methods: </strong>This retrospective study included 316 patients with bladder cancer from Wuhan Union Hospital who underwent preoperative unenhanced and arterial-phase CT before surgical resection. Patients were randomly divided into training and internal validation cohorts at an 8:2 ratio. Radiomic features were extracted from tumor volumes of interest on both CT phases, and delta-radiomic features were calculated as arterial-phase features minus unenhanced-phase features. Feature selection was performed within the training cohort using statistical filtering, correlation analysis, and LASSO regression. Multiple machine-learning classifiers were evaluated, and a combined clinico-radiomic model was constructed by integrating the delta-radiomics score with selected clinical predictors. Model performance was assessed using ROC analysis, calibration, decision curve analysis, DeLong testing, and repeated stratified random splitting. An additional TCIA cohort of 33 patients was used for exploratory transcriptomic analysis.</p><p><strong>Results: </strong>After feature selection, nine delta-radiomic features derived from paired unenhanced and arterial-phase CT images were retained for model construction. The LightGBM-based delta-radiomics model achieved AUCs of 0.837 and 0.822 in the training and validation cohorts, respectively. The combined clinical-radiomics model, constructed by integrating the delta-radiomics Rad-score with muscle invasion as a clinical predictor, achieved the best discrimination, with AUCs of 0.860 and 0.861 in the training and validation cohorts, respectively, and showed stable validation performance in 100 repeated splits. High radiomics scores were associated with significantly shorter recurrence-free survival. Exploratory transcriptomic analysis showed enrichment of immune-related pathways in the low-risk radiomic subgroup.</p><p><strong>Conclusions: </strong>Multiphasic CT-based delta-radiomics provides a non-invasive approach for predicting postoperative recurrence and stratifying prognosis in bladder cancer. A combined clinico-radiomic model incorporating delta-radiomics and muscle invasion achieved superior predictive performance and may support individualized postoperative risk assessment.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative white matter alterations of the anterior visual pathway predict injury following radiotherapy for nasopharyngeal carcinoma: a high-angular-resolution diffusion imaging study.","authors":"Yaqian Xing, Tiansheng Li, Yiying Zhang, Linjie Zhou, Weiyuan Huang, Gang Wu","doi":"10.1186/s12880-026-02565-z","DOIUrl":"10.1186/s12880-026-02565-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to use high-angular-resolution diffusion imaging (HARDI) to evaluate microstructural alterations and temporal evolution patterns in the anterior visual pathway (AVP) white matter of patients with nasopharyngeal carcinoma (NPC) following radiotherapy (RT).</p><p><strong>Methods: </strong>150 patients with nasopharyngeal carcinoma (NPC) were retrospectively enrolled and stratified into four groups according to the post-radiotherapy (post-RT) interval: G0 (pre-RT, n = 39), G1 (< 1 month post-RT, n = 30), G2 (< 6 months post-RT, n = 33), and G3 (> 6 months post-RT, n = 48). Based on high-angular-resolution diffusion imaging (HARDI), generalized q-sampling imaging (GQI) reconstruction was performed to derive GQI parameters for the anterior visual pathway, including generalized fractional anisotropy (GFA) and normalized quantitative anisotropy (NQA). Corresponding diffusion tensor imaging (DTI) parameters, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), were also obtained. One-way analysis of variance (ANOVA) was used to compare all parameters across the four groups, followed by post hoc pairwise comparisons. Cohen's d was calculated to assess the effect size of each parameter relative to pre-RT values.</p><p><strong>Results: </strong>Compared with the G0 group, fractional anisotropy (FA) and normalized quantitative anisotropy (NQA) values were significantly decreased in G1 (P < 0.05). Conversely, mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values were significantly increased bilaterally in G1 (P < 0.05). No significant differences were observed in other post-RT groups. No significant differences in generalized fractional anisotropy (GFA) values were observed between the pre-RT and any post-RT groups. Compared with the G0 group, effect-size analysis demonstrated that the largest effect sizes were present in G1. Effect sizes were generally smaller in G2. In G3, effect sizes were predominantly small to moderate.</p><p><strong>Conclusions: </strong>DTI and GQI together exhibit the potential to serve as a biomarker of detecting microstructural alterations in the white matter of the anterior visual pathway before visible changes appear on conventional MR images, enabling a better understanding of radiation-induced injury.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}