Polish journal of radiology最新文献

{"title":"Fibrosis-4 and Fibrosis-5 scores in predicting functional liver imaging score.","authors":"Gülsüm Kılıçkap, Numan Ilteris Çevik","doi":"10.5114/pjr/208327","DOIUrl":"10.5114/pjr/208327","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatic fibrosis can be predicted using fibrosis-4 (FIB-4) and fibrosis-5 (FIB-5) scores. Functional liver imaging score (FLIS) provides valuable information regarding hepatic function. We aimed to assess whether easily obtained blood parameters (FIB-4 and FIB-5) may be used to discriminate preserved and impaired hepatic function based on FLIS.</p><p><strong>Material and methods: </strong>Patients who underwent dynamic upper abdominal MRI with gadoxetic acid were retrospectively reviewed (<i>n</i> = 101, mean age 61.0 ± 11.3 years). FLIS values were categorized as FLIS < 4 (impaired hepatic function) and FLIS ≥ 4 (preserved hepatic function). The discriminative potential of FIB-4 and FIB-5 was assessed by plotting ROC curves.</p><p><strong>Results: </strong>While FIB-4 was significantly higher, FIB-5 was significantly lower in patients with FLIS < 4. They had significant discriminative value in distinguishing patients with preserved and impaired hepatic function (area under the ROC curves 0.794 for FIB-4 and 0.748 for FIB-5, <i>p</i>-values < 0.001). Comparison of the area under the 2 ROC curves revealed that FIB-4 and FIB-5 had similar discriminative values (<i>p</i> = 0.405). For FIB-4, a cut-off value of 4.2 had a sensitivity of 88.9%, specificity of 66.3%, PPV of 20.5%, and NPV of 98.4%, meaning that FIB-4 values of < 4.2 are valuable in ruling out FLIS < 4 (poor hepatic function). For FIB-5, a cut-off value of 36.2 had a sensitivity of 88.9%, specificity of 60.9%, PPV of 18.2%, and NPV of 98.2%, meaning that FIB-5 values of > 36.2 are valuable in ruling out FLIS < 4.</p><p><strong>Conclusions: </strong>FIB-4 and FIB-5 are valuable in discriminating preserved and impaired hepatic function based on FLIS scoring with similar diagnostic performance.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e445-e450"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373501","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":"Impact of interventions in endovascular arteriovenous fistula created using the WavelinQ 4-F EndoAVF system on personalised vascular access strategy for patients with end-stage renal disease.","authors":"Vadym Matsibora, Tadeusz Roman Grochowiecki, Michał Macech, Pawel Zebrowski, Daniel Jarosz, Rafał Waldemar Maciąg, Magdalena Januszewicz, Jolanta Małyszko, Zbigniew Gałązka","doi":"10.5114/pjr/207739","DOIUrl":"10.5114/pjr/207739","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to evaluate the interventions in endoAVF created with the WavelinQ 4-F EndoAVF system to clarify the role of this method in personalised vascular access strategy for end-stage renal disease patients.</p><p><strong>Material and methods: </strong>Endovascular fistula creation was performed in 16 patients. The type of additional endovascular procedures during fistula creation was evaluated. Postoperative surgical and endovascular intervention was divided into maintenance and enhanced maturation procedures. The necessity of using assisted maturation was examined by Kaplan-Meier analysis, the rate of interventions per patients per year and evaluation of the type, time, and the relationship between intraoperative and postoperative interventions.</p><p><strong>Results: </strong>Access primary patency was significantly lower than access cumulative and functional patency (<i>p</i> < 0.001). During endoAVF creation 73.3% patients required 16 additional endovascular procedures. After endoAVF creation 73.3% patients needed endovascular 22 procedures and 20% underwent surgical interventions. Nine (81.8%) out of 11 patients required intravascular procedures due to lack of fistula maturation - 9 (45%) angioplasties and 11 (55%) vein embolisations. The postoperative venous embolisation rate was significantly dependent on vein embolisation during endoAVF creation (<i>p</i> < 0.04). After endoAVF creation significantly more patients - 11 (73.3%) - required endovascular interventions compared to 3 (20%) with surgical interventions (<i>p</i> < 0.01). Postoperative endovascular and surgical interventions was 0.09 and 0.02 per patients per year, respectively.</p><p><strong>Conclusions: </strong>Maturation of endoAVFs required significantly more endovascular than surgical interventions. Venous embolisation combined with fistula creation reduced postoperative embolisation.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e438-e444"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380609","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":"Is hepatosteatosis overlooked in ultrasound relying only on B-mode? The impact of incorporating the attenuation coefficient into the standard abdominal ultrasound protocol.","authors":"Paweł Polewiak, Maciej Cebula, Jakub Kufel, Cyprian Olchowy, Dawid Szkudłapski","doi":"10.5114/pjr/205808","DOIUrl":"10.5114/pjr/205808","url":null,"abstract":"<p><strong>Purpose: </strong>Metabolic dysfunction-associated steatotic liver disease is currently one of the most common forms of chronic liver disease. This study aimed to assess whether extending the standard abdominal ultrasound protocol with quantitative liver evaluation increased the number of detected cases of liver steatosis.</p><p><strong>Material and methods: </strong>This study was a retrospective cross-sectional comparison of the detectability of liver steatosis in a study group of 108 patients analysed using the attenuation coefficient, in relation to a matched control group assessed qualitatively with B-mode.</p><p><strong>Results: </strong>Quantitative assessment based on the attenuation coefficient detected more patients with liver steatosis than qualitative assessment based on B-mode. With visual assessment in B-mode, we missed a significant number of patients, mainly those with an S1 steatosis grade.</p><p><strong>Conclusions: </strong>The inclusion of quantitative liver evaluation in everyday practice seems justified, despite current problems with selecting the optimal assessment method and the lack of population-specific cut-off values.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e431-e437"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380587","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":"Attention-enhanced deep learning for cervical cytology: combining convolutional networks with multi-head attention and fuzzy logic.","authors":"Garima Verma, Anurag Barthwal","doi":"10.5114/pjr/207475","DOIUrl":"10.5114/pjr/207475","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical cancer continues to be one of the leading causes of death among females worldwide, and thus early diagnosis by using more advanced diagnostic procedures is crucial. The conventional Pap-smear procedure is accurate but subject to human error; thus, computerised, standardised, and automated diagnosis becomes imperative. Herein we present a novel framework of a fuzzy distance-based ensemble of convolutional neural networks (CNNs) for efficient cervical cancer classification from Pap-smear images.</p><p><strong>Material and methods: </strong>The proposed approach integrates 5 models of CNN - Simple CNN, InceptionV3, Xception, Xception with Attention, and Inception Attention - via attention mechanisms to advance feature learning. A fuzzy distance-based aggregator function is introduced to fuse the predictions of these models optimally as per Euclidean, Manhattan, and cosine distance measures. Four advanced pre-processing techniques - wavelet denoising, contrast-limited adaptive histogram equalisation (CLAHE), background correction, and Laplacian sharpening - are employed to construct a cleaner dataset with enhanced image sharpness and segmentation.</p><p><strong>Results: </strong>Experimental outcomes prove that the model is significantly better than state-of-the-art approaches, with an accuracy of 94% on the original dataset and 98.3% on the pre-processed dataset.</p><p><strong>Conclusions: </strong>The method suggested herein has better noise robustness, interpretability through fuzzy logic, and automatic adaptation to various CNN frameworks without fine-tuning. These results acknowledge the promise of fuzzy logic-based CNN ensembles to improve machine-based cervical cancer diagnosis, which could be mapped to better and scalable diagnostic instruments in medical imaging.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e414-e430"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380556","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":"Preliminary experience with dynamic CT myocardial perfusion imaging: a single-centre perspective.","authors":"Agata Zdanowicz-Ratajczyk, Michał Puła, Adrian Korbecki, Michał Sobański, Maciej Guziński","doi":"10.5114/pjr/205451","DOIUrl":"10.5114/pjr/205451","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to optimise the dynamic coronary computed tomography perfusion (CTP) protocol, focusing on patient preparation, scanning parameters, and image acquisition, reconstruction, and interpretation. Future phases will evaluate the diagnostic accuracy of dynamic CTP in detecting haemodynamically significant coronary artery disease (CAD), using invasive coronary angiography (ICA) and fractional flow reserve (FFR) as reference standards.</p><p><strong>Material and methods: </strong>Thirty-six symptomatic patients with confirmed or suspected CAD underwent dynamic CTP using a whole-heart coverage CT scanner (Revolution Apex CT, GE Healthcare). Two patients were excluded due to non-diagnostic CTP results. Of the remaining 34 patients, 24 underwent both cardiac CT angiography (CCTA) and CTP, while 19 underwent CCTA, CTP, and ICA. Preliminary data were analysed by comparing CTP findings with CCTA and ICA/FFR when available.</p><p><strong>Results: </strong>Among 578 myocardial segments, 424 (73.3%) showed normal perfusion and 154 (26.6%) exhibited hypoperfusion. Of the 17 cases with perfusion deficits, ICA confirmed significant stenosis in 10, resulting in 100% sensitivity and 22% specificity for detecting haemodynamically significant stenosis. FFR assessment in 10 patients demonstrated 60% concordance between CTP, ICA, and FFR. Incorporating CTP into the diagnostic pathway led to a 29.4% reclassification in management strategies.</p><p><strong>Conclusions: </strong>The low specificity observed for detecting significant CAD underscores the need for further refinement of the CTP protocol. Future research should aim to optimise myocardial blood flow thresholds to improve diagnostic specificity and clinical applicability.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e404-e413"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373536","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":"Machine learning-based classification of multiple sclerosis lesion activity using multi-sequence MRI radiomics: a complete analysis of T1, T2, FLAIR, DWI, and SWI features.","authors":"Mohammadreza Elhaie, Masoud Etemadifar, Alireza Rezaei Adariani, Amir Khorasani, Daryoush Shahbazi-Gahrouei","doi":"10.5114/pjr/206986","DOIUrl":"10.5114/pjr/206986","url":null,"abstract":"<p><strong>Purpose: </strong>Differentiating active from non-active multiple sclerosis (MS) lesions is critical for disease management but often relies on gadolinium-enhanced magnetic resonance imaging (MRI), raising concerns about retention risks and costs. This study introduces a contrast-free, multi-sequence MRI approach using radiomics and machine learning to classify MS lesion activity.</p><p><strong>Material and methods: </strong>A total of 187 lesions from 31 MS patients (mean age 42.5 ± 11.3 years; 64.5% female) at Amin Hospital (November 2024 - February 2025) were retrospectively analysed using a 1.5 T MRI scanner. Five sequences - T1-weighted (T1W), T2-weighted (T2W), fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), and susceptibility-weighted imaging (SWI) - were processed to extract 8905 radiomic features, refined to 127 via correlation and recursive feature elimination. XGBoost classified lesions as active or non-active, validated on an internal test set (<i>n</i> = 28 lesions), with performance assessed by area under the receiver operating characteristic curve (AUC-ROC).</p><p><strong>Results: </strong>The XGBoost model achieved an AUC-ROC of 0.87 (95% CI: 0.82-0.92), sensitivity of 0.85, and specificity of 0.83, outperforming other classifiers (SVM AUC 0.84). FLAIR (35.4%) and T2W (28.3%) dominated feature contributions, with SWI (12.6%) enhancing accuracy (AUC dropped to 0.84 without SWI). Noise simulation (Gaussian σ = 0.1) confirmed robustness (AUC = 0.86).</p><p><strong>Conclusions: </strong>This integration of SWI with conventional sequences in a unified radiomic model offers a promising contrast-free alternative for MS lesion classification, achieving promising accuracy comparable to radiologist performance on an internal test set (<i>n</i> = 28 lesions), pending external validation. External validation is needed to confirm the generalisability, but this approach could reduce gadolinium reliance in clinical practice.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e394-e403"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373541","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":"Optimising strategies for artificial intelligence-assisted classification of viral pneumonias on CT imaging: a comparative study of selective and default approaches.","authors":"Francesco Rizzetto, Luca Berta, Giulia Zorzi, Francesca Travaglini, Diana Artioli, Luca Alessandro Carbonaro, Silvia Nerini Molteni, Chiara Vismara, Alberto Torresin, Paola Enrica Colombo, Angelo Vanzulli","doi":"10.5114/pjr/205344","DOIUrl":"10.5114/pjr/205344","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate how different artificial intelligence (AI)-powered approaches affect human performance in a demanding chest computed tomography (CT) task, such as distinguishing between viral pneumonias.</p><p><strong>Material and methods: </strong>Three radiologists blindly evaluated 220 chest CT scans of viral pneumonia cases (<i>n</i> = 151 COVID-19; <i>n</i> = 69 other viruses), classifying them with a probabilistic scoring system (COVID-19 Reporting and Data System - CO-RADS) in 2 phases: before (S1) and after (S2) receiving AI classifier results. Two S2 scenarios were investigated: a default approach, with AI predictions available for all cases, and a selective approach, with AI limited to equivocal S1 cases (CO-RADS = 3). Inter-reader agreement (Gwet's AC2) and diagnostic performance were analysed.</p><p><strong>Results: </strong>Radiologists demonstrated good-to-excellent agreement across all scenarios (AC2 = 0.77-0.81). Evaluation changes between S1 and S2 occurred in 18% of cases, with 29% of cases initially classified as CO-RADS = 3. In these equivocal cases, AI led to an average correct classification rate of 85%. Conversely, when radiologists were confident in their S1 diagnoses (CO-RADS ≠ 3), classification changes in S2 occurred in 7% of cases, preventing incorrect diagnoses in 45% of patients but resulting in missed correct classifications in 55%. Regarding diagnostic performance, S1 accuracy was 78%, with 15% of CO-RADS = 3 cases. In S2, under the default approach, accuracy increased to 81%, with 16% of CO-RADS = 3 cases, whereas the selective approach achieved 79% accuracy with only 10% of CO-RADS = 3 cases. Only the selective approach significantly reduced the proportion of equivocal cases (<i>p</i> < 0.009).</p><p><strong>Conclusions: </strong>A selective AI approach effectively reduces diagnostic uncertainty without introducing unnecessary complexity, emphasising its potential to optimise radiological workflows in challenging diagnostic scenarios.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e384-e393"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373559","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":"The use of ADC histogram analysis in the diagnosis and determination of aggressiveness of peripheral zone prostate cancer.","authors":"Halil İbrahim Şara, Hasan Aydin, Fatih Hizli","doi":"10.5114/pjr/205459","DOIUrl":"10.5114/pjr/205459","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine the effectiveness of ADC histogram analysis in diagnosing and determining the aggressiveness of peripheral zone (PZ) prostate cancer, and to reveal the relationship between Gleason and PI-RADS scores.Material and method: 61 patients who underwent standard 12-core and cognitive prostate biopsy and multiparametric prostate magnetic resonance imaging before biopsy were included in the study. According to the pathology results, patients were classified as either having clinically significant cancer with malignancy (<i>n</i> = 35) or as clinically insignificant - benign (<i>n</i> = 26). The effectiveness of ADC histogram parameters to distinguish between benign and malignant lesions was investigated. Subsequently, 35 patients in the malignant group were grouped according to their Gleason scores, and the relationship between ADC histogram parameters and Gleason scores was examined.</p><p><strong>Results: </strong>ADC max, standard deviation, entropy, voxel count, and volume were found to be significantly different between the benign and malignant groups (<i>p</i> < 0.05; <i>p</i> < 0.05; <i>p</i> < 0.01; <i>p</i> < 0.01; <i>p</i> < 0.01). According to the ROC curve: entropy (AUC = 0.75; 95% CI: 0.63-0.87), voxel count (AUC = 0.83; 95% CI: 0.73-0.93), and volume values (AUC = 0.83; 95% CI: 0.73-0.93) were statistically significant in the diagnosis of benign and malignant lesions in the prostate gland (area under the ROC curves). In the logistic regression analysis models (backward), it was found that an increase in volume increased the risk of malignant tumours by 1.75 times (<i>p</i> = 0.04; OR = 1.75; 95% CI: 1.00-3.04).</p><p><strong>Conclusions: </strong>ADC histogram data contribute to the diagnosis of benign-malignant differentiation in PZ prostate lesions and predict the Gleason score in malignant lesions.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e374-e383"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994992","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":"Rare complications of Crohn's disease - a series of three cases.","authors":"Filip Kwiatkowski, Marcin Łubiński, Piotr Kowalski, Ewa Walecka-Kapica, Anita Gąsiorowska, Agata Majos","doi":"10.5114/pjr/204062","DOIUrl":"10.5114/pjr/204062","url":null,"abstract":"<p><p>Crohn's disease (CD) is an increasingly common disease in clinical practice. The progress of medicine, which has resulted in an extension of the survival time of patients, the introduction of new treatment methods, and the nature of the disease itself means that we are seeing more and more new, unusual complications of this disease. We have reviewed three cases of rare complications of CD, with a focus on possible atypical complications that may be seen on imaging studies. Complications of CD and its treatment can occur in various organs and systems, and manifest in very non-specific ways. If unnoticed, they can be even life-threatening; therefore, it is important in clinical practice to take into account the possibility of their presence when evaluating patients with CD. When assessing radiological examinations of these people, we should take into account the possibility of atypical signs and radiographic features, and consider whether they may be related to the underlying disease.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e367-e373"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995041","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":"Impact of the ADMIRE reconstruction algorithm combined with the Sa36 kernel on quantitative measurement of coronary artery calcification in AI: a single-arm prospective study.","authors":"Huayang Du, Quanyu He, Jia Ren, Nan Jiang, Yanling Wang, Guisong Yang, Fei Han, Huahu Xu","doi":"10.5114/pjr/205465","DOIUrl":"10.5114/pjr/205465","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate quantification of coronary artery calcium (CAC) via computed tomography (CT) imaging is essential for effective cardiovascular risk assessment. This study investigates the impact of different iteration levels in the advanced model-based iterative reconstruction (ADMIRE) algorithm on artificial intelligence-driven CAC quantification and subsequent risk stratification, with filtered back projection (FBP) serving as the reference.</p><p><strong>Material and methods: </strong>For 254 patients undergoing coronary CT angiography (120 kVp, automated tube current), raw data were reconstructed using FBP and ADMIRE levels 1-5 (kernel Sa36, 3.0 mm slice thickness, 1.5 mm spacing). AI-derived CAC parameters (volume, mass, Agatston score) and risk stratification were compared across reconstruction groups. Statistical analysis employed the Friedman test, one-way analysis of variance, and c² test.</p><p><strong>Results: </strong>Compared to FBP, ADMIRE 1-5 reduced image noise by 9.70% to 49.76% (noise: 14.95 ± 2.26 HU vs. 7.55 ± 1.40 HU, <i>F</i> = 455.105, <i>p</i> < 0.001). Maximum CAC CT values progressively decreased with higher ADMIRE levels (FBP: 458.50 [306.00-645.00] HU vs. ADMIRE 5: 432.50 [281.75-620.75] HU; χ² = 455.105, <i>p</i> < 0.001). CAC volume, mass, and Agatston scores declined significantly (<i>p</i> < 0.001 for all): volume decreased by 8.56-32.55% (FBP: 47.56 ± 5.93 mm³ vs. ADMIRE 5: 21.77 ± 3.46 mm³; <i>F</i> = 32.310); mass decreased by 8.73-32.57% (<i>F</i> = 29.477); and Agatston scores decreased by 8.77-33.13% (<i>F</i> = 31.104). Risk stratification shifted in 24/161 patients (14.91%) with detectable CAC. The effective radiation dose was 0.61 ± 0.18 mSv.</p><p><strong>Conclusions: </strong>ADMIRE reconstruction reduces image noise but progressively lowers CAC quantification (volume, mass, Agatston score) and maximum CT values, leading to underestimation of cardiovascular risk in a subset of patients. Caution is warranted when applying ADMIRE iterative reconstruction for CAC scoring.</p>","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"90 ","pages":"e356-e366"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994924","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}