Cancer Imaging最新文献

{"title":"LI-RADS-based hepatocellular carcinoma risk mapping using contrast-enhanced MRI and self-configuring deep learning.","authors":"Róbert Stollmayer, Selda Güven, Christian Marcel Heidt, Kai Schlamp, Pál Novák Kaposi, Oyunbileg von Stackelberg, Hans-Ulrich Kauczor, Miriam Klauss, Philipp Mayer","doi":"10.1186/s40644-025-00844-6","DOIUrl":"10.1186/s40644-025-00844-6","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is often diagnosed using gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI). Standardized reporting according to the Liver Imaging Reporting and Data System (LI-RADS) can improve Gd-MRI interpretation but is rather complex and time-consuming. These limitations could potentially be alleviated using recent deep learning-based segmentation and classification methods such as nnU-Net. The study aims to create and evaluate an automatic segmentation model for HCC risk assessment, according to LI-RADS v2018 using nnU-Net.</p><p><strong>Methods: </strong>For this single-center retrospective study, 602 patients at risk for HCC were included, who had dynamic EOB-MRI examinations between 05/2005 and 09/2022, containing ≥ LR-3 lesion(s). Manual lesion segmentations in semantic segmentation masks as LR-3, LR-4, LR-5 or LR-M served as ground truth. A set of U-Net models with 14 input channels was trained using the nnU-Net framework for automatic segmentation. Lesion detection, LI-RADS classification, and instance segmentation metrics were calculated by post-processing the semantic segmentation outputs of the final model ensemble. For the external evaluation, a modified version of the LiverHccSeg dataset was used.</p><p><strong>Results: </strong>The final training/internal test/external test cohorts included 383/219/16 patients. In the three cohorts, LI-RADS lesions (≥ LR-3 and LR-M) ≥ 10 mm were detected with sensitivities of 0.41-0.85/0.40-0.90/0.83 (LR-5: 0.85/0.90/0.83) and positive predictive values of 0.70-0.94/0.67-0.88/0.90 (LR-5: 0.94/0.88/0.90). F1 scores for LI-RADS classification of detected lesions ranged between 0.48-0.69/0.47-0.74/0.84 (LR-5: 0.69/0.74/0.84). Median per lesion Sørensen-Dice coefficients were between 0.61-0.74/0.52-0.77/0.84 (LR-5: 0.74/0.77/0.84).</p><p><strong>Conclusion: </strong>Deep learning-based HCC risk assessment according to LI-RADS can be implemented as automatically generated tumor risk maps using out-of-the-box image segmentation tools with high detection performance for LR-5 lesions. Before translation into clinical practice, further improvements in automatic LI-RADS classification, for example through large multi-center studies, would be desirable.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"36"},"PeriodicalIF":3.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based fully automated detection and segmentation of pelvic lymph nodes on diffusion-weighted images for prostate cancer: a multicenter study.","authors":"Zhaonan Sun, Pengsheng Wu, Tongtong Zhao, Ge Gao, Huihui Wang, Xiaodong Zhang, Xiaoying Wang","doi":"10.1186/s40644-025-00840-w","DOIUrl":"10.1186/s40644-025-00840-w","url":null,"abstract":"<p><strong>Background: </strong>Accurate identification and evaluation of lymph nodes (LNs) in prostate cancer (PCa) patients is crucial for effective staging but can be time-consuming. We utilized a 3D V-Net model to improve the efficiency and accuracy of LN detection and segmentation.</p><p><strong>Methods: </strong>Utilizing pelvic diffusion-weighted imaging (DWI) scans, the 3D V-Net framework underwent training on a dataset comprising data from a hospital with 1,151 patients, encompassing 32,507 annotated LNs, following data augmentation procedures. Subsequently, external validation was conducted on data from 401 patients across three additional hospitals, encompassing 7,707 LNs. The segmentation performance was evaluated using the Dice similarity coefficient (DSC). The comparison between automated and manual segmentation regarding the short diameter and volume of LNs was conducted using Bland-Altman plots and correlation analysis. The performance for suspicious metastatic LN detection (short diameter > 8 mm) was evaluated using sensitivity, positive predictive value (PPV), and per-patient false-positive rate (FP/vol) at the LN level and sensitivity, specificity, and PPV at the patient level.</p><p><strong>Results: </strong>In the external validation test dataset, the model achieved a DSC of 0.77-0.82 for all, suspicious, and largest LNs. The model achieved a sensitivity, PPV, and FP/vol of 60.1% (95% confidence interval (CI), 57.6-62.6%), 79.2% (95% CI, 76.6-81.5%), and 0.56 at the LN level, respectively. At the patient level, the model achieved a sensitivity, specificity, and PPV of 81.1% (95% CI, 76.5-85.0%), 75.6% (95% CI, 65.1-83.8%), and 93.2% (95% CI, 89.7-95.6%), respectively. The model achieved a strong correlation and good consistency between the short diameter and volume of the automatically segmented and manually annotated LNs.</p><p><strong>Conclusion: </strong>This 3D V-Net model can segment LNs effectively based on pelvic DWI images for PCa and holds great potential for facilitating N-staging in clinical practice.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"37"},"PeriodicalIF":3.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of a deep learning framework for pelvic and sacral tumor segmentation from multi-sequence MRI: a retrospective study.","authors":"Ping Yin, Weidao Chen, Qianrui Fan, Ruize Yu, Xia Liu, Tao Liu, Dawei Wang, Nan Hong","doi":"10.1186/s40644-025-00850-8","DOIUrl":"10.1186/s40644-025-00850-8","url":null,"abstract":"<p><strong>Background: </strong>Accurate segmentation of pelvic and sacral tumors (PSTs) in multi-sequence magnetic resonance imaging (MRI) is essential for effective treatment and surgical planning.</p><p><strong>Purpose: </strong>To develop a deep learning (DL) framework for efficient segmentation of PSTs from multi-sequence MRI.</p><p><strong>Materials and methods: </strong>This study included a total of 616 patients with pathologically confirmed PSTs between April 2011 to May 2022. We proposed a practical DL framework that integrates a 2.5D U-net and MobileNetV2 for automatic PST segmentation with a fast annotation strategy across multiple MRI sequences, including T1-weighted (T1-w), T2-weighted (T2-w), diffusion-weighted imaging (DWI), and contrast-enhanced T1-weighted (CET1-w). Two distinct models, the All-sequence segmentation model and the T2-fusion segmentation model, were developed. During the implementation of our DL models, all regions of interest (ROIs) in the training set were coarse labeled, and ROIs in the test set were fine labeled. Dice score and intersection over union (IoU) were used to evaluate model performance.</p><p><strong>Results: </strong>The 2.5D MobileNetV2 architecture demonstrated improved segmentation performance compared to 2D and 3D U-Net models, with a Dice score of 0.741 and an IoU of 0.615. The All-sequence model, which was trained using a fusion of four MRI sequences (T1-w, CET1-w, T2-w, and DWI), exhibited superior performance with Dice scores of 0.659 for T1-w, 0.763 for CET1-w, 0.819 for T2-w, and 0.723 for DWI as inputs. In contrast, the T2-fusion segmentation model, which used T2-w and CET1-w sequences as inputs, achieved a Dice score of 0.833 and an IoU value of 0.719.</p><p><strong>Conclusions: </strong>In this study, we developed a practical DL framework for PST segmentation via multi-sequence MRI, which reduces the dependence on data annotation. These models offer solutions for various clinical scenarios and have significant potential for wide-ranging applications.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"34"},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intratumoral and peritumoral CT radiomics in predicting anaplastic lymphoma kinase mutations and survival in patients with lung adenocarcinoma: a multicenter study.","authors":"Weiyue Chen, Guihan Lin, Ye Feng, Yongjun Chen, Yanjun Li, Jianbin Li, Weibo Mao, Yang Jing, Chunli Kong, Yumin Hu, Minjiang Chen, Shuiwei Xia, Chenying Lu, Jianfei Tu, Jiansong Ji","doi":"10.1186/s40644-025-00856-2","DOIUrl":"10.1186/s40644-025-00856-2","url":null,"abstract":"<p><strong>Background: </strong>To explore the value of intratumoral and peritumoral radiomics in preoperative prediction of anaplastic lymphoma kinase (ALK) mutation status and survival in patients with lung adenocarcinoma.</p><p><strong>Methods: </strong>We retrospectively collected data from 505 eligible patients with lung adenocarcinoma from four hospitals (training and external validation sets 1-3). The CT-based radiomics features were extracted separately from the gross tumor volume (GTV) and GTV incorporating peritumoral 3-, 6-, 9-, 12-, and 15-mm regions (GPTV₃, GPTV₆, GPTV₉, GPTV₁₂, and GPTV₁₅), and screened the most relevant features to construct radiomics models to predict ALK (+). The combined model incorporated radiomics scores (Rad-scores) of the best radiomics model and clinical predictors was constructed. Performance was evaluated using receiver operating characteristic (ROC) analysis. Progression-free survival (PFS) outcomes were examined using the Cox proportional hazards model.</p><p><strong>Results: </strong>In the four sets, 21.19% (107/505) patients were ALK (+). The GPTV₃ radiomics model using a support vector machine algorithm achieved the best predictive performance, with the highest average AUC of 0.811 in the validation sets. Clinical TNM stage and pleural indentation were independent predictors. The combined model incorporating the GPTV₃-Rad-score and clinical predictors achieved higher performance than the clinical model alone in predicting ALK (+) in three validation sets [AUC: 0.855 (95% CI: 0.766-0.919) vs. 0.648 (95% CI: 0.543-0.745), P = 0.001; 0.882 (95% CI: 0.801-0.962) vs. 0.634 (95% CI: 0.548-0.714), P < 0.001; 0.810 (95% CI: 0.727-0.877) vs. 0.663 (95% CI: 0.570-0.748), P = 0.006]. The prediction score of the combined model could stratify PFS outcomes in patients receiving ALK-TKI therapy (HR: 0.37; 95% CI: 0.15-0.89; P = 0.026) and immunotherapy (HR: 2.49; 95% CI: 1.22-5.08; P = 0.012).</p><p><strong>Conclusion: </strong>The presented combined model based on GPTV₃ effectively mined tumor features to predict ALK mutation status and stratify PFS outcomes in patients with lung adenocarcinoma.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"35"},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in diffusion weighted imaging after induction chemotherapy outperforms RECIST guideline for long-term outcome prediction in advanced nasopharyngeal carcinoma.","authors":"Qi Yong H Ai, Ho Sang Leung, Frankie K F Mo, Kaijing Mao, Lun M Wong, Yannis Yan Liang, Edwin P Hui, Brigette B Y Ma, Ann D King","doi":"10.1186/s40644-025-00854-4","DOIUrl":"10.1186/s40644-025-00854-4","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate change in diffusion weighted imaging (DWI) between pre-treatment (pre-) and after induction chemotherapy (post-IC) for long-term outcome prediction in advanced nasopharyngeal carcinoma (adNPC).</p><p><strong>Materials and methods: </strong>Mean apparent diffusion coefficients (ADCs) of two DWIs (ADC_pre and ADC_post-IC) and changes in ADC between two scans (ΔADC%) were calculated from 64 eligible patients with adNPC and correlated with disease free survival (DFS), locoregional recurrence free survival (LRRFS), distant metastases free survival (DMFS), and overall survival (OS) using Cox regression analysis. C-indexes of the independent parameters for outcome were compared with that of RECIST response groups. Survival rates between two patient groups were evaluated and compared.</p><p><strong>Results: </strong>Univariable analysis showed that high ΔADC% predicted good DFS, LRRFS, and DMFS p < 0.05), but did not predict OS (p = 0.40). Neither ADC_pre nor ADC_post-IC (p = 0.07 to 0.97) predicted outcome. Multivariate analysis showed that ΔADC% independently predicted DFS, LRRFS, and DMFS (p < 0.01 to 0.03). Compared with the RECIST groups, the ΔADC% groups (threshold of 34.2%) showed a higher c-index for 3-year (0.47 vs. 0.71, p < 0.01) and 5-year DFS (0.51 vs. 0.72, p < 0.01). Compared with patients with ΔADC%<34.2%, patients with ΔADC%≥34.2% had higher 3-year DFS, LRRFS and DMFS of 100%, 100% and 100%, respectively (p < 0.05).</p><p><strong>Conclusion: </strong>Results suggest that ΔADC% was an independent predictor for long-term outcome and was superior to RECIST guideline for outcome prediction in adNPC. A ΔADC% threshold of ≥ 34.2% may be valuable for selecting patients who respond to treatment for de-escalation of treatment or post-treatment surveillance.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"32"},"PeriodicalIF":3.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robust vs. Non-robust radiomic features: the quest for optimal machine learning models using phantom and clinical studies.","authors":"Seyyed Ali Hosseini, Ghasem Hajianfar, Brandon Hall, Stijn Servaes, Pedro Rosa-Neto, Pardis Ghafarian, Habib Zaidi, Mohammad Reza Ay","doi":"10.1186/s40644-025-00857-1","DOIUrl":"10.1186/s40644-025-00857-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to select robust features against lung motion in a phantom study and use them as input to feature selection algorithms and machine learning classifiers in a clinical study to predict the lymphovascular invasion (LVI) of non-small cell lung cancer (NSCLC). The results of robust features were also compared with conventional techniques without considering the robustness of radiomic features.</p><p><strong>Methods: </strong>An in-house developed lung phantom was developed with two 22mm lesion sizes based on a clinical study. A specific motor was built to simulate motion in two orthogonal directions. Lesions of both clinical and phantom studies were segmented using a Fuzzy C-means-based segmentation algorithm. After inducing motion and extracting 105 radiomic features in 4 feature sets, including shape, first-, second-, and higher-order statistics features from each region of interest (ROI) of the phantom image, statistical analyses were performed to select robust features against motion. Subsequently, these robust features and a total of 105 radiomic features were extracted from 126 clinical data. Various feature selection (FS) and multiple machine learning (ML) classifiers were implemented to predict the LVI of NSCLC, followed by comparing the results of predicting LVI using robust features with common conventional techniques not considering the robustness of radiomic features.</p><p><strong>Results: </strong>Our results demonstrated that selecting robust features as input to FS algorithms and ML classifiers surges the sensitivity, which has a gentle negative effect on the accuracy and the area under the curve (AUC) of predictions compared with commonly used methods in 12 of 15 outcomes. The top performance of the LVI prediction was achieved by the NB classifier and RFE FS without considering the robustness of radiomic features with 95% area under the curve of AUC, 67% accuracy, and 100% sensitivity. Moreover, the top performance of the LVI prediction using robust features belonged to the NB classifier and Boruta feature selection with 92% AUC, 86% accuracy, and 100% sensitivity.</p><p><strong>Conclusion: </strong>Robustness over various influential factors is critical and should be considered in a radiomic study. Selecting robust features is a solution to overcome the low reproducibility of radiomic features. Although setting robust features against motion in a phantom study has a minor negative impact on the accuracy and AUC of LVI prediction, it boosts the sensitivity of prediction to a large extent.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"33"},"PeriodicalIF":3.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An interpretable machine learning model based on computed tomography radiomics for predicting programmed death ligand 1 expression status in gastric cancer.","authors":"Lihuan Dai, Jinxue Yin, Xin Xin, Chun Yao, Yongfang Tang, Xiaohong Xia, Yuanlin Chen, Shuying Lai, Guoliang Lu, Jie Huang, Purong Zhang, Jiansheng Li, Xiangguang Chen, Xi Zhong","doi":"10.1186/s40644-025-00855-3","DOIUrl":"10.1186/s40644-025-00855-3","url":null,"abstract":"<p><strong>Background: </strong>Programmed death ligand 1 (PD-L1) expression status, closely related to immunotherapy outcomes, is a reliable biomarker for screening patients who may benefit from immunotherapy. Here, we developed and validated an interpretable machine learning (ML) model based on contrast-enhanced computed tomography (CECT) radiomics for preoperatively predicting PD-L1 expression status in patients with gastric cancer (GC).</p><p><strong>Methods: </strong>We retrospectively recruited 285 GC patients who underwent CECT and PD-L1 detection from two medical centers. A PD-L1 combined positive score (CPS) of ≥ 5 was considered to indicate a high PD-L1 expression status. Patients from center 1 were divided into training (n = 143) and validation sets (n = 62), and patients from center 2 were considered a test set (n = 80). Radiomics features were extracted from venous-phase CT images. After feature reduction and selection, 11 ML algorithms were employed to develop predictive models, and their performance in predicting PD-L1 expression status was evaluated using areas under receiver operating characteristic curves (AUCs). SHapley Additive exPlanations (SHAP) were used to interpret the optimal model and visualize the decision-making process for a single individual.</p><p><strong>Results: </strong>Nine features significantly associated with PD-L1 expression status were ultimately selected to construct the predictive model. The light gradient-boosting machine (LGBM) model demonstrated the best performance for PD-L1 high expression status prediction in the training, validation, and test sets, with AUCs of 0.841(95% CI: 0.773, 0.908), 0.834 (95% CI:0.729, 0.939), and 0.822 (95% CI: 0.718, 0.926), respectively. The SHAP summary and bar plots illustrated that a feature's value affected the feature's impact attributed to the model. The SHAP waterfall plots were used to visualize the decision-making process for a single individual.</p><p><strong>Conclusion: </strong>Our CT radiomics-based LGBM model may aid in preoperatively predicting PD-L1 expression status in GC patients, and the SHAP method may improve the interpretability of this model.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"31"},"PeriodicalIF":3.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of whole-body MRI instead of only brain MRI in addition to 18 F-FDG PET/CT in the staging of advanced non-small-cell lung cancer.","authors":"Hanna Holmstrand, M Lindskog, A Sundin, T Hansen","doi":"10.1186/s40644-025-00852-6","DOIUrl":"10.1186/s40644-025-00852-6","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is a common neoplasm with poor prognosis in advanced stages. The clinical work-up in patients with locally advanced NSCLC mostly includes ¹⁸F-fluorodeoxyglucose positron emission tomography computed tomography (¹⁸F-FDG PET/CT) because of its high sensitivity for malignant lesion detection; however, specificity is lower. Diverging results exist whether whole-body MRI (WB-MRI) improves the staging accuracy in advanced lung cancer. Considering WB-MRI being a more time-consuming examination compared to brain MRI, it is important to establish whether or not additional value is found in detecting and characterizing malignant lesions. The purpose of this study is to investigate the value of additional whole-body magnetic resonance imaging, instead of only brain MRI, together with ¹⁸F-FDG PET/CT in staging patients with advanced NSCLC planned for curative treatment.</p><p><strong>Material and methods: </strong>In a prospective single center study, 28 patients with NSCLC stage 3 or oligometastatic disease were enrolled. In addition to ¹⁸F-FDG PET/CT, they underwent WB-MRI including the thorax, abdomen, spine, pelvis, and contrast-enhanced examination of the brain and liver. ¹⁸F-FDG PET/CT and WB-MRI were separately evaluated by two blinded readers, followed by consensus reading in which the likelihood of malignancy was assessed in detected lesions. Imaging and clinical follow-up for at least 12 months was used as reference standard. Statistical analyses included Fischer's exact test and Clopped-Pearson.</p><p><strong>Results: </strong>28 patients (mean age ± SD 70.5 ± 8.4 years, 19 women) were enrolled. WB-MRI and FDG-PET/CT both showed maximum sensitivity and specificity for primary tumor diagnosis and similar sensitivity (p = 1.00) and specificity (p = 0.70) for detection of distant metastases. For diagnosis of lymph node metastases, WB-MRI showed lower sensitivity, 0.65 (95% CI: 0.38-0.86) than FDG-PET/CT, 1.00 (95% CI: 0.80-1.00) (p < 0.05), but similar specificity (p = 0.59).</p><p><strong>Conclusions: </strong>WB-MRI in conjunction with ¹⁸F-FDG PET/CT provides no additional value over MRI of the brain only, in staging patients with advanced NSCLC.</p><p><strong>Trial registration: </strong>Registered locally and approved by the Uppsala University Hospital committee, registration number ASMR020.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"30"},"PeriodicalIF":3.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additional findings in prostate MRI.","authors":"Fabio Porões, Paraskevi Karampa, Thomas Sartoretti, Hugo Najberg, Johannes M Froehlich, Carolin Reischauer, Harriet C Thoeny","doi":"10.1186/s40644-025-00846-4","DOIUrl":"10.1186/s40644-025-00846-4","url":null,"abstract":"<p><strong>Background: </strong>Despite the increasing interest in abbreviated protocols, we adopted an extended protocol for all prostate MRIs. In this study, we assessed the benefits of an extended prostate MRI protocol, measured by the number and the clinical importance of additional findings (AFs) and their impact on patient management.</p><p><strong>Methods: </strong>In a single-center study, we retrospectively included 1282 patients undergoing prostate MRI between 01.10.2018 and 30.04.2022. Additional findings were defined as any pathology not located in the prostate or the seminal vesicles. These were classified as related or unrelated to prostate cancer (PCa). The latter were divided into groups based on low, moderate, or high clinical significance (group 1, 2, and 3). A finding unrelated to PCa was judged to be clinically significant (group 2: moderate, group 3: high) if further diagnostic investigations, or treatment was necessary. The degree of urgency of the latter determined moderate and high significance. For group 3 findings, a change in management was defined as further workup.</p><p><strong>Results: </strong>A total of 5206 AFs was recorded in 1240/1282 patients. One hundred and twenty-three (2.4% of all findings) extra-prostatic PCa related AFs were found in 106 (8.3% of all patients) patients. The remaining 5083 (97.6% of all findings) findings were not related to PCa, of which 3155 (60.6%), 1770 (34.0%), and 158 (3.0%) were assigned to groups 1, 2, and 3, respectively. A management shift was identified in 49 (3.8% of all patients) patients of group 3.</p><p><strong>Conclusion: </strong>The extended prostate MRI protocol shows a considerable prevalence of AFs of which more than a third are clinically significant, related or unrelated to PCa (groups 2 and 3). A substantial percentage (8.3%) of patients have extra-prostatic PCa-related AFs that change the patient's disease stage and management. However, a change in management due to AFs unrelated to PCA that belong to group 3 is observed in less than 4% of all patients. The choice between extended and abbreviated prostate MRI protocols should be made based on available resources.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"29"},"PeriodicalIF":3.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative optimization of greater omentum imaging report and data system for enhanced risk stratification of omental lesions.","authors":"Zhiguang Chen, Liang Sang, Yuan Cheng, Xuemei Wang, Mutian Lv, Yanjun Liu, ZhiQun Bai","doi":"10.1186/s40644-025-00848-2","DOIUrl":"10.1186/s40644-025-00848-2","url":null,"abstract":"<p><strong>Background: </strong>In 2020, we introduced the Greater Omentum Imaging-Reporting and Data System (GOI-RADS), a novel classification system related to peritoneal lesions. However, its clinical application remained unvalidated.</p><p><strong>Objective: </strong>This study aimed to validate GOI-RADS, optimize its parameters for a new grading system, and explore its clinical usefulness.</p><p><strong>Methods: </strong>A retrospective-prospective study was conducted to validate and refine the GOI-RADS system. The study consisted of two phases: a retrospective validation phase and a prospective application phase. The first phase included patients with peritoneal lesions from 2019 to 2021, classified by GOI-RADS and verified against pathology. Contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) data were collected for developing a new grading system. Odds ratios optimized parameters. The second phase (2021-2024) assessed diagnostic consistency among sonographers and performance of grading systems.</p><p><strong>Results: </strong>Among 215 patients with peritoneal lesions, the actual malignancy rates for GOI-RADS 2 (40.00%) and GOI-RADS 3 (61.22%) were much higher than predicted (5.56% and 37.25%). Combining CEUS and RTE parameters showed varying sensitivity and specificity: RTE + GOI-RADS (95.35%, 55.56%) and CEUS + GOI-RADS (96.51%, 44.44%). However, the grading system based on multiple ultrasound parameters, specifically when incorporating RTE, CEUS parameters, and GOI-RADS (Multi-GOIRADS), exhibited the highest diagnostic sensitivity and specificity of 88.37% and 83.33%, respectively. Its simplified version, sMulti-GOIRADS, had sensitivity of 73.26% and specificity of 94.44%. In the prospective study involving three sonographers of different qualifications, the use of sMulti-GOIRADS was found to be the most time-efficient and showed excellent diagnostic consistency among them. In contrast, Multi-GOIRADS required more time for scoring but offered superior diagnostic performance, particularly among senior sonographers (88.35% and 91.43%).</p><p><strong>Conclusions: </strong>This study proposes a multiparametric ultrasound-based imaging-reporting and data system for risk stratification of omental malignancy, Multi-GOIRADS, and presents an optimized and simplified version, sMulti-GOIRADS, which demonstrates excellent diagnostic consistency and performance in clinical applications.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"28"},"PeriodicalIF":3.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}