Predicting the outcome of asymptomatic univesicular liver hydatids: diagnostic accuracy of unenhanced CT
ConclusionsThe presence of either LMD or PDCs on unenhanced CT, in incidentally discovered asymptomatic univesicular liver hydatids, was associated with a high probability of a favorable outcome. Their absence does not rule out a favorable outcome.Key Points• Computed tomography can be used for predicting the outcome of those with incidentally discovered univesicular liver hydatids.• The presence of laminated membrane detachment and/or pericyst degenerative changes is associated with a favorable outcome.• Their absence does not necessarily indicate an unfavorable outcome. (Source: European Radiology)
Source: European Radiology - January 16, 2021 Category: Radiology Source Type: research

Mean apparent diffusion coefficient in a single slice may predict tumor response to whole-brain radiation therapy in non-small-cell lung cancer patients with brain metastases
This study aimed to access the performance of apparent diffusion coefficient (ADC) as a predictor for treatment response to whole-brain radiotherapy (WBRT) in patients with brain metastases (BMs) from non-small-cell lung cancer (NSCLC).MethodsA retrospective analysis was conducted of 102 NSCLC patients with BMs who underwent WBRT between 2012 and 2016. Diffusion-weighted MRI were performed pre-WBRT and within 12 weeks after WBRT started. Mean single-plane ADC value of ROIs was evaluated by two radiologists blinded to results of each other. The treatment response rate, intracranial progression-free survival (PFS), and overa...
Source: European Radiology - January 16, 2021 Category: Radiology Source Type: research

Predictors of moderate to severe ischemic mitral regurgitation after myocardial infarction: a cardiac magnetic resonance study
AbstractObjectivesThe purpose of this study is to explore the predictors of moderate to severe ischemic mitral regurgitation (IMR) after myocardial infarction with cardiovascular magnetic resonance (CMR).MethodsFrom January 2016 to September 2018, 109 patients (mean age 60  ± 8 years) with IMR were studied retrospectively. All patients underwent CMR-cine with True-FISP sequence and late gadolinium enhancement (LGE) with a phase-sensitive inversion recovery sequence. The presence of papillary muscle infarction (PMI), global left ventricular (LV) infarcted extent, LV functional parameters, and LV my...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Regional liver function analysis with gadoxetic acid –enhanced MRI and virtual hepatectomy: prediction of postoperative short-term outcomes for HCC
AbstractObjectivesTo explore the role of quantitative regional liver function assessed by preoperative gadoxetic acid –enhanced MRI with computer-aided virtual hepatectomy to predict short-term outcomes after major hepatectomy for HCC.MethodsWe retrospectively reviewed the records of 133 consecutive patients with HCC who underwent preoperative gadoxetic acid –enhanced MRI and indocyanine green (ICG) test. Forty-five patients received open major hepatectomy. Liver function reserve and the future liver remnant were evaluated by computer-aided virtual hepatectomy. Global liver functional parameters included the T1...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Automated quantitative MRI volumetry reports support diagnostic interpretation in dementia: a multi-rater, clinical accuracy study
ConclusionOur QReport referencing single-subject results to normative data alongside visual assessment improved sensitivity, accuracy, and interrater agreement for detecting volume loss. The QReport was most effective in the consultants, suggesting that experience is needed to fully benefit from the additional information provided by quantitative analyses.Key Points• The use of quantitative report alongside routine visual MRI assessment improves sensitivity and accuracy for detecting volume loss and AD vs visual assessment alone.• Consultant neuroradiologists’ assessment accuracy and agreement (kappa scores...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Survival outcomes for surgical resection versus CT-guided percutaneous ablation for stage I non-small cell lung cancer (NSCLC): a systematic review and meta-analysis
ConclusionSurgical resection of stage 1 NSCLC remains the optimal choice. However, for non-surgical patients with stage 1A, ablation offers promising DFS, CSS, and OS. Future prospective randomized controlled trials are warranted.Key Points• Surgical resection of stage 1 NSCLC remains the optimal choice.• In patients with stage 1A NSCLC who are not surgical candidates, CT-guided microwave or radiofrequency ablation may be an alternative which offers promising disease-free survival and overall survival. (Source: European Radiology)
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Patients undergoing multiphase CT scans and receiving a cumulative effective dose of ≥ 100 mSv in a single episode of care
ConclusionsThe finding of a sizeable percentage of patients undergoing CT exams and receiving CED ≥ 100 mSv in a single episode of care points toward the need of imaging appropriateness criteria, to revise the routine protocols, to replace older machines, and to provide to the radiologist the patient’s prior radiation history to facilitate an appropriate decision-making process.Key Points•Patients can receive effective doses greater than 100  mSv in a single CT or in multiple CT examinations performed in a single episode of care in 1.5% of patients in a 2.5-year period.•In this study, th...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Medical knowledge and clinical productivity: independently correlated metrics during radiology residency
This study analyzed the results of 6 DRPTs and time period –matched clinical production points of radiology residents affiliated to a tertiary care academic medical center between 2013 and 2016. The Spearman correlation analysis was performed to determine the association between DRPT percentile scores and average daily clinical production points. Linear r egression analyses were performed to determine the association of DRPT percentile scores with average daily clinical production points, adjusted for age and gender of the radiology resident, and postgraduate year.ResultsEighty-four DRPTs with time period –matc...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Diagnostic performance of loss of nigral hyperintensity on susceptibility-weighted imaging in parkinsonism: an updated meta-analysis
ConclusionsLoss of nigral hyperintensity on SWI can differentiate IPD or primary parkinsonism from a healthy/disease control group with high accuracy. However, the proportion of non-diagnostic scans is not negligible and must be taken into account.Key Points•For discrimination between idiopathic Parkinson ’s disease and healthy/disease controls, pooled sensitivity and specificity of loss of nigral hyperintensity were 0.96 and 0.95.•For discrimination between primary parkinsonism and healthy/disease controls, pooled sensitivity and specificity of loss of nigral hyperintensity were 0.87 and 0.93.•The poo...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Prognostic value of myocardial extracellular volume fraction evaluation based on cardiac magnetic resonance T1 mapping with T1 long and short in hypertrophic cardiomyopathy
AbstractObjectiveTo investigate the prognostic significance of T1 mapping using T1 long and short in hypertrophic cardiomyopathy (HCM) patients.MethodsA total of 263 consecutive patients with HCM referred for cardiovascular magnetic resonance (CMR) imaging were enrolled in this study. The imaging protocol consisted of cine, late gadolinium enhancement (LGE), and  T1 mapping with T1 long and short. All patients were followed up prospectively. Outcome events were divided into the primary and secondary endpoint events. Primary endpoint events included cardiac death, heart transplant, aborted sudden death, and cardio...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Imaging in scrotal trauma: a European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) position statement
AbstractImaging plays a crucial role in the evaluation of scrotal trauma. Among the imaging modalities, greyscale ultrasound and Colour Doppler ultrasound (CDUS) are the primary techniques with the selective utilisation of advanced techniques such as contrast-enhanced ultrasound (CEUS) and elastography. Despite ultrasound being the mainstay of imaging scrotal trauma, its diagnostic performance is not fully established. Considering these difficulties and their impact on clinical practice, the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology (ESUR-SPIWG) established an expert task forc...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Deep learning in breast radiology: current progress and future directions
AbstractThis review provides an overview of current applications of deep learning methods within breast radiology. The diagnostic capabilities of deep learning in breast radiology continue to improve, giving rise to the prospect that these methods may be integrated not only into detection and classification of breast lesions, but also into areas such as risk estimation and prediction of tumor responses to therapy. Remaining challenges include limited availability of high-quality data with expert annotations and ground truth determinations, the need for further validation of initial results, and unresolved medicolegal consi...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Comparison of diagnostic performance of the ACR and Kwak TIRADS applying the ACR TIRADS ’ size thresholds for FNA
ConclusionThe modified Kwak TIRADS incorporating the size thresholds of the ACR TIRADS showed higher diagnostic performance and a lower unnecessary FNA rate than the original point-scale based TIRADS.Key Points• Of the original guidelines, the ACR TIRADS had the highest specificity, accuracy, and area under the receiver operating characteristic curve (AUC) (63.1%, 68.9%, and 0.748, respectively).• When the size threshold of the ACR TIRADS was applied to the Kwak TIRADS, the resultant modified version of Kwak TIRADS had higher specificity, accuracy, and AUC (64.7%, 70.3%, and 0.765, respectively) than the ACR TIRA...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Performance of four dual-energy CT platforms for abdominal imaging: a task-based image quality assessment based on phantom data
ConclusionHighest detectability was found for DLCT for the lowest energy levels. The task-based image quality assessment used for the first time for DECT acquisitions showed the benefit of using low keV for the detection of contrast-enhanced lesions.Key Points• Detectability of both simulated contrast-enhanced lesions was higher for dual-layer CT for the lowest energy levels.• The image noise increased and the image texture changed for the lowest energy levels.• The detectability of both simulated contrast-enhanced lesions was highest at 40 keV for all dual-energy CT platforms except for fast kV-switching pl...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

CT diagnostic reference levels based on clinical indications: results of a large-scale European survey
ConclusionsThis is the first study reporting on feasibility of establishing CT DRLs based on CI using European data. Resulting values will serve as a baseline for comparison with local radiological practice, national authorities when DRLs are set/updated, or as a guideline for local DRL establishment.Key Points•First study reporting on the feasibility of establishing CT diagnostic reference levels based on clinical indication using data collected across Europe.•Only one-fourth of the hospitals had CT machines less than 5 years old.•Large dose variations were observed among hospitals and CT protocols were qui...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Location of embolization affects patency after coil embolization for pulmonary arteriovenous malformations: importance of time-resolved magnetic resonance angiography for diagnosis of patency
ConclusionsTR-MRA appears to be an appropriate method for follow-up examinations due to its high accuracy for the diagnosis of patency after coil embolization of PAVMs. The location of embolization is a factor affecting patency.Key Points• Diagnosis of patency after coil embolization for pulmonary arteriovenous malformations (PAVMs) is important because a patent PAVM can lead to neurologic complications.• The diagnostic accuracies of CT with a cutoff value of 55% and TR-MRA were 82% and 93%, respectively.• The positioning of the coils relative to the sac and the last normal branch of the artery was significa...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Rectal cancer with complete endoscopic response after neoadjuvant therapy: what is the meaning of a positive MRI?
ConclusionsAlthough most +DWI exams discordant with endoscopy are false positive, 22% will reveal that DWI-MRI detects tumor recurrence before endoscopy.Key Points• Most often, in post-treatment assessment for rectal cancer when DWI-MRI shows restriction in the tumor bed and endoscopy shows no tumor,+DWI MRI will be proven false positive.• Conversely, our study demonstrated that, allowing for sequential follow-up at a 3-month maximum interval, DWI-MRI may detect tumor presence in the treated tumor bed before endoscopy in 22% of discordant findings between DWI-MRI and endoscopy.• Our results showed that a maj...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Reliability and accuracy of time-resolved contrast-enhanced magnetic resonance angiography in hypervascular spinal metastases prior embolization
This study aimed to evaluate the reliability and accuracy of time-resolved contrast-enhanced magnetic resonance angiography (TR-CE-MRA) in assessing HSM prior to embolization.MethodsAll consecutive patients referred for preoperative embolization of an HSM were prospectively included. TR-CE-MRA sequences and selective IA-DSA were performed prior to embolization. Two readers independently reviewed imaging data to grade tumor vascularity (using a 3-grade and a dichotomized “yes vs no” scale) and identify the arterial supply of the spinal cord. Interobserver and intermodality agreements were estimated using kappa s...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Identifying response in colorectal liver metastases treated with bevacizumab: development of RECIST by combining contrast-enhanced and diffusion-weighted MRI
ConclusionsD-RECIST-defined responses provided significant prognostic information, and thus may serve as a better response evaluation approach than RECIST in CRLM treated with bevacizumab-containing therapy.Key Points•Changes in arterial enhancement area and apparent diffusion coefficient value are associated with pathological response in colorectal liver metastases treated with bevacizumab.•The MRI-based response criteria developed by combining size-based and functional features can provide significant prognostic information. (Source: European Radiology)
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Clinical and chest CT features as a predictive tool for COVID-19 clinical progress: introducing a novel semi-quantitative scoring system
ConclusionWe strongly recommend patients with age  ≥ 53, SpO2 ≤ 91, and PI score ≥ 8 or even only high PI score to be considered as high-risk patients for further managements and care plans.Key Points• Chest CT scan is a valuable tool in prioritizing the patients in hospital triage.• A more accurate and novel 35-scale semi-quantitative scoring system was designed to predict the COVID-19 patients’ outcome.• Patients with age ≥ 53, SpO2 ≤ 91, and PI score ≥ 8 or even only high PI score should be considered...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Prognostic implications of cardiac magnetic resonance feature tracking derived multidirectional strain in patients with chronic aortic regurgitation
AbstractObjectiveSpeckle-tracking echocardiography (STE) deformation parameters detect latent LV dysfunction in chronic aortic regurgitation (AR) and are associated with outcomes. The aim of the study was to evaluate cardiac magnetic resonance (CMR) feature tracking (FT) deformation parameters in asymptomatic patients with AR and implications in outcomes.MethodsFifty-five patients with AR and 54 controls were included. Conventional functional CMR parameters, aortic regurgitant volume, and fraction were assessed. CMR-FT analysis was performed with a dedicated software. Clinical data was obtained from hospital records. A com...
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Efficacy and safety of prostatic artery embolization for benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials
ConclusionPAE is non-inferior to TURP with regard to improving patient-reported outcomes, though most functional parameters undergo more changes after TURP than after PAE. Moreover, PAE can significantly continue to relieve symptoms for 24  months without causing serious complications.Key Points• PAE is as effective as TURP in improving subjective symptom scores, with fewer complications and shorter hospitalization times.• PAE is inferior to TURP in the improvement of most functional outcomes.• Improvements due to PAE are durable during follow-up to 24 months. (Source: European Radiology)
Source: European Radiology - January 15, 2021 Category: Radiology Source Type: research

Multi-scale and multi-parametric radiomics of gadoxetate disodium –enhanced MRI predicts microvascular invasion and outcome in patients with solitary hepatocellular carcinoma ≤ 5 cm
AbstractObjectivesTo develop radiomics-based nomograms for preoperative microvascular invasion (MVI) and recurrence-free survival (RFS) prediction in patients with solitary hepatocellular carcinoma (HCC) ≤ 5 cm.MethodsBetween March 2012 and September 2019, 356 patients with pathologically confirmed solitary HCC ≤ 5 cm who underwent preoperative gadoxetate disodium–enhanced MRI were retrospectively enrolled. MVI was graded as M0, M1, or M2 according to the number and distribution of invaded vessels. Radiomics features were extracted from DWI, arterial, portal venous, and hepatobiliary phase images in re gions of...
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

Preoperative classification of primary and metastatic liver cancer via machine learning-based ultrasound radiomics
ConclusionsMachine learning –based ultrasound radiomics features are able to non-invasively distinguish primary liver tumors from metastatic liver tumors.Key Points•Ultrasound-based radiomics was initially used for preoperative classification of primary versus metastatic liver cancer.•Multiple machine learning –based algorithms with cross-validation strategy were applied to extract machine learning–based ultrasound radiomics features.•Distinction between primary and metastatic tumors was obtained with a sensitivity of 0.768 and a specificity of 0.880. (Source: European Radiology)
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

Volumetric assessment of the periablational safety margin after thermal ablation of colorectal liver metastases
AbstractObjectivesTo retrospectively assess the periablational 3D safety margin in patients with colorectal liver metastases (CRLM) referred for stereotactic radiofrequency ablation (RFA) and to evaluate its influence on local treatment success.MethodsForty-five patients (31 males; mean age 64.5 [range 31 –87 years]) with 76 CRLM were treated with stereotactic RFA and retrospectively analyzed. Image fusion of pre- and post-interventional contrast-enhanced CT scans using a non-rigid registration software enabled a retrospective assessment of the percentage of predetermined periablational 3D safety m argin and CRLM suc...
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

Inter-scan and inter-scanner variation of quantitative dual-energy CT: evaluation with three different scanner types
AbstractObjectivesTo investigate inter-scan and inter-scanner variation of iodine concentration (IC) and attenuation in virtual monoenergetic images at 65 keV (HU65keV) in patients with repeated abdominal examinations on dual-source (dsDECT), rapid kV switching (rsDECT), and dual-layer detector DECT (dlDECT).MethodsWe retrospectively included 131 patients who underwent two abdominal DECT examinations on the same scanner (dsDECT:n = 46, rsDECT:n = 45, dlDECT:n = 40). IC and HU65keV were measured by placing regions of interest in the liver, spleen, kidneys, aorta, portal vein, and inferior vena cava. Overall IC and HU65keV f...
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

Validation of choroidal anastomosis on high-resolution magnetic resonance imaging as an imaging biomarker in hemorrhagic moyamoya disease
ConclusionsChoroidal anastomosis is independently associated with hemorrhagic events in adult patients with MMD at advanced stages. HRMRI can provide detailed information on both the anatomies and abnormal collaterals in MMD, which facilitates risk estimates of bleeding in MMD.Key Points•High-resolution magnetic resonance imaging allows for the evaluation of perforating arteries in patients with moyamoya disease.• Choroidal anastomosis is associated with hemorrhagic events in patients with moyamoya disease.• High-resolution magnetic resonance imaging might facilitate further grading and classification of moy...
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

Radiomics analysis of 18F-Choline PET/CT in the prediction of disease outcome in high-risk prostate cancer: an explorative study on machine learning feature classification in 94 patients
ConclusionThis machine learning model demonstrated to be feasible and useful to select Cho-PET features for T, N, and M with valuable association with high-risk PCa patients ’ outcomes.Key Points•Artificial intelligence applications are feasible and useful to select Cho-PET features.•Our model demonstrated the presence of specific features for T, N, and M with valuable association with high-risk PCa patients ’ outcomes.•Further prospective studies are necessary to confirm our results and to develop the application of artificial intelligence in PET imaging of PCa. (Source: European Radiology)
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

CT-like images based on T1 spoiled gradient-echo and ultra-short echo time MRI sequences for the assessment of vertebral fractures and degenerative bone changes of the spine
AbstractObjectivesTo evaluate the performance of 3D T1w spoiled gradient-echo (T1SGRE) and ultra-short echo time (UTE) MRI sequences for the detection and assessment of vertebral fractures and degenerative bone changes compared with conventional CT.MethodsFractures (n = 44) and degenerative changes (n = 60 spinal segments) were evaluated in 30 patients (65 ± 14 years, 18 women) on CT and 3-T MRI, including CT-like images derived from T1SGRE and UTE. Two radiologists evaluated morphological features on both modalities: Genant and AO/Magerl classifications, anterior/posterior vertebral height, fracture age; disc heigh...
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

Fusion of high b -value diffusion-weighted and unenhanced T1-weighted images to diagnose invasive breast cancer: factors associated with false-negative results
AbstractObjectivesWe sought factors associated with false-negative results in the diagnosis of invasive breast cancer via non-contrast breast magnetic resonance imaging (MRI) using fused highb-value diffusion-weighted imaging (DWI) and unenhanced T1-weighted images (T1WI).MethodsBetween 2018 and 2019, 316 consecutive women (mean age, 54.6 years) with invasive breast cancer who underwent preoperative breast MRI, including fused highb-value DWI and unenhanced T1WI, were retrospectively evaluated. Malignancy confidence ratings of the most suspicious breast lesions evident on fused DWI were derived by two radiologists using a ...
Source: European Radiology - January 14, 2021 Category: Radiology Source Type: research

CT quantification of the heterogeneity of fibrosis boundaries in idiopathic pulmonary fibrosis
AbstractObjectivesTo quantify the heterogeneity of fibrosis boundaries in idiopathic pulmonary fibrosis (IPF) using the Gaussian curvature analysis for evaluating disease severity and predicting survival.MethodsWe retrospectively included 104 IPF patients and 52 controls who underwent baseline chest CT scans. Normal lungs below − 500 HU were segmented, and the boundary was three-dimensionally reconstructed using in-house software. Gaussian curvature analysis provided histogram features on the heterogeneity of the fibrosis boundary. We analyzed the correlations between histogram features and the gender-age-physiology ...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Automated segmentation of kidney and renal mass and automated detection of renal mass in CT urography using 3D U-Net-based deep convolutional neural network
ConclusionsThe proposed automated segmentation and detection model based on 3D U-Net shows promising results for the segmentation of kidney and renal tumor, and the detection of renal tumor and cyst.Key Points• The segmentation model based on 3D U-Net showed high accuracy in segmentation of kidney and renal neoplasm, and good detection performance of renal neoplasm and cyst in corticomedullary phase of CTU.• The segmentation model based on 3D U-Net is a fully automated aided diagnostic tool that could be used to reduce the workload of radiologists and improve the accuracy of diagnosis.• The segmentation mode...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Overall survival and local recurrence following RFA, MWA, and cryoablation of very early and early HCC: a systematic review and Bayesian network meta-analysis
ConclusionsRFA, MWA, and CA are equally effective for locoregional treatment of very early and early HCC.Key Points• There is no significant difference in the OS and LR (at 1 year and 3 years) following ablation of very early and early HCC with RFA, MWA, and CA.• There was no effect of tumor size on the treatment efficacy.• More RCTs comparing CA with RFA and MWA should be performed. (Source: European Radiology)
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Value of bone suppression software in chest radiographs for improving image quality and reducing radiation dose
AbstractObjectivesTo compare image quality and radiation dose between dual-energy subtraction (DES) –based bone suppression images (D-BSIs) and software-based bone suppression images (S-BSIs).MethodsChest radiographs (CXRs) of forty adult patients were obtained with the two X-ray devices, one with DES and one with bone suppression software. Three image quality metrics (relative mean absolute error (RMAE), peak signal-to-noise ratio (PSNR), and structural similarity index (SSIM)) between original CXR and BSI for each of D-BSI and S-SBI groups were calculated for each bone and soft tissue areas. Two readers rated the v...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Noninvasive evaluation of liver fibrosis: comparison of the stretched exponential diffusion-weighted model to other diffusion-weighted MRI models and transient elastography
AbstractObjectivesTo compare the diagnostic performance of the stretched exponential model to those of other DWI models and transient elastography (TE) and to evaluate the influence of confounding factors on the staging of liver fibrosis.MethodsThis retrospective study included 78 consecutive patients who underwent both DWI and TE. The distributed diffusion coefficient (DDC) and intravoxel heterogeneity index (α) from the stretched exponential model, apparent diffusion coefficient (ADC), perfusion fraction (f), pseudodiffusion coefficient (Dp), true diffusion coefficient (Dt), and TE were obtained. Associations betwe...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Normal chest CT in 1091 symptomatic patients with confirmed Covid-19: frequency, characteristics and outcome
ConclusionsNormal initial chest CT occurred in 5.2% of symptomatic confirmed COVID-19 cases in our cohort. While better than those with abnormal chest CT, outcome was not entirely benign with 5.3% death and/or mechanical ventilation.Key Points• In a cohort of 1091 symptomatic COVID-19 patients, initial chest CT was normal in 5.2% of cases.• Normal chest CT in confirmed COVID-19 is frequent even when onset of symptoms is greater than 3 days.• The outcome of COVID-19 patients with initial normal chest CT, while better than those with abnormal CT, was not entirely benign with 5.3% death and/or mechanical ventil...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Radiomics signature of brain metastasis: prediction of EGFR mutation status
ConclusionsWe developed a T2-FLAIR radiomics signature that can be used as a noninvasive auxiliary tool for predicting EGFR mutation status in lung adenocarcinoma, which is helpful to guide therapeutic strategies.Key Points• MR-based radiomics signature of brain metastasis may help predict EGFR mutation status in lung adenocarcinoma, especially using T2-FLAIR.• Nine radiomics features extracted from T2-FLAIR sequence strongly correlate with EGFR mutation status.• Radiomics features reflect tumor heterogeneity through potential changes in tissue morphology caused by EGFR mutation. (Source: European Radiology)
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Hemodynamics is associated with vessel wall remodeling in patients with middle cerebral artery stenosis
AbstractObjectivesTo evaluate the relationship between hemodynamics and vessel wall remodeling patterns in middle cerebral artery (MCA) stenosis based on high-resolution magnetic resonance imaging and computational fluid dynamics (CFD).MethodsForty consecutive patients with recent ischemic stroke or transient ischemic attack attributed to unilateral atherosclerotic MCA stenosis (50 –99%) were prospectively recruited. All patients underwent a cross-sectional scan of the stenotic MCA vessel wall. The parameters of the vessel wall, the number of patients with acute infarction, translesional wall shear stress ratio (WSSR...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

High-resolution MRI demonstrates signal abnormalities of the 3rd cranial nerve in giant cell arteritis patients with 3rd cranial nerve impairment
AbstractObjectiveTo determine the sensitivity and specificity of high-resolution (HR) MRI for detecting signal abnormalities of cranial nerves (CN) in giant cell arteritis (GCA) patients presenting with diplopia.MethodsThis IRB-approved retrospective single-center study included GCA patients who underwent 3-T HR MRI from December 2014 to January 2020. Two radiologists, blinded to all data, individually assessed for the presence of enhancement of the 3rd, 4th, and/or 6th CN on post-contrast HR imaging and high signal intensity on HR T2-WI, for signal abnormalities of extraocular muscles and the brainstem, and for inflammato...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Validation of CT radiomics for prediction of distant metastasis after surgical resection in patients with clear cell renal cell carcinoma: exploring the underlying signaling pathways
AbstractObjectivesTo develop a radiomics model using preoperative multiphasic CT for predicting distant metastasis after surgical resection in patients with localized clear cell renal cell carcinoma (ccRCC) and to identify key biological pathways underlying the predictive radiomics features using RNA sequencing data.MethodsIn this multi-institutional retrospective study, a CT radiomics metastasis score (RMS) was developed from a radiomics analysis cohort (n = 184) for distant metastasis prediction. Using a gene expression analysis cohort (n = 326), radiomics-associated gene modules were identified. Based on a radiogenomics...
Source: European Radiology - January 13, 2021 Category: Radiology Source Type: research

Radiology in the lead: towards radiological profiling for precision medicine in glioblastoma patients? Editorial comment on Glioblastoma patients with a moderate vascular profile benefit the most from MGMT methylation
(Source: European Radiology)
Source: European Radiology - January 11, 2021 Category: Radiology Source Type: research

Soft tissue sarcomas: IVIM and DKI correlate with the expression of HIF-1 α on direct comparison of MRI and pathological slices
ConclusionsThis preliminary study demonstrated the association of IVIM and DKI parameters with the expression of HIF-1 α in STS.Key Points• IVIM and DKI parameters are correlated with the expression of HIF-1α in STS.• The MRI-pathology control method can be used in clinical studies to ensure correspondence between MRI slices and pathology sections. (Source: European Radiology)
Source: European Radiology - January 8, 2021 Category: Radiology Source Type: research

Low value of whole-body dual-modality [18f]fluorodeoxyglucose positron emission tomography/computed tomography in primary staging of stage I –II nasopharyngeal carcinoma: a nest case-control study
AbstractObjectivesThe value of using PET/CT for staging of stage I –II NPC remains unclear. Hence, we aimed to investigate the survival benefit of PET/CT for staging of early-stage NPC before radical therapy.MethodsA total of 1003 patients with pathologically confirmed NPC of stages I –II were consecutively enrolled. Among them, 218 patients underwent both PET/CT and conventional workup ([CWU], head-and-neck MRI, chest radiograph, liver ultrasound, bone scintigraphy) before treatment. The remaining 785 patients only underwent CWU. The standard of truth (SOT) for lymph node meta stasis was defined by the change ...
Source: European Radiology - January 8, 2021 Category: Radiology Source Type: research

Editorial comment on “Natural history of prostate cancer on active surveillance: stratification by MRI using the PRECISE recommendations in a UK cohort”
(Source: European Radiology)
Source: European Radiology - January 8, 2021 Category: Radiology Source Type: research

Image quality of ultralow-dose chest CT using deep learning techniques: potential superiority of vendor-agnostic post-processing over vendor-specific techniques
AbstractObjectiveTo compare the image quality between the vendor-agnostic and vendor-specific algorithms on ultralow-dose chest CT.MethodsVendor-agnostic deep learning post-processing model (DLM), vendor-specific deep learning image reconstruction (DLIR, high level), and adaptive statistical iterative reconstruction (ASiR, 70%) algorithms were employed. One hundred consecutive ultralow-dose noncontrast CT scans (CTDIvol; mean, 0.33 ± 0.056 mGy) were reconstructed with five algorithms: DLM-stnd (standard kernel), DLM-shrp (sharp kernel), DLIR, ASiR-stnd, and ASiR-shrp. Three thoracic radiologists blinded to the recon...
Source: European Radiology - January 7, 2021 Category: Radiology Source Type: research

Contrast-enhanced ultrasound: a valuable modality for extracapsular extension assessment in papillary thyroid cancer
AbstractObjectivesTo evaluate the diagnostic accuracy of preoperative contrast-enhanced ultrasound (CEUS) to detect extracapsular extension (ECE) and identify the relationship between ECE and nodule enhancement patterns in patients with papillary thyroid cancer (PTC).MethodsPatients with suspected thyroid cancer underwent ultrasound (US) and CEUS examinations. The US and CEUS features of the PTC nodules and thyroid capsule were recorded and classified individually. The accuracy of US and CEUS in detecting ECE was compared individually, and its relationship with various tumour enhancement patterns was analysed. The presence...
Source: European Radiology - January 7, 2021 Category: Radiology Source Type: research

Noninvasive diagnosis of portal hypertension using gadoxetate DCE-MRI of the liver and spleen
ConclusionsOur results demonstrate the potential utility of hepatocyte uptake parameters and spleen interstitial fraction obtained with gadoxetate DCE-MRI for the diagnosis of PH and CSPH.Key Points• Liver uptake and spleen interstitial fraction estimates from gadoxetate DCE-MRI are significantly correlated with portal pressure measurements.• Liver uptake rate shows good diagnostic performance for the diagnosis of portal hypertension.• The combination of liver uptake rate with spleen interstitial fraction exhibits excellent diagnostic performance for the diagnosis of clinically significant portal hypertensio...
Source: European Radiology - January 7, 2021 Category: Radiology Source Type: research

The Lisbon Agreement on Femoroacetabular Impingement Imaging —part 3: imaging techniques
ConclusionThe first international consensus on FAI imaging was developed. Researchers and clinicians working with FAI and hip-related pain may use these recommendations to guide, develop, and implement comprehensive, evidence-based imaging protocols and classifications.Key Points• Radiographic evaluation is recommended for the initial assessment of FAI, while MRI with a dedicated protocol is the gold standard imaging technique for the comprehensive evaluation of this condition.• The MRI protocol for FAI evaluation should include unilateral small FOV with radial imaging, femoral torsion assessment, and a fluid sen...
Source: European Radiology - January 7, 2021 Category: Radiology Source Type: research

The Lisbon Agreement on femoroacetabular impingement imaging —part 2: general issues, parameters, and reporting
ConclusionsThe available evidence was reviewed critically, recommended criteria for diagnostic imaging highlighted, and the roles/values of different imaging parameters assessed. Radiographic evaluation (AP pelvis and a Dunn 45 ° view) is the cornerstone of hip-imaging assessment and the minimum imaging study that should be performed when evaluating adult patients for FAI. In most cases, cross-sectional imaging is warranted because MRI is the ‘gold standard’ imaging modality for the comprehensive evaluation, different ial diagnosis assessment, and FAI surgical planning.Key Points• Diagnostic imaging fo...
Source: European Radiology - January 7, 2021 Category: Radiology Source Type: research

The prognostic value of late gadolinium enhancement in heart diseases: an umbrella review of meta-analyses of observational studies
ConclusionsThe prognostic role of LGE in DCM patients in terms of MACE is supported by highly suggestive evidence, which may facilitate the optimization of the timing of prophylactic implantable or wearable implantable cardioverter-defibrillators (ICD) considering the high risk of MACE and lower expectation of recovery.Key Points• Cardiac magnetic resonance imaging (CMR) has been widely used in the detection of various heart diseases. Numerous studies focusing on the prognostic aspect of LGE arose in recent years.• The meta-analysis on the prognostic role of LGE in dilated cardiomyopathy (DCM) patients in terms o...
Source: European Radiology - January 7, 2021 Category: Radiology Source Type: research