Discordance between MR enterography and endoscopic detection of Crohn's disease ileal strictures: evidence to inform recommendations.

Purpose: To evaluate correlation between terminal ileal (TI) stricture diagnosis at MR enterography (MRE) and ileocolonoscopy (IC) in patients with Crohn's disease (CD).

Methods: One hundred and four patients with CD (51% females; 41 ± 15 years) underwent IC and MRE within 3 months in this retrospective case-control study. Positive cases had TI strictures diagnosed by endoscopy (n = 35); or MRE (threshold small bowel dilation ≥ 3cm; n = 34).

Feasibility of thin-slice, low noise images created using multi-kernel synthesis to replace multiple image series in head CT.

Background: SynthesiZed Improved Resolution and Concurrent nOise reductioN (ZIRCON) is a multi-kernel synthesis method that creates a single series of thin-slice computed tomography (CT) images displaying low noise and high spatial resolution, increasing reader efficiency and minimizing partial volume averaging.

Purpose: To compare the diagnostic performance of a single set of ZIRCON images to two routine clinical image series using conventional CT head and bone reconstruction kernels for diagnosing intracranial findings and fractures in patients with trauma or suspected acute neurologic deficit.

Material And Methods: In total, 50 patients underwent clinically indicated head CT in the ER (15 normal, 35 abnormal cases).

Peripheral liver metastases are more frequently missed than central metastases in contrast-enhanced CT: insights from a 25-reader performance study.

Purpose: Subtle liver metastases may be missed in contrast enhanced CT imaging. We determined the impact of lesion location and conspicuity on metastasis detection using data from a prior reader study.

Methods: In the prior reader study, 25 radiologists examined 40 CT exams each and circumscribed all suspected hepatic metastases.

Clinical outcomes and future fertility after uterine artery embolization for postpartum and post-abortion hemorrhage.

Background: Postpartum hemorrhage (PPH) and post-abortion hemorrhage (PAH) are life-threatening conditions.

Purpose: To evaluate the efficacy and safety of uterine arterial embolization (UAE) for PPH and PAH and to investigate future fertility after UAE.

Material And Methods: This study included 57 consecutive patients (mean age = 34 years) who underwent UAE for PPH (n = 46) and PAH (n = 11) at our institution between January 2011 and December 2022.

Photon-counting CT in Thoracic Imaging: Early Clinical Evidence and Incorporation Into Clinical Practice.

Photon-counting CT (PCCT) is an emerging advanced CT technology that differs from conventional CT in its ability to directly convert incident x-ray photon energies into electrical signals. The detector design also permits substantial improvements in spatial resolution and radiation dose efficiency and allows for concurrent high-pitch and high-temporal-resolution multienergy imaging. This review summarizes key differences in PCCT image acquisition and image reconstruction compared with conventional CT; early evidence for the clinical benefit of PCCT for high-spatial-resolution diagnostic tasks in thoracic imaging, such as assessment of airway and parenchymal diseases, as well as benefits of high-pitch and multienergy scanning; anticipated radiation dose reduction, depending on the diagnostic task, and increased utility for routine low-dose thoracic CT imaging; adaptations for thoracic imaging in children; potential for further quantitation of thoracic diseases; and limitations and trade-offs.

Infrapopliteal Segments on Lower Extremity CTA: Prospective Intraindividual Comparison of Energy-Integrating Detector CT and Photon-Counting Detector CT.

The higher spatial resolution and image contrast for iodine-containing tissues of photon-counting detector (PCD) CT may address challenges in evaluating small calcified vessels when performing lower extremity CTA by energy-integrating detector (EID) CTA. The purpose of the study was to compare the evaluation of infrapopliteal vasculature between lower extremity CTA performed using EID CT and PCD CT. This prospective study included 32 patients (mean age, 69.

Self-trained deep convolutional neural network for noise reduction in CT.

Purpose: Supervised deep convolutional neural network (CNN)-based methods have been actively used in clinical CT to reduce image noise. The networks of these methods are typically trained using paired high- and low-quality data from a massive number of patients and/or phantom images. This training process is tedious, and the network trained under a given condition may not be generalizable to patient images acquired and reconstructed under different conditions.

The diagnostic accuracy of endoscopic ultrasound-shear wave elastography in multiple pancreatic regions for chronic pancreatitis based on the Rosemont criteria.

Purpose: Although endoscopic ultrasound (EUS) has been widely used for diagnosing chronic pancreatitis (CP), the assessment of fibrosis using the Rosemont criteria (RC) is generally subjective. Shear wave elastography using EUS (EUS-SWE) has been advocated as an objective approach to evaluating pancreatic fibrosis; however, it is unknown which pancreatic region should be selected for measurement. This study aims to compare the diagnostic accuracy in diagnosing CP by measurement site.

Targeted Training Reduces Search Errors but Not Classification Errors for Hepatic Metastasis Detection at Contrast-Enhanced CT.

Rationale And Objectives: Methods are needed to improve the detection of hepatic metastases. Errors occur in both lesion detection (search) and decisions of benign versus malignant (classification). Our purpose was to evaluate a training program to reduce search errors and classification errors in the detection of hepatic metastases in contrast-enhanced abdominal computed tomography (CT).

A training program to reduce reader search errors for liver metastasis detection in CT.

Detection of low contrast liver metastases varies between radiologists. Training may improve performance for lower-performing readers and reduce inter-radiologist variability. We recruited 31 radiologists (15 trainees, 8 non-abdominal staff, and 8 abdominal staff) to participate in four separate reading sessions: pre-test, search training, classification training, and post-test.

Seeing More with Less: Clinical Benefits of Photon-counting Detector CT.

Photon-counting detector (PCD) CT is an emerging technology that has led to continued innovation and progress in diagnostic imaging after it was approved by the U.S. Food and Drug Administration for clinical use in September 2021.

Bile duct penetrating duodenal wall sign: a novel computed tomography finding of common bile duct stone impaction into duodenal major papilla.

Purpose: Impacted common bile duct stones cause severe acute cholangitis. However, the early and accurate diagnosis, especially iso-attenuating stone impaction, is still challenging. Therefore, we proposed and validated the bile duct penetrating duodenal wall sign (BPDS), which shows the common bile duct penetrating the duodenal wall on coronal reformatted computed tomography (CT), as a novel sign of stone impaction.

Optimal Virtual Monoenergetic Photon Energy (keV) for Photon-Counting-Detector Computed Tomography Angiography.

Objective: This study aimed to determine the optimal photon energy for virtual monoenergetic images (VMI) in computed tomography angiography (CTA) using photon-counting-detector (PCD) CT.

Methods: Under institutional review board approval, 10 patients (abdominal, n = 4; lower extremity, n = 3; head and neck, n = 3) were scanned on an investigational PCD-CT (Count Plus, Siemens Healthcare) at 120 or 140 kV. All images were iteratively reconstructed with Bv48 kernel and 2-mm slice thickness.

CT or MR Enterography to Assess Response During Vedolizumab Therapy for Small Bowel Crohn's Disease.

Background: To describe response to therapy of small bowel (SB) Crohn's disease (CD) at CT or MR enterography (CTE/MRE) in patients on vedolizumab.

Methods: Patients with SB CD who underwent CTE/MRE exams greater than 12 months apart on vedolizumab therapy were included. Length (in cm) and inflammation severity (EMBARK score) of inflamed SB segments were assessed.

Multislice input for 2D and 3D residual convolutional neural network noise reduction in CT.

Purpose: Deep convolutional neural network (CNN)-based methods are increasingly used for reducing image noise in computed tomography (CT). Current attempts at CNN denoising are based on 2D or 3D CNN models with a single- or multiple-slice input. Our work aims to investigate if the multiple-slice input improves the denoising performance compared with the single-slice input and if a 3D network architecture is better than a 2D version at utilizing the multislice input.

Rectal cancer pelvic recurrence: imaging patterns and key concepts to guide treatment planning.

For rectal cancer, MRI plays an important role in assessing extramural tumor spread and informs surgical planning. The contemporary standardized management of rectal cancer with total mesorectal excision guided by imaging-based risk stratification has dramatically improved patient outcomes. Colonoscopy and CT are utilized in surveillance after surgery to detect intraluminal and extramural recurrence, respectively; however, local recurrence of rectal cancer remains a challenge because postoperative changes such as fat necrosis and fibrosis can resemble tumor recurrence; additionally, mucinous adenocarcinoma recurrence may mimic fluid collection or abscess on CT.

Lung Cancer Screening Using Clinical Photon-Counting Detector Computed Tomography and Energy-Integrating-Detector Computed Tomography: A Prospective Patient Study.

Objective: To evaluate the diagnostic quality of photon-counting detector (PCD) computed tomography (CT) in patients undergoing lung cancer screening compared with conventional energy-integrating detector (EID) CT in a prospective multireader study.

Materials: Patients undergoing lung cancer screening with conventional EID-CT were prospectively enrolled and scanned on a PCD-CT system using similar automatic exposure control settings and reconstruction kernels. Three thoracic radiologists blinded to CT system compared PCD-CT and EID-CT images and scored examinations using a 5-point Likert comparison score (-2 [left image is worse] to +2 [left image is better]) for artifacts, sharpness, image noise, diagnostic image quality, emphysema visualization, and lung nodule evaluation focusing on the border.

Mucinous cystic neoplasms of the liver with biliary prolapse.

Objectives: To describe the prevalence, clinical and radiological findings of biliary prolapse in pathologically proven mucinous cystic neoplasm of the liver (MCN-L).

Methods: Thirty-four patients, all female with median age 50 years (range, 14-82), with histologically confirmed MCN-L were enrolled. Median tumor size was 9 cm (range, 2-21 cm).

Understanding Reader Variability: A 25-Radiologist Study on Liver Metastasis Detection at CT.

Background Substantial interreader variability exists for common tasks in CT imaging, such as detection of hepatic metastases. This variability can undermine patient care by leading to misdiagnosis. Purpose To determine the impact of interreader variability associated with reader experience, image navigation patterns (eg, eye movements, workstation interactions), and eye gaze time at missed liver metastases on contrast-enhanced abdominal CT images.

Individualized and generalized models for predicting observer performance on liver metastasis detection using CT.

Radiologists exhibit wide inter-reader variability in diagnostic performance. This work aimed to compare different feature sets to predict if a radiologist could detect a specific liver metastasis in contrast-enhanced computed tomography (CT) images and to evaluate possible improvements in individualizing models to specific radiologists. Abdominal CT images from 102 patients, including 124 liver metastases in 51 patients were reconstructed at five different kernels/doses using projection domain noise insertion to yield 510 image sets.

Photon-Counting Detector CT: Key Points Radiologists Should Know.

Photon-counting detector (PCD) CT is a new CT technology utilizing a direct conversion X-ray detector, where incident X-ray photon energies are directly recorded as electronical signals. The design of the photon-counting detector itself facilitates improvements in spatial resolution (via smaller detector pixel design) and iodine signal (via count weighting) while still permitting multi-energy imaging. PCD-CT can eliminate electronic noise and reduce artifacts due to the use of energy thresholds.