To evaluate dual-layer dual-energy computed tomography (dlDECT)-based characterization of thrombus composition for differentiation of acute pulmonary embolism (PE) and chronic thromboembolic pulmonary hypertension (CTEPH). This retrospective single center cohort study included 49 patients with acute PE and 33 patients with CTEPH who underwent CT pulmonary angiography on a dlDECT from 06/2016 to 06/2022. Conventional images), material specific images (virtual non-contrast [VNC], iodine density overlay [IDO], electron density [ED]), and virtual monoenergetic images (VMI) were analyzed.
View Article and Find Full Text PDFObjective: The purpose of this study was to evaluate the effectiveness of a deep learning model (DLM) in improving the sensitivity of neurosurgery residents to detect intracranial aneurysms on CT angiography (CTA) in patients with aneurysmal subarachnoid hemorrhage (aSAH).
Methods: In this diagnostic accuracy study, a set of 104 CTA scans of aSAH patients containing a total of 126 aneurysms were presented to three blinded neurosurgery residents (a first-year, third-year, and fifth-year resident), who individually assessed them for aneurysms. After the initial reading, the residents were given the predictions of a dedicated DLM previously established for automated detection and segmentation of intracranial aneurysms.
Objectives: Coronary CT angiography (CCTA) is becoming increasingly important in the workup of coronary artery disease. Imaging of stents and in-stent stenoses remains a challenge. This work investigates the assessability of in-stent stenoses in photon counting CT (PCCT) using ultra-high-resolution (UHR) imaging and optimized reconstruction kernels.
View Article and Find Full Text PDFPurpose: To evaluate a novel flow-independent sequence (Relaxation-Enhanced Angiography without Contrast and Triggering (REACT)) for imaging of the extracranial arteries in acute ischemic stroke (AIS) at 1.5 T.
Methods: This retrospective single-center study included 47 AIS patients who received REACT (scan time: 3:01 min) and contrast-enhanced MRA (CE-MRA) of the extracranial arteries at 1.
Background: The continuous technical development of cardiac computed tomography (CT) over the last decades has led to an improvement in image quality and diagnostic accuracy, while simultaneously reducing radiation exposure. Despite these advancements, certain patient-related factors remain a challenge to conduct a high-quality diagnostic examination.
Question: What factors can negatively affect the image quality of cardiac CT and how can these be addressed?
Materials And Methods: Analysis of the available literature on cardiac CT and identification of the quality-limiting factors, discussion, and possible solutions.
Background: Diagnosing myocarditis relies on multimodal data, including cardiovascular magnetic resonance (CMR), clinical symptoms, and blood values. The correct interpretation and integration of CMR findings require radiological expertise and knowledge. We aimed to investigate the performance of Generative Pre-trained Transformer 4 (GPT-4), a large language model, for report-based medical decision-making in the context of cardiac MRI for suspected myocarditis.
View Article and Find Full Text PDFBackground Errors in radiology reports may occur because of resident-to-attending discrepancies, speech recognition inaccuracies, and large workload. Large language models, such as GPT-4 (ChatGPT; OpenAI), may assist in generating reports. Purpose To assess effectiveness of GPT-4 in identifying common errors in radiology reports, focusing on performance, time, and cost-efficiency.
View Article and Find Full Text PDFBackground: Recently, a disease modifying therapy has become available for transthyretin amyloid cardiomyopathy (ATTR-CM). A validated monitoring concept of treatment is lacking, but a current expert consensus recommends three clinical domains (clinical, biomarker and ECG/imaging) assessed by several measurable features to define disease progression.
Methods: We retrospectively analyzed data of wild-type ATTR-CM patients initiating tafamidis therapy assessed within our local routine protocol at baseline and 6-months follow-up with respect to the frequency of values beyond the proposed thresholds defining disease progression.
Aim: The purpose of this study was to investigate the clinical application of Compressed SENSE accelerated single-breath-hold LGE with 3D isotropic resolution compared to conventional LGE imaging acquired in multiple breath-holds.
Material & Methods: This was a retrospective, single-center study including 105 examinations of 101 patients (48.2 ± 16.
Objectives: To evaluate dual-layer dual-energy computed tomography (dlDECT)-derived pulmonary perfusion maps for differentiation between acute pulmonary embolism (PE) and chronic thromboembolic pulmonary hypertension (CTEPH).
Methods: This retrospective study included 131 patients (57 patients with acute PE, 52 CTEPH, 22 controls), who underwent CT pulmonary angiography on a dlDECT. Normal and malperfused areas of lung parenchyma were semiautomatically contoured using iodine density overlay (IDO) maps.
Background: Strain analyses derived from cardiovascular magnetic resonance-feature tracking (CMR-FT) provide incremental prognostic benefit in patients sufferring from acute myocardial infarction (AMI). This study aims to evaluate and revalidate previously reported prognostic implications of comprehensive strain analyses in a large independent cohort of patients with ST-elevation myocardial infarction (STEMI).
Methods: Overall, 566 STEMI patients enrolled in the CONDITIONING-LIPSIA trial including pre- and/or postconditioning treatment in addition to conventional percutaneous coronary intervention underwent CMR imaging in median 3 days after primary percutaneous coronary intervention.
Background: While computed tomography pulmonary angiography (CTPA) is an integral part of the work-up in patients with suspected pulmonary hypertension (PH), there is no established CTPA-derived prognostic marker. We aimed to assess whether quantitative readouts of lung vessel morphology correlate with established prognostic indicators in PH.
Methods: We applied a fully-automatic in-house developed algorithm for segmentation of arteries and veins to determine lung vessel morphology in patients with precapillary PH who underwent right heart catheterization and CTPA between May 2016 and May 2019.
Objective: To compare the measurement of aortic diameters using a novel flow-independent MR-Angiography (3D modified Relaxation-Enhanced Angiography without Contrast and Triggering (modified REACT)) and transthoracic echocardiography (TTE) in Marfan syndrome (MFS) patients.
Material And Methods: This retrospective, single-center analysis included 46 examinations of 32 MFS patients (mean age 37.5 ± 11.
Background: Diagnosing a coronavirus disease 2019 (COVID-19) infection with high specificity in chest computed tomography (CT) imaging is considered possible due to distinctive imaging features of COVID-19 pneumonia. Since other viral non-COVID pneumonia show mostly a different distribution pattern, it is reasonable to assume that the patterns observed caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are a consequence of its genetically encoded molecular properties when interacting with the respiratory tissue. As more mutations of the initial SARS-CoV-2 wild-type with varying aggressiveness have been detected in the course of 2021, it became obvious that its genome is in a state of transformation and therefore a potential modification of the specific morphological appearance in CT may occur.
View Article and Find Full Text PDFBackground: Chronic thromboembolic pulmonary hypertension (CTEPH) is considered a complication of pulmonary embolism (PE). However, signs of CTEPH may exist in patients with a first symptomatic PE.
Research Question: Which radiologic findings on CT pulmonary angiography (CTPA) at the time of acute PE could indicate the presence of preexisting CTEPH?
Study Design And Methods: This study included unselected patients with acute PE who were prospectively followed up for 2 years with a structured visit schedule.
Quant Imaging Med Surg
July 2022
Background: In stroke magnetic resonance imaging (MRI), contrast-enhanced magnetic resonance angiography (CE-MRA) is the clinical standard to depict extracranial arteries but native MRA techniques are of increased interest to facilitate clinical practice. The purpose of this study was to assess the detection of extracranial internal carotid artery (ICA) stenosis and plaques as well as the image quality of cervical carotid arteries between a novel flow-independent relaxation-enhanced angiography without contrast and triggering (REACT) sequence and CE-MRA in acute ischemic stroke (AIS).
Methods: In this retrospective, single-center study, 105 consecutive patients (65.
Objectives: To evaluate the usefulness of spectral detector CT (SDCT)-derived pulmonary perfusion maps and pulmonary parenchyma characteristics for the semiautomated classification of pulmonary hypertension (PH).
Methods: A total of 162 consecutive patients with right heart catheter (RHC)-proven PH of different aetiologies as defined by the current ESC/ERS guidelines who underwent CT pulmonary angiography (CTPA) on SDCT and 20 patients with an invasive rule-out of PH were included in this retrospective study. Semiautomatic lung segmentation into normal and malperfused areas based on iodine density (ID) as well as automatic, virtual non-contrast-based emphysema quantification were performed.
Background: To evaluate whether volumetric iodine quantification of the lung allows for the automatic identification of patients with chronic thromboembolic pulmonary hypertension (CTEPH) and whether the extent of pulmonary malperfusion correlates with invasive hemodynamic parameters.
Methods: Retrospective data base search identified 30 consecutive patients with CTEPH who underwent CT pulmonary angiography (CTPA) on a spectral-detector CT scanner. Thirty consecutive patients who underwent an identical CT examination for evaluation of suspected acute pulmonary embolism and had no signs of pulmonary embolism or PH, served as control cohort.
Purpose: To investigate the diagnostic value of spectral detector CT (SDCT)-derived virtual non-contrast (VNC), virtual monoenergetic images (VMI) and iodine overlays (IO) for distinguishing infected from noninfected fluid collections (FC) in the chest or abdomen.
Method: This retrospective study included 58 patients with venous phase SDCT with 77 FC. For all included FC, microbiological analysis of aspirated fluid served as reference.
Background: Myocardial deformation analyses using cardiovascular magnetic resonance (CMR) feature tracking (CMR-FT) have incremental value in the assessment of cardiac function beyond volumetric analyses. Since guidelines do not recommend specific imaging parameters, we aimed to define optimal spatial and temporal resolutions for CMR cine images to enable reliable post-processing.
Methods: Intra- and inter-observer reproducibility was assessed in 12 healthy subjects and 9 heart failure (HF) patients.