Background Detection of hepatic metastases at CT is a daily task in radiology departments that influences medical and surgical treatment strategies for oncology patients. Purpose To compare simulated photon-counting CT (PCCT) with energy-integrating detector (EID) CT for the detection of small liver lesions. Materials and Methods In this reader study (July to December 2023), a virtual imaging framework was used with 50 anthropomorphic phantoms and 183 generated liver lesions (one to six lesions per phantom, 0.4-1.5 cm in diameter). Virtual CT platforms simulated PCCT and EID CT scanners. Phantoms were virtually scanned using routine (6 mGy) and low-dose (1.5 mGy) conditions and reconstructed with three kernels. A subset of 300 scans (150 PCCT vs EID CT pairs) were selected. Four radiologists independently reviewed all scans to mark liver lesions, assigned confidence scores for detection, and rated scan quality. Analysis was performed on a per-lesion basis to determine sensitivity for several variables and on a per-scan basis for scan quality. The McNemar test, two-sided paired tests, and mixed-effects logistic regression models were fitted; < .05 was considered indicative of statistically significant difference. Results Consensus reader sensitivity in detecting lesions was 82.1% (451 of 549) for PCCT versus 77.6% (426 of 549) for EID CT ( < .001), with a mean sensitivity gain of 4.3 percentage points ± 1.3 ( < .001 to = .02 per reader). Readers had better subjective confidence for lesions at PCCT (mean score, 61.5 ± 22 vs 56.1 ± 24 [on a 101-point scale]; < .001). Sensitivity was lower for lesions smaller than 1 cm, with more pronounced difference between PCCT and EID CT (74.0% [271 of 366] vs 67.2% [246 of 366]; < .001). At the lower dose level, PCCT showed higher sensitivity than EID CT (68.9% [168 of 244] vs 61.1% [149 of 244]; < .001) for subcentimeter lesions. In a multivariable model, PCCT was independently associated with increased odds of lesion detection (odds ratio, 1.55; < .001). Image quality was slightly higher for PCCT (mean score, 55.3 vs 50.6 [on a 101-point scale]; < .001). Conclusion Compared with EID CT, PCCT showed better sensitivity in the detection of small liver lesions. © RSNA, 2025 See also the editorial by Menu in this issue.
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http://dx.doi.org/10.1148/radiol.241568 | DOI Listing |
Hepatology
January 2025
Division of Gastroenterology and Hepatology, University of California, San Francisco, San Francisco, CA.
Background Aims: Patients with hepatocellular carcinoma (HCC) meeting UNOS-downstaging (DS) criteria have excellent post-liver transplantation (LT) outcomes. Studies on HCC beyond UNOS-DS criteria ("All-comers" (AC)) have been limited by small sample size and short follow-up time, prompting this analysis.
Approach Results: 326 patients meeting UNOS-DS and 190 meeting AC criteria from 9 LT centers across 5 UNOS regions were enrolled from 2015 to 2023 and prospectively followed.
ACS Appl Mater Interfaces
January 2025
School of Public Health, Xinjiang Medical University, Urumqi 830054, China.
Alveolar echinococcosis (AE) is a serious parasitic infectious disease that is highly invasive and destructive to the liver and has a high mortality rate. However, currently, there is no effective targeted imaging and treatment method for the precise detection and therapy of AE. We proposed a new two-step targeting strategy (TSTS) for AE based on poly(lactic--glycolic acid) (PLGA).
View Article and Find Full Text PDFRadiology
January 2025
From the Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Box 3808, Durham, NC 27701 (B.W.T., K.R.K., B.C.A., S.P.T., D.E.K., B.H., M.R.B., D.M., E.S., E.A.); Department of Biostatistics and Bioinformatics (N.F., S.M., A.E.) and Department of Medical Physics (W.P.S., E.S., E.A.), Duke University, Durham, NC.
Background Detection of hepatic metastases at CT is a daily task in radiology departments that influences medical and surgical treatment strategies for oncology patients. Purpose To compare simulated photon-counting CT (PCCT) with energy-integrating detector (EID) CT for the detection of small liver lesions. Materials and Methods In this reader study (July to December 2023), a virtual imaging framework was used with 50 anthropomorphic phantoms and 183 generated liver lesions (one to six lesions per phantom, 0.
View Article and Find Full Text PDFmBio
January 2025
Department of Microbiology, Harvard Medical School, Boston, Massachusetts, USA.
Bacterial infections can induce exuberant immune responses that can damage host tissues. Previously, we demonstrated that systemic infection in mice causes tissue damage in the liver. This liver necrosis is associated with the expression of endogenous retroviruses, chromosomally integrated retroviruses that encode a reverse transcriptase.
View Article and Find Full Text PDFMed Phys
January 2025
Center for Virtual Imaging Trial, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA.
Background: This Special Report summarizes the 2022, AAPM grand challenge on Truth-based CT image reconstruction.
Purpose: To provide an objective framework for evaluating CT reconstruction methods using virtual imaging resources consisting of a library of simulated CT projection images of a population of human models with various diseases.
Methods: Two hundred unique anthropomorphic, computational models were created with varied diseases consisting of 67 emphysema, 67 lung lesions, and 66 liver lesions.
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