Siemens (China)

Publisher Correction: Early-phase semi-quantitative analysis versus full time-course quantitative modeling of ultrafast dynamic contrast-enhanced MRI for breast cancer diagnosis, molecular subtyping, and treatment response prediction

ObjectiveThis study aimed to investigate alterations in brain activity due to acute carbon monoxide poisoning (ACOP) and their relationship with clinical manifestations using static and dynamic amplitude of low-frequency fluctuation (ALFF) analyses.MethodsResting-state functional magnetic resonance imaging (fMRI) and clinical data were obtained from 31 ACOP patients and 28 healthy controls. The static ALFF value and dynamic ALFF variability were measured and compared between groups. Partial correlation analysis explored the relationships between changes in ALFF and clinical features in ACOP patients.ResultsACOP patients exhibited increased dynamic ALFF in the bilateral superior frontal gyrus (SFG) and left middle frontal gyrus (MFG) and decreased static ALFF in the left middle occipital gyrus (MOG) compared to controls. Aberrant dynamic ALFF in the left SFG and MFG was negatively correlated with MoCA-B scores (r = −0.430, p = 0.036; r = −0.439, p = 0.032).ConclusionACOP patients exhibited abnormal instability in intrinsic brain activity, particularly in prefrontal areas, where temporal variability in local brain activity correlates with cognitive performance. This study highlights the value of combined static and dynamic ALFF approaches in understanding brain disturbances caused by CO exposure, providing new insights into the neuropathological mechanisms of ACOP.

Accurate prenatal diagnosis of high-risk placenta accreta spectrum (PAS) is vital for maternal safety and can mitigate severe complications. We aimed to investigate the diagnostic value of a novel MRI sign, “increased intra-myometrial vascularity (IIMV),” and to evaluate its contribution to an optimal MRI sign combination for differentiating high-risk placenta accreta spectrum (PAS), specifically placenta increta (PI) and percreta (PP), from placenta accreta (PA) or normal placenta. This retrospective study reviewed 166 high-risk pregnant women who underwent MRI. Two radiologists independently assessed the presence of the seven established risk signs from the SAR-ESUR consensus and the novel IIMV sign. The IIMV sign was defined as continuous tubular or tortuous flow-void structures confined within the myometrium, associated with architectural distortion. Univariate logistic regression and interobserver agreement (kappa statistics) were used to select significant signs, which were then incorporated into a multivariate model to construct diagnostic combinations. AUCs were compared between combinations (with and without IIMV sign) in differentiating PI + PP group from PA + Normal groups. The novel IIMV sign demonstrated the highest specificity (0.91) and was independently associated with the differentiation between the PI + PP and Normal + PA groups. The optimal sign combination, which included IIMV, placental bulge, myometrial thinning, and bladder wall interruption, achieved an area under the curve (AUC) of 0.84. In contrast, the combination without IIMV showed a decreased AUC of 0.79 (p = 0.1203). The “increased intra-myometrial vascularity” sign is a highly specific marker for high-risk PAS. Its inclusion in an MRI-based diagnostic model improves the performance for identifying invasive placental disorders compared to combinations that do not utilize this novel sign.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-33179-0.

Human auditory cognition involves multiregional hierarchical processing, yet the neural mechanisms integrating cortical layers and large-scale networks remain unclear. Using high-resolution fMRI, we investigate cross-spatial scale dynamics during hierarchical auditory processing. Distinct activations across layers of superior temporal gyrus (STG) and inferior frontal gyrus (IFG) are detected during standard stimuli and violation. We identify the layer-specific effective connectivity among key nodes in the auditory hierarchy using dynamic causal modelling. The results are consistent with hierarchical predictive coding schemes: (i) tone and sequence processing provide input to the superficial and middle layers of STG, respectively. (ii) Forward connections came from the superficial layers of STG, while (iii) backward connections implicated the deep layers of IFG. The integration of mesoscale and macroscale activities confirms the interaction of superficial/middle layers of STG with higher-level regions. These findings elucidate a multiscale mechanism coordinating cortical layers and distributed networks in hierarchical auditory processing.

Clinical evaluation of the human dental pulp is limited to imprecise, subjective methods, necessitating the development of an accurate and objective diagnostic parameter. Diffusion-weighted imaging (DWI) could address this gap; however, no in vivo data are available. To illustrate the feasibility of DWI imaging of the human pulp and to investigate physiological patterns. A turbo gradient spin echo (TGSE) BLADE diffusion MRI sequence was optimized for dental pulp imaging in three volunteers, defining an optimal b-value range and assessing intraindividual fluctuations at 3 T. Apparent diffusion coefficient (ADC) values were calculated in 18 participants using the 2-point and 7-point methods in 329 healthy teeth, analyzing data according to tooth and jaw type. Statistical analysis was performed using Kruskal-Wallis, Wilcoxon signed-rank-test, and one-way ANOVA. Mean pulp ADCs (± SD) for the 2-/7-point methods were 1.219 ± 0.340 / 1.242 ± 0.297 × 10−9 m2/s (p ≤ 0.0001), with intraindividual variations of 0.159 × 10−9 m2/s. Minor but significant differences were observed between tooth types for maxillary premolars vs. maxillary incisors/canines, mandibular canines, and maxillary incisors vs. molars (ADC difference range: 0.209–0.272 × 10−9 m2/s; p-values: 0.0017–0.0473). In vivo assessment of the dental pulp by DWI is feasible and reliable using the TGSE BLADE sequence. Reference ADC values were established, with no substantial differences between jaw and tooth types, indicating that the ADC is a stable intraindividual parameter here. These findings may substantially improve the diagnostic evaluation of pulp diseases to minimize over- and undertreatment.

Lymphangioleiomyomatosis (LAM) is a rare disorder that primarily affects women of childbearing age. It is characterized by the abnormal growth of smooth muscle-like cells. While LAM typically occurs in the lungs, it can also be found in the retroperitoneum and pelvis. However, cases originating in the mediastinum are extremely rare. This report discusses an unusual case of mediastinal LAM in a male patient with no abnormal clinical symptoms. The patient, a 70-year-old man, the chest computed tomography (CT) scan revealed an irregular hypodense mass in the left side of the anterior superior mediastinum. Interestingly, the mass did not exhibit significant enhancement in the arterial phase. Instead, it showed striated enhancement in the central area during the venous phase, with no abnormalities observed in the marginal area. To further understand this condition, we conducted a comprehensive review of relevant literature, focusing on the imaging characteristics of mediastinal LAM and the pathogenesis and therapeutic prognosis of LAM. By sharing this information, we aim to enhance understanding and knowledge of this disease.

ObjectiveTo evaluate the reproducibility and effectiveness of the bone reporting and data system on CT (Bone‐RADS-CT) for incidental solitary bone lesions in adults.Materials and methodsWe retrospectively included 328 CT cases from three local and two public databases, respectively. All the cases were histopathologically or clinically confirmed bone lesions, “do not touch” lesions with typical appearance, and remained stable for at least 2 years. Each lesion with gender, age, and clinical history was categorized according to the Bone-RADS algorithm by two musculoskeletal radiologists and two non-musculoskeletal radiologists. The Bone-RADS categories were as follows: Bone-RADS-1, likely benign, leave alone; Bone-RADS-2, incomplete assessed on imaging, perform different imaging modality; Bone-RADS-3, intermediate, perform follow-up imaging; Bone-RADS-4, suspicious for malignancy or need for treatment, biopsy and/or oncologic referral. Inter-reader agreement was evaluated. The diagnostic performance of the Bone-RADS-CT for distinguishing positive cases (intermediate or malignant lesions or osteomyelitis) from negative cases (benign lesions), were measured, using histopathology results, clinical diagnosis, or follow-up as a standard reference.ResultsThere were 223 positive cases and 105 negative cases, respectively. The overall inter-reader agreement between two musculoskeletal and two non-musculoskeletal radiologists were both moderate (weighted kappa 0.553 and 0.403). The diagnostic performance for identifying intermediate or malignant lesions or osteomyelitis ranged according to radiologists with sensitivities of 88.8% to 94.6%, specificities of 42.9% to 71.1%, and accuracies of 78.0% to 86.6%.ConclusionBone-RADS-CT is effective for identifying bone lesions that need further treatment, but is only moderately reliable for readers of different specialties and experience.Critical relevance statementBone-RADS-CT has been demonstrated to be a reliable algorithm for non-musculoskeletal radiologists and an effective tool for identifying the “need for treatment” incidental solitary bone lesions in adults, but still needs improvement in the rating method and category definition.Key PointsBone-RADS-CT has been demonstrated to be reliable and accurate when rated by musculoskeletal radiologists.Bone-RADS-CT achieved moderate agreement for musculoskeletal and non-musculoskeletal radiologists.Bone-RADS-CT presented high sensitivities but low specificities for identifying “need for treatment” bone lesions.Graphical

Given the limitations of conventional imaging in accurately grading gliomas, predicting molecular subtypes, and assessing tumor proliferation and angiogenesis, there is a growing need for advanced quantitative magnetic resonance imaging (MRI) biomarkers. This study aimed to compare the diagnostic performance of histogram features of dynamic contrast enhanced (DCE) and dynamic susceptibility contrast (DSC) imaging in predicting glioma grade and genotyping, as well as to explore the association between DCE and DSC with Ki-67 and microvascular density (MVD). Forty-six patients with gliomas were enrolled prospectively. The histogram features of DCE and DSC were extracted from the entire tumor and compared among subgroups based on the grades and status of isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion. Pearson correlation analyses were employed to examine the associations among Ki-67, MVD, and histogram features of perfusion model. Receiver operating characteristic (ROC) analyses were used to evaluate the accuracy of DCE and DSC in differentiating glioma grades and genotypes, while Cox regression analyses identified prognostic factors associated with survival after surgical resection. A cohort of 46 patients with IDH-mutant (n=23) and IDH-wildtype (n=23) gliomas was analyzed. DCE-MRI histogram features demonstrated superior performance to DSC parameters in both IDH genotyping and tumor grading. For IDH discrimination, 90th percentile of volume fraction of the extravascular-extracellular space (Ve) [area under the curve (AUC) =0.849, sensitivity 91.3%, specificity 78.3%] and mean value of volume transfer constant (Ktrans) (AUC =0.847, sensitivity 87.0%, specificity 82.6%) showed optimal performance (both P<0.001). In contrast, DSC-derived relative cerebral blood volume (rCBV) (AUC =0.577) and relative cerebral blood flow (rCBF) (AUC =0.537) exhibited limited diagnostic value (P>0.05). In tumor grading, 90th percentile of Ve (AUC =0.923) and mean value of Ktrans (AUC =0.908) achieved near-perfect differentiation (sensitivity 83.9%, specificity 93.3%; P<0.001). While DSC-derived parameters showed improved performance compared to genotyping (rCBV: AUC =0.742, P=0.008; rCBF: AUC =0.688, P=0.040), DCE-based models remained significantly superior (DeLong's test P<0.05 for all comparisons). Significant correlations were observed between DCE parameters and both Ki-67 proliferation index (r=0.42-0.51) and MVD (r=0.35-0.56; all P<0.05). Survival analysis identified three independent prognostic factors: O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation [hazard ratio (HR) =4.15, 95% confidence interval (CI): 1.10-15.68, P=0.04], elevated Ktrans (HR =1.08, 95% CI: 1.01-1.17, P=0.03), and rCBV (HR =1.87, 95% CI: 1.17-2.97, P=0.009). The histogram features of DCE and DSC demonstrate exceptional diagnostic efficacy in glioma grading, with DCE providing deeper insights into the molecular characteristics of glioma.