A Rare Case of Fibrolamellar Hepatocellular Carcinoma in an Elderly Patient With Prior Hepatitis C Achieving Sustained Virologic Response.

Background/aim: Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare histological variant of hepatocellular carcinoma (HCC) that typically affects adolescents and young adults without underlying liver disease. In elderly patients, particularly those with a history of chronic hepatitis C virus (HCV) infection, FLHCC is extremely rare and presents diagnostic challenges.

Case Report: A 67-year-old woman with a history of chronic HCV infection and sustained virologic response (SVR) was incidentally found to have two hepatic lesions during routine follow-up imaging.

Intra-axial primary brain tumor differentiation: comparing large language models on structured MRI reports vs. radiologists on images.

Objective: Aimed to evaluate the potential of large language models (LLMs) in differentiating intra-axial primary brain tumors using structured magnetic resonance imaging (MRI) reports and compare their performance with radiologists.

Materials And Methods: Structured reports of preoperative MRI findings from 137 surgically confirmed intra-axial primary brain tumors, including Glioblastoma (n = 77), Central Nervous System (CNS) Lymphoma (n = 22), Astrocytoma (n = 9), Oligodendroglioma (n = 9), and others (n = 20), were analyzed by multiple LLMs, including GPT-4, Claude-3-Opus, Claude-3-Sonnet, GPT-3.5, Llama-2-70B, Qwen1.

Dual-layer spectral detector CT for improved assessment of right adrenal vein in patients with primary aldosteronism.

Purpose: To investigate whether virtual-monoenergetic images (VMI) from dual-layer spectral-detector computed tomography (DLCT) improve right adrenal vein (RAV) assessment before adrenal venous sampling (AVS), and portal-venous-phase (PVP) images alone can replace conventional multiphase CT combining late-arterial phase (LAP) and PVP.

Methods: Sixty-three patients with primary aldosteronism who underwent LAP and PVP DLCT before AVS were retrospectively analyzed. Conventional polyenergetic-images (PEI) and VMI at 40-70 keV (VMI) were reconstructed.

Impact of super-resolution deep learning-based reconstruction for hippocampal MRI: A volunteer and phantom study.

Background And Purpose: To evaluate the effects of super-resolution deep learning-based reconstruction (SR-DLR) on thin-slice T2-weighted hippocampal MR image quality using 3 T MRI, in both human volunteers and phantoms.

Materials And Methods: Thirteen healthy volunteers underwent hippocampal MRI at standard and high resolutions. Original (standard-resolution; StR) images were reconstructed with and without deep learning-based reconstruction (DLR) (Matrix = 320 × 320), and with SR-DLR (Matrix = 960 × 960).

Contrast medium dose optimization in the era of multi-energy CT.

With the increasing use of contrast-enhanced CT, optimizing the iodinated contrast medium (ICM) dose while maintaining diagnostically adequate image quality is essential to mitigate potential adverse effects on patients, the environment, and public health, as well as to reduce medical costs and address potential supply shortages. Multi-energy CT technologies including dual-energy CT and photon-counting detector CT enable data acquisition at multiple energy spectra, allowing for material characterization beyond the capabilities of conventional single-energy CT. Recent technical advancements and the growing adoption of these technologies in clinical practice have enhanced patient care across various diagnostic tasks.

Dynamic Computed Tomography Findings as Indicators of Uterine Artery Embolization in Postpartum Hemorrhage.

Importance: Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality globally. Although traditional management relies on blood loss quantification, identifying cases resistant to conventional treatment remains challenging, potentially delaying crucial interventions.

Objective: To determine the prevalence and clinical implications of PPH that is resistant to treatment showing arterial contrast extravasation on dynamic computed tomography (CT) (PRACE) and its association with intervention requirements.

Evaluating the Performance of Reasoning Large Language Models on Japanese Radiology Board Examination Questions.

Rationale And Objectives: This study evaluates the performance, cost, and processing time of OpenAI's reasoning large language models (LLMs) (o1-preview, o1-mini) and their base models (GPT-4o, GPT-4o-mini) on Japanese radiology board examination questions.

Materials And Methods: A total of 210 questions from the 2022-2023 official board examinations of the Japan Radiological Society were presented to each of the four LLMs. Performance was evaluated by calculating the percentage of correctly answered questions within six predefined radiology subspecialties.

Use of Electron Density Maps and Fused Images in Dual-Energy Cardiac Computed Tomography to Facilitate Detection of Late Iodine Enhancement.

Background: This study aimed to optimize the fusion of quantitative maps and morphological images to improve late iodine enhancement (LIE) imaging using cardiac dual-energy computed tomography (DECT).

Methods And Results: We retrospectively analyzed 15 patients with suspected old myocardial infarction who underwent cardiac DECT. Virtual monochromatic images (VMI) ranging from 40 to 200 keV and quantitative maps (e.

Imaging features of wild-type transthyretin amyloid cardiomyopathy in gated and non-gated contrast-enhanced CT.

Objective: Wild-type transthyretin amyloid cardiomyopathy (ATTR-CM) could be common, but its diagnosis is often overlooked. If the imaging features of ATTR-CM can be identified using conventional computed tomography (CT), which is commonly employed in clinical practice, its diagnostic value would be great. This study aimed to assess the imaging features of the condition in conventional non-gated contrast-enhanced CT.

Non-invasive Imaging Findings of Wild-type Transthyretin Amyloid Cardiomyopathy in Women: A Retrospective Study.

Rationale And Objectives: Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) predominantly affects males; however, female patients can also develop this condition. This study assessed the non-invasive imaging features of ATTRwt-CM in female patients.

Materials And Methods: In this study, 106 consecutive patients diagnosed with ATTRwt-CM were retrospectively analyzed, evaluating sex-related differences in imaging features, including echocardiography, cardiac magnetic resonance (CMR), and Tc-labeled pyrophosphate (Tc-PYP) scintigraphy.

A Huge Hepatocellular Carcinoma With Major Arteriovenous Shunt Successfully Treated With Chemoembolization Plus Lenvatinib Therapy Followed by Radiotherapy.

Background/aim: Large hepatocellular carcinoma (HCC) (defined as ≥10 cm) is associated with a poor prognosis in both resectable and unresectable patients. Liver resection and multidisciplinary treatment are recommended for solitary huge and multiple huge HCCs, respectively.

Case Report: The patient presented with a hypervascular HCC measuring over 10 cm in the right liver lobe and a suspected hypovascular tumor in the medial segment.

Splenic Angiosarcoma and Numerous Liver Metastases Presenting the Kasabach-Merritt Phenomenon.

Background/aim: Splenic angiosarcoma is a rare and serious malignancy. We investigated the diagnosis and the suitable treatment strategy for metastatic splenic angiosarcoma with the Kasabach-Merritt phenomenon.

Case Report: A 76-year-old man was referred because of abdominal discomfort together with anemia, thrombocytopenia, and disseminated intravascular coagulopathy.

MRI-Extracellular Volume Fraction Versus Histological Amyloid Load in Cardiac Amyloidosis: The Importance of T2 Mapping.

Background: Magnetic resonance imaging (MRI)-derived myocardial extracellular volume fraction (ECV) is elevated in the presence of fibrosis, amyloid deposition, inflammation, and edema. In patients with cardiac amyloidosis and prolonged T2 due to concomitant inflammation or edema, MRI-ECV may not correctly reflect histological amyloid load. The authors sought to determine whether MRI-ECV can accurately reflect histological amyloid load in 2 groups of patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM), with and without T2 prolongation.

Liver function estimation using multiphase hepatic CT: diagnostic performance of iodine-uptake and volumetric parameters.

Objectives: To investigate whether multiphase hepatic CT can predict liver function measured with indocyanine-green-retention test (ICG-R15) and identify patients with severe liver dysfunction contraindicating major hepatectomy, defined as ICG-R15 ≥ 20%, compared to technetium--galactosyl serum albumin (Tc-GSA) scintigraphy.

Materials And Methods: This retrospective study included 118 patients (84 men, mean age, 69.4 ± 11.

Basic verification of myocardial extracellular volume quantification by prototype photon-counting detector computed tomography: A phantom study.

Objectives: This study aimed to investigate the accuracy of myocardial extracellular volume (ECV) quantification using a prototype photon-counting detector (PCD) computed tomography (CT) and examine the association between radiation dose and spectral image settings.

Material And Methods: A multi-energy CT phantom that simulated the blood pool and myocardium was used. The tube voltage was set at 120 kVp and three types of tube current-time products (105, 150, and 300 mAs) were applied for pre- and post-contrast scans.

Super-resolution deep-learning reconstruction with 1024 matrix improves CT image quality for pancreatic ductal adenocarcinoma assessment.

Objectives: To evaluate the efficiency of super-resolution deep-learning reconstruction (SR-DLR) optimized for helical body imaging in assessing pancreatic ductal adenocarcinoma (PDAC) using normal-resolution (NR) CT scanner.

Methods: Fifty patients with PDAC who underwent multiphase pancreas CT on a 320-row NR scanner were retrospectively analyzed. Images were reconstructed using hybrid iterative reconstruction (HIR), normal-resolution deep-learning reconstruction (NR-DLR), and SR-DLR at a 0.

Serial assessment of coronary artery inflammation using cardiac CT in anthracycline chemotherapy for breast cancer.

Objectives: There is limited evidence of the pericoronary fat attenuation index (FAI) as an imaging marker to assess cancer therapy-related cardiovascular toxicity. We aimed to measure FAI in four consecutive coronary CT angiography (CTA) scans before and 3, 6, and 12 months after anthracycline treatment in patients with breast cancer to determine trends in dynamic changes in FAI after treatment.

Methods: We performed a post hoc analysis of a prospective study (between August 2019 and July 2020) in which anthracycline-induced myocardial injury was evaluated using cardiac CT.

Deep Learning Reconstruction for Enhanced Resolution and Image Quality in Breath-Hold MRCP: A Preliminary Study.

Objective: This preliminary study aims to assess the image quality of enhanced-resolution deep learning reconstruction (ER-DLR) in magnetic resonance cholangiopancreatography (MRCP) and compare it with non-ER-DLR MRCP images.

Methods: Our retrospective study incorporated 34 patients diagnosed with biliary and pancreatic disorders. We obtained MRCP images using a single breath-hold MRCP on a 3T MRI system.

Usefulness of Dual-Energy CT for Differentiating Hemorrhage From Iodine Extravasation in Meningiomas After Preoperative Embolization.

Objective: Discriminating between hemorrhage and iodine extravasation can pose challenges in conventional computed tomography (CCT) images following preoperative embolization for meningioma. This study aimed to assess the efficacy of dual-energy computed tomography (DECT) in differentiating hemorrhage from iodine extravasation after preoperative embolization for meningioma.

Methods: Twenty-one consecutive meningioma patients who underwent CCT before and DECT immediately after preoperative embolization were included in this study.

Enhancing thin slice 3D T2-weighted prostate MRI with super-resolution deep learning reconstruction: Impact on image quality and PI-RADS assessment.

Purposes: This study aimed to assess the effectiveness of Super-Resolution Deep Learning Reconstruction (SR-DLR) -a deep learning-based technique that enhances image resolution and quality during MRI reconstruction- in improving the image quality of thin-slice 3D T2-weighted imaging (T2WI) and Prostate Imaging-Reporting and Data System (PI-RADS) assessment in prostate Magnetic Resonance Imaging (MRI).

Methods: This retrospective study included 33 patients who underwent prostate MRI with SR-DLR between November 2022 and April 2023. Thin-slice 3D-T2WI of the prostate was obtained and reconstructed with and without SR-DLR (matrix: 720 × 720 and 240 × 240, respectively).

Machine Learning for Evaluating Vulnerable Plaque on Coronary Computed Tomography Using Spectral Imaging.

Background: This study aimed to determine whether spectral imaging with dual-energy computed tomography (CT) can improve diagnostic performance for coronary plaque characterization.

Methods And Results: We conducted a retrospective analysis of 30 patients with coronary plaques, using coronary CT angiography (dual-layer CT) and intravascular ultrasound (IVUS) studies. Based on IVUS findings, patients were diagnosed with either vulnerable or stable plaques.

CT-derived extracellular volume fraction in aortic stenosis, cardiac amyloidosis, and dual pathology.

Aims: To investigate CT-derived extracellular volume fraction (CT-ECV) in patients with lone aortic stenosis (AS), dual pathology of AS and transthyretin cardiac amyloidosis (AS-ATTR), and lone ATTR, and to examine the diagnostic performance and optimal cut-off values of CT-ECV for differentiating between patients with lone AS and AS-ATTR and between patients with lone AS and lone ATTR.

Methods And Results: This retrospective study included consecutive patients with severe AS (including lone AS and AS-ATTR) and lone ATTR who underwent CT-ECV analysis and technetium 99 m pyrophosphate (99mTc-PYP) scintigraphy. The diagnostic performance of CT-ECV for detecting cardiac amyloidosis was evaluated using the area under the receiver operating characteristic curve (AUC).

Gallbladder Follicular Lymphoma Mimicking Gallbladder Cancer.

Background/aim: Enlarged polypoid gallbladder lesions should first be evaluated to rule out gallbladder cancer. Gallbladder lymphoma rarely develops, and gallbladder follicular lymphoma is seldom observed.

Case Report: The case of a 70-year-old man with an enlarged polypoid gallbladder lesion and stable-sized multiple enlarged mesenteric lymph nodes is reported.

Impact of deep learning reconstruction on radiation dose reduction and cancer risk in CT examinations: a real-world clinical analysis.

Purpose: The purpose of this study is to estimate the extent to which the implementation of deep learning reconstruction (DLR) may reduce the risk of radiation-induced cancer from CT examinations, utilizing real-world clinical data.

Methods: We retrospectively analyzed scan data of adult patients who underwent body CT during two periods relative to DLR implementation at our facility: a 12-month pre-DLR phase (n = 5553) using hybrid iterative reconstruction and a 12-month post-DLR phase (n = 5494) with routine CT reconstruction transitioning to DLR. To ensure comparability between two groups, we employed propensity score matching 1:1 based on age, sex, and body mass index.