Purpose To explore the value of amide proton transfer(APT)imaging combined with diffusion kurtosis imaging(DKI)in the differential diagnosis of prostate carcinoma and benign prostatic hyperplasia.Materials and Methods A retrospective analysis was conducted on 120 patients who underwent multi-parameter prostate MRI and pathological biopsy at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to August 2021,including 66 cases of benign prostatic hyperplasia and 54 cases of prostate carcinoma.The parameters of APT imaging and DKI,including magnetization transfer ratio asymmetry(MTRasym),mean kurtosis(MK),mean diffusion coefficient(MD)and fraction anisotropy were measured,and the parameters between the two groups were compared and analyzed.The receiver operating characteristic curve and Delong test were used to analyze the efficacy of each parameter,APT or DKI sequence alone and their combined diagnosis,and the correlation among the parameters was analyzed.Results Compared with the benign prostatic hyperplasia group,the MTRasym,MK and fraction anisotropy of the prostate carcinoma group were significantly higher,while the MD was significantly lower,with statistical significance(t=8.23,12.53,2.20,-11.12,all P<0.05).The areas under the curve for the above parameters were 0.852,0.933,0.615 and 0.910,respectively.The diagnostic efficacy of APT combined with DKI for differentiating prostate carcinoma from benign prostatic hyperplasia is numerically higher than that of APT alone or DKI alone,with the areas under the curve being 0.994,0.988 and 0.852,respectively,as well as a sensitivity of 96.30%and a specificity of 98.48%.There was a statistically significant difference in efficacy between the APT+DKI combined approach and APT alone(Z=4.387,P<0.05),while no statistically significant difference exists between the combined approach and DKI alone(Z=1.375,P>0.05).MTRasym was positively correlated with MK(r=0.45,P<0.001).MD was negatively correlated with MTRasym and MK(r=-0.439,-0.500,both P<0.001).Conclusion The parameters MTRasym,MK and MD of APT and DKI have relatively high value in distinguishing prostate carcinoma from benign prostatic hyperplasia,and the combined diagnostic efficiency of the two sequences tends to increase,with some parameters showing correlation.

Placenta accreta spectrum,characterized by abnormal placental adhesion or invasion into the uterine myometrium,represent severe obstetric complications that may lead to uterine rupture and life-threatening postpartum hemorrhage.Although ultrasound remains the primary screening modality for placenta accreta spectrum,its diagnostic accuracy is limited by operator experience and gestational age.MRI with its advantages of multi-sequence acquisition,multiplanar capabilities,high soft-tissue resolution and wide field of view,serves as a critical adjunct for diagnosis when ultrasound results are inconclusive.However,MRI interpretation heavily relies on radiologists'expertise.The integration of artificial intelligence(AI)with MRI has emerged as a promising approach to address this challenge.This article reviews recent advances in MRI-based AI diagnostic and predictive models for placenta accreta spectrum,focusing on the application of radiomics and deep learning techniques in AI-driven diagnostic and predictive models.The technical strengths,clinical applicability and limitations of these models are critically analyzed,and future directions for enhancing generalizability and clinical translation are proposed.

Dual-energy CT enables acquisition of multi-parametric information beyond conventional CT through various post-processing techniques.Among these,virtual monoenergetic imaging has demonstrated outstanding performance in improving image quality,facilitating diagnosis,detecting isodense and small lesions,optimizing angiographic protocols,and reducing contrast medium dosage and radiation exposure.This article reviews the fundamental principles,technical advantages,and emerging clinical applications of virtual monoenergetic imaging.

Postherpetic neuralgia is a common chronic and intractable neuropathic pain.In recent years,a growing number of neuroimaging studies have used MRI to explore the different effects of postherpetic neuralgia on brain structure and function.This paper reviews the research progress of postherpetic neuralgia from various MRI techniques,revealing the remodeling mechanism of the central nervous system,such as abnormalities in various brain functional networks and activation of pain-related brain regions,to provide a reference for clinical auxiliary diagnosis and objective evaluation.

Purpose To investigate the evaluation value of multimodal MRI in the outcome of traumatic brain injury(TBI)in rats.Materials and Methods A total of 30 TBI rat models were established,randomly divided into an untreated TBI group and a TBI treated group(hyperbaric oxygen)with 15 rats each.The Sham group with 15 rats was used as a healthy control,and the brain injury status of the rats was evaluated at 1 d,3 d,7 d,14 d and 28 d of modeling.Multimodal MRI was performed in parallel,and coronary T2WI,diffusion weighted imaging,diffusion kurtosis imaging and diffusion tensor imaging sequences were routinely scanned.The correlation between rat neurological function scores and various sequence parameters were analyzed,as well as multimodal MRI and the outcome of brain injury after TBI treatment in rats.Results The neurological function score and average kurtosis of the TBI treatment group were lower than those of the TBI untreated group(P<0.05).The apparent diffusion coefficient and anisotropy score of the TBI treatment group were higher than those of the TBI untreated group(P<0.05).The diffusion weighted imaging parameter apparent diffusion coefficient value and diffusion tensor imaging parameter fraction anisotropy value were negatively correlated with the degree of brain injury in TBI rats after 28 days of treatment(r=-0.675,-0.611,P<0.05),while the diffusion kurtosis imaging parameter mean kurtosis value was positively correlated with the degree of brain injury in TBI rats after 28 days of treatment(r=0.623,P<0.05).Conclusion Multimodal MRI can effectively evaluate the brain injury status of TBI rats and provide valuable information for dynamic evaluation after hyperbaric oxygen therapy for TBI,with high evaluation value in treatment outcomes.

Purpose To explore the clinical and imaging characteristics of central nervous system candidiasis due to Candida albicans in immunocompetent infants children.Materials and Methods A retrospective analysis was conducted on immunocompetent children with central nervous system candidiasis diagnosed at Beijing Children's Hospital,Capital Medical University from October 2012 to October 2022,and their clinical and MRI characteristics were analyzed.Results Among the 26 enrolled children,88.5%(23 cases)were under one year old,and 88.5%(23 cases)had high-risk factors.Premature birth was the most common high-risk factor(16 cases,61.5%).All 26 cases had positive MRI examinations,with the main manifestations being meningeal thickening and enhancement(25 cases,96.2%),57.7%(15 cases)involving the skull base meninges,23.1%(six cases)involving the cranial nerves,intracranial localized granulomas(16 cases,61.5%),hydrocephalus(14 cases,53.8%),cerebral infarction(four cases,15.4%),subdural effusion(six cases,23.1%)and cerebral abscess(two cases,7.7%);13 cases of magnetic resonance angiography and magnetic resonance venography examinations were performed,and 10 cases of magnetic resonance angiography abnormalities were found,mainly due to thinning,narrowing or reduced branches of the arterial trunk,and one case of magnetic resonance venography transverse sinus thrombosis.Conclusion Central nervous system candidiasis mostly exists in children younger than one year old.MR imaging shows a more characteristic invasion of the skull base,often causing enhancement of the skull base meninges and cranial nerves,as well as localized granulomas and hydrocephalus.Imaging examination is of great significance for early diagnosis.

Purpose To investigate the value of peritumoral expansion-based radiomics from tumor regions of interest(ROIs)for predicting epidermal growth factor receptor(EGFR)mutation status and to identify the optimal peritumoral expansion margin.Materials and Methods This retrospective study included 390 patients with pathologically confirmed non-small cell lung cancer(NSCLC)and definitive EGFR genotyping results from the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University(December 2021 to September 2023).Patients were randomly divided into training and validation sets(8∶2 ratio,310 vs.80 patients;CT slice thickness:5-7 mm).An additional independent test set of 100 patients undergoing thin-section CT(1-2 mm)was included to assess model generalizability across slice thicknesses.Clinical characteristics and CT semantic features were analyzed.After automated tumor segmentation with manual refinement,ROIs were sequentially expanded outward by 1,2,3,4 and 5 mm.A total of 2 264 radiomic features were extracted from each ROI.Feature selection using minimum redundancy maximum relevance and least absolute shrinkage and selection operator algorithms was performed in the training set to calculate radiomics scores.Logistic regression was used to develop prediction models.A combined model integrating optimal peritumoral radiomics score with clinical and CT features was established,with performance compared across models.Results Gender(χ2=24.922,P<0.001),smoking history(χ2=11.199,P=0.001),emphysema(χ2=40.802,P<0.001),and lymph node metastasis(χ2=5.674,P=0.017)were associated with EGFR mutation status.In the validation set,the area under the curve for the tumor ROI-based radiomics model was 0.676,while the five expansion models achieved area under the curve of 0.723,0.720,0.734,0.681,and 0.598,respectively.The combined model based on 3 mm expansion demonstrated superior performance to individual radiomics and clinical models,with area under the curve of 0.826,0.734,0.711 in the validation set,and 0.809,0.760,0.702 in the independent test set.Conclusion Peritumoral expansion-based CT radiomics demonstrates value for predicting EGFR mutations in NSCLC,with 3 mm identified as the optimal expansion margin.Integration with clinical information further enhances predictive accuracy.

Purpose To develop an integrate model combining deep learning features from contrast-enhanced lung ultrasonography with clinical characteristics for predicting epidermal growth factor receptor mutation status in peripheral non-small cell lung cancer.Materials and Methods This retrospective study included 117 patients with pathologically confirmed non-small cell lung cancer from the First Affiliated Hospital of Guangxi Medical University(July 2021 to February 2024).Patients were randomly divided into training(n=93)and test(n=24)sets at an 8∶2 ratio.Regions of interest were delineated at the peak enhancement phase of contrast-enhanced lung ultrasonography.Various deep learning convolutional neural networks were pretrained,with ResNet18 selected as optimal for feature extraction.Deep learning,clinical,and integrated models were constructed using naive Bayesian algorithm.Performance was evaluated via receiver operating characteristic and calibration curves,while class activation mapping and Shapley additive explanation values provided model interpretability.Results In the training set,the deep learning,clinical and integrated models achieved area under the curve of 0.93(95%CI 0.88-0.98),0.86(95%CI 0.68-1.00),and 0.91(95%CI 0.85-0.97),respectively.Corresponding test set area under the curve were 0.81(95%CI 0.72-0.90),0.56(95%CI 0.33-0.80),and 0.87(95%CI 0.72-1.00).Both deep learning and integrated models significantly outperformed the clinical model in training(Z=2.380,P=0.017;Z=2.597,P=0.009)and test sets(Z=2.034,P=0.042;Z=2.577,P=0.010).The integrated model demonstrated excellent calibration and predictive performance.Conclusion The integrated model combining deep learning features from contrast-enhanced lung ultrasonography with clinical characteristics effectively predicts epidermal growth factor receptor mutation status in peripheral non-small cell lung cancer.

Purpose To observe the short-term efficacy of CalliSpheres? drug-eluting beads for embolization in the treatment of non-small lung cancer compared with bronchial artery chemoembolization and systemic vein chemotherapy.Materials and Methods A retrospective analysis was performed on 78 patients with pathologically confirmed non-small cell lung cancer from the First Affiliated Hospital of Dali University from March 2016 to September 2018.The patients were assigned to three groups(n=26 each):an observation group receiving CalliSpheres? drug-eluting bead embolization,a control group receiving bronchial arterial chemoembolization,and a conventional group receiving systemic intravenous chemotherapy.In both the observation and control groups,after the tumor-feeding arteries were identified by bronchial arteriography,a coaxial microcatheter was superselectively advanced into these arteries.Chemotherapeutic agents were then infused separately through each individual feeding artery.The observation group underwent embolization using drug-eluting microspheres,whereas the control group underwent embolization with blank microspheres.The conventional group was treated with intravenous chemotherapy.The objective response rates at 2 months post-procedure were compared among the three groups.Results The objective response rates at 2 months post-procedure were as follows:observation group,84.62%;control group,57.69%;conventional group,26.92%.The observation group showed a significantly superior objective response rate relative to the control group and the conventional group(χ2=4.591,17.541,P<0.05).Additionally,the objective response rate in the control group was significantly higher than that in the conventional group(χ2=5.042,P=0.025).Conclusion For non-small cell lung cancer,CalliSpheres? drug-eluting bead embolization provides significantly better short-term clinical efficacy than both bronchial arterial chemoembolization and systemic intravenous chemotherapy.Bronchial arterial chemoembolization itself is more effective than systemic intravenous chemotherapy.

Lung cancer represents the leading cause of cancer-related mortality worldwide,with non-small cell lung cancer(NSCLC)constituting the predominant histological subtype.Molecular targeted therapy serves as first-line treatment for advanced NSCLC patients with driver gene mutations,yet therapeutic response and prognosis vary substantially across molecular phenotypes.Conventional CT evaluation relies primarily on unidimensional tumor measurements but provides limited morphological and functional information.CT radiomics enables extraction and comprehensive analysis of numerous quantitative features from medical images,potentially revealing tumor genotype,treatment response and prognostic information.This approach shows significant promise for assessing targeted therapy outcomes in NSCLC.This review summarizes current applications and research advances in CT radiomics for NSCLC targeted therapy evaluation,providing insights to guide personalized precision medicine.