Journal highlights
The following are highlights from the current issues of RSNA’s peer-reviewed journals.
CT-QFR May Help Predict Long-Term Outcomes in CAD
Coronary CT angiography (CTA) is the recommended first-line noninvasive test for evaluating suspected coronary artery disease (CAD). CTA provides detailed views of coronary artery anatomy and the extent of CAD. However, CTA is only moderately effective at identifying hemodynamically significant lesions. Reliable, noninvasive methods are needed to better identify patients who may benefit from revascularization.
A new Radiology study investigated the prognostic value of CTA-derived quantitative flow ratio (CT-QFR) in predicting long-term CAD outcomes. QFR is a fast, noninvasive method for assessing blockage severity by calculating fractional flow reserve from CTA images. Zehang Li, PhD, from Ruijin Hospital, Shanghai Jiao Tong University, China, and colleagues found that CT-QFR and history of myocardial infarction were independent predictors of major adverse cardiovascular events. CT-QFR showed a five-year prognostic value similar to invasive CTA or SPECT, but its prognostic ability was reduced in patients with prior percutaneous intervention.
“The development of dual-source and photon-counting CT, which aims to distinguish different tissue components with high spatial resolution, might be able to address this issue, including a coronary artery tree reconstructed from CT angiography (CTA), with CTA-derived quantitative flow ratios presented,” the authors write.
Read the full article, “Prognostic Value of Coronary CT Angiography–Derived Quantitative Flow Ratio in Suspected Coronary Artery Disease,” at RSNA.org/Radiology.
Follow the Radiology editor on X @RadiologyEditor.
Images in a 53-year-old man with suspected coronary artery disease.
Complete legend details at https://doi.org/10.1148/radiol.240299 ©RSNA 2024
Lessons Learned from Photon-Counting CT
Photon-counting CT (PCCT) became clinically available in the U.S. in 2021. Compared with conventional energy-integrating detector-based (EID) CT systems, PCCT offers advantages such as improved contrast resolution and reduced radiation exposure. As PCCT gains wider acceptance, guidance on integrating this cutting-edge modality into clinical practice is critical.
A recent RadioGraphics article serves as a comprehensive reference for radiologists, technologists, medical physicists and informatics teams looking to maximize the potential of PCCT. Fides R. Schwartz, MD, from Brigham and Women’s Hospital in Boston, and colleagues use real-life case examples to review PCCT physics and explain key differences between PCCT and EID CT systems.
They discuss four essential steps for establishing a successful PCCT imaging practice: protocol building, imaging setup and acquisition, image reconstruction and archiving, and image review. The article focuses on one commercially available PCCT system, but the general concepts can be applied to future systems as well.
“As institutions contemplate the integration of PCCT into their clinical armamentarium, a nuanced understanding of the differences from EID systems is indispensable,” the authors conclude.
Read the full article, “Getting Started with Photon-counting CT: Optimizing Your Setup for Success,” at RSNA.org/RadioGraphics. This article is also available for CME on EdCentral. Follow the RadioGraphics editor on X @RadG_Editor.
Improved contrast resolution at bone imaging in a 63-year-old woman with osseous metastases (arrows) secondary to lung cancer. Axial EID CT acquisition displayed as a linear blended image (A) and axial 60-keV PCCT image obtained 5 months later (B) show differences in contrast resolution leading to improved conspicuity of a right femoral osseous metastasis.
https://doi.org/10.1148/rg.240106 © RSNA 2025
Using AI to Predict Prostate Cancer Progression Risk
The most common cancer among men, prostate cancer (PCa) demonstrates a high incidence of low-risk disease. Men with low-risk PCa are at substantial risk for overdiagnosis and overtreatment, making active surveillance an increasingly adopted approach for this group.
Risk calculators could aid management of PCa by estimating personalized future risk levels. These could be used to guide the timing and intensity of follow-up examinations. A recent Radiology: Imaging Cancer study examined the potential for deep learning as a tool to calculate PCa progression risk.
Christian Roest, MSc, University Medical Center Groningen, Netherlands, and colleagues retrospectively analyzed 1,607 MRI scans from 1,143 male patients suspected, but all initially negative, of having clinically significant PCa between 2012 and 2022.
The researchers used a deep learning model using baseline MRI and relevant clinical parameters to predict the time to clinically significant PCa progression.
“The deep learning model accurately predicted PCa progression and provided improved risk estimations, demonstrating its ability to aid in personalized follow-up for low-risk PCa,” the authors conclude.
Read the full article, “Development and Validation of a Deep Learning Model Based on MRI and Clinical Characteristic to Predict Risk of Prostate Cancer Progression,” at RSNA.org/Imaging-Cancer. Follow the Radiology: Imaging Cancer editor on X @RadIC_Editor.
Editorial Fellowship Applications Open
Applications are being accepted for the RSNA William R. Eyler Editorial Fellowship and the RSNA William W. Olmsted Editorial Fellowship for Trainees.
Both fellowships offer the opportunity to work with Radiology Editor Linda Moy, MD, in New York City, and RadioGraphics Editor Christine Cooky Menias, MD, in Phoenix.
The Eyler fellowship lasts three weeks and provides an opportunity for mid-career radiologists to further their experience in radiologic journalism. The Olmsted fellowship lasts one week and is intended for residents and fellows interested in scholarly publication and editorial processes at medical journal offices.
Each fellow will also visit the Publications Department at RSNA headquarters in Oak Brook, IL. The Eyler fellow will work with the RadioGraphics editorial team at RSNA 2025.
Applications are also being accepted for the RSNA Journals International Editorial Fellowship for early or mid-career radiologists currently residing in a non-North American country. The fellowship takes place over the course of two weeks through a series of virtual meetings.
Applications for all three fellowships are due March 3. Learn more at RSNA.org/Journals/Editorial-Fellowships.