Journal Of Magnetic Resonance Imaging[JOURNAL]
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200 papers
Evaluation of Brain Microstructural Alterations in Preschool Autism Spectrum Disorder: A Voxel-Wise Multimodal MRI Study.
Wang C, Cheng M, Lu Y … +5 more , Guo J, Liu X, Feng Z, Liu S, Zhao X
J Magn Reson Imaging · 2026 Apr · PMID 41543116 · Full text
BACKGROUND: Autism Spectrum Disorder (ASD) presents with early neurodevelopmental alterations in preschool children, yet comprehensive characterization using multimodal quantitative MRI remains limited in this age group....
BACKGROUND: Autism Spectrum Disorder (ASD) presents with early neurodevelopmental alterations in preschool children, yet comprehensive characterization using multimodal quantitative MRI remains limited in this age group. PURPOSE: To investigate voxel-wise brain microstructural differences in preschool ASD through integrated analysis of cerebral perfusion, multiparametric relaxometry, and magnetic susceptibility. STUDY TYPE: Prospective case-control. POPULATION: Twenty nine-children with ASD (age 2-6 years; 23 males/6 females) and 25 age-/sex-matched healthy controls (HC). FIELD STRENGTH/SEQUENCE: 3.0 T MRI; high-resolution 3D-T1WI, quantitative susceptibility mapping (QSM), synthetic MRI (SyMRI), 3D pseudo-continuous arterial spin labeling (3D-pCASL). ASSESSMENT: Clinical assessments included the Gesell Developmental Schedules (GDS) and Childhood Autism Rating Scale (CARS). Imaging analysis consisted of voxel-wise whole-brain assessment of QSM, T1/T2/PD, and cerebral blood flow (CBF) maps. STATISTICAL TESTS: General linear models with cluster-based thresholding were applied for group comparison; Spearman's rank correlation with Bonferroni correction was used for clinical associations; and receiver operating characteristic (ROC) analysis with Delong's test was performed to compare diagnostic performance based on the areas under the curve (AUCs). RESULTS: Compared to HC, children with ASD showed decreased QSM values in the left superior/middle frontal gyri (SFG/MFG; cluster = 212 voxels, peak T = 5.55, p < 0.001). They also had reduced T1 relaxation times in bilateral SFG/MFG/precentral/postcentral gyri (four clusters: 315-750 voxels, peak T = 5.11-5.88, all p < 0.001). QSM values in the left SFG/MFG correlated positively with fine motor scores (r = 0.630, p < 0.001), while T1 values in the bilateral precentral/postcentral gyri correlated with gross motor scores (right: r = 0.548, p = 0.002; left: r = 0.461, p = 0.012). ROC analysis showed high diagnostic accuracy for both QSM (left SFG/MFG AUC = 0.858) and T1 values (left SFG/MFG AUC = 0.905; bilateral precentral/postcentral gyri AUC = 0.892-0.908). DATA CONCLUSION: Preschool ASD demonstrates prefrontal iron deficiency (reduced QSM) and sensorimotor myelination alterations (decreased T1), which correlate with motor deficits and show high diagnostic efficacy. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 2.
Standardization of MR Electrical Properties Tomography: A Guideline From the ISMRM Electro-Magnetic Tissue Properties Study Group.
Mandija S, Arduino A, Cui C … +15 more , Fuchs P, Giannakopoulos II, Ider YZ, Jung KJ, Katoch N, Katscher U, Kim DH, Lattanzi R, Meerbothe T, Odille F, Shmueli K, Soullié P, Tha KK, Zilberti L, van den Berg CAT
J Magn Reson Imaging · 2026 Apr · PMID 41543109 · Full text
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Multisequence MRI Enables High-Fidelity FDG-PET Synthesis for Epilepsy Using GANs.
Yao C, Cui B, Wang J … +5 more , Wang ZM, Wu C, Shan Y, Yang H, Lu J
J Magn Reson Imaging · 2026 May · PMID 41542825 · Publisher ↗
BACKGROUND: FDG-PET aids presurgical epilepsy evaluation but is limited by access and radiation exposure. PURPOSE: To evaluate synthetic FDG-PET generated from T1-weighted imaging and resting-state fMRI metrics. STUDY TY...
BACKGROUND: FDG-PET aids presurgical epilepsy evaluation but is limited by access and radiation exposure. PURPOSE: To evaluate synthetic FDG-PET generated from T1-weighted imaging and resting-state fMRI metrics. STUDY TYPE: Retrospective. POPULATION: 481 participants underwent simultaneous FDG PET/MR. Internal cohort: 311 epilepsy patients split into training/validation/internal test sets (n = 249/31/31; age 18.79 ± 16.33/22.20 ± 11.21/21.65 ± 17.62 years; male/female 145/104, 13/18, 22/9). External cohort: 115 temporal lobe epilepsy patients (age 25.36 ± 10.95 years; male/female 68/47) and 55 healthy controls (age 27.62 ± 5.82 years; male/female 24/31); 92 had surgery with 1-year outcome. FIELD STRENGTH: Hybrid PET/MR at 3.0 T; gradient-echo T1WI, echo-planar imaging and resting-state BOLD gradient-echo EPI. ASSESSMENT: Performance was assessed using SSIM, PSNR, MSE, NRMSE, SUVR correlation, and Bland-Altman analysis. Three blinded readers performed visual quality grading and detection of temporal lobe hypometabolism. Hippocampal radiomics was used for classification of hippocampal sclerosis and Engel outcome. STATISTICAL TESTS: t-tests, chi-square tests, Pearson correlation, Kolmogorov-Smirnov tests, DeLong tests, and false discovery rate correction. RESULTS: Excellent/Good visual ratings occurred in 82.8% (166/201), with Fleiss' κ = 0.42. SSIM was 0.98 ± 0.01 (internal) and 0.97 ± 0.01 (external); PSNR was 66.66 ± 1.25 and 64.16 ± 1.83, respectively. SUVR correlation with ground-truth PET was r = 0.94 (internal) and r = 0.89 (external); Bland-Altman bias was -0.02 (95% limits of agreement: -0.22 to 0.18) internally and -0.00002 (95% limits: -0.35 to 0.35) externally. Detection accuracy for temporal hypometabolism was 90.3% (internal; κ = 0.735) and 87.1% (external; κ = 0.758). Radiomics AUCs using synthetic PET were 0.72 (95% CI: 0.62-0.83) for hippocampal sclerosis versus healthy controls and 0.77 (95% CI: 0.67-0.87) for Engel IA versus IB-IV; DeLong tests versus ground-truth PET were non-significant (p = 0.56 and p = 0.48). CONCLUSION: Multisequence MRI-based synthetic PET showed high agreement with ground-truth PET across image-quality and quantitative SUVR metrics, providing a PET-like metabolic surrogate when FDG-PET is unavailable or impractical. LEVEL OF EVIDENCE: Evidence Level 3. STAGES OF TECHNICAL EFFICACY: Stage 3.
Assessment of Myocardial Microvascular Function in Athletes Using Resting Cardiac Magnetic Resonance First-Pass Perfusion.
Liu Q, Li C, Qi WY … +5 more , Tang M, Luo Y, Zhang XY, Zhong L, Chen J
J Magn Reson Imaging · 2026 May · PMID 41542793 · Publisher ↗
BACKGROUND: Impaired myocardial microvascular function may promote cardiac remodeling (CR) and myocardial fibrosis (MF), increasing cardiovascular risks in athletes. Early assessment of myocardial microcirculatory perfus...
BACKGROUND: Impaired myocardial microvascular function may promote cardiac remodeling (CR) and myocardial fibrosis (MF), increasing cardiovascular risks in athletes. Early assessment of myocardial microcirculatory perfusion presents potential for improving athlete care. PURPOSE: To evaluate the characteristics of myocardial microvascular function in athletes using resting cardiac MRI first-pass perfusion. STUDY TYPE: Prospective. POPULATION: One hundred and eighty-six athletes (median age 24 years, range 18-57; 167 males; mean 10 h/week exercise for 5 years) and 43 controls (median age 25 years, range 21-56; 35 males; < 3 h/week exercise). FIELD STRENGTH/SEQUENCE: Balanced steady-state free precession, gradient echo sequence, and phase sensitive inversion recovery late gadolinium enhancement sequences at 3.0 T. ASSESSMENT: CR was defined as any cardiac parameters exceeding the 99th percentile upper reference limits. MF was visually evaluated by three independent radiologists. Left ventricular resting first-pass perfusion parameters were assessed and compared across different groups. A predictive model was developed to screen athletes with and without CR/MF. STATISTICAL TESTS: Univariate analysis and Pearson coefficient were used. Area under the receiver operating characteristic curve (AUC) was used to assess the performance of the predictive model. A p < 0.05 was considered significant. RESULTS: Athletes exhibited lower upslope (2.12 [1.72; 2.56] vs. 2.77 [1.94; 3.22]) and maximum signal intensity (MaxSI) (20.8 [18.3; 23.6] vs. 29.5 [26.8; 33.0]), longer time to maximum signal intensity (TTM) (35.1 [31.0; 47.7] vs. 29.5 [26.8; 33.0] s) than controls. Male athletes with CR and/or MF showed lower upslope (1.54 [1.29; 1.96] vs. 1.94 [1.62; 2.43]) and MaxSI (18.0 [15.5; 21.7] vs. 21.2 [19.0; 23.5]), higher TTM (40.3 [31.5; 53.9] vs. 34.5 [29.0; 44.0] s) than those without. These perfusion parameters of athletes showed a negative correlation with global T2 mapping, QRS and corrected QT interval (r = -0.210 to -0.292). The AUC for the prediction model of CR and/or MF was 0.837. DATA CONCLUSION: Athletes showed lower resting myocardial perfusion than controls, especially in those with CR and/or MF, suggesting an association between perfusion reduction and CR/MF. EVIDENCE LEVEL: 1. TECHNICAL EFFICACY: Stage 2.
Non-Subtractive Arterial Spin Labeling-Based (NSASL) Renal Magnetic Resonance Angiography (MRA): Development and Clinical Feasibility Evaluation.
Wang Y, Yuan Y, Yan K … +11 more , Zhang J, Zeng J, Niu S, Ke S, Yao C, Chen B, Dai Q, Guo L, Zheng J, Meersmann T, Wang C
J Magn Reson Imaging · 2026 May · PMID 41532968 · Full text
BACKGROUND: Non-contrast renal MR angiography (MRA) is valuable for patients who cannot receive contrast agents or when avoiding radiation is desired. However, the conventional inflow inversion recovery (IFIR) method is...
BACKGROUND: Non-contrast renal MR angiography (MRA) is valuable for patients who cannot receive contrast agents or when avoiding radiation is desired. However, the conventional inflow inversion recovery (IFIR) method is limited by incomplete background suppression, venous contamination, and motion sensitivity. PURPOSE: To develop and evaluate a non-subtractive arterial spin labeling-based (NSASL) sequence for renal MRA and compare it with IFIR in healthy volunteers, with exploratory feasibility assessment relative to contrast-enhanced (CE)-MRA or computed tomography angiography (CTA) in patients. STUDY TYPE: Prospective. SUBJECTS: Thirty healthy volunteers (10 male, 35.6 14.0 years) and six participants with renal diseases or high blood pressure (2 male, 62.7 9.03 years). FIELD STRENGTH/SEQUENCE: 1.5 T; 3D stack-of-stars balanced steady-state free precession (bSSFP) NSASL MRA, 3D Cartesian bSSFP IFIR MRA, and CE-MRA. ASSESSMENT: Three radiologists independently rated image quality (main and branch renal arteries visualization, motion artifacts, vessel-to-background contrast, diagnostic confidence) on a 5-point scale. SNR efficiency (or SNR and time) and contrast ratio (CR) were also measured. STATISTICAL TESTS: Intraclass coefficient (ICC), Shapiro-Wilk's test, paired Student's t-test, and Wilcoxon signed-rank test with Bonferroni correction, with p < 0.05 considered statistically significant. RESULTS: ICC was good to excellent (ICC = 0.61-0.89) for average subjective scores. Compared with IFIR, NSASL showed significantly better vessel-to-background contrast (approximately fivefold increase in CR, Cohen's |d| = 2.54; +1 subjective score, |r| = 0.88), improved renal arteries visualization (+0.7 points, |r| = 0.67, corrected p 0.003), fewer motion artifacts (+0.6 points, |r| = 0.67, corrected p = 0.002), and higher diagnostic confidence (+0.6 points, |r| = 0.80, corrected p < 0.001). Acquisition time was reduced from 267.3 ± 69.0 s to 240.2 ± 51.3 s (Cohen's |d| = 0.54, corrected p = 0.018) while SNR efficiency was moderately lower (~26%, Cohen's |d| = 1.99, corrected p = 0.002). In participants with disease, NSASL yielded similar diagnostic confidence to CE-MRA (n = 4, +0.7 points, p = 0.194) and to CTA (n = 2, -0.2 points, p = 0.317). DATA CONCLUSION: NSASL significantly outperformed IFIR, with improved background suppression, vessel conspicuity, motion tolerance, and scan time in healthy volunteers. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 2.
Multiparametric MRI for Predicting Renal Function Deterioration and Chronic Kidney Disease Development in Patients Undergoing Nephrectomy for Renal Masses: A Pilot Study.
Liu MM, Bane O, Mu X … +13 more , Al-Mubarak H, Reddy AM, Bolger I, Abboud G, Kennedy P, Robson P, Meilika K, Horowitz A, Kuhn B, Farouk S, Badani K, Taouli B, Lewis S
J Magn Reson Imaging · 2026 Apr · PMID 41532966 · Full text
BACKGROUND: Patients with solid renal masses (SRMs) are at risk of chronic kidney disease (CKD) after surgical resection without a reliable pre-operative predictor. PURPOSE: To investigate whether pre-operative multipara...
BACKGROUND: Patients with solid renal masses (SRMs) are at risk of chronic kidney disease (CKD) after surgical resection without a reliable pre-operative predictor. PURPOSE: To investigate whether pre-operative multiparametric MRI (mpMRI) can predict CKD development and progression to stage 3 CKD. STUDY TYPE: Prospective. POPULATION: Forty-three participants (female = 13, mean age: 59 ± 12 years) undergoing nephrectomy for SRM. FIELD STRENGTH/SEQUENCE: 1.5 T, diffusion-weighted echo-planar imaging (DWI) using nine b-values (0-800 s/mm), T-mapping using variable flip angle, multi-echo gradient-echo blood-oxygen-level-dependent (BOLD), and dynamic-contrast-enhanced MRI (DCE-MRI) using 3D T-weighted gradient-echo. ASSESSMENT: A clinical CKD risk score was calculated from estimated glomerular filtration rate (eGFR), age, diabetes, and surgery (partial or radical nephrectomy). mpMRI parameters included cortical and medullary apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), tri-exponential diffusion (fast, medium, and slow), and spectral diffusion (vascular, tubule, and tissue) from DWI, native T from T-mapping, R* from BOLD, and renal plasma flow and eGFR from DCE-MRI. Outcomes were a correlation with baseline eGFR, prediction of postoperative 12-month eGFR decline > 5 mL/min/1.73 m, and stage 3 CKD development (eGFR < 60 mL/min/1.73 m). STATISTICAL TESTS: Mann-Whitney U-test and Spearman's rank correlation coefficient (r). Diagnostic ability was determined by leave-one-out cross-validated logistic regression area-under-the-receiver-operator-curve (AUC) and diagnostic odds ratio (DOR) with p-value < 0.05 considered significant. RESULTS: Thirty of 43 (67%) participants had normal baseline renal function (eGFR ≥ 60 mL/min/1.73 m). Twenty-nine participants completed 12-month follow-up: among 66% (19/29) who had baseline normal eGFR, 37% (7/19) developed stage 3 CKD. eGFR from DCE-MRI and tubule diffusion correlated with baseline eGFR ( = 0.43 and 0.33 respectively). Reduced vascular diffusion predicted eGFR decline (AUC = 0.75-0.83, DOR = 6.8-16.5). A larger contralateral ADC corticomedullary difference (AUC = 0.89; DOR = 22.5), and clinical CKD risk score (AUC = 0.81; DOR = 5.5) were the strongest predictors of CKD development. DATA CONCLUSION: Pre-operative mpMRI predicted post-nephrectomy CKD development. A larger corticomedullary difference in ADC may indicate reduced functional reserve. EVIDENCE LEVEL: 1. TECHNICAL EFFICACY: Stage 2.
Characterization of Intratumoral Heterogeneity via MRI-Based Radiomic Habitats in Osteosarcoma.
Li A, Zheng R, Chu J … +6 more , He Z, Wang Y, Feng C, Yang G, Zhang D, Ma H
J Magn Reson Imaging · 2026 Apr · PMID 41531147 · Publisher ↗
BACKGROUND: Accurate risk stratification for osteosarcoma is hindered by intratumoral heterogeneity. Conventional radiomics often treats tumors as homogeneous entities, overlooking spatial subregions and limiting prognos...
BACKGROUND: Accurate risk stratification for osteosarcoma is hindered by intratumoral heterogeneity. Conventional radiomics often treats tumors as homogeneous entities, overlooking spatial subregions and limiting prognostic accuracy. PURPOSE: To evaluate the prognostic value of an MRI-based radiomic habitat approach-partitioning the tumor into biologically distinct subregions-for post-treatment recurrence in osteosarcoma, comparing its performance with conventional whole-tumor analysis. STUDY TYPE: Retrospective cohort study. POPULATION: Eighty-eight osteosarcoma patients (including 56 males, 63.6%) and a temporal independent validation cohort of 80 sarcoma patients (including 52 males, 65%). FIELD STRENGTH/SEQUENCE: 3.0 T; T1-weighted spin-echo (SE), T2-weighted fast spin-echo (FSE), and contrast-enhanced T1-weighted (CE-T1WI) spin-echo sequences. ASSESSMENT: Tumors segmented on pre-treatment images were partitioned into four habitats using k-means clustering. Support Vector Machine (SVM) models were developed using features from habitats versus the entire tumor to predict 1-year recurrence. Unsupervised clustering identified prognostic subtypes. STATISTICAL TESTS: The DeLong test was used to compare Area Under the Curve (AUC) values. Kaplan-Meier survival analysis (Log-rank test) and Chi-square tests were employed for prognostic stratification. A p-value < 0.05 was considered statistically significant. RESULTS: The habitat-SVM model achieved the best performance, with an AUC of 0.839 (95% CI: 0.759-0.929) in the training cohort and 0.815 (95% CI: 0.782-0.999) in the temporal independent validation cohort. This performance was significantly superior to the best conventional model (AUC = 0.803). Unsupervised analysis identified four radiomic subtypes with significantly distinct recurrence rates (7.7%-76.7%) and disease-free survival outcomes. DATA CONCLUSION: MRI-based radiomic habitat analysis may help to characterize intratumoral heterogeneity in osteosarcoma, providing superior risk stratification for post-treatment recurrence. This non-invasive strategy offers a promising tool for individualized prognostic assessment. Limitations include the single-center design and small sample size. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.
The Performance of MR Cytometry Imaging in Differentiating High- and Low-Grade Bladder Cancer.
Chen L, Jin C, Guo E … +18 more , Liu F, Wang Y, Zhu J, Zhang X, Zhang J, Xu Z, Bai X, Wu Y, Tan Z, Jiang X, Feiweier T, Jin Z, Xu J, Guo H, Zhang G, Xue H, Shi D, Sun H
J Magn Reson Imaging · 2026 Jul · PMID 41521156 · Publisher ↗
BACKGROUND: Accurate preoperative grading of bladder cancer is important for determining treatment and prognosis. PURPOSE: To investigate the diagnostic efficacy of MR cytometry imaging in differentiating high- and low-g...
BACKGROUND: Accurate preoperative grading of bladder cancer is important for determining treatment and prognosis. PURPOSE: To investigate the diagnostic efficacy of MR cytometry imaging in differentiating high- and low-grade bladder cancer. STUDY TYPE: Prospective. POPULATION: Sixty-participants (male: 27, mean age: 65 years) with pathologically confirmed bladder cancer (37 high-grade, 23 low-grade). FIELD STRENGTH/SEQUENCE: 3.0 T, pulsed gradient spin-echo (PGSE) and oscillating gradient spin-echo (OGSE, 20 and 40 Hz) diffusion-weighted imaging. ASSESSMENT: All tumors were manually delineated independently by two radiologists, and inter-observer agreement was assessed using intraclass correlation coefficient (ICC). Time-dependent apparent diffusion coefficients (ADCs), including OGSE at 20 HZ (ADC), OGSE at 40 HZ (ADC), and PGSE (ADC), and MR cytometry-derived microstructural parameters (cell diameter [ ], intracellular volume fraction [ ], extracellular diffusivity [ ], and cellularity [ ]) were calculated. Histopathological examination of surgical specimens served as the reference standard for tumor grading. STATISTICAL TESTS: Mann-Whitney U test was used for group comparisons. Diagnostic performance was evaluated by logistic regression and receiver operating characteristic (ROC) analysis; area under the ROC curve (AUCs) was compared with the DeLong test. Statistical significance was set at p < 0.05. RESULTS: High-grade tumors showed significantly higher (median: 0.31 vs. 0.20), (1.97 vs. 1.33 × 10 μm), and lower ADCs than low-grade tumors while (p = 0.85, 95% confidence interval [CI] of mean difference: -0.822 to -0.820) and (p = 0.053, 95% CI of mean difference: 0.025 to 0.352) were not different. demonstrated the highest AUC (0.89; 95% CI: 0.80-0.97) among single parameters, and the combined model of , , and ADC achieved the highest diagnostic accuracy (AUC = 0.92; 95% CI: 0.86-0.99). DATA CONCLUSION: MR cytometry noninvasively differentiates high- from low-grade bladder cancer. showed good discriminatory performance, and combining , , and ADC further improves preoperative assessment. EVIDENCE LEVEL: 1. TECHNICAL EFFICACY: Stage 3: Diagnostic Thinking.
Editorial for "The Performance of MR Cytometry Imaging in Differentiating High- and Low-Grade Bladder Cancer".
Mumuni AN
J Magn Reson Imaging · 2026 Jul · PMID 41521155 · Publisher ↗
Abstract loading — click title to view on PubMed.
Subregional Radiomics Analysis on Multiparametric MRI for Evaluating Lymphovascular Invasion and Survival in Gastric Cancer: A Multicenter Study.
Song R, Feng Q, Pei E … +8 more , Li Z, Yuan X, Huo Y, Ren J, Cui Y, Chen W, He B, Yang X
J Magn Reson Imaging · 2026 May · PMID 41518607 · Publisher ↗
BACKGROUND: Accurate preoperative assessment of lymphovascular invasion (LVI) remains challenging due to the high heterogeneity of gastric cancer (GC). PURPOSE: To evaluate the feasibility of a subregion-based radiomics...
BACKGROUND: Accurate preoperative assessment of lymphovascular invasion (LVI) remains challenging due to the high heterogeneity of gastric cancer (GC). PURPOSE: To evaluate the feasibility of a subregion-based radiomics model using multiparametric MRI (mpMRI) for preoperative evaluation of LVI and to further assess its prognostic value. STUDY TYPE: Retrospective. SUBJECTS: A total of 878 GC patients from four centers: 313 training, 133 internal test, and 432 external validation cases. FIELD STRENGTH/SEQUENCE: 1.5 T and 3 T/mpMRI including T2-weighted imaging (FSE/TSE), diffusion-weighted imaging (SS-EPI), and contrast-enhanced T1-weighted imaging (FFE/VIBE). ASSESSMENT: The fuzzy c-means clustering was applied to subregion generation after manual segmentation. The subregional radiomics model was established using LVI-related features from a four-step extracted pipeline, with logistic regression, random forest, and support vector machine algorithms. The corresponding intra-tumoral subregion (ITS) index for each patient was obtained from the optimal subregional model. Subsequently, a combined model incorporating the ITS index and independent clinical characteristics was developed. Performance was further validated in test and validation cohorts. Additionally, the prognostic utility for overall survival (OS) and disease-free survival (DFS) was assessed in the follow-up cohort. STATISTICAL TESTS: Model area under the receiver operating characteristic curves (AUCs) was compared using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Kaplan-Meier survival analyses were conducted for prognostic evaluation. p < 0.05 was considered statistically significant. RESULTS: Pathological LVI-positive was detected in 448 (51.0%) patients. The combined model demonstrated satisfactory discrimination of LVI, achieving AUCs of 0.814 (training), 0.769 (test), and 0.758-0.783 (validation), outperforming the optimal subregional model with positive NRI and IDI across all cohorts. Furthermore, the ITS index maintained a significant association with OS (HR 33.50) and DFS (HR 30.00). DATA CONCLUSION: The combined model, which integrated the ITS index derived from subregional radiomics with clinical factors, demonstrated robust performance in evaluating both LVI and survival outcomes in GC patients. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 3.
Magnetic Resonance Imaging of Patients With Retained Ballistic Projectiles: A Review of Ferromagnetism, Ammunition Composition, and Safety Protocols.
Marino MD, Palacio J, Patel A … +1 more , Shoela R
J Magn Reson Imaging · 2026 Mar · PMID 41517918 · Publisher ↗
Retained ballistic projectiles are a common consequence of firearm injuries in the United States. As the role of magnetic resonance imaging (MRI) in medicine continues to expand, clinicians increasingly encounter patient...
Retained ballistic projectiles are a common consequence of firearm injuries in the United States. As the role of magnetic resonance imaging (MRI) in medicine continues to expand, clinicians increasingly encounter patients with retained bullets who would benefit from an MRI. However, the interaction between the strong magnetic field of an MRI and ferromagnetic implants can cause dangerous projectile movement and significant susceptibility artifacts, creating both safety and diagnostic concerns. Most bullets encountered in the United States are composed of copper alloy jackets and lead cores, which are diamagnetic and generally safe for MRI. Yet, some bullets are manufactured with steel components and are ferromagnetic. Radiologists have identified several approaches to determine the MRI compatibility of retained bullets, but few definitive guidelines exist to decide which of these patients can safely undergo MRI. In this article, we review the interactions of ferromagnetic bullets with the magnetic field of an MRI, list the material construction of various ammunition, discuss various proposed methods for determining the MR safety of retained projectiles, and synthesize literature recommendations into simplified algorithms that can be utilized to effectively triage patients with retained ballistic projectiles. Standardizing this screening process enables clinicians to stratify patient risk and avoid unnecessary MRI exclusions. EVIDENCE LEVEL: 5. TECHNICAL EFFICACY: Stage 5-Improvements in Patient Care.
Risk Stratification Based on Imaging Findings for Pregnancies With Subamniotic or Subchorionic Hematoma on Placental MRI.
Harada K, Himoto Y, Chigusa Y … +12 more , Tomotaki S, Kurata Y, Yoshida A, Muramatsu Y, Hidaka Y, Morita S, Matsumoto YK, Kido A, Kirita M, Minamiguchi S, Mandai M, Nakamoto Y
J Magn Reson Imaging · 2026 Jul · PMID 41517906 · Publisher ↗
BACKGROUND: Subamniotic or subchorionic hematoma (SAH/SCH) is associated with diverse pregnancy outcomes. The clinical implications of accompanying oligohydramnios and hemorrhagic amniotic fluid on MRI remain unclear. PU...
BACKGROUND: Subamniotic or subchorionic hematoma (SAH/SCH) is associated with diverse pregnancy outcomes. The clinical implications of accompanying oligohydramnios and hemorrhagic amniotic fluid on MRI remain unclear. PURPOSE: To investigate the importance of oligohydramnios and hemorrhagic amniotic fluid on placental MRI for SAH/SCH in risk stratification. STUDY TYPE: Retrospective. POPULATION: Seventy-one singleton pregnancies with SAH/SCH identified on placental MRI performed during the second or third trimesters, from 2016 to 2023. FIELD STRENGTH/SEQUENCE: 1.5 T, Fat-saturated T1-weighted gradient echo and half-Fourier-acquired single-shot turbo spin echo sequences. ASSESSMENT: Cases were classified into three groups: Groups A (oligohydramnios and hemorrhagic amniotic fluid), B (either oligohydramnios or hemorrhagic amniotic fluid), and C (SAH or SCH only). Groups B and C were subclassified as B-1 (oligohydramnios), B-2 (hemorrhagic amniotic fluid), C-1 (detected hematoma on ultrasound before MRI), and C-2 (incidentally detected hematoma on MRI). Unfavorable obstetric outcome (abortion or birth before 34 gestational weeks) and neonatal outcome (duration of neonatal intensive care unit [NICU] stay) were compared. STATISTICAL TESTS: Fisher's exact test, Kruskal-Wallis test, Mann-Whitney U test, and Kaplan-Meier analysis with Log-rank test. Significance was determined at p < 0.05. RESULTS: Unfavorable obstetric outcomes were significantly higher in Group A (11/12, 91.7%) than groups B (6/17, 35.3%) and C (9/42, 21.4%). Significant differences were found among the five subclassified groups, most notably between B-1 and B-2. The median duration of NICU stay was 87, 30.5, 0, 25, and 8 days in Groups A (n = 12), B-1 (n = 5), B-2 (n = 12), C-1 (n = 11), and C-2 (n = 31), respectively. Group A showed the worst neonatal outcomes. DATA CONCLUSION: MRI findings of oligohydramnios and/or hemorrhagic amniotic fluid in pregnancies with SAH/SCH are associated with adverse obstetric and neonatal outcomes, supporting risk stratification. EVIDENCE LEVEL: 4. TECHNICAL EFFICACY: Stage 5.
Outcome Assessment in Stroke Using Multiparametric MRI: Integrating Infarct Location, Radiomics, and Global Brain Frailty.
Li J, Li J, Huang L … +17 more , Wang L, Xu L, Zhao S, Xiao L, Cao Z, Liu X, Pan L, Chen J, Zhai D, Cai W, Yin X, Xing W, Shi F, Zhu W, Zhang Q, Lu G, Cheng X
J Magn Reson Imaging · 2026 May · PMID 41499699 · Publisher ↗
BACKGROUND: Accurate assessment of 90-day functional outcomes after anterior circulation large vessel occlusion (LVO) stroke remains challenging. Conventional models relying on a single data dimension have limited assess...
BACKGROUND: Accurate assessment of 90-day functional outcomes after anterior circulation large vessel occlusion (LVO) stroke remains challenging. Conventional models relying on a single data dimension have limited assessment power, suggesting that a multidimensional integration strategy could enhance evaluations. PURPOSE: To develop and validate an interpretable machine learning model that integrates radiomics, infarct location, brain frailty, and clinical variables for assessing 90-day functional outcomes in LVO stroke. STUDY TYPE: Retrospective. POPULATION: 1051 patients with anterior circulation LVO stroke (mean age 63 ± 13 years; 722 males) from five centers (2018-2023). Eight hundred and seventy-five patients from four centers formed the training (n = 612) and internal validation (n = 263) cohorts, while 176 from the fifth center comprised the external validation cohort. FIELD STRENGTH/SEQUENCE: T1-weighted spin-echo imaging (T1WI), T2-weighted spin-echo imaging (T2WI), T2-weighted fluid-attenuated inversion recovery (FLAIR) imaging, and diffusion-weighted echo-planar imaging (DWI). ASSESSMENT: Infarct volume and radiomic features were extracted from DWI. Infarct location was assessed using the Alberta Stroke Program Early CT Score. Brain frailty was evaluated using cortical/subcortical atrophy, white matter hyperintensity (WMH), and old infarcts. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for feature selection. STATISTICAL TESTS: Chi-square, Fisher's exact, t-test, Mann-Whitney U, area under the receiver operating characteristic curve (AUC), DeLong test, decision curve analysis, calibration curves, sensitivity, specificity, positive predictive value, negative predictive value, F1 score. Significance level p < 0.05. RESULTS: The fused model outperformed all single-dimension models (ΔAUC = 0.12-0.22), achieving AUCs of 0.87 (training), 0.84 (internal validation), and 0.86 (external validation). The fused model achieved a sensitivity and a specificity of 0.80 in the external validation cohort. Features with the highest mean absolute Shapley Additive Explanations (SHAP) values included lentiform nucleus lesion burden (SHAP = 0.083), WMH (SHAP = 0.080), and lesion burden in the M6 region (posterior middle cerebral artery territory; SHAP = 0.061). DATA CONCLUSION: Integration of infarct location, brain frailty, radiomics, and clinical features improved the 90-day outcome assessment in anterior circulation LVO stroke, providing an interpretable tool for personalized prognosis. TECHNICAL EFFICACY STAGE: 2.
Evaluation of Image-Level Harmonization Methods for Multi-Center MR Neuroimaging.
Ho BC, Kim D, Kumar A … +5 more , Weiss S, Vossler H, Mormino E, Zaharchuk G, Alzheimer's Disease Neuroimaging Initiative
J Magn Reson Imaging · 2026 May · PMID 41489091 · Full text
BACKGROUND: Multi-center imaging studies create large-scale data that are useful for identifying pathological patterns and robust training of deep learning models. However, variation due to site and scanner differences c...
BACKGROUND: Multi-center imaging studies create large-scale data that are useful for identifying pathological patterns and robust training of deep learning models. However, variation due to site and scanner differences can confound analyses, emphasizing the need for harmonization. PURPOSE: To evaluate scanner-related differences in T1w and T2-FLAIR images in the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and assess the performance of publicly available image-level harmonization tools. STUDY TYPE: Retrospective. POPULATION: Scanner group analysis: 1143 ADNI3 subjects (233 GE, 173 Philips, 250 Siemens, with 487 Siemens subjects used as an independent reference group). Within-subject comparison: paired multi-vendor scan sessions from 8 subjects. FIELD STRENGTH/SEQUENCE: 3.0T, T1w, and T2-FLAIR MRI sequences. ASSESSMENT: Gray/white matter contrast ratio (G/W ratio), white matter hyperintensity (WMH) volume, and image feature similarity metrics (Fréchet Inception Distance [FID], Learned Perceptual Image Patch Similarity [LPIPS]) were compared across scanner vendors before and after harmonization with statistical (ComBat) and deep learning (HACA3) algorithms. STATISTICAL TESTS: One-way ANOVA and post hoc Games-Howell tests were conducted to assess differences between scanner groups across image pipelines (baseline, post-harmonization). Repeated-measures ANOVA and post hoc paired t-tests with Bonferroni correction were used to evaluate similarity metric changes pre- and post-harmonization for multi-vendor subjects. We defined statistical significance as p < 0.05. RESULTS: At baseline, significant image differences in G/W ratio and WMH volumes between vendors were identified. Both ComBat and HACA3 harmonization improved G/W ratio consistency for T1w and T2-FLAIR imaging across vendors, particularly for GE T2-FLAIRs. HACA3 led to the best similarity between scanner datasets: mean FID T1w/T2-FLAIR: 10.45/14.62 (Baseline); 7.45/11.71 (ComBat); 5.60/8.91 (HACA3). Only HACA3 harmonization resulted in non-significant differences between vendors for WMH volume. DATA CONCLUSION: HACA3 deep learning harmonization outperformed a statistical method, ComBat, improving MR contrast consistency and feature similarity across vendors. However, difficulties in harmonizing T2-FLAIRs highlight limitations in current multi-contrast MR harmonization tools. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 1.
Enhancing Study Design and Analysis of MR Imaging Markers Through Measurement Error Modeling.
Wang X, Zhao W, Wang Y … +6 more , Kwon DH, Su TY, Obuchowski NA, Griswold MA, Wang ZI, Ma D
J Magn Reson Imaging · 2026 Jun · PMID 41481854 · Full text
BACKGROUND: Measurement error in imaging reduces statistical power and potentially biases parameter estimation, compromising study reliability. PURPOSE: To introduce a dual data collection design (reliability and main da...
BACKGROUND: Measurement error in imaging reduces statistical power and potentially biases parameter estimation, compromising study reliability. PURPOSE: To introduce a dual data collection design (reliability and main datasets) to quantify measurement error and apply regression calibration to correct error-prone imaging markers, thereby improving biomarker-outcome estimation, statistical power, and sample size planning. STUDY TYPE: Prospective (reliability) and retrospective (regression calibration). POPULATION: 65 healthy volunteers (mean age: 23.2), 60 age and sex matched with 34 epilepsy patients (mean age: 28.7). FIELD STRENGTH/SEQUENCE: 3.0 T, MR fingerprinting (MRF) and T1-weighted (T1w) MPRAGE. ASSESSMENT: Three-dimensional brain scan-rescan data were acquired in 5 volunteers (6 identical acquisitions per volunteer across 3 scanners) to estimate reliability coefficients ( ) for MRF T1 and T1w signal intensity (SI) mean and standard deviation (SD). These coefficients were applied in regression calibration to correct imaging markers in the epilepsy cohort. Effect sizes for distinguishing lesional from control were compared before and after correction. Simulations evaluated the impact of additive and proportional bias on sample size, statistical power, and association estimates under single and multi-scanner scenarios. STATISTICAL TEST: Reliability coefficient, Cohen's d, regression calibration, generalized estimation equations. RESULTS: MRF T1 markers exhibited higher reliability ( = 0.887-0.941) than T1w SI markers with site effects ( = 0.246-0.554). Regression calibration increased effect size more for T1w SI mean (333.22% increase) than for MRF T1 mean (12.57% increase). In multi-site simulations, regression calibration alone achieved unbiased estimate under small site effects (additive and proportional SD ≤ 0.2), whereas under larger site effects (additive SD ≥ 0.5) only the combined regression calibration and Combat produced near-zero bias (-0.024), outperforming naïve analysis (-0.423). DATA CONCLUSION: The dual data acquisition design with regression calibration restores attenuated imaging biomarker associations, improves statistical power, and informs sampling requirements, thus enhancing reliability and generalizability in multi-site imaging studies. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: 2.
Editorial for "Deep Learning-Based Brainstem Segmentation and Multi-Class Classification for Parkinsonian Syndrome".
Chakraborty P
J Magn Reson Imaging · 2026 Apr · PMID 41473963 · Publisher ↗
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Editorial for "Association Between Gas-Free Cerebrovascular Reactivity (CVR) and Cognitive Function in Older Adults With a High Risk for Vascular Dementia".
Yan L
J Magn Reson Imaging · 2026 May · PMID 41473961 · Publisher ↗
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Detection of Early Knee Osteoarthritis Using Multi-Component T Mapping.
de Moura HL, Monga A, Singh D … +3 more , Zibetti MVW, Samuels J, Regatte RR
J Magn Reson Imaging · 2026 May · PMID 41473939 · Full text
BACKGROUND: Early detection of knee osteoarthritis (OA) is important. Spin-lattice relaxation in the rotating frame (T) mapping is sensitive to early cartilage changes, but the mono-exponential (ME) model may be limited....
BACKGROUND: Early detection of knee osteoarthritis (OA) is important. Spin-lattice relaxation in the rotating frame (T) mapping is sensitive to early cartilage changes, but the mono-exponential (ME) model may be limited. Multi-component models can capture more tissue complexity, but their diagnostic advantage has not been validated. PURPOSE: To evaluate if stretched- (SE) and bi-exponential (BE) T models can improve early knee OA detection over the ME model. STUDY TYPE: Case-control study. POPULATION: Twenty-six healthy subjects (mean age 51.5) and 26 early knee OA patients (mean age 61.8). FIELD STRENGTH/SEQUENCE: T-prepared Turbo FLASH sequence at 3 T field strength. ASSESSMENT: T parameters from three exponential models were adjusted for age. To maximize group separability, the parameters were combined into single discriminators for both global knee cartilage and six anatomical sub-regions. Diagnostic performance was assessed based on the ability of these combined models to distinguish early OA. STATISTICAL TESTS: Parameters were adjusted for age. Mann-Whitney U-test (group comparisons), linear discriminant analysis (LDA), and area under the receiver operating characteristic (ROC) curve (AUC) with bootstrapped 95% confidence intervals (CI). Significance level set at p < 0.05, using the false discovery rate (FDR) to correct for multiple comparisons. RESULTS: In the global analysis, no model demonstrated significant diagnostic performance (p-values of 0.63, 0.96, 0.63 for ME, SE, and BE). Multi-regional SE model (AUC = 0.83, CI: 0.72, 0.93) significantly distinguished OA and healthy groups. Calibration analysis showed the SE model had the lowest Brier score (0.17), significantly better than the ME model (0.26). DATA CONCLUSION: Sub-regional analysis of T parameter maps suggests an improvement in diagnostic performance for early knee OA compared to globally averaged measurements. The stretched-exponential model showed the most promise. However, small sample size and wide confidence intervals highlight the need for further validation with a larger cohort before clinical utility claims can be made. EVIDENCE LEVEL: 4. TECHNICAL EFFICACY: Stage 2.
Clinical Validation of a Fast MRI Method to Evaluate Brain Vascular and Parenchymal Abnormalities in Sturge-Weber Syndrome.
McKay SG, Chen Y, Haacke EM … +3 more , Xuan Y, Luat AF, Juhász C
J Magn Reson Imaging · 2026 May · PMID 41467540 · Full text
BACKGROUND: Sturge-Weber syndrome (SWS) is a rare neurocutaneous disorder associated with venous capillary malformations, atrophy, and calcifications. Longitudinal imaging is limited by risks of sedation and gadolinium e...
BACKGROUND: Sturge-Weber syndrome (SWS) is a rare neurocutaneous disorder associated with venous capillary malformations, atrophy, and calcifications. Longitudinal imaging is limited by risks of sedation and gadolinium exposure in children. PURPOSE: To evaluate whether strategically acquired gradient echo (STAGE), a rapid multi-contrast quantitative MRI method, can reliably detect vascular and parenchymal abnormalities in SWS compared with conventional pre-/post-contrast MRI. STUDY TYPE: Observational cross-sectional. POPULATION: Twenty-two patients with unilateral SWS diagnosed by previous MRI (13 female; ages 2-24 years). FIELD STRENGTH/SEQUENCE: 3T/T1-weighted (T1W) and T2-weighted (T2W) turbo-spin-echo, fluid attenuated inversion recovery, and a 3D gradient echo-based STAGE sequence providing T1, proton density (PD), T2*, and R2* maps, susceptibility-weighted imaging (SWI), quantitative susceptibility mapping (QSM), T1W with enhanced gray matter to white matter contrast (T1WE), and synthetic images of T2W, FLAIR, and gradient echo images. ASSESSMENT: Conventional MRI and STAGE images were reviewed in 10 patients (training group), side-by-side, to determine the STAGE-derived images that identify SWS abnormalities, including leptomeningeal venous capillary malformations (LVCM), enlarged deep medullary veins, choroid plexus enlargement, cerebral atrophy, and calcifications. In the remaining test group of 12 patients, three reviewers scored these abnormalities on STAGE images and compared them with scores from conventional MRI. STATISTICAL TESTS: Interrater reliability with intraclass correlation coefficient (ICC), Spearman's rank correlation, Wilcoxon signed-ranked test, Mann-Whitney U-test, Fisher's exact test. Statistical significance level was set as p < 0.05. RESULTS: LVCMs were visualized on STAGE with SWI and R2*. Calcifications were differentiated from venous abnormalities using PD, T1WE, synthetic gradient echo, and QSM. STAGE-derived scores had excellent interrater reliability (ICCs > 0.90) and were similar to the conventional MRI scores despite some minor differences in some individual cases (total scores from conventional MRI vs. STAGE 8.9 vs. 8.7, p = 0.29). DATA CONCLUSION: STAGE provided rapid, non-contrast, multi-parametric imaging that reliably detected vascular and parenchymal SWS abnormalities seen on conventional MRI. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 3.
Editorial for "Diffusion-Based Virtual MR Elastography: Association With Pancreatic Fibrosis and Identification of Postoperative Pancreatic Fistula After Pancreaticoduodenectomy".
Ichikawa S
J Magn Reson Imaging · 2026 May · PMID 41460656 · Publisher ↗
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