The Prostate Imaging Quality (PI-QUAL) V2 is a simplified update of PI-QUAL V1 for assessing image quality in multiparametric prostate MRI (mpMRI), aimed at improving clinical use and reproducibility. This study evaluated inter-reader agreement of PI-QUAL V2 among basic prostate readers using multicenter mpMRI data and compared it to PI-QUAL V1. Five readers assessed T2-weighted, DWI (including ADC maps), and DCE images from 274 men (median age: 71 years, IQR: 60–78) across five centers. Inter-reader agreement was measured using weighted Gwet’s AC1 coefficients and compared using bootstrapped confidence intervals. For PI-QUAL V1, coefficients ranged from 0.659 to 0.855, indicating substantial-to-almost perfect agreement. For PI-QUAL V2, coefficients ranged from 0.821 to 0.897, showing almost perfect agreement. All 10 pairwise comparisons achieved almost perfect agreement for PI-QUAL V2, compared to only 3 of 10 for V1. Additionally, three comparisons showed non-overlapping confidence intervals, indicating statistically significant improvements with V2. PI-QUAL V2 demonstrated consistently higher inter-reader agreement than V1, with basic prostate readers achieving almost perfect agreement across multicenter mpMRI data. These findings highlight the improved reliability and clinical applicability of PI-QUAL V2.

Pix2Pix generative-adversarial network in improving the quality of T2-weighted prostate magnetic resonance imaging: a multi-reader study - Diagnostic and Interventional Radiology

Objective: Our objective was to describe morphologic features and longitudinal changes observed on high-resolution vessel wall imaging (HR-VWI) in a selected retrospective case series of patients evaluated for suspected inflammatory intracranial vasculopathy. Methods: This retrospective case series included patients who underwent 3T intracranial HR-VWI for suspected inflammatory intracranial vasculopathy. Clinical and imaging data were collected from medical records and imaging archives. Three radiologists reviewed baseline and follow-up examinations for vessel wall enhancement (VWE) pattern and grade, wall thickness, luminal narrowing, arterial distribution, diffusion-restricted lesions, and susceptibility-sensitive findings. Analyses were descriptive and patient-level. Each patient contributed one baseline and one final examination to longitudinal summaries; intermediate scans characterized individual trajectories only. Results: Nineteen patients were included, and 17 underwent serial HR-VWI. Median age was 46 years (IQR, 35.5–60.0 years), and 11 patients were female. Follow-up HR-VWI was available in 17 patients over a median of 391 days (IQR, 237–1819 days; range, 15–4034 days). VWE was present in all patients, with a purely concentric pattern in 15/19 (78.9%). The middle cerebral and internal carotid arteries were involved in 17/19 and 13/19 patients, respectively. Among the 17 patients with paired examinations, VWE grade decreased in 13 patients (76.5%) and remained stable in four patients (23.5%), with the median decreasing from 3.0 to 1.0. Maximum wall thickness decreased in 16 patients and remained stable in one, with the median changing from 2.0 mm to 1.4 mm. Conclusions: In this selected retrospective case series of patients evaluated for suspected inflammatory intracranial vasculopathy, 3T HR-VWI commonly demonstrated concentric VWE and provided descriptive longitudinal information regarding enhancement evolution. These findings should not be interpreted as evidence of diagnostic performance.

Background/Objectives: Whether PCCT-derived virtual non-iodine (VNI) images can replace true non-contrast (TNC) for coronary artery calcium scoring (CACS) remains uncertain, particularly for small, low-density plaques. We aimed to evaluate agreement between VNI and TNC for CACS at the patient and lesion levels and to quantify risk-category reclassification. Methods: In this retrospective single-center sample (May 2024–May 2025), 211 patients without prior coronary intervention and with nonzero CAC on TNC underwent PCCT. VNI (55 keV, QIR 1; 60 keV, QIR 4; PureCalcium) and TNC were reconstructed with matched section thickness/increment and kernel. Agatston and total calcified volume were recorded. Paired comparisons used Wilcoxon tests; reclassification across CAC categories (0, 1–99, 100–399, ≥400) and lesion-level false negatives (FNs) were assessed with TNC as the reference. Results: Low-keV VNIs (55–60 keV) underestimated CAC versus TNC. The median Agatston score decreased from 35.9 (IQR, 10.3–121.2) on TNC to 23.6 at 55 keV (p = 0.0006) and 22.2 at 60 keV (p = 0.0003); the total volume declined from 37.8 mm³ to 20.2 mm³ (p = 0.001) and 18.3 mm³ (p < 0.0001), respectively. More than half of patients were reassigned to a lower CAC category; despite no patient being CAC = 0 on TNC, 46.9% (55 keV) and 47.4% (60 keV) were labeled CAC = 0 on VNI. Because this study deliberately included only patients with nonzero CAC on the TNC reference, these CAC = 0 rates on VNI represent misclassification within a CAC-positive sample and should not be interpreted as population-level prevalence. At the lesion level, 95% of patients had ≥1 FN plaques (430 FN plaques total), typically small (median 8 mm³) and of low density (median Agatston 6). Conclusions: In this single-center sample with relatively low-burden calcification, low-keV VNI (55–60 keV) significantly underestimates CAC and down-classifies patients, with frequent “false-zero” assignments (defined as CAC_VNI = 0 despite CAC_TNC > 0) driven predominantly by small, low-density plaques.