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Simple Summary: Effective assessment of treatment response is essential for optimizing outcomes in cancer patients. This study examines how specific features derived from CT scans can accurately predict the effectiveness of preoperative chemotherapy in patients with carcinoma of the gastroesophageal junction. We found measurable differences in imaging data between patients with significant tumor regression and those with limited or no response. These findings highlight the potential for advanced imaging to enhance personalized treatment strategies and improve overall patient management. This research offers a new approach to personalized cancer care. Background: The purpose of this retrospective study was to evaluate the value of contrast-enhanced computed tomography (CE-CT) image features at baseline and after neoadjuvant chemotherapy in predicting histopathological response in patients with adenocarcinoma of the gastroesophageal junction (GEJ). Methods: A total of 105 patients with a diagnosis of adenocarcinoma of the GEJ were examined by CE-CT at baseline and preoperatively after neoadjuvant chemotherapy. All patients underwent surgical resection. Histopathological parameters and tumor regression grading according to Becker et al. were collected in 93 patients. Line profiles of the primary tumor area in baseline and preoperative CE-CT were generated using ImageJ. Maximum tumor density and tumor-to-wall density delta were calculated and correlated with the histopathological tumor response. In addition, tumor response was assessed according to standard RECIST measurements in all patients and by endoscopy in 72 patients. Results: Baseline and change in baseline to preoperative CE-CT parameters showed no significant differences between responders (Becker grade 1a, 1b) and non-responders (Becker grade 2, 3). After neoadjuvant therapy, responders and non-responders showed significant differences in maximum density and tumor-to-wall density delta values. Line profile measurements showed excellent inter-rater agreement. In comparison, neither RECIST nor endoscopy showed significant differences between these groups. Conclusions: Posttreatment CE-CT can predict histopathological therapy response to neoadjuvant treatment in adenocarcinoma of GEJ patients with high accuracy and thus may improve patient management. [ABSTRACT FROM AUTHOR]

Objectives: To compare and correlate bone edema volume detected by 3D-short-tau-inversion-recovery (STIR) sequence to osseous decay detected by a T1-based sequence and conventional panoramic radiography (OPT)., Materials and Methods: Patients with clinical evidence of apical periodontitis were included retrospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR and a 3D-T1 gradient echo sequence. Bone edema was visualized using the 3D-STIR sequence and periapical hard tissue changes were evaluated using the 3D-T1 sequence. Lesions were segmented and volumes were calculated for bone edema and structural decay. OPTs were assessed for corresponding periapical radiolucencies using the periapical index (PAI)., Results: Of the 42 patients of the initial cohort 21 patients with 38 periapical lesions were included in the analysis (mean age 57.2 ± 13.8 years, 9 women). Reactive bone edema was detected on MRI in 23 periapical lesions with corresponding radiolucency on OPT. Fifteen periapical lesions were detected only in the STIR sequence. The volume of edema measured in the STIR was significantly larger in OPT-positive lesions (mean: STIR (OPT+) 207.3 ± 191.1 mm³) compared to OPT-negative lesions (mean: STIR (OPT-) 29.5 ± 34.2 mm³, p < 0.001). The ROC curve analysis demonstrated that Volume T1 (0.905, p < 0.01) and Volume STIR (0.857, p < 0.01) measurements have strong diagnostic performance for distinguishing OPT-positive from OPT-negative lesions., Conclusion: Clinically symptom-free patients without pathologic changes in OPT can show signs of inflammation within the periapical bone. Bone edema volume visualized by STIR sequence exceeds bone architecture changes indicated in T1-based imaging and might precede osteolysis in dental radiography., Critical Relevance Statement: These results show that subtle intraosseous inflammation within the periapical tissue might remain undetected by conventional dental radiography and T1-based sequences. This emphasizes the potential of MRI in secondary prevention in dentistry., Key Points: Conventional panoramic radiography (OPT) may show only delayed findings of pathological periapical changes. MRI detected bone edema in 23 radiolucent lesions on OPT. MRI revealed 15 lesions only visible with STIR sequences. STIR sequences showed bone inflammation undetectable by conventional radiography or T1 imaging. MRI offers diagnostic advantages for early dental pathology detection., Competing Interests: Declarations. Ethics approval and consent to participate: All procedures were conducted according to the principles expressed in the Declaration of Helsinki. Written informed consent was obtained from all participants prior to inclusion. The prospective analysis was approved by our institutional review boards (Technical University of Munich: Ref.-No.185/18 S and Ludwig-Maximilians-University Munich: Ref.-No. 18-657). The study was retrospectively registered at the DRKS (German Clinical Trials Register, DRKS00020761). Written informed consent was obtained from all subjects (patients) in this study. Consent for publication: Not applicable. Study subjects or cohorts overlap: There is a partial overlap in the patient cohort with two previously published studies: 1. Schwarting et al [36]. 2. Probst et al [2]. In the Insights into Imaging paper, the research focused on detecting bone edema in apical periodontitis. However, our current study extends this by defining cutoff values for edema volume that can be detected in conventional imaging modalities, emphasizing the significance of water-sensitive MRI sequences for secondary prevention in dental practice. This novel approach provides crucial insights into the diagnostic thresholds that were not addressed in the previous studies. Competing interests: The authors declare that they have no competing interests., (© 2025. The Author(s).)