ObjectiveTo collect and analyze radiation dose metrics from 23 commonly performed CT procedures, for which no national DRLs have yet been defined, as part of an international cooperation. The body region, the clinical task, and the relevant technical parameters were considered to define clinical diagnostic reference levels (DRLs).Materials and methodsDuring 2022-2023, a multicenter study was performed in Austria, Germany, Italy, and Switzerland. Healthcare providers supplied processed data from their dose management systems. The 5%-level was used to assess the statistical significance of dose differences between the countries of participants, as well as age and manufacturer of the scanners.ResultsDose metrics from 87 CT systems in academic and non-academic, public and private healthcare facilities were analyzed. Dose values from the same body region but for different clinical tasks and/or using different techniques might differ significantly. For the same procedures, median dose values varied between systems by a factor of up to 39. Approximately a third of the surveyed systems showed doses within the DRLs suggested in this study, while 6% do not fulfill any DRL. No significant dose differences were observed between systems when comparing age, manufacturer or country.ConclusionsIn this international study, clinical DRLs were suggested for the first time for many different CT procedures, including dose-intensive procedures such as cerebral perfusion or the CT-guided interventional periradicular therapy. The diversity in protocol optimization is one of the main reasons for dose variations. Establishing the proposed DRLs can help harmonize exposure practice across country borders.Critical relevance statementIn this international multicenter study, clinical task-based DRLs were suggested for 23 CT procedures to promote the optimization of the exposure practice, to reduce dose variations among institutions, even across national borders and to strengthen international cooperation among users.Key PointsAnalysis and differences in exposure practices in 23 different CT examinations in four neighboring European countries.Dose values for the same clinical tasks vary considerably between facilities using the same technology, but on average, not between countries.Establishing diagnostic reference levels helps to harmonize the exposure practice across country borders for frequently performed procedures.

Lateral mass screw fixation is the standard for posterior cervical fusion between C3 and C6. Traditional trajectories stabilize but carry risks, including nerve root and vertebral artery injuries. Minimally invasive spine surgery (MISS) is gaining popularity, but trajectories present anatomical challenges. Research Question. This study proposes a novel pars interarticularis screw trajectory to address these issues and enhance in-line instrumentation with cervical pedicle screws. A retrospective analysis of reformatted cervical CT scans included 10 patients. Measurements of the pars interarticularis morphology were performed on 80 segments (C3-C6). Two pars interarticularis screw trajectories were evaluated: Trajectory A (upper outer quadrant entry, horizontal trajectory) and Trajectory B (lower outer quadrant entry, cranially pointed trajectory). These were compared to standard lateral mass and cervical pedicle screw trajectories, assessing screw lengths, angles, and potential risks to the spinal canal and transverse foramen. Trajectory B showed significantly longer pars lengths (15.69 ± 0.65 mm) compared to Trajectory A (12.51 ± 0.24 mm; p < 0.01). Lateral mass screw lengths were comparable to pars interarticularis screw lengths using Trajectory B. Both trajectories provided safe angular ranges, minimizing the risk to delicate structures. and Conclusion. Pars interarticularis screws offer a viable alternative to lateral mass screws for posterior cervical fusion, especially in MISS contexts. Trajectory B, in particular, presents a feasible and safe alternative, reducing the risk of vertebral artery and spinal cord injury. Preoperative assessment and intraoperative technologies are essential for successful implementation. Biomechanical validation is needed before clinical application.

BACKGROUND:The choice of treatment for subcondylar fractures in children and adolescents remains a controversial issue. The aim of this study was to evaluate the association between the treatment modality of subcondylar fractures and functional outcomes at the six-month follow-up. METHODS:This retrospective study examined a cohort of children and adolescents with unilateral or bilateral subcondylar fractures treated at a level 1 trauma center over a five-year period. Radiological assessments of ramal height shortening (RHS) and subcondylar fracture angulation (SFA) were conducted using cone beam computed tomography. A total of 28 patients met the inclusion criteria, which required participants to be 18 years of age or younger, have a follow-up period of at least six months, and present with an initial SFA of less than 45°. Subcondylar fractures were classified into three categories: Class I (RHS <2 mm and/or SFA <10°), Class II (RHS ≥2 mm and ≤15 mm and/or SFA ≥10° and ≤35°), and Class III (RHS >15 mm and/or SFA >35°). Functional outcomes, including maximal mouth opening, lateral movements, and protrusive movements, were assessed at the six-month follow-up. Reference values specific to children and adolescents were applied to distinguish between normal and limited mandibular motion. The relationship between treatment modality and functional outcomes was analyzed using logistic regression, with adjustments made for age, sex, and fracture classification. Results: Twenty-eight patients (67.9% male; mean age 14.0±4.0 years) met the inclusion criteria. Of these, 53.6% (n=15) were treated with open reduction and internal fixation, while 46.4% (n=13) underwent closed reduction. The choice of treatment modality significantly influenced patient prognosis. Closed reduction was strongly associated with improved functional outcomes, specifically in the vertical range of movement (odds ratio (OR)=16.4; P=0.047), lateral range of movement (OR=18.7; P=0.044), and overall combined functional outcomes of vertical, lateral, and protrusive movements (OR=10.9; P=0.028). CONCLUSION:This preliminary study suggests a correlation between treatment modality and functional outcomes at the six-month follow-up. Open reduction and internal fixation of subcondylar fractures in children and adolescents may carry a higher risk of poor functional outcomes. The findings support closed reduction as the preferred approach for Class I-III cases with subcondylar fracture fragments angulated between 0° and 45°.

Rhinoresistometry (RRM) is implemented along with active anterior rhinomanometry (AAR) and can evaluate nasal dimensions [hydraulic diameter (HD)]. As acoustic rhinometry (AR) is time-consuming, the authors investigated if RRM can be an efficient alternative to AR in nasal dimension assessment in orthognathic surgery. In patients undergoing maxillary advancement and impaction (cases) and removal of maxillary cysts (controls), the authors evaluated RRM and AR, before and 1 year after surgery. Furthermore, the authors investigated the correlation of HD with Nasal Obstruction Symptom Evaluation score and volume by computed tomography and AAR. Lastly, the authors measured RMM reproducibility by the Bland-Altman agreement method in controls. In 14 cases, AR and RMM revealed a significant increase on both sides (all P < 0.011) and the right side, respectively ( P = 0.028). The authors noted no changes in 14 controls. Hydraulic diameter correlated only with AAR (most P < 0.004). Acoustic rhinometry lasted ~4 minutes before or after decongestion. In controls, HD after surgery was as large (1.05 times larger) as before surgery (up to 39% error rates). Rhinoresistometry can reproducibly assess nasal dimension changes in orthognathic surgery in a way that is different from AR and correlates with nasal function. Rhinoresistometry can help clinicians avoid AR and save significant time, as well as financial and human resources.

To collect and analyze radiation dose-related data as part of international cooperation; to define diagnostic reference levels (DRL) for 24 X-ray projections in plain radiography (DX) considering anatomical region, clinical task, and procedural technique; and to harmonize the exposure practice across country borders. A multicenter study was performed in Austria, Germany, Italy, and Switzerland in 2022–23 to provide dose-related data. Healthcare facilities were asked to provide processed data from their dose management systems. A 5

BackgroundOne of the key features of orthognathic surgery is altering temporomandibular joint (TMJ) condylar positions.PurposeThis multivariate study aimed to identify surgical intervention and patient factors significantly associated with changes in TMJ spatial dimensions after the surgical correction of skeletal Class II deformities.Study Design, Setting, SampleThis is a retrospective cohort study including patients who had undergone an isolated bilateral sagittal split ramus osteotomy (BSSO) or a bimaxillary osteotomy (BMO) for mandibular advancement, and a control sample of patients treated with the removal of odontogenic cysts in the mandibular posterior region. Excluded were those who presented with specific radiographic signs of TMJ osteoarthrosis, severe facial asymmetry, or deformity secondary to trauma.Predictor/Exposure/Independent VariableThe primary predictors were condylar position at baseline (anterior, concentric, and posterior), time points (T0, preoperatively; T1, immediately after surgery; and T2, 1-year follow-up), and surgical intervention type (BSSO, BMO, and control group).Main Outcome VariablesThe primary outcomes were changes in posterior (PSD), superior (SSD), and medial spatial dimensions (MSD) assessed by cone-beam computed tomography (CBCT) preoperatively, immediately after surgery, and at one-year follow-up.CovariatesCovariates included sex, age, and amount of mandibular advancement.AnalysesEstimations of independent effects of primary predictors on outcome variables were made by applying generalized estimation equation models. The value of statistical significance was P < .05.ResultsThe study sample included 88 participants. The BSSO samples included 39 patients, and the BMO group included 22 patients; the control group comprised 27 subjects. The average age was 31.2 years; the majority were female (61.4%). Adjusted GEE models yielded a significant time interaction between BSSO and spatial dimensions over time (PSD, P < .001). Key predictors of spatial dimension changes were the baseline posterior (PSD, P < .001) and the central condylar position (PSD, P < .001).Conclusions and RelevanceThis controlled study for the first time provides scientific evidence on the effects of surgical intervention type and baseline condylar position on spatial dimension changes in the TMJ. It shows a more favorable outcome in long-term spatial dimension changes for patients treated by a BMO procedure.

Occlusion of a ventriculoperitoneal shunt system is a potentially life-threatening complication in patients suffering from hydrocephalus. However, there is no imaging established as standard approach in this acute setting. In the present study, we evaluate the use of superb microvascular imaging for investigation of the patency of ventriculoperitoneal shunt systems. Simulation of low flow rates of cerebrospinal fluid through a small diameter CSF shunt system was performed in a dedicated phantom in order to proof the principle of superb microvascular imaging (SMI) being feasible for the measurement of slow CSF flow through the dedicated CSF shunt system. SMI is able to detect low flow rates in CSF shunt systems effectively and fast. Visualization of a Duplex ultrasound flow and Doppler wave pattern in the VP shunt system after the reservoir has been pressed confirms patency. SMI is an effective method for evaluating CSF shunt patency and diagnosing shunt obstruction. This bears the potential to facilitate evaluation of clinically symptomatic VP shunt patients in an acute setting. Further evaluation of ultrasound flow patterns is granted.

BackgroundTo model the effect of isolated bilateral sagittal split osteotomy (BSSO) on changes in posterior (PSD), superior (SSD), and medial space dimensions (MSD) of the temporomandibular joint.MethodsUsing a retrospective cohort study design, pre- and postoperative (immediately after surgery; 1 year follow-up) cone-beam computed tomography measurements of 36 patients who had undergone BSSO for mandibular advancement were compared with a control group of 25 subjects from whom a mandibular odontogenic cyst was removed under general anesthesia. Generalized estimation equation (GEE) models were used to examine the independent effects of study group, preoperative condylar position, and time points on PSD, SSD, and MSD adjusting for covariates (age, sex, and mandibular advancement).ResultsNo significant differences were found regarding changes in PSD (p = 0.144), SSD (p = 0.607), or MSD (p = 0.565) between the BSSO and control groups. However, the preoperative posterior condylar position showed significant effects on PSD (p < 0.001) and MSD (p = 0.043), while the preoperative central condylar position demonstrated a significant effect on PSD (p < 0.001).ConclusionThe data suggest that preoperative posterior condylar position is a significant effect modifier of PSD and MSD over time in this cohort.

Rationale , objectives: Patients receiving high cumulative effective doses (CED) from recurrent computed to-mography (CT) in a real-life setting are not well identified. Evaluation of causes and patient characteristics may help to define individuals potentially at risk of radiation-induced secondary malignancies.Materials and methods: Patients who received a CED > 100 mSv from CT scans during October 2012 and April 2020 at a tertiary university center were identified with the help of a radiological radiation dose monitoring system. The primary disease and referral diagnosis, number of CT exams, time period, age, BMI and gender distribution of the 1000 patients with the highest CED were analysed.Results: 3431 patients had a CED of more than 100 mSv, which corresponded to 2.75% of all patients who received a CT exam. From the 1000 patients with the highest CED, mean number of CT exams per patient was 14.6, mean CED was 257 mSv (SD 98, range 177-1339). Mean age of patients was 63.9 years (SD 10.6), male to female ratio 3:2 , mean BMI 28.7 kg/m2 (SD 5.5). 728 (72.9%) patients had cancer. The leading primary diagnosis was liver cirrhosis in 197 patients and 103 patients had a liver transplantation. In patients with liver cirrhosis, 750 exams were indicated for the follow-up of the disease, 662 for the clarification of an acute clinical condition, and 202 for CT-guided stereotactic radiofrequency ablation.Conclusion: Recurrent CT scans of patients with cancer, liver cirrhosis and liver transplantation may lead to critically high CED.

Background The number of fluoroscopically guided interventions (FGI) has increased significantly over time. However, little attention has been paid to possible stochastic radiation effects. The aim of this retrospective study was to investigate the number of patients who received cumulative effective doses over 100 mSv during FGI procedures. Material and Methods Five thousand five hundred and fifty four classified FGI procedures were included. Radiation dose data, retrieved from an in-house-dose-management system, was analysed. Effective doses and cumulative effective doses (CED) were calculated. Patients who received a CED > 100 mSv were identified. Radiology reports, patient age, imaging and clinical data of these patients were used to identify reasons for CED ≥ 100 mSv. Results One Hundred and thirty two (41.1% female) of 3981 patients received a CED > 100 mSy, with a mean CED of 173.5 ± 84.5 mSv. Mean age at first intervention was 66.1 ± 11.7 years. 81 (61.4%) of 132 were older than 64 years, one patient was < 30 years. 110 patients received ≥ 100 mSv within one year (83.4%), through FGIs: EVAR, pelvic/mesenteric interventions (stent or embolization), hepatic interventions (chemoembolization, TIPSS), embolization of cerebral aneurysms or arterio-venous-malformations. Conclusions Substantial CED may occur in a small but not ignorable fraction of patients (~ 3%) undergoing FGIs. Approximately 2/3rd of patients may most likely not encounter radiation-related stochastic effects due to life-threatening diseases and age at first treatment > 65 years but 1/3rd may. Patients undergoing more than one FGI (77%) carry a higher risk of accumulating effective doses > 100 mSv. Remarkably, 23% received a mean CED 162.2 ± 72.3 mSv in a single procedure.

The aim of this study was to investigate the change of nasal patency after maxillary advancement and impaction (MAXADV + IMP) in subjects with skeletal class III malocclusion (cases) and after removal of maxillary cysts in close proximity to the nasal floor in subjects that served as controls. NOSE score, volume derived by computed tomography (VOL), and acoustic rhinometry and rhinomanometry were retrospectively evaluated, before and one year after surgery. The movement of specific landmarks was also measured. NOSE score did not change after surgery, neither in 17 cases (p = 0.10) nor in 17 controls (p = 0.14). In cases, VOLpostop (10088 ± 4200 mm3) was significantly higher than VOLpreop (7807 ± 3721 mm3; p = 0.036). Maxillary advancement and inferior displacement of the ventral maxilla were noted by the movement of incisive foramen in the coronal (3.9 ± 5.4; p = 0.011) and Frankfurt Horizontal plane (2.2 ± 2.0; p = 0.001), respectively. In controls, VOLpostop (9749 ± 3654 mm3) was also significantly higher than VOLpreop (8473 ± 2624 mm3; p = 0.050). Cross-sectional areas, nasal flow and nasal resistance changed significantly after surgery in cases (6/30 pairs; p < 0.018), but not in controls (all p > 0.066). MAXADV + IMP increased nasal patency, but did not change the feeling of nasal breathing. Physicians should proceed with caution when informing patients about improvement of nasal breathing after MAXADV + IMP.

Background: Premature fusion of cranial sutures affects skull development and leads to head deformity. Intracranial pressure increase and brain growth restriction can occur in untreated craniosynostosis. Operative treatment aims to achieve an immediate and long-lasting correction of skull shape that is close to the average and to prevent or release possible increased intracranial pressure by increasing the intracranial volume (ICV) or normalizing the ICV if it is already below the standards. This study was designed to evaluate the effect of a total calvarial reconstruction on skull development in patients with nonsyndromic sagittal synostosis. Material and Methods: The study population included 19 male and 5 female patients with isolated nonsyndromic sagittal suture synostosis. During the operation, temporarily fixed prebent metal plates provided an intraoperative reference for the desired cranial expansion gain of height and shortening. Preoperative and postoperative ICVs and cephalic indices were measured on computed tomography datasets using the software program ImageJ and were compared with one another and with normative data. Results: The male population presented with a preoperative mean ICV of 863.3 cm³. A postoperative mean ICV increase of 243.5 cm³ (p < 0.001) and a further ICV enlargement (p < 0.001) was measured. The mean CI changed from 71.0% preoperatively to 75.4% postoperatively (p = 0.002) and decreased insignificantly in the follow-up (p = 0.546). The female population had a preoperative mean ICV of 804.9 cm³. Postoperatively, the mean ICV increased by 211.1 cm³ (p = 0.043) and also increased in the follow-up (p = 0.043). Their mean CI values increased from 66.5% preoperatively to 72.8% (p = 0.043) postoperatively and decreased insignificantly in the follow-up (p = 0.345). Conclusion: This method of total vault remodeling provides reliable ICV increase and improvement in length and width of skull proportions beyond the immediate postoperative period together with an ICV increase.

Voxel-based morphometry (VBM) is a widely used tool for studying structural patterns of brain plasticity, brain development and disease. The source of the T-1-signal changes is not understood. Most of these changes are discussed to represent loss or possibly gain of brain gray matter and recent publications speculate also about non-structural changes affecting T-1-signal. We investigated the potential of pain stimulation to ultra-short-term alter gray matter signal changes in pain relevant brain regions in healthy volunteers using a longitudinal design. Immediately following regional nociceptive input, we detected significant gray matter volume (GMV) changes in central pain processing areas, i.e. anterior cingulate and insula cortex. However, similar results were observed in a control group using the identical time intervals but without nociceptive painful input. These GMV changes could be reproduced in almost 100 scanning sessions enrolling 72 healthy individuals comprising repetitive magnetization-prepared rapid gradient-echo (MPRAGE) sequences. These data suggest that short-term longitudinal repetitive MPRAGE may produce significant GMV changes without any intervention. Future studies investigating brain plasticity should focus and specifically report a consistent timing at which time-point during the experiment the T-1-weighted scan is conducted. There is a necessity of a control group for longitudinal imaging studies.

ZusammenfassungZiel dieses Kurzreviews ist es, einen kompakten Überblick zum Thema Röntgenstrahlenschutz zu bieten. Für das Verständnis von Strahlenschutz sind Grundlagen der Physik der Röntgenstrahlung, ihrer biologischen Wirkung, sowie der Dosimetrie notwendig. Zu den deterministischen Gesundheitsrisiken zählen die Radiodermatitis und die posteriore, subkapsuläre Linsentrübung. Als stochastische Effekte werden eine mögliche Lebenszeit-attributable Risikoerhöhung von Krebserkrankungen v. a. für die erhöht strahlensensiblen Kinder und jungen Erwachsenen, sowie Frauen im gebärfähigen Alter diskutiert. Die EURATOM-Richtlinie 2013/59 verpflichtet alle EU-Mitgliedstaaten zu strenger rechtfertigender Indikationsstellung anhand wissenschaftlich basierter Guidelines, Anwendung und Review von diagnostischen Dosis Referenzwerten, sowie Dosismanagement unter Anwendung des „as low as reasonably achievable“ (ALARA) bzw. „as low as diagnostically acceptable“ (ALADA) Prinzips. Insbesondere Schnittbildgebung wie digitale Volumentomografie und Computertomografie erfordern durch die rasanten technischen Weiterentwicklungen zur Dosisreduktion einen kontinuierlichen, indikationsangepassten Optimierungsprozess von Untersuchungsprotokollen.

The aim of this short review is to provide a compact overview on radioprotection. Understanding of radioprotection requires basic knowledge in x-ray physics, biological effects and dosimetry. Deterministic health risks are radiodermatitis and posterior subcapular cataract. Stochastic effects such an increased life-time attributable risk of cancer for radiosensitive children and young adults, as well as in women of child-bearing age are discussed. The EURATOM-directive 2013/59 demands that all EU members states strictly apply evidence-based indications for imaging referral, application and review of diagnostic reference dose levels and dose management following the principles of "as low as reasonably achievable" (ALARA) and "as low as diagnostically acceptable" (ALADA). Especially cross-sectional imaging such as cone beam and multislice computed tomography with its ongoing technical progress in dose saving options need a continuous, indication specific process of protocol optimization.

Poster: EuroSafe Imaging 2019 / ESI-0100 / Dose estimation and comparison in clinical routine 2D mammography versus digital breast tomosynthesis by: M. Verius, P. Torbica, W. Jaschke; Department Radiology, Medical University Innsbruck Innsbruck/AT

Poster: EuroSafe Imaging 2018 / ESI-0074 / The routine use of Ultralow-Dose craniofacial CT in trauma imaging by: M. Verius1, E.-M. Gassner2, W. Jaschke2, G. Widmann3; 1Department Radiology, Medical University Innsbruck/AT, 2Departement Radiology, Medical University Innsbruck Innsbruck/AT, 3Department Radiology, Medical University Innsbruck Innsbruck/AT

PURPOSE:to explore whether the NK1 and Y2 receptors are involved in the pathogenesis of laser-induced CNV (choroidal neovascularization) in C57Bl/6N mice. METHODS:CNV was induced by laser damage of Bruch's membrane and the CNV volume was determined by OCT and/or flatmount preparation. First, the development of the CNV volume over time was evaluated. Second, the CNV development in NK1- and Y2 KO mice was analyzed. Third, the effect on the development as well as the regression of CNV by intravitreal injections of the NK1 antagonist SR140333 and the Y2 antagonist BIIEO246 separately and each in combination with Eylea®, was investigated. Furthermore, flatmount CNV volume measurements were correlated to volumes obtained by the in vivo OCT technique. RESULTS:CNV volume peak was observed at day 4 after laser treatment. Compared to wild type mice, NK1 and Y2 KO mice showed significantly smaller CNV volumes. Eylea® and the Y2 antagonist significantly reduced the volume of the developing CNV. In contrast to Eylea® there was no effect of either antagonist on the regression of CNV, additionally no additive effect upon combined Eylea®/antagonist treatment was observed. There was a strong positive correlation between CNV volumes obtained by OCT and flatmount. CONCLUSION:NK1 and Y2 receptors mediate the development of laser-induced CNVs in mice. They seem to play an important role at the developmental stage of CNVs, whereas VEGF via VEGF receptor may be an important mediator throughout the CNV existence. In vivo OCT correlates with flatmount CNV volume, representing a useful tool for in vivo evaluations of CNV over time.

To demonstrate the importance of calibration measurements in 3 Tesla proton magnetic resonance (MR) spectroscopy (1H-MRS) thermometry for human brain temperature estimation for routine clinical applications. In vitro proton MR spectroscopy to obtain calibration constants of the water-chemical shift was conducted at 3 Tesla with a temperature-controlled phantom, containing a pH-buffered aqueous solution of N-acetyl aspartate (NAA), creatine (Cr), methylene protons of Cr (Cr2), dimethyl silapentane sulfonic acid (DSS), and sodium formate (NaFor). Estimations of absolute human brain temperature were performed utilizing the correlation of temperature to the water-chemical shift for the resonances of NAA, Cr, and Cr2. Data for calibration of the metabolites' chemical shift differences and in vivo temperature estimations were acquired with single-voxel point-resolved spectroscopy (PRESS) sequences (repetition time/echo time = 2000/30 ms; voxel size 2 × 2 × 2 cm3). Spectroscopy data were quantified in the time-domain, and a Pearson correlation analysis was performed to estimate the correlation between the chemical shift of metabolites and measured temperatures. The correlation coefficients (r) of our calibration measurements were NAA 0.9975 (±0.0609), Cr -0.9979 (±0.0621), Cr2 - 0.9973 (±0.0577), DSS -0.9976 (±0.0615), and NaFor -0.8132 (±2.348). The mean calculated brain temperature was 37.78 ± 1.447°C, and the mean tympanic temperature was 36.83 ± 0.2456°C. Calculated temperatures derived from Cr and Cr2 provided significant (p = 0.0241 and p = 0.0210, respectively) correlations with measured temperatures (r = 0.4108 and r = -0.4194, respectively). Calibration measurements are vital for 1H-MRS thermometry. Small numeric differences in measured signal and data preprocessing without any calibration measurements reduce accuracy of temperature calculations, which indicates that calculated temperatures should be interpreted with caution. Application of this method for clinical purposes warrants further investigation and a more practical approach.

BACKGROUND:Chronic pelvic pain, in particular dysmenorrhoea, is a significant yet unresolved healthcare problem in gynaecology. As interoceptive sensitivity and underlying neural mechanisms remain incompletely understood, this functional magnetic resonance imaging (fMRI) study assessed behavioural and neural responses to visceral stimuli in primary dysmenorrhoea (PMD). METHODS:Women with PMD (N = 19) without psychological comorbidity and healthy women (N = 20) were compared with respect to visceral sensory and pain thresholds, and to neural responses to individually calibrated mildly painful and painful rectal distensions implemented during scanning. Trial-by-trial ratings of perceived intensity were accomplished with visual analogue scales (VAS). RESULTS:Although women with dysmenorrhoea reported significantly higher chronic pain intensity and pain interference with daily life activities (p < 0.01, assessed with the West Haven-Yale Multidimensional Pain Inventory), there were no differences between groups in visceral sensitivity and mean trial-by-trial VAS ratings were virtually identical. Analysis of neural responses revealed activation in brain regions previously shown to be involved in the processing of visceral stimuli with differences between painful and mildly painful stimulation, but no group differences were found even when using a liberal statistical threshold. CONCLUSIONS:Dysmenorrhoea patients show unaltered perceptual and neural responses to experimental interoceptive stimuli. Despite limited sample size, these negative results argue against a generalized sensitization towards interoceptive stimuli in patients without psychological comorbidities. Future studies should clarify the role of psychosocial factors in central sensitization using more pain region-specific models in larger and clinically more heterogeneous samples. SIGNIFICANCE:Despite higher chronic pain and pain interference with daily life activities, women with primary dysmenorrhoea do not differ from healthy women with respect to visceral sensitivity or neural processing of aversive interoceptive stimuli induced by rectal distensions. Generalized sensitization may be present only in subgroups with pronounced psychosocial or psychiatric disturbances.