Clinical Radiology[JOURNAL]
Sun
200 papers
Comment on "Noninvasive assessment of liver fibrosis in patients with autoimmune liver disease by two-dimensional shear wave elastography and portal haemodynamics".
Konukoglu O, Kaya M
Clin Radiol · 2026 Jan · PMID 41330062 · Publisher ↗
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Radiomics-driven machine learning models for noninvasive prediction of pathological differentiation in hepatocellular carcinoma: insights from multisequence magnetic resonance imaging (MRI).
Wu M, Jin ML, Huang SX … +7 more , Yang XQ, Huang Y, Ma W, Hu XL, Yu KQ, Deng XJ, Fang Y
Clin Radiol · 2026 Jan · PMID 41325721 · Publisher ↗
AIM: The aim of this study was to compare machine learning and radiomics models across institutions for predicting hepatocellular carcinoma (HCC) pathological grade and evaluate model robustness and generalisability. MAT...
AIM: The aim of this study was to compare machine learning and radiomics models across institutions for predicting hepatocellular carcinoma (HCC) pathological grade and evaluate model robustness and generalisability. MATERIALS AND METHODS: This multicentre retrospective study enrolled 321 patients with pathologically confirmed HCC. Radiomics models were developed using pretreatment magnetic resonance imaging (MRI) sequences (arterial phase [AP], T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI], and combined AP + T2WI + DWI). Manual volumetric segmentation was performed for all sequences. Feature selection utilised Least Absolute Shrinkage and Selection Operator (LASSO) regression with five-fold cross validation. Four machine learning classifiers (support vector machine [SVM], random forest [RF], eXtreme Gradient Boosting [XGBoost], and Light Gradient Boosting Machine [LightGBM]) were used. Model performance was evaluated based on discrimination (AUC, accuracy [ACC], recall, precision, and F1-score), clinical utility (decision curve analysis), and calibration (Brier score). Feature importance was interpreted via SHapley Additive exPlanations (SHAP) values. RESULTS: A total of 321 HCC patients were included (mean age: 58.55 years ± 11.006 [standard deviation (SD)]; 279 males [86.9%] and 42 females [13.1%]) from multiple medical centres, with histopathologically confirmed diagnosis and pretreatment multiphasic contrast-enhanced MRI examinations. Demographic and clinical characteristics showed no significant intergroup differences (high-grade vs low-grade) except for alpha-fetoprotein (AFP: P=0.004), glypican-3 (GPC-3, P<0.001), and microvascular invasion (MVI, P=0.015). Four machine learning models were developed and comparatively evaluated. The T2WI-/DWI-based RF model demonstrated superior diagnostic performance, while the SVM showed optimal efficacy using AP features. The combined model achieved the highest diagnostic ACC (0.829), outperforming single-sequence radiomics approaches. CONCLUSION: This study developed an MRI radiomics model using machine learning to noninvasively predict the pathological differentiation grade in HCC, with SHAP analysis identifying key discriminative features for preoperative decision support.
Comment on "Usefulness of balanced steady-state free precession for portosystemic shunts prior to balloon-occluded retrograde transvenous obliteration".
Dedeepya SD, Goel V, Desai NN
Clin Radiol · 2026 Jan · PMID 41308547 · Publisher ↗
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Diagnostic performance of radiomics and machine learning algorithms in differentiating grade 2-3 gliomas from glioblastomas among adult-type diffuse gliomas.
Coşkun BN, Barburoğlu M, Aksop C … +5 more , Durmaz S, Seyrek S, Ünverengil G, Yıldırım AY, Sencer A
Clin Radiol · 2026 Jan · PMID 41308546 · Publisher ↗
AIM: Glioma grading provides critical information for survival and prognosis. This study aims to determine the performance of machine learning (ML) algorithms using radiomic features to distinguish between grade 2-3 glio...
AIM: Glioma grading provides critical information for survival and prognosis. This study aims to determine the performance of machine learning (ML) algorithms using radiomic features to distinguish between grade 2-3 gliomas and glioblastomas (World Health Organization [WHO] grade 4) within adult-type diffuse gliomas, as defined by the recent central nervous system (CNS) tumour classification. MATERIALS AND METHODS: During the period of 2017-2023, preoperative magnetic resonance imaging (MRI) of 92 patients who underwent surgery at our institution was retrospectively analysed. Tumour segmentations were independently performed by two radiologists using the '3D Slicer (version 5.2.2; Slicer Community, www.slicer.org)' software. Apparent diffusion coefficient (ADC), T2-weighted (T2W), and contrast-enhanced T1-weighted (T1W-CE) images were used for segmentation. On the radiomics analysis, 107 features were extracted from each of the sequences. Reproducible features were determined by the intraclass correlation coefficient (ICC). Feature selection was performed using SelectKBest. Classification was done with 10 different ML algorithms. RESULTS: The highest area under the receiver operating characteristic curve (AUC) values in the classification were obtained from AdaBoost in the combined group (0.83, 95% confidence interval [CI]: 0.77-0.90) and random forest in the T1W-CE single-feature group (0.82, 95% CI: 0.70-0.93). CONCLUSION: This study showed that ML algorithms could distinguish grade 2-3 gliomas from glioblastomas in adult-type diffuse gliomas, with some algorithms performing better than others. However, the comparison was limited to glioblastomas within the grade 4 group and other grade 4 tumour subtypes were not included. Additionally, the lack of external validation is another important limitation of the study.
Natural history and clinical significance of postoperative pneumoperitoneum: a systematic review and meta-analysis.
Wells CI, Bhat S, Alexander H … +3 more , Joret MO, Bissett I, O'Grady G
Clin Radiol · 2026 Jan · PMID 41308545 · Publisher ↗
AIM: Postoperative pneumoperitoneum is a common radiological finding after abdominal surgery. Pneumoperitoneum is often benign but may be a sign of an anastomotic leak or other complications. This systematic review synth...
AIM: Postoperative pneumoperitoneum is a common radiological finding after abdominal surgery. Pneumoperitoneum is often benign but may be a sign of an anastomotic leak or other complications. This systematic review synthesises data on the prevalence, volume, and clinical implications of postoperative pneumoperitoneum. MATERIALS AND METHODS: A systematic search identified studies reporting postoperative pneumoperitoneum prevalence and volume following abdominal surgery. Data were extracted on pneumoperitoneum rates by postoperative day (POD), imaging modality, surgical approach, and association with clinical factors. Meta-analysis and meta-regression were used to analyse trends over the postoperative period. RESULTS: Forty studies (3,342 patients) met the inclusion criteria. Pneumoperitoneum was detected in 93% (95% CI: 36-100%) on POD1 using computed tomography (CT), compared with 62% (95% CI: 48-74%) using radiographs (XR). The pooled pneumoperitoneum volume on POD1 was 21 mL (95% CI: 5-38 mL). Pneumoperitoneum prevalence and volume gradually declined over time but showed significant heterogeneity. Greater volumes of pneumoperitoneum were predictive of complications in several studies, but no consistent threshold was identified. Pneumoperitoneum was associated with shoulder pain, male sex, and drain use in several studies, whereas obesity was negatively associated with pneumoperitoneum. CONCLUSION: Pneumoperitoneum is common after abdominal surgery and varies by imaging modality and time. While persistence and high volume on XR may indicate complications, considerable overlap with normal findings limits diagnostic utility. Prospective validation using standardised definitions is needed to better define the normal postoperative course of benign pneumoperitoneum and clarify the association with postoperative complications.
The value of low-energy images combined with deep learning image reconstruction to improve image quality, reduce radiation and contrast doses in dual-energy computed tomography (CT) portal venography in cirrhotic patients.
Li M, Jia Y, Fan L … +6 more , Han D, Zhang D, Fan J, Yu N, Yu Y, Yan Y
Clin Radiol · 2026 Jan · PMID 41297158 · Publisher ↗
AIM: To explore feasibility of low-energy images in dual-energy computed tomography (DECT) combined with deep learning image reconstruction (DLIR) to improve image quality, reduce radiation and contrast doses in computed...
AIM: To explore feasibility of low-energy images in dual-energy computed tomography (DECT) combined with deep learning image reconstruction (DLIR) to improve image quality, reduce radiation and contrast doses in computed tomography portal venography (CTPV) for cirrhotic patients. MATERIALS AND METHODS: Sixty cirrhotic patients scheduled for CTPV were randomly divided into group S and group L. Group S used 120 kVp, noise index (NI) of 10, contrast dosage of 1.4 ml/kg, reconstructed with 50% adaptive statistical iterative reconstruction-V (ASIR-V). Group L used DECT with double fast tube switching (80 and 140 kV), NI of 13, contrast dosage of 1.0 ml/kg, and reconstructed with 40, 50, and 60 keV DLIR-H. The effective radiation dose (ED) and contrast dose were recorded. The contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) of portal vein were calculated. The subjective image quality was scored by two radiologists blindly using 5-point scale. RESULTS: Compared to group S, group L showed an ED reduction of 48% (4.10 ± 1.56 vs 7.88 ± 1.08 mSv) and contrast dose reduced 32% (67.26 ± 8.74 vs 99.12 ± 8.84 ml) (all P < 0.001). The CNR and SNR of the portal vein in group L gradually increased with decreasing energy levels (P < 0.05) and were highest at 40 keV. The two radiologists had excellent consistency in the subjective score (kappa value ≥ 0.70). The 50 keV image had higher subjective score in image contrast, small vessel display, and overall image quality, but much low image noise than the 40 keV images. CONCLUSION: The use of low-keV (50 keV) images in DECT combined with DLIR-H can reduce ED 48% and contrast doses 32%, while still improving image quality in CTPV.
Dual-energy computed tomography (CT) versus cone-beam computed tomography (CT) in chronic thromboembolic pulmonary hypertension: diagnostic accuracy compared with digital subtraction angiography.
Páez-Carpio A, Serrano E, Domenech-Ximenos B … +5 more , Cornellas L, Barberà JA, Vollmer I, Blanco I, Gómez FM
Clin Radiol · 2026 Jan · PMID 41297157 · Publisher ↗
AIM: The aim of this study was to compare the diagnostic accuracy and interobserver agreement of dual-energy computed tomography pulmonary angiography (DECT-PA) and cone-beam computed tomography pulmonary angiography (CB...
AIM: The aim of this study was to compare the diagnostic accuracy and interobserver agreement of dual-energy computed tomography pulmonary angiography (DECT-PA) and cone-beam computed tomography pulmonary angiography (CBCT-PA) for the evaluation of chronic thromboembolic pulmonary hypertension (CTEPH), using digital subtraction angiography pulmonary angiography (DSA-PA) as the reference standard. MATERIALS AND METHODS: This retrospective study included 109 patients with confirmed CTEPH who underwent DECT-PA, CBCT-PA, and DSA-PA within a three-month interval between January 2017 and June 2022. Pulmonary arteries were evaluated at main, lobar, segmental, and subsegmental levels. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. Interobserver agreement was assessed using Cohen's kappa (κ). RESULTS: Overall diagnostic accuracy was comparable between DECT-PA (89.5%) and CBCT-PA (89.3%). DECT-PA demonstrated higher overall sensitivity (65.0% vs 53.5%, P = 0.019) but CBCT-PA achieved greater interobserver agreement (κ = 0.76 vs 0.74). Sensitivity declined in distal segments for both modalities, with CBCT-PA outperforming DECT-PA at the subsegmental level (51.9% vs 43.6%). Specificity remained high across modalities (>89%). The CBCT-PA showed superior agreement for lesion subtype classification, particularly for occlusions (κ = 0.839). CONCLUSION: DECT-PA and CBCT-PA offer complementary strengths for the evaluation of CTEPH. DECT-PA provides high specificity for central and segmental lesions, supporting its role in initial assessment. CBCT-PA improves sensitivity and reproducibility in distal arteries, reinforcing its value for procedural planning and detailed vascular assessment. These findings support the use of DECT-PA as a first-line diagnostic tool and highlight the role of CBCT-PA as an adjunct in patients with distal or morphologically complex disease, potentially influencing diagnostic pathways and procedural planning in CTEPH.
Utility of diffusion-weighted signal intensity ratio measurements for predicting malignancy in adnexal mass lesions and its comparison with ORADS MRI scoring: Can an abbreviated MRI protocol predict malignancy accurately?
Mahmood NS, Al Rashid AA, Ladumor SB … +12 more , Mohamed MA, Kambal AS, Saloum N, Mohamed SEMK, Abdelmoneim AHM, Al-Merekhi HSHS, Darweesh A, Alobadli AMH, Al Hyassat S, El Sayed MTH, Al-Ansari AAHM, Singh R
Clin Radiol · 2026 Jan · PMID 41297156 · Publisher ↗
AIM: To assess if diffusion-weighted signal intensity ratio (DW-SIR) is a good parameter for differentiating malignant from benign and borderline ovarian lesions. MATERIALS AND METHODS: The MRI studies of histopathologic...
AIM: To assess if diffusion-weighted signal intensity ratio (DW-SIR) is a good parameter for differentiating malignant from benign and borderline ovarian lesions. MATERIALS AND METHODS: The MRI studies of histopathologically diagnosed cases of ovarian tumors were reviewed by two groups of radiologists, both calculating the DW SIR for individual cases. The correlation between the DW SIR and ORADS scoring was tested statistically and the positive likelihood ratio of ORADS scoring for predicting malignancy when used solely as well as in conjunction with DW-SIR was calculated. RESULTS: A total of 184 cases were included, of which 74 cases were Benign/borderline (40 %) and 110 cases were malignant (60 %). A DW SIR cut off of 0.375 calculated after the first cycle of reading had an accuracy of 68.5 % and positive predictive value (PPV) of 73 % in predicting malignancy. The PPV for malignancy for each ORADS score increased especially in the ORADS 3 group when the DW SIR cut off was applied. Higher DW SIR values were associated with a higher ORADS score (p<0.001). A marginal increase in the positive likelihood ratio for malignancy was observed in the combined ORADS 4 and 5 groups upon using the DW-SIR cut off. CONCLUSION: DW-SIR can serve as an adjunctive tool to improve confidence in interpreting intermediate-risk ORADS cases or as a standalone triage tool when contrast MRI is contraindicated, keeping in mind its limitations in sensitivity.
Validation of a practical manual method of accurate positron emission tomography (PET) tumour size depiction for positron emission tomography/computed tomography (PET/CT)-guided interventions.
Hu EY, Guo Y, Alencar RO … +4 more , Cubre AJ, Shi A, Fintelmann FJ, Shyn PB
Clin Radiol · 2026 Jan · PMID 41297155 · Publisher ↗
AIM: Positron emission tomography/computed tomography (PET/CT) guidance for tumour ablation procedures offers unique advantages, including intraprocedural margin assessment and visualisation of tumours not visible with o...
AIM: Positron emission tomography/computed tomography (PET/CT) guidance for tumour ablation procedures offers unique advantages, including intraprocedural margin assessment and visualisation of tumours not visible with other modalities. However, accurate tumour size depiction on PET is necessary. This paper validates a manual method for accurately depicting liver and lung tumour sizes on F18-fluorodeoxyglucose (FDG) PET compared to anatomic imaging with magnetic resonance imaging (MRI) and CT. MATERIALS AND METHODS: This retrospective study included 63 patients with 105 tumours (75 liver and 30 lung) imaged between 2017 and 2021. Inclusion required FDG-avid tumours in the liver or lung, visibility on both PET/CT and MRI (liver tumours) or CT (lung tumours), tumour diameter 0.8-6.0 cm, and anatomical imaging within 7 days of PET/CT. Tumours were windowed on PET images using a manual segmentation method requiring no special software. Interreader agreement and pairwise difference between PET and anatomical tumour measurements were studied using linear mixed-effects models. RESULTS: Intraclass correlation coefficients for interreader agreement were 0.92 for PET and 0.93 for anatomical tumour measurements. The overall average tumour size difference between PET and anatomical imaging was -1.6 mm (P<.001). The average size difference was -0.6 mm for lung tumours (P=.41) and -2.0 mm for liver tumours (P<.001). The average size difference for tumours ≤2 cm was -0.2 mm and -2.6 mm for tumours >2 cm. CONCLUSION: A manual windowing method for PET tumour images provided comparable liver and lung tumour size depictions compared to MRI and CT with high interreader correlation.
A pragmatic approach to lipomatous tumours of the limbs and trunk wall.
Hopkinson M, Davies M, Uldin H … +3 more , Kanbour I, Hassan MS, Botchu R
Clin Radiol · 2026 Jan · PMID 41297154 · Publisher ↗
AIM: Soft tissue lipomatous lesions of the limbs and trunk wall are commonly referred to sarcoma services for specialist advice on diagnosis and management. The rates of such referrals place considerable strain on sarcom...
AIM: Soft tissue lipomatous lesions of the limbs and trunk wall are commonly referred to sarcoma services for specialist advice on diagnosis and management. The rates of such referrals place considerable strain on sarcoma multidisciplinary teams (MDTs) and are often unnecessary where lesions demonstrate no concerning features on imaging. The aim of this study was to retrospectively evaluate the referral rates and MDT outcomes for soft tissue lipomatous lesions of the limbs and trunk wall. MATERIALS AND METHODS: Data were retrospectively collected for referrals to a single specialist sarcoma centre based in the UK over a 12-month period. RESULTS: 350 fat-containing soft tissue lesions of the limbs and trunk wall were referred to the sarcoma service. Over two-thirds of lesions (242/350, 69.1 %) were solitary subcutaneous or intra/intermuscular lipomas with homogeneous fat signal on MRI. Twenty-one lesions (6.0 %) required percutaneous core needle biopsy. Only 2.0 % (7/350) of referrals constituted high grade liposarcomas. The authors present a new protocol entitled Birmingham Lipomatous Tumour Imaging Protocol (BLTIP) to guide referral of first-presentation soft tissue lipomatous tumours of the limbs and trunk wall based solely on MRI appearances. This approach emphasises the role of local radiologists in assessing lesions on MRI prior to sarcoma service referral. Homogeneously fatty lesions on MRI do not qualify for referral to the sarcoma service. Based on the retrospective dataset, this protocol reduced the number of benign referrals by up to three quarters without preventing referral of any liposarcomas. CONCLUSION: Implementation of alternative referral protocols such as the one proposed would reduce the rates of overtly benign lipomatous lesions currently referred to sarcoma services.
Evaluation of artificial intelligence detection of pulmonary embolism in dual-energy computed tomography.
Schwertner A, McMenamy J, Kerchberger J … +3 more , Wallace G, Baird J, Naeger DM
Clin Radiol · 2026 Jan · PMID 41270496 · Publisher ↗
BACKGROUND: Dual-energy CT can be utilized on CT pulmonary angiography (CTPA) exams, increasing detection of peripheral PE. Artificial Intelligence (AI) software has emerging applications including the detection of PE; h...
BACKGROUND: Dual-energy CT can be utilized on CT pulmonary angiography (CTPA) exams, increasing detection of peripheral PE. Artificial Intelligence (AI) software has emerging applications including the detection of PE; however, these AI models are not exclusively trained on dual-energy data. This study aims to evaluate the diagnostic performance of AI PE detection software on dual-energy virtual monochromatic (VMC) series compared to single-energy CTPA exams. METHODS: A retrospective study analyzing 200 CTPA exams comprised of dual-energy and single-energy studies with an equal distribution of scans reported as positive and negative for PE creating four groups for analysis. Dual-energy studies consisted of 50 keV and 70 keV VMC series. Each case was analyzed by the Aidoc pulmonary embolism detection software. In cases with a discrepancy between the radiologist and the AI detection software, two blinded radiologists reviewed the scan to establish a majority truth. Sensitivity and specificity analyses was calculated for each of the four groups. RESULTS: AI PE detection software had an 84.6 % sensitivity and a specificity of 100 % for single-energy PE exams. For the 50 keV dual-energy VMC PE cases the AI software had an 84.3 % sensitivity and a specificity of 100 %. For the 70 keV dual-energy VMC PE cases the AI software had an 87.5 % sensitivity and 100 % specificity. No significant difference was seen in sensitivity or specificity based on overlapping 95 % confidence intervals of groups. CONCLUSIONS: AI PE detection software can be utilized on dual-energy VMC CTPA exams without a significant difference in sensitivity of specificity when compared to single-energy CTPA exams.
Ultra-low-dose computed tomography (CT) protocol for guiding cryoablation in treating a T1a renal cell carcinoma (RCC): radiation doses and treatment outcomes.
Park BK
Clin Radiol · 2026 Jan · PMID 41270495 · Publisher ↗
AIM: The purpose of this study was to evaluate the utility of an ultra-low-dose computed tomography (CT) protocol in guiding cryoablation and oncologic outcomes in the treatment of small renal cell carcinoma (RCC). MATER...
AIM: The purpose of this study was to evaluate the utility of an ultra-low-dose computed tomography (CT) protocol in guiding cryoablation and oncologic outcomes in the treatment of small renal cell carcinoma (RCC). MATERIALS AND METHODS: CT-guided cryoablation using 120 kvp, 50 mA and 2.4 mGy was performed in 30 patients with 30 biopsy-proven T1a-RCCs between January 2023 and January 2024. Cryoablation procedures consisted of planning, targeting, monitoring, and survey phases. The dose-length product (DLP), estimated effective dose (eED), number of scans, scan ranges, total current, and exposure time of cryoablation phases were presented. The one-year local tumour progression (LTP)-free survival rate was calculated by Kaplan-Meier analysis. Nonparametric ANOVA with Dunn's multiple comparisons was used to compare radiation dose and CT parameters. RESULTS: The median DLP and eED per session were 442.3 mGy·cm (287.1-897.8 mGy·cm) and 6.6 mSv (4.3-13.5 mSv), respectively. The DLP, eED, number of scans, total current, and exposure time in the targeting and monitoring phases were significantly higher than those in the planning and survey phases (P < 0.001). The scan ranges in the targeting and monitoring phases were smaller than those in the planning and survey phases (P < 0.001). The one-year LTP-free survival rate was 96.7% (29/30). CONCLUSION: Ultra-low-dose CT-guided cryoablation contributes to significant dose reduction without compromising oncologic outcomes of small RCCs.
Biventricular and bia-trial strain by cardiac magnetic resonance in thalassaemia intermedia: patterns and correlates.
Meloni A, Saba L, Cossu A … +7 more , Positano V, Pistoia L, Longo F, Cecinati V, Giovangrossi P, Clemente A, Cau R
Clin Radiol · 2026 Jan · PMID 41264991 · Publisher ↗
AIM: The aim of this cross-sectional study was to investigate the association of biventricular and biatrial strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardia...
AIM: The aim of this cross-sectional study was to investigate the association of biventricular and biatrial strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardiac complications (atrial fibrillation and pulmonary hypertension) in a cohort of patients with β-thalassaemia intermedia (β-TI). MATERIALS AND METHODS: We considered 43 patients with β-TI (53.5 % females, mean age: 44.31 ± 14.38 years) who were consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassaemia (E-MIOT) project. Additionally, we included 25 healthy controls comparable for age and sex distribution (48 % females, mean age: 40.28 ± 7.65 years). Left and right atrial and ventricular strain parameters were analysed using CMR feature tracking with dedicated software. RESULTS: Compared to the healthy control group, patients with β-TI demonstrated lower right ventricular (RV) global circumferential strain and RV global radial strain. However, no differences were found in left atrial (LA), left ventricular (LV), or right atrial deformation parameters. β-TI patients with at least one cardiac segment with T2∗<20 ms showed significantly reduced LV global longitudinal strain (GLS) and RV GLS. Patients with cardiac complications exhibited significantly impaired LA reservoir and conduit strain parameters compared to those without cardiac complications. CONCLUSION: In patients with β-TI, only RV strain parameters were impaired compared to control subjects. Both RV and LV GLS were reduced in patients with β-TI with at least one cardiac segment showing myocardial iron overload. Furthermore, patients with cardiac complications exhibited impaired LA strain parameters.
Sound touch elastography for noninvasive assessment of renal fibrosis and chronic kidney disease progression: diagnostic accuracy and histopathological correlation.
Ge XY, Lan ZK, Huang WJ … +3 more , Qiu HF, Chen RR, Meng XY
Clin Radiol · 2026 Jan · PMID 41264990 · Publisher ↗
AIM: The aim of this study was to evaluate the clinical utility of sound touch elastography (STE) in assessing renal cortical elasticity across different stages of chronic kidney disease (CKD) and its association with hi...
AIM: The aim of this study was to evaluate the clinical utility of sound touch elastography (STE) in assessing renal cortical elasticity across different stages of chronic kidney disease (CKD) and its association with histopathological grading of interstitial fibrosisand tubular atrophy (IFTA). MATERIALS AND METHODS: All enrolled patients with clinically indicated renal biopsies for the diagnosis and monitoring of CKD, stratified across all five CKD stages based on estimated glomerular filtration rate (eGFR), underwent conventional B-mode ultrasound and STE examinations of the biopsied kidney, performed by an experienced sonographer blinded to clinical and histopathological data, to measure renal cortical elasticity parameters. Histopathological assessment of the biopsy samples served as the reference standard for IFTA grading. RESULTS: All STE-derived elasticity parameters demonstrated progressive elevation with advancing CKD stages (P<.001), receiver operating characteristic (ROC) analysis demonstrated STEmean's superior diagnostic performance for advanced CKD vs early-stage CKD (area under the curve [AUC] = 0.90, 95% confidenceinterval [CI]: 0.85-0.95; sensitivity 70.5%, specificity: 92.7% at 12.7 kPa), outperforming renal dimensional parameters and inversely correlating with eGFR (r=-0.75, 95% CI: -0.81 to -0.66; P<.001). Similarly, STE values increased significantly with IFTA severity: mild IFTA (11.31 ± 2.42 kPa), moderate IFTA (13.85 ± 3.65 kPa), and severe IFTA (15.3 ± 3.19 kPa) (P<.001). STEmean demonstrated high accuracy in differentiating IFTA severity, with AUCs of 0.81 (95% CI: 0.74-0.88) for d0iscriminating mild from moderate to severe IFTA and 0.79 (95% CI: 0.72-0.87) for distinguishing mild to moderate from severe IFTA. CONCLUSION: STE represents a reliable ultrasound-based method for evaluating CKD progression and tubulointerstitial fibrosis. The technique shows better diagnostic performance for CKD staging than for IFTA grading, suggesting its potential clinical utility in noninvasive renal assessment.
Radiomics in transition: bridging imaging, biology, and patient care.
Chen M, Linton-Reid K
Clin Radiol · 2026 Jan · PMID 41260954 · Publisher ↗
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Transcriptional expression patterns of orientation dispersion index of white matter in neuromyelitis optica spectrum disorder.
Huang CX, Huang SH, Zhang HT … +4 more , Li YY, Yang G, Lu W, Liu J
Clin Radiol · 2026 Jan · PMID 41259966 · Publisher ↗
AIM: Neuromyelitis optica spectrum disorder (NMOSD) is characterised by complex white matter (WM) structural abnormalities, yet the underlying genetic mechanisms remain largely unexplored. This study investigated the int...
AIM: Neuromyelitis optica spectrum disorder (NMOSD) is characterised by complex white matter (WM) structural abnormalities, yet the underlying genetic mechanisms remain largely unexplored. This study investigated the intricate relationships between cognitive impairment, genetic factors, and brain WM structure in NMOSD. MATERIALS AND METHOD: We performed diffusion magnetic resonance imaging (MRI) on 43 NMOSD patients and 39 age-, sex-, and education-matched healthy controls. Utilising whole-brain voxel-wise tract-based spatial statistics and neurite orientation dispersion and density imaging (NODDI), we conducted detailed analyses of WM microstructural changes. Clinical parameter correlations were assessed, and transcriptome-neuroimaging analyses were performed using the Allen Human Brain Atlas to explore gene expression patterns associated with NODDI parameter variations. RESULTS: NMOSD participants exhibited significantly elevated orientation dispersion index (ODI) in critical WM regions, including the corpus callosum, left corona radiata, left superior longitudinal fasciculus, and right superior corona radiata. Mean ODI values demonstrated significant correlations with neurocognitive assessments, including Digit Symbol Substitution Test and Trail-Making Test. Functional enrichment analysis revealed complex gene associations involving protein metabolism, inflammatory responses, immune regulation, and synaptic signalling mechanisms. CONCLUSION: Our study demonstrated alterations in the WM ODI in NMOSD, and uncovered their correlations with neurocognitive impairment as well as genetic profiles. This provides insights into transcriptional expression patterns and potential biomarkers for NMOSD pathogenesis.
Assessment of haemodynamics in patients with aortic regurgitation and tricuspid aortic valves using four-dimensional flow cardiovascular magnetic resonance imaging.
Liu F, Li R, Cao L … +1 more , Guo S
Clin Radiol · 2026 Jan · PMID 41259965 · Publisher ↗
AIM: This study measured the haemodynamic changes in patients with aortic valve regurgitation (AR) and tricuspid aortic valves using four-dimensional flow cardiovascular magnetic resonance imaging (4D Flow CMR). MATERIAL...
AIM: This study measured the haemodynamic changes in patients with aortic valve regurgitation (AR) and tricuspid aortic valves using four-dimensional flow cardiovascular magnetic resonance imaging (4D Flow CMR). MATERIALS AND METHODS: This study prospectively included 60 subjects who underwent 4D Flow CMR between May 2021 and May 2024: 18 AR patients with aortic dilation, 12 AR patients without aortic dilation, and 30 age- and sex-matched healthy volunteers. Image data analysis was performed using Circle cvi42 v6.1.2 software. Differences between groups were assessed using statistical methods. RESULTS: A linear correlation was observed between 4D Flow CMR and transthoracic echocardiography (TTE) in measuring forward blood flow, backward blood flow, and aortic regurgitation fraction in patients with AR (R = 0.775, 0.765, 0.874, respectively; P < 0.05). The peak velocity of patients with AR was lower than that of healthy volunteers at six planes (P < 0.05). The average axial and circumferential wall shear stress (WSS) of AR patients with aortic dilation were lower than those of healthy volunteers at the ascending aorta and aortic arch (P < 0.05). CONCLUSION: There was a strong correlation between 4D Flow CMR and TTE in evaluating AR. In patients with aortic regurgitation, lower peak flow velocity and reduced average WSS were observed and found to be associated with aortic dilation, although causal relationships require further investigation.
Validation of a novel automated Alberta Stroke Program Early Computed Tomography Score (ASPECTS) software: reliability, magnetic resonance imaging (MRI) correlation, and early ischaemic core discrimination.
Ha HJ, Lee M, Lee BC … +7 more , Yu KH, Oh MS, Park TH, Kim BJ, Sunwoo L, Ryu WS, Al Kasab S
Clin Radiol · 2026 Jan · PMID 41259964 · Publisher ↗
AIM: The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on noncontrast computed tomography (NCCT) is widely used to assess early ischaemic changes, but its consistency is limited by inter-rater variabil...
AIM: The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on noncontrast computed tomography (NCCT) is widely used to assess early ischaemic changes, but its consistency is limited by inter-rater variability. We aimed to validate a novel automated software (JLK ASPECTS) by assessing its scoring agreement against expert readers and a validated commercial software (RAPID ASPECTS), and by correlating its scores with diffusion-weighted imaging (DWI) infarct volumes. MATERIALS AND METHODS: We retrospectively included patients with acute ischaemic stroke (AIS) admitted to three comprehensive stroke centres between June 2022 and December 2023. For agreement analysis, we included 74 patients with anterior circulation large vessel occlusion (LVO) who achieved successful endovascular thrombectomy (EVT) and underwent follow-up DWI within 24 hours, allowing comparison between pretreatment NCCT ASPECTS and posttreatment DWI ASPECTS. For correlation analysis, 306 AIS patients who underwent DWI within 30 minutes of NCCT were included, regardless of EVT. Agreement was assessed using weighted kappa and intraclass correlation coefficient (ICC), and infarct volume correlation was analysed using Spearman's coefficient and receiver operating characteristics (ROC) analysis. RESULTS: JLK ASPECTS showed good agreement with both RAPID ASPECTS and experts (ICC range: 0.692-0.797), with higher concordance between software than between experts (0.797 vs 0.631; P = 0.039), particularly within 3 hours of onset (0.751 vs 0.434; P = 0.018). Automated ASPECTS correlated significantly with DWI infarct volume (P = -0.532, P < 0.001), effectively identifying infarcts ≥70 mL (cutoff = 5; sensitivity 88.2%, specificity 95.5%). CONCLUSION: We validated the newly developed automated ASPECTS software, demonstrating higher inter-rater agreement between software than experts in early time windows. Furthermore, automated ASPECTS correlated with infarct volume on DWI.
Retrospective SPECT-MR fusion: a great problem-solving tool.
Bukhari SMA, Singh A, AlArab N … +3 more , Johnson CR, Faraji N, Gupta A
Clin Radiol · 2026 Jan · PMID 41259963 · Publisher ↗
Images obtained from different imaging modalities serve different radiological purposes, some providing anatomical details while others provide functional and physiological insights. Seamless integration of these images...
Images obtained from different imaging modalities serve different radiological purposes, some providing anatomical details while others provide functional and physiological insights. Seamless integration of these images into a single image can yield a synergistic representation of these details, enhancing diagnostic accuracy and clinical decision-making. This is best achieved by retrospectively fusing the images using specialized software platforms that align and co-register multimodal datasets. Our review article delves into the fundamental principles underpinning this technique and provides a step-by-step guide for performing image fusion. Additionally, we explore the clinical implications of SPECT-MR fusion, its advantages over conventional standalone imaging and provide the potential future advances in this area.
Can radiomics from dynamic contrast-enhanced MRI effectively predict response to neoadjuvant chemotherapy in breast cancer?: A meta-analysis.
Ye T, Jin S, Xu H … +4 more , Li H, Li J, Sun L, Li Q
Clin Radiol · 2026 Jan · PMID 41240819 · Publisher ↗
OBJECTIVE: This study aimed to evaluate the diagnostic accuracy of radiomics based on dynamic contrast-enhanced MRI (DCE-MRI) in predicting pathological complete response (pCR) in breast cancer patients undergoing neoadj...
OBJECTIVE: This study aimed to evaluate the diagnostic accuracy of radiomics based on dynamic contrast-enhanced MRI (DCE-MRI) in predicting pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS: Relevant studies published up until September 2023, were searched in the PubMed, Web of Science, and The Cochrane Library databases, and screened based on inclusion criteria. The diagnostic performance of radiomics was evaluated using pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). RESULTS: The analysis included 7 studies with a total of 1272 cases. Pooled estimates suggested overall diagnostic accuracy of radiomics in detecting pCR were determined: sensitivity, 81% (95% CI, 73-87%); specificity, 74% (95% CI, 54-88%); PLR, 3.1 (95% CI, 1.6-6.1); NLR, 0.26 (95% CI, 0.17-0.39); DOR, 12 (95% CI, 5-31); and AUC, 0.83 (95% CI, 0.80-0.86). By MRI field, studies using 3.0 T showed slightly lower sensitivity compared to those using 1.5 T/3.0 T, but notably higher specificity in comparison, and PLR and DOR were higher when using 3.0 T than when using 1.5 T/3.0 T. By image acquisition time, combining pre-NAC with other time points showed better DOR and PLR performance than using pre-NAC alone. CONCLUSIONS: The radiomics analysis based on Dynamic Contrast-Enhanced MRI (DCE-MRI) demonstrated substantial predictive efficacy for achieving pathological complete response (pCR) following neoadjuvant chemotherapy in breast cancer. Consequently, we advocate for the integration of this tool as a supplementary resource to inform and enhance clinical decision-making processes.
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