Clinical Radiology[JOURNAL]
Sun
200 papers
Clinical outcomes of genicular artery embolization for knee osteoarthritis in an indian observational cohort: the GENIE study.
Damodharan K, Prasadaswamy VH, Majety SH … +1 more , Mohandas P
Clin Radiol · 2026 Jul · PMID 42140013 · Publisher ↗
AIMS: The GENIE Study (Genicular Artery Embolization: Indian Experience) evaluates real-world effectiveness and safety of GAE in an Indian cohort. MATERIALS AND METHODS: This ambispective, single-centre observational stu...
AIMS: The GENIE Study (Genicular Artery Embolization: Indian Experience) evaluates real-world effectiveness and safety of GAE in an Indian cohort. MATERIALS AND METHODS: This ambispective, single-centre observational study included patients who underwent GAE for symptomatic knee OA. Pain (Visual analogue score - VAS) and functional outcomes (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC) were assessed at baseline and follow-up timepoints up to 18 months. Safety outcomes included procedure-related adverse events, complications, repeat GAE, and conversion to total knee replacement (TKR). RESULTS: A total of 122 patients were analysed. The majority of the patients (n=110, 90.2%) had advanced OA (mean Kellgren-Lawrence (KL) grade 3.8) making this study one of the very few to report outcomes of GAE in a large cohort of advanced OA patients. An average of 3.55 genicular vessels were embolized using permanent particulate embolic agents. VAS decreased from 8.79 ± 1.27 to 4.15 ± 2.54 at 18 months (mean reduction 4.64 ± 2.72; p<0.001). WOMAC improved from 76.64 ± 11.08 to 42.03 ± 18.93 (mean improvement 34.61 ± 17.55). Improvements were sustained through 18 months. Adverse events were mostly minor; TKR conversion remained low (1.6-4.1%). Minimal Clinically Important Difference (MCID) achievement was high at Week 2 (VAS 97.5%, WOMAC 94.3%) and remained substantial at 18 months (VAS 90.3%, WOMAC 76.7%), indicating sustained clinical benefit. CONCLUSIONS: The GENIE Study demonstrates that GAE is a safe, effective, and durable minimally invasive treatment for knee OA in the Indian population. These findings reinforce its potential role within non-surgical OA management algorithms.
Computed tomography of traumatic abdominal wall hernias: recognition, associated injuries, and impact on management in blunt trauma.
Hickman S, Eleti S, Vara S … +2 more , Hancorn K, Cross S
Clin Radiol · 2026 Jul · PMID 42119267 · Publisher ↗
Traumatic abdominal wall hernias are seen following abdominal trauma, in the setting of blunt injuries. Due to the nature of presentation, their assessment and treatment is frequently deferred until threats to life are m...
Traumatic abdominal wall hernias are seen following abdominal trauma, in the setting of blunt injuries. Due to the nature of presentation, their assessment and treatment is frequently deferred until threats to life are managed surgically and the patient has made a sustained postoperative recovery, often extending beyond the period of rehabilitation. There can be an underappreciation of the substantial force required to create a hernia, which occur following blunt trauma secondary to shearing forces and sudden increase in intra-abdominal pressure. Traumatic abdominal wall hernias are a rare occurrence, most commonly occurring in the inferior lumbar triangle, typically following a road traffic collision. Prompt identification of traumatic abdominal wall hernias is critical as these injuries are commonly associated with severe internal injuries and complications. One of the most commonly associated injuries is to the mesentery/bowel. Other acute injuries associated with traumatic abdominal wall hernias include axial skeleton fractures, vascular injury, and solid organ injury including pancreatic injuries. Thus, identifying traumatic abdominal wall hernias on initial trauma imaging is essential to guide surgical management and the need for repeat imaging in the acute setting. Computed tomography (CT) is a highly sensitive imaging modality for detecting traumatic abdominal wall hernias and their associated acute complications and is the mainstay of acute imaging assessment. This pictorial review will describe the normal anatomy of the abdominal wall on CT; illustrate findings of traumatic abdominal wall hernias along with important concomitant, but potentially subtle, injuries on a number of complex polytrauma patients; and demonstrate the role of CT in the later definitive management of traumatic abdominal wall hernias.
Comparison of preoperative breast cancer disease extent on contrast-enhanced mammography (CEM) versus magnetic resonance imaging (MRI).
Ziada K, Siu M, Aggarwal R … +3 more , Jallad N, Gatt R, Al-Attar M
Clin Radiol · 2026 Jul · PMID 42119266 · Publisher ↗
PURPOSE: To compare the performance of preoperative contrast-enhanced mammography (CEM) and magnetic resonance imaging (MRI) in assessing index tumour size and detecting additional malignant lesions and to evaluate total...
PURPOSE: To compare the performance of preoperative contrast-enhanced mammography (CEM) and magnetic resonance imaging (MRI) in assessing index tumour size and detecting additional malignant lesions and to evaluate total disease extent using postoperative histopathology as the reference standard. METHODS: Retrospective analysis of 52 women with biopsy-proven breast cancer who underwent both CEM and MRI between July 2019 and December 2023. Two radiologists independently reviewed studies at separate times to reduce recall bias and were blinded to pathology. Index lesion size, additional suspicious lesions, and total disease extent were recorded. Statistical analysis included intraclass correlation coefficient (ICC) for lesion size, Kappa statistics for additional lesion detection, and Bland-Altman plots to assess agreement with histopathology. RESULTS: CEM detected 51 of the 52 (98%) index lesions; MRI detected all (100%). Mean index lesion size was similar (CEM 24.9 ± 22.9 mm vs MRI 25.2 ± 22.8 mm; ICC = 0.975). Additional lesions were identified in 23 of the 52 patients, with very good agreement between modalities (Kappa = 0.881, P<.001). Among 42 patients with histopathological data on total disease extent (including multifocal or multicentric disease), CEM measurements closely matched histopathology (mean 32.6 mm vs 32.6 mm), while MRI slightly overestimated extent (mean 35.0 mm vs 32.6 mm). Discrepancies >20 mm occurred in five patients, mainly in cases with non-mass enhancement. CONCLUSION: CEM shows high concordance with MRI for measuring index lesion size and detecting additional suspicious lesions, with closer agreement to histopathology for total disease extent. CEM is a viable, efficient alternative to MRI for preoperative locoregional staging of breast cancer.
Left ventricular volume on immediate postmortem computed tomography (CT) (<1 hour) as an indicator of cardiac death: a retrospective pilot study.
Hagita T, Kono T, Sakata M … +3 more , Yoshimura K, Shimbashi S, Hyodoh H
Clin Radiol · 2026 Jul · PMID 42119265 · Publisher ↗
AIM: Although postmortem computed tomography (PMCT) is widely performed, its applications in the diagnosis of cardiac death (CD) remain limited. This study aimed to evaluate whether the left ventricular volume (LVV) meas...
AIM: Although postmortem computed tomography (PMCT) is widely performed, its applications in the diagnosis of cardiac death (CD) remain limited. This study aimed to evaluate whether the left ventricular volume (LVV) measured on early PMCT could serve as an indicator of CD. MATERIALS AND METHODS: We retrospectively analysed 71 subjects (33 with clinically adjudicated CD (CACD) and 38 classified as non-CACD) with cardiopulmonary arrest who underwent PMCT within one hour after death. LVV was quantified from the 3D reconstruction of the PMCT data. Intergroup differences were assessed using the Mann-Whitney U-test, and the diagnostic performance of the LVV and LVV indexed to body surface area (LVV/BSA) was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: The CACD group demonstrated a significantly greater LVV than the non-CACD group (median: 35.4 mL vs 11.0 mL, P < 0.001). Similarly, the LVV/BSA ratio was significantly higher in the CACD group (median: 22.9 mL/m vs 8.0 mL/m, P < 0.001). ROC curve analysis yielded an area under the curve of 0.768 for LVV and 0.752 for LVV/BSA, indicating fair diagnostic performance. CONCLUSION: This study shows that LVV measured on PMCT within the first hour after death reflects reduced antemortem cardiac contractility, suggesting that the LVV may be a useful marker for estimating CD and could facilitate objective and standardised postmortem investigations.
Targeted magnetic resonance imagings (MRIs) inform clinical management in biochemically stable multiple myeloma patients presenting with new pain.
Dragan AD, Boyd K, Scurr E … +4 more , Koh DM, Riddell A, Kaiser M, Messiou C
Clin Radiol · 2026 Jul · PMID 42119264 · Publisher ↗
AIM: New bone pain raising concern for progressive disease in patients with multiple myeloma (MM), even when biochemical parameters are stable, can trigger requests for whole-body imaging as disease can become nonsecreto...
AIM: New bone pain raising concern for progressive disease in patients with multiple myeloma (MM), even when biochemical parameters are stable, can trigger requests for whole-body imaging as disease can become nonsecretory at relapse. Our study aims to investigate whether targeted magnetic resonance imaging (MRI) can safely inform patient management in this setting. MATERIAL AND METHODS: We conducted a retrospective, single-centre analysis of targeted MRI scans performed to investigate pain in biochemically stable MM patients, over a period of 2 years. Patients with known non/oligosecretory disease or second cancers were excluded. RESULTS: 134 scans were included, from 111 patients. One hundred and twelve (84%) scans covered one body area, while 22(16%) covered 2 areas. The most common finding was degenerative change on 57(43%) scans, followed by fractures on 52 (39%) scans. Only one fracture was related to progressing disease. Ninety seven (72%) scans showed no active disease. Of the 37(28%) scans showing active disease, 21(16%) demonstrated new or increasing lesions. Whole-body imaging was subsequently requested in 12 cases (9%). Targeted scans triggered active intervention in a total of 28 patients. Fifty patients (having 57 scans) had no recurrence on follow-up (median 26, range 2-40 months). Targeted MRI had a sensitivity of 96% and specificity of 90%. CONCLUSION: In MM patients presenting with new pain in the absence of biochemical progression, targeted MRI scans safely inform clinical decision-making, reducing the need for whole-body MRI and reducing scan duration for patients in pain.
Comparative reliability of internal and vendor-derived computed tomography angiography (CTA) measurements in pretranscatheter aortic valve replacement (TAVR) assessment.
Claus L, Zhang X, Ocasio L … +5 more , Chan KYK, Duran C, Leme Calazans Odisio EG, Dhoble A, Macedo TA
Clin Radiol · 2026 Mar · PMID 42106213 · Publisher ↗
AIM: Computed tomography angiography (CTA) is essential for preprocedural assessment in transcatheter aortic valve replacement (TAVR), particularly as TAVR becomes the preferred treatment for high-risk patients with seve...
AIM: Computed tomography angiography (CTA) is essential for preprocedural assessment in transcatheter aortic valve replacement (TAVR), particularly as TAVR becomes the preferred treatment for high-risk patients with severe aortic stenosis. This study compares CTA measurements generated internally with those from an external third-party vendor, focussing on consistency and reliability. MATERIALS AND METHODS: We retrospectively analysed 56 patients who underwent standardised pre-TAVR cardiac CTA and CTA of the chest, abdomen, and pelvis. Twenty-five key parameters were measured including cardiac and iliofemoral arterial dimensions. Agreement between internal and external data was assessed using intraclass correlation coefficients (ICCs). RESULTS: Among 13 cardiac CTA metrics, 10 metrics demonstrated excellent or good-to-excellent agreement (ICCs 0.91-0.98). Of the 12 iliofemoral metrics, 10 metrics demonstrated moderate-to-good agreement (ICCs 0.70-0.85). CONCLUSION: Cardiac measurements, often obtained at well-defined anatomical landmarks, demonstrated stronger agreement than iliofemoral measurements, which are more prone to variability due to complex vascular anatomy, calcifications, and operator-dependent site selection. Internally generated CTA measurements for TAVR planning show high reliability, especially for cardiac parameters. Although vascular access measurements showed lower agreement, differences were not clinically significant and did not alter patient management. These findings support the use of internal data processing as a safe and effective alternative to external analysis, with potential benefits in workflow efficiency and patient care.
Diffusion-weighted imaging and dynamic susceptibility contrast-enhanced perfusion-weighted imaging of the non-enhancing peritumoural region predict overall survival in glioblastoma.
Xiong M, Kang J, Yu F … +6 more , Lin X, Wang F, Yu S, Zhu Y, Cao D, Xing Z
Clin Radiol · 2026 Jul · PMID 42105722 · Publisher ↗
AIM: To investigate the preditive value of diffusion-weighted imaging (DWI) and dynamic sensitive contrast perfusion-weighted imaging (DSC-PWI) parameters based on contrast-enhancing regions (CER) and nonenhancing peritu...
AIM: To investigate the preditive value of diffusion-weighted imaging (DWI) and dynamic sensitive contrast perfusion-weighted imaging (DSC-PWI) parameters based on contrast-enhancing regions (CER) and nonenhancing peritumoural regions (NEPR) for overall survival (OS) in patients with ,isocitrate dehydrogenase 1 (IDH)-wildtype glioblastoma (GBM). MATERIALS AND METHODS: Adult patients with IDH-wildtype GBM who underwent gross total resection (GTR) and were histologically confirmed at our institution were retrospectively collected and followed up. Patients were categorised into two groups, short-term survivors (STS; OS ≦ 16 months, n=33) and long-term survivors (LTS; OS > 16 months, n=28). The relative minimum apparent diffusion coefficient (rADCmin-t, rADCmin-p) and relative maximum cerebral blood volume (rCBVmax-t, rCBVmax-p) in the CER and NEPR were measured and analysed via independent-samples t-test, receiver operating characteristic (ROC) curves, and Spearman correlation. RESULTS: Compared with the LTS, the STS demonstrated lower rADCmin-p (1.35 ± 0.27 vs 1.80 ± 0.32, P < 0.001) and higher rCBVmax-p (4.46 ± 2.34 vs 2.17 ± 0.85, P < 0.001). The area under the curves (AUCs) of rADCmin-p and rCBVmax-p for OS prediction were 0.856 and 0.832, respectively, with the combined models achieving the highest AUC (0.909, P > 0.05). In contrast, there was no significant difference in rADCmin-t and rCBVmax-t of CER between the two groups (both P > 0.05). CONCLUSION: Preoperative rADCmin-p and rCBVmax-p in NEPR serve as crucial imaging markers that correlate with long- and short-term OS in patients with IDH-wildtype GBM after GTR.
Imaging practices in neurofibromatosis type 1 (NF1) across Romanian centers: a national cross-sectional survey.
Blidaru TC, Pintilie SR, Zaharia MC … +7 more , Chirilă HC, Marinescu AN, Mitrea D, Ene MA, Pop M, Cocuz IG, Cuzino D
Clin Radiol · 2026 Jun · PMID 42090942 · Publisher ↗
AIM: Neurofibromatosis type 1 (NF1) is a common monogenic disorder with diverse clinical manifestations. Imaging is essential for diagnosis and follow-up yet international data reveal wide variability in imaging practice...
AIM: Neurofibromatosis type 1 (NF1) is a common monogenic disorder with diverse clinical manifestations. Imaging is essential for diagnosis and follow-up yet international data reveal wide variability in imaging practices. This study aimed to evaluate current NF1 imaging practices across Romania, identify gaps in standardisation, and assess needs for alignment with international guidelines. METHODS: A national, cross-sectional, questionnaire-based survey was conducted between March and May 2025 among Romanian imaging centres involved in NF1 diagnostics. Nineteen centres, both public and private, participated voluntarily. The survey addressed institutional characteristics, imaging modalities, paediatric protocols, reporting formats, multidisciplinary collaboration, and perceived challenges. Data were analysed descriptively as absolute frequencies and percentages. RESULTS: Marked heterogeneity was observed in imaging practices and institutional capacities. Only 5.3% of centres reported routine use of whole-body magnetic resonance imaging, and 78.9% did not employ structured imaging reports. Paediatric imaging protocols were available in 26.3% of centres. One-third (31.6%) reported multidisciplinary collaboration, while 57.9% lacked NF1 patient registries. Despite these gaps, most centres expressed readiness to adopt standardised protocols, structured reporting, and improved inter-institutional coordination. CONCLUSION: NF1 imaging in Romania remains fragmented, with limited use of structured reporting, and multidisciplinary integration. This first national survey provides a baseline for harmonising NF1 imaging practices and supports the development of standardised national protocols aligned with the European Reference Network for Genetic Tumour Risk Syndromes and REiNS guidelines.
Individualised prediction of HER2 status in colorectal cancer: development and validation of a radiomics prediction model using F-fluorodeoxyglucose positron emission tomography/magnetic resonance (F-FDG PET/MR).
Yuan Z, Ding J, Cao Z … +5 more , Zhou Z, Chen X, Wang W, Zhao J, Qi N
Clin Radiol · 2026 Jun · PMID 42060950 · Publisher ↗
AIM: Accurate, noninvasive preoperative identification of HER2 status in colorectal cancer (CRC) can support patient stratification and treatment planning. MATERIALS AND METHODS: This study validated the value of radiomi...
AIM: Accurate, noninvasive preoperative identification of HER2 status in colorectal cancer (CRC) can support patient stratification and treatment planning. MATERIALS AND METHODS: This study validated the value of radiomics derived from preoperative F-fluorodeoxyglucose positron emission tomography/magnetic resonance (F-FDG PET/MR) as an imaging surrogate for HER2 assessment in CRC. We retrospectively analysed 98 patients who underwent HER2 testing and PET/MR (27 HER2-positive, 71 HER2-negative). Radiomic features were extracted from PET, T1-weighted (T1WI), and T2-weighted (T2WI) images, and dimensionality reduction identified informative features. Twelve models were constructed by combining three classifiers (logistic regression (LR), random forest (RF), and support vector machine (SVM)) with four feature sets (PET-only, T1WI-only, T2WI-only, and combined) under stratified 5-fold cross-validation. RESULTS: The LR model with combined features achieved the best performance (area under the curve (AUC) = 0.921; sensitivity (SEN) = 0.813; specificity (SPE) = 0.942; accuracy (ACC) = 0.907; F1-score 0.825). Model interpretability using SHapley Additive exPlanations (SHAP) highlighted biologically plausible image traits contributing to classification. CONCLUSION: These findings indicate that PET/MR-based radiomics offers a noninvasive and interpretable approach for the preoperative evaluation of HER2 status in CRC patients.
Review of agentic artificial intelligence (AI) in radiology: from current clinical integration to future innovations.
Chinniah P, Gibson J, Chapala S … +2 more , Saran S, Botchu R
Clin Radiol · 2026 Jun · PMID 42048905 · Publisher ↗
AIM: Artificial intelligence (AI) is one of the most revolutionary developments in the field of medicine in recent history, with radiology being one of the strongest beneficiaries. AI models predominantly relied on user...
AIM: Artificial intelligence (AI) is one of the most revolutionary developments in the field of medicine in recent history, with radiology being one of the strongest beneficiaries. AI models predominantly relied on user input to generate 'human-like' responses through a series of algorithms. Newer developments in this domain include agentic AI systems, where individual AI systems work on prescribed tasks. This study reviews the current evidence base to provide a synthesis of the present literature. METHODS: For this scoping review, parallel searches of PubMed, Embase, Web of Science, and Scopus were conducted for all papers on the theme of agentic AI in radiology published between January 2015 and October 2025. Papers were then screened by two independent reviewers, with conflicts resolved through consensus. Data were extracted from papers according to a predetermined data extraction table and was grouped by common themes to provide a synthesis of the current evidence base. RESULTS: Searches yielded a total of 129 articles, 27 of which were included in the final review after screening. There were 5 main themes identified across the 27 studies: the role of agentic AI in autonomous clinical decision support; workflow orchestration; multimodal systems for image analysis; reporting and communications; and ethical guidance. Across all included studies, many were technical papers or exploratory, highlighting the need for prospective real-world application studies to assess integration into clinical workflows. CONCLUSION: Agentic AI provides an exciting and novel way to improve workflow efficiency and streamline reporting pipelines.
Large language models in radiology report quality: from linguistic adequacy to clinical validity.
Büyükceran EU, Seyfettin A, Babatürk A … +1 more , Gözükara Ç
Clin Radiol · 2026 Jun · PMID 42048904 · Publisher ↗
Abstract loading — click title to view on PubMed.
Ablation-first versus biopsy-first strategy in computed tomography (CT)-guided biopsy-cryoablation for pulmonary nodules: a retrospective cohort study.
Lai L, Xu F, Tu J
Clin Radiol · 2026 Jun · PMID 42048903 · Publisher ↗
AIM: The aim of this study was to investigate the safety and diagnostic performance of ablation-first versus biopsy-first approach for computed tomography (CT)-guided biopsy-cryoablation of pulmonary nodules. MATERIALS A...
AIM: The aim of this study was to investigate the safety and diagnostic performance of ablation-first versus biopsy-first approach for computed tomography (CT)-guided biopsy-cryoablation of pulmonary nodules. MATERIALS AND METHODS: This retrospective analysis included 60 patients (60 pulmonary nodules) undergoing CT-guided biopsy-cryoablation between February 2023 and October 2023 at authors' centre: 28 in the ablation-first cohort and 32 in the biopsy-first cohort. The two groups were compared in technical success rate, positive biopsy rate, 1-year disease-free survival (DFS) rate, and procedure-related complications. Multivariate logistic regression was conducted to identify variables associated with haemorrhage; results are shown as odds ratio (OR) and 95% confidence interval (CI). RESULTS: The mean size of pulmonary nodules was 1.6 ± 0.5 cm. The technical success rate was 100%, the median follow-up time was 13 months, and the 1-year DFS rate was 100%. The positive biopsy rate was 78.1% (25/32) in the biopsy-first cohort and 85.7% (24/28) in the ablation-first cohort (P=0.423). The ablation-first cohort had a lower rate of total procedure-related complications (53.6% vs 78.1% in the biopsy-first cohort, P=0.04) as well as a lower rate of intraoperative bleeding (10.7% vs 40.6%, P=0.03). In the multivariable regression analysis, intraoperative haemorrhage was independently associated with perivascular nodule location (OR: 4.20, 95% CI: 1.55-11.40, P=0.005) and the biopsy-first approach (OR: 3.70, 95% CI: 1.25-11.10, P=0.018). CONCLUSION: In comparison to biopsy-first approach, ablation-first approach was associated with comparable positive biopsy rate but lower haemorrhage risk in patients undergoing CT-guided biopsy-cryoablation of pulmonary nodules.
Pictorial review of chronic ketamine abuse on urinary and biliary systems: what a radiologist needs to know.
Cassels JA, Leung VJ, Ramadan O
Clin Radiol · 2026 Jun · PMID 42033947 · Publisher ↗
Ketamine abuse has increased in prevalence in the UK over the last decade, becoming more commonly abused than cocaine in young people. This pictorial review is a primer for radiologists on the pharmacology, pathophysiolo...
Ketamine abuse has increased in prevalence in the UK over the last decade, becoming more commonly abused than cocaine in young people. This pictorial review is a primer for radiologists on the pharmacology, pathophysiology, and varying imaging presentations of ketamine abuse across multiple modalities. The review discusses the changing epidemiology of ketamine abuse, the fundamentals of ketamine pharmacology, and pathophysiology of ketamine-related pathologies. We have included three cases of long-term ketamine abuse, including ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine studies which best demonstrate the varying appearances which can be encountered. Chronic ketamine abuse will lead to strictures in both the urinary and biliary tracts. The cases demonstrate examples of uropathy and cholangiopathy identified either together or in isolation. Within the renal tract, this includes the typical ketamine bladder, diffuse urothelial thickening, irregular strictures, and hydronephrosis. In mercaptoacetyltriglycine (MAG3) renogram or renal dimercaptosuccinic acid (DMSA), impaired renal cortical uptake with a slowly rising renogram curve or areas of cortical scarring can be seen. Similarly, in the biliary tree, multiple, irregular strictures, with dilatation of the intrahepatic and extrahepatic ducts can be seen. The mainstay of management in these cases is ketamine cessation, but certain surgical procedures are use in more severe cases, as determined by the urology team. By highlighting the common imaging presentations of ketamine-related pathology, these can be more quickly and easily identified by a radiologist. This can lead to timelier referral to the appropriate services and intervention to benefit these patients.
Letter to the editor: a pragmatic approach to lipomatous tumours of the limbs and trunk wall.
Coey J, Nadir R, Aftan M … +4 more , Ahmad G, Kirwadi A, Porter N, Butt Q
Clin Radiol · 2026 Jun · PMID 42025108 · Publisher ↗
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Subtle ground enhancement a new definition for breast magnetic resonance imaging (MRI) after neoadjuvant chemotherapy: is it a marker for microscopic residual disease?
Yılmaz E, Mısır ME, Seker ME … +4 more , Guldogan N, Turk EB, Gorucu H, Aribal ME
Clin Radiol · 2026 Jun · PMID 42025107 · Publisher ↗
AIM: This study aims to describe 'subtle ground enhancement' (SGE) patterns as a new definition and investigate the diagnostic contribution of 'SGE' in magnetic resonance imaging (MRI) evaluation after neoadjuvant chemot...
AIM: This study aims to describe 'subtle ground enhancement' (SGE) patterns as a new definition and investigate the diagnostic contribution of 'SGE' in magnetic resonance imaging (MRI) evaluation after neoadjuvant chemotherapy (NACT) by correlating with histopathology. MATERIALS AND METHODS: This is a single-centre retrospective study. Breast MRI examinations after NACT were analysed by 2 radiologists and classified according to the Respond Evaluation Criteria In Solid Tumours (RECIST) criteria. Cases with SGE, which is not included in the RECIST criteria, were the study group. On post-NACT, late-phase contrast-enhanced MRI series, areas that showed slightly more intense enhancement than the surrounding parenchyma with visual assessment were recorded. Measurements were made with region of interests, from the region where the SGE was most intense, and from the surrounding adjacent parenchyma, and ratios were calculated. Receiver operating characteristic curve analysis determined cut-off values according to the statistically significant parameters. The diagnostic values and CIs were obtained. RESULTS: SGE was detected in 27 of 332 patients. After surgery, histopathological examination revealed residual invasive tumours in 16 of 27 patients with SGE, a complete response in 11 patients. The optimum cut-off value calculated for the ratio of SGE to normal parenchyma was 1.595 showing a sensitivity and specificity at 87.5% (95% CI: 68.8%-100%) and 54.6% (95% CI: 27.3%-81.8%), respectively, in predicting the residual tumour. CONCLUSION: SGE is a new definition, and our studydespite the limited number of cases showed that this finding has the potential to increase the accuracy of MRI after NACT.
Double reading mammograms in the symptomatic setting.
Pervez A, Edey S, Ramanujam S … +6 more , Alluhayadan N, ElEssawy M, Javed M, Hasso S, Ntailiani K, Sever A
Clin Radiol · 2026 Jun · PMID 42019223 · Publisher ↗
AIM: Symptomatic breast clinics in the UK provide specialised assessment and treatment for patients with breast-related symptoms, including one-stop and follow-up clinics for patients under surveillance. The NHS Breast S...
AIM: Symptomatic breast clinics in the UK provide specialised assessment and treatment for patients with breast-related symptoms, including one-stop and follow-up clinics for patients under surveillance. The NHS Breast Screening Programme (NHSBSP) invites asymptomatic women between the ages of 50 and 70 years for breast cancer screening every three years. The NHSBSP employs double reading; however, its application in the symptomatic setting is debated. This study examines the impact of single versus double reader mammograms on cancer detection rates and arbitration time delays. MATERIALS AND METHODS: A retrospective analysis was performed between 2021 and 2023 of one-stop and surveillance clinic cases. Only cases in which one reader recommended recall (BI-RADS M3-M5) versus no recall (BI-RADS M1-M2) were considered discordant and required arbitration. Out of 9405 patients, 164 met the inclusion criteria (1.74% arbitrated cases). Information on reader decisions and patient outcomes were used to explore the impact of arbitration in each cohort. RESULTS: The average delay from the first read to arbitration was 12.7 days. The greatest impact was observed within the surveillance cohort. Of the 44 surveillance cases recalled by the first reader, 38 were downgraded to no recall following arbitration. Conversely, following arbitration, the second reader recalled 13 cases, 8 of which proceeded to biopsy: 4 were malignant and 4 were benign. In the symptomatic cohort, the second reader recalled 37 of 75 cases following arbitration, 18 of which underwent biopsy. This resulted in the detection of 4 additional malignancies, 5 cases of unknown malignant potential and 9 benign results. CONCLUSION: Double reading with arbitration improves cancer detection rates, particularly in surveillance cases. Although arbitration introduced a 12.7-day delay, the second reader identified eight malignancies and five B3 lesions, underscoring the value of this approach.
Diagnostic accuracy of proton density versus proton density fat-saturated magnetic resonance imaging (MRI) sequences in meniscal tear evaluation: a multireader ROC analysis.
Gama GJ, Zadeh C, O'Rourke H … +1 more , Bennett DL
Clin Radiol · 2026 Jun · PMID 42008859 · Publisher ↗
AIM: Compare the diagnostic performance of proton density (PD) and PD fat-saturated magnetic resonance imaging (MRI) sequences in detecting meniscal tears using receiver operating characteristic curve analysis with multi...
AIM: Compare the diagnostic performance of proton density (PD) and PD fat-saturated magnetic resonance imaging (MRI) sequences in detecting meniscal tears using receiver operating characteristic curve analysis with multiple independent readers. MATERIALS AND METHODS: This retrospective, institutional review board approved study included 98 patients who underwent knee arthroscopy for suspected meniscal tears between July 1, 2020, and January 31, 2021. Sagittal PD and PD fat-saturated MRI sequences were independently reviewed by 3 musculoskeletal radiologists on separate days. Readers rated diagnostic confidence on a 5-point scale. Diagnostic accuracy was assessed using area under the curve (AUC), DeLong tests, sensitivity, specificity, positive predictive value, and negative predictive value, with arthroscopy as the reference standard. Binary classification was based on reader scores of 4 or 5 and agreement from at least 2 of three 3 was required. RESULTS: For medial meniscal tears, PD sequences yielded an AUC of 0.9302, sensitivity of 93.2%, and specificity of 87.5%. PD fat-saturated sequences yielded an AUC of 0.9229, sensitivity of 95.9%, and specificity of 79.2% (DeLong p = 0.575). For lateral meniscal tears, AUC was 0.8329 for PD and 0.8088 for PD fat-saturated sequences (DeLong P = 0.339). CONCLUSION: Both sequences demonstrated high diagnostic performance for meniscal tear detection. Fat-saturated sequences showed slightly higher sensitivity but lower specificity. No significant difference in diagnostic accuracy was observed between sequences.
Prompt engineering enables open-source large language models to match proprietary models in diagnostic accuracy for annotation of radiology reports.
Petersen LA, Beck MS, Andersen MB … +2 more , Xu JJ, Bruun FJ
Clin Radiol · 2026 Jun · PMID 42008858 · Publisher ↗
AIM: This study aimed to test whether open-source large language models (LLMs) can match the diagnostic accuracy of proprietary models in annotating trauma radiology reports written in a low-resource language across 3 cl...
AIM: This study aimed to test whether open-source large language models (LLMs) can match the diagnostic accuracy of proprietary models in annotating trauma radiology reports written in a low-resource language across 3 clinical findings. MATERIALS AND METHODS: This retrospective study included 2939 radiology reports of trauma radiographs collected from 3 Danish emergency hospital centers. The data were split, with 600 cases for prompt engineering and 2339 for model evaluation. Eight LLMs, GPT-4o, GPT-4o-mini, Ministral-8b, Qwen3-8b, DeepseekR1-8b, and 3 Llama3 variants were prompted to annotate the reports for fractures, effusions, and luxations. The reference standard was human annotations. The diagnostic performance was assessed using accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: Prompt engineering improved the Match score for Llama3-8b from 77.8% (95% CI: 74.4%-81.1%) to 94.3% (95% CI: 92.5%-96.2%). GPT-4o achieved the highest overall diagnostic accuracy at 97.9% (95%; CI: 97.3%-98.5%), followed by Qwen3-8b (97.8%; 95% CI: 97.4%-98.1%), Llama3.1-405b (97.1%; 95% CI: 96.4%-97.8%), GPT-4o-mini (96.9%; 95% CI: 96.2%-97.6%), Ministral-8b (96.9%; 95% CI 96.4%-97.2%) and Llama3-8b (96.9%; 95% CI: 95.9%-97.3%). Across the 3 specific findings, all models performed best for fractures, whereas effusion and luxation were more prone to errors. Of the error types, semantic confusion was the most frequent, with 53.2%-59.4% of misclassifications. CONCLUSION: Small, open-source LLMs can accurately annotate trauma radiology reports written in a low-resource language when supported by effective prompt engineering, achieving accuracy levels that rival proprietary competitors. They offer a viable, privacy-conscious alternative for clinical use.
Cardiac implantable structural devices (CISDs) and cardiac implantable electronic devices (CIEDs) on chest radiography: a pictorial review.
Fenske O, Foran JP, Nowell S … +1 more , Burney K
Clin Radiol · 2026 Jun · PMID 42008857 · Publisher ↗
Implantable cardiac devices are increasingly used to manage cardiovascular conditions. Consequently, radiologists are more frequently encountering the ever-expanding range of both cardiac implantable electronic devices (...
Implantable cardiac devices are increasingly used to manage cardiovascular conditions. Consequently, radiologists are more frequently encountering the ever-expanding range of both cardiac implantable electronic devices (CIEDs) and cardiac implantable structural devices (CISDs) on chest radiography. Chest radiography remains a widely available, low-cost modality for confirming device presence and detecting complications such as gross malposition or migration. This pictorial review demonstrates the characteristic appearances of established and emerging CIEDs and CISDs on chest radiography, ranging from contemporary pacemakers and defibrillator systems to transcatheter valve prostheses and edge-to-edge repair implants. The aims and indications of these devices are discussed, with their radiographic appearances highlighted using posteroanterior and lateral chest radiographs, placing emphasis on typical positioning and distinguishing features. By demonstrating key radiographic features of these increasingly encountered implants, this review aims to enhance radiologist confidence in recognising modern cardiac devices and to support accurate, timely interpretation.
Clinicians' preferences for radiology reports in a tertiary hospital in Sub-Saharan Africa.
Aliyu I, Suleiman IA, Abdullahi MZ … +4 more , Bello N, Ismail A, Ibrahim MZ, Babandi ZS
Clin Radiol · 2026 Jun · PMID 42008856 · Publisher ↗
AIM: Radiology reports are the primary medium through which radiologists communicate imaging findings to referring clinicians. The format, structure, and mode of delivery of these reports influence clinical decision-maki...
AIM: Radiology reports are the primary medium through which radiologists communicate imaging findings to referring clinicians. The format, structure, and mode of delivery of these reports influence clinical decision-making and patient management. The study assessed clinicians' preferences for the format, structure, and mode of delivery of radiology reports and whether demographic characteristics affect these preferences. MATERIAL AND METHODS: A cross-sectional hospital-based descriptive and analytical study was conducted among 559 eligible clinicians. Data were collected via a structured online questionnaire, comprising closed-ended multiple-choice questions. The generated data were analysed using descriptive and inferential statistics. Chi-square, Fisher's exact, and Monte-Carlo simulation tests assessed associations between clinicians' preferences and demographic characteristics. RESULTS: Of 559 eligible clinicians, 403 responded (72.1%). The majority preferred either hybrid formats (44.4%) or structured format (43.9%), while only 11.7% favoured the narrative. Organ/system-based subheadings were the most preferred report structure (75.9%). Printed copies (64.3%) and digital access via electronic health records (58.1%) were the most common delivery preferences. Gender was significantly associated with reporting format preference (P = 0.009), while cadre/designation was not associated with format preference (P = 0.132) but was significantly associated with preferred report structure (P = 0.001). Preference for organ/system-based subheadings was particularly high among clinicians in General Practice (90.9%), Oncology (83.3%) and Obstetrics/Gynaecology (83.1%). Psychiatry and Orthopaedics had relatively higher proportions of clinicians preferring disease-specific headings (25.0% and 41.7%, respectively). CONCLUSION: Clinicians strongly favoured hybrid and structured reports, with organ/system-based subheadings and accessible delivery methods. Demographics play an important role in shaping their preferences, thus the need for the adoption of standardised reporting tailored to clinicians' needs.
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