Clinical Radiology[JOURNAL]
Sun
200 papers
Dual-view and dual-modality fusion in contrast-enhanced spectral mammography for breast-side classification: a patient-grouped evaluation.
Alkurdi AAH, Sallow AB
Clin Radiol · 2026 Apr · PMID 41740222 · Publisher ↗
AIM: To develop and evaluate a patient-grouped breast-side classifier for contrast-enhanced spectral mammography that integrates information across both standard projections and both routinely interpreted image types, an...
AIM: To develop and evaluate a patient-grouped breast-side classifier for contrast-enhanced spectral mammography that integrates information across both standard projections and both routinely interpreted image types, and to report calibrated probability outputs with uncertainty estimates. MATERIALS AND METHODS: The public categorised digital database for contrast-enhanced spectral mammography (CDD-CESM) dataset (326 patients; 2006 images) was analysed at the breast-side level (566 sides) using a binary endpoint (normal vs abnormal; benign and malignant grouped as abnormal). Each breast side was represented by up to four images: two projections (craniocaudal and mediolateral oblique) and two image types (low-energy and subtracted). A transformer-based fusion network with explicit handling of missing inputs was evaluated using five-fold patient-grouped cross-validation (277 patients) and a patient-disjoint holdout set (49 patients; 85 sides). Predictive probabilities were derived using Monte Carlo dropout (MC-dropout) with 10 sample passes and calibrated within each fold using validation-fitted logistic calibration; decision thresholds were selected on validation data and applied unchanged to test folds and the holdout set. RESULTS: In cross-validation, the model achieved receiver operating characteristic-area under the curve (ROC-AUC) 0.993 ± 0.008 and area under the precision-recall curve (PR-AUC) 0.996 ± 0.004, with sensitivity 0.971 ± 0.034 and specificity 0.950 ± 0.029 at the validation-selected threshold (F1-score 0.973 ± 0.022; accuracy 0.964 ± 0.029). Calibration metrics were Brier score 0.025 ± 0.017, expected calibration error 0.024 ± 0.009, and negative log-likelihood 0.144 ± 0.092. On the holdout set, ROC-AUC was 0.985 with sensitivity of 0.984 and specificity of 0.792 (F1-score 0.953; accuracy 0.930). CONCLUSION: Patient-grouped evaluation showed that dual-view, dual-modality fusion of contrast-enhanced spectral mammography can provide strong breast-side discrimination with calibrated probability outputs, while remaining robust to incomplete inputs.
Incidental splenic artery aneurysms: systematic literature review and single-centre study.
Lee RJ, Tong E, Alderson J … +8 more , Common M, Clark A, Sheehan KP, Lenihan J, Bruen R, Briody H, O'Sullivan N, Lee MJ
Clin Radiol · 2026 Apr · PMID 41723917 · Publisher ↗
AIM: The natural history and optimal management of splenic artery aneurysms (SAAs) remain uncertain. We combined a systematic literature review (2000-2025) with a local single-centre retrospective cohort to evaluate the...
AIM: The natural history and optimal management of splenic artery aneurysms (SAAs) remain uncertain. We combined a systematic literature review (2000-2025) with a local single-centre retrospective cohort to evaluate the natural history, predictors of growth, and rupture risk of incidental splenic artery aneurysms. MATERIALS AND METHODS: A systematic review of 5 databases (2000-2025) identified longitudinal studies of true SAAs and were quality assessed. A parallel local retrospective cohort of untreated SAA diagnosed on computed tomography (CT) (2008-2023) was analysed. Demographic, imaging, and clinical factors were examined for associations with growth and rupture. RESULTS: Eight studies plus our local cohort yielded 1774 SAA (1692 patients; mean age 64 years; 70% female). The mean follow-up was 49.5 months. 78% of aneurysms remained stable; the mean growth was 0.04 cm/year. The mean SAA size was 1.7 cm (1.2-2.4 cm). Rupture occurred in 4 aneurysms (0.2%), three <2 cm. Our local cohort of 275 SAA (241 patients; mean age 70; mean follow-up 46 months) grew minimally (0.05 cm/year) with no ruptures. Increasing circumferential calcification independently predicted reduced growth (P = 0.003) similar to 5 other studies. Mural thrombus showed no significant association with growth. Portal hypertension, female sex, size >1.4 cm, and smoking were associated with SAA growth. CONCLUSION: Incidental SAAs are typically indolent, with minimal growth and very low rupture risk. Calcification appears protective, while mural thrombus is not predictive of rupture. On discovery of asymptomatic SAAs under 2 cm, yearly surveillance for 3 years seems advisable, with further surveillance at increasing intervals, but prospective multicentre studies are required to refine surveillance strategies.
The postoperative elbow on MRI: recognizing normal findings and complications after tendon and ligament surgery.
Godoy IRB, Rodrigues TC, Skaf A … +2 more , Martinez-Salazar EL, Vicentini JRT
Clin Radiol · 2026 Apr · PMID 41713010 · Publisher ↗
AIM: To describe the role of postoperative elbow MRI in assessing surgically treated joint, osseous, tendon/ligament, and nerve structures, emphasizing expected postoperative findings that help radiologists identify comp...
AIM: To describe the role of postoperative elbow MRI in assessing surgically treated joint, osseous, tendon/ligament, and nerve structures, emphasizing expected postoperative findings that help radiologists identify complications and optimize care. MATERIALS AND METHODS: This educational review summarizes typical postoperative MRI appearances and potential complications after common elbow procedures, including common extensor and flexor-pronator debridement/repair, biceps and triceps tendon repairs, ulnar collateral ligament reconstruction, and ulnar nerve decompression or transposition performed for neuritis or injury. RESULTS: MRI enables comprehensive evaluation of the elbow joint, bone, and soft tissues after surgery, including the integrity of repaired tendons and reconstructed ligaments, postoperative changes at surgical sites, and the postoperative course of the ulnar nerve. Familiarity with expected MRI findings supports detection of complications such as repair failure, recurrent tearing, abnormal scarring, and postoperative neuropathic changes. CONCLUSION: Postoperative elbow MRI is central to imaging follow-up after common tendon, ligament, and nerve procedures. Knowledge of normal postoperative MRI appearances improves recognition of complications and can enhance clinical decision-making and patient care.
Sarcopenia, myosteatosis, and skeletal muscle loss as predictors of poor prognosis in hepatocellular carcinoma patients undergoing intra-arterial therapies.
Ozbay Y, Eldem FG, Cay F … +6 more , Bozkurt MF, Salancı BV, Ormancı A, Aydingoz U, Dizdar O, Peynircioglu B
Clin Radiol · 2026 Apr · PMID 41702047 · Publisher ↗
AIM: To assess the association between sarcopenia, myosteatosis, subcutaneous and visceral adipose tissue indexes and survival outcomes in patients undergoing intra-arterial therapy for hepatocellular carcinoma (HCC). MA...
AIM: To assess the association between sarcopenia, myosteatosis, subcutaneous and visceral adipose tissue indexes and survival outcomes in patients undergoing intra-arterial therapy for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: In this retrospective single-centre study, HCC patients treated with transarterial chemotherapy or transarterial radiotherapy between 2012 and 2022 were enrolled. Body composition parameters were analysed on pretreatment and follow-up computed tomography (CT) images at the L3 vertebral level. The body composition parameters-survival relationship was evaluated using Kaplan-Meier analysis. Factors associated with survival were investigated using Cox regression analyses. Propensity score matching (PSM) was performed to reduce potential confounding. RESULTS: A total of 160 patients were included. The mean age of patients was 63.45 ± 11.79 years, and 123 patients (76.9%) were male. Patients without sarcopenia had significantly longer progression-free survival (median PFS: 8.80 vs 2.97 months; P < 0.001) and overall survival (median OS: 19.73 vs 5.60 months; P < 0.001) compared with those with sarcopenia. Similarly, patients without myosteatosis demonstrated significantly longer PFS (median PFS: 8.57 vs 4.37 months; P = 0.003) and OS (median OS: 24.33 vs 9.47 months; P < 0.001) compared with those with myosteatosis. There was no significant relationship between subcutaneous or visceral adiposity and survival. In multivariate analysis, sarcopenia (hazard ratio [HR] = 1.59, P = 0.029), myosteatosis (HR = 1.96, P = 0.001) and larger loss of skeletal muscle index (HR = 2.13, P < 0.001) were independently associated with reduced OS. After PSM, sarcopenia (HR = 2.06, P = 0.005) and larger loss of skeletal muscle index (HR = 2.27, P = 0.002) remained poor prognostic factors for OS. CONCLUSION: Baseline sarcopenia, myosteatosis and larger loss of skeletal muscle index are associated with poorer survival outcomes in patients undergoing intra-arterial therapy for HCC.
Research participation amongst less than full-time (LTFT) UK radiology trainees: a cross-sectional survey-based study to evaluate trainees' views of barriers and aspirations to research participation.
Dhas K, Banjeglav J, Jehanli L … +4 more , Gangi-Burton A, Mak J, Ashok AH, Turmezei T
Clin Radiol · 2026 Apr · PMID 41702046 · Publisher ↗
AIM: To evaluate the research participation, barriers, and aspirations of Less Than Full-Time (LTFT) radiology trainees across the UK. MATERIALS AND METHODS: A web-based survey was distributed via RADIANT UK networks, Tr...
AIM: To evaluate the research participation, barriers, and aspirations of Less Than Full-Time (LTFT) radiology trainees across the UK. MATERIALS AND METHODS: A web-based survey was distributed via RADIANT UK networks, Training Programme Directors, and social media between 12 October 2023 and 14 December 2023. It included 34 questions across five sections: demographics, reasons for LTFT, research interests, research contributions, and recommendations. Quantitative data were analysed using descriptive statistics; qualitative data underwent thematic analysis. RESULTS: Forty-eight responses were received. The majority of respondents were female and reported carer responsibilities, with childcare and work-life balance being the leading reasons for choosing LTFT training. Academic and research motivations were cited less frequently. Despite this, 58.3 % of trainees expressed a strong interest in participating in research. However, significant barriers were reported, including lack of in-hours time for research (71.4 %), lack of mentorship (66.7 %), and concerns about meeting clinical training requirements. Over half of those who engaged in research did so outside of NHS-contracted hours. Qualitative responses highlighted missed opportunities, time pressure, and a perceived cultural mismatch between LTFT status and academic engagement. CONCLUSION: While LTFT trainees often reduce working hours to manage personal responsibilities, many remain motivated to engage in research. Addressing barriers such as insufficient protected time, lack of tailored mentorship, and rigid training structures is essential to unlocking this potential. Structural reforms, including formal allocation of pro-rata research time and expanded access to flexible academic pathways, are needed to foster a more inclusive research culture within radiology training.
Recommendations made in computed tomography (CT) reports: a comparison between outsourced and internal reports at a UK centre.
Ebbs S, Watura K, Cross G … +1 more , Little D
Clin Radiol · 2026 Apr · PMID 41702045 · Publisher ↗
AIM: Outsourcing is used in many centres as a standard approach to dealing with increasing unmet reporting demand. Anecdotally, some believe that outsourced reports may increase local workload due to requests to re-revie...
AIM: Outsourcing is used in many centres as a standard approach to dealing with increasing unmet reporting demand. Anecdotally, some believe that outsourced reports may increase local workload due to requests to re-review externally reported imaging. Our aim was to compare reports issued by in-house radiologists and outsourcing providers and assess the difference in imaging and nonimaging recommendations made. MATERIALS AND METHODS: A total of 248 computed tomography of the chest, abdomen, and pelvis (CTCAP) studies reported by outsourcing providers were compared with 248 in-house reports and the summaries assessed for the inclusion of imaging and nonimaging recommendations, as well as speciality advice or consultation. These recommendations were assessed by two in-house consultants and consensus agreed as to their appropriateness. A comparison between the two groups including assessment of significant differences was then made. RESULTS: Outsourcing providers recommended more follow-up imaging overall (76 individual studies vs 48), a greater proportion of which were considered inappropriate (20 [26%] vs 4 [8%]; P=0.019). While in-house radiologists tended to recommend more nonimaging recommendations and speciality consultations, these differences were not significant (P=0.599 and P=0.057, respectively). There were more occasions in outsourced reports where recommended imaging follow-up was subjectively unclear or vague. CONCLUSION: Our study suggests that reports issued by outsourcing providers recommend more inappropriate imaging follow-ups than reports issued by in-house radiologists. This has the potential to increase the workload and costs for local radiology departments, in turn reducing the cost-effectiveness of outsourcing as a means of tackling the increasing reporting demand.
Dynamic versus nondynamic magnetic resonance imaging (MRI) protocols in Ovarian-Adnexal Reporting and Data System for magnetic resonance imaging (O-RADS MRI) scoring of adnexal masses: a comparative performance analysis.
Peker AA, Dönmez Z, Akçay A … +2 more , Toprak H, Gülteki̇n MA
Clin Radiol · 2026 Apr · PMID 41702044 · Publisher ↗
AİM: To compare the diagnostic performance of the Ovarian-Adnexal Reporting and Data System for magnetic resonance imaging (O-RADS MRI) using dynamic and nondynamic contrast-enhanced protocols in the characterisation of...
AİM: To compare the diagnostic performance of the Ovarian-Adnexal Reporting and Data System for magnetic resonance imaging (O-RADS MRI) using dynamic and nondynamic contrast-enhanced protocols in the characterisation of adnexal masses. MATERİALS AND METHODS: This retrospective study included 369 patients (mean age, 43.6 ± 15 years) with 479 adnexal lesions who underwent pelvic MRI between January 2020 and March 2025. Dynamic contrast-enhanced MRI (DCE-MRI) was performed in 97 lesions and nondynamic contrast-enhanced MRI in 382. Two radiologists, with 8 and 4 years of experience, independently reviewed all examinations while blinded to clinical and histopathological data. Lesions scored as O-RADS 2-3 were classified as benign and O-RADS 4-5 as malignant. Histopathology or ≥12 months of imaging follow-up served as the reference standard. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both protocols. RESULTS: Among 479 lesions, 302 (76.8%) were benign, 28 (7.1%) borderline, and 63 (16.0%) malignant. The dynamic protocol achieved a sensitivity of 97.4%, specificity of 93.2%, PPV of 90.2%, NPV of 98.2%, and accuracy of 94.8%. The nondynamic protocol showed comparable results (sensitivity 96.4%, specificity 94.6%, PPV 91.2%, NPV 97.9%, accuracy 95.0%), with no significant difference in diagnostic accuracy (P =0.794). Malignancy rates increased progressively with higher O-RADS categories in both protocols. CONCLUSION: O-RADS MRI provides a reliable framework for risk stratification of adnexal masses. Nondynamic contrast-enhanced MRI achieves diagnostic performance equivalent to DCE-MRI and can be confidently used when dynamic acquisition is not feasible, supporting broader clinical adoption of simplified O-RADS MRI protocols.
Lung transplant evaluation-complications on a timeline.
Wu MY, Ferreira AO
Clin Radiol · 2026 Mar · PMID 41650494 · Publisher ↗
Lung transplantation is an important therapeutic option for patients with end-stage lung disease, significantly improving survival and quality of life. Advances in surgical techniques and posttransplant care have contrib...
Lung transplantation is an important therapeutic option for patients with end-stage lung disease, significantly improving survival and quality of life. Advances in surgical techniques and posttransplant care have contributed to improved outcomes. However, lung transplantation is associated with a range of complications that occur at different stages postoperatively. This article reviews the key indications for lung transplantation, common surgical techniques, and a major focus is placed on the complications that arise posttransplant, categorised by their timing: immediate, early, intermediate, and late. Radiologists play a pivotal role in identifying these complications, such as pulmonary torsion, primary graft dysfunction, infections, and chronic lung allograft dysfunction. Early recognition and intervention based on imaging findings are essential for improving patient outcomes and extending graft longevity. Understanding the imaging features and clinical manifestations of these complications is crucial in the multidisciplinary management of lung transplant recipients.
Validation of American College of Radiology Bone Reporting and Data System (ACR Bone-RADS) for risk stratification of bone tumuors on computed tomography.
Ramadan ZA, Denewar FA, Taman SE … +1 more , Elmorsy AH
Clin Radiol · 2026 Mar · PMID 41650493 · Publisher ↗
AIM: Neoplastic bone lesions show huge divergence. Accurate diagnosis is mandatory for optimal management. Computed tomography (CT) is of special importance in characterisation of bone tumuors, especially in complex anat...
AIM: Neoplastic bone lesions show huge divergence. Accurate diagnosis is mandatory for optimal management. Computed tomography (CT) is of special importance in characterisation of bone tumuors, especially in complex anatomical areas and the axial skeleton. This study aimed to test the validity of applying American College of Radiology (ACR) Bone Reporting and Data System (Bone-RADS) in interpreting bony lesions on CT to gain evidence supporting its implementation as a standard in reporting and communication with orthopaedic surgeons. MATERIALS AND METHODS: This retrospective study involved 336 patients (mean age; 30.3 ± 18.8, 190, 56.5% males) whose CT scans detected neoplastic bony lesions in the period from January 2021 to December 2024. Three radiologists independently reviewed CT exams and set Bone-RADS scores. Inter-reader agreement among the three readers was assessed, and validity of the results was tested. RESULTS: There were 227 benign, 16 intermediate, and 93 malignant lesions. The overall inter-reader agreement among two musculoskeletal radiologists and one nonmusculoskeletal radiologist was substantial to perfect (k: 0.66 to 1). The diagnostic performance for identifying intermediate or malignant lesions varied among radiologists with sensitivities ranging from 96.8% to 100%, specificities from 62.9% to 92.7%, and accuracies from 74.3% to 94%. CONCLUSION: The implementation of ACR Bone-RADS for CT imaging demonstrates robust reproducibility, high sensitivity, and accuracy in characterising bone lesions, thereby enhancing diagnostic confidence and informing clinical decision-making. These findings support the adoption of ACR Bone-RADS as a uniform reporting framework for bone lesions identified on radiographic and CT examinations.
Antegrade cholangioscopy via a percutaneous transhepatic approach-initial single-center experience.
Siepmann RM, Herbold T, von der Stück MS … +6 more , Amygdalos I, Vondran FWR, Kuhl C, Bruners P, Barabasch A, Röth AAJ
Clin Radiol · 2026 Mar · PMID 41643397 · Publisher ↗
AIM: To report on initial experiences with cholangioscopies via an antegrade transhepatic approach by prior percutaneous insertion of a biliary drainage (PTBD) and tract dilation, describing indications, procedural chara...
AIM: To report on initial experiences with cholangioscopies via an antegrade transhepatic approach by prior percutaneous insertion of a biliary drainage (PTBD) and tract dilation, describing indications, procedural characteristics, complication rates and peri-interventional laboratory changes. MATERIALS AND METHODS: This retrospective, single-arm study reviewed patients undergoing cholangioscopy via a PTBD access route in a tertiary hepatobiliary center from September 2020 to June 2023. Data on demographics and prior surgeries as well as clinical indications, pathology, lab values and medical reports were collected for PTBD insertion, drainage upsizing and cholangioscopy procedures. Complications were classified using the CIRSE classification (grade ≥ 3a defined as major). Follow-up time was defined as the interval between cholangioscopy and the last clinical contact. RESULTS: Thirteen patients (61.5 % female, mean age 58.3 years) underwent 41 interventions, including 13 PTBD insertions, 15 upsizings, and 13 cholangioscopies. The most common indication was cholestasis for PTBD placement and suspected biliary malignancy for cholangioscopy. Technical success was achieved in all procedures. PTBD insertion was associated with decreased bilirubin levels and an increase in CRP, whereas after cholangioscopy CRP remained stable. Overall complication rates were 2.4 % (n=1, relevant cholangitis) for major complications and 17.1 % (n=7, clinically silent infections) for minor complications. Mean follow-up time was 537.5 ± 400.6 days. CONCLUSION: Percutaneous antegrade cholangioscopy using PTBD as an access route appears to be a viable and safe alternative in patients in whom the usual endoscopic retrograde approach failed or is anatomically not accessible. Larger, preferably multicenter studies are required to validate these preliminary single-center findings.
Impact of a deep-learning image reconstruction algorithm on ventilation and perfusion parameters derived by phase-resolved functional lung (PREFUL) magnetic resonance imaging (MRI) in a prospective healthy cohort.
Kroschke J, Huber Y, Kerber B … +2 more , Lohezic M, Frauenfelder T
Clin Radiol · 2026 Mar · PMID 41643396 · Publisher ↗
AIM: Deep learning (DL)-based reconstruction algorithms are increasingly integrated into clinical practice, offering the potential for shorter imaging times and improved image quality. This study is the first to evaluate...
AIM: Deep learning (DL)-based reconstruction algorithms are increasingly integrated into clinical practice, offering the potential for shorter imaging times and improved image quality. This study is the first to evaluate whether DL-reconstructed magnetic resonance imaging (MRI) images affect ventilation and perfusion parameters derived from phase-resolved functional lung (PREFUL) MRI. MATERIALS AND METHODS: This prospective study included 24 healthy volunteers (12 male, mean age: 28.9 ± 12.8 years) with normal lung function confirmed by spirometry. Free-breathing lung MRI was performed at 1.5T using 2D fast spoiled gradient echo sequences. Raw imaging data were reconstructed using both conventional non-DL- and DL-based methods. Image quality was assessed via signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). PREFUL MRI was used to derive regional ventilation (Rvent), flow-volume loop correlation metric (FVL-CM), perfusion (Q), ventilation and perfusion defect percentages (VDPs and QDPs), and ventilation-perfusion (V/Q) match. Parameters were compared using paired statistical tests and Bland-Altman analysis. RESULTS: DL-based reconstruction significantly improved image quality (SNR: 41.7 ± 19.5 vs 18.0 ± 6.5; contrast-to-noise: 179.9 ± 84.4 vs 75.3 ± 25.7; both P<.001). No significant differences were found between DL and non-DL reconstructions for any PREFUL-derived parameters. Bland-Altman analysis showed good agreement and minimal bias across all functional metrics and strong to near-perfect correlation was found (r=0.8998 to 0.9998, P<.001). CONCLUSION: DL-based image reconstruction enhances image quality in lung MRI without altering ventilation or perfusion quantification from PREFUL analysis. In healthy individuals with normal PFTs, this approach can be safely integrated into functional lung MRI workflows. These results highlight the preservation of image characteristics with DL-based reconstruction and the robustness of the PREFUL method.
Child life intervention successfully decreases anaesthesia requirements in young children undergoing outpatient orthopaedic magnetic resonance imaging (MRI): a retrospective cohort study.
Tracey OC, Zucker C, Wisch J … +7 more , Adhiyaman A, Collins M, Denneen J, Jaramillo D, Potter H, Ipp L, Heyer JH
Clin Radiol · 2026 Mar · PMID 41643395 · Publisher ↗
AIM: Magnetic resonance imaging (MRI) is the preferred imaging modality for soft-tissue and nonossified bone in paediatric orthopaedics; however, the confines, noise, and prolonged duration may prove challenging. Sedatio...
AIM: Magnetic resonance imaging (MRI) is the preferred imaging modality for soft-tissue and nonossified bone in paediatric orthopaedics; however, the confines, noise, and prolonged duration may prove challenging. Sedation can mitigate these issues but introduces potential risks of allergic reactions and impact on neurocognitive development. Studies have demonstrated reduced anxiety following Certified Child Life Specialists (CCLSs) intervention during paediatric MRIs. This study presents one institution's experience with CCLS intervention in children undergoing MRIs. MATERIALS AND METHODS: This single-centre retrospective study reviewed patients from 2016-2024 children aged 4-12 who underwent outpatient orthopaedic MRI were included. CCLS intervention, diagnosis associated with MRI, MRI region, and use of sedation were recorded. Patients were stratified into the pre-CCLS cohort and post-CCLS cohort, based on the presence of CCLS at the institution. Descriptive statistics analysed frequency of sedation. RESULTS: 1931 patients (2300 scans) were included, with a mean age of 10.0 ± 2.1 years: 708 patients (817 scans) in the pre-CCLS intervention cohort and 1224 patients (1483 scans) in the post-CCLS intervention cohort (one patient was in both groups). Overall, 7/1931 (0.4%) of patients, (7/2300 scans, 0.3%) required IV sedation. 108/1224 patients (116/1483 scans) in the post-CCLS cohort received CCLS intervention; of these, 0/108 patients (0/116 scans) required IV sedation. Mean age was significantly lower in patients receiving CCLS intervention versus no intervention (7.0 ± 2.1 vs 10.0 ± 2.0 years, P < 0.001). CONCLUSION: overall sedation rate for children undergoing MRI with CCLS was 0%. Our positive experience supports CCLS as a potential therapeutic intervention for younger children to undergo MRI.
Seconds that matter: the hidden burden of vetting times on radiology workflow.
Jafari M, Kashthuri MS, Wong ZY … +1 more , Sinha R
Clin Radiol · 2026 Mar · PMID 41637918 · Publisher ↗
AIM: Vetting is an essential but often overlooked step in radiology workflow. No published data exist on time spent vetting in National Health Service radiology departments. This study aims to quantify vetting times, exa...
AIM: Vetting is an essential but often overlooked step in radiology workflow. No published data exist on time spent vetting in National Health Service radiology departments. This study aims to quantify vetting times, examine variation by professional role, outcome, modality and referral source and explores the relationship of vetting outcome to professional role and referral source. MATERIALS AND METHODS: Between April and August 2025, 344 vetting episodes in two tertiary hospitals in the North East and North Cumbria Imaging Network were prospectively observed. Time taken to vet, professional role of the vetter, outcome, referral source, and modality were recorded. RESULTS: The median vetting time was 31 seconds (IQR: 44.5; range: 4-347). Residents spent the longest time per request (61s, IQR: 79). Vetting times were similar for radiographers/sonographers (30s, IQR: 36) and consultant radiologists (28.5s, IQR: 39). Approved requests were processed fastest (median: 33s) and cancelled requests took longest (71s). Vetting times differed across modalities (H = 91.50, df (5), P<.001), longest for computed tomography (42s) and nuclear medicine (39s), and shortest for ultrasound (11s). Referral source influenced vetting time: musculoskeletal interface clinic were quickest (14s), whereas hospital referral was slowest (44s). Vetting outcomes differed by role (X(4, N=344) = 34.15, P<.001), with residents approving most requests. Outcomes were similar between consultants and radiographers/sonographers (X(2, N=278) = 4.46, P=.11). Approval rates varied by referrals source (X(8, N=344) = 106.93, P<.001)-lowest for general practice (GP) (62 %) and highest for accident and emergency (100 %). CONCLUSION: Vetting consumes a substantial amount of time and resources. Quantifying and understanding vetting time are vital for workforce planning and optimising departmental efficiency.
The impact of individualized CT contrast media protocols on total iodine load and contrast enhancement: a systematic review and meta-analysis.
Planken RN, den Boogert TV, Rengier F … +5 more , Butler O, Ullmann A, Pieritz C, Thuering J, Mihl C
Clin Radiol · 2026 Mar · PMID 41628578 · Publisher ↗
AIM: To evaluate the impact of individualized contrast media administration protocols, compared with fixed-volume protocols on total iodine load, image enhancement, and inter-patient variability across common CT indicati...
AIM: To evaluate the impact of individualized contrast media administration protocols, compared with fixed-volume protocols on total iodine load, image enhancement, and inter-patient variability across common CT indications. MATERIALS AND METHODS: A PRISMA-compliant systematic review and random-effects meta-analysis of studies comparing individualized versus fixed contrast administration protocols was conducted. MEDLINE/EMBASE searches up to December 2024 identified eligible studies reporting mean total iodine load (g iodine), Hounsfield units for specific regions of interest, and inter-patient standard deviation. Weighted descriptive statistics, weighted one-sample t test, and non-inferiority were utilized for analysis. Heterogeneity was assessed with τ, Cochran's Q, and I; prediction intervals were calculated. RESULTS: Eighteen studies (n=3,133 patients; nine CT angiography, nine parenchymal CT; 11 experimental and 7 proprietary individualization methods) met the predefined inclusion criteria. Mean weighted total iodine load was significantly lower with individualized versus fixed protocols: 25.59 ± 10.13 g I vs 30.62 ± 7.72 g I, a mean saving of 5.43 g I per patient (95 % CI 2.82-8.04; p<0.001), equating to a 17.7 % relative reduction. Subgroup savings were larger for CT angiography (7.99 g I) than parenchymal CT (3.27 g I). Overall HU ratio was 0.98 (95 % CI 0.94-1.02), meeting the predefined non-inferiority criterion. Inter-patient variability of enhancement was reduced with individualized protocols (CV ratio 0.75; 95 % CI 0.66-0.84), with consistent reductions across subgroups. CONCLUSION: Individualized contrast administration protocols significantly reduce total iodine load while maintaining non-inferior contrast enhancement and substantially reducing inter-patient variability. These findings support wider adoption of patient-tailored contrast dosing to optimize resource use and harmonize image quality.
Comment on "Natural history and clinical significance of postoperative pneumoperitoneum: a systematic review and meta-analysis".
Gupta AK, Kokiwar PR, Kavya A … +1 more , Dhyani A
Clin Radiol · 2026 Mar · PMID 41619328 · Publisher ↗
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Embedding equity, diversity, and inclusion in radiology: insights from the 2024 British Society of Gastrointestinal and Abdominal Radiology (BSGAR) member survey and mentorship programme.
ElGendy K, Chawla S, Rea B … +3 more , Kiandee MM, Haldar S, Chew C
Clin Radiol · 2026 Mar · PMID 41610676 · Publisher ↗
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Distinguishing between hepatocellular adenoma and well-differentiated hepatocellular carcinoma using MRI and clinical feature-based nomogram model.
Zhu Z, Hou L, Zhao Y … +2 more , Li L, Zhao X
Clin Radiol · 2026 Mar · PMID 41579498 · Publisher ↗
AIM: To assess MRI and clinical features for the differentiation of hepatocellular adenoma (HCA) and well-differentiated hepatocellular carcinoma (WDHCC). MATERIALS AND METHODS: Contrast-enhanced MRI images and clinical...
AIM: To assess MRI and clinical features for the differentiation of hepatocellular adenoma (HCA) and well-differentiated hepatocellular carcinoma (WDHCC). MATERIALS AND METHODS: Contrast-enhanced MRI images and clinical data of 144 pathologically confirmed HCA or WDHCC enrolled retrospectively from multiple centers between January 2015 and January 2024. Two readers reviewed images to identify imaging features and measure signal intensity on multiple phases images. The predictive model was established using binary Logistic regression, and the predictive ability was evaluated using the area under the curve (AUC), accuracy, sensitivity, and specificity by R software. RESULTS: Out of 144 eligible patients (35 HCAs, 109 WDHCCs), 23 in 37 indexes showed significant differences. Moreover, 10 parameters remained significant after the univariate regression analysis. To construct a highly accurate predictive model, the significant parameters were further subjected to a multivariate regression model. Six valuable factors (long axis, T1WI, T2WI/FS, capsule enhancement, septa, and cirrhosis) were selected to establish the diagnostic model. Then, a nomogram to discriminate HCA from WDHCC was built on the basis of a multivariate logistic regression model. The AUC of the MRI signal model, the clinical factors model, and the combined model in training sets and validation sets are 0.955, 0.929, 0.962, and 0.898, 0.835, 0.846, respectively. DCA and clinical impact curve was applied to assess the clinical utility of the diagnostic nomogram. Based on the DCA, the MRI signal showed superior clinical utility compared to the other models. CONCLUSION: MRI signal-based model provides high diagnostic performance as demonstrated in the differentiation of HCA and WDHCC, supported by a nomogram model.
Response from the UNITE Collaborative to "Interventional radiology in the United Kingdom - a long-term strategic plan".
UNITE Collaborative Group. Electronic address: deevia.kotecha@gmail.com, UNITE Collaborative Group
Clin Radiol · 2026 Mar · PMID 41579497 · Publisher ↗
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Predictive value of R2∗ values derived from blood oxygen level-dependent magnetic resonance imaging for lymph node metastasis after neoadjuvant chemotherapy for cervical squamous cell carcinoma.
Yin L, Zhang J, Pang Y … +4 more , Mou Y, Sun S, Guo Q, Guo S
Clin Radiol · 2026 Mar · PMID 41577492 · Publisher ↗
AIM: The aim of this study was to investigate the predictive value of R2∗ values obtained from blood oxygen-level-dependent magnetic resonance imaging (BOLD-MRI) for lymph node metastasis (LNM) after neoadjuvant chemothe...
AIM: The aim of this study was to investigate the predictive value of R2∗ values obtained from blood oxygen-level-dependent magnetic resonance imaging (BOLD-MRI) for lymph node metastasis (LNM) after neoadjuvant chemotherapy (NACT) in patients with stage IB-IIA cervical squamous cell carcinoma (CSCC). MATERIALS AND METHODS: Patients diagnosed with CSCC and scheduled to undergo radical hysterectomy following NACT were prospectively recruited. Each patient underwent conventional MRI and BOLD-MRI within 1 week before NACT and again within 1 week before surgery. RESULTS: In this study, 67 patients diagnosed with CSCC were recruited. Of the 67 evaluable women, 15 were finally classified as LNM-positive and 52 as LNM-negative. The evaluation based on the Response Evaluation Criteria in Solid Tumours version 1.1 performed within 1 week before surgery showed that none of the patients had progressive disease. No significant differences were observed between the LNM and non-LNM groups in basic clinical information (P > 0.05). Statistical differences were found between the patients who ultimately developed LNM (LNM group) and those who did not (non-LNM group), as well as in Federation of Gynaecology and Obstetrics staging, lymphovascular space invasion (LVSI) status, depth of stromal invasion, and NACT response (P < 0.05). In both groups, R2∗ values were higher than R2∗ (P = 0.017 and P < 0.001), whereas TS values were lower than TS values (P < 0.001). The LNM group had lower R2∗ values than the non-LNM group (P < 0.001). CONCLUSION: The R2∗ value of the primary tumour derived from BOLD-MRI may serve as a valuable imaging biomarker for predicting post-NACT LNM in CSCC patients.
Application of multidimensional diffusion-weighted magnetic resonance imaging in nasopharyngeal carcinoma: a prospective study.
Chen Y, Zou L, Zhang Y … +3 more , Cui W, Liu Z, Luo D
Clin Radiol · 2026 Mar · PMID 41577491 · Publisher ↗
AIM: The microstructural diffusional heterogeneity of nasopharyngeal carcinoma (NPC) impacts outcome assessment. This study aims to investigate the potential of multidimensional diffusion-weighted magnetic resonance imag...
AIM: The microstructural diffusional heterogeneity of nasopharyngeal carcinoma (NPC) impacts outcome assessment. This study aims to investigate the potential of multidimensional diffusion-weighted magnetic resonance imaging (MDD-MRI) in evaluating microscopic diffusion characteristics of NPC. MATERIALS AND METHODS: Sixty-six NPC patients underwent MDD-MRI to derive microscopic diffusion metrics, including anisotropic mean kurtosis (MK), isotropic MK, total MK, and microscopic fractional anisotropy (FA). Macroscopic metrics, such as the apparent diffusion coefficient (ADC), along with parameters from diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI), were also analysed for comparison. Differences between NPC and normal tissues, as well as among pathological subtypes, clinical stages, and Epstein-Barr virus infection statuses, were assessed. Receiver operating characteristic curve analysis evaluated the ability to distinguish NPC from normal tissue. Spearman's correlation analysis examined associations between diffusion metrics and primary tumour (T) stages. RESULTS: NPC tissues exhibited lower ADC (P<.001) and higher DKI-related MK (MK; P<.001) compared to normal nasopharyngeal tissues, with area under the curve values of 0.968 (95 % CI: 0.926-1) and 0.749 (95 % CI: 0.633-0.865) for ADC and MK, respectively. Microscopic metrics and ADC correlated with T stages: microscopic FA (rho = 0.52, P<.001), anisotropic MK (rho = 0.38, P=.002), isotropic MK (rho = 0.27, P=.03), total MK (rho = 0.32, P=.009), and ADC (rho = -0.36, P=.003). CONCLUSION: MDD-MRI is a valuable tool for assessing NPC's microscopic characteristics, possibly improves T-stage evaluation beyond conventional ADC.
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