Clinical Radiology[JOURNAL]
Sun
200 papers
Lung computed tomography (CT) imaging findings of chronic obstructive pulmonary disease patients with impaired sleep quality.
Zhang P, Li T, Song Q … +5 more , Liu C, Zeng Y, Chen S, Chen P, Lin L
Clin Radiol · 2026 Feb · PMID 41520629 · Publisher ↗
AIM: To investigate the computed tomography (CT) imaging characteristics (including diaphragm thickness [DT], pulmonary artery to aorta ratio [dPA/A], and airway indices) associated with impaired sleep quality in chronic...
AIM: To investigate the computed tomography (CT) imaging characteristics (including diaphragm thickness [DT], pulmonary artery to aorta ratio [dPA/A], and airway indices) associated with impaired sleep quality in chronic obstructive pulmonary disease (COPD) patients. MATERIALS AND METHODS: This cross-sectional study enrolled 190 COPD patients (December 2021-September 2024). Baseline data included demographics, COPD Assessment Test (CAT) scores, pulmonary function, exacerbation history, and CT parameters. Impaired sleep quality was defined as Pittsburgh Sleep Quality Index (PSQI) score ≥5, grouping patients accordingly. RESULTS: Patients (mean age 64.8 years; 93.1% male) included 56% with impaired sleep quality (linked to higher CAT scores and lower FEV/FVC). The impaired sleep group had smaller airway lumen area (LA), mean inner/outer diameters (mID/mOD), and DT; plus higher wall area percentage (WA%) and dPA/A. DT, WA%, and dPA/A were independent risk factors for impaired sleep; dPA/A had the highest ROC AUC (0.688), followed by CAT (0.667), DT (0.632), and WA% (0.602). CONCLUSION: Impaired sleep quality in COPD may relate to airway narrowing, airway wall thickening, reduced lumen diameter, and enlarged dPA/A.
Computerised tomography (CT)-like images based on T1-weighted gradient echo magnetic resonance imaging (MRI) sequences for the assessment of osteochondral lesions of the ankle.
Kang WY, Shim E, Kim MH … +3 more , Kim HJ, Park YH, Woo OH
Clin Radiol · 2026 Feb · PMID 41520628 · Publisher ↗
AIM: To compare the diagnostic performance of computerised tomography (CT)-like magnetic resonance imaging (MRI) using the fast field echo resembling a CT using restricted echo-spacing (FRACTURE) with conventional CT for...
AIM: To compare the diagnostic performance of computerised tomography (CT)-like magnetic resonance imaging (MRI) using the fast field echo resembling a CT using restricted echo-spacing (FRACTURE) with conventional CT for assessing osteochondral lesions (OCLs) of the ankle. MATERIALS AND METHODS: This prospective single-centre study included 29 patients (30 ankles) with suspected OCLs who underwent both 3T MRI with the 3D FRACTURE sequence and conventional CT. OCL detection, classification, and measurement accuracy were compared, using CT as the comparative group. Agreement between modalities and readers were analysed using Cohen's κ, Fleiss' κ, and intraclass correlation coefficients (ICCs). RESULTS: CT identified 22 OCLs, predominantly in the talus (59.1 % in the medioequator zone). CT-like MRI detected all OCLs, demonstrating excellent agreement with CT for lesion location (κ = 0.968-1.000), Ferkel classification (κ = 0.878-.970), and containment type (κ = 0.913-1.000). OCL size measurements showed strong correlation (ICC = 0.909-0.968 intraobserver; 0.797-0.999 interobserver). Evaluation of surrounding bone quality and additional osseous change yield substantial to almost perfect agreement (κ = 0.734-1.000). Image quality and diagnostic confidence were comparable between modalities. CONCLUSION: CT-like MRI using the FRACTURE sequence provides high diagnostic accuracy and excellent agreement with CT in the assessment of ankle OCLs and associated bony abnormalities. It offers a reliable, radiation-free alternative to CT that may support preoperative planning while reducing radiation exposure and overall imaging burden.
Lessons learned from the 2023 Türkiye twin earthquakes: how radiology facilities can respond to disasters.
Aydın S, Yurttutan N, Kızıldağ B … +4 more , Korkmaz İ, Peköz BÇ, Karazincir S, Onur MR
Clin Radiol · 2026 Feb · PMID 41520627 · Publisher ↗
On 6 February 2023, back-to-back earthquakes (Mw 7.7 and 7.6) in southeastern Türkiye produced a prolonged mass-casualty incident, placing heavy demands on radiology services nationwide. Operational and clinical lessons...
On 6 February 2023, back-to-back earthquakes (Mw 7.7 and 7.6) in southeastern Türkiye produced a prolonged mass-casualty incident, placing heavy demands on radiology services nationwide. Operational and clinical lessons were derived from frontline experience to guide emergency imaging under disaster conditions. Surge rostering and rapid staff redistribution were implemented; point-of-care ultrasound was employed for damage-control triage; and "CT-first" pathways were adopted for polytrauma. Workflow continuity during PACS/network outages was maintained with paper logs, downtime order sets, and standardized critical findings phrasing. Disaster teleradiology was activated through streamlined credentialing and ID-agnostic reporting, enabling rapid capacity expansion and support for hospitals beyond the epicentral region. Dominant injury patterns observed were crush injury with acute compartment syndrome; traumatic brain injury; chest trauma with sequential rib fractures, pulmonary contusion and pneumothorax; lumbar-predominant spinal fractures; and pelvic and long-bone injuries. Imaging correlates of rhabdomyolysis and non-lethal pneumomediastinum compatible with the Macklin effect are summarized. Protocol adaptations that preserved throughput and safety included abbreviated, low-dose trauma CT; cautious contrast use in renally vulnerable patients; and corridor-based scanner prioritisation during overflow. On the basis of these observations, a radiology preparedness bundle is presented: redundant power and IT failover; predefined modality-prioritisation matrices; caches of portable US/X-ray for secondary triage; streamlined trauma CT checklists; templated reports that foreground immediate actions; and interoperable teleradiology hooks that can be switched on rapidly. These measures are transferable to earthquakes and other mass-casualty events, sustaining diagnostic capacity, communication, and team alignment under extreme constraints.
Utility of ultrafast kinetic parameters in differentiation of suspicious breast lesions referred for MRI-guided biopsies.
Lam PL, Chan LY, Fenn D … +6 more , Wong KT, Cheung WP, Lo LW, Mak WS, Wong KML, Fung PYE
Clin Radiol · 2026 Feb · PMID 41520626 · Publisher ↗
AIM: To evaluate the diagnostic performance of ultrafast kinetic parameters in differentiating benign and malignancy lesions among suspicious breast lesions referred for MRI-guided biopsies. MATERIALS AND METHODS: Consec...
AIM: To evaluate the diagnostic performance of ultrafast kinetic parameters in differentiating benign and malignancy lesions among suspicious breast lesions referred for MRI-guided biopsies. MATERIALS AND METHODS: Consecutive MRI-guided biopsies of suspicious breast lesions (BI-RADS 4 or 5) in a tertiary referral hospital from June 2023 to May 2025 were retrospectively analyzed. Clinical information, procedural details and pathological results were retrieved. Pre-procedural standard and ultrafast dynamic contrast-enhanced magnetic resonance imaging (UF-DCE MRI) were reviewed. UF-DCE MRI consisted of high-temporal-resolution T1-weighted images obtained in the first minute using a 3T MRI scanner. Ultrafast kinetic parameters - maximum slope (MS), initial area-under-the-curve (iAUC), bolus arrival time (BAT) and time-to-enhancement (TTE) were acquired. Factors associated with benign and malignant breast lesions were assessed. Receiver operating characteristic curve analyses were performed. RESULTS: Fifty MRI-guided breast biopsies were performed for 31 adult (≥18 years) female patients (median age: 61.0 (IQR 13.0) years). Thirty-five biopsies (70.0 %) were benign. Fifteen (30.0 %) were malignant, including two surgically upgraded carcinomas from high-risk lesions. In malignant lesions, MS (P<0.001) and iAUC (P<0.001) were larger, while BAT (P<0.001) and TTE (P<0.001) were shorter compared with benign lesions. Areas under the curve of MS (0.98, 95 % CI [0.95, 1.00], iAUC (0.94, 95 % CI [0.84, 1.00], BAT (0.91, 95 % CI [0.80, 0.98] and TTE (0.93, 95 % CI [0.85, 1.00]) were obtained. CONCLUSION: Ultrafast kinetic parameters robustly distinguished between benignity and malignancy among suspicious breast lesions referred for MRI-guided biopsies.
CT and MRI characteristics of ovarian mucinous tumors associated with mature teratomas.
Hattori M, Kato H, Kawaguchi M … +7 more , Kobayashi K, Miyazaki T, Watanabe N, Nishibori H, Noda Y, Hyodo F, Matsuo M
Clin Radiol · 2026 Feb · PMID 41520625 · Publisher ↗
AIM: This study aimed to evaluate the CT and MRI features of ovarian mucinous tumors associated with mature teratomas. MATERIALS AND METHODS: The present study enrolled a total of 34 patients with histopathologically pro...
AIM: This study aimed to evaluate the CT and MRI features of ovarian mucinous tumors associated with mature teratomas. MATERIALS AND METHODS: The present study enrolled a total of 34 patients with histopathologically proven ovarian mucinous tumors associated with mature teratomas, including collision tumors composed of mucinous tumors and mature teratomas and mucinous tumors arising from mature teratomas. All patients underwent preoperative pelvic CT and/or MRI. Imaging findings were retrospectively reviewed. RESULTS: Histopathological diagnosis of mucinous tumors included mucinous cystadenoma in 22 patients, mucinous borderline tumor (MBT) in 10 patients, and mucinous carcinoma in two patients. The mean maximum tumor diameter was 168 mm (range, 39-314 mm). All tumors were unilateral, well-defined, predominantly cystic, and multilocular. A total of 14 tumors (41 %) had fewer than 10 loculi, while 12 tumors (35 %) had 30 or more. Fatty components were observed in 30 tumors (88 %), and 20 of 30 tumors (67 %) had multiple fatty components. On MRI, stained glass appearance was observed in 20 of 29 tumors (69 %). On CT, nodular calcifications within fatty components were observed in 12 of 21 tumors (57 %), whereas flattened calcifications within the septa of non-fatty components were observed in 7 of 21 tumors (33 %). Pseudomyxoma peritonei (PMP) was observed in three patients (9 %) with MBT. CONCLUSIONS: Ovarian mucinous tumors associated with mature teratomas typically presented as large, multilocular cystic lesions with fatty components and teratoma/mucinous tumor-associated calcifications. Although PMP was uncommon, it was rarely observed in patients with MBT.
The appropriateness of primary care physician referrals for lumbar spine magnetic resonance imaging (MRI): retrospective cross-sectional study.
Kelliher J, Bergin D
Clin Radiol · 2026 Feb · PMID 41519641 · Publisher ↗
AIM: Low back pain (LBP) affects a significant proportion of the population. There has been an increase in referrals for magnetic resonance imaging (MRI) of the lumbar spine (LS) for patients with back pain. The aim of t...
AIM: Low back pain (LBP) affects a significant proportion of the population. There has been an increase in referrals for magnetic resonance imaging (MRI) of the lumbar spine (LS) for patients with back pain. The aim of this study was to assess the appropriateness of referrals from primary care physicians for LS MRIs. MATERIALS AND METHODS: This is a retrospective cross-sectional study of randomly selected primary care referrals for LS MRIs between 01/01/2021 and 31/12/2022 to a single institution in the West of Ireland. The appropriateness of clinical referral was assessed against iRefer guidelines by the Royal College of Radiologists (RCRs). RESULTS: The patient group (n = 2,112) included 41.3% male and 58.7% females with a mean age of 54.2 years. Twenty-seven point seven percent were older than 65 years. Fifty-three point nine percent of referrals were inappropriate when referenced against iRefer guidelines. Category of inappropriate referrals included: no symptom duration documented (n = 869, 76.4%), symptom duration ≤ 6 weeks (n = 180, 15.8%), unrelated clinical details (n = 55, 4.8%), no clinical details (n = 32, 2.8%), and other (n = 2, 0.2%). There was no statistically significant difference in appropriateness between 2021 and 2022 (P = 0.438). CONCLUSION: Greater than half of referrals for LS MRIs did not meet iRefer guidelines criteria. Inappropriate referral for public MRI of LS by primary care physicians may be reduced by focused education. Radiology department staff vetting clinical referrals, as well as utilising artificial intelligence (AI) programmes, such as clinical decision tools, may improve the clinical appropriateness of referrals for LS MRIs.
MRI evaluation of congenital vaginal malformations-a pictorial review.
Wong KW, Wong SC, W Lo PH … +6 more , Wu LY, Yeung PHP, Chau CM, Wong T, Wan SFR, Fung TMM
Clin Radiol · 2026 Jan · PMID 41478033 · Publisher ↗
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Comparison of the diagnostic yield of cognitive magnetic resonance (MR)-targeted transperineal and MR-targeted transrectal prostate biopsy techniques in a matched patient cohort.
Brosnan C, Rohan P, Briody H … +6 more , Shah S, White S, Ryan J, Dunne R, Power R, Morrin MM
Clin Radiol · 2026 Jan · PMID 41478032 · Publisher ↗
AIM: Prostate cancer carries a major public health burden. Biopsy of the prostate gland is usually required to confirm its diagnosis. Traditional transrectal ultrasound (TRUS)-guided approaches have been superseded by tr...
AIM: Prostate cancer carries a major public health burden. Biopsy of the prostate gland is usually required to confirm its diagnosis. Traditional transrectal ultrasound (TRUS)-guided approaches have been superseded by transperineal (TP) approaches, which have superior safety profiles. Although saturation TP biopsies performed by urologists under general anaesthetic are well documented, there is a paucity in the literature on outcomes of cognitive magnetic resonance (MR)-targeted TP biopsies. MATERIALS AND METHODS: A single-centre, retrospective review of MR-targeted TP biopsies performed between August 2022 and August 2023 was conducted. Thirty-two patients who received TP biopsy within 5 years of prior MR-targeted TRUS, without evidence of disease progression on interval magnetic resonance imaging , were included. Histopathology results were compared with the detection of clinically significant prostate cancer (defined as International Society of Urological Pathology grade group ≥2) constituting the primary outcome measure. METHODS: A single-centre, retrospective review of MR-targeted TP biopsies performed between August 2022 and August 2023 was conducted. Thirty-two patients who received TP biopsy within 5 years of prior MR-targeted TRUS, without evidence of disease progression on interval magnetic resonance imaging , were included. Histopathology results were compared with the detection of clinically significant prostate cancer (defined as International Society of Urological Pathology grade group ≥ 2) constituting the primary outcome measure. RESULTS: The median age at biopsy was 63 years. Median prostate volume, prostate-specific antigen (PSA), and PSA density were 43.5 mL, 6.2 ng/mL and 0.14 ng/mL/mL, respectively. Overall, 34.3 % of patients were diagnosed with clinically significant prostate cancer on TP, having been diagnosed with clinically insignificant prostate cancer, atypical small acinar proliferation (ASAP), or high-grade prostatic intraepithelial neoplasia at prior TRUS. Of all, 28.1 % of patients with prostate adenocarcinoma (grade group 1) on TRUS subsequently had non-cancer diagnoses on TP. No complications were recorded. CONCLUSION: This study demonstrates that, in addition to a superior safety profile compared to TRUS, cognitive MR-targeted transrectal ultrasound-guided TP biopsy holds promise in enhancing detection of clinically significant prostate cancer.
Atypical course of fistulas and intramural abscesses in patients with perianal fistula on magnetic resonance imaging: predictive signs for Crohn's disease?
Kuru Öz D, Yılmazer Zorlu SN, Ergüden RE … +2 more , Erden A, Akyol C
Clin Radiol · 2026 Jan · PMID 41455178 · Publisher ↗
AIM: The aim of this study is to investigate the relationship between Crohn's disease (CD) and atypical fistula characteristics, including their course within the external anal sphincter (EAS) and concurrent intramural a...
AIM: The aim of this study is to investigate the relationship between Crohn's disease (CD) and atypical fistula characteristics, including their course within the external anal sphincter (EAS) and concurrent intramural abscesses, and to assess their role in distinguishing CD-associated fistulas. MATERIALS AND METHODS: A retrospective analysis of 624 patients with perianal fistulas was conducted via magnetic resonance imaging (MRI). Fistulas were classified by type, complexity, activity, course within the EAS, and presence of intramural abscesses. Logistic regression analyses identified factors differentiating CD-associated fistulas from idiopathic fistulas. RESULTS: Among the 624 patients, 109 had CD. Fistulas coursing within the EAS were observed in 10 % of patients, primarily of cryptoglandular origin (87.3 %), with a minority associated with CD (7.9 %). Intramural abscesses, which are significantly more prevalent in CD patients (P<.001), increased the likelihood of CD by 9.4-fold (95 % CI: 3.08-28.70, P<.001). Additionally, complex fistulas (OR = 2.46, P<.001) and internal orifice localisation in the proximal anal canal or distal rectum (OR = 2.26, P=.002) were identified as independent predictors of CD. CONCLUSION: Intramural abscesses, complex fistulas, and specific internal orifice locations are strong indicators of CD in patients with perianal fistulas. Furthermore, the course of fistulas within the EAS, although not strongly associated with CD, is a critical feature for treatment planning. Multidisciplinary studies are essential to refine classification systems and assess the prognostic implications of EAS-involving fistulas.
Ultrasound Ovarian-Adnexal Reporting and Data System (O-RADS) and modified ultrasound simple rules comparison in evaluation of surgically proven adnexal masses.
Kajal D, Nanapragasam A, Leckie A … +5 more , Sagheb S, Nasri F, Bouchard-Fortier G, Solnik J, Atri M
Clin Radiol · 2026 Jan · PMID 41455177 · Publisher ↗
AIM: The aim of this study was validating Ovarian-Adnexal Reporting and Data System (O-RADS) 2022 risk estimates in surgically treated ovarian/adnexal masses comparing accuracy of O-RADS with modified ultrasound simple r...
AIM: The aim of this study was validating Ovarian-Adnexal Reporting and Data System (O-RADS) 2022 risk estimates in surgically treated ovarian/adnexal masses comparing accuracy of O-RADS with modified ultrasound simple rules (mUSR) differentiating malignant from benign lesions. The mUSR was a simplified version of the International Ovarian Tumor Analysis (IOTA) using a binary classification of adnexal masses into benign/suspicious for malignancy. MATERIALS AND METHODS: multisite retrospective study was conducted including patients with pathology-proven adnexal masses between January 2008 and December 2018. All ultrasound (US) video clips reviewed by an experienced radiologist with randomly selected subset were reviewed by two additional radiologists. Areas under receiver operator characteristic curves (AUCs) were compared without and with CA-125. RESULTS: 791 ovarian masses in 765 patients (26 bilateral) (mean age: 44 ± 15 years) (628 benign, 49 borderline, and 114 malignancies) demonstrated malignancy rates of 0.3%, 3.0%, 24.9%, and 82.4% for O-RADS 2, 3, 4, and 5, respectively. O-RADS and mUSR had a sensitivity of 0.96 (confidence interval [CI]: 0.92-0.99) and 0.96 (CI: 0.91-0.98), negative predictive values (NPVs) of 0.99 (CI: 0.97-1.00) and 0.99 (CI: 0.98-1.00) (P>0.05), specificities 0.75 [CI: 0.71-0.78] and 0.88 [CI: 0.85-0.91], and positive predictive values (PPVs) 0.50 (CI: 0.44-0.55) and 0.68 (CI: 0.61-0.74) (P<0.01), respectively. The AUC was 0.855 for O-RADS and 0.920 for mUSR (P=0.005). Interobserver agreement was excellent across all readers for mUSR benign versus mUSR malignant and O-RADS 2/3 versus O-RADS 4/5 (kappa > 0.86). CA 125 improved performance of mUSR (P=0.002) and O-RADS (P=0.005) only in perimenopausal/postmenopausal patients. CONCLUSION: O-RADS and mUSR both with high sensitivity and NPV for detection of ovarian malignancy but mUSR with significantly higher specificity and PPV than O-RADS. This finding endorses the American College of Radiology (ACR) recommendation for expert sonologist consultation for O-RADS 3 and 4.
Predicting the cell differentiation of Pit-1 positivity of pituitary incidentaloma using radiomics analysis based on MRI.
Duan C, Wang M, Guo X … +4 more , Ye C, Zhao X, Yao S, Chen W
Clin Radiol · 2026 Jan · PMID 41447742 · Publisher ↗
AIM: This study aimed to construct and assess a predictive model based on radiomics features derived from preoperative MRI images to identify Pit-1 positivity in patients with pituitary incidentalomas (PIs), thereby prov...
AIM: This study aimed to construct and assess a predictive model based on radiomics features derived from preoperative MRI images to identify Pit-1 positivity in patients with pituitary incidentalomas (PIs), thereby providing a potential tool to support clinical decision-making (surgical or medical intervention versus radiological follow-up). MATERIALS AND METHODS: The study included 32 patients diagnosed with PIs who underwent surgery during a 1-3 years follow-up period. Clinical data and MRI scans, including T1-weighted with contrast (T1C) and T2-weighted (T2) sequences, were collected. Radiomics features were extracted from the region of interest (ROI), which was subjected to analysis using four machine learning algorithms namely Random Forest (RF), Support Vector Machine (SVM), K-Nearest Neighbors (KNN), and Naive Bayes (NB) to build predictive models. Their performance was evaluated using five-fold cross-validation to calculate the mean area under the curve (AUC), sensitivity, and specificity. RESULTS: 30 T1C features, 39 T2 features, and 45 combined T1C + T2 features were selected from the initial pool of 107 features for model construction. The RF model demonstrated superior performance with an AUC of 0.875, outperforming that of SVM (AUC = 0.716), KNN (AUC = 0.550), and NB (AUC = 0.725). The RF model achieved a sensitivity of 86.6 % and a specificity of 88.3 % when the ROI was delineated on T1C sequences. The models incorporating T2 features alone or in combination with T1C did not yield higher performance than those based solely on T1C. CONCLUSION: The findings of this study suggest that radiomics analysis combined with machine learning algorithms can effectively predict Pit-1 positivity in PIs using preoperative MRI images. This approach has the potential to identify high-risk PI subtypes at an earlier stage, thereby facilitating more timely clinical interventions.
Ultrasound-guided cryoablation for breast cancer ineligible for or refused surgery: a single-center experience.
Ye YY, Zhang Q, Zeng CH … +7 more , Zhu HD, Shen HM, Liu WH, Zhang YN, Hu HL, Qin Z, Teng GJ
Clin Radiol · 2026 Feb · PMID 41423394 · Publisher ↗
AIM: To evaluate the safety and feasibility of ultrasound-guided cryoablation for breast cancer in patients ineligible for or who refused surgery. MATERIALS AND METHODS: In this retrospective study, women with breast can...
AIM: To evaluate the safety and feasibility of ultrasound-guided cryoablation for breast cancer in patients ineligible for or who refused surgery. MATERIALS AND METHODS: In this retrospective study, women with breast cancer who were ineligible for or refused surgery underwent ultrasound-guided cryoablation and adjuvant therapy, as appropriate, from April 2020 to April 2023 and were included. The primary evaluation criterion was tumor progression assessed by mRECIST on both contrast-enhanced ultrasound and dynamic contrast-enhanced magnetic resonance imaging. Pain assessment using visual analog scale, complications, and cosmetic satisfaction were also evaluated. RESULTS: Seventeen patients receiving successful cryoablation were included in the study, and 16 received adjuvant endocrine therapy. The mean age was 70 ± 9 years. The median tumor diameter was 1.79 cm (interquartile range, 0.91-3.30 cm). During a mean follow-up period of 27.8 months (range, 12-36 months), the complete response rate was 100 %. Mild pain was indicated in 17.6 % (3/17) of patients using the visual analog scale. No severe procedure-related complications were reported, and cosmetic satisfaction reached 100 %. CONCLUSION: According to the results of the current study, ultrasound-guided cryoablation for breast cancer is a safe and feasible treatment in women who are ineligible for or refuse surgery.
Comparing conventional, peripheral, and transition zone prostate-specific antigen densities for the detection of clinically significant prostate cancer.
Cochran RL, Mercaldo ND, Nakrour N … +7 more , Ghosh S, Milshteyn E, Pohl M, Guidon A, Dahl DM, Feldman AS, Harisinghani MG
Clin Radiol · 2026 Jan · PMID 41420971 · Publisher ↗
AIM: Compare the diagnostic performance of whole-gland prostate-specific antigen density (wgPSAD) to zonal volume-adjusted prostate-specific antigen density (PSAD) for predicting prostate cancer in patients who underwent...
AIM: Compare the diagnostic performance of whole-gland prostate-specific antigen density (wgPSAD) to zonal volume-adjusted prostate-specific antigen density (PSAD) for predicting prostate cancer in patients who underwent a prostate magnetic resonance imaging (MRI) followed by prostate biopsy. MATERIALS AND METHODS: A retrospective study of consecutive patients who underwent prostate MRI followed by systematic biopsy with or without targeted biopsy between January 2019 and December 2020 was performed. Whole-gland (wgPSAD), transition-zone prostate-specific antigen density (tzPSAD), and peripheral-zone prostate-specific antigen density (pzPSAD) were calculated using prostate-specific antigen (PSA) levels drawn before imaging, and volume estimates were derived from MRI using artificial intelligence (AI) software assistance. Diagnostic performance was assessed using logistic regression and estimating internally validated receiver operating characteristic area under the characteristic (AUC) curves. RESULTS: A total of 551 patients with a median age of 66 years (interquartile range [IQR]: 61-72) were included. The univariable analysis demonstrated superior AUC for wgPSAD (AUC: 0.71 and 0.71) and tzPSAD (AUC: 0.72 and 0.72) compared to pzPSAD (AUC: 0.51 and 0.56) for any cancer and clinically significant prostate cancer (csPCa). The multivariable analysis including age and 5α-reductase inhibitor therapy demonstrated a superior AUC of tzPSAD for predicting csPCa (AUC: 0.77 vs 0.75; P=0.02) compared to both wgPSAD and pzPSAD (AUC: 0.77 vs 0.67; P<0.001). Variable importance analysis suggested prescribed 5α-reductase inhibitor therapy may be protective against csPCa. CONCLUSION: wgPSAD and tzPSAD are superior to pzPSAD for the detection of csPCa. When accounting for key covariates, tzPSAD may be superior to wgPSAD.
Corrigendum to "Assessment of thyroid-associated ophthalmopathy activity using corrected standardised uptake value maximum (SUVmax) and uptake ratios from 99Tcm-diethylene triamine pentaacetic acid single photon emission computed tomography/computed tomography (99Tcm-DTPA SPECT/CT) imaging" [Clin Radiol 86 (2025) 106946].
Sun J, Ma L, Yuan X … +1 more , Wang M
Clin Radiol · 2026 Jan · PMID 41418399 · Publisher ↗
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Clinical value of deep learning image reconstruction in chest computed tomography (CT) imaging: a systematic review.
Obhuli CM, Pendem S, Abhijith S … +4 more , Kadavigere R, Priyanka, Priya PS, Chacko C
Clin Radiol · 2026 Jan · PMID 41411962 · Publisher ↗
AIM: Computed tomography (CT) plays a central role in thoracic imaging, but maintaining diagnostic image quality at reduced doses remains a challenge. Filtered back projection (FBP) produces high noise, and iterative rec...
AIM: Computed tomography (CT) plays a central role in thoracic imaging, but maintaining diagnostic image quality at reduced doses remains a challenge. Filtered back projection (FBP) produces high noise, and iterative reconstruction (IR) reduces noise but alters image texture at low dose. Deep learning image reconstruction (DLIR) suppresses noise while preserving detail, yet its diagnostic performance in chest CT remains unclear. This review aimed to evaluate the clinical diagnostic value of DLIR in chest CT imaging. MATERIALS AND METHODS: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (International Prospective Register of Systematic Reviews [PROSPERO] registered). The following databases were searched for studies comparing DLIR with IR/FBP in chest CT: PubMed, Embase, Scopus, Web of Science, IEEE, and Cochrane Library. Eligible studies included human participants and reported diagnostic or image-quality outcomes. Quality assessment was performed using the QUADAS-2 tool. Given outcome heterogeneity, results were synthesised qualitatively using effect direction plots and sign tests. RESULTS: From 1,967 records, 13 studies met the inclusion criteria. DLIR demonstrated superior diagnostic performance compared with IR/FBP and showed higher sensitivity for nodule detection (up to 96.9%), improved area under the curve (AUC) for lung texture analysis (0.97-1.0 vs 0.91-0.97 with hybrid IR), and stronger interobserver agreement for interstitial lung disease (ILD) pattern classification (κ up to 0.992). DLIR achieved substantial dose reductions (up to 97%) and faster reconstruction times while maintaining diagnostic consistency. CONCLUSION: DLIR demonstrates noninferior to superior diagnostic performance compared with FBP/IR, supporting its role in routine chest CT. Large-scale studies remain essential to establish its impact on patient outcomes and guide clinical adoption.
Effect of high-tube current x-ray tube on computed tomography (CT) dose-index volume in low kilovolt peak (kVp) contrast-enhanced chest-abdomen-pelvis computed tomography (CT).
Noda Y, Ishihara T, Kawai N … +6 more , Kaga T, Miyoshi T, Hyodo F, Kato H, Kambadakone AR, Matsuo M
Clin Radiol · 2026 Jan · PMID 41411961 · Publisher ↗
AIM: The aim of this study is to investigate the relationship between participants' body weights and radiation doses in contrast-enhanced chest-abdomen-pelvis computed tomography (CT) scans, using both older and newer CT...
AIM: The aim of this study is to investigate the relationship between participants' body weights and radiation doses in contrast-enhanced chest-abdomen-pelvis computed tomography (CT) scans, using both older and newer CT scanners that can provide adequate output even at low tube voltages. MATERIALS AND METHODS: Participants who underwent contrast-enhanced chest-abdomen-pelvis CT from September to December 2021 were prospectively randomised into four groups based on kilovolt peak (kVp) and maximum tube current on two scanners-group A (120 kVp, 835 mA), group B (80 kVp, 700 mA), group C (120 kVp, 900 mA), and group D (80 kVp, 1,300 mA). The relationships between the participants' body weights and CT dose-index volume (CTDI) were compared among the four groups using non-linear regression analysis. The background noise was compared between groups A vs B and C vs D. RESULTS: A total of 118, 104, 100, and 106 participants were included in groups A, B, C, and D, respectively. The CTDI was lower in group B than in group A above the body weight of 57 kg (P < .001-.004). Similarly, the CTDI was lower in group D than in group C above a body weight of 68 kg (P < .001-.04). The background noise was higher in group B than in group A at abdominal and pelvic regions for participants weighing 57-67 kg (P < .001 for each); however, no difference was found between groups C and D (P = .21-.82). CONCLUSION: High-tube current output CT scanners necessitate an increase in the participants' body weight threshold for low-kVp scans from 57 kg to 68 kg to achieve a reduction in CTDI.
Where does spectral computed tomography (CT) fit in breast imaging? Insights and considerations for clinical practice.
Tekcan Sanli DE, Sanli AN
Clin Radiol · 2026 Jan · PMID 41406898 · Publisher ↗
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Fat-fluid level on standing lateral knee radiographs as a reliable indicator of occult intra-articular knee fractures in acute trauma evaluation.
Sinci KA, Aksoy B, Aydin OD … +3 more , Akdogan AI, Kazimoglu C, Tosun O
Clin Radiol · 2026 Jan · PMID 41401683 · Publisher ↗
AIM: To evaluate the diagnostic performance of the fat-fluid level (FFL) on standing knee radiographs for detecting intra-articular fractures in acute trauma. MATERIALS AND METHODS: This retrospective, single-centre stud...
AIM: To evaluate the diagnostic performance of the fat-fluid level (FFL) on standing knee radiographs for detecting intra-articular fractures in acute trauma. MATERIALS AND METHODS: This retrospective, single-centre study included 76 patients with acute knee trauma who underwent standing radiography and knee computed tomography (CT) within 12 hours. Patients were divided into FFL (+) (n=32) and randomly selected FFL (-) control (n=44) groups. Radiographs were assessed for FFL visibility by projection (anteroposterior [AP], lateral, or both) and for fracture presence. CT served as the reference standard. Diagnostic performance metrics were calculated and interobserver agreement was assessed using Cohen's kappa. RESULTS: An FFL was observed in 32 patients (42 %), visible on lateral radiographs in all and on AP views in 56 %. In seven patients, FFL-positive patients (22 %), no fracture line was radiographically visible yet CT-confirmed fractures in all FFL (+) cases (positive predictive value [PPV] = 100 %). Overall, CT-confirmed fractures in 42 patients (55 %); of these, 10 were FFL (-). Using CT as the reference, FFL sensitivity, specificity, PPV, and negative predictive value were 76 %, 100 %, 100 %, and 77 %, respectively. Tibial fractures were most common (69 %), followed by patellar fractures (26 %). AP views were more sensitive for fracture detection, while lateral views better demonstrated the FFL. Interobserver agreement was almost perfect (κ = 0.84-0.90). CONCLUSION: The FFL on standing lateral radiographs is a highly specific and reproducible indirect indicator of intra-articular fracture. Incorporating standing lateral radiographs into acute knee trauma protocols may improve fracture detection, particularly where CT access is limited.
Efficacy of autologous blood patch injection for the prevention of pneumothorax after transthoracic lung biopsy.
Gravel G, Roussel A, Lampson PA … +3 more , Belin X, Guth A, Mellot F
Clin Radiol · 2026 Jan · PMID 41401682 · Publisher ↗
AIM: Transthoracic computed tomography (CT)-guided lung biopsy (TLB) is associated with a risk of pneumothorax. Most studies evaluating the efficacy of blood patch injection for preventing pneumothorax also combined pati...
AIM: Transthoracic computed tomography (CT)-guided lung biopsy (TLB) is associated with a risk of pneumothorax. Most studies evaluating the efficacy of blood patch injection for preventing pneumothorax also combined patient positioning techniques, making it difficult to evaluate the sealing effect. This study aimed to assess the efficacy of autologous blood patch sealing without specific patient positioning technique after TLB for preventing pneumothorax and chest tube insertion. MATERIAL AND METHODS: In our single institution, from February 1, 2024, to January 31st, 2025, consecutive patients who underwent TLB with autologous blood patch injection were retrospectively compared with consecutive patients who underwent TLB from August 1, 2022, to July 30, 2023, with no blood patch injection. RESULTS: A total of 494 patients were included, with 245 patients in the blood patch group (group A) and 249 patients in the control group (group B). Blood patch injection was successfully performed in 235 of 245 (95.9%) patients in group A. The rate of pneumothorax was 32 of 245 patients in group A (13.1%) vs 78 of 249 patients in group B (31.3%) (P < .001). Seven (2.9%) patients required chest tube insertion in group A vs 20 (8.0%) in group B (P = .019). Five (2.0%) patients required a secondary chest radiograph for pneumothorax in group A vs 23 (9.2%) in group B (P = .001). CONCLUSION: Sealing the biopsy tract with an autologous blood patch after TLB, without a specific patient positioning technique is safe and effective in preventing pneumothorax and chest tube insertion.
Artificial intelligence in oncological positron emission tomography: advancing image analysis and interpretation.
Nakajo M, Hirahara D, Hirahara M … +6 more , Eizuru Y, Tani A, Kanzaki F, Takumi K, Kamimura K, Yoshiura T
Clin Radiol · 2026 Jan · PMID 41401681 · Publisher ↗
Functional and metabolic information provided by positron emission tomography (PET) imaging, such as patient diagnosis, tumour staging, and treatment evaluation, plays an important role in the clinical management of pati...
Functional and metabolic information provided by positron emission tomography (PET) imaging, such as patient diagnosis, tumour staging, and treatment evaluation, plays an important role in the clinical management of patients with cancer. Nonetheless, its clinical efficacy may be inhibited by differences in image quality and limitations in quantitative robustness. Artificial intelligence (AI) has transformed oncological PET imaging by improving image quality and facilitating a more consistent extraction of quantitative metrics. Recent research emphasises the value of AI in improving diagnostic accuracy and prognostic modelling. However, to ensure that AI-based PET analysis is successfully implemented in clinical practice, challenges such as imaging data standardisation, the development of reliable explainability methods, and the establishment of regulatory frameworks must be addressed. To optimise individualised care, future progress will likely be based on multimodal integration, federated learning, and probabilistic deep learning. Overall, this review highlights both the current progress and the remaining challenges of AI in oncological PET, aiming to provide a balanced perspective for future clinical translation.
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