Clinical Radiology[JOURNAL]
Sun
200 papers
Semiautomated magnetic resonance imaging-based breast density measurement from routine sequences: comparison with mammography.
Takatsu Y, Shimizu M, Nakamura T … +7 more , Sagawa H, Takano K, Harada S, Yamashiro T, Kobayashi S, Miyati T, Kumasaka S
Clin Radiol · 2026 Jun · PMID 42401077 · Publisher ↗
AIM: High breast density increases breast cancer risk and decreases mammographic sensitivity, yet prior magnetic resonance imaging (MRI)-based density assessments have relied on specialized sequences or vendor-dependent...
AIM: High breast density increases breast cancer risk and decreases mammographic sensitivity, yet prior magnetic resonance imaging (MRI)-based density assessments have relied on specialized sequences or vendor-dependent software. This study aimed to evaluate a semiautomated workflow for MRI-based breast density measurement using routinely acquired MRI sequences and compare its diagnostic performance and concordance with visual and software-based mammographic classifications. MATERIALS AND METHODS: In this single-center retrospective study, we analyzed 113 women (mean age: 60.8 ± 13.6 years) who underwent both breast MRI and mammography. The contralateral, normal breast was evaluated. MRI was performed using a 3.0-T scanner with a 3D T1-weighted gradient-echo sequence. Breast and fibroglandular tissues were segmented using a deep learning-assisted automated method with manual correction. Statistical analyses included correlation analysis, Bland-Altman analysis, and receiver operating characteristic (ROC) analysis. RESULTS: MRI-based breast density showed a strong correlation with mammographic density (r = 0.781, P < 0.001), although MRI values were on average 27.7% lower. The area under the ROC curve for detecting high-density breasts was 0.869 for MRI and 0.799 for mammography (P = 0.085). CONCLUSIONS: Semiautomated MRI-based breast density assessment using routine MRI sequences allowed for quantitative evaluation of breast composition without using ionizing radiation. MRI-based density measurements exhibited classification performance comparable to mammographic assessment. These findings support the potential utility of MRI for quantitative breast density evaluation, although further validation and workflow standardization are required before broader clinical application.
Where can we improve? An evaluation of discrepancies between radiology resident and consultant reports for noncontrast head computed tomography (NCHCT) scans in the emergency department at a tertiary care centre.
Nash K, Bhebhe Z, Bow A … +6 more , Hall M, Lowe D, Narbone M, OxCAIR, Romsauerova A, Ather S
Clin Radiol · 2026 May · PMID 42392936 · Publisher ↗
AIM: To evaluate the discrepancy rates of acute findings on non-contrast computed tomography head scans (NCHCT) between radiology trainees and neuroradiology consultants at a tertiary care centre in the United Kingdom. M...
AIM: To evaluate the discrepancy rates of acute findings on non-contrast computed tomography head scans (NCHCT) between radiology trainees and neuroradiology consultants at a tertiary care centre in the United Kingdom. MATERIALS AND METHODS: All reports for NCHCT over a 4 month period conducted in the emergency department were extracted from the radiology information system and screened to identify scans reported by a registrar. Reports were manually coded for acute findings and discrepancies. Acute findings included all subtypes of intracranial haemorrhage (ICH), mass effect, midline shift, cranial fracture, acute/subacute infarct, hydrocephalus, and space occupying lesion. RESULTS: In total, 2208 scans were included. Discrepancies for any acute finding were found in 94 cases (4.26%), including 38 disagreements related to intracranial haemorrhage. Specificity was over 99.5% for all acute findings. The highest sensitivity was observed for midline shift at 100% (95% confidence intervals 90.3-100.0%), intraventricular haemorrhage at 95.7% (78.1-99.9%) and mass effect at 92.8% (84.9-97.3%). Sensitivity was lowest at 66.7% for extradural haemorrhage (9.4-99.2%) and 57.1 for ICH of unclear location (18.4-90.1%), though the prevalence of these pathologies was low. Sensitivity was also lower for infarcts at 70% (57.9-80.4%) and subdural haemorrhage at 77.6 (63.4-88.2). CONCLUSION: There is a high concordance between radiology registrar and subsequent consultant reports, supporting registrar on-call reporting. Registrars were highly specific in diagnosing key acute pathologies, meaning few patients would have received unnecessary treatment. Sensitivity varied significantly between pathologies, with certain areas for improvement identified, which can be used to inform local teaching and clinical review to reduce misdiagnoses.
Proton beam therapy: neuroradiology considerations and challenges.
Brookes T, Crawley A, Gains J … +7 more , Kosmin M, Doig D, Fersht N, Mahay A, Soto C, Ching Chang Y, Hyare H
Clin Radiol · 2026 May · PMID 42392019 · Publisher ↗
Proton beam therapy (PBT) is increasingly used in paediatric neuro-oncology due to its favourable dose distribution and potential to reduce treatment toxicity. As its clinical use expands, neuroradiologists play a centra...
Proton beam therapy (PBT) is increasingly used in paediatric neuro-oncology due to its favourable dose distribution and potential to reduce treatment toxicity. As its clinical use expands, neuroradiologists play a central role in recognising therapy-related changes and supporting long-term surveillance. This review outlines key neuroradiological considerations across the PBT pathway. MRI is fundamental to planning, but its integration requires modified workflows, specialised immobilisation equipment, and tailored sequence design to balance geometric accuracy, signal-to-noise constraints, and patient tolerability. Ongoing sequence optimisation-including the use of high-resolution isotropic volumes and advanced reconstructions-aims to improve delineation of target structures and organs at risk. During treatment, anatomical changes such as tumour or cyst evolution may alter proton range, necessitating interval imaging and, in selected cases, adaptive replanning. Post-treatment assessment presents further challenges, as PBT may produce distinct radiological appearances compared with photon therapy. These include patterns of pseudoprogression, variations in white matter and microvascular injury, and a spectrum of vascular complications. Accurate interpretation is essential to distinguish treatment effects from recurrence and to guide further management. Advances in MRI-only workflow development, synthetic CT generation, ultra-high-field imaging, and computational modelling offer opportunities to further improve treatment precision and refine the characterisation of post-treatment effects. As PBT becomes more widely delivered, this review will aid neuroradiologists at referring centres who will increasingly encounter its distinct post-treatment appearances, highlighting the importance of familiarity with these patterns in routine practice and aiding standardisation of post-treatment imaging protocols.
Weight-based contrast media volume reduction in lower limb computed tomography angiography: a prospective feasibility study.
Vegas A, Aranha KN, Dsouza RJ … +1 more , Chand A
Clin Radiol · 2026 Jun · PMID 42392018 · Publisher ↗
AIM: Computed tomography lower-limb angiography (CT LLA) is widely used to evaluate peripheral arterial disease, in which adequate arterial enhancement is essential for accurate diagnosis. Conventional protocols typicall...
AIM: Computed tomography lower-limb angiography (CT LLA) is widely used to evaluate peripheral arterial disease, in which adequate arterial enhancement is essential for accurate diagnosis. Conventional protocols typically use fixed contrast volumes, which may result in unnecessary iodine exposure. This study aimed to evaluate whether a weight-based contrast protocol can maintain image quality compared with a standard fixed-dose protocol. METHODS: In this prospective study, 105 patients underwent CT LLA using a weight-based contrast protocol (80-100 mL of 350 mg I/mL) and were compared with 25 patients who received a standard fixed volume (120 mL). Objective image quality parameters, including arterial attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR), were assessed. Subjective image quality was independently evaluated using a five-point Likert scale. Between-group comparisons were performed using the Mann-Whitney U test. RESULTS: Subjective image quality scores were higher in the standard protocol group (all P < .001). There was no significant difference in arterial attenuation (P = .090) or SNR (P = .703), while CNR was modestly higher in the standard group (P = .010). All examinations in both groups were diagnostically adequate. Correlation analysis demonstrated that contrast volume did not significantly influence SNR or CNR, whereas arterial attenuation and image noise were the main determinants of image quality. CONCLUSION: Weight-based contrast protocols achieve significant contrast volume reduction while maintaining diagnostically acceptable image quality, with a 16.7%-33.3% reduction in contrast-related costs. This approach is a feasible alternative to fixed-dose strategies in routine lower-limb CT angiography.
Diagnostic accuracy of flat panel computed tomography for acute stroke: a systematic review and meta-analysis of diagnostic test accuracy studies.
Ghozy S, Jazayeri SB, Ali MA … +6 more , Ognard J, Borkar RR, Dmytriw AA, Kadirvel R, Brinjikji W, Kallmes DF
Clin Radiol · 2026 May · PMID 42378945 · Publisher ↗
AIM: This systematic review and diagnostic test accuracy meta-analysis aimed to evaluate the diagnostic performance of flat-panel computed tomography (FPCT) for acute stroke-related findings, particularly intracranial he...
AIM: This systematic review and diagnostic test accuracy meta-analysis aimed to evaluate the diagnostic performance of flat-panel computed tomography (FPCT) for acute stroke-related findings, particularly intracranial hemorrhage and ischemic events, in comparison with standard CT or MRI. MATERIALS AND METHODS: A systematic review and meta-analysis were conducted following PRISMA-DTA guidelines. PubMed, Scopus, and Embase were searched through September 2024 for diagnostic accuracy studies comparing FPCT with CT or MRI in acute stroke settings. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated using random-effects and bivariate models. Subgroup analyses and sensitivity analyses addressed heterogeneity. RESULTS: Thirteen studies were included in the meta-analysis. Pooled univariate estimates showed a sensitivity of 82.2% (95% CI: 75.1-87.7), specificity of 93.1% (95% CI: 88.5-96.0), and DOR of 78.6 (95% CI: 40.3-153.4). Bivariate analysis demonstrated improved diagnostic performance with a sensitivity of 86.5%, specificity of 96.7%, and DOR of 187.3. Subgroup analysis revealed higher sensitivity for intracerebral hemorrhage (92.6%) than ischemic stroke (62.3%, p=0.003). Specificity was highest for intraventricular hemorrhage (98.8%). While significant heterogeneity and publication bias were detected, results remained robust after exclusion of outliers. CONCLUSIONS: FPCT demonstrates high specificity and moderate-to-high sensitivity for stroke-related findings, with strongest performance for intracranial hemorrhage. These findings support consideration of FPCT as a complementary in-suite imaging tool in selected direct-to-angiosuite workflows, particularly for rapid hemorrhage exclusion. However, its lower sensitivity for ischemic changes and susceptibility to contrast-related artifacts indicate that FPCT should complement, rather than replace, standard CT/MRI-based evaluation.
Nuclear medicine techniques in gynaecological malignancy: a review of best practice.
Canham S, Khan SR, Naik M … +1 more , Barwick TD
Clin Radiol · 2026 May · PMID 42378944 · Publisher ↗
Gynaecological malignancies are increasing in incidence in the UK, primarily driven by a rise in cases of endometrial cancer. The most common in order of prevalence thereafter are ovarian, cervical, vulval and vaginal ca...
Gynaecological malignancies are increasing in incidence in the UK, primarily driven by a rise in cases of endometrial cancer. The most common in order of prevalence thereafter are ovarian, cervical, vulval and vaginal cancers. Imaging is fundamental to their diagnosis, staging, response assessment and surveillance; and has significant implications in management by guiding local, regional or systemic treatment strategies. Advanced nuclear medicine imaging modalities, in particular [F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT), have an evolving role in combining anatomical and functional data, resulting in superior sensitivity and specificity for detection of sites of disease compared to conventional techniques. Sentinel node lymphoscintigraphy using [Tc]-labelled nanocolloids is also integral to management pathways in selected cases, notably in patients with cervical and vulval cancer, to detect microscopic nodal disease and potentially avoid more extensive procedures which carry morbidity. This article provides a contemporary, evidence-based, overview of nuclear medicine imaging practice in gynaecological malignancy, separated by primary tumour location. It makes reference to current international guidelines and highlights key studies evidencing their utility, in addition to describing strengths and limitations compared to alternative modalities. Future advances on the horizon are also discussed, including novel radiopharmaceuticals and technological developments.
Deep learning reconstruction dual-energy computed tomography for gastrointestinal system tumors: low-kiloelectron volt imaging vs routine imaging.
Liu Y, Yuan M, Liang H … +7 more , You Y, Li J, Chen L, Sun X, Liu J, Lyu P, Gao J
Clin Radiol · 2026 Jun · PMID 42364263 · Publisher ↗
AIM: To qualitatively and quantitatively compare dual-energy computed tomography (DECT)-derived 55 keV virtual monochromatic images (VMIs) using deep learning image reconstruction (DLIR) with 70 keV VMIs using adaptive s...
AIM: To qualitatively and quantitatively compare dual-energy computed tomography (DECT)-derived 55 keV virtual monochromatic images (VMIs) using deep learning image reconstruction (DLIR) with 70 keV VMIs using adaptive statistical iterative reconstruction (ASiR-V) in the Gastrointestinal (GI) system tumors and to investigate whether DLIR can influence the measured iodine parameters. MATERIALS AND METHODS: This prospective, observational study included 47 patients with GI system tumors who underwent DECT. Qualitative and quantitative assessment was performed on 70 keV VMIs using ASiR-V40%, and 55 keV VMIs using DLIR at low (DLIR-L), medium (DLIR-M), and high strength (DLIR-H). Quantitative evaluation included calculation of the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR). Overall image quality, lesion conspicuity, and diagnostic confidence were evaluated qualitatively by 2 radiologists. Iodine parameters of tumor lesions were compared among four groups of algorithms. RESULTS: There were no significant differences in the image noise between DLIR-M and ASiR-V40%, whereas image noise was significantly lower in DLIR-H than ASiR-V40% and DLIR-M (both phases, P < 0.001). DLIR-M and DLIR-H had significantly higher CNR and SNR compared with ASiR-V40% on both phases (all P ≤ 0.001). When compared to ASiR-V40%, DLIR-M and DLIR-H had similar or improved qualitative assessment metrics. DLIR-L yielded the highest image noise and the lowest overall image quality score among these algorithms. Lastly, the measured iodine parameters were equivalent among different algorithms (all P > 0.1). CONCLUSION: Abdominal DECT at 55 keV with DLIR (-M and -H) provided qualitative and quantitative performance for GI tumor evaluation comparable to or exceeding that of ASiR-V 40% at 70 keV.
Deep learning-based reconstruction for 5.0T magnetic resonance imaging (MRI) in nasopharyngeal carcinoma: comparison of image quality and diagnostic efficacy.
Zhou P, Liu H, Xu G … +4 more , Lin H, Yu Z, He H, Xie C
Clin Radiol · 2026 Apr · PMID 42361579 · Publisher ↗
AIM: To investigate the effect of deep learning-based reconstruction (DLR) technology on image quality and diagnostic efficacy of 5T magnetic resonance imaging (MRI) in nasopharyngeal carcinoma (NPC). MATERIALS AND METHO...
AIM: To investigate the effect of deep learning-based reconstruction (DLR) technology on image quality and diagnostic efficacy of 5T magnetic resonance imaging (MRI) in nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: This prospective study included 70 NPC patients who underwent 5T MRI examinations. The protocol included axial T2-weighted imaging (T2WI), axial T1-weighted imaging (T1WI), and axial and coronal contrast-enhanced T1WIs. Images of six gear levels (0-5) were reconstructed using the DLR technology. Two radiologists independently evaluated the visibility of lesions, boundary sharpness, artefact presence, and overall image quality using a 5-point Likert scale. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also calculated for lesions and lateral pterygoid muscles (LPM). T-stage evaluation was performed for both conventional (level = 0) and DLR images, compared to clinical T-stage results. RESULTS: DLR images (levels 2-5) demonstrated significantly higher SNRs in lesions and LPM compared to conventional images (P < 0.001), with a maximum improvement of 94%. In axial T2WI, and axial and coronal contrast-enhanced T1WI DLR images (levels 2-5), the lesion-to-lateral pterygoid muscle CNR was significantly higher (P < 0.001), with a maximum improvement of 108%. Qualitative analysis revealed that DLR images (levels 2-5) were superior to conventional images (P < 0.05) across all subjective assessment dimensions except artefact reduction. Among the five reconstruction levels of DLR, level 3 yielded the highest overall image quality score. Additionally, the diagnostic performance of T-stage for DLR (level 3) and conventional images exhibited a comparable degree of consistency with the clinical T-stage results (κ = 0.771 and 0.796, respectively). CONCLUSION: DLR technology improves the quality of conventional nasopharyngeal MRI images without affecting the diagnostic accuracy of T-stage, offering potential clinical value.
Papillary muscle fibrosis on cardiac magnetic resonance imaging: a pictorial review of causes, diagnostic challenges and practical pearls.
Gutierrez M, McCreavy D, Radike M
Clin Radiol · 2026 May · PMID 42349353 · Publisher ↗
Papillary muscle fibrosis (PMF) is being increasingly recognised as a cause of ventricular arrhythmias; therefore, its identification is clinically relevant. PMF has been described in multiple cardiac conditions such as...
Papillary muscle fibrosis (PMF) is being increasingly recognised as a cause of ventricular arrhythmias; therefore, its identification is clinically relevant. PMF has been described in multiple cardiac conditions such as ischaemic cardiomyopathy, mitral valve prolapse and non-ischaemic cardiomyopathies such as hypertrophic cardiomyopathy (HCM), cardiac amyloidosis and cardiac sarcoidosis. Although cardiac magnetic resonance (CMR) imaging is a central tool in its diagnosis, PMF can be overlooked if the papillary muscles are not carefully assessed, especially in cases where the abnormal papillary muscle and the blood pool have the same signal intensity on the late gadolinium enhancement (LGE) phase. In an illustrative fashion, the present review aims to describe the normal anatomy of the papillary muscles, a range of conditions which can cause papillary muscle fibrosis and useful tips for its identification.
Deep learning-based automated assessment of pulmonary artery indices and surgical approach triage for tetralogy of Fallot from multicenter cardiac computed tomography (CT).
Yao X, Zhou Q, Guo C … +7 more , OuYang R, Hu L, He X, Zheng Z, Wang Q, Shi F, Zhong Y
Clin Radiol · 2026 Jun · PMID 42349352 · Publisher ↗
AIM: To develop an automated framework for deep learning (DL)-based segmentation, pulmonary artery indices (PAIs) computation, and rule-based surgical triage from cardiac CT (CCT) in pediatric Tetralogy of Fallot (TOF)....
AIM: To develop an automated framework for deep learning (DL)-based segmentation, pulmonary artery indices (PAIs) computation, and rule-based surgical triage from cardiac CT (CCT) in pediatric Tetralogy of Fallot (TOF). MATERIALS AND METHODS: Preoperative CCT scans of pediatric TOF patients were collected from the primary internal centers and two external centers. A modified 3D nnU-Net architecture was used for automated segmentation of the pulmonary arteries (PA) and descending aorta (DAO). Following segmentation, PAIs were automatically computed using predefined geometric algorithms. Segmentation performance, measurement agreement, and processing efficiency were evaluated. Surgical triage analysis was performed only in the primary internal dataset because the external dataset lacked palliative cases. RESULTS: 122 TOF patients were included (the training dataset n = 80, the internal validation dataset n = 20, the external dataset n = 22). The DL model achieved high segmentation performance, with PA/DAO dice similarity coefficient ranging (DSC) from 0.92 to 0.98 across datasets. DL-derived PAIs showed good agreement with manual measurements and reduced processing time by 90.11% (30.28 s vs. 205.00 s, P < 0.001). Automated PAIs demonstrated good rule-based surgical triage ability (AUC > 0.87). CONCLUSIONS: This automated framework enables rapid and automated PAI quantification from CCT in pediatric TOF across multi-center datasets. DL-derived PAIs demonstrated comparable performance to manual measurements for rule-based surgical triage.
Efficacy of saline tract sealing after CT-Guided lung biopsy: a systematic review and meta-analysis.
Kayaoglu AT, Almeida JM, Varela Betancourt VV … +4 more , Fuenmayor Mena LH, Carpilovsky PK, Barbosa D, Taneja AK
Clin Radiol · 2026 May · PMID 42322811 · Publisher ↗
INTRODUCTION: CT-guided percutaneous transthoracic lung biopsy is a high-value procedure with risks such as pneumothorax and chest tube placement. Several needle-tract sealing techniques have been proposed to reduce post...
INTRODUCTION: CT-guided percutaneous transthoracic lung biopsy is a high-value procedure with risks such as pneumothorax and chest tube placement. Several needle-tract sealing techniques have been proposed to reduce post-biopsy pneumothorax, although evidence regarding saline tract sealing remains limited. This study updated a meta-analysis comparing normal saline tract sealing to usual care for pneumothorax and chest tube placement in guided lung biopsies. METHODS: Embase, Scopus, PubMed, and Cochrane databases were systematically searched for studies comparing tract instillation with normal saline versus usual care in patients undergoing CT-guided lung biopsy. The outcomes assessed were pneumothorax and chest tube placement. Risk ratios (RR) with 95% confidence intervals (CI) were pooled with a random effects model. RESULTS: Seven studies were included following our inclusion criteria, comprising a total of 1,455 patients. Of these, 680 patients (46.7%) underwent tract instillation with saline after CT-guided lung biopsy. Compared to usual care, saline tract instillation was associated with significantly lower rates of pneumothorax (risk ratio 0.46; 95% CI 0.32-0.67; p=0.002; I = 50%) and chest tube placement (risk ratio 0.24; 95% CI 0.14-0.40; p<0.001; I = 0%). CONCLUSIONS: In patients undergoing CT-guided lung biopsy, tract sealing with normal saline reduces the incidence of pneumothorax and chest tube placement, compared to usual care. PROSPERO REGISTRATION: CRD420251249441.
Automated computed tomography (CT) perfusion in the assessment of the ischaemic core in wake-up strokes: is it reliable?
U-King-Im JM, Kallam N, Chandra J … +5 more , Patel J, Al Busaidi A, Mah YH, Teo J, Booth T
Clin Radiol · 2026 May · PMID 42320317 · Publisher ↗
AIM: Wake-up strokes represent up to 27% of all acute strokes. The main objective of this study was to assess the reliability of computed tomography perfusion (CTP) in the assessment of the acute ischaemic core in this p...
AIM: Wake-up strokes represent up to 27% of all acute strokes. The main objective of this study was to assess the reliability of computed tomography perfusion (CTP) in the assessment of the acute ischaemic core in this population. MATERIALS AND METHODS: Intracranial CT and CTP studies of 117 consecutive patients (55 female, mean age 75, range 32-90) presenting with wake-up strokes and large vessel occlusion on CT angiography were included. Studies were retrospectively reviewed by two neuroradiologists in consensus in a blinded manner to determine Alberta Stroke Programme Early CT Score (ASPECTS) score on the presenting CT and CTP (relative cerebral blood flow [rCBF] maps) studies, with follow-up CT acting as the reference standard. RESULTS: Correlation between rCBF ASPECTS and follow-up CT ASPECTS (Pearson correlation coefficient 0.68) was less compared to plain CT ASPECTS and follow-up CT ASPECTS (Pearson correlation coefficient 0.85) (P < 0.05). There was concordance between CT ASPECTS and rCBF ASPECTS in 55 patients (47%). However, in 44 cases (38%), rCBF ASPECTS underestimated the ischaemic core compared to CT ASPECTS. Out of these 44 cases, in 26 cases (22%), the CTP was normal, with a rCBF ASPECTS score of 10, whilst CT showed clear acute but established ischaemic change. CONCLUSION: This study shows that CTP alone is not reliable in the assessment of the ischaemic core in the wake-up stroke population. Both noncontrast CT and CTP need to be carefully assessed in conjunction when considering thrombectomy eligibility in this group as established ischaemic change may be underestimated by CTP in up to 38% of patients, likely due to the delayed presentation.
Effect of myocardial bridging on the fat attenuation index of proximal coronary arteries: a dual-centre study in a plaque-free population.
Xu X, Fu Q, Hao D … +6 more , Li Y, Zhu J, Zhou T, Li X, Nie P, Liu S
Clin Radiol · 2026 May · PMID 42320316 · Publisher ↗
AIM: The left anterior descending (LAD) myocardial bridge-mural coronary artery (MB-MCA) complex is a common coronary anatomical variation. The pericoronary fat attenuation index (FAI), derived from coronary computed tom...
AIM: The left anterior descending (LAD) myocardial bridge-mural coronary artery (MB-MCA) complex is a common coronary anatomical variation. The pericoronary fat attenuation index (FAI), derived from coronary computed tomography angiography (CCTA), is an imaging biomarker associated with pericoronary adipose tissue attenuation changes and should be interpreted as an imaging-derived surrogate rather than a direct measure of vascular inflammation. This study aimed to investigate the association between MB-MCA, particularly its morphological characteristics, and proximal pericoronary FAI in a plaque-free population. MATERIALS AND METHODS: In this dual-centre retrospective study, 2,094 patients with LAD MB-MCA without atherosclerotic plaque and 1,126 controls with normal CCTA findings were analysed. According to MB thickness, patients were categorised into superficial (<2 mm), moderate-depth (2-5 mm), and extreme-depth (≥5 mm) groups. FAI was measured in a 2 cm segment proximal to the MB entrance. MB thickness and length were assessed on systolic-phase CCTA images. Between-group comparisons, correlation analyses, and multivariable logistic regression analyses were performed. RESULTS: After 1:1 propensity score matching (769 pairs), proximal FAI remained significantly higher in the MB group than in matched controls. Proximal FAI values were significantly higher in all MB groups than in controls and increased progressively with greater MB thickness (median Hounsfield unit [HU]: control -90, superficial -83, moderate-depth -78, extreme-depth -68; P < 0.001). Within the deep MB subgroup (MB thickness ≥2 mm), MB thickness showed a moderate positive correlation with FAI (r = 0.463, P < 0.001), whereas MB length was not significantly correlated with FAI (r = 0.023, P = 0.45). On multivariable analysis, MB thickness remained independently associated with elevated FAI (odds ratio [OR] = 3.103, 95% confidence interval [CI]: 2.537-3.796, P < 0.001). CONCLUSION: The presence of an LAD MB-MCA, particularly deep bridges, is associated with higher proximal pericoronary FAI values in a plaque-free population. MB thickness, rather than length, was the primary anatomical parameter associated with FAI elevation.
The value of microvascular flow imaging and color Doppler flow imaging in the differential diagnosis of benign and malignant endometrial lesions.
Li F, Zhou GQ, Tang L … +7 more , Wang CP, Song WJ, Wang YN, An R, Wei W, Zhang MS, Fu Y
Clin Radiol · 2026 May · PMID 42314358 · Publisher ↗
AIM: To investigate the value of microvascular flow (MV-Flow) imaging and its quantitative parameter, the vascular index (VI), in the differential diagnosis of benign and malignant endometrial lesions, and to compare it...
AIM: To investigate the value of microvascular flow (MV-Flow) imaging and its quantitative parameter, the vascular index (VI), in the differential diagnosis of benign and malignant endometrial lesions, and to compare it with color Doppler flow imaging (CDFI). MATERIALS AND METHODS: This was a retrospective case-control study including 132 patients with endometrial lesions. Preoperative examinations with CDFI and MV-Flow were performed to assess blood flow visualization and calculate VI. Using postoperative histopathological results as the gold standard, receiver operating characteristic (ROC) curve analysis was employed to evaluate and compare the diagnostic performance of VI, MV-Flow, and CDFI. RESULTS: MV-Flow achieved higher overall blood flow detection rates for both benign and malignant lesions (88.63%) and for malignant lesions specifically (100%) compared to CDFI (73.48% and 86.36%, respectively), with clearer visualization of microvessels. The vascular pattern of MV-Flow differed significantly between benign and malignant groups (P<.001), with the malignant group predominantly showing multiple vessels (focal origin and multifocal origin). ROC analysis revealed AUCs for differentiating benign from malignant lesions of 0.872 for VI, 0.846 for MV-Flow, and 0.786 for CDFI. Using a VI cutoff value of ≥15.6 yielded a diagnostic sensitivity of 79.55% and specificity of 77.27%. Both VI and MV-Flow demonstrated significantly higher diagnostic efficacy than CDFI (P=.015 and P=.026, respectively). CONCLUSION: MV-Flow is superior to CDFI in visualizing microvessels in endometrial lesions and provides richer blood flow information. Its quantitative parameter VI has high diagnostic value.
Cervical subcutaneous fat index and lordosis in intervertebral disc degeneration: is there a link?
Can Y, Meral HB
Clin Radiol · 2026 May · PMID 42308671 · Publisher ↗
AIM: This retrospective study investigated the relationship between cervical intervertebral disc degeneration (IVDD), cervical lordosis angle (CL), and posterior subcutaneous fat index (SFI) in adults with neck pain. MAT...
AIM: This retrospective study investigated the relationship between cervical intervertebral disc degeneration (IVDD), cervical lordosis angle (CL), and posterior subcutaneous fat index (SFI) in adults with neck pain. MATERIALS AND METHODS: A total of 250 patients aged 18-65 years who underwent cervical magnetic resonance imaging (MRI) between 2023 and 2025 were included. Intervertebral discs from C2-T1 were graded using the Pfirrmann classification on T2-weighted midsagittal images. Cervical lordosis was measured using the posterior tangent method from C2-C7. Posterior SFI was calculated as the ratio of subcutaneous fat thickness to total posterior soft tissue thickness. Patients were grouped into loss of lordosis or normal lordosis groups. Statistical analyses included independent samples t-test, Spearman's correlation, and multiple regression analysis. RESULTS: The mean age was 39.15 ± 12.79 years; 58% were female. Mean body mass index (BMI) was 22.45 ± 1.48 kg/m, and mean CL angle was -10.08 ± 11.33°. No significant differences were found in segmental SFI values between the loss of lordosis (N = 96) and normal lordosis (N = 154) groups (P > 0.05). Pfirrmann grades were comparable across most cervical levels, except at C6-7, where greater degeneration was observed in the normal lordosis group (P = 0.039). No significant correlations were identified between CL and either SFI or disc degeneration grades. Regression analysis showed that age, BMI, SFI, and Pfirrmann grade were not independent predictors of CL. CONCLUSION: Posterior cervical SFI and CL were not generally associated with IVDD in this cohort. The isolated finding at C7-T1 should be interpreted cautiously. These results support the multifactorial nature of cervical disc degeneration and emphasise the need for larger prospective studies.
Delayed 18F-FDG PET for the evaluation of suspected recurrent disease in brain metastases treated with radiation.
Ciavarra B, Krayyem A, Ansari S … +4 more , Shindell E, Gule-Monroe MK, Patel CB, Johnson JM
Clin Radiol · 2026 May · PMID 42296939 · Publisher ↗
BACKGROUND AND PURPOSE: Differentiating progressive disease (PD) from radiation necrosis (RN) after treatment of brain metastases remains challenging. We evaluated the diagnostic utility of dual-timepoint 18F-FDG PET in...
BACKGROUND AND PURPOSE: Differentiating progressive disease (PD) from radiation necrosis (RN) after treatment of brain metastases remains challenging. We evaluated the diagnostic utility of dual-timepoint 18F-FDG PET in distinguishing PD from RN in patients with treated brain metastases showing suspicious MRI findings. MATERIALS AND METHODS: Thirty-four patients with suspicious MRI enhancement following radiation therapy were retrospectively analyzed. Seventeen had PD and 17 had RN, confirmed by a composite reference standard of clinical and radiologic follow-up (all 34 patients) or histopathology (10 patients, 29%). All underwent dual-timepoint 18F-FDG PET imaging (early at ∼77 minutes and delayed at ∼293 minutes post-injection). Tumor-to-background SUVmax ratios (T/B ratios) were calculated for each timepoint. RESULTS: T/B SUVmax ratios were significantly higher in PD compared to RN at both early (1.3 ± 0.6 vs. 0.9 ± 0.3, P = .01) and delayed (2.0 ± 1.1 vs. 1.1 ± 0.3, P = .004) imaging, with greater absolute increase from early to delayed imaging in PD (0.7 ± 0.6 vs. 0.2 ± 0.2, P = .007). The delayed T/B ratio achieved an AUC of 0.772 (95% CI: 0.582-0.921). A delayed T/B ratio ≥ 1.5 achieved 94.1% specificity (95% CI: 71.3%-99.9%) with moderate sensitivity (58.8%; 95% CI: 32.9%-81.6%). While no single PET metric outperformed MRI overall, PET correctly reclassified three of four MRI misdiagnoses. CONCLUSION: Dual-timepoint 18F-FDG PET may improve differentiation of PD from RN in equivocal MRI cases, particularly by reducing false-positive diagnoses, with a number needed to image of 8 (95% CI: 3-272). However, all thresholds were data-driven and confidence intervals are wide. Prospective validation with standardized protocols and pre-specified thresholds is warranted.
ADC histogram analysis for differentiating high-grade and low-grade meningiomas: a systematic review and meta-analysis.
Fernandes RT, Fonseca PEO, Santos LB … +2 more , Bonatti BF, Dutra-Melo A
Clin Radiol · 2026 May · PMID 42296938 · Publisher ↗
AIM: Accurate meningioma grading is essential in neurosurgical practice as World Health Organization grade influences prognosis, recurrence, and treatment strategies. This meta-analysis evaluating ADC histogram analysis...
AIM: Accurate meningioma grading is essential in neurosurgical practice as World Health Organization grade influences prognosis, recurrence, and treatment strategies. This meta-analysis evaluating ADC histogram analysis for preoperative meningioma grading represents a major methodological advancement by extracting multiple radiomic parameters, overcoming limitations of conventional single mean ADC approaches. This enables paradigmatic shift from histopathology-dependent to preoperative radiomic-based grading, transforming neurosurgical practice from reactive to predictive medicine. MATERIALS AND METHODS: We conducted a systematic review and meta-analysis following preferred reporting items for systematic reviews and meta-analysis, searching PubMed, Embase, and Cochrane Library databases. Studies evaluating preoperative ADC histogram analysis diagnostic performance in intracranial meningioma were included. Primary outcomes were sensitivity, specificity, and overall accuracy. Data were pooled using random-effects models with bivariate-derived area under the curve analysis. RESULTS: Six studies comprising 533 patients diagnosed with intracranial meningioma were analysed. Sensitivity and specificity analysis showed pooled sensitivity of 0.71 (95% CI: 0.55-0.83; I = 68.5%, P=.0072) and pooled specificity of 0.72 (95% CI: 0.55-0.85; I = 86.3%, P<.0001). Overall diagnostic accuracy was 0.76 (95% CI: 0.60-0.84). A moderate threshold effect was observed (correlation coefficient = 0.42), with no significant publication bias detected (P=0.27). Heterogeneity was substantial for specificity but moderate for sensitivity. CONCLUSION: ADC histogram analysis shows potential for preoperative meningioma grading despite moderate heterogeneity. In the era of minimally invasive medicine, findings suggest enhanced surgical decision-making and personalised patient management. Future research should focus on standardisation and multicenter validation.
Hypertension and myocardial fibrosis: A systematic review and meta-analysis.
Jiang J, Deng J, Dong L … +7 more , Liao B, Luo G, Wang M, Hu C, Ou S, Tang H, Song G
Clin Radiol · 2026 May · PMID 42296937 · Publisher ↗
BACKGROUND: Hypertension (HTN) is a major risk factor for myocardial fibrosis (MF), a key contributor to cardiac dysfunction. This meta-analysis aims to evaluate the relationship between HTN and MF using data from imagin...
BACKGROUND: Hypertension (HTN) is a major risk factor for myocardial fibrosis (MF), a key contributor to cardiac dysfunction. This meta-analysis aims to evaluate the relationship between HTN and MF using data from imaging and histological studies. METHODS: This study was searched EMBASE, PubMed, Cochrane Library, and Google Scholar to identify observational and interventional studies evaluating the association between HTN, blood pressure (BP), and antihypertensive medications with MF, assessed by histology or cardiac magnetic resonance imaging (T1 mapping parameters: extracellular volume fraction [ECV%] and native T1 values). RESULTS: A total of 39 studies comprising 45,776 participants were included in the analysis. The meta-analysis showed that HTN was significantly related to MF indicators, including collagen volume fraction (weighted mean difference [WMD]: 4.66; 95% confidence interval [CI]: 2.57 to 6.75), native T1 values (WMD: 38.34; 95% CI: 16.30 to 60.37), and ECV% (WMD: 1.89; 95% CI: 0.66 to 3.12). Higher MF levels correlated with left ventricular hypertrophy, heart failure, and elevated BP. Losartan, ramipril, and perindopril help control BP and attenuate MF, while amlodipine and hydrochlorothiazide do not statistically significantly alleviate MF. CONCLUSIONS: The extent of MF is closely associated with various factors, underscoring the importance of its identification in hypertensive patients. Histology and T1 mapping parameters are effective for quantifying MF. Due to the variable effects of antihypertensive medications on MF, the use of specific agents to mitigate MF in hypertensive patients is recommended.
Deep learning for visceral pleural invasion in non-small cell lung cancer.
Liu Y, Shi H, Wu Y … +5 more , Xu C, Xie Z, Wang J, Zhu J, Liang B
Clin Radiol · 2026 May · PMID 42296936 · Publisher ↗
BACKGROUND: To evaluate and compare the diagnostic performance of several commonly used deep learning (DL) models and a conventional clinical-radiological feature model based on preoperative computed tomography (CT) for...
BACKGROUND: To evaluate and compare the diagnostic performance of several commonly used deep learning (DL) models and a conventional clinical-radiological feature model based on preoperative computed tomography (CT) for predicting visceral pleural invasion (VPI) in non-small cell lung cancer (NSCLC). METHODS: A retrospective cohort of 3,406 patients from four hospitals was analyzed. Data were split into training, validation, and test sets. A logistic regression model using clinical-radiological features was compared against five DL architectures (including Res2Net_3D8F and ResNet variants). Performance was evaluated via AUC, sensitivity, specificity, PPV, and NPV. RESULTS: In the independent test set, the clinical-radiological feature model achieved the highest AUC (0.875), but with low sensitivity (0.21) and high specificity (0.96). The best-performing DL model (Res2Net_3D8F) achieved an AUC of 0.835, with sensitivity of 0.83, specificity of 0.74, PPV of 0.36, and NPV of 0.96. All DL models demonstrated higher sensitivity (0.71-0.83) but lower PPV (0.29-0.36) compared to the clinical model. There was no statistically significant difference in AUC between the Res2Net_3D8F model and the clinical-radiological model in the test set (P = .123, DeLong test). CONCLUSIONS: Although both clinical and DL models based on CT imaging showed moderate discriminatory ability for preoperative VPI prediction, neither approach achieved optimal clinical utility. The clinical model had high specificity but very low sensitivity, while DL models had improved sensitivity but low PPV and did not outperform the clinical model. Noninvasive VPI prediction remains a significant challenge, highlighting the need for further methodological advancements and validation.
Preoperative contrast enhanced mammography evaluation of breast ductal carcinoma in situ and comparative analysis with pathological grading.
Wang L, Wang P, Shao H … +3 more , Wang S, Mao N, Yang Q
Clin Radiol · 2026 May · PMID 42287862 · Publisher ↗
AIM: To assess the value of contrast-enhanced mammography (CEM) in the diagnosis of breast ductal carcinoma in situ (DCIS) and to analyse the correlation between the CEM manifestations and pathological nuclear grades of...
AIM: To assess the value of contrast-enhanced mammography (CEM) in the diagnosis of breast ductal carcinoma in situ (DCIS) and to analyse the correlation between the CEM manifestations and pathological nuclear grades of DCIS. MATERIALS AND METHODS: This single-center retrospective study included 190 patients with pure DCIS who underwent CEM within two weeks preoperatively. The CEM images of 196 DCIS lesions (bilateral DCIS in six patients) were reviewed to evaluate the diagnostic performance of CEM for DCIS with different nuclear grades. RESULTS: CEM showed significantly higher sensitivity to DCIS (89.3%) than low-energy image alone (72.4%; P < .001), whether for calcified (96.8% vs. 91.2%; P = .016), noncalcified (76.1% vs. 39.4%; P < .001), low-grade (83.3% vs. 61.1%; P = .008), intermediate-grade (87.3% vs. 65.8%; P < .001) and high-grade DCIS (93.8% vs. 84.0%; P = .008). CEM was equally sensitive in diagnosing different grades of DCIS (P = .183). CEM was superior to low-energy image alone in showing the extent of DCIS lesions. In CEM, high-grade DCIS showed more calcifications and larger size than low-grade DCIS, and showed higher enhancement conspicuity than low- and intermediate-grade DCIS (P < .05). Low-grade DCIS showed less pleomorphic and fine linear branching calcifications than intermediate- and high-grade DCIS (P < .05). The three grading groups were not different in terms of enhancement percentage and enhancement morphology (P > .05). CONCLUSIONS: CEM was superior to low-energy image alone in DCIS diagnosis. Different nuclear grades of DCIS manifested differently on CEM.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe