Clinical radiology最新文献

{"title":"Ultrasound-guided attenuation parameter: a liver fat quantification technique for forecasting the progression of metabolic dysfunction-associated steatotic liver disease in overweight/obese patients","authors":"F. Meng ,&nbsp;L. Pian ,&nbsp;Q. Wang ,&nbsp;J. Chen ,&nbsp;Y. Liu ,&nbsp;J. Zhao","doi":"10.1016/j.crad.2025.106854","DOIUrl":"10.1016/j.crad.2025.106854","url":null,"abstract":"<div><h3>AIM</h3><div>To investigate the application value of ultrasonic attenuation parameter imaging (UGAP) in the assessment of metabolic dysfunction-associated steatotic liver disease (MASLD) in overweight and obese patients.</div></div><div><h3>MATERIAL AND METHODS</h3><div>A total of 328 overweight/obese patients—225 in the MASLD group and 103 in the simple overweight/obese group—were chosen from XX between August 2023 and August 2024. As the typical control group, 236 healthy individuals who were matched for age and gender were chosen during the same period. The attenuation coefficient (AC) differences between the groups were compared, and Pearson correlation analysis was used to look into the relationship between AC and clinical indicators. A prediction model was created, the diagnostic efficacy was examined, and MASLD risk factors in overweight and obese patients were screened using the independent sample T-test and multiple logistic regression analysis.</div></div><div><h3>RESULTS</h3><div>AC of the MASLD group, overweight and obese group, and normal control group were (0.73 ± 0.08), (0.57 ± 0.04), and (0.54 ± 0.07) dB⁻¹·cm⁻¹·MHz⁻¹. There was a statistically significant difference between the groups (P&lt;0.05). In patients who were overweight or obese, AC, BMI, and visceral fat were the risk factors for predicting MASLD. The optimal cut-off values were AC ≥0.635dB⁻¹·cm⁻¹·MHz⁻¹, BMI ≥27.58kg/m², and visceral fat thickness (VFT) ≥66.115 mm. The areas under the receiver operating characteristic (ROC) curve were 0.993, 0.792, and 0.708. The area under ROC curve of AC combined with BMI and visceral fat was 0.997, and the prediction efficiency was greater than that of the single AC index and that of the AC + BMI bivariate prediction model. The diagnostic sensitivity and specificity were 96.4% and 98.1%.</div></div><div><h3>CONCLUSION</h3><div>UGAP can be utilised for clinical screening to assess the prevalence of MASLD in patients who are overweight or obese and to dynamically track the progression of the disease. In patients who are overweight or obese, the accuracy of the UGAP assessment of MASLD can be increased by combining AC with BMI and a visceral fat prediction model.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106854"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced MRI prediction model for anatomical site identification in uterine carcinoma: enhancing diagnostic accuracy","authors":"M. Malek ,&nbsp;M. Moayeri ,&nbsp;S. Akhavan ,&nbsp;S.S. Hasani ,&nbsp;F. Nili ,&nbsp;Z. Mahboubi- Fooladi","doi":"10.1016/j.crad.2025.106852","DOIUrl":"10.1016/j.crad.2025.106852","url":null,"abstract":"<div><h3>Aim</h3><div>The uterine carcinoma is the most commonly diagnosed malignancy in the female pelvis. Accurate identification of tumour origin is crucial for determining appropriate treatment approaches. This study aims to develop a prediction model using multiple MRI parameters to accurately diagnose uterine cancer with an indistinctive origin and those involving both the endometrium and cervix prior to treatment.</div></div><div><h3>Material and methods</h3><div>This prospective cohort study included patients who were newly diagnosed with uterine carcinoma who underwent MRI and were considered for hysterectomy within 6 months after MRI.</div></div><div><h3>Results</h3><div>A total of 78 patients with uterine carcinoma were enrolled. Certain imaging features were found to be consistent with cervical carcinoma, included parametrial, vaginal, stromal invasion, and peripheral rim enhancement. Cervical cancer appeared hyperintense compared to the myometrium unlike endometrial cancer.</div></div><div><h3>Discussion</h3><div>The study found that certain morphologic features were reliable indicators for detecting cervical carcinoma.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106852"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic assessment of the uterocervical angle in the second trimester of pregnancy as a predictor of spontaneous preterm birth","authors":"E.G. Nicolau ,&nbsp;L.O. Reis","doi":"10.1016/j.crad.2025.106853","DOIUrl":"10.1016/j.crad.2025.106853","url":null,"abstract":"<div><h3>AIM</h3><div>To evaluate the uterocervical angle in the second trimester in singleton pregnancies as a predictor of spontaneous preterm labour.</div></div><div><h3>MATERIAL AND METHODS</h3><div>An observational cohort study was carried out from March 2022 to May 2023, including consecutively selected patients with singleton pregnancies who underwent routine examinations between 18.0 and 23.6 weeks to analyse the risk of prematurity. The uterocervical angle (UCA) measurement was added to the transvaginal ultrasonographic analysis of the cervix. Birth-related outcomes were prospectively collected.</div></div><div><h3>RESULTS</h3><div>patients were evaluated. The occurrence of spontaneous preterm birth (sPTB) before 37 weeks was 12%, with 50 patients. An association was observed between a more obtuse uterocervical angle and the occurrence of birth before 37 weeks, with the area under the curve of 0.636 (p=0.003; 95% CI: 0.546–0.726). The cutoff point of 77.2 degrees demonstrated a sensitivity of 80% and specificity of 29.4% (p=0.003), a positive predictive value of 13.6%, and a negative predictive value of 91.3%, with a positive likelihood ratio of 1.13 and negative 0.88.</div></div><div><h3>CONCLUSION</h3><div>The measurement of UCA in the second trimester of pregnancy is associated with the occurrence of sPTB. The result corroborates recent literature conclusions that UCA is a relatively recent predictor of sPTB. New evidence in different populations may contribute to its possible incorporation into prematurity risk assessment.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106853"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of respiratory mechanics in adults with CF using dynamic chest radiography","authors":"T.S. FitzMaurice ,&nbsp;C. McCann ,&nbsp;R. Bedi ,&nbsp;D.S. Nazareth ,&nbsp;M.J. Walshaw ,&nbsp;P.S. McNamara","doi":"10.1016/j.crad.2025.106841","DOIUrl":"10.1016/j.crad.2025.106841","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>As the lifespan of people with CF (pwCF) improves, sensitive markers of lung health are needed. Dynamic chest radiography (DCR) is a low ionising radiation dose cineradiographic imaging system that provides real-time information on moving thoracic structures. We examined whether DCR provides quantitative motion analysis that correlates with pulmonary function, anthropometric and clinical variables in pwCF, to explore DCR as a marker of lung health.</div></div><div><h3>METHODS</h3><div>In this prospective, observational, single-centre, non-controlled study, participantsunderwent DCR and spirometry. We measured DCR parameters such as diaphragm motion and change in projected lung area (ΔPLA). The study is registered on the ________ registry (ID __________). Correlation was assessed using Spearman’s coefficient, and relationships between DCR and spirometric variables using linear regression modelling. Descriptive statistics are reported as mean ± standard deviation and median (interquartile range) as appropriate.</div></div><div><h3>RESULTS</h3><div>We assessed 129 adult pwCF (age 29[12] years, 48 female, ppFEV1 69±25). Average inspiratory lung area (PLAinsp) was 424±72cm2, and expiratory lung area (PLAexp) 325±68cm2. Left diaphragm motion range was 34±12mm, right 29±12mm. ΔPLA correlated with FEV1 (ρ=0.70,P&lt;0.001). PLAinsp correlated with FVC (ρ=0.56,P&lt;0.001). PLAexp correlated with FEV1/FVC ratio (ρ=-0.49,P&lt;0.001). BMI correlated with ΔPLA (ρ=0.29,P=0.001) and deep breathing hemidiaphragm excursion (right, ρ=0.4,P&lt;0.001; left 0.39,P&lt;0.001).</div></div><div><h3>CONCLUSIONS</h3><div>This study is the first to describe diaphragm motion and projected lung areas using DCR in non-exacerbating adult pwCF, and complements work by our group demonstrating change in DCR parameters in pwCF undergoing pharmacological interventions. DCR shows potential as a tool to investigate lung health in pwCF.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"83 ","pages":"Article 106841"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awake biopsy in paediatric patients with suspected musculoskeletal malignancy is feasible, cost-effective and reduces time to obtaining tissue","authors":"H.R.F. Walters ,&nbsp;A. Kothari ,&nbsp;M. Mifsud ,&nbsp;A. Wainwright ,&nbsp;K. Partington","doi":"10.1016/j.crad.2025.106850","DOIUrl":"10.1016/j.crad.2025.106850","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to evaluate the utility, feasibility, time, and cost-effectiveness of awake ultrasound-guided percutaneous biopsies (AUPBs) in children with suspected musculoskeletal tumours, when compared with more conventional biopsies under general anaesthesia (BGAs).</div></div><div><h3>Materials and Methods</h3><div>A retrospective analysis of paediatric biopsies performed in a UK tertiary musculoskeletal centre between March 2016 and March 2023 was undertaken. Eighty-six paediatric patients were included in the study, 53 undergoing BGA and 33 undergoing AUPB.</div></div><div><h3>Results</h3><div>The mean age of patients undergoing AUPB was more than that of patients undergoing BGA at 13.2 years (range: 5-16 years) and 8.5 years (range: 3 months-15 years), respectively. AUPB significantly reduced the time to biopsy, with a mean of 4.7 days (median: 3 days, interquartile range [IQR]: 2-7 days), compared with 11.1 days (median: 5 days, IQR: 2-18 days) for BGAs (<em>P</em> = 0.037). AUPB conferred a one-third reduction in financial cost at £1177 vs £1824 for BGA. Fifty-eight percent patients undergoing AUPB had their biopsy on the same day as their initial assessment in clinic, whilst none of the BGA cases had their biopsy on the same day as their initial assessment in clinic. No complications or procedural abandonment were reported in the AUPB group.</div></div><div><h3>Conclusion</h3><div>Awake ultrasound-guided biopsy in paediatric musculoskeletal tumours is safe, well tolerated, and cost-effective. It reduces the time to obtain a histological diagnosis compared to BGA. Collaboration between clinicians, radiologists, and play specialists in identifying suitable patients for AUPB can facilitate efficient one-stop clinics and timely diagnosis and reduce costs incurred in paediatric oncological services.</div></div><div><h3>Level of Evidence</h3><div>Level IV—Diagnostic.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106850"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram-based survival prediction model for non–small cell lung cancer patients based on clinical risk factors and multiregion radiomics features","authors":"R. Nishioka ,&nbsp;D. Kawahara ,&nbsp;N. Imano ,&nbsp;Y. Murakami","doi":"10.1016/j.crad.2025.106826","DOIUrl":"10.1016/j.crad.2025.106826","url":null,"abstract":"<div><h3>Aim</h3><div>This study focuses on developing a nomogram-based overall survival (OS) prediction model for non–small cell lung cancer (NSCLC) patients by integrating clinical factors with multiregion radiomics features extracted from pretreatment CT images. The proposed nomogram aims to assist clinicians in stratifying patients into high- and low-risk groups for personalised treatment strategies.</div></div><div><h3>Materials and Methods</h3><div>From 2008 to 2018, 77 NSCLC patients were included. The radiomics feature was extracted from the internal and peripheral tumour region of pretreatment computed tomography (CT) images. The least absolute shrinkage and selection operator (LASSO) and the univariable Cox regression model were used to select the radiomics features. The Rad-score was defined as a linear combination of the selected radiomics features and the Cox proportional hazards regression coefficients. The combined model was constructed based on the clinicopathological factors and the Rad-score. The discrimination capacity of the prediction model was evaluated by Harrell's concordance index (C-index), the calibration curve, and the Kaplan–Meier survival curve.</div></div><div><h3>Results</h3><div>We found that nine radiomics features and histology were independent predictors. The combined model showed the best performance (C-index: 0.799 [95% CI: 0.726–0.872]) compared with the clinical model (C-index: 0.692 [95% CI: 0.625–0.759]) and Rad-score (C-index: 0.663 [95% CI: 0.580–0.746]), and could significantly stratify into high-risk and low-risk NSCLC patients. The calibration curve also showed good consistency between the observation and the prediction.</div></div><div><h3>Conclusions</h3><div>The multregion radiomics features have the potential for predicting OS in NSCLC patients. The nomogram-based survival prediction model demonstrates significant potential in guiding clinical decision-making, allowing for precise and personalised treatment for NSCLC patients.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106826"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cone beam CT pulmonary angiography in balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension during the program initiation period","authors":"A. Páez-Carpio ,&nbsp;F.X. Zarco ,&nbsp;E. Serrano ,&nbsp;I. Vollmer ,&nbsp;J. Puig ,&nbsp;J.A. Barberà ,&nbsp;F.M. Gómez ,&nbsp;I. Blanco","doi":"10.1016/j.crad.2025.106847","DOIUrl":"10.1016/j.crad.2025.106847","url":null,"abstract":"<div><h3>AIM</h3><div>Cone beam CT pulmonary angiography (CBCT-PA) has proven to be a valuable technique during balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH) in established centres. This study aimed to demonstrate the safety and efficacy of CBCT-PA–guided BPA for CTEPH during the initial period of a BPA program. CBCT-PA improves procedural accuracy by visualising distal thromboembolic lesions and providing real-time guidance, which is critical during program initiation.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This single-centre, single-arm study prospectively evaluated patients with CTEPH undergoing BPA from 2017 to 2022. Outcomes of interest included pre-BPA and post-BPA 6-minute walking distance, New York Heart Association Functional Classification (NYHA-FC), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), N-terminal pro B-type natriuretic peptide (NT-proBNP), and BPA-related adverse events (AEs). Statistical analysis compared pre-BPA and post-BPA results. CBCT-PA was used for three-dimensional (3D) vascular mapping and precise lesion targeting.</div></div><div><h3>RESULTS</h3><div>Ninety BPA sessions were performed on 19 patients under CBCT-PA guidance. Significant improvements were observed in mPAP (37.0 mmHg [interquartile range (IQR): 28.0-46.0] vs 25.5 [IQR: 22.8-31.5]; <em>P&lt;</em>0.001), PVR (5.5 Wood units [IQR: 3.4-8.5] vs 3.3 [IQR: 2.7-4.6]; <em>P</em> &lt; 0.001), NYHA-FC I-II rate (8 [42%] vs 18 [94%]; <em>P</em> = 0.04), and NT-proBNP (165 pg/mL [IQR: 82-1146] vs 127.0 [IQR: 57-216]; <em>P</em> = 0.014). Overall AE rate was 14.4%, and major AE rate was 7.7% (all Cardiovascular and Interventional Radiology Society of Europe [CIRSE] grade 3). The haemoptysis rate was 4.4%. No periprocedural deaths were reported.</div></div><div><h3>CONCLUSION</h3><div>BPA performed under CBCT-PA guidance appeared to be an effective and safe approach in the program’s initial period, helping achieving similar results as established centres.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106847"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes, toxic effect, and immune microenvironment changes of drug-eluting bead bronchial arterial chemoembolisation/bronchial arterial chemoembolization combined with immunotherapy in treating elderly patients with non–small cell lung cancer","authors":"J. Xiang ,&nbsp;W. Lan ,&nbsp;D. Cai ,&nbsp;Y. Wang ,&nbsp;W. Li ,&nbsp;J. Tu ,&nbsp;J. Huang","doi":"10.1016/j.crad.2025.106849","DOIUrl":"10.1016/j.crad.2025.106849","url":null,"abstract":"<div><h3>AIM</h3><div>Systemic chemotherapy plus immune checkpoint inhibitors (ICIs) are first-line treatment for advanced non–small cell lung cancer (NSCLC). However, elderly patients typically have comorbidities that tend to limit the use of chemotherapy at standard dosage and frequency. Drug-eluting bead bronchial arterial chemoembolisation (DEB-BACE)/bronchial arterial chemoembolization (BACE) represents options in such patients.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This is a retrospective analysis. We screened all elderly patients (aged ≥70 years) undergoing treatment with immunotherapy plus DEB-BACE/BACE for pathologically confirmed stage III-IV NSCLC with negative driver gene mutations from October 2019 to December 2023 at our hospital. The response was evaluated according to the Response Evaluation Criteria in Solid Tumors version 1.1 criteria.</div></div><div><h3>RESULTS</h3><div>The final analysis included 46 patients (median age: 76 years; 42 men and 4 women). Eastern Cooperative Oncology Group (ECOG) performance status was either 1 or 2. The median progression-free survival and overall survival were 9.1 months (95% confidence interval [CI]: 8.4-9.9) and 18.2 months (95% CI: 16.5-19.9), respectively, after a median follow-up of 20.3 months (95% CI: 19.5-21.1) in all populations. The most prevalent adverse events (AEs) were myelosuppression (76.1%, 35/46), followed by decreased appetite (71.7%, 33/46), nausea (65.2%, 30/46), and fatigue (54.3%, 25/46). The rate of any grade and grade ≥3 immune-related AEs was 34.8% (16/46) and 6.5% (3/46), respectively. No patients experienced treatment-related deaths, haemoptysis, or unexpected embolisation.</div></div><div><h3>CONCLUSION</h3><div>DEB-BACE/BACE combined with immunotherapy was effective and well tolerated in elderly patients with advanced NSCLC.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106849"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RCR meetings","authors":"","doi":"10.1016/S0009-9260(25)00050-9","DOIUrl":"10.1016/S0009-9260(25)00050-9","url":null,"abstract":"","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"82 ","pages":"Article 106845"},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic validity of combined transbronchial and transoesophageal ultrasound in positron emission tomography node–negative lung cancer","authors":"K. Gambuś ,&nbsp;B. Kużdżał ,&nbsp;K. Moszczyński ,&nbsp;S. Popovchenko ,&nbsp;A. Szlubowski ,&nbsp;L. Rudnicka ,&nbsp;K. Żanowska ,&nbsp;Ł. Trybalski ,&nbsp;A. Galas ,&nbsp;P. Kocoń","doi":"10.1016/j.crad.2025.106843","DOIUrl":"10.1016/j.crad.2025.106843","url":null,"abstract":"<div><h3>Aim</h3><div>The role of invasive mediastinal diagnostic methods in lung cancer with negative positron emission tomography (PET) remains unclear. This study aimed to determine the sensitivity and negative predictive value (NPV) of combined endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS), referred to as combined ultrasound (CUS), for diagnosing N2 disease in this group of patients.</div></div><div><h3>MATERIALS AND METHODS</h3><div>single-centre study analysing medical records of clinical stage I to IVA lung cancer patients was conducted. All patients underwent positron emission tomography computed tomography (PET-CT), followed by CUS imaging and lung resection with systematic lymph node dissection. Pathological examination of lymph nodes was the reference standard.</div></div><div><h3>RESULTS</h3><div>Data from 596 patients were analysed. The prevalence of N2 disease was 8%. The sensitivity, specificity, and the NPV of CUS in detecting N2 disease were 14%, 98%, and 93%, respectively. Sensitivity and NPV were not significantly associated with age, sex, body mass index (BMI), tumour grade, lobar location, or histological type (<em>P</em> &gt; 0.05). Minimal N2 disease was found in 37 of 43 patients with negative CUS results; only 6 of 596 patients had more than minimal (N2b) disease missed by CUS. The NPV for minimal N2 involvement was 98%.</div></div><div><h3>CONCLUSION</h3><div>In PET-negative mediastinal lymph nodes, N2 disease prevalence is low. CUS has an NPV of 93% for N2 disease and 98% for more than minimal N2 involvement. The diagnostic yield of CUS is unaffected by clinical characteristics, making it a reliable method for ruling out significant N2 disease in PET-negative patients and potentially reducing the need for more invasive procedures.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"83 ","pages":"Article 106843"},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}