Diagnostic and interventional radiology最新文献

{"title":"How may complementary magnetic resonance imaging findings facilitate the diagnosis of inflammatory hand arthritis involving the distal interphalangeal joint? A prospective cohort study.","authors":"Yasin Yaraşır, Gizem Ayan, Hanife Avcı, Levent Kılıç, Üstün Aydıngöz, Umut Kalyoncu, Adalet Elçin Yıldız","doi":"10.4274/dir.2025.253502","DOIUrl":"https://doi.org/10.4274/dir.2025.253502","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we aimed to characterize the role of magnetic resonance imaging (MRI) in making a specific diagnosis of inflammatory hand arthritis (IHA), particularly in early stages or ambiguous cases.</p><p><strong>Methods: </strong>Patients aged ≥18 years with suspicious IHA in at least one joint were enrolled in this single-center prospective study. Three Tesla MRI (3T-MRI) with a fine-tuned protocol was utilized, whereby differential diagnoses were made by radiologists according to the predominant involvement of synovium or synovioentheseal complex (SEC) and/or specific degenerative findings. Physical examination, laboratory findings, treatment response, and already-established classification criteria were used to reach the final diagnostic groups: psoriatic arthritis (PsA), rheumatoid arthritis (RA), erosive osteoarthritis or calcium pyrophosphate dihydrate deposition disease (EOA/CPPD), and arthritis with distal interphalangeal joint (DIPJ) involvement (ADIPI) not otherwise classified into any group. Statistical analyses mainly included pairwise comparisons of MRI findings across diagnostic groups.</p><p><strong>Results: </strong>Of 80 patients enrolled, 57 [42 women; mean age, 54 years (range, 28-79 years)] constituted the final group with eventual clinical diagnoses of 11 PsA, 14 RA, 11 EOA/CPPD, and 21 ADIPI. MRI revealed no difference between the PsA and ADIPI groups, except for nailbed enthesitis (<i>P</i> = 0.048, effect size: 0.416). A comparison between PsA and RA revealed that enthesitis, excluding pulley enthesitis, was more frequently observed in PsA (<i>P</i> = 0.033, effect size: 0.497). Periarticular soft tissue edema was also more common in PsA than RA (<i>P</i> = 0.042, effect size: 0.461). When the ADIPI and PsA groups were combined, enthesitis and periarticular soft tissue edema were more common than in other groups (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>SEC inflammation and periarticular edema on MRI strongly predict PsA, especially in patients with DIPJ arthritis who do not meet rheumatological classification criteria.</p><p><strong>Clinical significance: </strong>3T-MRI with a fine-tuned protocol enables a more accurate differential diagnosis of hand inflammatory arthritis, potentially guiding earlier and more targeted interventions.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated detection and characterization of small cell lung cancer liver metastasis on computed tomography.","authors":"Sophia Ty, Fahmida Haque, Parth Desai, Nobuyuki Takahashi, Usamah Chaudhary, Peter L Choyke, Anish Thomas, Barış Türkbey, Stephanie A Harmon","doi":"10.4274/dir.2025.253310","DOIUrl":"https://doi.org/10.4274/dir.2025.253310","url":null,"abstract":"<p><strong>Purpose: </strong>Small cell lung cancer (SCLC) is an aggressive disease with diverse phenotypes that reflect the heterogeneous expression of tumor-related genes. Recent studies have shown that neuroendocrine (NE) transcription factors may be used to classify SCLC tumors with distinct therapeutic responses. The liver is a common site of metastatic disease in SCLC and can drive a poor prognosis. Here, we present a computational approach to detect and characterize metastatic SCLC (mSCLC) liver lesions and their associated NE-related phenotype as a method to improve patient management.</p><p><strong>Methods: </strong>This study utilized computed tomography scans of patients with hepatic lesions from two data sources for segmentation and classification of liver disease: (1) a public dataset from patients of various cancer types (segmentation; n = 131) and (2) an institutional cohort of patients with SCLC (segmentation and classification; n = 86). We developed deep learning segmentation algorithms and compared their performance for automatically detecting liver lesions, evaluating the results with and without the inclusion of the SCLC cohort. Following segmentation in the SCLC cohort, radiomic features were extracted from the detected lesions, and least absolute shrinkage and selection operator regression was utilized to select features from a training cohort (80/20 split). Subsequently, we trained radiomics-based machine learning classifiers to stratify patients based on their NE tumor profile, defined as expression levels of a preselected gene set derived from bulk RNA sequencing or circulating free DNA chromatin immunoprecipitation sequencing.</p><p><strong>Results: </strong>Our liver lesion detection tool achieved lesion-based sensitivities of 66%-83% for the two datasets. In patients with mSCLC, the radiomics-based NE phenotype classifier distinguished patients as positive or negative for harboring NE-like liver metastasis phenotype with an area under the receiver operating characteristic curve of 0.73 and an F1 score of 0.88 in the testing cohort.</p><p><strong>Conclusion: </strong>We demonstrate the potential of utilizing artificial intelligence (AI)-based platforms as clinical decision support systems, which could help clinicians determine treatment options for patients with SCLC based on their associated molecular tumor profile.</p><p><strong>Clinical significance: </strong>Targeted therapy requires accurate molecular characterization of disease, which imaging and AI may aid in determining.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal physiological variants and benign conditions in pelvic oncologic fluorodeoxyglucose positron emission tomography/magnetic resonance imaging.","authors":"Ayşe Erden, Diğdem Kuru Öz, Nuriye Özlem Küçük","doi":"10.4274/dir.2025.253390","DOIUrl":"https://doi.org/10.4274/dir.2025.253390","url":null,"abstract":"<p><p>Fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) is an advanced hybrid imaging modality that holds substantial promise in oncologic imaging. FDG PET, a well-established molecular imaging technique, enables assessment of tumor glucose metabolism and is widely utilized for diagnosing and monitoring a range of malignancies; MRI offers superior soft tissue contrast, facilitating precise anatomical localization of PET findings. This pictorial essay presents a series of physiological FDG uptake variants observed in the uterus, fallopian tubes, ovaries, colon, internal anal sphincter, pelvic musculature, and bone marrow. Additionally, it highlights benign conditions such as uterine tumors, vaginal condyloma acuminatum, and infected Bartholin cysts that may exhibit FDG uptake and potentially mimic malignancy. The essay also illustrates FDG-avid post-treatment changes and various infectious and inflammatory lesions such as osteitis pubis, perianal fistulas, and pelvic abscesses that may complicate oncologic interpretation.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T2 signal ratio enhances the diagnostic performance of apparent diffusion coefficient in differentiating orbital lymphoma from inflammatory mimickers.","authors":"Elif Günay Bulut, Ekim Gümeler, Jale Karakaya, Levent Kılıç, Ömer Karadağ, Kader Karlı Oğuz","doi":"10.4274/dir.2025.253536","DOIUrl":"https://doi.org/10.4274/dir.2025.253536","url":null,"abstract":"<p><strong>Purpose: </strong>Orbital lymphomas share overlapping clinical and radiological features with immunoglobulin G4-related orbital disease (IgG4-ROD) and granulomatous orbital diseases, which may lead to diagnostic delays. This study aims to evaluate the added diagnostic value of the transverse relaxation time (T2) signal ratio when combined with apparent diffusion coefficient (ADC) measurements in distinguishing orbital lymphoma from inflammatory mimickers.</p><p><strong>Methods: </strong>In this retrospective study, two blinded radiologists independently measured T2 signal ratios (lesion to cerebral cortex), ADC values, and ADC ratios on pretreatment orbital magnetic resonance imaging scans of 58 patients (21 lymphomas, 21 IgG4-ROD, 16 granulomatous inflammation). Measurements were performed on axial images at the lesion's maximal diameter. Regions of interest were manually drawn to cover the entire lesion, avoiding necrosis and edges. Diagnostic performance was assessed using receiver operating characteristic curve analysis, with optimal cut-off values determined by Youden's index. The ADC ratio (≤1) and T2 signal ratio (>0.88) were combined using OR (either positive) and AND (both positive) rules. Interobserver agreement was evaluated using intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>All measurements showed statistically significant differences between the two cohorts. Reviewer 1's ADC ratio measurements demonstrated excellent diagnostic performance, with an area under the curve (AUC) of 0.920 (85.7% sensitivity and 86.5% specificity at the optimal cut-off of ≤1). In comparison, T2 signal ratios showed moderate diagnostic value (AUC: 0.726; 80.95% sensitivity and 64.86% specificity at a cut-off >0.88). The combination of both parameters significantly improved diagnostic accuracy: the OR rule (ADC ≤1 or T2 >0.88) increased sensitivity to 95.2%, whereas the AND rule (ADC ≤1 and T2 >0.88) increased specificity to 94.6%. Interobserver reliability was excellent, with ICC values ranging from 0.969 to 0.985.</p><p><strong>Conclusion: </strong>Although diffusion imaging remains the primary discriminator for orbital lymphoma, the T2 signal ratio considerably enhances diagnostic confidence, particularly in borderline ADC cases.</p><p><strong>Clinical significance: </strong>Incorporating T2 signal ratio measurements adds minimal workflow burden in routine clinical practice and provides a practical tool for differentiating lymphoma from IgG4-ROD and granulomatous inflammatory mimics.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: diagnostic value of the flare sign in predicting extracapsular extension in metastatic axillary lymph nodes and nodal status on breast magnetic resonance imaging.","authors":"Cihan Özgür, Baran Serdar Sunal, Savaş Hereklioğlu, Meltem Öznur","doi":"10.4274/dir.2025.253598","DOIUrl":"https://doi.org/10.4274/dir.2025.253598","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of an inferior vena cava filter retrieval program: the effect on trauma and non-trauma patient populations.","authors":"Katelyn Gill, Hector Ferral, Alexandra H Fairchild, Bahri Üstünsöz, Dan F Laney Iv, John Hunt, Jonathan E Schoen, Alan Marr, Patrick Greiffenstein, Lance Stuke, Alison A Smith","doi":"10.4274/dir.2025.253409","DOIUrl":"https://doi.org/10.4274/dir.2025.253409","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the effect of establishing an inferior vena cava filter (IVCF) retrieval program (IVCFRP) on the IVCF retrieval rates in trauma and non-trauma patients.</p><p><strong>Methods: </strong>This was an institutional review board-approved retrospective study. IVCF retrieval in trauma and non-trauma patients was compared before and after the establishment of an IVCFRP in a single Level I Trauma Center. The IVCFRP at our institution was established in April 2020. All patients who underwent IVCF placement between January 2016 and March 2020 were compared with patients who had an IVCF placed between April 2020 and June 2024. A medical record review included the collection of demographic information, indication for IVCF insertion and retrieval, date of IVCF insertion and retrieval, IVCF retrieval rate, clinical outcomes, and complications. The patients were stratified into trauma and non-trauma groups. Univariate analyses were performed with a <i>P</i> value of <0.05 considered statistically significant.</p><p><strong>Results: </strong>A total of 164 patients underwent IVCF placement between January 2016 and June 2024. Fifty-two IVCFs were implanted before and 112 after the establishment of the IVCFRP. The overall rate of IVCF retrieval was significantly higher following the establishment of an IVCFRP (33.3% vs. 51%, <i>P</i> = 0.047). In non-trauma patients, the retrieval rate was significantly higher after the establishment of an IVCFRP (37.5% vs. 61.3%, <i>P</i> = 0.03). The retrieval rate in trauma patients (22.2% vs. 21.4%) was not significantly changed by the establishment of an IVCFRP. Clinical outcomes and complications were similar between groups.</p><p><strong>Conclusion: </strong>IVCF retrieval rates significantly improved after the establishment of an IVCFRP. This increase in IVCF retrieval rate was driven by an increase in filter retrievals in the non-trauma patient population. The rate of IVCF retrieval in trauma patients was not affected by the implementation of an IVCFRP. Special considerations and changes in practice may need to be established to improve IVCF retrieval rates in trauma patients.</p><p><strong>Clinical significance: </strong>Implementation of a structured IVCFRP significantly improved retrieval rates in non-trauma patients but did not yield similar results in trauma patients, highlighting the need for alternative strategies in this population.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: perinodal signal in breast magnetic resonance imaging: flare sign and extracapsular spread.","authors":"Deniz Esin Tekcan Şanlı, Ahmet Necati Şanlı","doi":"10.4274/dir.2025.253578","DOIUrl":"https://doi.org/10.4274/dir.2025.253578","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of ultrasound-guided bedside percutaneous cholecystostomy using the transhepatic approach and trocar technique in patients with acute cholecystitis.","authors":"Ahmet Cem Demirşah, Berat Acu, Çiğdem Öztunalı","doi":"10.4274/dir.2025.253478","DOIUrl":"https://doi.org/10.4274/dir.2025.253478","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the large number of patients requiring percutaneous cholecystostomy (PC) for acute cholecystitis (AC), no definitive results exist on the optimal imaging guidance modality, technique (Seldinger vs. trocar), or approach [transhepatic (TH) vs. transperitoneal]. This study evaluates the outcomes of ultrasound (US)-guided bedside PC using solely the TH approach and trocar technique in patients with AC.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted at a tertiary university hospital between 2018 and September 2023. The study included 81 patients with AC treated with US-guided bedside PC using the TH approach and trocar technique alone. Patients were diagnosed through clinical, laboratory, and radiological examinations, and an experienced interventional radiologist performed the procedures. Outcomes and complication rates were then evaluated.</p><p><strong>Results: </strong>Technical and clinical success rates were 100% and 93%, respectively. No procedure-related complications occurred. Catheter dislodgement occurred in 4.9% (4/81). The catheter sizes used were 6 F (12.3%), 7 F (40.7%), 8 F (37%), and 10 F (9.9%). The median catheter dwell time was 42 days. Catheters were successfully removed in the majority of surviving patients following resolution of cholecystitis. At the end of the follow-up, 10 patients (12.3%) underwent elective cholecystectomy, and 12 patients (14.8%) died due to comorbidities with the catheter in place.</p><p><strong>Conclusion: </strong>US-guided bedside PC using the TH approach and trocar technique is safe and effective for managing AC in high-risk patients. The study found no significant complications, highlighting the importance of thorough preprocedural evaluation and technique optimization. Further studies with larger, homogeneous patient groups are needed to compare outcomes across different PC techniques and approaches.</p><p><strong>Clinical significance: </strong>Despite the growing adoption of PC in the management of AC, the definitive optimal access route and procedural technique remain unresolved. The current body of literature is limited by considerable heterogeneity across studies, including variability in technical approach, operator experience, patient coagulation profiles, and outcome definitions. This study exclusively employed bedside US-guided PC using the TH approach and trocar technique, and observed no procedure-related complications, including hemorrhage, bile leakage, infection, or abscess formation.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photon-counting detector computed tomography in thoracic oncology: revolutionizing tumor imaging through precision and detail.","authors":"Masahiro Yanagawa, Midori Ueno, Rintaro Ito, Daiju Ueda, Tsukasa Saida, Ryo Kurokawa, Koji Takumi, Kentaro Nishioka, Shunsuke Sugawara, Satoru Ide, Maya Honda, Mami Iima, Mariko Kawamura, Akihiko Sakata, Keitaro Sofue, Seitaro Oda, Tadashi Watabe, Kenji Hirata, Shinji Naganawa","doi":"10.4274/dir.2025.253550","DOIUrl":"https://doi.org/10.4274/dir.2025.253550","url":null,"abstract":"<p><p>Photon-counting detector computed tomography (PCD-CT) is an emerging imaging technology that promises to overcome the limitations of conventional energy-integrating detector (EID)-CT, particularly in thoracic oncology. This narrative review summarizes technical advances and clinical applications of PCD-CT in the thorax with emphasis on spatial resolution, dose-image-quality balance, and intrinsic spectral imaging, and it outlines practical implications relevant to thoracic oncology. A literature review of PubMed through May 31, 2025, was conducted using combinations of \"photon counting,\" \"computed tomography,\" \"thoracic oncology,\" and \"artificial intelligence.\" We screened the retrieved records and included studies with direct relevance to lung and mediastinal tumors, image quality, radiation dose, spectral/iodine imaging, or artificial intelligence-based reconstruction; case reports, editorials, and animal-only or purely methodological reports were excluded. PCD-CT demonstrated superior spatial resolution compared with EID-CT, enabling clearer visualization of fine pulmonary structures, such as bronchioles and subsolid nodules; slice thicknesses of approximately 0.4 mm and <i>ex vivo</i> resolvable structures approaching 0.11 mm have been reported. Across intraindividual clinical comparisons, radiation-dose reductions of 16%-43% have been achieved while maintaining or improving diagnostic image quality. Intrinsic spectral imaging enables accurate iodine mapping and low-keV virtual monoenergetic images and has shown quantitative advantages versus dual-energy CT in phantoms and early clinical work. Artificial intelligence-based deep-learning reconstruction and super-resolution can complement detector capabilities to reduce noise and stabilize fine-structure depiction without increasing dose. Potential reductions in contrast volume are biologically plausible given improved low-keV contrast-to-noise ratio, although clinical dose-finding data remain limited, and routine K-edge imaging has not yet translated to clinical thoracic practice. In conclusion, PCD-CT provides higher spatial and spectral fidelity at lower or comparable doses, supporting earlier and more precise tumor detection and characterization; future work should prioritize outcome-oriented trials, protocol harmonization, and implementation studies aligned with \"Green Radiology\".</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prediction of neoadjuvant chemotherapy efficacy among patients with triple-negative breast cancer using an ultrasound-based radiomics nomogram.","authors":"Min-Jia Lin, Hai-Ling Zha, Man-Qi Zhang, Yu Du, Min Zong, Cui-Ying Li","doi":"10.4274/dir.2025.253361","DOIUrl":"https://doi.org/10.4274/dir.2025.253361","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a radiomics nomogram based on early ultrasound (US) imaging for predicting pathologic complete response (pCR) in patients with triple-negative breast cancer (TNBC) receiving neoadjuvant chemotherapy (NAC).</p><p><strong>Methods: </strong>This retrospective study included 328 patients with TNBC treated between September 2019 and January 2024, divided into a training cohort (n = 230) and a validation cohort (n = 98). Clinicopathologic data, US features before NAC, tumor volume reduction (TVR) after two cycles of NAC, and radiomics features were collected. Multiple logistic regression was applied to identify the potential predictors of pCR. The efficacy of the nomogram was evaluated through the receiver operating characteristic, calibration, and decision curve analyses. The study was approved by the ethics committee on February 28, 2024, with approval number 2023-SR-799, and the requirement for informed consent was waived.</p><p><strong>Results: </strong>Twelve features were selected to construct the radiomics signature (RS). The nomogram, incorporating tumor histologic grade, TVR, and RS, yielded an area under the curve of 0.856 [95% confidence interval (CI), 0.807-0.905] in the training cohort and 0.836 (95% CI, 0.749-0.923) in the validation cohort, outperforming both the clinico-ultrasonic and RS models. The calibration and decision curves confirmed the nomogram's excellent calibration and clinical utility.</p><p><strong>Conclusion: </strong>The nomogram, which includes US characteristics, clinical variables, and radiomics features, exhibited satisfactory performance in predicting NAC efficacy in patients with TNBC.</p><p><strong>Clinical significance: </strong>The US-based radiomics nomogram, incorporating histologic grade, TVR, and RS, shows preliminary clinical application potential for predicting NAC efficacy in patients with TNBC.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}