Diagnostic and interventional radiology最新文献

{"title":"Reply: Comment on the diagnostic sensitivity of ChatGPT for detecting hemorrhages in cranial computed tomography scans.","authors":"Olga Bayar Kapıcı, Erman Altunışık, Feyza Musabeyoğlu, Şeyda Dev, Ömer Kaya","doi":"10.4274/dir.2026.263888","DOIUrl":"10.4274/dir.2026.263888","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"393-394"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography and magnetic resonance imaging findings in congenital cardiovascular anomalies.","authors":"Mustafa Koplay, Nusret Seher","doi":"10.4274/dir.2025.252878","DOIUrl":"10.4274/dir.2025.252878","url":null,"abstract":"<p><p>The incidence of congenital heart disease (CHD) is approximately 6-7 per 1,000 newborns. With advanced diagnostic, medical, and surgical methods, survival of CHD is increasing, as is the number of people living with CHD. Echocardiography is a useful modality in non-invasive imaging, whereas magnetic resonance imaging (MRI), cardiac MR (CMR), cardiac computed tomography (CT), and CT angiography (CTA) are increasingly gaining ground in congenital cardiac imaging with developing technology. Considering the limited postoperative use of echocardiography, these techniques have assumed vital roles with the increasing population of CHD in children and adults. CMR and cardiac CT can complement the information obtained with echocardiography and invasive cardiac catheterization and can sometimes provide more detail. In postoperative imaging of CHD, CMR allows an evaluation of anatomy, especially with spin echo MRI techniques, whereas cine MRI, created in gradient echo sequences, allows functional data to be obtained. Phase contrast CMR data provides information on flow direction and flow rate, allowing accurate measurement of regurgitation and shunt volume. In addition, in post-gadolinium imaging, data such as on MR angiography, myocardial perfusion, and fibrosis can be obtained with CMR. Cardiac CT and CTA provide great advantages, especially in newborns, by almost completely reducing movement and respiratory artifacts through capabilities such as high spatial and temporal resolution, fast acquisition, and short acquisition time. Three-dimensional reformatted images with contrast-enhanced CMR or cardiac CT/CTA provide excellent visualization of vascular structures in complex CHDs. Coronary imaging can be viewed more easily with CT imaging. This article reviews the literature to provide an overview of the diagnostic value, relative advantages, and overall evaluation of CMR and cardiac CT examinations in the diagnosis and postoperative follow-up of CHD.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"409-425"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety and efficacy of the percutaneous balloon-expandable biodegradable magnesium biliary stents in patients with liver transplant.","authors":"Ramazan Kutlu, Nurullah Dağ, Eldiiar Saparbekov","doi":"10.4274/dir.2025.253585","DOIUrl":"10.4274/dir.2025.253585","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to present our institutional experience with the use of percutaneous balloon-expandable biodegradable magnesium biliary stents (MBS) in the treatment of benign, refractory anastomotic strictures (AS), where initial percutaneous or endoscopic approaches fail or are ineffective, after liver transplantation (LT).</p><p><strong>Methods: </strong>In this retrospective single-center study, 13 patients with clinically refractory AS who underwent MBS placement between July 2021 and August 2024 were evaluated. Statistical analyses included Kaplan-Meier survival analysis for patency and Spearman's correlation for recurrence risk. Primary outcomes included stricture recurrence and time to reintervention during follow-up.</p><p><strong>Results: </strong>The median age of patients was 35 years [interquartile range (IQR): 22-48], and 11 were male (85%). Living donor LT was performed in 12 (92%). The MBS were placed at a median of 8 months post-transplant (IQR: 5-44), with a technical success in all cases (100%). Before MBS placement, patients underwent a median of one endoscopic retrograde cholangiopancreatography (IQR: 0-3) and three percutaneous transhepatic biliary drainage procedures (IQR: 1-8). The median follow-up was 25 months (IQR: 15-33). The MBS patency rates were 93%, 85%, and 67% at 6, 12, and 24 months, respectively. Stricture recurrence occurred at a median of 30 months post-placement (95% confidence interval: 23.6-36.3). A moderate positive correlation was observed between the number of pre-stent interventions and recurrence risk (rho: 0.582, <i>P</i> = 0.023). Post-procedural complications (cholangitis) occurred in 1 patient.</p><p><strong>Conclusion: </strong>Balloon-expandable biodegradable MBS may provide a safe and effective treatment for refractory AS following LT. Early placement of MBS, particularly after fewer prior interventions, appears to be associated with improved patency and longer stricture-free survival.</p><p><strong>Clinical significance: </strong>Early use of biodegradable magnesium stents after LT may reduce the need for multiple interventions and improve long-term biliary patency.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"473-478"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of portable handheld digital radiography in a beagle model of thoracic trauma.","authors":"Gaofeng Liu, Xueqi Fang, Sujuan Cui, Li Zhou, Yong Zhang, Qingyuan Li, Xingjian Fang, Yutao Yan","doi":"10.4274/dir.2026.263936","DOIUrl":"10.4274/dir.2026.263936","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the diagnostic value of portable handheld digital radiography (DR) in a beagle model of thoracic trauma.</p><p><strong>Methods: </strong>Twenty-seven beagles were randomly assigned to three experimental groups: the pneumothorax group (induced by intrapleural air injection at 50 mL/kg), the pleural effusion group (induced by intrapleural normal saline injection at 30 mL/kg), and the rib fracture group (created by surgical transection of the 6^th rib). All animals underwent three imaging examinations in a randomized order: conventional chest X-ray, mobile DR, and portable handheld DR. Detection rates (using surgical outcomes as the gold standard), image quality, and total examination time (from positioning to image acquisition) were compared among the three modalities.</p><p><strong>Results: </strong>A total of 21 animals completed the full protocol (7 per group). There was no significant difference in detection rates among the three examination methods (<i>P</i> > 0.050). The image quality of both mobile DR and portable handheld DR was significantly superior to that of conventional chest X-ray (<i>P</i> = 0.021). Examination times for mobile DR (8.37 ± 0.80 minutes) and portable handheld DR (7.07 ± 0.67 minutes) were significantly shorter than for conventional chest X-ray (10.40 ± 0.96 minutes) (<i>P</i> < 0.001). Furthermore, portable handheld DR had a significantly shorter examination time than mobile DR (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Portable handheld DR provides detection rates comparable with mobile DR and conventional chest X-ray for thoracic trauma, with the advantages of superior image quality over conventional chest X-ray and the shortest examination time. Its user-friendly operation and high portability make it a valuable tool for emergency imaging in austere environments.</p><p><strong>Clinical significance: </strong>Based on diagnostic results in a beagle model of thoracic trauma, this study demonstrates that portable handheld DR can provide reliable methodological support for real-time imaging and rapid triage in harsh environments such as field and post-disaster settings.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"448-452"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Beyond publication rates: improving the quality and impact of radiology residency research.","authors":"Ali Salbas, Ali Murat Koc","doi":"10.4274/dir.2026.263862","DOIUrl":"10.4274/dir.2026.263862","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"455-456"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging-based morphologic features associated with ankle sprain and increased risk of ligament tear.","authors":"Hande Özen Atalay, Gizem Timoçin Yığman, Erol Erinç Dokuyucu, Evrim Özmen","doi":"10.4274/dir.2026.263921","DOIUrl":"10.4274/dir.2026.263921","url":null,"abstract":"<p><strong>Purpose: </strong>To identify magnetic resonance imaging (MRI)-based morphologic features of the distal tibiofibular syndesmosis and talocrural joint associated with ankle sprains and to determine which parameters are specifically linked to an increased risk of ligament tears after sprains.</p><p><strong>Methods: </strong>This retrospective study included ankle MRI examinations performed between January 2022 and November 2025. Two analytic datasets were constructed: Dataset 1 compared patients with ankle sprains and MRI-confirmed ligament tears to healthy controls with completely normal ankle MRIs; Dataset 2 compared controls, patients with sprains but no ligament tears, and patients with sprains and ligament tears. Standardized morphometric measurements of the distal tibiofibular syndesmosis and talocrural joint were obtained, including absolute and ratio-based parameters. Group comparisons were performed using appropriate univariable tests with multiple-comparison correction. Multivariable logistic regression was used to identify independent predictors of ligament tears. Inter-reader reliability was assessed using intraclass correlation coefficients and Bland-Altman analysis.</p><p><strong>Results: </strong>In Dataset 1, compared with healthy controls, tibiofibular clear space and the fibular notch depth-to-tibial thickness ratio were significantly higher in patients with ankle sprains and ligament tears, whereas the lateral malleolar height-to-talar articular width ratio was significantly lower (all <i>P</i> < 0.05). Multivariable analysis demonstrated that tibiofibular clear space and the fibular notch depth-to-tibial thickness ratio were independent predictors. In Dataset 2, tibiofibular clear space, fibular notch depth-to-tibial thickness ratio, and lateral malleolar height-to-talar articular width ratio differed significantly across three groups (all <i>P</i> < 0.05). Notably, only the lateral malleolar height-to-talar articular width ratio independently differentiated patients with sprains and ligament tears from those without tears (<i>P</i> = 0.025). Model discrimination was moderate to good (area under the curve: 0.699 and 0.785).</p><p><strong>Conclusion: </strong>Specific MRI-based morphologic features are associated with both ankle sprain susceptibility and an increased risk of ligament tears. Among these, the lateral malleolar height-to-talar articular width ratio appears to be a morphometric parameter associated with an increased likelihood of ligament tears.</p><p><strong>Clinical significance: </strong>MRI-based morphometric assessment, particularly the lateral malleolar height-to-talar articular width ratio, may help identify patients with ankle sprains who are at an increased risk for ligament tears and support more individualized clinical management.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"500-509"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turkish Society of Radiology artificial intelligence applications guide: a roadmap to help navigate the artificial intelligence landscape.","authors":"Oğuz Dicle, Fırat Atak, Abdullah Utku Şenol, Mustafa Nasuh Özmen, Nur Hürsoy, Naciye Sinem Gezer, Üstün Aydıngöz","doi":"10.4274/dir.2025.253489","DOIUrl":"10.4274/dir.2025.253489","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"391-392"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"457-462"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320191/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging kinetic heterogeneity and apparent diffusion coefficient for grading invasive breast cancer.","authors":"Xinyu Feng, Peiwei Ye, Hui Chen, Changyu Liu, Qingqiang Zhu","doi":"10.4274/dir.2026.263831","DOIUrl":"10.4274/dir.2026.263831","url":null,"abstract":"<p><strong>Purpose: </strong>To quantitatively compare the diagnostic value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) kinetic heterogeneity and conventional diffusion-weighted imaging (DWI) for the extent of breast cancer infiltration.</p><p><strong>Methods: </strong>This study employed a retrospective analysis of DCE-MRI data of patients with invasive breast cancer (IBC) diagnosed by pathology in our hospital between January 2023 and February 2025. The aim was to obtain quantitative measures of kinetic heterogeneity and apparent diffusion coefficients (ADCs) from DWI, and to extract the six main parameters for lesion heterogeneity analysis from preoperative MRI data using MATLAB, SPM12, and R 4.4.1. The parameters included peak, enhancement volume, persistent fraction, plateau, washout, and heterogeneity. The diagnostic efficacy of DCE-MRI, conventional DWI, and their combination on the extent of IBC infiltration was compared by analyzing the receiver operating characteristic curves, sensitivities, specificities, and correlations among the parameters.</p><p><strong>Results: </strong>The high-grade group exhibited significantly higher peak, plateau, washout, and heterogeneity values, along with lower persistent and ADC values, compared with the low-grade group (all <i>P</i> < 0.001); tumor volume did not differ between groups (<i>P</i> = 0.314). ADC and persistent fractions were negatively correlated with pathological grade, whereas peak, plateau, washout, and heterogeneity were positively correlated. Receiver operating characteristic analysis showed that heterogeneity achieved a significantly higher area under the curve (AUC) than ADC [0.910, 95% confidence interval (CI): 0.857-0.948 vs. 0.808, 95% CI: 0.741-0.863; DeLong Z = 2.626, <i>P</i> = 0.009]. The AUC for the combined model of heterogeneity, peak value, and ADC was 0.969 (95% CI: 0.946-0.992), with a sensitivity of 95.5% and a specificity of 89.2%.</p><p><strong>Conclusion: </strong>DCE-MRI combined with DWI has significant diagnostic value in identifying the extent of IBC infiltration.</p><p><strong>Clinical significance: </strong>DCE-MRI kinetic heterogeneity combined with DWI enables noninvasive discrimination of the extent of IBC infiltration before surgery, facilitating personalized systemic therapy and nodal evaluation while avoiding overtreatment in patients at low risk. Computer-aided, whole-tumor heterogeneity analysis replaces limited region-of-interest sampling, significantly improving both efficiency and accuracy of IBC grading. Integration of kinetic heterogeneity plus diffusion parameters provides a panoramic view of tumor size, location, and perilesional relationships, empowering multi-disciplinary teams to rapidly individualize surgical and adjuvant treatment strategies.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"399-408"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a multimodal artificial intelligence-based model for predicting post-prostatectomy treatment outcomes from baseline biparametric prostate magnetic resonance imaging.","authors":"Benjamin D Simon, Esra Akcicek, Stephanie A Harmon, Lei Clifton, Anshul Thakur, Sandeep Gurram, David Clifton, Bradford J Wood, Ali Devrim Karaosmanoglu, Peter L Choyke, Deniz Akata, Peter A Pinto, Baris Turkbey","doi":"10.4274/dir.2026.264095","DOIUrl":"10.4274/dir.2026.264095","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate cancer (PCa) is the second most common cancer and cause of cancer deaths among American men. Existing risk prediction methods have limited accuracy and reproducibility, resulting in difficulty in predicting treatment outcomes. We demonstrate the development and external validation of an automated multimodal artificial intelligence (AI) algorithm using biparametric magnetic resonance imaging (bpMRI) and clinical covariates for predicting biochemical recurrence (BCR) after radical prostatectomy (RP) in patients with PCa.</p><p><strong>Methods: </strong>The development cohort included 80% of patients from center 1 (n = 240) who underwent prostate MRI prior to RP between January 2008 and December 2018, with a minimum of 2 years of follow-up after RP. The test cohort included the remaining 20% of center 1 patients (n = 71) and an external validation cohort from center 2 (n = 168). Center 2 patients included those who underwent prostate MRI and RP between January 2015 and January 2024, with a minimum of 2 years of follow-up. Clinical comparisons were made using the Cancer of the Prostate Risk Assessment Postsurgical (center 1) and International Society of Urological Pathology Gleason Grade Group (ISUP GGG) scoring systems from post-RP pathology (center 2). The models developed were as follows: clinical (M0), automated clinical (M1), radiomics (M2), and a multimodal model (M3). Clinical variables (M0) included prostate-specific antigen (PSA), age, primary Gleason, and ISUP GGG. Automated clinical variables (M1 and M3) included PSA and age. Radiomic features (M2 and M3) were extracted from bpMRI using a lesion detection AI model. Accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated, and log-rank tests compared BCR-free survival to assess the models' ability to discriminate relative to clinical standards. Intermediate-risk groups were also assessed.</p><p><strong>Results: </strong>The multimodal model (M3) had the highest AUC across test sets (combined: 0.71; center 1: 0.70; center 2: 0.75). This was the only model that significantly differentiated BCR-free survival outcomes in intermediate-risk groups across both centers (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This automated multimodal model leveraging radiomics and clinical covariates can predict BCR after RP, approaching clinical gold standards, and may enhance imaging-based prognostication following further validation.</p><p><strong>Clinical significance: </strong>Given that this model demonstrated the potential to outperform pre-surgical and post-surgical clinical gold standards in an external cohort's intermediate-risk patient subgroup (for whom it is more challenging to predict disease trajectory), this model may contribute to enhanced personalized care in PCa after further validation.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316327","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}