European Journal of Radiology最新文献

{"title":"The predictive value of 18F-FDG PET/CT radiomics for pleural invasion in non-small cell lung cancer","authors":"Annan Zhang ,&nbsp;Meixin Zhao ,&nbsp;Xiangxing Kong ,&nbsp;Weifang Zhang ,&nbsp;Xiaoyan Hou ,&nbsp;Zhi Yang ,&nbsp;Xiangxi Meng ,&nbsp;Nan Li","doi":"10.1016/j.ejrad.2025.112199","DOIUrl":"10.1016/j.ejrad.2025.112199","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to develop and validate a PET/CT radiomics fusion model for preoperative predicting pleural invasion (PI) in non-small cell lung cancer (NSCLC) patients.</div></div><div><h3>Methods</h3><div>Data from Center A were divided into a training set (n = 260) and an internal validation set (n = 111), while data from Center B (n = 99) served as the external validation set. Radiomic features were extracted using PyRadiomics. Six feature screening methods and 12 machine learning methods were used to build clinical, PET/CT imaging, and radiomics fusion models. The best-performing model was selected based on accuracy, sensitivity, specificity, and area under the curve (AUC). A nomogram was created using logistic regression with clinical, PET/CT features, and Rad_score.</div></div><div><h3>Results</h3><div>The PET/CT radiomics fusion model exhibited superior predictive performance. In the internal validation set, it achieved an accuracy of 0.90, sensitivity of 0.88, specificity of 0.92, and AUC of 0.95 (95% CI 0.91–0.99). These metrics were significantly higher than those of the PET/CT imaging model (accuracy 0.83, sensitivity 0.83, specificity 0.82, AUC 0.85) and clinical model (accuracy 0.65, sensitivity 0.70, specificity 0.59, AUC 0.78). In the external validation set, the model demonstrated an accuracy of 0.81, sensitivity of 0.81, specificity of 0.81, and AUC of 0.85 (95% CI 0.77–0.94), outperforming the PET/CT imaging model (accuracy 0.76, sensitivity 0.75, specificity 0.77, AUC 0.80) and clinical model (accuracy 0.68, sensitivity 0.67, specificity 0.68, AUC 0.76). The nomogram showed excellent calibration, with a C index of 0.98 in the test set, 0.95 in the internal validation set, and 0.91 in the external validation set.</div></div><div><h3>Conclusion</h3><div>The PET/CT radiomics fusion model significantly improves PI prediction accuracy in NSCLC.</div><div><strong>Critical relevance statement:</strong>Pleural invasion is a critical prognostic factor in lung cancer and a challenge for preoperative CT evaluation. PET/CT radiomics fusion model has the highest predictive value in predicting PI of lung cancer.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112199"},"PeriodicalIF":3.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184606","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":"Vascular lesions of head and neck region: A pictorial review","authors":"Fahime Azizinik ,&nbsp;Sheida Javadi ,&nbsp;Faezeh Khorasanizadeh ,&nbsp;Fatemeh Shakki Katouli ,&nbsp;Reza Majidazar","doi":"10.1016/j.ejrad.2025.112190","DOIUrl":"10.1016/j.ejrad.2025.112190","url":null,"abstract":"<div><div>Vascular lesions in the head and neck region encompass a wide spectrum of malformations and tumors, ranging from hemangiomas to arteriovenous fistulas. The International Society for the Study of Vascular Anomalies classification system categorizes these anomalies into vascular tumors and malformations. Vascular tumors are further divided into benign, borderline, and malignant types, while vascular malformations are classified based on flow characteristics as high or low flow. Accurate delineation of these lesions is crucial due to their clinical implications, particularly their location and potential involvement of adjacent structures. Imaging modalities such as ultrasound, computed tomography, magnetic resonance imaging, and digital subtraction angiography play a vital role in diagnosis, surgical planning, and follow-up. Ultrasound is useful for superficial lesions, while computed tomography and magnetic resonance imaging provide detailed information on deep-seated anomalies. Vascular tumors include benign lesions like hemangiomas and pyogenic granuloma, borderline tumors such as hemangioendothelioma, and malignant tumors like angiosarcoma and Kaposi sarcoma. Vascular malformations include venous, lymphatic, capillary, arteriovenous malformations and combined lesions like lymphangiohemangioma. Each type has distinct imaging features, with magnetic resonance imaging being particularly valuable for assessing soft tissue involvement and lesion extent. This review highlights the importance of imaging in the diagnosis and management of head and neck vascular anomalies, emphasizing the need for a multidisciplinary approach to optimize patient outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112190"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134647","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":"Refining the Tmax malignant profile in large ischemic core patients receiving endovascular treatment","authors":"Giorgio Busto ,&nbsp;Andrea Morotti ,&nbsp;Ilaria Casetta ,&nbsp;Francesca Danesi ,&nbsp;Francesco Loverre ,&nbsp;Tommaso Casseri ,&nbsp;Francesco Arba ,&nbsp;Manuel Cappellari ,&nbsp;Enrico Fainardi","doi":"10.1016/j.ejrad.2025.112187","DOIUrl":"10.1016/j.ejrad.2025.112187","url":null,"abstract":"<div><h3>Background and purpose</h3><div>A significant proportion of patients with large ischemic core volume (LICV) have poor outcome despite successful recanalization. We aimed to assess the optimal cutoff for hypoperfusion volume, defined as Tmax &gt; 6-seconds lesion size, to identify a malignant profile in LICV patients and predict poor functional outcome after endovascular treatment (EVT).</div></div><div><h3>Materials and methods</h3><div>Sixty-six consecutive LICV with multimodal CT study protocol within 24 h from onset. A receiver operating characteristic curve analysis was used to identify the optimal Tmax &gt; 6-seconds lesion volume cutoff to define a malignant profile. Logistic regression was used to evaluate the predictive value of malignant profile for poor functional outcome (defined as modified Rankin Scale 4–6 at 3 months).</div></div><div><h3>Results</h3><div>Tmax &gt; 6-seconds volume had good discriminative ability for poor clinical outcome (AUC 0.85; 95 % CI 0.74–0.92). The best cut-off value for poor outcome was ≥160 mL (84 % sensitivity, 85 % specificity, 89 % positive predictive value, 80 % negative predictive value) and represented our definition of malignant profile. Among the 66 included patients, 39 (59 %) had poor functional outcome, of whom 29 (74.3 %) showed a malignant profile. The presence of malignant profile (OR = 9.11, 95 %CI = 2.78–29.80) and unsuccessful recanalization status (OR = 3.51, 95 %CI = 1.01–12.72) were independently associated with poor functional outcome in LICV patients. Patients with malignant profile showed higher hemorrhagic transformation (p = 0.026) and mortality (p = 0.013) rates compared to patients without malignant profile.</div></div><div><h3>Conclusions</h3><div>Tmax &gt; 6-seconds lesion volume ≥160 mL identified the malignant profile and predicts unfavorable outcome in LICV patients undergoing EVT within 24-hours from stroke onset.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112187"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117040","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":"What looks like a contrast reaction may not be a contrast reaction","authors":"Ingrid Böhm","doi":"10.1016/j.ejrad.2025.112193","DOIUrl":"10.1016/j.ejrad.2025.112193","url":null,"abstract":"<div><div>Adverse reactions following the application of a contrast medium are always a challenge for radiologists. To date, little consideration has been given to causality analyses. Hypersensitivity reactions in the context of contrast-enhanced imaging procedures may be caused by the contrast agent, but other culprit agens (such as latex allergy) should be also considered.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112193"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134645","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":"Computed tomography features of gastric cancer with deficient mismatch repair: Radiologic–pathologic correlation","authors":"Jia-zheng Li ,&nbsp;Yan-ling Li ,&nbsp;Xin-ya Zhao ,&nbsp;Yin-kui Wang ,&nbsp;Yan-li Li ,&nbsp;Yi-ting Liu ,&nbsp;Yi-yuan Wei ,&nbsp;Xiao-ting Li ,&nbsp;Zhen-hui Li ,&nbsp;Yu Sun ,&nbsp;Lei Tang ,&nbsp;Zi-yu Li","doi":"10.1016/j.ejrad.2025.112186","DOIUrl":"10.1016/j.ejrad.2025.112186","url":null,"abstract":"<div><h3>Objectives</h3><div>Our study aimed to identify CT features of locally advanced gastric cancer (LAGC) associated with deficient mismatch repair (dMMR), explore the underlying pathological basis, and develop a morphology-based model for dMMR prediction.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective analysis included 397 patients with LAGC treated at three institutions between January 2016 and January 2022. Mismatch repair (MMR) status was determined by immunohistochemical analysis of postoperative specimens. The patients were divided into training and external validation groups. CT features of primary tumours and lymph nodes associated with MMR status were identified, and the underlying pathological basis for these features were explored. Multivariable logistic analysis was used to identify independent CT features and to develop a morphology-based model.</div></div><div><h3>Results</h3><div>Tumours with dMMR were characterized by increased thickness (<em>p</em> = 0.04), location in the lower stomach (<em>p</em> &lt; 0.001), heterogeneous enhancement patterns (<em>p</em> = 0.02), a well-defined margin (<em>p</em> &lt; 0.001), the presence of mushroom sign (<em>p</em> &lt; 0.001), and the presence of abnormal lymph nodes (<em>p</em> = 0.07). Pathologically, tumours with dMMR exhibited extensive lymphocytic infiltration and solid growth with a pushing border, consistent with the distinctive CT features observed. Multivariable logistic analysis identified lower tumour location, well-defined tumour margin, and mushroom sign as independent predictors of dMMR. The morphology-based model achieved AUC values of 0.73–0.74 for dMMR prediction in the training and external validation groups.</div></div><div><h3>Conclusions</h3><div>LAGC with dMMR showed distinct CT features. A morphology-based model constructed from these CT features has the potential to predict dMMR status for LAGC.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112186"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177425","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":"Education and training satisfaction among radiology residents: Insights from a national survey","authors":"Nikolaos-Achilleas Arkoudis ,&nbsp;Kyriaki Tavernaraki ,&nbsp;Ornella Moschovaki-Zeiger ,&nbsp;Vassilis Balomenos ,&nbsp;Georgios Velonakis ,&nbsp;Olympia Papakonstantinou ,&nbsp;Dimitrios Filippiadis ,&nbsp;Efthymia Alexopoulou ,&nbsp;Nikolaos Kelekis ,&nbsp;Stavros Spiliopoulos","doi":"10.1016/j.ejrad.2025.112191","DOIUrl":"10.1016/j.ejrad.2025.112191","url":null,"abstract":"<div><h3>Objectives</h3><div>This national survey evaluates the perspectives and satisfaction of radiology residents in Greece regarding their educational program, aiming to enhance training at a national level and provide insights applicable to residency programs internationally.</div></div><div><h3>Materials &amp; Methods</h3><div>A 77-question online survey was distributed to all registered radiology residents. The survey collected data on demographics and several topics, including working conditions, academic engagement, satisfaction with training, and subspecialty preferences. Responses were analyzed using descriptive statistics, chi-square tests, and Spearman’s correlation test.</div></div><div><h3>Results</h3><div>The survey achieved a response rate of 46.3% (166/358). While 83% of respondents expressed satisfaction with their choice of radiology as a specialty, 67% weren’t satisfied with their training program’s overall quality. Key areas of dissatisfaction included inadequate working conditions (62%), limited access to structured curricula (45%), and insufficient academic research opportunities (95% lacked protected academic time). Subspecialty training interest in interventional radiology (IR) was rated as the most popular; 22% showed interest in pursuing it over other options. Training in classical radiology, mammography, and MRI received low satisfaction scores. Most respondents supported reforms, including using a logbook, standardizing the curriculum, establishing a more equitable examination process, and extending the residency duration.</div></div><div><h3>Conclusion</h3><div>This survey highlights the state of radiology residency programs in Greece, revealing significant challenges and opportunities for improvement. Key areas requiring attention include the development of a standardized curriculum, improving working conditions, and increasing opportunities for academic and research activities. IR emerged as a popular subspecialty interest. European-level surveys could provide significant insights and guidance.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112191"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125258","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":"Head-to-head comparison of [18F]florbetapir and [18F]FDG PET for the early detection of amyloidosis in systemic amyloidosis and plasma cell dyscrasias","authors":"Yanyan Kong ,&nbsp;Lei Cao ,&nbsp;Boyan He ,&nbsp;Zhongwen Zhou ,&nbsp;Minmin Zhang ,&nbsp;Qian Zhang ,&nbsp;Qian Wang ,&nbsp;Wei Wang ,&nbsp;Haoxiang Zhu ,&nbsp;Jianfei Xiao ,&nbsp;Axel Rominger ,&nbsp;Yihui Guan ,&nbsp;Haibo Tan ,&nbsp;Ruiqing Ni","doi":"10.1016/j.ejrad.2025.112188","DOIUrl":"10.1016/j.ejrad.2025.112188","url":null,"abstract":"<div><h3>Rationale and objectives</h3><div>Systemic amyloidosis is underdiagnosed in light-chain amyloidosis (AL), as is plasma cell dyscrasias (PCD). Early detection and accurate evaluation of organ involvement in systemic amyloidosis remain critical challenges. We aimed to assess the utility of [¹⁸F]florbetapir (FBP) and [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) for the early detection and evaluation of organ involvement in systemic amyloidosis.</div></div><div><h3>Materials and methods</h3><div>We included 66 participants and performed biochemical assays in serum and urine and whole-body PET/computed tomography using [¹⁸F]FBP and [¹⁸F]FDG, followed by visual, maximum standardized uptake value (SUV_max), and target-to-background ratio (TBR) analyses. The clinical evaluation of organ involvement was based on the histological analysis of tissue biopsies obtained from suspected organs in AL and PCD cases.</div></div><div><h3>Results</h3><div>[¹⁸F]FBP SUV_max and TBR analyses revealed comparable uptake in AL patients and significantly greater uptake than in PCD patients. Distinct regional distributions of [¹⁸F]FBP and [¹⁸F]FDG were observed between the PCD and AL groups. The [¹⁸F]FBP SUV_max and visual analysis provided comparable measures of organ involvement and demonstrated high sensitivity, outperforming [¹⁸F]FDG in detecting organ amyloidosis in both PCD and AL patients. More organ involvement was detected by [¹⁸F]FBP PET (SUV_max or visual) than by biopsies based evaluation.</div></div><div><h3>Conclusion</h3><div>[¹⁸F]FBP PET, through both visual and SUV_max analysis, is more sensitive than [¹⁸F]FDG PET and biopsy-based analysis for detecting organ amyloidosis in PCD and AL patients. It serves as a valuable noninvasive method for the early and accurate detection of systemic amyloidosis, with the potential to improve diagnostic precision and facilitate timely intervention in systemic amyloidosis patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112188"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125259","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":"Non-invasive CT based multiregional radiomics for predicting pathologic complete response to preoperative neoadjuvant chemoimmunotherapy in non-small cell lung cancer","authors":"Shuxuan Fan ,&nbsp;Jiping Xie ,&nbsp;Sunyi Zheng ,&nbsp;Jing Wang ,&nbsp;Bin Zhang ,&nbsp;Zhanshuo Zhang ,&nbsp;Shuo Wang ,&nbsp;Yuechen Cui ,&nbsp;Jiaxin Liu ,&nbsp;Xinru Zheng ,&nbsp;Zhaoxiang Ye ,&nbsp;Xiaonan Cui ,&nbsp;Dongsheng Yue","doi":"10.1016/j.ejrad.2025.112171","DOIUrl":"10.1016/j.ejrad.2025.112171","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to develop and validate a multiregional radiomics model to predict pathological complete response (pCR) to neoadjuvant chemoimmunotherapy in non-small cell lung cancer (NSCLC), and further evaluate the performance of the model in different specific subgroups (N2 stage and anti-PD-1/PD-L1).</div></div><div><h3>Materials and methods</h3><div>216 patients with NSCLC who underwent neoadjuvant chemoimmunotherapy followed by surgical intervention were included and assigned to training and validation sets randomly. From pre-treatment baseline CT, one intratumoral (T) and two peritumoral regions (P₃: 0–3 mm; P₆: 0–6 mm) were extracted. Five radiomics models were developed using machine learning algorithms to predict pCR, utilizing selected features from intratumoral (T), peritumoral (P₃, P₆), and combined intra- and peritumoral regions (T + P₃, T + P₆). Additionally, the predictive efficacy of the optimal model was specifically assessed for patients in the N2 stage and anti-PD-1/PD-L1 subgroups.</div></div><div><h3>Results</h3><div>A total of 51.4 % (111/216) of patients exhibited pCR following neoadjuvant chemoimmunotherapy. Multivariable analysis identified that only the T + P₃ radiomics signature served as independent predictor of pCR (<em>P</em> &lt; 0.001). The multiregional radiomics model (T + P₃) exhibited superior predictive performance for pCR, achieving an area under the curve (AUC) of 0.75 in the validation cohort. Furthermore, this multiregional model maintained robust predictive accuracy in both N2 stage and anti-PD-1/PD-L1 subgroups, with an AUC of 0.829 and 0.833, respectively.</div></div><div><h3>Conclusion</h3><div>The proposed multiregional radiomics model showed potential in predicting pCR in NSCLC after neoadjuvant chemoimmunotherapy, and demonstrated good predictive performance in different specific subgroups. This capability may assist clinicians in identifying suitable candidates for neoadjuvant chemoimmunotherapy and promote the advancement in precision therapy.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112171"},"PeriodicalIF":3.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088933","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":"Evaluation of recall rates in the Irish national breast screening programme: Insights from two million screening mammograms","authors":"Sophie Murphy ,&nbsp;Therese Mooney ,&nbsp;Niall Phelan ,&nbsp;Alan Smith ,&nbsp;Louise Campbell ,&nbsp;Alissa Connors ,&nbsp;Aideen Larke ,&nbsp;Sorcha McNally ,&nbsp;Patricia Fitzpatrick ,&nbsp;Maeve Mullooly ,&nbsp;Fidelma Flanagan","doi":"10.1016/j.ejrad.2025.112179","DOIUrl":"10.1016/j.ejrad.2025.112179","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer screening aims to reduce breast cancer mortality and morbidity through early detection and treatment. Recall rate is a key performance indicator of population-based breast screening, representing the proportion of women recalled for further evaluation. Guidance on acceptable recall rates vary internationally.</div></div><div><h3>Aim</h3><div>To examine recall patterns and characteristics within the population-based breast screening programme in Ireland.</div></div><div><h3>Methods</h3><div>An anonymous aggregate retrospective study of 2,031,995 mammography screening examination results, was conducted between 2000 and 2019. Descriptive patterns of recall rates and characteristics were examined and stratified by prevalent and incident examinations. Differences across the time-periods (2000–2008, 2009–2017 and 2018–2019) were assessed using Chi-square tests.</div></div><div><h3>Results</h3><div>Recall rate for screening examinations conducted during the full study period was 4.05 % (n = 82,338/2,031,995). Across three time-periods examined, recall rates among the prevalent screening examination group, increased, from 5.5 % to 8.0 % to 10.0 % and within the incident group from 2.3 % to 2.8 % to 3.0 %. Recalls due to calcifications and asymmetry increased over the time periods, most notably within the prevalent examinations where recalls due to calcification increased from 6.0/1,000 to 9.0/1,000 to 13.4/1,000 (p &lt; 0.001), whilst recalls due to asymmetry increased from 17.1/1,000 to 31.3/1,000 to 41.0/1,000 (p &lt; 0.001). Overall, among both prevalent and incident screening examinations, an increase in the cancer detection rate (CDR) was observed (p = 0.005 and p &lt; 0.001 respectively). However, the overall positive predictive value (PPV) remained relatively stable.</div></div><div><h3>Conclusion</h3><div>This study highlights the upward trajectory of recall within Ireland’s national breast screening service. The findings highlight the need for discussions among a diverse range of stakeholders, including national and international screening networks, to determine the optimal recall rate to ensure the benefits of screening are maximised and all potential harms are minimised.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112179"},"PeriodicalIF":3.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117039","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":"Personalized high pitch CTPA facilitates a reduction of contrast agent volume","authors":"Raoul Varga,&nbsp;Florian Weiss,&nbsp;Marcus Raudner,&nbsp;Helmut Prosch,&nbsp;Rüdiger E. Schernthaner","doi":"10.1016/j.ejrad.2025.112172","DOIUrl":"10.1016/j.ejrad.2025.112172","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite advancements in computed tomography pulmonary angiography (CTPA), optimizing contrast agent (CA) volume remains crucial due to inter-patient hemodynamic variability. This study aimed to evaluate a personalized scan delay approach using a test bolus technique to minimize CA volume while maintaining diagnostic image quality.</div></div><div><h3>Patient and Methods</h3><div>A prospective trial (n = 97) was conducted on patients referred for CTPA due to suspected pulmonary embolism (PE). The study group (n = 77) underwent CTPA with a reduced CA volume (20 mL Iomeron 400 i.v.) guided by a test bolus technique to determine the optimal scan delay. Standard CTPA exclusion criteria were applied; no study-related exclusion criteria were defined. A retrospectively selected control group (n = 31) underwent CTPA using a standard bolus tracking protocol with 50 mL Iomeron 400 i.v. Two independent readers performed image analysis.</div></div><div><h3>Results</h3><div>PE was detected in 21 patients in the study group and y patients in the control group. Attenuation values in the pulmonary trunk were significantly lower in the study group (mean 336 ± 116 HU) compared to the control group (mean 517 ± 185 HU) (p &lt; 0.001). However, a comparable proportion of patients in both groups achieved diagnostic attenuation values (&gt;200 HU) in the pulmonary trunk. The superior vena cava (SVC) attenuation was significantly higher in the control group (mean 1241 ± 795 HU) compared to the study group (mean 430 ± 337 HU) (p &lt; 0.001), suggesting potentially suboptimal contrast timing in the standard protocol.</div></div><div><h3>Conclusion</h3><div>Personalized high-pitch CTPA, guided by a test bolus technique, facilitates an optimized scan delay, enabling a significant reduction in contrast agent volume while preserving diagnostic attenuation of the pulmonary arteries. This approach may be particularly beneficial in patients at risk for contrast-induced nephropathy.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112172"},"PeriodicalIF":3.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166681","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}