European Journal of Radiology最新文献

{"title":"Inter-rater reliability of a classification systems for distal radius fractures using radiology text and x-rays: what really matters?","authors":"Joanna F. Dipnall ,&nbsp;Thomas O’Donnell ,&nbsp;Richard S. Page ,&nbsp;Raphael Hau ,&nbsp;Richard de Steiger ,&nbsp;Andrew Bucknill ,&nbsp;Andrew Oppy ,&nbsp;Elton Edwards ,&nbsp;Dinesh Varma ,&nbsp;Ronan A. Lyons ,&nbsp;Peter Cameron ,&nbsp;William Veitch ,&nbsp;Emily Doole ,&nbsp;Berwout Wiltschut ,&nbsp;Leah Sleaby ,&nbsp;Adil Zia ,&nbsp;Robin Lee ,&nbsp;Belinda J Gabbe","doi":"10.1016/j.ejrad.2026.112688","DOIUrl":"10.1016/j.ejrad.2026.112688","url":null,"abstract":"<div><h3>Purpose</h3><div>This study used different metrics to assess the reliability of radiology text and images in Distal Radial Fractures (DRF) classifications using classifiers with varying levels of experience.</div></div><div><h3>Methods</h3><div>A random sample of 534 patients (16 + years) admitted to two major trauma centres for &gt; 24 h for DRF management with 1,269 radiology images and radiology text reports were reviewed. Eight classifiers, with varying levels of experience, were randomly assigned patients, with overlap, to classify four different DRF classifications, nine radiological features and one treatment type: (two interns (802 text/images), three registrars (1,079 text/images), three orthopaedic trauma specialists (740 text/images)). The agreement measures utilised were: Percentage agreement (PA), Brennan/ Prediger coefficient, Cohen/Conger Kappa, Fleiss kappa, Gwet’s AC, Krippendorff’s alpha coefficient; all with 95% confidence intervals.</div></div><div><h3>Results</h3><div>For DRF classifications, the ulnar fracture (81%, 77%-86%) then AO Level 1 (67%, 60%-74%) had the highest PA; AO Level 3 had the lowest (29%, 23%-34%). For radiological features: highest PA was the presence/absence of tear drop/volar rim fragment (97%, 96%-98%) and severe dorsal comminution (97%, 96%-98%); lowest was ulnar variance (70%, 57%-83%). Treatment had high PA (96%, 87%-100%). Differences across classifier experience were not significant.</div></div><div><h3>Conclusions</h3><div>Even with descriptive texts from the radiology reports and x-ray images, DRF classification is complex and classifier experience not affecting classification. Generally, above fair agreement and interrater reliability was achieved, but the type and complexity of the classification task and the choice of agreement coefficient were important considerations in the reporting of agreement and reliability of the data.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112688"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124464","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":"Spectral CT-derived extracellular volume fraction for pathological characterization and noninvasive T staging in colon cancer","authors":"Zhanrong Shen ,&nbsp;Jiong Liu ,&nbsp;Ruidan Yang ,&nbsp;Yinfei Fan ,&nbsp;Shuanglu Wang ,&nbsp;Yue Shu ,&nbsp;Jian Shu","doi":"10.1016/j.ejrad.2026.112722","DOIUrl":"10.1016/j.ejrad.2026.112722","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the association between the extracellular volume fraction (ECV) quantified by spectral CT and multiparameter pathological features (Ki-67, mismatch repair status, WHO Grade, Perineural/Lymphovascular Invasion, pT/pN Stage) in colon cancer, and to develop a noninvasive preoperative prediction model for any indicator showing a significant association.</div></div><div><h3>Methods</h3><div>This single-center retrospective study enrolled 158 patients with pathologically confirmed colon cancer. All patients underwent contrast-enhanced spectral CT and hematocrit testing within 1 week before surgery for ECV calculation. Univariate logistic regression was used to evaluate associations between ECV and each pathological feature. For pathological features showing significant associations, three predictive models were developed: a clinical model, an ECV-only model and a fusion model. Models were trained using elastic net-regularized logistic regression with stratified 3-fold cross-validation. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), Brier score, and calibration.</div></div><div><h3>Results</h3><div>Univariate analysis showed that spectral CT-derived ECV was significantly associated with pathological T (pT) stage (OR = 1.07, 95% CI: 1.01–1.13, P = 0.02), with higher ECV values in advanced pT3–T4 tumors. No statistically significant associations were observed with other pathological features (P &gt; 0.05). For pT staging prediction, the fusion model achieved the highest discrimination performance (mean AUC = 0.815, 95% CI: 0.69–0.96) and best calibration (Brier score = 0.225), numerically outperforming the clinical model (AUC = 0.772) and the ECV-only model (AUC = 0.699). Decision curve analysis suggested that the fusion model provided higher net clinical benefit than single-modality approaches.</div></div><div><h3>Conclusion</h3><div> <!-->Spectral CT–derived ECV is associated with invasion depth in colon cancer. A multimodal model integrating ECV with clinical indicators showed promising internal performance for preoperative pT risk estimation, providing proof-of-concept for future validation studies.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112722"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178374","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":"Rotational thrombectomy for endovascular treatment of portomesenteric vein and TIPS thrombosis: Initial single-center experience","authors":"Max Masthoff ,&nbsp;Emily Hoffmann ,&nbsp;Markus Kimmann ,&nbsp;Jörn Arne Meier ,&nbsp;Philipp Schindler ,&nbsp;Gesa Pöhler ,&nbsp;Jonel Trebicka ,&nbsp;Michael Praktiknjo ,&nbsp;Michael Köhler","doi":"10.1016/j.ejrad.2026.112693","DOIUrl":"10.1016/j.ejrad.2026.112693","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the technical feasibility, efficacy, and safety of endovascular rotational thrombectomy (ERT) for treating portomesenteric thrombosis (PMVT) and Transjugular Intrahepatic Portosystemic Shunt thrombosis (TIPS-T) in a real-world clinical setting.</div></div><div><h3>Materials and Methods</h3><div>In this retrospective single-center study, 23 consecutive patients (n; 16 women; median age 60 years, range 27–80) underwent ERT for PMVT and/or TIPS-T between May 2024 and December 2025. Procedural data, technical outcomes, complications, and follow-up were analyzed.</div></div><div><h3>Results</h3><div>A total of 26 procedures (N) were performed. ERT was performed as first-line (N = 18, 69.2%) or second-line (N = 8, 30.8%) endovascular approach. Adjunctive thrombectomy techniques were required in 55.6% of procedures. Here, complete recanalization was achieved in 55.6%, partial in 44.4%, yielding a 100% technical success rate. The portosystemic pressure gradient significantly decreased post-procedure (median 17.0 mmHg (IQR 15.0–25.0) to median 7.0 mmHg (IQR 6.0–10.0), p &lt; 0.0001). No device-related adverse events occurred. One hemolysis event (N = 1/26, 6.25%) was likely related to adjunctive hydrodynamic thrombectomy. The 30-day mortality rate was 0.0% (n = 0); overall all-cause mortality during follow-up (median: 137 days; IQR: 83.5–270 days) was 21.7% (n = 5), mainly in patients with Yerdel class 4 thrombosis or advanced liver cirrhosis.</div></div><div><h3>Conclusion</h3><div>Endovascular rotational thrombectomy demonstrated high technical performance and a favorable safety profile for PMVT and TIPS-T. Effective both as a primary and rescue tool, it may represent a valuable addition to the existing mechanical and pharmacomechanical strategies.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112693"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074484","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":"Association between cognitive status and structural brain changes in Alzheimer’s disease: Clinical implication of lightweight deep learning-aided diagnosis","authors":"Po-Hsuan Hsieh ,&nbsp;Ya-Fang Chen ,&nbsp;Ta-Fu Chen ,&nbsp;Wen-Chau Wu ,&nbsp;for the Alzheimer’s Disease Neuroimaging Initiative","doi":"10.1016/j.ejrad.2026.112678","DOIUrl":"10.1016/j.ejrad.2026.112678","url":null,"abstract":"<div><h3>Background</h3><div>The complex brain changes involved in Alzheimer’s disease (AD) development constitute a high-dimensional nonlinear feature space where deep learning (DL) classification/diagnosis may be advantageous over classical non-learning methods. However, the practicality of DL remains under debate among healthcare professionals, largely because many models are computationally expensive and operate without explicit interpretability. This study aimed to construct a lightweight DL model to disclose the association between cognitive status and structural brain changes in AD.</div></div><div><h3>Methods</h3><div>By using the data obtained from the Alzheimer’s Disease Neuroimaging Initiative database, 418 AD patients and 418 age-matched cognitively normal (CN) subjects were included for DL model construction based on their T1-weighted magnetic resonance images at baseline visit. A lightweight design was achieved by incorporating group convolution, global pooling, and efficient channel attention.</div></div><div><h3>Results</h3><div>The accuracy rate of our model was 90.6 %, competitive with previous models built with up-to-ten times more parameters. The occlusion maps showed that the medial temporal area and thalamus accounted the most for our model’s differentiation between AD and CN, in line with current knowledge of the pathological trajectory. Hierarchical regression further revealed that the logit of the DL model output explained a significant amount of variance in the mini mental state examination score, above and beyond the clinical indices including age, sex, and education duration (<em>R</em>² change = 0.341, <em>F</em>(1, 91) = 57.623, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Lightweight DL can be clinically practicable for AD diagnosis by focusing on pathologically interpretable structural changes and offering image-based assessment of cognitive status.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112678"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009423","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":"Exploring white matter abnormalities in different subtypes of spastic cerebral palsy using fixel-based analysis","authors":"Chih-Chien Tsai ,&nbsp;Chia-Ling Chen ,&nbsp;Chih-Hua Yeh ,&nbsp;Yao-Liang Chen ,&nbsp;Yu-Chun Lin ,&nbsp;Jur-Shan Cheng ,&nbsp;Jiun-Jie Wang","doi":"10.1016/j.ejrad.2025.112636","DOIUrl":"10.1016/j.ejrad.2025.112636","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the white matter integrity in participants with cerebral palsy (CP) and among its different subtypes through diffusion MRI.</div></div><div><h3>Methods</h3><div>34 participants with CP (19 boys, 15 girls; mean age: 13.9 ± 3.6 years) and 27 typically developing (TD) participants (14 boys, 13 girls; mean age: 14.5 ± 3.2 years) were enrolled. Diffusion-weighted and T2-weighted images were obtained. Clinical assessments included Gross Motor Function Classification System, Manual Ability Classification System, and Bimanual Fine Motor Function test. Diffusion-weighted images were analyzed by fixel-based analysis and Tract-based spatial statistics. Lesion map was calculated from the T2-weighted images.</div><div>Differences in fixel-based metrics between CP or its subtype to TD participants, and among different subtypes, were evaluated through connectivity-based fixel enhancement and non-parametric permutation testing. The association of fixel-based metrics with clinical assessment scores was examined through general linear model.</div></div><div><h3>Results</h3><div>White matter damage can be noticed in CP participants, including corpus callosum, corticospinal tract, thalamic radiation, and optic radiation, when compared to TD participants. Fixel-based analysis detected additional regions in genu of corpus callosum. Fixel-based metrics in thalamic radiation and corticospinal tract were related to the severity of the motor impairment. Participants with diplegia had damage in the body of the corpus callosum and optic radiation when compared to those with hemiplegia.</div></div><div><h3>Conclusion</h3><div>Fixel-based<!--> <!-->analysis is sensitive to identify subtle white matter alterations that vary by CP<!--> <!-->subtype. The microstructural and macrostructural integrity of the corticospinal<!--> <!-->tract and thalamic<!--> <!-->radiation could be considered as promising image-based biomarkers to enhance clinical assessment.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112636"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017580","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 dual-elastography and 2D shear wave elastography for assessing steatosis, fibrosis, and inflammation in MASLD","authors":"Guangwen Cheng ,&nbsp;Xueqi Li ,&nbsp;Jing Liang ,&nbsp;Iwaki Akiyama ,&nbsp;Xiaohui Qiao ,&nbsp;Liyun Xue ,&nbsp;Hong Ding","doi":"10.1016/j.ejrad.2026.112673","DOIUrl":"10.1016/j.ejrad.2026.112673","url":null,"abstract":"<div><h3>Background</h3><div>Quantitative ultrasound techniques enable noninvasive assessment of hepatic steatosis, fibrosis, and inflammation in metabolic dysfunction-associated steatotic liver disease (MASLD). This study performed a head-to-head comparison of dual-elastography and 2D shear wave elastography (2D-SWE) for comprehensive histologic evaluation.</div></div><div><h3>Methods</h3><div>A total of 186 biopsy proven MASLD patients were enrolled. Dual-elastography provided attenuation imaging (ATI), fibrosis (F-index), and inflammatory activity (A-index), while 2D-SWE offered attenuation coefficient (ATT), shear wave elasticity (SWE), and shear wave dispersion (SWD). Histologic grades of steatosis (S0–S3), fibrosis (F0–F3), and inflammation (A0–A3) served as the reference standard. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.</div></div><div><h3>Results</h3><div>ATI outperformed ATT for detecting ≥S1 steatosis (AUROC 0.90 vs. 0.81, P = 0.036), while their performance for ≥S2 and ≥S3 was comparable. For significant fibrosis (≥F2), the F-index showed higher accuracy than SWE (AUROC 0.87 vs. 0.80, P = 0.046) with greater sensitivity (73.7%) and balanced specificity (85.3%). SWD demonstrated moderate diagnostic ability for inflammatory activity (AUROC 0.75 for ≥A2; 0.84 for ≥A3), and the A-index achieved AUROC 0.73 for detecting lobular inflammation grade ≥2.</div></div><div><h3>Conclusions</h3><div>ATI and ATT are reliable for assessing steatosis, the F-index provides superior accuracy for significant fibrosis, and SWD and A-index reflect overall and lobular inflammation, respectively. These multiparametric ultrasound techniques enable comprehensive, noninvasive evaluation of key histologic features in MASLD.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112673"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035335","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":"Comparison of central FLAIR hypointensity and central vein sign on FLAIR* in a diagnostic cohort","authors":"Karlo Toljan ,&nbsp;Moein Amin ,&nbsp;Lynn Daboul ,&nbsp;Kunio Nakamura ,&nbsp;Andrew J. Solomon ,&nbsp;Nancy L. Sicotte ,&nbsp;Russell T. Shinohara ,&nbsp;Daniel S. Reich ,&nbsp;Pascal Sati ,&nbsp;Daniel Ontaneda","doi":"10.1016/j.ejrad.2026.112707","DOIUrl":"10.1016/j.ejrad.2026.112707","url":null,"abstract":"<div><h3>Background</h3><div>The central vein sign (CVS) is a neuroimaging biomarker in multiple sclerosis (MS) with high diagnostic specificity. CVS is best detected with high-quality susceptibility-sensitive MRI sequences. For concurrent detection of lesions and veins, FLAIR* was developed as a post-processing method to provide contrast for T2 hyperintense lesions (FLAIR) and paramagnetic hypointense veins (T2*-weighted). Occasionally, CVS-like features have been noted on FLAIR, but the reliability of this finding is unknown.</div></div><div><h3>Objective</h3><div>To compare the central FLAIR hypointensity to FLAIR* CVS.</div></div><div><h3>Methods</h3><div>Scans from the CentrAl Vein Sign in MS (CAVS-MS) pilot study were included for the analysis. A blinded rater assessed all lesions for CVS on 3-tesla post-contrast FLAIR*. A second blinded rater assessed the same lesions for central hypointensity on FLAIR images alone. Counts were compared between methods. The same approach was applied for a subset with available non-contrast FLAIR* lesion ratings.</div></div><div><h3>Results</h3><div>With post-contrast FLAIR* CVS as the standard (n= 92; 1737 lesions), central FLAIR hypointensity demonstrated concordance of 64%, with sensitivity of 34% (95% CI, 30–37%) and specificity of 83% (95% CI, 81–85%). With non-contrast FLAIR* CVS as the standard (n= 38; 768 lesions), FLAIR demonstrated sensitivity of 40% (95% CI, 33–47%) and specificity of 85% (95% CI, 82–88%). Select 6 (≥6 central hypointense lesions) FLAIR was 59% accurate for a diagnosis of MS, with a lower specificity (63% vs. 90%, p= 0.008) in comparison to post-contrast FLAIR*.</div></div><div><h3>Conclusions</h3><div>Assessment of CVS on FLAIR alone is unreliable and requires susceptibility-sensitive sequences to be clinically useful.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112707"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104499","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 description of abdominal complications due to fishbone ingestion","authors":"Aya Ben Zitoun ,&nbsp;Aida Tankoano ,&nbsp;Alolia Aboikoni ,&nbsp;Magaly Zappa ,&nbsp;Lorenzo Garzelli","doi":"10.1016/j.ejrad.2026.112720","DOIUrl":"10.1016/j.ejrad.2026.112720","url":null,"abstract":"<div><div>Purpose: Inadvertent ingestion of fishbone can lead to bowel perforation. Numerous cases reports have been published; therefore, we aimed to describe the localization and type of complication in a dedicated cohort.</div><div>Material and Methods: From 2009 to 2023, we queried our local informatic department (Cayenne Hospital, French Guiana) to search electronic patient records (ICD-10 code T18: Foreign body in alimentary tract) and we reviewed each case to identify abdominal complication caused by fishbone ingestion. Patients with complication occurring above the stomach without a computed tomography available (CT) were excluded. Clinical, biological, imaging and treatment related data were collected. The overall raw incidence was estimated.</div><div>Results: Forty-two patients (mean age: 60 years old ± 15; female 36%) were included for analysis from May 2014 to June 2023. Abdominal pain was present in 41/42 patients (98%) and inflammatory biological syndrome was found in 34/42 patients (81%). On CT, perforation of the bowel wall was seen in 41/42 patients (98%), intra-abdominal collection in 17/42 patients (40%) and pneumoperitoneum in 2/42 patients (5%). The ileum (11/42, 26%) was the most common complication site, followed by the liver (6/42, 14%), and the right colon and stomach (5/42, 11% each). Treatment included surgery for 23/42 patients (55%), antibiotics alone for 14/42 patients (33%), endoscopic removal for 4/42 patients (10%), and percutaneous drainage for 1/42 patient (2%). The estimated incidence was 2.9 per 100,000 person-years.</div><div>Conclusion: We report the largest analysis of bowel perforation secondary to fishbone ingestion, providing an exhaustive spectrum of localization and type.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112720"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178338","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 novel and general spatiotemporal diagnostic model: Intratumoral outflow and peritumoral inflow for the differentiation and stratification of breast tumor","authors":"Zhanao Meng ,&nbsp;Chenyi Zhou ,&nbsp;Hui Xie ,&nbsp;Ting Chen ,&nbsp;Chunhua Wu ,&nbsp;Wenxuan Li ,&nbsp;Wenjie Tang ,&nbsp;Yanling Wang","doi":"10.1016/j.ejrad.2025.112622","DOIUrl":"10.1016/j.ejrad.2025.112622","url":null,"abstract":"<div><h3>Objective</h3><div>A novel Intratumoral Outflow and Peritumoral Inflow (IOPI) model based on spatiotemporal information was developed to quantify differences in blood perfusion and microcirculation. Its performance was compared with conventional indicators, and its clinical application for diagnosing benign and malignant breast tumors, as well as its potential for risk stratification, was validated in a two-center study.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis of 159 patients (80 malignant and 79 benign lesions) undergoing dynamic contrast-enhanced MRI was conducted. Training set was from Center 1, testing set was from Center 2. Conventional kinetic parameters (PE and SER) and interpreted MRI features (ADC and BI-RADS) were extracted. Hemodynamics models (IOPI, IIO, PIO and IPIO) and combined models (ADC + IOPI, BIRADS + IOPI) were constructed by logistic regression. Classification performance was assessed by AUC, sensitivity, specificity and accuracy.</div></div><div><h3>Results</h3><div>In the training cohort, the proposed IOPI model achieved an AUC of 0.911, with specificity of 95.1 %, sensitivity of 82.0 % and accuracy of 89.5 %. In external testing cohort, the AUC was 0.802, significantly outperformed conven tional indicators and others models (<em>p</em> &lt; 0.05). The BIRADS combined IOPI model achieved the highest diagnostic performance in classifying malignancy of breast lesions, with the AUC values of 0.940 and sensitivity of 92.0 % in training cohort. In the testing cohort, the ADC combined IOPI model achieved the highest diagnostic performance with the AUC of 0.878, accuracy of 84.2 % and specificity of 88.9 %. The combined models also showed comparable performance in stratifying invasive grades and predicting Ki-67 expression (exceptional specificity of 90.9 % in ADC combined IOPI).</div></div><div><h3>Conclusion</h3><div>IOPI serves as a valuable tool that highlights the additional potential of spatiotemporal kinetic information for improving breast tumor diagnosis. The combined model which integrates time and spatial concepts, exhibited strong diagnostic performance for improved breast cancer diagnosis and risk stratification.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112622"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074486","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":"Utilizing baseline multiregional MRI radiomics for prediction of tumor deposition and prognosis following neoadjuvant therapy in resectable rectal cancer","authors":"Bingjie Wu ,&nbsp;Lingwei Wang ,&nbsp;Yang Wang ,&nbsp;Fan Liu ,&nbsp;Xujie Gao ,&nbsp;Wenpeng Wang ,&nbsp;Bohan Xiao ,&nbsp;Ying Liu","doi":"10.1016/j.ejrad.2026.112676","DOIUrl":"10.1016/j.ejrad.2026.112676","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate whether pre-treatment T2WI-based multiregional radiomics can predict the probability of post-treatment tumor deposit (TD) and prognostic outcomes in patients with resectable rectal cancer after neoadjuvant therapy.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 159 patients with pathologically confirmed rectal cancer who received neoadjuvant therapy and then underwent surgery from March 2013 to March 2024. Radiomics features were extracted from the intratumoral region, a 3-mm-region straddling the tumor margin, and peritumoral 3 mm region on pre-treatment T2WI images. Clinical-radiomics nomogram was developed based on the most predictive radiomics signatures and clinical risk factors. Prognostic model for 5-year recurrence-free survival (RFS) was constructed by Cox regression analysis.</div></div><div><h3>Results</h3><div>The nomogram integrating clinical risk factors (Tumor distance to anal margin and MRI-reported extramural vascular invasion (EMVI)) with an intra-straddle 3 mm radiomics signature score (radscore) demonstrated optimal predictive performance with area under the receiver operating characteristic curve (AUC) of 0.953 (95% CI: 0.877–0.988), 0.810 (95% CI: 0.629–0.928) and 0.952 (95% CI: 0.857–0.992) in the training cohort, validation cohort and test cohort, respectively. The prognostic model constructed by intra-straddle 3 mm radscore (hazard ratio [HR] = 3.60, 95% CI: 1.59–8.16) and MRI-reported EMVI (HR = 6.07, 95% CI: 2.51–14.63) showed good performance for predicting 5‑year RFS with AUC of 0.827 (95% CI: 0.772–0.890) in the entire cohort.</div></div><div><h3>Conclusion</h3><div>The nomogram, incorporating pre-treatment MRI-based intra-straddle 3 mm radscore along with clinical risk factors, facilitates noninvasive assessment of the likelihood of TD positivity following neoadjuvant therapy, and has the power to predict 5-year RFS in patients with resectable rectal cancer.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112676"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074619","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}