European Journal of Radiology最新文献

{"title":"Hyperintense lesions suspect for acute cerebral microbleeds on ultra-high field T1 weighted 7 Tesla MRI in patients with cerebral amyloid angiopathy","authors":"O.F. de Bruin ,&nbsp;M.R. Schipper ,&nbsp;E.A. Koemans ,&nbsp;T.W. van Harten ,&nbsp;I. Rasing ,&nbsp;K. Kaushik ,&nbsp;L. Hirschler ,&nbsp;R. van Dort ,&nbsp;R.G.J. van der Zwet ,&nbsp;M.J.P. van Osch ,&nbsp;M.A.A. van Walderveen ,&nbsp;M.J.H. Wermer ,&nbsp;S. Voigt","doi":"10.1016/j.ejrad.2025.112428","DOIUrl":"10.1016/j.ejrad.2025.112428","url":null,"abstract":"<div><h3>Objective</h3><div>The aims of this study are to describe T1 hyperintense lesions on 7 T MRI in patients with hereditary Dutch-type (D-CAA) and sporadic cerebral amyloid angiopathy (sCAA) and their detection rate on 7 T and 3 T MRI.</div></div><div><h3>Methods</h3><div>We included D-CAA mutation carriers and patients with sCAA who participated between 2018 and 2023 in our natural history studies in D-CAA (AURORA) and sCAA (FOCAS). We assessed T1-weighted 7 T MRI for small (&lt;10 mm) hyperintense lesions and T1-weighted 3 T MRI for corresponding lesions. We classified them as possible acute (1–3 days after onset) CMBs when exhibiting characteristics of CMBs on the T2*-weighted gradient echo sequence (GRE) 7 T and/or susceptibility weighted imaging (SWI) 3 T MRI. Follow-up T1-weighted 7 T and 3 T MRI and T2*-weighted GRE 7 T and/or SWI 3 T MRI were assessed to confirm the hemorrhagic origin of 7 T T1 hyperintense lesions found at baseline.</div></div><div><h3>Results</h3><div>Baseline 7 T MRI and 3 T MRI was available in 112 participants. We found 16 T1 hyperintense lesions on 7 T in 12 participants (11 %). Of the 16 lesions, 10 (63 %) were subsequently identified on T1-weighted 3 T MRI. In patients with available follow-up imaging, 11 out of 15 lesions (73 %) were classified as acute CMBs based on 7 T and/or 3 T follow-up imaging.</div></div><div><h3>Conclusion</h3><div>7 T T1 hyperintense lesions were identified in approximately one in ten patients in our cohort. Acute CMBs were more often identified on 7 T MRI in comparison to 3 T MRI. This highlights the additional value of ultra-high field MRI in the assessment of CAA-related MRI markers<strong>.</strong></div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112428"},"PeriodicalIF":3.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148360","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":"Radiomic biomarkers for the recurrence prediction of hepatocellular carcinoma treated with postoperative TACE: A multicenter retrospective study","authors":"Lingling Zhou ,&nbsp;Liyun Zheng ,&nbsp;Kun Zhang ,&nbsp;Xinyu Guo ,&nbsp;Chaoming Huang ,&nbsp;Lingyi Zhu ,&nbsp;Shuang Liu ,&nbsp;Zhongwei Zhao ,&nbsp;Jianfei Tu ,&nbsp;Shiman Zhu ,&nbsp;Yanci Zhao ,&nbsp;Feng Chen ,&nbsp;Minjiang Chen ,&nbsp;Min Xu ,&nbsp;Weiqian Chen ,&nbsp;Wenbo Xiao ,&nbsp;Jiansong Ji","doi":"10.1016/j.ejrad.2025.112442","DOIUrl":"10.1016/j.ejrad.2025.112442","url":null,"abstract":"<div><h3>Purpose</h3><div>The study aims to evaluate the value of radiomics signature in predicting the recurrence risk in hepatocellular carcinoma (HCC) patients treated with postoperative adjuvant transarterial chemoembolization (PA-TACE).</div></div><div><h3>Patients and Methods</h3><div>In this retrospective study, 204 HCC patients treated with PA-TACE between November 2014 and May 2023 from three centers were included and stratified into the training (n = 91), the internal(n = 21) and external validation cohorts (n = 92). Based on multi-parametric magnetic resonance imaging (mpMRI), radiomics features were extracted and radiomics models were established by using 101 combinations of 10 machine learning algorithms. The most valuable radiomics model with the highest average C-index was identified and subsequently used to calculate the Rad-score. All patients were then stratified into low- and high-risk radiomics signature (LRS and HRS) groups based on the median value of the Rad-score and subgroup analyses were performed to explore the potential association between recurrence risk and benefit from PA-TACE. Furthermore, a combined nomogram was subsequently developed by integrating the Rad-score with relevant clinicopathological variables.</div></div><div><h3>Results</h3><div>The radiomics model developed by CoxBoost + survival-SVM method was regarded as the optimal model with C-index (95 % CI) of 0.828 (0.777–0.879), 0.796 (0.622–0.933), and 0.718 (0.647–0.781) in three cohorts. The RFS of the HRS group was superior to that of the LRS group in the training(52.4 months v.s. 27.5 months; P &lt; 0.0001) and external validation cohorts(45.8 months v.s. 43.0 months; P &lt; 0.0001). The combined nomogram presented better predictive performance in the training set (0.848, 0.793–0.903), internal validation (0.825, 0.689–0.962) and external validation (0.722, 0.657–0.787). The decision curve analysis indicated that the combined nomogram had relatively higher clinical net benefits.</div></div><div><h3>Conclusion</h3><div>mpMRI-based radiomics features are associated with recurrence risk in HCC patients receiving PA-TACE and may serve as the potential imaging biomarkers for stratifying candidates who are more likely benefit from PA-TACE.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112442"},"PeriodicalIF":3.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206092","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":"Development and validation of multiparametric models incorporating 18F-FDG PET/CT dissemination characteristic for predicting outcomes of small cell lung cancer","authors":"Yang Liu ,&nbsp;Xin Zhou ,&nbsp;Xiangxi Meng,&nbsp;Xiangxing Kong,&nbsp;Changzhi Du,&nbsp;Yan Cui,&nbsp;Yitong Liu,&nbsp;Jinyu Zhu,&nbsp;Yuan Yao,&nbsp;Chunxu Cao,&nbsp;Min Wang,&nbsp;Nan Li","doi":"10.1016/j.ejrad.2025.112425","DOIUrl":"10.1016/j.ejrad.2025.112425","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the prognostic value of the tumor dissemination characteristic, metabolic parameters from baseline ¹⁸F-FDG PET/CT, clinical indicators, and pathological indicators in small cell lung cancer (SCLC), and to construct prognostic models.</div></div><div><h3>Materials &amp; Methods</h3><div>SCLC patients who underwent baseline ¹⁸F-FDG PET/CT were retrospectively analyzed and randomly divided into training and validation cohorts (7:3). The tumor dissemination characteristic, metabolic characteristics, morphological features, and clinical and pathological indicators were collected. Cox regression analysis was employed to identify independent prognostic factors. Prognostic models and corresponding nomograms were developed and evaluated using receiver operating characteristic (ROC) curves.</div></div><div><h3>Results</h3><div>303 patients with SCLC were enrolled (including 204 males and 99 females; median age: 62 years, interquartile range: 56–67 years). Multivariate Cox regression analysis identified age, stage, neuron-specific enolase (NSE), and the standardized distance between the two farthest lesions (SD_max) as independent prognostic factors for progression-free survival (PFS). Area under curve (AUC) values for predicting 6-month, 12-month, and 24-month PFS were 0.790, 0.778, and 0.750 in the training cohort, and 0.778, 0.771, and 0.744 in the validation cohort. For overall survival (OS), age, stage, NSE, whole-body metabolic tumor volume (MTV_wb), and SD_max were independent prognostic factors. AUC values for predicting 1-year, 2-year, and 3-year OS were 0.861, 0.830, and 0.799 in the training cohort, and 0.834, 0.801, and 0.787 in the validation cohort.</div></div><div><h3>Conclusion</h3><div>The tumor dissemination characteristic from baseline ¹⁸F-FDG PET/CT is a novel independent prognostic factor in SCLC. Additionally, the models incorporating the dissemination characteristic, metabolic parameter, and clinical indicators demonstrate excellent predictive capabilities in SCLC.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112425"},"PeriodicalIF":3.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119518","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":"Human‒machine interaction based on real-time explainable deep learning for higher accurate grading of carotid stenosis from transverse B-mode scan videos","authors":"Jia Liu ,&nbsp;Xinrui Zhou ,&nbsp;Hui Lin ,&nbsp;Yuhao Huang ,&nbsp;Jian Zheng ,&nbsp;Erjiao Xu ,&nbsp;Hongye Li ,&nbsp;Min Zhong ,&nbsp;Xin Yang ,&nbsp;Xindi Hu ,&nbsp;Xue Lu ,&nbsp;Dong Ni ,&nbsp;Jie Ren","doi":"10.1016/j.ejrad.2025.112441","DOIUrl":"10.1016/j.ejrad.2025.112441","url":null,"abstract":"<div><h3>Objectives</h3><div>We aim to develop an explainable deep learning (DL) model to assist radiologists in carotid stenosis classification by providing understandable or explainable output.</div></div><div><h3>Materials and methods</h3><div>This prospective study included patients suspected ≥50 % carotid stenosis from three hospitals between February 2022 and October 2022. The DL model CaroNet-Dynamic 2.0 was trained based on carotid transverse ultrasound (US) videos. Model performance was evaluated using expert (with 15 years of experience in carotid US evaluation) diagnoses as the reference standard. Finally, CaroNet-Dynamic 2.0 was integrated into a user-friendly web graphical user interface to support artificial intelligence (AI) explainability and human supervision. The human‒machine interaction strategy was evaluated with five senior and five junior radiologists. Area under the receiver operating characteristic curve (AUROC) were calculated.</div></div><div><h3>Results</h3><div>A total of 311 patients (mean age ± standard deviation, 71.3 years ± 8.3; 247 men) were included. CaroNet-Dynamic 2.0 showed robust performance in carotid stenosis classification and approached that of senior radiologists (<em>P</em> &gt; 0.05 for all comparisons). Junior and senior radiologists initially disagreed with AI on 47 and 37 plaques, respectively. Using the human‒machine interaction, they adopted AI diagnoses for 38 and 28 plaques, overruling 9 each. The AUROCs of human‒machine interaction achieved 0.868–0.896 and 0.875–0.904 for junior and senior radiologists respectively, substantially outperforming junior radiologists alone (<em>P</em> &lt; 0.05 for all comparisons).</div></div><div><h3>Conclusion</h3><div>CaroNet-Dynamic 2.0 attempted to explain to radiologists the information the DL model used to make decisions and proactively involved them in the decision loop to further improve their performance.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112441"},"PeriodicalIF":3.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119517","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":"Physical examination before diagnostic ultrasonography: Alive and kicking or a relic of the past?","authors":"Andreea M. Pavel ,&nbsp;Yuki Arita ,&nbsp;Ömer Kasalak ,&nbsp;Thomas C. Kwee","doi":"10.1016/j.ejrad.2025.112431","DOIUrl":"10.1016/j.ejrad.2025.112431","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate how often physicians perform physical examination prior to referring patients for diagnostic ultrasonography (US), and whether its omission affects clinical reasoning quality or diagnostic yield.</div></div><div><h3>Methods</h3><div>In this prospective study, patients undergoing diagnostic US at a tertiary care center (December 2024-April 2025) were asked whether their referring physician had performed a physical examination. Patient demographics, referring specialty, healthcare professional, US indication, and anatomical region were recorded. Clinical reasoning quality (0–100%) was defined as the alignment between clinically suspected and US findings. US outcomes were classified as positive, negative, or indeterminate. Associations with omission of physical examination were analyzed using multivariate regression.</div></div><div><h3>Results</h3><div>Of 321 eligible patients, 302 were included (median age: 56 years; 48 % male). Physical examination was omitted in 168 cases (55.6 %). Omission was less likely in referrals from surgical specialties (odds ratio (OR) of 0.490, <em>P</em> = 0.032), family medicine (OR of 0.253, <em>P</em> = 0.016), and residents (OR 0.303, <em>P</em> &lt; 0.001), as well as in cases of new complaints (OR of 0.226, <em>P</em> &lt; 0.001) and head and neck US (OR of 0.261, <em>P</em> &lt; 0.001). Omission was marginally associated with lower clinical reasoning scores on univariate analysis (<em>P</em> = 0.050), but not after adjustment. Of all exams, 51 % were positive. Omission of physical examination showed a trend toward lower diagnostic yield (<em>P</em> = 0.059), but was not significant after adjustment.</div></div><div><h3>Conclusion</h3><div>Physical examination was frequently omitted before US referral. While initially linked to reduced clinical reasoning and diagnostic yield, these associations did not remain significant after adjustment, suggesting no clear impact on diagnostic outcomes.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112431"},"PeriodicalIF":3.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110058","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":"Surgically resected cystic lesions in the sellar-suprasellar region: Value of qualitative, semiquantitative, and quantitative imaging variables in the diagnostic work-up","authors":"R. Calandrelli ,&nbsp;A. Grimaldi ,&nbsp;S. Chiloiro ,&nbsp;S.A. De Sanctis ,&nbsp;A.G. Castelli ,&nbsp;P. Mattogno ,&nbsp;M. Gessi ,&nbsp;F. Doglietto","doi":"10.1016/j.ejrad.2025.112429","DOIUrl":"10.1016/j.ejrad.2025.112429","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify reliable imaging variables for differentiating cystic lesions by integrating qualitative, semiquantitative, and quantitative features.</div></div><div><h3>Materials &amp; Methods</h3><div>A retrospective analysis of 100 histologically confirmed cystic sellar-suprasellar lesions was performed using preoperative CT and MRI. Qualitative (topography, type, shape, intracystic components, edema, calcifications), semiquantitative (wall thickness), and quantitative (intracystic signal intensity from T2- and pre-contrast T1-weighted MRI) features were assessed. Multivariable models were developed by combining the most reliable imaging variables specific to each cystic lesion category.</div></div><div><h3>Results</h3><div>Lesions were categorized as Rathke’s cysts (RCC, 39), papillary (PCP, 14) and adamantinomatous craniopharyngiomas (ACP, 21), pituitary neuroendocrine tumors (PitNets, 18), arachnoid cysts (AC, 8). No clinical presentation was pathognomonic. Multivariable models showed high diagnostic accuracy: 82 % for RCC identifying wall thickness &lt; 1 mm (OR 7.160, p = 0.009) and low T2_min (OR 1.043, p = 0.006) as key predictors; 89 % for PCP despite the absence of distinct independent predictors; 89 % for ACP with parietal calcifications identified as the strongest predictor (OR 0.043, p &lt; 0.001); 90 % for PitNets identifying wall thickness &gt; 2 mm as the strongest predictor (OR 0.52, p &lt; 0.001); and 97 % for AC identifying wall thickness &lt; 1 mm (OR 10.983, p = 0.019) and high T2_min (OR 0.947, p = 0.039) as key predictors.</div></div><div><h3>Conclusion</h3><div>No single variable was sufficient for diagnosis but integrating specific and sensitive imaging features improved cystic lesion differentiation, aiding accurate diagnosis and management.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112429"},"PeriodicalIF":3.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097680","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":"Detection of adrenal gland lesions on CT: Development and external validation of a deep-learning-based model","authors":"Christian H. Krag ,&nbsp;Weronika Olech ,&nbsp;Michael B. Andersen ,&nbsp;Oliver Taubmann ,&nbsp;Felix C. Müller","doi":"10.1016/j.ejrad.2025.112430","DOIUrl":"10.1016/j.ejrad.2025.112430","url":null,"abstract":"<div><h3>Objectives</h3><div>We wanted to develop an AI model for the detection of adrenal lesions on CT scans and validate the model on internal and external datasets.</div></div><div><h3>Materials and Methods</h3><div>The model was trained on 647 CT-scans covering the upper abdomen with at least one adrenal lesion. In the internal test dataset 142 consecutive adult patients (median 72 years, 56% female) with adrenal lesions were retrospectively included, while the external dataset included 50 patients with known lung tumors and adrenal lesions. Presence of a lesion was the reference and the prediction score by the model was the index. We evaluated sensitivity and specific at prespecified thresholds and performed ROC-analysis. We also tested for the influence of lesion size, sex, age, scanner type and scan protocol on accuracy using Fisher’s exact test and did a false positive / negative analysis.</div></div><div><h3>Results</h3><div>The model had a sensitivity and specificity in the internal test cohort of 91% (86%-95%) and 92% (86%-97%) and 95% (85%-99%) and 94% (81%-99%) in the external cohort. AUROC ranged between 0.89 and 1.0. There was a significant (<em>p</em>&lt;0.001) lower accuracy in lesions below 1cm and above 4cm. False positive findings were significantly more often on the left (<em>p</em>=0.027) and false negative findings significantly more often on the right (<em>p</em>=0.035). Sex, age, scanner type and scan protocol did not significantly affect accuracy.</div></div><div><h3>Conclusion</h3><div>We developed a model for the detection of adrenal lesions on CT scans covering the upper abdomen. The model achieved a high sensitivity and specificity in an internal and an external validation dataset.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112430"},"PeriodicalIF":3.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148366","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":"Measuring the impact of using 3D helical scout scans on overscan and radiation exposure","authors":"Alice Gutowski ,&nbsp;Dana Jackson ,&nbsp;Daniel Carrion ,&nbsp;Mohamed Khaldoun Badawy","doi":"10.1016/j.ejrad.2025.112424","DOIUrl":"10.1016/j.ejrad.2025.112424","url":null,"abstract":"<div><h3>Objectives</h3><div>Scout scans in CT imaging guide scan range selection but are limited by restricted exposure angles and poor anatomical visibility, potentially increasing patient dose or missing vital anatomy. Low-dose 3D helical scout scans offer improved anatomical detail for range determination, yet their impact on overscan and radiation dose remains underexplored. This study investigates differences in overscan and effective dose between 2D and 3D helical scout scans to determine statistical significance.</div></div><div><h3>Methods</h3><div>This retrospective audit was conducted at a centre with two CT scanners from the same manufacturer—one supporting 3D helical scout scans, the other limited to 2D scouts. Overscan was measured for CT Abdomen Pelvis and CT Calcium Score examinations. Dose metrics (DLP and CTDI_vol) were extracted from Radiation Structured Dose Reports, and differences in effective dose were calculated using k-factors.</div></div><div><h3>Results</h3><div>No statistically significant difference in overscan was found for CT Calcium Score examinations (n = 214), suggesting 2D scouts are sufficient for planning these scans. In contrast, CT Abdomen Pelvis examinations (n = 118) showed a significant 9.2 mm reduction in total overscan when using the 3D helical scout, corresponding to a dose reduction of 0.2 mSv.</div></div><div><h3>Conclusions</h3><div>3D helical scout scans do not significantly reduce overscan for CT Calcium Score examinations but do significantly reduce overscan and overall exam time for CT Abdomen Pelvis examinations. Their use in other examinations and impact on workflow—beyond the limited measurement of irradiation time—should be explored further, including effects on planning, positioning, and reporting times.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112424"},"PeriodicalIF":3.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091634","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":"Periportal halo on early postoperative CT predicts biliary complications following liver transplantation","authors":"Hadrien Lasolle ,&nbsp;François Faitot ,&nbsp;Sébastien Molière","doi":"10.1016/j.ejrad.2025.112426","DOIUrl":"10.1016/j.ejrad.2025.112426","url":null,"abstract":"<div><h3>Background</h3><div>Biliary complications remain the leading non-vascular cause of morbidity, re-intervention and graft loss after liver transplantation (LT). Previous series have suggested that a “periportal halo” (PPH) on early post-operative CT might herald later graft dysfunction, but its prognostic value has never been quantified in a contemporary cohort.</div></div><div><h3>Purpose</h3><div>To determine whether the presence of a severe PPH on the routine early post-transplant CT independently predicts subsequent biliary complications and to explore its potential use for risk-adapted follow-up.</div></div><div><h3>Materials and methods</h3><div>In this retrospective study (institutional review-board waiver, January 2018–December 2019), 133 of 160 consecutive adult LT recipients who underwent contrast-enhanced abdominal CT within 30 days of transplantation were analysed. PPH was graded visually on a four-point scale by two blinded radiologists; inter-observer agreement was assessed with Cohen’s κ. Biliary complications were defined a priori as imaging-confirmed strictures, leaks or bilomas accompanied by biochemical cholestasis and/or requiring endoscopic, percutaneous or surgical treatment. Logistic regression identified variables independently associated with (i) any biliary complication and (ii) severe arterial or biliary events requiring Clavien-Dindo grade ≥ III intervention.</div></div><div><h3>Results</h3><div>Median interval from LT to CT was 10 days (IQR 5–15). Severe PPH was present in 59/133 patients (44 %); inter-observer agreement was excellent (κ = 0.91). Thirty-two patients (24 %) developed biliary complications during a median follow-up of 14 months (IQR 9–21). In univariate analysis, severe PPH (p = 0.006) and portal-vein stenosis (p = 0.050) were associated with biliary complications. After adjustment for age, MELD score, cold-ischemia time and CT indication, severe PPH remained an independent predictor (adjusted odds ratio [aOR] = 3.51; 95 % CI 1.41–8.76; p = 0.007). Severe arterial or biliary events (Clavien ≥ III, n = 32) were independently predicted by severe PPH as well (aOR = 5.82; 95 % CI 1.70–20.0; p = 0.005), whereas hepatic-artery or portal-anastomotic stenoses, ascites and progression of PPH between serial scans were not significant.</div></div><div><h3>Conclusion</h3><div>A severe periportal halo on the first post-operative CT—obtained a median of 10 days after liver transplantation—is a simple, reproducible imaging biomarker that triples the risk of any biliary complication and sextuples the risk of severe Clavien ≥ III arterial or biliary events. Incorporating PPH grading into routine reporting can identify a high-risk subgroup that may benefit from intensified biochemical monitoring, early MRCP and low-threshold therapeutic ERCP, thereby aligning surveillance intensity with objective early-imaging risk.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112426"},"PeriodicalIF":3.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110059","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 diffusion-weighted imaging datasets for the assessment of disease activity in lymphoma patients","authors":"Jennifer Haferkamp ,&nbsp;Michal-Kamil Chodyla ,&nbsp;Aydin Demircioglu ,&nbsp;Kim M. Pabst ,&nbsp;Kai Jannusch ,&nbsp;Christine Hanoun ,&nbsp;Lale Umutlu ,&nbsp;Bastian von Tresckow ,&nbsp;Benedikt M. Schaarschmidt ,&nbsp;Johannes M. Ludwig ,&nbsp;Johannes Grueneisen ,&nbsp;Aleksandar Milosevic","doi":"10.1016/j.ejrad.2025.112423","DOIUrl":"10.1016/j.ejrad.2025.112423","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the clinical applicability of Diffusion Weighted Imaging (DWI) datasets as a radiation-free alternative to 18F-FDG PET for the evaluation of the vitality of lymphoma lesions.</div></div><div><h3>Material and Methods</h3><div>A total of 181 patients (mean age: 30.9 ± 19.1 years) with confirmed lymphoma underwent 258 whole-body 18F-FDG PET/MR examinations for primary staging (n = 98), as interim scan during treatment (n = 67), as a follow-up examination (n = 49) or in case of suspected recurrence (n = 44). In each examination, the metabolic activity using standardized uptake values (SUVs) of lymphoma manifestations was measured and disease activity was determined according to the Deauville five-point-scale. In addition, DWI-derived ADC-values as well as the size and volume of the lesions were determined. Correlations between the different quantitative parameters were assessed using Spearman‘s rank test to evaluate the applicability of DWI-data for the discrimination between vital and non-vital lymphoma lesions.</div></div><div><h3>Results</h3><div>A total of 745 lymphoma manifestations were analyzed, comprising 622 nodal and 123 extranodal lesions. Spearman’s rank correlation revealed a strong/good inverse correlation between the ADCmean (r = 0.83) or ADCmin (0.69) and the SUVs, whereas for the size (r = 0.41) and volume (r = 0.52) a poor/moderate association was found. Furthermore, lymphoma lesions with a Deauville score of 1–3 had significantly higher ADCmean and ADCmin values than lesions with a score of 4–5. ROC-Analysis revealed an area under the curve of 0.95 (ADCmean) or 0.91 (ADCmin) to discriminate lymphoma manifestations with a Deauville-score of 1–3 from lesions with a score of 4 or 5.</div></div><div><h3>Conclusion</h3><div>The present study demonstrates a strong association between metabolic activity and the cellularity of lymphomas. Furthermore, our results reveal a good performance of DWI-derived ADC values for the differentiation between vital and avital lymphoma lesions. Therefore, DWI-sequences should be considered as a promising radiation-free alternative to FDG-PET, especially for the assessment of indolent lymphoma subtypes with variable FDG-avidity.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112423"},"PeriodicalIF":3.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091690","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}