European Journal of Radiology最新文献

{"title":"Enhancement slope of ultrafast dynamic contrast-enhanced MRI: a promising biomarker for assessing Crohn’s disease activity","authors":"Lei Cai ,&nbsp;Xiaoyu Tong ,&nbsp;Jingyi Ju ,&nbsp;Zhaoyang Li ,&nbsp;Deying Wen ,&nbsp;Shuang Liu ,&nbsp;Huilou Liang ,&nbsp;Yufang Wang ,&nbsp;Jiayu Sun","doi":"10.1016/j.ejrad.2026.112687","DOIUrl":"10.1016/j.ejrad.2026.112687","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>To investigate the diagnostic value of the enhancement slope in an 18-second ultrafast dynamic contrast-enhanced MRI (DCE-MRI) using differential subsampling with Cartesian ordering (DISCO) in quantifying Crohn’s Disease (CD) activity.</div></div><div><h3>Materials and Methods</h3><div>In a prospective cohort, 41CD patients (141 diseased segments) underwent endoscopy and 3.0 T magnetic resonance enterography (MRE). The DISCO sequence was employed for ultrafast DCE scanning. Using endoscopic results as the gold standard, the slope of the dynamic enhancement curve (K) and the magnetic resonance index of activity (MaRIA) were calculated. The correlations between the K value, MaRIA, relative contrast enhancement (RCE), and simple endoscopic activity score for Crohn’s disease (SES-CD) were analyzed. Diagnostic performance for categorizing CD activity (remission, mild, moderate–severe) was assessed by receiver operating characteristic (ROC) curve. To optimize the MaRIA for CD activity assessment, a modified MaRIA index was constructed by substituting the RCE in the original MaRIA with the K value. The diagnostic efficacy of this modified MaRIA was further validated, and its performance was compared with the original MaRIA to verify its clinical utility in distinguishing different CD activity states.</div></div><div><h3>Results</h3><div>The K showed positive correlation with the SES-CD score (r = 0.77, P &lt; 0.001) and the MaRIA score (r = 0.70, P &lt; 0.001), while the correlation between RCE and the SES-CD score was relatively weak (r = 0.54, P &lt; 0.001). For diagnosing moderate-to-severe CD, the K showed an AUC of 0.916 (95% CI: 0.869, 0.950); when using the clinically relevant cutoff of 22.64, it yielded a sensitivity of 87.56% and a specificity of 83.44%. Notably, there was no significant difference in diagnostic performance between K and MaRIA. However, the AUC for diagnosing remission and mild was 0.609 (95% CI: 0.512, 0.701) and 0.889 (95% CI: 0.829, 0.934), respectively, slightly lower than that of MaRIA. The modified-MaRIA score demonstrated high diagnostic efficacy in differentiating remission-phase, mild, and moderate-to-severe CD, with AUC values of 0.947 (95% CI: 0.902, 0.970), 0.964 (95% CI: 0.922, 0.987), and 0.981 (95% CI: 0.936, 0.998), respectively. Additionally, its sensitivity and specificity both exceed 85%.</div></div><div><h3>Conclusion</h3><div>The 18-second ultrafast DCE-MRI enhancement slope streamlines workflow while serving as a robust noninvasive biomarker for CD activity. This methodology exhibits strong diagnostic efficacy in distinguishing mild and moderate-to-severe Crohn’s disease. Furthermore, incorporating K into MaRIA enhances the detection of remission-phase CD.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112687"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074485","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":"Quantification of bone microarchitecture and strength with photon-counting detector CT at different radiation doses: an ex-vivo and in-vivo comparison with HR-pQCT","authors":"Melissa S.A.M. Bevers ,&nbsp;Sofia Spinthaki ,&nbsp;Joeri Kok ,&nbsp;Joop P. van den Bergh ,&nbsp;Edwin H.G. Oei ,&nbsp;Bert van Rietbergen ,&nbsp;Ronald Booij","doi":"10.1016/j.ejrad.2025.112630","DOIUrl":"10.1016/j.ejrad.2025.112630","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare trabecular microarchitecture measurements at the distal radius and tibia from photon-counting detector CT (PCD-CT) at varying radiation doses with high-resolution peripheral quantitative CT (HR-pQCT).</div></div><div><h3>Methods</h3><div>Two intact wrist and two intact ankle specimens from an 88-year-old man were scanned with PCD-CT at radiation doses of 2.5, 5, 10, and 20 mGy and with HR-pQCT. Additionally, clinical <em>in-vivo</em> HR-pQCT and PCD-CT scans at the radius and tibia were acquired of a 40-year-old woman with osteoporosis. After bone segmentation, the segmented PCD-CT and HR-pQCT scans were three-dimensionally registered. Cubic volumes (edge length: <em>ex-vivo</em> 6 mm, <em>in-vivo</em> 5 mm) were defined at corresponding locations in the PCD-CT and HR-pQCT scans based on the three-dimensional registration. For each cube, trabecular volume fraction (Tb.BV/TV), thickness (Tb.Th), number (Tb.N), separation (Tb.Sp), and heterogeneity (Tb.1/N.SD) were quantified and compared between corresponding PCD-CT and HR-pQCT cubes.</div></div><div><h3>Results</h3><div><em>Ex-vivo</em>, linear correlation coefficients (<em>R²</em>) between PCD-CT and HR-pQCT were 0.85–0.97 at 2.5 mGy and remained stable with increasing radiation dose for all parameters except Tb.1/N.SD. For Tb.1/N.SD, <em>R</em>^<em>2</em> increased between 2.5 and 5 mGy and remained stable at higher doses. At each radiation dose, Tb.BV/TV, Tb.N, and Tb.Th values were higher and Tb.Sp and Tb.1/N.SD lower on PCD-CT than on HR-pQCT. <em>In-vivo</em>, <em>R²</em> was 0.89–0.95 (radius) and 0.82–0.97 (tibia).</div></div><div><h3>Conclusions</h3><div>PCD-CT strongly correlated with HR-pQCT in trabecular microarchitecture measurements at the distal radius and tibia at low, clinically acceptable, radiation dose. Between-modality differences in microarchitecture values are likely related to chosen image analysis settings.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112630"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965752","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":"Navigating the complexities of recall rates in breast cancer screening: Insights from the Irish national breast cancer screening programme","authors":"Nuala A. Healy","doi":"10.1016/j.ejrad.2026.112663","DOIUrl":"10.1016/j.ejrad.2026.112663","url":null,"abstract":"","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112663"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975421","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":"Automated 3D body composition analysis on chest CT scans for survival prediction in high-grade extremity soft tissue sarcomas","authors":"Mathis Rombaut ,&nbsp;Nicolas Coquelet ,&nbsp;Roberto Casale ,&nbsp;Ayoub Mokhtari ,&nbsp;Maria Antonietta Bali ,&nbsp;Kevin Brou Boni ,&nbsp;Felix Nensa ,&nbsp;René Hosch ,&nbsp;Katarzyna Borys ,&nbsp;Riccardo De Angelis","doi":"10.1016/j.ejrad.2026.112710","DOIUrl":"10.1016/j.ejrad.2026.112710","url":null,"abstract":"<div><h3>Introduction</h3><div>High-grade soft tissue sarcomas (STShg) of the extremities are rare cancers with a poor prognosis. Accurate staging at initial evaluation is crucial for determining optimal treatment. Current guidelines recommend systematic chest computed tomography (CT) scans during initial assessment. Recent advances in artificial intelligence (AI)-based imaging software now enable automatic, rapid volumetric assessment of body composition from CT scans. Our study aims to evaluate the predictive role of body composition features, obtained using a dedicated AI program, on overall survival (OS) and disease-free survival (DFS), using staging chest CT scans from patients diagnosed with extremity STShg.</div></div><div><h3>Materials and methods</h3><div>We conducted a single-center retrospective study at the Jules Bordet Institute, including patients diagnosed with extremity STShg between January 2010 and January 2023 who underwent CT scans covering the thoracic region. Using dedicated software, we performed automated 3D quantitative analysis of various anatomical compartments, including intramuscular adipose tissue (IMAT), pericardial adipose tissue (PAT), epicardial adipose tissue (EAT), and visceral adipose tissue (VAT). We assessed the association between body composition metrics and OS, DFS, local recurrence-free survival, and metastatic recurrence-free survival.</div></div><div><h3>Results</h3><div>Higher volumes of IMAT and PAT were associated with shorter OS, DFS, and local recurrence-free survival. Increased EAT volume correlated with reduced OS, while higher VAT volume was linked to worse OS and DFS.</div></div><div><h3>Conclusion</h3><div>Our study suggests a potential predictive role of specific body composition features, particularly IMAT, PAT, EAT, and VAT volumes, in the prognosis of extremity STShg.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112710"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112725","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-Based habitat imaging for the prediction of occult lymph node metastasis in resectable pancreatic ductal Adenocarcinoma: Pathological validation via collagen ratio","authors":"Yi Chen ,&nbsp;Wei Liu ,&nbsp;Tiansong Xie ,&nbsp;Meng Gao ,&nbsp;Jing Sun ,&nbsp;Zehua Zhang ,&nbsp;Lei Chen ,&nbsp;Yu Wang ,&nbsp;Jin Xu ,&nbsp;Zhengrong Zhou","doi":"10.1016/j.ejrad.2026.112679","DOIUrl":"10.1016/j.ejrad.2026.112679","url":null,"abstract":"<div><h3>Importance</h3><div>Occult lymph node metastasis (LNM) remains challenging to detect preoperatively in resectable pancreatic ductal adenocarcinoma (PDAC), yet has significant implications for treatment and prognosis.</div></div><div><h3>Objective</h3><div>To evaluate the predictive value of spectral CT–based habitat imaging and CT-diagnosed peripancreatic invasion for occult LNM in resectable PDAC, with pathological validation using collagen ratio.</div></div><div><h3>Methods</h3><div>This retrospective study included 113 patients with resectable PDAC who underwent triple-phase spectral CT before surgery. Occult LNM was defined as pathologically confirmed nodal metastasis without radiologically suspicious lymph nodes; nodes with short-axis diameter ≥10 mm were excluded. Tumors were segmented into subregions based on pancreatic-to-venous phase iodine concentration ratio (PVICR), and subregional volume fractions were quantified. Correlations with collagen ratio were assessed via Spearman analysis. Patients were divided into a training cohort (n = 79; 30 with occult LNM) and a validation cohort (n = 34; 12 with occult LNM). A logistic regression model with backward stepwise selection was developed and evaluated by receiver operating characteristic analysis.</div></div><div><h3>Results</h3><div>Four subregions were identified. Subregion 1, characterized by the lowest PVICR, showed a moderate negative correlation with collagen ratio (r =  − 0.543, <em>p</em> &lt; 0.001). The combined model incorporating the Subregion 1 fraction and CT-diagnosed peripancreatic invasion yielded areas under the curve of 0.836 (95% CI: 0.733–0.921) and 0.820 (95% CI: 0.661–0.955) in the training and validation cohorts, respectively.</div></div><div><h3>Conclusions</h3><div>Subregion 1 fraction and CT-diagnosed peripancreatic invasion enable accurate preoperative prediction of occult LNM in resectable PDAC.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112679"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009445","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":"Synovitis mediates the association between medial meniscal extrusion and subchondral bone denudation in knee osteoarthritis: Data from the FNIH OA biomarkers consortium","authors":"Dongfan Liu ,&nbsp;Yingwei Sun ,&nbsp;Lunhao Bai ,&nbsp;Chunbo Deng","doi":"10.1016/j.ejrad.2026.112669","DOIUrl":"10.1016/j.ejrad.2026.112669","url":null,"abstract":"<div><h3>Background</h3><div>Medial meniscal extrusion (MME) accelerates structural progression in knee osteoarthritis (KOA). While its biomechanical impact has been established, its relationship with subchondral bone denudation and the potential mediating role of synovitis remain unclear.</div></div><div><h3>Purpose</h3><div>This study aimed to investigate the association between MME in the absence of medial meniscal posterior root tears and the size of denuded areas of subchondral bone (dABs), and to evaluate whether synovitis mediates this relationship.</div></div><div><h3>Methods</h3><div>Data from the Foundation for the National Institutes of Health (FNIH) Osteoarthritis Biomarkers Consortium were analyzed. MME and synovitis (effusion-synovitis and Hoffa-synovitis) were assessed semi-quantitatively using the MRI Osteoarthritis Knee Score (MOAKS) system. The size of medial tibiofemoral dABs was quantified at baseline and 24-month follow-up. Linear regression models evaluated cross-sectional and longitudinal associations. Causal mediation analysis was conducted to quantify the proportion of the total effect of MME on dABs mediated by synovitis.</div></div><div><h3>Results</h3><div>A total of 520 participants were included. Cross-sectionally, both baseline MME (β = 2.03,95 % CI: 0.67, 3.38) and synovitis score (β = 0.97,95 % CI: 0.48, 1.46) were significantly associated with central medial femoral (cMF) dABs. Longitudinal analysis revealed significant correlations between MME and both 24-month cMF dABs (β = 3.41,95 % CI: 1.49,5.33) and 24-month medial tibial (MT) dABs (β = 0.98,95 % CI: 0.47,1.87). Furthermore, the 24-month synovitis score showed significant associations with both cMF dABs (β = 2.06,95 % CI: 1.38,2.74) and MT dABs (β = 0.88,95 % CI: 0.55,1.21). Mediation analysis indicated that synovitis mediated 20.1 % (95 % CI: 6.6, 71.1) of the effect of MME on baseline cMF dABs. 24-month synovitis mediated 20.38 % (95 % CI: 6.61, 44.50) of the effect of MME on 24-month cMF dABs and 16.86 % (95 % CI: 2.71, 42.16) of its effect on 24-month MT dABs.</div></div><div><h3>Conclusion</h3><div>MME and dABs showed significant correlations in both cross-sectional and longitudinal studies. Synovitis acted as a mediator between MME and dABs, suggesting that inflammatory pathways may be involved in the pathological mechanisms of MME promoting KOA progression.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112669"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017550","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":"Letter to the Editor regarding “Allergological evaluation of hypersensitivity reactions after administration of contrast agents: What the radiologist needs to know” – The role of polyethylene glycol in contrast-induced hypersensitivity","authors":"Igor Rubinić ,&nbsp;Dominik Strikić ,&nbsp;Marija Kurtov ,&nbsp;Viktorija Erdeljić Turk","doi":"10.1016/j.ejrad.2025.112650","DOIUrl":"10.1016/j.ejrad.2025.112650","url":null,"abstract":"","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112650"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975422","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":"VIPs outperforms established models for predicting post-TIPS prognosis in viral hepatitis-dominant cirrhosis","authors":"Zhongsong Gao ,&nbsp;Kun Zhang ,&nbsp;Bo Li ,&nbsp;Zhaogang Zhang ,&nbsp;Hengtao Zhang ,&nbsp;Xin Zhang ,&nbsp;Bo Feng ,&nbsp;Ruihang Wang ,&nbsp;Wen Shen ,&nbsp;Kefeng Jia","doi":"10.1016/j.ejrad.2026.112672","DOIUrl":"10.1016/j.ejrad.2026.112672","url":null,"abstract":"<div><h3>Background</h3><div>Transjugular intrahepatic portosystemic shunt (TIPS) manages portal hypertension complications in cirrhosis, but predicting post-TIPS outcomes remains challenging, especially in viral hepatitis-dominated populations.</div></div><div><h3>Purpose</h3><div>To systematically evaluate the predictive performance of the novel Viral-Associated Index of Post-TIPS Score (VIPs) for post-TIPS prognosis. We also comprehensively compare it with six established clinical prognostic models and one imaging-based model (the spleen volume-based model, SvBM).</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed 247 cirrhotic patients undergoing TIPS (56.7 % viral hepatitis). Baseline data calculated prognostic scores (VIPs, MELD, MELD-Na, FIPS, Child-Pugh, ALBI, MOTS, and SvBM). The primary endpoint was transplant-free survival (TFS). Discrimination was assessed by the area under the receiver operating characteristic curve (AUROC) at 6, 12, 36, and 60 months post-TIPS. Calibration (Brier score), explanatory power (R²), and decision curve analysis (DCA) were also evaluated.</div></div><div><h3>Results</h3><div>VIPs demonstrated good-to-moderate discrimination for TFS, with AUROCs (95 % CI) of 0.794 (0.689–0.899), 0.753 (0.649–0.858), 0.721 (0.645–0.797), and 0.692 (0.617–0.767) at 6, 12, 36, and 60 months, respectively. This advantage was most pronounced in the viral hepatitis subgroup, with AUROCs ranging from 0.699 (0.603–0.796) to 0.822 (0.715–0.930) across follow-up. VIPs significantly outperformed Child-Pugh, ALBI, FIPS, MOTS and SvBM at all timepoints (all <em>p</em> &lt; 0.05), and surpassed MELD and MELD-Na for long-term predictions (36/60 months, both <em>p</em> &lt; 0.05). It also exhibited the best calibration (lowest Brier scores: 0.076–0.217) and the highest explanatory power (R² = 0.121–0.142). Subgroup analyses further confirmed robust performance in females and patients with variceal bleeding.</div></div><div><h3>Conclusions</h3><div>VIPs demonstrates superior predictive accuracy for post-TIPS survival in a viral hepatitis-dominated cohort and may serve as a preferred prognostic tool to guide individualized decision-making.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112672"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975733","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":"Cortical vein opacification measurement using hounsfield unit values is a predictor for outcome in anterior circulation acute ischemic stroke","authors":"Erling Wang ,&nbsp;Yueyan Bian ,&nbsp;Xiaoxu Yang ,&nbsp;Huihui Xie ,&nbsp;Xiuqin Jia ,&nbsp;Qi Yang","doi":"10.1016/j.ejrad.2026.112671","DOIUrl":"10.1016/j.ejrad.2026.112671","url":null,"abstract":"<div><h3>Objectives</h3><div>In acute ischemic stroke (AIS) patients, the cortical vein opacification on computed tomographic angiography (CTA) imaging is usually asymmetric. We aimed to explore the correlation between CT perfusion parameters and cortical vein opacification evaluated by Hounsfield unit (HU) values, which is more accurately, and compare the predictive ability between them for outcome in AIS.</div></div><div><h3>Methods</h3><div>Patients with AIS obtained within 24 h after onset from June 2023 to January 2024 were reviewed. Opacification of the cortical vein of Labbé, sphenoparietal sinus, and the Trolard vein was measured on CTA imaging using HU. Then HU ratio (rHU) was calculated by dividing the affected side by the controlateral side (rHU = HU-affected/HU-control). The sum of rHU of three cortical veins opacification (CVOR, CVOR = rHU_Labbé+ rHU_{sphenoparietal sinus} + rHU _{Trolard vein}) was calculated. The correlations between CVOR and CT perfusion parameters, hypoperfusion and ischemic core volume, were explored. Outcome was assessed at 90 days using the modified Rankin Scale (mRS), a standardized measure of disability ranging from 0 (no symptoms) to 6 (death). An mRS score of 2 or less is considered as functional outcome.</div></div><div><h3>Results</h3><div>A total of 143 patients (mean age, 67.3 ± 12.5 years; 106 men) were included. We found that CVOR had a strong negative correlation with hypoperfusion volume (<em>r</em> = -0.759, <em>P</em> &lt; 0.001) and had a moderate negative correlation with ischemic core volume (<em>r</em> = -0.517, <em>P</em> &lt; 0.001). Receiver operating characteristic curve analysis revealed CVOR performed better than hypoperfusion volume (area under the curve [AUC], 0.784 vs 0.711; <em>P</em> = 0.008) and ischemic core volume (AUC, 0.784 vs 0.693; <em>P</em> = 0.02) in predicting the favorable 90-day mRS. Multivariable analysis showed CVOR was an independent predictor for poor outcome after adjusting for confounding factors [odds ratio 0.06 (0.02–0.32), p &lt; 0.001].</div></div><div><h3>Conclusion</h3><div>Cortical vein opacification evaluated by HU values, had a strong negative correlation with hypoperfusion volume, and was also a novel independent predictor for clinical outcome.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112671"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028803","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":"Characterising liver lesions from free-text computer tomography reports – A real-world multicentre analysis","authors":"Jianliang Lu ,&nbsp;Keith Wan-Hang Chiu ,&nbsp;Chelsea Chan ,&nbsp;Ho-Ming Cheng ,&nbsp;Jian Zhou ,&nbsp;Justin Christopher NG ,&nbsp;Fanny Fong Yi Tang ,&nbsp;Wai Kuen Kan ,&nbsp;Philip Leung Ho Yu ,&nbsp;Wai-Kay Seto","doi":"10.1016/j.ejrad.2026.112689","DOIUrl":"10.1016/j.ejrad.2026.112689","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluates the performance of a general-purpose (GPT-4) and a medically fine-tuned (Med-LM) large language model (LLM) in classifying liver lesions from unstructured Computed Tomography (CT) reports.</div></div><div><h3>Methods</h3><div>Consecutive CT reports (2014–2020) from five institutions were input into GPT-4 and Med-LM with<!--> <!-->simple (sp)<!--> <!-->and<!--> <!-->optimised (op) prompts. Lesion-<!--> <!-->and<!--> <!-->patient-level performance were benchmarked against LI-RADS scores assigned by two radiologists, and report quality was analysed using a<!--> <!-->5-point Likert scale.</div></div><div><h3>Results</h3><div>A total of 296 CT reports (mean age, 64.6 years ± 11.3 [SD]; 193 men; 654 lesions) were included. Lesion- and patient-level accuracies for LI-RADS scoring ranged from 40.8% (Med-LMsp) to 61.3% (Med-LMop) and from 27.7% (Med-LMsp) to 52.4% (Med-LMop), respectively. When dichotomized into malignant and benign lesions, lesion- and patient-level accuracies rose to 56.1% (GPT-4sp) − 82.3% (Med-LMop) and 71.3% (Med-LMsp) – 86.5% (Med-LMop). Med-LMop demonstrated the highest performance in all analyses and was statistically superior to other models (all <em>p</em> &lt; 0.001). Non-classification rates ranged between 12.7% (Med-LMop) and 40.5% (GPT-4sp), particularly for benign lesions. Kappa values were weak to moderate between the two reviewers in different aspects of report quality (0.471–0.766), and Likert scores for lesion information differed significantly between correctly and incorrectly classified lesions (all <em>p</em> ≤ 0.04). Repeatability varied widely from 12.7% (Med-LMop) to 39.0% (GPT-4sp).</div></div><div><h3>Conclusions</h3><div>Med-LM outperforms GPT-4 in classifying liver lesions from unstructured CT reports with both models better at detecting malignancy than full LI-RADS classification. However, high misclassification rates and inconsistent repeatability hinder their clinical use.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112689"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035637","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}