European Journal of Radiology最新文献

{"title":"Rapid MR examination with deep learning reconstruction improves diagnosis of complicated acute appendicitis","authors":"Jing-Juan Liu ,&nbsp;Chen Lin ,&nbsp;Wei Liu ,&nbsp;Liang Zhu ,&nbsp;Chen-Xue Ma ,&nbsp;Xuan Wang ,&nbsp;Jia Xu ,&nbsp;Yi-Tong Lu ,&nbsp;Yi-Fei Zhang ,&nbsp;Bo Jiang ,&nbsp;Wei-Bin Wang ,&nbsp;Feng Feng","doi":"10.1016/j.ejrad.2025.112554","DOIUrl":"10.1016/j.ejrad.2025.112554","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the performance of a non-contrast rapid magnetic resonance imaging (MRI) protocol with deep learning reconstruction (DLR) for identifying complicated appendicitis in patients with acute appendicitis, compared to conventional MRI without DLR (non-DLR) and non-contrast computed tomography (NC-CT).</div></div><div><h3>Methods</h3><div>Sixty-two eligible patients were enrolled, of which 55 had a final diagnosis of acute appendicitis and were included for further analysis of complications. Among them, 51 underwent both NC-CT and MRI, while 4 pregnant patients underwent MRI only. The MRI protocol included T2-weighted imaging (with and without fat suppression), T1-weighted imaging, and diffusion-weighted imaging (DWI). Two abdominal radiologists independently evaluated the subjective and objective image quality of DLR and non-DLR images using a 5-point Likert scale to assess diagnostic confidence for complicated appendicitis. Interobserver agreement (kappa statistics) and receiver operating characteristic (ROC) analysis were performed.</div></div><div><h3>Results</h3><div>MRI with DLR demonstrated significantly better objective and subjective image quality than non-DLR MRI, with improved appendix delineation and reduced noise (<em>p</em> &lt; 0.01). With a mean acquisition time of 9.5 min, both MRI protocols outperformed NC-CT in the diagnosis of complicated appendicitis (<em>p</em> = 0.035 and<!--> <em>p</em> = 0.001, respectively). MRI-DLR achieved higher sensitivity (97.06 % vs. 88.24 %) and negative predictive value (95.45 % vs. 84.00 %) for complicated appendicitis than MRI-non-DLR. The detection rates of appendiceal wall discontinuity and <em>peri</em>-appendiceal abscesses were significantly higher with MRI-DLR (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Rapid MRI with DLR improves image quality and diagnostic accuracy for complicated appendicitis compared to non-DLR MRI and NC-CT, offering a valuable alternative for radiation-sensitive patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112554"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603275","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":"Quantitative susceptibility mapping for the comprehensive assessment of adult-type diffuse gliomas","authors":"Pengxin Shen ,&nbsp;Yangyang Li ,&nbsp;Wenji Xu ,&nbsp;Zhiyi Zhang ,&nbsp;Xiaochun Wang ,&nbsp;Guoqiang Yang ,&nbsp;Jiangfeng Du ,&nbsp;Hui Zhang ,&nbsp;Yan Tan","doi":"10.1016/j.ejrad.2025.112595","DOIUrl":"10.1016/j.ejrad.2025.112595","url":null,"abstract":"<div><h3>Objectives</h3><div>To comprehensively evaluate the value of intratumoral susceptibility signals (ITSS) and regional susceptibility values on quantitative susceptibility mapping (QSM) for adult-type diffuse glioma grading, molecular typing, prognosis, and recurrence prediction based on the 2021 World Health Organization classification of central nervous system tumors (WHO CNS).</div></div><div><h3>Methods</h3><div>A total of 70 pathologically confirmed adult-type diffuse glioma patients were retrospectively analyzed. The number of ITSS was evaluated on QSM, and susceptibility measurements were performed in regions of relatively high susceptibility, and relatively low susceptibility within the tumor. The associations of ITSS and regional susceptibility values with glioma WHO grade, isocitrate dehydrogenase (IDH) status, O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, telomerase reverse transcriptase (TERT) mutation, Ki67 expression, prognosis, and recurrence were evaluated.</div></div><div><h3>Results</h3><div>ITSS grading was significantly associated with glioma WHO grade, IDH status, 1-year survival, and recurrence (<em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, <em>p</em> = 0.049, <em>p</em> = 0.005, respectively). Relatively high tumor susceptibility was significantly correlated with glioma WHO grade, IDH status, MGMT promoter methylation, and Ki67 labeling index (<em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, <em>p</em> = 0.034, <em>p</em> = 0.025, respectively). Relatively low tumor susceptibility had limited value in evaluating the WHO grade, molecular markers, prognosis, and recurrence of gliomas. Kaplan-Meier analysis showed significantly better overall survival for ITSS grade 0 compared to grades 1–3 (<em>p</em> = 0.01), and multivariate analysis identified it as an independent prognostic factor (<em>p</em> = 0.042).</div></div><div><h3>Conclusions</h3><div>Noninvasive imaging parameters extracted from QSM images can reflect glioma WHO grade, molecular markers, prognosis, and recurrence risk. These preliminary findings showed that the QSM might be a noninvasive imaging biomarker for comprehensive evaluation of adult-type diffuse gliomas.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112595"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748712","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":"Predictive role of muscle MRI in juvenile dermatomyositis: A tertiary center experience","authors":"Sevtap Arslan ,&nbsp;Adalet Elcin Yildiz ,&nbsp;Yagmur Bayindir ,&nbsp;Erdal Sag ,&nbsp;Yelda Bilginer ,&nbsp;Seza Ozen ,&nbsp;Goknur Haliloglu","doi":"10.1016/j.ejrad.2025.112599","DOIUrl":"10.1016/j.ejrad.2025.112599","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate muscle MRI findings in juvenile dermatomyositis (JDM) and assess their relationship with clinical parameters and myositis-specific autoantibody (MSA) profile.</div></div><div><h3>Methods</h3><div>59 MRI scans from 42 cases with JDM were analyzed retrospectively. Distribution and pattern of myositis, symmetricity, fascial and/or subcutaneous involvement, and presence of calcinosis, were evaluated. Clinical features, serum creatine kinase (CK) levels, and MSA profile were recorded.</div></div><div><h3>Results</h3><div>Myositis was detected in 71.4 % of cases (n = 30), with 8/30 (26.6 %) being clinically inactive at the time of MRI. The most common dominant distribution and pattern types of myositis were diffuse (n = 15; 50 %) and foggy (n = 21; 70 %), respectively. Fascial and subcutaneous involvement were observed in 86.7 % and 73.3 % of cases and were significantly associated with the presence of calcinosis (p = 0.016 and 0.004, respectively). The dominant pattern of myositis was significantly associated with MSA profile, with the honeycomb pattern being more frequent in MSA-negative cases, and the foggy pattern in MSA-positive cases (p = 0.029 and 0.04, respectively). No significant associations were found between MRI findings and clinical features or serum CK levels.</div></div><div><h3>Conclusions</h3><div>Muscle MRI is a valuable tool for detecting subclinical disease activity in JDM, suggesting that disease activity and qualitative MRI findings may not always align with each other. Fascial and subcutaneous involvement were associated with the presence of calcinosis, suggesting a potential role of MRI in identifying cases at risk for developing calcinosis. Of note, the presence of foggy pattern on MRI was associated with the presence of MSAs.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112599"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691113","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":"Virtual non-calcium imaging to detect bone marrow edema in patients with arthritis: a feasibility study with MRI as standard of reference","authors":"Laura Büttner ,&nbsp;Torsten Diekhoff ,&nbsp;Katharina Ziegeler ,&nbsp;Jürgen Mews ,&nbsp;Sarah Ohrndorf ,&nbsp;Fabian Proft ,&nbsp;Denis Poddubnyy ,&nbsp;Sevtap Tugce Ulas","doi":"10.1016/j.ejrad.2025.112571","DOIUrl":"10.1016/j.ejrad.2025.112571","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic performance of virtual non-calcium (VNCa) imaging derived from dual-energy CT (DECT) for the detection of bone marrow edema (BME) in patients with suspected hand arthritis using magnetic resonance imaging (MRI) as standard of reference.</div></div><div><h3>Materials and methods</h3><div>In this post-hoc analysis, 68 patients ((50 women) with a mean age of 55 (SD 13.1)) were included. All patients underwent DECT and MRI of the hand. VNCa images were reconstructed using three-material decomposition. Two radiologists scored the VNCa images and MRI datasets in consensus for BME. Specificity, sensitivity, and diagnostic accuracy of VNCa were calculated. The sum score was calculated by adding all region-based BME scores per patient, providing an aggregated measure for correlation with MRI findings.</div></div><div><h3>Results</h3><div>MRI was positive in 21 patients and VNCa in 15 patients. VNCa achieved a high specificity (96.7 %), moderate sensitivity (61.9 %), and an overall accuracy of 85.3 %. The sum score in VNCa was strongly correlated with MRI (r = 0.77; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>VNCa imaging showed excellent specificity, albeit only moderate sensitivity for detecting BME in patients with suspected hand arthritis. These results underscore the clinical utility of DECT for arthritis imaging, adding to known strengths such as sensitivity for structural damage and ease of acquisition.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112571"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622656","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 an interpretable machine learning model for predicting intraoperative HDI in PPGL based on intratumoral and peritumoral CT radiomics","authors":"Shurong Li ,&nbsp;Zhiqiang Zhang ,&nbsp;Yubing Zhang ,&nbsp;Yulong Chen ,&nbsp;Jian Ling ,&nbsp;Qingfen Hong ,&nbsp;Xuanling Wu ,&nbsp;Fufu Zheng ,&nbsp;Cheng Luo","doi":"10.1016/j.ejrad.2025.112559","DOIUrl":"10.1016/j.ejrad.2025.112559","url":null,"abstract":"<div><h3>Purpose</h3><div>Intraoperative hemodynamic instability (HDI) might lead to severe complications for pheochromocytoma and paraganglioma (PPGL) patients. This study aims to construct a machine learning (ML) model to predict HDI based on intratumoral and peritumoral CT radiomics.</div></div><div><h3>Materials and methods</h3><div>Totally, 223 patients diagnosed with PPGL from two centers were retrospectively included and analyzed. Intratumoral and peritumoral radiomic features were derived from preoperative computed tomography (CT) imaging and then selected through least absolute shrinkage and selection operator (LASSO) algorithm. Three predictive models including intratumoral, peritumoral and fusion radiomic models were constructed by applying eight ML methods. The performance of predictive models were evaluated by receiver operating characteristic curve (ROC) with area under the curve (AUC), calibration and decision curves. Furthermore, SHapley Additive exPlanations (SHAP) analysis was used for the interpretability of the optimal model by ranking features importance.</div></div><div><h3>Results</h3><div>Enrolled patients were randomly divided into training cohort (n = 156) and testing cohort (n = 67). By the feature screening process, eight, fourteen and eighteen features were selected for intratumoral, peritumoral and fusion radiomic models, respectively. The fusion radiomic models exerted the best performance for predicting HDI with the AUC values of 0.840 (95 %CI: 0.779–0.901) and 0.800 (95 %CI: 0.693–0.907) in the training and testing cohort. Calibration curve indicated a high level of agreement between the predictive probabilities and observed outcomes, and further DCA showed the best clinical benefits among the three models.</div></div><div><h3>Conclusion</h3><div>The fusion radiomic model including intratumoral and peritumoral features is promising nonivasive tool for predicting intraoperative HDI for PPGL patients, which might facilitate individualized evaluation and management in clinical practice.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112559"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687399","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 adrenal gland volume reference ranges and development of a fully automated deep learning screening tool","authors":"Yi Li ,&nbsp;Yingnan Zhao ,&nbsp;Caihong li ,&nbsp;Liu Liu ,&nbsp;Hang Shen ,&nbsp;Ying Jing ,&nbsp;Xiaofang Zhao ,&nbsp;Huali Tang ,&nbsp;Ting Luo ,&nbsp;Yun Mao","doi":"10.1016/j.ejrad.2025.112591","DOIUrl":"10.1016/j.ejrad.2025.112591","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to develop a low-dose CT-based, fully automated deep learning tool for screening adrenal gland volume abnormalities and establishing personalized reference ranges to assist in diagnosing adrenal diseases.</div></div><div><h3>Methods</h3><div>This study included subjects (≥18 years) who underwent low-dose non-contrast chest CT during routine health check-ups, and three datasets were extracted based on specific criteria: healthy reference, hypertension/diabetes validation, and adrenal abnormality validation. Randomly sampled from these datasets 400 low-dose chest CT images were used to train the nnU-Net-based deep learning model, and 550 images were used for validation. Multivariable regression and restricted cubic splines (RCS) assessed the effects of factors like age, sex, body surface area, and blood markers on adrenal volume. A quantile regression model was used to create individualized reference ranges. A GMM-based anomaly detection system was developed for abnormal volume screening, tested on datasets for hypertension, diabetes, and adrenal hyperplasia.</div></div><div><h3>Results</h3><div>Among the 18,538 adults, 7,907 (42.65 %) were healthy. Adrenal volume ranges ere 3.24 cm³ (2.49–4.06) on the right and 4.51 cm³ (3.72–5.39) on the left. Adrenal volume correlated with age, sex, blood pressure, and glucose (p &lt; 0.05). The parameter-adjusted reference ranges were defined as: Lower limit = –2.739 + 0.016 × Age + 0.431 × Sex + 0.032 × Waist circumference (WC) + 0.874 × Body surface area (BSA) + 0.007 × Diastolic blood pressure (DBP) + 0.081 × Triglycerides (TG) – 0.445 × High-density lipoprotein cholesterol (HDL) + 0.306 × Fasting plasma glucose (FPG);Upper limit =  − 3.549 + 0.031 × Age + 0.339 × Sex + 0.030 × Waist + 2.721 × BSA + 0.020 × DBP + 0.004 × TG − 1.244 × HDL + 0.447 × FPG.The segmentation model achieved a Dice Similarity Coefficient of 0.926 and an ICC of 0.954(95 % CI: 0.946–0.961).In validation sets for diabetes and hypertension (n = 3,266), the screening detected 62.31 % abnormal cases, while in adrenal hyperplasia (n = 240), the rate was 77.09 %.</div></div><div><h3>Conclusion</h3><div>This study developed individualized adrenal gland volume reference ranges and a low-dose CT–based deep learning tool for automated measurement. The screening tool shows potential to assist in identifying adrenal abnormalities and may provide a methodological basis for future clinical evaluation and application.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112591"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691110","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":"Diagnostic value of ultrasound in different positions for detecting nutcracker syndrome during physical examination of flying cadets","authors":"Mengjie Li ,&nbsp;Mengnan Yu ,&nbsp;Wenli Hu ,&nbsp;Lu Li ,&nbsp;Xing Zhong ,&nbsp;Jiahui Huang ,&nbsp;Xi Liu ,&nbsp;Xiaozhou Fan","doi":"10.1016/j.ejrad.2025.112616","DOIUrl":"10.1016/j.ejrad.2025.112616","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the ultrasonographic parameters and diagnostic efficacy of nutcracker syndrome (NCS) in two positions and thus to ensure accurate recruitment.</div></div><div><h3>Materials and methods</h3><div>According to the presence or absence of left varicocele, 184 teenagers from Air Force medical selection in 2024 were classified into the NCS-positive group or the control. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of ultrasound parameters in the seated anteversion and supine position. Independent predictors were determined via regression analysis. Individual and combined diagnostic prediction models were developed based on these independent predictors through nomogram and the calibration curve.</div></div><div><h3>Results</h3><div>ROC curve analysis showed the superior diagnostic efficacy for NCS in the seated anteversion position. Regression analysis identified two independent diagnostic predictors: the diameter ratio between the dilatation and stenosis of the left renal vein (D2/D1) and the peak velocity (V1) at the stenosis.<!--> <!-->And the combination of these two diagnostic parameters (the cutoff value of D2/D1: 2.38 and the cutoff value of V1: 69.5 cm/s) achieved an AUC of 0.821 with a sensitivity of 68.3 % and a specificity of 84.3 %. The calibration curve demonstrated good consistency between the predictions made by the nomogram and actual clinical observations.</div></div><div><h3>Conclusions</h3><div>This study established the diagnostic criteria at the seated anteversion position for NCS, indicating that D2/D1 and V1 of left renal vein serve as independent diagnostic parameters. In the future, these criteria can enhance accuracy in aviation recruitment medical examinations.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112616"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833681","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":"Establishing updated diagnostic reference levels for interventional radiology: a national Italian survey incorporating procedure complexity Indices","authors":"Monica Cavallari ,&nbsp;Sveva Grande ,&nbsp;Alessandra Palma ,&nbsp;Catherine Klersy ,&nbsp;Renato Padovani ,&nbsp;Antonio Orlacchio ,&nbsp;Gaetano Compagnone ,&nbsp;Antonella Rosi ,&nbsp;Loredana D’Ercole","doi":"10.1016/j.ejrad.2025.112648","DOIUrl":"10.1016/j.ejrad.2025.112648","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The implementation of Euratom Council Directive 2013/59 into Italian legislation (D. Lgs 101/2020) requires the Ministry of Health, in collaboration with the Istituto Superiore di Sanità (ISS) and relevant scientific organizations, to facilitate the evaluation and regular updating of Diagnostic Reference Levels (DRLs) for procedures in diagnostic and interventional radiology.</div></div><div><h3>Materials and methods</h3><div>This study presents the update of the Italian Diagnostic Reference Levels derived from a survey conducted between 2019 and 2022 by a Working Group (WG) organized by ISS. A total of 53 hospitals across Italy were involved, of which 38 contributed to data collection related to body procedures. The survey concerned the collection of data related to different interventional radiology procedures: Trans-Arterial Chemo Embolization (TACE), EndoVascular Aneurysms Repair (EVAR), Transjugular Intrahepatic Porto-systemic Shunt (TIPS), Angioplasty and stenting for peripheral arterial disease of the lower limbs (LL), Percutaneous Biliary Interventions (PBI), Endoscopic Retrograde Cholangio-Pancreatography (ERCP), PTA (Percutaneous Transluminal Angioplasty) and/or Carotid stenting and Vertebroplasty. For each procedure, Air Kerma AT REFERENCE POINT(K_a,r), Kerma Area Product (P_KA) and Fluoroscopy Time (FT) were collected. Clinical parameters were obtained for TACE, EVAR, PBI, LL and Vertebroplasty, too. A P_KA multivariable analysis was performed to identify which parameters significantly influence the dosimetric data and to derive DRL related to procedure complexity.</div></div><div><h3>Results</h3><div>New DRL values were derived for each of these procedures, except for TIPS, for which the typical value was used: 45 Gy.cm² for PBI, 24 Gy.cm² for LL, 62 Gy.cm² for PTA and/or Carotid stenting, 252 Gy.cm² for TIPS, 18 Gy.cm² for ERCP, 134 Gy.cm² for EVAR, 91 Gy.cm² for Vertebroplasty and 255 Gy.cm² for TACE. DRL were also established according to the complexity of the procedure for TACE and EVAR.</div></div><div><h3>Conclusion</h3><div>This national survey successfully established diagnostic reference levels (DRLs) for seven interventional body procedures (TACE, EVAR, TIPS, LL, PBI, ERCP, PTA, Vertebroplasty) across Italian hospitals, providing facilities with systematic tools to optimize patient radiation exposure through comparison with national values and complexity-stratified reference levels.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112648"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921118","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":"Contrast enhancement potential of food-based imaging agents in cholangiopancreatography and digestive tract investigations using MRI: A systematic literature review and meta-analysis","authors":"Samuel Dushimirimana ,&nbsp;Edozie Iweka ,&nbsp;Hannah Rickman ,&nbsp;Benard Ohene-Botwe ,&nbsp;Theophilus N. Akudjedu","doi":"10.1016/j.ejrad.2025.112633","DOIUrl":"10.1016/j.ejrad.2025.112633","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the contrast enhancement potential of food-based substances (FBS) as clinical imaging agents in MR cholangiopancreatography (MRCP) and digestive tract investigations.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted using a pre-defined strategy and inclusion criteria to identify relevant articles<strong>.</strong> Two review authors independently screened and selected papers for inclusion, conducted risk of bias assessment using ROBINS-I (Risk of Bias In Non-randomised Studies of Interventions) tool and assessed certainty of evidence using the Cochrane’s GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Areas of disagreement were resolved through consensus and the involvement of a third reviewer. The data obtained were <em>meta</em>-analysed using both random and fixed effects models with inverse variance methods, depending on the included studies’ methodological heterogeneity, to estimate the pooled mean difference and odds ratio.</div></div><div><h3>Results</h3><div>16 studies (1360 participants) were included in this review. Eight studies each examined the effectiveness of FBS for contrast enhancement in MRCP and MRE, respectively. The pooled mean differences between MRCP with pineapple juice and non-contrast MRCP were 1.04 (95 % CI: 0.23, 1.84; I² = 96 %, p &lt; 0.01) for bile duct visibility and 0.95 (95 % CI: 0.04, 1.85; I² = 95 %, p &lt; 0.01) for pancreatic duct visibility. Compared to non-contrast MRCP, MRCP with pineapple juice showed improved pancreaticobiliary duct visibility (Combined odds ratio, 5.01; 95 % CI: 2.34, 10.64; p &lt; 0.0001). However, when compared with synthetic contrast agents, there is a lower likelihood of obtaining excellent quality MRE images with food-based contrast agents (FBCAs) (odds ratio, 0.36; 95 % CI: 0.18, 0.73, 0.73; p = 0.004). A generally high safety and acceptance profile was reported across the included studies for FBCAs. The certainty of the evidence obtained was considered moderate across all outcomes.</div></div><div><h3>Conclusion</h3><div>Oral administration of pineapple juice improves the diagnostic quality of MRCP investigations, while the contrast enhancement potential of FBS is limited in MRE studies. The high heterogeneity of results and moderate certainty of the evidence, however, require a cautious admission of results. Therefore, further research is necessary to gain a comprehensive understanding of the reliability of FBS in these MRI investigations, as well as in other imaging modalities that are yet to be explored.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112633"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921188","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":"Late gadolinium enhancement in patients with and without autoimmune rheumatic diseases: “walking, we create the way”","authors":"George Markousis-Mavrogenis ,&nbsp;Alessia Pepe ,&nbsp;Brittany N. Weber ,&nbsp;Anne Hui Sze Kwong ,&nbsp;Vassiliki Vartela ,&nbsp;Monica Mukherjee ,&nbsp;Juerg Schwitter ,&nbsp;Sophie I. Mavrogeni","doi":"10.1016/j.ejrad.2025.112542","DOIUrl":"10.1016/j.ejrad.2025.112542","url":null,"abstract":"<div><div>Myocardial fibrosis constitutes an important pathophysiologic and maladaptive process in the vast majority of cardiac diseases. Contemporary cardiologists are permitted a very nuanced glimpse of myocardial fibrosis by means of cardiovascular magnetic resonance imaging (CMR), and specifically late gadolinium enhancement (LGE) methods. These allow the evaluation of the presence, extent, and distribution of myocardial replacement fibrosis. An increasing amount of scientific evidence has demonstrated a significant role for LGE in the elucidation of cardiac pathophysiologic substrates in patients with autoimmune rheumatic diseases (ARDs) and cardiac involvement. However, whether existing methods for the evaluation of myocardial fibrosis can uniformly be extrapolated for use in patients with ARDs in their present form remains an important question. In this opinion paper, we provide a brief overview of the basic principles underlying LGE imaging, as well as the current status and challenges regarding its use in patients with and without ARDs.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112542"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603333","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}