European Journal of Radiology最新文献

{"title":"Recompensation after transjugular intrahepatic portosystemic shunt reduces mortality risk: A long-term follow-up study","authors":"Yaowei Bai ,&nbsp;Jiacheng Liu ,&nbsp;Yu Lei ,&nbsp;Bo Sun ,&nbsp;Wenlong Wu ,&nbsp;Xiatong Bai ,&nbsp;Yang Su ,&nbsp;Wei Tan ,&nbsp;Xuefeng Kan ,&nbsp;Chuansheng Zheng","doi":"10.1016/j.ejrad.2025.112212","DOIUrl":"10.1016/j.ejrad.2025.112212","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to analyze the occurrence of recompensation after transjugular intrahepatic portosystemic shunt (TIPS) for patients with cirrhosis and portal hypertension and its impact on mortality risk.</div></div><div><h3>Methods</h3><div>The clinical data of 621 cirrhotic patients who underwent TIPS creation were retrospectively analyzed. Patients were categorized into a recompensation group (n = 126) and a non-recompensation group (n = 495). Binary logistic regression was used to identify independent predictors of recompensation. Kaplan-Meier (KM) survival curves were employed to assess the differences in survival between the two groups, and the Cox proportional hazards model was utilized to analyze the risk factors for mortality.</div></div><div><h3>Results</h3><div>At 12 months after TIPS placement, 20.3 % of patients achieved recompensation. The recompensation group demonstrated significant improvements in both Child-Pugh and MELD scores (P &lt; 0.05). Sarcopenia and platelet count (PLT) were identified as independent predictors of recompensation. The cumulative survival rate in the recompensation group was significantly higher than that of the non-recompensation group (HR = 2.275, 95 % CI = 1.606–3.223, Log-rank P &lt; 0.001). Age, sarcopenia, and the occurrence of recompensation were identified as independent factors that influenced mortality risk.</div></div><div><h3>Conclusion</h3><div>TIPS was associated with recompensation in certain patients, and the occurrence of recompensation is significantly associated with improved long-term survival.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112212"},"PeriodicalIF":3.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242102","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":"Percutaneous placement of 12-mm metallic biliary stents in patients with malignant extrahepatic biliary obstruction: Outcomes of expanded polytetrafluoroethylene-covered stents versus uncovered stents","authors":"Dong Il Gwon,&nbsp;Hee Ho Chu,&nbsp;Gun Ha Kim,&nbsp;Jihoon Kim,&nbsp;Byung Soo Im,&nbsp;Gi-Young Ko,&nbsp;Hyun-Ki Yoon","doi":"10.1016/j.ejrad.2025.112213","DOIUrl":"10.1016/j.ejrad.2025.112213","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the outcomes of percutaneous placement of 12-mm metallic biliary stents in patients with malignant extrahepatic biliary obstruction and to compare the outcomes of covered stents with those of uncovered stents.</div></div><div><h3>Methods</h3><div>From May 2020 to February 2022, 49 consecutive patients who underwent placement of 12-mm-diameter expanded polytetrafluoroethylene (ePTFE) covered stents were retrospectively studied. The data from these patients were compared with data from 48 consecutive patients who underwent 12-mm-diameter uncovered stent placement between December 2018 and April 2020.</div></div><div><h3>Results</h3><div>There were no significant differences in technical success (<em>p</em> &gt; 0.999), successful internal drainage (<em>p</em> &gt; 0.999), adverse events (<em>p</em> = 0.774), and patient survival (<em>p</em> = 0.084) between the two groups. Adverse events occurred in eight (16.3 %) patients in the covered stent group and six (12.5 %) in the uncovered stent group. Cumulative stent patency rate was significantly higher in the covered stent group than in the uncovered stent group (<em>p</em> = 0.015), with cumulative patency rate at 6 months being 97.8 % in the covered stent group and 80.8 % in the uncovered stent group. Stent occlusion occurred in 3 (6.4 %) of 47 patients in the covered stent group and 15 (33.3 %) of 45 patients (41 %) in the uncovered stent group, with this difference being significant (<em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>Percutaneous placement of 12-mm-diameter metallic biliary stents is effective and safe in patients with malignant extrahepatic biliary obstruction. Moreover, ePTFE covered stents were significantly superior to uncovered stents in terms of stent patency.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112213"},"PeriodicalIF":3.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242103","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 Assessment of Spinal Cord Injury in Cervical Spondylotic Myelopathy: A Comparison Study of MAGiC and MUSE-DTI","authors":"Shuting Huang ,&nbsp;Haoyue Shao ,&nbsp;Qiufeng Liu ,&nbsp;Weiyin Vivian Liu ,&nbsp;Qiya Zhang ,&nbsp;Longyu Deng ,&nbsp;Chaoxu Liu ,&nbsp;Deeq Mohamed Omar ,&nbsp;Xiangyu Tang","doi":"10.1016/j.ejrad.2025.112214","DOIUrl":"10.1016/j.ejrad.2025.112214","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare synthetic magnetic resonance imaging (MAGnetic resonance image Compilation, MAGiC) and MUSE-DTI (MUltiplexed Sensitivity Encoding-Diffusion Tensor Imaging) in determining the severity of spinal cord injury in cervical spondylotic myelopathy (CSM).</div></div><div><h3>Methods</h3><div>All subjects (69 CSM subjects and 15 controls) underwent synthetic MRI and MUSE-DTI scans. Japanese Orthopaedic Association (JOA) score was evaluated preoperatively. Cervical canal stenosis degree was graded 0-Ⅲ using an MRI grading system. Twelve patients received surgical intervention and JOA evaluation 1 year after operation. Regions of interest covered the whole spinal cord at the maximal compression level (MCL) and C2 vertebral level to generate T1, T2 and PD values from synthetic quantitative map and fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values from MUSE-DTI map.</div></div><div><h3>Results</h3><div>AD_MCL values demonstrated higher sensitivity to spinal microstructural changes than other parameters, increasing from Grade Ⅰ-Ⅲ and decreasing at Grade Ⅰ compared to Grade 0 (P &lt; 0.05). FA_MCL and T1_MCL values decreased from Grade 0-Ⅱ. Furthermore, AD_C2 values in Grade I were significantly lower than Grade 0 (P = 0.005). FA_C2 values correlated with the minimum FA values of multi-segment compressed spinal cord (P = 0.007). All MUSE-DTI parameters at MCL correlated with JOA scores across all grades. The preoperative AD_MCL values correlated with postoperative recovery rate, whereas MAGiC-derived parameters did not.</div></div><div><h3>Conclusion</h3><div>MUSE-DTI parameters better reflected microstructural alterations and secondary damages of spinal cord and correlated with the JOA scores and postoperative recovery rate. Therefore, MUSE-DTI could provide more quantitative information to evaluate the severity of spinal cord injury in CSM.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112214"},"PeriodicalIF":3.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229717","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 accuracy of computed tomography in localizing gastrointestinal perforations: Focusing on gastric and duodenal defects","authors":"Aleksandar Pavlovic ,&nbsp;Tyler Herrington ,&nbsp;Ksenija Mijovic ,&nbsp;Richard M. Gore ,&nbsp;Dragan Vasin ,&nbsp;Francesco Alessandrino ,&nbsp;Aleksandar M. Ivanovic","doi":"10.1016/j.ejrad.2025.112192","DOIUrl":"10.1016/j.ejrad.2025.112192","url":null,"abstract":"<div><h3>Purpose</h3><div>To provide a detailed assessment of the accuracy and reproducibility of Computed Tomography (CT) in localizing gastrointestinal perforations, with a focus on distinguishing gastric and duodenal defects.</div></div><div><h3>Methods</h3><div>This single-center retrospective study evaluated subjects with surgically confirmed gastrointestinal perforation who underwent preoperative contrast-enhanced abdominopelvic CT. Two subspecialized radiologists reviewed each CT independently to identify the perforation site, to differentiate gastroduodenal from perforations in other locations, and to differentiate between gastric and duodenal perforation, using defined CT signs such as gas inclusions, pneumoperitoneum, and thickened gastrointestinal walls. For gastroduodenal perforations, accuracy of Minimum Intensity Projection (MinIP) reconstructions was also assessed. Inter-reader agreement was calculated using Cohen’s kappa statistics.</div></div><div><h3>Results</h3><div>156 patients (M/F: 89/67; median age: 62 years) met inclusion criteria. CT accuracy in distinguishing all perforation sites was 73.1 % for Reviewer 1 and 67.9 % for Reviewer 2 (k = 0.72). When differentiating gastroduodenal from other perforations, accuracy increased to 94.9 % and 88.5 % (k = 0.86). Among gastroduodenal perforations (n = 56; 35.9 %), Reviewer 1 correctly differentiated gastric from duodenal perforation in 79.6 % of cases, and Reviewer 2 in 64.8 %. MinIP imaging increased accuracy to 87 % and 77.8 %, though not significantly (p = 0.47 and p = 0.21).</div></div><div><h3>Conclusion</h3><div>CT demonstrates high accuracy and reproducibility in localizing gastrointestinal perforations, particularly in differentiating gastric from duodenal defects– a critical distinction for surgical decision making. MinIP reconstructions may be useful as a novel diagnostic adjunct in this context. CT signs such as fluid, fat stranding, and wall thickening were seen in most perforations, though none correlated significantly with correct perforation localization.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112192"},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222385","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":"Performance of AI methods in PET-based imaging for outcome prediction in lymphoma: A systematic review and meta-analysis","authors":"Mohammad Mehdi Mehrabi Nejad ,&nbsp;Mohammad Reza Ghanbari Boroujeni ,&nbsp;Alireza Hayati ,&nbsp;Fatemeh Dashti ,&nbsp;Jayaram K. Udupa ,&nbsp;Drew A. Torigian","doi":"10.1016/j.ejrad.2025.112204","DOIUrl":"10.1016/j.ejrad.2025.112204","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the predictive performance of artificial intelligence (AI) methods using pre-treatment PET-based imaging for outcome prediction in lymphoma through a systematic review and <em>meta</em>-analysis.</div></div><div><h3>Methods</h3><div>PubMed-MEDLINE, Scopus, and Web of Science were searched for original studies on AI prediction models using PET-based imaging in lymphoma up to October 2024. Eligible studies reported outcomes including progression-free survival (PFS), overall survival (OS), or treatment response. Meta-analyses, subgroup analyses, <em>meta</em>-regressions, sensitivity analysis, and publication bias analysis were conducted using Stata software.</div></div><div><h3>Results</h3><div>Seventy-five studies were included, predominantly focusing on non-Hodgkin lymphoma (NHL, n = 61). AI methods included deep learning (DL, n = 13), machine learning (ML, n = 2), combined ML/radiomics (n = 23), and radiomics (n = 37). Pooled analyses showed strong predictive performance for PFS (HR: 4.11 [3.20–5.29], AUC: 0.78 [0.68–0.86], C-index: 0.79 [0.76–0.83]) and OS (HR: 3.38 [2.29–4.99], AUC: 0.75 [0.66–0.83], C-index: 0.79 [0.76–0.81]) in the main groups with consistent results in the validation groups. For treatment response, pooled OR was 5.36 [1.53–18.78], and AUC was 0.85 [0.74–0.92]. DL outperformed other AI methods in PFS and treatment response prediction.</div></div><div><h3>Conclusion</h3><div>AI methods, particularly DL, show strong predictive performance for lymphoma outcomes using PET-based imaging, supporting their potential utility in precision medicine. Further prospective studies are needed for clinical integration.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112204"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203862","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 performance of abbreviated breast MRI in differentiating intraductal papilloma from ductal secretion","authors":"Gülbanu Güner,&nbsp;Ahmet Harun Turgan,&nbsp;Sevde Nur Emir","doi":"10.1016/j.ejrad.2025.112211","DOIUrl":"10.1016/j.ejrad.2025.112211","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic efficacy of abbreviated breast magnetic resonance imaging (AB-MRI) in aiding the differentiation of intraductal papilloma (IDP) from ductal secretion, as compared to full diagnostic breast magnetic resonance imaging (FDB-MRI).</div></div><div><h3>Materials and methods</h3><div>This retrospective study included patients who underwent breast MRI between June 2016 and January 2024 due to inconclusive ultrasonographic findings suggestive of IDP or ductal secretions, A total of 62 patients were analyzed with histopathological results used as the reference standard.</div><div>Two radiologists independently reviewed the AB-MRI protocols in a blinded manner. These protocols included fat-suppressed precontrast T1, first postcontrast T1, and subtracted images derived from the FDB-MRI. After a one-week interval, the same radiologists evaluated the FDB-MRI examinations in a separate session, blinded to the AB-MRI results. Diagnostic performance metrics including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Interobserver agreement for AB-MRI, as well as agreement between AB-MRI and FDB-MRI interpretations, were analyzed using Cohen’s kappa test.</div></div><div><h3>Results</h3><div>The mean age of the 62 patients was 46.05 ± 11.59 years, Histopathological results identified 48 IDPs, 6 cases of adenosis and fibrosis, and 8 cases of ductal secretions.</div><div>The FDB-MRI demonstrated high sensitivity (87.5 %) and PPV (85.7 %) for IDP detection but limited specificity (50 %) and NPV (53.85 %). The comparison between FDB-MRI and pathology did not reveal a statistically significant difference (p &gt; 0.05). The diagnostic performance of AB-MRI was observer-dependent; for Observer 1, sensitivity and specificity were 75.0 % and 57.1 %, respectively, with no significant difference compared to pathology (p = 0.0525) or FDB-MRI (p = 0.124). For Observer 2, sensitivity and specificity were 66.67 % and 57.14 %, also not significantly different from pathology (p = 0.1945) or FDB-MRI (p = 0.347). Interobserver agreement was high (Cohen’s Kappa = 0.79)</div></div><div><h3>Conclusion</h3><div>The AB-MRI protocol demonstrated moderate-to-high diagnostic performance and high interobserver agreement as a time-efficient alternative. While the FDB-MRI remains superior in sensitivity and diagnostic accuracy, AB-MRI offers a reasonable alternative in clinical scenarios where shorter imaging time is prioritized, such as in the differentiation of IDPs from ductal secretions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112211"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213036","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":"Corrigendum to “Safety and feasibility of percutaneous pulsed electrical field ablation in multiple organs: A multi-center retrospective study” [Eur. J. Radiol. 187C (2025) 112078]","authors":"William H. Moore ,&nbsp;Mikhail Silk ,&nbsp;Priya Bhattacharji ,&nbsp;Bradley B. Pua ,&nbsp;Joseph Mammarappallil ,&nbsp;R. Ryan Meyerhoff ,&nbsp;Jonathan Kessler ,&nbsp;Jordan Tasse ,&nbsp;Dustin Gulizia","doi":"10.1016/j.ejrad.2025.112197","DOIUrl":"10.1016/j.ejrad.2025.112197","url":null,"abstract":"","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112197"},"PeriodicalIF":3.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177426","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":"Radiomics classification of fresh and old vertebral compression fractures: Impact of compression grade and morphology on diagnostic performance","authors":"Ke Zhang ,&nbsp;Yunfei Zhu ,&nbsp;Chaoran Liu ,&nbsp;Wenjuan Li ,&nbsp;Jielin Pan ,&nbsp;Ximeng Li ,&nbsp;Shaolin Li ,&nbsp;Guobin Hong","doi":"10.1016/j.ejrad.2025.112210","DOIUrl":"10.1016/j.ejrad.2025.112210","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop a radiomics model for identifying fresh or old vertebral compression fractures (VCFs) from CT images, thereby assisting physicians in making more effective decisions.</div></div><div><h3>Methods</h3><div>Patients with VCFs who underwent both CT and MRI within one week were retrospectively enrolled from June 2018 to February 2023. VCFs were categorized as subgroups according to compression grades (mild, moderate or severe) or morphology types (wedge-shaped, biconcave or crush). For each subgroup, a radiomics classification model was built based on 1834 radiomics features extracted from the training dataset. And the diagnostic performance was evaluated in the testing dataset using receiver operating characteristic (ROC).</div></div><div><h3>Results</h3><div>The radiomics model trained on the entire cohort achieved an area under ROC curve (AUC) of 0.824. A nomogram integrating radiomics feature and clinical characteristics reached an AUC of 0.897. We graded the degree of compression as mild, moderate, and severe VCFs. The best performance was observed in the severe subgroup, with an AUC of 0.927, while the AUCs for mild and moderate were 0.633 and 0.774, respectively. In the morphology subgroups, the crush-type VCFs demonstrated the best performance, achieving an AUC of 0.909, while the AUCs for wedge-shaped and biconcave were 0.841 and 0.897, respectively.</div></div><div><h3>Conclusion</h3><div>The radiomics models effectively distinguished fresh and old VCFs, performing better when combined with clinical features. However, different grades and morphologies of VCFs showed distinct CT imaging patterns that could impact model performance, warranting consideration in future research and clinical applications.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112210"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196311","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":"Lesions located at the liver periphery: A stepwise cross-sectional imaging approach toward diagnosis","authors":"Rosa Alba Pugliesi ,&nbsp;Federica Vernuccio ,&nbsp;Cesare Maino ,&nbsp;Francesco Matteini ,&nbsp;Antonino Andrea Blandino ,&nbsp;Giuseppe Brancatelli ,&nbsp;Roberto Cannella","doi":"10.1016/j.ejrad.2025.112208","DOIUrl":"10.1016/j.ejrad.2025.112208","url":null,"abstract":"<div><div>Lesions at the liver periphery may originate from intrahepatic or extrahepatic tissues due to the unique anatomical, peritoneal, and hemodynamic characteristics of the hepatic capsular and subcapsular regions. In this article, the anatomical and physiological factors predisposing the hepatic periphery to pathology are examined, including Laennec’s capsule, perihepatic ligamentous connections, and alternative blood supply pathways. A stepwise imaging approach is outlined, emphasizing the role of computed tomography (CT) and magnetic resonance imaging (MRI) in lesion differentiation based on key imaging features.</div><div>Intrahepatic lesions discussed include focal confluent fibrosis, ciliated foregut cyst, perihepatic abscess, inflammatory pseudotumor, epithelioid hemangioendothelioma, and intrahepatic cholangiocarcinoma. Extrahepatic causes of capsular involvement, such as diaphragmatic slips, pseudolipoma of Glisson’s capsule, splenosis, hepatic tuberculosis, Fitz-Hugh-Curtis syndrome, hepatic endometriosis, peritoneal metastases, peritoneal carcinomatosis, pseudomyxoma peritonei, and peritoneal mesothelioma are also reviewed. Most benign lesions can confidently be diagnosed with either CT or MRI and without further intervention, though hepatic inflammatory pseudotumors may require biopsy. Most malignant lesions need pathological confirmation and treatment strategy. Effective management of focal liver lesions involves a multidisciplinary team, including radiologists, hepatologists, and surgeons, ensuring a comprehensive and individualized approach to patient care. On these bases, this review aims to provide a comprehensive review of benign and malignant focal liver lesions with a predilection for the hepatic periphery, including traumatic, infectious, inflammatory, and neoplastic conditions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112208"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229632","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":"MRI-based predictive model with obesity metabolic phenotype for postoperative survival in HBV-related hepatocellular carcinoma","authors":"Beixuan Zheng ,&nbsp;Bin Wang ,&nbsp;Wei Sun ,&nbsp;Heqing Wang ,&nbsp;Chun Yang ,&nbsp;Mengsu Zeng ,&nbsp;Ruofan Sheng","doi":"10.1016/j.ejrad.2025.112201","DOIUrl":"10.1016/j.ejrad.2025.112201","url":null,"abstract":"<div><h3>Purpose</h3><div>Obesity metabolic phenotypes may influence survival outcomes in hepatocellular carcinoma (HCC) patients. This study aimed to develop an MRI-based model for postoperative survival prediction in HBV-related HCC patients, focusing on obesity metabolic phenotypes.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 381 HBV-related HCC patients (312 males; mean age 55.9 ± 10.7 years) who underwent preoperative MRI and curative surgery was studied. Patients were categorized into three phenotypes: normal weight (NW), metabolically healthy overweight/obesity (MHOO) and metabolically unhealthy overweight/obesity (MUOO). Univariate and multivariate Cox regression analyses identified independent predictors of overall survival (OS). A predictive model was established and validated with cross-validation.</div></div><div><h3>Results</h3><div>MHOO patients showed significantly better overall survival (OS) than NW patients (adjusted HR = 0.42, <em>P</em> = 0.030), while MUOO had no significant effect on OS (adjusted HR = 0.92, <em>P</em> = 0.779). Independent predictors included MHOO (HR = 0.44, <em>P</em> = 0.036), AST/ALT ratio &gt; 1 (HR = 2.61, <em>P</em> = 0.001), tumor burden score &gt; 5.0 (HR = 3.02, <em>P</em> &lt; 0.001) and arterial rim enhancement (HR = 3.61, <em>P</em> &lt; 0.001). The combined model achieved good performance in both training (C-index = 0.737) and validation (C-index = 0.715) sets. The predicted high-risk patients had worse OS than low-risk patients in the whole cohort (<em>P</em> &lt; 0.001) and in patients at BCLC stage A (<em>P</em> &lt; 0.001). The model outperformed the BCLC and CNLC staging systems in predictive efficacy (all <em>P</em> &lt; 0.001) and clinical net benefit.</div></div><div><h3>Conclusions</h3><div>MHOO is protective for OS in HBV-related HCC. The MRI-based model integrating obesity metabolic phenotype, AST/ALT ratio, tumor burden score and arterial rim enhancement is valuable in survival prediction, offering superior prognostic stratification compared to current staging systems.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"189 ","pages":"Article 112201"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184706","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}