European Radiology最新文献

{"title":"Coding traumatic brain injury with the abbreviated injury scale following a standardised radiologic template will improve classification of trauma populations.","authors":"Jan C van Ditshuizen, Menco J S Niemeyer, Esther M M Van Lieshout, Dennis Den Hartog, Jan-Jaap Visser, Karlijn J P van Wessem, Michiel H J Verhofstad","doi":"10.1007/s00330-025-11384-9","DOIUrl":"10.1007/s00330-025-11384-9","url":null,"abstract":"<p><strong>Introduction: </strong>Injury coding with the Abbreviated Injury Scale (AIS) is an important element for benchmarking, trauma registries and research.</p><p><strong>Objective: </strong>To compare the severity of traumatic brain injury (TBI) coding derived from the AIS with or without the use of a standardised radiologic template.</p><p><strong>Methods: </strong>A retrospective two-centre cohort study including patients aged ≥ 18 years with isolated TBI admitted to an intensive care between 2011 and 2016 was conducted. TBI was re-coded to conform the AIS by coders, and CT-brain imaging was reassessed by a neuro-radiologist following a standardised radiologic template from which AIS codes were derived.</p><p><strong>Results: </strong>A total of 560 patients were included (median age 57, 37% female). The percentage of MAIS ≥ 4 and major trauma was higher when AIS coding for TBI was derived from a standardised radiologic template vs. coding without (n = 456 (81.4%) and n = 374 (66.8%), p < 0.001; n = 441 (78.8%) and n = 352 (62.9%), p < 0.001, respectively). There was an inter-centre difference in the proportion of MAIS ≥ 4 re-coded without a standardised radiologic template (n = 212 (68.2%) and n = 140 (56.2%), p = 0.004), and no difference when re-coded with the template (n = 251 (80.7%) and n = 190 (76.3%), p = 0.206).</p><p><strong>Conclusion: </strong>Coding TBI with AIS based on a standardised radiologic template results in fewer missed AIS head codes, more detailed AIS head codes, and more patients classified as 'major trauma'.</p><p><strong>Key points: </strong>Question Radiologic reports are an important source for injury coding with the abbreviated injury scale (AIS) and are often not sufficiently specific. Findings An AIS-based standardised radiologic template for reporting resulted in more detailed AIS head codes and more patients classified as major trauma. Clinical relevance Injury coding with the AIS based on a standardised radiologic template will improve exchanging medical information in the acute health care setting and classification of trauma populations.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5081-5090"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of temporal muscle thickness for prognosis in newly diagnosed IDH wild-type glioblastoma patients: evaluated for a Chinese population.","authors":"Boya Zha, Yajing Ma, Boqun Zha, Xinbin Guo","doi":"10.1007/s00330-025-11394-7","DOIUrl":"10.1007/s00330-025-11394-7","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the prognostic value of Temporal Muscle Thickness (TMT) in Chinese patients with newly diagnosed isocitrate dehydrogenase (IDH) wild-type glioblastoma.</p><p><strong>Methods: </strong>Data were retrospectively collected from patients with isocitrate dehydrogenase wild-type genotype glioblastoma, who underwent surgical treatment and concurrent chemoradiotherapy at our center between May 2019 and May 2023. Multi-model and multivariate Cox regression were used to examine factors associated with overall and progression-free survival. Subgroup analysis and sensitivity tests were performed to verify the robustness of the results. Restricted cubic spline regression was used to explore the possible nonlinear relationship between TMT and OS/PFS.</p><p><strong>Results: </strong>A total of 344 patients were enrolled in this study. The main analysis showed that TMT was positively correlated with overall survival and progression-free survival. The results of multivariate Cox regression after segmentation according to the optimal cutoff value showed that age ≥ 60 years (HR = 1.47, 95% CI: 1.14-1.90, p = 0.003), diabetes (HR = 1.95, 95% CI: 1.26-3.04, p = 0.003) were the risk factors for death. However, TMT ≥ 8.425 mm (HR = 0.45, 95% CI: 0.36-0.57, p < 0.001), Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59-0.97, p < 0.031) were associated with a lower risk of death. Age ≥ 60 years (HR = 1.33, 95% CI: 1.03-1.71, p = 0.028) was a risk factor for recurrence, Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59-0.97, p = 0.027), TMT ≥ 8.4 mm (HR = 0.64, 95% CI: 0.50-0.80, p < 0.001), and combination of targeted therapy (HR = 0.65, 95% CI: 0.47-0.90, p = 0.01) reduced recurrence risk.</p><p><strong>Conclusion: </strong>TMT is an independent predictor of OS and PFS in IDH wild-type GBM patients and can be used to predict prognosis in clinical practice.</p><p><strong>Key points: </strong>Question Performance status of glioblastoma patients is crucial for treatment decision-making and prognosis assessment; however, there is currently no objective evaluation metric for the Chinese population. Findings Temporal muscle thickness at initial diagnosis is positively correlated with overall survival and progression-free survival in Chinese patients with newly diagnosed IDH wild-type glioblastoma. Clinical relevance Temporal muscle thickness at initial diagnosis is an independent, objective prognostic factor for newly diagnosed IDH wild-type glioblastoma patients in China. It contributes to the formulation of individualized treatment plans and serves as a stratification factor in clinical trials.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4438-4447"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-stratified deep learning model for thyroid tumor classification: a multicenter diagnostic study.","authors":"Weijie Zou, Yahan Zhou, Jincao Yao, Bojian Feng, Danlei Xiong, Chen Chen, Yuqi Yan, Yuanzhen Liu, Lingyan Zhou, Liping Wang, Liyu Chen, Ping Liang, Dong Xu","doi":"10.1007/s00330-025-11386-7","DOIUrl":"10.1007/s00330-025-11386-7","url":null,"abstract":"<p><strong>Objectives: </strong>Thyroid cancer, the only cancer that uses age as a specific predictor of survival, is increasing in incidence, yet it has a low mortality rate, which can lead to overdiagnosis and overtreatment. We developed an age-stratified deep learning (DL) model (hereafter, ASMCNet) for classifying thyroid nodules and aimed to investigate the effect of age stratification on the accuracy of a DL model, exploring how ASMCNet can help radiologists improve diagnostic performance and avoid unnecessary biopsies.</p><p><strong>Methods: </strong>In this retrospective study, we used ultrasound images from three hospitals, a total of 10,391 images of 5934 patients were used for training, validation, and testing. The performance of ASMCNet was compared with that of model-trained non-age-stratified radiologists with different experience levels on the test data set with the DeLong method.</p><p><strong>Results: </strong>The area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity of ASMCNet were 0.906, 86.1%, and 85.1%, respectively, which exceeded those of model-trained non-age-stratified (0.867, 83.2%, and 75.5%, respectively; p < 0.001) and higher than all of the radiologists (p < 0.001). Reader studies show that radiologists' performances are improved when assisted by the explaining heatmaps (p < 0.001).</p><p><strong>Conclusions: </strong>Our study demonstrates that age stratification based on DL can further improve the performance of thyroid tumor classification models, which also suggests that age is an important factor in the diagnosis of thyroid tumors. The ASMCNet model shows promising clinical applicability and can assist radiologists in improving diagnostic accuracy.</p><p><strong>Key points: </strong>Question Age is crucial for differentiated thyroid carcinoma (DTC) prognosis, yet its diagnostic impact lacks research. Findings Adding age stratification to DL models can further improve the accuracy of thyroid nodule diagnosis. Clinical relevance Age-stratified multimodal classification network is a reliable tool used to help radiologists diagnose thyroid nodules, and integrating it into clinical practice can improve diagnostic accuracy and reduce unnecessary biopsies or treatments.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4599-4609"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of breast cancer screening in transgender and gender-diverse populations.","authors":"Anna D'Angelo, Flavia Caprini, Maria Adele Marino","doi":"10.1007/s00330-025-11355-0","DOIUrl":"10.1007/s00330-025-11355-0","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4882-4884"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An interpretable machine learning model assists in predicting induction chemotherapy response and survival for locoregionally advanced nasopharyngeal carcinoma using MRI: a multicenter study.","authors":"Hai Liao, Yang Zhao, Wei Pei, Xia Huang, Shiting Huang, Wei Wei, Penghao Lai, Weifeng Jin, Huayan Bao, Xueli Liang, Lei Xiao, Zhenyu Chen, Shaolu Lu, Danke Su, Bingfeng Lu, Linghui Pan","doi":"10.1007/s00330-025-11396-5","DOIUrl":"10.1007/s00330-025-11396-5","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and validate an interpretable and generalized machine learning model using MRI for the individualized prediction of induction chemotherapy (ICT) response and survival in locoregionally advanced nasopharyngeal carcinoma (LANPC).</p><p><strong>Methods: </strong>A total of 1368 patients who underwent MRI examinations before ICT from three hospitals were retrospectively enrolled and divided into training, internal validation, external validation, and cross-field strength validation cohorts. Significant radiomics and clinical features were selected from coarse to fine. An interpretable genetic algorithm-enhanced artificial neural network (GNN) was applied for models' development and validation. The performance of junior and senior doctors in predicting ICT response with and without model aid was evaluated.</p><p><strong>Results: </strong>The interpretable GNN model achieved good generalization performance in predicting ICT response, with areas under the curve (AUCs) ranging from 0.808 to 0.864 across all cohorts. Survival analysis demonstrated that low-risk patients defined by GNN-radiomics signature and clinical factors had better progression-free survival than high-risk patients in all cohorts (hazard ratio ranging from 3.231 to 12.787, p < 0.05). The predictive performance of junior and senior doctors for ICT response significantly improved with model assistance (AUCs: 0.686 vs. 0.785 and 0.736 vs. 0.836, p < 0.05).</p><p><strong>Conclusion: </strong>An interpretable, applicable, and generalized GNN model based on multi-center databases achieved superior performance in predicting ICT response and survival in LANPC patients, which may contribute to the personalized treatment of LANPC.</p><p><strong>Key points: </strong>Question Currently, there is a lack of accurate methods for predicting and evaluating the efficacy and prognosis of nasopharyngeal carcinoma (NPC). Findings Genetic algorithm-enhanced artificial neural network model excels in predicting induction chemotherapy response and survival outcome of NPC, providing valuable assistance to doctors in clinical practice. Clinical relevance This model can identify patients likely to benefit from induction chemotherapy, promoting individualized treatment and optimizing clinical management.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5121-5134"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter diagnostic study of thyroid nodule with Hashimoto's thyroiditis enabled by Hashimoto's thyroiditis nodule-artificial intelligence model.","authors":"Chen Chen, Yahan Zhou, Bo Xu, Lingyan Zhou, Mei Song, Shengxing Yuan, Wenwen Yue, Yibo Zhou, Hangjun Chen, Ruyi Yan, Benlong Xiao, Tian Jiang, Qi Zhang, Shanshan Zhao, Changsong Xu, Chenke Xu, Jiao Lu, Lin Sui, Yuqi Yan, Mingshun Lyu, Qingquan He, Vicky Yang Wang, Dong Xu","doi":"10.1007/s00330-025-11422-6","DOIUrl":"10.1007/s00330-025-11422-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a Hashimoto's thyroiditis nodule-artificial intelligence (HTN-AI) model to optimize the diagnosis of thyroid nodules with Hashimoto's thyroiditis (HT) of which the efficiency and accuracy remain challenging.</p><p><strong>Design and methods: </strong>This study included 5709 patients from 10 hospitals between January 2014 and March 2024. Among them, 5053 thyroid nodules were divided into training and testing sets in a 9:1 ratio. Then, we tested the model on an external dataset (n = 432). Finally, we prospectively recruited 224 patients with dynamic ultrasound videos acquired and employed the HTN-AI model to identify nodules from the dynamic ultrasound videos. Radiologists of varying seniority performed the categorization of thyroid nodules as benign and malignant, both with and without the assistance of the HTN-AI model, and their diagnostic performances were compared.</p><p><strong>Results: </strong>The results indicated that for the external testing set, the HTN-AI model achieved a Dice similarity coefficient (DSC) of 0.91, outperforming several other common convolutional neural network (CNN) models. Specifically, the DSCs of the HTN-AI model were similar for thyroid nodule patients with and without HT which were 0.91 ± 0.06 and 0.91 ± 0.09. Moreover, when the HTN-AI model was used to assist diagnosis, it demonstrated an improvement in the diagnostic performance of radiologists. The diagnostic areas under the receiver operating characteristic curve (AUCs) of the junior radiologists increased from 0.59, 0.59, and 0.57 to 0.68, 0.65, and 0.65.</p><p><strong>Conclusions: </strong>This research demonstrates that the HTN-AI model has excellent performance in identifying thyroid nodules associated with HT and can assist radiologists with more accurate and efficient diagnoses of thyroid nodules.</p><p><strong>Key points: </strong>Question The study developed an HTN-AI model aimed at assisting in the diagnosis of thyroid nodules in patients with HT. Findings The HTN-AI model achieved great performance with a Dice similarity coefficient (DSC) of 0.91, and consistent performance across patients with and without HT. Clinical relevance The HTN-AI model enhances the accuracy and efficiency of thyroid nodule diagnosis, particularly in patients with HT. By assisting radiologists at varying experience levels, this model supports improved decision-making in the management of thyroid nodules.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4610-4620"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of photon-counting detector CT technology for contrast medium reduction in portal venous phase thoracoabdominal CT.","authors":"Daniel Popp, Martin Siedlecki, Lena Friedrich, Mark Haerting, Christian Scheurig-Muenkler, Florian Schwarz, Thomas Kroencke, Stefanie Bette, Josua A Decker","doi":"10.1007/s00330-025-11409-3","DOIUrl":"10.1007/s00330-025-11409-3","url":null,"abstract":"<p><strong>Objectives: </strong>To compare image quality and iodine attenuation intra-individually in portal venous phase photon-counting detector CT (PCD-CT) scans using protocols with different contrast medium (CM) volume.</p><p><strong>Materials and methods: </strong>A prospectively acquired patient cohort between 04/2021 and 11/2023 was retrospectively screened if patients had the following combination of portal venous phase thoracoabdominal CT scans: (a) PCD-CT with 120 mL CM volume (PCD-CT_{120 mL}), (b) PCD-CT with 100 mL CM volume (PCD-CT_{100 mL}), and (c) prior energy-integrating detector CT (EID-CT) with 120 mL CM volume. On PCD-CT, virtual monoenergetic image (VMI) reconstructions at 70 keV were applied for both groups as well as additional VMI at 60 keV for PCD‑CT_{100 mL}. Quantitative analyses including signal-to-noise (SNR) and contrast-to-noise ratios (CNR) and qualitative analyses were performed using a mixed linear effects model.</p><p><strong>Results: </strong>The final study cohort comprised 49 patients (mean age 67 [31-86] years, 12 female). Comparison to EID-CT was available in 33 patients. In standard 70 keV VMI reconstructions, PCD-CT_{100 mL} was non-inferior to PCD-CT_{120 mL} as well as to EID-CT_{120 mL} for CNR in abdominal organs (all p > 0.050). The mixed linear effects model revealed significant differences between contrast volume groups for both contrast enhancement and image quality ratings. PCD-CT_{100 mL/70 keV} demonstrated the smallest deviation from optimal contrast enhancement (-0.306, p < 0.001).</p><p><strong>Conclusion: </strong>In portal venous phase thoracoabdominal PCD-CT, a nearly 17% reduction in CM was achievable while maintaining subjective and objective image quality compared to prior higher CM volume PCD-CT scans within the same patients and still surpassing image quality of previous exams on an EID-CT system.</p><p><strong>Key points: </strong>Question How do image quality and iodine attenuation intra-individually compare in portal venous phase photon-counting detector CT (PCD-CT) scans using protocols with different contrast medium volume. Findings PCD-CT scans exhibit superior quantitative and qualitative image quality compared to energy-integrating detector-CT acquisitions and are not negatively affected by contrast volume reductions up to 17%. Clinical relevance This study provides further evidence that PCD-CT enables a considerable reduction in iodine dose for portal venous phase acquisition, benefiting both patients and healthcare system costs.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4635-4648"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebellar hemorrhages in very preterm infants: presence, involvement of the dentate nucleus, and cerebellar hypoplasia are associated with adverse cognitive outcomes.","authors":"Karla Drommelschmidt, Thomas Mayrhofer, Borek Foldyna, Hanna Müller, Janika Raudzus, Sophia L Göricke, Bernd Schweiger, Selma Sirin","doi":"10.1007/s00330-025-11452-0","DOIUrl":"10.1007/s00330-025-11452-0","url":null,"abstract":"<p><strong>Objective: </strong>Impaired cognition is a frequent complication of prematurity, closely related to patients' outcomes. Imaging features of cerebellar hemorrhages (CBH) related to impaired cognition are not well studied. This study evaluated the relationship between cMRI-derived CBH characteristics and clinical risk factors for adverse cognition.</p><p><strong>Methods: </strong>Our analysis is threefold: (1) We included very preterm infants (2009-2018) undergoing cMRI, and compared clinical and cMRI findings between infants with and without CBH. (2) In the CBH cohort, we associated clinical and imaging findings with cognitive outcomes (Bayley Score of Infant Development at two years corrected age, impaired outcomes: < 85) using uni- and multivariable logistic regression analyses. (3) We conducted a matched pair case-control analysis (CBH vs. no CBH) matching for gestational age (GA) and supratentorial injury.</p><p><strong>Results: </strong>Among the 507 infants (52% male; mean GA 26.8 ± 2.7 weeks), 53 (10.5%) presented with CBH. Cognition was impaired in those with CBH (case-control: 88 (IQR: 75-110) vs. 105 (IQR: 90-112), p < 0.001), even in those with CBH < 5 mm (case-control: 95 (IQR: 77.5-115) vs. 105 (IQR: 91-113), p = 0.037). In infants with CBH, red-blood-cell-transfusion requirement (odds ratio (OR) 1.32, 95% CI: 1.01-1.72, p = 0.037), dentate nucleus involvement (OR 17.61, 95% CI: 1.83-169.83, p = 0.013) and moderate-to-severe cerebellar hypoplasia (OR 26.41, 95% CI: 1.11-626.21, p = 0.043) were independent predictors of impaired cognition. Adding dentate nucleus involvement to cerebellar hypoplasia increased the discriminatory capacity (AUC 0.85 vs. 0.71, p = 0.004).</p><p><strong>Conclusion: </strong>CBH (even < 5 mm) impact cognitive outcomes of very preterm infants, underlining the cerebellum's importance for cognition. In infants with CBH, involvement of the dentate nucleus and moderate-to-severe cerebellar hypoplasia are independent structural risk factors for impaired cognition.</p><p><strong>Key points: </strong>Question The cerebellum is important for cognition. Cerebellar hemorrhages are common in preterm infants, but the imaging features related to impaired cognition are not well studied. Findings Even small cerebellar hemorrhages affected cognition. Involvement of the dentate nucleus and moderate-to-severe cerebellar hypoplasia were identified as new structural risk factors for adverse cognition. Clinical relevance Cerebral MRI enables precise diagnosis of cerebellar hemorrhages and the detection of structural risk factors for adverse cognition like dentate nucleus involvement and cerebellar moderate-to-severe hypoplasia. This knowledge facilitates risk estimation, structured follow-up, and interventions after prematurity.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4747-4758"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular penetration sign: dual-phase enhanced CT manifestations of atypical liver abscess caused by Klebsiella pneumoniae.","authors":"Tao Yuan, TangLi Zhong, Jun Song","doi":"10.1007/s00330-025-11460-0","DOIUrl":"10.1007/s00330-025-11460-0","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the multislice spiral computed tomography (MSCT) features of atypical liver abscesses caused by Klebsiella pneumoniae (KP).</p><p><strong>Methods: </strong>A retrospective review was conducted on patients with atypical KP-caused liver abscesses, as verified by biopsy or surgery, from October 2019 to December 2023. All patients underwent dual-phase enhanced CT scan, and MSCT findings were analysed.</p><p><strong>Results: </strong>Seventy-two patients (58.5 ± 12.3 years, 43 males, 29 females) with atypical KP-induced liver abscess and 115 lesions were identified. Vascular penetration was detected in twelve lesions, presenting as vascular thickening, indistinct margins, and irregular invasive alterations. Among them, three lesions were initially misdiagnosed as primary hepatic lymphoma (PHL). Additionally, 50 lesions exhibited imaging patterns such as the \"honeycomb\", \"petal\", or \"cluster\" signs, and 40 lesions showed \"lesion shrinkage\" sign. Transient abnormal enhancement in hepatic parenchyma was observed in 83 lesions.</p><p><strong>Conclusion: </strong>Vascular penetration with inflammatory infiltration might be a crucial sign in the diagnosis of atypical liver abscess caused by KP; correctly recognising this sign could reduce misdiagnosis.</p><p><strong>Key points: </strong>Question Early imaging diagnosis of atypical liver abscesses caused by Klebsiella pneumoniae is significant because microbiology or blood cultures are time-consuming and may delay appropriate treatment. Findings The vascular penetration sign was noted in some Klebsiella pneumoniae atypical liver abscesses and play a vital role in the diagnosis of this disease. Clinical relevance The newly discovered vascular penetration sign in this study is an important sign for identifying atypical liver abscesses caused by Klebsiella pneumoniae. Accurate identification of this sign facilitates early clinical diagnosis and diminishes the risk of misdiagnosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4685-4691"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the diagnostic performance of non-contrast MR angiography and planar V/Q scintigraphy for pulmonary embolism: a systematic review and meta-analysis.","authors":"Ricardo F Silva, Matheus Zanon, Jeanne B Ackman, Gabriele C Forte, Stephan Altmayer, Jürgen Biederer, Liisa L Bergmann, Rubens Gabriel Feijó Andrade, Bruno Hochhegger","doi":"10.1007/s00330-025-11366-x","DOIUrl":"10.1007/s00330-025-11366-x","url":null,"abstract":"<p><strong>Objectives: </strong>To conduct a meta-analysis of the diagnostic performance of non-contrast magnetic resonance pulmonary angiography (NC-MRPA) and ventilation-perfusion (V/Q) scintigraphy for the detection of acute pulmonary embolism (PE).</p><p><strong>Materials and methods: </strong>Systematic searches of electronic databases were conducted from 2000 to 2024. Primary outcomes were per-patient sensitivity and specificity of NC-MRPA and V/Q scintigraphy. The pooled sensitivities, specificities, and 95% confidence intervals (95% CI) were calculated using a random-effect analysis. Summary receiver-operating characteristic (SROC) curves and the area under the curve (AUC) were obtained.</p><p><strong>Results: </strong>A total of 3709 studies (1941 NC-MRPA studies) were identified through systematic searches, with eight published MRI and nine published V/Q investigations meeting inclusion criteria. The results showed that NC-MRPA had a pooled sensitivity of 0.88 (95% CI: 0.83-0.91) and specificity of 0.97 (95% CI: 0.93-0.98), yielding an AUC of 0.92 (95% CI: 0.85-0.96). V/Q scanning had a pooled sensitivity of 0.81 (95% CI: 0.76-0.85) and specificity of 0.84 (95% CI: 0.74-0.91), yielding an AUC of 0.87 (95% CI: 0.75-0.91). The pooled proportion of non-diagnostic tests for V/Q scans (34.7%, 95% CI: 30.8-38.7) was greater than that of NC-MRPA studies (3.31%, 95% CI: 1.65-4.97).</p><p><strong>Conclusion: </strong>This meta-analysis suggests that NC-MRPA is more specific than V/Q scintigraphy for the detection of PE, with comparable accuracy and sensitivity. NC-MRPA yielded fewer non-diagnostic scans than V/Q scintigraphy and is a feasible alternative imaging modality for diagnosing PE in patients for whom intravenous contrast administration poses a substantive risk.</p><p><strong>Key points: </strong>Question V/Q lung scintigraphy has been used as a reserve, alternative modality for patients who cannot undergo CT pulmonary angiography. Findings Non-contrast MR angiography (MRA) is a feasible alternative for diagnosing PE in patients for whom intravenous iodinated contrast administration poses a substantial risk. Clinical relevance Non-contrast MRA provides similar sensitivity and superior specificity to V/Q scintigraphy for diagnosing PE, without ionizing radiation exposure.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4814-4823"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}