European Radiology最新文献

{"title":"Diagnostic performance of a single breath-hold lung MRI scan with AI-powered compressed sensing for nodule detection in comparison to photon counting detector-CT.","authors":"Anna Palmisano, Giulia Piccinni, Davide Serra, Elisa Bruno, Giulio Ferrazzi, Davide Vignale, Carlo Tacchetti, Antonio Esposito","doi":"10.1007/s00330-026-12738-7","DOIUrl":"10.1007/s00330-026-12738-7","url":null,"abstract":"<p><strong>Objective: </strong>The aim was to evaluate the performance of a single-breath-hold accelerated 3D-T1w-FFE 3-T MRI sequence for screening lung nodules, compared with photon-counting detector CT (PCD-CT), which served as the reference standard.</p><p><strong>Materials and methods: </strong>In this single-center prospective study, 148 healthy adults underwent lung 3-T MRI between June 2024 and June 2025 using a single-breath-hold, AI-aided compressed sensing (AI-CS)- accelerated 3D-T1-FFE sequence (acceleration factor of 9) to evaluate for the presence of lung nodules. Patients scanned within 24 h using PCD-CT, for comparison, were enrolled. Lung-RADS scores were evaluated per patient, and all nodules were assessed for size and composition. The diagnostic performance of MRI was compared with PCD-CT, including interobserver and intermodality agreement, using Lin's Concordance Correlation Coefficient (CCC).</p><p><strong>Results: </strong>97 patients were enrolled (65 men, 67%; mean age 58 ± 12 years old) and 33 (34%) were active smokers. MRI and CT showed complete agreement in the Lung-RADS 4A and 4B categories. MRI demonstrated an overall sensitivity of 83.1% (95% CI: 73.2-89.9) for solid nodules, increasing to 98.1% (95% CI: 90.2-99.7) for nodules ≥ 4 mm. Lin's CCC for nodule size was 0.985, indicating excellent agreement, with MRI showing a slight underestimation of 1.02 mm (95% CI: [-1.16, 3.20]) in Bland-Altman analysis. MRI failed to detect calcified nodules < 4 mm, which accounted for 51.2% of undetected nodules.</p><p><strong>Conclusions: </strong>A single breath-hold AI-CS accelerated 3D-T1-FFE MRI scan can be a valuable tool for solid lung nodule screening, showing very good agreement with CT.</p><p><strong>Key points: </strong>Question May lung MRI using an optimized AI-CS accelerated 3D-T1-FFE sequence acquired in a single breath hold be a radiation-free alternative to CT in lung cancer screening? Findings Lung MRI using AI-CS 3D-T1-FFE sequence achieved an overall accuracy of 87.3% for detecting solid nodules overall, increasing to 97.7% for nodules ≥ 4 mm. Clinical relevance Lung MRI using an optimized AI-CS 3D-T1-FFE is a promising alternative to chest CT in lung nodules screening, offering high diagnostic accuracy, especially for clinically relevant nodules, excellent Lung-RADS classification agreement, and short acquisition time (17.2 s [IQR, 17.2-17.3]).</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8322-8331"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal appearance of the parathyroid gland on CT.","authors":"Boeun Lee, Sae Rom Chung, Tae-Yon Sung, Young Jun Choi, Jeong Hyun Lee, Jung Hwan Baek","doi":"10.1007/s00330-026-12739-6","DOIUrl":"10.1007/s00330-026-12739-6","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize the CT imaging features of normal parathyroid glands validated by ultrasonography (US) and intraoperative findings.</p><p><strong>Materials and methods: </strong>This retrospective analysis used prospectively collected data from patients who underwent total thyroidectomy for benign or malignant thyroid nodules between February 1, 2023, and January 1, 2024. Patients were excluded if they had lateral neck node metastasis, renal disease, Graves' disease, biochemical parathyroid dysfunction, age < 19 or > 80 years, or insufficient imaging data. Normal parathyroid glands were defined as glands visualized on preoperative US and intraoperatively identified as non-enlarged glands without gross pathological abnormalities. Patients who underwent preoperative thyroid CT were included. CT images were independently reviewed by two radiologists to evaluate gland size, location, attenuation, and dynamic enhancement patterns. Interobserver agreement for attenuation measurements was assessed using intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>Thirty-eight patients with 117 normal parathyroid glands confirmed by US-intraoperative correlation were included. Inferior glands showed a higher CT identification rate than superior glands (94.4% vs. 87%), although the difference was not statistically significant. Superior glands were consistently located at the tracheoesophageal groove, whereas inferior glands demonstrated greater positional variability (p < 0.001). Most glands (96.6%) showed arterial enhancement followed by washout on venous-phase imaging and exhibited lower attenuation than the thyroid gland. Interobserver agreement was excellent (ICC, 0.95-0.96).</p><p><strong>Conclusions: </strong>Normal parathyroid glands demonstrated characteristic anatomical distribution and dynamic enhancement patterns on CT in this highly selected surgical cohort. Further validation in broader and independent populations is warranted.</p><p><strong>Key points: </strong>Question The CT appearance of normal parathyroid glands has not been well established. Findings Normal parathyroid glands demonstrated characteristic arterial enhancement with washout on venous-phase and lower attenuation than the thyroid gland on CT. Superior parathyroid glands demonstrate a relatively constant location at the tracheoesophageal groove, whereas inferior glands show greater positional variability. Clinical relevance Familiarity with the normal CT appearance of parathyroid glands may help avoid confusion with other enhancing cervical lesions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8132-8139"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561214","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":"LI-RADS v2018 versus KLCA-NCC v2022: comparison of probability-based HCC categories.","authors":"Jeong Hee Yoon, Eun Sun Lee, Young Kon Kim, Chang Hee Lee, Jeong Woo Kim, Won Chang, Joon-Il Choi, Beom Jin Park, Jin-Young Choi, Seung-Seob Kim, Jeong-Sik Yu, Seong Jin Park, Myung-Won You, Myoung-Jin Jang, Hee Sun Park, Jeong Min Lee","doi":"10.1007/s00330-026-12696-0","DOIUrl":"10.1007/s00330-026-12696-0","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the diagnostic performance of corresponding probability-based categories between LI-RADS v2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) v2022.</p><p><strong>Materials and methods: </strong>This retrospective multicenter study included treatment-naïve patients at risk of hepatocellular carcinoma (HCC) who underwent gadoxetic acid-enhanced MRI between January 2015 and June 2018. Four radiologists independently evaluated MRI and CT when available; observations were categorized according to both criteria. Reference standards were pathology or clinical diagnosis. Generalized estimating equations were used for lesion clustering.</p><p><strong>Results: </strong>The study included 2237 patients (1666 men; mean age, 59 ± 11 years) with 2445 lesions. On MRI, LR-5 showed a higher positive predictive value (PPV) than KLCA-NCC \"definite HCC\" (93.9% vs. 91.7%, p < 0.001). PPV was not different between LR-4 and KLCA-NCC \"probable HCC\" (68.2% vs. 64.1%, p = 0.141). HCC proportion was 13.2% in LR-3 and 40.8% in KLCA-NCC \"indeterminate nodule\" (p < 0.001). In 1455 patients with 1590 lesions on CT, LR-5 and KLCA-NCC had comparable PPV (92.9% in each). PPV of KLCA-NCC \"probable HCC\" was higher than LR-4 (83.8% vs. 73.9%, p = 0.012). HCC proportion was 52.0% in LR-3 and 46.2% in KLCA-NCC \"indeterminate nodule\" (p = 0.001).</p><p><strong>Conclusion: </strong>Both LI-RADS v2018 and KLCA-NCC v2022 demonstrated effective probability-based risk stratification, but corresponding probability categories were not interchangeable. On CT, category performance differed from MRI, highlighting the need for modality-specific refinement to improve diagnostic precision.</p><p><strong>Key points: </strong>Question Do conceptually corresponding diagnostic categories in LI-RADS v2018 and KLCA-NCC v2022 demonstrate equivalent diagnostic performance for HCC? Findings Both systems demonstrated effective probability-based stratification, but corresponding categories were not equivalent, and the performance was modality-specific. Clinical relevance Corresponding categories are not interchangeable between the two systems. The heterogeneity within \"probable HCC\" and modality-specific performance differences suggest potential benefits from subcategorization and refinement of CT-specific criteria.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8451-8464"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does adding a high-resolution 3D sequence improve the accuracy of erosion detection in pediatric sacroiliac joint MRI?","authors":"Nele Herregods, Robert G W Lambert, Stephanie Wichuk, Eva Schiettecatte, Thomas Renson, Joke Dehoorne, Lennart B O Jans, Jacob L Jaremko","doi":"10.1007/s00330-026-12709-y","DOIUrl":"10.1007/s00330-026-12709-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether adding an erosion-sensitive high-resolution 3D sequence to sacroiliac joint (SIJ) MRI protocols in children improves erosion detection and diagnosis of Juvenile Spondyloarthritis (JSpA).</p><p><strong>Materials and methods: </strong>SIJ-MRI were prospectively obtained in 84 children (50 girls, mean age 13.3 y) clinically suspected of JSpA, conforming to 2024 ASAS/SPARTAN recommendations including a volumetric interpolated breath-hold examination (VIBE) sequence. Three experienced radiologists recorded the presence of erosions, non-erosion bony defects, and the presence of JSpA, with confidence scoring for each, in 3 blinded re-randomized reading exercises: (1) T1-weighted spin-echo (T1) and short-tau inversion recovery (STIR) sequences only; (2) VIBE only; (3) all sequences. Discrepancies were resolved by consensus read-out. The reference standard was rheumatologist diagnosis of JSpA.</p><p><strong>Results: </strong>MRI was considered indicative of JSpA in 14 cases (16.7%) on T1/STIR, 21 (25.0%) on VIBE only, and 15 (17.9%) with all sequences. In the three exercises, erosions were scored in 12 (14.3%), 22 (26.2%), and 13 (15.5%) cases, and non-erosion bony defects in 43 (51.2%), 79 (94.0%), and 80 (95.2%) cases. Sensitivity/specificity for JSpA diagnosis was 34.6/91.4%, 42.3/82.8%, and 38.5/91.4%, after consensus read-out 38.5/94.8%. Mean absolute values of confidence scores significantly improved for all features after adding VIBE, although inter-reader agreement did not consistently improve.</p><p><strong>Conclusion: </strong>Adding VIBE to T1/STIR significantly increased reader confidence in JSpA diagnosis. However, a trend toward improved sensitivity and specificity was not statistically significant. If the ASAS-SPARTAN SIJ MRI protocol is applied to children, all sequences must be interpreted together to avoid mistaking non-erosion defects for true erosions.</p><p><strong>Key points: </strong>Question Can the recently published ASAS-SPARTAN adult standardized image acquisition protocol for sacroiliac joint MRI be used for diagnostic evaluation of sacroiliitis in children suspected for Juvenile Spondyloarthropathy (JSpA)? Findings The ASAS/SPARTAN recommendations including a high-resolution 3D erosion-sensitive sequence can also be applied to children, resulting in significantly increased reader confidence, with a trend toward improved sensitivity/specificity for diagnosing JSpA, although not statistically significant. Clinical relevance The ASAS-SPARTAN adult sacroiliac joint MRI protocol can also be beneficially applied to children, as long as all sequences are interpreted together to avoid mistaking non-erosion defects (almost universally seen on the 3D erosion-sensitive sequences in children) for true erosions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8062-8071"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of adjunctive quantitative analysis on visual interpretation of amyloid PET: a multiple tracer, multicentre study.","authors":"Seunggyun Ha, Byungwook Choi, Soo Jin Kwon, Sungmin Kang, Junik Son, Shin Young Jeong, Sang-Woo Lee, Yeong Sim Choe, Donghyeon Kim, Chae Moon Hong","doi":"10.1007/s00330-026-12687-1","DOIUrl":"10.1007/s00330-026-12687-1","url":null,"abstract":"<p><strong>Introduction: </strong>Visual amyloid positron emission tomography (PET) interpretation is standard for detecting cerebral amyloid-β but is limited by subjectivity, inter-reader variability, and tracer heterogeneity. We evaluated the impact of adjunctive quantitative analysis in real-world clinical practice.</p><p><strong>Materials and methods: </strong>This retrospective multicentre study included patients who underwent amyloid PET with F-18 florbetaben (FBB), flutemetamol (FMM), or florapronol (FPN) and T1-weighted brain MRI between 2015 and 2022. Scans were interpreted by visual assessment alone and then with adjunctive quantitative standardized uptake value ratio and Centiloid analysis. Primary outcomes were changes in reader confidence and inter-reader agreement; agreement metrics with an expert consensus adjudication (with quantitative and clinical information unblinded only when initial visual reads were discordant) were assessed as a secondary endpoint.</p><p><strong>Results: </strong>In 950 patients, adjunctive quantitative analysis significantly increased reader confidence, with high-confidence interpretations rising from 76.3% to 83.7% (p < 0.001). Inter-reader agreement also improved significantly (κ: 0.746 to 0.826, p < 0.001, respectively). Accuracy for the expert consensus adjudication increased modestly (0.930 to 0.940, p = 0.003), driven by higher specificity (0.915 to 0.944, p < 0.001) with a slight reduction in sensitivity (0.943 to 0.937, p = 0.52).</p><p><strong>Conclusion: </strong>Adjunctive quantitative analysis increases reader confidence and improves inter-reader agreement in real-world amyloid PET interpretation. Although agreement and diagnostic metrics with expert consensus adjudication also increased, this should not be interpreted as independent diagnostic validation. Overall, quantitative metrics appear most valuable as an adjunct to enhance consistency, particularly in equivocal cases.</p><p><strong>Key points: </strong>Question Does the use of adjunctive quantitative analysis significantly increase the diagnostic confidence of readers compared to visual interpretation alone? Findings Adjunctive quantitative support significantly increased reader confidence and inter-reader agreement. Clinical relevance Quantitative tools, when used as adjuncts to expert visual interpretation and supported by automated workflows, can improve consistency and confidence in amyloid PET reading, particularly in borderline cases, thereby supporting clinical decision-making in routine practice.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8097-8109"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270929","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":"Radiological risk factors for T2-T3 glottic carcinoma treated with (chemo)radiotherapy-a multicenter analysis.","authors":"Agatha S Baidun, Yves M H F Gorissen, Martine Hendriksma, Renske Gahrmann, Jose A Hardillo, Sjoert Pegge, Robert P Takes, Guido B van den Broek, Martin A de Jong, Federica Lucev, Elisabeth V Sjogren, Berit M Verbist","doi":"10.1007/s00330-026-12704-3","DOIUrl":"10.1007/s00330-026-12704-3","url":null,"abstract":"<p><strong>Objectives: </strong>In moderately advanced (T2-T3) glottic cancer, eligibility for organ-preserving surgery is limited by tumor extension into certain high-risk areas within the larynx that can be identified on preoperative imaging and serve as predictive factors for poorer outcomes. Their relevance in conservative treatment modalities, including (chemo)radiotherapy ([C]RT), remains unclear. The objective was to evaluate the impact of these predefined surgical high-risk zones in patients treated with (C)RT.</p><p><strong>Materials and methods: </strong>This retrospective study included patients with T2-3, N0-3, M0 glottic carcinoma treated with primary (C)RT and with available diagnostic imaging from three academic medical centers between 2014 and 2018. Imaging was scored for tumor involvement of high-risk areas. The 5-year rates of locoregional control (LRC) and disease-specific survival (DSS) were compared using the log-rank test and Cox proportional hazards model.</p><p><strong>Results: </strong>Imaging from 180 patients (mean age, 68 ± 11 years, 154 men) was assessed, with 173 entering the risk factor analysis after excluding unreliable scans. Significant findings were observed in the anterior larynx: vertical anterior commissure involvement negatively affected LRC and DSS, while horizontal anterior commissure and anterior paraglottic space reduced LRC. Deep vocal muscle infiltration showed negative trends. In multivariable analysis, vertical anterior commissure infiltration retained a trend toward lower DSS.</p><p><strong>Conclusion: </strong>Involvement of the anterior commissure, particularly vertical extension, which is a known predictive factor from surgical studies, likely predicts poorer outcomes after (C)RT for T2-T3 glottic carcinoma. Involvement of the anterior paraglottic space and depth of tumor infiltration carry potential predictive value.</p><p><strong>Key points: </strong>Question Can radiological risk factors proven in surgically treated patients with T2-T3 glottic carcinoma also predict treatment failure in patients treated with (chemo)radiotherapy? Findings On multivariable analysis, vertical anterior commissure involvement showed a trend toward poorer disease-specific survival. Clinical relevance Our findings contribute to the search for harmonized prognostic factors across treatment modalities for glottic carcinoma and provide a basis for integrating these risk factors into staging and treatment counseling.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8112-8122"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond STIR versus Dixon: musculoskeletal MRI protocol design as a moving target.","authors":"Patrick Omoumi","doi":"10.1007/s00330-026-12902-z","DOIUrl":"10.1007/s00330-026-12902-z","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8209-8211"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988755","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":"Key factors for predicting outcomes one year after Meso-Rex bypass surgery and optimizing the surgical plan in children with extrahepatic portal vein obstruction.","authors":"Fan He, Zhe Wen, Fuyu You, Jieqin Wang, Jinwei Chen, Hongying Wang, Xiaojuan Ji, Hongsheng Liu, Boyang Yang","doi":"10.1007/s00330-026-12712-3","DOIUrl":"10.1007/s00330-026-12712-3","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the factors for predicting 1-year outcomes and optimize surgical planning for Meso-Rex bypass (MRB) in children with extrahepatic portal vein obstruction (EHPVO).</p><p><strong>Materials and methods: </strong>From October 2014 to July 2024, children with EHPVO after MRB were retrospectively analyzed. The number of MRB, the type of bypass vessel, and the position of the lower anastomosis were collected. Predictive variables include the diameter of the connection between the left and right portal veins, the Rex vein (RV) diameter, the number of RV branches, the diameter of the thickest RV branch, and the bypass-to-superior mesenteric vein (SMV) angle, which were measured by Contrast-enhanced CT (CECT) one week after MRB. The upper and lower anastomotic stenosis were diagnosed by Ultrasound and CECT one year after MRB.</p><p><strong>Results: </strong>A total of 153 children (median age 72 months, 87 males) were included in this study. Univariate factors include the number of MRBs, the type of bypass vessel, and CECT variables (except the diameter of the thickest RV branch). Numbers of MRB and RV branches were retained in the final model for upper anastomotic stenosis. The combination of MRB > 1 and RV branches ≤ 4 predicts it post-MRB with 75% sensitivity, 86.4% specificity, and an area under the receiver operator characteristic curve (AUC) of 0.832. The bypass-to-SMV angle ≤ 110° predicts lower anastomotic stenosis after MRB with 90% sensitivity, 73.39% specificity, and AUC 0.847.</p><p><strong>Conclusions: </strong>Associated factors are useful for early postoperative risk stratification. Moreover, the type of bypass vessel and the bypass-to-SMV angle could be used to inform future surgical technique refinement.</p><p><strong>Key points: </strong>QuestionWhich factors predict 1-year outcomes and optimize surgical planning for MRB in children with EHPVO? FindingsAssociated factors include bypass-to-SMV angle, number of MRB, RV branches and diameter, left-right portal vein connection diameter, and type of bypass vessel. Clinical RelevanceAssociated factors are useful for early postoperative risk stratification. Moreover, the internal jugular vein as the bridge vessel and the bypass-to-SMV angle > 110° could be used to optimize the surgical plan for a better outcome.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8072-8082"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721774","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":"AI integration in pediatric radiology: perspectives from international academic leaders.","authors":"Hassan Shah, Brendan S Kelly, Susan Palasis, YoungHun Choi, Thierry A G M Huisman, Elaine Kan, Susan Sotardi, Luke Toh, Bruno Augusto Telles, Alex Towbin, Adam Oates, Caroline D Robson, Yumin Zhong, Robert Goetti, Dangouloff-Ros Volodia, Ashley Robinson, Ajay Prashanth Dsouza, Gian Luigi Natali, Kshitij Mankad","doi":"10.1007/s00330-026-12728-9","DOIUrl":"10.1007/s00330-026-12728-9","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence (AI) is increasingly integrated into radiology, but pediatric imaging remains underrepresented in implementation studies. To assess the current status, barriers, and enablers of AI adoption in Pediatric Radiology from a global leadership perspective.</p><p><strong>Materials and methods: </strong>A cross-sectional international survey of department leaders and division chiefs from pediatric radiology centers worldwide was conducted. The questionnaire included 14 items across domains of AI deployment, enablers, barriers, ethical concerns, stakeholder involvement, and future directions. Descriptive statistics were used for analysis.</p><p><strong>Results: </strong>Eighteen institutions completed the survey (69% response rate). Sixteen centers (88.9%) reported implementing at least one AI tool, with bone age assessment remaining the most widely used application (44.4%). Other applications included image segmentation and quantification (22.2%), imaging protocol optimization (16.7%), and natural language processing (16.7%). The mean clinical impact rating was 3.56/5, with only 16.7% describing AI as \"transformational.\" The most frequently cited barriers were lack of pediatric-specific datasets (83.3%), integration challenges (66.7%), high cost or unclear return on investment (ROI) (50%), and cybersecurity concerns (44.4%). Enablers were primarily human rather than technical, with vendor maturity and integration (72.2%) and internal champions (66.7%) most frequently highlighted. Regional variation was observed, with NLP/reporting clustered in North America and transformational impact ratings concentrated in the Asia-Pacific centers. A slim majority (55.6%) agreed that pediatric AI research currently overemphasizes model development over clinical integration, ethics, and sustainability.</p><p><strong>Conclusion: </strong>Global pediatric radiology leaders report cautious but growing AI adoption. Addressing pediatric data scarcity, enhancing multicenter collaboration, and prioritizing clinical integration and sustainability will be essential for safe and effective deployment.</p><p><strong>Key points: </strong>Question How are leading pediatric radiology centers worldwide implementing AI, and what institutional barriers and enablers determine successful clinical integration? Findings Most centers deploy at least one AI tool, but perceived impact remains modest due to pediatric data scarcity and workflow integration challenges. Clinical relevance Addressing pediatric-specific dataset limitations through multicenter collaboration, empowering institutional AI champions, and prioritizing clinical integration over model development alone will be essential for ensuring AI benefits children as effectively as adults.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8185-8196"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387406","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":"Association of hypertension and blood pressure control with aneurysm wall enhancement in unruptured intracranial aneurysms: a multicenter propensity score-matched study.","authors":"Pengjun Jiang, Xin Nie, Mervyn D I Vergouwen, Jun Wu, Yi Yang, Zheng Wen, Yang Liu, Mahmud Mossa-Basha, Michael R Levitt, Bing Zhao, Jinrui Ren, Xiaolin Chen, Yisen Zhang, Hongye Zeng, Beibei Sun, Xinyi Dong, Xiaomeng Lyu, Rong Wang, Shuo Wang, Qingyuan Liu, Chengcheng Zhu","doi":"10.1007/s00330-026-12714-1","DOIUrl":"10.1007/s00330-026-12714-1","url":null,"abstract":"<p><strong>Objectives: </strong>Aneurysm wall enhancement (AWE) on 3T magnetic resonance aneurysm wall imaging (MR-AWI) predicts aneurysm growth and rupture during follow-up. However, its association with hypertension and the impact of blood pressure (BP) control remain unclear. This study aims to evaluate the association between hypertension, BP control, and AWE in patients with unruptured intracranial aneurysms (UIAs).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed patients with UIAs from three prospective cohorts (IARP-CP, 100-Project, 100-Project II) who had 3.0 T MR-AWI. AWE was categorized into three patterns: no enhancement, focal enhancement, and circumferential enhancement. Hypertension was defined as a history of hypertension and/or use of antihypertensive drugs. Hypertensive patients were categorized as well-controlled (systolic BP [SBP] < 140 mmHg and diastolic BP [DBP] < 90 mmHg) or poorly controlled (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). Propensity score matching (PSM) (1:1) balanced confounders (age, sex, BMI, comorbidities, aneurysm characteristics). Ordinal logistic regression assessed associations between hypertension, BP control, and AWE.</p><p><strong>Results: </strong>From a cohort of 1351 patients with 1416 UIAs who had MR-AWI, we matched 427 hypertensive patients with 427 normotensive patients. Hypertension was associated with higher AWE prevalence in both the total cohort (odds ratio (OR) 1.98, 95% CI: 1.57-2.51) and the matched cohort (OR 1.93, 95% CI: 1.49-2.49). Compared with normotensive patients, well-controlled hypertension (OR 1.72, 95% CI: 1.31-2.28) and poorly controlled hypertension (OR 2.58, 95% CI: 1.77-3.77) were linked to higher AWE prevalence.</p><p><strong>Conclusion: </strong>Hypertension, particularly poorly controlled hypertension, is associated with higher AWE prevalence in patients with UIAs, suggesting a potential link between BP status and aneurysm wall imaging characteristics, which warrants further longitudinal follow-up studies to clarify its clinical significance.</p><p><strong>Key points: </strong>Question Hypertension is a well-established risk factor for aneurysm rupture, but its association with aneurysm wall enhancement (AWE) and role of blood pressure control remain unknown. Findings This study found that hypertension, especially poorly controlled hypertension, is significantly associated with a higher prevalence of AWE in patients with unruptured intracranial aneurysms (UIAs). Clinical relevance This study underscores the importance of strict blood pressure control in UIA management, as it may mitigate vessel wall inflammation and subsequent risk of aneurysm progression and rupture.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8287-8298"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387442","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}