{"title":"Second-generation unibody single-branched stent-graft for thoracic endovascular aortic repair of type B aortic dissection.","authors":"Xiaoye Li, Xunqiang Liu, Dongjin Wang, Minxin Wei, Zhixiong Zhong, Jinping Liu, Xinyan Pang, Chao Song, Qingsheng Lu","doi":"10.1007/s00330-025-12009-x","DOIUrl":"https://doi.org/10.1007/s00330-025-12009-x","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the safety and feasibility of thoracic endovascular repair (TEVAR) of type B aortic dissection (TBAD) with Cratos branched stent-graft.</p><p><strong>Materials and methods: </strong>A prospective, multicenter study consisting of consecutive TBAD patients across 12 centers in China who were treated with the Cratos branched stent-graft was conducted. Outcomes were reported using descriptive statistics. Overall survival, freedom from reintervention, and branch artery patency were estimated using Kaplan-Meier estimates.</p><p><strong>Results: </strong>The first enrollment started from January 2022 and ended in July 2023, with a total of 89 patients finally enrolled. All patients were diagnosed with TBAD and underwent TEVAR using the Cratos branched stent-graft. Technical success was achieved in all patients. One patient (1.1%) died of respiratory failure within the first 30 days after the operation. The rate was 1.1% for both stroke and spinal cord ischemia. The median follow-up was 369 days. Two patients (2.2%) died during follow-up, and neither death was related to the aorta. One patient had reintervention because of retrograde type A aortic dissection (RTAD). Two cases of endoleak resolved spontaneously but the one with RTAD and type Ia endoleak. Eighty-one patients completed a 12-month computed tomography angiography. The patency rate for the branch section was 95.06%. At the segment covered by the stent-graft, the complete thrombosis rate was 92.59% (75/81) at 12 months.</p><p><strong>Conclusions: </strong>Cratos branched stent-graft was a safe and feasible device for TEVAR of TBAD. The updated device exhibited easy, safe, and accurate deployment. (Chinese Clinical Trial Register identifier: ChiCTR2200064412: ChiCTR2200064412).</p><p><strong>Key points: </strong>Question How can thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) safely provide sufficient proximal landing while maintaining left subclavian artery perfusion? Findings The Cratos unibody single-branched stent-graft achieved high technical success, low complication rates, and excellent branch patency in treating TBAD while revascularizing the left subclavian artery. Clinical relevance The Cratos stent-graft enables one-stage, minimally invasive TEVAR for TBAD, addressing the need for safe left subclavian artery coverage and revascularization, thereby improving sealing, reducing complications, and enhancing clinical outcomes.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312762","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":"Night-shift neuroradiology under pressure: what trends from a Dutch academic center tell us about future necessities.","authors":"Vera C Keil, Jakob W Kist","doi":"10.1007/s00330-025-12061-7","DOIUrl":"https://doi.org/10.1007/s00330-025-12061-7","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312699","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":"Reply to the Letter to the Editor: Early post-treatment imaging enables timely diagnosis of viable hepatocellular carcinomas after selective internal radiation therapy.","authors":"Hong Wei, Hanyu Jiang, Jeong Min Lee","doi":"10.1007/s00330-025-11999-y","DOIUrl":"https://doi.org/10.1007/s00330-025-11999-y","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312710","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}
Lion Stammen, Eva J I Hoeijmakers, Thomas G Flohr, Hester A Gietema, Janneke Vandewall, Joachim E Wildberger, Cécile R L P N Jeukens, Bibi Martens
{"title":"Reducing contrast media dosage for pulmonary embolism CTPA in PCD-CT: a comparative study of EID-CT and PCD-CT in the era of individualized protocolling.","authors":"Lion Stammen, Eva J I Hoeijmakers, Thomas G Flohr, Hester A Gietema, Janneke Vandewall, Joachim E Wildberger, Cécile R L P N Jeukens, Bibi Martens","doi":"10.1007/s00330-025-12054-6","DOIUrl":"https://doi.org/10.1007/s00330-025-12054-6","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate diagnostic image quality (IQ) for pulmonary embolism detection in photon-counting detector CT (PCD-CT) with significantly reduced contrast media (CM) dose vs conventional energy-integrating detector CT (EID-CT), using optimized and individualized CM protocols.</p><p><strong>Materials and methods: </strong>Consecutive CT pulmonary angiography (CTPA) scans performed on the EID-CT (Jan 2024-Mar 2024) with an individualized kilovoltage (kV) and total body weight (TBW) adapted CM protocol, and on the PCD-CT (Aug 2023-Feb 2024) with a TBW adapted CM protocol matching the 70 kV EID-CT protocol, were retrospectively collected. EID-CT scans were performed at 70-120 kV, based on patients' size, while PCD-CT scans were performed at 120 kV with 55 keV virtual monoenergetic images. Objective IQ assessment included mean attenuation (in Hounsfield Units), signal-to-noise ratio, and contrast-to-noise ratio (CNR). Two board-certified radiologists assessed diagnostic IQ subjectively using a five-point Likert scale.</p><p><strong>Results: </strong>In 140 EID-CT and 118 PCD-CT scans, PCD-CT reduced total iodine load by 26.7% and CT dose index volume by 24.4%. Objective IQ parameters showed no significant differences, except for a decrease in CNR in the proximal pulmonary arteries in PCD-CT scans (p = 0.02). Subjective IQ was rated as moderate/good by observers 1 and 2 in 94.9% and 97.9% of the EID-CT scans, respectively, and 96.5% and 100% of the PCD-CT scans, respectively.</p><p><strong>Conclusion: </strong>PCD-CT with a TBW-adapted CM protocol can achieve substantial reductions in both CM and radiation dose compared to EID-CT with individualized kV and TBW adapted CM protocols, while maintaining diagnostic IQ in CTPA scans.</p><p><strong>Key points: </strong>Question The feasibility of CM reduction in PCD-CT vs EID-CT with highly individualized CM protocols, while maintaining diagnostic IQ. Findings PCD-CT reduces total iodine load by 26.7% and CT dose index volume by 24.4% compared to EID-CT, with comparable objective and subjective diagnostic IQ. Clinical relevance This approach enables CM reduction, potentially lowering patient risk and providing environmental and financial benefits. Additionally, PCD-CT allows for CM and radiation dose reduction while maintaining comparable IQ.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307246","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}
Ben J A Janssen, Frank M Zijta, Natasja Fraters, Ad de Man, Sandra Malagon, Saba Rafi, Henrius P Raat, Ankie Hersbach, Joachim E Wildberger, Estelle C Nijssen
{"title":"Effect of distributing urine-collection bags on contrast-material load in wastewater.","authors":"Ben J A Janssen, Frank M Zijta, Natasja Fraters, Ad de Man, Sandra Malagon, Saba Rafi, Henrius P Raat, Ankie Hersbach, Joachim E Wildberger, Estelle C Nijssen","doi":"10.1007/s00330-025-11984-5","DOIUrl":"https://doi.org/10.1007/s00330-025-11984-5","url":null,"abstract":"<p><strong>Objectives: </strong>Contrast materials (CM) are ubiquitous in modern clinical practice. Metabolically inert and excreted in urine, treatment plants (WWTP) have difficulty removing CM from wastewater and CM increasingly emerge as environmental contaminants. This study evaluates the effect of urine-collection bag (UCB) distribution on corresponding CM load in WWTP influent.</p><p><strong>Materials and methods: </strong>This prospective observational multicenter study includes patients scheduled for contrast-material-enhanced computed tomography (iodine-CM) or magnetic resonance imaging (gadolinium-CM) at an academic and a regional hospital. At each centre, data were collected over a 3-week control-period and a 3-week intervention-period with standard-clinical-care UCB distribution (4pp). Control and intervention were compared for cumulative iodine- and gadolinium-CM-loads in WWTP influent using linear regression analysis, corrected for administered CM. Compliance was evaluated in interviews with consenting patients; results were used to estimate achievable UCB-distribution effects.</p><p><strong>Results: </strong>UCB were distributed to 69.1% (1188/1719) eligible patients, and had a statistically significant effect on WWTP influent CM-loads: intervention versus control -17.4% iopromide [F(1,37) = 54.7, p < 0.001, η<sup>2</sup> = 0.60; R<sup>2</sup> = 0.966]; -14.8% ioversol [F(1,37) = 154.5, p < 0.001, η<sup>2</sup> = 0.82; R<sup>2</sup> = 0.989]; -7.2% gadolinium at the academic hospital [F(1,37) = 43.3, p < 0.001, η<sup>2</sup> = 0.54, R<sup>2</sup> = 0.967]; -33.2% gadolinium at the regional hospital [F(1,37) = 1.13, p = 0.296, η<sup>2</sup> = 0.03]. Interviews were conducted with 47.0% (558/1188) patients: 92.1% (514/558) reported using UCB, and they used 89.2% (1834/2056) of the UCB they were provided with. Compliance-based estimates were: achievable compliance 29.9% to 43.6%, interceptable CM 26.7% to 38.9%.</p><p><strong>Conclusion: </strong>UCB distribution had a significant but small impact on reducing wastewater CM-loads. Compliance data overestimate UCB-distribution effect, which underscores the importance of wastewater measurements when evaluating mitigation strategies.</p><p><strong>Key points: </strong>Question Contrast materials (CM) increasingly emerge as environmental contaminants; because treatment plants are currently unable to remove CM from wastewater, the effects of urine-collection-bag distribution are evaluated. Findings Standard-care urine-collection-bag distribution after CT and MRI led to small but significant CM-load reductions in wastewater; compliance data, however, led to sizeable overestimation of (achievable) effects. Clinical relevance Urine-collection bag distribution had a significant but small impact on reducing contrast materials in wastewater. Most studies only include compliance data, but results show these overestimate impact, underscoring the importance of contrast-load measurements when evaluat","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312790","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":"Letter to Editor: Respiratory symptoms associated with a new lobe-based bronchial scoring system in an urban Chinese low-dose CT screening population.","authors":"Dequan Liu, Lei Liu, Xiangyu Che, Guangzhen Wu","doi":"10.1007/s00330-025-12018-w","DOIUrl":"https://doi.org/10.1007/s00330-025-12018-w","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312773","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}
Roman Vuskov, Alexander Hermans, Martin Pixberg, Jonas Müller-Hübenthal, Andreas Brauksiepe, Eric Corban, Malin Cubukcu, Julia Nowak, Aleksandar Kargaliev, Marc von der Stück, Robert Siepmann, Christiane Kuhl, Daniel Truhn, Sven Nebelung
{"title":"Comprehensive deep learning-assisted multi-condition analysis of knee MRI studies improves resident radiologist performance.","authors":"Roman Vuskov, Alexander Hermans, Martin Pixberg, Jonas Müller-Hübenthal, Andreas Brauksiepe, Eric Corban, Malin Cubukcu, Julia Nowak, Aleksandar Kargaliev, Marc von der Stück, Robert Siepmann, Christiane Kuhl, Daniel Truhn, Sven Nebelung","doi":"10.1007/s00330-025-12052-8","DOIUrl":"https://doi.org/10.1007/s00330-025-12052-8","url":null,"abstract":"<p><strong>Objectives: </strong>Developing a deep-learning model for automated multi-tissue, multi-condition knee MRI analysis and assessing its clinical potential.</p><p><strong>Material and methods: </strong>This retrospective dual-center study included 3121 MRI studies from 3018 adults, who underwent routine knee MRI examinations at a radiologic practice (2012-2019). Twenty-three conditions across cartilage, menisci, bone marrow, ligaments, and other soft tissues were manually labeled. A 3D slice transformer network was trained for binary classification and evaluated in terms of the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity using a five-fold cross-validation and an external test set of 448 MRI studies (429 adults) from a university hospital (2022-2023). To assess differences in diagnostic performance, two inexperienced and two experienced radiology residents read 50 external test studies with and without model assistance. Paired t-tests were used for statistical analysis.</p><p><strong>Results: </strong>Averaged over cross-validation tests, the model's AUC was at least 0.85 for 8 conditions and at least 0.75 for 18 conditions. Generalization on the external test set was robust, with a mean absolute AUC difference of 0.05 ± 0.03 per condition. Model assistance improved accuracy and sensitivity for inexperienced residents, increased inter-reader agreement for both groups, and increased sensitivity and shortened reading times by 10% (p = 0.045) for experienced residents. Specificity decreased slightly when conditions with low model performance (AUC < 0.75) were included.</p><p><strong>Conclusion: </strong>Our deep-learning model performed well across diverse knee conditions and effectively assisted radiology residents. Future work should focus on more fine-grained predictions for subtle or rare conditions to enable comprehensive joint assessment in clinical practice.</p><p><strong>Key points: </strong>Question Increasing MRI utilization adds pressure on radiologists, necessitating comprehensive AI models for image analysis to manage this growing demand efficiently. Findings Our AI model enhanced diagnostic performance and efficiency of resident radiologists when reading knee MRI studies, demonstrating robust results across diverse conditions and two datasets. Clinical relevance Model assistance increases the sensitivity of radiologists, helping to identify pathologies that were overlooked without AI assistance. Reduced reading times suggest potential alleviation of radiologists' workload.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312787","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}
Dongdong Zhang, Ziwei Chen, Ran Jing, Pei Zhang, Ming Cai
{"title":"Letter to the Editor: Radiofrequency ablation for patients with primary hyperparathyroidism-a multicenter non-randomized open-label single-arm prospective clinical trial.","authors":"Dongdong Zhang, Ziwei Chen, Ran Jing, Pei Zhang, Ming Cai","doi":"10.1007/s00330-025-12076-0","DOIUrl":"https://doi.org/10.1007/s00330-025-12076-0","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299199","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":"Renal mass biopsies: time to tailor the approach.","authors":"Annemarie Uhlig","doi":"10.1007/s00330-025-12067-1","DOIUrl":"https://doi.org/10.1007/s00330-025-12067-1","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299177","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":"Ischemic core or reversible tissue? Limits of a single ADC threshold in predicting DWI reversal after rapid and successful thrombectomy.","authors":"Teresa Perillo, Liam O'Halloran","doi":"10.1007/s00330-025-12068-0","DOIUrl":"https://doi.org/10.1007/s00330-025-12068-0","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299227","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}