European Radiology最新文献

{"title":"Feasibility of spondyloplasty with SpineJack^® implants in patients with thin vertebral pedicles.","authors":"Marion Bouchet, Jean-Baptiste Pialat, Bastien Chalamet, William Boulade, Charles Mayard, Adrian Kastler, Sylvain Grange, Nicolas Stacoffe","doi":"10.1007/s00330-026-12719-w","DOIUrl":"10.1007/s00330-026-12719-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility of spondyloplasty with SpineJack^® implants in patients with thin vertebral pedicles, outside the manufacturer's recommendation.</p><p><strong>Materials and methods: </strong>In this retrospective bicentric study, all patients treated with spondyloplasty using SpineJack^® implants for traumatic, porotic or malignant vertebral compression fractures were enrolled. Pedicle diameter was assessed to classify patients into the \"Thin Pedicle\" (TP) group, outside the manufacturer's recommendation (< 5 mm and/or safety margin < 0.8 mm between implant and pedicle), or into the \"Advised Pedicle Size\" (APS) group. The primary outcome was correct implant positioning on postoperative imaging. Secondary outcomes included restoration of vertebral height, procedure duration, radiation dose, hospital stay, and complications.</p><p><strong>Results: </strong>A total of 148 patients (mean age 49 ± 37 years ; 55% of male) underwent 151 spondyloplasties: 51 in the TP group and 100 in the APS group. Correct implant positioning was achieved in all procedures in both groups (100%). There was no significant difference in vertebral height restoration (81% vs. 71%; p = 0.058). Radiation exposure was significantly lower in the TP group (p = 0.02), while procedure duration and hospital stay were comparable, with 55% of procedures performed on an outpatient basis. Complication rates did not differ significantly, consisting mostly of cement leakages (20% vs. 19%; p = 0.93).</p><p><strong>Conclusion: </strong>Spondyloplasty with SpineJack^® implants under radiological guidance appears feasible and safe in patients with thin pedicles, even when the pedicle size is below the manufacturer's suggested threshold.</p><p><strong>Key points: </strong>Question Does pedicle size below recommended thresholds affect procedural feasibility, safety, and clinical outcomes when performing SpineJack® implantation under radiological guidance? Findings SpineJack® implantation achieved 100% correct positioning in thin pedicles, with complication rates, procedure duration, and hospital stay comparable to standard pedicle sizes. Clinical relevance These findings support expanding SpineJack® indications to patients with narrow pedicles, increasing access to safe and efficient minimally invasive vertebral fracture treatment for a broader patient population.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8043-8051"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410984","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":"STIR or T2-Dixon? A false dilemma in musculoskeletal MRI.","authors":"Teodoro Martín-Noguerol, Oscar L Casado-Verdugo, Antonio Luna","doi":"10.1007/s00330-026-12723-0","DOIUrl":"10.1007/s00330-026-12723-0","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8206-8208"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367342","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: \"Implementing ESR essentials for trauma care: challenges and opportunities from a Latin American perspective\".","authors":"Florian Wolf, Antonio Bulum, Bora Peynircioglu, Dimitrios K Filippiadis, Philippe L Pereira","doi":"10.1007/s00330-026-12655-9","DOIUrl":"10.1007/s00330-026-12655-9","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8487-8488"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276669","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 the Editor: Vacuum-assisted breast biopsy vs core needle biopsy-a systematic review and meta-analysis.","authors":"Pascal A T Baltzer, Paola Clauser","doi":"10.1007/s00330-026-12690-6","DOIUrl":"10.1007/s00330-026-12690-6","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8503-8504"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307667","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":"Preoperative breast MRI and long-term survival in ductal carcinoma in situ: a propensity score-weighted analysis.","authors":"Hee Jeong Kim, Woo Jung Choi, Ga Young Yoon, Hye Joung Eom, Eun Young Chae, Hee Jung Shin, Joo Hee Cha, Hak Hee Kim","doi":"10.1007/s00330-026-12720-3","DOIUrl":"10.1007/s00330-026-12720-3","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of preoperative MRI on long-term survival outcomes in women with ductal carcinoma in situ (DCIS).</p><p><strong>Materials and methods: </strong>This retrospective study included women diagnosed with DCIS between January 2007 and December 2016. Propensity scores based on 25 demographic and clinicopathologic covariates were used to generate an overlap-weighted cohort, balancing patient groups according to MRI use. Recurrence-free survival (RFS) and overall survival (OS) were compared using Kaplan-Meier estimates with log-rank test and Cox proportional hazards models.</p><p><strong>Results: </strong>Among 1003 eligible women (mean age, 48.6 years ± 9.4 [SD]), 624 (62.2%) underwent MRI. During a median follow-up of 9.5 years, 122 (12%) experienced recurrence, including 75 (61%) invasive events. The 15-year recurrence rates did not differ between the MRI and no-MRI groups (27% vs 23%; p = 0.77). Preoperative MRI was not associated with recurrence in the overlap-weighted cohort (hazard ratio (HR), 0.88 [95% CI: 0.60, 1.30]; p = 0.53). The 15-year overall mortality rate was 7% in both groups (p = 0.93), and preoperative MRI was not associated with overall mortality in the overlap-weighted cohort (HR, 1.21 [95% CI: 0.55, 2.66]; p = 0.64). Preoperative MRI was not an independent factor for RFS (HR, 0.99 [95% CI: 0.71, 1.39]; p = 0.95) or OS (HR, 1.11 [95% CI: 0.52, 2.37]; p = 0.78).</p><p><strong>Conclusion: </strong>Preoperative breast MRI was not associated with improved RFS or OS among women with DCIS.</p><p><strong>Key points: </strong>Question The impact of preoperative MRI on long-term outcomes in women with ductal carcinoma in situ (DCIS) remains uncertain. Findings In this retrospective propensity score-weighted analysis, preoperative breast MRI was not associated with improved recurrence-free survival or overall survival in women with DCIS. Clinical relevance Routine preoperative MRI may not improve long-term outcomes in DCIS. Prospective multicenter studies are warranted to identify subgroups that may derive meaningful survival benefits.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8394-8406"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396174","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":"Lung nodule detection and potential impact on guideline-based management: a retrospective post-market evaluation of three commercial software systems.","authors":"Anna Jöbstl, Anna K Luger, Bernhard Nilica, Florian Kocher, Thomas Sonnweber, Ivan Tancevski, Florian Augustin, Laurenz Nagl, Daniel Leitner, Gerlig Widmann","doi":"10.1007/s00330-026-12702-5","DOIUrl":"10.1007/s00330-026-12702-5","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate three commercial AI software tools for pulmonary nodule detection and segmentation and to assess their impact on guideline-based management recommendations.</p><p><strong>Materials and methods: </strong>A total of 740 CT and PET-CT studies from clinical routine were analyzed using three software tools (S1, S2, S3). We compared the total number of detected nodules and \"actionable\" nodules (per British Thoracic Society (BTS) definition). We further evaluated how measurement variations between tools affected hypothetical management according to Fleischner Society and BTS guidelines for incidental nodules.</p><p><strong>Results: </strong>The tools differed significantly in the total number of detections (S1: 1336; S2: 1060; S3: 1536; p < 0.001) and wrong findings (S1: 965; S2: 720; S3: 1169; p < 0.001). However, the detection of actionable nodules was comparable across all tools (S1: 375; S2: 341; S3: 373; p = 0.73). While no statistically significant differences were found in mean diameter or volume measurements, small absolute variations led to significant differences in management. Specifically, S2 triggered significantly more 1-year follow-up recommendations than S3 under BTS guidelines (p < 0.001). No significant management differences were observed when applying Fleischner Society guidelines.</p><p><strong>Conclusion: </strong>While the three included AI tools show comparable performance in detecting actionable nodules, minor measurement variations significantly impact downstream management when using guidelines with narrow thresholds, such as the BTS criteria. Fleischner Society guidelines appear more robust to these inter-software variations.</p><p><strong>Key points: </strong>Question How do commercial software tools for pulmonary nodule detection perform in real-world settings and impact hypothetical management under BTS and Fleischner guidelines? Findings Detection of actionable nodules was comparable across all tools, but small absolute measurement variations triggered significantly more 1-year follow-up recommendations under BTS guidelines. Clinical relevance AI software can cause inconsistent BTS-based management due to narrow thresholds, while Fleischner criteria appear more stable. Frequent detection of benign lesions potentially poses a risk of overdiagnosis and overtreatment in standalone AI-based reporting.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8299-8310"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316515","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":"Quality metrics of synthetic radiomics data do not predict improvement under simulated external validation: an ecological fallacy across 50 public datasets.","authors":"Clemente García-Hidalgo, José Antonio Consentino Hernández, José Vicente Cayuela Espí, Gonzalo Pagán Vicente, Juan Francisco Mula Ponce, Ángel Vázquez Olmos","doi":"10.1007/s00330-026-12703-4","DOIUrl":"10.1007/s00330-026-12703-4","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether established synthetic data quality metrics predict when deep generative augmentation improves performance under simulated external validation in radiomics.</p><p><strong>Materials and methods: </strong>Three conditional generators (WGAN-GP, CVAE, TabDDPM) were trained on 50 public binary-classification radiomic datasets from radMLBench. For each dataset-generator pair (n = 150), five quality metrics and ΔAUC (change in simulated external AUC under domain shift) were recorded across 10 repetitions; undefined AUCs (single-class test folds) were excluded a priori (30/2500 external, 1.2%). Six analyses tested quality-ΔAUC associations: rank correlations with FDR correction, ROC discrimination, subgroup random-effects meta-analysis, composite scoring, quality-guided generator selection, and SMOTE comparison. All experiments were replicated with a random forest classifier.</p><p><strong>Results: </strong>Pooled quality metrics correlated significantly with ΔAUC (|ρ| = 0.30-0.36, all adjusted p < 0.001); within each generator, all correlations were non-significant (all p > 0.05), revealing an ecological fallacy. After Benjamini-Hochberg correction, 5 of 20 correlations survived: the 4 pooled associations and DDPM MMD (unexpected direction). ROC-AUC ranged from 0.42 to 0.61 (near-chance). Quality-guided selection yielded a significantly negative pooled Δ (-0.0051; 95% CI: -0.0083 to -0.0019) and improved external AUC in only 17/50 (34%) datasets versus 34/50 (68%) for an oracle. Random forest replication rendered pooled correlations non-significant (all p > 0.09). A pre-specified sensitivity analysis on the 29/50 datasets statistically distinguishable from chance produced identical conclusions.</p><p><strong>Conclusion: </strong>Aggregate quality-performance correlations are driven by between-generator differences, not within-generator variation that could guide practical decisions. Quality metrics are insufficient proxies for clinical utility; task-specific external validation remains indispensable.</p><p><strong>Key points: </strong>Question Can established quality metrics of synthetic radiomics data identify when generative augmentation actually improves the performance of prediction models under simulated external validation? Findings Across 50 public datasets, aggregate quality-performance correlations vanished within individual generators (ecological fallacy), and quality-guided generator selection underperformed real-only training. Clinical relevance Quality metrics commonly used to validate synthetic radiomics data cannot identify when augmentation improves clinical model performance under simulated domain shift, underscoring the irreplaceable role of task-specific external validation before clinical deployment.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8162-8174"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283325","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":"The bMRI-QUAL scoring system: an important first step toward standardizing breast MRI quality.","authors":"Simone Schiaffino, Katja Pinker","doi":"10.1007/s00330-026-12732-z","DOIUrl":"10.1007/s00330-026-12732-z","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8522-8524"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387394","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":"Improving diagnostic performance of O-RADS MRI: semi-quantitative intensity curves vs visual assessment of enhancement.","authors":"Emmanuel Salinas-Miranda, Andrew Nanapragasam, Fatemeh Nasri, Soudeh Sagheb, Mostafa Atri","doi":"10.1007/s00330-026-12742-x","DOIUrl":"10.1007/s00330-026-12742-x","url":null,"abstract":"<p><strong>Background: </strong>O-RADS MRI improves differentiation of benign adnexal lesions managed by a gynecologist and malignant lesions managed by a gynecologic oncologist.</p><p><strong>Objective: </strong>To compare O-RADS MRI visual assessment (VA) of mass enhancement with a semi-quantitative intensity curve of enhancement (SIC), a modified manual version of the time intensity curve.</p><p><strong>Materials and methods: </strong>We conducted a retrospective MRI review of patients who underwent surgical resection between January 2008 and December 2018 at two referral centers. O-RADS MRI score was assigned by two radiologists with different experience. O-RADS score ≥ 4 was considered suspicious for malignancy. Per-lesion diagnostic accuracy and impact on surgical management were compared between VA and SIC in lesions with solid components. Inter/intra-reader agreement was assessed. Borderline and invasive lesions were considered malignant.</p><p><strong>Results: </strong>Three hundred forty-one adnexal masses in 321 women (ages 18-89) were assessed; 35.2% (120/341) of the masses were malignant. Ninety-six and two-tenths percent had some solid component (329/341). O-RADS MRI using standard VA had a sensitivity, specificity, and PPV of 0.95 (CI: 0.89-0.98), 0.84 (CI: 0.79-0.89), and 0.77 (CI:0.69-0.83), respectively. Use of SIC improved specificity (0.92 [CI: 0.88-0.95, p = 0.007) and PPV (0.90 [CI: 0.83-0.95], p = 0.002). Including SIC in O-RADS MRI would have reduced the proportion of benign lesions operated by gyneoncologists from 16% [54/341] to 9% [1/341] (p = 0.0001). O-RADS score, SIC, and VA assessment had a moderate to high inter- and intra-reader agreement (Kappa 0.63-0.85).</p><p><strong>Conclusion: </strong>O-RADS MRI exhibited high diagnostic performance in triage of adnexal masses. Incorporation of SIC increased the specificity and PPV of O-RADS MRI with high inter- and intra-reader agreement of SIC interpretation.</p><p><strong>Key points: </strong>Question Differentiation of benign from malignant adnexal masses is important for surgical triage. Findings Integration of semiquantitative intensity curves (SIC) into O-RADS MRI improved specificity when compared to conventional VA. Clinical relevance Integration of SIC into O-RADS MRI improves surgical triage of patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8440-8450"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857083","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":"Reproducibility analysis to support prostate MRI-informed care: independent validation of risk-stratified PSA density thresholds for clinically significant prostate cancer.","authors":"Rikhil Makwana, Omer Tarik Esengur, Baris Turkbey","doi":"10.1007/s00330-026-12556-x","DOIUrl":"10.1007/s00330-026-12556-x","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8514-8515"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927952","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}