European Radiology最新文献

{"title":"Adjunctive quantification for more reproducible amyloid PET interpretation.","authors":"Takuro Shiiba, Kosuke Yamashita","doi":"10.1007/s00330-026-12692-4","DOIUrl":"10.1007/s00330-026-12692-4","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8110-8111"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351440","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":"Assessing the performance of deep learning and hand-crafted radiomics models using MRI and ultrasound in predicting axillary lymph node status in breast cancer: a systematic review and meta-analysis.","authors":"Iman Kiani, Niloufar Pourakbar, Amir Mohammad Azizpour, Tanya Mousavi, Saeed Mohammadzadeh, Farzad Pourghazi, Amirali Khosravi","doi":"10.1007/s00330-026-12682-6","DOIUrl":"10.1007/s00330-026-12682-6","url":null,"abstract":"<p><strong>Background: </strong>Axillary lymph node metastasis (ALNM) is a critical prognostic factor in breast cancer. While sentinel lymph node biopsy remains the gold standard, conventional imaging relies on operator expertise with variable diagnostic accuracy. This meta-analysis evaluates the diagnostic performance of deep learning (DL) and hand-crafted radiomics (HCR) models using MRI and ultrasound (US) for ALNM prediction.</p><p><strong>Methods: </strong>Literature search was conducted across four databases up to November 2024. Studies assessing DL or HCR models for ALNM prediction using MRI or US, with histopathological confirmation as the reference standard, were included. Diagnostic accuracy metrics were pooled using bivariate random-effects meta-analysis. Heterogeneity was assessed using Higgins I², and subgroup analyses explored its potential sources.</p><p><strong>Results: </strong>Across 41 included studies, pooled sensitivity was 0.79 (95% CI: 0.74-0.84) and specificity 0.78 (95% CI: 0.75-0.81) for internal validation, with AUC 0.84. External validation demonstrated sensitivity of 0.78 and specificity of 0.74, with an AUC of 0.82. Likelihood ratio analysis (LR+ 3.0, LR- 0.33) indicated limited standalone clinical utility. Ensemble approaches combining DL and HCR showed higher diagnostic performance (AUC = 0.88 in MRI and AUC = 0.92 in US) compared to individual methods. Models incorporating both intratumoral and peritumoral regions yielded higher AUCs (0.81 vs 0.75) than intratumoral alone.</p><p><strong>Conclusion: </strong>AI models demonstrate moderate diagnostic accuracy but limited standalone clinical utility. These tools may serve adjunctive roles in risk stratification and treatment planning. Ensemble approaches combining DL and HCR achieve superior performance. Methodological standardization and validation across diverse populations are essential before clinical implementation.</p><p><strong>Key points: </strong>Question Can artificial intelligence models applied to US and MRI accurately predict axillary lymph-node metastasis in breast cancer? Findings Across 41 studies, AI models demonstrated good diagnostic performance for predicting nodal metastasis. DL, HCR, and combined approaches each achieved clinically meaningful accuracy, with integrated DL + HCR models showing the highest pooled diagnostic effect and lowest heterogeneity. Clinical relevance AI-enhanced imaging can assist in non-invasively stratifying nodal status and may reduce reliance on invasive procedures such as sentinel lymph-node biopsy. Consistent imaging protocols, standardized model development, and external validation are needed before clinical adoption.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8363-8379"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276624","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":"Development and validation of the SYSU-score for MRI-based transmural healing assessment in Crohn's disease: a dual-center study.","authors":"Qingzhu Zheng, Qiaochu Zhao, Weitao He, Lili Huang, Xiaodi Shen, Luyao Wu, Yaoqi Ke, Weikai Zheng, Yangdi Wang, Yujun Chen, Ren Mao, Zhenpeng Peng, Shi-Ting Feng, Ruonan Zhang, Xuehua Li","doi":"10.1007/s00330-026-12701-6","DOIUrl":"10.1007/s00330-026-12701-6","url":null,"abstract":"<p><strong>Objectives: </strong>Standardizing magnetic resonance enterography (MRE)-defined transmural healing (TH) remains challenging in Crohn's disease (CD) despite its prognostic superiority. We aimed to evaluate seven conventional MRE-defined TH criteria and develop a machine-learning-optimized model for improved TH assessment.</p><p><strong>Materials and methods: </strong>In this double-center study, 467 active CD patients with 1263 MRE scans were stratified into three cohorts. Cohort 1 (n = 341) enabled retrospectively dual-metric comparison (attainment rate/prognostic protection) of seven MRE-defined TH criteria. Leveraging their strengths, we developed five machine-learning models for TH assessment to identify the optimal one. Semi-external validation was performed in prospective Ustekinumab (n = 92) and Upadacitinib (n = 34) cohorts.</p><p><strong>Results: </strong>Among seven conventional TH criteria, magnetic resonance index of activity (MaRIA), C-score, and simplified MaRIA (sMaRIA) demonstrated higher attainment rates (23.75%/28.74%/41.64%) and lower disease progression rates (14.81%/18.37%/25.35%). Random forest (RF) model showed the most favorable overall performance across cohorts: Cohort 1 (AUC, 0.82 vs. 0.71-0.81), Ustekinumab (AUC, 0.83 vs. 0.73-0.81), and Upadacitinib (AUC, 0.80 vs. 0.58-0.80) cohorts. Dual-metric evaluation identified the RF model and C-score as clinically applicable tools. Notably, the RF model (namely SYSU-score) was more strongly associated with lower progression risk than C-score: in the Ustekinumab cohort, SYSU-score-defined TH showed lower disease progression risk (HR = 0.07, p < 0.001) than C-score (HR = 0.15, p < 0.001); Upadacitinib cohort validated SYSU-score as the only system significantly associated with lower progression risk (HR = 0.20, p < 0.05).</p><p><strong>Conclusions: </strong>We established a validated machine-learning-derived TH criterion integrating the strengths of conventional MRE-defined systems. SYSU-score-defined TH status was associated with lower progression risk with robust prognostic discrimination, advancing standardized TH assessment for clinical implementation.</p><p><strong>Key points: </strong>Question Among available MRI-based transmural healing (TH) criteria for Crohn's disease (CD), which are the most clinically applicable, and can a new model improve standardized prognostic assessment? Findings MaRIA, C-score, and sMaRIA showed relatively favorable clinical applicability, and the machine-learning-derived SYSU-score demonstrated robust prognostic performance in internal and semi-external validation. Clinical relevance SYSU-score may support more standardized MRI-based assessment of TH and improve risk stratification for disease progression in patients with CD.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8465-8478"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276594","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":"Predictors of short-term pain relief after polidocanol foam sclerotherapy for painful venous malformations.","authors":"Shinji Wada, Hidefumi Mimura, Yusuke Kobayashi, Shinji Fujizuka, Kazuki Hashimoto, Shingo Hamaguchi","doi":"10.1007/s00330-026-12699-x","DOIUrl":"10.1007/s00330-026-12699-x","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate short-term pain relief and safety provided by polidocanol foam sclerotherapy for painful venous malformations (VMs) and determine imaging and procedural predictors of clinical efficacy.</p><p><strong>Materials and methods: </strong>From April 2015 to September 2025, this single-center retrospective study included 240 consecutive patients who underwent polidocanol foam sclerotherapy for predominantly peripheral VMs. Among these, 181 patients treated for pain were enrolled. Polidocanol at a 1% or 2% concentration was used according to the treatment period and recorded as a candidate predictor. Pain was evaluated using the visual analog scale (VAS). The primary endpoint was a ≥ 50% VAS reduction 2 months after the initial session. Secondary endpoints included technical success and complications, with predictors analyzed using univariable analysis and multivariable logistic regression.</p><p><strong>Results: </strong>The cohort comprised 181 patients (116 females and 65 males; mean age, 31.4 ± 16.0 years). Two months after initial treatment, 84% patients demonstrated pain reduction, and 47% achieved a favorable response, with complete pain resolution in 28%. In univariate analysis, a smaller lesion size (≤ 5 cm), lobulated morphology, well-defined margins, good sclerosant stasis, and lower VM types were associated with a favorable response. Multivariate analysis demonstrated that good sclerosant stasis was an independent predictor of a favorable response (odds ratio, 2.44; 95% confidence interval, 1.18-5.18, p = 0.016); polidocanol concentration was not significantly associated with outcomes.</p><p><strong>Conclusion: </strong>Polidocanol foam sclerotherapy provides substantial short-term pain relief with favorable safety in patients with painful VMs, with efficacy driven primarily by lesion hemodynamics and technical stasis.</p><p><strong>Key points: </strong>Question Identifying specific lesion- and technique-related predictors of short-term pain relief after polidocanol foam sclerotherapy for painful VMs remains an important unmet clinical need. Findings Multivariable analysis identified good sclerosant stasis as the sole independent predictor of a favorable clinical response, overriding baseline characteristics. Clinical relevance Polidocanol foam sclerotherapy safely relieves pain in VMs. To maximize efficacy, clinicians should support a stasis-first treatment strategy, prioritizing optimal intralesional stasis and management of outflow patterns.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8035-8042"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270898","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":"Beyond macrovascular recanalization: the search for a new parameter of success in endovascular thrombectomy.","authors":"Eduardo Gragnano","doi":"10.1007/s00330-026-12688-0","DOIUrl":"10.1007/s00330-026-12688-0","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8519-8521"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257968","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":"Vacuum-assisted breast biopsy vs core needle biopsy for breast tumour diagnosis.","authors":"Jie-Feng Wang, Chao Kong, Wei Ding","doi":"10.1007/s00330-026-12691-5","DOIUrl":"10.1007/s00330-026-12691-5","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8505-8506"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249178","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: Microflow imaging for ultrasound risk stratification of thyroid nodules: potential roles and key considerations.","authors":"Wanying Li, Luying Gao, Hongyan Wang, Jianchu Li","doi":"10.1007/s00330-026-12662-w","DOIUrl":"10.1007/s00330-026-12662-w","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8492-8494"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149079","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: Comparison of three algorithms to measure breast density on mammograms in a population-based screening cohort.","authors":"Madhuri Tribhuvan, Shashikant N Phatke","doi":"10.1007/s00330-026-12880-2","DOIUrl":"10.1007/s00330-026-12880-2","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8359-8360"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001434","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":"Can AI models detect abnormality in screening mammography years before confirmed diagnosis?","authors":"Min-Ying Lydia Su","doi":"10.1007/s00330-026-12811-1","DOIUrl":"10.1007/s00330-026-12811-1","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8391-8393"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790065","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":"MR-guided microwave ablation of liver tumors: outcomes in local tumor control and determinants of treatment success.","authors":"Vanessa F Schmidt, Philipp Linden, Olaf Dietrich, Sinan Deniz, Daniel Puhr-Westerheide, Osman Öcal, Moritz L Schnitzer, Florian Obereisenbuchner, Matthias Kassube, Mingming Wu, Luigi Nardone, Lars Grenacher, Florian Maier, Ricarda Seidensticker, Moritz Wildgruber, Jens Ricke, Matthias P Fabritius, Max Seidensticker","doi":"10.1007/s00330-026-12725-y","DOIUrl":"10.1007/s00330-026-12725-y","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate local tumor control and determinants of treatment success following magnetic resonance (MR)-guided microwave ablation (MWA) of liver malignancies.</p><p><strong>Materials and methods: </strong>This single-center retrospective study evaluated prospectively included patients undergoing MR-guided MWA between September 2021 and February 2025. Procedures were performed under general anesthesia using a 1.5-Tesla MR scanner and two MR-compatible MWA systems. Complications were assessed according to CIRSE. Technical success was defined as total lesion coverage on MR imaging one day post-ablation. Local recurrence and hepatic tumor progression were analyzed using follow-up liver MR imaging every three months. Determinants of treatment success included lesion size, tumor entity, ablation duration, MWA system, lesion and antenna conspicuity (6-point Likert scale), adjacent vascular structures, liver cirrhosis, and antenna position (central/non-central).</p><p><strong>Results: </strong>Forty-eight liver lesions in 40 patients (median age 62.5 years, 70.0% male) were treated. MWA systems 1 and 2 were used in 33/48 (68.8%) and 15/48 lesions (31.3%), respectively. Technical success was achieved in 46/48 lesions (95.8%), with one peri-procedural complication (CIRSE grade 3, 2.5%). Mean follow-up was 21.0 ± 10.9 months, with one patient lost to follow-up. Local recurrence occurred in 4/47 lesions (8.5%), all treated with system 1, while no recurrence was observed with system 2 (p = 0.173). As the only relevant determinant of treatment success, adjacent vascular structures were associated with higher local recurrence rates (p = 0.019). No local recurrence occurred in lesions < 20 mm.</p><p><strong>Conclusion: </strong>MR-guided MWA of liver tumors is safe, achieving high technical success and local tumor control. Adjacent vascular structures increase the risk of local recurrence and may warrant more aggressive treatment.</p><p><strong>Key points: </strong>Question Whether MR-guided MWA provides reliable local tumor control for liver malignancies and which procedural or anatomical factors influence treatment success. Findings MR-guided MWA achieved high technical success, low complication rates, and strong local tumor control; local recurrence occurred in lesions ≥ 20 mm and with low-power MWA systems, as well as adjacent vascular structures, significantly increased risk of local recurrence. Clinical relevance Prospectively acquired single-center cohorts of MR-guided MWA with real-time position monitoring in a standardized MR workflow, highlighting the impact of technical factors and the importance of lesion selection based on device-specific ablation characteristics.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8052-8061"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387431","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}