European Radiology最新文献

{"title":"Are patients willing to help reduce contrast material in the environment? The outpatient use of urine bags after contrast-enhanced computed tomography.","authors":"Helena M Dekker, Hendrik Bram Beltman, Mathias Prokop","doi":"10.1007/s00330-025-11565-6","DOIUrl":"10.1007/s00330-025-11565-6","url":null,"abstract":"<p><strong>Objectives: </strong>We studied the willingness of outpatients to reduce the environmental impact of contrast media by using urine bags to collect excreted contrast material after contrast-enhanced computed tomography (ceCT).</p><p><strong>Materials and methods: </strong>In this prospective single-center cohort study, we provided consecutive outpatients undergoing ceCT with information about contrast material excretion. We then offered urine bags to collect their urine for the first four consecutive urination sessions after the ceCT examination. An absorbent pad within these bags transforms the urine from liquid to solid so that the bags can be disposed of via the household waste system to avoid water contamination. Participants were asked to complete a questionnaire-based telephone interview after ceCT.</p><p><strong>Results: </strong>Of the 671 consecutive outpatients undergoing ceCT, 503 patients (75%) participated in the study, of whom 476 participants (mean age, 63 years; range, 20-88 years) successfully underwent a telephone interview. 455 of 476 patients (96%) had used at least one urine bag; 84% had used 3 or 4 urine bags. Time between ceCT and use of the final urine bag averaged 9.46 h (range, 0.1-28.5 h). 434 patients (91%) were \"willing to collaborate on solutions to reduce contrast agent residues in water.\" 380 patients (80% of participants) stated to \"definitely use the urine bag again after my next ceCT scan.\"</p><p><strong>Conclusion: </strong>Most outpatients were willing to use urine bags after ceCT. Urine bags were used for an average of 9 h after ceCT, ensuring that a substantial amount of the administered contrast medium does not enter the sewage system.</p><p><strong>Key points: </strong>Question It is not known whether there is enough willingness among patients to use urine bags after contrast-enhanced CT (ceCT) to reduce contrast material in the water supply. Findings Urine bags offer a viable option to reduce the environmental impact of contrast agents and are acceptable to most outpatients. Clinical relevance The majority of outpatients were willing to help reduce the environmental impact of contrast material by using urine bags after ceCT so that excreted contrast material does not enter the water supply.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6250-6257"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984613","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":"Visual ordinal grading of aortic valve calcification on routine non-gated chest CT predicts prognosis and alters management.","authors":"Samuel G S Gunning, John Graby, Yashesh Mody, Pia F P Charters, Tim A Burnett, David Murphy, Ali Khavandi, Jonathan C L Rodrigues","doi":"10.1007/s00330-025-11553-w","DOIUrl":"10.1007/s00330-025-11553-w","url":null,"abstract":"<p><strong>Objective: </strong>BSCI/BSTI guidelines recommend reporting aortic valve calcification (AVC) on all chest CTs regardless of indication. We assessed AVC frequency, severity, and association with aortic stenosis (AS) on echocardiography and its prognostic implications.</p><p><strong>Methods: </strong>Retrospective, single-centre analysis of consecutive chest CTs (January-December 2015) for 200 patients per age group (< 40, 40-49, 50-59, 60-69, 70-79, 80-89, ≥ 90) performed for medical, surgical, and oncological indications. CTs were re-reviewed for the presence and graded severity of AVC and coronary artery calcification (CAC). Corresponding echocardiography reports (within 5 years) reviewed for AS. Comorbidities and clinical outcomes were recorded.</p><p><strong>Results: </strong>One thousand three hundred seventy-seven patients were included (mean age 64 ± 20 years, 55% female). AVC was present in 25% (350/1377) and was more prevalent in males (p < 0.001). Frequency and severity increased with age (p < 0.001). 38% (524/1377) had an echocardiogram (median inter-test interval 4.3 months [IQR 0.4-17.5]). Sixteen per cent (29/178) with AVC had AS of any severity (8% [15/178] mild; 8% [14/178] moderate; 0% [0/178] severe). Sensitivity and specificity for AVC predicting AS were 91% and 70%, respectively. Extrapolating findings, 8% of individuals with AVC and without an echocardiogram may have undiagnosed AS. All-cause mortality occurred in 53% (734/1377), which AVC predicted independently of CAC and age (p < 0.001). Adjusting for confounders, severe AVC predicted all-cause mortality (HR 1.56 [1.10-2.22], p = 0.013).</p><p><strong>Conclusions: </strong>AVC identified AS in 16% of patients. Additionally, severe AVC is an independent predictor of all-cause mortality in multivariable analysis. Validation in a prospective cohort is required to inform clinical practice guidelines.</p><p><strong>Key points: </strong>Question New guidelines recommend reporting AVC on all non-gated chest CTs, the prognostic and clinical relevance of which is uncertain. Findings There are associations between visually quantified AVC, AS on echocardiography, and all-cause mortality in an unselected population referred for routine chest CT. Clinical relevance These results support the reporting of all severities of AVC, especially severe AVC, as a prognostic marker in all age groups. The clinical implications require further clarification in a prospective cohort.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6291-6301"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763542","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":"Personalized risk-adapted models in prostate cancer during active surveillance using MRI-a narrative review.","authors":"Davide Maffei, Caroline M Moore","doi":"10.1007/s00330-025-11518-z","DOIUrl":"10.1007/s00330-025-11518-z","url":null,"abstract":"<p><p>The presence of histologically defined prostate cancer (PCa) is common and rises with age. Nevertheless, histological evidence of PCa does not always lead to clinically evident or life-threatening disease, and we know that PSA-based population screening can find twice the prevalence of PCa than would present via clinical routes. The PROTECT study randomized men diagnosed through PSA screening, to surgery, radiotherapy, or active monitoring. At 15 years, PCa-related deaths ranged from 2.1% in the surgery group to 2.9% in the active monitoring group, while the risk of death from other causes was 22%. Modern PCa diagnosis uses MRI to determine who needs a biopsy and how it is done. Multiparametric MRI can selectively detect PCa of higher grade and volume, which is more likely to be associated with progression, metastases, and death, and hence to benefit from treatment. MRI and MRI-targeted biopsies are recommended prior to enrolment in active surveillance (AS) programs for accurate risk classification. The UCLH AS cohort based on per-cause MRI evaluations has shown baseline Gleason grade and MRI index lesion visibility to be strong predictors of progression to treatment. Serial evaluation with MRI has been codified with the PRECISE recommendations to support MRI-based monitoring during AS. AS recommendations have extended to certain favorable-intermediate risk cancers. The Movember International Consensus Meeting has determined a dynamic risk-stratified AS approach to be the highest-ranked research priority. We review the impact of MRI on AS from patient selection to risk stratification, and the development of MRI-led personalized AS protocols. KEY POINTS: Question Standardized protocols are not able to address the heterogeneity of men on active surveillance for PCa and are burdened by unnecessary examinations. Findings MRI can improve the selection of men for active surveillance, predict time to treatment, and risk-stratify patients at risk of progression. Clinical relevance MRI-led risk-adapted protocols may reduce the burden of active surveillance on patients, improve adherence, and reduce healthcare costs.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6444-6453"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788082","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":"ESR Essentials: assessing the radiological response of liver metastases to systemic therapy-practice recommendations by the European Society of Gastrointestinal and Abdominal Radiology.","authors":"Marco Dioguardi Burgio, Maxime Ronot, Valérie Vilgrain","doi":"10.1007/s00330-025-11540-1","DOIUrl":"10.1007/s00330-025-11540-1","url":null,"abstract":"<p><p>The liver is a common site for metastatic spread, especially in advanced colorectal, breast, and pancreatic cancers. Imaging evaluation of liver metastases after systemic treatments like chemotherapy, targeted therapy, or immunotherapy is essential to distinguish treatment response from disease progression. The widely used response evaluation criteria in solid tumours (RECIST 1.1) focus on lesion size changes to evaluate treatment response. However, newer therapies, mainly targeted therapy and immunotherapy, often induce changes beyond size reduction, such as tumour necrosis, fibrosis, cystic transformation, calcifications, and modifications at the liver-tumour interface. These morphological and enhancement changes can be evaluated on CT and MRI and may better reflect the biological response in specific clinical settings. Overall, RECIST 1.1 criteria are recommended for assessing the radiological response of liver metastases after systemic treatment. The use of alternative radiological criteria validated on CT (such as Chun or Choi criteria) is recommended in specific clinical settings (e.g. metastatic colorectal cancer or metastatic gastrointestinal stromal tumours). Additionally, CT and MR modifications that reflect fibrosis, necrosis, calcifications, and haemorrhage can serve as ancillary indicators of tumoural response. These alternative criteria and radiological findings should be systematically assessed, particularly in liver metastases with minimal size changes, to better identify responders. KEY POINTS: RECIST 1.1 is the standard for evaluating tumour response in solid tumours and is recommended for the assessment of liver metastases after systemic therapy. CT attenuation, enhancement, and liver/tumour interface may correlate better with tumoural response compared to size reduction. CT and MR changes suggesting necrosis, fibrosis, calcifications, and haemorrhage can be used as additional indicators of tumoural response.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6516-6526"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788045","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":"Multivariable model to predict breast cancer in non-mass enhancement lesions: a study on contrast-enhanced mammography.","authors":"Bei Hua, Jun Chen, Yong Wang, Peihua Hu, Jindan Ge, Lina Geng, Tao Yuan, Guanmin Quan","doi":"10.1007/s00330-025-11597-y","DOIUrl":"10.1007/s00330-025-11597-y","url":null,"abstract":"<p><strong>Background: </strong>To explore morphology and enhancement features of malignant non-mass enhancement (NME) lesions in contrast-enhanced mammography (CEM), and to develop a multivariable model that can accurately predict the probability of malignancy in NME lesions.</p><p><strong>Methods: </strong>A total of 162 patients with 206 NME lesions were enrolled. The ratio of 7:3 was randomly divided into a training data set and a test data set. Differences between benign and malignant NME diseases were compared using statistical analysis in the training data set. A logistic regression analysis was used to develop a multivariable model for predicting the probability of malignancy in the training data set. The predictive value of the model was assessed by calculating the area under the curve (AUC) in both training and test data sets.</p><p><strong>Results: </strong>The incidence of malignancy was higher in cases with malignant microcalcification (32.35%), segmental and linear distribution (55.88%), clumped and clustered ring enhancement pattern (70.59%), and Type III curve (64.71%) (all p < 0.002). The sensitivity, specificity, and AUC of the multivariable model in the training data set and the test data set were 79.41-80.77%, 94.44-97.37%, and 0.920-0.946, respectively.</p><p><strong>Conclusions: </strong>When combining microcalcification and enhancement features, the multivariable model for CEM demonstrated acceptable sensitivity and high specificity in predicting malignant NME lesions.</p><p><strong>Key points: </strong>Question CEM has gained momentum as an innovative and clinically useful method, but it has not been identified for the discrimination efficacy of NME lesions. Findings The multivariable model of CEM can improve the diagnostic efficiency of breast malignancy NME lesions, with acceptable sensitivity and high specificity. Clinical relevance CEM is an innovative advancement in breast imaging technology. This multivariable model of CEM integrates factors such as microcalcifications, enhancement morphological distribution, internal enhancement patterns, and time-signal intensity curves, thereby enabling accurate diagnosis of NME lesions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6410-6420"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959834","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":"Follow-up of brain lesions treated with laser interstitial thermal therapy: keep calm, my friend. Do not assess progressive disease too soon.","authors":"Carles Majós","doi":"10.1007/s00330-025-11657-3","DOIUrl":"10.1007/s00330-025-11657-3","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5979-5980"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076869","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: Translating MRI-detected extranodal extension into clinical practice in prostate cancer: practical considerations and future directions.","authors":"Shengyi Chen, Yuekun Fang, Bin Cheng","doi":"10.1007/s00330-025-11810-y","DOIUrl":"10.1007/s00330-025-11810-y","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6031-6032"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607837","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: MRI-detected extranodal extension as a marker of prostate cancer aggressiveness.","authors":"Mohammad Reza Keivany, Hossein Zare","doi":"10.1007/s00330-025-11896-4","DOIUrl":"10.1007/s00330-025-11896-4","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6035-6036"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793839","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: MRI-detected extranodal extension as a marker of prostate cancer aggressiveness.","authors":"Aline Araújo Naves, Gabriel de Lion Gouvea, Camila V B Machado, Leandro Machado Colli, Fernando Chahud, Rodolfo B Reis, Valdair F Muglia","doi":"10.1007/s00330-025-11897-3","DOIUrl":"10.1007/s00330-025-11897-3","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6037-6038"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793842","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":"Innovative 4D FreeBreathing technique in pediatric abdominal MRI improves feasibility and image quality.","authors":"Patricia Tischendorf, Laura Beck, Tobias Krähling, Jan H Lange, Walter Heindel","doi":"10.1007/s00330-025-11577-2","DOIUrl":"10.1007/s00330-025-11577-2","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the feasibility and imaging quality of a golden angle radial stack-of-stars dynamic three-dimensional free-breathing T1w turbo field echo acquisition (4D FreeBreathing) with a conventional dynamic cartesian breath-hold T1w sequence in young children undergoing abdominal magnetic resonance imaging (MRI).</p><p><strong>Materials and methods: </strong>Fifty consecutive pediatric patients (34 females; 3.4 ± 2.0 years) underwent abdominal MRI: 25 were examined with 4D FreeBreathing and 25 with conventional dynamic T1w sequence. The image quality was evaluated subjectively on a 5-point scale by two radiologists. Interobserver agreement, as well as signal-to-noise ratio for arterial (SNRart) and portal venous (SNRpv) phases, were evaluated separately. Additionally, the image quality of 4D FreeBreathing sequence was compared to a non-dynamic post-contrast radial stack-of-stars free-breathing T1w fast field echo acquisition (3D T1w Vane mDixon). Interobserver agreement of both assessors was calculated using quadratic weighted Cohen's kappa test (ϰ), while independent samples Student's t-test was employed to compare mean SNR values among the two groups.</p><p><strong>Results: </strong>Using 4D FreeBreathing, SNRart and SNRpv were significantly higher from 500 ± 170 and 550 ± 160 to 900 ± 210 and 820 ± 260 (p < 0.001); the diagnostic image quality increased from 77.6 to 89.6%; respiratory artifacts decreased from 22.4 to 10.4%, with an almost perfect interobserver agreement. Compared to 3D T1w Vane mDixon sequence, SNR and image quality were equal.</p><p><strong>Conclusion: </strong>4D FreeBreathing pediatric abdominal MRI improves the feasibility and image quality compared to conventional dynamic exams while showing an image quality equivalent to post-contrast 3D T1w Vane mDixon.</p><p><strong>Key points: </strong>Question During dynamic abdominal MRI in young children, it is important to conduct a brief yet robust examination without respiratory artifacts. Findings 4D FreeBreathing MRI technique for pediatric abdominal imaging enhances both image quality and feasibility when compared to conventional dynamic scans that require breath-holding. Clinical relevance Dynamic abdominal MRI using the 4D FreeBreathing sequence provides significant benefits for pediatric patients. The absence of breath-holding requirements improves patient cooperation, reduces the need for general anesthesia, and results in higher-quality diagnostic images.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5891-5899"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984935","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}