European Radiology最新文献

{"title":"Fetal dose in pregnant CT patients: a comparison of four software packages.","authors":"Joël Greffier, Asma Arjoun, Chris Serrand, Jean-Paul Beregi, Djamel Dabli","doi":"10.1007/s00330-025-11594-1","DOIUrl":"10.1007/s00330-025-11594-1","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the fetal dose (FD) as calculated by four different software packages for pregnant women who have undergone CT acquisitions directly exposing the whole fetus to X-rays.</p><p><strong>Materials and methods: </strong>Pregnant women who underwent CT abdomen-pelvis and/or thorax-abdomen-pelvis acquisitions from February 2018 to May 2024 and for whom the uterine dose and/or FD was calculated by a medical physicist were retrospectively included. FDs were computed per CT acquisition with VirtualDose-CT™ (VDCT), Duke Organ Dose (DOD), fetaldose.org, and COnceptus Dose Estimation (CODE) software, using phantoms taking the stage of pregnancy into account. FDs calculated by each software package were then compared.</p><p><strong>Results: </strong>A total of 51 pregnant women with a mean age of 30.2 ± 5.7 years at 17.5 ± 10.0 weeks of pregnancy were included. The mean number of CT acquisitions per pregnant patient was 1.4 ± 0.7 with a mean CTDI_vol of 6.77 ± 3.04 [2.34-15.64] mGy, and FDs were computed for a total of 69 acquisitions. For all CT acquisitions, the median FD was 8.6 (6.8; 10.3) mGy for VDCT, 7.7 (6.1; 9.7) mGy for DOD, 6.3 (4.9; 7.6) mGy for fetaldose.org, and 7.1 (4.6; 8.8) mGy for CODE. Differences between each software package were significant (p < 0.01), except between VDCT and DOD (p = 0.025) and between CODE and fetaldose.org (p = 0.15). The concordance of calculated FD values between the software packages was poor (ICC < 0.50), except between VDCT and CODE and between fetaldose.org and CODE.</p><p><strong>Conclusion: </strong>The choice of software used affects the calculation of the FD.</p><p><strong>Key points: </strong>Question Differences between calculation software in terms of morphologies and types of phantoms used have an impact on FD calculations? Findings Software choice has an impact on calculated FD, but is not expected to alter patient management except for extreme cases with multiple CT exams. Clinical relevance The FD limit of 100 mGy, defined by the International Commission on Radiological Protection, cannot be reached with a single CT examination, and may only be of concern in cases where the patient undergoes multiple exams with the whole fetus exposed.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6258-6267"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980656","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":"Lung microvasculopathy in chronic thromboembolic pulmonary hypertension: high-resolution findings with photon-counting detector CT in 29 patients.","authors":"Martine Remy-Jardin, Alain Duhamel, Marie Delobelle, Jean-François Bervar, Thomas Flohr, Jacques Remy","doi":"10.1007/s00330-025-11561-w","DOIUrl":"10.1007/s00330-025-11561-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate CT findings suggestive of lung microvasculopathy in patients with chronic thromboembolic pulmonary hypertension (CTEPH).</p><p><strong>Materials and methods: </strong>Twenty-nine patients were scanned with high-spatial resolution on a photon-counting detector (PCD)-CT unit. A maximum of three pairs per patient, each composed of hyper- and hypo-attenuating areas of mosaic perfusion, were selected.</p><p><strong>Results: </strong>Comparative analysis of the 86 selected pairs showed: (a) a higher frequency of ill-defined micronodules (p = 0.008), lobular ground-glass opacities (p = 0.01) and haziness (p = 0.003) in hypoattenuated areas; (b) there was no significant difference in the frequency of neovascularity (p = 0.43). Similar trends were observed in hypoattenuating areas of the 66 pairs studied in the 22 patients with central and peripheral CTEPH; an absence of ill-defined micronodules, lobular ground-glass opacities, and haziness in hyperattenuating areas was noticed in the 20 pairs studied in the 7 patients with peripheral CTEPH. Patients with a mean pulmonary artery pressure ≤ 42 mmHg (i.e., the median value of mean pulmonary artery pressure) had 45 pairs compared, showing a higher frequency of ill-defined micronodules (p = 0.003) and haziness (p < 0.001) in hypoattenuated areas, together with a higher frequency of subpleural systemic-to-pulmonary anastomoses (p = 0.02). There were no statistical differences in the frequency of CT findings between hypo- and hyper-attenuating areas in the 41 pairs of patients with a mean pulmonary artery pressure > 42 mm Hg.</p><p><strong>Conclusion: </strong>CT features suggestive of microvasculopathy were more frequent in areas of hypoperfusion, with a trend toward homogenization of CT findings in patients with severe PH.</p><p><strong>Key points: </strong>Question Lung microvascular lesions play a crucial role in the origin of residual pulmonary hypertension after successful thromboendarterectomy, currently beyond the scope of imaging. Findings The expected morphological abnormalities at the level of distal pulmonary circulation in CTEPH were found to be depictable in each zone of mosaic perfusion. Clinical relevance This study suggests that the high-spatial resolution of PCD-CT has the capability of approaching the complex pathophysiology of small-vessel disease in CTEPH, providing important information prior to therapeutic decisions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6369-6381"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975246","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":"Comparison of CT referral justification using clinical decision support and large language models in a large European cohort.","authors":"Mor Saban, Yaniv Alon, Osnat Luxenburg, Clara Singer, Monika Hierath, Alexandra Karoussou Schreiner, Boris Brkljačić, Jacob Sosna","doi":"10.1007/s00330-025-11608-y","DOIUrl":"10.1007/s00330-025-11608-y","url":null,"abstract":"<p><strong>Background: </strong>Ensuring appropriate use of CT scans is critical for patient safety and resource optimization. Decision support tools and artificial intelligence (AI), such as large language models (LLMs), have the potential to improve CT referral justification, yet require rigorous evaluation against established standards and expert assessments.</p><p><strong>Aim: </strong>To evaluate the performance of LLMs (Generation Pre-trained Transformer 4 (GPT-4) and Claude-3 Haiku) and independent experts in justifying CT referrals compared to the ESR iGuide clinical decision support system as the reference standard.</p><p><strong>Methods: </strong>CT referral data from 6356 patients were retrospectively analyzed. Recommendations were generated by the ESR iGuide, LLMs, and independent experts, and evaluated for accuracy, precision, recall, F1 score, and Cohen's kappa across medical test, organ, and contrast predictions. Statistical analysis included demographic stratification, confidence intervals, and p-values to ensure robust comparisons.</p><p><strong>Results: </strong>Independent experts achieved the highest accuracy (92.4%) for medical test justification, surpassing GPT-4 (88.8%) and Claude-3 Haiku (85.2%). For organ predictions, LLMs performed comparably to experts, achieving accuracies of 75.3-77.8% versus 82.6%. For contrast predictions, GPT-4 showed the highest accuracy (57.4%) among models, while Claude demonstrated poor agreement with guidelines (kappa = 0.006).</p><p><strong>Conclusion: </strong>Independent experts remain the most reliable, but LLMs show potential for optimization, particularly in organ prediction. A hybrid human-AI approach could enhance CT referral appropriateness and utilization. Further research should focus on improving LLM performance and exploring their integration into clinical workflows.</p><p><strong>Key points: </strong>Question Can GPT-4 and Claude-3 Haiku justify CT referrals as accurately as independent experts, using the ESR iGuide as the gold standard? Findings Independent experts outperformed large language models in test justification. GPT-4 and Claude-3 showed comparable organ prediction but struggled with contrast selection, limiting full automation. Clinical relevance While independent experts remain most reliable, integrating AI with expert oversight may improve CT referral appropriateness, optimizing resource allocation and enhancing clinical decision-making.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6150-6159"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964856","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":"Letter to the Editor: ABO incompatibility in liver transplantation-how should we face it?","authors":"Saiyu Gao, Hanwen Yang","doi":"10.1007/s00330-025-11591-4","DOIUrl":"10.1007/s00330-025-11591-4","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6618-6619"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957930","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":"Shading light in the black box of hepatobiliary imaging.","authors":"Aristeidis Grigoriadis, Annika Bergquist, Nikolaos Kartalis","doi":"10.1007/s00330-025-11740-9","DOIUrl":"10.1007/s00330-025-11740-9","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6541-6543"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233613","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":"Detection rates for prostate cancer using PI-RADS 2.1 upgrading rules in transition zone lesions align with risk assessment categories: a systematic review and meta-analysis.","authors":"Georgios Agrotis, Eduardo Pais Pooch, Kostas Marsitopoulos, Marianna Vlychou, Matthias Benndorf, Regina G H Beets-Tan, Ivo G Schoots","doi":"10.1007/s00330-025-11618-w","DOIUrl":"10.1007/s00330-025-11618-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare cancer detection rates (CDRs) of transition zone (TZ) lesions upgraded from PI-RADSv2.1 score 2 to 3 (\"2 + 1\") or from 3 to 4 (\"3 + 1\") using DWI and assess their clinical impact.</p><p><strong>Materials and methods: </strong>A systematic literature search was performed in Embase, Medline, and Web of Science for studies assessing TZ lesions with DWI in PI-RADSv2.1, with histology-confirmed grade group ≥ 2 cancer (GG ≥ 2) as the primary outcome. Risk of bias was evaluated using QUADAS-2. Pooled sensitivity, specificity, CDRs, and odds ratios (ORs) were estimated at the lesion level using a bivariate binomial random-effects model.</p><p><strong>Results: </strong>Eight studies with 1535 TZ lesions were included. GG ≥ 2 CDRs for PI-RADS scores of 1, 2, 2 + 1, 3, 3 + 1, 4, and 5 were 2% (95%CI: 0%-12%), 6% (4%-10%), 13% (6%-23%), 19% (15%-25%), 37% (24%-52%), 49% (32%-67%), and 73% (66%-79%), respectively. Scores of 2 + 1 had higher GG ≥ 2 CDRs than 2 (OR 3.37 (1.53-7.44), p = 0.003) but were similar to 3 (OR 0.80 (0.44-1.45), p = 0.46). Scores of 3 + 1 had higher GG ≥ 2 CDRs than 3 (OR 2.67 (1.27-5.59), p = 0.009) but were similar to 4 (OR 0.68 (0.33-1.44), p = 0.32). False-positive rates remained substantial (≥ 2 + 1: 69% (55%-80%); ≥ 3: 54% (46%-62%)).</p><p><strong>Conclusion: </strong>The risk of having significant prostate cancer in \"2 + 1\" and \"3 + 1\" TZ lesions, with an upgrading based on DWI images, is appropriately categorized within the PI-RADS v2.1 scoring system, as shown by this meta-analysis.</p><p><strong>Key points: </strong>Question PI-RADS v2.1 incorporates rules allowing scores of some transition zone (TZ) lesions to be increased. Literature on the clinical impact of these rules is scarce. Findings For TZ lesions upgraded with DWI: \"2 + 1\" lesions show a cancer detection rate (CDR) of 13%, and \"3 + 1\" lesions show a CDR of 37%. Clinical relevance Upgraded TZ lesions may impact individualized biopsy-decisions, especially as \"3 + 1\" lesions harbor significant disease in 2-out-of-5 patients. Still, the high rate of grade group = 1 and benign findings in these sub-categories emphasizes the need for strategies to minimize overdiagnosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6454-6465"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998264","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":"Intelligent extraction of CT image landmarks for improving cam-type femoroacetabular impingement assessment.","authors":"Sareh Tayyebinezhad, Mansoor Fatehi, Hossein Arabalibeik, Hossein Ghadiri","doi":"10.1007/s00330-025-11901-w","DOIUrl":"https://doi.org/10.1007/s00330-025-11901-w","url":null,"abstract":"<p><strong>Objectives: </strong>Femoroacetabular impingement (FAI) with cam-type morphology is a common hip disorder that can result in groin pain and eventually osteoarthritis. The pre-operative assessment is based on parameters obtained from x-ray or computed tomography (CT) scans, namely alpha angle (AA) and femoral head-neck offset (FHNO). The goal of our study was to develop a computer-aided detection (CAD) system to automatically select the hip region and measure diagnostic parameters from CT scans to overcome the limitations of the tedious and time-consuming process of subjectively selecting CT image slices to obtain parameters.</p><p><strong>Materials and methods: </strong>271 cases of ordinary abdominopelvic CT examination were collected retrospectively from two hospitals between 2018 and 2022, each equipped with a distinct CT scanner. First, a convolution neural network (CNN) was designed to select hip region slices among abdominopelvic CT scan image series. This CNN was trained using 80 CT scans divided into 50%, 20%, and 30% for training, validation and testing groups, respectively. Second, the most appropriate oblique slice passing through the femoral head-neck complex was selected, and AA and FHNO landmarks were calculated using image-processing algorithms. The best oblique slices were selected/measured manually for each hip as ground truth and its related parameters.</p><p><strong>Results: </strong>CT hip-region selection using CNN yielded 99.34% accuracy. Pearson correlation coefficient between manual and automatic parameters measurement were 0.964 and 0.856 for AA and FHNO, respectively.</p><p><strong>Conclusion: </strong>The results of this study are promising for future development of a CAD software application for screening CT scans that may aid physicians to assess FAI.</p><p><strong>Key points: </strong>Question Femoroacetabular impingement is a common, underdiagnosed hip disorder requiring time-consuming image-based measurements. Can AI improve the efficiency and consistency of its radiologic assessment? Findings Automated slice selection and landmark detection using a hybrid AI method improved measurement efficiency and accuracy, with minimal bias confirmed through Bland-Altman analysis. Clinical relevance An AI-based method enables faster, more consistent evaluation of cam-type femoroacetabular impingement in routine CT images, supporting earlier identification and reducing dependency on operator experience in clinical workflows.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198696","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":"Computer vision-based personal identification using 2D maximum intensity projection CT images.","authors":"Andreas Heinrich, Michael Hubig, Gita Mall, Ulf Teichgräber","doi":"10.1007/s00330-025-11630-0","DOIUrl":"10.1007/s00330-025-11630-0","url":null,"abstract":"<p><strong>Objectives: </strong>Computer vision (CV) mimics human vision, enabling the automatic comparison of radiological images from recent examinations with a vast image database for unique identification. This method offers significant potential in emergencies involving unknown individuals. This study assesses whether maximum intensity projection (MIP) images from thoracic computed tomography (CT) examinations are suitable for automated CV-based personal identification.</p><p><strong>Methods: </strong>The study analyzed 12,465 native CT examinations of the thorax from 8177 individuals, focusing on MIP images to assess their potential for CV-based personal identification in 300 cases. CV automatically identifies and describes features in images, which are then matched to reference images. The number of matching points was used as an indicator of identification accuracy.</p><p><strong>Results: </strong>The identification rate was 98.67% (296/300) at rank 1 and 99.67% (299/300) at rank 10, among over 8177 potential identities. Matching points were higher for images of the same individual (7.43 ± 5.83%) compared to different individuals (0.16 ± 0.14%), with 100% representing the maximum possible matching points. Reliable matching points were mainly found in the thoracic skeleton, sternum, and spine. Challenges arose when the patient was curved on the table or when medical equipment was present in the image.</p><p><strong>Conclusion: </strong>Unambiguous identification based on MIP images from thoracic CT examinations is highly reliable, even for large CV databases. This method is applicable to various 2D reconstructions, provided anatomical structures are comparably represented. Radiology offers extensive reference images for CV databases, enhancing automated personal identification in emergencies.</p><p><strong>Key points: </strong>Question Computer vision-based personal identification holds great potential, but it remains unclear whether maximum intensity projection images from thoracic-CT scans are suitable for this purpose. Findings Maximum intensity projection images of the thorax are highly individual, with computer vision-based identification achieving nearly 100% rank-1 accuracy across a potential 8177 identities. Clinical relevance Radiology holds a vast collection of reference images for a computer vision database, enabling automated personal identification in emergency examinations. This improves patient care and communication with relatives by providing access to medical history.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5900-5910"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980581","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":"Preoperative breast MRI for invasive ductal carcinoma with or without a DCIS component at needle biopsy: influence on surgical outcomes in the MIPA study.","authors":"Andrea Cozzi, Giovanni Di Leo, Nehmat Houssami, Fiona J Gilbert, Thomas H Helbich, Marina Álvarez Benito, Corinne Balleyguier, Massimo Bazzocchi, Peter Bult, Massimo Calabrese, Julia Camps Herrero, Francesco Cartia, Enrico Cassano, Paola Clauser, Marcos F de Lima Docema, Catherine Depretto, Valeria Dominelli, Gábor Forrai, Rossano Girometti, Steven E Harms, Sarah Hilborne, Raffaele Ienzi, Marc B I Lobbes, Claudio Losio, Ritse M Mann, Stefania Montemezzi, Inge-Marie Obdeijn, Umit Aksoy Ozcan, Federica Pediconi, Katja Pinker, Heike Preibsch, José L Raya Povedano, Carolina Rossi Saccarelli, Daniela Sacchetto, Gianfranco P Scaperrotta, Margrethe Schlooz, Botond K Szabó, Donna B Taylor, Sıla Ö Ulus, Mireille Van Goethem, Jeroen Veltman, Stefanie Weigel, Evelyn Wenkel, Chiara Zuiani, Francesco Sardanelli","doi":"10.1007/s00330-025-11572-7","DOIUrl":"10.1007/s00330-025-11572-7","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse the impact of preoperative breast MRI on surgical outcomes of patients diagnosed with pure invasive ductal carcinoma (IDC) or IDC with an associated in situ component (IDC + ductal carcinoma in situ [DCIS]) at needle biopsy.</p><p><strong>Methods: </strong>Patients aged 18-80 years referred for upfront surgery after a diagnosis of pure IDC or IDC + DCIS at needle biopsy were retrieved from the Multicenter International Prospective Analysis (MIPA) database. In each subgroup, patients who underwent preoperative MRI (MRI groups) were matched 1:1 to those who did not (noMRI groups) according to eight confounding covariates. Surgical outcomes were compared with non-parametric statistics after calculating odds ratios (ORs).</p><p><strong>Results: </strong>Among 1051 patients with IDC + DCIS, 510 were retained after matching (255 in each group): in comparison to the noMRI group, the MRI group had significantly higher rates of first-line mastectomy (13.3% vs 6.3%; OR 2.30, p = 0.011) and of overall mastectomy (14.5% vs 7.5%; OR 2.11, p = 0.016), without significantly lowering the reoperation rate (9.4% vs 10.6%, OR 0.88, p = 0.768). Among 2459 patients with pure IDC, 1638 were retained after matching (819 in each group): the first-line mastectomy rate was not significantly higher in the MRI group (12.9% vs 12.1% in the noMRI group; OR 1.08, p = 0.654). Instead, the reoperation rate was significantly lower (2.6% vs 7.9%; OR 3.28 for avoiding reoperation, p < 0.001) with no increase in overall mastectomies (13.6% vs 13.7%: OR 0.99, p = 1.000).</p><p><strong>Conclusions: </strong>In patients with IDC + DCIS, preoperative MRI did not reduce reoperations and increased mastectomies. Conversely, in patients with pure IDC, preoperative MRI reduced reoperations without increasing mastectomies.</p><p><strong>Key points: </strong>Question The impact of preoperative breast MRI on surgical outcomes of patients with IDC at needle biopsy is controversial and lacks large-scale investigations. Findings For pure IDC at needle biopsy, MRI reduced reoperations without increasing mastectomies; for IDC + DCIS, MRI did not reduce reoperations and increased mastectomies. Clinical relevance In patients with IDC at needle biopsy, the decision to perform preoperative breast MRI should take into account the presence of associated DCIS, as the benefits of MRI on surgical outcomes were observed only in patients with pure IDC.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6433-6443"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004966","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":"Hepatic arterial infusion chemotherapy versus transarterial chemoembolization in patients with unresectable intrahepatic cholangiocarcinoma: a multicenter retrospective cohort study.","authors":"Yi Zhang, Ze Zhang, Xiaoxv Yin, Anhui Xu, Yonghong Hao, Nan Jiang, Ruibing Zhou, Ketao Mu","doi":"10.1007/s00330-025-11557-6","DOIUrl":"10.1007/s00330-025-11557-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with unresectable intrahepatic cholangiocarcinoma (ICC) have poor overall survival (OS). Hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE), including conventional TACE (c-TACE) and drug-eluting bead TACE (DEB-TACE), are widely used to treat ICC, but the efficacy of these therapies has not been fully demonstrated. This study aimed to compare the efficacy of HAIC and TACE in unresectable ICC patients.</p><p><strong>Methods: </strong>This retrospective cohort study included unresectable ICC patients who received HAIC, c-TACE or DEB-TACE as initial treatment between June 2016 and October 2023 at three hospitals. The median OS (mOS), tumor response, and incidence of adverse events (AEs) were compared and propensity score matching (PSM) was used to reduce selection bias.</p><p><strong>Results: </strong>A total of 181 patients with unresectable ICC received HAIC (n = 24), c-TACE (n = 73) and DEB-TACE (n = 84). The HAIC group had significantly higher mOS (10.3 vs. 5.1 months, p = 0.0042), objective response rate (ORR) (29.2% vs. 4.1%, p = 0.002) and disease control rate (DCR) (95.8% vs. 43.8%, p < 0.001) than the c-TACE group. There was no significant difference between the HAIC and DEB-TACE groups in improving mOS (10.3 vs. 12.5 months, p = 0.61). Results remained consistent after PSM. The c-TACE and DEB-TACE groups had a higher incidence of AEs compared with the HAIC group. After matching, there was no significant difference in the incidence of AEs between groups.</p><p><strong>Conclusion: </strong>HAIC improves ICC patient prognosis better than c-TACE. Both HAIC and DEB-TACE are superior treatment options for unresectable ICC.</p><p><strong>Key points: </strong>Question The evidence of comparative effectiveness between hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE) is insufficient. Findings HAIC significantly improved median overall survival, tumor response, and prognosis while reducing adverse events compared to convention TACE (c-TACE) in unresectable intrahepatic cholangiocarcinoma (ICC) patients. Clinical relevance HAIC significantly improves OS and tumor response in patients with unresectable ICC compared to c-TACE, but HAIC shows no significant difference from drug-eluting bead-TACE. Notably, HAIC shows no significant difference in adverse events compared to both c-TACE and DEB-TACE.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6564-6574"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993466","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}