European Radiology最新文献

{"title":"Embracing graphical abstracts in European Radiology.","authors":"Brendan S Kelly","doi":"10.1007/s00330-025-11555-8","DOIUrl":"10.1007/s00330-025-11555-8","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5875-5877"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771872","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":"Concordance of vibration-controlled transient elastography and magnetic resonance elastography for fibrosis staging in patients with metabolic dysfunction-associated steatotic liver disease.","authors":"Anandita Mathur, Efe Ozkaya, Sonam Rosberger, Keith M Sigel, John T Doucette, Meena B Bansal, Bachir Taouli","doi":"10.1007/s00330-025-11533-0","DOIUrl":"10.1007/s00330-025-11533-0","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the concordance between vibration-controlled transient elastography (VCTE) and magnetic resonance elastography (MRE) for staging liver fibrosis and assessing hypothetical eligibility for resmetirom treatment in a cohort of patients with metabolic dysfunction-associated steatotic liver disease (MASLD). A secondary objective was to assess the performance of VCTE for liver fat quantification.</p><p><strong>Materials and methods: </strong>This retrospective study included 103 patients (61 males; mean age 54.7 years) with suspected MASLD who underwent VCTE and MRI/MRE. The following parameters were extracted: liver stiffness (LS) from both techniques, controlled attenuation parameter (CAP) from VCTE, and MRI-proton density fat fraction (PDFF). Agreement and fibrosis stage distributions were assessed using Cohen's Kappa and McNemar's tests. ROC analysis assessed the performance of CAP against MRI-PDFF (considered the reference for steatosis).</p><p><strong>Results: </strong>A significant difference was observed in assigned fibrosis stage distributions between VCTE and MRE across all combinations (F0-F1 vs F2-F4, F0-F2 vs F3-F4, F0-F3 vs F4, all p < 0.001) with fair to moderate agreement between modalities (Cohen's Kappa values 0.305-0.554). VCTE assigned a higher fibrosis stage in 42 patients (40.7%). Thirty-three vs eighteen patients were classified as F2-F3 (qualified for resmetirom treatment) with VCTE vs MRE (Cohen's Kappa 0.215), which was associated with estimated cost savings of $707,701/year with MRE. VCTE-CAP achieved AUCs of 0.547, 0.754, and 0.813 for diagnosing mild, moderate, and severe steatosis, respectively.</p><p><strong>Conclusion: </strong>VCTE and MRE have fair to moderate agreement for fibrosis staging, with VCTE tending to assign a higher fibrosis stage compared to MRE. VCTE-CAP reliably detects only severe steatosis.</p><p><strong>Key points: </strong>Question What is the agreement between VCTE and MRE in staging fibrosis in MASLD and identifying patients with F2-F3 disease? Findings Limited concordance was found between VCTE and MRE for staging liver fibrosis and identifying F2-F3 disease; VCTE tended to assign higher fibrosis stages compared to MRE. Clinical relevance MRE could represent the modality of choice for selecting patients with metabolic dysfunction-associated steatohepatitis for resmetirom therapy as it potentially offers high cost-savings compared to VCTE.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6507-6515"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751765","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":"Non-enhanced MRI flow evaluation using 4D versus 2D phase-contrast in repaired Tetralogy of Fallot adults.","authors":"Jean Alfred François Champollion, Thomas Senage, Lara Marteau, Jean-Michel Serfaty, Patrice Guerin, Jean-Nicolas Dacher, Karine Warin-Fresse","doi":"10.1007/s00330-025-11542-z","DOIUrl":"10.1007/s00330-025-11542-z","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the reliability of quantitative MRI analysis of flows using 4D-PC (Phase Contrast) compared to 2D-PC flow, without contrast agents.</p><p><strong>Materials and methods: </strong>The study was conducted at one centre in a retrospective manner from 2021 to 2023. Eligible patients were adults with repaired Tetralogy of Fallot (rToF) whose follow-up MRI protocol included 4D-PC and 2D-PC, without contrast agent. Assessment involved quantitative measurement of aortic and pulmonary flows on both 4D and 2D. Student's T was used for comparisons of means and Lin's concordance correlation coefficient agreement (CCC). A 2nd observer was hired.</p><p><strong>Results: </strong>Twenty-six patients were included (50% men, median age of 27 [20; 34]). Scanning mean time was 13 min for 4D and 47 min for non-4D part. Systematic underestimation in pulmonary regurgitation fraction (-10 ± 15%, p = 0.02) and backward volume (-13 ± 18 mL, p = 0.02) was found. Agreement on regurgitant fraction was strong for pulmonary (CCC = 0.75 [0.58-0.86], p < 0.001) and aortic (CCC = 0.91 [0.81-0.95], p < 0.001). Inter-observer showed overall strong results.</p><p><strong>Conclusion: </strong>Non-enhanced 4D-PC flow MRI seems to be a reliable method of quantitative flow in rToF patients, but it may underestimate pulmonary regurgitation.</p><p><strong>Key points: </strong>Question 4D-MRI stands out as an innovative tool for evaluating flows in adults with repaired Tetralogy of Fallot during follow-up. Findings 4D phase-contrast imaging without the use of contrast agents exhibits robust results and high reproducibility. Clinical relevance 4D-MR is presented as an accurate and versatile tool of cardiac exploration that could improve patient comfort. Minimizing brain gadolinium exposure and reducing scanning time are key objectives of non-enhanced 4D-MR.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6313-6322"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964858","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":"Advancing MS care: Are QReports the next leap in imaging?","authors":"Neus Mongay-Ochoa","doi":"10.1007/s00330-025-11716-9","DOIUrl":"10.1007/s00330-025-11716-9","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5965-5966"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198629","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":"Short-term intra- and peri-tumoral spatiotemporal CT radiomics for predicting major pathological response to neoadjuvant chemoimmunotherapy in non-small cell lung cancer.","authors":"Xiao Bao, Qin Peng, Dongliang Bian, Jianjiao Ni, Shuchang Zhou, Peng Zhang, Yajia Gu, Jing Gong, Jingyun Shi","doi":"10.1007/s00330-025-11563-8","DOIUrl":"10.1007/s00330-025-11563-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop a short-term spatiotemporal CT radiomics model to predict the major pathological response (MPR) to neoadjuvant chemoimmunotherapy (NCI) in NSCLC by decoding the intra- and peri-tumoral imaging phenotypes.</p><p><strong>Methods: </strong>A total of 352 patients undergoing curative surgery following NCI for NSCLC were enrolled from two centers, forming a training cohort (n = 186), an internal validation cohort (n = 80), and an external validation cohort (n = 86). Intra- and peri-tumoral CT radiomics features were computed to capture imaging phenotypes of the tumor microenvironment. Delta radiomics features were also calculated by quantifying changes in each radiomics feature. A support vector machine classifier was utilized to develop the short-term spatiotemporal model by analyzing changes in radiomics features.</p><p><strong>Results: </strong>The multi-timepoint short-term spatiotemporal model, incorporating pre-treatment, post-treatment and delta radiomic features, achieved AUC values of 0.84, 0.77, and 0.75 in the training, internal validation, and external validation cohorts, respectively. These results significantly outperformed the RECIST model and pre-treatment model, with p-values < 0.05 indicating statistical significance.</p><p><strong>Conclusion: </strong>This study demonstrates that short-term temporal analysis of intra- and peri-tumoral CT radiomics is a promising approach for predicting MPR to NCI in NSCLC. These findings underscore the potential of radiomics as a non-invasive tool for assessing treatment response and guiding personalized therapy in NSCLC patients.</p><p><strong>Key points: </strong>Question Neoadjuvant chemoimmunotherapy has improved in major pathological response rate for non-small cell lung cancer (NSCLC), but it is unclear which patients will benefit most. Findings The multi-timepoint short-term spatiotemporal model based on CT pictures demonstrates high predictive performance for assessing major pathological response following neoadjuvant chemoimmunotherapy in NSCLC. Clinical relevance Short-term intra- and peri-tumoral CT radiomics is a promising approach for predicting major pathological response to neoadjuvant chemoimmunotherapy in NSCLC. These findings underscore the potential of radiomics as a non-invasive tool for assessing treatment response in NSCLC.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6052-6064"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957860","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":"Sequential dual-energy CT for longitudinal assessment of pathologic response to neoadjuvant immuno-chemotherapy in locally advanced gastric cancer.","authors":"Xiaoxiao Lin, Shuning Xu, Yi Wang, Fei Ma, Jinrong Qu, Yue Wu, Jing Li","doi":"10.1007/s00330-025-11601-5","DOIUrl":"10.1007/s00330-025-11601-5","url":null,"abstract":"<p><strong>Objectives: </strong>To longitudinally evaluate pathologic response outcomes after neoadjuvant immuno-chemotherapy (NICT) for patients with locally advanced gastric cancer (LAGC) using pre- and post-treatment dual-energy CT (DECT).</p><p><strong>Materials and methods: </strong>Between Jan 2021 and Dec 2023, 115 patients who underwent NICT plus gastrectomy and triple-phase enhanced DECT scans before and after NICT were retrospectively enrolled. Pathologic tumor regression grade (TRG) was the reference standard, patients were labelled as responders (TRG = 0 + 1) and non-responders (TRG = 2 + 3) accordingly. A two-dimensional free-hand region of interest method was adopted to obtain the iodine concentration (IC) values. Pre- and post-NICT IC and normalized IC (nIC) were measured at arterial/venous/delay phase (AP/VP/DP), respectively; their changes [ΔIC (%)] defined as (IC_post-IC_pre)⁄IC_pre × 100% were calculated. Pre- and post-NICT imaging parameters and their changes were compared between different response groups. Non-responders' associated parameters were selected using multivariable logistic regression analysis. Their performances were analyzed by the area under the receiver operating characteristic curve (AUC). Their associations with patient survival were explored by using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>ICDP-pre, ΔICAP, thickness-post with cut-off value of > 2.306 mg/mL, ≤ 26.70%, > 18.5 mm, respectively, indicates non-responders with equivalent AUC being 0.616 (95% CI: 0.521-0.705), 0.625 (95% CI: 0.529-0.713), and 0.660 (95% CI: 0.565-0.745). Their combination demonstrated an improved AUC of 0.774 (95% CI: 0.686-0.846) and was associated with patient disease-free survival (DFS) with a hazard ratio being 2.239 (95% CI: 1.004-4.991) (p = 0.026).</p><p><strong>Conclusion: </strong>Pre- and post-NICT DECT-based quantifications are useful for longitudinal assessment of pathologic response outcomes after NICT in LAGC. ICDP-pre, ΔICAP, and thickness-post are equally useful, their combination demonstrated incremental benefit.</p><p><strong>Key points: </strong>Question Accurate evaluation of the efficacy of NICT in patients with LAGC remains challenging due to the lack of effective biomarkers. Findings Sequential DECT-based ICDP-pre, ΔICAP, and tumor thickness-post were predictive of TRG status. Their combination demonstrated enhanced performance and was associated with patient DFS. Clinical relevance DECT represents a promising imaging technique with added advantages for longitudinal assessment of pathologic response to NICT in LAGC, potentially facilitating more personalized treatment strategies among this population.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6469-6481"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992980","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":"Deep learning reconstruction for detection of liver lesions at standard-dose and reduced-dose abdominal CT.","authors":"Tormund H Njølstad, Kristin Jensen, Hilde K Andersen, Audun E Berstad, Gaute Hagen, Cathrine K Johansen, Kjetil Øye, Jan Glittum, Anniken Dybwad, Emma Thingstad, Marianne G Guren, Johann Baptist Dormagen, Anselm Schulz","doi":"10.1007/s00330-025-11596-z","DOIUrl":"10.1007/s00330-025-11596-z","url":null,"abstract":"<p><strong>Objectives: </strong>Deep learning reconstruction (DLR) has shown promising image denoising ability, but its radiation dose reduction potential remains unknown. The objective of this study was to investigate the diagnostic performance of DLR compared to iterative reconstruction (IR) in the detection of liver lesions at standard-dose and reduced-dose CT.</p><p><strong>Materials and methods: </strong>Participants with known liver metastases from gastrointestinal and pancreatic adenocarcinoma were prospectively included from routine follow-up (October 2020 to March 2022). Participants received standard-dose CT and two additional reduced-dose scans during the same contrast administration, each reconstructed with IR and high-strength DLR. Two radiologists evaluated images for the presence of liver lesions, and a third established a reference standard. Diagnostic performance was compared using McNemar's test and mixed effects logistic regression.</p><p><strong>Results: </strong>Forty-four participants (mean age 66 years ± 11 [standard deviation], 28 men) were evaluated with 348 included liver lesions ≤ 20 mm (297 metastases, 51 benign; mean size 9.1 ± 4.3 mm). Mean volume CT dose index was 14.2, 7.8 mGy, and 5.1 mGy. Between algorithms, no significant difference in lesion detection was observed within dose levels. Detection of 233 lesions ≤ 10 mm was deteriorated with lower dose levels despite DLR denoising, with 185 detected at standard-dose IR (79.4%; 95% CI: 73.5-84.3) vs 128 at medium-dose DLR (54.9%; 95% CI: 48.3-61.4; p < 0.001) and 105 at low-dose DLR (45.1%; 95% CI: 38.6-51.7; p < 0.001).</p><p><strong>Conclusion: </strong>Diagnostic performance for liver lesion detection was comparable between algorithms. When the detection of smaller lesions is important, DLR did not facilitate substantial dose reduction.</p><p><strong>Key points: </strong>Question Methods to reduce CT radiation dose are desirable in clinical practice, and DLR has shown promising image denoising capabilities. Findings Liver lesion detection was comparable for DLR and IR across dose levels, but detection of smaller lesions deteriorated with lower dose levels. Clinical relevance Although potent in image noise reduction, the diagnostic performance of DLR is comparable to IR at standard-dose and reduced-dose CT. Care must be taken in pursuit of dose reduction when the detection and characterization of smaller liver lesions are of clinical importance.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6140-6149"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999039","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":"Percutaneous image-guided cryoablation of venous malformation and fibro-adipose vascular anomaly: prognostic factors of clinical efficacy.","authors":"Clément Marcelin, Thomas Linet, Eva Jambon, Rim Maaloum, Yann Le Bras, Vincent Pinsolle, Christine Labreze, François H Cornelis","doi":"10.1007/s00330-025-11545-w","DOIUrl":"10.1007/s00330-025-11545-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prognostic factors for clinical and radiological responses to percutaneous image-guided cryoablation (CA) in treating venous malformation (VM) and fibro-adipose vascular anomaly (FAVA).</p><p><strong>Materials and methods: </strong>Fifty-five patients (12 males, 43 females; median age: 30 years) with symptomatic lesions (median VAS pain score: 70; median initial volume: 12.2 mm³) underwent CA between 2012 and 2023. CA was a first-line treatment in 23 patients (42%) and second-line in 32 (58%). Lesions were Goyal grade 1 in 24 cases (43%) and located on extremities in 44 (80%). Technical efficacy was assessed using MRI and applying RECIST criteria, while clinical efficacy was based on changes in VAS pain scores. Prognostic factors for residual pain were analyzed using univariable and multivariable analyses.</p><p><strong>Results: </strong>With a median follow-up of 13 months, technical success was achieved in all cases, and 20% of patients underwent multiple sessions. Technical efficacy was observed in 69% of cases, with 33% achieving complete response and 36% partial response (mean volume reduction: 47%). Clinical efficacy was reached in 72% of cases. Univariable analysis linked residual pain to sex (female, p = 0.013), initial pain level (p = 0.014), Goyal grade (p = 0.029), and residual volume (p = 0.012). Multivariable analysis revealed that grade (p = 0.035), post-therapeutic volume (p = 0.048), and completeness of treatment (p = 0.029) were statistically significant predictors.</p><p><strong>Conclusion: </strong>Cryoablation is an effective management strategy for venous malformation and FAVA, with residual volume emerging as a significant indicator of clinical success.</p><p><strong>Key points: </strong>Question Venous malformations (VA) and fibro-adipose vascular anomalies (FAVA) often cause chronic pain, with limited effective treatment options. Identifying predictors of pain relief following cryoablation could optimize patient outcomes. Findings Cryoablation achieved 72% pain relief for VA and FAVA. High lesion grade, treatment completeness, and residual volume were significantly associated with residual pain. Clinical relevance Cryoablation provides an effective, minimally invasive treatment for VA and FAVA, achieving significant pain relief while identifying predictors to optimize patient selection and outcomes.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6554-6563"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788077","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: An unenhanced 3D-FLAIR sequence using long repetition time and constant flip angle to image endolymphatic hydrops.","authors":"Barton F Branstetter, Barry E Hirsch","doi":"10.1007/s00330-025-11536-x","DOIUrl":"10.1007/s00330-025-11536-x","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6608-6609"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795030","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":"Congruency between publicly available pictorial displays of medial temporal lobe atrophy.","authors":"Felicia Forseni Flodin, Sven Haller, Leo Poom, David Fällmar","doi":"10.1007/s00330-025-11529-w","DOIUrl":"10.1007/s00330-025-11529-w","url":null,"abstract":"<p><p>The medial temporal lobe atrophy (MTA) score is used for visual assessment of MTA on radiological images in suspected neurodegenerative dementia. Although volumetric tools are available, many radiologists still use visual scoring and compare to reference images. Numerous such example images are found online on educational websites and in scientific articles. The aim of this study was to compare congruencies between MTA scores of publicly available sample images with normalized heights and areas of relevant brain structures, measured in the same images.</p><p><strong>Method: </strong>Systematic online searches yielded 148 individual sample images. The height and area of relevant brain structures were manually delineated, normalized, and compared with regard to the displayed MTA score.</p><p><strong>Results: </strong>The normalized heights and areas showed correlation with MTA but with considerable overlap between adjacent scores, especially when comparing heights. Also, displays of the MTA score were more consistent with the area of the temporal horn than with the hippocampal area.</p><p><strong>Conclusion: </strong>There is considerable overlap between adjacent scores in publicly available pictorial displays of the MTA grading system. Insufficient congruency leads to confusion and reduces inter-rater reliability. We also found that publicly available images are more consistent with temporal horn area than the hippocampus, which means that ventricular size may bias the grading. This can impede relevant differential diagnostics, especially regarding normal pressure hydrocephalus. Here, we present lectotype images selected specifically with regard to the hippocampal area.</p><p><strong>Key points: </strong>Question Overlap between publicly available example images of medial temporal atrophy causes confusion and limits reliability. Findings Available images are more consistent with ventricular dilatation than hippocampal atrophy; this article provides lectotype images selected specifically regarding the hippocampal area. Clinical relevance Visual assessment of medial temporal atrophy is used daily and worldwide in radiological examinations regarding suspected dementia. In clinical routine, many radiologists experience uncertainty, and hydrocephalus is often overlooked. This may be caused by insufficient congruency between educational sample images.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5944-5953"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779542","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}