European Radiology最新文献

{"title":"Diagnostic performance of radiologists in distinguishing post-COVID-19 residual abnormalities from interstitial lung abnormalities.","authors":"Jong Eun Lee, Hyo-Jae Lee, Gyeryeong Park, Kum Ju Chae, Kwang Nam Jin, Eva Castañer, Benoit Ghaye, Jane P Ko, Helmut Prosch, Scott Simpson, Anna Rita Larici, Jeffrey P Kanne, Thomas Frauenfelder, Yeon Joo Jeong, Soon Ho Yoon","doi":"10.1007/s00330-024-11075-x","DOIUrl":"10.1007/s00330-024-11075-x","url":null,"abstract":"<p><strong>Objective: </strong>Distinguishing post-COVID-19 residual abnormalities from interstitial lung abnormalities (ILA) on CT can be challenging if clinical information is limited. This study aimed to evaluate the diagnostic performance of radiologists in distinguishing post-COVID-19 residual abnormalities from ILA.</p><p><strong>Methods: </strong>This multi-reader, multi-case study included 60 age- and sex-matched subjects with chest CT scans. There were 40 cases of ILA (20 fibrotic and 20 non-fibrotic) and 20 cases of post-COVID-19 residual abnormalities. Fifteen radiologists from multiple nations with varying levels of experience independently rated suspicion scores on a 5-point scale to distinguish post-COVID-19 residual abnormalities from fibrotic ILA or non-fibrotic ILA. Interobserver agreement was assessed using the weighted κ value, and the scores of individual readers were compared with the consensus of all readers. Receiver operating characteristic curve analysis was conducted to evaluate the diagnostic performance of suspicion scores for distinguishing post-COVID-19 residual abnormalities from ILA and for differentiating post-COVID-19 residual abnormalities from both fibrotic and non-fibrotic ILA.</p><p><strong>Results: </strong>Radiologists' diagnostic performance for distinguishing post-COVID-19 residual abnormalities from ILA was good (area under the receiver operating characteristic curve (AUC) range, 0.67-0.92; median AUC, 0.85) with moderate agreement (κ = 0.56). The diagnostic performance for distinguishing post-COVID-19 residual abnormalities from non-fibrotic ILA was lower than that from fibrotic ILA (median AUC = 0.89 vs. AUC = 0.80, p = 0.003).</p><p><strong>Conclusion: </strong>Radiologists demonstrated good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA, but careful attention is needed to avoid misdiagnosing them as non-fibrotic ILA.</p><p><strong>Key points: </strong>Question How good are radiologists at differentiating interstitial lung abnormalities (ILA) from changes related to COVID-19 infection? Findings Radiologists had a median AUC of 0.85 in distinguishing post-COVID-19 abnormalities from ILA with moderate agreement (κ = 0.56). Clinical relevance Radiologists showed good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA; nonetheless, caution is needed in distinguishing residual abnormalities from non-fibrotic ILA.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"2265-2274"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282501","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":"Reducing energy consumption in musculoskeletal MRI using shorter scan protocols, optimized magnet cooling patterns, and deep learning sequences.","authors":"Saif Afat, Julian Wohlers, Judith Herrmann, Andreas S Brendlin, Sebastian Gassenmaier, Haidara Almansour, Sebastian Werner, Jan M Brendel, Alexander Mika, Christoph Scherieble, Mike Notohamiprodjo, Sergios Gatidis, Konstantin Nikolaou, Thomas Küstner","doi":"10.1007/s00330-024-11056-0","DOIUrl":"10.1007/s00330-024-11056-0","url":null,"abstract":"<p><strong>Objectives: </strong>The unprecedented surge in energy costs in Europe, coupled with the significant energy consumption of MRI scanners in radiology departments, necessitates exploring strategies to optimize energy usage without compromising efficiency or image quality. This study investigates MR energy consumption and identifies strategies for improving energy efficiency, focusing on musculoskeletal MRI. We assess the potential savings achievable through (1) optimizing protocols, (2) incorporating deep learning (DL) accelerated acquisitions, and (3) optimizing the cooling system.</p><p><strong>Materials and methods: </strong>Energy consumption measurements were performed on two MRI scanners (1.5-T Aera, 1.5-T Sola) in practices in Munich, Germany, between December 2022 and March 2023. Three levels of energy reduction measures were implemented and compared to the baseline. Wilcoxon signed-rank test with Bonferroni correction was conducted to evaluate the impact of sequence scan times and energy consumption.</p><p><strong>Results: </strong>Our findings showed significant energy savings by optimizing protocol settings and implementing DL technologies. Across all body regions, the average reduction in energy consumption was 72% with DL and 31% with economic protocols, accompanied by time reductions of 71% (DL) and 18% (economic protocols) compared to baseline. Optimizing the cooling system during the non-scanning time showed a 30% lower energy consumption.</p><p><strong>Conclusion: </strong>Implementing energy-saving strategies, including economic protocols, DL accelerated sequences, and optimized magnet cooling, can significantly reduce energy consumption in MRI scanners. Radiology departments and practices should consider adopting these strategies to improve energy efficiency and reduce costs.</p><p><strong>Clinical relevance statement: </strong>MRI scanner energy consumption can be substantially reduced by incorporating protocol optimization, DL accelerated acquisition, and optimized magnetic cooling into daily practice, thereby cutting costs and environmental impact.</p><p><strong>Key points: </strong>Optimization of protocol settings reduced energy consumption by 31% and imaging time by 18%. DL technologies led to a 72% reduction in energy consumption of and a 71% reduction in time, compared to the standard MRI protocol. During non-scanning times, activating Eco power mode (EPM) resulted in a 30% reduction in energy consumption, saving 4881 € ($5287) per scanner annually.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1993-2004"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145458","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":"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":"https://doi.org/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":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-30","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":"MRI-specific signature of dementia with Lewy bodies-a step towards improved differential diagnosis of the dementia spectrum.","authors":"Maria Marcella Laganà, Dejan Jakimovski","doi":"10.1007/s00330-025-11534-z","DOIUrl":"https://doi.org/10.1007/s00330-025-11534-z","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742741","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":"Interhemispheric cortical thickness asymmetry is an imaging biomarker of dementia type.","authors":"Francisco P M Oliveira, Cláudia S Constantino, Durval C Costa","doi":"10.1007/s00330-025-11535-y","DOIUrl":"https://doi.org/10.1007/s00330-025-11535-y","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742740","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-invasive PD-L1 stratification in non-small cell lung cancer using dynamic contrast-enhanced MRI.","authors":"Gaia Messana, Chandra Bortolotto, Sithin Thulasi Seetha, Alessandra Marrocco, Carlotta Pairazzi, Francesco Sanvito, Francesca Brero, Agnese Robustelli Test, Raffaella Fiamma Cabini, Alessandro Lascialfari, Domenico Zacà, Giulia Maria Stella, Francesco Agustoni, Jessica Saddi, Andrea Riccardo Filippi, Lorenzo Preda","doi":"10.1007/s00330-025-11524-1","DOIUrl":"https://doi.org/10.1007/s00330-025-11524-1","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess whether pharmacokinetic parameters derived from DCE-MRI can stratify Programmed Death-Ligand 1 (PD-L1) expression in NSCLC. The secondary aim was to identify a suitable pharmacokinetic model configuration for anisotropic temporally-spaced DCE-MRI sequences, considering Tofts variants, population-averaged arterial input functions (AIF), and bolus arrival time (BAT) estimation methods.</p><p><strong>Materials and methods: </strong>From April 2021 to May 2023, patients with locally advanced non-small cell lung cancer (NSCLC) were prospectively enrolled. Tumors were categorized based on: PD-L1 absence/presence (threshold 1%) and hyperexpression/hypoexpression (threshold 50%). Pharmacokinetic parameters were extracted using several candidate configurations; fit quality was evaluated using coefficient of determination (R²). Mann-Whitney U-test and ROC-AUC were used to assess correlation with PD-L1 for the best-fit configuration.</p><p><strong>Results: </strong>Thirty-eight patients (mean age 68 ± 9 years, 28 men) were included. PD-L1 expression was present in 25 patients (66%) and absent in 13 (34%). PD-L1 was hyperexpressed in 13 (34%) patients and hypoexpressed in 25 (66%). Voxel-wise pharmacokinetic parameters were extracted using the best-fit configuration-extended Tofts model (ETM) with Georgiou AIF and Peak-Gradient (PG) BAT estimation (R² = 0.79). K^trans median (0.25 vs. 0.12 min^-¹, p = 0.02), K^trans standard deviation (0.32 vs. 0.23 min^-¹, p = 0.01) and K_ep median (1.09 vs. 0.59 min^-¹, p = 0.02) were significantly higher in PD-L1 < 50% group (ROC-AUC 0.71-0.76).</p><p><strong>Conclusion: </strong>DCE-MRI pharmacokinetic parameters could stratify PD-L1 hypo/hyperexpression in NSCLC. The ETM with PG BAT estimation method and Georgiou AIF was the best-performing pharmacokinetic configuration.</p><p><strong>Key points: </strong>Question Could Dynamic Contrast-Enhanced (DCE) MRI offer a safe and non-invasive way to assess Programmed Death-Ligand 1 (PD-L1) expression? Findings Quantitative DCE-MRI parameters K^trans (the volume transfer rate) and K_ep (the efflux rate constant) show potential for distinguishing PD-L1 hyperexpression from hypoexpression. Clinical relevance Preliminary results suggest that DCE-MRI could be a safe method to stratify PD-L1 hypo/hyperexpression in non-small cell lung cancer, potentially optimizing treatment decisions, given the high cost of immunotherapy.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718240","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":"Sample size estimation for radiomics studies: an overlooked problem.","authors":"Michail E Klontzas, Burak Kocak, Renato Cuocolo","doi":"10.1007/s00330-025-11538-9","DOIUrl":"https://doi.org/10.1007/s00330-025-11538-9","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718315","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":"Conventional transcatheter arterial chemoembolization with gelatin spheres for hepatocellular carcinoma: comparison with nonspherical gelatin sponge particles.","authors":"Dong Il Gwon, Hee Ho Chu, Gun Ha Kim, Jihoon Kim, Byoung Soo Im, Eunbyeol Ko, Jeongyeon Kim, Jin Hyoung Kim, Gi-Young Ko, Hyun-Ki Yoon","doi":"10.1007/s00330-025-11527-y","DOIUrl":"https://doi.org/10.1007/s00330-025-11527-y","url":null,"abstract":"<p><strong>Objective: </strong>To compare the therapeutic effect, adverse events, and hepatic artery injury (HAI) between gelatin spheres (GS) and nonspherical gelatin sponge particles (GP) in conventional transcatheter arterial chemoembolization (C-TACE).</p><p><strong>Materials and methods: </strong>A total of 368 consecutive patients with hepatocellular carcinoma (HCC) who underwent C-TACE between September 2019 and May 2021 were included in this single center retrospective study. Adverse events, radiologic tumor response, local tumor recurrence, and HAI were evaluated.</p><p><strong>Results: </strong>Subsegmental C-TACE was performed using biodegradable GS in 165 patients and nonspherical biodegradable GP in 203 patients. No significant differences in patient background existed between the groups, and there was no significant difference in adverse event rate (p = 0.231). The CR and overall tumor response in the GS and GP groups were 73.3% vs 70.9%, and 99.4% vs 98.5%, respectively, with no significant between-group differences (p = 0.642 and p = 0.631). No significant difference in cumulative local tumor recurrence rate existed between the groups (p = 0.558). HAI was observed in 16% (20 of 125 patients) in the GS group and 37.4% (49 of 131 patients) in the GP group. The incidence of HAI was significantly higher in the GP group than in the GS group (p < 0.001). In multiple logistic regression analysis, risk factors for HAI were index tumor size ≥ 3 cm (p = 0.001) and use of GP (p < 0.001).</p><p><strong>Conclusion: </strong>C-TACE with GS resulted in the same therapeutic and adverse effects as C-TACE with nonspherical GP while causing significantly less HAI.</p><p><strong>Key points: </strong>Question Comparisons between GS and nonspherical GP are lacking, and the potential advantages of GS over nonspherical GP are not well studied. Findings HAI incidence was higher in the GP than the GS group, and risk factors of HAI were index tumor size ≥ 3 cm and GP use. Clinical relevance C-TACE with GS resulted in the same therapeutic and adverse effects as C-TACE with nonspherical GP while causing significantly less HAI.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718192","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":"Influence of plaque characteristics by coronary computed tomography angiography on lesion-specific ischemia: a systematic review and meta-analysis.","authors":"Nadia Iraqi, Bjarne L Nørgaard, Damini Dey, Jawdat Abdulla","doi":"10.1007/s00330-025-11516-1","DOIUrl":"https://doi.org/10.1007/s00330-025-11516-1","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between plaque characteristics and burden by coronary computed tomography angiography (CCTA) and ischemia determined by invasively measured fractional flow reserve (FFR), and whether the addition of plaque characteristics improves ischemia discrimination beyond coronary stenosis alone.</p><p><strong>Methods: </strong>A systematic literature review and meta-analysis of studies from PubMed, EMBASE, and the Cochrane Library databases, published between January 2005 and October 2024 were conducted to assess the relationship between quantitative and qualitative coronary plaque characteristics and invasive FFR. Pooled analyses were performed using weighted mean difference for plaque volumes with 95% confidence intervals and odds ratios for qualitative plaque findings.</p><p><strong>Results: </strong>A total of 29 studies involving 4416 patients (mean age 63 ± 9 years and 71% male) with predominantly stable coronary artery disease were included. Data on 3923 lesions and 3520 vessels were pooled. Total plaque, non-calcified plaque, and percent aggregate plaque volumes, as well as percent plaque burden, were inversely associated with FFR at both per-lesion and per-vessel levels (all, p-values < 0.05). The presence of high-risk plaque characteristics, including low-attenuation plaque, napkin-ring sign, and spotty calcification, were more frequently observed in lesions and vessels with FFR ≤ 0.80 (all, p-values < 0.05). Among plaque volumes, the percent aggregate plaque volume consistently improved ischemia discrimination independently of stenosis.</p><p><strong>Conclusion: </strong>CCTA-derived quantification of plaque volumes and identification of high-risk plaque characteristics are associated with ischemia and significantly enhance discrimination of ischemia-causing lesions independently of coronary stenosis severity.</p><p><strong>Key points: </strong>Question Plaque characteristics have been suggested as the missing link between coronary artery stenosis severity and ischemia. Findings High-risk plaque characteristics and larger coronary plaque volumes are associated with ischemia (FFR ≤ 0.80). Clinical relevance The addition of CCTA-derived plaque assessment improved the discrimination of ischemia compared with stenosis evaluation alone. Combining coronary stenosis and plaque assessment may improve the non-invasive assessment of patients with coronary artery disease and gatekeeping to the catheterization laboratory.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718239","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":"Safety and efficacy evaluation of contrast-enhanced ultrasound-guided omental biopsy: a single-center prospective study.","authors":"Zhiguang Chen, Zhiqun Bai, Puxu Yang, Liang Sang, Xiang Li, Xuemei Wang, Yanjun Liu","doi":"10.1007/s00330-025-11489-1","DOIUrl":"https://doi.org/10.1007/s00330-025-11489-1","url":null,"abstract":"<p><strong>Objectives: </strong>Contrast-enhanced ultrasound (CEUS) assesses omental lesion nature, but CEUS-guided biopsy feasibility, effectiveness, and safety are uncertain.</p><p><strong>Methods: </strong>From January 2020 to January 2024, patients scheduled for ultrasound-guided omental biopsy at the First Hospital of China Medical University were enrolled. They were divided into CEUS-guided and conventional ultrasound-guided groups, balanced using propensity score matching (PSM). Success rate, diagnostic accuracy, and complication rate were compared. Subgroup analyses considered sonographic features, with significance at p < 0.05.</p><p><strong>Results: </strong>After PSM, 310 CEUS-guided and 160 conventional ultrasound-guided patients were analyzed. Groups were similar in demographics and omental characteristics (p > 0.05). CEUS-guided biopsy had higher sample acquisition (97.42% vs. 93.13%, p = 0.029) and diagnostic accuracy (96.03% vs. 87.92%, p = 0.002). Overall complication rate was 9.36% (44/470), with distant metastasis in 0.43% (2/470). Complication rates did not differ significantly between groups. In hyperechoic group, dense group, and non-nodule group, CEUS-guided biopsy had higher success (97.99% vs. 92.55%, p = 0.042) and accuracy (96.48% vs. 86.17%, p = 0.002). In non-nodule group, CEUS-guided accuracy was superior (93.41% vs. 84.11%, p = 0.015).</p><p><strong>Conclusion: </strong>Ultrasound-guided omental biopsy is a safe and effective method for obtaining samples. CEUS-guided omental biopsy enhances sample acquisition and diagnostic accuracy, especially in hyperechoic group, dense group, and non-nodule group, suggesting it is a more accurate and effective diagnostic method.</p><p><strong>Key points: </strong>Question Selecting a puncture site for diffuse lesions of the greater omentum presents challenges, as conventional ultrasound-guided biopsy often encounters difficulties in avoiding local necrotic tissue. Findings Ultrasound-guided biopsy of the greater omentum is a safe and effective diagnostic method, especially when augmented with CEUS, which can significantly enhance diagnostic accuracy. Clinical relevance CEUS can markedly enhance diagnostic accuracy by providing a robust foundation for selecting the biopsy site and pathway. Therefore, it is advisable to routinely employ CEUS-guided puncture pathways for atypical omental lesions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718254","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}