European Radiology最新文献

{"title":"PSMA-avid rib lesions in prostate cancer patients: differentiating false positives from metastatic disease.","authors":"Sungmin Woo, Anton S Becker, Doris Leithner, Charlotte Charbel, Marius E Mayerhoefer, Kent P Friedman, Angela Tong, Sofya Murina, Matthew Siskin, Samir S Taneja, Michael J Zelefsky, David R Wise, Hebert A Vargas","doi":"10.1007/s00330-025-11514-3","DOIUrl":"https://doi.org/10.1007/s00330-025-11514-3","url":null,"abstract":"<p><strong>Objectives: </strong>Prostate-specific membrane antigen (PSMA)-PET/CT has become integral to management of prostate cancer; however, PSMA-avid rib lesions pose a diagnostic challenge. This study investigated clinicopathological and imaging findings that predict metastatic etiology of PSMA-avid rib lesions.</p><p><strong>Materials and methods: </strong>Consecutive patients with prostate cancer that underwent PET/CT with [¹⁸F]F-DCFPyL in 2021-2023 for newly diagnosed intermediate-/high-risk prostate cancer or recurrent/metastatic disease and had PSMA-avid rib lesions were included. Imaging findings assessed were: lesion number, PSMA expression (maximum standard uptake value (SUV_max), miPSMA score), CT features (sclerotic, lucent, fracture, no correlate), other sites of metastases, and primary tumor findings. A composite reference standard for rib lesion etiology (metastatic vs non-metastatic) based on histopathology, serial imaging, and clinical assessment was used.</p><p><strong>Results: </strong>One hundred and seventy-five men (median 71 years, IQR 65-77) with PSMA-avid rib lesions were included; 47/175 (26.9%) had rib metastases. Only 1/47 (2.1%) of these patients had isolated rib metastasis without PSMA-avid metastases in other bones, nodes, or visceral organs; the other 46/47 (97.9%) patients with rib metastases also had other sites of PSMA-avid disease. Patients with rib metastases were older, had higher prostate-specific antigen levels, and higher-grade tumors (p < 0.01). Metastatic rib lesions had higher uptake (SUV_max, miPSMA), more commonly involved multiple ribs, and were more often sclerotic (p < 0.01); lucency/fractures were only seen in benign lesions.</p><p><strong>Conclusion: </strong>Several imaging and clinicopathological factors differed between PSMA-avid metastatic and benign lesions. Isolated rib lesions without other sites of metastasis are almost always benign. Careful assessment of CT features can help diagnose benign lesions.</p><p><strong>Key points: </strong>Question While prostate-specific membrane antigen (PSMA)-PET/CT has become integral to the management of prostate cancer, PSMA-avid rib lesions pose a diagnostic challenge. Findings Approximately a quarter of patients who had PSMA-avid rib lesions were metastatic. However, only 2.1% of them had isolated rib metastasis (without PSMA-avid metastases elsewhere). Clinical relevance Isolated PSMA-avid rib lesions are almost always benign when there is no evidence of metastatic disease elsewhere. Scrutinizing CT features can help diagnose benign PSMA-avid lesions with greater certainty.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662881","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":"Preoperative estimation of the pathological breast tumor size in architectural distortions: a comparison of DM, DBT, US, CEM, and MRI.","authors":"Javier Azcona Sáenz, Javier Molero Calafell, Marta Román Expósito, Elisenda Vall Foraster, Laura Comerma Blesa, Rodrigo Alcántara Souza, María Del Mar Vernet Tomás","doi":"10.1007/s00330-025-11502-7","DOIUrl":"https://doi.org/10.1007/s00330-025-11502-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the accuracy of digital mammography (DM), digital breast tomosynthesis (DBT), ultrasound (US), magnetic resonance imaging (MRI), and contrast-enhanced mammography (CEM) in the preoperative evaluation of breast cancer size in architectural distortions (ADs). Additionally, it assesses whether including thin spicules in mammography measurements affects accuracy.</p><p><strong>Materials and methods: </strong>We planned a retrospective analysis of invasive breast cancers presenting as ADs in our breast screening program between 2018 and 2022. Tumor size was measured in mm using DM, DBT, US, MRI, and CEM. Measurements were compared to the surgical specimen sizes. Two measurement approaches for DM and DBT were applied, considering and not considering thin spicules. T-student test was used to compare mean sizes across imaging techniques with the surgical specimen.</p><p><strong>Results: </strong>The study encompassed 59 female patients with 63 ADs. Mean age was 60.1 years (Standard Deviation (SD): 6.3). The cancers included four histological subtypes, ductal (69.8%), lobular (23.8%), tubular (4.8%), and micropapillary (1.6%). All imaging techniques, except for US (mean: 12.4 mm, SD: 5.7), overestimated tumor size compared to histology (mean: 16.40 mm, SD: 9). CEM, MRI, and DBT without thin spicules closely matched histological size. Including thin spicules in DM and DBT led to overestimation. Concordance was highest with CEM (75%) and MRI (67.6%). No significant differences were found between ductal and lobular carcinoma.</p><p><strong>Conclusion: </strong>For preoperative tumor size estimation of breast cancer in ADs, DBT excluding thin spicules, CEM, and MRI seemed most accurate. Including thin spicules in mammography leads to overestimation.</p><p><strong>Key points: </strong>Question Identifying the most accurate imaging technique for preoperative tumor staging of architectural distortions (ADs) is crucial now that contrast-enhanced mammography (CEM) is widely implemented. Findings Measuring thin wispy spicules in ADs on digital (DM) and digital breast tomosynthesis (DBT) should be avoided, as they consistently overestimate pathological tumor stage. Clinical relevance Precise tumor size estimation in ADs is critical for proper staging and treatment planning. This study favors the use of DBT excluding thin spicules, CEM, and magnetic resonance imaging (MRI) for optimal accuracy.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669321","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":"ESR Essentials: pseudolesions in head and neck-practice recommendations by the European Society of Head and Neck Radiology.","authors":"Darka Hadnadjev Šimonji, Aleksandar Spasić, Maja Stankov","doi":"10.1007/s00330-025-11477-5","DOIUrl":"https://doi.org/10.1007/s00330-025-11477-5","url":null,"abstract":"<p><p>The differentiation between pathological and physiological entities constitutes a fundamental aspect of daily radiological practice. Pseudolesions manifest as a transient phenomenon within this spectrum, displaying features of pathology within the context of normal or variant anatomy. A variety of structures, including vascular components, ectopic formations, or deviations from typical developmental patterns, can mimic pathological entities. It is crucial to discern between the two: lesions warranting treatment or ongoing radiological monitoring and pseudolesions where further analysis or treatment is unnecessary. Radiology plays a key role in classifying these entities. Comprehensive knowledge and accurate assessment of head and neck pseudolesions are necessary for radiologists to avoid unnecessary further diagnostic tests, treatments, and distress for the patient. KEY POINTS: Pseudolesions are an aspect of typical anatomy. Ectopic structures will have the same intensity/density no matter the location. Pursuit of a vascular origin can be a problem solver. Incorporate pseudolesions in the report.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669140","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":"Effectiveness of noncontrast-abbreviated magnetic resonance imaging in a real-world hepatocellular carcinoma surveillance.","authors":"Hyun Kyung Yang, Sunyoung Lee, Min Young Lee, Myeong-Jin Kim","doi":"10.1007/s00330-025-11517-0","DOIUrl":"https://doi.org/10.1007/s00330-025-11517-0","url":null,"abstract":"<p><strong>Objectives: </strong>Noncontrast-abbreviated magnetic resonance imaging (NC-AMRI) is emerging as a promising alternative to ultrasound (US) for surveillance of hepatocellular carcinoma (HCC) in at-risk patients. We aimed to assess the effectiveness of NC-AMRI in a real-world surveillance population, and to evaluate the appropriateness of NC-AMRI in selected patients with inadequate prior US.</p><p><strong>Materials and methods: </strong>This retrospective study included Child-Pugh class A or B adults with chronic hepatitis B or cirrhosis from any cause who underwent NC-AMRI between December 2018 and August 2022. Early- and very early-stage detection, receipt of curative treatment, and false referral were evaluated. Subgroup analysis was performed for patients with inadequate prior US examinations. Descriptive statistics were used.</p><p><strong>Results: </strong>Among the 1853 patients (mean age, 58.8 years; 1045 males), 68 HCCs developed in 61 (61/1853, 3.3%, 95% confidence interval: 2.5-4.2) patients. The proportions of early- and very early-stage detection were 95.1% (58/61, 72.2-100.0) and 70.5% (43/61, 51.0-95.0); receipt of curative treatment, 67.2% (41/61, 48.2-91.2); and proportion of false referral, 12.9% (9/70, 5.9-24.4). Among the 375 patients with inadequate prior US, the proportions of early- and very early-stage detection were 94.7% (18/19, 56.2-100.0) and 57.9% (11/19, 28.9-100.0); receipt of curative treatment, 52.6% (10/19, 25.2-96.8); and proportion of false referrals, 17.4% (4/23, 4.7-44.5).</p><p><strong>Conclusion: </strong>NC-AMRI may be an effective HCC surveillance modality given the results related to early- and very early-stage detection, receipt of curative treatment, and false referral. NC-AMRI can be an alternative HCC surveillance strategy, especially for patients with inadequate prior US examinations.</p><p><strong>Key points: </strong>Question There is insufficient evidence to support the use of noncontrast-abbreviated MRI as an effective surveillance tool in large real-life populations under surveillance. Findings Using noncontrast-abbreviated MRI, most patients who developed HCCs during surveillance were diagnosed at an early stage, with an acceptable false referral rate of 12.9%. Clinical relevance Noncontrast-abbreviated MRI is an effective HCC surveillance modality, especially for patients with inadequate prior ultrasound examinations.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668955","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":"Preoperative breast MRI in HER2-positive/hormone receptor-negative breast cancer: surgical outcomes using propensity score matching.","authors":"Hye Joung Eom, Woo Jung Choi, Youn Jin Sun, Hee Jeong Kim, Eun Young Chae, Hee Jung Shin, Joo Hee Cha, Hak Hee Kim","doi":"10.1007/s00330-025-11494-4","DOIUrl":"https://doi.org/10.1007/s00330-025-11494-4","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the association between preoperative magnetic resonance imaging (MRI) and surgical outcomes in human epidermal growth factor receptor 2 (HER2)-positive/hormone receptor (HR)-negative breast cancer through a propensity score (PS)-matched analysis.</p><p><strong>Materials and methods: </strong>Patients with HER2-positive/HR-negative invasive ductal carcinoma between 2007 and 2014 were retrospectively assessed and compared according to whether they underwent preoperative MRI. Inverse probability weighting (IPW) analysis and PS matching were used to adjust 17 covariates to control between the MRI and no-MRI groups. Surgical outcomes were compared between two groups and clinicopathologic variables were evaluated to determine who benefited from MRI.</p><p><strong>Results: </strong>Among 965 women (mean age ± standard deviation, 52 years ± 10), 423 (44%) underwent preoperative MRI and 542 (56%) did not. In the MRI group, a change in surgical management occurred in 48 patients (11%), and the change was appropriate in 31 of those patients (65%). The MRI group had a lower odds of initial mastectomy (odds ratio [OR], 0.63; 95% confidence interval [CI]: 0.47, 0.84; p = 0.002 and OR, 0.67; 95% CI: 0.48, 0.92; p = 0.01 for IPW and PS matching, respectively) and overall mastectomy (OR, 0.60; 95% [CI]: 0.45, 0.80; p = 0.001 and OR, 0.68; 95% CI: 0.49, 0.93; p = 0.02 for IPW and PS matching, respectively). In the subgroup analysis, asymptomatic patients or those with multifocal or multicentric lesions benefited more from MRI (61% vs 36%, p = 0.006 and 52% vs 31%, p = 0.02, respectively).</p><p><strong>Conclusion: </strong>Patients with HER2-positive/HR-negative breast cancer who received preoperative MRI had a lower likelihood of undergoing mastectomy.</p><p><strong>Key points: </strong>Question The role of preoperative MRI in predicting surgical outcomes in patients with HER2-positive/HR-negative breast cancer remains uncertain. Findings Preoperative MRI in HER2-positive/HR-negative breast cancer reduces mastectomy rates without increasing the positive resection margin or reoperation rate. Clinical relevance Preoperative MRI is beneficial in reducing mastectomy rates in women with HER2-positive/HR-negative breast cancer.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662774","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":"Financial illiteracy among internal medicine, surgery, and radiology residents regarding medical imaging costs in the Netherlands.","authors":"Ton Velleman, Rudi A J O Dierckx, Yfke P Ongena, Klaas P Koopmans, Walter Noordzij, Thomas C Kwee","doi":"10.1007/s00330-025-11510-7","DOIUrl":"https://doi.org/10.1007/s00330-025-11510-7","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the knowledge of internal medicine, surgery, and radiology residents of medical imaging costs at a university hospital in the Netherlands.</p><p><strong>Methods: </strong>A survey was conducted among internal medicine, surgery, and radiology residents at a tertiary care university hospital to determine their knowledge and view on medical imaging costs. Participants were asked to estimate the costs of a two-view chest X-ray, unenhanced CT of the brain, unenhanced MRI of the brain, contrast-enhanced CT of the chest and abdomen, ultrasound of the complete abdomen, and FDG-PET and PSMA-PET torso. Estimates within ± 25% of the available published costs were considered accurate.</p><p><strong>Results: </strong>A total of 44 participants (18 in internal medicine, 15 in surgery, and 11 in radiology) were included. No resident accurately estimated all imaging costs, with accuracies ranging from 18% for contrast-enhanced CT of the chest and abdomen to 39% for two-view chest X-rays. Cost estimation accuracy did not significantly vary by specialty or training duration. Most participants were concerned about the affordability of medical care within or beyond the next five years (80%, 95%), 66% of residents felt that doctors bear responsibility for limiting healthcare costs, and 89% agreed that education about the financial aspects of medical imaging is useful.</p><p><strong>Conclusion: </strong>This study showed that residents are financially illiterate regarding medical imaging costs, and neither the duration of training nor specialty influences their knowledge levels. Nevertheless, residents share common concerns and responsibilities about rising healthcare costs and express a desire for additional education regarding the finance of medical imaging.</p><p><strong>Key points: </strong>Question Assessing the knowledge levels of residents regarding medical imaging costs provides valuable information for policymakers involved in the design of medical curricula. Findings Residents from internal medicine, surgery, and radiology demonstrate limited knowledge of medical imaging costs but appear eager to learn. Clinical relevance There is a need to educate residents about the costs of medical imaging, promote the efficient use of limited resources, and reduce overall healthcare expenses.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669136","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":"Next-Gen Radiology: Disease-specific structured reports.","authors":"Atul B Shinagare, Stephanie Nougaret","doi":"10.1007/s00330-025-11482-8","DOIUrl":"https://doi.org/10.1007/s00330-025-11482-8","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662771","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":"Prognostic significance of myocardial fibrosis in men with alcoholic cardiomyopathy: insights from cardiac MRI.","authors":"Shuang Li, Baiyan Zhuang, Chen Cui, Jian He, Yue Ren, Hui Wang, Marco Francone, Guang Yang, Raad Mohiaddin, Minjie Lu, Lei Xu","doi":"10.1007/s00330-025-11428-0","DOIUrl":"https://doi.org/10.1007/s00330-025-11428-0","url":null,"abstract":"<p><strong>Objectives: </strong>Myocardial fibrosis significantly impacts prognosis in various cardiovascular diseases, yet its role in alcoholic cardiomyopathy (ACM) remains poorly understood. This study evaluates the prognostic value of myocardial fibrosis, as detected by cardiac magnetic resonance (CMR), in ACM patients.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of consecutive ACM patients who underwent enhanced CMR from August 2015 to October 2023. Assessment of myocardial fibrosis was performed using late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV) fraction. The primary outcome was a composite of cardiac-related mortality, heart transplantation, hospitalization for heart failure, life-threatening arrhythmias, and the need for implantable cardioverter-defibrillator or cardiac resynchronization therapy.</p><p><strong>Results: </strong>A total of 141 male patients were finally enrolled with 27.7% experiencing the primary outcome over a median follow-up of 30.6 months (IQR: 18.0-44.9). LGE was found in 55.3% of patients, with a median extent of 2.9%. Compared to DCM patients who didn't consume alcohol, ACM patients showed lower LGE, native T1, and ECV values. Multivariate analysis showed LGE (HR, 1.09 [1.04, 1.15]; p < 0.001), native T1 (per 10 ms increase, 1.06 [1.02, 1.10]; p = 0.003), and ECV (per 3% increase, 1.57 [1.22, 2.01]; p < 0.001) had significant prognostic associations with adverse outcomes. Including myocardial fibrosis parameters improved predictive accuracy beyond standard assessments. A nonlinear relationship was found between lifetime ethanol consumption and myocardial fibrosis, with a plateau at low exposures and a sharp increase at higher levels.</p><p><strong>Conclusion: </strong>CMR-identified myocardial fibrosis has an association with major adverse cardiac events in ACM patients, underscoring its utility in risk stratification.</p><p><strong>Key points: </strong>Question The prognostic role of myocardial fibrosis in alcoholic cardiomyopathy remains poorly understood. Findings Fibrosis detected by cardiac MRI has good incremental value for predictive models in assessing the risk of adverse cardiovascular events in patients with alcoholic cardiomyopathy. Clinical relevance Cardiac MRI may be a potential tool to identify high-risk alcoholic cardiomyopathy patients with cardiovascular adverse event, which is helpful for early clinical treatment, and improves patients prognosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662778","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":"Dual-energy CT for evaluating the tumor regression grade of gastric cancer after neoadjuvant chemotherapy.","authors":"Yuying Lin, Yanfen Lan, Yunyan Zheng, Mingping Ma","doi":"10.1007/s00330-025-11508-1","DOIUrl":"https://doi.org/10.1007/s00330-025-11508-1","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical value of dual-energy CT (DECT) parameters in estimating tumor regression grade (TRG) of gastric cancer after neoadjuvant chemotherapy (NAC).</p><p><strong>Materials and methods: </strong>In this retrospective study, the patients with pathologically confirmed gastric cancer were classified into two groups based on TRG results: the effective group and the ineffective group. DECT parameters, including iodine concentration (IC), normalized iodine concentration (NIC), and slope of the energy spectrum curve (λ), were obtained. Quantitative parameters and their change rates were compared before and after chemotherapy. The receiver operating characteristic (ROC) curves were plotted.</p><p><strong>Results: </strong>A total of 54 patients were included and divided into the effective group (n = 21) and the ineffective group (n = 33). After NAC, the change rates of parameters in the venous phase (%ΔIC-v, %ΔNIC-v, and %Δλ-v) were notably higher in the effective group were higher than in the ineffective group (all p < 0.05). The consistency between the response evaluation criteria in solid tumors version 1.1 (RECIST 1.1) and TRG was fair, with a Kappa value of 0.299 (p < 0.05). The %ΔIC-v, %ΔIC-d, %ΔNIC-v, %ΔNIC-d, and %Δλ-v exhibited moderate or strong correlations with TRG, with correlation coefficients (r) of -0.624, -0.475, -0.766, -0.516, and -0.431, respectively (all p < 0.05). %ΔNIC-v achieved a significantly greater area under the curve (AUC) compared to RECIST 1.1 (AUC, 0.877; 95% CI: 0.772-0.957; vs AUC, 0.649; 95% CI: 0.496-0.803; p < 0.05) for estimating TRG in gastric cancer.</p><p><strong>Conclusion: </strong>DECT parameters, particularly %ΔNIC-v, show promise in assessing the efficacy of NAC for gastric cancer.</p><p><strong>Key points: </strong>Question Two-dimensional morphological change is insufficient for accurately assessing the pathological TRG following NAC in gastric cancer. Findings DECT parameters show higher preoperative predictive efficacy than RECIST 1.1 for TRG in gastric cancer. Clinical relevance DECT-derived quantitative parameters offer a reliable and noninvasive tool for the preoperative prediction of pathological response in gastric cancer patients undergoing NAC.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656610","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":"Early rheumatoid arthritis, two distinctive structural damage patterns revealed by MRI: an 8-year longitudinal study.","authors":"Su Wu, James Francis Griffith, Fan Xiao, Chungwun Yiu, Jason C S Leung, Lai-Shan Tam","doi":"10.1007/s00330-025-11493-5","DOIUrl":"https://doi.org/10.1007/s00330-025-11493-5","url":null,"abstract":"<p><strong>Objective: </strong>To determine how inflammatory and structural parameters change long-term on standard treatment in rheumatoid arthritis patients and which baseline parameter best predicts long-term structural damage.</p><p><strong>Material and methods: </strong>Prospective study of early rheumatoid arthritis (ERA) patients (symptom duration ≤ 24 months) who underwent identical clinical, serological, radiographic, and dynamic contrast-enhanced MRI of the wrist assessments at baseline, year-1, and year-8. MR images were analyzed semi-quantitatively (Rheumatoid Arthritis Magnetic Resonance Imaging Score [RAMRIS]) and quantitatively (synovial volume (cm³); synovial perfusion; bone marrow edema (BME) proportion [%]). Multivariate analyses and receiver operating curves were applied to find the best predictor of long-term structural damage.</p><p><strong>Results: </strong>81 patients (61 ± 12 years, F/M:67/14) were studied. MRI-detected inflammatory parameters markedly improved from baseline to year-1 and slightly deteriorated from year-1 to year-8 (synovial volume:6.7 ± 5.0→2.6 ± 2.9→3.6 ± 3.3 cm³ (p < 0.01); BME proportion:13.1 ± 9.3→7.4 ± 5.0→9.2 ± 9.7% [p < 0.01]). Structural damage progressively deteriorated from baseline to year-8. Two long-term structural damage pattern groups were apparent, namely a \"non-progressive structural damage pattern\" (62%, 50/81) and a \"progressive structural damage pattern\" (38%, 31/81). Functional impairment was more frequent and more severe at year-8 in patients with progressive structural damage. MRI-detected bone erosion score better predicted (AUC = 0.81, CI: 0.71-0.91) year-8 structural damage than clinical (SDAI AUC = 0.61, CI: 0.48-0.74), serological (CRP AUC = 0.60, CI: 0.47-0.73), or radiographic (AUC = 0.59, CI: 0.45-0.72) assessment.</p><p><strong>Conclusion: </strong>In ERA patients, two distinct structural damage patterns are evident. Baseline bone erosion score is better than clinical, serological, or radiographic assessment at predicting long-term structural damage.</p><p><strong>Key points: </strong>Questions The value of MRI in predicting long-term structural damage in ERA patients is not clear. Findings This study identified two distinct long-term structural damage progression patterns of ERA patients. MRI can better differentiate between these two groups at baseline than clinical, serological, or radiographic assessment. Clinical relevance MRI examination should be performed in all ERA patients at baseline to determine their structural damage pattern. This will allow a better prediction of patient outcomes in the long-term.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656614","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}