European Radiology最新文献

{"title":"Are we systematically overdosing women? Revisiting standardized contrast protocols for thoracoabdominal CT scans.","authors":"Judith Becker, Adrian Huber, Stefanie Bette, Anna Rubeck, Tim Tobias Arndt, Gernot Müller, Franka Risch, Luca Canalini, Claudia Wollny, Florian Schwarz, Christian Scheurig-Muenkler, Thomas Kroencke, Josua A Decker","doi":"10.1007/s00330-024-11329-8","DOIUrl":"10.1007/s00330-024-11329-8","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate whether the iodine contrast in blood and solid organs differs between men and women and to evaluate the effect of BMI, height, weight, and blood volume (BV) on sex-specific contrast in staging CT.</p><p><strong>Materials and methods: </strong>Patients receiving a venous-phase thoracoabdominal Photon-Counting Detector CT (PCD-CT) scan with 100- or 120-mL CM between 08/2021 and 01/2022 were retrospectively included in this single-center study. Image analysis was performed by measuring iodine contrast in the liver, portal vein, spleen, left atrium, left ventricle, pulmonary trunk, ascending and descending aorta on spectral PCD-CT datasets. Univariable and multivariable analyses were performed to assess the impact of sex, age, BMI, height, weight, and BV on the iodine contrast.</p><p><strong>Results: </strong>A total of 274 patients were included (mean age 68 years ± 12 SD, 168 men). Iodine contrast in organs and blood attenuation was significantly higher in women when using the same volume of CM. Sex, age, BMI, height, weight, and BV significantly influenced iodine contrast. After adjusting for confounding variables, sex remained a significant factor, with women having higher parenchymal and vascular iodine contrast.</p><p><strong>Conclusion: </strong>Standardized or weight-adapted use of CM in venous-phase thoracoabdominal CT scans results in significantly higher contrast in women compared to men. Customizing the CM dose to the patient's BV could result in a similar contrast between sexes. This approach has the potential to reduce the amount of CM, resulting in cost savings, and to decrease the risks associated with CM, particularly for the female sex.</p><p><strong>Key points: </strong>Question This study addresses whether current standardized iodinated contrast media protocols lead to systematically higher iodine enhancement in women than in men during thoracoabdominal CT. Findings Women consistently show greater iodine enhancement in blood and abdominal organs compared to BMI-matched men when receiving identical volumes of contrast media. Clinical relevance Adjusting contrast media dosage based on blood volume in venous-phase CT scans could equalize parenchymal and intravascular iodine enhancement across sexes. This approach may reduce unnecessary contrast exposure in women, lower associated risks, and optimize healthcare resource allocation.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3729-3738"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947012","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":"Ultrasound-guided needle positioning confirmation with injection of saline solution for nodal dynamic contrast-enhanced MR-lymphangiography in pediatric patients.","authors":"Julia Wagenpfeil, Katharina Hoß, Andreas Henkel, Sergej Geiger, Julian Alexander Luetkens, Daniel Kuetting, Claus Christian Pieper","doi":"10.1007/s00330-025-11346-1","DOIUrl":"10.1007/s00330-025-11346-1","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the success rate of confirmation of ultrasound-guided intranodal needle positioning by saline injection for dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) in pediatric patients.</p><p><strong>Material and methods: </strong>Data from children undergoing nodal DCMRL after ultrasound-guided needle positioning into inguinal lymph nodes and validation of the needle position by injection of plain saline solution between 05/2020 and 12/2022 were reviewed. On injection of saline solution, adequate needle position was confirmed by lymph node distension without leakage. Detection rates and lymph node diameters were recorded. Technical success of needle placement was defined as enhancement of ipsilateral iliac draining lymph vessels on DCMRL, while clinical success was based on enhancement of central lymphatics and/or lymphatic pathologies being observed.</p><p><strong>Results: </strong>One hundred sixteen DCMRL were performed in 90 children (58 male, mean age 6.1 years, range 3 weeks-18 years). In 232/232 groins lymph nodes were identified on ultrasound with a mean diameter of 2.5 mm (smallest diameter 1 mm in n = 24 patients). Due to skin inflammation, no puncture was performed in 2/232 groins. Saline injection showed lymph node distension in 230/230 punctured nodes. On MR contrast injection enhancement of draining lymph vessels was seen in 228/230 nodes. In 1/230 nodes, in-bore needle retraction led to lymphatic enhancement, so a total of 229/230 needle placements were technically successful. One of the 230 DCMRLs was successful with only a unilateral contrast application. Overall, 116/116 DCMRLs were clinically successful.</p><p><strong>Conclusion: </strong>Confirmation of ultrasound-guided needle positioning for nodal DCMRL using saline injection is a reliable technique with a very high success rate in pediatric patients with small lymph nodes.</p><p><strong>Key points: </strong>Question Evaluation of ultrasound-guided injection needle positioning for dynamic contrast-enhanced MR-lymphangiography in children requires validation. Findings Confirmation of needle positioning by ultrasound-guided saline injection is a reliable technique with a very high success rate for MR-lymphangiography in pediatric patients. Clinical relevance Intranodal needle position for dynamic contrast-enhanced lymphangiography can be confirmed with a very high success rate using saline injection alone in a pediatric cohort.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"4180-4190"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983111","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":"The radiohumeral synovial plica: anatomy, histology, and implications in chronic lateral epicondylitis.","authors":"Jianing Cui, Ping Wang, Wenting Li, Zhanhua Qian, Naili Wang, Lihua Gong, Huili Zhan, Wei Ye, Yuming Yin, Rongjie Bai","doi":"10.1007/s00330-024-11293-3","DOIUrl":"10.1007/s00330-024-11293-3","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aimed to elucidate synovial plica (SP) of the elbow histological characteristics and the anatomical relationship with adjacent structures. Subsequently, we sought to assess the relationship between SP and clinical symptoms as well as magnetic resonance imaging (MRI) features in patients with chronic lateral epicondylitis.</p><p><strong>Methods: </strong>MRI was performed on eight cadaveric elbows specimens. The MRI findings were compared with those in anatomic sections and histologic preparations. In addition, ninety-nine patients with chronic lateral epicondylitis who underwent preoperative elbow MRI and arthroscopic surgery were included. The patients were divided into SP and without SP groups. The differences in clinical symptoms and MRI features between the two groups were compared.</p><p><strong>Results: </strong>SP is located proximal to the annular ligament that extends into the joint cavity, then moves to the lateral collateral ligament (LCL) complex, and finally attaches to the lateral epicondyle of the elbow along with the common extensor tendon (CET). The SP, ligament, and tendon blend imperceptibly without distinct boundaries. Furthermore, in a study of patients with chronic lateral epicondylitis, we found that compared to the without SP group, patients in the SP group had higher preoperative and 3-week postoperative VAS scores and more severe abnormalities in LCL complex and CET.</p><p><strong>Conclusion: </strong>The SP is distinct from the annular ligament and closely correlates with the LCL complex and CET enthesis at the lateral epicondyle. Chronic lateral epicondylitis patients with SP have more severe abnormalities of the LCL complex and CET, more severe pain, and longer postoperative recovery times.</p><p><strong>Key points: </strong>Question Synovial plica (SP) cause lateral elbow pain, but few studies regarding histological and imaging features of SP and its relationship to chronic lateral epicondylitis exist. Findings The presence of SP leads to more severe common extensor tendon abnormalities and higher visual analog scale scores in patients with chronic lateral epicondylitis. Clinical relevance The combination of magnetic resonance imaging and clinical symptoms to further understand the effect of SP on the clinical symptoms and postoperative recovery in chronic lateral epicondylitis can help refine treatment strategies and improve the prognosis of patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3687-3696"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853070","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":"Serial assessment of coronary artery inflammation using cardiac CT in anthracycline chemotherapy for breast cancer.","authors":"Masafumi Kidoh, Seitaro Oda, Daisuke Sueta, Koichi Egashira, Hidetaka Hayashi, Takeshi Nakaura, Yasunori Nagayama, Yutaka Yamamoto, Kenichi Tsujita, Toshinori Hirai","doi":"10.1007/s00330-025-11347-0","DOIUrl":"10.1007/s00330-025-11347-0","url":null,"abstract":"<p><strong>Objectives: </strong>There is limited evidence of the pericoronary fat attenuation index (FAI) as an imaging marker to assess cancer therapy-related cardiovascular toxicity. We aimed to measure FAI in four consecutive coronary CT angiography (CTA) scans before and 3, 6, and 12 months after anthracycline treatment in patients with breast cancer to determine trends in dynamic changes in FAI after treatment.</p><p><strong>Methods: </strong>We performed a post hoc analysis of a prospective study (between August 2019 and July 2020) in which anthracycline-induced myocardial injury was evaluated using cardiac CT. FAI was quantified using coronary CTA images before and 3, 6, and 12 months after anthracycline treatment. The FAIs of the three coronary arteries were averaged to calculate the FAI (Total).</p><p><strong>Results: </strong>FAI was analyzed on 14 patients with breast cancer who had adequate CT image quality (mean age, 62 years ± 11 (SD); 14 women). During the observation period, all 14 patients treated with anthracycline developed mild asymptomatic cardiac dysfunction related to cancer treatment (CTRCD). FAI (Total) showed a gradual increase during the observation period compared to baseline (baseline: -77.3 ± 5.6 HU, 3 months: -77.1 ± 4.8 HU, 6 months: -76.5 ± 5.4 HU, 12 months: -73.8 ± 5.8 HU). FAI (Total) was significantly elevated at 12 months compared to baseline (p < 0.001).</p><p><strong>Conclusion: </strong>In patients with breast cancer, FAI showed a gradual increase at 3, 6, and 12 months after treatment with anthracyclines compared to before treatment. FAI may be used as an imaging biomarker of coronary artery inflammation in the follow-up of anthracycline therapy and may contribute to the personalization of therapy through early detection of coronary toxicity.</p><p><strong>Key points: </strong>Question Is pericoronary fat attenuation index (FAI) a potential imaging biomarker for assessing changes in pericoronary adipose tissue related to cancer therapy-related cardiovascular toxicity? Findings In 14 patients with breast cancer, FAI showed a gradual increase at 3, 6, and 12 months after treatment with anthracyclines compared to before treatment. Clinical relevance FAI may be an imaging biomarker for the detection and treatment of cancer therapy-related cardiovascular toxicity.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3897-3906"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002559","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 value of coronary plaque composition in symptomatic patients with obstructive coronary artery disease.","authors":"Emmanuel Gall, Théo Pezel, Solenn Toupin, Thomas Hovasse, Thierry Unterseeh, Bernard Chevalier, Francesca Sanguineti, Stéphane Champagne, Antoinette Neylon, Hakim Benamer, Mariama Akodad, Trecy Gonçalves, Antoine Lequipar, Jean Guillaume Dillinger, Patrick Henry, Tania Ah-Singh, Lounis Hamzi, Valérie Bousson, Philippe Garot, Jérôme Garot","doi":"10.1007/s00330-025-11353-2","DOIUrl":"10.1007/s00330-025-11353-2","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether plaque composition analysis defined by cardiac CT can provide incremental prognostic value above coronary artery disease (CAD) burden markers in symptomatic patients with obstructive CAD.</p><p><strong>Materials and methods: </strong>Between 2009 and 2019, a multicentric registry included all consecutive symptomatic patients with obstructive CAD (at least one ≥ 50% stenosis on CCTA) and was followed for major adverse cardiovascular (MACE) defined by cardiovascular death or nonfatal myocardial infarction. Each coronary segment was scored visually for both the degree of stenosis and composition of plaque, which were classified as non-calcified, mixed, or calcified. To assess the prognostic value of each CCTA findings, different multivariable Cox regression models were used: model 1: clinical (traditional risk factors); model 2: model 1 + CAD burden (number of proximal segments with stenosis ≥ 50% + number of vessels with obstructive CAD); and model 3: model 2 + plaques feature (number of segments with non-calcified plaque).</p><p><strong>Results: </strong>Of 2312 patients (mean age 70 ± 12 years, 46% men), 319 experienced a MACE (13.8%) (median follow-up: 6.7 years (5.9-9.1)). The number of proximal segments with ≥ 50% stenosis, the number of vessels with obstructive CAD, and the number of segments with non-calcified plaque were all independently associated with MACEs (all p < 0.001). The addition of plaque composition analysis (model 3) showed the best improvement in model discrimination and reclassification (C-statistic improvement = 0.03; net reclassification improvement = 28.6%; integrative discrimination index = 5.4%, all p < 0.001).</p><p><strong>Conclusions: </strong>In this population, the analysis of coronary plaque composition had an incremental prognostic value to predict MACEs above a model combining traditional risk factors and CAD burden.</p><p><strong>Key points: </strong>Question Several coronary computed tomography angiography (CCTA) studies have shown the potential interest of plaque composition analysis, which can be further evaluated. Findings In symptomatic patients with obstructive coronary artery disease (CAD), plaque composition analysis had an incremental prognostic value above a model combining traditional risk factors and CAD burden. Clinical relevance In symptomatic patients with obstructive CAD, plaque composition analysis using CCTA has a strong incremental prognostic value above a model combining traditional risk factors and CAD burden, thus translating into a more accurate long-term major adverse cardiovascular event prediction.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3937-3947"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032740","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":"Lung cancer screening with low-dose CT: definition of positive, indeterminate, and negative screen results. A nodule management recommendation from the European Society of Thoracic Imaging.","authors":"Annemiek Snoeckx, Mario Silva, Helmut Prosch, Jürgen Biederer, Thomas Frauenfelder, Fergus Gleeson, Colin Jacobs, Hans-Ulrich Kauczor, Anagha P Parkar, Cornelia Schaefer-Prokop, Mathias Prokop, Marie-Pierre Revel","doi":"10.1007/s00330-025-11648-4","DOIUrl":"https://doi.org/10.1007/s00330-025-11648-4","url":null,"abstract":"<p><p>Early detection of lung cancer through low-dose CT lung cancer screening in a high-risk population has proven to reduce lung cancer-specific mortality. Nodule management plays a pivotal role in early detection and further diagnostic approaches. The European Society of Thoracic Imaging (ESTI) has established a nodule management recommendation to improve the handling of pulmonary nodules detected during screening. For solid nodules, the primary method for assessing the likelihood of malignancy is to monitor nodule growth using volumetry software. For subsolid nodules, the aggressiveness is determined by measuring the solid part. The ESTI-recommendation enhances existing protocols but puts a stronger focus on lesion aggressiveness. The main goals are to minimise the overall number of follow-up examinations while preventing the risk of a major stage shift and reducing the risk of overtreatment. KEY POINTS: Question Assessment of nodule growth and management according to guidelines is essential in lung cancer screening. Findings Assessment of nodule aggressiveness defines follow-up in lung cancer screening. Clinical relevance The ESTI nodule management recommendation aims to reduce follow-up examinations while preventing major stage shift and overtreatment.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539704","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":"Multiparametric MRI for assessing residual tumors in patients with muscle-invasive bladder cancer after neoadjuvant treatment: a reliable tool for guiding bladder preservation.","authors":"Qian Cai, Li Tian, Lingmin Kong, Keyi Zhang, Bei Weng, Bin Huang, Yan Guo, Jun-Xing Chen, Huanjun Wang","doi":"10.1007/s00330-025-11773-0","DOIUrl":"https://doi.org/10.1007/s00330-025-11773-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical utility of multiparametric MRI in differentiating pathological stages (ypT0 vs ypT1-4) in patients with muscle-invasive bladder cancer (MIBCa) following neoadjuvant therapy (NAT).</p><p><strong>Materials and methods: </strong>In this double-center cohort study, post-NAT multiparametric MRI in all consecutive patients who underwent surgery after NAT was analyzed. Two experienced radiologists independently evaluated the MRI features obtained after NAT. The post-NAT yT stage was assigned based on T2-weighted diffusion-weighted imaging (T2DWI) and on contrast-enhanced MRI scans. The diagnostic accuracies for distinguishing post-NAT ypT0 from ypT1-4 tumors with the two protocols were evaluated. Cohen's kappa (κ) statistics were used to evaluate the consistency between readers for the post-NAT yT stage.</p><p><strong>Results: </strong>A total of 149 patients (mean age, 62 years ± 10 [SD]; 131 men) from two institutions were enrolled. The area under the receiver operating characteristic curve of the contrast-enhanced MRI protocol in predicting post-NAT ypT0 stage was 0.84 (95% CI: 0.77, 0.91), which was better than that of the T2DWI protocol (0.75; 95% CI: 0.67, 0.81; p = 0.002). The interobserver agreement was excellent for both the T2DWI protocol (κ = 0.89) and the contrast-enhanced MRI protocol (κ = 0.85).</p><p><strong>Conclusions: </strong>Multiparametric MRI, particularly contrast-enhanced MRI, demonstrated superior accuracy in identifying ypT0 status following NAT in MIBCa, establishing it as an essential diagnostic tool for guiding bladder preservation in clinical decision-making.</p><p><strong>Key points: </strong>Question Accurately identifying pathological complete response (ypT0) after NAT is essential for selecting bladder-preservation strategies, yet remains clinically challenging. Findings Post-treatment contrast-enhanced MRI accurately identified ypT0 status with an AUC of 0.84 and excellent inter-reader agreement, outperforming T2DWI. Clinical relevance Contrast-enhanced MRI is a reliable, non-invasive method for detecting complete tumor response after NAT, enabling better patient selection for bladder-sparing approaches and potentially improving quality of life.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527059","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":"Updated ESUR Guidelines for Endometrial Cancer: integrating MRI with the 2023 FIGO Staging Revolution.","authors":"Stephanie Nougaret, Evis Sala, Yulia Lakhman, Elisabeth Sadowski, Aradhana M Venkatesan, Andrea Rockall, Isabelle Thomassin-Naggara, Aki Kido, Nishat Bharwani, Teresa Margarida Cunha, Rosemarie Forstner, Pamela Causa-Andrieu, Giacomo Avesani, Ingfrid Haldorsen, Alejandra Martinez, Lucia Manganaro, Stefania Rizzo","doi":"10.1007/s00330-025-11700-3","DOIUrl":"https://doi.org/10.1007/s00330-025-11700-3","url":null,"abstract":"<p><strong>Objectives: </strong>To summarize the key updates introduced in the 2023 International Federation of Gynecology and Obstetrics (FIGO) classification for endometrial cancer (EC), and to highlight the role of MRI in aligning with these changes for improved staging and patient management.</p><p><strong>Materials and methods: </strong>A review of the updated 2023 FIGO classification, which integrates molecular profiling and histopathological criteria, was conducted. Additionally, the revised European Society of Urogenital Radiology (ESUR) MRI recommendations were analyzed to assess their alignment with the new FIGO framework, focusing on their role in evaluating myometrial invasion (MI) and cervical stromal involvement.</p><p><strong>Results: </strong>The updated FIGO classification incorporates molecular data to refine risk stratification and staging accuracy. MRI continues to play a pivotal role in distinguishing between stages, mapping disease extent, and guiding surgical planning. The updated ESUR recommendations emphasize standardized MRI protocols, particularly the use of multiphase contrast-enhanced imaging, to improve diagnostic confidence in assessing MI.</p><p><strong>Conclusion: </strong>The integration of molecular classification into FIGO staging, supported by standardized and advanced MRI protocols as recommended by ESUR, enhances the management of endometrial cancer.</p><p><strong>Key points: </strong>Question The 2023 FIGO update integrates molecular profiling into endometrial cancer staging, requiring MRI adaptations to improve accuracy in assessing disease extent, including myometrial invasion. Findings Updated ESUR MRI guidelines emphasize multiphase contrast-enhanced imaging, structured reporting, and integration with FIGO 2023 classification, enhancing diagnostic precision for staging and treatment planning. Clinical relevance Standardized MRI protocols aligned with FIGO 2023 system improve endometrial cancer staging, guiding optimal surgical and therapeutic strategies, reducing diagnostic variability, and enhancing patient outcomes through individualized risk stratification and personalized treatment.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527063","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":"Developing ultrasound-based machine learning models for accurate differentiation between sclerosing adenosis and invasive ductal carcinoma.","authors":"Guohao Liu, Na Yang, Yikun Qu, Guangxin Chen, Guiqiong Wen, Gai Li, Li Deng, Yuanqi Mai","doi":"10.1007/s00330-025-11777-w","DOIUrl":"https://doi.org/10.1007/s00330-025-11777-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a machine learning model using breast ultrasound images to improve the non-invasive differential diagnosis between Sclerosing Adenosis (SA) and Invasive Ductal Carcinoma (IDC).</p><p><strong>Materials and methods: </strong>2046 ultrasound images from 772 SA and IDC patients were collected, Regions of Interest (ROI) were delineated, and features were extracted. The dataset was split into training and test cohorts, and feature selection was performed by correlation coefficients and Recursive Feature Elimination. 10 classifiers with Grid Search and 5-fold cross-validation were applied during model training. Receiver Operating Characteristic (ROC) curve and Youden index were used to model evaluation. SHapley Additive exPlanations (SHAP) was employed for model interpretation. Another 224 ROIs of 84 patients from other hospitals were used for external validation.</p><p><strong>Results: </strong>For the ROI-level model, XGBoost with 18 features achieved an area under the curve (AUC) of 0.9758 (0.9654-0.9847) in the test cohort and 0.9906 (0.9805-0.9973) in the validation cohort. For the patient-level model, logistic regression with 9 features achieved an AUC of 0.9653 (0.9402-0.9859) in the test cohort and 0.9846 (0.9615-0.9978) in the validation cohort. The feature \"Original shape Major Axis Length\" was identified as the most important, with its value positively correlated with a higher likelihood of the sample being IDC. Feature contributions for specific ROIs were visualized as well.</p><p><strong>Conclusion: </strong>We developed explainable, ultrasound-based machine learning models with high performance for differentiating SA and IDC, offering a potential non-invasive tool for improved differential diagnosis.</p><p><strong>Key points: </strong>Question Accurately distinguishing between sclerosing adenosis (SA) and invasive ductal carcinoma (IDC) in a non-invasive manner has been a diagnostic challenge. Findings Explainable, ultrasound-based machine learning models with high performance were developed for differentiating SA and IDC, and validated well in external validation cohort. Critical relevance These models provide non-invasive tools to reduce misdiagnoses of SA and improve early detection for IDC.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527057","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":"Open-source domain adaptation to handle data shift for volumetric segmentation-use case kidney segmentation.","authors":"Ramon Correa-Medero, Umar Ghaffar, Sam Fathizadeh, Bhavik Patel, Haidar Abdul-Muhsin, Imon Banerjee","doi":"10.1007/s00330-025-11786-9","DOIUrl":"https://doi.org/10.1007/s00330-025-11786-9","url":null,"abstract":"<p><strong>Objectives: </strong>Current development of kidney segmentation models has focused on using a single-phase CT, resulting in significant performance degradation caused by simple characteristic drift in testing datasets, e.g., difference in contrast phase appearance.</p><p><strong>Materials and methods: </strong>We introduce a domain adaptation approach leveraging a latent space discriminator to train a robust model for segmenting kidneys from CT volume irrespective of the contrast dose and functional anomaly. We aim to handle three primary domain shifts between training and testing datasets-(i) contrast to non-contrast, (ii) arterial to venous phase, and (iii) normal to abnormal kidney.</p><p><strong>Results: </strong>Our model is trained on two publicly available non-contrast and arterial phase image datasets and validated on both public (KiTS21 and STU) and private (Mayo Clinic) datasets with distinct contrast phases and abnormality in the kidney. On all four datasets with domain shift, the proposed model achieved a 0.8892 DICE score, and interestingly, it outperformed the baseline models, including TotalSegmentator, and popular domain adaptation methodologies on the external validation.</p><p><strong>Conclusion: </strong>Evaluation of internal and external tests demonstrates improved segmentation quality with domain adaptation while leveraging less data than the baseline. An open-source codebase can be accessed.</p><p><strong>Key points: </strong>Question Variations in contrast phase uptake are challenging for evaluating impaired kidney function due to differences in imaging appearance. Findings The proposed open-source domain adaptation approach for kidney segmentation from CT volumes, handles domain shifts to accurately measure kidney volume regardless of contrast dose or functional anomaly. Clinical relevance The domain-shift resilient kidney segmentation of the volumetric CT images is crucial for patients as it ensures accurate and automated assessment of kidney health, irrespective of contrast uptake, enabling timely diagnosis and personalized treatment plans, regardless of contrast uptake.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527060","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}