European Radiology最新文献

{"title":"Could MR elastography be a way to make violent contact sports safer?","authors":"Tzu-Chao Chuang, Yu-Hsiu Lee, Hsiao-Wen Chung","doi":"10.1007/s00330-025-11531-2","DOIUrl":"https://doi.org/10.1007/s00330-025-11531-2","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718208","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":"Retrospective evaluation of a CE-marked AI system, including 1,017,208 mammography screening examinations.","authors":"Tone Hovda, Marthe Larsen, Marie Burns Bergan, Jonas Gjesvik, Lars A Akslen, Solveig Hofvind","doi":"10.1007/s00330-025-11521-4","DOIUrl":"https://doi.org/10.1007/s00330-025-11521-4","url":null,"abstract":"<p><strong>Objectives: </strong>To retrospectively evaluate the performance of a CE-marked AI system for identifying breast cancer on screening mammograms. Evidence from large retrospective studies is crucial for planning prospective studies and to further ensure safe implementation.</p><p><strong>Materials and methods: </strong>We used data from screening examinations performed from 2004 to 2021 at ten breast centers in BreastScreen Norway. In the standard independent double reading setting, each radiologist scored each breast from 1 (negative) to 5 (high probability of cancer). The AI system assigned each examination an NT and an SN score; the NT score aimed to classify examinations as negative with minimal misclassification while the SN score aimed to classify examinations as positive with high confidence. N70 was defined as being among the 70% with the lowest NT score and P3 was defined as being among the 3% with the highest SN score.</p><p><strong>Results: </strong>A total of 1,017,208 screening examinations were included in the study sample. At N70, 1.8% (107/5977) of the screen-detected and 34.5% (625/1812) of the interval cancers were defined as negative. Using P3 to define cases as positive, 81.5% (4871/5977) of the screen-detected and 19.0% (344/1812) of the interval cancers were defined as positive. Among the screen-detected cancers in N70, 11.2% (12/107) had an interpretation score > 2 by both radiologists.</p><p><strong>Conclusion: </strong>The AI system performed well according to identifying negative cases and cancer cases. Thus, the AI system can be used to reduce workload for the radiologists and potentially increase the sensitivity of mammography.</p><p><strong>Key points: </strong>Question Results from large mammography screening samples not used in training AI algorithms are important to consider when planning prospective studies and implementation. Findings More than 80% of the screening-detected cancers were classified as positive by AI when considering 3% of the examinations with the highest AI risk score as positive. Clinical relevance A lack of radiologists is a challenge in mammographic screening. Our findings support other studies that suggest the use of AI to reduce screen-reading workload.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718242","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":"A novel pN stage prediction model for resectable rectal adenocarcinoma based on preoperative MRI features and multiregional apparent diffusion coefficients.","authors":"Hui Luo, Yue-Qin Gou, Yue-Su Wang, Hui-Lin Qin, Hai-Ying Zhou, Xiao-Ming Zhang, Tian-Wu Chen","doi":"10.1007/s00330-025-11528-x","DOIUrl":"https://doi.org/10.1007/s00330-025-11528-x","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a novel model based on preoperative MRI features and multiregional apparent diffusion coefficients (ADCs) to improve the prediction of pN stage in resectable rectal adenocarcinoma (RA).</p><p><strong>Methods: </strong>Two hundred fifty-four consecutive patients (median age [interquartile range], 67 [56-74] years; 156 males) with resectable RA were retrospectively collected at two medical centers from January 2017 to December 2023 and were divided into the training (n = 139), internal validation (n = 60), and external validation (n = 55) sets. All patients underwent preoperative MRI scans. Univariate and multivariate logistic regression analyses were conducted on the MRI features and multiregional (RA, peritumoral tissue, and tumor-adjacent rectal wall) ADCs to construct a nomogram model for preoperative predicting pN stage in the training set. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive performance of the nomogram model vs the conventional MRI-assessed N (mriN) stage. The ROC curves were compared using the DeLong test.</p><p><strong>Results: </strong>The predictors incorporated in the nomogram model comprised gross tumor volume, categories of short diameter of maximum node, extramural vascular invasion, mesorectal fascia involvement, and ADCs of RA and peritumoral tissue. This model yielded a better prediction of the pN stage compared to the mriN stage in training (AUC, 0.848 vs 0.672; p < 0.001), internal validation (AUC, 0.843 vs 0.699; p = 0.008), and external validation (AUC, 0.857 vs 0.723; p = 0.01) sets.</p><p><strong>Conclusion: </strong>This novel model based on the preoperative MRI features and multiregional ADCs can improve the prediction of the pN stage in RA.</p><p><strong>Key points: </strong>Question Accurate preoperative assessment of the pN stage is important for determining an appropriate therapeutic strategy in rectal cancer, but the conventional mriN stage has low sensitivity. Findings Utilization of certain MRI features and multiregional ADCs improves preoperative assessment of the pN stage in RA when compared with conventional MRI assessment. Clinical relevance The novel model, based on preoperative MRI features and multiregional ADC values, can improve the prediction of the pN stage compared to the mriN stage in RA. The combination of this model with the mriN stage helps personalize treatment plans to improve patient prognosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709299","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":"Optimizing prostate cancer diagnosis: combining imaging modalities for tailored treatment.","authors":"Laura Evangelista, Carlo Vallone, Priscilla Guglielmo","doi":"10.1007/s00330-025-11551-y","DOIUrl":"https://doi.org/10.1007/s00330-025-11551-y","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709308","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":"Digital mammography with AI-based computer-aided diagnosis to predict neoadjuvant chemotherapy response in HER2-positive and triple-negative breast cancer patients: comparison with MRI.","authors":"Haejung Kim, Ji Soo Choi, Sang Ah Chi, Jai Min Ryu, Jeong Eon Lee, Myoung Kyoung Kim, Jeongmin Lee, Eun Sook Ko, Eun Young Ko, Boo-Kyung Han","doi":"10.1007/s00330-025-11390-x","DOIUrl":"https://doi.org/10.1007/s00330-025-11390-x","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether digital mammography (DM) with artificial intelligence-based computer-aided diagnosis (AI-CAD) predicts pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in human epidermal growth factor receptor 2 (HER2)-positive and triple-negative (TN) breast cancers and compare performance with dynamic contrast-enhanced (DCE)-MRI.</p><p><strong>Materials and methods: </strong>In this single-center study, patients who underwent NAC and surgery for HER2-positive or TN cancers between September 2020 and August 2021 were retrospectively selected to develop prediction models for pCR after NAC. From a prospective ASLAN (Avoid axillary Sentinel Lymph node biopsy After Neoadjuvant chemotherapy) trial, HER2-positive and TN cancer patients who underwent NAC and surgery between December 2021 and July 2022 were prospectively selected for model validation. Clinical-pathologic data and DM and MRI scans were obtained before and after NAC. Logistic regression analyses identified factors associated with pCR for model development and four models (clinical-pathologic, MRI, DM-AI-CAD, and combined) were evaluated.</p><p><strong>Results: </strong>A total of 259 women (mean age, 53 years ± 10.5 [SD]) constituted the development cohort and 119 (50.8 years ± 11.1) the validation cohort. Age, clinical N stage, estrogen receptor, progesterone receptor, and Ki-67 were incorporated into the clinical-pathologic model. In the validation cohort, the DM-AI-CAD model, applying AI-CAD score ≤ 16 on post-NAC DM as the radiologic CR criterion, showed a higher area under the receiver operating characteristic curve (AUC) compared to the clinical-pathologic model (0.72 vs. 0.62; p = 0.01) for pCR. However, the MRI model showed the highest AUC (0.83), then the combined model (0.78).</p><p><strong>Conclusion: </strong>The model utilizing post-NAC DM with AI-CAD score ≤ 16 predicted pCR more accurately than the clinical-pathologic model in HER2-positive and TN cancers but was inferior to the MRI model.</p><p><strong>Key points: </strong>Question The performance of digital mammography (DM) with AI-based computer-aided diagnosis (AI-CAD) for predicting pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) is unclear. Findings The DM-AI-CAD model incorporating AI-CAD score ≤ 16 on post-NAC DM predicted pCR more accurately than the clinical-pathologic model but not the MRI model. Clinical relevance The DM-AI-CAD model has potential to predict pCR after NAC in breast cancer patients for whom MRI is unavailable or contraindicated.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709301","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":"Assessment of proximal tibial fractures with 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI-intra-individual comparison with CT.","authors":"Inka Ristow, Shuo Zhang, Christoph Riedel, Alexander Lenz, Ralph Akoto, Matthias Krause, Gerhard Adam, Peter Bannas, Frank Oliver Henes, Lennart Well","doi":"10.1007/s00330-025-11522-3","DOIUrl":"https://doi.org/10.1007/s00330-025-11522-3","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility and diagnostic performance of a 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI sequence for the detection and classification of proximal tibial fractures compared with CT.</p><p><strong>Methods: </strong>We retrospectively included 126 patients (85 male; 39.6 ± 14.5 years) from two centers following acute knee injury. Patients underwent knee MRI at 3 T including FRACTURE-MRI. Additional CT was performed in patients with tibial fractures (32.5%; n = 41) as the reference standard for fracture classification. Two radiologists independently evaluated FRACTURE-MRI for the presence of fractures and classified them according to AO/OTA, Schatzker, and the 10-segment classification. Diagnostic performance of FRACTURE-MRI was assessed using crosstabulations. Inter-reader agreement was estimated using Krippendorff's alpha. Image quality was graded on a five-point scale (5 = excellent; 1 = inadequate definition of fracture lines and fracture displacement) and assessed using estimated marginal means.</p><p><strong>Results: </strong>Fractures were detected by FRACTURE-MRI with a sensitivity of 91.5% (83.2-96.5%) and a specificity of 97.1% (93.3-99.0%). Regarding fracture classification, diagnostic performances were slightly lower, with the 10-segment classification yielding the best sensitivity of 85.7% (81.4-89.3%) and specificity of 97.4% (96.6-98.0%), and the Schatzker classification yielding the lowest sensitivity of 78.2% (67.4-86.8%) and specificity of 97.7% (94.1-99.4%). Inter-reader agreement across the whole cohort was excellent (Krippendorff's alpha 0.89-0.96) and when considering only patients with fractures, good to acceptable (0.48-0.91). Image quality was rated good (estimated marginal mean 4.3 (4.1-4.4)).</p><p><strong>Conclusion: </strong>FRACTURE-MRI is feasible at 3 T enabling accurate delineation of fracture lines for precise diagnosis and classification of proximal tibial fractures.</p><p><strong>Key points: </strong>Question CT-like MRI is increasingly being evaluated for its advantages in bone imaging but is not yet established in routine practice. Findings The 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI sequence is feasible at 3 T, allowing for diagnosis and classification of proximal tibial fractures. Clinical relevance FRACTURE-MRI might be a helpful alternative to computed tomography in an acute trauma setting by reducing costs and radiation exposure in patients requiring a preoperative MRI anyway.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700095","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":"Synthetic tumor extracellular volume as a predictive biomarker for colorectal liver metastasis patients prior to curative hepatectomy.","authors":"Kiyoyuki Minamiguchi, Harufumi Maki, Antony Haddad, Andrea C Cortes, Mateo Lendoire, Toshihiro Tanaka, Marshall E Hicks, Jean-Nicolas Vauthey, Rony Avritscher","doi":"10.1007/s00330-025-11503-6","DOIUrl":"https://doi.org/10.1007/s00330-025-11503-6","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the prognostic value of synthetic tumor extracellular volume fraction (ECV) and its association with somatic gene alternations in patients with colorectal liver metastases (CRLM) receiving neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>This retrospective single-center study included patients undergoing curative hepatectomy after neoadjuvant chemotherapy for CRLM (2013-2020). Contrast-enhanced computed tomography (CT) studies obtained after neoadjuvant chemotherapy were used to calculate synthetic ECV and synthetic hematocrit by linear regression analysis. Patients were grouped according to synthetic ECV cutoff point based on the Youden index. Multivariate analyses were performed with Cox regression models to analyze the prognostic factors of overall survival (OS) and recurrence-free survival (RFS).</p><p><strong>Results: </strong>A total of 209 patients (median age 56 years, 119 men) were enrolled. Synthetic ECV correlated well with conventional ECV (r = 0.996, p < 0.0001) with minimal bias, according to the Bland-Altman analysis (bias = 0.007). The optimal synthetic ECV cutoff point was determined to be 21%, with 115 patients having high ECV and 94 low ECV. Multivariable analysis for predicting high ECV demonstrated significant associations with synchronous CRLM, anti-VEGF agent-containing regimen, and RAS-BRAF mutation (p = 0.022, < 0.001, and = 0.003, respectively). OS and RFS were significantly higher in the high ECV group compared to the low ECV group (p = 0.019 and p = 0.015, respectively). High ECV was independently associated with improved OS (HR 0.55, 95% CI 0.34-0.91) and RFS (HR 0.71, 95% CI 0.52-0.97).</p><p><strong>Conclusions: </strong>Synthetic ECV can help predict OS and RFS in patients undergoing curative-intent CRLM resection after neoadjuvant chemotherapy and could be a useful imaging biomarker to stratify risk.</p><p><strong>Key points: </strong>Question There is a need for a biomarker predictive of treatment response after neoadjuvant chemotherapy, prior to curative-intent colorectal liver metastases. Findings Synthetic extracellular volume fraction can help predict overall and recurrence-free survival and is associated with somatic gene alterations. Clinical relevance Prognostic markers of response to neoadjuvant chemotherapy in curative-intent colorectal liver metastases include extracellular volume fraction. Synthetic extracellular volume fraction obviates the need for hematocrit; a simplification that is expected to streamline routine clinical practice.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700097","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":"Less may be more in PET (with AI).","authors":"Mario Quarantelli, Camilla Russo","doi":"10.1007/s00330-025-11483-7","DOIUrl":"https://doi.org/10.1007/s00330-025-11483-7","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700096","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":"Automated abdominal CT imaging biomarkers and clinical frailty measures associated with postoperative deceased-donor liver transplant outcomes.","authors":"Daniel Liu, David Ji, John W Garrett, Ryan Zea, Adam Kuchnia, Ronald M Summers, Joshua D Mezrich, Perry J Pickhardt","doi":"10.1007/s00330-025-11523-2","DOIUrl":"https://doi.org/10.1007/s00330-025-11523-2","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the potential of fully automated CT-based body composition metrics and clinical frailty data in predicting liver transplant recipient postoperative outcomes.</p><p><strong>Methods: </strong>AI-enabled body composition tools were applied to pre-transplant abdominal CT scans in a retrospective cohort of first-time deceased-donor liver transplant recipients. Clinical frailty data (Fried frailty score) was obtained from an established transplant database. Age- and sex-corrected hazard ratios (HRs) were analyzed according to highest-risk quartiles compared with the other three quartiles combined. Area under the receiver operating characteristic curve (ROC AUC) analysis in univariate and multivariate scenarios was also performed.</p><p><strong>Results: </strong>598 liver transplant recipients (median age, 56 years [IQR, 49-61]; 383 men/215 women) were included from 2005 to 2021. Mean clinical follow-up interval after transplant was 8.6 ± 4.5 years, with 224 deaths (mean interval, 5.3 ± 3.9 years post-transplant) and 246 graft failures (mean interval, 4.7 ± 4.0 years post-transplant) observed. Univariate HRs for post-transplant survival included 1.53 (95% CI, 1.14-2.06) for muscle attenuation, 1.66 (95% Cl, 1.24-2.22) for aortic Agatston score, 1.35 (1.02-1.80) for SAT area, and 1.82 (1.35-2.46) for liver volume. For those meeting the frailty criteria, HR was 2.14 (1.08-4.22). Multivariate 10-year AUC for predicting mortality was 0.675 using liver volume, aortic Agatston score, and muscle attenuation. 10-year univariate AUC for clinical frailty assessment was 0.601 but increased to 0.878 when combined with CT measures.</p><p><strong>Conclusion: </strong>Automated CT measurements of muscle density (myosteatosis), aortic calcification, subcutaneous fat, and liver volume are predictive of mortality in liver transplant recipients. Frailty was likewise predictive. Combining CT and clinical frailty assessment was complementary.</p><p><strong>Key points: </strong>Question What is the prognostic value of pre-transplant CT-based body composition measures for deceased-donor liver transplant outcomes, and how do they correlate with frailty assessment? Findings Increased post-transplant mortality was associated with pre-transplant increased liver volume, increased abdominal aortic Agatston score, decreased skeletal muscle attenuation, and decreased subcutaneous adipose tissue area. Clinical relevance Pre-transplant AI-enabled body composition measures have predictive value for post-transplant survival, offering a novel and objective diagnostic tool to identify high-risk transplant recipients that are complementary to clinical assessments.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691519","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":"Magnetic resonance imaging for suspected perianal Crohn's disease in children: a multi-reader agreement study.","authors":"Pradipta Debnath, Michael R Acord, Christopher G Anton, Jesse Courtier, Alexander M El-Ali, Monica M Forbes-Amrhein, Michael S Gee, Mary-Louise C Greer, R Paul Guillerman, Murat Kocaoglu, Shailee V Lala, Mitchell A Rees, Gary R Schooler, Alexander J Towbin, Bin Zhang, Jason S Frischer, Phillip Minar, Jonathan R Dillman","doi":"10.1007/s00330-025-11469-5","DOIUrl":"https://doi.org/10.1007/s00330-025-11469-5","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to assess inter-radiologist agreement when interpreting pelvic MRI in children with newly diagnosed perianal Crohn's disease (CD).</p><p><strong>Materials and methods: </strong>In this retrospective multi-reader study, we identified pediatric patients (< 18 years of age) who underwent a pelvic MRI examination for newly diagnosed perianal CD. Images were de-identified and uploaded to a cloud-based image platform for review by 13 fellowship-trained pediatric radiologists The reviewers assessed for the presence of a fistula and abscess, categorization of different imaging findings, and classification using the Parks and St James' University Hospital systems. Fleiss' kappa (κ) statistics and intra-class correlation coefficients (ICC) were used to measure inter-reader agreement, along with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Forty-six patients were included in our study (median age = 13.0 years [IQR: 10.5 to 16.0 years]); thirty-five (76.1%) were boys. Most imaging features showed fair agreement (κ = 0.21 to 0.35). There was moderate agreement for categorical fistula length (κ = 0.42 [95% CI: 0.32 to 0.53]), involvement of the genitalia (κ = 0.45 [95% CI: 0.26 to 0.63]), and presence of an abscess/collection (κ = 0.52 [95% CI: 0.31 to 0.73]). Maximum abscess/collection length had good agreement (ICC = 0.81 [95% CI: 0.41, 1.00]). There was an almost equal split (yes vs. no: 50.7% vs. 49.3%) regarding whether postcontrast T1-weighted images added value compared to T2-weighted images alone across all radiologists and examinations.</p><p><strong>Conclusion: </strong>Inter-radiologist agreement when interpreting pelvic MRI for perianal CD in children is fair for most imaging features, with fewer features demonstrating moderate or good agreement.</p><p><strong>Key points: </strong>Question Pelvic magnetic resonance imaging (MRI) is used for diagnosing and monitoring children with perianal Crohn's disease (CD). Limited information is known about inter-radiologist agreement. Findings Agreement between pediatric radiologists when interpreting MRI for perianal CD in children is only fair for most imaging features (κ = 0.21 to 0.35). Clinical relevance Understanding MRI inter-radiologist agreement is crucial to improve the reliability of pelvic MRI in children with perianal Crohn's disease since it may affect patient management (e.g., surgery); further radiologist education and improved imaging feature definitions may help improve inter-radiologist agreement.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691529","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}