Insights into Imaging最新文献

{"title":"Pelvic nerve endometriosis: MRI features and key findings for surgical decision.","authors":"Justine Bourg, Edouard Ruaux, Pierre Adrien Bolze, Marie Gavrel, Mathilde Charlot, François Golfier, Isabelle Thomassin-Naggara, Pascal Rousset","doi":"10.1186/s13244-025-02005-6","DOIUrl":"10.1186/s13244-025-02005-6","url":null,"abstract":"<p><p>Endometriosis is a prevalent gynecological disorder in women of reproductive age. It is the leading cause of chronic pelvic pain. While the mechanisms underlying this pain remain elusive, rare cases of pelvic nerve involvement can result in severe, debilitating symptoms, adding complexity to the clinical landscape. Nerve involvement typically results from the direct extension of deep infiltrating endometriosis, though it may also occur in isolation. The nerves most commonly affected include the inferior hypogastric and lumbosacral plexuses, as well as the sciatic, pudendal, obturator, and femoral nerves. Early and accurate diagnosis is essential for the effective management of the pain and the prevention of irreversible nerve damage. Given the limitations of transvaginal ultrasonography in visualizing the lateral compartment, MRI is considered the gold standard for detecting and evaluating pelvic nerve involvement. Through the use of optimized protocols to enhance the visualization of nerves and their anatomical landmarks, radiologists play a key role in the identification of endometriotic lesions. A comprehensive and structured radiology report is essential for surgical planning, as nerve involvement often requires precise interventions to alleviate symptoms and restore quality of life. CRITICAL RELEVANCE STATEMENT: Accurate identification and a structured reporting of pelvic nerve endometriosis in the lateral compartment are pivotal to guide surgical decision-making and optimize patient outcomes. KEY POINTS: Pelvic nerve endometriosis is often overlooked, underestimated by clinicians, and underdiagnosed on imaging. Timely nerve involvement diagnosis prevents permanent damage in pelvic pain with neurological symptoms. Deep endometriosis in the lateral compartment may extend to the pelvic nerves. The inferior hypogastric plexus, sacral plexus, sciatic, and pudendal nerves are commonly affected. A dedicated MRI protocol with 3D T2-weighted sequence ensures accurate pelvic nerve assessment.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"131"},"PeriodicalIF":4.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333067","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":"Association between ultrasound-based biliary and parenchymal intrahepatic mass-forming cholangiocarcinoma subtypes and clinicopathological features and survival.","authors":"Cong-Jian Wen, Hui Liu, Li-Ping Sun, Chong-Ke Zhao, Hao-Hao Yin, Li-Fan Wang, Ming-Rui Zhu, Yi-Kang Sun, Ya-Qin Zhang, Zi-Tong Chen, Xi Wang, Han-Sheng Xia, Hong Han, Hui-Xiong Xu, Bo-Yang Zhou","doi":"10.1186/s13244-025-02019-0","DOIUrl":"10.1186/s13244-025-02019-0","url":null,"abstract":"<p><strong>Objective: </strong>Mass-forming intrahepatic cholangiocarcinomas (MF-ICCs) can be classified into ductal and parenchymal types using magnetic resonance imaging (MRI). We aimed to subclassify MF-ICC into biliary and parenchymal types based on ultrasound (US) findings and to investigate the differences in their contrast-enhanced ultrasound (CEUS) patterns, clinicopathologic features, and prognosis.</p><p><strong>Methods: </strong>In this study, 141 patients who underwent US with pathologically proven MF-ICC from two hospitals were retrospectively enrolled. MF-ICCs were divided into biliary (bMF-ICCs) and parenchymal MF-ICC (pMF-ICCs) based on the signs of bile duct dilation in US images. Clinicopathological, imaging, and short-term survival data were collected from medical records and compared.</p><p><strong>Results: </strong>Among 141 patients (61.96 ± 10.15 years, 83 men), bMF-ICCs (33/141, 23.4%) showed significantly more CEA ≥ 5 µg/L (42.4% vs 20.2%, p = 0.01), microvascular invasion (54.5% vs 10.2%, p < 0.001), lymph node metastasis (48.5% vs 5.6%, p < 0.001), bile duct invasion (48.5% vs 5.6%, p < 0.001), and high Ki-67 expression (63.6% vs 38.9%, p = 0.01) than pMF-ICCs. Pathologically, bMF-ICCs were more inclined toward the large duct type (78.1% vs 11.7%, p < 0.001). In addition, the bMF-ICCs were usually located in the left lobe of the liver (63.6% vs 41.7%, p = 0.03). pMF-ICCs showed better overall survival than bMF-ICCs (p = 0.04).</p><p><strong>Conclusions: </strong>Subclassification of MF-ICCs into biliary and parenchymal types based on US is useful for discriminating clinicopathological characteristics.</p><p><strong>Critical relevance statement: </strong>The subclassification of mass-forming intrahepatic cholangiocarcinoma (MF-ICC) into biliary (bMF-ICC) and parenchymal (pMF-ICC) subtypes using ultrasound can provide clinicopathological and prognostic information before surgery.</p><p><strong>Key points: </strong>We subclassified mass-forming intrahepatic cholangiocarcinomas into biliary and parenchymal types using ultrasound. Biliary and parenchymal types have different clinicopathological features and postsurgical outcomes. Biliary type above and below 50 mm exhibits different unfavorable clinicopathological characteristics. Our classification has certain similarities with MRI classification in clinicopathological characteristics.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"130"},"PeriodicalIF":4.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325594","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":"Differentiation of benign and malignant breast lesions by ultrasound localization microscopy.","authors":"Jia Li, Cong Wei, Tao Ying, Yan Liu, Ronghui Wang, Maoyao Li, Chao Feng, Di Sun, Yuanyi Zheng","doi":"10.1186/s13244-025-02013-6","DOIUrl":"10.1186/s13244-025-02013-6","url":null,"abstract":"<p><strong>Objective: </strong>We investigated the role of ultrasound localization microscopy (ULM) qualitative and quantitative parameters in distinguishing benign from malignant breast lesions.</p><p><strong>Methods: </strong>The ULM qualitative and quantitative parameters of breast lesions were recorded. A receiver operating characteristic (ROC) curve was applied to assess the diagnostic performance of ULM. Intra- and inter-operator reliabilities of quantitative parameters were assessed.</p><p><strong>Results: </strong>Thirty-one breast lesions were verified by pathologic results, 14 of which were benign and 17 were malignant. Benign lesions were associated with dot-like, line-like, or branch-like patterns (93% vs 6%), whereas malignant lesions were associated with chaotic patterns (94% vs 7%) (p < 0.001). The microvasculature morphology had an area under the curve (AUC) of 0.935, a sensitivity of 94.1%, and a specificity of 92.9%. The microvasculature density, mean diameter, largest diameter, and max tortuosity of malignant lesions were significantly greater than those of benign lesions (p < 0.05, p < 0.001, p < 0.001, p < 0.05). The microvasculature mean flow velocity of benign lesions was significantly greater than that of malignant lesions (p < 0.05). For the quantitative parameters, the AUC was highest for the microvasculature's largest diameter (0.962), with a sensitivity of 88.2% and a specificity of 92.9%. The intra- and inter-operator reliabilities of quantitative parameters were excellent (ICC greater than 0.90).</p><p><strong>Conclusions: </strong>ULM is useful for distinguishing benign from malignant breast lesions. ULM can offer a new diagnostic method for breast lesions, which deserves further research.</p><p><strong>Critical relevance statement: </strong>This study suggests that ULM is a new technology with super-resolution that is helpful for distinguishing benign from malignant breast lesions.</p><p><strong>Trial registration: </strong>ChiCTR, ChiCTR2100048361. Registered 6 July 2021, https://www.chictr.org.cn/ .</p><p><strong>Key points: </strong>ULM is an emerging technology that can detect highly detailed networks of microvasculature. Microvasculature morphology based on ULM can be a good indicator for the differential diagnosis of breast lesions. Among quantitative parameters extracted from ULM, microvasculature largest diameter was the best for the classification of breast lesions.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"128"},"PeriodicalIF":4.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325595","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":"Quality appraisal of radiomics-based studies on chondrosarcoma using METhodological RadiomICs Score (METRICS) and Radiomics Quality Score (RQS).","authors":"Salvatore Gitto, Renato Cuocolo, Michail E Klontzas, Domenico Albano, Carmelo Messina, Luca Maria Sconfienza","doi":"10.1186/s13244-025-02016-3","DOIUrl":"10.1186/s13244-025-02016-3","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the methodological quality of radiomics-based studies on bone chondrosarcoma using METhodological RadiomICs Score (METRICS) and Radiomics Quality Score (RQS).</p><p><strong>Methods: </strong>A literature search was conducted on EMBASE and PubMed databases for research papers published up to July 2024 and focused on radiomics in bone chondrosarcoma, with no restrictions regarding the study aim. Three readers independently evaluated the study quality using METRICS and RQS. Baseline study characteristics were extracted. Inter-reader reliability was calculated using intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Out of 68 identified papers, 18 were finally included in the analysis. Radiomics research was aimed at lesion classification (n = 15), outcome prediction (n = 2) or both (n = 1). Study design was retrospective in all papers. Most studies employed MRI (n = 12), CT (n = 3) or both (n = 1). METRICS and RQS adherence rates ranged between 37.3-94.8% and 2.8-44.4%, respectively. Excellent inter-reader reliability was found for both METRICS (ICC = 0.961) and RQS (ICC = 0.975). Among the limitations of the evaluated studies, the absence of prospective studies and deep learning-based analyses was highlighted, along with the limited adherence to radiomics guidelines, use of external testing datasets and open science data.</p><p><strong>Conclusions: </strong>METRICS and RQS are reproducible quality assessment tools, with the former showing higher adherence rates in studies on chondrosarcoma. METRICS is better suited for assessing papers with retrospective design, which is often chosen in musculoskeletal oncology due to the low prevalence of bone sarcomas. Employing quality scoring systems should be promoted in radiomics-based studies to improve methodological quality and facilitate clinical translation.</p><p><strong>Critical relevance statement: </strong>Employing reproducible quality scoring systems, especially METRICS (which shows higher adherence rates than RQS and is better suited for assessing retrospective investigations), is highly recommended to design radiomics-based studies on chondrosarcoma, improve methodological quality and facilitate clinical translation.</p><p><strong>Key points: </strong>The low scientific and reporting quality of radiomics studies on chondrosarcoma is the main reason preventing clinical translation. Quality appraisal using METRICS and RQS showed 37.3-94.8% and 2.8-44.4% adherence rates, respectively. Room for improvement was noted in study design, deep learning methods, external testing and open science. Employing reproducible quality scoring systems is recommended to design radiomics studies on bone chondrosarcoma and facilitate clinical translation.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"129"},"PeriodicalIF":4.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325596","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":"Colour map displays.","authors":"Nandita M deSouza, Miha Fuderer, Nico Sollmann, Barbara Daria Wichtmann, Xavier Golay","doi":"10.1186/s13244-025-01970-2","DOIUrl":"10.1186/s13244-025-01970-2","url":null,"abstract":"","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"127"},"PeriodicalIF":4.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316846","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":"Solitary rectal ulcer syndrome: MRI findings and differentiation from rectal cancer.","authors":"Peiyi Xie, Xiaoying Lou, Shuai Fu, Xiaohui Di, Qitong Huang, Zhiming Zeng, Kexin Niu, Junying Zhu, Meiyu Hu, Xiaochun Meng","doi":"10.1186/s13244-025-01979-7","DOIUrl":"10.1186/s13244-025-01979-7","url":null,"abstract":"<p><strong>Background: </strong>Systematic MRI findings of solitary rectal ulcer syndrome (SRUS) are lacking. We aimed to evaluate the MRI findings of SRUS and to identify the MRI features that differentiate SRUS from rectal cancer.</p><p><strong>Methods: </strong>This retrospective study consecutively included 30 patients diagnosed with SRUS from January 2015 to December 2021. The clinical and MRI findings of SRUS patients were summarized. We randomly selected 120 rectal cancer patients with ≤ T2N0 pathological staging in a 1:4 ratio of SRUS to rectal cancer cases to perform differential diagnosis analysis.</p><p><strong>Results: </strong>SRUS patients were significantly younger (mean age ± standard deviation [SD], 37 years ± 17; 22 men) than rectal cancer patients (mean age ± SD, 62 years ± 12; 67 men; p < 0.001). Compared to rectal cancer patients, SRUS patients had a significantly higher incidence of ulceration (63.33%), submucosal edema (36.67%), unrestricted diffusion (76.67%), hypo- or high-low mixed intensity on T2-weighted imaging (T2WI, 76.67%), and layer enhancement (40%) (all p < 0.001). Interestingly, in the combinations of MRI features including unrestricted diffusion, hypo- or high-low mixed intensity on T2WI, and layer enhancement or submucosal edema showed an excellent diagnostic performance with area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 0.97 (95% CI: 0.92, 1.00), 93%, 100%, 100%, 98%, and 99%, respectively, in differentiating SRUS from rectal cancer.</p><p><strong>Conclusion: </strong>The combinations of three MRI features are simple and show excellent diagnostic performance. These may be useful tools for differentiating SRUS from rectal cancer.</p><p><strong>Critical relevance statement: </strong>The combinations of three MRI features including unrestricted diffusion, hypo- or high-low mixed intensity on T2WI, and layer enhancement or submucosal edema show excellent diagnostic performance, which have potential to serve as useful tools for differentiating SRUS from rectal cancer.</p><p><strong>Key points: </strong>MRI could differentiate solitary rectal ulcer syndrome (SRUS) from rectal cancer. SRUS patients had a significantly higher incidence of several MRI features. The combinations have potential for differentiating SRUS from rectal cancer.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"126"},"PeriodicalIF":4.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301999","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":"Predicting mucosal healing in Crohn's disease: development of a deep-learning model based on intestinal ultrasound images.","authors":"Li Ma, Yuepeng Chen, Xiangling Fu, Jing Qin, Yanwen Luo, Yuanjing Gao, Wenbo Li, Mengsu Xiao, Zheng Cao, Jialin Shi, Qingli Zhu, Chenyi Guo, Ji Wu","doi":"10.1186/s13244-025-02014-5","DOIUrl":"10.1186/s13244-025-02014-5","url":null,"abstract":"<p><strong>Objective: </strong>Predicting treatment response in Crohn's disease (CD) is essential for making an optimal therapeutic regimen, but relevant models are lacking. This study aimed to develop a deep learning model based on baseline intestinal ultrasound (IUS) images and clinical information to predict mucosal healing.</p><p><strong>Methods: </strong>Consecutive CD patients who underwent pretreatment IUS were retrospectively recruited at a tertiary hospital. A total of 1548 IUS images of longitudinal diseased bowel segments were collected and divided into a training cohort and a test cohort. A convolutional neural network model was developed to predict mucosal healing after one year of standardized treatment. The model's efficacy was validated using the five-fold internal cross-validation and further tested in the test cohort.</p><p><strong>Results: </strong>A total of 190 patients (68.9% men, mean age 32.3 ± 14.1 years) were enrolled, consisting of 1038 IUS images of mucosal healing and 510 images of no mucosal healing. The mean area under the curve in the test cohort was 0.73 (95% CI: 0.68-0.78), with the mean sensitivity of 68.1% (95% CI: 60.5-77.4%), specificity of 69.5% (95% CI: 60.1-77.2%), positive prediction value of 80.0% (95% CI: 74.5-84.9%), negative prediction value of 54.8% (95% CI: 48.0-63.7%). Heat maps showing the deep-learning decision-making process revealed that information from the bowel wall, serous surface, and surrounding mesentery was mainly considered by the model.</p><p><strong>Conclusions: </strong>We developed a deep learning model based on IUS images to predict mucosal healing in CD with notable accuracy. Further validation and improvement of this model with more multi-center, real-world data are needed.</p><p><strong>Critical relevance statement: </strong>Predicting treatment response in CD is essential to making an optimal therapeutic regimen. In this study, a deep-learning model using pretreatment ultrasound images and clinical information was generated to predict mucosal healing with an AUC of 0.73.</p><p><strong>Key points: </strong>Response to medication treatment is highly variable among patients with CD. High-resolution IUS images of the intestinal wall may hide significant characteristics for treatment response. A deep-learning model capable of predicting treatment response was generated using pretreatment IUS images.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"125"},"PeriodicalIF":4.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301998","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":"Diagnostic work-up of lipomatous tumors: a decision-making analysis among European sarcoma centers.","authors":"Ali Naimi, Paul Martin Putora, Christian Rothermundt, Antonia Digklia, Jose Manuel Asencio, Sylvie Bonvalot, Florian Bösch, Anant Desai, Amer James Durrani, Haim Gutman, Daphne Hompes, Jens Jakob, Wolfram Trudo Knoefel, Elisabetta Pennacchioli, Piotr Rutkowski, Winan J van Houdt, Barbara L van Leeuwen, Stephan Waelti, Tim Steffen Fischer, Stefan Markart, Simon Wildermuth, Tobias Johannes Dietrich","doi":"10.1186/s13244-025-02012-7","DOIUrl":"10.1186/s13244-025-02012-7","url":null,"abstract":"<p><strong>Objectives: </strong>Lipomatous soft-tissue tumors present a diagnostic burden. The aim of this work was to compare standard operating procedures (SOPs) for the diagnostic management of lipomatous soft-tissue tumors among European academic centers.</p><p><strong>Methods: </strong>Experts of the Soft Tissue and Bone Sarcoma Group of the European Organization for Research and Treatment of Cancer were asked for their SOPs in the diagnosis of adipocytic soft-tissue tumors in an otherwise healthy patient. The answers were converted to decision trees and subsequently compared using the objective consensus methodology. Mediastinal and retroperitoneal lipomatous tumors were excluded from the analysis.</p><p><strong>Results: </strong>The highest consensus (93%) among fourteen institutions was noted for evaluation with core needle biopsy (CNB) as SOP for lipomatous tumors located deep in tissue exceeding 7 cm and tumor-associated symptoms. Evaluation of heterogeneous features on imaging by CNB usually showed a consensus rate of at least 75%. Consensus was less likely for lipomatous tumors without symptoms or heterogeneous features. In these settings, CNB and follow-up were almost equally recommended. For lipomatous tumors smaller than 3 cm, without growth or symptoms, no localization in the trunk, and homogeneous imaging features, a consensus rate of 71% was achieved for follow-up.</p><p><strong>Conclusions: </strong>SOPs for diagnostic work-up of lipomatous tumors varied despite their geographical proximity. The highest consensus for biopsy was for deep large tumors with associated symptoms. For follow-up, consensus was shown for small homogenous tumors outside the trunk, without growth or symptoms. Consensus on resection involved homogeneous deeply located small tumors outside the trunk with growth and symptoms.</p><p><strong>Critical relevance statement: </strong>This study identifies the decision-making criteria with the highest consensus rate among participating academic sarcoma centers in diagnosing lipomatous tumors: tumors located deep in the tissue, a tumor size exceeding 7 cm, and associated symptoms emerge as pivotal criteria.</p><p><strong>Key points: </strong>Standard operating procedures for diagnostic work-up of lipomatous tumors among fourteen sarcoma centers were analyzed. Identified diagnostic criteria are: imaging features, size, growth, symptoms, superficial and trunk location. The highest consensus concerned recommending biopsies for deep tumors > 7 cm with associated symptoms.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"123"},"PeriodicalIF":4.1,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293694","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":"Contrast-enhanced mammography for breast cancer detection and diagnosis with high concentration iodinated contrast medium.","authors":"Federica Pediconi, Annarita Speranza, Giuliana Moffa, Roberto Maroncelli, Sara Coppola, Francesca Galati, Claudia Bernardi, Giacomo Maccagno, Dominga Pugliese, Carlo Catalano, Andrea Laghi, Veronica Rizzo","doi":"10.1186/s13244-025-01994-8","DOIUrl":"10.1186/s13244-025-01994-8","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the diagnostic performance of contrast-enhanced mammography (CEM) using a high-concentration iodinated contrast medium (HCCM, 400 mgI/mL) to determine whether the reduced iodine dose and increased iodine delivery rate (IDR) achieved might offer a more sustainable alternative to CEM performed with lower iodine concentrations.</p><p><strong>Methods: </strong>This two-center retrospective study included 205 patients who underwent CEM between March 2021 and February 2022. Patients were injected with HCCM at 1.0 mL/kg bodyweight at an IDR of 1.2 gL/s. Standard cranio-caudal and mediolateral-oblique views were acquired. Images were reviewed independently by two experienced radiologists who were blinded to patient clinical and imaging information. Diagnostic performance, including sensitivity, specificity, and accuracy, was assessed based on histological or long-term imaging follow-up as the reference standard.</p><p><strong>Results: </strong>Among the 205 patients, 149 (72.7%) had malignant lesions, and 56 (27.3%) had benign findings. The sensitivity and specificity of CEM were 96-97% and 84-87.5%, respectively, with an overall accuracy of 93-95%. The IDR achieved with HCCM resulted in excellent contrast enhancement, particularly in patients with aggressive malignancies. ROC analysis confirmed the good diagnostic performance, with AUC values of 0.90-0.92. Compared to conventional mammography and ultrasound, CEM demonstrated significantly higher diagnostic accuracy, especially in patients with dense breast tissue.</p><p><strong>Conclusions: </strong>CEM with HCCM provides excellent diagnostic performance, achieving high sensitivity and specificity while allowing for a reduced iodine dose and increased IDR. This approach may offer a more sustainable alternative to conventional contrast media without compromising diagnostic accuracy, particularly for the detection and characterization of aggressive breast lesions.</p><p><strong>Critical relevance statement: </strong>This study demonstrates that reducing the volume of injected contrast media while increasing iodine concentration maintains the diagnostic benefits of CEM, further supporting its potential to improve early cancer detection, thereby advancing clinical radiology practices and optimizing screening strategies for women with dense breasts.</p><p><strong>Key points: </strong>Currently, CEM protocols utilize a variety of iodine concentrations and flow rates. CEM with high-concentration contrast (400 mgI/mL) achieved 96% sensitivity and 87.5% specificity. High-concentration contrast in CEM improves early detection of aggressive breast cancers.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"124"},"PeriodicalIF":4.1,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293693","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":"Neuroimaging features of immune-related adverse events due to immune checkpoint inhibitor therapy.","authors":"Arian Lasocki, Lavinia Spain","doi":"10.1186/s13244-025-01999-3","DOIUrl":"10.1186/s13244-025-01999-3","url":null,"abstract":"<p><p>Immune checkpoint inhibitors, a type of intravenous immunotherapy targeting T cells, are being increasingly used in cancer treatment. They work by increasing the immune system's response to tumour cells, through blockade of inhibitory \"checkpoint\" receptors. Immune checkpoint inhibitors commonly induce immune-related adverse events (irAEs) affecting multiple organ systems. Hypophysitis is strictly an endocrine irAE, but is the most common irAE identified on neuroimaging. True neurologic irAEs are rare and widely varied. Examples include meningitis, encephalitis, vasculitis, demyelinating syndromes and neuritis. Some neurologic irAEs are not associated with neuroimaging findings (for example, neuromuscular junction disorders), while in others, imaging findings are present in only a proportion of patients (for example, encephalitis). Diagnosing, or at least considering, a neurologic irAE is important for instigating the appropriate management and optimising patient outcomes. This educational review illustrates irAEs that may be identified on neuroimaging and provides practical tips for optimising diagnosis, including relevant clinical considerations. CRITICAL RELEVANCE STATEMENT: Immune checkpoint inhibitors, which are being increasingly used in cancer treatment, commonly induce immune-related adverse events. This educational review illustrates the range of immune-related adverse events for which neuroimaging plays a key role in diagnosis. KEY POINTS: Immune checkpoint inhibitors commonly result in immune-related adverse events (irAEs) affecting multiple organ systems. Hypophysitis, the most common irAE identified on neuroimaging, is characterised by transient pituitary enlargement. True neurologic irAEs are rare and include meningitis, encephalitis, vasculitis, demyelination and neuritis. An understanding of the overall clinical picture is important for supporting the diagnosis.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"120"},"PeriodicalIF":4.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283825","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}