Insights into Imaging最新文献

{"title":"Precision imaging and evolving therapies in paragangliomas and pheochromocytomas: from molecular diagnostics to imaging-guided management.","authors":"Aurelie Choucair, Anna Zdunek, Matthew Liao, Lisa Bodei, Desiree Deandreis, Jeeban Das, Remy Barbe, Emily Bergsland, Susan Geyer, Francois Bidault, Gabriel Garcia, Randy Yeh, Corinne Balleyguier, Nathalie Lassau, Laurent Dercle, Samy Ammari","doi":"10.1186/s13244-025-02195-z","DOIUrl":"10.1186/s13244-025-02195-z","url":null,"abstract":"<p><p>Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors originating from neural crest-derived chromaffin tissue, marked by clinical heterogeneity and substantial genetic underpinnings. With up to 70% of cases linked to germline or somatic mutations, including Succinate DeHydrogenase genetic alterations (SDHx), and Von Hippel-Lindau (VHL), genetic profiling is central to diagnosis, risk stratification, and therapeutic planning. Clinical presentation varies by tumor location and secretory status-from catecholamine-driven crises to mass effect in head and neck paragangliomas (H&N PGLs). The diagnostic workflow begins with biochemical testing, followed by high-resolution anatomical and functional imaging. Computed tomography (CT) and magnetic resonance imaging (MRI) remain essential for localization and staging, while radiopharmaceuticals such as ⁶⁸Ga-DOTA⁰-Tyr³-octreotate (⁶⁸Ga-DOTATATE), ¹⁸F-fluoro-L-dihydroxyphenylalanine (¹⁸F-FDOPA), and ¹³¹I-metaiodobenzylguanidine (¹³¹I-MIBG) refine tumor characterization and guide peptide receptor radiopharmaceutical therapy (RPT) with radiolabeled octreotide derivatives or therapeutic MIBG Imaging features such as size, necrosis, and diffusion restriction correlate with malignancy risk, but novel molecular imaging offer promise for more precise prognostication. Therapeutic options span from curative surgery to systemic therapies, including temozolomide, tyrosine kinase inhibitors, and nuclide therapy. Minimally invasive, image-guided interventions provide palliation for metastatic or inoperable disease. Importantly, artificial intelligence and molecular assays such as the NETest and ¹H-MRS are emerging as pivotal tools in real-time tumor monitoring, early relapse detection, and biomarker discovery. This review underscores the necessity of a multidisciplinary, genomics-informed, and imaging-guided approach to PPGL management. With the integration of advanced imaging and AI-driven analytics, precision oncology for PPGLs is transitioning from potential to practice. CRITICAL RELEVANCE STATEMENT: This article offers an overview of the diverse manifestations of paragangliomas, illustrated with examples from various anatomical locations. It also highlights different patterns of tumor evolution and provides an up-to-date review of current management and therapeutic strategies, with a special focus on emerging AI-guided approaches. KEY POINTS: Review the genetic associations, including Von Hippel-Lindau, Multiple Endocrine Neoplasia, Neurofibromatosis, and Carney Triad. Overview of anatomical imaging features (CT and MRI) of paragangliomas. Improve knowledge about the different Nuclear Medicine and functional imaging techniques in detecting lesions, depending on their location, secretory function and underlying genetic mutation. Discuss the multiple radiopharmaceuticals available for Scintigraphy and PET-CT, according to the paraganglioma site and mutational pattern.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"37"},"PeriodicalIF":4.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142210","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":"Tumour mutation burden drives survival outcomes in pancreatic ductal adenocarcinoma and enables noninvasive prediction via dual-layer spectral CT.","authors":"Jiawei Liu, Siya Shi, Meicheng Chen, Jiadan Luo, Luyong Wei, Mingjie Chen, Zujiang Shi, Liqin Wang, Yanji Luo, Shi-Ting Feng","doi":"10.1186/s13244-026-02216-5","DOIUrl":"10.1186/s13244-026-02216-5","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prognostic significance of tumour mutation burden (TMB) in pancreatic ductal adenocarcinoma (PDAC) and explore the performance of dual-layer spectral CT (DLCT) for noninvasive TMB evaluation.</p><p><strong>Materials and methods: </strong>This retrospective analysis enroled patients with histopathologically confirmed PDAC who underwent DLCT between June 2019 and December 2023. Clinical, qualitative radiological, and quantitative conventional CT and DLCT parameters were evaluated. Survival analysis evaluated TMB's association with progression-free survival (PFS) and identified an optimal TMB cutoff. Independent TMB predictors were identified through univariable and LASSO regression. Predictive performance was quantified via receiver operating characteristic and precision-recall curve assessments.</p><p><strong>Results: </strong>Among 75 patients (mean age 60.4 ± 11.2 years; 41 males, 34 females), median TMB was 2.13 mut/Mb (interquartile range: 1.00-4.26). A 5 mut/Mb cutoff revealed distinct prognostic groups, with high-TMB cases exhibiting better PFS (median PFS: 7 vs 5 months, p = 0.02). Normalised iodine concentration in the pancreatic phase (nICa) was the sole independent TMB predictor (area under the curve [AUC] = 0.901; cutoff = 0.089; accuracy = 89.3% [89.1-89.6%], sensitivity = 81.8% [59.0-100%], specificity = 90.6% [83.5-97.8%]), surpassing conventional CT attenuation metrics (nCTa, AUC = 0.834), peripancreatic tumour infiltration (AUC = 0.679), and their combined model (AUC = 0.864) with significant net reclassification improvement (all p < 0.05). Precision-recall curve validation reinforced nICa's superior predictive capacity. Patients classified by nICa-predicted high TMB status demonstrated better PFS (median PFS: 7 vs 5 months, p = 0.04).</p><p><strong>Conclusion: </strong>Elevated TMB is a positive biomarker for PFS in PDAC. DLCT-derived nICa facilitates precise, noninvasive TMB prediction, outperforming conventional imaging parameters and supporting its potential role in therapeutic stratification.</p><p><strong>Critical relevance statement: </strong>Elevated tumour mutational burden (TMB) in PDAC correlated with prolonged PFS. DLCT provided noninvasive, accurate TMB quantification, enabling meaningful survival stratification.</p><p><strong>Key points: </strong>High TMB in patients with PDAC portends better PFS, particularly those receiving combination immunotherapy. A clinically applicable TMB cutoff of 5 mut/Mb was identified, stratifying patients into biologically distinct low- and high-TMB prognostic groups. DLCT-derived pancreatic phase normalized iodine concentration emerged as a superior noninvasive TMB biomarker compared to conventional imaging parameters.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"36"},"PeriodicalIF":4.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142238","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":"Environmental sustainability of ultrasound-guided core-needle breast biopsy: a survey on current practices by the European Society of Breast Imaging (EUSOBI).","authors":"Andrea Cozzi, Serena Carriero, Maria Adele Marino, Simone Schiaffino, Fleur Kilburn-Toppin, Matthew G Wallis, Paola Clauser, Michael H Fuchsjäger, Elisabetta Giannotti","doi":"10.1186/s13244-026-02215-6","DOIUrl":"10.1186/s13244-026-02215-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;In the context of a global appraisal of the environmental impact of radiology, this survey among members of the European Society of Breast Imaging (EUSOBI) investigated procedural aspects of ultrasound-guided core-needle breast biopsy that may impact its environmental sustainability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A 25-item online questionnaire, developed by a panel of nine breast imaging experts, was distributed from September 25th to December 25th, 2024, within the EUSOBI mailing list and social media platforms. The survey investigated materials routinely used for ultrasound-guided core-needle biopsies, waste disposal practices, the relationship between perceived procedural hygiene levels and self-reported frequency of post-procedural infectious complications, and results' communication methods. Replies were analysed with descriptive and non-parametric statistics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 787/823 respondents (95.6%) who routinely perform ultrasound-guided core-needle biopsy, most (460/787, 58.4%) perceived to attain aseptic conditions, without significant associations (p = 0.334) of hygiene levels with post-procedural infectious complications (never seen by 549/776 respondents, 70.7%). For most disposable materials, the majority of respondents used no more than one unit per procedure, including sterile gloves (551/787, 70.0%), sterile drapes (651/787, 82.7%), and sterile gel packets (729/787, 92.6%), also avoiding to use prepackaged biopsy kits (424/787, 53.9%). However, most respondents did not use recycling bins (404/787, 51.3%) and employed at least one resource-intensive modality to communicate benign results (in-person or by letter, 584/787, 74.2%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Procedural aspects of ultrasound-guided core-needle biopsy carrying an environmental impact vary widely. In the absence of significant associations between perceived hygiene levels and post-procedural infectious complications, resource-intensive habits could be safely streamlined to improve sustainability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Critical relevance statement: &lt;/strong&gt;This EUSOBI survey demonstrates that, despite widely varying procedural aspects in ultrasound-guided core-needle breast biopsy, higher perceived sterility levels are not associated with fewer infections, highlighting opportunities to safely reduce resource use and environmental impact.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;This EUSOBI survey investigated how procedural habits and the use and amount of material in ultrasound-guided core-needle breast biopsy impact its environmental sustainability. Procedural aspects varied widely among the 787/823 respondents who routinely perform ultrasound-guided core-needle breast biopsy. While some economically driven sustainable behaviours are already in place, there are several opportunities to reduce materials use and waste. As no association was found between perceived hygiene levels and post-procedural in","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"33"},"PeriodicalIF":4.5,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12868546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112967","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":"A nomogram including body composition parameters for predicting recurrence of pT1 clear cell renal cell carcinoma: a multicenter retrospective study.","authors":"Haonan Chen, Lingkai Cai, Juntao Zhuang, Yiran Tao, Zhengye Tan, Hao Yu, Chang Chen, Qikai Wu, Qiang Cao, Bo Liang, Pengchao Li, Xiao Yang, Qiang Lu","doi":"10.1186/s13244-025-02202-3","DOIUrl":"10.1186/s13244-025-02202-3","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a body composition parameters (BCPs)-based nomogram for predicting recurrence in T1-stage clear cell renal cell carcinoma (ccRCC), comparing its performance with established models while exploring potential biological mechanisms.</p><p><strong>Materials and methods: </strong>536 patients from three institutions (training cohort: 343, external validation cohort: 193) were included. Univariate and multivariate Cox regression analyses identified independent prognostic factors for recurrence-free survival (RFS), which were incorporated into the nomogram. The model performance was evaluated, and potential biological mechanisms were explored.</p><p><strong>Results: </strong>The postoperative nomogram included three independent adverse prognostic factors for RFS: high Leibovich score (HR = 2.18, 95% CI: 1.44-3.31), high visceral adipose tissue density (VATD; HR = 2.34, 95% CI: 1.33-4.12), and high intramuscular adipose tissue content (IMAC; HR = 3.60, 95% CI: 1.29-10.07). The nomogram demonstrated superior discrimination, with a C-index of 0.732 (95% CI: 0.655-0.810) in the training cohort and 0.766 (95% CI: 0.677-0.855) in the validation cohort. The area under the curves (AUCs) for predicting 3- and 5-year RFS were 0.761 and 0.709 (training), and 0.844 and 0.765 (validation), outperforming the TNM, Leibovich, and SSIGN models. Through 5-fold cross-validation within the training cohort, the model achieved mean AUCs of 0.761 (3-year) and 0.683 (5-year). Calibration curves showed good consistency. Decision curve analysis indicated favorable clinical utility. Risk stratification (cutoff = 94.18) based on nomogram scores revealed significant RFS differences. Exploratory in silico analyses of transcriptomic data suggested enrichment in distinct cancer-related and metabolic pathways, as well as varying drug sensitivities between cohorts.</p><p><strong>Conclusion: </strong>The BCPs-based nomogram effectively predicts recurrence of T1 ccRCC and significantly improves upon existing prognostic models.</p><p><strong>Critical relevance statement: </strong>The nomogram, combining body composition parameters and Leibovich score, outperformed established prognostic models in predicting T1 ccRCC recurrence, enabling personalized risk stratification.</p><p><strong>Key points: </strong>Body composition parameters correlate with oncological outcomes in RCC, but remain underexplored in the T1 clear cell subtype. Elevated Leibovich score, visceral adipose tissue density, and intramuscular adipose tissue content independently predicted reduced RFS, linked to cancer-related and metabolic pathways enrichment. The body composition parameters-based nomogram could effectively predict postoperative recurrence in T1 ccRCC patients.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"30"},"PeriodicalIF":4.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105345","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":"MRI-derived radiomics for risk stratification of tumor deposits in rectal cancer: a dual-center study.","authors":"Changjiang Zhang, Xiaojuan Deng, Zehong Cao, Feng Shi, Yi Yang, Yutong Chen, Huan Zhao, Xiaojing He, Xinjie Liu, Yindeng Luo","doi":"10.1186/s13244-025-02204-1","DOIUrl":"10.1186/s13244-025-02204-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic utility of MRI-based radiomics in stratifying the risk of tumor deposits (TD) in patients with rectal cancer (RC).</p><p><strong>Materials and methods: </strong>This study retrospectively analyzed 729 patients with RC from two institutions (January 2018-August 2024). Patients were classified into three groups according to the number of TD: no TD (TD0), 1-2 TD (TD1-2), and ≥ 3 TD (TD3+). Radiomics features were extracted from the tumor and the largest nodule within the rectal mesentery on MRI images. Predictive models were developed with the XGBoost algorithm. Model performance was evaluated using the receiver operating characteristic curve, area under the curve, confusion matrix, precision, accuracy, recall, and F1 score.</p><p><strong>Results: </strong>Three hundred seventy-six patients were ultimately included and allocated into training, test, and validation sets. The tumor model (developed using tumor features) achieved AUCs of 0.871 (test set) and 0.848 (validation set), with corresponding accuracy, precision, recall, and F1 of 0.745/0.716, 0.764/0.688, 0.764/0.734, and 0.764/0.710, respectively. The nodule model (developed using the largest nodule) yielded AUCs of 0.839/0.804, accuracy of 0.673/0.637, precision of 0.571/0.614, recall of 0.800/0.686, and F1 of 0.667/0.648 in the test and validation sets, respectively. The fusion model, which combined tumor and nodule features, achieved enhanced performance with AUCs of 0.873/0.858, accuracy of 0.800/0.784, precision of 0.804/0.712, recall of 0.745/0.775, and F1 of 0.774/0.742, outperformed both individual models and two radiologists (accuracy 0.676/0.589).</p><p><strong>Conclusions: </strong>MRI-derived radiomics demonstrates significant potential for risk stratification of TD in RC.</p><p><strong>Critical relevance statement: </strong>The radiomics model integrating tumor features and maximal short-axis diameter of mesorectal nodules effectively predicts three distinct quantity-based categories of TD in RC, enabling preoperative risk stratification and assisting personalized treatment planning.</p><p><strong>Key points: </strong>Tumor and nodule features support effective stratification of TD. The fusion model for TD classification outperforms two radiologists. MRI-based radiomics aids TD risk stratification.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"31"},"PeriodicalIF":4.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105375","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 potential association between degree of mammographic spiculation and prognosis.","authors":"Li Sturesdotter, Hanna Sartor, Hedvig Kristensson, Oskar Hagberg, Kristina Lång","doi":"10.1186/s13244-025-02194-0","DOIUrl":"10.1186/s13244-025-02194-0","url":null,"abstract":"<p><strong>Objectives: </strong>Mammographically spiculated breast cancer is frequently less aggressive than cancers with alternative appearances. This study aims to investigate whether the degree of spiculations relative to the tumor mass on mammography, termed the spic mass ratio (SMR), is associated with breast cancer characteristics and survival.</p><p><strong>Materials and methods: </strong>This retrospective exploratory single-center study analyzed mammograms from 161 women with spiculated breast cancer in the Malmö Diet and Cancer Study cohort (2004-2014). Radiologists segmented the tumor mass and the spiculation areas. The SMR was calculated by dividing the combined tumor and spiculation area by the tumor area alone. The subjects were stratified into tertiles with low, medium, and high SMR. The study examined associations between SMR and breast density, mode of detection, age, tumor size, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, Ki67, histological grade, axillary lymph node involvement (ALNI), histological type, and breast cancer-specific survival, utilizing the Chi-squared test, ANOVA, Fisher's exact test, Kaplan-Meier curves, and Cox regression.</p><p><strong>Results: </strong>The mean age was 68 years (range 55-91). SMR was statistically significantly associated with both age and breast density. No other significant associations were observed. Among the nine women with the highest SMR values, axillary lymph node negativity, estrogen positivity, and an overall low Ki67 index were noted.</p><p><strong>Conclusions: </strong>The SMR, representing the degree of spiculations relative to tumor mass, was not significantly associated with breast cancer survival or ALNI. Further research is necessary to explore the prognostic implications of extensive spiculations in spiculated breast cancer.</p><p><strong>Critical relevance statement: </strong>The degree of spiculation relative to the tumor mass is an unexplored mammographic feature that can be measured subjectively, as in this study. Extensive spiculation was associated with higher age and lower breast density. No certain conclusions could be drawn regarding the impact on breast cancer survival.</p><p><strong>Key points: </strong>The degree of spiculation relative to the tumor mass on mammography is an unexplored mammographic feature. A high ratio of spiculations in relation to tumor mass was associated with higher age and lower breast density. The nine women with a very high spiculation to tumor mass ratio were all axillary lymph node negative.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"29"},"PeriodicalIF":4.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105342","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":"An integrative deep learning model based on dual-mode ultrasound for diagnosing gallbladder polyps.","authors":"Congyu Tang, Yilei Shi, Lifan Wang, Xing Zhao, Chunlei Li, Peishan Guan, Zhidan Geng, Jianfei Chen, Qing Yu, Wenping Wang, Xiao Xiang Zhu, Haixia Yuan","doi":"10.1186/s13244-026-02213-8","DOIUrl":"10.1186/s13244-026-02213-8","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to develop an artificial intelligence model to automatically differentiate between non-neoplastic and neoplastic gallbladder polyps, while also distinguishing benign from malignant polyps.</p><p><strong>Materials and methods: </strong>Patients with gallbladder polyps who underwent cholecystectomy from January 2022 to June 2023 were recruited from two hospitals retrospectively. Conventional ultrasound findings and clinical characteristics of patients before cholecystectomy were acquired. Ultrasound image blocks of gallbladder lesions were automatically segmented by the Unet network for diagnosis. A fusion deep learning model based on dual-mode ultrasound (grey-scale ultrasound and colour Doppler flow imaging) was established to diagnose gallbladder polyps and validated in the validation and test set. Finally, we compared the diagnostic efficiency of the model with that of radiologists and guidelines.</p><p><strong>Results: </strong>A total of 339 patients (mean ages 53.17 ± 15.89, 182 females) were enroled in this study. The Dice coefficient and intersection over union (IoU) value of the automatic segmentation based on the Unet-efficientnet-b4 network were 0.912 and 0.838. In differentiating non-neoplastic from neoplastic polyps, the integrative deep learning (IDL) model showed area under the curves (AUCs) of 0.829 and 0.802 in validation and test sets, respectively. In differentiating benign and malignant polyps, the IDL model showed AUCs of 0.844 and 0.839 in validation and test sets, respectively. In the test set, the diagnostic performance of two junior radiologists was improved with the assistance of the IDL model.</p><p><strong>Conclusion: </strong>The IDL model based on dual-mode ultrasound could achieve accurate and automatic segmentation of gallbladder lesions, and showed excellent diagnostic performance for diagnosing gallbladder polyps.</p><p><strong>Critical relevant statement: </strong>We developed a deep learning model based on conventional ultrasound that performs gallbladder segmentation while differentiating neoplastic from non-neoplastic polyps and benign from malignant polyps.</p><p><strong>Key points: </strong>Diagnosing gallbladder polyps through a deep learning model based on conventional ultrasound presents challenges. IDL model enables automated segmentation of the gallbladder and diagnosis of gallbladder polyps. The IDL model is a reliable tool to assist junior radiologists in diagnosis and has potential for reducing unnecessary cholecystectomies.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"32"},"PeriodicalIF":4.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105385","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":"Assessment of MRI susceptibility-weighted imaging-based liver-to-muscle signal intensity ratios for the staging of liver fibrosis.","authors":"Xuan Jin, Yufan Ren, Xuchang Zhang, Haojun Lu, Jiaqi Lv, Tianyuan Zhang, Wen Liang, Yongzhou Xu, Qing Yu, Xianyue Quan, Xinming Li","doi":"10.1186/s13244-025-02203-2","DOIUrl":"10.1186/s13244-025-02203-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility of susceptibility-weighted imaging (SWI) for the diagnosis of different stages of liver fibrosis, and to assess its diagnostic accuracy compared with the serum fibrosis index commonly used in clinical settings.</p><p><strong>Materials and methods: </strong>This prospective study included 108 patients and 16 healthy volunteers. All patients underwent MRI with SWI and histopathological evaluation. Liver and bilateral erector spinae signal intensities were measured on SWI to calculate liver-to-muscle signal intensity ratios (SIR). Serological biomarkers were collected to calculate the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4). Histological correlation analysis between the SIR and liver fibrosis/iron deposition was performed using Spearman's rank correlation analysis. The diagnostic accuracies of SIR, APRI, and FIB-4 for staging liver fibrosis were assessed, and their performances were compared using the DeLong test.</p><p><strong>Results: </strong>Receiver operating characteristic (ROC) curve analysis showed good-to-excellent diagnostic performance of SIR for different stages of liver fibrosis. The areas under the curve (AUC) of SIR for the diagnosis of liver fibrosis stages S0 vs S1-S4, S0-S1 vs S2-S4, S0-S2 vs S3-S4, and S0-S3 vs S4 were 0.851, 0.868, 0.872, and 0.931. Delong's test showed that the SIR outperformed the APRI and FIB-4 in the diagnosis of liver fibrosis S0-S1 vs S2-S4, S0-S2 vs S3-S4, and S0-S3 vs S4 (p = 0.011-0.036).</p><p><strong>Conclusion: </strong>SWI-based SIR outperforms the serum indicators APRI and FIB-4 in diagnosing liver fibrosis of S0-S1 vs S2-S4, S0-S2 vs S3-S4, and S0-S3 vs S4.</p><p><strong>Critical relevance statement: </strong>SWI-based SIR offers a new perspective on non-invasive diagnostic methods to guide the clinical diagnosis of liver fibrosis, particularly in cases where biopsy is contraindicated or impractical.</p><p><strong>Key points: </strong>Searching for a non-invasive method to accurately diagnose stages of liver fibrosis is necessary because of the limitations of histopathological evaluation. SWI offers a dependable and non-invasive diagnostic approach for evaluating different stages of liver fibrosis compared to serological biomarkers. SWI-based SIR provides a highly accurate, non-invasive alternative to serum biomarkers for detecting advanced liver fibrosis.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"27"},"PeriodicalIF":4.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146062644","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":"Imaging persistent spinal pain syndrome and spine surgery complications: an interpretation guide for radiologists.","authors":"Jean-François Budzik, Tatiana Musset, Guillaume Lefebvre, Julie Legrand, Julien Decaudain, Vincent Ducoulombier, Sébastien Verclytte","doi":"10.1186/s13244-025-02065-8","DOIUrl":"10.1186/s13244-025-02065-8","url":null,"abstract":"<p><p>This educational review provides a comprehensive guide for radiologists on the imaging interpretation of persistent spinal pain syndrome (PSPS) and complications following spine surgery. PSPS, previously known as failed back surgery syndrome, describes persistent or recurrent, primarily neuropathic, pain after spine surgery affecting 10-40% of patients. Radiologists often encounter challenges in diagnosing PSPS due to unfamiliarity with postoperative anatomical modifications and the complexity of surgical interventions. This review emphasises the necessity of correlating imaging findings with the clinical context through an interdisciplinary collaboration, while keeping in mind the particular psychological context of postoperative patients in chronic pain. We focus on lumbar spine surgery such as lumbar spine discectomy, lumbar spine stenosis, posterior decompression and stabilisation-fusion procedures. The review offers practical insights into managing key clinical scenarios: early complications with genuine emergencies, but also more subtle diagnoses such as low-grade infections or hardware failures. We underscore the utility of various imaging modalities-radiography, CT, MRI, PET and SPECT, and propose the ideal combination for each clinical situation. Plain radiographs are useful for assessing patients in standing positions and detecting intervertebral instability. CT is ideal for examining bone fusion and surgical hardware, while MRI excels in soft tissue analysis. PET and SPECT provide crucial insights into bone metabolism, detecting micromobility or infections. Based on 15 years of interdisciplinary collaboration, this guide, based on clinical scenarios, aims to enhance radiologists' confidence and accuracy in interpreting postoperative spine imaging, improving diagnostic precision, patient management and communication with referring clinicians. KEY POINTS: Managing postoperative spine imaging is often challenging for surgeons and radiologists. Postoperative spine imaging requires precise clinical correlation and careful multidisciplinary evaluation. Different imaging modalities can be combined to answer difficult issues.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"26"},"PeriodicalIF":4.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12847616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146062668","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":"Fetal MRI: abdominal cystic lesions.","authors":"David García Castellanos, Manuel Recio Rodríguez, Lucía Sanabria Greciano, Alejandra Aguado Del Hoyo, Alejandro Díaz Moreno, Julia López Alcolea, Carolina Sampietro, Vicente Martínez de Vega","doi":"10.1186/s13244-025-02169-1","DOIUrl":"10.1186/s13244-025-02169-1","url":null,"abstract":"<p><p>Fetal MRI has become an essential tool for evaluating abdominal cystic lesions detected on prenatal ultrasound, offering superior soft tissue contrast and multiplanar imaging capabilities. This observational case series, conducted at Quironsalud Madrid University Hospital, analyzed fetuses diagnosed with abdominal cystic lesions who underwent fetal MRI. Lesions were classified into gastrointestinal, genitourinary, teratomatous, and syndromic categories. Fetal MRI allowed for precise lesion characterization, differentiating cystic masses from solid or mixed lesions, and identifying associated structural abnormalities. MRI findings were correlated with fetal ultrasound and, when available, postnatal imaging or surgical outcomes, demonstrating complementary information and improved diagnostic confidence compared to ultrasound alone. This improved accuracy has direct clinical implications, aiding in prenatal counseling, optimizing perinatal management, and guiding postnatal surgical planning. Our results reinforce the role of fetal MRI as a complementary imaging modality for refining the diagnosis of congenital abdominal cystic lesions and improving neonatal outcomes. CRITICAL RELEVANCE STATEMENT: This article critically evaluates the role of fetal MRI, in conjunction with prenatal ultrasound, in characterizing abdominal cystic lesions, highlighting its diagnostic advantages over ultrasound and its clinical impact on prenatal counseling, perinatal management, and postnatal surgical planning in radiological practice. KEY POINTS: Abdominal cystic lesions are frequently detected on prenatal ultrasound, but their characterization and differentiation remain challenging. Fetal MRI characterizes lesions, assesses their extent, improves classification and diagnosis, and offers superior soft tissue contrast for evaluating complex anomalies. Fetal MRI complements prenatal ultrasound, allowing a more precise assessment of lesion characteristics and facilitating prenatal counseling and perinatal planning.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":"28"},"PeriodicalIF":4.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146062721","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}