Insights into Imaging最新文献

{"title":"MRI-derived radiomics model for predicting intratumoral tertiary lymphoid structures in soft tissue sarcoma.","authors":"Tongyu Wang, Liping Wang, Hao Zhong, Yuanyuan Zong, Feng Hou, Hexiang Wang, Ruizhi Zhou, Song Gao, Xianglong Shi, Jiangfei Yang, Dapeng Hao","doi":"10.1186/s13244-025-02086-3","DOIUrl":"10.1186/s13244-025-02086-3","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and validate an MRI-derived radiomics model for the prediction of intratumoral tertiary lymphoid structures (TLSs) status of soft tissue sarcoma (STS) and explore its prognostic value.</p><p><strong>Materials and methods: </strong>This study retrospectively included 302 patients of three cohorts who underwent surgical resection of STS from two medical centers. Radiomics features were derived for both intratumoral and peritumoral regions from preoperative axial fat-suppressed T2-weighted and T1-weighted imaging sequences. Intratumoral, peritumoral, and combined radiomics models were constructed using a logistic regression algorithm. The area under the receiver operator characteristic curve (AUC) and the DeLong test were utilized to assess and compare the performances of three radiomics models. By applying a linear combination of the chosen features, the Rad-score for the optimal radiomics model was computed.</p><p><strong>Results: </strong>TLS positivity was identified in 114 (38%) of the 302 patients. No clinical, radiological, or pathological variable was found to show a statistically significant association with TLSs status. The combined radiomics model showed superior performance compared to both the intratumoral and peritumoral models, with an AUC of 0.878 (95% CI 0.812-0.927) in the development cohort, 0.778 (95% CI 0.649-0.876) in the internal validation cohort, and 0.772 (95% CI 0.679-0.850) in the external validation cohort. In the cohort for all patients, the 36-month cumulative PFS rate was 66.1% in the high Rad-score (≥ 0.5) group vs. 37.2% in the low Rad-score group (p < 0.05, log-rank test).</p><p><strong>Conclusion: </strong>An MRI-derived radiomics model could predict intratumoral TLS status in patients with STS and demonstrated a correlation with PFS.</p><p><strong>Critical relevance statement: </strong>The MRI-derived radiomics model could predict intratumoral TLSs status in patients with STS accurately, which may help to screen patients who will benefit from immunotherapy and have a better prognosis.</p><p><strong>Key points: </strong>Intratumoral tertiary lymphoid structure status in patients with soft tissue sarcomas was accurately predicted by an MRI-derived radiomics model. The combined radiomics model showed superior performance compared to both the intratumoral and peritumoral radiomics models. Progression-free survival was significantly longer in patients with a high Rad-score (≥ 0.5) in the development, internal validation, and external validation cohorts.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"201"},"PeriodicalIF":4.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124550","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":"Enhancing OSCE reliability and effectiveness in radiology resident training with long-term systemic evaluation.","authors":"Ning Ding, Xinyu Gao, Hao Sun, Lan Song, Xuan Wang, Yu Chen, Daming Zhang, Zhengyu Jin, Huadan Xue","doi":"10.1186/s13244-025-02024-3","DOIUrl":"10.1186/s13244-025-02024-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the long-term systematic effectiveness and reliability of the Objective Structured Clinical Examination (OSCE) in radiology resident training, from the perspectives of both examiners and examinees.</p><p><strong>Methods: </strong>This retrospective observational study analyzed subjective evaluations and objective examination data collected over 6 years (2018-2021, 2023, and 2024). Subjective evaluations were gathered via questionnaires from 198 examiners and 818 examinees to assess the difficulty and satisfaction with the OSCE. Objective data, including examination scores, difficulty indices, and discrimination indices, for each OSCE station were analyzed using correlation analysis and t-tests.</p><p><strong>Results: </strong>The OSCE demonstrated stable performance over 6 years, with consistent difficulty levels and discrimination ability across all stations. The average scores for individual stations varied; however, the overall final scores remained stable. Strong correlations between the station and final scores indicate good discrimination. Examinees rated the overall difficulty higher than examiners, but the objective indices aligned with examiner assessments. Over 6 years (198 examiners, 818 examinees), OSCE scores stabilized (85.48-88.48), with improved consistency (station range narrowed to 85.51-93.9 by 2024). Difficulty (0.12-0.15) and discrimination indices remained stable (most p < 0.05). Examinees rated it harder than examiners (p < 0.001).</p><p><strong>Conclusion: </strong>The OSCE is a reliable, valid, and effective assessment tool in radiology. Evaluating the OSCE from both subjective and objective perspectives ensured the robustness and validity of the examination.</p><p><strong>Critical relevance statement: </strong>This 6-year study evaluates the Objective Structured Clinical Examination (OSCE) in radiology training through multidimensional analysis of examination metrics (difficulty indices and discrimination coefficients) and stakeholder feedback (n = 198 examiners, 818 examinees), demonstrating its consistency for clinical competency assessment.</p><p><strong>Key points: </strong>The radiology OSCE demonstrated consistent reliability, stable difficulty indices, and strong score correlations. Examinees overestimated exam difficulty compared to examiners, likely due to stress-related perception bias. Standardized examiner training improved scoring consistency and enhanced overall OSCE assessment quality.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"203"},"PeriodicalIF":4.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130714","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":"Dynamic contrast-enhanced ultrasound perfusion analysis for preoperative prediction of aggressive hepatocellular carcinoma subtypes.","authors":"Xin Guan, Xiao Li, Daohui Yang, Chongke Zhao, Dan Lu, Yaqin Zhang, Yikang Sun, Boyang Zhou, Zitong Chen, Xinyuan Hu, Hong Han, Qing Lu, Huixiong Xu, Lifan Wang","doi":"10.1186/s13244-025-02052-z","DOIUrl":"10.1186/s13244-025-02052-z","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the potential of dynamic contrast-enhanced ultrasound (CEUS) quantitative parameters in preoperative prediction of macrotrabecular-massive (MTM) subtype and high Ki-67 pattern in hepatocellular carcinoma (HCC) patients.</p><p><strong>Materials and methods: </strong>This study included a retrospective primary cohort and a multicenter prospective validation cohort comprising HCC patients who underwent surgical resection and preoperative CEUS between January 2023 and April 2024. The Clinic-CEUS model was established by combining clinical data and CEUS features, while the Clinic-Q-CEUS model was constructed by combining clinical data and CEUS features with matched quantitative parameters. Model performance was tested with the area under the receiver operating characteristic curve (AUC) in the validation cohort.</p><p><strong>Results: </strong>A total of 170 patients (mean age, 61 years ± 11 [SD]; 130 men; primary cohort, n = 118; validation cohort, n = 52) were included. The Clinic-Q-CEUS model better predicted MTM subtype and high Ki-67 pattern than the Clinic-CEUS model (AUC, 0.860 vs. 0.753, p = 0.027 and AUC, 0.836 vs. 0.738, p = 0.036) in the primary cohort, with similar performance in the validation cohort (AUC, 0.868 vs. 0.693, p = 0.046 and AUC, 0.787 vs. 0.610, p = 0.018).</p><p><strong>Conclusions: </strong>Dynamic CEUS quantification analysis could be used as an effective adjunct tool for preoperative identification of MTM subtype and high Ki-67 pattern in HCC patients.</p><p><strong>Critical relevance statement: </strong>Dynamic contrast-enhanced ultrasound (CEUS) quantitative parameters can help radiologists more accurately identify aggressive macrotrabecular-massive (MTM) subtype and high Ki-67 pattern in HCC patients preoperatively, which provides useful information for subsequent treatment planning.</p><p><strong>Key points: </strong>Macrotrabecular-massive (MTM) subtype and high Ki-67 pattern in HCC affect prognosis, but diagnosis relies on invasive histopathology. A clinical-Q-CEUS model performed well in preoperative predicting aggressive HCC subtypes. Quantitative parameters of dynamic CEUS can provide valuable information to help accurately identify aggressive HCC subtypes.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"202"},"PeriodicalIF":4.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130721","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 pictorial essay of thoracic wall diseases: multiple pathologies in the same anatomical site.","authors":"Giuliana La Rosa, Miriam Adorna, Letizia Antonella Mauro, Monica Pennisi, Andrea Giovanni Musumeci, Alessandra Sigona, Claudia Mattina, Giuseppe Belfiore, Pietro Valerio Foti, Antonio Basile, Stefano Palmucci","doi":"10.1186/s13244-025-02073-8","DOIUrl":"10.1186/s13244-025-02073-8","url":null,"abstract":"<p><strong>Objectives: </strong>To describe diagnostic and radiological features of the main pathologies affecting the thoracic wall, providing a pictorial atlas based on several clinical cases extracted from our archive.</p><p><strong>Materials and methods: </strong>A wide variety of pathologies affect the tissues of the thoracic cage; these conditions are often encountered by radiologists during examinations performed for unrelated clinical questions. Modern imaging techniques enable the detection of these pathologies and allow definitive diagnoses to be achieved.</p><p><strong>Results: </strong>Pathological processes that involve the chest wall may be classified into: (1) congenital and developmental diseases: pectus excavatum, pectus carinatum, supernumerary rib syndrome, Poland syndrome, neurofibromatosis, osteogenesis imperfecta, mucopolysaccharidosis, Marfan syndrome; (2) infectious and inflammatory diseases-such as aspergillosis, tuberculosis, abscesses from pyogenic bacteria, Tietze's syndrome; (3) bone injuries (traumatic and degenerative diseases): sternal, vertebral and costal fractures, degenerative disc and arthrosis pathology; (4) chest wall tumors-such as sarcomas, lymphomas, neurogenic tumors, lipoma.</p><p><strong>Conclusions: </strong>Thoracic wall pathologies include a wide spectrum of conditions, with some clinical implications that often require a correct nosological framing. Recognizing these pathologies is essential for radiologists so that they can make a correct description in the report and direct toward appropriate treatment if required.</p><p><strong>Critical relevance statement: </strong>Cage diseases are various and difficult to understand, so multimodality imaging plays a crucial role in achieving an efficient and final diagnosis.</p><p><strong>Key points: </strong>Thoracic wall pathologies have different etiologies. Imaging represents a fundamental tool to clarify their extension, location, and nature. The prognosis of some of these diseases can be poor.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"200"},"PeriodicalIF":4.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102813","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":"Pretreatment intravoxel incoherent motion histogram metrics and clinical characteristics for prediction of perineural invasion status and survival in patients with rectal cancer.","authors":"Ao Yang, Hao Xu, Xin Zhang, Ping Zheng, Li Bo Lin, Jie Ke Liu, Peng Zhou, Xiao Li Chen","doi":"10.1186/s13244-025-02075-6","DOIUrl":"10.1186/s13244-025-02075-6","url":null,"abstract":"<p><strong>Objectives: </strong>To explore intravoxel incoherent motion (IVIM) for evaluation of the perineural invasion (PNI) status and survival in patients with rectal cancer.</p><p><strong>Materials and methods: </strong>The true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and microvascular volume fraction (f) were recorded together with histogram metrics. Differences in IVIM histogram metrics between the PNI-positive group and the PNI-negative group were analyzed. Univariable and multivariable logistic regression analysis were used for model construction. The area under the receiver operating characteristic curve (AUC) was used to assess the diagnostic performance of the models. Histopathology was used as the PNI endpoint. Kaplan-Meier curve analysis was employed to estimate the disease-free survival (DFS) and overall survival (OS) of patients.</p><p><strong>Results: </strong>A total of 175 patients were retrospectively enrolled in this study. Multivariable logistic regression analysis showed that higher D_median (odds ratio (OR) = 2.036, p = 0.003) and D_min (OR = 1.479, p = 0.002) and lower f_SD (OR = 0.697, p < 0.001) and f_kurtosis (OR = 0.485, p < 0.001) were independently associated with PNI-positive. The combined model showed the best performance in predicting the PNI status with AUCs, sensitivity, specificity, and accuracy of 0.885, 81.67%, 82.61%, and 82.29%, respectively. Kaplan-Meier curves analysis revealed that the patients with higher scores (> -1.12) of the combined model showed relatively lower 2-year DFS (81.6% vs 93.2%, p = 0.014) compared to the patients with lower scores (≤ -1.12).</p><p><strong>Conclusion: </strong>IVIM histogram metrics could predict the PNI status and serve as a preoperative risk stratification tool.</p><p><strong>Critical relevance statement: </strong>The combination of IVIM histogram metrics and clinical characteristics could discriminate the PNI status and serve as a surrogate for PNI.</p><p><strong>Key points: </strong>The PNI is an important prognostic factor in rectal cancer. The IVIM histogram metrics were associated with the PNI status. The combination of IVIM and clinical factors could serve as a surrogate for PNI.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"199"},"PeriodicalIF":4.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086042","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":"Benefits and challenges of multi-delay arterial spin labeling in clinical practice: measuring perfusion and cerebrovascular reactivity in intracranial steno-occlusive disease.","authors":"Simone M Uniken Venema, Alex Bhogal, Jan Willem Dankbaar, H Bart van der Worp, Jeroen Hendrikse, Bart van der Zwan, Kees Braun, Jeroen C W Siero, Pieter T Deckers","doi":"10.1186/s13244-025-02077-4","DOIUrl":"10.1186/s13244-025-02077-4","url":null,"abstract":"<p><p>Magnetic resonance imaging (MRI) techniques have now widely replaced positron emission tomography (PET) as the modality of choice to assess cerebrovascular reactivity (CVR) and other hemodynamic parameters in intracranial steno-occlusive disease (ISOD), such as moyamoya vasculopathy (MMV). Therefore, radiologists should be aware of the choices in imaging techniques and potential pitfalls in the imaging interpretation. We developed a protocol based on multi-delay arterial spin labeling (ASL), with which, since its implementation in routine clinical practice in 2018, approximately 100 patients have been evaluated for CVR and other parameters. The protocol demonstrates clinical feasibility and utility, allowing detailed cerebral hemodynamic evaluations of individual patients that are useful for clinical decision-making. While multi-delay ASL offers benefits compared to single-delay ASL in patients with arterial transit delays, it is not completely insensitive to transit times, and further methodological improvements could mitigate this issue in the near future. Potential pitfalls in imaging acquisition and interpretation include artefacts due to motion, susceptibility, and misalignment in imaging registration, inadequate labeling, and the effects of anesthesia on CVR. This work serves as a practical guide for clinicians, radiologists, and MRI experts seeking to implement these advanced imaging methods in their institutions. CRITICAL RELEVANCE STATEMENT: Our MRI protocol, based on multi-delay ASL with a vascular challenge of acetazolamide, can be successfully used for hemodynamic assessments of patients with ISOD in clinical settings. KEY POINTS: We developed and implemented a protocol using acetazolamide-augmented multi-delay ASL for hemodynamic assessments in patients with steno-occlusive disease. Obtaining hemodynamic maps from ASL source data requires pre- and post-processing steps using customized toolboxes. CVR, if decreased, indicates hemodynamic compromise. Multi-delay ASL is not completely insensitive to delayed arterial transit, and technical improvements are needed to mitigate this.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"197"},"PeriodicalIF":4.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080658","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":"Technical requirements and optimization strategies for home-based teleradiology workstations: a review article.","authors":"Mustafa S Alhasan, Ayman S Alhasan","doi":"10.1186/s13244-025-02081-8","DOIUrl":"10.1186/s13244-025-02081-8","url":null,"abstract":"<p><p>Teleradiology has advanced from an occasional modality to a cornerstone of modern radiology practice, with the COVID-19 pandemic catalyzing widespread adoption of home-based reading environments. This review synthesizes current literature and expert recommendations on hardware and software optimization for effective home-based teleradiology implementation. Available data indicate 65% of institutions established home workstations during the pandemic, with 74% transitioning routine daytime shifts to internal teleradiology. We reviewed key components of successful remote reading environments, including diagnostic display specifications, environmental controls, ergonomic considerations, computational infrastructure, and network architecture. Evidence suggests that properly configured remote workstations maintain diagnostic performance equivalent to hospital reading rooms while enhancing radiologist satisfaction and productivity. We found that 65% of radiologists reported reduced stress levels when working from home, and 96% observed similar or improved report turnaround times. Essential technical specifications include display luminance standards, ambient lighting levels between 25 and 75 lux, acoustic conditions below 40 decibels, and temperature control within 20-24 °C. Computational requirements include a minimum sustained bandwidth of 50-100 Mbps. We review multi-layered security architectures and workflow integration strategies supporting distributed reading environments. Our review concludes that properly implemented home-based teleradiology is a viable practice model extending specialized expertise across geographic boundaries while promoting radiologist well-being. However, knowledge gaps remain in technical standardization, regulatory harmonization, and long-term clinical outcomes, underscoring the need for further research to support confident, data-driven teleradiology implementation. CRITICAL RELEVANCE STATEMENT: This review critically evaluates the technical, ergonomic, and operational requirements for home-based teleradiology, offering evidence-based recommendations that address current practice gaps and support the development of sustainable, high-performance remote reading environments in modern clinical radiology. KEY POINTS: Home teleradiology maintains diagnostic quality while improving radiologist well-being; 65% report reduced stress and 96% show similar or improved report turnaround times. Optimal implementation requires medical-grade displays, a controlled environment (25-75 lux lighting), 50-100 Mbps bandwidth, and robust security measures. Standardization varies across jurisdictions; some countries have protocols, but gaps persist in cross-border teleradiology and long-term outcomes assessment.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"198"},"PeriodicalIF":4.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080588","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":"Percutaneous microwave ablation of bone lesions: a retrospective cohort study.","authors":"Sylvain Bodard, Amgad M Moussa, Max Vaynrub, Meredith Bartelstein, Ernesto Santos-Martin, Majid Maybody, Francois H Cornelis","doi":"10.1186/s13244-025-02083-6","DOIUrl":"10.1186/s13244-025-02083-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility, safety, and efficacy of microwave ablation (MWA) of bone lesions with regard to local control and pain palliation.</p><p><strong>Materials and methods: </strong>We reviewed 43 patients (23 males, 20 females) with 51 lesions (44 metastatic, 7 benign) treated with MWA from January 2016 to December 2023. Pain intensity was measured using the Visual Analogue Scale (VAS), SF-36 Bodily Pain Scale, and Patient Global Impression of Change (PGIC) from pre-operation to various follow-up stages. Adverse events were categorized according to the Society of Interventional Radiology (SIR) grading system.</p><p><strong>Results: </strong>The procedure demonstrated 100% technical success. Grades I and III adverse events were observed in 8.3% (3/36) and 2.8% (1/36) of patients with metastatic disease, respectively. In those with benign lesions, no adverse events were reported. A significant reduction in pain was observed, with the VAS score decreasing by 74.3% from baseline to the last follow-up [6.7 ± 2.3 (range: 0-10) to 1.8 ± 2.3 (range: 0-7) (p < 0.001)] for metastatic patients, and from 5.7 ± 2.1 (range: 3-8) to 0 ± 0 (range: 0-0) by the final follow-up (p = 0.0011) for benign lesions. 77.8% (29/36) of metastatic patients, and all (7/7) benign patients were much or very much improved according to Patient Global Impression Change. Complete imaging response was achieved in 55.6% (20/36) of metastatic lesions. At last follow-up, 25% (9/36) had radiological evidence of recurrence, with a median recurrence time of 13 months (IQR: 8-14). Complete response was achieved in all benign lesions.</p><p><strong>Conclusions: </strong>MWA is a safe and effective treatment for pain management in patients with bone lesions.</p><p><strong>Critical relevance statement: </strong>This study confirms the potential of microwave ablation as a treatment for bone lesions, providing significant pain relief with a favorable safety profile.</p><p><strong>Key points: </strong>Microwave ablation (MWA) significantly reduced pain scores in patients with bone lesions, maintaining pain relief over time. The procedure exhibited high technical success with minimal adverse events, indicating a high safety profile. Subgroup analysis revealed no significant differences in pain reduction among different procedural combinations over time.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"193"},"PeriodicalIF":4.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075185","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":"Augmenting conventional criteria: a CT-based deep learning radiomics nomogram for early recurrence risk stratification in hepatocellular carcinoma after liver transplantation.","authors":"Ziqian Wu, Danyang Liu, Siyu Ouyang, Jingyi Hu, Jie Ding, Qiu Guo, Jidong Gao, Jiawen Luo, Ke Ren","doi":"10.1186/s13244-025-02082-7","DOIUrl":"10.1186/s13244-025-02082-7","url":null,"abstract":"<p><strong>Background: </strong>We developed a deep learning radiomics nomogram (DLRN) using CT scans to improve clinical decision-making and risk stratification for early recurrence of hepatocellular carcinoma (HCC) after transplantation, which typically has a poor prognosis.</p><p><strong>Materials and methods: </strong>In this two-center study, 245 HCC patients who had contrast-enhanced CT before liver transplantation were split into a training set (n = 184) and a validation set (n = 61). We extracted radiomics and deep learning features from tumor and peritumor areas on preoperative CT images. The DLRN was created by combining these features with significant clinical variables using multivariate logistic regression. Its performance was validated against four traditional risk criteria to assess its additional value.</p><p><strong>Results: </strong>The DLRN model showed strong predictive accuracy for early HCC recurrence post-transplant, with AUCs of 0.884 and 0.829 in training and validation groups. High DLRN scores significantly increased relapse risk by 16.370 times (95% CI: 7.100-31.690; p  < 0.001). Combining DLRN with Metro-Ticket 2.0 criteria yielded the best prediction (AUC: training/validation: 0.936/0.863).</p><p><strong>Conclusion: </strong>The CT-based DLRN offers a non-invasive method for predicting early recurrence following liver transplantation in patients with HCC. Furthermore, it provides substantial additional predictive value with traditional prognostic scoring systems.</p><p><strong>Critical relevance statement: </strong>AI-driven predictive models utilizing preoperative CT imaging enable accurate identification of early HCC recurrence risk following liver transplantation, facilitating risk-stratified surveillance protocols and optimized post-transplant management.</p><p><strong>Key points: </strong>A CT-based DLRN for predicting early HCC recurrence post-transplant was developed. The DLRN predicted recurrence with high accuracy (AUC: 0.829) and 16.370-fold increased recurrence risk. Combining DLRN with Metro-Ticket 2.0 criteria achieved optimal prediction (AUC: 0.863).</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"194"},"PeriodicalIF":4.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080624","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":"Novel ultrasound classification of tubal ectopic pregnancy: exploring underlying connections among sonographic and serum markers.","authors":"Na Su, Lin-Ru Fu, Zhe Du, Hua-Zhen Liu, Zhao Tian, Tao Xu, Zi-Jing Fu, Zhen-Hong Qi, Zhi-Jing Sun","doi":"10.1186/s13244-025-02079-2","DOIUrl":"10.1186/s13244-025-02079-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to propose a novel ultrasound classification for tubal ectopic pregnancy (TEP) and explore relationships between sonographic features and serum markers.</p><p><strong>Materials and methods: </strong>A retrospective single-center cohort study was conducted involving TEP patients, who were classified into two groups (simple gestational sac (GS)-like and complicated masses) based on ultrasound characteristics indicating a clear trophoblastic ring, hematosalpinx, or clear salpinx structure. Statistical comparisons and Spearman's rank correlation analyses were performed.</p><p><strong>Results: </strong>In this study, 320 women with TEP were classified into a simple GS-like mass group (n = 128) and a complicated mass group (n = 192). Compared with complicated masses, simple GS-like masses were smaller, had higher β-human chorionic gonadotropin (β-hCG) levels, and higher color Doppler flow imaging grades (all p < 0.05). β-hCG was strongly correlated with mass size in simple GS-like mass cases (r = 0.720, p < 0.01), but weakly correlated in complicated mass cases (r = 0.211, p < 0.01). Hemoglobin levels were inversely correlated with pelvic free fluid depth in complicated masses (r = -0.344, p < 0.01).</p><p><strong>Conclusions: </strong>The proposed ultrasound classification differentiates TEPs into subtypes with unique clinical and pathophysiological profiles. The variation in the correlation among sonographic indices and serum markers across TEP subtypes underscores the necessity for tailored clinical strategies. In simple GS-like masses, β-hCG and mass size are positively correlated, thus, clinical decisions could be made based on these two factors as recommended by guidelines. However, in complicated masses, β-hCG and mass size were poorly correlated, thus, the mass size should be deemphasized. Decisions should be made through comprehensive assessments under such circumstances.</p><p><strong>Critical relevance statement: </strong>The novel ultrasound-based classification proposed in this study differentiates tubal ectopic pregnancies into simple gestational-sac-like and complicated subtypes presenting with different correlations between sonographic indices and serum markers, which require tailored strategies in clinical settings.</p><p><strong>Key points: </strong>Addresses the lack of unified ultrasound classification for TEP. Different TEP types reveal distinct sonographic and serum profiles, with various relationships between them. This novel classification aids in tailored treatment and clinical decision-making.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"195"},"PeriodicalIF":4.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080646","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}