Insights into Imaging最新文献

{"title":"MRI for restaging pancreatic cancer.","authors":"Giulia A Zamboni, Federica Omboni, Irene Panozzo","doi":"10.1186/s13244-026-02422-1","DOIUrl":"10.1186/s13244-026-02422-1","url":null,"abstract":"<p><p>Pancreatic adenocarcinoma is a tumor with a dismal prognosis, as the majority of patients are diagnosed when the tumor is not resectable. Neoadjuvant treatment has significantly improved prognosis, but assessing treatment response can be challenging for radiologists. Given the fibrotic nature of the primary tumor, differentiating between residual viable tumor and fibrotic response can be difficult. MRI can have a role in reassessing the primary tumor and disease spread. In this review, we discuss MR techniques that can be used for this assessment, including routinely used sequences (e.g., DWI) and sequences that are not yet routinely included in pancreatic protocols (e.g., T1 mapping, ECV imaging, and USPIO contrast for nodal staging). KEY POINTS: Question Imaging assessment of the response of pancreatic adenocarcinoma to neoadjuvant treatment is difficult and still has limited accuracy. Findings Different MRI sequences and techniques have been suggested as possibly improving this assessment, reflecting on better patient management. Critical relevance statement We summarize the available evidence on MRI for restaging pancreatic carcinoma after neoadjuvant treatment.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181751","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":"Impact of deep learning image reconstruction on CT radiomics reproducibility in patients with pulmonary nodules.","authors":"Huiyuan Zhu, Tingle Wei, Luna Wang, Lin Zhu, Qunhui Chen, Guangyu Tao, Linlin Sun, Xiwen Sun, Zike Huang, Hong Yu","doi":"10.1186/s13244-026-02417-y","DOIUrl":"10.1186/s13244-026-02417-y","url":null,"abstract":"<p><strong>Objective: </strong>Ensuring CT feature reproducibility across imaging protocols and reconstruction algorithms is essential for the generalizability of radiomics applications. This study aimed to evaluate the reproducibility of CT radiomic features in pulmonary nodules using deep learning image reconstruction (DLIR) compared with conventional reconstruction techniques under different radiation doses.</p><p><strong>Materials and methods: </strong>We included 94 patients between March and June 2023. Standard- and low-dose CT images were scanned to assess the impact of dose reduction on feature reproducibility. DLIR strengths at low (DLIR-L), medium (DLIR-M), and high (DLIR-H), representing progressive levels of noise suppression, were compared against filtered back projection (FBP) and adaptive statistical iterative reconstruction-V at 50% strength (ASIR-V-50%) reconstructions. 2264 features were extracted from pulmonary nodules. The concordance correlation coefficient (CCC) and the coefficient of variation (CV) were used to evaluate inter-dose reproducibility, inter-reconstruction reproducibility, and feature variability.</p><p><strong>Results: </strong>The mean CCC for inter-dose reproducibility using DLIR-H, ASIR-V-50%, and FBP was 0.934 ± 0.104, 0.922 ± 0.128, and 0.922 ± 0.113, respectively (p = 0.055), with 29.8%, 27.9%, and 20.2% of features showing near-perfect agreement. In low-dose CT, DLIR-L achieved the highest inter-reconstruction reproducibility against ASIR-V-50% (0.950 ± 0.094), with 39.4% of features showing near-perfect agreement. The overall CV across reconstructions was 9.87 ± 20.32%, with 74.0% of features highly stable. Part-solid nodules showed the lowest variability (7.17 ± 13.48%, p < 0.001). Reproducibility improved significantly with increasing nodule size (p < 0.001).</p><p><strong>Conclusion: </strong>DLIR improves the radiomic feature reproducibility in pulmonary nodules, making it particularly suitable for low-dose CT protocols. However, the robustness tends to decrease with higher DLIR strengths. Nodule characteristics significantly influence variability.</p><p><strong>Key points: </strong>Question The impact of DLIR on radiomic feature reproducibility across radiation doses and reconstruction methods in pulmonary nodules remains unknown. Findings DLIR-H demonstrated high inter-dose reproducibility, while DLIR-L achieved the highest inter-reconstruction reproducibility; feature variability decreased significantly with increasing nodule size, with 21 robust features identified. Critical relevance statementThis study critically assesses reconstruction-related instability in CT radiomics and identifies DLIR settings and nodule characteristics that influence feature robustness, supporting protocol optimization and more reliable quantitative pulmonary nodule assessment in clinical radiology.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181620","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":"Ultrasonography in disaster medicine: a narrative review.","authors":"Félix Amiot, Karim Tazarourte, Guillaume Gorincour, Axel Benhamed","doi":"10.1186/s13244-026-02420-3","DOIUrl":"10.1186/s13244-026-02420-3","url":null,"abstract":"<p><p>This narrative review aimed to critically appraise the diagnostic accuracy, clinical impact, and operational feasibility of ultraportable point-of-care ultrasonography (POCUS) across the four domains of disaster medicine. A literature search was conducted following the SANRA and PRISMA-trAIce guidelines. Records were identified through an AI-assisted literature-discovery tool (the Undermind Deep-Search platform, interrogating the Semantic Scholar corpus) run on 15 June 2025, rather than through an independent structured multi-database search. Candidate references were screened manually against pre-specified eligibility criteria by a single reviewer, with the search parameters independently verified by the senior author. Of 71 records identified, 63 met the inclusion criteria. The included studies comprised 32 original studies, 10 systematic or scoping reviews, 20 narrative or operational papers, and one guideline. In CBRN scenarios, lung ultrasound demonstrated sensitivities of 90-97% for COVID-19 pneumonia versus 60-69% for chest radiography while minimizing healthcare worker exposure. For blast and ballistic injuries, FAST showed a pooled sensitivity of 92.1% (95% CI: 87.8-95.6) and specificity of 98.7% (95% CI: 96.0-99.9) for intra-abdominal hemorrhage. In natural disasters, ultrasound altered management in up to 44% of patients. Post-disaster applications included vascular access, tube confirmation, and complication monitoring. Ultraportable POCUS demonstrates diagnostic utility and operational feasibility across multiple disaster domains. However, evidence quality varies significantly, and standardized protocols remain lacking. Prospective studies linking ultrasound deployment to improved patient outcomes are needed. KEY POINTS: Question When disasters disable conventional imaging, how does ultraportable point-of-care ultrasonography perform for diagnosis, triage, and procedural guidance across the four domains of disaster medicine? Findings Across 63 studies, FAST reached 92.1% pooled sensitivity for hemoperitoneum, lung ultrasound 90-97% versus 60-69% for radiography; management changed in up to 44%. Critical relevance statement This review critically appraises ultraportable ultrasound across all four disaster domains, showing that radiation-free bedside imaging accelerates triage, conserves scarce CT capacity, and extends radiological expertise through tele-guidance, while exposing an evidence base still lacking prospective outcome data.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181814","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":"RAPID perfusion CT in acute ischemic stroke: an educational pictorial review of common patterns, pearls, and pitfalls.","authors":"Andrea Buoso, Caterina Bernetti, Michele Tondo, Ilenia Barbalace, Teresa Giannarelli, Michele Pillitteri, Andrea Romano, Alessandro Bozzao, Bruno Beomonte Zobel, Carlo A Mallio","doi":"10.1186/s13244-026-02427-w","DOIUrl":"10.1186/s13244-026-02427-w","url":null,"abstract":"<p><p>Rapid processing of Perfusion and Diffusion (RAPID) software for CT perfusion (CTP) is a valuable tool for the evaluation of acute ischemic stroke and therapeutic decision-making in extended therapeutic windows. However, automated maps should not be interpreted in isolation. A structured, pattern-based approach, integrating qualitative visual assessment with automated quantitative output and clinical information to refine therapeutic selection, remains essential to mitigate pitfalls and optimize patient care. The aim of this article is to provide an educational pictorial review based on selected illustrative cases of the most common imaging patterns, interpretive pitfalls, and technical features of CTP processed with RAPID software in acute ischemic stroke, that may serve as a practical guide for radiologists and neuroradiologists. KEY POINTS: Question How can radiologists effectively interpret automated RAPID CT perfusion maps in acute ischemic stroke while avoiding common technical traps, diagnostic pitfalls, and anatomical limitations? Findings Integrating qualitative visual assessment, quantitative RAPID outputs, and clinical-vascular data within a structured workflow minimizes diagnostic errors and optimizes patient selection for reperfusion. Critical relevance statement This educational pictorial review provides a practical, pattern-based approach to RAPID CT perfusion interpretation, highlighting clinical applications, technical limitations, software variability, and diagnostic pitfalls to advance everyday neuroradiological practice and personalized stroke management.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181745","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 maps for representation of quantitative metrics in radiology: meaningful or misleading?","authors":"Nico Sollmann, Maria T Wetscherek, Barbara D Wichtmann, Miha Fuderer, Clemens C Cyran, Edwin H G Oei, Fabio Crameri, Nandita M deSouza","doi":"10.1186/s13244-026-02414-1","DOIUrl":"10.1186/s13244-026-02414-1","url":null,"abstract":"<p><p>The increased utility of quantitative metrics in medical imaging has prompted the use of colour representation of the data. Colour schemes for image display can highlight pathology and distinguish normal anatomy, thus potentially aiding image interpretation. Adding colour schemes to images may serve the sole purpose of visualising an abnormality or may seek to represent and meaningfully convey a quantitative metric. An early use of colour representation is exemplified by colour Doppler in ultrasound (US), where a two-sided linear scale is commonly applied. More recently, many schemes have arisen, ranging from a single colour to depict a segmented region to a range of colours that embrace the entire colour spectrum. These may be applied as continuous or discrete palettes, depending on the software vendor or even on individual user settings. The lack of standardisation of colour schemes across the medical community, especially in medical imaging, risks misinterpretation of quantitative data and potential unintended negative clinical consequences. The purpose of this article is to review the colour schemes used for quantitative imaging across US, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), the way in which they are applied, the clinical applications where their use is desirable for enhanced interpretation, and the pitfalls where standardisation is lacking in a variety of clinical applications. Finally, we discuss some solutions that could be employed to enable standardisation and augment the use of colour in image interpretation. KEY POINTS: Question Colour schemes in medical imaging can highlight pathology, but standardisation is lacking for most imaging modalities, thus risking misinterpretation of quantitative data. Findings For T1, T2, and T2* maps and their inverses, colour map recommendations have recently been proposed, but are mostly lacking for other quantitative data. Critical relevance statement Standardised colour maps can enhance data analyses across scanners and institutions, which is important for multicentre studies and handling big data. Furthermore, standardised and harmonised colour maps could improve lesion conspicuity, cross-platform comparability, and longitudinal reliability.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165961","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":"Sustainable iodine contrast media for a healthy future (SUSTAINED): a global survey of practice.","authors":"Andrew England, Yasser H Hadi, Helle Precht, Dávid Sipos, Nejc Mekiš, Patrizia Cornacchione, Anastasia Sarchosoglou, Tiina Nousiainen, Altino Cunha, Caroline Justich, Cheryl Cruwys, Dominique Carrié, Mark F McEntee","doi":"10.1186/s13244-026-02392-4","DOIUrl":"10.1186/s13244-026-02392-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate healthcare professionals' knowledge, attitudes, and practices (KAPs) of the environmental impact and sustainability of iodinated contrast media (ICM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A cross-sectional web-based survey was distributed to members of professional societies and advertised via social media between June and December 2024. The questionnaire covered themes including sustainability attitudes, reduction strategies, waste management, patient awareness, and institutional policies. Data were analysed using descriptive statistics, chi-square tests, and analysis of variance (ANOVA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;231 respondents from 44 countries completed the survey, primarily diagnostic radiographers (59%) and radiologists (38%). Most respondents (60%) reported that their institutions had sustainable ICM policies, and there was a significant association between institutional size and alignment with sustainability goals &lt;math&gt; &lt;mfenced&gt; &lt;mrow&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;X&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;14.2&lt;/mn&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;0.003&lt;/mn&gt;&lt;/mrow&gt; &lt;/mfenced&gt; &lt;/math&gt; . Adoption of reduction strategies such as protocol optimisation, saline chasers, and multi-patient systems varied significantly across institutions &lt;math&gt; &lt;mfenced&gt; &lt;mrow&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;X&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;18.5&lt;/mn&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;0.001&lt;/mn&gt;&lt;/mrow&gt; &lt;/mfenced&gt; &lt;/math&gt; , with younger professionals (25-44 years) more engaged &lt;math&gt; &lt;mfenced&gt;&lt;mrow&gt;&lt;mi&gt;A&lt;/mi&gt; &lt;mi&gt;N&lt;/mi&gt; &lt;mi&gt;O&lt;/mi&gt; &lt;mi&gt;V&lt;/mi&gt; &lt;mi&gt;A&lt;/mi&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;F&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;5.62&lt;/mn&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;0.001&lt;/mn&gt;&lt;/mrow&gt; &lt;/mfenced&gt; &lt;/math&gt; . Respondents reported waste management practices being inconsistently applied, with 26% of respondents reporting \"never engaging\" &lt;math&gt; &lt;mfenced&gt; &lt;mrow&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;X&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;19.6&lt;/mn&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mspace&gt;&lt;/mspace&gt; &lt;mo&gt;&lt;&lt;/mo&gt; &lt;mspace&gt;&lt;/mspace&gt; &lt;mn&gt;0.001&lt;/mn&gt;&lt;/mrow&gt; &lt;/mfenced&gt; &lt;/math&gt; . Patient awareness was perceived as low, 47% \"strongly disagreeing\" that patients understood the environmental impact of ICM use &lt;math&gt; &lt;mfenced&gt; &lt;mrow&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;X&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;16.9&lt;/mn&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;0.002&lt;/mn&gt;&lt;/mrow&gt; &lt;/mfenced&gt; &lt;/math&gt; . Variability in KAPs across European countries was minimal &lt;math&gt; &lt;mfenced&gt; &lt;mrow&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;s&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;0.0068&lt;/mn&gt;&lt;/mrow&gt; &lt;/mfenced&gt; &lt;/math&gt; .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This survey highlights widespread professional awareness of ICM sustainability issues but reveals variability in institutional practices, limited patient awareness, and inconsistent waste management. Findings emphasise the importance of stronger institutional policies, targeted education, and international collaboration to","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165958","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":"Myocardial work in light-chain and transthyretin-related amyloidosis with preserved ejection fraction: a cardiovascular magnetic resonance study.","authors":"Shichu Liang, Jing Chen, Qiao Deng, Danni Li, Ke Wan, Keying Bi, Jiayu Sun, Qing Zhang, Yuchi Han, Yucheng Chen","doi":"10.1186/s13244-026-02408-z","DOIUrl":"10.1186/s13244-026-02408-z","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate pressure-volume loop (PV-loop) changes by cardiovascular magnetic resonance (CMR) imaging in cardiac amyloidosis (CA) patients with preserved left ventricular ejection fraction (LVEF), and to assess PV-loop parameters' potential as subtype differential diagnostic markers.</p><p><strong>Materials and methods: </strong>Between May 2017 and September 2023, 100 consecutive confirmed CA patients (14 transthyretin-related [ATTR-CA] and 86 light-chain [AL-CA]) and 40 age- and sex-matched healthy controls (HCs) were prospectively enrolled. PV-loop parameters were derived from CMR cine images and brachial blood pressure. Clinical and CMR parameters were compared between CA patients and HCs, as well as between CA subtypes. The correlations between PV-loop parameters and clinical and imaging parameters were assessed. Furthermore, the differential diagnostic performance of these PV-loop parameters was evaluated using the area under the receiver operating characteristic curve (ROC-AUC). Bootstrapping was performed 2000 times for internal validation.</p><p><strong>Results: </strong>Compared to HCs, CA patients showed significantly lower stroke work index, potential energy index (PEI), and work efficiency (all p < 0.001). AL-CA patients had higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (2358.00 [IQR: 903.25, 5559.00] vs 810.00 [IQR: 269.00, 1136.01] pg/mL, p = 0.002) and lower PEI (0.13 [IQR: 0.07, 0.15] vs 0.15 [IQR: 0.13, 0.19] J/m², p = 0.025) than ATTR-CA patients. NT-proBNP (β = -1.94, OR = 0.14, 95% CI: 0.03-0.64, p = 0.016) and PEI (β = 0.20, OR = 1.23, 95% CI: 1.07-1.44, p = 0.007) were independent predictors for AL-CA vs ATTR-CA differentiation, and combining these two parameters enhanced the diagnostic performance (bootstrapping AUC 0.847).</p><p><strong>Conclusion: </strong>By providing pathophysiological insights into the distinctions between AL-CA and ATTR-CA, PV-loop parameters have the potential to serve as a complementary, contrast-free approach for differential diagnosis.</p><p><strong>Key points: </strong>Question PV-loop changes by CMR in CA patients with preserved LVEF remain unknown. Findings Light-chain CA patients with preserved LVEF had higher NT-proBNP levels and lower PEI than transthyretin-related CA patients. Critical relevance statement The CMR-derived PV-loop parameters revealed pathophysiological differences between the two subtypes of CA, suggesting potential differential diagnostic value.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147789","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 diagnostic value of high-resolution 3D T2-weighted MRI in preoperative evaluation and classification of Herlyn-Werner-Wunderlich syndrome: a prospective study.","authors":"Yafei Qi, Shuang Song, Xin Gao, Shu Wang, Yiwei Zhang, Yonglan He, Peng Zhang, Menglin Huang, Huadan Xue, Lan Zhu","doi":"10.1186/s13244-026-02405-2","DOIUrl":"10.1186/s13244-026-02405-2","url":null,"abstract":"<p><strong>Objective: </strong>Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare female reproductive tract malformation. Accurate preoperative diagnosis and classification are vital for surgical planning. This study aims to evaluate the diagnostic value of high-resolution three-dimensional (3D) T2-weighted MRI in the preoperative assessment and classification of HWWS.</p><p><strong>Materials and methods: </strong>The study prospectively enrolled 84 patients clinically diagnosed with HWWS between May 2020 and January 2025. Seventy patients underwent pelvic MRI examinations, including high-resolution 3D T2 sequences (1 mm slice thickness) and conventional T2 TSE sequences, supplemented by large-field-of-view (FOV) T2 coronal imaging for urinary system evaluation and full-spine X-ray examinations for skeletal assessment. Two experienced radiologists independently evaluated the imaging features in a blinded manner, focusing on uterine morphology, obstruction sites, presence of communications, and related anomalies and complications. Consistency analysis was performed between imaging findings and surgical results in 52 surgical patients.</p><p><strong>Results: </strong>Uterine morphology included: didelphys (54/70, 77.1%), complete septate (14/70, 20%), and bicornuate uterus (2/70, 2.9%). Among 52 surgical patients, 31 (59.6%) had vaginal-level obstruction with 18 (34.6%) Type I, 11 (21.2%) Type II, and 2 (3.8%) Type III, and 21 (40.4%) had cervical-level obstruction (Type IV and mixed). 3D T2 sequences identified 7 (63.6%) vaginal septum fistulas, outperforming TSE sequences, which detected none (0%) (p = 0.005). Associated findings were ipsilateral renal agenesis (98.6%), ovarian endometriosis (22.9%), hematosalpinx (22.9%), and spinal abnormalities (scoliosis (25.7%), mild scoliosis (41.4%).</p><p><strong>Conclusion: </strong>High-resolution 3D T2 MRI is superior to conventional T2 TSE sequences in the preoperative evaluation of HWWS, especially for identifying communications and precisely locating obstruction sites.</p><p><strong>Key points: </strong>Question Accurate preoperative structural assessment and classification of HWWS are clinically essential, yet conventional MRI has limitations in identifying fine anatomical structures and small communications. Findings High-resolution 3D T2 MRI outperforms conventional T2 TSE in identifying vaginal and cervical communications and precisely localizing obstruction sites in preoperative evaluation of HWWS. Critical relevance statement This study supports routine inclusion of 3D sequences in HWWS imaging protocols. Combined with renal and spinal assessment, it provides a comprehensive preoperative evaluation that enhances surgical planning precision and optimizes patient management strategies.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147797","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":"Practical applications of photon-counting CT in oncology: an organ-based pictorial review.","authors":"Yusuke Kawasaki, Kota Yokoyama, Hiroto Hada, Hirofumi Yamada, Junichi Tsuchiya, Kurara Yamamoto, Iichiroh Onishi, Yosuke Ariizumi, Takayuki Honda, Kenichi Okubo, Tomoyuki Aruga, Daisuke Asano, Daisuke Ban, Soichiro Yoshida, Yasuhisa Fujii, Kimio Wakana, Marie Hanaoka, Keisuke Tanaka, Masahide Yamamoto, Takehiko Mori, Sadakatsu Ikeda, Ukihide Tateishi","doi":"10.1186/s13244-026-02399-x","DOIUrl":"10.1186/s13244-026-02399-x","url":null,"abstract":"<p><p>Spectral computed tomography (CT) has become an important extension of contrast-enhanced CT (CECT) in oncologic imaging by providing material-specific information beyond conventional morphologic assessment. Dual-energy CT (DECT), implemented on energy-integrating detector CT (EID-CT) platforms, has demonstrated the value of low-keV virtual monoenergetic imaging (VMI), iodine mapping, and material decomposition for improving tumor conspicuity, delineating local extent, and supporting tissue characterization. However, broader clinical adoption of EID-CT-based DECT has been limited by increased low-keV image noise and workflow complexity. Photon-counting detector CT (PCD-CT) addresses these limitations by offering improved energy resolution, reduced electronic noise, and routine acquisition of multi-energy data without dedicated dual-energy protocols. In particular, low-keV VMI around 40 keV can be generated with clinically acceptable noise, enabling consistent enhancement-based assessment in daily practice. Iodine-based reconstructions further complement morphologic evaluation by visualizing viable tumor enhancement and enabling quantitative analysis. This organ-based pictorial review summarizes practical applications of PCD-CT-based spectral imaging in oncology. Across organ systems, spectral CT may provide complementary problem-solving information by improving lesion detection, tumor extent delineation, and diagnostic confidence, particularly when conventional CT findings are equivocal, or MRI is unavailable, contraindicated, or limited. Emerging quantitative parameters, including electron density, effective atomic number, and advanced material decomposition, may further expand oncologic CT applications, although outcome-driven validation remains limited. Together, these features position PCD-CT as a practical spectral imaging platform for routine oncologic CT. KEY POINTS: Question How can PCD-CT address low-keV image noise and workflow barriers that have limited routine DECT-based spectral imaging in oncologic CT practice? Findings PCD-CT enables low-keV VMI and iodine-based reconstructions that may improve lesion conspicuity, tumor-extent assessment, and problem-solving across organ-specific oncologic workflows. Critical relevance statement This review clarifies practical, evidence-aware uses of PCD-CT spectral reconstructions in oncology, highlighting low-keV VMI as an adjunct, selective iodine-map problem-solving, and investigational quantitative parameters.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147632","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":"Proton-density fat-saturated non-contrast MR imaging is comparable to post-contrast MR imaging for revealing wrist synovitis.","authors":"Su Wu, James Francis Griffith, João Dourado, Lai Shan Tam","doi":"10.1186/s13244-026-02406-1","DOIUrl":"10.1186/s13244-026-02406-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Standard MR imaging (MRI) for rheumatoid arthritis (RA) patients comprises a post-contrast T1-fat-saturated (T1FS + C) sequence to detect wrist synovitis and tenosynovitis. This study investigates whether non-contrast sequences can provide similar information to post-contrast imaging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Seventy-seven RA patients (F/M:  64/13; age: 61 ± 12 years) underwent MRI examination of the most symptomatic wrist on a 3.0-T system. Axial T1FS + C as well as proton-density imaging with fat-saturation (PDFS) and T2-weighted imaging with fat-saturation (T2FS) sequences were performed. Two radiologists independently scored synovitis and tenosynovitis severity on all sequences, using the rheumatoid arthritis magnetic resonance imaging scoring system (RAMRIS). Intra- and interclass correlation coefficients (ICCs) were assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For synovitis severity scoring, PDFS was practically identical to T1FS + C, while T2FS overestimated synovitis severity by up to 19%. For synovitis severity, PDFS imaging correlated better with T1FS + C than T2FS imaging (ICC: Reader 1: 0.931 vs 0.897; Reader 2: 0.969 vs 0.948). For tenosynovitis severity, PDFS and T2FS both yielded higher tenosynovitis scores than T1FS + C (p &lt; 0.001). Compared to T1FS + C imaging, PDFS overestimated tenosynovitis severity by up to 39%, while T2FS overestimated tenosynovitis severity by up to 54%. For tenosynovitis severity, PDFS imaging correlated better with T1FS + C than T2FS imaging (ICC: Reader 1: 0.856 vs 0.731; Reader 2: 0.808 vs 0.800).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PDFS imaging had good (for tenosynovitis) to excellent (for synovitis) intra- and inter-reader reliability and provides comparable scoring to T1FS + C imaging when evaluating synovitis severity, though it tends to overestimate tenosynovitis severity. PDFS imaging can reasonably replace contrast-enhanced imaging for assessing wrist synovitis in RA patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Question Post-contrast imaging is recommended for evaluating synovitis and tenosynovitis in rheumatoid arthritis (RA) patients, though it involves higher cost, scan time, and discomfort. Findings Proton-density imaging with fat-saturation (PDFS) imaging had good to excellent intra- and inter-reader reliability for evaluating synovitis and tenosynovitis in RA wrists. Compared to post-contrast T1-fat-saturated (T1FS + C) imaging, PDFS imaging provides comparable semi-quantitative synovitis severity grading but tends to overestimate tenosynovitis severity. Critical relevance statement Post-contrast imaging for synovitis and tenosynovitis in RA patients involves discomfort, a longer time, and cost. PDFS imaging has good reliability and compares well with post-contrast imaging. In RA wrists, compared to T1FS+C imaging, PDFS imaging provides comparative semi-quantitative synovitis severity grading but tends to overestimate tenosynovitis severity.","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148153","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}