Insights into Imaging最新文献

{"title":"Real-time CT/MR fusion imaging-guided core needle biopsy: enhancing diagnostic precision in head and neck lesions.","authors":"Xing Liang, Ying Wang, Zheng Yuan, Jiliang Ren, Gongxin Yang, Weiqing Tang, Ying Yuan","doi":"10.1186/s13244-026-02426-x","DOIUrl":"10.1186/s13244-026-02426-x","url":null,"abstract":"<p><strong>Objectives: </strong>To establish an intraoperative CT/MR fusion imaging (FI)-guided core needle biopsy (CNB) approach for head and neck lesions and to evaluate its diagnostic performance in comparison with conventional CT-guided biopsy.</p><p><strong>Material and methods: </strong>This retrospective study included patients undergoing CT-guided or FI-guided CNB for head and neck lesions between January 2020 and December 2024. Clinical information was collected, including demographics, lesion size, needle insertion depth, number of biopsy cores obtained, and complications. Diagnostic performance was evaluated at both the case-based and core-based levels by comparing biopsy histopathology with the final diagnosis. Subgroup analyses were performed according to lesion size, needle insertion depth, and pathological type.</p><p><strong>Results: </strong>A total of 152 patients with 426 biopsy cores were included, comprising 66 patients (183 cores) in the CT-guided group and 86 patients (243 cores) in the FI-guided group. At the case-based level, FI-guided biopsy demonstrated significantly higher diagnostic accuracy than CT-guided biopsy (98.8% vs 90.9%, p = 0.04), particularly for lesions < 3.7 cm and non-squamous cell carcinoma (non-SCC) lesions. At the core-based level, FI-guided biopsy also achieved higher accuracy (96.3% vs 73.2%, p < 0.001) and sensitivity (93.8% vs 65.0%, p < 0.001), with consistent advantages across all predefined subgroups. No major procedure-related complications were observed.</p><p><strong>Conclusions: </strong>FI-guided CNB is a safe and feasible technique for head and neck lesions that improves diagnostic accuracy compared with conventional CT guidance.</p><p><strong>Key points: </strong>Question Can CT/MR FI overcome the limitations of conventional CT guidance for precise targeting and accurate biopsy of anatomically complex head and neck lesions? Findings CT/MR FI-guided biopsy demonstrated higher diagnostic accuracy at both case-based and core-based analyses than conventional CT-guided biopsy for complex head and neck lesions. Critical relevance statement This study provides evidence that CT/MR fusion-guided biopsy improves targeting precision and diagnostic performance compared with conventional CT-guided biopsy, supporting its application for complex head and neck lesions in clinical radiology practice.</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/PMC13653010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147816","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 in localized intrahepatic bile duct dilatation: a pictorial review of diagnostic and differential approaches.","authors":"Yongyi Cen, Xiaoqi Zhou, Mimi Tang, Yanjin Qin, Chenyu Song, Jifei Wang, Yanji Luo, Zhi Dong, Hongyan Dai, Zhibing Ruan, Zhenpeng Peng, Shi-Ting Feng","doi":"10.1186/s13244-026-02419-w","DOIUrl":"10.1186/s13244-026-02419-w","url":null,"abstract":"<p><p>Localized intrahepatic bile duct dilatation (LIBD) is a prevalent radiological finding characterized by a variety of etiologies, including congenital anomalies, inflammatory conditions, hepatolithiasis, and neoplastic lesions. Accurate differential diagnosis of diseases associated with LIBD is crucial for formulating appropriate treatment strategies and improving patient prognosis. This review provides a comprehensive overview of the definitions, etiologies, clinical symptoms, and key imaging features of common diseases associated with LIBD. Furthermore, it proposes a structured approach for differential diagnosis. By integrating imaging findings with clinical and laboratory data, this approach aims to improve diagnostic accuracy and assist radiologists in making optimal clinical decisions. KEY POINTS: Question LIBD has diverse etiologies and overlapping imaging patterns, but a practical, standardized radiological framework for differential diagnosis remains lacking. Findings This pictorial review summarizes characteristic CT/MRI findings of common LIBD-associated diseases and establishes a stepwise diagnostic approach integrating obstruction points, morphology, and clinical information. Critical Relevance Statement By combining specific imaging patterns with clinical context, this review provides a practical differential diagnostic framework that may improve diagnostic confidence, guide further evaluation, and facilitate earlier detection of malignant transformation in LIBD.</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/PMC13652791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148416","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":"Contralateral-controlled thigh muscle biomarkers on CT angiography for prediction of 1-year restenosis after endovascular therapy for unilateral peripheral artery disease.","authors":"Shuangxiang Lin, Xinhong Wang, Yifeng Pan, Libing Zhang, Jianzhong Sun, Bing Chen","doi":"10.1186/s13244-026-02407-0","DOIUrl":"10.1186/s13244-026-02407-0","url":null,"abstract":"<p><strong>Objective: </strong>To develop and internally validate a model using contralateral-controlled thigh muscle biomarkers, measured on routine computed tomography angiography (CTA), to predict clinically driven, DSA-confirmed 1-year restenosis after endovascular therapy for unilateral peripheral artery disease (PAD).</p><p><strong>Materials and methods: </strong>In this retrospective cohort study, 378 patients with unilateral PAD undergoing endovascular therapy and having baseline and 1-year follow-up CTA were included. Mid-thigh skeletal muscle cross-sectional area and whole-thigh muscle volume were quantified bilaterally with semi-automated software. Contralateral-controlled biomarkers (affected minus contralateral) were derived to isolate limb-specific ischemic effects. The primary endpoint was clinically driven 1-year restenosis (≥ 50%) confirmed by DSA.</p><p><strong>Results: </strong>Among 378 patients, 162 (43%) developed restenosis at a median follow-up of 12.5 months. Contralateral-controlled muscle asymmetry was independently associated with restenosis after adjustment for lesion length, baseline stenosis degree, Fontaine stage, disease duration, and TASC II classification (OR 1.43, 95% CI: 1.08-1.89, p = 0.01). Adding muscle asymmetry to a severity-only model improved discrimination from AUC 0.76 to 0.79 (DeLong p = 0.04). A baseline predictive model combining lesion length and muscle asymmetry achieved AUC 0.74; a full explanatory model incorporating longitudinal muscle changes reached AUC 0.88, with the greatest net benefit on decision curve analysis.</p><p><strong>Conclusion: </strong>Thigh muscle biomarkers, acquired opportunistically from routine CTA scans, improved the prediction of 1-year restenosis after endovascular therapy and may support targeted surveillance in patients with unilateral PAD.</p><p><strong>Key points: </strong>Question Can contralateral-controlled thigh muscle biomarkers on routine CT angiography improve the prediction of 1-year restenosis after endovascular therapy for unilateral peripheral artery disease? Findings In 378 PAD patients, baseline contralateral thigh muscle asymmetry independently predicted clinically driven, DSA-confirmed restenosis and improved AUC from 0.76 to 0.79. Critical relevance statement Opportunistic contralateral-controlled thigh muscle analysis on routine CT angiography provides a no-cost imaging biomarker that refines post-endovascular restenosis risk stratification, supporting targeted angiographic surveillance and advancing personalized vascular imaging practice in peripheral artery disease.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127485","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":"Organization of Interventional Neuroradiology in Belgium: results of a national survey.","authors":"Adam Dmytriw, Iman Kiani, Luciana Koren, Hamza Salim, Thomas Lefebvre, Matea Prenc, Chiara Brechbühl, Denis Brisbois, Frans Vanden Bergh, Maurits Voormolen, Stephanie Elens, Luca Scarcia, Vivek Yedavalli, Louis Deprez, Yacine Boudiba, Adrien Guenego","doi":"10.1186/s13244-026-02416-z","DOIUrl":"10.1186/s13244-026-02416-z","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a comprehensive national overview of interventional neuroradiology (INR) in Belgium through a structured survey conducted under the auspices of the Belgian Society for Interventional and Therapeutic Neuroradiology (BSITN).</p><p><strong>Materials and methods: </strong>An anonymized online survey was distributed by email through the BSITN to all known active interventional neuroradiologists. The questionnaire assessed workforce demographics, organization of INR services, procedural activity, on-call systems, training and certification pathways, and remuneration models. Associations were tested using Fisher's exact or chi-square tests. Workforce projections were estimated using a stock-flow model based on respondent age distribution and current training pipeline capacity.</p><p><strong>Results: </strong>Thirty-five interventional neuroradiologists responded, representing more than 70% of the estimated active INR workforce in Belgium. Respondents were predominantly senior physicians (88.6%), with nearly half reporting more than 10 years of post-fellowship practice. Annual center-level procedural volumes were high, exceeding 200 cases in two-thirds of responses. Despite this variability, 68.6% of respondents felt sufficiently exposed across the full spectrum of INR procedures. Greater professional experience (> 10 years) was strongly associated with perceived procedural sufficiency (p = 0.001). A 24/7 stroke unit was available for 33 of 35 physicians. Workforce projections indicated a potential decline of approximately 23% over the next decade under current training capacity.</p><p><strong>Conclusions: </strong>This national BSITN survey reveals significant variability in Belgian INR organizational models. The results of the survey also point to challenges related to workforce sustainability, training standardization, and service organization. As such, they can serve as a reference point for coordinated national initiatives.</p><p><strong>Key points: </strong>Question While procedural efficacy of INR is well established, the organizational structures, workforce characteristics, and training pathways that underpin INR services have not been systematically described at a national level. Findings This study showed significant variability in institutional models, on-call systems, training pathways, and remuneration across centers. While a 24/7 stroke unit was available for 33 of 35 physicians, workforce projections indicated a potential 23% decline in the active INR workforce by 2035 under current training capacity.</p><p><strong>Critical relevance statement: </strong>These data establish the first national organizational baseline for Belgian INR and identify an impending workforce shortfall that threatens the sustainability of time-critical neurovascular services. The strong professional consensus favoring a standardized national training curriculum provides a clear mandate.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127474","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 swallow tail sign: mechanisms, neuroimaging advances and future perspectives.","authors":"Zhixuan Li, Haoxuan Lu, Yongqin Xiong, Caohui Duan, Xin Lou","doi":"10.1186/s13244-026-02401-6","DOIUrl":"https://doi.org/10.1186/s13244-026-02401-6","url":null,"abstract":"<p><p>Parkinson's disease (PD), the second most common neurodegenerative disorder, poses a significant challenge to elderly health. Its diagnosis currently relies primarily on clinical symptoms, which often proves inadequate for differentiating PD from other forms of parkinsonism, particularly in early disease stages. Although positron emission tomography (PET) has offered compelling evidence supporting the differential diagnosis of PD, its high cost and radiation exposure limit its widespread use. Consequently, there is a pressing need for more accessible, convenient, non-invasive, and safe diagnostic approaches. The \"swallow tail sign\" (STS)-an MRI-based biomarker characterized by a hyperintensity in the posterolateral substantia nigra pars compacta (SNc), surrounded by hypointense areas-has emerged as a highly promising adjunct tool. This biomarker holds potential not only to enhance diagnostic certainty in distinguishing PD from similar neurodegenerative disorders but also to improve the understanding of its pathophysiology. In this review, we outline the anatomical basis of the STS and the pathological changes in PD leading to its disappearance. We further summarize its applications across various magnetic resonance imaging (MRI) techniques and evaluate its value in identifying PD and differentiating it from other parkinsonian syndromes. With significant advancements in ultra-high-field MRI (≥ 7 T) and artificial intelligence (AI), combined with other MRI biomarkers, the value of STS will be further explored in the future. KEY POINTS: Question Despite its diagnostic potential, the biological basis, imaging interpretation, and clinical utility of the STS remain incompletely understood and warrant further investigation in parkinsonism. Findings The normal STS appears as dorsolateral nigral hyperintensity on susceptibility-sensitive MRI, while its attenuation or loss in PD supports cautious adjunctive diagnostic use. Critical Relevance Statement This review critically evaluates the biological basis, MRI interpretation, diagnostic limitations, and evolving multimodal and AI-based assessment of the STS, guiding radiologists toward its standardized and cautious adjunct use in the clinical imaging assessment of parkinsonism.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109297","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 MOBCART (magnetic resonance observation of bone and cartilage repair tissue) add-on score.","authors":"Felix R M Koenig, Markus Schreiner, Pavol Szomolanyi, Vladimir Juras, Marcus Raudner, Philipp Sorgo, Gregor Wollner, Giuseppe Filardo, Carl S Winalski, Ali Guermazi, William D Bugbee, Siegfried Trattnig","doi":"10.1186/s13244-026-02404-3","DOIUrl":"10.1186/s13244-026-02404-3","url":null,"abstract":"<p><strong>Objectives: </strong>To introduce the magnetic resonance observation of bone and cartilage repair tissue (MOBCART) bone score as a dedicated add-on to the established MOCART 2.0 knee score, and to evaluate its reproducibility for MRI-based assessment of the osseous component after osteochondral reconstruction of the knee.</p><p><strong>Materials and methods: </strong>Thirty-two postoperative knee MRI examinations from 23 patients were scored using the three-domain MOBCART add-on (Integration, Normalization, Cysts; 0-50 points) by four independent readers (expert musculoskeletal radiologist, expert orthopedic cartilage specialist, radiology resident, orthopedic resident). Inter- and intrarater reliability were assessed using linear weighted kappa for individual ordinal domains and intraclass correlation coefficients (ICC; two-way mixed, absolute agreement, single measures) for the total score. Two readers repeated scoring for intrarater reliability.</p><p><strong>Results: </strong>Interrater reliability across all four readers was moderate-to-good for the total score (ICC(A,1) = 0.72) and substantial-to-almost perfect for domain scores (κ = 0.71-0.82). Expert-reader agreement was good for the total score (ICC(A,1) = 0.90) and almost perfect for all domains (κ = 0.93-0.95). Intrarater reliability was excellent for Reader 1 (ICC(A,1) = 0.98) and good for Reader 4 (ICC(A,1) = 0.85).</p><p><strong>Conclusions: </strong>The MOBCART add-on score is a reproducible, bone-focused supplement to the MOCART 2.0 knee score that enables standardized MRI reporting of osseous features after osteochondral reconstruction.</p><p><strong>Key points: </strong>Question Can a dedicated MRI add-on score to MOCART 2.0 reliably assess the osseous component after osteochondral knee repair across readers of varying experience? Findings The MOBCART add-on showed moderate-to-good interrater reliability across mixed-experience readers, good agreement between experts, and high test-retest reliability for both experienced and resident readers. Critical relevance statement As a complement to the MOCART 2.0 knee score, the MOBCART add-on score may facilitate standardized reporting of the osseous compartment after osteochondral reconstruction and enable objective comparison of bone-related imaging outcomes across procedures and studies.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080448","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":"Helium-free MRI systems: What does that mean for a radiology decision maker?","authors":"Michael Friebe","doi":"10.1186/s13244-026-02410-5","DOIUrl":"10.1186/s13244-026-02410-5","url":null,"abstract":"<p><p>Traditional MRI systems rely on large liquid-helium baths to maintain superconductivity, requiring complex infrastructure, quench pipes, and ongoing helium supply management. Modern \"dry\" or sealed micro-helium MRI magnets replace this approach using conduction cooling and sealed helium volumes of only a few liters. These systems drastically reduce helium dependence, eliminate routine refilling, simplify installation, and lower the lifetime operating costs. The major practical advance came from moving from the open helium baths in the 2010s, which still required quench pipes and other safety features, to sealed systems, rather than from differences in small helium volumes (e.g., 0.7 vs. 7 L or 20 L) marketed by vendors. Smaller volumes marginally affect safety margins and resilience during power interruptions, rather than affecting routine clinical operations. This paper provides a brief introduction to the problem and terminology, and subsequently presents the technological issues related to the volume of sealed micro-helium MRI magnets. It also provides a list of questions to ask about the magnet sub-assembly itself, which enables the calculation of the total cost of ownership. KEY POINTS: Question What does it mean and how relevant is a \"helium-free\" MRI magnet and the remaining sealed liquid Helium volume? Findings The real operational leap in MRI magnet technology was from hundreds/thousands of liters of liquid helium to single-digit sealed systems; the sub-liter distinction does not really matter. Clinical relevance statement The article argues from a technical and economic perspective. While these sealed systems eliminate helium logistics, come with simpler siting, and reduced infrastructure costs, they raise other procurement questions for suppliers, like quench recovery time and resilience in low-resource settings.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080508","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":"Hepatobiliary phase imaging in HCC: revisiting diagnostic algorithms and clinical utility of gadoxetic acid-enhanced MRI across international guidelines.","authors":"Shuwei Zhou, Jie Yang, Shuhang Zhang, Yu Song, Shuang Li, Xiaofeng Yu, Siyu Wang, Shenghong Ju, Tian You, Yuan-Cheng Wang","doi":"10.1186/s13244-026-02402-5","DOIUrl":"10.1186/s13244-026-02402-5","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality worldwide. In at-risk populations, noninvasive imaging diagnosis relies primarily on the vascular hallmarks of arterial phase hyperenhancement and washout appearance. However, these features are often absent in early hepatocarcinogenesis, thereby limiting timely detection. Gadoxetic acid-enhanced MRI has expanded the role of imaging in HCC, yet its clinical value is often oversimplified as a comparison of diagnostic performance with CT or extracellular contrast MRI. A critical issue is that the same imaging feature, particularly hepatobiliary phase (HBP) hypointensity, carries different diagnostic consequences across international frameworks. Because HBP signal loss reflects early hepatocellular dysfunction that may precede typical vascular hallmarks, gadoxetic acid-enhanced MRI provides a biologically driven sensitivity advantage for detecting small and early-stage HCC. However, its apparent performance varies largely according to diagnostic intent: sensitivity-oriented Asian guidelines incorporate HBP hypointensity as a major feature to enable earlier detection, whereas Western guidelines prioritize specificity in high-stakes decision contexts, such as liver transplantation, and therefore restrict its diagnostic weight. This intent-dependent interpretation explains much of the inconsistency reported in the literature and underscores the limitations of pooled, guideline-agnostic performance estimates. Beyond diagnosis, HBP imaging also offers complementary information for assessing treatment response, although it remains underutilized in current criteria. Overall, the clinical value of gadoxetic acid-enhanced MRI lies not in universal superiority but in context-aligned application, shifting the focus from modality comparison to optimization according to downstream clinical consequences. KEY POINTS: Question Gadoxetic acid-enhanced MRI is interpreted differently across international hepatocellular carcinoma diagnostic guidelines, resulting in uncertainty regarding optimal imaging criteria and clinical decision-making. Findings Hepatobiliary phase hypointensity reflects early hepatocellular dysfunction and improves sensitivity for small and early-stage HCC, but its impact varies according to diagnostic intent. Critical Relevance Statement An intent-aligned interpretation strategy may help reconcile guideline heterogeneity and optimize the use of gadoxetic acid-enhanced MRI, particularly in the evaluation of small HCC.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074510","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 space of Retzius: anatomy, imaging features, and patterns of disease spread.","authors":"Sevtap Arslan, Deniz Berkay Sonu, Ali Enes Aldur, Musturay Karcaaltincaba, Deniz Akata, Mustafa Nasuh Ozmen, Ali Devrim Karaosmanoglu","doi":"10.1186/s13244-026-02403-4","DOIUrl":"10.1186/s13244-026-02403-4","url":null,"abstract":"<p><p>The space of Retzius is a clinically important but often overlooked extraperitoneal compartment that serves as a common site of disease involvement and a key pathway for the spread of pelvic and retroperitoneal pathology. Its complex anatomical relationship with other extraperitoneal/retroperitoneal spaces renders it prone to involvement in different pathologic processes. Most cases represent secondary involvement rather than primary pathology. CT and MRI play a pivotal role in depicting the anatomy of the space of Retzius, characterizing lesions, and identifying routes of disease extension. This review provides a comprehensive imaging-based overview of the anatomy of the space of Retzius and illustrates the imaging findings of a broad spectrum of diseases involving this region. We highlighted the anatomical pathways of disease spread, characteristic imaging features, and surgical considerations relevant to radiologists. Familiarity with these imaging patterns and anatomical relationships can improve diagnostic confidence, facilitate identification of the underlying disease process, and guide appropriate clinical management. KEY POINTS: Question Accurate recognition of diseases involving the space of Retzius is challenging because of its complex anatomy and diverse patterns of disease spread. Findings Most pathologies involving the space of Retzius represent secondary extension from adjacent compartments rather than primary disease. Critical relevance statement By integrating imaging anatomy, patterns of disease spread, and surgical relevance, this review provides a practical framework for evaluating abnormalities involving the space of Retzius, improves diagnostic confidence, facilitates identification of the disease process, and guides clinical and surgical management.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060672","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":"Radiology residency across Europe: a fragmented yet converging path.","authors":"Emanuele Neri, Salvatore Claudio Fanni, Dania Cioni","doi":"10.1186/s13244-026-02396-0","DOIUrl":"10.1186/s13244-026-02396-0","url":null,"abstract":"<p><p>Radiology has evolved into a central specialty at the core of modern medicine, with radiologists increasingly serving as integral members of multidisciplinary teams. Despite the specialty's central role, the structure and content of radiology residency training remain highly variable across Europe. Differences persist in program duration, entry requirements, curriculum design, assessment modalities, and certification authorities, largely due to divergent national educational frameworks and healthcare policies. This fragmentation poses challenges to workforce mobility, training equivalence, and quality assurance. In response, the European Society of Radiology (ESR) has introduced harmonization initiatives, including the European Training Curriculum (ETC), the European Diploma in Radiology (EDiR), and the European Training Assessment Programme (ETAP), all aimed at promoting standardization while respecting national autonomy. This narrative review offers a comparative analysis of radiology training programs across European countries, with particular focus on admission pathways, curricular alignment with the ETC, implementation of research and subspecialty training, and variations in evaluation and certification. While most nations have adopted the ETC in whole or in part, practical implementation remains uneven. Entry mechanisms range from competitive national exams to local interviews, and while some programs include dedicated research time or thesis requirements, others lack structured scientific training. Furthermore, differences in legal and political frameworks influence how training is funded, organized, and certified. As Europe moves toward greater integration of specialist education, understanding these disparities is essential for developing a coherent, high-quality training landscape that ensures both clinical excellence and cross-border professional mobility. KEY POINTS: Question How heterogeneous are radiology residency structures and curricula across Europe, and to what extent do current frameworks address inconsistencies in training quality and standardization? Findings Radiology training across Europe remains markedly heterogeneous, while the European Training Curriculum, EDiR, and ETAP only partially mitigate variability in education, assessment, and quality standards. Critical Relevance Statement This narrative review critically evaluates persistent inconsistencies in European radiology training and demonstrates the limited but essential role of harmonization initiatives, supporting the need for stronger integration to ensure comparable competencies and improve clinical practice standards.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060728","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}