Insights into Imaging最新文献

{"title":"Complication imaging after laparoscopic Roux-en-Y gastric bypass: clues to the diagnosis and pitfalls.","authors":"Camilla Gebauer, Helmut Kopf, Christiane Kulinna-Cosentini, Georg Tentschert, Raphael Schima, Alexander Klaus, Wolfgang Schima","doi":"10.1186/s13244-026-02231-6","DOIUrl":"10.1186/s13244-026-02231-6","url":null,"abstract":"<p><p>Obesity is a complex chronic disease with a rising global prevalence and significant health implications. The laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely performed bariatric procedures worldwide, ensuring significant weight loss and reducing obesity-related comorbidities. However, the risk of postoperative complications remains considerable. Multidetector computed tomography (MDCT) is regarded as the primary imaging modality for the assessment of suspected complications, due to its high diagnostic accuracy. This review offers a comprehensive overview of early (≤ 30 days) and late (> 30 days) postoperative complications, including anastomotic leak, abscess, hemorrhage, small bowel obstruction (SBO), internal hernia, gastro-gastric fistula, intussusception, and marginal ulcer, with emphasis on characteristic MDCT features. Due to its advantage as a dynamic method, upper gastrointestinal (Gl) studies with oral contrast material may be helpful for the diagnosis of leak and gastro-gastric fistula formation. A comprehensive understanding of the altered postoperative anatomy and the specific radiological signs of complications are essential for accurate MDCT interpretation, minimizing diagnostic errors and enabling timely, targeted clinical intervention. Today, MRI can be considered a problem-solver through its possibility of combining static with dynamic sequences in selected cases. In this narrative review, we highlight the most frequent complications of Roux-en-Y gastric bypass (LRYGB), allowing radiologists to become familiar with the typical radiological features and pitfalls in MDCT, upper GI studies, and MRI, when facing this type of surgery. CRITICAL RELEVANCE STATEMENT: Postoperative complications following laparoscopic LRYGB can pose considerable diagnostic challenges. Although MDCT is the most important modality, upper GI studies (for leakage or suspected gastro-gastric fistula) and increasingly MRI (for pouch problems or in pregnant patients) can improve diagnostic accuracy and support effective clinical decision-making. KEY POINTS: LRYGB complications are challenging due to altered anatomy and distinct imaging features. Postoperative bleeding, leaks with/without abscess, small bowel obstruction, and internal hernia are the most common serious complications. MDCT evaluation and reporting should be structured and focus on characteristic CT signs to support accurate imaging diagnosis.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354823","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":"Deep learning ensemble models for CT-based differentiation of malignant and benign sacral bone tumors: development and evaluation.","authors":"Ping Yin, Fei Zheng, Ke Liu, Kewei Liang, Li Yang, Lin Lu, Ning Lang, Yongmei Li, Nan Hong","doi":"10.1186/s13244-026-02220-9","DOIUrl":"10.1186/s13244-026-02220-9","url":null,"abstract":"<p><strong>Objective: </strong>Radiologists often face challenges in differentiating benign from malignant sacral bone lesions due to their similar imaging characteristics. This study aimed to develop an ensemble deep learning (DL) model that can preoperatively distinguish between benign and malignant sacral tumors using noncontrast computed tomography images.</p><p><strong>Materials and methods: </strong>Preoperative sacral CT scans from 569 patients with confirmed sacral lesions were analyzed. Data from Center 1 were utilized in model development and internal test via fivefold cross-validation, and those from Centers 2 and 3 were employed in external test. Various ensemble models combining human-readable interpretation and DL were developed. The diagnostic performance of the models and radiologists was assessed using metrics such as precision, recall, accuracy, area under the curve (AUC), F1 score, and confusion matrix. Furthermore, the clinical benefits derived from radiologists' interpretations and supported by the DL model were evaluated.</p><p><strong>Results: </strong>The ensemble model, which integrates 3D-DenseNet121 with human interpretation, exhibited the most robust performance. The ensemble model demonstrated high performance on the internal and external test sets and achieved AUCs of 0.9139 and 0.8713, F1 scores of 0.9054 and 0.8571, precision of 0.9041 and 0.8824, recall of 0.9136 and 0.8333, and accuracy of 0.8630 and 0.8182, respectively. Across the external test cohort, all radiologists experienced improvements in AUC, accuracy, sensitivity, and specificity. Notably, junior radiologists demonstrated significant improvements compared with senior radiologists.</p><p><strong>Conclusion: </strong>The potential clinical application of the DL model lies in its capacity to considerably enhance the diagnostic efficiency of radiologists.</p><p><strong>Critical relevance statement: </strong>This study presents the first ensemble deep learning model integrating 3D-DenseNet121 with radiologists' interpretation for preoperative differentiation of sacral tumors on noncontrast CT that improved diagnostic performance across all experience levels, particularly for junior radiologists.</p><p><strong>Key points: </strong>First artificial intelligence-radiologist ensemble for noncontrast computed tomography (NCCT)-based sacral tumor classification. Boosts all radiologists' performance, with the greatest gains for juniors, potentially reducing referrals. Enables reliable NCCT diagnosis, overcoming contrast/magnetic resonance imaging dependency in musculoskeletal oncology.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344096","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":"Creating a work environment that keeps you happy.","authors":"Giles Maskell, Sarah Coope","doi":"10.1186/s13244-026-02230-7","DOIUrl":"10.1186/s13244-026-02230-7","url":null,"abstract":"<p><p>Reports of work-related stress among healthcare workers in all disciplines have increased sharply in recent years, and radiology is no exception. Rising demand, relentless pressures and reduced time for meaningful human contact are all contributing. Against this backdrop, it is more important than ever that we recognise the characteristics of a happy radiology department and then consider strategies which we can deploy as individuals to keep us happy and healthy at work. CRITICAL RELEVANCE STATEMENT: The article discusses the importance of a healthy radiology department culture and describes the strategies which an individual radiologist can employ to maximise their own wellbeing in the face of relentless, increasing workload pressure. KEY POINTS: The frequency of burnout is increasing among radiologists. A happy work environment is essential for providing optimal patient care. There are strategies which an individual radiologist can employ to maintain their own well-being in the face of relentless increasing pressure.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344117","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":"Comparison of non-contrast CT, CT perfusion, and CT angiography for predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.","authors":"Xin Yao, Haifeng Cheng, Chen Yang, Xiaojun Hao, Xintong Zhao, Xinggen Fang, Yunfeng Zhou, Chao Zhang","doi":"10.1186/s13244-026-02238-z","DOIUrl":"10.1186/s13244-026-02238-z","url":null,"abstract":"<p><strong>Objective: </strong>Non-contrast CT (NCCT), CT perfusion (CTP), and CT angiography (CTA) are recommended for predicting delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). However, not all patients can undergo all three examinations on admission. We aimed to compare the predictive abilities of NCCT, CTP, and CTA for DCI.</p><p><strong>Materials and methods: </strong>This retrospective study enrolled consecutive aSAH patients admitted to our center between November 2015 and September 2023. NCCT, CTP, and CTA models were constructed using logistic regression analyses adjusted for confounders. The model performances were assessed by discrimination and calibration. Internal validation was conducted using bootstrapping. The predictive abilities were further evaluated in subgroup analyses.</p><p><strong>Results: </strong>A total of 950 patients (median [IQR] age: 59 [51-68] years; 651 women) were enrolled, of whom 246 (25.9%) developed DCI. The NCCT model had an area under the curve (AUC) of 0.837 (95% CI: 0.808-0.866), and was superior to the CTP (AUC: 0.783; 95% CI: 0.748-0.818; p < 0.001) and CTA (AUC: 0.760; 95% CI: 0.723-0.797; p < 0.001) models. All three models had good calibration ability (all p > 0.05). Internal validation showed satisfactory discrimination ability (optimism-adjusted AUC: 0.840 for the NCCT model, 0.785 for the CTP model, and 0.761 for the CTA model). The NCCT and CTP models exhibited similar predictive abilities (AUC: 0.763 vs. 0.735; p = 0.399) in the poor-grade aSAH (World Federation of Neurological Surgeons 4-5) group.</p><p><strong>Conclusion: </strong>The NCCT model performed better than the CTP and CTA models for predicting DCI and was comparable to the CTP model in poor-grade aSAH patients.</p><p><strong>Critical relevance statement: </strong>For most aneurysmal subarachnoid hemorrhage patients, non-contrast CT performed at emergency admission is sufficient to evaluate disease severity and reliably predict the risk of delayed cerebral ischemia.</p><p><strong>Key points: </strong>More straightforward and reliable indicators are required to facilitate early delayed cerebral ischemia prediction. The non-contrast CT model, utilizing admission variables, was most predictive of delayed cerebral ischemia. Non-contrast CT at admission reliably predicts delayed cerebral ischemia risk and severity in most aneurysmal subarachnoid hemorrhage patients.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344084","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 value of gadobenate dimeglumine-enhanced MRI quantification in predicting aggressiveness and prognosis of typical intrahepatic mass-forming cholangiocarcinoma: a multicenter retrospective study.","authors":"Shuo Zhang, Bing Kang, Chenyang Qiu, Kai Deng, Haitao Sun, Yicong Nie, Ximing Wang, Cong Sun","doi":"10.1186/s13244-026-02225-4","DOIUrl":"10.1186/s13244-026-02225-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the predictive value of quantitative gadobenate dimeglumine-enhanced MRI parameters in aggressiveness and prognosis of intrahepatic mass-forming cholangiocarcinoma (IMCC).</p><p><strong>Materials and methods: </strong>A total of 158 patients with IMCC who underwent preoperative MRI at three centers were included, and their clinical and imaging data were analyzed retrospectively. Multimodal quantitative parameters were measured in various tumor areas, including relative intensity ratio (RIR) and relative enhancement ratio (RER) of the central and rim areas of the tumor to the liver in the hepatobiliary phase, and the center area-tumor volume ratio. Patients were classified into low-aggressiveness (Ki-67 LI < 25%) and high-aggressiveness (Ki-67 LI ≥ 25%) groups based on the Ki-67 labeling index (LI). Potential risk factors of aggressiveness were determined using multivariate logistic regression analysis. The prediction efficacy of factors was assessed using receiver operating characteristic (ROC) curves. Overall survival (OS) and disease-free survival (DFS) were evaluated using the Cox proportional-hazards regression model.</p><p><strong>Results: </strong>The volume ratio (VR) and RIR_rim were independent risk factors for aggressiveness (p < 0.05). The area under the ROC curve was 0.803 [95% confidence interval (CI), 0.728-0.878] and 0.799 (95% CI, 0.727-0.872), both higher than that of CA19-9 ≥ 34 U/mL and intratumoral necrosis (all, p < 0.05). VR and RIR_rim were identified as independent predictors of OS and DFS in patients with IMCC (p < 0.05).</p><p><strong>Conclusion: </strong>The multimodal quantitative MRI parameters, VR and RIR_rim, were effective risk factors for predicting both aggressiveness and prognoses in patients with IMCC.</p><p><strong>Critical relevance statement: </strong>Noninvasive MRI hepatobiliary-phase quantification stratified aggressiveness and prognosis in intrahepatic mass-forming cholangiocarcinoma. It might provide important clinical information for treatment strategies.</p><p><strong>Key points: </strong>The volume ratio (VR), relative intensity ratio (RIR_rim), CA19-9 ≥ 34 U/mL, and necrosis were independent predictors of high aggressiveness. The VR, RIR_rim, CA19-9 ≥ 34 U/mL, and tumor boundary were independent predictors of poorer overall survival. The VR, RIR_rim, CA19-9 ≥ 34 U/mL, tumor boundary, and tumor maximum size ≥ 3 cm were independent predictors of shorter disease-free survival.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344175","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":"Prognostic value of Node-RADS scoring in stage IIICr cervical cancer: development and validation of novel nomograms.","authors":"Li Jiang, Shanshan Ma, Qinghua Du, Jun Lv, Minghua Guo, Huisi Lin, Yanmei Que, Ting Gao, Shuxin Liang, Fang Wu, Yong Zhang","doi":"10.1186/s13244-026-02222-7","DOIUrl":"10.1186/s13244-026-02222-7","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to establish and validate nomograms integrating the Node-Reporting and Data System (Node-RADS) score and clinical variables to predict overall survival (OS) and progression-free survival (PFS) in patients with International Federation of Obstetrics and Gynecology (FIGO) 2018 stage IIICr cervical cancer receiving definitive chemoradiotherapy.</p><p><strong>Materials and methods: </strong>A retrospective two-center cohort study was conducted, enrolling eligible patients treated between March 2011 and December 2022. Nomograms were established based on least absolute shrinkage and selection operator (LASSO) regression, and Cox regression was used to identify prognostic features. The performance of the nomograms was assessed using receiver operating characteristic curves (ROC), calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 307 eligible patients were analyzed. For OS, independent prognostic factors included para-aortic lymph node (PALN) metastasis, non-squamous histology, Node-RADS score, and lymph node (LN) boost irradiation ≥ 60 Gy EQD2 (Equivalent dose in 2Gy fractions); for PFS, these were T stage, non-squamous histology, and LN boost irradiation ≥ 60 Gy EQD2. Nomograms outperformed FIGO 2009/2018 staging in discrimination and clinical utility, with calibration curves showing good agreement between predicted and observed outcomes. Kaplan-Meier analysis linked higher Node-RADS scores, PALN metastasis, > 3 positive LNs, and LN boost irradiation < 60 Gy EQD2 to poorer OS and PFS.</p><p><strong>Conclusion: </strong>A nomogram incorporating the Node-RADS score, which is significantly associated with survival, can serve as a potential prognostic marker to assist clinicians in making informed decisions and developing individualized treatment strategies. Notably, the inherent treatment-selection bias in the retrospective design limits its direct therapeutic implications.</p><p><strong>Critical relevance statement: </strong>Node-RADS-based nomograms offer superior risk stratification and prognosis prediction for stage IIICr cervical cancer patients.</p><p><strong>Key points: </strong>The nomogram incorporating the Node-Reporting and Data System (Node-RADS) score can serve as a potential prognostic marker to assist clinicians. The nomogram incorporating the Node-RADS score, which integrated clinicopathological data and therapies, outperformed Federation of Obstetrics and Gynecology (FIGO) staging in discriminative ability and clinical utility. Higher Node-RADS scores correlated with worse survival outcomes of patients, and lymph node (LN) boost irradiation ≥ 60 Gy EQD2 might provide survival benefits.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344112","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":"Low-flow vascular malformations without arteriovenous shunting of the central nervous system: a pictorial review.","authors":"Lorena Nicolosi, Francesco Tiralongo, Corrado Inì, Daniele Grippaldi, Pietro Valerio Foti, Emanuele David, Cristina Mosconi, Stefania Tamburrini, Davide Giuseppe Castiglione, Giuseppe Messina, Rosita Comune, Roberto Minici, Stefano Palmucci, Antonio Basile","doi":"10.1186/s13244-026-02209-4","DOIUrl":"10.1186/s13244-026-02209-4","url":null,"abstract":"<p><p>This review aims to provide a comprehensive pictorial review of low-flow vascular malformations (LFVMs) of the central nervous system (CNS) without arteriovenous shunting, focusing on their epidemiology, pathophysiology, imaging features, and associations with other vascular anomalies. LFVMs - developmental venous anomalies (DVAs), cavernous malformations (CMs), brain capillary telangiectasias (BCTs), and sinus pericranii (SP) - are typically benign and incidental but may cause symptoms or hemorrhage. Differentiating LFVMs from neoplastic, inflammatory, or high-flow vascular lesions is critical to avoid misdiagnosis and inappropriate treatment. MRI is the reference technique. DVAs show a \"caput medusae\" venous pattern; CMs have a mulberry-like core with a complete hemosiderin rim on T2*/SWI; BCTs are often occult on routine MRI but may display brush-like enhancement and subtle SWI hypointensity; SP consists of an extracranial venous mass communicating with a dural sinus through a transosseous vein. Familiarity with the imaging spectrum and typical associations of CNS LFVMs enables confident diagnosis and helps avoid unnecessary invasive procedures. CRITICAL RELEVANCE STATEMENT: By illustrating key imaging features of low-flow CNS vascular malformations, this article critically addresses frequent diagnostic pitfalls. It advances radiological practice by guiding differentiation from neoplastic or high-flow lesions and improving multidisciplinary patient care. KEY POINTS: LFVMs (DVAs, CMs, capillary telangiectasia, SP) are frequently incidental but may cause hemorrhage, seizures, or neurological deficits. DVAs are typically benign drainage variants; hemodynamic congestion on perfusion weighted imaging explains occasional symptoms and the frequent association with acquired CMs. CMS presents as \"mulberry-shaped\" lesions with a hemosiderin rim on SWI sequences, reflecting microhemorrhages and the absence of intervening brain parenchyma. Capillary telangiectasia most often occurs in the pons; recognition of the characteristic SWI hypointensity with faint enhancement prevents misdiagnosis as a neoplasm or ischemia. AP shows trans‑osseous venous channels connecting dural sinuses to epicranial varices; CT characterizes bony defects, and MRI depicts venous communication.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344165","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":"Publisher Correction: Early-phase semi-quantitative analysis versus full time-course quantitative modeling of ultrafast dynamic contrast-enhanced MRI for breast cancer diagnosis, molecular subtyping, and treatment response prediction.","authors":"Ying Cao, Xueqin Gong, Yao Huang, Huifang Chen, Jie Fang, Lu Wang, Lan Li, Sun Tang, Ting Yin, Xiaoxia Wang, Jiuquan Zhang","doi":"10.1186/s13244-026-02233-4","DOIUrl":"10.1186/s13244-026-02233-4","url":null,"abstract":"","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325690","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":"Burnout and work-life balance: the generational points of view.","authors":"Isabel Molwitz, Amine Mohamed Korchi, Ioana Andreea Gheonea, Luis Curvo-Semedo, Gennaro D'Anna","doi":"10.1186/s13244-026-02232-5","DOIUrl":"10.1186/s13244-026-02232-5","url":null,"abstract":"<p><p>Work-life balance has emerged as a central theme in modern medicine, particularly in radiology, where high burnout rates underscore the urgency for systemic change. This narrative review explores how perceptions of work-life balance vary across generations-Baby Boomers, Generation X, Millennials, and Generation Z-and how these differences shape workplace expectations and cultural evolution within healthcare. Baby Boomers often view medicine as a vocation requiring sacrifice and long hours, while Gen X emphasises flexibility and independence. Millennials prioritise purpose, inclusivity, and work-life integration, favouring fluid schedules and value-driven environments. Gen Z, as digital natives, seeks ethical workplaces, diversity, and clearly defined personal-professional boundaries. That paper started from a dedicated session at the European Congress of Radiology (ECR) 2025, combining literature references with reflections on evolving professional values. It highlights that while generational perspectives differ, common ground exists: across all groups, well-being, fulfilment, and supportive workplace structures are increasingly seen as essential rather than optional. The paper emphasises the importance of adapting institutional policies to accommodate generational needs through flexible scheduling, mentorship, protected time, and inclusive leadership. Ultimately, we aim for the embracing of intergenerational collaboration and recognition of the diverse definitions of professional success, which are key to building resilient radiology teams. Sustainable solutions must move beyond one-size-fits-all models to foster innovation, prevent burnout, and retain talent across all career stages. It is also calling for healthcare institutions to proactively integrate these perspectives to shape a more supportive and effective professional culture. CRITICAL RELEVANCE STATEMENT: This paper offers a narrative overview of generational perspectives on work-life balance in radiology, highlighting both shared values and evolving priorities across age groups KEY POINTS: Burnout remains a widespread issue in radiology, with high prevalence across all career stages, emphasising the need for systemic solutions rather than individual resilience alone. Generational views on work-life balance vary: Boomers value duty, Millennials seek purpose and flexibility, while Gen Z demands ethics, diversity, and personal sustainability. Intergenerational collaboration and adaptability are essential for building resilient teams, requiring healthcare institutions to embrace diverse expectations and implement inclusive, flexible work models.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of prostate magnetic resonance imaging in men with prostate-specific antigen levels ≥ 15 ng/mL for biopsy decision-making.","authors":"Samuel Trappe, Lars Schimmöller, Patrick Althoff, Karla Johanna Schero, Sebastian Berg, Jan Philipp Radtke, Irene Esposito, Florian Roghmann, Peter Albers, Gerald Antoch, Rouvier Al-Monajjed, Matthias Boschheidgen","doi":"10.1186/s13244-026-02235-2","DOIUrl":"10.1186/s13244-026-02235-2","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the value of MRI in men with highly elevated PSA values for the exclusion of clinically significant prostate cancer (csPC).</p><p><strong>Materials and methods: </strong>In this retrospective bicenter cohort study, consecutive men with PSA values ≥ 15 ng/mL and multiparametric (mp) MRI were included. We excluded patients with acute prostatitis and patients without histopathology or follow-up. Examinations were evaluated regarding MRI quality, PSAD, and PI-RADS classification. For all patients with subsequent biopsy, PC and csPC detection rates were determined. In a subgroup analysis, patients with and without the presence of csPC were compared regarding clinical and MRI parameters.</p><p><strong>Results: </strong>Finally, 376 patients (median PSA 20 ng/mL) were included. MRI quality was excellent (median PI-QUAL 3). 26% of the patients revealed an MRI with a PI-RADS category 2, 16% were classified as category 3, 12% PI-RADS 4, and 46% showed a PI-RADS 5. A total of 280 patients underwent systematic screening with or without targeted prostate biopsy. Among these, 42% with PSA values ranging from 15 to 116 ng/mL (median 19.5 ng/mL) showed no presence of PC. Overall, csPC detection rates were 94% for PI-RADS 5 and 51% for PI-RADS 4. No csPC were identified in PI-RADS 2, and 8% in PI-RADS 3. Comparative analysis between patients with and without csPC revealed significant differences in age, PSA, PSAD, and PI-RADS (p ≤ 0.05).</p><p><strong>Conclusions: </strong>mpMRI demonstrated excellent performance in the detection of csPC in this high-risk cohort with PSA levels ≥ 15 ng/mL. High-quality MRI helps to exclude csPC in cases with significantly elevated PSA levels to avoid unnecessary prostate biopsies. CRITICAL RELEVANCE STATEMENT: mpMRI demonstrated a high diagnostic accuracy for csPCs in men with PSA ≥ 15 ng/mL, and in cases of non-suspicious MRI findings, it can avoid unnecessary biopsies in these patients at risk.</p><p><strong>Key points: </strong>MpMRI demonstrated high diagnostic accuracy in men with PSA values of ≥ 15 ng/mL. MpMRI enables the reliable exclusion of csPC in cases with non-suspicious MRI findings in these patients. In patients with significantly elevated PSA levels, mpMRI provides an effective risk stratification to avoid unnecessary biopsies.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325350","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}