Journal of Clinical Imaging Science最新文献

{"title":"Magnetic resonance imaging evaluation of oblique injuries: Introduction of the deadrise sign.","authors":"William Welton, Nicholas Hanna, Vincent Key, Brian M Everist, Jamie Crist","doi":"10.25259/JCIS_27_2025","DOIUrl":"https://doi.org/10.25259/JCIS_27_2025","url":null,"abstract":"<p><p>Oblique injuries are a common sports-related injury to the lateral abdominal wall, most commonly caused by forceful trunk rotation, which tears the internal oblique from the undersurface of the lower ribs. Despite increased awareness and prevention efforts, these injuries remain a significant contributor to missed playing time. A single institution retrospective cohort review of oblique injury magnetic resonance images (MRIs) was performed, followed by a comprehensive review including relevant anatomy, grading considerations, and introduction of the deadrise sign, interpretation pearls, case examples, MRI protocols, and treatment algorithms.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"37"},"PeriodicalIF":1.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Torsion of a pedunculated accessory hepatic lobe: Cross-sectional imaging and histopathological correlation.","authors":"Andrew Dinh Nguyen, Meghan Single, Layla Hatem, Joel P Thompson","doi":"10.25259/JCIS_62_2026","DOIUrl":"https://doi.org/10.25259/JCIS_62_2026","url":null,"abstract":"<p><p>Accessory hepatic lobes represent uncommon birth defects that usually remain clinically silent and are discovered incidentally. Torsion of an accessory hepatic lobe is a rare complication causing abdominal discomfort difficult to discern from other etiologies of acute abdominal pain. Cross-sectional imaging is utilized to detect the process and establish a treatment plan. This case study presents a 57-year-old female with acute epigastric pain radiating to the right upper quadrant. Computed tomography and magnetic resonance imaging successfully identified an edematous, torsed accessory hepatic lobe. The patient underwent surgical resection of the torsed accessory lobe, and histopathologic analysis confirmed the process observed on imaging. Prior literature on imaging and histopathologic findings for accessory hepatic lobe torsion is limited. This report serves to describe key imaging features of this entity.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"36"},"PeriodicalIF":1.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular management of superficial femoral artery chronic total occlusions: Influence of lesion complexity and popliteal access on the efficacy of rotational atherectomy plus drug-coated balloon versus drug-coated balloon alone.","authors":"Ibrahim Ilker Oz, Emre Karacay, Betül Ozaslan, Temel Fatih Yilmaz, Tamer Baysal","doi":"10.25259/JCIS_42_2026","DOIUrl":"https://doi.org/10.25259/JCIS_42_2026","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the safety and efficacy of rotational atherectomy combined with drug-coated balloon angioplasty (RA+DCB) versus DCB alone in patients with superficial femoral artery chronic total occlusions (SFA CTOs) and to evaluate the influence of lesion complexity and vascular access site (femoral or popliteal) on procedural success and 12-month clinical outcomes.</p><p><strong>Material and methods: </strong>This single-center retrospective cohort included 98 consecutive patients (117 SFA CTOs) treated between December 2022 and January 2024. All patients presented with lifestyle-limiting claudication or chronic limb-threatening ischemia (Rutherford 3-6). The primary outcome was 12-month primary patency on duplex ultrasound; secondary outcomes were technical success and freedom from target-lesion revascularization (TLR). Multivariable logistic regression identified predictors of loss of primary patency and TLR, and Kaplan- Meier analysis compared patency across treatment groups and access sites.</p><p><strong>Results: </strong>Successful lesion crossing was achieved in 109 of 117 CTOs (93.2%). Technical success was similar for RA + DCB (94.3%) and DCB alone (94.6%). At 12 months, primary patency (67.3% vs. 50%, <i>p</i> = 0.16) and freedom from TLR (70.2% vs. 54.2%, <i>p</i> = 0.26) did not differ between treatment modalities, nor between femoral and popliteal access. Diabetes mellitus independently reduced the odds of primary patency (odds ratio [OR], 0.30, 95% confidence interval [CI], 0.11-0.88) and TLR-free survival (OR, 0.28, 95% CI, 0.09-0.86). Longer occlusion length predicted crossing failure (<i>p</i> = 0.008) but not loss of patency. No procedure-related major adverse limb events occurred.</p><p><strong>Conclusion: </strong>Routine addition of RA to DCB angioplasty for all SFA CTOs is not supported. RA-facilitated DCB may confer benefit only in selected heavily calcified lesions. Mid-term outcomes are driven primarily by diabetes and lesion length, rather than the access route, underscoring the importance of a risk-adapted, lesion-specific treatment strategy.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"35"},"PeriodicalIF":1.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical feasibility and image quality assessment of deep learning-based virtual contrast enhancement from photon-counting computed tomography.","authors":"Julien G Cohen, Joel Valentin Stadelmann, David Leite-Arada, Pierre-Alexandre Poletti","doi":"10.25259/JCIS_99_2026","DOIUrl":"https://doi.org/10.25259/JCIS_99_2026","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate image quality and diagnostic performance of deep learning-based virtual contrast-enhanced (VCE) images generated from photon-counting CT (PCCT) datasets.</p><p><strong>Material and methods: </strong>Forty consecutive patients who underwent contrast-enhanced PCCT were retrospectively included and divided into training (<i>n</i> = 20) and testing (<i>n</i> = 20) cohorts. A supervised U-Net-based convolutional neural network was trained to generate VCE images from virtual non-contrast inputs, using true contrast-enhanced (TC) images as the reference. Quantitative similarity was assessed using the structural similarity index measure (SSIM), mean absolute error (MAE), mean squared error (MSE), and peak signal-to-noise ratio (PSNR). Qualitative evaluation was performed independently by two radiologists using a 5-point Likert scale across thoracic and abdominal structures, with assessment of exact, ±1-point, and diagnostic agreement.</p><p><strong>Results: </strong>Quantitative analysis demonstrated high similarity between VCE and TC images, with very high SSIM and PSNR values and low MAE, while MSE showed a right-skewed distribution. Qualitatively, VCE images were consistently rated lower than TC images. However, central thoracic vascular structures, cardiac chambers, and mediastinal lymph nodes were frequently rated as diagnostic (Likert ≥3) with high diagnostic agreement. In contrast, abdominal solid organs and vessels were often judged non-diagnostic, mainly due to heterogeneous enhancement and apparent contrast defects.</p><p><strong>Conclusion: </strong>The synthesis of VCE images from PCCT datasets is feasible and shows excellent quantitative similarity to TC images, with promising results for thoracic applications but limited reliability for abdominal evaluation at this stage.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"34"},"PeriodicalIF":1.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging evidence of osseous fusion of patients undergoing segmental mandibular fibular free flap reconstruction - a retrospective analysis.","authors":"Dinesh Rao, Ashleigh Weyh, Mauricio Hernandez, Rachel Stein, Adam Holtzman, Sukhwinder Sandhu, Anthony Bunnell, Rui Fernandes","doi":"10.25259/JCIS_211_2025","DOIUrl":"10.25259/JCIS_211_2025","url":null,"abstract":"<p><strong>Objectives: </strong>There is a lack of literature detailing evidence of osseous fusion following mandibular free flap reconstruction. This purpose of this study was to determine the presence of osseous union following mandibular free flap reconstruction, the timing of fusion and risk factors associated with non-union.</p><p><strong>Material and methods: </strong>A retrospective chart and imaging review was performed to determine the presence of fusion and risk factors for non-union following fibular free flap reconstruction of the mandible. Indications for surgery included malignancy, benign lesions, osteoradionecrosis, and trauma. Chi-square analyses were performed in aggregate and for each subgroup to determine associations between different factors for the presence of fusion.</p><p><strong>Results: </strong>This study included 79 subjects with 62 (78%) achieving at least partial fusion, and 53 (67%) achieving complete fusion. Subjects who underwent surveillance imaging for longer periods of time were more likely to achieve fusion. (<i>p</i><0.005). Malignant lesions were more likely to fuse than other subgroups (<i>p</i><0.029). T4 lesions had less fusion (<i>p</i><0.048). Adjuvant chemotherapy (<i>p</i><0.035), steroids (<i>p</i><0.046), and prior radiotherapy (<i>p</i><0.024) were associated with transient delays in fusion.</p><p><strong>Conclusion: </strong>Most patients undergoing mandibular reconstruction demonstrate complete fusion at one year after surgery. Transient delays in bone union may occur secondary to adjuvant chemotherapy, perioperative steroid use and prior radiotherapy.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"33"},"PeriodicalIF":1.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphoscintigraphic patterns in lymphedema with normal body mass index, obesity-induced lymphedema, phlebolymphedema, and lipedema.","authors":"Sina Oh, Jaewon Yang, Michael Fediw, Robert Carson Sibley","doi":"10.25259/JCIS_121_2026","DOIUrl":"10.25259/JCIS_121_2026","url":null,"abstract":"<p><p>Lower extremity swelling has a broad differential diagnosis, including lymphedema, obesity-induced lymphedema, phlebolymphedema, and lipedema. Although these conditions may appear similar clinically, their pathophysiology and lymphoscintigraphic findings differ. Obesity, venous insufficiency, and abnormal adipose tissue can complicate image interpretation. We present four representative cases to illustrate characteristic imaging patterns across these conditions. These cases highlight the importance of interpreting lymphoscintigraphy in a clinical context.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"32"},"PeriodicalIF":1.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up after an abnormal screening mammogram: Impact of a pandemic on mobile mammography patients.","authors":"Ethan Oren Cohen, Charisma DeSai, Chingyi Young, Jia Sun, Gary J Whitman","doi":"10.25259/JCIS_238_2025","DOIUrl":"10.25259/JCIS_238_2025","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effect of COVID-19 on a mobile screening mammography program as measured by turnaround time (TAT) in days between an abnormal screening mammogram (sMG) and diagnostic mammography.</p><p><strong>Material and methods: </strong>All of our institution's sMG (mobile and non-mobile) from January 2017, to December 2022 were retrospectively reviewed, and those dated March 7, 2020-July 7, 2020 were excluded because our mobile sMG program was non-operative at that time due to COVID-19. TATs and patient demographics were compared for mobile and non-mobile sMG patients between 2 time periods: Pre-pandemic (January 1, 2017-March 6, 2020) and pandemic (July 8, 2020-December 31, 2022). Statistics included multiple linear regression analysis, Fisher's Exact, and Wilcoxon Rank Sum tests.</p><p><strong>Results: </strong>During the pre-pandemic period, 11,439 female patients (9309 without insurance, 81.3%) underwent 14,161 mobile sMG, while 28,737 female patients (429 without insurance, 1.5%) underwent 57,840 non-mobile sMG. During the pandemic period, 6805 female patients (6720 without insurance, 98.8%) underwent 7663 mobile sMG, while 32,655 female patients (868 without insurance, 2.7%) underwent 53,540 non-mobile sMG. Median TATs for mobile uninsured patients increased from 41 days during the pre-pandemic period to 51 days during the pandemic period (<i>p</i> < 0.001), while median TATs for non-mobile insured patients decreased from 20 days during the pre-pandemic period to 14 days during the pandemic period (<i>p</i> < 0.001). Increased TATs were associated with Asian, African American, and Other race compared with White race (Asian, <i>p</i> = 0.004; African American, <i>p</i> < 0.001; and Other, <i>p</i> = 0.02) and self-pay insurance status (<i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>For mobile uninsured screening patients, the number of days between screening and diagnostic mammography increased with the COVID-19 pandemic, while it decreased for non-mobile insured screening patients. Mobile uninsured mammography patients may represent a population that needs additional attention. These findings highlight a health equity concern, as the pandemic disproportionately widened disparities in timely follow-up care for uninsured patients served by mobile mammography programs.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"31"},"PeriodicalIF":1.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of zoomed and parallel diffusion-weighted imaging: A phantom study.","authors":"Akiyoshi Iwase, Yasuo Takatsu, Naoki Ohno, Azusa Kitao, Tosiaki Miyati","doi":"10.25259/JCIS_92_2025","DOIUrl":"10.25259/JCIS_92_2025","url":null,"abstract":"<p><strong>Objectives: </strong>Single-shot echo-planar imaging sequences with parallel imaging are widely used for diffusion-weighted imaging (DWI). However, when small fields of view and higher phase-encoding reduction ratios (PRs) are applied, image quality may deteriorate because of imperfections in the unfolding process of parallel imaging. Previous studies have suggested that Zoomed DWI (Zoom-DWI) may address this limitation. Therefore, we compared Zoom-DWI with parallel DWI (Parallel-DWI) across different PRs to evaluate image quality.</p><p><strong>Material and methods: </strong>Zoom-DWI and Parallel-DWI were performed using identical acquisition times and imaging parameters at different PRs. Signal-to-noise ratio (SNR), image uniformity, slice thickness, spatial resolution, and image distortion were evaluated.</p><p><strong>Results: </strong>At a PR of 66.6%, the SNR of Zoom-DWI was approximately 1.4-3.3-fold higher than that of Parallel-DWI at the image center, where reconstruction errors in parallel imaging become more pronounced as PR increases. Image uniformity was also higher in Zoom-DWI than in Parallel-DWI, and the difference increased by approximately 41.0% at a PR of 66.6%. Slice thickness, spatial resolution, and image distortion were comparable between the two methods.</p><p><strong>Conclusion: </strong>In this phantom study, Zoom-DWI demonstrated higher SNR and greater image uniformity than Parallel-DWI, particularly at higher PRs and in the central image region.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"30"},"PeriodicalIF":1.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image quality evaluation of neonatal brain magnetic resonance imaging using a deep learning reconstruction algorithm: A quantitative and multireader study using variable denoising levels at 3 tesla.","authors":"Zain Alvi, Eduardo P Reis, Mateus A Esmeraldo, David Shin, Suchandrima Banerjee, Hisham M Dahmoush, Andrew Campion, Stefanie Chambers, Yanniklas Kravutske, Sergios Gatidis, Bruno P Soares","doi":"10.25259/JCIS_32_2026","DOIUrl":"10.25259/JCIS_32_2026","url":null,"abstract":"<p><strong>Objectives: </strong>Neonatal imaging is particularly challenging because newborns are prone to head motion, which can degrade image quality and complicate interpretation. Improving brain magnetic resonance imaging (MRI) image quality may help reduce diagnostic uncertainty and facilitate the nuanced assessment of early myelinating structures in the neonatal brain. Although deep learning reconstruction algorithms designed to improve MRI image quality have been evaluated in pediatric imaging, they have not been specifically studied in exclusively neonatal populations. This pilot study sought to evaluate image quality improvement through the employment of a deep learning reconstruction algorithm in neonatal brain imaging.</p><p><strong>Materials and methods: </strong>3D T1-weighted brain MRIs were obtained in a small cohort of 15 neonates. A deep learning reconstruction algorithm was applied to the image sets using low, medium, and high levels of denoising. Three radiologists qualitatively rated image quality (signal-to-noise ratio [SNR], presence of artifacts, and overall clarity) on a 4-point scale of eight early myelinating structures. Objective apparent SNR (aSNR) and apparent contrast-to-noise ratio (aCNR), based on signal intensities of white and gray matter, were measured across all three denoising levels.</p><p><strong>Results: </strong>Evaluation by radiologists indicated an overall increase in all image quality categories and increased conspicuity of the early myelinating structures as the level of denoising increased. Objective aSNR and aCNR values also increased progressively with denoising, with significant differences observed for nearly all pairwise comparisons.</p><p><strong>Conclusion: </strong>Our findings suggest improvement in image quality with the use of the deep learning reconstruction algorithm in 3D T1-weighted neonatal brain MRI, though the small sample size and pilot design limit generalizability. Diagnostic accuracy and clinical outcomes were not evaluated and warrant future investigation.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"29"},"PeriodicalIF":1.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of low-cost, off-label balloons during balloon-occluded retrograde transvenous obliteration procedure.","authors":"Umamaheswari Nusum, Shoban Haridass, Shikhar Garg, K B Santhosh Babu, Shyamkumar N Keshava","doi":"10.25259/JCIS_232_2025","DOIUrl":"10.25259/JCIS_232_2025","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of the study is to assess the technical feasibility, safety, and clinical efficacy of balloon-occluded retrograde transvenous obliteration (BRTO) using low-cost, off-label balloon catheters.</p><p><strong>Material and methods: </strong>A retrospective study was conducted on 31 patients (20 males, 11 females; mean age 56.6 years; range 47-75 years) who underwent BRTO between January 2009 and November 2023. All patients had gastric varices with a demonstrable gastrorenal shunt on pre-procedural computed tomography; six of them presented with intractable hepatic encephalopathy. Off-label balloon catheters (Swan-Ganz, Fogarty, or stone extractor) were selected based on shunt anatomy. Sodium tetradecyl sulfate foam, with or without Lipiodol, was used as the sclerosing agent. Technical success was defined as sustained sclerosant stasis during balloon inflation. Clinical success was defined as cessation of variceal bleeding or resolution of encephalopathy.</p><p><strong>Results: </strong>Technical success was achieved in 29 of 31 patients (93.5%). Balloon rupture or deflation occurred in two patients; however, hemostasis was successfully maintained without any rebleeding. Of the 25 patients with follow-up data (mean 953.6 days; range 1-4015 days), clinical success was observed in 23 (92%). One patient required surgical shunt creation for immediate post-procedure bleeding, and another experienced rebleeding after 1 year, which was successfully managed with a transjugular intrahepatic portosystemic shunt. Among 17 patients with follow-up imaging or endoscopy, complete obliteration of gastric varices was observed in 70.5% and partial obliteration in 29.5%. Balloon-related complications were rare and not associated with adverse clinical outcomes.</p><p><strong>Conclusion: </strong>BRTO using inexpensive off-label balloon catheters is a technically feasible, safe, and clinically effective treatment for gastric varices and hepatic encephalopathy. In combination with a modified Lipiodol-free sclerosant protocol, this technique offers a cost-effective alternative to conventional BRTO in resource-constrained environments. Prospective studies are needed to confirm these findings and to develop standardized clinical guidelines.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"28"},"PeriodicalIF":1.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}