Journal of Medical Imaging and Radiation Oncology最新文献

{"title":"Fat-Containing Soft Tissue Lesions of the Limbs and Body Wall—A Pictorial Essay","authors":"Kai-Zheong Lim,&nbsp;Cathryn Hui","doi":"10.1111/1754-9485.70181","DOIUrl":"10.1111/1754-9485.70181","url":null,"abstract":"<p>Lipomatous tumours are frequently encountered on imaging. The spectrum of lipomatous tumours ranges from simple lipomas, which can be monitored clinically, to high-grade liposarcomas, which require timely, multidisciplinary management. The presence of fat within lesions may also be observed in non-lipomatous tumours, as well as in a variety of non-neoplastic conditions. This pictorial review examines the key imaging characteristics of primary lipomatous tumours and other fat-containing soft tissue lesions that can be found in the limbs and body wall.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 7","pages":"657-666"},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.70181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-Guided Interventions for Intercostal Neuralgia: What the Radiologist Needs to Know","authors":"Anusha Kannan,&nbsp;Sivasubramanian Srinivasan","doi":"10.1111/1754-9485.70151","DOIUrl":"10.1111/1754-9485.70151","url":null,"abstract":"<div>\u0000 \u0000 <p>Nerve blocks are excellent adjuncts to multimodal systemic analgesia in patients needing complex pain management, often producing days, weeks, or months of pain-free periods. Pain often debilitates patients with significant disruption to quality of life. Intercostal nerve injection and ablations are very useful procedures in patients suffering from pain caused by trauma, tumour, or inflammation. Traditionally done using anatomical landmarks, these procedures have been associated with a higher rate of complications. When imaging modalities (such as ultrasonography or computed tomography (CT)) are used for guidance, complications are significantly reduced, ensuring better outcomes in these vulnerable patients. A variety of other regional techniques can also be used as alternatives to intercostal nerve block such as epidural, paravertebral, erector spinae plane blocks, anterolateral and anteromedial chest wall plane blocks. Interventions for intercostal neuralgia are relatively easy to perform under imaging guidance, with reliable results and fewer complications.</p>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 7","pages":"629-638"},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Invasive Imaging Assessment of Liver Fibrosis","authors":"Patrick J. Navin,&nbsp;Christopher L. Welle,&nbsp;Kay M. Pepin,&nbsp;Meng Yin,&nbsp;Sudhakar K. Venkatesh","doi":"10.1111/1754-9485.70184","DOIUrl":"10.1111/1754-9485.70184","url":null,"abstract":"<div>\u0000 \u0000 <p>Chronic liver disease (CLD) is a major cause of global morbidity and mortality, with outcomes closely linked to the severity of liver fibrosis. While liver biopsy has historically been the reference standard for fibrosis staging, its invasiveness, sampling variability and limited suitability for longitudinal monitoring have driven the widespread adoption of non-invasive tests (NITs). Imaging-based biomarkers, particularly elastography, now play a central role in the clinical assessment and care pathway design. This review focuses on imaging techniques for non-invasive assessment of liver fibrosis, with emphasis on elastography techniques: vibration-controlled transient elastography (VCTE), ultrasound-based shear wave elastography (SWE) and magnetic resonance elastography (MRE). Technical principles, advantages, limitations and implementation considerations are discussed to support informed selection across clinical contexts. VCTE offers rapid point-of-care assessment with extensive validation for identifying advanced fibrosis but is limited by operator dependence, reduced repeatability and lack of anatomical information. SWE provides real-time, radiologist-controlled assessment with improved applicability in obesity and ascites, though intervendor variability and operator dependence remain challenges. MRE demonstrates the highest diagnostic accuracy, reproducibility and technical success, with assessment of larger liver volume and strong performance across etiologies, albeit with limited access due to the requirement of an MRI system. Adjunct MRI biomarkers, including proton-density fat fraction and iron-corrected T1 mapping, further enhance liver phenotyping by characterising steatosis and fibro-inflammatory activity. Understanding the strengths and limitations of each technique is essential for radiologists supporting multidisciplinary CLD management and service implementation, particularly in evolving healthcare environments such as Australia.</p>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 7","pages":"639-652"},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Safety and Clinical Appropriateness of Breast Cancer Advice From Consumer-Grade Large Language Models","authors":"Michael Njunge,&nbsp;Yang Huang,&nbsp;Ran Li,&nbsp;Anitha Karunairajah,&nbsp;Nathan Burns,&nbsp;Nathalie Falkner,&nbsp;Gareth Porter","doi":"10.1111/1754-9485.70092","DOIUrl":"10.1111/1754-9485.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Freely available consumer large language models (LLMs) have become a common source of health information for patients. Though convenient, their consumer use by patients raises concerns about accuracy, safety and applicability to local clinical practice. We set out to assess how reliable and clinically appropriate breast cancer advice from three widely used LLMs (ChatGPT 3.5o, Gemini 2.0 and Perplexity (Standard)) is when applied in a Western Australian (WA) context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We developed 31 questions covering breast cancer prevention, screening, imaging and management. Each LLM was asked the same question three times. The final answers were assessed for qualitative and quantitative reliability and graded for clinical appropriateness by a blinded panel of Consultant Breast Surgeons and Radiologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All three models performed well in terms of reliability, with ChatGPT and Perplexity providing consistent answers to all questions. ChatGPT had the highest rate of clinically appropriate answers (97%), followed by Perplexity (90%) and Gemini (87%). Inappropriate responses were more common when questions included WA-specific terminology, particularly for Perplexity and Gemini. Agreement between Surgeons was strong, while Radiologists showed variability in their ratings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LLMs can provide reliable and generally appropriate breast cancer advice, but performance suffers regarding WA-specific breast screening terminology. Our findings highlight how LLM performance is region-specific, and this fact is likely generalisable to other areas of medicine where there may be regional variance in practice. Overall, LLMs are useful as educational tools, but their outputs should always be interpreted considering local guidelines and with clinical oversight.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 7","pages":"623-628"},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SpyGlass-Assisted Percutaneous Transhepatic Cholangioscopy for Benign and Malignant Biliary Strictures: A Retrospective Observational Study","authors":"Yi Sing Wee,&nbsp;Tae Gon Yoo,&nbsp;Snehal Patel,&nbsp;Sanket Srinivasa,&nbsp;Jonathan Koea,&nbsp;Rahul Bera","doi":"10.1111/1754-9485.70123","DOIUrl":"10.1111/1754-9485.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>SpyGlass-assisted percutaneous transhepatic cholangioscopy is increasingly used to evaluate biliary strictures when standard endoscopic approaches are limited. This study evaluates the clinical indications, diagnostic performance, and safety of SpyGlass-assisted percutaneous transhepatic cholangioscopy with targeted forceps biopsy for biliary strictures at a tertiary centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective single-centre review identified all SpyGlass-assisted percutaneous transhepatic cholangioscopy procedures performed between May 2021 and January 2025 where biopsy of a biliary stricture was attempted. Demographic characteristics, clinical presentation, procedural details, histological findings, and complications were obtained from the hospital's electronic database. The primary outcome was technical and diagnostic success. Technical success required cholangioscope advancement, visualisation of the biliary tree, and attempted biopsy. Diagnostic success required a definitive histopathological diagnosis from the biopsy sample. Secondary outcomes included complication rates, length of hospital stay, and subsequent clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 99 total procedures, 39 involved biopsies of biliary strictures. The mean patient age was 67 years, and 66.7% were male. Cholangioscopy was used as the first-line intervention in most procedures (87.2%). Technical success was achieved in all procedures. Diagnostic success was 84.6%, identifying malignancy in 24 procedures and benign pathology in 9. Six biopsies (15.4%) were non-diagnostic due to atypical cells, crush artefact, or insufficient tissue. Two procedures demonstrated discordance, with negative or atypical biopsy results despite later confirmation of malignancy. Complications occurred in 16 procedures, most commonly Grade II, including one procedure-related death. Median hospital stay was 11 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SpyGlass-assisted percutaneous transhepatic cholangioscopy demonstrates high technical success and strong diagnostic performance for biliary strictures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 7","pages":"670-677"},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Ultrasound Shear Wave Elastography (SWE) and Attenuation Imaging (ATI) for the Assessment of Hepatic Fibrosis and Steatosis—A Prospective Comparison With MRI Liver Elastography and Proton Density Fat Fraction (PDFF)","authors":"Jessica Y. Lee,&nbsp;Wayland Wang,&nbsp;Paul Simkin,&nbsp;Beng Ghee Lim,&nbsp;Damien L. Stella,&nbsp;Jeffrey K. C. Lai,&nbsp;Siddharth Sood,&nbsp;Joel Hng,&nbsp;Robert N. Gibson","doi":"10.1111/1754-9485.70093","DOIUrl":"10.1111/1754-9485.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To assess competing US techniques in evaluation of chronic liver disease, we performed a study to determine the diagnostic accuracy of 2D-shear wave elastography (2D-SWE) and attenuation imaging (ATI) compared with more established methods of point shear wave elastography (pSWE) and visual B-mode grading of hepatic steatosis. Magnetic resonance elastography (MRE) and proton density fat fraction (MR-PDFF) were used as respective reference standards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-five patients underwent same-day liver ultrasound (conventional B-mode, pSWE, 2D-SWE, and ATI) and 3 T MRI (MRE and MR-PDFF). Diagnostic performance for steatosis (mild, moderate, severe) and fibrosis (≥ F2, ≥ F3, and F4) grades was assessed using receiver operating characteristic (ROC) curve analysis, with area under the curve (AUC) calculated. Agreement was evaluated using Cohen's kappa for categorical comparisons and intraclass correlation coefficients (ICC) for continuous measurements within the same modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For fibrosis, 2D-SWE demonstrated high sensitivity (100%) for advanced fibrosis (≥ F3; AUC 0.87), compared with pSWE (sensitivity of 71.4%). In contrast, pSWE showed higher specificity (92.3%) for significant fibrosis (≥ F2) compared to 2D-SWE (73.9%). Categorical agreement with MRE was higher for pSWE (kappa = 0.66) than 2D-SWE (kappa = 0.45). For steatosis, visual B-mode across all grades had AUC 0.85–0.89 compared to 0.68–0.85 for ATI. ATI performed best in detecting severe steatosis (AUC 0.85).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Across the spectrum of clinically relevant assessment of liver fibrosis and steatosis, pSWE and visual B-mode grading showed better correlation with MRI results than 2D-SWE and ATI, respectively. However, they did provide good diagnostic performance in grading liver fibrosis and steatosis in advanced disease. Further research may better define more accurate standardised cut-off scores for the 2D-SWE and ATI techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"70 7","pages":"611-622"},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous Cerebral Cone Beam Computed Tomography vs. Diagnostic Intraarterial Cerebral Angiography: A Cost Comparison.","authors":"Gillian Bruce, Bjoern Picker, Chevy Maat, Brendan Erskine","doi":"10.1111/1754-9485.70204","DOIUrl":"https://doi.org/10.1111/1754-9485.70204","url":null,"abstract":"<p><strong>Introduction: </strong>Whilst intra-arterial (IA) cerebral angiography is a well-established diagnostic tool, the use of intravenous (IV) cerebral cone beam computed tomography (CBCT) is a comparatively new diagnostic method that is gaining popularity in the interventional neuroradiology (NIR) community. With the cost of healthcare being central to the delivery of modern medicine, this study aimed to further understand this shift by investigating the procedural cost of intravenous cerebral CBCT with IA cerebral angiography.</p><p><strong>Methods: </strong>Retrospective cohort study of 40 patients imaged over a four-month period in 2024, with total costs related to the patient encounter and procedure calculated.</p><p><strong>Results: </strong>For each procedure, median cost was formulated from the combination of day procedure costs (where appropriate), capital equipment usage, staff wages, and consumables. The median cost for IV cerebral CBCT vs. IA cerebral angiography was AUD$187 vs. AUD$1290.</p><p><strong>Conclusion: </strong>For all cases, the total procedural cost for IV cerebral CBCT was significantly lower than IA cerebral angiography. Additionally, there was a substantial reduction in periprocedural risk as well as the hospital resources utilised (beds and health care workers).</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroidal Melanoma Treated With Ruthenium-106 Eye Plaque Brachytherapy: Results of an Australian Statewide Service From November 2020 to January 2025.","authors":"Sarah Li, Lindsay A McGrath, Timothy Beckman, Adrian Gibbs, Lucy Sim, William Glasson, Sunil Warrier, Andrew Pullar, Luke Nicholls","doi":"10.1111/1754-9485.70200","DOIUrl":"https://doi.org/10.1111/1754-9485.70200","url":null,"abstract":"<p><strong>Introduction: </strong>Uveal melanoma is a rare but aggressive malignancy, predominantly affecting the choroid. This study is the first retrospective review performed on adult choroidal melanoma patients treated with Ruthenium-106 plaque brachytherapy in Queensland.</p><p><strong>Method: </strong>The study period was November 2020 to January 2025, where patient, tumour, and treatment factors, as well as local control, salvage treatments, radiation retinopathy, and visual acuity were assessed at 6, 12, 24, and 36 months post-treatment.</p><p><strong>Results: </strong>A total of 151 patients with a mean tumour thickness of 3.85 mm and mean largest basal diameter of 10.2 mm received treatment. A dose of 100 Gy to the tumour apex was prescribed to 88.7% of patients. The short-term risk factor for disease progression was tumour thickness (odds ratio [OR] 2.01, 95% confidence interval [CI], 1.11-3.87; p = 0.025), whereas tumour to optic nerve distance was a protective factor in both the short- (OR 0.55, 95% CI 0.31-0.82; p = 0.013) and long-term (OR 0.75, 95% CI 0.60-0.90; p = 0.005). At 36 months post-treatment, local control was 89.5%, the enucleation rate was 3.3%, tumour thickness (OR 1.77, 95% CI 1.1-2.98; p = 0.022) and sclera dose (OR 1.01, 95% CI 1-1.01; p = 0.045) were risk factors for severe radiation retinopathy. Median visual acuity decreased by one Snellen chart line. When tumour distance to optic nerve or foveola is greater than 3 mm, there was minimal change to visual acuity.</p><p><strong>Conclusion: </strong>The findings demonstrate that high-quality plaque brachytherapy can be delivered effectively at a statewide level.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linear Accelerator-Based Stereotactic Body Radiotherapy of 36.25 Gy in Five Fractions for Localised Prostate Cancer: A Retrospective Single-Institution Cohort Study.","authors":"Atsuto Katano, Hideomi Yamashita","doi":"10.1111/1754-9485.70202","DOIUrl":"https://doi.org/10.1111/1754-9485.70202","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic body radiotherapy has become an established treatment option for localised prostate cancer. However, real-world evidence from routine clinical practice remains limited, particularly in cohorts that include older patients. We therefore report long-term outcomes and treatment-related adverse events after a uniform linear accelerator-based stereotactic body radiotherapy regimen.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients with localised prostate adenocarcinoma treated between May 2016 and June 2020 with definitive stereotactic body radiotherapy of 36.25 Gy in five fractions delivered every other day. Risk stratification followed National Comprehensive Cancer Network criteria.</p><p><strong>Results: </strong>A total of 232 patients were included. The median age was 73 years (range, 52-88), and the median follow-up was 84.5 months (range, 3.6-113.8). Overall survival at 3, 5, and 7 years was 98.2%, 95.1%, and 93.3%, respectively. Biochemical recurrence-free survival at 3, 5, and 7 years was 95.9%, 90.2%, and 87.8%, respectively. In patients with higher-risk disease, biochemical recurrence-free survival at 5 years was 90.9% in the high-risk group and 74.2% in the very high-risk group. No Grade 3 acute gastrointestinal or genitourinary events occurred. Late Grade 3 genitourinary adverse events occurred in 5 patients (2.2%) and late Grade 3 gastrointestinal adverse events in 3 patients (1.3%); no Grade 4 or 5 treatment-related adverse events were observed.</p><p><strong>Conclusions: </strong>In this single-institution real-world cohort, linear accelerator-based stereotactic body radiotherapy was associated with long-term disease control and a limited incidence of severe late adverse events. These findings support implementation of five-fraction prostate stereotactic body radiotherapy in routine practice with appropriate patient counselling and long-term surveillance.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of ACR TI-RADS for Predicting Cytological Outcomes in Thyroid Nodules: A Large FNA Cohort Study.","authors":"Ilona Lavender, Dee Nandurkar","doi":"10.1111/1754-9485.70207","DOIUrl":"https://doi.org/10.1111/1754-9485.70207","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of ACR TI-RADS for predicting malignant cytology in thyroid nodules undergoing fine-needle aspiration (FNA) in a large tertiary centre.</p><p><strong>Methods: </strong>A retrospective analysis was performed of 3368 thyroid nodules undergoing ultrasound-guided FNA. Nodules were classified according to ACR TI-RADS (TR1-TR5). Cytological outcomes were recorded using the Bethesda System. Malignant cytology was defined as Bethesda V-VI and Bethesda IV-VI was evaluated as a secondary composite cytological outcome. The distribution of cytology across TI-RADS categories was assessed, and malignancy rates were calculated. Diagnostic performance was evaluated using TR4-TR5 as a positive threshold.</p><p><strong>Results: </strong>Nodules were classified as TR1 (1.4%), TR2 (5.3%), TR3 (23.7%), TR4 (51.0%) and TR5 (18.7%). Malignant cytology increased across categories from 0.0% in TR1 to 6.5% in TR5, while Bethesda IV-VI cytology increased from 0.0% to 12.6%. Among TR3-TR5 nodules, 81.0% met the corresponding ACR size threshold for FNA; malignant cytology occurred in 2.6% meeting the threshold and 1.7% below threshold (p = 0.24). TI-RADS category was significantly associated with cytological outcome (p < 0.001). Using TR4-TR5 as a threshold, sensitivity was 88.2% and negative predictive value 99.1%.</p><p><strong>Conclusion: </strong>ACR TI-RADS demonstrates a clear association with cytology outcomes, with increasing malignancy risk across categories. In this large FNA-based cohort, TI-RADS showed excellent negative predictive value, supporting its role in ultrasound-based risk stratification and optimisation of FNA decision-making.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}