Radiologia Medica最新文献

{"title":"Efficacy and safety of CT-guided oxygen-ozone (O₂-O₃) therapy for low back pain: a retrospective single-center study.","authors":"Alberto Bellelli, Valerio D'Andrea, Matteo Pileri, Bruno Beomonte Zobel","doi":"10.1007/s11547-025-02071-2","DOIUrl":"https://doi.org/10.1007/s11547-025-02071-2","url":null,"abstract":"<p><strong>Purpose: </strong>Oxygen-ozone (O₂-O₃) therapy is increasingly recognized as a minimally invasive option for managing low back pain (LBP). This study aims to assess the efficacy and safety of CT-guided O₂-O₃ injections, both as a standalone therapy and in combination with other medications, across a diverse cohort of patients with LBP.</p><p><strong>Materials and methods: </strong>We conducted a single-center retrospective observational study of patients with LBP who underwent CT-guided O₂-O₃ intradiscal and/or facet joint injections between January 2016 and March 2017. Patients were categorized into three groups: Group A (facet joint osteoarthritis), Group B (single-level disc herniation with unilateral sciatica), and Group C (double-level disc herniation with bilateral or unilateral sciatica). Pain intensity was assessed using the Visual Analog Scale (VAS) at baseline and three weeks after the final injection. Statistical analysis included paired t-tests for pre- and post-treatment comparisons and one-way ANOVA with Tukey's HSD for group comparisons.</p><p><strong>Results: </strong>A total of 123 patients were included. The mean baseline VAS score for the entire cohort was 7.5 ± 1.2, which significantly decreased to 3.5 ± 1.5 following treatment (T = 43.74, p < 0.001). In Group A, the mean VAS decreased from 7.2 ± 1.3 to 3.8 ± 1.4; in Group B, from 7.8 ± 1.0 to 3.2 ± 1.3; and in Group C, from 8.0 ± 0.9 to 3.0 ± 1.2. ANOVA revealed significant differences in post-treatment VAS scores among groups (F = 27.36, p < 0.001). Tukey's HSD indicated significant differences between Groups A and B (p < 0.001) and A and C (p < 0.001), with no significant difference between Groups B and C (p = 0.247). Overall, 21.95% of patients experienced significant improvement (VAS reduction > 4 points), 57.72% had moderate improvement (VAS reduction 2-4 points), and 18.7% showed minimal improvement (VAS reduction ≤ 1 point). No complications were reported during or after the procedures.</p><p><strong>Conclusion: </strong>The findings strongly support the efficacy and safety of O₂-O₃ therapy for the treatment of LBP, offering significant short-term pain relief across diverse patient subgroups. Further controlled studies are warranted to confirm long-term efficacy and optimize treatment protocols.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head‑to‑head comparison of contrast‑enhanced mammography and MRI in assessing the tumor response to neoadjuvant therapy in breast cancer: a prospective, multireader study.","authors":"Simin Wang, Jinhui Li, Ruchuan Chen, Ruimin Li, Xigang Shen, Min Qian, Chao You, Tingting Jiang, Yajia Gu","doi":"10.1007/s11547-025-02068-x","DOIUrl":"https://doi.org/10.1007/s11547-025-02068-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare contrast-enhanced mammography (CEM) and MRI in the evaluation of the tumor response to neoadjuvant therapy (NAT) in breast cancer.</p><p><strong>Materials and methods: </strong>Patients who underwent CEM and breast MRI before and after NAT were prospectively enrolled in this study. Three readers with different levels of experience independently assessed the images and classified the tumor response following NAT. Radiological complete response (rCR) was defined as the absence of a suspiciously enhanced area. The sensitivity, specificity, and accuracy of CEM and MRI in determining pathological complete response (pCR) were calculated per reader and averaged with a generalized estimating equation. The agreement in the residual tumor extent between imaging and pathology was assessed by intraclass correlation coefficient (ICC) analyses.</p><p><strong>Results: </strong>Fifty-seven patients (age: 47 ± 10 years) were enrolled, 21/57 of whom (36.8%) achieved pCR. In determining pCR, the estimated average sensitivity, specificity, and accuracy were 0.778, 0.714, and 0.754 for CEM, respectively, and 0.714, 0.944, and 0.860 for MRI, respectively (all P values > 0.050). Both imaging modalities slightly overestimated the residual lesion extent (mean overestimations: 1.7 mm and 2.7 mm). In ICC analysis, CEM and MRI showed poor consistency with pathology (average ICCs = 0.4467 and 0.449, respectively).</p><p><strong>Conclusions: </strong>Compared with MRI, CEM showed comparable but slightly lower accuracy, higher sensitivity, and lower specificity in predicting pCR after NAT. In assessing residual tumor extent, CEM and MRI showed similar performance and tended to overestimate the pathological extent. CEM could be an acceptable alternative to MRI in certain patients undergoing NAT.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Artificial intelligence-based tumor size measurement on mammography: agreement with pathology and comparison with human readers' assessments across multiple imaging modalities.","authors":"Mi-Ri Kwon, Sung Hun Kim, Ga Eun Park, Han Song Mun, Bong Joo Kang, Yun Tae Kim, Inyoung Youn","doi":"10.1007/s11547-025-02059-y","DOIUrl":"10.1007/s11547-025-02059-y","url":null,"abstract":"","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing fractures that are hard to diagnose on imaging: Radiomics or deep learning?","authors":"Junlin Xu, Xiaobo Wen, Yingchun Shao, Qing Liu, Sha Zhou, Li Jiyixuan, Dan Wang, Ying Yang, Han Li, Linyuan Xue, Kunyue Xing, Xiaolin Wu, Dongming Xing","doi":"10.1007/s11547-025-02051-6","DOIUrl":"https://doi.org/10.1007/s11547-025-02051-6","url":null,"abstract":"<p><p>Fractures and their complications are recognized as major public health problems. Especially for occult fractures that are difficult to judge radiologically, timely and accurate diagnosis is particularly important for the treatment and prognosis of patients. In recent years, the successful application of radiomics and deep learning in medical diagnosis has shown great potential for providing more timely and accurate diagnostic methods for occult fractures. This review provides an introduction to radiomics and deep learning, summarizes their respective characteristics in detecting occult fractures, and subsequently conducts a detailed analysis on the potential value and future prospects of integrating these two techniques to develop an enhanced approach for prompt and precise detection of occult fractures.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional vs. DEB vs. DSM: Which technique for palliative TACE in intermediate-stage HCC? Results on 70 patients in terms of efficacy and tolerance.","authors":"Francesco Giurazza, Claudio Carrubba, Ernesto Punzi, Raffaella Tortora, Marco Guarracino, Fiorella Brangi, Federica Falaschi, Carla Migliaccio, Fabio Corvino, Giovanni Vennarecci, Giuseppe Giovanni Di Costanzo, Giulio Lombardi, Raffaella Niola","doi":"10.1007/s11547-025-02069-w","DOIUrl":"https://doi.org/10.1007/s11547-025-02069-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare palliative cTACE, DEB-TACE and DSM-TACE in patients affected by HCC in intermediate BCLC stage in terms of efficacy and patient tolerance.</p><p><strong>Materials and methods: </strong>Patients treated with palliative TACE were prospectively enrolled in two centers during 9 months. Procedures were performed superselectively in all patients. Inclusion criteria were: HCC diagnosis, intermediate BCLC stage, portal tree patency, preserved hepatic-renal-coagulation functions, palliative procedural aim, follow-up available up to 6-month post-TACE intervention. Exclusion criteria were: previous TACE treatments, alone or in combination with ablation in the same session, ascites, bilirubin > 2mg/dL, age < 18years, bridge to transplant procedural aim, concomitant infectious diseases. Primary endpoint was to compare efficacy and patients tolerance among the 3 different TACE techniques; secondary endpoint was to compare post-procedural complications occurrence.</p><p><strong>Results: </strong>Seventy patients were included and divided into three groups according to the TACE technique: 24 were treated with cTACE, 25 with DEB-TACE, 21 with DSM-TACE. According to mRECIST criteria at 1-, 3- and 6-month follow-up, DEB-TACE presented better local response rates but without statistically significant differences. Patients treated with DSM-TACE showed significantly better tolerance, considering post-procedural transaminases and INR values together with clinical adverse events occurrence monitored up to 7 days. There were no differences in post-procedural complications and no major complications occurred.</p><p><strong>Conclusions: </strong>In this study, in patients with intermediate-stage HCC undergoing palliative treatments, no significant differences emerged comparing cTACE, DEB-TACE and DSM-TACE in terms of procedural efficacy; however, patients treated with DSM-TACE showed significant better procedural tolerance.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomic phenotype of epicardial adipose tissue derived from coronary artery calcium score predicts myocardial ischemia.","authors":"Lihua Yu, Wenli Yang, Runjianya Ling, Yarong Yu, Xu Dai, Jianqing Sun, Jiayin Zhang, Xingdong Zheng","doi":"10.1007/s11547-025-02063-2","DOIUrl":"https://doi.org/10.1007/s11547-025-02063-2","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the radiomic phenotype of epicardial adipose tissue (EAT) derived from coronary artery calcium score (CACS) and its predictive value for myocardial ischemia.</p><p><strong>Materials and methods: </strong>This retrospective study included patients with angina and intermediate-to-high pre-test probability of coronary artery disease who underwent CACS, dynamic CT myocardial perfusion imaging (CT-MPI) and coronary CT angiography (CCTA). All image acquisitions were performed with third generation dual source CT. Radiomic features of EAT derived from CACS were extracted. EAT volume, EAT density, Coronary Artery Disease-Reporting and Data System (CAD-RADS) grades, CACS, and clinical characteristics were recorded. The diagnostic abilities of CT-derived parameters, clinical + CACS model, the EAT radiomic model, and combined model for identification of myocardial ischemia (defined as quantitative myocardial blood flow of less than 100 mL/100 mL/min) were evaluated.</p><p><strong>Results: </strong>A total of 555 patients from two hospitals were included and divided into training set and external validation set separately. The EAT radiomic model was found to have a larger area under the curve (AUC) (0.840 for training set, 0.838 for validation set) than other CT-derived parameters and the clinical + CACS model for predicting myocardial ischemia (all p < 0.05). The overall diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of radiomic model in validation set were 65%, 80%, 59%, 41% and 89%, respectively.</p><p><strong>Conclusion: </strong>The EAT radiomic model demonstrated superior diagnostic performance over clinical + CACS model and other CT-derived parameters in discriminating myocardial ischemia with highest sensitivity and NPV. Nevertheless, the PPV of the EAT radiomic model was found to be low.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in facet orientation may simultaneously affect the potential risk of annulus tears and zygapophyseal joint osteoarthritis: a clinical review and biomechanical simulation.","authors":"Zhipeng Xi, Yimin Xie, Shenglu Sun, Xiong Kang, Jingchi Li","doi":"10.1007/s11547-025-02050-7","DOIUrl":"https://doi.org/10.1007/s11547-025-02050-7","url":null,"abstract":"<p><strong>Background: </strong>The lumbar motion segment, comprising the intervertebral disc and bilateral articular processes, functions as a cohesive unit for load transmission. Morphological alterations in these components can influence local stress distribution, potentially contributing to the development of degenerative changes. Research indicates that sagittally oriented articular processes may reduce the incidence of severe zygapophyseal joint osteoarthritis (ZJOA) by lowering the load transmission ratio. However, this alignment may also heighten the risk of annular tears by intensifying stress concentration.</p><p><strong>Methods: </strong>A retrospective analysis of clinical data from 111 patients was conducted to test this hypothesis. Facet orientations and ZJOA grades were assessed using MRI and CT imaging, while annular integrity was evaluated with diffusion tensor fibre tractography. Regression analyses identified independent predictors for ZJOA severity and annular tears. Furthermore, lumbo-sacral numerical models with varying facet orientations in the L45 motion segment were developed to compute stress distributions on the annulus and facet cartilage, elucidating the biomechanical mechanisms behind the observed clinical phenomena.</p><p><strong>Results: </strong>Consistent with existing literature, sagittally oriented articular processes were identified as an independent predictor of severe ZJOA. In contrast, coronally oriented processes were associated with a higher incidence of mild ZJOA and a greater likelihood of annular tears. Numerical simulations demonstrated that coronally oriented articular processes shift load transmission anteriorly, thereby increasing stress on the annulus while reducing stress on the facet cartilage, and vice versa.</p><p><strong>Conclusions: </strong>Facet orientation influences local load transmission. Coronally oriented articular processes may reduce ZJOA severity while increasing the risk of annular tears by redistributing load anteriorly. Conversely, sagittally oriented articular processes likely exert the opposite effect on both ZJOA progression and annular integrity, driven by the same biomechanical principles.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in renal cancer: diagnosis, treatment, and emerging technologies.","authors":"Tsukasa Saida, Mami Iima, Rintaro Ito, Daiju Ueda, Kentaro Nishioka, Ryo Kurokawa, Mariko Kawamura, Kenji Hirata, Maya Honda, Koji Takumi, Satoru Ide, Shunsuke Sugawara, Tadashi Watabe, Akihiko Sakata, Masahiro Yanagawa, Keitaro Sofue, Seitaro Oda, Shinji Naganawa","doi":"10.1007/s11547-025-02066-z","DOIUrl":"https://doi.org/10.1007/s11547-025-02066-z","url":null,"abstract":"<p><p>This review provides a comprehensive overview of current practices and recent advancements in the diagnosis and treatment of renal cancer. It introduces updates in histological classification and explains the imaging characteristics of each tumour based on these changes. The review highlights state-of-the-art imaging modalities, including magnetic resonance imaging, computed tomography, positron emission tomography, and ultrasound, emphasising their crucial role in tumour characterisation and optimising treatment planning. Emerging technologies, such as radiomics and artificial intelligence, are also discussed for their transformative impact on enhancing diagnostic precision, prognostic prediction, and personalised patient management. Furthermore, the review explores current treatment options, including minimally invasive techniques such as cryoablation, radiofrequency ablation, and stereotactic body radiation therapy, as well as systemic therapies such as immune checkpoint inhibitors and targeted therapies.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-driven incidental detection of vertebral fractures in cancer patients: advancing diagnostic precision and clinical management.","authors":"El Mehdi Mniai, Vladimir Laletin, Lambros Tselikas, Tarek Assi, Baptiste Bonnet, Astrid Orfali Camez, Amir Zemmouri, Serge Muller, Tania Moussa, Yasmina Chaibi, Julie Kiewsky, Sarah Quenet, Christophe Avare, Nathalie Lassau, Corinne Balleyguier, Angela Ayobi, Samy Ammari","doi":"10.1007/s11547-025-02058-z","DOIUrl":"https://doi.org/10.1007/s11547-025-02058-z","url":null,"abstract":"<p><strong>Purpose: </strong>Vertebral compression fractures (VCFs) are the most prevalent skeletal manifestations of osteoporosis in cancer patients. Yet, they are frequently missed or not reported in routine clinical radiology, adversely impacting patient outcomes and quality of life. This study evaluates the diagnostic performance of a deep-learning (DL)-based application and its potential to reduce the miss rate of incidental VCFs in a high-risk cancer population.</p><p><strong>Materials and methods: </strong>We retrospectively analysed thoraco-abdomino-pelvic (TAP) CT scans from 1556 patients with stage IV cancer collected consecutively over a 4-month period (September-December 2023) in a tertiary cancer center. A DL-based application flagged cases positive for VCFs, which were subsequently reviewed by two expert radiologists for validation. Additionally, grade 3 fractures identified by the application were independently assessed by two expert interventional radiologists to determine their eligibility for vertebroplasty.</p><p><strong>Results: </strong>Of the 1556 cases, 501 were flagged as positive for VCF by the application, with 436 confirmed as true positives by expert review, yielding a positive predictive value (PPV) of 87%. Common causes of false positives included sclerotic vertebral metastases, scoliosis, and vertebrae misidentification. Notably, 83.5% (364/436) of true positive VCFs were absent from radiology reports, indicating a substantial non-report rate in routine practice. Ten grade 3 fractures were overlooked or not reported by radiologists. Among them, 9 were deemed suitable for vertebroplasty by expert interventional radiologists.</p><p><strong>Conclusion: </strong>This study underscores the potential of DL-based applications to improve the detection of VCFs. The analyzed tool can assist radiologists in detecting more incidental vertebral fractures in adult cancer patients, optimising timely treatment and reducing associated morbidity and economic burden. Moreover, it might enhance patient access to interventional treatments such as vertebroplasty. These findings highlight the transformative role that DL can play in optimising clinical management and outcomes for osteoporosis-related VCFs in cancer patients.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluoroscopy-guided transvenous femoral renal transplant biopsies: a monocentric retrospective study about 109 consecutive patients.","authors":"Farha Tessier, Charles Roux, Isabelle Brocheriou, Benoit Barrou, Marine Bravetti, Mathilde Aïssaoui, Jean-Charles Bijot, Eloi Varin, Jérome Tourret, Hélène François, Sarah Drouin, Louis Meyblum","doi":"10.1007/s11547-025-02045-4","DOIUrl":"https://doi.org/10.1007/s11547-025-02045-4","url":null,"abstract":"<p><strong>Objectives: </strong>Renal transplant biopsy remains the gold standard for etiological diagnosis of graft dysfunction and subsequent management. When percutaneous renal biopsy (PRB) is contraindicated due to bleeding risk or limited percutaneous access, the fluoroscopy-guided transvenous femoral renal transplant biopsy (TFRB) might be a valuable alternative. This study aims to describe the TFRB technique, its safety, and efficacy.</p><p><strong>Methods: </strong>All patients who underwent TFRB at our institution between 2020 and 2023 were retrospectively analyzed. Procedure outcomes, patients' characteristics and follow-up data were collected. Adverse events were graded using the Adverse Events Classification of the Society of Interventional Radiology.</p><p><strong>Results: </strong>From January 2020 to December 2023, 109 patients (median age 61.2 years (Interquartile range (IQR), 54.5-68.6) ; 49 males (45.0%)) underwent 122 TFRB. Transvenous approach was indicated due to high bleeding risk in 61.5% (75/122), limited percutaneous access in 13.9% (17/122), or previous failed PRB in 2.5% (3/122). Biopsy success rate was 94.3%, with 7 graft vein catheterization failures. Adequate Banff 97 criteria specimens were obtained in 68.7% of cases, and a definitive histological diagnosis was achieved in 96.5% of biopsies. Complications occurred in 20.0% of procedures (23/115), including 9 major complications (7.8%), with no significant difference according to the TFRB indication (bleeding risk versus percutaneous limited access) (p = 0.70), use of antiplatelet agents (p = 0.24) or anticoagulants (p = 1.00).</p><p><strong>Conclusion: </strong>This is the first large cohort study to demonstrates TFRB to be effective and safe in case of contraindication to PRB, providing valuable insights for graft dysfunction management.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}