Radiology最新文献

{"title":"Abbreviated MRI for the Evaluation of Treatment Response in Patients Undergoing Neoadjuvant Chemotherapy for Breast Cancer.","authors":"Roberto Lo Gullo, Marie Surovitsky, Diane Kim, Varadan Sevilimedu, Kailyn Li, Sunitha B Thakur, Katja Pinker","doi":"10.1148/radiol.252413","DOIUrl":"10.1148/radiol.252413","url":null,"abstract":"<p><p>Background Abbreviated MRI offers faster interpretation and shorter acquisition times than full-protocol MRI. Purpose To assess the diagnostic performance of abbreviated breast MRI compared with full-protocol MRI in determining pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in patients with breast cancer. Materials and Methods This retrospective, single-center study included patients with breast cancer who underwent full-protocol MRI before and after NAC from January 2016 to May 2020, followed by surgical resection. Three readers independently interpreted abbreviated MRI data, which included an axial T2-weighted sequence and precontrast and early postcontrast T1-weighted sequences. After a 4-week washout period, the readers interpreted the full-protocol MRI data. Response was classified as complete, partial, stable, or progressive disease. Interpretation times were recorded, and residual enhancement was measured (longest and shortest orthogonal lesion diameters). For statistical analysis, abbreviated MRI and full-protocol MRI were compared using two pCR definitions: the absence of invasive cancer and the absence of both invasive cancer and ductal carcinoma in situ. Statistical tests included generalized estimating equation models, Wilcoxon rank sum tests, and Pearson correlation. Results The study sample included 478 patients (mean age, 51 years ± 12 [SD]; all female). Full-protocol MRI yielded higher specificity than abbreviated MRI did (82.1% vs 85.4% using pCR definition 1; 85.4% vs 88.6% using pCR definition 2; <i>P</i> = .047 for both). There was no evidence of a difference in sensitivity, negative predictive value, positive predictive value, or overall accuracy between abbreviated MRI and full-protocol MRI across pCR definitions and reader (all <i>P</i> > .22). The median interpretation times for abbreviated MRI and full-protocol MRI were 39-44 seconds and 42-64 seconds, respectively (all <i>P</i> < .001). Conclusion Abbreviated MRI offered a time-efficient alternative for assessing the response to neoadjuvant chemotherapy, with similar diagnostic performance to full-protocol MRI in all metrics except specificity. © RSNA, 2026 <i>Supplemental material is available for this article.</i> See also the editorial by Slanetz and Yeh in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"319 1","pages":"e252413"},"PeriodicalIF":15.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676271","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":"Endovascular versus Medical Management of Basilar Artery Occlusion Strokes in Patients with Low Stroke Severity.","authors":"Huanwen Chen, Marco Colasurdo, Mihir Khunte, Ajay Malhotra, James E Siegler, Thanh N Nguyen, Dheeraj Gandhi","doi":"10.1148/radiol.251983","DOIUrl":"https://doi.org/10.1148/radiol.251983","url":null,"abstract":"<p><p>Background The efficacy and safety of endovascular treatment (EVT) in patients with basilar artery occlusion (BAO) stroke and low (score <10) National Institutes of Health Stroke Scale (NIHSS) score are unclear. Purpose To assess whether EVT improves outcomes in patients with low-scoring NIHSS BAO stroke. Materials and Methods A retrospective cohort study of the Nationwide Re-admissions Database (NRD; January 2016 to December 2022) was conducted. Adults with acute BAO stroke and NIHSS score 1-9 were identified and grouped by EVT (thrombectomy, angioplasty, and/or stenting) versus medical management (MM). Primary outcomes were routine discharge to home with self-care and in-hospital mortality. Propensity score matching was performed to balance EVT and MM cohorts, accounting for demographics, comorbidities, symptoms, stroke etiology, and other factors. Subgroup analyses were performed to identify sources of treatment-effect heterogeneity. χ² tests and logistic regression analyses were used to compare outcomes. Results Among 9461 patients (median age, 68 years; IQR, 58-77 years; 5842 males), 1807 were administered EVT. After propensity score matching, 2888 and 1632 patients with MM and EVT, respectively, remained. Rates of routine discharge were similar (MM vs EVT, 34.0% vs 34.0%; <i>P</i> = .24), but the EVT arm had higher in-hospital mortality (16.0% vs 7.1%; <i>P</i> < .001). In subgroup analyses, EVT was associated with higher odds of routine discharge among patients with NIHSS score of 6-9 (odds ratio [OR], 1.42; 95% CI: 1.07, 1.90; <i>P</i> = .02), whereas it was not associated with higher odds of mortality among those with embolic stroke etiology (OR, 1.42; 95% CI: 0.71, 2.86; <i>P</i> = .32) or those who were 75 years or older (OR, 1.63; 95% CI: 0.79, 3.39; <i>P</i> = .19). Conclusion EVT was not associated with better outcomes but was associated with increased mortality among patients with low-score NIHSS BAO stroke; however, NIHSS score, stroke etiology, and patient age may be sources of clinically significant treatment effect heterogeneity. © RSNA, 2026 <i>Supplemental material is available for this article.</i></p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"319 1","pages":"e251983"},"PeriodicalIF":15.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779477","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":"The Value of SSTR PET for Detection, Definition, and Ongoing Management of Meningioma.","authors":"Rishi Jain,Derek Hesse,Connor Tierney,Hatice Savas,Ryan Avery,Stephen T Magill,Eric J Russell","doi":"10.1148/radiol.251079","DOIUrl":"https://doi.org/10.1148/radiol.251079","url":null,"abstract":"Meningiomas are the most common primary brain tumors and present unique diagnostic challenges due to their diverse morphologic features and behavior. Somatostatin receptor (SSTR) PET imaging promises to address these hurdles and bolster the comprehensive management of meningioma. By leveraging the high SSTR expression of meningiomas, SSTR PET can provide superior sensitivity for diagnosis, delineation of tumor extent, and guidance for surgical and radiation planning, particularly in complex cases involving bone or the skull base. As evidence grows, SSTR PET may also provide insights into prognosis, with uptake patterns potentially correlating with recurrence risk and treatment response. Two illustrative cases from the authors' institution are discussed that demonstrate how SSTR PET influenced both diagnosis and treatment strategy.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"17 1","pages":"e251079"},"PeriodicalIF":19.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625749","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":"Imaging of De Novo Malignancy after Solid Organ Transplant.","authors":"Samar Hajj, Rosy Linda Njonkou Tchoquessi, Nikita Rednam, Ankur Pandey, Kathryn Kline, Vikas Kundra","doi":"10.1148/radiol.251384","DOIUrl":"10.1148/radiol.251384","url":null,"abstract":"<p><p>The life expectancy of solid organ transplant recipients has improved over the years because of advanced immunosuppressive regimens, improved anti-infectious agents, and aggressive prophylactic treatments that have decreased the risk of acute rejection and organ loss, life-threatening infections, and cardiovascular events. In comparison, malignancy has increasingly become the leading cause of morbidity and mortality in patients with solid organ transplants. Noninvasive imaging after organ transplantation aids in detecting tumors, planning treatments, and monitoring for complications, thereby leading to improved outcomes. This article discusses the pathogenesis, classification, and imaging findings of de novo posttransplant malignancies.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"319 1","pages":"e251384"},"PeriodicalIF":15.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between CT-evaluated Poststenotic Dilatation in Human Renal Artery Stenosis and Kidney Release of MCP-1.","authors":"Mina Al Saeedi, Dilbar A Abdurakhimova, Tarek Arabi, Jakob Nyvad, Mouaz Oudih, Li Xing, Bo Lu, Lei Zhang, Xiangyang Zhu, Sanjay Misra, Amir Lerman, Lilach O Lerman","doi":"10.1148/radiol.252637","DOIUrl":"10.1148/radiol.252637","url":null,"abstract":"<p><p>Background Renal artery stenosis (RAS) can trigger the development of renal damage and poststenotic dilatation (PSD). However, the clinical relevance and mechanisms are ill-characterized. Purpose To characterize the mechanisms underlying PSD development distal to the site of RAS in humans. Materials and Methods Forty-nine individuals with RAS were prospectively consecutively recruited from October 2013 to September 2024. The characteristics of the stenosis, including the dilatation-diameter ratio (DDR), and single-kidney volumes, perfusion, and glomerular filtration rate (GFR) were measured at three-dimensional multidetector abdominal CT. Additional characteristics included stenotic kidney (STK) oxygenation (blood oxygen level-dependent MRI), cytokine levels in the STK renal vein (RV) and inferior vena cava (blood sampling), and measured GFR (iothalamate clearance). Seven participants subsequently underwent percutaneous transluminal renal angioplasty (PTRA). Data were analyzed with Spearman correlation and linear regression. Results Of 49 participants with RAS (median age, 73 years [IQR, 67-75 years]; 28 male participants), age, blood pressure, measured GFR, and STK oxygenation were comparable between participants with PSD (<i>n</i> = 31) and participants without PSD (<i>n</i> = 18), but participants with PSD had a lower median STK cortical volume. DDR positively correlated with the STK RV levels of neutrophil gelatinase-associated lipocalin, interferon-γ, and monocyte chemoattractant protein-1 (MCP-1), which were elevated in participants with PSD versus participants without PSD or in the STK RV versus the IVC (all <i>P</i> < .05). The regression coefficient between STK RV MCP-1 level and DDR was 0.813 (95% CI: 0.328, 1.298; <i>P</i> = .002) in an unadjusted model and 0.889 (95% CI: 0.246, 1.532; <i>P</i> = .009) after multivariable adjustment for potential confounders; that is, each 1-ng/mL increase in STK RV MCP-1 level was independently associated with a 0.889-unit DDR increase. DDR also correlated positively with urinary protein level (<i>r</i> = 0.33; <i>P</i> = .04) and negatively with estimated GFR (<i>r</i> = -0.51; <i>P</i> = .004), but there was no evidence of a correlation of DDR with renal hemodynamics, arterial morphologic features, or blood flow velocity at Doppler US. PTRA did not improve estimated GFR but did induce PSD regression, the extent of which correlated negatively with STK RV MCP-1 level. Conclusion PSD, as evaluated at abdominal CT, may be associated with STK damage and the release of MCP-1. Clinical trial registration nos. NCT02266394 and NCT04508049 © RSNA, 2026 <i>Supplemental material is available for this article.</i></p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"319 1","pages":"e252637"},"PeriodicalIF":15.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Step Closer to the Promise of Quantitative MRI for Prostate Cancer.","authors":"Daniel J A Margolis,Vikas Gulani","doi":"10.1148/radiol.260545","DOIUrl":"https://doi.org/10.1148/radiol.260545","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"117 1","pages":"e260545"},"PeriodicalIF":19.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625754","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":"Midbrain Energy Homeostasis Biomarker for Differential Diagnosis of Early-Stage Parkinson Disease: A 1H and 31P MRI Study.","authors":"Qiurong Yu,Youmin Zhang,Pei Huang,Yan Li,Peng Liu,Zhijia Jin,Xinhui Wang,Baoyi Zhang,Jinyuan Weng,Peng Wu,Ewart Mark Haacke,Evita C Wiegers,Jannie P Wijnen,Dennis W J Klomp,Sven Haller,Shengdi Chen,Fuhua Yan,Naying He","doi":"10.1148/radiol.251533","DOIUrl":"https://doi.org/10.1148/radiol.251533","url":null,"abstract":"Background Whether phosphorus 31 (31P) MR spectroscopy outperforms or complements conventional hydrogen 1 (1H) MRI biomarkers in the differential diagnosis of early-stage Parkinson disease (PD) remains unclear. Purpose To evaluate 31P MR spectroscopy and its integration with conventional 1H MRI for discriminating early-stage PD from mimics. Materials and Methods This prospective study consecutively enrolled participants with early-stage PD, participants with PD mimics, and controls (November 2023 to October 2024). Participants underwent 31P MR spectroscopy for inorganic phosphate (Pi), phosphocreatine (PCr), and adenosine triphosphate (ATP); quantitative susceptibility mapping for iron; and neuromelanin-sensitive MRI. Intergroup imaging differences were assessed using multivariable general linear models, and partial correlations with clinical scores were analyzed. A penalized logistic regression classifier evaluated discrimination performance of energy metabolites, alone and combined with iron and/or neuromelanin. Results Seventy-two participants with early-stage PD (mean age, 60.1 years ± 6.8 [SD]; 44 male participants), 34 with PD mimics (mean age, 62.1 years ± 7.9; 18 male participants), and 46 controls (mean age, 56.3 years ± 9.6; 33 female controls) were included. Early-stage PD showed a decreased Pi/PCr ratio (mean, 0.47 [95% CI: 0.44, 0.50] vs 0.57 [95% CI: 0.52, 0.63]) and an increased total ATP/Pi ratio (mean, 4.89 [95% CI: 4.57, 5.24] vs 4.06 [95% CI: 3.50, 4.68]) in the left midbrain compared with participants with PD mimics (both Bonferroni-corrected P < .05). The Pi/PCr ratio correlated with nonmotor symptom scores (r = 0.42; 95% CI: 0.12, 0.69; P = .008) and autonomic symptom scores (r = 0.60; 95% CI: 0.34, 0.80; P < .001) in PD. Energy metabolites outperformed both iron (area under the receiver operating characteristic curve [AUC], 0.90 vs 0.50; P < .001) and neuromelanin (AUC, 0.90 vs 0.64; P = .04) in differentiating PD from mimics. There was no evidence that combining iron and/or neuromelanin improved AUC over energy metabolites alone (0.90 vs 0.90 with the addition of iron [P > .99] vs 0.91 with the addition of neuromelanin [P = .70] vs 0.93 with the addition of both [P = .42]). Conclusion 31P MR spectroscopy revealed disrupted midbrain energy homeostasis in early-stage PD and effectively helped differentiate it from mimics. © RSNA, 2026 Supplemental material is available for this article.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"30 1","pages":"e251533"},"PeriodicalIF":19.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625755","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":"Quantitative Post-¹⁷⁷Lu-PSMA-617 SPECT/CT Analysis: Evidence for Adaptive Treatment Planning and Prognostication in Prostate Cancer.","authors":"Samuel J Galgano, Eric M Turner","doi":"10.1148/radiol.260836","DOIUrl":"https://doi.org/10.1148/radiol.260836","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"319 1","pages":"e260836"},"PeriodicalIF":15.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779494","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":"Assessing the Effectiveness of the <i>Radiology</i> In Training Program in Fostering Highly Skilled Reviewers.","authors":"Joice Prodigios, Cristina Marrocchio, Enis C Yilmaz, Alessia Guarnera, Linda Moy, Victoria Chernyak","doi":"10.1148/radiol.252352","DOIUrl":"https://doi.org/10.1148/radiol.252352","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"319 1","pages":"e252352"},"PeriodicalIF":15.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779506","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":"Contrast-Enhanced US Using Perfluorobutane for Diagnosing Small HCC in High-Risk Patients: Comparison with MRI LI-RADS Version 2018.","authors":"Yu Li,Shilin Lu,Siyue Mao,Qing Li,Xuebin Zou,Sheng Li,Xiaoxian Li,Dan Lu,Min Xu,Hui-Xiong Xu,Tian'An Jiang,Andrej Lyshchik,Lingling Li,Jianhua Zhou","doi":"10.1148/radiol.252271","DOIUrl":"https://doi.org/10.1148/radiol.252271","url":null,"abstract":"Background Evidence supporting the incorporation of perfluorobutane (PFB) contrast-enhanced US (CEUS) into Liver Imaging Reporting and Data System (LI-RADS) in diagnosing small hepatocellular carcinoma (HCC) (≤20 mm) in patients at high risk for HCC remains limited. Purpose To compare diagnostic performance of PFB CEUS and MRI for small HCC in high-risk patients. Materials and Methods This multicenter retrospective study included high-risk patients who underwent PFB CEUS and concurrent MRI for evaluating liver nodules 20 mm or smaller from March 2020 to November 2023. PFB CEUS strategy A followed LR-5 criteria based on CEUS LI-RADS version 2017: observations that were at least 10 mm with nonrim arterial-phase hyperenhancement (APHE), with late and mild washout assessed up to 5 minutes postinjection; strategy B expanded on strategy A by also incorporating observations 10 mm or larger with nonrim APHE, no washout up to 5 minutes, and hypoenhancement on Kupffer-phase images. The diagnostic performance of these two CEUS strategies and MRI LI-RADS version 2018 was compared using a generalized estimating equations approach. Results A total of 365 patients (median age, 54 years; IQR, 47-61 years; 310 men) with 399 observations (median diameter, 16 mm; IQR, 12-19 mm; 252 HCCs, 41 non-HCC malignancies, 106 benign nodules) were included. Strategy B yielded higher sensitivity than strategy A (65.9% [166 of 252] vs 57.1% [144 of 252]; P < .001) without evidence of a decrease in specificity (91.8% [135 of 147] vs 93.9% [138 of 147]; P = .07). Compared with MRI, strategy B showed no evidence of a difference in sensitivity (65.9% [166 of 252] vs 72.6% [183 of 252]; P = .07) and specificity (91.8% [135 of 147] vs 90.5% [133 of 147]; P = .59). Strategies A and B showed higher specificity (97.4% [76 of 78] vs 89.9% [62 of 69]; 96.2% [75 of 78] vs 87.0% [60 of 69], respectively; both P = .04) but no evidence of a difference in sensitivity (54.8% [46 of 84] vs 58.3% [98 of 168] [P = .63]; 61.9% [52 of 84] vs 67.9% [114 of 168] [P = .39], respectively) in patients without cirrhosis versus in patients with cirrhosis. Conclusion In patients at high risk for HCC, PFB CEUS incorporating Kupffer-phase findings was effective for diagnosing small HCC, with diagnostic performance similar to MRI. © RSNA, 2026 Supplemental material is available for this article.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"37 1","pages":"e252271"},"PeriodicalIF":19.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329471","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}