Radiology最新文献

{"title":"A Safe MRI- and PET-guided Method for Increasing Osmotic Blood-Brain Barrier Permeability.","authors":"Guanda Qiao,Chengyan Chu,David Gulisashvili,Shalini Sharma,Lukasz Kalkowski,Lucia Fadon-Padilla,Josh Ostovitz,Wojciech G Lesniak,Daniel Deredge,Maciej Walczak,Lei Zhang,Anna Jablonska,Yajie Liang,Dheeraj Gandhi,Piotr Walczak,Miroslaw Janowski","doi":"10.1148/radiol.243396","DOIUrl":"https://doi.org/10.1148/radiol.243396","url":null,"abstract":"Background Given the current lack of widely adopted strategies for facilitating drug penetration into the brain, developing new techniques to increase blood-brain barrier (BBB) permeability is essential to address the increasing burden of central nervous system disorders. Osmotic blood-brain barrier opening (OBBBO), achieved through intra-arterial delivery of 25% mannitol to the cerebral vasculature, is a pioneering strategy demonstrating both safety and partial efficacy. Purpose To investigate the potential of 25% mannitol with 4% NaCl, a combination that doubles the osmotic power, to safely increase OBBBO efficacy. Materials and Methods To visualize penetration into the brain, OBBBO with intra-arterial, intravenous, or intraperitoneal infusion of molecules was performed in mice (n = 44). Brain penetration of small molecules (gadolinium-based contrast agent) and the safety of the infusion procedure were assessed via MRI and histologic examination. Brain penetration of large molecules (zirconium 89-radiolabeled antibodies) was assessed via PET imaging. A head-to-head comparison was performed of brain penetration of both these molecules using the standard approach (25% mannitol) versus the combination of 25% mannitol with 4% NaCl. The Wilcoxon signed rank test, Mann-Whitney U test, and mixed-model analysis were used for the statistical analyses. Results The findings showed robust OBBBO across the entire targeted hemisphere of mouse brains following administration of 4% NaCl in 25% mannitol (n = 9), surpassing that achieved with 25% mannitol alone (n = 8) (ratio of OBBBO area to intact BBB area, 1.99 ± 0.17 vs 1.41 ± 0.15; P < .001). Follow-up MRI and postmortem histologic examination confirmed the safety of this procedure. PET imaging revealed that brain uptake of radiolabeled antibodies was significantly improved using this new method. Conclusion Combining 4% NaCl with 25% mannitol showed promise for improving the safe delivery of therapeutic agents to the brain through the endovascular route. © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Clement and Gaultier in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"2 1","pages":"e243396"},"PeriodicalIF":19.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959896","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":"Node Reporting and Data System Evaluation of Axillary Nodes in Invasive Ductal and Lobular Carcinoma.","authors":"Hee Jeong Kim, Eun Young Chae, Hye Joung Eom, Woo Jung Choi, Hee Jung Shin, Joo Hee Cha, Hak Hee Kim","doi":"10.1148/radiol.243823","DOIUrl":"https://doi.org/10.1148/radiol.243823","url":null,"abstract":"<p><p>Background Although the Node Reporting and Data System (Node-RADS) offers a standardized method for assessing lymph node metastasis, its performance may vary according to the histologic type of breast cancer. Purpose To evaluate the applicability of the Node-RADS score in assessing axillary lymph node involvement in patients with invasive ductal carcinoma (IDC) or invasive lobular carcinoma (ILC). Materials and Methods In this retrospective study, data from consecutive women with pathologically confirmed IDC or ILC who underwent preoperative breast MRI between January 2017 and December 2018 were analyzed. Axillary nodal status was assessed using Node-RADS, in which nodal size and configuration criteria are combined into a final assessment score ranging from 1 (very low suspicion) to 5 (very high suspicion). The performance of the Node-RADS score for predicting axillary lymph node metastasis was compared between the two histologic types using the χ² test. Results A total of 1602 women (mean age, 50.6 years ± 9.8 [SD]), including 25 with bilateral cancers, were included, yielding 1627 breast cancers. Among these cancers, 1486 were IDC and 141 were ILC. The frequency of lymph node metastasis was 25% (377 of 1486) for IDC and 28% (40 of 141) for ILC (<i>P</i> = .44). A Node-RADS score of 3 or greater yielded the highest Youden index for predicting axillary lymph node metastasis for both histologic types. At this cutoff, the sensitivity and specificity were 71.1% (268 of 377) and 86.5% (959 of 1109) for IDC and 52.5% (21 of 40) and 85.1% (86 of 101) for ILC, respectively. Although there was no evidence of a difference in specificity between the histologic types, sensitivity was significantly lower for ILC (<i>P</i> = .02). The area under the receiver operating characteristic curve (AUC) was 0.83 for IDC and 0.74 for ILC (<i>P</i> = .08). Multivariable logistic regression analyses confirmed Node-RADS score as an independent predictor of axillary lymph node metastasis (odds ratio, 3.1; <i>P</i> < .001). Conclusion The Node-RADS score demonstrated comparable performance in terms of AUC in axillary nodal evaluation for IDC and ILC but lower sensitivity for ILC. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Freitas in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 3","pages":"e243823"},"PeriodicalIF":15.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966587","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":"Radiologist's Guide to the Ninth Edition TNM Staging System for Quantitative and Qualitative Assessment of Pleural Mesothelioma.","authors":"David J Murphy, Anna K Nowak, Thomas Frauenfelder, Michelle S Ginsberg, Hiroshi Kodama, Veronica Lenge de Rosen, Maria Mayoral, Christopher Straus, Giulia Benedetti, Valerie W Rusch, Ritu R Gill","doi":"10.1148/radiol.250531","DOIUrl":"10.1148/radiol.250531","url":null,"abstract":"<p><p>Pleural mesothelioma is a highly lethal, rare thoracic malignant neoplasm arising from mesothelial cells. Previous versions of the clinical TNM staging classification have relied on a qualitative radiologic assessment of tumor invasion. However, these qualitative assessments have not proved practical to implement, with poor interobserver agreement and lack of prognostic significance. The updated ninth edition of the International Association for the Study of Lung Cancer TNM staging system for pleural mesothelioma, jointly published by the American Joint Committee on Cancer and Union for International Cancer Control, proposes key evidence-based changes. The ninth edition incorporates quantitative measurements of pleural tumor and fissural thickness in the T descriptors for pleural mesothelioma and removes the qualitative descriptors that cannot be reliably detected on CT scans, such as endothoracic fascia, lung parenchymal invasion, and nontransmural diaphragm invasion or involvement. This article explains the rationale behind these changes and provides a practical guide to the ninth edition of the TNM staging system in clinical practice.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 3","pages":"e250531"},"PeriodicalIF":15.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070458","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":"18F-FDG PET/CT of Oligometastatic Disease in Locally Advanced Breast Cancer: PETABC Trial Post Hoc Analysis.","authors":"Ur Metser,Seyed Ali Mirshahvalad,Ian S Dayes,Sameer Parpia,Mark N Levine","doi":"10.1148/radiol.243788","DOIUrl":"https://doi.org/10.1148/radiol.243788","url":null,"abstract":"Background The optimal treatment of patients with oligometastatic breast cancer and the methods for selecting individuals who may benefit from metastasis-directed therapies are controversial. Purpose To determine the prevalence of oligometastatic disease (OMD; defined as five or fewer distant metastases) in patients with locally advanced breast cancer initially staged at fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT or at CT and bone scintigraphy (CTBS), and to compare patterns of local-regional and distant metastatic disease. Materials and Methods This is a post hoc analysis of data from a prospective, multicenter randomized trial including participants with stage IIb (T3N0) or III invasive ductal carcinoma in the breast between December 2016 and April 2022. Participants were randomized for staging at 18F-FDG PET/CT or at conventional chest, abdomen, and pelvis CTBS. The prevalence of OMD, sites of distant metastases, and extent of local-regional disease were compared using the χ2 test or Fisher exact test. Logistic regression was used to assess the association between imaging and disease extent, with P < .05 indicating a statistically significant difference. Results The study included 369 participants (mean age, 53 years ± 13 [SD]). OMD was more common on 18F-FDG PET/CT scans (19 of 180; 11%; 95% CI: 6.9, 15.9) than on CTBS scans (eight of 185; 4%; 95% CI: 2.2, 8.3; P = .03). Polymetastatic disease (more than five distant metastases) was also more common on 18F-FDG PET/CT scans (24 of 180; 13%) than on CTBS scans (13 of 185; 7%; P = .04). Patients with OMD that was depicted on 18F-FDG PET/CT and CTBS scans had axillary lymph node metastases, but 18F-FDG PET/CT helped to detect extra-axillary regional lymphadenopathy, extra-regional lymph node metastases, and liver metastases more frequently than did CTBS (six of 19 [32%] vs one of eight [13%], three of 19 [16%] vs 0 of eight [0%], and six of 19 [32%] vs one of eight [13%], respectively; P = .63, .53, and .63, respectively). Conclusion At patient presentation, 18F-FDG PET/CT helped to detect OMD in more than one in 10 participants with locally advanced breast cancer, which was more than 2.5 times more often than CTBS, and 18F-FDG PET/CT helped to detect more extensive local-regional metastatic disease. ClinicalTrials.gov Identifier: NCT02751710 © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Ulaner in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"13 1","pages":"e243788"},"PeriodicalIF":19.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778011","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":"How I Do It: Advancing Point-of-Care US in a Large Hospital Setting.","authors":"Javier M Romero,James A Brink,Sai Dhanush Reddy Jeggari,Lauren A Ling,Theodore T Pierce,Anthony E Samir","doi":"10.1148/radiol.241553","DOIUrl":"https://doi.org/10.1148/radiol.241553","url":null,"abstract":"Point-of-care US (POCUS), also known as focused US, targeted US, clinical US, bedside US, or emergency US, is a rapidly evolving, dynamic imaging tool that aids in rapid diagnoses and informed bedside decision-making. POCUS devices are portable, affordable, and considered easy to use for nonradiologists. POCUS has several advantages over diagnostic US, including improved accessibility, real-time assessment, and provision of immediate results. This makes POCUS useful to guide bedside procedures, such as vascular access for central and peripheral line placement. However, advancing POCUS across a broad health care network requires collaboration among the POCUS stakeholders and clinical departments within the existing multidisciplinary ecosystem. This collaboration should support nonradiology colleagues to ensure quality patient care and streamlined operations while ensuring POCUS imaging availability for comparison. Creating a comprehensive POCUS program in a large hospital setting requires policies and guidelines like those of other clinical imaging programs. Leadership, training programs, credentialing bodies, documentation, proper image storage, and quality assurance are essential for any clinical imaging program, including POCUS. This review article presents a framework aimed to standardize POCUS practice across a health care system, thereby enhancing both diagnostic accuracy and patient outcomes.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"13 1","pages":"e241553"},"PeriodicalIF":19.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778015","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":"Middle Neck Involvement: New Layer of Risk Stratification in Nasopharyngeal Carcinoma.","authors":"Pejman Jabehdar Maralani, Heejun Tony Kang","doi":"10.1148/radiol.252512","DOIUrl":"10.1148/radiol.252512","url":null,"abstract":"<p><p></p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 2","pages":"e252512"},"PeriodicalIF":15.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966626","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":"Myocardial Strain Imaging with MRI: A Long Journey.","authors":"David A Bluemke","doi":"10.1148/radiol.252364","DOIUrl":"10.1148/radiol.252364","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 2","pages":"e252364"},"PeriodicalIF":15.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966561","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":"MRI Quantitative Features: A Bridge to Hepatocellular Carcinoma Tumor Profiling.","authors":"Roberto Cannella","doi":"10.1148/radiol.252216","DOIUrl":"https://doi.org/10.1148/radiol.252216","url":null,"abstract":"\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in Radiology. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"15 1","pages":"e252216"},"PeriodicalIF":19.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778014","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":"Demystifying Artificial Intelligence: Understanding Transformer Models for Practicing Radiologists.","authors":"Chang Min Park, Dabin Min","doi":"10.1148/radiol.252060","DOIUrl":"https://doi.org/10.1148/radiol.252060","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 2","pages":"e252060"},"PeriodicalIF":15.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966501","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 Appearance of Heavy Eye Syndrome.","authors":"Navya S Vanjavaka, Saravana K Swaminathan","doi":"10.1148/radiol.250655","DOIUrl":"https://doi.org/10.1148/radiol.250655","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"316 2","pages":"e250655"},"PeriodicalIF":15.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966556","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}