Radiology最新文献

{"title":"Case 338: Right Retroperitoneal Lymphatic-Venous Malformation.","authors":"Amar Shah, Maria Zulfiqar","doi":"10.1148/radiol.242728","DOIUrl":"10.1148/radiol.242728","url":null,"abstract":"<p><strong>History: </strong>A 25-year-old female patient presented to the emergency department with worsening abdominal discomfort over the past 2-3 months. The patient had not experienced fever, chills, or dysuria. Past medical history was notable for two completed pregnancies; otherwise, there was no pertinent medical history or family history. At physical examination, the patient was uncomfortable but not in acute distress. There was tenderness to palpation in the right upper quadrant and epigastric region, but no rebound tenderness or guarding. Vital signs were blood pressure of 141/85 mm Hg, pulse rate of 91/min, and temperature of 37.2 °C. The serum β-human chorionic gonadotropin test result was negative for pregnancy, and urinalysis showed no leukocyte esterase or nitrites. Routine blood investigations, including white blood cell count, were within normal limits. Initial evaluation with contrast-enhanced CT of the abdomen and pelvis was performed, followed by MRI of the abdomen without and with intravenous contrast material.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e242728"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476494","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":"Update on Liquid Biopsy.","authors":"Marius E Mayerhoefer, Andreas Kienzle, Sungmin Woo, Hebert Alberto Vargas","doi":"10.1148/radiol.241030","DOIUrl":"10.1148/radiol.241030","url":null,"abstract":"<p><p>Liquid biopsy helps detect cells and cell-derived metabolites, proteins, nucleic acids, and vesicles that are shed into body fluids by tumors. This diagnostic test requires only approximately 10 mL of blood or urine. It has received considerable attention as a minimally invasive tool for whole-body tumor interrogation for use in patients with cancer. It poses an attractive and potentially cost-effective alternative to invasive tissue sampling through tissue biopsies, especially serial assessments, such as for treatment response evaluation and mutations that occur during cancer treatment. Cell-free and circulating tumor DNA are the most frequently tested liquid biopsy analytes, and have shown promise for cancer screening, assessment of residual disease after treatment, and clinical outcome prediction and prognostication. Whereas liquid biopsy is less sensitive than imaging in early tumor stages, it is more specific and may help detect treatment response earlier than the Response Evaluation Criteria in Solid Tumors, or RECIST. Aimed primarily at radiologists, this review article provides an update on recent developments in the use of liquid biopsy, including findings from landmark clinical trials and U.S. regulatory approvals as companion diagnostic tests for clinical use, particularly in four malignancies: lymphoma, breast cancer, prostate cancer, and melanoma. Finally, current challenges for the clinical implementation of liquid biopsy are discussed.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e241030"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317804","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":"Erratum for: Preoperative Diagnosis of Ipsilateral and Contralateral Breast Cancer: Role of Diffusion-weighted MRI.","authors":"Ha Jung Kim, Savannah C Partridge, JungBok Lee, Heera Yoen, Woo Kyung Moon, Su Min Ha","doi":"10.1148/radiol.259012","DOIUrl":"10.1148/radiol.259012","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e259012"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476498","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":"Modulation of Cortical and Hippocampal Functional MRI Connectivity Following Transcranial Alternating Current Stimulation in Mild Alzheimer Disease.","authors":"Tao Wang, Shaozhen Yan, Yi Shan, Hanxiao Xue, Yi Xing, Sheng Bi, Zhigeng Chen, Hanyu Xi, Zhigang Qi, Yi Tang, Jie Lu","doi":"10.1148/radiol.241463","DOIUrl":"10.1148/radiol.241463","url":null,"abstract":"<p><p>Background Transcranial alternating current stimulation (tACS) may be effective for improving cognitive function in Alzheimer disease (AD), but its impact on brain functional connectivity (FC) has not been well studied. Purpose To evaluate tACS efficacy in improving cognitive performance and modulating FC between brain regions in individuals with AD using functional MRI. Materials and Methods In this prospective randomized controlled trial (September 2020 to April 2022), participants with mild AD were assigned to active (40 Hz tACS with 15-mA intensity) or sham (no γ frequency or current) tACS groups for 3 weeks (referred to as week 3), with a 3-month follow-up (referred to as month 3). Functional MRI and cognitive testing were performed at baseline, week 3, and month 3. Primary outcomes were changes in Mini-Mental State Examination and Montreal Cognitive Assessment scores from baseline to week 3. Secondary outcomes included FC changes within multiple cortical networks and between cortex and hippocampus from baseline to week 3 and month 3, assessed using Fisher <i>z</i>-transformed correlation coefficient (hereafter, <i>z</i> score). Results Forty-six participants were randomized into the active group (<i>n</i> = 23; median age, 66 years; IQR, 62-69 years; 16 female participants) or the sham group (<i>n</i> = 23; mean age, 64 years; IQR, 61-69 years; 14 female participants). The active group had higher Mini-Mental State Examination (median score change, 2 [IQR, 1-5] vs 0 [IQR, -1 to 2]; <i>P</i> = .001) and Montreal Cognitive Assessment (median score change, 2 [IQR, 0-4] vs 0 [IQR, -1 to 2]; <i>P</i> = .03) scores than the sham group at week 3, respectively. Compared with the sham group, the active group had increased FC between left hippocampus and left middle cingulate gyrus (<i>z</i> score difference, 0.29; 95% CI: 0.17, 0.42; false discovery rate [FDR]-adjusted <i>P</i> < .001) and between the left hippocampus and the left middle frontal gyrus (<i>z</i> score difference, 0.16; 95% CI: 0.03, 0.29; FDR-adjusted <i>P</i> = .04) within the posterior default-mode network (<i>z</i> score difference, 0.40; 95% CI: 0.07, 0.73; FDR-adjusted <i>P</i> = .046) and within the visual network (<i>z</i> score difference, 0.45; 95% CI: 0.17, 0.73; FDR-adjusted <i>P</i> = .007) from baseline to week 3. Conclusion Cognitive performance in mild AD improved following tACS, with increased FC within cortical networks and between the hippocampus and specific cortical regions. ClinicalTrials.gov Identifier: NCT03920826 © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Shepherd in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e241463"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476524","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 the Treatment of Alzheimer Disease: 2030 Could Look Very Different.","authors":"Timothy M Shepherd","doi":"10.1148/radiol.251704","DOIUrl":"10.1148/radiol.251704","url":null,"abstract":"<p><p>\u0000 <i>\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in <i>Radiology</i>. 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.</i>\u0000 </p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e251704"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476501","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":"Improved Understanding of False-Negative AI Mammographic Interpretation.","authors":"Lisa A Mullen","doi":"10.1148/radiol.251066","DOIUrl":"https://doi.org/10.1148/radiol.251066","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e251066"},"PeriodicalIF":12.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476502","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":"Preoperative Diagnosis of Ipsilateral and Contralateral Breast Cancer: Role of Diffusion-weighted MRI.","authors":"Ha Jung Kim, Savannah C Partridge, JungBok Lee, Heera Yoen, Woo Kyung Moon, Su Min Ha","doi":"10.1148/radiol.242423","DOIUrl":"10.1148/radiol.242423","url":null,"abstract":"<p><p>Background The interpretation of the multiparametric MRI, which combines dynamic contrast-enhanced (DCE) MRI with diffusion-weighted imaging (DWI), has the potential to increase MRI diagnostic accuracy. Purpose To investigate and validate the potential of DWI with an apparent diffusion coefficient (ADC) cutoff in evaluating additional lesions detected at preoperative MRI in patients with breast cancer. Materials and Methods In this retrospective review, data from patients with additional lesions (Breast Imaging Reporting and Data System [BI-RADS] category 3 or higher) who underwent MRI between June 2019 and June 2021 were evaluated. Two breast radiologists independently evaluated additional enhanced lesions and measured the ADC values. The optimal ADC cutoff for downgrading lesions was determined according to the Youden index and was applied to a separate validation cohort. The efficacy of prespecified ADC values (1.53 × 10^-3 mm²/sec and 1.3 × 10^-3 mm²/sec) was investigated. Diagnostic performance was evaluated and compared using generalized estimating equations. Results Data from 219 patients (mean age, 50.8 years ± 10.2 [SD]) with 292 additional lesions were evaluated. The optimal ADC cutoff was 1.0 × 10^-3 mm²/sec, which, compared with that for DCE MRI alone, increased specificity (from 28.7% to 73.1%; <i>P</i> < .001) but decreased sensitivity (from 99.2% to 89.6%; <i>P</i> < .001) of MRI. In the validation cohort (104 patients, 133 additional lesions), 48 of 133 (36.1%) lesions were diagnosed as cancer, and applying the ADC cutoff derived from the development cohort increased specificity (from 21.2% to 68.2%; <i>P</i> < .001) but decreased sensitivity (from 97.9% to 83.3%; <i>P</i> = .01). For ipsilateral lesions, specificity increased (from 8.7% to 65.2%; <i>P</i> < .001), but the sensitivity did not decrease significantly (from 97.1% to 85.3%; <i>P</i> = .052). For contralateral lesions, similar performance improvements were observed for specificity (from 35.9% to 71.8%; <i>P</i> < .001), but a greater decrease in sensitivity was observed (from 100% to 78.6%; <i>P</i> < .001). Application of the prespecified ADC cutoffs achieved higher sensitivity values but smaller improvements in specificity. Conclusion The ADC cutoff based on MRI with DWI improved the performance of preoperative MRI in diagnosing additional lesions in patients with breast cancer. © RSNA, 2025 <i>Supplemental material is available for this article.</i> See also the editorial by Honda and Iima in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 3","pages":"e242423"},"PeriodicalIF":15.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258900","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":"Ultrafast Breast MRI: Possibly Just a Diagnostic Compromise to Dynamic Contrast-Enhanced Imaging.","authors":"Claudia Cotes,Michael A Jacobs","doi":"10.1148/radiol.250746","DOIUrl":"https://doi.org/10.1148/radiol.250746","url":null,"abstract":"","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"315 1","pages":"e250746"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914799","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":"Maximum Resection of Noncontrast-enhanced Tumor at MRI Is a Favorable Prognostic Factor in IDH Wild-Type Glioblastoma.","authors":"Hye Hyeon Moon,Doonyaporn Wongsawaeng Wave,Ji Eun Park,Seo Young Park,Seunghee Baek,Young-Hoon Kim,Sang Woo Song,Chang-Ki Hong,Jeong Hoon Kim,Myung Hwan Lee,Yae Won Park,Sung Soo Ahn,Jeffrey Michael Pollock,Ramon Francisco Barajas,Ho Sung Kim","doi":"10.1148/radiol.241393","DOIUrl":"https://doi.org/10.1148/radiol.241393","url":null,"abstract":"Background Isocitrate dehydrogenase (IDH) wild-type glioblastoma often includes a noncontrast-enhanced tumor (NET) component, and the extent of NET resection may serve as a prognostic marker. Purpose To assess clinical outcomes based on gross total resection (GTR) of NET, develop a real-world survival model incorporating GTR-NET for IDH wild-type glioblastoma, and validate the findings in multinational external cohorts. Materials and Methods A retrospective analysis included patients with IDH wild-type glioblastoma in a prospective registry (March 2017 to October 2020) as the training set. External validation used consecutive patients from two centers (March 2017 to January 2023). Patients were stratified into three groups: GTR-NET, GTR in contrast-enhanced tumor (CET) only, and no GTR. A conditional inference tree (CIT) model was developed using GTR type, age, and O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status to predict overall survival (OS) and was externally validated. Kaplan-Meier analysis, log-rank test, time-dependent area under the receiver operating characteristic curve, and Harrell C-indexes were used for evaluation. Results In the training set (n = 201; mean age, 60 years ± 11.3; 109 males), four survival groups were identified. GTR-NET was associated with longer OS (median, 32.6 months; IQR, 18.7-46.7 months; P < .001). When GTR-NET was not achieved, OS was stratified as follows: younger than age 60 years (median OS, 23.4 months; IQR, 12.2-34.8 months), age 60 years or older and positive for MGMT (median OS, 19.1 months; IQR, 13.0-27.8 months), and age 60 years or older and negative for MGMT (median OS, 10.7 months; IQR, 6.5-14.1 months). External validation sets (352 patients in external validation set 1 and 60 patients external validation set 2) confirmed these groups (P < .001 and P = .04). Time-dependent areas under the receiver operating characteristic curve ranged from 0.684 (95% CI: 0.623, 0.745) to 0.694 (95% CI: 0.631, 0.758) and from 0.610 (95% CI: 0.449, 0.771) to 0.678 (95% CI: 0.512, 0.844), with CIT sensitivity for GTR-NET at 70.7%-77.3% and 87.6%-87.9% and C-indexes of 0.65 and 0.63. Conclusion A GTR-NET-based survival model was developed and validated, demonstrating that GTR-NET is an independent prognostic marker for longer OS in IDH-wildtype glioblastoma. ClinicalTrials.gov identifier: NCT02619890 © RSNA, 2025 Supplemental material is available for this article.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"9 1","pages":"e241393"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914845","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":"Intraindividual Comparison of Ultrafast versus Standard Two-dimensional Dynamic Contrast-enhanced Breast MRI.","authors":"Maike Bode,Stephanie Morscheid,Elene Iordanishvili,Luisa C Huck,Shuo Zhang,Teresa Lemainque,Christiane K Kuhl","doi":"10.1148/radiol.241371","DOIUrl":"https://doi.org/10.1148/radiol.241371","url":null,"abstract":"Background Ultrafast breast MRI promises to improve conspicuity of cancers by avoiding masking due to background parenchymal enhancement (BPE) and to improve classification of enhancing lesions. However, published studies systematically penalized standard dynamic contrast-enhanced (DCE) MRI because they integrated ultrafast MRI into existing DCE protocols, such that postcontrast acquisitions of DCE MRI began only after completion of ultrafast MRI. Purpose To perform an intraindividual comparison of conspicuity and classification of enhancing breast lesions with ultrafast MRI versus standard DCE MRI, where both methods included the early postcontrast phase. Materials and Methods This was a retrospective analysis of 31 women (median age, 48 years [IQR, 39-51 years]) from September 2021 to January 2023. Women underwent DCE MRI at 1.5 T and, within 2 days, a second contrast-enhanced examination using ultrafast MRI, for further diagnostic assessment of difficult-to-interpret enhancing lesions and/or BPE. For DCE MRI, a two-dimensional gradient-echo series (0.61 × 0.61 × 3.0-mm spatial resolution, 60 seconds per dynamic frame) was obtained once before and four times after injection of 0.1 mmol/kg gadobutrol. For ultrafast MRI, a compressed-sense accelerated three-dimensional gradient-echo series (0.92 × 0.97 × 2.5-mm spatial resolution, 4 seconds per keyhole dynamic frame) was obtained over 90 seconds before, during, and after injection of 0.1 mmol/kg gadobutrol. Two breast radiologists independently rated BPE, image quality, and conspicuity and morphology of enhancing lesions, and enhancement kinetics were analyzed (ultrafast MRI: maximum slope and time to enhancement; DCE MRI: wash-in rate and time course pattern). Results A total 59 enhancing lesions were reported in the 62 breasts of the 31 patients. BPE ratings were on average 0.8 points lower at ultrafast versus DCE MRI (mean, 2.5 ± 1.2 [SD] vs 3.3 ± 1.2; P < .001). Despite this mild reduction in BPE, lesion conspicuity was rated lower at ultrafast than at DCE MRI (mean, 3.5 ± 1.3 vs 4.1 ± 1.0; P = .001), as was image quality (mean, 2.3 ± 0.9 vs 4.1 ± 0.8; P < .001). Lesion morphology (shape, margin, internal architecture) was less assessable at ultrafast MRI (all P < .05). Kinetic parameters derived from ultrafast MRI did not improve classification of enhancing lesions compared with those derived from DCE MRI: At ultrafast MRI, time to enhancement was shorter for malignant versus benign lesions (P = .01), but maximum slope did not differ, whereas at DCE MRI, both wash-in rate and time course pattern differed between malignant and benign lesions (both P = .01). Conclusion In this enriched cohort in which ultrafast MRI was expected to provide diagnostic advantages over DCE MRI, ultrafast MRI in fact led to reduced lesion conspicuity and did not improve lesion classification. © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Cotes and Jacobs in this issue.","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"115 1","pages":"e241371"},"PeriodicalIF":19.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914856","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}