Clinical Imaging最新文献

{"title":"Explainable deep learning-based multiclass classification of foot radiographs into normal, plantar fasciitis, and flatfoot","authors":"Jun-hee Kim","doi":"10.1016/j.clinimag.2026.110724","DOIUrl":"10.1016/j.clinimag.2026.110724","url":null,"abstract":"<div><h3>Background</h3><div>The medial longitudinal arch plays a critical role in foot biomechanics, and its abnormalities are associated with conditions such as flatfoot and plantar fasciitis. Early and accurate diagnosis of these disorders is clinically important, but plain radiographs have limitations in visualizing soft tissue pathology.</div></div><div><h3>Purpose</h3><div>This study aimed to develop and interpret a deep learning model capable of classifying foot radiographs into normal, plantar fasciitis, and flatfoot categories.</div></div><div><h3>Methods</h3><div>A DenseNet-121 architecture was trained on 9500 synthetic lateral foot X-ray images from the AI-Hub dataset, with augmentation applied for generalization. Model interpretability was enhanced using Grad-CAM++ to identify class-specific regions of interest, followed by quantitative analysis of six spatial attention features.</div></div><div><h3>Results</h3><div>The model achieved an overall accuracy of 98.53% on an independent test set, with F1-scores of 0.9900 for normal, 0.9837 for plantar fasciitis, and 0.9823 for flatfoot. Visualization revealed anatomically consistent activation patterns: midfoot and arch regions in normal cases, calcaneal and plantar fascia insertion sites in plantar fasciitis, and inferiorly displaced midfoot–hindfoot regions in flatfoot. Quantitative analysis confirmed significant group differences in activation area, intensity, compactness, spatial focus, and entropy (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>These findings demonstrate that explainable deep learning models trained on synthetic radiographic datasets can achieve high classification performance and provide interpretable, anatomically potential insights from structural radiographs. This approach may offer preliminary guidance for developing clinical decision support system, while highlighting the need for further validation in real clinical settings.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110724"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999652","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":"Women at the fifth International Congress of Radiology: A historical account","authors":"Maria Camas ,&nbsp;Geraldine McGinty","doi":"10.1016/j.clinimag.2026.110738","DOIUrl":"10.1016/j.clinimag.2026.110738","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110738"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078248","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":"Does presence of hip dysplasia affect the prevalence and location of cam morphologies in pediatric hip pain patients?","authors":"Stuart D. Ferrell Jr. ,&nbsp;Samuel X. Ramirez ,&nbsp;Scott B. Rosenfeld ,&nbsp;Pritish X. Bawa ,&nbsp;Andrew C. Sher ,&nbsp;J. Herman Kan","doi":"10.1016/j.clinimag.2026.110731","DOIUrl":"10.1016/j.clinimag.2026.110731","url":null,"abstract":"<div><h3>Background</h3><div>Hip dysplasia and cam morphology are both common causes of hip pain in pediatric patients. However, there is limited literature on how the presence of hip dysplasia may affect the prevalence of cam morphology.</div></div><div><h3>Objective</h3><div>This study aims to assess if hip dysplasia in pediatric patients has a similar prevalence and location of cam morphology compared with non-dysplastic hips.</div></div><div><h3>Materials and methods</h3><div>This retrospective study assessed pediatric patients with hip pain from April 2012 to June 2024. Data collection was based on chart review and imaging consensus review of all hip MRIs conducted by two musculoskeletal radiologists and a pediatric orthopedic surgeon. Data included were the presence of hip dysplasia, defined as a lateral center-edge angle (LCEA) &lt;18°, cam morphology, and their location. Chi-square and Fisher's exact test were used with <em>p</em>-values for significance set to 0.05.</div></div><div><h3>Results</h3><div>From our study cohort of 118 hips in 107 patients (mean age 15.3. years, 66% female, 81 hips underwent surgery), there were 64 cam morphology hips present. Cam morphology was present in 55.6% of dysplastic hips and 53.7% of non-dysplastic hips (<em>p</em> = 0.849). Cam morphology was most commonly located anterosuperior femoral head-neck in 70% of dysplastic hips and 65.9% in non-dysplastic hips (<em>p</em> = 0.747).</div></div><div><h3>Conclusion</h3><div>Cam morphology is frequently identified in pediatric patients with hip pain. The prevalence and location of cam morphology is not affected by the presence of co-existing hip dysplasia. During imaging work-up and treatment planning, it is important to recognize that a high proportion of pediatric hip dysplasia patients may have a co-existing cam morphology.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110731"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078214","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":"Improving risk-stratified use of preoperative MRI in young women with breast","authors":"Amit Kumar Gupta ,&nbsp;Chandrashekar Patil ,&nbsp;Varshini Vadhithala ,&nbsp;Jeffrin Reneus Paul","doi":"10.1016/j.clinimag.2026.110721","DOIUrl":"10.1016/j.clinimag.2026.110721","url":null,"abstract":"<div><div>This Letter to the Editor critiques Erguven et al.'s single centre study of universal preoperative breast MRI in women 40 years or younger with newly diagnosed breast cancer. We place their findings within mixed evidence on the effect of MRI on re-excision, mastectomy rates and outcomes, and highlight design and reporting limitations that restrict causal inference and generalisability in this young, higher risk population. We then outline priorities for future prospective, risk stratified research and policy, linking MRI use to tumour biology, surgical planning, patient reported outcomes and equity to ensure that expanded imaging leads to better and fairer care.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110721"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012499","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":"Menstrual toxic shock syndrome: A systematic review of imaging findings","authors":"Fatemeh Khounsarian ,&nbsp;Damoon Ranjbar ,&nbsp;Muhammad Israr Ahmad ,&nbsp;Mohammed Alturiqy ,&nbsp;AmirAli Khounsarian ,&nbsp;Savvas Nicolaou","doi":"10.1016/j.clinimag.2026.110716","DOIUrl":"10.1016/j.clinimag.2026.110716","url":null,"abstract":"<div><div>Menstrual toxic shock syndrome (mTSS) is a rare, life-threatening condition mainly affecting young menstruating women. While the clinical and microbiological aspects of mTSS are well-documented, consolidated evidence on its radiologic findings remains limited in the literature. This study aimed to systematically review published case reports of mTSS to describe the spectrum of radiologic findings and assess the role of imaging in diagnosis and management.</div><div>A systematic search of Medline and Embase was conducted from the earliest available records to September 2024. Case reports were included if they described mTSS cases meeting CDC criteria and involved imaging in diagnosis or management. Twelve eligible reports were identified and analyzed for demographics, microbiology, imaging modality and findings, clinical course, and patient outcome.</div><div>Imaging was typically performed early during hospitalization and included CT, ultrasound, chest x-ray, and echocardiography. Pulmonary findings were most common, including bilateral infiltrates and features of acute respiratory distress syndrome (ARDS) or septic emboli. Abdominal and pelvic imaging revealed ascites, mesenteric edema, bowel wall thickening, and adnexal inflammation. Imaging also identified sources of infection, such as intrauterine devices, and guided management decisions such as drainage or ICU admission. In some cases, imaging was normal despite severe clinical presentations.</div><div>While radiologic findings are non-specific, their presence supports the clinical suspicion of mTSS and helps assess systemic complications. This review highlights the importance of early, multimodal imaging in patients with unexplained shock or fever, particularly in menstruating women, and emphasizes the need for interdisciplinary collaboration in managing this syndrome.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110716"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068398","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":"Ultrasound imaging of pediatric nail psoriasis","authors":"Gabriel Castro Tavares ,&nbsp;Carolina Ávila de Almeida ,&nbsp;Sandra Valéria Coelho da Silva ,&nbsp;Simone Saintive ,&nbsp;Flavio Roberto Sztajnbok ,&nbsp;Adriana Rodrigues Fonseca","doi":"10.1016/j.clinimag.2026.110727","DOIUrl":"10.1016/j.clinimag.2026.110727","url":null,"abstract":"<div><h3>Background</h3><div>High-frequency ultrasound (US) of the nail in pediatric psoriasis remains underexplored.</div></div><div><h3>Objective</h3><div>To describe nail US features and Power Doppler (PD) activity in children with psoriasis.</div></div><div><h3>Methods</h3><div>Cross-sectional study of 43 consecutive patients evaluated with an 18-MHz probe and sensitive PD settings. Recorded variables included nail plate irregularity, trilaminar pattern, Wortsman classification and distal extensor enthesis. Demographic and clinical characteristics and nail physical examination were also collected.</div></div><div><h3>Results</h3><div>US abnormalities were identified in 46.5% of children. PD activity was present in 37.2%, including nails without clinical changes. Trilaminar loss was observed in 4.7%, and classic Wortsman-type patterns were uncommon. No distal extensor enthesitis was detected. Descriptively, PD positivity was observed in both clinically normal and clinically altered nails, without formal hypothesis testing.</div></div><div><h3>Conclusion</h3><div>High-frequency nail US frequently reveals subclinical nail abnormalities in pediatric psoriasis, with PD signal in over one-third of patients and minimal entheseal involvement. These descriptive findings support the feasibility of pediatric nail ultrasound and highlight the need for pediatric-focused technical parameters and longitudinal controlled studies to clarify prognostic value.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110727"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023975","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":"I saw the floating lens sign","authors":"Kathleen M. Kilroe ,&nbsp;Tushar Garg ,&nbsp;Shahmir Kamalian","doi":"10.1016/j.clinimag.2026.110736","DOIUrl":"10.1016/j.clinimag.2026.110736","url":null,"abstract":"<div><div>The floating lens sign describes the radiologic appearance of a completely dislocated crystalline (native) lens or intraocular lens (IOL) on computed tomography imaging. It is visualized as a biconvex, hyperdense structure lying freely within the posterior vitreous cavity in the case of a native lens, and as a linear, hyperdense structure in the case of an IOL. This finding reflects complete zonular and/or capsular disruption, most commonly due to blunt ocular trauma, but it may also occur in patients with connective tissue disorders or advanced hypermature cataracts. Recognizing this sign is important for timely diagnosis of lens dislocation, particularly when physical examination is limited by trauma or preexisting ocular pathology. Prompt ophthalmologic evaluation is essential to prevent complications such as lens-induced glaucoma, uveitis, retinal detachment, and permanent visual loss.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110736"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078247","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":"Pooled diagnostic accuracy of 68Ga-pentixafor PET/CT for aldosterone-producing lesions in primary aldosteronism","authors":"Victor Arthur Ohannesian ,&nbsp;Diego Rajchenberg ,&nbsp;Isabelle R. Menezes ,&nbsp;Mariana Lee Han ,&nbsp;Karina L.A. Pereira ,&nbsp;Wilson C.N. Castro ,&nbsp;Ariana F. Fagundes ,&nbsp;Ricardo F.O. Suruagy Motta ,&nbsp;Miguel José Francisco Neto ,&nbsp;Cesar Augusto P. Braga ,&nbsp;Marcelo R.C. Silva ,&nbsp;Marcos Roberto G. Queiroz ,&nbsp;Solange Amorim Nogueira","doi":"10.1016/j.clinimag.2026.110743","DOIUrl":"10.1016/j.clinimag.2026.110743","url":null,"abstract":"<div><h3>Background</h3><div>Primary aldosteronism is a leading cause of secondary hypertension and is associated with increased cardiovascular risk. Accurate localization of aldosterone-producing lesions is essential to guide curative treatment. Although adrenal venous sampling (AVS) remains the gold standard for subtyping, it is invasive and not widely available. Recent advances in molecular imaging, including ⁶⁸Ga-Pentixafor PET/CT targeting CXCR4, have shown potential for non-invasive localization of functional adrenal lesions.</div></div><div><h3>Purpose</h3><div>To assess the pooled diagnostic accuracy of ⁶⁸Ga-Pentixafor PET/CT for detecting aldosterone-producing lesions.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA-DTA guidelines. Databases including PubMed, Embase, Scopus, Web of Science, and CENTRAL were searched through January 2025. Eligible studies included adult patients with primary aldosteronism who underwent ⁶⁸Ga-Pentixafor PET/CT, with reference standards including AVS, histopathology, or immunohistochemistry. Diagnostic accuracy outcomes were pooled using a bivariate random-effects model.</div></div><div><h3>Results</h3><div>Eight studies comprising 564 patients were included. Agreement between reviewers during full-text assessment was almost perfect (Cohen's κ = 0.93). Pooled sensitivity was 83% (95% CI: 75–89), specificity 94% (95% CI: 83–98), AUC 0.91 (95% CI: 0.88–0.93), LR⁺ 14.6 (95% CI: 5.3–40.2), and LR⁻ 0.18 (95% CI: 0.12–0.27). Diagnostic performance remained stable across subgroups, with no significant variation according to tracer dose, SUVmax, acquisition time, study design, or CXCR4/CYP11B2 expression. No evidence of publication bias was detected (Deeks' test, <em>p</em> = 0.93).</div></div><div><h3>Conclusions</h3><div>⁶⁸Ga-Pentixafor PET/CT demonstrates high diagnostic accuracy for identifying aldosterone-producing lesions and may serve as a reliable, non-invasive alternative to AVS in selected patients.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110743"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138077","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":"Cash price transparency of common radiology services in the United States: An analysis of 2024 healthcare transparency data by state","authors":"Torrin Jacobsen ,&nbsp;Jalal Ibrahim ,&nbsp;Yusuf Ahmad ,&nbsp;Anirudh Bikmal ,&nbsp;Michael Schacht","doi":"10.1016/j.clinimag.2025.110707","DOIUrl":"10.1016/j.clinimag.2025.110707","url":null,"abstract":"<div><h3>Rational and objective</h3><div>This manuscript aims to analyze a limited dataset containing 14 shoppable services regarding healthcare transparency in the United States; focusing on 3 radiology CPTs within the 14 services provided. It compares the affordability of the average discounted cash cost per service by state.</div></div><div><h3>Materials and methods</h3><div>A limited research dataset from Turquoise Health was uploaded to a local SQL database. 3 radiology CPTs (70553, 72193, 76700) were filtered and exported to Excel. Data was cleaned using inclusion criteria of populated discount cash column, populated gross charges column, ‘Facility’ billing class, ‘Inpatient’, ‘Outpatient, or ‘Inpatient or Outpatient’ billing settings, and applicable imaging revenue codes. Improbable costs and charges were excluded. Analyses were performed to find average discount cash cost for each CPT. Ratios of average discounted cash cost to state median household income were calculated for each CPT and <em>Z</em>-score and percentiles populated.</div></div><div><h3>Results</h3><div>Across the three separate imaging services 4 states (AL, NM, CA, NV) were consistently greater than +1 and 4 states (RI, AR, NH, OK) less than −1 standard deviation of the mean discounted cash cost to income ratio. States with higher affordability had higher discounts on gross charges (50 %–57 %) and states with less affordability had lower discounts off gross charges (&lt;30 %).</div></div><div><h3>Conclusion</h3><div>The analysis highlights state-level disparities in healthcare costs, with AL, NM, CA, and NV being less affordable and RI, AR, NH, and OK more affordable comparitively.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110707"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898211","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":"Impact of breast MRI on the surgical management of young women with breast cancer","authors":"Tugce Erguven ,&nbsp;Yagiz Matthew Akiska ,&nbsp;Ayah Arafat ,&nbsp;Rachel Brem","doi":"10.1016/j.clinimag.2026.110722","DOIUrl":"10.1016/j.clinimag.2026.110722","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110722"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994726","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}