Abdominal radiology (New York)最新文献

{"title":"CT radiomics and topology-based intratumoral heterogeneity for preoperative prediction of nuclear β-catenin expression in hepatocellular carcinoma.","authors":"Yongming Tan, Siya Xu, Xiaofang Liu, Weiwei Liao, Ru Zhu, Minghui Shen, Weijia Wang, Meng Liu, Jianwei Liu","doi":"10.1007/s00261-026-05788-4","DOIUrl":"https://doi.org/10.1007/s00261-026-05788-4","url":null,"abstract":"<p><strong>Background: </strong>Nuclear β-catenin accumulation reflects activation of the Wnt/β-catenin pathway in hepatocellular carcinoma (HCC), but noninvasive preoperative prediction of this immunohistochemical phenotype remains incompletely established.</p><p><strong>Purpose: </strong>To develop and externally validate CT radiomics and topology-based intratumoral heterogeneity (ITH) models for preoperative prediction of nuclear β-catenin expression in HCC.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study included 1029 patients with histopathologically confirmed HCC. Patients from two participating institutions formed the development cohort and were split into training (n=620; nuclear β-catenin-positive, 293) and internal validation (n=267; nuclear β-catenin-positive, 126) sets. Patients from an independent third institution formed the external validation cohort (n=142; nuclear β-catenin-positive, 43). Whole-tumor portal venous phase CT radiomics features and topology-based ITH features were extracted from the audited image-mask cohort. Model discrimination, calibration, and clinical utility were evaluated using AUC, bootstrap 95% confidence intervals, calibration summaries, Brier scores, and decision curve analysis.</p><p><strong>Results: </strong>In external validation, AUCs were 0.677 for the clinical model, 0.862 for the radiomics model, 0.857 for the ITH model, 0.831 for the core ITH model, 0.863 for the radiomics-ITH model, and 0.886 for the stacking model. Compared with radiomics alone, stacking showed a numerical ΔAUC of 0.024 (95% CI, -0.010 to 0.060; P=0.180).</p><p><strong>Conclusion: </strong>CT radiomics and topology-based ITH features showed external predictive value for nuclear β-catenin expression in HCC. The stacking model had the highest external AUC, but its improvement over radiomics alone was not statistically significant. If prospectively validated, these CT-based approaches could complement tissue assessment for pretreatment biological stratification.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal hydatid disease and its mimics: a comprehensive pictorial review of imaging clues to the differential diagnosis.","authors":"Amr Shabana, Asmaa Y Elkasabi, Mohamed Neimatallah, Jullanar AlKhunein, Maram Alghamdi, Faisal Alballa, Ayman H Gaballah","doi":"10.1007/s00261-026-05812-7","DOIUrl":"https://doi.org/10.1007/s00261-026-05812-7","url":null,"abstract":"<p><strong>Background: </strong>Hydatid disease (HD), also known as echinococcosis, is a parasitic disease caused by tapeworms. HD is endemic in many parts of the world and can affect virtually any organ system. Due to the rapid growth of worldwide migration, especially in recent decades, the disease can be diagnosed anywhere, particularly among immigrants in non-endemic areas.</p><p><strong>Objective: </strong>To illustrate the spectrum of abdominal imaging manifestations of HD and to review the principal benign and malignant abdominal cystic lesions that can mimic HD, using an organ-based approach with emphasis on imaging features that aid in differential diagnosis.</p><p><strong>Findings: </strong>Radiologic imaging is crucial for diagnosing HD, assessing disease activity, progression, and complications, and detecting stage- and organ-specific features. Hydatid disease in the abdomen can mimic other abdominal diseases, depending on the organ involved. Additionally, many other abdominal lesions can mimic hydatid disease and present with similar clinical symptoms. This pictorial review demonstrates characteristic imaging findings of HD and its mimics across the different abdominal organs and spaces, highlighting specific morphological features and potential diagnostic pitfalls. This review incorporates the World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification to provide a standardized framework for describing the imaging appearances of cystic echinococcosis.</p><p><strong>Conclusion: </strong>Recognizing the characteristic imaging features of HD and its mimics is essential for accurate diagnosis and appropriate management. A systematic approach that incorporates lesion morphology, organ involvement, disease stage, and relevant clinical and epidemiological information can improve diagnostic confidence, enable early diagnosis, and help avoid misdiagnosis and inappropriate intervention.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a preoperative CT-based radiomics nomogram for predicting postpancreatectomy acute pancreatitis after pancreatoduodenectomy.","authors":"Hebing Chen, Limeng Sun, Jingyi Liu, Fuze Cong, Xiang Li, Qiang Xu, Huadan Xue","doi":"10.1007/s00261-026-05822-5","DOIUrl":"https://doi.org/10.1007/s00261-026-05822-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the value of radiomics based on preoperative contrast-enhanced computed tomography (CECT) for predicting postpancreatectomy acute pancreatitis (PPAP) after pancreatoduodenectomy (PD).</p><p><strong>Methods: </strong>A retrospective analysis included 104 patients who underwent PD and preoperative CECT between May 2019 and March 2025. Patients were randomly divided into training (n = 73) and test (n = 31) sets at a 7:3 ratio. PPAP was defined according to the biochemical and radiologic components of the International Study Group for Pancreatic Surgery (ISGPS) criteria. After pancreatic parenchyma delineation, radiomics feature extraction and selection, an optimal model was developed on the training set to calculate the radiomics score (rad-score). Independent clinical and morphological features were selected by univariate and multivariate logistic regression analyses. Conventional quantitative CT attenuation ratios of the pancreatic parenchyma were also evaluated. Predictive performance was assessed by receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>PPAP occurred in 41 patients. Four models were compared: a clinical-morphologic model (age and main pancreatic duct [MPD] dilation), a conventional model (age, MPD dilation and arterial-to-portal ratio [A/P]), a radiomics model (rad-score alone), and a radiomics-integrated model (age, MPD dilation and rad-score). The radiomics-integrated model achieved the highest area under the curve (AUC) among the four models, with the AUC of 0.854 (95% CI 0.758-0.951) in the training set and 0.862 (95% CI 0.732-0.993) in the test set.</p><p><strong>Conclusion: </strong>The radiomics-integrated model demonstrated promising performance for preoperative prediction of PPAP after PD, which may facilitate individualized risk stratification and perioperative management.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of PSA density velocity in diagnosing prostate cancer on prostate MR.","authors":"Sabarish Narayanasamy, Yasuhisa Kurata, Ayumu Kido, Hirotsugu Nakai, Hiroaki Takahashi, Jordan D LeGout, Adam T Froemming, Akira Kawashima, Abhinav Khanna, Naoki Takahashi","doi":"10.1007/s00261-026-05821-6","DOIUrl":"https://doi.org/10.1007/s00261-026-05821-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess if PSA density (PSAD) velocity is a predictor of clinically significant prostate cancer (csPCa).</p><p><strong>Methods: </strong>Patients undergoing prostate MR for suspected csPCa between 2017 and 2023 were included. Of these, patients who underwent two or more MR exams within 0.3 to 2 years to each other and pathological confirmation within 1 year after the last MR were identified. PI-RADS score, patient age, no-prior-PCa cohort or active surveillance (AS), PSA, PSAD, PSA-velocity and PSAD-velocity were assessed if they were predictor of csPCa. For univariate analysis, all variables were assessed using student t or chi-square tests. When variables were considered significant, variables were entered into multivariate logistic regression model. To assess whether PSAD-velocity adds diagnostic value beyond established predictors, we compared a base model (age, PI-RADS score, clinical cohort, and current PSAD) with the same model plus PSAD-velocity, using optimism-corrected AUC from 1,000 bootstrap resamples.</p><p><strong>Results: </strong>23,244 MRs were performed (17,703 for no-prior-PCa, 5,541 for AS). 1,174 patients (mean age: 65.9 years) met the inclusion criteria, and 550 (46.8%) were diagnosed with csPCa. On univariate analysis, PI-RADS score (p<.0001), age (67.0 vs. 64.9 years, p<.0001), AS status (67% vs. 59%, p = .004), PSA (7.5 vs. 6.6 ng/mL, p<.001), PSAD (p<.0001), and PSAD-velocity (0.023 vs. 0.012 ng/mL/mL/year, p = .005) were associated with csPCa, but PSA-velocity (1.4 vs. 1.2 ng/mL/year, p=.38) was not. On multivariable analysis, PI-RADS score (p<.0001), age (p<.0001), AS status (p = .002), PSA (p<.0001), and PSAD (p<.0001) remained significant predictors, but PSAD-velocity was not (p = .13). Adding PSAD-velocity to the base model produced no significant improvement in optimism-corrected AUC (0.7605 vs. 0.7611; ΔAUC = + 0.0006, 95% CI -0.0002 to +0.0019).</p><p><strong>Conclusions: </strong>Higher PSAD-velocity was associated with presence of csPCa on univariate analysis but not on multivariate analysis, and on fixed-model analysis did not meaningfully improve diagnostic discrimination beyond established predictors.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritumoral ultrasound-driven multimodal AI model for predicting lymphovascular space invasion and prognosis in cervical cancer.","authors":"Hui Shen, Yuting Jiang, Yueting Sun, Qiao Zheng, Lihe Zhang, Miao He, Lihong Wu, Junfeng Liu, Liu Du, Hongning Xie","doi":"10.1007/s00261-026-05804-7","DOIUrl":"https://doi.org/10.1007/s00261-026-05804-7","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate preoperative assessment of lymphovascular space invasion (LVSI) in cervical cancer (CC) remains challenging despite its importance for treatment planning and risk stratification. This study aimed to develop and evaluate a hybrid model integrating peritumoral ultrasound radiomics features, deep learning features, and clinical data for preoperative prediction of LVSI in CC. Additionally, we assessed the model's prognostic value for disease-free survival (DFS) and explored LVSI-associated molecular pathways using data from The Cancer Genome Atlas (TCGA).</p><p><strong>Methods: </strong>In a retrospective cohort (n = 241) and a prospective cohort (n = 51), radiomics features were extracted from tumor and peritumoral regions of interest on ultrasound images. Least absolute shrinkage and selection operator regression and machine learning classifiers generated a radiomics score (Rad-score). Simultaneously, transfer learning with pre-trained convolutional neural networks constructed a deep learning score (DL-score). A hybrid model integrating clinical factors, Rad-score, and DL-score was developed. Model performance was evaluated using the area under the curve (AUC). Furthermore, prognostic value (Kaplan-Meier analysis), model interpretability using Shapley Additive Explanations (SHAP), and biological pathways were assessed.</p><p><strong>Results: </strong>Overall, 292 women were included: 188 in the training set, 53 in the internal validation set, and 51 in the prospective testing set. The hybrid model achieved the highest performance (AUC: 0.79, 95%CI: 0.66-0.92; sensitivity: 0.85, 95%CI: 0.71-0.98) in the prospective testing set, outperforming the single-modality models. Exploratory survival analysis showed shorter DFS in the high-risk group (P < 0.05). SHAP analysis identified the DL-score as the primary predictor. Biologically, the Wnt/β-catenin pathway was significantly enriched in LVSI-positive patients.</p><p><strong>Conclusions: </strong>The hybrid model, evaluated in a prospective cohort, showed potential for preoperative LVSI prediction and DFS risk stratification in CC. TCGA analysis showed Wnt/β-catenin enrichment in LVSI-positive tumors, providing complementary biological context. Further validation in larger independent multicenter cohorts is needed before clinical application.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced cervical cancer and its complications: a cross-sectional imaging review.","authors":"Andrés Felipe Herrera Ortiz, Valeria Del Castillo Herazo, Laura Manuela Olarte, Rodrigo Borrero León","doi":"10.1007/s00261-026-05809-2","DOIUrl":"https://doi.org/10.1007/s00261-026-05809-2","url":null,"abstract":"<p><p>The assessment of advanced cervical cancer and its complications on cross-sectional imaging remains challenging due to the broad range of disease manifestations, and frequently nonspecific clinical presentation. This pictorial review outlines the essential components that should be systematically addressed in radiology reports when evaluating CT and MRI studies in advanced cervical cancer. To improve diagnostic precision and clinical utility, we summarized the main cervical cancer manifestations in an algorithm to facilitate a comprehensive evaluation of local tumor extent, treatment-related/infectious complications, urinary complications, and metastatic spread, serving as a practical tool for both radiologists and clinicians.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water-T1, PDFF, and T2* mapping of the liver using chemical shift-encoded MOLLI.","authors":"Amol Pednekar, Joshua S Greer, Pradipta Debnath, Andrew T Trout, Jonathan R Dillman, Mary Kate Manhard","doi":"10.1007/s00261-026-05820-7","DOIUrl":"https://doi.org/10.1007/s00261-026-05820-7","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatic MRI T1 relaxation time is a putative measure of fibrosis and inflammation but may be confounded by hepatic fat. This study evaluated a chemical shift-encoded Modified Look-Locker Inversion Recovery (CSE-MOLLI) technique for simultaneous water-specific T1 (water-T1), proton density fat fraction (PDFF), and T2* mapping within a single breath-hold.</p><p><strong>Methods: </strong>Numerical simulations, reference standard phantoms, and in vivo imaging were used to assess CSE-MOLLI performance. Twenty participants, including healthy/asymptomatic controls, individuals with steatotic liver disease, and individuals with non-steatotic chronic liver disease, underwent CSE-MOLLI and comparator quantitative MRI sequences. All quantitative maps were generated in real-time on the scanner. Water-T1, PDFF, and T2* were measured from regions of interest (ROIs) by two readers and compared with reference standard methods using simple and intraclass correlation and Bland-Altman analysis. Scan-rescan repeatability was assessed for CSE-MOLLI.</p><p><strong>Results: </strong>Phantom experiments demonstrated strong agreement between CSE-MOLLI and reference measurements for water-T1 (r = 0.98), PDFF (r = 1.00), and T2* (r = 0.99) estimates. In vivo, inter-reader agreement was excellent for water-T1, PDFF, and T2* (ICC > 0.97). CSE-MOLLI showed very strong correlation and excellent agreement with comparator PDFF (r = 1.00; ICC = 0.98) and water-T1 (r = 0.95; ICC = 0.89), while T2* demonstrated strong correlation and moderate agreement with comparator values (r = 0.67; ICC = 0.65). Water-T1 remained relatively consistent across PDFF values from 1% to 43%, suggesting reduced sensitivity of CSE-MOLLI to fat-related deviation. Water-T1 exhibited good scan-rescan repeatability (bias = 2.0 ms, ICC = 0.95).</p><p><strong>Conclusion: </strong>CSE-MOLLI enables simultaneous water-T1, PDFF, and T2* mapping of the liver within a single breath-hold. Phantom validation, repeatability assessment, and preliminary in vivo results in healthy, steatotic, and non-steatotic liver disease participants suggest that hepatic water-T1 measurements are less sensitive to fat-related deviations than conventional MOLLI-based T1 estimates. Further studies are needed to determine clinical utility in diffuse liver disease.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head-to-head comparison of quantitative perfusion parameters derived from DECT, IVIM, and DCE-MRI for renal mass characterization: a within-patient, prospective study.","authors":"Soham Banerjee, Amit Gupta, Kumble Seetharama Madhusudhan, Amlesh Seth, Prabhjot Singh, Rishi Nayyar, Seema Kaushal, Sanjay Sharma","doi":"10.1007/s00261-026-05770-0","DOIUrl":"https://doi.org/10.1007/s00261-026-05770-0","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate characterization of solid renal masses is essential because management and outcomes differ substantially by histologic subtype. Clear cell renal cell carcinoma (ccRCC), the most common and aggressive RCC subtype, is also the most responsive to targeted anti-angiogenic therapies. Quantitative perfusion imaging may enable a noninvasive \"virtual biopsy\" approach, but the comparative performance of dual-energy CT (DECT), intravoxel incoherent motion (IVIM), and dynamic contrast-enhanced MRI (DCE-MRI) remains unclear. This study compared perfusion biomarkers from these modalities for differentiating ccRCC from other solid renal masses.</p><p><strong>Methods: </strong>In this prospective single-center study, adults with solid renal masses underwent preoperative DECT, IVIM, and DCE-MRI, with postoperative histopathology as the reference standard. DECT-derived iodine concentration (IC) and iodine ratio (IR), IVIM-derived perfusion fraction (f) and pseudodiffusivity (D*), and DCE-MRI-derived wash-in rate (WIR), wash-out rate (WOR), and area under the time-intensity curve (AUTIC) were evaluated. Diagnostic performance for differentiating ccRCC from other solid renal masses was assessed using receiver operating characteristic (ROC) analysis and multivariable logistic regression.</p><p><strong>Results: </strong>Thirty-three patients (mean age, 49.8 ± 11.9 years; 21 men) were included. Compared with other solid renal masses, ccRCC demonstrated significantly higher IC and IR (p < 0.02) and higher AUTIC and WIR (p < 0.05). IVIM parameters did not differ significantly (p > 0.05). IC achieved the highest diagnostic performance across readers (AUC, 0.79-0.83). After exclusion of benign tumors, IC demonstrated excellent discrimination (AUC, 0.96; 95% CI, 0.89-1.00). Multivariable models did not improve performance over the best individual parameter.</p><p><strong>Conclusion: </strong>DECT and DCE-MRI perfusion biomarkers showed comparable performance for differentiating ccRCC from other solid renal masses, whereas IVIM provided limited diagnostic value. The lack of incremental benefit from multiparametric modeling suggests that DECT-derived iodine concentration alone may be sufficient for clinical virtual biopsy workflows, particularly when MRI is unavailable or contraindicated.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine CT reporting of vascular involvement in pancreatic ductal adenocarcinoma: completeness and association with margin-positive resection.","authors":"Jehan Bista, Yiqiu Shen, Michael D Kluger, Lyndon Luk, Yuxuan Chen, Winston Winkler, Sarah A Fischell, Wenqing Cao, Chenchan Huang","doi":"10.1007/s00261-026-05815-4","DOIUrl":"https://doi.org/10.1007/s00261-026-05815-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;National Comprehensive Cancer Network (NCCN) guidelines emphasize detailed reporting of tumor-vessel relationships for pancreatic ductal adenocarcinoma (PDAC), but the completeness and prognostic significance of vascular findings documented in routine clinical CT reports remain uncertain in the contemporary era of neoadjuvant therapy (NAT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To assess the completeness of NCCN-relevant vascular reporting in routine preoperative CT examinations and determine whether CT-reported vascular findings and derived NCCN resectability categories are associated with margin-positive (R1) resection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this retrospective single-center study, 528 patients who underwent resection for pathologically confirmed PDAC between 2011 and 2026 were identified. For each patient, the most recent preoperative staging CT report and corresponding surgical pathology report were linked. Tumor-vessel relationships involving the superior mesenteric artery (SMA), celiac axis, common hepatic artery (CHA), superior mesenteric vein (SMV), and portal vein (PV) were extracted from routine clinical reports via a large language model, which underwent validation against 2 readers. Multivariable logistic regression was used to evaluate associations between vascular findings, NCCN resectability category, and R1 resection after adjustment for age, sex, tumor size, tumor location, and NAT status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 528 patients (mean age, 69.2 years ±9.9; 277 men), 257 (48.7%) received NAT and 172 (32.6%) had R1 resection. Complete reporting of all five NCCN vessels was present in 224/528 (42.4%) reports. NCCN resectability category could be assigned in 322 patients, including 150 (46.6%) resectable, 123 (38.2%) borderline resectable, and 49 (15.2%) locally advanced tumors. R1 rates increased progressively across categories (26.7%, 45.5%, and 53.1%, respectively; p &lt; 0.001). After adjustment, SMA abutment (OR, 2.85; p = 0.001), SMA encasement (OR, 2.49; p = 0.023), celiac encasement (OR, 2.81; p = 0.021), CHA encasement (OR, 2.31; p = 0.031), PV abutment (OR, 2.31; p = 0.007), and SMV encasement (OR, 2.50; p = 0.014) were independently associated with R1 resection. In sensitivity analysis assuming unreported vessels had no tumor contact, borderline resectable tumors (OR, 2.68; 95% CI, 1.60-4.50) and locally advanced tumors (OR, 4.77; 95% CI, 2.22-10.23) demonstrated progressively higher odds of R1 resection relative to resectable tumors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Complete NCCN-compliant vascular reporting was uncommon in routine PDAC CT reports, limiting standardized resectability classification. Nevertheless, CT-reported vascular findings and NCCN resectability categories derived from routine reports retained significant associations with margin-positive resection, supporting the continued clinical relevance of vascular staging information communicated in e","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of [¹⁸F]-FDG or [⁶⁸Ga]-FAPI PET/MRI for nodal assessment in colorectal cancer: a retrospective comparative analysis.","authors":"Minghe Zhao, Xinfeng Lin, Nina Zhou, Boqi Yu, Yunfeng Yao, Lin Wang, Zhi Yang, Aiwen Wu","doi":"10.1007/s00261-026-05775-9","DOIUrl":"https://doi.org/10.1007/s00261-026-05775-9","url":null,"abstract":"<p><strong>Purpose: </strong>The evaluation of lymph node metastasis in colorectal cancer (CRC) remains a critical challenge, as it significantly impacts prognosis and treatment decisions. PET/MRI with various tracers may take advantages of MRI together with the functional imaging of PET. This study aims to evaluate the diagnostic performance of PET/MRI for lymph node metastasis of CRC in a real-world clinical cohort and to explore the imaging characteristics of PET/MRI using [¹⁸F]-FDG or [⁶⁸Ga]-FAPI tracers.</p><p><strong>Methods: </strong>This retrospective study included 51 patients with confirmed colorectal cancer who underwent PET/MRI imaging ([¹⁸F]-FDG or [⁶⁸Ga]-FAPI) between March 2020 and December 2022. The choice of PET tracer was determined according to clinical indication and tracer availability. The N stage and lesion status (N0 vs. N + and positive node vs. negative node) were independently evaluated by two nuclear medicine physicians. ROC curve analysis was performed using histopathological results and clinical follow-up as the reference standards.</p><p><strong>Results: </strong>The accuracy for nodal (N) status assessment was 91.4% for PET/MRI and 85.7% for MRI. PET/MRI showed numerical higher diagnostic performance than MRI for detecting lymph node metastases (AUC 0.88 vs. 0.81; p = 0.19). At the region-based lymph node level, PET/MRI demonstrated significantly higher accuracy (93.6% vs. 87.8%, p = 0.002), specificity (98.9% vs. 92.5%, p = 0.01), and positive predictive value (85.7% vs. 40.0%, p = 0.002). In the exploratory analysis of [⁶⁸Ga]-FAPI subgroup, no false-positive regional findings were observed, corresponding to a specificity of 100% (50/50; 95% CI, 92.9%-100%). It also showed numerical higher SUV_max and TBR compared to [¹⁸F]-FDG PET/MRI, although the differences were not statistically significant (4.35 vs. 2.25, p = 0.64; 17.4 vs. 5.65, p = 0.29). Among 11 patients who underwent a watch-and-wait or local excision strategy under PET/MRI surveillance, 1 experienced local regrowth and 1 developed lung metastasis. No nodal recurrence was observed during follow-up.</p><p><strong>Conclusion: </strong>PET/MRI demonstrated encouraging diagnostic accuracy and high specificity in evaluating lymph node metastasis in colorectal cancer. These findings support further investigation of PET/MRI as part of multimodal imaging strategies for CRC management, particularly in patients considered for organ preservation.</p>","PeriodicalId":520541,"journal":{"name":"Abdominal radiology (New York)","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}