Abdominal Radiology最新文献

{"title":"From common to rare: imaging spectrum of gastric malignancies","authors":"Hajra Arshad,&nbsp;Linda C. Chu,&nbsp;Elliot K. Fishman","doi":"10.1007/s00261-026-05476-3","DOIUrl":"10.1007/s00261-026-05476-3","url":null,"abstract":"<div><p>Multidetector CT has improved the detection, diagnosis, and characterization of gastric malignancies, and as well as the evaluation of distant metastases. Gastric malignancies range from common types such as adenocarcinoma, lymphoma, and GISTs to rare types such as neuroendocrine tumors, liposarcoma, leiomyosarcoma, plasmacytoma, and metastases from other cancers. CT is often the preferred modality for their assessment. These tumors can appear as a single lesion, multifocal involvement, or diffuse wall thickening, and they often have overlapping imaging features, making diagnosis challenging. This pictorial review presents the CT findings of these malignancies to help radiologists understand the differential diagnosis, recognize early CT patterns, and guide appropriate management.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5415 - 5427"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically interpretable nomogram incorporating radiomics and deep learning feature fusion from abdominal CT for preclinical type 2 diabetes","authors":"Mansuor A. Alanazi,&nbsp;Saud S. Alharbi","doi":"10.1007/s00261-026-05536-8","DOIUrl":"10.1007/s00261-026-05536-8","url":null,"abstract":"<div><h3>Objective</h3><p>To develop and externally validate a multimodal artificial intelligence framework for opportunistic detection of preclinical type 2 diabetes mellitus (T2DM) from routine portal venous–phase abdominal CT in patients without recent laboratory testing.</p><h3>Materials and methods</h3><p>In this multicenter retrospective study, 1257 adults without prior diabetes who underwent routine portal venous–phase abdominal CT were included. Patients were classified as preclinical T2DM or normal glucose tolerance based on fasting plasma glucose and oral glucose tolerance testing. Pancreatic segmentation was performed using an nnU-Net–based deep learning model with expert validation. From the segmented pancreas, 1708 Image Biomarker Standardization Initiative (IBSI)-compliant radiomic features were extracted following standardized preprocessing, reproducibility filtering, and ComBat harmonization. In parallel, multi-scale deep features were derived from five state-of-the-art encoder backbones, including transformer-based and segmentation-derived architectures. Clinical variables were incorporated to construct clinical-only, radiomics-only, deep-only, and multimodal fusion models. Six feature selection methods and five classifiers were systematically evaluated using stratified cross-validation.</p><h3>Results</h3><p>In 1257 patients (879 training, 378 external), preclinical T2DM cases were significantly older and had higher BMI, waist circumference, and glycemic indices than controls (all <i>p</i> &lt; 0.001), with comparable demographics between cohorts despite protocol heterogeneity. Clinical-only models reached AUC 0.738. Radiomics improved discrimination (best AUC 0.792). Deep feature models performed better, led by MedFormer-v2 (AUC 0.834), significantly surpassing radiomics. Multimodal fusion achieved the highest external performance (best AUC 0.861). In a secondary analysis excluding all glycemic laboratory variables, the multimodal model still reached AUC 0.837, confirming the added value of imaging biomarkers for opportunistic detection. The stacking ensemble was well calibrated (AUC 0.856) and significantly outperformed three abdominal radiologists who evaluated CT images alone (mean AUC 0.671), while AI assistance improved readers’ performance.</p><h3>Conclusions</h3><p>Multimodal analysis of routine abdominal CT enables accurate and generalizable detection of preclinical T2DM, supporting opportunistic imaging-based metabolic risk assessment. A simplified nomogram was developed to support individualized risk estimation, although its interpretability remains partial due to the inclusion of a multimodal fusion score.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5803 - 5826"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of fetal magnetic resonance imaging to assess fetuses with umbilical-portal-systemic venous shunt","authors":"Lin Xu,&nbsp;Ming Zhu,&nbsp;Su-Zhen Dong","doi":"10.1007/s00261-026-05557-3","DOIUrl":"10.1007/s00261-026-05557-3","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to report our cases of umbilical-portal-systemic venous shunt (UPSVS) and to evaluate the utility of fetal magnetic resonance imaging (MRI) to diagnose this rare anomaly.</p><h3>Methods</h3><p>This retrospective study included the fetuses with umbilical-portal venous system anomalies. All the cases were performed at 1.5 T magnetic resonance unit including the steady-state free precession (SSFP) and single-shot fast spin echo (SSFSE) sequences. We analyzed the abnormal anatomical findings by fetal MRI and compared them with the prenatal ultrasound (US).</p><h3>Results</h3><p>15 cases with prenatally diagnosed UPSVS based on MRI or US were enrolled. Eight cases were identified by both MRI and US, including umbilical-systemic shunts (<i>n</i> = 3), ductus venosus-systemic shunt (<i>n</i> = 1), intrahepatic portal-systemic shunts (<i>n</i> = 3) and extrahepatic portal-systemic shunt (<i>n</i> = 1). Six cases were only identified by MRI including intrahepatic portal-systemic shunts (<i>n</i> = 5) and ductus venosus-systemic shunt (<i>n</i> = 1). In the remaining single case, prenatal ultrasound findings were suspicious for an intrahepatic portal-systemic shunt, without corresponding fetal MRI abnormalities. Follow-up data were obtained from thirteen patients. Two cases were lost to follow up. Of the thirteen patients undergoing follow-up, two cases of UPSVS were surgically confirmed. Postnatal imaging failed to identify any abnormalities of portal venous system in nine cases. The rest two cases demonstrated normal development and liver function after birth.</p><h3>Conclusion</h3><p>Umbilical-portal-systemic venous shunt can be diagnosed prenatally via MRI. Fetal MRI can serve as a valuable adjunct to prenatal US and improve the diagnostic accuracy.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5848 - 5853"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging biomarkers of liver hypertrophy after portal vein embolization in patients with liver tumors: cholestasis, arterial hyperperfusion, and splenic response","authors":"Anne B. Beeskow,&nbsp;Karoline Rucker,&nbsp;Jakob Leonhardi,&nbsp;Aboelyazid Elkilany,&nbsp;Daniel Seehofer,&nbsp;Hans-Michael Tautenhahn,&nbsp;Thomas Berg,&nbsp;Florian van Bömmel,&nbsp;Holger Gößmann,&nbsp;Timm Denecke,&nbsp;Florian Struck,&nbsp;Sebastian Ebel","doi":"10.1007/s00261-026-05540-y","DOIUrl":"10.1007/s00261-026-05540-y","url":null,"abstract":"<div><h3>Purpose</h3><p>To identify imaging and clinical factors associated with future liver remnant (FLR) hypertrophy after portal vein embolization (PVE) prior to major hepatectomy.</p><h3>Materials and methods</h3><p>This retrospective single-center study included 98 patients (mean age 61 ± 14 years, 56 female) with benign or malignant liver tumors who underwent PVE between 2019 and 2024 before planned major liver resection. 10 patients also received liver venous deprivation (LVD). FLR volumes were measured on cross-sectional imaging before and after PVE. Embolic agent, cholestasis, arterial perfusion patterns, signal intensities in MRI, spleen volume, and venous diameters were assessed.</p><h3>Results</h3><p>Mean FLR growth was 35.6 ± 22.2% (628.9 ± 256.2 to 979.6 ± 313.8 ml (p &lt; 0.001)). Patients undergoing combined LVD demonstrated significantly greater FLR hypertrophy (mean FLR growth 61.3 ± 23.1%, 422 ± 97 ml; p &lt; 0.001) compared with PVE alone. Arterial hyperperfusion of the embolized liver lobe was found to be associated with increased FLR growth (p = 0.036). Isolated cholestasis confined to the embolized lobe was also associated with greater FLR hypertrophy (p = 0.038), whereas cholestasis involving the FLR was associated with impaired growth (p = 0.042). No significant difference in FLR hypertrophy was observed regarding the used embolic agent (p = 0.11). Splenic volume increased significantly following PVE (311.9 ± 146.5 mL after PVE vs. 271.3 ± 118.5 mL prior to PVE, p &lt; 0.001).</p><h3>Conclusion</h3><p>Imaging features such as arterial hyperperfusion and cholestasis of the embolized liver lobe, and postinterventional splenic enlargement are associated with larger FLR-growth. These findings may provide valuable early indicators of regenerative response and could help refine patient selection for PVE and hepatectomy, warranting further prospective evaluation.</p><h3>Graphical abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5827 - 5837"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05540-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of MRI protocols for diagnosis of benign and malignant ovarian tumors: a systematic review and meta-analysis","authors":"Pin Yang,&nbsp;Fengxian Fan,&nbsp;Tingli Yang,&nbsp;Rui Wang","doi":"10.1007/s00261-026-05501-5","DOIUrl":"10.1007/s00261-026-05501-5","url":null,"abstract":"<div><h3>Objective</h3><p>With the continuous increase in the incidence of ovarian tumors in gynecology, the differential diagnosis of benign and malignant ovarian tumors is of great significance for subsequent treatment. The primary aim of this meta-analysis was to systematically evaluate the diagnostic value of MRI in differentiating benign from malignant ovarian tumors.</p><h3>Methods</h3><p>A search was conducted in the PubMed and Web of Science databases to identify diagnostic tests for ovarian tumors using MRI, The search deadline is April 29, 2025. Two reviewers independently screened the literature, extracted data, and assessed the methodological quality of the included studies according to inclusion and exclusion criteria. Subsequently, a meta-analysis was performed using Stata 15.1 software.</p><h3>Results</h3><p>Ultimately, 81 articles were included, encompassing 12,594 patients and 14,023 lesions. Based on the lesion analysis, the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, and diagnostic odds ratio for differentiating benign and malignant ovarian tumors by MRI were 0.92 (95% CI: 0.91–0.94), 0.88 (95% CI: 0.86–0.90), 7.9 (95% CI: 6.6–9.5), 0.09 (95% CI: 0.07–0.11), and 93 (95% CI: 69–125), respectively. The pooled area under the SROC curve was 0.96 (95% CI: 0.94–0.97). Of the 81 included studies, 13 reported diagnostic performance for DWI alone; these were analyzed as a distinct subgroup within the overall meta-analysis. Based on the lesion analysis, the pooled sensitivity, pooled specificity, diagnostic odds ratio, and area under the curve for differentiating benign and malignant ovarian tumors by DWI were 0.88 (95% CI: 0.83–0.92), 0.79 (95% CI: 0.72–0.84), 28 (95% CI: 17–47), and 0.90 (95% CI: 0.87–0.92), respectively. For using MR scoring system (36 studies), pooled sensitivity was 0.94 (95% CI: 0.92–0.96) and specificity 0.90 (95% CI: 0.87–0.93). For contrast-enhanced MRI (69 studies), pooled sensitivity was 0.93 (95% CI: 0.91–0.95) and specificity 0.89 (95% CI: 0.86–0.91). However, whether dynamic contrast-enhanced (DCE) was performed during MRI diagnosis of benign and malignant ovarian tumors had little effect on the pooled sensitivity, while the pooled specificity of studies that performed DCE might be slightly higher than those that did not.</p><h3>Conclusions</h3><p>MRI plays a crucial role in differentiating between benign and malignant ovarian tumors, and DWI can serve as an auxiliary diagnostic tool, used concurrently with conventional MRI, while the diagnostic efficacy of DCE and non-DCE is similar. Prospective studies using MRI scoring systems and sample sizes exceeding 100 also show better diagnostic performance.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5428 - 5446"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT presentations of pancreatic lymphoma: what radiologists need to know","authors":"Zahra F. Rahmatullah,&nbsp;Linda C. Chu,&nbsp;Ralph H. Hruban,&nbsp;Satomi Kawamoto,&nbsp;Atif Zaheer,&nbsp;Elliot K. Fishman","doi":"10.1007/s00261-026-05538-6","DOIUrl":"10.1007/s00261-026-05538-6","url":null,"abstract":"<div><p>Pancreatic lymphoma is a rare entity that can mimic other pancreatic pathologies, particularly pancreatic ductal adenocarcinoma (PDAC), making accurate radiologic recognition essential as management differs significantly. Pancreatic lymphoma is treated with chemotherapy and generally carries a more favorable prognosis, whereas PDAC typically requires surgical intervention. Through a series of illustrative cases, many of which were initially referred to a PDAC multidisciplinary conference but ultimately proven to be lymphoma, we highlight the diverse CT imaging spectrum of pancreatic lymphoma, which extends well beyond the classically described bulky pancreatic mass. Observed patterns include focal well-defined hypodense masses, multifocal pancreatic lesions, diffuse infiltrative enlargement mimicking pancreatitis, and masses with extrapancreatic spread into adjacent organs. While classic features such as absent pancreatic ductal dilatation, lack of vascular occlusion, and homogeneous hypoattenuation can help distinguish lymphoma from PDAC, variant presentations with ductal dilation, necrosis, or vascular involvement may occur. Awareness of these diverse imaging appearances may help radiologists include pancreatic lymphoma in the differential diagnosis of hypodense pancreatic masses, advising tissue sampling to ensure accurate diagnosis and guide appropriate management.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5447 - 5454"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LI-RADS TRA v2024 succeeds where RECIST and mRECIST fail: viability-based survival prediction in TACE-treated hepatocellular carcinoma","authors":"Alisa Mohebbi,&nbsp;Mehrad Zare,&nbsp;Afshin Mohammadi,&nbsp;Neda Pak","doi":"10.1007/s00261-026-05556-4","DOIUrl":"10.1007/s00261-026-05556-4","url":null,"abstract":"<div><h3>Background</h3><p>Despite robust response assessment validation of Liver Imaging Reporting and Data System Treatment Response Algorithm (LI-RADS TRA) version 2024, a critical evidence gap exists for its prognostic value in non-radiation hepatocellular carcinoma (HCC) therapies. Conventional response assessment criteria (RECIST, mRECIST) focus on morphologic changes, not tumor viability.</p><h3>Purpose</h3><p>To evaluate the prognostic implications of LI-RADS TRA v2024 versus RECIST and mRECIST for predicting overall survival and time to progression in HCC patients treated with trans-arterial chemoembolization (TACE), and to assess whether quantitative enhancement reduction augments prognostic stratification.</p><h3>Methods</h3><p>A total of 105 HCC patients undergoing TACE with multi-phasic contrast-enhanced CT were included. Four board-certified radiologists independently assessed tumor response using LI-RADS TRA v2024, RECIST, and mRECIST criteria.</p><h3>Results</h3><p>LI-RADS TRA demonstrated convergent prognostic discrimination for overall survival, with non-responders achieving mean survival of 719.8 days versus responders 1,002.1 days (<i>p</i> = 0.014; hazard ratio 1.63). In contrast, RECIST (<i>p</i> = 0.670, hazard ratio 0.72) and mRECIST (<i>p</i> = 0.457, hazard ratio 1.16) showed negligible stratification. Importantly, LI-RADS TRA exhibited weak discrimination for time to progression (<i>p</i> = 0.095). Incorporating quantitative enhancement-size change from pre-TACE to post-TACE (%) substantially enhanced LI-RADS TRA prognostic performance for survival (HR 1.91, <i>p</i> = 0.026), but not progression prediction.</p><h3>Conclusion</h3><p>LI-RADS TRA v2024 outperforms conventional size-based and enhancement-duration criteria for mortality risk stratification in TACE-treated HCC, reflecting mechanistic potential of viability-based assessment. However, imaging response predicts cumulative mortality, not progression timing. Integration of quantitative enhancement metrics refines risk stratification for surveillance planning.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5838 - 5847"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early recurrence of hepatocellular carcinoma after hepatectomy: predictive role of whole-tumor iodine density histogram features and resection margin distance","authors":"Yuan Xu,&nbsp;Bo Liu,&nbsp;Xiaojing Ming,&nbsp;Tiezhu Ren,&nbsp;Jiachen Sun,&nbsp;Rui Xu,&nbsp;Jianli Liu,&nbsp;Junlin Zhou","doi":"10.1007/s00261-026-05409-0","DOIUrl":"10.1007/s00261-026-05409-0","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the predictive value of whole-tumor iodine density (ID) histogram parameters and resection margin distance for early recurrence (ER) after curative resection of hepatocellular carcinoma (HCC).</p><h3>Methods</h3><p>This retrospective study included patients with HCC who underwent R0 resection and received preoperative spectral CT scans. Patients were categorized into ER+ (<i>n</i> = 42) and ER− (<i>n</i> = 43) groups. Independent predictors of recurrence-free survival (RFS) were identified using multivariate Cox regression analysis. The performance of the prediction model was assessed using time-dependent receiver operating characteristic (td-ROC) curves, calibration and decision curves analysis. Kaplan-Meier analysis was used to evaluate differences in RFS between groups.</p><h3>Results</h3><p>Multivariate Cox regression identified Max, Skewness, microvascular invasion (MVI), and resection margin distance as independent risk factors for ER. Kaplan-Meier analysis revealed significantly shorter mean RFS in patients with MVI+ (12.34 months vs. 29.02 months), extremely narrow margin (9.54 months) and narrow margin (15.42 months) compared to wide margin (28.41 months), high Max (≥ 2041.00 vs. &lt;2041.00; 15.15 vs. 26.13 months), and high Skewness (≥ 0.22 vs. &lt;0.22; 16.83 vs. 23.62 months) (all <i>P</i> &lt; 0.05).</p><h3>Conclusion</h3><p>Whole-tumor ID histogram parameters (Max and Skewness) and clinicopathological factors (MVI and resection margin distance) are independent predictors of ER. These factors allow effective stratification of RFS and may guide individualized postoperative management.</p><h3>Critical relevance statement</h3><p>Whole-tumor iodine density histogram features and resection margin distance provide independent predictors of early recurrence after hepatectomy in HCC, enabling improved risk stratification and guiding individualized postoperative management.</p><h3>Graphical abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5778 - 5788"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-energy CT-derived multiparameters for noninvasive prediction of vessels encapsulating tumor clusters and microvascular invasion in hepatocellular carcinoma","authors":"Mengsi Li,&nbsp;Huayu You,&nbsp;Ma Luo,&nbsp;Anqi Li,&nbsp;Jinhui Zhou,&nbsp;Lina Zhang,&nbsp;Yuanqiang Xiao,&nbsp;Xiao Yu,&nbsp;Weiwei Deng,&nbsp;Zhongping Zhang,&nbsp;Chuanmiao Xie,&nbsp;Shiting Feng,&nbsp;Jin Wang","doi":"10.1007/s00261-026-05533-x","DOIUrl":"10.1007/s00261-026-05533-x","url":null,"abstract":"<div><h3>Objective</h3><p>Vessels encapsulating tumor clusters (VETC) and microvascular invasion (MVI) are risk factors for early recurrence after hepatectomy in patients with hepatocellular carcinoma (HCC). This study aimed to assess the performance of multiparameters of dual-phase contrast-enhanced dual-energy CT (DECT) in identifying VETC and MVI statuses noninvasively.</p><h3>Methods</h3><p>This retrospective study enrolled 122 patients with pathologically confirmed HCC (VETC +/−, N = 57/65; MVI +/−, N = 54/68) who underwent contrast-enhanced DECT examinations. Conventional clinical information and radiological features were collected. DECT-derived multiparameters in the arterial phase (AP) and portal venous phase (PVP) were analyzed, including non-normalized effective atomic number (Zeff), electron density (ED), and iodine density (ID), and their corresponding normalized parameters (N1-2 Zeff, N1-2 ED, N1-2 ID) based on two normalization approaches (N1 = tumor-to-aorta ratio; N2 = tumor-to-liver parenchyma). The slope of the energy spectrum curve (λ) was also evaluated. Univariate and multivariate logistic regression analyses were performed to construct nomograms and conventional models. The performance of each parameter, conventional model, and nomogram for assessing VETC and MVI was assessed using the area under the receiver operating characteristic curve (AUC).</p><h3>Results</h3><p>Multiparameters predicted VETC and MVI with AUCs ranging from 0.64 to 0.77 (all <i>p</i> &lt; 0.01). Compared with their non-normalized counterparts, the performances of N1-Zeff_AP (AUC: 0.77, <i>p</i> = 0.01) and N1-ID_AP (AUC: 0.70, <i>p</i> = 0.01) in predicting VETC were significantly improved, and N1-ED_PVP and N1-ID_PVP showed numerically higher sensitivity (88.2%) and specificity (88.9%) for predicting MVI, respectively. Nomogram_VETC—integrating N1-Zeff_AP, AST &gt; 40 IU/L, and mosaic appearance—for evaluating VETC, and nomogram_MVI—integrating N1-ED_PVP, N1-ID_PVP, nonsmooth tumor margin, and intratumoral arteries—for evaluating MVI outperformed their corresponding conventional models (AUC: 0.80 vs. 0.70, and 0.83 vs. 0.77, respectively; both <i>p</i> &lt; 0.05).</p><h3>Conclusion</h3><p>DECT-derived multiparameters can be used to noninvasively identify VETC and MVI statuses. Nomograms incorporating these parameters enhance VETC and MVI prediction in HCC.</p><h3>Graphic abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5789 - 5802"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronal reduced field-of-view diffusion-weighted imaging improves image quality and T staging of upper tract urothelial carcinoma compared with conventional axial DWI: a retrospective study","authors":"Wei Wang,&nbsp;Wei Li,&nbsp;Junzhe Yang,&nbsp;Qi Tang,&nbsp;Ke Xue,&nbsp;Jingyun Wu,&nbsp;Jianxing Qiu","doi":"10.1007/s00261-026-05562-6","DOIUrl":"10.1007/s00261-026-05562-6","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether coronal reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) improves image quality and local T staging of upper tract urothelial carcinoma (UTUC) compared with conventional axial full field-of-view (f-FOV) DWI.</p><h3>Methods</h3><p>In this retrospective single-center study, 60 patients with pathologically confirmed UTUC who underwent preoperative magnetic resonance urography (MRU) were included. The imaging protocol comprised both axial f-FOV DWI and coronal r-FOV DWI acquired on a 3.0-T scanner. Two radiologists independently assessed subjective image quality (sharpness, distortion, artifacts, and lesion conspicuity). Tumor contrast and apparent diffusion coefficient (ADC) values were measured. Local T staging was performed using each DWI sequence, with particular focus on identifying locally advanced disease (≥ T3). Histopathology from radical nephroureterectomy served as the reference standard.</p><h3>Results</h3><p>Coronal r-FOV DWI demonstrated significantly higher image quality scores across all subjective parameters than axial f-FOV DWI (all <i>p</i> ≤ 0.003). Tumor contrast was higher on r-FOV DWI (<i>p</i> &lt; 0.001), and ADC values measured on r-FOV DWI were significantly lower than those on f-FOV DWI (<i>p</i> &lt; 0.001), with a strong correlation between the two techniques (<i>r</i> = 0.765). High-grade UTUC showed significantly lower ADC values than low-grade tumors on both sequences (<i>p</i> &lt; 0.05). For detecting locally advanced disease (≥ T3), coronal r-FOV DWI achieved higher sensitivity (91.7% vs. 75.0%), specificity (80.6% vs. 75.0%), and overall accuracy (85.0% vs. 75.0%) compared with axial f-FOV DWI. The addition of coronal r-FOV DWI was subjectively considered diagnostically useful in 91.7% of cases.</p><h3>Conclusion</h3><p>Coronal r-FOV DWI significantly improves image quality, tumor conspicuity, and local T staging performance in UTUC compared with conventional axial f-FOV DWI. When incorporated as a complementary sequence in MRU, coronal r-FOV DWI provides added diagnostic value, particularly for identifying locally advanced disease.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5854 - 5862"},"PeriodicalIF":2.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}