Abdominal Radiology最新文献

{"title":"Diagnostic value of intravoxel incoherent motion-based virtual MR elastography for differentiating prostate cancer from benign prostate lesion","authors":"Ze Wang,&nbsp;Rui Zhang,&nbsp;Jian Liu,&nbsp;Hongbiao Jiang,&nbsp;Yongsheng Pan,&nbsp;Bing Zheng,&nbsp;Hongbin Liu,&nbsp;Tianle Wang,&nbsp;Lin Wang","doi":"10.1007/s00261-026-05535-9","DOIUrl":"10.1007/s00261-026-05535-9","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the diagnostic efficacy of virtual magnetic resonance elastography (vMRE) derived from intravoxel incoherent motion (IVIM) imaging in distinguishing prostate cancer (PCa) from benign prostate lesion (BPL).</p><h3>Methods</h3><p>In this prospective study, patients with suspected prostate lesions underwent 3.0-T MRI, including an IVIM-vMRE sequence, prior to biopsy or surgery. Virtual stiffness maps (µ_diff) were generated using a custom MATLAB algorithm. Two radiologists, blinded to pathology, performed manual region-of-interest segmentation and PI-RADS v2.1 scoring. The protocol focused on comparing µ_diff values between malignant and benign lesions. Diagnostic performance was assessed via receiver operating characteristic (ROC) analysis, and the correlation between µ_diff and Gleason scores was evaluated using Spearman’s rank correlation. Internal validation was performed via 1,000-sample bootstrapping.</p><h3>Results</h3><p>The final cohort comprised 120 patients (70 PCa; 50 BPL). PCa lesions exhibited significantly higher µ_diff values compared to BPL (9.25 ± 1.06 kPa vs. 7.27 ± 0.53 kPa, <i>P</i> &lt; 0.001). ROC analysis revealed an optimal µ_diff cutoff of 7.90 kPa, which yielded an AUC of 0.931 (95% CI: 0.886–0.976). Furthermore, µ_diff values were significantly positively correlated with pathological Gleason scores (<i>r</i> = 0.670, <i>P</i> &lt; 0.001). The combined model of µ_diff and PI-RADS v2.1 significantly outperformed PI-RADS v2.1 alone (AUC: 0.941 vs. 0.811, <i>P</i> &lt; 0.001), and it achieved an optimism-corrected AUC of 0.940 in bootstrap validation.</p><h3>Conclusion</h3><p>IVIM-vMRE provides an objective, quantifiable measure of prostate tissue stiffness that correlates with tumor grade. As a non-invasive adjunct to bpMRI, vMRE significantly improves the diagnostic accuracy of PI-RADS v2.1 and facilitates the stratification of tumor aggressiveness.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5679 - 5693"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825897","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":"The local efficacy and influencing factors of ultrasound-guided percutaneous radiofrequency ablation in sub-cardiac hepatic tumor: A 7-year experience at a single center","authors":"Chunxu Liao,&nbsp;Jianchuan Yang,&nbsp;ZhiLiang Hong,&nbsp;Xiantao Zeng,&nbsp;Ting Hu,&nbsp;Songsong Wu","doi":"10.1007/s00261-026-05519-9","DOIUrl":"10.1007/s00261-026-05519-9","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the effectiveness and safety of ultrasound (US)-guided percutaneous radiofrequency ablation (PRFA) for sub-cardiac hepatic tumors and evaluate the factors influencing local tumor progression (LTP).</p><h3>Methods</h3><p>Between January 2016 and January 2023, we included 118 patients (118 lesions) of US-guided RFA for sub-cardiac hepatic tumors (located in S2 or S4a, with a gap between the tumor and the left diaphragm ≤ 10 mm). We retrospectively analyzed patients’ electronic medical records and imaging follow-up data to evaluate the success rate, LTP, and complications. We also used univariate and multivariate Cox regression to explore the risk factors for LTP.</p><h3>Results</h3><p>The primary technical success rate for treating sub-cardiac hepatic tumors was 113/118 (95.8%). The success rate after the second ablation was 118/118 (100%). A single serious complication was recorded 1/118(0.8%), including acute pericardial tamponade and sudden cardiac arrest. The median follow-up period was 24 months (range, 1.2–72 months), with LTP occurring in 19 lesions (16.1%). Besides, the 1-year, 2-year, and 3-year cumulative rates of LTP were 12.7%, 15.3%, and 16.1%, respectively. Tumor size was an independent risk factor for LTP following ablation of sub-cardiac hepatic tumors (HR 1.06; 95% CI 1.02–1.11; <i>P</i> = 0.008). A larger minimal ablative margin (MAM) was associated with a lower hazard of LTP (HR 0.78; 95% CI 0.65–0.92; Wald <i>P</i> = 0.004; LR <i>P</i> = 0.002). Stratified analysis indicated that lesions ≥ 30 mm in diameter carried a significantly higher risk of LTP (HR 4.35; 95% CI 1.46–12.99; <i>P</i> = 0.009).</p><h3>Conclusions</h3><p>US-guided PRFA for sub-cardiac hepatic tumors is effective and safe, though caution is advised for tumors ≥ 30 mm due to a significantly higher LTP risk.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5666 - 5678"},"PeriodicalIF":2.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794778","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":"Normal liver stiffness values measured with MR elastography and two-dimensional shear wave elastography in children aged 9–17 years","authors":"Mehmet Seker,&nbsp;Mehmet Sait Dogan,&nbsp;Hayrettin Temel,&nbsp;Osman Kahraman,&nbsp;Fatma Zeynep Gungoren,&nbsp;Mehmet Kocak,&nbsp;Cengiz Erol","doi":"10.1007/s00261-026-05431-2","DOIUrl":"10.1007/s00261-026-05431-2","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to establish pediatric reference ranges for liver stiffness measured by magnetic resonance elastography (MRE) and two‑dimensional shear‑wave ultrasound elastography (2D‑SWE) in healthy Turkish children aged 9–17 years.</p><h3>Materials and methods</h3><p>Of the 100 initially recruited volunteers, nine were excluded based on strict imaging and biochemical criteria. A final cohort of 91 healthy participants with normal clinical, biochemical, and serological evaluation underwent same‑day MRE (3.0 T, external 60 Hz pneumatic active driver, anterior passive driver paddle over the right upper quadrant, breath‑hold acquisition; non‑vascular ROIs in the right lobe) and 2D‑SWE (intercostal approach, supine position, right arm elevated, 3–5 circular ROIs placed 1.5–2.0 cm below the liver capsule in the right lobe, during end‑expiration breath‑hold). Reference intervals were calculated as mean ±1.96 SD and represent modality‑specific reference limits. Group comparisons were evaluated using the Wilcoxon–Mann–Whitney and Kruskal–Wallis tests.</p><h3>Results</h3><p>Mean liver stiffness values (LSV) were 2.16 ± 0.24 kPa for MRE (reference interval 1.69–2.63 kPa) and 5.34 ± 1.00 kPa for 2D‑SWE (reference interval 3.38–7.30 kPa). No significant differences were observed across age groups (9–11, 12–14, 15–17 years) or between sexes. Correlations with laboratory values were limited and clinically non‑significant in this healthy cohort.</p><h3>Conclusion</h3><p>Same‑day MRE and 2D‑SWE provide modality‑specific pediatric liver stiffness reference ranges in healthy children aged 9–17 years. These values appear independent of age and sex and should be interpreted as non‑interchangeable, modality‑dependent reference intervals.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5656 - 5665"},"PeriodicalIF":2.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05431-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794797","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":"A case of β-catenin-activated hepatocellular adenoma with concurrent hepatocellular carcinoma","authors":"Daichi Ito,&nbsp;Ryota Hyodo,&nbsp;Keisuke Kurimoto,&nbsp;Takashi Mizuno,&nbsp;Akira Satou,&nbsp;Motoko Sasaki,&nbsp;Yoji Ishizu,&nbsp;Mami Iima,&nbsp;Shinji Naganawa","doi":"10.1007/s00261-026-05522-0","DOIUrl":"10.1007/s00261-026-05522-0","url":null,"abstract":"<div>\u0000 \u0000 <p>β-Catenin-activated hepatocellular adenoma (B-HCA), particularly the exon 3-mutated subtype, has a high risk of malignant transformation to hepatocellular carcinoma (HCC). Here, we report a rare case of a man in his 60s with B-HCA containing embedded HCC. On dynamic contrast-enhanced computed tomography (DCE-CT), a 6-cm poorly enhancing mass suggestive of HCC was identified in the enlarged lateral segment of the left hepatic lobe. A 9-cm region surrounding the poorly enhancing mass appeared similar to adjacent liver parenchyma on non-contrast CT, but showed mild arterial enhancement without washout on DCE-CT. In addition, abrupt displacement of the adjacent hepatic vessels at its margins suggested a tumor component rather than a pseudolesion. On gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (EOB-MRI), the surrounding region exhibited mild arterial enhancement and mild hyperintensity in the hepatobiliary phase (HBP) relative to the background liver parenchyma. Pathological analysis confirmed the poorly enhancing mass as well- to moderately differentiated HCC and the surrounding region as exon 3-mutated B-HCA, showing diffuse strong glutamine synthetase positivity. This case demonstrates malignant transformation of B-HCA to HCC and highlights the importance of recognizing this entity in clinical practice.</p>\u0000 </div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5623 - 5630"},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05522-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794572","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":"Hypervascular solid-appearing serous cystadenoma as a mimic of nonfunctioning pancreatic neuroendocrine tumour: a systematic review","authors":"Mario Annecchiarico,&nbsp;Giuseppe Loiaco,&nbsp;Giulio Argenio,&nbsp;Antonio Varricchio,&nbsp;Gianluca Rompianesi,&nbsp;Roberto Cannella","doi":"10.1007/s00261-026-05532-y","DOIUrl":"10.1007/s00261-026-05532-y","url":null,"abstract":"<div><h3>Background</h3><p>Solid pancreatic serous cystadenoma (SCA) may present as a hypervascular mass and mimic nonfunctioning pancreatic neuroendocrine tumour (NF-pNET), potentially leading to pancreatic resection for benign disease. We synthesized the available evidence on this diagnostic pitfall.</p><h3>Methods</h3><p>A PRISMA 2020–aligned systematic review searched MEDLINE, Embase, and Web of Science (1 January 2000–1 December 2025). We included comparative cohorts of pathology-proven SCA versus NF-pNET reporting CT/MRI discriminative features and case reports/series of pathology-proven SCA preoperatively interpreted as NF-pNET. Comparative cohorts and case reports/series were synthesized separately; no meta-analysis was performed.</p><h3>Results</h3><p>Thirty-five publications were included: four retrospective single-center comparative cohorts (50 SCA and 89 NF-pNET patients) and 31 case reports/series (39 SCA patients). In comparative cohorts, unenhanced CT attenuation was consistently lower in SCA than in NF-pNET (18.5–29.6 vs. 38.8–48.4 HU), with study-specific ROC-derived cutoffs in the low 30-HU range; attenuation ratios performed similarly. Diffusion-weighted MRI showed higher ADC values in SCA, with reported study-specific cutoffs of &gt; 1.36 × 10^− 3 mm²/s and &gt; 1.99 × 10^− 3 mm²/s. In case reports/series, arterial hyperenhancement occurred in 32/33 (97.0%), ⁶⁸Ga-DOTA–peptide uptake in 17/39 (43.6%), and EUS-guided sampling was diagnostic in 9/17 (52.9%).</p><h3>Conclusions</h3><p>NF-pNET–mimicking SCA is an uncommon but clinically consequential benign mimic. In the available retrospective comparative cohorts of resected, pathology-proven lesions, lower unenhanced CT attenuation (and attenuation ratios) and higher DWI–ADC values consistently favored SCA over NF-pNET, whereas arterial hyperenhancement and positive somatostatin receptor imaging uptake were not specific. These findings may support cautious multiparametric assessment in selected hypervascular solid-appearing pancreatic lesions, but should not be applied as definitive diagnostic thresholds without external validation.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5644 - 5655"},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05532-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794824","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":"An explainable clinical–radiomics machine learning model for preoperative prediction of WHO/ISUP nuclear grade in clear cell renal cell carcinoma","authors":"Yue Li,&nbsp;Mingzhi Lin,&nbsp;Linlin Sun,&nbsp;Changming Dong,&nbsp;Jinshan Yang,&nbsp;Xinxin Li,&nbsp;Yuxin Lin,&nbsp;Jinting Wu,&nbsp;Junjie Zhao,&nbsp;Chunhua Lin","doi":"10.1007/s00261-026-05521-1","DOIUrl":"10.1007/s00261-026-05521-1","url":null,"abstract":"<div><h3>Background</h3><p>Accurate preoperative assessment of the WHO/ISUP nuclear grade of clear cell renal cell carcinoma (ccRCC) is critical for guiding individualized surgical strategies and prognostic evaluation. However, current grading still depends on postoperative pathology. This study aimed to develop and validate a noninvasive, machine learning–based model integrating clinical and radiomic features for predicting WHO/ISUP pathological grade in ccRCC.</p><h3>Methods</h3><p>A total of 415 patients with pathologically confirmed ccRCC were retrospectively enrolled, including 320 for model development and 95 for external validation. Clinical variables significantly associated with tumor grade in univariate analysis were further analyzed using multivariate logistic regression and machine learning algorithms. Radiomic features were extracted from preoperative CT images and screened using three strategies: least absolute shrinkage and selection operator (LASSO), principal component analysis (PCA), and maximum relevance minimum redundancy (mRMR). Twelve algorithms—including Random Forest (RF), XGBoost, LightGBM, and Support Vector Machine (SVM)—were trained and validated. Model performance was evaluated by area under the curve (AUC), accuracy, sensitivity, specificity, and negative predictive value (NPV). Model interpretability was assessed using SHAP (SHapley Additive Explanations) analysis.</p><h3>Results</h3><p>Six independent predictors of WHO/ISUP grade were identified: body mass index (BMI), maximum tumor diameter, perirenal infiltration, serum albumin (SA), osmolality (OSM), and neuron-specific enolase (NSE). Among clinical-only models, RF achieved the best performance (AUC = 0.852, 0.734, and 0889 in training, test, and external validation cohorts, respectively). Incorporating radiomic features further improved prediction accuracy. In the combined LASSO–RF model, the external validation cohort achieved an AUC of 0.912 (95% CI: 0.854–0.970), accuracy of 0.853, sensitivity of 0917, and specificity of 0.831. SHAP analysis revealed that OSM, SA, and NSE were the most influential features, while radiomic texture features such as log–sigma–1–mm–3D first-order maximum also contributed significantly.</p><h3>Conclusion</h3><p>The LASSO–RF model integrating clinical and radiomic features demonstrated excellent accuracy and generalizability for predicting WHO/ISUP grade in ccRCC. This noninvasive approach enables individualized preoperative grading and risk stratification, providing valuable support for nephron-sparing surgical decision-making and precision oncology in renal cancer management.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5609 - 5622"},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05521-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794568","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":"Clinical course and predictive factors of incidentally detected adult intussusceptions on CT: a retrospective cohort study","authors":"Abdullah Enes Ataş,&nbsp;Zuhal Ak,&nbsp;Furkan İmrek,&nbsp;Ülkü Kerimoğlu","doi":"10.1007/s00261-026-05531-z","DOIUrl":"10.1007/s00261-026-05531-z","url":null,"abstract":"<div><h3>Background</h3><p>Adult intussusception is traditionally considered a surgical pathology often associated with a malignant lead point. However, the widespread use of computed tomography (CT) has led to more frequent incidental detections. We aimed to evaluate the clinical and radiological characteristics of incidentally detected adult intussusceptions and identify predictors of lesion persistence.</p><h3>Methods</h3><p>In this retrospective study, we reviewed 150 adult patients with incidentally detected intussusception on abdominal CT between 2020 and 2025. Demographic data, clinical history, and radiological parameters (location, segment length, lead point, and ileus) were recorded. In the subgroup of patients with follow-up imaging (<i>n</i> = 59), factors predicting the persistence of the intussusception were statistically analyzed.</p><h3>Results</h3><p>The mean age was 43.4 ± 18.0 years. The majority of intussusceptions were localized in the jejunum (77.3%). A pathological lead point was identified in only 11.3% of patients, and 4.7% presented with ileus. On follow-up imaging, 74.6% of the intussusceptions resolved spontaneously, while 10.2% required surgical intervention. There was no statistically significant association between the persistence of the lesion and the length of the intussuscepted segment (<i>p</i> = 0.184), history of malignancy (<i>p</i> = 0.236), or the presence of a lead point (<i>p</i> = 0.595).</p><h3>Conclusion</h3><p>Most incidentally detected adult intussusceptions are benign, transient, jejunal predominant processes. Traditional predictive factors, such as segment length or malignancy history, are insufficient to foresee lesion persistence. A conservative approach prioritizing clinical observation should be considered in asymptomatic patients lacking a distinct lead point or ileus.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 8","pages":"3785 - 3793"},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05531-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794684","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":"Radiomics and artificial intelligence in pancreatic cyst characterization: future or fiction?","authors":"Cesare Maino,&nbsp;Paolo Niccolò Franco,&nbsp;Federica Omboni,&nbsp;Giuseppe Di Giovanni,&nbsp;Riccardo Inchingolo,&nbsp;Giulia A Zamboni,&nbsp;Davide Ippolito","doi":"10.1007/s00261-026-05515-z","DOIUrl":"10.1007/s00261-026-05515-z","url":null,"abstract":"<div><p>Pancreatic cystic lesions (PCLs) are increasingly detected due to the widespread use of cross-sectional imaging and represent a significant diagnostic challenge because of their heterogeneous biological behavior, ranging from benign lesions to neoplasms with malignant potential. Accurate characterization and risk stratification are essential to guide appropriate management and avoid unnecessary surgical interventions. Conventional imaging modalities, including computed tomography (CT), magnetic resonance (MR) imaging, and endoscopic ultrasound (EUS), remain central to the diagnostic work-up; however, their ability to reliably differentiate cyst subtypes and predict malignant transformation remains limited. In recent years, artificial intelligence (AI) and radiomics have emerged as promising approaches for improving the non-invasive characterization of PCLs by extracting quantitative imaging features beyond those appreciable through visual assessment. This narrative review summarizes the current evidence regarding CT- and MR-based radiomics and AI in pancreatic cyst characterization, focusing on their role in differentiating mucinous from non-mucinous cysts, identifying high-risk intraductal papillary mucinous neoplasms (IPMNs), and supporting clinical decision-making. The potential advantages of these techniques are discussed alongside main methodological limitations, including variability in imaging acquisition protocols, segmentation reproducibility, small and often retrospective datasets, limited external validation, and interpretability of AI-based models. Further multicenter studies, standardized radiomic pipelines, and prospective validation are required before these tools can be reliably integrated into routine clinical practice.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5359 - 5369"},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794805","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":"The emerging role of 4D flow MRI in abdominal interventional radiology","authors":"Ryota Hyodo,&nbsp;Ryota Horiguchi,&nbsp;Mami Iima,&nbsp;Shinji Naganawa","doi":"10.1007/s00261-026-05526-w","DOIUrl":"10.1007/s00261-026-05526-w","url":null,"abstract":"<div><p>Four-dimensional flow magnetic resonance imaging (4D Flow MRI) enables time-resolved three-dimensional visualization and retrospective quantification of vascular hemodynamics within a single volumetric acquisition. Beyond morphology-based imaging, it provides comprehensive assessment of multidirectional flow patterns, collateral redistribution, and treatment-related hemodynamic changes across vascular territories. In abdominal interventional radiology (IR), 4D Flow MRI may offer incremental value in clinical scenarios where morphology alone is insufficient to characterize physiologically relevant hemodynamics. This review summarizes its applications in aortic interventions, portal venous interventions, and hepatic venous outflow disorders. In these settings, 4D Flow MRI may support functional assessment of endoleaks, evaluation of portal flow redistribution, and characterization of venous outflow obstruction and treatment response. Among current applications, endoleak characterization and early assessment of portal hemodynamic change after portal vein embolization, which may reflect subsequent liver hypertrophy, represent particularly promising use cases. However, current evidence remains limited and largely observational. Important technical considerations, including velocity encoding strategy, physiologic variability, metal-related artifacts, and workflow integration, must be addressed. In practical terms, 4D Flow MRI is best regarded as a complementary or problem-solving technique rather than a modality for routine clinical decision-making. Further multicenter validation and outcome-driven studies are required to define its clinical impact in IR practice.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5370 - 5384"},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05526-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794808","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":"Preoperative prediction of perineural invasion in pancreatic ductal adenocarcinoma using dual-layer spectral CT","authors":"Jiawei Liu,&nbsp;Luyong Wei,&nbsp;Jiadan Luo,&nbsp;Jinhui Yu,&nbsp;Tingting Wen,&nbsp;Weiwei Deng,&nbsp;Shi-Ting Feng,&nbsp;Mingjie Chen,&nbsp;Siya Shi,&nbsp;Yanji Luo","doi":"10.1007/s00261-026-05529-7","DOIUrl":"10.1007/s00261-026-05529-7","url":null,"abstract":"<div><h3>Purpose</h3><p>Perineural invasion (PNI) is an independent predictive factor for pancreatic ductal adenocarcinoma (PDAC); however, preoperative prediction is difficult. This study aimed to evaluate the value of dual-layer spectral CT (DLCT) parameters in PNI in PDAC.</p><h3>Materials and methods</h3><p>This retrospective study included patients with pathologically confirmed PDAC who underwent DLCT between August 2019 and March 2024. Risk factors were identified using univariable and least absolute shrinkage and selection operator (LASSO) regression. Receiver operating characteristic (ROC), precision-recall (PR) curves, calibration curves and decision curve analysis (DCA) accessed diagnostic performance.</p><h3>Results</h3><p>We included 100 patients (mean age: 60.88 ± 11.39 years old, 59 males). There were 71 patients with PNI and 29 without PNI. Relevant factors for PNI included tumour diameter, normalised CT attenuation during the pancreatic parenchymal phase in conventional CT (nCTa), normalised CT attenuation during the pancreatic parenchymal phase in DLCT at 40 keV, and normalised iodine concentration during the pancreatic parenchymal phase (nDIa) (odds ratio [OR], 1.34; 95% confidence interval [CI]: 1.19, 1.51; <i>p</i> &lt; 0.001). Of these, nDIa was the only independent predictor (<i>p</i> &lt; 0.001; adjusted OR, 1.41; 95% CI: 1.19, 1.68) and demonstrated superior diagnostic performance compared to nCTa, with a cutoff value of 0.16, higher area under the curve (ROC: 0.86 vs. 0.68, PR: 0.93 vs. 0.84; both <i>p</i> &lt; 0.001), higher accuracy (77.0% vs. 52.0%, <i>p</i> = 0.048), an F₁ score of 0.90, higher sensitivity (71.8% vs. 36.6%, <i>p</i> = 0.03), and the same specificity of 89.7% (<i>p</i> = 0.13). The calibration plot illustrated satisfactory agreement of nDla and DCA confirmed its promising clinical application value.</p><h3>Conclusion</h3><p>The DLCT parameter nDIa allows for non-invasive prediction of PNI in PDAC with superior diagnostic efficacy compared to conventional CT parameters.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5631 - 5643"},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794757","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}