Abdominal Radiology最新文献

{"title":"A novel CT-based normalization strategy using lesion-to-spleen density ratios for renal mass characterization","authors":"Oguzhan Akpinar,&nbsp;Anil Erkan,&nbsp;Alper Keskin,&nbsp;Muhammet Guzelsoy","doi":"10.1007/s00261-026-05534-w","DOIUrl":"10.1007/s00261-026-05534-w","url":null,"abstract":"<div><h3>Purpose</h3><p>Accurate preoperative characterization of renal masses remains a major clinical challenge, as a substantial proportion of surgically resected lesions ultimately prove to be benign. Absolute Hounsfield unit (HU) measurements on contrast-enhanced computed tomography (CT) are widely used but are vulnerable to technical and patient-related variability. This study aimed to introduce and evaluate a novel CT-based normalization strategy using lesion-to-organ HU ratios to improve differentiation between benign and malignant renal masses and to explore its performance across renal cell carcinoma (RCC) subtypes.</p><h3>Methods</h3><p>This retrospective single-center study included 248 patients with histopathologically confirmed renal tumors who underwent multiphasic CT. Attenuation values were measured from the lesion, contralateral renal cortex, and spleen on both non-contrast and contrast-enhanced images. Lesion-to-kidney (LK) and lesion-to-spleen (LS) HU ratios were calculated. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, and predictors of malignancy were assessed with univariate and multivariate logistic regression. Subgroup analysis was performed across RCC subtypes.</p><h3>Results</h3><p>Both contrast-enhanced lesion-to-kidney (CE-LK) and lesion-to-spleen (CE-LS) HU ratios differed significantly between benign and malignant lesions (<i>p</i> &lt; 0.01). The CE-LK HU ratio demonstrated excellent diagnostic performance (AUC = 0.914), achieving 83.8% sensitivity and 100% specificity at a cut-off of ≤ 0.76. The CE-LS HU ratio showed similarly high accuracy (AUC = 0.883), with 87.4% sensitivity and 87.5% specificity at a cut-off of ≤ 0.89. In multivariate analysis adjusting for lesion size and absolute enhancement, only the CE-LS HU ratio remained an independent predictor of malignancy (OR = 36.9, <i>p</i> = 0.004). Subtype analysis revealed that papillary RCC exhibited significantly lower CE-LS HU ratios compared with clear cell RCC (<i>p</i> = 0.020), while no significant differences were observed between chromophobe RCC and other subtypes.</p><h3>Conclusion</h3><p>Lesion-to-spleen HU normalization is a simple, reproducible, and broadly applicable CT-based approach that enhances renal mass characterization and may aid in reducing unnecessary surgical interventions.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5601 - 5608"},"PeriodicalIF":2.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794580","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":"Habitat-based radiomics-clinical analysis for early prediction of bladder cancer recurrence: a retrospective cohort study","authors":"Yanjie Yang,&nbsp;Bingxin Gong,&nbsp;Xiangchuang Kong,&nbsp;Yusheng Guo,&nbsp;Jie Lou,&nbsp;Xiaona Fu,&nbsp;Weiwei Liu,&nbsp;Qingmin Feng,&nbsp;Lian Yang","doi":"10.1007/s00261-026-05516-y","DOIUrl":"10.1007/s00261-026-05516-y","url":null,"abstract":"<div><h3>Purpose</h3><p>A high recurrence rate is a serious problem in the bladder cancer (BC) treatment. To develop a habitat-based radiomics-clinical model for noninvasive recurrence prediction in BC patients undergoing transurethral resection of bladder tumor (TURBT) or radical cystectomy (RC).</p><h3>Methods</h3><p>We retrospectively enrolled 294 BC patients who underwent TURBT or RC at our Hospital. Tumor regions of interest (ROIs) were automatically segmented and manually checked. Voxel-wise radiomic features were extracted. The K-means clustering algorithm was applied to perform cluster analysis on the extracted features. The Calinski-Harabasz (CH) index was calculated to determine the optimal number of clusters (the one yielding the highest CH value). Subsequently, features from these subregions were extracted and further filtered using the t-test and Pearson correlation analysis. The final feature set was selected through the least absolute shrinkage and selection operator regression. The dataset was randomly divided into the training (<i>n</i> = 235) and validation (<i>n</i> = 59) sets (8:2 ratio) for model training and evaluation. The habitat-based radiomics model based on Support Vector Machine (SVM) was developed based on the final feature set. Additionally, we combined clinical risk factors to establish and validate a radiomics-clinical model.</p><h3>Results</h3><p>We divided the tumor ROIs into three subregions. The Areas Under the Curve (AUCs) for the habitat-based radiomics-model were 0.870 (95% confidence interval [CI]: 0.825–0.914) and 0.865 (95% CI: 0.774–0.956) in the training and validation set. The radiomics-clinical model, incorporating tumor grades and intravesical therapy, achieved AUCs of 0.883 (95% CI: 0.842–0.924) and 0.956 (95% CI: 0.912-1.000) in the training and validation sets, respectively.</p><h3>Conclusions</h3><p>The habitat-based radiomics-clinical model demonstrated superior performance in predicting BC recurrence.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5589 - 5600"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794747","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":"Mucinous vs. non-mucinous pancreatic cysts: diagnostic keys on CT and MRI","authors":"Marco Dioguardi Burgio,&nbsp;Maxime Ronot,&nbsp;Caroline Chassaing,&nbsp;Pauline Copin,&nbsp;Safi Dokmak,&nbsp;Jerome Cros,&nbsp;Vinciane Rebours,&nbsp;Louis de Mestier,&nbsp;Valérie Vilgrain,&nbsp;Riccardo Sartoris,&nbsp;Jules Grégory","doi":"10.1007/s00261-026-05509-x","DOIUrl":"10.1007/s00261-026-05509-x","url":null,"abstract":"<div><p>The prevalence of incidentally detected pancreatic cystic lesions has increased substantially with the widespread use of high-resolution CT and MRI. Differentiating mucinous from non-mucinous cystic lesions is a central diagnostic task, as mucinous lesions are associated with a risk of malignant transformation and distinct management pathways. In clinical practice, this distinction is primarily driven by imaging findings. This review summarizes the key CT and MRI features that allow differentiation between mucinous and non-mucinous pancreatic cystic lesions, with a focus on reproducible criteria applicable in routine practice. Particular emphasis is placed on the assessment of communication with the main pancreatic duct, lesion morphology, wall thickness and enhancement pattern, internal architecture, calcification pattern, cyst multiplicity, and associated ductal or parenchymal abnormalities. Common diagnostic challenges are discussed, including atypical lesion location, atypical presentation and imaging overlap between cystic lesions. These scenarios illustrate the limitations of relying on a single imaging criterion and highlight the need for a comprehensive, pattern-based approach. The review also underscores the importance of integrating imaging findings with patient demographics, lesion distribution, clinical context, and longitudinal imaging behavior. In selected cases, CT and MRI may not allow definitive classification, and diagnostic uncertainty should be explicitly acknowledged to guide appropriate multidisciplinary decision-making. Emerging imaging techniques, including artificial intelligence algorithms, are briefly addressed. While preliminary results are encouraging, current evidence remains insufficient to support routine clinical implementation. At present, systematic analysis of CT and MRI findings, supported by multidisciplinary expert interpretation, remains the cornerstone for differentiating mucinous from non-mucinous pancreatic cystic lesions.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5346 - 5358"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794761","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":"Prognostic value of abdominal aortic calcification in patients with esophageal cancer undergoing neoadjuvant therapy and esophagectomy","authors":"Jacob Jalil Hassan,&nbsp;Daniele Romeo,&nbsp;Stefan Niebisch,&nbsp;Matthias Mehdorn,&nbsp;Daniel Seehofer,&nbsp;Gertraud Stocker,&nbsp;Florian Lordick,&nbsp;Timm Denecke,&nbsp;Hans-Jonas Meyer","doi":"10.1007/s00261-026-05511-3","DOIUrl":"10.1007/s00261-026-05511-3","url":null,"abstract":"<div><h3>Background</h3><p>Computed tomography (CT) is a first line imaging tool for staging of esophageal cancer (EC). Previous studies have shown promising results of the prognostic relevance of vessel calcifications quantified by CT, especially coronary and aortic calcifications, in oncological patients. The aim of this study was to analyze the prognostic relevance of aortic calcification assessed in staging CT in patients with EC undergoing curative treatment.</p><h3>Methods</h3><p>All patients with EC treated with neoadjuvant therapy followed by curative resection at the University of Leipzig Medical Center, a tertiary care hospital, were retrospectively evaluated between 2016 and 2023. A total of 89 patients were included in the analysis. Abdominal aorta and iliac artery calcification volume was measured in a semi-automated fashion at baseline before neoadjuvant therapy using staging CT images. The primary endpoint was overall survival and disease-free survival was assessed as a secondary endpoint. For statistical analysis group differences were calculated using the Mann-Whitney-U test. Kaplan-Meier curves and multivariable Cox regression analysis were used to test the effect of aortic calcification volume and clinical variables on mortality.</p><h3>Results</h3><p>In univariable Cox regression, higher abdominal aortic calcification volume was significantly associated with shorter overall survival (Hazard ratio (HR) 1.259 per 1 cm³, 95% CI: 1.100–1.411, <i>p</i> &lt; 0.001) and disease-free survival (HR 1.279 per 1 cm³, 95% CI: 1.135–1.411, <i>p</i> &lt; 0.001). The abdominal aortic calcification volume remained an independent predictor of overall survival in multivariable analysis (HR 1.248, 95% CI 1.069–1.458, <i>p</i> = 0.005). Kaplan–Meier analyses demonstrated progressively reduced overall survival and disease-free survival with increasing abdominal aortic calcification volume.</p><h3>Conclusions</h3><p>CT-quantified abdominal aortic calcification provides independent prognostic information for both overall and disease-free survival in patients with EC undergoing neoadjuvant therapy followed by curative resection. Prospective evaluations of CT-defined vessel calcification and potential translation in clinical routine seem promising.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5579 - 5588"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05511-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794823","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":"Emphysematous cholecystitis managed with percutaneous cholecystostomy compared to cholecystectomy or medical management: a 10-year single center experience","authors":"Mohamad Mohayad Alzein,&nbsp;Saad Abu Zahra,&nbsp;Albert A. Nemcek Jr.,&nbsp;Ahsun Riaz,&nbsp;Andrew C. Gordon","doi":"10.1007/s00261-026-05506-0","DOIUrl":"10.1007/s00261-026-05506-0","url":null,"abstract":"<div><h3>Purpose</h3><p>To describe outcomes of percutaneous cholecystostomy (PC), cholecystectomy, and medical management (MM) for emphysematous cholecystitis at our institution.</p><h3>Methods</h3><p>A retrospective review of patients treated with PC, cholecystectomy, or MM for emphysematous cholecystitis was conducted. Clinical outcomes, including hospital length of stay, complications, conversion to cholecystectomy following PC, and overall mortality, were analyzed. Fisher’s exact test was used for categorical variables, and Kruskal-Wallis and Mann-Whitney tests for continuous variables in three and two groups, respectively. Kaplan-Meier analysis evaluated conversion to cholecystectomy and overall survival.</p><h3>Results</h3><p>Fourteen patients underwent PC (median age, 68.6 years), 13 had cholecystectomy (median age, 69.1), and 7 received MM (median age, 80.0). The PC group had a significantly longer hospital stay (median, 10 days) compared to cholecystectomy (median, 4 days; <i>P</i> = 0.009) and a trend toward significance versus MM (7 days; <i>P</i> = 0.077). Complications were not significantly different among the three groups (<i>P</i> = 0.254). Eleven patients (79%) converted to cholecystectomy following PC at a median of 2.3 months. Overall mortality was similar among the groups (<i>P</i> = 0.270).</p><h3>Conclusions</h3><p>PC did not demonstrate significant differences in mortality compared to cholecystectomy or MM. PC was associated with increased length of stay and allowed conversion to cholecystectomy at a median of 2.3 months in the majority of patients when clinically appropriate.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5562 - 5568"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794716","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":"Inter-reader agreement for the assessment of portal vein thrombosis on computed tomography","authors":"Vincent Plaforet,&nbsp;Lucile Moga,&nbsp;Laure Elkrief,&nbsp;Pierre-Emmanuel Rautou,&nbsp;Maxime Ronot","doi":"10.1007/s00261-026-05510-4","DOIUrl":"10.1007/s00261-026-05510-4","url":null,"abstract":"<div><h3>Background and aims</h3><p>To evaluate the inter-reader reliability of CT-based measurements of portal vein thrombosis (PVT) to support the development of standardized response criteria endorsed by the Vascular Liver Disease Group (VALDIG) group.</p><h3>Methods</h3><p>In this retrospective bi-centric study, 44 patients with PVT who underwent contrast-enhanced CT (2020–2024) were included. Two independent abdominal radiologists evaluated thrombus characteristics using pre-specified standardized measurements on portal venous phase CT acquisition. For the analysis of the main PVT, quantitative continuous measurement included thrombus length, thickness, and remnant lumen assessment based on diameter (%RL_diam) and surface area (%RL_surf). Categorical classifications were derived using both three-tier and four-tier occlusion scales. Qualitative categorical assessments were performed for involvement of the right and left portal branches, splenic vein, and superior mesenteric vein. Inter-reader agreement was assessed using intraclass correlation coefficients (ICC), weighted and unweighted Cohen’s kappa (κ), and Bland Altman plots.</p><h3>Results</h3><p>Inter-reader agreement for thrombus thickness and length yielded ICC values of 0.92 and 0.84 respectively. Agreement was highest for diameter-based remnant lumen assessment (%RL_diam; ICC = 0.93), outperforming surface-based measurements (%RL_surf; ICC = 0.83). Bland Altman plots confirmed narrower limits of agreement for diameter-based metrics (±22%) compared with surface-based metrics (-32% to +40%). Categorical classification based on diameter showed substantial agreement (weighted κ = 0.71 and 0.78 for three- and four-tier systems, respectively). Semi-quantitative assessment demonstrated substantial concordance, particularly for the right portal branch (κ = 0.77) and superior mesenteric vein (κ = 0.72).</p><h3>Conclusions</h3><p>Diameter-based quantitative assessment of PVT on CT demonstrates higher inter-reader reproducibility than surface-based measurements. The three-tier diameter-based categorization achieved substantial agreement and aligns with current hepatology guidelines, supporting its applicability in clinical practice and research settings.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5569 - 5578"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794771","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":"Large language model–assisted radiology reporting in a single-radiologist implementation: a retrospective cohort study interpreted through a UTAUT lens","authors":"Nelly Tan","doi":"10.1007/s00261-026-05524-y","DOIUrl":"10.1007/s00261-026-05524-y","url":null,"abstract":"<div><h3>Background</h3><p>Radiologist burnout affects approximately 40% of US radiologists. Large language models (LLMs) may improve workflow efficiency, but real-world implementation data are limited.</p><h3>Objective</h3><p>To evaluate the impact of an LLM-assisted workflow on radiologist efficiency using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework.</p><h3>Design, setting, and participants</h3><p>HIPAA-compliant, IRB-approved retrospective cohort study of a single fellowship-trained abdominal radiologist exploratory study at Mayo Clinic Arizona. We compared baseline (January–April 2024) and post-implementation (December 2025–February 2026) periods. A custom generative pre-trained transformer was developed using ChatGPT Enterprise Model 5.2 Thinking with disease-specific templates.</p><h3>Main outcome measures</h3><p>Inter-study interval time, used as a proxy for interpretation time, compared using Wilcoxon rank-sum tests with Bonferroni correction (α = 0.01). UTAUT constructs assessed: performance expectancy (efficiency), effort expectancy (training burden), facilitating conditions (infrastructure), and behavioral intention (satisfaction).</p><h3>Results</h3><p>We analyzed 609 studies (495 CT, 114 MRI). LLM assistance significantly reduced inter-study intervals for outpatient CT with contrast (23.0 vs. 13.0 min; difference 10 min; <i>p</i> = 0.0021) and without contrast (18.5 vs. 7.0 min; difference 11.5 min; <i>p</i> = 0.0017). No improvement occurred for MRI with contrast (14.0 vs. 16.0 min; <i>p</i> = 0.2808) or without contrast (14.0 vs. 7.0 min; <i>p</i> = 0.0889). The radiologist reported improved work-life balance for CT but neutral satisfaction for complex MRI templates. Training required 10 h over 5 days.</p><h3>Conclusions</h3><p>LLM-assisted workflow reduced inter-study interpretation times for standardized CT studies and no clear efficiency benefit was observed for MRI in this small implementation sample, when interpreted through a UTAUT lens, particularly on performance expectancy and task–technology fit as adoption drivers. Efficiency gains may reduce documentation burden when tools align with task complexity.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5554 - 5561"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731062","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":"[68Ga]-FAPI-04 outperforms [18F]-FDG in gastric cancer staging: a comparative study using PET/CT and PET/MR","authors":"Zhenghao Jiang,&nbsp;Lifang Pang,&nbsp;Yihan Yan,&nbsp;Masong Tang,&nbsp;Yiqiu Zhang","doi":"10.1007/s00261-026-05517-x","DOIUrl":"10.1007/s00261-026-05517-x","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to systematically compare the diagnostic performance of gallium-68–labeled fibroblast activation protein inhibitor-04 ([⁶⁸Ga]-FAPI-04) and fluorine-18 fluorodeoxyglucose ([¹⁸F]-FDG) for gastric cancer staging using positron emission tomography combined with computed tomography (PET/CT) and positron emission tomography combined with magnetic resonance imaging (PET/MR).</p><h3>Methods</h3><p>In this single-center retrospective study, 35 patients with pathologically confirmed gastric cancer underwent sequential imaging with [⁶⁸Ga]-FAPI-04 (PET/CT and PET/MR) and [¹⁸F]-FDG (PET/CT and/or PET/MR) within 48 h. Diagnostic performance for primary tumors, lymph node metastases, and distant metastases was evaluated against histopathological results or clinical follow-up. Semi-quantitative parameters, including maximum standardized uptake value (SUV_max) and target-to-background ratio (TBR), were compared across tracers and modalities.</p><h3>Results</h3><p>[⁶⁸Ga]-FAPI-04 exhibited significantly higher SUV_max and TBR than [¹⁸F]-FDG in primary tumors, lymph node and peritoneal metastases. Notably, [⁶⁸Ga]-FAPI-04 maintained consistently high uptake in signet-ring cell carcinoma, a subtype where [¹⁸F]-FDG uptake was significantly lower. Both [⁶⁸Ga]-FAPI-04 PET/CT and PET/MR significantly outperformed all [¹⁸F]-FDG-based modalities for metastasis detection, with no statistically significant difference in overall diagnostic efficacy between the two [⁶⁸Ga]-FAPI-04 platforms. [⁶⁸Ga]-FAPI-04 PET/MR achieved 100% lesion-level sensitivity for peritoneal metastases, while PET/CT yielded higher absolute SUV_max values and PET/MR showed superior TBR.</p><h3>Conclusion</h3><p>[⁶⁸Ga]-FAPI-04 outperforms [¹⁸F]-FDG in the detection of primary gastric cancer, regional lymph node metastases and peritoneal metastases, with consistently high tumor uptake in [¹⁸F]-FDG-insensitive histological subtypes including signet-ring cell carcinoma. [⁶⁸Ga]-FAPI-04 PET/CT and PET/MR offer comparable overall diagnostic performance at the patient level, with no statistically significant differences observed between the two platforms and both modalities markedly improve the accuracy of gastric cancer staging.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5529 - 5539"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731083","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 evaluation of acute abdominal pain in the pregnant patient","authors":"Suzanne Czerniak,&nbsp;Pouya Entezari,&nbsp;Yasaman Moazeni,&nbsp;Mahan Mathur","doi":"10.1007/s00261-026-05525-x","DOIUrl":"10.1007/s00261-026-05525-x","url":null,"abstract":"<div><p>Acute abdominal and pelvic pain during pregnancy presents a unique diagnostic challenge. Many pathologies may mimic signs and symptoms attributed to maternal physiologic adaptations and physical examination findings can be confounded by the gravid uterus. While US and MRI are preferred first-line imaging modalities, CT remains appropriate in selected time-sensitive situations when benefits outweigh risks, particularly when MRI is unavailable or for suspected perforation, ischemia, or complicated obstruction. Etiologies are variable and include obstetric-gynecologic disorders as well as other common entities such as gastrointestinal (including hepatobiliary), genitourinary, or even vascular causes. Prompt diagnosis plays a crucial role in appropriate treatment to ensure optimal maternal and fetal outcomes. This paper will explore the depth and breadth of acute abdominopelvic pathologies during pregnancy.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5202 - 5221"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731129","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":"Pretreatment multiphasic contrast-enhanced CT predicts tumor regression grade and survival in locally advanced gastric cancer","authors":"Youqiang Hu,&nbsp;Mengli Xia,&nbsp;Longquan Zou,&nbsp;Wenqi He,&nbsp;Yuan-lin Zhang,&nbsp;Lin Lan,&nbsp;Mixue Sun,&nbsp;Yu Zhuang,&nbsp;Wenbin Wang,&nbsp;Ping Jiang","doi":"10.1007/s00261-026-05523-z","DOIUrl":"10.1007/s00261-026-05523-z","url":null,"abstract":"<div><h3>Objectives</h3><p>Reliable pretreatment prediction of pathological response remains a major challenge in locally advanced gastric cancer (LAGC). This study evaluated whether quantitative parameters from multiphasic contrast-enhanced CT (CECT) can predict tumor regression grade (TRG) after neoadjuvant chemotherapy (NAC) and provide prognostic information.</p><h3>Methods</h3><p>We retrospectively analyzed 116 patients with cT2-4NxM0 gastric adenocarcinoma treated with NAC treatment followed by gastrectomy between January 2019 and December 2024. Quantitative imaging variables included phase-specific tumor attenuation (<span>(:{CT}_{p}^{Tumor},:p=NE,AP,:VP,:DP))</span>, normalized enhancement difference (<span>(:{NormvarDelta:CT}_{p}^{Tumor},:p=AP,:VP,:DP)</span>), normalized enhancement rate (<span>(:{NormRate}_{p}^{Tumor},:p=AP,:VP,:DP)</span>), tumor area, and enhancement pattern. TRG was assessed on surgical specimens using the Mandard system; responders were defined as TRG 1–2 and non-responders as TRG 3–5. Candidate variables were screened by univariate analysis and Spearman correlation, then enrolled into weighted multivariable logistic regression with 5-fold cross-validation. Associations with overall survival were evaluated using univariate Cox and Kaplan-Meier analyses.</p><h3>Results</h3><p>Forty-one patients were responders and 75 were non-responders. CA199, CEA, and age were independent clinical predictors. Among imaging features, venous-phase tumor attenuation (<span>(:{CT}_{VP}^{Tumor})</span>; OR = 8.809, 95% CI: 2.134–36.358, <i>P</i> = 0.003) and arterial-phase normalized enhancement rate (<span>(:{NormRate}_{AP}^{Tumor})</span>; OR = 3.200, 95% CI: 1.365–7.504, <i>P</i> = 0.007) independently predicted TRG response. The clinical, imaging, and combined models achieved mean AUCs of 0.746, 0.807, and 0.869, respectively; the combined model showed the best overall discrimination (accuracy 0.759, sensitivity 0.703, specificity 0.787) with good calibration. Higher <span>(:{NormRate}_{DP}^{Tumor})</span> (HR = 1.01, <i>P</i> = 0.004) and <span>(:{NormRate}_{VP}^{Tumor})</span> (HR = 1.01, <i>P</i> = 0.043) were associated with worse overall survival.</p><h3>Conclusion</h3><p>Pretreatment CECT-derived quantitative features can predict TRG response in LAGC, and a combined clinical–imaging model improves predictive performance. Higher normalized enhancement rates in the venous and delayed phases are associated with poorer overall survival, supporting pre-treatment risk stratification in clinical practice.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 11","pages":"5540 - 5553"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731071","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}