Abdominal Radiology最新文献

{"title":"Interpretable prediction of occult lymph node metastasis in pancreatic ductal adenocarcinoma using a model fusing habitat radiomics and deep learning","authors":"Jun Guan,&nbsp;Yuanqing Liu,&nbsp;Feiwen Feng,&nbsp;Can Chen,&nbsp;Dezhen Song,&nbsp;Wu Cai,&nbsp;Su Hu","doi":"10.1007/s00261-026-05504-2","DOIUrl":"10.1007/s00261-026-05504-2","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the value of integrating habitat radiomics features and deep learning features for predicting occult lymph node metastasis (OLNM) in pancreatic ductal adenocarcinoma (PDAC).</p><h3>Methods</h3><p>Data from 212 eligible PDAC patients across two institutions were analyzed. Cohorts were allocated as follows: training (n = 115), internal validation (n = 50), and external validation (n = 47). Habitat subregion partitioning of the tumor volume of interest (VOI) from portal venous phase computed tomography images was performed using a K-means clustering algorithm, and radiomics features were subsequently extracted. A 2.5D deep learning model based on ResNet18 was used to extract features from the whole VOI. After feature selection, models based on single-feature types and a fusion model integrating habitat radiomics features and deep learning features were developed. Model performance was assessed using receiver operating characteristic curves, decision curve analysis (DCA), and calibration curves. Model interpretability was evaluated via SHapley Additive exPlanations (SHAP).</p><h3>Results</h3><p>Relative to single-feature-based models, the fusion model achieved superior predictive performance with an area under the curve (AUC) of 0.832 (95% CI: 0.712–0.951) in the external validation cohort. DCA and calibration curves revealed that this model provided greater net clinical benefit compared with other models and demonstrated good calibration. SHAP analysis indicated that deep learning features were the top and third most important predictors.</p><h3>Conclusion</h3><p>The fusion model exhibited favorable predictive performance for preoperative OLNM diagnosis in PDAC and represents a promising auxiliary tool for personalized therapeutic decision-making.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5012 - 5023"},"PeriodicalIF":2.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680112","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":"Anteroposterior diameter of the pancreas in the diagnosis of autoimmune pancreatitis and acute pancreatitis on MRI","authors":"Zhaochen Sun,&nbsp;Xuefeng Zhu,&nbsp;Nan Zhang,&nbsp;Jie Geng,&nbsp;Jingchao Han,&nbsp;Yang Liu,&nbsp;Lingfei Guo","doi":"10.1007/s00261-026-05493-2","DOIUrl":"10.1007/s00261-026-05493-2","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to quantitatively analyze the anteroposterior diameter of pancreas (AD_pancreas) based on magnetic resonance imaging (MRI) data, and to evaluate their clinical value in diagnosing autoimmune pancreatitis (AIP) and differentiating it from acute pancreatitis (AP).</p><h3>Materials and methods</h3><p>MRI data from 32 patients with clinically confirmed diffuse AIP-1 were retrospectively analyzed. Thirty patients with AP and 32 individuals with normal pancreases were included as control groups. The anteroposterior diameters of the pancreatic head (AD_head), body (AD_body), and tail (AD_tail), along with pancreatic volume and the transverse diameter of the first lumbar vertebral body (TDL1), were measured and compared across groups. Diagnostic performance was analyzed using receiver operating characteristic (ROC) curves.</p><h3>Results</h3><p>AD_head, AD_body, AD_tail, and their ratios to TDL1 were significantly higher in the AIP group compared to the normal pancreas group (<i>P</i> &lt; 0.05). AD_body, AD_tail, and their ratios to TDL1 were also significantly higher in the AIP group than in the AP group (<i>P</i> &lt; 0.05). No statistically significant difference was observed in pancreatic volume between the AIP and AP groups (<i>P</i> &gt; 0.05). The area under the ROC curve (AUC) for AD_head, AD_body, AD_tail, and their ratios to TDL1 in diagnosing AIP were 0.804, 0.773, 0.818, 0.786, 0.727, and 0.810, respectively. In the differential diagnosis of AIP and AP, the AUCs for AD_head, AD_body and AD_tail and their ratios to TDL1 were 0.597, 0.708, 0.704, 0.545, 0.673, and 0.667, respectively. A logistic regression model incorporating AD_head, AD_body, and AD_tail yielded an AUC of 0.732, which was significantly higher than that of pancreatic volume alone.</p><h3>Conclusion</h3><p>AD_bodyand AD_tail are valuable and practical adjunctive indicators for differentiating AIP from AP. The combination of AD_head, AD_body, and AD_tail demonstrates higher diagnostic efficiency than pancreatic volume alone. These quantitative measurements are best used as supportive findings rather than standalone diagnostic criteria.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5037 - 5048"},"PeriodicalIF":2.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680061","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 value of enhanced CT volumetric measurement compared with RECIST 1.1 criteria in evaluating the efficacy of neoadjuvant chemotherapy combined with immunotherapy for gastric cancer","authors":"Jie Chen,&nbsp;Yang Liu,&nbsp;Zhidong Zhang,&nbsp;Weishuai Zhang,&nbsp;Chenyu Hou,&nbsp;Zicheng Bao,&nbsp;Yushuo Cao","doi":"10.1007/s00261-026-05425-0","DOIUrl":"10.1007/s00261-026-05425-0","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the value of tumor volume reduction rate (VRR) measured by enhanced CT, compared with RECIST 1.1 criteria, in evaluating the efficacy of neoadjuvant chemotherapy combined with immunotherapy(NACI) for patients with locally advanced gastric cancer (LAGC), and its impact on prognosis.</p><h3>Methods</h3><p>This retrospective study included 107 gastric adenocarcinoma patients. VRR and RECIST 1.1 response were calculated from pre-treatment and post-treatment CT. Interobserver agreement was evaluated using the intraclass correlation coefficient(ICC), while correlation with pathological tumor regression grade (TRG) and diagnostic performance (ROC analysis) were assessed. The optimal VRR cut-off was determined. Prognostic value was evaluated via survival analysis.</p><h3>Results</h3><p>The ICC for the tumor VRR was 0.966 (95% CI: 0.951–0.977), which was significantly higher than the ICC for the tumor longest diameter reduction rate (0.701, 95% CI: 0.590–0.785). VRR showed a moderate negative correlation with TRG (<i>r</i>= -0.389, <i>P</i> &lt; 0.001), which was significantly better than the weak correlation between RECIST 1.1 and TRG (<i>r</i> = 0.196, <i>P</i> = 0.043). The area under the curve (AUC) for VRR in predicting major pathological response was significantly higher (AUC = 0.7953) than that for RECIST 1.1 (AUC = 0.6127, <i>P</i> = 0.0017). Survival analysis showed that grouping based on VRR (2-year PFS: 69.4% vs. 37.8%, <i>P</i> = 0.018) and TRG (2-year PFS: 82.8% vs. 46.2%, <i>P</i> = 0.0029) significantly distinguished patient prognosis, whereas RECIST 1.1 criteria did not (<i>P</i> = 0.74). The combined model integrating VRR and TRG failed to provide more refined prognostic stratification. Among patients with TRG 2–3, whether VRR was greater than 47.4% did not significantly stratify prognosis (<i>P</i> = 0.7935).</p><h3>Conclusions</h3><p>(1) The tumor VRR demonstrates significantly superior observer agreement compared to the RECIST 1.1 criteria. (2) The correlation with TRG and diagnostic efficacy of VRR before and after neoadjuvant chemotherapy combined with immunotherapy are significantly superior to RECIST 1.1 criteria. (3) Regarding 2-year PFS, both VRR and TRG are effective indicators for prognostic evaluation after this treatment regimen, whereas RECIST 1.1 criteria lack statistical significance for 2-year PFS. (4) The combined model of VRR and TRG did not enable more precise prognostic stratification, indicating a need for further research.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4849 - 4857"},"PeriodicalIF":2.3,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663516","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":"MR-based techniques for imaging prostate cancer metabolism: current status and future perspectives","authors":"Xueqing Cheng,&nbsp;Jinshun Xu,&nbsp;Jin Yao,&nbsp;Bin Song","doi":"10.1007/s00261-025-05373-1","DOIUrl":"10.1007/s00261-025-05373-1","url":null,"abstract":"<div><p>Prostate cancer (PCa) is a heterogeneous disease ranging from indolent to highly aggressive forms (e.g., castration-resistant PCa). Although multiparametric MRI plays an important role in the routine diagnosis and management of PCa, emerging challenges underscore a critical unmet need in the era of precision and personalized medicine. Given that metabolic reprogramming is a hallmark of PCa, metabolic imaging techniques that focus on and target changes in metabolic pathways, such as PET and hyperpolarized (HP) ¹³C MRI, represent critical tools for facilitating early diagnosis, risk stratification, and monitoring of PCa treatment. This review discusses the metabolic characteristics of PCa, the current landscape of MR-based metabolic imaging techniques, and their applications to PCa, with a particular emphasis on recent advances in proton magnetic resonance spectroscopy imaging (¹H-MRSI), HP ¹³C MRI, and other emerging advanced MRI techniques, including chemical exchange saturation transfer (CEST) MRI, sodium (²³Na) MRI, and deuterium metabolic imaging (DMI). Additionally, we discuss the challenges and future perspectives for their further clinical translation.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5186 - 5201"},"PeriodicalIF":2.3,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663561","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":"Quantitative CT Perfusion as a prognostic biomarker for chemotherapy response in patients with pancreatic ductal adenocarcinoma","authors":"Tom Perik,&nbsp;Geke Litjens,&nbsp;Natalia Alves,&nbsp;Ewoud J. Smit,&nbsp;Martijn W. J. Stommel,&nbsp;Erwin van Geenen,&nbsp;Henkjan Huisman,&nbsp;John Hermans","doi":"10.1007/s00261-026-05420-5","DOIUrl":"10.1007/s00261-026-05420-5","url":null,"abstract":"<div><h3>Background</h3><p>Response evaluation of pancreatic ductal adenocarcinoma (PDAC) with routine contrast-enhanced CT (CECT) using RECIST is currently inadequate for identification of patients benefiting from chemotherapy treatment, as the majority of patients show stable disease. This might lead to inappropriate treatment and potentially diminishes patients' quality of life. Recent developments in CT perfusion (CTP) show its potential as a biomarker to evaluate therapy response in PDAC.</p><h3>Purpose</h3><p>To investigate quantitative CT Perfusion as a prognostic biomarker during chemotherapy treatment in patients with PDAC.</p><h3>Materials and methods</h3><p>This prospective cohort trial included patients between January 2018 and December 2022 with biopsy-proven PDAC of all stages who underwent CT Perfusion before (i.e. baseline) and after three months of chemotherapy treatment. A previously developed AI-assisted CTP analysis method provided automatic segmentations of tumor and pancreas parenchyma. A trilinear non-parametric CTP contrast-enhancement model described the upslope and the peak of the time intensity curve for both tumor and parenchyma. Perfusion features of baseline and follow-up scans were compared to calculate the percentual difference. The primary endpoint was the association between quantitative CTP parameters and overall survival (OS). Secondary endpoints included comparison with RECIST 1.1 and CA 19–9 response criteria for prognostic stratification. Statistical analysis included Kaplan–Meier curves and log-rank test.</p><h3>Results</h3><p>A total of 25 patients were included. Treatment response based on RECIST 1.1 criteria showed two cases with progressive and 23 with stable disease. Patients with increased peak enhancement after chemotherapy demonstrated significantly longer survival compared to those with decreased enhancement (p = 0.02). In contrast, CA19-9 response (≥ 30% decrease) did not significantly differentiate survival (758 days vs 371 days, p = 0.27). Furthermore, CTP found more patients with a higher chance of long survival compared to RECIST (60% vs 25% survival in 24 months). In the subgroup with RECIST stable disease CTP still finds patients with a significantly longer survival (p = 0.02). Combined analysis showed that patients with both CTP increase and CA19-9 response had the best median survival at 758 days (IQR: 561–895).</p><h3>Conclusion</h3><p>Our study demonstrates that quantitative CTP is associated with better identification of long-term survivors than RECIST, based on increased peak enhancement after chemotherapy. Quantitative CTP may serve as a valuable complement to current treatment assessment methods in patients with PDAC.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5049 - 5057"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05420-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648762","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":"Intraindividual comparison of 3-T and 5-T gadoxetic acid-enhanced MRI for evaluating HCC: initial findings","authors":"Shaopeng Li,&nbsp;Shuhang Liang,&nbsp;Mengqiu Liu,&nbsp;Xudan Chen,&nbsp;Dawei Yin,&nbsp;Zhichao Feng,&nbsp;Runyu Tang,&nbsp;Xiaopeng Song,&nbsp;Peng Wang,&nbsp;Ying Liu,&nbsp;Lianxin Liu","doi":"10.1007/s00261-026-05500-6","DOIUrl":"10.1007/s00261-026-05500-6","url":null,"abstract":"<div><h3>Background</h3><p>We aimed to evaluate the utility of 5-T Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) by intraindividual comparison with 3-T MRI, with a focus on the image quality and diagnosis of hepatocellular carcinoma (HCC).</p><h3>Methods</h3><p>We prospectively enrolled 41 patients with suspected HCC who underwent dynamic Gd-EOB-DTPA-enhanced MRI using both 5-T and 3-T scanners. Artificial intelligence-assisted compressed sensing (ACS) and parallel imaging (PI) were both used for hepatobiliary phase (HBP) imaging at 5-T. Two radiologists performed qualitative and quantitative assessments of image quality and evaluations of imaging features. Wilcoxon signed-rank, paired χ², and Cochran Q tests as well as intraclass correlation coefficients and the Cohen κ value were used.</p><h3>Results</h3><p>All subjective image quality scores ranged from good to excellent. The subjective scores of contrast-enhanced phases for 5-T images were higher than those for 3-T images (all <i>p</i> &lt; 0.05), except for image artifacts. For diffusion-weighted imaging (DWI), the subjective scores of the clarity of the lesion margins on 5-T images were higher than those on 3-T images (<i>p</i> = 0.021). Quantitative measures were also greater for 5-T images (all <i>p</i> &lt; 0.05). For DWI, the contrast ratio (CR) at 5-T was greater (<i>p</i> &lt; 0.05). Subjective and quantitative assessments of HBP imaging were higher with ACS (all <i>p</i> &lt; 0.05). The detection rate of enhancing capsule was greater for 5-T images (<i>p</i> = 0.016), as was the rate of peritumoral hypointensity on the HBP images at 5-T using ACS (<i>p</i> = 0.015).</p><h3>Conclusions</h3><p>Compared with 3-T MRI, liver dynamic Gd-EOB-DTPA-enhanced 5-T MRI demonstrated superior image quality for contrast-enhanced phases and greater sensitivity in detecting enhancing capsule in HCC. The integration of 5-T MRI and ACS technology has the potential to further improve image quality and the assessment of imaging features.</p><h3>Relevance statement</h3><p>Gd-EOB-DTPA-enhanced 5-T MRI provides promising potential for accurate HCC evaluation.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4987 - 4996"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648673","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-based Node-RADS for metastatic lymph node detection in colon cancer and influence of microsatellite instability","authors":"Martina Conca,&nbsp;Giovanni Maria Rodà,&nbsp;Maurizio Cè,&nbsp;Letizia Di Meglio,&nbsp;Ejona Duka,&nbsp;Renato Fabrizio,&nbsp;Ludovica Baldari,&nbsp;Luigi Boni,&nbsp;Gianpaolo Carrafiello","doi":"10.1007/s00261-026-05477-2","DOIUrl":"10.1007/s00261-026-05477-2","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the diagnostic accuracy of the CT-based Node-RADS score in differentiating benign and metastatic lymph nodes in colon cancer compared with standard size parameters and to assess the influence of microsatellite instability on diagnostic performance.</p><h3>Methods</h3><p>This retrospective study included 166 patients with histologically confirmed colon cancer who underwent preoperative contrast-enhanced CT. Two radiologists, blinded to histopathological findings, evaluated a total of 166 lymph nodes under the supervision of a third radiologist, calculating Node-RADS scores and long and short diameters. Univariate and multivariate analyses were performed, stratifying data based on histopathological findings and microsatellite instability. Diagnostic performance for the various radiological variables was assessed using Receiver Operating Characteristic (ROC) curves. Predictive logistic models were created.</p><h3>Results</h3><p>Sixty-nine lymph nodes (42%) were histologically positive. Interobserver agreement for the Node-RADS score was excellent (κ = 0.88). All Node-RADS features were significantly associated with nodal status (<i>p</i> &lt; 0.001), with texture showing the strongest correlation (Cramér’s V = 0.74) and emerging as the only independent predictor in multivariable analysis (OR 5.10, 95% CI 2.46–12.05, <i>p</i> &lt; 0.001). Overall, the Node-RADS score demonstrated good discriminative ability (AUC = 0.79, 95% CI 0.72–0.86), although not superior to short axis diameter (AUC = 0.75, 95% CI 0.68–0.83). Optimal diagnostic accuracy (0.77, 95% CI 0.70–0.93) was observed using a cutoff between Node-RADS categories 3 and 4. In tumors with microsatellite instability, Node-RADS performance decreased (AUC = 0.42, 95% CI 0.19–0.66) compared with microsatellite-stable tumors (AUC = 0.83, 95% CI 0.76–0.9). Repeated 5-fold cross-validation showed that the composite Node-RADS score was not inferior to logistic regression models including individual imaging features (AUC 0.786–0.802; all DeLong <i>p</i> &gt; 0.01).</p><h3>Conclusion</h3><p>The Node-RADS score demonstrates good diagnostic performance for nodal staging in colon cancer; however, its superiority over standard size criteria was not confirmed. Its diagnostic performance declines in tumors with microsatellite instability, underscoring the potential influence of microsatellite status on the reliability of CT-based lymph node assessment.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5319 - 5330"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648646","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":"Metastatic carcinomatous cirrhosis from diffuse breast cancer liver metastasis: a case report","authors":"Takahiro Komori,&nbsp;Norihide Yoneda,&nbsp;Kanako Terada,&nbsp;Kazuto Kozaka,&nbsp;Hirofumi Terakawa,&nbsp;Hiroko Ikeda,&nbsp;Kenichi Harada,&nbsp;Satoshi Kobayashi","doi":"10.1007/s00261-026-05495-0","DOIUrl":"10.1007/s00261-026-05495-0","url":null,"abstract":"<div><p>Metastatic carcinomatous cirrhosis is a rare condition associated with several malignancies. It is characterized by diffuse hepatic tumor infiltration, leading to rapid progression to liver failure. We report a case of metastatic carcinomatous cirrhosis caused by diffuse hepatic metastasis from breast cancer and describe the computed tomography (CT), magnetic resonance imaging (MRI), and histopathological findings. A woman in her 50s who had undergone left mastectomy with reconstruction for breast cancer 9 years prior presented with fatigue and abdominal distension. Following the initial surgery, she received adjuvant hormone therapy. Five years prior to presentation, a local recurrence at the surgical site was detected and surgically resected; thereafter, she was followed up without additional treatment. At presentation, non-contrast CT revealed massive ascites, prompting further evaluation with contrast-enhanced dynamic CT and gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI. Imaging showed a cirrhosis-like morphology, suggesting pseudocirrhosis. However, considering the absence of previously documented hepatic metastases and no history of chemotherapy, metastatic carcinomatous cirrhosis was suspected. A transjugular liver biopsy confirmed the diagnosis, revealing extensive tumor infiltration of the portal areas accompanied by fibrosis and scar formation that dissected the hepatic parenchyma. In patients with malignancies who develop rapidly progressive liver dysfunction and cirrhosis-like imaging findings, metastatic carcinomatous cirrhosis should be considered in the differential diagnosis. Additionally, recognizing this entity that represents a pathophysiology distinct from that of pseudocirrhosis is crucial, despite their similar morphological appearances on imaging.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5093 - 5098"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05495-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648666","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":"Diagnostic evaluation of renal masses in chronic kidney disease: a clinical and radiologic challenge","authors":"Laura Eusebi,&nbsp;Federica Masino,&nbsp;Manuela Montatore,&nbsp;Valentina Testini,&nbsp;Giuseppe Guglielmi","doi":"10.1007/s00261-026-05491-4","DOIUrl":"10.1007/s00261-026-05491-4","url":null,"abstract":"<div><p>Chronic kidney disease (CKD) increases the risk of renal cell carcinoma (RCC), particularly with long-term dialysis exposure and acquired cystic kidney disease (ACKD). At the same time, CKD-related architectural distortion and hypoperfusion reduce lesion conspicuity on ultrasound and weaken enhancement-based interpretation on CT and MRI. In advanced CKD, restrictions on iodinated and gadolinium-based contrast agents further increase the proportion of renal masses that remain indeterminate after conventional imaging. Contrast-enhanced ultrasound (CEUS) addresses the key unmet need in this setting: a safe, direct assessment of microvascular perfusion. Microbubble agents are purely intravascular and non-nephrotoxic, enabling use across all CKD stages and in dialysis patients. By showing real-time enhancement of septa, wall thickening and mural nodules, CEUS distinguishes vascular tumour components from avascular hemorrhagic or proteinaceous material that can mimic enhancement on CT/DECT or signal abnormalities on non-contrast MRI. This capability supports a CEUS-adapted Bosniak approach: lesion categorization is driven by enhancement of septa, wall and nodules rather than by attenuation or T1 hyperintensity of cyst contents, helping avoid misclassification in ACKD. We propose a structured workflow that integrates the triad of CKD stage/eGFR, dialysis status and ACKD with pre- and post-CEUS Bosniak assessment to guide follow-up versus biopsy or nephron-sparing treatment. This article is a narrative review of the literature, complemented by an illustrative clinical case which demonstrates how CEUS can resolve ambiguity when CT/DECT and non-contrast MRI remain inconclusive.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5174 - 5185"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05491-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648657","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":"Contrast-enhanced ultrasound LI-RADS nonradiation treatment response assessment: applications, challenges, and future directions","authors":"David T. Fetzer,&nbsp;Yuko Kono,&nbsp;Fabio Piscaglia,&nbsp;Christoph F Dietrich,&nbsp;Franca Meloni,&nbsp;Qiang Lu,&nbsp;Dirk-Andre Clevert,&nbsp;Andrej Lyshchik,&nbsp;Yasunori Minami,&nbsp;Jeong Min Lee,&nbsp;Tae Kyoung Kim,&nbsp;Hyun-Jung Jang,&nbsp;Masatoshi Kudo,&nbsp;Stephanie R. Wilson","doi":"10.1007/s00261-026-05469-2","DOIUrl":"10.1007/s00261-026-05469-2","url":null,"abstract":"<div><p>Hepatocellular carcinoma (HCC) requires nuanced treatment response assessment to balance oncologic control with preservation of liver function. CT and MRI, cornerstones of response evaluation, are often limited by contraindications to their use or indeterminate findings. The recently introduced ACR LI-RADS Contrast-Enhanced Ultrasound (CEUS) Non-Radiation Treatment Response Assessment (TRA) algorithm offers a real-time, radiation-free alternative for evaluating treated HCC after ablation, transarterial therapies, or surgical resection. This review summarizes the CEUS TRA lexicon, criteria, and application across common clinical scenarios, emphasizing its value as a troubleshooting tool when conventional imaging is non-evaluable due to artifacts, contrast limitations, or heterogeneous post-treatment changes. We highlight pitfalls unique to CEUS interpretation, including poor lesion visibility, resection cavity complexity, and the inability to assess extrahepatic disease. Emerging areas include CEUS assessment after radiation-based therapies and the potential for integration of Kupffer-cell–specific contrast agents. Together, these developments position CEUS as an increasingly important modality for precise, timely, and individualized management of HCC following non-radiation locoregional therapy.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4968 - 4986"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05469-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648641","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}