Abdominal Radiology最新文献

{"title":"Prognostic value of quantitative multiparametric magnetic resonance imaging parameters and histopathologic features for disease-free survival in locally advanced non-mucinous rectal adenocarcinoma","authors":"Zhiyu Chen,&nbsp;Xiaofei Wu,&nbsp;Yuxi Ge,&nbsp;Jianmin Xu,&nbsp;Zhijian Su,&nbsp;Bo Liu,&nbsp;Yuanyuan Gao,&nbsp;Zi Wang,&nbsp;Binghua Xu","doi":"10.1007/s00261-026-05480-7","DOIUrl":"10.1007/s00261-026-05480-7","url":null,"abstract":"<div><h3>Objectives</h3><p>To develop a postoperative risk stratification model integrating baseline T2 mapping and histopathologic factors for predicting disease-free survival (DFS) in patients with locally advanced non-mucinous rectal adenocarcinoma after neoadjuvant chemoradiotherapy (NCRT) and surgery.</p><h3>Methods</h3><p>This retrospective study included 116 patients with non-mucinous rectal adenocarcinoma who underwent NCRT followed by surgery. Baseline T2 values and apparent diffusion coefficient (ADC) values were measured. Prognostic factors for DFS were assessed using Cox proportional hazards regression. Given the limited number of DFS events, the multivariable model size was prespecified, with baseline pretreatment T2 forced into the model. To assess the incremental prognostic value of T2, a clinicopathologic model was compared with a full model additionally including baseline pretreatment T2. The full model was refitted in the entire cohort and presented as a nomogram. Internal validation was performed using 1000 bootstrap resamples. Model performance was assessed by Harrell’s concordance index (C-index), bootstrap-estimated calibration slope, bootstrap calibration plots, time-dependent receiver operating characteristic analysis, and decision curve analysis.</p><h3>Results</h3><p>During a median follow-up of 51 months after surgery, 35 of 116 patients (30.2%) experienced DFS events. In multivariable analysis, EMVI positivity (HR 2.42, 95% CI 1.21–4.68; <i>p</i> = 0.013), ypN-positive status (HR 4.37, 95% CI 2.07–9.92; <i>p</i> &lt; 0.001), and perineural invasion (HR 3.97, 95% CI 1.90–8.29; <i>p</i> &lt; 0.001) were independently associated with worse DFS, whereas a higher baseline pretreatment T2 value was independently associated with better DFS (HR 0.88, 95% CI 0.82–0.94; <i>p</i> &lt; 0.001). The full model included baseline pretreatment T2, EMVI, ypN status, and perineural invasion. After refitting in the entire cohort, the model showed an apparent C-index of 0.796 and an optimism-corrected C-index of 0.780 after 1000 bootstrap resamples. The bootstrap-estimated calibration slope was 0.914, and calibration plots showed reasonable agreement between predicted and observed 3-year and 5-year DFS probabilities.</p><h3>Conclusion</h3><p>A postoperative risk stratification model integrating baseline quantitative T2 mapping with postoperative histopathologic factors showed potential value for estimating DFS risk in locally advanced non-mucinous rectal adenocarcinoma. Lower baseline T2 values may reflect a more aggressive tumor microenvironment characterized by greater cellularity and denser fibrotic stroma, which may partly explain their association with worse DFS. After bootstrap internal validation, the model demonstrated acceptable discrimination and reasonable calibration, although external validation is required before clinical application.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4834 - 4848"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641245","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":"Standardizing computed tomographic assessment of the mesopancreas in pancreatic cancer patients","authors":"Stephan David,&nbsp;Sami Safi,&nbsp;Bijan Fink,&nbsp;Iskender Pustu,&nbsp;Sascha Vaghiri,&nbsp;Ahmad Sultani,&nbsp;Andrea Alexander,&nbsp;Michael Wolf-Vollenbroeker,&nbsp;Lena Haeberle-Graser,&nbsp;Christoph Roderburg,&nbsp;Irene Esposito,&nbsp;Wolfram Knoefel,&nbsp;Farid Ziayee","doi":"10.1007/s00261-026-05486-1","DOIUrl":"10.1007/s00261-026-05486-1","url":null,"abstract":"<div><h3>Purpose</h3><p>The mesopancreas (MP), the dorsal area of the pancreas, is infiltrated in the majority of patients with pancreatic ductal adenocarcinoma of the pancreatic head (hPDAC) and is associated with an increased risk of incomplete resection. Current radiographic resectability criteria primarily focus on tumor involvement of major peripancreatic vessels. However, the dorsal resection margin, represented by the mesopancreas, is not explicitly considered in current staging concepts. The aim of this study was therefore to standardize a quantitative radiographic assessment of the mesopancreas and to correlate these findings with histopathology.</p><h3>Methods</h3><p>Radiographic parameters of the primary tumor and the mesopancreas were evaluated in 173 patients with hPDAC who underwent upfront surgery. Patients were stratified according to NCCN anatomical resectability criteria. Mesopancreatic dimensions (mm) and density (HU) were analyzed on preoperative multidetector computed tomography (MDCT). Nineteen patients served as a reference group. Histopathological evaluation followed the Leeds Pathology Protocol (LEEPP).</p><h3>Results</h3><p>124 patients (71.7%) were classified as primary resectable and 49 (28.3%) as borderline resectable. Mesopancreatic infiltration was present in 125 patients (72.3%). Resectability classification was not associated with mesopancreatic infiltration (<i>p</i> = 0.344; OR 1.5). The median density of the mesopancreas in hPDAC patients was 3 HU. Increased mesopancreatic density correlated with histopathologically confirmed mesopancreatic infiltration (<i>p</i> = 0.005), with an optimal threshold of −9 HU. In subgroup analysis, this association remained significant in primary resectable patients (<i>p</i> = 0.021) but not in borderline resectable tumors (<i>p</i> = 0.780). Additionally, higher mesopancreatic density was associated with poorer disease-free survival in primary resectable patients (<i>p</i> = 0.040). </p><h3>Conclusion</h3><p>Increased mesopancreatic density on preoperative MDCT correlated with histopathologically confirmed mesopancreatic tumor infiltration. Radiographic assessment of mesopancreatic density may therefore provide additional information for preoperative risk stratification.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5058 - 5069"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05486-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641256","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":"Transperineal 3D vector magnetic resonance elastography of the prostate is feasible in men with benign prostatic hyperplasia and lower urinary tract symptoms","authors":"Cody Johnson,&nbsp;Juan Pablo Gonzalez-Pereira,&nbsp;Matthew Grimes,&nbsp;Lu Mao,&nbsp;William Ricke,&nbsp;John Wei,&nbsp;Christopher Brace,&nbsp;Shane Wells","doi":"10.1007/s00261-026-05407-2","DOIUrl":"10.1007/s00261-026-05407-2","url":null,"abstract":"<div><h3>Purpose</h3><p>To establish feasibility of 3D vector magnetic resonance elastography of the prostate (pMRE) with a novel transperineal passive driver in men with benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS).</p><h3>Methods</h3><p>Following informed consent, 21 men (median age: 41 years, IQR: 35–61) without (<i>n</i> = 6) or with mild (<i>n</i> = 9) and moderate/severe (<i>n</i> = 6) LUTS underwent multiparametric prostate MRI including pMRE, on a 3.0T MRI using a commercially available active driver and prototype transperineal passive driver. Prostate volume (PV), prostatic urethra length (PUL), postvoid residual (PVR) and bladder wall thickness (BWT) were measured. Regions-of-interest were drawn on the prostate TZ shear stiffness maps at the base and midgland. Mean TZ shear stiffness was calculated. The product of mean TZ shear stiffness and PUL [kPa x U length] were calculated. LUTS severity and uroflowmetry parameters, including peak (Qmax) and average (Qave) urine flow were measured with the International Prostate Symptom Score (IPSS) and a uroflowmeter, respectively. The Kruskal-Wallis rank sum test and Spearman correlation coefficients were used to assess relationships between imaging and clinical data. A p-value of &lt; 0.05 was considered statistically significant.</p><h3>Results</h3><p>Men with moderate/severe LUTS (median IPSS: 20, IQR: 13.25–23.25) were older (<i>p</i> = 0.008), had a higher BMI (<i>p</i> = 0.044), and a lower Qmax (<i>p</i> = 0.005) and Qave (<i>p</i> = 0.017) compared to men without and with mild LUTS. PV and PVR were similar across groups. Stiffness analysis included 19 men. Higher midgland TZ shear stiffness correlated with lower Qmax (ρ = -0.57; <i>p</i> = 0.017). Increase in [kPa x U length] correlated with a lower Qmax (ρ = -0.59; <i>p</i> = 0.015) and Qave (ρ = -0.51; <i>p</i> = 0.04). The correlation between Qmax, Qave and voided volume was higher with [kPa x U length] compared to mean TZ shear stiffness alone.</p><h3>Conclusions</h3><p>pMRE with a novel transperineal passive driver is feasible and can be used to measure TZ shear stiffness. Higher TZ shear stiffness and longer PUL are associated with voiding dysfunction in men with moderate/severe LUTS.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5164 - 5173"},"PeriodicalIF":2.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05407-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641225","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":"Vessel-density distribution mapping on portal venous CT and deep learning for 2-year overall survival risk stratification after transarterial chemoembolization in hepatocellular carcinoma","authors":"Chen Wang,&nbsp;Yimeng He,&nbsp;Yufeng Wang,&nbsp;Zengtian Deng,&nbsp;Lixia Wang,&nbsp;Debiao Li","doi":"10.1007/s00261-026-05505-1","DOIUrl":"10.1007/s00261-026-05505-1","url":null,"abstract":"<div><h3>Purpose</h3><p>Overall survival after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is heterogeneous, and portal venous remodeling may contribute to outcome variability. We evaluated whether portal venous local vessel volume fraction (LVVF) maps carry prognostic information for 2-year overall survival (OS) after TACE, with a prespecified focus on the intermediate-stage Barcelona Clinic Liver Cancer (BCLC)-B subgroup.</p><h3>Methods</h3><p>In this retrospective study, pre-TACE portal venous CT from 105 patients in the public HCC-TACE–Seg dataset were analyzed. OS was dichotomized at 104 weeks (OS &lt; 104 weeks vs. OS ≥ 104 weeks). LVVF maps were computed by convolving the portal venous vessel mask with a 2-mm-radius 3D spherical kernel to yield voxel-wise local vessel volume fractions. In the full cohort, image-based risk models were trained and evaluated with fixed five-fold patient-level cross-validation using CT-only, LVVF-only, and combined CT+LVVF inputs. In the prespecified BCLC-B subgroup, incremental prognostic value of LVVF was assessed primarily via model ablation (CT-only vs. CT+LVVF) under a matched cross-validation protocol.</p><h3>Results</h3><p>LVVF-only modeling achieved a cross-validated area under the receiver operating characteristic curve (AUC) of 0.76 ± 0.03 with recall 0.94 ± 0.05. In the BCLC-B subgroup (<i>n</i> = 24; 13 events), incorporating LVVF improved risk stratification compared with CT-only [CT-only AUC/F1, 0.77/0.69 (95% CI for AUC, 0.67–0.80); LVVF-only F1, 0.85; CT+LVVF AUC/F1, 0.91/0.86 (95% CI for AUC, 0.80–1.00)]; high-risk recall increased from 0.75 (CT-only) to 1.00 (LVVF-only) and 0.95 (CT+LVVF).</p><h3>Conclusion</h3><p>Portal venous LVVF maps carried prognostic information for 2-year OS after TACE, supporting LVVF maps as a potential vessel-aware imaging biomarker. In the prespecified BCLC-B subgroup, incorporating LVVF improved risk stratification compared with CT-only, particularly for identifying high-risk patients.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4957 - 4967"},"PeriodicalIF":2.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629734","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":"Exploring the feasibility of inferring prostate cancer pathological grade from multiparametric MRI text reports using natural language processing: assessment of four large language models","authors":"Yao Niu,&nbsp;Liting Shen,&nbsp;Jin Liu,&nbsp;Zhenghan Yang,&nbsp;Liang Wang,&nbsp;Yue Cheng","doi":"10.1007/s00261-026-05492-3","DOIUrl":"10.1007/s00261-026-05492-3","url":null,"abstract":"<div><h3>Objectives</h3><p>This study conducted a natural language processing feasibility analysis aimed at comparing four large language models (LLMs) in terms of (a) reproducibility and (b) predictive accuracy for International Society of Urological Pathology Grade Groups (ISUP GGs) based on structured text reports from prostate multiparametric magnetic resonance imaging (mpMRI).</p><h3>Methods</h3><p>The study first used LLMs to perform the initial round of ISUP GGs predictions based solely on the mpMRI text reports. This was followed by a second round of predictions that incorporated clinical information. Each prediction round was repeated three times to assess consistency. Three radiologists independently completed the first two rounds of ISUP GG predictions and then performed a third round of assessment after reviewing the LLMs’ predictions. The study recorded the response times.</p><h3>Results</h3><p>The study included 150 patients (median age, 69 years). Statistically significant differences were observed among different ISUP GGs in terms of age, PSA levels, prostate volume, PSA density, and PI-RADS scores. The four LLMs demonstrated good to excellent reproducibility (Kappa 0.671–0.861). ChatGPT-4.1 had the shortest response time (0.95–17.19 s). Furthermore, the study found that the accuracy of the LLMs (32.7–50.0%) was significantly lower than that of senior radiologist (72.7–76.0%) and intermediate-level radiologist (66.0–68.7%), but was comparable to that of junior radiologist (59.3–65.3%).</p><h3>Conclusion</h3><p>General-purpose LLMs demonstrate excellent reproducibility. While ChatGPT-4.1 outperforms other LLMs in ISUP GGs prediction and response time, its predictive accuracy remains inferior to that of intermediate and senior radiologists. Therefore, specific fine-tuning of this technology is necessary before general-purpose LLMs can be applied in clinical practice.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5151 - 5163"},"PeriodicalIF":2.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629761","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":"Deep learning reconstruction for 40-keV virtual monoenergetic CT of colon cancer: evaluation of image quality and edge sharpness","authors":"Yuhan Bao,&nbsp;Juan Long,&nbsp;Zhen Wang,&nbsp;Xiaohan Liu,&nbsp;Chen Wu,&nbsp;Haini Zhang,&nbsp;Mingyue Zhou,&nbsp;Chong Meng,&nbsp;Zhongxiao Liu,&nbsp;Aiyun Sun,&nbsp;Kai Xu,&nbsp;Yankai Meng","doi":"10.1007/s00261-026-05494-1","DOIUrl":"10.1007/s00261-026-05494-1","url":null,"abstract":"<div><h3>Background</h3><p>Virtual monoenergetic imaging (VMI) at 40 keV improves iodine attenuation in colon cancer CT but is constrained by severe image noise. Deep learning image reconstruction (DLIR) may address this limitation, but its effect on anatomical edge preservation across multiple targets requires investigation.</p><h3>Purpose</h3><p>To evaluate the impact of DLIR on objective and subjective image quality of 40-keV VMIs in colon adenocarcinoma, with emphasis on the trade-off between noise reduction and edge definition.</p><h3>Methods</h3><p>In this completed retrospective study (patient enrollment window: May 2024 to February 2025), 60 patients (mean age, 62.8 years ± 15.1; 34 men) with confirmed colon adenocarcinoma underwent dual-energy CT using a low-iodine protocol (1.0 mL/kg). Portal venous phase data were reconstructed at 40 keV using adaptive statistical iterative reconstruction-V (ASIR-V) 50%, medium-strength DLIR (DLIR-M), and high-strength DLIR (DLIR-H). Objective metrics, including contrast-to-noise ratio (CNR), edge rise distance (ERD), and edge rise slope (ERS), were measured. Two radiologists independently scored five qualitative categories, including regional lymph node visualization, using a 5-point Likert scale.</p><h3>Results</h3><p>DLIR-H yielded the lowest image noise and highest CNR across all anatomical targets compared with DLIR-M and ASIR-V 50% (all <i>P</i> &lt; 0.001). For colon tumors, the CNR of DLIR-H (5.4 ± 2.2) was 80% higher than that of ASIR-V 50% (3.0 ± 1.1, <i>P</i> &lt; 0.001). Although ASIR-V 50% maintained a higher ERS than DLIR-H (median, 108.3 vs. 101.5 HU/mm; <i>P</i> &lt; 0.001), the ERD remained highly stable across all algorithms (median, 2.5 mm; pairwise <i>P</i> &gt; 0.05). Subjectively, DLIR-H received the highest scores for overall image quality and regional lymph node visualization (median, 5.0 and 4.5, respectively, vs. 3.0 for both in ASIR-V 50%; all <i>P</i> &lt; 0.001).</p><h3>Conclusion</h3><p>In 40-keV virtual monoenergetic CT of colon cancer, DLIR-H significantly improves objective and subjective image quality for tumors, vessels, and lymph nodes. While a minor objective edge-smoothing effect exists, DLIR-H provides an optimal balance between robust noise suppression and anatomical clarity. Although these findings suggest the potential to facilitate low-iodine spectral protocols, future diagnostic accuracy trials are required to confirm their true clinical impact.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4820 - 4833"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625478","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 usefulness of two-dimensional shearwave elastography in pediatric liver","authors":"Wenying Zhou,&nbsp;Shasha Huang,&nbsp;Meixi Chen,&nbsp;Luyao Zhou","doi":"10.1007/s00261-026-05483-4","DOIUrl":"10.1007/s00261-026-05483-4","url":null,"abstract":"<div><p>Elastography enables the evaluation of tissue biomechanical properties and can be considered a form of virtual palpation. Two-dimensional shear wave elastography (2D-SWE) is an advanced elastography technique that offers non-invasive assessment, demonstrates diagnostic value, and maintains a favorable safety profile. These advantages make it an ideal tool for pediatric liver imaging. This up-to-date review provides radiologists with technical insights into 2D-SWE, practical guidance on performing examinations in children, an overview of common clinical applications in various pediatric liver diseases, and recommendations for integrating elastography into routine clinical practice for pediatric liver imaging.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4944 - 4956"},"PeriodicalIF":2.3,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619158","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":"Urologic oncologic emergencies: a radiologist’s guide","authors":"Ahmed Elbanna,&nbsp;Mamie Gao,&nbsp;Mahmoud Diab,&nbsp;Alexandra Janda,&nbsp;Mohammed Mousa,&nbsp;Mostafa A. Shehata,&nbsp;Afaf M. Soliman,&nbsp;Anuradha S. Shenoy-Bhangle,&nbsp;Margarita V. Revzin,&nbsp;Akram M. Shaaban,&nbsp;Douglas S. Katz,&nbsp;Khaled M. Elsayes,&nbsp;Mindy X. Wang","doi":"10.1007/s00261-026-05481-6","DOIUrl":"10.1007/s00261-026-05481-6","url":null,"abstract":"<div><p>Urologic oncologic emergencies represent a relatively narrow yet diverse group of critical conditions that require prompt recognition and intervention to prevent potentially life-threatening complications. These oncologic emergencies may arise as direct consequences of a malignancy, including local invasion, or as sequelae of surgical or therapeutic interventions. Common urologic emergencies include malignant obstructive uropathy or ureteral obstruction, which may lead to urosepsis or acute kidney injury; large volume hematuria and hemorrhagic cystitis, which both can result in substantial blood loss; renal hemorrhage, which can lead to hemodynamic instability; fistula formation; and postsurgical urinary leaks. Radiologists play a key role in promptly detecting and evaluating such emergencies and can help differentiate expected post-treatment findings from urgent or potentially life-threatening complications. Imaging not only helps to diagnose these emergencies but can also guide subsequent management strategies and thus is essential for optimizing patient outcomes. This review article aims to highlight the clinical and multi-modality imaging manifestations of urologic oncologic emergencies and their potential management strategies.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5136 - 5150"},"PeriodicalIF":2.3,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619279","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 equivalence of Quantitative Imaging Biomarkers Alliance (QIBA)-2023- and QIBA-2020-compliant MR elastography protocols for liver stiffness assessment","authors":"Takahisa Tokimori,&nbsp;Satoshi Saitoh,&nbsp;Shingo Ohira,&nbsp;Hidesato Suzuki,&nbsp;Isao Kurita,&nbsp;Masakatsu Tano,&nbsp;Takuyo Kozuka","doi":"10.1007/s00261-026-05490-5","DOIUrl":"10.1007/s00261-026-05490-5","url":null,"abstract":"<div><h3>Purpose</h3><p>Magnetic resonance elastography (MRE) has become an essential noninvasive tool for quantitative assessment of liver stiffness and fibrosis staging, particularly in patients with steatotic liver disease. To enhance standardization and reproducibility, the Quantitative Imaging Biomarkers Alliance (QIBA) released an updated liver MRE profile in 2023, replacing the previous 2020 version. However, the quantitative continuity between these two protocol versions, particularly for longitudinal liver stiffness measurements, has not been sufficiently validated. This study aimed to evaluate the quantitative equivalence and clinical utility of a QIBA-2023-compliant MRE protocol through direct comparison with the conventional QIBA-2020-compliant protocol in the same subjects, with emphasis on longitudinal liver stiffness assessment and image quality.</p><h3>Methods</h3><p>This retrospective study included 130 consecutive patients who underwent liver MRE in 2024. Each patient was examined using both the conventional QIBA-2020-compliant protocol and the updated QIBA-2023-compliant protocol during a single imaging session. Liver stiffness values were compared using Spearman correlation, Bland–Altman analysis, and intraclass correlation coefficients (ICC). Measurement variability and repeatability were evaluated with reference to QIBA-defined repeatability metrics. Image quality was evaluated by comparing region-of-interest (ROI) size and measurable liver parenchymal area excluding low-confidence (cross-hatched) regions.</p><h3>Results</h3><p>Mean liver stiffness values were 3.62 ± 1.81 kPa for the conventional protocol and 3.69 ± 1.94 kPa for the updated protocol, with a very strong correlation (<i>r</i> = 0.98, <i>p</i> &lt; 0.001) and excellent agreement (ICC = 0.988). Bland–Altman analysis showed a minimal mean bias of 0.07 kPa with 95% limits of agreement from − 0.48 to 0.63 kPa, which were within established MRE repeatability thresholds. Although the difference between protocols reached statistical significance, the absolute difference was not clinically meaningful. The updated protocol produced significantly larger ROIs and a greater measurable liver parenchymal area, consistent with reduced imaging artifacts and improved image quality.</p><h3>Conclusions</h3><p>The QIBA-2023-compliant MRE protocol demonstrates quantitative equivalence to the conventional QIBA-2020 protocol while offering improved artifact suppression and expanded measurable liver parenchyma. These findings support use of the updated protocol for reliable longitudinal liver stiffness assessment without compromising diagnostic performance.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"4931 - 4943"},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611678","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":"Coaxial liver biopsy with tract electrocauterization: technique and outcomes in high-risk patients with suspected hepatocellular carcinoma","authors":"Tolga Zeydanli,&nbsp;Muhammet Kursat Simsek,&nbsp;Ozgur Ozen,&nbsp;Batuhan Kirisci,&nbsp;Adem Safak,&nbsp;Fatih Boyvat,&nbsp;Mehmet Haberal","doi":"10.1007/s00261-026-05496-z","DOIUrl":"10.1007/s00261-026-05496-z","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the safety and efficacy of a technique combining coaxial biopsy with electrocauterization of the biopsy tract in high-risk patients with suspected hepatocellular carcinoma (HCC).</p><h3>Methods</h3><p>We retrospectively analyzed 102 liver biopsies performed in 99 patients (78 males, 21 females) with suspected HCC using a 17-gauge coaxial introducer needle and 18G automatic biopsy needle. After sample collection, the biopsy tract was sealed by applying monopolar electrocauterization to the coaxial needle during its removal. Patient demographics, procedural details, contraindications (INR &gt; 1.5, platelet count &lt; 50,000/mm³, ascites, antiplatelet/anticoagulant use), pathology results, and complications were recorded. Follow-up imaging (range: 18–360 days) was systematically reviewed to identify potential tumor seeding along the biopsy tract. All procedures were performed under ultrasound guidance with 4-h post-procedure observation.</p><h3>Results</h3><p>All 102 biopsies yielded 100% diagnostic success rate with cirrhosis in 85.2% and HCC in 73.5% of patients. Most patients (75.8%) had at least one contraindication for standard biopsy. We observed one mortality in a high-risk Jehovah's Witness patient and one minor complication (hemoglobin drop) managed conservatively. Among 52 patients with follow-up imaging (mean 149 days), one case of suspected intrahepatic tract seeding occurred with no extrahepatic seeding.</p><h3>Conclusion</h3><p>This refined electrocauterization technique provides a safe, effective approach for obtaining diagnostic tissue in high-risk HCC patients with contraindications to standard percutaneous biopsy, offering advantages over conventional tract embolization methods through precise thermal effect localization.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"51 10","pages":"5261 - 5268"},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00261-026-05496-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611685","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}