Frontiers in radiology最新文献

{"title":"Deep learning image reconstruction technique for improving image quality and radiation dose reduction compared to iterative reconstruction technique in non-contrast CT head imaging.","authors":"Obhuli Chandran M, Saikiran Pendem, Rajagopal Kadavigere, Priyanka, Priya Ps, Cijo Chacko","doi":"10.3389/fradi.2026.1824489","DOIUrl":"10.3389/fradi.2026.1824489","url":null,"abstract":"<p><strong>Introduction: </strong>Non-contrast CT (NCCT) head is a standard imaging modality for evaluating central nervous system pathologies. Repeated CT brain examinations are associated with a cumulative risk of cancer development. Deep learning image reconstruction (DLIR) techniques help improve image quality (IQ) while reducing radiation dose (RD) compared with iterative reconstruction techniques (iDose⁴). Therefore, our study compared IQ parameters among low-dose (LD) CT with DLIR (Precise Image), LD CT with iterative reconstruction (iDose⁴), and standard-dose (SD) CT with iDose⁴ and further evaluated radiation dose reduction between SD-iDose⁴ and LD-DLIR in NCCT head imaging.</p><p><strong>Methods: </strong>Group A (SD with iDose⁴) and Group B (LD with DLIR; Precise Image) each included 96 patients. All NCCT brain scans were performed using a 128-slice incisive CT scanner (Philips Healthcare Systems) with iDose⁴ and DLIR. Qualitative and quantitative IQ analyses and radiation dose indices were compared between the groups. Lesion conspicuity was also assessed between LD-DLIR and LD-iDose⁴.</p><p><strong>Results: </strong>There was a significant reduction in RD (effective dose: 1.01 vs. 2.4 mSv; <i>p</i><0.05) with LD-DLIR. LD-DLIR demonstrated superior IQ compared with both SD-iDose⁴ and LD-iDose⁴. Subjectively, gray-white matter differentiation improved from scores of 3 (SD-iDose⁴) and 2.5 (LD-iDose⁴) to 4.5 (LD-DLIR), while overall image quality and subjective image noise increased from 3-3.5 (SD-iDose⁴) and 2.5-3 (LD-iDose⁴) to 4-4.5 with LD-DLIR (<i>p</i> < 0.05). Image noise was lowest with LD-DLIR in gray matter thalamus (GMT: 2.30-2.31) compared with SD-iDose⁴ (4.80-4.85) and LD-iDose⁴ (6.15-6.25); similar results were seen in the white matter posterior limb of the internal capsule (WMPIC: 1.98-2.21 vs. 4.36-4.38 vs. 5.19-5.32) and adjacent cortical gray matter (ACGM: 2.17-2.19 vs. 4.14-4.22 vs. 5.04-5.08). SNR was highest with LD-DLIR [GMT: 16.29-16.36 vs. 7.32-7.34 (SD-iDose⁴) and 5.61-5.75 (LD-iDose⁴); WMPIC: 14.69-14.75 vs. 6.49-6.51 vs. 5.18-5.26], and contrast-to-noise ratio (CNR) was also markedly improved [GMT-WMPIC: 2.59-2.61 (LD-DLIR) vs. 0.98-0.99 (SD-iDose⁴) and 0.82-0.83 (LD-iDose⁴); ACGM-FWM: 2.15-2.29 vs. 0.93-0.95 vs. 0.85-0.86]. Lesion conspicuity was superior with LD-DLIR for all brain lesions compared with LD-iDose⁴.</p><p><strong>Conclusion: </strong>Our study demonstrated that LD NCCT head imaging with DLIR provides superior noise reduction and improved GWMD, SNR, and CNR compared with SD and LD with iDose⁴ and supports the clinical utilization of DLIR.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1824489"},"PeriodicalIF":4.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Structured MRI assessment of posterior thalamic infarction in a distribution compatible with posterior choroidal artery territory presenting as Déjerine-Roussy syndrome in an adolescent: differentiating arterial ischemia from venous thrombosis and thalamic neoplasm.","authors":"ZainEdeen Zyadah, Hala Issa, Rana Issa, Anees Naser","doi":"10.3389/fradi.2026.1869031","DOIUrl":"10.3389/fradi.2026.1869031","url":null,"abstract":"<p><strong>Background: </strong>Isolated thalamic lesions with post-contrast T1 hyperintensity in children may mimic arterial infarction, cerebral venous thrombosis, inflammatory disease, or neoplasm. Structured interpretation of standard magnetic resonance imaging (MRI) sequences, particularly diffusion-weighted imaging/apparent diffusion coefficient (DWI/ADC) correlation and interval follow-up, can help distinguish these entities. Posterior thalamic infarction in a distribution compatible with posterior choroidal artery territory is rare in pediatric patients.</p><p><strong>Case presentation: </strong>A previously healthy 15-year-old female developed headache and blurred vision on the day of tetanus-diphtheria (Td) vaccination, followed by progressive right hemibody numbness, impaired hand dexterity, and severe cold allodynia over 10 days. Examination localized to the left thalamus, consistent with Déjerine-Roussy syndrome. MRI on 2 June 2024, day 10 after symptom onset, showed DWI hyperintensity with subtle corresponding ADC reduction in the left posterior thalamic/pulvinar lesion, supporting early-subacute infarction. T2/fluid-attenuated inversion recovery (FLAIR) distribution was compatible with posterior choroidal artery territory involvement. Susceptibility-weighted imaging (SWI) showed no hemorrhage or venous-congestion pattern. Post-contrast MPRAGE demonstrated patchy T1 hyperintensity interpreted as probable enhancement, but true enhancement could not be definitively confirmed because corresponding pre-contrast T1-weighted images were unavailable. Etiologic workup was unrevealing, and the event was classified as cryptogenic pediatric arterial ischemic stroke (AIS). Follow-up MRI showed reduced post-contrast T1 hyperintensity and encephalomalacic evolution.</p><p><strong>Discussion: </strong>The unilateral territorial pattern, DWI/ADC abnormality, lack of hemorrhagic venous features, and follow-up maturation favored arterial infarction over venous thrombosis or neoplasm. Available post-contrast images showed no obvious filling defect of the major dural venous sinuses or principal deep venous structures, although dedicated magnetic resonance venography/computed tomography venography (MRV/CTV) was not performed. Corresponding pre-contrast T1 images were unavailable, limiting definitive enhancement assessment. The temporal association with Td vaccination is reported for pharmacovigilance; causality cannot be established from a single case.</p><p><strong>Conclusion: </strong>This case illustrates a rare adolescent posterior thalamic infarct presenting as Déjerine-Roussy syndrome and highlights the value of DWI/ADC and follow-up MRI in evaluating thalamic lesions with post-contrast T1 hyperintensity.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1869031"},"PeriodicalIF":4.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bringing light to the reading room.","authors":"Christine Joyce, Mohammad Adam Kassar, Alexandria Knecht, Melissa Jung, Joe Joseph, Justin McCloskey, Jarunee Intrapiromkul, Dhairya A Lakhani, Tyler McGaughey","doi":"10.3389/fradi.2026.1821486","DOIUrl":"10.3389/fradi.2026.1821486","url":null,"abstract":"<p><strong>Background: </strong>According to the American College of Radiology (ACR) Technical Standard Guidelines, there is a recommended illuminance level for reading rooms set between 25 and 75 lux. However, these guidelines are based on studies completed in 2007-2009, which predate significant advancements in display technology. No recent study has re-evaluated these lighting conditions, and more specifically, no prior studies have examined the effects of ambient lighting on the detection of intracranial hemorrhage on non-contrast brain CT.</p><p><strong>Objective: </strong>To determine if higher ambient lighting levels (> 400 lux) significantly effects the diagnostic accuracy of board-certified neuroradiologists in detecting intracranial hemorrhage on brain CT, compared with standard low-light reading room conditions (20-70 lux).</p><p><strong>Methods: </strong>Forty-two standard-of-care non-contrast head CT scans (axial acquisitions with coronal/sagittal reformats) from a tertiary-care hospital were selected by two independent neuroradiologists. These neuroradiologists established the presence or absence of intracranial hemorrhage. Four additional board-certified neuroradiologists independently interpreted all cases twice: first in a brightly lit environment (> 400 lux, measured at desktop level) and, after a > 6-month washout period to minimize recognition memory bias, in a standard reading room (20-70 lux). Interpretations were performed on calibrated Barco MDNC-3421 displays using the institutional Fuji PACS. Sensitivity, specificity, and accuracy were calculated for each condition and compared using paired two-tailed t-tests with Bonferroni correction for multiple comparisons.</p><p><strong>Results: </strong>No statistically significant differences were found between bright and dark conditions for sensitivity (0.974 vs. 0.974, <i>p</i> = 1.00), specificity (0.978 vs. 1.0, <i>p</i> = 0.49 adjusted), or overall accuracy (0.976 vs. 0.988, <i>p</i> = 1.00 adjusted).</p><p><strong>Conclusion: </strong>Increased ambient lighting levels (> 400 lux) do not significantly affect the ability of board-certified neuroradiologists to accurately detect intracranial hemorrhage on modern high-resolution displays. These findings suggest that current guidelines should be re-evaluated with recent improvements in technology. Larger multi-center studies are warranted to confirm these results across additional pathologies and modalities.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1821486"},"PeriodicalIF":4.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-adaptive forward-forward network for anomaly detection and medical image analysis.","authors":"Johanna P Müller, Matthew Baugh, Bernhard Kainz","doi":"10.3389/fradi.2026.1771850","DOIUrl":"10.3389/fradi.2026.1771850","url":null,"abstract":"<p><strong>Introduction: </strong>Robust anomaly and out-of-distribution (OOD) detection in radiology demands learning methods that are accurate, interpretable, computationally efficient, and reliable under real-world distributional shifts. Existing back-propagation-trained models often struggle to meet these requirements simultaneously, while forward-forward learning, despite its conceptual appeal as a resource-efficient and biologically plausible alternative, has so far seen limited adoption in image-based and safety-critical medical applications due to scalability and generalisation limitations.</p><p><strong>Methods: </strong>We revisit back-propagation-free learning for the open-world clinical setting and discuss the Convolutional Forward-Forward Algorithm (CFFA), a parameter-efficient reformulation of the Forward-Forward Algorithm tailored to high-dimensional medical image analysis. CFFA incorporates convolutional structure and layer-wise local objectives, overcoming key scalability and generalisation limitations of existing forward-forward approaches while retaining their resource-efficient training paradigm. Building on the observation that the forward-forward objective yields intrinsic and interpretable goodness statistics that directly quantify conformity to the learned data distribution, we introduce SaFF-AD, a self-adaptive forward-forward network explicitly designed for anomaly and OOD detection. SaFF-AD autonomously configures optimisation dynamics, architectural depth, and goodness normalisation, enabling stable learning under constrained computational budgets and in one-shot training regimes.</p><p><strong>Results: </strong>Extensive experiments across multiple medical imaging benchmarks demonstrate that SaFF-AD achieves competitive or superior anomaly detection performance compared to back-propagation-trained models, while requiring substantially fewer parameters and forward evaluations. The forward-forward goodness signal enables self-supervised anomaly and OOD detection without auxiliary networks, post-hoc uncertainty estimation, or heuristically designed scoring functions.</p><p><strong>Discussion: </strong>These results establish forward-forward learning as a viable and practically attractive alternative to conventional deep learning for safety-critical medical image analysis, particularly in settings characterised by constrained computational budgets, limited labelled data, and distributional uncertainty. By treating anomaly detection as an intrinsic property of the learned model rather than a post-hoc addition, SaFF-AD offers a unified framework that is interpretable, efficient, and well-suited to the open-world conditions encountered in real-world clinical deployment.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1771850"},"PeriodicalIF":4.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transarterial embolization in the management of chronic shoulder pain: clinical evidence and emerging therapeutic role.","authors":"Nicolò Ubaldi, Federico Virgili, Federico Perconti, Aleksejs Zolovkins, Gianluigi Orgera, Edoardo Ronconi, Miltiadis Krokidis, Michele Rossi, Marcello Andrea Tipaldi","doi":"10.3389/fradi.2026.1753020","DOIUrl":"10.3389/fradi.2026.1753020","url":null,"abstract":"<p><p>Chronic shoulder pain is a prevalent and disabling condition encompassing diverse pathologies such as adhesive capsulitis, tendinopathy, enthesopathy, and trapezius myalgia. These disorders share multifactorial mechanisms involving chronic inflammation, angiogenesis, and neurogenic sensitization, leading to persistent pain and functional limitation. Recent insights into the vascular basis of shoulder pain have highlighted pathological neovascularization as a potential therapeutic target. This narrative review explores the role of transarterial embolization (TAE) as a minimally invasive treatment option for chronic shoulder pain refractory to conservative management. Adhesive capsulitis, characterized by capsular fibrosis and restricted motion, demonstrates significant pain reduction and improved range of motion following TAE, with technical success rates approaching 100% and minimal adverse events. Similarly, rotator cuff tendinopathy and trapezius myalgia have shown marked improvement in pain and function, confirming the role of TAE in disrupting pathological neovascular and neurogenic pathways. Various embolic agents, including imipenem/cilastatin sodium, polyethylene glycol, and calibrated microspheres, have been used with favorable safety profiles, though concerns regarding antibiotic resistance warrant further evaluation. Overall, current evidence supports TAE as a safe, effective, and joint-preserving alternative to surgery for patients with chronic shoulder pain of vascular-inflammatory origin. While the literature demonstrates consistent improvements in pain scores and functional outcomes, large-scale randomized controlled trials remain necessary to validate these findings and establish standardized treatment protocols.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1753020"},"PeriodicalIF":4.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: The rise of postmortem imaging in forensic radiology and paleoradiology.","authors":"Dominic Gascho, Mislav Čavka","doi":"10.3389/fradi.2026.1874150","DOIUrl":"https://doi.org/10.3389/fradi.2026.1874150","url":null,"abstract":"","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1874150"},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Diagnostic challenge between epileptic seizure and tetany in Albright hereditary osteodystrophy.","authors":"Madeleine D Burns, Madelynn Paul, Alekya Menta, Olivia Hofheinz, Sachin Vallamkonda, Rebecca E Irvine, Alexis P Kruger, Eric D Schwartz, Anna D Hohler","doi":"10.3389/fradi.2026.1753367","DOIUrl":"10.3389/fradi.2026.1753367","url":null,"abstract":"<p><strong>Background: </strong>Albright hereditary osteodystrophy (AHO) is an epigenetically inherited condition resulting in end-organ resistance to parathyroid hormone (PTH) and consequent hypocalcemia, leading to tetany and seizures. AHO-driven calcification of the basal ganglia can often be visualized on computed tomography (CT).</p><p><strong>Case description: </strong>We report the case of a 36-year-old patient with AHO presenting with epileptic seizure vs. tetany, with an analysis of non-contrast head CT. An adult patient presented with bilateral clenching of fists, progressing to motor weakness, atonic loss of upright posture, and diffuse clonic shaking. The patient's history included alcohol use disorder with generalized tonic-clonic seizures on withdrawal. A physical examination revealed short stature, round facies, short fourth metacarpal bones, and subcutaneous calcifications on the right extremities. Laboratory tests showed leukocytosis with neutrophilic predominance, hypokalemia, hypocalcemia, hyperphosphatemia, and elevated PTH. A non-contrast head CT showed marked bilateral basal ganglia calcifications. An EEG showed generalized slowing with no epileptiform activity. This presentation is consistent with tetany secondary to poor medication adherence in the setting of AHO.</p><p><strong>Conclusions: </strong>Tetany in the setting of AHO may mimic epileptic seizure because of hypocalcemia causing clonus. Home medication adherence, early disease diagnosis, and prompt electrolyte correction are critical to the management of AHO.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1753367"},"PeriodicalIF":4.0,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonography for suspected mild-to-moderate acute left colonic diverticulitis: a prospective head-to-head study with computed tomography.","authors":"Nuria Roson, Andreu Antolin, Miriam Flores-Yelamos, M Victoria Garriga, Xavier Pruna, Salvador Pedraza, Manuel Lopez-Cano, Josep M Badia","doi":"10.3389/fradi.2026.1829813","DOIUrl":"10.3389/fradi.2026.1829813","url":null,"abstract":"<p><strong>Background: </strong>The preferred imaging modality for acute left colonic diverticulitis (ALCD) remains controversial. This prospective study compares ultrasonography (US) and computed tomography (CT) in selected patients with clinically suspected mild-to-moderate localised ALCD.</p><p><strong>Materials and methods: </strong>Consecutive patients presenting to the emergency department with suspected localised mild-to-moderate ALCD underwent both US and CT within 1 h and before treatment initiation. US and CT examinations were performed and interpreted by three trained abdominal radiologists. A multidisciplinary consensus panel established the reference (\"final\") diagnosis, against which both tests were compared. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each modality. Agreement between US and CT for severity stratification was also assessed. This study was not designed as a non-inferiority or equivalence analysis.</p><p><strong>Results: </strong>Sixty-three patients were included in the study; 50 (79.4%) had a final diagnosis of ALCD. US correctly identified 47/50 patients with ALCD, yielding a sensitivity of 97.9%, specificity of 91.7%, PPV of 97.9%, and NPV of 91.7%, while CT showed a sensitivity of 98.0%, specificity of 92.3%, PPV of 98.0%, and NPV of 92.3%. A moderate agreement was found between the two treatment modalities for differentiating stage 0 (mild-to-moderate) from stage >0 (severe) localised ALCD (<i>κ</i> = 0.568, <i>p</i> < 0.001), which increased when US was performed by a more experienced operator (<i>κ</i> = 0.70, <i>p</i> < 0.001). Higher C-reactive protein levels were associated with higher radiological severity (<i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>In this selected prospective cohort, ultrasonography performed by experienced abdominal radiologists showed diagnostic estimates similar to CT and identified most ALCD cases. Given the limited sample size, operator dependence, and non-independent reference standard, these findings should be interpreted cautiously and are most applicable to specialised centres with dedicated ultrasound expertise.<b>Clinical Trial Registration</b>: ClinicalTrials.gov, NCT05323968.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1829813"},"PeriodicalIF":4.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The preoperative temporal bone CT: a mnemonic for reducing surgical risk.","authors":"Benjamin T Ostrander, Vivian Vo, Adam Robinson, Jennifer Chang, Elina Kari","doi":"10.3389/fradi.2026.1784554","DOIUrl":"10.3389/fradi.2026.1784554","url":null,"abstract":"<p><p>Otologic surgery provides safe and effective treatment for a variety of ear and skull base pathologies. However, even routine procedures are not without risk of serious surgical complications. Ear surgery requires sub-millimeter tolerances near a variety of critical structures in a complex anatomic region. As such, preoperative computed tomography (CT) can be helpful to surgeons and radiologists for identifying anatomic variants that can influence surgical technique, and which may predispose patients to surgical complications. However, the analysis and reporting of temporal bone CT is not always detailed, consistent, or comprehensive. The purpose of this narrative review is to illustrate important landmarks and anatomic variants on the preoperative temporal bone CT, with special attention towards features important in otologic surgery and that may impact surgical risk. These critical landmarks and variants can be recalled using the mnemonic \"<b>M</b>aking <b>M</b>iracles <b>I</b>nvolves <b>F</b>ocused <b>V</b>ision,\" which provides an educational framework for the major regions that should be systematically reviewed in the imaging report: mastoid, middle ear, inner ear, facial nerve, and vascular anatomy.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1784554"},"PeriodicalIF":4.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13230221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prophylaxis in percutaneous nephrostomy placements and replacements for malignant urinary tract obstruction. Retrospective cohort study with systematic review and meta-analysis.","authors":"Jeferson Rodrigo Zanon, Thiago Morais Santos, Henrique Durante, Welinton Yoshio Hirai, Marcelo Jenné Mimica, José Humberto Tavares Guerreiro Fregnani, Ricardo Dos Reis","doi":"10.3389/fradi.2026.1787168","DOIUrl":"10.3389/fradi.2026.1787168","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous nephrostomy (PN) can lead to urinary tract infections (UTIs), but these can be prevented by administering antibiotics. However, the effectiveness of this approach is debated.</p><p><strong>Methods: </strong>To evaluate the association between PN-related UTIs and antibiotic prophylaxis in cancer patients. This is a hybrid study was designed. A retrospective cohort study was conducted on cancer patients requiring PN, comparing antibiotic prophylaxis with no prophylaxis. The outcome, UTI, was measured up to seven days after the procedure. This cohort study was included in a systematic review and meta-analysis, for which random-effects models were used to synthesize the outcomes.</p><p><strong>Results: </strong>734 PN procedures were performed. The UTI rate following antibiotic prophylaxis was 0/158 for catheter placement and 3/66 (4.5%; <i>p</i> = 0.025) without prophylaxis. For catheter replacement, the UTI rate was 10/229 (4.4%) with prophylaxis and 2/67 (3.0%; <i>p</i> > 0.999) without. Nineteen studies with 4,606 patients were included. The binary meta-analysis included five studies and this cohort, with an odds ratio (OR) of 0.883 (95% CI = 0.400-1.951; <i>I</i> ² = 50.2%) for UTI. These studies had a moderate to critical risk of bias.</p><p><strong>Discussion: </strong>Antibiotics may only protect against UTIs during PN catheter placement, but this was not confirmed by the meta-analysis. A randomized clinical trial is needed.</p><p><strong>Conclusion: </strong>Antibiotics may only protect against UTIs during PN catheter placement, but this was not confirmed by the meta-analysis. A randomized clinical trial is needed.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42021231063, ClinicalTrials.gov NCT06801405 and PROSPERO CRD42021231063.</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"6 ","pages":"1787168"},"PeriodicalIF":4.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}