{"title":"[Anatomical variants of the petrous bone].","authors":"A Haußmann","doi":"10.1007/s00117-025-01465-7","DOIUrl":"https://doi.org/10.1007/s00117-025-01465-7","url":null,"abstract":"<p><strong>Clinical issue: </strong>The anatomy of the petrous bone is very complex, particularly due to the many important nervous, vascular and muscular structures that run through it, as well as the protection of hearing and balance organs. Anatomical standard variants complicate radiological interpretation, can imitate pathologies, and present surgeons with enormous challenges during surgical procedures.</p><p><strong>Standard radiological methods: </strong>Morphological imaging-based diagnostics for detecting normal anatomical variants of the petrous bone include computed tomography (CT) and/or magnetic resonance imaging (MRI). The patient's precise history of existing symptoms or previous surgery also plays a role in the assessment of the findings. Radiologists must be aware that some anatomical standard variants can mimic pathology, and therefore there is a risk of misinterpretation. The imaging helps surgeons facilitating preoperative planning and identification of possible complications.</p><p><strong>Conclusion: </strong>Precise radiological knowledge of the complex anatomical relationships of the petrous bone is crucial in routine radiological and neuroradiological practice. A detailed description of existing anatomical standard variants enables colleagues in surgical disciplines such as otolaryngology and neurosurgery to efficiently prepare the procedures and assess possible complications.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yanbing Guo, Qiuju Fan, Zhanli Ren, Nan Yu, Hui Tan, Guangming Ma
{"title":"Feasibility of replacing true non-contrast images with virtual non-contrast images in quantitative analysis of emphysema.","authors":"Yanbing Guo, Qiuju Fan, Zhanli Ren, Nan Yu, Hui Tan, Guangming Ma","doi":"10.1007/s00117-025-01448-8","DOIUrl":"https://doi.org/10.1007/s00117-025-01448-8","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of virtual non-contrast (VNC) images in comparison with true non-contrast (TNC) images in dual-energy computed tomography (DECT) for the assessment of emphysema quantification.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted of 57 patients who underwent three-phase chest CT. The VNC images of the arterial phase (VNC(AP)) and venous phase (VNC(VP)) were generated on an AW4.7 workstation. The objective assessment of image noise in TNC and VNC images was conducted through the quantification of image quality, which was then subjected to a double-blind review by two physicians for image quality and visual classification of emphysema. Furthermore, quantified emphysema at three distinct thresholds (950 HU, 930 HU, and 910 HU) using the three sets of images was compared. Bland-Altman plots were used to compare the quantitative discrepancies at the -950HU threshold.</p><p><strong>Results: </strong>There was no statistically significant difference in subjective image quality and emphysema visual classification between TNC and VNC images (all p > 0.05). In the quantitative measurement, no statistical difference was observed in image noise or total lung volume among the three groups. When compared with TNC, VNC(VP) images demonstrated no statistical difference in 15th percentile lung density (Perc 15), low attenuation volume (LAV), percentage of low attenuation area (LAA%), and mean lung density (MLD; all p > 0.05). The use of VNC images was found to reduce the radiation dose by 32.6%.</p><p><strong>Conclusion: </strong>The use of VNC, particularly VNC(VP) images, in chest CT has the potential to supplant TNC for the quantitative assessment of emphysema, thereby streamlining scans and reducing radiation dose.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mitteilungen des Berufsverbandes der Deutschen Radiologie.","authors":"","doi":"10.1007/s00117-025-01457-7","DOIUrl":"https://doi.org/10.1007/s00117-025-01457-7","url":null,"abstract":"","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":"65 5","pages":"381-401"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Lymphatic malformations in childhood and adolescence].","authors":"Anne Groteklaes, Andreas Müller","doi":"10.1007/s00117-025-01450-0","DOIUrl":"https://doi.org/10.1007/s00117-025-01450-0","url":null,"abstract":"<p><strong>Clinical issue: </strong>Lymphatic malformations (LM) are congenital abnormalities of the lymphatic system and occur with an incidence of 1:6000-1:16,000 live births. Simple LMs manifest as soft-elastic space-occupying lesions, whereas complex LMs affect several organ systems and can lead to chylous effusions due to lymph leakage. In addition, LM can occur together with other vascular malformations or as part of overgrowth syndromes. Primary lymphedema is a special subgroup of LMs, which can first be clinically manifested in advanced age.</p><p><strong>Diagnostics: </strong>Imaging procedures are of great importance in the diagnostics of LM, in particular magnetic resonance imaging (MRI) and MR lymphangiography. Additionally, genetic testing should be carried out to detect possible comorbidities at an early stage and to enable targeted treatment.</p><p><strong>Treatment strategies: </strong>The decision for treatment depends on the underlying LM as well as the extent and localization. Medicinal treatment is possible with the mTOR inhibitor sirolimus and with propranolol via the vascular endothelial growth factor (VEGF)-Ras-MAPK pathway, also as a combined treatment, Depending on the results of genetic analyses, targeted treatment with alpelisib/trametinib is also an option. Moreover, surgical and radiological interventional approaches can be used, depending on the underlying findings.</p><p><strong>Practical recommendations: </strong>Patients with LM should be referred to an expert center to enable an early diagnosis and treatment in an interdisciplinary team. Together with the clinical and genetic findings MRI and MR lymphangiography enable the evaluation of interventional and surgical treatment options.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":"65 5","pages":"354-361"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Nodal x-ray lymphangiography and therapy of central lymphatic leakage].","authors":"J Wagenpfeil, C C Pieper","doi":"10.1007/s00117-025-01437-x","DOIUrl":"10.1007/s00117-025-01437-x","url":null,"abstract":"<p><strong>Background: </strong>Transnodal x‑ray lymphangiography has become increasingly important in recent years as it enables precise visualization of the anatomy, function and pathologies of the central lymphatic system. It is usually performed after ultrasound-guided puncture of a lymph node with injection of an oily contrast medium.</p><p><strong>Objective: </strong>The aim of this study is to present the basic principles of transnodal x‑ray lymphangiography and the interventional treatment options for central lymphatic pathologies.</p><p><strong>Results: </strong>Regardless of the specific cause of the lymphatic pathology, transnodal lymphangiography is an effective and safe procedure which, in addition to its diagnostic value, can also have a therapeutic effect on lymphatic leakage. However, due to the employed oily contrast medium, it's purely diagnostic use in patients with lymphoedema is not advisable.</p><p><strong>Conclusion: </strong>Nodal lymphangiography also forms the basis for targeted interventional radiological treatments (e.g. lymph vessel embolization) of a wide range of often rare lymphatic diseases. Interventional methods are often more precise, faster and less-invasive than surgical procedures and have lower morbidity and mortality rates.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"339-346"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Lymphatic system and lymphangiography].","authors":"Claus C Pieper, Ulrike Attenberger","doi":"10.1007/s00117-025-01442-0","DOIUrl":"https://doi.org/10.1007/s00117-025-01442-0","url":null,"abstract":"","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":"65 5","pages":"299-300"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lukas Müller, Mirjam Gerwing, Daniel Pinto Dos Santos
{"title":"[Role of social media in radiology].","authors":"Lukas Müller, Mirjam Gerwing, Daniel Pinto Dos Santos","doi":"10.1007/s00117-025-01444-y","DOIUrl":"10.1007/s00117-025-01444-y","url":null,"abstract":"","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"367-370"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804992","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}
Christian Dirk Taeger, Claus Christian Pieper, Daniel Schiltz
{"title":"[Therapeutic concepts in treatment of lymphedema].","authors":"Christian Dirk Taeger, Claus Christian Pieper, Daniel Schiltz","doi":"10.1007/s00117-025-01441-1","DOIUrl":"https://doi.org/10.1007/s00117-025-01441-1","url":null,"abstract":"<p><strong>Background: </strong>Lymphoedema is a chronically progressive disease which, if left untreated, can lead to a massive reduction in quality of life and secondary diseases such as recurrent erysipelas. For a long time, purely conservative therapy was considered the only treatment option for primary or secondary chronic lymphedema of the upper or lower extremities. Only in very pronounced late forms were resection procedures such as liposuction or tissue removal considered as further treatment options. A series of modern reconstructive therapy procedures are now available thanks to the-in some cases rapid-further development of diagnostic and microsurgical procedures, which in many cases can significantly alleviate the severity of the disease in the hands of experienced microsurgeons.</p><p><strong>Aim: </strong>The aim of this article is to present the modern treatment options for lymphedema according to the current state of scientific knowledge in a practice-oriented manner and to provide guidelines for the optimal treatment of affected patients.</p><p><strong>Conclusion: </strong>In addition to indispensable conservative therapy, modern microsurgical procedures can lead to successful and lasting symptom relief in mandy cases and should be considered at an early stage. Preoperative diagnostics are essential for choosing the right treatment and its success.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":"65 5","pages":"347-353"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051833","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":"[Lymphatic vessel imaging-Indications and clinical applications].","authors":"Claus C Pieper","doi":"10.1007/s00117-025-01451-z","DOIUrl":"https://doi.org/10.1007/s00117-025-01451-z","url":null,"abstract":"<p><strong>Background: </strong>The armamentarium of lymphatic imaging techniques and treatment concepts available at specialized centers has significantly increased in recent years. The rarity and complexity of lymphatic vascular diseases presents the particular challenge of implementing these methods in a meaningful and targeted manner in patient care; however, there are currently no generally accepted diagnostic guidelines.</p><p><strong>Objective: </strong>Which lymphatic imaging technique is useful in which clinical situations?</p><p><strong>Material and methods: </strong>This article provides an overview of clinical and technical considerations that are relevant for a targeted evaluation of indications for lymphatic imaging in a multidisciplinary diagnostic and therapeutic approach.</p><p><strong>Results: </strong>The lymphatic vascular system can be affected by a wide range of primary and secondary pathologies, which often lead to relatively uniform clinical presentations (especially localized swellings, chylolymphatic effusions). In general, dedicated imaging should be discussed if a lymphatic vascular disease is suspected based on such a typical presentation. The choice of imaging strategy is then individually determined by the urgency of treatment, suspected localization and etiology of the pathology, comorbidities, specific properties of the imaging techniques, the treatment strategy pursued and local availability. When interpreting imaging and planning treatment, in addition to the large spectrum of different pathologies, the individual variability of the lymphatic system must also be taken into account.</p><p><strong>Conclusion: </strong>An individual pretherapeutic assessment of lymphatic flow should nowadays be mandatory in order to be able to optimize the therapeutic approach for each patient with a suspected lymphatic vascular disease. Interdisciplinary patient care is of decisive importance.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":"65 5","pages":"316-324"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Importance of peptide receptor radionuclide therapy for the management of neuroendocrine tumours].","authors":"I Ciuciulkaite, K Herrmann, H Lahner","doi":"10.1007/s00117-025-01452-y","DOIUrl":"https://doi.org/10.1007/s00117-025-01452-y","url":null,"abstract":"<p><p>Neuroendocrine tumours (NETs) are rare, heterogeneous neoplasms that often express somatostatin receptors (SSTRs). This allows targeted peptide receptor radionuclide therapy (PRRT) for NETs. PRRT is currently indicated as second- or third-line therapy for metastatic or unresectable, progressive, SSTR-positive NETs of grade (G) 1 or 2. Adequate bone marrow reserves as well as renal and hepatic function are required for PRRT. The most commonly used radiopharmaceutical for PRRT is <sup>177</sup>Lu-DOTA-TATE. PRRT prolongs progression-free and overall survival, reduces or stabilises tumour burden, and improves tumour symptoms and quality of life. Adverse events associated with PRRT are mostly mild and transient. Haemato- and nephrotoxicity are the most common toxicities following PRRT. The NETTER‑2 and COMPOSE trials are investigating PRRT with <sup>177</sup>Lu-DOTA-TATE/-TOC in G2 and G3 gastroenteropancreatic NETs.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":"65 5","pages":"371-380"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}