British Journal of Radiology最新文献

{"title":"Pulmonary Hypertension and the Role of MRI Flow Assessment: A Systematic Review.","authors":"Khalid S Alghamdi, Ahmed Maiter, Georgia A Hyde, Turki Alnasser, Michael Sharkey, Mahan Salehi, Pankaj Garg, Jim M Wild, David Kiely, Andrew J Swift, Samer Alabed","doi":"10.1093/bjr/tqaf182","DOIUrl":"https://doi.org/10.1093/bjr/tqaf182","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiac magnetic resonance imaging (CMR) plays an increasingly important role in non-invasive assessment of pulmonary hypertension (PH). This systematic review aimed to assess the utility, accuracy and clinical applications of CMR flow techniques in evaluating pulmonary arterial blood flow in patients with suspected or confirmed PH.</p><p><strong>Methods: </strong>MEDLINE and EMBASE databases were searched on 10 December 2024, utilising the following key terms: 'cardiac MRI', 'flow', and 'pulmonary hypertension'. Eligible studies were screened, and data extraction included study design, cohort characteristics, CMR flow techniques and outcomes. Risk of bias was assessed using the Newcastle-Ottawa scale.</p><p><strong>Results: </strong>38 studies (mean sample size: 30 [20-57]) published between 2012 to 2024 were included. These utilised 2D flow (19 studies), 4D flow (15 studies), black blood imaging (one study) and combined flow techniques (three studies). Vortex duration derived by 4D flow demonstrated the strongest correlation (r = 0.96) with mean pulmonary artery pressure and the highest diagnostic accuracy in identifying PH patients (area under the curve 0.99). Risk of bias rated 14 studies as good/very good and 13 as unsatisfactory, with none justifying their sample size selection.</p><p><strong>Conclusion: </strong>CMR flow parameters correlate strongly with right heart catheterisation (RHC) measurements and demonstrate high diagnostic accuracy in identifying patients with PH, with 4D flow potentially adding greater value. This systematic review reinforces the potential benefit of CMR flow techniques in the investigation, prognostication and monitoring of PH patients.</p><p><strong>Advances in knowledge: </strong>This systematic review is the first to evaluate the role of CMR flow techniques in PH and should inform guidelines on flow assessment in pulmonary hypertension.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the different imaging time points in delayed Dual-Energy CT extracellular volume in assessing the staging of liver fibrosis.","authors":"Chuanlin Yu, Wanjing Zhou, Yingjie Peng, Ting Dai, Peng Liu, Yaqiong He","doi":"10.1093/bjr/tqaf177","DOIUrl":"https://doi.org/10.1093/bjr/tqaf177","url":null,"abstract":"<p><strong>Objective: </strong>To stage liver fibrosis by using delayed dual-energy CT (DECT) and determine the optimal delay time for acquisition of delayed CT scans.</p><p><strong>Materials and methods: </strong>This prospective study included patients with chronic liver disease, who were scheduled to undergo multiphase abdominal DECT (including 3-min and 5-min delayed periods) and liver biopsies from January 2021 to December 2021. The iodine densities of the parenchyma and aorta were measured and extracellular volume (ECV) was calculated. Kendall rank correlation was employed to assess the relationship between the ECV and the fibrosis stage. Comparison of ECVs was made for different stages of liver fibrosis. In addition, the diagnostic performances of ECV for staging liver fibrosis were evaluated by using receiver operating characteristic (ROC) curve analysis, and area under the ROC curve (AUC) was calculated.</p><p><strong>Results: </strong>A total of 90 participants were evaluated, and distributed as follows: 10 in S1, 29 in S2, 25 in S3, and 26 in S4. Both ECV of 3-min delayed (ECV3 min) and 5-min delayed (ECV5 min) showed a positive correlation with the stage of liver fibrosis (ECV3 min: τ  =  0.478, P ＜ 0.01, moderate correlation; ECV5 min: τ  =  0.352, P ＜ 0.01, weak correlation). In terms of diagnostic performances, ECV3 min showed significantly higher diagnostic accuracy than ECV5 min for significant liver fibrosis (S2-4) (AUC: 0.87 vs. 0.79, P = 0.037), but no significant differences were observed for progressive fibrosis (S3-4) (AUC: 0.76 vs. 0.71, P = 0.206) or cirrhosis (S4) (AUC: 0.75 vs. 0.74, P = >0.774).</p><p><strong>Conclusion: </strong>DECT ECV may have some potential in noninvasively liver fibrosis staging, ECV3 min is not definitely inferior to ECV5 min.</p><p><strong>Advances in knowledge: </strong>A 3-min delay for the delayed-phase ECV assessment can guide clinical treatment decisions for patients and enhance the efficiency of scanning work, holding significant clinical value.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total body PET and Oncology (Invited Commentary).","authors":"Gary J R Cook","doi":"10.1093/bjr/tqaf180","DOIUrl":"https://doi.org/10.1093/bjr/tqaf180","url":null,"abstract":"<p><p>In recent years, total body positron emission tomography coupled with computed tomography (PET/CT) scanners have become commercially available, allowing coverage of all or most of the body in one scan with higher speed, lower administered radiation dose, improved sensitivity, scan quality and temporal resolution. This not only enables faster and higher quality clinical scans but opens up areas of research that would not have previously been possible or acceptable. For example, the ability to significantly reduce associated radiation burden opens PET research to normal volunteer cohorts and the increase in sensitivity and timing resolution allows exploitation of dynamic data acquisition for calculating kinetic indices of biological processes and producing parametric images beyond static standardised uptake value assessment. As total body PET technology advances and costs reduce, it is likely that availability as well as clinical and research applications will increase to allow this significant step in technology to contribute to clinical outcomes in oncology and other fields where PET is used.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Applications of Portable CT Scanners.","authors":"Rehab Naeem Khalid, Dufan Wu, Quirin D Strotzer, Junyoung Park, Rajiv Gupta","doi":"10.1093/bjr/tqaf175","DOIUrl":"https://doi.org/10.1093/bjr/tqaf175","url":null,"abstract":"<p><p>Portable Computed Tomography (CT) scanners have revolutionized diagnostic imaging by bringing advanced imaging capabilities directly to the point of care in critical settings such as intensive care units, operating rooms, ambulances, and other resource-limited environments. Integrating portable CT into clinical workflows improves patient outcomes through immediate, on-site imaging, eliminating the risks and delays associated with intra-hospital transportation. These systems are indispensable in critical care, reducing complications and time to diagnosis while enabling timely interventions for life-threatening conditions such as intracranial hemorrhage. Portable CT scanners are also transforming prehospital care, particularly in mobile stroke units, where they facilitate rapid diagnosis and treatment of strokes. This review examines the fundamentals of portable CT technology and its transformative role in various clinical scenarios such as ICUs and intraoperative imaging. It traces the evolution of CT from stationary Energy Integrating Detector-based systems to Portable Photon Counting Detector-based systems, highlighting the advantages of this technological transition. Key benefits include reduced patient complications, enhanced spatial resolution, improved diagnostic accuracy, lower radiation doses, and superior material differentiation, illustrated through clinical examples. As innovation advances in detector design and artificial intelligence, portable CT scanners are expected to grow further, expanding their clinical applications and solidifying their role as essential tools in modern diagnostic radiology.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are high-dose CT examinations on the rise?","authors":"Madan M Rehani, Maria T Mataac, Parisa Kaviani, Mannudeep K Kalra, Xinhua Li","doi":"10.1093/bjr/tqaf178","DOIUrl":"https://doi.org/10.1093/bjr/tqaf178","url":null,"abstract":"<p><strong>Objective: </strong>To analyse high-dose CT examinations (≥50 mSv) over a 10-year period to study temporal changes and identify causes.</p><p><strong>Methods: </strong>CT dose provided by the dose management system (Radimetrics) was assessed for the years 2013-2022. CT protocols that led to ≥ 50 mSv exams were identified. Using body mass index (BMI), patients were classified into underweight, normal weight, overweight, and obese, and correlation with dose was studied. Stratified analysis was performed for diagnostic and interventional examinations according to procedure type, patient age, and protocol.</p><p><strong>Results: </strong>Over 10 years, 1,353,168 consecutive CTs were performed on 381,790 patients. From 2017 to 2022, exams with doses ≥50 mSv increased by 244% (0.25% to 0.86%), despite introduction of new scanners. In the 4991 CTs for which BMI was available, about 80% pertained to overweight or obese patients. These groups showed nearly 7 times the increase (250 exam increase per year from 2018-2022 versus 39) of underweight and normal weight patients. Common protocols for these high-dose exams included CT angiography of the aorta, coronary arteries, head and neck, and thorax-abdomen/abdomen (for aortic aneurysm/dissection and aortic valve replacement planning).</p><p><strong>Conclusions: </strong>The rise in ≥ 50 mSv CTs aligns with newer scanners having powerful X-ray tubes but with insufficient safeguards notably for overweight and obese patients.</p><p><strong>Advances in knowledge: </strong>The awareness of exams with ≥50 mSv and their increased frequency in recent years with some newer scanners and in patients with high BMI and in multiphase imaging necessitates actions by manufacturers, policymakers, regulators, and users.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare and uncommon tumours of the female pelvis: what the radiologist should know.","authors":"Silvia Bottazzi, Luca Russo, Veronica Celli, Anna Rame, Alessandra Iacono, Guido Imbemba, Evis Sala, Benedetta Gui","doi":"10.1093/bjr/tqaf176","DOIUrl":"https://doi.org/10.1093/bjr/tqaf176","url":null,"abstract":"<p><p>Gynaecological tumours present a broad spectrum of histological subtypes due to the diverse anatomical and tissue origin of the reproductive organs. Rare tumours affect less than 6 per 100,000 individuals annually, posing significant challenges in diagnosis and management due to limited clinical awareness. Indeed, treatment protocols rely on options developed for more common histotypes, which may have limited efficacy on these rare tumours. In recent years, collaborative international efforts have started to address these gaps, improving standards of care. A comprehensive understanding of rare tumours' clinical and imaging features is necessary for radiologists in order to provide clinicians with useful information for treatment planning. In this review, we adopted an organ-based outline, describing rare tumours of the uterine corpus (leiomyosarcoma, endometrial stromal sarcoma, carcinosarcoma), cervix (gastric-type adenocarcinoma), and ovary (cystadenofibroma, lipid-poor teratoma, struma ovarii, immature teratoma, dysgerminoma). Additionally, tumours occurring at multiple sites, including lymphoma, neuroendocrine tumours, and aggressive angiomyxoma, are discussed. The objective is to help radiologists become familiar with these uncommon entities, ultimately increasing awareness on this topic.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agentic AI in radiology: Emerging Potential and Unresolved Challenges.","authors":"Nicholas Dietrich","doi":"10.1093/bjr/tqaf173","DOIUrl":"https://doi.org/10.1093/bjr/tqaf173","url":null,"abstract":"<p><p>This commentary introduces agentic artificial intelligence (AI) as an emerging paradigm in radiology, marking a shift from passive, user-triggered tools to systems capable of autonomous workflow management, task planning, and clinical decision support. Agentic AI models may dynamically prioritize imaging studies, tailor recommendations based on patient history and scan context, and automate administrative follow-up tasks, offering potential gains in efficiency, triage accuracy, and cognitive support. While not yet widely implemented, early pilot studies and proof-of-concept applications highlight promising utility across high-volume and high-acuity settings. Key barriers, including limited clinical validation, evolving regulatory frameworks, and integration challenges, must be addressed to ensure safe, scalable deployment. Agentic AI represents a forward-looking evolution in radiology that warrants careful development and clinician-guided implementation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Citation and adherence to TRIPOD guidelines by published radiological prognostic models: Systematic review.","authors":"M Hameed, L Dwyer-Hemmings, J K C Mak, W Weston, S A Taylor, S Mallett DipStatOpen, S Halligan","doi":"10.1093/bjr/tqaf174","DOIUrl":"https://doi.org/10.1093/bjr/tqaf174","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to establish the extent to which prognostic models published in highly indexed radiological journals cite and adhere to generally accepted reporting guidelines.</p><p><strong>Methods: </strong>We identified articles reporting multivariable prognostic models, developed using regression and published in the top 3 indexed general radiological journals, December 2022 to May 2023 inclusive. We determined whether they cited the generally accepted reporting guideline, TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis). We scored adherence to individual TRIPOD domains to determine reporting quality both overall and for specific areas.</p><p><strong>Results: </strong>We included 140 articles. Only 4% (n = 6) cited TRIPOD, with just one including the checklist. TRIPOD adherence was poor overall, with a median score of 57% (inter-quartile range, IQR 48% to 64%, range 30% to 87%). Individual domains particularly poorly reported were, title (2% adherence), abstract (3%), and statistical analysis (5%). Only 38% articles (n = 53) named a statistician author. Only one journal mentioned TRIPOD guidelines in their \"Instructions For Authors\" but did not mandate checklist submission.</p><p><strong>Conclusions: </strong>The large majority of prognostic models published in highly indexed radiological journals did not cite TRIPOD, nor fulfil its recommendations.</p><p><strong>Advances in knowledge: </strong>Authors should adhere to the TRIPOD statement so that their work is reported with sufficient clarity, and radiological journals should stipulate adherence for authors submitting prognostic models for publication.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major complications and surgical reintervention after ultrasound-guided transcervical radiofrequency ablation of uterine fibroids : A 10-year Experience.","authors":"Ning Hai, Shan Jin, Runyu Tian, Qingxiang Hou","doi":"10.1093/bjr/tqaf167","DOIUrl":"https://doi.org/10.1093/bjr/tqaf167","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the incidence of and risk factors for major complications and surgical reintervention following transcervical ultrasound-guided radiofrequency ablation (RFA) of uterine fibroids.</p><p><strong>Methods: </strong>In this retrospective study, 1290 patients with 1358 symptomatic uterine fibroids underwent outpatient transcervical ultrasound-guided RFA between July 2009 and July 2021. Medical records were reviewed to assess major complications and surgical reintervention rates.</p><p><strong>Results: </strong>The overall incidence of major complications was 5.1% (66/1290), including intestinal perforation (n = 1, 0.08%), infection (n = 39, 3.0%), intrauterine adhesions (n = 24, 1.9%), and deep venous thrombosis (n = 2, 0.15%). The 10-year cumulative surgical reintervention rate was 8.5%. Indications for reintervention included persistent fibroid-related symptoms (n = 65, 5.0%), fibroid recurrence (n = 35, 2.7%), intracavitary free myoma (n = 9, 0.7%), and malignant uterine mesenchymal neoplasia (n = 1, 0.08%). Multivariate analysis identified increased puncture frequency as a risk factor for postoperative infection (OR = 3.32, 95% CI: 1.02-10.7; P = 0.046).</p><p><strong>Conclusion: </strong>Transcervical ultrasound-guided RFA is a well-tolerated outpatient procedure with an acceptably low rate of major complications and surgical reintervention for treatment of uterine fibroids.</p><p><strong>Advances in knowledge: </strong>ore punctures may contribute to higher infection rate. There is a need to keep all the uterine fibroids in check after RFA since malignant neoplasia may occur over a period.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Diffusion Weighted Imaging and Blood Inflammatory markers to preoperatively differentiate between leiomyosarcoma and atypical leiomyomas.","authors":"Saranya Das, Kavita Shapriya, Andrea Da Silva, Xingfeng Li, Alastair Jackson, Nishat Bharwani, Baljeet Kaur, Andrea G Rockall","doi":"10.1093/bjr/tqaf172","DOIUrl":"https://doi.org/10.1093/bjr/tqaf172","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to compare apparent diffusion coefficient (ADC) findings between leiomyosarcoma (LMS) and atypical/degenerate leiomyoma (LM) and evaluate the usefulness of this biomarker for diagnosis. Additionally it will explore the potential of preoperative neutrophil lymphocyte ratio (NLR) as a haematological marker to aid in the differentiation of LMS from atypical LM.</p><p><strong>Methods: </strong>Histologically proven LMS and LM patients between 2013-2023 were included. For all patients (191 LM, 18 LMS), the pre-operative full blood count was analysed, and the NLR calculated. Whole volume of interest (VOI) and focal region of interest (ROI) areas were manually segmented on patients with DW-MRI sequences available (52 LM, 12 LMS). Mann-Whitney and Fishers exact test were used to assess statistical significance and ROC curves for diagnostic performance.</p><p><strong>Results: </strong>VOI and ROI mean ADC values were significantly lower for LMS than LM, with ROI mean ADC demonstrating greater diagnostic accuracy (AUC 0.817 vs 0.755). Applying a threshold ROI mean ADC value of ≤ 1.00 x10-3 mm2/sec achieved a sensitivity and specificity of 88.3% and 65.4% respectively. A higher NLR was suggestive of LMS (median 2.8 vs 1.7 for LM).</p><p><strong>Conclusions: </strong>ADC, particularly a focal ROI is useful in differentiating LMS from LM. Differences in preoperative blood markers, suggest an inflammatory-malignancy relationship. Future risk stratification models of ADC and haematological parameters should be explored.</p><p><strong>Advances in knowledge: </strong>This study adds to few studies comparing using both ROI and VOI based methods, and no study has assessed both haematological markers and ADC metrics to aid differentiation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}