British Journal of Radiology最新文献

{"title":"Enhanced Blood Vessel Visualization and Accelerated Image Acquisition Using Spiral MRA in Moyamoya Disease: A Comparative Study with Cartesian MRA.","authors":"Maoxue Wang, Yongbo Yang, Yujie Yu, Chuyue Chen, Kun Wang, Mahmud Mossa-Basha, Baochen Chu, Pin Lv, Mei Yao, Wen Zhang, Xin Zhang, Zhengyang Zhu, Xiance Zhao, Lei Zhou, Bing Zhang","doi":"10.1093/bjr/tqaf038","DOIUrl":"https://doi.org/10.1093/bjr/tqaf038","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the blood vessel visualization with spiral MRA (MRAspiral) and compressed SENSE accelerated Cartesian MRA (MRACS) in moyamoya disease (MMD) patients, with digital subtraction angiography (DSA) as the reference standard.</p><p><strong>Methods: </strong>We prospectively collected MRAspiral with different acquisition windows (τ = 4, 6, 10 ms), MRACS and DSA in MMD patients. Contrast-to-noise ratio (CNR) was measured in the M1, M2, M3, and M4 segments of the middle cerebral artery (MCA) for each MRA sequence. Vessel visualization of the distal MCA, leptomeningeal artery (LMA) collaterals, distal external carotid artery (ECA), and internal carotid artery (ICA) steno-occlusion was qualitatively analyzed using 3- and 4-point likert scales compared to DSA. A linear fixed-effects model was used to determine differences among the four sequences.</p><p><strong>Results: </strong>A total of 98 hemispheres from 55 MMD patients were included. CNR in the M2, M3 and M4 segments of the MCA was not significantly different between MRACS and MRAτ4 or MRAτ6, but it was significantly higher in MRACS than MRAτ10 (M2: P < 0.001, M3: P < 0.001, M4: P = 0.013). MRAspiral sequences provided better visualization of the distal MCA, LMA collaterals and distal ECA compared to MRACS (all P < 0.001).</p><p><strong>Conclusions: </strong>MRAspiral offers improved vessel visualization in distal arteries with adequate image quality for patients with MMD. Compared to MRACS, MRAspiral can reduce scan time by 32.31% when the τ value is set to 6 ms, while also providing superior image quality.</p><p><strong>Advances in knowledge: </strong>Spiral MRA performs well in visualizing collateral vessels in moyamoya disease with shorter scan time.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555900","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":"Dilation of the Left Renal Vein: An Indicator of Spontaneous Splenorenal Shunt in Chronic Liver Disease Patients.","authors":"Afak Durur Karakaya, Mine Sorkun, Murat Akyıldız, Turan Kanmaz, Bengi Gürses","doi":"10.1093/bjr/tqaf048","DOIUrl":"https://doi.org/10.1093/bjr/tqaf048","url":null,"abstract":"<p><strong>Objectives: </strong>Spontaneous splenorenal shunts (SSS) in chronic liver disease (CLD) impact liver perfusion and prognosis post-liver transplantation. This study aims to identify radiological findings that predict the presence of SSS in CLD patients and to examine the relationship between SSS and left renal vein diameter.</p><p><strong>Methods: </strong>A retrospective study was conducted on 150 adult patients evaluated for liver transplants from June 2018 to April 2021. The study groups included healthy controls (Group 1), CLD patients without SSS (Group 2), and those with SSS (Group 3). Multidetector CT angiography was used to measure the diameters of renal veins, portal vein, spleen size, and SSS.</p><p><strong>Results: </strong>Significant differences were found between the groups for spleen size, splenic vein diameter, portal vein diameter, left renal vein diameter, and renal vein diameter difference, except for the right renal vein diameter. A left renal vein diameter of 10.5 mm or greater and both renal veins diameter difference of 0.5 mm or more favoring the left showed good diagnostic performance for predicting SSS, with AUC values of 0.828 and 0.833, respectively.</p><p><strong>Conclusion: </strong>Dilation of the left renal vein and a greater diameter difference between renal veins favoring the left are strong indicators of SSS in CLD patients. These findings can aid in pre-transplant assessments and potentially improve post-transplant outcomes.</p><p><strong>Advances in knowledge: </strong>This study establishes that an increased diameter of the left renal vein and a greater diameter difference between renal veins are reliable radiological indicators for predicting the presence of SSS in CLD patients.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555897","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":"Incidental breast cancer on CT: factors associated with detection and relationship to prognostics and treatment options.","authors":"Ali Abougazia, Deepali Sharma, Omnia Abdelghani","doi":"10.1093/bjr/tqaf044","DOIUrl":"https://doi.org/10.1093/bjr/tqaf044","url":null,"abstract":"<p><strong>Objectives: </strong>With the increasing use of CT, it may help detecting incidental breast cancers. Our study analysed the relationship between breast cancer detection on CT and features of the cancer, factors related to the scan and report, the treatment offered, and cancer prognostics, in NHS settings.</p><p><strong>Methodology and results: </strong>Out of the retrospectively included 56 scans in 42 patients, 38 reports (67.9%) missed the breast cancers. Missed cancers were found to be smaller (P = 0.0042), progressed more by the time they were diagnosed (P = 0.0011), and their initial treatment was delayed by a median of 3.4 years (P < 0.0001). Cancers were more likely to be missed out of hours (P = 0.0485), in an outpatient reporting session (P = 0.0397), when the cancer presented as a circumscribed mass (P = 0.0196), and when the breasts were dense (P = 0.0250).</p><p><strong>Conclusion: </strong>A significant percentage of breast cancer is missed on CT, with subsequent delay in starting treatment. Systematic approach when reporting, awareness of atypical cancer presentations, and minimising distractions while reporting, may improve the detection of breast cancer on CT.</p><p><strong>Advances in knowledge: </strong>This study identified opportunities to detect, and the factors associated with missing and delayed treatment of, incidental breast cancer on CT, specifically in NHS settings. By increasing radiologists' awareness of those factors, it is hoped to prevent delay in treatment of this cohort of cancer patients.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555905","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":"Enhancement of colorectal cancer liver metastases with gadoxetate-enhanced MRI at multiple time points is associated with disease free survival following hepatectomy.","authors":"Joshua Shur, Leila Kafaei, Angela Riddell, Ian Chau, Ricky Bhogal, Long Jiao, Dow-Mu Koh","doi":"10.1093/bjr/tqaf040","DOIUrl":"https://doi.org/10.1093/bjr/tqaf040","url":null,"abstract":"<p><strong>Aim: </strong>Investigate signal intensity of colorectal liver metastases (CRLM) at hepatobiliary phase (HBP) gadoxetate-enhanced MRI at two time points pre- (TP1) and post- chemotherapy (TP2) and association with disease-free survival (DFS) in patients undergoing curative liver resection.</p><p><strong>Methods: </strong>Retrospective study. Single largest tumours outlined and HBP T1 signal intensity measured, normalised to skeletal muscle at TP1 and TP2. Enhancement thresholds defined and risk groups at each TP and Kaplan-Meier survival curves compared using the log-rank test. Univariate and multivariate association of enhancement and 8 clinical features with risk of recurrence calculated using Cox proportional hazards.</p><p><strong>Results: </strong>82 patients (48 male, mean age 59 years) underwent 135 imaging studies, 58 at TP1, 77 at TP2 and 53 patients at TP1 + 2. Of 82 patients, 58 recurred with median time to recurrence 11.7 months. Enhancement of > =135 and > =15 at TP1 and TP2 respectively were predictive of reduced risk of recurrence (p < 0.05), although not when corrected for multiple testing (p = 0.33 and 0.20 respectively). Enhancement was not associated with recurrence in multivariate model including 8 clinical features (p > 0.05). Change in enhancement between TP was not associated with risk of recurrence however tumours that consistently exhibited low enhancement were 9 times more likely to recur.</p><p><strong>Conclusions: </strong>Increased CRLM enhancement in the HBP following gadoxetic acid at two TPs is associated with improved DFS in patients undergoing liver resection. This initial observation warrants further investigation of serial enhancement measurements as prognostic biomarkers.</p><p><strong>Advances in knowledge: </strong>Dual-timepoint signal assessment may be informative for clinical outcomes in CRLM undergoing resection.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555903","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":"Automated contouring and radiotherapy treatment planning of spine metastases using atlas-based auto-segmentation and knowledge-based planning approaches.","authors":"Emma-Louise Jones, Porsher Oppong, Caroline Sisodia, Carolina Napoleone-Filho, Victoria Harris, Christopher Golby, David Eaton, Antony Greener","doi":"10.1093/bjr/tqaf041","DOIUrl":"https://doi.org/10.1093/bjr/tqaf041","url":null,"abstract":"<p><strong>Objectives: </strong>Uncomplicated spine metastases are routinely treated with conventional external beam radiotherapy (cEBRT). In cEBRT, there is no delineation of target volumes or organs at risk (OAR), or attempt to optimise dose distribution to deliver conformal, homogeneous dose distributions with sparing of OAR. Atlas-based auto-segmentation (ABAS) for target volume and OAR delineation, followed by knowledge-based planning (KBP) could facilitate conformal planning of spine metastases.</p><p><strong>Methods: </strong>ABAS using SmartSegmentation for delineation of thoracic and lumbar vertebrae, and OAR in their vicinity, provided target volumes and OAR for conformal treatment planning. 30 volumetric-modulated arc therapy (VMAT) treatment plans were produced using RapidPlan KBP. Plans produced using this automated approach were compared to the equivalent cEBRT treatment plans.</p><p><strong>Results: </strong>Target volume coverage for RapidPlan VMAT generated plans was superior to cEBRT. PTV Dmean = 7.86 ± 0.16 Gy, Dmin = 3.46 ± 1.79 Gy, Dmax = 8.56 ± 0.05 Gy for RapidPlan VMAT compared to Dmean = 7.78 ± 0.24 Gy, Dmin = 1.83 ± 1.08 Gy, Dmax = 10.46 ± 0.41 Gy for cEBRT. With homogeneity index and conformity index 0.236 ± 0.215 and 1.201 ± 0.121 respectively for RapidPlan VMAT compared to 0.508 ± 0.137 and 1.789 ± 0.437 for cEBRT. Dose to dose-limiting OAR spinal cord and cauda equina was reduced for RapidPlan VMAT, with Dmax of 7.91 ± 0.16 Gy and 7.94 ± 0.13 Gy respectively compared to 8.67 ± 0.13 Gy and 8.90 ± 0.16 Gy for cEBRT. KBP was superior to cEBRT in terms of target coverage, homogeneity and conformity and was achievable in a clinically acceptable time, with improved sparing of the spinal cord and cauda equina.</p><p><strong>Conclusions: </strong>Implementation of automated treatment planning for uncomplicated spine metastases is feasible in the clinical environment with superior plan quality compared to cEBRT.</p><p><strong>Advances in knowledge: </strong>Automated contouring and treatment planning are feasible in the clinical environment using this approach and would allow patients conformal as opposed to conventional external beam radiotherapy for treatment of spine metastases.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482191","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":"Quadriceps muscle injuries in athletes: a narrative review.","authors":"Sisith P Ariyaratne, Kapil Shirodkar, Rajesh Botchu, Steven L J James","doi":"10.1093/bjr/tqaf042","DOIUrl":"https://doi.org/10.1093/bjr/tqaf042","url":null,"abstract":"<p><p>The quadriceps muscles are a large group of four muscles in the anterior compartment of the thigh, comprising the rectus femoris, vastus medialis, vastus intermedius and vastus lateralis, which in combination act as the primary extensors of the knee joint. The rectus femoris is also responsible for hip joint flexion. Quadriceps muscle injuries are frequently encountered in sports and athletic activities, and present a significant challenge in the realm of sports medicine, impacting athletes across various disciplines and levels of competition. A spectrum of sporting injuries and imaging findings can affect this muscle group, including strains and tears, avulsions, contusions, degloving injuries, and exercise related signal abnormalities (ERSA). A thorough understanding of these various pathologies and imaging features is crucial to guide appropriate diagnosis, management and rehabilitation, as well as ensure safe and prompt return to play, minimise risk of re-injury or long term adverse sequela, optimise performance and improve career longevity of these athletes. This comprehensive review article aims to review the unique anatomy of the quadriceps muscle group and integrate current knowledge of the various forms of sporting injuries affecting it, with a specific emphasis on the imaging features.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482192","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":"Coronary angiography with photon-counting detector CT -New options and some critical decisions.","authors":"Victor Mergen, Matthias Eberhard, Hatem Alkadhi","doi":"10.1093/bjr/tqaf037","DOIUrl":"https://doi.org/10.1093/bjr/tqaf037","url":null,"abstract":"<p><p>The advent of photon-counting detector CT brought up various new interesting possibilities for coronary imaging including different scan modes and various post-processing options. The two main scan modes include spectral data acquisition with inherent energy-resolved imaging and ultra-high-resolution scanning with unprecedented high spatial resolution, both at the highest available temporal resolution. Post-processing options include the generation of virtual monoenergetic images at different levels and the generation of virtual non-calcium images. Many early studies indicated the potential of each of these options for coronary CT angiography but also show that much more work is needed to clarify the optimal scan mode for each individual patient and clinical setting.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466954","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 18F-FDG PET/CT to Predict PD-L1 Expression in NSCLC via Metabolic Tumor Heterogeneity.","authors":"Ruxi Chang, Liang Luo, Cong Shen, Weishan Zhang, Xiaoyi Duan","doi":"10.1093/bjr/tqaf034","DOIUrl":"https://doi.org/10.1093/bjr/tqaf034","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study is to evaluate the effectiveness of using F-18 FDG PET/CT metabolic heterogeneity to assess the PD-L1 expression in primary tumors.</p><p><strong>Methods: </strong>Data from 103 NSCLC patients undergoing F-18 FDG PET/CT was collected. PD-L1 expression was verified via biopsy or surgical specimens. The coefficient of variation (COV) assessed metabolic heterogeneity of the primary tumor. ROC curves evaluated the predictive potential of metabolic metrics and defined thresholds. Logistic regression examined predictors of PD-L1 expression.</p><p><strong>Results: </strong>The study included 103 patients (mean age: 63.65 ± 9.28 years), of whom 60 were male. 64 patients were PD-L1 expression positive, while 39 were negative. COV was significantly higher in the PD-L1 positive group (Z = -2.529, P = 0.011),while no significant differences noted in otherparameters between the groups (P > 0.05 for all). The optimal cutoff value was proposed as 28.9, with sensitivity and specificity of 46.9% (34.3%-59.8%)and 82.1%(66.5%-92.5%), respectively (AUC: 0.649(0.549, 0.741)) whichcan more effectively identify PD-L1 negative patients. Other metabolic parameters are less effective than COV.(AUV < 0.6). In addition, COV-defined metabolic heterogeneity outperformed other metabolic parameters in predicting PD-L1 expression (p = 0.049) and emerged as an independent predictor.</p><p><strong>Conclusion: </strong>Metabolic heterogeneity, described by the COV of the primary lesion, is a marker for predicting PD-L1 expression in NSCLC patients. Therefore, the COV of the primary tumor may complement conventional imaging in providing immunohistochemical information before biopsy.</p><p><strong>Advances in knowledge: </strong>COV of the primary tumor can predict PD-L1 expression, potentially complementing conventional imaging for immunohistochemical information prior to biopsy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466956","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":"PREDICTing Post-Embolisation Syndrome after uterine fibroid embolisation: the PREDICT-PES study.","authors":"Prof Warren Clements, Matthew W Lukies, Madeleine Coleman, Rohan Nandurkar, Laura Le Mercier, Georgina Venn, Jim Koukounaras","doi":"10.1093/bjr/tqaf036","DOIUrl":"https://doi.org/10.1093/bjr/tqaf036","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the rate of clinically significant post-embolisation syndrome (csPES) in our cohort of patients after uterine artery embolisation for symptomatic fibroids, and to identify risk factors associated with the development of csPES.</p><p><strong>Methods: </strong>Retrospective case-control study. All patients that underwent uterine artery embolisation for symptomatic fibroids between the 18-month period of 1 March 2022 and 1 September 2023 were recruited. csPES was defined as maximum pain score on visual analogue scale of > 5 out of 10, plus at least one of: morphine patient-controlled analgesia dose >10mg, fever, or use of 2 or more antiemetics.</p><p><strong>Results: </strong>69 patients were included, mean age 46.2 years, and median uterine volume 393 mL (range 80-2288 mL). The rate of csPES was 47.8% (33 patients). After adjusting for confounding using multiparametric logistic regression, a positive association was seen between nulliparity and developing csPES (OR 5.51, 95%CI 1.297-23.410, p = 0.021). In addition, a trend was shown between increasing age and a reduced odds of developing csPES (OR 0.87, 95%CI 0.748-1.002, p = 0.054).</p><p><strong>Conclusion: </strong>The rate of csPES in our cohort was 47.8%, and nulliparity was strongly associated with the development of csPES. We can use this to better counsel our patients regarding the odds of csPES when these risks are present at pre-procedure consultation, and target additional interventions at reducing csPES in this population.</p><p><strong>Advances in knowledge: </strong>Clinically significant post-embolisation syndrome is common after uterine artery embolisation for symptomatic fibroids. This study showed that nulliparity is a risk factor for developing, previously not known or reported.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448163","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":"Approvers, disapprovers and strugglers: A q-methodology study of rectal cancer magnetic resonance imaging proforma use.","authors":"Sarah Alderson, Chand Muthoo, Hannah Rossington, Phil Quirke, Damian Tolan","doi":"10.1093/bjr/tqaf035","DOIUrl":"https://doi.org/10.1093/bjr/tqaf035","url":null,"abstract":"<p><strong>Objectives: </strong>Rectal cancer Magnetic Resonance Imaging (rcMRI) allows accurate staging and informs treatment decisions in rectal cancer. There is variability in reporting completeness, however template proforma reports can significantly increase the inclusion of key tumour descriptors. We aimed to identify socially shared viewpoints of radiologists relating to barriers to implementing proforma reporting. Measuring the subjectivity of opinions relative to other radiologists will allow identification of common patterns preventing implementation.</p><p><strong>Methods: </strong>Specialist gastrointestinal radiologists from 16 hospital trusts were invited to a q-methodology study. Participants ranked 56 statements on barriers to using proforma reports (the q-set) in a normal distribution (q-grid). Factor analyses were undertaken to identify independent accounts, and additional survey data were used to support interpretation.</p><p><strong>Results: </strong>Twenty-seven radiologists participated; 11 (41%) had more than 10 years reporting rcMRIs. Three distinct accounts of radiologist attitudes to proforma-use were identified: Approvers, Disprovers and Struggling champions. The highest ranked barriers related to proforma format, individual radiologists' preferences and beliefs about efficacy and factors relating to wider multidisciplinary teams and health system-level implementation.</p><p><strong>Conclusions: </strong>Radiologists that disapprove of proformas are unlikely to use them unless external influences are applied, such as a requirement by treating clinicians. Increased internal and organisational support would also increase use. Targeted implementation strategies focusing on these barriers has the potential to increase uptake of similar interventions.</p><p><strong>Advances in knowledge: </strong>Specialist Radiologists require a multi-level adaptive implementation strategy, tailored to proforma characteristics as well as individual and organisational barriers to increase proforma reporting for rectal cancer MRI to support accurate treatment decision making.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448140","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}