British Journal of Radiology最新文献

{"title":"The Diagnostic Value of SUVmax in Predicting Lymphovascular Space Invasion in Patients with Endometrial Cancer: A Systematic Review and Meta-Analysis.","authors":"Xuxu Meng, He Jin, Hui Xu, Jun Lu, Zhenchang Wang, Dawei Yang, Zhenghan Yang","doi":"10.1093/bjr/tqag039","DOIUrl":"https://doi.org/10.1093/bjr/tqag039","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the ability of the maximum standardized uptake value (SUVmax) to predict the lymphovascular space invasion (LVSI) status in endometrial cancer (EC).</p><p><strong>Method: </strong>PubMed/MEDLINE, Web of Science, Embase, and the Cochrane Library were systematically searched for all original studies evaluating the diagnostic efficacy of LVSI using PET/CT or PET/MR. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). A bivariate random effects model was used to acquire pooled sensitivity, specificity, heterogeneity, and the area under the summary receiver operating characteristic curve (AUROC). Meta-regression and sensitivity analysis were performed to identify sources of heterogeneity.</p><p><strong>Results: </strong>A total of 6 studies (257 patients) were included. Most studies had a low risk of bias, and all studies had minimal applicability concerns. The summary AUROC values, pooled sensitivity and specificity of SUVmax in detecting LVSI in EC were 0.77, 62% and 83%, respectively. One study may have contributed to the unstable results of this study according to the sensitivity analysis.</p><p><strong>Conclusion: </strong>Our study showed that SUVmax has moderate accuracy in noninvasively predicting LVSI in EC. More original studies with large samples are needed in the future to evaluate the role of SUVmax in differentiating LVSI.</p><p><strong>Advances in knowledge: </strong>LVSI is closely related to the prognosis of EC, and it can only be obtained by surgical pathology. SUVmax has moderate diagnostic performance in preoperatively predicting LVSI in EC. Future studies with large samples are needed to confirm the clinical value of SUVmax in the preoperative prediction of LVSI.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466999","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":"CT to CT-Angiography Time-an easy target for acute stroke pathway improvement: A Retrospective Analysis of Time from CT to CT-Angiography in Thrombectomy for Ischaemic Stroke.","authors":"Tatyana Sarnecki, Marco Mancuso-Marcello, Christos Nikola, Oliver Spooner, Pervinder Bhogal","doi":"10.1093/bjr/tqag061","DOIUrl":"https://doi.org/10.1093/bjr/tqag061","url":null,"abstract":"<p><strong>Objectives: </strong>To assess CT-to-CT angiography (CT-CTA) times at primary stroke centres (PSCs) for patients eligible for mechanical thrombectomy (MT) in acute ischaemic stroke, and to identify causes of imaging delays.</p><p><strong>Methods: </strong>This retrospective study analysed CT-CTA intervals in 200 consecutive patients referred from 18 PSCs in South-East England to a comprehensive stroke centre (CSC) (Jan 2022 - Mar 2023). Times were benchmarked (≤5 min = excellent, ≤10 min = adequate). Inclusion/exclusion following MT guidelines. Confounding variables were analysed using Welch's t-test and one-way ANOVA. A qualitative survey explored delay causes.</p><p><strong>Results: </strong>The mean CT-CTA time at PSCs was 62 minutes (SD 21), versus 1 minute (SD 1) at the CSC (p < .00001, Hedges' g = 3). Only 9% of PSCs achieved excellent, and 36% adequate, CT-CTA times. No significant differences were found based on time of day, thrombolysis, or NIHSS. However, wide variation existed between PSCs. Survey findings cited technical (e.g., lack of CT perfusion, out-of-hours reporting), organisational (e.g., scanner access, lack of stroke specialists), and educational (e.g., unawareness or dismissal of guidelines) barriers.</p><p><strong>Conclusions: </strong>CT-CTA delays at PSCs impede timely MT referrals. Improvements in training, infrastructure, and policy (e.g., revised SSNAP metrics) are needed for optimising stroke care pathways.</p><p><strong>Advances in knowledge: </strong>This study is the first to systematically assess CT-CTA time adherence across PSCs and it reveals substantial delays and modifiable barriers. It provides actionable insights for optimising stroke imaging protocols, reinforcing the need for integrated workflows to enhance MT accessibility and outcomes.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467026","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":"PI-RADS 3-5 lesions MRI pattern after Prostate Artery Embolization.","authors":"Romain Bossi Croci, Marc Sapoval, Charles Dariane, Olivier Pellerin, Nicolas Thiounn, Carole Dean, Tom Boeken, Sylvain Bodard","doi":"10.1093/bjr/tqag062","DOIUrl":"https://doi.org/10.1093/bjr/tqag062","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate changes in PI-RADS ≥ 3 lesions on prostate MRI after prostate artery embolization (PAE) performed for lower urinary tract symptoms.</p><p><strong>Methods: </strong>This retrospective single-center study included 18 consecutive patients, each presenting with 1 PI-RADS ≥ 3 prostatic images on pre-PAE MRI and who underwent follow-up MRI after PAE. We assessed changes in PI-RADS score, infarcted areas, and prostate volume.</p><p><strong>Results: </strong>Before PAE, all 18 lesions (mean PSA density : 0,078) were either biopsy-negative (n = 4) or deemed not requiring biopsy based on multidisciplinary consensus (n = 12), except for 1 case of non-clinically significant prostate cancer identified before PAE and 1 patient with a PIRADS 4 lesion who declined biopsy. The mean delay to post-PAE MRI was 120 days. After PAE, no new PI-RADS ≥ 3 lesions appeared, and no lesion was upgraded. Both initially classified as PI-RADS 5 lesions (negative on biopsies) were downgraded to PI-RADS 1. Among the 6 PI-RADS 4 lesions, 3 remained stable, 2 were downgraded to PI-RADS 3 and 1 to PI-RADS 2. Of the 10 PI-RADS 3 lesions, 8 achieved PI-RADS 1 status and 2 remained stable.</p><p><strong>Conclusions: </strong>Following PAE, pre-existing PI-RADS ≥ 3 lesions demonstrate stability or reduction in PI-RADS on MRI. However, radiopathological correlation studies are warranted to estimate the diagnostic reliability of the PI-RADS score in the post-PAE settings.</p><p><strong>Advances in knowledge: </strong>This study shows that PI-RADS ≥ 3 images are downgraded after PAE. It doesn't imply that potential prostate cancer can be cured by PAE.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462559","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":"Long Axial Field-of-View (LAFOV) PET in the Era of Multi-Parametric Imaging and Theranostics.","authors":"Nicolas A Karakatsanis","doi":"10.1093/bjr/tqag060","DOIUrl":"https://doi.org/10.1093/bjr/tqag060","url":null,"abstract":"<p><p>This review explores the revolutionary impact of long axial field-of-view (LAFOV) PET/CT imaging in modern nuclear medicine and molecular imaging. LAFOV PET offers extended axial fields-of-view from 50 cm to 200 cm with unprecedented 3D sensitivity, enabling ultra-fast scans at regular doses or ultra-low dose scans at regular scan times as well as simultaneous whole-body dynamic imaging. We discuss the potential of these specifications in facilitating the clinical translation of multi-parametric whole-body PET imaging for superior quantification, lesion detectability, and treatment response assessments across a diverse range of clinical diagnostic and treatment response assessment applications, in oncology, cardiovascular diseases, inflammatory diseases, neurology as well as for systemic multi-organ assessments and other novel imaging applications. Furthermore, we present LAFOV PET's crucial role for optimizing personalized radionuclide therapy via quantitative precision dosimetry and development of theranostic digital twins. Challenges, such as high acquisition costs, large data volumes, and the need for more extensive validation and wider equitable adoption by enhancing cost-effectiveness through novel detector configurations, innovative data-driven correction methods and Artificial Intelligence are also discussed. Ultimately, LAFOV PET has the potential to redefine precision diagnostics and theranostics in nuclear medicine but its currently limited accessibility should be democratized to disseminate its benefits globally and equitably.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455628","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":"99mTc-HYNIC-PSMA-11 Whole-Body SPECT/CT: A Clinically Viable Alternative to 68Ga-PSMA PET/CT in patients with Prostate Cancer.","authors":"Hooda Monika, Kaur Komalpreet, Ankit Watts, Singh Harmandeep, Kaur Harneet, Gunasekaran Vinisha, Sharma Aditya P, Mavuduru Ravimohan, Singh Baljinder","doi":"10.1093/bjr/tqag052","DOIUrl":"https://doi.org/10.1093/bjr/tqag052","url":null,"abstract":"<p><strong>Objectives: </strong>The diagnostic performance of 99mTc-HYNIC-PSMA-11 whole body SPECT/CT versus 68Ga-PSMA PET/CT was evaluated in prostate cancer patients.</p><p><strong>Methods: </strong>As a part of the diagnostic workup, all the prostate cancer (PCa) patients (n = 10; mean age 66.4 ± 9.6 years) underwent whole-body 68Ga-PSMA-11 PET/CT followed by serial whole body (anterior and posterior) 99mTc-HYNIC-PSMA-11 imaging The serial whole body imaging was performed at multiple time points of 10 min, 2 h, 4 h, 6 h, 24 h and the whole body SPECT/CT was acquired at 3 h. The whole-body SPECT/CT data was analyzed for lesions detection and to calculate the standardized uptake values (SUVmax) for 99mTc-HYNIC-PSMA-11 avid lesions using the Q- Metrix software. These values were compared with the corresponding SUVmax values obtained from 68Ga-PSMA-11 PET/CT. The serial whole body imaging data were used for estimating the radiation absorbed doses (mSv/MBq) to various organs using the MIRD schema and the OLINDA/EXM software.</p><p><strong>Results: </strong>68Ga-PSMA-11 PET/CT identified a total of 64 metastatic lesions, while 99mTc- HYNIC-PSMA-11 SPECT/CT detected 49/64 metastatic lesions, presenting a sensitivity of 76.6%. Notably, the mean SUVmax values for 68Ga-PSMA-11 PET/CT and 99mTc-HYNIC- PSMA-11 were comparable and a highly significant positive correlation (r > 0.93; p < 0.01) The average absorbed doses to the salivary glands, lungs, kidneys, urinary bladder, and liver were found to be comparable with 99mTc-MDP bone scanning.</p><p><strong>Conclusion: </strong>The diagnostic performance of whole-body 99mTc-HYNIC PSMA-11 SPECT/CT is fairly comparable to 68Ga-PSMA PET/CT and offers a favorable dosimetry indicating its potential for PCa evaluation.</p><p><strong>Advances in knowledge: </strong>99mTc-PSMA-11 SPECT/CT may be an alternative and cost-effective tool for evaluation of initial PSMA disease burden as well as for response evaluation to PSMA targeted therapies.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442825","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":"Adaptive radiotherapy in paediatric patients: A SIOP Europe ROWG survey on practice patterns across Europe.","authors":"Andrada Turcas, Stephanie Bolle, Raquel Davila Fajardo, Mariangela Fiorente, Sarah M Kelly, Yasmin Lassen-Ramshad, Monica Ramos, Enrica Seravalli, Sabina Vennarini, Anne Laprie","doi":"10.1093/bjr/tqag059","DOIUrl":"https://doi.org/10.1093/bjr/tqag059","url":null,"abstract":"<p><strong>Objectives: </strong>Adaptive radiotherapy (ART) is increasingly recognized for its potential to optimize treatment accuracy by adjusting to anatomical changes during therapy. In children, who are particularly sensitive to radiation-induced toxicities and experience rapid anatomical changes, ART could be especially beneficial. We conducted an online survey to assess the current state of ART in children across Europe.</p><p><strong>Methods: </strong>A 21-question survey regarding ART implementation, techniques, indications, and technical infrastructure was distributed online to SIOP-Europe affiliated centres.</p><p><strong>Results: </strong>Sixty responses from 18 European countries were received. ART was available for children in 68% of centres. Most frequent sites for implementation were pelvis, abdomen, and head-and-neck, with an average of 20% of respondents using ART for >75% of these cases. Higher-volume centres were more likely to implement ART (r = 0.34, p = 0.048). Fifteen percent performed daily adaptation, while 75% applied it only for major anatomical changes. Half of the centres used offline and 24% online ART. Specific infrastructure included Ethos (21%), MR-LINAC (5%), and Tomotherapy (13%). Automatic contouring was mostly used for OARs (57%). Barriers to implementation included a need for more evidence (50%), specialized equipment (52%) and guidelines (39%).</p><p><strong>Conclusions: </strong>ART use in paediatric patients is highly variable and remains limited. Only a subset of centres reported routine use of ART, with notable variation in frequency and criteria for adaptation.</p><p><strong>Advances in knowledge: </strong>This is the first Europe-wide survey to comprehensively map ART practices in paediatric oncology, revealing substantial heterogeneity and identifying key barriers to wider adoption, representing a base to guide standardization and future clinical validation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430754","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":"Impact of PSMA PET/CT on Initial Staging and Planning of Definitive Radiation Therapy in Prostate Cancer.","authors":"Rasha Elsaka, Hanady Hegazy, Ahmed Eldrieny, Mahmoud Kotb, Mohamed Morsi, Amr Abdelaziz","doi":"10.1093/bjr/tqag057","DOIUrl":"https://doi.org/10.1093/bjr/tqag057","url":null,"abstract":"<p><strong>Objectives: </strong>comparing risk grouping, target delineation, and dosimetric parameters between RT plans based on conventional imaging (CT and/or MRI pelvis with bone scan) versus 18F-PSMA PET/CT in the same patients.</p><p><strong>Methods: </strong>A 75 newly diagnosed PCa patients treated with definitive RT between January 2019 and December 2022 at our center were included. Each underwent standard imaging and 18F-PSMA PET/CT. Two RT plans were generated; one from conventional imaging and another from PSMA PET/CT data using IMRT or RapidArc on the Eclipse (Varian, USA) system. Plans were compared regarding target volumes (TVs), dose-volume histograms (DVH), and doses to organs at risk (OARs).</p><p><strong>Results: </strong>Mean age was 69.6 ± 8.1 years, and mean pretreatment PSA was 33.47 ± 42.05 ng/mL. Gleason score (GS) was 7 in 50.7% and 8-10 in 26.6%. PSMA -PET/CT altered TVs in 26 patients (34.7%). PSMA-based RT plans showed significantly higher rectal V60% (19.96% vs. 18.1%, p = 0.024), femoral maximum dose (46.37 Gy vs. 41.98 Gy, p = 0.006), and bowel maximum dose (54.7 Gy vs. 46.3 Gy, p = 0.014). Upstaged patients had larger mean prostate volumes (77.53 ± 34.76 cc vs. 59.76 ± 30.6 cc; p = 0.026).</p><p><strong>Conclusion: </strong>18F-PSMA -PET/CT significantly impacts staging and RT planning in prostate cancer, leading to altered TVs and dosimetry, significantly in patients with larger prostates, but non significantly in patients with GS ≥ 8, and higher PSA levels.</p><p><strong>Advances in knowledge: </strong>PSMA PET/CT meaningfully changes staging, TVs, and dosimetry. It highlights the modality's value in improving accuracy in definitive RT planning.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430825","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":"Automatic Hepatic Steatosis Quantification using Low-Dose CT with deep learning-based noise reduction and CT Fat Fraction Analysis Software.","authors":"Sung Joon Youn, Sun Kyung Jeon, Jeong Hee Yoon, Chulkyun Ahn, Jeong Min Lee","doi":"10.1093/bjr/tqag054","DOIUrl":"https://doi.org/10.1093/bjr/tqag054","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the accuracy of CT-derived fat fraction (CDFF) software for quantifying hepatic steatosis at various radiation doses, using MRI-derived proton density fat fraction (MRI-PDFF) as the reference standard, and examines the impact of deep learning (DL)-based noise reduction on CDFF accuracy in low-dose CT (LDCT) scans.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 125 living liver donor candidates who underwent non-contrast CT and MRI between July 2016 and December 2017. CDFF was measured on full-dose and simulated LDCT scans at 50%, 25%, and 10% radiation doses. Deep learning-based denoising reconstruction (DLDR) was applied to LDCT scans for CDFF recalculation. The accuracy of CDFF was compared with MRI-PDFF using Pearson correlation coefficients and receiver operating characteristic (ROC) curve analysis, focusing on the effects of radiation dose and DLDR.</p><p><strong>Results: </strong>: Of the 125 participants (mean age 38 ± 10 years; 77 males), 29 (23%) had hepatic steatosis (MRI-PDFF ≥5%). Full-dose CDFF showed moderate correlation with MRI-PDFF (r = 0.728; P < .001). Correlation decreased with lower doses (r = 0.684-0.725) but improved with DLDR (r = 0.725-0.736). ROC AUC for diagnosing hepatic steatosis was 0.82 for full-dose CDFF, with similar performance across other doses except 10%.</p><p><strong>Conclusion: </strong>CDFF accuracy declines at lower radiation doses, but DLDR enhances accuracy, improving alignment with MRI-PDFF, especially at reduced doses.</p><p><strong>Advances in knowledge: </strong>DLDR significantly enhances the accuracy of CDFF accuracy at lower radiation doses, enabling high diagnostic performance for hepatic steatosis while potentially reducing patient radiation exposure.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363992","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":"Computed tomography utilization and radiation risk in the elderly: Let us not downplay frequent imaging.","authors":"Grace Pham, Sophia Hahjean Kim, Madan M Rehani","doi":"10.1093/bjr/tqag051","DOIUrl":"https://doi.org/10.1093/bjr/tqag051","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate trends in CT utilization and recurrent exam frequency among elderly patients and assess implications for radiation risk.</p><p><strong>Methods: </strong>We retrospectively analyzed CT exams performed at a quaternary-care academic hospital from 2014 to 2024. Patients were stratified into decade-based age groups, with the elderly defined as ≥ 60 years. Annual CT volume share and per-patient exam frequencies were computed, with emphasis on high-frequency use (≥2, ≥3, ≥5, and ≥10 exams/year). Temporal trends were assessed using centered log-ratio transformation and linear regression analysis.</p><p><strong>Results: </strong>The proportion of CTs performed in patients aged 60-90 years rose from 50.4% in 2014 to 58.3% in 2024 (+7.9%). Elderly patients undergoing ≥2 exams/year increased from 25.6% to 26.6% (+1.0%), while for non-elderly patients it decreased from 17.4% to 12.7% (-4.8%). Similar trends were observed for those undergoing ≥10 exams/year. Elderly patients represent the largest group receiving recurrent CTs. The proportion of CTs in elderly is expected to rise to nearly 66% in 2035, a projected 7.2% increase from 58.3% in 2024.</p><p><strong>Conclusions: </strong>CT imaging is becoming increasingly concentrated in elderly populations, reflecting both demographic and clinical drivers. While the radiation risk per individual exam remains small, cumulative exposure and the growing demand for imaging in older adults highlight the need for balanced strategies that ensure clinical benefit while maintaining optimized, justified radiation use.</p><p><strong>Advances in knowledge: </strong>CT utilization among elderly patients is projected to reach two-thirds of all CTs by 2035, underscoring that radiation safety considerations for the elderly should not be neglected.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324535","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":"Is exceeding estimated bladder capacity during voiding cystourethrograms harmful?","authors":"Robert M DeFlorio, Monica S Epelman, Kimberly Christnacht, Henry Zheng, Chetan C Shah","doi":"10.1093/bjr/tqaf293","DOIUrl":"10.1093/bjr/tqaf293","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to compare the actual bladder capacity of children undergoing voiding cystourethrogram (VCUG) with existing formula-derived estimates and to describe any adverse effects of bladder overdistention during VCUG.</p><p><strong>Methods: </strong>This retrospective study involved review of 884 consecutive VCUG performed over 3 years. Cases with underlying conditions that could artificially increase bladder capacity, such as neurogenic bladders or vesicoureteral reflux, were excluded.</p><p><strong>Results: </strong>Included were 440 normal VCUG procedures. Bladder volumes exceeded the expected bladder capacity set by the American Academy of Pediatrics (AAP) and American College of Radiology in 284 VCUG (65%). Of 261 VCUG performed on children <2 years of age, 164 (63%) VCUG exceeded the expected capacity. In the 2- to 14-year-old age group, 113 (68%) of the 165 VCUG performed exceeded the expected bladder capacity. Among the 14 VCUG performed on children >14 years of age, 7 (50%) exceeded the bladder capacity. No adverse effects were found after the VCUG in the 32 VCUG (7.3%) requiring a contrast volume of more than 2 times the AAP estimates and in the 22 VCUG studies (5%) requiring a contrast volume of more than 3 times the AAP estimates.</p><p><strong>Conclusion: </strong>This study suggests that current guidelines often underestimate bladder capacity, and exceeding the expected bladder capacity appears to be reasonably safe without the occurrence of complications.</p><p><strong>Advances in knowledge: </strong>Current AAP guidelines often underestimate the capacity of the urinary bladder. Exceeding the expected bladder capacity appears to be reasonably safe.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"468-472"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660448","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}