British Journal of Radiology最新文献

{"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}

{"title":"A Systematic Review and Meta-Analysis Comparing the 2019 and 2005 Bosniak Classification Systems for Assessing Renal Cysts and Cystic Renal Masses: Diagnostic Accuracy and Inter-rater Agreement Evaluation.","authors":"Mohammad Taghi Niknejad, Shiva Mohajeri, Reza Javadrashid, Mohammad Shahir Eftekhar, Farzaneh Shojaeshafiei, Mansoureh Baradaran, Bahareh Hatami, Michail E Klontzas, Ramin Shahidi","doi":"10.1093/bjr/tqaf033","DOIUrl":"https://doi.org/10.1093/bjr/tqaf033","url":null,"abstract":"<p><strong>Objectives: </strong>The Bosniak Classification System (BCS) is integral in clinical decision-making for Renal cysts and cystic renal masses, with updates in 2005 and 2019 aiming to enhance diagnostic accuracy and clinical utility. Despite these revisions, challenges in inter-rater agreement and practical applicability persist, underscoring the need for comprehensive evaluation of both versions' effectiveness in guiding patient care.</p><p><strong>Methods: </strong>This meta-analysis adhered to PRISMA guidelines and systematically reviewed studies comparing the 2005 and 2019 BCS versions using CT or MRI. We searched PubMed, Embase, Scopus, and Web of Science, and used QUADAS-2 for quality assessment. In this study, we focused on diagnostic performance and inter-observer agreement. Statistical analysis involved bivariate random-effects modeling and assessing pooled sensitivity, specificity, and inter-rater reliability.</p><p><strong>Results: </strong>We included eleven articles. The 2019 Bosniak classification showed higher diagnostic performance for CT (sensitivity: 85.7%, specificity: 81.9%) and MRI (sensitivity: 96.2%, specificity: 70.9%) compared to the 2005 version. Inter-rater reliability was better with the 2019 classification (CT kappa: 0.813, MRI kappa: 0.601) than with the 2005 version. The quality assessment indicated low risk of bias overall, though some studies had high risk in specific areas.</p><p><strong>Conclusion: </strong>The Bosniak 2019 classification provides improved diagnostic specificity and inter-rater reliability compared to the 2005 version. Its adoption may enhance clinical decision-making and reduce overtreatment in managing cystic renal masses.</p><p><strong>Advances in knowledge: </strong>This paper is novel in being the first meta-analysis to demonstrate that the Bosniak 2019 classification system significantly enhances inter-rater agreement, and overall diagnostic performance compared to the 2005 version, particularly in CT imaging, thus offering a more accurate and reliable tool for evaluating cystic renal masses.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440150","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":"Investigating The Effect on Backscatter Factor When Measuring Entrance Surface Dose Using the Raysafe X2 Solid State Radiography and Fluoroscopy Detector.","authors":"Vadim Lordinot, Chris Koller","doi":"10.1093/bjr/tqaf030","DOIUrl":"https://doi.org/10.1093/bjr/tqaf030","url":null,"abstract":"<p><strong>Objectives: </strong>Assessment of patient dose is a critical quality assurance check towards ensuring it is kept as low as reasonably practicable. One metric used to evaluate this is Entrance Surface Dose (ESD)- the summed magnitudes of the incident radiation and Compton scatter resulting from photon interactions within tissue. ESD can be directly measured using a dosemeter that is sensitive to backscattered radiation. However, the increasing use of solid-state detectors such as the tin backed RaySafe X2 R/F detector, means that ESD cannot be directly measured. The IAEA Technical Report No.457, recommends using backscatter factors (BSF) as calculated by Petoussi-Henss et al in1998 via Monte Carlo methods when measuring ESD using such dosemeters. This research seeks to practically determine a reliable method of calculating the BSF using a PMMA patient-equivalent phantom.</p><p><strong>Methods: </strong>A comparison between the solid-state detector and an ionisation chamber capable of detecting backscatter was conducted. Special attention was given to BSF variation with both radiation field size and beam quality by varying additional copper and aluminium filtration to mimic the behaviour of patient-dose reducing techniques on modern fluoroscopy systems.</p><p><strong>Results: </strong>Results have shown significant correspondence with those of Petoussi-Henss et al using the simulated water and ICRU tissue equivalent phantoms.</p><p><strong>Conclusions: </strong>Given the results consistency, BSFs from this study have been proposed for use when measuring ESD using the RaySafe solid state detector with a PMMA patient-equivalent phantom for quality assurance purposes.</p><p><strong>Advances in knowledge: </strong>This research provides the opportunity to obtain more accurate patient dose data during quality assurance testing with modern solid-state dosemeters.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398300","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":"18F-FDG PET or PET/CT in detecting high-grade transformation of chronic lymphocytic leukaemia and indolent lymphomas: A systematic review and meta-analysis.","authors":"Osher N Y Lee, John Kuruvilla, David C Hodgson, Patrick Veit-Haibach, Ur Metser","doi":"10.1093/bjr/tqaf028","DOIUrl":"https://doi.org/10.1093/bjr/tqaf028","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic accuracy of 18F-FDG PET or PET/CT in detecting histological transformation (HT) of indolent lymphomas.</p><p><strong>Methods: </strong>A systematic search of articles up to July 2024 was performed in Embase and Medline. Eligible studies included adults with histologically proven indolent lymphoma, 18F-FDG PET or PET/CT as the index test, and sufficient data to assess diagnostic performance. Summary receiver operating characteristic curves were plotted using a bivariate model to estimate diagnostic accuracy with area under the curve (AUC).</p><p><strong>Results: </strong>Fifteen studies with 1,307 participants were included. Ten studies assessed PET ability to detect Richter's transformation, and 5 studies focussed on HT in follicular lymphoma and other subtypes. A meta-analysis of the former showed pooled sensitivity of 0.90 (95% CI, 0.84-0.93) and specificity of 0.54 (95% CI, 0.28-0.77) when using a SUVmax threshold of around 5. AUC was 0.89. Pooled sensitivity was 0.74 (95% CI, 0.54-0.87) and specificity was 0.84 (95% CI, 0.67-0.93) when using a SUVmax threshold of around 10. AUC was 0.84. For detecting HT in follicular lymphoma, thresholds were found higher than those for Richter's transformation.</p><p><strong>Conclusions: </strong>18F-FDG PET or PET/CT demonstrates good diagnostic accuracy to detect Richter's transformation, best when employing SUVmax ≥ 5. SUVmax thresholds may be limited in discriminating follicular lymphoma from HT, and alternatives should be sought.</p><p><strong>Advances in knowledge: </strong>If biopsy is feasible, SUVmax ≥ 5 can guide biopsy in patients with clinically suspicious Richter's transformation. If biopsy is infeasible, SUVmax ≥ 10 can better identify HT and guide patient management.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398296","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}