British Journal of Radiology最新文献

{"title":"Impact of steatotic liver disease on hepatitis B-related hepatocellular carcinoma: MRI manifestation and prognostic potential.","authors":"Beixuan Zheng, Yuyao Xiao, Fei Wu, Chun Yang, Ruofan Sheng, Mengsu Zeng","doi":"10.1093/bjr/tqaf121","DOIUrl":"10.1093/bjr/tqaf121","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the impact of steatotic liver disease (SLD) on hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) in clinical and MRI manifestations and prognostic potential.</p><p><strong>Methods: </strong>Four hundred and forty-one HBV-related HCC patients were retrospectively enrolled (mean age 55.5 years ±10.8, 366 males, 237 without and 204 with concurrent SLD). Kaplan-Meier analyses were performed to compare the overall survival (OS) and recurrence-free survival (RFS). Clinical and MRI characteristics were compared. Univariate and multivariate analyses were used to identify the different imaging features between patients with and without concurrent SLD.</p><p><strong>Results: </strong>Patients with concurrent SLD had a better OS (P = .047). Except for metabolism-related indicators, the level of alpha fetoprotein (Z = 7.82, P = .007), the grade of tumour lesion (χ2 = 6.567, P = .035) and microvascular invasion (χ2 = 6.252, P = .044) appeared to be lower in patients with SLD. According to the multivariate analysis, non-adjacent to porta hepatis or confluence of hepatic veins (odds ratio [OR] = 1.624, P = .041), absent washout appearance (OR = 2.047, P = .001) and intact enhancing capsule (OR = 2.584, P = .003) were significantly different MRI manifestations between tumours with and without SLD.</p><p><strong>Conclusions: </strong>For HBV-related HCC, concurrent SLD tended to be associated with better OS. The clinical and radiological characteristics were different, which seemed to be less aggressive for those with concurrent SLD.</p><p><strong>Advances in knowledge: </strong>Concurrent SLD in HBV-related HCC patients may be associated with better overall survival, and it exhibits distinct clinical and radiological features, which seem to be less aggressive.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1313-1320"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186624","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":"MRI-based distal femur cortical thickness analysis for osteoporosis detection.","authors":"Sevde Nur Emir, Servet Emir","doi":"10.1093/bjr/tqaf132","DOIUrl":"10.1093/bjr/tqaf132","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the presence of osteoporosis by measuring the distal femur cortex thickness on routine knee MRI performed for any reason. We aim to determine if these measurements can serve as a reliable indicator of bone mineral density (BMD) and thus facilitate early diagnosis of osteoporosis.</p><p><strong>Methods: </strong>A retrospective study was conducted with approval from the hospital's Ethics Committee. Patients who underwent dual-energy X-ray absorptiometry (DXA) and knee MRI within 6 months were included. Exclusion criteria were patients under 18, those with a gap of more than 6 months between scans, prior knee surgeries, trauma, bone tumours, or non-diagnostic MRI results. MRI examinations were performed on a 1.5 Tesla scanner. Measurements included average cortical bone thickness (CBTavg), distal femoral cortical index-1 (DFCI-1), and distal femoral cortical index-2 (DFCI-2). A radiologist blinded to DXA scores conducted the measurements. Statistical analyses were performed using the Mann-Whitney U test and receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>A total of 74 patients were included. Significant differences were found between the normal BMD group and the osteopenia/osteoporosis group for CBTavg, DFCI-1, and DFCI-2 (P < 0.01). ROC analysis showed high diagnostic accuracy with an area under the curve (AUC) of 0.92 for CBTavg, 0.90 for DFCI-1, and 0.91 for DFCI-2. Optimal cut-off values were determined as 4.52 mm for CBTavg, 2.58 mm for DFCI-1, and 1.12 mm for DFCI-2.</p><p><strong>Conclusion: </strong>The study demonstrates that osteopenia/osteoporosis can be effectively diagnosed using distal femur cortex thickness measurements on routine knee MRI. These measurements provide a simple, fast, and practical method for opportunistically detecting osteoporosis, facilitating early intervention and management.</p><p><strong>Advances in knowledge: </strong>This study is the first to demonstrate that distal femur cortex thickness measurements on routine knee MRI can effectively predict osteoporosis, offering a novel, opportunistic screening method that enhances early detection and intervention strategies.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1327-1332"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504884","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":"High resolution-dynamic characterization of cardiac masses: radio-frequency spoiled 3D gradient echo sequence.","authors":"Elif Peker, Sena Ünal, Ruhi Erdem Ergüden, Nil Sezer Yılmazer Zorlu, Sena Bozer Uludağ","doi":"10.1093/bjr/tqaf093","DOIUrl":"10.1093/bjr/tqaf093","url":null,"abstract":"<p><strong>Objectives: </strong>Volumetric interpolated breath-hold examination (VIBE) sequence is a radio-frequency-spoiled gradient echo sequence that is mostly used in the evaluation of soft tissues, allows dynamic high-resolution images to be taken in 30 seconds of breath-holding time in MRI, and is used to create 3D images. In this study, we aimed to determine the detectability of cardiac masses and thrombi and their differentiation from the blood pool with the T1 VIBE imaging method.</p><p><strong>Methods: </strong>Precontrast, early and late postcontrast VIBE images were evaluated. Lesion contours were drawn with a free-hand regìon of ìnterest (ROI) in the phase in which the lesion was better depicted. All ROIs were placed in the phase where the lesion appeared best and then copied to other phases.</p><p><strong>Results: </strong>Sìgnal to noìse ratìo (SNR) was calculated as SI/SD of background intensity, CNR was calculated as SNR thrombus-SNR myocardium and SNR thrombus-SNR blood pool. SNR and CNR values of thrombus, blood pool, and myocardium measured at maps and contrast-enhanced images were compared with each other.</p><p><strong>Conclusions: </strong>There are many sequences used routinely to detect cardiac masses and thrombi. Many of these techniques require long acquisition time. With the VIBE sequence, precontrast, arterial, and venous images of the lesion can be obtained quickly. Although the SNR and CNR values obtained with VIBE images are lower than those with routine post-contrast images, our study can be considered a preliminary study for future studies to evaluate dynamic images.</p><p><strong>Advances in knowledge: </strong>For our knowledge, this is the first paper written on the visual assessment of cardiac masses on VIBE images.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1233-1235"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of contrast-enhanced agent on segmentation using a deep learning-based software \"Ai-Seg\" for head and neck cancer.","authors":"Sayaka Kihara, Yoshihiro Ueda, Shuichi Harada, Akira Masaoka, Naoyuki Kanayama, Toshiki Ikawa, Shoki Inui, Takashi Akagi, Teiji Nishio, Koji Konishi","doi":"10.1093/bjr/tqaf108","DOIUrl":"10.1093/bjr/tqaf108","url":null,"abstract":"<p><strong>Objectives: </strong>In radiotherapy, auto-segmentation tools using deep learning assist in contouring organs-at-risk (OARs). We developed a segmentation model for head and neck (HN) OARs dedicated to contrast-enhanced (CE) computed tomography (CT) using the segmentation software, Ai-Seg, and compared the performance between CE and non-CE (nCE) CT.</p><p><strong>Methods: </strong>The retrospective study recruited 321 patients with HN cancers and trained a segmentation model using CE CT (CE model). The CE model was installed in Ai-Seg and applied to additional 25 patients with CE and nCE CT. The Dice similarity coefficient (DSC) and average Hausdorff distance (AHD) were calculated between the ground truth and Ai-Seg contours for brain, brainstem, chiasm, optic nerves, cochleae, oral cavity, parotid glands, pharyngeal constrictor muscle, and submandibular glands (SMGs). We compared the CE model and the existing model trained with nCE CT available in Ai-Seg for 6 OARs.</p><p><strong>Results: </strong>The CE model obtained significantly higher DSCs on CE CT for parotid and SMGs compared to the existing model. The CE model provided significantly lower DSC values and higher AHD values on nCE CT for SMGs than on CE CT, but comparable values for other OARs.</p><p><strong>Conclusions: </strong>The CE model achieved significantly better performance than the existing model and can be used on nCE CT images without significant performance difference, except SMGs. Our results may facilitate the adoption of segmentation tools in clinical practice.</p><p><strong>Advances in knowledge: </strong>We developed a segmentation model for HN OARs dedicated to CE CT using Ai-Seg and evaluated its usability on nCE CT.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1272-1280"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149514","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":"Exploiting the endothelial-immune axis to improve radiotherapy efficacy.","authors":"Olivier Guipaud, Claire Lago, Lucie Portier, Vincent Paget, Agnès François, Stéphane Supiot, Fabien Milliat","doi":"10.1093/bjr/tqaf114","DOIUrl":"10.1093/bjr/tqaf114","url":null,"abstract":"<p><p>The immune system is essential for controlling tumours and plays a crucial role in how normal and cancer tissues respond to radiotherapy. Lining the inner surface of vessels, the endothelium acts as a barrier that normally prevents the passage of cells from the bloodstream into tissues and promotes the recruitment of immune cells during stressful, injured, or infected conditions. Profound changes in endothelial function occur in response to irradiation, determining the tumour response to radiotherapy and participating in the initiation and development of adverse effects. In both normal tissues and tumours, radiation makes endothelial cells more adhesive to circulating cells, stimulates transendothelial migration and promotes immune infiltration, possibly chronic and harmful to normal tissues. Considering the active role of endothelium in immune cell recruitment, targeting endothelial cells becomes an attractive strategy to improve the therapeutic gain of radiotherapy. To this end, it is crucial to better understand how endothelial cells respond to irradiation in vivo and to determine their role in regulating immune cell recruitment. Advanced analytical technologies, such as single-cell RNA sequencing and spatial transcriptomics, now enable to uncover the molecular responses of cells in living organisms and comprehend their interactions within an organ. Here, we present the latest findings regarding the impact of radiation on the vascular endothelium and its implications for normal tissues and tumours. We also explore current research using single-cell analysis to uncover new cell types, molecular pathways, and cell-cell interactions in irradiated animal models and human patients. Additionally, we highlight how endothelial cell-mediated immune recruitment may represent a potential target for modulating the immune response.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1176-1187"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149505","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":"Phenotyping pulmonary sarcoidosis.","authors":"Hiba Abbas, Maria Kokosi, Nishanth Sivarasan","doi":"10.1093/bjr/tqaf118","DOIUrl":"10.1093/bjr/tqaf118","url":null,"abstract":"<p><p>Pulmonary sarcoidosis, although generally associated with a good prognosis, remains challenging to manage in view of its unpredictable disease behaviour and outcome. Being able to phenotype patients with sarcoidosis could potentially facilitate treatment decisions and promote research anchored to disease behaviour and outcome. Efforts to phenotype sarcoidosis using imaging date back to the early 1900s when chest X-rays were the main modality for lung parenchymal evaluation. However, despite significant advances in technology, there is currently no consensus on how we should classify this disease utilizing more modern imaging techniques. In this review, we provide an overview of imaging phenotypes in sarcoidosis, discuss the challenges of disease classification, evaluate associations between imaging appearance and outcome, and explore new developments in this field.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1188-1196"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172720","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":"Imaging of cancer of unknown primary: a systematic literature review of the past, present, and future.","authors":"Sajjad Rostami, Hannah W Stutterheim, Olga Maxouri, Jeroen R J Willemse, Diana Ivonne Rodríguez Sánchez, Winnie Schats, Larissa W van Golen, Marieke A Vollebergh, Zing Cheung, Wouter V Vogel, Serena Marchetti, Petur Snaebjornsson, Max J Lahaye, Doenja M J Lambregts, Zuhir Bodalal, Regina G H Beets-Tan","doi":"10.1093/bjr/tqaf039","DOIUrl":"10.1093/bjr/tqaf039","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the evolution and current diagnostic capabilities of medical imaging in cancer of unknown primary (CUP) and explore promising technologies for enhancing diagnostic precision.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across MEDLINE, Embase, and Scopus in March 2023 (updated in August 2024) to identify original articles focusing on CUP imaging. Two reviewers independently selected articles and extracted data. Quality assessment was performed using QUADAS-2 and Radiomics Quality Score. Given the variability in study designs, imaging techniques, and reported outcomes, a narrative synthesis was performed. Subgroup analyses compared detection rates across modalities.</p><p><strong>Results: </strong>From 4760 de-duplicated search results, 140 original articles were included. Early CUP imaging relied on 2D modalities with notable diagnostic limitations. Modern 3D modalities have risen in prominence, though mammography and ultrasound remain in CUP guidelines. Implementing CT and MRI significantly improved primary tumour detection and disease characterization. CT is fundamental for CUP evaluation, and MRI offers superior soft tissue resolution, effective for detecting occult breast cancer, head and neck primaries, and suspected abdominopelvic neoplasms. FDG-PET/CT showed varying primary detection capabilities, adding value in identifying lesions/metastases missed by other modalities, essential for confirming locoregional treatment strategies. Emerging technologies for CUP imaging include whole-body MRI, FAPI-PET/CT, and AI/radiomics.</p><p><strong>Conclusions: </strong>Advancements in imaging have improved the diagnostic workup for CUP. Innovative approaches show potential for further improvement in diagnostic accuracy.</p><p><strong>Advances in knowledge: </strong>This study provides a comprehensive overview of CUP imaging and introduces emerging modalities that could boost diagnostic accuracy.</p><p><strong>Prospero registration: </strong>CRD42023453393.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1209-1226"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of aneurysms treated with endovascular devices (The SEATED Study).","authors":"Ahmed R Bassiouny, Anand Sastry, Alex Mortimer, Jeremy Lynch, Hemant Sonwalkar, Aaron Bleakley, Ahmed Iqbal, Ana Paula Narata, Tufail Patankar, Islim Fathallah, Naga Kandasamy, Parthiban Balasundaram, Sara Sciacca, Juveria Siddiqui, Thomas C Booth","doi":"10.1093/bjr/tqaf094","DOIUrl":"10.1093/bjr/tqaf094","url":null,"abstract":"<p><strong>Objectives: </strong>To create a nationwide consortium to gather all the data related to advanced devices used for aneurysm treatment and conduct pragmatic real-world studies despite the variations among all centres. The strength of this study will be in pooling data of the less commonly used recent devices where there is less evidence. The study will be prospective and retrospective where the initial recruitment figure is expected to be around 5000 patients.</p><p><strong>Methods: </strong>To assess how endovascular techniques vary among different UK centres, we illustrate the results of initial surveys that were sent to those centres across the United Kingdom using a single device, the pipeline embolization device with vantage technology (PEDV).</p><p><strong>Results: </strong>Although the centres were using the same device, the antiplatelet protocol varied from one centre to another as well as follow-up protocols according to the local experience, patient clinical status or even according to the adjuncts uses (e.g., adjunct coiling).</p><p><strong>Conclusions: </strong>The illustrated results show that although the centres were using the same device, the antiplatelet protocol varied from one centre to another. Also, follow-up protocols vary from one centre to another according to the local experience, patient clinical status or even according to the adjuncts used (e.g., adjunct coiling). This exemplar serves to illustrate that a nationwide consortium can pool and analyse data of any recent endovascular device.</p><p><strong>Advances in knowledge: </strong>Obtaining nationwide data regarding safety, efficacy as well as risk factors for aneurysm recurrence when using recent devices. This study will add valuable data regarding the less commonly used recent devices where there is less evidence.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1227-1232"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging biomarkers of post-acute sequelae of Coronavirus Disease 2019.","authors":"Swati Rane Levendovszky, Payal Patel, Chengcheng Zhu, Aaron M Rutman, Mahmud Mossa Basha","doi":"10.1093/bjr/tqaf090","DOIUrl":"10.1093/bjr/tqaf090","url":null,"abstract":"<p><p>COVID-19, caused by SARS-CoV-2, has led to the condition known as Long COVID or post-acute sequelae of COVID-19 (PASC), where individuals experience persistent debilitating symptoms long after the initial infection. We provide here a comprehensive review of findings in the central nervous system associated with PASC. Neuroimaging has been instrumental in identifying brain changes associated with PASC. Structural MRI studies consistently reveal grey matter volume reductions in the frontal and temporal lobes and white matter hyperintensities, particularly in the periventricular regions. Studies especially found these changes to correlate strongly with cognitive deficits. Diffusion tensor imaging has shown increased tissue damage and oedema in the brain's white matter tracts, particularly in the sagittal stratum and thalamic radiation. Resting-state functional MRI studies indicate altered brain connectivity in PASC patients, especially in those with post-traumatic stress symptoms. Reduced connectivity within and between critical networks, such as the default mode network and the executive control network, has been observed. These changes correlate with cognitive impairments, such as attention and memory deficits. Dynamic functional connectivity analyses further reveal that PASC patients spend less time in states with rich inter-regional connectivity, and transitions between connectivity states were linked to post-traumatic stress disorder symptoms. Positron emission tomography scans have shown hypometabolism in the frontal and temporal lobes, particularly in regions associated with memory and executive functions. Hypometabolism in the hippocampus and thalamus is linked to symptoms like anosmia and fatigue. Despite the heterogeneity in clinical presentations and diagnostic criteria, these neuroimaging findings underscore the significant impact of COVID-19 on brain structure and function. Continued research using advanced imaging techniques is essential for a deeper understanding of PASC's neurological effects. This will aid in developing targeted interventions and improving outcomes for those affected by Long COVID and inform studies investigating downstream effects of viral infections on the brain.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1165-1175"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977771","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":"Repeated ultraselective transcatheter arterial chemoembolization for hepatocellular carcinoma with portal vein thrombus.","authors":"Akira Yamamoto, Ken Kageyama, Atsushi Jogo, Etsuji Sohgawa, Ryuichi Kita, Sawako Uchida-Kobayashi, Shigekazu Takemura, Akihiro Tamori, Toshio Kaminou, Yukio Miki","doi":"10.1093/bjr/tqaf112","DOIUrl":"10.1093/bjr/tqaf112","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the safety and long-term effectiveness of repeated ultraselective transarterial chemoembolization (rusTACE) using a 1.7-Fr-tip microcatheter in hepatocellular carcinoma (HCC) patients with portal vein tumour thrombus (PVTT).</p><p><strong>Methods: </strong>This retrospective analysis includes HCC patients with PVTT treated with rusTACE between May 2014 and July 2022. A 1.7-Fr-tip microcatheter was used to perform rusTACE for ultraselective embolization of the tumour-feeding artery. Treatment was repeated at least 2 times within 2 months. Treatment responses, survival rates, adverse event, liver function, and tumour-feeding arteries were assessed.</p><p><strong>Results: </strong>Twenty patients underwent rusTACE with a mean interval of 42 days between treatments. RusTACE was well-tolerated. Median survival time was 26.1 months, with 1-, 2-, 3-, and 5-year survival rates of 85.0%, 61.0%, 40.9%, and 24.6%, respectively. Complete response (CR) of PVTT was achieved in 75%. Among these, 35% maintained CR of PVTT throughout follow-up (mean, 25.0 months). Univariate analysis showed prognostic factors included Child-Pugh score 5, CR of PVTT, CR of systemic tumours at the end of rusTACE, and liver tumour burden <30%. In 17%, a peribiliary vascular plexus or communicating artery was identified as the tumour-feeding artery.</p><p><strong>Conclusions: </strong>RusTACE is a safe and effective treatment option for HCC with PVTT in selected patients (Child-Pugh class A). RusTACE showed a high CR rate and long overall survival. The short interval between treatments and ultraselective embolization of tumour-feeding arteries contributed to favourable outcomes.</p><p><strong>Advances in knowledge: </strong>RusTACE can be safely performed in HCC with PVTT and has a high local control rate.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1290-1297"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149532","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}