British Journal of Radiology最新文献

{"title":"Nuclear medicine in the operating room: present and future.","authors":"Renato A Valdés Olmos, Angela Collarino, Daphne D D Rietbergen, Giusi Pisano, Lenka Pereira Arias-Bouda, Francesco Giammarile, Sergi Vidal-Sicart","doi":"10.1093/bjr/tqag073","DOIUrl":"https://doi.org/10.1093/bjr/tqag073","url":null,"abstract":"<p><p>The current role of nuclear medicine in the operating room is closely related to the enhancement of the sentinel node (SN) procedure developed more than three decades ago. At that moment, the so-called triple approach (lymphoscintigraphy, gamma probe detection and blue dye) was established as the standard of care for SN biopsy in melanoma and breast cancer. It also marked a first international multidisciplinary learning effort based on skill transfer and outcome evaluation, laying the fundaments to delineate the emerging field of interventional nuclear medicine (iNM) thanks to a similar multimodality approach and multidisciplinary practice. Currently, imaging modalities like SPECT/CT and PET/CT allow to preoperatively generate precision roadmaps for navigation in the operating room. The combination of modern technologies has facilitated iNM incorporation for surgery in more complex anatomical areas. The SN procedure has been expanded to different gynaecological and urological malignancies as well as head and neck and gastrointestinal cancers. Besides iNM for open surgery, it is also possible to guide robot-assisted laparoscopic procedures for both SN biopsy and resection of oligometastases. The increasing development of hybrid tracers for combined radioguidance and fluorescence will reinforce the role of iNM in the future.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590276","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":"Evaluating liver fibrosis in chronic hepatitis B patients using multi-compartment restriction spectrum imaging.","authors":"Jing Zhang, Zhiyang Lu, Kaifan Yang, Yiyuan Zhu, Hongxiang Li, Yikai Xu","doi":"10.1093/bjr/tqag072","DOIUrl":"https://doi.org/10.1093/bjr/tqag072","url":null,"abstract":"<p><strong>Objectives: </strong>To optimize multi-compartment restriction spectrum imaging (RSI) models and validate their diagnostic performance for non-invasive staging of liver fibrosis in chronic hepatitis B (CHB), compared to conventional apparent diffusion coefficient (ADC).</p><p><strong>Methods: </strong>This prospective study enrolled 80 CHB patients and 19 healthy controls (METAVIR F0-F4). All underwent 3.0 T MRI with multi-shell diffusion-weighted imaging (b = 0-2000 s/mm2). Four RSI models (2-5 compartments) were fitted; the optimal model was selected using Bayesian Information Criterion (ΔBIC). Conventional ADC and RSI compartmental fractions were compared across fibrosis stages. Diagnostic performance was assessed via ROC analysis.</p><p><strong>Results: </strong>The 4-compartment RSI model demonstrated the lowest ΔBIC. Compartment C4 (fast pseudo-diffusion fraction) decreased significantly with fibrosis (P = 0.004), showing a stronger inverse correlation with fibrosis stage than ADC (r = -0.493 vs. -0.324, P < 0.001). For distinguishing F0-F2 vs. F3-F4, C4 achieved: Higher AUC than ADC (0.774 [95% CI: 0.679-0.852] vs. 0.654 [0.552-0.747]; P = 0.033); Superior specificity (75.0% vs. 44.6%) For F0-F1 vs. F2-F4, C4's AUC was 0.814 vs. ADC's 0.686 (P = 0.020).</p><p><strong>Conclusion: </strong>The 4-compartment RSI model is a promising non-invasive tool for liver fibrosis staging. By resolving distinct diffusion and perfusion compartments, RSI overcomes key limitations of conventional DWI, with the C4 fraction (thought to reflect perfusion decline) serving as a sensitive biomarker for fibrosis progression and outperforming ADC in staging accuracy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580612","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":"Transformer-based super-resolution lung CT images improve visualization of multiple diseases.","authors":"Qingyao Li, Min Xu, Yaping Zhang, Lu Zhang, Lingyun Wang, Zhijie Pan, Xue Qian Xie","doi":"10.1093/bjr/tqag069","DOIUrl":"https://doi.org/10.1093/bjr/tqag069","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the Transformer-based Swin2SR model for super-resolution (SR) enhancement of lung CT images and its clinical potential.</p><p><strong>Methods: </strong>Chest CT scans from 303 patients at three hospitals were retrospectively included. Standard 512-matrix images were enhanced to 1024- and 2048-matrix versions (SR-1024, SR-2048). Image noise and signal-to-noise ratio (SNR) for lung tissue, muscle, and background air were quantified. A panel of radiologists rated overall image quality and lesion visibility using a 5-point Likert scale in a multi-reader, multi-case (MRMC)​ analysis.</p><p><strong>Results: </strong>A total of 303 patients (age 67 [interquartile range: 59-75] years, 184 males [60.7%]) were included, diagnosed with 13 major lung diseases. Quantitative analysis showed no significant differences in image noise and SNR among the three image types for lung tissue, muscle tissue, and background air (all p > 0.05). SR-1024 and SR-2048 images showed substantial improvements in overall image quality, with 84.5% and 85.1% of patients showing improvements, respectively. SR processing significantly enhanced lesion visibility and image quality for bacterial pneumonia, bronchitis, solid nodules, atelectasis, bronchiectasis, and lung cancer compared to the standard 512-matrix images (all p < 0.05).</p><p><strong>Conclusions: </strong>The Swin2SR model, particularly when generating 2048-matrix images, significantly enhances radiologists' subjective ratings of image quality and lesion visibility in lung CT imaging, providing clear benefits for visualizing lung diseases.</p><p><strong>Advancements in knowledge: </strong>This study demonstrates that the Swin2SR model significantly improves radiologists' subjective ratings of image quality and lesion visibility in lung CT images, and highlights the potential of deep learning in enhancing medical image interpretation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580634","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":"Artificial Intelligence prognostication of liver disease using imaging.","authors":"Manil D Chouhan, Kate McLean, James A Thomas, Jason Dowling","doi":"10.1093/bjr/tqag070","DOIUrl":"https://doi.org/10.1093/bjr/tqag070","url":null,"abstract":"<p><p>Accurate prognostic tools in patients with chronic liver disease (CLD) have the potential to improve clinical outcomes and reduce health care costs. Imaging studies of CLD patients analysed using artificial intelligence (AI) algorithms for segmentation, detection and classification tasks have the potential to inform and improve prognostic models for liver-related outcomes. In this narrative review, we provide an overview of the strengths, weaknesses and approaches to inclusion of AI in prognostic models that use ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). We then use a prognostic endpoint-based approach to examine AI-based US, CT and MRI prognostic models in chronic liver disease (CLD). We highlight how AI has been applied to extract imaging features or build predictive models directly, and assess the limitations that currently hinder clinical translation. We also outline key challenges specific to prognostication in CLD and propose directions for future research.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580669","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":"Evaluation of Patient Setup Accuracy using Optical Surface Guidance in Postoperative Radiotherapy for Patients with Breast Cancer after Breast-Conserving Surgery.","authors":"Bao Wan, Jiangtao Han, Yongtai Zheng, Chao Liu, Shuo Sun, Yu Zhao, Fukui Huan, Tantan Li","doi":"10.1093/bjr/tqag058","DOIUrl":"https://doi.org/10.1093/bjr/tqag058","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical application of AlignRT surface-guided radiotherapy (SGRT) by quantifying interfractional setup errors in patients with breast-conserving surgery (BCS) stratified by the surgical side and use of thermoplastic immobilization masks.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 125 patients with BCS treated at our center between January 2021 and June 2025. Patients were grouped by the surgical side (left/right) and immobilization method (with/without thermoplastic mask). After SGRT setup, cone-beam computed tomography (CBCT) was acquired for each fraction. Systematic and random errors were analyzed and three-dimensional planning target volume (PTV) margins were calculated.</p><p><strong>Results: </strong>In total, 868 CBCT scans were obtained. With immobilization masks, left-sided patients exhibited significantly different setup errors from right-sided patients in the X (0.04 ± 0.25 cm vs -0.05 ± 0.30 cm, p < 0.001) and Y (-0.09 ± 0.26 cm vs 0.02 ± 0.30 cm, p < 0.001) directions. Without immobilization masks, differences persisted in X (-0.05 ± 0.22 cm vs 0.01 ± 0.27 cm, p = 0.017) and Y (0.03 ± 0.23 cm vs 0.08 ± 0.27 cm, p = 0.039). Irrespective of the side, mask use significantly affected the errors in all three directions (all p < 0.05). The required PTV margins (cm) were: left BCS with mask (0.51, 0.51, 0.54), and without mask (0.47, 0.49, 0.57); right BCS with mask (0.64, 0.63, 0.55), and without mask (0.59, 0.62, 0.53).</p><p><strong>Conclusion: </strong>In SGRT-based workflows for patients with BCS, omitting the thermoplastic mask improves setup reproducibility. Right-sided BCS cases require larger margins than left-sided cases.</p><p><strong>Advances in knowledge: </strong>This study provides clinical recommendations for patient positioning and immobilization techniques in whole-breast radiotherapy following breast-conserving surgery.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572529","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":"Improved Visualization of the Middle Glenohumeral Ligament of the Shoulder with Internal Rotation in Axial MR Arthrography: A Comparative Positional Analysis.","authors":"Zakir Sakci, Yusuf Yahsi, Hayri Ogul, Mutlu Ay, Safiye Sanem Dereli Bulut, Mecit Kantarci","doi":"10.1093/bjr/tqag065","DOIUrl":"https://doi.org/10.1093/bjr/tqag065","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates the contribution of rotational maneuvers of the shoulder joint to the MR arthrographic visualization of the middle glenohumeral ligament (MGHL).</p><p><strong>Methods: </strong>In this prospective study, 181 MR arthrography examinations referred to our clinic between May 2019 and January 2024 were evaluated for the MGHL. In addition to conventional MR arthrography sequences, axial MR arthrography images were obtained in internal rotation, external rotation, and neutral positions of the shoulder to demonstrate the MGHL. The arthrographic images obtained on a 3 T MR scanner were analyzed by a radiologist with 20 years of experience in musculoskeletal radiology. In each position, the subjective visibility of the MGHL was assessed in five categories: none, poor, fair, good, and excellent. The number of slices in which the MGHL could be visualized in each position was also recorded. The detectability of the MGHL in each position was then statistically compared.</p><p><strong>Results: </strong>Of the 181 shoulder MR arthrograms evaluated in this study, 37 were excluded for various reasons. The mean age of the 144 patients included was 38.51 ± 13.83 years (range = 18-76); 96 were male and 48 were female. In 29 of the 144 MR arthrograms (21.1%), different anomalies of the MGHL were detected. Among 134 patients with MGHL, partial- or full-thickness ruptures were found in 36 (26.9%). In axial MR arthrography, the MGHL was best visualized in the internal rotation position. In addition, axial MR arthrography slices obtained in internal rotation allowed visualization of the MGHL in a greater number of sections.</p><p><strong>Conclusions: </strong>The middle glenohumeral ligament is one of the important passive stabilizers of the shoulder joint. Optimal MR arthrographic imaging of pathologies and abnormalities of MGHL is critical for surgical planning. Our MR arthrographic series demonstrated that axial images obtained in internal rotation are more useful for visualizing the MGHL compared to neutral and external rotation.</p><p><strong>Advances in knowledge: </strong>The middle glenohumeral ligament (MGHL) is an important passive stabilizer of the shoulder joint. Accurate identification of this ligament is crucial because its variations can mimic certain pathologies. Particularly, axial MR arthrography images are highly effective for evaluating MGHL pathologies and variations. Axial MR arthrography images obtained in internal rotation allow clearer evaluation of the MGHL compared to neutral and external rotation images.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572639","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":"Nuclear medicine imaging to guide antibiotic therapy: an expert review.","authors":"Domenico Albano, Chiara Lauri, Alberto Signore, Giorgio Treglia","doi":"10.1093/bjr/tqag068","DOIUrl":"https://doi.org/10.1093/bjr/tqag068","url":null,"abstract":"<p><p>Bacterial infections and multidrug resistance remain a major global threat. New clinical tools are, therefore, urgently needed to identify bacterial infections and monitor response to antibiotics. Nuclear medicine imaging affords unique opportunities to target and identify bacterial infections, enabling spatial characterization as well as noninvasive, temporal monitoring of the natural course of the disease and response to therapy. In this expert review, we present an overview of the role of [18F]-FDG PET/CT and WBC scintigraphy +/-SPECT/CT in predicting treatment response to antibiotics and guide their interruption. A decrease in the [18F]FDG uptake or a change of uptake patterns could be potentially used to assess the results of antibiotic therapy in patients with different infectious diseases, despite robust evidence lacking. Concerning WBC scan, their high specificity to target and accumulation over time in infected areas is crucial for the differential diagnosis between infections and sterile inflammation, thus being useful also for therapy follow-up. However, specificity can be reduced in patients with ongoing antibiotics and little is known about the best time window to perform scintigraphy. Finally, we analyzed the potential usefulness of most promising radiolabelled bacterial tracers as potential alternative to FDG and WBC for therapy follow-up.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520171","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":"FLASH radiotherapy enables dose escalation and improves survival in an orthotopic muscle-invasive bladder cancer mouse model.","authors":"Jia-Ling Ruan, Carl Lee, Osheen Sharma, Nathalie Lövgren, Salomé Paillas, Christian Cooper, Iain D C Tullis, Amato J Giaccia, Anne E Kiltie, Kristoffer Petersson","doi":"10.1093/bjr/tqag071","DOIUrl":"https://doi.org/10.1093/bjr/tqag071","url":null,"abstract":"<p><strong>Objectives: </strong>FLASH radiotherapy is an innovative technique that delivers radiation at ultra-high dose rates (UHDR), offering tumour control comparable to conventional (CONV) radiotherapy while significantly reducing normal tissue toxicity. Here we aim to determine the effects of FLASH compared to CONV radiotherapy in muscle-invasive bladder cancer (MIBC) models.</p><p><strong>Methods: </strong>Using an in-house 6 MeV linear accelerator able to deliver electron beam at UHDR or CONV dose rate, we employed clonogenic survival assays, RNA sequencing (RNA-seq), and in vivo tumour growth analyses using MBT2 cells and C3H MIBC models. Both subcutaneous and orthotopic tumour models were used to assess tumour response, survival and treatment-related toxicity as demonstrated by weight loss.</p><p><strong>Results: </strong>Clonogenic analysis demonstrated comparable cancer cell survival between FLASH and CONV irradiation in vitro. RNA-seq analysis of in vitro irradiated cells revealed similar gene expression at 5 Gy but significant transcriptional divergence at 10 Gy. Intestinal organoids exhibited preserved growth after FLASH compared with CONV irradiation, consistent with a normal tissue sparing effect. In subcutaneous models, FLASH and CONV radiotherapy exhibited similar tumour responses. However, in the orthotopic model, FLASH radiotherapy enabled dose escalation, significantly extending survival at 15 Gy (p = 0.02) and 17.5 Gy (p = 0.004). Dose rate (100 vs 106 Gy/s) did not significantly affect survival. The benefit of single-fraction FLASH was not retained with fractionated (3 × 7.3 Gy) delivery.</p><p><strong>Conclusion: </strong>FLASH radiotherapy demonstrates significant potential for treating MIBC, offering enhanced survival through effective dose escalation. These findings support continued investigation into optimal FLASH parameters and its clinical application.</p><p><strong>Advances in knowledge: </strong></p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520128","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":"Towards optimised CT lung cancer screening scan protocols.","authors":"Gareth R Iball, Charlotte A Porter","doi":"10.1093/bjr/tqag066","DOIUrl":"https://doi.org/10.1093/bjr/tqag066","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate radiation dose and image quality for CT lung cancer screening protocols and to determine which reconstruction kernels deliver accurate nodule volumetry.</p><p><strong>Methods: </strong>A variable size anthropomorphic chest phantom and a lung screening image quality phantom were scanned on 17 different scanner models. Dose metrics from the chest phantom scans were compared against international dose recommendations.Image quality phantom scans were used to assess whether the protocol yielded accurate nodule volumetry as per the Quantitative Imaging Biomarkers Alliance (QIBA) criteria, and to determine whether changes were needed to enable this.</p><p><strong>Results: </strong>Doses varied by up to a factor of seven for the largest phantom size. All protocols delivered doses below the UK standards but only two scanners met the European dose criteria. Many scanners failed to meet the QIBA criteria with lung reconstruction kernels, primarily due to excessive edge enhancement and insufficient 3-dimensional spatial resolution. With alternative reconstruction kernels, the QIBA criteria were met on all bar two scanners.</p><p><strong>Conclusions: </strong>Standard lung screening CT protocols on contemporary scanners produce images of varying image quality, over a wide range of radiation doses. Scanner-specific reconstruction kernel selection is required to meet the QIBA criteria. The study findings enable the development of optimised CT scanning protocols for lung cancer screening programmes.</p><p><strong>Advances in knowledge: </strong>Standard lung cancer screening scanning protocols demonstrate notable variations in dose. Lung reconstruction kernels often yield inaccurate measurements of nodule volume; instead, soft tissue kernels are necessary to obtain reliable results.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509759","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":"Clinicopathological and imaging features of pediatric adrenocortical carcinoma: compared with non-carcinoma.","authors":"Peian Hu, Lei Chen, Zhengrong Zhou","doi":"10.1093/bjr/tqag067","DOIUrl":"https://doi.org/10.1093/bjr/tqag067","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the differences in clinicopathological and imaging features between pediatric adrenocortical carcinoma (ACC) and non-carcinoma.</p><p><strong>Methods: </strong>The clinicopathological and imaging (CT/MR) findings of thirty-two children with pathologically proven adrenocortical tumors (ACT) (10 adenomas, 10 with uncertain malignant potential, and 12 carcinomas) were reviewed and compared retrospectively. Multivariate logistic regression was used further to explore the independent predictive factors for ACC and non-carcinoma.</p><p><strong>Results: </strong>The median age of children with ACC was 3 years old, with an IQR (interquartile range) of 1.813-4.375 years old. ACC was larger and more likely to be accompanied by extensive internal necrosis, calcification, and distant metastasis. ACC commonly showed a spoke-wheel enhanced pattern and peripheral fibrous septa with small blood-feeding arteries. There were significant statistical differences among these three groups in the maximum value of unenhanced CT, the maximum and skewness value in the venous phase, the minimum ADC value, and Ki-67 labeling index (p = 0.02, 0.003, 0.022, 0.002, and 0.000). The fibrous septa with small blood-feeding arteries and Ki-67 labeling index were independent predictive factors for the prediction of ACC and non-carcinoma, with p values and OR values of 0.038 and 15.62, and 0.011 and 1.16. And the AUC, the accuracy, the sensitivity, and specificity were 0.962 (95% CI: 0.828-0.998), 90.62%, 100%, and 85%, respectively.</p><p><strong>Conclusions: </strong>Pediatric ACC was larger and was commonly accompanied by extensive internal necrosis, calcification, and distant metastasis. Fibrous septa with small blood-feeding arteries and the Ki-67 labeling index were independent predictors of ACC.</p><p><strong>Advances in knowledge: </strong>Pediatric ACC showed a spoke-wheel enhanced pattern and peripheral fibrous septa with small blood-feeding arteries. The fibrous septa with small blood-feeding arteries and Ki-67 labeling index were independent predictive factors for the differentiation of ACC and non-carcinoma.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520204","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}