Current problems in diagnostic radiology最新文献

{"title":"Aspiration of wrist ganglion cysts: a scoping review of aspiration alone versus aspiration with intralesional corticosteroid injection and implications for contemporary ultrasound-guided practice.","authors":"Faisal Ahmadi, Syed Husain, Batou Ahmed Belhadj, Masehullah Sadiqi, Douglas Gordon, Dimitri Amiras","doi":"10.1067/j.cpradiol.2026.10.006","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.10.006","url":null,"abstract":"<p><strong>Objectives: </strong>To map the extent, nature and quality of the available comparative literature evaluating aspiration alone versus aspiration with intralesional corticosteroid injection for wrist ganglion cysts, and to identify evidence gaps relevant to contemporary ultrasound-guided practice. Given the anticipated scarcity of comparative studies, the review aimed to characterise the evidence base rather than determine treatment superiority.</p><p><strong>Materials and methods: </strong>Given the anticipated scarcity and heterogeneity of comparative studies, a scoping review was conducted in accordance with the PRISMA-ScR framework. Embase, PubMed and Google Scholar were searched from inception, with additional studies identified through citation tracking. Comparative studies involving adults with wrist ganglion cysts managed by aspiration alone or aspiration combined with corticosteroid injection, with or without image guidance, were included. Studies comparing aspiration-based treatments with surgical excision were included for contextual mapping only. Two published systematic reviews were used exclusively as secondary contextual evidence. No meta-analysis was performed.</p><p><strong>Results: </strong>Database searches identified 335 records, with one additional record identified from other sources. After duplicate removal, 219 records were screened; 35 full-text articles were assessed; and 10 studies were included. Only two studies directly compared aspiration alone with aspiration plus corticosteroid injection. These studies reported conflicting findings regarding recurrence and were insufficient to permit definitive conclusions regarding the effect of adjunct corticosteroid injection. Contextual comparative studies consistently reported higher recurrence rates following aspiration-based treatments compared with surgical excision. Evidence derived from radiology-led or ultrasound-guided practice was limited.</p><p><strong>Conclusion: </strong>The evidence directly comparing aspiration alone with aspiration plus intralesional corticosteroid injection for wrist ganglion cysts is sparse, dated, and methodologically heterogeneous. The available direct comparative evidence is insufficient to determine whether adjunct corticosteroid injection reduces recurrence following wrist ganglion aspiration. The principal finding of this review is the scarcity of high-quality comparative studies, particularly within contemporary ultrasound-guided practice. This evidence gap supports the need for adequately powered prospective comparative studies before robust treatment recommendations can be made.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI assisted development of interactive multimedia modules for resident self-directed learning.","authors":"Sameed Khan, Charit Tippareddy, Navid Faraji","doi":"10.1067/j.cpradiol.2026.10.003","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.10.003","url":null,"abstract":"<p><p>Traditional digital supplements for resident self-directed learning, such as PowerPoint slides and recorded lectures, are primarily passive and may have lower effectiveness due to limitations of the communication medium. Interactive multimedia modules incorporating text explanations, dynamic interactive diagrams, and interspersed assessments represent stronger candidates for supplementing resident self-directed instruction alongside traditional avenues of teaching. Creating interactive modules requires a high time commitment and relevant technical expertise, however, AI assistants such as Claude and ChatGPT can enable radiology educators to produce comprehensive, aesthetic, and well-crafted educational modules. This article provides guidance for educators on how to use AI assistants to create effective and accurate interactive multimedia modules. Using an example of a module for hip arthrocentesis, the article walks through a pedagogy-first workflow from learning objective to finished artifact.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Predominantly Middle Authors in Radiology: A Bibliometric Assessment\". [Current Problems in Diagnostic Radiology September 2026; 55(5):671-676.].","authors":"Caline Azzi, Mahla Radmard, David M Yousem","doi":"10.1067/j.cpradiol.2026.09.012","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.09.012","url":null,"abstract":"","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of thoracic interventional radiologists in the management of chest infections: a pictorial review.","authors":"Luis Gorospe, Ana María Ayala-Carbonero, Miguel Ángel Gómez-Bermejo, Marta González-Sanz, Paola Arrieta, Gemma María Muñoz-Molina, Elia Gómez-García de la Pedrosa, Jesús Fortún-Abete","doi":"10.1067/j.cpradiol.2026.10.005","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.10.005","url":null,"abstract":"<p><p>Thoracic infections remain a major cause of morbidity and mortality worldwide, requiring accurate and timely diagnosis to guide appropriate treatment. This pictorial review illustrates the role of the interventional thoracic radiologist in the management of infectious processes involving the lung, pleura, mediastinum, and chest wall. We describe a range of non-vascular image-guided percutaneous diagnostic and therapeutic techniques. These include targeted sampling for microbiological identification in complicated pneumonias and cavitary lesions, as well as image-guided drainage of pulmonary, pleural, mediastinal, and thoracic wall infectious collections. The advantages of these minimally invasive percutaneous techniques, especially in peripheral/subpleural lung lesions, are highlighted. In addition, we present practical technical considerations and diagnostic \"tips and tricks,\" aimed at improving diagnostic yield. By integrating imaging findings with interventional strategies, this review underscores the growing clinical impact of interventional radiology in thoracic infections.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing pediatric radiology workflow amidst workforce shortages: A single-center experience reducing off-hours fluoroscopy.","authors":"Laith E Abandeh, Usman Nabi, Ramesh S Iyer, H Nelson Conley Iv, Helen Hye Ryong Kim","doi":"10.1067/j.cpradiol.2026.10.004","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.10.004","url":null,"abstract":"<p><p>Pediatric radiology is facing an escalating workforce crisis, fueled primarily by a constrained fellowship pipeline and rising imaging volumes. This imbalance has created difficulty providing and maintaining off-hours fluoroscopic services, which require on-site radiologist presence. The resulting burden on the existing labor force exacerbates burnout, challenges radiologist retention and recruitment, and risks undermining the long-term sustainability of pediatric radiology practice. There is a shared imperative to seek alternative, creative strategies to alleviate these issues while achieving comparable diagnostic performance and maintaining credibility and trust with our referring providers. This Learning From Experience article outlines a practical, protocol-based approach to reducing fluoroscopy dependence through alternative imaging modalities while maintaining diagnostic accuracy and patient safety. These include midgut ultrasound as the first-line imaging modality for bilious emesis workup, low-dose CT of the esophagus for impacted esophageal foreign bodies instead of fluoroscopic esophagram, and technologist-performed contrast studies for percutaneous feeding tubes to reduce on-site radiologist-performed fluoroscopy. In addition, an advanced practice provider-supported fluoroscopy model is discussed to improve resource utilization. Lastly, potential delay of intussusception reductions overnight is discussed as a future direction that has not been implemented. Following implementation of the three examination-specific pathways at our institution, off-hours fluoroscopy utilization decreased by 64%, from approximately three to one examination per week; much of the remaining off-hours fluoroscopy volume involved intussusception reduction. In our experience, these alternative imaging pathways and systematic changes can meaningfully reduce after-hours procedural burden while maintaining diagnostic quality and patient safety.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical MRI interpretation of intracranial metastases before and after multidisciplinary management: a pictorial review.","authors":"Brian H Mu, Shehbaz M Ansari, Miral D Jhaveri, Surjith Vattoth, Ken Tatebe, Santhosh Gaddikeri","doi":"10.1067/j.cpradiol.2026.10.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.10.002","url":null,"abstract":"<p><p>Intracranial metastases represent the most common form of brain tumors in adults. Their diagnosis and post-treatment evaluation are routine tasks in neuroradiology. In this setting, radiologists collaborate with neuro-oncologists, neurosurgeons, radiation oncologists, and other specialists to guide multidisciplinary treatment strategies and assess their response. A well-appointed radiologist should therefore be familiar with current treatment paradigms and their respective manifestations on imaging. This pictorial review begins by reviewing imaging findings of intracranial metastases, emphasizing features germane to management decision-making. Major treatment modalities including radiation, systemic, and surgical approaches, are discussed. The focus of this article is then post-treatment imaging appearance of intracranial metastases, and the major complications associated with each treatment modality are surveyed. Additionally, applications of advanced imaging techniques to differentiate residual or recurrent metastatic disease from treatment-related changes are explored.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presacral cystic lesions: Multimodality imaging features and diagnostic approach.","authors":"Zuhair Sadiq, Caroline Merriam, Sowmya Mahalingam","doi":"10.1067/j.cpradiol.2026.10.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.10.001","url":null,"abstract":"<p><p>The presacral space is an uncommon but clinically important location for congenital and neurogenic lesions, most of which are cystic or cystic-appearing on imaging. These lesions are frequently detected incidentally, and their overlapping computed tomography (CT) appearances often necessitate magnetic resonance imaging (MRI) for accurate characterization. This pictorial review presents a multimodality imaging approach to the spectrum of presacral cystic lesions, including tailgut cysts, epidermoid and dermoid cysts, rectal duplication cysts, anterior sacral meningoceles, and lymphangiomas, as well as cystic-appearing neurogenic tumors such as schwannoma and neurofibroma. Representative CT and MRI cases illustrate the imaging features that most reliably narrow the differential diagnosis, including macroscopic fat, diffusion restriction, a sacral defect with thecal sac communication, and the lesion's relationship to the rectum and adjacent fascial planes. A practical, stepwise diagnostic algorithm and a summary table incorporating these discriminators are provided to guide the practicing radiologist. Additional sections address common diagnostic pitfalls and mimics (e.g., tailgut cyst versus endometrioma, epidermoid cyst, or cystic schwannoma), imaging findings that should raise concern for infection or malignant transformation. Management considerations - including indications for surgical resection, imaging surveillance, and the role of multidisciplinary evaluation for atypical or indeterminate lesions - are also discussed. Familiarity with this diagnostic framework can help radiologists confidently characterize presacral cystic lesions, reduce preoperative misdiagnosis, and guide appropriate management.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of shear wave elastography in differentiating Bland vs tumoral portal vein thrombosis.","authors":"Tanka Karki, Shritik Devkota, Harish Bhujade, Madhumita Premkumar, Naveen Kalra, Ajay Duseja","doi":"10.1067/j.cpradiol.2026.09.010","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.09.010","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of shear wave elastography (SWE) in distinguishing bland from tumoral (malignant) portal vein thrombosis (PVT), using dynamic contrast-enhanced MRI (DCE-MRI) as the reference standard.</p><p><strong>Methods: </strong>A prospective observational study was conducted on patients with ultrasound-confirmed PVT. SWE was performed, followed by DCE-MRI within 48 hours. Mean and median SWE values of the thrombus, liver parenchyma, and any focal hepatic lesions were calculated, and novel SWE ratios (liver-to-PVT and lesion-to-PVT) were derived. At least five RoI measurements were obtained to ensure reliability. Using MRI as the reference standard, diagnostic performance metrics for SWE, including sensitivity, specificity, PPV, NPV, and overall accuracy, were calculated. Fisher's exact test and Chi-square test were used to compare these parameters between bland and tumoral thrombus groups. A p value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Fifty patients (mean age: 54.3 ± 10.7 years; 82% males) were included. 16 patients (32%) had bland portal vein thrombosis (PVT), whereas 34 (68%) had tumoral PVT. The mean SWE of PVT was 8.74 ± 4.24 kPa, with significantly lower values in bland PVT (4.63 ± 3.31 kPa) compared with tumoral PVT (10.68 ± 3.11 kPa; p < 0.001). Significant differences were also observed in the ultrasound diameters of the main, right, and left portal veins. The liver SWE/PVT SWE ratio was significantly higher in bland PVT (3.47 ± 3.08 vs. 1.68 ± 0.70; p = 0.033), while the lesion SWE/PVT SWE ratio was higher in tumoral PVT (p = 0.041). ROC analysis showed excellent diagnostic performance of SWE for differentiation of bland versus tumoral thrombus, with AUROC values of 0.903 and 0.915 at cutoff values of ≥6.1 kPa and ≥5.7 kPa for mean and median SWE, respectively.</p><p><strong>Conclusion: </strong>SWE is a reliable, non-invasive tool for differentiating tumoral from bland PVT, with diagnostic performance comparable to MRI.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring beyond the typical Wilms tumor: What a radiologist needs to know.","authors":"Supraja Laguduva Mohan, Stuti Chandola, Sandeep Agarwala, Simran Meet, Aanchal Kakkar, Devasenathipathy Kandasamy, Manisha Jana","doi":"10.1067/j.cpradiol.2026.09.011","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.09.011","url":null,"abstract":"<p><p>Wilms tumor is the most common pediatric renal neoplasm. The diagnosis of Wilms tumor is made on imaging when the radiological features and age of presentation are typical. Percutaneous biopsy is reserved for cases with atypical imaging appearance or older age at presentation, as the biopsy itself upgrades Wilms tumor to stage III. This is more relevant when it comes to the International Society of Pediatric Oncology (SIOP) guideline, which states that chemotherapy should be given before surgery, when compared to the Children's Oncology Group (COG) guideline, which recommends surgery, without neoadjuvant chemotherapy for the initial stages. Few uncommon renal neoplasms may have typical imaging and clinical characteristics, which can help to differentiate them from Wilms tumor. While upfront nephrectomy or nephron-sparing surgery can be done for small masses confined within the kidney and non-aggressive or benign histological types, preoperative chemotherapy with or without biopsy is required for most atypical renal neoplasms. Pseudomasses can mimic atypical renal tumors, but with a few distinguishing imaging features. This review describes the atypical imaging appearances of Wilms tumor and the typical imaging appearance of uncommon renal neoplasms and pseudomasses.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurointerventional publication metrics by rank, specialty and gender: The impact of academic age and mega-authorship.","authors":"Estelle Schurink, Mahla Radmard, Philippe Gailloud, David M Yousem","doi":"10.1067/j.cpradiol.2026.09.008","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2026.09.008","url":null,"abstract":"<p><strong>Background: </strong>Bibliometric measures are used to compare neurointerventional faculty trained in neurosurgery, radiology and neurology, but the comparability of citation-weighted metrics across these pathways is not established.</p><p><strong>Objective: </strong>To provide national bibliometric data for academic neurointerventional faculty and to determine whether academic age and mega-authored research distort cross-specialty comparison.</p><p><strong>Methods: </strong>Cross-sectional study of 423 neurointerventional faculty at 148 institutions. Scopus data were retrieved in July 2026. Academic age was defined as 2026 minus year of first publication. Specialties were compared unadjusted, adjusted for academic-age tertile, and in multivariable models exploring academic age, rank and gender. Mega-authored publications (>25 authors) were identified and models refitted excluding them.</p><p><strong>Results: </strong>Median academic age differed by specialty (radiology 24, neurosurgery 20, neurology 18 years; p < 0.001). Output rose steeply with rank (median publications 34, 70 and 160; p < 0.001), which accounted for more variance than academic age. Unadjusted, specialties were indistinguishable on citations (p = 0.698) and h-index (p = 0.177); after age adjustment both differed (p = 0.005, p = 0.028) in favor of neurosurgery over radiology with differences concentrated among assistant professors. Mega-authored publications accounted for a median 44.9% of citations in neurology, 10.6% in neurosurgery and 4.7% in radiology (p < 0.001); excluding them abolished neurology's adjusted citation advantage. Women (9.5%) recorded fewer last-author publications after adjustment (0.68, 95% CI 0.51-0.90).</p><p><strong>Conclusions: </strong>Citation-weighted bibliometrics are not comparable across neurointerventional faculty. Academic age and mega-authorship each independently distort them, and both must be accounted for before h-index or citation counts are used in career assessment.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}