Cancer Imaging最新文献

{"title":"Lauren classification-based combined model integrating clinicopathological and spectral CT features for disease-free survival prediction in gastric cancer.","authors":"Haibo You, Tiezhu Ren, Min Xu, Qianqian Chen, Long Ma, Yue Peng, Chenyang Zhang, Xinyu Liu, Wenjuan Zhang","doi":"10.1186/s40644-026-01064-2","DOIUrl":"10.1186/s40644-026-01064-2","url":null,"abstract":"<p><strong>Background: </strong>The Lauren classification (intestinal versus diffuse type) is pivotal for prognosing gastric cancer and guiding treatment selection. This study developed an integrated preoperative prediction model that merges preoperatively available clinicopathological characteristics with spectral CT parameters to distinguish Lauren subtypes and predict disease-free survival (DFS).</p><p><strong>Methods: </strong>This single-centre, retrospective diagnostic-accuracy study included 224 chemotherapy-treated gastric cancer patients with histopathologically confirmed intestinal or diffuse-type Lauren classification and two-year disease-free survival outcomes. Portal-venous phase spectral computed tomography (CT) parameters (CT₇₀ₖₑ_v, iodine concentration, and normalized iodine concentration) and clinicopathological variables (tumor differentiation and Borrmann type) were assessed. Independent predictors were identified using multivariate logistic regression, and three models were constructed: clinicopathological, spectral CT, and combined. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, calibration curves, decision curve analysis, and 1000-bootstrap internal validation. Disease-free survival was further analysed using Kaplan-Meier curves, the log-rank test, and Cox proportional hazards regression.</p><p><strong>Results: </strong>Multivariate analysis identified poor differentiation (OR = 9.80, P < < 0.001) and Borrmann type III/IV (OR = 2.65, P = 0.004) as clinicopathological predictors, while portal-venous phase CT at 70 keV (OR = 1.34, P < < 0.001), iodine concentration (OR = 2.08, P = 0.001), and normalized iodine concentration (OR = 2.09, P < < 0.001) were significant spectral CT predictors of diffuse-type histology. The combined model demonstrated an area under the curve (AUC) of 0.901 (95% CI: 0.859-0.944) for Lauren classification, outperforming both the pathological model (AUC = 0.810) and the spectral CT model (AUC = 0.861). The optimism-corrected AUC was 0.901 (95% CI: 0.857-0.943) based on 1000-bootstrap validation. For disease-free survival (DFS) prediction, the model achieved an AUC of 0.896 (95% CI: 0.851-0.941) at a cut-off value of 0.646, with an optimism-corrected AUC of 0.895 (95% CI: 0.850-0.939). Calibration curves and decision curve analysis indicated satisfactory agreement and a superior net benefit. Kaplan-Meier analysis revealed significant separation between high-risk and low-risk groups (2-year DFS rates: 7.2% versus 84.4%; log-rank chi2 = 158.88, P < < 0.001), and Cox regression analysis confirmed a substantially increased recurrence risk in the high-risk group (HR = 10.97, 95% CI: 6.68-17.99, P < < 0.001).</p><p><strong>Conclusion: </strong>The integrated model provides accurate preoperative Lauren classification and robust DFS prediction, serving as a multimodal tool for gastric cancer risk stratification and treatment planning.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[¹⁸F]AlF-NOTA-FAPI-04 PET/CT outperforms contrast-enhanced CT and contrast-enhanced MRI in clinical staging evaluation of patients with initial pancreatic cancer.","authors":"Lili Lin, Shuye Yang, Wenxin Wang, Xiang Li, Yafei Zhang, Guolin Wang, Xue Wen, Kui Zhao, Jun Yang, Xinhui Su","doi":"10.1186/s40644-026-01055-3","DOIUrl":"10.1186/s40644-026-01055-3","url":null,"abstract":"<p><strong>Objectives: </strong>Contrast-enhanced CT (CE-CT) and MRI (CE-MRI) are routine examinations for staging of pancreatic cancer (PC). This study aimed to directly compare the diagnostic performance of the novel [¹⁸F]AlF-NOTA-FAPI-04 PET/CT against these established modalities for initial clinical staging.</p><p><strong>Methods: </strong>A total of 127 patients with initial PC who had simultaneously undergone [¹⁸F]AlF-NOTA-FAPI-04 PET/CT, CE-CT and CE-MRI were enrolled in this retrospective study. Their clinical features and imaging data were evaluated and staged according to TNM classification. Histopathological findings or follow-up data or multidisciplinary team (MDT) discussion served as the reference standard for the final diagnosis.</p><p><strong>Results: </strong>For primary tumor (T) staging, CE-CT and CE-MRI demonstrated equivalent performance and outperformed [¹⁸F]AlF-NOTA-FAPI-04 PET/CT across all T stages except T1c. However, the PET/CT modality achieved significantly higher sensitivity, accuracy, and negative predictive value for both nodal (N) and distant metastasis (M) staging (all p < 0.05). It changed the N stage in 26 patients, altering management in 5 (3.93%), and revised the M stage in 16 and 18 patients compared to CE-CT and CE-MRI, respectively, leading to major treatment changes in 15 (11.81%) and 17 (13.38%) patients. A SUVmax cutoff of 4.85 for lymph node metastasis provided moderate sensitivity (67.1%) and high specificity (93.7%).</p><p><strong>Conclusion: </strong>[¹⁸F]AlF-NOTA-FAPI-04 PET/CT outperforms CE-CT and CE-MRI in evaluating N and M staging except T staging in initial pancreatic cancer, leading to a more accurate clinical staging and a more rational therapeutic decision-making. [¹⁸F]AlF-NOTA-FAPI-04 PET/CT should be considered a useful diagnostic tool for initial staging of pancreatic cancer.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microstructure mapping with time-dependent diffusion MRI differentiates primary central nervous system lymphoma from glioblastoma.","authors":"Jun Wu, Jue Lu, Xinli Zhang, Xiaotong Guo, Qian Qin, Jiaqi Chen, Ning Zheng, Peng Sun, Xuan Gao, Jing Wang","doi":"10.1186/s40644-026-01052-6","DOIUrl":"10.1186/s40644-026-01052-6","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL) are two distinct malignant brain tumors, and precise preoperative differentiation is crucial for guiding optimal treatments. This study aimed to evaluate the diagnostic value of time-dependent diffusion MRI (t_d-dMRI)-derived microstructural parameters in differentiating PCNSL from GBM and to correlate these parameters with histopathologic findings.</p><p><strong>Methods: </strong>This study included 32 GBM and 19 PCNSL patients who underwent 3.0-T MRI with oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) sequences. Microstructural parameters [intracellular volume fraction (V_in), cell diameter, cellularity, extracellular diffusivity (D_ex)] were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic performance of these parameters. The DeLong test was applied to compare AUC values across parameters. Ridge regression was applied for variable selection, followed by logistic regression to construct a combined diagnostic model. Histopathological validation was performed by correlating t_d-dMRI parameters with hematoxylin-eosin (H&E)-stained sections.</p><p><strong>Results: </strong>In enhancing tumor regions, PCNSL exhibited significantly smaller cell diameter and lower D_ex, but higher V_in and cellularity than GBM (all p < 0.001). V_in yielded the highest diagnostic accuracy (AUC = 0.901; sensitivity = 0.737; specificity = 0.906), which was significantly higher than diameter and D_ex (all p < 0.05). No significant differences were observed in AUC values between V_in and other ADC-derived parameters, such as ADC_0 Hz (AUC = 0.864; sensitivity = 0.895; specificity = 0.781). Ridge regression identified V_in and cellularity as potential independent predictors. However, no statistically robust combined diagnostic model could be established owing to insignificant combined regression results. No significant differences were observed in peritumoral regions. Additionally, V_in showed a strong positive correlation with histopathological nuclei fraction (r = 0.76; p < 0.001).</p><p><strong>Conclusion: </strong>Among all t_d-dMRI-derived microstructural parameters, V_in achieves the highest AUC and serves as a promising biomarker for the preoperative differential diagnosis between GBM and PCNSL.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's next for VI-RADS? Updates and future perspectives from the ACR VI-RADS steering committee.","authors":"Sungmin Woo, Valdair F Muglia, Lyndon Luk, Mitsuru Takeuchi, Maarten de Rooij, Bernadette Redd, Samuel J Galgano, Jason Efstathiou, Alberto Briganti, J Alfred Witjes, Valeria Panebianco, Hebert Alberto Vargas","doi":"10.1186/s40644-026-01062-4","DOIUrl":"10.1186/s40644-026-01062-4","url":null,"abstract":"<p><p>Since the introduction of the Vesical Imaging-Reporting and Data System (VI-RADS), MRI has become an important imaging modality in the management of patients with bladder cancer. Its excellent diagnostic performance for determining muscle invasion in bladder cancer has been supported by numerous prospective and retrospective studies. Nevertheless, there needs to be continued improvement of the diagnostic performance of VI-RADS and sustained efforts to address remaining unmet clinical needs within the field of bladder cancer. In this paper, we highlight several such areas, some of which are actively being investigated. These include (1) whether to use intravenous contrast media or not (multiparametric vs. biparametric MRI), (2) quantitative metrics to enhance assessment of muscle invasion, (3) anatomic locations that come with pitfalls in staging, (4) introduction of bladder MRI image quality, (5) neoadjuvant chemotherapy VI-RADS (nacVI-RADS) and other considerations needed in the treatment response assessment after systemic therapies, (6) need for wider adoption, training, and implementation, and (7) application of artificial intelligence.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of primary tumor ¹⁸F-FDG PET/CT metabolic parameters for lymph node metastasis in treatment-naïve ALK-positive NSCLC.","authors":"Tingting Qiao, Jie Gu, Yangchun Chen, Juan Zhao","doi":"10.1186/s40644-026-01058-0","DOIUrl":"10.1186/s40644-026-01058-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between primary tumor metabolic parameters on ¹⁸F-FDG PET/CT and lymph node metastasis (LNM) in treatment-naïve anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC), and to evaluate their utility in discriminating the cases with radiographically occult LNM (OLNM).</p><p><strong>Methods: </strong>We retrospectively analyzed 157 patients with pathologically confirmed ALK-positive NSCLC who underwent ¹⁸F-FDG PET/CT before the treatment between October 2021 and December 2024. Primary tumor metabolic parameters, including SUVmax, SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured. Logistic regression analyses were performed to identify LNM predictors. Receiver operating characteristic curve analysis evaluated predictive performance, with area under the curve (AUC) was calculated. The relation between OLNM status and metabolic parameters of primary tumor was analyzed using Kruskal-Wallis test.</p><p><strong>Results: </strong>Among 157 patients (62 males and 95 females; mean age 56 ± 11 years), 71 patients (45.2%) had pathologically confirmed LNM. Patients with LNM exhibited evidently larger primary tumor size and higher SUVmax, SUVpeak, MTV, and TLG than those without LNM (all P < 0.001). Univariate analysis showed primary tumor size, SUVmax, SUVpeak, MTV, and TLG were remarkedly associated with LNM. Multivariate analysis identified primary tumor size (OR: 1.043, 95%CI: 1.004-1.084; P = 0.032) and SUVmax (OR: 1.322, 95%CI: 1.159-1.532; P < 0.001) as independent predictors. The AUCs for tumor size, SUVmax, and combined factors were 0.76, 0.77, and 0.81, respectively. In addition, false-negative (OLNM-positive) cases showed markedly larger tumor size (P = 0.003) and higher TLG (P = 0.011) than true-negative cases.</p><p><strong>Conclusion: </strong>Metabolic parameters of ¹⁸F-FDG PET/CT before treatment, particularly when combined with primary tumor size, may help stratify LNM risk in treatment-naïve ALK-positive NSCLC patients. These parameters may help identify OLNM, potentially guiding personalized lymph node dissection strategies and optimizing treatment plans.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early radiological response pattern predicts long-term response in patients with non-small cell lung cancer treated with immune-checkpoint inhibitors.","authors":"Markus Kleinberger, Maximilian J Mair, Julia M Berger, Lynn Gottmann, Vincent Sunder-Plassmann, Martin Korpan, Isabella Solano Henao, Josef Fuerst, Luzia Berchtold, Ahmed Mohamed, Angelika M Starzer, Matthias Preusser, Anna S Berghoff, Julia Furtner","doi":"10.1186/s40644-026-01048-2","DOIUrl":"10.1186/s40644-026-01048-2","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICI) benefit only a subset of patients with non-small cell lung cancer (NSCLC). We evaluated whether response patterns differ by metastatic site and whether early radiological change predicts long-term outcomes.</p><p><strong>Methods: </strong>Patients with advanced NSCLC treated with ICI were prospectively enrolled between 03/2019 - 03/2023. Imaging was assessed blindly by a board-certified radiologist per iRECIST. Early response was defined as change in sum of diameters (SoD) from baseline to first restaging (8-12 weeks). Baseline and early inflammatory laboratory markers were collected. Endpoints were associations of early radiological response with durable clinical benefit (DCB; disease control ≥ 6 months), best overall response (BOR), overall survival (OS), progression-free survival (PFS) and organ-specific tumor burden.</p><p><strong>Results: </strong>Among 122 patients (46% female; median age 65) 32.8% were BOR responders and 47.5% achieved DCB. Median OS was 64.6 weeks and PFS 31.6 weeks. Early SoD reduction predicted DCB (p > 0.05, AUC 0.764) and BOR (p < 0.01, AUC 0.701). Organ-specific effects were seen particularly in lung and lymph nodes (all p ≤ 0.021). First-line ICI showed greater early shrinkage (p < 0.001) and higher response (p = 0.024), later-line therapy reduced response odds (BOR: OR 0.34; DCB: OR 0.38). Although selected baseline inflammatory markers were associated with survival in univariable analyses, neither baseline nor dynamic laboratory parameters retained independent significance in multivariable models after correction for multiple testing.</p><p><strong>Conclusions: </strong>Specific organ sites show differential sensitivity to ICI, with lung and nodal metastases demonstrating the most pronounced early regression. Early radiological dynamics robustly predicted DCB, BOR, PFS, and OS and outperformed laboratory biomarkers, supporting their use as a practical, clinically relevant tool to identify patients most likely to benefit from ICI.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline and interim ¹⁸F-FDG PET/CT imaging in outcome prediction in adult patients with Hodgkins lymphoma.","authors":"Xianwen Hu, Guangyao Yang, Ying Zhao, Pan Wang, Changyin Yu, Jiong Cai, Dongfeng Pan","doi":"10.1186/s40644-026-01059-z","DOIUrl":"10.1186/s40644-026-01059-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prognostic value of baseline and interim Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) parameters, including maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and Deauville score, in adult patients with Hodgkin lymphoma (HL).</p><p><strong>Methods: </strong>A single-center retrospective study included adult patients with HL who underwent baseline and interim ¹⁸F-FDG PET/CT scans after four chemotherapy cycles from December 2018 to October 2025. Baseline and interim PET/CT parameters (SUVmax, SUVmean, MTV, TLG) were collected, and interim response was assessed using the Deauville score. Overall survival (OS) and progression-free survival (PFS) were analyzed using receiver operating characteristic (ROC) analysis, Kaplan-Meier survival analysis, and Cox regression models.</p><p><strong>Results: </strong>A total of 116 patients were included (81 males, 35 females), with a median age of 35 years and a median follow-up of 44 months (IQR 37-58). ROC analysis first established the individual prognostic performance and optimal cut-off values for PET parameters, with interim MTV and TLG achieving AUCs of 0.891 and 0.896 for OS, respectively (cut-offs: 21.8 cm³ and 94.4 g). Subsequently, multivariable Cox regression identified baseline MTV, interim MTV, and the Deauville score as significant independent predictors of PFS. Finally, based on these independent factors, combined models were evaluated; however, they yielded AUCs of 0.901 (95% CI: 0.857-0.943) for OS and 0.824 (95% CI: 0.745-0.902) for PFS, which showed comparable efficacy and did not significantly surpass the predictive power of individual quantitative metrics. While similar trends for interim MTV and the Deauville score were observed for OS, the analysis was constrained by the small number of death events.</p><p><strong>Conclusion: </strong>Baseline and interim ¹⁸F-FDG PET/CT parameters-particularly interim MTV and Deauville score-were associated with survival outcomes in adult HL. Quantitative interim PET metrics may complement standard visual assessment for risk stratification.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative low-attenuation area on computed tomography is associated with recurrence after curative resection for non-small-cell lung cancer.","authors":"Hironobu Samejima, Kensuke Kojima, Shigeki Shimizu, Toshiteru Tokunaga, Kyoichi Okishio, Hyungeun Yoon","doi":"10.1186/s40644-026-01054-4","DOIUrl":"10.1186/s40644-026-01054-4","url":null,"abstract":"<p><strong>Background: </strong>Recurrence after curative-intent resection remains a major determinant of long-term outcomes in non-small-cell lung cancer (NSCLC). Preoperative computed tomography (CT)-derived low-attenuation area (LAA) is an objective marker of smoking-related parenchymal injury, but its independent association with postoperative recurrence and the shape of its exposure-response relationship remain incompletely defined.</p><p><strong>Methods: </strong>We retrospectively analyzed 660 consecutive patients who underwent R0 resection for NSCLC between 2017 and 2021. LAA was quantified on inspiratory CT as the percentage of lung volume with attenuation values < - 950 Hounsfield units. The primary endpoint was recurrence-free survival (RFS). Prespecified multivariable Cox models adjusted for major clinicopathologic and treatment-related factors, with LAA modeled per 1% increase and dichotomized using a Youden index-derived cutoff. Potential nonlinearity was assessed using restricted cubic splines and a one-knot hinge model. Model performance was summarized using time-specific calibration and decision-curve analysis. Machine learning analyses visualized the LAA-recurrence relationship using random forest partial dependence plots and explored predictor importance using permutation-based methods and a random survival forest.</p><p><strong>Results: </strong>Recurrence occurred in 119 patients (18%), including 32 locoregional-only recurrences and 87 distant recurrences with or without locoregional recurrence. Higher LAA was independently associated with shorter RFS (per 1% increase: adjusted hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.01-1.08; P = 0.007). In an exploratory dichotomized analysis using a data-derived 1.3% cutoff, LAA ≥ 1.3% was also associated with shorter RFS (HR, 1.84; 95% CI, 1.20-2.83; P = 0.005). Global spline tests did not show statistically significant nonlinearity across the full LAA distribution; however, prespecified low-range analyses suggested a possible change in the risk gradient around 1%-2% LAA. Machine learning analyses ranked pathologic stage and PD-L1 as the strongest predictors, with LAA contributing additional but smaller prognostic information.</p><p><strong>Conclusions: </strong>Preoperative CT-derived LAA was independently associated with postoperative recurrence after R0 resection for NSCLC. LAA may provide complementary host-lung imaging information alongside established clinicopathologic predictors, but the low-range signal and the data-derived 1.3% cutoff should be regarded as hypothesis-generating pending external validation in multicenter cohorts with standardized CT acquisition and quantification.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Lean body mass using whole-body low-dose Ct from Pet/Ct to identify cancer Cachexia.","authors":"G J O'Keefe, C Senko, S T Lee, S J Gong, S Pillai, R Fogliaro, T Chen, G Ninatti, K Pathmaraj, Z Cao, I Burvenich, L Osellame, N Hoogenraad, A M Scott","doi":"10.1186/s40644-026-01047-3","DOIUrl":"10.1186/s40644-026-01047-3","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer cachexia is a multifactorial syndrome characterised by involuntary weight loss and muscle wasting, commonly seen in patients with advanced malignancies. Lean Body Mass (LBM) assessment is crucial for the early indentification and monitoring of cancer cachexia. Dual-energy X-ray absorptiometry (DEXA) is widely accepted as the gold standard for evaluating body composition. This study aims to develop a method for estimating LBM using whole-body low-dose CT acquired during PET/CT imaging.</p><p><strong>Methods: </strong>A cohort of patients enrolled in a prospective pilot study on cancer cachexia were included in the analysis. All patients underwent both DEXA and [¹⁸F]FDG PET/CT imaging. Lean body mass was assessed by calculating the Total Body Lean Mass ratio (TBLMr) from DEXA (TBLMr_DEXA) and also whole-body low-dose CT (TBLMr_CT).</p><p><strong>Results: </strong>A total of 32 (13-cachectic, 19-non-cachectic) patients with advanced malignancies were included in the analysis. The TBLMr_CT and TBLMr_DEXA were highly correlated (R² = 0.92). Bland-Altman plots indicated a scaling bias with increasing TBLMr_DEXA values, with the non-cachectic group exhibiting a tighter distribution (0.06 ± 0.05) compared to the cachectic group (0.03 ± 0.11). TBLMr values were significantly different between cachectic and non-cachectic groups for both the DEXA-derived (p < 0.004) and low-dose CT-derived (p < 0.010) measurements.</p><p><strong>Conclusion: </strong>Whole-body low-dose CT obtained from routine [¹⁸F]FDG PET/CT imaging can provide an accurate estimate of LBM, showing high concordance with DEXA-derived measurements and clinical diagnosis of cachexia. This method offers a practical method for monitoring cancer cachexia in patients undergoing routine [¹⁸F]FDG PET/CT scans.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application Value of a nomogram integrating contrast-enhanced CT radiomics and clinical indicators in evaluating lymph node metastasis in pediatric peripheral neuroblastoma.","authors":"Wenbin Guo, Guangyong Yang, Zhengjun Dai, Yang Jing, Baoxin Qian, Jianshe Zhao, Guangfeng Zhang","doi":"10.1186/s40644-026-01053-5","DOIUrl":"10.1186/s40644-026-01053-5","url":null,"abstract":"<p><strong>Objective: </strong>To construct a machine learning model using contrast-enhanced CT radiomics and clinical indicators, aiming to improve the diagnostic accuracy for lymph node metastasis in children with peripheral neuroblastoma and provide practical evidence for clinical diagnosis and treatment.</p><p><strong>Methods: </strong>A total of children with pathologically confirmed neuroblastoma were retrospectively enrolled between February 2014 and December 2024, and then randomly divided into a training set and a test set via random sampling. Radiomics features were extracted separately from CT images of the arterial phase and venous phase. In the training set, four radiomics models, one clinical model, and one combined model incorporating radiomics and clinical features were constructed respectively using the filtered radiomics features and clinical features. All models were validated against the pathological reference standard in the test set, and the area under the receiver operating characteristic curve of each model was calculated. The clinical utility of each model was evaluated using the decision curve analysis curve. The optimal model was visualized with a nomogram, and the diagnostic gain of the nomogram for evaluating lymph node metastasis in neuroblastoma children was quantified via human-machine comparison.</p><p><strong>Results: </strong>A total of 225 children with neuroblastoma were enrolled in this study, (with a mean age of 2.23 ± 2.34 years and an age range of 0-13 years). All subjects were randomly divided into a training set (n = 157) and a test set (n = 68) at a ratio of 7:3. Compared with four radiomics models (Arterial phase, Venous phase, Delta-Absolute, Delta-Relative) and one clinical model (Ki-67), the nomogram integrating radiomics and clinical features (Arterial phase + Delta-Relative + Ki-67) exhibited superior diagnostic performance in evaluating lymph node metastasis in pediatric peripheral neuroblastoma. The AUC values of the nomogram reached 0.937 and 0.829 in the training set and validation set, respectively. In the human-machine comparison experiment, the diagnostic accuracy of radiologists for lymph node metastasis in neuroblastoma children was improved by 21% when assisted by the nomogram.</p><p><strong>Conclusion: </strong>The nomogram combining contrast-enhanced CT radiomics and clinical indicators has significant diagnostic value in evaluating lymph node metastasis in pediatric patients with peripheral neuroblastoma. Moreover, it can substantially improve the diagnostic accuracy of radiologists with different levels of clinical experience.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}