Cancer Imaging最新文献

{"title":"Malignant lymph nodes of the head and neck: imaging pearls, pitfalls, and practical approach to reporting in the era of extranodal extension.","authors":"Pavan M Brahmbhatt, Emma Bentley, Mark A Edgar, Patricia A Rhyner, Alok A Bhatt","doi":"10.1186/s40644-026-01049-1","DOIUrl":"10.1186/s40644-026-01049-1","url":null,"abstract":"<p><p>Accurate characterization and reporting of cervical lymph nodes is critical when evaluating head and neck malignancies, as findings directly impact staging, treatment planning, and prognosis. Knowledge of lymphatic drainage patterns predicts nodal spread of disease and conversely, may help in identifying primary malignancy. Variability in size criteria for an abnormal lymph node across literature makes reporting difficult when used in isolation; however, careful attention to morphologic changes improves diagnostic accuracy. FDG-PET imaging serves as a valuable complementary tool when available, detecting metabolically active nodes that may appear normal on anatomic imaging. Identifying radiologic features of extranodal extension impacts AJCC staging and subsequently, treatment course. For lymphoproliferative disorders, diffuse lymphadenopathy presents a challenge in reporting size and number of lymph nodes. This article provides a systematic, reproducible checklist approach for lymph node reporting in the head and neck, thereby reducing inter-reader variability and producing a useful radiologic report for the multidisciplinary team.Clinical trial number Not applicable.</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/PMC13386796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004703","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":"The CT colonography radiology and data system: history, updates, and future directions.","authors":"Emily Calabria, Maha Ahmed, Courtney C Moreno, Kevin J Chang","doi":"10.1186/s40644-026-01043-7","DOIUrl":"10.1186/s40644-026-01043-7","url":null,"abstract":"<p><p>Computed tomography colonography, also known as virtual colonoscopy, is a minimally invasive imaging technique developed in the early 1990s to evaluate the colon for polyps, cancer, and other abnormalities. Advances in multidetector computed tomography, bowel preparation protocols, and three-dimensional reconstruction rapidly improved diagnostic performance. Landmark trials demonstrating sensitivity for clinically significant adenomas comparable to optical colonoscopy led to its acceptance as a colorectal cancer screening option. Standardized reporting further accelerated clinical uptake. The CT Colonography Reporting and Data System (C-RADS), introduced in 2005, provided a structured lexicon for colonic and extracolonic findings, allowing more consistent communication and management. Prior to structured reporting, early clinical implementation of computed tomography colonography was challenged by wide variability in terminology and follow-up thresholds. C-RADS addressed these issues by categorizing colonic findings according to adequacy of evaluation and likelihood of neoplastic disease and stratifying extracolonic observations based on clinical significance. The system enhanced clarity, increased reproducibility, and supported longitudinal research efforts by enabling systematic outcome tracking. Experience gained over the next decade and a half led to the C-RADS 2023 update. Notable changes included subdivision of intermediate colonic findings to distinguish likely benign diverticular-associated soft tissue thickening from indeterminate lesions, and simplification of extracolonic categories to reduce over-reporting of clinically unimportant findings. Future directions include broader adoption across health systems, automated detection and computer-assisted interpretation, and integration with artificial intelligence to improve polyp identification and extracolonic assessment. Together, these advances are expected to expand access, improve efficiency, and further solidify computed tomography colonography within evidence-supported screening practice.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986772","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":"The evolving PI-RADS paradigm.","authors":"Andrea Ponsiglione, Ivo G Schoots, Anwar R Padhani","doi":"10.1186/s40644-026-01035-7","DOIUrl":"10.1186/s40644-026-01035-7","url":null,"abstract":"<p><p>Prostate MRI is central to the diagnostic pathway for prostate cancer (PCa), reducing unnecessary biopsies, improving the detection of clinically significant disease (csPCa), and limiting overdiagnosis of indolent tumours. The Prostate Imaging Reporting and Data System (PIRADS) version 2.1 is the current international standard for MRI data acquisition and interpretation. This review synthesises the evidence for its use, its strengths and limitations, and future developments. PI-RADS v2.1 improved the assessments of multiparametric MRI (mpMRI) by clarifying technical requirements, zone-specific interpretation rules, and structured reporting recommendations. Its diagnostic performance is well established, particularly for ruling out csPCa and guiding risk-adapted biopsy strategies. However, significant gaps remain. MRI image quality varies substantially across centres, and PI-RADS lacks a mechanism to exclude non-diagnostic scans, resulting in inconsistent classification. Several scoring challenges persist, most notably the ambiguous definition and heterogeneous management of PI-RADS 3 lesions, imprecise lesion measurement standards, and limited guidance for central-zone and atypical lesions. Gaps include the absence of strategies for assessing background tissue changes and infiltrative patterns. Cancer detection specificity and inter-reader agreement remain moderate, with significant discrepancies in transition-zone assessments. Artificial intelligence (AI) holds promise for reducing variability, improving lesion detection, and optimising workflow, though rigorous validation and clear human-AI integration frameworks are needed. Advances in deep learning reconstructions improve image quality and enable shorter protocols, thereby supporting the adoption of biparametric MRI. A shift toward risk-based pathways, integrating MRI findings with PSA density and clinical parameters, is reflected in the forthcoming PI-RADS Pathway 2026, which aims to standardize global biopsy practice and reduce unnecessary interventions.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970301","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":"PEM as an adjunct to MRI or CESM for characterizing non-mass enhancement: a retrospective two-arm diagnostic study.","authors":"Nourhan Emad El-Din Ali Mohamed, Dalia Elmesidy, Rasha Wessam Abdel Rahman, Abdel Rahman Omar Ahmed, Maher Hassan Ibraheem, Ghada Mohamed Abdel Salam, Aalaa Sobhi","doi":"10.1186/s40644-026-01046-4","DOIUrl":"10.1186/s40644-026-01046-4","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic performance of positron emission mammography (PEM) as an adjunct to breast MRI or contrast-enhanced spectral mammography (CESM) for characterizing non-mass enhancement (NME).</p><p><strong>Materials and methods: </strong>This retrospective two-arm study included 108 women with NME. Patients were categorized into Arm 1 (MRI + PEM, n = 54) or Arm 2 (CESM + PEM, n = 54). Two experienced radiologists independently reviewed all imaging studies blinded to histopathology. Diagnostic performance metrics were calculated using histopathology as the reference standard.</p><p><strong>Results: </strong>In Arm 1, PEM demonstrated 100% sensitivity (34/34) and higher specificity (100%, 20/20) compared with MRI (30.0%, 6/20; P < 0.001). In Arm 2, PEM showed 100% sensitivity (28/28) and higher specificity (92.3%, 24/26) compared with CESM (61.5%, 16/26; P < 0.01). Inter-observer agreement was higher for PEM (κ = 0.674) than for MRI (κ = 0.351) and CESM (κ = 0.210). In a combined analysis of 38 indeterminate cases, PEM correctly reclassified 29 of 30 benign lesions.</p><p><strong>Conclusion: </strong>In this cohort, PEM demonstrated high diagnostic performance and improved specificity when used as an adjunct to MRI or CESM. These findings suggest that PEM may serve as a valuable problem-solving tool in selected indeterminate cases. However, results should be interpreted with caution given the retrospective design and limited sample size.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"26 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926602","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 dual-ROI mpMRI radiomics integrating intratumoral and periprostatic adipose tissue features with clinical factors for predicting positive surgical margins after radical prostatectomy.","authors":"De-Shi Hong, Xiao-Hui Wu, Chao-Xia Ruan, Dong-Shan Pan, Xu-Feng Huang, En-Ming Yang, Jun-Long Wang, Fei Wang, Kang Li, Jie-Bin Lin, Le-Le Yang, Shao-Hao Chen, Shi-Xian Wang","doi":"10.1186/s40644-026-01034-8","DOIUrl":"10.1186/s40644-026-01034-8","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a preoperative mpMRI-based radiomics-clinical nomogram integrating dual-region radiomics features from intratumoral lesions and periprostatic adipose tissue (PPAT) with clinical factors for predicting positive surgical margins (PSM) after radical prostatectomy (RP) in non-metastatic prostate cancer (PCa).</p><p><strong>Materials and methods: </strong>This two-center retrospective study included 423 patients (age, 69.78 ± 6.30 years) with non-metastatic PCa who underwent mpMRI followed by RP between January 2019 and December 2024. Intratumoral and PPAT ROIs were manually segmented on T2-weighted images and apparent diffusion coefficient (ADC) maps. After reproducibility filtering, high-correlation removal, and least absolute shrinkage and selection operator (LASSO) regression, three radiomics signatures were constructed. Independent predictors were identified by multivariable logistic regression and integrated into a radiomics-clinical nomogram. Performance was assessed using ROC/AUC, FDR-adjusted DeLong tests, calibration curves, Hosmer-Lemeshow tests, decision curve analysis (DCA), and 1,000-iteration bootstrap validation; subgroup ROC analyses were also performed.</p><p><strong>Results: </strong>Twelve intratumoral and nine PPAT radiomics features were selected, and the combined tumor-PPAT radiomics signature (TPR signature) demonstrated superior predictive performance compared with either single-ROI signature across cohorts (training AUC = 0.824; 95% CI, 0.776-0.865; validation AUC = 0.816; 95% CI, 0.737-0.935). Independent predictors included initial PSA, biopsy ISUP grade group, clinical T stage, and the TPR signature. The radiomics-clinical nomogram showed strong discrimination (AUC = 0.908 and 0.885 in the training and validation cohorts, respectively), with good calibration (Hosmer-Lemeshow p = 0.848 and 0.782) and favorable decision-curve performance across threshold probabilities of 0.1-1.0. Bootstrap resampling confirmed model stability, yielding mean AUCs of 0.908 (95% CI, 0.871-0.939) in the training cohort and 0.888 (95% CI, 0.827-0.936) in the validation cohort.</p><p><strong>Conclusions: </strong>A dual-ROI mpMRI radiomics-clinical nomogram integrating intratumoral and PPAT phenotypes enables accurate preoperative prediction of PSM after RP and may aid individualized surgical planning.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926654","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":"Diffusion weighted imaging-based tumor growth rate for predicting long-term survival in nasopharyngeal carcinoma.","authors":"Fan Yang, Ya Zhang, Michael Iv, Haoran Wei, Sai Wang, Xiaolu Li, Xiaoduo Yu, Lin Li, Yanfeng Zhao, Lizhi Xie, Dehong Luo, Meng Lin, Hongmei Zhang","doi":"10.1186/s40644-026-01041-9","DOIUrl":"10.1186/s40644-026-01041-9","url":null,"abstract":"<p><strong>Background: </strong>To explore the prognostic value of tumor special growth rate (TSGR) in patients with NPC and investigate the potential of diffusion-weighted imaging (DWI) habitat analysis as a surrogate marker.</p><p><strong>Methods: </strong>Patients who underwent two MRI scans before any type of treatment at two institutes were included. Radiologists manually delineated the volume of the primary tumor, and the doubling time and TSGR were calculated. Correlation between TSGR and long-term survival was evaluated using multivariate Cox analysis. Moreover, a radiologist delineated the tumor on b = 0 s/mm² images during the first MRI scan. Each tumor was divided into two subregions based on the individual mean apparent diffusion coefficient value (ADC_Mean), and the ADC value (ADC_down [mm²/s] and ADC_up [mm²/s]) of each subregion was calculated. ADC values for diagnosing TSGR and predicting survival were evaluated and validated using 5-fold cross-validation (iterations = 1000) and in an independent cohort.</p><p><strong>Results: </strong>A total of 98 patients were included (median age: 51 years; 24 females; training cohort: 64). The median doubling time was 131.9 days. Patients in the rapid-growth group (TSGR ≥ 1.4%) had significantly poorer survival than those in the slow-growth group (TSGR < 1.4%) in both the training and validation cohorts (p ≤ 0.006). ADC_down was a valuable factor in predicting TSGR (area under the curve: 0.792). Notably, the addition of ADC_down further improved the predictive value of TNM stage (0.663-0.848 vs. 0.631-0.785).</p><p><strong>Conclusion: </strong>Patients with high ADC_down value may have the rapid-growth potential and were more likely to have a poor prognosis.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863543","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":"Analysis of colorectal liver metastases in photon-counting detector CT - optimizing imaging through spectral reconstruction.","authors":"Maximilian Moos, Tilman Emrich, Maximilian Nguyen, Sebastian Steinmetz, Roman Kloeckner, Felix Hahn, Paul Steiner, Constantin Scholz, Markus Moehler, Hauke Lang, Tobias Bäuerle, Tobias Jorg, Lukas Müller","doi":"10.1186/s40644-026-01044-6","DOIUrl":"10.1186/s40644-026-01044-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the visibility of colorectal liver metastases (CRLM) using photon-counting detector computed tomography (PCD-CT) and to determine the optimal virtual monoenergetic image (VMI) and iodine map reconstructions for improved contrast detection between metastases and surrounding liver parenchyma.</p><p><strong>Materials and methods: </strong>A total of 117 patients with 227 CRLM (up to three measurements per patient) who underwent abdominal PCD-CT for staging between 09/2022 and 08/2024 were retrospectively included. VMI were reconstructed at energy levels between 40 and 90 keV (in 10 keV increments), and scanner-generated iodine maps were additionally analysed. To quantify contrast between CRLM and liver parenchyma, the parenchyma-to-lesion ratio (PLR) was calculated for each VMI and iodine map. The contrast-to-noise ratio (CNR) was determined based on attenuation values of the metastases and the bilateral musculus erector spinae, as well as its standard deviation. For the iodine map, lesion and parenchyma iodine concentrations were used analogously. Subjective assessment of metastases visibility on the three best VMIs in PLR and CNR (40-60 keV) and iodine maps were independently performed by three radiologists.</p><p><strong>Results: </strong>Lesion and liver attenuation decreased steadily with higher keV levels. Iodine maps showed markedly higher iodine concentration in liver parenchyma than in metastases. The PLR was highest on the iodine map (3.29 ± 2.01), followed by 40 keV (2.19 ± 0.73). Regarding CNR, the 40 keV VMI showed the highest value (1.49 ± 1.70), followed by the iodine map (1.09 ± 0.99). CNR values decreased further at higher energies and significantly reduced at 70-90 keV. Paired superiority testing confirmed 40 keV as the best-performing VMI, showing significantly higher CNR than the iodine map, whereas PLR remained superior on the iodine map. Subjective ratings indicated that the 50 keV VMI provided the best visibility of CRLM. The iodine map consistently received lower subjective ratings across all criteria.</p><p><strong>Conclusion: </strong>Both iodine maps and low-keV VMIs, particularly at 40 keV, demonstrated high PLR and CNR values, contributing to improved depiction of CRLM in PCD-CT. The complementary use of these reconstructions may enhance lesion detection and overall diagnostic confidence.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"26 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834094","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":"Altered glymphatic-related MRI markers in children with acute lymphoblastic and myeloid leukemia at diagnosis.","authors":"Shu Su, Zhou Liu, Shuzhen Huang, Xiang Gao, Chengfen Deng, Weifeng Hou, Long Qian, Libin Huang, Yanlai Tang, Zhiyun Yang, Liping Lin","doi":"10.1186/s40644-026-01045-5","DOIUrl":"10.1186/s40644-026-01045-5","url":null,"abstract":"<p><strong>Background: </strong>While the discovery of the glymphatic system has greatly advanced our understanding of waste clearance and fluid dynamics in central nervous system diseases, the neurofluid dynamics in pediatric acute leukemia remain to be elucidated. This study sought to evaluate MRI markers putatively related to neurofluid dynamics in pediatric acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), including perivascular space (PVS) burden, free water (FW) fraction, and diffusion tensor imaging along the PVS (DTI-ALPS).</p><p><strong>Methods: </strong>Seventy-two children with acute leukemia and 72 age- and sex-matched typically developing (TD) children (50 ALL and TDs1; 22 AML and TDs2) were included in this prospective study. Group differences in brain volumetric measures and glymphatic-related MRI markers were evaluated. In addition, MRI metrics that differed significantly between groups were further examined for associations with clinical variables and total sleep scale scores using partial correlation analyses.</p><p><strong>Results: </strong>Compared to TDs, ALL and AML showed no significant differences in intracranial volume. Compared with TDs, decreased brain parenchymal volume and gray matter volume were found in both children with ALL and AML (all FDR-corrected P ≤ 0.04). Compared with TDs, the ALL group exhibited reduced white matter volume and increased cerebrospinal fluid volume (all FDR-corrected P ≤ 0.001), while the AML group showed no significant differences in these measures. For glymphatic-related MRI markers, decreased PVS volume and count, FW value, and DTI-ALPS index were observed in both ALL and AML (all FDR-corrected P ≤ 0.02). In addition, the DTI-ALPS index was negatively correlated with risk stratification and total scale scores in children with ALL (all P ≤ 0.03).</p><p><strong>Conclusions: </strong>This preliminary, cross-sectional study identified a neuroimaging pattern in pediatric acute leukemia, characterized by reduced brain parenchyma volume and alterations in MRI markers putatively linked to neurofluid dynamics. In patients with ALL, a lower ALPS index was correlated with higher clinical risk stratification and greater sleep disturbance. These observations support future studies to clarify the biological relevance of neurofluid-related imaging features in acute leukemia.</p><p><strong>Prospectively registered trials number: </strong>ChiCTR2000031353; registered date: 2020-04.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834081","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":"Prognostic value of PSMA PET-derived tumor volume in metastatic castration-resistant prostate cancer treated with abiraterone or enzalutamide.","authors":"Tugay Atasever, Gunduzalp Bugrahan Babacan, Ömer Burak Ekinci, Aslı Buyukkuscu, Beyza Soylu Uslu, Fatma Zehra Yıldız Kabaca, Muhammed Mustafa Atcı, Savaş Karyagar, Kayhan Ertürk, Emir Çelik","doi":"10.1186/s40644-026-01036-6","DOIUrl":"10.1186/s40644-026-01036-6","url":null,"abstract":"<p><strong>Background: </strong>In metastatic castration-resistant prostate cancer (mCRPC), clinical outcomes remain highly heterogeneous despite the widespread use of next-generation androgen receptor pathway inhibitors. Reliable imaging-based biomarkers capable of reflecting whole-body tumor burden and predicting prognosis are needed. Prostate-specific membrane antigen (PSMA) PET-derived volumetric parameters have emerged as potential prognostic tools, yet their role in patients treated with abiraterone or enzalutamide remains insufficiently defined.</p><p><strong>Methods: </strong>We retrospectively analyzed 54 patients with mCRPC treated with abiraterone or enzalutamide between 2013 and 2025. Baseline 68Ga-PSMA PET/CT scans were used to derive quantitative imaging parameters, including PSMA tumor volume (PSMA-TV), total lesion PSMA expression (PSMA-TL), and SUV-based metrics. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier analyses. Receiver operating characteristic analyses identified optimal cut-off values, and Cox proportional hazards models were used to determine independent prognostic factors.</p><p><strong>Results: </strong>Higher baseline PSMA-TV and PSMA-TL were significantly associated with inferior OS and PFS. A PSMA-TV cut-off of ≥ 44.84 demonstrated good discriminatory ability for mortality prediction (AUC = 0.707, p = 0.010). In multivariate analysis, PSMA-TV ≥ 44.84 emerged as an independent predictor of mortality (HR 9.48, 95% CI 1.14-78.97; p = 0.037). Early PSA kinetics provided complementary prognostic information, and a PSA level ≥ 0.20 ng/mL at 6 months was independently associated with disease progression.</p><p><strong>Conclusion: </strong>PSMA PET-derived volumetric parameters, particularly PSMA tumor volume, provide robust prognostic information in mCRPC patients treated with abiraterone or enzalutamide. When combined with early PSA kinetics, these imaging biomarkers enable improved risk stratification and may support more individualized treatment strategies. Prospective multicenter studies are warranted to validate these findings.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811451","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":"Prediction of relapsed/refractory primary central nervous system lymphoma using pre-chemotherapy ITSS grade on SWI and pre-/post-chemotherapy ADC parameters on DWI.","authors":"Yijing Zhao, Feiman Yang, Meina Li, Feifei Yu, Na Lin, Dairong Cao, Zhen Xing","doi":"10.1186/s40644-026-01042-8","DOIUrl":"10.1186/s40644-026-01042-8","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the role of SWI and DWI in predicting the relapsed/refractory primary central nervous system lymphoma (R/R PCNSL).</p><p><strong>Materials and methods: </strong>Seventy-seven patients with histologically confirmed PCNSL were enrolled. Patients were divided into R/R group (n = 40) and Non-R/R group (n = 37), according to follow-up outcomes. Demographics, pathological indicators, conventional MRI characteristics, pre-chemotherapy intratumoral susceptibility signal (ITSS) grade, ADC parameters, including pre-chemotherapy relative minimum ADC (rADC_min-pre) and relative mean ADC (rADC_mean-pre), post-chemotherapy relative minimum ADC (rADC_min-post) and relative mean ADC (rADC_mean-post), as well as the change in relative minimum ADC (rADC_min-change) and relative mean ADC (rADC_mean-change), were compared between the two groups. Receiver operating characteristic curves and logistic regression analysis were used to assess the predictive performance.</p><p><strong>Results: </strong>Compared with Non-R/R PCNSL group, R/R PCNSL group showed significantly lower Ki-67 index (P = 0.004) but higher pre-chemotherapy ITSS grade (P < 0.001). The comparison of rADC_min-pre and rADC_mean-pre between the two groups showed no significant differences (P > 0.05). However, among the 50 patients with available post-treatment ADC data, rADC_min-post, rADC_mean-post, rADC_min-change and rADC_mean-change in R/R group were significantly lower than in Non-R/R group (all P < 0.001). The predictive performance of rADC_min-post, rADC_mean-post, rADC_min-change and rADC_mean-change was comparable to that of pre-chemotherapy ITSS grade for R/R PCNSL (0.894 vs. 0.714, 0.867 vs. 0.714, 0.877 vs. 0.714, 0.814 vs. 0.714, all P > 0.05), but superior to that of Ki-67 index (0.894 vs. 0.665, 0.867 vs. 0.665, 0.877 vs. 0.665, 0.814 vs. 0.665, all P < 0.05).</p><p><strong>Conclusions: </strong>The pre-chemotherapy ITSS grade, rADC_min-post, rADC_mean-post, rADC_min-change and rADC_mean-change may serve as preferable imaging biomarkers for predicting R/R PCNSL, and compare favorably with Ki-67 index.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811372","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}