Pub Date : 2025-11-19DOI: 10.1016/j.crad.2025.107182
J Wang, T Yang, W Gong, Z Cao, W Fu, D Yang, Y Guo
Aim: This study investigates the use of multiparametric magnetic resonance imaging (mp-MRI)-based radiomics for assessing perineural invasion (PNI) in rectal cancer.
Materials and methods: A retrospective analysis was performed on clinical and MRI data from 423 rectal cancer patients with confirmed surgical pathology, gathered from two centres. Of these, 343 patients from centre 1 were divided into a training set and an internal validation (in-vad) set in an 8:2 ratio, while 80 patients from centre 2 were used for independent external validation (ex-vad). Univariate and multivariate analyses were conducted on clinical features to build a clinical model. A combined model integrating both clinical and radiomic features was developed.
Results: Among all patients, 131 cases (31.0 %) were PNI-positive. A multivariate analysis revealed MRI-reported T (mrT) stage (odds ratio [OR] = 1.66, P=.010) and MRI-reported N (mrN) stage (OR = 1.91, P=.002) as independent predictors of PNI, forming the clinical model. After selecting radiomic features, 30 features were used to construct the radiomics model. The area under the curve (AUC) values for the clinical model in the training, in-vad, and ex-vad sets were 0.719, 0.631, and 0.760, respectively. The AUC values for the radiomics model in the training, in-vad, and ex-vad sets were 0.841, 0.815, and 0.916, respectively, while the AUC values for the combined model in the training, in-vad, and ex-vad sets showed AUC values of 0.899, 0.826, and 0.914, respectively.
Conclusion: The mp-MRI-based radiomics model demonstrates high accuracy in predicting PNI status in rectal cancer, offering a noninvasive and reliable tool for preoperative assessment.
{"title":"Novel magnetic resonance imaging (MRI)-based radiomics for predicting perineural invasion in rectal cancer: a two-centre study.","authors":"J Wang, T Yang, W Gong, Z Cao, W Fu, D Yang, Y Guo","doi":"10.1016/j.crad.2025.107182","DOIUrl":"https://doi.org/10.1016/j.crad.2025.107182","url":null,"abstract":"<p><strong>Aim: </strong>This study investigates the use of multiparametric magnetic resonance imaging (mp-MRI)-based radiomics for assessing perineural invasion (PNI) in rectal cancer.</p><p><strong>Materials and methods: </strong>A retrospective analysis was performed on clinical and MRI data from 423 rectal cancer patients with confirmed surgical pathology, gathered from two centres. Of these, 343 patients from centre 1 were divided into a training set and an internal validation (in-vad) set in an 8:2 ratio, while 80 patients from centre 2 were used for independent external validation (ex-vad). Univariate and multivariate analyses were conducted on clinical features to build a clinical model. A combined model integrating both clinical and radiomic features was developed.</p><p><strong>Results: </strong>Among all patients, 131 cases (31.0 %) were PNI-positive. A multivariate analysis revealed MRI-reported T (mrT) stage (odds ratio [OR] = 1.66, P=.010) and MRI-reported N (mrN) stage (OR = 1.91, P=.002) as independent predictors of PNI, forming the clinical model. After selecting radiomic features, 30 features were used to construct the radiomics model. The area under the curve (AUC) values for the clinical model in the training, in-vad, and ex-vad sets were 0.719, 0.631, and 0.760, respectively. The AUC values for the radiomics model in the training, in-vad, and ex-vad sets were 0.841, 0.815, and 0.916, respectively, while the AUC values for the combined model in the training, in-vad, and ex-vad sets showed AUC values of 0.899, 0.826, and 0.914, respectively.</p><p><strong>Conclusion: </strong>The mp-MRI-based radiomics model demonstrates high accuracy in predicting PNI status in rectal cancer, offering a noninvasive and reliable tool for preoperative assessment.</p>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"92 ","pages":"107182"},"PeriodicalIF":1.9,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-17DOI: 10.1016/j.crad.2025.107179
G.C. Croley , A.K. Taneja , F.D. Silva , A. Chhabra
Objective
To evaluate clinical performance and diagnostic accuracy of the MRI-based Osseous Tumour Reporting and Data System (OT-RADS) compared with traditional descriptive impressions.
Materials and Methods
After prospective integration of OT-RADS into the electronic dictation system, fellowship-trained musculoskeletal radiologists applied OT-RADS scoring in routine bone tumour reporting. This retrospective review included consecutive patients from July 2021 to May 2024, aged 17–100 years, with extremity or body wall osseous lesions evaluated by MRI and confirmed by surgery, biopsy, or benign follow-up. Demographics, imaging findings, lesion characteristics, biopsy results, treatments, and outcomes were collected. Diagnostic accuracy was compared using McNemar's test.
Results
The study included 352 patients (60.2 % female, mean age 54.7 ± 15.7 years). Most lesions (66.1 %) were managed conservatively, while surgery and chemotherapy each accounted for 8.4 %. Biopsy was performed in 18.8 %. The distribution included OT-RADS I (4.8 %), II (46.1 %), III (18.2 %), and malignant-suspicion categories IV–V (36.1 %). Outcomes were favorable in 60.8 % of patients. OT-RADS demonstrated higher diagnostic accuracy than descriptive impressions (95.4 % vs. 88.0 %; p<.0001), particularly in biopsy-confirmed cases (84.6 % vs. 61.5 %; p<.0001). Accuracy was consistently superior across benign (II–III; p=.003) and malignant lesions (IV–V; p<.001), with subgroup analysis confirming significance for OT-RADS IV (p=.0078) and V (p=.0156).
Conclusions
OT-RADS significantly outperforms descriptive reporting in accuracy for benign and malignant bone tumours. These results support broader adoption of OT-RADS as a standardized framework to stratify lesion risk, optimize management, and improve patient outcomes.
{"title":"MRI-BASED osseous tumour reporting and data system (OT-RADS): clinical experience of prospective implementation and diagnostic accuracy","authors":"G.C. Croley , A.K. Taneja , F.D. Silva , A. Chhabra","doi":"10.1016/j.crad.2025.107179","DOIUrl":"10.1016/j.crad.2025.107179","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate clinical performance and diagnostic accuracy of the MRI-based Osseous Tumour Reporting and Data System (OT-RADS) compared with traditional descriptive impressions.</div></div><div><h3>Materials and Methods</h3><div>After prospective integration of OT-RADS into the electronic dictation system, fellowship-trained musculoskeletal radiologists applied OT-RADS scoring in routine bone tumour reporting. This retrospective review included consecutive patients from July 2021 to May 2024, aged 17–100 years, with extremity or body wall osseous lesions evaluated by MRI and confirmed by surgery, biopsy, or benign follow-up. Demographics, imaging findings, lesion characteristics, biopsy results, treatments, and outcomes were collected. Diagnostic accuracy was compared using McNemar's test.</div></div><div><h3>Results</h3><div>The study included 352 patients (60.2 % female, mean age 54.7 ± 15.7 years). Most lesions (66.1 %) were managed conservatively, while surgery and chemotherapy each accounted for 8.4 %. Biopsy was performed in 18.8 %. The distribution included OT-RADS I (4.8 %), II (46.1 %), III (18.2 %), and malignant-suspicion categories IV–V (36.1 %). Outcomes were favorable in 60.8 % of patients. OT-RADS demonstrated higher diagnostic accuracy than descriptive impressions (95.4 % vs. 88.0 %; p<.0001), particularly in biopsy-confirmed cases (84.6 % vs. 61.5 %; p<.0001). Accuracy was consistently superior across benign (II–III; p=.003) and malignant lesions (IV–V; p<.001), with subgroup analysis confirming significance for OT-RADS IV (p=.0078) and V (p=.0156).</div></div><div><h3>Conclusions</h3><div>OT-RADS significantly outperforms descriptive reporting in accuracy for benign and malignant bone tumours. These results support broader adoption of OT-RADS as a standardized framework to stratify lesion risk, optimize management, and improve patient outcomes.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"92 ","pages":"Article 107179"},"PeriodicalIF":1.9,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1016/j.crad.2025.107175
X.-Z. Yang , S. Hachaichi , J. Endrikat , A. Ullmann , L. Cao , G. Wang
Aim
The aim of this study was to systematically investigate protocols and performance of iopromide contrast-enhanced coronary computed tomography angiography (CCTA) for diagnosing coronary artery disease (CAD) in patients with atrial fibrillation (AF).
Materials and methods
We searched PubMed, Embase, Web of Science, and the Cochrane Library for eligible studies of iopromide contrast-enhanced CCTA in patients with AF from inception to February 2025. Using a random-effect model, we pooled the following diagnostic metrics of CCTAs from included studies: diagnostic segments, effective radiation dose, sensitivity, specificity, and receiver operating characteristic (ROC) curve for CAD diagnosis versus conventional angiography.
Results
We included 14 studies involving 601 patients with AF who underwent iopromide 370 mgI/ml contrast-enhanced CCTA. Most studies applied individualised contrast and voltage protocols. Pooled analysis in 11 of those 14 studies indicated 98% segments were diagnostic (95% confidence interval [CI]: 0.96–0.99) with consistent results in subgroups of patients with heart rate variation >50 beats per minute, patients with overweight status, and patients with heart valve diseases. Scanners with ≥128 slices or individualised protocols could further improve image quality. The per-patient ROC was 0.97 (95% CI: 0.95–0.98), while the per-segment ROC was 0.99 (95% CI: 0.98–0.99). In addition, prospective-triggered or individualised voltage protocols reduced radiation dose by approximately 50%.
Conclusion
Our meta-analysis showed that 370-mgI/ml iopromide contrast-enhanced CCTA delivers consistent image quality and accurate diagnosis of CAD in patients with AF. The use of high-performance scanners combined with individualised protocols and prospective acquisition could further enhance image quality while reducing radiation exposure.
{"title":"Protocol and performance of coronary computed tomography angiography in patients with atrial fibrillation: a systematic review and meta-analysis","authors":"X.-Z. Yang , S. Hachaichi , J. Endrikat , A. Ullmann , L. Cao , G. Wang","doi":"10.1016/j.crad.2025.107175","DOIUrl":"10.1016/j.crad.2025.107175","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to systematically investigate protocols and performance of iopromide contrast-enhanced coronary computed tomography angiography (CCTA) for diagnosing coronary artery disease (CAD) in patients with atrial fibrillation (AF).</div></div><div><h3>Materials and methods</h3><div>We searched PubMed, Embase, Web of Science, and the Cochrane Library for eligible studies of iopromide contrast-enhanced CCTA in patients with AF from inception to February 2025. Using a random-effect model, we pooled the following diagnostic metrics of CCTAs from included studies: diagnostic segments, effective radiation dose, sensitivity, specificity, and receiver operating characteristic (ROC) curve for CAD diagnosis versus conventional angiography.</div></div><div><h3>Results</h3><div>We included 14 studies involving 601 patients with AF who underwent iopromide 370 mgI/ml contrast-enhanced CCTA. Most studies applied individualised contrast and voltage protocols. Pooled analysis in 11 of those 14 studies indicated 98% segments were diagnostic (95% confidence interval [CI]: 0.96–0.99) with consistent results in subgroups of patients with heart rate variation >50 beats per minute, patients with overweight status, and patients with heart valve diseases. Scanners with ≥128 slices or individualised protocols could further improve image quality. The per-patient ROC was 0.97 (95% CI: 0.95–0.98), while the per-segment ROC was 0.99 (95% CI: 0.98–0.99). In addition, prospective-triggered or individualised voltage protocols reduced radiation dose by approximately 50%.</div></div><div><h3>Conclusion</h3><div>Our meta-analysis showed that 370-mgI/ml iopromide contrast-enhanced CCTA delivers consistent image quality and accurate diagnosis of CAD in patients with AF. The use of high-performance scanners combined with individualised protocols and prospective acquisition could further enhance image quality while reducing radiation exposure.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"92 ","pages":"Article 107175"},"PeriodicalIF":1.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1016/j.crad.2025.107176
S.S. Dereli Bulut , B. Akcayoz , Z. Sakci , N. Günay
AIM
Diastolic dysfunction (DD) is central to hypertrophic cardiomyopathy (HCM), yet comprehensive cardiac magnetic resonance (CMR)–based staging is limited. We evaluated a multiparametric CMR framework combining time-volume indices, left atrial volume index (LAVI), and phase-contrast magnetic resonance imaging (PC-MRI) flow analysis against echocardiographic staging and healthy controls.
MATERIALS AND METHODS
Fifty-four HCM patients and 65 matched controls underwent cine-CMR to derive peak filling rate (PFR), peak filling rate acceleration (PFRA), peak filling rate end time (PFRE), and peak ejection rate (PER). PC-MRI at the sinotubular junction yielded peak velocity, ejection time (ET), time to peak velocity (TPV), and TPV-to-ET ratio. LAVI was measured from 4-chamber cine. Serum N-terminal pro–B-type natriuretic peptide (NT-proBNP) and troponin I were analysed. DD was classified per American Society of Echocardiography / European Association of Cardiovascular Imaging (ASE/EACVI) early-to-late diastolic mitral inflow velocity ratio (E/A)-based criteria. Diagnostic performance was assessed by receiver operating characteristic (ROC) analysis; reproducibility was assessed by intraclass correlation coefficients (ICCs).
RESULTS
DD was present in 70% of HCM patients. In controls, HCM showed a lower PFR (286.4 vs 397.8 ml/s), reduced PFRA (0.91 vs 1.48 ml/s2), prolonged PFRE (321.3 vs 205.7 ms), and higher LAVI (48.3 vs 29.8 ml/m2) (all P<0.001). Obstructive HCM demonstrated delayed systolic acceleration with a lower TPV-to-ET ratio (0.55 vs 0.67). LAVI and TPV-to-ET ratio each achieved an area under the curve (AUC) of 0.85 for DD discrimination, exceeding isolated time-volume indices. NT-proBNP correlated with DD severity and PFRE (r=0.42, P=0.01). PER decline indicated subclinical systolic impairment despite preserved ejection fraction (EF). Reproducibility was excellent (ICC: 0.92–0.95).
CONCLUSION
A CMR framework integrating time-volume metrics, LAVI, and aortic flow kinetics enables accurate DD classification, detection of early systolic dysfunction, and characterisation of obstruction-related haemodynamics in HCM, supporting clinical application and longitudinal surveillance.
aim舒张功能障碍（DD）是肥厚性心肌病（HCM）的核心，但基于心脏磁共振（CMR）的综合分期是有限的。我们评估了一个多参数CMR框架，结合时间-体积指数、左心房容积指数（LAVI）和超声心动图分期和健康对照的相对比磁共振成像（PC-MRI）血流分析。材料与方法54例HCM患者和65例对照者进行了cine-CMR，获得了峰填充率（PFR）、峰填充率加速（PFRA）、峰填充率结束时间（PFRE）和峰射血率（PER）。在窦管交界处的PC-MRI得到了峰值速度、弹射时间（ET）、峰值速度时间（TPV）和TPV- ET比值。LAVI从4室cine测量。检测血清n端b型前利钠肽（NT-proBNP）和肌钙蛋白I。DD根据美国超声心动图学会/欧洲心血管成像协会（ASE/EACVI）早舒张晚期二尖瓣流入速度比（E/A）标准进行分类。采用受试者工作特征（ROC）分析评估诊断效能；用类内相关系数（ICCs）评价再现性。结果70% HCM患者存在dd。在对照组中，HCM表现出较低的PFR (286.4 vs 397.8 ml/s)，降低的PFRA (0.91 vs 1.48 ml/s2)，延长的PFRE （321.3 vs 205.7 ms）和较高的LAVI (48.3 vs 29.8 ml/m2)（所有P<；0.001）。阻塞性HCM表现为延迟收缩加速，tpv / et比较低（0.55 vs 0.67）。LAVI和TPV-to-ET的曲线下面积（AUC）均达到0.85，优于单独的时间-体积指数。NT-proBNP与DD严重程度、PFRE相关（r=0.42， P=0.01）。PER下降表明亚临床收缩期损伤，尽管射血分数（EF）保持不变。重现性极好（ICC: 0.92-0.95）。结论CMR框架整合了时间-容量指标、LAVI和主动脉血流动力学，可以准确地对HCM进行DD分类、早期收缩功能障碍检测和梗阻相关血流动力学表征，支持临床应用和纵向监测。
{"title":"Temporal patterns of diastolic and systolic dysfunction in hypertrophic cardiomyopathy assessed by cardiac magnetic resonance (CMR) time-volume parameters","authors":"S.S. Dereli Bulut , B. Akcayoz , Z. Sakci , N. Günay","doi":"10.1016/j.crad.2025.107176","DOIUrl":"10.1016/j.crad.2025.107176","url":null,"abstract":"<div><h3>AIM</h3><div>Diastolic dysfunction (DD) is central to hypertrophic cardiomyopathy (HCM), yet comprehensive cardiac magnetic resonance (CMR)–based staging is limited. We evaluated a multiparametric CMR framework combining time-volume indices, left atrial volume index (LAVI), and phase-contrast magnetic resonance imaging (PC-MRI) flow analysis against echocardiographic staging and healthy controls.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Fifty-four HCM patients and 65 matched controls underwent cine-CMR to derive peak filling rate (PFR), peak filling rate acceleration (PFRA), peak filling rate end time (PFRE), and peak ejection rate (PER). PC-MRI at the sinotubular junction yielded peak velocity, ejection time (ET), time to peak velocity (TPV), and TPV-to-ET ratio. LAVI was measured from 4-chamber cine. Serum N-terminal pro–B-type natriuretic peptide (NT-proBNP) and troponin I were analysed. DD was classified per American Society of Echocardiography / European Association of Cardiovascular Imaging (ASE/EACVI) early-to-late diastolic mitral inflow velocity ratio (E/A)-based criteria. Diagnostic performance was assessed by receiver operating characteristic (ROC) analysis; reproducibility was assessed by intraclass correlation coefficients (ICCs).</div></div><div><h3>RESULTS</h3><div>DD was present in 70% of HCM patients. In controls, HCM showed a lower PFR (286.4 vs 397.8 ml/s), reduced PFRA (0.91 vs 1.48 ml/s<sup>2</sup>), prolonged PFRE (321.3 vs 205.7 ms), and higher LAVI (48.3 vs 29.8 ml/m<sup>2</sup>) (all <em>P</em><0.001). Obstructive HCM demonstrated delayed systolic acceleration with a lower TPV-to-ET ratio (0.55 vs 0.67). LAVI and TPV-to-ET ratio each achieved an area under the curve (AUC) of 0.85 for DD discrimination, exceeding isolated time-volume indices. NT-proBNP correlated with DD severity and PFRE (r=0.42, <em>P</em>=0.01). PER decline indicated subclinical systolic impairment despite preserved ejection fraction (EF). Reproducibility was excellent (ICC: 0.92–0.95).</div></div><div><h3>CONCLUSION</h3><div>A CMR framework integrating time-volume metrics, LAVI, and aortic flow kinetics enables accurate DD classification, detection of early systolic dysfunction, and characterisation of obstruction-related haemodynamics in HCM, supporting clinical application and longitudinal surveillance.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"92 ","pages":"Article 107176"},"PeriodicalIF":1.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1016/j.crad.2025.107168
U. Eryuruk , M.N. Tasdemir , E. Cakir , S. Aslan
AIM
This study aimed to investigate the relationship between the residual liver relative enhancement index (RL-REI), which is derived from gadoxetic acid (GA)–enhanced magnetic resonance imaging (MRI), and albumin-bilirubin (ALBI) and Child-Pugh (CP) scores in assessing liver function in patients with hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
Patients with histopathologically confirmed HCC who underwent GA-enhanced MRI were retrospectively analysed. Receiver operating characteristic (ROC) curve analysis was conducted to identify the optimal cut-off values for the residual liver volume (RLV), the enhancement ratio (ER), and the RL-REI in predicting ALBI grades and CP classes. Spearman’s rank correlation was used to assess the relationships of the RLV, the ER, and the RL-REI with the ALBI and CP scores. Intraclass correlation coefficient (ICC) was applied to evaluate intrareader reliability and inter-reader agreement.
Results
Forty-one patients (mean age: 56.7 ± 11.5 years, 33 men) met the study criteria. The RL-REI showed high diagnostic performance (area under the curve [AUC] ≥ 0.945 and accuracy ≥ 85.3%) for both readers in differentiating ALBI grades and CP classes (P<0.001). The RL-REI demonstrated a strong correlation with the ALBI and CP scores (r=−0.852 and −0.766 for reader 1, r=−0.839 and −0.758 for reader 2) (p<0.001). Intrareader and inter-reader agreement was almost perfect for all measurements (ICC ≥ 0.922) (P<0.001).
Conclusion
The RL-REI demonstrated a strong correlation with ALBI and CP scores for assessing liver function in HCC patients and showed high accuracy in predicting ALBI grades and CP classes, highlighting its potential as a valuable radiological tool.
{"title":"The residual liver relative enhancement index: a quantitative tool from gadoxetic acid–enhanced magnetic resonance imaging for assessing liver function in hepatocellular carcinoma patients","authors":"U. Eryuruk , M.N. Tasdemir , E. Cakir , S. Aslan","doi":"10.1016/j.crad.2025.107168","DOIUrl":"10.1016/j.crad.2025.107168","url":null,"abstract":"<div><h3>AIM</h3><div>This study aimed to investigate the relationship between the residual liver relative enhancement index (RL-REI), which is derived from gadoxetic acid (GA)–enhanced magnetic resonance imaging (MRI), and albumin-bilirubin (ALBI) and Child-Pugh (CP) scores in assessing liver function in patients with hepatocellular carcinoma (HCC).</div></div><div><h3>MATERIALS AND METHODS</h3><div>Patients with histopathologically confirmed HCC who underwent GA-enhanced MRI were retrospectively analysed. Receiver operating characteristic (ROC) curve analysis was conducted to identify the optimal cut-off values for the residual liver volume (RLV), the enhancement ratio (ER), and the RL-REI in predicting ALBI grades and CP classes. Spearman’s rank correlation was used to assess the relationships of the RLV, the ER, and the RL-REI with the ALBI and CP scores. Intraclass correlation coefficient (ICC) was applied to evaluate intrareader reliability and inter-reader agreement.</div></div><div><h3>Results</h3><div>Forty-one patients (mean age: 56.7 ± 11.5 years, 33 men) met the study criteria. The RL-REI showed high diagnostic performance (area under the curve [AUC] ≥ 0.945 and accuracy ≥ 85.3%) for both readers in differentiating ALBI grades and CP classes (<em>P</em><0.001). The RL-REI demonstrated a strong correlation with the ALBI and CP scores (<em>r</em>=−0.852 and −0.766 for reader 1, <em>r</em>=−0.839 and −0.758 for reader 2) (<em>p</em><0.001). Intrareader and inter-reader agreement was almost perfect for all measurements (<em>ICC</em> ≥ 0.922) (<em>P</em><0.001).</div></div><div><h3>Conclusion</h3><div>The RL-REI demonstrated a strong correlation with ALBI and CP scores for assessing liver function in HCC patients and showed high accuracy in predicting ALBI grades and CP classes, highlighting its potential as a valuable radiological tool.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"92 ","pages":"Article 107168"},"PeriodicalIF":1.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-10DOI: 10.1016/j.crad.2025.107167
D Koku, Y Agarwala, M Vithayathil, P Tait, E O Aboagye, R Sharma
Radiomics allows for quantitative utilisation of radiological data and carries great potential for improving the diagnosis and management of hepatopancreatobiliary (HPB) cancers. Radiomic features represent changes at the mesoscopic scale and serve as noninvasive markers for tumour heterogeneity. Using deep learning and machine learning approaches, retrospective studies have demonstrated that radiomic signatures have the capability to improve the diagnosis of hepatocellular carcinoma (HCC), pancreatic cancer, and cholangiocarcinoma, in conjunction with radiological evaluation. Radiomic models have been successfully implemented to predict prognosis and treatment response, consistently outperforming established clinical markers. Novel pretreatment radiomic signatures predicting progression, survival and response to immunotherapy in advanced HCC demonstrate the great potential for radiomics in precision medicine. Correlation and integration of radiomics with genomic, metabolomic, and immunological data allows for noninvasive profiling of HPB cancers and the development of highly predictive integrated models. Future adoption of these works into clinical practice will allow for personalised diagnostic and treatment strategies. However, though these works show promise, further evaluation of optimal imaging strategies, image standardisation, and prospective validation across diverse patient populations is needed before widespread adoption in routine clinical practice.
{"title":"Radiomics of hepatopancreatobiliary cancer diagnosis, management, and future prospects.","authors":"D Koku, Y Agarwala, M Vithayathil, P Tait, E O Aboagye, R Sharma","doi":"10.1016/j.crad.2025.107167","DOIUrl":"https://doi.org/10.1016/j.crad.2025.107167","url":null,"abstract":"<p><p>Radiomics allows for quantitative utilisation of radiological data and carries great potential for improving the diagnosis and management of hepatopancreatobiliary (HPB) cancers. Radiomic features represent changes at the mesoscopic scale and serve as noninvasive markers for tumour heterogeneity. Using deep learning and machine learning approaches, retrospective studies have demonstrated that radiomic signatures have the capability to improve the diagnosis of hepatocellular carcinoma (HCC), pancreatic cancer, and cholangiocarcinoma, in conjunction with radiological evaluation. Radiomic models have been successfully implemented to predict prognosis and treatment response, consistently outperforming established clinical markers. Novel pretreatment radiomic signatures predicting progression, survival and response to immunotherapy in advanced HCC demonstrate the great potential for radiomics in precision medicine. Correlation and integration of radiomics with genomic, metabolomic, and immunological data allows for noninvasive profiling of HPB cancers and the development of highly predictive integrated models. Future adoption of these works into clinical practice will allow for personalised diagnostic and treatment strategies. However, though these works show promise, further evaluation of optimal imaging strategies, image standardisation, and prospective validation across diverse patient populations is needed before widespread adoption in routine clinical practice.</p>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":" ","pages":"107167"},"PeriodicalIF":1.9,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.crad.2025.107164
M. Charnock , N. Kotnis
AIM
The aim of this study was to assess the prevalence of a subcoracoid effusion and its association with rotator cuff tears at shoulder ultrasound.
MATERIALS AND METHODS
This was a prospective study involving 3,405 patients who underwent shoulder ultrasound referred from both primary and secondary care between January 2019 and January 2025. Demographic details, sonographic diagnosis including the size of a rotator cuff tear, and subcoracoid bursal distension was recorded. Details of further imaging studies and surgical outcomes were also documented.
RESULTS
Of the 3405 patients examined, ultrasound revealed a subcoracoid effusion in 132 patients. Four patients had a subcoracoid effusion and no rotator cuff tear on ultrasound, and six patients reported a subcoracoid effusion and a partial thickness tear on ultrasound. A total of 122 (4%) patients had a subcoracoid effusion and a full-thickness tear on ultrasound, with 64 patients having surgical correlation (Fisher’s exact test P<0.001).
CONCLUSION
While subcoracoid effusions are not common, this study confirms a strong association between subcoracoid effusions and full-thickness rotator cuff tears. Careful assessment of the rotator cuff is essential when subcoracoid effusions are identified on ultrasound.
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