European Journal of Radiology最新文献

{"title":"Idiopathic pulmonary fibrosis and progressive pulmonary fibrosis: correlation between radiological progression criteria and pulmonary function tests","authors":"Çağlar Uzun ,&nbsp;Ebru Düşünceli Atman ,&nbsp;Ayşegül Gürsoy Çoruh ,&nbsp;Fatma Arslan ,&nbsp;Pelin Ekici ,&nbsp;Fatih Taşci ,&nbsp;Nilüfer Doruk ,&nbsp;Atilla Halil Elhan ,&nbsp;Özlem Özdemir Kumbasar","doi":"10.1016/j.ejrad.2025.112631","DOIUrl":"10.1016/j.ejrad.2025.112631","url":null,"abstract":"<div><h3>Purpose</h3><div>The study aimed to evaluate the relationship between radiological progression criteria and pulmonary function tests (PFTs) and to identify which radiological marker best reflects functional decline.</div></div><div><h3>Material and methods</h3><div>A total of 112 patients were included: 61 with idiopathic pulmonary fibrosis (IPF) and 51 with progressive pulmonary fibrosis (PPF); 63 had a usual interstitial pneumonia (UIP) pattern and 49 a non-UIP pattern. Consecutive scans were compared, yielding 245 comparisons (138 UIP, 107 non-UIP) from 357 exams. Radiological progression was defined according to ATS/ERS/JRS/ALAT guidelines and compared with PFTs. Univariable and multivariable logistic regression analyses were performed to identify radiological predictors of PFT decline, with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated.</div></div><div><h3>Results</h3><div>In multivariable analysis, increased lobar volume loss was the only independent predictor of a ≥ 5 % decline in FVC in the UIP group (OR 6.673; 95 % CI: 2.270–19.609; p &lt; 0.001), showing 65.5 % sensitivity, 84.4 % specificity, 76.9 % PPV, 75.5 % NPV, and 76 % accuracy. In the non-UIP group, significant predictors included new ground-glass opacity (GGO) with traction bronchiectasis (OR 5.043), increased extent or coarseness of reticular abnormality (OR 3.669), and increased lobar volume loss (OR 4.059), all statistically significant (p &lt; 0.05). This model showed 65.3 % sensitivity, 82.8 % specificity, 76.2 % PPV, 73.9 % NPV, and 74.7 % accuracy.</div></div><div><h3>Conclusions</h3><div>Increased lobar volume loss was significantly associated with FVC decline in both UIP and non-UIP groups. When PFTs are unreliable or infeasible, increased lobar volume loss may serve as a reliable marker of functional deterioration. However, early radiologic progression may precede both volume loss and PFT changes, suggesting that HRCT can detect subtle disease progression more sensitively.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112631"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916788","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}

{"title":"Advances in the pathogenesis of pulsatile tinnitus induced by sigmoid sinus wall abnormalities: A narrative review","authors":"Lanyue Chen,&nbsp;Zhaohui Liu","doi":"10.1016/j.ejrad.2026.112653","DOIUrl":"10.1016/j.ejrad.2026.112653","url":null,"abstract":"<div><div>Pulsatile tinnitus (PT) is characterized by the perception of rhythmic sounds synchronized with the heartbeat, with sigmoid sinus wall abnormalities (SSWA) being the most common etiology. The generation and transmission of sound in SSWA-PT are closely related to abnormal hemodynamics, elevated intracranial pressure, and anatomical abnormalities of the sigmoid plate and temporal bone pneumatization. Despite extensive research, the exact pathophysiological mechanisms of SSWA-PT remain unclear, often leading to misdiagnosis and suboptimal treatment outcomes. This narrative review synthesizes studies on the underlying mechanisms of SSWA-PT, published between 2000 and 2025, and selected based on relevance from databases such as PubMed and Google Scholar. We included clinical and imaging studies related to SSWA-PT, emphasizing that its occurrence results from the interplay of multiple factors. The review also discusses existing issues and highlights potential directions for future research.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112653"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917366","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}

{"title":"Safety and preliminary efficacy of percutaneous co-ablation system under local anesthesia for the treatment of malignant lung tumors: A retrospective cohort study","authors":"Linling Zhang ,&nbsp;Shuo Yang ,&nbsp;Jizhong Yin ,&nbsp;Bin Chen","doi":"10.1016/j.ejrad.2025.112645","DOIUrl":"10.1016/j.ejrad.2025.112645","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is a common malignancy with the highest mortality rate. Currently, Image-guided thermal ablation (IGTA) therapy has been widely applied in lung cancer. This study aimed to evaluate the safety and preliminary efficacy of co-ablation therapy in the treatment of malignant pulmonary tumors. The co-ablation system is a novel ablation device that integrates the technical advantages of both cryoablation and high-intensity thermal ablation.</div></div><div><h3>Methods</h3><div>From February 2022 to May 2024, 194 patients (182 with primary lung cancer and 12 with metastatic lung tumor) underwent percutaneous co-ablation for the treatment of malignant lung tumors at our institution. A retrospective study was conducted to analyze the adverse events (AEs), and preliminary efficacy in 205 treatment sessions targeting 224 lesions.</div></div><div><h3>Results</h3><div>The median diameter of the targeted tumor was 1.3 cm. All co-ablation procedures were performed under local anesthesia. 55 sessions (26.83 %) experienced AEs (grade 2 or higher), with pneumothorax being the most common (44 sessions, 21.46 %). Grade 3 AEs occurred in 7 sessions (3.41 %), with pneumothorax and pleural effusion being the most common. In multivariate analysis, independent predictors of AEs included severe emphysema [odds ratio (OR) = 3.14; 95 % confidence interval (CI): 1.55–4.74], tumor size (OR = 1.09; 95 % CI: 0.0642–2.11), and number of tumors (OR = 4.60; 95 % CI: 2.83–6.38). Median follow-up time was 6 months. Follow-up assessments of local tumor control (LTC) rates at 3, 6, and 12 months post-ablation revealed that smaller tumor size was associated with higher LTC rates. There was statistical difference for progress-free survival(PFS) between group ≤ 3 cm and group＞3cm of tumor size [NR vs 6 (95 %CI:4.1–7.9) months, P = 0.0045].</div></div><div><h3>Conclusion</h3><div>Co-ablation is a safe treatment for malignant lung tumors with acceptable AEs rates. The incidence of pneumothorax was comparable to that of conventional cryoablation, whereas pleural effusion and hemoptysis rates were significantly lower. Furthermore, the procedure achieved favorable local control rates and prolonged progression-free survival, particularly for small (≤3 cm) lesions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112645"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899613","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}

{"title":"Acceleration of chemical shift encoding-based water-fat imaging for pancreatic proton density fat fraction mapping in a single breath-hold: Data from the LION study","authors":"Selina Rupp ,&nbsp;Jessie Han ,&nbsp;Stella Marlene Naebauer ,&nbsp;Kilian Weiss ,&nbsp;Johannes M. Peeters ,&nbsp;Marcus M. Makowski ,&nbsp;Anna Reik ,&nbsp;Hans Hauner ,&nbsp;Christina Holzapfel ,&nbsp;Daniela Junker ,&nbsp;Egon Burian ,&nbsp;Dimitrios C. Karampinos ,&nbsp;Mingming Wu","doi":"10.1016/j.ejrad.2025.112641","DOIUrl":"10.1016/j.ejrad.2025.112641","url":null,"abstract":"<div><h3>Purpose</h3><div>With the rising prevalence of obesity and metabolic syndrome, there is an increasing need for noninvasive quantification of pancreatic fat as a marker of metabolic risk. Chemical shift encoding (CSE)-based water–fat separation enables pancreatic proton density fat fraction (PDFF) mapping. This study evaluates techniques for accelerating high-resolution, single-breath-hold PDFF mapping using sparse sampling with compressed sensing with sensitivity encoding (C-SENSE) and a deep learning (DL)-assisted reconstruction algorithm, focusing on reproducibility, precision, and clinical applicability.</div></div><div><h3>Methods</h3><div>104 abdominal MRI datasets were obtained from 71 adults (58 % female; age 18–65 years; body mass index (BMI) 30.0–39.9 kg/m²; without diabetes) enrolled in a lifestyle intervention trial. Imaging was performed at 3 T (Ingenia Elition X, Philips) using two six-echo gradient-echo acquisitions (2 × 2 × 3 mm³, identical TR/TE/echo spacing). Acceleration factors of R = 6 (16.9 s) and R = 10 (10.3 s) were reconstructed using vendor compressed sensing (C-SENSE6, C-SENSE10); the DL-assisted reconstruction (C-SENSE AI10) was applied only to R = 10 to evaluate denoising of higher-acceleration data. PDFF maps were analyzed using three regional regions of interest (ROIs) (head, body, tail) and whole-pancreas segmentation.</div></div><div><h3>Results</h3><div>A Mean pancreatic PDFF measured with C-SENSE6 was 15.0 [10.9 – 23.0] % at baseline (V1) and 8.2 [7.1 – 11.4] % after one year (V3)<strong>.</strong> Across all reconstructions, PDFF ranged 3.5 – 47.6 %<strong>.</strong> Strong linearity was observed between C-SENSE10 and C-SENSE AI10 compared with C-SENSE6 (R² ≥ 0.99). Whole-pancreas analysis showed high reproducibility (intraclass correlation coefficient = 0.87 – 1.00 across methods). The DL-assisted reconstruction reduced map noise compared with conventional C-SENSE10 without affecting PDFF accuracy.</div></div><div><h3>Conclusion</h3><div>Accelerated CSE-based pancreatic PDFF mapping enables precise, reproducible, and clinically feasible single-breath-hold fat quantification. The approach provides a robust tool for evaluating pancreatic steatosis in obesity and metabolic disease research.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112641"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917425","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}

{"title":"Research progress and clinical utility of multi-parameter orbital MRI in thyroid-associated ophthalmopathy","authors":"Xinyi Gou ,&nbsp;Jin Cheng ,&nbsp;Tianyuan Li ,&nbsp;Wei Zhao ,&nbsp;Yi Wang ,&nbsp;Xiuying Zhang ,&nbsp;Nan Hong","doi":"10.1016/j.ejrad.2025.112644","DOIUrl":"10.1016/j.ejrad.2025.112644","url":null,"abstract":"<div><div>Thyroid-associated ophthalmopathy (TAO), the most common orbital disease in adults, is a specific autoimmune condition closely associated with thyroid dysfunction, primarily affecting orbital fat and extraocular muscles. Multiparametric magnetic resonance imaging (MRI) holds unique value in diagnosing TAO, staging disease activity and progression evaluation by providing multidimensional information on tissue morphology, edema, fat infiltration, and fibrosis. This review examines conventional and advanced MRI techniques—such as T1WI, T2WI, diffusion-weighted imaging, dynamic contrast-enhanced MRI and magnetization transfer imaging—for their research progress and clinical utility. Recent advances in artificial intelligence (AI) applications for orbital MRI in TAO are also discussed. AI-enhanced multiparametric orbital MRI facilitates the comprehensive evaluation of TAO, covering image acquisition, quantification of metrics, and the establishment of predictive assessment models. Despite these advancements, challenges persist, such as the need to standardize quantitative parameters, validate findings through larger multicenter studies, and develop more efficient scanning protocols. Future research should prioritize parameter standardization, automated analysis workflows, and integration of multiparametric data to advance personalized TAO management.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112644"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921025","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}

{"title":"Preoperative MRI for non-invasive assessment of pancreatic acinar cell composition","authors":"Sevde Nur Emir ,&nbsp;Aylin Acar ,&nbsp;Ali Koyuncuer ,&nbsp;Servet Emir ,&nbsp;Abdulbaki Ağaçkıran ,&nbsp;Tolga Canbak","doi":"10.1016/j.ejrad.2025.112649","DOIUrl":"10.1016/j.ejrad.2025.112649","url":null,"abstract":"<div><h3>Objective</h3><div>This study explores the predictive power of preoperative MRI in evaluating pancreatic acinar cell composition. We aimed to determine whether MRI-derived signal intensity ratios could serve as reliable biomarkers for preoperative assessment.</div></div><div><h3>Methods</h3><div>In this retrospective study, 47 patients (30 males, 17 females; mean age: 64.6 years) who underwent pancreatoduodenectomy between January 2022 and May 2024 were included. Preoperative MRI signal intensities from T1-weighted sequences, dynamic contrast-enhanced phases, and diffusion-weighted imaging were quantified. The acinar cell ratio was determined via histopathological analysis of the pancreatic resection margin. Pearson and Spearman correlation tests assessed associations between MRI parameters and acinar cell content, while a logistic regression model evaluated their predictive accuracy.</div></div><div><h3>Results</h3><div>A significant correlation was observed between various MRI parameters and pancreatic acinar cell ratio. The strongest association was found for the pre-contrast pancreas T1-weighted to venous phase signal intensity ratio (Ratio-3), which yielded a correlation coefficient of 0.696 (p &lt; 0.0001). ROC analysis demonstrated that Ratio-3 had an area under the curve (AUC) of 0.91, with 94 % sensitivity and 80 % specificity in predicting an acinar cell ratio exceeding 40 %.</div></div><div><h3>Conclusion</h3><div>Ratio-3 (Pre-contrast pancreas T1W/Venous phase signal) shows strong potential as a non-invasive biomarker for assessing pancreatic acinar cell composition. These findings may improve preoperative risk stratification, aiding in pancreatic fistula prediction and surgical planning.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112649"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910867","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}

{"title":"Establishing updated diagnostic reference levels for interventional radiology: a national Italian survey incorporating procedure complexity Indices","authors":"Monica Cavallari ,&nbsp;Sveva Grande ,&nbsp;Alessandra Palma ,&nbsp;Catherine Klersy ,&nbsp;Renato Padovani ,&nbsp;Antonio Orlacchio ,&nbsp;Gaetano Compagnone ,&nbsp;Antonella Rosi ,&nbsp;Loredana D’Ercole","doi":"10.1016/j.ejrad.2025.112648","DOIUrl":"10.1016/j.ejrad.2025.112648","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The implementation of Euratom Council Directive 2013/59 into Italian legislation (D. Lgs 101/2020) requires the Ministry of Health, in collaboration with the Istituto Superiore di Sanità (ISS) and relevant scientific organizations, to facilitate the evaluation and regular updating of Diagnostic Reference Levels (DRLs) for procedures in diagnostic and interventional radiology.</div></div><div><h3>Materials and methods</h3><div>This study presents the update of the Italian Diagnostic Reference Levels derived from a survey conducted between 2019 and 2022 by a Working Group (WG) organized by ISS. A total of 53 hospitals across Italy were involved, of which 38 contributed to data collection related to body procedures. The survey concerned the collection of data related to different interventional radiology procedures: Trans-Arterial Chemo Embolization (TACE), EndoVascular Aneurysms Repair (EVAR), Transjugular Intrahepatic Porto-systemic Shunt (TIPS), Angioplasty and stenting for peripheral arterial disease of the lower limbs (LL), Percutaneous Biliary Interventions (PBI), Endoscopic Retrograde Cholangio-Pancreatography (ERCP), PTA (Percutaneous Transluminal Angioplasty) and/or Carotid stenting and Vertebroplasty. For each procedure, Air Kerma AT REFERENCE POINT(K_a,r), Kerma Area Product (P_KA) and Fluoroscopy Time (FT) were collected. Clinical parameters were obtained for TACE, EVAR, PBI, LL and Vertebroplasty, too. A P_KA multivariable analysis was performed to identify which parameters significantly influence the dosimetric data and to derive DRL related to procedure complexity.</div></div><div><h3>Results</h3><div>New DRL values were derived for each of these procedures, except for TIPS, for which the typical value was used: 45 Gy.cm² for PBI, 24 Gy.cm² for LL, 62 Gy.cm² for PTA and/or Carotid stenting, 252 Gy.cm² for TIPS, 18 Gy.cm² for ERCP, 134 Gy.cm² for EVAR, 91 Gy.cm² for Vertebroplasty and 255 Gy.cm² for TACE. DRL were also established according to the complexity of the procedure for TACE and EVAR.</div></div><div><h3>Conclusion</h3><div>This national survey successfully established diagnostic reference levels (DRLs) for seven interventional body procedures (TACE, EVAR, TIPS, LL, PBI, ERCP, PTA, Vertebroplasty) across Italian hospitals, providing facilities with systematic tools to optimize patient radiation exposure through comparison with national values and complexity-stratified reference levels.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112648"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921118","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}

{"title":"Contrast enhanced ultrasound at first month: A feasible predictor for retreatment after benign thyroid nodule thermal ablation","authors":"Tinghui Yin ,&nbsp;Yifei Leng ,&nbsp;Bowen Zheng ,&nbsp;Jinfen Wang,&nbsp;Lei Tan,&nbsp;Yuting He,&nbsp;Yufan Lian,&nbsp;Yanping Ma,&nbsp;Ge Tong,&nbsp;Xiuling Chen,&nbsp;Tao Wu,&nbsp;Jie Ren","doi":"10.1016/j.ejrad.2025.112628","DOIUrl":"10.1016/j.ejrad.2025.112628","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the clinical values of contrast enhanced ultrasound (CEUS) at the first follow-up for predicting retreatment in benign thyroid nodules (BTNs) after thermal ablation (TA).</div></div><div><h3>Materials and methods</h3><div>A total of 176 BTNs from 155 patients who underwent TA with a median follow-up period of 32.5 months (range 7 to 83 months) were enrolled in this study. Initial ablation ratio (IAR) and CEUS base IAR (CIAR) was calculated by conventional US and CEUS at 1-month after TA. The predicting performances for retreatment of quantitative and qualitative CEUS at 1-month after TA were analyzed by receiver operating characteristic (ROC) curves and Kaplan-Meier survival analysis.</div></div><div><h3>Results</h3><div>The median final volume reduction rate (VRR) of all nodules was 96.9% (range 31.4% to 100%). The areas under curves (AUCs) of quantitative and qualitative CEUS at 1-month for nodular retreatment were 0.986 and 0.981. Correspondingly, the sensitivity, negative predictive value (NPV) and negative likelihood ratio (LR) were 100%, 100% and 0 for both quantitative and qualitative CEUS.</div></div><div><h3>Conclusion</h3><div>CEUS at 1-month is a feasible predictor for nodular retreatment after BTNs TA. According to our results, CEUS is recommended as routine at the first follow-up for BTNs underwent TA.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112628"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916531","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}

{"title":"Evaluation of Age-Related compositional changes in the infrapatellar fat pad using MRI-Derived PDFF and T₂* at 1.5 T.","authors":"Kecheng Yuan, Qingyun Liu, Weijie Zheng, Xiaoqiong Tang, Chuang Zhang, Jiantai Zhou, Penghui Luo, Fulang Qi, Lin Chen, Bensheng Qiu","doi":"10.1016/j.ejrad.2025.112632","DOIUrl":"https://doi.org/10.1016/j.ejrad.2025.112632","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate age-related compositional changes in the infrapatellar fat pad (IFP) using chemical shift-encoded MRI-derived proton density fat fraction (PDFF) and T₂* at 1.5 T, and to evaluate their associations with clinical symptoms and structural abnormalities.</p><p><strong>Methods: </strong>A cross-sectional study was performed in 100 adults (mean age: 44 ± 14 years; 54 men, 46 women) who underwent 1.5 T MRI using a six-echo spoiled gradient-echo sequence for quantitative assessment of PDFF and T₂* in the IFP. Clinical symptoms were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and structural abnormalities were evaluated using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Spearman correlation and mediation analyses were performed.</p><p><strong>Results: </strong>Age showed a strong negative correlation with IFP PDFF (r =  - 0.46, p < 0.001) and a moderate inverse association with T₂* (r =  - 0.30, p = 0.003). Lower PDFF was associated with worse WOMAC pain (r =  - 0.33, p = 0.001) and WORMS scores (r =  - 0.41, p < 0.001). The mediation analysis revealed a significant indirect pathway linking age to both pain (ACME = 0.19, 95 % CI: 0.02-0.38) and WORMS scores (ACME = 0.24, 95 % CI: 0.06-0.45) through PDFF. In contrast, the indirect pathway through T₂* was weaker and less precise (ACME = 0.12, 95 % CI: 0.01-0.28).</p><p><strong>Conclusions: </strong>PDFF and T₂* reflect age-related compositional and microstructural changes in the IFP, with PDFF demonstrating stronger associations with clinical symptoms and joint degeneration. These findings indicate PDFF as a superior imaging biomarker for early detection, monitoring, and potential therapeutic targeting in age-related musculoskeletal degeneration.</p>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"112632"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959128","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}

{"title":"CEM in women prospectively assessed for screening recalls: Per-breast diagnostic performance with 3-year or longer follow-up","authors":"Sara Marziali ,&nbsp;Andrea Cozzi ,&nbsp;Veronica Magni ,&nbsp;Laura Menicagli ,&nbsp;Adrienn Benedek ,&nbsp;Andrea Cisarri ,&nbsp;Alessandra Marrocco ,&nbsp;Giuseppe Di Giulio ,&nbsp;Francesco Sardanelli","doi":"10.1016/j.ejrad.2025.112652","DOIUrl":"10.1016/j.ejrad.2025.112652","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the performance of contrast-enhanced mammography (CEM) for the assessment of screening recalls at ≥ 3-year follow-up.</div></div><div><h3>Materials and methods</h3><div>Women recalled after screening mammography at two Italian centers were prospectively enrolled to undergo CEM alongside standard assessment (SA) through additional views, tomosynthesis, and/or ultrasound. SA and CEM were independently evaluated, recommending biopsy or referral to a subsequent screening round. Per-breast diagnostic performance of CEM (low-energy plus recombined images) was calculated by taking histopathology and/or ≥ 3-year follow-up as the reference standard.</div></div><div><h3>Results</h3><div>Of the original 414 breasts (from 207 women), 393 (from 198 women) had available biopsy or follow-up data for the purposes of this analysis, being negative either at the original biopsy or at follow-up (316/393, 80.4%), or having a malignant finding at the original biopsy (74/393, 18.8%), or an interval cancer during follow-up (3/393, 0.8%, two at 1-year, one at 3-year). These interval cancers were 1 DCIS, two node-negative invasive (one 5-mm mixed no special type/lobular; one 6-mm mucinous). Per-breast analysis of the 393 breasts yielded a 96.1% sensitivity (74/77, 95% confidence interval 89.3–98.8%)<strong>,</strong> 94.9% specificity (300/316, 92.0–96.9%)<strong>,</strong> 95.2% accuracy (374/393, 92.6–97.1%)<strong>,</strong> 82.2% positive predictive value (74/90, 73.2–88.8%)<strong>,</strong> 99.0% negative predictive value (300/303, 97.2–99.7%)<strong>.</strong></div></div><div><h3>Conclusions</h3><div>In a cohort of women undergoing screening recall with CEM, when considering ≥ 3-year follow-up, per-breast sensitivity was about 96 %, specificity 95 %, negative predictive value 99 %.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112652"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917375","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}