Pub Date : 2026-03-01Epub Date: 2026-01-25DOI: 10.1016/j.ejrad.2026.112701
Sari Luthfiyah , Triwiyanto Triwiyanto , Luthfi Rusyadi , Mohammed Ismath
We comment on Ba-Ssalamah et al.’s study comparing MRI-derived and biopsy-confirmed liver iron concentration in chronic liver disease. The strong agreement between two R2*-based methods supports the robustness of relaxometry-based LIC estimation in the low–mild iron range. We discuss physics-related considerations, including R2* nonlinearity, spatial sampling, signal modeling, and calibration dependence, and outline future directions toward volumetric mapping and cross-platform harmonization for quantitative liver MRI.
{"title":"Letter to Editor: Correlation between MRI-derived and biopsy-confirmed liver iron concentration in patients with chronic liver disease","authors":"Sari Luthfiyah , Triwiyanto Triwiyanto , Luthfi Rusyadi , Mohammed Ismath","doi":"10.1016/j.ejrad.2026.112701","DOIUrl":"10.1016/j.ejrad.2026.112701","url":null,"abstract":"<div><div>We comment on Ba-Ssalamah et al.’s study comparing MRI-derived and biopsy-confirmed liver iron concentration in chronic liver disease. The strong agreement between two R2*-based methods supports the robustness of relaxometry-based LIC estimation in the low–mild iron range. We discuss physics-related considerations, including R2* nonlinearity, spatial sampling, signal modeling, and calibration dependence, and outline future directions toward volumetric mapping and cross-platform harmonization for quantitative liver MRI.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112701"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099918","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 : 2026-03-01Epub Date: 2026-01-28DOI: 10.1016/j.ejrad.2026.112706
Rosa Alba Pugliesi, Roberto Cannella, Federica Vernuccio, Marika Triscari Barberi, Giovanni Roccella, Giuseppe Brancatelli, Giuseppe Lo Re
Pelvic floor dysfunction encompasses a spectrum of disorders characterized by organ descent, muscular weakness, and impaired coordination across the anterior, middle, and posterior compartments. MRI defecography has become an established non-invasive technique for comprehensive assessment of both static anatomy and dynamic function of the pelvic floor. This review describes the MRI defecography technique, protocol components, and quantitative parameters that provide an objective evaluation of pelvic floor dysfunction. Standard MRI defecography protocol incorporates resting, contraction, straining, and evacuation phases, with single-shot fast spin-echo and real-time sequences enabling visualization of pelvic structures throughout motion. Quantitative parameters, including the anorectal angle, pubococcygeal line, H and M lines, minimal prolapse level, and levator plate angle, allow for objective evaluation of pelvic floor dysfunction. MRI defecography is particularly valuable in complex and postoperative scenarios, allowing detection of cystoceles, rectoceles, enteroceles, uterine or vaginal prolapse, intussusception, and post-surgical complications. In addition, MRI-defecography highlights the importance of stabilizing structures such as the urogenital diaphragm, endopelvic fascia, and levator ani complex. By integrating anatomic and functional findings, MRI defecography supports individualized therapeutic planning, guides surgical decision-making, and improves long-term outcomes. MRI defecography has thus emerged as a cornerstone in the multidisciplinary management of pelvic floor dysfunction.
{"title":"Pelvic floor dysfunction: Anatomical characterization and functional imaging with MRI defecography","authors":"Rosa Alba Pugliesi, Roberto Cannella, Federica Vernuccio, Marika Triscari Barberi, Giovanni Roccella, Giuseppe Brancatelli, Giuseppe Lo Re","doi":"10.1016/j.ejrad.2026.112706","DOIUrl":"10.1016/j.ejrad.2026.112706","url":null,"abstract":"<div><div>Pelvic floor dysfunction encompasses a spectrum of disorders characterized by organ descent, muscular weakness, and impaired coordination across the anterior, middle, and posterior compartments. MRI defecography has become an established non-invasive technique for comprehensive assessment of both static anatomy and dynamic function of the pelvic floor. This review describes the MRI defecography technique, protocol components, and quantitative parameters that provide an objective evaluation of pelvic floor dysfunction. Standard MRI defecography protocol incorporates resting, contraction, straining, and evacuation phases, with single-shot fast spin-echo and real-time sequences enabling visualization of pelvic structures throughout motion. Quantitative parameters, including the anorectal angle, pubococcygeal line, H and M lines, minimal prolapse level, and levator plate angle, allow for objective evaluation of pelvic floor dysfunction. MRI defecography is particularly valuable in complex and postoperative scenarios, allowing detection of cystoceles, rectoceles, enteroceles, uterine or vaginal prolapse, intussusception, and post-surgical complications. In addition, MRI-defecography highlights the importance of stabilizing structures such as the urogenital diaphragm, endopelvic fascia, and levator ani complex. By integrating anatomic and functional findings, MRI defecography supports individualized therapeutic planning, guides surgical decision-making, and improves long-term outcomes. MRI defecography has thus emerged as a cornerstone in the multidisciplinary management of pelvic floor dysfunction.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112706"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118375","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":"Corrigendum to “Degeneration of the cartilage quality is correlated with a higher intramuscular fat infiltration of the vastus medialis in older adults with pre-to-mild knee osteoarthritis” [Eur. J. Radiol. 183 (2025) 111930]","authors":"Shogo Okada , Masashi Taniguchi , Masahide Yagi , Yoshihiro Fukumoto , Tetsuya Hirono , Momoko Yamagata , Ryusuke Nakai , Masashi Kobayashi , Noriaki Ichihashi","doi":"10.1016/j.ejrad.2026.112714","DOIUrl":"10.1016/j.ejrad.2026.112714","url":null,"abstract":"","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112714"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131874","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 : 2026-03-01Epub Date: 2026-01-22DOI: 10.1016/j.ejrad.2026.112696
Yujie Chen , Yan Sun , Yu Song , Yi Liao , Xuesheng Li , Xijian Chen , Gang Ning
Background
Three-dimensional ultrashort echo time (3D-UTE) MRI enables proton-density assessment of lung parenchyma without radiation. We aimed to evaluate the feasibility of 3D-UTE for quantifying lung density of preterm infants and characterize gestational-age (GA)-dependent developmental patterns.
Methods
101 infants (1 day-24 months) were enrolled as extremely-to-very preterm (EVP, <32 weeks, n = 33), moderate-to-late preterm (MLP, 32–<37 weeks, n = 34), and full-term (FT, 37–42 weeks, n = 34). Lung protocol including 3D-UTE, 3D-GRE (gradient-echo) and T2-FSE (fast spin-echo) sequences were used. Image quality was assessed qualitatively and quantitatively. Lung density was quantified using UTE-derived lung-to-muscle ratios (LMRs), and group differences and age-related patterns were evaluated.
Results
UTE-MRI provided superior visualization of lung structure with significantly higher signal-to-noise and contrast-to-noise ratios. Lung-to-muscle ratios demonstrated a consistent anterior–posterior gradient (R2 = 0.582, p < 0.001) and decreased with lower gestational age (LMR-total: FT 50.8 ± 9.7; MLP 48.7 ± 7.6; EVP 45.1 ± 7.6), with EVP significantly lower than FT (p < 0.05). Within the first year of life, age-related analyses revealed distinct developmental patterns across gestational age groups.
Conclusions
UTE-MRI enables radiation-free quantification of lung density. UTE-MRI-derived lung-to-muscle ratios provide a radiation-free biomarker of preterm lung structural deficits and support risk-adapted follow-up.
{"title":"Quantitative assessment of lung density and developmental patterns in preterm infants using three-dimensional ultrashort echo time MRI (UTE-MRI)","authors":"Yujie Chen , Yan Sun , Yu Song , Yi Liao , Xuesheng Li , Xijian Chen , Gang Ning","doi":"10.1016/j.ejrad.2026.112696","DOIUrl":"10.1016/j.ejrad.2026.112696","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional ultrashort echo time (3D-UTE) MRI enables proton-density assessment of lung parenchyma without radiation. We aimed to evaluate the feasibility of 3D-UTE for quantifying lung density of preterm infants and characterize gestational-age (GA)-dependent developmental patterns.</div></div><div><h3>Methods</h3><div>101 infants (1 day-24 months) were enrolled as extremely-to-very preterm (EVP, <32 weeks, n = 33), moderate-to-late preterm (MLP, 32–<37 weeks, n = 34), and full-term (FT, 37–42 weeks, n = 34). Lung protocol including 3D-UTE, 3D-GRE (gradient-echo) and T2-FSE (fast spin-echo) sequences were used. Image quality was assessed qualitatively and quantitatively. Lung density was quantified using UTE-derived lung-to-muscle ratios (LMRs), and group differences and age-related patterns were evaluated.</div></div><div><h3>Results</h3><div>UTE-MRI provided superior visualization of lung structure with significantly higher signal-to-noise and contrast-to-noise ratios. Lung-to-muscle ratios demonstrated a consistent anterior–posterior gradient (R<sup>2</sup> = 0.582, <em>p</em> < 0.001) and decreased with lower gestational age (LMR-total: FT 50.8 ± 9.7; MLP 48.7 ± 7.6; EVP 45.1 ± 7.6), with EVP significantly lower than FT (<em>p</em> < 0.05). Within the first year of life, age-related analyses revealed distinct developmental patterns across gestational age groups.</div></div><div><h3>Conclusions</h3><div>UTE-MRI enables radiation-free quantification of lung density. UTE-MRI-derived lung-to-muscle ratios provide a radiation-free biomarker of preterm lung structural deficits and support risk-adapted follow-up.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112696"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060911","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}
To update the Italian Diagnostic Reference Levels (NDRLs) in interventional neuroradiology, the Istituto Superiore di Sanità coordinated a working group with consolidated expertise in this field. Establishing DRLs in interventional procedures is particularly challenging due to the complexity influenced by clinical and technical factors. For this reason, aim of this work is to provide DRLs that also take into account procedure complexity.
Material and methods
Data were collected from 20 Italian hospitals concerning cerebral angiography(CA), embolization of cerebral aneurysms (ECA), and Mechanical Thrombectomy (MT). For each procedure, Air-Kerma (Ka,r), Kerma-Area-Product(PKA), and Fluoroscopy Time(FT) were recorded.
Data related to patient age, sex, and radiological equipment were registered. Additionally, for CA number of arteries evaluated, diagnostic priority (elective or emergency), and study type were documented. For ECA, aneurysm status, dome-to-neck ratio, aneurysm size, aneurysm location, and aneurysm morphology were recorded. For MT, collected data included occlusion type, thrombus location, and use of a stent retriever.
Results
PKA distributions were analysed with non-parametric tests and generalized linear regression models to identify clinical and technical factors affecting dosimetry. Log transformations helped develop a complexity score to classify procedures. The new NDRLs are 191 Gy.cm2 for CA (71 Gy.cm2 for simple, 117 Gy.cm2 for medium, 198 Gy.cm2 for complex), 252 Gy.cm2 for ECA (136 Gy.cm2 for simple, 174 Gy.cm2 medium, 268 Gy.cm2 complex) and 169 Gy.cm2 for MT (71 Gy.cm2 for simple, 132 Gy.cm2 for medium, 169 Gy.cm2 for complex).
Conclusion
This study establishes updated national diagnostic reference levels for interventional neuroradiology in Italy through a comprehensive complexity-stratified approach. The research demonstrates the critical importance of regular DRL updates to reflect evolving practice patterns and technological advances, offering a more nuanced framework that recognizes the inherent variability of neuro interventional procedures across different complexity tiers.
{"title":"Establishing updated diagnostic reference levels for interventional radiology: a national Italian survey incorporating procedure complexity indices – Part II: interventional neuroradiology","authors":"Monica Cavallari , Loredana D’Ercole , Sveva Grande , Catherine Klersy , Renato Padovani , Antonio Orlacchio , Gaetano Compagnone , Antonella Rosi , Alessandra Palma","doi":"10.1016/j.ejrad.2026.112662","DOIUrl":"10.1016/j.ejrad.2026.112662","url":null,"abstract":"<div><h3>Introduction</h3><div>To update the Italian Diagnostic Reference Levels (NDRLs) in interventional neuroradiology, the Istituto Superiore di Sanità coordinated a working group with consolidated expertise in this field. Establishing DRLs in interventional procedures is particularly challenging due to the complexity influenced by clinical and technical factors. For this reason, aim of this work is to provide DRLs that also take into account procedure complexity.</div></div><div><h3>Material and methods</h3><div>Data were collected from 20 Italian hospitals concerning cerebral angiography(CA), embolization of cerebral aneurysms (ECA), and Mechanical Thrombectomy (MT). For each procedure, Air-Kerma (K<sub>a,r</sub>), Kerma-Area-Product(P<sub>KA</sub>), and Fluoroscopy Time(FT) were recorded.</div><div>Data related to patient age, sex, and radiological equipment were registered. Additionally, for CA number of arteries evaluated, diagnostic priority (elective or emergency), and study type were documented. For ECA, aneurysm status, dome-to-neck ratio, aneurysm size, aneurysm location, and aneurysm morphology were recorded. For MT, collected data included occlusion type, thrombus location, and use of a stent retriever.</div></div><div><h3>Results</h3><div>P<sub>KA</sub> distributions were analysed with non-parametric tests and generalized linear regression models to identify clinical and technical factors affecting dosimetry. Log transformations helped develop a complexity score to classify procedures. The new NDRLs are 191 Gy.cm<sup>2</sup> for CA (71 Gy.cm<sup>2</sup> for simple, 117 Gy.cm<sup>2</sup> for medium, 198 Gy.cm<sup>2</sup> for complex), 252 Gy.cm<sup>2</sup> for ECA (136 Gy.cm<sup>2</sup> for simple, 174 Gy.cm<sup>2</sup> medium, 268 Gy.cm<sup>2</sup> complex) and 169 Gy.cm<sup>2</sup> for MT (71 Gy.cm<sup>2</sup> for simple, 132 Gy.cm<sup>2</sup> for medium, 169 Gy.cm<sup>2</sup> for complex).</div></div><div><h3>Conclusion</h3><div>This study establishes updated national diagnostic reference levels for interventional neuroradiology in Italy through a comprehensive complexity-stratified approach. The research demonstrates the critical importance of regular DRL updates to reflect evolving practice patterns and technological advances, offering a more nuanced framework that recognizes the inherent variability of neuro interventional procedures across different complexity tiers.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112662"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009466","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 : 2026-03-01Epub Date: 2026-01-03DOI: 10.1016/j.ejrad.2026.112656
Xiaowen Zhang , Thom R.G. Stams , Gonda J. de Jonge , Marcel van Tuinen , Caroline van de Wauwer , Michiel Erasmus , Mieke Zwager , Geertruida H. de Bock , Monique Dorrius
Objective
In December 2020, our center transitioned from a fish-hook to a spiral wire for CT-guided pulmonary nodule localization. This study compared the effectiveness and safety of both techniques.
Methods
We retrospectively analyzed 154 consecutive patients with 157 pulmonary nodules who underwent CT-guided wire localization between November 2017 and December 2024. Demographic, lesion, procedural, surgical details, and pathology were collected. Technical success was defined as localization without wire dislodgement. Complications were categorized as minor (no intervention) or major (requiring intervention). Logistic regression identified risk factors for localization success and complications.
Results
Localization was performed using fish-hook wires in 79 and spiral wires in 78 procedures. Technical success rates were comparable (94.9 %, 95 %CI: 90.1 %-99.8 % vs. 94.9 %, 95 %CI: 90 %-99.8 %). Major complications were rare (two air embolisms and one drainage-requiring pneumothorax across all procedures). Minor complication rates were 34.2 % (95 % CI: 23.7 %–44.6 %) for fish-hook wires and 21.8 % (95 % CI: 12.6 %–31.0 %) for spiral wires. Pathological representativeness was similar. Wire type showed no difference in localization success (OR = 1.26, 95 % CI: 0.29–5.53). Fish-hook use (OR 2.36, 95 % CI 1.11–5.09) and longer procedure duration (OR 1.06, 95 % CI 1.02–1.10) were associated with minor complication risk.
Conclusion
Fish-hook and spiral shaped wires achieved comparable technical success and safety profile regarding major complications for CT-guided pulmonary nodule localization. However, from a patient perspective the relevance of minor complications should also be considered.
{"title":"Comparison of fish-hook shaped and spiral shaped wires in CT-guided pulmonary nodule localization: Impact on complications and clinical outcomes","authors":"Xiaowen Zhang , Thom R.G. Stams , Gonda J. de Jonge , Marcel van Tuinen , Caroline van de Wauwer , Michiel Erasmus , Mieke Zwager , Geertruida H. de Bock , Monique Dorrius","doi":"10.1016/j.ejrad.2026.112656","DOIUrl":"10.1016/j.ejrad.2026.112656","url":null,"abstract":"<div><h3>Objective</h3><div>In December 2020, our center transitioned from a fish-hook to a spiral wire for CT-guided pulmonary nodule localization. This study compared the effectiveness and safety of both techniques.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 154 consecutive patients with 157 pulmonary nodules who underwent CT-guided wire localization between November 2017 and December 2024. Demographic, lesion, procedural, surgical details, and pathology were collected. Technical success was defined as localization without wire dislodgement. Complications were categorized as minor (no intervention) or major (requiring intervention). Logistic regression identified risk factors for localization success and complications.</div></div><div><h3>Results</h3><div>Localization was performed using fish-hook wires in 79 and spiral wires in 78 procedures. Technical success rates were comparable (94.9 %, 95 %CI: 90.1 %-99.8 % vs. 94.9 %, 95 %CI: 90 %-99.8 %). Major complications were rare (two air embolisms and one drainage-requiring pneumothorax across all procedures). Minor complication rates were 34.2 % (95 % CI: 23.7 %–44.6 %) for fish-hook wires and 21.8 % (95 % CI: 12.6 %–31.0 %) for spiral wires. Pathological representativeness was similar. Wire type showed no difference in localization success (OR = 1.26, 95 % CI: 0.29–5.53). Fish-hook use (OR 2.36, 95 % CI 1.11–5.09) and longer procedure duration (OR 1.06, 95 % CI 1.02–1.10) were associated with minor complication risk.</div></div><div><h3>Conclusion</h3><div>Fish-hook and spiral shaped wires achieved comparable technical success and safety profile regarding major complications for CT-guided pulmonary nodule localization. However, from a patient perspective the relevance of minor complications should also be considered.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112656"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941148","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 : 2026-03-01Epub Date: 2026-01-28DOI: 10.1016/j.ejrad.2026.112702
Yixuan Hu , Jinxia Wang , Lingzhi Meng , Jinzhen Song , Zongli Yang
Background
The SRU consensus on pelvic ultrasound proposed standardized augmented ultrasound, but its validity and indirect signs’ role require validation. This study will explore the application value of this consensus in deep endometriosis.
Method
This prospective study enrolled patients with clinically suspected endometriosis at Qingdao University Affiliated Hospital from May 2024 to April 2025. TVUS findings were compared with surgical findings. The diagnostic performance of TVUS for endometriosis was calculated, and multivariable logistic regression was applied to analyze associations between indirect sonographic signs and lesion locations.
Results
Included were 288 patients with clinical suspicion of DE. For DE detection, TVUS showed an overall accuracy of 84.4% (sensitivity 87.4%, specificity 76.8%). Fixed uterine retroflexion was significantly associated with bowel (OR 2.07, 95% CI 1.16–3.71), RVS (OR 2.83, 95% CI 1.34–6.32), and uterine serosal involvement (OR 2.38, 95% CI 1.19–4.88). Bowel tethering predicted bowel (OR 6.45, 95% CI 3.69–11.53), RVS (OR 4.53, 95% CI 2.24–9.62), uterine serosal (OR 2.15, 95% CI 1.12–4.18), and vaginal lesions (OR 3.83, 95% CI 1.85–8.25). Ipsilateral ovarian fixation or abnormal position was indicative of ipsilateral ovarian endometriosis (right: OR 16.9, 95% CI 9.15–32.96; left: OR 14.54, 95% CI 8.02–27.63) and USL involvement (right: OR 4.38, 95% CI 2.40–8.29, left: OR 2.23, 95%CI 1.3–3.91).
Conclusion
SRU-based ultrasound demonstrates high diagnostic accuracy for DE. Indirect signs effectively localize endometriotic lesions, enhancing surgical planning.
SRU关于骨盆超声的共识提出了标准化增强超声，但其有效性和间接标志的作用有待验证。本研究将探讨该共识在深部子宫内膜异位症中的应用价值。方法本前瞻性研究纳入2024年5月至2025年4月青岛大学附属医院临床疑似子宫内膜异位症患者。将TVUS结果与手术结果进行比较。计算TVUS对子宫内膜异位症的诊断效果，并应用多变量logistic回归分析间接超声征象与病变部位的相关性。结果入选288例临床疑似DE患者，TVUS检测DE的总准确率为84.4%（敏感性87.4%，特异性76.8%）。固定子宫后倾与肠道（OR 2.07, 95% CI 1.16-3.71）、RVS （OR 2.83, 95% CI 1.34-6.32）和子宫浆膜受累（OR 2.38, 95% CI 1.19-4.88）显著相关。肠栓术预测肠道（OR 6.45, 95% CI 3.69-11.53）、RVS （OR 4.53, 95% CI 2.24-9.62）、子宫浆膜（OR 2.15, 95% CI 1.12-4.18）和阴道病变（OR 3.83, 95% CI 1.85-8.25）。同侧卵巢固定或位置异常提示同侧卵巢子宫内膜异位症（右侧：or 16.9, 95%CI 9.15-32.96；左侧：or 14.54, 95%CI 8.02-27.63）和USL受累（右侧：or 4.38, 95%CI 2.40-8.29，左侧：or 2.23, 95%CI 1.3-3.91）。结论超声超声对DE的诊断准确率高，间接征象能有效定位子宫内膜异位症病变，提高手术计划。
{"title":"Transvaginal ultrasound for deep endometriosis: Prospective validation of SRU criteria and diagnostic value of indirect signs","authors":"Yixuan Hu , Jinxia Wang , Lingzhi Meng , Jinzhen Song , Zongli Yang","doi":"10.1016/j.ejrad.2026.112702","DOIUrl":"10.1016/j.ejrad.2026.112702","url":null,"abstract":"<div><h3>Background</h3><div>The SRU consensus on pelvic ultrasound proposed standardized augmented ultrasound, but its validity and indirect signs’ role require validation. This study will explore the application value of this consensus in deep endometriosis.</div></div><div><h3>Method</h3><div>This prospective study enrolled patients with clinically suspected endometriosis at Qingdao University Affiliated Hospital from May 2024 to April 2025. TVUS findings were compared with surgical findings. The diagnostic performance of TVUS for endometriosis was calculated, and multivariable logistic regression was applied to analyze associations between indirect sonographic signs and lesion locations.</div></div><div><h3>Results</h3><div>Included were 288 patients with clinical suspicion of DE. For DE detection, TVUS showed an overall accuracy of 84.4% (sensitivity 87.4%, specificity 76.8%). Fixed uterine retroflexion was significantly associated with bowel (OR 2.07, 95% CI 1.16–3.71), RVS (OR 2.83, 95% CI 1.34–6.32), and uterine serosal involvement (OR 2.38, 95% CI 1.19–4.88). Bowel tethering predicted bowel (OR 6.45, 95% CI 3.69–11.53), RVS (OR 4.53, 95% CI 2.24–9.62), uterine serosal (OR 2.15, 95% CI 1.12–4.18), and vaginal lesions (OR 3.83, 95% CI 1.85–8.25). Ipsilateral ovarian fixation or abnormal position was indicative of ipsilateral ovarian endometriosis (right: OR 16.9, 95% CI 9.15–32.96; left: OR 14.54, 95% CI 8.02–27.63) and USL involvement (right: OR 4.38, 95% CI 2.40–8.29, left: OR 2.23, 95%CI 1.3–3.91).</div></div><div><h3>Conclusion</h3><div>SRU-based ultrasound demonstrates high diagnostic accuracy for DE. Indirect signs effectively localize endometriotic lesions, enhancing surgical planning.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112702"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074524","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 : 2026-03-01Epub Date: 2026-01-28DOI: 10.1016/j.ejrad.2026.112705
Langlang Tang , Kaiqian Que , Yanfen Lan , Yimin Li , Bin Wang , Zhuting Fang
Purpose
To develop and validate a prognostic model integrating pretreatment MRI features and clinical characteristics for hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) combined targeted immunotherapy (TII). A weighted scoring system was developed to improve the model’s clinical utility.
Methods
We retrospectively recruited 141 patients with HCC from multiple centers, with 98 in the training cohort and 43 in the validation cohort. The independent predictors were identified using univariate and multivariate Cox regression analyses and developed a clinical nomogram. We constructed an 10-point weighted scoring system incorporating imaging features. Model performance was evaluated using AUC, decision curve analysis (DCA), and calibration curves assessed via bootstrapping.
Results
Logistic regression identified four risk factors for objective response (OR): irregular tumor border, absent of Intratumoral artery, albumin-bilirubin (ALBI) score ≥ -2.352, number ≥ 2, and tumor histopathological enhancement (THPE). The AUC was 0.804 in the training cohort and 0.580 in the validation cohort. The Akaike Information Criterion (AIC) for the scoring model was lower than the other model for predicting OR, progression-free survival (PFS), and overall survival (OS). Patients with a scoring model value > 5.5 points were classified as high-risk. The Kaplan-Meier (K-M) curves of the scoring model showed the better discriminative ability for PFS and OS.
Conclusion
The functional imaging-liver function synergy model demonstrates superior prognostic accuracy over conventional tumor burden parameters in hepatocellular carcinoma patients receiving quadruple therapy. Furthermore, the derived 10-point scoring system enables clinically actionable risk stratification.
目的建立并验证肝细胞癌（HCC）经动脉化疗栓塞（TACE）和肝动脉灌注化疗（HAIC）联合靶向免疫治疗（TII）的预后模型。开发了加权评分系统以提高模型的临床实用性。方法我们回顾性地从多个中心招募了141例HCC患者，其中98例为培训组，43例为验证组。使用单变量和多变量Cox回归分析确定独立预测因子，并制定临床nomogram。我们构建了一个包含影像特征的10分加权评分系统。采用AUC、决策曲线分析（DCA）和自举校准曲线评估模型性能。结果logistic回归分析确定了4个客观反应（OR）的危险因素：肿瘤边界不规则、瘤内动脉缺失、白蛋白-胆红素（ALBI）评分≥-2.352、数量≥2、肿瘤组织病理学增强（THPE）。训练组和验证组的AUC分别为0.804和0.580。评分模型的赤池信息标准（Akaike Information Criterion， AIC）在预测OR、无进展生存期（PFS）和总生存期（OS）方面低于其他模型。评分模型值为>； 5.5分的患者为高危患者。评分模型的Kaplan-Meier （K-M）曲线对PFS和OS有较好的判别能力。结论功能影像学-肝功能协同模型对肝细胞癌四联治疗患者预后的准确性优于常规肿瘤负荷参数。此外，衍生的10分评分系统使临床可操作的风险分层。
{"title":"Prognostic value of functional MRI and liver function synergy in hepatocellular carcinoma patients receiving combined locoregional-systemic therapy: A multicenter scoring model","authors":"Langlang Tang , Kaiqian Que , Yanfen Lan , Yimin Li , Bin Wang , Zhuting Fang","doi":"10.1016/j.ejrad.2026.112705","DOIUrl":"10.1016/j.ejrad.2026.112705","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop and validate a prognostic model integrating pretreatment MRI features and clinical characteristics for hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) combined targeted immunotherapy (TII). A weighted scoring system was developed to improve the model’s clinical utility.</div></div><div><h3>Methods</h3><div>We retrospectively recruited 141 patients with HCC from multiple centers, with 98 in the training cohort and 43 in the validation cohort. The independent predictors were identified using univariate and multivariate Cox regression analyses and developed a clinical nomogram. We constructed an 10-point weighted scoring system incorporating imaging features. Model performance was evaluated using AUC, decision curve analysis (DCA), and calibration curves assessed via bootstrapping.</div></div><div><h3>Results</h3><div>Logistic regression identified four risk factors for objective response (OR): irregular tumor border, absent of Intratumoral artery, albumin-bilirubin (ALBI) score ≥ -2.352, number ≥ 2, and tumor histopathological enhancement (THPE). The AUC was 0.804 in the training cohort and 0.580 in the validation cohort. The Akaike Information Criterion (AIC) for the scoring model was lower than the other model for predicting OR, progression-free survival (PFS), and overall survival (OS). Patients with a scoring model value > 5.5 points were classified as high-risk. The Kaplan-Meier (K-M) curves of the scoring model showed the better discriminative ability for PFS and OS.</div></div><div><h3>Conclusion</h3><div>The functional imaging-liver function synergy model demonstrates superior prognostic accuracy over conventional tumor burden parameters in hepatocellular carcinoma patients receiving quadruple therapy. Furthermore, the derived 10-point scoring system enables clinically actionable risk stratification.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112705"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074617","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 : 2026-03-01Epub Date: 2026-01-25DOI: 10.1016/j.ejrad.2026.112699
Hangzhi Liu , Yingzhu Zhao , Jing Li , Xiaoxia Qu , Tianying Ma , Chen Zhang , Thorsten Feiweier , Xinyan Wang , Junfang Xian
Background
Preoperative discrimination between orbital B-cell lymphoma and inflammatory lesions remains a significant challenge using conventional imaging. This study evaluates the potential of time-dependent diffusion MRI (td-dMRI) alongside diffusion-weighted imaging (DWI) to improve differential diagnosis.
Methods
Patients with suspected orbital tumors were prospectively enrolled between October 2023 and November 2024. All participants underwent td-dMRI using oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) sequences on a 3 T scanner. Microstructural parameters—including cell diameter (d), cellularity, extracellular diffusivity (Dex), and intracellular volume fraction (Vin)—were derived. Correlations between apparent diffusion coefficient (ADC), d, cellularity, and histopathological metrics were assessed through quantitative morphometric analysis. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis.
Results
Forty-eight patients were enrolled (20 orbital MALT lymphoma, 28 inflammatory lesions). All parameters showed excellent interobserver agreement (ICCs: 0.82–0.93). Strong correlations were observed between histological cell diameter and d (r = 0.75), and between histological cellularity and both td-dMRI-derived cellularity (r = 0.71) and ADC (r = -0.74) (all p < 0.001). Lymphomas exhibited significantly lower ADC, d, and Dex, and higher Vin and cellularity compared to inflammatory lesions (all p < 0.01). Cellularity demonstrated the highest discriminative power (AUC = 0.87), followed by Vin (AUC = 0.82), while ADC showed moderate performance (AUC = 0.74). No significant differences in diagnostic efficacy were observed among the parameters.
Conclusions
The td-dMRI provides highly reproducible, histologically correlated biomarkers that effectively differentiate orbital lymphoma from inflammatory lesions, thereby enabling orbital lesion risk-stratification and providing valuable non-invasive characterization to complement conventional ADC-based assessment for preoperative diagnosis of orbital lesions.
{"title":"Discriminating orbital lymphoma from inflammation and correlating with histopathology using microstructure-based time-dependent diffusion MRI","authors":"Hangzhi Liu , Yingzhu Zhao , Jing Li , Xiaoxia Qu , Tianying Ma , Chen Zhang , Thorsten Feiweier , Xinyan Wang , Junfang Xian","doi":"10.1016/j.ejrad.2026.112699","DOIUrl":"10.1016/j.ejrad.2026.112699","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative discrimination between orbital B-cell lymphoma and inflammatory lesions remains a significant challenge using conventional imaging. This study evaluates the potential of time-dependent diffusion MRI (td-dMRI) alongside diffusion-weighted imaging (DWI) to improve differential diagnosis.</div></div><div><h3>Methods</h3><div>Patients with suspected orbital tumors were prospectively enrolled between October 2023 and November 2024. All participants underwent td-dMRI using oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) sequences on a 3 T scanner. Microstructural parameters—including cell diameter (d), cellularity, extracellular diffusivity (Dex), and intracellular volume fraction (Vin)—were derived. Correlations between apparent diffusion coefficient (ADC), d, cellularity, and histopathological metrics were assessed through quantitative morphometric analysis. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis.</div></div><div><h3>Results</h3><div>Forty-eight patients were enrolled (20 orbital MALT lymphoma, 28 inflammatory lesions). All parameters showed excellent interobserver agreement (ICCs: 0.82–0.93). Strong correlations were observed between histological cell diameter and d (r = 0.75), and between histological cellularity and both td-dMRI-derived cellularity (r = 0.71) and ADC (r = -0.74) (all p < 0.001). Lymphomas exhibited significantly lower ADC, d, and Dex, and higher Vin and cellularity compared to inflammatory lesions (all p < 0.01). Cellularity demonstrated the highest discriminative power (AUC = 0.87), followed by Vin (AUC = 0.82), while ADC showed moderate performance (AUC = 0.74). No significant differences in diagnostic efficacy were observed among the parameters.</div></div><div><h3>Conclusions</h3><div>The td-dMRI provides highly reproducible, histologically correlated biomarkers that effectively differentiate orbital lymphoma from inflammatory lesions, thereby enabling orbital lesion risk-stratification and providing valuable non-invasive characterization to complement conventional ADC-based assessment for preoperative diagnosis of orbital lesions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112699"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074549","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}
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