Pub Date : 2026-01-06DOI: 10.1016/j.ejrad.2026.112658
Yongjia Chen , Lu Jiang , Zequn Nie , Jing Liu , Bo Pang , Shuai Zhang , Yijiang Bai , Heng Liu , Zihang Guo , Jilin Nie , Shuangyuan Zhou , Lingyun Mei
Objectives
This study aimed to determine whether there are differences of cerebrospinal fluid pressure (CSF-P) on patients with Ménière’s disease (MD) during different phases.
Methods
Noninvasive CSF-P measurement was performed using MRI with a fat-suppressed fast recovery fast spin echo T2-weighted sequence, with the optic nerve subarachnoid space width (ONSASW) posterior to the globe serving as an indicator. Endolymphatic hydrops (EH) grades and hearing thresholds were analysed to investigate the potential correlations with CSF-P.
Results
A total of 66 participants were included. At the location of 3 mm behind the globe, the ONSASW and CSF-P were significantly smaller in the acute phase of MD group compared to both the remission phase of MD group (p < 0.001, p = 0.005, respectively) and control group (p < 0.001, p = 0.043, respectively). No statistically significant differences were found between the remission phase of MD group and the control group (both p > 0.05). Statistically significant correlation between CSF-P and hearing threshold was exclusively observed during the acute phase, with a correlation coefficient of 0.479 (p = 0.024). No significant associations between CSF-P and EH grades in both the two MD groups (all p > 0.05).
Conclusion
The study suggests that patients with MD experience a reduction in intracranial pressure during acute episodes, and these fluctuations may indicate hearing threshold variations in early-stage of patients.
目的探讨mims患者脑脊液压(CSF-P)在不同时期是否存在差异。方法以视神经球后蛛网膜下腔间隙宽度(ONSASW)为指标,采用脂肪抑制快速恢复快速旋转回声t2加权序列进行无创CSF-P测量。分析内淋巴积液(EH)等级和听力阈值,以探讨与CSF-P的潜在相关性。结果共纳入66例受试者。在地球仪后3mm位置,MD组急性期的ONSASW和CSF-P明显小于MD组缓解期(p < 0.001, p = 0.005,分别)和对照组(p < 0.001, p = 0.043)。MD组缓解期与对照组比较差异无统计学意义(p > 0.05)。CSF-P与听阈仅在急性期有统计学意义相关,相关系数为0.479 (p = 0.024)。两组患者CSF-P和EH分级之间无显著相关性(均p >; 0.05)。结论MD患者急性发作时颅内压降低,这种波动可能提示早期患者的听阈变化。
{"title":"Noninvasive MRI assessment of cerebrospinal fluid pressure in different phases of Ménière’s disease: a prospective study","authors":"Yongjia Chen , Lu Jiang , Zequn Nie , Jing Liu , Bo Pang , Shuai Zhang , Yijiang Bai , Heng Liu , Zihang Guo , Jilin Nie , Shuangyuan Zhou , Lingyun Mei","doi":"10.1016/j.ejrad.2026.112658","DOIUrl":"10.1016/j.ejrad.2026.112658","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to determine whether there are differences of cerebrospinal fluid pressure (CSF-P) on patients with Ménière’s disease (MD) during different phases.</div></div><div><h3>Methods</h3><div>Noninvasive CSF-P measurement was performed using MRI with a fat-suppressed fast recovery fast spin echo T2-weighted sequence, with the optic nerve subarachnoid space width (ONSASW) posterior to the globe serving as an indicator. Endolymphatic hydrops (EH) grades and hearing thresholds were analysed to investigate the potential correlations with CSF-P.</div></div><div><h3>Results</h3><div>A total of 66 participants were included. At the location of 3 mm behind the globe, the ONSASW and CSF-P were significantly smaller in the acute phase of MD group compared to both the remission phase of MD group (<em>p</em> < 0.001, <em>p</em> = 0.005, respectively) and control group (<em>p</em> < 0.001, <em>p</em> = 0.043, respectively). No statistically significant differences were found between the remission phase of MD group and the control group (both <em>p</em> > 0.05). Statistically significant correlation between CSF-P and hearing threshold was exclusively observed during the acute phase, with a correlation coefficient of 0.479 (<em>p</em> = 0.024). No significant associations between CSF-P and EH grades in both the two MD groups (all <em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>The study suggests that patients with MD experience a reduction in intracranial pressure during acute episodes, and these fluctuations may indicate hearing threshold variations in early-stage of patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112658"},"PeriodicalIF":3.3,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921121","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 : 2026-01-05DOI: 10.1016/j.ejrad.2026.112657
Qian Yu , Ali Ahmed , Wali Badar , Daniel Kwak , Aaron William Lyon , Yating Wang , Carla Harmath , Mikin Patel , Divya Kumari , Thuong Van Ha , Osman Ahmed
Purpose
The effectiveness of percutaneous thermoablation as curative treatment of hepatic oligometastases greater than 3 cm can be limited by the ability to achieve adequate ablation coverage. Radiation segmentectomy (RS) using yttrium-90 (Y90) microspheres is an established treatment and potentially curative for hepatocellular carcinoma (HCC) up to 8 cm. This study evaluates the safety and effectiveness of RS for secondary liver tumors larger than 3 cm.
Methods
A retrospective review at a single institution was performed from December 2017 to February 2024 to include patients treated with transarterial radioembolization (TARE) for liver metastases using glass Y90 microspheres. RS was defined as a target dose > 200 Gy to no more than two liver segments. The following outcomes were retrieved: overall survival (OS), radiologic response, progression-free survival (PFS), adverse events, and 3-month serum toxicity.
Results
A total of 14 patients (mean age: 64.2 ± 18.5, M:F = 5:9) with secondary liver tumors (mean diameter: 4.7 ± 1.4 cm; single hepatic lesion: 57.1 %[8/14]), including 5 colorectal cancer (35.7 %), 2 renal cell carcinoma (14.3 %), 2 uveal melanoma (14.3 %), 2 adenoid cystic carcinoma (14.3 %), 1 pancreatic adenocarcinoma (7.1 %), 1 endometrial carcinoma (7.1 %), and 1 tonsillar adenocarcinoma (7.1 %). The mean segmentectomy dose was 352.6 ± 149.1 Gy. Response rate and disease control rate were 42.9 % (6/14) and 85.7 % (12/14), respectively. The 1-yr and 3-yr target tumor response rates were 51.4 % (95 %CI: 21.9–74.8 %) and 34.2 % (95 %CI: 7.1–64.9 %), respectively, with a median PFS of 16.3 months 95 %CI: 5.4 months-not reached). The 1-yr and 3-yr OS were 80.8 % (95 %CI: 42.4–94.9 %) and 40.4 % (95 %CI: 9.8–70.2 %), respectively, with a median OS of 24.3 months (95 %CI: 8.9-not reached). One patient developed grade 3 thrombocytopenia, requiring holding of systemic treatment (7.1 %). No additional grade 3 or above adverse events occurred.
Conclusion
Preliminary results suggest that RS is a feasible treatment option for secondary liver tumors > 3 cm with few major adverse events.
{"title":"Radiation segmentectomy for treatment of hepatic oligometastases greater than 3 cm","authors":"Qian Yu , Ali Ahmed , Wali Badar , Daniel Kwak , Aaron William Lyon , Yating Wang , Carla Harmath , Mikin Patel , Divya Kumari , Thuong Van Ha , Osman Ahmed","doi":"10.1016/j.ejrad.2026.112657","DOIUrl":"10.1016/j.ejrad.2026.112657","url":null,"abstract":"<div><h3>Purpose</h3><div>The effectiveness of percutaneous thermoablation as curative treatment of hepatic oligometastases greater than 3 cm can be limited by the ability to achieve adequate ablation coverage. Radiation segmentectomy (RS) using yttrium-90 (Y90) microspheres is an established treatment and potentially curative for hepatocellular carcinoma (HCC) up to 8 cm. This study evaluates the safety and effectiveness of RS for secondary liver tumors larger than 3 cm.</div></div><div><h3>Methods</h3><div>A retrospective review at a single institution was performed from December 2017 to February 2024 to include patients treated with transarterial radioembolization (TARE) for liver metastases using glass Y90 microspheres. RS was defined as a target dose > 200 Gy to no more than two liver segments. The following outcomes were retrieved: overall survival (OS), radiologic response, progression-free survival (PFS), adverse events, and 3-month serum toxicity.</div></div><div><h3>Results</h3><div>A total of 14 patients (mean age: 64.2 ± 18.5, M:F = 5:9) with secondary liver tumors (mean diameter: 4.7 ± 1.4 cm; single hepatic lesion: 57.1 %[8/14]), including 5 colorectal cancer (35.7 %), 2 renal cell carcinoma (14.3 %), 2 uveal melanoma (14.3 %), 2 adenoid cystic carcinoma (14.3 %), 1 pancreatic adenocarcinoma (7.1 %), 1 endometrial carcinoma (7.1 %), and 1 tonsillar adenocarcinoma (7.1 %). The mean segmentectomy dose was 352.6 ± 149.1 Gy. Response rate and disease control rate were 42.9 % (6/14) and 85.7 % (12/14), respectively. The 1-yr and 3-yr target tumor response rates were 51.4 % (95 %CI: 21.9–74.8 %) and 34.2 % (95 %CI: 7.1–64.9 %), respectively, with a median PFS of 16.3 months 95 %CI: 5.4 months-not reached). The 1-yr and 3-yr OS were 80.8 % (95 %CI: 42.4–94.9 %) and 40.4 % (95 %CI: 9.8–70.2 %), respectively, with a median OS of 24.3 months (95 %CI: 8.9-not reached). One patient developed grade 3 thrombocytopenia, requiring holding of systemic treatment (7.1 %). No additional grade 3 or above adverse events occurred.</div></div><div><h3>Conclusion</h3><div>Preliminary results suggest that RS is a feasible treatment option for secondary liver tumors > 3 cm with few major adverse events.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112657"},"PeriodicalIF":3.3,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035314","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 : 2026-01-04DOI: 10.1016/j.ejrad.2026.112655
Yi Fang , Milan Sigdel , Manoj Sigdel , Madan Sigdel , Roshan Bhattarai , Mikias Legesse Gebremedhin , Zhanguo Sun , Xinwei Han , Dechao Jiao
Purpose
To evaluate the feasibility and safety of percutaneous radiofrequency ablation (RFA) of lung tumors under the guidance of robotic navigation system.
Material and methods
From January 2022 to December 2023, 62 cases with solitary lung tumors who underwent RFA procedure at our department and were divided into two groups: the robotic navigation assisted puncture (RNAP) group (n = 26) and manual puncture (MP) group (n = 36). Two groups were compared in terms of technical success (TS), puncture scoring (PS), CT scan times, Total procedure time (TPT), puncture time (PT), radiation exposure (RE), complete ablation (CA) rate and local tumor progression rate (LTP) rate.
Results
PS, PT, total number of CT scans, and RE showed significance between patients in the RNAP compared to those in the MP group (15/8/2/1 vs. 6/8/18/4, P = <0.001; 13.71 min vs. 16.97 mins, P < 0.01; 4.57 vs 6.94, P < 0.01; 2215.38 vs. 4615 mGy.cm, P < 0.01). TS, TPT, major complications, CA rate and LTP rate showed no difference (100 % vs.100 %; 40.52 min vs. 42.53 min; 11.53 % vs. 11.11 %; 88.46 % vs. 86.11 %; 11.53 % % vs. 13.88 %; respectively, and all P > 0.05).
Conclusions
Robotic navigation-assisted radiofrequency ablation of lung tumors is a feasible and safe technique. It can minimize needle adjustments, thereby shortening puncture time and reducing radiation exposure for patients.
目的:评价机器人导航系统引导下经皮肺肿瘤射频消融(RFA)的可行性和安全性。材料与方法:选取2022年1月至2023年12月在我科行RFA手术的孤立性肺肿瘤62例,分为机器人导航辅助穿刺(RNAP)组(n = 26)和手动穿刺(MP)组(n = 36)。比较两组手术技术成功率(TS)、穿刺评分(PS)、CT扫描次数、总手术时间(TPT)、穿刺时间(PT)、放射暴露(RE)、完全消融(CA)率和局部肿瘤进展率(LTP)率。结果:与MP组相比,RNAP组患者的PS、PT、CT扫描总次数、RE差异有统计学意义(15/8/2/1 vs 6/8/18/4, P = 0.05)。结论:机器人导航辅助射频消融治疗肺肿瘤是一种安全可行的技术。它可以减少针的调整,从而缩短穿刺时间,减少患者的辐射暴露。
{"title":"Robotic navigation-assisted radio-frequency ablation of lung tumors: a pilot study","authors":"Yi Fang , Milan Sigdel , Manoj Sigdel , Madan Sigdel , Roshan Bhattarai , Mikias Legesse Gebremedhin , Zhanguo Sun , Xinwei Han , Dechao Jiao","doi":"10.1016/j.ejrad.2026.112655","DOIUrl":"10.1016/j.ejrad.2026.112655","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the feasibility and safety of percutaneous radiofrequency ablation (RFA) of lung tumors under the guidance of robotic navigation system.</div></div><div><h3>Material and methods</h3><div>From January 2022 to December 2023, 62 cases with solitary lung tumors who underwent RFA procedure at our department and were divided into two groups: the robotic navigation assisted puncture (RNAP) group (n = 26) and manual puncture (MP) group (n = 36). Two groups were compared in terms of technical success (TS), puncture scoring (PS), CT scan times, Total procedure time (TPT), puncture time (PT), radiation exposure (RE), complete ablation (CA) rate and local tumor progression rate (LTP) rate.</div></div><div><h3>Results</h3><div>PS, PT, total number of CT scans, and RE showed significance between patients in the RNAP compared to those in the MP group (15/8/2/1 vs. 6/8/18/4, P = <strong><0.001</strong>; 13.71 min vs. 16.97 mins, P <strong>< 0.01</strong>; 4.57 vs 6.94, P <strong>< 0.01</strong>; 2215.38 vs. 4615 mGy.cm, P <strong>< 0.01</strong>). TS, TPT, major complications, CA rate and LTP rate showed no difference (100 % vs.100 %; 40.52 min vs. 42.53 min; 11.53 % vs. 11.11 %; 88.46 % vs. 86.11 %; 11.53 % % vs. 13.88 %; respectively, and all P > 0.05).</div></div><div><h3>Conclusions</h3><div>Robotic navigation-assisted radiofrequency ablation of lung tumors is a feasible and safe technique. It can minimize needle adjustments, thereby shortening puncture time and reducing radiation exposure for patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112655"},"PeriodicalIF":3.3,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965740","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 : 2026-01-03DOI: 10.1016/j.ejrad.2025.112633
Samuel Dushimirimana , Edozie Iweka , Hannah Rickman , Benard Ohene-Botwe , Theophilus N. Akudjedu
Objective
To evaluate the contrast enhancement potential of food-based substances (FBS) as clinical imaging agents in MR cholangiopancreatography (MRCP) and digestive tract investigations.
Methods
A systematic literature search was conducted using a pre-defined strategy and inclusion criteria to identify relevant articles. Two review authors independently screened and selected papers for inclusion, conducted risk of bias assessment using ROBINS-I (Risk of Bias In Non-randomised Studies of Interventions) tool and assessed certainty of evidence using the Cochrane’s GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Areas of disagreement were resolved through consensus and the involvement of a third reviewer. The data obtained were meta-analysed using both random and fixed effects models with inverse variance methods, depending on the included studies’ methodological heterogeneity, to estimate the pooled mean difference and odds ratio.
Results
16 studies (1360 participants) were included in this review. Eight studies each examined the effectiveness of FBS for contrast enhancement in MRCP and MRE, respectively. The pooled mean differences between MRCP with pineapple juice and non-contrast MRCP were 1.04 (95 % CI: 0.23, 1.84; I2 = 96 %, p < 0.01) for bile duct visibility and 0.95 (95 % CI: 0.04, 1.85; I2 = 95 %, p < 0.01) for pancreatic duct visibility. Compared to non-contrast MRCP, MRCP with pineapple juice showed improved pancreaticobiliary duct visibility (Combined odds ratio, 5.01; 95 % CI: 2.34, 10.64; p < 0.0001). However, when compared with synthetic contrast agents, there is a lower likelihood of obtaining excellent quality MRE images with food-based contrast agents (FBCAs) (odds ratio, 0.36; 95 % CI: 0.18, 0.73, 0.73; p = 0.004). A generally high safety and acceptance profile was reported across the included studies for FBCAs. The certainty of the evidence obtained was considered moderate across all outcomes.
Conclusion
Oral administration of pineapple juice improves the diagnostic quality of MRCP investigations, while the contrast enhancement potential of FBS is limited in MRE studies. The high heterogeneity of results and moderate certainty of the evidence, however, require a cautious admission of results. Therefore, further research is necessary to gain a comprehensive understanding of the reliability of FBS in these MRI investigations, as well as in other imaging modalities that are yet to be explored.
目的评价食品基物质(FBS)作为临床显像剂在MR胆管造影(MRCP)和消化道检查中的增强潜力。方法采用预先设定的策略和纳入标准进行系统的文献检索,以确定相关文献。两位综述作者独立筛选和选择纳入的论文,使用ROBINS-I(非随机干预研究的偏倚风险)工具进行偏倚风险评估,并使用Cochrane的GRADE(推荐评估、发展和评价分级)方法评估证据的确定性。分歧的领域通过协商一致和第三方审稿人的参与得到解决。根据纳入研究的方法学异质性,采用随机效应和固定效应模型和反方差方法对获得的数据进行meta分析,以估计合并平均差异和优势比。结果16项研究(1360名受试者)纳入本综述。8项研究分别检测了FBS在MRCP和MRE中的增强效果。菠萝汁MRCP与非对比MRCP在胆管可见性方面的总平均差异为1.04 (95% CI: 0.23, 1.84; I2 = 96%, p < 0.01),在胰管可见性方面的总平均差异为0.95 (95% CI: 0.04, 1.85; I2 = 95%, p < 0.01)。与非对照MRCP相比,菠萝汁MRCP可改善胰胆管可见性(综合优势比为5.01;95% CI: 2.34, 10.64; p < 0.0001)。然而,与合成造影剂相比,食物基造影剂(fbca)获得高质量MRE图像的可能性较低(优势比0.36;95% CI: 0.18, 0.73, 0.73; p = 0.004)。在纳入的研究中,报告了fbca的总体安全性和可接受性。获得的证据的确定性在所有结局中被认为是中等的。结论口服菠萝汁可提高MRCP检查的诊断质量,而FBS在MRE研究中的增强潜力有限。然而,由于结果的高度异质性和证据的中等确定性,需要谨慎地承认结果。因此,需要进一步的研究来全面了解FBS在这些MRI调查中的可靠性,以及其他尚未探索的成像方式。
{"title":"Contrast enhancement potential of food-based imaging agents in cholangiopancreatography and digestive tract investigations using MRI: A systematic literature review and meta-analysis","authors":"Samuel Dushimirimana , Edozie Iweka , Hannah Rickman , Benard Ohene-Botwe , Theophilus N. Akudjedu","doi":"10.1016/j.ejrad.2025.112633","DOIUrl":"10.1016/j.ejrad.2025.112633","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the contrast enhancement potential of food-based substances (FBS) as clinical imaging agents in MR cholangiopancreatography (MRCP) and digestive tract investigations.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted using a pre-defined strategy and inclusion criteria to identify relevant articles<strong>.</strong> Two review authors independently screened and selected papers for inclusion, conducted risk of bias assessment using ROBINS-I (Risk of Bias In Non-randomised Studies of Interventions) tool and assessed certainty of evidence using the Cochrane’s GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Areas of disagreement were resolved through consensus and the involvement of a third reviewer. The data obtained were <em>meta</em>-analysed using both random and fixed effects models with inverse variance methods, depending on the included studies’ methodological heterogeneity, to estimate the pooled mean difference and odds ratio.</div></div><div><h3>Results</h3><div>16 studies (1360 participants) were included in this review. Eight studies each examined the effectiveness of FBS for contrast enhancement in MRCP and MRE, respectively. The pooled mean differences between MRCP with pineapple juice and non-contrast MRCP were 1.04 (95 % CI: 0.23, 1.84; I<sup>2</sup> = 96 %, p < 0.01) for bile duct visibility and 0.95 (95 % CI: 0.04, 1.85; I<sup>2</sup> = 95 %, p < 0.01) for pancreatic duct visibility. Compared to non-contrast MRCP, MRCP with pineapple juice showed improved pancreaticobiliary duct visibility (Combined odds ratio, 5.01; 95 % CI: 2.34, 10.64; p < 0.0001). However, when compared with synthetic contrast agents, there is a lower likelihood of obtaining excellent quality MRE images with food-based contrast agents (FBCAs) (odds ratio, 0.36; 95 % CI: 0.18, 0.73, 0.73; p = 0.004). A generally high safety and acceptance profile was reported across the included studies for FBCAs. The certainty of the evidence obtained was considered moderate across all outcomes.</div></div><div><h3>Conclusion</h3><div>Oral administration of pineapple juice improves the diagnostic quality of MRCP investigations, while the contrast enhancement potential of FBS is limited in MRE studies. The high heterogeneity of results and moderate certainty of the evidence, however, require a cautious admission of results. Therefore, further research is necessary to gain a comprehensive understanding of the reliability of FBS in these MRI investigations, as well as in other imaging modalities that are yet to be explored.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112633"},"PeriodicalIF":3.3,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921188","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 : 2026-01-03DOI: 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":"2026-01-03","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}
Silent Magnetic Resonance Angiography (S-MRA) is a non-contrast MR imaging method that utilises ultrashort echo in conjunction with the arterial spin labeling technique to produce angiographic images. The present article discusses the technical aspects of Silent MR angiography and its applications in neurovascular imaging, along with its advantages and pitfalls.
Methods
Using illustrative cases, various applications of the Silent MRA are explored along with a brief discussion on its technique and limitations. The Silent MR sequence provides an angiographic image with good background suppression in a duration of about 6–7 min and is devoid of saturation artefacts seen with Time of Flight (TOF) MR angiography.
Results
Applications include assessment of aneurysms (both untreated and treated cases), direct and indirect carotico-cavernous fistulas, dural arteriovenous fistulas, intracranial atherosclerotic disease, and Moya Moya disease with superior image quality compared to MR TOF angiography. It is particularly useful in post-procedural scans, such as after stenting and flow diverter placement, owing to reduced artefacts. In the pediatric population and acutely ill patients, an additional advantage includes reduced acoustic noise during the sequence, leading to diminished requirements for repeat studies.
Conclusions
S-MRA is a useful non-contrast MR angiography technique with improved image quality and reduced artifacts compared to MR TOF angiography, thereby facilitating the evaluation of multiple neurovascular diseases both pre- and post-interventions.
{"title":"Silent magnetic resonance angiography: Techniques and applications of neurovascular imaging","authors":"Sunil Kumar, Smily Sharma, Vishnu Shivshankar Pujari, Venkata Subbaih Arunachalam, Bejoy Thomas, Santhosh Kumar Kannath, Jayadevan E.R., Chandrasekharan Kesavadas","doi":"10.1016/j.ejrad.2026.112654","DOIUrl":"10.1016/j.ejrad.2026.112654","url":null,"abstract":"<div><h3>Purpose</h3><div>Silent Magnetic Resonance Angiography (S-MRA) is a non-contrast MR imaging method that utilises ultrashort echo in conjunction with the arterial spin labeling technique to produce angiographic images. The present article discusses the technical aspects of Silent MR angiography and its applications in neurovascular imaging, along with its advantages and pitfalls.</div></div><div><h3>Methods</h3><div>Using illustrative cases, various applications of the Silent MRA are explored along with a brief discussion on its technique and limitations. The Silent MR sequence provides an angiographic image with good background suppression in a duration of about 6–7 min and is devoid of saturation artefacts seen with Time of Flight (TOF) MR angiography.</div></div><div><h3>Results</h3><div>Applications include assessment of aneurysms (both untreated and treated cases), direct and indirect carotico-cavernous fistulas, dural arteriovenous fistulas, intracranial atherosclerotic disease, and Moya Moya disease with superior image quality compared to MR TOF angiography. It is particularly useful in post-procedural scans, such as after stenting and flow diverter placement, owing to reduced artefacts. In the pediatric population and acutely ill patients, an additional advantage includes reduced acoustic noise during the sequence, leading to diminished requirements for repeat studies.</div></div><div><h3>Conclusions</h3><div>S-MRA is a useful non-contrast MR angiography technique with improved image quality and reduced artifacts compared to MR TOF angiography, thereby facilitating the evaluation of multiple neurovascular diseases both pre- and post-interventions.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112654"},"PeriodicalIF":3.3,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965721","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 : 2026-01-03DOI: 10.1016/j.ejrad.2025.112646
Haini Zhang , Juan Long , Xinran Zhang , Chenzi Wang , Xiaohan Liu , Wenbei Xu , Xiaonan Sun , Aiyun Sun , Shaohui Zheng , Yingying Cui , Hao Wang , Yankai Meng , Kai Xu
Background
Accurate preoperative evaluation of rectal cancer is essential for staging and treatment planning. Low-energy virtual monoenergetic imaging (VMI) enhances iodine contrast in dual-energy computed tomography (DECT) but increases image noise. Deep learning image reconstruction (DLIR) may mitigate this issue, but its effectiveness for 40 keV VMI in rectal cancer is underexplored.
Objective
To evaluate the impact of DLIR on 40 keV VMI image quality and its diagnostic performance in assessing extramural venous invasion (EMVI) and T staging, compared to adaptive statistical iterative reconstruction (ASIR-V).
Methods
Sixty-two patients with rectal adenocarcinoma underwent preoperative DECT using a low-iodine contrast protocol (1 mL/kg, 300 mg iodine/mL). Images were reconstructed at 70 keV ASIR-V 40 %, 40 keV ASIR-V 40 %, and 40 keV DLIR (medium [DLIR-M] and high [DLIR-H] settings). Objective and subjective image quality were compared using repeated-measures ANOVA or Friedman tests. Pathological findings were used as the reference standard for EMVI and T staging.
Results
Both 40 keV ASIR-V 40 %, DLIR-M, and DLIR-H significantly improved image quality compared to 70 keV ASIR-V, with improvements in CT attenuation, image noise, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), edge rise slope (ERS), and the area under the noise power spectrum (NPS) curve (all P < 0.001). DLIR-M and DLIR-H outperformed 40 keV ASIR-V in terms of image noise and CNR. Subjective image quality scores were highest with DLIR-H. In diagnostic performance, DLIR-H achieved slightly better results for EMVI (AUC = 0.882) and T staging (AUC = 0.592) compared to ASIR-V.
Conclusion
DLIR, particularly DLIR-H, significantly improves 40 keV VMI image quality but offers mild improvement in diagnostic performance for EMVI and T staging. The combination of low-keV VMI and DLIR provides high-quality imaging with reduced iodine doses, making it a promising approach for optimized DECT protocols in rectal cancer.
{"title":"Deep learning image reconstruction improves 40 keV virtual monoenergetic image quality in rectal cancer","authors":"Haini Zhang , Juan Long , Xinran Zhang , Chenzi Wang , Xiaohan Liu , Wenbei Xu , Xiaonan Sun , Aiyun Sun , Shaohui Zheng , Yingying Cui , Hao Wang , Yankai Meng , Kai Xu","doi":"10.1016/j.ejrad.2025.112646","DOIUrl":"10.1016/j.ejrad.2025.112646","url":null,"abstract":"<div><h3>Background</h3><div>Accurate preoperative evaluation of rectal cancer is essential for staging and treatment planning. Low-energy virtual monoenergetic imaging (VMI) enhances iodine contrast in dual-energy computed tomography (DECT) but increases image noise. Deep learning image reconstruction (DLIR) may mitigate this issue, but its effectiveness for 40 keV VMI in rectal cancer is underexplored.</div></div><div><h3>Objective</h3><div>To evaluate the impact of DLIR on 40 keV VMI image quality and its diagnostic performance in assessing extramural venous invasion (EMVI) and T staging, compared to adaptive statistical iterative reconstruction (ASIR-V).</div></div><div><h3>Methods</h3><div>Sixty-two patients with rectal adenocarcinoma underwent preoperative DECT using a low-iodine contrast protocol (1 mL/kg, 300 mg iodine/mL). Images were reconstructed at 70 keV ASIR-V 40 %, 40 keV ASIR-V 40 %, and 40 keV DLIR (medium [DLIR-M] and high [DLIR-H] settings). Objective and subjective image quality were compared using repeated-measures ANOVA or Friedman tests. Pathological findings were used as the reference standard for EMVI and T staging.</div></div><div><h3>Results</h3><div>Both 40 keV ASIR-V 40 %, DLIR-M, and DLIR-H significantly improved image quality compared to 70 keV ASIR-V, with improvements in CT attenuation, image noise, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), edge rise slope (ERS), and the area under the noise power spectrum (NPS) curve (all <em>P</em> < 0.001). DLIR-M and DLIR-H outperformed 40 keV ASIR-V in terms of image noise and CNR. Subjective image quality scores were highest with DLIR-H. In diagnostic performance, DLIR-H achieved slightly better results for EMVI (AUC = 0.882) and T staging (AUC = 0.592) compared to ASIR-V.</div></div><div><h3>Conclusion</h3><div>DLIR, particularly DLIR-H, significantly improves 40 keV VMI image quality but offers mild improvement in diagnostic performance for EMVI and T staging. The combination of low-keV VMI and DLIR provides high-quality imaging with reduced iodine doses, making it a promising approach for optimized DECT protocols in rectal cancer.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112646"},"PeriodicalIF":3.3,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921186","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 : 2026-01-03DOI: 10.1016/j.ejrad.2025.112630
Melissa S.A.M. Bevers , Sofia Spinthaki , Joeri Kok , Joop P. van den Bergh , Edwin H.G. Oei , Bert van Rietbergen , Ronald Booij
Purpose
To compare trabecular microarchitecture measurements at the distal radius and tibia from photon-counting detector CT (PCD-CT) at varying radiation doses with high-resolution peripheral quantitative CT (HR-pQCT).
Methods
Two intact wrist and two intact ankle specimens from an 88-year-old man were scanned with PCD-CT at radiation doses of 2.5, 5, 10, and 20 mGy and with HR-pQCT. Additionally, clinical in-vivo HR-pQCT and PCD-CT scans at the radius and tibia were acquired of a 40-year-old woman with osteoporosis. After bone segmentation, the segmented PCD-CT and HR-pQCT scans were three-dimensionally registered. Cubic volumes (edge length: ex-vivo 6 mm, in-vivo 5 mm) were defined at corresponding locations in the PCD-CT and HR-pQCT scans based on the three-dimensional registration. For each cube, trabecular volume fraction (Tb.BV/TV), thickness (Tb.Th), number (Tb.N), separation (Tb.Sp), and heterogeneity (Tb.1/N.SD) were quantified and compared between corresponding PCD-CT and HR-pQCT cubes.
Results
Ex-vivo, linear correlation coefficients (R2) between PCD-CT and HR-pQCT were 0.85–0.97 at 2.5 mGy and remained stable with increasing radiation dose for all parameters except Tb.1/N.SD. For Tb.1/N.SD, R2 increased between 2.5 and 5 mGy and remained stable at higher doses. At each radiation dose, Tb.BV/TV, Tb.N, and Tb.Th values were higher and Tb.Sp and Tb.1/N.SD lower on PCD-CT than on HR-pQCT. In-vivo, R2 was 0.89–0.95 (radius) and 0.82–0.97 (tibia).
Conclusions
PCD-CT strongly correlated with HR-pQCT in trabecular microarchitecture measurements at the distal radius and tibia at low, clinically acceptable, radiation dose. Between-modality differences in microarchitecture values are likely related to chosen image analysis settings.
{"title":"Quantification of bone microarchitecture and strength with photon-counting detector CT at different radiation doses: an ex-vivo and in-vivo comparison with HR-pQCT","authors":"Melissa S.A.M. Bevers , Sofia Spinthaki , Joeri Kok , Joop P. van den Bergh , Edwin H.G. Oei , Bert van Rietbergen , Ronald Booij","doi":"10.1016/j.ejrad.2025.112630","DOIUrl":"10.1016/j.ejrad.2025.112630","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare trabecular microarchitecture measurements at the distal radius and tibia from photon-counting detector CT (PCD-CT) at varying radiation doses with high-resolution peripheral quantitative CT (HR-pQCT).</div></div><div><h3>Methods</h3><div>Two intact wrist and two intact ankle specimens from an 88-year-old man were scanned with PCD-CT at radiation doses of 2.5, 5, 10, and 20 mGy and with HR-pQCT. Additionally, clinical <em>in-vivo</em> HR-pQCT and PCD-CT scans at the radius and tibia were acquired of a 40-year-old woman with osteoporosis. After bone segmentation, the segmented PCD-CT and HR-pQCT scans were three-dimensionally registered. Cubic volumes (edge length: <em>ex-vivo</em> 6 mm, <em>in-vivo</em> 5 mm) were defined at corresponding locations in the PCD-CT and HR-pQCT scans based on the three-dimensional registration. For each cube, trabecular volume fraction (Tb.BV/TV), thickness (Tb.Th), number (Tb.N), separation (Tb.Sp), and heterogeneity (Tb.1/N.SD) were quantified and compared between corresponding PCD-CT and HR-pQCT cubes.</div></div><div><h3>Results</h3><div><em>Ex-vivo</em>, linear correlation coefficients (<em>R<sup>2</sup></em>) between PCD-CT and HR-pQCT were 0.85–0.97 at 2.5 mGy and remained stable with increasing radiation dose for all parameters except Tb.1/N.SD. For Tb.1/N.SD, <em>R</em><sup><em>2</em></sup> increased between 2.5 and 5 mGy and remained stable at higher doses. At each radiation dose, Tb.BV/TV, Tb.N, and Tb.Th values were higher and Tb.Sp and Tb.1/N.SD lower on PCD-CT than on HR-pQCT. <em>In-vivo</em>, <em>R<sup>2</sup></em> was 0.89–0.95 (radius) and 0.82–0.97 (tibia).</div></div><div><h3>Conclusions</h3><div>PCD-CT strongly correlated with HR-pQCT in trabecular microarchitecture measurements at the distal radius and tibia at low, clinically acceptable, radiation dose. Between-modality differences in microarchitecture values are likely related to chosen image analysis settings.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"196 ","pages":"Article 112630"},"PeriodicalIF":3.3,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965752","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 : 2026-01-03DOI: 10.1016/j.ejrad.2025.112629
Andrea Ponsiglione, Antonio Rizzo, Massimo Imbriaco
{"title":"Large language models in radiomics quality assessment—promise, progress, and precautions","authors":"Andrea Ponsiglione, Antonio Rizzo, Massimo Imbriaco","doi":"10.1016/j.ejrad.2025.112629","DOIUrl":"10.1016/j.ejrad.2025.112629","url":null,"abstract":"","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112629"},"PeriodicalIF":3.3,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916776","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 : 2026-01-02DOI: 10.1016/j.ejrad.2025.112651
Anis Halimi , Ahmed Msherghi , Mohamedhen Vall Nounou , Basma Mansor Elhabbasi , Bushray Abdulrahman , Ahmed Abouelella , Asmaa Shanab , Rihane Zakraoui , Ayatallah Ahmed Farrag , Muhammed Elhadi
Background
Biliary atresia (BA) is a rare condition that can lead to serious health complications. Artificial Intelligence (AI)- based medical imaging has shown potential to improve the detection of BA diagnosis, offering increased accuracy over traditional imaging methods. This meta-analysis aimed to evaluate the diagnostic accuracy of imaging-based AI for detecting BA.
Methods
The study followed PRISMA DTA guidelines and was registered in the PROSPERO database. The search was performed in PubMed, Web of Science, Embase, and Scopus databases for studies reporting the diagnostic accuracy of imaging-based AI models in detecting BA. Meanwhile, pre-defined eligibility criteria were used for the selection of studies. Pooled sensitivity, specificity, and area under the curve (AUC) were calculated utilizing R 4.4.2. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–AI (QUADAS-AI) criteria and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, and the GRADE approach was applied to evaluate the certainty of the synthesised evidence.
Results
A total of nine studies were included in this meta-analysis. The overall quality of the included studies was moderate to high, although a high risk of bias was noted in the index test domain of several studies. A total of 11,006 patients were analyzed, comprising 2,357 BA cases and 8,649 non-BA cases, with 11,500 ultrasound images.
Patient-level analysis revealed pooled sensitivities, specificities, and AUCs of 93.8 % (95 % CI: 86–97.4 %), 93.2 % (95 % CI: 91.8–94.4 %), and 0.94, respectively. Additionally, the pooled results of image-based analysis revealed sensitivity, specificity, and AUC of 86.9 % (95 % CI: 73.7–94.1 %), 94.3 % (95% CI: 90.9–96.4 %), and 0.965, respectively.
Conclusion
AI shows satisfactory performance in the imaging-based diagnosis of biliary atresia. It should be regarded as an assistive tool that supports clinical decision-making, and further high-quality studies are needed to confirm its generalizability.
{"title":"Artificial intelligence performance in image-based biliary atresia identification: a systematic review and meta-analysis","authors":"Anis Halimi , Ahmed Msherghi , Mohamedhen Vall Nounou , Basma Mansor Elhabbasi , Bushray Abdulrahman , Ahmed Abouelella , Asmaa Shanab , Rihane Zakraoui , Ayatallah Ahmed Farrag , Muhammed Elhadi","doi":"10.1016/j.ejrad.2025.112651","DOIUrl":"10.1016/j.ejrad.2025.112651","url":null,"abstract":"<div><h3>Background</h3><div>Biliary atresia (BA) is a rare condition that can lead to serious health complications. Artificial Intelligence (AI)- based medical imaging has shown potential to improve the detection of BA diagnosis, offering increased accuracy over traditional imaging methods. This meta-analysis aimed to evaluate the diagnostic accuracy of imaging-based AI for detecting BA.</div></div><div><h3>Methods</h3><div>The study followed PRISMA DTA guidelines and was registered in the PROSPERO database. The search was performed in PubMed, Web of Science, Embase, and Scopus databases for studies reporting the diagnostic accuracy of imaging-based AI models in detecting BA. Meanwhile, pre-defined eligibility criteria were used for the selection of studies. Pooled sensitivity, specificity, and area under the curve (AUC) were calculated utilizing R 4.4.2. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–AI (QUADAS-AI) criteria and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, and the GRADE approach was applied to evaluate the certainty of the synthesised evidence.</div></div><div><h3>Results</h3><div>A total of nine studies were included in this meta-analysis. The overall quality of the included studies was moderate to high, although a high risk of bias was noted in the index test domain of several studies. A total of 11,006 patients were analyzed, comprising 2,357 BA cases and 8,649 non-BA cases, with 11,500 ultrasound images.</div><div>Patient-level analysis revealed pooled sensitivities, specificities, and AUCs of 93.8 % (95 % CI: 86–97.4 %), 93.2 % (95 % CI: 91.8–94.4 %), and 0.94, respectively. Additionally, the pooled results of image-based analysis revealed sensitivity, specificity, and AUC of 86.9 % (95 % CI: 73.7–94.1 %), 94.3 % (95% CI: 90.9–96.4 %), and 0.965, respectively.</div></div><div><h3>Conclusion</h3><div>AI shows satisfactory performance in the imaging-based diagnosis of biliary atresia. It should be regarded as an assistive tool that supports clinical decision-making, and further high-quality studies are needed to confirm its generalizability.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"195 ","pages":"Article 112651"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917405","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}