Radiology最新文献

This article provides a practice-oriented overview of current concepts in rapid musculoskeletal MRI of central and peripheral joints, focusing on echo train optimization and the application of modern acceleration techniques. Parallel imaging, simultaneous multislice acquisition, and compressed sensing-based undersampling can be applied independently or in combination to expedite MRI of the joints. Clinically available three- to eightfold acceleration of two-dimensional (2D) and three-dimensional turbo spin-echo (TSE) pulse sequences enables comprehensive 5-10-minute MRI protocols of joints. This acceleration allows for the efficient integration of advanced metal artifact reduction techniques into clinical MRI protocols. When conventional image reconstruction techniques fail, clinically available deep learning-based image reconstruction and superresolution augmentation methods effectively reconstruct images from highly accelerated acquisitions. Together, moderate acceleration and advanced image reconstruction techniques provide high diagnostic image quality of heavily undersampled MRI data, enabling three- to sixfold accelerated 2D TSE MRI of multiple joints in 4-6 minutes. Recent studies indicate that specially designed and trained deep learning methods may achieve 10-fold accelerated musculoskeletal MRI, with acquisition times under 3 minutes. Although further research and data are necessary, these promising developments are poised to enhance the value of musculoskeletal MRI.

Background Recent guidelines lowered the prestenotic dilatation threshold from >3 cm to ≥2.5 cm for diagnosing small-bowel stricture at CT enterography (CTE) in Crohn disease (CD). Its impact on stricture prevalence and risk stratification is unknown. Purpose To quantify the increase in stricture prevalence when applying a threshold of ≥2.5 cm and to assess whether risks for adverse outcomes are stratified according to the new threshold. Materials and Methods This retrospective study included patients with CD without acute obstructive symptoms who underwent CTE from 2017 to 2018 for routine follow-up of CD. Patients were classified into three groups: nonstricture, stricture with a prestenotic dilatation of 2.5-3 cm, and stricture with a dilatation of >3 cm. Stricture prevalence was calculated using both conventional and revised thresholds. Clinical outcomes during follow-up were analyzed using a Cox proportional hazards regression and Poisson regression, adjusting for relevant covariates. Results Among 1022 patients (median age, 35 years [IQR, 28-42 years]; 719 [70.4%] men), 190 (18.6%) had strictures with a prestenotic dilatation of >3 cm, and 137 (13.4%) had strictures with a prestenotic dilatation of 2.5-3 cm-a prevalence of 32.0% (327 of 1022 patients) using the new threshold. Compared with the nonstricture group, both stricture groups-2.5-3 cm and >3 cm-had a higher risk for emergency department visits (adjusted hazard ratios [HRs], 2.13 [P < .001] and 2.04 [P < .001], respectively; incidence rate ratio, 2.46 [P < .001] and 2.05 [P = .002]), small-bowel surgery (adjusted HRs, 2.27 [P = .006] and 3.58 [P < .001]), symptomatic obstruction (adjusted HRs, 7.99 [P < .001] and 6.25 [P < .001]), and small-bowel penetration (ie, de novo occurrence or progression of a sinus or fistula to an abscess or inflammatory mass) (adjusted HRs, 3.47 [P < .001] and 4.41 [P < .001]). Conclusion Applying a prestenotic dilatation threshold of ≥2.5 cm at CTE enabled identification of small-bowel strictures in additional patients with CD without acute obstructive symptoms, and these patients had increased risks of adverse clinical outcomes. © RSNA, 2026 Supplemental material is available for this article.

Background Transarterial radioembolization (TARE) of liver tumors exposes medical staff to radiation. Comparative data between three microspheres, ⁹⁰Y-resin, ⁹⁰Y-glass, and ¹⁶⁶Ho-poly-L-lactic acid (PLLA), is lacking. Purpose To evaluate radiation exposure among medical staff in a real-world setting and provide reliable data for involved occupations and microspheres. Materials and Methods This prospective consecutive single-tertiary care center study included individuals undergoing TARE between February 2024 and February 2025. Radiation exposure of five radiopharmacists, seven interventional radiologists, five medical physics experts, five nuclear medicine physicians, eight radiologic technologists, and six nurses was monitored using multimodal dosimetric surveillance. Skin surface doses on hands, body doses on the chest, maximum procedural dose rates, and exposure times were measured per step. Comparisons between microspheres were conducted using analysis of variance and post hoc Tukey honestly significant difference tests. Pearson correlation coefficients for body doses, exposure times, and therapeutic radioactivity were determined. Results A total of 53 participants (mean age, 64 years ± 11; 42 male) underwent 60 TARE procedures (20 per microsphere type). Radiation exposure was generally low, with body and hand doses under 5 and under 350 µSv, respectively, per procedure. ¹⁶⁶Ho-PLLA generated the highest body doses (maximum, 17 µSv) due to direct gamma radiation and higher therapeutic radioactivity. ⁹⁰Y-resin generated the highest hand doses due to procedural handling (maximum, 309 µSv). Interventional radiologists received the highest body (mean, 2.5-4.5 µSv) and hand (mean, 146-309 µSv) doses per procedure among all occupations because of additional angiography. Maximum dose rate (adjusted to 1 GBq therapeutic radioactivity) was 1157 µSv/h during portioning of ⁹⁰Y-resin by radiopharmacists. Results show moderate overall correlation between exposure time and body dose (r_p = 0.51, P < .001). Conclusion TARE radiation exposure to medical staff was generally low, but highest for interventional radiologists. Since ⁹⁰Y-resin microspheres result in high hand doses due to procedural handling, their portioning, assembly, and application should be performed with optimal efficiency by trained staff using long tweezers. © The Authors 2026. Published by the Radiological Society of North America under a CC BY 4.0 license.

Ovarian cancer affects over 250 000 women worldwide, with epithelial ovarian cancer accounting for approximately 90% of cases. Lack of effective screening and absence of early symptoms result in nearly 70% of patients presenting with late-stage disease. A distinct feature of advanced ovarian cancer is that peritoneal spread does not preclude curative surgical resection. Ovarian cancer is staged using the International Federation of Gynecology and Obstetrics, or FIGO, system, last updated in 2014. US is the first-line imaging modality for evaluating the symptomatic female pelvis, while MRI is the best modality for characterizing US-indeterminate adnexal masses. CT is the current standard of care to assess disease extent in advanced ovarian cancer, guiding treatment selection and surgical planning. Diffusion-weighted MRI may complement CT in the detection of disease in hard-to-resect areas. This article provides a practical approach to assessing and reporting peritoneal carcinomatosis, highlighting the importance of imaging in mapping disease extent and the added value of diffusion-weighted MRI in improving tumor visualization, especially in unresectable or hard-to-resect areas. The article also discusses the role of PET in initial staging and detecting recurrence. Furthermore, it highlights the role of radiologists as key members of the multidisciplinary team and emphasizes the importance of disease-specific structured reporting for clear communication.