Radiology最新文献

Background Pulmonary nodules (PNs) are clinically challenging because differentiation between benign and malignant PNs is not possible at CT detection; recurring CT examinations and invasive procedures are often required in PN follow-up. Purpose To investigate PN prevalence in a middle-aged population and the risk factors associated with these nodules. Materials and Methods In this secondary analysis of the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (known as SCAPIS, from November 2013 to November 2018), participants aged 50-64 years with chest CT data were analyzed. Risk factors such as smoking history, occupational exposure (vapor, dust, gas, and fumes), and lung diseases were derived from comprehensive questionnaires. Robust Poisson regression was used to evaluate associations, adjusted for age and sex, between potential risk factors and the binary outcome of nodule presence or absence. Prevalence ratios (PRs), adjusted for age and sex, and 95% CIs were estimated. Results Among 29 574 participants (median age, 57.4 years; IQR, 53.7-61.2 years; 15 168 women), solid nodules sized 100-300 mm³, part-solid, and ground-glass nodules were found in 1420 (4.8%), 199 (0.7%), and 430 (1.5%), respectively. The prevalence of solid nodules among participants who never, formerly, and currently smoked was 32.5% (4713 of 14 515), 34.5% (3602 of 10 437), and 37.9% (1381 of 3644), respectively. Solid nodules sized 100-300 mm³ were associated with current smoking (PR, 1.38; 95% CI: 1.19, 1.60), chronic obstructive pulmonary disease (PR, 1.72; 95% CI: 1.17, 2.53), occupational exposure (PR, 1.31; 95% CI: 1.11, 1.54), emphysema (PR, 1.56; 95% CI: 1.31, 1.86), reticulation (PR, 1.96; 95% CI: 1.47, 2.61), and bronchiectasis (PR, 2.03; 95% CI: 1.64, 2.50). In participants who had never smoked, associations were found between solid nodules at least 100 mm³ and reticulation (PR, 2.28; 95% CI: 1.55, 3.36), reported lung disease other than asthma or chronic obstructive pulmonary disease (PR, 2.26; 95% CI: 1.49, 3.43), and bronchiectasis (PR, 2.17; 95% CI: 1.60, 2.94). Conclusion PN prevalence was approximately the same in a middle-aged population regardless of smoking history. In participants who had never smoked, nodules were linked to reported lung disease, reticulation, and bronchiectasis. © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. Supplemental material is available for this article.

Background Only a minority of patients with recurrent intrahepatic cholangiocarcinoma (iCCA) are eligible for repeat resection. However, whether they benefit from minimally invasive ablation treatment is unclear. Purpose To compare the survival outcomes in microwave ablation (MWA) and repeat liver resection (rLR) in the treatment of first recurrent iCCA. Materials and Methods In this secondary analysis of a prospective study (Microwave Ablation and Liver Resection for Intrahepatic Cholangiocarcinoma [MALRIC]) from January 2009 to June 2024, participants from 10 hospitals who underwent curative-intent MWA or rLR for recurrent iCCA within Milan-equivalent criteria were identified. One-to-many propensity score matching and overlap weighting were used to balance baseline characteristics. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. Log-rank test and Cox stratified modeling on matched sets tested survival differences. Results MWA (n = 375) or rLR (n = 119) was performed in 494 participants (mean age, 57.8 years ± 10.7 [SD]; 344 men). Compared with rLR, participants who underwent MWA had similar OS (MWA vs rLR median, 29.8 vs 34.0 months, respectively; hazard ratio [HR], 0.89; 95% CI: 0.68, 1.17; P = .31) and DFS (MWA vs rLR median, 10.7 vs 14.8 months; HR, 0.78; 95% CI: 0.61, 1.00; P = .07). RLR showed improved DFS compared with MWA when the primary tumor was the large duct subtype (HR, 0.51; 95% CI: 0.32, 0.91; P = .03); there were no surgical complications after the initial resection (HR, 0.72; 95% CI: 0.52, 0.98; P = .04), and the DFS was less than 12 months (HR, 0.65; 95% CI: 0.46, 0.92; P = .02). Compared with rLR, participants who underwent MWA had shorter hospitalization (median, 9 vs 14 days; P < .001) and fewer complications above Clavien-Dindo grade II (rLR vs MWA, 31.3% vs 5.5%, respectively; P < .001). Conclusion Compared with rLR, MWA resulted in similar OS and DFS, and better perioperative outcomes. Clinical trial registration no. NCT06462742 © RSNA, 2026 Supplemental material is available for this article. See also the editorial by Georgiades in this issue.