{"title":"Commentary on “Diagnostic value of grayscale inversion imaging for detecting difficult cases of pulmonary nodules”","authors":"Bhumesh Tyagi , Leelabati Toppo , Aishwarya Biradar","doi":"10.1016/j.clinimag.2026.110723","DOIUrl":"10.1016/j.clinimag.2026.110723","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110723"},"PeriodicalIF":1.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1016/j.clinimag.2026.110729
Eda Cingoz , Merve Tokocin , Mehmet Cingoz
Purpose
This study aimed to compare the therapeutic efficacy along with the intra-procedural and post-procedural pain scores associated with ethanol or povidone‑iodine ablation in the management of symptomatic simple breast cysts (SSBC).
Materials and methods
Seventy-five female patients with SSBC (≥2 cm) were retrospectively analyzed. The patients underwent ultrasound-guided ablation with either 99% ethanol (n = 41) or 10% povidone‑iodine (n = 34). Pain was assessed before, during, and one month after the procedure using the visual analog scale (VAS). Cyst dimensions were measured pre- and post-treatment.
Results
Both groups showed significant reductions in cyst size and VAS scores at 1 month (p < 0.001). Ethanol ablation led to greater overall pain reduction but caused more intra-procedural pain (p < 0.001). Povidone‑iodine ablation was better tolerated and provided significant symptomatic relief.
Conclusion
Both ethanol and povidone‑iodine ablation are effective for managing SSBC. While ethanol provided greater post-procedural pain relief, povidone‑iodine offered superior intra-procedural tolerability, supporting its use in pain-sensitive patients.
{"title":"Ultrasound-guided percutaneous ablation of symptomatic simple breast cysts: A comparative study of ethanol and povidone-iodine","authors":"Eda Cingoz , Merve Tokocin , Mehmet Cingoz","doi":"10.1016/j.clinimag.2026.110729","DOIUrl":"10.1016/j.clinimag.2026.110729","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to compare the therapeutic efficacy along with the intra-procedural and post-procedural pain scores associated with ethanol or povidone‑iodine ablation in the management of symptomatic simple breast cysts (SSBC).</div></div><div><h3>Materials and methods</h3><div>Seventy-five female patients with SSBC (≥2 cm) were retrospectively analyzed. The patients underwent ultrasound-guided ablation with either 99% ethanol (<em>n</em> = 41) or 10% povidone‑iodine (<em>n</em> = 34). Pain was assessed before, during, and one month after the procedure using the visual analog scale (VAS). Cyst dimensions were measured pre- and post-treatment.</div></div><div><h3>Results</h3><div>Both groups showed significant reductions in cyst size and VAS scores at 1 month (<em>p</em> < 0.001). Ethanol ablation led to greater overall pain reduction but caused more intra-procedural pain (p < 0.001). Povidone‑iodine ablation was better tolerated and provided significant symptomatic relief.</div></div><div><h3>Conclusion</h3><div>Both ethanol and povidone‑iodine ablation are effective for managing SSBC. While ethanol provided greater post-procedural pain relief, povidone‑iodine offered superior intra-procedural tolerability, supporting its use in pain-sensitive patients.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110729"},"PeriodicalIF":1.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1016/j.clinimag.2026.110724
Jun-hee Kim
Background
The medial longitudinal arch plays a critical role in foot biomechanics, and its abnormalities are associated with conditions such as flatfoot and plantar fasciitis. Early and accurate diagnosis of these disorders is clinically important, but plain radiographs have limitations in visualizing soft tissue pathology.
Purpose
This study aimed to develop and interpret a deep learning model capable of classifying foot radiographs into normal, plantar fasciitis, and flatfoot categories.
Methods
A DenseNet-121 architecture was trained on 9500 synthetic lateral foot X-ray images from the AI-Hub dataset, with augmentation applied for generalization. Model interpretability was enhanced using Grad-CAM++ to identify class-specific regions of interest, followed by quantitative analysis of six spatial attention features.
Results
The model achieved an overall accuracy of 98.53% on an independent test set, with F1-scores of 0.9900 for normal, 0.9837 for plantar fasciitis, and 0.9823 for flatfoot. Visualization revealed anatomically consistent activation patterns: midfoot and arch regions in normal cases, calcaneal and plantar fascia insertion sites in plantar fasciitis, and inferiorly displaced midfoot–hindfoot regions in flatfoot. Quantitative analysis confirmed significant group differences in activation area, intensity, compactness, spatial focus, and entropy (p < 0.001).
Conclusion
These findings demonstrate that explainable deep learning models trained on synthetic radiographic datasets can achieve high classification performance and provide interpretable, anatomically potential insights from structural radiographs. This approach may offer preliminary guidance for developing clinical decision support system, while highlighting the need for further validation in real clinical settings.
{"title":"Explainable deep learning-based multiclass classification of foot radiographs into normal, plantar fasciitis, and flatfoot","authors":"Jun-hee Kim","doi":"10.1016/j.clinimag.2026.110724","DOIUrl":"10.1016/j.clinimag.2026.110724","url":null,"abstract":"<div><h3>Background</h3><div>The medial longitudinal arch plays a critical role in foot biomechanics, and its abnormalities are associated with conditions such as flatfoot and plantar fasciitis. Early and accurate diagnosis of these disorders is clinically important, but plain radiographs have limitations in visualizing soft tissue pathology.</div></div><div><h3>Purpose</h3><div>This study aimed to develop and interpret a deep learning model capable of classifying foot radiographs into normal, plantar fasciitis, and flatfoot categories.</div></div><div><h3>Methods</h3><div>A DenseNet-121 architecture was trained on 9500 synthetic lateral foot X-ray images from the AI-Hub dataset, with augmentation applied for generalization. Model interpretability was enhanced using Grad-CAM++ to identify class-specific regions of interest, followed by quantitative analysis of six spatial attention features.</div></div><div><h3>Results</h3><div>The model achieved an overall accuracy of 98.53% on an independent test set, with F1-scores of 0.9900 for normal, 0.9837 for plantar fasciitis, and 0.9823 for flatfoot. Visualization revealed anatomically consistent activation patterns: midfoot and arch regions in normal cases, calcaneal and plantar fascia insertion sites in plantar fasciitis, and inferiorly displaced midfoot–hindfoot regions in flatfoot. Quantitative analysis confirmed significant group differences in activation area, intensity, compactness, spatial focus, and entropy (<em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>These findings demonstrate that explainable deep learning models trained on synthetic radiographic datasets can achieve high classification performance and provide interpretable, anatomically potential insights from structural radiographs. This approach may offer preliminary guidance for developing clinical decision support system, while highlighting the need for further validation in real clinical settings.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110724"},"PeriodicalIF":1.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1016/j.clinimag.2026.110721
Amit Kumar Gupta, Chandrashekar Patil, Varshini Vadhithala, Jeffrin Reneus Paul
This Letter to the Editor critiques Erguven et al.'s single centre study of universal preoperative breast MRI in women 40 years or younger with newly diagnosed breast cancer. We place their findings within mixed evidence on the effect of MRI on re-excision, mastectomy rates and outcomes, and highlight design and reporting limitations that restrict causal inference and generalisability in this young, higher risk population. We then outline priorities for future prospective, risk stratified research and policy, linking MRI use to tumour biology, surgical planning, patient reported outcomes and equity to ensure that expanded imaging leads to better and fairer care.
{"title":"Improving risk-stratified use of preoperative MRI in young women with breast.","authors":"Amit Kumar Gupta, Chandrashekar Patil, Varshini Vadhithala, Jeffrin Reneus Paul","doi":"10.1016/j.clinimag.2026.110721","DOIUrl":"https://doi.org/10.1016/j.clinimag.2026.110721","url":null,"abstract":"<p><p>This Letter to the Editor critiques Erguven et al.'s single centre study of universal preoperative breast MRI in women 40 years or younger with newly diagnosed breast cancer. We place their findings within mixed evidence on the effect of MRI on re-excision, mastectomy rates and outcomes, and highlight design and reporting limitations that restrict causal inference and generalisability in this young, higher risk population. We then outline priorities for future prospective, risk stratified research and policy, linking MRI use to tumour biology, surgical planning, patient reported outcomes and equity to ensure that expanded imaging leads to better and fairer care.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":" ","pages":"110721"},"PeriodicalIF":1.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1016/j.clinimag.2026.110722
Tugce Erguven, Yagiz Matthew Akiska, Ayah Arafat, Rachel Brem
{"title":"Impact of breast MRI on the surgical management of young women with breast cancer.","authors":"Tugce Erguven, Yagiz Matthew Akiska, Ayah Arafat, Rachel Brem","doi":"10.1016/j.clinimag.2026.110722","DOIUrl":"https://doi.org/10.1016/j.clinimag.2026.110722","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":" ","pages":"110722"},"PeriodicalIF":1.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.clinimag.2026.110715
Imran Bitar , Bashar Jawich , Alexander Restum , Sidra Hasaba , Sayf Al-Katib , Kiran Nandalur
Objective
To evaluate the quality and reliability of breast cancer screening information on TikTok using the DISCERN tool, and to compare scores across content creators, including physicians, non-physicians, and private clinics.
Methods
A search for the hashtag #BreastCancerScreening on TikTok was conducted March 2025. From 983 videos retrieved, 75 met inclusion criteria after applying filters for language, relevance, and engagement. Each video was evaluated independently by two reviewers using the DISCERN questionnaire. Videos were categorized by content creator type, gender, physician specialty, and video format. Statistical analysis included Kruskal-Wallis tests and weighted-Cohen's-kappa for inter-rater reliability.
Results
Among 75 analyzed videos, 41% were created by physicians, 31% by non-physicians, and 28% by private clinics. Physician videos received the highest mean DISCERN score (3.12), followed by private clinics (3.07), and non-physicians (2.29). Videos focusing on breast cancer imaging scored highest (3.14), while those based on personal experiences scored lowest (2.35). Kruskal-Wallis testing revealed significant differences in DISCERN scores across creator types (p < 0.001). Post-hoc analysis showed that physician and private clinic videos scored significantly higher than non-physician videos. Inter-rater reliability was moderate for physicians, fair for non-physicians, and very good for private clinics.
Conclusion
Breast cancer screening information on TikTok varies in quality. Content created by physicians and clinics is more reliable/comprehensive. Because DISCERN evaluates quality rather than scientific accuracy, these findings reflect how clearly information is communicated rather than its medical correctness. Improving clarity and reliability of social media health content could enhance public understanding and encourage informed screening behaviors.
{"title":"Mammograms in the media: a quality assessment of breast cancer screening videos on TikTok","authors":"Imran Bitar , Bashar Jawich , Alexander Restum , Sidra Hasaba , Sayf Al-Katib , Kiran Nandalur","doi":"10.1016/j.clinimag.2026.110715","DOIUrl":"10.1016/j.clinimag.2026.110715","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the quality and reliability of breast cancer screening information on TikTok using the DISCERN tool, and to compare scores across content creators, including physicians, non-physicians, and private clinics.</div></div><div><h3>Methods</h3><div>A search for the hashtag #BreastCancerScreening on TikTok was conducted March 2025. From 983 videos retrieved, 75 met inclusion criteria after applying filters for language, relevance, and engagement. Each video was evaluated independently by two reviewers using the DISCERN questionnaire. Videos were categorized by content creator type, gender, physician specialty, and video format. Statistical analysis included Kruskal-Wallis tests and weighted-Cohen's-kappa for inter-rater reliability.</div></div><div><h3>Results</h3><div>Among 75 analyzed videos, 41% were created by physicians, 31% by non-physicians, and 28% by private clinics. Physician videos received the highest mean DISCERN score (3.12), followed by private clinics (3.07), and non-physicians (2.29). Videos focusing on breast cancer imaging scored highest (3.14), while those based on personal experiences scored lowest (2.35). Kruskal-Wallis testing revealed significant differences in DISCERN scores across creator types (<em>p</em> < 0.001). Post-hoc analysis showed that physician and private clinic videos scored significantly higher than non-physician videos. Inter-rater reliability was moderate for physicians, fair for non-physicians, and very good for private clinics.</div></div><div><h3>Conclusion</h3><div>Breast cancer screening information on TikTok varies in quality. Content created by physicians and clinics is more reliable/comprehensive. Because DISCERN evaluates quality rather than scientific accuracy, these findings reflect how clearly information is communicated rather than its medical correctness. Improving clarity and reliability of social media health content could enhance public understanding and encourage informed screening behaviors.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110715"},"PeriodicalIF":1.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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.clinimag.2025.110708
Faezeh Khorasanizadeh , Arman Momeni , Alireza Daneshvar , Rad Ghannadzadeh , Ifa Etesami , Ximena Wortsman
Purpose
The use of cosmetic fillers has become increasingly popular. Radiologists and sonographers should be aware of the ultrasonographic characteristics of the most commonly used cosmetic fillers and the sonographic features of their frequent complications.
Methods
Ultrasound findings of hyaluronic acid (HA), poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), polymethylmethacrylate (PMMA), polycaprolactone (PCL), silicone oil, polyalkylimide, polyacrylamide (PAAG) and autologous fat were systematically reviewed. Immediate, early, and delayed filler complications—including vascular occlusion, cellulitis and abscess formation, panniculitis, foreign-body granulomatous reaction, fat necrosis, capsular contraction, filler migration, and overfilling—were described with their specific sonographic characteristics.
Results
Filler-pattern ultrasound is material-specific: HA—anechoic/hypoechoic, pseudocystic deposits; PLLA—initially hyperechoic, fading over time; PCL—a hypoechoic matrix with hyperechoic comet-tail spots; PMMA—bright echogenic deposits with comet-tail artifacts; CaHA—echoes/shadows depend on dilution/mixing; PAAG—mostly anechoic/hypoechoic and stable over time; silicone—distinctive snowstorm/posterior reverberation; autologous fat—hypoechoic nodules with possible fat necrosis. Vascular occlusion shows absent/reduced Doppler flow; Cellulitis/panniculitis show increased echogenicity, thickened septa, and edema; abscess is an anechoic/hypoechoic lesion with debris and posterior enhancement. Granulomas are hypoechoic nodules with possible calcifications or vascularity. Fat necrosis presents as oil cysts (round anechoic deposits with echogenic borders; calcifications possible). Migration is filler in abnormal locations; overfilling denotes accumulated filler; capsular contracture shows as hyperechoic capsule surrounding deposits.
Conclusion
High-frequency ultrasound, with color Doppler, is the first-line modality for identifying filler type, location, and complications. Routine use improves diagnostic accuracy and patient safety in esthetic medicine and guides therapeutic interventions.
{"title":"Ultrasonographic evaluation of cosmetic fillers: patterns and frequent complications – A literature review","authors":"Faezeh Khorasanizadeh , Arman Momeni , Alireza Daneshvar , Rad Ghannadzadeh , Ifa Etesami , Ximena Wortsman","doi":"10.1016/j.clinimag.2025.110708","DOIUrl":"10.1016/j.clinimag.2025.110708","url":null,"abstract":"<div><h3>Purpose</h3><div>The use of cosmetic fillers has become increasingly popular. Radiologists and sonographers should be aware of the ultrasonographic characteristics of the most commonly used cosmetic fillers and the sonographic features of their frequent complications.</div></div><div><h3>Methods</h3><div>Ultrasound findings of hyaluronic acid (HA), poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), polymethylmethacrylate (PMMA), polycaprolactone (PCL), silicone oil, polyalkylimide, polyacrylamide (PAAG) and autologous fat were systematically reviewed. Immediate, early, and delayed filler complications—including vascular occlusion, cellulitis and abscess formation, panniculitis, foreign-body granulomatous reaction, fat necrosis, capsular contraction, filler migration, and overfilling—were described with their specific sonographic characteristics.</div></div><div><h3>Results</h3><div>Filler-pattern ultrasound is material-specific: HA—anechoic/hypoechoic, pseudocystic deposits; PLLA—initially hyperechoic, fading over time; PCL—a hypoechoic matrix with hyperechoic comet-tail spots; PMMA—bright echogenic deposits with comet-tail artifacts; CaHA—echoes/shadows depend on dilution/mixing; PAAG—mostly anechoic/hypoechoic and stable over time; silicone—distinctive snowstorm/posterior reverberation; autologous fat—hypoechoic nodules with possible fat necrosis. Vascular occlusion shows absent/reduced Doppler flow; Cellulitis/panniculitis show increased echogenicity, thickened septa, and edema; abscess is an anechoic/hypoechoic lesion with debris and posterior enhancement. Granulomas are hypoechoic nodules with possible calcifications or vascularity. Fat necrosis presents as oil cysts (round anechoic deposits with echogenic borders; calcifications possible). Migration is filler in abnormal locations; overfilling denotes accumulated filler; capsular contracture shows as hyperechoic capsule surrounding deposits.</div></div><div><h3>Conclusion</h3><div>High-frequency ultrasound, with color Doppler, is the first-line modality for identifying filler type, location, and complications. Routine use improves diagnostic accuracy and patient safety in esthetic medicine and guides therapeutic interventions.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110708"},"PeriodicalIF":1.5,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.clinimag.2025.110707
Torrin Jacobsen , Jalal Ibrahim , Yusuf Ahmad , Anirudh Bikmal , Michael Schacht
Rational and objective
This manuscript aims to analyze a limited dataset containing 14 shoppable services regarding healthcare transparency in the United States; focusing on 3 radiology CPTs within the 14 services provided. It compares the affordability of the average discounted cash cost per service by state.
Materials and methods
A limited research dataset from Turquoise Health was uploaded to a local SQL database. 3 radiology CPTs (70553, 72193, 76700) were filtered and exported to Excel. Data was cleaned using inclusion criteria of populated discount cash column, populated gross charges column, ‘Facility’ billing class, ‘Inpatient’, ‘Outpatient, or ‘Inpatient or Outpatient’ billing settings, and applicable imaging revenue codes. Improbable costs and charges were excluded. Analyses were performed to find average discount cash cost for each CPT. Ratios of average discounted cash cost to state median household income were calculated for each CPT and Z-score and percentiles populated.
Results
Across the three separate imaging services 4 states (AL, NM, CA, NV) were consistently greater than +1 and 4 states (RI, AR, NH, OK) less than −1 standard deviation of the mean discounted cash cost to income ratio. States with higher affordability had higher discounts on gross charges (50 %–57 %) and states with less affordability had lower discounts off gross charges (<30 %).
Conclusion
The analysis highlights state-level disparities in healthcare costs, with AL, NM, CA, and NV being less affordable and RI, AR, NH, and OK more affordable comparitively.
{"title":"Cash price transparency of common radiology services in the United States: An analysis of 2024 healthcare transparency data by state","authors":"Torrin Jacobsen , Jalal Ibrahim , Yusuf Ahmad , Anirudh Bikmal , Michael Schacht","doi":"10.1016/j.clinimag.2025.110707","DOIUrl":"10.1016/j.clinimag.2025.110707","url":null,"abstract":"<div><h3>Rational and objective</h3><div>This manuscript aims to analyze a limited dataset containing 14 shoppable services regarding healthcare transparency in the United States; focusing on 3 radiology CPTs within the 14 services provided. It compares the affordability of the average discounted cash cost per service by state.</div></div><div><h3>Materials and methods</h3><div>A limited research dataset from Turquoise Health was uploaded to a local SQL database. 3 radiology CPTs (70553, 72193, 76700) were filtered and exported to Excel. Data was cleaned using inclusion criteria of populated discount cash column, populated gross charges column, ‘Facility’ billing class, ‘Inpatient’, ‘Outpatient, or ‘Inpatient or Outpatient’ billing settings, and applicable imaging revenue codes. Improbable costs and charges were excluded. Analyses were performed to find average discount cash cost for each CPT. Ratios of average discounted cash cost to state median household income were calculated for each CPT and <em>Z</em>-score and percentiles populated.</div></div><div><h3>Results</h3><div>Across the three separate imaging services 4 states (AL, NM, CA, NV) were consistently greater than +1 and 4 states (RI, AR, NH, OK) less than −1 standard deviation of the mean discounted cash cost to income ratio. States with higher affordability had higher discounts on gross charges (50 %–57 %) and states with less affordability had lower discounts off gross charges (<30 %).</div></div><div><h3>Conclusion</h3><div>The analysis highlights state-level disparities in healthcare costs, with AL, NM, CA, and NV being less affordable and RI, AR, NH, and OK more affordable comparitively.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"131 ","pages":"Article 110707"},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.1016/j.clinimag.2025.110699
Lei-Jian Wang , Cheng-Hua Li
{"title":"Re: “Why ultrasound is the missing piece of the puzzle in the imaging and management pathway of acute ankle injuries”","authors":"Lei-Jian Wang , Cheng-Hua Li","doi":"10.1016/j.clinimag.2025.110699","DOIUrl":"10.1016/j.clinimag.2025.110699","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"130 ","pages":"Article 110699"},"PeriodicalIF":1.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cryoablation (CA) is an image-guided, minimally invasive technique that is gaining traction in the treatment of both benign and malignant soft tissue and bone tumors. This narrative review presents the current evidence supporting its clinical applications in both curative and palliative settings. In malignant tumors—including soft tissue sarcomas and bone metastases—cryoablation provides effective local control, particularly in cases of recurrence, inoperability, or metastatic disease, and enables chemotherapy-free intervals, contributing to improved quality of life. In benign lesions, such as desmoid fibromatosis, cryoablation offers significant symptomatic relief and substantial tumor volume reduction with a low complication profile. CA demonstrates high local tumor control rates, especially in patients with recurrent, unresectable, or metastatic lesions and offers significant advantages over conventional treatments in terms of safety, anesthesia requirements, pain control, and hospitalization duration. Technological innovations, including robotic assistance and advanced navigation systems, have enhanced CA's precision and feasibility in anatomically challenging regions. Although current evidence supports its role as an alternative or adjunctive therapy in selected patients, prospective, randomized studies are still needed to define optimal patient selection, long-term outcomes, and standardized protocols.
Methods
This narrative review was conducted to evaluate the current role of cryoablation (CA) in the treatment of soft tissue and bone tumors. A targeted literature search was performed in PubMed and Scopus databases up to August 2025, using keywords including cryoablation, soft tissue tumors, bone tumors, and image-guided ablation. Relevant clinical studies, reviews, and retrospective series were included. Priority was given to publications reporting therapeutic outcomes and safety data. Data concerning CA efficacy, local tumor control, complication rates, and other relevant clinical metrics were extracted and synthesized qualitatively to reflect current evidence across both benign and malignant tumor entities.
{"title":"The current role of cryoablation in the management of soft tissue and bone tumors: A narrative review","authors":"Marios Platon Dimopoulos , Nefeli Chaniotaki , Maria Papageorgiou , Sylvain Bodard , Andreas Antzoulas , Francesk Mulita , Zafiria Papathanassiou , Leonidas Goudas , Panagiotis Kitrou , Dimitrios Karnabatidis , Konstantinos Katsanos","doi":"10.1016/j.clinimag.2025.110704","DOIUrl":"10.1016/j.clinimag.2025.110704","url":null,"abstract":"<div><div>Cryoablation (CA) is an image-guided, minimally invasive technique that is gaining traction in the treatment of both benign and malignant soft tissue and bone tumors. This narrative review presents the current evidence supporting its clinical applications in both curative and palliative settings. In malignant tumors—including soft tissue sarcomas and bone metastases—cryoablation provides effective local control, particularly in cases of recurrence, inoperability, or metastatic disease, and enables chemotherapy-free intervals, contributing to improved quality of life. In benign lesions, such as desmoid fibromatosis, cryoablation offers significant symptomatic relief and substantial tumor volume reduction with a low complication profile. CA demonstrates high local tumor control rates, especially in patients with recurrent, unresectable, or metastatic lesions and offers significant advantages over conventional treatments in terms of safety, anesthesia requirements, pain control, and hospitalization duration. Technological innovations, including robotic assistance and advanced navigation systems, have enhanced CA's precision and feasibility in anatomically challenging regions. Although current evidence supports its role as an alternative or adjunctive therapy in selected patients, prospective, randomized studies are still needed to define optimal patient selection, long-term outcomes, and standardized protocols.</div></div><div><h3>Methods</h3><div>This narrative review was conducted to evaluate the current role of cryoablation (CA) in the treatment of soft tissue and bone tumors. A targeted literature search was performed in PubMed and Scopus databases up to August 2025, using keywords including cryoablation, soft tissue tumors, bone tumors, and image-guided ablation. Relevant clinical studies, reviews, and retrospective series were included. Priority was given to publications reporting therapeutic outcomes and safety data. Data concerning CA efficacy, local tumor control, complication rates, and other relevant clinical metrics were extracted and synthesized qualitatively to reflect current evidence across both benign and malignant tumor entities.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"130 ","pages":"Article 110704"},"PeriodicalIF":1.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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