Clinical Imaging最新文献

{"title":"Patient perception of artificial intelligence in breast imaging: A pilot survey study","authors":"Sarah Ameri ,&nbsp;Nikki Mehran ,&nbsp;Laurie R. Margolies","doi":"10.1016/j.clinimag.2025.110649","DOIUrl":"10.1016/j.clinimag.2025.110649","url":null,"abstract":"<div><h3>Purpose</h3><div>Artificial intelligence (AI) has the potential to improve diagnostic accuracy and efficiency in breast imaging. Though radiologists appreciate its benefits and limitations, patients' receptiveness and understanding of AI in breast imaging remain unclear. We aim to investigate patients' preferences and perceptions of AI and its role in breast imaging interpretation.</div></div><div><h3>Methods</h3><div>Structured questionnaires were distributed to patients presenting for imaging or biopsies within the breast radiology department at six facilities within an urban hospital system between September 2023 and March 2024. The survey included 21 questions evaluating patient demographics and attitudes towards AI in breast imaging analysis. Data was analyzed using Pearson's Chi squared test and <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Among 130 survey respondents, 48 % supported the use of AI in breast radiology, independent of age, sex, race, education, and subjective understanding of AI. A significant percentage (70 %) of patients that have heard of examples of AI used in the medical field support its implementation in breast imaging (<em>p</em> &lt; 0.0001). Most patients (64 %) would feel more comfortable with AI implementation, if they better understood how AI was used. The most frequently cited concern about AI in breast radiology was loss of patient-doctor relationship (43 %). Only 16 % would accept AI integration if it increased imaging cost. Most patients (60 %) prefer a primary radiologist read with a second physician consulted for questions versus AI.</div></div><div><h3>Conclusions</h3><div>Patients have variable understanding and preferences about AI in breast imaging. Educational measures to increase transparency and understanding of medical AI may improve patient trust in their healthcare experience.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110649"},"PeriodicalIF":1.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364848","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}

{"title":"Clinical significance of new suspicious enhancement on breast MRI during neoadjuvant chemotherapy","authors":"Michael D. Villalba ,&nbsp;Haley P. Letter ,&nbsp;James W. Jakub ,&nbsp;Ahmed Yahya ,&nbsp;Santo Maimone","doi":"10.1016/j.clinimag.2025.110651","DOIUrl":"10.1016/j.clinimag.2025.110651","url":null,"abstract":"<div><h3>Purpose</h3><div>The goal of this study was to evaluate outcomes of new suspicious enhancement in women undergoing breast MRI during neoadjuvant chemotherapy (NAC).</div></div><div><h3>Methods</h3><div>This retrospective review evaluated patients with breast cancer who underwent NAC with breast MRI performed from 2012 to 2022. Patients were included for further evaluation if an MRI during NAC recommended additional workup or biopsy of any new suspicious enhancing lesion separate from the index tumor. Medical records, subsequent imaging studies, and pathology reports were reviewed in eligible patients to identify lesion characteristics and outcomes of further workup.</div></div><div><h3>Results</h3><div>A total of 425 patients had pre- and post-treatment MRI. After exclusions, final study population included 14/425 (3.3 %) patients with new suspicious findings after initiation of NAC, none (0/14, 0 %) of which were shown to represent malignancy on biopsy, surgery, or follow-up. Imaging manifestations included non-mass enhancement (5/14, 35.7 %), enhancing foci (5/14, 35.7 %), and masses (4/14, 28.6 %), with the new finding contralateral to the malignancy in 10/14 (71.4 %) and ipsilateral in 4/14 (28.6 %). Most patients (11/14; 78.6 %) demonstrated an imaging response to NAC. Of 11 patients with pathology, stromal fibrosis and fibrocystic change were described most commonly, in 8/11 (72.7 %) and 5/11 (45.5 %) respectively. Inflammatory cysts were present in 8/14 patients (57.1 %).</div></div><div><h3>Conclusion</h3><div>New enhancing lesions on breast MRI during NAC, particularly in setting of treatment response, are unlikely to indicate malignancy. This data corroborates other contemporaneous studies investigating this topic. Radiologists can incorporate this mounting evidence to help limit unnecessary workups.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110651"},"PeriodicalIF":1.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326666","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}

{"title":"PMSA-avid intracranial lesions are more likely to reflect metastases in men with polymetastatic disease","authors":"Sophia R. O'Brien,&nbsp;Austin R. Pantel","doi":"10.1016/j.clinimag.2025.110646","DOIUrl":"10.1016/j.clinimag.2025.110646","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110646"},"PeriodicalIF":1.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310155","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}

{"title":"Ferumoxytol vs gadolinium based contrast for comprehensive MR angiography of the thorax: A feasibility study","authors":"Arash Bedayat ,&nbsp;Kim-Lien Nguyen ,&nbsp;Mohammad H. Jalili ,&nbsp;Zaid Haddadin ,&nbsp;Ashley E. Prosper ,&nbsp;John M. Moriarty ,&nbsp;J. Paul Finn","doi":"10.1016/j.clinimag.2025.110637","DOIUrl":"10.1016/j.clinimag.2025.110637","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110637"},"PeriodicalIF":1.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294280","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}

{"title":"Concordance between artificial intelligence and radiologists in BIRADS classification of breast ultrasound: A study using ChatGPT-4o","authors":"Nigar Erkoc ,&nbsp;Elif Hazal Karlı ,&nbsp;Emre Tunay ,&nbsp;Ahmet Tan Cimilli","doi":"10.1016/j.clinimag.2025.110636","DOIUrl":"10.1016/j.clinimag.2025.110636","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the diagnostic concordance and consistency of ChatGPT-4o, a multimodal large language model, in assigning BI-RADS categories on breast ultrasound images, and to compare its performance with that of experienced radiologists.</div></div><div><h3>Materials and methods</h3><div>In this retrospective, single-center study, 405 breast ultrasound images from 350 patients were analyzed. Two board-certified radiologists (8–10 years of experience) independently reviewed the images and assigned BI-RADS categories. ChatGPT-4o evaluated the same images in isolated sessions, using a standardized prompt, without access to clinical data or dynamic scanning features. Cohen's kappa was used to assess interobserver agreement between radiologists; Fleiss' kappa was used to measure agreement among the radiologists and ChatGPT-4o.</div></div><div><h3>Results</h3><div>Interobserver agreement between the two radiologists was almost perfect (Cohen's κ = 0.832; <em>p</em> &lt; 0.001). ChatGPT-4o showed moderate agreement with Radiologist 1 (κ = 0.593) and substantial agreement with Radiologist 2 (κ = 0.621). The highest concordance was observed in BI-RADS 1 (κ = 0.848) and BI-RADS 5 (κ = 0.894) categories, while agreement was lower in BI-RADS 3 (κ = 0.487). Overall agreement among all three readers was substantial (Fleiss' κ = 0.682; 95 % CI: 0.639–0.725). ChatGPT-4o occasionally upstaged borderline BI-RADS 3 cases to BI-RADS 4 and tended to misclassify anatomical structures, such as ribs or fibroglandular tissue, as lesions.</div></div><div><h3>Conclusion</h3><div>ChatGPT-4o demonstrated promising diagnostic performance in breast ultrasound interpretation, particularly for clearly benign and malignant lesions. However, its limitations in intermediate-risk classification and artifact interpretation indicate that it should be used as an adjunct rather than a replacement for expert radiologist evaluation.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110636"},"PeriodicalIF":1.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326667","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}

{"title":"Is pelvic arterial angioembolization associated with increased infection risk following pelvic fracture fixation?","authors":"Phillip C. McKegg ,&nbsp;Amber I. Campo ,&nbsp;Suhas B. Nagappala ,&nbsp;Noah M. Hodson ,&nbsp;William Brigode","doi":"10.1016/j.clinimag.2025.110638","DOIUrl":"10.1016/j.clinimag.2025.110638","url":null,"abstract":"<div><h3>Background</h3><div>Angiography with or without embolization is commonly performed in patients with pelvic fractures and suspected arterial bleeding. While this intervention is often life-saving, concerns remain regarding its potential impact on postoperative infection following surgical fixation. This study aims to evaluate the relationship between angiography, angioembolization, and postoperative infection in operatively managed pelvic fractures.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilizes 2017–2021 data from the American College of Surgeons Trauma Quality Improvement Program (TQIP) to investigate the relationship between pelvic angiography/angioembolization and postoperative infection in patients undergoing surgical fixation for pelvic or acetabular fractures. Adult patients undergoing operative fixation for pelvic or acetabular fractures were stratified into three groups: no angiography, angiography only, and angiography with embolization. The primary outcome was pooled infection (superficial, deep, organ space surgical site infections, and osteomyelitis). Multivariable logistic regression was used to adjust for injury severity and other confounders.</div></div><div><h3>Results</h3><div>A total of 107,748 patients were included. Unadjusted analysis showed increased pooled infection rate in patients undergoing angiography or angioembolization (2.7 %) compared to no angiography (1.2 %, <em>p</em> &lt; 0.001). Multivariate regression suggested that this association was likely due to higher injury severity and hypotension rather than the procedure itself, as Injury Severity Score (ISS) and hypotension were significantly associated with increased infection risk. Analysis of secondary endpoints showed an independent association between angioembolization and osteomyelitis (OR 1.86, 95 % CI 1.06–3.25).</div></div><div><h3>Conclusion</h3><div>Angiography is not independently associated with an increased risk of infections following pelvic fracture surgery. Additionally, angioembolization does not independently increase infection risk overall, but is associated with an increased risk of postoperative osteomyelitis.</div><div>Level of Evidence: Level 3.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110638"},"PeriodicalIF":1.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356751","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}

{"title":"The diagnostic accuracy of artificial intelligence models in detecting lymph node metastases in lung cancer using endobronchial ultrasound (EBUS) images: A bivariate meta-analysis","authors":"Victor Arthur Ohannesian ,&nbsp;Luciano Falcão ,&nbsp;Bruno Marçola Ishizuka ,&nbsp;Isabelle Rodrigues Menezes ,&nbsp;Mariana Lee Han ,&nbsp;Ricardo F.O. Suruagy-Motta ,&nbsp;Mariana Letícia B. Maximiano ,&nbsp;Davi M.H. Cordeiro ,&nbsp;João Marcelo Baptista ,&nbsp;Miriana Mariussi ,&nbsp;Atul Kumar Taneja ,&nbsp;Miguel José Francisco Neto ,&nbsp;Rodrigo Gobbo Garcia ,&nbsp;Marcia Jacomelli","doi":"10.1016/j.clinimag.2025.110633","DOIUrl":"10.1016/j.clinimag.2025.110633","url":null,"abstract":"<div><h3>Purpose</h3><div>This study systematically evaluated AI models for detecting lymph node metastases in lung cancer using EBUS images and assessed their role in thoracic oncology.</div></div><div><h3>Materials and methods</h3><div>A systematic search following PRISMA-DTA guidelines was conducted in PubMed, Embase, Scopus, and Web of Science. Studies using AI models with cytologic or histologic analysis as the reference standard were included (PROSPERO: CRD42025635581). A bivariate random-effects model pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC). AI models were categorized as CNN-A (Convolutional Neural Networks), BASM (Biomedical Application-Specific Models), AFP (Automated Frameworks and Platforms), and G-DDN (Generic Deep Neural Networks).</div></div><div><h3>Results</h3><div>Twenty-two studies were included. The pooled sensitivity was 0.87 (95 % CI: 0.68–0.95), specificity 0.90 (95 % CI: 0.83–0.94), AUC 0.94 (95 % CI: 0.92–0.96), and DOR 56 (95 % CI: 17–182). CNN-A showed the highest accuracy, with an AUC of 0.970 and a DOR of 182, while AFP had the lowest sensitivity (0.058) and DOR (5.125), suggesting limited clinical applicability. Likelihood ratios were LR+ 8.39 (95 % CI: 4.93–14.28) and LR− 0.15 (95 % CI: 0.06–0.39), corresponding to post-test probabilities of 74 % for positive and 5 % for negative results. Subgroup analyses highlighted performance variations, emphasizing the need for refinement and validation in diverse settings.</div></div><div><h3>Conclusion</h3><div>AI models demonstrate high diagnostic accuracy in detecting lymph node metastases in lung cancer using EBUS images, reinforcing their potential in clinical decision-making. Future studies should refine accuracy metrics and further evaluate CNN-A across disease contexts.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110633"},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304446","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}

{"title":"The Tyrer-Cuzick risk model: Is it effective for all races?","authors":"Siya Patil ,&nbsp;Nikki A. Mehran ,&nbsp;Joel Erblich ,&nbsp;Guy H. Montgomery ,&nbsp;Julie B. Schnur ,&nbsp;Laurie R. Margolies","doi":"10.1016/j.clinimag.2025.110635","DOIUrl":"10.1016/j.clinimag.2025.110635","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The IBIS/Tyrer-Cuzick [version 8 (TC8)] risk model is widely used to estimate breast cancer risk, and to inform the allocation of magnetic resonance imaging (MRI) screening for high-risk breast patients. No study to date has evaluated the latest TC model in diverse populations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To assess the predictive value of the TC8 Risk Model across diverse racial and ethnic groups in an urban American population.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Retrospective data analysis from five sites within a single urban health care system from January 1, 2018-November 1, 2022. The sample included 73,435 patients; 639 had a history of breast cancer. Average TC risk scores were calculated by racial and ethnic groups for the overall sample, and then for those with a history of breast cancer. Analyses were conducted to evaluate relationships between TC8 risk scores, cancer rates, ethnicity and race.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;As expected, analyses revealed that TC8 scores were significantly associated with increased risk of cancer, with each percentage point increase in TC8 score the odds of cancer caseness increased by 2 %; (OR = 1.02, 95 % CI [1.01, 1.03]). Black/AA patients were less likely to be diagnosed with cancer than Whites; OR = 0.72, 95 % CI [0.59, 0.89]. Hispanic patients were less likely to be diagnosed with cancer than Non-Hispanic patients; OR = 0.49, 95 % CI [0.39, 0.61]. White patients had the highest TC8 scores, followed by Asian, Black/AA, and Other patients. Among cancer patients, White patients had higher TC8 scores than Black/AA patients (&lt;em&gt;p&lt;/em&gt; &lt; 0.02). Interestingly, we also found a stronger effect of TC8 scores on cancer caseness among Hispanic patients than Non-Hispanic patients [χ&lt;sup&gt;2&lt;/sup&gt;(1) = 5.1, &lt;em&gt;p&lt;/em&gt; &lt; 0.024]. White patients had a greater odds of reaching the TC8 threshold of 20 than Black/AA (OR = 0.49, 95 % CI [0.46, 0.53]), Asian (OR = 0.62, 95 % CI [0.57, 0.68]), and Other (OR = 0.44, 95 % CI [0.41, 0.47]) patients. Similarly, Hispanic patients were significantly less likely to meet TC8 threshold scores than Non-Hispanic patients; χ&lt;sup&gt;2&lt;/sup&gt;(1) = 390.6, &lt;em&gt;p&lt;/em&gt; &lt; 0.001, OR = 0.53, 95 % CI [0.50, 0.57].&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;A higher TC8 risk score is significantly associated with increased odds of cancer across demographic groups. White patients exhibited the highest TC8 scores, and White patients have the highest odds of reaching the TC8 threshold for qualifying for breast MRI, while the relationship between TC8 scores and caseness was highest for Hispanic patients.Among cancer patients, Black/AA patients continued to have lower TC8 scores, raising the question of whether the cut-off of TC8 = 20 is appropriate for all groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical impact&lt;/h3&gt;&lt;div&gt;TC8 scores guide decisions for MRI screening, but the predictive value of the TC8n score may differ based on ethnicity. Furthermore, due to pot","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110635"},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294235","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}

{"title":"Prevalence, severity, and modifiable predictors of scanxiety in patients undergoing routine oncologic imaging: a prospective longitudinal study","authors":"Mohammad Sibtain Shah ,&nbsp;Jawad Ali Memon ,&nbsp;Uzma Malik ,&nbsp;Zubair Ali Memon ,&nbsp;Mohammad Saleh Chandio","doi":"10.1016/j.clinimag.2025.110634","DOIUrl":"10.1016/j.clinimag.2025.110634","url":null,"abstract":"<div><h3>Background</h3><div>Anxiety related to oncologic imaging, “scanxiety,” is common and may impair quality of life and adherence to surveillance. However, data on its prevalence, severity, temporal pattern, and modifiable predictors across routine imaging phases remain limited. Identifying modifiable predictors such as communication quality and wait times is essential for developing targeted interventions.</div></div><div><h3>Methods</h3><div>This prospective longitudinal study enrolled 406 adult cancer patients undergoing routine CT, MRI, or PET/CT at a tertiary center. Participants completed the HADS-A, STAI-State, and SAA-VAS at the pre-scan, during, and waiting phases, as well as FACT-G, IES-R, and a questionnaire assessing wait times, communication, information, and social support. Data were analyzed using chi-square, Pearson correlations, <em>t</em>-tests, logistic regression, and repeated-measures ANOVA.</div></div><div><h3>Results</h3><div>Among 406 patients (mean age 58.4 ± 12.7 years, 57.6 % female), 71.2 % exhibited clinically significant scanxiety, with 60.1 % scoring HADS-A ≥ 8 and a mean SAA-VAS score at the result waiting phase (7.1 ± 2.3). Multivariate analysis identified scan-to-result wait time associated with increased odds (OR 1.19 per day; 95 % CI 1.08–1.31), advanced disease stage (OR 1.78; 95 % CI 1.08–2.93), and prior scans (OR 1.12 per scan; 95 % CI 1.02–1.23) as significant risk factors. Protective factors included procedural explanations (OR 0.46), staff friendliness (OR 0.82), information provision (OR 0.52), and social support (OR 0.57).</div></div><div><h3>Conclusion</h3><div>Scanxiety affected over 70 % of patients and escalated across imaging phases, peaking during result waiting. Modifiable factors offer intervention targets to mitigate distress and improve patient outcomes.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110634"},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271445","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}

{"title":"The importance of FDG avidity in incidental thyroid nodules on FDG PET/CT","authors":"Ummuhan Abdulrezzak ,&nbsp;Emre Temizer ,&nbsp;Ahmet Tutus","doi":"10.1016/j.clinimag.2025.110626","DOIUrl":"10.1016/j.clinimag.2025.110626","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to determine the relationship between fluoro 2-deoxy-<span>d</span>-glucose (FDG) uptake patterns and malignancy potential in thyroid incidentalomas detected on FDG positron emission tomography/computed tomography (PET/CT).</div></div><div><h3>Method</h3><div>A retrospective review was conducted on 11,591 patients who underwent FDG PET/CT. Of these, 1611 patients with diffuse, focal, or mixed FDG uptake in the thyroid gland were included in the study. Histopathological data were obtained for 214 (13 %) of these patients.</div></div><div><h3>Results</h3><div>The mean age of the 1611 patients was 62 ± 13 years (age range: 2–96). Of the patients, 874 (54 %) were female, and 737 (46 %) were male. Diffuse involvement was observed in 227 (14 %) cases, focal involvement in 1339 (83 %), and mixed involvement in 45 (3 %) cases. In the malignancy group, 20 (61 %) had papillary carcinoma, 2 (6 %) had follicular carcinoma, 2 (6 %) had anaplastic carcinoma, 2 (6 %) had metastasis, 1 (3 %) had medullary carcinoma, and 6 (18 %) were classified as AUS (Atypia of Undetermined Significance). While the median thyroid SUVmax (IQR) was 5.3 (6.5) in the group with malignancy and AUS, it was 2.2 (2.5) in the benign group, with a significant difference between them (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Malignant potential (including malignant and AUS cases) was present in 42 % of patients with FDG uptake above the threshold value of 3.5 for SUVmax. Contrary to the classical understanding that “well-differentiated thyroid cancers show low FDG uptake,” the rate of both well-differentiated and other thyroid malignancies significantly increases in thyroid incidentalomas with high FDG uptake.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"128 ","pages":"Article 110626"},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402796","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}