Radiographics最新文献

The Prostate Imaging for Recurrence Reporting (PI-RR) system was introduced in 2021 to standardize the performance and interpretation of pelvic MRI after whole-gland treatment with radical prostatectomy (RP) or radiation therapy (RT). The Prostate Imaging Reporting and Data System (PI-RADS) defines technical and reporting standards for imaging prostate cancer before treatment. Although similar imaging techniques can be applied in assessing the treated prostate gland, the interpretation varies substantially between PI-RADS and PI-RR. With PI-RADS, T2-weighted and diffusion-weighted imaging are emphasized for cancer detection. After treatment, the emphasis shifts in PI-RR to detect recurrence with dynamic contrast enhancement (DCE) imaging. Focal early enhancement on DCE images, and to a lesser degree marked diffusion restriction, are the key MRI findings of recurrence after RP and RT. Using nomenclature similar to that of PI-RADS version 2.1, PI-RR uses established knowledge of recurrent prostate cancer MRI features and systematically codifies scoring elements. The authors discuss the PI-RR rationale, technical standards, and reporting guidelines. The scoring system for posttreatment MRI after RT and RP is reviewed, exploring the relevant T2-weighted, diffusion-weighted, and DCE features for both scenarios. The use of PI-RR is illustrated through instructive cases. Finally, pitfalls in the initial implementation of PI-RR and areas for future development are described. The goal is to provide a comprehensive reference for prostate MRI readers of all experience levels to use PI-RR in standardizing reporting of suspected recurrent prostate cancer. ^©RSNA, 2025 See the invited commentary by Dias and Haider in this issue.

Parasitic worms (ie, helminths) encompass a broad spectrum of organisms that lead to a myriad of acute, chronic, and multisystemic disease manifestations rooted in the life cycles of helminths, their migratory paths within humans, and the immunologic reactions they provoke. Although geographic distribution is traditionally given substantial consideration in the process of diagnosing these diseases, increased world travel and migration has resulted in cases all over the world. Because physicians in areas where these organisms are nonendemic are less likely to be familiar with them, the diseases are unexpected, resulting in difficulty and delay in diagnosis and appropriate treatment of patients. The authors aim to familiarize radiologists with helminthiases and their imaging findings, including diseases caused b y cestodes (tapeworms) such as Echinococcus granulosus and Taenia solium, trematodes (flatworms) such as Clonorchis sinensis and Schistosoma species, and nematodes (roundworms) such as Ascaris lumbricoides and various types of filaria. By interlinking parasite transmission and disease development mechanisms with the observable patterns at imaging, the authors help to elucidate how and why these manifestations appear as they do. Radiologists will enhance their ability to identify typical and atypical sequelae of helminthiases with multiple imaging modalities, including US, CT, and MRI and other imaging techniques, using an organism-based approach. ^©RSNA, 2025 Supplemental material is available for this article. See the invited commentary by Volpacchio in this issue.

It is essential to identify vascular anomalies of the thorax because of their potential association with congenital heart diseases and genetic abnormalities. Although some patients present with symptoms early in childhood, others remain asymptomatic until adulthood. However, certain anomalies can impact the prognosis significantly and necessitate tailored treatment strategies. Moreover, understanding the embryologic origins and anatomic variations of each vasculature is paramount because many of these anomalies arise from disruptions in the developmental process and can coexist simultaneously. The authors describe the embryology, anatomy, and specific imaging findings of each vascular anomaly in two primary systems: pulmonary circulation and systemic circulation. Within the pulmonary circulation, conditions explored are unilateral absence of the pulmonary artery, aberrant pulmonary artery (pulmonary sling), partial anomalous pulmonary venous return, total anomalous pulmonary venous return, and anomalous unilateral single pulmonary vein. For systemic circulation, the anomalies reviewed are double aortic arch, aberrant right subclavian artery, right aortic arch, aberrant left subclavian artery, Kommerell diverticulum, patent ductus arteriosus, persistent left superior vena cava, and azygos continuation of the inferior vena cava. By thoroughly examining these conditions alongside their imaging findings and embryologic backgrounds, radiologists and clinicians can gain the expertise required for precise diagnosis and effective management in patients with thoracic vascular anomalies. ^©RSNA, 2025 Supplemental material is available for this article.

Familial pulmonary fibrosis (FPF) represents a subset of patients with interstitial lung disease that can be a diagnostic dilemma for the clinician and radiologist. Diagnosis can be challenging, as the age at presentation and penetrance can vary even among family members. In fact, many of these diseases have been only recently discovered with improved gene sequencing. In addition, imaging patterns are often unclassifiable, and there can be a wide range of extrapulmonary symptoms such as bone marrow and liver failure, which can further obscure the diagnosis. Given that these patients have an overall worse prognosis than that of sporadic cohorts, accurate and early diagnosis is pivotal. The authors review the general concepts of FPF and highlight the known key mutations implicated in FPF, including those that cause abnormal surfactant function, premature shortening of telomeres, and other specific genetic syndromes such as dyskeratosis congenita, Hermansky-Pudlak syndrome, and coatomer-associated protein α syndrome. The clinical presentations and imaging findings are also highlighted. The authors raise awareness of FPF among radiologists who may encounter this entity when interpreting imaging or participating in multidisciplinary conferences. ^©RSNA, 2025 Supplemental material is available for this article.