Radiographics最新文献

Targeted radionuclide therapy (TRT) plays an important role in management of oncology patients, particularly those with thyroid cancer, prostate cancer, or neuroendocrine tumor. Use of TRTs has expanded rapidly in recent years, with approval of new agents and indications. The number of ongoing TRT clinical trials suggests that this trend is likely to continue in the future. Adequate knowledge of potential adverse events and their management is essential for treating physicians to optimize outcomes in patients undergoing TRT. The authors review adverse events that may occur in TRT; their clinical manifestations, incidence, risk factors, and management; and strategies to prevent or decrease their risk of occurrence. ^©RSNA, 2025.

In radiology practice, medical images are described and interpreted by radiologists in text reports. Recent technical developments enabling deep learning models to connect images and text may facilitate the radiologic workflow. These developments include advances in data embedding, self-supervised learning, zero-shot learning, and transformer-based model architectures. Models connecting images and text can be divided into four categories: (a) Text-image alignment models associate text descriptions with corresponding images. (b) Image-to-text models create text descriptions from images. (c) Text-to-image models generate images from text descriptions. (d) Multimodal models integrate and interpret multiple types of data such as images, videos, text, and numbers simultaneously. Potential clinical applications of these models include automated captioning of medical images, generation of the preliminary radiology report, and creation of educational images. These advances may enable case prioritization, streamlining of clinical workflows, and improvements in diagnostic accuracy. Published under a CC BY 4.0 license.

Health disparities represent a significant and growing concern in the United States, largely due to recent recognition of worse outcomes experienced by historically underserved groups. Radiologists have an opportunity to address these disparities by using community engagement (CE) to deepen their knowledge about patient and community-level barriers and inform the development of programs focused on improving patient access to timely radiology care. Various established frameworks, such as the socioecologic model and the National Institute on Minority Health and Health Disparities research framework, can be adapted and leveraged by radiology practices to promote CE and advance health equity. These models emphasize multilevel interactions among individual factors to broader societal influences, enabling tailored approaches to addressing disparities in access to radiologic services. Providing practical ways of applying these models will increase the presence and impact of radiology in the community. In this article, case-based practical examples of current CE efforts in radiology are presented, with the aim of empowering radiologists to engage in and lead community-focused initiatives. For each case study, specific disparities and access to radiologic services, as well as intervention strategies, are described. Finally, the authors present adaptations to existing models and frameworks to inform a radiology-centric CE model that can be used to sustainably address health disparities by enhancing educational efforts, building coalitions, and developing comprehensive outreach strategies. This proposed model is intended to not only alleviate disparities but also mitigate radiologist burnout, thereby enhancing both community health outcomes and radiologist well-being. ^©RSNA, 2025 See the invited commentary by Hajjar and Brewington in this issue.

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.