Irreversible electroporation to bring initially unresectable locally advanced pancreatic adenocarcinoma to surgery: the IRECAP phase II study
ConclusionAfter neoadjuvant chemotherapy, IRE could provide R0 or R1 resection in 35% of LAPC, which seems to be associated with higher OS.Clinical relevance statementAfter induction chemotherapy, stable locally advanced pancreatic cancers can be treated by irreversible electroporation, which could lead to a secondary 35% rate of R0 or R1 surgical resection which may be associated with a significantly higher overall survival.Key Points• In cases of unresectable LAPC (locally advanced pancreatic cancer), percutaneous irreversible electroporation (pIRE) is feasible (100% success rate of the procedure), but is associated wi...
Source: European Radiology - March 18, 2024 Category: Radiology Source Type: research

Synthetic MRI and amide proton transfer –weighted MRI for differentiating between benign and malignant sinonasal lesions
ConclusionThe combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions.Clinical relevance statementCombining synthetic MRI with amide proton transfer –weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling.Key Points•Synthetic MRI and amide proton transfer –weighted MRI could differentiate benign from mal...
Source: European Radiology - March 16, 2024 Category: Radiology Source Type: research

Enhancing gadoxetic acid –enhanced liver MRI: a synergistic approach with deep learning CAIPIRINHA-VIBE and optimized fat suppression techniques
ConclusionDL and HR-DL CAIPIRINHA-VIBE achieved superior image quality compared to standard CAIPIRINHA-VIBE. Additionally, HR-DL CAIPIRINHA-VIBE improved the lesion conspicuity and detection of small solid FLLs. DL and HR-DL CAIPIRINHA-VIBE hold the potential clinical utility for gadoxetic acid –enhanced liver MRI.Clinical relevance statementDL and HR-DL CAIPIRINHA-VIBE hold promise as potential alternatives to standard CAIPIRINHA-VIBE in routine clinical liver MRI, improving the image quality and lesion conspicuity, enhancing the detection of small (<  2 cm) solid focal liver lesions, and reducing the acquisition ...
Source: European Radiology - March 16, 2024 Category: Radiology Source Type: research

Evaluating persistent T1-weighted lesions without concurrent abnormal enhancement on breast MRI in neoadjuvant chemotherapy patients: implications for complete pathological response
ConclusionPersistent T1-weighted lesions without associated abnormal enhancement on post-treatment breast MRI correlate with lower complete pathological and imaging response rates.Clinical relevance statementThe study underscores the importance of persistent T1-weighted lesions on breast MRI as vital clinical markers, being inversely related to a complete pathological response following neoadjuvant chemotherapy; they should be a key factor in guiding post-neoadjuvant chemotherapy treatment decisions.Key Points•Persistent T1 lesions on post-chemotherapy breast MRI indicate a reduced likelihood of achieving a complete path...
Source: European Radiology - March 16, 2024 Category: Radiology Source Type: research

Diffusion-/perfusion-weighted imaging fusion to automatically identify stroke within 4.5  h
ConclusionsThe automatic segmentation-classification models based on DWI and PWI fusion images had high performance in identifying stroke within 4.5  h.Clinical relevance statementPerfusion-weighted imaging (PWI) fusion images had high performance in identifying stroke within 4.5  h. The automatic segmentation-classification models based on DWI and PWI fusion images could provide clinicians with decision-making guidance for acute stroke patients with unknown onset time.Key Points•The diffusion/perfusion-weighted imaging fusion model had the best performance in identifying stroke within 4.5  h.•The X-Net model had th...
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

What is the added value of specialist radiology review of multidisciplinary team meeting cases in a tertiary care  center?
ConclusionRadiologists ’ time investment in MDTMs is considerable relative to the small proportion of cases in which they influence patient management in the MDTM. The use of radiologists for MDTMs should therefore be improved.Clinical relevance statementThe use of radiologists for MDTMs (multidisciplinary team meetings) should be improved, because their time investment in MDTMs is considerable relative to the small proportion of cases in which they influence patient management in the MDTM.Key Points•Multidisciplinary team meetings (MDTMs) are an important component of the workload of radiologists.•In a tertiary care...
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

Does the presence of macroscopic intralesional fat exclude malignancy? An analysis of 613 histologically proven malignant bone lesions
ConclusionMalignant lesions rarely contain macroscopic intralesional fat on CT or MRI. While CT is effective in detecting macroscopic intralesional fat in primarily lytic lesions, MRI may be better for the assessment of heterogenous and infiltrative lesions with mixed lytic and sclerotic components.Clinical relevance statementMacroscopic intralesional fat is rarely seen in malignant bone tumors and its presence can help to guide the diagnostic workup of bone lesions.Key Points•Presence of macroscopic intralesional fat in bone lesions has been widely theorized as a sign of benignity, but there is limited supporting eviden...
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

MR-contrast enhanced mammography (CEM) for follow-up of breast cancer patients: a “pros and cons” debate
AbstractWomen with a personal history of breast cancer (PHBC) are at an increased risk of either a local recurrence or a new primary breast cancer. Thus, surveillance is essential for the detection of recurrent disease at the earliest possible stage, allowing for prompt treatment, and potentially improving overall survival. Nowadays, mammography follow-up is the only surveillance imaging technique recommended by international guidelines. Nevertheless, sensitivity of mammography is lower after breast cancer treatment, particularly during the first 5 years, due to increased density or post-treatment changes. Contrast-enhance...
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

High-performance presurgical differentiation of glioblastoma and metastasis by means of multiparametric neurite orientation dispersion and density imaging (NODDI) radiomics
ConclusionThe NODDI radiomics model showed promising performance for preoperative discrimination between Gb and SBM.Clinical relevance statementThe NODDI radiomics model showed promising performance for preoperative discrimination between Gb and SBM, and radiomics features can be incorporated into the multidimensional phenotypic features that describe tumor heterogeneity.Key Points•The neurite orientation dispersion and density imaging (NODDI) radiomics model showed promising performance for preoperative discrimination between glioblastoma and solitary brain metastasis.•Compared with other tumor volumes of interest, th...
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

Recommender-based bone tumour classification with radiographs —a link to the past
ConclusionOur novel approach surpasses current models in tumour classification and links to past patient data, leveraging expert insights.Clinical relevance statementThe proposed algorithm could serve as a vital support tool for clinicians and general practitioners with limited experience in bone tumour classification by identifying similar cases and classifying bone tumour entities.Key Points•Addressed accurate bone tumour classification using radiographic features.•Model achieved 92.86%, 92.86% and 34.08% mean accuracy, precision and recall, respectively, significantly surpassing state-of-the-art models.•Enhanced d...
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

Paris classification of colonic polyps using CT colonography: prospective cohort study of interobserver variation
ConclusionRadiologist agreement when using the Paris classification at CT colonography is low, and radiologist classification agrees poorly with colonoscopy. Using the full Paris classification in routine CTC reporting is of questionable value.Clinical relevance statementInterobserver agreement for radiologists using the Paris classification to categorise colorectal polyp morphology is only fair; routine use of the full Paris classification at CT colonography is questionable.Key Points• Overall interobserver agreement for the Paris classification at CT colonography (CTC) was only fair, and lower than for colonoscopy.• ...
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

ESR Bridges: imaging and treatment of hepatocellular carcinoma —a multidisciplinary view
(Source: European Radiology)
Source: European Radiology - March 15, 2024 Category: Radiology Source Type: research

Highest 3-month international normalized ratio (INR): a predictor of bleeding following ultrasound-guided liver biopsy
ConclusionThe highest INR in 3  months preceding ultrasound-guided percutaneous liver biopsy is associated with, and a better predictor for, post-procedural bleeding than the most recent INR and should be considered in patient risk stratification.Clinical relevance statementDespite correction of coagulopathic indices, the highest international normalized ratio within the 3  months preceding percutaneous liver biopsy is associated with, and a better predictor for, bleeding and should considered in clinical decision-making and determining biopsy approach.Key Points•Bleeding occurred in 2% of patients following ultrasound...
Source: European Radiology - March 14, 2024 Category: Radiology Source Type: research

Diagnostic performance of photon-counting detector CT for differentiation between adrenal adenomas and metastases
ConclusionVNC algorithms overestimate CT values compared to TNC in the assessment of adrenal lesions. However, they allow a reliable discrimination between adrenal adenomas and metastases and could be used in clinical routine in near future with an increased threshold (e.g., 26 HU). Further (multi-center) studies with larger patient cohorts and standardized protocols are required.Clinical relevance statementVNC reconstructions overestimate CT values compared to TNC. Using a different threshold (e.g., 26 HU compared to the established 10 HU), VNC has a high diagnostic accuracy for the discrimination between adrenal adenomas...
Source: European Radiology - March 14, 2024 Category: Radiology Source Type: research

Diagnostic efficacy of image-guided core needle biopsy of suspected malignant osseous lesions: pitfalls and factors affecting diagnostic yield
(Source: European Radiology)
Source: European Radiology - March 14, 2024 Category: Radiology Source Type: research