Tag: nevin manimala

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12793-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare reading time, cancer detection rate (CDR), and abnormal interpretation rate (AIR) between AI-assisted and non-AI-assisted periods in screening and diagnostic mammography performed in routine clinical practice.

MATERIALS AND METHODS: We prospectively collected reading times for consecutive two-view full-field digital mammography interpreted by four radiologists between August 2023 and July 2024. Both screening and diagnostic examinations were included. A commercially available AI system was integrated into the clinical workflow, with results displayed or hidden on a monthly basis. Reading time, CDR, and AIR were compared between two periods. For reading time analysis, a subset of 2917 examinations with times ≤ 5 min was included to minimize the impact of non-interpretive interruptions. Reading time was extracted from the PACS log.

RESULTS: Among 4577 mammography examinations (mean age 51.7 ± 10.4 years), the overall CDR was higher during the AI-assisted period (22.3 vs 11.5 per 1000; p = 0.005). AIR did not differ for screening mammography (9.5% vs 8.4%; p = 0.293) but was higher with AI assistance for diagnostic mammography (18.7% vs 12.1%; p = 0.026). Mean reading times were comparable between AI-assisted and non-AI-assisted periods (65.0 vs 64.3 s; p = 0.723).

CONCLUSION: AI assistance in routine mammography interpretation was not associated with prolonged reading time and was associated with a higher overall CDR.

KEY POINTS: Question Does artificial intelligence assistance in routine mammography affect radiologists’ reading time, cancer detection, or abnormal interpretation in daily practice? Findings Artificial intelligence assistance was not associated with prolonged reading time and was associated with a higher overall cancer detection rate. Abnormal interpretation increased only for diagnostic examinations, with no difference in screening examinations. Clinical relevance AI assistance may support screening mammography by aiding cancer detection without disrupting workflow, whereas diagnostic use should be applied carefully due to higher abnormal interpretation rates.

PMID:42593499 | DOI:10.1007/s00330-026-12793-0

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12712-3. Online ahead of print.

ABSTRACT

OBJECTIVES: To analyze the factors for predicting 1-year outcomes and optimize surgical planning for Meso-Rex bypass (MRB) in children with extrahepatic portal vein obstruction (EHPVO).

MATERIALS AND METHODS: From October 2014 to July 2024, children with EHPVO after MRB were retrospectively analyzed. The number of MRB, the type of bypass vessel, and the position of the lower anastomosis were collected. Predictive variables include the diameter of the connection between the left and right portal veins, the Rex vein (RV) diameter, the number of RV branches, the diameter of the thickest RV branch, and the bypass-to-superior mesenteric vein (SMV) angle, which were measured by Contrast-enhanced CT (CECT) one week after MRB. The upper and lower anastomotic stenosis were diagnosed by Ultrasound and CECT one year after MRB.

RESULTS: A total of 153 children (median age 72 months, 87 males) were included in this study. Univariate factors include the number of MRBs, the type of bypass vessel, and CECT variables (except the diameter of the thickest RV branch). Numbers of MRB and RV branches were retained in the final model for upper anastomotic stenosis. The combination of MRB > 1 and RV branches ≤ 4 predicts it post-MRB with 75% sensitivity, 86.4% specificity, and an area under the receiver operator characteristic curve (AUC) of 0.832. The bypass-to-SMV angle ≤ 110° predicts lower anastomotic stenosis after MRB with 90% sensitivity, 73.39% specificity, and AUC 0.847.

CONCLUSIONS: Associated factors are useful for early postoperative risk stratification. Moreover, the type of bypass vessel and the bypass-to-SMV angle could be used to inform future surgical technique refinement.

KEY POINTS: QuestionWhich factors predict 1-year outcomes and optimize surgical planning for MRB in children with EHPVO? FindingsAssociated factors include bypass-to-SMV angle, number of MRB, RV branches and diameter, left-right portal vein connection diameter, and type of bypass vessel. Clinical RelevanceAssociated factors are useful for early postoperative risk stratification. Moreover, the internal jugular vein as the bridge vessel and the bypass-to-SMV angle > 110° could be used to optimize the surgical plan for a better outcome.

PMID:42593498 | DOI:10.1007/s00330-026-12712-3

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12784-1. Online ahead of print.

NO ABSTRACT

PMID:42593497 | DOI:10.1007/s00330-026-12784-1

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12789-w. Online ahead of print.

NO ABSTRACT

PMID:42593496 | DOI:10.1007/s00330-026-12789-w

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12785-0. Online ahead of print.

NO ABSTRACT

PMID:42593495 | DOI:10.1007/s00330-026-12785-0

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12788-x. Online ahead of print.

NO ABSTRACT

PMID:42593494 | DOI:10.1007/s00330-026-12788-x

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12782-3. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate a DINOv2-based medical slice transformer (MST) for triaging abbreviated breast MRI by ruling out examinations with suspicious findings that are immediately actionable (Breast Imaging Reporting and Data System [BI-RADS] ≥ 4) across contrast-enhanced and non-contrast-enhanced protocols.

MATERIALS AND METHODS: This institutional review board-approved retrospective study included 1847 single-breast MRI examinations (377 BI-RADS ≥ 4) from an in-house dataset and 924 from an external dataset (Duke). Four abbreviated protocols were tested: T1-weighted early subtraction (T1_sub), diffusion-weighted imaging with b = 1500 s/mm² (DWI₁₅₀₀), DWI₁₅₀₀ + T2-weighted (T2w), and T1_sub + T2w. Performance was assessed at 90%, 95%, and 97.5% sensitivity using five-fold cross-validation and area under the receiver operating characteristic curve (AUC). AUC differences were compared with the DeLong test. False negatives were characterized, and attention maps were rated in the external dataset.

RESULTS: A total of 1448 female patients (mean age, 49 ± 12 years) were included. T1_sub + T2w achieved an AUC of 0.77 ± 0.04; DWI₁₅₀₀ + T2w, 0.74 ± 0.04, with no significant differences across protocols. At 97.5% sensitivity, T1sub + T2w had the highest specificity (19% ± 7%), followed by DWI₁₅₀₀ + T2w (17% ± 11%). At 95% and 97.5% sensitivity, missed lesions were predominantly < 10 mm, mainly non-mass enhancements. External validation of the T1_sub protocol yielded an AUC of 0.77, with 88% of attention maps rated good or moderate.

CONCLUSION: At 97.5% sensitivity, the MST framework triaged cases without BI-RADS ≥ 4, achieving 19% specificity for contrast-enhanced and 17% for non-contrast-enhanced MRI. These findings highlight the potential of foundation-model-based AI to support efficient triaging of abbreviated breast MRI protocols.

KEY POINTS: Question Can an adapted DINOv2-based MST accurately stratify abbreviated breast MRI examinations to support triaging across contrast-enhanced and non-contrast-enhanced imaging protocols? Findings The model achieved 19% specificity for contrast-enhanced and 17% for non-contrast-enhanced MRI at 97.5% sensitivity; external validation of the T1sub protocol yielded an AUC of 0.77. Clinical relevance A foundation-model-based triage approach may reduce radiologist workload in breast MRI screening by identifying examinations unlikely to contain suspicious findings, including on non-contrast-enhanced protocols, thereby enabling prioritization of higher-risk studies.

PMID:42593493 | DOI:10.1007/s00330-026-12782-3

Front Med (Lausanne). 2026 Jul 29;13:1871179. doi: 10.3389/fmed.2026.1871179. eCollection 2026.

ABSTRACT

BACKGROUND: Sarcopenia and frailty are common issues faced by individuals suffering from liver cirrhosis. These ailments greatly diminish life quality and increase the likelihood of death. Engaging in physical activity is a popular method to improve sarcopenia. Consequently, this systematic review and meta-analysis seeks to assess the effectiveness of exercise programs for addressing sarcopenia in those with liver cirrhosis.

PURPOSE: This study evaluated the efficacy of exercise interventions on sarcopenia in patients with liver cirrhosis through a meta-analysis of randomized controlled trials (RCTs).

METHODS: A comprehensive literature search was conducted across five databases: PubMed, Embase, CINAHL, CNKI, and the Cochrane Library, up to March 2026. Manually search for references in review articles that may meet the requirements. Two researchers independently carried out the literature search and review, data extraction and assessment of risk of bias. The analysis of results includes 6-min walk distance (6MWD), thigh circumference, knee extensor strength, gait speed, thigh muscle thickness, Chronic Liver Disease Questionnaire (CLDQ), Model for End-Stage Liver Disease (MELD) scores and handgrip strength. Statistical analyses were performed using Rev Man 5.3 and STATA 14.0.

RESULTS: This meta-analysis included 16 studies involving a total of 942 patients. The results demonstrated that exercise significantly enhanced various physical and clinical metrics in patients suffering from liver cirrhosis and sarcopenia. Notably, significant improvements were recorded in the 6MWD (MD = 54.35, 95% CI = 34.56-74.14, P < 0.001), thigh circumference (MD = 1.83, 95% CI = 0.92-3.38, P = 0.020), knee extensor strength (MD = 8.06, 95% CI = 2.59-13.53, P = 0.004), thigh muscle thickness (MD = 0.09, 95% CI = 0.05-0.14, P < 0.001), and scores on the CLDQ (MD = 0.75, 95% CI = 0.51-0.99, P < 0.001). Additionally, gait speed exhibited a significant increase (MD = 1.17, 95% CI = 0.09-2.26, P = 0.030). However, no significant changes were observed in grip strength, or MELD scores. Subgroup analysis indicates that aerobic exercise, or Resistance exercise, appear to improve physical activity levels in patients with cirrhosis.

CONCLUSION: Exercise may improve selected indicators of muscle mass and physical performance in patients with cirrhosis. Exercise improves thigh muscle thickness, thigh circumference, and knee extension strength in patients with sarcopenia and cirrhosis, while also enhancing their physical activity capacity and quality of life. In terms of exercise type, both aerobic and resistance training appear to improve physical activity levels in patients with cirrhosis. However, further research is needed to confirm this.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420261326379.

PMID:42591090 | PMC:PMC13461329 | DOI:10.3389/fmed.2026.1871179

Front Physiol. 2026 Jul 29;17:1860201. doi: 10.3389/fphys.2026.1860201. eCollection 2026.

ABSTRACT

BACKGROUND: Cerebral hyperperfusion syndrome (CHS) after revascularization for moyamoya disease (MMD) represents a failure of cerebrovascular autoregulation-a system-level vascular physiological process. Non-invasive tools to quantify autoregulatory reserve and support early risk stratification remain limited. This study aimed to evaluate whether postoperative perfusion volume measured by territorial arterial spin labeling (tASL) provides an exploratory risk signal for cerebrovascular autoregulation failure after MMD revascularization and to identify candidate physiological factors associated with this complication.

METHODS: This prospective cohort study enrolled 116 adult MMD patients who underwent combined revascularization (suprasylvian approach, n=60; infrasylvian approach, n=56). All patients underwent 3D pseudo-continuous arterial spin labeling (3D-pCASL) preoperatively and postoperatively, and tASL on postoperative day 1. Postoperative perfusion volume and regional cerebral blood flow (CBF) were quantified. Firth’s penalized multivariable logistic regression was used to evaluate candidate factors associated with autoregulation failure (CHS) while avoiding statistical overfitting due to rare events (13 CHS cases). Receiver operating characteristic analysis determined exploratory threshold values. CHS was diagnosed contemporaneously during hospitalization by integrating new neurological symptoms, blood-pressure/hemodynamic context, and ASL evidence of focal postoperative hyperperfusion.

RESULTS: In the Firth penalized multivariable model, hypertension and Stage IV angiographic disease were associated with postoperative CHS, while Stage V showed a positive but statistically imprecise estimate. Age and tASL-derived postoperative perfusion volume showed exploratory ROC signals, with cutoffs of 61 years and 104.45 cm³, respectively. The suprasylvian approach showed a numerically higher early CHS rate than the infrasylvian approach (16.7% vs. 5.4%; Fisher exact P = 0.077), while showing higher regional CBF at postoperative day 30 and lower postoperative mRS scores at POD30. The low overall CHS incidence (13/116, 11.2%) should be interpreted in the context of standardized inpatient monitoring and active postoperative blood-pressure management.

CONCLUSION: Quantitative tASL perfusion volume provides a non-invasive, exploratory physiological marker of postoperative cerebrovascular autoregulatory stress after MMD revascularization. In this cohort, the suprasylvian approach was associated with greater POD30 CBF improvement and lower POD30 mRS scores, but also a numerically higher early CHS rate; these findings should be interpreted as early postoperative associations rather than evidence of long-term surgical superiority. The 104.45 cm³ tASL threshold requires internal and external validation before it can be used as a stand-alone clinical decision rule.

PMID:42591086 | PMC:PMC13461402 | DOI:10.3389/fphys.2026.1860201

Jpn J Nurs Sci. 2026 Oct;23(4):e70071. doi: 10.1111/jjns.70071.

ABSTRACT

AIM: To evaluate the benefits and harms of bathing during the first stage of labor among healthy women with uncomplicated singleton cephalic pregnancies at ≥ 36 weeks’ gestation.

METHODS: Randomized controlled trials comparing warm-water bathing during the first stage of labor with no bathing were included. MEDLINE (PubMed), Cochrane Database of Systematic Reviews, CENTRAL, and Ichu-shi Web (updated to December 2024) were searched for English- and Japanese-language studies. Two reviewers independently assessed risk of bias using the Cochrane Risk of Bias 1.0 tool, and evidence certainty was appraised with GRADE. Random-effects meta-analyses reported risk ratios (RRs) or mean differences with 95% prediction intervals (PIs), and I² statistics.

RESULTS: Nine studies from eight countries (1994-2018; n = 1823) met inclusion criteria. Bathing did not significantly affect regional analgesia use (RR 0.91, 95% PI 0.82-1.01; I² = 0%), perineal trauma, spontaneous vaginal birth, intact perineum, caesarean section, abnormal fetal heart rate patterns, neonatal infection, or episiotomy. Instrumental vaginal birth was reduced (RR 0.78, 95% PI 0.61-0.98; I² = 0%). Satisfaction tended to be higher in the bathing group, though evidence was limited to two small heterogeneous trials.

CONCLUSIONS: Evidence certainty was low to very low because of risk of bias, imprecision, lack of blinding, and limited woman-reported outcomes. Bathing appears safe for mothers and infants and may reduce instrumental delivery, but a clear analgesic-sparing effect was not shown. Implementation should ensure tub hygiene, water temperature regulation, and regular maternal and fetal monitoring.

TRIAL REGISTRATION: Register name: Effect of Bathing for Pain Relief During the First Stage of Labor: A protocol for a systematic review and meta-analysis. Registration DOI: https://doi.org/10.17605/OSF.IO/J9GTS.

PMID:42591025 | DOI:10.1111/jjns.70071