DAILY NEWS of March 6

The first examined the value of interpreting the T2 signal of breast lesions on MRI (T2 without fat suppression). The authors retrospectively reviewed 1,387 MRIs and found no association between T2 signal intensity and whether breast lesions were benign or malignant. However, the most aggressive lesions (Luminal B, triple-negative tumors, and tumors with high Ki-67) showed a significantly higher T2 signal (p < 0.05) than less aggressive tumors. Notably, tumors with an in situ component generally did not demonstrate a high T2 signal.

The second study aimed to identify ADC threshold values to differentiate benign from malignant lesions on MRI. The authors analyzed 773 lesions (77.2% malignant). Malignant lesions had a lower mean ADC value (0.85) than benign lesions (1.23). An ADC threshold of 1.03 allowed discrimination between the two, with a sensitivity of 85% and a specificity of 72%.

Both studies concluded that these characteristics should be integrated with the full set of multiparametric MRI data, particularly dynamic contrast-enhancement findings.

RPS 1410 - Detecting damage : sports and trauma imaging

Author : Maxime PASTOR, CHU de Montpellier

Speciality : MSK

This scientific session focused on recent advances in imaging of sports-related and traumatic injuries. Several key messages emerged from the presentations.

One study confirmed the value of MRI for predicting the evolution of muscle injuries in athletes. In thigh muscle injuries among professional football players, the BAMIC and MLG-R classifications, together with specific MRI features, such as anatomical location, lesion length, and the presence of intermuscular fluid, were correlated with return-to-play time and risk of recurrence. The integration of artificial intelligence models using existing MRI classifications may further improve prognostic stratification.

Regarding anterior cruciate ligament injuries, one study reported that multiparametric MRI analysis can accurately distinguish recent from chronic ACL tears, which may be useful for clinical management and in certain medico-legal situations. Another study presented promising results using a novel low-field MRI system (0.15T) exploiting the “magic angle” effect, enabling improved visualization of the orientation and structure of ACL fibers.

Overall, this session highlighted the ongoing transition toward more quantitative and predictive musculoskeletal imaging, with an increasing integration of artificial intelligence in the evaluation and management of sports injuries.

RPS 1311 - Imaging the psychiatric brain: new frontiers and insights

Author : Clara COHEN, Pôle Imagerie Centre Hospitalier Universitaire d'Orléans

Speciality : Neuroradiology

Psychiatric Disorders: MRI Biomarkers Are Becoming Essential

Brain imaging plays a key role in the evaluation of psychiatric disorders. At an initial level of investigation, its purpose is to rule out so-called “organic” causes. In reality, thanks to MRI, evidence of structural and metabolic abnormalities is accumulating, contributing to a better understanding of the underlying pathophysiological substrates and opening the door to new neuromodulatory treatments.

At the onset of schizophrenia, two subtypes were identified using functional MRI in a study of 77 patients. The first pattern (45%) was associated with a diffuse reduction in cortical excitability in the frontal, sensorimotor, and cuneus regions, along with more severe symptoms (depression, cognitive impairment, and negative symptoms). The second pattern (55%) showed more moderate MRI and clinical involvement, reflecting likely compensatory processes. These two neurobiological models are promising for linking molecular alterations with neuronal dysfunction.

Bipolar disorder is characterized by progressive psychiatric deterioration. In a study of 45 patients stratified by severity, tractography and connectomic analysis demonstrated a decrease in “nodal strength” and an increase in “nodal betweenness” in the posterior cingulate cortex (PCC) among the most severely affected patients. Connectivity in the PCC is thus becoming a target biomarker for the progression of bipolar disorder.

Finally, on a lighter note: slow and regular music does not activate the same brain regions as intense music, offering exciting prospects for music therapy!

*To know more : https://doi.org/10.1186/s12916-026-04721-2

RPS 1417 - Hot Topic: AI in emergency imaging

Author : Ahmed-Ali EL AHMADI, AP-HM

Speciality : Emergency

AI Triage in Emergency Radiology: Enhancing Detection or Adding Noise?

This multicenter retrospective study evaluated the performance of the simultaneous use of several AI-based alert systems. Algorithms for detecting intracranial hemorrhage on brain CT, pneumothorax on chest radiography, and incidental pulmonary embolism on CT were applied to 2,336 CT scans and 119 chest radiographs.

The authors show that AI improves diagnostic performance compared with the radiologist alone (1.5%, 2/133 for intracranial hemorrhage; 0.8%, 1/119 for pneumothorax; and 1.3%, 22/1654 for pulmonary embolism), but at the cost of an increased number of false positives, particularly for pulmonary embolism detection. Thus, at the cost of approximately 1.5 false alerts per day, AI enabled the detection of one additional potentially life-threatening condition every five days.

They conclude that AI tools in emergency radiology are useful for improving patient safety, provided that vigilance is maintained regarding false positives.

AI Assistance Improves Radiology Resident Reader Performance in CT Diagnosis of Intracranial Hemorrhage

This study compared the diagnostic performance of two radiology residents for the detection of intracranial hemorrhage, with and without the assistance of a validated AI software. The study, conducted on 1,337 CT scans, showed that the tool significantly increased sensitivity (0.85 to 0.94; p < 0.01) and specificity (0.87 to 0.97; p < 0.01). The greatest benefit was observed for subdural hematomas (SDH), with the error rate decreasing from 20.3% to 5.7% (p < 0.001).

AI therefore appears to be a valuable tool for improving the interpretations of unsupervised junior residents.

RPS1304 Advances in MRI for pulmonary imaging – research presentation session : Chest

Author : Mehdi HAIDAR, CHU de Lille

Session recherche - Imagerie Thoracique

This presentation aimed to highlight recent advances in lung MRI. Among the seven studies presented, two particularly drew our attention.

The first was a prospective study including 12 patients with connective tissue disease–associated interstitial lung disease (CTD-ILD) at a moderate to severe clinical stage. A respiratory-gated T2-weighted fast spin-echo (FSE) sequence was acquired and compared with computed tomography (CT). In six patients, interstitial abnormalities visible on CT corresponded to T2 hyperintense lesions, predominantly located in the most affected areas. According to the authors, these findings were suggestive of interstitial edema, without correlation with disease stage. At the 6-month follow-up, an increase in edema was observed in three patients without any change on CT; two of these patients experienced clinical worsening, suggesting that MRI-detected edema could represent a predictive marker of disease progression.

The second study assessed the role of MRI in analyzing the relationship between bronchial artery dilatation and bronchopulmonary involvement in primary ciliary dyskinesia (PCD). A 3-year longitudinal follow-up with annual MRI examinations was performed in 68 patients, including perfusion and angiographic sequences. Disease severity was assessed using spirometry and the MRI chest score developed for cystic fibrosis (Eichinger, Eur J Radiol, 2012), which was applied here to primary ciliary dyskinesia. More than half of the patients (54%) had dilated bronchial arteries at baseline, most commonly originating from the aorta. During follow-up, newly dilated arteries appeared in 5.8% of patients, and an increase in their number was observed in 4.4%. Older age and more severe pulmonary involvement were significantly associated with the presence of dilated arteries (p = 0.002). Owing to its non-ionizing nature, MRI may therefore play an important role in the follow-up of these often young patients.

EDUCATIONAL SESSIONS

RC 1202 – Symptomatic breast imaging

Author : Juliette COUTUREAU, CHU de Montpellier

Speciality : Breast

The key points emerging from this session are the following:

1. Breast pain is not a sign of breast cancer. There is no indication for imaging in the absence of associated signs (palpable mass, nipple discharge). The appropriate management in this context consists of reassurance and the prescription of analgesics and/or topical anti-inflammatory medications.

2. During pregnancy and breastfeeding, ultrasound has very good diagnostic performance in cases of focal symptoms, and mammography exposes the fetus to very low radiation (0.001–0.01 mGy for two views of both breasts).

In practice, in the case of a focal complaint lasting more than two weeks, ultrasound alone can be proposed for women under 30 years old, and mammography may be added if necessary after the age of 30. MRI is not recommended by the ACR because of the lack of certainty regarding the long-term safety of gadolinium for the fetus, except when indispensable (e.g., for staging). MRI without contrast is not useful.

E³ 22D - Elbow and wrist in sports

Author : Maxime PASTOR, CHU de Montpellier

A key highlight of this educational session was the excellent presentation by Prof. Reno Sutter, focusing on overuse injuries of the elbow and wrist in athletes.

At the elbow, the most common injuries involve the epicondylar tendon insertions, corresponding to lateral epicondylitis (“tennis elbow”) and medial epicondylitis (“golfer’s elbow”). In children, the main differential diagnosis is « Little League elbow », which represents a traction apophysitis.

At the wrist, several overuse conditions were discussed. Tendon disorders are dominated by De Quervain tenosynovitis, the most common entity, frequently observed in racket sports but also in young parents due to repetitive wrist strain. Other associated findings may include dorsal ganglion cysts related to the scapholunate ligament or stress fractures of the hamate, particularly in climbers.

The session also highlighted that specific sports or activities are associated with characteristic injury patterns, emphasizing the importance of recognizing these imaging patterns. Overall, the session provided valuable educational insights for both junior radiologists and more experienced musculoskeletal imaging specialists.

RC 1208 - Structured approach to skull base and temporal bone imaging

Author : Guillaume HAMON, CHU de Rennes

Speciality : Neuroradiology

The session first emphasizes the importance of knowing the anatomical basics and having a systematic analysis plan when reviewing a temporal bone CT scan, from lateral to medial, following the pathway of sound transmission: the external auditory canal, the tympanic membrane, the ossicular chain and tympanic cavity, and the inner ear structures (Cavaliere M, Frontiers in Neurology, 2021). It is also important not to forget to review the rest of the acquisition volume, particularly the nasopharynx.

The second key message is that the interpretation of postoperative skull base imaging depends mainly on the pre-surgical appearance of the lesion, the lesion’s histology, and the surgical technique used. In particular, it is emphasized that enhancement of a muscle flap observed postoperatively is related to an expected phenomenon of acute denervation and should not be interpreted as a concerning finding.

CT and MRI are complementary in the evaluation of the many etiologies of pulsatile tinnitus. The third message of this session is that there is no association between vascular loops within the internal auditory canal or vestibulocochlear neurovascular contacts and the presence of pulsatile tinnitus (Chong ML, European Radiology, 2025).

RC 1311 – Pick Up the Phone in the Neuroradiology Reading Room

Author : Guillaume HAMON, CHU de Rennes

Speciality : Neuroradiology

The presentation of the main neuro-ophthalmological, vascular/traumatic, and infectious/inflammatory emergencies was illustrated through numerous clinical cases. The speakers emphasized the importance of clinical context in guiding imaging strategies. For example, in the presence of binocular diplopia, certain associated features require urgent imaging: headache (aneurysm rupture, pituitary apoplexy), sudden onset (stroke), intracranial hypertension (venous thrombosis, tumor), infectious syndrome (abscess), or trauma (muscle entrapment, carotid–cavernous fistula).

It is difficult to summarize the many key points of this excellent presentation; I strongly encourage you to watch this session in replay (RC 1311).

The final part focused on findings that should not be over-reported and frequent interpretation errors. A reminder was given about the appearance of dilated perivascular spaces on CT, which should not be confused with lacunar infarcts. These are classically located at the level of the anterior commissure, have smooth contours around a vessel, and appear isointense to CSF without FLAIR edema, in contrast to deep lacunes (typically located within the thalamus and basal ganglia). One exception exists, however: dilated perivascular spaces in the anterior temporal region may show peripheral FLAIR hyperintensity in this location, without pathological significance.

RC 1212 - Imaging complications of prematurity: bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL), necrotising enterocolitis (NEC)

Author : Ahmed-Ali EL-AHMADI, AP-HM

This session focused on the complications of prematurity: bronchopulmonary dysplasia, cerebral hemorrhagic lesions, periventricular leukomalacia, and necrotizing enterocolitis.

Bronchopulmonary dysplasia may be complicated by pulmonary vein stenosis, bronchomalacia, or pulmonary arterial hypertension. Chest radiography remains the first-line imaging modality. The role of CT is debated; however, it remains essential for the pre-therapeutic assessment of certain complications and should be performed with contrast injection.

Systematic surveillance with transfontanellar ultrasound is necessary for the screening of neurological complications related to prematurity. MRI is recommended in all preterm infants at term-equivalent age for a comprehensive evaluation.

The diagnosis of necrotizing enterocolitis relies on radiography and ultrasound. Ultrasound allows the detection of signs of complications such as pneumoperitoneum, peritoneal effusion, and absence of peristalsis. Pneumatosis intestinalis and portal venous gas are signs that may disappear rapidly, and their absence does not exclude the diagnosis. Contrast-enhanced ultrasound has been reported as a potential tool for detecting digestive complications.

PL 2 - Whole Brain Living: The Anatomy of Choice and the Four Characters That Drive Our Life

Author : Clara COHEN, Pôle Imagerie Centre Hospitalier Universitaire d'Orléans

Speciality : Neuroradiology

A Trailblazer in Schizophrenia Research

A spectacular holographic presentation was given by neurophysiologist Jill Bolte Taylor, a pioneer in schizophrenia (SCZ) research, to which she devoted her career in order to better understand her brother, who was affected by the illness.

She helped identify the middle temporal visual area, involved in tracking moving objects, as a neural substrate of the disease. Indeed, unlike healthy individuals who focus their gaze directly on a moving object, people with SCZ tend to fix their gaze slightly behind the moving object. As a result, the integration of information from the surrounding world is disrupted from the outset in these patients. Their altered perception of reality makes it difficult for them to share common experiences with others.

In the 1990s, she and her colleagues helped shift the research paradigm in schizophrenia. Dopamine had initially been identified as the main dysfunctional neuromodulator. However, they demonstrated an alteration in the serotonin system, which during the embryonic period acts as a pathfinder for cortical maturation. Dopaminergic fibers subsequently follow the pathways laid down by serotonin.

Frequently discouraged from continuing her research because of the poor reputation associated with psychiatric disorders, she persevered. She also actively advocated—sometimes even through song—for the importance of brain tissue donation for research in the United States.

An inspiring journey!

Cube 16 : the cube : innovative fusion imaging in neurointervention : tips and tricks

Author : Mehdi HAIDAR, CHU de Lille

Interventional neuroradiology procedures are complex and require careful analysis of preoperative imaging.

Advanced guidance tools such as image fusion are essential for optimizing the success of endovascular procedures, and their usefulness has been demonstrated in the literature. Image fusion enables optimized navigation and also contributes to a reduction in procedural time, radiation exposure, and contrast agent use (Zhang et al., Medicine, 2016).

Image fusion can be generated either by integration with preoperative imaging (CT angiography or MR angiography) or through intraoperative acquisition of 2D or 3D reference images, which are subsequently superimposed onto fluoroscopy using increasingly advanced software and imaging systems. Fusion guidance can be adjusted according to procedural circumstances (patient movement, need to modify the working projection, or changes in anatomical relationships). It also allows verification of the correct positioning of devices during or after implantation (coils, stents). Finally, multimodal image fusion guidance is also routinely used during aortic endovascular procedures (Sailer, Eur J Vasc Endovasc Surg, 2014).

RC1410 – Imaging of the Shoulder

Author : Nicolas STACOFFE, CHU de Lyon

This text summarizes one of the educational lectures dedicated to shoulder imaging.

Shoulder pain is most commonly attributed to glenohumeral instability or rotator cuff pathology. However, other etiologies should be systematically considered during imaging evaluation. Among these, pulley lesions of the long head of the biceps tendon, located within the rotator interval, represent an important cause of pain and instability of the biceps tendon. These lesions involve structures such as the superior glenohumeral ligament and the coracohumeral ligament and can be classified according to the Habermeyer classification.

Adhesive capsulitis is another frequent cause of shoulder pain and functional limitation. Imaging—particularly after intra-articular contrast injection (MR arthrography or CT arthrography), allows better visualization of capsular thickening and reduction of the joint volume. At the level of the rotator interval, especially during the so-called “frozen” phase, inflammatory infiltration and thickening of the ligamentous structures may be observed.

It is also essential to evaluate the acromioclavicular joint, as degenerative or inflammatory changes may contribute to shoulder pain. In addition, paralabral cysts should be carefully assessed, as they may cause nerve compression, particularly of the suprascapular nerve, potentially leading to functional impairment.

Finally, rarer conditions may be encountered, such as migration of calcific deposits into the muscle, an unusual complication of calcific tendinopathy that can lead to acute shoulder pain.

RC 1510 – Refresher Course Spine Imaging

Author : Nicolas STACOFFE, CHU de Lyon

In the session dedicated to spine imaging, I selected a presentation focusing on imaging of spinal trauma.

The primary objective of imaging in spinal trauma is to identify neurological complications that may be preventable in both the short and long term. Imaging must allow rapid detection of vertebral injuries, spinal cord damage, and potential associated vascular involvement.

Conventional radiographs currently have a limited role due to their low sensitivity for detecting spinal injuries. However, they may still be used in cases of minor trauma.

Computed tomography (CT) is the imaging modality of choice in trauma patients, particularly in the setting of polytrauma. It provides excellent evaluation of osseous structures and allows rapid detection of fractures and dislocations.

Magnetic resonance imaging (MRI) plays an essential complementary role, enabling assessment of spinal cord injuries, ligamentous damage, and bone marrow abnormalities. It is particularly useful in patients presenting with neurological deficits or when injury is suspected despite a normal CT scan.

Interpretation of spinal trauma imaging should always take the mechanism of injury into account, and a systematic approach based on a structured reading checklist is recommended.

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DAILY NEWS of March 6

DAILY NEWS ECR 2026 - MARCH 6, 2026 - Scholarship CERF-GUERBET

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