DAILY NEWS ECR 2026 - MARCH 4, 2026 - Scholarship CERF-GUERBET
ENGLISH VERSION
With the support of 
All summaries of scientific and educational sessions are available here.
SCIENTIFIC SESSIONS
RPS 110 - What is new in sarcopenia and body composition
RPS 211 - Modern imaging in stroke
RPS 205: Improving diagnosis and prognosis through AI in CNS diseases
RPS 111 - Glymphatic system, venous and small vessel disease: small lesions, big impact
RPS 517 : New approaches in trauma imaging in peace and war times
MS1 Acute retrosternal chest pain : from symptom to diagnosis ; multidisciplinary session
EDUCATIONAL SESSIONS
Abdominal Imaging in pregnant women
How 1: How we do it : MRI with or without GBCA. Updates and recommendations from the ESMRMB-GREC
E³ 226a - Cybersecurity in AI-driven radiology systems
E³ 226b - Application of photon-counting CT in paediatrics: need or nice to have?
RPS404 Photon counting CT : advances in chest imaging ; research presentation session : chest
SCIENTIFIC SESSIONS
Scientific session : RPS 110 - What is new in sarcopenia and body composition
Author : Maxime PASTOR, CHU de Montpellier
Speciality : MSK
This session focused on body composition imaging and sarcopenia, with a strong emphasis on automation and artificial intelligence.
Several studies confirmed the strong prognostic value of CT-derived muscle parameters. In sepsis, longitudinal loss of lumbar skeletal muscle mass index(SMI), measured at the L1 level, emerged as the strongest independent predictor of mortality. In both lung and kidney transplantation, preoperative sarcopenia and visceral adiposity were also associated with significantly increased morbidity and mortality. Similarly, a meta-analysis demonstrated a higher risk of refracture and persistent pain after vertebral augmentation procedures in sarcopenic patients.
Several studies proposed simplified approaches for muscle assessment. The analysis of “sentinel” muscles (autochthonous, gluteal, and psoas muscles) appears to reliably approximate established metrics of muscle radiodensity and myosteatosis.
Artificial intelligence approaches also played a major role in this session. Automated muscle and fat quantification on whole-body Dixon MRI using deep learning models (3D U-Net) demonstrated excellent accuracy and reproducibility, paving the way for large-scale cohort studies that would be difficult to perform with time-consuming manual segmentation.
RPS 211 - Modern imaging in stroke
Author : Clara COHEN, CHU d'Orléans
Updates in imaging of Acute Ischemic Stroke
Revascularization alert: searching for the missing etiology
In stroke pathways without MRI, non–ECG-gated thoracic arterial CT angiography improves the initial etiological assessment. In the cohort (n = 223), 10% of patients had one of the following findings: intracardiac thrombus, aortic dissection, or an ulcerated plaque of the aortic arch, and 11.4% had an incidental diagnosis (pulmonary embolism, neoplasia, etc.).
Furthermore, adding a cardiac CT during the venous phase improves the detection of intracardiac thrombi (13%) or left atrial appendage dilation, both of which are associated with a worse prognosis.
Finally, “I-shaped” thrombi at the termination of the internal carotid artery (ICA-I) are underdiagnosed. Among 3,730 patients, 9.5% had ICA-I occlusion, 18% ICA-T occlusion, and 73% M1 occlusion. Only 29% of ICA-I occlusions were correctly diagnosed initially, as they were frequently mistaken for dissections or proximal internal carotid artery occlusions.
Neuroradiology tip: When facing a proximal occlusion, perform two consecutive acquisitions of the supra-aortic vessels (MRA or CT angiography) without reinjecting contrast, in order to distinguish subocclusion, true occlusion, or delayed flow upstream from a thrombus at the ICA terminus.
RPS 205: Improving diagnosis and prognosis through AI in CNS diseases
Author : Guillaume HAMON, CHU de Rennes
Neuroradiology and Head and Neck Imaging
The scientific session entitled “Improving Diagnosis and Prognosis through AI in CNS Diseases” covered a wide range of topics.
Several presentations focused on the use of AI in vascular imaging, including the development of deep learning (DL) models to assess the stability of intracranial aneurysms or to identify aneurysms at risk of rupture. From a practical perspective, one study evaluated a commercially available AI software for detecting vascular occlusions on CTA, compared with standard radiological reading. Interestingly, despite overall similar performance, the AI model detected 42 occlusions missed by radiologists (approximately 15 per 1,000 scans), mainly located in the distal segment of the MCA, the carotid siphon, and the P2 segment of the PCA. On the other hand, radiologists identified around 40 occlusions missed by the AI, highlighting the complementary roles of AI and human expertise.
Finally, one study analyzed the impact of technical variations on Brain Age Gap Estimation (BrainAGE), comparing the influence of MRI field strength and scanner manufacturer in healthy subjects, emphasizing the importance of taking into accounts these factors when interpretating results.
For those interested in these topics, all abstracts are available in the ECR 2026 program.
Author :
Speciality :
Abstract
RPS 111 - Glymphatic system, venous and small vessel disease: small lesions, big impact
Author : Antoine FRAISSENON, CHU de Saint Etienne
The scientific session addressed several topics related to advanced brain imaging and its applications in neurological disorders. Below is a summary of three presented studies.
Regarding the “glymphatic” system, an intracerebral circulation system of cerebrospinal fluid (CSF), the research focused on the increase in choroid plexus (CP) volume in different pathological contexts. On one hand, an enlargement of the choroid plexus has been proposed as a potential biomarker of future dementia. This change may be related to altered cerebrospinal fluid turnover, suggesting a role of the plexus in the early pathophysiology of cognitive impairment. On the other hand, a correlation between choroid plexus volume and clinical severity in Parkinson’s disease was reported. However, this enlargement does not appear to be specific to this condition, limiting its differential diagnostic value. No precise pathophysiological explanation was provided for the observed volumetric increase. One hypothesis suggests a possible link with inflammatory processes involving the CSF.
Regarding pericerebral spaces, one study demonstrated improved detection of pericerebral space dilatation using 5T MRI acquisitions compared to 3T. An important discussion point concerned the potential limitations of 5T imaging. Despite its higher resolution, the increased magnetic field strength may lead to greater field inhomogeneity, potentially affecting the quality of certain structures or sequences compared with 3T imaging.
RPS 517 : New approaches in trauma imaging in peace and war times
Author : Ahmed-Ali EL-AHMADI, AP-HM
Two studies particularly drew our attention during this session.
The first focused on MRI follow-up of traumatic injuries to abdominal solid organs. In this study, diffusion-weighted imaging proved to be the most effective sequence for delineating traumatic splenic lesions, compared with T2-weighted and contrast-enhanced sequences. Vascular injuries were identified by the presence of flow voids as well as on post-contrast images. Furthermore, MRI appeared particularly valuable for lesion follow-up, especially from a radiation protection perspective.
The second study investigated the prognostic impact of contrast extravasation volume measured on CT on transfusion requirements and 30-day mortality in patients presenting with acute bleeding treated by embolization. This volume was estimated using a bleeding rate that incorporated the volume of extravasation, its attenuation in Hounsfield units (HU), and the acquisition time, calculated from arterial and portal phase CT images. The bleeding rate was strongly correlated with 30-day mortality and with blood transfusion volume in patients who underwent arterial embolization.
MS1 Acute retrosternal chest pain : from symptom to diagnosis ; multidisciplinary session
Author : Mehdi HAIDAR, CHU de Lille
Among the complementary investigations used to assess a potential cardiac etiology, in addition to transthoracic echocardiography (TTE) and high-sensitivity troponin assays, coronary CT angiography (CCTA) has particular value in patients at low cardiovascular risk due to its very high negative predictive value (approximately 99%), allowing reliable exclusion of a coronary cause.
In patients at intermediate cardiovascular risk, CCTA can identify approximately 50–75% of significant coronary lesions. However, its purely anatomical assessment does not, by itself, establish the hemodynamic significance of a given stenosis.
In this context, adjunct functional imaging techniques, such as CT-derived fractional flow reserve (CT-FFR), and plaque characterization and quantification using spectral imaging, are emerging as major developments in non-invasive coronary imaging (Vliegenhart et al., Radiology, 2026). These approaches move beyond purely morphological evaluation by integrating functional and tissue-level assessment.
Nevertheless, the benefit of CCTA in the emergency setting remains debated and has not yet been definitively established (JAMA, 2026). The future of non-invasive cardiac imaging in the evaluation of acute chest pain likely lies in the integration of anatomical and functional imaging, including coronary artery assessment, perfusion analysis, and myocardial tissue characterization (notably extracellular volume quantification). Novel technologies such as photon-counting CT may enable a comprehensive approach, thereby refining diagnostic reasoning in complex clinical scenarios (e.g., aborted myocardial infarction, MINOCA, myocarditis), alongside the current therapeutic armamentarium.
To date, however, these advanced tools remain of limited applicability in routine acute care practice.
Author :
Speciality :
Abstract
EDUCATIONAL SESSIONS
Author : Maxime PASTOR, CHU de Montpellier
Speciality : MSK
This educational session focused on imaging of the painful shoulder and sports-related shoulder injuries.
The first speaker emphasized the key elements that should be included in the imaging report of a painful shoulder, particularly the assessment of the main tendon abnormalities. It was also highlighted that acromioclavicular joint abnormalities are frequently observed on imaging and that their clinical relevance should always be correlated with the clinical examination.
The second part of the session addressed sports-related shoulder injuries, with particular emphasis on labral lesions such as Bankart, Perthes, and ALPSA lesions, for which the addition of axial sequences can improve detection. Regarding SLAP lesions, the speaker suggested a pragmatic descriptive approach, limiting the classification to the first four stages.
More specific lesions were also discussed, including humeral avulsion of the inferior glenohumeral ligament (HAGL) associated with the “J sign”, as well as posterior labral injuries such as Kim lesions.
An important take-home message was that arthro-MRI is considered the reference imaging modality for the evaluation of a painful shoulder in several European countries, particularly in Switzerland, although it is less commonly performed in France. This technique allows accurate detection of tendon tears and precise characterization of their extent, including partial or full-thickness tears and tendon retraction.
Author : Clara COHEN, CHU d'Orléans
Speciality : Neuroradiology
The 3R rule also applies to contrast agents!
Iodinated Contrast Agents (ICA): 40% of CT scans use contrast injection, but iodinated residues are cytotoxic, genotoxic, and ecotoxic. Reducing the injected amount relies on a personalized protocol adjusted to the patient’s weight (target: 0.3–0.6 g/kg), the acquisition time, the use of a 30–50 mL saline bolus, and lowering the kilovoltage.
Recovering iodinated contrast agents is necessary to limit environmental contamination. Since more than 50% of ICA are excreted in urine within 2 hours after injection, collecting the first urine using dedicated toilets or collection bags is common practice in Germany. Iodinated waste is then treated by incineration.
Recycling unused contrast agents represents a cost of €10 per contrast-enhanced CT scan, or about €30 million per year in Germany, highlighting the need for legislation and support from public funding.
Gadolinium is not removed by conventional wastewater treatment. Strategies to reduce its use rely on high-relaxivity gadolinium-based contrast agents and optimization of imaging sequences (possibly with AI). New wastewater treatment protocols should also be considered.
And the patients? In 2025, 90% were willing to extend their hospital stay by 60 minutes to help reduce the environmental impact associated with contrast agent injections.
Contrast agents: Reduce, Recover, Recycle — it’s up to us to act!
Abdominal Imaging in pregnant women
Author : Juliette COUTUREAU
Speciality : Imagerie génito-urinaire, sénologique et des urgences
1 — Optimization of imaging examinations in pregnant women
Regarding MRI, according to the latest best-practice recommendations, there is no particular risk associated with performing an MRI in the first trimester (T1) compared with the other trimesters of pregnancy.
However, the ACR (American College of Radiology) does not take a definitive position on the risks related to gadolinium injection. Teratogenic risks have been demonstrated in animals and are related to the intensity and duration of exposure.
Gadolinium injection should therefore be avoided, unless “the potential benefit outweighs the potential long-term risk to the fetus.” If necessary, macrocyclic agents should be preferred.
Regarding CT scans, the risk to the fetus remains negligible for doses < 50 mGy, which applies to the majority of routine examinations.
For reference, the estimated fetal doses per examination are as follows:
Head CT: 0 mGy / Standard chest CT: 0 mGy /Pulmonary embolism CT: 0.2 mGy /Abdominal–pelvic CT: 25 mGy / Thoraco-abdomino-pelvic CT: 34 mGy /Abdominal–pelvic CT for renal colic: 10 mGy
Regarding ultrasound, contrast microbubbles do not cross into the fetal circulation, but there are currently no recommendations regarding their use.
2 — Abdominal emergencies on MRI: key points
MRI is most often requested during pregnancy to exclude renal colic, appendicitis, or adnexal torsion.
For all these diagnoses, it is useful to acquire T2 SE sequences, T2 fat-suppressed (T2FS) sequences, and diffusion sequences with low b-values.
The appendix is not visualized in 24–40% of cases, but the absence of edema, collection, or diffusion restriction has a very high negative predictive value for ruling out appendicitis, even if the appendix is not seen.
For ovarian torsion, the aim is to look for ovarian edema on T2FS and diffusion sequences, and a “twisted pedicle” (whirlpool sign) on morphological T2 sequences.
Contrast injection is theoretically not necessary.
3 — Liver and pregnancy
Hepatobiliary disorders specific to pregnancy include: intrahepatic cholestasis of pregnancy, acute fatty liver and HELLP syndrome. Only the last two show notable imaging abnormalities. Acute fatty liver of pregnancy shows diffuse hyperechogenicity on ultrasound/global hepatic hypodensity on CT whereas HELLP syndrome shows hypodense areas centered around the portal veins, corresponding to necrosis related to disseminated microangiopathy.
Both diagnoses are very severe and require urgent fetal delivery.
How 1: How we do it : MRI with or without GBCA. Updates and recommendations from the ESMRMB-GREC
Author : Guillaume HAMON, CHU de Rennes
Neuroradiology and Head and Neck Imaging
In multiple sclerosis (MS), Alejandro Rovira Cañellas emphasized that GBCA injection is indicated at the initial diagnosis or when the detection of an active lesion may influence therapeutic management. In contrast, routine injection during follow-up for the detection of new lesions is not recommended, in line with the MAGNIMS–CMSC–NAIMS consensus published in Lancet Neurology in 2025.
In tumor pathology, Fabio Martino Doniselli points out that contrast injection remains most often indispensable, but notes that certain benign tumors such as internal auditory canal schwannomas can rely on high-resolution 3D T2 morphological sequences (“Recommendations on the use of gadolinium-based contrast agents in the diagnosis and monitoring of common adult intracranial tumours” published in 2025 in European Radiology).
In imaging of the inner ear and IAC, Aïna Venkatasamy underscored the value of gadolinium in tumor evaluation (initial diagnosis), acute inflammatory conditions (labyrinthitis, neuritis), and in the assessment of endolymphatic hydrops (primary or secondary, using a delayed acquisition protocol that enables visualization of the endolymphatic compartment). However, injection may be avoided in the follow-up of stable vestibular schwannomas or in the evaluation of inner ear malformations.
For those interested, the next ESMRMB-GREC congress will take place in October in Girona, Spain.
E³ 226a - Cybersecurity in AI-driven radiology systems
Author : Antoine FRAISSENON, CHU de Saint Etienne
This session addressed the growing cybersecurity risks associated with the integration of artificial intelligence in healthcare, particularly in radiology and in the use of generative models such as large language models (LLMs). The rapid expansion of these technologies is accompanied by new vulnerabilities that require increased vigilance.
Medical data are among the primary targets of cyberattacks. Phishing remains the most common threat, mainly targeting users through manipulation or fraud rather than technical infrastructures themselves. In radiology, the multiplicity and complexity of imaging modalities increase the number of potential entry points for attacks. Additionally, attacks such as data poisoning—injecting corrupted data during training—can significantly impair model performance, even when only a small proportion of the dataset is affected.
In response to these threats, security measures must encompass all stages of the algorithm lifecycle: design, training, testing, and validation. Traceability and verification of data sources are becoming essential, with some proposing labeling systems to assess data reliability. Furthermore, a regulatory framework is progressively being implemented, and the development of AI training programs in radiology appears essential, despite the rapid evolution of models and attack strategies.
E³ 226b - Application of photon-counting CT in paediatrics: need or nice to have?
Author : Ahmed-Ali EL-AHMADI, AP-HM
Application of photon-counting CT in paediatrics: need or nice to have?
Photon-counting CT represents a recent innovation in imaging, still little documented in pediatrics.
Thoracic imaging shows the most promising applications, with a marked improvement in spatial resolution (analysis of distal airways, detection of vascular anomalies, and identification of blebs or cysts), optimization of follow-up for nodular lesions in oncology, while significantly reducing both the delivered dose and the amount of iodinated contrast agent.
In neuroradiology, significant limitations remain, notably the presence of artifacts near bone and in the posterior fossa, which can lead to false positives such as pseudo-subdural hematomas, and the need to increase the dose to improve brain parenchymal differentiation. Due to its spatial resolution performance, this technique is also of interest for the analysis of the petrous bone.
Photon-counting CT appears to be a promising technology in pediatric imaging for some indications and anatomical regions. Work on standardizing protocols (indications, acquisition parameters, image post-processing) is ongoing within the ESPR (European Society of Pediatric Radiology).
MS1 Acute retrosternal chest pain : from symptom to diagnosis ; multidisciplinary session
Author : Mehdi HAIDAR, CHU de Lille
Among the complementary investigations used to assess a potential cardiac etiology, in addition to transthoracic echocardiography (TTE) and high-sensitivity troponin assays, coronary CT angiography (CCTA) has particular value in patients at low cardiovascular risk due to its very high negative predictive value (approximately 99%), allowing reliable exclusion of a coronary cause.
In patients at intermediate cardiovascular risk, CCTA can identify approximately 50–75% of significant coronary lesions. However, its purely anatomical assessment does not, by itself, establish the hemodynamic significance of a given stenosis.
In this context, adjunct functional imaging techniques, such as CT-derived fractional flow reserve (CT-FFR), and plaque characterization and quantification using spectral imaging, are emerging as major developments in non-invasive coronary imaging (Vliegenhart et al., Radiology, 2026). These approaches move beyond purely morphological evaluation by integrating functional and tissue-level assessment.
Nevertheless, the benefit of CCTA in the emergency setting remains debated and has not yet been definitively established (JAMA, 2026). The future of non-invasive cardiac imaging in the evaluation of acute chest pain likely lies in the integration of anatomical and functional imaging, including coronary artery assessment, perfusion analysis, and myocardial tissue characterization (notably extracellular volume quantification). Novel technologies such as photon-counting CT may enable a comprehensive approach, thereby refining diagnostic reasoning in complex clinical scenarios (e.g., aborted myocardial infarction, MINOCA, myocarditis), alongside the current therapeutic armamentarium.
To date, however, these advanced tools remain of limited applicability in routine acute care practice.
Author :
Speciality :
Abstract