Latest Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging research

Top 10 this week

Week of 1 November 2026

1. 1

   Revascularization in Asymptomatic Carotid Artery Stenosis With Hemodynamic Impairment and Cognitive Outcomes: The CREST-H Substudy of the CREST-2 Randomized Clinical Trial

   JAMA · Q1 journal · RCT · Evidence level 1 (High) · 16 September 2026

   Perfusion imaging links carotid hemodynamics to cognition and revascularization outcomes

2. 2

   Automated Opportunistic Bone Mineral Density Assessment at Low-Dose CT Lung Cancer Screening: Incident Vertebral Fractures and Mortality

   Radiology · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

   In 21,856 heavy smokers aged 55 to 74, automated bone-density measurements from lung-screening CT identified a group with osteoporosis whose two-year vertebral fracture rate was 5.9%, compared with 0.9% among those with normal bone density. That exceeds a treatment threshold cited in current guidelines; low bone density was also linked to higher mortality in men, but the analysis does not show that screening or treatment reduces either outcome.

3. 3

   Active Surveillance in Low- and Intermediate-Risk Prostate Cancer: Comparative Oncologic Safety, Patient Selection, and Predictors of Treatment Conversion in the Era of Multiparametric MRI: A Systematic Review and Meta-Analysis

   Cancers · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 19 October 2026

   A meta-analysis of 46,318 patients found 98.9% prostate cancer-specific survival and 96.2% metastasis-free survival at 10 years with active surveillance, with outcomes reported as comparable to immediate treatment. Serial MRI had a 93.4% negative predictive value, leaving a 6.6% risk of missed high-grade disease; cribriform growth strongly predicted progression, underscoring the need for careful patient selection.

4. 4

   Computed tomography multi-phase radiomics models for differentiating benign and malignant thyroid nodules

   Frontiers in endocrinology · Q1 journal · RCT · Evidence level 1 (High) · 15 October 2026

   In an external validation group, a model combining clinical details, conventional CT signs, and radiomics features had an area under the curve of 0.865, with 74% sensitivity and 84.5% specificity for distinguishing benign from malignant thyroid nodules. It outperformed radiomics alone, but the retrospective study included surgically confirmed nodules, so performance in broader groups with incidental findings remains uncertain.

5. 5

   Model-Based Normal Tissue Complication Probability Comparison Between Proton and Photon Therapies for Brain Tumors Complying With Planning Study Guidelines

   Advances in radiation oncology · Q1 journal · RCT · Evidence level 1 (High) · 19 October 2026

   In planning comparisons for 66 patients, proton therapy had lower estimated risks of cataracts, memory problems, hearing impairment, tinnitus, and secondary brain cancer than intensity-modulated radiation therapy; 31 patients had at least one difference exceeding the study's threshold for clinical importance. Proton plans also showed higher estimated risks of hair loss, blindness, and brain necrosis, and whether these modeled differences translate into patient outcomes remains unknown.

6. 6

   Use of autofluorescence and/or indocyanine green in thyroid surgery: recommendations by the European Society of Endocrine Surgeons (ESES)

   The British journal of surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 5 October 2026

   A review of 34 studies, including 11 randomized trials, found promising results for near-infrared imaging with or without indocyanine green in reducing postoperative hypoparathyroidism, inadvertent gland removal, and autotransplantation. The European Society of Endocrine Surgeons used the evidence and expert consensus to develop guidance, but the abstract gives no effect sizes or specific recommendations.

7. 7

   Does Immobilization Method Make a Difference in Conservative Management of Proximal Humeral Fractures? A Prospective Randomized Trial

   Journal of shoulder and elbow surgery · Q1 journal · RCT · Evidence level 1 (High) · 21 August 2026

   In a randomized trial of 105 patients, Velpeau bandage, standard sling, and padded sling yielded similar scores on pain, function, and range of motion, and showed comparable rates of nonunion (4%) and malunion (21%). Because the devices performed alike, clinicians can choose the immobilizer based on comfort and cost, though larger studies are needed to confirm these findings.

8. 8

   Comparison of ultrasound-guided two-point block of the rhomboid intercostal vs. thoracic paravertebral for postoperative analgesia in patients undergoing three-port thoracoscopic surgery: a prospective, randomized, non-inferiority study

   Annals of medicine · Q1 journal · RCT · Evidence level 1 (High) · 8 August 2026

   In a randomized trial of 68 patients, a two-point rhomboid intercostal block gave resting pain scores at 24 hours that were essentially the same as a thoracic paravertebral block (mean difference 0.09 on a 0-10 scale). Rescue analgesia use was modestly higher with the rhomboid technique, while overall recovery quality and opioid consumption were comparable.

9. 9

   Deep learning multimodal fusion model based on ultrasound images and clinical-ultrasound texts for differentiating benign and malignant renal tumors

   The British journal of radiology · Q1 journal · RCT · Evidence level 1 (High) · 23 October 2026

   In an independent prospective test of 82 patients, a model combining ultrasound images with clinical-ultrasound text achieved an area under the curve of 0.92 and outperformed radiologists at different experience levels. The results suggest the tool could support tumor assessment, but testing at other hospitals and in larger patient groups is needed before its role in care is clear.

10. 10

    Impact of gastric length of myotomy during POEM on the incidence of gastroesophageal reflux: A randomized controlled trial

    Gastrointestinal endoscopy · Q1 journal · RCT · Evidence level 1 (High) · 18 September 2026

    In a randomized trial of 100 achalasia patients, those receiving a gastric myotomy shorter than 3 cm developed LA grade B or higher esophagitis in 24% versus 44% with longer cuts, while symptom scores and treatment success were similar. The finding suggests a shorter myotomy may lower endoscopic reflux risk without compromising efficacy, but longer follow-up is needed.

Paper of the day, last two weeks

• Comparison of PSMA- and CD70-targeted PET/CT in The Diagnosis of Renal Cell Carcinoma: A Retrospective Cohort and Prospective Head-to-head Study

  Clinical cancer research : an official journal of the American Association for Cancer Research · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 6 November 2026

  In a retrospective cohort and a 36-patient prospective comparison, CD70-targeted PET/CT detected clear-cell renal cell carcinoma lesions with 88.7% sensitivity, versus 76.1% with PSMA-targeted imaging, with particular gains for lung and liver metastases. It showed more disease in 9 of 26 patients and changed treatment decisions in 4, but detection remained limited for non-clear-cell tumors and the prospective study was small.

• An integrated CT/MRI diagnostic system for pancreatic cystic lesions that supports pathological classification and risk stratification

  Cancer biology & medicine · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 29 October 2026

  In a 1,102-patient retrospective study, the imaging-based system classified five pancreatic cyst types with 93% discrimination and was associated with fewer unnecessary surgeries than current practice: 11.5% versus 23.1%. In a prospective group of 76 patients, classification accuracy was 86.2%; the results apply to surgically evaluated cysts, and broader validation is still needed.

• High-dose reirradiation of in-field recurrence lung cancer in the THOrax (RETHO): toxicity analysis of a prospective trial

  International journal of radiation oncology, biology, physics · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 2 November 2026

  In this prospective trial of 60 patients receiving high-dose reirradiation for recurrent lung cancer, 10 developed grade 3 toxicity, including 7 with radiation pneumonitis; no grade 4 or 5 toxicity occurred over a median 26 months. Higher cumulative lung dose measures were linked to moderate or severe pneumonitis, so careful dose planning remains key.

• Added Value of Preoperative Contrast Enhanced Mammography in Staging of Malignant Breast Lesions (PROCEM): A Randomized Controlled Trial

  Radiology · Q1 journal · RCT · Evidence level 1 (High) · 1 November 2026

  In this randomized trial of 415 women with early-stage breast cancer, contrast-enhanced mammography changed treatment for 17 of 202 patients who received it, below the trial's 10% target. It estimated cancer extent more closely than standard imaging, but mastectomy and reoperation rates did not differ between groups, leaving the clinical benefit of those more accurate estimates uncertain.

• Coronary CT Angiography versus Intravascular Ultrasound Guidance for PCI

  The New England journal of medicine · Q1 journal · RCT · Evidence level 1 (High) · 1 November 2026

  In a randomized trial of 1,105 patients, target-vessel failure at 12 months occurred in 4.1% of those assigned to coronary CT angiography-guided PCI and 4.6% with intravascular ultrasound guidance. The CT-guided strategy met the trial's standard for noninferiority, but follow-up was limited to one year and the findings apply to patients meeting the study's specific criteria.

• Ultrasonography (IOTA-ADNEX) vs magnetic resonance imaging (ADNEX MR) for diagnosing ovarian cancer in high-risk patients: a prospective study

  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 29 October 2026

  In 342 patients referred for suspected ovarian cancer, the ultrasound-based IOTA-ADNEX model and MRI scoring system both distinguished benign from malignant masses well, with similar performance. The ultrasound model's advantage was small, and it was less reliable at separating borderline tumors from stage I invasive cancer; the single-center study's high-risk cohort limits how broadly results apply.

• Long-Term Outcomes of a Prospective Study on Magnetic Resonance Imaging-Guided Whole-Gland Salvage High-Dose-Rate Prostate Brachytherapy for Locally Recurrent Prostate Cancer

  Advances in radiation oncology · Q1 journal · Cohort · Evidence level 3 (Low) · 21 August 2026

  In this prospective study of 30 men with prostate cancer recurring after radiation, 69.6% remained free of hormone therapy at five years, but only 24.8% were free of prostate-specific antigen progression. Severe toxicity was uncommon, affecting one patient, while most relapses involved the treated prostate target; the small study leaves long-term disease control uncertain.

• Prospective evaluation of an optimized low-dose CT enterography protocol for patients with Crohn's disease

  European journal of radiology · Q1 journal · RCT · Evidence level 5 (Expert Opinion) · 23 October 2026

  Randomized prospective trial of reduced-dose CT enterography and image quality

• ACR Appropriateness Criteria® Pretreatment Evaluation and Follow-Up of Endometrial Cancer: 2026 Update

  Journal of the American College of Radiology : JACR · Q1 journal · Guideline · Evidence level 1 (High) · 29 October 2026

  The updated guidance rates pelvic MRI as usually appropriate for assessing local tumor spread. CT and PET/CT are usually appropriate for aggressive tumors, suspected metastases, or suspected recurrence, but routine imaging is not recommended for asymptomatic patients treated for low- or intermediate-risk disease. Selected high-risk patients may warrant CT, underscoring that follow-up imaging should match recurrence risk.

• Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO Clinical Practice Guideline

  Practical radiation oncology · Q1 journal · Guideline · Evidence level 1 (High) · 27 October 2026

  The guideline recommends moderate hypofractionation over conventional radiation for all risk groups, with randomized evidence showing comparable cancer control, toxicity and quality of life in less treatment time. Very short schedules are a standard option for low- and intermediate-risk disease, but their role in high-risk cancer remains less certain; patients with significant urinary problems may be better suited to moderate schedules.

• Dosimetric impact of intrafractional ocular motion in LINAC-based ocular SRS/SRT: Defining real-time eye-tracking thresholds

  Medical physics · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 1 November 2026

  In simulations of 98 ocular radiosurgery plans, target coverage fell and optic nerve doses rose as gaze deviation increased. Considering both outcomes, about 5 degrees is a reasonable starting point for real-time eye-motion monitoring, not a universal clinical cutoff. Robustness varied substantially by plan, and prospective studies are needed to validate individualized tolerances.

• ESTRO-EPTN guidelines for independent dose calculation and log file-based patient-specific quality assurance in scanned particle therapy

  Physics and imaging in radiation oncology · Q1 journal · Guideline · Evidence level 1 (High) · 10 October 2026

  New European consensus guidelines recommend independent dose calculation to verify the treatment plan and log file review to assess what was delivered in scanned particle therapy. When validated and combined with robust machine quality checks, the methods can detect clinically relevant deviations and reduce reliance on phantom measurements. Their safe use still depends on managing model limits, risks, and data traceability.

• Streamlining Liver SABR: Validation and Initial Experience of Bulk Density Override Based Single-Session, Simulation-Free Adaptive Workflow

  Practical radiation oncology · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 22 October 2026

  A simulation-free, single-session MRI-guided liver radiation workflow produced dose calculations close to CT-based plans: in its first five patients, target coverage differed by no more than 1.5%, and key doses to nearby organs differed by less than 0.5 Gy. Retrospective testing in 17 prior treatment plans also showed close agreement, but the approach needs evaluation in more patients.

Evidence summaries in Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging

• Hepatocellular Carcinoma (Radiology)
• CT Pulmonary Angiography for Pulmonary Embolism