PET-CT earns its place after chemotherapy, but not for staging

The edition in brief

Today's radiology edition leads with a single-centre comparison of FDG PET-CT and contrast-enhanced CT for restaging oesophagogastric adenocarcinoma after neoadjuvant chemotherapy, in 66 patients who had both contemporaneously. For pathological T stage the two were comparable (AUC 0.65 versus 0.62, p=0.76) and for N stage both were close to useless (0.52 versus 0.53). PET-CT was better for pathological tumour response (AUC 0.72 versus 0.51, p=0.041) and picked up all eight patients with metastatic disease at restaging, against four on CT. A validation study applied Bone-RADS and OT-RADS to MRI in 80 children under 18 with solitary bone lesions, read by five radiologists of differing experience. Interrater agreement was moderate for both — Fleiss kappa 0.470 (95% CI 0.410-0.530) for Bone-RADS and 0.432 (0.389-0.475) for OT-RADS — with Bone-RADS the more consistent, attributed to its algorithm. GPT-5 was tested on grading endolymphatic hydrops on delayed gadolinium-enhanced 3D-FLAIR MRI in 436 patients with Ménière's disease. Given images alone it managed 25% accuracy for cochlear grading. Given structured image descriptions, clinical context and examples it reached 87%. In a human-first assisted workflow, junior readers rose from 36% to 59%. And a post hoc subanalysis of the TARGET trial found CT-FFR guidance reduced unnecessary angiography in men, while women in the CT-FFR arm had lower two-year events — with no significant sex-by-treatment interaction.