Three signs on liver MRI that mark a small HCC as likely to come back

The edition in brief

Today's radiology desk covers three imaging questions with different degrees of readiness. A review of photon-counting CT in head and neck imaging sets out five technical gains — spatial resolution, noise, metal artefact, radiation dose and iodine dose, and spectral reconstructions — and where each matters, particularly around cochlear implants and dental hardware and in children needing repeated surveillance. A meta-analysis of FDG PET/CT in relapsing polychondritis pooled only three studies and 97 patients but found a PET-positivity rate of 94 per cent (95% CI 73 to 99, I squared 0 per cent) with pooled baseline SUVmax 4.0 (3.5 to 4.6), asymptomatic cartilage involvement in more than a quarter of patients, and better detection at inaccessible sites such as the peripheral airways. A deep learning system trained on multiparametric MRI from 1844 patients classified gliomas and glioneuronal tumours across six categories, reaching external AUCs of 0.92 for separating adult-type diffuse gliomas from circumscribed astrocytic gliomas, 0.92 for IDH status and 0.83 for 1p/19q codeletion — good enough to triage, not to replace histology. The practice-changer comes from 315 patients with hepatocellular carcinoma of 3 cm or less: a hypovascular component of 20 per cent or more, an intratumoral artery and an incomplete capsule on Gd-EOB-DTPA-enhanced MRI independently predicted the macrotrabecular-massive subtype (validation AUC 0.75) and, when two or three were present, a higher three-year recurrence risk after hepatectomy (HR 2.55, 95% CI 1.24 to 5.22).