For small papillary thyroid cancers, ablation traded fewer complications for a higher recurrence risk than surgery

The edition in brief

A meta-analysis comparing image-guided thermal ablation (radiofrequency, microwave or laser) with surgery for T1N0M0 papillary thyroid carcinoma found surgery carried higher odds of overall complications (OR 2.75), permanent hoarseness (OR 2.24) and transient hypoparathyroidism (OR 5.67), but lower odds of recurrence (OR 0.64); progression and nodal metastasis did not differ. BI-RADS v2025 restructures reports, clarifies categories 0 and 6, introduces 4A to 4C subcategories for breast MRI, adds structured lymph node reporting and formally brings contrast-enhanced mammography into the lexicon. In a prospective shadow-mode study of 3,856 brain CT angiograms, an FDA-cleared AI tool detected aneurysms with sensitivity 0.85 against 0.72 for radiologists, at similar specificity, finding 55 aneurysms radiologists missed, most under 3 mm; the yield was best for inpatients and poor for outpatients. In 39,323 chest CTs at a Dutch tertiary centre, introducing a commercial nodule AI was associated with a 14.6% fall in median reporting time, though emergency department reports got slower. A RadioGraphics review sets out breast imaging in pregnancy and lactation: mammography is safe but less sensitive, ultrasound leads for symptoms, and contrast MRI is avoided in pregnancy. The pearl covers when to repeat ultrasound for a palpable lump with negative mammography.