The edition · Radiology
AI reads stroke on plain CT, and a spectral trick for the pancreatic tail
Plus the 2026 appropriateness update for diffuse lung disease, a reminder on incidental nodules, and why prostate MRI AI still needs a hand on it.
The edition in brief
Today's radiology edition opens on stroke triage. A diagnostic-accuracy network meta-analysis of 3,632 patients found noncontrast-CT artificial intelligence detected anterior-circulation large vessel occlusion with higher sensitivity than expert readers (0.78 vs 0.62) at similar specificity, though the evidence is retrospective and low-certainty and supports AI only as a human-in-the-loop prompt, not a replacement. A spectral-CT study of 85 patients showed that iodine and effective-atomic-number maps separated intrapancreatic accessory spleen from hypervascular pancreatic neoplasms with high accuracy on a single portal-venous phase, potentially sparing further workup. The ACR Appropriateness Criteria for diffuse lung disease were updated for 2026, covering initial imaging, suspected acute exacerbation and surveillance. A clinic pearl reaffirms Fleischner-based follow-up of incidental pulmonary nodules. The practice-changer is a governance one: an ESUR working-group report on prostate MRI AI stresses that these tools support rather than replace the radiologist, and that local validation, post-market surveillance for algorithmic drift and user training must precede routine clinical use.
AI detected large vessel occlusion on plain CT more sensitively than readers
Noncontrast-CT AI can raise sensitivity for large vessel occlusion as a human-in-the-loop escalation prompt, but it is not validated to replace reader interpretation or to improve outcomes.
Spectral CT separated accessory spleen from pancreatic tumour on one phase
Where spectral CT is available, use iodine and effective-atomic-number maps on the portal-venous phase to distinguish intrapancreatic accessory spleen from a hypervascular neoplasm and avoid extra tests.
ACR appropriateness criteria for diffuse lung disease, 2026 update
Adopt the 2026 ACR Appropriateness Criteria for diffuse lung disease to match imaging to the clinical scenario across initial assessment, acute deterioration and surveillance.
Follow incidental pulmonary nodules by the Fleischner rules
Apply the Fleischner size- and risk-based intervals to incidental solid pulmonary nodules and give a definite follow-up recommendation in the report.
Prostate MRI AI belongs in a human-in-the-loop workflow
Deploy prostate MRI AI as a human-in-the-loop support tool with local validation, ongoing performance monitoring and user training, not as an autonomous reader.
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