The edition · Radiology
Catheter drainage beat needle aspiration for liver abscess across 12 trials
A meta-analysis of 1,425 patients found higher treatment success with no extra complications. Plus AI prostate MRI tested across 12 countries, and imaging postmenopausal pelvic pain.
The edition in brief
A meta-analysis of 12 randomised trials in 1,425 adults with liver abscess found percutaneous catheter drainage achieved treatment success more often than needle aspiration (OR 4.12, 95% CI 2.01 to 8.45), with no difference in complications; heterogeneity was moderate. For a condition common in India, it supports catheter drainage as the default percutaneous approach, with aspiration kept for small or selected abscesses. The SCARLET-1 study trained an AI system on about 20,000 prostate MRIs and tested it externally in 1,974 men across 12 countries: agreement with standard diagnoses of grade group 2 or higher cancer was 83 to 88% and met prespecified interchangeability criteria, but AUC fell below 0.80 at more than a quarter of sites, so local validation remains essential. The ACR Appropriateness Criteria update on postmenopausal acute pelvic pain keeps ultrasound as the first test, with MRI or CT when ultrasound is inconclusive, and stresses atypical presentation and higher malignancy risk in this group. The pearl covers metformin and iodinated contrast.
Acute pelvic pain after the menopause: ultrasound first
Start with pelvic ultrasound in postmenopausal acute pelvic pain and escalate to MRI or CT only if it is inconclusive.
AI for prostate MRI held up across 12 countries, with site caveats
Consider AI as a second reader for prostate MRI only after checking its performance on your own scanners.
Liver MR elastography: a 19% change is the real-change threshold
Read a change of less than about 19% in MR elastography liver stiffness as within measurement error.
Metformin and iodinated contrast
Do not stop metformin before contrast unless eGFR is below 30 or there is acute kidney injury.
Catheter drainage over needle aspiration for liver abscess
Place a catheter rather than aspirate when a liver abscess needs percutaneous drainage, unless it is small or awkward.
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