The edition · Radiology
Amyloid PET in Centiloids: below 11 negative, above 26 positive, caution between
A JAMA individual-participant meta-analysis of 49,227 scans sets Centiloid cut-offs with a grey zone, while European radiologists map MRI into prostate screening and a US cohort tests pancreatic cyst guidelines over five years.
The edition in brief
Today's radiology edition opens on prostate screening. An ESUR working group report concludes that MRI, preferably biparametric, improves detection of clinically significant prostate cancer and reduces unnecessary biopsies when added to screening, most practically as a reflex test after a raised PSA, while long-term mortality and interval-cancer data remain limited. A single-centre cohort of 13,269 patients with pancreatic cysts found ACR, Kyoto and European guidelines predicted five-year malignancy only modestly (AUROC 0.62 to 0.66), agreed completely on high-risk lesions, and showed an 8-year cancer incidence of 0.71% after five years of stability. A prospective study of 328 men found the PI-RADS ellipsoid formula matched manual segmentation closely (ICC 0.985) for prostate volume, with underestimation above 80 cc but little effect on PSA density decisions. The pearl covers the cyst features every report should state. The edition closes on a JAMA meta-analysis of individual data from 49,227 amyloid PET scans in 53 studies: a data-driven positivity cut-off of 18 Centiloids, a visual-read cut-off of 27, and a double-cutoff approach in which values below 11 are confidently negative, above 26 confidently positive, and 11 to 26 need caution.
MRI in prostate cancer screening: best as a reflex after PSA
Where MRI is used in early prostate cancer detection, a biparametric scan after a raised PSA is the most practical model.
Pancreatic cyst guidelines predict cancer only modestly, but stable cysts stay low risk
Report pancreatic cyst features consistently and flag five-year stability, which identified a low-risk group in this cohort.
Prostate volume by ellipsoid formula is close enough for PSA density
The ellipsoid formula is accurate enough for routine PSA density, but double-check borderline results in glands over 80 cc.
The pancreatic cyst features every report should state
Every pancreatic cyst report should give size, growth, duct calibre, nodules and wall features, and name the guideline used.
Centiloid cut-offs for amyloid PET: a grey zone between 11 and 26
Report amyloid PET with a Centiloid value and flag 11 to 26 as a grey zone needing clinical correlation.
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