Contrast-free breast MRI comes close, with a sensitivity gap still open

The edition in brief

A European Radiology study generated virtual dynamic contrast-enhanced breast MRI from unenhanced T1, T2 and diffusion sequences with a deep-learning model. Two radiologists reading 3 T examinations found mean diagnostic accuracy of 76% for virtual against 77% for standard contrast imaging; sensitivity was 92% against 96% and specificity 65% against 64%, differences that were not statistically significant but which the authors judge too large for clinical use yet. In 82 patients with glioblastoma after chemoradiation, a compact, smooth necrosis phenotype on MRI was associated with lower hazard of death after adjustment for MGMT status and other factors (HR 0.29). A semi-automated method quantified cerebral venous outflow on routine single-phase CTA in 242 patients with large-vessel occlusion, correlating strongly with visual scores (ρ 0.72 to 0.77). In 92 intra-arterial liver procedures, dual-phase angio-CT gave a fourfold lower 3D effective dose than cone-beam CT, and total dose was not higher. The pearl covers timing premenopausal breast MRI in the menstrual cycle.