The edition · Radiology
Lung cancer screening uptake rose with navigation and outreach, not with leaflets
A meta-analysis found multicomponent, high-contact interventions raised low-dose CT completion; education alone did nothing. Also: models that predict immunotherapy pneumonitis are not ready, image quality decides VI-RADS accuracy in small bladder tumours, and germline carriers' prostate MRIs look more aggressive.
The edition in brief
Today's radiology edition leads on lung cancer screening participation. A European Respiratory Review meta-analysis of 14 completed studies found shared decision-making plus patient navigation (OR 4.34) and outreach plus navigation (OR 2.20) raised low-dose CT completion, while educational material (OR 1.03) and shared decision-making alone (OR 1.15) did not; multicomponent interventions outperformed single ones (OR 2.64 vs 1.00). Certainty was low. A meta-analysis of 12 models predicting checkpoint inhibitor pneumonitis in lung cancer pooled a C-statistic of 0.82, but the prediction interval ran from 0.51 to 0.95 and only two models had external validation, so none is ready for clinical use. In 587 bladder MRIs, VI-RADS quality scores showed substantial agreement between readers, and higher image quality improved positive predictive value for muscle invasion in tumours under 3 cm (51.0% vs 22.7%), mainly for the less experienced reader. A single-centre case-control study found prostate cancer in germline pathogenic variant carriers more often scored PI-RADS 5 (OR 2.7) and was more often upgraded at prostatectomy (37% vs 20%). The pearl covers stating a study's limitations in the report.
Models predicting immunotherapy pneumonitis look good on average but are not ready for the clinic
Rely on careful CT review with treatment history, not prediction models, to catch checkpoint inhibitor pneumonitis.
VI-RADS: image quality decides accuracy in small bladder tumours
Report the VI-RADS quality score, and treat a muscle-invasion call on a poor study of a small tumour with caution.
Germline variant carriers' prostate cancers scored higher on MRI and were upgraded more often
In known germline variant carriers, read prostate MRI with a higher expectation of aggressive disease.
Say what the study could not show
Name every limitation that changes the meaning of a negative report, and give a specific next step.
Lung screening uptake: navigation and outreach worked, leaflets did not
Give a lung screening programme a navigator and active outreach; information alone does not raise uptake.
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