Journal highlights
The following are highlights from the current issues of RSNA’s peer-reviewed journals.
Coronary CT Helps Triage Patients with Possible Acute Coronary Syndrome in the ED
Acute chest pain is a common concern in the emergency department (ED), but accurate diagnosis of acute coronary syndrome (ACS) is challenging. Although ACS is present in only 5% to 10% of patients with chest pain, most undergo extensive evaluation to avoid the clinical and legal ramifications of misdiagnosis.
Coronary CT angiography (CCTA) is the first-line modality for assessing stable chest pain of suspected coronary origin. According to a recent Radiology review, a logical next step is expanding CCTA to help triage appropriate patients with possible ACS.
Authors led by Rozemarijn Vliegenthart, MD, PhD, from the University of Groningen, the Netherlands, describe the current role of CCTA in managing different risk populations and optimizing resources. CCTA is a safe, reliable tool for triaging patients at low risk for ACS, they concluded. However, its role in triaging patients with higher risk is less certain and warrants more evaluation.
“Integrating CT-based plaque features, CT fractional flow reserve, and CT perfusion, along with high-sensitivity cardiac troponins, may enhance diagnostic pathways and improve triage effectiveness in the ED,” the authors summarized.
Read the full article, “Coronary CT Angiography for Acute Chest Pain in the Emergency Department.”
Follow the Radiology editor on X @RadiologyEditor.
A 70-year-old female patient presented with hemodynamic instability and underwent a contrast-enhanced CT examination after stabilization due to an unclear underlying cause. (A–D) A triple rule-out CT examination showed a large perfusion defect in the myocardium (arrows on the axial [A], coronal [B], and sagittal [C] images), severely calcified coronary arteries on an axial CT image (D), and a possible proximal occlusion of the left circumflex artery (circle in D).
https://doi.org/10.1148/radiol.250533 ©RSNA 2026
Understanding Incidental Findings on Abdominal and Pelvic Images
Incidental findings (IFs) are results found at imaging performed for unrelated indications. IFs are reported in about 16% to 31% of all diagnostic imaging studies. Most IFs are clinically insignificant, but others require further evaluation. For radiologists, appropriate management can be unclear; IFs may lead to overdiagnosis, overtreatment and cascading procedures. The American College of Radiology published white papers for common IFs, but the recommendations are not comprehensive. In addition, recent research both supports and contradicts existing guidelines.
In a new RadioGraphics article, Chirag Govardhan, MD, UC Davis Health, Sacramento, CA, and colleagues concentrate on common abdominal and pelvic IFs that are not covered by prior white papers. The authors discuss updated evidence for topics such as hepatic and renal findings and review the recent literature.
“While not exhaustive, this article can serve as an educational reference for current guidelines on IFs, as well as a call to action that advocates for future research, updates to existing guidelines, and creation of new guidelines,” wrote the authors.
Read the full article, “Update on Management of Incidental Findings Seen on Imaging Studies of the Abdomen and Pelvis.” This article is also available for CME on EdCentral.
Follow the RadioGraphics editor on X @RadG_Editor.
Misty mesentery in a 41-year-old man with known lymphoma. Axial portal venous phase CECT images show misty mesentery with multiple prominent nonenlarged lymph nodes (arrows in A) and one enlarged lymph node (arrow in B) within the area of increased mesenteric attenuation. Misty mesentery with associated lymphadenopathy requires further evaluation with follow-up imaging, PET/CT, or biopsy, depending on the degree of lymphadenopathy.
https://doi.org/10.1148/rg.250104 ©RSNA 2026
Deep Learning-based Multiphase Arterial MRI Improves HCC Diagnosis
Hepatocellular carcinoma (HCC) diagnosis relies heavily on well‑timed arterial phase MRI, yet single arterial phase scans often miss the optimal late arterial phase, especially with hepatobiliary contrast agents that are prone to motion artifacts and narrow timing windows.
These limitations can compromise image quality and reduce detection of key features such as arterial phase hyperenhancement.
In a study recently published in Radiology: Imaging Cancer, researchers led by Kai Liu, BS, Zhongshan Hospital at Fudan University in Shanghai, compared conventional single phase imaging with an ultrafast, deep learning-based multiphase MRI technique, which can rapidly acquire six high-resolution arterial phases in a single breath hold.
In a cohort of 236 participants, the deep learning–based multiphase MRI technique markedly improved late arterial capture, boosted overall image quality and enhanced detection of lesions and HCC for both extracellular and hepatobiliary agents. The method achieved a late arterial capture rate of 98% (vs. 81% to 85% with single phase imaging) and showed strong performance in identifying small tumors.
“These findings support the potential of deep learning-based multiphase arterial MRI to streamline HCC diagnosis,” the authors conclude.
Read the full article, “Clinical Utility of Deep Learning–based Multiple Arterial Phase MRI in Hepatocellular Carcinoma.”
All Your RSNA Journal Podcasts—All in One Place
Stay informed with the latest episodes from RSNA’s journal podcasts—now available in one easy-to-navigate hub. Explore expert discussions, fresh insights and the latest research from across RSNA’s leading journals.