Journal highlights

Since the introduction of the Breast Imaging Reporting and Data System (BI-RADS) in the 1980s, similar systems have standardized radiologic assessment for other organs, including LI-RADS for liver cancer and PI-RADS for prostate cancer. However, no such system exists for the kidney.

The current radiologic approach focuses on the Bosniak classification, where cystic and solid masses are evaluated separately based on historical precedent, differences in appearance and biologic behavior. But, the World Health Organization does not support this separation. Furthermore, although identifying benign versus malignant masses is important, data show that many renal cancers will not cause harm.

A recent Radiology review outlines the rationale, challenges and research needed to establish a Kidney Imaging Reporting and Data System (KI-RADS) for renal masses. Lead author Stuart G. Silverman, MD, Brigham and Women’s Hospital, Boston, and colleagues discuss the need for a unified, evidence-based classification system that predicts both the likelihood of cancer and the likelihood of aggressive cancer.

“This system could inform the need for treatment or active surveillance and reduce prevalent overdiagnosis and overtreatment,” the authors explain.

Read the full article, “In Pursuit of KI-RADS: Toward a Single, Evidence-based Imaging Classification of Renal Masses.”

Follow the Radiology editor on X @RadiologyEditor.

Lung cancer is a leading cause of can[1]cer-related deaths worldwide. Advances in CT screening have led to earlier detection; about 30% of patients with non–small cell lung cancer (NSCLC) are diagnosed at Stage I. Surgical resection is the standard of care for early-stage NSCLC and oligometastatic disease. However, not all patients are suitable candidates for surgery. Image[1]guided lung cryoablation (LCA) has emerged as a safe, effective alternative.

In a new RadioGraphics article, authors led by Àngel Castillo-Fortuño, MD, and Alfredo Páez-Carpio, MD, EBIR, from Hospital Clinic Barcelona, Spain, explore the growing role of LCA in managing NSCLC and oligometastatic disease. Unlike heat-based ablative techniques, LCA uses extreme cold, allowing for better preservation of surrounding healthy tissue and improving precision near critical structures like the heart and central airways. The authors discuss the principles, indications, contraindications, expected findings and potential complications of LCA.

“Emerging research suggests a synergistic effect between LCA and various systemic immunotherapies, potentially opening new avenues for treating advanced-stage lung cancer,” the authors conclude.

Read the full article, “Lung Cryoablation: Patient Selection, Techniques, and Postablation Imaging.” This article is also available for CME on EdCentral. Follow the RadioGraphics editor on X @RadG_Editor.

Cardiac MRI is essential for evaluating heart function, but conventional cine imaging requires patient cooperation and multiple breath holds, making it challenging for some patients.

According to a study published in Radiology: Cardiothoracic Imaging, a novel free-breathing, highly accelerated cardiac cine MRI sequence could be used to perform rapid, high-quality imaging in a short time, reducing the scan time while maintaining diagnostic accuracy.

Fahime Ghanbari, MD, Beth Israel Deaconess Medical Center in Boston, and colleagues evaluated 136 participants—40 healthy individuals and 96 patients with cardiac conditions—using 3-T MRI. The team used a commercial deep learning model to reconstruct images and compared results with conventional k-space–segmented cine MRI. The new single-beat cine MRI significantly reduced scan time while maintaining strong correlation with traditional imaging and demonstrating excellent reproducibility.

“Free breathing 30-second single-beat cardiac cine MRI yielded accurate biventricular measurements, reduced scan time, and maintained high diagnostic and image quality compared with conventional multibreath-hold k-space–segmented cine images,” the authors conclude.

Read the full article, “Free-breathing, Highly Accelerated, Single-beat, Multisection Cardiac Cine MRI with Generative Artificial Intelligence.”