research topics in radiology

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Radiology Thesis – More than 400 Research Topics (2022)!

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Introduction

A thesis or dissertation, as some people would like to call it, is an integral part of the Radiology curriculum, be it MD, DNB, or DMRD. We have tried to aggregate radiology thesis topics from various sources for reference.

Not everyone is interested in research, and writing a Radiology thesis can be daunting. But there is no escape from preparing, so it is better that you accept this bitter truth and start working on it instead of cribbing about it (like other things in life. #PhilosophyGyan!)

Start working on your thesis as early as possible and finish your thesis well before your exams, so you do not have that stress at the back of your mind. Also, your thesis may need multiple revisions, so be prepared and allocate time accordingly.

Tips for Choosing Radiology Thesis and Research Topics

Keep it simple silly (kiss).

Retrospective > Prospective

Retrospective studies are better than prospective ones, as you already have the data you need when choosing to do a retrospective study. Prospective studies are better quality, but as a resident, you may not have time (, energy and enthusiasm) to complete these.

Choose a simple topic that answers a single/few questions

Original research is challenging, especially if you do not have prior experience. I would suggest you choose a topic that answers a single or few questions. Most topics that I have listed are along those lines. Alternatively, you can choose a broad topic such as “Role of MRI in evaluation of perianal fistulas.”

You can choose a novel topic if you are genuinely interested in research AND have a good mentor who will guide you. Once you have done that, make sure that you publish your study once you are done with it.

Get it done ASAP.

In most cases, it makes sense to stick to a thesis topic that will not take much time. That does not mean you should ignore your thesis and ‘Ctrl C + Ctrl V’ from a friend from another university. Thesis writing is your first step toward research methodology so do it as sincerely as possible. Do not procrastinate in preparing the thesis. As soon as you have been allotted a guide, start researching topics and writing a review of the literature.

At the same time, do not invest a lot of time in writing/collecting data for your thesis. You should not be busy finishing your thesis a few months before the exam. Some people could not appear for the exam because they could not submit their thesis in time. So DO NOT TAKE thesis lightly.

Do NOT Copy-Paste

Reiterating once again, do not simply choose someone else’s thesis topic. Find out what are kind of cases that your Hospital caters to. It is better to do a good thesis on a common topic than a crappy one on a rare one.

Books to help you write a Radiology Thesis

Event country/university has a different format for thesis; hence these book recommendations may not work for everyone.

How to Write the Thesis and Thesis Protocol: A Primer for Medical, Dental, and Nursing Courses: A Primer for Medical, Dental and Nursing Courses

Amazon Kindle Edition
Gupta, Piyush (Author)
English (Publication Language)
206 Pages - 10/12/2020 (Publication Date) - Jaypee Brothers Medical Publishers (P) Ltd. (Publisher)

In A Hurry? Download a PDF list of Radiology Research Topics!

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List of Radiology Research /Thesis / Dissertation Topics

State of the art of MRI in the diagnosis of hepatic focal lesions
Multimodality imaging evaluation of sacroiliitis in newly diagnosed patients of spondyloarthropathy
Multidetector computed tomography in oesophageal varices
Role of positron emission tomography with computed tomography in the diagnosis of cancer Thyroid
Evaluation of focal breast lesions using ultrasound elastography
Role of MRI diffusion tensor imaging in the assessment of traumatic spinal cord injuries
Sonographic imaging in male infertility
Comparison of color Doppler and digital subtraction angiography in occlusive arterial disease in patients with lower limb ischemia
The role of CT urography in Haematuria
Role of functional magnetic resonance imaging in making brain tumor surgery safer
Prediction of pre-eclampsia and fetal growth restriction by uterine artery Doppler
Role of grayscale and color Doppler ultrasonography in the evaluation of neonatal cholestasis
Validity of MRI in the diagnosis of congenital anorectal anomalies
Role of sonography in assessment of clubfoot
Role of diffusion MRI in preoperative evaluation of brain neoplasms
Imaging of upper airways for pre-anaesthetic evaluation purposes and for laryngeal afflictions.
A study of multivessel (arterial and venous) Doppler velocimetry in intrauterine growth restriction
Multiparametric 3tesla MRI of suspected prostatic malignancy.
Role of Sonography in Characterization of Thyroid Nodules for differentiating benign from
Role of advances magnetic resonance imaging sequences in multiple sclerosis
Role of multidetector computed tomography in evaluation of jaw lesions
Role of Ultrasound and MR Imaging in the Evaluation of Musculotendinous Pathologies of Shoulder Joint
Role of perfusion computed tomography in the evaluation of cerebral blood flow, blood volume and vascular permeability of cerebral neoplasms
MRI flow quantification in the assessment of the commonest csf flow abnormalities
Role of diffusion-weighted MRI in evaluation of prostate lesions and its histopathological correlation
CT enterography in evaluation of small bowel disorders
Comparison of perfusion magnetic resonance imaging (PMRI), magnetic resonance spectroscopy (MRS) in and positron emission tomography-computed tomography (PET/CT) in post radiotherapy treated gliomas to detect recurrence
Role of multidetector computed tomography in evaluation of paediatric retroperitoneal masses
Role of Multidetector computed tomography in neck lesions
Estimation of standard liver volume in Indian population
Role of MRI in evaluation of spinal trauma
Role of modified sonohysterography in female factor infertility: a pilot study.
The role of pet-CT in the evaluation of hepatic tumors
Role of 3D magnetic resonance imaging tractography in assessment of white matter tracts compromise in supratentorial tumors
Role of dual phase multidetector computed tomography in gallbladder lesions
Role of multidetector computed tomography in assessing anatomical variants of nasal cavity and paranasal sinuses in patients of chronic rhinosinusitis.
magnetic resonance spectroscopy in multiple sclerosis
Evaluation of thyroid nodules by ultrasound elastography using acoustic radiation force impulse (ARFI) imaging
Role of Magnetic Resonance Imaging in Intractable Epilepsy
Evaluation of suspected and known coronary artery disease by 128 slice multidetector CT.
Role of regional diffusion tensor imaging in the evaluation of intracranial gliomas and its histopathological correlation
Role of chest sonography in diagnosing pneumothorax
Role of CT virtual cystoscopy in diagnosis of urinary bladder neoplasia
Role of MRI in assessment of valvular heart diseases
High resolution computed tomography of temporal bone in unsafe chronic suppurative otitis media
Multidetector CT urography in the evaluation of hematuria
Contrast-induced nephropathy in diagnostic imaging investigations with intravenous iodinated contrast media
Comparison of dynamic susceptibility contrast-enhanced perfusion magnetic resonance imaging and single photon emission computed tomography in patients with little’s disease
Role of Multidetector Computed Tomography in Bowel Lesions.
Role of diagnostic imaging modalities in evaluation of post liver transplantation recipient complications.
Role of multislice CT scan and barium swallow in the estimation of oesophageal tumour length
Malignant Lesions-A Prospective Study.
Value of ultrasonography in assessment of acute abdominal diseases in pediatric age group
Role of three dimensional multidetector CT hysterosalpingography in female factor infertility
Comparative evaluation of multi-detector computed tomography (MDCT) virtual tracheo-bronchoscopy and fiberoptic tracheo-bronchoscopy in airway diseases
Role of Multidetector CT in the evaluation of small bowel obstruction
Sonographic evaluation in adhesive capsulitis of shoulder
Utility of MR Urography Versus Conventional Techniques in Obstructive Uropathy
MRI of the postoperative knee
Role of 64 slice-multi detector computed tomography in diagnosis of bowel and mesenteric injury in blunt abdominal trauma.
Sonoelastography and triphasic computed tomography in the evaluation of focal liver lesions
Evaluation of Role of Transperineal Ultrasound and Magnetic Resonance Imaging in Urinary Stress incontinence in Women
Multidetector computed tomographic features of abdominal hernias
Evaluation of lesions of major salivary glands using ultrasound elastography
Transvaginal ultrasound and magnetic resonance imaging in female urinary incontinence
MDCT colonography and double-contrast barium enema in evaluation of colonic lesions
Role of MRI in diagnosis and staging of urinary bladder carcinoma
Spectrum of imaging findings in children with febrile neutropenia.
Spectrum of radiographic appearances in children with chest tuberculosis.
Role of computerized tomography in evaluation of mediastinal masses in pediatric
Diagnosing renal artery stenosis: Comparison of multimodality imaging in diabetic patients
Role of multidetector CT virtual hysteroscopy in the detection of the uterine & tubal causes of female infertility
Role of multislice computed tomography in evaluation of crohn’s disease
CT quantification of parenchymal and airway parameters on 64 slice MDCT in patients of chronic obstructive pulmonary disease
Comparative evaluation of MDCT and 3t MRI in radiographically detected jaw lesions.
Evaluation of diagnostic accuracy of ultrasonography, colour Doppler sonography and low dose computed tomography in acute appendicitis
Ultrasonography , magnetic resonance cholangio-pancreatography (MRCP) in assessment of pediatric biliary lesions
Multidetector computed tomography in hepatobiliary lesions.
Evaluation of peripheral nerve lesions with high resolution ultrasonography and colour Doppler
Multidetector computed tomography in pancreatic lesions
Multidetector Computed Tomography in Paediatric abdominal masses.
Evaluation of focal liver lesions by colour Doppler and MDCT perfusion imaging
Sonographic evaluation of clubfoot correction during Ponseti treatment
Role of multidetector CT in characterization of renal masses
Study to assess the role of Doppler ultrasound in evaluation of arteriovenous (av) hemodialysis fistula and the complications of hemodialysis vasular access
Comparative study of multiphasic contrast-enhanced CT and contrast-enhanced MRI in the evaluation of hepatic mass lesions
Sonographic spectrum of rheumatoid arthritis
Diagnosis & staging of liver fibrosis by ultrasound elastography in patients with chronic liver diseases
Role of multidetector computed tomography in assessment of jaw lesions.
Role of high-resolution ultrasonography in the differentiation of benign and malignant thyroid lesions
Radiological evaluation of aortic aneurysms in patients selected for endovascular repair
Role of conventional MRI, and diffusion tensor imaging tractography in evaluation of congenital brain malformations
To evaluate the status of coronary arteries in patients with non-valvular atrial fibrillation using 256 multirow detector CT scan
A comparative study of ultrasonography and CT – arthrography in diagnosis of chronic ligamentous and meniscal injuries of knee
Multi detector computed tomography evaluation in chronic obstructive pulmonary disease and correlation with severity of disease
Diffusion weighted and dynamic contrast enhanced magnetic resonance imaging in chemoradiotherapeutic response evaluation in cervical cancer.
High resolution sonography in the evaluation of non-traumatic painful wrist
The role of trans-vaginal ultrasound versus magnetic resonance imaging in diagnosis & evaluation of cancer cervix
Role of multidetector row computed tomography in assessment of maxillofacial trauma
Imaging of vascular complication after liver transplantation.
Role of magnetic resonance perfusion weighted imaging & spectroscopy for grading of glioma by correlating perfusion parameter of the lesion with the final histopathological grade
Magnetic resonance evaluation of abdominal tuberculosis.
Diagnostic usefulness of low dose spiral HRCT in diffuse lung diseases
Role of dynamic contrast enhanced and diffusion weighted magnetic resonance imaging in evaluation of endometrial lesions
Contrast enhanced digital mammography anddigital breast tomosynthesis in early diagnosis of breast lesion
Evaluation of Portal Hypertension with Colour Doppler flow imaging and magnetic resonance imaging
Evaluation of musculoskeletal lesions by magnetic resonance imaging
Role of diffusion magnetic resonance imaging in assessment of neoplastic and inflammatory brain lesions
Radiological spectrum of chest diseases in HIV infected children High resolution ultrasonography in neck masses in children
with surgical findings
Sonographic evaluation of peripheral nerves in type 2 diabetes mellitus.
Role of perfusion computed tomography in the evaluation of neck masses and correlation
Role of ultrasonography in the diagnosis of knee joint lesions
Role of ultrasonography in evaluation of various causes of pelvic pain in first trimester of pregnancy.
Role of Magnetic Resonance Angiography in the Evaluation of Diseases of Aorta and its Branches
MDCT fistulography in evaluation of fistula in Ano
Role of multislice CT in diagnosis of small intestine tumors
Role of high resolution CT in differentiation between benign and malignant pulmonary nodules in children
A study of multidetector computed tomography urography in urinary tract abnormalities
Role of high resolution sonography in assessment of ulnar nerve in patients with leprosy.
Pre-operative radiological evaluation of locally aggressive and malignant musculoskeletal tumours by computed tomography and magnetic resonance imaging.
The role of ultrasound & MRI in acute pelvic inflammatory disease
Ultrasonography compared to computed tomographic arthrography in the evaluation of shoulder pain
Role of Multidetector Computed Tomography in patients with blunt abdominal trauma.
The Role of Extended field-of-view Sonography and compound imaging in Evaluation of Breast Lesions
Evaluation of focal pancreatic lesions by Multidetector CT and perfusion CT
Evaluation of breast masses on sono-mammography and colour Doppler imaging
Role of CT virtual laryngoscopy in evaluation of laryngeal masses
Triple phase multi detector computed tomography in hepatic masses
Role of transvaginal ultrasound in diagnosis and treatment of female infertility
Role of ultrasound and color Doppler imaging in assessment of acute abdomen due to female genetal causes
High resolution ultrasonography and color Doppler ultrasonography in scrotal lesion
Evaluation of diagnostic accuracy of ultrasonography with colour Doppler vs low dose computed tomography in salivary gland disease
Role of multidetector CT in diagnosis of salivary gland lesions
Comparison of diagnostic efficacy of ultrasonography and magnetic resonance cholangiopancreatography in obstructive jaundice: A prospective study
Evaluation of varicose veins-comparative assessment of low dose CT venogram with sonography: pilot study
Role of mammotome in breast lesions
The role of interventional imaging procedures in the treatment of selected gynecological disorders
Role of transcranial ultrasound in diagnosis of neonatal brain insults
Role of multidetector CT virtual laryngoscopy in evaluation of laryngeal mass lesions
Evaluation of adnexal masses on sonomorphology and color Doppler imaginig
Role of radiological imaging in diagnosis of endometrial carcinoma
Comprehensive imaging of renal masses by magnetic resonance imaging
The role of 3D & 4D ultrasonography in abnormalities of fetal abdomen
Diffusion weighted magnetic resonance imaging in diagnosis and characterization of brain tumors in correlation with conventional MRI
Role of diffusion weighted MRI imaging in evaluation of cancer prostate
Role of multidetector CT in diagnosis of urinary bladder cancer
Role of multidetector computed tomography in the evaluation of paediatric retroperitoneal masses.
Comparative evaluation of gastric lesions by double contrast barium upper G.I. and multi detector computed tomography
Evaluation of hepatic fibrosis in chronic liver disease using ultrasound elastography
Role of MRI in assessment of hydrocephalus in pediatric patients
The role of sonoelastography in characterization of breast lesions
The influence of volumetric tumor doubling time on survival of patients with intracranial tumours
Role of perfusion computed tomography in characterization of colonic lesions
Role of proton MRI spectroscopy in the evaluation of temporal lobe epilepsy
Role of Doppler ultrasound and multidetector CT angiography in evaluation of peripheral arterial diseases.
Role of multidetector computed tomography in paranasal sinus pathologies
Role of virtual endoscopy using MDCT in detection & evaluation of gastric pathologies
High resolution 3 Tesla MRI in the evaluation of ankle and hindfoot pain.
Transperineal ultrasonography in infants with anorectal malformation
CT portography using MDCT versus color Doppler in detection of varices in cirrhotic patients
Role of CT urography in the evaluation of a dilated ureter
Characterization of pulmonary nodules by dynamic contrast-enhanced multidetector CT
Comprehensive imaging of acute ischemic stroke on multidetector CT
The role of fetal MRI in the diagnosis of intrauterine neurological congenital anomalies
Role of Multidetector computed tomography in pediatric chest masses
Multimodality imaging in the evaluation of palpable & non-palpable breast lesion.
Sonographic Assessment Of Fetal Nasal Bone Length At 11-28 Gestational Weeks And Its Correlation With Fetal Outcome.
Role Of Sonoelastography And Contrast-Enhanced Computed Tomography In Evaluation Of Lymph Node Metastasis In Head And Neck Cancers
Role Of Renal Doppler And Shear Wave Elastography In Diabetic Nephropathy
Evaluation Of Relationship Between Various Grades Of Fatty Liver And Shear Wave Elastography Values
Evaluation and characterization of pelvic masses of gynecological origin by USG, color Doppler and MRI in females of reproductive age group
Radiological evaluation of small bowel diseases using computed tomographic enterography
Role of coronary CT angiography in patients of coronary artery disease
Role of multimodality imaging in the evaluation of pediatric neck masses
Role of CT in the evaluation of craniocerebral trauma
Role of magnetic resonance imaging (MRI) in the evaluation of spinal dysraphism
Comparative evaluation of triple phase CT and dynamic contrast-enhanced MRI in patients with liver cirrhosis
Evaluation of the relationship between carotid intima-media thickness and coronary artery disease in patients evaluated by coronary angiography for suspected CAD
Assessment of hepatic fat content in fatty liver disease by unenhanced computed tomography
Correlation of vertebral marrow fat on spectroscopy and diffusion-weighted MRI imaging with bone mineral density in postmenopausal women.
Comparative evaluation of CT coronary angiography with conventional catheter coronary angiography
Ultrasound evaluation of kidney length & descending colon diameter in normal and intrauterine growth-restricted fetuses
A prospective study of hepatic vein waveform and splenoportal index in liver cirrhosis: correlation with child Pugh’s classification and presence of esophageal varices.
CT angiography to evaluate coronary artery by-pass graft patency in symptomatic patient’s functional assessment of myocardium by cardiac MRI in patients with myocardial infarction
MRI evaluation of HIV positive patients with central nervous system manifestations
MDCT evaluation of mediastinal and hilar masses
Evaluation of rotator cuff & labro-ligamentous complex lesions by MRI & MRI arthrography of shoulder joint
Role of imaging in the evaluation of soft tissue vascular malformation
Role of MRI and ultrasonography in the evaluation of multifidus muscle pathology in chronic low back pain patients
Role of ultrasound elastography in the differential diagnosis of breast lesions
Role of magnetic resonance cholangiopancreatography in evaluating dilated common bile duct in patients with symptomatic gallstone disease.
Comparative study of CT urography & hybrid CT urography in patients with haematuria.
Role of MRI in the evaluation of anorectal malformations
Comparison of ultrasound-Doppler and magnetic resonance imaging findings in rheumatoid arthritis of hand and wrist
Role of Doppler sonography in the evaluation of renal artery stenosis in hypertensive patients undergoing coronary angiography for coronary artery disease.
Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis in ankylosing spondylitis.
Mr evaluation of painful hip
Role of MRI imaging in pretherapeutic assessment of oral and oropharyngeal malignancy
Evaluation of diffuse lung diseases by high resolution computed tomography of the chest
Mr evaluation of brain parenchyma in patients with craniosynostosis.
Diagnostic and prognostic value of cardiovascular magnetic resonance imaging in dilated cardiomyopathy
Role of multiparametric magnetic resonance imaging in the detection of early carcinoma prostate
Role of magnetic resonance imaging in white matter diseases
Role of sonoelastography in assessing the response to neoadjuvant chemotherapy in patients with locally advanced breast cancer.
Role of ultrasonography in the evaluation of carotid and femoral intima-media thickness in predialysis patients with chronic kidney disease
Role of H1 MRI spectroscopy in focal bone lesions of peripheral skeleton choline detection by MRI spectroscopy in breast cancer and its correlation with biomarkers and histological grade.
Ultrasound and MRI evaluation of axillary lymph node status in breast cancer.
Role of sonography and magnetic resonance imaging in evaluating chronic lateral epicondylitis.
Comparative of sonography including Doppler and sonoelastography in cervical lymphadenopathy.
Evaluation of Umbilical Coiling Index as Predictor of Pregnancy Outcome.
Computerized Tomographic Evaluation of Azygoesophageal Recess in Adults.
Lumbar Facet Arthropathy in Low Backache.
“Urethral Injuries After Pelvic Trauma: Evaluation with Uretrography
Role Of Ct In Diagnosis Of Inflammatory Renal Diseases
Role Of Ct Virtual Laryngoscopy In Evaluation Of Laryngeal Masses
“Ct Portography Using Mdct Versus Color Doppler In Detection Of Varices In
Cirrhotic Patients”
Role Of Multidetector Ct In Characterization Of Renal Masses
Role Of Ct Virtual Cystoscopy In Diagnosis Of Urinary Bladder Neoplasia
Role Of Multislice Ct In Diagnosis Of Small Intestine Tumors
“Mri Flow Quantification In The Assessment Of The Commonest CSF Flow Abnormalities”
“The Role Of Fetal Mri In Diagnosis Of Intrauterine Neurological CongenitalAnomalies”
Role Of Transcranial Ultrasound In Diagnosis Of Neonatal Brain Insults
“The Role Of Interventional Imaging Procedures In The Treatment Of Selected Gynecological Disorders”
Role Of Radiological Imaging In Diagnosis Of Endometrial Carcinoma
“Role Of High-Resolution Ct In Differentiation Between Benign And Malignant Pulmonary Nodules In Children”
Role Of Ultrasonography In The Diagnosis Of Knee Joint Lesions
“Role Of Diagnostic Imaging Modalities In Evaluation Of Post Liver Transplantation Recipient Complications”
“Diffusion-Weighted Magnetic Resonance Imaging In Diagnosis And
Characterization Of Brain Tumors In Correlation With Conventional Mri”
The Role Of PET-CT In The Evaluation Of Hepatic Tumors
“Role Of Computerized Tomography In Evaluation Of Mediastinal Masses In Pediatric patients”
“Trans Vaginal Ultrasound And Magnetic Resonance Imaging In Female Urinary Incontinence”
Role Of Multidetector Ct In Diagnosis Of Urinary Bladder Cancer
“Role Of Transvaginal Ultrasound In Diagnosis And Treatment Of Female Infertility”
Role Of Diffusion-Weighted Mri Imaging In Evaluation Of Cancer Prostate
“Role Of Positron Emission Tomography With Computed Tomography In Diagnosis Of Cancer Thyroid”
The Role Of CT Urography In Case Of Haematuria
“Value Of Ultrasonography In Assessment Of Acute Abdominal Diseases In Pediatric Age Group”
“Role Of Functional Magnetic Resonance Imaging In Making Brain Tumor Surgery Safer”
The Role Of Sonoelastography In Characterization Of Breast Lesions
“Ultrasonography, Magnetic Resonance Cholangiopancreatography (MRCP) In Assessment Of Pediatric Biliary Lesions”
“Role Of Ultrasound And Color Doppler Imaging In Assessment Of Acute Abdomen Due To Female Genital Causes”
“Role Of Multidetector Ct Virtual Laryngoscopy In Evaluation Of Laryngeal Mass Lesions”
MRI Of The Postoperative Knee
Role Of Mri In Assessment Of Valvular Heart Diseases
The Role Of 3D & 4D Ultrasonography In Abnormalities Of Fetal Abdomen
State Of The Art Of Mri In Diagnosis Of Hepatic Focal Lesions
Role Of Multidetector Ct In Diagnosis Of Salivary Gland Lesions
“Role Of Virtual Endoscopy Using Mdct In Detection & Evaluation Of Gastric Pathologies”
The Role Of Ultrasound & Mri In Acute Pelvic Inflammatory Disease
“Diagnosis & Staging Of Liver Fibrosis By Ultraso Und Elastography In
Patients With Chronic Liver Diseases”
Role Of Mri In Evaluation Of Spinal Trauma
Validity Of Mri In Diagnosis Of Congenital Anorectal Anomalies
Imaging Of Vascular Complication After Liver Transplantation
“Contrast-Enhanced Digital Mammography And Digital Breast Tomosynthesis In Early Diagnosis Of Breast Lesion”
Role Of Mammotome In Breast Lesions
“Role Of MRI Diffusion Tensor Imaging (DTI) In Assessment Of Traumatic Spinal Cord Injuries”
“Prediction Of Pre-eclampsia And Fetal Growth Restriction By Uterine Artery Doppler”
“Role Of Multidetector Row Computed Tomography In Assessment Of Maxillofacial Trauma”
“Role Of Diffusion Magnetic Resonance Imaging In Assessment Of Neoplastic And Inflammatory Brain Lesions”
Role Of Diffusion Mri In Preoperative Evaluation Of Brain Neoplasms
“Role Of Multidetector Ct Virtual Hysteroscopy In The Detection Of The
Uterine & Tubal Causes Of Female Infertility”
Role Of Advances Magnetic Resonance Imaging Sequences In Multiple Sclerosis Magnetic Resonance Spectroscopy In Multiple Sclerosis
“Role Of Conventional Mri, And Diffusion Tensor Imaging Tractography In Evaluation Of Congenital Brain Malformations”
Role Of MRI In Evaluation Of Spinal Trauma
Diagnostic Role Of Diffusion-weighted MR Imaging In Neck Masses
“The Role Of Transvaginal Ultrasound Versus Magnetic Resonance Imaging In Diagnosis & Evaluation Of Cancer Cervix”
“Role Of 3d Magnetic Resonance Imaging Tractography In Assessment Of White Matter Tracts Compromise In Supra Tentorial Tumors”
Role Of Proton MR Spectroscopy In The Evaluation Of Temporal Lobe Epilepsy
Role Of Multislice Computed Tomography In Evaluation Of Crohn’s Disease
Role Of MRI In Assessment Of Hydrocephalus In Pediatric Patients
The Role Of MRI In Diagnosis And Staging Of Urinary Bladder Carcinoma
USG and MRI correlation of congenital CNS anomalies
HRCT in interstitial lung disease
X-Ray, CT and MRI correlation of bone tumors
“Study on the diagnostic and prognostic utility of X-Rays for cases of pulmonary tuberculosis under RNTCP”
“Role of magnetic resonance imaging in the characterization of female adnexal pathology”
“CT angiography of carotid atherosclerosis and NECT brain in cerebral ischemia, a correlative analysis”
Role of CT scan in the evaluation of paranasal sinus pathology
USG and MRI correlation on shoulder joint pathology
“Radiological evaluation of a patient presenting with extrapulmonary tuberculosis”
CT and MRI correlation in focal liver lesions”
Comparison of MDCT virtual cystoscopy with conventional cystoscopy in bladder tumors”
“Bleeding vessels in life-threatening hemoptysis: Comparison of 64 detector row CT angiography with conventional angiography prior to endovascular management”
“Role of transarterial chemoembolization in unresectable hepatocellular carcinoma”
“Comparison of color flow duplex study with digital subtraction angiography in the evaluation of peripheral vascular disease”
“A Study to assess the efficacy of magnetization transfer ratio in differentiating tuberculoma from neurocysticercosis”
“MR evaluation of uterine mass lesions in correlation with transabdominal, transvaginal ultrasound using HPE as a gold standard”
“The Role of power Doppler imaging with trans rectal ultrasonogram guided prostate biopsy in the detection of prostate cancer”
“Lower limb arteries assessed with doppler angiography – A prospective comparative study with multidetector CT angiography”
“Comparison of sildenafil with papaverine in penile doppler by assessing hemodynamic changes”
“Evaluation of efficacy of sonosalphingogram for assessing tubal patency in infertile patients with hysterosalpingogram as the gold standard”
Role of CT enteroclysis in the evaluation of small bowel diseases
“MRI colonography versus conventional colonoscopy in the detection of colonic polyposis”
“Magnetic Resonance Imaging of anteroposterior diameter of the midbrain – differentiation of progressive supranuclear palsy from Parkinson disease”
“MRI Evaluation of anterior cruciate ligament tears with arthroscopic correlation”
“The Clinicoradiological profile of cerebral venous sinus thrombosis with prognostic evaluation using MR sequences”
“Role of MRI in the evaluation of pelvic floor integrity in stress incontinent patients” “Doppler ultrasound evaluation of hepatic venous waveform in portal hypertension before and after propranolol”
“Role of transrectal sonography with colour doppler and MRI in evaluation of prostatic lesions with TRUS guided biopsy correlation”
“Ultrasonographic evaluation of painful shoulders and correlation of rotator cuff pathologies and clinical examination”
“Colour Doppler Evaluation of Common Adult Hepatic tumors More Than 2 Cm with HPE and CECT Correlation”
“Clinical Relevance of MR Urethrography in Obliterative Posterior Urethral Stricture”
“Prediction of Adverse Perinatal Outcome in Growth Restricted Fetuses with Antenatal Doppler Study”
Radiological evaluation of spinal dysraphism using CT and MRI
“Evaluation of temporal bone in cholesteatoma patients by high resolution computed tomography”
“Radiological evaluation of primary brain tumours using computed tomography and magnetic resonance imaging”
“Three dimensional colour doppler sonographic assessment of changes in volume and vascularity of fibroids – before and after uterine artery embolization”
“In phase opposed phase imaging of bone marrow differentiating neoplastic lesions”
“Role of dynamic MRI in replacing the isotope renogram in the functional evaluation of PUJ obstruction”
Characterization of adrenal masses with contrast-enhanced CT – washout study
A study on accuracy of magnetic resonance cholangiopancreatography
“Evaluation of median nerve in carpal tunnel syndrome by high-frequency ultrasound & color doppler in comparison with nerve conduction studies”
“Correlation of Agatston score in patients with obstructive and nonobstructive coronary artery disease following STEMI”
“Doppler ultrasound assessment of tumor vascularity in locally advanced breast cancer at diagnosis and following primary systemic chemotherapy.”
“Validation of two-dimensional perineal ultrasound and dynamic magnetic resonance imaging in pelvic floor dysfunction.”
“Role of MR urethrography compared to conventional urethrography in the surgical management of obliterative urethral stricture.”

Search Diagnostic Imaging Research Topics

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Free Resources for Preparing Radiology Thesis

Radiology thesis topics- Benha University – Free to download thesis
Radiology thesis topics – Faculty of Medical Science Delhi
Radiology thesis topics – IPGMER
Fetal Radiology thesis Protocols
Radiology thesis and dissertation topics
Radiographics

Proofreading Your Thesis:

Make sure you use Grammarly to correct your spelling , grammar , and plagiarism for your thesis. Grammarly has affordable paid subscriptions, windows/macOS apps, and FREE browser extensions. It is an excellent tool to avoid inadvertent spelling mistakes in your research projects. It has an extensive built-in vocabulary, but you should make an account and add your own medical glossary to it.

Grammarly spelling and grammar correction app for thesis

Guidelines for Writing a Radiology Thesis:

These are general guidelines and not about radiology specifically. You can share these with colleagues from other departments as well. Special thanks to Dr. Sanjay Yadav sir for these. This section is best seen on a desktop. Here are a couple of handy presentations to start writing a thesis:

Read the general guidelines for writing a thesis (the page will take some time to load- more than 70 pages!

A format for thesis protocol with a sample patient information sheet, sample patient consent form, sample application letter for thesis, and sample certificate.

Resources and References:

Guidelines for thesis writing.
Format for thesis protocol
Thesis protocol writing guidelines DNB
Informed consent form for Research studies from AIIMS
Radiology Informed consent forms in local Indian languages.
Sample Informed Consent form for Research in Hindi
Guide to write a thesis by Dr. P R Sharma
Guidelines for thesis writing by Dr. Pulin Gupta.
Preparing MD/DNB thesis by A Indrayan
Another good thesis reference protocol

Hopefully, this post will make the tedious task of writing a Radiology thesis a little bit easier for you. Best of luck with writing your thesis and your residency too!

More guides for residents :

Guide for the md/dmrd/dnb radiology exam, guide for first-year radiology residents.

FRCR Exam: THE Most Comprehensive Guide (2022)!
Radiology Practical Exams Questions compilation for MD/DNB/DMRD !
Radiology Exam Resources (Oral Recalls, Instruments, etc )!
Tips and Tricks for DNB/MD Radiology Practical Exam
FRCR 2B exam- Tips and Tricks !
FRCR exam preparation – An alternative take!
Why did I take up Radiology?
Radiology Conferences – A comprehensive guide!
ECR (European Congress Of Radiology)
European Diploma in Radiology (EDiR) – The Complete Guide!
Radiology NEET PG guide – How to select THE best college for post-graduation in Radiology (includes personal insights)!
Interventional Radiology – All Your Questions Answered!
What It Means To Be A Radiologist: A Guide For Medical Students!
Radiology Mentors for Medical Students (Post NEET-PG)
MD vs DNB Radiology: Which Path is Right for Your Career?
DNB Radiology OSCE – Tips and Tricks

More radiology resources here: Radiology resources This page will be updated regularly. Kindly leave your feedback in the comments or send us a message here . Also, you can comment below regarding your department’s thesis topics.

Note: All topics have been compiled from available online resources. If anyone has an issue with any radiology thesis topics displayed here, you can message us here , and we can delete them. These are only sample guidelines. Thesis guidelines differ from institution to institution.

Image source: Thesis complete! (2018). Flickr. Retrieved 12 August 2018, from https://www.flickr.com/photos/cowlet/354911838 by Victoria Catterson

About The Author

Dr. amar udare, md, related posts ↓.

7 thoughts on “Radiology Thesis – More than 400 Research Topics (2022)!”

Amazing & The most helpful site for Radiology residents…

Thank you for your kind comments 🙂

Dr. I saw your Tips is very amazing and referable. But Dr. Can you help me with the thesis of Evaluation of Diagnostic accuracy of X-ray radiograph in knee joint lesion.

Wow! These are excellent stuff. You are indeed a teacher. God bless

Glad you liked these!

happy to see this

Glad I could help :).

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Radiology Research Paper Topics

Radiology research paper topics encompass a wide range of fascinating areas within the field of medical imaging. This page aims to provide students studying health sciences with a comprehensive collection of radiology research paper topics to inspire and guide their research endeavors. By delving into various categories and exploring ten thought-provoking topics within each, students can gain insights into the diverse research possibilities in radiology. From advancements in imaging technology to the evaluation of diagnostic accuracy and the impact of radiological interventions, these topics offer a glimpse into the exciting world of radiology research. Additionally, expert advice is provided to help students choose the most suitable research topics and navigate the process of writing a research paper in radiology. By leveraging iResearchNet’s writing services, students can further enhance their research papers with professional assistance, ensuring the highest quality and adherence to academic standards. Explore the realm of radiology research paper topics and unleash your potential to contribute to the advancement of medical imaging and patient care.

100 Radiology Research Paper Topics

Radiology encompasses a broad spectrum of imaging techniques used to diagnose diseases, monitor treatment progress, and guide interventions. This comprehensive list of radiology research paper topics serves as a valuable resource for students in the field of health sciences who are seeking inspiration and guidance for their research endeavors. The following ten categories highlight different areas within radiology, each containing ten thought-provoking topics. Exploring these topics will provide students with a deeper understanding of the diverse research possibilities and current trends within the field of radiology.

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Diagnostic Imaging Techniques

Comparative analysis of imaging modalities: CT, MRI, and PET-CT.
The role of artificial intelligence in radiological image interpretation.
Advancements in digital mammography for breast cancer screening.
Emerging techniques in nuclear medicine imaging.
Image-guided biopsy: Enhancing accuracy and safety.
Application of radiomics in predicting treatment response.
Dual-energy CT: Expanding diagnostic capabilities.
Radiological evaluation of traumatic brain injuries.
Imaging techniques for evaluating cardiovascular diseases.
Radiographic evaluation of pulmonary nodules: Challenges and advancements.

Interventional Radiology

Minimally invasive treatments for liver tumors: Embolization techniques.
Radiofrequency ablation in the management of renal cell carcinoma.
Role of interventional radiology in the treatment of peripheral artery disease.
Transarterial chemoembolization in hepatocellular carcinoma.
Evaluation of uterine artery embolization for the treatment of fibroids.
Percutaneous vertebroplasty and kyphoplasty: Efficacy and complications.
Endovascular repair of abdominal aortic aneurysms: Long-term outcomes.
Interventional radiology in the management of deep vein thrombosis.
Transcatheter aortic valve replacement: Imaging considerations.
Emerging techniques in interventional oncology.

Radiation Safety and Dose Optimization

Strategies for reducing radiation dose in pediatric imaging.
Imaging modalities with low radiation exposure: Current advancements.
Effective use of dose monitoring systems in radiology departments.
The impact of artificial intelligence on radiation dose optimization.
Optimization of radiation therapy treatment plans: Balancing efficacy and safety.
Radioprotective measures for patients and healthcare professionals.
The role of radiology in addressing radiation-induced risks.
Evaluating the long-term effects of radiation exposure in diagnostic imaging.
Radiation dose tracking and reporting: Implementing best practices.
Patient education and communication regarding radiation risks.

Radiology in Oncology

Imaging techniques for early detection and staging of lung cancer.
Quantitative imaging biomarkers for predicting treatment response in solid tumors.
Radiogenomics: Linking imaging features to genetic profiles in cancer.
The role of imaging in assessing tumor angiogenesis.
Radiological evaluation of lymphoma: Challenges and advancements.
Imaging-guided interventions in the treatment of hepatocellular carcinoma.
Assessment of tumor heterogeneity using functional imaging techniques.
Radiomics and machine learning in predicting treatment outcomes in cancer.
Multimodal imaging in the evaluation of brain tumors.
Imaging surveillance after cancer treatment: Optimizing follow-up protocols.

Radiology in Musculoskeletal Disorders

Imaging modalities in the evaluation of sports-related injuries.
The role of imaging in diagnosing and monitoring rheumatoid arthritis.
Assessment of bone health using dual-energy X-ray absorptiometry (DXA).
Imaging techniques for evaluating osteoarthritis progression.
Imaging-guided interventions in the management of musculoskeletal tumors.
Role of imaging in diagnosing and managing spinal disorders.
Evaluation of traumatic injuries using radiography, CT, and MRI.
Imaging of joint prostheses: Complications and assessment techniques.
Imaging features and classifications of bone fractures.
Musculoskeletal ultrasound in the diagnosis of soft tissue injuries.

Neuroradiology

Advanced neuroimaging techniques for early detection of neurodegenerative diseases.
Imaging evaluation of acute stroke: Current guidelines and advancements.
Role of functional MRI in mapping brain functions.
Imaging of brain tumors: Classification and treatment planning.
Diffusion tensor imaging in assessing white matter integrity.
Neuroimaging in the evaluation of multiple sclerosis.
Imaging techniques for the assessment of epilepsy.
Radiological evaluation of neurovascular diseases.
Imaging of cranial nerve disorders: Diagnosis and management.
Radiological assessment of developmental brain abnormalities.

Pediatric Radiology

Radiation dose reduction strategies in pediatric imaging.
Imaging evaluation of congenital heart diseases in children.
Role of imaging in the diagnosis and management of pediatric oncology.
Imaging of pediatric gastrointestinal disorders.
Evaluation of developmental hip dysplasia using ultrasound and radiography.
Imaging features and management of pediatric musculoskeletal infections.
Neuroimaging in the assessment of pediatric neurodevelopmental disorders.
Radiological evaluation of pediatric respiratory conditions.
Imaging techniques for the evaluation of pediatric abdominal emergencies.
Imaging-guided interventions in pediatric patients.

Breast Imaging

Advances in digital mammography for early breast cancer detection.
The role of tomosynthesis in breast imaging.
Imaging evaluation of breast implants: Complications and assessment.
Radiogenomic analysis of breast cancer subtypes.
Contrast-enhanced mammography: Diagnostic benefits and challenges.
Emerging techniques in breast MRI for high-risk populations.
Evaluation of breast density and its implications for cancer risk.
Role of molecular breast imaging in dense breast tissue evaluation.
Radiological evaluation of male breast disorders.
The impact of artificial intelligence on breast cancer screening.

Cardiac Imaging

Imaging evaluation of coronary artery disease: Current techniques and challenges.
Role of cardiac CT angiography in the assessment of structural heart diseases.
Imaging of cardiac tumors: Diagnosis and treatment considerations.
Advanced imaging techniques for assessing myocardial viability.
Evaluation of valvular heart diseases using echocardiography and MRI.
Cardiac magnetic resonance imaging in the evaluation of cardiomyopathies.
Role of nuclear cardiology in the assessment of cardiac function.
Imaging evaluation of congenital heart diseases in adults.
Radiological assessment of cardiac arrhythmias.
Imaging-guided interventions in structural heart diseases.

Abdominal and Pelvic Imaging

Evaluation of hepatobiliary diseases using imaging techniques.
Imaging features and classification of renal masses.
Radiological assessment of gastrointestinal bleeding.
Imaging evaluation of pancreatic diseases: Challenges and advancements.
Evaluation of pelvic floor disorders using MRI and ultrasound.
Role of imaging in diagnosing and staging gynecological cancers.
Imaging of abdominal and pelvic trauma: Current guidelines and techniques.
Radiological evaluation of genitourinary disorders.
Imaging features of abdominal and pelvic infections.
Assessment of abdominal and pelvic vascular diseases using imaging techniques.

This comprehensive list of radiology research paper topics highlights the vast range of research possibilities within the field of medical imaging. Each category offers unique insights and avenues for exploration, enabling students to delve into various aspects of radiology. By choosing a topic of interest and relevance, students can contribute to the advancement of medical imaging and patient care. The provided topics serve as a starting point for students to engage in in-depth research and produce high-quality research papers.

Radiology: Exploring the Range of Research Paper Topics

Introduction: Radiology plays a crucial role in modern healthcare, providing valuable insights into the diagnosis, treatment, and monitoring of various medical conditions. As a dynamic and rapidly evolving field, radiology offers a wide range of research opportunities for students in the health sciences. This article aims to explore the diverse spectrum of research paper topics within radiology, shedding light on the current trends, innovations, and challenges in the field.

Radiology in Diagnostic Imaging : Diagnostic imaging is one of the core areas of radiology, encompassing various modalities such as X-ray, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine. Research topics in this domain may include advancements in imaging techniques, comparative analysis of modalities, radiomics, and the integration of artificial intelligence in image interpretation. Students can explore how these technological advancements enhance diagnostic accuracy, improve patient outcomes, and optimize radiation exposure.

Interventional Radiology : Interventional radiology focuses on minimally invasive procedures performed under image guidance. Research topics in this area can cover a wide range of interventions, such as angioplasty, embolization, radiofrequency ablation, and image-guided biopsies. Students can delve into the latest techniques, outcomes, and complications associated with interventional procedures, as well as explore the emerging role of interventional radiology in managing various conditions, including vascular diseases, cancer, and pain management.

Radiation Safety and Dose Optimization : Radiation safety is a critical aspect of radiology practice. Research in this field aims to minimize radiation exposure to patients and healthcare professionals while maintaining optimal diagnostic image quality. Topics may include strategies for reducing radiation dose in pediatric imaging, dose monitoring systems, the impact of artificial intelligence on radiation dose optimization, and radioprotective measures. Students can investigate how to strike a balance between effective imaging and patient safety, exploring advancements in dose reduction techniques and the implementation of best practices.

Radiology in Oncology : Radiology plays a vital role in the diagnosis, staging, and treatment response assessment in cancer patients. Research topics in this area can encompass the use of imaging techniques for early detection, tumor characterization, response prediction, and treatment planning. Students can explore the integration of radiomics, machine learning, and molecular imaging in oncology research, as well as advancements in functional imaging and image-guided interventions.

Radiology in Neuroimaging : Neuroimaging is a specialized field within radiology that focuses on imaging the brain and central nervous system. Research topics in neuroimaging can cover areas such as stroke imaging, neurodegenerative diseases, brain tumors, neurovascular disorders, and functional imaging for mapping brain functions. Students can explore the latest imaging techniques, image analysis tools, and their clinical applications in understanding and diagnosing various neurological conditions.

Radiology in Musculoskeletal Imaging : Musculoskeletal imaging involves the evaluation of bone, joint, and soft tissue disorders. Research topics in this area can encompass imaging techniques for sports-related injuries, arthritis, musculoskeletal tumors, spinal disorders, and trauma. Students can explore the role of advanced imaging modalities such as MRI and ultrasound in diagnosing and managing musculoskeletal conditions, as well as the use of imaging-guided interventions for treatment.

Pediatric Radiology : Pediatric radiology focuses on imaging children, who have unique anatomical and physiological considerations. Research topics in this field may include radiation dose reduction strategies in pediatric imaging, imaging evaluation of congenital anomalies, pediatric oncology imaging, and imaging assessment of developmental disorders. Students can explore how to tailor imaging protocols for children, minimize radiation exposure, and improve diagnostic accuracy in pediatric patients.

Breast Imaging : Breast imaging is essential for the early detection and diagnosis of breast cancer. Research topics in this area can cover advancements in mammography, tomosynthesis, breast MRI, and molecular imaging. Students can explore topics related to breast density, imaging-guided biopsies, breast cancer screening, and the impact of artificial intelligence in breast imaging. Additionally, they can investigate the use of imaging techniques for evaluating breast implants and assessing high-risk populations.

Cardiac Imaging : Cardiac imaging focuses on the evaluation of heart structure and function. Research topics in this field may include imaging techniques for coronary artery disease, valvular heart diseases, cardiomyopathies, and cardiac tumors. Students can explore the role of cardiac CT, MRI, nuclear cardiology, and echocardiography in diagnosing and managing various cardiac conditions. Additionally, they can investigate the use of imaging in guiding interventional procedures and assessing treatment outcomes.

Abdominal and Pelvic Imaging : Abdominal and pelvic imaging involves the evaluation of organs and structures within the abdominal and pelvic cavities. Research topics in this area can encompass imaging of the liver, kidneys, gastrointestinal tract, pancreas, genitourinary system, and pelvic floor. Students can explore topics related to imaging techniques, evaluation of specific diseases or conditions, and the role of imaging in guiding interventions. Additionally, they can investigate emerging modalities such as elastography and diffusion-weighted imaging in abdominal and pelvic imaging.

Radiology offers a vast array of research opportunities for students in the field of health sciences. The topics discussed in this article provide a glimpse into the breadth and depth of research possibilities within radiology. By exploring these research areas, students can contribute to advancements in diagnostic accuracy, treatment planning, and patient care. With the rapid evolution of imaging technologies and the integration of artificial intelligence, the future of radiology research holds immense potential for improving healthcare outcomes.

Choosing Radiology Research Paper Topics

Introduction: Selecting a research topic is a crucial step in the journey of writing a radiology research paper. It determines the focus of your study and influences the impact your research can have in the field. To help you make an informed choice, we have compiled expert advice on selecting radiology research paper topics. By following these tips, you can identify a relevant and engaging research topic that aligns with your interests and contributes to the advancement of radiology knowledge.

Identify Your Interests : Start by reflecting on your own interests within the field of radiology. Consider which subspecialties or areas of radiology intrigue you the most. Are you interested in diagnostic imaging, interventional radiology, radiation safety, oncology imaging, or any other specific area? Identifying your interests will guide you in selecting a topic that excites you and keeps you motivated throughout the research process.
Stay Updated on Current Trends : Keep yourself updated on the latest advancements, breakthroughs, and emerging trends in radiology. Read scientific journals, attend conferences, and engage in discussions with experts in the field. By staying informed, you can identify gaps in knowledge or areas that require further investigation, providing you with potential research topics that are timely and relevant.
Consult with Faculty or Mentors : Seek guidance from your faculty members or mentors who are experienced in the field of radiology. They can provide valuable insights into potential research areas, ongoing projects, and research gaps. Discuss your research interests with them and ask for their suggestions and recommendations. Their expertise and guidance can help you narrow down your research topic and refine your research question.
Conduct a Literature Review : Conducting a thorough literature review is an essential step in choosing a research topic. It allows you to familiarize yourself with the existing body of knowledge, identify research gaps, and build a strong foundation for your study. Analyze recent research papers, systematic reviews, and meta-analyses related to radiology to identify areas that need further investigation or where controversies exist.
Brainstorm Research Questions : Once you have gained an understanding of the current state of research in radiology, brainstorm potential research questions. Consider the gaps or controversies you identified during your literature review. Develop research questions that address these gaps and contribute to the existing knowledge. Ensure that your research questions are clear, focused, and answerable within the scope of your study.
Consider the Practicality and Feasibility : When selecting a research topic, consider the practicality and feasibility of conducting the study. Evaluate the availability of resources, access to data, research facilities, and ethical considerations. Assess the time frame and potential constraints that may impact your research. Choosing a topic that is feasible within your given resources and time frame will ensure a successful and manageable research experience.
Collaborate with Peers : Consider collaborating with your peers or forming a research group to enhance your research experience. Collaborative research allows for a sharing of ideas, resources, and expertise, fostering a supportive environment. By working together, you can explore more complex research topics, conduct multicenter studies, and generate more impactful findings.
Seek Multidisciplinary Perspectives : Radiology intersects with various other medical disciplines. Consider exploring interdisciplinary research topics that integrate radiology with fields such as oncology, cardiology, neurology, or orthopedics. By incorporating multidisciplinary perspectives, you can address complex healthcare challenges and contribute to a broader understanding of patient care.
Choose a Topic with Clinical Relevance : Select a research topic that has direct clinical relevance. Focus on topics that can potentially influence patient outcomes, improve diagnostic accuracy, optimize treatment strategies, or enhance patient safety. By choosing a clinically relevant topic, you can contribute to the advancement of radiology practice and have a positive impact on patient care.
Seek Ethical Considerations : Ensure that your research topic adheres to ethical considerations in radiology research. Patient privacy, confidentiality, and informed consent should be prioritized when conducting studies involving human subjects. Familiarize yourself with the ethical guidelines and regulations specific to radiology research and ensure that your study design and data collection methods are in line with these principles.

Choosing a radiology research paper topic requires careful consideration and alignment with your interests, expertise, and the current trends in the field. By following the expert advice provided in this section, you can select a research topic that is engaging, relevant, and contributes to the advancement of radiology knowledge. Remember to consult with mentors, conduct a thorough literature review, and consider practicality and feasibility. With a well-chosen research topic, you can embark on an exciting journey of exploration, innovation, and contribution to the field of radiology.

How to Write a Radiology Research Paper

Introduction: Writing a radiology research paper requires a systematic approach and attention to detail. It is essential to effectively communicate your research findings, methodology, and conclusions to contribute to the body of knowledge in the field. In this section, we will provide you with valuable tips on how to write a successful radiology research paper. By following these guidelines, you can ensure that your paper is well-structured, informative, and impactful.

Define the Research Question : Start by clearly defining your research question or objective. It serves as the foundation of your research paper and guides your entire study. Ensure that your research question is specific, focused, and relevant to the field of radiology. Clearly articulate the purpose of your study and its potential implications.
Conduct a Thorough Literature Review : Before diving into writing, conduct a comprehensive literature review to familiarize yourself with the existing body of knowledge in your research area. Identify key studies, seminal papers, and relevant research articles that will support your research. Analyze and synthesize the literature to identify gaps, controversies, or areas for further investigation.
Develop a Well-Structured Outline : Create a clear and well-structured outline for your research paper. An outline serves as a roadmap and helps you organize your thoughts, arguments, and evidence. Divide your paper into logical sections such as introduction, literature review, methodology, results, discussion, and conclusion. Ensure a logical flow of ideas and information throughout the paper.
Write an Engaging Introduction : The introduction is the opening section of your research paper and should capture the reader’s attention. Start with a compelling hook that introduces the importance of the research topic. Provide background information, context, and the rationale for your study. Clearly state the research question or objective and outline the structure of your paper.
Conduct Rigorous Methodology : Describe your research methodology in detail, ensuring transparency and reproducibility. Explain your study design, data collection methods, sample size, inclusion/exclusion criteria, and statistical analyses. Clearly outline the steps you took to ensure scientific rigor and address potential biases. Include any ethical considerations and institutional review board approvals, if applicable.
Present Clear and Concise Results : Present your research findings in a clear, concise, and organized manner. Use tables, figures, and charts to visually represent your data. Provide accurate and relevant statistical analyses to support your results. Explain the significance and implications of your findings and their alignment with your research question.
Analyze and Interpret Results : In the discussion section, analyze and interpret your research results in the context of existing literature. Compare and contrast your findings with previous studies, highlighting similarities, differences, and potential explanations. Discuss any limitations or challenges encountered during the study and propose areas for future research.
Ensure Clear and Coherent Writing : Maintain clarity, coherence, and precision in your writing. Use concise and straightforward language to convey your ideas effectively. Avoid jargon or excessive technical terms that may hinder understanding. Clearly define any acronyms or abbreviations used in your paper. Ensure that each paragraph has a clear topic sentence and flows smoothly into the next.
Citations and References : Properly cite all the sources used in your research paper. Follow the citation style recommended by your institution or the journal you intend to submit to (e.g., APA, MLA, or Chicago). Include in-text citations for direct quotes, paraphrased information, or any borrowed ideas. Create a comprehensive reference list at the end of your paper, following the formatting guidelines.
Revise and Edit : Take the time to revise and edit your research paper before final submission. Review the content, structure, and organization of your paper. Check for grammatical errors, spelling mistakes, and typos. Ensure that your paper adheres to the specified word count and formatting guidelines. Seek feedback from colleagues or mentors to gain valuable insights and suggestions for improvement.

Conclusion: Writing a radiology research paper requires careful planning, attention to detail, and effective communication. By following the tips provided in this section, you can write a well-structured and impactful research paper in the field of radiology. Define a clear research question, conduct a thorough literature review, develop a strong outline, and present your findings with clarity. Remember to adhere to proper citation guidelines and revise your paper before submission. With these guidelines in mind, you can contribute to the advancement of radiology knowledge and make a meaningful impact in the field.

iResearchNet’s Writing Services

Introduction: At iResearchNet, we understand the challenges faced by students in the field of health sciences when it comes to writing research papers, including those in radiology. Our writing services are designed to provide you with expert assistance and support throughout your research paper journey. With our team of experienced writers, in-depth research capabilities, and commitment to excellence, we offer a range of services that will help you achieve your academic goals and ensure the success of your radiology research papers.

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Custom Written Works : We understand that each research paper is unique, and we tailor our services to meet your specific requirements. Our writers craft custom-written research papers that align with your research objectives, ensuring originality and authenticity in every piece.
In-Depth Research : Research is at the core of any high-quality paper. Our writers conduct comprehensive and in-depth research to gather relevant literature, scientific articles, and other credible sources to support your research paper. They have access to reputable databases and libraries to ensure that your paper is backed by the latest and most reliable information.
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Radiology Dissertation topics – Based on The Latest Study and Research

Published by Ellie Cross at December 29th, 2022 , Revised On May 16, 2024

A dissertation is an essential part of the radiology curriculum for an MD, DNB, or DMRD degree programme. Dissertations in radiology can be very tricky and challenging due to the complexity of the subject.

Students must conduct thorough research to develop a first-class dissertation that makes a valuable contribution to the file of radiology. The first step is to choose a well-defined and clear research topic for the dissertation.

We have provided some interesting and focused ideas to help you get started. Choose one that motivates you so you don’t lose your interest in the research work halfway through the process.

List of Radiology Dissertation Topics

The use of computed tomography and positron emission tomography in the diagnosis of thyroid cancer
MRI diffusion tensor imaging is used to evaluate traumatic spinal injury
Analysing digital colour and subtraction in comparison patients with occlusive arterial disorders and Doppler
Functional magnetic resonance imaging is essential for ensuring the security of brain tumour surgery
Doppler uterine artery preeclampsia prediction
Utilising greyscale and Doppler ultrasonography to assess newborn cholestasis
MRI’s reliability in detecting congenital anorectal anomalies
Multivessel research on intrauterine growth restriction (arterial, venous) Doppler speed
Perfusion computed tomography is used to evaluate cerebral blood flow, blood volume, and vascular permeability for brain neoplasms
In post-radiotherapy treated gliomas, compare perfusion magnetic resonance imaging with magnetic resonance spectroscopy to identify recurrence
Using multidetector computed tomography, pediatric retroperitoneal masses are evaluated. Tomography
Female factor infertility: the role of three-dimensional multidetector CT hysterosalpingography
Combining triphasic computed tomography with son elastography allows for assessing localised liver lesions
Analysing the effects of magnetic resonance imaging and transperineally ultrasonography on female urinary stress incontinence
Using dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging, evaluate endometrial lesions
For the early diagnosis of breast lesions, digital breast tomosynthesis and contrast-enhanced digital mammography are also available
Using magnetic resonance imaging and colour Doppler flow, assess portal hypertension
Magnesium resonance imaging enables the assessment of musculoskeletal issues
Diffusion magnetic resonance imaging is a crucial diagnostic technique for neoplastic or inflammatory brain lesions
Children with chest ailments that are HIV-infected and have a radiological spectrum high-resolution ultrasound for childhood neck lumps
Ultrasonography is useful when determining the causes of pelvic discomfort in the first trimester
Magnetic resonance imaging is used to evaluate diseases of the aorta or its branches. Angiography’s function
Children’s pulmonary nodules can be distinguished between benign and malignant using high-resolution CT
Research on multidetector computed urography for treating diseases of the urinary tract
The evaluation of the ulnar nerve in leprosy patients involves significantly high-resolution sonography
Using computed tomography and magnetic resonance imaging, radiologists evaluate musculoskeletal tumours that are malignant and locally aggressive before surgery
The function of MRI and ultrasonography in acute pelvic inflammatory disorders
Ultrasonography is more efficient than computed tomographic arthrography for evaluating shoulder discomfort
For patients with blunt abdominal trauma, multidetector computed tomography is a crucial tool
Compound imaging and expanded field-of-view sonography in the evaluation of breast lesions
Focused pancreatic lesions are assessed using multidetector CT and perfusion CT
Ct virtual laryngoscopy is used to evaluate laryngeal masses
In the liver masses, triple-phase multidetector computed tomography
The effect of increasing the volume of brain tumours on patient survival
Colonic lesions can be diagnosed using perfusion computed tomography
A role for proton MRI spectroscopy in the diagnosis and management of temporal lobe epilepsy
Functions of multidetector CT and Doppler ultrasonography in assessing peripheral arterial disease
There is a function for multidetector computed tomography in paranasal sinus illness
In neonates with an anorectal malformation, transperineal ultrasound
Using multidetector CT, comprehensive imaging of an acute ischemic stroke is performed
The diagnosis of intrauterine neurological congenital disorders requires the use of fetal MRI
Children with chest masses may benefit from multidetector computed angiography
Multimodal imaging for the evaluation of palpable and non-palpable breast lesions
As measured by sonography and in relation to fetal outcome, fetal nasal bone length at 11–28 gestational days
Relationship between bone mineral density, diffusion-weighted MRI imaging, and vertebral marrow fat in postmenopausal women
A comparison of the traditional catheter and CT coronary imaging angiogram of the heart
Evaluation of the descending colon’s length and diameter using ultrasound in normal and intrauterine-restricted fetuses
Investigation of the hepatic vein waveform in liver cirrhosis prospectively. A connection to Child Pugh’s categorisation
Functional assessment of coronary artery bypass graft patency in symptomatic patients using CT angiography
MRI and MRI arthrography evaluation of the labour-ligamentous complex lesion in the shoulder
The evaluation of soft tissue vascular abnormalities involves imaging
Colour Doppler ultrasound and high-resolution ultrasound for scrotal lesions
Comparison of low-dose computed tomography and ultrasonography with colour Doppler for diagnosing salivary gland disorders
The use of multidetector CT to diagnose lesions of the salivary glands
Low dose CT venogram and sonography comparison for evaluating varicose veins: a pilot study
Comparison of dynamic contrast-enhanced MRI and triple phase CT in patients with liver cirrhosis
Carotid intima-media thickness and coronary artery disease are examined in individuals with coronary angiography for suspected CAD
Unenhanced computed tomography assessment of hepatic fat levels in fatty liver disease
Bone mineral density in postmenopausal women and vertebral marrow fat on spectroscopic and diffusion-weighted MRI images are correlated
Evaluation of CT coronary angiography against traditional catheter coronary angiography in comparison
High-frequency ultrasonography and colour Doppler evaluation of the median nerve in carpal tunnel syndrome in contrast to nerve conduction tests
Role of MR urethrography in the surgical therapy of obliterative urethral stricture compared to conventional urethrography
High-resolution computed tomography evaluation of the temporal bone in cholesteatoma patients.
Ultrasonographic assessment of sore shoulders and linkage of clinical examination and rotator cuff diseases
A Study to Evaluate the Performance of Magnetisation Transfer Ratio in Distinguishing Neurocysticercosis from Tuberculoma
Deep learning applications in radiology diagnostics.
Radiomics for personalised cancer therapy.
AI-driven image enhancement techniques in radiology.
Role of virtual reality in radiology education.
Nanotechnology advancements in radiology imaging.
Radiogenomics for predicting treatment response.
IoT-enabled devices for remote radiology consultations.
Biomarker discovery through radiological imaging.
3D printing in pre-surgical planning for radiology.
Radiological imaging for early detection of Alzheimer’s disease.
Applications of machine learning in radiology workflow optimization.
Radiological imaging modalities for sports injuries assessment.
Role of radiology in assessing COVID-19 complications.
Interventional radiology techniques for stroke management.
Automated reporting systems in radiology.
Radiology-guided minimally invasive surgeries.
Quantitative imaging for assessing tumour heterogeneity.
Big data analytics in radiology for population health.
Augmented reality for intraoperative radiological guidance.
Radiological imaging in assessing cardiovascular risks.
Radiology applications in detecting rare diseases.
Role of radiology in precision medicine.
Artificial intelligence for improving mammography accuracy.
Radiological imaging is used to monitor Parkinson’s disease progression.
Tele-radiology applications in resource-limited settings.
Radiological imaging in pediatric orthopaedics.
Artificial intelligence for improving CT image reconstruction.
Role of radiology in assessing infectious diseases.
Radiological imaging for assessing lung fibrosis.
3D visualization techniques in radiology reporting.
Radiology applications in evaluating renal disorders.
Imaging biomarkers for predicting dementia risk.
Radiomics for predicting treatment response in prostate cancer.

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You can use or get inspired by our selection of the best radiology diss. You can also check our list of critical care nursing dissertation topics and biology dissertation topics because these areas also relate to the discipline of medical sciences.

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Radiography articles from across Nature Portfolio

Radiography is the use of X-rays or gamma rays to examine non-uniformly composed material; images are recorded on a sensitized surface, such as photographic film or a digital detector. Medical radiography includes examination of any part of the body for diagnostic purposes, such as detecting fractures or a bowel obstruction.

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At the time the article was created Daniel J Bell had no recorded disclosures.

At the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.

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The first ever radiology journal, the Archives of Clinical Skiagraphy was published in the United Kingdom in May 1896, a mere six months after Wilhelm Roentgen's discovery of x-rays. This journal is the ultimate forerunner of the British Journal of Radiology (BJR) 1 .

The American X-Ray Journal was the first radiology journal published in the United States. Its first issue was issued in May 1897, its founder and first editor was an American physician Heber Robarts (1852-1922). Robarts was also a co-founder of what later became the American Roentgen Ray Society (ARRS) 2 . The American X-ray Journal, then called the American Journal of Progressive Therapeutics, ceased publication in 1906 2 .

1. Bishop P. The Evolution of the British Journal of Radiology. Br J Radiol. 1973;46(550):833-6. doi:10.1259/0007-1285-46-550-833 - Pubmed
2. Ronald L. Eisenberg. Radiology. (1994) ISBN: 9780815130529 - Google Books

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Radiology Research in Quality and Safety: Current Trends and Future Needs

Affiliations.

1 Department of Radiology and Imaging Sciences, Emory University Hospital Midtown, 550 Peachtree St, Atlanta, Georgia 30308. Electronic address: [email protected].
2 Department of Radiology, University of Virginia, Charlottesville, Virginia.
3 Department of Radiology, NYU School of Medicine, New York, New York.
4 Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
5 Division of Abdominal Imaging and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
6 Abdominal and Cross-Sectional Interventional Radiology, University of Michigan School of Medicine, Ann Arbor, Michigan.
7 Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
8 Department of Radiology, Division of Interventional Radiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York.
9 Sunnybrook Health Sciences Centre, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
10 Harrington Healthcare System, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
11 Lean Six Sigma, UPMC Health Plan, Pittsburgh, Pennsylvania.
12 Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
PMID: 28193376
DOI: 10.1016/j.acra.2016.07.021

Promoting quality and safety research is now essential for radiology as reimbursement is increasingly tied to measures of quality, patient safety, efficiency, and appropriateness of imaging. This article provides an overview of key features necessary to promote successful quality improvement efforts in radiology. Emphasis is given to current trends and future opportunities for directing research. Establishing and maintaining a culture of safety is paramount to organizations wishing to improve patient care. The correct culture must be in place to support quality initiatives and create accountability for patient care. Focused educational curricula are necessary to teach quality and safety-related skills and behaviors to trainees, staff members, and physicians. The increasingly complex healthcare landscape requires that organizations build effective data infrastructures to support quality and safety research. Incident reporting systems designed specifically for medical imaging will benefit quality improvement initiatives by identifying and learning from system errors, enhancing knowledge about safety, and creating safer systems through the implementation of standardized practices and standards. Finally, validated performance measures must be developed to accurately reflect the value of the care we provide for our patients and referring providers. Common metrics used in radiology are reviewed with focus on current and future opportunities for investigation.

Keywords: Culture of Safety; Performance Metrics; Quality and Safety Research.

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How ai and robotics will advance interventional radiology: narrative review and future perspectives.

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Zhang, J.; Fang, J.; Xu, Y.; Si, G. How AI and Robotics Will Advance Interventional Radiology: Narrative Review and Future Perspectives. Diagnostics 2024 , 14 , 1393. https://doi.org/10.3390/diagnostics14131393

Zhang J, Fang J, Xu Y, Si G. How AI and Robotics Will Advance Interventional Radiology: Narrative Review and Future Perspectives. Diagnostics . 2024; 14(13):1393. https://doi.org/10.3390/diagnostics14131393

Zhang, Jiaming, Jiayi Fang, Yanneng Xu, and Guangyan Si. 2024. "How AI and Robotics Will Advance Interventional Radiology: Narrative Review and Future Perspectives" Diagnostics 14, no. 13: 1393. https://doi.org/10.3390/diagnostics14131393

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Trends and hot topics in radiology, nuclear medicine and medical imaging from 2011–2021: a bibliometric analysis of highly cited papers

Original Article
Published: 28 March 2022
Volume 40 , pages 847–856, ( 2022 )

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Sheng Yan 1 ,
Huiting Zhang 2 &
Jun Wang 3

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To spotlight the trends and hot topics looming from the highly cited papers in the subject category of Radiology, Nuclear Medicine & Medical Imaging with bibliometric analysis.

Materials and methods

Based on the Essential Science Indicators, this study employed a bibliometric method to examine the highly cited papers in the subject category of Radiology, Nuclear Medicine & Medical Imaging in Web of Science (WoS) Categories, both quantitatively and qualitatively. In total, 1325 highly cited papers were retrieved and assessed spanning from the years of 2011 to 2021. In particular, the bibliometric information of the highly cited papers based on WoS database such as the main publication venues, the most productive countries, and the top cited publications was presented. An Abstract corpus was built to help identify the most frequently explored topics. VoSviewer was used to visualize the co-occurrence networks of author keywords.

The top three active journals are Neuroimage, Radiology and IEEE T Med Imaging . The United States, Germany and England have the most influential publications. The top cited publications unrelated to COVID-19 can be grouped in three categories: recommendations or guidelines, processing software, and analysis methods . The top cited publications on COVID-19 are dominantly in China . The most frequently explored topics based on the Abstract corpus and the author keywords with the great link strengths overlap to a great extent. Specifically, phrases such as magnetic resonance imaging, deep learning, prostate cancer, chest CT, computed tomography, CT images, coronavirus disease, convolutional neural network(s) are among the most frequently mentioned.

The bibliometric analysis of the highly cited papers provided the most updated trends and hot topics which may provide insights and research directions for medical researchers and healthcare practitioners in the future.

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Avoid common mistakes on your manuscript.

Introduction

Citation distributions are extremely skewed. Most scientific papers are seldom cited, if ever, in the subsequent scientific literature while some papers receive an unusually high citation counts [ 1 ]. In the past decade, there has been a growing interest in using highly cited papers as indicators in research assessments. There may be two reasons for this tendency. First, the increasing focus on scientific excellence in science policy in the context of the enormous quantities of scientific outputs makes it imperative to screen out the most successful or influential work. “Many countries are moving towards research policies that emphasize excellence; consequently; they develop evaluation systems to identify universities, research groups, and researchers that can be said to be “excellent” [ 2 ]. Second, for visibility issues, academic professionals are consistently interested in pursuing high citations for their own work and also tend to follow the research with higher citations. In this way, they can stay current regarding research trends and make informed decisions on potential research topics. High citations imply more visibility, generally accompanied by more supports from public or private funders. Therefore, scientific researchers will be very much proud if their publications are selected as highly cited papers (HCPs).

Incites Essential Science Indicators (ESI), an analytic tool provided by Clarivate Analytics for identifying the top-charting research in Web of Science (WoS)-indexed journals, is widely used to evaluate HCPs, providing information such as the countries/regions [ 3 , 4 ], institutes [ 5 ], and researchers [ 6 ], etc. ESI-HCPs, representing the top 1% in each of the 22 ESI subject fields, vary by fields and by years in a 10 years’ rolling. A paper is selected as a HCP only if its citation count exceeds the 1% citation threshold of the corresponding research fields and publication year.

Over recent years, a number of studies have been conducted on HCPs based on data from ESI [ 7 , 8 , 9 ]. For example, Ioannidis Boyack et al. surveyed the most-cited authors of biomedical research for their views on their own influential published work [ 9 ]. Aksnes found that HCPs are typically authored by a large number of scientists, often involving international collaboration [ 10 ]. Some studies even try to predict the HCPs by mathematical models [ 11 ], implying “the first mover advantage in scientific publication” [ 12 , 13 ]. That is, the first papers in a field will, essentially regardless of content, receive citations at a rate enormously higher than papers published later.

Bibliometrics, a term coined by Pritchard A [ 14 ], is a statistical method used to evaluate scientific development, determine research impacts, compare research performance and identify emerging fronts [ 15 , 16 ]. There have been many bibliometric studies on natural science or social science as a general field [ 17 , 18 ]. There have also been a few subject-specific ones on computer science [ 19 , 20 ], on applied linguistics [ 21 ], and on operations research and management Science [ 22 ]. In this regard, bibliometrics has been applied to summarize the development of a specific subject, generating valuable information such as the most cited publications/journals and the most frequently explored topics, etc. Such information is of great importance and interest to researchers as well as academic institutions and government/private agencies in making funding and science policy decisions. However, to our knowledge, there has not been one bibliometric study on the specific subject “ Radiology, Nuclear Medicine & Medical Imaging ” (RNMI) , a subject that covers resources on radiation research in biology and biophysics. Of the five broad research areas ( Arts & Humanities, Life Sciences & Biomedicine, Physical Sciences, Social Sciences, technology ) in Web of Science database, Life Sciences & Biomedicine has the most number of subject categorizations (76 in total), implying the complexity and richness as well as importance of this research line. As an important subject area in Life Sciences & Biomedicin e in response to the rapidly evolving healthcare industry, the research productivity in this RNMI has been tremendous. A thorough investigation of the existing literature especially the HCPs will help keep researchers informed about the state of the arts and research trends in this subject.

The purpose of this study is to spotlight the trends and hot topics in the subject category of Radiology, Nuclear Medicine & Medical Imaging with the bibliometric analysis of highly cited papers to help researchers get the most updated information in the future study.

A bibliometric approach was used in the present study to map the HCPs in RNMI in WoS. As one of the biggest bibliometric databases, WoS is the most frequently used database in bibliometric studies [ 23 ]. The methods for data retrieval are described as follows.

We searched in WoS Core Collection at the portal of the University library. We filtered the results by clicking the “ Highly Cited in Field ” trophy icon. We then downloaded all the bibliometric data for further analysis including publication years, authors and affiliations, publication titles, countries/regions, organizations, abstracts, citation reports, etc. After the removal of the publications with incomplete bibliometric information, a total of 1325 HCPs were harvested. The yearly publication distributions of the 1325 HCPs were shown in Figure S1 (Online Resource 1). The data retrieval was completed on 15 December, 2021. We collected the impact factor (IF) of each journal from the 2021 Journal Citation Reports (JCR).Table 1 shows the strategies of the retrieval queries.

Three points are to be mentioned here. First, the WoS Core Collection was searched because it boasts as an important bibliometric database which includes literature and citation information indexed in SCIE, SSCI and A&HCI. More importantly, it has been widely used in bibliometric analysis of previous studies both in natural sciences [ 24 , 25 ] and in social sciences [ 21 , 26 ]. Because RNMI belongs to the natural sciences, we restrict the index in SCI-expanded to retrieve the relevant data. Second, only articles and reviews are considered in HCPs selection. There is no need to restrict the document types in our search. Third, the dataset of ESI-HCPs is automatically updated every 2 months to include the most recent 10 years of publications. Therefore, only the papers in the recent decade will be counted as HCPs. There is no need to set the date range.

To identify the most influential papers, we ranked all the HCPs by the Relative Citation Rate (RCR), a new metric that uses citation rates to measure influence at the paper level [ 27 ]. Since the citation count a paper receives is closely associated with the number of years it is published, it is invalid to rank paper impact solely on Raw Citations (RC). Therefore, RCR, recently endorsed by the National Institutes of Health, has been employed here to pinpoint the most highly cited papers. RCR is based on weighting the number of citations a paper receives to a comparison group within the same field [ 28 ]. The icite tool is used here to generate RCR metrics for all the HCPs ( https://icite.od.nih.gov/ ).

Word frequency analysis based on corpus is a bibliometric method to identify hotspots and developmental trend of one domain. In this study, we built an Abstract corpus with all the abstracts of the HCPs. The n -grams (2–4) in the corpus were retrieved and analyzed to detect the most frequently researched topics in the HCPs. The procedures to retrieve the n-grams were described as follows. First, the abstracts of all the 1325 HCPs from the downloaded bibliometric data were saved in separate files in txt. Formats in one folder to create a mini abstract corpus with a total of 299,810 tokens. Second, Anthony’s AntConc, a freeware corpus analysis toolkit for concordancing and text analysis, was used to extract n-grams that include clusters of two to four continuous words [ 29 ]. AntConc is widely used in previous studies [ 16 , 21 , 26 ]. It automatically ranks all the retrieved n-grams in decreasing order. We also generated a list of individual nouns in case of missing some important topics. The reason to exclude the pronouns, modals and many other functional words is that research topics are usually phrases that do not contain these functional words. For topic candidacy, we adopt both frequency (10) and range criteria (10). That is, a candidate n-gram has to appear at least ten times and in at least ten different abstracts for further consideration. The frequency threshold ensures the significance of the candidate topics while the range threshold ensures the topics are not overly clustered in a limited number of papers. In this process, we actually tested the frequency and range thresholds several rounds for the inclusion of all the potential topics. In total, we got 521 nouns, 205 2 g, 39 3 g, and 5 4 g. Third, concerning the list of n-grams and monograms (nouns here), the authors discussed extensively to decide which should be taken as the potential research topics until full agreements were reached.

Besides the word frequency analysis based on the Abstract corpus, we performed knowledge mapping (i.e., network analysis) using VOSviewer ( www.vosviewer.com ), in which we focused on the network and “link strength” between author keywords. Knowledge mapping can be employed to map the scope and structure of the discipline while revealing key research clusters [ 30 ]. Since fractional counting approach assigns co-authored publications fractionally to each author, proper field-normalized results can be obtained [ 31 ]. Therefore, we used fractional counting in our analysis. This process produced the co-occurrence network of the most frequently used author keywords. Knowledge mapping of the author keywords was an important addition to the corpus based investigation of the abstracts.

Main publication venues of HCPs

The top 20 journals with more than 17 HCPs published are listed in Table 2 . They contributed around 80% of the total HCPs (1039/1325). The highest contribution comes from Neuroimage (207) , followed by Radiology (159) . They are also the only 2 journals with more than 100 HCPs, accounting for almost 30% of the total number of the HCPs, overwhelmingly exceeding the others on the list. As the only Q2 journal (between top 50% and top 25%) among the top five (the other four in the Q1, top 25%) by the Journal Citation Reports (JCR) quantile rankings, Neuroimage tops the list with certain surprise.

Because the total number of papers published in each journal varies greatly per year and the HCPs are also connected with journal circulations, we divide the total number of papers (TP) in the examined years (2011–2021) with the number of the HCPs to acquire the HCP percentage for each journal (HCPs/TP). As we can see, the top six journals with the highest percentage of the HCPs are Med Image Anal (2.91), IEEE T Med Imaging (2.83) , Radiology (2.67) , Neuroimage (1.91) , J Cardiovasc Magn Reson (1.91), JACC-Cardiovasc Imag (1.75). That implies that papers published in these journals have a higher probability to enter the HCPs list. In terms of the latest journal impact factor (IF) in 2021, the top five journals with the highest IF are JACC-Cardiovasc Imag (14.805), Radiology (11.105), J Nucl Med (10.057), IEEE T Med Imaging (10.048) and Eur J Nucl Med Mol I (9.236) . The number of the HCPs in these journals take up a large share of the total HCPs (over 30%), implying a close relationship between the journal IF and the number of the HCPs in the journal.

Countries distribution

The top 16 productive countries with more than 50 HCPs are presented in Fig. 1 . The USA took the lead with 707 HCPs (53.358%), confirming its leading position as a traditional scientific powerhouse in this subject, followed by Germany (20.302%) and England (19.623%). It is to be mentioned that only three Asian countries enter the top 16 list ( China, South Korea, Japan ). China even boasts the fourth position with 196 HCPs (14.792%). However, scholars from outside the traditional publishing countries need to be more visible for their work in RNMI.

Top 16 countries/regions with the most HCPs

Most influential papers by RCR

During the data processing, we found that the papers on COVID-19 published in the year of 2020 had extremely high RCR compared to papers on other subjects. As an unexpected global epidemic starting in late 2019, COVID-19 ignited research interests from all over the world especially in China where the epidemic was first reported. Many papers got quickly published and cited during this period in response to the urgent needs to find treatments. If we mix the papers, paying no attention to this public health incident, the COVID-19-related papers will take up 75% of the top 20 highly cited papers in terms of RCR (15/20), which was unfair for other non-COVID-19-related papers because of the distorted impact image. Therefore, we produced two lists of ranking: one for the non-COVID-19 papers in Table 3 and one for the COVID-19 papers in Table 4 . The yearly citation trends of each listed HCP can be seen in Figure S2 (Online Resource 2).

Table 3 shows some interesting patterns. First, 9 out of the top 20 HCPs were published in Neuroimage , which helps corroborate the findings on the main publication venues. Second, in terms of the document types, reviews (11) slightly outnumber articles (9), which may imply that reviews share the same amount of citation opportunities as the articles in the field of medical studies if not more. Third, three types of research orientations can be discerned from the top 20 HCPs: recommendations or guidelines (#1, 6, 11, 16, 18, 19); processing software (#2, 7, 9); analysis methods (#4, 5, 8, 12, 13, 15, 17, etc.).

The top ten highly cited papers on COVID-19 shows a different picture in Table 4 . 9 out of the top ten HCPs were published in Radiology , which once again testifies its popularity and importance in the field of RNMI . Ai tao ’s (2020) Correlation of Chest CT and …tops the list with RCR at 703.55, three times more than Roberto M Lang (2015) with RCR at 203.92, which shows the enormous attention paid to this unprecedented epidemic outbreak.

Most frequently explored topics

Table 5 presents the top 33 research topics above the observed frequency of 38. The observed frequency count for each topic in the abstract corpus is included in the brackets. Topics such as magnetic resonance imaging (325), deep learning (191), prostate cancer (162), chest CT (145), computed tomography (141), CT images (121), PSMA PET (119), coronavirus disease (115), convolutional neural network(s) (108) and FDG PET (100) were the top ten most frequently mentioned topics based on the corpus analysis of the abstracts. We grouped the topics into five broad categories, including devices, organs, artificial intelligence (AI), images, and others, according to topic relationships.

The first group is mainly about the imaging devices in the RNMI field including MRI (396) , CT (484) and PET (279) .

The second group concerns the human organs such as brains (250), prostate (162), heart (160), lungs (153), and breast (93) . Cancer-related phrases (prostate cancer, and breast cancer) were among the top list in frequency. For the brain, topics such as functional connectivity and white matter were more mentioned.

The third group are all related to AI technology ( artificial intelligence, deep learning, machine learning, convolutional neural networks, etc.).

The fourth group is about image information. Image quality is an important focus in MR/CT/PET scanning because it determines whether the images can been used or not. Imaging features can provide more information and are widely used in AI.

Topics in the last group constitute the core concepts in radiology. Radiation therapy is the most important treatment method for cancers. Especially when combined with MRI and CT, precise radiotherapy will be a promising alternative for cancer treatment in the future. As the method for assessing diagnosis performance of quantitative parameters, receiver operating characteristic (ROC) is also the main technology. Contrast agents is the important part of CT and MRI scans. Polymerase chain reaction is the gold standard in the detection COVID-19. It is no wonder that these topics enter the hot topic list because they are closely connected to the topics in other categories.

Author keywords analysis

A total of 2796 keywords were retrieved. We set the minimum number of occurrences of a keyword at 5. Then, 131 keywords meet the threshold. For each of the 131 keywords, the total strength of the co-occurrence links with other keywords were calculated. The top 15 keywords with the greatest total link strength were shown in decreasing order in Table 6 . VOSviewer classified the 131 keywords into 9 clusters, as shown in Fig. 2 . The link strengths for deep learning, covid-19, mri, machine learning, prostate cancer, computed tomography were 79, 74, 42, 40, 39, 39, respectively. The thickness of the lines which was determined by the frequency of the keywords in HCPs shows the link strength between the keywords.

The co-occurrence of author’s keywords

A comparison between the word frequency analysis of the Abstract corpus and the knowledge mapping of the author keywords shows similar research activities, which can be evidenced by the overlapping of the high frequent topics and the author keywords. These hot terms not only reflects the important research trends up to now, but also points the direction for future research in RNMI. For example, AI is gaining increasing popularity in the healthcare industry especially in handling a huge amount of patient data and recognizing complex disease patterns. In the future, AI-based technology is bound to unfold more hidden information from big data and inform healthcare policymakers and clinicians in making effective clinical decisions. Besides, considering the complex functioning of the human brain, the research is multidisciplinary in nature. Therefore, a collaboration across scientific disciplines will better reveal the intricacies of the human brains.

To our knowledge, this is the first comprehensive bibliometric study of Highly Cited Papers (HCPs) in the subject category of RNMI across the years spanning from 2011 to 2021. The results showed that Neuroimage, Radiology, IEEE T Med Imaging, J Nucl Med had the largest number of HCPs published, accounting for about 40% of the total 1325 HCPs. The traditional academic powerhouses in RNMI such as the USA, Germany and England are leading the publications while countries such as China and Italy are catching up. For the top 20 non-COVID-19 HCPs, 3 types of research orientations can be detected: recommendations or guidelines; processing soft wares; analysis methods . Reviews slightly outnumber articles in terms of document types. Among the top ten COVID-19 HCPs published in the year 2020, nine were published in Radiology, and chest CT was the most frequent used term in the paper titles.

It is interesting to find Neuroimage, the only Q2 journal in the top five, tops the list with the most HCPs. Research on human brains is increasing rapidly since the initiation of the WU-Minn Human Connectome Project in America in September 2010, aiming to map macroscopic human brain circuits and their relationship to behavior[ 32 ]. Many countries/regions follow the lead by starting their own brain projects, such as Human Brain Project in European Union, Brain/Minds in Japan, and Brain Science and Brain-Like Intelligence Technology in China. Therefore, topics such as functional connectivity, white matter, brain regions can be found (Table 5 ), reflecting the scientific enthusiasm in human brains. The surging research interest in brain functioning in the last decade across the globe stimulated more papers in related journals such as Neuroimage , especially after the initiation of the WU-Minn Human Connectome Project in September 2010. Besides, from January 2020, Neuroimage is an open access journal. Authors who publish in Neuroimage can make their work visible immediately, which might encourage more authors to contribute their work. It can be evidenced by more publications in Neuroimage in 2020 compared to those in previous years.

United States, Germany and England are undoubtedly the most impactful in the research area of RNMI. Historically, western countries, especially the United States, have been at the center of academic publishing, supported by huge investments in scholarly research and technical infrastructure. Besides, because the research in RNMI usually involves highly priced facilities such as MRI scanner, the developed countries with more resources clearly stand in a more advantageous position in research and publishing. It should be noted here that a HCP is usually the joint writing of multiple authors from different institutions and/or countries[ 10 ]. Web of Science will generate all the bibliometric information of the papers, not restricted to the information about the first author or the corresponding author. In other words, all the countries and institutions listed on the HCPs will be treated evenly. In this way, a clearer picture about the HCPs distribution across countries can be painted.

Scientific research has always been driven by practical needs. It comes with no surprise that Roberto M Lang ’s (2015) Recommendations for cardiac chamber quantification [ 33 ] … tops the list with RCR at 203.92. The quantification of cardiac chamber size and function is the cornerstone of cardiac imaging. Jointly written by the American Society of Echo cardiography and the European Association of Cardiovascular Imaging , Roberto M Lang ’s (2015) is the updated recommendations for cardiac chamber quantification that guide the echo cardiographic practice with sweeping popularity. Because COVID-19 was first reported in China, most of the studies during this period were conducted in hospitals or universities in China, which can be easily seen from the top ten HCPs list. Sana Salehi’s (2020) Coronavirus Disease 2019 (COVID-19)… stands as the only HCP among the top ten beyond China (in USA). From the titles, Chest CT emerges as one of the hottest phrases. The fact that most patients infected with COVID-19 had pneumonia and characteristic CT imaging patterns helps explain its frequent use.

A great overlap between the most frequently explored topics and author keywords is identified. The hot topics can be generally grouped into five broad categories: devices, organs, artificial intelligence (AI), images, and others . MRI is the most frequently mentioned phrase. Compared to CT which only shows signal attenuation and has ionizing radiation, MRI can obtain the multi-contract images without ionizing radiation, and is widely used in whole human bodies except the lung. Especially, in the human brain projects, MRI is the main device. However, CT showed greater values in the lung disease than MRI, which can be evidenced by frequent use of CT in the COVID-19 publications. The use of PET (positron emission tomography) scan along with CT in clinical practice increases side by side with publications in this regard which can be seen in such frequent topics as PET CT, PSMA PET, FDG PET . Moreover, the clinical value of PET with MR is also increasing proven. In the future, PET will be an important device in the field of nuclear medicine and radiology.

Besides brain, lung, prostate, heart, and breast are the most concerned organ. According to the World Health Statistics released in 2020, an estimated 41 million people worldwide died of NCDs (noncommunicable diseases) in 2016, equivalent to 71% of all deaths. Four NCDs caused most of those deaths: cardiovascular diseases (17.9 million deaths), cancer (9.0 million deaths), and chronic respiratory diseases (3.8 million deaths), and diabetes (1.6 million deaths) ( World health statistics 2020: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2020. ). Of different cancer types, breast cancer, lung cancer, and prostate cancer were the top three most prevalent cancers, according to the latest GLOBOCAN2020 report by the International Agency of Research on Cancer, part of World Health Organization.

In recent years, AI has been a hot theme of modern technology and is creeping into almost every facet of modern life including medical research. Up to now, AI has been actively used in medical images recognition, medical intelligent decision-making, medical intelligent voice, and “Internet plus” medical treatment. As one of the first specialty in healthcare to adopt digital technology, radiology is well positioned to deploy AI for diagnostics due to digital images [ 34 ]. Gulshan first reported that AI could automated detected diabetic retinopathy and diabetic macular edema from over 100 thousand retinal fundus photographs, with high sensitivity and specificity [ 35 ]. In 2017, Golden reported that AI can quickly read photos to diagnose breast cancer with lymph mode metastases, greatly improving the speed of diagnosis [ 36 ]. AI also played an important role in detecting COVID-19 [ 37 , 38 , 39 ]. In the future, AI is bound to exert greater influence on the medical field. For example, AI shows great promise in changing treatment models, promoting medicine development, reshaping the medical industry, and even impacting the career paths of the medical practitioners. It is believed that artificial intelligence will bring profound changes to future medical technology and will be a powerful driving force for future medical innovation and reform.

There are several points to be mentioned here as for the most frequently explored topics. Decisions regarding the candidate topics were not easy and involved subjectivity. It was the results of several rounds of discussions from multiple professionals. Some n-grams are discarded because they are too general or not meaningful topics in RNMI. For example, quantitative analysis, high sensitivity, imaging technique and medical image are too general to be included. By meaningful topics, we mean the n-grams can help journal editors and readers to quickly locate their interested fields, as the author keywords such as brain networks, MRI imaging, CT scans. Besides, the examination of the limited 3/4-g and monograms (nouns) revealed that most of them were either not meaningful topics such as cancer detection rate and patients with prostate cancer or they were topics already identified in the 2 g such as weighted MR imaging in MR imaging. Therefore, the final list is mostly 2-g topics.

It should be noted that large numbers of quantitative data have been used here to map the HCPs from different perspectives. Despite the quantitative nature, our study also involves qualitative analysis and hence subjectivity, especially concerning what constitutes the research topics and topic categorization. Given the rapid developments in RNMI, more bibliometric research is needed in the future to help test and enhance the validity and reliability of this research approach and to help keep us accurately informed about the trends in RNMI.

Our study also has some limitations. The subject category of Radiology, Nuclear Medicine & Medical Imaging listed in WoS Categories needs to be further broken down into subcategories and subjects in future analysis. A finer granular subject classification of the research area would have painted a more detailed picture. In additional, the study focuses on the apex of the publishing pyramid in RNMI, the HCPs. And the bibliometric indexes here are all based on the WoS SCI international journals. Although these are the most celebrated and accessible works, some other publications of similar importance or highly localized publications which do not have the chance to enter the list and are not indexed in WoS are not given due attention in our study. This less widely cited research is a rich vein for future study. At last, the study seems to show that the number of citations a review paper receives is higher than that of an original article in RNMI. Therefore, it might be more useful to distinguish the two types of papers in future method design.

In conclusion, our results of the bibliometric analysis provided the updated trends and hot topics in RNMI. And the practitioners and researchers in RNMI can be better aided to locate the relevant literature and keep informed about the hot topics.

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Acknowledgement

This study was funded by the grant from Humanities and Social Sciences Youth Fund of China, Ministry of Education (MOE) (Grant Number 20YJC740076)

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Supplementary file1 (TIF 720 KB) Fig. S1. The yearly publication distribution of the examined 1325 HCPs.

11604_2022_1268_moesm2_esm.tif.

Supplementary file2 (TIF 7093 KB) Fig. S2. The yearly citation distribution of the top 20 HCPs (non-COVID-19) and the top 10 HCPs (COVID-19)

About this article

Yan, S., Zhang, H. & Wang, J. Trends and hot topics in radiology, nuclear medicine and medical imaging from 2011–2021: a bibliometric analysis of highly cited papers. Jpn J Radiol 40 , 847–856 (2022). https://doi.org/10.1007/s11604-022-01268-z

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Published : 28 March 2022

Issue Date : August 2022

DOI : https://doi.org/10.1007/s11604-022-01268-z

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ACR unveils new AI quality assurance program for radiology practices

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The ACR Recognized Center for Healthcare-AI , launched this past week by the American College of Radiology, is touted as a first-of-its-kind quality assurance program for radiology facilities seeking to make use of artificial intelligence in their imaging workflows.

WHY IT MATTERS As radiology practices work toward and attest to the program's compliance goals, participation in ARCH-AI can help them implement safer and more effective AI products while helping radiologists provide better patient care, according to ACR – which lists recognition criteria such as establishing an interdisciplinary AI governance group and maintaining an inventory of AI algorithms with detailed documentation.

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Published: 02 July 2024

Radiology of fibrosis part II: abdominal organs

Sofia Maria Tarchi ORCID: orcid.org/0009-0001-4024-2667 1 , 2 ,
Mary Salvatore 2 ,
Philip Lichtenstein 2 ,
Thillai Sekar 2 ,
Kathleen Capaccione 2 ,
Lyndon Luk 2 ,
Hiram Shaish 2 ,
Jasnit Makkar 2 ,
Elise Desperito 2 ,
Jay Leb 2 ,
Benjamin Navot 2 ,
Jonathan Goldstein 2 ,
Sherelle Laifer 2 ,
Volkan Beylergil 2 ,
Hong Ma 2 ,
Sachin Jambawalikar 2 ,
Dwight Aberle 2 ,
Belinda D’Souza 2 ,
Stuart Bentley-Hibbert 2 &
Monica Pernia Marin 2

Journal of Translational Medicine volume 22 , Article number: 610 ( 2024 ) Cite this article

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Fibrosis is the aberrant process of connective tissue deposition from abnormal tissue repair in response to sustained tissue injury caused by hypoxia, infection, or physical damage. It can affect almost all organs in the body causing dysfunction and ultimate organ failure. Tissue fibrosis also plays a vital role in carcinogenesis and cancer progression. The early and accurate diagnosis of organ fibrosis along with adequate surveillance are helpful to implement early disease-modifying interventions, important to reduce mortality and improve quality of life. While extensive research has already been carried out on the topic, a thorough understanding of how this relationship reveals itself using modern imaging techniques has yet to be established. This work outlines the ways in which fibrosis shows up in abdominal organs and has listed the most relevant imaging technologies employed for its detection. New imaging technologies and developments are discussed along with their promising applications in the early detection of organ fibrosis.

This is the second instalment of a three-part series regarding the radiology of fibrosis across organs. This installment concerns abdominal organs, in particular, the pancreas, the liver, and the colon. The prior and subsequent parts of this series are respectively titled “Radiology of Fibrosis Part I: Thoracic Organs” and “Radiology of Fibrosis Part III: Urogenital Organs”. By structuring our work in this manner, we hope to have provided the readership with a clear image of a complex issue, paving the way for future betterment of clinical practice.

As discussed in the first third of this work, fibrosis is the aberrant process of connective tissue deposition resulting from complications in tissue repair following injury [ 1 ]. It can affect any organ and is responsible for chronic and debilitating structural and functional impairment of the affected tissue [ 2 , 3 ]. It has been estimated to account for up to 45% of all deaths in the industrialized world [ 4 ]. The profound implications of this datum—both in terms of quality of life and health care burden—argue the need for a more comprehensive understanding of wound healing, the chronic inflammation that may be borne of it, and the fibrosis that ensues. The wound healing mechanism is four-fold and comprises the following: hemostasis, inflammation, proliferation, and remodeling [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Pathological response to tissue damage may determine an undue protraction of this process resulting in chronic inflammation, aberrant fibroblast proliferation, exaggerated collagen deposition, and a sequent imbalance in the alternation between scar formation and remodeling [ 3 , 5 ]. Today, chronic inflammation-related fibrosis is widely accepted to be a critical instigator of tumor insurgence, believed to be associated with up to 20% of cancers [ 2 ]. The evident gravity of such an assertion highlights the need for a more in-depth knowledge of the interconnectedness of wound healing and fibrosis to encourage subsequent research into cancer insurgence and prevention.

While extensive research has already been carried out on the topic, a thorough understanding of how this relationship reveals itself using modern imaging techniques has yet to be established. Considering the far-reaching implications research furtherance in this field may have—starting from more early and accurate diagnosis—and with the aim of exploring and expanding upon all relevant knowledge, in this work, we have attempted to outline the ways in which fibrosis shows up in the pancreas, liver, and intestines; and have described the most relevant imaging technologies employed for its detection.

Pancreatic fibrosis

Mechanism of injury.

Pancreatic fibrosis is a hallmark of chronic pancreatitis (CP), defined as the irreversible fibrotic destruction of pancreatic architecture and function [ 15 , 16 , 17 ]. The disorder occurs due to recurrent bouts of acute pancreatitis, often progressing to chronic epigastric pain [ 15 ]. Annual incidence is low, ranging from 5 to 12/100,000 US adults, and treatment options are limited to lifestyle modifications, pain management, and surgery in case of advanced stage disease [ 15 , 18 ]. CP’s etiology is multifactorial, having been linked to both genetic and environmental risk factors [ 15 , 19 ]. The disorder’s evolution in time is tripartite, starting with cellular injury, followed by inflammation, and culminating in fibrosis [ 19 ]. Cited environmental determinants include alcohol abuse and nicotine addiction [ 16 ]. Studies have shown how the metabolic end products of alcohol’s oxidative and nonoxidative pathways, acetaldehyde and fatty acid ethyl esters, in addition to smoking’s metabolite nitrosamine ketone—derived from nicotine enact direct deleterious effects on pancreatic acinar cells leading to their excessive stimulation of pancreatic stellate cell activity [ 16 , 19 ]. Similarly, pathologic alterations to one’s genetic makeup have been found to determine cellular dysfunction in the form of increased endoplasmic reticulum stress, oxidative stress, and impaired autophagy, as well as through the pathological alteration of the pancreatic ductal cells’ secretion of bicarbonate [ 19 ]. Cell injury and death result in inflammation, initiated by NF-κB and perpetuated by innate immune cells, predominantly macrophages [ 17 , 19 ]. When excessively prolonged, this physiological response to pathological stimuli leads to excess deposition of extracellular matrix (ECM) and tissue remodeling, ultimately resulting in interlobular and intralobular fibrosis, acinar cell loss, distorted architecture, dilated ducts, and loss of function [ 18 , 19 ]. When 90% of pancreatic activity is compromised, patients present with signs of exocrine and endocrine insufficiency: steatorrhea, malabsorption, fat soluble vitamin deficiencies, and the development of diabetes mellitus type 2 [ 15 , 17 ].

The diagnosis of pancreatic fibrosis is challenging, relying solely on clinical anamnesis and imaging findings [ 15 , 20 ]. To date, the most relevant imaging techniques comprise trans-abdominal US, endoscopic US (EUS), endoscopic retrograde cholangiopancreatography (ERCP) (considered the diagnostic gold standard tool for pancreatic ductal investigation), computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), MRCP with secretin stimulation (S‐MRCP), and Elastography [ 15 , 20 , 21 ].

Ultrasound (US)

Conventional transabdominal gray-scale B-mode US is often the first radiological assessment performed to evaluate the pancreas given its great availability, low cost, and lack of ionizing radiation [ 21 , 22 , 23 ]. While US is seldom useful in early-stage detection of CP, common pancreatic parenchymal findings later in the disease process include increased gland dimensions, altered echogenicity with mixed areas of hyperechogenicity (representing fibrotic tissues and pancreatic calcification) and hypoechogenicity (representing inflammatory tissues), dilatation and irregularity of the pancreatic duct [ 21 , 23 , 24 ]. Use of transabdominal US may be limited by the retroperitoneal location of the gland [ 22 ]. Overlying bowel gas shadows often cause partial or complete obscuration [ 21 , 23 ]. Image quality is heavily dependent on patient body habitus and the radiologist’s skill [ 21 , 23 ].

US’ limitations relative to patient body build and gaseous abdomen are overcome by endoscopic ultrasound (EUS) [ 21 , 22 , 23 ]. EUS is a common diagnostic tool for CP because of its superior spatial resolution, helping to evaluate subtle morphologic changes in the pancreatic parenchymal structure and allowing for early-stage diagnosis of pancreatic fibrosis [ 15 , 20 , 21 , 23 , 24 , 25 ]. Indeed, placement of high-frequency transducers in close proximity to the pancreas increases resolution allowing for improved imaging [ 21 , 23 ]. This technology has been reported to have high sensitivity (81–97%), specificity (60–90%), and diagnostic accuracy [ 15 , 20 , 21 ]. Drawbacks of EUS are its considerable intra- and interobserver variability and considerable false positivity rate given that some findings may occur normally with aging, in smokers and in alcoholics [ 21 , 23 ]. Furthermore, this modality is invasive and presents a non-negligible risk of postprocedural complications [ 24 ].

As in all fibrosis affected tissues, stiffness elevation is a determining characteristic of pancreatic fibrosis and, consequently, could be quantified via the elasticity-based imaging technologies such as USE [ 21 , 22 , 26 , 27 ]. USE is a noninvasive and real-time US based elastography technique which helps to quantitatively measure the stiffness of a tissue to assess fibrosis of the pancreas in CP [ 21 , 22 , 25 , 26 , 28 ]. USE can be classified into two categories: strain elastography (SE) and shear-wave elastography (SWE) [ 20 , 21 , 25 ]. In USE-SE, the strain created by compression of the target tissue with the US probe is measured: a larger strain indicates softer tissue [ 20 , 25 ]. In USE-SWE, instead, an acoustic radiation force is sent to a focal point within the tissue and a shear wave is generated [ 20 , 21 , 25 ]. Consequently, the shear wave velocity is calculated: if the tissue is hard, the shear wave propagates faster [ 25 ]. Both SWE and SE yield elastograms, which are colored elasticity maps superimposed onto tissue images, although USE-SWE is the more precise modality for diagnosing CP because it can provide absolute values of pancreatic hardness [ 21 , 25 ]. USE is currently considered to be the most sensitive—71% to 91%—and specific—86% to 100%—modality for diagnosing CP [ 26 , 27 ]. Even so, it presents inadequate standardization in mode of execution, evaluation, and choice of terminology inducing discord among professionals [ 20 , 26 ]. Moreover, it has also been found to have limited reliability in patients who smoke, abuse alcohol, are obese, and in the elderly [ 20 , 27 ].

Computed tomography (CT)

Contrast-enhanced CT (CE-CT) is the preferred imaging technique in case of suspected chronic pancreatitis given its non-invasivity and ubiquity, providing highly resolute images within seconds, with high sensitivity and specificity [ 15 , 20 , 22 , 24 , 25 , 29 ]. While its detection of early structural CP related fibrotic changes is not reliable, this technology has been reported to have high sensitivity (60‐95%), specificity (85–91%), and diagnostic accuracy later in the disease [ 15 , 20 , 21 , 23 , 25 ]. Multiphase protocol is now commonly used in the assessment of pancreas [ 21 ]. It includes a precontrast unenhanced sequence to identify calcifications, a pancreatic or late-arterial phase to assess arterial complications, and a portal venous phase to evaluate the parenchyma, pancreatic duct, focal lesions, pancreatic masses or complications from pancreatitis [ 21 , 25 , 30 ]. This method allows for the detection of morphological alterations, such as pancreatic ductal calcifications (pathognomonic findings of chronic pancreatitis), dilation of the main pancreatic duct and side branches secondary to traction from periductal fibrosis, altered size and shape of the gland, pseudocysts, pseudoaneurysms, vascular thrombosis, necrosis, and parenchymal atrophy [ 15 , 22 , 23 , 24 , 25 , 30 , 31 ]. The main drawback to the application of CE-CT is the radiation exposure to which patients are subject, especially since this chronic disease state often calls for serial monitoring [ 20 , 22 ]. When CT results are inconclusive, magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), EUS, and endoscopic retrograde cholangiopancreatography (ERCP) may be used [ 15 ].

MRI is an alternative imaging modality for those in whom CT or ERCP is contraindicated or not tolerated [ 32 ]. Indeed, it is a non-invasive method for the early recognition of pancreatic fibrosis having excellent soft-tissue contrast, with high sensitivity (78%) and specificity (96–100%) [ 15 , 20 , 21 , 24 , 32 ]. MRI’s main drawback consists of its high cost [ 20 ]. Due to the high content of proteinaceous enzymes, the normal pancreas typically appears diffusely hyperintense on T1-weighted images [ 21 , 22 ]. In CP, chronic inflammation and fibrotic replacement of parenchyma diminish the proteinaceous fluid content of the pancreas resulting in heterogenous hypointense areas on T1-weighted imaging and heterogenous and mildly hyperintense on T2-weighted images with diminished and heterogenous parenchymal enhancement after administration of intravenous gadolinium agents [ 22 , 23 , 25 , 30 , 32 , 33 , 34 ].

MRCP is the most effective, safe, noninvasive MR imaging technique for the evaluation of the pancreatic parenchyma, main pancreatic, and common bile ducts [ 15 , 21 , 22 , 23 , 25 ]. It presents with high sensitivity (78%), specificity (96%), and diagnostic accuracy [ 21 ]. It only makes use of nonionizing radiation and for this reason it is increasingly used in the diagnosis of CP [ 15 , 23 , 25 , 30 ]. MRCP is the preferred alternative to ERCP in patients for whom this imaging modality has failed or is not tolerated [ 21 , 32 ]. Even so, the typical calcifications in chronic pancreatitis are not visualized as effectively as on CT and the evaluation of side branches is less sensitive than in ERCP [ 15 , 30 ]. Addition of secretin enhancement to MRCP (S‐MRCP) can improve morphological and functional assessment of abnormalities of the main pancreatic duct and its side branches, which may not be seen on routine MRCP [ 21 , 22 , 23 , 25 , 30 , 32 ]. Secretin is a polypeptide amino acid which is normally secreted by the S cells of the duodenal mucosa and can be synthetically purified [ 21 , 22 ]. Its physiological effects include stimulation of the pancreas to secrete fluid and bicarbonate from acinar cells into the duodenum, thus increasing the absolute volume of intraductal free water and filling the collapsed branches [ 21 , 22 , 23 , 25 ]. Additionally, secretin increases the tone of the sphincter of Oddi, thus hindering the release of this accumulated fluid through the papilla of Vater, and making it easier to distinguish the main pancreatic duct and its branches [ 23 , 25 ]. In S‐MRCP, pre‐secretin images are obtained before the polypeptide is injected intravenously after which a series of T2‐weighted images are acquired [ 21 , 23 ]. In cases of CP, a lack of ductal compliance results in dilated side branches [ 21 ]. By injecting intravenous secretin, MRI can also diagnose chronic pancreatitis by evaluating exocrine secretion response [ 24 ]. Even so, S-MRCP lacks proper analysis of parenchyma, thus limiting its use [ 20 ]. Axial and coronal T2 weighted MRI and MRCP images of a liver affected by CP are reported in Fig. 1 . Note how hypointense the pancreatic signal is on T2, the tortuosity of the main pancreatic duct, and its numerous prominent side branches.

MRI (coronal T2 and axial) and MRCP from two patients with crhonic pancreatitis, showing T2 hypointense pancreatic signal (red arrow), tortuosity of the main pancreatic duct (blue arrow), and numerous prominent side branches (green arrows)

ERCP is a combined endoscopic and fluoroscopic procedure mainly used in the diagnosis of early CP with high sensitivity (71–95%), specificity (89–100%), and diagnostic accuracy [ 15 , 21 , 25 , 29 ]. For these reasons, it is currently considered the diagnostic gold standard tool for pancreatic ductal investigation. It has great spatial resolution and the ability to depict side branch abnormalities, characteristic of early disease [ 25 , 32 ]. In ERCP, an endoscope is advanced into the second part of the duodenum, thus allowing other tools to be passed into the biliary and pancreatic ducts via the major duodenal papilla [ 29 ]. Contrast material injected into these ducts, allows radiologic visualization of pancreatic duct abnormalities—ductal dilation, stricture, abnormal side branching, communicating pseudocyst, pancreatic duct stone, and pancreatic duct leakage—and therapeutic intervention—dilation for pancreatic duct stenosis, stone extraction, and stenting of the pancreatic duct [ 25 , 29 , 32 ]. This technique is, however, the most invasive of the diagnostic modalities for CP, only allows for visualization of duct anatomy and not that of pancreatic parenchyma, and is associated with a high risk of complications [ 15 , 23 , 24 , 25 ]. The possibility for adverse events directly attributed to ERCP is as high as 6.8% and include post-ERCP pancreatitis, infections, gastrointestinal bleeding, duodenal and biliary perforations [ 25 , 29 ]. For all these reasons, ERCP should be performed only when all other tests are inconclusive [ 15 , 25 ].

Future directions

Promising future techniques, benefits, and drawbacks of each imaging technique discussed above are summarized in Table 1 . Among the proposed alternatives, the authors of this review believe MRCP (Fig. 1 ) and USE to be the most promising. Indeed, USE is currently considered to be the most sensitive—71% to 91%—and specific—86% to 100%—modality for diagnosing CP provided that standardization in mode of execution, evaluation, and choice of terminology be enacted [ 20 , 26 , 27 ]. USE is a noninvasive and real-time US based elastography technique which helps to quantitatively measure the stiffness of a tissue, a determining characteristic of pancreatic fibrosis [ 15 , 21 , 22 , 25 , 26 ]. Both USE sub modalities—SWE and SE—yield elastograms, which are colored elasticity maps superimposed onto tissue images to help locate fibrotic areas [ 20 , 21 , 25 ]. Instead, MRCP presents with high sensitivity, specificity, and diagnostic accuracy [ 21 ]. It only makes use of nonionizing radiation and for this reason it is increasingly used in the diagnosis of CP [ 15 , 23 , 25 , 30 ]. Addition of secretin enhancement to MRCP (S‐MRCP) can improve morphological and functional assessment of abnormalities of the main pancreatic duct and its side branches, which may not be seen on routine MRCP [ 21 , 22 , 23 , 25 , 30 , 32 ].

Liver fibrosis

Chronic liver disease (CLD) is characterized by progressive deterioration of liver function due to persistent inflammatory response, parenchymal injury and regeneration leading to abnormal wound healing and, ultimately, liver failure [ 35 , 36 , 37 ]. CLD etiology is varied and determines the patterns of liver fibrosis [ 35 , 37 ]. Among the most notable causes are toxins, excessive alcohol consumption, viral and autoimmune hepatitis, as well as genetic and metabolic disorders [ 35 , 37 ]. Since the end of the last century, the incidence of CLD has undergone a 62.03% increase worldwide. In line with this datum is the CDC’s estimates of the number of American adults affected by CLD being 4.5 million, about 1.8% of the population, making it of great clinical relevance [ 36 , 38 ]. The aberrant accumulation of ECM that follows CLD onset is triggered by injured hepatic stellate cells (HSC) and inflammatory cells’ paracrine stimulation which induces rapid gene conversion of quiescent HSCs into proliferative myofibroblasts [ 35 , 37 , 38 ]. This fibrotic response is perpetuated by cellular events that amplify the activated phenotype through enhanced growth factor expression leading to fibrous scar formation [ 39 ]. Only the withdrawal of injury-causing stimuli can promote the spontaneous resolution of hepatic fibrosis, otherwise, CLD can progress into cirrhosis, a pre-malignant condition that may ultimately lead to hepatocellular carcinoma [ 35 , 37 , 39 ]. Through senescence and apoptosis, the levels of cytokines and myofibroblasts lowers, triggering, in turn, the start of fibrotic regression by decreasing the levels of tissue inhibitors of metalloproteinase (TIMPs) and by increasing the levels of matrix metalloproteinases (MMPs) [ 35 , 39 ]. In so doing, TIMPs are kept from inactivating collagenases and exercising their antiapoptotic influence on stellate cells, while MMPs’ type I collagenase activity is encouraged to effectively cleave collagen and other matrix components [ 35 , 39 ]. When withdrawal of injury-causing stimuli is not possible, persistent fibrosis leads to remodeling of the hepatic parenchyma and development of a shrunken nodular contour, detectable via imaging and pathology [ 35 , 36 ].

Traditionally ultrasound—one of the most common and affordable techniques—and CT—more precise than the previous—have been used to assess the presence of fibrosis in the liver, focusing on gross morphological changes of the organ’s architecture [ 38 , 40 ]. Unfortunately, these methods do not allow for detection of less advanced stages of fibrosis [ 40 ]. A need which is, instead, met by transient elastography (TE) and magnetic resonance elastogragphy (MRE), the most widely used novel hepatic fibrosis assessment methods in Europe [ 38 , 40 ]. They are rapid, noninvasive, and reproducible [ 40 ]. TE and MRE measure the velocity of a mild amplitude and low frequency (50 Hz) elastic shear wave travelling through the liver [ 38 , 40 ]. The wave speed is measured and used to approximately quantify tissue stiffness: the faster the wave, the stiffer the tissue [ 38 ]. It has been estimated that these novel imaging techniques eliminate the need for liver biopsy in up to 70% of patients as well as allowing for early detection of reversible liver fibrosis, thus greatly reducing morbidity and mortality [ 40 , 41 , 42 ]. It is important to note, however, that increased liver stiffness is not always a satisfactory proxy for fibrosis [ 40 ].

When withdrawal of injury-causing stimuli is not possible, persistent fibrosis leads to remodeling of the hepatic parenchyma and development of a shrunken nodular contour, detectable via imaging and pathology [ 35 , 36 ]. Traditionally US, MRI, and CT have been used to non-invasively diagnose and stage hepatic fibrosis, focusing on gross morphological changes of the organ’s architecture [ 40 , 43 ]. However, it has been found that these methods do not allow for reliable detection of less advanced stages of fibrosis [ 40 ]. A need which is, instead, met by US and MR elastography [ 38 , 40 , 43 ]. Other diagnostic methods include diffusion weighted imaging, MRI with hepatobiliary contrast agents, MR and CT perfusion, dual energy CT, contrast-enhanced US (CEUS), image texture analysis, and Magnetization transfer imaging [ 43 , 44 , 45 , 46 ]. It has been estimated that these novel imaging techniques eliminate the need for liver biopsy in up to 70% of patients as well as allowing for early detection of reversible liver fibrosis, thus greatly reducing morbidity and mortality [ 40 , 41 , 42 ].

In patients with suspected CLD, liver US is the first modality employed, because it is widely available, ionizing radiation-free, and less expensive than its alternatives [ 38 , 45 , 47 ]. US findings that suggest fibrotic disease include coarse surface nodularity and increased parenchymal echogenicity [ 45 , 48 ]. In the early stages of CLD, however, these findings present with low sensitivity and specificity [ 45 ]. Indeed, other conditions, such as steatosis may also lead to brighter image acquisition, resulting in a potential for confusion [ 48 ]. Finally, obesity reduces the accuracy of US due to increased attenuation of signal by subcutaneous fat [ 48 ].

In time, USE has become the leading US-based alternative to basic US for the detection and staging of liver fibrosis [ 40 , 47 , 50 , 53 , 56 ]. The impulse’s sheer wave velocity and resultant tissue displacement is dependent on tissue elasticity which has been found to decrease with increasing fibrosis [ 48 , 49 , 50 ]. Thus, elastography techniques quantify increased tissue stiffness as proxy for fibrosis, even in early stages [ 47 , 49 , 50 , 57 ]. USE is currently the most widely used noninvasive means of quantifying hepatic fibrosis [ 40 , 51 ]. It may be subdivided into vibration-controlled TE (VCTE), point sheer wave elastography (pSWE), and two-dimensional SWE (2D-SWE) [ 41 , 49 , 50 ].VCTE is a one-dimensional technique that uses a mechanical driver to generate a low-frequency sheer wave whose velocity across the liver parenchyma is measured using sonographic Doppler [ 38 , 40 , 49 , 50 ]. Intraobserver agreement for VCTE is excellent having high repeatability and reproducibility and requiring little dedicated training time [ 49 , 50 ]. It has demonstrated high accuracy for advanced fibrosis; however, diagnostic performance is more modest in case of lesser degrees of fibrosis [ 49 , 50 ]. Furthermore, this technology is subject to several technical and patient-related limitations. Indeed, technical failure rate increase in the presence of confounders such as acute inflammation, narrow intercostal space, ascites, increased steatosis, and obesity [ 49 , 50 ].

In pSWE, a high frequency sonographic impulse generates a single push pulse into a focal point in the liver [ 49 , 50 ]. This shear wave’s velocity is measured via conventional pulse echo US [ 38 , 50 ]. Interpretation of pSWE is aided by incorporation into a standard B-mode US device which allows the operator to visualize the liver tissue [ 50 ]. Instead, in 2D-SWE, a high frequency sonographic impulse generates shear waves at multiple points, producing a cone-shaped shear wave front which is monitored in real-time at multiple spatial and temporal points using 2D US waves and is ultimately depicted as a colorized elasticity map known as an elastogram [ 49 , 50 ]. In general, SWE presents with good interobserver variability (greater in 2D-SWE), as well as excellent repeatability and reproducibility having low scan failure rate following an initial learning curve [ 49 , 50 ]. Despite recent evidence showing high diagnostic accuracy for diagnosing advanced fibrosis stages, they do not perform as well in case of lower liver fibrosis [ 50 ]. Both are susceptible to motion and, thus, require breath holding [ 50 ].

Conventional no-contrast-medium CT scans have been found to be useful in assessing morphological liver changes—stage, extent, and distribution of fibrosis—with positive correlation between histological and CT findings depending on the homogeneity of the fibrosis distribution [ 45 , 51 , 52 ]. Radiographic density on CT full-liver analysis allows for more highly accurate and precise diagnosis of fibrosis than in US [ 38 , 48 , 51 , 52 ]. However, the use of ionizing radiation confers increased patient risk to this technique, making it less suited for repeated measurements [ 48 ]. Similar to US, CT is less sensitive for less advanced stages of liver fibrosis [ 45 , 51 ].

This same shortcoming is presented by conventional MR imaging as the presence of hepatic fibrosis generally causes little anatomic change in the liver until late in the disease [ 45 , 51 , 53 ]. In attempts to more reliably stage hepatic fibrosis, mapping of T1 relaxation time, which has been found to be positively correlated to increased levels of ECM, inflammation, and fibrosis, may be adopted [ 48 ]. Indeed, by comparing histological data to hepatic T1 mapping, Pavlides et al. were able to determine optimal T1 cut-off values and create a liver inflammation and fibrosis staging score with which to classify hepatic fibrosis [ 48 , 54 ]. Further research is needed to validate this scoring system [ 48 ]. In Fig. 2 , hepatic bands of fibrosis can be seen on a post contrast T1 weighted axial MRI image with fat suppression.

Axial T1 Weighted post contrast sequence with fat suppression demonstrates hepatic fibrotic bands

Along with morphological T1 mapping, several alternative MRI-based imaging techniques have been developed [ 55 ]. These include texture analysis MRI, spin–lattice relaxation time mapping in the rotating frame (T1q), diffusion-weighted imaging, perfusion MRI, and the use of hepatobiliary contrast agents, for all of which, studies have demonstrated a clear correlation to increased liver fibrosis [ 53 , 55 ].

Among these alternative MRI-based imaging techniques, MRE has emerged as a leading non-invasive, objective, and quantitative alternative method for the detection and staging of liver fibrosis [ 40 , 47 , 50 , 53 , 56 ].

It is considered the most accurate noninvasive imaging technique for detecting and staging liver fibrosis [ 40 , 51 , 53 ]. It may be subclassified into two-dimensional MRE (2D-MRE), currently the gold standard for hepatic fibrosis detection, and three-dimensional MRE (3D-MRE) [ 50 ]. In 2D-MRE, an external acoustic driver system generates low-amplitude vibrations [ 38 , 40 , 47 , 50 , 53 ]. Resultant shear waves propagate in a largely transverse manner, allowing analysis of wave motion by MR sequences to be carried out only in a single 2D plane [ 38 , 48 , 50 , 53 ]. The acquired wave images are post-processed to generate a color-scaled representation of tissue stiffness known as an elastogram [ 50 , 53 ]. By examining a wider portion of liver in comparison to that examined by USE, MRE appears more accurate and is less prone to sampling error, ultimately producing more representative maps of liver stiffness [ 47 , 48 , 49 ]. Technical failure is rare (≤ 5%) and is mostly determined by the presence of excess iron in liver parenchyma [ 49 , 50 , 53 ]. Indeed, iron causes T2 shortening and signal loss, which diminishes the visibility of shear waves on phase contrast images [ 50 ]. Furthermore, being a motion-sensitive technique, a fraction of the failure rate is due to motion artifacts [ 50 ]. 2D-MRE benefits from robust repeatability and reproducibility between radiologists, it calls for an extremely short acquisition time (1–2 min) and can be included in any standard MRI exam of the liver [ 47 , 49 , 50 , 53 ]. Even so, it is not yet recommended in routine clinical practice given its cost, limited availability, and a minority of patients’ inability to tolerate MR exams due to claustrophobia, inability to fit into the MR scanner bore, or having been implanted with MR-incompatible devices [ 47 , 50 ]. Instead, 3D-MRE is an emerging imaging modality, mainly used in research settings, which carries out analysis of wave motion in a 3D volume rather than in a single 2D plane [ 50 ]. Although they have been demonstrated to be more accurate in predicting advanced fibrosis than 2D-MRE, further validation is required prior to recommending it for routine clinical use [ 49 , 50 ]. Finally, the diagnostic performances of elastography techniques are set to be maximized by artificial intelligence in the near future [ 47 ]. In fact, this technology promises to achieve high diagnostic performance and high accuracy for the prediction of fibrosis stages, largely outperforming radiologists [ 47 ]. In Fig. 3 , tissue displacement subsequent to harmonic shear wave induction is depicted. Areas in which wavelengths are longer correspond to stiffer areas. This wave data is then converted into a shear stiffness elastogram In Fig. 4 , an example of such an elastogram in which areas of highest liver stiffness measurements appear red and yellow is provided.

Liver MR elastography examination. Red and yellow areas represent highest liver stiffness measurements within the right hepatic lobe consistent with fibrosis

Shear wave image demonstrates waves that are thicker than normal. This is because they move more quickly through the stiffer, fibrotic liver parenchyma

Promising future techniques, benefits, and drawbacks of each imaging technique discussed above are summarized in Table 2 . Among the proposed alternatives, the authors of this review believe AI supplemented 3D-MRE to be the most promising. Indeed, preliminary data has shown 3D-MRE – an emerging imaging modality which carries out analysis of wave motion in a 3D volume rather than in a single 2D plane – to be more accurate in predicting advanced fibrosis than 2D-MRE [ 49 , 50 ]. Furthermore, the diagnostic performance of such elastography techniques is set to be maximized by AI in the near future [ 47 ]. The pairing of these technologies promises to achieve high diagnostic performance and high accuracy for the prediction of fibrosis stages, largely outperforming human radiologists [ 47 ].

Intestinal fibrosis

Intestinal fibrosis can develop from several conditions, including chronic ischemic enteritis, radiation enteritis, cystic fibrosis and, most importantly, inflammatory bowel diseases (IBD). IBD, comprising Crohn’s disease (CD) and ulcerative colitis (UC), consists of an exaggerated, recurrent inflammatory response to bowel injury leading to disorganized ECM deposition [ 58 , 59 , 60 , 61 ]. Ultimately, CD and UC’s protracted course of relapse and remission leads to bowel damage, weakened barrier function, and disability [ 58 , 61 , 62 , 63 ]. Its prevalence, while increasing worldwide, was estimated to be more than 3 million in the USA and Europe by a 2017 Global Burden of Disease Study [ 61 , 62 , 64 ]. Prevalence is greatest among industrialized nations and metropolitan areas [ 61 ]. However, low-risk regions have experienced a marked surge in IBD rates, in concordance with their development and adoption of traditionally “western” lifestyles, thus implicating environmental factors in CD and UC pahtophysiology [ 61 ]. The most studied of these influences are cigarette smoking, associated with a two-fold increase in CD risk, and dietary imbalance, in particular, a reduction in dietary fiber and an increase in saturated fat intake leading to dysbiosis [ 61 ]. Additionally, more that 200 allelic mutations have been found to be positively associated with IBD incidence [ 61 , 63 ]. Even so, only 13% of the disease’s transmission can be explained this way, emphasizing once more environmental determinants’ role in CD and UC development [ 60 , 61 , 63 ]. Clinically, CD manifests with abdominal pain, chronic diarrhea, weight loss, and typically segmental and transmural gastrointestinal (GI) inflammation [ 58 , 61 , 62 ]. The excess secretion of ECM in intestinal fibrosis is made possible by intestinal mesenchymal cell expansion [ 59 , 62 ]. Primarily that of fibroblasts, myofibroblasts, and smooth muscle cells [ 62 ]. Immune cells contribute to these fibrotic processes by secreting IL-17A and IL-13 cytokines [ 62 ]. These augment mesenchymal cell activation, thus promoting scar formation through positive feedback loops [ 62 ]. In particular, IL-17A is found to be upregulated in the mucosa and lamina propria of CD patients [ 62 ]. Myofibroblasts upregulate their receptors for these proteins, resulting in their reduced migratory ability as well as increased ECM production [ 62 ]. Similarly, IL-13, Th-2 cells’ most potent fibrogenic mediator, facilitates ECM deposition through increased TGF-β1 secretion [ 62 ]. Furthermore, a sharp downregulation of matrix metalloproteinases (MMPs), enzymes meant to degrade deposited ECM, and overexpression of TIMPs, MMP inhibitors, further favors uncontrolled ECM synthetization [ 58 ]. Abnormal wall thickening and contraction ultimately lead to tissue distortion and increased stiffness [ 60 , 62 ]. This may take place at any time during IBD progression and occurs at equal rate in all segments of the gut [ 60 , 62 ]. The most common clinical sequelae of intestinal fibrosis, occurring in more than half of all CD patients within 10 years of diagnosis, are strictures, abscesses, and fistulae, predominantly in the terminal ileum and the ileocolonic region [ 58 , 61 , 62 ]. In turn, these cause bowel obstruction, requiring anti-inflammatory, endoscopic, and/or surgical relief [ 62 ]. Secondary to intestinal obstruction, patients experience muscularis propria hypertrophy, which results in peristaltic abnormalities [ 60 ]. CD diagnosis relies on a combination of clinical, imaging, histological, blood, and stool findings [ 65 , 66 ]. Choosing which of these strategies to put in place depends on the patient's age, pregnancy status, general health, and availability [ 67 ].

The current gold standard imaging technique is endoscopic evaluation via ileo-colonoscopy [ 65 , 66 ]. This procedure is widely available and well tolerated among patients despite its invasiveness [ 65 , 68 ]. It allows for direct inspection of the GI lumen, facilitating physicians in identifying common lesions and overseeing treatment progression [ 67 ]. Endoscopically, CD may manifest as mucosal nodularity, swelling, ulceration, and narrowing [ 66 ]. However, while the vast majority of those affected by IBD will have colonoscopically detectable sequalae, this technique cannot ensure satisfactory imaging of extraluminal and intramural inflammation, the small intestine—the most commonly affected segment of the GI tract—or the intestine beyond a stricture [ 65 , 66 , 68 ]. Moreover, interobserver variability, the risk of bowel perforation, the need for bowel preparation, and the occasional need for anesthesia comprise some of endoscopy’s major limitations [ 65 ]. For all these reasons, CD complications are often best identified via small bowel imaging techniques, the most popular of which are US, CT, and MRI [ 66 , 68 ]. These allow for the identification and examination of pathology not accessible through ileo-colonoscopy [ 67 ]. Other promising technologies are transabdominal USE, CEUS, DWI, and magnetization transfer MRI (MT-MRI). US is recommended as a first-line test for the assessment of inflammatory lesions and long-term follow-up of CD given its non-invasivity, lack of ionizing radiation, increased availability, relatively low cost, and real-time capabilities [ 65 , 68 , 70 ]. It has proven to be as sensitive and specific as MR, CT, and endoscopy for detecting IBD [ 65 ]. Even so, it is highly operator-dependent, limited by disease location and patient body build, with limited reproducibility and generalization [ 68 ].

Transabdominal USE is a promising real-time bowel imaging technique. It has been designed to indirectly assess bowel fibrosis in CD through the direct evaluation of intestinal wall stiffness. Its main drawback is given by its operator dependent nature as well as its poor performance on deep bowel loops [ 69 , 70 , 71 ]. There are two main elastographic subtypes: US-SE and US-SWE [ 70 ]. In US-SE, an external force applied to a fixed area of the tissue under investigation evokes a strain, the measurement of which allows for the estimation of tissue stiffness [ 68 , 70 , 71 , 72 ]. This noninvasive assessment of tissue mechanical properties is useful seeing as strictures have been found to be significantly stiffer than their surroundings [ 68 , 71 ]. Thus, increased tissue strain may be assumed to be an accurate surrogate marker for intestinal fibrosis [ 71 ]. In US-SWE, instead, US shear waves are generated through an acoustic radiation impulse originating from the US probe and are applied onto a limited region of bowel wall [ 70 , 72 ]. Its speed of propagation through the underlying tissue can be measured and speaks to its stiffness: the denser the material, the faster the propagation [ 68 , 70 , 72 ].

CEUS substantially improves upon standard US diagnostic potential by making use of an intravenously administered microbubble contrast agent with the aim of providing a more accurate depiction of the bowel wall microvasculature [ 65 , 70 , 72 ]. Indeed, tissue perfusion has been found to be negatively correlated to fibrosis and, thus, may serve as its surrogate index [ 68 , 72 ]. Specific image analysis software programs are used to obtain an objectively quantitative measurement of the enhancement pattern (i.e., of the perfusion) [ 70 , 72 ]. Nevertheless, studies have reported that CEUS is incapable of effectively detecting bowel wall fibrosis in the presence of inflammation [ 70 ].

CT and MRI are widely employed imaging techniques having excellent diagnostic accuracy (> 90%) for intestinal fibrosis distribution and severity [ 66 , 68 ]. On CT, features such as mucosal enhancement, mesenteric hypervascularity, and mesenteric fat stranding are all suggestive of active CD related inflammation [ 66 ] (Fig. 5 ). This technology is widely available and offers 3D, multi-planar images with high spatial resolution and short acquisition time [ 65 , 70 ]. Furthermore, it makes use of oral contrast agents to visualize the extent of bowel wall abnormalities and evaluate inflammatory activities [ 65 , 70 ]. Recent development in the field of artificial intelligence has allowed for the realization of CT-based deep learning models which have proven to outperform human interpreters with increased accuracy and objectivity [ 73 ]. This technology’s main limitation, however, is that of exposure to ionizing radiation [ 65 , 68 ]. Axial and coronal CT images of the distal ileum are provided in Fig. 5 . In particular, they showcase a prominent regional fibrofatty proliferation separating the loops of the bowel known as "creeping fat" sign, typical of severe inflammation.

Axial and coronal CT images of the distal ileum showing extensive submucosal fat deposition (red arrrow) corresponding with sequela of chronic and severe inflammation in a 62-year-old patient with Crohn’s disease. Also, prominent regional fibrofatty proliferation separating the loops of bowel, “creeping fat” sign (blue arrow), typical of Crohn’s disease

CE-MR has comparable sensitivity to that of CT with the added benefit of having superior soft tissue contrast capabilities and being radiation-free [ 65 , 66 , 68 ]. For this reason, it should be used preferentially in patients who are young, pregnant, or who are likely to need serial examination [ 66 ]. Similarly, to CT, CE-MR is performed after administration of oral contrast agents and allows for transmural observation of the bowel from various perspectives [ 65 , 73 ] (Fig. 6 ). This technology is reported to be able to differentiate severe from mild to moderate fibrosis [ 69 ]. However, its ability to differentiate among none, mild, and moderate fibrosis is poor [ 69 ]. Further, it is a costly and more time-consuming alternative that is not as widely available [ 68 ]. Axial T1 and T2 weighted MRI images highlighting submucosal fat deposition as well as dark thickened fibrotic walls are shown in Fig. 6 .

Axial T1 ( A ) and T2 weighted MRI ( B ) images highlighting submucosal fat deposition as well as thickened walls. See dark fibrotic wall on T2 (red arrow)

Diffusion-weighted imaging (DWI) capitalizes on the fact that the random motion of water molecules in the body is dependent on the cellular density of the tissue they are in [ 65 , 73 ]. Indeed, excess collagen deposition, such as that found in fibrotic tissues, results in restricted extracellular water molecule motion [ 70 ]. The quantitative index with which this phenomenon is studied is the Apparent Diffusion Coefficient (ADC) [ 70 , 73 ]. The ADC has been found to be significantly inversely related to the degree of inflammation and fibrosis, with high sensitivity (72%), high specificity (94%), and accuracy in agreement with that of contrast enhanced MR, proving its potential usefulness as a non-invasive technology contributing to intestinal fibrosis identification [ 65 , 73 ]. Notably, DWI could be beneficial in patients for whom the use of MR contrast agents is contraindicated [ 65 ]. Even so, severe inflammatory background has been found to interfere with the accurate detection of fibrosis via ADC [ 70 ].

Magnetization transfer MRI (MT-MRI), a promising advancement in the field of MR imaging of CD related intestinal fibrosis, is a non-invasive technique that generates image contrast between protons in free water molecules and those within water molecules associated with large macromolecules, such as collagen [ 65 , 70 , 72 , 73 ]. The resultant image enhancement can be quantified using the MT ratio, a measure of the transfer of nuclear spin polarization from one population of nuclei to another, which indirectly reflects the concentrations of macromolecules [ 65 , 69 ]. Tissues containing high concentrations of collagen, such as fibrotic tissues, exhibit a higher mean MT ratio, making this technique of interest for bowel fibrosis detection, differentiation, and quantification [ 65 , 69 , 70 , 72 , 73 ]. Indeed, MT-MRI imaging outperforms Diffusion weighted MRI and contrast-enhanced imaging in distinguishing varying degrees of bowel fibrosis with or without coexisting inflammation [ 65 , 69 , 70 ]. This technique has also shown promise in distinguishing between mixed inflammatory fibrosis and pure inflammatory intestinal wall [ 69 , 70 ].

At present, common MR techniques for evaluating intestinal wall perfusion of CD include dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion (IVIM) [ 70 ]. DCE-MRI involves the serial acquisitions of T1-weighted images before, during, and after intravenous injection of gadolinium-based contrast agent [ 74 ]. Its perfusion parameters have been found to successful in assessing the characteristics of the bowel CD inflammation and in discriminating active and inactive CD [ 74 ]. Intravoxel incoherent motion-diffusion weighted Imaging (IVIM- DWI), instead, is a novel DWI technique which simultaneously measures both the random movement of water molecules in tissues and blood flow in capillary networks [ 74 ]. It has been reported to successfully detect significant differences in enhanced segments versus nonenhanced bowel segments as well as the degree of intestinal fibrosis [ 70 , 74 ]. The advantage of IVIM over DCE-MRI is that it can produce image contrast without an IV enhancement [ 70 ]. It seems thatDCE-MRI and IVIM-DWI are both promising noninvasive ways to provide precise quantitative evaluation CD bowel inflammation [ 74 ]. In particular, IVIM-DWI without the need of contrast-agent injection to reflect the diffusion of water molecules and microcirculation perfusion in living tissues, has received special attention [ 70 , 74 ].

Nuclear medicine

Fluorodeoxyglucose (FDG) PET localizes and quantifies FDG uptake in tissues of increased metabolic activity, such as areas of inflammation in CD [ 75 ]. The possibility to fuse functional data from PET and morphological data from CT or MR (PET-CT and PET-MR) has emerged as a promising imaging modality, having the potential to better assess the extent and location of disease than either sub-modality alone [ 70 , 75 ]. PET/MR offers several advantages over PET/CT [ 75 ]. While PET/CT has been shown to be a useful modality for the identification of active bowel inflammation with results correlating well with the current gold standard and with an absolute reduction in false positive rates with respects to FDG-PET alone, its intrinsic need for sequential rather than concurrent acquisition may lead to motion artifacts and its use of ionizing radiation poses a substantial threat to CD patients, whose treatment plans often include serial examinations [ 69 , 75 ]. Conversely, PET/MR’s synchronous image acquisition enables more accurate spatial and temporal matching of anatomical to functional data, and studies have shown it to present a 20%-73% reduction in radiation dose when compared to CT-MRI [ 75 ]. On top of having been reported to be significantly more accurate than either sub-modality alone in the detection of active inflammation (91% Vs 84% and 83%), PET-MR has also been found to be more accurate than PET-CT in detecting intestinal fibrosis [ 70 , 75 ]. Further, PET-MR hybrid imaging has been reported to be useful in distinguishing fibrotic from inflammatory strictures, in accurately detecting extra-luminal disease, and to have superior soft tissue signal-to-noise ratio and contrast-to-noise ratio than CT-MRI [ 69 , 75 ]. For all these reasons, this technology may potentially play a significant future role in the management of CD patients [ 75 ].

Promising future techniques, benefits, and drawbacks of each imaging technique discussed above are summarized in Table 3 . Among the proposed alternatives, the authors of this review believe MT-MRI to be the most promising. MT-MRI imaging outperforms competitors in distinguishing varying degrees of bowel fibrosis with or without coexisting inflammation [ 65 , 69 , 70 ]. This technique has also shown promise in distinguishing between mixed inflammatory fibrosis and pure inflammatory intestinal wall [ 69 , 70 ]. It is a non-invasive technique that generates image contrast between protons in free water molecules and those within water molecules associated with large macromolecules, such as collagen, rather than requiring exogenous contrast administration [ 65 , 70 , 72 , 73 ]. The resultant image enhancement can be quantified using the MT ratio, a proxy for fibrosis quantification [ 65 , 69 , 70 , 72 , 73 ].

Conclusions

Fibrosis is the aberrant process of connective tissue deposition resulting from complications in tissue repair following repetitive injury, hypoxia, or ongoing infection [ 1 ]. It can affect any organ and is responsible for chronic and debilitating structural and functional impairment of the affected tissue [ 2 , 3 ]. In fibrosis, pathological response to tissue damage determines an undue protraction of the healing process resulting in chronic inflammation, aberrant fibroblast proliferation, exaggerated collagen deposition, and a sequent imbalance in the alternation between scar formation and remodelling [ 3 , 5 ]. While extensive research has already been carried out on the topic of aberrant wound healing and fibrogenesis, a thorough understanding of how this relationship reveals itself through imaging has yet to be established. Considering the far-reaching implications research furtherance in this field may have—starting from more early and accurate diagnosis—and with the aim of exploring and expanding upon all relevant knowledge, in this work we have attempted to outline the ways in which fibrosis shows up across abdominal organs and have listed the most relevant imaging technologies employed for its detection. A review of all pertinent literature has revealed US, CT, MR and PET to be among the most commonly adopted imaging technologies for the detection of fibrosis across all organs. Among the proposed alternatives, the authors of this review believe MRI to be the most promising imaging technique across all considered organs. Indeed, MRI has proven clear superiority when compared to competitors by virtue of elevated soft tissue contrast, lack of ionizing radiations, and its ability to successfully pair with elastography and DCE technology, among others. Furthermore, this imaging technique is widely available, allows for full-body scanning, and has been reported to produce fewer allergic reactions when compared to other contrast exploiting techniques (ex. C-ray and CT) (Table 4 ). Table 4 Authors’ opinion regarding the most promising radiology techniques to diagnose fibrosis in each organ Suspected affected organ Promising radiology techniques for diagnosis Pancreas MRCP and US (SE and SWE) Liver 3D-MRE Intestines MT-MRI.

Disclosures

Mary Salvatore, MD, MBA- Consultant: Genentech, Boehringer Ingelheim. Grant funding: Boehringer Ingelheim, Genentech. Speaker: France Foundation, Peer View, Genentech, Boehringer Ingelheim. Research: Bioclinica, AbbVie, Lunglife AI.

Availability of data and materials

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

Abbreviations

18 F-Fluorodeoxyglucose

Acute Exacerbation of IPF

Automated Whole-Breast Us

Benign Breast Disease

Breast Computed Tomography

Breast Imaging Reporting and Data System

Bronchoalveolar

Cardiac Magnetic Resonance

Contrast Enhanced Multi-Detector CT

Contrast-Enhanced Breast CT

Digital Breast Tomosynthesis

Extracellular volume

High resolution computed tomography

Idiopathic pulmonary fibrosis

Insulin-like growth factor I

Insulin-like growth factor-binding protein 3

Interleukin-8

Late gadolinium enhancement

Macrophage colony-stimulating factor

Magnetic resonance imaging

Matrix metalloproteinases

Monocyte chemotactic protein-1

Natural killer cells

Platelet-derived growth factor

Positron emission tomography

Protease activated receptors

Quantitative CT

Reactive oxygen species

Renin–angiotensin–aldosterone system

Speckle tracking echocardiography

Tissue inhibitors of metalloproteinases

Transforming growth factor Β1

Ultrashort echo time

Zero echo time

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Tarchi, S.M., Salvatore, M., Lichtenstein, P. et al. Radiology of fibrosis part II: abdominal organs. J Transl Med 22 , 610 (2024). https://doi.org/10.1186/s12967-024-05346-w

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2 Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA USA

Antonio Luna

Performing scientific research and publishing the results in peer-reviewed journals is vital to the advancement of medicine. In medical imaging, scientific research should be an integral part of the continuing education of radiologists. Research in radiology (or any other field of medicine) represents an international currency that transcends political borders, helps radiologists globally keep up to date with current advances, complements teaching, improves resident training, and enhances patient care [ 1 ].

Drawing up a research project is, in most cases, the result of a deep understanding of the purpose and expected outcomes related to a specific topic. However, it is not uncommon to become discouraged when looking at a blank page (or computer screen) or contemplating if the work is novel, whether it is relevant, or if it provides new information. This lack of inspiration may cause many radiologists to relinquish their research efforts.

Needless to say, radiologists need to be constantly submerged and actively involved in continuous educational and ongoing research activities in this ever-changing landscape of medicine to accomplish two main goals: address the issues that radiologists have to face in their daily clinical and radiological practice and stay up-to-date in all the innovations that are continuously emerging not only related to radiology but also in other medical or even social disciplines. Search engines such as PubMed or Google Scholar may help scientific communities in several ways from research to keeping bibliographies up to date. Social networks can also help radiologists stay informed about current trends by means of following general or specific radiologic society accounts or social media profiles. Along the same lines, virtual radiology meetings and webinars have experienced considerable growth in the last decade and are almost an endless supplier of resources not only for teaching and learning but also for developing ideas about research topics in radiology and its subspecialties. These scenarios can serve as the optimal breeding ground as a starting point to conceive promising research projects and address unresolved questions.

A deep understanding of what questions have been already answered and what issues still need to be fully explained or have not been adequately covered will for sure assist in the selection of relevant topics for further research, especially for younger radiologists under guidance from more senior experts.

Personal and institutional expertise can also help in identifying potential research projects in radiology, playing mentorship a crucial role to guide less experienced radiologists [ 2 ]. Radiology department seminars and hospital interdisciplinary conferences may also open a door to potential synergistic collaborations with other specialists, discovering specific needs not previously covered, and thus, finding innovative ideas and opportunities for scientific pursuit. In other words, thinking outside the “radiology box” and focusing on what other specialties need for improving their clinical practice and their patients’ outcomes and how can radiology play a role in answering these questions help in carving ideas for meaningful and translational research. The institutional work environment and available infrastructure is also an important consideration when identifying potential topics and ideas for research. Hospitals with a high prevalence of cases of a specific disease or tertiary care-referral hospitals can provide much-needed information to institutions and hospitals with limited experience in those specific clinical areas and thus enhancing patient care locally, and simultaneously providing radiologists a potential source for original scientific research projects. Along the same lines, if your institution or radiology department is a referral center for specific or advanced diagnostic or interventional techniques (already implemented or even under development), it can also be explored and exploited to obtain ideas for research and dissemination of knowledge to other centers.

In some cases, the source of inspiration or opportunities may even be found outside the work environment. Visiting other radiology departments or away rotations can open avenues and provide insights about how other colleagues address a specific task and how these can be imported into their home institutions. Of course, these kinds of experiences may enhance cooperative working between institutions and partners and thus, boost the possibilities of promoting collaborative science in radiology [ 3 ]. In some cases, national, international, or even regional radiology societies launch outreach programs and projects to address specific needs as identified by their expert committees in which radiologists may participate as researchers, as global challenges (e.g., COVID-19) require global solutions.

Scientific journals may also launch a call for papers asking to submit proposals for consideration for research and publication in a special issue dedicated to a specific topic. These proposals are usually endorsed into a focused issue and cover a spectrum of related topics across multiple radiology subspecialties, including areas such as practice management, quality, and safety. This scenario provides a potential opportunity for authors and can assist with channeling or tailoring their research ideas to fit into the editor’s requirements.

The global and scientific community, and by extension, the world, is in a state of continuous change and update. There are new technologies or trends in radiology , such as all topics related to artificial intelligence (AI), including the recent hype related to ChatGPT, and new emerging diseases that need radiology and imaging such as the COVID-19, where research interest has grown exponentially in the last few years [ 4 , 5 ]. AI and COVID-19 are just some examples of new niches that were previously unknown and that can be explored and exploited as potential sources of ideas for research in radiology [ 6 ]. At this point, a critical view of what radiologists do and what can they do is essential to find answers and shed light on important research topics in a meaningful way to eventually improve outcomes, healthcare, and radiology practice in general. For example, trying to export radiologic techniques from one anatomic region to another is also an interesting topic currently used to generate innovative ideas for research in radiology. For example, well-tested and proven techniques such as diffusion-weighted imaging, which was primarily developed for central nervous system imaging, have been successfully exported to other anatomic sites and organs such as the liver, prostate, or breast [ 7 ]. Nowadays there are still dozens of advanced radiologic technologies waiting to be explored and tested with applications different for which they were initially created and can help in providing answers or filling gaps in knowledge to previously scarcely addressed imaging challenges, clinical issues, or patients’ needs.

Nevertheless, ideas for research in radiology should be broad and not just limited to the clinical or purely radiological-image-based scope. As mentioned above, we are experiencing continuous changes in society with a real and worldwide impact. For this reason, our research should also be focused outside our comfort zone with the aim to explore and provide newer insights and potential solutions by tackling other usually neglected topics that could be related to economics (i.e., climatic change and reducing energy-related costs for radiology equipment), health equity, inclusion and diversity (i.e., gender differences or global access to screening programs), or resources management (i.e., a worldwide shortage of radiologists or facing with the “feared” integration of AI) among others.

Finally, the possibility of successfully identifying ideas for research in radiology depends on a strong team you can count on, which includes experts, PhD scientists, physicists, and coordinator support staff. Steady support and a collaborative working environment, mentorship, collegiality with other radiologists from the same department or different institutions, other clinical specialists, radiographers, engineers, data analysts, or the support of scientific societies or stakeholders will facilitate the development of new ideas with greater chances of success [ 8 ].

In conclusion, ideas and opportunities for conducting research in radiology are plentiful. They usually arise from the radiologist’s individual professional experience and their observations of the world around them. Inspiration will only emerge in a fertile environment of continuous research and study, or in the words of Pablo Picasso (Málaga 1881, Mougins 1973), one of the greatest avant-garde artists of all time, “inspiration exists, but it has to find you working.”

The authors state that this work has not received any funding.

Declarations

The scientific guarantor of this publication is Dr. Antonio Luna.

The authors of this manuscript declare relationships with the following companies: Antonio Luna, MD, PhD, is an occasional lecturer of Philips, Siemens Healthineers, Bracco, and Canon and receives royalties as a book editor from Springer-Verlag.

The rest of the authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

No complex statistical methods were necessary for this paper.

Written informed consent was not required for this study because the manuscript is an Editorial.

Institutional Review Board approval was not required because the manuscript is an Editorial.

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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17 short-term strategies to address the national radiologist shortage.

An article in the American Journal of Roentgenology (AJR) outlines 17 ways to reduce the impact of the growing national shortage of radiologists.[1]

"Our focus was on systematically identifying potential short-term interventions and their impact," wrote lead author James V. Rawson, MD , director, Radiology Center for Outcomes Research Institute, Beth Israel Medical Center, Harvard Medical School, and colleagues. "The current radiology landscape has an imbalance between the rising demand for radiology services and the national radiologist workforce available. Rather than working longer and/or faster, radiologists can work smarter."

The article presents multiple short-term strategies to increase the effective radiologist workforce or increase efficiency to alleviate the current workload challenges. Rawson, et al., said these strategies are derived from an analysis of possible practice-level changes in personnel, process and the working environment.

"This article by Rawson et al. will serve as a landmark reference for navigating short-term labor challenges in radiology," explained Khushboo Jhala, MD , MBA, Brigham and Women’s Hospital, who wrote an editorial about the article.[2] "The article is unique in that it provides theoretic examples illustrating the impact of each approach, which is a conceptual scaffold used in scenario planning. For example, in the category of people, the authors determined that if all 4,352 national part-time radiologists increased their work by one additional day per month, the equivalent of 261 additional radiologists would be added to the national workforce."

"This article should stimulate practices to systematically try specific strategies and evaluate outcomes on the basis of objective metrics such as radiologist job satisfaction, burnout, rate of turnover, or rate of retirement. Practices can discard ineffective strategies and increase efforts on successful strategies that augment their workforce," explained J ay R. Parikh, MD , FACR, a professor at University of Texas MD Anderson Cancer Center, explained in a second editorial.[3]

Where to find additional people to aid radiology:

• Retired radiologists are an untapped workforce that might have interest in part-time positions, per diem work and phased retirements.

• Part-time radiologists could be enticed to work just a couple more hours. An estimated 16% of the radiology workforce is currently part time, including about 28% of female radiologists who are looking for more home-work life balance.

• Seasonal workers are not a normal model for radiology, but could be adopted in locations impacted by temporary volume increases, such as during flu season, an influx of tourists or snowbirds, or anticipated increased volumes during breast cancer awareness month.

• Fellowship trainees who completed radiology residency can be members of the hospital medical staff in some settings.

• International medical graduates may qualify for the American Board of Radiology (ABR) alternate pathway for those not planning to enter a standard residency as a path to enter the U.S. radiology workforce. A working radiologist in another country can become a faculty member at a U.S. academic radiology department, with that faculty time counting toward their four years in the alternative pathway.

• Reading room assistants can provide administrative support by providing telephone coverage, calling ordering practitioners for noncritical actionable findings, and answering basic scheduling or protocol questions to free up more time for the radiologist.

• Nonphysician practitioners (NPPs) can serve as radiology extenders, such as nurse practitioners, physician assistants, advanced sonographers, “super techs,” and registered radiologist assistants. This includes a variety of roles from predicting diagnostic examinations to working up patients for and performing some minimally invasive procedures. However, NPPs have been controversial because of concerns about scope creep by non-physicians.

Redefining process suggestions to augment radiology:

• Use teleradiology services to cover evening and overnight work hours.

• Leveraging private practice radiologists who have vacation time or conference time and can moonlight at other practices.

• Internal moonlighting to encourage filling weekend and evening hour shifts.

• Develop thresholds for significant study backlogs that prompt specific actions, or institute surge pricing similar to ride share services like Uber.

• Develop ways to reduce low-value imaging exam volumes.

• Adopt technology to enable easy sharing of patient imaging when patients are transferred from another emergency department or hospital to eliminate the need for repeat exams.

The authors also suggest use of hybrid workflows, remote work, and better ergonomics in the reading room as additional ways to stem burnout and keep the radiologists practices do have.

Radiologist shortage renews interest in AUC to reduce unnecessary exams

Rawson and colleagues noted in their article that the use of appropriate use criteria (AUC) as a required field when referring physicians order imaging exams could help reduce the number of needed or low-value exams. This too would help reduce the volume of exams radiologists are required to read so they can concentrate on the exams that are more likely to yield a clear diagnosis.

The researchers noted Medicare has attempted for years without success to implement the clinical decision support required in the Protecting Access to Medicare Act legislation. They suggest efforts may be more successful locally before national progress is made.

The authors also noted that artificial intelligence (AI) to help radiologists in a variety of ways also holds a lot of promise, but this technology will probably not be an immediate short-term solution.

Long-term solutions to the radiology shortage

"In the long term, graduate medical education expansion to increase the pipeline of radiologist trainees is needed to meet the needs of the growing and aging population. Other longer-term solutions, such as shortening residency or incorporating fellowship into residency, have also been raised," the study authors said.

The article explains a lot about the trends and contributing factors that led to the current shortage of radiologists. It also goes into more detail and offers examples on how each item could help radiology. Read more in the article.

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Study reveals why AI models that analyze medical images can be biased

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Artificial intelligence models often play a role in medical diagnoses, especially when it comes to analyzing images such as X-rays. However, studies have found that these models don’t always perform well across all demographic groups, usually faring worse on women and people of color.

These models have also been shown to develop some surprising abilities. In 2022, MIT researchers reported that AI models can make accurate predictions about a patient’s race from their chest X-rays — something that the most skilled radiologists can’t do.

That research team has now found that the models that are most accurate at making demographic predictions also show the biggest “fairness gaps” — that is, discrepancies in their ability to accurately diagnose images of people of different races or genders. The findings suggest that these models may be using “demographic shortcuts” when making their diagnostic evaluations, which lead to incorrect results for women, Black people, and other groups, the researchers say.

“It’s well-established that high-capacity machine-learning models are good predictors of human demographics such as self-reported race or sex or age. This paper re-demonstrates that capacity, and then links that capacity to the lack of performance across different groups, which has never been done,” says Marzyeh Ghassemi, an MIT associate professor of electrical engineering and computer science, a member of MIT’s Institute for Medical Engineering and Science, and the senior author of the study.

The researchers also found that they could retrain the models in a way that improves their fairness. However, their approached to “debiasing” worked best when the models were tested on the same types of patients they were trained on, such as patients from the same hospital. When these models were applied to patients from different hospitals, the fairness gaps reappeared.

“I think the main takeaways are, first, you should thoroughly evaluate any external models on your own data because any fairness guarantees that model developers provide on their training data may not transfer to your population. Second, whenever sufficient data is available, you should train models on your own data,” says Haoran Zhang, an MIT graduate student and one of the lead authors of the new paper. MIT graduate student Yuzhe Yang is also a lead author of the paper, which appears today in Nature Medicine . Judy Gichoya, an associate professor of radiology and imaging sciences at Emory University School of Medicine, and Dina Katabi, the Thuan and Nicole Pham Professor of Electrical Engineering and Computer Science at MIT, are also authors of the paper.

Removing bias

As of May 2024, the FDA has approved 882 AI-enabled medical devices, with 671 of them designed to be used in radiology. Since 2022, when Ghassemi and her colleagues showed that these diagnostic models can accurately predict race, they and other researchers have shown that such models are also very good at predicting gender and age, even though the models are not trained on those tasks.

“Many popular machine learning models have superhuman demographic prediction capacity — radiologists cannot detect self-reported race from a chest X-ray,” Ghassemi says. “These are models that are good at predicting disease, but during training are learning to predict other things that may not be desirable.”

In this study, the researchers set out to explore why these models don’t work as well for certain groups. In particular, they wanted to see if the models were using demographic shortcuts to make predictions that ended up being less accurate for some groups. These shortcuts can arise in AI models when they use demographic attributes to determine whether a medical condition is present, instead of relying on other features of the images.

Using publicly available chest X-ray datasets from Beth Israel Deaconess Medical Center in Boston, the researchers trained models to predict whether patients had one of three different medical conditions: fluid buildup in the lungs, collapsed lung, or enlargement of the heart. Then, they tested the models on X-rays that were held out from the training data.

Overall, the models performed well, but most of them displayed “fairness gaps” — that is, discrepancies between accuracy rates for men and women, and for white and Black patients.

The models were also able to predict the gender, race, and age of the X-ray subjects. Additionally, there was a significant correlation between each model’s accuracy in making demographic predictions and the size of its fairness gap. This suggests that the models may be using demographic categorizations as a shortcut to make their disease predictions.

The researchers then tried to reduce the fairness gaps using two types of strategies. For one set of models, they trained them to optimize “subgroup robustness,” meaning that the models are rewarded for having better performance on the subgroup for which they have the worst performance, and penalized if their error rate for one group is higher than the others.

In another set of models, the researchers forced them to remove any demographic information from the images, using “group adversarial” approaches. Both strategies worked fairly well, the researchers found.

“For in-distribution data, you can use existing state-of-the-art methods to reduce fairness gaps without making significant trade-offs in overall performance,” Ghassemi says. “Subgroup robustness methods force models to be sensitive to mispredicting a specific group, and group adversarial methods try to remove group information completely.”

Not always fairer

However, those approaches only worked when the models were tested on data from the same types of patients that they were trained on — for example, only patients from the Beth Israel Deaconess Medical Center dataset.

When the researchers tested the models that had been “debiased” using the BIDMC data to analyze patients from five other hospital datasets, they found that the models’ overall accuracy remained high, but some of them exhibited large fairness gaps.

“If you debias the model in one set of patients, that fairness does not necessarily hold as you move to a new set of patients from a different hospital in a different location,” Zhang says.

This is worrisome because in many cases, hospitals use models that have been developed on data from other hospitals, especially in cases where an off-the-shelf model is purchased, the researchers say.

“We found that even state-of-the-art models which are optimally performant in data similar to their training sets are not optimal — that is, they do not make the best trade-off between overall and subgroup performance — in novel settings,” Ghassemi says. “Unfortunately, this is actually how a model is likely to be deployed. Most models are trained and validated with data from one hospital, or one source, and then deployed widely.”

The researchers found that the models that were debiased using group adversarial approaches showed slightly more fairness when tested on new patient groups than those debiased with subgroup robustness methods. They now plan to try to develop and test additional methods to see if they can create models that do a better job of making fair predictions on new datasets.

The findings suggest that hospitals that use these types of AI models should evaluate them on their own patient population before beginning to use them, to make sure they aren’t giving inaccurate results for certain groups.

The research was funded by a Google Research Scholar Award, the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program, RSNA Health Disparities, the Lacuna Fund, the Gordon and Betty Moore Foundation, the National Institute of Biomedical Imaging and Bioengineering, and the National Heart, Lung, and Blood Institute.

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Influence of helical pitch and gantry rotation time on image quality and file size in ultrahigh-resolution photon-counting detector CT

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Prasugrel superior to ticagrelor in ACS

Cardiovascular MRI versus FFR in stable angina

Spotting brain bleeding after sparse training

Early invasive assessment of NSTE-ACS

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