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Grand RoundsWeekly Evidence Brief

Radiology

Edition
Latest

30-Second Takeaway

  • Radiomics-based AI on contrast-enhanced MRI reasonably predicts VETC in HCC and associates with early recurrence.
  • LLM assistance in primary care was safe but did not reduce short-term treatment failure in this trial.

Latest - Week ending July 4, 2026

Grand Rounds: Selected evidence briefs for radiology and clinical trialists

Radiomics-AI predicts VETC on preop imaging and links to early recurrence

JOURNAL OF MEDICAL INTERNET RESEARCHJul 3, 2026

Radiomics/deep-learning models using contrast-enhanced MRI showed pooled sensitivity 0.84 and specificity 0.79 for predicting CD34-confirmed VETC in HCC. AI-predicted VETC positivity was associated with higher risk of early recurrence (pooled HR 2.34). Evidence came from 15 retrospective studies (729 internal and 613 external validation patients) with heterogeneity and low-to-moderate GRADE certainty. These tools may aid preoperative risk stratification but require prospective validation before changing surgical management.

Modified Zelen design broadly acceptable to THA patients after debriefing

JOURNAL OF CLINICAL EPIDEMIOLOGYJun 30, 2026

Among 235 CAPS-THA respondents, 76% agreed the delayed-consent design was justified and 91% judged the study ethical. Trust in medical research was unchanged or increased for 94% after disclosure. Seventy-one percent reported willingness to join a similar future study. Findings support responsible use of modified Zelen designs with robust debriefing and transparency during follow-up.

Generative AI clinical support was safe but did not lower short-term treatment failure

NATURE MEDICINEJun 27, 2026

In a pragmatic cluster RCT of 9,691 primary care patients, treatment failure occurred in 2.2% with LLM assistance versus 2.0% without (adjusted OR 0.77, 95% CI 0.55–1.08, P=0.13). No serious adverse events were attributed to the intervention and independent review found no safety signal. The trial found no statistically significant reduction in 14-day treatment failure; any benefit is likely modest. LLM assistance appears safe in this setting but is not ready to deliver clear clinical benefit without further study.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Use radiomics-AI VETC predictions for preoperative risk discussion, but expect low-to-moderate certainty.
  • Do not base immediate workflow changes on LLM assistance; monitor for modest or null clinical benefit.
  • Interpret nonrandomized treatment comparisons with skepticism; seek multidisciplinary input.