Objectives: The objective is to quantify the extent of resection (EOR) and assess the survival of High-grade gliomas (HGG) using intraoperative fluorescein sodium compared to non-fluoresceinguided resection using pre-operative and post-operative contrast-enhanced magnetic resonance imaging. Materials and Methods: A prospective randomized controlled study was carried out in which the study group underwent florescence guided surgery (FGS) and was compared with non-FGS control group. Evaluation was done on EOR and gross total resection (GTR) based on radiological imaging. Karnofsky performance status (KPS), length of hospital stay, and survival rate were also evaluated. Results: Thirty-two patients (16 in each group) with Grade 3/4 gliomas with comparable pre-operative clinical features and tumor volume were recruited. In the study group, the mean EOR was found to be 95.13% and the control group showed an EOR of 85.19%, which was statistically significant ( P = 0.046). There was also a statistically significant difference in GTR rates ( P = 0.046) and KPS at 3 months (0.050) between the two groups. Conclusion: Microscopic fluorescein-guided resection of HGGs is feasible and safe. The present study was able to demonstrate higher rates of EOR and GTR in the FGS group, which resulted in a higher KPS score as compared to the non-FGS group.

Abstract Stage III colorectal cancer (CRC) patients exhibit substantial variability in survival outcomes despite standardized Tumor–Node–Metastasis (TNM) staging and oxaliplatin‐based adjuvant chemotherapy. Current prognostic models often rely on single‐modality data, limiting their predictive accuracy and clinical utility. We developed a novel Multimodal Prognostic Index (MMPI) that integrates histopathological features from hematoxylin and eosin–stained whole‐slide images and radiomic features from preoperative computed tomography scans. This retrospective, multicenter study included 253 stage III CRC patients from three institutions, all of whom received oxaliplatin‐based adjuvant chemotherapy. Prognostic predictions were generated using a robust, risk‐aware joint and individual representation learning algorithm (Robust risk‐Aware Joint and Individual [RAJI]). MMPI was trained and tested on internal cohorts and validated externally. Feature contributions were interpreted using SHapley Additive exPlanations. MMPI consistently outperformed unimodal models based solely on pathomics or radiomics in predicting overall survival (concordance index: training set, 0.716 vs. 0.596–0.620; testing set, 0.672 vs. 0.594–0.642; external validation set, 0.632 vs. 0.580–0.605) and recurrence‐free survival (C‐index: training set, 0.713 vs. 0.609–0.656; testing set, 0.735 vs. 0.611–0.639). It remained an independent prognostic factor after multivariate adjustment and improved risk stratification within TNM‐defined subgroups. Furthermore, MMPI effectively predicted chemotherapy efficacy, particularly distinguishing high‐risk patients less responsive to 3‐ or 6‐month XELOX and FOLFOX regimens. This study is the first to integrate radiological and pathological imaging for prognostic assessment in stage III CRC. It offers a non‐invasive, interpretable tool to improve survival prediction and guide individualized chemotherapy decisions.

Suspected anal malignancy turned out to be sarcoidosis; a case report

Optimizing Next Generation Sequencing for Genetic Diagnosis in Autosomal Dominant Polycystic Kidney Disease.

Integrating multimodal radiological images and clinical data is critical for survival prediction in rectal cancer. However, existing methods often lack sufficient consideration of 1) modality heterogeneity (caused by rectal peristalsis, noise artifacts, and missing modalities) and 2) site heterogeneity (caused by different imaging protocols and patient populations). These factors hinder the model from capturing reliable cross-modal relationships and adapting to distribution shifts across clinical sites. In this work, we propose UICSurv, a novel multimodal Survival prediction framework highlighted by Uncertainty-guided Iterative Contrastive fusion, to capture robust cross-site multimodal interactions while leveraging sample-level uncertainty to enhance fusion reliability. Specifically, UICSurv initializes a shared multimodal embedding and iteratively refines it by fusing each heterogeneous modality via the cross-attention mechanism. In each iteration, a novel Survival Contrastive Learning (SCL) strategy is designed to progressively enhance both cross-site alignment and survival discriminability of the multimodal embedding space. Moreover, we design an EvidenceHit module, which employs temporally consistent evidential learning to jointly estimate survival probabilities and uncertainty. The estimated uncertainty further guides the embedding alignment by reducing the interference of unreliable samples. All components operate synergistically within UICSurv to reinforce reliable survival prediction in rectal cancer. Extensive experiments on multimodal datasets of rectal cancer (collected from three sites) demonstrate the superiority of our method both in survival prediction and uncertainty estimation. The code is available open-source: https://github.com/ScorpioBao/UICSurv.

ProtoRadNet: Prototypical patches of Convolutional Features for Radiology Image Classification Network.

Defining indication for intervention in substernal goiter, and secondarily define when thoracic intervention may be required. PubMed, Scopus, CINAHL. A systematic review and meta-analysis were performed on studies employing thyroidectomy for substernal goiters. Meta-analysis of continuous measures, proportions, and comparison of weighted proportions was performed for patient characteristics, symptoms, and outcomes. Data from 102 studies were included, with a total study population of 15,719 patients undergoing substernal thyroidectomies. Criteria for classifying substernal goiter were heterogeneous across studies, with a plurality (21/102) defining diagnosis by > 50% of the goiter mass located below the thoracic inlet. There was a female predominance at 67% (CI 64.2-69.9) with a mean age of 58 years old (10-94). Most common preoperative symptoms were a described "neck mass" (71.1%, CI 57.6-82.9) and overall compressive symptoms (64.8%, CI 52.4-76.2). 27.6% (CI 22.4-33.1) of the population remained asymptomatic. On radiologic imaging, tracheal deviation and compression were identified in 60.6% (CI 52.5-68.5) and 48.6% (CI 37.6-59.6) of the population, respectively. Cervical approach alone was performed in 88.7% (CI 86.0-91.1) of the population, while 10.4% (CI 8.2-12.8) required additional thoracic intervention. Malignancy was moderate and seen in 12.4% (CI 10.4-14.6) of cases. Results highlight the indication for substernal surgery is largely due to the presence of clinical symptoms or compressive findings on imaging; however, over a quarter of the population is asymptomatic and over 50% are without compressive findings on imaging. When surgery is undertaken, a cervical approach is often adequate, suggesting that only a minority of the population may require thoracic intervention.

Background: Peritoneal tuberculosis (PTB) is a significant manifestation of abdominal tuberculosis (TB), common in endemic regions like India, and often mimics other intra-abdominal diseases, leading to diagnostic delays. Radiological imaging plays a central role in detection, but confirmation requires pathological or microbiological correlation. Aims and Objectives: This study aims to evaluate the clinico-radiological features of PTB and correlate them with pathological findings to improve diagnostic accuracy and guide timely management. Materials and Methods: This hospital-based cross-sectional study was conducted in the Department of Radio-diagnosis, Maharani Laxmi Bai Medical College, Jhansi, from December 2023 to March 2025, including 55 patients aged 15–70 years with suspected PTB. Clinical assessment, ultrasound, and contrast-enhanced computed tomography were performed, documenting ascites, peritoneal/omental thickening, mesenteric changes, and lymphadenopathy. When indicated, image-guided biopsy or ascitic fluid analysis (adenosine deaminase [ADA], serum ascites albumin gradient [SAAG], Ziehl–Neelsen staining, Löwenstein–Jensen culture, reverse transcription-polymerase chain reaction [RT-PCR]) was done. Data were analyzed using the Statistical Package for the Social Sciences, v22.0, with Chi-square tests. Results: Mean patient age was 37.69 years, with a slight female predominance (54.55%). Wet type PTB was most common (49.09%), followed by dry (27.27%) and fibrotic (10.91%). Mesenteric involvement and lymphadenopathy were universal, whereas omental thickening was seen in 96.36%. RT-PCR positivity was 18.18%, and raised ADA with low SAAG was observed in 63.64%. Pulmonary TB coexisted in 61.82% of patients. Conclusion: Combining clinical evaluation with characteristic imaging findings, supported by ADA and RT-PCR, enhances early diagnosis of PTB. This approach can prevent misdiagnosis, facilitate timely therapy, and reduce unnecessary surgical interventions.

Introduction Chondroblastic osteosarcoma is a rare malignant bone tumor characterised by the presence of osteoid and cartilagineous components and its occurence in the lateral nasal wall is extremely uncommon which presented with nasal obstruction. Case Report A- 15- year old boy presented with a history of chronic right nasal obstruction lasting for more than 1 year. It was gradually progressive in nature. Clinical examination revealed a large sinonasal mass in the right nasal cavity which extended upto the middle meatus on Anterior Rhinoscopy. On Posterior Rhinoscopy the mass extended into the maxillary sinus . It was senseless on probing and free on medial side and . Laterally, the probe could not be moved as mass was attached. Discussion Chondroblastic Osteosarcoma of the lateral nasal wall and nasal bone is an extremely rare entity and only a few cases have been reported in the literature. It predominantly affects the adolescents and young adults with a slight male predominance. The clinical presentation is often non specific and includes sypmtoms such as nasal obstruction, facial swelling, epistaxis,facial swelling and pain. Radiological imaging including CT and MRI is essential for assessing tumor extent and involvement of adjacent structures. Surgical management with wide excisionis the mainstay of treatment. Adjuvant Chemotherapy and Radiotherapy may be considered depending on the risk factors. Histopathological examination and Immunohistochemistry plays a crucial role in confirming the diagnosis.

Increasing ED-CT Pulmonary Angiography (CTPA) use raises concerns about overuse and low yield. CTPA numbers at Sir Charles Gairdner ED were seemingly increasing. This single-site, retrospective, observational study looked for increasing usage over ten years, and whether lower yields suggested over-testing. Two linked hypotheses: (1) CTPA rates increased over a decade and (2) if CTPA is increasing significantly, yield reduces suggesting overuse. For Hypothesis 1, ED-CTPA per 1000 attendances 2014-2023 were calculated from radiology imaging data. For Hypothesis 2, 2023/24 CTPA results were reviewed for demographics, PE diagnosis, imaging quality, and largest vessel with PE, using similar methods to previous studies. We calculated 700 cases needed reviews if CTPA increased 5%-6% annually (previous regional studies) and yield decreased inversely. Statistical analysis compared rates over time and compared 2012-2013 versus 2023-2024 for Hypothesis 1. For Hypothesis 2, analysis was for difference in proportions for yield (and largest vessel with PE) versus previous 2012-2013 data. Rates of ED-CTPA increased 65% over 2014-2023 but yield was stable (16.3% vs. 15.7%). PE diagnoses increased by over 60% (1.3-2.1 PE/1000). Large vessel PE (≥ lobar) decreased significantly (59.9%-40.5%), intermediate-vessel PE increased (20%-35.1%), but small vessel PE was unchanged (19.2 vs. 24.3%). Women ≤ 50 years had significantly lower yield (5.4%). CTPA use increased markedly, without expected decreased yield. Increased PE diagnosis rates suggest maintained diagnostic discrimination. Large vessel PE proportions reduced, but small PE rates didn't increase significantly. Younger women seem over-investigated with low yield (5.6%) versus all other groups.

Total laparoscopic hysterectomy (TLH) is the most common gynecologic procedure for fibroids. However, massive serous ascites has not yet been reported. For this reason, the management of ascites is challenging because it is an unexpected situation. We present the case of a 42-year-old woman complaining of menorrhagia who was diagnosed with multiple leiomyomas on ultrasound examination. No abnormal findings were observed in the endometrium or ovaries. TLH and bilateral salpingectomy were performed. Specimens were extracted via vaginal morcellation using a scalpel. No intraoperative complications were observed. The final pathologic examination of the uterus, which contained 25 fibroids and tubes, was benign. However, serous ascites began to enter the drain on the first day. The volume of the ascites was approximately 9000 mL over 3 days. There were no abnormalities in vital signs, liver test results, or serum albumin, electrolyte, or hemoglobin levels. Radiologic images excluded bowel and urinary tract injuries. However, an intra-abdominal mass measuring 26 × 33 × 44 mm was detected on magnetic resonance imaging. Diagnostic laparoscopy revealed a myoma between the bowel loops, which was removed by placing it in an endobag. Thereafter, the ascites spontaneously resolved. Ascitic fluid is generally observed in gynecologic cancers. The basic treatment principles include close monitoring of vital signs, appropriate replacement of fluid deficits, drainage, and mobilization. Furthermore, treatment based on the etiopathology is crucial. In cases of multiple myomas, when extracting the uterus vaginally, a pedunculated myoma may break off or be missed in the abdomen. Leiomyomas have oncotic properties and can induce fluid flow from the intravascular to the peritoneal space. Rapid resolution of ascites after myoma removal indicates pseudo-Meigs syndrome.

Denervation from various conditions typically results in muscular atrophy; in contrast, a paradoxical volumetric increase can also rarely occur in affected muscles, which is called denervation pseudohypertrophy. Although this condition may potentially affect any muscle group, it is most commonly seen in the calf muscles. When evaluating patients with painless calf muscle enlargement, denervation pseudohypertrophy is an important differential diagnosis that should be considered. Radiological imaging methods and electromyography (EMG) are useful for differentiating pseudohypertrophy from muscular hypertrophy. Identifying denervation pseudohypertrophy requires multidisciplinary evaluation. Alongside radiological imaging and EMG findings, patient's detailed medical history and physical examination remain essential components of the diagnostic process. In this case report, we aim to present a 73-year-old man with bilateral calf muscle denervation pseudohypertrophy due to S1 radiculopathy, along with the relevant literature.

Recent advancements in radiological imaging have raised the possibility of diagnosing prostate cancer (PCa) without biopsy; however, the safety, feasibility, and diagnostic accuracy of this approach require comprehensive evaluation. This study proposes and evaluates an initial decision-making algorithm using PSMA PET/CT and mpMRI for selecting candidates suitable for radical prostatectomy without prior biopsy (RP-WPB). Patient enrollment was conducted strictly according to the prospectively established decision-making algorithm. Candidates for RP-WPB were required to fulfill four essential criteria: PSA > 4 ng/mL, PI-RADS score≥4, miPSMA score≥2, and co-positive lesions identified on mpMRI and PSMA PET/CT. Patients staged as cT3-4, cN1, or cM1 (solitary metastasis) underwent RP-WPB directly. For patients with stage cT2N0M0, PSA levels were further stratified: those with PSA ranging from 4 to 30 ng/mL were invited to participate in the prospective study, whereas individuals with PSA ≥ 30 ng/mL qualified for RP-WPB only if they satisfied additional conditions, including age≥75 years, PSA density (PSAD) ≥ 0.2 ng/mL/cm3, and willingness to undergo non-neurovascular-bundle-sparing surgery. From January 2022 to February 2024, 150 patients were prospectively enrolled following the algorithm; 30 patients withdrew, and 120 underwent RP-WPB. Among the latter, 84 patients were classified as cT2N0M0, 27 as cT3-4, 10 as cN1, and 9 as cM1. The detection rate of clinically significant PCa (csPCa) (ISUP grade ≥2) patients was 100% (95% CI: 0.97-1.00, p = 0.176), and pathological concordance was achieved in all cases. No perioperative complications greater than Clavien-Dindo grade Ⅱ occurred. The proposed algorithm based on PSMA PET/CT and mpMRI for performing RP-WPB demonstrates safety, feasibility, and high diagnostic accuracy, presenting a promising option for selected PCa patients.

Abstract Introduction Life-expectancy and quality of life after transcatheter aortic valve replacement (TAVR) procedure vary substantially among individuals. However, prognostic factors contributing to favorable outcomes remain poorly understood. Severe aortic stenosis can cause left ventricular hypertrophy due to increased afterload, which may become maladaptive as the disease progresses and can lead to myocardial fibrosis. TAVR promotes left ventricle myocardium (LVM) remodeling by reducing the afterload. However, prior maladaptive structural changes of the myocardium may not be reversible in some individuals and lead to poor outcomes. Currently, there are no established methods to evaluate the remodeling capacity of the LVM which may correlate with long-term survival. Purpose Radiomic analysis allows morphological and textural analyses of structures on radiological images. Our aim was to explore whether the radiomic phenotype of the LVM on pre-TAVR CT scans is associated with adverse outcomes following TAVR in a matched case-control study. Methods We identified 89 patients who underwent TAVR at our institution between died more than 30 days post-procedure. These cases were matched to control patients without an event based on age, sex, aortic valve gradient, ejection fraction, diabetes status and prior coronary intervention. Pre-TAVR LVM was segmented into the 17 American Heart Association regions and the segments were exported for radiomic analysis. The association between radiomic features and all-cause mortality was evaluated using conditional logistic regression models correcting for LVM volume index. Multiple comparisons were adjusted for using the false discovery rate (FDR) method. Results A total of 178 individuals were evaluated (age of 81.3 ± 3.3 years; 44% female, 71% high-gradient aortic stenosis). The median follow-up period was 2.57 years (interquartile range: 1.22–3.76 years). Across 3,026 LVM segments, 258 radiomic features were assessed, comprising of 42 histogram-based, 158 texture-based, and 58 volume-based features. Utilizing conditional logistic regression models to account for the matched study design and adjust for the LVM volume index, 22.5% of the radiomic features (n=58) were found to have a significant correlation with all-cause mortality (Figure 1). Among these, 7 were histogram-based, 50 texture-based, and 1 volume-based. The odds ratios for protective features ranged from 0.84 to 0.95, whereas those for adverse features spanned from 1.05 to 1.18 per population standard deviation. Conclusions Morphological and textural patterns of the LVM on pre-TAVR CT are associated with all-cause mortality. Precision phenotyping of LVM could aid in identifying individuals at higher risk of adverse outcomes, potentially guiding the use of additional therapies following the TAVR procedure.

A 3D-printed craniofacial fracture library with QR-integrated pedagogical content: a technical note for maxillofacial trauma teaching.

In paediatric patients with suspected osteomyelitis, magnetic resonance imaging (MRI) remains an essential diagnostic tool. Timely access to an MRI scanner remains a challenge in the Canadian system. For some paediatric patients, the need for sedation can introduce considerable time delays, particularly for those admitted to services who may rely heavily on radiology image interpretation. This study aimed to assess the current delivery of care for osteomyelitis by analyzing MRI wait times, the use of contrast and sedation, and associated patient outcomes. A single-centre retrospective cohort study from a level one paediatric children's hospital was performed. Data were collected from electronic medical records of paediatric patients with a diagnosis of osteomyelitis from December 1, 2018 to December 31, 2023. Records were reviewed to collect patient factors (e.g., age, sex, comorbidities), relevant MRI parameters (e.g., time of order, time of image acquisition, contrast, sedation), non-surgical and surgical management, involvement of infectious diseases, length of stay in the hospital, follow-up complications, and follow-up MRI. Patient data were compared based on time from the MRI order to image acquisition and interpretation. Continuous variables were assessed for normality using a Shapiro-Wilks test to determine the use of parametric or non-parametric tests. Regression analyses were performed to identify predictive indicators of delays in MRI image acquisition and treatment for osteomyelitis. A total of 60 pediatric patients with a definitive diagnosis of osteomyelitis had undergone an MRI at our center. The cohort consisted of 33 (55%) males with a mean age of 8.5 (+/- 4.5) years old. The average length of hospital stay for these patients was 9.4 (+/- 10.1) days. Patients with both osteomyelitis and a soft tissue abscess were more often admitted and underwent surgery more frequently, although these differences did not reach statistical significance. Contrast was indicated and administered in 95% of all MRI scans, with 19 (32%) of total scans performed with sedation. There were no differences in MRI acquisition time before, during, nor after the COVID-19 pandemic for these patients. The average time from MRI order to scan acquisition was 48.2 (+/- 41.8) hours for sedated patients, compared to 40.4 (+/- 30.6) hours for those not sedated, with no statistically significant difference between groups. The time from MRI order to interpretation followed similarly in the sedated scans, 53.3 (+/- 43.4) hours, and unsedated scans, 51.7 (+/−46.9) hours, with differences not found to be statistically significant. Based on our hospital's average hourly cost of pediatric inpatient care, the time from image request to formalized interpretation reached $3,405.87 for sedated scans and $3,303.63 for unsedated scans. Overall, the findings indicate delays in obtaining MRI scans, irrespective of need for sedation, which can contribute to prolonged hospital stays, increased costs and potentially delay in care. The substantial wait times for diagnostic MRIs highlight a critical area for quality improvement initiatives, suggesting that enhanced prioritization or further resource allocation for paediatric patients must be considered. Further, emphasis on incorporating rapid whole-body MRI scout protocols could significantly enhance patient care, image acquisition time and efficiency.

Introduction This study examines the approaches used for cancer screening in women, insisting on the roles of mammography, breast ultrasound, breast MRI, computed tomography (CT), and positron emission tomography. Mammography is still the key method for early detection, with modern digital technology boosting image quality and diagnostic accuracy. Breast MRI provides increased sensitivity for high-risk individuals, and it is recommended to be used with mammography for full screening. Methods This review article provides a comprehensive assessment of breast imaging techniques, focussing on screening recommendations and advancements in mammography, ultrasonography, MRI, CT, and PET. These methods provide a multidisciplinary approach to improving breast cancer detection, diagnosis, and personalized care. Early detection is necessary for less aggressive treatment. Digital breast tomosynthesis consists of contrast-enhanced spectral mammography, molecular breast imaging, MRI, and USG. Results Mammography remains the primary imaging modality for detecting breast abnormalities, including cancer. The use of standardized interpretation systems improves the communication of findings. The present paper summarizes the primary disputes surrounding breast cancer management. Conclusion According to the literature, low-dose mammography is the only radiographic technique that has significantly impacted the diagnosis, staging, and patient follow-up for asymptomatic breast cancer screening. Mammography is also the only accurate screening test for breast imaging. Implications for practice.

Deep learning has enhanced the analysis of medical images but privacy issues and institutional variations restrict their large scale application in clinics. FedVLM, a federated vision language model tailored to privacy-preserving multimodal medical image analysis, is one of the solutions to these problems. Contrary to the conventional federated design, which can only process single modal image data, FedVLM takes paired radiological images and clinical reports jointly, which demonstrates high zero-shot and few-shot diagnostic performance. The design consists of secure aggregation, differential privacy and proximal optimization that ensure protection of patient data and minimize variability across sites. Large scale experiments on the NIH ChestX-ray14, MIMIC-CXR, and BraTS datasets indicate that FedVLM is an accurate and interpretable model that achieves near-centralized performance on vision language models without violating privacy. Building on previous works such as FACMIC, BioViL, and FAA-CLIP, FedVLM introduces new methods, including privacy-aware optimization, proximal regularization for varied data, and multimodal contrastive alignment, creating a unified federated framework for clear and secure medical image analysis. Although FedVLM shows promising performance, this work is currently at a research stage and is not yet ready for clinical use. We need validation through future multi-institutional clinical studies.

Oral potentially malignant disorders (OPMDs) can lead to oral cancer, which is one of the most common cancers worldwide. Prevention is crucial in the avoidance of malignant transformations of OPMDs. Artificial intelligence (AI) provides a new and noninvasive tool for analyzing medical data, such as patient data, radiologic images, and clinical photographs. These AI-based tools can help in the decision-making process. However, histological examination is still the gold standard for diagnosing OPMDs. This systematic review and meta-analysis aimed to investigate the diagnostic accuracy of artificial intelligence on intraoral photographs of patients with OPMDs. A systematic search was conducted on 5 major databases (MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) on November 10, 2023. Included studies compared AI methods to histology examination as the reference. A quantitative analysis was carried out to assess sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio (DOR), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) calculated with 95% confidence intervals (CIs). Six eligible articles were included, with 898 images out of 4,046 tested using AI-based architectures. Five studies investigated at least 2 AI models. The overall sensitivity, specificity, DOR, LR+, and LR- were 0.94 (95% CI, 0.88 to 0.95), 0.95 (95% CI, 0.85 to 0.98), 212.39 (95% CI, 56.39 to 800.00), 16.89 (95% CI, 5.72 to 48.68), and 0.08 (95% CI, 0.05 to 0.13) for the best-performing AI-based architectures in terms of sensitivity, respectively. AI-based diagnostic tools have high negative predictive value that could help identify OPMD lesions using intraoral photographs.Knowledge Transfer Statement:This systematic review on AI-based methods to diagnose oral potentially malignant disorders showed that although their high negative predictive value could reduce unnecessary specialist consultations, clinical judgment remains paramount. Further prospective studies are needed to evaluate the integration of AI diagnostics into routine care and screening and policies to enhance efficiency and support early detection and prevention of oral cancer.

Chest wall reconstruction (CWR) is a complex and evolving field that clinically benefits from the use of multimodal radiologic imaging. This review summarizes the essential role of multimodal imaging, such as ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), in preoperative and postoperative CWR evaluation. Preoperative CWR planning involves characterization of defects, assessment of surrounding structures, and guidance for surgical approach and implant selection. Postoperative CWR evaluation focuses on monitoring graft/flap viability, assessing structural integrity, and identifying complications such as infection or hardware failure. This article guided radiologists in approaching CWR cases and creating effective reports to guide patient management.