搜索结果：Cardiovascular and interventional radiology

This study evaluates Large Language Models (LLMs) integrated with Retrieval-Augmented Generation (RAG) frameworks for generating accurate, guideline-concordant anticoagulation (AC) recommendations in Interventional Radiology (IR) MATERIALS AND METHODS: 394 IR procedure-AC pairs were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Five state-of-the-art LLMs, Claude-3.5-Sonnet, GPT-4o, LLaMA-3.1, Mistral-Large-2411, and Qwen-2.5, were deployed within a RAG system built using LlamaIndex, which indexed the Society of Interventional Radiology (SIR) guidelines. Claude was evaluated without RAG integration (Base Claude). Models were evaluated on withholding AC, withholding and reinitiation timeframes, and platelet and International Normalized Ratio (INR) thresholds. A human assessor scored outputs for guideline concordance (2 = complete, 1 = partial, 0 = none), which were subsequently averaged. Claude achieved the highest overall guideline concordance (1.51/2). Claude, GPT-4o, and Mistral performed similarly in withholding decisions (1.88 [95% CI 1.83, 1.93], 1.86 [1.81, 1.91], and 1.88 [1.84, 1.93]). Claude and GPT-4o showed comparable accuracy in both withholding (1.56 [1.44, 1.67] vs. 1.55 [1.44, 1.67]; p=0.871) and reinitiation timeframes (1.34 [1.20, 1.47] vs. 1.37 [1.26, 1.49]; p=0.920). Mistral achieved the highest platelet threshold concordance (1.52 [1.45, 1.59]), while Claude led in International Normalized Ratio (INR) recommendations (1.37 [1.32, 1.42]). LLaMA (0.76) and Qwen (0.52) significantly underperformed across all categories (p<0.001). RAG integration significantly improved Claude's performance across all categories, except platelet thresholds. LLMs integrated with RAG systems, especially Claude, GPT-4o, and Mistral, demonstrate potential for delivering guideline-concordant, patient-specific AC recommendations in IR, supporting their role as safe, efficient, and customizable clinical decision-support tools.

Information on childhood cancer burden is crucial for effective cancer policy planning. Unfortunately, observed paediatric cancer data are not available in every country, and previous global burden estimates have not discretely reported several common cancers of childhood. We aimed to inform efforts to address childhood cancer burden globally by analysing results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, which now include nine additional cancer causes compared with previous GBD analyses. GBD 2023 data sources for cancer estimation included population-based cancer registries, vital registration systems, and verbal autopsies. For childhood cancers (defined as those occurring at ages 0-19 years), mortality was estimated using cancer-specific ensemble models and incidence was estimated using mortality estimates and modelled mortality-to-incidence ratios (MIRs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the standard life expectancy at the age of death. Prevalence was estimated using survival estimates modelled from MIRs and multiplied by sequelae-specific disability weights to estimate years lived with disability (YLDs). Disability-adjusted life-years (DALYs) were estimated as the sum of YLLs and YLDs. Estimates are presented globally and by geographical and resource groupings, and all estimates are presented with 95% uncertainty intervals (UIs). Globally, in 2023, there were an estimated 377&#x2008;000 incident childhood cancer cases (95% UI 288&#x2008;000-489&#x2008;000), 144&#x2008;000 deaths (131&#x2008;000-162&#x2008;000), and 11&#xb7;7 million (10&#xb7;7-13&#xb7;2) DALYs due to childhood cancer. Deaths due to childhood cancer decreased by 27&#xb7;0% (15&#xb7;5-36&#xb7;1) globally, from 197&#x2008;000 (173&#x2008;000-218&#x2008;000) in 1990, but increased in the WHO African region by 55&#xb7;6% (25&#xb7;5-92&#xb7;4), from 31&#x2008;500 (24&#x2008;900-38&#x2008;500) to 49&#x2008;000 (42&#x2008;600-58&#x2008;200) between 1990 and 2023. In 2023, age-standardised YLLs due to childhood cancer were inversely correlated with country-level Socio-demographic Index. Childhood cancer was the eighth-leading cause of childhood deaths and the ninth-leading cause of DALYs among all cancers in 2023. The percentage of DALYs due to uncategorised childhood cancers was reduced from 26&#xb7;5% (26&#xb7;5-26&#xb7;5) in GBD 2017 to 10&#xb7;5% (8&#xb7;1-13&#xb7;1) with the addition of the nine new cancer causes. Target cancers for the WHO Global Initiative for Childhood Cancer (GICC) comprised 47&#xb7;3% (42&#xb7;2-52&#xb7;0) of global childhood cancer deaths in 2023. Global childhood cancer burden remains a substantial contributor to global childhood disease and cancer burden and is disproportionately weighted towards resource-limited settings. The estimation of additional cancer types relevant in childhood provides a step towards alignment with WHO GICC targets. Efforts to decrease global childhood cancer burden should focus on addressing the inequities in burden worldwide and support comprehensive improvements along the childhood cancer diagnosis and care continuum. St Jude Children's Research Hospital, Gates Foundation, and St Baldrick's Foundation.

We review burnout risk factors in interventional radiology (IR) and explore how artificial intelligence (AI) would address burnout from a workplace aspect. We performed a literature search on PubMed on risk factors for burnout in interventional radiology and AI tools to address burnout challenges. IR specialists face burnout risk at personal, workplace and system levels. AI could identify burnout using demographic data and free text, alleviate administrative workload, and manage workflow. AI could also enhance procedural efficiency via automated navigation systems, reducing stress from radiation exposure. Future directions include enhanced burnout identification and medical coding for access to longitudinal data. AI may be a solution to addressing specific burnout risk factors in interventional radiology. No level of evidence. Review Article.

Obesity prevalence is increasing globally, accompanied by increases in obesity-related diseases. While obesity is usually defined by BMI, the development of obesity-related disease might be better characterized by specific adipose tissue (AT) distributions or body composition subphenotypes. Serum metabolite patterns reflecting AT distribution could provide insights into potential underlying pathophysiological pathways and the interplay between AT depots. We therefore aim to identify metabolite signatures associated with specific AT depots and body composition subphenotypes. Targeted metabolites (Biocrates p180 kit) were measured in fasted serum for N&#x2009;=&#x2009;390 individuals from the population-based KORA-FF4 cohort (42% women, average age 56y). AT was measured by magnetic resonance imaging. Association of n&#x2009;=&#x2009;29 AT depots (visceral (VAT), subcutaneous (SAT), pancreas, bone marrow, skeletal muscle, heart, kidney) and five body composition subphenotypes with 146 metabolites and 40 derived indicators were investigated by linear regressions with confounder adjustment for traditional cardiovascular disease risk factors and life style parameters. Subphenotypes were associated with 59, and single ATs with 275 metabolites or indicators, with VAT and SAT showing most associations. Compared to subphenotype I (low overall ATs), subphenotype II (average ATs) showed positive associations with diacylglycerophospholipids with differently saturated C32 fatty acid and sphingomyelins. Subphenotype III (high muscle and bone marrow fat) was negatively associated with total lysophosphatidylcholines (lyso-PCs) and total monounsaturated lyso-PCs, while showing a positive association with total long-chain acylcarnitines (C14-C18). Subphenotype IV (high SAT, high VAT and high liver fat) exhibited positive associations with short-chain acylcarnitines, alanine and aromatic amino acids. Subphenotype V (high pancreas fat fraction) was related to arginine and the ratio of ornithine and arginine as surrogate for ornithine synthesis. Three metabolites or indicators (lysoPC C 18.2, total polyunsaturated lyso-PC, phospholipase A2 as ratio of lyso-PC/diacyl- and acylalkylglycerophospholipids) were associated with all subphenotypes. These results were supported by the associations of individual ATs with metabolites or indicators. ATs, including ectopic fat depots such as pancreas fat, and subphenotypes of body composition show distinct serum metabolite patterns, which can serve as a first step to characterize potential obesity-related pathophysiological pathways.

Inflammatory bowel disease (IBD) is a chronic immune-mediated gastrointestinal disease, and its global incidence is on the rise, which seriously affects the quality of life of patients. Infliximab is the key therapeutic drug for IBD, and a comprehensive safety assessment is needed. In this pharmacovigilance study, we investigated the adverse events (AE) of infliximab in IBD patients by analyzing the reports submitted to the FDA's Adverse Event Reporting System (FAERS) database. We analyzed the reports of AEs related to infliximab in FAERS database (2004-2024). Disproportionality analysis (ROR, PRR, BCPNN) was used to identify the safety signals in the general population and gender subgroups. Based on the model of ROR, the influence of gender difference and combined medication was evaluated. The onset time (TTO) and Weibull shape parameter (WSP) were used to analyze and evaluate the occurrence time and risk trend of AEs. Among 80,138 AE reports, 57 Preferred Term (PT) and 14 System Organ Classification (SOC) signals were detected (ROR025 > 1, PRR > 2, &#x3c7;&#xb2; > 4, N &#x2265; 3, IC025 > 0). Some emerging AE signals, such as Horner's syndrome and Henoch-Schoenlein Henoch-Schonlein purpura nephritis (not mentioned in the drug label), suggest that there are new safety hazards. Females (50.7%) exhibited 67 signals, predominantly immune-related (e.g., lupus-like syndrome, N = 1028, ROR = 7.09), while males (41.8%) showed 42 signals, mainly cardiovascular (e.g., blood pressure fluctuation, ROR = 29.33) and infectious. Combined medication (67.3%) will increase cardiovascular risk, while monotherapy is associated with immune/tumor-related AEs (such as breast cancer, ROR = 1.2). Kidney and urinary system diseases (ROR = 21.84) are an under-reported problem. Time trade-off analysis (TTO, N = 15,682) showed that the median treatment duration was 620 days, and the early treatment failed (Weibull &#x3b2;=0.73). In addition, there was a significant gender difference in the incidence of AEs related to infliximab in IBD patients. This study emphasizes that there is a significant burden of AEs in IBD patients treated with infliximab, and finds new safety signals that need further verification. The characteristics of gender-specific AEs suggest that gender-specific monitoring is needed. Women have a higher risk of immune/tumor events, while men have a higher risk of cardiovascular/infectious AEs. Combined medication will aggravate cardiovascular risk, while monotherapy will increase immune/carcinogenic risk. The occurrence of early AEs highlights the necessity of early close monitoring. These findings suggest that pharmacovigilance needs to be improved to optimize the safety of infliximab.

To compare the added benefit of optical see-through, the Magic Leap 2 (ML2), and video see-through, the Apple Vision Pro (AVP), head-mounted displays extended reality (XR) during percutaneous biopsies on an abdominal phantom. In this phantom-based prospective cohort study, sixteen radiologists (5 experienced and 11 beginners) performed six needle insertions: two without XR, two with ML2, and two with AVP. Two lesions of differing difficulty (depth and proximity to vessels) were targeted. Post-procedure CT measured accuracy (hitting the target and distance and angle to lesion center). Cognitive workload and user experience were assessed using a structured questionnaire with a rating of 0-20. Beginners benefited more from XR than experienced radiologists. Beginners improved their targeting accuracy with XR, especially for the more complex lesion closer to blood vessels, where success rates increased using XR (conventional: 1/11, ML2: 2/11, AVP: 4/11), with a decrease in mean distance to target (conventional: 17.95&#x2009;&#xb1;&#x2009;9.14&#xa0;mm; ML2: 14.21&#x2009;&#xb1;&#x2009;6.27&#xa0;mm; AVP: 12.02&#x2009;&#xb1;&#x2009;7.19&#xa0;mm). Advanced radiologists had overall lower success rates (conventional: 1/5, ML2: 0/5, AVP: 1/5). XR also reduced puncture time for beginner (ML2: 68.1%, AVP: 56.9% of baseline) and advanced radiologists (ML2: 79.0%, AVP: 61.7%). Questionnaire results indicated AVP was perceived as more mentally demanding, particularly by experienced radiologists (mental demand: conventional: 11, ML2: 9, AVP: 12, for beginners, and conventional: 12, ML2: 11, AVP: 17, for advanced). Beginners adapted well to both systems, showing no significant difference in perceived workload compared to conventional puncture and similar performance levels (conventional: 9, ML2: 9, AVP: 12, for beginners, and conventional: 15, ML2: 11, AVP: 7, for advanced). Our work demonstrates that AVP performs similar to ML2 in needle placement tasks and can be used in further research and clinical application in interventional radiology. No level of evidence.

This study aimed to investigate the impact of evidence-based continuity of care (EBCC) on the recurrence rate of major adverse cardiovascular events (MACE) following interventional procedures in elderly patients with cardiovascular disease. A retrospective cohort study was conducted involving 210 patients who underwent cardiovascular interventions at our hospital between January 2021 and December 2023. Patients were divided into 2 groups based on the care method received: an EBCC group (n&#x2005;=&#x2005;94) and a conventional care group (n&#x2005;=&#x2005;116). Over a 12-month postoperative period, we assessed the incidence of MACE, quality of life, medication adherence, functional status, psychological well-being, and satisfaction with care. The incidence of MACE was significantly lower in the EBCC group compared to the conventional care group. Patients receiving continuity of care also demonstrated significant improvements in quality of life, medication adherence, functional status, and psychological health. Satisfaction with nursing care was notably higher in the continuity of care group. EBCC effectively reduces the incidence of postoperative MACE in elderly patients with cardiovascular disease. It enhances quality of life, medication adherence, psychological well-being, and patient satisfaction, thereby promoting comprehensive postoperative recovery.

To review the available evidence on the effectiveness and safety of bleomycin electrosclerotherapy (BEST) for slow-flow vascular malformations. A systematic review was conducted according to PRISMA guidelines, with a protocol registered in PROSPERO. Five databases were searched, supplemented by citation tracking, to identify peer-reviewed studies reporting clinical outcomes of BEST for slow-flow vascular malformations. Single-patient case reports were excluded. Two authors independently extracted data and assessed risk of bias. Ten studies were included, with a total of 401 patients and 416 lesions. Seven studies were retrospective, three were prospective, and one was comparative. Any symptom improvement was reported in 62-100% of patients; however, outcome definitions and assessment methods varied substantially across studies, limiting direct comparability. Any size reduction was reported in 83-100% of lesions, based on clinical and imaging-based assessments, including volumetry. Serious adverse events were uncommon, and no systemic toxicity was reported. All non-randomised studies had serious risk of bias. BEST appears promising for selected slow-flow vascular malformations. However, evidence is limited by methodological heterogeneity and high risk of bias, and treatment decisions should remain individualised and based on multidisciplinary evaluation.

To compare outcomes (clinical, laboratory and imaging features) and identify predictive factors for arterial embolization versus conservative treatment in the management of anticoagulated patients with spontaneous abdominal or pelvic hematomas. This retrospective single-center study analyzed 219 patients under anticoagulation therapy with spontaneous soft-tissue hematoma, between 2015 and 2020. Sixty two patients (28%) were treated with transcatheter arterial embolization (TAE) after multidisciplinary team discussion. Demographics, clinical, laboratory data, computed tomography (CT) findings, and treatment details were compared. Clinical success was defined as cessation of bleeding, hemodynamic stabilization, and hemoglobin level stabilization. Prognostic factors for 30-day mortality were assessed using univariate and multivariate Cox analyses. Patients referred for embolization presented more frequently with hemodynamic instability (41.7% vs. 10.2%,&#xa0;p&#x2009;<&#x2009;0.001), larger hematomas (1024 cm3 vs. 488 cm3,&#xa0;p&#x2009;<&#x2009;0.001), and more frequent contrast extravasation in the arterial phase (85.4% vs. 51.0%,&#xa0;p&#x2009;<&#x2009;0.001) and fascial rupture (45.2% vs. 12.7%,&#xa0;p&#x2009;<&#x2009;0.001) on CT. Conservative management was more common in patients with anticoagulant overdose (51.1% vs. 25.5%,&#xa0;p&#x2009;=&#x2009;0.002), especially vitamin K antagonists (50.4% vs. 33.0%,&#xa0;p&#x2009;=&#x2009;0.024). Technical success of TAE was 93.5%, and primary clinical success was 75%. The 30-day all-cause mortality rate following embolization was 22.6%. Univariate analysis identified impaired renal function (p&#x2009;<&#x2009;0.001), large hematoma volume (p&#x2009;=&#x2009;0.038), and fascial rupture (p&#x2009;=&#x2009;0.037) as predictors of mortality. No independent variable remained significant in multivariate analysis. TAE is an effective treatment option in selected patients with severe anticoagulant-related muscle hematomas, particularly in cases of hemodynamic instability or CT evidence of active bleeding and fascial rupture.

To evaluate the technical and clinical efficacy of the low-profile braided occluder (LOBO) device for proximal splenic artery embolization (SAE) and compare its performance with conventional coil embolization. This retrospective multi-institutional study included 44 consecutive patients who underwent proximal SAE between June 2023 and October 2025. Demographic data, etiology, embolic device type, fluoroscopy time, radiation dose, and outcomes were recorded. Technical success was defined as complete angiographic occlusion using the index device. Clinical success was defined as the absence of rebleeding or reintervention within 30 days. Of the 44 patients (mean age, 43.2 years; 39% females), 22 were treated using the LOBO device and 22 with coils. Trauma was the most common etiology (n&#x2009;=&#x2009;37, 84.1%). There were no clinical or demographic characteristic differences between the LOBO and coil groups. Proximal SAE was achieved with a single LOBO device in all patients. The mean number of coils used was 4.6 per case (median 3.5), p&#x2009;<&#x2009;0.001. Median fluoroscopy time was significantly reduced with LOBO compared with coils (11.65 vs 18.9 min; p&#x2009;=&#x2009;0.01). Radiation dose was significantly lower as well in the LOBO group compared with the coil group (128.4 vs 198.5 mGy; p&#x2009;=&#x2009;0.04). Clinical success was not significantly different between the groups, with the LOBO group achieving 100% and the coil group 90.9% (p&#x2009;>&#x2009;0.05). Splenic infarction was significantly higher with coils than with LOBO (33.3% vs 22.7%; p&#x2009;=&#x2009;0.046). No major adverse events occurred, and minor events were self-limited. One death in each group was attributable to polytrauma and unrelated to the procedure. The LOBO device provides safe, effective proximal SAE with significantly reduced fluoroscopy time and radiation dose compared with coils. Larger prospective studies are warranted. Level 4, study (retrospective, standard quality).

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Intraoperative microwave ablation (MWA) can be used simultaneously with liver resection in patients with colorectal liver metastases (CLM) with curative intent. It is uncertain whether this treatment concept is limited by the number of intraoperative MWAs or the number of CLMs. This study was performed to investigate whether the number of CLMs and intraoperative MWAs is associated with overall survival (OS) and recurrence-free survival (RFS). Patients with CLM who underwent both liver resection and intraoperative MWA between 1.1.2010 and 1.9.2020 were examined. The influence of the number of MWAs and CLMs on OS and RFS was assessed. Seventy-five patients were examined. The sex ratio (m:f) was 48:27. The median age was 61 years (range 34-86). The number of MWAs and CLMs was not associated with OS or RFS. Only adjuvant chemotherapy was associated with OS (HR 0.14 (0.04, 0.45), P < 0.001). The number of intraoperative MWAs and CLMs did not influence clinical outcomes. Liver resection and intraoperative MWA can be recommended to all patients regardless of the number of MWAs and CLMs, based on the findings of this study. Adjuvant chemotherapy emerges as a critical component of this multidisciplinary treatment strategy.

This study aimed to evaluate the safety and efficacy of catheter-directed mechanical thrombectomy without adjunctive thrombolysis in patients with intermediate-to-high-risk acute pulmonary embolism. A systematic review was performed across PubMed, Embase and the Cochrane Library until January 21, 2026. We included studies with intermediate-to-high-risk pulmonary embolism patients that underwent mechanical thrombectomy without thrombolysis. Continuous outcomes were analyzed using means and binary outcomes using proportion of events ratios, each with corresponding 95% confidence intervals. All analyses were performed using R software (version 4.4.1). A total of 13 studies comprising 1001 patients were included. The pooled rate of major bleeding was 2.39% (95% CI 1.20-3.58). In-hospital mortality occurred in 0.38% of patients (95% CI 0.00 to 1.00), and 30-day all-cause mortality was 0.72% (95% CI 0.00-1.49). Mean reduction in right ventricle-to-left ventricle ratio was 0.42 (95% CI 0.38-0.46). The mean intensive care unit and hospital length of stay were 1.96&#xa0;days (95% CI 1.22-2.70) and 5.41&#xa0;days (95% CI 4.48-6.34), respectively. Subgroup analyses suggested that higher bleeding and mortality rates were associated with higher-risk populations and smaller catheter sizes, although differences were not statistically significant. This meta-analysis suggests that catheter-directed mechanical thrombectomy without thrombolysis for intermediate-to-high-risk pulmonary embolism is associated with low rates of bleeding and mortality, improvements in hemodynamic parameters and short hospital and intensive care unit stays.

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Stroke caused by carotid plaques is a major cause of morbidity and mortality. Magnetic resonance imaging (MRI) can assess the degree of stenosis and plaque composition. Inflammation and lipid content are challenging to image with conventional imaging and MRI sequences, although being a major pathogenetic factor. This study investigates novel approaches to quantify inflammation or hemorrhage and lipid volume in association with neurologic symptoms on ex-vivo 7&#xa0;T MRI. Plaques from 44 patients with low calcification content were selected for imaging. T1w magnetization transfer water sat (T1-MTWS), diffusion tensor imaging (DTI), T1w, T2w, and T2*w images were acquired. Signal intensities (SIs) were referenced to agarose gel and volumetrically quantified. Hypo-/hyperintense volumes as well as volumetric SI measurements were compared between plaques from symptomatic versus asymptomatic patients. Histological validation was performed for specimens with areas of diffusion restriction or lipid signal. SIs were indifferent on T1w and T2*w images. Plaques from symptomatic patients were more hypointense on T2w-images (90.3% vs. 73.4%, p&#xa0;=&#xa0;0.02). Lower apparent diffusion coefficient (ADC) volume was associated with symptoms (%hypointense volume on ADC from DTI - area under the receiver operator curve: 0.76 (0.61-0.90)). Plaques displaying signals on T1-MTWS images were symptomatic in 9/10 cases, but the odds-ratio was insignificant (OR: 1.3 (0.95-1.8)). This study highlights the potential for 7&#xa0;T MRI to assess radiological properties indicative of vulnerable plaque features, such as inflammation or hemorrhage and lipid content in association with neurologic symptoms. To date, 7&#xa0;T MRI is not commonly available for clinical routine, but these findings support further research into more sophisticated imaging techniques to improve risk stratification before revascularization therapy.

Trans-radial access (TRA) offers advantages in elective settings, but its safety and feasibility in emergencies remain understudied. This study compares TRA and trans-femoral access (TFA) in emergency embolizations at a Level 1 trauma center. Ethical approval was obtained for this retrospective analysis. A total of 421 emergency embolizations performed on 389 patients were included. TRA (n&#x2009;=&#x2009;95, including 44 distal radial) and TFA (n&#x2009;=&#x2009;326) were compared for technical success rate, procedural success rate, and access-site complications. Multivariate analysis was used to identify independent predictors of complications. TRA patients were younger (median 58 vs. 66&#xa0;years; p&#x2009;=&#x2009;0.044) with less hypertension (33.7% vs. 46.6%; p&#x2009;=&#x2009;0.025). Technical success rate was 99.0% for TRA and 99.7% for TFA (p&#x2009;=&#x2009;1.000). Procedural success was 100% for TRA and 99.7% for TFA (p&#x2009;=&#x2009;1.000). Overall complications occurred in 5.5% (3.2% TRA vs. 6.1% TFA; p&#x2009;=&#x2009;0.234), most were minor bleeding-related complications (2.1% TRA vs. 5.2% TFA; p&#x2009;=&#x2009;0.164). Major complications (1.0% total) included pseudoaneurysm formation (n&#x2009;=&#x2009;3; 1 in TRA, 2 in TFA) and retroperitoneal hemorrhage (n&#x2009;=&#x2009;1 in TFA), with no group differences (p&#x2009;=&#x2009;0.908). Adjusting for age, hypertension, diabetes mellitus, antithrombotic use and sheath size, multivariate analysis found that access site (TRA vs. TFA) was not found to be an independent predictor of all complications (OR 0.524; 95% CI: 0.147&#xa0;-&#xa0;1.859; p&#x2009;=&#x2009;0.317). TRA, including distal radial "snuffbox" access, is a safe alternative to TFA for emergency embolization, demonstrating high technical and procedural success rates. Level 4, Cohort study.

Preoperatively differentiating uterine sarcomas from leiomyomas remains challenging using routine imaging. We evaluated whether quantitative venous-phase CT metrics, such as attenuation profiling and dual-energy CT (DECT) iodine mapping, can aid in discrimination. In this retrospective single-center study, cases of women with histopathology-proven leiomyoma or uterine sarcoma who underwent contrast-enhanced abdominopelvic CT (01/2010-01/2025) were included; lesions with dominant macrocalcifications were excluded. On venous-phase CT, ROI-based HU profiles were computed on the slice showing the maximal cross-sectional area of each lesion; the leading profile-derived parameters were the intralesional minimum HU, maximal HU, and the &#x394;HU (&#x394;HU&#xa0;=&#xa0;max-min). Reader-consensus values were analyzed. In a DECT subset of 20 cases, readers placed lesion and aortic ROIs to compute normalized iodine concentration (NIC&#xa0;=&#xa0;iodine_lesion/iodine_aorta). 81 patients were analyzed (leiomyoma n&#xa0;=&#xa0;41, sarcoma n&#xa0;=&#xa0;40; sarcoma subtypes: LMS n&#xa0;=&#xa0;15, MMMT/CS n&#xa0;=&#xa0;10, ESS n&#xa0;=&#xa0;9, adenosarcoma n&#xa0;=&#xa0;3, and UUS n&#xa0;=&#xa0;3). Sarcomas showed lower minimum HU and higher &#x394;HU than leiomyomas (all p&#xa0;<&#xa0;0.001), yielding AUC&#xa0;=&#xa0;0.75 (minimum HU) and AUC&#xa0;=&#xa0;0.73 (&#x394;HU). DECT with normalized iodine concentration (NIC) was available in n&#xa0;=&#xa0;20 (10/10) and was higher in sarcomas, achieving AUC&#xa0;=&#xa0;0.96 (Youden&#xa0;=&#xa0;0.733, sensitivity&#xa0;=&#xa0;0.80, specificity&#xa0;=&#xa0;1.00). Reliability was good-to-excellent for HU features (ICC&#xa0;=&#xa0;0.86-0.97) and excellent for iodine metrics (ICC&#xa0;=&#xa0;0.99-1.00). Simple, aorta-normalized CT metrics may capture biologically plausible differences between uterine leiomyomas and sarcomas. In particular, aorta-normalized attenuation features showed fair discriminatory performance in the overall cohort, while DECT-derived NIC showed promising but exploratory performance in a small spectral subset that requires external confirmation.