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This pictorial essay introduces a structured, four-category framework for recognizing and interpreting abdominal artifacts and related phenomena (ARPs): (1) the \u201cVirtual Biopsy,\u201d encompassing ARPs that aid in characterizing tissue composition and pathology; (2) the \u201cFlowmeter,\u201d representing ARPs that provide insight into physiologic or pathologic flow states; (3) the \u201cSignpost,\u201d describing ARPs that direct attention toward or mimic the underlying pathology; and (4) the \u201cTiebreaker,\u201d reviewing ARPs that prompt multi-modality correlation or other problem-solving to reach the correct diagnosis. Representative clinical cases illustrate each category across medical imaging modalities. This framework provides a systematic approach to incorporating ARPs into diagnostic reasoning.<\/jats:p>","DOI":"10.1007\/s00261-026-05800-x","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:20:57Z","timestamp":1790259657000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Decoding the image: finding diagnostic signals in multi-modality abdominal artifacts"],"prefix":"10.1007","author":[{"given":"Gabrielle","family":"Dickerson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Chirico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-7467","authenticated-orcid":false,"given":"Andreas","family":"Loening","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jade J.","family":"Wong-You-Cheong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7088-1910","authenticated-orcid":false,"given":"Barton Frederick","family":"Lane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6519-5222","authenticated-orcid":false,"given":"Florence Xini","family":"Doo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"issue":"5","key":"5800_CR1","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1148\/rg.2015140289","volume":"35","author":"SY Huang","year":"2015","unstructured":"Huang SY, Seethamraju RT, Patel P, Hahn PF, Kirsch JE, Guimaraes AR. 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