Pub Date : 2024-09-02DOI: 10.1007/s00234-024-03455-3
Daniel Barber, Nicholas Trost, Christiane Stehmann, Victoria Lewis, James Doecke, Ash Jhamb, Shin-Han Leon Winata, Steven Collins
{"title":"Correction to: Assessing the newly proposed MRI criteria for diagnosing sporadic Creutzfeldt-Jakob disease.","authors":"Daniel Barber, Nicholas Trost, Christiane Stehmann, Victoria Lewis, James Doecke, Ash Jhamb, Shin-Han Leon Winata, Steven Collins","doi":"10.1007/s00234-024-03455-3","DOIUrl":"https://doi.org/10.1007/s00234-024-03455-3","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The preoperative assessment of carotid plaques is necessary to render revascularization safe and effective. The aim of this study is to evaluate the usefulness of chemical exchange saturation transfer (CEST)-MRI, particularly amide proton transfer (APT) imaging as a preoperative carotid plaque diagnostic tool.
Methods: We recorded the APT signal intensity on concentration maps of 34 patients scheduled for carotid endarterectomy. Plaques were categorized into group A (APT signal intensity ≥ 1.90 E-04; n = 12) and group B (APT signal intensity < 1.90 E-04; n = 22). Excised plaques were subjected to histopathological assessment and, using the classification promulgated by the American Heart Association, they were classified as intraplaque hemorrhage-positive [type VI-positive (tVI+)] and -negative [no intraplaque hemorrhage (tVI-)].
Results: Of the 34 patients, 22 (64.7%) harbored tVI+- and 12 (35.3%) had tVI- plaques. The median APT signals were significantly higher in tVI+- than tIVI- patients (2.43 E-04 (IQR = 0.98-4.00 E-04) vs 0.54 E-04 (IQR = 0.14-1.09 E-04), p < .001). Histopathologically, the number of patients with tVI+ plaques was significantly greater in group A (100%, n = 12) than group B (45%, n = 22) (p < .01). The number of symptomatic patients or asymptomatic patients with worsening stenosis was also significantly greater in group A than group B (75% vs 36%, p < .01).
Conclusion: In unstable plaques with intraplaque hemorrhage and in patients with symptoms or progressive stenosis, the ATP signals were significantly elevated. CEST-MRI studies has the potential for the preoperative assessment of the plaques' characteristics.
目的:为使血管重建安全有效,术前评估颈动脉斑块十分必要。本研究旨在评估化学交换饱和转移(CEST)-MRI,尤其是酰胺质子转移(APT)成像作为术前颈动脉斑块诊断工具的实用性:我们在 34 名计划接受颈动脉内膜切除术的患者的浓度图上记录了 APT 信号强度。斑块分为 A 组(APT 信号强度≥ 1.90 E-04;n = 12)和 B 组(APT 信号强度 +)]和阴性[无斑块内出血(tVI-)]:34名患者中,22人(64.7%)患有tVI+-斑块,12人(35.3%)患有tVI-斑块。tVI+-患者的 APT 信号中位数明显高于 tIVI- 患者(2.43 E-04 (IQR = 0.98-4.00 E-04) vs 0.54 E-04 (IQR = 0.14-1.09 E-04)),A 组(100%,n = 12)的 p +斑块明显多于 B 组(45%,n = 22)(p 结论:tVI+-患者的 APT 信号中位数明显高于 tIVI- 患者(2.43 E-04 (IQR = 0.98-4.00 E-04) vs 0.54 E-04 (IQR = 0.14-1.09 E-04)):在斑块内出血的不稳定斑块以及有症状或进行性狭窄的患者中,ATP 信号明显升高。CEST-MRI 研究可用于术前评估斑块的特征。
{"title":"Characterization of carotid plaques using chemical exchange saturation transfer imaging.","authors":"Yasuhisa Kanematsu, Yuki Kanazawa, Kenji Shimada, Masaaki Korai, Takeshi Miyamoto, Shu Sogabe, Manabu Ishihara, Izumi Yamaguchi, Takeshi Oya, Nobuaki Yamamoto, Yuki Yamamoto, Mitsuharu Miyoshi, Masafumi Harada, Yasushi Takagi","doi":"10.1007/s00234-024-03401-3","DOIUrl":"10.1007/s00234-024-03401-3","url":null,"abstract":"<p><strong>Purpose: </strong>The preoperative assessment of carotid plaques is necessary to render revascularization safe and effective. The aim of this study is to evaluate the usefulness of chemical exchange saturation transfer (CEST)-MRI, particularly amide proton transfer (APT) imaging as a preoperative carotid plaque diagnostic tool.</p><p><strong>Methods: </strong>We recorded the APT signal intensity on concentration maps of 34 patients scheduled for carotid endarterectomy. Plaques were categorized into group A (APT signal intensity ≥ 1.90 E-04; n = 12) and group B (APT signal intensity < 1.90 E-04; n = 22). Excised plaques were subjected to histopathological assessment and, using the classification promulgated by the American Heart Association, they were classified as intraplaque hemorrhage-positive [type VI-positive (tVI<sup>+</sup>)] and -negative [no intraplaque hemorrhage (tVI<sup>-</sup>)].</p><p><strong>Results: </strong>Of the 34 patients, 22 (64.7%) harbored tVI<sup>+</sup>- and 12 (35.3%) had tVI<sup>-</sup> plaques. The median APT signals were significantly higher in tVI<sup>+</sup>- than tIVI<sup>-</sup> patients (2.43 E-04 (IQR = 0.98-4.00 E-04) vs 0.54 E-04 (IQR = 0.14-1.09 E-04), p < .001). Histopathologically, the number of patients with tVI<sup>+</sup> plaques was significantly greater in group A (100%, n = 12) than group B (45%, n = 22) (p < .01). The number of symptomatic patients or asymptomatic patients with worsening stenosis was also significantly greater in group A than group B (75% vs 36%, p < .01).</p><p><strong>Conclusion: </strong>In unstable plaques with intraplaque hemorrhage and in patients with symptoms or progressive stenosis, the ATP signals were significantly elevated. CEST-MRI studies has the potential for the preoperative assessment of the plaques' characteristics.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-09DOI: 10.1007/s00234-024-03428-6
Frederick J A Meijer
{"title":"Artificial intelligence will make neuroradiology even more exciting.","authors":"Frederick J A Meijer","doi":"10.1007/s00234-024-03428-6","DOIUrl":"10.1007/s00234-024-03428-6","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The Centiloid project helps calibrate the quantitative amyloid-β (Aβ) load into a unified Centiloid (CL) scale that allows data comparison across multi-site. How the smaller regional amyloid converted into CL has not been attempted. We first aimed to express regional Aβ deposition in CL using [18F]Flutemetamol and evaluate regional Aβ deposition in CL with that in standardized uptake value ratio (SUVr). Second, we aimed to determine the presence or absence of focal Aβ deposition by measuring regional CL in equivocal cases showing negative global CL.
Methods: Following the Centiloid project pipeline, Level-1 replication, Level-2 calibration, and quality control were completed to generate corresponding Centiloid conversion equations to convert SUVr into Centiloid at regional levels. In equivocal cases, the regional CL was compared with visual inspection to evaluate regional Aβ positivity.
Results: 14 out of 16 regional conversions from [18F]Flutemetamol SUVr to Centiloid successfully passed the quality control, showing good reliability and relative variance, especially precuneus/posterior cingulate and prefrontal regions with good stability for Centiloid scaling. The absence of focal Aβ deposition could be detected by measuring regional CL, showing a high agreement rate with visual inspection. The regional Aβ positivity in the bilateral anterior cingulate cortex was most prevalent in equivocal cases.
Conclusion: The expression of regional brain Aβ deposition in CL with [18F]Flutemetamol has been attempted in this study. Equivocal cases had focal Aβ deposition that can be detected by measuring regional CL.
{"title":"Expression of regional brain amyloid-β deposition with <sup>[18F]</sup>Flutemetamol in Centiloid scale -a multi-site study.","authors":"Yi-Wen Bao, Zuo-Jun Wang, Li-Li Guo, Gen-Ji Bai, Yun Feng, Guo-Dong Zhao","doi":"10.1007/s00234-024-03364-5","DOIUrl":"10.1007/s00234-024-03364-5","url":null,"abstract":"<p><strong>Purpose: </strong>The Centiloid project helps calibrate the quantitative amyloid-β (Aβ) load into a unified Centiloid (CL) scale that allows data comparison across multi-site. How the smaller regional amyloid converted into CL has not been attempted. We first aimed to express regional Aβ deposition in CL using <sup>[18F]</sup>Flutemetamol and evaluate regional Aβ deposition in CL with that in standardized uptake value ratio (SUVr). Second, we aimed to determine the presence or absence of focal Aβ deposition by measuring regional CL in equivocal cases showing negative global CL.</p><p><strong>Methods: </strong>Following the Centiloid project pipeline, Level-1 replication, Level-2 calibration, and quality control were completed to generate corresponding Centiloid conversion equations to convert SUVr into Centiloid at regional levels. In equivocal cases, the regional CL was compared with visual inspection to evaluate regional Aβ positivity.</p><p><strong>Results: </strong>14 out of 16 regional conversions from <sup>[18F]</sup>Flutemetamol SUVr to Centiloid successfully passed the quality control, showing good reliability and relative variance, especially precuneus/posterior cingulate and prefrontal regions with good stability for Centiloid scaling. The absence of focal Aβ deposition could be detected by measuring regional CL, showing a high agreement rate with visual inspection. The regional Aβ positivity in the bilateral anterior cingulate cortex was most prevalent in equivocal cases.</p><p><strong>Conclusion: </strong>The expression of regional brain Aβ deposition in CL with <sup>[18F]</sup>Flutemetamol has been attempted in this study. Equivocal cases had focal Aβ deposition that can be detected by measuring regional CL.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-17DOI: 10.1007/s00234-024-03430-y
Doo Young Lee, Ka Eum Choi, Kyunghwa Han, Seo Hee Choi, Narae Lee, Sung Soo Ahn, Jong Hee Chang, Se Hoon Kim, Seung-Koo Lee, Yae Won Park
Purpose: To investigate whether qualitative and quantitative imaging phenotypes can predict the grade of oligodendroglioma.
Methods: Retrospective chart and imaging reviews were conducted on 180 adults with oligodendroglioma (IDH-mutant and 1p/19q codeleted) between 2005 and 2021. Qualitative imaging characteristics including tumor location, calcification, gliomatosis cerebri, cystic change, necrosis, and infiltrative pattern were analyzed. Quantitative imaging assessment was performed from the tumor mask via automatic segmentation to calculate total, contrast-enhancing (CE), non-enhancing (NE), and necrotic tumor volumes. Logistic analyses were conducted to determine predictors of oligodendroglioma grade.
Results: This study included 180 patients (84 [46.7%] with grade 2 and 96 [53.3%] with grade 3 oligodendrogliomas), with a median age of 42 years (range 23-76 years), comprising 91 females and 89 males. On univariable analysis, calcification (odds ratio [OR] = 6.00, P < 0.001), necrosis (OR = 21.84, P = 0.003), presence of CE tumor (OR = 7.86, P < 0.001), larger total (OR = 1.01, P < 0.001), larger CE (OR = 2.22, P = 0.010), and larger NE (OR = 1.01, P < 0.001) tumor volumes were predictors of grade 3 oligodendroglioma. On multivariable analysis, calcification (OR = 3.79, P < 0.001) and larger CE tumor volume (OR = 2.70, P = 0.043) remained as independent predictors of grade 3 oligodendroglioma. The multivariable model exhibited an AUC, accuracy, sensitivity, specificity of 0.78 (95% confidence interval 0.72-0.84), 72.8%, 79.2%, 69.1%, respectively.
Conclusion: Presence of calcification and larger CE tumor volume may serve as useful imaging biomarkers for prediction of oligodendroglioma grade.
Clinical relevance statement: Assessment of intratumoral calcification and CE tumor volume may facilitate accurate preoperative estimation of oligodendroglioma grade. Presence of intratumoral calcification and larger contrast-enhancing tumor volume were the significant predictors of higher grade oligodendroglioma based on the 2021 WHO classification.
{"title":"Revisiting oligodendroglioma grading in the 2021 WHO classification: calcification and larger contrast-enhancing tumor volume may predict higher oligodendroglioma grade.","authors":"Doo Young Lee, Ka Eum Choi, Kyunghwa Han, Seo Hee Choi, Narae Lee, Sung Soo Ahn, Jong Hee Chang, Se Hoon Kim, Seung-Koo Lee, Yae Won Park","doi":"10.1007/s00234-024-03430-y","DOIUrl":"10.1007/s00234-024-03430-y","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether qualitative and quantitative imaging phenotypes can predict the grade of oligodendroglioma.</p><p><strong>Methods: </strong>Retrospective chart and imaging reviews were conducted on 180 adults with oligodendroglioma (IDH-mutant and 1p/19q codeleted) between 2005 and 2021. Qualitative imaging characteristics including tumor location, calcification, gliomatosis cerebri, cystic change, necrosis, and infiltrative pattern were analyzed. Quantitative imaging assessment was performed from the tumor mask via automatic segmentation to calculate total, contrast-enhancing (CE), non-enhancing (NE), and necrotic tumor volumes. Logistic analyses were conducted to determine predictors of oligodendroglioma grade.</p><p><strong>Results: </strong>This study included 180 patients (84 [46.7%] with grade 2 and 96 [53.3%] with grade 3 oligodendrogliomas), with a median age of 42 years (range 23-76 years), comprising 91 females and 89 males. On univariable analysis, calcification (odds ratio [OR] = 6.00, P < 0.001), necrosis (OR = 21.84, P = 0.003), presence of CE tumor (OR = 7.86, P < 0.001), larger total (OR = 1.01, P < 0.001), larger CE (OR = 2.22, P = 0.010), and larger NE (OR = 1.01, P < 0.001) tumor volumes were predictors of grade 3 oligodendroglioma. On multivariable analysis, calcification (OR = 3.79, P < 0.001) and larger CE tumor volume (OR = 2.70, P = 0.043) remained as independent predictors of grade 3 oligodendroglioma. The multivariable model exhibited an AUC, accuracy, sensitivity, specificity of 0.78 (95% confidence interval 0.72-0.84), 72.8%, 79.2%, 69.1%, respectively.</p><p><strong>Conclusion: </strong>Presence of calcification and larger CE tumor volume may serve as useful imaging biomarkers for prediction of oligodendroglioma grade.</p><p><strong>Clinical relevance statement: </strong>Assessment of intratumoral calcification and CE tumor volume may facilitate accurate preoperative estimation of oligodendroglioma grade. Presence of intratumoral calcification and larger contrast-enhancing tumor volume were the significant predictors of higher grade oligodendroglioma based on the 2021 WHO classification.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-12DOI: 10.1007/s00234-024-03413-z
Karl Jacobs, Daniel Docter, Lotte de Smit, Hans A M Korfage, Sophie C Visser, Frank Lobbezoo, Ruslan Hlushchuk, Bernadette S de Bakker
Background: Visualizing (micro)vascular structures remains challenging for researchers and clinicians due to limitations in traditional radiological imaging methods. Exploring the role of vascular development in craniofacial malformations in experimental settings can enhance understanding of these processes, with the effectiveness of high-resolution imaging techniques being crucial for successful research in this field. Micro-CT imaging offers 3D microstructural insights, but requires contrast-enhancing staining agents (CESAs) for visualizing (micro)-vascular tissues, known as contrast-enhanced micro-CT (CECT). As effective contrast agents are crucial for optimal visualization, this review focuses on comparative studies investigating such agents for micro-vascular tissue imaging using micro-CT. Furthermore, we demonstrate the utilization of B-Lugol solution as a promising contrast agent for acquiring high-quality micro-CT images of (micro)vascular structures in human embryonic samples.
Method: This scoping review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. PubMed database provided relevant articles, screened initially by title and abstract. Inclusion and exclusion criteria defined outcomes of interest.
Results: From an initial search, 273 records were identified, narrowed down to 9 articles after applying our criteria. Additionally, two articles were added through citation searching. This, a total of 11 articles were incorporated in this study.
Conclusion: This micro-CT contrast agent review underscores the need for tailored choices based on research goals. Both Barium sulfate and Iodine-based agents showing excellent results, providing high resolution (micro) vascular content, especially in ex-vivo specimens. However, careful consideration of protocols and tissue characteristics remains imperative for optimizing the effectiveness of micro-CT imaging for the study of cranio-facial vascular development.
{"title":"High resolution imaging of human development: shedding light on contrast agents.","authors":"Karl Jacobs, Daniel Docter, Lotte de Smit, Hans A M Korfage, Sophie C Visser, Frank Lobbezoo, Ruslan Hlushchuk, Bernadette S de Bakker","doi":"10.1007/s00234-024-03413-z","DOIUrl":"10.1007/s00234-024-03413-z","url":null,"abstract":"<p><strong>Background: </strong>Visualizing (micro)vascular structures remains challenging for researchers and clinicians due to limitations in traditional radiological imaging methods. Exploring the role of vascular development in craniofacial malformations in experimental settings can enhance understanding of these processes, with the effectiveness of high-resolution imaging techniques being crucial for successful research in this field. Micro-CT imaging offers 3D microstructural insights, but requires contrast-enhancing staining agents (CESAs) for visualizing (micro)-vascular tissues, known as contrast-enhanced micro-CT (CECT). As effective contrast agents are crucial for optimal visualization, this review focuses on comparative studies investigating such agents for micro-vascular tissue imaging using micro-CT. Furthermore, we demonstrate the utilization of B-Lugol solution as a promising contrast agent for acquiring high-quality micro-CT images of (micro)vascular structures in human embryonic samples.</p><p><strong>Method: </strong>This scoping review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. PubMed database provided relevant articles, screened initially by title and abstract. Inclusion and exclusion criteria defined outcomes of interest.</p><p><strong>Results: </strong>From an initial search, 273 records were identified, narrowed down to 9 articles after applying our criteria. Additionally, two articles were added through citation searching. This, a total of 11 articles were incorporated in this study.</p><p><strong>Conclusion: </strong>This micro-CT contrast agent review underscores the need for tailored choices based on research goals. Both Barium sulfate and Iodine-based agents showing excellent results, providing high resolution (micro) vascular content, especially in ex-vivo specimens. However, careful consideration of protocols and tissue characteristics remains imperative for optimizing the effectiveness of micro-CT imaging for the study of cranio-facial vascular development.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-12DOI: 10.1007/s00234-024-03399-8
Yihua Liu, Fengfeng Zhao, Enjing Niu, Liang Chen
Purpose: Early identification of hematoma enlargement and persistent hematoma expansion (HE) in patients with cerebral hemorrhage is increasingly crucial for determining clinical treatments. However, due to the lack of clinically effective tools, radiomics has been gradually introduced into the early identification of hematoma enlargement. Though, radiomics has limited predictive accuracy due to variations in procedures. Therefore, we conducted a systematic review and meta-analysis to explore the value of radiomics in the early detection of HE in patients with cerebral hemorrhage.
Methods: Eligible studies were systematically searched in PubMed, Embase, Cochrane and Web of Science from inception to April 8, 2024. English articles are considered eligible. The radiomics quality scoring (RQS) tool was used to evaluate included studies.
Results: A total of 34 studies were identified with sample sizes ranging from 108 to 3016. Eleven types of models were involved, and the types of modeling contained mainly clinical, radiomic, and radiomic plus clinical features. The radiomics models seem to have better performance (0.77 and 0.73 C-index in the training cohort and validation cohort, respectively) than the clinical models (0.69 C-index in the training cohort and 0.70 C-index in the validation cohort) in discriminating HE. However, the C-index was the highest for the combined model in both the training (0.82) and validation (0.79) cohorts.
Conclusions: Machine learning based on radiomic plus clinical features has the best predictive performance for HE, followed by machine learning based on radiomic features, and can be used as a potential tool to assist clinicians in early judgment.
目的:脑出血患者血肿扩大和持续性血肿扩大(HE)的早期识别对于决定临床治疗越来越重要。然而,由于缺乏临床有效的工具,放射组学已逐渐被引入血肿扩大的早期识别中。尽管如此,由于操作程序的不同,放射组学的预测准确性有限。因此,我们进行了一项系统性回顾和荟萃分析,以探讨放射组学在早期发现脑出血患者 HE 中的价值:方法:在 PubMed、Embase、Cochrane 和 Web of Science 中系统检索了从开始到 2024 年 4 月 8 日的符合条件的研究。符合条件的文章均为英文文章。采用放射组学质量评分(RQS)工具对纳入的研究进行评估:共确定了 34 项研究,样本量从 108 到 3016 不等。共涉及 11 种模型,模型类型主要包括临床特征、放射组学特征和放射组学加临床特征。放射组学模型在鉴别 HE 方面的表现(训练队列和验证队列中的 C 指数分别为 0.77 和 0.73)似乎优于临床模型(训练队列中的 C 指数为 0.69,验证队列中的 C 指数为 0.70)。然而,在训练队列(0.82)和验证队列(0.79)中,组合模型的 C 指数都是最高的:结论:基于放射学和临床特征的机器学习对 HE 的预测效果最好,其次是基于放射学特征的机器学习,可作为辅助临床医生进行早期判断的潜在工具。
{"title":"Machine learning for predicting hematoma expansion in spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.","authors":"Yihua Liu, Fengfeng Zhao, Enjing Niu, Liang Chen","doi":"10.1007/s00234-024-03399-8","DOIUrl":"10.1007/s00234-024-03399-8","url":null,"abstract":"<p><strong>Purpose: </strong>Early identification of hematoma enlargement and persistent hematoma expansion (HE) in patients with cerebral hemorrhage is increasingly crucial for determining clinical treatments. However, due to the lack of clinically effective tools, radiomics has been gradually introduced into the early identification of hematoma enlargement. Though, radiomics has limited predictive accuracy due to variations in procedures. Therefore, we conducted a systematic review and meta-analysis to explore the value of radiomics in the early detection of HE in patients with cerebral hemorrhage.</p><p><strong>Methods: </strong>Eligible studies were systematically searched in PubMed, Embase, Cochrane and Web of Science from inception to April 8, 2024. English articles are considered eligible. The radiomics quality scoring (RQS) tool was used to evaluate included studies.</p><p><strong>Results: </strong>A total of 34 studies were identified with sample sizes ranging from 108 to 3016. Eleven types of models were involved, and the types of modeling contained mainly clinical, radiomic, and radiomic plus clinical features. The radiomics models seem to have better performance (0.77 and 0.73 C-index in the training cohort and validation cohort, respectively) than the clinical models (0.69 C-index in the training cohort and 0.70 C-index in the validation cohort) in discriminating HE. However, the C-index was the highest for the combined model in both the training (0.82) and validation (0.79) cohorts.</p><p><strong>Conclusions: </strong>Machine learning based on radiomic plus clinical features has the best predictive performance for HE, followed by machine learning based on radiomic features, and can be used as a potential tool to assist clinicians in early judgment.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-24DOI: 10.1007/s00234-024-03408-w
Imad Zak, Shahram Hadidchi, Philip Ross
Keyhole aqueduct syndrome is a rare progressive neurodegenerative disorder describing a unique set of neuro-ophthalmologic, neuroimaging, and histopathological findings on autopsy. A midline mesencephalic cleft communicating with the cerebral aqueduct resembling syrinx is seen on imaging and histopathology. There are 9 cases published in the literature. We encountered a patient with vertical nystagmus, internuclear ophthalmoplegia, and progressive ataxia who has a midline cleft connecting the cerebral aqueduct with the interpeduncular cistern highlighting a distinguishing feature of this syndrome.
{"title":"Keyhole Aqueduct Syndrome.","authors":"Imad Zak, Shahram Hadidchi, Philip Ross","doi":"10.1007/s00234-024-03408-w","DOIUrl":"10.1007/s00234-024-03408-w","url":null,"abstract":"<p><p>Keyhole aqueduct syndrome is a rare progressive neurodegenerative disorder describing a unique set of neuro-ophthalmologic, neuroimaging, and histopathological findings on autopsy. A midline mesencephalic cleft communicating with the cerebral aqueduct resembling syrinx is seen on imaging and histopathology. There are 9 cases published in the literature. We encountered a patient with vertical nystagmus, internuclear ophthalmoplegia, and progressive ataxia who has a midline cleft connecting the cerebral aqueduct with the interpeduncular cistern highlighting a distinguishing feature of this syndrome.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-20DOI: 10.1007/s00234-024-03426-8
Joshua Loewenstern, Pierce McMahon, Daiqi Wang, Andrew D Schweitzer, Gayle Salama, Sara Strauss
Introduction: Identifying spontaneous CSF leaks can be difficult on CT myelography (CTM) in patients with suspected spontaneous intracranial hypotension (SIH). The current study compared renal collecting system (RCS) density during CTM in patients with suspected SIH relative to non-SIH controls and evaluated the overall utility as an indirect sign of spontaneous CSF leak in patients with SIH.
Methods: All CTM performed over an 8-year period (n = 392) were retrospectively reviewed and included cases (n = 295) were divided into groups consisting of SIH patients with (n = 35) or without (n = 77) confirmed CSF leak on CTM and non-SIH controls (n = 183). Average and relative average (relative to systemic contrast density) RCS densities were compared with multivariate analysis adjusting for patient characteristics and CTM technical differences.
Results: Average RCS densities were greater for confirmed versus non-confirmed SIH groups and greater for both SIH groups relative to non-SIH controls. Correlations between RCS density and time from injection to CTM were higher within SIH patient groups compared to controls. Measured RCS density had a higher negative predictive value for excluding CSF leak both within the SIH patient groups as well as the overall cohort (84% and 96%, respectively), with optimized thresholds yielding 80% sensitivity and 70% specificity for the presence of leak in the overall cohort.
Conclusion: Accounting for RCS density may provide reliable additional indirect diagnostic value about the suspicion of a CSF leak in patients undergoing CTM for evaluation of SIH symptoms.
{"title":"Clinical utility of CT myelography renal collecting system density in the evaluation of spinal CSF leak or CSF-venous connection in patients with spontaneous intracranial hypotension.","authors":"Joshua Loewenstern, Pierce McMahon, Daiqi Wang, Andrew D Schweitzer, Gayle Salama, Sara Strauss","doi":"10.1007/s00234-024-03426-8","DOIUrl":"10.1007/s00234-024-03426-8","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying spontaneous CSF leaks can be difficult on CT myelography (CTM) in patients with suspected spontaneous intracranial hypotension (SIH). The current study compared renal collecting system (RCS) density during CTM in patients with suspected SIH relative to non-SIH controls and evaluated the overall utility as an indirect sign of spontaneous CSF leak in patients with SIH.</p><p><strong>Methods: </strong>All CTM performed over an 8-year period (n = 392) were retrospectively reviewed and included cases (n = 295) were divided into groups consisting of SIH patients with (n = 35) or without (n = 77) confirmed CSF leak on CTM and non-SIH controls (n = 183). Average and relative average (relative to systemic contrast density) RCS densities were compared with multivariate analysis adjusting for patient characteristics and CTM technical differences.</p><p><strong>Results: </strong>Average RCS densities were greater for confirmed versus non-confirmed SIH groups and greater for both SIH groups relative to non-SIH controls. Correlations between RCS density and time from injection to CTM were higher within SIH patient groups compared to controls. Measured RCS density had a higher negative predictive value for excluding CSF leak both within the SIH patient groups as well as the overall cohort (84% and 96%, respectively), with optimized thresholds yielding 80% sensitivity and 70% specificity for the presence of leak in the overall cohort.</p><p><strong>Conclusion: </strong>Accounting for RCS density may provide reliable additional indirect diagnostic value about the suspicion of a CSF leak in patients undergoing CTM for evaluation of SIH symptoms.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-02DOI: 10.1007/s00234-024-03411-1
Theresa J van Lith, Wouter M Sluis, Naomi T Wijers, Frederick J A Meijer, Karin Kamphuis-van Ulzen, Jeroen de Bresser, Jan Willem Dankbaar, Quirijn de Mast, Frederikus A Klok, Suzanne C Cannegieter, Marieke J H Wermer, Menno V Huisman, Anil M Tuladhar, H Bart van der Worp, Frank-Erik de Leeuw
Purpose: To investigate the prevalence of cerebrovascular MRI markers in unselected patients hospitalized for COVID-19 (Coronavirus disease 2019), we compared these with healthy controls without previous SARS-CoV-2 infection or hospitalization and subsequently, investigated longitudinal (incidental) lesions in patients after three months.
Methods: CORONIS (CORONavirus and Ischemic Stroke) was an observational cohort study in adult hospitalized patients for COVID-19 and controls without COVID-19, conducted between April 2021 and September 2022. Brain MRI was performed shortly after discharge and after 3 months. Outcomes included recent ischemic (DWI-positive) lesions, previous infarction, microbleeds, white matter hyperintensities (WMH) and intracerebral hemorrhage and were analysed with logistic regression to adjust for confounders.
Results: 125 patients with COVID-19 and 47 controls underwent brain MRI a median of 41.5 days after symptom onset. DWI-positive lesions were found in one patient (1%) and in one (2%) control, both clinically silent. WMH were more prevalent in patients (78%) than in controls (62%) (adjusted OR: 2.95 [95% CI: 1.07-8.57]), other cerebrovascular MRI markers did not differ. Prevalence of markers in ICU vs. non-ICU patients was similar. After three months, five patients (5%) had new cerebrovascular lesions, including DWI-positive lesions (1 patient, 1.0%), cerebral infarction (2 patients, 2.0%) and microbleeds (3 patients, 3.1%).
Conclusion: Overall, we found no higher prevalence of cerebrovascular markers in unselected hospitalized COVID-19 patients compared to controls. The few incident DWI-lesions were most likely to be explained by risk-factors of small vessel disease. In the general hospitalized COVID-19 population, COVID-19 shows limited impact on cerebrovascular MRI markers shortly after hospitalization.
{"title":"Prevalence and 3-month follow-up of cerebrovascular MRI markers in hospitalized COVID-19 patients: the CORONIS study.","authors":"Theresa J van Lith, Wouter M Sluis, Naomi T Wijers, Frederick J A Meijer, Karin Kamphuis-van Ulzen, Jeroen de Bresser, Jan Willem Dankbaar, Quirijn de Mast, Frederikus A Klok, Suzanne C Cannegieter, Marieke J H Wermer, Menno V Huisman, Anil M Tuladhar, H Bart van der Worp, Frank-Erik de Leeuw","doi":"10.1007/s00234-024-03411-1","DOIUrl":"10.1007/s00234-024-03411-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prevalence of cerebrovascular MRI markers in unselected patients hospitalized for COVID-19 (Coronavirus disease 2019), we compared these with healthy controls without previous SARS-CoV-2 infection or hospitalization and subsequently, investigated longitudinal (incidental) lesions in patients after three months.</p><p><strong>Methods: </strong>CORONIS (CORONavirus and Ischemic Stroke) was an observational cohort study in adult hospitalized patients for COVID-19 and controls without COVID-19, conducted between April 2021 and September 2022. Brain MRI was performed shortly after discharge and after 3 months. Outcomes included recent ischemic (DWI-positive) lesions, previous infarction, microbleeds, white matter hyperintensities (WMH) and intracerebral hemorrhage and were analysed with logistic regression to adjust for confounders.</p><p><strong>Results: </strong>125 patients with COVID-19 and 47 controls underwent brain MRI a median of 41.5 days after symptom onset. DWI-positive lesions were found in one patient (1%) and in one (2%) control, both clinically silent. WMH were more prevalent in patients (78%) than in controls (62%) (adjusted OR: 2.95 [95% CI: 1.07-8.57]), other cerebrovascular MRI markers did not differ. Prevalence of markers in ICU vs. non-ICU patients was similar. After three months, five patients (5%) had new cerebrovascular lesions, including DWI-positive lesions (1 patient, 1.0%), cerebral infarction (2 patients, 2.0%) and microbleeds (3 patients, 3.1%).</p><p><strong>Conclusion: </strong>Overall, we found no higher prevalence of cerebrovascular markers in unselected hospitalized COVID-19 patients compared to controls. The few incident DWI-lesions were most likely to be explained by risk-factors of small vessel disease. In the general hospitalized COVID-19 population, COVID-19 shows limited impact on cerebrovascular MRI markers shortly after hospitalization.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}