D. C. Fragoso, D. Nunes, A. Maia, L. Garcia, H. Alves, C. J. D. Silva, C. Leite
Down syndrome is the foremost common genetic cause of intellectual disability. The additional copy of chromosome 21 confers potential changes in virtually all organ systems, including the brain, neck structures, and spine. Neuroradiologists should be aware of the multitude of imaging findings in patients with Down syndrome to correctly identify and diagnose life-altering conditions associated with this syndrome. In particular, the high prevalence of age-related cognitive decline and dementia stands out more clearly in recent decades due to the notable increase in these individuals' survival. Although the early and timely diagnosis of cognitive decline in patients with varying degrees of intellectual disability has not been an easy task from the clinical point of view, anatomic and functional brain studies have shown an essential role because they allow the early recognition of abnormalities that precede the cognitive decline. Furthermore, the similarities and differences in neuropathologic, genetic, and imaging aspects in patients with Down syndrome have allowed extrapolation for a better understanding of the mechanisms linked to Alzheimer disease development.Learning Objective: To review and systematize the distinctive characteristics and abnormalities of the head and neck, vertebral column, and CNS present in Down syndrome
{"title":"What We Should Not Forget about Down Syndrome","authors":"D. C. Fragoso, D. Nunes, A. Maia, L. Garcia, H. Alves, C. J. D. Silva, C. Leite","doi":"10.3174/ng.2000043","DOIUrl":"https://doi.org/10.3174/ng.2000043","url":null,"abstract":"Down syndrome is the foremost common genetic cause of intellectual disability. The additional copy of chromosome 21 confers potential changes in virtually all organ systems, including the brain, neck structures, and spine. Neuroradiologists should be aware of the multitude of imaging\u0000 findings in patients with Down syndrome to correctly identify and diagnose life-altering conditions associated with this syndrome. In particular, the high prevalence of age-related cognitive decline and dementia stands out more clearly in recent decades due to the notable increase in these\u0000 individuals' survival. Although the early and timely diagnosis of cognitive decline in patients with varying degrees of intellectual disability has not been an easy task from the clinical point of view, anatomic and functional brain studies have shown an essential role because they allow the\u0000 early recognition of abnormalities that precede the cognitive decline. Furthermore, the similarities and differences in neuropathologic, genetic, and imaging aspects in patients with Down syndrome have allowed extrapolation for a better understanding of the mechanisms linked to Alzheimer disease\u0000 development.Learning Objective: To review and systematize the distinctive characteristics and abnormalities of the head and neck, vertebral column, and CNS present in Down syndrome","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44462844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 15-year-old girl presented with intermittent nausea and vomiting, headache, and vision changes. MR imaging of the brain revealed an avidly enhancing infratemporal dural-based mass arising from the tentorium, with hyperintensity on T2WI and transdural extension into the posterior cranial fossa. The well-encapsulated fibrous tumor was resected en bloc after cauterization of its rich tentorial arterial supply. Histologic examination demonstrated pleomorphic myofibroblastic cells admixed with an inflammatory infiltrate. Spindle cells showed strong, diffusely positive immunostaining for anaplastic lymphoma kinase, and genomic sequencing uncovered a tropomyosin 3 gene and anaplastic lymphoma kinase fusion and an activating mutation in the Kirsten rat sarcoma oncogene. A diagnosis of inflammatory myofibroblastic tumor was made. Primary intracranial involvement of inflammatory myofibroblastic tumor is exceptionally rare, and few cases that feature an anaplastic lymphoma kinase translocation have been described. Inflammatory myofibroblastic tumor‐CNS is an important differential diagnosis for dural-based lesions in children and young adults due to its propensity for recurrence and malignant degeneration.
{"title":"Anaplastic Lymphoma Kinase‐Positive Inflammatory Myofibroblastic Tumor Mimicking Meningioma: A Case Report","authors":"J. Stone, R. Stonebridge, R. Bhuta, J. Boxerman","doi":"10.3174/ng.2000037","DOIUrl":"https://doi.org/10.3174/ng.2000037","url":null,"abstract":"A 15-year-old girl presented with intermittent nausea and vomiting, headache, and vision changes. MR imaging of the brain revealed an avidly enhancing infratemporal dural-based mass arising from the tentorium, with hyperintensity on T2WI and transdural extension into the posterior cranial\u0000 fossa. The well-encapsulated fibrous tumor was resected en bloc after cauterization of its rich tentorial arterial supply. Histologic examination demonstrated pleomorphic myofibroblastic cells admixed with an inflammatory infiltrate. Spindle cells showed strong, diffusely positive immunostaining\u0000 for anaplastic lymphoma kinase, and genomic sequencing uncovered a tropomyosin 3 gene and anaplastic lymphoma kinase fusion and an activating mutation in the Kirsten rat sarcoma oncogene. A diagnosis of inflammatory myofibroblastic tumor was made. Primary intracranial involvement of inflammatory\u0000 myofibroblastic tumor is exceptionally rare, and few cases that feature an anaplastic lymphoma kinase translocation have been described. Inflammatory myofibroblastic tumor‐CNS is an important differential diagnosis for dural-based lesions in children and young adults due to its propensity\u0000 for recurrence and malignant degeneration.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43907926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lateral meningocele syndrome, also known as Lehman syndrome, is an exceptionally uncommon genetic disorder, which is characterized by specific facial features and multisystem involvement, including skeletal, cardiac, and urogenital anomalies, akin to other connective tissue disorders, but it is set apart by the unique occurrence of multiple lateral meningoceles. Knowledge of the distinctive imaging features can strongly suggest the diagnosis in patients with complex clinical presentations to assist in the guidance of appropriate and timely clinical management.
{"title":"Imaging Diagnosis of Lateral Meningocele Syndrome","authors":"Surbhi Raichandani, D. Tassel, Kevin Wong","doi":"10.3174/ng.2000027","DOIUrl":"https://doi.org/10.3174/ng.2000027","url":null,"abstract":"Lateral meningocele syndrome, also known as Lehman syndrome, is an exceptionally uncommon genetic disorder, which is characterized by specific facial features and multisystem involvement, including skeletal, cardiac, and urogenital anomalies, akin to other connective tissue disorders,\u0000 but it is set apart by the unique occurrence of multiple lateral meningoceles. Knowledge of the distinctive imaging features can strongly suggest the diagnosis in patients with complex clinical presentations to assist in the guidance of appropriate and timely clinical management.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49218059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although sinonasal malignancies are relatively rare entities, the frequency of sinus imaging ensures that most radiologists will encounter an unsuspected sinonasal neoplasm at some point in their career. Given that the initial clinical presentations are often nonspecific and may mimic inflammatory rhinosinusitis, it is essential that the practicing radiologist becomes familiar with the specific CT and MR imaging findings that should raise suspicion for an underlying neoplasm. In the course of this review, we highlight the imaging features of a spectrum of sinonasal neoplasms, both benign and malignant, with emphasis on the distinct and complementary roles of CT and MR imaging in the differentiation from common inflammatory disease. We also highlight key anatomic relationships crucial to identifying routes of disease spread with an eye toward disease staging and surgical management.Learning Objectives: To familiarize the practicing radiologist with the key imaging features that should raise suspicion for an underlying sinonasal malignancy and to understand the complementary roles of CT and MR imaging in evaluating routes of locoregional and perineural disease spread.
{"title":"Masses, Malignancy, and Mimics: CT and MR Imaging of the Sinonasal Cavity","authors":"E. Funk, S. Dorros, A. Deconde, M. A. McDonald","doi":"10.3174/ng.2000030","DOIUrl":"https://doi.org/10.3174/ng.2000030","url":null,"abstract":"Although sinonasal malignancies are relatively rare entities, the frequency of sinus imaging ensures that most radiologists will encounter an unsuspected sinonasal neoplasm at some point in their career. Given that the initial clinical presentations are often nonspecific and may mimic\u0000 inflammatory rhinosinusitis, it is essential that the practicing radiologist becomes familiar with the specific CT and MR imaging findings that should raise suspicion for an underlying neoplasm. In the course of this review, we highlight the imaging features of a spectrum of sinonasal neoplasms,\u0000 both benign and malignant, with emphasis on the distinct and complementary roles of CT and MR imaging in the differentiation from common inflammatory disease. We also highlight key anatomic relationships crucial to identifying routes of disease spread with an eye toward disease staging and\u0000 surgical management.Learning Objectives: To familiarize the practicing radiologist with the key imaging features that should raise suspicion for an underlying sinonasal malignancy and to understand the complementary roles of CT and MR imaging in evaluating routes of locoregional\u0000 and perineural disease spread.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44105344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Anderson, W. B. Overcast, J. Brosch, B. Graner, M. Veronesi
Protein misfolding has been an area of intense research and is implicated in a number of neurodegenerative diseases. Key proteins in the brain lose their native ability to fold and instead assume abnormal conformations. Misfolded proteins cluster to form pathologic aggregates, which cause cellular dysfunction, neuronal death, and neurodegeneration. The prionopathies are best known among the neurodegenerative diseases for their ability to misfold, self-propagate, and infect other organisms. There is increasing evidence of a rationale for a prionlike mechanism of spread of other neurodegenerative diseases through a similar seeding mechanism. In this review, we detail the role of a key protein aberration known to the various prion diseases, including sporadic, variant, and iatrogenic Creutzfeldt-Jakob disease; variably protease-sensitive prionopathy; Gerstmann-Straussler-Scheinker disease; fatal familial insomnia; and kuru. We also discuss the clinical presentation, the available, and emerging imaging options for these diseases. In the second part of this review, we delineate how a prionlike seeding process may be driving the progression of other neurodegenerative diseases, including Parkinson disease, Alzheimer disease, and Huntington disease. A discussion of clinical presentation and imaging features of these example diseases follows to make a case for a common approach to developing imaging biomarkers and therapies of these diseases.Learning Objective: Upon completion of this article, one should be able to describe the various types of prion diseases, recognize and identify the common the neuro-imaging findings in prion diseases, describe seeding mechanism of prion disease, list the common amyloid PET tracers used for Alzheimer’s disease, and list common imaging biomarkers in neurodegenerative diseases.
{"title":"Prionopathies and Prionlike Protein Aberrations in Neurodegenerative Diseases","authors":"K. Anderson, W. B. Overcast, J. Brosch, B. Graner, M. Veronesi","doi":"10.3174/ng.2000035","DOIUrl":"https://doi.org/10.3174/ng.2000035","url":null,"abstract":"Protein misfolding has been an area of intense research and is implicated in a number of neurodegenerative diseases. Key proteins in the brain lose their native ability to fold and instead assume abnormal conformations. Misfolded proteins cluster to form pathologic aggregates, which\u0000 cause cellular dysfunction, neuronal death, and neurodegeneration. The prionopathies are best known among the neurodegenerative diseases for their ability to misfold, self-propagate, and infect other organisms. There is increasing evidence of a rationale for a prionlike mechanism of spread\u0000 of other neurodegenerative diseases through a similar seeding mechanism. In this review, we detail the role of a key protein aberration known to the various prion diseases, including sporadic, variant, and iatrogenic Creutzfeldt-Jakob disease; variably protease-sensitive prionopathy; Gerstmann-Straussler-Scheinker\u0000 disease; fatal familial insomnia; and kuru. We also discuss the clinical presentation, the available, and emerging imaging options for these diseases. In the second part of this review, we delineate how a prionlike seeding process may be driving the progression of other neurodegenerative diseases,\u0000 including Parkinson disease, Alzheimer disease, and Huntington disease. A discussion of clinical presentation and imaging features of these example diseases follows to make a case for a common approach to developing imaging biomarkers and therapies of these diseases.Learning Objective:\u0000 Upon completion of this article, one should be able to describe the various types of prion diseases, recognize and identify the common the neuro-imaging findings in prion diseases, describe seeding mechanism of prion disease, list the common amyloid PET tracers used for Alzheimer’s disease,\u0000 and list common imaging biomarkers in neurodegenerative diseases.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42757493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Caton, A. Copelan, K. Narsinh, D. Murph, A. Abla, D. Cooke, S. Hetts, V. Halbach, C. Dowd, R. Higashida, M. Amans
The use of intracranial stents in neurointerventional surgery has been practiced for decades. However, the spectrum of treatable pathology, available devices, and clinical adoption of intracranial stents has exploded in recent years. Diagnostic neuroradiologists play a critical role in the evaluation of these devices after deployment, yet may not be familiar with state-of-the-art intracranial stent devices and indications. This review provides an overview of intracranial stents for cerebrovascular disease, with 3 chief learning objectives: 1) to understand the basic principles of stent design, biomechanics, and deployment, and the resulting influence on cerebrovascular hemodynamics; 2) to be familiar with the spectrum of intracranial pathology amenable to endovascular stent placement; and 3) to recognize the radiographic appearance of successful intracranial stent deployment and intracranial stent‐related complications.Learning Objective: Recognize the key principles of design (form), current indications (function), and potential complications of intracranial stents used in neurointerventional surgery
{"title":"Form and Function in Intracranial Neurovascular Stents: A Historical Perspective and State-of-the-Art Clinical Review for the Noninterventionalist","authors":"M. Caton, A. Copelan, K. Narsinh, D. Murph, A. Abla, D. Cooke, S. Hetts, V. Halbach, C. Dowd, R. Higashida, M. Amans","doi":"10.3174/ng.2000058","DOIUrl":"https://doi.org/10.3174/ng.2000058","url":null,"abstract":"The use of intracranial stents in neurointerventional surgery has been practiced for decades. However, the spectrum of treatable pathology, available devices, and clinical adoption of intracranial stents has exploded in recent years. Diagnostic neuroradiologists play a critical role\u0000 in the evaluation of these devices after deployment, yet may not be familiar with state-of-the-art intracranial stent devices and indications. This review provides an overview of intracranial stents for cerebrovascular disease, with 3 chief learning objectives: 1) to understand the basic principles\u0000 of stent design, biomechanics, and deployment, and the resulting influence on cerebrovascular hemodynamics; 2) to be familiar with the spectrum of intracranial pathology amenable to endovascular stent placement; and 3) to recognize the radiographic appearance of successful intracranial stent\u0000 deployment and intracranial stent‐related complications.Learning Objective: Recognize the key principles of design (form), current indications (function), and potential complications of intracranial stents used in neurointerventional surgery","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49576402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Subacute combined degeneration is uncommonly a result of nitrous oxide abuse and presents with high signal in the dorsal columns of the spinal cord on T2-weighted MR imaging. We present a case of subacute combined degeneration in a young patient who abused nitrous oxide, which is an uncommon cause and infrequently seen in this patient population. Symptoms are often reversible with treatment of vitamin B12, and radiologists should be aware of these findings to avoid delay in treatment.
{"title":"Nitrous Oxide Abuse‐Induced Subacute Combined Degeneration: Classic Neuroimaging Findings on MRI","authors":"A. Kirsch, S. M. Allison, S. Kilanowski","doi":"10.3174/ng.2000063","DOIUrl":"https://doi.org/10.3174/ng.2000063","url":null,"abstract":"Subacute combined degeneration is uncommonly a result of nitrous oxide abuse and presents with high signal in the dorsal columns of the spinal cord on T2-weighted MR imaging. We present a case of subacute combined degeneration in a young patient who abused nitrous oxide, which is an\u0000 uncommon cause and infrequently seen in this patient population. Symptoms are often reversible with treatment of vitamin B12, and radiologists should be aware of these findings to avoid delay in treatment.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46682825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. B. Assunção, T. Scoppetta, B. S. Yonekura Inada, L.D.A. Martins, E. Narvaez, M. Soldatelli, L. Freitas, V. Marussi, C. S. Campos, L. Amaral
CNS WM tracts are mainly composed of axons, and when these structures undergo apoptosis or lose their integrity, neurodegeneration may occur. Secondary neuronal degeneration can be classified as axonal degeneration and involves only the first neuron in a pathway (Wallerian degeneration of the corticospinal tract being its prototype) or be classified as transaxonal degeneration and involve more than a single neuron in a common pathway, usually a closed neuronal circuit, in specific tracts, such as the dentate-rubro-olivary tract, tracts of the limbic system, corticopontocerebellar tract, cranial nerve tracts, and nigrostriatal pathway. This study aimed to review the anatomy of the main CNS tracts susceptible to secondary neuronal degeneration and to illustrate, through different imaging modalities, the findings associated with this poorly explored and understood process involved in the pathophysiologic substrate of numerous neurologic diseases.Learning Objective: Recognize the anatomy of the main CNS tracts susceptible to secondary neuronal degeneration and identify its main imaging findings in different imaging modalities.
{"title":"Secondary Neurodegeneration: A General Approach to Axonal and Transaxonal Degeneration","authors":"F. B. Assunção, T. Scoppetta, B. S. Yonekura Inada, L.D.A. Martins, E. Narvaez, M. Soldatelli, L. Freitas, V. Marussi, C. S. Campos, L. Amaral","doi":"10.3174/ng.2000050","DOIUrl":"https://doi.org/10.3174/ng.2000050","url":null,"abstract":"CNS WM tracts are mainly composed of axons, and when these structures undergo apoptosis or lose their integrity, neurodegeneration may occur. Secondary neuronal degeneration can be classified as axonal degeneration and involves only the first neuron in a pathway (Wallerian degeneration\u0000 of the corticospinal tract being its prototype) or be classified as transaxonal degeneration and involve more than a single neuron in a common pathway, usually a closed neuronal circuit, in specific tracts, such as the dentate-rubro-olivary tract, tracts of the limbic system, corticopontocerebellar\u0000 tract, cranial nerve tracts, and nigrostriatal pathway. This study aimed to review the anatomy of the main CNS tracts susceptible to secondary neuronal degeneration and to illustrate, through different imaging modalities, the findings associated with this poorly explored and understood process\u0000 involved in the pathophysiologic substrate of numerous neurologic diseases.Learning Objective: Recognize the anatomy of the main CNS tracts susceptible to secondary neuronal degeneration and identify its main imaging findings in different imaging modalities.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41962315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Sananmuang, S. Prakkamakul, N. Ngampaiboon, S.H. Huang, L. Alshafai, E. Yu
Immune checkpoint inhibitors have revolutionized treatment in many cancers, including head and neck squamous cell carcinoma. The number of drugs recently approved by the FDA and the European Medicine Agency is growing. Pembrolizumab and nivolumab, which are anti-programmed cell death protein 1 monoclonal antibodies, were first adopted in 2016 as the second-line treatment for recurrent or metastatic head and neck squamous cell carcinoma in patients with disease progression after platinum-based chemotherapy. Recently, pembrolizumab with or without platinum-based chemotherapy was approved as the first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma. Imaging studies play an essential role in assessing treatment response and monitoring efficacy and safety during and after treatments. Given the rapid increase in the use of immunotherapy in head and neck squamous cell carcinoma, neuroradiologists need to be familiar with the unique features indicative of treatment response in addition to a broad array of immune-related adverse events to avoid misinterpreting secondary drug-related adverse effects as tumor progression or metastasis. Moreover, emerging imaging techniques, including molecular imaging and radiomics, in an effort to assess or gauge the likelihood of treatment response to immune checkpoint inhibitors, is an ongoing area of active research.Learning Objectives: To recognize the emerging role, basic mechanism, and unique treatment response patterns of immune checkpoint inhibitors for the treatment of head and neck cancer, and to describe imaging findings of immune-related adverse events of immune checkpoint inhibitors.
{"title":"Immune Checkpoint Inhibitor: An Emerging Treatment for Head and Neck Cancer. A Primer for the Radiologist","authors":"T. Sananmuang, S. Prakkamakul, N. Ngampaiboon, S.H. Huang, L. Alshafai, E. Yu","doi":"10.3174/ng.2000016","DOIUrl":"https://doi.org/10.3174/ng.2000016","url":null,"abstract":"Immune checkpoint inhibitors have revolutionized treatment in many cancers, including head and neck squamous cell carcinoma. The number of drugs recently approved by the FDA and the European Medicine Agency is growing. Pembrolizumab and nivolumab, which are anti-programmed cell death\u0000 protein 1 monoclonal antibodies, were first adopted in 2016 as the second-line treatment for recurrent or metastatic head and neck squamous cell carcinoma in patients with disease progression after platinum-based chemotherapy. Recently, pembrolizumab with or without platinum-based chemotherapy\u0000 was approved as the first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma. Imaging studies play an essential role in assessing treatment response and monitoring efficacy and safety during and after treatments. Given the rapid increase in the use of immunotherapy\u0000 in head and neck squamous cell carcinoma, neuroradiologists need to be familiar with the unique features indicative of treatment response in addition to a broad array of immune-related adverse events to avoid misinterpreting secondary drug-related adverse effects as tumor progression or metastasis.\u0000 Moreover, emerging imaging techniques, including molecular imaging and radiomics, in an effort to assess or gauge the likelihood of treatment response to immune checkpoint inhibitors, is an ongoing area of active research.Learning Objectives: To recognize the emerging role, basic mechanism,\u0000 and unique treatment response patterns of immune checkpoint inhibitors for the treatment of head and neck cancer, and to describe imaging findings of immune-related adverse events of immune checkpoint inhibitors.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45379411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Dennison, J. T. Philip, A. Leyva, A. Cibulas, S. Schroff, S.C. Dodson, R. Beegle
Cerebral amyloid, also known as amyloid-related diseases of the CNS, is a heterogenous group of chronic, progressive disorders in which abnormal amyloid protein accumulates in the brain. Subtypes of cerebral amyloid include Alzheimer disease, cerebral amyloid angiopathy, inflammatory cerebral amyloid angiopathy, and amyloidoma. Abnormal amyloid accumulation often leads to adverse events within the CNS. Cerebral amyloid can present with multiple distinct imaging appearances that often overlap with several other CNS pathologies, which ultimately makes an accurate diagnosis a challenge. In this article, we discuss the various imaging patterns seen in cerebral amyloid. In addition, we review the differential diagnoses and highlight the radiologic features that aid in distinction.Learning Objective: Become familiar with the multiple subtypes of cerebral amyloidosis, also known as amyloid-related diseases of the CNS, and their imaging manifestations, and be able to differentiate these subtypes from common mimickers.
{"title":"Ambiguous Cerebral Amyloidosis","authors":"J. Dennison, J. T. Philip, A. Leyva, A. Cibulas, S. Schroff, S.C. Dodson, R. Beegle","doi":"10.3174/ng.1900051","DOIUrl":"https://doi.org/10.3174/ng.1900051","url":null,"abstract":"Cerebral amyloid, also known as amyloid-related diseases of the CNS, is a heterogenous group of chronic, progressive disorders in which abnormal amyloid protein accumulates in the brain. Subtypes of cerebral amyloid include Alzheimer disease, cerebral amyloid angiopathy, inflammatory\u0000 cerebral amyloid angiopathy, and amyloidoma. Abnormal amyloid accumulation often leads to adverse events within the CNS. Cerebral amyloid can present with multiple distinct imaging appearances that often overlap with several other CNS pathologies, which ultimately makes an accurate diagnosis\u0000 a challenge. In this article, we discuss the various imaging patterns seen in cerebral amyloid. In addition, we review the differential diagnoses and highlight the radiologic features that aid in distinction.Learning Objective: Become familiar with the multiple subtypes of cerebral amyloidosis,\u0000 also known as amyloid-related diseases of the CNS, and their imaging manifestations, and be able to differentiate these subtypes from common mimickers.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41979339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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