Chris Kang, Pritesh Mehta, Yi S Chang, Rafeeque A Bhadelia, Rafael Rojas, Max Wintermark, Jalal B Andre, Ethan Yang, Magdy Selim, Ajith J Thomas, Aristotelis Filippidis, Yan Wen, Pascal Spincemaille, Nils D Forkert, Yi Wang, Salil Soman
{"title":"Enhanced Reader Confidence and Differentiation of Calcification from Cerebral Microbleed Diagnosis Using QSM Relative to SWI.","authors":"Chris Kang, Pritesh Mehta, Yi S Chang, Rafeeque A Bhadelia, Rafael Rojas, Max Wintermark, Jalal B Andre, Ethan Yang, Magdy Selim, Ajith J Thomas, Aristotelis Filippidis, Yan Wen, Pascal Spincemaille, Nils D Forkert, Yi Wang, Salil Soman","doi":"10.1007/s00062-024-01478-0","DOIUrl":"https://doi.org/10.1007/s00062-024-01478-0","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate detection of cerebral microbleeds (CMBs) is important for detection of multiple conditions. However, CMBs can be challenging to identify on MR images, especially for distinguishing CMBs from the mimic of calcification. We performed a comparative reader study to assess the diagnostic performance of two primary MR sequences for differentiating CMBs from calcification.</p><p><strong>Methods: </strong>Under IRB approved exempt retrospective protocol, 49 adult patients with identifiable intracranial hemorrhage who underwent multi-echo 3D Gradient Recall Echo (GRE) using 3T MRI were non-sequentially recruited under a retrospective IRB approved protocol. Multi-echo complex total field inversion quantitative susceptibility mapping (QSM) and susceptibility weighted imaging/phase (SWI/P) images were generated for all patients. 53 lesion ROIs were identified and classified on provided images by an expert panel of three neuroradiologists as either: CMB, Blood, Calcification, or Other. Three additional neuroradiologists subsequently reviewed the same SWI/P and QSM images in independent sessions and designated lesions as either blood and/or calcification using a 5-point Likert scale. Statistical analyses, on lesion classification and reader diagnostic accuracy, reader confidence-level, reader agreement-level, and the predictability of mean susceptibility values between SWI/P and QSM were conducted with logistic regression and calculation of Fleiss' κ, Kendall's w, Krippendorff's α.</p><p><strong>Results: </strong>Across all qualitative assessment and quantitative metrics measured (simple accuracy, confidence as degree of ground truth alignment, and inter-rater agreement) QSM outperformed SWI/P. Additionally, logistic regression of average QSM voxel susceptibility achieved near-perfect separation in differentiating between CMB and calcification in the limited number of CMB/Calcification ROIs, indicating a high predictability.</p><p><strong>Conclusion: </strong>Our study demonstrates that QSM offers improved detectability and classification of CMBs compared to the conventionally utilized SWI/P sequence. In addition, QSM simplifies the interpretation workflow by reducing the number of requisite images compared with the conventional counterpart, with improved diagnostic confidence.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845888","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}
Lina Wang, Chi Zhang, Bijia Wang, Li Zhang, Guangjun Xi, Jingyu Deng, Feng Wang
{"title":"Decreased Cortical Sulcus Depth in Parkinson's Disease with Excessive Daytime Sleepiness.","authors":"Lina Wang, Chi Zhang, Bijia Wang, Li Zhang, Guangjun Xi, Jingyu Deng, Feng Wang","doi":"10.1007/s00062-024-01482-4","DOIUrl":"https://doi.org/10.1007/s00062-024-01482-4","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive daytime sleepiness (EDS), a prevalent non-motor symptom in Parkinson's disease (PD), significantly impacts the quality of life for PD patients and elevates the risks of injury. Our study is to investigate the altered cortical surface morphology characteristics in PD patients with EDS (PD-EDS).</p><p><strong>Methods: </strong>Clinical data and magnetic resonance imaging were obtained from the Parkinson's Progression Marker Initiative database, comprising 36 PD-EDS and 98 PD patients without EDS (PD-nEDS). The computational anatomy toolbox was utilized to derive sulcus depth (SD) and deep grey matter (GM) nuclei volumes.</p><p><strong>Results: </strong>PD-EDS patients exhibited significantly decreased SD values in the right caudal middle frontal gyrus, pars opercularis, and superior temporal cortex relative to PD-nEDS patients. However, no significant differences in deep GM nuclei volumes were identified. Receiver operating characteristic (ROC) curve analyses further revealed that these cortical SD values could potentially serve as a screening index for distinguishing PD-EDS from PD-nEDS. Additionally, although PD-EDS patients had a longer disease duration and poorer performance in motor function and depression compared to PD-nEDS patients, these factors were included as covariates in the neuroimaging analyses.</p><p><strong>Conclusion: </strong>Our study findings demonstrated that decreased cortical SD values might induce sleep-wake state instability and contribute to the pathophysiological mechanisms of EDS in early-stage PD.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784357","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}
{"title":"Discriminators of Paraclinoid Aneurysm Rupture Based On Morphological Computer-Assisted Semiautomated Measurement (CASAM) and Hemodynamic Analysis.","authors":"Xiaodong Zhai, Sishi Xiang, Jiewen Geng, Peng Hu, Chuan He, Guilin Li, Jingwei Li, Liming Zhang, Wei Yang, Hongqi Zhang","doi":"10.1007/s00062-024-01475-3","DOIUrl":"https://doi.org/10.1007/s00062-024-01475-3","url":null,"abstract":"<p><strong>Background: </strong>Paraclinoid aneurysms, arising from the proximal dural ring and extending to the origin of the posterior communicating artery of the internal carotid artery (ICA), represent a significant proportion of all intracranial aneurysms (IAs). Accurate prediction of the rupture risk of paraclinoid aneurysms is crucial for optimal management. The objective of this study was to identify risk factors for the rupture of paraclinoid aneurysms on the basis of computer-assisted semiautomated measurement (CASAM) and hemodynamics.</p><p><strong>Methods: </strong>The clinical, demographic and radiological data of the 304 paraclinoid aneurysms (285 unruptured and 19 ruptured) included were extracted from the Chinese Intracranial Aneurysm Project (CIAP) database. Morphological parameters were quantified via CASAM, and hemodynamic simulations were performed via computational fluid dynamics (CFD). Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for aneurysm rupture.</p><p><strong>Results: </strong>The mean age of the patients was 56.91 ± 11.0 years, with a female predominance (71.7%). Univariate analysis revealed that the undulation index (UI) and nonsphericity index (NSI) were significantly greater in ruptured paraclinoid aneurysms than in unruptured aneurysms. The proportion of ruptured paraclinoid aneurysms located laterally on the ICA was significantly lower than that of those located anteriorly (p = 0.002). Multivariate logistic regression analysis revealed that a greater UI (OR = 1.086, 95% CI 1.012-1.165; p = 0.022) and larger low shear area (LSA) (OR = 1.034, 95% CI 1.004-1.064; p = 0.028) were independent risk factors for rupture.</p><p><strong>Conclusions: </strong>Our findings indicate that a greater UI and a larger LSA are independent risk factors for the rupture of paraclinoid aneurysms. Compared with aneurysms in other orientations, paraclinoid aneurysms located anteriorly to the ICA are more prone to rupture. These findings may be useful in developing more consummate predictive models to enhance the management and surveillance of paraclinoid aneurysms in the future, leading to improved clinical decision-making and better patient outcomes.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766764","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}
Xinyue Huan, Yang Yang, Shengwen Niu, Yongwei Yang, Bitong Tian, Dajing Guo, Kunhua Li
{"title":"AI-Based Automated Quantification of Arterial Stenosis in Head and Neck CT Angiography: A Comparison with Manual Measurements from Digital Subtraction Angiography and CT Angiography.","authors":"Xinyue Huan, Yang Yang, Shengwen Niu, Yongwei Yang, Bitong Tian, Dajing Guo, Kunhua Li","doi":"10.1007/s00062-024-01464-6","DOIUrl":"https://doi.org/10.1007/s00062-024-01464-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of an artificial intelligence (AI) algorithm for automated quantification of arterial stenosis in head and neck CT angiography (CTA).</p><p><strong>Methods: </strong>Patients who received head and neck CTA and DSA between January 2019 and December 2021 in two centers were included. The quantitative performance of CerebralDoc per-lesion was evaluated through intraclass correlation coefficients (ICCs) and Bland-Altman analysis, comparing automated stenosis measurements and manual measurements across 0-100%, < 50%, ≥ 50% and ≥ 70% thresholds. Sensitivity analysis included linear and logistic regression, and subgroups analysis was performed to identify influencing factors.</p><p><strong>Results: </strong>287 patients with 1765 lesions were analyzed. ICCs between CerebralDoc and DSA for ≥ 50% and ≥ 70% stenosis were excellent (0.955, 0.922, respectively), for 0-100% stenosis was good (0.735), and for < 50% stenosis was poor (0.056). For ≥ 50% and ≥ 70% stenosis of CerebralDoc and CTA manual measurements versus DSA, ICCs were close (0.955 vs 0.994; 0.922 vs 0.986), and differences were small (0.258% vs -0.362%; 0.369% vs -0.199%). The sensitivity analysis revealed that specific locations (V1, V2, V3, V4) and slender vessels have large or remarkable differences ranging from 15.551% to 44.238%.</p><p><strong>Conclusion: </strong>CerebralDoc exhibited excellent performance in automatically quantifying arterial stenosis of ≥ 50% and ≥ 70% in head and neck CTA. However, further research was needed to improve its performance for < 50% stenosis and to address differences in specific locations and slender vessels.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766759","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}
Clinical NeuroradiologyPub Date : 2024-12-01Epub Date: 2024-05-30DOI: 10.1007/s00062-024-01423-1
Lukas Goertz, David Zopfs, Jonathan Kottlors, Jan Borggrefe, Lenhard Pennig, Marc Schlamann, Christoph Kabbasch
{"title":"Long-term Safety and Efficacy of the Derivo Embolization Device in a Single-center Series.","authors":"Lukas Goertz, David Zopfs, Jonathan Kottlors, Jan Borggrefe, Lenhard Pennig, Marc Schlamann, Christoph Kabbasch","doi":"10.1007/s00062-024-01423-1","DOIUrl":"10.1007/s00062-024-01423-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study analyzes the long-term clinical and angiographic outcomes of the Derivo Embolization Device (DED), an advanced flow diverter device with an electropolished surface, for the treatment of intracranial aneurysms.</p><p><strong>Methods: </strong>A consecutive series of 101 patients (mean age: 58 years, 72% female) treated with the DED for 122 aneurysms at a single center between 2017 and 2023 was retrospectively analyzed for major (change in National Institutes of Health Stroke Scale [NIHSS] score ≥ 4 points) and minor (change in NIHSS score < 4 points) neurological events, procedural morbidity (increase of at least one point on the modified Rankin Scale), and angiographic results.</p><p><strong>Results: </strong>There were 14 (11%) recurrent aneurysms, 15 (12%) ruptured aneurysms, 26 (21%) posterior circulation aneurysms and 16 (13%) fusiform or dissecting aneurysms. Device deployment failed in 1 case (1%). Procedure-related symptomatic procedural complications consisted of 2 (2%) major events (1 major stroke and 1 vessel perforation with intracranial hemorrhage and infarction) and 6 minor events (6 minor strokes). Procedural morbidity was 5%. There were no late ischemic or hemorrhagic events during follow-up. Complete and favorable aneurysm occlusion was achieved in 54% (40/74) and 62% (46/74) at a mean of 5 months, 71% (27/38) and 87% (33/38) at a mean of 12 months, and 76% (25/33) and 97% (32/33) at a mean of 35 months, respectively.</p><p><strong>Conclusion: </strong>The results demonstrate progressive aneurysm occlusion beyond 12 months after DED implantation with an almost 100% favorable occlusion rate. Procedural morbidity was low and there were no late complications.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"789-798"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174269","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}
Clinical NeuroradiologyPub Date : 2024-12-01Epub Date: 2024-06-19DOI: 10.1007/s00062-024-01430-2
Lukas Goertz, Thomas Liebig, Eberhard Siebert, David Zopfs, Lenhard Pennig, Marc Schlamann, Alexandra Radomi, Franziska Dorn, Christoph Kabbasch
{"title":"Propensity Score-matched Comparison of WEB 17 and WEB 21 with 4-7 mm Device Sizes for the Treatment of Unruptured Intracranial Aneurysms.","authors":"Lukas Goertz, Thomas Liebig, Eberhard Siebert, David Zopfs, Lenhard Pennig, Marc Schlamann, Alexandra Radomi, Franziska Dorn, Christoph Kabbasch","doi":"10.1007/s00062-024-01430-2","DOIUrl":"10.1007/s00062-024-01430-2","url":null,"abstract":"<p><strong>Purpose: </strong>The WEB 17 system represents the fifth generation of Woven Endobridge (WEB) flow disruptors and features a low profile with fewer wires than its predecessor, the WEB 21. The present study compares the safety and efficacy of the WEB 17 and WEB 21 for the treatment of unruptured cerebral aneurysms with 4-7 mm device sizes, which were available for both systems.</p><p><strong>Methods: </strong>Patient and aneurysm characteristics, complications, clinical outcome and angiographic results were retrospectively analysed. 1:1 propensity score matching was performed to adjust for minor baseline differences between the groups.</p><p><strong>Results: </strong>Sixty aneurysms treated with WEB 21 and 90 with WEB 17 were included. The overall failure rate (deployment failure and adjunctive stent) was significantly higher with WEB 21 (16.7%) than with WEB 17 (3.3%, p < 0.01). The rates of neurological events between WEB 21 (6.7%) and WEB 17 treatment (1.1%) were not significantly different (p = 0.08). Also, procedural morbidity was comparably low in both groups (WEB 21: 3.3%, WEB 17: 0%, p = 0.16). The rates of complete/adequate occlusion at follow up were 69.7%/86.4% for WEB 17 vs. 80.4%/91.3% for WEB 21 at short-term (p = 0.27), and 64.5%/83.9% vs. 75.9%/86.2% at mid-term (p = 0.41), respectively. Propensity score matching confirmed the results of the unmatched series.</p><p><strong>Conclusion: </strong>WEB 17 and WEB 21 had a similar safety and efficacy profile, but WEB 17 was associated with an improved feasibility. Prospective studies with long-term follow-up will define the full potential of the WEB 17 system.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"841-850"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418195","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}
Clinical NeuroradiologyPub Date : 2024-12-01Epub Date: 2024-05-30DOI: 10.1007/s00062-024-01428-w
Takayuki Inomata, Koji Nakaya, Mikio Matsuhiro, Jun Takei, Hiroto Shiozaki, Yasuto Noda
{"title":"Clinical Use of Hematoma Volume Based On Automated Segmentation of Chronic Subdural Hematoma Using 3D U-Net.","authors":"Takayuki Inomata, Koji Nakaya, Mikio Matsuhiro, Jun Takei, Hiroto Shiozaki, Yasuto Noda","doi":"10.1007/s00062-024-01428-w","DOIUrl":"10.1007/s00062-024-01428-w","url":null,"abstract":"<p><strong>Purpose: </strong>To propose a method for calculating hematoma volume based on automatic segmentation of chronic subdural hematoma (CSDH) using 3D U‑net and investigate whether it can be used clinically to predict recurrence.</p><p><strong>Methods: </strong>Hematoma volumes manually measured from pre- and postoperative computed tomography (CT) images were used as ground truth data to train 3D U‑net in 200 patients (400 CT scans). A total of 215 patients (430 CT scans) were used as test data to output segmentation results from the trained 3D U‑net model. The similarity with the ground truth data was evaluated using Dice scores for pre and postoperative separately. The recurrence prediction accuracy was evaluated by obtaining receiver operating characteristic (ROC) curves for the segmentation results. Using a typical mobile PC, the computation time per case was measured and the average time was calculated.</p><p><strong>Results: </strong>The median Dice score of the test data were preoperative hematoma volume (Pre-HV): 0.764 and postoperative subdural cavity volume (Post-SCV): 0.741. In ROC analyses assessing recurrence prediction, the area under the curve (AUC) of the manual was 0.755 in Pre-HV, whereas the 3D U‑net was 0.735. In Post-SCV, the manual AUC was 0.779; the 3D U‑net was 0.736. No significant differences were found between manual and 3D U‑net for all results. Using a mobile PC, the average time taken to output the test data results was 30 s per case.</p><p><strong>Conclusion: </strong>The proposed method is a simple, accurate, and clinically applicable; it can contribute to the widespread use of recurrence prediction scoring systems for CSDH.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"799-807"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174290","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}
Clinical NeuroradiologyPub Date : 2024-12-01Epub Date: 2024-06-26DOI: 10.1007/s00062-024-01432-0
Qi Xie, Yan-Hui Liao, Wen-Juan He, Peng-Peng Han, Jun Wu
{"title":"Evaluation of Neonatal Cerebral Circulation Under Hypoxic Ischemic Risk Factors Based on Quantitative Analysis of Cerebral Veins with Magnetic Resonance Susceptibility Weighted Imaging.","authors":"Qi Xie, Yan-Hui Liao, Wen-Juan He, Peng-Peng Han, Jun Wu","doi":"10.1007/s00062-024-01432-0","DOIUrl":"10.1007/s00062-024-01432-0","url":null,"abstract":"<p><strong>Purpose: </strong>To observe the regulation of cerebral circulation in vivo based on image segmentation algorithms for deep learning in medical imaging to automatically detect and quantify the neonatal deep medullary veins (DMVs) on susceptibility weighted imaging (SWI) images. To evaluate early cerebral circulation self-rescue for neonates undergoing risk of cerebral hypoxia-ischaemia in vivo.</p><p><strong>Methods: </strong>SWI images and clinical data of 317 neonates with or without risk of cerebral hypoxia-ischaemia were analyzed. Quantitative parameters showing the number, width, and curvature of DMVs were obtained using an image segmentation algorithm.</p><p><strong>Results: </strong>The number of DMVs was greater in males than in females (p < 0.01), and in term than in preterm infants (p = 0.001). The width of DMVs was greater in term than in preterm infants (p < 0.01), in low-risk than in high-risk group (p < 0.01), and in neonates without intracranial extracerebral haemorrhage (ICECH) than with ICECH (p < 0.05). The curvature of DMVs was greater in term than in preterm infants (P < 0.05). The width of both bilateral thalamic veins and anterior caudate nucleus veins were positively correlated with the number of DMVs; the width of bilateral thalamic veins was positively correlated with the width of DMVs.</p><p><strong>Conclusion: </strong>The DMVs quantification based on image segmentation algorithm may provide more detailed and stable quantitative information in neonate. SWI vein quantification may be an observable indicator for in vivo assessment of cerebral circulation self-regulation in neonatal hypoxic-ischemic brain injury.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"859-869"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449884","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}
Clinical NeuroradiologyPub Date : 2024-12-01Epub Date: 2024-06-25DOI: 10.1007/s00062-024-01427-x
Markus Hittinger, Till Hartlieb, Dieter Henrik Heiland, Pamela Heiland, Tom Pieper, Martin Staudt, Ansgar Berlis, Manfred Kudernatsch, Irina Mader
{"title":"Subacute Degeneration of Fibers After Vertical Parasagittal Hemispherotomy.","authors":"Markus Hittinger, Till Hartlieb, Dieter Henrik Heiland, Pamela Heiland, Tom Pieper, Martin Staudt, Ansgar Berlis, Manfred Kudernatsch, Irina Mader","doi":"10.1007/s00062-024-01427-x","DOIUrl":"10.1007/s00062-024-01427-x","url":null,"abstract":"<p><strong>Purpose: </strong>After vertical parasagittal hemispherotomy a restricted diffusion is often seen ipsilaterally and even distant from the adjacent resection margin. This retrospective cohort study analyses the anatomic site and the time course of the diffusion restriction after vertical parasagittal hemispherotomy.</p><p><strong>Methods: </strong>Fifty-nine patients were included into this study, all of them having had one pre-operative and at least one post-operative MRI, including diffusion imaging at b‑values of 0 and 1000 s/mm<sup>2</sup> with a calculated ADC.</p><p><strong>Results: </strong>Diffusion restriction occurred exclusively on the operated site in all patients. In the basal ganglia, diffusion restriction was present in 37 of 38 patients at the first postoperative day with a duration of 38 days. In the midbrain, the posterior limb of the internal capsule and the thalamus, a restricted diffusion became postoperatively prominent at day 9 in all three localizations, with a duration of 36, 34 and 36 days, respectively. The incidence of thalamic lesions was lower if a preoperative damage had occurred.</p><p><strong>Conclusion: </strong>The restricted diffusion in the basal ganglia resembles direct effects of the operation at its edges, whereas the later appearing diffusion restriction in the midbrain and the posterior limb of the internal capsule rather belong to a degeneration of the descending fibers being transected by the hemispherotomy in the sense of a Wallerian degeneration. The presence of preoperative hemispheric lesions influences the development of diffusion restriction at subacute fiber degeneration.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"851-858"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449896","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}
{"title":"Radiomics Analysis of Quantitative Maps from Synthetic MRI for Predicting Grades and Molecular Subtypes of Diffuse Gliomas.","authors":"Danlin Lin, Jiehong Liu, Chao Ke, Haolin Chen, Jing Li, Yuanyao Xie, Jianhua Ma, Xiaofei Lv, Yanqiu Feng","doi":"10.1007/s00062-024-01421-3","DOIUrl":"10.1007/s00062-024-01421-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the feasibility of using radiomics analysis of quantitative maps from synthetic MRI to preoperatively predict diffuse glioma grades, isocitrate dehydrogenase (IDH) subtypes, and 1p/19q codeletion status.</p><p><strong>Methods: </strong>Data from 124 patients with diffuse glioma were used for analysis (n = 87 for training, n = 37 for testing). Quantitative T1, T2, and proton density (PD) maps were obtained using synthetic MRI. Enhancing tumour (ET), non-enhancing tumour and necrosis (NET), and peritumoral edema (PE) regions were segmented followed by manual fine-tuning. Features were extracted using PyRadiomics and then selected using Levene/T, BorutaShap and maximum relevance minimum redundancy algorithms. A support vector machine was adopted for classification. Receiver operating characteristic curve analysis and integrated discrimination improvement analysis were implemented to compare the performance of different radiomics models.</p><p><strong>Results: </strong>Radiomics models constructed using features from multiple tumour subregions (ET + NET + PE) in the combined maps (T1 + T2 + PD) achieved the highest AUC in all three prediction tasks, among which the AUC for differentiating lower-grade and high-grade diffuse gliomas, predicting IDH mutation status and predicting 1p/19q codeletion status were 0.92, 0.95 and 0.86 respectively. Compared with those constructed on individual T1, T2, and PD maps, the discriminant ability of radiomics models constructed on the combined maps separately increased by 11, 17 and 10% in predicting glioma grades, 35, 52 and 19% in predicting IDH mutation status, and 16, 15 and 14% in predicting 1p/19q codeletion status (p < 0.05).</p><p><strong>Conclusion: </strong>Radiomics analysis of quantitative maps from synthetic MRI provides a new quantitative imaging tool for the preoperative prediction of grades and molecular subtypes in diffuse gliomas.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"817-826"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300201","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}