Clinical Neuroradiology最新文献

{"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}

{"title":"Endovascular Treatment of Large Core Infarcts: no Limits?","authors":"Martin Bendszus","doi":"10.1007/s00062-024-01472-6","DOIUrl":"10.1007/s00062-024-01472-6","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"34 4","pages":"747-748"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616136","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":"Stroke Evaluation in the Interventional Suite Using Dual-Layer Detector Cone-Beam CT: a First-in-human Prospective Cohort Study (the Next Generation X-ray Imaging System Trial).","authors":"Fredrik Ståhl, Håkan Almqvist, Åsa Aspelin, Jens Kolloch, Odett Ghalamkari, Vamsi Gontu, Dirk Schäfer, Peter van de Haar, Klaus-Jürgen Engel, Fred van Nijnatten, Åke Holmberg, Michael V Mazya, Michael Söderman, Anna Falk Delgado","doi":"10.1007/s00062-024-01439-7","DOIUrl":"10.1007/s00062-024-01439-7","url":null,"abstract":"<p><strong>Purpose: </strong>Cone-beam CT in the interventional suite could be an alternative to CT to shorten door-to-thrombectomy time. However, image quality in cone-beam CT is limited by artifacts and poor differentiation between gray and white matter. This study compared non-contrast brain dual-layer cone-beam CT in the interventional suite to reference standard CT in stroke patients.</p><p><strong>Methods: </strong>A prospective single-center study enrolled consecutive participants with ischemic or hemorrhagic stroke. The hemorrhage detection accuracy, per-region ASPECTS accuracy and subjective image quality (Likert scales for gray-white matter differentiation, structure perception and artifacts) were assessed by three neuroradiologists blinded to clinical data on dual-layer cone-beam CT 75 keV monoenergetic images compared to CT. Objective image quality was assessed by region-of-interest metrics. Non-inferiority for hemorrhage detection and ASPECTS accuracy was determined by the exact binomial test with a one-sided lower performance boundary prospectively set to 80% (98.75% CI).</p><p><strong>Results: </strong>27 participants were included (74 years ± 9; 19 female) in the hyperacute or acute stroke phase. One reader missed a small bleeding, but all hemorrhages were detected in the majority analysis (100% accuracy, CI lower boundary 86%, p = 0.002). ASPECTS majority analysis showed 90% accuracy (CI lower boundary 85%, p < 0.001). Sensitivity was 66% (individual readers 67%, 69%, and 76%), specificity was 97% (97%, 96%, 89%). Subjective and objective image quality were inferior to CT.</p><p><strong>Conclusion: </strong>In a small single-center cohort, dual-layer cone-beam CT showed non-inferior hemorrhage detection and ASPECTS accuracy to CT. Despite inferior image quality, the technique may be useful for stroke evaluation in the interventional suite.</p><p><strong>Trial registration number: </strong>NCT04571099 (clinicaltrials.gov). Prospectively registered 2020-09-04.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"929-937"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757540","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":"Roles of Nontraditional Lipid Parameters for Predicting Restenosis in Patients with Intracranial Atherosclerotic Stenosis After Endovascular Treatment.","authors":"Guoming Li, Xuecheng Cen, Zelan Ma, Fajun Chen","doi":"10.1007/s00062-024-01409-z","DOIUrl":"10.1007/s00062-024-01409-z","url":null,"abstract":"<p><strong>Purpose: </strong>Nontraditional lipid parameters are associated with intracranial atherosclerotic stenosis (ICAS) progression. This study aimed to investigate the association of nontraditional lipid parameters with the risk of restenosis in patients with ICAS after endovascular treatment (EVT).</p><p><strong>Methods: </strong>This study retrospectively enrolled consecutive patients with symptomatic ICAS after successful EVT followed by at least 3 months of angiography. Participants were divided into restenosis or non-restenosis groups based on the angiographic follow-up results. The nontraditional lipid parameters were calculated from conventional lipid parameters. The COX regression models and restricted cubic splines (RCS) were used to explore the association between nontraditional lipid parameters and restenosis.</p><p><strong>Results: </strong>This study recruited 222 cases with 224 lesions eligible for our study, of which 56 (25%) had restenosis. Compared with the non-restenosis group, patients in the restenosis group had higher levels of the atherogenic index of plasma (AIP) (0.211, interquartile range, IQR, 0.065-0.404 vs. 0.083, IQR, -0.052-0.265, P = 0.001), remnant cholesterol (RC) (0.55, IQR, 0.33-0.77 vs. 0.30, IQR, 0.18-0.49, P < 0.001) and Castelli's index‑I (CRI-I) (4.13, IQR, 3.39-5.34 vs. 3.74, IQR, 2.94-4.81, P = 0.030). In the multivariable COX regression analysis, a 0.1 unit increase of AIP was an independent risk factor for restenosis (hazard ratio, HR = 1.20, 95% confidence interval, CI 1.05-1.35, P = 0.005) whereas such an association was not observed for RC (HR = 1.01, 95% CI 0.90-1.15, P = 0.835). The restricted cubic spline (RCS) plot revealed a linear relationship between AIP and restenosis (P for nonlinear = 0.835) but a nonlinear relationship for RC (P for nonlinear = 0.012). Patients were stratified according to tertiles (T) of AIP and RC and the risk of restenosis increased in T3 compared to T1 (HR = 3.21, 95% CI 1.35-7.62, P = 0.008 and HR = 2.99, 95% CI 1.11-8.03, P = 0.030, respectively). Furthermore, this association remained stable within each LDL‑C level subgroup.</p><p><strong>Conclusion: </strong>The AIP and RC were positively and independently associated with restenosis in patients with ICAS after EVT.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"827-840"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418196","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":"Thrombectomy Plus Intra-Arterial Thrombolysis Versus Thrombectomy for Acute Large Vessel Occlusions: a Matched-Control Study.","authors":"Bin Han, Xu Tong, Raynald, Baixue Jia, Anxin Wang, Dapeng Mo, Feng Gao, Ning Ma, Zhongrong Miao","doi":"10.1007/s00062-024-01431-1","DOIUrl":"10.1007/s00062-024-01431-1","url":null,"abstract":"<p><strong>Aim: </strong>We conducted a matched-control analysis to compare the outcomes of large vessel occlusion (LVO) patients treated with mechanical thrombectomy (MT) plus Intra-arterial thrombolysis (IAT) versus those treated with MT alone.</p><p><strong>Methods: </strong>The subjects of this study were chosen from ANGEL-ACT registry. All patients who received MT were identified and categorized into two groups: \"MT + IAT\" and \"MT,\" based on whether or not they received additional intra-arterial medication IAT during the MT procedure. After being subjected to 1:1 propensity score matching, the outcome measures, including modified Rankin Scale (mRS) score at 90 days, successful recanalization at the final angiogram, symptomatic intracranial hemorrhage (sICH) within 36 h, and death within 90 days, were compared.</p><p><strong>Results: </strong>The study encompassed a total of 1607 patients, with 641 individuals assigned to the MT + IAT group and 966 to the MT group. After applying propensity score matching, a total of 524 pairs were identified for comparison. The results indicated that there were no significant differences between the two groups with regard to the modified Rankin Scale (mRS) score (median: 3 vs. 3 points; P = 0.83), successful recanalization (89.9 vs. 88.9%; P = 0.62), sICH (8.3 vs. 8.7%; P = 0.79), and death (15.5 vs. 16.4%; P = 0.70).</p><p><strong>Conclusions: </strong>IAT during MT does not confer an elevated risk of sICH or mortality. Furthermore, the combination of MT and IAT may produce comparable functional outcomes in comparison to MT alone, when treating acute LVO patients.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"871-879"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491142","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":"Freiburg Neuropathology Case Conference : Posterior fossa tumour 15 years after microsurgical resection of a cerebellar pilocytic astrocytoma.","authors":"M Schwabenland, L Becker, C J Gizaw, M Prinz, H Urbach, D Erny, C A Taschner","doi":"10.1007/s00062-024-01468-2","DOIUrl":"10.1007/s00062-024-01468-2","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"983-989"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496318","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":"Focally Enlarged Perivascular Spaces in Pediatric and Adolescent Patients with Polymicrogyria—an MRI Study","authors":"Maximilian Rauch, Karsten Lachner, Lea Frickel, Monika Lauer, Simon Jonas Adenauer, Elisabeth Neuhaus, Elke Hattingen, Luciana Porto","doi":"10.1007/s00062-024-01457-5","DOIUrl":"https://doi.org/10.1007/s00062-024-01457-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Polymicrogyria (PMG) is a cortical malformation frequently associated with epilepsy. Our aim was to investigate the frequency and conspicuity of enlarged perivascular spaces (EPVS) underneath dysplastic cortex as a potentially underrecognized feature of PMG in pediatric and adolescent patients undergoing clinical magnetic resonance imaging (MRI).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We analyzed data from 28 pediatric and adolescent patients with PMG and a matched control group, ranging in age from 2 days to 21 years, who underwent MRI at 1.5T or 3T. T2-weighted MR images were examined for the presence of EPVS underneath the dysplastic cortex. The quantity of EPVS was graded from 0 to 4 (0: none, 1: &lt; 10, 2: 11–20, 3: 21–40, 4: &gt; 40 EPVS). We then compared the presence and quantity of EPVS to the matched controls in terms of total EPVS scores, and EPVS scores underneath the dysplastsic cortex depending on the age groups, the localization of PMG, and the MRI field strength.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In 23/28 (82%) PMG patients, EPVS spatially related to the dysplastic cortex were identified. EPVS scores were significantly higher in PMG patients compared to controls, independent from age or PMG location. No significant differences were observed in EPVS scores in patients examined at 1.5T compared to those examined at 3T.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>EPVS underneath the dysplastic cortex were identified in 82% of patients. EPVS may serve as an important clue for PMG and a marker for cortical malformation.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217367","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":"Seeing more than the Tip of the Iceberg: Approaches to Subthreshold Effects in Functional Magnetic Resonance Imaging of the Brain.","authors":"Benedikt Sundermann, Bettina Pfleiderer, Anke McLeod, Christian Mathys","doi":"10.1007/s00062-024-01422-2","DOIUrl":"10.1007/s00062-024-01422-2","url":null,"abstract":"<p><p>Many functional magnetic resonance imaging (fMRI) studies and presurgical mapping applications rely on mass-univariate inference with subsequent multiple comparison correction. Statistical results are frequently visualized as thresholded statistical maps. This approach has inherent limitations including the risk of drawing overly-selective conclusions based only on selective results passing such thresholds. This article gives an overview of both established and newly emerging scientific approaches to supplement such conventional analyses by incorporating information about subthreshold effects with the aim to improve interpretation of findings or leverage a wider array of information. Topics covered include neuroimaging data visualization, p-value histogram analysis and the related Higher Criticism approach for detecting rare and weak effects. Further examples from multivariate analyses and dedicated Bayesian approaches are provided.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"531-539"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261205","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":"Retrograde Parent Artery Occlusion for Ruptured Intracranial Vertebral Artery Dissecting Aneurysms Involving the Posterior Inferior Cerebellar Artery: The \"Breakwater\" Technique.","authors":"Satoshi Kitamura, Yoshiki Hanaoka, Jun-Ichi Koyama, Daisuke Yamazaki, Takuya Nakamura, Tetsuyoshi Horiuchi","doi":"10.1007/s00062-024-01388-1","DOIUrl":"10.1007/s00062-024-01388-1","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"723-730"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671410","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":"Hemodynamic Impairments of Evaluating Symptomatic Intracranial Atherosclerotic Stenosis using Quantitative Flow Ratio on Digital Subtraction Angiography : A Comparison with Computed Tomography Perfusion, MRI and Fractional Flow Reserve.","authors":"Yingchun Wu, Feng Gao, Honglin Feng","doi":"10.1007/s00062-024-01395-2","DOIUrl":"10.1007/s00062-024-01395-2","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebral hemodynamics are important for the management of intracranial atherosclerotic stenosis (ICAS). The quantitative flow ratio (QFR) is a novel angiography-derived index for assessing the functional relevance of ICAS without pressure wires and adenosine. Good diagnostic yield with the hyperemic fractional flow reserve (FFR) have been reported, while data on the comparison of QFR to FFR are scarce.</p><p><strong>Methods: </strong>In this prospective study 56 patients with anterior circulation symptomatic ICAS who received endovascular treatment were included. The new method of computing QFR from a single angiographic view, i.e., the Murray law-based QFR (μQFR), was applied to the examined vessels. An artificial intelligence algorithm was developed to realize the automatic delineation of vascular contour. Pressure gradients were measured before and after treatment within the lesion vessel using a pressure guidewire and the FFR was calculated.</p><p><strong>Results: </strong>There was a good correlation between μQFR and FFR. Preoperative FFR predicted DWI watershed infarction (FFR optimal cut-off level: 0.755). Preoperative μQFR predicted DWI watershed infarction (μQFR optimal cut-off level: 0.51). Preoperative FFR predicted CTP hypoperfusion (FFR best predictive value: 0.62). Preoperative μQFR predicted CTP hypoperfusion (μQFR best predictive value: 0.375).</p><p><strong>Conclusion: </strong>The μQFR based on DSA images can be used as an indicator to assess the functional status of the lesion in patients with ICAS.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"613-624"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136578","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}