Neuroradiology最新文献

{"title":"Real-time measurement of radiation exposure in interventional radiologists during CT-guided intrathecal injections of nusinersen.","authors":"Grzegorz Rosiak, Jakub Franke, Krzysztof Milczarek, Dariusz Konecki, Anna Frączek-Kozlovska, Anna Potulska-Chromik, Anna Kostera-Pruszczyk, Anna Łusakowska","doi":"10.1007/s00234-024-03496-8","DOIUrl":"https://doi.org/10.1007/s00234-024-03496-8","url":null,"abstract":"<p><strong>Purpose: </strong>Some patients with spinal muscular atrophy and scoliosis require CT guidance during injections of nusinersen. The radiation applied to the operator in such procedures becomes an important issue in terms of staff health and safety. The aim of the study was to assess the operator's radiation exposure during CT-guided nusinersen injections in patients with spinal muscular atrophy and scoliosis.</p><p><strong>Methods: </strong>Consecutive 40 CT-guided nusinersen injections were analyzed in terms of operator's radiation exposure measured in real time.</p><p><strong>Results: </strong>The median radiation dose measured under the physician's lead apron and patient dose in terms of DLP was 0.20 µSv and 31.90 mGy*cm respectively. The radiation doses were significantly higher (p = 0.047) in patients with spinal instrumentation.</p><p><strong>Conclusion: </strong>The results show that CT-guided nusinersen injection is a relatively safe procedure in terms of operator's radiation exposure. This can allow for interventional radiologists to perform more procedures without exceeding their annual dose limit.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605420","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":"Automated assessment of brain MRIs in multiple sclerosis patients significantly reduces reading time.","authors":"Victoria Sieber, Thilo Rusche, Shan Yang, Bram Stieltjes, Urs Fischer, Stefano Trebeschi, Philippe Cattin, Dan Linh Nguyen-Kim, Marios-Nikos Psychogios, Johanna M Lieb, Peter B Sporns","doi":"10.1007/s00234-024-03497-7","DOIUrl":"https://doi.org/10.1007/s00234-024-03497-7","url":null,"abstract":"<p><strong>Introduction: </strong>Assessment of multiple sclerosis (MS) lesions on magnetic resonance imaging (MRI) is tedious, time-consuming, and error-prone. We evaluate whether assessment of new, expanding, and contrast-enhancing MS lesions can be done more time-efficiently by radiologists with assistance of artificial intelligence (AI).</p><p><strong>Methods: </strong>Baseline and three follow-up (FU) MRIs of thirty-five consecutive patients diagnosed with MS were assessed by a radiologist manually, and with assistance of an AI-tool. Results were discussed with a consultant neuroradiologist and time metrics were evaluated.</p><p><strong>Results: </strong>The mean reading time for the resident radiologist was 9.05 min (95CI: 6.85-11:25). With AI-assistance, the reading time was reduced by 2.83 min (95CI: 3.28-2.41, p < 0.001). The reading decreased steadily from baseline to FU3 for the resident radiologist (9.85 min baseline, 9.21 FU1, 8.64 FU2 and 8.44 FU3, p < 0.001). Assistance of AI further remarkably decreased reading times during follow-ups (3.29 min FU1, 3.92 FU2, 3.79 FU3, p < 0.001) but not at baseline (0.26 min, p = 0.96). The baseline reading time of the resident radiologist was 5.04 min (p < 0.001), with each lesion adding 0.14 min (p < 0.001). There was a substantial decrease in the baseline reading time from 5.04 min to 1.59 min (p = 0.23) with AI-assistance. Discussion of the reading results of the resident with the neuroradiology consultant (as usual in clinical routine) was exemplary done for FU-3 MRIs and added another 3 min (CI:2.27-3.76) to the reading time without AI-assistance.</p><p><strong>Conclusion: </strong>We found that AI-assisted reading of MRIs of patients with MS may be faster than evaluating these MRIs without AI-assistance.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605417","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":"SISCOS in focal cortical dysplasia: localization and comparative analysis with MRI.","authors":"Dikhra Khan, Sambit Sagar, Jasim Jaleel, Mohammad Umar, Madhavi Tripathi, Manjari Tripathi, M C Sharma, Chandrasekhar Bal","doi":"10.1007/s00234-024-03434-8","DOIUrl":"10.1007/s00234-024-03434-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the efficacy of SISCOS (Subtraction ictal-interictal SPECT coregistered to SPECT) in localizing the epileptogenic zone (EZ) in focal cortical dysplasia (FCD), comparing its predictive performance with MRI and post-surgical outcomes based on ILAE classification.</p><p><strong>Methods: </strong>84 patients with drug refractory epilepsy (DRE) who were operated and had histopathology consistent with FCD, were included in the study. All patients had undergone a complete work-up including SISCOS and MRI for EZ localization, followed by discussion in the multidisciplinary epilepsy surgery meeting prior to surgery. Ictal & interictal perfusion SPECT studies were performed with Tc-99 m Ethylene Cysteinate Dimer (Tc-99 m ECD) followed by SISCOS analysis using SPM2 and Bioimage Suite 2.6. Concordance for localization was determined by comparing with the surgical resection site and post-surgical outcomes were assessed using the ILAE classification.</p><p><strong>Results: </strong>The concordance for EZ localization demonstrated by SISCOS was 73.8% and MRI was 82.1%. 52 patients (61.9%) had good surgical outcome and 31(59%) of these were FCD type 2. In patients with discordant MRI findings, SISCOS was able to provide localisation in 86% (13/15), with 69.2% showing good surgical outcomes. Sensitivity of SISCOS and MRI was 73% (95% CI = 59-84.8%) and 78% (95% CI = 67.5-90.3%) respectively with no significant difference between the two. In FCD type I, both SISCOS and MRI revealed a similar a sensitivity of 76.4% (95%CI = 50.1-93.2%). Concordant cases exhibited higher seizure-free odds ratios for both modalities.</p><p><strong>Conclusion: </strong>SISCOS is effective in localizing the EZ in FCD patients, comparable to MRI. Integrating SISCOS and MRI enhances lesion detection, especially in MRI discordant cases. A comprehensive diagnostic approach utilizing SISCOS and MRI can optimize the non-invasive pre-surgical assessment in DRE thereby guiding surgical decision-making in a resource-limited setting.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766898","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":"Radiomics features for the discrimination of tuberculomas from high grade gliomas and metastasis: a multimodal study.","authors":"Abhilasha Indoria, Karthik Kulanthaivelu, Chandrajit Prasad, Dwarakanath Srinivas, Shilpa Rao, Neelam Sinha, Vivek Potluri, M Netravathi, Atchayaram Nalini, Jitender Saini","doi":"10.1007/s00234-024-03435-7","DOIUrl":"10.1007/s00234-024-03435-7","url":null,"abstract":"<p><strong>Background: </strong>Tuberculomas are prevalent in developing countries and demonstrate variable signals on MRI resulting in the overlap of the conventional imaging phenotype with other entities including glioma and brain metastasis. An accurate MRI diagnosis is important for the early institution of anti-tubercular therapy, decreased patient morbidity, mortality, and prevents unnecessary neurosurgical excision. This study aims to assess the potential of radiomics features of regular contrast images including T1W, T2W, T2W FLAIR, T1W post contrast images, and ADC maps, to differentiate between tuberculomas, high-grade-gliomas and metastasis, the commonest intra parenchymal mass lesions encountered in the clinical practice.</p><p><strong>Methods: </strong>This retrospective study includes 185 subjects. Images were resampled, co-registered, skull-stripped, and zscore-normalized. Automated lesion segmentation was performed followed by radiomics feature extraction, train-test split, and features reduction. All machine learning algorithms that natively support multiclass classification were trained and assessed on features extracted from individual modalities as well as combined modalities. Model explainability of the best performing model was calculated using the summary plot obtained by SHAP values.</p><p><strong>Results: </strong>Extra tree classifier trained on the features from ADC maps was the best classifier for the discrimination of tuberculoma from high-grade-glioma and metastasis with AUC-score of 0.96, accuracy-score of 0.923, Brier-score of 0.23.</p><p><strong>Conclusion: </strong>This study demonstrates that radiomics features are effective in discriminating between tuberculoma, metastasis, and high-grade-glioma with notable accuracy and AUC scores. Features extracted from the ADC maps surfaced as the most robust predictors of the target variable.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889806","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":"Conventional magnetic resonance imaging key features for distinguishing pathologically confirmed corticobasal degeneration from its mimics: a retrospective analysis of the J-VAC study.","authors":"Keita Sakurai, Aya M Tokumaru, Mari Yoshida, Yuko Saito, Koichi Wakabayashi, Takashi Komori, Masato Hasegawa, Takeshi Ikeuchi, Yuichi Hayashi, Takayoshi Shimohata, Shigeo Murayama, Yasushi Iwasaki, Toshiki Uchihara, Motoko Sakai, Ichiro Yabe, Satoshi Tanikawa, Hiroshi Takigawa, Tadashi Adachi, Ritsuko Hanajima, Harutoshi Fujimura, Kentaro Hayashi, Keizo Sugaya, Kazuko Hasegawa, Terunori Sano, Masaki Takao, Osamu Yokota, Tomoko Miki, Michio Kobayashi, Nobutaka Arai, Takuya Ohkubo, Takanori Yokota, Keiko Mori, Masumi Ito, Chiho Ishida, Jiro Idezuka, Yasuko Toyoshima, Masato Kanazawa, Masashi Aoki, Takafumi Hasegawa, Hirohisa Watanabe, Atsushi Hashizume, Hisayoshi Niwa, Keizo Yasui, Keita Ito, Yukihiko Washimi, Akatsuki Kubota, Tatsushi Toda, Kenji Nakashima, Ikuko Aiba","doi":"10.1007/s00234-024-03432-w","DOIUrl":"10.1007/s00234-024-03432-w","url":null,"abstract":"<p><strong>Purpose: </strong>Due to the indistinguishable clinical features of corticobasal syndrome (CBS), the antemortem differentiation between corticobasal degeneration (CBD) and its mimics remains challenging. However, the utility of conventional magnetic resonance imaging (MRI) for the diagnosis of CBD has not been sufficiently evaluated. This study aimed to investigate the diagnostic performance of conventional MRI findings in differentiating pathologically confirmed CBD from its mimics.</p><p><strong>Methods: </strong>Semiquantitative visual rating scales were employed to assess the degree and distribution of atrophy and asymmetry on conventional T1-weighted and T2-weighted images. Additionally, subcortical white matter hyperintensity (SWMH) on fluid-attenuated inversion recovery images were visually evaluated.</p><p><strong>Results: </strong>In addition to 19 patients with CBD, 16 with CBD mimics (progressive supranuclear palsy (PSP): 9, Alzheimer's disease (AD): 4, dementia with Lewy bodies (DLB): 1, frontotemporal lobar degeneration with TAR DNA-binding protein of 43 kDa(FTLD-TDP): 1, and globular glial tauopathy (GGT): 1) were investigated. Compared with the CBD group, the PSP-CBS subgroup showed severe midbrain atrophy without SWMH. The non-PSP-CBS subgroup, comprising patients with AD, DLB, FTLD-TDP, and GGT, showed severe temporal atrophy with widespread asymmetry, especially in the temporal lobes. In addition to over half of the patients with CBD, two with FTLD-TDP and GGT showed SWMH, respectively.</p><p><strong>Conclusion: </strong>This study elucidates the distinct structural changes between the CBD and its mimics based on visual rating scales. The evaluation of atrophic distribution and SWMH may serve as imaging biomarkers of conventional MRI for detecting background pathologies.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748677","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":"Choroid plexus volume changes in multiple sclerosis: insights from a systematic review and meta-analysis of magnetic resonance imaging studies.","authors":"Shahriar Kolahi, Diana Zarei, Mahbod Issaiy, Madjid Shakiba, Narges Azizi, Kavous Firouznia","doi":"10.1007/s00234-024-03439-3","DOIUrl":"10.1007/s00234-024-03439-3","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple sclerosis (MS) is a chronic autoimmune disease characterized by the destruction of the myelin sheath within the central nervous system. The etiology of MS involves a complex interplay of genetic, environmental, and immunological factors. Recent studies indicated the potential role of the choroid plexus (CP) in the pathogenesis and progression of MS. This systematic review aims to assess existing research on the volume alterations of the CP in MS patients compared to the normal population.</p><p><strong>Methods: </strong>A comprehensive search was conducted across databases including PubMed, Embase, Scopus, and Web of Science up to June 2024. Data from the included studies were synthesized using a meta-analytical approach with a random-effects model, assessing heterogeneity with the I² and Tau-squared indices.</p><p><strong>Results: </strong>We included 17 studies in this systematic review. The meta-analysis, which included data from eight studies reporting CP volume relative to TIV, found a statistically significant increase in CP volume in MS patients compared to healthy controls (HCs). The SMD was 0.77 (95% CI: 0.61 to 0.93), indicating a large effect size. This analysis showed no heterogeneity (I² = 0%). A separate meta-analysis was conducted using five studies that reported CP volume as normalized volume, resulting in an SMD of 0.63 (95% CI: 0.2-1.06).</p><p><strong>Conclusion: </strong>This study demonstrates an increase in CP volume among MS patients compared to HCs, implying the potential involvement of CP in MS pathogenesis and/or progression. These results show that CP might serve as a radiological indicator in the diagnosis and prognosis of MS.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894004","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":"The benefit of optimizing recanalization during mechanical thrombectomy in patients with acute ischemic stroke depends on preprocedural tissue-level collateralization.","authors":"Paweł Wrona, Dominik Wróbel, Paweł Mizera, Joanna Jóźwik, Klaudia Jakobschy, Kaja Zdrojewska, Tomasz Homa, Katarzyna Sawczyńska, Tadeusz Popiela, Agnieszka Słowik, Wojciech Turaj","doi":"10.1007/s00234-024-03443-7","DOIUrl":"10.1007/s00234-024-03443-7","url":null,"abstract":"<p><strong>Purpose: </strong>Thrombolysis in Cerebral Infarction (TICI) 3 represents the optimal angiographic outcome following mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Although it is known to yield better outcomes than TICI 2b, the influence of preprocedural cerebral hemodynamics on the clinical advantage of TICI 3 over TICI 2b remains unexplored.</p><p><strong>Methods: </strong>This single-center retrospective analysis involved patients with anterior circulation AIS who underwent successful recanalization during MT at the Comprehensive Stroke Center, University Hospital, Krakow between January 2019 and July 2023. We assessed the benefit of achieving TICI 2c/3 over TICI 2b on the basis of preprocedural computed perfusion imaging results, primarily focusing on early infarct volume (EIV) and tissue-level collaterals indicated by hypoperfusion intensity ratio (HIR). Good functional outcome (GFO) was defined as a modified Rankin Score < 3 on day 90.</p><p><strong>Results: </strong>The study comprised 612 patients, of whom 467 (76.3%) achieved TICI 2c/3. GFO was more frequent in the TICI 2c/3 group (54.5% vs 69.4%, p < 0.001). There was interaction between the recanalization status and both HIR (Pi = 0.042) and EIV (Pi = 0.012) in predicting GFO, with disproportionately higher impact of HIR and EIV in TICI 2b group. The benefit from TICI 2c/3 over TICI 2b was insignificant among patients with good collaterals, defined by HIR < 0.3 (odds ratio:1.36 [0.58-3.18], p = 0.483).</p><p><strong>Conclusion: </strong>TICI 2c/3 improves patient functional outcomes compared to TICI 2b regardless of EIV. However, such angiographic improvement may be clinically futile in patients with good tissue-level collateralization. Our findings suggest that preprocedural HIR should be considered when optimization of recanalization is considered during MT.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996229","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":"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/s00234-024-03440-w","DOIUrl":"10.1007/s00234-024-03440-w","url":null,"abstract":"<p><p>Sporadic Creutzfeldt-Jakob disease (sCJD) is a frequent differential diagnostic consideration in patients with rapidly progressive dementia (RPD). Fortunately, in the last 2 decades there has been substantial cumulative improvements in sCJD biomarkers, particularly those based on imaging and cerebrospinal fluid (CSF) interrogation. Brain MRI is a very frequently employed investigation in patients with RPD, often utilized quite early in the evaluation and thereby offering a potentially key role in prompting initial concerns for sCJD. Extant conventional MRI criteria for sCJD diagnosis are relatively stringent, requiring fluid attenuated inversion recovery (FLAIR) or diffusion weighted imaging (DWI) high signal changes in 2 or more cortical regions (excluding frontal) or in both the caudate and putamen. Challenging these conventional criteria, a recent publication described improved sensitivity and unchanged specificity if MRI criteria were arguably less rigorous, requiring DWI high signal changes in only 1 or more of 7 discrete brain regions: frontal, parietal, occipital or temporal cortices, as well as the caudate, putamen or thalamus. The aim of the current study was to test the diagnostic performance of this proposed change in MRI criteria in the Australian context and compare it with conventional criteria, as well as 2 other stringent sets of criteria, predicting that a similar improved sensitivity with unchanged specificity would be observed when the proposed criteria were utilized. Sixty-five definite sCJD cases were compared with 63 age- and sex-matched controls. Radiological review of all MRIs applying the different sets of MRI criteria was undertaken by a blinded neuroradiologist, very experienced in CJD interpretation, with independent assessment of 71 MRIs performed by a second blinded neuroradiologist less experienced in sCJD imaging findings. Our study found the sensitivity of the recently proposed MRI criteria (92.3%) to be comparable to that originally reported (90-95%) and also equivalent to the conventional MRI diagnostic criteria (92.3%), while the specificities were also quite similar between the conventional MRI criteria (87.3%) and proposed criteria (85.7%), with the latter lower than previously reported. Negative predictive values and positive predictive values were also very similar between the conventional and proposed MRI criteria. Other MRI criteria assessed were associated with unacceptably low sensitivity for clinical use. Inter-rater reliability as assessed by intra-class correlation coefficients (ICC) revealed moderate reliability for the conventional and proposed MRI criteria, modestly better in the former and when the frontal lobe was retained versus excluded in comparisons.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971540","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":"Self-expanding intracranial drug-eluting stent system in patients with symptomatic intracranial atherosclerotic stenosis: initial experience and midterm angiographic follow-up.","authors":"Feifan Zhang, Jinbiao Yao, Pei Wu, Qiaowei Wu, Chunxu Li, Jinshuo Yang, Yixuan Liu, Ilgiz Gareev, Huaizhang Shi, Chunlei Wang","doi":"10.1007/s00234-024-03423-x","DOIUrl":"10.1007/s00234-024-03423-x","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke worldwide. In patients undergoing endovascular treatment for ICAS, in-stent restenosis (ISR) is associated with ischemic stroke recurrence.</p><p><strong>Objective: </strong>Intracranial drug-eluting self-expanding stent systems (COMETIU; Sinomed Neurovita Technology Inc., CHN) are new devices for treating ICAS. This study evaluated the perioperative experience and medium-term outcomes of COMETIU in 16 patients.</p><p><strong>Methods: </strong>We prospectively analyzed 16 patients with ICAS (≥ 70% stenosis) who underwent intravascular therapy between September 4, 2022, and February 1, 2023. The primary outcome was the incidence of ISR at 6 months postoperatively. The secondary efficacy outcomes were device and technical success rates. The secondary safety outcomes included stroke or death within 30 days after the procedure and the cumulative annual rate of recurrent ischemic stroke in the target-vessel territory from 31 days to 6 months and 1 year.</p><p><strong>Results: </strong>A total of 16 patients with 16 intracranial atherosclerotic lesions were treated with 16 COMETIUs. All procedures were performed under general anesthesia with 100% device and technical success rates, with no cases of periprocedural stroke or death. The mean radiographic follow-up duration was at least 6 months postoperatively, and all patients presented for radiographic and clinical follow-up. There were no reported ischemic or hemorrhagic strokes. Angiographic follow-up for all patients revealed no cases of ISR.</p><p><strong>Conclusion: </strong>COMETIU is safe and effective for treating ICAS, with minimal risk during the procedure and a low rate of ISR during medium-term follow-up.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559372","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":"Defining tumor growth in vestibular schwannomas: a volumetric inter-observer variability study in contrast-enhanced T1-weighted MRI.","authors":"Stefan Cornelissen, Sammy M Schouten, Patrick P J H Langenhuizen, Suan Te Lie, Henricus P M Kunst, Peter H N de With, Jeroen B Verheul","doi":"10.1007/s00234-024-03416-w","DOIUrl":"10.1007/s00234-024-03416-w","url":null,"abstract":"<p><strong>Purpose: </strong>For patients with vestibular schwannomas (VS), a conservative observational approach is increasingly used. Therefore, the need for accurate and reliable volumetric tumor monitoring is important. Currently, a volumetric cutoff of 20% increase in tumor volume is widely used to define tumor growth in VS. The study investigates the tumor volume dependency on the limits of agreement (LoA) for volumetric measurements of VS by means of an inter-observer study.</p><p><strong>Methods: </strong>This retrospective study included 100 VS patients who underwent contrast-enhanced T1-weighted MRI. Five observers volumetrically annotated the images. Observer agreement and reliability was measured using the LoA, estimated using the limits of agreement with the mean (LOAM) method, and the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>The 100 patients had a median average tumor volume of 903 mm³ (IQR: 193-3101). Patients were divided into four volumetric size categories based on tumor volume quartile. The smallest tumor volume quartile showed a LOAM relative to the mean of 26.8% (95% CI: 23.7-33.6), whereas for the largest tumor volume quartile this figure was found to be 7.3% (95% CI: 6.5-9.7) and when excluding peritumoral cysts: 4.8% (95% CI: 4.2-6.2).</p><p><strong>Conclusion: </strong>Agreement limits within volumetric annotation of VS are affected by tumor volume, since the LoA improves with increasing tumor volume. As a result, for tumors larger than 200 mm³, growth can reliably be detected at an earlier stage, compared to the currently widely used cutoff of 20%. However, for very small tumors, growth should be assessed with higher agreement limits than previously thought.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559370","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}