Neuroradiology最新文献

{"title":"Photon-counting CT-angiography in comparison to digital subtraction angiography for assessing intracranial aneurysms after coiling or clipping.","authors":"Frederic De Beukelaer, Laura Wuyts, Sophie De Beukelaer, Steven Van Hedent, Omid Nikoubashman, Martin Wiesmann, Michael Veldeman, Rastislav Pjontek, Anke Höllig, Hani Ridwan, Charlotte Weyland","doi":"10.1007/s00234-025-03650-w","DOIUrl":"https://doi.org/10.1007/s00234-025-03650-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the potential of Photon-Counting Detector CT Angiography (PCD-CTA) for the post-interventional assessment of intracranial aneurysms treated with coil-embolization or clipping, compared to digital subtraction angiography (DSA).</p><p><strong>Methods: </strong>Retrospective analysis of consecutive patients treated with coils or clips between April 2023 and May 2024, who underwent PCD-CTA and, if necessary, DSA as part of their clinical routine. Polyenergetic images and spectral reconstructions were performed at different kiloelectron volt (keV) levels (40, 80 and 120) and with reconstruction kernels: Quantitative (Qr56 and Qr72) and Head vessel (Hv56 and Hv72), both with and without iterative metal artifact reduction (iMAR). Three independent readers assessed image quality using a 5-point Likert scale and region of interest analysis. A blinded, independent reading was performed to determine the presence of aneurysm remnants and intracranial vessel stenosis in the parent vessel.</p><p><strong>Results: </strong>A total of 21 patients (mean age 58 ± 14 years; range 36-74; 18 women) with intracranial, saccular aneurysms treated with either clipping (17/21) or coiling (4/21) were included. Reconstructions using smooth kernels (Hv56, Qr56) at a low keV level (40 keV) yielded increased signal- and contrast-to-noise ratios compared to sharper kernels (Hv72, Qr72) and higher keV levels (80 and 120 keV) (p < 0.001). Unexpectedly, reconstructions with iMAR negatively impacted evaluation, with only 6/21 diagnostic images at the clip site. The sensitivity of PCD-CTA for detecting aneurysm remnants was 100% (7 of 7 aneurysm clip/coil site), while specificity was 89% for patients with clips (8/9). A 100% negative predictive value was observed for all readers regarding aneurysm remnants.</p><p><strong>Conclusion: </strong>Photon-Counting CT-Angiography demonstrated adequate diagnostic value in most patients with intracranial clips. However, while coil artifacts were reduced, spectral reconstructions and iMAR were not sufficient to fully minimize these artifacts.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199662","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":"Flow diverting stents in acutely ruptured intracranial aneurysms: a single centre experience of 40 consecutive cases.","authors":"Jing Yi Liu, James Caldwell, Shane Lee, Matthew Page, Ben McGuinness","doi":"10.1007/s00234-025-03655-5","DOIUrl":"https://doi.org/10.1007/s00234-025-03655-5","url":null,"abstract":"<p><strong>Purpose: </strong>Certain subsets of acutely ruptured intracranial aneurysms (IAs) may require treatment with flow diverting stents (FDS); however, use of FDS in this context warrants antiplatelet therapy which may increase the risk of further haemorrhage. Here we present our single centre experience of 40 consecutive patients.</p><p><strong>Methods: </strong>We retrospectively reviewed our institutional databases for all patients between 2011 and 2024 with acutely ruptured IAs treated using FDS alone or with simultaneous coiling within 20 days of haemorrhage. Primary outcome was modified Rankin Score (mRS) at latest follow-up. Secondary outcomes were aneurysm occlusion rate and procedure-related complications.</p><p><strong>Results: </strong>Forty patients met the inclusion criteria: 22 females; mean age 44.7 years (range 18-66). These included 28 blister-like, 5 fusiform, 4 dissecting and 3 saccular aneurysms, with 73% in the anterior circulation. Median time to FDS insertion was 1.5 days from ictus. Favourable functional outcome (mRS 0-2) was observed in 75%. Overall mortality rate was 13% and procedure-related mortality rate was 5%. Complete aneurysm occlusion rate was 97% on follow-up imaging. Procedure-related complications occurred in 18%, with 8% aneurysm rebleed rate, and 8% in-stent thrombosis rate on follow-up imaging (this group of three patients includes the only two patients treated with single antiplatelet therapy (SAPT)).</p><p><strong>Conclusion: </strong>Our series yielded favourable clinical outcomes and excellent aneurysm occlusion rate following FDS treatment of ruptured IAs. Complications are not negligible, especially the thrombotic risk associated with SAPT use. However, given the innate high mortality risk of aneurysmal subarachnoid haemorrhage, FDS remain a useful alternative for aneurysms unsuitable for traditional endovascular treatment options.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199661","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":"White matter microstructural changes across the menstrual cycle: a differential tractography study.","authors":"Michele Porcu, Luigi Cocco, Luca Pasquini, Jasjit S Suri, Francesco Marrosu, Luca Saba","doi":"10.1007/s00234-025-03662-6","DOIUrl":"https://doi.org/10.1007/s00234-025-03662-6","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192059","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":"Evaluation of glymphatic system function in patients with thalassemia: a study based on DTI-ALPS technology.","authors":"Mingrui Yang, Guowei Chen, Cheng Tang, Fei Peng, Chaotian Luo, Chunxia Zhu, Rong Kong, Jiatong Liang, Peng Peng","doi":"10.1007/s00234-025-03654-6","DOIUrl":"https://doi.org/10.1007/s00234-025-03654-6","url":null,"abstract":"<p><strong>Background: </strong>Thalassemia is an inherited hematological disorder characterized by chronic anemia and multisystem involvement, including potential impacts on the central nervous system. Research has suggested a relationship between thalassemia and glymphatic system dysfunction, which may contribute to neurocognitive impairments. However, the exact mechanisms linking thalassemia to changes in glymphatic function remain unclear.</p><p><strong>Objective: </strong>To investigate the relationship between glymphatic system function and thalassemia severity, particularly in patients with transfusion-dependent and non-transfusion-dependent thalassemia.</p><p><strong>Methods: </strong>The study included a population of 40 thalassemia patients (TM, n = 40) confirmed through genetic testing, consisting of 19 patients who were transfusion-dependent (TDT, n = 19) and 21 patients who were non-transfusion-dependent (NTDT, n = 21), along with 39 healthy controls (HC, n = 39) matched for age and sex. Glymphatic function was assessed using the index for diffusivity along the perivascular space (ALPS-index), with regions of interest selected from the medullary veins and crossing fibers in the lateral ventricles. Statistical analyses were performed using Analysis of Variance (ANOVA) for intergroup comparisons, supplemented by Bonferroni correction for multiple comparisons. Pearson correlation was utilized to explore the relationships between the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index and demographic factors, while multiple linear regression was employed to adjust for confounding variables. A significance threshold of P less than 0.05 was established for all statistical tests.</p><p><strong>Results: </strong>The mean DTI-ALPS Index for thalassemia patients were significantly lower than those of healthy controls, indicating impaired glymphatic function. No significant differences in DTI-ALPS Index were found between transfusion-dependent and non-transfusion-dependent groups. Correlation analysis showed minimal influence of age and education on glymphatic function in the study population.</p><p><strong>Conclusion: </strong>This study demonstrates significant impairment in glymphatic system function in thalassemia patients, potentially related to chronic anemia and iron overload. These findings contribute to understanding the mechanisms underlying cognitive dysfunction in thalassemia.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174209","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":"Image analysis research in neuroradiology: bridging clinical and technical domains.","authors":"Deborah Pareto, Pablo Naval-Baudin, Albert Pons-Escoda, Núria Bargalló, María Garcia-Gil, Carlos Majós, Àlex Rovira","doi":"10.1007/s00234-025-03633-x","DOIUrl":"https://doi.org/10.1007/s00234-025-03633-x","url":null,"abstract":"<p><strong>Purpose: </strong>Advancements in magnetic resonance imaging (MRI) analysis over the past decades have significantly reshaped the field of neuroradiology. The ability to extract multiple quantitative measures from each MRI scan, alongside the development of extensive data repositories, has been fundamental to the emergence of advanced methodologies such as radiomics and artificial intelligence (AI). This educational review aims to delineate the importance of image analysis, highlight key paradigm shifts, examine their implications, and identify existing constraints that must be addressed to facilitate integration into clinical practice. Particular attention is given to aiding junior neuroradiologists in navigating this complex and evolving landscape.</p><p><strong>Methods: </strong>A comprehensive review of the available analysis toolboxes was conducted, focusing on major technological advancements in MRI analysis, the evolution of data repositories, and the rise of AI and radiomics in neuroradiology. Stakeholders within the field were identified and their roles examined. Additionally, current challenges and barriers to clinical implementation were analyzed.</p><p><strong>Results: </strong>The analysis revealed several pivotal shifts, including the transition from qualitative to quantitative imaging, the central role of large datasets in developing AI tools, and the growing importance of interdisciplinary collaboration. Key stakeholders-including academic institutions, industry partners, regulatory bodies, and clinical practitioners-were identified, each playing a distinct role in advancing the field. However, significant barriers remain, particularly regarding standardization, data sharing, regulatory approval, and integration into clinical workflows.</p><p><strong>Conclusions: </strong>While advancements in MRI analysis offer tremendous potential to enhance neuroradiology practice, realizing this potential requires overcoming technical, regulatory, and practical barriers. Education and structured support for junior neuroradiologists are essential to ensure they are well-equipped to participate in and drive future developments. A coordinated effort among stakeholders is crucial to facilitate the seamless translation of these technological innovations into everyday clinical practice.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160508","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":"Measuring cerebrovascular reactivity with breath-hold fMRI in patients with Moyamoya angiopathy: MR perfusion based delay correction significantly improves agreement to [¹⁵O]water PET.","authors":"Leonie Zerweck, Uwe Klose, Constantin Roder, Deborah Staber, Emely Renger, Ganna Blazhenets, Kathrin Grundmann-Hauser, Philipp T Meyer, Ulrike Ernemann, Till-Karsten Hauser","doi":"10.1007/s00234-025-03649-3","DOIUrl":"https://doi.org/10.1007/s00234-025-03649-3","url":null,"abstract":"<p><strong>Purpose: </strong>Breath-hold functional MRI (bh-fMRI) is able to quantify cerebrovascular reactivity. Vessel stenoses can lead to delayed hemodynamic responses. We aimed to investigate whether delay correction improves the quality of bh-fMRI compared to the diagnostic standard [¹⁵O]water PET.</p><p><strong>Methods: </strong>The bh-fMRI data sets of 25 patients with Moyamoya Angiopathy were analyzed retrospectively without and with delay correction. Delay correction was calculated using time-to-peak (TTP) maps derived from dynamic susceptibility contrast (DSC) perfusion MRI. [¹⁵O]water PET maps and bh-fMRI maps without and with delay correction were presented blinded for delay correction to two neuroradiologists. The agreement between bh-fMRI without and with delay correction and [¹⁵O]water PET was independently and consensually rated on a 4-point-Likert scale (1 = poor, 2 = moderate, 3 = good, 4 = excellent) and compared with Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The agreement between bh-fMRI and [¹⁵O]water PET without delay correction was good/excellent (median = 3, modus = 4), and improved significantly after delay correction with medium effect size (median = 4, modus = 4, z = -2.121, p = 0.034, r = 0.42).</p><p><strong>Conclusion: </strong>Delay correction improves the quality of bh-fMRI and seems to be helpful in clinical practice.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136046","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":"Prediction of early hematoma enlargement in hypertensive intracerebral hemorrhage using CT and CTA imaging features.","authors":"Ting Lyu, Xue Xu, Gang Li, Qing Zhu, Gang Zhao","doi":"10.1007/s00234-025-03656-4","DOIUrl":"https://doi.org/10.1007/s00234-025-03656-4","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between CT low density, CTA dot and early hematoma enlargement in patients with hypertensive intracerebral hemorrhage (HICH), to analyse the influencing factors of hematoma enlargement and construct the prediction model.</p><p><strong>Methods: </strong>A retrospective analysis was performed on the clinical data of 400 patients with HICH in the hospital between August 2022 and July 2024, and patients were randomly divided into the modeling group (n = 300) and the verification group (n = 100). According to examination results of head CT at admission, disease deterioration or 24 h after admission, hematoma volume was calculated by Tada formula. The increment of hematoma volume > 33% was defined as hematoma enlargement. The patients in the modeling group were divided into hematoma enlargement group and non-enlargement group. The relationship between CT, CTA signs and early hematoma enlargement was analyzed by Logistic regression analysis.</p><p><strong>Results: </strong>The patients in the modeling group were divided into hematoma enlargement group (92 cases) and non-enlargement group (208 cases). The results of logistic analysis showed that large baseline hematoma volume, irregular morphology, island sign, low density sign, mixed sign, black hole sign and CTA spot sign were independent risk factors of early hematoma enlargement in HICH patients. According to data verification in modeling group, area under ROC curve (AUC), sensitivity and specificity were 0.817 [95%CI (0.768-0.866)], 78.26% and 73.56%, respectively. According to the principle of maximum Youden index, the cut-off value was 0.302.</p><p><strong>Conclusion: </strong>The risk factors of early hematoma enlargement are analyzed and screened in HICH patients to construct a prediction model. The model is proved to have good validity, which can provide reference for the identification of high-risk groups.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128225","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":"Comparative analysis of optical coherence tomography angiography findings before and after flow-diverting stent treatment covering the ophthalmic artery origin in the management of paraclinoid aneurysms.","authors":"Mehmet Cingoz, Tevfik Guzelbey, Murat Karapapak, Ali Dablan, Emrullah Simsek, Cagri Erdim, Mustafa Fatih Arslan, Oguzhan Turksayar, Ilhan Nahit Mutlu, Eda Cingoz, Ozgur Kilickesmez","doi":"10.1007/s00234-025-03652-8","DOIUrl":"https://doi.org/10.1007/s00234-025-03652-8","url":null,"abstract":"<p><strong>Purpose: </strong>Flow-diverter stents (FDSs) are being increasingly used for endovascular treatment of paraclinoid aneurysms. However, their impact on ophthalmic artery (OA) flow and retinal microvasculature remains unclear. Using optical coherence tomography angiography (OCTA), we evaluated the microvascular changes after FDS placement on the OA.</p><p><strong>Methods: </strong>This retrospective study included 38 patients with paraclinoid aneurysms who had an FDS placed on the OA origin. OCTA imaging was performed preoperatively, on postoperative day 1, and at the 6th month. The superficial and deep capillary plexus (SCP, DCP) densities in the treated and untreated fellow eyes were determined and compared with a control group of 31 healthy individuals who underwent single-session OCTA. OA status and stent-related changes were assessed at the 6th month follow-up with digital subtraction angiography (DSA).</p><p><strong>Results: </strong>A significant reduction in SCP and DCP densities was observed in the stent-treated eyes over time, particularly in the central, superior, temporal, and inferior regions (p < 0.05), while untreated fellow eyes and controls showed no significant changes.</p><p><strong>Conclusion: </strong>FDS placement covering the OA orifice leads to measurable retinal microvascular changes that are detectable by OCTA, demonstrating the value of the latter as a useful non-invasive tool for this purpose.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120432","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 small-parent artery aneurysms: mid-term results of the silk vista baby flow diverter.","authors":"Celal Cinar, Alperen Elek, Mahmut Kusbeci, Egemen Ozturk, Cemre Yanbol Utli, Ismail Oran","doi":"10.1007/s00234-025-03653-7","DOIUrl":"https://doi.org/10.1007/s00234-025-03653-7","url":null,"abstract":"<p><strong>Purpose: </strong>We aim to retrospectively evaluate patients treated with SVB at our single center, assessing its efficacy, radiologic and clinical outcomes, and complication profile.</p><p><strong>Method: </strong>This retrospective, single-center study included patients with small parent artery aneurysms treated with SVB. Patients were monitored for procedural success, aneurysm occlusion, and complications, with radiologic and clinical follow-up conducted.</p><p><strong>Results: </strong>The study included 64 patients with 66 small parent artery aneurysms treated using SVB FDs. Among these patients, 26 (40.6%) presented with subarachnoid hemorrhage (SAH). The mean index aneurysm size was 5.7 ± 5.25 mm. The cohort consisted of 15 males (23.4%) and 49 females (76.6%), with a mean age of 54.23 ± 14.95 years (range: 5-80 years). SVB was used as a standalone treatment in 42 patients (65.6%), while adjunctive materials were applied in 22 cases (34.4%)-coils in 16 (24.2%) and a regular stent in 6 (9.1%). A total of 71 SVB stents were deployed for 66 aneurysms, achieving a 100% technical success rate. In 30 patients with multiple aneurysms, additional aneurysms were addressed during the same session along with the index aneurysm. The mean duration of clinical and radiological follow-up was 10.5 ± 7.94 months. Among a total of 7 patients (10.9%) with ischemic complications, 3 (4.7%) were related to SVB implantation. Index aneurysm occlusion was accomplished in 93.3% of cases at the last follow-up. Favorable neurological outcomes (mRS 0-2) were recorded in 53 patients (82.8%). Subgroup analysis showed that 6 out of 7 total complications (85.7%) occurred in patients with multiple aneurysms.</p><p><strong>Conclusion: </strong>The SVB FDs are a highly effective and safe treatment option for distal intracranial aneurysms, achieving high occlusion rates with a favorable safety profile.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120435","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":"PET/MR for predicting extranodal extension of head and neck cancer.","authors":"Vanessa Sanchez, Daniele A Pizzuto, Alexander Maurer, Urs J Muehlematter, Bert-Ram Sah, Lars Husmann, Stephan Skawran, Caecilia E Mader, Gregoire B Morand, Simon A Mueller, Christian Meerwein, Niels J Rupp, Sandra Freiberger, Martin Lanzer, Michael Messerli, Martin W Huellner","doi":"10.1007/s00234-025-03635-9","DOIUrl":"https://doi.org/10.1007/s00234-025-03635-9","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the diagnostic accuracy of multiparametric FDG-PET/MR in identifying pathologic extranodal extension (pENE) of lymph node metastases (LNM) in head and neck squamous cell carcinoma (HNSCC) patients.</p><p><strong>Methods and materials: </strong>Retrospective analysis of 57 HNSCC patients who underwent preoperative FDG-PET/MR imaging. PET parameters of LNM SUVmax and MTV, lymph node size as well as MR parameters flare sign, shaggy margin sign and vanishing border sign were analyzed. Histopathological assessment of neck dissection specimens served as standard of reference.</p><p><strong>Results: </strong>A logistic regression model consisting of lymph node size (p = 0.029), shaggy margin sign (p = 0.031) and MTV (p = 0.035) proved that all three parameters significantly contributed to the prediction of pENE (χ²(3) = 54.23, p < 0.001). A second model without the reader-dependent parameter shaggy margin sign yielded similar results (χ²(2) = 45.36, p < 0.001), with every increase in lymph node size (p = 0.006) by 1 mm increasing the likelihood of pENE by a factor of 1.41 (95%-CI[1.11, 1.81]), and every increase in MTV (p = 0.023) by 1 cm3 increasing the likelihood of pENE by a factor of 1.64 (95%-CI[1.07, 2.50]). This model yielded an accuracy of 94.7% (95%-CI [85.4, 98.9]) for predicting pENE, with a specificity of 97.3% (95%-CI [85.8, 99.9]) and a sensitivity of 90.0% (95%-CI [68.3, 98.8]). Internal validation using a test dataset confirmed high accuracy of this model.</p><p><strong>Conclusion: </strong>PET/MR-based multivariate binomial logistic regression models consisting of MTV, lymph node size and/or shaggy lymph node margins predict pENE with high accuracy.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111085","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}