Neuroradiology最新文献

{"title":"End-to-end deep learning patient level classification of affected territory of ischemic stroke patients in DW-MRI.","authors":"Ilker Ozgur Koska, Alper Selver, Fazıl Gelal, Muhsın Engın Uluc, Yusuf Kenan Çetinoğlu, Nursel Yurttutan, Mehmet Serındere, Oğuz Dicle","doi":"10.1007/s00234-024-03520-x","DOIUrl":"https://doi.org/10.1007/s00234-024-03520-x","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an end-to-end DL model for automated classification of affected territory in DWI of stroke patients.</p><p><strong>Materials and methods: </strong>In this retrospective multicenter study, brain DWI studies from January 2017 to April 2020 from Center 1, from June 2020 to December 2020 from Center 2, and from November 2019 to April 2020 from Center 3 were included. Four radiologists labeled images into five classes: anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior circulation (PC), and watershed (WS) regions, as well as normal images. Additionally, for Center 1, clinical information was encoded as a domain knowledge vector to incorporate into image embeddings. 3D convolutional neural network (CNN) and attention gate integrated versions for direct 3D encoding, long short-term memory (LSTM-CNN), and time-distributed layer for slice-based encoding were employed. Balanced classification accuracy, macro averaged f1 score, AUC, and interrater Cohen's kappa were calculated.</p><p><strong>Results: </strong>Overall, 624 DWI MRIs from 3 centers were utilized (mean age, interval: 66.89 years, 29-95 years; 345 male) with 439 patients in the training, 103 in the validation, and 82 in the test sets. The best model was a slice-based parallel encoding model with 0.88 balanced accuracy, 0.80 macro-f1 score, and an AUC of 0.98. Clinical domain knowledge integration improved the performance with 0.93 best overall accuracy with parallel stream model embeddings and support vector machine classifiers. The mean kappa value for interrater agreement was 0.87.</p><p><strong>Conclusion: </strong>Developed end-to-end deep learning models performed well in classifying affected regions from stroke in DWI.</p><p><strong>Clinical relevance statement: </strong>The end-to-end deep learning model with a parallel stream encoding strategy for classifying stroke regions in DWI has performed comparably with radiologists.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801863","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":"Morphological variations of the middle and superior turbinates, olfactory fossa and nasal septum in different sphenoid sinus pneumatization patterns.","authors":"Ahmet Safa Gökşan, Gülay Açar, Betül Digilli Ayaş, Aynur Emine Çiçekcibaşı, Demet Aydoğdu","doi":"10.1007/s00234-024-03518-5","DOIUrl":"https://doi.org/10.1007/s00234-024-03518-5","url":null,"abstract":"<p><strong>Purpose: </strong>Detailed assessment of the extrasinusal pneumatization of the superior and middle turbinate (SCB, MCB), olfactory fossa (OFP), and nasal septum (NSP) in coronal and sagittal sphenoid sinus (SS) pneumatization types provides a precise understanding of the surgical corridors used for skull base surgery. We aimed to analyze the relationships among these variations using computed tomography (CT) images.</p><p><strong>Methods: </strong>CT images of 153 patients were retrospectively analyzed for all types of sinonasal pneumatizations and volumes of SCB and sphenoid sinus, together with the prevalence of mucosal thickening of the sphenoid sinus (MTSS).</p><p><strong>Results: </strong>The prevalences of cellular, extensive, and complete SCB were 28.6%, 21.1%, and 23.5% in prepterygoid; 38.1%, 42.1%, and 35.3% in prerotundum; and 33.3%, 36.8%, and 41.2% in postrotundum CSSP types, respectively. The frequencies of lamellar, bulbous, and extensive MCB were 29%, 14.3%, and 33.3% in pterygoid, 38.7%, 57.1%, and 25.9% in prerotundum, 32.3%, 8%, and 40.8% in postrotundum CSSP types, respectively. SCB and MCB were observed unilaterally at 24.8% and 30% and bilaterally at 12.8% and 32.7%, respectively. OFP, NSP, and MTSS were detected at 24.2%, 31.4%, and 27.5%, respectively. Increased age was significantly associated with a lower probability of pneumatization in SS and MCB.</p><p><strong>Conclusions: </strong>The data obtained showed that the degree of SS pneumatization significantly affected the frequencies of the SCB, MCB, OFP, NSP, and MTSS. Also, the SCB volume is significantly related to the CSSP types. Preoperative CT evaluation is crucial for surgeons to be aware of these variations and to avoid iatrogenic injury.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791866","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":"Thalamic changes in patients with chronic facial pain.","authors":"Anton Pashkov, Elena Filimonova, Boris Zaitsev, Azniv Martirosyan, Galina Moysak, Jamil Rzaev","doi":"10.1007/s00234-024-03508-7","DOIUrl":"https://doi.org/10.1007/s00234-024-03508-7","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate structural alterations in the thalamus in patients with primary trigeminal neuralgia and provide a detailed perspective on thalamic remodeling in response to chronic pain at the level of individual thalamic nuclei.  METHODS: We analyzed a sample of 62 patients with primary trigeminal neuralgia who underwent surgical treatment, along with 28 healthy participants. Magnetic resonance imaging (MRI) data were acquired using a 3T system equipped with a 16-channel receiver head coil. Segmentation of the thalamic nuclei was performed using FreeSurfer 7.2.0. We divided the group of patients with trigeminal neuralgia into two subgroups: those with right-sided pain and those with left-sided pain. Each subgroup was compared to a control group by means of one-way ANOVA. Associations between morphometric and clinical variables were assessed with Spearman correlation coefficient.</p><p><strong>Results: </strong>Our results revealed significant gray matter volume changes in thalamic nuclei among patients with trigeminal neuralgia. Notably, the intralaminar nuclei (centromedian/parafascicular) and nuclei associated with visual and auditory signal processing (lateral and medial geniculate bodies) exhibited significant alterations, contrasting with the ventral group nuclei involved in nociceptive processing. Additionally, we found no substantial volume increase in any of the studied nuclei following successful surgical intervention 6 months later. The volumes of thalamic nuclei were negatively correlated with pain intensity and disease duration.</p><p><strong>Conclusion: </strong>The results of this study, although preliminary, hold promise for clinical applications as they reveal previously unknown structural alterations in the thalamus that occur in patients with chronic trigeminal neuralgia.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791869","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":"Comprehensive assessment of supratentorial and infratentorial volumes in infants with myelomeningocele with and without Chiari malformation type II.","authors":"Hiroaki Hashimoto, Makoto Shimada, Osamu Takemoto, Yasuyoshi Chiba","doi":"10.1007/s00234-024-03514-9","DOIUrl":"https://doi.org/10.1007/s00234-024-03514-9","url":null,"abstract":"<p><strong>Purpose: </strong>Chiari malformation type II (CM-II) is a congenital anomaly commonly associated with myelomeningocele (MMC), a severe form of open spina dysraphism. This study aimed to evaluate both supratentorial and infratentorial volumes in MMC infants with and without CM-II.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective study of 52 MMC infants treated between April 2006 and July 2023. Infants were classified as non-CM-II or CM-II based on the presence of cerebellar displacement. All patients underwent computed tomography (CT) at 0 months of age. Volumetric parameters included intracranial volume (ICV), lateral ventricles volume (LVV), posterior cranial fossa volume (PCFV), cerebellum volume (CBMV), and brainstem volume (BSV). LVV represented supratentorial structures, while PCFV, CBMV, and BSV represented infratentorial structures.</p><p><strong>Results: </strong>CM-II was diagnosed in 30 infants (57.7%). Correlation analysis revealed significant negative correlations between supratentorial (LVV) and infratentorial volumes (PCFV, CBMV, and BSV), and positive correlations among volumes within the same space(e.g., PCFV, CBMV, and BSV). CM-II infants exhibited significantly larger ICV (p = 0.04) and LVV (p < 0.001), but smaller PCFV (p < 0.001) and CBMV (p < 0.001) than non-CM-II infants. LVV was the best predictor for distinguishing non-CM-II from CM-II (area under the curve = 0.91).</p><p><strong>Conclusion: </strong>This study identified positive correlations within the same space and negative correlations between supratentorial and infratentorial volumes. LVV emerged as a critical indicator of CM-II, reflecting the relationship between reduced infratentorial space and enlarged supratentorial ventricles (hydrocephalus). These findings provide insights into the pathophysiology and clinical implications of CM-II in MMC patients.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771011","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":"Response assessment in pediatric neurooncology (RAPNO) criteria revisited: a practical navigation guide for neuroradiologists.","authors":"Ana Filipa Geraldo, Francisco Maldonado, Mariasavina Severino, Kshitij Mankad, Hisham Dahmoush, Bruno Soares, Carlos Rugilo, Andrea Rossi","doi":"10.1007/s00234-024-03493-x","DOIUrl":"10.1007/s00234-024-03493-x","url":null,"abstract":"<p><p>The Response Assessment in Pediatric Neuro-Oncology (RAPNO) Working Group is an international, collaborative network of experts dedicated to pediatric central nervous system (CNS) tumors that was created in 2011. Since then, six RAPNO articles with imaging guidelines for response assessment in diverse pediatric tumor subgroups have been published, namely: 1) medulloblastomas and leptomeningeal seeding tumors (2018), 2) pediatric high-grade gliomas (2020), 3) pediatric low-grade gliomas (2020), 4) diffuse intrinsic pontine gliomas (2020), 5) pediatric intracranial ependymomas (2022) and 6) pediatric craniopharyngiomas (2023). The purpose of this article is to review all current available RAPNO criteria using a systematized and comparative approach centered on the role of neuroradiologists and supported by neuroimaging examples. Special emphasis will be placed on clarification of core concepts as well as practical adoption aspects of the RAPNO guidelines, namely how and when to image the brain and/or the spine; how to interpret the imaging findings; which other clinical, therapeutic and laboratory variables to consider; and finally how to apply the information to attribute the final appropriate response assessment classification.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2117-2142"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505049","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":"Artificial intelligence can help detecting incidental intracranial aneurysm on routine brain MRI using TOF MRA data sets and improve the time required for analysis of these images.","authors":"Ilya Adamchic, Sven R Kantelhardt, Hans-Joachim Wagner, Michael Burbelko","doi":"10.1007/s00234-024-03460-6","DOIUrl":"10.1007/s00234-024-03460-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of our study was to assess the diagnostic performance of commercially available AI software for intracranial aneurysm detection and to determine if the AI system enhances the radiologist's accuracy in identifying aneurysms and reduces image analysis time.</p><p><strong>Methods: </strong>TOF-MRA clinical brain examinations were analyzed using commercially available software and by an consultant neuroradiologist for the presence of intracranial aneurysms. The results were compared with the reference standard, to measure the sensitivity and specificity of the software and the consultant neuroradiologist. Furthermore, we examined the time required for the neuroradiologist to analyze the TOF-MRA image set, both with and without use of the AI software.</p><p><strong>Results: </strong>In 500 TOF-MRI brain studies, 106 aneurysms were detected in 85 examinations by combining AI software with neuroradiologist readings. The neuroradiologist identified 98 aneurysms (92.5% sensitivity), while AI detected 77 aneurysms (72.6% sensitivity). Specificity and sensitivity were calculated from the combined effort as reference. Combining AI and neuroradiologist readings significantly improves detection reliability. Additionally, AI integration reduced TOF-MRA analysis time by 19 s (23% reduction).</p><p><strong>Conclusions: </strong>Our findings indicate that the AI-based software can support neuroradiologists in interpreting brain TOF-MRA. A combined reading of the AI-based software and the neuroradiologist demonstrated higher reliability in identifying intracranial aneurysms as compared to reading by either neuroradiologist or software, thus improving diagnostic accuracy of the neuroradiologist. Simultaneously, reading time for the neuroradiologist was reduced by approximately one quarter.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2195-2204"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126196","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":"Pineal gland ADC values in children aged 0 to 4 years: normative data and usefulness in the differential diagnosis with trilateral retinoblastoma.","authors":"Inês Freire, Lydia Viviana Falsitta, Chetan Sharma, Ulrike Löbel, Sniya Sudhakar, Asthik Biswas, Jessica Cooper, Kshitij Mankad, Kiran Hilal, Catriona Duncan, Felice D'Arco","doi":"10.1007/s00234-024-03479-9","DOIUrl":"10.1007/s00234-024-03479-9","url":null,"abstract":"<p><strong>Purpose: </strong>Normative ADC values of the pineal gland in young children are currently lacking, however, these are potentially useful in the differential diagnosis of pineal involvement in trilateral retinoblastoma, which is challenging when the size of the tumor is less than 10-15 mm. The main objective of this study was to establish ADC reference values of the normal pineal gland in a large cohort of children between 0 and 4 years.</p><p><strong>Methods: </strong>This retrospective study was conducted in a tertiary pediatric hospital. We collected 64 patients with normal MRI examination (between 2017 and 2024) and clinical indication unrelated to the pineal gland, and divided them into 5 age groups (0 to 4 years). Gland size and mean ADC values were calculated, using the ellipsoid formula and ROI/histogram analysis, respectively. The established values were tested in three cases of trilateral retinoblastoma (10 to 20 months).</p><p><strong>Results: </strong>Mean ADC values were always above 1000 × 10^- 6 mm²/s, while in patients with trilateral retinoblastoma they were around 800 × 10^- 6 mm²/s. Pineal ADC values were identical in both genders. The volume of the pineal gland showed a tendency to increase with age.</p><p><strong>Conclusions: </strong>We present ADC reference data for the pineal gland in children under 4 years of age. The distribution of mean ADC values of trilateral retinoblastoma was significantly different from the normative values, hence, the use DWI/ADC may help to identify small trilateral retinoblastoma in children with ocular pathology.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2291-2299"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372443","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":"Iron changes within infarct tissue in ischemic stroke patients after successful reperfusion quantified using QSM.","authors":"Victoria Mercy Kataike, Patricia M Desmond, Christopher Steward, Peter J Mitchell, Christian Davey, Nawaf Yassi, Andrew Bivard, Mark W Parsons, Bruce C V Campbell, Felix Ng, Vijay Venkatraman","doi":"10.1007/s00234-024-03444-6","DOIUrl":"10.1007/s00234-024-03444-6","url":null,"abstract":"<p><strong>Purpose: </strong>For nearly half of patients who undergo Endovascular Thrombectomy following ischemic stroke, successful recanalisation does not guarantee a good outcome. Understanding the underlying tissue changes in the infarct tissue with the help of biomarkers specific to ischemic stroke could offer valuable insights for better treatment and patient management decisions. Using quantitative susceptibility mapping (QSM) MRI to measure cerebral iron concentration, this study aims to track the progression of iron within the infarct lesion after successful reperfusion.</p><p><strong>Methods: </strong>In a prospective study of 87 ischemic stroke patients, successfully reperfused patients underwent MRI scans at 24-to-72 h and 3 months after reperfusion. QSM maps were generated from gradient-echo MRI images. QSM values, measured in parts per billion (ppb), were extracted from ROIs defining the infarct and mirror homolog in the contralateral hemisphere and were compared cross-sectionally and longitudinally.</p><p><strong>Results: </strong>QSM values in the infarct ROIs matched those of the contralateral ROIs at 24-to-72 h, expressed as median (interquartile range) ppb [0.71(-7.67-10.09) vs. 2.20(-10.50-14.05) ppb, p = 0.55], but were higher at 3 months [10.68(-2.30-21.10) vs. -1.27(-12.98-9.82) ppb, p < 0.001]. The infarct QSM values at 3 months were significantly higher than those at 24-to-72 h [10.41(-2.50-18.27) ppb vs. 1.68(-10.36-12.25) ppb, p < 0.001]. Infarct QSM at 24-to-72 h and patient outcome measured at three months did not demonstrate a significant association.</p><p><strong>Conclusion: </strong>Following successful endovascular reperfusion, iron concentration in infarct tissue, as measured by QSM increases over time compared to that in healthy tissue. However, its significance warrants further investigation.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2233-2242"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018184","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":"Mechanical properties of pediatric low-grade gliomas in children with and without neurofibromatosis type 1.","authors":"Grace McIlvain, Laura L Hayes, Andrew W Walter, Lauren W Averill, Vinay Kandula, Curtis L Johnson, Rahul M Nikam","doi":"10.1007/s00234-024-03491-z","DOIUrl":"10.1007/s00234-024-03491-z","url":null,"abstract":"<p><strong>Introduction: </strong>Prognoses for pediatric brain tumors are suboptimal, as even in low-grade tumors, management techniques can lead to damage in the developing brain. Therefore, advanced neuroimaging methods are critical for developing optimal management plans and improving patient care. Magnetic resonance elastography (MRE) has allowed for the characterization of adult gliomas by their mechanical properties, which are uniquely sensitive to the complex interplay of cellularity, vasculature, and interstitium. However, pediatric tumors differ in behavior and cytoarchitecture, and their mechanical properties have never been assessed.</p><p><strong>Methods: </strong>Here, we conduct the first study of pediatric brain tumor mechanical properties by using MRE to measure tissue stiffness and damping ratio in low grade gliomas (LGGs). We additionally measure the mechanical properties of non-neoplastic focal abnormal signal intensities (FASIs) in children with neurofibromatosis type 1 (NF1).</p><p><strong>Results: </strong>23 patients age 4-17 years who had MR imaging results consistent with a primary LGG or with NF1 were included in this study. We found that pediatric gliomas are on an average 10.9% softer (p = 0.010) with a 17.3% lower (p = 0.009) viscosity than reference tissue. Softness of tumors appeared consistent across tumor subtypes and unrelated to tumor size or contrast-enhancement. In NF1 we found that, unlike gliomas, FASIs are stiffer, though not significantly, than reference tissue by an average of 10.4% and have a 16.7% lower damping ratio.</p><p><strong>Conclusions: </strong>Measuring tumor mechanical properties patterning and heterogeneity has potential to aid in prediction of biological behavior and inform management strategies for pediatric patients.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2301-2311"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471189","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":"Distinguishing glioblastoma progression from treatment-related changes using DTI directionality growth analysis.","authors":"R van den Elshout, B Ariëns, M Esmaeili, B Akkurt, M Mannil, F J A Meijer, A G van der Kolk, T W J Scheenen, D Henssen","doi":"10.1007/s00234-024-03450-8","DOIUrl":"10.1007/s00234-024-03450-8","url":null,"abstract":"<p><strong>Background: </strong>It is difficult to distinguish between tumor progression (TP) and treatment-related abnormalities (TRA) in treated glioblastoma patients via conventional MRI, but this distinction is crucial for treatment decision making. Glioblastoma is known to exhibit an invasive growth pattern along white matter architecture and vasculature. This study quantified lesion development patterns in treated glioblastoma lesions and their relation to white matter microstructure to distinguish TP from TRA.</p><p><strong>Materials and methods: </strong>Glioblastoma patients with confirmed TP or TRA with T1-weighted contrast-enhanced and DTI MR scans from two posttreatment follow-up timepoints were reviewed. The contrast-enhancing regions were segmented, and the regions were coregistered to the DTI data. Lesion increase vectors were categorized into two groups: parallel (0-20 degrees) and perpendicular (70-90 degrees) to white matter. FA-values were also extracted. To test for a statistically significant difference between the TP and TRA groups, a Mann‒Whitney U test was performed.</p><p><strong>Results: </strong>Of 73 glioblastoma patients, fifteen were diagnosed with TRA, whereas 58 patients suffered TP. TP had a 25.8% (95% CI 24.1%-27.6%) increase in parallel lesions, and TRA had a 25.4% (95% CI 20.9%-29.9%) increase in parallel lesions. The perpendicular increase was 14.7% for TP (95% CI 13.0%-16.4%) and 18.0% (95% CI 13.5%-22.5%) for TRA. These results were not significantly different (p = 0.978). FA value for TP showed to be 0.248 (SD = 0.054) and for TRA it was 0.231 (SD = 0.075), showing no statistically significant difference (p = 0.121).</p><p><strong>Conclusions: </strong>Based on our results, quantifying posttreatment contrast-enhancing lesion development directionality with DTI in glioblastoma patients does not appear to effectively distinguish between TP and TRA.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2143-2151"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996228","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}