Neuroradiology最新文献

{"title":"Does initiating aspiration with microcatheter navigation improve the efficacy of thrombectomy in acute ischemic stroke patients with vascular angulation at the level of occlusion?","authors":"Mehmet Beyazal, Hasan Dinç, Esat Kaba, Ahmet Tüfekçi","doi":"10.1007/s00234-025-03771-2","DOIUrl":"https://doi.org/10.1007/s00234-025-03771-2","url":null,"abstract":"<p><strong>Background: </strong>Vascular angulation at the level of occlusion negatively affects the success of aspiration thrombectomy in patients with acute ischemic stroke (AIS). This study aims to evaluate the efficacy of the aspiration thrombectomy with microcatheter navigation (ATMN) technique in AIS patients where the direct aspiration first pass technique (DAPT) failed due to vascular angulation at the occlusion level.</p><p><strong>Methods: </strong>The patients admitted to our institution with AIS due to large vessel occlusion and treated with DAPT as a first-line technique between August 2020 and December 2022 were retrospectively evaluated. The feasibility and success of the ATMN technique in patients with DAPT failure were evaluated. Vascular angulation at the occlusion level was measured and compared.</p><p><strong>Results: </strong>43 patients were included in the study. Successful revascularization was achieved with DAPT in 29 of 43 patients (67.5%). ATMN technique was performed on 14 of 43 patients (32.5%) after DAPT failure. The ATMN technique achieved a high success rate, with 78.5% (11 out of 14) of patients experiencing successful recanalization. The mean vascular angulation at the occlusion level was significantly increased in patients with sufficient recanalization by DAPT as first-line therapy compared to the patients with insufficient recanalization by DAPT who underwent successful thrombectomy with the ATMN technique (143.5 ± 23.3 vs. 107.6 ± 15.6, p ˂ 0.001).</p><p><strong>Conclusion: </strong>This study's results showed that the ATMN technique was a useful alternative with a high level of success in stroke patients with vascular angulation in which DAPT failed to achieve sufficient recanalization.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086691","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":"Deep learning-based acceleration and denoising of 0.55T MRI for enhanced conspicuity of vestibular Schwannoma post contrast administration.","authors":"Maximilian Hinsen, Armin Nagel, Rafael Heiss, Matthias May, Marco Wiesmueller, Claudius Mathy, Martin Zeilinger, Joachim Hornung, Sarina Mueller, Michael Uder, Markus Kopp","doi":"10.1007/s00234-025-03758-z","DOIUrl":"https://doi.org/10.1007/s00234-025-03758-z","url":null,"abstract":"<p><strong>Background and purpose: </strong>Deep-learning (DL) based MRI denoising techniques promise improved image quality and shorter examination times. This advancement is particularly beneficial for 0.55T MRI, where the inherently lower signal-to-noise (SNR) ratio can compromise image quality. Sufficient SNR is crucial for the reliable detection of vestibular schwannoma (VS). The objective of this study is to evaluate the VS conspicuity and acquisition time (TA) of 0.55T MRI examinations with contrast agents using a DL-denoising algorithm.</p><p><strong>Materials and methods: </strong>From January 2024 to October 2024, we retrospectively included 30 patients with VS (9 women). We acquired a clinical reference protocol of the cerebellopontine angle containing a T1w fat-saturated (fs) axial (number of signal averages [NSA] 4) and a T1w Spectral Attenuated Inversion Recovery (SPAIR) coronal (NSA 2) sequence after contrast agent (CA) application without advanced DL-based denoising (w/o DL). We reconstructed the T1w fs CA sequence axial and the T1w SPAIR CA coronal with full DL-denoising mode without change of NSA, and secondly with 1 NSA for T1w fs CA axial and T1w SPAIR coronal (DL&1NSA). Each sequence was rated on a 5-point Likert scale (1: insufficient, 3: moderate, clinically sufficient; 5: perfect) for: overall image quality; VS conspicuity, and artifacts. Secondly, we analyzed the reliability of the size measurements. Two radiologists specializing in head and neck imaging performed the reading and measurements. The Wilcoxon Signed-Rank Test was used for non-parametric statistical comparison.</p><p><strong>Results: </strong>The DL&4NSA axial/coronal study sequence achieved the highest overall IQ (median 4.9). The image quality (IQ) for DL&1NSA was higher (M: 4.0) than for the reference sequence (w/o DL; median 4.0 versus 3.5, each p < 0.01). Similarly, the VS conspicuity was best for DL&4NSA (M: 4.9), decreased for DL&1NSA (M: 4.1), and was lower but still sufficient for w/o DL (M: 3.7, each p < 0.01). The TA for the axial and coronal post-contrast sequences was 8:59 minutes for DL&4NSA and w/o DL and decreased to 3:24 minutes with DL&1NSA.</p><p><strong>Conclusions: </strong>This study underlines that advanced DL-based denoising techniques can reduce the examination time by more than half while simultaneously improving image quality.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086739","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":"Diagnostic value of MRI and diffusion-weighted imaging in dysthyroid optic neuropathy: a cross-sectional study providing insights into predictive parameters and pathogenesis.","authors":"Arnaud R G G Potvin, Maartje M L de Win, Peter H Bisschop, Michael W T Tanck, Robert Loontjens, Pim de Graaf, Ioana C Lacraru, Hinke Marijke Jellema, Peerooz Saeed","doi":"10.1007/s00234-025-03695-x","DOIUrl":"https://doi.org/10.1007/s00234-025-03695-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare magnetic resonance imaging (MRI) and clinical characteristics between patients with moderate-to-severe Graves orbitopathy (GO) and dysthyroid optic neuropathy (DON), and to assess the diagnostic value of these factors for DON.</p><p><strong>Methods: </strong>Monocentric prospective cross-sectional study. Thirty-four orbits with DON and 62 orbits with moderate-to-severe GO were included. Patients were older than 18 years, had never undergone surgical decompression, and did not receive glucocorticoid or radiotherapy within 6 months prior to participation. A standardized orbital MRI protocol was performed followed by ophthalmic and orthoptic examination within 4 weeks. Main outcome measures were: maximal radial diameter of the extraocular muscles (EOMs), signal intensity ratio of the EOMs (relative to the temporalis muscle), relative apparent diffusion coefficient (rADC) of the EOMs (relative to the temporalis muscle), apical crowding index, optic nerve stretching, clinical activity score (CAS), and duction scores. Data were analyzed using a multivariable generalized linear mixed model to identify measures associated with DON.</p><p><strong>Results: </strong>The combination of medial rectus diameter and superior rectus rADC resulted in an area under the curve of 0.937 with a sensitivity of 85.2%, specificity of 93.2%, positive predictive value of 85.2%, and negative predictive value of 93.2% at a cutoff of 0.461. Apical crowding and optic nerve stretching were not independently associated with DON.</p><p><strong>Conclusions: </strong>MRI with diffusion-weighted imaging sequences can be a useful adjunct in the diagnosis of DON. Medial rectus diameter and superior rectus rADC are independently associated with DON. Apical crowding and optic nerve stretching may be less important pathogenically.</p><p><strong>Key messages: </strong>1. What is already known? The diagnosis of dysthyroid optic neuropathy (DON) can be challenging due to the lack of validated diagnostic imaging features. 2.</p><p><strong>What this study adds: </strong>a. Medial rectus diameter and superior rectus relative apparent diffusion coefficient measured by magnetic resonance imaging are independent predictors of DON. b. Apical crowding and optic nerve stretching are not independently associated with DON. 3. How this study might affect research: MRI with diffusion-weighted imaging sequences can be a useful adjunct in the diagnosis of DON.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075751","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":"Mesial temporal lobe epilepsy with hippocampal sclerosis: comparative clinical and arterial spin labeling findings according to neocortical MRI changes.","authors":"Sri Venkata Ganesh Viswanadh Kalaparti, Ashalatha Radhakrishnan, Deepti A Narasimhaiah, Rajalakshmi Poyuran, George C Vilanilam, Bejoy Thomas","doi":"10.1007/s00234-025-03735-6","DOIUrl":"https://doi.org/10.1007/s00234-025-03735-6","url":null,"abstract":"<p><strong>Purpose: </strong>High-field strength MRI reveals that Mesial Temporal Sclerosis (MTS) can be divided into two entities-(1) MTLE-HS (Mesial Temporal lobe epilepsy with hippocampal involvement), (2) MTLE-HS[N] (Mesial temporal lobe epilepsy with hippocampal sclerosis, and neocortical changes). The purpose of the study was to identify clinical, electrophysiological, histopathological, post-operative outcome differences between these entities and evaluate the role of Arterial spin labeling (ASL) in this regard.</p><p><strong>Methods: </strong>Prospective observational study in MTS-patients undergoing epilepsy protocol-MRI (including 3D-ASL with pseudo-continuous tagging), followed by anterior-temporal lobectomy + amygdalohippocampectomy (ATL + AH). Based on T2WI/3D-FLAIR MRI findings, patients were classified into MTLE-HS and MTLE-HS[N]. The ASL, clinical, VEEG, histopathological characteristics, postoperative outcomes were compared.</p><p><strong>Results: </strong>The MTLE-HS[N] and MTLE-HS groups had 63 and 37 patients respectively. MTLE-HS[N] group showed earlier age of epilepsy onset (7.82 ± 6.19y vs. 11.12 ± 8.1y, P-value = 0.04) and higher incidence of neocortical epileptogenesis (66.67% vs. 13.51%, P-value < 0.001). Histopathology revealed diffuse temporal neocortical astrogliosis in all patients, myelin loss in some patients from both groups and neocortical dysplasia in 6 patients with no significant differences in individual histopathological characteristics or postoperative outcomes. Within the MTLE-HS[N] group, more patients with neocortical epileptogenesis had ASL abnormality (P < 0.05). Qualitative ASL abnormality was also seen in most (83.33%) patients with neocortical dysplasia.</p><p><strong>Conclusion: </strong>Although MTLE-HS and MTLE-HS[N] show differences in certain clinical, electrophysiological features, the postoperative outcomes were not different. MRI cannot predict the histopathological substrate responsible for temporal neocortical changes. ASL may be useful in predicting neocortical epileptogenesis. It could also help to postulate the presence of dysplasia, although this needs further evaluation for confirmation.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075760","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":"Multiparametric MRI to stratify risk factors for hemorrhagic complications in inoperable glioblastomas following stereotactic needle biopsy.","authors":"Matia Martucci, Claudia Tocilă-Mătășel, Luigi Ruscelli, Giuseppe Varcasia, Giammaria Marziali, Francesco Schimperna, Giovanni Pentassuglia, Amato Infante, Quintino Giorgio D'Alessandris, Alessandro Olivi, Simona Gaudino","doi":"10.1007/s00234-025-03769-w","DOIUrl":"https://doi.org/10.1007/s00234-025-03769-w","url":null,"abstract":"<p><strong>Purpose: </strong>Histological confirmation of glioblastoma (GB) is essential for therapeutic planning, even in inoperable cases where stereotactic needle biopsy (STNB) is the only option. However, post-procedural bleeding remains a known risk. This study aimed to evaluate the association between MRI features of GB and hemorrhagic complications following STNB.</p><p><strong>Methods: </strong>This retrospective, single-center study included 78 patients with IDH-wildtype GB (mean age: 61 years; 33 females) who underwent pre-biopsy MRI (including SWI and DSC-perfusion) and post-biopsy CT within 72 h. Lesions were anatomically classified into four groups based on their location: cortical/superficial grey matter (sGM n = 12), subependymal white matter (sWM; n = 36), deep nuclei/thalamus (n = 26), or brainstem (n = 4). Hemorrhage incidence and area were correlated with lesion location, intratumoral susceptibility signal (ITSS) grade, rCBVmax values, and peritumoral edema. Clinical outcomes were also recorded.</p><p><strong>Results: </strong>Hemorrhage incidence significantly differed by lesion location (p = 0.009), with the highest frequency in deep lesions (85%). Most non-hemorrhagic cases (53%) occurred in sWM. While rCBVmax did not correlate with hemorrhage incidence, a significant linear association with hemorrhage area was noted (p = 0.016, r = 0.331). Grade 3 ITSS lesions showed more extensive bleeding. No correlation was found between peritumoral edema and bleeding. Most hemorrhages were asymptomatic; only two patients experienced transient neurological symptoms.</p><p><strong>Conclusions: </strong>Lesion location was the strongest predictor of post-biopsy hemorrhage. The absence of correlation between rCBVmax and bleeding risk suggests biopsies can be safely performed even in hyperperfused (and potentially more aggressive) tumor areas. STNB remains a safe and valuable diagnostic tool when appropriate preoperative evaluation and postoperative monitoring are ensured.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069982","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":"Prominence of deep medullary veins associated with the risk of stroke in unilateral chronic internal carotid artery occlusion patients.","authors":"Na Liang, Wei Di, Zhiwei Li, Xiaoling Liu, Xiansong Cheng, Sheng Liu, Jun Hu","doi":"10.1007/s00234-025-03767-y","DOIUrl":"https://doi.org/10.1007/s00234-025-03767-y","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the relationship between deep medullary veins (DMV) and risk of post-discharge stroke in chronic internal carotid artery occlusion (CICAO) patients.</p><p><strong>Methods: </strong>Hospitalized patients were divided into CICAO patients and control group without cerebral artery occlusion. SWI assessed DMV prominence in both cerebral hemispheres on a 0-3 scale. If the DMV scores of both hemispheres were consistent, DWV was not prominent (DMV-). Otherwise, DWV was prominent (DMV+) in the higher score hemisphere. In DMV + patients with CICAO, if the DMV score in the ipsilateral hemisphere of CICAO was higher than the contralateral hemisphere, DMV + was DMVi, otherwise, DMV + was DMVc.</p><p><strong>Results: </strong>110 unilateral CICAO patients and 75 control group patients were finally enrolled. 89CICAO patients and 5 control group patients were DMV+. In CICAO patients, 54 were DMVi patients and 35 were DMVc patients. Binary logistic regression analysis showed that CICAO was the independent risk factor of DMV+ (OR: 75.23; 95%CI :25.58-240.07; P < 0.001). Compared with DMVc patients, DMVi patients had a lower proportion of simultaneous primary and secondary collaterals activation(P = 0.034), decreased perfusion in the CICAO ipsilateral hemisphere (P < 0.001) and higher DMV scores in the prominent hemisphere (P = 0.012). Cox regression showed that the risk of stroke events post discharge in DMVi patients was higher than that in DMVc patients (HR: 4.68; 95%CI: 1.02-21.50; P = 0.047).</p><p><strong>Conclusion: </strong>CICAO is an independent risk factor for DMV. The collateral circulation and cerebral perfusion are related to DMVc. DMVc predictes a lower risk of stroke in CICAO patients post discharge.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065051","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":"A propensity score matching analysis of the efficacy and safety of middle meningeal artery embolization versus burr hole drainage in the treatment of chronic subdural hematomas.","authors":"Junhui Li, Zhengwen Chen, Junjie Shao, Qi Jia, Zhixiang Fan, Qingfeng Huang, Xiaojian Lu","doi":"10.1007/s00234-025-03740-9","DOIUrl":"https://doi.org/10.1007/s00234-025-03740-9","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of middle meningeal artery embolization (MMAE) and burr hole drainage in the treatment of chronic subdural hematoma (CSDH).</p><p><strong>Methods: </strong>Patients diagnosed with CSDH who underwent MMAE or surgical treatment were retrospectively recruited to this single-center study. Propensity score matching (PSM) analysis was carried out to compare the efficacy and safety of MMAE and burr hole drainage. Efficacy outcomes included hematoma clearance, cure, recurrence, and re-intervention rates within a 90-day postoperative follow-up period. Safety outcomes included the modified Rankin Scale (mRS) of 0-2 at the 90-day postoperative follow-up, procedure-related complications during hospitalization, and hospital stay length.</p><p><strong>Results: </strong>Among the 183 CSDH patients, 34.4% (63 patients) received MMAE and 65.6% (120 patients) underwent burr hole drainage surgery. The MMAE group showed a higher hematoma clearance rate (90.62±8.98% vs. 81.12±18.62%, P=0.005), higher cure rate (63.4% vs. 41.5%, P=0.047), and lower recurrence rate (2.4% vs. 14.6%, P=0.048) after PSM compared to the burr hole group. The re-intervention rates in the MMAE and burr hole groups showed no significant differences (2.4% vs. 7.3%, P=0.305). Safety outcomes favored the MMAE group, with a lower 90-day mRS score (0.34±0.53 vs. 0.73±0.55, P=0.02) and shorter hospital stay (6.41±2.53 days vs. 9.29±3.71 days, P<0.001). Surgery-related adverse events occurred in 4.9% of the MMAE group and 9.7% of the burr hole group patients (P=0.392).</p><p><strong>Conclusions: </strong>MMAE was a safe and efficacious alternative procedure for CSDH treatment that showed a reduced recurrence rate.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040937","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":"Resting-state functional MRI activity and connectivity in inflammatory bowel disease: a systematic review.","authors":"Maria Veatriki Christodoulou, George A Alexiou, Marios Lampros, Loukas Astrakas, Konstantinos H Katsanos, Maria I Argyropoulou","doi":"10.1007/s00234-025-03756-1","DOIUrl":"https://doi.org/10.1007/s00234-025-03756-1","url":null,"abstract":"<p><strong>Purpose: </strong>Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), primarily affects the gastrointestinal tract but can also present with systemic manifestations, including those affecting the central nervous system (CNS). Resting-state functional MRI (rs-fMRI) provides insights into alterations in brain activity and connectivity. This review aims to evaluate rs-fMRI findings in IBD patients compared to healthy controls and to explore potential differences between CD and UC.</p><p><strong>Methods: </strong>A systematic search of PubMed/MEDLINE and SCOPUS identified rs-fMRI studies in neurologically asymptomatic IBD patients. Observational rs-fMRI studies assessing local neural activity and/or functional connectivity, were included.</p><p><strong>Results: </strong>Twenty-seven studies met eligibility criteria and findings were summarized descriptively based on rs-fMRI analysis technique, given the methodological variability. UC patients showed reduced neural activity in the hippocampus and altered functional connectivity in the visual and cerebellar networks, highlighting memory and motor control disruptions. CD patients exhibited increased neural activity in the anterior cingulate cortex and frontal regions, alongside altered connectivity in multiple sensory and higher-order cognitive networks. Both IBD types displayed disruptions in key networks, including the default mode, salience, and cerebellar networks, associated with emotional processing, pain perception and stress response regulation.</p><p><strong>Conclusion: </strong>Despite shared rs-fMRI disruptions, UC is primarily associated with decreased neural activity in areas linked to memory and motor coordination, whereas CD exhibits increased activity in regions regulating emotion and cognition. Connectivity disruptions underscore the broader impact of IBD on brain function, emphasizing the role of the brain-gut axis in emotional and sensory impairments.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040977","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 best diagnostic approach for classifying ischemic stroke onset time: A systematic review and meta-analysis.","authors":"Seyed Salman Zakariaee, Dler Hussein Kadir, Mikaeil Molazadeh, Shahab Abdi","doi":"10.1007/s00234-025-03745-4","DOIUrl":"https://doi.org/10.1007/s00234-025-03745-4","url":null,"abstract":"<p><strong>Background: </strong>The success of intravenous thrombolysis with tPA (IV-tPA) as the fastest and easiest treatment for stroke patients is closely related to time since stroke onset (TSS). Administering IV-tPA after the recommended time interval (< 4.5 h) increases the risk of cerebral hemorrhage. Despite advances in diagnostic approaches have been made, the determination of TSS remains a clinical challenge. In this study, the performances of different diagnostic approaches were investigated to classify TSS.</p><p><strong>Materials and methods: </strong>A systematic literature search was conducted in Web of Science, Pubmed, Scopus, Embase, and Cochrane databases until July 2025. The overall AUC, sensitivity, and specificity magnitudes with their 95%CIs were determined for each diagnostic approach to evaluate their classification performances.</p><p><strong>Results: </strong>This systematic review retrieved a total number of 9030 stroke patients until July 2025. The results showed that the human readings of DWI-FLAIR mismatch as the current gold standard method with AUC = 0.71 (95%CI: 0.66-0.76), sensitivity = 0.62 (95%CI: 0.54-0.71), and specificity = 0.78 (95%CI: 0.72-0.84) has a moderate performance to identify the TSS. ML model fed by radiomic features of CT data with AUC = 0.89 (95%CI: 0.80-0.98), sensitivity = 0.85 (95%CI: 0.75-0.96), and specificity = 0.86 (95%CI: 0.73-1.00) has the best performance in classifying TSS among the models reviewed.</p><p><strong>Conclusion: </strong>ML models fed by radiomic features better classify TSS than the human reading of DWI-FLAIR mismatch. An efficient AI model fed by CT radiomic data could yield the best classification performance to determine patients' eligibility for IV-tPA treatment and improve treatment outcomes.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040944","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":"Predicting molecular subtypes of pediatric medulloblastoma using MRI-based artificial intelligence: A systematic review and meta-analysis.","authors":"Jiaying Liu, Zhenzhuang Zou, Yunfei He, Zhenfeng Guo, Changwei Yi, Bo Huang","doi":"10.1007/s00234-025-03759-y","DOIUrl":"https://doi.org/10.1007/s00234-025-03759-y","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis aims to assess the diagnostic performance of artificial intelligence (AI) based on magnetic resonance imaging (MRI) in detecting molecular subtypes of pediatric medulloblastoma (MB) in children.</p><p><strong>Methods: </strong>A thorough review of the literature was performed using PubMed, Embase, and Web of Science to locate pertinent studies released prior to October 2024. Selected studies focused on the diagnostic performance of AI based on MRI in detecting molecular subtypes of pediatric MB. A bivariate random-effects model was used to calculate pooled sensitivity and specificity, both with 95% confidence intervals (CI). Study heterogeneity was assessed using I² statistics.</p><p><strong>Results: </strong>Among the 540 studies determined, eight studies (involving 1195 patients) were included. For the wingless (WNT), the combined sensitivity, specificity, and receiver operating characteristic curve (AUC) based on MRI were 0.73 (95% CI: 0.61-0.83, I² = 19%), 0.94 (95% CI: 0.79-0.99, I² = 93%), and 0.80 (95% CI: 0.77-0.83), respectively. For the sonic hedgehog (SHH), the combined sensitivity, specificity, and AUC were 0.64 (95% CI: 0.51-0.75, I² = 69%), 0.84 (95% CI: 0.80-0.88, I² = 54%), and 0.85 (95% CI: 0.81-0.88), respectively. For Group 3 (G3), the combined sensitivity, specificity, and AUC were 0.89 (95% CI: 0.52-0.98, I² = 82%), 0.70 (95% CI: 0.62-0.77, I² = 44%), and 0.88 (95% CI: 0.84-0.90), respectively. For Group 4 (G4), the combined sensitivity, specificity, and AUC were 0.77 (95% CI: 0.64-0.87, I² = 54%), 0.91 (95% CI: 0.68-0.98, I² = 80%), and 0.86 (95% CI: 0.83-0.89), respectively.</p><p><strong>Conclusions: </strong>MRI-based artificial intelligence shows high diagnostic performance in detecting molecular subtypes of pediatric MB. However, all included studies employed retrospective designs, which may introduce potential biases. More researches using external validation datasets are needed to confirm the results and assess their clinical applicability.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040931","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}