Neuroradiology Journal最新文献

{"title":"Endovascular treatment in patients with cervical or intracranial isolated internal carotid artery occlusion: A systematic review and meta-analysis.","authors":"Mariana Letícia de Bastos Maximiano, Ocilio Ribeiro Gonçalves, Luciano Falcão, Filipe Virgilio Ribeiro, Pedro Lucas Machado Magalhães, Giovana Menegucci, Nathalia Chaves Bezerra, Artur Kipper Neto, Lucca Tamara Alves Carretta, Helvécio Neves Feitosa Filho, Ahmet Günkan, Dylan N Wolman","doi":"10.1177/19714009261423694","DOIUrl":"10.1177/19714009261423694","url":null,"abstract":"<p><p>The optimal treatment strategy for isolated internal carotid artery occlusion (IICAO) presenting as acute ischemic stroke (AIS) remains uncertain because these patients were largely excluded from pivotal thrombectomy trials. We compared endovascular treatment (EVT) with best medical treatment (BMT) for IICAO, assessing functional independence, mortality, and safety, and explored outcomes by occlusion site (cervical vs intracranial). Following PRISMA guidelines (PROSPERO CRD420251004624), PubMed, Embase, and Cochrane Library were searched through September 2025. Eligible studies enrolled adults with IICAO treated with EVT or BMT and reported ≥1 predefined outcome: modified Rankin Scale (mRS) 0-2 at 90 days, 90-day mortality, or symptomatic intracranial hemorrhage (sICH). Data were pooled using Mantel-Haenszel random-effects models, reporting odds ratios (ORs) with 95% confidence intervals (CIs). Risk of bias was assessed with ROBINS-I. Five studies including 1531 patients (878 EVT; 653 BMT) met inclusion criteria. EVT patients were younger and had more severe strokes. Pooled analysis showed no significant difference in 90-day functional independence between EVT and BMT (OR 1.78; 95% CI 0.99-3.21; I² = 71%), and adjusted analyses attenuated the effect (OR 1.22; 95% CI 0.82-1.82). No significant differences were found for 90-day mortality (OR 0.84; 95% CI 0.64-1.09; I² = 0%) or sICH (OR 1.48; 95% CI 0.72-3.07; I² = 0%). Subgroup analyses by occlusion site yielded similar neutral results. Current evidence does not demonstrate superiority of EVT over BMT for IICAO, though a possible benefit for intracranial occlusions cannot be excluded. These findings remain hypothesis-generating and emphasize the need for dedicated randomized trials.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"557-566"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical thrombectomy for elderly stroke patients: An updated systematic review and meta-analysis of randomized clinical trials.","authors":"Leonardo Januário Campos Cardoso, Ahmet Günkan, Marcio Yuri Ferreira, Madhav Sambhu, Xiaoyi Gao, Christian Ken Fukunaga, Filipe Virgilio Ribeiro, Anderson Matheus Pereira da Silva, Elison Emanuel Araújo Lima, Ocílio Ribeiro Gonçalves, Ivan Petterson Santana Teixeira, Christian Ferreira, Yafell Serulle, David Stuart Gordon, Panagiotis Papanagiotou, Jean-Claude Baron","doi":"10.1177/19714009261427328","DOIUrl":"10.1177/19714009261427328","url":null,"abstract":"<p><p>BackgroundAlthough multiple clinical trials have established the efficacy of mechanical thrombectomy (MT) in managing acute ischemic stroke (AIS) in the general population, its outcomes specifically in elderly patients remain uncertain. This study aims to evaluate the efficacy and safety of MT in elderly patients with AIS, providing a clearer understanding of its potential benefits in this population.MethodsWe searched PubMed, Embase, and Cochrane databases for randomized clinical trials (RCTs) comparing MT with standard medical management in patients with AIS, with data available for elderly patients (over 70 years). Outcomes included functional recovery (≥1-point mRS improvement), excellent (mRS 0-2), good (mRS 0-3), poor (mRS ≥5) outcomes, and mortality at 90 days. Pooled odds and risk ratios (OR and RR) with 95% confidence intervals (CIs) were estimated using a random-effects model.ResultsFifteen RCTs, involving 1481 elderly patients, were included. MT was associated with a better functional recovery (OR 1.54; 95% CI: 1.22-1.94; P < .01), higher rates of excellent (RR 1.60; 95% CI: 1.11-2.30; P = .01) and good (RR 1.84; 95% CI: 1.45-2.35; P < .01), and lower rates of poor functional outcomes (RR 0.71; 95% CI: 0.58-0.85; P < .01) and mortality (RR 0.65; 95% CI: 0.45-0.96; P = .03). Subgroup analyses based on age threshold (>80 years), anterior/posterior circulation, and country socioeconomic status were consistent with the overall results.ConclusionsThis updated meta-analysis suggests that MT may be associated with better functional outcomes and lower mortality in selected elderly patients with AIS; however, limited elderly specific safety data and selective trial populations warrant cautious interpretation.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"581-598"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12916345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic approach to detection of epileptogenic foci on imaging: protocols, entities, search pattern, and reporting tools.","authors":"Richard J Lozano, Irene Dixe de Oliveira Santo, Carys Kenny-Howel, Robert A Bronen, Mehmet E Adin, Long H Tu","doi":"10.1177/19714009261417577","DOIUrl":"10.1177/19714009261417577","url":null,"abstract":"<p><p>Accurate detection of epileptogenic lesions on imaging requires a systematic search for abnormalities with diverse etiologies, appearances, and locations. This article provides a practical approach to the detection of epileptogenic foci for radiologists. First, we review protocols tailored to seizure evaluation. Next, we present a pictorial review of structural etiologies for seizure, including temporal lobe pathologies, developmental malformations, neoplastic lesions, vascular lesions, and infectious/inflammatory processes. We provide a step-by-step, systematic approach to ensure detection of the manifold potential pathologies visible on imaging as well as appropriate correlation with clinical findings. Finally, we present example reporting templates which can ensure efficient reporting by radiologists as well as serve as mnemonic aids.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"541-556"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Neuroimaging Modalities to Distinguish Parkinson's Disease from its Mimics: Imaging Features and Implications for Clinical Practice.","authors":"Mona Gad, Francis Deng, Jannik Prasuhn, Licia P Luna","doi":"10.1177/19714009261423704","DOIUrl":"10.1177/19714009261423704","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a chronic progressive neurodegenerative disorder characterized by tremors, rigidity, and bradykinesia. This is primarily attributed to loss of nigrostriatal dopaminergic neurons to varying degrees. Many conditions that present similar classic motor symptoms of PD, known as atypical parkinsonian syndromes (APS), have also been identified. These encompass multiple system atrophy (MSA), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), and corticobasal degeneration (CBD). On the other hand, causes of non-neurodegenerative parkinsonism include vascular parkinsonism, drug-induced parkinsonism, and essential tremors. Neuroimaging plays a significant role in discriminating PD from its mimics which may represent a significant challenge in clinical practice. This article aims to review recent developments in imaging technologies, particularly magnetic resonance imaging (MRI) and nuclear medicine imaging techniques, that have the potential to unravel characteristic morphological and metabolic changes in the brain and would aid in the early diagnosis of PD and its differentiation from its potential mimickers.Learning objectivesTo identify the peculiar structural imaging features of atypical parkinsonian syndromes and recognize the role of the current state-of-the-art neuroimaging modalities (particularly MRI and nuclear medicine techniques) in discriminating Parkinson's disease from its mimics.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"567-580"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular treatment in acute ischemic stroke patients with pre-stroke disability: A systematic review and meta-analysis.","authors":"Lucca Tamara Alves Carretta, Mariana Letícia de Bastos Maximiano, Rudolfh Batista Arend, Henrique Padilha Gnoatto, Rafael Torres Fonseca Dos Santos, Filipe Virgilio Ribeiro, Ocilio Ribeiro Gonçalves, Beatriz Gonçalves da Silva Miroski Gerente, Nicole Baptista de Oliveira, Tassiane Cristina Morais, Fernando Rocha Oliveira, Leandro de Assis Barbosa, Ahmet Günkan","doi":"10.1177/19714009261423695","DOIUrl":"10.1177/19714009261423695","url":null,"abstract":"<p><p>This meta-analysis investigated endovascular thrombectomy (EVT) efficacy and safety versus best medical treatment (BMT), including intravenous thrombolysis or other treatments when applicable, in acute ischemic stroke (AIS) patients with pre-stroke disability (mRS >2), a group frequently excluded from large vessel occlusion trials. Following PRISMA 2020 guidelines, systematic searches of PubMed, Cochrane Central, Web of Science, Scopus, and Embase databases (inception-July 2025) identified English studies (≥4 patients) comparing EVT versus BMT. Data on all-cause mortality, return to baseline mRS, and symptomatic intracranial hemorrhage (sICH) were extracted. OR with 95% CI was estimated via a random-effects model. Five studies (1400 patients; 897 EVT and 503 BMT) with pre-stroke mRS 2-4 were included. EVT significantly reduced all-cause mortality (OR: 0.49, 95% CI: 0.29-0.82, <i>p</i> = .007), demonstrating moderate heterogeneity (I² = 66.9%). It also improved return to baseline mRS (OR: 3.21, 95% CI: 2.02-6.09, <i>p</i> < .001) with negligible heterogeneity (I² = 0%). sICH was more frequent in EVT (OR: 2.24, 95% CI: 0.84-5.94) but not statistically significant (<i>p</i> = .11). EVT offers survival benefits and increased return to baseline functional status for AIS patients with pre-stroke disability, without definitively increasing sICH. Prospective studies are crucial for informing inclusive clinical guidelines.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"611-619"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic approach to MR spectroscopy of the brain: Indications, protocol, metabolites, and spectral analysis in neurologic diseases.","authors":"Shadman M Rahman, Allison Peng, Kristen Si, Carys L Kenny-Howell, Mantej Singh, Muhammad Ahsan Asif, Saumik Z Rahman, Saeed Rahmani, Luca Pasquini, Mehmet Adin, Elizabeth Schrickel, Long H Tu","doi":"10.1177/19714009261487613","DOIUrl":"10.1177/19714009261487613","url":null,"abstract":"<p><p>Magnetic resonance spectroscopy (MRS) is a noninvasive imaging technique that complements conventional magnetic resonance imaging by providing in vivo metabolic and biochemical characterization of brain tissue. By quantifying metabolites such as N-acetylaspartate, choline, creatine, lactate, and myo-inositol (myo-Ins), MRS offers insight into neuronal integrity, membrane turnover, energy metabolism, inflammation, and necrosis, features that help distinguish between pathologies with greater specificity than anatomic imaging alone.This review presents a clinically focused, systematic approach to brain MRS, addressing indications, acquisition strategies, spectral interpretation, and characteristic metabolic patterns across a broad spectrum of neuropathologies. Key technical factors influencing spectral quality and reproducibility, such as voxel selection, field strength, echo time, and sequence choice, are highlighted. Metabolic signatures of neoplastic, infectious, inflammatory, demyelinating, metabolic, and neurodegenerative disorders are reviewed with an emphasis on practical differentiation in the setting of overlapping imaging appearances. Recognizing the limited specificity of isolated metabolite abnormalities, this review emphasizes integration of MRS findings with clinical context and conventional MRI. A structured interpretive framework is proposed to promote consistent analysis and enhance diagnostic confidence, reinforcing the role of MRS as a valuable adjunct in contemporary neuroradiologic practice.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261487613"},"PeriodicalIF":1.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative prediction of pituitary macroadenoma consistency using diffusion-weighted MRI: A prospective study with surgical correlation.","authors":"Marwan Mohamed Mohamed El Toukhy, Noha Ahmed Kamal Metaweh, Mohammed Fathallah AlSawy, Pensee Omar Yasser Mahmoud ElKhodery, Dalia Khaled Abdelhakim Serour","doi":"10.1177/19714009261487304","DOIUrl":"10.1177/19714009261487304","url":null,"abstract":"<p><p>BackgroundPreoperative knowledge of pituitary macroadenoma consistency holds considerable importance in guiding surgical strategy and optimizing patient outcomes. The mechanical properties of the tumor may determine both the feasibility of complete resection and the most appropriate operative technique. This study was designed to examine the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) quantification as preoperative tools for characterizing pituitary macroadenoma consistency.ResultsAmong the studied macroadenomas, the mean ADC value was 0.937 ± 0.261 ×10^‒3 mm²/s. A statistically significant relationship was established between ADC measurements and intraoperative tumor consistency (<i>p</i> < .001). Soft tumors demonstrated the lowest mean ADC (0.780 ± 0.074 × 10^‒3 mm²/s), firm tumors showed intermediate values (0.871 ± 0.09 × 10^‒3 mm²/s), and hard tumors exhibited the highest ADC (1.270 ± 0.268 × 10^‒3 mm²/s). The optimal ADC cutoff for discriminating hard from firm adenomas was 1.08 × 10^‒3 mm²/s (sensitivity 90%, specificity 100%, accuracy 94.4%), and 0.88 × 10^‒3 mm²/s for firm versus soft discrimination (sensitivity 62.5%, specificity 88.9%, accuracy 80.8%).ConclusionQuantitative ADC measurements obtained through DWI may serve as a useful non-invasive imaging parameter for the preoperative assessment of pituitary macroadenoma consistency and could provide supportive information for surgical planning.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261487304"},"PeriodicalIF":1.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Region and phase-specific diffusion tensor imaging dynamics in Japanese encephalitis: A linear mixed-effects analysis.","authors":"Pranjal Phukan, Gajendra Kumar Mourya, Kalyan Sarma, Deb Kumar Boruah, Prince Das, Sandhyamoni Gogoi","doi":"10.1177/19714009261487307","DOIUrl":"10.1177/19714009261487307","url":null,"abstract":"<p><p>BackgroundJapanese encephalitis (JE) is a mosquito-borne disease caused by a flavivirus and responsible for significant morbidity and mortality. Asymmetrical deep nuclei involvement is the characteristic Magnetic Resonance Imaging finding. However, it fails to highlight the evolution of microstructural alteration throughout the disease progression. The study aims to describe the longitudinal, stage-specific evolution of diffusion tensor imaging parameters in JE.MethodsThis was a retrospective study of 72 serologically established JE patients, determining microstructural alteration in JE in acute (≤7 days) and subacute (8-30 days) phases. The DTI values for ADC, MD, FA, RD, and AD were extracted from bilateral thalami and basal ganglia. The longitudinal changes of the DTI values were determined using linear mixed-effects models with phase, region, and phase × region interaction as fixed effects.ResultsThe most frequent involvement was the thalami compared to the basal ganglia on conventional MRI. Mixed-model effects analysis revealed significant phase-related increases in ADC and MD, while FA and RD demonstrated strong region-specific temporal effects. Significant phase × region interactions were detected for ADC, FA, RD, and AD, suggesting greater temporal variability in the thalamus than the basal ganglia. Post hoc testing confirmed a marked discrepancy between acute and subacute stages, particularly in the thalamus.ConclusionDTI reveals dynamic, region-dependent microstructural evolution in JE. The thalamus is showing the most distinct changes over time. These findings suggest that DTI may provide complementary information regarding disease activity and may be considered a potential imaging marker of disease evolution.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261487307"},"PeriodicalIF":1.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenecteplase for anterior-circulation vessel occlusion at 4.5-24 hours across reperfusion paradigms: A meta-analysis.","authors":"João Vitor Andrade Fernandes, Gabriel Caruso Novaes Tudella, Leonardo Reischoffer do Nascimento, João Victor de Oliveira Ramos, Mohamad Abdalkader, Adam A Dmytriw","doi":"10.1177/19714009261487616","DOIUrl":"10.1177/19714009261487616","url":null,"abstract":"<p><p>IntroductionThe role of intravenous tenecteplase (TNK) in patients with acute ischemic stroke presenting 4.5-24 hours after last known well remains uncertain.MethodsWe performed a systematic review and frequentist and Bayesian meta-analysis of Randomized Controlled Trials (RCTs) comparing TNK-containing with trial-specific non-TNK strategies in imaging-selected patients with anterior-circulation large- or medium-vessel occlusion treated 4.5-24 hours after last known well. Trials represented heterogeneous reperfusion paradigms. The primary efficacy outcome was mRS 0-1 at 90 days; other functional, neurological, reperfusion, and recanalization outcomes were secondary or exploratory, and hemorrhagic events were assessed separately as safety outcomes.ResultsFour multicenter RCTs comprising 1,589 patients were included. Frequentist analysis showed no significant difference in the primary outcome, mRS 0-1 at 90 days (OR 1.29, 95% CI 0.99-1.67), or in secondary functional outcomes and mortality. Symptomatic intracranial hemorrhage (OR 1.79, 95% CI 0.88-3.60) and parenchymal hematoma (OR 2.02, 95% CI 0.60-6.74) were numerically more frequent with TNK. No significant interaction was observed according to reperfusion strategy (P-interaction >0.36), although subgroup analyses were exploratory and underpowered. Bayesian analyses yielded estimates favoring TNK for excellent functional outcome (OR 1.29, 95% CrI 1.10-1.51) but also suggested increased risks of symptomatic intracranial hemorrhage (OR 1.79, 95% CrI 1.15-2.76) and parenchymal hematoma (OR 2.02, 95% CrI 1.14-3.47); these findings should be interpreted cautiously given their dependence on Bayesian model assumptions.ConclusionAcross heterogeneous reperfusion paradigms, TNK-containing strategies showed no consistent functional benefit, while hemorrhagic outcomes raised a potential safety signal. Pooled estimates should not be interpreted as a uniform treatment effect.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261487616"},"PeriodicalIF":1.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain metastases in lung cancer patients: Correlation between radiologic phenotypes and outcome parameters in neurosurgically treated cohort.","authors":"Yosef Laviv, Ohad Regev, Andrew A Kanner, Susana Fichman, Tali Siegal, Shlomit Yust-Katz, Alexandra Benouaich-Amiel, Dror Limon","doi":"10.1177/19714009261487297","DOIUrl":"10.1177/19714009261487297","url":null,"abstract":"<p><p>BackgroundUp to 50% of Brain metastases (BM) are associated with lung cancer. Different radiologic features such as tumor size, anatomical location and peritumoral edema affect the clinical course. However, their impact on prognosis and survival is controversial.Patients and MethodsA retrospective study of lung cancer patients who underwent surgical resection of solitary BM. Based on pre-operative radiologic features of the BM, the cohort was divided into 3 groups: solid, cystic-necrotic, and purely cystic lesion. Extent of peritumoral edema and the cerebral vascular territory affected were also examined.ResultsThe studied cohort included 89 patients. Following categorization, 24 (27%), 46 (51.6%) and 19 (21.4%) cases were considered solid, cystic-necrotic and purely cystic, respectively. Severity of peritumoral edema (<i>p</i> = 0.019) as well as the vascular territory affected (<i>p</i> = 0.011) were the principal differences between groups. Rate of distal brain recurrence was nearly two-fold higher in the purely cystic subgroup vs. the cystic-necrotic subgroup (<i>p</i> = 0.075). On multivariable analysis, adjusted to vascular territory and edema severity, only purely cystic lesions were significantly associated with increased risk for distal recurrence (HR = 2.92, <i>p</i> = 0.040) and showed a trend towards worse progression-free survival (HR = 2.10, <i>p</i> = 0.089) when compared to solid cases. Overall survival curves showed no significant difference between groups.ConclusionThe radiologic phenotype of BM seems to have limited impact on OS in surgically treated lung cancer patients. Purely cystic BM might be associated with unfavorable risk for distal recurrence. For some outcome parameters, meaningful differences between the 3 radiologic groups were found, suggesting potential clinical implications.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261487297"},"PeriodicalIF":1.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}