Neuroradiology Journal最新文献

{"title":"Cumulative intraprocedural complexity and diffusion-weighted imaging lesions after endovascular coil embolization.","authors":"SangWoo Yoo, HakSoo Lee, YongWoo Shim, DoYeon Kim, HyokRae Cho, Junghyun Park","doi":"10.1177/19714009261487309","DOIUrl":"10.1177/19714009261487309","url":null,"abstract":"<p><p>BackgroundPostprocedural diffusion-weighted imaging (DWI) lesions are common markers of microembolic injury after coil embolization of unruptured intracranial aneurysms. We evaluated associations of a thrombus-excluded cumulative procedural complexity score with DWI lesion burden and periprocedural neurologic events.MethodsWe retrospectively analyzed 394 patients who underwent elective coil embolization of unruptured intracranial aneurysms between 2021 and 2024. Cumulative procedural complexity was assessed using an exploratory five-domain framework that excluded thrombus-related events. Associations with postprocedural DWI lesion count and periprocedural neurologic events were evaluated using multivariable negative binomial and logistic regression analyses, respectively.ResultsPostprocedural DWI lesions were identified in 160 patients (40.6%), and periprocedural neurologic events occurred in 35 patients (8.9%). Each 1-point increase in the thrombus-excluded cumulative procedural complexity score was associated with a 10% increase in the expected postprocedural DWI lesion count (adjusted IRR, 1.10; 95% CI, 1.02-1.19; p = .015) and 22% higher odds of periprocedural neurologic events (adjusted OR, 1.22; 95% CI, 1.08-1.38; p = .002).ConclusionsA higher thrombus-excluded cumulative procedural complexity score was associated with greater postprocedural DWI lesion burden and higher odds of periprocedural neurologic events. This exploratory, consensus-based framework should be considered hypothesis-generating and requires external validation before clinical application.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261487309"},"PeriodicalIF":1.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892455","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":"Optic and peri-optic enhancement as an imaging finding after particle therapy.","authors":"Kentaro Yuba, Keita Watanabe, Ryo Kimura, Toshiyuki Ogata, Takuya Kimoto, Norihiro Aibe, Kentaro Akazawa, Gen Suzuki, Katsumi Hayakawa, Kei Yamada","doi":"10.1177/19714009261487615","DOIUrl":"10.1177/19714009261487615","url":null,"abstract":"<p><p>BackgroundParticle therapy involving the optic nerve may cause optic neuropathy. Knowledge of post-treatment imaging findings is important for early detection.PurposeTo investigate optic nerve and peri-optic enhancement following particle therapy for periorbital malignancies.Materials and methodsThis retrospective study included 16 patients with contrast-enhanced MRI after particle therapy (15 proton beam therapy and one heavy-ion radiotherapy), comprising 24 evaluated optic nerve sides. Two experienced neuroradiologists independently reviewed the reference and most recent follow-up MR images, and disagreements were resolved by consensus. Exploratory dose associations were evaluated using side-level logistic generalized estimating equations accounting for within-patient correlation.ResultsGrade 2 enhancement was observed in 7 of 16 patients (43.8%) and 9 of 24 sides (37.5%), involving the optic nerve in 6 sides and the peri-optic region in 7. Among 21 sides in 14 proton-treated patients, optic nerve enhancement was not significantly associated with maximum dose (OR per 10 Gy [RBE], 1.481; 95% CI, 0.883-2.482; <i>p</i> = 0.137) but was nominally associated with BED₃ (OR, 1.705; 95% CI, 1.201-2.421; <i>p</i> = 0.003). Peri-optic enhancement was not significantly associated with maximum dose (OR, 1.479; 95% CI, 0.734-2.980; <i>p</i> = 0.274) or BED₃ (OR, 1.490; 95% CI, 0.999-2.222; <i>p</i> = 0.051). One patient was clinically diagnosed with RION; no visual symptoms were documented in the remaining 15 patients.ConclusionOptic nerve or peri-optic enhancement may occur after particle therapy, including in patients without documented visual symptoms, and may represent subclinical radiation-related injury or nonspecific post-radiation changes.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261487615"},"PeriodicalIF":1.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892520","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":"Diagnostic performance of the proposed DECT NI-RADS criteria for imaging surveillance of post-treatment head and neck squamous cell carcinoma: A preliminary study.","authors":"Thiparom Sananmuang, Bhuwid Chinwatanawongwan, Thanwa Sudsang","doi":"10.1177/19714009261481791","DOIUrl":"10.1177/19714009261481791","url":null,"abstract":"<p><p>BackgroundThe value of dual-energy CT (DECT) in enhancing the diagnostic performance of the NI-RADS criteria has not been investigated.PurposeTo compare the diagnostic performance of the proposed DECT NI-RADS with conventional contrast-enhanced (CECT) NI-RADS.Materials and methodsThis retrospective study included 47 patients with head and neck squamous cell carcinoma (HNSCC) who underwent surgery, chemotherapy, or radiation therapy, followed by post-treatment DECT neck scans. Three circular regions of interest (ROIs) were placed in the primary tumor bed and contralateral normal sternocleidomastoid muscle (SCM) on 120-kVp conventional images, 40-keV images, and iodine concentration (IC) maps. Mean density (HU), spectral HU (SHU) at 40 keV, IC values, and their normalized tumor-to-SCM ratios were calculated. Differences between benign and malignant groups were assessed. Receiver operating characteristic (ROC) analysis identified the parameter with the highest area under the curve (AUC), which was used to modify the CECT NI-RADS into a DECT-based NI-RADS system. Lesions in category 2 exceeding the cutoff were upgraded to category 3, and vice versa. Diagnostic performance was compared between conventional NI-RADS and DECT-based NI-RADS.ResultsMalignant lesions showed significantly higher attenuation, IC, and normalized IC than benign post-treatment changes. Normalized IC had the highest AUC, with a cutoff of 2.769 yielding 86.7% sensitivity, 80.0% specificity, 65.0% PPV, 93.3% NPV, and 82.0% accuracy. The proposed DECT NI-RADS criteria may improve both diagnostic performance and interreader agreement compared with conventional CECT NI-RADS.ConclusionsDECT NI-RADS system, integrating normalized IC ratio, may enhance diagnostic performance and interreader agreement compared with the conventional CECT NI-RADS criteria.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261481791"},"PeriodicalIF":1.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833304","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":"Paediatric-type diffuse low-grade gliomas: A pictorial review.","authors":"Krishanthi Nilushi Hewawasam Wadige, Robert Goetti","doi":"10.1177/19714009261478303","DOIUrl":"https://doi.org/10.1177/19714009261478303","url":null,"abstract":"<p><p>The fifth edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System (WHO CNS5) introduces a revised framework for classifying brain and spinal cord tumours, emphasizing the crucial role of molecular diagnostics in accurately identifying neoplasms. A key advancement in this edition is the clear distinction between paediatric-type diffuse low-grade gliomas (pDLGGs) and paediatric-type diffuse high-grade gliomas (pDHGGs) as separate tumour entities. Although histologically and morphologically similar, paediatric diffuse gliomas differ significantly from their adult counterparts in terms of molecular genetics, prognosis, and treatment approaches. The pDLGG category comprises four tumour types: diffuse astrocytoma with MYB- or MYBL1-alterations, angiocentric glioma, polymorphous low-grade neuroepithelial tumour of the young (PLNTY), and diffuse low-grade glioma with MAPK pathway alterations-three of which have been newly recognized. As imaging plays a critical role in the initial diagnosis, surgical planning, and post-treatment monitoring, it is essential for radiologists to be familiar with the imaging hallmarks that distinguish pDLGGs from other paediatric brain tumours, including high-grade gliomas and non-glial neoplasms. This pictorial review aims to provide an updated, image-rich overview of paediatric diffuse low-grade gliomas, emphasizing their typical and atypical imaging findings in MRI, offering valuable diagnostic insights for clinical practitioners and Radiologist.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261478303"},"PeriodicalIF":1.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799579","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":"Safety, efficacy and angiographic outcomes of the Lattice flow diverter for intracranial aneurysms: A systematic review and meta-analysis.","authors":"Irving Gabriel Calisaya-Madariaga, Tiara Valverde-Martinez, Jimena Gonzalez-Salido, Raul Peceros-Peña, Katherin Cordova-Suarez, Niels Pacheco-Barrios","doi":"10.1177/19714009261478304","DOIUrl":"https://doi.org/10.1177/19714009261478304","url":null,"abstract":"<p><p>IntroductionThe Lattice flow diverter is a novel mechanical balloon-based device designed to enhance wall apposition and optimize aneurysm neck coverage. Yet, its safety, efficacy, and angiographic outcomes have not been systematically evaluated.MethodsA systematic review and meta-analysis were conducted following PRISMA guidelines. Primary outcomes were complete aneurysm occlusion, satisfactory occlusion, and favorable functional outcome (mRS 0-2). Secondary outcomes included near-complete and incomplete occlusion, in-stent stenosis, morbidity (mRS 3-5), and mortality (mRS 6). Pooled proportions with 95% confidence intervals (CIs) were calculated using a random-effects model.ResultsSeven studies comprising 460 patients with 472 aneurysms were included (Table 1).The pooled rates of complete occlusion, satisfactory occlusion, and favorable functional outcome (mRS 0-2) were 80%, 89%, and 98%, respectively. Near-complete and incomplete occlusion occurred in 11% and 10% of cases, while in-stent stenosis was observed in 3%. The pooled rates of morbidity (mRS 3-5) and mortality (mRS 6) were 2% and 1%, respectively (Figure 2). Comparative data demonstrated no statistically significant differences in angiographic and clinical outcomes between the LFD and the PED Flex within the studied cohorts. These findings suggest the LFD as a promising alternative that warrants further long-term validation.ConclusionCurrent very-low-certainty evidence suggests that the Lattice flow diverter exhibits preliminary feasibility and acceptable short-term occlusion rates, with a low incidence of in-stent stenosis compared to established devices. These hypothesis-generating findings warrant confirmation through larger prospective, randomized trials.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261478304"},"PeriodicalIF":1.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799613","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 therapy versus best medical treatment in pediatric acute ischemic stroke: A systematic review and meta-analysis.","authors":"Lucca Tamara Alves Carretta, Mariana Letícia de Bastos Maximiano, Rudolfh Batista Arend, Rafael Torres Fonseca Dos Santos, Mariana Lee Han, Bruna Lara Zardin, Ocilio de Deus, Anderson Silva Corin, Nicole Baptista de Oliveira, Marianna Leite, Pedro Torezani Colodetti, Fernando Rocha Oliveira, Tassiane Cristina Morais, Leandro de Assis Barbosa, Ahmet Günkan","doi":"10.1177/19714009261476069","DOIUrl":"10.1177/19714009261476069","url":null,"abstract":"<p><p>PurposeThis systematic review and meta-analysis evaluates endovascular therapy (EVT) versus best medical treatment (BMT) in pediatric acute ischemic stroke (AIS) due to large-vessel occlusion.MethodsSystematic searches were conducted across PubMed, Cochrane, and Embase, inception July-2025. Comparative studies of EVT versus BMT in pediatric AIS were included. Efficacy outcomes assessed were Modified Rankin Scale (mRS) 0-2, mRS 0-1 and Pediatric Stroke Outcome Measure (PSOM). Safety outcomes included mortality, symptomatic intracranial hemorrhage (sICH), any intracranial hemorrhage (aICH), hospital stay length and need for craniectomy.Results10 studies (<i>n</i> = 20,083) were included. In the primary analysis restricted to confirmed large-vessel occlusion (LVO), EVT was associated with significantly higher odds of achieving a good functional outcome (mRS 0-2: OR 2.08; 95% CI 1.07-4.03) and showed no significant difference in all-cause mortality (OR 2.01; 95% CI 0.34-12.01) compared to BMT. In the all-comers analysis, EVT was associated with higher all-cause mortality (OR 3.00; 95% CI 2.23-4.02) and increased risk of aICH (OR 3.12; 95% CI 1.78-5.47); however, these signals were heavily confounded by baseline stroke severity.ConclusionWhen restricted to confirmed LVO, EVT demonstrates a potential functional benefit over BMT in pediatric AIS. The increased risks of aICH and mortality observed in broader analyses are likely confounded by indication, reflecting the selection of the most severe cases for intervention. Based on GRADE assessments, the certainty of evidence remains very low, highlighting the critical need for prospective studies incorporating standardized reperfusion metrics.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009261476069"},"PeriodicalIF":1.2,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702399","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":"Prognostic and etiological implications of the susceptibility vessel sign in acute ischemic stroke: An updated meta-analysis.","authors":"Rafaela Correia Maciel, Wei Jun Lee, Beatriz Aguiar de Macedo, Tam Quoc Minh Tran, Davi Barbosa Pereira da Silva, Vitoria Batista Carneiro, Maria Clara Merighi, Marianna Leite, Luisa Braga Salles Machado, Bernard Giancristoforo Campos, Natalia Vasconcellos de Oliveira Souza","doi":"10.1177/19714009251414368","DOIUrl":"10.1177/19714009251414368","url":null,"abstract":"<p><p>BackgroundThe susceptibility vessel sign (SVS) on MRI has been linked to functional outcomes and reperfusion success after endovascular treatment (EVT), suggesting its potential as a prognostic marker. This updated systematic review and meta-analysis aimed to evaluate the prognostic and etiological significance of SVS in acute ischemic stroke (AIS).MethodsWe conducted a systematic search of PubMed, Embase, and Cochrane in May 2025. Eligible studies included post-hoc analyses of randomized controlled trials (RCTs) and observational studies of AIS patients treated with EVT and/or intravenous thrombolysis (IVT). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Primary outcome was successful reperfusion (mTICI 2b-3). Secondary outcomes included functional independence (modified Rankin Scale [mRS] score 0-2), mortality, stroke etiology, and time metrics.ResultsEighteen studies (<i>n</i> = 2602) were included. Overall, SVS was not associated with higher reperfusion rates (12 studies; <i>n</i> = 2083; RR: 1.01; 95% CI: 0.93-1.10; <i>p</i> = .832; I² = 56.0%), except in the SWI subgroup (2 studies; RR: 1.17; 95% CI: 1.02-1.34; <i>p</i> = .022; I² = 0.0%). SVS⁺ was linked to lower 90-day mortality in anterior circulation strokes (3 studies; <i>n</i> = 865; RR: 0.52; 95% CI: 0.36-0.74; <i>p</i> < .001; I² = 0%), improved 90-day functional independence in Western populations (7 studies; <i>n</i> = 1481; RR: 1.22; 95% CI: 1.01-1.47, <i>p</i> = .039; I² = 37.7%), and in cardioembolic stroke etiology using GRE (9 studies; <i>n</i> = 1058; RR: 1.29; 95% CI: 1.05-1.57; <i>p</i> = .014; I² = 36.3%). The mean time from onset to treatment was 238.19 minutes ± 147.5.ConclusionsAlthough SVS⁺ did not predict reperfusion, it was associated with better functional outcomes in Western populations, particularly in cardioembolic stroke, and lower mortality, thereby reinforcing its prognostic value. MRI protocols did not delay treatment, but high heterogeneity limits certainty, highlighting the need for prospective studies.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"438-451"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991336","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":"Actionable strategies to minimize diagnostic errors in radiology.","authors":"Vladimir Ivanovic, Lotfi Hacein-Bey, Yu-Ming Chang, James V Rawson","doi":"10.1177/19714009251395719","DOIUrl":"10.1177/19714009251395719","url":null,"abstract":"<p><p>Medical errors are a significant cause of morbidity and mortality. Literature on common mechanisms to reduce radiological error are reviewed including shifting from general to subspecialized care, improving expertise, instituting shift volume and shift length limits, minimizing non-interpretive tasks, participating in focused educational and multidisciplinary conferences, and increasing practice size. Implementation of shift volume limits and full sub-specialization has the potential to significantly reduce radiologist error rates.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"420-427"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460149","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":"Revisiting traumatic brachial plexus injury-Imaging correlation of modified Sunderland classification and beyond.","authors":"Nivedita Sarkar, Akhila Prasad, Mukesh Bansal, Lukshay Bansal","doi":"10.1177/19714009251395714","DOIUrl":"10.1177/19714009251395714","url":null,"abstract":"<p><p>Bourgeoning vehicular accidents is leading to a rise in the traumatic brachial plexus injuries (TBPIs). Brachial plexus is a cardinal neural plexus catering to the sensory-motor function of the upper limb. Thus, prompt diagnosis and early management are must in case of TBPIs. Although no single modality is a universal gold standard across the full spectrum of TBPIs, Magnetic resonance imaging (MRI) forms the corner stone of imaging evaluation. Even with excellent resolution, clinching the diagnosis is an uphill task, as already complicated anatomy, becomes scrambled following trauma. Imaging plays a crucial role in management, as it not only diagnose TBPIs, but also accurately identify the site of injury and stratify it. Grading of TBPIs have bearing of management decisions and an accurate stratification, leads to significant reduction in morbidity. Modified Sunderland Classification is widespread accepted classification which can be correlated on MRI. Through this manuscript, the author has tried to simplify this correlation and provide an image guide for imagers along with a table summarizing the important take home points at last.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"452-460"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452889","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":"Rasmussen encephalitis without atrophy and increased ¹¹C-methionine PET uptake mimicking glioma: A case report.","authors":"Rofat Askoro, Fumiyuki Yamasaki, Ushio Yonezawa, Akira Taguchi, Shumpei Onishi, Iori Ozono, Vishwa Jeet Amatya, Yukio Takeshima, Nobutaka Horie","doi":"10.1177/19714009251409307","DOIUrl":"10.1177/19714009251409307","url":null,"abstract":"<p><p>Diagnosing Rasmussen encephalitis presents a significant challenge when cortical atrophy is absent on MRI. We present a case of Rasmussen encephalitis in a 13-year-old boy with lack of atrophy and imaging features mimicking glioma, including increased ¹¹C-methionine (MET)-PET uptake, which led to diagnostic uncertainty. The patient had been previously diagnosed with chronic autoimmune encephalitis and epilepsy for about 6 years prior. Initial MRI revealed an FLAIR hyperintensity in the left frontal lobe and basal ganglia region without cortical atrophy, which remained stable for several years. However, 1 year after the last follow-up, the lesion demonstrated progressive enlargement. MRS demonstrated an increased choline/NAA ratio, increased CBF on ASL, and increased accumulation on MET-PET primarily in the gray matter adjacent to the FLAIR hyperintense lesion. Because these imaging characteristics could not rule out the possibility of glioma, we decided to perform open biopsy via a small craniotomy to establish definitive diagnosis while minimizing the burden on the patient. The pathological examination revealed cortical thickening, increased astrogliosis, and CD3+ and CD8+ T-cells infiltration. A final diagnosis of Rasmussen encephalitis was established, with follow-up MRI demonstrating a gradual reduction in the lesion signal intensity. The current case highlights the difficulties of distinguishing Rasmussen encephalitis from glioma in the absence of cortical atrophy, as they share similar MRI features and MET-PET uptake patterns. In such cases, a minimally invasive biopsy is recommended to establish a definitive diagnosis and reduce patient burden.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"532-535"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795176","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}