Clinical Neuroradiology最新文献

{"title":"Continuation or Withdrawal of Life-sustaining Therapies After Acute Anoxic Events in Childhood and Adolescence : Can Early MRI Predict Particularly Severe Outcomes?","authors":"Katharina Staudt, Martin Staudt, Irina Mader, Melanie Hessenauer, Ingeborg Kraegeloh-Mann, Samuel Groeschel","doi":"10.1007/s00062-026-01657-1","DOIUrl":"https://doi.org/10.1007/s00062-026-01657-1","url":null,"abstract":"<p><strong>Purpose: </strong>Withholding or withdrawing life-sustaining therapies is often discussed when children or adolescents suffer severe anoxic events. Previous studies have demonstrated that early MRI can identify patients with major neurological sequelae, but not whether, within a cohort with major neurological sequelae, early MRI can predict particularly severe outcomes. This was the purpose of the present study.</p><p><strong>Methods: </strong>We retrospectively assessed MRI (analyzing 14 brain regions for signal abnormalities on diffusion, T1, T2 and FLAIR) of 38 patients who had suffered acute anoxic events between 8 months and 17 years of age and had required inpatient neurorehabilitation, looking for differences between patients with \"particularly severe outcomes\" (the 22/38 patients who were still unable to interact with their environment 22 weeks after the event) and patients with \"less severe outcomes\" (the 16/38 patients who had regained this ability within 22 weeks).</p><p><strong>Results: </strong>Prediction of \"particularly severe outcome\" was optimal using diffusion MRI obtained on days 4-5 after the event (available in 11 patients, 7 with particularly severe outcomes), when all patients with diffusion restrictions in any of the following regions-putamen (4/7), caudate nucleus (4/7), globus pallidus (6/7), or substantia nigra (4/7)-later showed particularly severe outcomes. In contrast, identification of \"less severe outcome\" was optimal using MRI obtained between days 6-9 after the event, when absence of diffusion restrictions in the cerebral white matter always predicted \"less severe outcome\".</p><p><strong>Conclusion: </strong>Early MRI can identify patients with particularly severe outcomes-and thus can contribute to discussions about the continuation or withdrawal of life-sustaining therapies in the acute phase after anoxic events.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845121","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":"Reframing Medium-Vessel Occlusion Thrombectomy in Acute Ischemic Stroke: Device-Vessel Matching and Patient Selection as Keys to Clinical Benefit.","authors":"Matija Zupan, René Chapot, Senta Frol","doi":"10.1007/s00062-026-01667-z","DOIUrl":"https://doi.org/10.1007/s00062-026-01667-z","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845088","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":"Evans' Index and Frontal and Occipital Horn Ratio in Correlation to Volumetric Data of Lateral Ventricles in a Population-based MRI Study.","authors":"Daniel Cantré, Robin Bülow, Eiko Rathmann, Jörg Baldauf, Felix Streckenbach, Sönke Langner","doi":"10.1007/s00062-026-01665-1","DOIUrl":"https://doi.org/10.1007/s00062-026-01665-1","url":null,"abstract":"<p><strong>Purpose: </strong>Evans' Index (EI) and Frontal and Occipital Horn Ratio (FOHR) are routinely used in screening for enlargement of the ventricular system. However, both lack epidemiological definition of normal values in adults. In a representative, randomized sample of adult normal population in Germany we studied the correlation of lateral ventricle volumes with EI and FOHR to evaluate the performance of pre-established cutoff values of EI > 0.3 and FOHR > 0.37, and to introduce age- and sex-specific thresholds, which for FOHR do not yet exist in adults.</p><p><strong>Methods: </strong>In a population-based sample of 3058 subjects of the \"Study of Health in Pomerania\" (SHIP), aged 21-90 years, brain imaging with T1 weighted MPRAGE with 1 mm isotropic voxel-size was obtained. We semiautomatically determined the volumes of the lateral ventricles and manually performed measurements to calculate EI and FOHR for every individual. Besides descriptive statistics, ROC analyses were carried out to determine test performance of both parameters. Negative and positive predictive values were derived from contingency analyses.</p><p><strong>Results: </strong>Average values were 0.257 ± 0.025 for EI and 0.363 ± 0.024 for FOHR, with sex- and age-depending differences. Using the established cut-off value of EI > 0.3, this index achieved high specificity of 97.1% and moderate sensitivity of 55.3% for diagnosing ventricular enlargement. Using a threshold of > 0.4, FOHR achieved a specificity of 93.4%, and higher sensitivity of 81.4%. FOHR showed stronger correlation with actual lateral ventricle volumes, as compared to EI (r_{s FOHR} = 0.741 vs. r_{s EI} = 0.656; p < 0.001).</p><p><strong>Conclusion: </strong>For the first time, EI and FOHR were evaluated in a reasonable sized, randomized, representative sample of normal adult population in Germany, and were confirmed as useful screening tools in the diagnosis of ventricular enlargement. We introduce a cut-off value of > 0.4 for FOHR in adults, with emphasis on specific caveats.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845116","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":"Early Postthrombectomy Neurological Improvement: the NIHSS Drop as an Immediate Predictor of Good Functional Outcomes.","authors":"Pablo Baena-Palomino, Marta Aguilar-Pérez, Asier de Albóniga-Chindurza, Elena Zapata-Arriaza, Leire Ainz-Gómez, Henry A Andrade-Ruiz, Carlota Villar-Rodríguez, Diego Villagrán-Sancho, Manuel Medina-Rodríguez, Andrés Hermosín-Gómez, Blanca Pardo-Galiana, Juan Antonio Cabezas-Rodríguez, Joan Montaner, Francisco Moniche, Alejandro González","doi":"10.1007/s00062-026-01654-4","DOIUrl":"https://doi.org/10.1007/s00062-026-01654-4","url":null,"abstract":"<p><strong>Purpose: </strong>Despite advances in mechanical thrombectomy for acute ischemic stroke (AIS), the relationship between successful angiographic reperfusion and functional outcome remains imperfect. We investigated the value of an optimal immediate postthrombectomy National Institutes of Health Stroke Scale (NIHSS) cutoff, termed the \"NIHSS drop,\" as a predictor of favorable 90-day outcome and compared its prognostic performance with first-pass effect (FPE).</p><p><strong>Methods: </strong>We conducted a single-center retrospective analysis of prospectively collected data from 554 patients with AIS who underwent mechanical thrombectomy between 2018 and 2024. Eligible patients presented with an NIHSS score > 8, an Alberta Stroke Program Early CT Score (ASPECTS) of 6-10, and M1 occlusion. Immediate postprocedural NIHSS assessment allowed calculation of the NIHSS drop. Receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff, and logistic regression was used to assess its predictive value after adjustment for complete reperfusion (Thrombolysis in Cerebral Infarction [TICI] grade 3 vs 2b), FPE, and other major confounders.</p><p><strong>Results: </strong>An NIHSS drop ≥ 6 was strongly associated with favorable outcome (area under the curve [AUC] = 0.762, sensitivity 63%, specificity 82%). Patients with an NIHSS drop ≥ 6 (n = 235) had better outcomes (modified Rankin Scale [mRS] 0-2: 83% vs 40%, p < 0.001), fewer complications, and lower median NIHSS scores at 24 h (3 vs 12) and at discharge (1 vs 5), as well as lower in-hospital mortality (1.7% vs 15%, p < 0.001) and 90-day mortality (3.0% vs 19%, p < 0.001). In multivariable analysis, an NIHSS drop ≥ 6 remained the strongest predictor of favorable outcome (odds ratio [OR] 7.21, 95% confidence interval [CI] 4.62-11.5; p < 0.001), showing a stronger association than complete reperfusion or FPE individually.</p><p><strong>Conclusion: </strong>Immediate neurological improvement after thrombectomy was strongly associated with favorable functional outcome. An NIHSS drop ≥ 6 may serve as a useful early prognostic marker and may complement traditional procedural metrics such as TICI grade and FPE, although prospective validation is needed.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730374","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":"Intra-Arterial Thrombolytic vs. Mechanical Thrombectomy in Distal Medium Middle Cerebral Artery Acute Ischemic Stroke: A Preliminary Multinational Multicenter Propensity Score-Matched Study.","authors":"Hamza Adel Salim, Benjamin Pulli, Vivek Yedavalli, Takahiro Ota, Dhairya Lakhani, Orabi Hajjeh, Basel Musmar, Nimer Adeeb, Fathi Milhem, Tobias D Faizy, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard L L Yeo, Benjamin Y Q Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Max Wintermark, Adrien Guenego, Adam A Dmytriw","doi":"10.1007/s00062-026-01644-6","DOIUrl":"https://doi.org/10.1007/s00062-026-01644-6","url":null,"abstract":"<p><strong>Background: </strong>Optimal treatment for acute ischemic stroke due to distal medium-vessel occlusion (DMVO) in the middle cerebral artery (MCA) remains uncertain. While mechanical thrombectomy (MT) may pose higher risks in DMVO, intra-arterial thrombolysis (IAT)-with or without intravenous thrombolysis (IVT)-could be a safer alternative.</p><p><strong>Purpose: </strong>To compare functional outcomes and safety profiles of IAT versus MT in acute ischemic stroke caused by MCA DMVO (M2-M4 segments).</p><p><strong>Methods: </strong>We performed a retrospective, propensity score-matched study across 37 centers (Asia, Europe, North America) using the MAD-MT registry. Patients with MCA DMVO (M2-M4) treated with IAT or MT (with/without IVT) were included. Propensity score matching adjusted for confounders. The primary outcome was excellent functional outcome (modified Rankin Scale [mRS] 0-1 at 90 days).</p><p><strong>Results: </strong>After matching, 184 patients were analyzed (19 IAT, 165 MT). Baseline characteristics were balanced. At 90 days, excellent functional outcomes occurred in 38% (IAT) versus 21% (MT) (P = 0.20). Functional independence (mRS 0-2) rates were 50% (IAT) versus 40% (MT) (P = 0.42). Mortality was comparable (13% vs. 17%). Successful reperfusion (modified Thrombolysis in Cerebral Infarction [mTICI] 2b-3) was higher with MT (90% vs. 68%; P = 0.02), but symptomatic intracranial hemorrhage occurred only with MT (6.7% vs. 0%; P = 0.60).</p><p><strong>Conclusion: </strong>For MCA DMVO, IAT showed similar functional outcomes and numerically fewer safety events than MT despite lower recanalization rates. These findings should be interpreted cautiously, given the small IAT sample size and require validation in larger prospective studies.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730394","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":"Migratory Venous Sinus Stenosis After Stenting for Idiopathic Intracranial Hypertension: a Single-Center Case Series.","authors":"Lizhang Chen, Jian Wang, Xue Lin, Fayun Hu, Hongbo Zheng","doi":"10.1007/s00062-026-01653-5","DOIUrl":"https://doi.org/10.1007/s00062-026-01653-5","url":null,"abstract":"<p><strong>Background and purpose: </strong>Venous sinus stenting (VSS) is an effective intervention for medically refractory idiopathic intracranial hypertension (IIH) with hemodynamically significant dural venous sinus stenosis. However, some patients develop de novo stenosis in venous segments that were angiographically normal at the index procedure-a phenomenon we define as migratory venous sinus stenosis (mVSS). We aimed to characterize the incidence, anatomical distribution, and clinical management of symptomatic mVSS in a consecutive VSS cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed of all consecutive IIH patients who underwent VSS at West China Hospital (November 2011-October 2025). Patients developing symptomatic mVSS were identified, and clinical presentations, anatomical localization, hemodynamic parameters, and treatment outcomes were analyzed.</p><p><strong>Results: </strong>Among 65 patients, 4 (6.2%) developed symptomatic mVSS (3 women, 1 man; age range 15-44 years). Symptom recurrence occurred 4 days to 9 months after index VSS. New stenoses localized to the venous segment immediately distal to the original stent in all cases. Recurrent trans-stenotic pressure gradients ranged from 16 to 30 mm Hg (manometry was unavailable in one patient). Three patients underwent successful repeat stenting with immediate hemodynamic normalization and durable symptom resolution. One patient with concurrent paraspinal infection improved with conservative management alone.</p><p><strong>Conclusions: </strong>Symptomatic mVSS is an uncommon but clinically significant failure mode after VSS for IIH, characteristically arising at or immediately beyond the distal stent margin. Structured post-stenting surveillance and timely consideration of repeat intervention are warranted in symptomatic cases.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700542","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":"Incidence of Fish-mouthing and Wall Malapposition of Different Flow Diverters in the Treatment of Cerebral Aneurysms: Device-specific Findings in a Retrospective Single-center Analysis.","authors":"Maximilian Rothe, Martin Renz, Maria Berndt-Mück, Dennis Hedderich, Dominik Sepp, Bernhard Meyer, Chiara Negwer, Jannis Bodden, Jan Kirschke, Tobias Boeckh-Behrens, Christian Maegerlein","doi":"10.1007/s00062-026-01651-7","DOIUrl":"https://doi.org/10.1007/s00062-026-01651-7","url":null,"abstract":"<p><strong>Purpose: </strong>Flow diverter (FD) braid stability is crucial for optimal wall apposition, thereby reducing the risk of device-related complications following intracranial aneurysm treatment. We compared wall apposition characteristics across different FD designs to evaluate inter-device differences.</p><p><strong>Methods: </strong>Retrospective single-center analysis of 104 patients with 127 aneurysms treated with 121 FD (35 Derivo Embolization Devices (DED; Acandis, Pforzheim, Germany), 50 p64 (Phenox Wallaby, Bochum, Germany), 24 p48 (Phenox), 11 Silk (Balt, Montmorency, France), and 1 Pipeline (Medtronic, Dublin, Ireland)) between February 2013 and June 2023. The analysis focused on fish-mouthing-like deformities (≥ 10% focal diameter reduction at device ends) and the need for mechanical wall apposition maneuvers, as well as aneurysm occlusion, thrombus-associated events, and neurological outcomes.</p><p><strong>Results: </strong>Fish-mouthing-like deformities occurred more frequently with DED (50.0%) than with other FD-types (27.2%; p = 0.021), mainly due to \"pre\"-fish-mouthing (31.3% vs. 14.8%; p = 0.047). Mechanical wall apposition maneuvers were more often required in DED cases (60.0% vs. 25.6%; p < 0.001), particularly for proximal malapposition. Aneurysm occlusion rates were comparable at final FU (84.2% vs. 88.6%; p = 0.563). Thrombus-associated events occurred more frequently with DED (29.4% vs. 11.3%; p = 0.008), though neurological outcomes did not differ significantly (6.0% vs. 2.6%; p = 0.148). Mean FU time was 26.0 ± 21.0 months.</p><p><strong>Conclusion: </strong>DED required more frequent intraprocedural wall apposition maneuvers and showed higher rates of fish-mouthing-like deformities compared with other FD-types. However, long-term aneurysm occlusion and neurological outcomes were comparable. These findings suggest that while DED deployment may require greater technical expertise, its safety and efficacy should be further evaluated in larger, multicenter studies.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693078","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 Through-&-Through Technique: A Safe Bailout Access Route for Difficult Aortic Arch Anatomy During Thrombectomy.","authors":"Johan Wasselius, Emma Hall, Lovisa Landström, Alex Szolics, Björn Hansen","doi":"10.1007/s00062-025-01612-6","DOIUrl":"https://doi.org/10.1007/s00062-025-01612-6","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610490","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":"Correction to: Long-Term Follow-up of the Woven EndoBridge (WEB) Device for the Treatment of Broad Based Intracranial Aneurysms: A Single-Center Retrospective Observational Analysis.","authors":"Humberto Abraham Cortés Magdaleno, Ansgar Berlis, Guilherme Quint, Mahmoud Zaki, Christoph Maurer","doi":"10.1007/s00062-026-01647-3","DOIUrl":"https://doi.org/10.1007/s00062-026-01647-3","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575873","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":"From Anatomy to Outcome: Linking Glioma Location Patterns to Survival Using Non-Negative Matrix Factorization.","authors":"Marianne Schell, Joel Kohler, Martha Folty-Dumitru, Haidar Alzaid, Irada Pflüger, Katharina Schregel, Tim Hilgenfeld, Julius Kernbach, Sandro Krieg, Felix Sahm, Wolfgang Wick, Martin Bendszus, Jessica Jesser","doi":"10.1007/s00062-026-01642-8","DOIUrl":"https://doi.org/10.1007/s00062-026-01642-8","url":null,"abstract":"<p><strong>Purpose: </strong>The anatomical distribution of IDH-wildtype gliomas may encode prognostic information not captured by conventional clinical or molecular markers. The purpose of this study was to determine whether continuous, data-driven spatial patterns of tumor involvement provide prognostic value beyond established clinical and molecular factors.</p><p><strong>Methods: </strong>We applied non-negative matrix factorization (NMF) to preoperative tumor segmentations from 429 patients with IDH-wildtype gliomas to identify coherent spatial components of tumor involvement. Six reproducible spatial signatures were extracted and integrated into multivariate Cox proportional hazards models. Models additionally included tumor volume, age, sex, O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status, Eastern Cooperative Oncology Group (ECOG) performance status, and extent of resection.</p><p><strong>Results: </strong>All six spatial patterns demonstrated significant association with overall survival (p ≤ 0.005). Notably, involvement of the left parietal-occipital regions was linked to the poorest outcomes, while temporal patterns showed weaker associations with survival. Incorporating spatial patterns into the prognostic model improved its discriminatory power and altered the influence of tumor volume, indicating an interaction between tumor location and tumor burden.</p><p><strong>Conclusion: </strong>Continuous spatial phenotyping of IDH-wildtype gliomas using NMF captures prognostically relevant information not reflected by conventional markers. Integration of spatial patterns into prognostic models enhances risk stratification and supports the incorporation of detailed spatial analyses into radiologic workflows.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534048","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}