AJNR. American journal of neuroradiology最新文献

{"title":"Susceptibility Changes on Preoperative Acetazolamide-Loaded 7T MR Quantitative Susceptibility Mapping Predict Post-Carotid Endarterectomy Cerebral Hyperperfusion.","authors":"Kazuto Kimura, Yosuke Akamatsu, Kentaro Fujimoto, Ikuko Uwano, Makoto Sasaki, Shunrou Fujiwara, Masakazu Kobayashi, Takahiro Koji, Kenji Yoshida, Kazunori Terasaki, Kuniaki Ogasawara","doi":"10.3174/ajnr.A8692","DOIUrl":"10.3174/ajnr.A8692","url":null,"abstract":"<p><strong>Background and purpose: </strong>Post-carotid endarterectomy (CEA) cerebral hyperperfusion (CH) can cause intracerebral hemorrhage and cognitive decline. Alterations in susceptibility in response to acetazolamide (ACZ) on 7T MRI quantitative susceptibility mapping (QSM) detect elevated CBV occurring due to impaired cerebrovascular autoregulation. We explored preoperative relative susceptibility changes on 7T MRI QSM in response to ACZ and their ability to predict CH following CEA.</p><p><strong>Materials and methods: </strong>Sixty-three patients with uni- or bilateral cervical ICA stenosis of ≥70% underwent 7T MRI at baseline and at 5, 10, 15, and 20 minutes after ACZ administration before surgery. The difference between the susceptibility of venous structures and surrounding brain parenchyma at each time point after ACZ administration relative to the difference at baseline (relative susceptibility difference [RSD]) on QSM images was calculated in the cerebral hemisphere ipsilateral to the surgery site. Brain perfusion SPECT was conducted preoperatively and immediately following CEA to detect postoperative CH (≥100% rise in CBF postoperatively).</p><p><strong>Results: </strong>In 9 patients with postoperative CH, the RSD was significantly increased at 5 or 10 minutes following ACZ administration (<i>P</i> < .05) but was reduced at 15 and 20 minutes (<i>P</i> < .05). In 54 patients without postoperative CH, the SD at all 4 time points after ACZ administration was significantly lower than the baseline value (<i>P</i> < .05). The area under the receiver operating characteristic curve to predict postoperative CH was significantly greater in RSD₅ (0.981; 95% CI, 0.910-0.999) than in RSD₁₅ (0.872; 95% CI, 0.764-0.943) (<i>P</i> < .05) or RSD₂₀ (0.780; 95% CI, 0.658-0.874) (<i>P</i> < .01). Sensitivity, specificity, and positive and negative predictive values for RSD₅ at a cutoff near the left upper corner of the curve were 100%, 89%, 60%, and 100%, respectively. Logistic regression analysis revealed that only RSD₅ significantly predicted postoperative CH (95% CI, 455.9-4043.6; <i>P</i> < .05).</p><p><strong>Conclusions: </strong>Changes in susceptibility on preoperative 7T MRI QSM following ACZ administration predict CH following CEA. Patients with increased RSD₅ on pre-CEA 7T MRI QSM following ACZ administration should undergo brain perfusion imaging immediately after surgery. Detection of CH on postoperative brain perfusion imaging warrants intensive blood pressure control.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficulties in Transvenous Embolization via the Cavernous Sinus: Buddy-Wire Anchoring Technique.","authors":"Ryuichi Noda, Mohamad Izzat Arslan Che Ros, Suzana Saleme, Aymeric Rouchaud, Charbel Mounayer","doi":"10.3174/ajnr.A8879","DOIUrl":"https://doi.org/10.3174/ajnr.A8879","url":null,"abstract":"<p><p>The cavernous sinus drains venous blood from most of the temporal lobe through the superficial middle cerebral vein (SMCV).¹ Brain AVMs located on the surface of the temporal and parietal lobes often drain into the SMCV.² Therefore, in cases treated with transvenous embolization, accessing the SMCV passing through relaying the cavernous sinus (CS), which can interfere with the deployment of the microcatheter by trapping the catheter in the CS. In this video article, we describe a bailout technique for this situation using another microguidewire. This additional guidewire provides support by serving as an \"anchor,\" enabling the microcatheter to advance. The buddy-wire anchoring technique can be used to help catheterize the SMCV distally without it becoming trapped in the CS. This is the first report of the buddy-wire anchoring technique described in transvenous embolization for brain AVMs.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Clusters of Pediatric Low-Grade Glioma Are Associated with Distinct Molecular Characteristics.","authors":"Anahita Fathi Kazerooni, Adam Kraya, Komal S Rathi, Meen Chul Kim, Varun Kesherwani, Ryan Corbett, Arastoo Vossough, Nastaran Khalili, Deep Gandhi, Neda Khalili, Ariana M Familiar, Run Jin, Xiaoyan Huang, Yuankun Zhu, Alex Sickler, Matthew R Lueder, Saksham Phul, Phillip B Storm, Jeffrey B Ware, Jessica B Foster, Sabine Mueller, Jo Lynne Rokita, Michael J Fisher, Adam C Resnick, Ali Nabavizadeh","doi":"10.3174/ajnr.A8699","DOIUrl":"10.3174/ajnr.A8699","url":null,"abstract":"<p><strong>Background and purpose: </strong>Cancers show heterogeneity at various levels, from genome to radiologic imaging. This study aimed to explore the interplay between genomic, transcriptomic, and radiophenotypic data in pediatric low-grade glioma (pLGG), the most common group of brain tumors in children.</p><p><strong>Materials and methods: </strong>We analyzed data from 201 patients with pLGG in the Children's Brain Tumor Network by using principal component analysis and K-means clustering on 881 radiomic features, along with clinical variables (age, sex, tumor location), to identify imaging clusters and examine their association with pLGG classifications as described in the World Health Organization Classification of Tumors of the Central Nervous System, 5th edition, 2021 (WHO 2021 CNS 5). To determine the transcriptome pathways linked to imaging clusters, we employed a supervised machine-learning model with elastic net logistic regression based on the pathways identified through gene set enrichment and gene coexpression network analyses.</p><p><strong>Results: </strong>Three imaging clusters with distinct radiomic characteristics were identified. <i>BRAF V600E</i> mutations were primarily found in imaging cluster 3, while <i>KIAA1549::BRAF</i> fusion occurred in subtype 1. The model's predictive accuracy was 0.77 for subtype 1, 0.78 for subtype 2, and 0.70 for subtype 3. Each imaging cluster exhibited unique molecular mechanisms: subtype 1 was linked to oxidative phosphorylation, <i>PDGFRB</i>, and interleukin signaling, whereas subtype 3 was associated with histone acetylation and DNA methylation pathways, related to <i>BRAF V600E</i> pLGGs.</p><p><strong>Conclusions: </strong>Our radiogenomics study indicates that the intrinsic molecular characteristics of tumors correlate with distinct imaging subgroups in pLGG, paving the way for future multimodal investigations that may enhance understanding of disease progression and targetability.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Prophylactic Endovascular Treatments for Threatened or Impending Internal/Common Carotid Artery Blowout Syndrome.","authors":"Han-Yi Yen, Yen-Heng Lin, Ya-Fang Chen, Jia-Zheng Huang, Pin-Chen Chen, Chung-Wei Lee, Bo-Ching Lee","doi":"10.3174/ajnr.A8716","DOIUrl":"10.3174/ajnr.A8716","url":null,"abstract":"<p><strong>Background and purpose: </strong>The outcomes of prophylactic endovascular interventions for patients facing threatened or impending carotid blowout syndrome (CBS) involving the ICA/common carotid artery (CCA) have not been extensively elucidated. We aimed to delineate the specific treatment outcomes for this group of patients.</p><p><strong>Materials and methods: </strong>We retrospectively enrolled 109 patients with threatened or impending CBS of the ICA/CCA between 2006 and 2023. Patients were categorized into group 1 (no intervention for ICA/CCA, <i>n</i>=43), group 2 (ICA/CCA embolization, <i>n</i>=36), or group 3 (ICA/CCA stent placement, <i>n</i>=30). ANOVA and Cox regression analyses were employed to evaluate basic characteristics and the rates of recurrent bleeding, overall survival, and major complications.</p><p><strong>Results: </strong>Age (56.8 ± 8.7 versus 54.3 ± 11.6 versus 56.6 ± 9.2), male sex (39/43 versus 33/36 versus 26/30), tumor size, and type of blowout were similar (<i>P</i> > .05) among groups. Tumor location (<i>P</i> < .001) and presence of air-containing necrosis on CT/MRI before transarterial embolization (<i>P</i> = .001) varied between groups. Cox regression analysis adjusted for age and sex revealed group 2 had a lower risk of recurrent bleeding than group 1 (adjusted hazard ratio [HR], 0.22; 95% CI: 0.10-0.47; <i>P</i> < .001) and group 3 (0.41; 95% CI: 0.17-0.96; <i>P</i> = .042), but a higher risk of acute stroke (<i>P</i> = .016). Group 2 had higher overall survival than groups 1 and 3 (0.55; 95% CI: 0.31-0.96; <i>P</i> = .036).</p><p><strong>Conclusions: </strong>In threatened or impending CBS of the ICA/CCA, prophylactic embolization was associated with a lower risk of recurrent bleeding but a higher risk of acute stroke compared with ICA/CCA stent placement or no intervention.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASNR International Collaboration Committee's Anne Osborn International Outreach Program: Tools and Barriers, Lessons Learned.","authors":"Noushin Yahyavi-Firouz-Abadi, Bruno A Policeni, Amy F Juliano","doi":"10.3174/ajnr.A8762","DOIUrl":"https://doi.org/10.3174/ajnr.A8762","url":null,"abstract":"<p><p>The Anne Osborn International Outreach Professor Program, founded by the American Society of Neuroradiology (ASNR), is dedicated to advancing global neuroradiology education through meaningful collaboration and engagement. This review integrates findings from surveys of host countries and participating professors to evaluate the program's impact, strengths, and areas for improvement. Host countries praised the program's high educational value and interactive teaching formats, while professors highlighted the opportunity to make meaningful contributions. Survey data identified logistical challenges, resource limitations, and the need for longer-lasting collaboration. Recommendations include enhancing program continuity, expanding outreach, and addressing infrastructure variability for sustained global impact.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Epidural Hematoma Expansion and the Need for Surgery.","authors":"Mahla Radmard, Luke Miller, Armin Tafazolimoghadam, Shahram Hadidchi, Joyce Hsu, Jee Moon, Samuel Speer, David M Yousem, Caline Azzi","doi":"10.3174/ajnr.A8832","DOIUrl":"https://doi.org/10.3174/ajnr.A8832","url":null,"abstract":"<p><strong>Background and purpose: </strong>The use of head CT in trauma settings has increased significantly, driven by the need to detect and monitor intracranial hemorrhages. Among intracranial hemorrhage subtypes, epidural hematomas (EDHs) are relatively uncommon but require careful evaluation due to their potential for expansion and the need for surgical intervention. This study aimed to identify risk factors for initial EDH size, subsequent enlargement, and the need for surgical intervention to guide imaging and treatment strategies.</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of 32,401 noncontrast head CT reports from 2 trauma centers (The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center) between 2018 and 2024. Patients with EDHs were identified using a structured search of radiology reports. Clinical, demographic, and imaging characteristics were analyzed to assess the predictors of EDH enlargement and the need for surgery. Statistical analyses included the χ² or Fisher exact test, Mann-Whitney <i>U</i> test, Kruskal-Wallis H test, and logistic regression analysis.</p><p><strong>Results: </strong>Among 91 cases of EDH, a larger initial EDH size was associated with arterial bleeding sources, mixed attenuation, and the spot sign. These same factors, plus a midline shift, predicted the need for initial surgery. No clinical features or comorbidities predicted a larger EDH. Follow-up imaging revealed EDH enlargement in 25/89 cases (28.1%), with SAH as the only significant predictor (OR = 2.60; 95% CI, 1.00-6.77; <i>P</i> = .05). The scans that demonstrated EDH enlargement were performed after a mean of 6.6 (SD 3.3) hours. Ultimately, 25/91 (27.5%) EDHs required surgical intervention; only EDH enlargement was predictive of the need for follow-up surgery after initial observation.</p><p><strong>Conclusions: </strong>The presence of concurrent SAH was the strongest predictor of EDH enlargement, and radiologists should recommend short-term monitoring of patients with EDH and SAH. Repeat CT at 6-13 hours will detect nearly all cases of EDH enlargement, which may lead to subsequent surgery. Initial large size, midline shift, arterial sources of bleeds, and active bleeding imaging findings correlated with an early surgical intervention. Future multicenter studies are needed to refine risk stratification and optimize imaging follow-up to balance patient safety and health care resource use.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing Intracranial Solitary Fibrous Tumors from Meningiomas: The Diagnostic Value of T1-Weighted MRI Signal Intensity and ADC Values.","authors":"Shinichi Cho, Ryo Kurokawa, Shiori Amemiya, Sosuke Hatano, Shintaro Kano, Tomohiro Higuchi, Haruka Masuzawa, Mai Sato, Osamu Abe","doi":"10.3174/ajnr.A8703","DOIUrl":"10.3174/ajnr.A8703","url":null,"abstract":"<p><strong>Background and purpose: </strong>Intracranial solitary fibrous tumors (SFTs) and meningiomas are CNS tumors that share identical imaging manifestations but exhibit different clinical behaviors. This study aimed to compare ADC values and conventional imaging features, particularly precontrast T1-weighted signal intensity, between intracranial SFTs and meningiomas.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated 13 patients with pathologically proved intracranial SFTs and 27 patients with meningiomas who attended our hospital between January 2002 and December 2023. Signal intensity on precontrast T1-weighted imaging (compared with cerebral cortex), presence of dural tail sign, flow voids, hyperostosis, and normalized mean T1-weighted imaging values and mean ADC values were assessed.</p><p><strong>Results: </strong>T1-weighted hyperintensity was significantly more frequent in SFTs (10/13, 76.9%) compared with meningiomas (5/27, 18.5%) (<i>P</i> = .0010). Normalized mean T1-weighted imaging values (<i>P</i> = .035) and normalized mean ADC values (<i>P</i> = .039) were significantly higher in SFTs compared with meningiomas. A significant inverse correlation between normalized mean T1-weighted imaging and ADC values was observed in SFTs (<i>R</i> ² = 0.42, <i>P</i> = .017). Binomial logistic regression analysis showed moderate efficacy in differentiating these tumors (mean cross-validation score = 0.83). Dural tail sign and hyperostosis were more frequent in meningiomas, though these differences were not statistically significant.</p><p><strong>Conclusions: </strong>Precontrast T1-weighted signal intensity is a useful characteristic for differentiating intracranial SFTs from meningiomas, with hyperintensity compared with cerebral cortex being a distinctive feature of SFTs. The combination of normalized T1-weighted imaging and ADC values provides moderate diagnostic accuracy.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Smoking on Recurrence and Angiographic Outcomes after Endovascular Treatment of Intracranial Aneurysms: A Systematic Review and Meta-analysis.","authors":"Sherief Ghozy, Seyed Behnam Jazayeri, Alireza Hasanzadeh, Julien Ognard, Hassan Kobeissi, Ali Ahmadzade, Ehsan Naseh, Mobina Motaghian Fard, Alzhraa S Abbas, Rachana R Borkar, David F Kallmes, Ramanathan Kadirvel","doi":"10.3174/ajnr.A8712","DOIUrl":"10.3174/ajnr.A8712","url":null,"abstract":"<p><strong>Background: </strong>Cerebral aneurysm recurrence remains a critical endpoint in evaluating the success of endovascular treatment. While smoking is a recognized risk factor for aneurysm formation and rupture, its impact on post-treatment angiographic outcomes is unclear due to conflicting evidence.</p><p><strong>Purpose: </strong>To systematically assess the association between smoking and angiographic outcomes-including occlusion, recurrence, and retreatment-following endovascular treatment of intracranial aneurysms.</p><p><strong>Data sources: </strong>A comprehensive search of PubMed, Embase, Scopus, and Web of Science was conducted from inception to June 25, 2024. Bibliographies of included studies were also screened.</p><p><strong>Study selection: </strong>Studies were eligible if they involved adult patients with intracranial aneurysms treated via endovascular approaches and reported outcomes stratified by smoking status. Case reports, abstracts, and studies not reporting smoking data were excluded.</p><p><strong>Data analysis: </strong>Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted using generalized linear mixed models to estimate risk ratios (RRs) with 95% confidence intervals (CIs). Subgroup, sensitivity, and meta-regression analyses were also performed.</p><p><strong>Data synthesis: </strong>Twenty-five studies involving 5,828 patients were included. Smokers had a higher rate of complete aneurysm occlusion (RR 1.12, 95% CI 1.06-1.19; <i>P</i> < .01), especially among those undergoing flow diversion (RR 1.14, 95% CI 1.07-1.21; <i>P</i> < .01). No significant differences were found in recurrence/recanalization rates (RR 1.20, 95% CI 0.91-1.60; <i>P</i> = .20) or retreatment rates (RR 0.81, 95% CI 0.58-1.13; <i>P</i> = .22) between smokers and non-smokers. Heterogeneity was moderate to high for some outcomes but reduced after sensitivity analyses.</p><p><strong>Limitations: </strong>Heterogeneity in smoking definitions, variable follow-up durations, reliance on retrospective data, and limited granularity on smoking intensity (eg, pack-years) may affect interpretation. Results are not generalizable to surgical clipping or long-term outcomes.</p><p><strong>Conclusions: </strong>Smoking is associated with increased complete occlusion rates following flow diversion, but does not significantly impact recurrence or retreatment rates. While smoking cessation remains essential for vascular health, its influence on endovascular treatment efficacy may be limited. Standardized reporting and further mechanistic studies are needed to elucidate smoking's role in aneurysm healing.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroradiology Fellowship Programs: A Comprehensive Guide for Neuroradiology Fellowship Program Directors.","authors":"Mari Hagiwara, Ranliang Hu, Alok A Bhatt, Ashesh A Thaker, Erik H Middlebrooks, Ashley H Aiken, Tabassum A Kennedy","doi":"10.3174/ajnr.A8838","DOIUrl":"10.3174/ajnr.A8838","url":null,"abstract":"<p><p>The scope of responsibilities and time commitment required for program directors (PDs) of neuroradiology fellowship programs has become quite substantial over the past decade. PDs must continually refine and document a robust, effective curriculum that meets growing accreditation requirements while aligning with institution policies and workflow. This article serves as a comprehensive guide for neuroradiology fellowship PDs, providing direction and resources needed to lead a successful and compliant fellowship program.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital FDG-PET detects <i>MYD88</i> mutation-driven glycolysis in primary central nervous system lymphoma.","authors":"Mayu Sasaki, Yuri Teraoka, Ayumi Kato, Tadaaki Nakajima, Yoshinobu Ishiwata, Yohei Miyake, Hirokuni Honma, Taishi Nakamura, Naoki Ikegaya, Yutaro Takayama, Osamu Yazawa, Shungo Sawamura, Akito Oshima, Hiroaki Hayashi, Wei Kai Ye, Kanoko Sasaoka, Yukie Yoshii, Satoshi Fujii, Ukihide Tateishi, Tetsuya Yamamoto, Daisuke Utsunomiya, Shingo Kato, Kensuke Tateishi","doi":"10.3174/ajnr.A8935","DOIUrl":"https://doi.org/10.3174/ajnr.A8935","url":null,"abstract":"<p><strong>Background and purpose: </strong>The relationship between digital ¹⁸F-fluorodeoxyglucose positron emission tomography (dFDG-PET) findings and glucose metabolism-related genetic alterations remains unclear in primary central nervous system lymphoma (PCNSL). This study aimed to evaluate whether dFDG-PET can serve as a noninvasive tool to detect <i>MYD88</i> mutation-driven glycolytic activity in PCNSL.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the imaging and molecular data of 54 patients with PCNSL (55 lesions). MRI and FDG-PET parameters, including the maximum standardized uptake value (SUVmax) and tumor-to-background ratio (TBR), were assessed. Tumor specimens were subjected to histopathological and genomic evaluations, including the <i>MYD88</i> mutation status.</p><p><strong>Results: </strong>Among 55 tumors, 34 (61.8%) were examined with dFDG-PET and 21 (38.2%) with analog ¹⁸F-FDG-PET (aFDG-PET). In the dFDG-PET group, <i>MYD88</i>-mutant tumors showed significantly higher SUVmax (30.2 ± 9.9) and TBR (6.1 ± 1.5) compared to wild-type tumors (SUVmax: 19.3 ± 7.2, <i>P</i> = 0.006; TBR: 3.5 ± 1.3, <i>P</i> < 0.001). In the aFDG-PET group, the SUVmax was significantly higher in <i>MYD88</i>-mutant tumors (<i>P</i> = 0.01), whereas the TBR differences were not statistically significant (<i>P</i> = 0.38). Receiver operating characteristic analysis of TBR in dFDG-PET yielded an area under the curve of 0.913 (95% CI: 0.954-1.000) with a cutoff value of 4.49, achieving 88% sensitivity and 88% specificity for <i>MYD88</i> mutation detection. Multivariate logistic regression identified SUVmax and TBR from dFDG-PET as independent predictors of <i>MYD88</i> mutation status. The transcriptomic analysis confirmed the significant upregulation of glycolysis-related genes, including <i>hexokinase 2</i>, in <i>MYD88</i>-mutant tumors, supporting increased glycolytic activity.</p><p><strong>Conclusions: </strong>dFDG-PET may serve as a valuable noninvasive imaging modality to detect <i>MYD88</i> mutation-driven enhanced glycolysis in patients with PCNSL.</p><p><strong>Abbreviations: </strong>dPET＝ Digital positron emission tomography; PCNSL＝ Primary central nervous system lymphoma; SUVmax＝maximum standardized uptake value; TBR＝ tumor-to background ratio.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}