AJNR. American journal of neuroradiology最新文献

{"title":"The cortical vein opacification score (COVES) is independently associated with DSA ASITN collateral score.","authors":"Dhairya A Lakhani, Aneri B Balar, Subtain Ali, Musharaf Khan, Hamza Salim, Manisha Koneru, Sijin Wen, Richard Wang, Janet Mei, Argye E Hillis, Jeremy J Heit, Greg W Albers, Adam A Dmytriw, Tobias D Faizy, Max Wintermark, Kambiz Nael, Ansaar T Rai, Vivek S Yedavalli","doi":"10.3174/ajnr.A8601","DOIUrl":"https://doi.org/10.3174/ajnr.A8601","url":null,"abstract":"<p><p><u>Background</u> : Pretreatment CTA-based Cortical Vein Opacification Score (COVES) has been shown to predict good functional outcomes at 90 days in patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO). This is thought to be related to its ability to measure collateral status (CS). However, its association with the reference standard test, the DSA-based American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score, has yet to be established. Therefore, this study assesses the relationship between COVES and ASITN CS.<u>Methods</u> : In this prospectively collected, retrospectively reviewed analysis, patients with anterior circulation LVO from September 1, 2017, to October 1, 2023, were included. The COVES grading, which ranges from 0 to 6, was independently assessed by two board-certified neuroradiologists. The ASITN CS was independently assessed by a board-certified neuroradiologist and the performing neurointerventionalist. Any discrepancies were resolved through consensus review. Spearman's rank correlation, univariable logistic regression, multivariable logistic regression, and receiver operating characteristic curve analysis were performed. A p-value of ≤0.05 was considered significant.<u>Results</u> : In total, 311 consecutive patients (median, IQR=68 years [59-78 years]; 55.9% female) met our inclusion criteria. There was significant positive correlation between COVES and ASITN CS (ρ=0.41,p<0.001), and higher COVES was significantly and independently associated with good ASITN CS (unadjusted-OR=1.74,p<0.001) and adjusted-OR=1.73, p<0.001). ROC analysis showed AUC of 0.71, p<0.001).<u>Conclusion</u> : In conclusion, by demonstrating the independent association of COVES with the reference standard test for collateral status assessment, the ASITN CS, we further validate the role of COVES in estimating collateral status.ABBREVIATIONS: AIS: Acute ischemic stroke; ASITN: American Society of Interventional and Therapeutic Neuroradiology; CS: Collateral status; COVES: Cortical Vein Opacification Score; HIR: Hypoperfusion Intensity Ratio; IVT: Intravenous thrombolysis; LVO: Large vessel occlusion; mRS: modified Rankin score; MT: mechanical thrombectomy; OR: odds ratio; aOR: adjusted odds ratio; ua: unadjusted odds ratio; rCBF: relative cerebral blood flow; Tmax: Time-to-Maximum.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694083","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":"[18F]-Fluorodeoxyglucose Uptake as a Marker of Residual Anaplastic and Poorly Differentiated Thyroid Carcinoma Following BRAF-Targeted Therapy.","authors":"Samir A Dagher, Kim O Learned, Richard Dagher, Jennifer Rui Wang, Xiao Zhao, S Mohsen Hosseini, Anastasios Maniakas, Maria E Cabanillas, Naifa L Busaidy, Ramona Dadu, Priyanka Iyer, Mark E Zafereo, Alexander M Khalaf","doi":"10.3174/ajnr.A8588","DOIUrl":"https://doi.org/10.3174/ajnr.A8588","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neoadjuvant BRAF-directed therapy and immunotherapy followed by surgery improves survival in patients with BRAF^V600E-mutant anaplastic thyroid carcinoma (ATC), more so in those who have complete ATC pathologic response. This study assesses the ability of FDG-PET to non-invasively detect residual high-risk pathologies including ATC and poorly differentiated thyroid carcinoma (PDTC) in the preoperative setting.</p><p><strong>Materials and methods: </strong>This retrospective, single-center study included consecutive BRAF^V600E-mutant ATC patients treated with at least 30 days of neoadjuvant BRAF-directed therapy and who underwent FDG-PET/CT within 30 days prior to surgery. The highest pathologic grade observed for every head and neck lesion resected was recorded. Each lesion on pre-operative PET/CT was retrospectively characterized. The primary endpoint was to contrast the standardized uptake normalized by lean body mass (SULmax) for lesions with residual high-risk (ATC, PDTC) versus low-risk pathologies (papillary thyroid carcinoma, negative). An optimal SULmax threshold was then identified using a ROC analysis, and the ability of this threshold to non-invasively and preoperatively risk-stratify patients by overall survival was then evaluated with a Kaplan-Meier plot.</p><p><strong>Results: </strong>30 patients (mean age 66.5±9.0; 17 males) were included in this study, with 94 surgically sampled lesions. Of these lesions, 57 (60.6%) were low-risk (39 negative, 18 papillary thyroid carcinoma) and 37 (39.4%) were high-risk (29 ATC, 8 PDTC). FDG uptake was higher for high-risk compared to low-risk pathologies: median SULmax 5.01 [IQR 2.81 - 10.95] versus 1.29 [IQR 1.06 - 3.1] (P<.001, Mann-Whitney U test). The sensitivity, specificity, and accuracy for detecting high-risk pathologies at the optimal threshold of SULmax ≥ 2.75 were 0.784 [95% CI 0.628-0.886], 0.702 [95% CI 0.573-0.805], and 0.734 [95% CI 0.637-0.813], respectively. Patients with at least 1 high-risk lesion identified with the aforementioned cut-off had a worse prognosis compared to patients without high-risk lesions in the head and neck: median OS for the former group was 259 days and was not attained for the latter (P=.038, log-rank test).</p><p><strong>Conclusions: </strong>Preoperative FDG-PET non-invasively identifies lesions with residual high-risk pathologies following neoadjuvant BRAF-directed targeted therapy and immunotherapy for BRAF-mutated ATC. FDG-PET avidity may serve as an early prognostic marker which correlates with residual high-risk pathology in BRAF-mutated ATC following neoadjuvant therapy.</p><p><strong>Abbreviations: </strong>ATC = anaplastic thyroid carcinoma; IQR = interquartile range; OS = overall survival; PDTC = poorly differentiated thyroid carcinoma; PTC = papillary thyroid carcinoma; ROC = receiver operating characteristic; SUL= standardized uptake value normalized by lean body mass.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689923","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":"Contrast Enhanced CISS/FIESTA Imaging for Increased Conspicuity of Pituitary Microadenomas in Cushing Disease.","authors":"Ian T Mark, Jamie Van Gompel, Maria Peris Celda, Eric G Stinson, Irina Bancos, Lucinda M Gruber, Jason T Little, Derek R Johnson, Steven A Messina","doi":"10.3174/ajnr.A8596","DOIUrl":"https://doi.org/10.3174/ajnr.A8596","url":null,"abstract":"<p><strong>Background and purpose: </strong>Pituitary microadenomas can be challenging to see on MRI, particularly when they are small. The detection of microadenomas commonly relies on contrast-enhanced sequences, highlighting the adenoma that demonstrates hypoenhancement relative to the native pituitary on T1-weighted sequences. Detecting adenomas in patients with Cushing disease is crucial, as surgery is the standard of care treatment. Accurate pre-operative lesion localization is directly associated with improved outcomes. The purpose of our study was to determine the utility of contrast-enhanced CISS/FIESTA-C for identifying pituitary microadenomas in patients with Cushing disease.</p><p><strong>Materials and methods: </strong>This cross-sectional study retrospectively reviewed pituitary MR images in patients with Cushing disease who had post-contrast CISS/FIESTA-C. Images were evaluated for lesion conspicuity (well-defined margins), as well as the signal intensity of the adenoma and native pituitary. The normalized signal intensity difference (nSID) was calculated by subtracting the lesion signal intensity from the pituitary signal intensity, and dividing by the pituitary signal intensity. Patient age, sex, and diagnosis based on intraoperative findings, pathology results, and post-operative adrenal insufficiency were recorded.</p><p><strong>Results: </strong>17 patients (15 female) were included in this study. 16 (94%) adenomas were discrete on CISS/FIESTA-C compared to 11 (65%) on T1-weighted imaging. The mean adenoma nSID with CISS/FIESTA-C was 0.512 (SD 0.12), relative to 0.242 (SD 0.15) on T1-weighted imaging (p<0.001).</p><p><strong>Conclusion: </strong>In comparison to MRI T1-weighted images, contrast-enhanced CISS/FIESTA-C imaging detects a higher number of pituitary microadenomas with superior conspicuity. As up to 50% of patients with Cushing disease present without a pituitary lesion detect on MRI, post contrast CISS/FIESTA-C may be especially valuable as an additional sequence in this population.</p><p><strong>Abbreviations: </strong>CISS = Constructive interference in steady state; FIESTA-C = fast imaging employing steady-state acquisition with cycling; SI = Signal Intensity, nSID = normalized signal intensity difference.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689925","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":"Laser Interstitial Thermal Therapy for Intra-Axial Brain Tumors: Everything the Neuroradiologist Should Know.","authors":"Anneliese F Rademacher, Hassan A Fadel, Jacob A Pawloski, Mia Ma, Ken N Nkongchu, Ian Y Lee, Arafat Y Ali","doi":"10.3174/ajnr.A8427","DOIUrl":"https://doi.org/10.3174/ajnr.A8427","url":null,"abstract":"<p><p>Laser interstitial thermal therapy (LITT) is a minimally invasive cytoreductive treatment option for patients with intracranial tumors. Utilizing real-time MR thermometry, LITT delivers tailored, targeted, and permanent cytotoxic thermal injury to intra-axial pathology. As a minimally invasive and nonionizing treatment option proved to be an effective, less morbid, and more efficient alternative to surgery, the utility of LITT has rapidly expanded. Along with this growth comes the need for neurosurgeons and neuroradiologists to accurately assess the radiographic outcomes of LITT in a standardized, dependable, and longitudinal fashion. We present a comprehensive overview of the indications and mechanisms of action of LITT for intra-axial brain tumors as well as guidance on thorough pre-, intra-, and postoperative imaging assessments. Using detailed case examples describing the contemporary uses of LITT, we hope to provide a foundational understanding of LITT that will inform imaging assessment and guide accurate multi disciplinary tumor board discussion.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689929","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":"Does Long-Term Surveillance Imaging Improve Survival in Patients Treated for Head and Neck Squamous Cell Carcinoma? A Systematic Review of the Current Evidence.","authors":"Pattana Wangaryattawanich, Yoshimi Anzai, Carolyn Mead-Harvey, Diana Almader-Douglas, Tanya J Rath","doi":"10.3174/ajnr.A8392","DOIUrl":"10.3174/ajnr.A8392","url":null,"abstract":"<p><strong>Background: </strong>Long-term posttreatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months.</p><p><strong>Purpose: </strong>We performed a systematic review to evaluate the impact of long-term imaging surveillance (ie, imaging beyond 6 months following completion of treatment) on survival in patients treated definitively for head and neck squamous cell carcinoma.</p><p><strong>Data sources: </strong>A search was conducted on PubMed, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma.</p><p><strong>Study selection: </strong>We screened 718 abstracts and performed full-text review for 95 abstracts, with 2 articles meeting the inclusion criteria. The Risk of Bias in Non-Randomized Studies of Interventions assessment tool was used.</p><p><strong>Data analysis: </strong>A qualitative assessment without a pooled analysis was performed for the 2 studies meeting inclusion criteria.</p><p><strong>Data synthesis: </strong>No randomized prospective controlled trials were identified. Two retrospective 2-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having a moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to different conclusions, with 1 study reporting a survival benefit for long-term surveillance imaging with FDG-PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit.</p><p><strong>Limitations: </strong>Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma.</p><p><strong>Conclusions: </strong>There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of a standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multicenter registry assessing outcomes.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447777","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":"Diagnostic Confidence of Contrast-Enhanced T1-Weighted MRI for the Detection of Brain Metastases: 3D FSE-vs. 3D GRE-Based Sequences.","authors":"Maria Gule-Monroe, Nathan Chasen, James P Long, Vinodh A Kumar, Komal Shah, Melissa Chen, Jason Stafford, Caroline Chung, Max Wintermark, Ping Hou, Ekta Sura, Chenyang Wang, Jeffrey Weinberg, Ho-Ling Liu","doi":"10.3174/ajnr.A8590","DOIUrl":"https://doi.org/10.3174/ajnr.A8590","url":null,"abstract":"<p><strong>Background and purpose: </strong>This retrospective study evaluated the utility of contrast-enhanced (CE) T1-weighted 3D fast spinecho-based SPACE sequences for brain metastasis detection on 3T MRI compared to gradient recalled-echo-based 3D fast low-angle shot (FLASH) sequence.</p><p><strong>Materials and methods: </strong>We identified all patients at a single institution who underwent SPACE and 3D FLASH sequences as part of a practice quality improvement project. Their medical records were retrospectively reviewed. Five certified neuroradiologists reviewed the images, with at least 2 weeks separation between scoring sequences for the same patient. The following parameters were evaluated: number of metastatic lesions, number of indeterminate lesions, lesion margin, contrast-to-noise ratio (CNR), extent of image artifacts, and overall image quality. CNR was also quantified for solidly enhancing lesions > 1 cm.</p><p><strong>Results: </strong>We identified 220 patients who underwent SPACE and 3D FLASH sequences (the order of the sequences was equally distributed). Of these, 79 had brain metastases on imaging, and 7 were excluded; thus, 72 patients were included in the study. Twenty patients were scored by 2 radiologists. Out of the 92 evaluations, SPACE detected more lesions than did 3D FLASH in 35, while 3D FLASH detected more lesions in 10. More indeterminate lesions were seen on 3D FLASH (27) than on SPACE (9). For lesion margin, CNR, and overall image quality on a Likert scale, SPACE performed significantly better than did 3D FLASH, with less image artifacts (<i>P</i> < 0.00001). Higher quantitative CNRs were found on SPACE than on 3D FLASH images, although this result was not statistically significant (median = 22.9 vs. 15.5, respectively, <i>P</i> = 0.134). There was a high inter-reader lesion detection concordance with Krippendorf's alpha ordinals at 0.962 for SPACE, 0.870 for 3D FLASH, and 0.918 for the two sequences combined.</p><p><strong>Conclusions: </strong>Compared with 3D FLASH, the SPACE sequence detected more metastatic lesions and was rated higher for image quality, lesion margin, and CNR, with fewer artifacts. Importantly, the SPACE sequence resulted in increased reader confidence, with fewer indeterminate lesions detected.</p><p><strong>Abbreviations: </strong>FLASH = fast low-angle shot; FSE = fast spin-echo; GRE = gradient-recalled echo; MP-RAGE = magnetization-prepared rapid gradient echo; SPACE = Sampling Perfection with Application-optimized Contrasts using different flip angle Evolution; VIBE = volumetric interpolated breath-hold examination.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689927","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":"Gadolinium-Enhanced T2 FLAIR is an Imaging Biomarker of Radiation Necrosis and Tumor Progression in Patients with Brain Metastases.","authors":"Chris Heyn, Jonathan Bishop, Alan R Moody, Tony Kang, Erin Wong, Peter Howard, Pejman Maralani, Sean Symons, Bradley J MacIntosh, Julia Keith, Mary Jane Lim-Fat, James Perry, Sten Myrehaug, Jay Detsky, Chia-Lin Tseng, Hanbo Chen, Arjun Sahgal, Hany Soliman","doi":"10.3174/ajnr.A8431","DOIUrl":"10.3174/ajnr.A8431","url":null,"abstract":"<p><strong>Background and purpose: </strong>Differentiating radiation necrosis (RN) from tumor progression (TP) after radiation therapy for brain metastases is an important clinical problem requiring advanced imaging techniques that may not be widely available and are challenging to perform at multiple time points. The ability to leverage conventional MRI for this problem could have a meaningful clinical impact. The purpose of this study was to explore contrast-enhanced T2 FLAIR (T2FLAIRc) as a new imaging biomarker of RN and TP.</p><p><strong>Materials and methods: </strong>This single-institution retrospective study included patients with treated brain metastases undergoing DSC-MRI between January 2021 and June 2023. Reference standard assessment was based on histopathology or serial follow-up, including the results of DSC-MRI for a minimum of 6 months from the first DSC-MRI. The index test was implemented as part of the institutional brain tumor MRI protocol and preceded the first DSC-MRI. T2FLAIRc and gadolinium-enhanced T1 (T1c) MPRAGE signal were normalized against normal brain parenchyma and expressed as a <i>z</i> score. The mean signal intensity of enhancing disease for the RN and TP groups was compared using an unpaired <i>t</i> test. Receiver operating characteristic curves and area under the receiver operating characteristic curve (AUC) were derived by bootstrapping. The DeLong test was used to compare AUCs.</p><p><strong>Results: </strong>Fifty-six participants (mean age, 62 [SD, 12.7] years; 39 women; 28 with RN, 28 with TP) were evaluated. The index MRI was performed, on average, 73 [SD, 34] days before the first DSC-MRI. Significantly higher <i>z</i> scores were found for RN using T2FLAIRc (8.3 versus 5.8, <i>P</i> < .001) and T1c (4.1 versus 3.5, <i>P </i>= .02). The AUC for T2FLAIRc (0.83; 95% CI, 0.72-0.92) was greater than that for T1c (0.70; 95% CI, 0.56-0.83) (<i>P </i>= .04). The AUC of DSC-derived relative CBV (0.82; 95% CI, 0.70-0.93) was not significantly different from that of T2FLAIRc (<i>P </i>= .9).</p><p><strong>Conclusions: </strong>A higher normalized T1c and T2FLAIRc signal intensity was found for RN. In a univariable test, the mean T2FLAIRc signal intensity of enhancing voxels showed good discrimination performance for distinguishing RN from TP. The results of this work demonstrate the potential of T2FLAIRc as an imaging biomarker in the work-up of RN in patients with brain metastases.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899130","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":"Flexible Array Coil for Cervical and Extraspinal (FACE) for MR Neurography of the Occipital Nerves at 3 Tesla.","authors":"Yenpo Lin, Ek T Tan, Martijn Lunenburg, Shayna Turbin, Lisa Gfrerer, Darryl B Sneag","doi":"10.3174/ajnr.A8597","DOIUrl":"https://doi.org/10.3174/ajnr.A8597","url":null,"abstract":"<p><p>This technical report describes use of a novel, conformable receive-only radiofrequency coil for 3T magnetic resonance (MR) neurography in a cohort of patients with occipital neuralgia. Applying a sub-millimeter, isotropic three-dimensional double-echo steady-state sequence, detailed visualization of the occipital nerves and associated pathologies could be achieved.ABBREVIATIONS: ABC＝ definition; XYZ＝ definition. FACE＝ Flexible Array coil for Cervical and Extraspinal; DESS＝ double-echo steady-state; C1, C2, C3＝ First, second, and third cervical vertebrae respectively.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689928","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":"A Review of The Opportunities and Challenges with Large Language Models in Radiology: The Road Ahead.","authors":"Neetu Soni, Manish Ora, Amit Agarwal, Tianbao Yang, Girish Bathla","doi":"10.3174/ajnr.A8589","DOIUrl":"https://doi.org/10.3174/ajnr.A8589","url":null,"abstract":"<p><p>In recent years, generative artificial intelligence (AI), particularly large language models (LLMs) and their multimodal counterparts, Multi-Modal Large Language Models (MM-LLMs), including Vision Language Models (VLMs), have generated considerable interest in the global AI discourse. LLMs, or pre-trained language models (such as ChatGPT, Med-PaLM, LLaMA, etc.), are neural network architectures trained on extensive text data, excelling in language comprehension and generation. MM-LLMs, a subset of foundation models, are trained on multimodal datasets, integrating text with another modality, such as images, to better learn universal representations akin to human cognition. This versatility enables them to excel in tasks like chatbots, translation, and creative writing while facilitating knowledge sharing through transfer learning, federated learning, and synthetic data creation.Several of these models can have potentially appealing applications in the medical domain, including, but not limited to, enhancing patient care by processing patient data, summarizing reports and relevant literature, providing diagnostic, treatment, and follow-up recommendations, and ancillary tasks like coding and billing. As radiologists enter this promising but uncharted territory, it is imperative for them to be familiar with the basic terminology and processes of LLMs. Herein, we present an overview of the LLMs and their potential applications and challenges in the imaging domain.ABBREVIATIONS: AI: Artificial Intelligence; BERT: Bidirectional Encoder Representations from Transformers; CLIP: Contrastive Language-Image Pretraining; FM: Foundation Models; GPT: Generative Pre-trained Transformer; LLM: Large language model; NLP: natural language processing; VLM: Vision Language Models.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689924","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":"CT-Guided Epidural Contrast Injection for the Identification of Dural Defects.","authors":"Ian T Mark, Michael Oien, John Benson, Jared Verdoorn, Ben Johnson-Tesch, D K Kim, Jeremy Cutsforth-Gregory, Ajay A Madhavan","doi":"10.3174/ajnr.A8437","DOIUrl":"10.3174/ajnr.A8437","url":null,"abstract":"<p><p>Post-dural puncture headache is an increasingly recognized cause of chronic headache. Outside of clinical history and myelography that requires an additional dural puncture, there is no reliable diagnostic test to evaluate for persistent dural defects. We describe the injection of iodinated contrast into the dorsal epidural space under CT guidance in 5 patients as a potential tool to visualize persistent dural defects.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972422","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}