AJNR. American journal of neuroradiology最新文献

{"title":"Methionine PET Findings in the Diagnosis of Brain Tumors and Non-Tumorous Mass Lesions: A Single-Center Report on 426 Cases.","authors":"Yoshiki Shiba, Kosuke Aoki, Fumiharu Ohka, Shoichi Deguchi, Junya Yamaguchi, Hiroki Shimizu, Sachi Maeda, Yuhei Takido, Ryo Yamamoto, Akihiro Nakamura, Ryuta Saito","doi":"10.3174/ajnr.A8871","DOIUrl":"https://doi.org/10.3174/ajnr.A8871","url":null,"abstract":"<p><strong>Background and purpose: </strong>Differentiating between a brain tumor and a non-tumorous lesion remains a significant diagnostic challenge, particularly when conventional imaging modalities such as CT and MRI provide inconclusive results. While MET-PET has shown potential in neuro-oncology, its diagnostic performance across a broad spectrum of brain pathologies has not been comprehensively evaluated. This study therefore assessed the sensitivity, specificity, and uptake patterns of MET-PET in a large cohort of brain lesions.</p><p><strong>Materials and methods: </strong>This single-center retrospective study analyzed 426 consecutive patients with undiagnosed brain lesions who underwent MET-PET imaging between January 2019 and May 2024. TNRs were calculated using a threshold of 1.5 for positive findings. Histological diagnoses were established based on the World Health Organization 2021 criteria, IDH mutation status and 1p/19q-codeletion.</p><p><strong>Results: </strong>Among the cohort, 342 cases (67.8%) were confirmed as having tumorous lesions, 76 (17.8%) as having non-tumorous lesions, and 61 (14.3%) remained undiagnosed. MET-PET exhibited high sensitivity (86.2%) but limited specificity (47.4%) for tumor detection. In multiple sclerosis cases, MET-PET showed a remarkably high positivity rate (n = 10/12) that was significantly higher than for other non-tumorous lesions. In terms of tumors, IDH-wildtype glioblastomas had significantly higher TNRs compared to IDH-mutant gliomas, while oligodendrogliomas had higher TNRs compared to astrocytomas, in which TNR values correlated with tumor grade.</p><p><strong>Conclusions: </strong>MET-PET demonstrated robust sensitivity for brain tumor detection, but was limited by low specificity due to false positives in inflammatory conditions and false negatives for low-grade tumors. These findings imply the importance of integrating MET-PET with other imaging modalities to enhance diagnostic accuracy.</p><p><strong>Abbreviations: </strong>MET-PET＝¹¹C-methionine positron emission tomography; TNR＝Tumor/normal region ratio; IDH＝isocitrate dehydrogenase.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287443","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":"Contemporary Results of Mechanical Thrombectomy and Impact of First-Line Technique on Outcome: The INSPIRE-S Global Registry.","authors":"Marc Rodrigo-Gisbert, Marc Ribo, Markus Möhlenbruch, Sanjeev Nayak, Christophe Cognard, Jens Fiehler, Luc Defreyne, Eva González, Pedro Vega, Anderson Tsang, David Orion, Piotr Piasecki, Manuel Ribeiro, Andrés Fernández-Prieto, Jean C Gentric, Oscar Vila, Samer Elsheikh, Charlotte Barbier, Paolo Machi, Luc Stockx, Vincent Costalat, Pedro Lylyk, Alejandro González, Konstantinos Lagios, Olivier Naggara, Laurent Spelle, Jose A Larrea, Omer F Eker, Kyriakos Lobotesis, Riitta Rautio, Pasquale Mordasini","doi":"10.3174/ajnr.A8848","DOIUrl":"https://doi.org/10.3174/ajnr.A8848","url":null,"abstract":"<p><strong>Background and purpose: </strong>Three mechanical thrombectomy (MT) techniques are predominantly used for the treatment of acute ischemic stroke (AIS): stent retriever (SR) alone, aspiration (ASP) alone, and combination therapy (CT) with a general goal of achieving first-pass reperfusion (FPR: eTICI≥2c). Factors influencing FPR and the relative efficacy and safety of the 3 techniques are loosely understood.</p><p><strong>Materials and methods: </strong>INSPIRE-S is a prospective, imaging core-lab adjudicated, safety clinical events committee adjudicated, global registry of AIS patients treated with Medtronic Neurovascular devices on the first pass and grouped according to first-pass MT technique.</p><p><strong>Results: </strong>From May 2020 through December 2022, 802 patients (29 sites, 13 countries) who met eligibility criteria were enrolled in the INSPIRE-S registry and were grouped by first-pass MT technique (259 in SR, 146 in ASP, and 397 in CT). Overall, MCA-M1/M2 occlusions were present in 76.1% of patients, and the mean number of passes was 1.9±1.3. Among the techniques, the primary endpoint, good clinical outcome (mRS≤ 2 or mRS≤ pre-stroke mRS) at 90 days was achieved in 60.5% in SR, 52.8% in ASP, and 56.6% in CT (p>0.05 in unadjusted and adjusted analyses). The FPR rates were 48.6% in SR, 39.9% in ASP, and 47.5% in CT (p>0.05), and final complete (eTICI≥2c) reperfusion rates were 77.4% in SR, 70.6% in ASP, and 72.0% in CT (p>0.05 in adjusted analyses). In subgroup analyses by occlusion location, ASP had the lowest FPR in the ICA (p=0.003), while ASP was more frequently employed than SR for ICA (p=0.03). There was no significant difference in FPR among techniques when patients were treated with site-preferred technique. The overall rates of CEC-adjudicated all-cause mortality (14.0%) and sICH (1.5%) did not significantly differ among the techniques.</p><p><strong>Conclusions: </strong>The primary results of real-world data from INSPIRE-S showed overall high rates of first pass complete reperfusion and final clinical outcomes that were similar among the 3 MT techniques.</p><p><strong>Abbreviations: </strong>AIS＝ Acute Ischemic Stroke; CT＝ Combined technique; ASP＝ Aspiration alone; LVO＝ Large vessel occlusion; MT＝ Mechanical Thrombectomy; SR＝ Stent Retriever alone.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287440","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":"Clinical and Imaging Features of Primary Intradural Extramedullary Ewing Sarcoma.","authors":"Sahar Alizada, Rami W Eldaya, Hamza A Salim, Ceylan A Taslicay, Maria A Gubbiotti, Brian De, Shiao-Pei Weathers, Max Wintermark, Heba Al Qudah","doi":"10.3174/ajnr.A8872","DOIUrl":"https://doi.org/10.3174/ajnr.A8872","url":null,"abstract":"<p><p>Primary intradural extramedullary Ewing sarcoma (PIEES) is a very rare and aggressive tumor with poorly recognized radiological features. In this case series, we present our institutional experience with PIEES with emphasis on imaging and temporal evolution of the disease. In total, 8 patients with pathological diagnosis of PIEES were included in this study. All patients were symptomatic at time of presentation. MRI findings demonstrated T1 isointensity and T2 slightly hyperintensity relative to skeletal muscle, T2 hypointensity relative to CSF, and homogeneously enhancement in all cases with spinal cord edema/cord compression or cauda equina nerve roots compression. Tumor recurrence occurred in six patients (6/8, 75%). None of the patients developed recurrence outside the CNS. Four patients (50%) were deceased at the time of our study. In conclusion, PIEES is an extremely rare malignancy with poor outcomes. This case series highlights imaging features of PIEES and its temporal evolution including patterns of recurrence while reinforcing the importance of distinguishing PIEES from benign intradural lesions.ABBREVIATIONS: PIEES = Primary intradural extramedullary Ewing sarcoma, IQR = interquartile range, CI = confidence interval.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287439","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":"Automated Diffusion Analysis for Non-Invasive Prediction of IDH Genotype in WHO Grade 2-3 Gliomas.","authors":"Jiaming Wu, Stefanie C Thust, Stephen J Wastling, Gehad Abdalla, Massimo Benenati, John A Maynard, Sebastian Brandner, Ferran Prados Carrasco, Frederik Barkhof","doi":"10.3174/ajnr.A8776","DOIUrl":"https://doi.org/10.3174/ajnr.A8776","url":null,"abstract":"<p><strong>Background and purpose: </strong>Glioma molecular characterization is essential for risk stratification and treatment planning. Noninvasive imaging biomarkers such as apparent diffusion coefficient (ADC) values have shown potential for predicting glioma genotypes. However, manual segmentation of gliomas is time-consuming and operator-dependent. To address this limitation, we aimed to establish a single-sequence-derived automatic ADC extraction pipeline using T2-weighted imaging to support glioma isocitrate dehydrogenase (IDH) genotyping.</p><p><strong>Materials and methods: </strong>Glioma volumes from a hospital data set (University College London Hospitals; n=247) were manually segmented on T2-weighted MRI scans using ITK-Snap Toolbox and co-registered to ADC maps sequences using the FMRIB Linear Image Registration Tool in FSL, followed by ADC histogram extraction (Python). Separately, a nnUNet deep learning algorithm was trained to segment glioma volumes using T2w only from BraTS 2021 data (n=500, 80% training, 5% validation and 15% test split). nnUnet was then applied to the University College London Hospitals (UCLH) data for segmentation and ADC read-outs. Univariable logistic regression was used to test the performance manual and nnUNet derived ADC metrics for IDH status prediction. Statistical equivalence was tested (paired two-sided t-test).</p><p><strong>Results: </strong>nnUnet segmentation achieved a median Dice of 0.85 on BraTS data, and 0.83 on UCLH data. For the best performing metric (rADCmean) the area under the receiver operating characteristic curve (AUC) for differentiating IDH-mutant from IDHwildtype gliomas was 0.82 (95% CI: 0.78-0.88), compared to the manual segmentation AUC 0.84 (95% CI: 0.77-0.89). For all ADC metrics, manually and nnUNet extracted ADC were statistically equivalent (p<0.01). nnUNet identified one area of glioma infiltration missed by human observers. In 0.8% gliomas, nnUnet missed glioma components. In 6% of cases, over-segmentation of brain remote from the tumor occurred (e.g. temporal poles).</p><p><strong>Conclusions: </strong>The T2w trained nnUnet algorithm achieved ADC readouts for IDH genotyping with a performance statistically equivalent to human observers. This approach could support rapid ADC based identification of glioblastoma at an early disease stage, even with limited input data.</p><p><strong>Abbreviations: </strong>AUC = Area under the receiver operating characteristic curve, BraTS = The brain tumor segmentation challenge held by MICCAI, Dice = Dice Similarity Coefficient, IDH = Isocitrate dehydrogenase, mGBM = Molecular glioblastoma, ADCmin = Fifth ADC histogram percentile, ADCmean = Mean ADC value, ADCNAWM = ADC in the contralateral centrum semiovale normal white matter, rADCmin = Normalized ADCmin, VOI rADCmean = Normalized ADCmean.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268156","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 Practical Guide to Microtia Scoring: Step-by-Step.","authors":"Mark J Greenhill, Jada R Hislop, Nandini Govil, Manish Bajaj, Darragh Brady, Nadja Kadom","doi":"10.3174/ajnr.A8842","DOIUrl":"https://doi.org/10.3174/ajnr.A8842","url":null,"abstract":"<p><p>Radiologists play an important role in identifying anatomical abnormalities on temporal bone CT imaging in patients with microtia. This anatomical detail aids in identifying surgical candidates based on the Jahrsdoerfer score. Here, we review the temporal bone anatomy and pathology as it relates to the Jahrsdoerfer score to help radiologists in issuing accurate scoring for use in surgical decision-making. In this paper, we review the temporal bone anatomy and pathology as it relates to the Jahrsdoerfer score in order to help radiologists to methodically and accurately score temporal bone CTs accurately for use in surgical decision-making.ABBREVIATIONS: OW = oval window, MES = middle ear space, MIC = malleus-incus complex, ISJ = incudostapedial joint, RW = round window, EAC = External Auditory Canal FN = Facial Nerve.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251234","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":"CSF Venous Fistula Transvenous Onyx Embolization: Evaluation of Onyx Migration into the CSF and Potential One-way Physiology.","authors":"Charlotte E Michaelcheck, Waleed Brinjikji, Ajay A Madhavan, John C Benson, Jared T Verdoorn, Ben Johnson-Tesch, Jeremy Cutsforth-Gregory, Ian T Mark","doi":"10.3174/ajnr.A8746","DOIUrl":"https://doi.org/10.3174/ajnr.A8746","url":null,"abstract":"<p><strong>Background and purpose: </strong>CSF-venous fistulas (CVF) are abnormal connections between the subarachnoid space and a paraspinal vein. Transvenous Onyx embolization is a recently adopted treatment method for CVF closure, however no studies have specifically evaluated for Onyx migration into the CSF. The purpose of our study was to evaluate patients who underwent transvenous CVF embolization for Onyx migration into the CSF.</p><p><strong>Materials and methods: </strong>We evaluated 100 patients who underwent transvenous CVF embolization for post-treatment CT of the spine. Images were reviewed for Onyx migration into the CSF at the level of the embolization as well as distally in the lumbar spine. Basic demographic information including age and sex were recorded.</p><p><strong>Results: </strong>The mean age was 59.2 years (+/-10.9, 28-88). 68 were female. 48 patients had post-embolization imaging of the treated level, and none had Onyx migration into the CSF at the level of the CVF. 34 patients had imaging of the lumbar spine, and none had Onyx migration distally in the lumbar spine.</p><p><strong>Conclusions: </strong>Our study did not find any cases of unintended Onyx migration into the subarachnoid space in patients who underwent transvenous CVF embolization. This speaks to the safety profile of transvenous CVF embolization and suggests possible one-way physiology of CVF that allows for egress from the CSF to the veins only.</p><p><strong>Abbreviations: </strong>CVF＝ CSF venous fistula; DSM＝ digital subtraction myelography.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236213","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]-FDG Uptake as a Marker of Residual Anaplastic and Poorly Differentiated Thyroid Carcinoma following <i>BRAF</i>-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":"10.3174/ajnr.A8588","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neoadjuvant <i>BRAF</i>-directed therapy and immunotherapy followed by surgery improves survival in patients with <i>BRAF</i> ^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 noninvasively 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 <i>BRAF</i> ^V600E-mutant patients with ATC treated with at least 30 days of neoadjuvant <i>BRAF</i>-directed therapy and who underwent FDG-PET/CT within 30 days before surgery. The highest pathologic grade observed for every head and neck lesion resected was recorded. Each lesion on preoperative PET/CT was retrospectively characterized. The primary end point 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 by using a receiver operating characteristic analysis, and the ability of this threshold to noninvasively and preoperatively risk-stratify patients by overall survival was then evaluated with a Kaplan-Meier plot.</p><p><strong>Results: </strong>Thirty patients (mean age 66.5 ± 9.0; 17 men) 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 with low-risk pathologies: median SULmax 5.01 (interquartile range [IQR] 2.81-10.95) versus 1.29 (IQR 1.06-3.1) (<i>P</i> < .001, Mann-Whitney <i>U</i> 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 cutoff had a worse prognosis compared with patients without high-risk lesions in the head and neck: median overall survival for the former group was 259 days and was not attained for the latter (<i>P</i> = .038, log-rank test).</p><p><strong>Conclusions: </strong>Preoperative FDG-PET noninvasively identifies lesions with residual high-risk pathologies following neoadjuvant <i>BRAF</i>-directed targeted therapy and immunotherapy for <i>BRAF</i>-mutated ATC. FDG-PET avidity may serve as an early prognostic marker that correlates with residual high-risk pathology in <i>BRAF</i>-mutated ATC after neoadjuvant therapy.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1260-1267"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689923","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":"Effectiveness and Safety of Mechanical Thrombectomy in Mild Stroke due to Large-Vessel Occlusion: Insights from the ASSIST Registry.","authors":"Sophia Hohenstatt, Dominik F Vollherbst, Salvador Miralbés, Bharath Naravetla, Alejandro Spiotta, Christian Loehr, Mario Martínez-Galdámez, Ryan McTaggart, Luc Defreyne, Pedro Vega, Osama O Zaidat, Paul Jenkins, Sergio Lucio Vinci, David S Liebeskind, Rishi Gupta, Markus A Möhlenbruch, Agostino Tessitore","doi":"10.3174/ajnr.A8613","DOIUrl":"10.3174/ajnr.A8613","url":null,"abstract":"<p><strong>Background and purpose: </strong>Mechanical thrombectomy (MT) is effective for acute ischemic stroke, yet its indication in mild stroke remains unclear. This study evaluates the effectiveness and safety of MT in patients with low NIHSS scores and assesses the impact of different MT strategies on procedural success and clinical outcomes.</p><p><strong>Materials and methods: </strong>Data from the ASSIST Registry were analyzed. We categorized patients with large-vessel occlusion of the anterior circulation into mild (NIHSS ≤5) and moderate-severe (NIHSS >5) stroke groups. Baseline characteristics, procedural parameters, angiographic and imaging outcomes, clinical outcomes, and safety end points were compared. Within the mild stroke subgroup, outcomes were compared between different MT techniques.</p><p><strong>Results: </strong>Among 1360 patients with large-vessel occlusion, 122 had minor ischemic strokes (9%). Patients with mild stroke had high rates of excellent functional outcomes (mRS 0-1) at 90 days (77.1%) and functional independence (mRS 0-2) (85.7%). Procedural success rates were similar between NIHSS groups, while safety outcomes, except mortality, were comparable. No statistically significant differences were observed in treatment techniques within the mild stroke subgroup. Significant predictors of early neurologic deterioration (END) in patients with mild stroke were the total number of passes (OR, 1.49; 95% CI, 1.01-2.19; <i>P</i> = .04) and total procedural time (OR, 1.02; 95% CI, 1.01-1.04; <i>P</i> = .01). Patients with END were more likely to have an unfavorable functional outcome (mRS 3-6) at 90 days (89% versus 6%, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>MT is effective and safe in patients with mild stroke. Procedural success did not vary among MT techniques in mild stroke. The total number of passes predict END, which suggests a causal pathway that requires further exploration.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1130-1136"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775551","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":"Dissociation of Structural and Functional Connectivity and Metabolism in the Neocortex of Idiopathic Generalized Epilepsy: A Simultaneous PET/MRI Multimodal Study.","authors":"Chenyang Yao, Jie Hu, Bixiao Cui, Jingjuan Wang, Zhen-Ming Wang, Yaqin Hou, Kharel Sudeep, Hongwei Yang, Yihe Wang, Yongzhi Shan, Jie Lu","doi":"10.3174/ajnr.A8612","DOIUrl":"10.3174/ajnr.A8612","url":null,"abstract":"<p><strong>Background and purpose: </strong>Idiopathic generalized epilepsy (IGE) accounts for approximately 20% of epilepsy cases. Characterized by generalized spike-wave discharge, IGE is increasingly recognized as a network disorder with potential metabolic underpinnings. This study leverages the advantages of simultaneous PET/MRI, which enables the concurrent acquisition of MRI and PET data, to integrate structural connectivity (SC), functional connectivity (FC), and glucose metabolism into a unified framework. This study aims to elucidate the multimodal abnormalities of the neocortex in IGE, to analyze the correlations between these abnormalities and clinical presentations, and to investigate the interactions among different imaging modalities.</p><p><strong>Materials and methods: </strong>Twenty-one patients with IGE and 34 healthy controls (HCs) were recruited. Simultaneous PET/MRI scans were performed, incorporating DTI, resting-state fMRI, and [¹⁸F]FDG-PET. DTI generated a neocortical connectivity blueprint, while resting-state fMRI provided a whole-brain connectivity matrix. [¹⁸F]FDG-PET data were processed to obtain standardized uptake value ratios (SUVRs). Multivariate distance matrix regression was used to identify abnormal neocortical regions in SC and FC. Differences in SUVRs were identified by using least absolute shrinkage and selection operator regression. Statistical analyses, including <i>t</i> tests, linear models, mediation analysis, and Pearson correlations, were conducted to compare values of each technique between groups and explore relationships with clinical features.</p><p><strong>Results: </strong>SC abnormalities were primarily found in the limbic (40% of all abnormal neocortical regions) and visual networks (31%), while FC abnormalities were mostly in the default mode network (DMN, 45%). Metabolic abnormalities were predominantly in the frontoparietal (26%) and somatomotor (22%) networks. SC in the limbic was positively correlated with onset age, while seizure frequency was negative correlated with DMN FC and positively correlated with frontoparietal metabolism. Mediation analysis showed that DMN FC mediated the relationship between limbic SC and frontoparietal and somatomotor metabolism.</p><p><strong>Conclusions: </strong>A multimodal approach reveals distinct and interrelated abnormalities in IGE, with different modalities reflecting various aspects of the disease, thus enhancing our understanding of its complex mechanisms. This integrative analysis could inform more effective treatments.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1208-1215"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627145","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":"Decreased Visibility of Deep Medullary Vein Associated with Cerebral Small Vessel Disease Burden through Increased Interstitial Fluid in White Matter.","authors":"Zhihua Xu, Haiyuan Lan, Xinjun Lei, Hongxia Zhang, Fanfan Xiong, Lebing Wang","doi":"10.3174/ajnr.A8632","DOIUrl":"10.3174/ajnr.A8632","url":null,"abstract":"<p><strong>Background and purpose: </strong>Decreased visibility of deep medullary veins (DMVs) on susceptibility-weighted imaging (SWI) has been reported in individuals with cerebral small vessel disease (CSVD). This study aims to explore the relationship between the decreased visibility of the DMV, interstitial fluid (ISF), and the CSVD burden.</p><p><strong>Materials and methods: </strong>Patients with CSVD (<i>n</i> = 128) were enrolled with multimode MRI. The DMV score was used to score visibility of DMVs on SWI. ISF was evaluated by mean free water (FW) on diffusion tensor imaging in white matter. CSVD burden was evaluated, including the severity of each CSVD marker at MRI and total CSVD MR score.</p><p><strong>Results: </strong>The DMV score was associated with the severity of each CSVD imaging marker and total CSVD MR score (<i>P</i> < .05). Further, the indirect effect of the DMV score on the severity of CSVD imaging makers [white matter hyperintensity (WMH), cerebral microbleed (CMB) and lacunar infarct (LI)] and total CSVD MR score mediated by FW was significant [WMH: β, 95% CI: 0.13 (0.05, 0.24); LI: β, 95% CI: 0.19 (0.06, 0.32); CMB: β, 95% CI: 0.13 (0.01, 0.30); total CSVD MR score: β, 95% CI: 0.16 (0.05, 0.29)] controlling with age and vascular risk factors.</p><p><strong>Conclusions: </strong>The DMV score was associated with the CSVD burden through FW in white matter in individuals with CSVD and may describe a venous aspect of the pathogenesis of the CSVD burden.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1112-1119"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082750","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}