Journal Of Neuroimaging[JOURNAL]
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200 papers
Distal Access Catheter Improves Balloon Guide and Stent Retriever Thrombectomy Outcomes in Nonagenarians.
Puig J, Werner M, Dolz G … +28 more , Pascagaza A, Daunis-I-Estadella P, Comas-Cufí M, González E, Fondevila J, Vega P, Murias E, Romero V, Martínez C, Aparici-Robles F, Morales-Caba L, Remollo S, Rodríguez-Caamaño I, Pérez-García C, Rosati S, Bashir S, Vielba-Gomez I, Aixut S, Paipa AJ, Martínez-Fernández J, Aguilar Y, Fandiño E, Barbieri G, García-Villalba B, Cuba V, Castaño M, Blasco J, ROSSETTI Group
J Neuroimaging · 2025 · PMID 39803799 · Full text
BACKGROUND AND PURPOSE: The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonage...
BACKGROUND AND PURPOSE: The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR). METHODS: We analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group). Demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale score at 24 h [24h-NIHSS] and modified Rankin Scale score at 3 months) were compared. Predictors of the first-pass effect (FPE), defining Modified Treatment In Cerebral Ischemia 2c-3 (mTICI 2c-3) after one pass, were explored. RESULTS: Of the 4111 patients from the ROSSETTI registry, 243 nonagenarians (68.7% female) were included in the analysis. The distribution of endovascular techniques was 101-group (61.4%), 111-group (15.6%), and 011-group (23%). The 101-group and 111-group had significantly shorter procedural times than the 011-group. The 111-group had a higher FPE rate, a lower number of passes, and a higher rate of final mTICI ≥2c than the other groups. The 24h-NIHSS score was significantly lower in the 111-group. In multivariate analysis, the only independent predictor for FPE was the BGC+DAC+SR endovascular technique (odds ratio 2.74 [confidence interval 1.16-6.47]; p = 0.021). CONCLUSIONS: The addition of a DAC to a BGC increases the likelihood of FPE in nonagenarians with anterior circulation LVO SR-based thrombectomy for acute stroke.
Transcranial Doppler Arterial Pressure Gradient Is Associated With Delayed Infarction After Subarachnoid Hemorrhage.
Kim Y, Kim A, Williams JD … +8 more , Withington C, Tefera E, Gizaw S, Felbaum DR, Mai JC, Liu AH, Armonda RA, Chang JJ
J Neuroimaging · 2025 · PMID 39803790 · Full text
BACKGROUND AND PURPOSE: While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in pat...
BACKGROUND AND PURPOSE: While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (ΔP) can be estimated using PI, we investigated the potential significance of TCD-estimated ΔP. METHODS: In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures. Using a previously reported mathematical model, we estimated ΔP by dividing pulse pressure by PI. We investigated the association between ΔP and mCBFV values and two acute phase complications of SAH-DCI and angiographic vasospasm. Additionally, we explored the association between DCI, vasospasm, and 90-day functional outcome. RESULTS: Elevated ΔP was associated with DCI (odds ratio [OR] 1.021, 95% confidence interval [CI] 1.004-1.039, p = 0.014) but not vasospasm (OR 1.006, 95% CI 0.991-1.022, p = 0.402). Elevated mCBFV was associated with vasospasm (OR 1.037, 95% CI 1.017-1.057, p < 0.001) but not DCI (OR 0.998, 95% CI 0.979-1.018, p = 0.873). DCI (OR 29.380, 95% CI 2.930-294.615, p = 0.004), rather than vasospasm (OR 0.695, 95% CI 0.120-4.043, p = 0.686), was associated with functional outcome. CONCLUSIONS: Increased ΔP, rather than elevated mCBFV, was associated with DCI. While elevated mCBFV was associated with vasospasm, it was not associated with DCI. Hence, TCD-estimated ΔP may serve as a predictor for the DCI in SAH patients, a condition that impacts long-term outcome.
Utilizing Quantitative Analysis of CSF Volume from Clinical T1-Weighted MRI to Predict Thrombectomy Outcomes.
Kawas MI, Shamulzai A, Atcheson KM … +9 more , Horn AC, Ma R, Kittel C, Curry B, Lipford M, Kim J, Solingapuram Sai KK, Wolfe SQ, Whitlow CT
J Neuroimaging · 2025 · PMID 39803742 · Full text
BACKGROUND AND PURPOSE: Endovascular thrombectomy (EVT) is the standard for acute ischemic stroke from large vessel occlusion, but post-EVT functional independence varies. Brain atrophy, linked to higher cerebrospinal fl...
BACKGROUND AND PURPOSE: Endovascular thrombectomy (EVT) is the standard for acute ischemic stroke from large vessel occlusion, but post-EVT functional independence varies. Brain atrophy, linked to higher cerebrospinal fluid volume (CSFV), may affect outcomes. Baseline CSFV could predict EVT benefit by assessing brain health. We aimed to quantify total CSFV from clinical T1-weighted (w) magnetic resonance imaging (MRI) to assess global brain atrophy and its association with functional outcomes following successful EVT. METHODS: We performed a retrospective analysis of patients achieving thrombolysis-in-cerebral-infarction ≥2b revascularization via prospectively maintained single-institution stroke thrombectomy registry (n = 432) between 2015 and 2021. We included 214 patients (mean age 67.5 ± 14.6, 49% female) with acceptable quality MRI within 14 days of EVT and available modified Rankin-scale (mRS) at 90 days post EVT. Clinical T1w images were transformed into high-resolution images using the convolutional neural-network SynthSR. FreeSurfer software was then used to estimate total cranial CSFV. To correct for head size, percentage of CSFV to intracranial volume was used. RESULTS: Baseline CSFV% significantly predicted 90-day mRS in an ordinal regression model adjusted for baseline mRS (p < 0.001). Further modeling was performed to account for age, sex, 24-h National-Institutes-Health-Stroke-Scale (NIHSS), smoking history, prior stroke, hypertension, congestive heart failure, hemoglobin-A1c, atrial fibrillation, and Alberta-Stroke-Program-Early-CT-Score (ASPECTS). Total CSFV% remained an independent predictor of 90-day mRS (p = 0.012). CSFV% did not significantly predict the occurrence of any type of hemorrhagic transformation in a logistic regression model. CONCLUSIONS: Increased CSFV% correlates with poorer functional outcomes post EVT. Total CSFV% may serve as a useful imaging biomarker for clinicians determining patient prognostication prior to EVT.
Longitudinal Serotonergic and Dopaminergic Binding: Impact on Parkinson's Disease Progression and Levodopa Dyskinesia.
Jeong EH, Lee JY, Song YS
J Neuroimaging · 2025 · PMID 39800858 · Publisher ↗
BACKGROUND AND PURPOSE: We investigated the relationship between serotonergic and dopaminergic specific binding transporter ratios (SBRs) over 4 years in Parkinson's disease (PD) patients. We assessed serotonergic innerv...
BACKGROUND AND PURPOSE: We investigated the relationship between serotonergic and dopaminergic specific binding transporter ratios (SBRs) over 4 years in Parkinson's disease (PD) patients. We assessed serotonergic innervation's potential compensatory role for dopaminergic denervation, association with PD symptoms, and involvement in the development of levodopa-induced dyskinesia (LID). METHODS: SBRs of the midbrain and striatum were evaluated from [I-123] N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane SPECT images at baseline and after 4 years. Correlations between SBRs and PD symptoms were analyzed, alongside interval changes. RESULTS: Study included 177 PD patients (110 males, 67 females; mean age 61.0 ± 9.0 years). Significant worsening was observed in Hoehn and Yahr staging and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II and III scores over 4 years (p < 0.05, p < 0.001, and p < 0.001, respectively). SBRs of the caudate, putamen, and midbrain declined significantly (p < 0.001). Midbrain and striatal SBRs correlated significantly at both baseline and 4-year follow-up (p < 0.0001). Striatal SBRs correlated significantly with MDS-UPDRS II and III scores at both time points, while midbrain SBRs correlated with changes in MDS-UPDRS III scores over the 4 years (p < 0.01). Putamen and midbrain SBRs at 4 years were significantly lower in patients who developed LID compared to those who did not (p < 0.05). CONCLUSION: The study demonstrates correlations between midbrain and putamen SBRs and MDS-UPDRS scores over 4 years in PD patients. Midbrain serotonin dysfunction may contribute to the development of LID.
Voxel-Based Morphometry and Subfield Volumetry Analysis Reveal Limbic System Involvement in Tinnitus.
Lee S, Pyun SB, Sim Y … +3 more , Um S, Tae WS, Nam EC
J Neuroimaging · 2025 · PMID 39789953 · Publisher ↗
BACKGROUND AND PURPOSE: Tinnitus is a condition in which individuals perceive sounds, such as ringing or buzzing, without any external source. Although the exact cause is not fully understood, recent studies have indicat...
BACKGROUND AND PURPOSE: Tinnitus is a condition in which individuals perceive sounds, such as ringing or buzzing, without any external source. Although the exact cause is not fully understood, recent studies have indicated the involvement of nonauditory brain structures, including the limbic system. We aimed to compare the volumes of specific brain structures between patients with tinnitus and controls. METHODS: Voxel-based morphometry and subfield volumetry were applied to analyze the brain structures of 53 patients with tinnitus and 52 age- and sex-matched controls. The volumes of the amygdala, hippocampus, and thalamus were measured and compared between the groups. RESULTS: Patients with tinnitus had larger volumes in the whole amygdala, basal nucleus, right lateral nucleus, and left paralaminar nucleus compared with controls. In addition, the subiculum head, left fimbria, and left presubiculum head in the hippocampus were larger in patients with tinnitus. No differences were found in the total thalamic volume or thalamic subnuclei between groups. The gray matter volumes in the thalamus, amygdala, and hippocampus were significantly high in the tinnitus group. The cortical thicknesses of both of the marginal branches of the cingulate sulcus, the left superior parietal lobule, and the left subparietal sulcus were also high in the tinnitus group. CONCLUSIONS: These findings indicate the involvement of the limbic system in tinnitus, and enhance our understanding of the condition. The subfield volumetry technique used in this study may aid in identifying the structural differences associated with specific neurological and psychiatric conditions.
Impact of Pediatric Posterior Fossa Tumor Treatments on Working Memory Tracts Using Resting-State fMRI and Tractography.
Habibi AT, Alaya IB, Tensaouti F … +7 more , Baudou E, Arribarat G, Pollidoro L, Péran P, Chaix Y, Labidi S, Laprie A
J Neuroimaging · 2025 · PMID 39789950 · Publisher ↗
BACKGROUND AND PURPOSE: Working memory, a primary cognitive domain, is often impaired in pediatric brain tumor survivors, affecting their attention and processing speed. This study investigated the long-term effects of t...
BACKGROUND AND PURPOSE: Working memory, a primary cognitive domain, is often impaired in pediatric brain tumor survivors, affecting their attention and processing speed. This study investigated the long-term effects of treatments, including surgery, radiotherapy (RT), and chemotherapy (CT), on working memory tracts in children with posterior fossa tumors (PFTs) using resting-state functional MRI (rs-fMRI) and diffusion MRI tractography. METHODS: This study included 16 medulloblastoma (MB) survivors treated with postoperative RT and CT, 14 pilocytic astrocytoma (PA) survivors treated with surgery alone, and 16 healthy controls from the Imaging Memory after Pediatric Cancer in children, adolescents, and young adults study (NCT04324450). Working memory tracts were identified by combining seed masks from rs-fMRI maps and whole-brain tractography from diffusion MRI. Connectivity alterations were assessed qualitatively and quantitatively, alongside neuropsychological evaluations and correlations with behavioral outcomes and mean supratentorial dose. RESULTS: Compared to controls, MB survivors exhibited significant impairments in the working memory network, including reductions in tract volume (TV), fiber density, fiber cross-section (FC), mean streamline length (MLS), and fractional anisotropy (FA) (all p = 0.04). Lower working memory scores were correlated with reduced TV and FA in MB survivors. Higher mean supratentorial doses were associated with lower TV, FC, and FA values across multiple tracts, particularly in the arcuate and superior longitudinal fasciculi. CONCLUSIONS: Tractography-derived features highlighted white matter damage as a biomarker of treatment-related neurotoxicity in PFTs survivors. These findings underscore the detrimental impact of RT and CT on working memory networks and emphasize the importance of preserving cognitive function during treatment planning.
Brain MRI Detection of an Abnormal Peak Width of Skeletonized Mean Diffusivity in REM Sleep Behavior Disorder.
Lee DA, Lee HJ, Park KM
J Neuroimaging · 2025 · PMID 39786324 · Publisher ↗
BACKGROUND AND PURPOSE: Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of white matter damage, which may be related to small vessel disease. This study aimed to investigate the presence of white mat...
BACKGROUND AND PURPOSE: Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of white matter damage, which may be related to small vessel disease. This study aimed to investigate the presence of white matter damage in patients with isolated rapid eye movement sleep behavior disorder (RBD) using PSMD. METHODS: We enrolled patients with newly diagnosed isolated RBD confirmed by polysomnography and age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was conducted using a 3-Tesla MRI scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the Functional Magnetic Resonance Imaging of the Brain Software Library program. We compared the incidence of PSMD between patients with RBD and healthy controls and performed a correlation analysis between PSMD and clinical factors in patients with RBD. RESULTS: Thirty patients with isolated RBD and 41 healthy controls were enrolled. The PSMD was significantly higher in patients with RBD than that in the healthy controls (3.078 vs. 2.746 × 10 mm/s, p = 0.001). In addition, PSMD positively correlated with age in patients with RBD (r = 0.477, p = 0.007). However, PSMD was not associated with other clinical or polysomnographic factors. CONCLUSION: Patients with isolated RBD had a higher PSMD than healthy controls, indicating the evidence of white matter damage in patients with RBD. This finding highlights the potential of PSMD as a marker for detecting white matter damage, which may be related to small vessel diseases, in patients with sleep disorders.
Role and Prognostic Implications of Venous Outflow Assessment in Acute Ischemic Stroke.
Barghash M, Salim HA, Mei J … +22 more , Tantawi M, Elnaeem AK, Frade HC, Kabeel K, Lakhani DA, Koneru M, Hillis AE, Llinas R, Lu H, Leigh R, Bahouth M, Urrutia VC, Marsh EB, Xu R, Huang J, Wintermark M, Nael K, Albers GW, Stracke P, Faizy TD, Heit JJ, Yedavalli V
J Neuroimaging · 2025 · PMID 39786201 · Publisher ↗
INTRODUCTION: The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upst...
INTRODUCTION: The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upstream arterial collaterals and cerebral microperfusion. This enables it to circumvent the limitations of various arterial collateral evaluation systems, which often fail to consider impaired autoregulation and its impact on cerebral blood flow at the microcirculatory levels. In this narrative review, we will highlight the different parameters and modalities used to assess the VOP in acute ischemia. VO ASSESSMENT WITH DIFFERENT MODALITIES: CT parameters include cortical vein opacification score, interhemispheric difference of composite scores of the draining veins classifications on single-phase CT angiography (CTA), as well as the extent and velocity of optimal cortical venous filling on multiphase CTA. Differences in contrast administration and acquisition time render the single-phase CTA parameters less reliable. Perfusion parameters are semiautomated, thus offering greater reproducibility. These include time to peak and prolonged venous transit. Finally, the venous transit time is an MRI parameter. ASSOCIATIONS AND PROGNOSTIC IMPLICATIONS: VOP parameters' significance lies in their potential to predict tissue fate and, subsequently, clinical outcomes. Recent studies indicate that favorable VOP is independently associated with slower rates of infarct edema progression, smaller infarct volumes, and higher rates of functional independence after 90 days. Moreover, it is considered a predictor of recanalization success and the first-pass effect during mechanical thrombectomy. Conversely, an unfavorable VOP predicts futile recanalization and indicates a higher risk of reperfusion hemorrhage. Our aim is to explore these prognostic implications and their relevance in determining the utility of intracranial intervention.
Functional Connectivity to the Amygdala in the Neonate Is Impacted by the Maternal Anxiety Level During Pregnancy.
Hill TL, Na X, Bellando J … +2 more , Glasier CM, Ou X
J Neuroimaging · 2025 · PMID 39757405 · Full text
BACKGROUND AND PURPOSE: Anxiety during pregnancy is common, and exposure to heightened anxiety during pregnancy may influence children's brain development and functioning. However, it is unclear if exposure to low levels...
BACKGROUND AND PURPOSE: Anxiety during pregnancy is common, and exposure to heightened anxiety during pregnancy may influence children's brain development and functioning. However, it is unclear if exposure to low levels of anxiety in utero would also impact the developing brain. The current prospective and longitudinal study included 40 healthy pregnant women without pregnancy complications or previous diagnosis of anxiety disorders. METHODS: Pregnant women's anxiety symptoms were measured at 12, 24, and 36 weeks of gestation. Their healthy, full-term offspring underwent a brain MRI scan without sedation, including resting-state functional MRI, at 2 weeks postnatal age. The associations between neonatal brain cortical functional connectivity originating from the amygdala and maternal prenatal anxiety symptom scores were examined using correlational analyses. RESULTS: Significant correlations were identified after controlling for child sex, postmenstrual age at MRI, and mother's depression symptom scores. Higher maternal anxiety during pregnancy was related to alterations in offspring's functional connectivity between the amygdala and other brain regions involved in fear learning. Specifically, higher maternal prenatal anxiety during the first trimester of pregnancy was associated with lower connectivity between the amygdala and fusiform gyrus and higher connectivity between the amygdala and thalamus. Higher maternal prenatal anxiety during the third trimester was also associated with lower connectivity between the amygdala and fusiform gyrus. CONCLUSIONS: The findings from this study indicate that exposure to low levels of anxiety in utero may also impact offspring brain development and functioning, particularly brain regions that are important for threat detection.
Middle Cerebral Artery M2 Occlusions: Impact of Segment Dominance and Benefit of Direct Aspiration for the First-Pass Effect.
Navia P, Barrios AJ, Utrilla C … +13 more , Fuentes B, Fernández-Prieto A, Álvarez-Muelas A, Frutos R, Marín B, Royo A, García-Raya P, Fernández-Zubillaga A, de Celis E, Puig J, Comas-Cufí M, Arráez-Aybar LA, Garzón G
J Neuroimaging · 2025 · PMID 39757402 · Publisher ↗
BACKGROUND AND PURPOSE: Endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) with M2 segment occlusion of the middle cerebral artery (MCA) is debatable. This study assessed the efficacy, safety, and functional...
BACKGROUND AND PURPOSE: Endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) with M2 segment occlusion of the middle cerebral artery (MCA) is debatable. This study assessed the efficacy, safety, and functional outcomes of EVT in M2 occlusion patients, examining differences in outcomes based on the dominance of the occluded segment (DomM2 vs. Non-DomM2). METHODS: A prospective cohort of 108 patients with AIS resulting from M2 segment occlusion of the MCA who underwent EVT was analyzed. We compared demographic, clinical, angiographic, and clinical outcome data (National Institutes of Health Stroke Scale [NIHSS] score at 24 h and modified Rankin Scale [mRS] score at 3 months) between patients with or without DomM2. The primary endpoint was the first-pass effect (FPE), defined as achieving modified Thrombolysis in Cerebral Infarction 2c-3 after one pass. We examined the symptomatic hemorrhagic transformation, 3-month functional outcomes, and mortality rates. RESULTS: Seventy-five patients (69.44%) had DomM2. FPE rates (48.48% for DomM2; 42.66% for Non-DomM2, p = 0.521), final successful recanalization rate, and functional outcomes were comparable between subgroups. Direct aspiration yielded a higher FPE rate (56.25%). FPE was associated with lower NIHSS scores at discharge (median, 2 [interquartile range 0-4] vs. 5 [1-10]; p < 0.001) and higher 3-month functional independence (83.33% vs. 60.34%; p < 0.001). Direct aspiration independently predicted FPE, with a 75% likelihood compared to stent retriever (p = 0.007). CONCLUSIONS: EVT is a safe and effective treatment for acute M2 occlusion regardless of the dominance of the M2 segment. Direct aspiration used as a frontline technique increases the likelihood of FPE.
Real-Time 2D Phase-Contrast MRI to Assess Cardiac- and Respiratory-Driven CSF Movement in Normal Pressure Hydrocephalus.
Karki P, Murphy MC, Ganji S … +9 more , Gunter JL, Graff-Radford J, Jones DT, Botha H, Cutsforth-Gregory JK, Elder BD, Jack CR, Huston J, Cogswell PM
J Neuroimaging · 2025 · PMID 39737803 · Full text
BACKGROUND AND PURPOSE: In idiopathic normal pressure hydrocephalus (iNPH) patients, cerebrospinal fluid (CSF) flow is typically evaluated with a cardiac-gated two-dimensional (2D) phase-contrast (PC) MRI through the cer...
BACKGROUND AND PURPOSE: In idiopathic normal pressure hydrocephalus (iNPH) patients, cerebrospinal fluid (CSF) flow is typically evaluated with a cardiac-gated two-dimensional (2D) phase-contrast (PC) MRI through the cerebral aqueduct. This approach is limited by the evaluation of a single location and does not account for respiration effects on flow. In this study, we quantified the cardiac and respiratory contributions to CSF movement at multiple intracranial locations using a real-time 2D PC-MRI and evaluated the diagnostic value of CSF dynamics biomarkers in classifying iNPH patients. METHODS: This study included 37 participants: 16 iNPH, 10 Alzheimer's disease (AD), and 11 cognitively unimpaired (CU) controls. Anatomical and real-time (non-gated) PC images were acquired in a 3T Philips scanner. CSF flow was assessed at the foramen magnum, fourth ventricle, Sylvian fissure, lateral ventricle, and cerebral aqueduct. We calculated three CSF dynamics biomarkers: mean velocity amplitude, cardiac signal power, and respiratory signal power. Biomarkers from each location were evaluated for classifying iNPH versus AD and CU using support vector machine (SVM). A p-value of 0.05 or less was considered statistically significant. RESULTS: The velocity amplitude and cardiac signal power were significantly reduced in iNPH compared to CU (p < 0.005) and AD (p < 0.05) at the lateral ventricle. The SVM model using biomarkers from the lateral ventricle performed significantly better at classifying iNPH than the other locations in terms of accuracy (p < 0.005) and diagnostic odds ratio (p < 0.05). CONCLUSION: Evaluation of CSF movement beyond the cerebral aqueduct may aid in identifying patients with and understanding the pathophysiology of iNPH.
Nerve cross-sectional area in vincristine-induced polyneuropathy: A nerve ultrasound pilot study.
Philipps J, Knaup M, Katz M … +8 more , Axton K, Mork H, Treichel J, Lüling B, Klimas R, Wille K, Schellinger PD, Pitarokoili K
J Neuroimaging · 2025 · PMID 39654061 · Full text
BACKGROUND AND PURPOSE: The role of high-resolution nerve ultrasound (HRUS) in the diagnosis of chemotherapy-induced polyneuropathy is unclear. The present prospective longitudinal controlled study evaluates the utility...
BACKGROUND AND PURPOSE: The role of high-resolution nerve ultrasound (HRUS) in the diagnosis of chemotherapy-induced polyneuropathy is unclear. The present prospective longitudinal controlled study evaluates the utility of HRUS in vincristine-induced polyneuropathy (VIPN). METHODS: Twelve patients receiving vincristine and 12 healthy age-matched controls were included. Visits before and 3 weeks, 8 weeks, and 6 months after the start of vincristine treatment included clinical examination, the total neuropathy score (TNS), nerve conduction studies (NCSs), and HRUS of the bilateral median, ulnar, radial, tibial, peroneal, and sural nerve cross-sectional areas (CSAs). RESULTS: Median TNS increased from 0 points (interquartile range [IQR] 0) to 0.5 points (IQR 1, p = .26) at Week 3 and to 4 points (IQR 2.5, p < .001) at Week 8. At 6 months, there was a nonsignificant decrease to 2 points (IQR 2, p = .66). HRUS of individual nerve sites showed no significant changes in CSA and intranerve variability. The total CSA of all entrapment sites increased significantly (p = .007) at Week 8. Sensory nerve action potentials decreased significantly after 6 months (sural nerve, p = .001; radial nerve, p = .004; ulnar and median nerve, p < .001). The tibial nerve compound muscle action potential (p = .006) and nerve conduction velocity (p < .001) were reduced. CONCLUSIONS: At mid-treatment, there is an increase in the total CSA at entrapment sites parallel to an increase in clinical symptoms. In individual nerve sites, HRUS does not detect significant signs of VIPN. NCSs exhibit signs of a predominantly sensory axonal polyneuropathy. The clinical examination remains the most sensitive tool in the early detection of VIPN.
Predicting glioblastoma progression using MR diffusion tensor imaging: A systematic review.
Cozzi FM, Mayrand RC, Wan Y … +1 more , Price SJ
J Neuroimaging · 2025 · PMID 39648937 · Full text
BACKGROUND AND PURPOSE: Despite multimodal treatment of glioblastoma (GBM), recurrence beyond the initial tumor volume is inevitable. Moreover, conventional MRI has shortcomings that hinder the early detection of occult...
BACKGROUND AND PURPOSE: Despite multimodal treatment of glioblastoma (GBM), recurrence beyond the initial tumor volume is inevitable. Moreover, conventional MRI has shortcomings that hinder the early detection of occult white matter tract infiltration by tumor, but diffusion tensor imaging (DTI) is a sensitive probe for assessing microstructural changes, facilitating the identification of progression before standard imaging. This sensitivity makes DTI a valuable tool for predicting recurrence. A systematic review was therefore conducted to investigate how DTI, in comparison to conventional MRI, can be used for predicting GBM progression. METHODS: We queried three databases (PubMed, Web of Science, and Scopus) using the search terms: (diffusion tensor imaging OR DTI) AND (glioblastoma OR GBM) AND (recurrence OR progression). For included studies, data pertaining to the study type, number of GBM recurrence patients, treatment type(s), and DTI-related metrics of recurrence were extracted. RESULTS: In all, 16 studies were included, from which there were 394 patients in total. Six studies reported decreased fractional anisotropy in recurrence regions, and 2 studies described the utility of connectomics/tractography for predicting tumor migratory pathways to a site of recurrence. Three studies reported evidence of tumor progression using DTI before recurrence was visible on conventional imaging. CONCLUSIONS: These findings suggest that DTI metrics may be useful for guiding surgical and radiotherapy planning for GBM patients, and for informing long-term surveillance. Understanding the current state of the literature pertaining to these metrics' trends is crucial, particularly as DTI is increasingly used as a treatment-guiding imaging modality.
Comparison of antithrombogenic coated and uncoated flow diverters in ruptured and unruptured cerebral aneurysms.
Weiss D, Vach M, Ivan VL … +5 more , Muhammad S, Hofmann BB, Neyazi M, Turowski B, Kaschner M
J Neuroimaging · 2025 · PMID 39636089 · Full text
BACKGROUND AND PURPOSE: Flow diversion has become a key treatment option for complex intracranial aneurysms. Recent advancements include coated flow diverters (FDs), designed to potentially reduce the need for dual antip...
BACKGROUND AND PURPOSE: Flow diversion has become a key treatment option for complex intracranial aneurysms. Recent advancements include coated flow diverters (FDs), designed to potentially reduce the need for dual antiplatelet therapy, thereby removing the associated secondary risks while maintaining patency and low complication rates. Comparing coated and uncoated FDs may offer insights into long-term outcomes and treatment optimization. METHOD: In this retrospective single-center study, we investigated the data of 21 consecutive patients with cerebral aneurysms, treated between 2021 and 2023 with the coated Derivo 2heal Embolization Device and the uncoated Derivo Embolization Device (both Acandis). We described the procedure and analyzed clinical and radiological data, along with long-term outcomes after 18 months of follow-up. RESULTS: Nine patients (42.9%) had incidental, while 12 (57.1%) had symptomatic aneurysms, including 10 with World Federation of Neurosurgical Societies classification IV subarachnoid hemorrhages. Aneurysm locations included mostly the internal carotid (n = 9) and the vertebral artery (n = 7). All FDs were successfully deployed: 11 patients received the coated and 10 the uncoated device. After 18 months, 73.3% of patients had favorable outcomes (modified Rankin Score 0-2). One coated FD occluded asymptomatically after 6 months, and one uncoated FD occluded immediately but could be recanalized. CONCLUSIONS: We observed favorable occlusion rates for both coated and uncoated FDs. The role of dual antiplatelet therapy remains debated. Large multicenter studies are essential to evaluate the patency of coated compared to uncoated FDs and determine whether they can reduce thrombogenicity, potentially allowing for less or no antiplatelet therapy in emergencies.
Functional MRI and cognition in multiple sclerosis-Where are we now?
Mahmoudi F, McCarthy M, Nelson F
J Neuroimaging · 2025 · PMID 39636088 · Full text
Multiple sclerosis-related cognitive impairment (MSrCI) affects most patients with multiple sclerosis (MS), significantly contributing to disability and socioeconomic challenges. MSrCI manifests across all disease stages...
Multiple sclerosis-related cognitive impairment (MSrCI) affects most patients with multiple sclerosis (MS), significantly contributing to disability and socioeconomic challenges. MSrCI manifests across all disease stages, mainly impacting working memory, information processing, and attention. To date, the underlying mechanisms of MSrCI remain unclear, with its pathogenesis considered multifactorial. While conventional MRI findings correlate with MSrCI, there is no consensus on reliable imaging metrics to detect or diagnose cognitive impairment (CI). Functional MRI (fMRI) has provided unique insights into the brain's neuroplasticity mechanisms, revealing evidence of compensatory mechanisms in response to tissue damage, both beneficial and maladaptive. This review summarizes the current literature on the application of resting-state fMRI (rs-fMRI) and task-based fMRI (tb-fMRI) in understanding neuroplasticity and its relationship with cognitive changes in people with MS (pwMS). Searches of databases, including PubMed/Medline, Embase, Scopus, and the Web of Science, were conducted for the most recent fMRI cognitive studies in pwMS. Key findings ifrom rs-fMRI studies reveal disruptions in brain connectivity and hub integration, leading to CI due to decreased network efficiency. tb-fMRI studies highlight abnormal brain activation patterns in pwMS, with evidence of increased fMRI activity in earlier disease stages as a beneficial compensatory response, followed by reduced activation correlating with increased lesion burden and cognitive decline as the disease progresses. This suggests a gradual exhaustion of compensatory mechanisms over time. These findings support fMRI not only as a diagnostic tool for MSrCI but also as a potential imaging biomarker to improve our understanding of disease progression.
Time-dependent MR diffusion analysis of functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors.
Kamimura K, Tokuda T, Kamizono J … +14 more , Nakano T, Hasegawa T, Nakajo M, Ejima F, Kanzaki F, Takumi K, Nakajo M, Fujio S, Hanaya R, Tanimoto A, Iwanaga T, Imai H, Feiweier T, Yoshiura T
J Neuroimaging · 2025 · PMID 39636086 · Full text
BACKGROUND AND PURPOSE: Differentiation between functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors (PAs) is clinically relevant. The goal of this study was to determine the feasibility of u...
BACKGROUND AND PURPOSE: Differentiation between functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors (PAs) is clinically relevant. The goal of this study was to determine the feasibility of using time-dependent diffusion MRI (dMRI) for microstructural characterization of PAs. METHODS: The study included 54 participants, 24 with functioning PA and 30 with nonfunctioning PA. Time-dependent dMRI of the pituitary gland was performed using an inner field-of-view echo-planar imaging based on 2-dimensional-selective radiofrequency excitations with oscillating gradient and pulsed gradient preparation (effective diffusion time: 7.1 and 36.3 ms) at b-values of 0 and 1000 seconds/mm. Each tumor had its apparent diffusion coefficients (ADCs) measured at two diffusion times (ADC and ADC), its ADC change (cADC), and relative ADC change. The mean values of diffusion parameters were compared between functioning and nonfunctioning PAs. We compared the diffusion parameters of nonfunctioning PAs with those of each type of hormone-producing PAs. The diagnostic performances of the diffusion parameters were assessed. RESULTS: The cADC was significantly higher in functioning PAs than nonfunctioning PAs (p = .0124). The receiver operating characteristic (ROC) curve analysis revealed that cADC (area under the ROC curve [AUC] = .677, p = .017) is effective in distinguishing between functioning and nonfunctioning PAs. The cADC was significantly higher in growth hormone (GH)-producing PAs compared to nonfunctioning PAs (p = .006). The ROC curve analysis indicated that cADC (AUC = .771, p < .001) effectively distinguishes between GH-producing and nonfunctioning PAs. CONCLUSIONS: The cADC derived from time-dependent dMRI could distinguish between functioning and nonfunctioning PAs, particularly those producing GH.
Evaluating performance and quality of a fast multi-contrast scan in routine brain MRI.
Milshteyn E, Griffin H, Chang YS … +5 more , Shaikh I, Sprenger T, Skare S, Maclellan CJ, Soman S
J Neuroimaging · 2025 · PMID 39616403 · Publisher ↗
BACKGROUND AND PURPOSE: Neuromix is a fast, motion robust multi-contrast sequence capable of providing all diagnostic contrasts in ∼3.5 minutes. However, more evaluation is needed across the various contrasts compared to...
BACKGROUND AND PURPOSE: Neuromix is a fast, motion robust multi-contrast sequence capable of providing all diagnostic contrasts in ∼3.5 minutes. However, more evaluation is needed across the various contrasts compared to gold standard, optimized sequences routinely used in the clinic. The goal of this study was to prospectively determine how NeuroMix performs in the clinical setting compared to routine clinical MRI. METHODS: NeuroMix and routine clinical MRI sequences were acquired on a 3 Tesla clinical scanner for 39 patients clinically indicated for brain MRI. Three radiologists were asked to assess the diagnostic confidence of NeuroMix compared to the routine MRI using a series of questions. Signal-to-noise and contrast-to-noise ratios (SNR and CNR) were assessed for NeuroMix. Fleiss' free-marginal multirater kappa was calculated for the qualitative assessment performed by the radiologists. RESULTS: Radiologists were comfortable substituting or reading some of the NeuroMix sequences in place of the corresponding conventional sequence for some contrasts, including diffusion-weighted imaging, single-shot T, and susceptibility-weighted imaging. The image quality, SNR, and CNR allowed the radiologists to visualize anatomy and pathology on NeuroMix images. There was no significant difference between coefficient of variation for the apparent diffusion coefficient maps (p = .084). CONCLUSIONS: Analysis revealed both positives and some pitfalls of NeuroMix. However, these results indicate Neuromix as having the capability to be a backup sequence in case artifacts are present in routine sequences, or potentially a replacement for some contrasts altogether.
Exploring subcortical pathology and processing speed in neuromyelitis optica spectrum disorder with myelin water imaging.
Tsai W, Combes A, McMullen K … +2 more , Kolind SH, Traboulsee AL
J Neuroimaging · 2025 · PMID 39511966 · Full text
BACKGROUND AND PURPOSE: Neuromyelitis optica spectrum disorder (NMOSD) affects the optic nerves and spinal cord but can also cause focal brain inflammation. Subcortical pathology may contribute to the etiology of cogniti...
BACKGROUND AND PURPOSE: Neuromyelitis optica spectrum disorder (NMOSD) affects the optic nerves and spinal cord but can also cause focal brain inflammation. Subcortical pathology may contribute to the etiology of cognitive deficits in NMOSD. Using myelin water imaging, we investigated cerebral normal-appearing white matter (NAWM) and thalamic metrics and their association with cognition in NMOSD participants compared to healthy controls (HC). METHODS: Seventeen NMOSD participants and 21 HC were scanned on a 3.0-Tesla MRI scanner using a multicomponent driven-equilibrium single-pulse observation of T and T protocol. Tissue compartment and thalamic volumes (normalized to intracranial volume), T relaxation time, and myelin water fraction (MWF) were reported. Eleven NMOSD participants underwent the Symbol Digit Modalities Test (SDMT) for cognitive evaluation. Group comparisons were performed using Student's t-test. The association between thalamic metrics and SDMT score was assessed using multiple regression analysis with age as a covariate. RESULTS: Compared to HC, NMOSD participants had reduced white matter volume (-14.2%, p < .0001), increased T relaxation time (+2.29%, p = .022), and lower MWF (-3.64%, p = .024) in NAWM. NMOSD group had a trend for smaller thalamic volumes than HC (-5.52%, p = .082) and no differences in thalamic MWF (p = .258) or T (p = .714). Thalamic T predicted SDMT score (adjusted R = .51, p = .04) when controlling for age. CONCLUSIONS: NAWM in NMOSD demonstrates diffuse abnormalities with increased water content and demyelination, suggesting a diffuse disease process overlooked by focal inflammation measures. Increased water content, as a biomarker for diffuse thalamic pathology, may partially explain cognitive impairment in NMOSD.
Reduced visual and middle temporal gyrus activity correlates with years of exercise in athletes using resting-state fMRI.
Peng L, Li J, Xu L … +6 more , Zhang Z, Wang Z, Zhong X, Wang L, Shao Y, Yue Y
J Neuroimaging · 2025 · PMID 39501905 · Publisher ↗
BACKGROUND AND PURPOSE: Different types of physical training can lead to changes in brain activity and function, and these changes can vary depending on the type of training. However, it remains unclear whether there are...
BACKGROUND AND PURPOSE: Different types of physical training can lead to changes in brain activity and function, and these changes can vary depending on the type of training. However, it remains unclear whether there are commonalities in how different types of training affect brain activity and function. The purpose of this study is to compare the brain activity states of professional athletes with those of ordinary university students and to explore the relationship between training and differences in brain activity states. METHODS: This study primarily utilizes resting-state MRI and the degree centrality metric to investigate spontaneous brain activity in 86 high-level athletes with extensive training and 74 age- and gender-matched nonathletes. Additionally, a correlation analysis between brain activity in relevant regions and years of training was conducted. RESULTS: The analysis revealed that, compared to nonathletes, high-level athletes exhibited reduced activity in the Calcarine (a visual area) and Middle Temporal Gyrus. Furthermore, changes in the activity of the Calcarine and Middle Temporal Gyrus were significantly correlated with the number of years of professional training. CONCLUSIONS: The study results indicate that long-term physical training is associated with changes in brain activity in athletes, providing insights into the neural mechanisms underlying behavioral performance in professional athletes.
A novel automated pipeline to assess MR spectroscopy quality control: Comparing current standards and manual assessment.
Beroukhim B, McComas S, Joyce JM … +4 more , Schuhmacher LS, Koerte I, Lan Z, Lin A
J Neuroimaging · 2025 · PMID 39501534 · Publisher ↗
BACKGROUND AND PURPOSE: The absence of a consensus data quality control (DQC) process inhibits the widespread adoption of MR spectroscopy. Poor DQC can lead to unreliable clinical diagnosis and irreproducible research co...
BACKGROUND AND PURPOSE: The absence of a consensus data quality control (DQC) process inhibits the widespread adoption of MR spectroscopy. Poor DQC can lead to unreliable clinical diagnosis and irreproducible research conclusions. Currently, manual visual assessment or the standard quantitative metrics of signal-to-noise, linewidth, and model fit are used as classifiers, but these measures may not be sufficient. To supplement standard metrics, this paper proposes a novel automated DQC pipeline named Visual Evaluative Control Technology Of Resonance Spectroscopy (VECTORS). METHODS: Manual DQC ratings were conducted on 7180 spectra obtained from 110 young adults using short-echo chemical shift imaging at 3 Tesla. Four reviewers conducted manual ratings on the presence of artifacts and location of metabolites. The ratings were labor intensive, taking over 180 hours. VECTORS was developed to quantify their DQC criteria, detecting artifacts that present as duplicate peaks, vertical shifts, and glutamine + glutamate and myoinositol peak shapes. Run on the same data using a standard laptop, VECTORS only took 2 hours. RESULTS: The manual ratings were not monotonic to the standard quantitative metrics. VECTORS correctly flagged spectra that the manual ratings missed. VECTORS accurately flagged an additional 126 poor DQ spectra that consensus cutoffs of the standard quantitative metrics deemed good DQ. CONCLUSION: Standard quantitative metrics may not account for all DQC artifacts as they are not monotonic to the manual ratings. However, manual ratings are labor intensive, subjective, and irreproducible. VECTORS addresses these issues and should be used in conjunction with standard quantitative metrics.
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