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Objective: This study aimed to compare psychosocial outcomes and functional neuroimaging among youth with concussion, youth with anxiety, and age- and sex-matched controls., Methods: Using archival data from the Adolescent Brain Cognitive Development SM Study, we analyzed between-group differences in psychosocial outcomes measured by the Child Behavior Checklist's internalizing and externalizing problem scales, and assessed brain function using resting-state fMRI network-region connectivity (specifically frontoparietal network (FPN) and default mode network (DMN) connectivity with the amygdala)., Results: Significant differences in psychosocial outcomes were found across all groups, with the anxiety group reporting the most internalizing problems, followed by the concussion group which significantly differed from controls. Additionally, FPN-amygdala connectivity was significantly reduced in the concussion group only; this reduced connectivity did not predict psychosocial outcomes across groups., Conclusion: This study provided preliminary findings that brain connectivity is reduced exclusively in individuals with concussion. Although disruptions were observed in the concussion group, further investigation is warranted to understand how disruptions may be associated with concussion symptoms. Studies that utilize well-defined control and study groups, and comprehensive cognitive and mental health measures will offer a deeper understanding of the relationship between brain function and psychosocial outcomes.

Objective: This study aims to investigate the association between patients with migraine headaches and brain magnetic resonance imaging (MRI) findings., Background: Migraine is a frequently encountered primary headache disorder with a disproportionate female predominance. Diagnosis is usually based on the patient's clinical history with neuroimaging reserved for severe or atypical presentations to exclude other pathologies. Migraine patients often experience a profound impact on their quality of life., Methods: A retrospective study was conducted at King Abdullah University Hospital, Jordan, involving patients with a clinical diagnosis of migraine who had undergone MRI brain imaging between January 2021 to March 2023. Descriptive data were documented, with two independent neuro-radiologists interpreting MRI findings., Results: Our study included 670 migraine patients (510 females; mean age, 40.3 years). White matter hyperintensity lesions were found in 309 patients (46.1%), significantly affecting older age groups with a mean age of 46.8 years (p > 0.001). Additionally, gender played a role, with a higher prevalence of these lesions in female migraine patients, accounting for 79.6% (p = 0.05). Multiple logistic regression analysis proved age to be an independent risk factor for the presence of white matter hyperintensity lesions (OR: 1.0688, 95% CI: 1.0546-1.0831, p > 0.001)., Conclusion: White matter hyperintensity lesions were seen in the MRI imaging of a subset of migraine patients. Patients with these lesions tend to be older and of female gender. However, the clinical significance of these findings remains unclear., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Conflict of interest: The authors declare no conflict of interest. Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Institutional Review Board of Jordan University of Science and Technology. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. Informed consent: Statement: Informed consent was obtained from all individual participants included in the study. Participants were fully informed about the purpose of the research, the procedures involved, potential risks and benefits, and their rights to withdraw from the study at any time without any consequences. The confidentiality and anonymity of all participants were maintained throughout the study., (© 2025. The Author(s).)

Persistent post-surgical pain (PPSP) occurs in a proportion of patients following surgical interventions. Research suggests that specific microbiome components are important for brain development and function, with recent studies demonstrating that chronic pain results in changes to the microbiome. Consumption of a high fat, high sugar (HFHS) diet can drastically alter composition of the microbiome and is a modifiable risk factor for many neuroinflammatory conditions. Therefore, we investigated how daily consumption of a HFHS diet modified the development of PPSP, brain structure and function, and the microbiome. In addition, we identified significant correlations between the microbiome and brain in animals with PPSP. Male and female rats were maintained on a control or HFHS diet. Animals were further allocated to a sham or surgery on postnatal day (p) p35. The von Frey task measured mechanical nociceptive sensitivity at a chronic timepoint (p65-67). Between p68-72 rats underwent in-vivo MRI to examine brain volume and diffusivity. At p73 fecal samples were used for downstream 16 s rRNA sequencing. Spearman correlation analyses were performed between individual microbial abundance and MRI diffusivity to determine if specific bacterial species were associated with PPSP-induced brain changes. We found that consumption of a HFHS diet exacerbated PPSP in adolescents. The HFHS diet reduced overall brain volume and increased white and grey matter density. The HFHS diet interacted with the surgical intervention to modify diffusivity in numerous brain regions which were associated with specific changes to the microbiome. These findings demonstrate that premorbid characteristics can influence the development of PPSP and advance our understanding of the contribution that the microbiome has on function of the brain-microbiota-gut axis., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Richelle Mychasiuk reports financial support was provided by National Health and Medical Research Council. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.)

Posttraumatic stress disorder (PTSD) is widely recognized as involving disruption of core neurocircuitry that underlies processing, regulation, and response to threat. In particular, the prefrontal cortex-hippocampal-amygdala circuit is a major contributor to posttraumatic dysfunction. However, the functioning of core threat neurocircuitry is partially dependent on sensorial inputs, and previous research has demonstrated that dense, reciprocal connections exist between threat circuits and the ventral visual stream. Furthermore, emergent evidence suggests that trauma exposure and resultant PTSD symptoms are associated with altered structure and function of the ventral visual stream. In the current review, we discuss evidence that both threat and visual circuitry together are an integral part of PTSD pathogenesis. An overview of the relevance of visual processing to PTSD is discussed in the context of both basic and translational research, highlighting the impact of stress on affective visual circuitry. This review further synthesizes emergent literature to suggest potential timing-dependent effects of traumatic stress on threat and visual circuits that may contribute to PTSD development. We conclude with recommendations for future research to move the field toward a more complete understanding of PTSD neurobiology., (Copyright © 2024 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)

Purpose: The addition of systematic prostate biopsy enhances the detection of clinically significant prostate cancer compared to MRI-targeted biopsy alone. However, there is growing interest in using only MRI-targeted biopsy. We sought to evaluate PSA density as an adjunctive predictor of clinically significant prostate cancer detection in men undergoing combined biopsy and as a potential metric to stratify which patients may reasonably avoid systematic biopsies in favor of MRI-targeted biopsy only., Materials and Methods: Men with elevated PSA and/or abnormal digital rectal exam found to have an MRI-visible prostate lesion underwent MRI-targeted and systematic prostate biopsy. Primary outcomes were clinically significant cancer detection rates by MRI-targeted, systematic biopsy, and combined biopsy across four discrete PSA density intervals (<0.1, > 0.1 and <0.15, > 0.15 and <0.2, and > 0.2 ng/ml/cm 3 ). Secondary outcomes were the added value of systematic biopsy relative to MRI-targeted biopsy alone., Results: Among men with PI-RADS > 2 lesions, as PSA density surpassed each interval, the rate of grade group > 3 cancer detection approximately doubled (<0.1:9.3%, > 0.1 and <0.15:18.2%, > 0.15 and <0.2:36%, and > 0.2:61.2%). For PSA density > 0.2, added detection of clinically significant cancer with systematic biopsy was low(2%, 95%CI:0.4%-5.9%)., Conclusions: Given an approximate doubling in grade group > 3 cancer detection on combined biopsy with rising PSA density intervals, clinicians may consider PSA density in risk stratifying men at high risk of clinically significant prostate cancer. Clinicians may consider omitting systematic biopsy for targeted biopsy of MRI-visible lesions in patients with PSA density > 0.2ng/ml/cm 3 , as systematic biopsy results in low rates of additional clinically significant cancer detection.

Purpose: To investigate the factors affecting indirect dural sac expansion on MRI in single-level Lateral Lumbar Interbody Fusion (LLIF) for degenerative lumbar spondylolisthesis. The focus was on identifying preoperatively selectable and intraoperatively modifiable factors that contribute to or detract from successful indirect decompression, as evidenced by dural sac expansion., Methods: A retrospective review of 88 consecutive patients who underwent single-level LLIF surgery for degenerative lumbar spondylolisthesis at a single academic institute from January 2013 to December 2022 was conducted. Parameters measured included preoperative and postoperative slip distance, disc height (DH), cage position, and the canal cross-sectional area (CSA) of the dural sac using MRI. Multivariable regression analysis was conducted to identify factors affecting the change in CSA and segmental disc angle (SDA)., Results: The study included patients with an average age of 68.1, primarily undergoing L4-5 LLIF. Significant improvements were noted postoperatively in CSA and disc heights. Multivariable regression showed that smaller preoperative posterior DH and more posterior cage positions significantly increased CSA, whereas smaller anterior DH and more anterior cage positions increased SDA. There was no significant correlation between the change in slip distance and CSA., Conclusions: Factors contributing to indirect decompression following LLIF for lumbar degenerative spondylolisthesis are primarily associated with an increase in posterior intervertebral height. However, an excessive increase due to posterior placement of the interbody cage may negatively impact the local lordotic angle. The study also suggests that a focus on slip correction may not significantly influence the efficacy of indirect decompression., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the institutional review board of Kyoto University (No. R2901). Conflict of interest: This manuscript does not contain information about medical devices/drugs. Disclosure: The authors have no relevant financial connections relevant to this work., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To evaluate early and mid-term imaging and clinical outcomes following transvenous embolization of cerebrospinal fluid-venous fistulas (CSFVFs) in patients with spontaneous intracranial hypotension (SIH)., Methods: From November 2022 to November 2024, 60 consecutive patients with SIH and confirmed CSFVF underwent transvenous embolization using Onyx. Of these, 40 patients underwent brain MRI pre-treatment, 24 hours post-treatment, and at a 3-month follow-up. The primary outcome was regression of brain MRI abnormalities at 24 hours and 3 months. Secondary outcomes included rates of symptom improvement, predictors of clinical improvement, and complication rates., Results: The mean patient age was 61 years, and 65% were female. All procedures were technically successful. The median SIH score significantly decreased from 6 pre-treatment to 3.5 at 24 hours (P=0.01) and to 2 at 3 months (P=0.004). Early improvement in SIH score correlated with clinical improvement at 24 hours (P=0.002), which was observed in 77.5% of patients. Pachymeningeal enhancement (87.5%) and venous sinus engorgement (75%) were the most common MRI abnormalities. Both findings regressed in approximately 50% of patients at 24 hours and in 80% of patients at 3 months. At 3 months, 82.5% of patients achieved complete clinical recovery. Rebound post-treatment headaches occurred in 32.5% of patients but resolved within 7 days. The morbidity rate was 0%., Conclusions: Transvenous embolization of CSFVFs results in early and sustained clinical and imaging improvements in patients with SIH. These findings support the efficacy of this intervention as a primary treatment for CSFVFs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Annually, millions of children undergo a magnetic resonance imaging (MRI) examination. Hospitals increasingly aim to scan young children awake, as doing so benefits both patients and health care systems. To help hospitals reduce the need for anesthesia, we have developed solutions to prepare pediatric patients at home and in the hospital., Objective: The goal of our project was to design, develop, and test a solution that extends our preparation solutions by guiding and engaging children during their MRI examination., Methods: Pediatric In-bore was designed to deliver a familiar experience by reusing design elements from our preparation solutions. It offers child-friendly movies and auditory and visual guidance about examination progress and breath holding. To evaluate children's liking and understanding of the solution, we conducted a usability study. Ten healthy children participated in a mock MRI examination featuring pediatric In-bore. We observed task compliance (ability to lie still and hold one's breath) and conducted guided interviews to assess their experience and understanding of the guidance offered., Results: Participants (aged 5 to 10 years) were generally positive about pediatric In-bore. They liked the main character (Ollie the elephant) and her movie. Auditory and visual guidance were generally liked and understood. All but one participant successfully managed to lie still during the mock examination, and 6 (60%) out of 10 participants successfully held their breath., Conclusions: Pediatric In-bore appears promising for engaging and guiding young children during awake MRI. It completes the Pediatric Coaching solution that now offers guidance throughout the MRI journey. Future research can expand on this work by evaluating the clinical impact of the Pediatric Coaching solution in a larger and more diverse sample of pediatric patients., (©Annerieke Heuvelink, Privender Saini, Özgür Taşar, Sanne Nauts. Originally published in JMIR Serious Games (https://games.jmir.org), 13.02.2025.)

The structural MRI of the cortex, subcortical structures, hippocampal subfields, and brainstem regions in patients with persecutory delusions in schizophrenia (ICD-10 code: F20) and delusional disorder (ICD-10 code: F22.0) were analyzed. Patients demonstrated multiple regions of decreased cortical gray matter thickness, reduced volumes of the left thalamus and some hippocampal sub-fields compared to mentally healthy subjects. No alterations in brainstem structures were found. The results were analyzed within the framework of the transnosological model of delusions., (© 2025. Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Accurate staging of distal colorectal cancers is paramount in guiding neoadjuvant therapy, peri-operative, and ostomy planning. Early colonic lesions can be difficult to visualise on computed tomography (CT) scans, with tumour location solely deduced via endoscopy with the potential for introducing error. We aimed to address the paucity in literature in this area and assessed the accuracy of radiological and endoscopic localisation of distal colorectal cancers., Methods: Retrospective analysis of an electronic database of patients at a large District General Hospital (DGH) diagnosed with distal colorectal cancer between January 2014 to January 2023 was performed. Patient demographics, investigations, endoscopic, and operative findings were analysed. Outcomes were assessed to determine disparities between pre-operative endoscopy and final tumour location., Results: A total of 212 patients were endoscopically diagnosed with distal sigmoid tumour. Of these, 207 (97.6%) had a CT scan performed with 25.1% (52/207) lesions not being identified on this imaging modality with the remainder (74.9%; 155/207) being reported as visible. 38.2% (79/207) of tumours were in the sigmoid colon, 17.4% (36/207) rectosigmoid, and 19.3% (40/207) in the rectum. Pre-operative magnetic resonance imaging (MRI) was performed in 42.5% (90/212) of cases showing 84 tumours: 6.0% (5/84) sigmoid colon, 9.5% (8/84) rectosigmoid and 83.3% (70/84) rectal cancers (upper: 34, mid-rectum: 26, low: 10), with one anal cancer. 42.3% (22/52) of patients with non-visible lesions on CT had MRI scans: 68.2% (15/22) had rectal cancer (upper: 10, mid-rectum: 4, low: 1). Of the 30 where MRI was not performed, 46.7% (14) had sigmoid cancer, 16.7% (5) rectosigmoid, and 33.3% (10) rectal intraoperatively. Overall, 30.7% (65/212) of patients reported as having a distal sigmoid lesion endoscopically in fact had rectal cancer intra-operatively (rectosigmoid lesions excluded)., Conclusion: Endoscopic localisation of distal colorectal tumours can be unreliable for accurate staging and operative planning. A pre-operative MRI scan should be considered in such instances, and particularly for non-visible lesions on CT scan. This may improve peri-operative planning, staging accuracy and patient outcomes., Competing Interests: Declarations. Ethical approval: Approval from the local research committee was gained, and ethical approval was waived as the current study did not influence or alter the management course or treatment of any patients analysed. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Lumbosacral transitional vertebra (LTV) is a congenital anomaly in dogs and have been proposed to be associated with cauda equina syndrome (CES) in German Shepherd dogs. This prospective study, including 32 dogs from two breeds, aims to investigate if LTV is associated with lower back pain in dogs. The study compared owners' assessment of their dogs' well-being and clinical evaluation with advanced diagnostic imaging to identify changes that might explain clinical findings., Results: Dogs with LTV type 2 (57.0%) and with LTV type 3 (70.0%) exhibited mild lower back pain, which was significantly more frequent (P = 0.012) compared to dogs with LTV type 0 and LTV type 1. Advanced diagnostic imaging identified a plausible cause for this pain. Dogs diagnosed with LTV types 2 and 3 with lower back pain tended to be lighter (median 14.50 kg) and younger (median 4.10 years) than breeds typically reported for degenerative lumbosacral stenosis (DLSS). Based on the owners' assessment of their dogs, they considered them pain-free., Conclusions: The study identified a correlation between LTV types 2 and 3 and lower back pain in these dog breeds. Advanced diagnostic imaging findings confirmed that dogs with these LTV types were more likely to exhibit pathological changes associated with DLSS., Competing Interests: Declarations. Ethics approval: The animals were handled according to high ethical standards and national legislation. The Norwegian Food Safety Authorities ethically approved this study (Approval ID: 29257). Consent for publication: All dog owners were required to provide written consent to participate. Competing interests: The authors declare that they have no competing interests. Prior publication: Data have not been published previously., (© 2025. The Author(s).)

Purpose: Heterogeneity in clinical phenotypes has led to the description of different phenotypes of Alzheimer's disease (AD). Besides the most frequent amnestic variant of AD (aAD), patients presenting with language deficits are diagnosed with logopenic variant primary progressive aphasia (lvPPA), whereas patients presenting with visual deficits are classified as posterior cortical atrophy (PCA)., Methods: This study set out to investigate the value of a multi-parametric [ 18 F]PI-2620 tau PET/MRI protocol to distinguish aAD, lvPPA and PCA to support clinical diagnosis in 32 patients. Phenotype-specific information about tau accumulation, relative perfusion, grey matter density, functional network alterations and white matter microstructural alterations was collected., Results: The aAD patients showed significantly higher tau accumulation, relative hypoperfusion and grey matter density loss in the temporal lobes compared to PCA and lvPPA patients. PCA patients, on the other hand, showed significantly higher tau accumulation in the occipital lobe as compared to aAD patients. Relative hypoperfusion in the occipital lobe and loss of functional connectivity of the posterior cingulate cortex to supplementary visual cortical regions helped to distinguish PCA from lvPPA. Tau accumulation in the cerebellum and microstructural changes in the cingulum were found to help differentiate lvPPA from aAD., Conclusion: This study highlights structural and functional differences between patients with different AD phenotypes. Differences in regional tau PET signals suggest that refinements in the Braak staging system are needed for the non-aAD cases. These patterns of tau accumulation align with the cascading network failure hypothesis, though more research is needed to warrant the here presented results in larger patient cohorts., Competing Interests: Declarations. Ethics approval: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of LMU Munich (application numbers 17–569 and 19–022) and the medical faculty of the University of Leipzig (EC number 155/15-ff). Clinical trial number not applicable. Consent to participate: Informed consent was obtained from all subjects involved in the study. Competing interests: MB is a member of the Neuroimaging Committee of the EANM. MB has received speaker honoraria from Roche, GE Healthcare, and Life Molecular Imaging; has advised Life Molecular Imaging; and is currently on the advisory board of MIAC. NK and AS are full-time employees at Life Molecular Imaging. All the other authors declare that no conflicts of interest exist., (© 2025. The Author(s).)

Competing Interests: Declarations. Conflicts of interest: None

Purpose: To explore the value of laboratory serum markers and magnetic resonance imaging(MRI) features in the preoperative differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) in periampullary carcinoma (PAC)., Methods: A retrospective analysis of clinical data from 105 PAC patients who underwent pancreaticoduodenectomy was conducted, including 33 cases of PDAC (observation group) and 72 cases of non-PDAC (control group), with 25 cases of ampullary carcinoma, 38 cases of distal bile duct carcinoma, and 9 cases of periampullary duodenal carcinoma. Laboratory serum markers, MRI features, and pathological diagnosis data were compared between the two groups to analyze the value of laboratory serum markers and MRI features for differential diagnosis of PDAC within PAC., Results: Compared to the control group, the observation group had higher proportions in total bilirubin, direct bilirubin, carcinoembryonic antigen(CEA), carbohydrate antigen 19 - 9 (CA19-9), quadruple duct sign, pancreatobiliary junction angle, main pancreatic duct diameter, pancreatic head side branch duct dilation, and hypovascular mass in pancreatic head, consistency of imaging and pathology diagnosis, perineural invasion (p < 0.05).The common bile duct diameter was smaller in the observation group (p < 0.05). The sensitivities of CA19-9, main pancreatic duct diameter, pancreatic head side branch duct dilation, and hypovascular mass in pancreatic head in PDAC within PAC are 53.8%, 51%, 84.6%, and 81.1%, respectively; the specificities are 81.8%, 87%, 86.1%, and 95.6%, respectively; and the areas under the ROC curve are 0.74, 0.749, 0.806, and 0.906, respectively., Conclusion: In the preoperative diagnosis of PAC, CA19-9, main pancreatic duct diameter, hypovascular mass in pancreatic head, and pancreatic head side branch duct dilation are effective indicators for distinguishing PDAC., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Active targeting is more effective than conventional passive targeted drug delivery systems in increasing therapeutic efficacy and minimizing systemic toxicities. Importantly, the nanoparticle-based targeted drug delivery systems combine active and passive targeting properties and significantly enhance therapeutic efficacy. In this study, we utilized ultrasmall superparamagnetic iron oxide (uSPIO) nanoparticles conjugated with anti-prostate-specific membrane antigen (PSMA) 5D3 monoclonal antibody, mertansine (DM1) antitubulin agent, and fluorophore to develop a targeted uSPIO-5D3-DM1-AF488/CF750 nanotheranostic for PSMA(+) prostate cancer (PC) therapy. This agent enables multimodality in vivo imaging using near-infrared (NIR) fluorescence and magnetic resonance imaging (MRI). uSPIO-5D3-DM1-AF488 is selectively internalized into PSMA-positive cells by receptor-mediated endocytosis, and uSPIO-5D3-DM1-CF750 exhibited 1.62 and 166.2 ng/mL IC 50 values in PSMA(+) and PSMA(-) cells, respectively. The image-guided therapeutic study was conducted in vivo in human PC xenograft mouse models bearing bilateral PSMA(±) tumors ( n = 10, two 10 mg/kg doses on days 1 and 14). The therapeutic results exhibited a significant control of the growth of PSMA(+) tumors starting at day 5 ( p = 0.05) and significantly improved efficacy after day 9 ( p = 0.0005) during the treatment period ( t = 21 days). We observed the PSMA-specific uptake of uSPIO-5D3-DM1-CF750 in tumors in NIR IVIS Xenogen images and T 1 -weighted MRI with 20.6% and 42% reduction of overall T 2 -weighted MRI with 20.6% and 42% reduction of overall T 1 and T 2 , respectively. Approximately 70% of mice with PSMA(+) tumors treated with uSPIO-5D3-DM1-CF750 survived or did not exceed the threshold level of the tumor size during the treatment. Ex vivo biodistribution study proved 50% and 45% higher uptake of uSPIO-5D3-DM1-CF750 by PSMA(+) tumors compared to untargeted uSPIO-DM1-CF750 by PSMA(+) tumors and uSPIO-5D3-DM1-CF750 by PSMA(-) tumors, respectively. ICP-MS analysis demonstrated a 73% increase in uSPIO-5D3-DM1-CF750 uptake by PSMA(+) tumors compared to PSMA(+) tumors treated with pure uSPIO. The toxicological results reveal the safe profile in systemic toxicities without life-threatening changes in the complete blood count and clinical chemistry profile of toxicology.

Magnetic resonance imaging (MRI)-derived texture features are quantitative imaging parameters that may have valuable associations with clinical aspects. Their prognostic ability in patients undergoing percutaneous MRI-guided liver biopsy to identify associations with post-interventional bleeding complications and biopsy success rate has not been sufficiently investigated. The patient sample consisted 79 patients (32 females, 40.5%) with a mean age of 58.7 ± 12.4 years. Clinical parameters evaluated included comorbidities, pre-existing liver disease, known cancer diagnosis, and hemostaseological parameters. Several puncture-related parameters such as biopsy angle, distance of needle entry to capsule, and lesion were analyzed. MRI texture features of the target lesion were extracted from the planning sequence of the MRI-guided liver biopsy. Mann-Whitney U test and Fisher's exact test were used for group comparison; multivariate regression model was used for outcome prediction. Overall, the diagnostic outcome of biopsy was malignant in 38 cases (48.1%) and benign in 32 cases (40.5%). A total of 11 patients (13.9%) had post-interventional bleeding, while nine patients (11.4%) had a negative biopsy result. Several texture features were statistically significantly different between patients with and without hemorrhage. The texture feature GrVariance (1.37 ± 0.78 vs. 0.80 ± 0.35, p = 0.007) reached the highest statistical significance. Regarding unsuccessful biopsy results, S(1,1)DifEntrp (0.80 ± 0.10 vs. 0.89 ± 0.12, p = 0.022) and S(0,4)DifEntrp (1.14 ± 0.10 vs. 1.22 ± 0.11, p = 0.021) reached statistical significance between groups. Several MRI texture features of the target lesion were associated with bleeding complications or negative biopsy after MRI-guided percutaneous liver biopsy. This could be used to identify at-risk patients at the beginning of the procedure and should be further analyzed., Competing Interests: Declarations. Conflict of Interest: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Severe lumbar radiculopathy pain during pregnancy requiring surgical intervention poses significant risks to foetal and maternal health from use of potentially teratogenic general anaesthetic drugs, prone positioning and intra-operative radiation from fluoroscopy., Case Report: A 28-year-old 14 weeks primigravida patient suffering from severe lumbar radiculopathy due to right sided L5-S1disc herniation was offered a discectomy procedure after failed conservative treatment. A multidisciplinary team including anaesthetists, gynaecologist, radiologist and spine surgeon was constituted. A novel two-tier marking technique utilizing ultrasonography and magnetic resonance imaging (MRI) was used to accurately plan the L5-S1 surgical incision. The surgery was performed under spinal anaesthesia in left lateral decubitus position to avoid pressure on foetus and inferior vena cava. A tubular minimally invasive approach was used to access the L5-S1 disc. No intra-operative fluoroscopy marking was used. Post-operatively patient reported complete relief from radiating right leg pain and MRI confirmed adequate nerve decompression. Post-operative foetal scans were performed at regular intervals which were normal. Patient delivered a normal term baby girl without any complications., Conclusion: Our two-tier marking technique and use of regional anaesthesia in lateral decubitus position avoids potentially teratogenic general anaesthetic agents and intra-operative radiation. It can be used to effectively decompress lumbar spine disc herniation and represents an advancement in ensuring safe spine surgery in pregnant females., Competing Interests: Declarations. Conflict of interest: The authors report no conflict of interest concerning the materials Or methods used in this study or the findings specified in this paper., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: This study aimed to investigate the diagnostic test accuracy of MRI-based radiomics studies for predicting EGFR mutation in brain metastasis originating from lung cancer., Methods: This meta-analysis, conducted following PRISMA guidelines, involved a systematic search in PubMed, Embase, and Web of Science up to November 3, 2024. Eligibility criteria followed the PICO framework, assessing population, intervention, comparison, and outcome. The RQS and QUADAS-2 tools were employed for quality assessment. A Bayesian model determined summary estimates, and statistical analysis was conducted using R and STATA software., Results: Eleven studies consisting of nine training and ten validation cohorts were included in the meta-analysis. In the training cohorts, MRI-based radiomics showed robust predictive performance for EGFR mutations in brain metastases, with an AUC of 0.90 (95% CI: 0.82-0.93), sensitivity of 0.84 (95% CI: 0.80-0.88), specificity of 0.86 (95% CI: 0.80-0.91), and a diagnostic odds ratio (DOR) of 34.17 (95% CI: 19.16-57.49). Validation cohorts confirmed strong performance, with an AUC of 0.91 (95% CI: 0.69-0.95), sensitivity of 0.79 (95% CI: 0.73-0.84), specificity of 0.88 (95% CI: 0.83-0.93), and a DOR of 31.33 (95% CI: 15.50-58.3). Subgroup analyses revealed notable trends: the T1C + T2WI sequences and 3.0 T scanners showed potential superiority, machine learning-based radiomics and manual segmentation exhibited higher diagnostic accuracy, and PyRadiomics emerged as the preferred feature extraction software., Conclusion: This meta-analysis suggests that MRI-based radiomics holds promise for the non-invasive prediction of EGFR mutations in brain metastases of lung cancer., Competing Interests: Declarations. Ethical approval: Not applicable. Informed consent: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Compressive neuropathies of the upper extremity are a common cause of pain, weakness, and functional impairment, often resulting from chronic mechanical compression or entrapment of peripheral nerves in anatomical regions such as osteofibrous tunnels, fibrous bands, or muscular pathways. While traditional diagnostic methods, including clinical evaluation and electrophysiological studies, are essential, they are limited in localizing lesions and identifying underlying causes. Advances in ultrasonography (US) and magnetic resonance imaging (MRI), particularly MR neurography and high-resolution 3D volumetric imaging, have significantly improved the evaluation of peripheral nerves by enabling detailed visualization of nerve anatomy, adjacent structures, and muscle denervation patterns. This article reviews the role of these imaging techniques in diagnosing and managing compressive neuropathies affecting the brachial plexus, suprascapular, axillary, median, ulnar, and radial nerves, highlighting key imaging findings such as nerve thickening, signal abnormalities, and muscle changes. The integration of advanced imaging modalities into clinical practice enhances diagnostic accuracy, facilitates surgical planning, and improves treatment outcomes for patients with peripheral nerve compression., Competing Interests: Declarations. Human ethics and consent to participate: not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: For unicompartmental knee arthroplasty (UKA), patient selection using correct indications can optimise postsurgical outcomes. The current gold standard for assessing eligibility is with radiographs; however, magnetic resonance imaging (MRI) may allow for more accurate assessments of cartilage damage. This study aimed to evaluate the utility of MRI for preoperative assessment of medial UKA patients by (1) comparing osteoarthritis severity of the medial, lateral and patellofemoral (PF) compartments when assessed using MRI compared with standard radiographs, and (2) investigating associations of these two assessments with postoperative clinical outcomes., Methods: This study had ethical approval. A retrospective review was performed for 88 primary medial UKA between 1 January 2017 and 31 December 2021. The main outcome measures were preoperative cartilage loss and patient-reported clinical outcomes. Preoperative cartilage loss was recorded using the International Cartilage Repair Society (ICRS) classification using MRI, and Kellgren-Lawrence (K-L) scores from radiographs. Patient-reported clinical outcomes were measured using preop, early (6-week) and late (1- or 2-year) Oxford Knee Score (OKS) change scores., Results: The use of MRI has improved accuracy over radiographs. In the medial compartment, 37 (44%) patients had less severe radiographic K-L scores (1-3); however, all patients had the most severe MRI ICRS scores (4). For patients with mild K-L scores (0 and 1), 20 (43%) and 7 (78%) patients had more severe ICRS scores (3 and 4) within their lateral and PF compartments, respectively. No associations were found between ICRS or K-L scores and OKS for any compartments., Conclusions: Assessment of medial cartilage thickness loss using MRI provides additional utility over standard radiographs in preoperative assessments of medial UKA patients. However, evidence of disease in the PF compartment assessed using MRI should not be considered a contraindication for UKA., Level of Evidence: Level III, retrospective cohort study., (© 2025 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Objective: In the field of diagnosing the adult discoid lateral meniscus (DLM), MRI has undergone extensive research. However, the use of MRI for diagnosing DLM in children and adolescents remains controversial. This study aimed to explore the diagnostic efficiency of MRI for DLM in children and adolescents and to determine the diagnostic value of these indicators., Methods: This retrospective study included children (aged between 4 and 11 years) and adolescents (aged between 12 and 17 years) from September 1, 2019 to January 1, 2023, who were diagnosed with lateral meniscus (LM) or DLM injury through arthroscopic surgery. All patients underwent a 3 T MRI examination before surgery. The MRI indicators included the LM width (LMW), ratio of the LMW to the tibia (RMT), percent coverage of the meniscus (PCM), tibial width (TW), height of the medial tibial spine (HMTS), height of the lateral tibial spine (HLTS), tibial eminence width (TEW), lateral slope angle of the medial tibial eminence (LSAMTE), lateral slope angle of the lateral tibial eminence (LSALTE), and presence of three "bow tie signs." A diagnostic efficacy analysis of all indicators was conducted to determine characteristic MRI diagnostic indicators and analyze their diagnostic value. Pearson's correlation analysis was conducted to evaluate the correlation between diagnostic indicators and baseline information., Results: This study included 90 patients (26 with LM injuries and 64 with DLM injuries). The average age was 12.81 ± 4.34 years, height was 151.24 ± 23.82 cm, weight was 48.20 ± 21.82 kg, and BMI was 19.69 ± 4.22 kg/m 2 . A total of 10 MRI indicators were included and evaluated for their diagnostic value. The comparison between the DLM and LM groups revealed significant differences in LMW, TW, RMT, PCM, LSAMTE, and "bow tie signs" (p < 0.05). In the diagnostic efficacy analysis, LMW had a sensitivity of 85.94%, specificity of 76%, and accuracy of 83.13%; RMT had a sensitivity of 95.31%, specificity of 76%, and accuracy of 89.89%; PCM had a sensitivity of 75.28%, specificity of 60%, and accuracy of 75.28%; LSAMTE had a sensitivity of 72.92%, specificity of 84%, and accuracy of 72.92%; and "bow tie signs" had a sensitivity of 80.95%, specificity of 81.25%, and accuracy of 81.11%., Conclusion: The MRI diagnosis of DLM in children and adolescents can be based on LMW, RMT, PCM, LSAMTE, and "bow-tie signs," with these indicators demonstrating good diagnostic efficacy., (© 2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Background: Generative adversarial networks (GANs) have recently demonstrated significant potential for producing virtual images with the same characteristics as real-life landscapes, thereby enhancing various medical tasks., Purpose: To design a region-guided focal GAN (Focal-GAN) for translating images between CT and MRI and test its clinical applicability in patients with hepatocellular carcinoma (HCC)., Methods: Between January 2012 and October 2021, two cohorts of patients with HCC who underwent contrast-enhanced CT (Center 1, n = 685) and MRI (Center 1, n = 516; Center 2, n = 318) were retrospectively enrolled. We trained the Focal-GAN model by adding tumor regions to a baseline Cycle-GAN framework to steer the model toward focal attention learning. The quality of the images generated was assessed using an open-source MRQy tool. The clinical applicability of the Focal-GAN was evaluated by applying the nnUNet and ResNet-50 model for tumor segmentation and microvascular invasion (MVI) prediction in HCC on the generated images., Results: In the ablation tests, Focal-GAN achieved a higher fidelity than the conventional Cycle-GAN in the generated image quality assessment with MRQy. Regarding applicability, regardless of tumor size, nnUNet trained with focal-GAN-generated images achieved higher Dice scores than nnUNet trained using Cycle-GAN-generated images for HCC segmentation in both internal (0.607 vs. 0.341, p < 0.01) and external (0.796 vs. 0.753, p < 0.001) validation. Additionally, ResNet-50 trained with Focal-GAN-generated images produced higher areas-under-curve (AUCs) than ResNet-50 trained with real images for MVI prediction in both internal (0.754 vs. 0.665, p = 0.048) and external (0.670 vs. 0.579, p < 0.001) validation., Conclusions: The designed Focal-GAN model can generate virtual MR images from unpaired CT images, thereby extending the clinical applicability of CT in the liver tumor diagnostic pathway., (© 2025 American Association of Physicists in Medicine.)

Medical imaging is crucial for artificial intelligence-based clinician decision-making. However, learning anatomical features from limited samples poses a challenge. To address this issue, recent studies have employed diffusion models to generate medical imaging data, demonstrating the potential for high-quality medical image generation through deep learning. In this paper, we propose a high-quality cervical MRI image generation method called the Cervical Spine MRI Diffusion Probabilistic Model (CSM-DPM). Considering the complexity of neck MRI image data, our method uses a hybrid of standard Gaussian noise and point noise obtained by sampling within 2D Gaussian noise fields to approximate the true distribution of the image data. Meanwhile, the cosine noise schedule is used to make the morphology of the generated vertebral blocks and other focal areas more visually natural and clear. Furthermore, to enhance the noise prediction capabilities of UNet in DDPM, we devise the Asa-ResUNet module, which incorporates an asymmetric attention mechanism. This mechanism includes spatial attention on different ResUNet layers to improve feature extraction and incorporates high-level semantic information. We further enhance the stability and robustness of the Asa-ResUNet by using an exponential weighting strategy (EMA). Experiments demonstrate that our method produces cervical spine MRI images with FID values that are up to 15.79%, 52.61%, and 46.57% lower than those produced by DDPM, DDIM, and F-PNDM, respectively, indicating superior image quality. Segmentation experiments confirm that the generated images can enhance the overall performance of segmentation models when used for training., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Rationale and Objectives: To evaluate the accuracy of ChatGPT-4o in identifying magnetic resonance imaging (MRI) findings and diagnosing brain tumors by comparing its performance with that of experienced radiologists., Materials and Methods: This retrospective study included 46 patients with pathologically confirmed brain tumors who underwent preoperative MRI between January 2021 and October 2024. Two experienced radiologists and ChatGPT 4o independently evaluated the anonymized MRI images. Eight questions focusing on MRI sequences, lesion characteristics, and diagnoses were answered. ChatGPT-4o's responses were compared to those of the radiologists and the pathology outcomes. Statistical analyses were performed, which included accuracy, sensitivity, specificity, and the McNemar test, with p<0.05 considered to indicate a statistically significant difference., Results: ChatGPT-4o successfully identified 44 of the 46 (95.7%) lesions; it achieved 88.3% accuracy in identifying MRI sequences, 81% in perilesional edema, 79.5% in signal characteristics, and 82.2% in contrast enhancement. However, its accuracy in localizing lesions was 53.6% and that in distinguishing extra-axial from intra-axial lesions was 26.3%. As such, ChatGPT-4o achieved success rates of 56.8% and 29.5% for differential diagnoses and most likely diagnoses when compared to 93.2-90.9% and 70.5-65.9% for radiologists, respectively (p<0.005)., Conclusion: ChatGPT-4o demonstrated high accuracy in identifying certain MRI features but underperformed in diagnostic tasks in comparison with the radiologists. Despite its current limitations, future updates and advancements have the potential to enable large language models to facilitate diagnosis and offer a reliable second opinion to radiologists., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Purpose: As a portable and cost-effective imaging modality with better accessibility than Magnetic Resonance Imaging (MRI), transcranial sonography (TCS) has demonstrated its flexibility and potential utility in various clinical diagnostic applications, including Parkinson's disease and cerebrovascular conditions. To better understand the information in TCS for data analysis and acquisition, MRI can provide guidance for efficient imaging with neuronavigation systems and the confirmation of disease-related abnormality. In these cases, MRI-TCS co-registration is crucial, but relevant public databases are scarce to help develop the related algorithms and software systems., Acquisition and Validation Methods: This dataset comprises manually registered MRI and transcranial ultrasound volumes from eight healthy subjects. Three raters manually registered each subject's scans, based on visual inspection of image feature correspondence. Average transformation matrices were computed from all raters' alignments for each subject. Inter- and intra-rater variability in the transformations conducted by raters are presented to validate the accuracy and consistency of manual registration. In addition, a population-averaged MRI brain vascular atlas is provided to facilitate the development of computer-assisted TCS acquisition software., Data Format and Usage Notes: The dataset is provided in both NIFTI and MINC formats and is publicly available on the OSF data repository: https://osf.io/zdcjb/., Potential Applications: This dataset provides the first public resource for the development and assessment of MRI-TCS registration with manual ground truths, as well as resources for establishing neuronavigation software in data acquisition and analysis of TCS. These technical advancements could greatly boost TCS as an imaging tool for clinical applications in the diagnosis of neurological conditions such as Parkinson's disease and cerebrovascular disorders., (© 2025 The Author(s). Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

Joint stability depends on various properties that include the bone anatomy, joint capsule geometry and stiffness, and soft tissues within. The multiscale biomechanical relationships between the whole joint and individual tissues are useful in estimating the physiological condition of the knee. To better understand these relationships, we evaluated multiple structural and mechanical parameters in healthy ovine stifles, specifically joint laxity, joint morphology, individual tissue T 2 relaxation and mechanical properties of ligaments (ACL, PCL, MCL, LCL), patellar tendon, menisci, and cartilage. By combining mechanical testing at two length scales and magnetic resonance imaging (MRI) scans, we quantify the strength of correlation coefficients between measured metrics, among joint size, whole joint and individual tissue properties. We observe positive correlations between joint laxity forces and the inter-epicondylar distance. Further, the viscoelastic properties of the tendons and ligaments correlate positively with joint laxity forces; however, no such correlations were observed for the cartilage and menisci. We also found weak inverse correlation between tissue viscoelasticity and T * relaxation and mechanical properties of ligaments (ACL, PCL, MCL, LCL), patellar tendon, menisci, and cartilage. By combining mechanical testing at two length scales and magnetic resonance imaging (MRI) scans, we quantify the strength of correlation coefficients between measured metrics, among joint size, whole joint and individual tissue properties. We observe positive correlations between joint laxity forces and the inter-epicondylar distance. Further, the viscoelastic properties of the tendons and ligaments correlate positively with joint laxity forces; however, no such correlations were observed for the cartilage and menisci. We also found weak inverse correlation between tissue viscoelasticity and T 2 * for MCL; and positive correlations for cartilage and menisci, LCL and PCL respectively. These results provide useful insights into the role of individual tissues that are crucial in measuring whole joint responses as key indicators of knee health., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: Predictive coding is a theoretical framework that integrates models of brain dysconnectivity and psychopathology in psychosis. Thalamocortical dysconnectivity as well as reduced thalamic volumes have been reported in psychotic disorders. However, the role of the thalamus in predictive coding is not clear. We examined the relationship between magnetic resonance imaging (MRI)- based thalamic nuclei volumes and mismatch negativity (MMN), a purported index of prediction error signaling known to be impaired in psychosis., Methods: We obtained MRI and MMN using a roving paradigm from individuals with SCZ spectrum disorder (SSD, n = 60) or bipolar disorder (BD, n = 69) and HC (n = 252). We segmented volumes of 25 thalamic nuclei bilaterally and tested their associations with MMN amplitude using linear models while covarying for age, sex, diagnosis, and intracranial volumes (ICV)., Results: We did not find group differences in thalamic volumes that could account for differences in MMN, neither did we find significant volume × diagnosis interactions on MMN for any of the 25 nuclei examined. Across the whole sample, significant positive associations were found between MMN amplitude and the volumes of several higher-order thalamic nuclei, including the mediodorsal medial and lateral nuclei, anterior and medial pulvinar, nucleus reuniens, as well as the lateral geniculate nucleus., Conclusion: The results demonstrate a positive association between MMN amplitude and volumes of thalamic association nuclei in patients with psychotic disorders and HC. These findings may suggest a modulatory role of the thalamus in prediction error signaling., Competing Interests: Declaration of competing interest Torbjørn Elvsåshagen. is a consultant to BrainWaveBank and Synovion and received speaker's honoraria from Lundbeck and Janssen Cilag. Ole Andreassen. is a consultant to HealthLytix and received speaker's honoraria from Lundbeck. The other authors declare no competing interests., (Copyright © 2025. Published by Elsevier B.V.)

Purpose: Pituitary adenomas are much rarer in children than in adults. We aimed to analyze their imaging characteristics in this age group and to compare them according to the hormonal secretion. We conducted an observational monocentric retrospective study on clinical and imaging data., Methods: We analyzed imaging features before surgery or drug treatment of pituitary adenomas in children confirmed by histopathology or hormonal secretion. We assessed tumoral signal intensity, volume and aggressiveness, and compared it according to the hormonal secretion., Results: We included 31 children (13 lactotroph (42%), 8 corticotroph (26%), 5 somatotroph (16%), 5 plurihormonal adenomas (16%) including 1 non-secreting macroadenoma) with a median age of 13 years (range 2-16 years-old), without age or sex difference between secretion types. Lactotroph and somatotroph adenomas were larger than corticotroph adenomas (p = 0.007) and were more aggressive (p = 0.01). They also had higher signal intensity on T2-weighted images (p = 0.04). T1 signal intensity was similar between the groups on pre and post-contrast images (lower enhancement than the normal pituitary). No non-secreting micro-adenoma became clinically significant enough to lead to a pathological confirmation or specific treatment. Genetic research was conducted on 20 children, finding MEN1 mutations in 80% of the patients., Conclusions: Pituitary adenomas in children are rare but should be considered when facing similar imaging features than in adults. Imaging characteristics may allow to suspect the hormonal secretion., Competing Interests: Conflict of interest: F. Kassem, R. Levy, A. Tauziède-Espariat, C.-J. Roux, T. Samoyeau, A. Ollitrault, G. Pinto, D. Samara-Boustani, D. Kariyawasam, M. Polak, K. Beccaria, T. Blauwblomme,P. Varlet, N. Boddaert and V. Dangouloff-Ros declare that they have no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

An 11-year-old neutered male Asian small-clawed otter fell down the stairs while sleeping, after which it developed left-sided paralysis. Initial treatment involved once daily administration of prednisolone at 0.5 mg/kg. Despite slight clinical sign improvements by day 10, paralysis persisted. MRI (T2WI) identified a well-defined, hyper-intense lesion on the left side within the spinal cord at the C2-3 intervertebral level. Based on CT and MRI findings, fibrocartilaginous embolus (FCE) was suspected. Prednisolone was then tapered and by day 23 of illness, the otter was able to walk normally, so prednisolone administration was discontinued. No neurological symptom recurrence was observed, and the course remained favorable. One year later, a follow up MRI revealed a diminished lesion compared to initial examination.

Thyroid-associated ophthalmopathy (TAO) is a vision-threatening autoimmune disease that involves the extraocular muscles (EOMs) and periorbital fat. Typical signs of TAO include eyelid recession, proptosis, diplopia, and decreased visual acuity. As a self-limited disease, there is major bipolarity in clinical outcomes in TAO population. The early diagnosis and prediction of these refractory and relapsed patients is essential. Unfortunately, commonly used tools such as CAS/NOSPECTS, are based on clinical symptoms and signs alone, have significant limitations. Some imaging techniques or examinations, such as magnetic resonance imaging (MRI), can be very effective in assisting TAO assessment, from exhaustive whiteboard notes to optimized patient outcomes. Being one of the most commonly used and accurate objective examinations for TAO assessment, MRI boosts no ionizing radiation, high soft tissue contrast, better reflection of tissue water content, and the ability to quantify multiple parameters. In addition, novel MR sequences are becoming increasingly more familiar in TAO and other areas of clinical and scientific research. Moreover, radiomics, a method involving the extraction of a large number of features from medical images through algorithms, is a more recent approach used in the analysis and characterization of TAO data. Thus, this review aims to summarize and compare the value of routine and novel functional MRI sequences and radiomics prediction models in the diagnosis and evaluation of TAO.

Objectives: This study aimed to compare the imaging findings associated with the recurrence of HPV-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC). Methods: In total, 68 patients (51 men; mean age, 64.4 years; age range, 41-86 years; 48 HPV-positive patients and 20 HPV-negative patients) with histopathologically proven OPSCC who underwent CT, MRI, and 18F-FDG-PET/CT before treatment between October 2014 and July 2022 were enrolled in this study. The imaging findings were retrospectively evaluated and statistically compared. Results: HPV-positive OPSCC had a significantly lower recurrence rate compared with that of HPV-negative OPSCC ( p < 0.01). Among HPV-positive OPSCCs, patients with recurrence were considerably older than those without recurrence ( p < 0.05); however, the T and N categories did not differ between the two groups. Meanwhile, among HPV-negative OPSCCs, the T and N categories were associated with recurrence ( p < 0.05). Furthermore, the attenuation on contrast-enhanced CT ( p < 0.05) and signal intensity on contrast-enhanced T1-weighted images ( p < 0.05) of nodal metastases were significantly lower in recurrence patients compared to those in nonrecurrence patients. Cystic change in nodal metastases in HPV-positive and HPV-negative OPSCCs were similar in patients with and without recurrence. Conclusions: The T and N categories were associated with recurrence in HPV-negative OPSCC but not in HPV-positive OPSCC. Prognostic factors differed significantly between HPV-positive and HPV-negative OPSCC.

Purpose: This study aimed to evaluate the applicability and technical feasibility of magnetic resonance imaging (MRI) and ultrasonography (US) fusion-guided transforaminal epidural steroid injection (TFESI) in patients with lumbar disc herniation (LDH) leading to radiculopathy, who are unresponsive to conservative treatment., Methods: This retrospective study included 21 patients aged 18-65 years who underwent MRI-US fusion-guided TFESI for LDH-induced radiculopathy. Patient data, including demographic characteristics, body mass index (BMI), fluoroscopy duration, radiation dose, and procedure success, were analyzed. Success was defined by the contrast-spread pattern during the procedure. Statistical analyses were performed to identify factors predicting procedural success., Results: The MRI-US fusion-guided TFESI procedure was successful in 81% of patients. Successful outcomes were significantly associated with younger age (≤ 56 years, p < 0.001), lower BMI (≤ 28 kg/m², p < 0.001), shorter fluoroscopy duration (> 4.9 s, p < 0.001), and lower radiation dose (> 3.7 mGy, p < 0.001). A positive correlation was observed between age and radiation dose (p = 0.030), as well as between BMI and radiation dose (p = 0.049)., Conclusion: MRI-US fusion-guided TFESI is a feasible and safe technique with a high success rate and low radiation exposure in patients with LDH-induced radiculopathy. Younger age, lower BMI, shorter fluoroscopy duration, and lower radiation dose are significant predictors of procedural success. This technique may enhance spatial orientation during the procedure, potentially improving outcomes particularly in younger patients with lower BMI., Competing Interests: Declarations. Conflict of interest: There is no conflict of interest to declare. This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Stroke is the most frequent arterial thrombosis in antiphospholipid syndrome (APS) with high rates of recurrence., Methods and Patients: A retrospective, single-centre 10-year review of patients with APS having sequential cerebral magnetic resonance imaging (MRI) was performed to describe ischaemic features in APS and associated disease risk factors and progression over time., Results: A total of 120 patients and 307 scans were included with 67% of patients receiving vitamin K antagonists (VKA). Note that 65% of patients had baseline ischaemic features with white matter hyperintensities (WMH), as a feature of small vessel disease (SVD), seen in 79% of abnormal scans. Fifteen percent of patients had progressive ischaemic changes with 83% demonstrating progressive WMH and 33% new infarcts (predominantly lacunar) on sequential scans. Progression-free survival for progressive ischaemia was 88% at 5 years. Multivariate analysis showed longer follow-up was a risk for developing progressive ischaemia (odds ratio [OR] 1.43, 95% confidence interval [CI] 1.13-1.86, p  = 0.005). Hypertension (56% vs. 30%, p  = 0.04) and ischaemic heart disease (22% vs. 6%, p  = 0.04) were more prevalent with progressive ischaemia. There was no difference in progression or bleeding events according to VKA therapeutic intensity., Discussion: These results show SVD is a common feature of APS using MRI with progressive changes despite anticoagulation. Traditional risk factors for cerebrovascular disease were associated with progression., Competing Interests: The authors declare no conflicts of interest., (© 2025 The Author(s). eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.)

Purpose: To investigate how endolymphatic hydrops (EH) affects the entry of intratympanic gadolinium in the inner ear of patients with Meniere's disease (MD)., Materials and Methods: This study included 166 MD patients. MRI was performed 24 h after intratympanic injection of dexamethasone and 20-fold diluted Gd-DTPA. The region of interest with the strongest enhancement in the cochlea and vestibule was selected to calculate the signal intensity ratio (SIR), representing transport speed. The enhancement area in the vestibular perilymph, indicating the distribution volume of Gd-DTPA, was measured., Results: EH was detected in 77.7% of patients, specifically in 60 out of 63 definite MD cases and 51 out of 103 probable MD cases. Vestibular EH with various grades was present in 76.1% of patients, whereas 17.5% exhibited impaired barriers of endolymph. Cochlear EH with various grades was observed in 68.7% of patients, and 34.9% located at the apex; 12.7% had impaired barriers of endolymph. The severity of cochlear symptoms and the stage of MD significantly correlated with the presence of EH. The vestibular SIR inversely correlated with vestibular EH. The enhancement area of the vestibular perilymph inversely correlated with EH and the stage of MD., Conclusions: Gadolinium transport from the middle ear into the inner ear and the distribution volume in the inner ear inversely correlated with EH, which is compromised in more advanced stages MD patients., Competing Interests: Declarations. Ethical approval: The protocol for intratympanic injections of gadolinium and dexamethasone was reviewed and approved by the ethical committee of Shanghai Changhai Hospital (CHEC2020-107). Conflict of interest: The authors declare that they have no conflict of interest., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cerebellar functional connectivity changes have been reported in Alzheimer's disease (AD), but a comprehensive framework integrating these findings is lacking. This retrospective study investigates the cerebello-thalamo-cortical (CTC) circuit in AD, using functional gradient analysis to elucidate deficits and potential biomarkers. We analyzed data from 246 participants enrolled in the Alzheimer's Disease Neuroimaging Initiative (ADNI-3; NCT02854033), including 58 with AD, 103 with mild cognitive impairment (MCI), and 85 cognitively normal (CN) controls, matched for age and sex. All individuals underwent comprehensive neuropsychological assessments (MMSE, MoCA, ADAS-Cog) and MRI scans. We extracted mean time series for 270 brain regions (an extended Power atlas) and computed pairwise functional connectivity, focusing on CTC circuitry. Thalamic and cerebellar connectivity gradients were derived using voxel-wise correlation matrices and the BrainSpace toolbox, defining thalamic and cerebellar masks from the Melbourne subcortical atlas and AAL atlas, respectively. ANCOVA with post hoc analyses, controlling for age and sex, was conducted to assess abnormal CTC connectivity across AD, MCI, and CN groups. LASSO regression identified edges within the CTC circuitry that significantly differed between AD and CN, MCI and CN, AD and MCI, as well as was used to construct Logistic classification model. Pearson correlations were performed to examine relationships between mean CTC connectivity, individual edges, and cognitive scores (MMSE, MoCA, ADAS-Cog). To explore the hierarchical organization of the thalamus and cerebellum, global gradient distributions were compared across groups using two-sample Kolmogorov-Smirnov tests. Additionally, ANCOVA was applied to compare subfield- and functional-level gradients of the thalamus and cerebellum among AD, MCI, and CN. False discovery rate (FDR) corrections were used, setting the statistical significance threshold was set at P < 0.05. AD and MCI individuals exhibited increased CTC connectivity compared to CN (all P < 0.05). Average CTC connectivity did not correlate with cognitive scores (P > 0.05), but specific CTC edges were correlated. LASSO regression identified 20 discriminative edges, achieving high accuracy in AD-CN classification (AUC = 0.92 training, AUC = 0.80 test). Thalamic and cerebellar gradient distributions differed significantly across groups (all P < 0.05), with specific regions showing distinct gradient scores. Five cerebellar functional networks exhibited decreased gradient scores. Significant CTC hyperconnectivity in AD and MCI compared with CN suggests early thalamic and cerebellar dysregulation. Classification analyses effectively distinguished AD vs. CN but were moderate for MCI vs. CN and limited for MCI vs. AD. Gradient analyses revealed global- and subfield-level disruptions in AD, emphasizing the role of thalamic and cerebellar interactions in cognitive decline and offering potential diagnostic markers and therapeutic targets., Competing Interests: Declarations. Ethics Approval and Consent to Participate: Our research data were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) multicenter public dataset. Approval was granted by the Ethics Committee of each participating ADNI site. Informed consent was obtained from all individual participants included in the dataset. Our study was performed in line with the principles of the Declaration of Helsinki and approved by the Ethics Committee of Xuanwu Hospital Capital Medical University. Human Ethics and Consent to Participate: Not applicable. Competing Interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Mild cognitive impairment (MCI) and preclinical MCI (e.g., subjective cognitive decline, SCD) are considered risk states of dementia, such as Alzheimer's Disease (AD). However, it is challenging to accurately predict conversion from normal cognition (NC) to MCI, which is important for early detection and intervention. Since neuropathological changes may have occurred in the brain many years before clinical AD, we sought to detect the subtle brain changes in the pre-MCI stage using a deep-learning method based on structural Magnetic Resonance Imaging (MRI)., Objectives: To discover early structural neuroimaging changes that differentiate between stable and progressive cognitive status, and to establish a predictive model for MCI conversion., Design, Setting and Participants: We first created a unique deep-learning framework for pre-AD conversion prediction through the Alzheimer's Disease Neuroimaging Initiative-1 (ADNI-1) database (n = 845). Then, we tested the model on ADNI-2 (n = 321, followed 3 years) and our private study (n = 109), the China Longitudinal Aging Study (CLAS), to validate the rationality for pre-MCI conversion prediction. The CLAS is a 7-year community-based cohort study in Shanghai. Our framework consisted of two steps: 1) a single-ROI-based network (SRNet) for identifying informative regions in the brain, and 2) a multi-ROI-based network (MRNet) for pre-AD conversion prediction. We then utilized these "ROI-based deep learning" neural networks to create a composite score using advanced algorithm-building. We coined this score as the Progressive Index (PI), which serves as a metric for assessing the propensity of AD conversion. Ultimately, we employed the PI to gauge its predictive capability for MCI conversion in both ADNI-2 and CLAS datasets., Measurements: We primarily utilized baseline T1-weighted MRI scans to identify the most discriminative brain regions and subsequently developed the PI in both training and validation datasets. We compared the PI across different cognitive groups and conducted logistic regression models along with their AUCs, adjusting for education level, gender, neuropsychological test scores, and the presence of comorbid conditions., Results: We trained the SRNet and MRNet using 845 subjects from ADNI-1 with baseline MRI data, in which AD and progressive MCI (converting to AD within 3 years) patients were considered as positive samples, while NC and stable MCI (remaining stable for 3 years) subjects were considered as negative samples. The convolutional neural networks identified the top 10 regions of interest (ROIs) for distinguishing progressive from stable cases. These key brain regions included the hippocampus, amygdala, temporal lobe, insula, and anterior cerebellum. A total of 321 subjects from ADNI-2, including 209 NC (18 progressive NC (pNC), 113 stable NC (sNC), and 78 remaining NC (rNC)) and 112 SCD (11 pSCD, 5 sSCD, and 96 rSCD), as well as 109 subjects from CLAS, including 17 sNC, 16 pNC, 52 sSCD and 24 pSCD participated in the test set, separately. We found that the PI score effectively sorted all subjects by their stages (stable vs progressive). Furthermore, the PI score demonstrated excellent discrimination between the two outcomes in the CLAS data(p<0.001), even after controlling for age, gender, education level, depression symptoms, anxiety symptoms, somatic diseases, and baseline MoCA score. Better performance for prediction progression to MCI in CLAS was obtained when the PI score was combined with clinical measures (AUC=0.812; 95 %CI: 0.725-0.900)., Conclusions: This study effectively predicted the progression to MCI among order individuals at normal cognition state by deep learning algorithm with MRI scans. Exploring the key brain alterations during the very early stages, specifically the transition from NC to MCI, based on deep learning methods holds significant potential for further research and contributes to a deeper understanding of disease mechanisms., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Background: There has been increasing interest in associations between paraspinal muscle phenotypes and common spinal disorders, including lumbar spinal stenosis (LSS). However, the relation of paraspinal muscle morphology and composition with LSS is unclear., Objectives: To provide a systematic overview and synthesis of current evidence on the association of paraspinal muscle morphology and composition with LSS presence, pain and disability or function., Design: Systematic review METHODS: Relevant studies were identified from a search of EMBASE, PubMed, SPORTDiscuss, Cinahl, Web of Science and PEDro. Relevant studies were selected, data were extracted, and risk of bias was assessed by two independent reviewers prior to conducting a narrative synthesis to summarize evidence using GRADE considerations. The study protocol was prospectively registered (Prospero: CRD42021246492)., Results: Of 33 studies included in the review, multifidus (n=22) was most frequently studied, followed by psoas (n=10). Fatty infiltration (20 studies), CSA (n=11) and relative CSA (n=10) were the most studied paraspinal phenotypes. Most studies (n=31) had low risk of bias, with selection and confounding bias (n=13) most common. High variability in approaches used to measure muscle morphology and composition and LSS disability and pain, and variable control of confounding factors, created challenges in synthesizing findings. The only association identified for which there was moderate certainty of evidence was between increased multifidus fatty infiltration and the presence of LSS (4 of 6 studies). All other associations studied with high or moderate strength of evidence demonstrated no association, including no association between multifidus fatty infiltration and pain severity (8 studies), multifidus CSA and LSS disability (7 studies), psoas morphology and LSS anatomical severity (4 studies), or psoas composition and LSS pain severity (4 studies) for which there was high certainty. There was moderate certainty of no association between multifidus morphology and LSS pain severity (5 of 7 studies), and erector spinae morphology and pain severity (3 studies), and erector spinae composition and LSS pain severity (3 studies) and function (3 studies). Other associations remain more unclear., Conclusion: Largely consistent results suggest multifidus fatty infiltration is associated with the presence of LSS. However, other specific associations examined with high or moderate certainty of evidence demonstrated no association, and others remain largely undetermined. Although interest has grown in paraspinal muscle morphology and composition for improved phenotyping, prognosis and treatment of common spinal disorders, the clinical utility of paraspinal muscle imaging in LSS remains unclear., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2025. Published by Elsevier Inc.)

There is a growing interest in developing drugs with a general geroprotective effect, aimed at slowing down aging. Several compounds have been shown to increase the lifespan and reduce the incidence of age-related diseases in model organisms. Translating these results is challenging, due to the long lifespan of humans. To address this, we propose using a battery of medical imaging protocols that allow for assessments of age-related processes known to precede disease onset. These protocols, based on magnetic resonance imaging, positron emission-, computed-, and optical coherence tomography, are already in use in drug development and are available at most modern hospitals. Here, we outline how an informed use of these techniques allows for detecting changes in the accumulation of age-related pathologies in a diverse set of physiological systems. This in vivo imaging battery enables efficient screening of candidate geroprotective compounds in early phase clinical trials, within reasonable trial durations., Competing Interests: Declarations. Conflict of interest: MS is employed by Antaros Medical. JES and PPS declare no conflict of interest., (© 2025. The Author(s).)

Current European Stroke Organisation (ESO) guidelines recommend extended time window reperfusion therapies (4.5-9 h for thrombolysis, 6-24 h for thrombectomy) based on advanced imaging. However, the workload and clinical benefit of this strategy on a population basis are not known. To determine the caseload, treatment rates, and outcomes in the extended as compared to the standard time windows. All consecutive ischaemic stroke patients within 24 h of last known well between 1st March 2021 and 28th February 2022 were included in a prospective single-centre study. Treatment eligibility in the extended time windows or wake-up strokes recognized within 4 h was based on current ESO guideline criteria using MRI DWI-PWI or DWI-FLAIR mismatch. MRI was only available during working hours (8-20 h); otherwise, CT/CTA was used. Clinical outcome in treated patients was assessed at three months. Among the 777 admitted patients, 252 (32.4%) had MRI. The thrombolysis rate was 119/304 (39.1%) in standard and 14/231 (6.1%) in the extended time window. The thrombectomy rate was 34/386 (8.8%) in standard and 15/391 (3.8%) in the extended time window. Independent clinical outcomes (mRS ≤ 2) were not statistically different in early and late-treated patients both for thrombolysis (48% vs. 28.6%, p = 0.25) and thrombectomy (38.4% vs. 33.3%, p = 0.99). Even with a limited availability of advanced imaging extending therapeutic time windows resulted in an 11.7% increase in thrombolysis and a 44% increase in thrombectomy with comparable clinical outcomes in early and late-treated patients at the price of a twofold burden in clinical and advanced imaging screening., Competing Interests: Declarations. Ethics approval: This study was approved by the Semmelweis University Regional and Institutional Committee of Research Ethics (approval no. 123/2019) on October 19, 2019. Consent to participate: Patient consent was obtained for treatment in the extended thrombolysis time window (off-label use). For treatment in the standard time window and for data collection without treatment, consent was not obtained because the data were analysed anonymously. Data was accessed between the 1st and 15th of May, 2022, for research purposes. The first and last authors had information that could identify individual participants during data collection. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background and Purpose . Although radiotherapy techniques are a primary treatment for head and neck cancer (HNC), they are still associated with substantial toxicity and side effects. Machine learning (ML) based radiomics models for predicting toxicity mostly rely on features extracted from pre-treatment imaging data. This study aims to compare different models in predicting radiation-induced xerostomia and sticky saliva in both early and late stages HNC patients using CT and MRI image features along with demographics and dosimetric information. Materials and Methods. A cohort of 85 HNC patients who underwent radiation treatment was evaluated. We built different ML-based classifiers to build a multi-objective, multimodal radiomics model by extracting 346 different features from patient data. The models were trained and tested for prediction, utilizing Relief feature selection method and eight classifiers consisting eXtreme Gradient Boosting (XGBoost), Multilayer Perceptron (MLP), Support Vector Machines (SVM), Random Forest (RF), K-Nearest Neighbor (KNN), Naive Bayes (NB), Logistic Regression (LR), and Decision Tree (DT). The performance of the models was evaluated using sensitivity, specificity, area under the curve (AUC), and accuracy metrics. Results. Using a combination of demographics, dosimetric, and image features, the SVM model obtained the best performance with AUC of 0.77 and 0.81 for predicting early sticky saliva and xerostomia, respectively. Also, SVM and MLP classifiers achieved a noteworthy AUC of 0.85 and 0.64 for predicting late sticky saliva and xerostomia, respectively. Conclusion . This study highlights the potential of baseline CT and MRI image features, combined with dosimetric data and patient demographics, to predict radiation-induced xerostomia and sticky saliva. The use of ML techniques provides valuable insights for personalized treatment planning to mitigate toxicity effects during radiation therapy for HNC patients., (Creative Commons Attribution license.)

Objectives: Axial bone involvement in sarcoidosis is observed in approximately 25 % of patients on positron emission tomography (PET). Many of these lesions are asymptomatic, and their long-term outcomes are not well defined. This study aims to evaluate the prognosis of axial bone lesions in histologically confirmed sarcoidosis., Methods: We assessed initial and follow-up MRI and PET from 48 patients diagnosed with axial bone sarcoidosis (135 MRI and 132 PET), with a mean follow-up duration of 33 and 44 months, respectively. Baseline and longitudinal associations between imaging results and patient variables were evaluated., Results: MRI revealed predominantly nodular marrow replacement lesions, while PET identified multifocal bone involvement, with no corresponding bone lesions detected on CT in 80.8 % of cases. Compared to baseline imaging, serial MRI and PET showed significant reduction or resolution of bone lesions over time (MRI: p < 0.01; PET: p < 0.001). This was more frequently observed on PET (68.3 % of patients) than on MRI (19.5). During follow-up, bone pain improved significantly (p = 0.01), which was associated with favorable changes in both PET and MRI findings (p = 0.02 and p = 0.04, respectively). Seven patients had bone relapse. No epiduritis or soft-tissue infiltration was observed., Discussion: This longitudinal evaluation over a 3-year period, combining clinical, radiological, and biochemical data, shows that sarcoidosis axial bone lesions have a favorable prognosis. Significant improvement was observed on both MRI and PET. The improvement in bone pain was associated with favorable imaging changes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2025. Published by Elsevier Inc.)

Background: Optimal prognostic stratification for colorectal liver metastases (CRLM) patients undergoing surgery with neoadjuvant therapy (NAT) remains elusive. This study aimed to develop and validate dual-time-point radiomic models for CRLM prognosis prediction using pre- and post-NAT imaging features., Methods: Radiomic features were extracted from four MRI sequences in 100 cases of CRLM patients who underwent NAT and radical resection. RAD scores were generated, and clinical/pathologic variables were incorporated into uni- and multivariate Cox regression analyses to construct prognosis models. Time-ROC, time-C index, decision curve analysis (DCA), and calibration curves assessed the predictive performance of Fong score and pre- and post-NAT models for overall survival (OS) and disease-free survival (DFS) in a testing set., Results: The final models included four variables for OS and three variables for DFS. The post-NAT models outperformed the pre-NAT models in time-ROC, time-C index, calibration, and DCA analysis, except for the 1-year DFS area under the curve (AUC). The Fong score models underperformed. The post-NAT OS RAD score effectively stratified patients into prognostic subgroups., Conclusions: The radiomic models incorporating pre- and post-NAT MRI features and clinical/pathologic variables effectively stratified CRLM patients prognositically. The post-NAT models demonstrated superior performance., Competing Interests: DISCLOSURE: There are no conflicts of interest., (© 2025. Society of Surgical Oncology.)

Gender differences in adaptation to high-altitude environments are evident, but the specific patterns in Tibetan brains remain unclear. We analyzed T1-weighted magnetic resonance imaging scans and neuropsychological test results from 61 male and 68 female Tibetans, with lowland Han participants as controls. Tibetan females had poorer performance than males in digit serial accumulation and forward digit span. Both Tibetan and Han males had significantly larger global gray matter volume and white matter volume than females, only Tibetan female brains contained a larger proportion of gray matter than male brains. Tibetan females (vs. males) had smaller regional gray matter volume in the left rostral middle frontal gyrus and pars opercularis and right caudal middle frontal gyrus, and gray matter volume in the left pars opercularis in all Tibetans had a significant positive correlation with forward digit span. Conversely, Tibetan females had greater cortical thickness in these regions, which negatively correlated with altitude. Han populations exhibited different gender-based patterns in gray matter volume and cortical thickness compared to Tibetans. These findings suggest that Tibetan female brains are more susceptible to high-altitude, and the observed gender differences in brain volume may relate to distinct neuropsychological performances., (© The Author(s) 2025. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background: Preoperative intramuscular fat (IMF) is a strong predictor of tendon failure after a rotator cuff repair. Due to the contemporary labor intensive and time-dependent manual segmentation required for quantitative assessment of IMF, clinical implementation remains a challenge. The emergence of accurate three-dimensional evaluation of the rotator cuff may permit implementation with greater inter-rater reliability than common subjective scales (e.g., Goutallier classification (GC)). Here, we developed and validated convolutional neural network (CNN) model for auto-segmentation of the shoulder on Dixon MRI. Also, we aimed to assess the agreement between GC, two-dimensional (2D) and 3D IMF including their discriminatory ability for the identification of muscles above an IMF threshold shown to negatively impact surgical outcomes (i.e., GC ≥ 3)., Methods: This study retrospectively obtained fat-water Dixon shoulder MRIs between March 2023 and March 2024 to develop and validate a CNN model for the segmentation of individual rotator cuff muscles and surrounding tissues. The CNN model was trained using a modified U-Net architecture (n = 80) and tested on an external dataset (n = 25). Accuracy was primarily evaluated using the Dice Similarity Coefficient (DSC) compared to manual segmentation. Reliability was evaluated by the intraclass correlation coefficient (ICC 2,1 ) and discriminatory ability was evaluated by the area under the receiver operating characteristic curve (AUC)., Results: The model after training (37 male and 43 female, mean age = 55.8 ± 15.6 years) and testing (15 male and 10 female, mean age = 56.6 ± 19.7 years) produced DSCs of ≥ 0.89 except for teres minor (DSC = 0.86 ± 0.03). The model demonstrated excellent reliability for volume (ICC 2,1 ≥ 0.93) and good to excellent reliability for IMF (ICC 2,1 ≥ 0.80), with the exceptions of teres major volume (ICC 2,1 = 0.82, 95% CI: 0.63 - 0.92, p < 0.001) and subscapularis IMF (ICC 2,1 = 0.55, 95% CI: 0.22 - 0.77, p < 0.001). 3D IMF but not 2D IMF was associated with GC for the supraspinatus, subscapularis and infraspinatus (U ≥ 4.02, p < 0.045). The proposed CNN model's IMF outputs produced excellent discriminatory capability of muscles above the IMF threshold shown to negatively impact outcomes (AUC ≥ 0.93)., Conclusion: The development of a CNN model allows for efficient, accurate segmentation of muscle and bone, enabling reliable evaluation of muscle quality. The model demonstrates that 2D evaluation of IMF is insufficient for differentiating between rotator cuff muscles either side of a clinically meaningful IMF threshold on the GC scheme, whereas 3D IMF shows excellent discriminant validity across all rotator cuff muscles., (Copyright © 2025. Published by Elsevier Inc.)

Background: It is essential to exclude alternative diagnoses to diagnose multiple sclerosis (MS). However, detailed descriptions of alternative diagnoses in patients with suspected MS presenting with clinically isolated syndrome (CIS) are limited., Objectives: To describe alternative diagnoses in patients presenting with CIS suggestive of MS., Methods: We conducted a descriptive analysis of patients from the Barcelona CIS cohort including subjects under 50 years of age with a CIS suggestive of MS but later diagnosed with conditions other than MS. We collected clinical, biological, and radiological data, and described the alternative etiologies identified., Results: Among 1468 patients in the Barcelona CIS cohort, 100 (6.8%) were diagnosed with an alternative condition. The most common neurological syndrome was optic neuritis (43.0%). Four patients (4.0%) had inflammatory-demyelinating lesions in at least two typical MS topographies on baseline magnetic resonance imaging (MRI), and 2 (2.0%) met the 2017 McDonald MS criteria. The most common etiologies were immune-mediated diseases (42.0%), especially MOGAD, followed by functional neurological disorders (15.0%) and vascular disease (10.0%)., Conclusion: The range of alternative diagnoses encountered during the MS diagnostic process highlights the need to rule out better explanations than MS. However, current MS diagnostic criteria effectively identify patients without MS in this context., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: A.V. has received a Rio Hortega grant (CM22/00247) by Institute of Health Carlos III (ISCIII). A.V-.J. has received support has received support for contracts Juan Rodes (JR16/00024) and from Fondo de Investigación en Salud (PI17/02162 and PI22/01589) from Instituto de Salud Carlos III, Spain, and has engaged in consulting and/or participated as speaker in events organized by Roche, Novartis, and Merck. A.P. has received funding travel from Roche and speaking honoraria from Novartis. He performed an ECTRIMS Clinical Training Fellowship program during 2021, and is currently performing an MSIF-ARSEP Fellowship program. N.M-.O. has a predoctoral grant Rio Hortega, from the Instituto de Salud Carlos III (CM21/00018). She has also received speaking honoraria and travel expenses from Merck and Roche. L.B. is supported by a 1-year stipend endowed by the NMSS/AAN John Dystel Prize for Multiple Sclerosis Research awarded to Prof. Xavier Montalban in 2022. B.R-.A. has received speaking honoraria from Merck and honoraria for consulting services from Novartis. A.Z. has a predoctoral grant Rio Hortega, from the Instituto de Salud Carlos III, Spain (CM22/00237), received travel expenses for scientific meetings from Biogen-Idec, Merck-Serono and Novartis; speaking honoraria from Eisai; and a study grant from Novartis. J.R. has received speaking honoraria and personal compensation for participating on Advisory Boards from Biogen-Idec, Genzyme, Janssen, Merck- Serono, Novartis, Teva, Roche, and Sanofi-Aventis. R.C. is currently being funded by the Vall d’Hebron Institut de Recerca. In 2023, he was awarded with a Research Training Program from the European Charcot Foundation. From 2021 to 2022, he received an ECTRIMS Clinical and Research Fellowship training. He has also engaged in consulting and/or participated as speaker in events organized by Roche, Novartis, BIIB-Colombia, Merck, Sanofi. H.A. has received grant from Instituto de Salud Carlos III, Spain; JR22/00072. A.C-.C. has received grant from Instituto de Salud Carlos III, Spain; JR19/00007. G.A. has received speaking honoraria and consulting services or participation in advisory boards from Sanofi, Roche and Horizon Therapeutics/Amgen; and travel expenses for scientific meetings from Novartis, Roche, ECTRIMS and EAN. M.C. has received compensation for consulting services and speaking honoraria from Bayer Schering Pharma, Merck-Serono, Biogen-Idec, Teva Pharmaceuticals, Sanofi- Aventis, Genzyme, and Novartis; Received grants from Instituto de Salud Carlos III, Spain: PI19/01590 and PI22/01570. She is editor for Europe of Multiple Sclerosis Journal - Experimental, Translational and Clinical. J.V-.Á. has received a grant from Instituto de Salud Carlos III, Spain; FI21/00282. C.T. is currently being funded by a Junior Leader La Caixa Fellowship (fellowship code is LCF/BQ/PI20/11760008), awarded by “la Caixa” Foundation (ID 100010434). She has also received the 2021 Merck’s Award for the Investigation in MS, awarded by Fundación Merck Salud (Spain) and a grant awarded by the Instituto de Salud Carlos III (ISCIII), Ministerio de Ciencia e Innovación de España (PI21/01860). In 2015, she received an ECTRIMS Post-doctoral Research Fellowship and has received funding from the UK MS Society. She is a member of the Editorial Board of Neurology and Multiple Sclerosis Journal. She has also received honoraria from Roche and Novartis and is a steering committee member of the O’HAND trial and of the Consensus group on Follow-on DMTs. J.S-.G. serves as co-Editor for Europe on the editorial board of Multiple Sclerosis Journal and as Editor-in-Chief in Revista de Neurología, receives research support from Fondo de Investigaciones Sanitarias (19/950) and has served as a consultant/speaker for Biogen, Celgene/Bristol Meyers Squibb, Sanofi, Novartis and Merck. M.T. has received compensation for consulting services, speaking honoraria and research support from Almirall, Bayer Schering Pharma, Biogen-Idec, Genzyme, Janssen, Merck-Serono, Novartis, Roche, Sanofi-Aventis, Viela Bio and Teva Pharmaceuticals. Data Safety Monitoring Board for Parexel and UCB Biopharma. A.R. serves/ed on scientific advisory boards for Novartis, Sanofi-Genzyme, Synthetic MR, TensorMedical, Roche, and Biogen, and has received speaker honoraria from Bayer, Sanofi-Genzyme, Merck-Serono, Teva Pharmaceutical Industries Ltd, Novartis, Roche, Bristol-Myers and Biogen, is CMO and co-founder of TensorMedical, and receives research support from Fondo de Investigación en Salud (PI19/00950) from Instituto de Salud Carlos III, Spain. X.M. has received speaking honoraria and travel expenses for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past years with Abbvie, Actelion, Alexion, Biogen, Bristol-Myers Squibb/Celgene, EMD Serono, Genzyme, Hoffmann-La Roche, Immunic, Janssen Pharmaceuticals, Medday, Merck, Mylan, Nervgen, Novartis, Sandoz, Sanofi-Genzyme, Teva Pharmaceutical, TG Therapeutics, Excemed, MSIF, and NMSS. Other authors report no disclosures.

Background and Objectives: Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently defined demyelinating disorder with an age-related phenotypic spectrum. At disease onset, there is considerable clinical overlap between MOGAD and other demyelinating conditions, and it remains difficult to identify MOGAD radiographically. This study aims to further describe neuroimaging findings in the brain and the spine at presentation and throughout relapses in children with MOGAD., Methods: We present a retrospective cohort study including all children presenting to a single center between 2010 and 2020 with acute demyelination who were positive for serum MOG-IgG antibodies and negative for serum aquaporin-4 antibodies. For each patient, magnetic resonance imaging (MRI) scans of the brain and spine at presentation and on each relapse were reviewed and categorized in a blinded fashion by 2 pediatric neuroradiologists., Results: Sixteen patients met the inclusion criteria. Four had diffuse and bilateral fluid-attenuated inversion recovery signal in the white matter, but only on initial presentation. The area postrema was never affected. All 5 patients with optic neuritis had pre-chiasmatic (but not chiasmatic) involvement on presentation. The brachium pontis was involved in 3 patients on initial presentation, and in 8 patients at any time. Eleven patients demonstrated spinal cord involvement, and the cervical, thoracic, and lumbar regions were involved at similar frequencies., Discussion: The radiographic features of MOGAD in children appear to reflect their presenting demyelinating syndromes. However, certain features, such as diffuse fluid-attenuated inversion recovery hyperintensities and expansile fluid-attenuated inversion recovery signal in the brachium pontis, may be more frequent in MOGAD compared with other demyelinating disorders., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background/purpose: To evaluate the advantages of including versus excluding the tumor periphery and combining diffusion-weighted imaging (DWI) with T2-weighted imaging (T2w) for outcome predictions of preoperative radio(chemo)therapy in rectal cancer., Methods: Four analysis strategies, based on two segmentation methods and two magnetic resonance imaging (MRI) sequences, were evaluated in 106 patients examined with pretreatment MRI. One segmentation method included the tumor periphery in the region of interest (ROI) encompassing the whole tumor (wROI), considered as the reference segmentation approach, and one included only the central part (cROI). Relevant radiomics imaging features were extracted from either T2w alone or from both T2w and DWI and used by a machine learning algorithm for the prediction of pathologic complete response (pCR), neoadjuvant rectal (NAR) score, and disease recurrence. The area under the curve (AUC) was the performance measure. AUCs were compared with a bootstrapping method based on 10 4 bootstraps., Results: cROI applied to both T2w and DWI provided the highest numerical prediction of pCR (AUC 0.76), however, not significantly superior to the other strategies (p ≥ 0.138). cROI applied to both T2w and DWI also yielded the highest numerical prediction of NAR score (AUC 0.84), showing advantages over wROI-based analysis strategies (AUC 0.66 and 0.69; p ≤ 0.008). When compared to cROI applied to T2w alone (AUC 0.73), the benefit was borderline statistically significant (p = 0.053). For prediction of disease recurrence, no differences were found between the analysis strategies., Conclusions: Inclusion of the tumor periphery in radiomic analysis of magnetic resonance images does not improve predictions of the preoperative therapy response in patients with rectal cancer. Excluding tumor periphery while adding DWI to T2w improves prediction of the NAR score, although it does not affect pCR or recurrence prediction., Competing Interests: Declarations. Competing interests: Håkan Ahlström and Joel Kullberg are co-founders and part time employees of Antaros Medical AB.The rest of the authors did not declare financial interests that are directly or indirectly related to the work submitted for publication., (© 2025. The Author(s).)

Introduction: Chronic systemic inflammation is highly prevalent and has deleterious effects on the brain, impacting both function and structure, and manifesting in elevations in psychological symptoms transdiagnostically. Asthma is a chronic inflammatory disease of the airway that affects more than 300 million people worldwide and is known to be highly comorbid with psychological and cognitive dysfunction. Though a growing corpus of work has identified functional brain abnormalities associated with asthma, limited research has investigated structural differences which may partially underlie functional changes. Identifying and characterizing asthma-related structural brain changes will shed light on the neurobiology through which asthma impacts mental function and has the potential to inform prophylaxis and treatment., Methods: We examined differences in regional brain volume, cortical thickness, and surface area, in 128 individuals with asthma compared to 134 non-asthma healthy controls. Five regions of interest were examined a priori, based on their previous implication in inflammation-related functional consequences (dorsal and ventral striatum, pallidum, and insula), or previous evidence of asthma-related structural impact (hippocampus and thalamus). We supplemented our region of interest approach with a voxel-wise whole-brain analysis. Additionally, we examined the association of brain structure with depression symptoms, asthma severity, degree of inflammation, and plasma biomarkers of neuroinflammation, neurodegeneration, and Alzheimer's disease specific pathology., Results: Compared to non-asthma control participants, those with asthma had smaller nucleus accumbens volumes, thicker orbitofrontal cortices, larger middle frontal cortex surface areas, and greater diencephalon volumes. Those with more severe asthma had smaller nucleus accumbens and dorsal striatal volumes, reduced anterior cingulate cortex surface area, and greater amygdala volume compared to those with mild asthma. In untreated asthma patients, greater depressive symptoms were associated with smaller striatal volume, suggesting a potential CNS-protective effect of medications that reduce airway inflammation in asthma. In addition, a plasma marker of astrogliosis was associated with larger diencephalon, cerebellum, brainstem, and thalamus volumes, but reduced insula thickness and surface area., Conclusions: Patterns of structural brain changes in participants with asthma encompass key regions of reward and salience networks, which may in part give rise to the functional alterations in these networks characteristic of chronic systemic inflammation., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [HZ has served at scientific advisory boards and/or as a consultant for Abbvie, Acumen, Alector, Alzinova, ALZPath, Amylyx, Annexon, Apellis, Artery Therapeutics, AZTherapies, Cognito Therapeutics, CogRx, Denali, Eisai, LabCorp, Merry Life, Nervgen, Novo Nordisk, Optoceutics, Passage Bio, Pinteon Therapeutics, Prothena, Red Abbey Labs, reMYND, Roche, Samumed, Siemens Healthineers, Triplet Therapeutics, and Wave, has given lectures in symposia sponsored by Alzecure, Biogen, Cellectricon, Fujirebio, Lilly, Novo Nordisk, and Roche, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program (outside submitted work). KB has served as a consultant and at advisory boards for Abbvie, AC Immune, ALZPath, AriBio, BioArctic, Biogen, Eisai, Lilly, Moleac Pte. Ltd, Neurimmune, Novartis, Ono Pharma, Prothena, Roche Diagnostics, and Siemens Healthineers; has served at data monitoring committees for Julius Clinical and Novartis; has given lectures, produced educational materials and participated in educational programs for AC Immune, Biogen, Celdara Medical, Eisai and Roche Diagnostics; and is a co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program, outside the work presented in this paper. The other authors declare no competing interests]., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Purpose: To comprehensively summarize the magnetic resonance imaging (MRI) features of angiosarcomas presenting as Stewart-Treves syndrome (STS) through a retrospective case series and systematic review of previous publications., Materials and Methods: We identified five patients with STS from our institutional database and 25 patients with STS from 15 publications through a systemic review. We reviewed the MR features of 30 patients with STS, including five males and 25 females with a mean age of 59.5 years., Results: The tumors most commonly involved both the cutis and subcutis (17/25, 68.0%); the remaining tumors were limited to the cutis or subcutis. Multiple tumors were observed in more than half of the cases (16/27, 59.3%), and most of the tumors had poorly defined margins (26/28, 92.9%). The most common signal intensities of the tumors on T1-weighted images were intermediate (16/19, 84.2%), and the remainder were a mixture of intermediate and high, with a predominance of intermediate signal intensity. The signal intensities of the tumors on T2-weighted images were intermediate in seven cases (7/13, 53.8%), a mixture of intermediate and high in five cases (5/13, 38.5%), and a mixture of intermediate and low in one case (1/13, 7.7%). Available diffusion-weighted images from four institutional cases showed restricted diffusion of the tumors with mean apparent diffusion coefficient (ADC) values ranging from 0.77 × 10 -3 mm 2 /s to 0.96 × 10 -3 mm 2 /s., Conclusion: Typical MRI features of angiosarcomas in STS were superficially located in multiple masses with ill-defined margins. Internal signal intensity was intermediate on T1-weighted images, and intermediate or a mixture of intermediate and high on T2-weighted images. ADC values obtained from the limited number of cases were low., Competing Interests: Declarations. Conflict of interest: The authors have no conflicts of interest. Ethical approval: This study was approved by the Institutional Review Board of the Osaka International Cancer Center, Ethics Committee Approval No. 22210. The study procedures were conducted in accordance with the tenets of the Declaration of Helsinki. Informed consent: The requirement for written informed consent specific to this study was waived due to the retrospective nature of the study. All participants provided written consent at the time of their initial visit for anonymized medical information to be published in future research studies., (© 2025. The Author(s).)

Background/Objectives : Alzheimer's disease (AD) is characterized by progressive brain atrophy marked by cognitive decline and memory loss, which significantly affect patients' quality of life. Transcranial ultrasound stimulation (TUS) is a potential physical treatment for AD patients. However, the specific brain regions stimulated by TUS and its therapeutic effects remain unclear. Methods : In this study, magnetic resonance imaging (MRI) and FreeSurfer segmentation were employed to assess alterations in the brain volume of AD patients after TUS. Results : Our findings revealed significant volume increases in the corpus callosum (CC) and lateral orbitofrontal cortex (lOFC) in the TUS group. Moreover, the volumetric changes in the CC were strongly correlated with improvements in the Mini-Mental State Examination score, which is a widely used measure of cognitive function of AD patients. Conclusions : TUS has the potential to alleviate disease progression and offers a non-invasive therapeutic approach to the improvement of cognitive function in AD patients.