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Cerebral aneurysms are an abnormal ballooning of blood vessels which have the potential to rupture and cause hemorrhagic stroke. The diagnosis, treatment, and monitoring of cerebral aneurysms is highly dependant on high resolution imaging. As an imaging modality capable of cross-sectional resolution down to 10 μm, intraluminal optical coherence tomography (OCT) has great potential in improving care for cerebral aneurysms. The ability to assess the blood vessel microanatomy in vivo may be able to predict aneurysm growth and rupture. During treatment, intraluminal OCT may aid in assessment of treatment efficacy and complication avoidance, such as via visualization of in-stent thrombosis, stent wall apposition, and the fate of covered branch vessels. This technology can also be used in post-treatment monitoring, to assess for aneurysmal remnants or for endothelialisation and healing over the diseased segments. The goal of this clinically focused narrative review is to provide an overview of the previous applications of intraluminal OCT in cerebral aneurysms and future prospects of applying this technology to improve care in patients with cerebral aneurysms, including a specific neurovascular OCT catheter, doppler OCT for high resolution blood flow assessment, and further research endeavors.

The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.

Computer-assistance for pedicle screw insertion is becoming increasingly common. As in the case presented below, image guided neuronavigation can be used to improve the accuracy and safety of subaxial cervical pedicle screw placement, given their increased difficulty of cannulation relative to the larger pedicles in the thoracolumbar spine. A 49-year-old man presented with a traumatic sagittal split fracture of C4 (AO Classification type A4) and a left lateral mass fracture of C5 (AO Classification type F1) with anterior depression and 50% height loss. MRI revealed evidence of strain of the interspinous/supraspinous ligaments (AO Classification type B2), as well as fluid within the left C4-C5 facet joint. Along with these fractures, the young patient had Klippel-Feil syndrome with autofusion of the C2-3 posterior elements, and a left vertebral artery dissection. He had neck pain but was otherwise neurologically intact. The patient underwent machine-vision image guided C4-C5 unilateral pedicle screw insertion connected by a fixation rod for stabilization and bone graft to augment the instrumented fusion with good outcome. The use of machine vision spinal navigation was able to provide accurate and precise placement of pedicle screws without significantly increasing surgical time. This method has the potential to allow for the safe and accurate insertion of cervical pedicle screws and to reduce the rate of pedicle breach which could avoid significant neurovascular injury.