Joint multi-site domain adaptation and multi-modality feature selection for the diagnosis of psychiatric disorders.

Identifying biomarkers for computer-aided diagnosis (CAD) is crucial for early intervention of psychiatric disorders. Multi-site data have been utilized to increase the sample size and improve statistical power, while multi-modality classification offers significant advantages over traditional single-modality based approaches for diagnosing psychiatric disorders. However, inter-site heterogeneity and intra-modality heterogeneity present challenges to multi-site and multi-modality based classification. In this paper, brain functional and structural networks (BFNs/BSNs) from multiple sites were constructed to establish a joint multi-site multi-modality framework for psychiatric diagnosis. To do this we developed a hypergraph based multi-source domain adaptation (HMSDA) which allowed us to transform source domain subjects into a target domain. A local ordinal structure based multi-task feature selection (LOSMFS) approach was developed by integrating the transformed functional and structural connections (FCs/SCs). The effectiveness of our method was validated by evaluating diagnosis of both schizophrenia (SZ) and autism spectrum disorder (ASD). The proposed method obtained accuracies of 92.2 %±2.22 % and 84.8 %±2.68 % for the diagnosis of SZ and ASD, respectively. We also compared with 6 DA, 10 multi-modality feature selection, and 8 multi-site and multi-modality methods. Results showed the proposed HMSDA+LOSMFS effectively integrated multi-site and multi-modality data to enhance psychiatric diagnosis and identify disorder-specific diagnostic brain connections.

Multimodal Large Language Models in Health Care: Applications, Challenges, and Future Outlook.

In the complex and multidimensional field of medicine, multimodal data are prevalent and crucial for informed clinical decisions. Multimodal data span a broad spectrum of data types, including medical images (eg, MRI and CT scans), time-series data (eg, sensor data from wearable devices and electronic health records), audio recordings (eg, heart and respiratory sounds and patient interviews), text (eg, clinical notes and research articles), videos (eg, surgical procedures), and omics data (eg, genomics and proteomics). While advancements in large language models (LLMs) have enabled new applications for knowledge retrieval and processing in the medical field, most LLMs remain limited to processing unimodal data, typically text-based content, and often overlook the importance of integrating the diverse data modalities encountered in clinical practice. This paper aims to present a detailed, practical, and solution-oriented perspective on the use of multimodal LLMs (M-LLMs) in the medical field. Our investigation spanned M-LLM foundational principles, current and potential applications, technical and ethical challenges, and future research directions. By connecting these elements, we aimed to provide a comprehensive framework that links diverse aspects of M-LLMs, offering a unified vision for their future in health care. This approach aims to guide both future research and practical implementations of M-LLMs in health care, positioning them as a paradigm shift toward integrated, multimodal data-driven medical practice. We anticipate that this work will spark further discussion and inspire the development of innovative approaches in the next generation of medical M-LLM systems.

The role of multimodality imaging in diffuse pelvicoabdominal plexiform neurofibroma: A rare case report.

Pelvicoabdominal plexiform neurofibroma is a rare and complicated form of type 1 neurofibromatosis (NF1), distinguished by developing benign nerve sheath tumors in the pelvis and abdomen. A male patient, aged 26, came to our center with dysuria, abdominal bloating, rectal mucosa prolapses, and trouble walking and moving legs. Physical examination revealed a palpable mass of solid consistency fixed in the pelvic cavity to the abdominal cavity. A large and extensive mass in the pelvic to the abdominal region can be evaluated with multimodality radiological imaging, including ultrasound, computed tomography, and magnetic resonance imaging. Imaging is crucial for diagnosis, evaluation of extension, and early detection of potential malignant transformation in these patients. The patient was scheduled for palliative surgical resection due to the extensive mass; however, he did not survive while waiting for the operation. Pathology examination and immunohistochemical staining revealed positive S-100 protein, indicating the neural crest originate lesion. We report the clinical and radiological features of plexiform neurofibroma in a young male patient, confirmed by pathology examination.

Coronary sinus thrombosis in a patient with amyloidosis, the role of multimodality imaging: a case report.

Background: Amyloidosis can affect the heart, causing arrhythmia, thromboembolic events, and sudden cardiac death. Coronary sinus thrombosis is an uncommon though life-threatening condition which requires early identification and management. Case summary: A 72-year-old Caucasian man, who recovered from out-of-hospital cardiorespiratory arrest, was diagnosed with coronary sinus thrombosis using cardiac imaging techniques. He had no history of invasive procedures and was diagnosed with cardiac amyloidosis based on an extra-cardiac biopsy positive for light chain amyloid, with consistent clinical, echocardiographic, and magnetic resonance criteria. Discussion: A high frequency of intracardiac thrombosis is seen in amyloidosis. However, coronary sinus thrombosis is an uncommon complication. A multimodality imaging approach appears to be useful for the early diagnosis of coronary sinus thrombosis. The low specificity of the clinical signs, as well as the fast impairment of the patients, could result in fatal complications such as acute myocardial infarction, arrhythmia, and sudden death. Early screening, particularly in high-risk patients, as well as the use of early anticoagulant therapy, could reduce the associated morbidity and mortality.

Phenotypic characterisation of people at risk of atrial fibrillation: Protocol for the FIND-AF longitudinal cohort study.

AIMS: The Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF) longitudinal cohort study is a multi-centre prospective cohort study of patients identified at risk of atrial fibrillation (AF). The aim of the FIND-AF longitudinal cohort study is to provide multi-modal phenotypic characterisation of these patients. METHODS AND RESULTS: 1955 participants identified as at risk of AF by the FIND-AF algorithm from primary care electronic health (EHR) data, aged 30 years and above and eligible for oral anticoagulation, will be be recruited between October 2023 and November 2024 to receive home-based intermittent ECG monitoring. About 500 participants without diagnosed AF will then undergo cross-sectional phenotypic characterisation including physical examination, symptoms assessment, serum blood biomarkers and echocardiography, and non-stress cardiac magnetic resonance imaging. Longitudinal information about cardio-renal-metabolic-pulmonary outcomes will be ascertained from linkages to EHR data. The study is funded by the British Heart Foundation (CC/22/250026). The study has ethical approval (North West - Greater Manchester South Research Ethics Committee reference 23/NW/0180). Findings will be announced at relevant conferences and published in peer-reviewed journals in line with the Funder's open access policy. CONCLUSIONS: The FIND-AF multi-centre prospective longitudinal cohort study aims to (i) provide evidence for the impact of comorbidities on AF genesis (ii) uncover actionable targets to prevent AF, and (iii) act as a platform for cohort randomised clinical trials that investigate enhanced detection and prevention of AF.

Atrial fibrillation (AF) is the most common abnormal heart rhythm encountered in clinical practice but we know little about changes to the heart before AF starts, and whether these can be reversed to reduce the risk of future AF. In this study people we will recruit people who have been identified as higher risk of AF using a decision support tool in their medical records, but who have not been found to have AF at the moment when they have had their ECG checked.We will look at the structure and function of their hearts using ultrasound and MRI, and we will also check their blood tests. We aim to learn if people without AF, but at higher risk of AF, have changes to their heart and then conduct studies to establish if these changes can be reversed.

Surgery-based radiation-free multimodality treatment for locally advanced cervical cancer.

The current review described a 55-year woman using 28 months to finish her surgery-based radiation-free multimodality treatment journey to fight International Federation of Gynaecology & Obstetrics (FIGO) 2018 clinical stage IIA2 (cT2aN0M0) squamous cell carcinoma (SCC) of the cervix. She received six cycles of perioperative adjuvant therapy, including three cycles of neoadjuvant therapy (NAT) and three cycles of postoperative adjuvant therapy by using combination of dose-dense chemotherapy (CT, weekly paclitaxel 80 mg/m2+triweekly cisplatin 40 mg/m2), immunotherapy (IO, triweekly pembrolizumab 200 mg) and half-dose anti-angiogenic agent (triweekly bevacizumab 7.5 mg/kg) plus interval radical surgery (radical hysterectomy + bilateral salpingo-oophorectomy + bilateral pelvic lymph node dissection + para-aortic lymph node sampling) and following maintenance therapy with monthly 22 cycles of half-dose of IO (pembrolizumab 100 mg) and concomitant 4 cycles of single-agent CT (paclitaxel 175 mg/m2) and 18 cycles of half-dose anti-angiogenic agent (bevacizumab 7.5 mg/kg). During the cervical SCC fighting journey, two unwanted adverse events (AEs) occurred. One was pseudo-progressive disease during the NAT treatment and pathology-confirmed upgrading FIGO stage IIIC1p (ypT2a1N1M0) after radical surgery and the other was the occurrence of hypothyroidism during the post operative adjuvant therapy. Based on this case we presented, we review the recent trend in the management of women with locally advanced cervical cancer (LACC) using the radiation-free but surgery-based multimodality strategy and highlight the strengths and limitations about perioperative adjuvant therapy with dose-dense CT + IO + half-dose anti-angiogenic agent and maintenance treatment of half-dose IO combining with short-term single agent CT and following long-term half-dose anti-angiogenic agent. All underscore the possibility that women with LACC have an opportunity to receive surgery-based RT-free multi-modality strategy to manage their diseases with satisfactory results. Additionally, the evolving role of IO plus CT with/without anti-angiogenic agent functioning as either primary treatment or adjuvant therapy for the treatment of advanced CC has been in process continuously. Moreover, the patient's positive response to IO, pembrolizumab as an example, both during the primary and maintenance therapy, highlights the importance of integrating IO into CT regimens for CC, especially in cases where conventional therapies, RT as an example, are insufficient or who do not want to receive RT-based treatment. The sustained disease-free status of the patient over several years reinforces the potential of IO to significantly increase long-term survival outcomes in CC patients, particularly for those with LACC.

A radioactive and fluorescent dual modality cysteine cathepsin-B activity-based probe for the detection and treatment evaluation in rheumatoid arthritis.

Activated macrophages are key effector cells and specific markers in patients with rheumatoid arthritis (RA). Cysteine cathepsin B (CTS-B) is highly expressed in macrophages and positively associated with RA activity and severity. This study aims to evaluate an activity-based multi-modality diagnostic agent, 68Ga-BMX2, which targets CTS-B to visualize the arthritis activity and evaluate the treatment efficacy. A CTS-B activity-based probe, BMX2, was labeled efficiently with 68Ga to produce 68Ga-BMX2 for fluorescent and positron emission tomography (PET) multi-modality imaging. The affinity and specificity of BMX2 binding with the CTS-B enzyme in macrophages were determined by radioactive experiment using RAW 264.7 cell lines, with CA074 and BMX5 as the inhibitors to test the specificity of the binding. Then, PET and fluorescence imaging were acquired on collagen-induced arthritis (CIA) mice. Additionally, the treatment monitoring capability of 68Ga-BMX2 PET/CT imaging was tested with methotrexate (MTX). RAW 264.7 macrophage cells showed significant uptake of 68Ga-BMX2. The binding of BMX2 with CTS-B in RAW 264.7 macrophage cells is time-dependent and could be blocked by CA074 and BMX5. In vivo optical and PET imaging showed high signals in the right hind arthritis in CIA mice from 68Ga-BMX2 and BMX2 accumulated for at least 120 h. Additionally, 68Ga-BMX2 signals were significantly reduced in the MTX-treated CIA mice compared to the control group. The 68Ga-BMX2, a radioactive and fluorescent dual-modality diagnostic agent targeting CTS-B, demonstrated a practical approach for CIA PET and fluorescence imaging. The 68Ga-BMX2 multimodality imaging could significantly monitor the treatment response in the CIA mice.

Multimodality Imaging for Rare Presentation of Placenta Increta in the First Trimester in a Patient with Previous Cesarean Section and Asherman Syndrome.

We report multi-modality imaging (Ultrasound and Magnetic Resonance Imaging) findings of a rare complication in a multi-gravida patient with history of Asherman syndrome presenting with placenta increta in a cesarean scar ectopic pregnancy. The appropriate diagnosis was established with imaging and patient was managed surgically with total abdominal hysterectomy and bilateral salpingectomy. Asherman syndrome and its management of hysteroscopic adhesiolysis are associated with increased odds of placenta accreta spectrum and postpartum hemorrhage. Patients with Asherman syndrome are considered high risk in pregnancy and should be closely monitored for placental site abnormalities during current and subsequent pregnancies.

Exploring innovative strides in radiolabeled nanoparticle progress for multimodality cancer imaging and theranostic applications.

Multimodal imaging unfolds as an innovative approach that synergistically employs a spectrum of imaging techniques either simultaneously or sequentially. The integration of computed tomography (CT), magnetic resonance imaging (MRI), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and optical imaging (OI) results in a comprehensive and complementary understanding of complex biological processes. This innovative approach combines the strengths of each method and overcoming their individual limitations. By harmoniously blending data from these modalities, it significantly improves the accuracy of cancer diagnosis and aids in treatment decision-making processes. Nanoparticles possess a high potential for facile functionalization with radioactive isotopes and a wide array of contrast agents. This strategic modification serves to augment signal amplification, significantly enhance image sensitivity, and elevate contrast indices. Such tailored nanoparticles constructs exhibit a promising avenue for advancing imaging modalities in both preclinical and clinical setting. Furthermore, nanoparticles function as a unified nanoplatform for the co-localization of imaging agents and therapeutic payloads, thereby optimizing the efficiency of cancer management strategies. Consequently, radiolabeled nanoparticles exhibit substantial potential in driving forward the realms of multimodal imaging and theranostic applications. This review discusses the potential applications of molecular imaging in cancer diagnosis, the utilization of nanotechnology-based radiolabeled materials in multimodal imaging and theranostic applications, as well as recent advancements in this field. It also highlights challenges including cytotoxicity and regulatory compliance, essential considerations for effective clinical translation of nanoradiopharmaceuticals in multimodal imaging and theranostic applications.

A rare case of ventricular tachycardia caused by an intramyocardial fibroma with successful surgical resection in an adult.

BACKGROUND: Cardiac fibromas are extremely rare in adults. The preferred treatment is surgical resection, but antiarrhythmic medications or heart transplantation have also been used previously. The cardiac imaging, particularly MRI, can be useful to help delineate between primary cardiac tumors, and surgical factors such as the extent/size of the fibroma, involvement of the coronary arteries or mitral apparatus and amount of residual myocardium influence whether surgical resection is feasible. CASE PRESENTATION: A 42-year-old male presented with a wide-complex tachycardia, unresponsive to amiodarone. An echocardiogram was performed which showed a possible posterior wall mass. A cardiac MRI showed a well circumscribed lateral wall intracardiac fibroma, measuring 5.2 × 5.1 × 3.8 cm with preserved function. Surgical resection was successful, and he was discharged without a defibrillator. CONCLUSIONS: Cardiac fibromas are encapsulated tumors which do not infiltrate myocardium and should be surgically resected if possible.

Imaging Findings in Cardiovascular Involvements of IgG4 Related Disease: A Systematic Review Study.

BACKGROUND: Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition characterized by IgG4-positive plasma cell infiltration that can affect multiple organs, including the cardiovascular system. The diagnosis of IgG4-RD relies on a combination of clinical, serological, radiological, and pathological findings. However, due to the varied and insidious clinical presentations, normal IgG4 levels in a significant percentage of patients, and frequent multi-organ involvement, imaging plays a crucial role in the diagnosis of IgG4-RD. The aim of study is to comprehensively examine the imaging findings in IgG4-related cardiovascular disease for accurate diagnosis and appropriate treatment. METHODS: A systematic search was conducted across electronic databases, PubMed, Scopus, and Web of Sciences, until 1 September 2023, following PRISMA guidelines by searching major databases for studies reporting detailed cardiovascular imaging findings in IgG4-RD. RESULTS: The search yielded 68 studies (60 case reports, 5 case series, 2 cross-sectional, 1 case-control) with 120 cases of cardiovascular IgG4-RD. Most of the cases were male, averaging 62.8 years. The common initial symptoms were dyspnea and chest pain. The most common imaging finding was vasculopathy, including vessel wall thickening, periarteritits, periaortitis, aortitis, stenosis, ectasia, aneurysm formation, intramural hemorrhage, fistula formation, and dissection, followed by pericardial involvement and mediastinal masses. Case series and cross-sectional studies also showed vasculopathy being the most common finding on various imaging modalities, including angiography and PET/CT, highlighting the complex pathology of IgG4-RD. CONCLUSION: This study evaluated current IgG4-RD articles, revealing a higher prevalence in men and vasculopathy as the most common cardiovascular complication.

Motion shapes for sound shaping.

The focus of this perspective paper is on relationships between sound-producing body motion and corresponding perceived sound features, guided by the idea of shapes as the common denominator of these two domains. The term shape is used to denote graphical-pictorial renderings of phenomena that we perceive or imagine, and may have physical manifestations as tracings on paper or on screen, or as gesticulations, or just as imagined tracings in our minds. Shapes give us intermittent snapshots of unfolding motion and sound fragments, and the point of shapes is to make ephemeral sound and motion features tractable as more permanent objects. Shapes of perceived sound include dynamic, spectral, textural, pitch-related, harmonic, etc. features as shapes, whereas shapes of sound-producing motion include both motion trajectories and postures of sound-producing effectors, i.e., of fingers, hands, arms, etc., or mouth, lips, and tongue.

How to measure quality of surgery as a component of multimodality treatment of gastric cancer.

Gastric cancer (GC) is one of the most frequent reasons for cancer-related death worldwide. The multimodal therapeutic strategies are now pragmatically tailored to each patient, especially in advanced GC. A radical but safe gastrectomy remains the cornerstone of the GC treatment. Moreover, the quality-of-life (QoL) outcome measures are now routinely utilized in order to select optimal type of gastrectomy, as well as reconstruction method. Postoperative complications are frequent, and effective diagnosis and treatment of complications is crucial to lower the mortality rates. The postoperative complications prolong hospital stay and may result in poor QoL, thus eliminating the completion of perioperative adjuvant therapy. Therefore, avoiding morbidity is not only relevant for the immediate postoperative course, but can also affect long-term oncological outcome. Measuring outcome enables surgeons to: monitor their own results; compare quality of treatment between centres; facilitate improvement both for surgery alone and combined treatment; select optimal procedure for an individual patient. Textbook oncological outcome is a composite quality measure representing the ideal hospitalization for gastrectomy, as well as stage-appropriate (perioperative) adjuvant chemotherapy. Standardized system for recording complications and adherence to multimodality treatment guidelines are crucial for achieving the ultimate goal of surgical quality-improvement that can benefit patients QoL and long-term outcomes after fast and uneventful hospitalization for gastrectomy.

Kin Cognition and Communication: What Talking, Gesturing, and Drawing About Family Can Tell us About the Way We Think About This Core Social Structure.

When people talk about kinship systems, they often use co-speech gestures and other representations to elaborate. This paper investigates such polysemiotic (spoken, gestured, and drawn) descriptions of kinship relations, to see if they display recurring patterns of conventionalization that capture specific social structures. We present an exploratory hypothesis-generating study of descriptions produced by a lesser-known ethnolinguistic community to the cognitive sciences: the Paamese people of Vanuatu. Forty Paamese speakers were asked to talk about their family in semi-guided kinship interviews. Analyses of the speech, gesture, and drawings produced during these interviews revealed that lineality (i.e., mother's side vs. father's side) is lateralized in the speaker's gesture space. In other words, kinship members of the speaker's matriline are placed on the left side of the speaker's body and those of the patriline are placed on their right side, when they are mentioned in speech. Moreover, we find that the gesture produced by Paamese participants during verbal descriptions of marital relations are performed significantly more often on two diagonal directions of the sagittal axis. We show that these diagonals are also found in the few diagrams that participants drew on the ground to augment their verbo-gestural descriptions of marriage practices with drawing. We interpret this behavior as evidence of a spatial template, which Paamese speakers activate to think and communicate about family relations. We therefore argue that extending investigations of kinship structures beyond kinship terminologies alone can unveil additional key factors that shape kinship cognition and communication and hereby provide further insights into the diversity of social structures.

Echocardiographic Predictors of Readiness for Double Switch Operation and Postoperative Ejection Fraction in Patients with Congenitally Corrected Transposition of the Great Arteries Undergoing Left Ventricular Retraining.

BACKGROUND: In patients with congenitally corrected transposition of the great arteries (ccTGA), assessment of readiness for double switch operation (DSO) after pulmonary arterial band (PAB) placement involves cardiac MRI (cMRI) to measure LV ejection fraction (EF) and mass and cardiac catheterization (cath) to assess LV:RV pressure ratio (LV:RVp). We described the relationships between echocardiographic and cath/cMRI measures of readiness for DSO, and developed risk factors for LV dysfunction after DSO based on echocardiographic measures of ventricular arterial coupling (VAC). METHODS: We reviewed patients with ccTGA undergoing LV retraining at a DSO referral center. We compared EF measured by echo to cMRI, and LV:RVp measured by echo to cath with Bland-Altman (BA) analysis. We analyzed the relationship between preoperative VAC markers and postoperative echocardiogram using end-systolic elastance (EES), and a novel marker consisting of the product of EF and the LV:RVp (EFPR). RESULTS: We included 31 patients with 56 evaluations for DSO, 24 of which underwent DSO. Echo EF correlated well with cMRI (r= 0.79), and BA slightly overestimated cMRI (mean difference +3%). Echo EF had moderate ability to identify normal cMRI EF (AUC of 0.80) and at optimal cutpoint of echo EF threshold of 61%, there was 71% sensitivity and 76% specificity to detect cMRI LVEF >=55%. Echo LV:RVp correlated well with cath (r=0.77) and slightly underestimated cath (mean difference of -0.11). Echo LV:RVp had good ability to identify adequate LV:RVp by cath (AUC=0.95) and at optimal echo cutpoint of 0.75 had 100% Sensitivity and 85% specificity to detect a catheterization LV:RVp above 0.9. Echo-based criteria for DSO readiness (echo EF of 61% and LV:RVp of 0.75) demonstrated specificity of 97% and positive predictive value of 96% for published criteria of DSO readiness (cMRI EF of 55% and cath LV:RVp of 0.9). EES and EFPR correlated with post DSO EF (rho= 0.72 and 0.60). EFPR of 0.51 demonstrated 78% sensitivity and 100% specificity for post DSO LV dysfunction (EF < 55%). Age at first PAB also strongly correlated with post DSO EF (rho=0.75). No patient with first PAB under age 1 years exhibited post DSO LV dysfunction. CONCLUSIONS: Echocardiographic measures of EF and LV:RVp are reliable indicators of reference standard modalities, and can guide management during retraining. Preoperative VAC markers EES and EFPR may be useful markers of post-DSO LV dysfunction. Echo LV:RVp > 0.75 are likely to meet pressure-generation criteria for DSO and should be considered for referral for cath and cMRI evaluation for DSO. PAB placement before 1 year of life may optimize LV outcomes in patients considered for DSO.

Non-Invasive Imaging for Native Aortic Valve Regurgitation.

Aortic regurgitation (AR) is associated with left ventricular volume and pressure overload, resulting in eccentric left ventricular (LV) remodeling and enlargement. This condition may be well tolerated for years before the onset of myocardial dysfunction and symptoms. Echocardiography plays a crucial role in the diagnosis of AR, assessing its mechanism and severity, and detecting LV remodeling. The assessment of AR severity is challenging and frequently requires the integration of information from multiple different measurements to assess the severity. Recent data suggests that echocardiographically derived LV volumes (end-systolic volume index > 45 ml/m2), an ejection fraction threshold of <60%, and abnormal global longitudinal strain may help identify early dysfunction and may be used to improve clinical outcomes. Consequently, these parameters can identify candidates for surgery. Cardiac magnetic resonance imaging is emerging as a valuable tool for assessing severity when it remains unclear after an echocardiographic evaluation. This review emphasizes the importance of imaging, particularly echocardiography, in the evaluation of AR. It focuses on various echocardiographic parameters, including technical details, and how to integrate them for assessing the mechanism and severity of AR, as well as LV remodeling.

Assessment of multi-modal magnetic resonance imaging for glioma based on a deep learning reconstruction approach with the denoising method.

BACKGROUND: Deep learning reconstruction (DLR) with denoising has been reported as potentially improving the image quality of magnetic resonance imaging (MRI). Multi-modal MRI is a critical non-invasive method for tumor detection, surgery planning, and prognosis assessment; however, the DLR on multi-modal glioma imaging has not been assessed. PURPOSE: To assess multi-modal MRI for glioma based on the DLR method. MATERIAL AND METHODS: We assessed multi-modal images of 107 glioma patients (49 preoperative and 58 postoperative). All the images were reconstructed with both DLR and conventional reconstruction methods, encompassing T1-weighted (T1W), contrast-enhanced T1W (CE-T1), T2-weighted (T2W), and T2 fluid-attenuated inversion recovery (T2-FLAIR). The image quality was evaluated using signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and edge sharpness. Visual assessment and diagnostic assessment were performed blindly by neuroradiologists. RESULTS: In contrast with conventionally reconstructed images, (residual) tumor SNR for all modalities and tumor to white/gray matter CNR from DLR images were higher in T1W, T2W, and T2-FLAIR sequences. The visual assessment of DLR images demonstrated the superior visualization of tumor in T2W, edema in T2-FLAIR, enhanced tumor and necrosis part in CE-T1, and fewer artifacts in all modalities. Improved diagnostic efficiency and confidence were observed for preoperative cases with DLR images. CONCLUSION: DLR of multi-modal MRI reconstruction prototype for glioma has demonstrated significant improvements in image quality. Moreover, it increased diagnostic efficiency and confidence of glioma.