A Comprehensive Review on the Role of MRI in the Assessment of Supratentorial Neoplasms: Comparative Insights Into Adult and Pediatric Cases.

Magnetic resonance imaging (MRI) is a critical diagnostic tool in assessing supratentorial neoplasms, offering unparalleled detail and specificity in brain imaging. Supratentorial neoplasms in the cerebral hemispheres, basal ganglia, thalamus, and other structures above the tentorium cerebelli present significant diagnostic and therapeutic challenges. These challenges vary notably between adult and pediatric populations due to differences in tumor types, biological behavior, and patient management strategies. This comprehensive review explores the role of MRI in diagnosing, planning treatment, monitoring response, and detecting recurrence in supratentorial neoplasms, providing comparative insights into adult and pediatric cases. The review begins with an overview of the epidemiology and pathophysiology of these tumors in different age groups, followed by a detailed examination of standard and advanced MRI techniques, including diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), and magnetic resonance spectroscopy (MRS). We discuss the specific imaging characteristics of various neoplasms and the importance of tailored approaches to optimize diagnostic accuracy and therapeutic efficacy. The review also addresses the technical and interpretative challenges unique to pediatric imaging and the implications for long-term patient outcomes. By highlighting the comparative utility of MRI in adult and pediatric cases, this review aims to enhance the understanding of its pivotal role in managing supratentorial neoplasms. It underscores the necessity of age-specific diagnostic and therapeutic strategies. Emerging MRI technologies and future research directions are also discussed, emphasizing the potential for advancements in personalized imaging approaches and improved patient care across all age groups.

Moderate Aortic Stenosis-Advanced Imaging, Risk Assessment, and Treatment Strategies.

Moderate aortic stenosis is increasingly recognized as a disease entity with poor prognosis. Diagnosis of moderate aortic stenosis may be complemented by laboratory tests and advanced imaging techniques focused at detecting signs of cardiac damage such as increase of cardiac enzymes (N-terminal pro-B-type Natriuretic Peptide, troponin), left ventricular remodeling (hypertrophy, reduced left ventricular ejection fraction), or myocardial fibrosis. Therapy should include guideline-directed optimal medical therapy for heart failure. Patients with signs of cardiac damage may benefit from early intervention, which is the focus of several ongoing randomized controlled trials. As yet, no evidence-based therapy exists to halt the progression of aortic valve calcification.

Strategic multidisciplinary management of pelvic carcinosarcoma: Emphasizing advanced diagnostic imaging and staged surgical interventions.

Pelvic carcinosarcoma is an aggressive malignancy with significant diagnostic and management hurdles due to its complex vascularity and potential for extensive local invasion. A 59-year-old female presented with severe abdominal pain and significant weight loss, leading to the discovery of a large, complex pelvic mass through CT scans, MRI, and PET CT, suggesting aggressive malignancy. Initial management included a robotic laparoscopic proximal sigmoid loop colostomy to alleviate obstruction. Significant vascularity led to consultations with Vascular Surgery and subsequent preoperative embolization. Definitive surgery involved a supralevator posterior exenteration for en bloc resection of the vagina, mass, and sigmoid colon, combined with a low anterior resection and an omental J flap in anticipation of potential postoperative radiation therapy. This case underscores the importance of integrated imaging and staged surgical interventions in managing pelvic carcinosarcoma, emphasizing a multidisciplinary approach to optimize outcomes and minimize complications.

Computational Methods for Image Analysis in Craniofacial Development and Disease.

Observation is at the center of all biological sciences. Advances in imaging technologies are therefore essential to derive novel biological insights to better understand the complex workings of living systems. Recent high-throughput sequencing and imaging techniques are allowing researchers to simultaneously address complex molecular variations spatially and temporarily in tissues and organs. The availability of increasingly large dataset sizes has allowed for the evolution of robust deep learning models, designed to interrogate biomedical imaging data. These models are emerging as transformative tools in diagnostic medicine. Combined, these advances allow for dynamic, quantitative, and predictive observations of entire organisms and tissues. Here, we address 3 main tasks of bioimage analysis, image restoration, segmentation, and tracking and discuss new computational tools allowing for 3-dimensional spatial genomics maps. Finally, we demonstrate how these advances have been applied in studies of craniofacial development and oral disease pathogenesis.

Case report: Evaluation of head trauma in a tawny owl (Strix aluco) with advanced imaging diagnostic, FVEP and BAER test.

An adult pet tawny owl (Strix aluco) presented to a veterinary hospital at Parma University with a history of head trauma. After a critical care protocol including thermal, oxygen and fluid support aimed at stabilizing the patient, a neurological examination was performed. During neurological evaluation, marked lethargy and an inability to rise from a recumbent position was noted. Anisocoria was also present, with a mydriatic left pupil exhibiting no pupillary light response (PLR) even on direct illumination of both eyes. On ocular fundus examination, retinal hemorrhage and retinal detachment were observed. Based on these clinical findings, a complete work-up was performed, including hematological exams and total body X-ray studies followed by a computed tomography (CT) scan. Additional examinations, such as brainstem auditory evoked response (BAER) measurement and flash visual evoked potential (FVEP) recording, were performed. FVEP measurements performed on the left eye exhibited no peaks in either series of stimulations, indicating an altered functional integration within the visual pathway. A CT scan revealed a large hypoattenuating lesion within the right cerebral hemisphere, suspected to be intraparenchymal edema. The BAER test demonstrated an altered trace consistent with brainstem involvement and left hypoacusis due to cranial nerve VIII deficiency. Head trauma can result in significant neurological impairments in birds, impacting their behavior, mobility, and cognitive abilities. FVEP recordings, BAER tests and CT scans may be useful diagnostic tools in clinical practice. Understanding the causes and neurologic presentation of avian traumas is essential for effective prevention, diagnosis and treatment of affected birds.

When advanced MRI is not about naming musculoskeletal lesions.

Nowadays, the use of advanced MRI sequences such as diffusion-weighted imaging or perfusion-weighted imaging in the field of musculoskeletal radiology remains limited compared to other anatomical regions and subspecialties. Several reasons underpin this, primarily technical challenges, and a longstanding reliance on conventional and morphological evaluations of soft tissue and bone lesions. Experienced radiologists often assert that these advanced sequences do not offer added diagnostic value, claiming that a morphological approach suffices. However, in our opinion, the role of these advanced MRI sequences extends beyond merely naming an MSK lesion. In this commentary, we elucidate how these sequences can aid radiologists in various scenarios, from determining patient prognosis and tracking treatment progress to enhancing clinical-radiological correlations or guiding less experienced radiologists in evaluating soft tissues or bone tumours.

Special Types of Breast Cancer: Clinical Behavior and Radiological Appearance.

Breast cancer is a complex disease that includes entities with different characteristics, behaviors, and responses to treatment. Breast cancers are categorized into subgroups based on histological type and grade, and these subgroups affect clinical presentation and oncological outcomes. The subgroup of "special types" encompasses all those breast cancers with insufficient features to belong to the subgroup "invasive ductal carcinoma not otherwise specified". These cancers account for around 25% of all cases, some of them having a relatively good prognosis despite high histological grade. The purpose of this paper is to review and illustrate the radiological appearance of each special type, highlighting insights and pitfalls to guide breast radiologists in their routine work.

Exploring molecular glioblastoma: Insights from advanced imaging for a nuanced understanding of the molecularly defined malignant biology.

Background: Molecular glioblastoma (molGB) does not exhibit the histologic hallmarks of a grade 4 glioma but is nevertheless diagnosed as glioblastoma when harboring specific molecular markers. MolGB can easily be mistaken for similar-appearing lower-grade astrocytomas. Here, we investigated how advanced imaging could reflect the underlying tumor biology. Methods: Clinical and imaging data were collected for 7 molGB grade 4, 9 astrocytomas grade 2, and 12 astrocytomas grade 3. Four neuroradiologists performed VASARI-scoring of conventional imaging, and their inter-reader agreement was assessed using Fleiss κ coefficient. To evaluate the potential of advanced imaging, 2-sample t test, 1-way ANOVA, Mann-Whitney U, and Kruskal-Wallis test were performed to test for significant differences between apparent diffusion coefficient (ADC) and relative cerebral blood volume (rCBV) that were extracted fully automatically from the whole tumor volume. Results: While conventional VASARI imaging features did not allow for reliable differentiation between glioma entities, rCBV was significantly higher in molGB compared to astrocytomas for the 5th and 95th percentile, mean, and median values (P < .05). ADC values were significantly lower in molGB than in astrocytomas for mean, median, and the 95th percentile (P < .05). Although no molGB showed contrast enhancement initially, we observed enhancement in the short-term follow-up of 1 patient. Discussion: Quantitative analysis of diffusion and perfusion parameters shows potential in reflecting the malignant tumor biology of molGB. It may increase awareness of molGB in a nonenhancing, "benign" appearing tumor. Our results support the emerging hypothesis that molGB might present glioblastoma captured at an early stage of gliomagenesis.

Imaging panorama of pediatric central nervous system tuberculosis.

Central nervous system tuberculosis (CNS TB) is the most dreaded manifestation of systemic tuberculosis in the pediatric age group. It is associated with high morbidity and mortality due to severe neurological complications and sequelae. Knowledge about the imaging spectrum of CNS TB will help in early presumptive diagnosis and prompt treatment, reducing the development of complications. Imaging also plays a vital role in monitoring the progression of disease after the initiation of antituberculosis therapy. Advanced magnetic resonance imaging (MRI) techniques have recently improved the diagnostic efficacy manifold.In this review, we describe the imaging characteristics, the role of advanced imaging techniques, and follow-up imaging in various types of CNS TB in the pediatric population.

A Comprehensive Multidisciplinary Approach to Diagnosing Chronic Inflammatory Bowel Diseases: Integration of Clinical, Endoscopic, and Imaging Modalities.

Chronic inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, present diagnostic challenges due to their complex and heterogeneous nature. While histology remains fundamental for accurate diagnosis, a multidisciplinary approach incorporating clinical, endoscopic, and imaging modalities is increasingly recognized as essential for comprehensive evaluation. This article delves into the importance of integrating various diagnostic techniques in the assessment of IBD. Colonoscopy and histology, with its ability to directly visualize the intestinal mucosa, play a central role in the diagnostic process. However, histological analysis alone may not suffice, necessitating the inclusion of advanced imaging techniques, such as magnetic resonance enterography (MRE), computed tomography enterography (CTE), and intestinal ultrasound (IUS). These techniques provide valuable insights into the disease's extent, severity, and complications, and should be used in conjunction with biochemical parameters. These modalities complement traditional endoscopic and histological findings, offering a more holistic understanding of the disease process. A multidisciplinary approach that incorporates clinical, endoscopic, histological, serological, and imaging assessments enables clinicians to achieve a more accurate and timely diagnosis of IBD. Moreover, this integrated approach facilitates personalized treatment strategies tailored to individual patient needs, ultimately improving clinical outcomes and quality of life for those affected by chronic inflammatory bowel diseases.

Comprehensive insights into lumbar epidural varicose veins: Three clinical cases and surgical strategies.

Lumbar epidural varicose veins (LEVs) present a challenging clinical scenario with limited literature. This series addresses the scarcity of comprehensive understanding, emphasizing the need for nuanced exploration. Varied prevalence estimates and clinical oversights underscore the urgency for a standardized approach to surgical interventions. We present three diverse clinical cases: (1) segmental varicose veins causing radicular pain, (2) local varicosities leading to lower paraparesis, and (3) widespread varicose veins with prolonged symptoms. Surgical tactics involved targeted coagulation, crossing of veins, and preservation of collateral blood flow. Advanced imaging techniques guided interventions. Tailoring interventions based on varicose vein subtype, preserving collateral flow, and adopting a staged postoperative approach contribute to successful outcomes. This series provides valuable insights into LEV management, emphasizing the significance of advanced imaging in diagnosis and surgical planning.

Electrophysiologic and cardiovascular manifestations of Duchenne and Becker muscular dystrophies.

There have been significant advances in the diagnosis and management of the hereditary muscular disorders Duchenne and Becker muscular dystrophy (DMD and BMD). Cardiac electrophysiologic and cardiovascular involvement has long been important in the surveillance, care, and prognosis of patients with both BMD and DMD and is the leading cause of mortality in patients with DMD. With improved long-term prognosis, rhythm disorders and progressive cardiomyopathy with resultant heart failure are increasingly common. This review aimed to provide an overview to electrophysiologists and cardiologists of the cardiac electrophysiologic phenotypes and genetics of BMD and DMD and to highlight the recent discoveries that have advanced clinical course and management. A systematic review was performed of the diagnosis and management of DMD and BMD. The Cochrane Library, PubMed, MEDLINE, Europe PubMed Central, AMED, and Embase databases were accessed for available evidence. The research reported in this paper adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Evidence from randomized controlled trials and studies cited in expert consensus and practice guidelines are examined. Advanced imaging techniques and a spectrum of rhythm disorders associated with the progressive cardiomyopathy are presented. Early initiation of heart failure therapies, the role of cardiac implantable devices, and novel gene therapies approved for use with the potential to alter the disease course are discussed. When profound cardiac and cardiac electrophysiologic involvement is diagnosed and treated earlier, outcomes for DMD and BMD patients may be improved.

Update on Rheumatic Diseases in Clinical Practice: Recent Concepts and Developments.

Diagnostic imaging is essential in the diagnostic process of rheumatic diseases. Given the heterogeneity of this group of diseases and the tremendous impact of novel therapeutic options, guidelines and recommendations regarding the optimal choice of the most appropriate technique/s are continuously revised and radiologists should always be up-to-date. Last, because of the continuous technological innovations, we will assist to the progressive application of advanced techniques and tools in rheumatology.

Diffuse and focal liver fat: advanced imaging techniques and diagnostic insights.

The fatty liver disease represents a complex, multifaceted challenge, requiring a multidisciplinary approach for effective management and research. This article uses conventional and advanced imaging techniques to explore the etiology, imaging patterns, and quantification methods of hepatic steatosis. Particular emphasis is placed on the challenges and advancements in the imaging diagnostics of fatty liver disease. Techniques such as ultrasound, CT, MRI, and elastography are indispensable for providing deep insights into the liver's fat content. These modalities not only distinguish between diffuse and focal steatosis but also help identify accompanying conditions, such as inflammation and fibrosis, which are critical for accurate diagnosis and management.

The Evolution of Lesions on Follow-Up Magnetic Resonance Imaging of the Proximal Metacarpal Region in Non-Racing Sport Horses That Returned to Work (2015-2023).

BACKGROUND: This study evaluates the change in an MRI of the proximal metacarpal region in a group of sport horses that returned to work. This retrospective analysis evaluated 18 limbs represented by 17 horses. RESULTS: The hyperintense signal within the dorsal collagenous part of the proximal suspensory ligament (PSL) on T1W/T2*W GRE sequences decreased or stayed the same in the majority of cases. The hyperintense STIR signal within the dorsal collagenous part of the PSL resolved in the majority of the patients, and the third metacarpal bone (McIII) hyperintense STIR signal resolved in all patients. The dorsal margin irregularity of the PSL stayed the same, and McIII sclerosis and resorption of the palmar margin of McIII stayed the same in the majority of cases. McIII hyperintense STIR signal resolution carries a broad time range, with a mean of 94 days and a range of 47-202 days. CONCLUSIONS: Complete normalization of the dorsal collagenous part of the PSL does not appear necessary for a return to soundness, but a resolution of the McIII hyperintense STIR signal is expected for horses returning to soundness. A rescan period of 120 days for the proximal metacarpal region is suggested. In addition, there was no significant change in the size of the PSL between the initial and final MRI.

Fabrication and Advanced Imaging Characterization of Magnetic Aerogel-Based Thin Films for Water Decontamination.

Aerogels have emerged as appealing materials for various applications due to their unique features, such as low density, high porosity, high surface area, and low thermal conductivity. Aiming to bring the advantages of these materials to the environmental field, this study focuses on synthesizing magnetic silica aerogel-based films suitable for water decontamination. In this respect, a novel microfluidic platform was created to obtain core-shell iron oxide nanoparticles that were further incorporated into gel-forming precursor solutions. Afterward, dip-coating deposition was utilized to create thin layers of silica-based gels, which were further processed by 15-hour gelation time, solvent transfer, and further CO2 desiccation. A series of physicochemical analyses (XRD, HR-MS FT-ICR, FT-IR, TEM, SEM, and EDS) were performed to characterize the final films and intermediate products. The proposed advanced imaging experimental model for film homogeneity and adsorption characteristics confirmed uniform aerogel film deposition, nanostructured surface, and ability to remove pesticides from contaminated water samples. Based on thorough investigations, it was concluded that the fabricated magnetic aerogel-based thin films are promising candidates for water decontamination and novel solid-phase extraction sample preparation.

The value of whole tumor apparent diffusion coefficient histogram parameters in predicting meningiomas progesterone receptor expression.

This letter provides a critical assessment of a previous study on the utility of whole tumor apparent diffusion coefficient (ADC) histogram characteristics in predicting meningioma progesterone receptor expression. While acknowledging the benefits of employing classical diffusion-weighted imaging (DWI) for non-invasive tumor evaluation, it also emphasizes significant drawbacks. Advanced imaging techniques such as diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) were not used in the study, which could have provided a more comprehensive understanding of tumor microstructure and heterogeneity. Furthermore, the inclusion of necrotic and cystic areas in ADC analysis may distort results due to their different diffusion properties. While focusing on first-order ADC histogram characteristics is useful, it ignores the potential insights gained from higher-order features and texture analysis. These limitations indicate that future research should combine improved imaging modalities with thorough analytical methodologies to increase the predictive value of imaging biomarkers for meningioma features and progesterone receptor expression.

Technology use among the nation's medical examiner and coroner offices: Data from the 2018 Census of Medical Examiner and Coroner Offices.

Technology uses among medical examiner and coroner (MEC) offices in the United States are not well characterized, yet technology is essential to job-performing duties. Resources, operational infrastructure, and MECs' policies and procedures that affect technology use should be better understood. MEC offices need access to technologies like internet, case management systems (CMSs), databases, and advanced imaging to perform their basic duties. A current state of the technologies MEC offices use to complete a death investigation is presented by analyzing data from the 2018 Census of Medical Examiner and Coroner Offices. This analysis shows the New England division reported the most internet and CMS access. Many offices reported limited access to, and low participation in, databases for assessing and sharing case data. Offices serving populations >250,000 have more access to the internet, CMSs, databases, and advanced imaging. Although MEC office technology use has improved over time, it is still disparate.

Virtual reality modelling for planning of percutaneous first step palliation in a newborn with heterotaxy syndrome.

We report the first-stage percutaneous palliation in a newborn with a rare heterotaxy syndrome variant including interrupted inferior vena cava, partial anomalous pulmonary venous drainage, and restrictive interatrial communication. Virtual reality imaging aided visualisation, decision-making, and planning. Successful atrial septoplasty performed via the internal jugular vein and anomalous pulmonary vein was followed by stenting of ductus arteriosus.

Transient deoxyhemoglobin formation as a contrast for perfusion MRI studies in patients with brain tumors: a feasibility study.

Background: Transient hypoxia-induced deoxyhemoglobin (dOHb) has recently been shown to represent a comparable contrast to gadolinium-based contrast agents for generating resting perfusion measures in healthy subjects. Here, we investigate the feasibility of translating this non-invasive approach to patients with brain tumors. Methods: A computer-controlled gas blender was used to induce transient precise isocapnic lung hypoxia and thereby transient arterial dOHb during echo-planar-imaging acquisition in a cohort of patients with different types of brain tumors (n = 9). We calculated relative cerebral blood volume (rCBV), cerebral blood flow (rCBF), and mean transit time (MTT) using a standard model-based analysis. The transient hypoxia induced-dOHb MRI perfusion maps were compared to available clinical DSC-MRI. Results: Transient hypoxia induced-dOHb based maps of resting perfusion displayed perfusion patterns consistent with underlying tumor histology and showed high spatial coherence to gadolinium-based DSC MR perfusion maps. Conclusion: Non-invasive transient hypoxia induced-dOHb was well-tolerated in patients with different types of brain tumors, and the generated rCBV, rCBF and MTT maps appear in good agreement with perfusion maps generated with gadolinium-based DSC MR perfusion.