Absolute quantification of cerebral metabolites using two-dimensional proton MR spectroscopic imaging with quantitative MRI-based water reference.

Purpose: Metabolite concentrations are valuable biomarkers in brain tumors (BTs). However, absolute quantification of metabolites using MR spectroscopy requires a correction of water relaxation using time-consuming quantitative MRI (qMRI) sequences in addition to a lengthy two-dimensional spectroscopic water-reference acquisition. The goal of this work was to develop and validate a fast quantification method where a two-dimensional spectroscopic water reference is obtained using qMRI and a single-voxel stimulated-echo acquisition mode (STEAM) sequence.

Vanishing vacuum disc phenomenon: A diagnostic key in spinal infection.

Objectives: Differentiating between pyogenic spondylodiscitis (SD) and degenerative disc disease (DDD) can be challenging due to overlapping clinical and radiological features. However, accurate distinction is critical to ensure timely and appropriate treatment and to avoid serious complications. This study aimed to identify imaging features that reliably distinguish pyogenic SD from DDD, including its erosive subtype, in clinical practice.

Mitochondrial dysfunction in peripheral mononuclear blood cells (PBMC) of individuals with mild cognitive impairment.

Mitochondrial dysfunction is a hallmark of aging and many age-related neurodegenerative diseases. Mild cognitive impairment (MCI) refers to a clinical condition characterized by noticeable cognitive decline that exceeds normal age-related changes but does not significantly interfere with daily functioning. MCI is often considered an early stage of neurodegenerative conditions, including Alzheimer's disease.

Decoding glioblastoma survival: unraveling the prognostic potential of olfactory function in a prospective observational study.

Introduction: Olfactory impairment is common in glioblastoma and has been associated with unfavorable overall survival. However, prior studies were limited by imbalances in key prognostic factors and the absence of longitudinal olfactory assessments to evaluate treatment-related neurotoxicity. The aim of the study is to determine whether olfactory function serves as an independent prognostic marker for survival, neurocognitive outcomes, and quality of life in glioblastoma.

In-vivo Assessment of the Proximal Branches of the Anterior Cerebral Artery Using Rotational Angiography.

Background: The anatomy of the proximal anterior cerebral artery (ACA) and its branches, including the recurrent artery of Heubner (RAH) and medial lenticulostriate arteries (MLSAs), is known for frequent variations. Impairment of these branches can result in severe consequences, including neurological deficits or cognitive impairment. This study aimed to analyze these branches and their variations in vivo, using data from 3D rotational angiographies (3D-RA).

Transcriptomic decoding of surface-based imaging phenotypes and its application to pharmacotranscriptomics.

Imaging transcriptomics has become a power tool for linking imaging-derived phenotypes (IDPs) to genomic mechanisms. Yet, its potential for guiding CNS drug discovery remains underexplored. Here, utilizing spatially-dense representations of the human brain transcriptome, we present an analytical framework for the transcriptomic decoding of high-resolution surface-based neuroimaging patterns, and for linking IDPs to the transcriptomic landscape of complex neurotransmission systems in vivo.

Susceptibility- and T2*-weighted MRI features of CNS large B-cell lymphoma in a large single-center cohort: prevalence, patterns, and clinical associations.

Purpose: The prevalence of susceptibility effects (SE) on T2*-weighted imaging (WI) and susceptibility-WI (SWI) in primary large B-cell lymphoma (IP-LBCL) of the central nervous system (CNS) and diffuse LBCL (DLBCL) with secondary CNS lymphoma (SCNSL) remains debated. This study aimed to clarify SE prevalence and their associations with primary versus secondary manifestations, immune status, corticosteroid treatment, and structural MRI features.

Methods: This retrospective, single-center study included histologically confirmed DLBCL cases (WHO ICD-10 C83.

Impact on the microstructure of deep gray matter in unvaccinated patients after moderate-to-severe COVID-19: insights from MRI T1 mapping.

Background: To determine changes in quantitative T1 relaxation times (qT1) in deep gray matter in patients recovered from coronavirus disease 2019 (COVID-19).

Methods: Unvaccinated COVID-19 participants ≥ 3 months after seropositivity and age- and sex-matched controls were examined using 3-T magnetic resonance imaging. Bilateral measures of thalamus, pallidum, putamen, caudate and accumbens nuclei, and hippocampus were extracted from qT1 maps after automated segmentation.

Interventional pain treatment in radiology: An overview of practical approaches.

Pain is a complex syndrome that occurs in conjunction with a multitude of benign and malignant diseases. For a considerable number of patients, optimal pain management requires a multidisciplinary approach. Interventional radiology has become an important pillar of pain treatment, offering a viable option for patients who have not responded to conventional therapy.

Morphological Alterations in Schizophrenia - An Interdisciplinary Review.

Schizophrenia is characterized by the presence and persistence of psychiatric symptoms such as delusions, hallucinations, thought disorders, or disorganized behavior for at least 1 month. An internal medical examination and the exclusion of other causes for the symptoms are an integral part of the diagnostic procedure. However, despite constant improvements in technology and resolution, radiological imaging of structural changes of the brain is not part of the standard clinical care of schizophrenia patients, except to rule out tumors or other causes for the symptoms.

Clinical Findings in Temporal Lobe Epilepsy Associated With Isolated Amygdala Enlargement.

Background: Mesial temporal lobe epilepsy (mTLE) infrequently presents with isolated amygdala enlargement (AE), but its relevance remains ambiguous. We therefore investigated clinical, imaging, and histopathological findings in mTLE-AE compared to non-lesional mTLE (mTLE-NL) patients, and additionally strategies for identifying AE.

Methods: We detected AE by automated volumetry of otherwise unremarkable magnetic resonance images of mTLE patients, compared with a healthy comparator.

Toward Noninvasive High-Resolution In Vivo pH Mapping in Brain Tumors by P-Informed deepCEST MRI.

The intracellular pH (pH) is critical for understanding various pathologies, including brain tumors. While conventional pH measurement through P-MRS suffers from low spatial resolution and long scan times, H-based APT-CEST imaging offers higher resolution with shorter scan times. This study aims to directly predict P-pH maps from CEST data by using a fully connected neuronal network.

Neurological disorders caused by recreational use of nitrous oxide-a retrospective study from a German metropolitan area and review of the literature.

Background: The recreational use of nitrous oxide (NO) has seen a worldwide rise in the recent years, resulting in an increased incidence of neurological complications due to NO-induced functional vitamin B deficiency. Here, we report on a cohort of patients admitted to a tertiary care center with neurological symptoms in the context of recreational NO use between 2020 and 2024.

Methods: We screened the database of the University Hospital Frankfurt for patients ≥ 18 years of age who presented with neurological deficits and a history of NO consumption between January 2020 and December 2024.

Safety, efficacy and timing of antithrombotic therapy in emergency stenting of acute stroke patients with tandem lesions, German multicenter data-analysis.

Background: Antithrombotic therapy of acute stroke patients with tandem lesions and emergent carotid artery stenting (CAS) is still a matter of controversial debates. The lack of evidence from dedicated studies favors a variety of clinical practices. The aim of this study was to use German Stroke Registry (GSR) data of selected high-volume centers to analyze the spectrum of antithrombotic regimens and their influence on complication rates and clinical outcome.

Optimized Long-TE H sLASER MR Spectroscopic Imaging at 3T for Separate Quantification of Glutamate and Glutamine in Glioma.

Background: Glutamate and glutamine are critical metabolites in gliomas, each serving distinct roles in tumor biology. Separate quantification of these metabolites using in vivo MR spectroscopy (MRS) at clinical field strengths (≤ 3T) is hindered by their molecular similarity, resulting in overlapping, hence indistinguishable, spectral peaks.

Purpose: To develop an MRS imaging (MRSI) protocol to map glutamate and glutamine separately at 3T within clinically feasible time, using J-modulation to enhance spectral differentiation, demonstrate its reliability/reproducibility, and quantify the metabolites in glioma subregions.

A public benchmark for human performance in the detection of focal cortical dysplasia.

Objective: This study aims to report human performance in the detection of Focal Cortical Dysplasias (FCDs) using an openly available dataset. Additionally, it defines a subset of this data as a "difficult" test set to establish a public baseline benchmark against which new methods for automated FCD detection can be evaluated.

Methods: The performance of 28 human readers with varying levels of expertise in detecting FCDs was originally analyzed using 146 subjects (not all of which are openly available), we analyzed the openly available subset of 85 cases.

Cerebral Amyloid Angiopathy: Clinical Presentation, Sequelae and Neuroimaging Features-An Update.

The prevalence of cerebral amyloid angiopathy (CAA) has been shown to increase with age, with rates reported to be around 50-60% in individuals over 80 years old who have cognitive impairment. The disease often presents as spontaneous lobar intracerebral hemorrhage (ICH), which carries a high risk of recurrence, along with transient focal neurologic episodes (TFNE) and progressive cognitive decline, potentially leading to Alzheimer's disease (AD). In addition to ICH, neuroradiologic findings of CAA include cortical and subcortical microbleeds (MB), cortical subarachnoid hemorrhage (cSAH) and cortical superficial siderosis (cSS).

Borderline Findings in -(2-[F]-Fluoroethyl)-l-Tyrosine PET of Patients with Suspected Glioma Relapse: Role in Clinical Practice.

One of the most common clinical indications for amino acid PET using the tracer -(2-[F]-fluoroethyl)-l-tyrosine (F-FET) is the differentiation of tumor relapse from treatment-related changes in patients with gliomas. A subset of patients may present with an uptake of F-FET close to recommended threshold values. The goal of this study was to investigate the frequency of borderline cases and the role of quantitative F-FET PET parameters in this situation.

Detection of focal cortical dysplasia: Development and multicentric evaluation of artificial intelligence models.

Objective: Focal cortical dysplasia (FCD) is a common cause of drug-resistant focal epilepsy but can be challenging to detect visually on magnetic resonance imaging. Three artificial intelligence models for automated FCD detection are publicly available (MAP18, deepFCD, MELD) but have only been compared on single-center data. Our first objective is to compare them on independent multicenter test data.

A fast protocol for multicenter and multiparametric quantitative MRI studies in brain tumor patients using vendor sequences.

Background: Multiparametric quantitative MRI (mp-qMRI) provides noninvasive, quantitative measurements sensitive to a variety of tissue properties. In brain tumors (BTs), longitudinal relaxation time (T1), effective transverse relaxation time (T2*), transverse relaxation time (T2), water content (HO), and quantitative susceptibility (χ) give valuable insights into the microenvironment. To generate large multicenter datasets, protocols need to be short and implementable on any scanner.

Pathological tissue changes in brain tumors affect the pH-sensitivity of the T1-corrected apparent exchange dependent relaxation (AREX) of the amide protons.

Measuring the intracellular pH (pHi) is of interest for brain tumor diagnostics. Common metrics of CEST imaging like the amide proton transfer-weighted (APTw) MTR are pHi sensitive and allow differentiating malignant tumor from healthy tissue. Yet, the image contrast also depends on additional magnetization transfer effects and T1.

A Quantitative Comparison Between Human and Artificial Intelligence in the Detection of Focal Cortical Dysplasia.

Objectives: Artificial intelligence (AI) is thought to improve lesion detection. However, a lack of knowledge about human performance prevents a comparative evaluation of AI and an accurate assessment of its impact on clinical decision-making. The objective of this work is to quantitatively evaluate the ability of humans to detect focal cortical dysplasia (FCD), compare it to state-of-the-art AI, and determine how it may aid diagnostics.

Improving Therapy for Children with Scoliosis through Reducing Ionizing Radiation by Using Alternative Imaging Methods-A Study Protocol.

Background: Patients with scoliosis often require multiple imaging modalities. The aim of this study was to find out whether primary diagnosis, including surgical planning, could be carried out entirely without computed tomography (CT) scans and whether follow-up could be replaced with alternative methods without the use of X-rays. In order to reduce the radiation exposure in the diagnosis and treatment of severe scoliosis, we expect to replace X-rays with radiation-free or less-intensive radiation examinations.

Minimal Invasive Pre-Op CT-Guided Gold-Fiducials in Local Anesthesia for Easy Level Localization in Thoracic Spine Surgery.

The accurate identification of intraoperative levels is of paramount importance in spinal surgery, particularly in cases of obesity or anatomical anomalies affecting the thoracic spine. The aim of this work was to clarify whether the preoperative percutaneous placement of fiducial markers under local anesthesia only, with minimal discomfort to the patient, can be performed safely and efficiently. Patients treated at our institution between June 2019 and June 2020 for thoracic intraspinal lesions with preoperative percutaneous gold fiducial placement were analyzed.