Evaluating large language model-generated brain MRI protocols: performance of GPT4o, o3-mini, DeepSeek-R1 and Qwen2.5-72B.

Objectives: To evaluate the potential of LLMs to generate sequence-level brain MRI protocols.

Materials And Methods: This retrospective study employed a dataset of 150 brain MRI cases derived from local imaging request forms. Reference protocols were established by two neuroradiologists.

Safety and efficacy of the pipeline vantage flow diverter for the treatment of saccular aneurysms in the posterior cerebral circulation.

IntroductionPosterior circulation aneurysms are particularly challenging to treat due to their anatomical complexity and the high perforator density within this region. The pipeline vantage flow diverter (PVFD) has shown promising results in treating anterior circulation aneurysms. However, its efficacy and safety in treating posterior circulation saccular aneurysms are not well investigated.

Changes in Gray Matter Morphology and White Matter Microstructure Across the Adult Lifespan in People With Temporal Lobe Epilepsy.

Background And Objectives: Temporal lobe epilepsy (TLE) is commonly associated with mesiotemporal pathology and widespread alterations of gray and white matter structures. Evidence supports a progressive condition, although the temporal evolution of TLE is poorly defined. In this ENIGMA-Epilepsy study, we aim to investigate structural alterations in gray and white matter across the adult lifespan in patients with TLE by charting both gray and white matter changes and explore the covariance of age-related alterations in both compartments.

Indirect flow diversion for the treatment of saccular posterior inferior cerebellar artery aneurysms: An 11-year single-center retrospective study.

IntroductionPosterior inferior cerebellar artery (PICA) aneurysms are rare but associated with high rupture rates and significant morbidity and mortality. Both surgical and endovascular treatments can be technically challenging. This study evaluates the efficacy and safety of indirect flow diversion using flow-diverting stents (FDS) deployed in the vertebral artery, covering the PICA origin.

Middle Meningeal Artery Embolization for the Treatment of Chronic Subdural Hematomas-a German Nationwide Multi-center Study On 718 Embolizations.

Background: Embolization of the middle meningeal artery (EMMA) is a promising novel technique for the treatment of patients with chronic subdural hematomas (cSDH).

Methods: After a nationwide query in Germany, patients with cSDH, treated with EMMA were retrospectively analyzed. Patient and cSDH characteristics, procedural parameters, complications, and rates of treatment failure (TF; residual cSDH > 10 mm, cSDH progression or requirement of rescue surgery) were investigated.

Safety of endovascular therapy in ischemic stroke patients ⩾90 years: A cohort study from the EVA-TRISP collaboration.

Introduction: Data on safety of endovascular therapy (EVT) in the very elderly are scarce. Using data from a large prospective EVT registry, we aimed at providing better evidence for EVT decision-making in patients aged 90 years and older.

Patients And Methods: In this multicentre observational study from the EVA-TRISP collaboration outcomes were compared between patients aged ⩾90 years with those aged <90 years using multivariate logistic regression analysis and reporting odds ratios and 95% confidence intervals.

Body size and intracranial volume interact with the structure of the central nervous system: A multi-center in vivo neuroimaging study.

Clinical research emphasizes the implementation of rigorous and reproducible study designs that rely on between-group matching or controlling for sources of biological variation such as subject's sex and age. However, corrections for body size (i.e.

Intracranial Hemorrhage in Patients With Stroke After Endovascular Treatment With or Without IV Alteplase: An Individual Participant Data Meta-Analysis.

Importance: For patients with acute ischemic stroke due to anterior circulation large vessel occlusion and presenting directly to endovascular treatment (EVT)-capable centers, intravenous thrombolysis (IVT) before EVT raises concerns about intracranial hemorrhage (ICH), but details are not well understood.

Objective: To determine the frequency and subtypes of ICH in patients treated with IVT plus EVT vs EVT alone and to determine the association between various ICH subtypes and patient functional outcomes.

Data Sources: PubMed and MEDLINE were searched from database inception through March 9, 2023.

DeepISLES: a clinically validated ischemic stroke segmentation model from the ISLES'22 challenge.

Diffusion-weighted MRI is critical for diagnosing and managing ischemic stroke, but variability in images and disease presentation limits the generalizability of AI algorithms. We present DeepISLES, a robust ensemble algorithm developed from top submissions to the 2022 Ischemic Stroke Lesion Segmentation challenge we organized. By combining the strengths of best-performing methods from leading research groups, DeepISLES achieves superior accuracy in detecting and segmenting ischemic lesions, generalizing well across diverse axes.

Headache After Sealing of Cerebrospinal Fluid Leaks in Patients With Spontaneous Intracranial Hypotension.

Introduction: Spontaneous intracranial hypotension (SIH) is an important cause of headache that might require invasive treatment. The aim of this study was to systematically investigate (1) clinical presentation, (2) factors associated with incomplete headache resolution, and (3) the long-term outcomes in patients with persistent headache after invasive treatment for SIH.

Methods: This is an observational longitudinal study.

Predictive factors and comparative analysis of surgical vs. endovascular treatment for spinal dural arteriovenous fistulas: a 22-year experience at a neurovascular and spine center.

Background: Spinal dural arteriovenous fistula (SDAVF) is a rare disease with insidious clinical manifestations that can often be overlooked on initial examination. Our aim was to identify predictive factors associated with favorable long-term outcomes and to compare the clinical results between surgical and endovascular treatment.

Methods: A retrospective chart review was conducted of 81 patients with SDAVF who underwent either surgical (n = 70, 86.

Impact of lesion metrics and neurological functions on long-term cognitive outcome in childhood stroke.

The prevalence of cognitive impairment after childhood stroke is high and various risk factors influence long-term cognitive outcome. Whether and how risk factors are associated with cognitive outcome is still incompletely understood. This study investigated how lesion volume, lesion location and neurological functions at discharge, 6 months and 2 years after childhood stroke contribute to long-term cognitive outcome.

First Application of a Novel Brain Template: Motor Training Improves Cortico-cerebellar Connectivity in Cerebellar Ataxia.

People with cerebellar degeneration show characteristic ataxic motor impairments. Despite cerebellar dysfunction, they can improve motor performance through sensorimotor training. Yet, how such training changes functional brain networks affected by cerebellar degeneration is unknown.

Primary central nervous system mucosa-associated lymphoid tissue lymphoma: a diagnostic challenge.

Primary central nervous system (CNS) mucosa-associated lymphoid tissue (MALT) lymphoma is a rare condition frequently mistaken for meningioma. Since these conditions require distinct treatment approaches, recognizing their imaging characteristics is essential for accurate clinical decision-making. A 69-year-old woman presented with headaches and forehead swelling, prompting MRI of the CNS.

The utility of preoperative computed tomography-guided screw marking in thoracic spine surgery.

Introduction: Wrong-level surgery (WLS) is a preventable yet severe complication in spinal surgery, particularly for pathologies located in the thoracic spine, where localizing the intended level is more challenging compared to the lumbar or cervical spine, which have more distinct landmark structures and fewer vertebral bodies.

Research Question: Evaluate the impact of preoperative, computed tomography (CT)-guided screw marking on avoiding WLS and optimizing intraoperative workflows.

Material And Methods: We conducted a retrospective case-control study at Bern University Hospital, enrolling all patients treated with thoracic spinal surgery between February 2017 and August 2022.

Privacy-Preserving Generation of Structured Lymphoma Progression Reports from Cross-sectional Imaging: A Comparative Analysis of Llama 3.3 and Llama 4.

Efficient processing of radiology reports for monitoring disease progression is crucial in oncology. Although large language models (LLMs) show promise in extracting structured information from medical reports, privacy concerns limit their clinical implementation. This study evaluates the feasibility and accuracy of two of the most recent Llama models for generating structured lymphoma progression reports from cross-sectional imaging data in a privacy-preserving, real-world clinical setting.

An fNIRS dataset for Multimodal Speech Comprehension in Normal Hearing Individuals and Cochlear Implant Users.

Understanding cortical processing in cochlear implant (CI) users is crucial for improving speech outcomes. Functional near-infrared spectroscopy (fNIRS) provides a non-invasive, implant-compatible method for assessing cortical activity during speech comprehension. However, existing studies suffer from methodological heterogeneity and a lack of standardized datasets, limiting cross-study comparisons and generalizability.

Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case-Control Study.

Background: The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine auras and cortical spreading depression (CSD). The aim of this study was to assess in humans if SWI asymmetry can be found in patients who have migraine attacks without auras.

Methods: We included patients ( = 100 per group) from the emergency room setting when they (i) presented with an acute neurological deficit or headache; (ii) had a discharge diagnosis of a migraine aura, a migraine without an aura, or neither (controls without stroke or epilepsy); and (iii) had a brain MRI with SWI in the acute setting.

Metabolic and Structural Alterations in the Motor System Following Spinal Cord Injury: An In-Vivo H-MR Spectroscopy Investigation.

Spinal cord injury (SCI) disrupts spinal tracts and neuronal pathways, including those in the primary motor cortex (M1) and the lumbar cord enlargement (LCE) involved in motor control. This study sought to determine whether metabolite concentrations deviate between SCI and healthy controls (HC) in M1 and LCE using proton magnetic resonance spectroscopy (H-MRS) and structural MRI, and if these correlate with clinical impairment. Sixteen chronic SCI (mean age: 54.

Intravenous Thrombolysis in Patients With Recent Intake of Direct Oral Anticoagulants: A Target Trial Analysis and Comparison With Reversal Agent Use.

Background: Intravenous thrombolysis (IVT) in patients with recent ingestion of direct oral anticoagulants (DOACs) is a frequent challenge and remains controversial. The benefit of DOAC reversal before IVT is uncertain.

Methods: Using target trial methodology, we analyzed data from 28 comprehensive stroke centers.

Is helicopter transferal in the "drip-and-ship" approach for endovascular treatment the better choice? A retrospective analysis of transfer times.

Background: For patients with large vessel occlusion (LVO) admitted to primary stroke centers (PSC) without neuro-interventional capabilities, timely transfer to comprehensive stroke centers (CSC) is crucial. In this study, we compared the transport time of ground- and air-based transfer for patients receiving endovascular treatment at our CSC.

Methods: In a retrospective cohort study, consecutive ischemic stroke patients with LVO who were transferred ground- or air-based to our CSC between October 2018 and December 2022 were examined.

Towards fair decentralized benchmarking of healthcare AI algorithms with the Federated Tumor Segmentation (FeTS) challenge.

Computational competitions are the standard for benchmarking medical image analysis algorithms, but they typically use small curated test datasets acquired at a few centers, leaving a gap to the reality of diverse multicentric patient data. To this end, the Federated Tumor Segmentation (FeTS) Challenge represents the paradigm for real-world algorithmic performance evaluation. The FeTS challenge is a competition to benchmark (i) federated learning aggregation algorithms and (ii) state-of-the-art segmentation algorithms, across multiple international sites.

Generative AI for weakly supervised segmentation and downstream classification of brain tumors on MR images.

Segmenting abnormalities is a leading problem in medical imaging. Using machine learning for segmentation generally requires manually annotated segmentations, demanding extensive time and resources from radiologists. We propose a weakly supervised approach that utilizes binary image-level labels, which are much simpler to acquire, rather than manual annotations to segment brain tumors on magnetic resonance images.

Rapid Diagnosis of Intracerebral Hemorrhage in Patients With Acute Stroke by Measuring Prehospital GFAP Levels on a Point-of-Care Device (DETECT).

Background And Objectives: The rapid identification of intracerebral hemorrhage (ICH) in patients with symptoms of acute stroke is decisive for prehospital triage and initiation of targeted therapies. Glial fibrillary acidic protein (GFAP) is a highly promising blood-biomarker indicating ICH. In this study, we investigated the potential of a new GFAP test run on a point-of-care platform for distinguishing ICH from ischemic stroke (IS) and stroke mimics (SM) in the prehospital phase.