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Topic Review
Assessment of Patients with Vertebral Lesions
There are several classifications for vertebral bone lesions. By itself, vertebral bone lesions are a form of spinal lesion that only affects the osseous portion; thus, they are referred to as spinal osseous lesions, spinal neoplasms, vertebral lesions, or vertebral tumors. A vertebral primary bone lesion is a general term describing any abnormal change to the bone originating from disease or injury to healthy bone. In this context, primary is an oncological term that indicates the lesion originates from the bone, whereas secondary lesions are when the lesion metastasizes to the bone from another region of the body. When cells in the bone undergo uncontrolled growth, these lesions are referred to as bone tumors, and when the abnormal tissue closely resembles the healthy bone structure, the lesion is considered benign. Examples of benign lesions include hemangiomas, lipomas, sclerosis, aneurysmal bone cysts, osteoid osteomas, and osteoblastomas. Malignant lesions are similar to bone tumors but demonstrate a growth capable of metastasis. Malignant vertebral lesions include chondrosarcoma, chordoma, Ewing’s sarcoma, neuroblastoma, and osteosarcoma. Classification of a lesion depends on the spinal level, location of the lesion on the vertebra, layer of bone affected, number of lesions, and morphology. Typically, since lesion type determines treatment, correct identification of the lesion can have a major role in clinical outcomes.
  • 354
  • 09 Mar 2023
Topic Review
SSTR-based PET-CT in Neuroendocrine Tumors
Somatostatin receptor (SSTR) agonist-based Positron Emission Tomography-Computed Tomography (PET-CT) imaging is nowadays the mainstay for the assessment and diagnostic imaging of neuroendocrine neoplasms (NEN), especially in well-differentiated neuroendocrine tumors (NET) (World Health Organization (WHO) grade I and II). Major clinical indications for SSTR imaging are primary staging and metastatic workup, especially (a) before surgery, (b) detection of unknown primary in metastatic NET, (c) patient selection for theranostics and appropriate therapy, especially peptide receptor radionuclide therapy (PRRT), while less major indications include treatment response evaluation on and disease prognostication.
  • 349
  • 12 Jul 2023
Topic Review
Neuroimaging Techniques in Differentiating Parkinson’s Disease
Neuroimaging can provide significant benefits in evaluating patients with movement disorders associated with drugs. The dopaminergic radiotracers already reported to assess patients with drug-induced parkinsonism are [123I]-FP-CIT, [123I]-β-CIT, [99mTc]-TRODAT-1, [18F]-DOPA, [18F]-AV-133, and [18F]-FP-CIT. The most studied one and the one with the highest number of publications is [123I]-FP-CIT. Fludeoxyglucose (18F) revealed a specific pattern that could predict individuals susceptible to developing drug-induced parkinsonism.
  • 316
  • 01 Feb 2024
Topic Review
Advanced Magnetic Resonance Imaging in Treated Glioblastoma Evaluation
Magnetic resonance imaging (MRI) plays a key role in the evaluation of post-treatment changes, both in the immediate post-operative period and during follow-up. There are many different treatment’s lines and many different neuroradiological findings according to the treatment chosen and the clinical timepoint at which MRI is performed. Structural MRI is often insufficient to correctly interpret and define treatment-related changes. For that, advanced MRI modalities, including perfusion and permeability imaging, diffusion tensor imaging, and magnetic resonance spectroscopy, are increasingly utilized in clinical practice to characterize treatment effects more comprehensively.
  • 311
  • 03 Aug 2023
Topic Review
Conventional MRI Characteristics of Peri- and Para-Vascular Spaces
Brain spaces around (perivascular spaces) and alongside (paravascular or Virchow–Robin spaces) vessels have gained significant attention due to the advancements of in vivo imaging tools and to their crucial role in maintaining brain health, contributing to the anatomic foundation of the glymphatic system. In fact, it is widely accepted that peri- and para-vascular spaces function as waste clearance pathways for the brain for materials such as ß-amyloid by allowing exchange between cerebrospinal fluid and interstitial fluid. Visible brain spaces on magnetic resonance imaging are often a normal finding, but they have also been associated with a wide range of neurological and systemic conditions, suggesting their potential as early indicators of intracranial pressure and neurofluid imbalance.
  • 304
  • 01 Feb 2024
Topic Review
Biomarkers of Invasive Imaging for Carotid Plaque Vulnerability
Carotid artery disease has traditionally been assessed based on the degree of luminal narrowing. However, this approach, which solely relies on carotid stenosis, is being questioned with regard to modern risk stratification approaches. Guidelines have introduced the concept of the “vulnerable plaque,” emphasizing specific features such as thin fibrous caps, large lipid cores, intraplaque hemorrhage, plaque rupture, macrophage infiltration, and neovascularization.
  • 291
  • 21 Aug 2023
Topic Review
Diagnostic Approaches to Adult-Type Diffuse Glial Tumors
Gliomas are the most frequent intrinsic central nervous system tumors. The new 2021 WHO Classification of Central Nervous System Tumors brought significant changes into the classification of gliomas, that underline the role of molecular diagnostics, with the adult-type diffuse glial tumors now identified primarily by their biomarkers rather than histology. The status of the isocitrate dehydrogenase (IDH) 1 or 2 describes tumors at their molecular level and together with the presence or absence of 1p/19q codeletion are the most important biomarkers used for the classification of adult-type diffuse glial tumors. 
  • 244
  • 27 Sep 2023
Topic Review
Contrast-Enhanced Ultrasound of the Brain
An ultrasound (US) is a type of medical imaging that is commonly used in pediatric radiology due to its multiple advantages for the imaging of young patients. Advancements in technology have allowed the use of contrast-enhanced ultrasounds (CEUS) with high-frequency transducers, which in turn, led to new possibilities in diagnosing a variety of diseases and conditions in the field of radiology, including neonatal brain imaging. CEUS overcomes some of the limitations of conventional US and Doppler US. It allows the visualization of dynamic perfusion even in the smallest vessels in the whole brain and allows the quantitative analysis of perfusion parameters. 
  • 236
  • 11 Aug 2023
Topic Review
Application of Diffusion Spectrum Imaging
Studies have demonstrated that many regions in the human brain include multidirectional fiber tracts, in which the diffusion of water molecules within image voxels does not follow a Gaussian distribution. Therefore, the conventional diffusion tensor imaging (DTI) that hypothesizes a single fiber orientation within a voxel is intrinsically incapable of revealing the complex microstructures of brain tissues. Diffusion spectrum imaging (DSI) employs a pulse sequence with different b-values along multiple gradient directions to sample the diffusion information of water molecules in the entire q-space and then quantitatively estimates the diffusion profile using a probability density function with a high angular resolution. Studies have suggested that DSI can reliably observe the multidirectional fibers within each voxel and allow fiber tracking along different directions, which can improve fiber reconstruction reflecting the true but complicated brain structures that were not observed in the previous DTI studies. Moreover, with increasing angular resolution, DSI is able to reveal new neuroimaging biomarkers used for disease diagnosis and the prediction of disorder progression. However, this method has not been used widely in clinical studies, due to its overly long scanning time and difficult post-processing.
  • 207
  • 15 Nov 2023
Topic Review
Mechanisms of Cognitive Impairment in Chronic Kidney Disease
A notable feature of dementia in chronic kidney disease (CKD) patients is the high frequency of vascular dementia, making its prevention through the management of classical risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking, etc., associated with atherosclerosis and arteriosclerosis. Other effective measures, including the use of renin–angiotensin system inhibitors, addressing anemia, exercise therapy, and lifestyle improvements, have been reported. The incidence and progression of cognitive impairment (CI) may also be influenced by the type of kidney replacement therapy, with reports suggesting that long-duration dialysis, low-temperature hemodialysis, peritoneal dialysis, and kidney transplantation can have a preferable effect on the preservation of cognitive function. In conclusion, patients with CKD are at a higher risk of developing CI, with brain atrophy being a contributing factor. 
  • 188
  • 12 Mar 2024
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