- In situ cell cycle analysis in giant cell tumor of bone reveals patients with elevated risk of reduced progression-free survival. [Journal Article]
- BONEBone 2019 Jun 21
- CONCLUSIONS: Ploidy and elevated replication licensing (mcm2), G1-phase (cyclin D1) and post-G1 phase (cyclin A) marker positive cell fractions, indicating enhanced cell cycle progression, can assist in identifying GCTB patients with increased risk for a reduced PFS.
- Large epileptogenic type IIIb dysplasia: a radiological and anatomopathological challenge. [Journal Article]
- WNWorld Neurosurg 2019 Jun 21
- CONCLUSIONS: We describe a rare condition of type IIIb dysplasia combining a focal cortical dysplasia with a DNET. Pre-operative diagnosis of such lesion is utmost difficult, thereby rendering mandatory a thorough histopathological examination of resected specimens in the vast majority of cases. Increased recognition of the condition arises the hypothesis of a genetic continuum or linkage between the two conditions. Functional results on seizure activity after ablative surgery are good and maximal safe resection should be the goal.
- Influence of orbital morphology on proptosis reduction and ocular motility after decompression surgery in patients with Graves' orbitopathy. [Journal Article]
- PlosPLoS One 2019; 14(6):e0218701
- CONCLUSIONS: We were able to show that orbital morphology influences the outcome of balanced orbital decompression surgery in terms of proptosis reduction and motility. However, the rather low coefficients of correlation show that the surgical outcome cannot be predicted with simple CT measurements, although risk factors for postoperative abduction deficit could be found. Therefore, preoperative planning should consider especially the orbital surface area and depth of ethmoidal sinus. Patients should be informed about the higher risk of diplopia with higher proptosis reduction.
- Detrimental Effect of Chronic Hypertension on Leptomeningeal Collateral Flow in Acute Ischemic Stroke. [Journal Article]
- SStroke 2019; 50(7):1751-1757
- Background and Purpose- We aimed to evaluate the effect of chronic hypertension on acute leptomeningeal collateral flow in patients with large-vessel ischemic stroke using digital subtraction angiogr…
Background and Purpose- We aimed to evaluate the effect of chronic hypertension on acute leptomeningeal collateral flow in patients with large-vessel ischemic stroke using digital subtraction angiography, which is the gold standard for the assessment of collateral circulation. Methods- Of the consecutive ischemic stroke patients from October 2011 to December 2017 seen in our institution, patients with acute occlusion of the M1 segment of the middle cerebral artery confirmed on initial digital subtraction angiography were enrolled. Chronic hypertension was defined as its documentation before the index stroke or as the administration of antihypertensive medications before onset. Angiographic leptomeningeal collateral flow was evaluated according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Flow Grading System and dichotomized the findings into excellent (grade 3-4) or poor (grade 0-2) collateral status for analysis. Results- Of the 3759 consecutive ischemic stroke patients, 100 patients were analyzed. Thirty-nine patients (39%) had poor collateral status. Patients with poor collateral status were older, more frequently male, and had chronic hypertension more frequently, shorter time from onset to angiography, and higher admission systolic blood pressure than those with excellent collateral status. Multivariable logistic analysis with prespecified covariates showed a significantly positive association between chronic hypertension and poor collateral status (odds ratio, 2.80; 95% CI, 1.08-7.70; P=0.034). This association was independent of admission systolic blood pressure. The proportion of patients with poor collateral status increased in a stepwise manner in patients without chronic hypertension, hypertensive patients with premorbid antihypertensive medications, and hypertensive patients without antihypertensive medications ( P for trend <0.001). Conclusions- Our data suggest that chronic hypertension has a detrimental effect on acute leptomeningeal collateral flow in patients with cerebral large-vessel occlusion. Clinical Trial Registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT02251665.
- IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke. [Journal Article]
- SStroke 2019; 50(4):909-916
- Background and Purpose- As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram fo…
Background and Purpose- As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods- We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results- National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions- The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.
- Current Advances in Emergency Department Care of Acute Ischemic Stroke: Part 2: Endovascular Therapy [Journal Article]
- EMEmerg Med Pract 2019 06 15; 21(Suppl 6):23-52
- This review discusses the current evidence for endovascular therapy in the treatment of acute ischemic stroke and explores the indications for its use. Imaging studies and procedural techniques for e…
This review discusses the current evidence for endovascular therapy in the treatment of acute ischemic stroke and explores the indications for its use. Imaging studies and procedural techniques for endovascular therapy are also discussed.
- T1ρ-based dynamic glucose-enhanced (DGEρ) MRI at 3 T: method development and early clinical experience in the human brain. [Journal Article]
- MRMagn Reson Med 2019 Jun 23
- CONCLUSIONS: DGEρ imaging was optimized for clinical field strengths of 3 T, and a robust protocol was established for broader application. Early experience shows that DGEρ seems possible at 3 T and could not only be attributed to motion artifacts. Observed DGEρ maps showed unique patterns, partly matching with the T1 -ce tumor ring enhancement. However, effect sizes are small and careful clinical application is necessary.
- A Critical Appraisal of the Quality of Glioma Imaging Guidelines Using the AGREE II Tool: A EuroAIM Initiative. [Journal Article]
- FOFront Oncol 2019; 9:472
- CONCLUSIONS: The available guidelines on glioma imaging emerged as of average quality according to the AGREE II tool analysis. Based on these results, further efforts should be made in order to involve different professional bodies and stakeholders and increase patient and public involvement in any future guideline drafting as well as to improve the applicability of these guidelines into the clinical practice.
- Modulation of creativity by transcranial direct current stimulation. [Journal Article]
- BSBrain Stimul 2019 Jun 05
- CONCLUSIONS: The findings provide new insights into ways of modulating creativity, whereby a deactivation of the left and an activation of the right prefrontal cortex with tDCS is associated with increased creativity. Potential future applications might include tDCS for patients with mental disorders and for healthy individuals in creative professions.
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- A methodology for generating four-dimensional arterial spin labeling MR angiography virtual phantoms. [Journal Article]
- MIMed Image Anal 2019 Jun 13; 56:184-192
- Four-dimensional arterial spin labeling magnetic resonance angiography (4D ASL MRA) is a non-invasive medical imaging modality that can be used for anatomical and hemodynamic analysis of the cerebrov…
Four-dimensional arterial spin labeling magnetic resonance angiography (4D ASL MRA) is a non-invasive medical imaging modality that can be used for anatomical and hemodynamic analysis of the cerebrovascular system. However, it generates a considerable amount of data, which is tedious to analyze visually. As an alternative, medical image processing methods can be used to process the data and present measurements of the geometry and blood flow in the cerebrovascular system to the user, such as vessel radius, tortuosity, blood flow volume, and transit time. Nevertheless, evaluating medical image processing methods developed for this modality requires annotated data, which can be time-consuming and expensive to obtain. Alternatively, virtual simulations are a faster and less expensive option that can be used for initial evaluation of image processing methods. The present work proposes a methodology for generating annotated 4D ASL MRA virtual phantoms, in different scenarios with different acquisition parameter settings. In each scenario, the phantoms are generated using real cerebrovascular geometries of healthy volunteers, where blood flow is simulated according to a mathematical model specifically designed to describe the signal observed in 4D ASL MRA images. Realistic noise is added using an homomorphic approach, designed to replicate noise characteristic of multi-coil acquisitions. In order to exemplify the utility of the phantoms, they are used to evaluate the accuracy of a method to estimate blood flow parameter values, such as relative blood volume and transit time, in different scenarios. The estimated values are then compared to its corresponding virtual ground-truth values. The accuracy of the results is ranked according to the average absolute error. The results of the experiments show that blood flow parameters can be more accurately estimated when blood is magnetically labeled for longer periods of time and when the datasets are acquired with higher temporal resolution. In summary, the present work describes a methodology to create annotated virtual phantoms, which represent a useful alternative for initial evaluation of medical image processing methods for 4D ASL MRA images.