Acute modulation of brain connectivity in Parkinson disease after automatic mechanical peripheral stimulation: A pilot study

The present study shows the results of a double-blind sham-controlled pilot trial to test whether measurable stimulus-specific functional connectivity changes exist after Automatic Mechanical Peripheral Stimulation (AMPS) in patients with idiopathic Parkinson Disease.Eleven patients (6 women and 5 men) with idiopathic Parkinson Disease underwent brain fMRI immediately before and after sham or effective AMPS. Resting state Functional Connectivity (RSFC) was assessed using the seed-ROI based analysis. Seed ROIs were positioned on basal ganglia, on primary sensory-motor cortices, on the supplementary motor areas and on the cerebellum. Individual differences for pre- and post-effective AMPS and pre- and post-sham condition were obtained and first entered in respective one-sample t-test analyses, to evaluate the mean effect of condition.Effective AMPS, but not sham stimulation, induced increase of RSFC of the sensory motor cortex, nucleus striatum and cerebellum. Secondly, individual differences for both conditions were entered into paired group t-test analysis to rule out sub-threshold effects of sham stimulation, which showed stronger connectivity of the striatum nucleus with the right lateral occipital cortex and the cuneal cortex (max Z score 3.12) and with the right anterior temporal lobe (max Z score 3.42) and of the cerebellum with the right lateral occipital cortex and the right cerebellar cortex (max Z score 3.79).Our results suggest that effective AMPS acutely increases RSFC of brain regions involved in visuo-spatial and sensory-motor integration.This study provides Class II evidence that automatic mechanical peripheral stimulation is effective in modulating brain functional connectivity of patients with Parkinson Disease at rest.Clinical Trials.gov NCT01815281

The role of gadolinium-based contrast agents in magnetic resonance imaging structured reporting and data systems (RADS)

Contrast media; Gadolinium; MRIMitjans de contrast; Gadolini; Ressonància magnèticaMedios de contraste; Gadolinio; Resonancia magnéticaAmong the 28 reporting and data systems (RADS) available in the literature, we identified 15 RADS that can be used in Magnetic Resonance Imaging (MRI). Performing examinations without using gadolinium-based contrast agents (GBCA) has benefits, but GBCA administration is often required to achieve an early and accurate diagnosis. The aim of the present review is to summarize the current role of GBCA in MRI RADS. This overview suggests that GBCA are today required in most of the current RADS and are expected to be used in most MRIs performed in patients with cancer. Dynamic contrast enhancement is required for correct scores calculation in PI-RADS and VI-RADS, although scientific evidence may lead in the future to avoid the GBCA administration in these two RADS. In Bone-RADS, contrast enhancement can be required to classify an aggressive lesion. In RADS scoring on whole body-MRI datasets (MET-RADS-P, MY-RADS and ONCO-RADS), in NS-RADS and in Node-RADS, GBCA administration is optional thanks to the intrinsic high contrast resolution of MRI. Future studies are needed to evaluate the impact of the high T1 relaxivity GBCA on the assignment of RADS scores.Open access funding provided by Università degli Studi di Trento within the CRUI-CARE Agreement

Imaging of Renal Medullary Carcinoma

Renal medullary carcinoma (RMC) is a rare, highly aggressive tumor recognized as an independent pathological entity. African-descent adolescents and young adults with sickle cell hemoglobinopathy are the most affected groups. This rare subtype of renal cell carcinoma has its own morphogenetic and pathological characteristics. The major clinical manifestations include gross hematuria, abdominal or flank pain, and weight loss. The prognosis is very poor, with 95% of cases diagnosed at an advanced stage of the disease. In this review, we summarize the morphologic and dynamic characteristics of RMC under various imaging modalities such as ultrasound, computed tomography, and magnetic resonance. Differential diagnosis and management strategies are also discussed

imaging of renal angiomyolipomatosis

Angiomyolipoma is a type of benign renal tumor. It is sporadic and isolated in 80% of cases. The remaining 20% is associated with tuberous sclerosis complex or pulmonary lymphangioleiomyomatosis. Generally, angiomyolipomas manifest themselves as angiomyolipomatosis, in which the angiomyolipomas are larger, bilateral, and widespread. Understanding whether angiomyolipomas are present in the context of angiomyolipomatosis is of considerable importance because it might be associated with malignant lesions. This article provides an overview of the radiological features of renal angiomyolipomatosis under different imaging techniques such as ultrasound, computed tomography, and magnetic resonance

Imaging of Renal Medullary Carcinoma

Renal medullary carcinoma (RMC) is a rare, highly aggressive tumor recognized as an independent pathological entity. African-descent adolescents and young adults with sickle cell hemoglobinopathy are the most affected groups. This rare subtype of renal cell carcinoma has its own morphogenetic and pathological characteristics. The major clinical manifestations include gross hematuria, abdominal or flank pain, and weight loss. The prognosis is very poor, with 95% of cases diagnosed at an advanced stage of the disease. In this review, we summarize the morphologic and dynamic characteristics of RMC under various imaging modalities such as ultrasound, computed tomography, and magnetic resonance. Differential diagnosis and management strategies are also discussed.</p

Symmetrical Central Tegmental Tract Hyperintensity on T2-weighted Images in Pediatrics: A Systematic Review

AbstractPurpose: The aim of the present study is to provide a systematic literature review of the current evidence about the Central Tegmental Tract Hyperintensity (CTTH).Methods: The literature search was performed on December 2017 using Medline PubMed, Google Scholar and Cochrane Central databases. Statistical analysis was performed using Kolmogorov-Smirnov, chi-square and the Mann-Whitney U tests.Results: Twenty publications were included. Of these, 11 were retrospective studies and 9 were case reports. In total, CTTH was reported in 226 cases. The age parameter showed a significantly non-Gaussian distribution (KS test; p-value < 0.001). The median age was 1,83 years (range: 7 days – 21 years; P25 = 1.00 year, P75 = 3.00 years; IQR = 2 years). The two most common clinical conditions associated to CTTH were cerebral palsy (51 cases; 22.6%) and glutaric aciduria type 1 (50 cases; 22.10%). CTTH was often found in the absence of other concomitant brain MRI abnormalities (32 cases; 21.8%).Conclusions: CTTH is an uncommon neuroimaging finding that is mainly related to the acquisition\improvement of a physiologicalmotor developmental process. The finding is influenced by hypoxic ischemic and toxic?metabolic factors. Data regarding DWI and follow-up are largely unreported and deserve to be further explored

Impact of Quantitative Computed Tomography-Based Analysis of Abdominal Adipose Tissue in Patients with Lymphoma

Quantitative abdominal adipose tissue analysis is important for obtaining information about prognosis and clinical outcomes on a wide array of diseases. In recent years, the effects of abdominal adipose tissue compartments in patients with lymphoma and the changes in their distribution after therapies have been studied. This information could facilitate the improvement of therapies in patients with lymphoma, to prevent or treat both visceral obesity and sarcopenia. Opportunistic analysis of body composition on computed tomography (CT) images might contribute to the improvement of patient management and clinical outcomes together with implementation of targeted patient-tailored therapies. The purpose of this literature review is to describe the role of CT to evaluate abdominal adipose tissue quantity and distribution in patients with lymphoma

Imaging findings in carcinomatous encephalitis secondary to malignant melanoma

Abstract Background The case of disseminated cancer cell spreading throughout the brain is called “miliary metastases” or “carcinomatous encephalitis”, a very rare and critical condition (primarily associated with lung and breast cancer) in which there are multiple plaque with a perivascular distribution, made of punctate lesions spread in all the brain. To our knowledge this represents the fourth case of melanotic miliary brain metastases described in the literature, also associated with melanin content of the lesions that is already evident on unenhanced T1-weighted images. Case presentation A 75-year-old patient with history of metastatic cutaneous melanoma (BRAF V600E mutate, PD-L1 negative) in treatment with dabrafenib and trametinib after 9 years from the diagnosis developed severe cognitive-motor slowing. Contrast-enhanced brain MRI showed miliary enhancing intra-axial brain lesions involving supra- and sub-tentorial regions and also the perivascular spaces, characterized by a bright appearance on unenhanced T1-weighted images without signal hypointensity in T2*-weighted images, as for melanotic pattern. Thus, the radiological diagnosis of “carcinomatous encephalitis” was made. Neurological examination showed an alert and cooperative subject with increased reaction time in verbal and motor responses. No ocular motility disturbances were found, and there were no motor or sensory deficits in the four limbs. The finger-to-nose test was normal, and no coordination deficit was found bilaterally. Blood tests and body temperature demonstrated no signs of ongoing infection. Electroencephalography showed slow and punctate abnormalities in bilateral fronto-temporal regions, with left prevalence. Corticosteroid therapy was started during hospitalization, improving the clinical picture. The patient was then discharged after 4 days in good clinical conditions with the indication to start second-line treatment with ipilimumab and nivolumab and to perform a whole-brain irradiation. Conclusions Brain MRI plays a crucial role for the non-invasive diagnosis of carcinomatous encephalitis and for the differential diagnosis with other pathologies. Awareness of the existence of this disorder even in patients with melanoma is necessary to avoid diagnostic delays. Miliary brain metastases should be suspected in all melanoma patients with new neurological findings and contrast-enhanced MRI should be performed to assess the real burden of the disease

Radiogenomics and Texture Analysis to Detect von Hippel–Lindau (VHL) Mutation in Clear Cell Renal Cell Carcinoma

Radiogenomics, a burgeoning field in biomedical research, explores the correlation between imaging features and genomic data, aiming to link macroscopic manifestations with molecular characteristics. In this review, we examine existing radiogenomics literature in clear cell renal cell carcinoma (ccRCC), the predominant renal cancer, and von Hippel–Lindau (VHL) gene mutation, the most frequent genetic mutation in ccRCC. A thorough examination of the literature was conducted through searches on the PubMed, Medline, Cochrane Library, Google Scholar, and Web of Science databases. Inclusion criteria encompassed articles published in English between 2014 and 2022, resulting in 10 articles meeting the criteria out of 39 initially retrieved articles. Most of these studies applied computed tomography (CT) images obtained from open source and institutional databases. This literature review investigates the role of radiogenomics, with and without texture analysis, in predicting VHL gene mutation in ccRCC patients. Radiogenomics leverages imaging modalities such as CT and magnetic resonance imaging (MRI), to analyze macroscopic features and establish connections with molecular elements, providing insights into tumor heterogeneity and biological behavior. The investigations explored diverse mutations, with a specific focus on VHL mutation, and applied CT imaging features for radiogenomic analysis. Moreover, radiomics and machine learning techniques were employed to predict VHL gene mutations based on CT features, demonstrating promising results. Additional studies delved into the relationship between VHL mutation and body composition, revealing significant associations with adipose tissue distribution. The review concludes by highlighting the potential role of radiogenomics in guiding targeted and selective therapies