Table of Contents
Editorial
Review Articles
- Comprehensive Review of Inner Ear Anatomy on Photon-Counting CT
Compared to traditional energy-integrating CT detectors, photon-counting CT allows greater spatial and contrast resolution of small channels containing nerves, arteries, and normal anatomy such as the cochlear cleft and cochlear and vestibular aqueducts. This review article updates the existing literature by redefining these structures in greater resolution.
General Contents
- A Comparative Study of CT Perfusion Postprocessing Tools in Medium/Distal Vessel Occlusion Stroke
This retrospective single-center cohort study investigated the discrepancy of 2 widely used postprocessing tools (Syngo.via and RapidAI) for CTP in patients with medium/distal vessel occlusion (MDVO) stroke. The 2 postprocessing tools were discordant on the volume and the location of perfusion deficit in isolated MDVO as well as the volume of potentially salvageable penumbra. As such, this questions whether infarct core size or penumbra volume should routinely be used to identify candidates for MDVO thrombectomy.
- Stroke Thrombectomy for Large Infarcts with Limited Penumbra: Systematic Review and Meta-Analysis of Randomized Trials
This meta-analysis evaluated randomized clinical trial results to provide more definitive guidance on the role of EVT for patients with stroke with large infarcts based on perfusion metrics. The results showed that the effectiveness of thrombectomy is uncertain regarding the safety and efficacy of thrombectomy for patients with limited areas of at-risk tissue. EVT may be beneficial for those with intermediate perfusion mismatch (ratio of 1.2-1.8 or volume of 10-15 mL) but not for those with low perfusion mismatch (ratio <1.2 or volume <10 mL).
- Change in Emergency Department Length of Stay following Routine Adoption of Dual-Energy CT to Differentiate Intracranial Hemorrhage from Calcification
This retrospective study compared ED LOS over a 1-year period before and after implementing automated DECT processing in the evaluation of indeterminate intracranial hyperdensities. The authors showed that with intracranial indeterminate hyperdensities, there was a larger statistically significant difference in pre-DECT versus post-DECT ED LOS. The pre-DECT ED LOS correlated with increased frequency of neurosurgical consultation and repeat head CT.
- Development and Evaluation of Automated Artificial Intelligence–Based Brain Tumor Response Assessment in Patients with Glioblastoma
The goal of this study was to compare AI-based volumetric GBM MRI response assessment with standardized radiologist response assessments. The AI-based volumetric response assessment yielded overall moderate performance for recapitulating most human response assessment categories (BT-RADS 1, 2, and 4) but demonstrated the lowest performance for predicting BT-RADS 3, which is likely related to the high variability of this assessment. In comparison to radiologist assessment, the AI-based volumetric GBM MRI response assessment showed comparable performance for overall survival.
- Assessing the Diagnostic Value of Brain White Matter Hyperintensities and Clinical Symptoms in Predicting the Detection of CSF-Venous Fistula in Patients with Suspected Spontaneous Intracranial Hypotension
The purpose of this retrospective cohort study was to assess the quantity and distribution pattern of WMH in patients with suspected SIH who underwent subsequent dynamic CTM. Patients with CVF had significantly higher Bern scores and significantly fewer WMH than those without CVF. Also, the migraine-type pattern of WMH was present at a nearly 4-fold greater frequency in the CVF- group versus the CVF+ group. Additionally, the symptom data demonstrated distinct clinical phenotypes between patients with CVF (eg, higher occurrence of a pressure-type or throbbing headache, symptoms worsening with the Valsalva maneuver) and those without CVF (eg, neck pain, fatigue, photophobia, and phonophobia).
