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Kong Y, Huang X, Peng G, Cao X, Zhou X. Efficacy of first-line radiofrequency ablation combined with systemic chemotherapy plus targeted therapy for initially unresectable colorectal liver metastases. Int J Hyperthermia 2025; 42:2432988. [PMID: 39894452 DOI: 10.1080/02656736.2024.2432988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 10/16/2024] [Accepted: 11/18/2024] [Indexed: 02/04/2025] Open
Abstract
BACKGROUND/OBJECTIVE The optimal strategy for patients with colorectal liver metastases is still controversially discussed. This study aimed to evaluate the efficacy of radiofrequency ablation (RFA) combined with systemic chemotherapy plus targeted therapy as first-line treatment in patients with initially unresectable colorectal liver metastases (CRLM), to identify prognostic factors and construct nomograms predicting survival. METHODS This retrospective study included patients with initially unresectable CRLM treated with (study group n = 74) or without (control group n = 83) RFA at the National Cancer Center from January 2018 to January 2021. Survival curves were assessed using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox regression analyses were used to determine prognostic factors and include these factors in the nomograms to predict progression-free survival (PFS) and overall survival (OS). RESULTS The study group had significantly better median PFS (17.16 months vs. 8.35 months, p < 0.01) and OS (34.9 months vs. 21.1 months, p < 0.01) than the control group after propensity score matching. Cox regression analyses identified RFA treatment and clinical risk score (CRS) as independent prognostic factors for PFS. The largest diameter of liver metastases, RFA treatment, and CRS were independent prognostic factors for OS. Based on this finding, nomograms with good discrimination and calibration were constructed. CONCLUSION RFA combined with systemic chemotherapy plus targeted therapy as first-line treatment could significantly prolong PFS and OS in patients with initially unresectable CRLM compared with systemic chemotherapy plus targeted therapy. The nomograms predicting PFS and OS might help clinicians select personalized treatment.
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Affiliation(s)
- Yaqing Kong
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyu Huang
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Peng
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaojing Cao
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiang Zhou
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Dang Q, Zhang L, Ma H, Sun X, Ren A, Chen J, Huang X, Zhang B, Sun W. Lighthouses illuminating tumor metastasis: The application of fluorescent probes in the localization and imaging metastatic lymph nodes across various tumors. Biomaterials 2025; 316:123020. [PMID: 39693784 DOI: 10.1016/j.biomaterials.2024.123020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 11/24/2024] [Accepted: 12/13/2024] [Indexed: 12/20/2024]
Abstract
The significance of metastatic lymph nodes in tumor diagnosis and prognosis is self-evident. With the deepening of research on the lymphatic system and the advancement of imaging technology, an increasing number of near-infrared fluorescent probes targeting tumor metastatic lymph nodes have been developed. These probes can identify tumors while further detecting lymph nodes (LNs), showcasing great potential in image-guided surgery. In this review, we comprehensively outline the design strategies and applications of near-infrared fluorescent probes for cancers with a high propensity for lymph node metastasis during disease progression. Particular emphasis is placed on two targeting mechanisms: tumor-directed probes capable of identifying metastatic lymph nodes and lymph node-specific probes utilizing passive targeting of metastatic lymph nodes or active targeting of lymph nodes directly. Additionally, we discuss current issues and future prospects in this field, which will facilitate the development of new fluorescent probes and their further clinical translation.
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Affiliation(s)
- Qi Dang
- College of Medical Laboratory, Dalian Medical University, Dalian, 116044, China
| | - Linhao Zhang
- State Key Laboratory of Fine Chemicals, Frontiers Science Center for Smart Materials Oriented Chemical Engineering, Dalian University of Technology, Dalian, 116024, China
| | - Huipeng Ma
- College of Medical Laboratory, Dalian Medical University, Dalian, 116044, China
| | - Xiaoshan Sun
- College of Medical Laboratory, Dalian Medical University, Dalian, 116044, China
| | - Anguo Ren
- College of Medical Laboratory, Dalian Medical University, Dalian, 116044, China
| | - Jiuyang Chen
- College of Medical Laboratory, Dalian Medical University, Dalian, 116044, China
| | - Xiaohua Huang
- College of Medical Laboratory, Dalian Medical University, Dalian, 116044, China
| | - Boyu Zhang
- College of Medical Laboratory, Dalian Medical University, Dalian, 116044, China.
| | - Wen Sun
- State Key Laboratory of Fine Chemicals, Frontiers Science Center for Smart Materials Oriented Chemical Engineering, Dalian University of Technology, Dalian, 116024, China.
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Dhakal N, Dahal P. Grey matter hypertropia in a child with recurrent seizure: A case report. Radiol Case Rep 2025; 20:1807-1811. [PMID: 39897746 PMCID: PMC11782804 DOI: 10.1016/j.radcr.2024.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Revised: 12/14/2024] [Accepted: 12/22/2024] [Indexed: 02/04/2025] Open
Abstract
Heterotopia is a common anomaly of cortical development often associated with early-onset and familial epilepsy. Grey matter heterotopias are macroscopically classified into nodular and diffuse types and clinically categorized as subependymal, subcortical, or band heterotopia. They are frequently associated with other neurological conditions, such as corpus callosum agenesis, pachygyria, schizencephaly, polymicrogyria, Chiari II malformation, and basilar cephalocele. The clinical presentation varies depending on the thickness of the arrested neuronal band, ranging from partial complex and atypical absence epilepsy to normal cognitive function, developmental delay, or severe intellectual disability. Magnetic resonance imaging (MRI) is the preferred diagnostic modality, as it reveals the abnormally located heterotopic grey matter within the white matter. Carbamazepine is the most commonly prescribed antiepileptic drug, but its use depends on patient-specific factors such as tolerance, side effects, and efficacy. Here, we report the case of a 7-year-old male with a history of three seizure episodes over the past three years, initially diagnosed as febrile seizures with atypical focal features.
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Affiliation(s)
- Natasha Dhakal
- Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu, Nepal
| | - Prajwal Dahal
- Department of Radiology and Imaging, Grande International Hospital, Kathmandu, Nepal
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Chen MJ, Makehei S, Chen I, De Michele S, Bhanu S, Wei J. Large retroperitoneal mass: A case of an undifferentiated pleomorphic sarcoma. Radiol Case Rep 2025; 20:1850-1853. [PMID: 39897756 PMCID: PMC11783216 DOI: 10.1016/j.radcr.2024.09.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Accepted: 09/28/2024] [Indexed: 02/04/2025] Open
Abstract
Soft tissue sarcomas (STS) are a group of rare malignant tumors arising from mesenchymal stem cells. There are more than 60 different types of neoplasms that fall under the umbrella of STS, including tumors that originate from cartilage, adipose tissue, skeletal muscle, or connective tissue, among many other tissue types. One particular type of high-grade aggressive STS is the undifferentiated pleomorphic sarcoma (UPS), formerly known as the malignant fibrous histiocytoma (MFH). There has historically been much debate about the classification and differentiation of UPS from other types of sarcomas, which has only recently been characterized by novel methods of immunohistochemistry markers and sophisticated cytogenetics. This has left much of the literature regarding UPS largely irrelevant in context of our current classification standards. A recent retrospective analysis of 100 UPS cases revealed an incidence of only 9% for UPS originating in the retroperitoneum. We present a case of UPS originating in the retroperitoneum. In this case, a patient suffering from a large right-sided intra-abdominal mass underwent complete surgical resection. We also demonstrate some of the complexities involved in the diagnosis and treatment of a rare retroperitoneal form of UPS.
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Affiliation(s)
| | | | | | - Simona De Michele
- Riverside Community Hospital, 4445 Magnolia Ave, Riverside, CA 92501, USA
| | - Shiv Bhanu
- Riverside Community Hospital, 4445 Magnolia Ave, Riverside, CA 92501, USA
| | - Justin Wei
- Riverside Community Hospital, 4445 Magnolia Ave, Riverside, CA 92501, USA
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5
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Allen TJ, van der Heijden RA, Simchick G, Hernando D. Reproducibility of liver ADC measurements using first moment optimized diffusion imaging. Magn Reson Med 2025; 93:1568-1584. [PMID: 39529300 PMCID: PMC11782722 DOI: 10.1002/mrm.30372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 09/23/2024] [Accepted: 10/22/2024] [Indexed: 11/16/2024]
Abstract
PURPOSE Cardiac-induced liver motion can bias liver ADC measurements and compromise reproducibility. The purpose of this work was to enable motion-robust DWI on multiple MR scanners and assess reproducibility of the resulting liver ADC measurements. METHODS First moment-optimized diffusion imaging (MODI) was implemented on three MR scanners with various gradient performances and field strengths. MODI-DWI and conventional Stejskal-Tanner monopolar (MONO) DWI were acquired in eight (N = 8) healthy volunteers on each scanner, and DWI repetitions were combined using three different averaging methods. For each combination of scanner, acquisition, and averaging method, ADC measurements from each liver segment were collected. Systematic differences in ADC values between scanners and methods were assessed with linear mixed effects modeling, and reproducibility was quantified via reproducibility coefficients. RESULTS MODI reduced left-right liver lobe ADC bias from 0.43 × 10-3 mm2/s (MONO) to 0.19 × 10-3 mm2/s (MODI) when simple (unweighted) repetition averaging was used. The bias was reduced from 0.23 × 10-3 mm2/s to 0.06 × 10-3 mm2/s using weighted averaging, and 0.14 × 10-3 mm2/s to 0.01 × 10-3 mm2/s using squared weighted averaging. There was no significant difference in ADC measurements between field strengths or scanner gradient performance. MODI improved reproducibility coefficients compared to MONO: 0.84 × 10-3 mm2/s vs. 0.63 × 10-3 mm2/s (MODI vs. MONO) for simple averaging, 0.66 × 10-3 mm2/s vs. 0.50 × 10-3 mm2/s for weighted averaging, and 0.61 × 10-3 mm2/s vs. 0.47 × 10-3 mm2/s for squared weighted averaging. CONCLUSION The feasibility of motion-robust liver DWI using MODI was demonstrated on multiple MR scanners. MODI improved interlobar agreement and reproducibility of ADC measurements in a healthy cohort.
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Affiliation(s)
- Timothy J. Allen
- Department of Medical PhysicsUniversity of Wisconsin‐Madison
MadisonWisconsinUSA
| | - Rianne A. van der Heijden
- Department of RadiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of Radiology and Nuclear MedicineErasmus University Medical CenterRotterdamThe Netherlands
| | - Gregory Simchick
- Department of RadiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Diego Hernando
- Department of Medical PhysicsUniversity of Wisconsin‐Madison
MadisonWisconsinUSA
- Department of RadiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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6
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Plähn NMJ, Safarkhanlo Y, Açikgöz BC, Mackowiak ALC, Radojewski P, Bonanno G, Peper ES, Heule R, Bastiaansen JAM. ORACLE: An analytical approach for T 1, T 2, proton density, and off-resonance mapping with phase-cycled balanced steady-state free precession. Magn Reson Med 2025; 93:1657-1673. [PMID: 39710877 DOI: 10.1002/mrm.30388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 11/08/2024] [Accepted: 11/09/2024] [Indexed: 12/24/2024]
Abstract
PURPOSE To develop and validate a novel analytical approach simplifyingT 1 $$ {T}_1 $$ ,T 2 $$ {T}_2 $$ , proton density (PD), and off-resonanceΔ f $$ \Delta f $$ quantifications from phase-cycled balanced steady-state free precession (bSSFP) data. Additionally, to introduce a method to correct aliasing effects in undersampled bSSFP profiles. THEORY AND METHODS Off-resonant-encoded analytical parameter quantification using complex linearized equations (ORACLE) provides analytical solutions for bSSFP profiles. which instantaneously quantifyT 1 $$ {T}_1 $$ ,T 2 $$ {T}_2 $$ , proton density (PD), andΔ f $$ \Delta f $$ . An aliasing correction formalism was derived to allow undersampling of bSSFP profiles. ORACLE was used to quantifyT 1 $$ {T}_1 $$ ,T 2 $$ {T}_2 $$ , PD,T 1 $$ {T}_1 $$ /T 2 $$ {T}_2 $$ , andΔ f $$ \Delta f $$ based on fully sampled (N = 20 $$ N=20 $$ ) bSSFP profiles from numerical simulations and 3T MRI experiments in phantom and 10 healthy subjects' brains. Obtained values were compared with reference scans in the same scan session. Aliasing correction was validated in subsampled (N = 4 $$ N=4 $$ ) bSSFP profiles in numerical simulations and human brains. RESULTS ORACLE quantifications agreed well with input values from simulations and phantom reference values (R2 = 0.99). In human brains,T 1 $$ {T}_1 $$ andT 2 $$ {T}_2 $$ quantifications when compared with reference methods showed coefficients of variation below 2.9% and 3.9%, biases of 182 and 16.6 ms, and mean white-matter values of 642 and 51 ms using ORACLE. TheΔ f $$ \Delta f $$ quantification differed less than 3 Hz between both methods. PD andT 1 $$ {T}_1 $$ maps had comparable histograms. TheΛ $$ \varLambda $$ maps effectively identified cerebrospinal fluid. Aliasing correction removed aliasing-related quantification errors in undersampled bSSFP profiles, significantly reducing scan time. CONCLUSION ORACLE enables simplified and rapid quantification ofT 1 $$ {T}_1 $$ ,T 2 $$ {T}_2 $$ , PD, andΔ f $$ \Delta f $$ from phase-cycled bSSFP profiles, reducing acquisition time and eliminating biomarker maps' coregistration issues.
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Affiliation(s)
- Nils M J Plähn
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | - Yasaman Safarkhanlo
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
- Department of Cardiology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Berk C Açikgöz
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | - Adèle L C Mackowiak
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Piotr Radojewski
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- University Institute of Diagnostic and Interventional Neuroradiology, Bern, Switzerland
| | - Gabriele Bonanno
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- University Institute of Diagnostic and Interventional Neuroradiology, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Bern, Switzerland
| | - Eva S Peper
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Rahel Heule
- Center for MR Research, University Children's Hospital, Zurich, Switzerland
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
- High-Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Jessica A M Bastiaansen
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
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Marrapu S, Kumar R. Transition from acute kidney injury to chronic kidney disease in liver cirrhosis patients: Current perspective. World J Nephrol 2025; 14:102381. [DOI: 10.5527/wjn.v14.i1.102381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 12/22/2024] [Accepted: 01/11/2025] [Indexed: 01/20/2025] Open
Abstract
In liver cirrhosis patients, acute kidney injury (AKI) is a common and severe complication associated with significant morbidity and mortality, often leading to chronic kidney disease (CKD). This progression reflects a complex interplay of renal and hepatic pathophysiology, with AKI acting as an initiator through maladaptive repair mechanisms. These mechanisms—such as tubular cell cycle arrest, inflammatory cascades, and fibrotic processes—are exacerbated by the hemodynamic and neurohormonal disturbances characteristic of cirrhosis. Following AKI episodes, persistent kidney dysfunction or acute kidney disease (AKD) often serves as a bridge to CKD. AKD represents a critical phase in renal deterioration, characterized by prolonged kidney injury that does not fully meet CKD criteria but exceeds the temporal scope of AKI. The progression from AKD to CKD is further influenced by recurrent AKI episodes, impaired renal autoregulation, and systemic comorbidities such as diabetes and metabolic dysfunction-associated steatotic liver disease, which compound kidney damage. The clinical management of AKI and CKD in cirrhotic patients requires a multidimensional approach that includes early identification of kidney injury, the application of novel biomarkers, and precision interventions. Recent evidence underscores the inadequacy of traditional biomarkers in predicting the AKI-to-CKD progression, necessitating novel biomarkers for early detection and intervention.
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Affiliation(s)
- Sudheer Marrapu
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, India
| | - Ramesh Kumar
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, India
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Kiani I, Aarabi MH, Cattarinussi G, Sambataro F, Favalli V, Moltrasio C, Delvecchio G. White matter changes in paediatric bipolar disorder: A systematic review of diffusion magnetic resonance imaging studiesA systematic review of diffusion magnetic resonance imaging studies. J Affect Disord 2025; 373:67-79. [PMID: 39689732 DOI: 10.1016/j.jad.2024.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 12/11/2024] [Accepted: 12/12/2024] [Indexed: 12/19/2024]
Abstract
BACKGROUND Paediatric bipolar disorder (PBD) is characterized by severe mood fluctuations that deviate from typical childhood emotional development. Despite the efforts, the pathophysiology of this disorder is not well understood yet. In this review, we aimed to synthesize existing diffusion magnetic resonance imaging (dMRI) research findings in PBD. METHODS A literature search was conducted using PubMed, Embase, Scopus, and Web of Science databases to identify relevant studies published before April 2024. RESULTS A total of 23 studies were included in the review. The findings showed variations of fractional anisotropy (FA), axial diffusivity, radial diffusivity, and apparent diffusion coefficient in PBD compared to healthy controls (HCs). Key findings included decreased FA in the anterior cingulate, anterior corona radiata, and corpus callosum, particularly the genu, which correlated with clinical symptoms. Furthermore, longitudinal studies emphasized the significance of the uncinate fasciculus as having atypical developmental trajectories in PBD compared to HCs. In addition, graph analysis revealed widespread changes in structural connectivity, especially affecting the orbitofrontal cortex, frontal gyrus, and basal ganglia. Lastly, machine learning models showed promising results in differentiating PBD from HCs. LIMITATIONS Cross-sectional design of the studies, small sample sizes, and different imaging protocols preclude integration of the findings. CONCLUSION PBD seems to be associated with widespread structural changes compared to HC. Understanding these changes, which might account for the clinical manifestations of this disorder, increase our knowledge of the neurobiological underpinnings of PBD. This, in turn, may help develop more effective treatments for this disorder.
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Affiliation(s)
- Iman Kiani
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Virginia Favalli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Lu XY, Cao JY, Chen S, Wang Y, Wei L, Gong W, Lou WH, Dong Y. Added Value of Dynamic Contrast-Enhanced Ultrasound Analysis for Differential Diagnosis of Small (≤20 mm) Solid Pancreatic Lesions. ULTRASOUND IN MEDICINE & BIOLOGY 2025; 51:535-542. [PMID: 39753466 DOI: 10.1016/j.ultrasmedbio.2024.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 11/09/2024] [Accepted: 11/14/2024] [Indexed: 01/25/2025]
Abstract
OBJECTIVE To evaluate the added value of dynamic contrast-enhanced ultrasound (DCE-US) analysis in pre-operative differential diagnosis of small (≤20 mm) solid pancreatic lesions (SPLs). METHODS In this retrospective study, patients with biopsy or surgerical resection and histopathologically confirmed small (≤20 mm) SPLs were included. One wk before biopsy/surgery, pre-operative B-mode ultrasound and contrast-enhanced ultrasound were performed. An ultrasonic system (ACUSON Sequoia, Siemens Medical Solutions, PA, USA) equipped with a 5C1 MHz convex array transducer was utilized. A dose of 1.5 ml SonoVue (Bracco, Italy) was injected as the contrast agent. Time-intensity curves were generated using VueBox software (Bracco) and various DCE-US quantitative parameters were subsequently calculated after curve fitting. Univariate and multivariate logistic regression analysis were utilized. RESULTS From August 2020 to November 2023, a total of 76 patients (31 males and 45 females; mean age: 61.9 ± 10.5 y) with 76 small (≤20 mm) SPLs were included. Mean size of the lesions was 16.4 ± 0.4 mm (range: 7-20 mm). Final diagnosis included 37 benign and 39 malignant small SPLs. On B-mode ultrasound, the majority of malignant (37/39, 94.9%) and benign SPLs (30/37, 81.1%) were hypo-echoic lesions with ill-defined borders and irregular shapes (p > 0.05). During the arterial phase of contrast-enhanced ultrasound, most SPLs (59/76, 77.6%) exhibited iso-enhancement when compared with surrounding pancreatic parenchyma. Subsequently, 82.1% (32/39) of malignant SPLs and 35.1% (13/37) of benign SPLs demonstrated wash-out in the venous phase and showed hypo-enhancement in venous and late phases (p > 0.05). Compared with benign SPLs, the time-intensity curves of small malignant SPLs revealed earlier and lower enhancement in the arterial phase, and a faster decline during the venous phase with a decreased area under the curve. Among the quantitative parameters, a lower peak enhancement ratio and higher fall time ratio were more common in small malignant SPLs (p < 0.05). For DCE-US analysis, the combined areas under the curve of significant quantitative parameters was 0.919, with 87.2% sensitivity and 86.5% specificity when differentiating between small malignant and benign SPLs. This result was better than contrast-enhanced computed tomography, which has a sensitivity of 74.4% and a specificity of 75.7%. CONCLUSION DCE-US analysis provides added value for the pre-operative differential diagnosis of small malignant SPLs.
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Affiliation(s)
- Xiu-Yun Lu
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jia-Ying Cao
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Sheng Chen
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Li Wei
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Gong
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen-Hui Lou
- Department of Pancreatic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
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10
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Grine FE, Post NW, Greening V, Crevecoeur I, Billings BK, Meyer A, Holt S, Black W, Morris AG, Veeramah KR, Mongle CS. Frontal sinus size in South African Later Stone Age Holocene Khoe-San. Anat Rec (Hoboken) 2025; 308:801-826. [PMID: 39118368 DOI: 10.1002/ar.25556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/01/2024] [Accepted: 07/19/2024] [Indexed: 08/10/2024]
Abstract
Frontal size variation is comparatively poorly sampled among sub-Saharan African populations. This study assessed frontal sinus size in a sample of Khoe-San skeletal remains from South African Later Stone Age contexts. Volumes were determined from CT scans of 102 adult crania; individual sex could be estimated in 82 cases. Sinus volume is not sexually dimorphic in this sample. The lack of frontal sinus aplasia is concordant with the low incidences recorded for other sub-Saharan African and most other global populations save those that inhabit high latitudes. There is considerable variation in frontal sinus size among global populations, and the Khoe-San possess among the smallest. The Khoe-San have rather diminutive sinuses compared to sub-Saharan Bantu-speaking populations but resemble a northern African (Sudanese) population. Genetic studies indicate the earliest population divergence within Homo sapiens to have been between the Khoe-San and all other living groups, and that this likely occurred in Africa during the span of Marine Isotope Stages 8-6. There is scant information on frontal sinus development among Late Quaternary African fossils that are likely either closely related or attributable to Homo sapiens. Among these, the MIS 3 cranium from Hofmeyr, South Africa, exhibits distinct Khoe-San cranial affinities and despite its large size has a very small frontal sinus. This raises the possibility that the small frontal sinuses of the Holocene South African Khoe-San might be a feature retained from an earlier MIS 3 population.
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Affiliation(s)
- Frederick E Grine
- Department of Anthropology, Stony Brook University, Stony Brook, New York, USA
- Department of Anatomical Sciences, School of Medicine, Stony Brook University, New York, USA
| | - Nicholas W Post
- Richard Gilder Graduate School and Division of Anthropology, American Museum of Natural History, New York, New York, USA
| | | | - Isabelle Crevecoeur
- Laboratoire de la Préhistoire à l'Actuel: Culture, Environnement et Anthropologie, Université de Bordeaux, Pessac Cedex, France
- Chargée de Recherche CNRS, Université de Bordeaux, Pessac Cedex, France
| | - Brendon K Billings
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand Parktown, Johannesburg, South Africa
| | - Anja Meyer
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand Parktown, Johannesburg, South Africa
| | - Sharon Holt
- Florisbad Quaternary Research Station, National Museum, Bloemfontein, South Africa
| | - Wendy Black
- Archaeology Unit, Iziko Museums of South Africa, Cape Town, South Africa
| | - Alan G Morris
- Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Krishna R Veeramah
- Department of Ecology & Evolution, Stony Brook University, Stony Brook, New York, USA
| | - Carrie S Mongle
- Department of Anthropology, Stony Brook University, Stony Brook, New York, USA
- Turkana Basin Institute, Stony Brook University, Stony Brook, New York, USA
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11
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Mohana-Borges AVR, Silva LTSD, Mohana-Borges RS, Statum S, Jerban S, Wu Y, Barrère V, Souza SAL, Chung CB. Neurovascular crossing patterns between leash of Henry and deep branch of radial nerve: implications for neurointervention and diagnostic imaging. Skeletal Radiol 2025; 54:493-507. [PMID: 39080031 PMCID: PMC11769873 DOI: 10.1007/s00256-024-04740-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 01/28/2025]
Abstract
OBJECTIVE To detail the neurovascular crossing patterns between the leash of Henry (LoH) and the deep branch of the radial nerve (DBRN) in supination and pronation of the forearm, using imaging methods with anatomic correlation. MATERIALS AND METHODS This cross-sectional study was performed ex vivo with HRUS and MRI with anatomic correlation on 6 samples and in vivo with HRUS with Doppler on 55 participants scanned bilaterally. The in vivo participants were enrolled over a 6-month period. The crossing patterns between the LoH and DBRN were assessed ex vivo and in vivo. Additional morphological features of the DBRN, LoH, and fat plane were assessed in vivo only. Biometric features of the participants were recorded. Statistical analyses were performed using Shapiro-Wilk, parametric and non-parametric tests. RESULTS The most common neurovascular crossing pattern was the ascending branch of the radial recurrent artery (RRAab) crossing below (ex vivo: 83.3%, in vivo: 85.3%) and the muscular branch crossing above (ex vivo: 100%, in vivo: 63.2% %) the DBRN. Both the deep and superficial surfaces of the DBRN exhibited an intimate relationship with the vessels of the LoH. A positive correlation between vessel diameter and anthropometric factors was observed. In addition, the muscular branch exhibited a significantly smaller diameter than the RRAab. CONCLUSION Our study detailed the relationship between the LoH and the DBRN and highlighted the high incidence of vessel crossing above the DBRN at the level of the muscular branch. Knowledge of neurovascular crossings is crucial for understanding neurovascular entrapment syndromes and planning interventional procedures to reduce vascular complications.
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Affiliation(s)
- Aurea V R Mohana-Borges
- Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Radiology, University of California, San Diego, USA
- Veterans Affairs Medical Center, San Diego, USA
| | | | - Ronaldo S Mohana-Borges
- Laboratory of Biotechnology and Structural Bioengineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sheronda Statum
- Radiology, University of California, San Diego, USA
- Veterans Affairs Medical Center, San Diego, USA
| | - Saeed Jerban
- Radiology, University of California, San Diego, USA
| | - Yuanshan Wu
- Department of Orthopaedic Surgery, University of California, San Diego, CA, USA
- Department of Bioengineering, University of California, San Diego, CA, USA
| | - Victor Barrère
- Department of Orthopaedic Surgery, University of California, San Diego, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Sergio A L Souza
- Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Christine B Chung
- Radiology, University of California, San Diego, USA.
- Veterans Affairs Medical Center, San Diego, USA.
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12
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Agirlar Trabzonlu T, Allen BD. Role of Cardiovascular MR Imaging and MR Angiography in Patients with Pulmonary Vascular Disease. Radiol Clin North Am 2025; 63:279-291. [PMID: 39863380 DOI: 10.1016/j.rcl.2024.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2025]
Abstract
Cardiac MR imaging and pulmonary MR angiography (MRA) are important clinical tools for the assessment of pulmonary vascular diseases. There are evolving noncontrast and contrast-enhanced techniques to evaluate pulmonary vasculature. Pulmonary MRA is a feasible imaging alternative to CTA in pulmonary embolism detection. Perfusion MR imaging and cardiac MR imaging help diagnose and monitor the treatment response of chronic thromboembolic pulmonary hypertension. Cardiac MR imaging is pivotal in assessing the potential underlying etiology and impact of pulmonary hypertension on the heart. Multiphasic acquisitions and dynamic phase imaging are unique to pulmonary MRA, which aid in diagnosing many pulmonary vascular diseases, including shunts and masses.
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Affiliation(s)
- Tugce Agirlar Trabzonlu
- Radiology Department, Northwestern University Feinberg School of Medicine, Arkes Pavilion, 676 North St Clair Street, Suite 800, Chicago, IL 60611, USA.
| | - Bradley D Allen
- Radiology Department, Northwestern University Feinberg School of Medicine, Arkes Pavilion, 676 North St Clair Street, Suite 800, Chicago, IL 60611, USA.
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13
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Gonzalez RDLF, Cabra A, Liu D, Gueco M, Naslazi E, Fu S, Maliszewska Z, Hummel N, Dunham DM. Comparative Safety of Ultrasound Enhancing Agents: A Systematic Review and Bayesian Network Meta-Analysis. Am J Cardiol 2025; 237:6-13. [PMID: 39549824 DOI: 10.1016/j.amjcard.2024.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 10/28/2024] [Accepted: 11/10/2024] [Indexed: 11/18/2024]
Abstract
Ultrasound enhancing agents (UEAs), including OPTISON, DEFINITY, and LUMASON, enhance the diagnostic performance of echocardiography, particularly, in patients with suboptimal acoustic windows. However, there remains a paucity of comparative safety assessments among the Food and Drug Administration-approved UEAs. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic literature review performed in August 2023 searched Medline, Embase, Cochrane Library, and gray literature. Randomized and nonrandomized comparative evidence on safety of contrast-enhanced procedures were included. A feasibility assessment ensured homogeneity across studies by comparing patient characteristics and outcomes. Bayesian hierarchical network meta-regression was used to indirectly compare published safety outcomes across different UEAs. In addition, adverse events (AEs) between 2019 and 2023 for each UEA were retrieved from the Food and Drug Administration Adverse Events Reporting System (FAERS), and comparative safety outcomes were derived using annual UEA administration in the United States. The screening of 4,146 records rendered 19 studies for inclusion in the indirect comparison analysis after feasibility assessment. OPTISON demonstrated favorable safety in direct comparisons with DEFINITY and LUMASON across the majority of investigated AEs. Network meta-regression results on serious AEs within 30 minutes revealed odds ratios (ORs) of 0.59 (95% confidence interval 0.27 to 1.23) and 0.63 (0.29 to 1.33) for OPTISON versus LUMASON and DEFINITY, respectively, indicating a decreased risk of serious AEs for OPTISON versus LUMASON and DEFINITY, further supported by statistically significant ORs within FAERS: 0.01 (0 to 0.02), p <0.001 and 0.15 (0.05 to 0.48), p = 0.001 for OPTISON versus LUMASON and DEFINITY, respectively. In conclusion, our results restate the favorable comparative safety profile of OPTISON, providing new evidence to inform clinical decision-making.
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Affiliation(s)
| | - Arturo Cabra
- GE HealthCare, Market Access, Arlington Heights, IL
| | - Daphne Liu
- GE HealthCare, Medical Affairs, Arlington Heights, IL
| | - Myra Gueco
- GE HealthCare, Marketing, Arlington Heights, IL
| | - Emi Naslazi
- Certara Netherlands B.V., Real World Evidence & Modeling Solutions, The Netherlands
| | - Shuai Fu
- Certara China, Quantitative Science Services, Shanghai, China
| | | | - Noemi Hummel
- Certara Germany GmbH, Real World Evidence & Modeling Solutions, Lörrach, Germany
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14
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Safariyan M, Mohammadrafie N, Pourmasumi S, Mohammadi V, Xu X, Hermis AH, Al-Jabri MM, Jafarian F, Zakeri MA. Anomalous origin of the left main coronary artery in a 62‑year‑old woman: a case report and review of the literature. J Cardiothorac Surg 2025; 20:119. [PMID: 39910612 DOI: 10.1186/s13019-024-03217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 12/24/2024] [Indexed: 02/07/2025] Open
Abstract
INTRODUCTION Abnormalities of the coronary arteries, including abnormal origins, are often detected in heart patients who undergo coronary angiography. Although only a small percentage of these abnormalities lead to serious complications, the consequences can be extremely fatal. CASE PRESENTATION We report the case of a 62-year-old woman who presented with chest pain. The patient has a history of hypertension and complains of chest pain that worsens with walking and improves with rest. A basic electrocardiogram (ECG) showed sinus rhythm with no signs of arrhythmia or ischemic changes. Coronary angiography revealed an anomalous left coronary artery originating from the right sinus of Valsalva (RSoV). CONCLUSIONS We report a rare case of an anomalous left coronary artery originating from the RSoV without specific clinical symptoms. The patient presented with unstable angina, and after further investigation, this anomaly was diagnosed. Investigating these abnormalities, especially in young individuals with cardiac symptoms, should be prioritized. Cardiologists should also be aware of this rare condition that can have fatal consequences.
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Affiliation(s)
- Mohammad Safariyan
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Cardiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Najmeh Mohammadrafie
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Soheila Pourmasumi
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Vahid Mohammadi
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Cardiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Xiao Xu
- Department of Nursing, Nantong Health College of Jiangsu Province, Nantong, China
| | | | - Mohammed Musaed Al-Jabri
- Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Nursing Department, Wadi Aldawaser, Saudi Arabia
| | - Farkhondeh Jafarian
- Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Ali Zakeri
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan , Iran.
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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15
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Duman Kavus IE, Sankowski R, Rölz R, Dressing A, Prinz M, Urbach H, Erny D, Taschner CA. Freiburg Neuropathology Case Conference: Progressive Optic Nerve Lesion Over a 16-Year Period. Clin Neuroradiol 2025:10.1007/s00062-025-01505-8. [PMID: 39909919 DOI: 10.1007/s00062-025-01505-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2025] [Indexed: 02/07/2025]
Affiliation(s)
- I E Duman Kavus
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Sankowski
- Department of Neuropathology, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Rölz
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Dressing
- Department of Neurology, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Prinz
- Department of Neuropathology, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Erny
- Department of Neuropathology, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C A Taschner
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacherstrasse 64, 79106, Freiburg, Switzerland.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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16
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Daga A, Karlekar M, Lila A, Sarathi V, Sharma A, Memon SS, Barnabas R, Patil V, Thakker H, Shah N, Bandgar T. Insights in non-CAH pediatric primary adrenal insufficiency: a single-center experience from India. J Pediatr Endocrinol Metab 2025:jpem-2024-0476. [PMID: 39898459 DOI: 10.1515/jpem-2024-0476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 01/14/2025] [Indexed: 02/04/2025]
Abstract
OBJECTIVES Pediatric primary adrenal insufficiency (PAI) etiologies beyond congenital adrenal hyperplasia (CAH) show regional variations. Given limited data from India, this study aims to describe the etiological profile, phenotype, and genotype of pediatric PAI in an Indian cohort. METHODS We conducted a retrospective review of patients with PAI onset before 20 years of age from 1998 to 2023 at a single center. After excluding patients with inadequate data (n=20), CAH (n=218), and bilateral adrenalectomy (n=19), we analyzed demographic, clinical, biochemical, and genetic data of the remaining patients. RESULTS Among 54 patients (45 probands), the median age at presentation was 6 years (range 0.1-19). Common clinical features included hyperpigmentation (90.7 %), adrenal crisis (33.3 %), and seizures (29.6 %). Mineralocorticoid deficiency was present in two-third patients including one patient each with AAAS, MRAP, and NNT mutation. Adrenoleukodystrophy (ALD) was the most common cause (40 %), followed by ACTH resistance states (20 %), early steroidogenic defects (13.3 %), congenital adrenal hypoplasia (11.1 %), autoimmune causes (8.9 %), and tuberculosis (4.5 %). Genetics diagnosed 14/15 patients without phenotypic clues and confirmed diagnoses in 21 tested of 30 with phenotypic pointers (alacrimia in AAAS, hypoparathyroidism/candidiasis in autoimmune polyendocrine syndrome-1 and neurodeficit in ALD). Genetics differentiated CYP11A1 mutation from suspected ALD in two siblings with neurological deficits. We identified seven novel gene variants. We report the first case of NNT associated with 46,XY gonadal dysgenesis. Adrenal tuberculosis was a unique cause of pediatric PAI. CONCLUSIONS This study reveals diverse non-CAH pediatric PAI etiologies in India, emphasizing genetic testing's importance for precise diagnoses and suggests region-specific diagnostic algorithm.
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Affiliation(s)
- Aaditya Daga
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Manjiri Karlekar
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Anurag Lila
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Vijaya Sarathi
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | - Anima Sharma
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Saba Samad Memon
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Rohit Barnabas
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Virendra Patil
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | | | - Nalini Shah
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Tushar Bandgar
- Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, India
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17
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Huppert A, Schreiner S, Kunte C. Electrochemotherapy as a treatment option for venous malformations. J Dtsch Dermatol Ges 2025. [PMID: 39901440 DOI: 10.1111/ddg.15647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 11/27/2024] [Indexed: 02/05/2025]
Affiliation(s)
- Anna Huppert
- Artemed Fachklinik München, Abteilung für Dermatochirurgie und Dermatologie
| | - Sandra Schreiner
- Artemed Fachklinik München, Abteilung für Dermatochirurgie und Dermatologie
| | - Christian Kunte
- Artemed Fachklinik München, Abteilung für Dermatochirurgie und Dermatologie
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18
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Vegas A, Wells B, Braum P, Denault A, Miller Hance WC, Kaufman C, Patel MB, Salvatori M. Guidelines for Performing Ultrasound-Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography. J Am Soc Echocardiogr 2025; 38:57-91. [PMID: 39909653 DOI: 10.1016/j.echo.2024.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2025]
Abstract
Vascular access is a commonly performed procedure to facilitate patient care. This document provides expert consensus from diverse specialists on best practices and techniques for incorporating ultrasound (US) into vascular access procedures. This update replaces the 2011 American Society of Echocardiography guidelines for US-guided vascular cannulation. It includes recommendations for US-guided access to central and peripheral veins and arteries in adult and pediatric patients based on the strength of the scientific evidence present in the literature. The major roles of US during vascular access include (1) precannulation vessel assessment, (2) dynamic US guidance during cannulation, and (3) identification of local complications. This document discusses the general aspects of anatomic and US imaging of vessels, US-guided vascular cannulation techniques, and the identification of local vascular cannulation complications. Proper training should impart the cognitive knowledge and technical skills necessary to perform US-guided cannulation. There is an increasing body of literature indicating that US-guided vascular access improves success rates and reduces complications, although the quality of the evidence to date remains weak. A gap remains between the existing evidence and guidelines for the use of US in clinical practice. The availability of US equipment and clinical proficiency will more likely influence the role of US-guided vascular access as a standard of care than will future research studies.
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Affiliation(s)
- Annette Vegas
- Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Bryan Wells
- Emory University School of Medicine, Atlanta, Georgia
| | - Paul Braum
- Northside Hospital and Health System, Atlanta, Georgia
| | - Andre Denault
- Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada
| | - Wanda C Miller Hance
- Children's Memorial Hermann Hospital, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
| | | | | | - Marcus Salvatori
- Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
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19
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Sakai M, Hiyama T, Kuno H, Kobayashi T, Nakajima T. Imaging of the skull base and orbital tumors. Jpn J Radiol 2025; 43:152-163. [PMID: 39302526 PMCID: PMC11790709 DOI: 10.1007/s11604-024-01662-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024]
Abstract
The skull base and orbit have complicated anatomical structures where various tumors can occur. The tumor may present with neurological symptoms; however, its diagnosis is clinically difficult owing to accessibility issues. Therefore, diagnostic imaging is crucial in assessing tumors in the skull base and orbit and guiding subsequent management. Notably, some tumors have a predilection for a specific site of origin, and identifying the site of origin on imaging can help narrow the differential diagnosis. At the skull base, chordomas typically occur in the clivus, chondrosarcomas in the paramedian areas, paragangliomas in the jugular foramen, neurogenic tumors, and perineural spread in the neural foramen. Among orbital tumors, cavernous hemangiomas usually occur in the intraconal space, and pleomorphic adenomas and adenoid cystic carcinomas occur in the lacrimal glands. Some skull base and orbital tumors exhibit distinctive imaging features. Chordomas and chondrosarcomas of the skull base show high signal intensities on T2-weighted images, with chondrosarcomas often displaying cartilaginous calcifications. Paragangliomas are characterized by their hypervascular nature. In the orbit, cavernous hemangiomas and pleomorphic adenomas present unique dynamic patterns. Immunoglobulin G4-related disease forms lesions along the nerves. Identifying the tumor origin and its imaging characteristics can help narrow the differential diagnosis of skull base and orbital tumors.
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Affiliation(s)
- Masafumi Sakai
- Department of Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takashi Hiyama
- Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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