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Findlay MC, Campbell JM, Rahimpour S, Shofty B. Incidental Brain Lesions in Parkinson Disease: High Prevalence, Minimal Impact on DBS Outcomes. World Neurosurg 2024:S1878-8750(24)01511-0. [PMID: 39317597 DOI: 10.1016/j.wneu.2024.08.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Affiliation(s)
- Matthew C Findlay
- Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Justin M Campbell
- Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Shervin Rahimpour
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Ben Shofty
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
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2
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Landes-Chateau C, Levraut M, Cohen M, Sicard M, Papeix C, Cotton F, Balcerac A, Themelin A, Mondot L, Lebrun-Frenay C. Identification of demyelinating lesions and application of McDonald criteria when confronted with white matter lesions on brain MRI. Rev Neurol (Paris) 2023; 179:1103-1110. [PMID: 37730469 DOI: 10.1016/j.neurol.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/14/2023] [Accepted: 04/18/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION White matter lesions (WML) on magnetic resonance imaging (MRI) are common in clinical practice. When analyzing WML, radiologists sometimes propose a pathophysiological mechanism to explain the observed MRI abnormalities, which can be a source of anxiety for patients. In some cases, discordance may appear between the patient's clinical symptoms and the identification of the MRI-appearing WML, leading to extensive diagnostic work-up. To avoid misdiagnosis, the analysis of WML should be standardized, and a consensual MRI reading approach is needed. OBJECTIVE To analyze the MRI WML identification process, associated diagnosis approach, and misinterpretations in physicians involved in WML routine practice. METHODS Through a survey distributed online to practitioners involved in WML diagnostic work-up, we described the leading causes of MRI expertise misdiagnosis and associated factors: clinical experience, physicians' subspecialty and location of practice, and type of device used to complete the survey. The survey consisted of sixteen T2-weighted images MRI analysis, from which ten were guided (binary response to lesion location identification), four were not shown (multiple possible answers), and two were associated with dissemination in space (DIS) McDonald criteria application. Two independent, experienced practitioners determined the correct answers before the participants' completion. RESULTS In total, 364 participants from the French Neuro Radiological (SFNR), French Neurological (SFN), and French Multiple Sclerosis (SFSEP) societies completed the survey entirely. According to lesion identification, 34.3% and 16.9% of the participants correctly identified juxtacortical and periventricular lesions, respectively, whereas 56.3% correctly identified non-guided lesions. Application of the 2017 McDonald's DIS criteria was correct for 35.3% of the participants. According to the global survey scoring, factors independently associated with correct answers in multivariate analysis were MS-expert subspecialty (P<0.001), young clinical practitioners (P=0.02), and the use of a computer instead of a smartphone to perform WML analysis (P=0.03). CONCLUSION Our results highlight the difficulties regarding WML analysis in clinical practice and suggest that radiologists and neurologists should rely on each other to ensure the diagnosis of multiple sclerosis and related disorders and limit misdiagnoses.
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Affiliation(s)
- C Landes-Chateau
- UR2CA-URRIS, CRCSEP neurologie, CHU de Nice, université Côte d'Azur, Nice, France.
| | - M Levraut
- UR2CA-URRIS, CRCSEP neurologie, CHU de Nice, université Côte d'Azur, Nice, France
| | - M Cohen
- UR2CA-URRIS, CRCSEP neurologie, CHU de Nice, université Côte d'Azur, Nice, France
| | - M Sicard
- UR2CA-URRIS, CRCSEP neurologie, CHU de Nice, université Côte d'Azur, Nice, France
| | - C Papeix
- Service de neurologie générale, hôpital Fondation Adolphe-de-Rothschild, Paris, France
| | - F Cotton
- U1044 Inserm, CREATIS, UMR 5220 CNRS, service de radiologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard Lyon, Lyon, France
| | - A Balcerac
- Département de neurologie, université la Sorbonne, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - A Themelin
- Service de radiologie, CHU de Nice, université Côte d'Azur, Nice, France
| | - L Mondot
- UR2CA-URRIS, CRCSEP neurologie, CHU de Nice, université Côte d'Azur, Nice, France
| | - C Lebrun-Frenay
- UR2CA-URRIS, CRCSEP neurologie, CHU de Nice, université Côte d'Azur, Nice, France
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3
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Rowley PA, Paukner MJ, Eisenmenger LB, Field AS, Davidson RJ, Johnson SC, Asthana S, Chin NA, Prabhakaran V, Bendlin BB, Postle BR, Goldsmith HH, Carlsson CM, Brooks MA, Kalin NH, Williams LE, Rowley HA. Incidental Findings from 16,400 Brain MRI Examinations of Research Volunteers. AJNR Am J Neuroradiol 2023; 44:417-423. [PMID: 36927761 PMCID: PMC10084899 DOI: 10.3174/ajnr.a7821] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND AND PURPOSE Incidental findings are discovered in neuroimaging research, ranging from trivial to life-threatening. We describe the prevalence and characteristics of incidental findings from 16,400 research brain MRIs, comparing spontaneous detection by nonradiology scanning staff versus formal neuroradiologist interpretation. MATERIALS AND METHODS We prospectively collected 16,400 brain MRIs (7782 males, 8618 females; younger than 1 to 94 years of age; median age, 38 years) under an institutional review board directive intended to identify clinically relevant incidental findings. The study population included 13,150 presumed healthy volunteers and 3250 individuals with known neurologic diagnoses. Scanning staff were asked to flag concerning imaging findings seen during the scan session, and neuroradiologists produced structured reports after reviewing every scan. RESULTS Neuroradiologists reported 13,593/16,400 (83%) scans as having normal findings, 2193/16,400 (13.3%) with abnormal findings without follow-up recommended, and 614/16,400 (3.7%) with "abnormal findings with follow-up recommended." The most common abnormalities prompting follow-up were vascular (263/614, 43%), neoplastic (130/614, 21%), and congenital (92/614, 15%). Volunteers older than 65 years of age were significantly more likely to have scans with abnormal findings (P < .001); however, among all volunteers with incidental findings, those younger than 65 years of age were more likely to be recommended for follow-up. Nonradiologists flagged <1% of MRIs containing at least 1 abnormality reported by the neuroradiologists to be concerning enough to warrant further evaluation. CONCLUSIONS Four percent of individuals who undergo research brain MRIs have an incidental, potentially clinically significant finding. Routine neuroradiologist review of all scans yields a much higher rate of significant lesion detection than selective referral from nonradiologists who perform the examinations. Workflow and scan review processes need to be carefully considered when designing research protocols.
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Affiliation(s)
- P A Rowley
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | | | - L B Eisenmenger
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | - A S Field
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | - R J Davidson
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychology (R.J.D., B.R.P., H.H.G.)
| | - S C Johnson
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - S Asthana
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - N A Chin
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - V Prabhakaran
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | - B B Bendlin
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - B R Postle
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychology (R.J.D., B.R.P., H.H.G.)
| | - H H Goldsmith
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychology (R.J.D., B.R.P., H.H.G.)
| | - C M Carlsson
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - M A Brooks
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Orthopedics (M.A.B.)
| | - N H Kalin
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychiatry (N.H.K., L.E.W.), University of Wisconsin-Madison, Madison, Wisconsin
| | - L E Williams
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychiatry (N.H.K., L.E.W.), University of Wisconsin-Madison, Madison, Wisconsin
| | - H A Rowley
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
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4
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Tsuchida A, Laurent A, Crivello F, Petit L, Joliot M, Pepe A, Beguedou N, Gueye MF, Verrecchia V, Nozais V, Zago L, Mellet E, Debette S, Tzourio C, Mazoyer B. The MRi-Share database: brain imaging in a cross-sectional cohort of 1870 university students. Brain Struct Funct 2021; 226:2057-2085. [PMID: 34283296 DOI: 10.1007/s00429-021-02334-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023]
Abstract
We report on MRi-Share, a multi-modal brain MRI database acquired in a unique sample of 1870 young healthy adults, aged 18-35 years, while undergoing university-level education. MRi-Share contains structural (T1 and FLAIR), diffusion (multispectral), susceptibility-weighted (SWI), and resting-state functional imaging modalities. Here, we described the contents of these different neuroimaging datasets and the processing pipelines used to derive brain phenotypes, as well as how quality control was assessed. In addition, we present preliminary results on associations of some of these brain image-derived phenotypes at the whole brain level with both age and sex, in the subsample of 1722 individuals aged less than 26 years. We demonstrate that the post-adolescence period is characterized by changes in both structural and microstructural brain phenotypes. Grey matter cortical thickness, surface area and volume were found to decrease with age, while white matter volume shows increase. Diffusivity, either radial or axial, was found to robustly decrease with age whereas fractional anisotropy only slightly increased. As for the neurite orientation dispersion and densities, both were found to increase with age. The isotropic volume fraction also showed a slight increase with age. These preliminary findings emphasize the complexity of changes in brain structure and function occurring in this critical period at the interface of late maturation and early ageing.
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Affiliation(s)
- Ami Tsuchida
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Alexandre Laurent
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Fabrice Crivello
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Laurent Petit
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Marc Joliot
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Antonietta Pepe
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Naka Beguedou
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Marie-Fateye Gueye
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Violaine Verrecchia
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Victor Nozais
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Laure Zago
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Emmanuel Mellet
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Stéphanie Debette
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, Bordeaux, France.,Centre Hospitalier Universitaire Pellegrin, Bordeaux, France
| | - Christophe Tzourio
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, Bordeaux, France.,Centre Hospitalier Universitaire Pellegrin, Bordeaux, France
| | - Bernard Mazoyer
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France. .,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France. .,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France. .,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France. .,Centre Hospitalier Universitaire Pellegrin, Bordeaux, France.
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