UNASSIGNED: To assess the diagnostic accuracy of machine learning (ML)-based radiomics for predicting isocitrate dehydrogenase (IDH) mutations in patients with glioma.
UNASSIGNED: A systematic search of PubMed, Web of Science, Embase, and the Cochrane Library from inception to 1 September 2023, was conducted to collect all articles investigating the diagnostic performance of ML for the prediction of IDH mutations in gliomas. Two reviewers independently screened all papers for eligibility. Methodological quality and risk of bias were assessed using the METhodological RadiomICs Score and Quality Assessment of Diagnostic Accuracy Studies-2, respectively. The pooled sensitivity, specificity, and 95% confidence intervals were calculated, and the area under the receiver operating characteristic curve (AUC) was obtained.
UNASSIGNED: In total, 14 original articles assessing 1740 patients with gliomas were included. The AUC of ML for predicting IDH mutation was 0.90 (0.87-0.92). The pooled sensitivity, specificity, and diagnostic odds ratio were 0.83 (0.71-0.90), 0.84 (0.74-0.90), and 25 (12,50) respectively. In subgroup analyses, modeling methods, glioma grade, and the combination of magnetic resonance imaging and clinical features affected the diagnostic performance in predicting IDH mutations in gliomas.
UNASSIGNED: ML-based radiomics demonstrated excellent diagnostic performance in predicting IDH mutations in gliomas. Factors influencing the diagnosis included the modeling methods employed, glioma grade, and whether the model incorporated clinical features.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/#myprospero, PROSPERO registry (CRD 42023395444).

OBJECTIVE: To perform a systematic review and meta-analysis of the diagnostic performance of contrast enhancement to differentiate benign and malignant renal lesions using CT and MRI.
METHODS: A systematic literature search of databases was performed between January 1, 1980 and September 26, 2022. We included studies reporting the accuracy of CE thresholds on CT and MRI indeterminate renal lesions, with pathologic examination and follow-up as the reference standard. Studies meeting the inclusion criteria underwent quality assessment with the Cochrane recommendation for diagnostic accuracy study Quality Assessment 2. We excluded studies with high risk of bias. Summary estimates of diagnostic performance were obtained with the bivariate Bayesian model for CT and MRI. Effects of different thresholds and index test modalities were investigated through subgroup analysis.
RESULTS: Eleven studies (1372 patients) using CT and six studies (218 patients) using MRI were included. Of the eleven studies, 15 parts from 9 studies were considered for the CT meta-analysis, and 6 parts from 3 studies for the MRI meta-analysis. Diagnostic performance meta-analysis on enhancement found a 96% summary sensitivity (95% CI 92, 98) and a 92% summary specificity (95% CI 85, 96) in 2056 renal lesions for CT; and 82% summary sensitivity (95% CI 65, 89) and an 89% summary specificity (95% CI 77, 95) in 634 lesions for MRI.
CONCLUSIONS: CT and MRI have high accuracy to determine enhancement and classify renal lesions, and both modalities can be used with confidence for this purpose. There are still some controversies about the optimal thresholds. Future research should evaluate outcomes and decision-making pathways to determine whether basing clinical decisions on a specific threshold on CT and MRI would do more harm than good.

UNASSIGNED: Epidural lymphoma of the lumbosacral region is a rare condition that manifests with back pain and nonspecific neurological symptoms. Our case which was diagnosed with diffuse large B-cell lymphoma, highlights the importance of recognizing early lymphoma symptoms to enable timely treatment and improved outcomes.
UNASSIGNED: Lymphoma rarely presents in the lumbosacral epidural space. Initial presentations of lymphoma are of paramount importance in the timely diagnosis and management of the disease. We report a 42-year-old woman presented with 4 years of low back pain and progressive right lower extremity paresthesia. Lumbar MRI revealed an epidural soft tissue lesion compressing nerves at L4 to the coccyx. Laminectomy and tumor resection were performed. Pathologic findings confirmed diffuse large B-cell lymphoma. We systematically reviewed the literature on lymphomas with lumbar epidural space involvement reported since 1990. Twenty-four cases from 19 reports were identified. The mean age of lumbar epidural lymphoma cases was 39.5 ± 17.8 years, and 72% were male. The most common subtype was diffuse large B-cell lymphoma, and common presentations included back pain, lower extremity neurological deficits, and bowel/bladder dysfunction. Overall, lymphomas presenting in the spine can pose diagnostic challenges owing to nonspecific initial symptoms. Our case highlights the importance of recognizing early lymphoma symptoms to enable timely treatment and improved outcomes.

This study aimed to evaluate the correlation between measuring proton-density fat fraction (PDFF) in bone marrow using multi-echo chemical shift-encoded MRI and osteoporosis, assessing its effectiveness as a biomarker for osteoporosis. A systematic review was conducted by two independent researchers using Cochrane, PubMed, EMBASE, and Web of Science databases up to December 2023. Quality assessments were evaluated using the Cochrane risk of bias tool and the Agency for Healthcare Research and Quality (AHRQ) checklist. Fourteen studies involving 1495 patients were analyzed. The meta-analysis revealed a significant difference in PDFF values between the osteoporosis/osteopenia group and the normal control group, with a mean difference of 11.04 (95% CI: 9.17 to 12.92, Z=11.52, P < 0.00001). Measuring PDFF via MRI shows potential as an osteoporosis biomarker and may serve as a risk factor for osteoporosis. This insight opens new avenues for future diagnostic and therapeutic strategies, potentially improving osteoporosis management and patient care.
OBJECTIVE: This study aims to assess the correlation between measuring proton-density fat fraction (PDFF) in bone marrow using multi-echo chemical shift-encoded MRI and osteoporosis, evaluating its effectiveness as a biomarker for osteoporosis.
METHODS: This systematic review was carried out by two independent researchers using Cochrane, PubMed, EMBASE, and Web of Science databases up to December 2023. Quality assessments were evaluated using the Cochrane risk of bias tool and the Agency for Healthcare Research and Quality (AHRQ) checklist.
RESULTS: Fourteen studies involving 1495 patients were analyzed. The meta-analysis revealed a significant difference in PDFF values between the osteoporosis/osteopenia group and the normal control group, with a (MD = 11.04, 95% CI: 9.17 to 12.92, Z = 11.52, P < 0.00001). Subgroup analyses indicated that diagnostic methods, gender, and echo length did not significantly impact the PDFF-osteoporosis association.
CONCLUSIONS: PDFF measurement via MRI shows potential as an osteoporosis biomarker and may serve as a risk factor for osteoporosis. This insight opens new avenues for future diagnostic and therapeutic strategies, potentially improving osteoporosis management and patient care.

BACKGROUND: The diagnosis and treatment of head and neck tumors present significant challenges due to their infiltrative nature and diagnostic hindrances such as the blood-brain barrier. The intricate anatomy of the head and neck region also complicates the clear identification of tumor boundaries and assessment of tumor characteristics.
OBJECTIVE: This review aims to explore the efficacy of molecular imaging techniques that employ targeted contrast agents in head and neck cancer imaging. Head and neck cancer imaging benefits significantly from the combined advantages of CT and MRI. CT excels in providing swift, high-contrast images, enabling the accurate localization of tumors, while MRI offers superior soft tissue resolution, contributing to the detailed evaluation of tumor morphology in this region of the body. Many of these novel contrast agents have integration of dual-modal, triple-modal, or even dual-tissue targeting imaging, which have expanded the horizons of molecular imaging. Emerging contrast agents for the purpose of MRI and CT also include the widely used standards in imaging such as gadolinium and iodine-based agents, respectively, but with peptide, polypeptide, or polymeric functionalizations. Relevance for patients. For patients, the development and use of these targeted contrast agents have potentially significant implications. They benefit from the enhanced accuracy of tumor detection and characterization, which are critical for effective treatment planning. Additionally, these agents offer improved imaging contrast with the added benefit of reduced toxicity and bioaccumulation. The summarization of preclinical nanoparticle research in this review serves as a valuable resource for scientists and students working towards advancing tumor diagnosis and treatment with targeted contrast agents.

Spontaneous convexity subarachnoid hemorrhage (cSAH) is a vascular disease different from aneurysmal SAH in neuroimaging pattern, causes, and prognosis. Several causes might be considered in individual patients, with a limited value of the patient\'s age for discriminating among these causes. Cerebral amyloid angiopathy (CAA) is the most prevalent cause in people > 60 years, but reversible cerebral vasoconstriction syndrome (RCVS) has to be considered in young people. CAA gained attention in the last years, but the most known manifestation of cSAH in this context is constituted by transient focal neurological episodes (TFNEs). CAA might have an inflammatory side (CAA-related inflammation), whose diagnosis is relevant due to the efficacy of immunosuppression in resolving essudation. Other causes are hemodynamic stenosis or occlusion in extracranial and intracranial arteries, infective endocarditis (with or without intracranial infectious aneurysms), primary central nervous system angiitis, cerebral venous thrombosis, and rarer diseases. The diagnostic work-up is fundamental for an etiological diagnosis and includes neuroimaging techniques, nuclear medicine techniques, and lumbar puncture. The correct diagnosis is the first step for choosing the most effective and appropriate treatment.

BACKGROUND: Lately, radiomic studies featuring the development of a signature to use in prediction models in diagnosis or prognosis outcomes have been increasingly published. While the results are shown to be promising, these studies still have many pitfalls and limitations. One of the main issues of these studies is that radiomic features depend on how the images are preprocessed before their computation. Since, in widely known and used software for radiomic features calculation, it is possible to set these preprocessing parameters before the calculation of the radiomic feature, there are ongoing studies assessing the stability and repeatability of radiomic features to find the most suitable preprocessing parameters for every used imaging modality.
METHODS: We performed a comprehensive literature search using four electronic databases: PubMed, Cochrane Library, Embase, and Scopus. Mesh terms and free text were modeled in search strategies for databases. The inclusion criteria were studies where preprocessing parameters\' influence on feature values and model predictions was addressed. Records lacking information on image acquisition parameters were excluded, and any eligible studies with full-text versions were included in the review process, while conference proceedings and monographs were disregarded. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool to investigate the risk of bias. We synthesized our data in a table divided by the imaging modalities subgroups.
RESULTS: After applying the inclusion and exclusion criteria, we selected 43 works. This review examines the impact of preprocessing parameters on the reproducibility and reliability of radiomic features extracted from multimodality imaging (CT, MRI, CBCT, and PET/CT). Standardized preprocessing is crucial for consistent radiomic feature extraction. Key preprocessing steps include voxel resampling, normalization, and discretization, which influence feature robustness and reproducibility. In total, 44% of the included works studied the effects of an isotropic voxel resampling, and most studies opted to employ a discretization strategy. From 2021, several studies started selecting the best set of preprocessing parameters based on models\' best performance. As for comparison metrics, ICC was the most used in MRI studies in 58% of the screened works.
CONCLUSIONS: From our work, we highlighted the need to harmonize the use of preprocessing parameters and their values, especially in light of future studies of prospective studies, which are still lacking in the current literature.

OBJECTIVE: Multiple sclerosis (MS) is a chronic autoimmune disease characterized by the destruction of the myelin sheath within the central nervous system. The etiology of MS involves a complex interplay of genetic, environmental, and immunological factors. Recent studies indicated the potential role of the choroid plexus (CP) in the pathogenesis and progression of MS. This systematic review aims to assess existing research on the volume alterations of the CP in MS patients compared to the normal population.
METHODS: A comprehensive search was conducted across databases including PubMed, Embase, Scopus, and Web of Science up to June 2024. Data from the included studies were synthesized using a meta-analytical approach with a random-effects model, assessing heterogeneity with the I2 and Tau-squared indices.
RESULTS: We included 17 studies in this systematic review. The meta-analysis, which included data from eight studies reporting CP volume relative to TIV, found a statistically significant increase in CP volume in MS patients compared to healthy controls (HCs). The SMD was 0.77 (95% CI: 0.61 to 0.93), indicating a large effect size. This analysis showed no heterogeneity (I² = 0%). A separate meta-analysis was conducted using five studies that reported CP volume as normalized volume, resulting in an SMD of 0.63 (95% CI: 0.2-1.06).
CONCLUSIONS: This study demonstrates an increase in CP volume among MS patients compared to HCs, implying the potential involvement of CP in MS pathogenesis and/or progression. These results show that CP might serve as a radiological indicator in the diagnosis and prognosis of MS.

OBJECTIVE: Our aim was to review the evidence concerning the non-invasive diagnosis of endometriosis in adolescents.
METHODS: A systematic review was written following the SWiM reporting guidelines. The study research was made across three databases (MEDLINE/PubMed, Scopus, and Web of Science) to identify articles about the adolescent population and the diagnosis of endometriosis through non-invasive methods. The search included the keywords \"endometriosis,\" \"adolescents,\" \"diagnosis,\" \"ultrasound,\" and \"MRI.\" Only English-language articles were considered, and those published prior to 2000 were excluded. The established outcomes focused on clinical symptoms, ultrasound (US), and magnetic resonance imaging (MRI) findings suggestive of endometriosis.
RESULTS: We included 26 articles, mostly comprising case series and cross-sectional studies. The pooled analysis involved 2,299 female adolescents (age range 8-25 years old) with clinically suspected, imaged, and/or surgically confirmed endometriosis. The most frequently reported symptom was dysmenorrhea, followed by chronic pelvic pain. Among adolescents clinically suspected of endometriosis undergoing ultrasound (US), 32.8% exhibited at least one sign of endometriosis. Of the 167 patients with ultrasound-diagnosed endometriosis, 48.5% had deep infiltrating endometriosis (DIE), and 45.5% had an endometrioma detected. Three studies assessed MRI findings, revealing that 49.8% presented with signs of endometriosis.
CONCLUSIONS: Dysmenorrhea and chronic pelvic pain stand out as key symptoms of adolescent endometriosis. Although their diagnostic accuracy varies, US and MRI have emerged as valuable tools for diagnosing the disease. While the US may have limitations, especially in detecting subtle lesions, MRI shows promise, even in cases with normal previous ultrasounds. Early recognition and proactive diagnosis are crucial for improving the management of endometriosis in adolescents.

UNASSIGNED: Many COVID-19 survivors experience persistent COVID-19 related cardiac abnormalities weeks to months after recovery from acute SARS-CoV-2 infection. Non-invasive cardiac magnetic resonance (CMR) imaging is an important tool of choice for clinical diagnosis of cardiac dysfunctions. In this systematic review, we analyzed the CMR findings and biomarkers of COVID-19 related cardiac sequela after SARS-CoV-2 infection.
UNASSIGNED: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), we conducted a systematic review of studies that assessed COVID-19 related cardiac abnormalities using cardiovascular magnetic resonance imaging. A total of 21 cross-sectional, case-control, and cohort studies were included in the analyses.
UNASSIGNED: Ten studies reported CMR results < 3 months after SARS-CoV-2 infection and 11 studies > 3 months after SARS-CoV-2 infection. Abnormal T1, abnormal T2, elevated extracellular volume, late gadolinium enhancement and myocarditis was reported less frequently in the > 3-month studies. Eight studies reported an association between biomarkers and CMR findings. Elevated troponin was associated with CMR pathology in 5/6 studies, C-reactive protein in 3/5 studies, N-terminal pro-brain natriuretic peptide in 1/2 studies, and lactate dehydrogenase and D-dimer in a single study. The rate of myocarditis via CMR was 18% (154/868) across all studies. Most SARS-CoV-2 associated CMR abnormalities resolved over time.
UNASSIGNED: There were CMR abnormalities associated with SARS-CoV-2 infection and most abnormalities resolved over time. A panel of cardiac injury and inflammatory biomarkers could be useful in identifying patients who are likely to present with abnormal CMR pathology after COVID-19. Multiple mechanisms are likely responsible for COVID-19 induced cardiac abnormalities.