The forgotten lacrimal gland and lacrimal drainage apparatus: pictorial review of CT and MRI findings and differential diagnosis.

The lacrimal gland is a bilobed serous gland located in the superolateral aspect of the orbit. Lacrimal system pathologies can be broadly divided into pathologies of the lacrimal gland and those of the nasolacrimal drainage apparatus. These include distinct congenital, infectious, inflammatory, and benign, indeterminate, and malignant neoplastic lesions.

Baseline MRI findings as predictors of hypopituitarism in patients with non-functioning pituitary adenomas.

Hypopituitarism tends to occur in large pituitary adenomas. However, similar tumors could present with strikingly different hormonal deficiencies. In this study, we looked at MRI characteristics in non-functioning pituitary adenomas (NFPA), which could predict secondary adrenal insufficiency (SAI) and central hypothyroidism (CHT).

Atypical resting state functional connectivity in mild traumatic brain injury.

Objectives: This study aimed to investigate changes in three intrinsic functional connectivity networks (IFCNs; default mode network [DMN], salience network [SN], and task-positive network [TPN]) in individuals who had sustained a mild traumatic brain injury (mTBI).

Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 27 mTBI patients with persistent postconcussive symptoms, along with 26 age- and sex-matched controls. These individuals were recruited from a Level-1 trauma center, at least 3 months after a traumatic episode.

Creating Low-Cost Phantoms for Needle Manipulation Training in Interventional Radiology Procedures.

Image-guided procedures play a critical role in the clinical practice of radiologists. Training radiology residents in these procedures, with early teaching of basic but fundamental skills, is therefore crucial to develop competence before they become autonomous and start their practice. It has been proposed in the literature that low-fidelity phantoms are appropriate to teach novice trainees.

Dual Energy Computed Tomography in Head and Neck Imaging: Pushing the Envelope.

Multiple applications of dual energy computed tomography (DECT) have been described for the evaluation of disorders in the head and neck, especially in oncology. We review the body of evidence suggesting advantages of DECT for the evaluation of the neck compared with conventional single energy computed tomography scans, but the full potential of DECT is still to be realized. There is early evidence suggesting significant advantages of DECT for the extraction of quantitative biomarkers using radiomics and machine learning, representing a new horizon that may enable this technology to reach its full potential.

Radiogenomic Models Using Machine Learning Techniques to Predict EGFR Mutations in Non-Small Cell Lung Cancer.

Background: The purpose of this study was to build radiogenomics models from texture signatures derived from computed tomography (CT) and F-FDG PET-CT (FDG PET-CT) images of non-small cell lung cancer (NSCLC) with and without epidermal growth factor receptor () mutations.

Methods: Fifty patients diagnosed with NSCLC between 2011 and 2015 and with known mutation status were retrospectively identified. Texture features extracted from pretreatment CT and FDG PET-CT images by manual contouring of the primary tumor were used to develop multivariate logistic regression (LR) models to predict mutations in exon 19 and exon 20.

Magnetic Resonance Imaging Texture Analysis Predicts Recurrence in Patients With Nasopharyngeal Carcinoma.

Background: The personalization of oncologic treatment using radiomic signatures is mounting in nasopharyngeal carcinoma (NPC). We ascertain the predictive ability of 3D volumetric magnetic resonance imaging (MRI) texture features on NPC disease recurrence.

Methods: A retrospective study of 58 patients with NPC undergoing primary curative-intent treatment was performed.

Head and neck squamous cell carcinoma: prediction of cervical lymph node metastasis by dual-energy CT texture analysis with machine learning.

Objectives: This study was conducted in order to evaluate a novel risk stratification model using dual-energy CT (DECT) texture analysis of head and neck squamous cell carcinoma (HNSCC) with machine learning to (1) predict associated cervical lymphadenopathy and (2) compare the accuracy of spectral versus single-energy (65 keV) texture evaluation for endpoint prediction.

Methods: Eighty-seven patients with HNSCC were evaluated. Texture feature extraction was performed on virtual monochromatic images (VMIs) at 65 keV alone or different sets of multi-energy VMIs ranging from 40 to 140 keV, in addition to iodine material decomposition maps and other clinical information.

Anatomical Variations of the Vertebral Artery in the Upper Cervical Spine: Clinical Relevance for Procedures Targeting the C1/C2 and C2/C3 Joints.

Background And Objectives: Accidental breach of the vertebral artery (VA) during the performance of cervical pain blocks can result in significant morbidity. Whereas anatomical variations have been described for the foraminal (V2) segment of the VA, those involving its V3 portion (between the C2 transverse process and dura) have not been investigated and may be of importance for procedures targeting the third occipital nerve or the lateral atlantoaxial joint.

Methods: Five hundred computed tomography angiograms of the neck performed in patients older than 50 years for the management of cerebrovascular accident or cervical trauma (between January 2010 and May 2016) were retrospectively and independently reviewed by 2 neuroradiologists.

Antibiotics in the treatment of patients with lower back pain associated with Modic changes: a case series.

Purpose: To determine the clinical effect of antibiotic treatment for patients with low back pain and Modic 1 changes.

Methods: This is a retrospective case series of patients treated at the Canadian Forces Health Services Centre in Ottawa and the McGill University Health Centre. Where available, pain, functional, and imaging outcomes in 11 patients treated between 2013 and 2015 were analyzed to determine effect of antibiotic treatment for patients with low back pain and associated Modic 1 changes on magnetic resonance imaging.

The Steinberg Centre for Simulation and Interactive Learning at McGill University.

Simulation allows for learner-centered health professions training by providing a safe environment to practice and make mistakes without jeopardizing patient care. It was with this goal in mind that the McGill Medical Simulation Center was officially opened on September 14, 2006, as a partnership between McGill University, the Faculty of Medicine and its affiliated hospitals. Its mandate is to provide state-of-the-art facilities to support simulation-based medical and allied health education initiatives.

Placement accuracy of external ventricular drain when comparing freehand insertion to neuronavigation guidance in severe traumatic brain injury.

Background: External ventricular drain (EVD) placement is a frequently performed neurosurgical procedure. Inaccuracies in drain positioning and the need for multiple passes using the classic freehand insertion technique is well reported in the literature, especially in the traumatic brain injury (TBI) population. The purpose of this study was to evaluate if electromagnetic neuronavigation guidance for EVD insertion improves placement accuracy and minimizes the number of passes in severe TBI patients.

Epiphora as first presenting sign of primary extranodal NK/T-cell lymphoma of the lacrimal sac.

A 28-year-old Caucasian female presented with a six-month history of epiphora of the right eye. Diagnostic lacrimal syringing revealed obstruction of the right nasolacrimal duct. During external dacryocystorhinostomy (DCR), the lacrimal sac had an unusual papillary appearance.

A pilot study using dynamic contrast enhanced-MRI as a response biomarker of the radioprotective effect of memantine in patients receiving whole brain radiotherapy.

Purpose: This pilot prospective study sought to determine whether dynamic contrast enhanced MRI (DCE-MRI) could be used as a clinical imaging biomarker of tissue toxicity from whole brain radiotherapy (WBRT).

Method: 14 patients who received WBRT were imaged using dynamic contrast enhanced DCE-MRI prior to and at 8-weeks, 16-weeks and 24-weeks after the initiation of WBRT. Twelve of the patients were also enrolled in the RTOG 0614 trial, which randomized patients to the use of placebo or memantine.

Impaired RASGRF1/ERK-mediated GM-CSF response characterizes CARD9 deficiency in French-Canadians.

Background: Caspase recruitment domain-containing protein 9 (CARD9) deficiency is an autosomal recessive primary immunodeficiency conferring human susceptibility to invasive fungal disease, including spontaneous central nervous system candidiasis (sCNSc). However, clinical characterization of sCNSc is variable, hindering its recognition. Furthermore, an in-depth understanding of the bases for this susceptibility has remained elusive.

Evolving role of MRI in optimizing the treatment of multiple sclerosis: Canadian Consensus recommendations.

Background: Magnetic resonance imaging (MRI) is increasingly important for the early detection of suboptimal responders to disease-modifying therapy for relapsing-remitting multiple sclerosis. Treatment response criteria are becoming more stringent with the use of composite measures, such as no evidence of disease activity (NEDA), which combines clinical and radiological measures, and NEDA-4, which includes the evaluation of brain atrophy.

Methods: The Canadian MRI Working Group of neurologists and radiologists convened to discuss the use of brain and spinal cord imaging in the assessment of relapsing-remitting multiple sclerosis patients during the treatment course.

Magnetic resonance imaging of the temporal lobe: normal anatomy and diseases.

Objective: This pictorial essay will review the magnetic resonance imaging anatomy of the temporal lobes and describe the major pathologic processes of this complex area.

Conclusions: Magnetic resonance imaging is an essential tool in the investigation of a patient with suspected temporal lobe pathology. Various conditions may affect this anatomic region, and, therefore, classification of imaging findings into specific groups may help provide a more focused differential diagnosis.

Methylene blue in the treatment of discogenic low back pain.

Background: The personal and societal impact of chronic low back pain is considerable. The intervertebral disc is considered the etiologic source in up to 40% of patients, with considerable previous efforts directed at developing reliable and efficacious treatments. Recent publications, including a double-blind, randomized, placebo-controlled trial, using a one-time treatment of methylene blue, showed statistically significant, clinically relevant improvements in pain and function in the treatment groups.

Radiological localization of Schneiderian papilloma.

Background: It has been recently reported that the site of attachment of Schneiderian papillomas can be predicted with high accuracy on preoperative computed tomography (CT) scans using bony osteitic changes as an indicator. The objective of this study is to evaluate, in a blinded fashion, the reliability of the osteitis sign at predicting the site of attachment of Schneiderian papillomas.

Methods: A retrospective cohort study of patients who underwent endoscopic surgical resection for inverted papilloma (IP) or cylindrical papilloma between September 2002 and September 2009 in a tertiary care rhinology center was carried out.

Acquired restrictive strabismus and high axial myopia: diagnosis and management.

Objective: This paper documents the clinical, ultrasound, magnetic resonance imaging (MRI), and anatomic characteristics of 6 patients with esohypotropia and high axial myopia. The results of strabismus surgery performed on these patients are evaluated.

Study Design: Retrospective cohort study.

Quantitative analysis of the orbital floor defect after zygoma fracture repair.

Purpose: Moderate-energy zygoma fractures result frequently in a posteromedially displaced bone fragment. Closed reduction using a force vector directed in an anterolateral direction frequently produces stable repair of these injuries. Exploration of the orbital floor (OF) is not routinely undertaken.

Kingella kingae spondylodiscitis in a child.

Most osteoarticular infections in children are due to Staphylococcus aureus. In this case, the isolation of Kingella kingae by image guided disc aspiration resulted in modification and optimization of treatment. We take a look at a case of spondylodiscitis in a young child and review some of the current literature with regards to Kingella kingae infections.