A Case of a Large Brain Metastasis: Time for Multidisciplinary Consultation.

Patients with complex diseases are mostly treated in a multidisciplinary setting. The impact of multidisciplinary care cannot be emphasized enough as it has the potential to significantly increase survival and, in some cases, help avoid a risky treatment approach. The aim of this case illustration is to emphasize the importance of multidisciplinary treatment and learn from the different approaches that can be made while treating such patients.

White matter integrity and cognitive performance in the subacute phase after ischemic stroke in young adults.

Introduction: Reduced white matter integrity outside the stroke lesion may be a potential contributor of post-stroke cognitive impairment. We aimed to investigate how a stroke lesion affects the integrity of surrounding white matter, and whether the integrity of the non-lesioned part of white matter tracts is associated with cognitive performance after ischemic stroke in young adults.

Methods: Patients from the ODYSSEY study, aged 18-49 years, with a first-ever ischemic stroke, underwent 3T MRI and cognitive assessment within six months after the index event.

Ultrasound Strain Imaging for Characterizing Atherosclerotic Plaque in the Carotid Arteries of Asymptomatic Subjects.

Objective: The rupture of vulnerable plaques in the carotid artery is a leading cause of strokes. While magnetic resonance imaging (MRI) is the standard for quantifying plaque composition, its high costs and lengthy procedure times limit large-scale use. Compound ultrasound strain imaging (CUSI) ultrasound offers a non-invasively alternative by assessing tissue deformation/strain within the arterial wall.

In-vivo cerebral artery pulsation assessment with Dynamic computed tomography angiography.

Four-Dimensional Computed Tomography Angiography (4D CTA) seems a promising technique for capturing vessel motion of cerebral arteries, which may help to assess pathological conditions such as intracranial aneurysms. The goal of our current observational study is to capture the lumen diameter of cerebral arteries during three subsequent cardiac cycles with 4D CTA and to assess vessel motion, anticipating consistent expansion patterns within each cardiac cycle. Eighteen adult patients with unruptured and untreated intracranial aneurysms were recruited at Radboud University Medical Center.

Functional connectivity in resting-state networks relates to short-term global cognitive functioning in cardiac arrest survivors.

Long-term cognitive impairment is common in cardiac arrest survivors. Screening to identify patients at risk is recommended. Functional magnetic resonance brain imaging (fMRI) holds potential to contribute to prediction of cognitive outcomes.

Can written prompts help medical residents to accurately monitor their own communication skills and those of others?

In healthcare, effective communication in complex situations such as end of life conversations is critical for delivering high quality care. Whether residents learn from communication training with actors depends on whether they are able to select appropriate information or 'predictive cues' from that learning situation that accurately reflect their or their peers' performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predictive cues and judgement of communication skills.

White matter integrity in hospitalized COVID-19 patients is not associated with short- and long-term clinical outcomes.

Objectives: SARS-CoV-2 infection is associated with a decline in functional outcomes; many patients experience persistent symptoms, while the underlying pathophysiology remains unclear. This study investigated white matter (WM) integrity on brain MRI in hospitalized COVID-19 patients and its associations with clinical outcomes, including long COVID.

Materials And Methods: We included hospitalized COVID-19 patients and controls from CORONavirus and Ischemic Stroke (CORONIS), an observational cohort study, who underwent MRI-DWI imaging at baseline shortly after discharge (<3 months after positive PCR) and 3 months after baseline scanning.

Distinguishing glioblastoma progression from treatment-related changes using DTI directionality growth analysis.

Background: It is difficult to distinguish between tumor progression (TP) and treatment-related abnormalities (TRA) in treated glioblastoma patients via conventional MRI, but this distinction is crucial for treatment decision making. Glioblastoma is known to exhibit an invasive growth pattern along white matter architecture and vasculature. This study quantified lesion development patterns in treated glioblastoma lesions and their relation to white matter microstructure to distinguish TP from TRA.

Feasibility of capturing vessel expansion with 4D-CTA: Phantom study to determine reproducibility, spatial and temporal resolution.

Background: Dynamic Computed Tomography Angiography (4D CTA) has the potential of providing insight into the biomechanical properties of the vessel wall, by capturing motion of the vessel wall. For vascular pathologies, like intracranial aneurysms, this could potentially refine diagnosis, prognosis, and treatment decision-making.

Purpose: The objective of this research is to determine the feasibility of a 4D CTA scanner for accurately measuring harmonic diameter changes in an in-vitro simulated vessel.

Fractional tumor burden maps increase the confidence of reading brain MR perfusion.

Rationale And Objectives: Various methods exist to perform and post-process perfusion weighted MR imaging in the post-treatment imaging of glioma patients to differentiate tumor progression from tumor-related abnormalities. One of these post-processing methods produces 'fractional tumor burden' maps. This multi-reader study investigated the clinical feasibility of fractional tumor burden maps on real world data from radiological follow-up of high-grade astrocytoma patients.

Clinical applicability of signal heterogeneity and tumor border assessment on T2-weighted MR images to distinguish astrocytic from oligodendroglial origin of gliomas.

Background And Purpose: Radiological features on magnetic resonance imaging (MRI) were attributed to oligodendroglioma, although the diagnostic accuracy in a real-world clinical setting remains partially elusive. This study investigated the accuracy and robustness of tumor heterogeneity and tumor border delineation on T2-weighted MRI to distinguish oligodendroglioma from astrocytoma.

Materials And Methods: Eight readers from three different specialties (radiology, neurology, neurosurgery) with varying levels of experience blindly rated 79 T2-weighted MR images of patients with either oligodendroglioma or astrocytoma.

Implementing a community rotation to the internship training in Kenya: barriers and enablers.

Community placements among trainee doctors have proven beneficial in understanding community problems, the role of primary care in health, and increasing the likelihood of pursuing a primary care career, albeit with some challenges. In 2020, Kenya started community rotations as part of the mandatory internship programme. This study aimed to describe the experiences among medical interns and their educational supervisors during the rotation from which insights on how to improve the community rotation may be drawn.

Reimagining nutrition education for pregnant adolescents in the face of climate change: a community approach.

Objectives: To explore challenges with current nutrition education for teenage pregnant women in a drought-prone community in Kenya and to elicit the communities' suggestions on how to best adapt it in the face of climate change.

Design: Nine serial focus group discussions (four with adolescents, two with their parents, two with community health volunteers and one with healthcare workers) were conducted on a purposively selected study population in Kaloleni, Kilifi County, Kenya. Data collection took place between March and November 2022, with a total of 73 participants.

How to evaluate perfusion imaging in post-treatment glioma: a comparison of three different analysis methods.

Introduction: Dynamic susceptibility contrast (DSC) perfusion weighted (PW)-MRI can aid in differentiating treatment related abnormalities (TRA) from tumor progression (TP) in post-treatment glioma patients. Common methods, like the 'hot spot', or visual approach suffer from oversimplification and subjectivity. Using perfusion of the complete lesion potentially offers an objective and accurate alternative.

Quantification of perineural satellitosis in pretreatment glioblastoma with structural MRI and a diffusion tensor imaging template.

Background: Survival outcomes for glioblastoma (GBM) patients remain unfavorable, and tumor recurrence is often observed. Understanding the radiological growth patterns of GBM could aid in improving outcomes. This study aimed to examine the relationship between contrast-enhancing tumor growth direction and white matter, using an image registration and deformation strategy.

Dynamic Computed Tomography Angiography for capturing vessel wall motion: A phantom study for optimal image reconstruction.

Background: Reliably capturing sub-millimeter vessel wall motion over time, using dynamic Computed Tomography Angiography (4D CTA), might provide insight in biomechanical properties of these vessels. This may improve diagnosis, prognosis, and treatment decision making in vascular pathologies.

Purpose: The aim of this study is to determine the most suitable image reconstruction method for 4D CTA to accurately assess harmonic diameter changes of vessels.

The Effect of Remote Ischemic Postconditioning on Quality of Life and Clinical Events after an Ischemic Stroke.

Objectives: Repeated remote ischemic postconditioning (rIPostC) may be an easily applicable treatment following ischemic stroke to improve quality of life (QoL) and clinical outcomes. rIPostC consists of repeated, brief periods of limb ischemia (through inflation of a blood pressure cuff), followed by reperfusion. This study investigated the 1-year follow-up of rIPostC on QoL and clinical events.

Overdue Assignment: A Case Study on Academic Writing Development for Postgraduate Health Professional Trainees in Kenya.

Objectives: Though essential for research capacity building, development of authorial identity for thesis projects and publications has been overlooked in African postgraduate residency programs. This study aims to explore authorial identity among postgraduate health professional trainees at two universities in Kenya. It also evaluated the effect of Age of Acquisition of English on confidence in writing.

AI-support for the detection of intracranial large vessel occlusions: One-year prospective evaluation.

Purpose: Few studies have evaluated real-world performance of radiological AI-tools in clinical practice. Over one-year, we prospectively evaluated the use of AI software to support the detection of intracranial large vessel occlusions (LVO) on CT angiography (CTA).

Method: Quantitative measures (user log-in attempts, AI standalone performance) and qualitative data (user surveys) were reviewed by a key-user group at three timepoints.