Extended nnU-Net for Brain Metastasis Detection and Segmentation in Contrast-Enhanced Magnetic Resonance Imaging With a Large Multi-Institutional Data Set.

Purpose: The purpose of this study was to investigate an extended self-adapting nnU-Net framework for detecting and segmenting brain metastases (BM) on magnetic resonance imaging (MRI).

Methods And Materials: Six different nnU-Net systems with adaptive data sampling, adaptive Dice loss, or different patch/batch sizes were trained and tested for detecting and segmenting intraparenchymal BM with a size ≥2 mm on 3 Dimensional (3D) post-Gd T1-weighted MRI volumes using 2092 patients from 7 institutions (1712, 195, and 185 patients for training, validation, and testing, respectively). Gross tumor volumes of BM delineated by physicians for stereotactic radiosurgery were collected retrospectively and curated at each institute.

Magnetic resonance imaging of a temporal lobe cerebral amyloidoma.

Amyloidomas are focal solitary amyloid masses without systemic involvement that have been observed to occur in various body locations. When presenting intracranially, they pose a challenging diagnostic and therapeutic course given their location and rarity. We report a case of a 62-year-old man with a 4-year history of seizure and headaches.

Subdural hematoma prevalence and long-term developmental outcomes in patients with benign expansion of the subarachnoid spaces.

Objective: Benign expansion of the subarachnoid spaces (BESS) is a condition seen in macrocephalic infants. BESS is associated with mild developmental delays which tend to resolve within a few years. It is accepted that patients with BESS are at increased risk of spontaneous subdural hematomas (SDHs), although the exact pathophysiology is not well understood.

Contrast Pediatric Brain Perfusion: Dynamic Susceptibility Contrast and Dynamic Contrast-Enhanced MR Imaging.

Magnetic resonance (MR) perfusion is a robust imaging technique that assesses the passage of blood through the cerebral vascular network using a variety of techniques. The applications of MR perfusion have been expanded and is well suited to investigate cerebrovascular diseases and cerebral neoplastic processes in pediatric patients. Assessment of brain perfusion can augment the information obtained on conventional MR imaging and provides additional information on the biological and physiologic features of pediatric brain tumors.

Teaching Radiology to Medical Students in Canada; a Virtual, Integrative, Clinical Approach.

Purpose: To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students.

Methods: A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems.

MRI evaluation of nerve root avulsion in neonatal brachial plexus palsy: understanding the presence of isolated dorsal/ventral rootlet disruption.

Objective: The evaluation, treatment, and prognosis of neonatal brachial plexus palsy (NBPP) continues to have many areas of debate, including the use of ancillary testing. Given the continued improvement in imaging, it is important to revisit its utility. Nerve root avulsions have historically been identified by the presence of pseudomeningoceles or visible ruptures.

CT and FDG-PET radiologic biomarkers in p16+ oropharyngeal squamous cell carcinoma patients treated with definitive chemoradiotherapy.

Purpose: To assess associations between imaging biomarkers from standard of care pre-treatment CT and FDG-PET scans and locoregional (LR) and distant metastatic (DM) recurrences in patients with p16+ oropharyngeal squamous cell carcinoma (OPSCC) treated with definitive chemoradiotherapy (CRT).

Methods: An institutional database from a single NCI-designated cancer center identified 266 patients with p16+ OPSCC treated with definitive CRT in our department from 2005 to 2016 with evaluable pre-treatment FDG-PET scans. Quantitative SUV metrics and qualitative imaging metrics were determined from FDG-PET and CT scans, while clinical characteristics were abstracted from the medical record.

Essentials of Spine Trauma Imaging: Radiographs, CT, and MRI.

Traumatic injuries of the spine portend long-term morbidity and mortality. Timely diagnosis and appropriate management of mechanical instability of the spine is of utmost importance in preventing further neurologic deterioration. We present a comprehensive review of the indications for spinal imaging in the trauma setting, describe each imaging modality including plain radiographs, multidetector computed tomography and magnetic resonance imaging, basic anatomy and common fracture patterns, and discuss the traditional spinal injury classification systems and the new Subaxial Cervical Spine Injury Classification and Thoracolumbar Injury Classification and Severity score.

Comparison of virtual monochromatic series, iodine overlay maps, and single energy CT equivalent images in head and neck cancer conspicuity.

Objective: To compare lesion conspicuity amongst DECT monochromatic series (40, 45, 50keV), and single-energy CT (SECT) equivalent images in head and neck squamous cell carcinomas (HNSCC).

Methods: Two readers compared DECT images to 70keV SECT equivalent series in 39 patients with HNSCC on lesion margin, enhancement, and overall conspicuity.

Results: The 45keV and 50keV images were significantly better (p-values ≤0.

Dorsal scapular artery as a recipient vessel in the vessel-depleted neck during free tissue transfer in head and neck reconstruction.

Background: The vessel-depleted neck poses a unique challenge to the microvascular surgeon. Using 3D modeling and cadaveric dissection, we describe the approach and advantages of a known but less frequently used recipient vessel, the dorsal scapular artery, during free tissue transfer.

Methods: Three patients with vessel-depleted necks required reconstruction with free tissue transfer.

Unusual Cause of Horner Syndrome 13 Years After In Situ Ductal Carcinoma.

Horner syndrome can be caused by a wide range of pathologies along the sympathetic nerve chain, from the hypothalamus to the orbit. Imaging workup of Horner syndrome is necessary given the potential for deadly lesions, especially in a patient with a previous cancer history. The authors report a case of a woman who presented with a preganglionic Horner syndrome secondary to vertebral metastasis from previously diagnosed breast cancer that involved the neural foramina at T1 and T2.

Techniques and Approaches for Safe, High-Yield CT-Guided Suprahyoid Head and Neck Biopsies.

Objective: The purpose of this article is to present imaging approaches and key technical, safety, and patient care best practices critical for safe, successful image-guided biopsy of head and neck masses.

Conclusion: Image-guided sampling is an important adjunct to the diagnosis and management of head and neck masses and may be particularly useful when lesions are not accessible via an endoscope or by palpation-guided sampling. Appropriate workup is mandatory before the patient is scheduled for such a procedure.

Morphometric analysis of the developing pediatric cervical spine.

OBJECTIVE Our understanding of pediatric cervical spine development remains incomplete. The purpose of this analysis was to quantitatively define cervical spine growth in a population of children with normal CT scans. METHODS A total of 1458 children older than 1 year and younger than 18 years of age who had undergone a cervical spine CT scan at the authors' institution were identified.

The current role of diagnostic imaging in the preoperative workup for refractory neonatal brachial plexus palsy.

Introduction: Despite recent improvements in perinatal care, the incidence of neonatal brachial plexus palsy (NBPP) remains relatively common. CT myelography is currently considered to be the optimal imaging modality for evaluating nerve root integrity. Recent improvements in MRI techniques have made it an attractive alternative to evaluate nerve root avulsions (preganglionic injuries).

Exploration for an Algorithm for Deintensification to Exclude the Retropharyngeal Site From Advanced Oropharyngeal Squamous Cell Carcinoma Treatment.

Importance: Understanding the drainage patterns to the retropharyngeal lymph nodes is an important consideration in oropharyngeal squamous cell carcinoma (OPSCC) because treatment of these nodes is related to increased morbidity. Prediction of these drainage patterns could not only help minimize treatment morbidity but also prevent failures in at-risk patients as deintensification trials are under way for this disease.

Objective: To evaluate the prevalence of pathologic retropharyngeal adenopathy (RPA) in OPSCC relative to involvement of the oropharyngeal subsite, number of metastatic neck nodes, T classification, and N classification.

Impact of retropharyngeal adenopathy on distant control and survival in HPV-related oropharyngeal cancer treated with chemoradiotherapy.

Purpose: Retropharyngeal adenopathy (RPA) is poor prognostic factor in head and neck (HN) cancer. However, the prognostic significance of RPA in Human Papillomavirus-related (HPV+) oropharyngeal cancer (OPC) is unknown.

Patients And Methods: 185 patients with HPV+OPC were assessed.

Matted nodes: High distant-metastasis risk and a potential indication for intensification of systemic therapy in human papillomavirus-related oropharyngeal cancer.

Background: The purpose of this study was to determine whether matted nodes uniquely identify patients with human papillomavirus (HPV)-positive oropharyngeal cancer at disproportionately high distant failure risk who may benefit from intensified systemic therapy.

Methods: One hundred seventy-eight patients with stage III/IV HPV-positive oropharyngeal cancer who completed definitive chemoradiotherapy were stratified by risk group (low-risk = T1-3/N0-2c/<10 pack-years; intermediate-risk = T1-3/N0-2c/≥10 pack-years; and high-risk = T4 or N3). Prognostic impact of matted nodes was assessed.

Variations in the cochlear implant experience in children with enlarged vestibular aqueduct.

Objectives/hypothesis: To describe the clinical experience and characterize the outcomes of cochlear implantation (CI) in children with isolated enlarged vestibular aqueduct (IEVA) as compared to children with enlarged vestibular aqueduct (EVA) associated with other bony labyrinth abnormalities.

Study Design: Single, tertiary care, institutional retrospective review over 2 decades.

Methods: The clinical course and outcomes of 55 children with EVA undergoing CI between 1991 and 2013 were reviewed.