SNMMI PIC case competition finalist: Subcutaneous Panniculitis-Like T-Cell Lymphoma on 18F-FDG PET/CT.

A 9-month-old girl was evaluated for recurrent fevers, rash, and indurated plaques, with laboratories demonstrating hyperferritinemia, hypertriglyceridemia, and pancytopenia, concerning for hemophagocytic lymphohistiocytosis. Biopsy of thigh lesion ultimately demonstrated subcutaneous panniculitis-like T-cell lymphoma. In a rare neoplasm of cytotoxic T-cells, subcutaneous panniculitis-like T-cell lymphoma presents with subcutaneous nodules in all age groups including children.

-rearranged B-cell ALL with extramedullary lineage switch to AML following CD19-targeted therapy.

Lineage switch (LS) refers to the immunophenotypic transformation of one leukemia lineage to another (ie, lymphoid to myeloid) with retention of baseline genetics. This phenomenon was originally observed in infants with B-lymphoblastic leukemia (B-ALL) with rearrangements following chemotherapy, but is now increasingly being observed as a form of immune escape following targeted therapies among children and adults with B-ALL with and without rearrangements. In this report, we present two cases of adolescents with B-ALL harboring rearrangements (Philadelphia-like phenotype) who developed LS to acute myeloid leukemia following CD19 targeted therapy.

Evaluation of 3-dimensional stereotactic surface projection rendering of arterial spin labeling data in a clinical cohort.

Background And Purpose: To assess the feasibility of 3-dimensional stereotactic surface projection (3D-SSP) as applied to arterial spin labeling (ASL) in a clinical pilot study.

Methods: A retrospective sample of 10 consecutive patients who underwent ASL as part of a clinically indicated MR examination was collected during this pilot study. Five additional subjects with normal cerebral perfusion served as a control group.

A Comparison of CT-Guided Bone Biopsy and Fluoroscopic-Guided Disc Aspiration as Diagnostic Methods in the Management of Spondylodiscitis.

Background And Purpose: Percutaneous tissue biopsy is a key step in the diagnosis and management of spondylodiscitis, often utilizing CT-guided bone biopsy or fluoroscopic-guided disc aspirations. Our objective was to compare radiation exposure, procedure time, sedation requirement & yield between the two modalities.

Materials And Methods: 103 patients in 2 cohorts underwent fluoroscopic-guided disc aspirations (n = 47) or CTguided bone biopsy (n = 46) for diagnosis of spondylodiscitis.

Is a Close Follow-Up Computed Tomography Necessary for Acute Falcine and Tentorial Subdural Hematoma?

Objective: This study aimed to assess the changes and values on follow-up computed tomography (F/U-CT) for isolated falcine (F-SDH) and tentorial (T-SDH) subdural hematomas (SDHs).

Method: Fifty-four cases of isolated F-SDH and/or T-SDH were retrospectively reviewed. Subdural hematoma morphology, mass effect on the adjacent parenchyma, and interval change at F/U-CT were evaluated.

Improving the detection of ventricular shunt disruption using volume-rendered three-dimensional head computed tomography.

Hydrocephalus is the most common neurosurgical disorder in children, and cerebrospinal fluid (CSF) diversion with shunt placement is the most commonly performed pediatric neurosurgical procedure. CT is frequently used to evaluate children with suspected CSF shunt malfunction to assess change in ventricular size. Moreover, careful review of the CT images is important to confirm the integrity of the imaged portions of the shunt system.

Gadolinium retention: should pediatric radiologists be concerned, and how to frame conversations with families.

Gadolinium retention in the brain and other organs has recently been identified by imaging and confirmed histologically. No direct clinical effects of gadolinium retention, which occurs after gadolinium-based contrast agent (GBCA) administration for MRI, have been scientifically accepted at this time. However, there is understandable concern among medical professionals and the public about the potential effects of gadolinium retention, particularly in the brain.

Making Magnets More Attractive: Physics and Engineering Contributions to Patient Comfort in MRI.

Patient comfort is an important factor of a successful magnetic resonance (MR) examination, and improvements in the patient's MR scanning experience can contribute to improved image quality, diagnostic accuracy, and efficiency in the radiology department, and therefore reduced cost. Magnet designs that are more open and accessible, reduced auditory noise of MR examinations, light and flexible radiofrequency (RF) coils, and faster motion-insensitive imaging techniques can all significantly improve the patient experience in MR imaging. In this work, we review the design, development, and implementation of these physics and engineering approaches to improve patient comfort.

Gentle Touch: Noninvasive Approaches to Improve Patient Comfort and Cooperation for Pediatric Imaging.

Pediatric imaging presents unique challenges related to patient anxiety, cooperation, and safety. Techniques to reduce anxiety and patient motion in adults must often be augmented in pediatrics, because it is always mentioned in the field of pediatrics, children are not miniature adults. This article will review methods that can be considered to improve patient experience and cooperation in imaging studies.

Practical Considerations for Radiologists in Implementing a Patient-friendly MRI Experience.

For many patients, numerous unpleasant features of the magnetic resonance imaging (MRI) experience such as scan duration, auditory noise, spatial confinement, and motion restrictions can lead to premature termination or low diagnostic quality of imaging studies. This article discusses practical, patient-oriented considerations that are helpful for radiologists contemplating ways to improve the MRI experience for patients. Patient friendly scanner properties are discussed, with an emphasis on literature findings of effectiveness in mitigating patient claustrophobia, other anxiety, or motion and on reducing scan incompletion rates or need for sedation.

Applying Artificial Intelligence to Mitigate Effects of Patient Motion or Other Complicating Factors on Image Quality.

Artificial intelligence, particularly deep learning, offers several possibilities to improve the quality or speed of image acquisition in magnetic resonance imaging (MRI). In this article, we briefly review basic machine learning concepts and discuss commonly used neural network architectures for image-to-image translation. Recent examples in the literature describing application of machine learning techniques to clinical MR image acquisition or postprocessing are discussed.

The Dancing Cord: Inherent Spinal Cord Motion and Its Effect on Cord Dose in Spine Stereotactic Body Radiation Therapy.

Background: Spinal cord dose limits are critically important for the safe practice of spine stereotactic body radiotherapy (SBRT). However, the effect of inherent spinal cord motion on cord dose in SBRT is unknown.

Objective: To assess the effects of cord motion on spinal cord dose in SBRT.

Updates in the Neuoroimaging and WHO Classification of Primary CNS Gliomas: A Review of Current Terminology, Diagnosis, and Clinical Relevance From a Radiologic Prospective.

As new advances in the genomics and imaging of CNS tumors continues to evolve, a standardized system for classification is increasingly essential to diagnosis and management. The molecular markers introduced in the 2016 WHO classification of CNS tumors bring both practical and conceptual advances to the characterization of gliomas, strengthening the prognostic and predictive value of terminology while shedding light on the underlying mechanisms that drive biologic behavior. The purpose of this article is to provide a succinct overview of primary intracranial gliomas from a neuroradiologic prospective and according to the 5th edition WHO classification that was revised in 2016.

What Neuroradiologists Need to Know About Radiation Treatment for Neural Tumors.

Radiation oncologists and radiologists have a unique and mutually dependent relationship. Radiation oncologists rely on diagnostic imaging to locate the tumor and define the treatment target volume, evaluation of response to therapy, and follow-up. Accurate interpretation of post-treatment imaging requires diagnostic radiologists to have a basic understanding of radiation treatment planning and delivery.

Intrathyroidal ectopic thymus in children: a sonographic survey.

Aims: Intrathyroidal ectopic thymus (IET) is being increasingly reported in the radiology literature. Most of the reports are of individual cases or small series and prevalence and natural course of the pathology is not well known. The purpose of this study is to establish the prevalence of IET in children and report long term follow-up results.

Hydatid disease located in the cerebellomedullary cistern.

Hydatid disease is an endemic zoonotic disease in many areas of the world. Liver, followed by lung, is the most commonly affected organ and involvement of other organs is rare. When brain is involved, lesions are typically supratentorial, and infratentorial localisation is even rarer.