Publications by authors named "Vivek Pai"

Background: The diagnosis of leptomeningeal metastatic disease has major prognostic and therapeutic implications. We report 13 patients with a radiologically distinct kind of focal, enhancing leptomeningeal lesion on brain MRI that mimics leptomeningeal metastatic disease.

Methods: These patients were assessed at University Health Network (Toronto, Canada) between January 2001 and December 2023.

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  • Pediatric neurovascular diseases are serious conditions that can lead to significant health problems and even death.
  • These diseases show a wide range of symptoms, from urgent neurological issues to long-term cognitive and developmental challenges, making accurate diagnosis important.
  • The article reviews the imaging techniques used to diagnose these diseases and highlights common findings observed in pediatric patients.
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  • * It can be triggered by various factors, including infections or cancers, and shares imaging features with other types of encephalitis, particularly limbic encephalitis.
  • * Increased awareness and understanding of AE have improved its detection, highlighting the importance of recognizing its signs in MRI reports for better treatment outcomes.
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The innate and adaptive immune systems are critical in defense against pathogens and ensuring homeostasis. The central nervous system (CNS) was initially considered to be impermeable to immune cells due to the blood-brain barrier. However, this has now been debunked, with modern research delineating immune cell trafficking within the CNS, ensuring constant immune surveillance.

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Background And Purpose: Perivascular spaces (PVS) are interstitial fluid-filled spaces surrounding blood vessels traversing the deep gray nuclei and white matter of the brain. These are commonly encountered on CT and MR imaging and are generally asymptomatic and of no clinical significance. However, occasional changes in the size of focal PVS, for example, when enlarging, may mimic pathologies including neoplasms and infections, hence potentially confounding radiological interpretation.

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Background And Purpose: Interest in artificial intelligence (AI) and machine learning (ML) has been growing in neuroradiology, but there is limited knowledge on how this interest has manifested into research and specifically, its qualities and characteristics. This study aims to characterize the emergence and evolution of AI/ML articles within neuroradiology and provide a comprehensive overview of the trends, challenges, and future directions of the field.

Materials And Methods: We performed a bibliometric analysis of the ; the journal was queried for original research articles published since inception (January 1, 1980) to December 3, 2022 that contained any of the following key terms: "machine learning," "artificial intelligence," "radiomics," "deep learning," "neural network," "generative adversarial network," "object detection," or "natural language processing.

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Retinoblastoma is the most common cause of all intraocular pediatric malignancies. It is caused by the loss of tumor suppressor gene function, although some tumors occur due to oncogene amplification with normal genes. Nearly half of all retinoblastomas occur due to a hereditary germline pathogenic variant, most of which manifest with bilateral tumors.

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Introduction: There is a dearth of research available on the outcomes, complications, and recurrence rates of the modalities employed in treatment of diverticula after stone clearance by PCNL. We present our experience of various approaches employed in our institute for treatment of caliceal diverticulum after stone clearance by PCNL. We aimed to review the outcomes, complications, and recurrence rates of these procedures which can provide valuable insights into the effectiveness of these techniques in the treatment of stone containing caliceal diverticulum.

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  • Magnetic resonance imaging (MRI) is becoming more popular for diagnosing and monitoring various medical issues during pregnancy, for both mothers and fetuses.
  • There are concerns about MRI safety in pregnancy due to limited data, which can lead to anxiety for patients and healthcare providers.
  • The review highlights major safety topics such as energy deposition, noise, contrast agents, and the use of sedatives, recommending that gadolinium-based contrast agents and sedation should be avoided when possible.
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Introduction Non-transitional cell carcinomas of the bladder (NTCCB) represent a significant clinical challenge due to their rarity, heterogeneity, and poor prognosis. Despite their poor prognosis, the treatment of NTCCB has historically been based on the same principles used for transitional cell carcinomas (TCCs). Our study focuses on the management of non-transitional cell carcinomas and aims to identify areas where treatment outcomes can be improved based on our institutional experience.

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  • - This study examines the impact of nephrostomy tube placement on patients with moderate renal stones during uncomplicated percutaneous nephrolithotomy (PCNL), focusing on whether this routine practice affects blood loss.
  • - A randomized controlled trial involving 60 patients found that the tubeless PCNL group had significantly lower postoperative hemoglobin levels and required blood transfusions, while the tube PCNL group exhibited less blood loss.
  • - Results indicate that tubeless PCNL offers benefits such as reduced hospital stay, quicker recovery, and lower overall costs, making it a viable alternative to conventional tube PCNL procedures.
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Developmental venous anomaly (DVA) is one of the commonest vascular malformations in the brain but rarely symptomatic. Various pathomechanisms such as mechanical compression, increased in-flow into DVA or outflow obstruction have been described as causative factors in symptomatic DVAs. We report a unique case of a pontomedullary DVA with venous outflow obstruction causing progressive neurological worsening in a young adult despite anticoagulation, who was treated with a novel approach of venous outlet stenting of the collector vein with favorable outcome.

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In acute ischemic stroke (AIS), large vessel occlusion (LVO) and the status of pial collaterals are important factors in decision-making for further treatment such as endovascular therapy. Multiphasic CT Angiogram (mCTA) is the mainstay of AIS imaging, allowing detection of LVO, evaluation of intracranial arterial dynamics, and quantification of pial collaterals. However, thorough mCTA evaluation entails scrutiny of multiple image datasets, individually and then simultaneously, which can be time-consuming, causing a potential delay in treatment.

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Amyotrophic Lateral Sclerosis (ALS) is a rare, devastating motor neuron disease characterized by the degeneration of upper and lower motor neurons causing muscular weakness, paralysis, and eventual death. MRI plays a supportive role in the diagnosis; its primary role is to exclude other clinical mimics. Some of the imaging features associated with ALS include hypointense signal along the motor cortices on susceptibility or T2*-weighted imaging and hyperintensity along the corticospinal tracts (CST) within the cerebral hemispheres, brainstem, and spinal cord on the T2 weighted imaging.

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Mucormycosis (MCR) is a fulminant, potentially lethal, opportunistic fungal infection. Diabetes, immunocompromised states and elevated serum iron levels are the most important risk factors for contracting MCR infection. Recently, MCR co-infections have been observed in patients with COVID-19 disease owing to a complex interplay of metabolic factors and corticosteroid therapy.

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Background: The coronavirus disease 2019 (COVID-19) pandemic has led to governments implementing a variety of public health measures to control transmission and has affected health services. Leprosy is a communicable neglected tropical disease caused by Mycobacterium leprae and is an important health problem in low- and middle-income countries. The natural history of leprosy means that affected individuals need long-term follow-up.

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Dural sinus thrombosis (DST) is a potentially fatal neurological condition that can be reversed with early diagnosis and prompt treatment. Non-enhanced CT scan is often the first imaging investigation in patients presenting with acute neurological symptoms; however, its poor sensitivity in detecting DST is a major drawback. Magnetic resonance (MR) imaging offers multiple advantages such as excellent contrast resolution and unenhanced venography possibilities, making it the mainstay in the non-invasive diagnosis of DST.

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