Publications by authors named "Vossough A"

Article Synopsis
  • Pediatric low-grade gliomas (pLGGs) show varying treatment responses and poor outcomes when complete tumor removal isn't possible, making early treatment prediction important.
  • A radiogenomic analysis combining MRI and RNA sequencing reveals three immune clusters in pLGGs, with one cluster having higher immune activity but worse prognosis, suggesting they might benefit from immunotherapy.
  • A developed radiomic signature accurately predicts these immune profiles and progression-free survival, identifying high-risk patients for potential targeted therapies.
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Background: Fully automatic skull-stripping and tumor segmentation are crucial for monitoring pediatric brain tumors (PBT). Current methods, however, often lack generalizability, particularly for rare tumors in the sellar/suprasellar regions and when applied to real-world clinical data in limited data scenarios. To address these challenges, we propose AI-driven techniques for skull-stripping and tumor segmentation.

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Background And Purpose: Privacy concerns, such as identifiable facial features within brain scans, have hindered the availability of pediatric neuroimaging datasets for research. Consequently, pediatric neuroscience research lags adult counterparts, particularly in rare disease and under-represented populations. The removal of face regions (image defacing) can mitigate this, however existing defacing tools often fail with pediatric cases and diverse image types, leaving a critical gap in data accessibility.

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Rationale And Objectives: The emergence of low-dose protocols for CT imaging has mitigated pediatric radiation exposure, yet ionizing radiation remains a concern for children with complex craniofacial conditions requiring repeated radiologic monitoring. In this work, the clinical feasibility of an ultrashort echo time (UTE) MRI sequence was investigated in pediatric patients.

Materials And Methods: Twelve pediatric patients (6 female, age range 8 to 18 years) with various imaging conditions were scanned at 3T using a dual-radiofrequency, dual-echo UTE MRI sequence.

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Article Synopsis
  • Artificial intelligence in medicine usually faces challenges related to small, non-diverse patient data due to privacy concerns, but federated learning (FL) offers a solution by allowing training across different hospitals without sharing sensitive data.
  • The newly developed FL-PedBrain platform is specifically designed for pediatric brain tumors, enabling collaborative training for tumor classification and segmentation across 19 international centers, addressing the lack of diverse datasets in this area.
  • FL-PedBrain shows impressive performance metrics, maintaining almost equivalent accuracy to centralized data training while significantly improving segmentation performance by 20 to 30% at external sites, and allows for the examination of data variability in real-world situations.
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Article Synopsis
  • The study investigates the spheno-occipital synchondrosis (SOS) fusion in patients with Muenke syndrome, a genetic condition associated with less severe facial deformities compared to other syndromes like Apert and Crouzon.
  • Researchers evaluated CT scans from 28 Muenke syndrome patients and compared them to matched controls, focusing on SOS fusion status and facial measurements.
  • The findings suggest that while Muenke syndrome patients exhibit minor retropositioning of the infraorbital rim, their SOS fusion patterns are similar to those of controls, indicating that any fusion timing differences might show up more at the infraorbital rim rather than the maxilla.
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Background: Isolated tumefactive demyelinating lesions (≥2 cm) may be difficult to distinguish from contrast-enhancing brain tumors, central nervous system infections, and (rarely) tissue dysgenesis, which may all occur with increased signal on T2-weighted images. Establishing an accurate diagnosis is essential for management, and we delineate our single-center experience.

Methods: We performed a retrospective review of medical records, imaging, and biopsy specimens for patients under 18 years presenting with isolated tumefactive demyelination over a 10-year period.

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GB (Glioblastoma WHO Grade 4) is the most aggressive type of brain tumor in adults that has a short survival rate even after aggressive treatment with surgery and radiation therapy. The changes in magnetic resonance imaging (MRI) for patients with GB after radiotherapy are indicative of either radiation-induced necrosis (RN) or recurrent brain tumor (rBT). Screening for rBT and RN at an early stage is crucial for facilitating faster treatment and better outcomes for the patients.

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Background And Purpose: Intracranial epidermoids temporal bone cholesteatomas, and head and neck epidermal inclusion cysts are typically slow-growing, benign conditions arising from ectodermal tissue. They exhibit increased signal on DWI. While much of the imaging literature describes these lesions as showing diffusion restriction, we investigated these qualitative signal intensities and interpretations of restricted diffusion with respect to normal brain structures.

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Importance: Neurodevelopmental outcomes for children with congenital heart defects (CHD) have improved minimally over the past 20 years.

Objectives: To assess the feasibility and tolerability of maternal progesterone therapy as well as the magnitude of the effect on neurodevelopment for fetuses with CHD.

Design, Setting, And Participants: This double-blinded individually randomized parallel-group clinical trial of vaginal natural progesterone therapy vs placebo in participants carrying fetuses with CHD was conducted between July 2014 and November 2021 at a quaternary care children's hospital.

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Rationale And Objectives: Artificial intelligence (AI) technologies are rapidly evolving and offering new advances almost on a day-by-day basis, including various tools for manuscript generation and modification. On the other hand, these potentially time- and effort-saving solutions come with potential bias, factual error, and plagiarism risks. Some journals have started to update their author guidelines in reference to AI-generated or AI-assisted manuscripts.

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Article Synopsis
  • MR imaging is essential for assessing tumor burden and changes in pediatric neuro-oncology, but accurately identifying tumor components can be complex and subjective.
  • Current response assessment guidelines do not fully address challenges such as differentiating tumor types and understanding the impact of imaging inconsistencies, leading to variability in evaluations by different observers.
  • The paper emphasizes the need for standardized criteria to improve the identification of tumor subregions and suggests that automated segmentation using AI could enhance objective assessments, aiming for more reliable metrics in clinical studies.
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Background And Purpose: Tumor segmentation is essential in surgical and treatment planning and response assessment and monitoring in pediatric brain tumors, the leading cause of cancer-related death among children. However, manual segmentation is time-consuming and has high interoperator variability, underscoring the need for more efficient methods. After training, we compared 2 deep-learning-based 3D segmentation models, DeepMedic and nnU-Net, with pediatric-specific multi-institutional brain tumor data based on multiparametric MR images.

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Background And Purpose: While classic brain MR imaging features of Alexander disease have been well-documented, lesional patterns can overlap with other leukodystrophies, especially in the early stages of the disease or in milder phenotypes. We aimed to assess the utility of a new neuroimaging sign to help increase the diagnostic specificity of Alexander disease.

Materials And Methods: A peculiar bilateral symmetric hyperintense signal on T2-weighted images affecting the medulla oblongata was identified in an index patient with type I Alexander disease.

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Objective: The brain arteriovenous malformation (BAVM) nidus compactness score (CS), determined on angiography, predicts BAVM recurrence after surgical resection among children with sporadic BAVMs. We measured the angiographic CS for BAVMs among children with hereditary hemorrhagic telangiectasia (HHT) to determine CS characteristics in this population.

Methods: A pediatric interventional neuroradiologist reviewed angiograms to determine the CS of BAVMs in children with HHT recruited to the BVMC.

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Purpose: This article is the first in a two-part series designed to provide a comprehensive overview of the range of supratentorial intraventricular masses observed in children. Our primary objective is to discuss the diverse types of intraventricular masses that originate not only from cells within the choroid plexus but also from other sources.

Methods: In this article, we review relevant epidemiological data, the current genetics/molecular classification as outlined in the fifth edition of the World Health Organization's Classification of tumours of the Central Nervous System and noteworthy imaging findings.

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Background And Objectives: EEG and MRI features are independently associated with pediatric cardiac arrest (CA) outcomes, but it is unclear whether their combination improves outcome prediction. We aimed to assess the association of early EEG background category with MRI ischemia after pediatric CA and determine whether addition of MRI ischemia to EEG background features and clinical variables improves short-term outcome prediction.

Methods: This was a single-center retrospective cohort study of pediatric CA with EEG initiated ≤24 hours and MRI obtained ≤7 days of return of spontaneous circulation.

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Polymorphous low-grade neuroepithelial tumors of the young (PLNTY) are rare brain tumors first described in 2017 and recently included in the 2021 5th World Health Organization Classification of Tumors of the Central Nervous System. They typically affect children and young adults. Few pediatric cases have been reported in the literature.

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Aim: Cerebral blood flow (CBF) is dysregulated after cardiac arrest. It is unknown if post-arrest CBF is associated with outcome. We aimed to determine the association of CBF derived from arterial spin labelling (ASL) MRI with outcome after pediatric cardiac arrest.

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Resting-state (rs) fMRI has been shown to be useful for preoperative mapping of functional areas in patients with brain tumors and epilepsy. However, its lack of standardization limits its widespread use and hinders multicenter collaboration. The American Society of Functional Neuroradiology, American Society of Pediatric Neuroradiology, and the American Society of Neuroradiology Functional and Diffusion MR Imaging Study Group recommend specific rs-fMRI acquisition approaches and preprocessing steps that will further support rs-fMRI for future clinical use.

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Pediatric brain and spinal cancers remain the leading cause of cancer-related death in children. Advancements in clinical decision-support in pediatric neuro-oncology utilizing the wealth of radiology imaging data collected through standard care, however, has significantly lagged other domains. Such data is ripe for use with predictive analytics such as artificial intelligence (AI) methods, which require large datasets.

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Background: Infants with complex congenital heart disease (CHD) require life-saving corrective/palliative heart surgery in the first weeks of life. These infants are at risk for brain injury and poor neurodevelopmental outcomes. Cerebral microhemorrhages (CMH) are frequently seen after neonatal bypass heart surgery, but it remains unknown if CMH are a benign finding or constitute injury.

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