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Journal of Internal Medicine Mar 2022Colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy is a rare but fatal microgliopathy. The diagnosis is often delayed due to multifaceted symptoms... (Meta-Analysis)
Meta-Analysis Review
Colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy is a rare but fatal microgliopathy. The diagnosis is often delayed due to multifaceted symptoms that can mimic several other neurological disorders. Imaging provides diagnostic clues that help identify cases. The objective of this study was to integrate the literature on neuroimaging phenotypes of CSF1R-related leukoencephalopathy. A systematic review and meta-analysis were performed for neuroimaging findings of CSF1R-related leukoencephalopathy via PubMed, Web of Science, and Embase on 25 August 2021. The search included cases with confirmed CSF1R mutations reported under the previous terms hereditary diffuse leukoencephalopathy with spheroids, pigmentary orthochromatic leukodystrophy, and adult-onset leukoencephalopathy with axonal spheroids and pigmented glia. In 78 studies providing neuroimaging data, 195 cases were identified carrying CSF1R mutations in 14 exons and five introns. Women had a statistically significant earlier age of onset (p = 0.041, 40 vs 43 years). Mean delay between symptom onset and neuroimaging was 2.3 years. Main magnetic resonance imaging (MRI) findings were frontoparietal white matter lesions, callosal thinning, and foci of restricted diffusion. The hallmark computed tomography (CT) finding was white matter calcifications. Widespread cerebral hypometabolism and hypoperfusion were reported using positron emission tomography and single-photon emission computed tomography. In conclusion, CSF1R-related leukoencephalopathy is associated with progressive white matter lesions and brain atrophy that can resemble other neurodegenerative/-inflammatory disorders. However, long-lasting diffusion restriction and parenchymal calcifications are more specific findings that can aid the differential diagnosis. Native brain CT and brain MRI (with and without a contrast agent) are recommended with proposed protocols and pictorial examples are provided.
Topics: Brain; Female; Humans; Leukoencephalopathies; Magnetic Resonance Imaging; Mutation; Neuroimaging; Phenotype
PubMed: 34875121
DOI: 10.1111/joim.13420 -
Hand (New York, N.Y.) Jan 2023Magnetic resonance diffusion tensor imaging (DTI) can detect microstructural changes in peripheral nerves. Studies have reported that the median nerve apparent diffusion... (Meta-Analysis)
Meta-Analysis Review
Magnetic resonance diffusion tensor imaging (DTI) can detect microstructural changes in peripheral nerves. Studies have reported that the median nerve apparent diffusion coefficient (ADC), a quantification of water molecule diffusion direction, is sensitive in diagnosing carpal tunnel syndrome (CTS). Five databases were searched for studies using ADC to investigate CTS. Apparent diffusion coefficient (measured in mm/s) were pooled in random-effects meta-analyses. Twenty-two studies met criteria yielding 592 patients with CTS and 414 controls. Median nerve ADC were measured at the level of the distal radioulnar joint (CTS ADC: 1.11, 95% CI: 1.07-1.15, I = 54%; control ADC: 1.04, 95% CI: 1.01-1.07, I = 57%), pisiform (CTS ADC: 1.39, 95% CI: 1.37-1.42, I = 0%; control ADC: 1.27, 95% CI: 1.23-1.31, I = 59%), hamate (CTS ADC: 1.40, 95% CI: 1.36-1.43, I = 58%; control ADC: 1.27, 95% CI: 1.25-1.28, I = 47%), and as an combination of several measurements (CTS ADC: 1.40, 95% CI: 1.37-1.47, I = 100%; control ADC: 1.39, 95% CI: 1.24-1.53, I = 100%). Median nerve ADC is decreased in individuals with CTS compared to controls at the levels of the hamate and pisiform. ADC cut-offs to diagnose CTS should be established according to these anatomic levels and can be improved through additional studies that include use of a wrist coil.
Topics: Humans; Carpal Tunnel Syndrome; Diffusion Tensor Imaging; Median Nerve; Magnetic Resonance Imaging; Wrist Joint
PubMed: 35695339
DOI: 10.1177/15589447221096706 -
PloS One 2017Putaminal diffusivity in brain magnetic resonance diffusion-weighted imaging (DWI) is increased in patients with the parkinsonian variant of multiple system atrophy... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Putaminal diffusivity in brain magnetic resonance diffusion-weighted imaging (DWI) is increased in patients with the parkinsonian variant of multiple system atrophy (MSA-P) compared to Parkinson disease (PD) patients.
PURPOSE
We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of DWI to distinguish MSA-P from PD.
METHODS
Studies on DWI were identified through a systematic PubMed and Clarivate Analytics® Web of Science® Core Collection search. Papers were selected based on stringent inclusion criteria; minimum requirement was the inclusion of MSA-P and PD patients and documented true positive, true negative, false positive and false negative rates or overall sample size and reported sensitivity and specificity. Meta-analysis was performed using the hierarchical summary receiver operating characteristics curve approach.
RESULTS
The database search yielded 1678 results of which 9 studies were deemed relevant. Diagnostic accuracy of putaminal diffusivity measurements were reported in all of these 9 studies, whereas results of other regions of interest were only reported irregularly. Therefore, a meta-analysis could only be performed for putaminal diffusivity measurements: 127 patients with MSA-P, 262 patients with PD and 70 healthy controls were included in the quantitative synthesis. The meta-analysis showed an overall sensitivity of 90% (95% confidence interval (CI): 76.7%-95.8%) and an overall specificity of 93% (95% CI: 80.0%-97.7%) to distinguish MSA-P from PD based on putaminal diffusivity.
CONCLUSION
Putaminal diffusivity yields high sensitivity and specificity to distinguish clinically diagnosed patients with MSA-P from PD. The confidence intervals indicate substantial variability. Further multicenter studies with harmonized protocols are warranted particularly in early disease stages when clinical diagnosis is less certain.
Topics: Aged; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Female; Humans; Male; Parkinson Disease; Parkinsonian Disorders; Sensitivity and Specificity
PubMed: 29287113
DOI: 10.1371/journal.pone.0189897 -
Scientific Reports Jun 2017Traumatic brain injury (TBI) often leads to impaired consciousness. Recent diffusion tensor imaging studies associated consciousness with imaging metrics including... (Meta-Analysis)
Meta-Analysis Review
Traumatic brain injury (TBI) often leads to impaired consciousness. Recent diffusion tensor imaging studies associated consciousness with imaging metrics including fractional anisotropy (FA) and apparent diffusion coefficient (ADC). We evaluated their correlations and determined the best index in candidate regions. Six databases were searched, including PubMed and Embase, and 16 studies with 701 participants were included. Data from region-of-interest and whole-brain analysis methods were meta-analysed separately. The FA-consciousness correlation was marginal in the whole-brain white matter (r = 0.63, 95% CI [0.47, 0.79], p = 0.000) and the corpus callosum (CC) (r = 0.60, 95% CI [0.48, 0.71], p = 0.000), and moderate in the internal capsule (r = 0.48, 95% CI [0.24, 0.72], p = 0.000). Correlations with ADC trended negative and lacked significance. Further subgroup analysis revealed that consciousness levels correlated strongly with FA in the CC body (r = 0.66, 95% CI [0.43, 0.89]), moderately in the splenium (r = 0.58, 95% CI [0.38, 0.78]), but insignificantly in the genu. In conclusion, FA correlates better with consciousness levels than ADC in TBI. The degree of correlation varies among brain regions. The CC (especially its splenium and body) is a reliable candidate region to quantitatively reflect consciousness levels.
Topics: Biomarkers; Brain; Brain Injuries, Traumatic; Consciousness; Diffusion Magnetic Resonance Imaging; Female; Humans; Image Processing, Computer-Assisted; Male; Publication Bias; Severity of Illness Index
PubMed: 28584256
DOI: 10.1038/s41598-017-02950-3 -
Frontiers in Neurology 2022It is difficult to differentiate between a few primary central nervous system lymphoma (PCNSL) and high-grade glioma (HGG) using conventional magnetic resonance imaging...
Diagnostic Accuracy of the Diffusion-Weighted Imaging Method Used in Association With the Apparent Diffusion Coefficient for Differentiating Between Primary Central Nervous System Lymphoma and High-Grade Glioma: Systematic Review and Meta-Analysis.
BACKGROUND
It is difficult to differentiate between a few primary central nervous system lymphoma (PCNSL) and high-grade glioma (HGG) using conventional magnetic resonance imaging techniques. The purpose of this study is to explore whether diffusion-weighted imaging (DWI) can be effectively used to differentiate between these two types of tumors by analyzing the apparent diffusion coefficient (ADC).
RESEARCH DESIGN AND METHODS
Data presented in Pubmed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Science and Technology Journal Database (CQVIP) were analyzed. High-quality literature was included, and the quality was evaluated using the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool, and the studies were based on the inclusion and exclusion rules. The pooled sensitivity, pooled specificity, pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (), area under the curve (AUC) of the summary operating characteristic curve (SROC), and corresponding 95% confidence interval () were calculated using the bivariate mixed effect model. Meta-regression analysis and subgroup analysis were used to explore the sources of heterogeneity. The publication bias was evaluated by conducting Deek's test.
RESULTS
In total, eighteen high-quality studies were included. The pooled sensitivity was 0.82 (95% CI: 0.75-0.88), the pooled specificity was 0.87 (95% CI: 0.84-0.90), the pooled positive likelihood ratio was 6.49 (95% CI: 5.06-8.32), the pooled NLR was 0.21 (95% CI: 0.14-0.30), the pooled was 31.31 (95% CI: 18.55-52.86), and the pooled AUC was 0.90 (95% CI: 0.87-0.92). Sample size, language and country of publication, magnetic field strength, region of interest (ROI), and cut-off values of different types of ADC can potentially be the sources of heterogeneity. There was no publication bias in this meta-analysis.
CONCLUSIONS
The results obtained from the meta-analysis suggest that DWI is characterized by high diagnostic accuracy and thus can be effectively used for differentiating between PCNSL and HGG.
PubMed: 35812103
DOI: 10.3389/fneur.2022.882334 -
Nephrology, Dialysis, Transplantation :... Sep 2018Diffusion-weighted magnetic resonance imaging (DWI) is a non-invasive method sensitive to local water motion in the tissue. As a tool to probe the microstructure,...
Diffusion-weighted magnetic resonance imaging (DWI) is a non-invasive method sensitive to local water motion in the tissue. As a tool to probe the microstructure, including the presence and potentially the degree of renal fibrosis, DWI has the potential to become an effective imaging biomarker. The aim of this review is to discuss the current status of renal DWI in diffuse renal diseases. DWI biomarkers can be classified in the following three main categories: (i) the apparent diffusion coefficient-an overall measure of water diffusion and microcirculation in the tissue; (ii) true diffusion, pseudodiffusion and flowing fraction-providing separate information on diffusion and perfusion or tubular flow; and (iii) fractional anisotropy-measuring the microstructural orientation. An overview of human studies applying renal DWI in diffuse pathologies is given, demonstrating not only the feasibility and intra-study reproducibility of DWI but also highlighting the need for standardization of methods, additional validation and qualification. The current and future role of renal DWI in clinical practice is reviewed, emphasizing its potential as a surrogate and monitoring biomarker for interstitial fibrosis in chronic kidney disease, as well as a surrogate biomarker for the inflammation in acute kidney diseases that may impact patient selection for renal biopsy in acute graft rejection. As part of the international COST (European Cooperation in Science and Technology) action PARENCHIMA (Magnetic Resonance Imaging Biomarkers for Chronic Kidney Disease), aimed at eliminating the barriers to the clinical use of functional renal magnetic resonance imaging, this article provides practical recommendations for future design of clinical studies and the use of renal DWI in clinical practice.
Topics: Biomarkers; Diffusion Magnetic Resonance Imaging; Humans; Kidney; Practice Guidelines as Topic; Renal Insufficiency, Chronic
PubMed: 30137580
DOI: 10.1093/ndt/gfy163 -
Infectious Agents and Cancer 2017Literature data suggest that multi-parametric Magnetic Resonance Imaging (MRI), including morphologic T2-weigthed images (T2-MRI) and functional approaches such as... (Review)
Review
BACKGROUND
Literature data suggest that multi-parametric Magnetic Resonance Imaging (MRI), including morphologic T2-weigthed images (T2-MRI) and functional approaches such as Dynamic Contrast Enhanced-MRI (DCE-MRI), Diffusion Weighted Imaging (DWI) and Magnetic Resonance Spectroscopic Imaging (MRSI), give an added value in the prostate cancer localization and local staging.
METHODS
We performed a systematic review of literature about the role and the potentiality of morphological and functional MRI in prostate cancer, also in a multimodal / multiparametric approach, and we reported the diagnostic accuracy results for different imaging modalities and for different MR coil settings: endorectal coil (ERC) and phased array coil (PAC). Forest plots and receiver operating characteristic curves were performed. Risk of bias and the applicability at study level were calculated.
RESULTS
Thirty three papers were identified for the systematic review. Sensitivity and specificity values were, respectively, for T2-MRI of 75% and of 60%, for DCE-MRI of 80% and of 72%, for MRSI of 89% and of 69%, for combined T2-MRI and DCE-MRI of 87% and of 46%, for combined T2-MRI and MRSI of 79% and of 57%, for combined T2-MRI, DWI and DCE-MRI of 81% and of 84%, and for combined MRSI and DCE-MRI of 83% and of 83%. For MRI studies performed with ERC we obtained a pooled sensitivity and specificity of 81% and of 66% while the pooled values for MRI studies performed with PAC were of 78% and of 64%, respectively (p>0.05 at McNemar test). No studies were excluded from the analysis based on the quality assessment.
CONCLUSIONS
ERC use yielded no additional benefit in terms of prostate cancer detection accuracy compared to multi-channel PAC use (71% versus 68%) while the use of additional functional imaging techniques (DCE-MRI, DWI and MRSI) in a multiparametric MRI protocol improves the accuracy of prostate cancer detection allowing both the early cure and the guidance of biopsy.
PubMed: 29093748
DOI: 10.1186/s13027-017-0168-z -
NeuroImage. Clinical 2017Antisocial behavior (AB), including aggression, violence, and theft, is thought be underpinned by abnormal functioning in networks of the brain critical to emotion... (Review)
Review
Antisocial behavior (AB), including aggression, violence, and theft, is thought be underpinned by abnormal functioning in networks of the brain critical to emotion processing, behavioral control, and reward-related learning. To better understand the abnormal functioning of these networks, research has begun to investigate the connections between brain regions implicated in AB using diffusion tensor imaging (DTI), which assesses white-matter tract microstructure. This systematic review integrates findings from 22 studies that examined the relationship between white-matter microstructure and AB across development. In contrast to a prior hypothesis that AB is associated with greater diffusivity specifically in the uncinate fasciculus, findings suggest that adult AB is associated with greater diffusivity across a range of white-matter tracts, including the uncinate fasciculus, inferior fronto-occipital fasciculus, cingulum, corticospinal tract, thalamic radiations, and corpus callosum. The pattern of findings among youth studies was inconclusive with both higher and lower diffusivity found across association, commissural, and projection and thalamic tracts.
Topics: Antisocial Personality Disorder; Diffusion Tensor Imaging; Humans; Neural Pathways; White Matter
PubMed: 28180079
DOI: 10.1016/j.nicl.2017.01.014 -
AJNR. American Journal of Neuroradiology Feb 2017Endovascular treatment of intracranial aneurysms is associated with the risk of thromboembolic ischemic complications. Many of these events are asymptomatic and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
Endovascular treatment of intracranial aneurysms is associated with the risk of thromboembolic ischemic complications. Many of these events are asymptomatic and identified only on diffusion-weighted imaging. We performed a systematic review and meta-analysis to study the incidence of DWI positive for thromboembolic events following endovascular treatment of intracranial aneurysms.
MATERIALS AND METHODS
A comprehensive literature search identified studies published between 2000 and April 2016 that reported postprocedural DWI findings in patients undergoing endovascular treatment of intracranial aneurysms. The primary outcome was the incidence of DWI positive for thromboembolic events. We examined outcomes by treatment type, sex, and aneurysm characteristics. Meta-analyses were performed by using a random-effects model.
RESULTS
Twenty-two studies with 2148 patients and 2268 aneurysms were included. The overall incidence of DWI positive for thromboembolic events following endovascular treatment was 49% (95% CI, 42%-56%). Treatment with flow diversion trended toward a higher rate of DWI positive for lesions than coiling alone (67%; 95% CI, 46%-85%; versus 45%; 95% CI, 33%-56%; = .07). There was no difference between patients treated with coiling alone and those treated with balloon-assisted (44%; 95% CI, 29%-60%; = .99) or stent-assisted (43%; 95% CI, 24%-63%; = .89) coiling. Sex, aneurysm rupture status, location, and size were not associated with the rate of DWI positive for lesions.
CONCLUSIONS
One in 2 patients may have infarcts on DWI following endovascular treatment of intracranial aneurysms. There is a trend toward a higher incidence of DWI-positive lesions following treatment with flow diversion compared with coiling. Patient demographics and aneurysm characteristics were not associated with DWI-positive thromboembolic events.
Topics: Aneurysm, Ruptured; Diffusion Magnetic Resonance Imaging; Embolization, Therapeutic; Endovascular Procedures; Female; Humans; Incidence; Intracranial Aneurysm; Male; Middle Aged; Thromboembolism; Treatment Outcome
PubMed: 27856436
DOI: 10.3174/ajnr.A4989 -
Journal of Biomedical Optics Aug 2022Measurement and imaging of hemoglobin oxygenation are used extensively in the detection and diagnosis of disease; however, the applied instruments vary widely in their... (Review)
Review
SIGNIFICANCE
Measurement and imaging of hemoglobin oxygenation are used extensively in the detection and diagnosis of disease; however, the applied instruments vary widely in their depth of imaging, spatiotemporal resolution, sensitivity, accuracy, complexity, physical size, and cost. The wide variation in available instrumentation can make it challenging for end users to select the appropriate tools for their application and to understand the relative limitations of different methods.
AIM
We aim to provide a systematic overview of the field of hemoglobin imaging and sensing.
APPROACH
We reviewed the sensing and imaging methods used to analyze hemoglobin oxygenation, including pulse oximetry, spectral reflectance imaging, diffuse optical imaging, spectroscopic optical coherence tomography, photoacoustic imaging, and diffuse correlation spectroscopy.
RESULTS
We compared and contrasted the ability of different methods to determine hemoglobin biomarkers such as oxygenation while considering factors that influence their practical application.
CONCLUSIONS
We highlight key limitations in the current state-of-the-art and make suggestions for routes to advance the clinical use and interpretation of hemoglobin oxygenation information.
Topics: Hemoglobins; Oximetry; Spectrum Analysis; Tomography, Optical Coherence
PubMed: 35922891
DOI: 10.1117/1.JBO.27.8.080901