<?xml version="1.0" encoding="UTF-8"?><rss version="2.0" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:wfw="http://wellformedweb.org/CommentAPI/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:sy="http://purl.org/rss/1.0/modules/syndication/" xmlns:slash="http://purl.org/rss/1.0/modules/slash/" > <channel> <title>Head and Neck – AJNR Blog</title> <atom:link href="https://www.ajnrblog.org/tag/head-and-neck/feed/" rel="self" type="application/rss+xml" /> <link>https://www.ajnrblog.org</link> <description>The Official Blog of the American Journal of Neuroradiology</description> <lastBuildDate>Tue, 14 Feb 2023 22:36:39 +0000</lastBuildDate> <language>en-US</language> <sy:updatePeriod> hourly </sy:updatePeriod> <sy:updateFrequency> 1 </sy:updateFrequency> <generator>https://wordpress.org/?v=6.7.2</generator> <item> <title>Neuroimaging Anatomy, Part 2: Head, Neck, and Spine, An Issue of Neuroimaging Clinics of North America</title> <link>https://www.ajnrblog.org/2023/02/14/neuroimaging-anatomy-part-2-head-neck-and-spine-an-issue-of-neuroimaging-clinics-of-north-america/</link> <dc:creator><![CDATA[bookreviews]]></dc:creator> <pubDate>Tue, 14 Feb 2023 22:31:11 +0000</pubDate> <category><![CDATA[Book Reviews]]></category> <category><![CDATA[Full Reviews]]></category> <category><![CDATA[anatomy]]></category> <category><![CDATA[Head and Neck]]></category> <category><![CDATA[neuroimaging]]></category> <category><![CDATA[Spine]]></category> <guid isPermaLink="false">https://www.ajnrblog.org/?p=20321</guid> <description><![CDATA[Massoud TF, ed. Mukherji SK, consulting ed. Neuroimaging Anatomy, Part 2: Head, Neck, and Spine, An Issue of Neuroimaging Clinics of North America. Theclinics.com; 2022;32(4):1052–5149; Online and print $413.00; Online only $359.00 The November 2022 issue of Neuroimaging Clinics deals]]></description> <content:encoded><![CDATA[<p><strong>Massoud TF, ed. Mukherji SK, consulting ed. <em>Neuroimaging Anatomy, Part 2: Head, Neck, and Spine, An Issue of Neuroimaging Clinics of North America. </em>Theclinics.com; 2022;32(4):1052–5149; Online and print $413.00; Online only $359.00</strong></p> <p>The November 2022 issue of <em>Neuroimaging Clinics</em> deals with a myriad of material relating to normal anatomy. As all neuroradiologists are aware, a deep understanding of normal anatomy is the key to successful interpretations of MRI and CT, so a volume such as this can have great value.</p> <p>Dr. Massoud, the guest editor of this issue, along with 24 authors, has assembled 13 chapters totaling 215 pages, all of which have relevance to our daily practice of radiology. He has done an excellent job of gathering in 1 issue anatomic features that should be read, reread, and reviewed. These chapters in order are: Anatomy of the Orbit; Sinonasal Anatomy; Maxillofacial Skeleton and Facial Anatomy; Anatomy of the Mandible, TM Joint, and Dentition; Temporal Bone Anatomy; Oral Cavity and Salivary Gland Anatomy; Anatomy of the Pharynx and Cervical Esophagus; Anatomy of the Larynx and Cervical Trachea; Anatomy of Neck Muscles, Spaces, and Lymph Nodes; Root of the Neck and Extracranial Vessel Anatomy; Craniocervical Junction and Cervical Spine Anatomy; Thoracic and Lumbar Spine Anatomy; and Anatomy of the Spinal Cord, Coverings, and Nerves.</p> <p>The chapters vary in their presentation of the pertinent material, but all summarize at the conclusion of each chapter what the clinical care points are, expressed in very general terms. The variation in chapters is exemplified by looking, for example, at the chapter on sinonasal anatomy, where the authors nicely present in tabular form patterns of pneumatization/ossifications of the sinuses, dimensions of structures, and surgically important details, among other important details. This type of detail is important for reference material, but authors in some other chapters do not present their material in such a precise way.</p> <p>The chapter on maxillofacial skeleton and facial anatomy does bring about a degree of sadness when it is realized that the co-author of this material is Peter Som, a pioneer in head and neck radiology, who has recently passed away. His contributions to our field have been enormous and it is recalled how glad he was to bring this material, particularly the detailed description of facial muscles, to the attention of neuroradiologists.</p> <p>The illustrative material is for the most part of good quality; however, in several chapters the labeling is so small and indistinct that a magnifying glass is needed to easily see the material shown. This detracts from the educational value of some of the chapters; you give up trying to squint through several illustrations. One should not have to have the visual acuity of a Navy carrier pilot to appreciate the labeled material. A prime example of this is Figure 10 in the chapter on the root of the neck. Even with a magnifying glass, it is a strain to go through the labeling. Additionally, it is noted that a few illustrations are far too dark and too small to fully appreciate the anatomy (examples are Figures 8 and 10 in the chapter on neck muscles).</p> <p>Those drawbacks aside, this is a highly valuable issue because it not only reviews pertinent and important anatomy but also emphasizes and, in some cases, introduces anatomy with which a neuroradiologist may not be facile or confident. There are many noteworthy chapters and specific material in each chapter; among these is the material on the larynx and cervical trachea, the extracranial vessel anatomy, data on the paranasal sinuses, and pharyngeal anatomy.</p> <p>This issue is a highly recommended purchase. If it is on one’s bookshelf, it will be referred to frequently.</p> ]]></content:encoded> </item> <item> <title>Neuroimaging Clinics of North America: State of the Art Evaluation of the Head and Neck</title> <link>https://www.ajnrblog.org/2020/10/09/neuroimaging-clinics-of-north-america-state-of-the-art-evaluation-of-the-head-and-neck/</link> <dc:creator><![CDATA[bookreviews]]></dc:creator> <pubDate>Fri, 09 Oct 2020 18:35:56 +0000</pubDate> <category><![CDATA[Book Reviews]]></category> <category><![CDATA[Full Reviews]]></category> <category><![CDATA[Head and Neck]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=18912</guid> <description><![CDATA[Srinivasan A, ed. Mukherji SK, consulting ed. Neuroimaging Clinics of North America: State of the Art Evaluation of the Head and Neck. Elsevier; 2020;30(3):261–392; $397.00 Coming nearly in a coordinated fashion with the just-ended virtual American Society of Head and]]></description> <content:encoded><![CDATA[<p><strong>Srinivasan A, ed. Mukherji SK, consulting ed. <em>Neuroimaging Clinics of North America: State of the Art Evaluation of the Head and Neck</em>. Elsevier; 2020;30(3):261–392; $397.00</strong></p> <p><a href="http://www.ajnrblog.org/wp-content/uploads/Neuroimaging-Clinics-of-North-America-State-of-the-Art-Evaluation-of-the-Head-and-Neck-Suresh-K.-Mukherji.jpg"><img fetchpriority="high" decoding="async" class="alignright wp-image-18914 size-medium" src="http://www.ajnrblog.org/wp-content/uploads/Neuroimaging-Clinics-of-North-America-State-of-the-Art-Evaluation-of-the-Head-and-Neck-Suresh-K.-Mukherji-203x300.jpg" alt="cover of Srinivasan" width="203" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/Neuroimaging-Clinics-of-North-America-State-of-the-Art-Evaluation-of-the-Head-and-Neck-Suresh-K.-Mukherji-203x300.jpg 203w, https://www.ajnrblog.org/wp-content/uploads/Neuroimaging-Clinics-of-North-America-State-of-the-Art-Evaluation-of-the-Head-and-Neck-Suresh-K.-Mukherji-101x150.jpg 101w, https://www.ajnrblog.org/wp-content/uploads/Neuroimaging-Clinics-of-North-America-State-of-the-Art-Evaluation-of-the-Head-and-Neck-Suresh-K.-Mukherji-405x600.jpg 405w, https://www.ajnrblog.org/wp-content/uploads/Neuroimaging-Clinics-of-North-America-State-of-the-Art-Evaluation-of-the-Head-and-Neck-Suresh-K.-Mukherji.jpg 528w" sizes="(max-width: 203px) 100vw, 203px" /></a></p> <p>Coming nearly in a coordinated fashion with the just-ended virtual American Society of Head and Neck Radiology Annual Meeting, the current issue of <em>Neuroimaging Clinics</em> develops a number of themes that are pertinent to the practice of head and neck radiology or will soon become incorporated into interpretation and reporting of head and neck cases.</p> <p>Edited by Dr. Ashok Srinivasan from the University of Michigan and authored/co-authored by 33 contributors, there are 9 chapters, which delve into some of the major areas of imaging of the head and neck. After a review of the general principles of DWI, the chapter on diffusion MR imaging shows, with good examples, how DWI can be useful in differential diagnosis, and more importantly, how separation of some malignant versus benign lesions can be suggested by findings on DWI. Shown are examples where the DWI/ADC findings are typical for malignancy but also where relying on those criteria alone could be misleading (as in the example of chondrosarcoma). Beyond the conventional DWI, this chapter explores diffusion tensor imaging and diffusion kurtosis imaging while showing classic examples of how these and routine DWI can be helpful in diagnosis. The illustrations illuminate the points made in the text.</p> <p>Whether MR spectroscopy ever becomes more than a rarely used technique is a matter of conjecture, but the chapter entitled “MR Spectroscopy of the Head and Neck” could serve as a platform for those attempting to utilize spectroscopy in their practice.</p> <p>The need to continually improve image quality in the head and neck by applying new or modified sequences is the theme of the chapter “Technical Improvements in Head and Neck Imaging: At the Cutting Edge.” Covered in adequate background detail are 3D techniques, black bone imaging, variations in fat suppression, and vascular MR imaging (which includes angiography, permeability, ASL, and perfusion). Faster image acquisition often means the difference between a nondiagnostic and a diagnostic study, so a review of accelerated acquisition fits well in this chapter.</p> <p>While most practices do not utilize dual-energy CT, the chapter entitled “Dual-Energy Computed Tomography in Head and Neck Imaging: Pushing the Envelope” points out the principles behind the effectiveness of dual-energy CT and how it can be applied. Where it is useful, as in thyroid cartilage evaluation or in generating iodine maps, is shown in proper illustrative material. In the latter instance, suspected tumor boundaries are more clearly defined in SCC.</p> <p>Following the lead of other standardized reporting systems such as BI-RADS or TI-RADS, the chapter “Neck Imaging Reporting and Data System: Principles and Implementation” sets forth parameters/templates to be used in the reporting of posttreatment evaluation of head and neck cancer, here called NI-RADS, in which a well-developed point system is used. The included table shows exactly how this information is determined and reported. The level of suspicion for tumor recurrence or residual lends itself to clarifying the imaging/clinical status of each patient. The trick, of course, is getting this integrated into individual practices in a manner similar to that universally used in breast imaging.</p> <p>For those even more deeply involved in head and neck imaging as a subspecialty area, additional chapters on PET imaging in tumor hypoxia, the role of advanced imaging in radiation therapy, artificial intelligence in head and neck imaging, and common data elements in head and neck radiology reporting will be of interest. This last chapter defines the specific elements that should be in a report for a given examination or clinical question. This chapter points out the advantage of these common elements, but also indicates differences in attitude and advantages/disadvantages toward structured reports versus narrative reports. Some examples are shown, but the font size on some of the reports makes it difficult to impossible to read.</p> <p>This is a valuable volume and Drs. Suresh Mukherji and Ashok Srinivasan are to be congratulated for having put together material that will be important in the hands of all those who interpret head and neck imaging.</p> ]]></content:encoded> </item> <item> <title>Rhoton’s Atlas of Head, Neck, and Brain: 2D and 3D Images</title> <link>https://www.ajnrblog.org/2019/07/19/rhotons-atlas-of-head-neck-and-brain-2d-and-3d-images/</link> <dc:creator><![CDATA[bookreviews]]></dc:creator> <pubDate>Fri, 19 Jul 2019 17:00:51 +0000</pubDate> <category><![CDATA[Full Reviews]]></category> <category><![CDATA[adult brain]]></category> <category><![CDATA[Head and Neck]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=17718</guid> <description><![CDATA[Peris-Celda M; Martinez-Soriano F; Rhoton AL. Rhoton’s Atlas of Head, Neck, and Brain: 2D and 3D Images;Thieme 2017; 648 pp; 624 ill; $ 299.99. Rhoton’s Atlas of Head, Neck, and Brain represents some of the finest work of the late]]></description> <content:encoded><![CDATA[<p><img decoding="async" class="alignright size-medium wp-image-17720" src="http://www.ajnrblog.org/wp-content/uploads/Rhotons-Atlas-of-Head-Neck-and-Brain-Maria-Peris-Celda-222x300.jpg" alt="" width="222" height="300" />Peris-Celda M; Martinez-Soriano F; Rhoton AL. <em>Rhoton’s Atlas of Head, Neck, and Brain: 2D and 3D Images</em>;Thieme 2017; 648 pp; 624 ill; $ 299.99.</p> <p><em>Rhoton’s Atlas of Head, Neck, and Brain</em> represents some of the finest work of the late Dr. Albert L. Rhoton, an extraordinary neurosurgeon, anatomist, and teacher. It is perhaps no surprise then, that this work includes some of the highest quality anatomical dissections of the head, neck, and brain, presented here in exquisite detail.</p> <p>The book is entirely made of labeled and annotated photographs of cadaveric dissections. Labeled photographs are presented at various depths through the specimen and are typically oriented in classic anterior-posterior, lateral, or top-down views which correlate well with standard radiographical images. The remainder of the dissections are presented in the views that would be obtained during classic surgical approaches.</p> <p>The organization of the book is intuitive, with bony anatomy, the face and neck, interior structures (ear, nose, pharynx, larynx, orbit), and cranial anatomy presented separately. The sections are further divided into detailed exposures of substructures, often presented in multiple views. Interspersed among the sections devoted to specific entities are views designed to match surgical approaches with specific attention paid to endoscopic views to the cerebral ventricular system and endonasal approach to the anterior skull base. Thus, while the level of detail and sectioning through the cadavers at various depths is appropriate for the most sophisticated anatomists, the overall layout and apparent intention is to aid the surgeon. Some impressive examples include the surgical view during endonasal approaches to the anterior skull base, and midline posterior fossa approaches.</p> <p>The level of detail is impressive, and the quality of the photographs and cadaveric specimens is spectacular. Even minor nerve branches are often labeled and the relationship of vascular structures with adjacent entities is emphasized. The size of the print and figures is also helpful, in the 11 x 12 inch format – even small structures are easily identifiable. It would be hard to find a comparable resource in terms of breadth of content and quality of detail and photographs.<br /> The style of labeling – discrete lines lead to text labels of all structures on each side of the image – facilitates self-study and enables this book to function as a wonderful educational tool for learning and memorizing anatomy in addition to its status as a near-perfect anatomical reference. There is specific emphasis on the cranial nerves and cerebrovascular anatomy, with a chapter devoted to each subject. This is especially useful as these structures often appear in cross section and can be it if often challenging to track their course in standard serial coronal, sagittal, and axial images.</p> <p>Thus, the book is well suited as a companion to radiology texts and guides as it can elucidate relationships between anatomical structures that are difficult to appreciate in standard images and cross-section. The index is thorough and matches the detail in labeling, thus providing an efficient means of identifying specific structures and their relevant anatomical relationships in space and in relation to major adjacent structures. Given the emphasis on surgical approaches, one imagines this book offering special value to the radiologist and surgeon, providing an accessible link between important features of radiographic and surgical anatomy.</p> <p>Finally, 3D images are available online and viewing glasses are included in the book. The images are stunning and the high resolution, three-dimensional views provide the closest approximation to inspecting a dissected cadaver in person. The quality in many of these images is remarkable and enhances one’s appreciation of often complex anatomy of the head, neck and brain. For the surgeon and radiologist, the ability to follow and understand small anatomical structures in relation to major bony and vascular anatomy is vital and this work certainly aides in this endeavor.</p> <p>In summary, Rhoton’s Atlas of Head, Neck, and Brain is a masterpiece. It is at once a superb anatomical reference in which specific structures are indexed and can be quickly found in various positions and via different views, a companion to the radiologist wherein even the smallest structures can be understood in their position and course, and a guide to the surgeon, who is able to see meticulously dissected views of his or her approach before the operation. But perhaps above all, as the late Dr. Rhoton would have intended, it is ultimately a supreme learning tool for the student of anatomy.</p> ]]></content:encoded> </item> <item> <title>Fellows’ Journal Club: Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation</title> <link>https://www.ajnrblog.org/2019/06/23/fellows-journal-club-readout-segmented-echo-planar-dwi-for-the-detection-of-cholesteatomas-correlation-with-surgical-validation/</link> <dc:creator><![CDATA[Editorial Office]]></dc:creator> <pubDate>Sun, 23 Jun 2019 17:00:40 +0000</pubDate> <category><![CDATA[Fellows' Journal Club]]></category> <category><![CDATA[Head and Neck]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=17495</guid> <description><![CDATA[Fellows’ Journal Club Readout-segmented echo-planar (RESOLVE)-DWI is a new alternative technique for obtaining DWI with high quality, delivering sharp images at high spatial resolution and reduced slice thickness. Fifty patients with chronic otitis media who underwent MR imaging before an]]></description> <content:encoded><![CDATA[<div class="editor-comment"> <h1>Fellows’ Journal Club</h1> <p>Readout-segmented echo-planar (RESOLVE)-DWI is a new alternative technique for obtaining DWI with high quality, delivering sharp images at high spatial resolution and reduced slice thickness. Fifty patients with chronic otitis media who underwent MR imaging before an operation of the middle ear were included. The MR imaging protocol consisted of axial and coronal readout-segmented echo-planar DWI with b-values of 0 and 1000 s/mm2 and 3-mm slice thickness. The readout segmented echo-planar diffusion-weighted images were fused with standard T2-weighted sequences for better anatomic assignment. Readout-segmented echo-planar DWI detected 22 of the 25 cases of surgically proved cholesteatoma. It has an accuracy of 92%, a sensitivity of 88%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 89%. Readout-segmented echo-planar DWI is a promising and reliable MR imaging sequence for the detection and exclusion of cholesteatoma.</p> <figure> <figure> <figure><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt=""></figure> </figure> </figure> <p class="signature"> </div> <h2 class="signature">Abstract</h2> <div id="sec-1" class="subsection"> <h3 id="p-3">BACKGROUND AND PURPOSE</h3> <figure id="attachment_17496" aria-describedby="caption-attachment-17496" style="width: 286px" class="wp-caption alignright"><img decoding="async" class="size-medium wp-image-17496" src="http://www.ajnrblog.org/wp-content/uploads/FJC3-3-286x300.jpg" alt="" width="286" height="300"><figcaption id="caption-attachment-17496" class="wp-caption-text">A 13-year-old female patient with chronic otitis media on the right side. RESOLVE-DWI shows a large hyperintense lesion on the right side.</figcaption></figure> <p>MR imaging has become an important tool for the detection of cholesteatomas of the middle ear. Various diffusion-weighted imaging sequences are available and have shown promising results. This study aimed to evaluate readout-segmented echo-planar DWI for the detection of cholesteatoma and compare the results with surgical validation.</p> <div id="sec-2" class="subsection"> <h3 id="p-4">MATERIALS AND METHODS</h3> <p>Fifty patients with chronic otitis media (24 females and 26 males; range, 12–76 years of age; mean age, 41 years) who underwent MR imaging before an operation of the middle ear (1–169 days) were included. The MR imaging protocol consisted of axial and coronal readout-segmented echo-planar DWI with b-values of 0 and 1000 s/mm2 and 3-mm slice thickness. The readout-segmented echo-planar diffusion-weighted images were fused with standard T2-weighted sequences for better anatomic assignment. The results of the MR imaging evaluation were correlated with the results from the operation.</p> </div> <div id="sec-3" class="subsection"> <h3 id="p-5">RESULTS</h3> <p>Readout-segmented echo-planar DWI detected 22 of the 25 cases of surgically proved cholesteatoma. It has an accuracy of 92% (95% confidence interval, 80.8%–97.8%), a sensitivity of 88%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 89%. In 1 case, a positive finding for cholesteatoma with readout-segmented echo-planar DWI could not be proved by histology, and in 3 cases, histology yielded a cholesteatoma that was not detected with MR imaging.</p> </div> <div id="sec-4" class="subsection"> <h3 id="p-6">CONCLUSIONS</h3> <p>Readout-segmented echo-planar DWI is a promising and reliable MR imaging sequence for the detection and exclusion of cholesteatoma.</p> </div> </div> <p><strong>Read this article: <a href="http://bit.ly/2Mq5Jkc">http://bit.ly/2Mq5Jkc</a></strong></p> ]]></content:encoded> </item> <item> <title>Evaluation of the Normal Cochlear Second Interscalar Ridge Angle and Depth on 3D T2-Weighted Images: A Tool for the Diagnosis of Scala Communis and Incomplete Partition Type II</title> <link>https://www.ajnrblog.org/2018/06/03/evaluation-normal-cochlear-second-interscalar-ridge-angle-depth-3d-t2-weighted-images-tool-diagnosis-scala-communis-incomplete-partition-type-ii/</link> <dc:creator><![CDATA[jross]]></dc:creator> <pubDate>Sun, 03 Jun 2018 19:30:46 +0000</pubDate> <category><![CDATA[Fellows' Journal Club]]></category> <category><![CDATA[Head and Neck]]></category> <category><![CDATA[cochlear]]></category> <category><![CDATA[ear]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=13809</guid> <description><![CDATA[Fellows’ Journal Club The second interscalar ridge notch angle and depth were measured on MR imaging in normal ears by a single experienced neuroradiologist. The images of normal ears were then randomly mixed with images of ears with incomplete partition]]></description> <content:encoded><![CDATA[<div class="editor-comment"> <h1>Fellows’ Journal Club</h1> <p>The second interscalar ridge notch angle and depth were measured on MR imaging in normal ears by a single experienced neuroradiologist. The images of normal ears were then randomly mixed with images of ears with incomplete partition II malformation for 2 novice evaluators to measure both the second interscalar ridge notch angle and depth in a blinded manner. For the mixed group, interobserver agreement was calculated, normal and abnormal ear measurements were compared, and receiver operating characteristic curves were generated. The 94 normal ears had a mean second interscalar ridge angle of 80.86° and depth of 0.54mm with the 98th percentile for an angle of 101° and a depth of 0.3 mm. In the mixed group, agreement between the 2 readers was excellent, with significant differences found between normal and incomplete partition type II ears for angle and depth on average. The authors conclude that a measured angle of >114° and a depth of the second interscalar ridge notch of ≤0.31 mm suggest the diagnosis of incomplete partition type II malformation and scalacommunis.</p> <p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt="" /></p> <p><span id="more-13809"></span></p> </div> <h2 class="signature">Abstract</h2> <div id="sec-1" class="subsection"> <figure id="attachment_13810" aria-describedby="caption-attachment-13810" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/FJC-fig-1-3.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13810" src="http://www.ajnrblog.org/wp-content/uploads/FJC-fig-1-3-300x121.jpg" alt="Figure 1 from paper" width="300" height="121" srcset="https://www.ajnrblog.org/wp-content/uploads/FJC-fig-1-3-300x121.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/FJC-fig-1-3-150x61.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/FJC-fig-1-3-630x254.jpg 630w, https://www.ajnrblog.org/wp-content/uploads/FJC-fig-1-3.jpg 1800w" sizes="auto, (max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-13810" class="wp-caption-text">Axial 3D T2-weighted images from inferior to superior showing a normal osseous spiral lamina and interscalar septum. <em>A</em>, A normal osseous spiral lamina separating the scala tympani (posterior) and scala vestibuli (anterior) of the basal (<em>anterior arrow</em>) and middle turns (<em>posterior arrow</em>). <em>B</em>, A normal lateral R2 notch (<em>arrow</em>) associated with the second part of the interscalar septum between the upper basal and upper middle turns of the cochlea.</figcaption></figure> <h3 id="p-3">BACKGROUND AND PURPOSE</h3> <p>Cochlear malformations may be be subtle on imaging studies. The purpose of this study was to evaluate the angle and depth of the lateral second interscalar ridge or notch in ears without sensorineural hearing loss (normal ears) and compare them with ears that have a documented incomplete type II partition malformation.</p> <div id="sec-2" class="subsection"> <h3 id="p-4">MATERIALS AND METHODS</h3> <p>The second interscalar ridge notch angle and depth were measured on MR imaging in normal ears by a single experienced neuroradiologist. The images of normal and incomplete partition II malformation ears were then randomly mixed for 2 novice evaluators to measure both the second interscalar ridge notch angle and depth in a blinded manner. For the mixed group, interobserver agreement was calculated, normal and abnormal ear measurements were compared, and receiver operating characteristic curves were generated.</p> </div> <div id="sec-3" class="subsection"> <h3 id="p-5">RESULTS</h3> <p>The 94 normal ears had a mean second interscalar ridge angle of 80.86° ± 11.4° and depth of 0.54 ± 0.14 mm with the 98th percentile for an angle of 101° and a depth of 0.3 mm. In the mixed group, agreement between the 2 readers was excellent, with significant differences for angle and depth found between normal and incomplete partition type II ears for angle and depth on average (<em>P</em> < .001). Receiver operating characteristic cutoffs for delineating normal from abnormal ears were similar for both readers (depth, 0.31/0.34 mm; angle, 114°/104°).</p> </div> <div id="sec-4" class="subsection"> <h3 id="p-6">CONCLUSIONS</h3> <p>A measured angle of >114° and a depth of the second interscalar ridge notch of ≤0.31 mm suggest the diagnosis of incomplete partition type II malformation and scala communis. These measurements can be accurately made by novice readers.</p> </div> <p><strong>Read this article: <a href="http://bit.ly/2wONsFo">http://bit.ly/2wONsFo</a></strong></p> </div> ]]></content:encoded> </item> <item> <title>MRI with DWI for the Detection of Posttreatment Head and Neck Squamous Cell Carcinoma: Why Morphologic MRI Criteria Matter</title> <link>https://www.ajnrblog.org/2018/04/29/mri-dwi-detection-posttreatment-head-neck-squamous-cell-carcinoma-morphologic-mri-criteria-matter/</link> <dc:creator><![CDATA[jross]]></dc:creator> <pubDate>Sun, 29 Apr 2018 19:30:41 +0000</pubDate> <category><![CDATA[Fellows' Journal Club]]></category> <category><![CDATA[Head and Neck]]></category> <category><![CDATA[carcinoma]]></category> <category><![CDATA[MRI]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=13705</guid> <description><![CDATA[Fellows’ Journal Club The authors analyzed 1.5T MRI examinations of 100 consecutive patients treated with radiation therapy with or without additional surgery for head and neck squamous cell carcinoma. MRI examinations included morphologic sequences and DWI. Histology and follow-up served]]></description> <content:encoded><![CDATA[<div class="editor-comment"> <h1>Fellows’ Journal Club</h1> <p>The authors analyzed 1.5T MRI examinations of 100 consecutive patients treated with radiation therapy with or without additional surgery for head and neck squamous cell carcinoma. MRI examinations included morphologic sequences and DWI. Histology and follow-up served as the standard of reference. Two readers, blinded to clinical/histologic/ follow-up data, evaluated images according to clearly defined criteria for the diagnosis of recurrent head and neck squamous cell carcinoma/second primary head and neck squamous cell carcinoma occurring after treatment, post-radiation therapy inflammatory edema, and late fibrosis. They conclude that adding precise morphologic MRI criteria to quantitative DWI enables reproducible and accurate detection of recurrent head and neck squamous cell carcinoma/second primary head and neck squamous cell carcinoma occurring after treatment.</p> <p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt="" /></p> <p><span id="more-13705"></span></p> </div> <h2 class="signature">Abstract</h2> <div id="sec-1" class="subsection"> <figure id="attachment_13706" aria-describedby="caption-attachment-13706" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F3.large-8.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13706" src="http://www.ajnrblog.org/wp-content/uploads/F3.large-8-300x270.jpg" alt="Figure 3 from paper" width="300" height="270" srcset="https://www.ajnrblog.org/wp-content/uploads/F3.large-8-300x270.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/F3.large-8-150x135.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/F3.large-8-630x566.jpg 630w, https://www.ajnrblog.org/wp-content/uploads/F3.large-8.jpg 1800w" sizes="auto, (max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-13706" class="wp-caption-text">DWI MRI obtained 3 months after RTH and bucopharyngectomy for squamous cell carcinoma of the retromolar trigone. The patient had right reflex otalgia and progressing trismus. Endoscopy could not be performed. Axial T2 (<em>A</em>) and coronal STIR (<em>B</em>) images show a triangular, elongated, strongly hypointense lesion (<em>arrows</em>) on the right. There was no contrast enhancement (not shown). The diagnosis of benign post-RTH late fibrosis was made. The b=1000 image (<em>C</em>) reveals low signal. ADC map (<em>D</em>) likewise shows low signal (ADC mean = 0.731 × 10<sup>−3</sup> mm<sup>2</sup>/s). Follow-up at 38 months (not shown) showed no recurrence but progressive scar retraction on MRI.</figcaption></figure> <h3 id="p-3">BACKGROUND AND PURPOSE</h3> <p>Although diffusion-weighted imaging combined with morphologic MRI (DWIMRI) is used to detect posttreatment recurrent and second primary head and neck squamous cell carcinoma, the diagnostic criteria used so far have not been clarified. We hypothesized that precise MRI criteria based on signal intensity patterns on T2 and contrast-enhanced T1 complement DWI and therefore improve the diagnostic performance of DWIMRI.</p> <div id="sec-2" class="subsection"> <h3 id="p-4">MATERIALS AND METHODS</h3> <p>We analyzed 1.5T MRI examinations of 100 consecutive patients treated with radiation therapy with or without additional surgery for head and neck squamous cell carcinoma. MRI examinations included morphologic sequences and DWI (<em>b</em>=0 and <em>b</em>=1000 s/mm<sup>2</sup>). Histology and follow-up served as the standard of reference. Two experienced readers, blinded to clinical/histologic/follow-up data, evaluated images according to clearly defined criteria for the diagnosis of recurrent head and neck squamous cell carcinoma/second primary head and neck squamous cell carcinoma occurring after treatment, post-radiation therapy inflammatory edema, and late fibrosis. DWI analysis included qualitative (visual) and quantitative evaluation with an ADC threshold.</p> </div> <div id="sec-3" class="subsection"> <h3 id="p-5">RESULTS</h3> <p>Recurrent head and neck squamous cell carcinoma/second primary head and neck squamous cell carcinoma occurring after treatment was present in 36 patients, whereas 64 patients had post-radiation therapy lesions only. The Cohen κ for differentiating tumor from post-radiation therapy lesions with MRI and qualitative DWIMRI was 0.822 and 0.881, respectively. Mean ADCmean in recurrent head and neck squamous cell carcinoma/second primary head and neck squamous cell carcinoma occurring after treatment (1.097 ± 0.295 × 10<sup>−3</sup> mm<sup>2</sup>/s) was significantly lower (<em>P</em> < .05) than in post-radiation therapy inflammatory edema (1.754 ± 0.343 × 10<sup>−3</sup> mm<sup>2</sup>/s); however, it was similar to that in late fibrosis (0.987 ± 0.264 × 10<sup>−3</sup> mm<sup>2</sup>/s, <em>P</em> > .05). Although ADCs were similar in tumors and late fibrosis, morphologic MRI criteria facilitated distinction between the 2 conditions. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (95% CI) of DWIMRI with ADCmean < 1.22 × 10<sup>−3</sup> mm<sup>2</sup>/s and precise MRI criteria were 92.1% (83.5–100.0), 95.4% (90.3–100.0), 92.1% (83.5–100.0), 95.4% (90.2–100.0), 19.9 (6.58–60.5), and 0.08 (0.03–0.24), respectively, indicating a good diagnostic performance to rule in and rule out disease.</p> </div> <div id="sec-4" class="subsection"> <h3 id="p-6">CONCLUSIONS</h3> <p>Adding precise morphologic MRI criteria to quantitative DWI enables reproducible and accurate detection of recurrent head and neck squamous cell carcinoma/second primary head and neck squamous cell carcinoma occurring after treatment.</p> </div> <p><strong>Read this article: <a href="http://bit.ly/2v5gFuI">http://bit.ly/2v5gFuI</a></strong></p> </div> ]]></content:encoded> </item> <item> <title>Neuroimaging Clinics of North America: Dual Energy CT: Applications in Head and Neck and Neurologic Imaging</title> <link>https://www.ajnrblog.org/2018/04/11/neuroimaging-clinics-north-america-dual-energy-ct-applications-head-neck-neurologic-imaging/</link> <dc:creator><![CDATA[bookreviews]]></dc:creator> <pubDate>Wed, 11 Apr 2018 21:33:03 +0000</pubDate> <category><![CDATA[Book Reviews]]></category> <category><![CDATA[Full Reviews]]></category> <category><![CDATA[CT]]></category> <category><![CDATA[Head and Neck]]></category> <category><![CDATA[neuroimaging]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=13676</guid> <description><![CDATA[Forghani R, Kelly HR, eds. Mukherji SK, consulting ed. Neuroimaging Clinics of North America: Dual Energy CT: Applications in Head and Neck and Neurologic Imaging. Elsevier; 2017;27(3):371–546; $365.00 Dual energy CT (DECT) is probably the single most exciting innovation in CT]]></description> <content:encoded><![CDATA[<p><strong>Forghani R, Kelly HR, eds. Mukherji SK, consulting ed. <em>Neuroimaging Clinics of North America: Dual Energy CT: Applications in Head and Neck and Neurologic Imaging.</em> Elsevier; <strong>2017;27(3):371–546; $365.00</strong></strong></p> <p><a href="http://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji.jpg"><img loading="lazy" decoding="async" class="alignright size-medium wp-image-13677" src="http://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-200x300.jpg" alt="Cover of Mukherji" width="200" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-200x300.jpg 200w, https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-100x150.jpg 100w, https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-399x600.jpg 399w, https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji.jpg 511w" sizes="auto, (max-width: 200px) 100vw, 200px" /></a></p> <p>Dual energy CT (DECT) is probably the single most exciting innovation in CT in the last decade. I have been passionate about this topic since 2006 when DECT was first introduced into clinical practice. There are many excellent publications covering this topic; however, this long-awaited issue of <em>Neuroimaging Clinics</em> is an excellent place to start.</p> <p>The entire issue is dedicated to DECT and provides a rather comprehensive review of this topic. It is comprised of 13 articles contributed by 32 authors, many of whom are well-recognized neuroradiologists. In order to simplify this review, I chose to categorize the articles into 4 sections:</p> <p><strong>DECT Physics</strong>: Two articles cover the fundamental principles of DECT. The authors make a genuine effort to simplify a very complicated topic. The articles are comprehensive and cover physical principles, CT scanner systems, and practical considerations for implementing DECT acquisition in clinical practice.</p> <p><strong>DECT Applications</strong>: Nine articles deal with the practical clinical applications of DECT. One article discusses the evaluation of intracranial pathology, another the evaluation of spine pathology, and 6 articles thoroughly review the DECT evaluation of head and neck anatomy and pathology with specific emphasis on head and neck tumor imaging, including squamous cell carcinoma and cervical lymphadenopathy. Overall, the articles are well written, and each topic is methodically discussed. The authors include scenarios where DECT provides superfluous information and others where DECT is key in making a correct diagnosis. Generally, the image quality is excellent and most images and diagrams are of high resolution and vibrant in color.</p> <p>A separate article in this “section” highlights the advantages of DECT in reducing artifacts and improving image quality in neuroimaging. This is an invaluable article validating the utility of DECT in many common clinical scenarios where conventional scanning can be degraded by metal artifacts.</p> <p>My only criticism of this “section” is that it does not cover DECT application after cochlear implantation. This is a very exciting topic where DECT can provide invaluable information that is not possible with conventional scanning. This information, namely the exact electrode position, can have significant implications for management.</p> <p><strong>DECT in Clinical Practice:</strong> This is a very important article for any radiologist or group considering incorporating DECT in their practice. The article objectively goes over advantages and hurdles for implementing this technique and suggests a practical workflow.</p> <p><strong>DECT Tissue Characterization and Emerging Applications</strong>: The final article of this issue deals with advanced applications of DECT in tissue characterization and discusses exciting potential future applications of this scanning technique.</p> <p>Overall, I really enjoyed reading this well-organized, well-illustrated book. In my opinion, it provides essential information that each and every neuroradiologist should be familiar with. It is a must read for neuroradiology fellows and faculty alike.</p> ]]></content:encoded> </item> <item> <title>Dynamic Contrast-Enhanced MRI–Derived Intracellular Water Lifetime (τi): A Prognostic Marker for Patients with Head and Neck Squamous Cell Carcinomas</title> <link>https://www.ajnrblog.org/2018/02/03/dynamic-contrast-enhanced-mri-derived-intracellular-water-lifetime-%cf%84i-prognostic-marker-patients-head-neck-squamous-cell-carcinomas/</link> <dc:creator><![CDATA[jross]]></dc:creator> <pubDate>Sat, 03 Feb 2018 20:30:40 +0000</pubDate> <category><![CDATA[Editor's Choices]]></category> <category><![CDATA[Head and Neck]]></category> <category><![CDATA[MRI]]></category> <category><![CDATA[squamous cell carcinoma]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=13489</guid> <description><![CDATA[Editor’s Choice The authors evaluated 60 patients with dynamic contrast-enhanced MR imaging before treatment. Median, mean intracellular water molecule lifetime, and volume transfer constant values from metastatic nodes were computed from each patient. Kaplan-Meier analyses were performed to associate mean]]></description> <content:encoded><![CDATA[<div class="editor-comment"> <h1>Editor’s Choice</h1> <p>The authors evaluated 60 patients with dynamic contrast-enhanced MR imaging before treatment. Median, mean intracellular water molecule lifetime, and volume transfer constant values from metastatic nodes were computed from each patient. Kaplan-Meier analyses were performed to associate mean intracellular water molecule lifetime and volume transfer constant and their combination with overall survival and beyond. Patients with high mean intracellular water molecule lifetime had overall survival significantly prolonged by 5 years compared with those with low mean intracellular water molecule lifetime. Patients with high mean intracellular water molecule lifetime had significantly longer overall survival at long-term duration than those with low mean intracellular water molecule lifetime. Volume transfer constant was a significant predictor for only the 5-year follow-up period. They conclude that a combined analysis of mean intracellular water molecule lifetime and volume transfer constant provided the best model to predict overall survival in patients with squamous cell carcinomas of the head and neck.</p> <p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt="" /></p> <p><span id="more-13489"></span></p> </div> <h2 class="signature">Abstract</h2> <div id="sec-1" class="subsection"><figure id="attachment_13491" aria-describedby="caption-attachment-13491" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F2.large-20.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13491" src="http://www.ajnrblog.org/wp-content/uploads/F2.large-20-300x286.jpg" alt="Figure 2 from paper" width="300" height="286" srcset="https://www.ajnrblog.org/wp-content/uploads/F2.large-20-300x286.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/F2.large-20-150x143.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/F2.large-20-630x600.jpg 630w, https://www.ajnrblog.org/wp-content/uploads/F2.large-20.jpg 1280w" sizes="auto, (max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-13491" class="wp-caption-text">Representative images from a patient who died 2.12 years after the end of CRT. Axial T2-weighted image (<em>A</em>) demonstrates a heterogeneous hyperintense metastatic left level IIb lymph node (<em>arrow</em>). It appears hypointense on a coregistered T1-weighted image (<em>B</em>) with heterogeneous enhancement on postcontrast T1-weighted image (<em>C</em>). DCE-MRI–derived τi (0.031 seconds; [<em>D</em>]) and K<sup>trans</sup> (0.135 minutes<sup>−1</sup> [<em>E</em>]) maps overlaid on postcontrast T1-weighted images demonstrating lower τi and <em>Ktrans</em> values from the node compared with the patient with longer survival as shown in Fig 1.</figcaption></figure></p> <h3 id="p-3">BACKGROUND AND PURPOSE</h3> <p>Shutter-speed model analysis of dynamic contrast-enhanced MR imaging allows estimation of mean intracellular water molecule lifetime (a measure of cellular energy metabolism) and volume transfer constant (a measure of hemodynamics). The purpose of this study was to investigate the prognostic utility of pretreatment mean intracellular water molecule lifetime and volume transfer constant in predicting overall survival in patients with squamous cell carcinomas of the head and neck and to stratify p16-positive patients based upon survival outcome.</p> </div> <div id="sec-2" class="subsection"> <h3 id="p-4">MATERIALS AND METHODS</h3> <p>A cohort of 60 patients underwent dynamic contrast-enhanced MR imaging before treatment. Median, mean intracellular water molecule lifetime and volume transfer constant values from metastatic nodes were computed from each patient. Kaplan-Meier analyses were performed to associate mean intracellular water molecule lifetime and volume transfer constant and their combination with overall survival for the first 2 years, 5 years, and beyond (median duration, >7 years).</p> </div> <div id="sec-3" class="subsection"> <h3 id="p-5">RESULTS</h3> <div id="sec-3" class="subsection"> <p id="p-6">By the last date of observation, 18 patients had died, and median follow-up for surviving patients (<em>n</em> = 42) was 8.32 years. Patients with high mean intracellular water molecule lifetime (4 deaths) had significantly (<em>P</em> = .01) prolonged overall survival by 5 years compared with those with low mean intracellular water molecule lifetime (13 deaths). Similarly, patients with high mean intracellular water molecule lifetime (4 deaths) had significantly (<em>P</em> = .006) longer overall survival at long-term duration than those with low mean intracellular water molecule lifetime (14 deaths). However, volume transfer constant was a significant predictor for only the 5-year follow-up period. There was some evidence (<em>P</em> < .10) to suggest that mean intracellular water molecule lifetime and volume transfer constant were associated with overall survival for the first 2 years. Patients with high mean intracellular water molecule lifetime and high volume transfer constant were associated with significantly (<em>P</em> < .01) longer overall survival compared with other groups for all follow-up periods. In addition, p16-positive patients with high mean intracellular water molecule lifetime and high volume transfer constant demonstrated a trend toward the longest overall survival.</p> </div> </div> <div id="sec-4" class="subsection"> <h3 id="p-6">CONCLUSIONS</h3> <p>A combined analysis of mean intracellular water molecule lifetime and volume transfer constant provided the best model to predict overall survival in patients with squamous cell carcinomas of the head and neck.</p> </div> <p><strong>Read this article: <a href="http://bit.ly/2DQfyjz">http://bit.ly/2DQfyjz</a></strong></p> ]]></content:encoded> </item> <item> <title>CT Texture Analysis Potentially Predicts Local Failure in Head and Neck Squamous Cell Carcinoma Treated with Chemoradiotherapy</title> <link>https://www.ajnrblog.org/2018/01/07/ct-texture-analysis-potentially-predicts-local-failure-head-neck-squamous-cell-carcinoma-treated-chemoradiotherapy/</link> <dc:creator><![CDATA[jross]]></dc:creator> <pubDate>Sun, 07 Jan 2018 20:30:08 +0000</pubDate> <category><![CDATA[Fellows' Journal Club]]></category> <category><![CDATA[Head and Neck]]></category> <category><![CDATA[Chemoradiotherapy]]></category> <category><![CDATA[squamous cell carcinoma]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=13457</guid> <description><![CDATA[Fellows’ Journal Club This was a retrospective study including 62 patients diagnosed with primary head and neck squamous cellcarcinoma who underwent contrast-enhanced CT examinations for staging, followed by chemoradiotherapy. CT texture features of thewhole primary tumor were measured using an]]></description> <content:encoded><![CDATA[<div class="editor-comment"> <h1>Fellows’ Journal Club</h1> <p>This was a retrospective study including 62 patients diagnosed with primary head and neck squamous cellcarcinoma who underwent contrast-enhanced CT examinations for staging, followed by chemoradiotherapy. CT texture features of thewhole primary tumor were measured using an in-house developed Matlab-based texture analysis program. Histogram, gray-level co-occurrence matrix, gray-level run-length, gray-level gradient matrix, and Laws features were used for texture feature extraction. Three histogram features (geometric mean, harmonic, and fourth moment) and 4 gray-level run-length features (short-run emphasis, gray-level nonuniformity, run-length nonuniformity, and short-run low gray-level emphasis) were significant predictors of outcome.</p> <p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt="" /></p> <p><span id="more-13457"></span></p> </div> <h2 class="signature">Abstract</h2> <div id="sec-1" class="subsection"> <figure id="attachment_13458" aria-describedby="caption-attachment-13458" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F1.large-6-1.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13458" src="http://www.ajnrblog.org/wp-content/uploads/F1.large-6-1-300x300.jpg" alt="Figure 1 from paper" width="300" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/F1.large-6-1-300x300.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/F1.large-6-1-150x150.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/F1.large-6-1-599x600.jpg 599w, https://www.ajnrblog.org/wp-content/uploads/F1.large-6-1-230x230.jpg 230w, https://www.ajnrblog.org/wp-content/uploads/F1.large-6-1-330x330.jpg 330w, https://www.ajnrblog.org/wp-content/uploads/F1.large-6-1-120x120.jpg 120w, https://www.ajnrblog.org/wp-content/uploads/F1.large-6-1.jpg 1798w" sizes="auto, (max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-13458" class="wp-caption-text">Representative axial contrast-enhanced CT images (<em>A</em> and <em>C</em>) and corresponding axial section ROI mask-segmented primary tumor (<em>B</em> and <em>D</em>) for 2 different patients with oropharyngeal squamous cell carcinoma. Segmented tumor is from a 75-year-old man (<em>B</em>) with right tonsil squamous cell carcinoma (HPV-positive; smoking, 0 pack-year; tumor volume, 16.4 mL; clinical T-stage, T4) who developed local failure and a 43-year-old woman (<em>D</em>) with squamous cell carcinoma of the right base of tongue (HPV- positive; smoking, 0 pack-year; tumor volume, 20.6 mL; clinical T-stage, T4) who showed local control. Representative texture features of each patients are as follows; for geometric mean, 973.2 (local failure,<em> B</em>) and 906.6 (local control, <em>D</em>); for harmonic mean, 285.1 (local failure, <em>B</em>) and 210.3 (local control, <em>D</em>); for SRE, 0.026 (local failure, <em>B</em>) and 0.043 (local control, <em>D</em>); for GLN, 0.026 (local failure, <em>B</em>) and 0.042 (local control, <em>D</em>); for RLN, 0.019 (local failure, <em>B</em>) and 0.032 (local control, <em>D</em>); and for SRLGE, 479.1 (local failure, <em>B</em>) and 459.1 (local control, <em>D</em>).</figcaption></figure> <h3 id="p-3">BACKGROUND AND PURPOSE</h3> <p>The accurate prediction of prognosis and failure is crucial for optimizing treatment strategies for patients with cancer. The purpose of this study was to assess the performance of pretreatment CT texture analysis for the prediction of treatment failure in primary head and neck squamous cell carcinoma treated with chemoradiotherapy.</p> <div id="sec-2" class="subsection"> <h3 id="p-4">MATERIALS AND METHODS</h3> <p>This retrospective study included 62 patients diagnosed with primary head and neck squamous cell carcinoma who underwent contrast-enhanced CT examinations for staging, followed by chemoradiotherapy. CT texture features of the whole primary tumor were measured using an in-house developed Matlab-based texture analysis program. Histogram, gray-level co-occurrence matrix, gray-level run-length, gray-level gradient matrix, and Laws features were used for texture feature extraction. Receiver operating characteristic analysis was used to identify the optimal threshold of any significant texture parameter. We used multivariate Cox proportional hazards models to examine the association between the CT texture parameter and local failure, adjusting for age, sex, smoking, primary tumor stage, primary tumor volume, and human papillomavirus status.</p> </div> <div id="sec-3" class="subsection"> <h3 id="p-5">RESULTS</h3> <p>Twenty-two patients (35.5%) developed local failure, and the remaining 40 (64.5%) showed local control. Multivariate analysis revealed that 3 histogram features (geometric mean [hazard ratio = 4.68, <em>P</em> = .026], harmonic mean [hazard ratio = 8.61, <em>P</em> = .004], and fourth moment [hazard ratio = 4.56, <em>P</em> = .048]) and 4 gray-level run-length features (short-run emphasis [hazard ratio = 3.75, <em>P</em> = .044], gray-level nonuniformity [hazard ratio = 5.72, <em>P</em> = .004], run-length nonuniformity [hazard ratio = 4.15, <em>P</em> = .043], and short-run low gray-level emphasis [hazard ratio = 5.94, <em>P</em> = .035]) were significant predictors of outcome after adjusting for clinical variables.</p> </div> <div id="sec-4" class="subsection"> <h3 id="p-6">CONCLUSIONS</h3> <p>Independent primary tumor CT texture analysis parameters are associated with local failure in patients with head and neck squamous cell carcinoma treated with chemoradiotherapy.</p> </div> <p><strong>Read this article: <a href="http://bit.ly/2AyqNK0">http://bit.ly/2AyqNK0</a></strong></p> </div> ]]></content:encoded> </item> <item> <title>The American Society of Head and Neck Radiology Presents 2017 Gold Medal to Edward E. Kassel, M.D., FACR</title> <link>https://www.ajnrblog.org/2017/10/04/american-society-head-neck-radiology-presents-2017-gold-medal-edward-e-kassel-m-d-facr/</link> <comments>https://www.ajnrblog.org/2017/10/04/american-society-head-neck-radiology-presents-2017-gold-medal-edward-e-kassel-m-d-facr/#comments</comments> <dc:creator><![CDATA[kcammarata]]></dc:creator> <pubDate>Wed, 04 Oct 2017 17:02:27 +0000</pubDate> <category><![CDATA[Head and Neck]]></category> <category><![CDATA[Press Release]]></category> <category><![CDATA[radiology]]></category> <guid isPermaLink="false">http://www.ajnrblog.org/?p=13262</guid> <description><![CDATA[PRESS RELEASE The American Society of Head and Neck Radiology Presents 2017 Gold Medal to Edward E. Kassel, M.D., FACR during 51st Annual Meeting The American Society of Head and Neck Radiology (ASHNR) awarded its 2017 Gold Medal to Edward E. Kassel,]]></description> <content:encoded><![CDATA[<p style="text-align: center;"><a href="http://www.ajnrblog.org/wp-content/uploads/logo-1.jpg"><img loading="lazy" decoding="async" class="aligncenter size-medium wp-image-13264" src="http://www.ajnrblog.org/wp-content/uploads/logo-1-300x106.jpg" alt="logo" width="300" height="106" srcset="https://www.ajnrblog.org/wp-content/uploads/logo-1-300x106.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/logo-1-150x53.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/logo-1.jpg 442w" sizes="auto, (max-width: 300px) 100vw, 300px" /></a><br /> <strong>PRESS RELEASE</strong></p> <p style="text-align: center;"><strong>The American Society of Head and Neck Radiology </strong><strong>Presents 2017 Gold Medal to Edward E. Kassel, M.D., FACR during 51<sup>st </sup>Annual Meeting</strong></p> <figure id="attachment_13263" aria-describedby="caption-attachment-13263" style="width: 225px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/Gold-Medal-Photo-Kassel-2-e1507135908526.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13263" src="http://www.ajnrblog.org/wp-content/uploads/Gold-Medal-Photo-Kassel-2-e1507135908526-225x300.jpg" alt="Edward E. Kassel, M.D., FACR" width="225" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/Gold-Medal-Photo-Kassel-2-e1507135908526-225x300.jpg 225w, https://www.ajnrblog.org/wp-content/uploads/Gold-Medal-Photo-Kassel-2-e1507135908526-113x150.jpg 113w, https://www.ajnrblog.org/wp-content/uploads/Gold-Medal-Photo-Kassel-2-e1507135908526-450x600.jpg 450w" sizes="auto, (max-width: 225px) 100vw, 225px" /></a><figcaption id="caption-attachment-13263" class="wp-caption-text">Edward E. Kassel, M.D., FACR</figcaption></figure> <p>The American Society of Head and Neck Radiology (ASHNR) awarded its 2017 Gold Medal to <strong>Edward E. Kassel, M.D., FACR</strong> during the Gold Medal Award Luncheon on September 18, 2017 during the ASHNR 51<sup>st</sup>Annual Meeting at Caesars Palace in Las Vegas, Nevada, September 16-20, 2017.</p> <p>The ASHNR Gold Medal is presented annually to a member who has provided dedicated service to the Society, and to the science and education of head and neck radiology. Dr. Kassel became the twenty-first recipient of the ASHNR Gold Medal since the Awards inception in 2000.</p> <p>Dr. Kassel obtained his DDS from the University of Toronto’s Faculty of Dentistry and his MD at the University of Western Ontario. He completed his post-graduate training in Medical Imaging at U of T in 1977. He was an attending neuroradiologist at Sunnybrook Health Sciences Centre (1977- 1992), Radiologist-in-Chief at Mount Sinai Hospital (1992-1996) and the attending neuroradiologist in the University Health Network/Mount Sinai Hospital Joint Department of Medical Imaging (1997-2014). Dr. Kassel served as 2008-2009 ASHNR President.</p> <p>For more information on the ASHNR Gold Medal, or the Society in general, contact Business Manager Ken Cammarata at ASHNR, 800 Enterprise Drive, Suite 205, Oak Brook, IL 60523-4216, Phone: 630-574-0220, ext. 226, Fax: 630-574-0661, Email: <a href="mailto:kcammarata@asnr.org">kcammarata@asnr.org</a>, Website: <a href="http://www.ashnr.org">www.ashnr.org</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.ajnrblog.org/2017/10/04/american-society-head-neck-radiology-presents-2017-gold-medal-edward-e-kassel-m-d-facr/feed/</wfw:commentRss> <slash:comments>2</slash:comments> </item> </channel> </rss>