Dr. Omid Nikoubashman Announced as 2016 Lucien Appel Laureate

Dr. Omid

Omid Nikoubashman recently received the Lucien Appel Prize for best research paper from the European Society of Neuroradiology Scientific Awards Committee. This honor was presented for his article “Prospective Hemorrhage Rates of Cerebral Cavernous Malformations in Children and Adolescents Based on MRI Appearance,” which appeared in the November 2015 issue of the American Journal of Neuroradiology.

Seven neuroradiologists comprised the ESNR Scientific Awards Committee, which evaluated submitted papers and determined the recipients of each prize. The members of this committee were Nadine Girard (France), Sven Haller (Switzerland), Marco Leonardi (Italy), Per Nakstad (Norway), Isil Saatci (Turkey), Joanna Wardlaw (UK), and Chairman Rüdiger von Kummer (Germany). Members based their ratings of each submission on the following criteria: 1) publication in a high-ranking scientific journal, 2) scientific integrity, 3) advances in knowledge, and 4) implications for patient care. Dr. Nikoubashman’s paper was among 5 submissions considered for the Lucien Appel Prize, and the committee’s decision was unanimous.

Click here to read Dr. Nikoubashman’s award-winning article.

More on the 2016 Lucien Appel Prize Recipient:

Dr. Omid Nikoubashman was born in Tehran, Iran in 1983. He studied Human Medicine in cities such as Düsseldorf, Paris, and London. After completing his education in 2010, he began his residency in the Department of Diagnostic and Interventional Neuroradiology at the University Hospital Aachen. He also spent a year in the institution’s Department of Neurology. Since 2014, he has served as a research fellow at the Institute of Neuroscience and Medicine (medical imaging) at Forschungszentrum Jülich GmbH, Jülich, Germany. He earned his doctorate degree in 2013 upon the completion of his thesis, “Natural History of Cerebral Cavernous Angiomas in the Paediatric Age Group.” The German Society of Neuroradiology previously awarded Dr. Nikoubashman the Marc-Dünzel Award. He has authored and co-authored 33 peer-reviewed articles in the field of …

Foundation of ASNR Grant Announcements: Awards and Deadlines

FASNR Logo

The Foundation of the ASNR is pleased to announce that we will be utilizing FluidReview, a grant management software system, for the application and review of its upcoming grant awards. The FluidReview software will streamline the LOI, application and review processes. Our FluidReview website is now open for registration. Please visit http://www.asnr.fluidreview.com/ and register for a free account if you plan on submitting an application for the following grants:

LOI deadline has passed. Application deadline Monday, Jan. 18, 9:00 am CST

  • Comparative Effectiveness Research Award
  • Scholar Award in Neuroradiology Research
  • Research Scientist Award in Neuroradiology

No LOI Required. Applications must be received by 9:00 AM CST, January 31, 2017. (Budgets that exceed $100,000 require pre-approval by the Chairs of the Research Committee prior to submission.) Please submit to Rahul Bhala, Director of Economics & Health Policy at rbhala@asnr.org.

  • Alzheimer’s Imaging Research Award

Please feel free to contact Rahul Bhala, Director of Economics & Health Policy at rbhala@asnr.org with any questions or comments. We look forward to your submissions.

 

Second Round of Alzheimer’s Grant Funding

On behalf of the Foundation of the ASNR, we are delighted to announce the second round of a funding opportunity made possible by a generous donor committed to supporting imaging research in Alzheimer’s disease and dementia.

Grant submissions are due January 31, 2017 at 9:00 AM CST.

The goal of this program is to translate the novel imaging research into strategies that will increase understanding of the mechanism of Alzheimer’s disease and help stratify populations and possible treatments. All proposals must have a clear focus on Alzheimer’s disease and may also include other neurodegenerative diseases. Submissions from collaborative research that have experience across aging and neurodegenerative diseases are strongly encouraged. Novel and creative ideas are sought from investigators at any career stage.

The ASNR …

Cervical Spinal Cord DTI Is Improved by Reduced FOV with Specific Balance between the Number of Diffusion Gradient Directions and Averages

Fellows’ Journal Club

The authors evaluated multiple parameters of reduced-FOV DTI to optimize image quality. Fifteen healthy individuals underwent cervical spinal cord 3T MRI, including an anatomic 3D Multi-Echo Recombined Gradient Echo, high-resolution full-FOV DTI with a NEX of 3 and 20 diffusion gradient directions, and 5 sets of reduced-FOV DTIs differently balanced in terms of NEX/number of diffusion gradient directions. Qualitatively, reduced-FOV DTI sequences with a NEX of >5 were significantly better rated than the full-FOV DTI and the reduced-FOV DTI with low NEX (N=3) and a high number of diffusion gradient directions (D=20). Quantitatively, the best trade-off was reached by the reduced-FOV DTI with a NEX of 9 and 9 diffusion gradient directions. They conclude that the best compromise was obtained with a NEX of 9 and 9 diffusion gradient directions, which emphasizes the need for increasing the NEX at the expense of the number of diffusion gradient directions for spinal cord DTI, unlike brain imaging.

Abstract

Figure 2 from paper
Examples of MR images available for qualitative analysis. All the images came from the same subject. Cervical levels are located on 3D T2-MERGE and sagittal T2-spin echo. Fusion of FA − 3D MERGE clearly shows that f-FOV DTI and r-FOV 3N/20D are more distorted and more blurred with less anatomic precision than the other r-FOV images.

BACKGROUND AND PURPOSE

Reduced-FOV DTI is promising for exploring the cervical spinal cord, but the optimal set of parameters needs to be clarified. We hypothesized that the number of excitations should be favored over the number of diffusion gradient directions regarding the strong orientation of the cord in a single rostrocaudal axis.

MATERIALS AND METHODS

Fifteen healthy individuals underwent cervical spinal cord MR imaging at 3T, including an anatomic 3D-Multi-Echo Recombined Gradient Echo, high-resolution full-FOV DTI with a NEX of 3 and 20 diffusion gradient

Mechanical Thrombectomy in Patients with Acute Ischemic Stroke and Lower NIHSS Scores: Recanalization Rates, Periprocedural Complications, and Clinical Outcome

Editor’s Choice

This is a retrospective analysis of 484 patients in a prospectively collected stroke data base. The inclusion criteria were anterior circulation ischemic stroke treated with mechanical thrombectomy at a single institution between September 2010 and October 2015 with an NIHSS score of ≤8. The purpose was to assess the clinical and interventional data in patients treated with mechanical thrombectomy in case of ischemic stroke with mild-to-moderate symptoms (n = 33). Recanalization (TICI 2b–3) was achieved in 26 (78.7%) patients. Two cases of symptomatic intracranial hemorrhage occurred. Favorable (mRS 0–2) and moderate (mRS 0–3) clinical 90-day outcome was achieved in 63.6% and 90.9% of patients, respectively. The authors conclude that the clinical outcome of patients undergoing mechanical thrombectomy for acute ischemic mild stroke due to large-vessel occlusion is predominately favorable, even in a prolonged time window.

RadCases: Head and Neck Imaging

Shah G, Wesolowski J, Choi J, Friedman ER. RadCases: Head and Neck Imaging. Thieme; 2016; 224 pp; 441 ill; $59.99

Cover of Shah

RadCases: Head and Neck Imaging features a nice series of 100 cases that illustrates both relatively common and challenging head and neck abnormalities; these cases are supplemented with additional material (150 cases), which is accessible through a scratch-off code that readers can enter into the Thieme website. These extra 150 cases provide an excellent self-quiz.

The print version shows each unknown with its history and, on the overleaf, the diagnosis is stated, the images are reproduced and labeled, and a differential diagnosis is provided, along with what are called “essential facts,” other potential and associated imaging findings, and “pearls and pitfalls.” These 100 cases and the 150 online are well chosen; however, it would have been worthwhile to include additional postoperative neck scans (along with the PET scanning). It also might have been valuable to have included more cases in which the findings were not so blatant. As we all know, the major challenge is finding or identifying lesions, not necessarily giving a differential diagnosis. For the online cases, the ability to go from images, to image annotations, to differential diagnoses, to key points makes learning efficient. This book serves as a refresher that helps one sharpen diagnostic abilities in head and neck imaging.

Side note: When some minor difficulty was encountered in accessing these web-based images, Thieme was contacted directly, and its representatives were immediately responsive and helpful in their assistance. This should be reassuring to those who purchase Thieme publications that have a web link to extra material.…

Imaging Features of Malignant Lacrimal Sac and Nasolacrimal Duct Tumors

Fellows’ Journal Club

This case series presents 18 patients with primary and secondary malignant lacrimal sac and nasolacrimal duct tumors and their pattern of tumor spread. Squamous cell carcinoma was the most common histology and, in 15/18 patients tumor involved both the lacrimal sac and duct at the time of diagnosis. In 11/16 patients on CT, the nasolacrimal bony canal was smoothly expanded without erosive changes. Tumor was not observed solely within the nasolacrimal duct in any patient. Only 1 patient presented with nodal metastasis and there was no intracranial tumor extension or perineural tumor spread. The authors conclude that malignant lacrimal sac and nasolacrimal duct tumors tend to expand the nasolacrimal bony canal, rather than erode it. CT was superior to MR imaging in characterizing expansion versus erosion of the nasolacrimal bony canal.

Summary

Figure 5 from paper
A 73-year-old woman with well-differentiated SCCA of the lacrimal sac and nasolacrimal duct. A, Post-contrast-enhanced CT demonstrates an enhancing tumor within the left lacrimal sac (arrow). B, At a slightly more inferior level (bone window), note the mild expansion of the lacrimal bony canal by tumor (arrow).

The purpose of this study was to present the imaging features of primary and secondary malignant lacrimal sac and nasolacrimal duct tumors and their pattern of tumor spread in 18 patients. The most common tumor histology in our series was squamous cell carcinoma. In 15/18 patients, tumor involved both the lacrimal sac and duct at the time of diagnosis. In 11/16 patients on CT, the nasolacrimal bony canal was smoothly expanded without erosive changes. The medial canthus region (16/18) was a frequent site of direct tumor spread. Two patients had intraconal orbital spread of tumor. Tumor spread to the sinus or nasal cavity was observed in 5/13 primary tumors. Only 1 patient presented with nodal metastasis. There was

Comparison of CTA- and DSA-Based Collateral Flow Assessment in Patients with Anterior Circulation Stroke

Editor’s Choice

The authors set out to determine the agreement between collateral flow assessment on CTA and DSA and their respective associations with clinical outcome. They used patient data that was randomized in MR CLEAN with middle cerebral artery occlusion and both baseline CTA images and complete DSA runs. Collateral flow on CTA and DSA was graded 0 (absent) to 3 (good).Of 45 patients with evaluable imaging data, collateral flow was graded on CTA as 0, 1, 2, 3 for 3, 10, 20, and 12 patients, respectively, and on DSA for 12, 17, 10, and 6 patients, respectively. The adjusted odds ratio for favorable outcome on mRS was 2.27 and 1.29 for CTA and DSA, respectively. The relationship between the dichotomized collateral score and mRS 0–2 was significant for CTA, but not for DSA. They conclude that the commonly applied collateral flow assessment on CTA and DSA showed large differences and that these techniques are not interchangeable. CTA was significantly associated with mRS at 90 days, whereas DSA was not.

Neurosurgery Practice Questions and Answers, 2nd Edition

Shaya MR, Gragnaniello C, Nader R. Neurosurgery Practice Questions and Answers. 2nd ed. Thieme; 2016; 256 pp; 150 ill; $59.99

Cover of Shaya

In this 256-page, softcover publication, there are 805 multiple choice questions, followed by the answers to each question. There are a considerable number of imaging studies, each followed by a question that requires an understanding of the imaging/diagnosis and the surgical possibilies associated with each. Actually, the questions pose interesting dilemmas in choosing the correct answer. Of course, many questions involve issues that do not directly touch on neuroradiology, but it is surprising how many do. This book is clearly written for and recommended for housestaff in neurosurgery; however, if you know someone who has the book, try testing yourself. These brief questions are significantly educational.…

Vitamin D and Vulnerable Carotid Plaque

Fellows’ Journal Club

Angiotensin II stimulates intraplaque hemorrhage in animal models, and the angiotensin system is highly regulated by vitamin D. The authors’ purpose was to determine whether low vitamin D levels predict carotid intraplaque hemorrhage (IPH). In this cross-sectional study, 65 patients with carotid disease underwent carotid MR imaging and blood draw. Systemic clinical confounders and local lumen imaging markers were recorded. They performed multivariable Poisson regression by using generalized estimating equations to account for up to 2 carotid arteries per patient and backward elimination of confounders. The authors found that low vitamin D levels (<30 ng/mL) were a significant predictor of MRI-detected IPH, along with plaque thickness. They conclude that vitamin D insufficiency was associated with both the presence and volume of carotid IPH in patients with carotid atherosclerosis and that these results link low vitamin D levels with plaque vulnerability.

Abstract

Figure 5 from text
Vitamin D supplementation and follow-up. A, Patient 1: Baseline (upper arrow) versus 1-year follow-up (lower arrow) with vitamin D supplementation and medical therapy, including statins and antiplatelet and antihypertensive medications, demonstrates decreased IPH volume in a patient with no interval stroke (vitamin D baseline/1 year: 18.1/26.8 ng/mL; carotid IPH baseline/1 year: 0.151/0.115 cm3, or 24.1% decreased IPH volume). The patient remained asymptomatic in the year between the 2 scans. B, Patient 2: Baseline (upper arrow) versus 1-year follow-up (lower arrow) without vitamin D supplementation but with medical therapy, including statins and antiplatelet and antihypertensive medications, demonstrates minimally changed IPH volume (vitamin D baseline/1 year: 20.9/10.7 ng/mL; carotid IPH baseline/1 year: 1.041/0.996 cm3, or 4.3% decreased IPH volume). In addition, this patient had bilateral strokes in the year between the 2 scans.

BACKGROUND AND PURPOSE

MR imaging–detected carotid intraplaque hemorrhage indicates vulnerable plaque with high stroke risk. Angiotensin II stimulates intraplaque hemorrhage in animal models, and the angiotensin system is highly regulated by vitamin D. Our purpose was to determine whether low vitamin D levels predict carotid intraplaque hemorrhage in humans.

MATERIALS AND METHODS

In this cross-sectional study, 65 patients with carotid disease underwent carotid MR imaging and blood draw. Systemic clinical confounders

Early Biomarkers from Conventional and Delayed-Contrast MRI to Predict the Response to Bevacizumab in Recurrent High-Grade Gliomas

Editor’s Choice

Twenty-four patients with recurrent high-grade gliomas were scanned before and during bevacizumab treatment with standard and delayed-contrast MRI. The mean change in lesion volumes of responders (overall survival, 1 year) and nonresponders (overall survival, <1 year) was evaluated. Treatment-response-assessment maps (TRAMs) were calculated by subtracting conventional T1WI (acquired a few minutes postcontrast) from delayed T1WI (acquired with a delay of 1 hour postcontrast). These maps depict the spatial distribution of contrast accumulation and clearance. At progression, the increase in lesion volumes in delayed-contrast MR imaging was 37.5% higher than the increase in conventional T1WI. The authors conclude that the benefit of standard and delayed-contrast MRI for assessing and predicting the response to bevacizumab was demonstrated and that the increased sensitivity of delayed-contrast MRI reflects its potential contribution to the management of bevacizumab-treated patients with recurrent HGG.