Author Archives: Editorial Office


About Editorial Office (@TheAJNR)

The American Journal of Neuroradiology (AJNR) publishes original articles pertaining to the clinical imaging, therapy, and basic science of the central and peripheral nervous system, including but not limited to the brain, spine, head and neck, interventional procedures, techniques in imaging and intervention, and related educational, socioeconomic, and medicolegal issues.

AJNR Welcomes New Statistical Senior Editor

Bryan Comstock, MS

Bryan Comstock, MS

The AJNR would like to welcome Bryan Comstock, MS, who joined us as our first Statistical Senior Editor on October 1. Manuscripts submitted to AJNR now undergo separate statistical review, during which they are assessed for the statistical validity of their findings and for study design. We hope this added level of scrutiny will further improve the quality of papers we publish and also help authors to revise and refine their work during review.

Bryan is Senior Biostatistician at the Center for Biomedical Statistics at the University of Washington in Seattle, where he develops and supports grant applications for extramural funding in the areas of health services research, radiology, neonatology, nephrology, and surgery. He has served as the primary biostatistician for numerous randomized clinical trials and observational cohort studies and has developed electronic data capture systems for multisite randomized studies. He is a member of the Society of Clinical Trials and the co-author of more than 50 peer-reviewed articles indexed on MEDLINE.… Continue reading >>

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In Memoriam – Georges Salamon

salamon_obitGeorges Salamon, one of neuroradiology’s pioneers, early thought leaders, and international spokesmen died on October 10, 2015, at age 84. Born in Montpellier, France to a Russian father and a Polish mother of Jewish descent, he acutely experienced the traumas of World War II, but kept throughout his life a unique, optimistic spirit of adventure. Knowing the costs and benefits of the vicissitudes of life, Georges maintained an exceptional open-mindedness and a zest for change and new opportunities.

Receiving his Doctor of Medicine from the Faculty of Aix-Marseille in 1958, he was spurred into specialty training by his teachers, Herman Fischgold, Henri Gastaut, and Robert Naquet, graduating in radiology in 1962 and neurology in 1965. This dual experience in imaging and neuroscience provided the stimulus for Georges to enter the nascent field of Neuroradiology and the basis of a prestigious career bridging these disciplines. Post training, Georges quickly joined the Hôpital de la Timone in that “considerable town,” Marseille, first as assistant professor in 1964, and then as head of the Department of Neuroradiology from 1972 to 1996.

Though broadly curious and an eclectic thinker, Georges’ first scientific love was neuroanatomy. Between 1965 and 1970 his students’ numerous theses on cerebral vasculature formed the basis of and culminated in the publication of the Atlas of Arteries of the Human Brain in 1974, of Radiologic Anatomy of the Brain in collaboration with Y.P. Huang in 1978, and Vascularization and Cerebral Circulation with G. Lazorthes and A. Gill that same year. This work became the anatomic bible for a whole generation of neuroradiologists and neurosurgeons. It also served as a basis for the subsequent development of therapeutic angiography and the emergence in France of a new generation of vascular neuroradiologists under the joint stimulus of Georges Salamon and René Djindjian.

The cross-sectional … Continue reading >>

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Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI

Fellows’ Journal Club Editor’s Comments

This is a retrospective study that included 54 patients with a cystic pituitary adenoma and 28 patients with a Rathke cleft cyst who underwent MR imaging followed by surgery. Regression analysis showed that cystic pituitary adenomas and Rathke cleft cysts could be distinguished on the basis of the presence of a fluid-fluid level, septation, an off-midline location, and the presence of an intracystic nodule.

Diagnostic decision tree for the differentiation of cystic pituitary adenomas and RCCs using MR imaging.

Diagnostic decision tree for the differentiation of cystic pituitary adenomas and RCCs using MR imaging.


Cystic pituitary adenomas may mimic Rathke cleft cysts when there is no solid enhancing component found on MR imaging, and preoperative differentiation may enable a more appropriate selection of treatment strategies. We investigated the diagnostic potential of MR imaging features to differentiate cystic pituitary adenomas from Rathke cleft cysts and to develop a diagnostic model.


This retrospective study included 54 patients with a cystic pituitary adenoma (40 women; mean age, 37.7 years) and 28 with a Rathke cleft cyst (18 women; mean age, 31.5 years) who underwent MR imaging followed by surgery. The following imaging features were assessed: the presence or absence of a fluid-fluid level, a hypointense rim on T2-weighted images, septation, an off-midline location, the presence or absence of an intracystic nodule, size change, and signal change. On the basis of the results of logistic regression analysis, a diagnostic tree model was developed to differentiate between cystic pituitary adenomas and Rathke cleft cysts. External validation was performed for an additional 16 patients with a cystic pituitary adenoma and 8 patients with a Rathke cleft cyst.


The presence of a fluid-fluid level, a hypointense rim on T2-weighted images, septation, and an off-midline location were more common with pituitary adenomas, whereas the presence of an intracystic nodule was

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AJNR Teams with Publons to Give Credit for Peer Review

alternativeThe American Journal of Neuroradiology is pleased to announce its new partnership with Publons. The Journal joins more than 100 other publications that are rewarding their reviewers through this innovative system that offers greater recognition for peer review. AJNR reviewers who opt-in to Publons will be able to make use of its features for peer reviewers, including tools to export their verified review activity to their resumé, stats and graphs to show their reviewing characteristics compared with others in their field, and the ability to link their Publons review record to their ORCID.

Editor-in-Chief Jeffrey S. Ross, who initiated the partnership, hopes reviewers will benefit from this acknowledgment of their invaluable contributions:

The reviewers of the AJNR are an amazing group of individuals who selflessly give of their precious time, knowledge, and experience to validate and improve each manuscript. Daily, I have had the privilege of seeing the wisdom of reviewers’ comments integrated into manuscript revisions to ultimately improve the science that we publish. While we cannot reward reviewers adequately for their efforts, we would like to make it easier for reviewers to track and catalog their reviewing history across all the journals to which they contribute. Towards that end, the AJNR has partnered with Publons as a method of getting credit for, and keeping track of your reviews.

Early results from the more than 100 journals that have joined the Publons platform have shown giving credit for peer review leads to more motivated reviewers and better reviews. For more infomation and details on how the partnership works, see the AJNR-Publons landing page.… Continue reading >>

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ASNR 2016 Abstract Submission Site Is Now Open

asnr2016The abstract submission site for the ASNR 54th Annual Meeting at the Washington Marriott Wardman Park to be held on May 21-26, 2016 is now open at:


Note:  The Submission Site has changed; we recommend prior review before submitting.

Reminders… All authors must disclose. For submitted abstracts to be finalized, all primary and co-authors must complete online disclosure process to be considered for presentation for ASNR 2016. Author changes will not be allowed after the submission deadline Friday, December 11, 2015. All correspondence (including the notification) will be sent via email to the primary/presenting author. Any notification emails from the abstract system will be labeled as being from We suggest you add this email to your safe sender list.

The 2015 Annual Meeting was a success with over 2000 attendees and a record number of submitted research abstracts; let’s keep that momentum and make our 2016 meeting another memorable year.

For more details about the ASNR 2016 Annual Meeting and The Foundation of the ASNR Symposium 2016: Emergency Neuroradiology, please visit:… Continue reading >>

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ICYMI: September-October 2015 News Digest on the Clinical Applications of Arterial Spin-Labeling

Guest Editor

Karl-Olof Lövblad

Geneva University Hospitals, Neurodiagnostic and Neurointerventional Service, Geneva, Switzerland


socialThis edition focuses on clinical applications of arterial spin-labeling (ASL). ASL has been available for a number of years, with little initial fanfare despite its potential to map cerebral blood flow without the need for a contrast agent. Recently, however, ASL has been the subject of resurgent enthusiasm, spurred in part by technological advancements such as clinical 3T scanners and faster imaging techniques that overcame early limitations preventing the acquisition of more than a single section. Since its re-emergence, ASL has been used in the clinical assessment of epilepsy, dementia, stroke, and brain tumors, and has promise where perfusion techniques are required and contrast is not indicated or possible. Five authors discuss their research into various applications of ASL.

Read the full introduction …

Featured Authors Kristen W. Yeom

Arterial Spin-Labeled Perfusion of Pediatric Brain Tumors

Hydrocephalus Decreases Arterial Spin-Labeled Cerebral Perfusion

Whitney B. Pope

Perfusion Deficits Detected by Arterial Spin-Labeling in Patients with TIA with Negative Diffusion and Vascular Imaging

Toshinori Hirai

Quantitative Blood Flow Measurements in Gliomas Using Arterial Spin-Labeling at 3T: Intermodality Agreement and Inter- and Intraobserver Reproducibility Study

Tae Jin Yun

Clinical Utility of Arterial Spin-Labeling as a Confirmatory Test for Suspected Brain Death

Robert Goetti

Quantitative Cerebral Perfusion Imaging in Children and Young Adults with Moyamoya Disease: Comparison of Arterial Spin-Labeling–MRI and H2[15O]-PETContinue reading >>

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Fellows’ Journal Club Recap: Provocative Discography and Lumbar Injury

Review by: Dr. James Fernandez and Dr. Sepand Salehian

Click to listen to the accompanying podcast (discussion of this article begins at 19:15)
A group of 75 asymptomatic or minimally symptomatic for low back pain were enrolled in a study for provocative discography involving L3-S1 disc spaces.  The subjects were recruited from one of three patient pools: those having documented cervical disease, subjects with previous lumbar disc herniation with complete symptom resolution, and subjects with no history of cervical or lumbar disc illness but with a history of somatization disorder.  Another 75 matched subjects from the same subject pools who did not have discography performed were utilized as control subjects.

After the 75 subjects underwent discography, both groups were followed for up to 10 years. Primary outcomes measured were any reported imaging or surgical intervention; and secondary outcomes measured any low back pain events occurring 6 months prior to the interview, serious low back pain episodes, disability due to back pain, or medical visits for evaluation and treatment of back pain.

In terms of primary outcome measures, as defined by this study, the results were reported as follows:

By 10-years follow-up, there were 16 lumbar surgeries performed in 11 subjects in the discography group and 4 surgeries in 3 subjects in the control group; resulting in a number needed to harm value (NNH value) of 7.3.

At 10 years after enrollment, 21 discography subjects and 11 control subjects had new CT or MRI evaluations for the clinical evaluation of low back pain and/or lower extremity radiculopathy. Based on these data, the number needed to harm (NNH) for 12 provocative lumbar discography with respect to new lumbar imaging is 6.2.

In reading this paper, we reached the following conclusions:

  1. The aggregate of those patients who have undergone provocative discography incur
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In Memoriam – William W.M. Lo, MD

by John L. Go, MD

William W.M. Lo, MD passed away on July 16, 2015 after a long illness peacefully surrounded by his family at home. Known as Bill by his friends and colleagues, he was born August 24, 1934 in Hong Kong. Attending the University of Iowa Medical School, he graduated in 1960, and completed radiology residency as well as fellowships in cardiovascular radiology and neuroradiology at the Los Angeles County-University of Southern California Medical Center from 1961-1966. His first and only job was as a radiologist at St. Vincent Medical Center from 1966-2005, where he served as Chief of Neuroradiology from 1983-1986 and 1989-2005, serving as chair of Radiology from 1986-1989. Bill also served as Clinical Professor of Radiology at the Keck School of Medicine at the University of Southern California from 1989 to 2015.

Bill joined St. Vincent Medical Center to work with the Otologists at the world famous House Ear Clinic where he developed a successful and fruitful collaborative relationship for over 40 years during the Golden Age of Radiology. A world expert on temporal bone imaging, Bill published over 50 peer-review articles on the temporal bone, 18 book chapters, and gave over 150 national and international invited lectures during his career. Some of his major contributions to temporal bone imaging include describing the aberrant carotid artery, descriptions of the endolymphatic duct and sac and pathology, and defining and describing pathology of the anterior epitympanic space, just to name a few, besides beautiful and descriptive pictorials of temporal bone anatomy. Because of his seminal work on temporal bone imaging, Bill was honored with the ASHNR Gold Medal Award in 2007 as well as a Presidential Citation Award from the American Otological Society in 2007.

Bill was also active in the radiology community, being elected as a … Continue reading >>

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ICYMI: July-August 2015 News Digest: Fetal Neuroimaging

Guest Editors

Thierry A.G.M Huisman and Andrea Poretti

Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA


socialIn recent years, significant and continuous development of fetal MR imaging has revolutionized prenatal diagnosis of congenital and acquired brain abnormalities. Procedures that were once time-consuming and placed the mother and fetus at some risk have been made safer and more convenient thanks to developments such as ultrafast MR sequences, which are capable of producing high-resolution anatomic and functional images of the fetus. Furthermore, when ultrasonography (US) — still the primary imaging modality for studying the fetal brain — cannot provide a sufficiently detailed evaluation, fetal brain MRI has emerged as a crucial tool for confirming, correcting, and completing diagnoses made via US of complex pathologies in the fetal CNS. In this edition, 5 authors discuss their research.

Read the full introduction . . .

Commenting Authors

 … Continue reading >>

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Differential Diagnosis in Musculoskeletal MRI

differential-dx-mskltl-mri_HollenbergHollenberg GM, Weinberg EP, Meyers SP. Differential Diagnosis in Musculoskeletal MRI. Thieme; 2015; 676 pp; $199.99

Differential Diagnosis in Musculoskeletal MRI was written with the goal of providing a simple reference book on the various pathologies encountered in a musculoskeletal radiology practice through an image-rich presentation of disease states and injuries. In this aim, the authors have succeeded, and should be applauded for the breadth of topics they were able to cover. The book is about 676 pages in length, but because the text is focused and organized into tables and the figures occupy many full pages, the volume reads much quicker than a standard text of similar size. The authors have organized the material into 12 chapters, with the first half of the book devoted to joint imaging (shoulder, elbow, wrist, hand, hip, knee, ankle, and foot), and the second half covering bone and soft tissue tumors and tumor-like conditions. Unfortunately for readers of this journal, there is no dedicated spine chapter, although spine MRI examples play a prominent role in the illustration of hematopoietic disorders/red marrow conversion.

The focus of this book is really on MRI findings—there is little detail on clinical presentation or considerations of surgical management. Radiographs and CT are infrequently depicted, except in the chapter on bone tumors. Some readers may feel that the images are too small in some cases to optimally highlight the intended pathology, and in certain instances the educational value might have been enhanced by more robust cropping (eg, depictions of superior labral tears and “turf toe” injuries. However, because this book is primarily aimed at trainees, providing enough surrounding anatomy is important so that the scale of the abnormality (often miniscule in MSK) is properly appreciated.

The joint chapters are straightforward in terms of organization and depiction of pathology. The … Continue reading >>

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