Imaging approach to ingested foreign bodies in the neckPoésy, Serena; Sakai, Osamu; Andreu-Arasa, V. Carlota
doi: 10.1007/s00234-024-03348-5pmid: 38619570
Foreign body ingestion is a common clinical occurrence worldwide, with high morbidity in the pediatric population and in adult patients with intentional attempts. Coins and button battery ingestions are more common among children. Bone impaction and swallowed dentures are usually seen in older adults. While most ingested foreign bodies pass through the gastrointestinal tract spontaneously with no complications, some require endoscopic and/or surgical intervention. Complications such as pharyngoesophageal ulceration, perforation, stricture, and deep neck infection can develop without timely diagnosis and management. The purpose of this article is to familiarize radiologists with the imaging approach to assess for characteristics and impacted locations of ingested foreign bodies in the neck.
CT and MR anatomy of the larynx and hypopharynxRavanelli, Marco; Rondi, Paolo; Ferrari, Marco; Lancini, Davide; Buffoli, Barbara; Borghesi, Andrea; Maroldi, Roberto; Farina, Davide
doi: 10.1007/s00234-024-03320-3pmid: 38418594
Imaging of the larynx and hypopharynx is frequently requested to assess the extent of neoplasms beyond the field of view of endoscopic evaluation. The combination of optical and cross-sectional imaging allows tumors to be classified according to AJCC/UICC guidelines. A thorough understanding of laryngeal and hypopharyngeal anatomy is crucial to guide the radiological eye along the possible pathways of the spread of diseases and to guide differential diagnoses. Computed tomography (CT) has been the first cross-sectional imaging technique used to evaluate the larynx and hypopharynx; its spatial resolution combined with volumetric capability and the use of injectable contrast medium made CT the working horse in the assessment of neoplastic and inflammatory diseases. In the last two decades, magnetic resonance (MR) supported CT in the most challenging cases, when the optimal contrast resolution due to the multisequence portfolio is needed to assess the neoplastic involvement of laryngeal cartilages, paraglottic space(s), and extra laryngeal spread. The aim of this paper is to give a comprehensive radiological overview of larynx and hypopharynx complex anatomy, combining in vivo images, anatomical sections, and images of ex vivo specimens.
Analysis of the initial orbital MRI in aquaporin-4 antibody-positive optic neuritis (AQP4-ON): lesion location and lesion length can be predictive of visual prognosisShaw, Hanyu; Feng, Chaoyi; Qi, Meng; Deng, Yalan; Chen, Wei; Zhang, Yiyin; Wang, Luxi; Lin, Naier; Tian, Guohong; Sha, Yan
doi: 10.1007/s00234-024-03306-1pmid: 38358511
PurposeDespite mounting evidence indicating that aquaporin-4 antibody-positive optic neuritis (AQP4-ON) presents a less favorable prognosis than other types of optic neuritis, there exists substantial heterogeneity in the prognostic outcomes within the AQP4-ON cohort. Considering the persistent debate over the role of MRI in assessing the prognosis of optic neuritis, we aim to investigate the correlation between the MRI appearance and long-term visual prognosis in AQP4-ON patients.MethodsWe retrospectively reviewed the ophthalmological and imaging data of AQP4-ON patients admitted to our Neuro-ophthalmology Department from January 2015 to March 2018, with consecutive follow-up visits for a minimum of 3 years.ResultsA total of 51 AQP4-ON patients (59 eyes) meeting the criteria were enrolled in this research. After assessing the initial orbital MR images of each patient at the first onset, we observed the involvement of the canalicular segment (p < 0.001), intracranial segment (p = 0.004), optic chiasm (p = 0.009), and the presence of LEON (p = 0.002) were significantly different between recovery group and impairment group. For quantitative measurement, the length of the lesions is significantly higher in the impairment group (20.1 ± 9.3 mm) than in the recovery group (12.5 ± 5.3 mm) (p = 0.001).ConclusionAQP4-ON patients with involvement of canalicular, intracranial segment and optic chiasm of the optic nerve, and the longer range of lesions threaten worse vision prognoses. Timely MR examination during the initial acute phase can not only exclude the intracranial or orbital mass lesions but also indicate visual prognosis in the long term.
Prognostic value of radiological T category using conventional MRI in patients with oral tongue cancer: comparison with pathological T categoryKawaguchi, Masaya; Kato, Hiroki; Kanayama, Tomohiro; Tomita, Hiroyuki; Hara, Akira; Shibata, Hirofumi; Ogawa, Takenori; Hatakeyama, Daijiro; Yamada, Yoichi; Ando, Tomohiro; Noda, Yoshifumi; Hyodo, Fuminori; Matsuo, Masayuki
doi: 10.1007/s00234-024-03345-8pmid: 38607437
PurposeThis study aimed to compare the radiological tumor (T)-category using multiparametric MRI with the pathological T category in patients with oral tongue squamous cell carcinoma (OTSCC) and to examine which is a better predictor of prognosis.MethodsThis retrospective study included 110 consecutive patients with surgically resected primary OTSCC who underwent preoperative contrast-enhanced MRI. T categories determined by maximum diameter and depth of invasion were retrospectively assessed based on the pathological specimen and multiparametric MRI. The MRI assessment included the axial and coronal T1-weighted image (T1WI), axial T2-weighted image (T2WI), coronal fat-suppressed T2WI, and axial and coronal fat-suppressed contrast-enhanced T1WI (CET1WI). Axial and coronal CET1WI measurements were divided into two groups: measurements excluding peritumoral enhancement (MEP) and measurements including peritumoral enhancement. The prognostic values for recurrence and disease-specific survival after radiological and pathological T categorization of cases into T1/T2 and T3/T4 groups were compared.ResultsThe T category of MEP on coronal CET1WI was the most relevant prognostic factor for recurrence [hazard ratio (HR) = 3.30, p = 0.001] and the HR was higher than the HR for pathological assessment (HR = 2.26, p = 0.026). The T category determined by MEP on coronal CET1WI was also the most relevant prognostic factor for disease-specific survival (HR = 3.12, p = 0.03), and the HR was higher than the HR for pathological assessment (HR = 2.02, p = 0.20).ConclusionThe T category determined by MEP on the coronal CET1WI was the best prognostic factor among all radiological and pathological T category measurements.
Prediction of pathological complete response in locally advanced head and neck squamous cell carcinoma treated with neoadjuvant chemo-immunotherapy using volumetric multisequence MRI histogram analysisLiu, Hangzhi; Zhu, Changyu; Wang, Xinyan; Chen, Xiaohong; Li, Zhixin; Xian, Junfang
doi: 10.1007/s00234-024-03339-6pmid: 38503986
PurposeThis study aimed to develop a multisequence MRI-based volumetric histogram metrics model for predicting pathological complete response (pCR) in advanced head and neck squamous cell carcinoma (HNSCC) patients undergoing neoadjuvant chemo-immunotherapy (NCIT) and compare its predictive performance with AJCC staging and RECIST 1.1 criteria.MethodsTwenty-four patients with locally advanced HNSCC from a prospective phase II trial were enrolled for analysis. All patients underwent pre- and post-NCIT MRI examinations from which whole-tumor histogram features were extracted, including T1WI, T2WI, enhanced T1WI (T1Gd), diffusion-weighted imaging (DWI) sequences, and their corresponding apparent diffusion coefficient (ADC) maps. The pathological results divided the patients into pathological complete response (pCR) and non-pCR (N-pCR) groups. Delta features were calculated as the percentage change in histogram features from pre- to post-treatment. After data reduction and feature selection, logistic regression was used to build prediction models. ROC analysis was performed to assess the diagnostic performance.ResultsEleven of 24 patients achieved pCR. Pre_T2_original_firstorder_Minimum, Post_ADC_original_firstorder_MeanAbsoluteDeviation, and Delta_T1Gd_original_firstorder_Skewness were associated with achieving pCR after NCIT. The Combined_Model demonstrated the best predictive performance (AUC 0.95), outperforming AJCC staging (AUC 0.52) and RECIST 1.1 (AUC 0.72). The Pre_Model (AUC 0.83) or Post-Model (AUC 0.83) had a better predictive ability than AJCC staging.ConclusionMultisequence MRI-based volumetric histogram analysis can non-invasively predict the pCR status of HNSCC patients undergoing NCIT. The use of histogram features extracted from pre- and post-treatment MRI exhibits promising predictive performance and offers a novel quantitative assessment method for evaluating pCR in HNSCC patients receiving NCIT.
Imaging of salivary gland cancers derived from a sublingual gland herniated into the submandibular space: a report of three casesMiyasaka, Yusuke; Hiyama, Takashi; Kuno, Hirofumi; Shinozaki, Takeshi; Tomioka, Toshifumi; Sakashita, Shingo; Kobayashi, Tatsushi
doi: 10.1007/s00234-024-03360-9pmid: 38639791
Sublingual gland herniation into the submandibular space through a mylohyoid muscle defect is a common anatomical variation; however, salivary gland cancers that arise from a herniated sublingual gland have not been described yet. Here, we report three patients with salivary gland cancers originating from a herniated sublingual gland. All tumors were detected as palpable submandibular masses, located anterior to the submandibular gland, medial to the mandible, and lateral to the mylohyoid muscle, with contact with the sublingual gland through a mylohyoid muscle defect. Intraoperative findings confirmed that the masses were derived from herniated sublingual glands. Pathological examination showed one case of mucoepidermoid carcinoma and two cases of adenoid cystic carcinoma. Imaging findings of the tumor location, in addition to the continuity with the sublingual gland through the mylohyoid muscle defect, are crucial for accurately diagnosing the tumor origin, which is essential for determining the appropriate clinical management.