Table of Contents
Review Article
- Monoclonal Antibodies: What the Diagnostic Neuroradiologist Needs to Know
The therapeutic use of monoclonal antibodies is rapidly expanding for a variety of diseases. This review article describes commonly used monoclonal antibody-targeted therapeutic agents, their mechanism of action, clinical applications, and major adverse events with a focus on neurologic and neuroimaging manifestations. For example, immunostimulating anticancer mAbs can lead to proinflammatory conditions, while immunosuppressive medications can lead to activation of underlying opportunistic infections. Amyloid-segregating mAbs can lead to amyloid-related imaging abnormalities, and TNF-inhibiting mAbs have a higher incidence of demyelinating abnormalities.
General Contents
- Prevalence and Characteristics of Intracranial Aneurysms in Hereditary Hemorrhagic Telangiectasia
In this retrospective study, the authors evaluated the prevalence and characteristics of intracranial aneurysms in patients with hereditary hemorrhagic telangiectasia with brain vascular malformations. In their study cohort of 180 patients with HHT and brain vascular malformations, the authors demonstrated that the prevalence of intracranial aneurysm in hereditary hemorrhagic telangiectasia is comparable with that in the general population without clear association with shunting brain vascular malformations.
- Cervical Osteomyelitis and Diskitis as a Complication of Neopharyngeal Breakdown: A Multisite Case Series Review
This case series of 11 patients status post laryngectomy/pharyngectomy describes the imaging findings of pharyngoesophageal wall breakdown with subsequent cervical spine infection. The authors show that MRI is more sensitive for spine infection in these patients presenting with neck, fever, and serologic evidence of infection.
- CT of the Larynx: Is an Additional High-Resolution Acquisition Necessary for Diagnostic Accuracy?
The purpose of this study was to determine whether reformatted laryngeal images derived from a standard neck CT acquisition can replace a separate dedicated high-resolution laryngeal acquisition. In 200 patients, the authors found a discrepancy in nearly one-quarter of the interpretations. Both up-staging and down-staging errors were made with the standard neck CT protocol and were critical in defining the optimal therapeutic approach. The authors concluded that the addition of focused images of the larynx after a second contrast bolus and a second acquisition sequence improves the radiologic staging of laryngeal tumors.
- T1-Weighted, Dynamic Contrast-Enhanced MR Perfusion Imaging Can Differentiate between Treatment Success and Failure in Spine Metastases Undergoing Radiation Therapy
Routine MRI techniques are rather limited in assessing treatment response versus disease progression following radiation therapy as lesion size often fluctuates after both successful and unsuccessful treatment. In this study, dynamic contrast-enhanced MRI perfusion parameters were used to predict treatment success or failure regarding spinal osseous metastases and to show the concordance with lesion-size measurements in the determination of treatment success or failure. The authors found there were significant differences in the change in plasma volume following radiation treatment between their clinical response and persistent disease groups. Additionally, they demonstrated that plasma volume had a higher specificity than size measurements.
