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DNA being the necessary element in cell regeneration, controlled cellular apoptosis via DNA binding/cleaving is considered an approach to combat cancer cells. The widely prescribed metallodrug cisplatin has shown interactions with the guanine-N7 center, and a plethora of complexes are continually developed to enhance crosslinking properties as well as covalent and non-covalent interactions. Two pentadentate ligands, L1 (1-(6-(1H-benzo[d]imidazol-2-yl)pyridin-2-yl)-N,N-bis(pyridin-2-ylmethyl)methanamine) and L2 (1-(6-(1-methyl-1H-benzo[d]imidazol-2-yl)pyridin-2-yl)-N,N-bis(pyridin-2-ylmethyl)methanamine), were synthesized together with their respective copper(II) complexes [1](ClO4)2 and [2](ClO4)2, which crystallized in a trigonal bipyramidal fashion. Different analytical and spectroscopic methods confirmed their formation, and their redox behaviour was also examined. The interactions of salmon sperm DNA (ss-DNA) with these two complexes were explored using absorbance spectroscopy, and they both exhibited a binding affinity (Kb) of ∼104 M−1. Fluorescence quenching experiments with ethidium bromide (EB)-bound DNA (EB–DNA) were also performed, and Stern–Volmer constant (KSV) values of 6.93 × 103 and 2.34 × 104 M−1 for [1](ClO4)2 and [2](ClO4)2, respectively, were obtained. Furthermore, DNA conformational changes due to the interactions of both complexes were validated via circular dichroism. We also assessed the DNA cleavage property of these complexes, which resulted in the linearization of circular plasmid DNA. This finding was supported by studying the growth of MDA-MB-231 breast cancer cells upon treatment with both Cu(II) complexes; IC50 values of 5.34 ± 1.02 μM and 0.83 ± 0.18 μM were obtained for [1](ClO4)2 and [2](ClO4)2, respectively. This validates their affinity towards DNA, and these insights can be further utilized for non-platinum based economical metallodrug development based on first row transition metals. [ABSTRACT FROM AUTHOR]

In recent years, the global perspective of small molecule activation has directed the focus towards biomimetic oxidations. Phenoxazinone synthase and catechol oxidase, two vital metalloenzymes, have drawn the attention of the scientific community towards their catalytic performances. Different transition metal-based complexes have been investigated to mimic their activities, yet many factors related to their mechanistic aspects and structure–activity relationship still lack detailed investigation. To get better insights into these factors, two penta-coordinated cis-dichloro and dibromo Cu(II) complexes [Cu(L)Cl2] 1 and [Cu(L)Br2] 2 (where L = N,N-dimethyl-4,6-di(pyridin-2-yl)-1,3,5-triazin-2-amine) were synthesized and comprehensively characterized through various spectroscopic and analytical tools such as UV-vis, FT-IR, NMR, EPR and ESI-MS. The redox behaviour of ligands as well as both the copper complexes were analysed. The molecular structure of 1 and 2 was elucidated via single-crystal X-ray diffraction analysis and a distorted square pyramidal geometry was determined. The halogen atoms (Cl for 1 and Br for 2) are found to be coordinated in a cis fashion for better substrate attachment. Catalytic performances towards the oxidation of o-aminophenol (OAPH) and 3,5-di-tert-butylcatechol (3,5-DTBC) were investigated using UV-vis spectrophotometry. Significant kinetic parameters towards the catalytic activities for 1 and 2 were determined. In terms of OAPH oxidation ability, both complexes were found to be quite comparable, with 2 having greater catalytic performance (Kcat = 156.7 h−1) than 1 (Kcat = 124.5 h−1). However, 2 shows remarkably superior activity for 3,5-DTBC oxidation (Kcat = 367.8 h−1, ∼4.5 times) than 1 (Kcat = 82.2 h−1). The mass spectrometric investigation provides information about the probable mechanistic path towards the oxidation of both the substrates. Iodometric titration experiments were performed to identify H2O2 formation, which proves the involvement of molecular O2 during the catalytic oxidation. Overall, this study offers a detailed investigation on the significance of structural lability and their profound catalytic activities for biomimetic applications, which may open a new direction toward future advancements. [ABSTRACT FROM AUTHOR]

The activation of molecular oxygen remains a persistent challenge to the scientific community owing to its poor selectivity, especially towards organic substrates. In biological systems, phenoxazinone synthase and catechol oxidase are two copper-based metalloenzymes that have been extensively studied because of their catalytic properties in the formation of a phenoxazinone core and quinones, which subsequently produce value-added compounds. Inspired by the design of a native catechol oxidase metalloenzyme, two copper(II) complexes (1 and 2) with dipicolylamine (DPA)-derived tridentate ligands L1 (4-methyl-N,N-bis(pyridin-2-ylmethyl)aniline) and L2 (2,4,6-trimethyl-N,N-bis(pyridin-2-ylmethyl)aniline) are synthesized. The tridentate ligands provided similar environmental facilities for attachment with three histidine moieties found in nature and our goal is to understand their biomimicking activity. On the amine nitrogen center, basicity is varied by systematic substitutions via methyl groups, thus affecting the bond strength of the apical chloride atom, which results in increased lability. The ligands were thoroughly characterized using different spectroscopic methods, i.e., FT-IR, 1H NMR, UV-vis spectroscopy, and ESI mass spectrometry. The molecular structures of 1 and 2 were elucidated using single-crystal X-ray diffraction, which confirms their distorted square pyramidal geometries with two distinct chlorines attached in a cis fashion. The investigation of their catalytic abilities was performed under ambient aerobic conditions in methanol with both o-aminophenol and 3,5-ditertbutyl catechol, which provided kinetic values that correlated with their structural modifications. Toluene-appended 1 (kcat 525 h−1 for o-aminophenol and 612 h−1 for 3,5-ditertbutyl catechol) showed almost twice the activities of mesitylene-derived 2 (kcat 255 h−1 for o-aminophenol and 343 h−1 for 3,5-ditertbutyl catechol). Mass spectroscopy supported their probable mechanisms for both substrates and confirmed the involvement of molecular oxygen in the reaction. EPR studies further confirmed radical generation during adduct formation in the case of catechol oxidation. This study offers detailed information regarding metal–ligand cooperation and their biomimicking activity, which directs the importance of designing suitable bioinspired catalysts. [ABSTRACT FROM AUTHOR]

Mixed ligand copper(II) complexes [Cu(L1)(bpy)](ClO4)21 and [Cu(L2)(bpy)](ClO4)22 (where L1 = 1-(anthracen-9-yl)-N,N-bis(pyridin-2-ylmethyl)methanamine, L2 = 1-(pyren-1-yl)-N,N-bis(pyridin-2-ylmethyl)methanamine and bpy = 2,2′-bipyridine) were synthesised and characterised thoroughly via different analytical and spectroscopic techniques i.e., UV-vis spectroscopy, fluorescence spectroscopy, FT-IR spectroscopy, HRMS and EPR spectroscopy. The molecular structures of the synthesised complexes were obtained using the single-crystal X-ray diffraction technique. Both complexes exhibited penta-coordinated and acquired distorted square pyramidal geometry. The redox behaviour of complexes 1 and 2 was investigated by employing cyclic voltammetry. The DNA binding study was carried out by UV-vis spectrophotometry using double-stranded salmon sperm DNA (ds-ss-DNA). The binding constant (Kb) values of 1 and 2 were 0.11 × 104 M−1 and 1.05 × 104 M−1, respectively, which indicates that 2 has better binding ability than 1. This might be due to the higher conjugative abilities with the extended surface area of the aromatic pyrene ring compared to the anthracene moiety. The fluorescence quenching experiments were also performed with EB bound DNA (EB–DNA) and Stern–Volmer constant (KSV) values were calculated as 1.23 × 105 M−1 and 1.39 × 105 M−1 for 1 and 2, respectively, suggesting that 2 showed stronger interaction with ss-DNA than 1. The molecular docking data support the DNA-binding studies, with the sites and mode of interactions against B-DNA varying with 1 and 2. Evaluation of the DNA binding properties of the complexes to linearized plasmid DNA indicated that 2 had modest DNA binding properties, which is a pre-requisite for a genotoxic agent. The effect of 1 and 2 on cell survival was analysed using HeLa cells by MTT assay and it was observed that the IC50 values of 1 and 2 were 43.7 μM and 18.6 μM, respectively. Our study paves the way for the designing of bio-inspired novel mixed metal complexes, which shows promising results for further exploration of molecular and mechanistic studies towards the development of non-platinum based economical metallodrugs. [ABSTRACT FROM AUTHOR]

This paper presents an information-technology-based collaboration framework that facilitates disaster response operations. The collaboration framework incorporates a web collaboration service, radio frequency identification (RFID) tags, a building blackbox system (BBS), a geo-database, and a geographic information system (GIS). Through the integration of these technologies, the framework provides a collaboration medium for first responders, including civil engineers, to cohesively respond to disasters. Access to critical building information, such as construction documents, through the BBS supports assessments of building integrity during disaster response. Building assessment information is stored on RFID tags, which are accessible to first responders through digital devices via a wireless ad hoc network. With on-site assessment information shown on a digital map, decision makers locate, collect, and distribute critical resources through the GIS to first responders. In addition, the decision makers at distributed locations evaluate the incident through discussion sessions, hosted by the web collaboration environment, for integrated decision making. Test-bed simulations for the framework have been carried out with encouraging results at the training ground of the Illinois Fire Service Institute. DOI: 10.1061/(ASCE)CP. 1943-5487.0000033 CE Database subject headings: Disasters; Emergency services; Damage; Assessment; Information systems; Information management; Geographic information systems; Computer networks. Author keywords: Disasters; Emergency services; Damage assessment; Information systems; Information management; Ad hoc networks; Geographic information systems.

The use of diagnostic imaging studies in the emergency setting has increased dramatically over the past couple of decades. The emergency imaging of pregnant and lactating patients poses unique challenges and calls upon the crucial role of radiologists as consultants to the referring physician to guide appropriate use of imaging tests, minimize risk, ensure timely management, and occasionally alleviate unwarranted trepidation. A clear understanding of the risks and benefits involved with various imaging tests in this patient population is vital to achieve this. This review discusses the different safety and appropriateness issues that could arise with the use of ionizing radiation, iodinated-, and gadolinium-based contrast media and radiopharmaceuticals in pregnant and lactating patients. Special considerations such as trauma imaging, safety concerns with magnetic resonance imaging and ultrasound, management of claustrophobia, contrast extravasation, and allergic reactions are also reviewed. The consent process for these examinations has also been described. [ABSTRACT FROM AUTHOR]

Background: Multi-detector contrast-enhanced abdominal computed tomography (CT) allows for the accurate detection and classification of traumatic splenic injuries, leading to improved patient management. Their effective use requires rapid study interpretation, which can be a challenge on busy emergency radiology services. A machine learning system has the potential to automate the process, potentially leading to a faster clinical response. This study aimed to create such a system. Method: Using the American Association for the Surgery of Trauma (AAST), spleen injuries were classified into 3 classes: normal, low-grade (AAST grade I-III) injuries, and high-grade (AAST grade IV and V) injuries. Employing a 2-stage machine learning strategy, spleens were initially segmented from input CT images and subsequently underwent classification via a 3D dense convolutional neural network (DenseNet). Results: This single-centre retrospective study involved trauma protocol CT scans performed between January 1, 2005, and July 31, 2021, totaling 608 scans with splenic injuries and 608 without. Five board-certified fellowship-trained abdominal radiologists utilizing the AAST injury scoring scale established ground truth labels. The model achieved AUC values of 0.84, 0.69, and 0.90 for normal, low-grade injuries, and high-grade splenic injuries, respectively. Conclusions: Our findings demonstrate the feasibility of automating spleen injury detection using our method with potential applications in improving patient care through radiologist worklist prioritization and injury stratification. Future endeavours should concentrate on further enhancing and optimizing our approach and testing its use in a real-world clinical environment. [ABSTRACT FROM AUTHOR]

A 22-year-old female presented to our services with back pain and paraparesis for 11 months. She was earlier diagnosed with tuberculosis of spine, and antitubercular chemotherapy was started. However her condition had worsened. Plain and contrast-enhanced computed tomography scans of the thorax and magnetic resonance imaging of the thoracic spine showed heterogenous, lytic, expansile lesion involving third thoracic vertebra with epidural extension and large bilateral paraspinal and mediastinal components. Multiple variably sized loculations with fluid-fluid levels were seen within the lesion. These imaging findings suggestive of aneurysmal bone cyst of thoracic spine were compared with the findings seen 11 months earlier, which were mistaken for spinal tuberculosis. Histopathology confirmed the diagnosis of aneurysmal bone cyst. The imaging features, diagnostic challenges and the lessons learned have been briefly discussed. [ABSTRACT FROM AUTHOR]

Here in Canada, we often think of gun violence as confined to conflict zones, terrorism, and more of a problem for our southern neighbor. However, in recent years, it has also become a Canadian problem with increased gun violence related to criminal activity presenting in daily practice. Radiologists play a critical role in the evaluation of ballistic trauma and must therefore be familiar with both the common and uncommon patterns of ballistic injury. In this article, we review the mechanisms of ballistic trauma as well as their resultant injury patterns in order to guide image interpretation. [ABSTRACT FROM AUTHOR]

Background: Portable chest radiograph for COVID-19 positive patients and persons under investigation can be acquired through glass doors or walls of isolation rooms to limit exposure to the pathogen and conserve resources. Purpose: To report our initial experience with acquiring portable chest radiographs through glass doors of isolation rooms. Methods: Only 1 of 2 radiology technologist team members donned personal protective equipment and stayed inside the isolation room, while the second technologist and the radiography unit remained outside during the procedure. First hundred radiographs acquired through glass at the emergency department of our institute formed the "through glass radiograph" group. Hundred consecutive portable chest radiographs performed in a conventional manner formed the "conventional radiograph" group for comparison. Imaging database and feedback from operations leader were used to identify occurrences of a failed procedure. Suggestion of repeating the study and comments related to quality of the study were recorded from the reports of the staff radiologist. Results: There was no instance of failed acquisition, nondiagnostic examination, or suggestion of repetition in both groups. No significant difference in the number of reports with quality related remarks (P >.05) was found between the 2 groups. Radiography through glass doors was associated with increased suboptimal positioning related remarks in radiology reports (P <.05). No significant association was identified among other comments about image quality. Conclusion: Our initial clinical experience suggests that the acquisition of portable chest radiographs through the glass doors of isolation rooms is technically feasible and results in diagnostic quality studies. [ABSTRACT FROM AUTHOR]

Dual-energy computed tomography (CT) is a promising tool with increasing availability and multiple emerging and established clinical applications in neuroradiology. With its ability to allow characterization of materials based on their differential attenuation when imaged at two different energy levels, dual-energy CT can help identify the composition of brain, neck, and spinal components. Virtual monoenergetic imaging allows a range of simulated single energy-level reconstructions to be created with postprocessing. Low-energy reconstructions can aid identification of edema, ischemia, and subtle lesions due to increased soft tissue contrast as well as increasing contrast-to-noise ratios on angiographic imaging. Higher energy reconstructions can reduce image artifact from dental amalgam, aneurysm clips and coils, spinal hardware, dense contrast, and dense bones. Differentiating iodine from hemorrhage may help guide management of patients after thrombectomy and aid diagnosis of enhancing tumors within parenchymal hemorrhages. Iodine quantification may predict hematoma expansion in aneurysmal bleeds and outcomes in traumatic brain injury. Calcium and bone subtraction can be used to distinguish hemorrhage from brain parenchymal mineralization as well as improving visualization of extra-axial lesions and vessels adjacent to dense plaque or skull. This article reviews the basics of dual-energy CT and highlights many of its clinical applications in the evaluation of acute neurological presentations. [ABSTRACT FROM AUTHOR]

"Just Accepted" papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence . This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Purpose To evaluate the performance of the top models from the RSNA 2022 Cervical Spine Fracture Detection challenge on a clinical test dataset of both noncontrast and contrast-enhanced CT scans acquired at a level I trauma center. Materials and Methods Seven top-performing models in the RSNA 2022 Cervical Spine Fracture Detection challenge were retrospectively evaluated on a clinical test set of 1,828 CT scans (1,829 series: 130 positive for fracture, 1,699 negative for fracture; 1,308 noncontrast, 521 contrast-enhanced) from 1,779 patients (mean age, 55.8 ± 22.1 years; 1,154 male). Scans were acquired without exclusion criteria over one year (January to December 2022) from the emergency department of a neurosurgical and level I trauma center. Model performance was assessed using area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. False positive and false negative cases were further analyzed by a neuroradiologist. Results Although all 7 models showed decreased performance on the clinical test set compared with the challenge dataset, the models maintained high performances. On noncontrast CT scans, the models achieved a mean AUC of 0.89 (range: 0.81-0.92), sensitivity of 67.0% (range: 30.9%-80.0%), and specificity of 92.9% (range: 82.1%-99.0%). On contrast-enhanced CT scans, the models had a mean AUC of 0.88 (range: 0.76-0.94), sensitivity of 81.9% (range: 42.7%-100.0%), and specificity of 72.1% (range: 16.4%-92.8%). The models identified 10 fractures missed by radiologists. False-positives were more common in contrast-enhanced scans and observed in patients with degenerative changes on noncontrast scans, while false-negatives were often associated with degenerative changes and osteopenia. Conclusion The winning models from the 2022 RSNA AI Challenge demonstrated a high performance for cervical spine fracture detection on a clinical test dataset, warranting further evaluation for their use as clinical support tools. ©RSNA, 2024.

DNA being the necessary element in cell regeneration, controlled cellular apoptosis via DNA binding/cleaving is considered an approach to combat cancer cells. The widely prescribed metallodrug cisplatin has shown interactions with the guanine-N7 center, and a plethora of complexes are continually developed to enhance crosslinking properties as well as covalent and non-covalent interactions. Two pentadentate ligands, L1 (1-(6-(1 H -benzo[ d ]imidazol-2-yl)pyridin-2-yl)- N , N -bis(pyridin-2-ylmethyl)methanamine) and L2 (1-(6-(1-methyl-1 H -benzo[ d ]imidazol-2-yl)pyridin-2-yl)- N , N -bis(pyridin-2-ylmethyl)methanamine), were synthesized together with their respective copper(II) complexes [1](ClO 4 ) 2 and [2](ClO 4 ) 2 , which crystallized in a trigonal bipyramidal fashion. Different analytical and spectroscopic methods confirmed their formation, and their redox behaviour was also examined. The interactions of salmon sperm DNA (ss-DNA) with these two complexes were explored using absorbance spectroscopy, and they both exhibited a binding affinity ( K b ) of ∼10 4 M -1 . Fluorescence quenching experiments with ethidium bromide (EB)-bound DNA (EB-DNA) were also performed, and Stern-Volmer constant ( K SV ) values of 6.93 × 10 3 and 2.34 × 10 4 M -1 for [1](ClO 4 ) 2 and [2](ClO 4 ) 2 , respectively, were obtained. Furthermore, DNA conformational changes due to the interactions of both complexes were validated via circular dichroism. We also assessed the DNA cleavage property of these complexes, which resulted in the linearization of circular plasmid DNA. This finding was supported by studying the growth of MDA-MB-231 breast cancer cells upon treatment with both Cu(II) complexes; IC 50 values of 5.34 ± 1.02 μM and 0.83 ± 0.18 μM were obtained for [1](ClO 4 ) 2 and [2](ClO 4 ) 2 , respectively. This validates their affinity towards DNA, and these insights can be further utilized for non-platinum based economical metallodrug development based on first row transition metals.

Background and Purpose: Low-field 64mT portable brain MRI (pMRI) has recently shown diagnostic promise for MS. This study aimed to evaluate the utility of pMRI in assessing dissemination in space (DIS) in patients presenting with optic neuritis and determine whether deploying pMRI in the MS clinic can shorten the time from symptom onset to MRI., Materials and Methods: Newly diagnosed optic neuritis patients referred to a tertiary academic MS center from July 2022 to January 2024 underwent both point-of-care pMRI and subsequent conventional 3T MRI (cMRI). Images were evaluated for periventricular (PV), juxtacortical (JC) and infratentorial (IT) lesions. DIS was determined on brain MRI per 2017 McDonald criteria. Test characteristics were computed using cMRI as the reference. Interrater and intermodality agreement between pMRI and cMRI were evaluated using Cohen's kappa. Time from symptom onset to pMRI and cMRI during the study period was compared to the preceding 1.5 years before pMRI implementation using Kruskal-Wallis with post-hoc Dunn's tests., Results: Twenty patients (median age: 32.5 [IQR, 28-40]; 80% females) were included, of whom 9 (45%) and 5 (25%) had DIS on cMRI and pMRI, respectively. Median time interval between pMRI and cMRI was 7 days (IQR, 3.5-12.5). Interrater agreement was very good for PV (95%, κ=0.89), and good for JC and IT lesions (90%, κ=0.69 for both). Intermodality agreement was good for PV (90%, κ=0.80) and JC (85%, κ=0.63), and moderate for IT lesions (75%, κ=0.42) and DIS (80%, κ=0.58). pMRI had a sensitivity of 56% and specificity of 100% for DIS.The median time from symptom onset to pMRI was significantly shorter (8.5 days [IQR 7-12]) compared to the interval to cMRI before pMRI deployment (21 days [IQR 8-49], n=50) and after pMRI deployment (15 days [IQR 12-29], n=30) (both p<0.01). Time from symptom onset to cMRI in those periods was not significantly different (p=0.29)., Conclusions: In optic neuritis patients, pMRI exhibited moderate concordance, moderate sensitivity and high specificity for DIS compared to cMRI. Its integration into the MS clinic reduced the time from symptom onset to MRI. Further studies are warranted to evaluate the role of pMRI in expediting early MS diagnosis and as an imaging tool in resource-limited settings., Abbreviations: pMRI = portable MRI; cMRI = conventional MRI; pwMS = patients with MS; PV = periventricular; JC= juxtacortical; IT = infratentorial; DIS = dissemination in space., (© 2024 by American Journal of Neuroradiology.)

Purpose To develop an automated triage tool to predict neurosurgical intervention for patients with traumatic brain injury (TBI). Materials and Methods A provincial trauma registry was reviewed to retrospectively identify patients with TBI from 2005 to 2022 treated at a specialized Canadian trauma center. Model training, validation, and testing were performed using head CT scans with binary reference standard patient-level labels corresponding to whether the patient received neurosurgical intervention. Performance and accuracy of the model, the Automated Surgical Intervention Support Tool for TBI (ASIST-TBI), were also assessed using a held-out consecutive test set of all patients with TBI presenting to the center between March 2021 and September 2022. Results Head CT scans from 2806 patients with TBI (mean age, 57 years ± 22 [SD]; 1955 [70%] men) were acquired between 2005 and 2021 and used for training, validation, and testing. Consecutive scans from an additional 612 patients (mean age, 61 years ± 22; 443 [72%] men) were used to assess the performance of ASIST-TBI. There was accurate prediction of neurosurgical intervention with an area under the receiver operating characteristic curve (AUC) of 0.92 (95% CI: 0.88, 0.94), accuracy of 87% (491 of 562), sensitivity of 87% (196 of 225), and specificity of 88% (295 of 337) on the test dataset. Performance on the held-out test dataset remained robust with an AUC of 0.89 (95% CI: 0.85, 0.91), accuracy of 84% (517 of 612), sensitivity of 85% (199 of 235), and specificity of 84% (318 of 377). Conclusion A novel deep learning model was developed that could accurately predict the requirement for neurosurgical intervention using acute TBI CT scans. Keywords: CT, Brain/Brain Stem, Surgery, Trauma, Prognosis, Classification, Application Domain, Traumatic Brain Injury, Triage, Machine Learning, Decision Support Supplemental material is available for this article. © RSNA, 2024 See also commentary by Haller in this issue.

Background and Purpose: Gadolinium leakage in ocular structures (GLOS) is characterized by hyperintense signal in the chambers of the eye on FLAIR and has been reported in association with blood-ocular barrier breakdown in patients with ischemic strokes. The underlying mechanism of GLOS remains poorly understood; however, some studies suggest it may be part of a physiologic excretion pathway of gadolinium. This study aimed to determine the prevalence of GLOS in an unselected patient population., Materials and Methods: A retrospective analysis was conducted on 439 patients who underwent brain MR imaging within 7 days of receiving a gadolinium-based contrast agent injection for a prior MR imaging study. Clinical, imaging, and laboratory data were collected. Descriptive and logistic regression analyses were performed., Results: GLOS was observed in 26 of 439 patients (6%). The occurrence of GLOS varied with time, with 3 (12%), 14 (54%), 8 (31%), and 1 (4%) patient showing GLOS within 24, 25-72, 73-120, and >120 hours after gadolinium-based contrast agent injection, respectively. Patients with GLOS were older (median age: 72 versus 55 years, P = .001) and had higher median serum creatinine levels (73 versus 64 µmol/L, P = .005) and a lower median estimated glomerular filtration rate (84 versus 101 mL/min/1.73 m 2 , P < .001). A shorter median time interval between gadolinium-based contrast agent injection and the index brain MR imaging was observed in the group positive for GLOS (62 versus 91 hours, P = .003). Multivariable regression analysis identified the estimated glomerular filtration rate (OR = 0.970; 95% CI, 0.049-0.992; P = .008) and time interval since gadolinium-based contrast agent injection (OR = 0.987; 95% CI, 0.977-0.997; P = .012) as independent factors associated with GLOS., Conclusions: GLOS was observed in only a small percentage of patients receiving gadolinium-based contrast agent within 7 days before brain MR imaging. This phenomenon was noted in patients with normal findings on brain MR imaging and those with various CNS pathologies, and it was associated with lower estimated glomerular filtration rates and shorter time intervals after gadolinium-based contrast agent injection. While GLOS may be a physiologic gadolinium-based contrast agent excretion pathway, the presence of ocular disease was not formally evaluated in the included population. Awareness of GLOS is nonetheless useful for appropriate radiologic interpretation., (© 2024 by American Journal of Neuroradiology.)