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Myositis and myonecrosis are rare sequela of coronavirus disease 2019 (COVID-19). Until now, it has not been seen in muscles of the head and neck. We present a 22-year-old male with 4 months of retroauricular headaches following COVID-19 infection. Magnetic resonance imaging revealed rim-enhancing fluid collections in the bilateral masticator spaces which were sampled by fine-needle aspiration. We also discuss this case in the context of the current understanding of COVID-19-related myositis.

Background and Purpose: MRI features of tumor progression and pseudoprogression may be indistinguishable especially without enhancing portion of the diffuse gliomas. Our aim is to discriminate these two conditions using radiomics and machine learning algorithm and to compare them with human observations. Materials and Methods: Three consecutive MRI studies before a definitive biopsy in 43 diffuse glioma patients (7 pseudoprogression and 36 true progression cases) who underwent treatment were evaluated. Two neuroradiologists reviewed pre- and post-contrast T1, T2, FLAIR, ADC, rCBV, rCBF, K2, and MTT maps. Patterns of enhancement, ADC maps, rCBV, rCBF, MTT, K2 values, and perilesional FLAIR signal intensity changes were recorded. Odds ratios (OR) for each descriptor, raters' success in predicting true and pseudoprogression, and inter-observer reliability were calculated using the R statistics software. Unpaired Student's t-test and receiver operating characteristic (ROC) analysis were applied to compare the texture parameters and histogram analysis of pseudo- and true progression groups. All first-order and second-order image texture features and shape features were used to train and test the Random Forest classifier (RFC). Observers' success and RFC were compared. Results: Observers could not identify true progression in the first visit. However, accuracy of the RFC model was 81%. For the second and third visits, the rater's success of prediction was between 62% and 72%. The accuracy for the second and last visit with RFC was 75% and 81%. Conclusions: Random Forest classifier was more successful than human observations in predicting pseudoprogression using MRI.

Succinate dehydrogenase gene mutation (SDH) is known as a cause of familial paraganglioma, and the dysfunction of SDH leads to the accumulation of succinate in the cell. Succinate detection using 1H- Magnetic Resonance Spectroscopy is reported as a highly specific biomarker for SDH mutation, but the technical limitation in head and neck is causing difficulty detecting due to artifact such as fat contamination and magnetic field inhomogeneity. We are presenting a case of SDHB mutated paraganglioma in the jugular foramen, with successfully detection and quantification of the succinate peak in MRS with short acquisition time.

We present a case of an ectopic mediastinal parathyroid adenoma in a 58-year-old male patient. We show how different imaging modalities were successfully used to reach a diagnosis. We particularly focus on the role of four-dimensional CT scan in preoperative localization of ectopic adenomas and discuss how diverse imaging modalities can be integrated in the workup of ectopic parathyroid adenomas.

Background: People with depression have autonomic function disturbances. In Japan, workers who take leave due to depression often undergo a work-focused intervention program called the return to work (RTW) program at a mental health hospital during their leave of absence. However, its biological efficacy remains unclear. We investigated the biological efficacy of the RTW program, including changes in autonomic nervous system (ANS) activity, in workers on sick leave due to depression in Japan. Methods: The study involved 104 workers on sick leave due to major depressive disorder or bipolar disorder who underwent the RTW program for 3 months in Yokohama City University Hospital. The ANS activity of all patients was evaluated using heart rate variability at the beginning and end of the 3-month RTW program. Psychiatric symptoms were evaluated using the Montgomery-Åsberg Depression Rating Scale-Japanese (MADRS-J) and Social Adaptation Self-evaluation Scale (SASS). We followed up 3 months after the end of the program and investigated the association between the success in returning to work within 3 months after the end of the RTW program and several factors, including ANS activity, depressive symptoms, and demographic factors. Results: Parasympathetic activity was significantly higher and depressive symptom severity was significantly lower at program end than at baseline. Logistic regression analysis showed that the change in depressive symptoms was significantly associated with success in returning to work. Conclusion: We suggest that the RTW program improves parasympathetic activity as well as psychiatric symptoms. ANS activity was not a predictor of a successful return to work within 3 months after the end of the program in workers on sick leave due to depression, but further studies with a larger sample size are needed.