Search

Craniofacial chondromyxoid fibromas (CMFs) are a rare benign tumor of cartilaginous origin. They are commonly misdiagnosed due to the paucity of information on tumor characteristics. We performed a systematic review to characterize CMFs located in different regions of the craniofacial skeleton. A search of the literature was executed using the search phrase "chondromyxoid fibroma" and included articles from 1990–2020. Sixty-eight articles met the inclusion criteria, with a total of 91 patients with analyzable data (22 with calvarial and 69 with sinonasal tumor locations). Descriptive analyses were performed to compare pre-selected characteristics between the 2 groups. Sinonasal CMF frequently presented with cranial nerve palsy and expectedly had a high rate of nasal symptoms. Calvarial tumors frequently presented with an external mass and headache. Gross total resection (GTR) was achieved in a higher proportion of cases in the calvarial group versus the sinonasal group (83.3% vs. 53.1%). Overall recurrence rate at 17.7% was higher in sinonasal CMF compared with the calvarial tumors at 8.3%. Recurrences after GTR were similar in the sinonasal and calvarial groups (9.7% vs. 9.1%). In patients who did not achieve GTR, recurrence was higher in the sinonasal compared with the calvarial group (27.6% vs. 0%). Craniofacial CMF in calvarial and sinonasal locations have distinct clinical characteristics and response to treatment. Sinonasal lesions tend to have higher recurrence compared to calvarial CMF. Performance of GTR is associated with decreased recurrence in all CMFs. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency and accuracy of diffusion restriction (DR) of the retina and/or optic nerve (ON) detection on standard brain magnetic resonance diffusion-weighted imaging (DWI-MRI) in patients presenting with acute non-arteritic central retinal artery occlusion (CRAO)., Methods: This is a retrospective case-control study that includes all consecutive patients presenting to our tertiary academic center from 2013-2021 with acute non-arteritic CRAO (cases) or acute ischemic stroke syndrome (controls, age and gender-matched) that had brain MRI performed within 14 days from symptom onset. Two neurology residents (junior and senior), a vascular neurologist, and two neuroradiologists, blinded to the site of CRAO, independently reviewed the brain MRIs to assess for the presence of retina and ON DR. The consensus agreement between the two neuroradiologists was used to perform sensitivity and specificity analyses and calculate inter-rater reliability (prevalence-adjusted bias-adjusted kappa coefficient)., Results: A total of 128 patients with acute non-arteritic CRAO (mean (SD) age 69 (14) years; 50% female; median time from CRAO to DW-MRI 2 days (IQR 1-5)) and 128 age and gender-matched controls with acute cerebral ischemia were included. After the neuroradiologist consensus, DR was correctly identified in the retina or ON in 51/128 (39.8%) CRAO cases, retina alone 27.3%, ON alone 24.2%, and both retina and ON 11.7%, with almost perfect neuroradiologists' inter-rater reliability for retina (K = 0.91) and ON (K = 0.83). Among controls, the retina DR was identified in 1/128 (0.8%) and ON DR in 5/128 (3.9%). The sensitivity, specificity, positive predictive value, and negative predictive value were 28.1%, 99.2%, 97.3%, and 58.0% for retina DR, and 27.3%, 96.1%, 87.5%, and 56.9% for ON DR., Conclusions: Though experienced neuroradiologists identified retina and ON DR with excellent inter-rater reliability, these are infrequent findings in real world CRAO practice, with excellent specificity but limited sensitivity. Prospective studies with larger cohort of patients, optimization of standardized orbit DWI-MRI protocols are needed to facilitate a more accurate and reliable identification of retina and ON DR in acute CRAO., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Long-term posttreatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months., Purpose: We performed a systematic review to evaluate the impact of long-term imaging surveillance (ie, imaging beyond 6 months following completion of treatment) on survival in patients treated definitively for head and neck squamous cell carcinoma., Data Sources: A search was conducted on PubMed, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma., Study Selection: We screened 718 abstracts and performed full-text review for 95 abstracts, with 2 articles meeting the inclusion criteria. The Risk of Bias in Non-Randomized Studies of Interventions assessment tool was used., Data Analysis: A qualitative assessment without a pooled analysis was performed for the 2 studies meeting inclusion criteria., Data Synthesis: No randomized prospective controlled trials were identified. Two retrospective 2-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having a moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to different conclusions, with 1 study reporting a survival benefit for long-term surveillance imaging with FDG-PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit., Limitations: Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma., Conclusions: There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of a standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multicenter registry assessing outcomes., (© 2025 by American Journal of Neuroradiology.)

Jaw and maxillofacial bone lesions encompass a wide variety of both neoplastic and non-neoplastic pathologies. These lesions can arise from various tissues, including bone, cartilage, and soft tissue, each presenting distinct challenges in diagnosis and treatment. While some pathologies exhibit characteristic imaging features that aid in diagnosis, many others are nonspecific. This overlap often necessitates a multimodal imaging approach, combining techniques such as radiographs, computed tomography, and magnetic resonance imaging to achieve a diagnosis or narrow the diagnostic considerations. This article provides a comprehensive review of the imaging approach to jaw and maxillofacial bone tumors, including updates on the 2022 World Health Organization classification of these tumors. The relevant anatomy of the jaw and dental structures that is important for accurate imaging interpretation is discussed., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: The purpose of our study was to determine the diagnostic and therapeutic yield of the head and abdomen portions of PET/CT scans of patients with head and neck squamous cell cancer (HNSCC) to determine whether these areas should be routinely included with PET/CT of the neck and chest., Materials and Methods: Patients with pathologically proven HNSCC who underwent full-body PET/CT were evaluated for metastases to the head, chest, and abdomen. Medical records were reviewed to determine whether the head and abdominal findings changed the clinical management, beyond the findings in the neck and chest., Results: Five hundred ninety-eight patients who underwent 1625 PET/CT scans were included. All studies included the head, neck, and chest. For 542 of 598 patients (91%), the PET/CT scans included the abdomen. Two of 598 patients (0.3%) had distant calvarial metastases. Neither of the calvarial metastases changed patient management. Twelve of 542 patients (2.2%) had abdominal metastases. For 10 of 542 patients (1.8%), the abdominal findings changed patient management. Thoracic metastases were found in 82 of 598 patients (13.7%). The total rate of distant metastases to the head and abdomen in patients with thoracic metastatic disease was 12.2% (10/82), whereas in patients without thoracic metastases, it was 0.8% (4/460)., Conclusion: Routine extension of PET/CT scans to include the head and abdomen in patients with HNSCC is not indicated. For patients without evidence of thoracic metastases, routine PET/CT examinations should include the neck and chest only.

Importance: At many institutions, computed tomography with iodinated intravenous contrast medium is the preferred imaging modality for staging of the neck in squamous cell carcinoma of the head and neck. However, few studies have specifically assessed the diagnostic accuracy of computed tomography for determining the presence or absence of extracapsular spread (ECS)., Objective: To determine the accuracy of modern, contrast-enhanced, multidetector computed tomography in the diagnosis of ECS of cervical lymph node metastases from squamous cell carcinoma of the head and neck., Design, Setting, and Participants: Retrospective observational study at an academic tertiary referral center among 100 consecutive patients between May 1, 2007, and February 1, 2012, who underwent a lateral cervical neck dissection for squamous cell carcinoma of the head and neck with neck metastases of at least 1 cm in diameter on pathologic assessment. Exclusion criteria included malignant neoplasms other than squamous cell carcinoma, a delay in surgery longer than 6 weeks from the time of staging computed tomography, and prior treatment of the neck or recurrent disease or a second primary., Main Outcomes and Measures: Each patient was independently assigned a subjective score for the presence of ECS by 2 Certificate of Added Qualification-certified neuroradiologists according to a 5-point scale. Receiver operating characteristic curves were generated, and sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated for each observer., Results: The areas under the receiver operating characteristic curve for observers 1 and 2 are 0.678 (95% CI, 0.578-0.768) and 0.621 (95% CI, 0.518-0.716), respectively. For observer 1, the positive and negative predictive values for the detection of ECS were 84% (95% CI, 68%-93%) and 49% (95% CI, 36%-62%), respectively. For observer 2, the positive and negative predictive values for the detection of ECS were 71% (95% CI, 57%-82%) and 48% (95% CI, 32%-64%), respectively., Conclusions and Relevance: Computed tomography cannot be used to reliably determine the presence of pathologic ECS. Radiologic findings suggestive of ECS should not be relied on for treatment planning in squamous cell carcinoma of the head and neck.