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PURPOSE: The ACGME recognizes radiology's neuroradiology fellowship programs as the pathway to neuroradiology expertise. Members of the American Society of Neuroimaging have called for the expansion of neuroradiology fellowships for neurologists with informal accreditation through the United Council for Neurologic Subspecialties. The aim of this study was to investigate the number of neuroradiologic studies read by neurologists to assess their capacity to support fellowship positions at ACGME training criteria. METHODS: The numbers of neuroradiologic studies interpreted by radiologists and neurologists in the inpatient and hospital outpatient settings were determined from the CMS Physician/Supplier Procedure Summary Master Files for 1996 to 2008. The ACGME requirements of 1,500 neuroradiologic CT and 1,500 neuroradiologic MR scans per fellow per year were used to calculate the number of fellowship positions that could be supported by each specialty. RESULTS: In 2008, in the inpatient and hospital outpatient setting, radiologists interpreted 9,287,768 (98.3% of the total) and neurologists interpreted 43,107 (0.5% of the total) neuroradiologic examinations on Medicare patients. Per ACGME requirements, on the basis of CT volumes, radiologists could potentially train 4,256 neuroradiology fellows, compared with neurologists' 12 fellows, assuming a single fellow was exposed to every Medicare case. On the basis of MR volumes, radiologists and neurologists could train 1,935 and 16 fellows, respectively. CONCLUSIONS: Radiologists are responsible for interpreting the vast majority (98.3%) of neuroradiologic studies. Neurologists have a limited exposure to neuroradiologic CT and MR and could support only 12 fellowship positions by ACGME criteria on the basis of reading available 1996 to 2008 Medicare cases. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate clinical attitudes and expectations in the implementation of a neuroradiology picture archiving and communication system (PACS). A 1-page survey of expectations and clinical attitudes toward a neuroradiology mini-PACS was distributed to 49 full-time faculty members in the departments of neurosurgery, neurology, and otorhinolaryngology at an academic center. Interest in viewing soft-copy images was moderate to very high for over 89% of clinicians. All clinicians were comfortable with phone consultations with radiologists while viewing soft-copy images. Clinicians preferred retrieving images from personal computers over workstations and film libraries by 72.9%, 27.1%, and 0%, respectively. However, 38.5% of surgeons felt the need for hard copy in the operating room. Clinicians estimated that in 18.3% of cases, patients took their in-house films to outside institutions for consultations. Clinicians were enthusiastic about implementing PACS. Although acceptance of soft-copy viewing among clinicians is high, some provision for supplying hard-copy images appears to be necessary. Copyright © 2000 by W.B. Saunders Company [ABSTRACT FROM AUTHOR]

Objective: To evaluate lipomas of the internal auditory canal (IAC) and cerebellopontine angle (CPA).Study Design: Retrospective review.Methods: Review of a multi-institutional series of 17 lipomas of the IAC/CPA, combined with a Medline review of the 67 cases reported in the world literature.Results: This series of 17 IAC/CPA lipomas is the largest reported series to date, bringing the total number of documented cases to 84. There appears to be a nearly 2:1 male to female predominance. Sixty percent were left-sided lesions, and three were bilateral. Hearing loss, dizziness, and tinnitus were the most common presenting symptoms. Surgical resection was performed in 52 (62%) of these lesions; however, total tumor removal was accomplished in only 17 (33%), which is most likely because of the fact that these tumors tend to have a poorly defined matrix and a dense adherence to neurovascular structures. Sixty-eight percent of patients experienced a new deficit postoperatively, 11% were unchanged, and only 19% improved with no new deficit. Only one documented case of tumor growth was identified; however, the reported follow-up was short (average, less than 3 years).Conclusion: With the magnetic resonance imaging techniques now available, lipomas can be reliably differentiated from other masses within the CPA and IAC, so histopathologic diagnosis is rarely necessary. Because of the potential for significant morbidity with resection of these lesions, we believe that conservative follow-up is the best treatment option for patients with these rare lesions. Surgery is indicated only when significant progressive or disabling symptoms are present. [ABSTRACT FROM AUTHOR]

Purpose: Radiology faculty across various specialties have been reported to receive an average of 20.7 invitations to submit manuscripts to bogus journals and 4.1 invitations to speak at unsuitable events over a two-week span. Radiology trainees also receive a fair number of unsolicited invitations from unknown senders to submit manuscripts and speak at meetings. Trainees can be more vulnerable to predatory invitations due to potential naivety. We aimed to determine the prevalence of these spam invitations received by radiology trainees., Material and Methods: The designed survey for evaluating the experience of radiology trainees regarding phishing scams of predatory publications and conferences was sent to radiology residency and neuroradiology fellowship program leadership to redistribute amongst their trainees, and was advertised on social media platforms. The survey was first sent out on September 28, 2023, and was closed two weeks later October 12, 2023. Spearman's correlation, univariable and multivariable linear regression analyses were performed., Results: Our study included 151 respondents who completed the survey. Of the survey respondents, 53 % reported receiving unsolicited emails from predatory publications (mean = 6.76 ± 7.29), and 32 % reported receiving emails from fraudulent conferences (mean = 5.61 ± 5.77). Significant positive correlation was observed between number of unsolicited email invitations with number of PubMed indexed publications, number as corresponding author, number in open access journals and number of abstract presentations., Conclusions: Trainees in radiology receive many unsolicited invitations to publish papers as well as to present at meetings that are not accredited. This could lead to wasted time and financial resources for unsuspecting trainees., Competing Interests: Declaration of competing interest All authors declare no conflict of interest with respect to this work. Dr. Yousem reports royalties from Elsevier, personal fees from Medicolegal consultant, speaking and consulting fees from MRIOnline.com, outside the submitted work. Dr. Lakhani receives grant support from American Society of Neuroradiology and Physician Scientist Training Program at Johns Hopkins University, outside the submitted work., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Rationale and Objectives: Literature shows that discrimination has been pervasive in the field of medicine. The aim of this study was to collect experiences related to discrimination among US radiology residents, including type and source, as well as the residents' perception on lectures about discrimination and harassment. We also explored the barriers to reporting, and suggested strategies to overcome them., Material and Methods: Following Institutional Review Board (IRB) approval, an online survey was sent to program directors and coordinators across the US, who were asked to forward the link to their radiology residents. A reminder email was sent over a period of 4 months. The participants were reassured the survey was confidential and anonymous., Results: Among the respondents, the most reported types of discrimination were based in gender, race and nationality, the majority of which not being reported. The most common perpetrators were attending radiologists, co-residents, technologists, and patients. The main barriers for reporting were fear of retaliation, confidentiality concerns, and skepticism about a positive outcome., Conclusion: Our study examines some experiences of discrimination shared by residents during their training, with gender and race being the most common causes. This sheds light into a hidden and unspoken issue and highlights the need for more active discussions in radiology on microaggressions and implicit bias. Our data can guide future studies as well as residency programs to build effective strategies to address discrimination, aiming for sustainable changes., Competing Interests: Declaration of competing interest All authors declare no conflict of interest with respect to this work. Dr. Yousem reports royalties from Elsevier, personal fees from Medicolegal consultant, speaking and consulting fees from MRIOnline.com, outside the submitted work., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Two-tiered preference signaling has been implemented in the radiology residency application system to reduce congestion in the setting of high-volume applications. Signals are an indicator of strong interest that an applicant can transmit to a limited number of programs. This study assessed the impact of program signaling on interview invitations, how applicants strategically used signals based on their application's competitiveness, and applicants' attitudes toward the current signaling system., Methods: A survey was sent to radiology residency applicants registered with TheRadRoom during the 2024 application cycle. We queried the applicant's background, applications, signal distribution, and interview outcome depending on the type of signal sent. We also asked whether respondents received an interview invitation from a hypothetical "comparator non-signaled program" if they had one additional signal to use. Group differences were assessed using nonparametric Wilcoxon signed rank test., Results: A total of 202 applicants completed the survey (28% response rate). Most applied to diagnostic radiology (81%). Nearly all respondents utilized all 6 gold (98%) and 6 silver (96.5%) signals. Interview invitation rates were significantly higher for signaled programs (59.8%±27.4%) than non-signaled (8.5%±8.5%); the invitation rate at the comparator non-signaled programs was 37%. Gold signaled programs had significantly higher interview rates (67.8%±29.3) than silver (51.8%±31.3%). Respondents used 49.2%(±21.7%) of their signals for "likely to match" programs, 33.1%(±20.9%) for "aspirational" programs, and 17.6%(±15.8%) for "safety" programs. Most respondents (146;76%) supported continuing the signaling system for future cycles., Conclusion: Signaling programs significantly enhanced interview invitation rates, with gold signals being more effective than silver. The applicants used about 6 total signals for "likely-to-match" programs, 2 for "aspirational" programs, and about 4 for "safety" programs., (Copyright © 2024. Published by Elsevier Inc.)

Background and Purpose: Brain Arteriovenous malformations (AVMs) are congenital anomalies of the cerebrovascular system, often discovered incidentally or through symptomatic presentations such as intracranial hemorrhage, seizure, headache, or neurological deficits. Various treatment modalities exist for AVMs, including radiosurgery, a treatment modality that is noninvasive and efficient. Accurate imaging is crucial for risk assessment, treatment planning, and monitoring of these patients before and after radiosurgery. Currently, Digital Subtraction Angiography (DSA) stands as the preferred imaging modality. Despite its efficacy, DSA is notably invasive, presenting inherent risks to the patients. This systematic review and meta-analysis aim to evaluate the efficacy of magnetic resonance imaging (MRI) sequences for monitoring brain AVMs after radiosurgery., Data Source: A comprehensive search of PubMed, Scopus, Web of Science, and Embase databases was done and methodological quality assessment performed with the QUADAS-2 checklist diagnostic test accuracy., Data Analysis and Synthesis: We utilized the bivariate random-effects meta-analysis model (BRMA) with STATA/MP 17 software for data analysis. No significant publication bias was detected.14 studies were eligible for qualitative and quantitative analysis. MRI offers high sensitivity (85%) and specificity (99%) in detecting residual AVMs. Different MRI sequences, including 3DTOF MRA, 4D-MRA, and ASL demonstrated varying diagnostic accuracies with area under the curve (AUC) of 0.92, 0.97, and 0.96 respectively. 4D-MRA exhibited a sensitivity of 72% and specificity of 99%, ASL showed a sensitivity of 90% and specificity of 92% while 3D-TOF MRA showed 90% sensitivity and 87% specificity., Limitations: Meta-regression did not fully explain the sources of heterogeneity. Only one study assessed the SWAN method, and most studies involved small participant groups with varied MR techniques and sequences. Additionally, the retrospective nature of most studies may introduce bias, warranting cautious interpretation of the results., Conclusions: MRI sequences show acceptable diagnostic performance in post-radiosurgery monitoring of brain AVMs, with ASL and 4D-MRA showing acceptable diagnostic accuracy. Combining different MRI sequences may further enhance diagnostic reliability. However, Further investigation is needed to assess whether MRI sequences can serve as a feasible substitute for DSA, taking into account their risk-benefit profile, with the potential to establish them as the recommended standard., Competing Interests: The authors declare no conflicts of interest related to the content of this article., (© 2024 by American Journal of Neuroradiology.)

Rationale and Objectives: The number of international medical graduates (IMGs) entering radiology residencies and neuroradiology fellowships averaged 9.7% and 20.9% from 2021 to 2023, respectively. We aimed to determine whether IMG graduates are populating leadership roles at a proportionate rate in diagnostic radiology (DR) and neuroradiology., Materials and Methods: We surveyed 191 DR program directors, 94 neuroradiology program directors (PDs), 192 chairs of radiology, and 91 directors of neuroradiology inquiring about their original citizenship and medical school (American Medical Graduates [AMG] vs IMG). We reviewed institutional websites to obtain missing data and recorded H indices for each person using Scopus., Results: We confirmed the original citizenship and medical school location in 61-75% and 93-98% of each leadership group. We found that 16.2% of DR program directors, 43.7% of neuroradiology PDs, 28.5% of Chairs, and 40.6% of neuroradiology directors were not originally US citizens. The IMG rate was 18/188 (9.6%), 20/90 (22.2%), 26/186 (14.0%), and 19/85 (22.4%) for the same groups respectively. The most common country of origin and medical school cited was India for all leadership groups. IMGs had a median H index of 14 while AMG 10, significantly different (p = 0.021) CONCLUSION: Compared to the rate of diagnostic and neuroradiology trainees entering from 2021 to 2023, IMGs are proportionately represented at the leadership positions studied. The H index of the IMGs was higher than AMG. We conclude that IMGs have made substantial and proportionate inroads in radiology and neuroradiology leadership., Competing Interests: Declaration of Competing Interest Dr. Yousem reports royalties from Elsevier, personal fees from Medicolegal consultant, speaking and consulting fees from MRIOnline.com/Medality, outside the submitted work. The remaining authors declare that they have no conflict of interest., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Background: Financial security and retirement planning are essential for all medical professionals including radiology residents. Given the available discretionary income during residency it is crucial to have insights into investment. We aimed to assess the prevalence of retirement plans offered to radiology residents, the available choices, and their degree of participation., Methods: Two surveys were created using Qualtrics platform, one targeting program directors and another one oriented to radiology residents with items focused on demographic, financial status, offered plans, and participation. Analysis was performed using chi square whenever appropriate using Qualtrics platform. P values less than 0.05 were considered statistically significant., Results: 199 radiology residents (72.6% attending university-based programs) responded to the survey. 83.7% participated in retirement plans; university-based programs had the highest rate of offering plans; 82.8% vs 70% and 53.8% for university, community and hybrid programs respectively. The most frequently offered retirement plan was a 403(b). Most of the residents (94.3%) started investment in the retirement program as early as PGY1 and PGY2. A considerable proportion of programs lacked formal training on retirement plans; however, residents emphasized the significance of financial education during their residency., Conclusion: Radiology residents are more likely to participate in a retirement plan if it is offered by their program. Providing proper guidance by incorporating financial education into radiology residency curricula can optimize residents' decision making and economical planning, leading to a more secure financial future., Competing Interests: Declaration of competing interests The authors have no competing interests to declare. The authors declare no conflict of interest. Unrelated, Dr. Yousem reports royalties from Elsevier, personal fees from Medicolegal consultant, speaking and consulting fees from MRIOnline.com, outside the submitted work. Dr. Bar-Or reports that he receives royalties on book sales and is sometimes paid to teach financial literacy., (Copyright © 2024. Published by Elsevier Inc.)

We sought to determine the diagnostic accuracy of radiomics features in predicting HPV status in oropharyngeal squamous cell carcinoma (SCC) compared to routine paraclinical measures used in clinical practice. Twenty-six articles were included in the systematic review, and thirteen were used for the meta-analysis. The overall sensitivity of the included studies was 0.78, the overall specificity was 0.76, and the overall area under the ROC curve was 0.84. The diagnostic odds ratio (DOR) equaled 12 (8, 17). Subgroup analysis showed no significant difference between radiomics features extracted from CT or MR images. Overall, the studies were of low quality in regard to radiomics quality score, although most had a low risk of bias based on the QUADAS-2 tool. Radiomics features showed good overall sensitivity and specificity in determining HPV status in OPSCC, though the low quality of the included studies poses problems for generalizability.

Despite decades of faculty professional development programs created to prepare women for leadership, gender inequities persist in salary, promotion, and leadership roles. Indeed, men still earn more than women, are more likely than women to hold the rank of professor, and hold the vast majority of positions of power in academic medicine. Institutions demonstrate commitment to their faculty's growth by investing resources, including creating faculty development programs. These programs are essential to help prepare women to lead and navigate the highly matrixed, complex systems of academic medicine. However, data still show that women persistently lag behind men in their career advancement and salary. Clearly, training women to adapt to existing structures and norms alone is not sufficient. To effectively generate organizational change, leaders with power and resources must commit to gender equity. This article describes several efforts by the Office of Faculty in the Johns Hopkins University School of Medicine to broaden inclusivity in collaborative work for gender equity. The authors are women and men leaders in the Office of Faculty, which is within the Johns Hopkins University School of Medicine dean's office and includes Women in Science and Medicine. Here, we discuss potential methods to advance gender equity using inclusivity based on our institutional experience and on the findings of other studies. Ongoing data collection to evaluate programmatic outcomes in the Johns Hopkins University School of Medicine will be reported in the future.

The supplemental ERAS application that includes three components: past experiences, geographic preferences, and program signals was introduced in 2022 to complement the standard ERAS CV material. The goal was to help programs identify optimal candidates to interview and to improve the chances of applicants being invited for interviews at programs that align with their goals and interests. Based on limited data, Program signal is the most emphasized component by the programs. Applicants should realize that programs have used signals to determine who to interview (aligned with AAMC guidance), and to determine the program's candidate rank list (contrary to AAMC guidance). We have herein suggested options for leveraging benefits from the ERAS supplemental application which has now been incorporated into the full ERAS application., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

BACKGROUND. International medical graduates (IMGs) are a source of physicians who could help alleviate radiologist workforce shortages in the United States. However, IMGs may face barriers in obtaining appropriate visas (e.g., H-1B or O-1 visas) to allow faculty employment. OBJECTIVE. The purpose of this study was to assess the policies and experiences of U.S. academic radiology departments in offering visas to IMGs applying for faculty positions. METHODS. A web-based survey on policies and experiences in offering visas to IMG faculty candidates was distributed to chairs of U.S. radiology departments with a diagnostic radiology training program recognized by the National Resident Matching Program. Individual survey questions were optional. The initial survey and subsequent reminders were sent from October 7, 2022, through November 7, 2022. RESULTS. The survey response rate was 81% (143/177). A total of 24% (28/115), 38% (44/115), 17% (20/115), and 20% (23/115) of departments offered H-1B visas to IMG faculty frequently, sometimes, rarely, and never, respectively; 3% (3/113), 27% (31/113), 22% (25/113), and 48% (54/113) of departments offered O-1 visas frequently, sometimes, rarely, and never, respectively. However, 41% (46/113) and 5% (6/113) of departments had default policies of offering H-1B and O-1 visas for IMG faculty candidates, respectively. The most common reasons given for why departments did not offer visas included, for both H-1B and O-1 visas, the time-consuming process, lack of reliability of candidates' starting time, and the expense of the visa application; for O-1 visas, the reasons given also included lack of expertise. A total of 15% (16/108) of departments set their own visa policies, 75% (81/108) followed institutional policies, and 10% (11/108) followed policies set by other entities (e.g., state government). CONCLUSION. Although to at least some extent most U.S. academic radiology departments offer H-1B and O-1 visas for IMGs seeking faculty positions, use of such visas typically is not the departments' default policy. A variety of barriers contributed to visas not being offered. The departments' visa policies were primarily determined at the institutional level. CLINICAL IMPACT. The identified barriers faced by U.S. academic radiology departments in offering visas to IMG faculty candidates impact the role of IMGs in helping to address radiologist workforce shortages.

Rationale and Objectives: The number of international medical graduates (IMG) in radiology residencies has varied from year to year even as the number of candidates continues to grow. It is unclear from which countries the IMGs are arriving and what visas are being used to accommodate them., Materials and Methods: We sent a survey to 195 program directors (PD) in diagnostic radiology (DR) inquiring about the number and nationality of IMG residents in their program, their attitudes about IMG candidates, the performance of their IMG trainees, and the visas that are offered., Results: We received responses from 121 of 195 (62.1%) DR programs (121/149 =81.2% of actionable emails). 80/121 (66.1%) had at least one IMG in their DR residency program and the countries of origin included India (36), Iran (30), Saudi Arabia (24), Egypt (16), Canada (14), Brazil (14), and Pakistan (9), as the most common. While most programs (76/104, 73.1%) offered J1 visas, 23/99 (23.2%) provided H-1B visas to trainees. IMG DR residents overall performed as well as American graduates, with an equal number of PDs saying IMGs performed better and worse than American graduates. PDs' issues with IMGs centered on visas: (1) expense, (2) lack of familiarity, (3) Educational Commission for Foreign Medical Graduates regulations, and (4) time commitment in submitting paperwork., Conclusion: Most radiology IMG residents originate from India and Middle Eastern countries. Once enrolled, IMG residents perform similarly to US graduates. However, adding IMG candidates to the training program requires overcoming bureaucratic and monetary hurdles around visas., Summary Sentence: Most DR international medical graduate residents are from India or the Middle East. Although their performance is the same as American graduates in general, PDs note the monetary and bureaucratic hassles accompanying their recruitment., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: David M. Yousem reports a relationship with Elsevier that includes: consulting or advisory. David M. Yousem reports a relationship with Medality that includes: board membership, consulting or advisory, and speaking and lecture fees. David M. Yousem reports a relationship with Medicolegal Expert Witness that includes: paid expert testimony., (Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Objective: Unsolicited invitations to speak at medical meetings have proliferated as a type of spam email and phishing strategy to scam unsuspecting victims. We sought to determine the prevalence of such invitations to questionable meetings and determine the factors associated with receiving such solicitations., Materials and Methods: Data was collected for the number of speakers' invitations received over a 2-week period (April -May 2023) by radiologists of different subspecialties, academic ranks, and histories of publications and speaking engagements in the past 2-5 years. We analyzed the number of invitations received based on the variables., Results: Thirty-three of 45 (73.3%) faculty members received 188 inappropriate invitation emails in the 2-week observation period. The mean number of invitation emails was 4.13 for each faculty (SD: 5.03, range 0-20). There was no correlation between the number of invitations and radiologists' subspecialty, academic rank (3.8 ± 5, 3.0 ± 4, and 5.5 ± 5.7 invitations for full, associate, and assistant professors respectively) and previous legitimate speaker invites. Only 6 (3.2%) out of 188 invitations to speak sent to radiologists were for radiology-related meetings. Having more than 10 publications since 2022 was associated with a 5.0 (1.2, 19.4) times higher odds of receiving more than 4 solicitations., Conclusions: A total of 73.3% of the faculty surveyed received unsolicited invitations to meetings in the 2-week study period and over 96% of the invitations were unrelated to their field of practice. Our results show that publications since 2022 was the most significant factor associated with receiving more solicitations., Clinical Relevance/application: Invitations to questionable meetings targeting radiologists are frequent and often are unrelated to their specialties. The risk factors for receiving the invitations are unclear. Understanding these risk factors may enable educators especially junior investigators, to be better prepared to appropriately address such solicitations., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: To assess the effectiveness of an online, case-based interactive course in emergency neuroradiology to prepare radiology residents for night call in neuroradiology., Methods: A total of 15 residents participated in a pretest assessment of preparedness for neuroradiology call. After completing a 6-week interactive course incorporating case review, didactic lectures, quiz feedback, and references for further review, the same residents were quizzed on cognitive questions and feelings of readiness to enter the on-call pool for neuroradiology., Results: Knowledge and confidence both significantly increased due to the course. Knowledge-wise, the scores for precourse quiz to postcourse quiz went from 18.4%-72.2% (53.8% increase) in Brain Imaging and went from 22.3%-77.1% (54.8% increase) in Head, Neck, and Spine (P < 0.001 for both). Confidence-wise, residents demonstrated statistically significant increases in all 6 confidence measures. Prior to the course, 29% were not confident, 71% were fairly confident, and 0% were confident/very confident. After the course, 0% were not confident, 43% were fairly confident, and 57% were confident/very confident. Belief in the statement "I can provide high quality Neuroimaging services in the emergency care setting" increased from a confidence score of 1.29-2.57 after training (P = 0.004). Nearly all residents completing their first emergency call reported that they felt more confident reading neuroradiology studies during their call as a direct result of the course., Conclusions: Completing the multi-pronged interactive, case-based online emergency neuroradiology course led to improved funds of knowledge and feelings of confidence and impacted imaging approach in residents taking neuroradiology call., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Major depressive disorder (MDD) is a common psychiatric illness with a wide range of symptoms such as mood decline, loss of interest, and feelings of guilt and worthlessness. Women develop depression more often than men, and the diagnostic criteria for depression mainly rely on female patients' symptoms. By contrast, male depression usually manifests as anger attacks, aggression, substance use, and risk-taking behaviors. Various studies have focused on the neuroimaging findings in psychiatric disorders for a better understanding of their underlying mechanisms. With this review, we aimed to summarize the existing literature on the neuroimaging findings in depression, separated by male and female subjects. A search was conducted on PubMed and Scopus for magnetic resonance imaging (MRI), functional MRI (fMRI), and diffusion tensor imaging (DTI) studies of depression. After screening the search results, 15 MRI, 12 fMRI, and 4 DTI studies were included. Sex differences were mainly reflected in the following regions: 1) total brain, hippocampus, amygdala, habenula, anterior cingulate cortex, and corpus callosum volumes, 2) frontal and temporal gyri functions, along with functions of the caudate nucleus and prefrontal cortex, and 3) frontal fasciculi and frontal projections of corpus callosum microstructural alterations. Our review faces limitations such as small sample sizes and heterogeneity in populations and modalities. But in conclusion, it reflects the possible roles of sex-based hormonal and social factors in the depression pathophysiology., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Annular fissures are common findings on MR studies of the lumbar spine but have not been specifically examined in the thoracic spine. We sought to review the prevalence and stability of MRI imaging features of thoracic annular fissures and the association of thoracic AFs with intervertebral degenerative disk changes., Materials and Methods: We surveyed 10 years of MRI studies in which patients had one or more repeated examinations of the thoracic spine. For every annular fissure, we recorded its imaging features on all pulse sequences and the evolution of those imaging findings across all time periods., Results: We reviewed 210 patients and discovered that 66 (31.4%) had at least one thoracic annular fissure. The presence of annular fissures was positively correlated with older age and male gender. The initial annular fissure was always hyperintense on T2WI and annular fissures remained hyperintense on T2WI over time in all cases but showed less hyperintensity in 23.9% (n = 39/163) and more hyperintensity in 4.9% (n = 8/163). The rate of concomitant disk bulges was 85.8% (n = 140/163). Of the 71 annular fissures in which gadolinium-enhanced studies were performed, 20 (28.1%) showed enhancement and 14/20 (70%) annular fissures showed persistent enhancement over time (mean follow-up = 39.6 ± 44.1 months)., Conclusion: Thoracic annular fissures rarely resolve, remain hyperintense on T2WI, and, if they enhance, that enhancement generally persists., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. Unrelated, Dr. David Yousem reports royalties from Elsevier, personal fees from Medicolegal consultant, speaking and consulting fees from MRIOnline.com, outside the submitted work., (Copyright © 2023 Elsevier Inc. All rights reserved.)

This study examines the patterns of faculty solicitations by open-access (OA) publishers in radiology. The purpose of the research is to determine the factors that predict the likelihood of receiving such solicitations. We recruited 6 faculty members from 7 subspecialties in radiology to collect emails from OA journals for 2 weeks. We assessed the number of publications by each faculty member in 2022 and 2023, the previous 5 years, and entire career in PubMed. For each email, the solicitation was categorized for article submission, article review, and editorial board membership. An invitation to submit a manuscript was the most common type of solicitation received, followed by editorial boards and reviewer invites. Faculty with more than 10 indexed articles in PubMed since January 2022 were significantly more likely to receive article solicitations than those with 10 or fewer publications. Additionally, scholars with more than 40 articles since 2018 were significantly more likely to receive more than 10 article solicitations. Full professors were significantly more likely to receive solicitations to serve on editorial boards. A multivariate linear regression model predicted that publications since 2022 had the highest predictive value for the number of article solicitations and total solicitations. This study provides insight into the patterns of mass communication and various solicitations by OA publishers in radiology. The study highlights the importance of publication productivity as a predictor of article and total email solicitations and of professorial rank for editorial board invitations., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Cervical annular fissures (AFs) have not been studied specifically as to their prevalence, imaging features, and persistence over time. We sought to determine the prevalence and natural history of cervical AFs. We hypothesized that these are static lesions that are not prevalent in the population., Methods: This was a cross-sectional retrospective study of cervical MRI examinations performed between 2011-2021. We retrospectively reviewed the studies of 115 consecutive patients (63 female, 52 male) who had 2 or more MRI studies of the cervical spine to identify (1) imaging features of cervical AFs on various pulse sequences, (2) the concurrence of disc bulges/herniations, (3) changes in those imaging findings over time (mean follow-up 39.3 months) and (4) rate at which cervical AFs were mentioned in radiology reports. 620 initial and follow-up studies were reviewed., Results: 50/115 (43.5%) patients had cervical AFs; 21 patients had a single AF and 29 patients had multi-level AFs (total 109 AFs). The most common levels affected were C4-C5 (28%, n = 31) and C5-C6 (27%, n = 30). All cervical AFs were hyperintense on T2WI and, over time, 95% (n = 104/109) of the AFs remained hyperintense; 22% (n = 25) showed less hyperintensity, 10% (n = 11) more hyperintensity, and 60% (n = 66) the same hyperintensity. 5 AFs (4%) resolved completely. Only 2 (8%) of 25 cervical AFs enhanced with gadolinium. The rate of concomitant disc bulges and herniations was 71% (n = 78) and 22% (n = 24) respectively. The presence of cervical AFs did not increase the risk of progression to bulges or herniations. None of the cervical AFs were mentioned in the radiology reports., Conclusions: Cervical AFs occurred in 43.5% of patients but were rarely reported. They usually remained bright on T2W but their brightness could vary over time. Cervical AFs were often associated with disc bulges/herniations and enhanced less frequently (8%) than lumbar disk AFs., Competing Interests: The authors declare no conflict of interest. Unrelated, Dr. Yousem reports royalties from Elsevier, personal fees from Medicolegal consultant, speaking and consulting fees from MRIOnline.com, outside the submitted work., (© 2023 The Author(s).)

Purpose: One possible limitation of structured template radiology reports is that radiologists look back and forth between viewing and dictation monitors, thereby impacting the length of time spent reviewing images and generating a report. We hypothesize that the total time spent viewing case images is diminished and/or the total time spent creating a report is prolonged when the report is generated using a structured template compared with free text format., Approach: Three neuroradiologists and three senior residents viewed five brain magnetic resonance imaging cases with unique findings while eye position was recorded. Participants generated reports for each case utilizing both structured templates and free text dictation. The time spent viewing images was compared with the time spent looking at the dictation screen., Results: The two main hypotheses were confirmed: the total time viewing images diminished with templates versus free text dictation and the total time to create a report was prolonged with templates. The mean time (s) spent on the "image" region of interest approached statistical significance as a function of the report type [free: attendings = 236.79 (154.43), residents = 223.55 (77.79); template: attendings = 163.40 (73.42), residents = 182.48 (77.47)] and was overall lower with the template reporting for both attendings and residents ( F = 3.77 , p = 0.0623 ), but it did not differ as a function of seniority ( F = 0.017 , p = 0.8977 )., Conclusions: Template-based radiology reports have significant potential to alter the way radiologists view images and report on them, spending more time viewing the report monitor rather than diagnostic images compared with free text dictation. Many radiologists prefer templates for reporting as the structured format may aid in conducting a more systematic or thorough search for findings, although prior work on this assumption is mixed. Future eye-tracking studies could further elucidate whether and how templates and free reports impact the detection and classification of radiographic findings., (© 2023 Society of Photo-Optical Instrumentation Engineers (SPIE).)

Purpose: To assess the diagnostic yield of computed tomography angiography (CTA)/magnetic resonance angiography (MRA) brain and neck ordered in the emergency department (ED) for patients who have intraparenchymal hemorrhage (IPH) on their initial noncontrast CT (NCCT) of the head., Methods: In this retrospective study, we reviewed 156 patients presenting to the ED with nontraumatic IPH, documented on NCCT. We assessed if the subsequent CTA/MRA was positive, and collected data regarding the location of the bleed, patients' age group, and presence/absence of associated SAH/IVH. Two neuroradiologists were asked to predict, based on age and NCCT appearance, whether the CTA/MRA would be positive or negative for demonstrating a vascular etiology of the hemorrhage., Results: The yield of CTA/MRA head for patients above 75 years old was 2% (1/49), as the etiology for IPH in such age group was more commonly related to hypertensive bleed or amyloid angiopathy. The concomitant presence of subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH), particularly in patients younger than 75 years, correlated with a higher likelihood of a positive CTA. Statistically, the neuroradiologists were able to exclude a vascular source of the IPH based on CT appearance, bleed location, and patient's age in over 92% of cases., Conclusion: CTA/MRA for IPH has a lower yield in patients at older age and with deep gray matter distribution without SAH. Neuroradiologists were accurate at excluding a vascular source of the IPH in most cases. This study suggests that CTA/MRA can be omitted in certain scenarios, thereby preventing overutilization, and leading to optimal use of health care resources., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Transcranial magnetic stimulation (TMS) is a type of noninvasive neurostimulation used increasingly often in clinical medicine. While most studies to date have focused on TMS's ability to treat major depressive disorder, it has shown promise in several other conditions including post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). As different treatment protocols are often used across studies, the ability to predict patient outcomes and evaluate immediate and long-term changes using imaging becomes increasingly important. Several imaging features, such as thickness, connectedness, and baseline activity of a variety of cortical and subcortical areas, have been found to be correlated with a greater response to TMS therapy. Intrastimulation imaging can reveal in real time how TMS applied to superficial areas activates or inhibits activity in deeper brain regions. Functional imaging performed weeks to months after treatment can offer an understanding of how long-term effects on brain activity relate to clinical improvement. Further work should be done to expand our knowledge of imaging features relevant to TMS therapy and how they vary across patients with different neurological and psychiatric conditions., (Copyright © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Purpose: The neurotropism of SARS-CoV-2 and the consequential damage to the olfactory system have been proposed as one of the possible underlying causes of olfactory dysfunction in COVID-19. We aimed to aggregate the results of the studies which reported imaging of the olfactory system of patients with COVID-19 versus controls., Methods: PubMed and EMBASE were searched to identify relevant literature reporting the structural imaging characteristics of the olfactory bulb (OB), olfactory cleft, olfactory sulcus (OS), or olfactory tract in COVID-19 patients. Hedge's g and weighted mean difference were used as a measure of effect size. Quality assessment, subgroup analyses, meta-regression, and sensitivity analysis were also conducted., Results: Ten studies were included in the qualitative synthesis, out of which seven studies with 183 cases with COVID-19 and 308 controls without COVID-19 were enrolled in the quantitative synthesis. No significant differences were detected in analyses of right OB volume and left OB volume. Likewise, right OS depth and left OS depth were also not significantly different in COVID-19 cases compared to non-COVID-19 controls. Also, we performed subgroup analysis, meta-regression, and sensitivity analysis to investigate the potential effect of confounding moderators., Conclusion: The findings of this review did not confirm alterations in structural imaging of the olfactory system, including OB volume and OS depth by Covid-19 which is consistent with the results of recent histopathological evaluations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Multiple exposures to gadolinium-based contrast agents (GBCAs) is known to be associated with gadolinium deposition in the brain in certain patients. Such deposition has been correlated with specific brain MRI findings, although most available data is in patients with underlying neurologic disorders. We aim to prospectively evaluate brain MRI signal changes as well as neurologic and neuropsychologic testing results in women undergoing screening breast MRI., Methods: In this IRB-approved, HIPAA-compliant prospective study, 9 women with 5 or more exposures to linear and/or macrocyclic GBCA due to screening breast MRI underwent noncontrast brain MRI, neurologic exam and neuropsychologic testing. Women with underlying neurologic, psychologic, hepatic or renal disorders were excluded., Results: The mean total number of GBCA exposures was 8 (standard deviation 2.7), with 63/72 (87%) of the exposures being linear agents. There was no association between brain MRI signal changes and abnormalities on neurologic or neuropsychologic examination. There was no association between total number of GBCA exposures and abnormalities on neurologic or neuropsychologic examination., Conclusion: In this prospective exploratory study of 9 women with 5 or more GBCA exposures due to screening breast MRI, there was no association between brain MRI signal changes and clinical abnormalities on neurologic or neuropsychologic examination. While larger studies are needed in this patient population, the lack of clinical impact of multiple GBCA exposures in this study is reassuring., (Copyright © 2022 Elsevier Inc. All rights reserved.)

In this review article we have consolidated the imaging literature of patients with schizophrenia across the full spectrum of modalities in radiology including computed tomography (CT), morphologic magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and magnetoencephalography (MEG). We look at the impact of various subtypes of schizophrenia on imaging findings and the changes that occur with medical and transcranial magnetic stimulation (TMS) therapy. Our goal was a comprehensive multimodality summary of the findings of state-of-the-art imaging in untreated and treated patients with schizophrenia. Clinical imaging in schizophrenia is used to exclude structural lesions which may produce symptoms that may mimic those of patients with schizophrenia. Nonetheless one finds global volume loss in the brains of patients with schizophrenia with associated increased cerebrospinal fluid (CSF) volume and decreased gray matter volume. These features may be influenced by the duration of disease and or medication use. For functional studies, be they fluorodeoxyglucose positron emission tomography (FDG PET), rs-fMRI, task-based fMRI, diffusion tensor imaging (DTI) or MEG there generally is hypoactivation and disconnection between brain regions. However, these findings may vary depending upon the negative or positive symptomatology manifested in the patients. MR spectroscopy generally shows low N -acetylaspartate from neuronal loss and low glutamine (a neuroexcitatory marker) but glutathione may be elevated, particularly in non-treatment responders. The literature in schizophrenia is difficult to evaluate because age, gender, symptomatology, comorbidities, therapy use, disease duration, substance abuse, and coexisting other psychiatric disorders have not been adequately controlled for, even in large studies and meta-analyses., Competing Interests: Author DY reports royalties from Elsevier, personal fees as a Medicolegal consultant, he also received speaking and consulting fees from MRIOnline.com, outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dabiri, Dehghani Firouzabadi, Yang, Barker, Lee and Yousem.)

Background and Purpose: Repeat contrast-enhanced MR imaging exposes patients with relapsing-remitting MS to frequent administration of gadolinium-based contrast agents. We aimed to investigate the potential metabolite and neurochemical alterations of visible gadolinium deposition on unenhanced T1WI in the dentate nucleus using MRS., Materials and Methods: This prospective study was conducted in a referral university hospital from January 2020 to July 2021. The inclusion criteria for case and control groups were as follows: 1) case: patients with relapsing-remitting MS, visible gadolinium deposition in the dentate nucleus (ribbon sign), >5 contrast-enhanced MR images obtained; 2) control 1: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, >5 contrast-enhanced MR images obtained; 3) control 2: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, <5 contrast-enhanced-MR images obtained; and 4) control 3: adult healthy individuals, with no contrast-enhanced MR imaging. Dentate nucleus and pontine single-voxel 12 × 12 × 12 MRS were analyzed using short TEs., Results: Forty participants (10 per group; 27 [67.5%] female; mean age, 35.6 [SD, 9.6] years) were enrolled. We did not detect any significant alteration in the levels of NAA and choline between the studied groups. The mean concentrations of mIns were 2.7 (SD, 0.73) (case), 1.5 (SD, 0.8) (control 1), 2.4 (SD, 1.2) (control 2), and 1.7 (SD, 1.2) (control 3) ( P = .04). The mean concentration of Cr and mIns ( P = .04) and the relative metabolic concentration (dentate nucleus/pons) of lipid 1.3/Cr ( P = .04) were significantly higher in the case-group than in healthy individuals (controls 1-3). Further analyses compared the case group with cumulative control 1 and 2 groups and showed a significant increase in lactate ( P = .02), lactate/Cr ( P = .04), and Cr (dentate nucleus/pons) ( P = .03) in the case group., Conclusions: Although elevated concentrations of Cr, lactate, mIns, and lipid in the dentate nucleus of the case group indicate a metabolic disturbance, NAA and choline levels were normal, implying no definite neuronal damage., (© 2022 by American Journal of Neuroradiology.)

Purpose: Acute neurovascular imaging including MRA and/or CTA are routinely performed in the emergency departments (ED) for patients who present with suspected transient ischemic attacks (TIA). Given the current emphasis on mitigating the rising cost of health care nationally, and promoting high value practice, we sought to determine 1) the value of acute neurovascular imaging in patients presenting to the ED with TIA-like symptoms, and 2) whether these neurovascular studies led to a difference in management strategies., Method: We retrospectively reviewed 398 ED patients who presented with transient neurological deficits and underwent neurovascular imaging from 2015 to 2018. We reviewed diffusion weighted imaging (DWI) and neurovascular results by patient demographics, baseline risk factors, final diagnosis, treatment/management dispositions and three-month follow-up., Results: 28.1% (112/398) of patients were diagnosed with true TIA, whereas 71.9% patients were deemed to have a non-vascular etiology. Total rates of positive MRA/CTA for severe intracranial (>50%) and cervical vessel (>70%) stenosis were 10.5% and 1.7%. Patients with positive DWI scans had significantly higher rates of severe vascular stenosis (24.4% versus 7.8% intracranially and 2.4% versus 0.9% in the neck) compared to those with negative DWI scans. All patients were treated with multi-pronged medical therapies with no immediate surgical intervention. A follow-up stroke was equally likely in TIA patients with or without severe vascular stenosis., Conclusions: In patients presenting with TIA-like symptoms and DWI negative scans, the overall rate of positive neurovascular studies is very low. Triaging with DWI can reduce the frequency of unnecessary neurovascular imaging., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Headache is a common presenting symptom in the ambulatory setting that often prompts imaging. The increased use and associated health care money spent in the setting of headache have raised questions about the cost-effectiveness of neuroimaging in this setting. Neuroimaging for headache in most cases is unlikely to reveal significant abnormality or impact patient management. In this article, reasons behind an observed increase in neuroimaging and its impact on health care expenditures are discussed. The typical imaging modalities available and various imaging guidelines for common clinical headache scenarios are presented, including recommendations from the American College of Radiology., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Artificial intelligence (AI) is having a disruptive and transformative effect on clinical medicine. Prompt clinical diagnosis and imaging are critical for minimizing the morbidity and mortality associated with ischemic strokes. Clinicians must understand the current strengths and limitations of AI to provide optimal patient care. Ischemic stroke is one of the medical fields that have been extensively evaluated by artificial intelligence. Presented herein is a review of artificial intelligence applied to clinical management of stroke, geared toward clinicians. In this review, we explain the basic concept of AI and machine learning. This review is without coding and mathematical details and targets the clinicians involved in stroke management without any computer or mathematics' background. Here the AI application in ischemic stroke is summarized and classified into stroke imaging (automated diagnosis of brain infarction, automated ASPECT score calculation, infarction segmentation), prognosis prediction, and patients' selection for treatment., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Autism spectrum disorder (ASD) is neuropsychiatric continuum of disorders characterized by persistent deficits in social communication and restricted repetitive patterns of behavior which impede optimal functioning. Early detection and intervention in ASD children can mitigate the deficits in social interaction and result in a better outcome. Various non-invasive imaging methods and molecular techniques have been developed for the early identification of ASD characteristics. There is no general consensus on specific neuroimaging features of autism; however, quantitative magnetic resonance techniques have provided valuable structural and functional information in understanding the neuropathophysiology of ASD and how the autistic brain changes during childhood, adolescence, and adulthood. In this review of decades of ASD neuroimaging research, we identify the structural, functional, and molecular imaging clues that most accurately point to the diagnosis of ASD vs. typically developing children. These studies highlight the 1) exaggerated synaptic pruning, 2) anomalous gyrification, 3) interhemispheric under- and overconnectivity, and 4) excitatory glutamate and inhibitory GABA imbalance theories of ASD. The application of these various theories to the analysis of a patient with ASD is mitigated often by superimposed comorbid neuropsychological disorders, evolving brain maturation processes, and pharmacologic and behavioral interventions that may affect the structure and function of the brain. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 3., (© 2021 International Society for Magnetic Resonance in Medicine.)

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition that leads to impaired attention and impulsive behaviors diagnosed in, but not limited to, children. ADHD can cause symptoms throughout life. This article summarizes the structural (conventional, volumetric, and diffusion tensor imaging) and functional (task-based functional MRI [fMRI], resting-state fMRI, PET, and MR spectroscopy) brain findings in patients with ADHD. Consensus is lacking regarding altered anatomic or functional imaging findings of the brain in children with ADHD, likely because of the heterogeneity of the disorder. Most anatomic studies report abnormalities in the frontal lobes, basal ganglia, and corpus callosum; decreased surface area in the left ventral frontal and right prefrontal cortex; thinner medial temporal lobes; and smaller caudate nuclei. Using fMRI, researchers have focused on the prefrontal and temporal regions, reflecting perception-action mapping alterations. Artificial intelligence models evaluating brain anatomy have highlighted changes in cortical thickness and the shape of the inferior frontal cortex, bilateral sensorimotor cortex, left temporal lobe, and insula. Early intervention and/or normal brain maturation can alter imaging patterns and convert functional imaging studies to a normal pattern. Although imaging findings provide insight into the neuropathophysiology of the disease, no definitive structural or functional pattern defines the disorder from a neuroradiologic perspective.

Creating a joyful workplace is not the same as dealing with issues of stress, fatigue, burn-out, and resilience. It requires a proactive approach to augment feelings of worth, appreciation, and well-being in the members of the team. The sense that one is pursuing worthwhile, valuable activities requires a wholesale commitment to the mission, vision and values of the organization. These tenets are often created through an organic consensus of collegial workmates and then put to action by a leadership team. Reassessing the goals and virtues of the organization at appropriate intervals leads to ongoing loyalty and commitment to the team and a positive attitude. Well-being is addressed through the creation of a bright and cheerful physical and psychosocial workplace that offers programs that encourage mindfulness, humor, playfulness, and fitful lifestyle choices. The sense that one's work is appreciated and valued stems from an attitude of gratitude on behalf of all levels of the organization including management and peers where such encouragement flourishes. Those expressions of appreciation may be in the form of celebrations in the workplace and/or compensation and benefits that appropriately value the contributions of the employee. The organization's executive team should be dedicated to crafting an environment that leads to delighted, healthy employees., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Olfaction is a fundamental sense that plays a vital role in daily life in humans, and can be altered in neuropsychiatric and neurodegenerative diseases. Blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) using conventional echo-planar-imaging (EPI) based sequences can be challenging in brain regions important for olfactory processing, such as the olfactory bulb (OB) and orbitofrontal cortex, mainly due to the signal dropout and distortion artifacts caused by large susceptibility effects from the sinonasal cavity and temporal bone. To date, few studies have demonstrated successful fMRI in the OB in humans. T2-prepared (T2prep) BOLD fMRI is an alternative approach developed especially for performing fMRI in regions affected by large susceptibility artifacts. The purpose of this technical study is to evaluate T2prep BOLD fMRI for olfactory functional experiments in humans. Olfactory fMRI scans were performed on 7T in 14 healthy participants. T2prep BOLD showed greater sensitivity than GRE EPI BOLD in the OB, orbitofrontal cortex and the temporal pole. Functional activation was detected using T2prep BOLD in the OB and associated olfactory regions. Habituation effects and a bi-phasic pattern of fMRI signal changes during olfactory stimulation were observed in all regions. Both positively and negatively activated regions were observed during olfactory stimulation. These signal characteristics are generally consistent with literature and showed a good intra-subject reproducibility comparable to previous human BOLD fMRI studies. In conclusion, the methodology demonstrated in this study holds promise for future olfactory fMRI studies in the OB and other brain regions that suffer from large susceptibility artifacts., Competing Interests: Equipment used in the study was manufactured by Philips Healthcare and Whiff LLC. PZ is a paid lecturer for the Philips Healthcare and has technology licensed to them. This arrangement has been approved by Johns Hopkins University in accordance with its conflict of interest policies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Miao, Paez, Rajan, Cao, Liu, Pantelyat, Rosenthal, van Zijl, Bassett, Yousem, Kamath and Hua.)

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a distinct CNS inflammatory disease with symptoms and imaging findings that overlap other neuroinflammatory disorders. We highlight the imaging characteristics of MOGAD and contrast them with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). Intracranial features that suggest MOGAD include childhood acute disseminated encephalomyelitis pattern with diffuse signal abnormality in the cortical gray matter, subcortical white matter, deep white matter, and deep gray matter on T2-weighted and FLAIR images; few bilateral T2-hyperintense fluffy and poorly demarcated lesions; pontine or thalamic involvement (or both); and cerebellar peduncle lesions in children. Intraorbitally, one sees edematous, enlarged, tortuous optic nerve or nerves; bilateral long-segment T2 hyperintensity of anterior segments of the optic nerve; sparing of the optic chiasm and retrochiasmatic pathways; and perioptic nerve sheath and surrounding orbital fat enhancement. Spinal involvement is seen as longitudinally extensive transverse myelitis with a sagittal T2-hyperintense intramedullary spinal line, the axial "H" spinal cord sign (central cord gray matter T2 hyperintensity), and conus medullaris involvement. Early accurate diagnosis of MOGAD is important because prognosis and treatment differ from those for NMOSD and MS.

Background and Purpose: Screening for blunt cerebrovascular injury in patients after motor vehicle collision (MVC) solely based on the presence of cervical seat belt sign has been debated in the literature without consensus. Our aim was to assess the value of emergent neurovascular imaging in patients after an MVC who present with a seat belt sign through a large-scale multi-institutional study., Materials and Methods: The electronic medical records of patients admitted to the emergency department with CTA/MRAs performed with an indication of seat belt injury of the neck were retrospectively reviewed at 5 participating institutions. Logistic regression analysis was used to determine the association among age, sex, and additional trauma-related findings with blunt cerebrovascular injury., Results: Five hundred thirty-five adult and 32 pediatric patients from June 2003 until March 2020 were identified. CTA findings were positive in 12/567 (2.1%) patients for the presence of blunt cerebrovascular injury of the vertebral ( n = 8) or internal carotid artery ( n  = 4) in the setting of acute trauma with the seat belt sign. Nine of 12 patients had symptoms, signs, or risk factors for cervical blunt cerebrovascular injury other than the seat belt sign. The remaining 3 patients (3/567, 0.5%) had Biffl grades I-II vascular injury with no neurologic sequelae. The presence of at least 1 additional traumatic finding or the development of a new neurologic deficit was significantly associated with the presence of blunt cerebrovascular injury among adult patients, with a risk ratio of 11.7 ( P  = .001). No children had blunt cerebrovascular injury., Conclusions: The risk of vascular injury in the presence of the cervical seat belt sign is small, and most patients diagnosed with blunt cerebrovascular injury have other associated findings. Therefore, CTA based solely on this sign has limited value (3/567 =  a 0.5% positivity rate). We suggest that in the absence of other clinical findings, the seat belt sign does not independently justify neck CTA in patients after trauma., (© 2021 by American Journal of Neuroradiology.)

Purpose: When deciding among imaging equipment vendors, one may use a vendor's prevalence in peer-reviewed publications as a measure of their research and development. We sought to determine which vendors, countries, and journals were dominant in hepatic imaging literature of 2018 with respect to magnetic resonance (MR), computed tomography (CT), and ultrasound (US)., Methods: We recorded and analyzed the modality (MR, CT, US), journal, vendor, and authors' country for all original hepatic imaging articles published in 2018 in 29 imaging journals., Results: Of 197 MR articles, investigators used Siemens in 98 (50%), General Electric (GE) in 65 (33%), and Philips in 63 (32%). Of 115 CT articles, investigators mentioned Siemens in 55 (48%), GE in 45 (39%), Philips in 25 (22%) and other vendors in 27 (24%). Of 68 ultrasound articles, Siemens dominated with 27 (40%), versus GE with 19 (28%), Philips with 11 (16%), and other vendors with 42 (62%). We found a significant difference in vendor usage for MR, CT, and all modalities (p < .01). The plurality of articles was written in the United States (73 [23%]) with South Korea (56 [17%]) and China (56 [17%]) following. European Radiology published the most hepatic articles. For American journals, we found a significant difference in MR (p = .02) and CT (p < .01) vendor usage, whereas non-American journals nearly reached significance in MR (p = .06) and CT (p = .06) vendor usage., Conclusion: Siemens was the most cited vendor in hepatic imaging literature for all modalities. American institutions and non-American journals published the most hepatic imaging articles., (Copyright © 2020 Elsevier Inc. All rights reserved.)