Jie Lu

MRI Signs for the Preoperative Diagnosis of Intracranial Solitary Fibrous Tumors.

BACKGROUND Intracranial solitary fibrous tumors (ISFTs) are frequently misdiagnosed as meningiomas on MRI. Existing MRI signs have been evaluated individually, without a standardized and externally validated diagnostic framework. PURPOSE To develop and validate an MRI-based diagnostic score for intracranial solitary fibrous tumors (ISFT-DS) for the preoperative identification of ISFTs. STUDY TYPE Retrospective multicenter diagnostic accuracy study. POPULATION Five hundred with ISFTs (mean age, 46.4 ± 11.7 years; 269 men), 250 with low-grade meningiomas (mean age, 57.0 ± 11.1 years; 51 men), and 250 with high-grade meningiomas (mean age, 49.6 ± 14.3 years; 108 men). The development and external validation cohorts included 840 (84%) and 160 (16%) patients, respectively. FIELDSTRENGTH/SEQUENCE Spin-echo T1-weighted imaging (T1WI), fast or turbo spin-echo T2-weighted imaging, and contrast-enhanced spin-echo T1-weighted imaging. ASSESSMENT Three potential MRI features-T1WI hyperintensity, honeycomb-like cystic change, and trans-compartmental growth pattern-were assessed by three neuroradiologists and combined into the 0-3-point ISFT-DS. Diagnostic performance and the effects of standardized training in six readers were evaluated. STATISTICAL TESTS Sensitivity, specificity, accuracy, kappa statistics, receiver operating characteristic analysis, DeLong tests, χ2and Fisher exact tests, analysis of variance, McNemar test, Kruskal-Wallis tests. p < 0.05 indicated statistical significance. RESULTS At an ISFT-DS cutoff of ≥ 1, sensitivity/specificity were 81.4%/83.3% in the development cohort and 76.3%/86.3% in the external validation cohort, respectively. Specificity reached 98.3%/98.8% at ≥ 2 and 100%/100% at 3. Interreader agreement was good to excellent for the three MRI features and the ISFT-DS (κ = 0.80-0.87). Standardized reader training on the ISFT-DS increased the overall AUC from 0.67 to 0.80 (ΔAUC = 0.13), with larger gains for Readers 1 and 2 (ΔAUC = 0.21 and 0.15, respectively). DATA CONCLUSION The ISFT-DS provides a reproducible and teachable MRI-based scoring system for standardized preoperative identification of ISFTs. EVIDENCE LEVEL 3. TECHNICAL EFFICACY Stage 2.

Distance-dependent Functional Connectivity Strength Analysis Using Resting-State fMRI: Application to Vascular Cognitive Impairment, No Dementia.

We present a resting-state fMRI-based protocol for quantifying anatomical distance-dependent functional connectivity strength (FCS) and demonstrate its application in vascular cognitive impairment, no dementia (VCIND). Resting-state fMRI data from VCIND patients and demographically matched normal controls were analyzed using voxel-wise FCS across six anatomical distance intervals to characterize short-, medium-, and long-range functional connectivity. Network-level analyses were also performed to identify large-scale network involvement. The results reveal a hierarchical distance-dependent organization of functional connectivity, with short-range connectivity concentrated in primary sensory systems and long-range connectivity increasingly involving higher-order association networks. In VCIND, significant alterations were observed particularly within the frontoparietal network, suggesting compensatory network reorganization associated with cognitive performance. These distance-dependent FCS alterations may serve as potential neuroimaging markers for early identification and risk stratification of VCIND and may also support longitudinal monitoring of functional network changes.

Quantitative dual-tracer 18F-FDG and 18F-DPA-714 PET/MR for characterizing pathological subtypes in refractory mesial temporal lobe epilepsy.