The recently proposed glymphatic pathway for solute transport and waste clearance from the brain has been the focus of intense debate. By exploiting an isotopically enriched MRI tracer, H 217 O, we directly imaged glymphatic water transport in the rat brain in vivo. Our results reveal glymphatic transport that is dramatically faster and more extensive than previously thought and unlikely to be explained by diffusion alone. Moreover, we confirm the critical role of aquaporin-4 channels in glymphatic transport.
Background/Objectives: Glioblastoma (GBM) is an aggressive and lethal primary brain tumor with a poor prognosis, with a 5-year survival rate of approximately 5%. Despite advances in oncologic treatments, including surgery, radiotherapy, and chemotherapy, survival outcomes have remained stagnant, largely due to the failure of conventional therapies to address the tumor’s inherent heterogeneity. Radiomics, a rapidly emerging field, provides an opportunity to extract features from MRI scans, offering new insights into tumor biology and treatment response. This study evaluates the potential of delta radiomics, the study of changes in radiomic features over time in response to treatment or disease progression, exploring the potential of delta radiomics to track temporal radiation changes in tumor morphology and microstructure. Methods: A cohort of 50 female CD1 nude mice was injected intracranially with G7 glioblastoma cells and divided into irradiated (IR) and non-irradiated (non-IR) groups. MRI scans were performed at baseline (week 11) and post-radiation (weeks 12 and 14), and radiomic features, including shape, histogram, and texture parameters, were extracted and analyzed to capture radiation-induced changes. The most robust features were those identified through intra-observer reproducibility assessment, ensuring reliability in feature selection. A machine learning model was developed to classify irradiated tumors based on delta radiomic features, and statistical analyses were conducted to evaluate feature feasibility, stability, and predictive performance. Results: Our findings demonstrate that delta radiomics effectively captured significant temporal variations in tumor characteristics. Delta radiomics features exhibited distinct patterns across different time points in the IR group, enabling machine learning models to achieve a high accuracy. Conclusions: Delta radiomics offers a robust, non-invasive method for monitoring the treatment of glioblastoma (GBM) following radiation therapy. Future research should prioritize the application of MRI delta radiomics to effectively capture short-term changes resulting from intratumoral radiation effects. This advancement has the potential to significantly enhance treatment monitoring and facilitate the development of personalized therapeutic strategies.
Objectives: Diagnostic reference levels (DRLs) are crucial tools for optimizing radiation exposure during different radiological examinations. This study aimed to establish preliminary DRLs for commonly performed computed tomographic angiography (CTA) examinations in Saudi Arabia. Methods: Data for three types of CTA examinations (cerebral, pulmonary, and lower-extremity) were collected from six medical cities across Saudi Arabia. Data sets related to 723 CTAs with a mean patient weight of 75 kg were analysed in detail. The DRL values were determined based on the 75th, median, and 25th CT dose index volume (CTDIvol) and dose length product (DLP) values. Results: The established DRLs were 1221 mGy cm for cerebral CTAs, 475 mGy cm for pulmonary CTAs, and 1040 mGy cm for lower-extremity CTAs. These values were comparable to those reported in other studies. Conclusions: This study provides preliminary DRLs for three common CTA procedures in Saudi Arabia. The widespread implementation of a low kVp and a high level of image reconstruction (IR) presents an opportunity for further dose reduction. These findings can serve as a foundation for future nationwide DRL surveys and the optimization of CTA imaging protocols in Saudi Arabia.
(1) Background: Colorectal cancer is the third most common type of cancer with a high mortality rate and poor prognosis. The accurate prediction of key genetic mutations, such as the KRAS status, tumor staging, and extramural venous invasion (EMVI), is crucial for guiding personalized treatment decisions and improving patients’ outcomes. MRI radiomics was assessed to predict the KRAS status and tumor staging in colorectal cancer patients across different imaging platforms to improve the personalized treatment decisions and outcomes. (2) Methods: Sixty colorectal cancer patients (35M/25F; avg. age 56.3 ± 12.9 years) were treated at an oncology unit. The MRI scans included T2-weighted (T2W) and diffusion-weighted imaging (DWI) or the apparent diffusion coefficient (ADC). The manual segmentation of colorectal cancer was conducted on the T2W and DWI/ADC images. The cohort was split into training and validation sets, and machine learning was used to build predictive models. (3) Results: The neural network (NN) model achieved 73% accuracy and an AUC of 0.71 during training for predicting the KRAS mutation status, while during testing, it achieved 62.5% accuracy and an AUC of 0.68. In the case of tumor grading, the support vector machine (SVM) model excelled with a training accuracy of 72.93% and an AUC of 0.7, and during testing, it reached an accuracy of 72% and an AUC of 0.69. (4) Conclusions: ML models using radiomics from ADC maps and T2-weighted images are effective for distinguishing KRAS genes, tumor grading, and EMVI in colorectal cancer. Standardized protocols are essential to improve MRI radiomics’ reliability in clinical practice.