Parkinson's disease is a progressive degenerative nervous system disease. Recent studies have shown that secondary changes in the GABA system play directly affect the pathogenesis of PD. There is still much debate about GABA concentrations because currently, GABA concentrations in the brain tissue are obtained indirectly by measuring its concentration in the blood and cerebrospinal fluid. These results are unreliable. Magnetic resonance spectroscopy (MRS) is the only noninvasive method for evaluating the concentration of metabolites in living brain tissue and has been widely applied in research and clinical practice. In addition, combining MEGA-PRESS technology with LCModel software for quantitative GABA measurements is largely recognized. At present, the PD monkeys model in primates has been increasingly proficient. Primates are more similar to humans in terms of brain structure and function than other animals. However, 3.0 T MRS studies involving the PD monkey model to measure metabolites in living subjects with PD are still rare. The study was performed at 3.0 T MRI with control monkeys and PD monkeys that were injected methyl-phenyl-tetrahydropyridine (MPTP) in one side of common carotid artery before and 3 months after successful model establishment to measure GABA concentrations in the bilateral striatum. Behavioral observations were performed for all animals, and the behavioral score was recorded. After 3 months, the GABA concentration in the bilateral striatum was measured in both groups by high-performance liquid chromatography (HPLC). The data obtained from magnetic resonance spectroscopy (MRS) were compared with the actual measured GABA concentrations in tissues isolated from the corresponding regions, and their correlations with the behavior score were analyzed. The research objectives are to investigate the changes of γ-aminobutyric acid (GABA) concentration in the bilateral striatum of monkeys with Parkinson's disease (PD) and the value of quantitatively measuring its concentration by noninvasive 3.0 T spectroscopy. (1) The MRS results showed that the GABA concentration in the injured side of the striatum of the PD monkeys was higher than in the contralateral side, but the difference was not statistically significant (P = 0.154). Compared with that the blank control group, the GABA concentration in the striatum of the PD monkeys increased, but there was no difference between the groups (P = 0.381; P = 0.425). (2) The GABA concentration that determined from the isolated specimens by HPLC in the injured side of the striatum of the PD monkeys was significantly higher than that in the contralateral side (P < 0.01). Compared with the blank control group, the PD monkeys had higher GABA concentrations in both sides of the striatum, and there was a significant difference in the lesion side (P = 0.004), while there was a non-significant difference in the contralateral side (P = 0.475). (3) The mean GABA concentration in the injured striatum of PD monkeys determined by MRS was not significantly correlated with the behavioral score (r = 0.146, P = 0.688). The mean GABA concentration in the injured striatum determined from the isolated specimens was positively correlated with the behavioral score in the same period (r = 0.444, P = 0.038). The GABA concentration in the injured striatum of PD monkeys is increased and positively correlated with behavioral changes. Validity of noninvasive 3.0 T MRS to detect PD neurotransmitter changes is limited.

Objective To investigate the impact of sarcopenia assessed by pretherapy magnetic resonance imaging (MRI) of the third cervical vertebra (C3) on the survival of patients with locally advanced nasopharyngeal carcinoma (LANPC). Methods We analyzed the clinical information of 478 patients with LANPC who underwent radiotherapy between July 2016 and June 2019. Sarcopenia was evaluated using the skeletal muscle mass index, which was determined based on an MRI of the C3. The cutoff values for sarcopenia were determined using receiver operating characteristic curves. The thresholds were < 12.83 cm²/m² for male and < 11.15 cm²/m² for female. Comparisons between patients with and without sarcopenia were conducted using the chi-squared test. The Kaplan–Meier method was applied to plot survival curves, which were then assessed using the log-rank test. Survival factors were identified using univariate and multivariate analyses. Results The 5-year overall survival (OS) rate was 75.3%, with a median follow-up period of 59 months. Patients with sarcopenia (181/478) had a lower OS than those without sarcopenia (70.7% vs 78.1%, hazard ratio = 1.87, 95% confidence interval: 1.26–2.77, P < 0.01). Sarcopenia was elevated in patients with advanced T-stage tumors and a low body mass index. Univariate and multivariate analyses showed that sarcopenia, age, sex, T stage, and N stage were significant variables that affected the OS of patients with LANPC (P < 0.05). Conclusions MRI-based sarcopenia is significantly correlated with the OS of patients with LANPC. This finding highlights the importance of evaluating sarcopenia before treatment, as it can guide personalized treatment programs, thereby enhancing patient prognosis.

Objective: The prognosis of medulloblastoma (MB) is extremely poor. This study aimed to develop a nomogram model for predicting the recurrence of MB in children by integrating pre-treatment magnetic resonance imaging radiomics and clinical characteristics.Methods: A retrospective analysis was conducted on 95 children with MB who were pathologically diagnosed with MB and underwent radical resection surgery. On the basis of recurrence status observed within the two-year post-treatment follow-up period, patients were categorized into recurrent and non-recurrent groups. The entire cohort was subsequently randomized into a training dataset and a test dataset using a 7:3 allocation ratio. Radiomic feature extraction was carried out utilizing the Feature Explorer Pro platform, with features derived from T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and contrast-enhanced T1-weighted imaging (T1WI_CE) sequences. The most significant features were selected using the Pearson correlation coefficient, analysis of variance (ANOVA), recursive feature elimination, and the Kruskal-Wallis test. A radiomics prediction model was developed using a support vector machine classifier. Logistic regression analysis was employed to identify the most valuable clinical characteristics, and they were used to develop a clinical model. The clinical and radiomics features were combined to develop a clinical-radiomics hybrid model, followed by establishing a nomogram. The predictive performance of each model was assessed using receiver operating characteristic curve analysis. The clinical utility of the model was evaluated via decision curve analysis (DCA) and calibration curves.Results: Two clinical characteristics and six radiomics features exhibiting the strongest associations with MB recurrence were selected to independently develop a hybrid model. The results showed that the hybrid model exhibited good predictive performance for MB recurrence in children. The AUC of the hybrid model reached 0.833 (95% confidence interval [CI], 0.730–0.937) in the training dataset and 0. 802 (95% CI, 0.635–0.970) in the test dataset, both of which exceeded the performance of the clinical model and the radiomics model. The calibration curve and DCA indicated that the nomogram possessed favorable clinical utility for predicting MB recurrence.Conclusion: The hybrid model, integrating pre-treatment MRI-based radiomics features and clinical characteristics, could effectively predict MB recurrence in pediatric patients.

To evaluate the prognostic value of the pretreatment Geriatric Nutritional Risk Index (GNRI) in middle-aged and older patients with nasopharyngeal carcinom

Introduction: This case highlights the rare but life-threatening complication of carotid blowout syndrome (CBS) after radiotherapy for nasopharyngeal carcinoma (NPC). It is characterized by rupture of the carotid artery, often occurring months or years after treatment. Early diagnosis and timely intervention are essential to improve clinical outcomes. Case Presentation: A 45-year-old woman with NPC developed recurrent epistaxis 31 months after chemoradiotherapy. MRI and MRA ruled out tumor recurrence. High-resolution vessel wall imaging (VWI) revealed eccentric thickening, irregular enhancement, and a pseudoaneurysm in the lacerum segment of the left internal carotid artery (ICA), which was confirmed by CTA and DSA. The patient underwent embolization and remained stable at 1-year follow-up. Conclusion: This case underscores the value of VWI in detecting CBS-related vascular changes. Imaging is crucial for early diagnosis and timely intervention in high-risk patients with NPC who have undergone radiotherapy.

Background: Nasopharyngeal carcinoma (NPC) patients frequently have multiple comorbidities that affect treatment efficacy and survival. Prior studies focused only on individual common comorbidities, lacking a comprehensive analysis of the full spectrum of chronic diseases in NPC patients from endemic areas. This study adopted phenotypic comorbidity networks (PCNs) based on large-scale hospital discharge data to systematically characterize the overall comorbidity patterns of endemic NPC patients. Methods: This retrospective cohort study was conducted using data from NPC patients identified in the electronic medical record systems of two large general hospitals in endemic regions between January 2010 and December 2023. Diagnoses were classified using ICD-10 (International Classification of Diseases, 10th Revision) codes at the 3-digit level. PCNs were constructed to represent comorbidity patterns, where nodes represented comorbidities, and edges depicted significant associations. Subgroup analysis was conducted by sex and metastatic status. Results: A total of 18481 NPC patients were involved in the study. NPC patients’ median age was 47–48 years. In Datasets 1 and 2, 82.9% and 78.2% of patients, respectively, had fewer than three comorbidities. Hypertension, chronic sinusitis, other anemias and disorders of fluid, electrolyte and acid-base balance were the top 4 comorbidities with the highest prevalence in all subgroups. The average number of comorbidities was higher in males than in females and in the non-metastatic subgroup compared with the metastatic subgroup. PCNs in males and non-metastatic patients exhibited more complex interconnections. Significant gender disparities existed in multiple comorbidities. Chronic viral hepatitis and kidney-ureteral calculi predominated in males, while fluid, electrolyte and acid-base disturbances along with nontoxic goiter were more prevalent in females. The PCN of the aplastic anemia subgroup was more complex than those of the two secondary malignant neoplasm subgroups. Conclusions: This study revealed the specific characteristics in comorbidity patterns of NPC patients. There were disparities in the prevalence of individual comorbidities and their complex coexistence among NPC patients as stratified by sex and metastatic status. These findings highlight the importance of understanding comorbidity patterns and their interactions in NPC patients, which are noteworthy for guiding personalized medical treatments and developing comprehensive strategies for disease management and prognosis improvement.