To investigate the impact of cigarette consumption on mucosal thickening in paranasal sinuses and the relationships of smoking-related factors and dental status with mucosal thickening at different maxillary sinus locations using MRI. This retrospective study investigated 1094 paranasal sinuses on MRIs by correlating mucosal thickening with smoking-related factors. Presence/absence of maxillary posterior teeth was correlated with mucosal thickening on the maxillary sinus floor and other sinus locations. Compared with nonsmokers, current and former smokers exhibited similarly more mucosal thickening in the maxillary (58.9%/62.8% vs 38.3%, P < .01) and ethmoid (22.7%/17.1% vs 6.6%, P < .01) sinuses, but not in the sphenoid sinus (P = .08) and similarly more mucosal thickening on the medial/superior walls of the maxillary sinus (40.4%/41.5% vs 18.4%, P < .01). Patients with mucosal thickening in the maxillary and ethmoid sinuses had greater daily cigarette consumption and years of smoking than those without mucosal thickening in these sinuses (P < .01). Edentulous individuals had more mucosal thickening on the maxillary sinus floor compared to dentate individuals (43.7% vs 32.2%, P < .01). Cigarette consumption is associated with increased mucosal thickening in paranasal sinuses, with a dose-response association. This thickening may be persistent after quitting smoking. Cigarette smoking may have a more pronounced impact on the sinus mucosa in areas near the primary maxillary ostium, while dental status may be more likely to affect that on the maxillary sinus floor.
We aimed to determine the effect of semaglutide on patients with acute large vessel occlusion (LVO) receiving endovascular therapy (EVT). In this phase 2, investigator-initiated, multicenter, prospective, randomized, open-label, blinded endpoint trial conducted in China, we recruited patients with disabling LVO undergoing EVT. Patients were randomized to semaglutide therapy (0.5 mg subcutaneous semaglutide before and 1 week after EVT) or standard therapy. The primary outcome was defined as favorable neurological recovery (modified Rankin Scale 0–2 at 90 days). Between August 2023 and July 2024, 140 patients were randomized to semaglutide ( n = 69) or standard therapy ( n = 71). The primary outcome occurred in 39 (56.5%) in the semaglutide group and 39 (54.9%) in the standard therapy group (adjusted RR 1.05, 95% CI 0.95–1.15, p = 0.37). We observed treatment effect modification by intravenous thrombolysis (IVT) on semaglutide therapy ( pinteraction = 0.02); thus we performed the following exploratory analyses: The primary outcome occurred in 22 (64.7%) in the semaglutide group and 15 (44.1%) in the standard therapy group (adjusted RR 1.18, 95% CI 1.02–1.36) in the no-IVT stratum ( n = 68). The primary outcome was similar between two groups in the IVT-stratum. No severe adverse event was attributed to semaglutide treatment. This phase 2 trial suggested semaglutide was safe in patients with LVO and was associated with an improved neurological outcome in patients not receiving IVT. These preliminary observations should be confirmed in a phase 3 randomized trial (ClinicalTrials.gov Identifier: NCT05920889).
Eagle jugular syndrome is an uncommon condition caused by compression of an elongated styloid process onto the internal jugular vein. Its presentation is non-specific but may represent in severe clinical consequences including venous thrombosis and intracranial haemorrhage. Thorough understanding of local anatomy is important in understanding the pathogenesis and establishing the diagnosis. Our case reported here illustrates the use of multimodality imaging, including dynamic Computer tomography manoeuvre, in identifying the site of obstruction and guidance towards successful surgical treatment.
6 May 2025 in Journal of Imaging Informatics in Medicine
Wavelet decomposition (WD), widely used in radiomics, redistributes information among derived wavelet components when the input is rotated. This redistribution may alter predictions for the same lesion when scanned at different angles. Despite its potential significance, this vulnerability has frequently been overlooked in radiomic studies while its impact remains poorly understood. Therefore, this study aims to investigate how variations in lesion orientation affect both WD and non-WD radiomic feature values, and subsequently, model performance. We analyzed CT radiomics of primary non-small-cell lung cancer (NSCLC). Prior to feature extraction, we introduced random rotations ranging from 5° to 80° to the tumors. Their effects were quantified by evaluating the percentage difference ( $$\%\Delta$$ ) between the rotated and unrotated feature values, and validated using Spearman’s rank test. Additionally, radiomics models were trained to discriminate between three histological subtypes of NSCLC using the original features, and then tested on rotated inputs. The correlation between the model accuracies and the degree of rotation was again evaluated using Spearman’s rank test. Four-hundred nineteen NSCLC patients (mean age: 68.1 ± 10.1, 289 men) were evaluated. Significant correlations between feature values and rotations (Spearman’s correlation [CC] magnitude ≥ 0.1, p < .05) were found in 23.7% (176/744) of the WD and 0.5% (5/930) of the non-WD texture features. Significant association between performance and rotation was observed in WD-based models built to discriminate between NSCLC histological subtypes (CC = − 0.44, p < .001) but not in non-WD-based models (CC = 0.03, p = 0.07). Input lesion orientation affects radiomic feature values and model reproducibility. WD features exhibited significantly greater instability to orientation variations compared to non-WD features.
Pre-operative embolization of spinal tumours are mainly performed using a transarterial approach. Percutaneous embolization of spinal tumours are undertaken much less frequently, though its use has been reported in hypervascular spinal metastases 1,2 and spinal paraganglioma. 3 We present a patient in whom pre-operative percutaneous embolization has been performed to a recurrent lumbar nerve root haemangioblastoma that had previously been embolized using a transarterial approach. Percutaneous embolization, through targeted percutaneous puncture of the extradural component, helped reduce intraoperative blood loss, and minimize risk of spinal ischaemia.
Background/Objectives: The detection of unknown primary tumours in the palatine tonsils (PTs) on imaging relies heavily on asymmetry in size between the right and left sides, but the expected normal range in asymmetry is not well documented. This study aimed to document the expected range of asymmetry in the size of the PTs in adults without cancer. Methods: This retrospective study evaluated 250 pairs of normal PTs on MRIs of adults without head and neck cancer. The size (volume, V) of the PTs on the left and right sides were measured, and the percentage difference in volume (ΔV%) between the two sides was calculated. An additional analysis of PT volumes in 29 patients with ipsilateral early-stage palatine tonsillar cancer (PTCs) was performed. Results: In patients without PTC, the normal PTs had a mean volume of 3.0 ± 1.7 cm3, and there was a difference in size between the left and right PTs, showing a median ΔV% of 11.6% (range: 0.1–79.0%); most patients had a ΔV% of ≤40% (95%) for PTs. In patients with ipsilateral PTC, the normal PT had a smaller size compared with PTC (p < 0.01), showing a median ΔV% of 132.9% (range: 8.5–863.2%). Compared with patients without PTC, those with PTC showed a greater ΔV% (p < 0.01). An optimal ΔV% threshold of >39.6% achieved the best accuracy of 95% for identifying PTC. Conclusions: PTs are asymmetrical in size in adults without PTC. An additional analysis involving patients with PTC confirmed a threshold of ΔV% of 40% for PTs, which may be clinically valuable to help detect pathology using MRI.