Objective: To determine the frequency and types of incidental findings on magnetic resonance imaging (MRI) scans of the cervical, thoracic, and lumbar spine in patients with intervertebral discopathy. Patients and Methods: This retrospective study included 1000 patients (513 females and 487 males, with a mean age of 50.5 years) with clinically suspected intervertebral discopathy who underwent MRI. Any abnormal findings and congenital anomalies/anatomical variations unrelated to the primary complaint were referred to as incidental findings. Frequency distributions of the assessed imaging characteristics were calculated. Results: Of the 1000 patients, 192 (19.2%) patients were presented with incidental findings. The positive findings in the thoracic spine (26%) were higher than those in the lumbar (19.8%) and cervical spine (13.7%). The study found vertebral haemangioma to be the most common finding, followed by Schmorl’s nodes in the thoracic and lumbar spine. Thyroid nodules constituted the most common finding in the cervical spine, followed by vertebral haemangioma. Renal cysts in the thoracic and lumbar spine and thyroid nodules in the cervical spine were the most frequent extraspinal findings. Conclusion: Incidental findings are commonly detected during MRI examination of intervertebral discs, and most are benign findings. However, incidental findings including clinically essential findings can alter the patient’s treatment or affect the patient’s life. Therefore, it is crucial to systematically evaluate MRIs without focusing solely on the spine and report incidental findings detected on MRI.

Background/Objectives: This study aimed to evaluate the ability of ChatGPT-5, a multimodal large language model, to perform automated ASPECTS assessment on non-contrast CT (NCCT) in patients with acute ischemic stroke. Methods: This retrospective, single-center study included 199 patients with anterior circulation AIS who underwent baseline NCCT before reperfusion therapy between November 2020 and February 2025. Each NCCT was evaluated by two human readers and by ChatGPT-5 using four representative images (two ganglionic and two supraganglionic). Interobserver agreement was measured with the intraclass correlation coefficient (ICC), and prognostic performance was analyzed using multivariable logistic regression and receiver operating characteristic (ROC) analysis for 3-month functional independence (mRS ≤ 2). Results: ChatGPT-5 demonstrated good-to-excellent agreement with expert consensus (ICC = 0.845; 95% CI, 0.792–0.884; κ = 0.79). ChatGPT-ASPECTS were independently associated with 3-month functional independence (OR = 1.28 per point; p = 0.004), comparable to consensus-ASPECTS (OR = 1.31; p = 0.003). Prognostic discrimination was similar between ChatGPT-5 and consensus scoring (AUC = 0.78 vs. 0.80; p = 0.41). Conclusions: ChatGPT-5 achieved high reliability and strong prognostic validity in automated ASPECTS assessment without task-specific training. These findings highlight the emerging potential of large language models for quantitative image interpretation, though clinical implementation will require multicenter validation and regulatory approval.

Purpose: To evaluate the feasibility, technical success, and safety of ultrasound (US)-guided direct thrombolytic injection in patients with acute and early-subacute extremity arterial occlusions. Materials and Methods: This retrospective, single-center study included 24 patients treated between July 2023 and January 2025 for acute (≤14 days) or early-subacute (14-21 days) arterial occlusions (Rutherford I-IIb). Under real-time US guidance, alteplase (2-10 mg total) was injected into the thrombus at 2 to 3 cm intervals using a 27-gauge (40-mm) or, for deeper targets, a 22-gauge (90-mm) needle. Doppler US was performed at 2, 4, and 6 hours to assess recanalization. The primary endpoint was Doppler US-based recanalization category at 6 hours (complete/partial/none) prior to any adjunct endovascular revascularization. Secondary endpoints included adjunct angiography/endovascular procedures, complications, and follow-up primary-assisted and secondary patency at 1, 3, and 6 months. Results: At 6 hours, complete recanalization was observed in 12/24 (50.0%), partial in 4/24 (16.7%), and no recanalization in 8/24 (33.3%). The median alteplase dose was 6 mg (range, 2-10 mg). Diagnostic angiography was performed in 15/24 (62.5%), and adjunct endovascular procedures were performed as indicated. Minor complications occurred in 10/24 (41.7%); no major bleeding or procedure-related mortality occurred. Two patients with Rutherford IIb ischemia and symptom duration >14 days ultimately underwent major amputation after refusing further revascularization. Primary-assisted patency rates were 66.7%, 58.3%, and 41.7%, and secondary patency rates were 87.5%, 79.2%, and 75.0% at 1, 3, and 6 months, respectively. In multivariable ordinal regression, shorter time to alteplase administration was independently associated with a more favorable 6-hour Doppler recanalization category (OR 15.67; 95% CI, 1.88-130.59; p=0.011), with wide confidence intervals indicating limited precision. Conclusions: US-guided direct intrathrombus alteplase injection appears feasible with an acceptable safety profile and provides an early Doppler-defined response in selected patients. Prospective comparative studies are needed to define its role and refine patient selection. Clinical Impact: Ultrasound-guided direct intrathrombus alteplase injection is a feasible, minimally invasive option for selected patients with acute and early-subacute arterial occlusions. The innovation is localized, real-time US-targeted delivery of low-dose tPA without catheter placement or prolonged infusion, combined with serial Doppler assessment to guide repeat dosing and timely escalation to angiography and adjunct endovascular therapy when indicated. For clinicians, this provides a practical workflow with close non-ICU monitoring, enabling early identification of residual thrombus, distal embolization, or underlying stenosis. The study also reinforces that shorter symptom duration strongly influences early recanalization.

Objective: To determine the patency rates and reasons for failure using different access routes for tunneled hemodialysis catheters. Methods: The records of patients who underwent insertion of 14 French tunnelled hemodialysis catheters were retrospectively analyzed. Catheter patency survival was demonstrated using Kaplan-Meier survival curve. Catheter failure and exchange reasons were evaluated. Results: One hundred and six patients underwent 474 catheter exchanges (mean/patient 4.47±1.62). Access was via right internal jugular vein (IJV) n=40, left IJV n=23, right femoral vein (FV) n=18, left FV n=11 and transhepatic vein n=14. The causes of catheter failure and exchange were: catheter-associated infection, catheter thrombosis, fibrin sheath and catheter tip malposition. Mean primary and cumulative catheter patency time was higher in the right IJV group (732 and 1337 days, respectively) compared with the others (p

Aim: We aimed to assess the quality and reliability of YouTube videos on percutaneous ablation of thyroid nodules (PATN) to evaluate their utility as educational tools for patients and healthcare professionals. Materials and Methods: This cross-sectional study analyzed 76 YouTube videos identified through keyword searches ("percutaneous ablation of thyroid nodules", "thyroid radiofrequency ablation", and "thyroid microwave ablation") on November 10, 2024. Videos were categorized by type (informative, technical, personal experience, and news), duration (≤4 minutes, >4 minutes), upload source (professional healthcare providers, non-professionals, or independent users), and target audience (patients or healthcare professionals). Quality and reliability were assessed using the Journal of the American Medical Association (JAMA) criteria, the Global Quality Score (GQS), and the modified DISCERN (mDISCERN). Statistical analyses, including the Kruskal-Wallis and Spearman correlation tests, were conducted. Results: A total of 76 videos were evaluated. Informative videos scored significantly higher on quality metrics (GQS, 2.85 ± 0.15, p= 0.002; mDISCERN, 2.13 ± 0.16, p= 0.008). Videos >4 minutes demonstrated higher quality scores (p= 0.001). No statistically significant differences in popularity metrics (likes, comments, view rates) were observed across groups (p> 0.05). No significant correlations were found between quality scores (JAMA, GQS, mDISCERN) and popularity metrics (R² = -0.019 to 0.147). Conclusion: While informative and longer videos exhibited higher quality, popularity metrics were not reliable indicators of video quality. These findings highlight the need for healthcare professionals to produce engaging and accurate content for platforms like YouTube to improve public education about PATN.

Objective: Transthoracic needle biopsy (TTNB) under image guidance is a cornerstone technique for the diagnosis of pulmonary lesions. Despite its high diagnostic accuracy, procedure-related complications remain a concern. This study aimed to evaluate the safety, diagnostic yield, and complication profile of image-guided TTNB and to identify lesion-related factors influencing adverse outcomes.Materials and Methods: This single-center retrospective cohort study included 184 consecutive patients (143 males, 41 females; median age, 65 years) who underwent image-guided TTNB between January 2023 and May 2025. Most procedures (98.9%) were CT-guided, and a coaxial 17 G/18 G core needle technique was consistently used. Lesion characteristics, procedural parameters, and complications were recorded. Statistical analysis was performed to assess associations between lesion depth, size, and complication occurrence.Results: The diagnostic yield was 94.1%, with nondiagnostic samples in 5.9% of cases. Histopathological results revealed adenocarcinoma (29.3%), squamous cell carcinoma (12.5%), small-cell carcinoma (4.3%), metastatic tumors (4.9%), and benign lesions (17.4%). Pneumothorax occurred in 27.7% of patients, requiring drainage in 4.3%. Minor alveolar hemorrhage was observed in 16.3%, and one patient (0.5%) experienced a fatal air embolism. Complication rates were significantly associated with greater lesion depth (p = 0.0000632) and smaller lesion size (p = 0.001704), while emphysema showed no significant correlation (p = 0.3928).Conclusion: Image-guided TTNB using a coaxial 17 G/18 G technique demonstrates high diagnostic accuracy and an acceptable safety profile. Lesion depth and size are key predictors of procedural complications. Careful pre-procedural planning and experienced operator technique are critical to optimizing outcomes and minimizing risks.