- Automatic Machine Learning to Differentiate Pediatric Posterior Fossa Tumors on Routine MR Imaging
This retrospective study included preoperative MR imaging of 288 pediatric patients with pediatric posterior fossa tumors, including medulloblastoma (n=111), ependymoma (n=70), and pilocytic astrocytoma (n=107). Radiomics features were extracted from T2-weighted images, contrast-enhanced T1-weighted images, and ADC maps. Models generated by standard manual optimization by a machine learning expert were compared with automatic machine learning via the Tree-Based Pipeline Optimization Tool for performance evaluation. The authors conclude that automatic machine learning based on routine MR imaging classified pediatric posterior fossa tumors with high accuracy compared with manual expert pipeline optimization and qualitative expert MR imaging review.
- Intra-Arterial Chemotherapy for Retinoblastoma in Infants ≤10 kg: 74 Treated Eyes with 222 IAC Sessions
Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered the natural history of the disease. Cure rates, globe salvage, and vision preservation have dramatically increased. This retrospective chart review evaluated 207 Rb tumors of 207 eyes in 196 consecutive patients who underwent 658 IAC infusions overall. Patient weights were ≤10 kg in 69 (35.2%) and >10 kg in 127 (64.8%) patients. Comparison (≤10 kg versus >10 kg) revealed that the total number of IAC infusions was 222 versus 436. Periprocedural complications were not significantly different. The authors conclude that intra-arterial chemotherapy in patients weighing ≤10 kg is a safe and effective treatment.
- Spine MRI in Spontaneous Intracranial Hypotension for CSF Leak Detection: Nonsuperiority of Intrathecal Gadolinium to Heavily T2-Weighted Fat-Saturated Sequences
The authors performed a retrospective study of patients with spontaneous intracranial hypotension examined from February 2013 to October 2017. The spine MR imaging was reviewed by 3 blinded readers for the presence of epidural CSF using 3 different sequences (T2WI, 3D T2WI fat-saturated, T1WI gadolinium). In patients with leaks, the presumed level of the leak was reported. They conclude that intrathecal gadolinium-enhanced spine MR imaging does not improve the diagnostic accuracy for the detection of epidural CSF. Gadolinium myelography lacks a rationale to be included in the routine spontaneous intracranial hypotension work-up. Heavily T2-weighted images with fat saturation provide high accuracy for the detection of an epidural CSF collection.
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