Axial Loading During MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis

Background: In patients with soft-tissue sarcomas, tumor grading constitutes a decisive factor to determine the best treatment decision. Tumor grading is obtained by pathological work-up after focal biopsies. Deep learning (DL)-based imaging analysis may pose an alternative way to characterize STS tissue. In this work, we sought to non-invasively differentiate tumor grading into low-grade (G1) and high-grade (G2/G3) STS using DL techniques based on MR-imaging. Methods: Contrast-enhanced T1-weighted fat-saturated (T1FSGd) MRI sequences and fat-saturated T2-weighted (T2FS) sequences were collected from two independent retrospective cohorts (training: 148 patients, testing: 158 patients). Tumor grading was determined following the French Federation of Cancer Centers Sarcoma Group in pre-therapeutic biopsies. DL models were developed using transfer learning based on the DenseNet 161 architecture. Results: The T1FSGd and T2FS-based DL models achieved area under the receiver operator characteristic curve (AUC) values of 0.75 and 0.76 on the test cohort, respectively. T1FSGd achieved the best F1-score of all models (0.90). The T2FS-based DL model was able to significantly risk-stratify for overall survival. Attention maps revealed relevant features within the tumor volume and in border regions. Conclusions: MRI-based DL models are capable of predicting tumor grading with good reproducibility in external validation.

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Change in Neural Tube Size for a Lumbar Spinal Stenosis Patient on Axial Loading Magnetic Resonance Imaging

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2016.51.6.473 ◽

2016 ◽

Vol 51 (6) ◽

pp. 473 ◽

Cited By ~ 1

Author(s):

Ho Yeon Jeong ◽

Tae Kyun Kim ◽

Dae Ho Ha ◽

Dae Moo Shim ◽

Young Ha Woo ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Neural Tube ◽

Axial Loading ◽

Resonance Imaging ◽

Tube Size ◽

Lumbar Spinal Stenosis Patient ◽

Lumbar Spinal

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Gait analysis does not correlate with clinical and MR imaging parameters in patients with symptomatic lumbar spinal stenosis

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-9-89 ◽

2008 ◽

Vol 9 (1) ◽

Cited By ~ 47

Author(s):

Felix Zeifang ◽

Marcus Schiltenwolf ◽

Rainer Abel ◽

Babak Moradi

Keyword(s):

Mr Imaging ◽

Gait Analysis ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Imaging Parameters ◽

Lumbar Spinal

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Prevalence and clinical features of intraspinal facet cysts after decompression surgery for lumbar spinal stenosis

Journal of Neurosurgery Spine ◽

10.3171/2009.2.spine08769 ◽

2009 ◽

Vol 10 (6) ◽

pp. 617-622 ◽

Cited By ~ 20

Author(s):

Ko Ikuta ◽

Osamu Tono ◽

Masayoshi Oga

Keyword(s):

Lumbar Spine ◽

Mr Imaging ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Comparative Evaluation ◽

Degenerative Spondylolisthesis ◽

Spinal Instability ◽

Decompression Surgery ◽

Lumbar Spinal ◽

Cyst Development

Object Although many cases of primary intraspinal facet cysts in the lumbar spine have been reported, there have only been a few reports of postoperative intraspinal facet cysts in the lumbar spine. The purpose of this study was to investigate the prevalence and clinical features of postoperative intraspinal facet cysts in the lumbar spine. Methods Data from 81 patients undergoing microendoscopic posterior decompression to treat lumbar spinal stenosis were reviewed. The development of a postoperative intraspinal facet cyst was observed using MR imaging during 1 year after surgery. If the patient demonstrated a postoperative intraspinal facet cyst, additional MR imaging was performed to evaluate the natural course of the cyst. Furthermore, the authors conducted a comparative evaluation to identify the factors associated with the causes of cyst development. Results A postoperative intraspinal facet cyst developed in 7 patients (8.6%) during 1 year after surgery. Spondylotic spinal stenosis, degenerative spondylolisthesis, and degenerative scoliosis were revealed before surgery in 2, 4, and 1 patient, respectively. In 5 patients, the cysts developed within 3 months after surgery. Although 3 patients exhibited symptoms caused by cyst development, all symptoms were relieved by conservative treatment. On radiographic evaluations, postoperative segmental spinal instability, including a progression of spondylolisthesis and disc degeneration, was revealed in 6 (86%) of the 7 patients. Spontaneous regression of the cysts was observed in 5 (71%) of these 7 patients. On comparative evaluation of patients with and without postoperative intraspinal facet cysts, the presence of segmental spinal instability before surgery (including degenerative spondylolisthesis) and the appearance of postoperative segmental spinal instability were related to the development of the cysts. Conclusions The prevalence of postoperative intraspinal facet cysts, including asymptomatic cysts, was 8.6% during 1 year after decompression surgery for lumbar spinal stenosis. The development of postoperative intraspinal facet cysts was related to the presence of segmental spinal instability before surgery (including degenerative spondylolisthesis) and postoperative segmental spinal instability, including a progression of spondylolisthesis and disc degeneration after surgery. A postoperative intraspinal facet cyst, which can be expected to regress spontaneously with a probability > 50%, should be recognized as one of the postoperative complications of decompression surgery for lumbar spinal stenosis.

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Effect of Intervertebral Disk Degeneration on Spinal Stenosis During Magnetic Resonance Imaging With Axial Loading

Neurologia medico-chirurgica ◽

10.2176/nmc.49.242 ◽

2009 ◽

Vol 49 (6) ◽

pp. 242-247 ◽

Cited By ~ 7

Author(s):

Tae-Joon AHN ◽

Sang-Ho LEE ◽

Gun CHOI ◽

Yong AHN ◽

Wei Chiang LIU ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Spinal Stenosis ◽

Axial Loading ◽

Intervertebral Disk ◽

Resonance Imaging ◽

Intervertebral Disk Degeneration ◽

Disk Degeneration

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Treatment decision making based on the published natural history and growth rate of small meningiomas

Journal of Neurosurgery ◽

10.3171/2010.3.jns091966 ◽

2010 ◽

Vol 113 (5) ◽

pp. 1036-1042 ◽

Cited By ~ 75

Author(s):

Michael E. Sughrue ◽

Martin J. Rutkowski ◽

Derick Aranda ◽

Igor J. Barani ◽

Michael W. McDermott ◽

...

Keyword(s):

Systematic Review ◽

Natural History ◽

Mr Imaging ◽

Growth Rates ◽

Treatment Decision ◽

Linear Increase ◽

Chi Square ◽

Initial Tumor ◽

Chi Square Test

Object Definitive data allowing clinicians to predict which meningioma patients will fail to respond to conservative management are lacking. To address this need, the authors systematically reviewed the published literature regarding the natural history of small, untreated meningiomas. Methods The authors performed a systematic review of the existing literature on untreated meningiomas that were followed with serial MR imaging. They summarize the published linear rates of tumor growth, and the risk factors for development of new or worsened symptoms during follow-up by using a stratified chi-square test. Results The search methods identified 22 published studies reporting on 675 patients with untreated meningiomas followed by serial MR imaging. Linear growth rates varied significantly: no growth was the most common rate, although reports of more aggressive tumors noted growth rates of up to a 93% linear increase in size per year. The authors found that few patients with initial tumor diameters < 2 cm went on to develop new or worsened symptoms over a median follow-up period of 4.6 years. Patients with initial tumor diameters of 2–2.5 cm demonstrated a marked difference in the rate of symptom progression if their tumors grew > 10% per year, compared with those tumors growing ≤ 10% per year (42% vs 0%; p < 0.001, chi-square test). Patients with tumors between > 2.5 and 3 cm in initial size went on to develop new or worsened symptoms 17% of the time. Conclusions This systematic review of the literature regarding the clinical behavior of untreated meningiomas suggests that most meningiomas ≤ 2.5 cm in diameter do not proceed to cause symptoms in the approximately 5-year period following their discovery. Those that do cause symptoms can usually be predicted with close radiographic follow-up. Based on these findings, the authors suggest the importance of observation in the early course of treatment for small asymptomatic meningiomas, especially those with an initial diameter < 2 cm.

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