Advancing Diagnostics in Neuroimaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 3627

Special Issue Editor

Department of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
Interests: radiology; neuroradiology; epilepsy

Special Issue Information

Dear Colleagues,

We are pleased to announce this Special Issue of Diagnostics, entitled “Advancing Diagnostics in Neuroimaging.” This issue aims to capture the transformative momentum in the field, driven by rapid innovations in artificial intelligence, novel MRI and PET techniques, quantitative biomarkers, and multimodal data integration. We seek to highlight contributions that not only demonstrate technical excellence but also directly enhance diagnostic precision, guide therapeutic decisions, and improve patient outcomes across pediatric and adult populations.

We cordially invite the submission of original research, comprehensive reviews, and clinical perspectives that bridge the gap between technological innovation and clinical application. By bringing together a diverse collection of manuscripts, this issue will provide a critical snapshot of the present and future of neuroimaging, underscoring its indispensable role in neurology. We encourage submissions that will shape this discourse and contribute to the advancement of patient-centered neurological care.

Dr. Ali Y Mian
Guest Editor

Manuscript Submission Information

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Keywords

  • neuroimaging
  • magnetic resonance imaging (MRI)
  • positron emission tomography (PET)
  • radiomics
  • neurological disorders
  • precision medicine
  • quantitative biomarkers
  • multimodal integration

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Published Papers (3 papers)

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15 pages, 2967 KB  
Case Report
Occipital Pial AVM Rupture in a Young Adult: Dual Intranidal Aneurysms, Solitary Parasagittal SSS Drainage, and Hematoma-Corridor Microsurgical Cure
by Alexandru Breazu, Stefan Oprea, Nicolaie Dobrin, Ionut Bogdan Diaconescu, Octavian Munteanu, Matei Șerban, Răzvan-Adrian Covache-Busuioc, Corneliu Toader, Mugurel Petrinel Rădoi and Cosmin Pantu
Diagnostics 2026, 16(2), 265; https://doi.org/10.3390/diagnostics16020265 - 14 Jan 2026
Viewed by 597
Abstract
Background and Clinical Significance: Focal hemorrhagic severity associated with posterior convexity pial brain arteriovenous malformation (AVM) cases can be exacerbated by hemodynamic stress focusing on focal areas of architectural weakness and by superficial venous outflow being restricted by non-redundant superficial venous drainage. This [...] Read more.
Background and Clinical Significance: Focal hemorrhagic severity associated with posterior convexity pial brain arteriovenous malformation (AVM) cases can be exacerbated by hemodynamic stress focusing on focal areas of architectural weakness and by superficial venous outflow being restricted by non-redundant superficial venous drainage. This clinical case report exemplifies how bedside neurologic localization and angioarchitectural characteristics can inform the selection of microsurgical approaches for the treatment of ruptured AVMs that are directed at reducing hemorrhage recurrence risk through corridors based on rupture location. Case Presentation: An otherwise healthy young adult male (modified Rankin scale [mRS] pre-morbid = 0) initially presented with a thunderclap headache, emesis, photophobia, decreased level of consciousness (admitted Glasgow Coma Score [GCS] = 11; E3V3M5), and subsequent deficits including left-sided pyramidal weakness, visual field loss, and visuo-spatial neglect. A non-contrast computed tomogram (CT) confirmed an intraparenchymal hemorrhage (ICH) located within the right hemisphere’s posterior lobe. Angiographic evaluation of this AVM with catheter injection and three-dimensional reconstruction revealed a compact right occipital posterior convexity pial AVM (nidus 8 × 3 mm) supplied by distal cortical branches of the right middle cerebral artery (MCA); all blood draining from the nidus was directed to a single cortical vein which then drained into the superior sagittal sinus; there were two additional intranidal saccular aneurysms (approximately 3 × 2 mm and 3 × 3 mm). Because of the acute worsening secondary to ICH and because all venous drainage was superficial-only, a single-stage approach was selected given the urgency: decompressive evacuation of the hematoma via a corridor to the site of the AVM, followed by microsurgical removal of the AVM. The removal of the AVM was accomplished in a feeder-first, vein-last sequence, and en-passage arteries and parasagittal bridging veins were preserved throughout the procedure. Additionally, the two intranidal aneurysms identified as potential weak points during progressive devascularization of the AVM were specifically treated during the removal procedure. Following the successful removal of the AVM, the patient experienced a rapid recovery and returned to a nearly premorbid state of functioning, excepting a persistent small area of quadrantanopia. Conclusions: Rupture of posterior convexity AVMs may result in increased hemorrhagic severity due to localized architectural weaknesses in addition to the overall size of the AVM nidus. By correlating neurological findings, the topography of the hemorrhage, and angioarchitectural features early after rupture, emergency decisions regarding management can be better informed. The application of a hematoma-corridor, feeder-first/vein-last microsurgical approach for the treatment of such AVMs can achieve definitive curative results while minimizing damage to posterior cortical regions. Full article
(This article belongs to the Special Issue Advancing Diagnostics in Neuroimaging)
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14 pages, 3443 KB  
Case Report
Telovelar Approach for Fourth-Ventricular Epidermoid Cyst: Anatomical Respect, Functional Recovery, and Long-Term Stability
by Cosmin Pantu, Alexandru Breazu, Stefan Oprea, Mugurel Petrinel Rădoi, Octavian Munteanu, Nicolaie Dobrin, Catalina-Ioana Tataru, Alexandru Vladimir Ciurea and Adrian Vasile Dumitru
Diagnostics 2026, 16(1), 129; https://doi.org/10.3390/diagnostics16010129 - 1 Jan 2026
Viewed by 565
Abstract
Background and Clinical Significance: Fourth-ventricular epidermoid cysts are rare intracranial lesions. They account for fewer than 1% of all primary brain tumors. Fourth-ventricular epidermoid cysts grow slowly because they are closely related to brainstem, cerebellum, and major blood vessels, so their treatment [...] Read more.
Background and Clinical Significance: Fourth-ventricular epidermoid cysts are rare intracranial lesions. They account for fewer than 1% of all primary brain tumors. Fourth-ventricular epidermoid cysts grow slowly because they are closely related to brainstem, cerebellum, and major blood vessels, so their treatment requires special caution. Because the cyst capsule attaches to functionally sensitive locations, complete removal is usually not possible without compromising some aspect of brain or spinal cord function. Surgical decision-making always involves weighing the need to remove the entire cyst against the potential loss of function of the affected area. The following case study describes how a patient was treated with a focus on the relationship between the cyst and surrounding anatomy, allowing for successful decompression with minimal risk to the patient’s neurologic status. Case Presentation: A young adult female patient was hospitalized with progressive truncal ataxia, disequilibrium and occipital headache accompanied by papilledema. Her physical examination disclosed significant dysfunction of the midline cerebellar region (SARA score = 18/40, ICARS score = 42/100), gaze-evoked nystagmus and bilaterally elevated grade II papilledema. MRI and MRA demonstrated a large, lobulated, nonenhancing, avascular mass located within the fourth ventricle, encroaching upon the dorsal medulla and obstructing both the foramen of Magendie and foramina of Luschka—findings typical of an epidermoid cyst. Microsurgical resection was accomplished via a median suboccipital craniectomy using a telovelar approach along the embryonic cerebellomedullary fissure to protect the integrity of the vermis and brainstem. The cyst contained layers of keratin embedded in a thin, translucent capsule. The capsule was carefully dissected away from the floor of the fourth ventricle. A very narrow band of capsule attached to the rhomboid fossa was intentionally spared to avoid damaging the cranial nerves. The patient had normal cerebrospinal fluid circulation restored and normal ventricular pulsation observed during surgery. Histopathology confirmed a benign epidermoid cyst consisting of keratinizing stratified squamous epithelium containing cholesterol clefts and laminated keratin debris. After surgery, the patient exhibited continuous neurological improvement including restoration of balance, disappearance of her headaches, and normalization of ocular pursuit. Sequential imaging studies were conducted post-operatively at one week, one month, three months, five months, and seven months to document stable decompression of the fourth ventricle, re-expansion of the fourth ventricle, and no evidence of cyst recurrence. Post-operative course was uncomplicated and the patient has remained free of symptoms and fully independent functionally at most recent follow-up. Conclusions: This case illustrates that when anatomically oriented, “maximal safe resection” can result in long-lasting decompression and clinically meaningful improvement in neurological function in patients with fourth-ventricular epidermoid cysts. Restoration of the patient’s natural cerebrospinal fluid pathway and preservation of neural interface relationships is more beneficial than pursuing aggressive removal of the cyst capsule. Although the risk of late recurrence is present even after nearly total removal, continuous radiologic monitoring is necessary to identify any recurrence. These experiences illustrate that with the principles of surgical restraint and anatomical guidance, there can be a balance between long-term stability and low operative risk. Full article
(This article belongs to the Special Issue Advancing Diagnostics in Neuroimaging)
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16 pages, 2885 KB  
Case Report
Precision in Complexity: A Protocol-Driven Quantitative Anatomic Strategy for Giant Olfactory Groove Meningioma Resection in a High-Risk Geriatric Patient
by Valentin Titus Grigorean, Cosmin Pantu, Alexandru Breazu, George Pariza, Octavian Munteanu, Mugurel Petrinel Radoi and Adrian Vasile Dumitru
Diagnostics 2026, 16(1), 127; https://doi.org/10.3390/diagnostics16010127 - 1 Jan 2026
Viewed by 683
Abstract
Background/Objectives: Managing large midline olfactory groove meningiomas is especially difficult in elderly patients who have limited physiological reserves. Here we describe a unique and dangerous geriatric case where we used new quantifiable anatomical measurements and developed a structured multidisciplinary preoperative and postoperative [...] Read more.
Background/Objectives: Managing large midline olfactory groove meningiomas is especially difficult in elderly patients who have limited physiological reserves. Here we describe a unique and dangerous geriatric case where we used new quantifiable anatomical measurements and developed a structured multidisciplinary preoperative and postoperative protocol to assist in all aspects of surgery. Case Presentation: A 68-year-old male with fronto-lobe syndrome and disability (astasia-abasia; Tinetti Balance Score of 4/16 and Gait Score of 0/12) as well as cognitive dysfunction (MoCA score of 12/30) and blindness bilaterally. Imaging prior to surgery demonstrated a very large olfactory groove meningioma which severely compressed both optic pathways at the level of the optic canals (up to 71% reduction in cross-sectional area of the optic nerves) and had complex vascular relationships with the anterior cerebral artery complex (210° contact surface). Due to significant cardiovascular disease and liver disease, his care followed a coordinated optimization protocol for the perioperative period. He underwent bifrontal craniotomy, initial early devascularization and then staged ultrasonic internal decompression (approximately 70% reduction in tumor volume) and finally microsurgical dissection of the tumor under multi-modal monitoring of neurophysiology. Discussion: We analyzed his imaging data prior to surgery using a standardized measurement protocol to provide quantitative measures of the degree of compression of the optic pathways (traction-stretch index = 1.93; optic angulation = 47.3°). These quantitative measures allowed us to make a risk-based evaluation of the anatomy and to guide our choices of corridors through which to dissect and remove the tumor. Following surgery, imaging studies demonstrated complete removal of the tumor with significant relief of the frontal lobe and optic apparatus from compression. His pathology showed that he had a WHO Grade I meningioma with an AKT1(E17K) mutation identified on molecular profiling. Conclusions: This case is intended to demonstrate the feasibility of integrating quantitative anatomical measurements into a multidisciplinary, protocol-based perioperative pathway to maximize the safety and effectiveness of the surgical removal of a complex and high-risk skull-base tumor. While the proposed quantitative indices are experimental and require additional validation, the use of a systematic approach such as this may serve as a useful paradigm for other complex skull-base cases. Full article
(This article belongs to the Special Issue Advancing Diagnostics in Neuroimaging)
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