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Article ; Online: Imaging of Neuromodulation and Surgical Interventions for Epilepsy.

Adin, M E / Spencer, D D / Damisah, E / Herlopian, A / Gerrard, J L / Bronen, R A

AJNR. American journal of neuroradiology

2021 Volume 42, Issue 10, Page(s) 1742–1750

Abstract: About one-third of epilepsy cases are refractory to medical therapy. During the past decades, the availability of surgical epilepsy interventions has substantially increased as therapeutic options for this group of patients. A wide range of surgical ... ...

Abstract	About one-third of epilepsy cases are refractory to medical therapy. During the past decades, the availability of surgical epilepsy interventions has substantially increased as therapeutic options for this group of patients. A wide range of surgical interventions and electrophysiologic neuromodulation techniques are available, including lesional resection, lobar resection, thermoablation, disconnection, multiple subpial transections, vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation. The indications and imaging features of potential complications of the newer surgical interventions may not be widely appreciated, particularly if practitioners are not associated with comprehensive epilepsy centers. In this article, we review a wide range of invasive epilepsy treatment modalities with a particular focus on their postoperative imaging findings and complications. A state-of-the-art treatment algorithm provides context for imaging findings by helping the reader understand how a particular invasive treatment decision is made.
MeSH term(s)	Deep Brain Stimulation ; Diagnostic Imaging ; Drug Resistant Epilepsy ; Epilepsy/diagnostic imaging ; Epilepsy/surgery ; Humans ; Vagus Nerve Stimulation
Language	English
Publishing date	2021-08-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A7222
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Article ; Online: Machine Learning in Differentiating Gliomas from Primary CNS Lymphomas: A Systematic Review, Reporting Quality, and Risk of Bias Assessment.

Cassinelli Petersen, G I / Shatalov, J / Verma, T / Brim, W R / Subramanian, H / Brackett, A / Bahar, R C / Merkaj, S / Zeevi, T / Staib, L H / Cui, J / Omuro, A / Bronen, R A / Malhotra, A / Aboian, M S

AJNR. American journal of neuroradiology

2022 Volume 43, Issue 4, Page(s) 526–533

Abstract: Background: Differentiating gliomas and primary CNS lymphoma represents a diagnostic challenge with important therapeutic ramifications. Biopsy is the preferred method of diagnosis, while MR imaging in conjunction with machine learning has shown ... ...

Abstract	Background: Differentiating gliomas and primary CNS lymphoma represents a diagnostic challenge with important therapeutic ramifications. Biopsy is the preferred method of diagnosis, while MR imaging in conjunction with machine learning has shown promising results in differentiating these tumors. Purpose: Our aim was to evaluate the quality of reporting and risk of bias, assess data bases with which the machine learning classification algorithms were developed, the algorithms themselves, and their performance. Data sources: Ovid EMBASE, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and the Web of Science Core Collection were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study selection: From 11,727 studies, 23 peer-reviewed studies used machine learning to differentiate primary CNS lymphoma from gliomas in 2276 patients. Data analysis: Characteristics of data sets and machine learning algorithms were extracted. A meta-analysis on a subset of studies was performed. Reporting quality and risk of bias were assessed using the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) and Prediction Model Study Risk Of Bias Assessment Tool. Data synthesis: The highest area under the receiver operating characteristic curve (0.961) and accuracy (91.2%) in external validation were achieved by logistic regression and support vector machines models using conventional radiomic features. Meta-analysis of machine learning classifiers using these features yielded a mean area under the receiver operating characteristic curve of 0.944 (95% CI, 0.898-0.99). The median TRIPOD score was 51.7%. The risk of bias was high for 16 studies. Limitations: Exclusion of abstracts decreased the sensitivity in evaluating all published studies. Meta-analysis had high heterogeneity. Conclusions: Machine learning-based methods of differentiating primary CNS lymphoma from gliomas have shown great potential, but most studies lack large, balanced data sets and external validation. Assessment of the studies identified multiple deficiencies in reporting quality and risk of bias. These factors reduce the generalizability and reproducibility of the findings.
MeSH term(s)	Glioma/diagnostic imaging ; Humans ; Lymphoma/diagnostic imaging ; Machine Learning ; Magnetic Resonance Imaging ; Reproducibility of Results
Language	English
Publishing date	2022-03-31
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A7473
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Article ; Online: Dorsal bed nucleus of stria terminalis in depressed and nondepressed temporal lobe epilepsy patients.

Dhaher, Roni / Bronen, Richard A / Spencer, Linda / Colic, Lejla / Brown, Franklin / Mian, Ali / Sandhu, Mani / Pittman, Brian / Spencer, Dennis / Blumberg, Hilary P / Altalib, Hamada

Epilepsia

2022 Volume 63, Issue 10, Page(s) 2561–2570

Abstract: Objective: Temporal lobe epilepsy (TLE) and depression are common comorbid disorders whose underlying shared neural network has yet to be determined. Although animal studies demonstrate a role for the dorsal bed nucleus of the stria terminalis (dBNST) ... ...

Abstract	Objective: Temporal lobe epilepsy (TLE) and depression are common comorbid disorders whose underlying shared neural network has yet to be determined. Although animal studies demonstrate a role for the dorsal bed nucleus of the stria terminalis (dBNST) in both seizures and depression, and human clinical studies demonstrate a therapeutic effect of stimulating this region on treatment-resistant depression, the role of the dBNST in depressed and nondepressed TLE patients is still unclear. Here, we tested the hypothesis that this structure is morphologically abnormal in these epilepsy patients, with an increased abnormality in TLE patients with comorbid depression. Methods: In this case-controlled study, 3-T structural magnetic resonance imaging scans were obtained from TLE patients with no depression (TLEonly), TLE patients with depression (TLEdep), and healthy control (HC) subjects. TLE subjects were recruited from the Yale University Comprehensive Epilepsy Center, diagnosed with the International League Against Epilepsy 2014 Diagnostic Guidelines, and confirmed by video-electroencephalography. Diagnosis of major depressive disorder was confirmed by a trained neuropsychologist through a Mini International Neuropsychiatric Interview based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. The dBNST was delineated manually by reliable raters using Bioimage Suite software. Results: The number of patients and subjects included 35 TLEonly patients, 20 TLEdep patients, and 102 HC subjects. Both TLEonly and TLEdep patients had higher dBNST volumes compared to HC subjects, unilaterally in the left hemisphere in the TLEonly patients (p = .003) and bilaterally in the TLEdep patients (p < .0001). Furthermore, the TLEdep patients had a higher dBNST volume than the TLEonly patients in the right hemisphere (p = .02). Significance: Here, we demonstrate an abnormality of the dBNST in TLE patients, both without depression (left enlargement) and with depression (bilateral enlargement). Our results demonstrate this region to underlie TLE both with and without depression, implicating it as a target in treating the comorbidity between these two disorders.
MeSH term(s)	Depressive Disorder, Major/complications ; Depressive Disorder, Major/diagnostic imaging ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe/complications ; Epilepsy, Temporal Lobe/diagnostic imaging ; Humans ; Magnetic Resonance Imaging/methods ; Septal Nuclei
Language	English
Publishing date	2022-08-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17377
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Article: The status of status: seizures are bad for your brain's health.

Bronen, R A

AJNR. American journal of neuroradiology

2000 Volume 21, Issue 10, Page(s) 1782–1783

MeSH term(s)	Animals ; Brain/physiopathology ; Humans ; Magnetic Resonance Imaging ; Status Epilepticus/complications ; Status Epilepticus/physiopathology
Language	English
Publishing date	2000-11
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
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Article: MR of mesial temporal sclerosis: how much is enough?

Bronen, R

AJNR. American journal of neuroradiology

1998 Volume 19, Issue 1, Page(s) 15–18

MeSH term(s)	Cerebral Ventricles/pathology ; Epilepsy, Temporal Lobe/pathology ; Hippocampus/pathology ; Humans ; Magnetic Resonance Imaging ; Sclerosis
Language	English
Publishing date	1998-01
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
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Article: MR imaging of epilepsy: strategies for successful interpretation.

Vattipally, Venkatramana R / Bronen, Richard A

Magnetic resonance imaging clinics of North America

2006 Volume 14, Issue 2, Page(s) 225–247

Abstract: MR imaging plays a pivotal role in the evaluation of patients with epilepsy. With its high spatial resolution, excellent inherent soft tissue contrast, multiplanar imaging capability, and lack of ionizing radiation, MR imaging has emerged as a versatile ... ...

Abstract	MR imaging plays a pivotal role in the evaluation of patients with epilepsy. With its high spatial resolution, excellent inherent soft tissue contrast, multiplanar imaging capability, and lack of ionizing radiation, MR imaging has emerged as a versatile diagnostic tool in the evaluation of patients with epilepsy. MR imaging not only identifies specific epileptogenic substrates but also determines specific treatment and predicts prognosis. Employing appropriate imaging protocols and reviewing the images in a systematic manner helps in the identification of subtle epileptogenic structural abnormalities. With future improvements in software, hardware, and post-processing methods, MR imaging should be able to throw more light on epileptogenesis and help physicians to better understand its structural basis.
Language	English
Publishing date	2006-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1196851-5
ISSN	1557-9786 ; 1064-9689
ISSN (online)	1557-9786
ISSN	1064-9689
DOI	10.1016/j.mric.2006.06.006
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Article ; Online: Simulated driving in the epilepsy monitoring unit: Effects of seizure type, consciousness, and motor impairment.

Kumar, Avisha / Martin, Reese / Chen, William / Bauerschmidt, Andrew / Youngblood, Mark W / Cunningham, Courtney / Si, Yang / Ezeani, Cel / Kratochvil, Zachary / Bronen, Jared / Thomson, James / Riordan, Katherine / Yoo, Ji Yeoun / Shirka, Romina / Manganas, Louis / Krestel, Heinz / Hirsch, Lawrence J / Blumenfeld, Hal

Epilepsia

2021 Volume 63, Issue 1, Page(s) e30–e34

Abstract: People with epilepsy face serious driving restrictions, determined using retrospective studies. To relate seizure characteristics to driving impairment, we aimed to study driving behavior during seizures with a simulator. Patients in the Yale New Haven ... ...

Abstract	People with epilepsy face serious driving restrictions, determined using retrospective studies. To relate seizure characteristics to driving impairment, we aimed to study driving behavior during seizures with a simulator. Patients in the Yale New Haven Hospital undergoing video-electroencephalographic monitoring used a laptop-based driving simulator during ictal events. Driving function was evaluated by video review and analyzed in relation to seizure type, impairment of consciousness/responsiveness, or motor impairment during seizures. Fifty-one seizures in 30 patients were studied. In terms of seizure type, we found that focal to bilateral tonic-clonic or myoclonic seizures (5/5) and focal seizures with impaired consciousness/responsiveness (11/11) always led to driving impairment; focal seizures with spared consciousness/responsiveness (0/10) and generalized nonmotor (generalized spike-wave bursts; 1/19) usually did not lead to driving impairment. Regardless of seizure type, we found that seizures with impaired consciousness (15/15) or with motor involvement (13/13) always led to impaired driving, but those with spared consciousness (0/20) or spared motor function (5/38) usually did not. These results suggest that seizure types with impaired consciousness/responsiveness and abnormal motor function contribute to impaired driving. Expanding this work in a larger cohort could further determine how results with a driving simulator may translate into real world driving safety.
MeSH term(s)	Consciousness ; Electroencephalography/methods ; Epilepsy/complications ; Epilepsy/diagnosis ; Humans ; Motor Disorders ; Retrospective Studies ; Seizures/diagnosis
Language	English
Publishing date	2021-11-24
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17136
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Article: Is there any role for gadopentetate dimeglumine administration when searching for mesial temporal sclerosis in patients with seizures?

Bronen, R A

AJR. American journal of roentgenology

1995 Volume 164, Issue 2, Page(s) 503

MeSH term(s)	Contrast Media ; Drug Combinations ; Epilepsy/diagnosis ; Gadolinium DTPA ; Hippocampus/pathology ; Humans ; Magnetic Resonance Imaging ; Meglumine ; Organometallic Compounds ; Pentetic Acid/analogs & derivatives ; Sclerosis ; Temporal Lobe/pathology
Chemical Substances	Contrast Media ; Drug Combinations ; Organometallic Compounds ; Meglumine (6HG8UB2MUY) ; Pentetic Acid (7A314HQM0I) ; Gadolinium DTPA (K2I13DR72L)
Language	English
Publishing date	1995-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/ajr.164.2.7839999
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Article: Imaging of lumbar spinal surgery complications.

Malhotra, Ajay / Kalra, Vivek B / Wu, Xiao / Grant, Ryan / Bronen, Richard A / Abbed, Khalid M

Insights into imaging

2015 Volume 6, Issue 6, Page(s) 579–590

Abstract: Unlabelled: Lumbar spine surgery for spinal stenosis is a frequently performed procedure and was the fastest growing type of surgery in the US from 1980 to 2000. With increasing surgical invasiveness, postoperative complications also tend to be higher. ... ...

Abstract	Unlabelled: Lumbar spine surgery for spinal stenosis is a frequently performed procedure and was the fastest growing type of surgery in the US from 1980 to 2000. With increasing surgical invasiveness, postoperative complications also tend to be higher. Cross-sectional imaging techniques (CT and MRI) are more sensitive than radiographs and play an increasingly important role in evaluation of patients with lumbar spine surgery. Their use in patients with metallic implants is somewhat limited by artefacts, which can obscure pathology and decrease accuracy and reader confidence. Metal artefact reduction techniques have been developed, which can significantly improve image quality and enable early detection of postoperative complications. Complications can occur throughout postoperative course. Early complications include hardware displacement, incidental durotomy, postoperative collections-most commonly seroma, and less likely haematoma and/or infection. Incidental durotomy with CSF leak causing intracranial hypotension has characteristic MR brain findings and diagnosis of occult leak sites have been improved with use of dynamic CT myelography. Haematomas, even when compressing the thecal sac, are usually asymptomatic. Early infection, with nonspecific MR findings, can be diagnosed accurately using dual radiotracer studies. Delayed complications include loosening, hardware failure, symptomatic new or recurrent disc herniation, peri-/epidural fibrosis, arachnoiditis, and radiculitis. Teaching points: • CT and MRI play an increasingly important role in evaluation of patients with lumbar spine surgery • Complications can occur throughout the postoperative course and early detection is critical • Artefact reduction techniques can improve image quality for early and improved detection of complications.
Language	English
Publishing date	2015-10-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2543323-4
ISSN	1869-4101
ISSN	1869-4101
DOI	10.1007/s13244-015-0435-8
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Article ; Online: Transitioning from Radiology Training to Academic Faculty: Defining Your Role and Interests.

Grajo, Joseph R / Retrouvey, Michele / Awan, Omer / Catanzano, Tara / Cheong, Li Hsia Alicia / Mankoff, David / Burdette, Jonathan H / Mendiratta-Lala, Mishal / Spalluto, Lucy B / Bronen, Richard A / DeBenedectis, Carolynn M

Current problems in diagnostic radiology

2019 Volume 49, Issue 4, Page(s) 227–230

Abstract: Transitioning from radiology training to academic faculty presents many challenges. In this review, we discuss strategies to navigate this process and to facilitate success through appropriate selection of career tracks. Various modern avenues include ... ...

Abstract	Transitioning from radiology training to academic faculty presents many challenges. In this review, we discuss strategies to navigate this process and to facilitate success through appropriate selection of career tracks. Various modern avenues include roles as a Clinician-Educator, Clinician-Investigator, and Clinician-Administrator. Selection of the appropriate career track based on personal interests and institutional culture is critical for early and long-term career satisfaction.
MeSH term(s)	Career Mobility ; Education, Medical, Graduate ; Faculty, Medical ; Humans ; Internship and Residency ; Radiology/education
Language	English
Publishing date	2019-03-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	198954-6
ISSN	1535-6302 ; 0363-0188
ISSN (online)	1535-6302
ISSN	0363-0188
DOI	10.1067/j.cpradiol.2019.03.001
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