Explore every episode of the podcast AJNR Podcast

In this AJNR author interview episode, Dr. Evgenia Grik speaks with Dr. Rami Eldaya about his recently published ASSR white paper on reporting of spinal metastases with a focus on the contents of the proposed structured system and rationale behind its creation. We discuss what neurosurgeons and radiation oncologists need to know from radiology reports for spinal metastatic disease and walk through an example case.

Featured Article: Spinal Metastasis Reporting: Evidence-Based Recommendation on Behalf of the American Society of Spine Radiology Education and Standards Committee

In this AJNR Author Interview episode, Dr. Francis Deng speaks with Dr. Mona Gad about arterial spin labeling in code-stroke patients who actually had seizures. They discuss ASL’s sensitivity, perfusion patterns, concordance with EEG and structural MRI, and cases that illustrate how ASL may complement DWI, FLAIR, and assessment in acute care.

Featured article: Diagnostic Utility of Arterial Spin-Labeling MRI in Straight to MRI Code Stroke Patients for Seizure Detection: A Comparison with FLAIR, DWI, and EEG

In this podcast episode, Dr. Vilanilam discusses “Cerebral Proliferative Angiopathy: Imaging Spectrum and Diagnostic Insights,” by first author Rai.

Cerebral proliferative angiopathy is a rare cerebrovascular malformation that can mimic an arteriovenous malformation but has a fundamentally different vascular architecture and underlying physiology. This comprehensive review of 75 studies and 153 patients highlights its characteristic multimodal imaging features, including a diffuse vascular network intermingled with normal brain, absence of a compact nidus or dominant arterial feeders, frequent transdural recruitment, relatively limited early venous drainage, and evidence of chronic hypoperfusion.

Dr. Vilanilam reviews the key CT, MRI, perfusion, and angiographic findings that help distinguish cerebral proliferative angiopathy from conventional arteriovenous malformations and other vascular mimics. Recognizing this distinction is critical because normal functioning brain is incorporated within the abnormal vascular network, substantially influencing treatment decisions and emphasizing the importance of accurate imaging diagnosis.

Featured Article: Cerebral Proliferative Angiopathy: Imaging Spectrum and Diagnostic Insights

In this podcast episode, Dr. Vilanilam discusses "Indeterminate T1-Hypointense Spine Lesions: Prevalence of Malignancy in the Absence of Aggressive Imaging Features," by first author Barkovich.

Indeterminate low-T1-signal vertebral lesions are commonly encountered on spine MRI, but deciding which lesions require additional imaging or follow-up can be challenging. This study examines the outcomes of 278 such lesions and finds an overall malignancy rate of only 2%, with all malignant lesions representing metastases in patients with known or concurrently diagnosed extraskeletal metastatic disease and no primary malignant bone tumors identified.

Dr. Vilanilam reviews the imaging features of these lesions, the importance of incorporating the patient's oncologic history into risk assessment, and the implications for follow-up recommendations. The findings suggest that short-interval imaging may be appropriate when there is meaningful concern for metastatic disease, while follow-up may not be necessary for low-risk patients without aggressive imaging features or extraskeletal metastatic disease.

In this AJNR Podcast author interview, Dr. Francis Deng speaks with Dr. Caline Azzi about recent studies identifying imaging and clinical predictors of expansion in traumatic subdural, subarachnoid, and intraparenchymal hemorrhage. Hemorrhage size, multicompartment injury, coagulopathy, mass effect, and neurologic status may help determine which patients truly need routine repeat CT.

Related Articles:

Risk Stratification for Traumatic SAH Enlargement and Surgical Intervention: Guides to Follow-Up Imaging in Patients with Trauma

Predictive Factors for Traumatic Intraparenchymal Hemorrhage Expansion and Its Clinical Outcomes

Improving the management of acute subdural hematomas; identifying characteristics associated with acute subdural hematoma size and expansion

In this AJNR Article Summary, Dr. George Vilanilam discusses the article, "Sinking Flap Syndrome: Risk Factors, Outcomes, and the Role of Neuroradiology in Cranioplasty Timing." Sinking flap syndrome is a common yet frequently underrecognized complication of decompressive craniectomy, with imaging findings often preceding clinical deterioration. Recognition and reporting of key features - including a markedly sunken flap, ventricular compression, and significant midline shift (8 mm or greater) were associated with a two-fold reduction in time to cranioplasty highlighting the important role neuroradiologists can play in expediting definitive treatment and improving patient care.

In this AJNR Article Summary, Dr. Francis Deng reviews CTA-based Carotid Plaque-RADS and its role beyond stenosis grading. He explains the key imaging features that define plaque vulnerability, then highlights two AJNR studies showing that the system is learnable, reproducible, and clinically meaningful for predicting future stroke risk, especially in patients with only mild or moderate carotid stenosis.

Visit the website to read the related articles.

Carotid Plaque-RADS: Inter- and Intrareader Agreement and Learning Curve Analysis in CTA

CTA-Based Carotid Plaque-RADS Classification Improves Risk Stratification for Ischemic Cerebrovascular Events

In this AJNR Article Summary, Dr. George Vilanilam discusses the article, "Maximizing the Conspicuity of Cerebrospinal Fluid–Venous Fistulas on Computed Tomography Myelography: Assessment of Contrast Density and Timing Effects." Contrast density, not just timing, plays the dominant role in detecting CSF-venous fistulas, with higher subarachnoid contrast significantly improving diagnostic confidence. These findings support prioritizing contrast pooling strategies during CT myelography to enhance fistula detection in patients with spontaneous intracranial hypotension.

In this AJNR Article Summary, Dr. George Vilanilam discusses the article, "Risk Stratification for Traumatic Subarachnoid Hemorrhage Enlargement and Surgical Intervention: Guides to Follow-Up Imaging in Patients with Trauma." Not all traumatic subarachnoid hemorrhages behave the same - risk factors such as coagulopathy, concurrent intracranial hemorrhage, and low Glasgow Coma Scale scores predict hemorrhage progression and need for intervention. A risk-stratified imaging approach may reduce unnecessary repeat CT scans while focusing surveillance on patients most likely to deteriorate.

In this AJNR Author Interview, Dr. Francis Deng speaks with Dr. Cynthia Greene about her article, "Posttreatment Follow-Up MR Imaging Biomarkers of Collateral Status Are Associated with Short-Term Outcomes in Large-Vessel Acute Ischemic Stroke." In a retrospective study of follow-up MRI after anterior-circulation large-vessel occlusion stroke, a greater burden of FLAIR hyperintense vessels was associated with worse short-term neurologic outcomes, even among successfully reperfused patients, suggesting persistent FLAIR hyperintense vessels may mark ongoing perfusion abnormality or possible no-reflow physiology.

In this AJNR Author Interview, Dr. Francis Deng speaks with Dr. Jimmy Moon about his article, "Use of CTA in Strangulation Evaluation". In a retrospective review, the yield of CTA neck for blunt cerebrovascular injury in patients who presented after strangulation was 1 in 138 (0.7%), suggesting the broad use of CTAs in this setting may be of low value.

In this AJNR Podcast Author Interview, Dr. Francis Deng and Dr. Amy Juliano discuss how CT can subtype Menière disease by assessing the vestibular aqueduct and adjacent bone. During normal childhood, the angular trajectory of the vestibular aqueduct progressively narrows; an angle greater than 120 degrees after age 12 indicates adult-persistent hypoplasia and thus the hypoplastic endolymphatic sac endotype rather than normal maturation. A retrolabyrinthine bone thickness of at least 1.2 mm serves as a practical surrogate for a mature vestibular aqueduct orientation, reliably excluding the hypoplastic endotype and identifying ears that do not belong to this high-risk subgroup. In contrast, in the degenerative endotype of Menière disease, retrolabyrinthine bone thickness is more variable and does not follow this simple threshold pattern, so CT features must be interpreted in a broader clinical and imaging context.

Read the AJNR articles mentioned in this episode:

"Postnatal Development of the Vestibular Aqueduct Trajectory on CT: Establishing Age-Specific Norms to Distinguish Normal from Arrested (Hypoplastic) Development"

"Retrolabyrinthine Bone Thickness as a Radiologic Marker for the Hypoplastic Endotype in Menière Disease".

In this AJNR Article Summary, Dr. George Vilanilam discusses the article, "Biphasic Progression of Radiation-Induced Carotid Stenosis: The Predictive Role of Low-Density Plaque". Low‑density carotid plaque on imaging may signal accelerated stenosis progression in post‑radiation patients, highlighting the need for earlier intervention and a shift toward evaluating plaque composition, not just degree of narrowing, to help prevent stroke in this high‑risk group.

In this AJNR Fellows' Journal Club article summary, Dr. Francis Deng and Dr. Amir Khadivi discuss the article by Proner et al., "Impact of Clinical and Radiologic Factors on CTP Timing in Acute Ischemic Stroke." They discuss the authors' findings that cardiac arrhythmias and older age are independent predictors of nondiagnostic CTP exams. Specifically, these factors often lead to the truncation of reference vessel time-attenuation curves that fail to reach equilibrium within a 45-second acquisition window.

Dr. Francis Deng discusses the article by Vankawala et al. entitled "Evaluating the Role of Imaging Markers in Predicting Stroke Risk and Guiding Management after Vertebral Artery Injury: A Retrospective Study." The Biffl grading scale assess blunt cerebrovascular injury severity, but its prognostic validity for vertebral artery injuries with respect to stroke risk remains controversial.

In this AJNR Author Interview, Dr. Francis Deng discusses with Dr. Babatunde Akinpelu the article "Assessing the Accuracy of Artificial Intelligence in Detecting Intracranial Aneurysms in a Clinical Setting Relative to Neuroradiologists." Neuroradiologists performed better than a commercial AI program for intracranial aneurysm detection in sensitivity and accuracy, while achieving comparable specificity. Common failure modes are reviewed.

In this AJNR article summary, Dr. Francis Deng reviews a study, from corresponding author Dr. Katherine Reinshagen, entitled "Retrospective Review of MR Findings in Sudden Sensorineural Hearing Loss and Associated Clinical Features". In this large cohort, the yield of MRI for relevant findings was 5.9%, including tumors in less than 3%. The spectrum of pathology is illustrated

In this AJNR article summary, Dr. Francis Deng reviews an article by Dr. Andrew Callen and colleagues entitled "Enhancing Clarity in Dynamic Myelography Reporting: Results of a Survey of Patients and Referring Providers Evaluating a Standardized Reporting System in the Myelographic Workup of Patients with Suspected Spontaneous Intracranial Hypotension". The SIH-RADS system provides a structured manner of reporting results of dynamic CT myelography that are clear, actionable, and preferred by both patients and providers.

In this AJNR Author Interview, Dr. Francis Deng discusses with Dr. Rohini Nadgir the article "Clinical Impact of Sinus CT Surveillance Imaging among Febrile Neutropenic Patients: A Retrospective Observational Study." CT sinus imaging results, positive or negative, did not directly alter clinical management in this patient population, suggesting that routine sinus CT may be a low-yield examination in the setting of febrile neutropenia.

Podcast editor Francis Deng explores a recent AJNR article, "Diagnostic Performance of Ultrasound in Neck Node NIRADS Category 2."

Bottom line is: Ultrasound, with targeted FNA, can accurately determine tumor recurrence in patients with NI-RADS 2 (low suspicion) lymph node findings during surveillance of head and neck cancer.

Dr. Francis Deng interviews Dr. Ajay Madhavan about his article "Evaluation of Spontaneous Intracranial Hypotension Probabilistic Brain MRI Scoring Systems in Normal Patients" published in the September issue of AJNR.

In this AJNR Podcast author interview, Dr. Francis Deng is joined by leading expert Dr. Ana Franceschi, lead author of the recent AJNR State of the Practice paper on brain PET for Alzheimer disease. Dr. Franceschi breaks down everything clinicians need to know about this new era of molecular neuroimaging relevant to Alzheimer disease diagnostics and response assessment, from scan interpretation to the practical logistics of scaling up services.

New AJNR Podcast Editor Dr. Francis Deng discusses "Frontal Paraventricular Cysts: Refined Definitions and Outcomes" from the August issue of AJNR in this episode. Be sure to visit our website to watch the video version of this podcast. (8:34)

Dr. Hiatt and Dr. Vilanilam discuss four papers from the July issue of AJNR in this episode. Be sure to visit our website to watch the video version of this podcast. (29:42)

Dr. Hiatt talks with Drs. Dhairya Lakhani and Vivek Yedavalli about their paper The Cortical Vein Opacification Score (COVES) is Independently Associated with Good and Excellent Functional Outcomes at 90 Days in Minor Stroke Patients with Anterior Circulation Large Vessel Occlusion: A Multicenter Study, which will be featured in the August issue of AJNR. (9:54)

Join Dr. Hiatt and Dr. Vilanilam for a recap of some of the highlights of the June issue of AJNR. Be sure to visit our website to watch the video version of this podcast. (22:47)

Dr. Vilanilam welcomes Dr. Samantha L. Pisani Petrucci for a discussion of her paper Assessing the Diagnostic Value of Brain White Matter Hyperintensities and Clinical Symptoms in Predicting the Detection of CSF-Venous Fistula in Patients with Suspected Spontaneous Intracranial Hypotension, published in the May issue of AJNR. (21:54)

Dr. Vilanilam and Dr. Hiatt review some of the highlights of the May issue of AJNR. Be sure to visit our website to watch the video version of this podcast. (25:18)

Dr. Vivek Yedavalli returns this month, along with Dr. Hamza Adel Salim to share insights on their papers Association of Pretreatment Perfusion Imaging Parameters With 90-Day Excellent Functional Outcomes in Anterior Circulation Distal Medium Vessel Occlusion Stroke and Hypoperfusion Intensity Ratio Less Than 0.4 Is Associated with Favorable Outcomes in Unsuccessfully Reperfused Acute Ischemic Stroke with Large-Vessel Occlusion. (16:55)

Dr. Hiatt and Dr. Vilanilam share highlights and commentary from the April issue of AJNR. Be sure to visit our website to watch the video version of this podcast. (21:19)

Dr. Manisha Koneru and Vivek Yedavalli are Dr. Hiatt's guests this month. They discuss their paper Prolonged Venous Transit on Perfusion Imaging Is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions, which will be published in the May issue of AJNR.

Join Dr. Hiatt and Dr. Vilanilam for their reviews of three featured articles in the March issue of AJNR. Be sure to visit our website to watch the video version of this podcast. (22:37)

Dr. Hiatt and Dr. Vilanilam share insight and commentary on three featured articles in the February issue of AJNR. Be sure to visit our website to watch the video version of this podcast. (23:36)

Dr. Kirk Welker is Dr. Hiatt's guest this month. They discuss the research and collaboration involved in creating the State of Practice: ASNR Statement on Gadolinium-Based Contrast Agent Use in Patients with Chronic Kidney Disease, published in the February issue of AJNR. Be sure to visit our website to watch the video version of this podcast. (13:04)

Dr. Petrice Cogswell is Dr. Hiatt's guest this month. They discuss Alzheimer Disease Anti-Amyloid Immunotherapies: Imaging Recommendations and Practice Considerations for Monitoring of Amyloid-Related Imaging Abnormalities, the ASNR Alzheimer, ARIA, and Dementia Study Group's paper in the January issue of AJNR. (11:28)

Welcome the new year with Dr. Hiatt and Dr. Vilanilam's round-up of featured articles from AJNR's January issue. You can now visit our website to watch the video version of our podcasts! Be sure to bookmark this page to view upcoming article summaries and author interviews, a part of AJNR's new website, which offers many multimedia features. (20:04)

Dr. Hiatt and Dr. Vilanilam ring out 2024 with highlights of the December issue. This is the final print edition and it contains a selection of the journal's most impactful articles from its first 45 years of publication. Be sure to join us next year when we introduce video podcasts to our feed. (12:29)

Tune in to hear a review of the highlights from the November issue of AJNR presented by Dr. Hiatt and Dr. Vilanilam. (18:51)

Listen to highlights from the October issue of AJNR presented by Dr. Hiatt and Dr. Vilanilam. (14:41)

Dr. Hiatt welcomes back Ian Mark (@iantmark) to talk about his article, "Skull Base CSF Leaks: Potential Underlying Pathophysiology and Evaluation of Brain MR Imaging Findings Associated with Spontaneous Intracranial Hypotension," one of the Fellows' Journal Club selections from the October issue of AJNR. (10:13)

Dr. Hiatt and Dr. Vilanilam review articles of interest from the September issue of AJNR. (24:09)

Dr. Hiatt welcomes Adam Dmytriw for a discussion of his paper, "Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of a Multicenter Retrospective Study." (11:33)

Dr. Vilanilam and Dr. Hiatt review highlights of the August issue of AJNR. (14:57)

Dr. Hiatt and Dr. Vilanilam review highlights of the July issue of AJNR. (12:11)

Ian Mark (@iantmark) joins Dr. Vilanilam as this month's guest. They discuss Dr. Mark's article, "7T MRI for Cushing Disease: A Single-Institution Experience and Literature Review," from the July issue of AJNR. (16:36)

Selections from the June issue of AJNR are presented by Dr. Hiatt and Dr. Vilanilam. (17:50)

Dr. Hiatt welcomes Drs. Koji Tanaka and Andrew Demchuk from Foothills Medical Centre at the University of Calgary for a discussion of their paper, "Timing of Spot Sign Appearance, Spot Sign Volume, and Leakage Rate among Phases of Multiphase CTA Predict Intracerebral Hemorrhage Growth." (11:40)

Dr. Jeffrey Ross joins Dr. Hiatt to continue our series on expert advice for reviewing manuscripts. A former Editor-in-Chief of AJNR, Dr. Ross gives listeners detailed tips to prepare outstanding reviews. Part 1 of 2 (13:42)

Dr. Jeffrey Ross joins Dr. Hiatt to continue our series on expert advice for reviewing manuscripts. A former Editor-in-Chief of AJNR, Dr. Ross gives listeners detailed tips to prepare outstanding reviews. Part 2 of 2 (14:25)

Dr. Hiatt and Dr. Vilanilam present highlights of the May issue of AJNR. (17:52)