Emerging Utility of Applied Magnetic Resonance Imaging in the Management of Traumatic Brain Injury

Nadel, Jeffrey; McNally, J. Scott; DiGiorgio, Anthony M; Grandhi, Ramesh

doi:10.3390/medsci9010010

Cited by 6 publications

(7 citation statements)

References 72 publications

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“…For long-term prognostication of TBI, MRI has been shown to be a valuable and accurate tool, especially with regard to visualization and grading of injury. 9,19,20 While MR imaging and related modalities (diffusion tensor imaging, spectroscopy, etc.) are valuable in these contexts, this study evaluated its usefulness in the acute setting.…”

Section: Discussionmentioning

confidence: 99%

“…Endpoints of existing studies have largely focused on longer-term outcomes (such as 1 month or 1 year), largely using Glasgow Outcome Scale-related metrics, whereas our analysis evaluated more acute outcome variables related to in-hospital and disposition endpoints. For long-term prognostication of TBI, MRI has been shown to be a valuable and accurate tool, especially with regard to visualization and grading of injury 9,19,20 . While MR imaging and related modalities (diffusion tensor imaging, spectroscopy, etc.)…”

Section: Discussionmentioning

confidence: 99%

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Use of MRI in patients with severe diffuse traumatic brain injury: a matched National Trauma Data Bank analysis

Chilakapati,

Dragun,

Chiu

et al. 2024

J Trauma Acute Care Surg

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Objective MRI is increasingly used to evaluate patients with diffuse traumatic brain injury (dTBI). However, the utility of early MRI is understudied. We hypothesize that early MRI patients will have increased length of stay but no changes in ICP management or disposition. Methods The 2019 NTDB was queried for patients with dTBI and Glasgow Coma Scale score ≤ 8. Extra-axial and focal intra-axial hemorrhages were excluded. Clinical characteristics were controlled for. Patients with and without MRI were compared for ICP management, outcome, mortality, and disposition. A propensity score matching algorithm was used to create a 1:1 match cohort. Results In 2568 patients, MRI was less common in severe dTBI patients with clear reasons for poor exam, including bilaterally unreactive pupils or midline shift. After matching, 501 patients who underwent MRI within one week were compared to 501 patients without MRI. MRI patients had longer ICU stays (11.6 ± 9.6 vs. 13.4 ± 9.5, p < 0.01 [-3.03, -0.66 95% CI]). There was no difference between groups in ICP monitor (23.6% vs. 27.3%, p = 0.17 [-0.09, 0.02 95% CI]) or ventriculostomy placement (13.6% vs. 13.2%, p = 0.85 [-0.04, 0.05 95% CI]) or in withdrawal of care (15.0% versus 18.6%, p = 0.12 [-0.08, 0.01 95% CI]). MRI patients were more likely to be discharged to inpatient rehabilitation (42.9% vs. 33.5%, p < 0.01 [0.03, 0.15 95% CI]) but not to home (9.4% versus 9.0 %, p = 0.83 [-0.03, 0.04 95% CI]). Conclusions The decision to pursue early brain MRI may be driven by lack of obvious reasons for a patient’s poor neurologic status. MRI patients had longer ICU stays but no difference in rates of placement of ICP monitors or ventriculostomies or withdrawal of care. Further study is required to define the role of early MRI in dTBI patients. Level of evidence Prognostic/epidemiological, IV

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of MRI in patients with severe diffuse traumatic brain injury: a matched National Trauma Data Bank analysis

Chilakapati,

Dragun,

Chiu

et al. 2024

J Trauma Acute Care Surg

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“…CT and MRI techniques that are typically relied upon for TBI diagnosis primarily detect anatomical and functional changes, and hence are of little use for detecting the early molecular fluctuations that underwrite TBI. There is therefore an urgent need to develop highly sensitive methods for early in situ real-time diagnosis and therapeutic evaluation of TBI, an issue currently being addressed in part by the fluorescent probe research community. , …”

Section: Fluorescent Probes For Organ Damagementioning

confidence: 99%

Fluorescent Probes for Disease Diagnosis

Wang,

Ding,

Groleau

et al. 2024

Chem. Rev.

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The identification and detection of disease-related biomarkers is essential for early clinical diagnosis, evaluating disease progression, and for the development of therapeutics. Possessing the advantages of high sensitivity and selectivity, fluorescent probes have become effective tools for monitoring disease-related active molecules at the cellular level and in vivo. In this review, we describe current fluorescent probes designed for the detection and quantification of key bioactive molecules associated with common diseases, such as organ damage, inflammation, cancers, cardiovascular diseases, and brain disorders. We emphasize the strategies behind the design of fluorescent probes capable of disease biomarker detection and diagnosis and cover some aspects of combined diagnostic/ therapeutic strategies based on regulating disease-related molecules. This review concludes with a discussion of the challenges and outlook for fluorescent probes, highlighting future avenues of research that should enable these probes to achieve accurate detection and identification of disease-related biomarkers for biomedical research and clinical applications. CONTENTS 5.3.

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“…1). Since the primary focus of this review is molecular imaging, we will briefly summarize such MRI modalities, which have been described in more detail elsewhere (19).…”

Section: Imaging In Tbi Research Mri Of Brain Injurymentioning

confidence: 99%

Brain Trauma Imaging

Bischof

Cross²

2023

J Nucl Med

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the current status of brain imaging for the evaluation and diagnosis of brain injuries; (2) the advantages and disadvantages of different imaging modalities used for research of traumatic brain injury; and (3) specific radioligands that have been applied to characterize brain alterations in a chronic phase following injury.Financial Disclosure: Support was received from VA Rehabilitation Research and Development (grants I01RX000521, I01RX001612, and I01RX003087: Elaine R. Peskind, PI); the NIH (grant 5R01NS045254-05 to Satoshi Minoshima and Donna Cross); and, to G erard Bischof, via K€ oln Fortune 479/2018 and Hannelore-Kohl Stiftung e.V. (grant 2018016). G erard Bischof has been funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) via project 431549029-SFB 1451. Donna Cross is on the scientific advisory board for Ceremark Pharma, the producer of 18 F-FDDNP (Flornaptitril). This tracer for CTE was not discussed in the article. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest.CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www. snmmilearningcenter.org) through January 2026.

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Emerging Utility of Applied Magnetic Resonance Imaging in the Management of Traumatic Brain Injury

Cited by 6 publications

References 72 publications

Use of MRI in patients with severe diffuse traumatic brain injury: a matched National Trauma Data Bank analysis

Use of MRI in patients with severe diffuse traumatic brain injury: a matched National Trauma Data Bank analysis

Fluorescent Probes for Disease Diagnosis

Brain Trauma Imaging

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