Objectives: Adult posterior cervical spinal dysraphism, including meningocele (MC), myelomeningocele (MMC), and myelocystocele (MyCC) is exceptionally rare and remains insufficiently characterised. This study aimed to conduct the first systematic review of the literature on adult cases and report an additional illustrative case. Methods: A PRISMA 2020 systematic review of PubMed/MEDLINE, Web of Science and Scopus was conducted (PROSPERO CRD420261426944). Data were extracted at case level, grouped by the lesion label used by the original authors, and synthesised narratively. Results: Nineteen studies (18 case reports and one case series) described 23 adults (median age 24 years; 19 male): 16 MC, one MyCC and six MMC. An objective neurological abnormality was documented in 14 of 21 examined patients. Nineteen patients were operated on; among 17 with a classified outcome, ten improved, five were intact and two were stable, and none were reported worse (median follow-up 12 months). The additional case was a 62-year-old man with a radiologically diagnosed C4–C5 lesion most consistent with MMC and no objective neurological deficit, managed by observation (3 months of follow-up). Conclusions: The evidence is sparse, heterogeneous and prone to publication bias, and it is insufficient to establish natural history, optimal management or the relative merits of surgery and observation. Standardised terminology, multicentre registries and long-term follow-up are needed.

BACKGROUND Severe atherosclerotic internal carotid artery stenosis may progress to complete internal carotid artery occlusion (ICAO). Therefore, ICAO represents an advanced form of carotid artery disease. We sought to investigate the association between ICAO with atherosclerotic disease in other arterial beds and vascular risk factors and to identify the patient implications of the diagnosis of ICAO. MATERIALS AND METHODS Using the term "Internal carotid artery occlusion", a search of PubMed/MEDLINE, Scopus and Embase between 1980 and 2025 revealed 10,588 results. After exclusion of case reports, letters to the Editor and Editorials, 5,771 reports were identified. Following meticulous screening of the identified reports, 28 studies specifically addressing ICAO patient cohorts were included in the final analysis. A quantitative and qualitative synthesis analysis was performed. A questionnaire was subsequently developed and sent out to 63 participants from the United States (n=21) and several European countries (n=42), aiming to achieve consensus regarding the optimal management of patients with ICAO. Three participants did not respond. The Consensus Coordinator abstained from voting to avoid introducing bias, resulting in a final voting panel of 60 participants. RESULTS Across included studies, the proportion of patients with ICAO presenting with neurologic symptoms varied widely, ranging from 38-100%, while approximately 24-27% of patients were asymptomatic at the time of diagnosis. Consensus (≥75%) was achieved in 11 of the 17 (64.7%) pre-specified statements. Most participants agreed that atherosclerotic ICAO represents a systemic manifestation of advanced atherosclerosis rather than isolated cerebrovascular pathology (56/60; 93.3%). Duplex ultrasound should be used as the first-line diagnostic tool for suspected ICAO, with CTA or MRA confirmation if necessary (59/60; 98.3%). Optimal medical therapy (including antiplatelet, antihypertensives, statins, and glycemic control) remains the cornerstone of ICAO management (59/60; 98.3%). Lifestyle and metabolic risk factor optimization, smoking cessation, optimizing body weight, a healthy diet and exercise, should be strongly advised in all ICAO patients (60/60; 100%). Most participants concurred that ICAO revascularization should be centralized in specialized vascular-neuro centers equipped for intra-operative neuromonitoring and advanced hemodynamic control (57/60; 95.0%). Finally, most participants agreed that current evidence for ICAO intervention is insufficient and that a global registry should be created to record outcomes and guide future trials (56/60; 93.3%). CONCLUSIONS This international, multi-specialty consensus highlights ICAO as a marker of advanced, systemic atherosclerosis. Management should emphasize comprehensive evaluation for multisystem vascular disease and aggressive modification of cardiovascular risk factors. Best medical therapy remains the cornerstone of the management of patients with ICAO, with conservative or invasive interventions considered selectively based on symptom status, anatomic considerations, procedural risk, and institutional expertise, to reduce the overall cardiovascular disease burden.

The RSNA Lumbar Degenerative Imaging Spine Classification dataset is the largest publicly available adult MRI lumbar spine dataset for degenerative disease. The dataset includes multisequence, multiplanar MRIs from 2,697 patients through contributions from 8 institutions across 6 countries and 5 continents. ©RSNA, 2026.

Abstract Introduction: Osteoarthritis (OA) of the knee is the leading cause of disability in the middle-aged and elderly population. Early detection of degenerative cartilage changes is crucial for timely therapeutic intervention and slowing the progression of the disease. Standard radiological methods often do not provide insight into the biochemical changes preceding morphological degeneration. Objective: This review aims to evaluate the diagnostic value of different MRI mapping sequences (T2, T1ρ, dGEMRIC, UTE,  3D DESS and MMF) in the early detection of biochemical changes in knee cartilage in OA, and to compare their technical and clinical characteristics. Methodology: 15 reviews of research published in the last ten years were analyzed, which used quantitative MRI sequences in assessing cartilage changes. Comparative analysis was performed based on the number of subjects, MRI techniques applied, results obtained and clinical validation. Results: T2 and T1ρ sequences are highly sensitive to disturbances in the collagen network and proteoglycan content, while dGEMRIC remains the reference method for the evaluation of glycosaminoglycans, despite the need for contrast. UTE and MMF provide additional insight into the surface and calcified zones of the cartilage, while 3D DESS enables high morphological resolution within a short time. The combination of multiple sequences shows the best diagnostic value. Most studies confirm that quantitative MRI mapping allows the detection of OA in the preclinical phase. Conclusion: MRI mapping techniques are an extremely promising tool for early diagnosis of knee OA, with the potential to replace conventional methods in clinical practice. Additional prospective research on larger samples, as well as standardization of protocols, is needed to enable wider application of these methods.

Introduction: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, with significant mortality and limited therapeutic options in advanced stages of the disease. In patients who are not candidates for resection or ablative procedures, transarterial chemoembolization (TACE) has established itself as standard therapy. Case report: We show a male patient, 69 years of age, diagnosed with an extensive right hepatic lobe tumor based on the CTA of the abdomen, unsuitable for surgical resection and thermal ablation. The TACE procedure using doxorubicin and embolization material was successfully performed in the catheterization laboratory (cath lab) of the Clinic of Radiology of KCUS, after which the control CTA showed a complete therapeutic response according to mRECIST criteria. Discussion: The case presented confirms that TACE is an effective treatment modality in patients with intermediate HCC, even in those with large tumor lesions. A multidisciplinary approach, adequate patient selection and precise intervention technique are key success factors. This case further emphasizes the need to integrate the TACE procedure with modern systemic therapies, including immunotherapy and targeted drugs. Conclusion: The TACE method has significant therapeutic potential in the treatment of HCC, and achieving a complete response in this case highlights the importance of an individualized approach and further research aimed at optimizing the procedure.

OBJECTIVE The optimal management of patients with asymptomatic (AsxCS) and symptomatic (SxCS) carotid stenosis is controversial and includes intensive medical management (i.e., best medical therapy [BMT]) with/without an additional carotid revascularization procedure (i.e., carotid endarterectomy [CEA], transfemoral carotid artery stenting [TFCAS] or TransCarotid Artery Revascularization [TCAR]). The aim of this international, expert-based, multispecialty Delphi Consensus document was to reconcile the conflicting views regarding the optimal management of AsxCS and SxCS patients. METHODS A three-round Delphi Consensus process was performed including 63 experts from Europe (n=37) and the United States (n=26). A total of 6 different clinical scenarios were identified involving patients with either AsxCS or SxCS. For each scenario, 5 treatment options were available: (i) BMT alone, (ii) BMT plus CEA, (iii) BMT plus TFCAS, (iv) BMT plus TCAR, or (v) BMT plus CEA/TFCAS/TCAR. Differences in treatment preferences between U.S. and European participants were assessed using Fisher's Exact Test, and odds ratios were used to quantify the magnitude and direction of association. Consensus was achieved when >70% of the Delphi Consensus participants agreed on a therapeutic approach. RESULTS Most participants concurred that BMT alone is not adequate for the management of a 70-year-old fit male or female patient with 80-99% AsxCS (52/63; 82.5% and 45/63; 71.5%, respectively). In contrast, most panelists would opt for BMT alone for an 80-year-old male AsxCS patient with several co-morbidities (48/63; 76.2%). The majority of participants would opt for BMT plus a carotid revascularization procedure for an 80-year-old male SxCS patient with a recent ipsilateral cerebrovascular event, an ipsilateral 70-99% SxCS and a 5-year predicted risk of ipsilateral ischemic event of 10% (54/63; 85.7%), 15% (59/63; 93.6%), or 20% (63/63; 100%). The opinion of U.S.-based participants varied from that of Europe-based respondents in some scenarios. CONCLUSIONS The panel agreed that BMT alone is insufficient for most patients with SxCS, and that select subgroups of AsxCS patients may also benefit from revascularization, especially when high-risk features are present. Patients should be stratified according to their predicted stroke risk, as well as their individual clinical/anatomical/imaging features and should be treated accordingly.

Background: The optimal management of patients with asymptomatic (AsxCS) and symptomatic (SxCS) carotid stenosis is controversial and includes intensive medical management (i.e., best medical therapy [BMT]) with/without an additional carotid revascularization procedure (i.e., carotid endarterectomy [CEA], transfemoral carotid artery stenting [TFCAS] or TransCarotid Artery Revascularization [TCAR]). The aim of this international, expert-based, multispecialty Delphi Consensus document was to reconcile the conflicting views regarding the optimal management of AsxCS and SxCS patients. Methods: A three-round Delphi Consensus process was performed including 63 experts from Europe (n=37) and the United States (n=26). A total of 6 different clinical scenarios were identified involving patients with either AsxCS or SxCS. For each scenario, 5 treatment options were available: (i) BMT alone, (ii) BMT plus CEA, (iii) BMT plus TFCAS, (iv) BMT plus TCAR, or (v) BMT plus CEA/TFCAS/TCAR. Consensus was achieved when >70% of the Delphi Consensus participants agreed on a therapeutic approach. Results: Most participants concurred that BMT alone is not adequate for the management of a 70-year-old fit male or female patient with 80-99% AsxCS (52/63; 82.5% and 45/63; 71.5%, respectively). In contrast, most panelists would opt for BMT alone for an 80-year-old male AsxCS patient with several co-morbidities (48/63; 76.2%). The majority of participants would opt for BMT plus a carotid revascularization procedure for an 80-year-old male SxCS patient with a recent ipsilateral cerebrovascular event, an ipsilateral 70-99% SxCS and a 5-year predicted risk of ipsilateral ischemic event of 10% (54/63; 85.7%), 15% (59/63; 93.6%), or 20% (63/63; 100%). The opinion of U.S.-based participants varied from that of Europe-based respondents in some scenarios. Conclusions: The present Delphi Consensus document showed that a "one-size-fits-all" approach is not appropriate for patients with either AsxCS or SxCS. Patients should be stratified according to their future stroke risk and should be treated accordingly.

The Radiological Society of North America (RSNA) Lumbar Degenerative Imaging Spine Classification (LumbarDISC) dataset is the largest publicly available dataset of adult MRI lumbar spine examinations annotated for degenerative changes. The dataset includes 2,697 patients with a total of 8,593 image series from 8 institutions across 6 countries and 5 continents. The dataset is available for free for non-commercial use via Kaggle and RSNA Medical Imaging Resource of AI (MIRA). The dataset was created for the RSNA 2024 Lumbar Spine Degenerative Classification competition where competitors developed deep learning models to grade degenerative changes in the lumbar spine. The degree of spinal canal, subarticular recess, and neural foraminal stenosis was graded at each intervertebral disc level in the lumbar spine. The images were annotated by expert volunteer neuroradiologists and musculoskeletal radiologists from the RSNA, American Society of Neuroradiology, and the American Society of Spine Radiology. This dataset aims to facilitate research and development in machine learning and lumbar spine imaging to lead to improved patient care and clinical efficiency.