AJNR Podcasts

Episodi

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  Follow-Up or Forget It? Managing Indeterminate T1-Hypointense Spine Lesions 18.08.2026 10min

  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.
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  Traumatic Hemorrhage Expansion feat. Caline Azzi 12.08.2026 15min

  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    
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  Seeing It First: How Recognizing Sinking Flap Syndrome Can Change Patient Outcomes 02.07.2026 11min

  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.
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  CTA Carotid Plaque-RADS 28.05.2026 17min

  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
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  Optimizing CSF-Venous Fistula Detection 14.04.2026 9min

  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.
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  Traumatic SAH Risk Stratification 31.03.2026 8min

  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.
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  Poststroke Collaterals on MRI feat. Cynthia Greene 25.03.2026 14min

  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.
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  CTA for Strangulation feat. Jimmy Moon 03.03.2026 10min

  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.
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  Menière Disease Associated Vestibular Aqueduct Hypoplasia feat. Amy Juliano 19.02.2026 29min

  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".
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  Post-Radiation Carotid Disease 04.02.2026 10min

  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.
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  CT Perfusion Timing feat. Amir Khadivi 27.01.2026 16min

  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.
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  Vertebral Artery Injury Grading 07.01.2026 11min

  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.
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  AI intracranial aneurysm detection feat. Babatunde Akinpelu 19.12.2025 23min

  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.
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  Sudden Sensorineural Hearing Loss 25.11.2025 10min

  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
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  SIH-RADS: Structured Reporting for CSF Leaks in Dynamic CT Myelography 07.11.2025 12min

  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.
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  Sinus CT in Neutropenic Fever feat. Rohini Nadgir 31.10.2025 17min

  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.
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  Ultrasound for Neck NI-RADS 2 Evaluation 14.10.2025 10min

  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.
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  Specificity of spontaneous intracranial hypotension MRI scoring feat. Ajay Madhavan 01.10.2025 16min

  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.    
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  PET in Alzheimer Disease feat. Ana Franceschi 26.08.2025 32min

  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.
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  August 2025 Article Summary 15.08.2025 8min

  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)