Laser Speckle Contrast Imaging (LSCI) is a minimally invasive full field optical technique used to generate blood flow maps with high spatial and temporal resolution. The lack of quantitative accuracy and the inability to predict flows in the presence of static scatterers such as an intact or thinned skull have been the primary limitation of LSCI. We present a new Multi-Exposure Speckle Imaging (MESI) instrument that has potential to obtain quantitative baseline flow measures. We show that the MESI instrument extends the range over which relative flow measurements are linear. We also present a new speckle model which can discriminate flows in the presence of static scatters. We show that in the presence of static scatterers the new model used along with the new MESI instrument can predict correlation times of flow consistently to within 10% of the value without static scatterers compared to an average deviation of more than 100% from the value without static scatterers using traditional LSCI. We also show that the new speckle model used with the MESI instrument can maintain the linearity of relative flow measurements in the presence of static scatterers.

Though laser speckle contrast imaging enables the measurement of scattering particle dynamics with high temporal resolution, the subsequent processing has previously been much slower. In prior studies, generating a laser speckle contrast image required about 1 s to process a raw image potentially collected in 10 ms or less. In this paper, novel algorithms are described which are demonstrated to convert 291 raw images per second to laser speckle contrast images and as many as 410 laser speckle contrast images per second to relative correlation time images. As long as image processing occurs during image acquisition, these algorithms render processing time irrelevant in most circumstances and enable real-time imaging of blood flow dynamics.

We sought to report a central T2 hypointensity within the optic nerve on 3 T MRI studies obtained as part of the NASA Flight Medicine Visual Impairment Intracranial Pressure Protocol that had not been described previously. Twenty-one astronauts, who had undergone MRI of both orbits with direct coronal T2 sequences between 2010 and 2012, were retrospectively included. Two of the astronauts did not have previous exposure to microgravity at the time of their scans. A central T2 hypointensity was observed in 100% of both right and left eyes. It was completely visualized throughout the nerve course in 15 right eyes (71.4%) and in 19 left eyes (90.5%).We describe a new finding seen in all study participants: a central T2 hypointensity in the epicenter of the optic nerve. We speculate that this T2 hypointensity may represent flow voids caused by the central retinal vessels.

Inflammatory pseudotumors imitate neoplasms on imaging but actually represent focal inflammation. We report a case of follicular pancreatitis, which is a recently recognized distinct form of mass-forming focal chronic pancreatitis pathologically characterized by lymphoid infiltration with abundant reactive germinal centers. In our patient, follicular pancreatitis manifested as a pancreatic tail mass that was resected due to imaging findings, which were suggestive of pancreatic malignancy. We performed a literature review of this rare condition and present a summary of reported imaging findings. The most distinguishing feature from pancreatic adenocarcinoma is the enhancement pattern, as follicular pancreatitis enhances more than the surrounding pancreatic parenchyma on delayed post-contrast images which is unusual for pancreatic adenocarcinoma. If this benign diagnosis is suggested on imaging, unnecessary surgery and its potential complications may be avoided.

Immunotherapy is increasingly used in the treatment of glioblastoma (GBM), with immune checkpoint therapy gaining in popularity given favorable outcomes achieved for other tumors. However, immune-mediated (IM)-pseudoprogression is common, remains poorly characterized, and renders conventional imaging of little utility when evaluating for treatment response. We present the case of a 64-year-old man with GBM who developed pathologically proven IM-pseudoprogression after initiation of a checkpoint inhibitor, and who subsequently developed true tumor progression at a distant location. Based on both qualitative and quantitative analysis, we demonstrate that an advanced diffusion-weighted imaging (DWI) technique called restriction spectrum imaging (RSI) can differentiate IM-pseudoprogression from true progression even when conventional imaging, including standard DWI/apparent diffusion coefficient (ADC), is not informative. These data complement existing literature supporting the ability of RSI to estimate tumor cellularity, which may help to resolve complex diagnostic challenges such as the identification of IM-pseudoprogression.