Management of Intracranial Incidental Findings on Brain MRI

Langner, Sönke; Buelow, R; Fleck, Steffen; Angermaier, Anselm; Kirsch, Michael

doi:10.1055/s-0042-111075

Cited by 17 publications

(9 citation statements)

References 46 publications

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“…A false positive resulted in gold standard testing. Incidental findings from MRI could result in additional imaging and physician visits 12 . The most common incidental finding requiring additional intervention was a brain aneurysm, which was modeled according to treatment with clipping or endovascular repair 13 .…”

Section: Methodsmentioning

confidence: 99%

“…Incidental findings from MRI could result in additional imaging and physician visits. 12 The most common incidental finding requiring additional intervention was a brain aneurysm, which was modeled according to treatment with clipping or endovascular repair. 13 Incidental findings from nasopharyngoscopy were assumed to be negligible.…”

Section: Model Characteristicsmentioning

confidence: 99%

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Cost‐effectiveness of Screening for Nasopharyngeal Carcinoma among Asian American Men in the United States

Harris

Saraswathula

Kaplun

et al. 2019

Otolaryngol.--head neck surg.

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Objective Most patients with nasopharyngeal carcinoma (NPC) in the United States are diagnosed with stage III-IV disease. Screening for NPC in endemic areas results in earlier detection and improved outcomes. We examined the cost-effectiveness of screening for NPC with plasma Epstein-Barr virus DNA among Asian American men in the United States. Study Design We used a Markov cohort model to estimate discounted life-years, quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios for screening as compared with usual care without screening. Setting The base case analysis considered onetime screening for 50-year-old Asian American men. Subjects and Methods Confirmatory testing was magnetic resonance imaging and nasopharyngoscopy. Cancer-specific outcomes, health utility values, and costs were determined from cancer registries and the published literature. Results For Asian American men, usual care without screening resulted in the detection of NPC at stages I, II, III-IVB, and IVC among 6%, 29%, 54%, and 11% of those with cancer, respectively, whereas screening resulted in earlier detection with a stage distribution of 43%, 24%, 32%, and 1%. This corresponded to an additional 0.00055 QALYs gained at a cost of $63 per person: an incremental cost of $113,341 per QALY gained. In probabilistic sensitivity analysis, screening Asian American men was cost-effective at $100,000 per QALY gained in 35% of samples. Conclusion Although screening for NPC with plasma Epstein-Barr virus DNA for 50-year-old Asian American men may result in earlier detection, in this study it was unlikely to be cost-effective. Screening may be reasonable for certain subpopulations at higher risk for NPC, but clinical studies are necessary before implementation.

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Section: Methodsmentioning

confidence: 99%

Section: Model Characteristicsmentioning

confidence: 99%

Cost‐effectiveness of Screening for Nasopharyngeal Carcinoma among Asian American Men in the United States

Harris

Saraswathula

Kaplun

et al. 2019

Otolaryngol.--head neck surg.

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“…In traffic hydrocephalus formed by aSAH, in the case of the slow development of hydrocephalus after hemorrhage, cerebral CT usually cannot detect blood residue. However, changes after hemorrhage can be detected on T2*w MRI scans for a much longer time [108].…”

Section: Imaging Examinationmentioning

confidence: 99%

Hydrocephalus after aneurysmal subarachnoid hemorrhage: Epidemiology, Pathogenesis, Diagnosis, and Management

2021

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Hydrocephalus is one of the most common complications of aneurysmal subarachnoid hemorrhage (aSAH), which seriously affects the quality of life and shortens the survival time of affected patients. By reviewing the recent studies on the risk factors of aSAH-associated hydrocephalus, we aimed to explicitly present the pathogenesis of acute and chronic hydrocephalus after aSAH and make a comprehensive list of the associated risk factors of aSAH-associated hydrocephalus and shunt-dependent hydrocephalus. It would help us to better explain the occurrence of hydrocephalus after aSAH, especially hydrocephalus caused by inflammation after bleeding. Many studies have recently suggested that high mobility group box 1 may be an early upstream promoter of inflammatory response after aSAH, which also provides important ideas for us to look for potential drug treatments. The surgery, such as external ventricular drain and lumbar drainage, is the most common and effective treatment. Yet, there are often complications, such as rebleeding and intracranial infection, and the optimal timing of intervention is controversial. Besides, this is also a systematic review of the recent advances in epidemiology, pathogenesis, diagnosis, and management of aSAH-associated hydrocephalus.

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“…Even if colloid cysts are histologically benign lesions, there is a risk of acute life-threatening hydrocephalus, e. g. due to an increase in the size of the cyst [23]. Therefore, neurosurgical examination should be performed [24]. Obstruction of the foramen of Monro can also be caused by primary brain tumors, inflammatory changes, and the formation of septa (▶ Fig.…”

Section: Foramen Of Monromentioning

confidence: 99%

Diagnosis and Differential Diagnosis of Hydrocephalus in Adults

Langner

Fleck

Baldauf

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TPurpose Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment.Methods This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Results and Conclusion

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Management of Intracranial Incidental Findings on Brain MRI

Cited by 17 publications

References 46 publications

Cost‐effectiveness of Screening for Nasopharyngeal Carcinoma among Asian American Men in the United States

Cost‐effectiveness of Screening for Nasopharyngeal Carcinoma among Asian American Men in the United States

Hydrocephalus after aneurysmal subarachnoid hemorrhage: Epidemiology, Pathogenesis, Diagnosis, and Management

Diagnosis and Differential Diagnosis of Hydrocephalus in Adults

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