Updates and Future Perspectives on Vessel Wall Imaging of Intracranial Aneurysms Detection, Prediction, and Classification

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Background

Located at the Cross-roads of medical Physics, diagnostic radiology, and neurological surgery, Evaluation of intracranial aneurysm walls with vessel wall imaging (VWI) has been a hot topic in diagnostic/interventional radiology the past several years. High resolution techniques of Intracranial vessel wall imaging are relatively new, increasing in use/publication, and have great promise to have a transformational effect on characterization of arterial pathology and patient care. In brief, it would be useful to identify additional biomarkers of instability of intracranial aneurysms to help guide management.

Although there is an increasing number of publications addressing this topic, VWI utility remains unproven. The potential advantages should be recognized, but also the need for further study and the challenges in this endeavor.
Therefore, the goal of this Research Topic is to detail, summarize, and analyze the scope, strengths, and limitations of VWI (such as difficulty with long-term prospective studies to date) of the current state of knowledge.
Furthermore, Topic Editors want to provide a critical appraisal of the current status by a multidisciplinary field of experts with perspectives/commentary, including commentary from interventional radiologists, neurosurgeons or vascular neurologists, physicists, and scientists (such as those who work with vessel flow models, animal models, etc).

As such, Topic Editors sought contributions from neurointerventional radiologists/neurosurgeons, neuroradiologists, physicists, and scientists experts alike. Original Research, Reviews, and case series about, but not limited to the following topics will be welcomed:
• Aneurysm morphology;
• Histologic correlations (e.g. clipped aneurysm, animals models);
• Clinical features/prediction score;
• The ability of vessel wall imaging to predict aneurysm stability, in particular evidence with longitudinal data and data that shows how enhancement can predict rupture or be used to decrease likelihood of future rupture;
• Methods to identify a ruptured aneurysm in the setting of uncertainty of subarachnoid hemorrhage origin (e.g., multiple aneurysms, blood blister aneurysms, etc.);
• Categories beyond saccular aneurysm (including case series of novel or under-reported categories);
• Methods of evaluation beyond contrast enhancement (such as different contrast weightings (e.g. QSM);
• Experience with accelerated or high-field strength techniques;
• New angles (e.g. correlation of VWI findings to state-of-the art techniques to assess near-wall blood flow shear stress);
• Discussions and exemples on current challenges using animal models of intracranial aneurysms for studying VWI (both technical and biological);
• Flow/flow dynamics relationships with aneurysms stability;
• An updated meta-analysis.

Keywords: aneurysm morphology, histology, evaluation methods, vessel walls imaging, VWI, aneurysms stability, subarachnoid hemorrhage origin

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Topic editors

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