{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:05:13Z","timestamp":1783699513952,"version":"3.55.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuroradiology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current diagnostic approaches of leptomeningeal disease (LMD) rely heavily on cerebrospinal fluid (CSF) cytology, which shows significant limitations and the requirement for invasive procedures. We aim to develop an MRI-based grading scores for LMD diagnosis and prognosis that address current diagnostic limitations and provide standardized, reproducible assessment criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 32 adult cancer patients evaluated for suspected LMD. Two experienced neuroradiologists independently assessed MRI studies using our novel grading system, which incorporates leptomeningeal enhancement\/intensity patterns (grades 1\u20136), Evans index for hydrocephalus assessment, brain metastases characteristics, and spinal involvement. Confirmation of LMD cases was employed using dual confirmation approach combining CSF cytology and follow-up MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our MRI grading system demonstrated promising inter-observer performance. Inter-rater reliability between two attending level neuroradiologists was excellent (ICC\u2009=\u20090.953, P-value\u2009&lt;\u20090.001) using a cutoff score of 2 or higher, the system demonstrated comparable performance. Risk stratification analysis revealed clear prognostic value, with mortality rates of 8.6% for low-risk patients (Grade 1\u20132), 50% for medium-risk patients (Grade 3\u20134), and 80.0% for high-risk patients (Grade 5\u2009+). The Kaplan\u2013Meier survival curves demonstrate a statistically significant difference in overall survival between patients with varying grades (p-value of 0.00011). Notably, survival probability drops steeply in the Grade 5\u2009+\u2009group early on, suggesting that higher LMD burden is associated with rapid clinical deterioration. In contrast, low risk patients appear to have a more indolent course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our preliminary findings detail a promising approach in evaluating LMD patients which offers valuable prognostic information for clinical decision making. Furthermore, the high inter-rater reliability across various tumor types further encourages the potential utility of this approach, although further research on a broader population is needed before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-026-03904-1","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T02:58:24Z","timestamp":1769396304000},"page":"1651-1660","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preliminary assessment of an MRI-based grading system for leptomeningeal disease: an exploratory prognostic framework"],"prefix":"10.1007","volume":"68","author":[{"given":"Ahmed","family":"Msherghi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Glue-Monroe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"W Eldaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Pirhoushiaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba","family":"Al Qudah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceylan Altintas","family":"Taslicay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Alizada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza A.","family":"Salim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leomar","family":"Y. 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