{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:57:04Z","timestamp":1772999824600,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Chimeric antigen receptor\u2013engineered T\u2010cell (CAR\u2010T) therapy in hematological malignancies may be associated with severe complications, as Cytokine Release Syndrome (CRS) and Immune effector Cell\u2010Associated Neurotoxicity Syndrome (ICANS). The aim of the study is to investigate MRI\u2010derived macrostructural and microstructural features potentially able to identify patients at higher ICANS risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty\u2010two patients treated with CAR\u2010T from October 2020 to June 2025 performed brain MRIs before CAR\u2010T administration, including diffusion\u2010weighted imaging. A general linear model was used to compare patients who developed ICANS, CRS, or neither at baseline in terms of MRI macro\u2010 and microstructural features. A binary logistic regression analysis was performed to evaluate the role of microstructural features in predicting the risk of developing ICANS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age 59.2\u00a0\u00b1\u00a013 years, 59.5% male; 21 (50%) patients received tisagenlecleucel, 21 (50%), axicabtagene ciloleucel or brexucabtagene autoleucel; 14 (33%) and 31 (73.8%) patients developed ICANS and CRS, respectively. At baseline MRI, fluid\u2010attenuated inversion recovery (FLAIR) white matter (WM) hyperintensities were detected in 41\/42 (97.6%). No significant differences between patients who developed ICANS, CRS and neither both were observed in terms of FLAIR hyperintensities nor total brain volume at baseline. Fractional anisotropy extracted from FLAIR hyperintensities and WM areas without macroscopic abnormalities was a predictor of ICANS in the logistic regression model (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03 and 0.02, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FLAIR hyperintensities and brain volume prior to CAR\u2010T were not informative, whereas the severity of WM microstructural (axonal) damage predicted ICANS risk. Greater axonal damage was associated with a higher likelihood of ICANS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70115","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T06:58:45Z","timestamp":1768633125000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Brain Microstructural Damage as Potential Biomarker of Immune Cell\u2010Associated Neurotoxicity Syndrome"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-6520","authenticated-orcid":false,"given":"Caterina","family":"Lapucci","sequence":"first","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimiliano","family":"Gambella","sequence":"additional","affiliation":[{"name":"UO Ematologia e Terapie Cellulari IRCCS Ospedale Policlinico San Martino  Genoa 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Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Centanaro","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Unit IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Capello","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Schenone","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucio","family":"Castellan","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino  Genoa 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