Background: Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI). Aim of the work: To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care. Material and methods: Review based on an unsystematic literature search. Results: Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS. Discussion: Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.

The present work shows an application of the Chan-Vese algorithm for the semi-automatic segmentation of anatomical structures of interest (lungs and lung tumor) in 4DCT images of the thorax, as well as their three-dimensional reconstruction. The segmentation and reconstruction were performed on 10 CT images, which make up an inspiration-expiration cycle. The maximum displacement was calculated for the case of the lung tumor using the reconstructions of the onset of inspiration, the onset of expiration, and the voxel information. The proposed method achieves appropriate segmentation of the studied structures regardless of their size and shape. The three-dimensional reconstruction allows us to visualize the dynamics of the structures of interest throughout the respiratory cycle. In the future, it is expected to have more evidence of the good performance of the proposed method and to have the feedback of the clinical expert, since the knowledge of the characteristics of anatomical structures, such as their dimension and spatial position, helps in the planning of Radiotherapy (RT) treatments, optimizing the radiation dose to cancer cells and minimizing it in healthy organs. Therefore, the information found in this work may be of interest for the planning of RT treatments.

Acute abdomen is a frequent clinical picture in emergency diagnostics. Pathologic changes of the female genital organs play an important role. Gynecologic emergencies threaten fertility and are potentially life-threatening. Many differential diagnoses must be considered in the diagnostic process, depending on the age of the patient and any pregnancy. In particular, acute gastrointestinal symptoms often cannot be differentiated from gynecologic emergencies on clinical examination. Here, imaging makes a significant contribution to narrowing the differential diagnosis, making treatment decisions, and monitoring therapy. This review article will discuss the central role of imaging in the context of common gynecologic emergencies.

The temporomandibular joint (TMJ) is considered a bicondylar diarthrosis type joint. Imaging evaluation is a fundamental part of its assessment, which should include both bony and soft tissue characteristics and the relationship between them. Magnetic resonance imaging (MRI) represents the gold standard for the study of soft tissues; however, up to now, its main application continues to be the visualization of the articular disc. For this reason, the present article aimed to point out the information available in the literature regarding the visualization of the joint capsule in MRI and to evaluate it as an independent structure.

Colorectal cancer is the fourth leading cause of death worldwide and the fifth leading cause of cancer death in Colombia. Magnetic resonance imaging is the ideal modality for the evaluation of colorectal cancer, since it allows staging by determining invasion beyond the muscularis propria, extension towards adjacent organs, identification of patients who are candidates for chemotherapy or pre-surgical radiotherapy and planning of the surgical procedure. The key point is based on the differentiation between T2 and T3 stages through the use of sequences with high-resolution T2 information. In addition to this, it allows the assessment of the size and morphology of the lymph nodes, and considerably increases the specificity for the detection of lymph node involvement. MRI is a technique with high specificity and high reproducibility.

Gout is an arthritis characterized by the deposition of sodium monoacid crystals in the synovial membrane, articular cartilage, and periarticular tissues that leads to an inflamatory process. In most cases, the diagnosis is established by clinical criteria and analysis of the synovial fluid for MSU crystals. However, gout may manifest in atypical ways and make diagnosis difficult. In these situations, imaging studies play a fundamental role in helping to confirm the diagnosis or even exclude other differential diagnoses. Conventional radiography is still the most commonly used method in the follow-up of these patients, but it is a very insensitive test, because it only detects late changes. In recent years, advances in imaging methods have emerged in relation to gout. Ultrasound has proven to be a highly accurate test in the diagnosis of gout, identifying MSU deposits in articular cartilage and periarticular tissues, and detecting and characterizing tophi, tendinopathies, and tophi enthesopathies. Computed tomography is an excellent exam for the detection of bone erosions and evaluation of spinal involvement. Dual-energy computed tomography, a new method that provides information on the chemical composition of tissues, allows identification of MSU deposits with high accuracy. MRI can be useful in the evaluation of deep tissues not accessible by ultrasound. In addition to diagnosis, with the emergence of drugs that aim to reduce the tophaceous burden, imaging examinations become a useful tool in the follow-up treatment of gout patients.