Updates in Neuroradiology and Cutting Edge Imaging Techniques

Lama Abdel-Wahed, MD

Tracey A. Cho, MD, FAAN

Neuroimaging has transformed from a diagnostic tool into a cornerstone of precision medicine in neurology. Today's advanced imaging techniques not only enable visualization of anatomy and function to aid in accurate diagnosis, but also guide targeted therapies, monitor disease progression, and assess therapeutic response. In the near future, artificial intelligence and machine learning programs promise to further revolutionize how we interpret and utilize neuroimaging data in clinical practice. Despite these remarkable advances, significant barriers remain. Neuroimaging alone rarely provides definitive diagnosis, and neurologists must use clinical judgment both to decide when to obtain neuroimaging and to interpret the results in context. Furthermore, access to cutting-edge imaging technologies is often limited beyond major research centers, and insurance coverage for advanced techniques remains inconsistent across the United States. These challenges underscore the importance of providing practical, evidence-based guidance to help clinicians maximize the utility of available imaging resources. The next two issues will focus on the latest updates most relevant for practicing clinicians across the spectrum of neurological subspecialties.

In this issue, Part 1, we begin with a comprehensive approach to spinal cord imaging from Spencer Hutto, emphasizing how morphological characteristics, enhancement patterns, and longitudinal length help distinguish between autoimmune, infectious, neoplastic, and vascular pathologies. Prashanth Rajarajan, Carson Quinn, and Kathryn Holroyd detail the neuroimaging of central nervous system infections, focusing on pathogen-specific imaging patterns that aid in clinical diagnosis.

We then turn to cerebrovascular imaging, where Hamid Ali, Ahmad Abu Qdais, Arindam Chatterjee, Mohamad Abdalkader, Eytan Raz, Thanh Nguyen, and Sami Al Kasab explore how innovations like artificial intelligence-driven stroke detection and high-resolution vessel wall imaging are revolutionizing acute stroke care and vascular diagnostics. Bart Chwalisz offers a systematic clinicoradiologic approach to skull base and cranial nerve disorders, providing practical diagnostic pearls for these complex anatomical regions.

Finally, Tyler Schmidt and Lama Abdel Wahed examine recent advances in multiple sclerosis imaging, highlighting biomarkers such as the central vein sign and paramagnetic rimlesions that aim to improve diagnostic specificity and reduce misdiagnosis.

This comprehensive collection is designed for trainees, general neurologists, neuroradiologists, and neurology subspecialists seeking practical, up-to-date guidance on contemporary neuroimaging applications. We are deeply grateful to our authors from multiple disciplines who dedicated their time and expertise to creating these comprehensive reviews and thoughtfully addressed our editorial suggestions throughout the revision process. The next issue, Part 2 of our Updates in Neuroradiology, will cover traumatic brain and spinal cord injury, epilepsy, movement disorders, neuro-oncology, neuromuscular disorders and functional neuroimaging.

We hope readers will find these articles informative and useful for their clinical practice. As neuroimaging continues to evolve, our goal is to bridge the gap between technological advancement and clinical application, ensuring that these powerful tools translate into better patient outcomes.

Publication History

Article published online:
27 October 2025