New insights into the evaluation of peripheral nerves lesions: a survival guide for beginners.

Abstract

To perform a review of the physical basis of DTI and DCE-MRI applied to Peripheral Nerves (PNs) evaluation withthe aim of providing readers the main concepts and tools to acquire these types of sequences for PNs assessment.The potential added value of these advanced techniques for pre-and post-surgical PN assessment is also reviewedin diverse clinical scenarios. Finally, a brief introduction to the promising applications of Artificial Intelligence (AI) forPNs evaluation is presented. We review the existing literature and analyze the latest evidence regarding DTI, DCE-MRI and AI for PNsassessment. This review is focused on a practical approach to these advanced sequences providing tips and tricksfor implementing them into real clinical practice focused on imaging postprocessing and their current clinicalapplicability. A summary of the potential applications of AI algorithms for PNs assessment is also included. DTI, successfully used in central nervous system, can also be applied for PNs assessment. DCE-MRI can helpevaluate PN's vascularization and integrity of Blood Nerve Barrier beyond the conventional gadolinium-enhancedMRI sequences approach. Both approaches have been tested for PN assessment including pre- and post-surgicalevaluation of PNs and tumoral conditions. AI algorithms may help radiologists for PN detection, segmentation andcharacterization with promising initial results. DTI, DCE-MRI are feasible tools for the assessment of PN lesions. This manuscript emphasizes the technicaladjustments necessary to acquire and post-process these images. AI algorithms can also be considered as analternative and promising choice for PN evaluation with promising results.