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Aydogdu M, Adisen MZ, Ertas G. The effect of imaging programs and segmentation methods on the accuracy of volume measurements of teeth. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:794-802. [PMID: 39395890 DOI: 10.1016/j.oooo.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/20/2024] [Accepted: 07/07/2024] [Indexed: 10/14/2024]
Abstract
OBJECTIVE This study investigated whether there are differences between software programs, voxel sizes, segmentation techniques, and intraoral scanners in terms of volume measurement in incisor teeth. STUDY DESIGN Thirty extracted teeth were scanned using a 3D intraoral scanner. Physical volumes were measured using the water displacement method (WDM) as the gold standard. Cone beam computed tomography images were taken at two voxel sizes (0.3-0.4 mm voxel). The volumes of the teeth were calculated using the manual segmentation technique in the 3D Doctor and ImageJ (Fiji) Program, manual and automatic segmentation methods in the ITK-Snap program, and automatic segmentation methods in the 3D Slicer program. The data were analyzed using the Statistical Package for Social Sciences (SPSS, v 20.0). RESULTS There is a significant difference between WDM and 3D Doctor volume measurements at the voxel size of 0.4 mm (P < .05). The 3D Doctor program showed more than 13% difference compared to the WDM. There is no significant difference between WDM, intraoral scanner, ITK-Snap, ImageJ (Fiji), 3D Slicer, and 3D-Doctor volume measurements at the voxel size of 0.3 mm. CONCLUSIONS Measurements with manual segmentation in ITK-Snap and ImageJ programs give the closest results to the physical volume measurements of the teeth. The automatic segmentation method in ITK-Snap and 3D Slicer programs may be preferred due to its ease of use and less time-consuming. In the 3D Doctor software, volume measurements tend to increase with larger voxel size.
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Affiliation(s)
- Merve Aydogdu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
| | - Mehmet Zahit Adisen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
| | - Gülsah Ertas
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
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Konca C, Elhan AH. Unveiling the Accuracy of Ultrasonographic Assessment of Thyroid Volume: A Comparative Analysis of Ultrasonographic Measurements and Specimen Volumes. J Clin Med 2023; 12:6619. [PMID: 37892758 PMCID: PMC10607290 DOI: 10.3390/jcm12206619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
In endocrine surgery, a precise ultrasonographic measurement of thyroid volume is crucial. However, there is limited comparative research between ultrasonographic and specimen volumes, which has left this issue open to debate. This study aims to assess the accuracy of recommended formulas for ultrasonographic thyroid volume measurement by comparing them to specimen volumes and analyzing the influencing variables. From the data of 120 eligible patients, different formulas, including ultrasonographic thyroid volume (US-TV) based on the ellipsoid formula, lower correction factor thyroid volume (LCF-TV), and calculated ultrasonographic (derived formula) thyroid volume (CU-TV), were used to estimate the thyroid volume based on measurements taken prior to surgery. These measurements were compared with the intraoperative specimen volume (IO-TV) derived using Archimedes' principle. According to our findings, the mean values for US-TV and LCF-TV were significantly lower, whereas CU-TV was higher than IO-TV. Deviations were more significant in patients who had surgery for benign indications or compressive symptoms and in those with suppressed thyroid-stimulating hormone levels. Although the ellipsoid formula tends to underestimate the actual thyroid volume, it remains the most accurate method for measuring ultrasonographic thyroid volume. The deviation is greater for larger volumes.
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Affiliation(s)
- Can Konca
- Department of General Surgery, Ankara University School of Medicine, 06230 Ankara, Turkey
| | - Atilla Halil Elhan
- Department of Biostatistics, Ankara University School of Medicine, 06230 Ankara, Turkey;
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Wang F, Nie H, Li W, Zhang R, Li W. The clinical significance of remnant thyroid tissue in thyroidectomized differentiated thyroid cancer patients on 131I-SPECT/CT. BMC Med Imaging 2021; 21:78. [PMID: 33964885 PMCID: PMC8105984 DOI: 10.1186/s12880-021-00612-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To explore the 131I-SPECT/CT characteristics of remnant thyroid tissue (RTT) in differentiated thyroid cancer (DTC), further assess the risk factors and clinical significance. METHODS 52 DTC patients after total thyroidectomy had undergone neck 131I-SPECT/CT before 131I ablation. The diagnosis of RTT was based on SPECT/CT and follow-up at least 3 months. The anatomic locations and features of SPECT/CT of RTT were assessed by reviewers. The risk factors of RTT with CT positive were analyzed by the chi-square test. RESULTS A total of 80 lesions of RTT were diagnosed in this study, most of them were mainly located in the regions adjacent to trachea cartilage (37/80) or lamina of thyroid cartilage (17/80). On SPECT/CT of RTT, low, moderate and high uptake were respectively noted in 10, 24 and 46 lesions, definite positive, suspected positive and negative CT findings were respectively noted in 10, 21 and 49. The RTT lesions with definite positive CT findings were mainly located adjacent to lamina of thyroid cartilage (5/10). Primary thyroid tumor (P = 0.029) and T stage (P = 0.000) were the effective risk factors of CT positive RTT. CONCLUSIONS RTT has certain characteristic distribution and appearances on SPECT/CT. Most of RTT with definite CT abnormalities located adjacent to lamina of thyroid cartilage, which suggest surgeons should strengthen the careful removal in this region, especially primary thyroid tumor involving bilateral and T4 stage. This study can provide a certain value for the improvement of thyroidectomy quality in DTC patients.
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Affiliation(s)
- Feng Wang
- Department of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, Guangdong Province, China
| | - Hui Nie
- Department of Health Care, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, Guangdong Province, China
| | - Wei Li
- Department of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, Guangdong Province, China.
| | - Rusen Zhang
- Department of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, Guangdong Province, China
| | - Wen Li
- Department of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, Guangdong Province, China
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Fujita N, Kato K, Abe S, Naganawa S. Variation in thyroid volumes due to differences in the measured length or area of the cross-sectional plane: A validation study of the ellipsoid approximation method using CT images. J Appl Clin Med Phys 2021; 22:15-25. [PMID: 33779118 PMCID: PMC8035568 DOI: 10.1002/acm2.13125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study examined the variation in the thyroid volume determined by the ellipsoid approximation method due to differences in the measured length or area of the cross-sectional plane of CT images. METHODS Forty-five patients with Graves' disease were included in this retrospective study. We designated the three-dimensional thyroid volumes extracted manually (VCT ) as the reference data and calculated five approximate volumes for comparison: (a) the mean volume of 8100 different thyroid volumes depending on the diameter of the cross-sectional plane at the midpoint of the major axis, (Vellipsoid,mean ); (b) the volume using the maximum diameter and its orthogonal diameter, (Vellipsoid,maxlength ); (c) the maximum (Vellipsoid,maxvolume ); (d) minimum (Vellipsoid,minvolume ) of the 8100 thyroid volumes; and (e) the volume determined with an equivalent circle diameter, (Vellipsoid,Heywood ). RESULTS Thyroid volumes obtained via the ellipsoid approximation method varied depending on the diameter of the cross-sectional plane and included a mean error of approximately 20%, while the concordance correlation coefficient (CCC) differed for each approximate volume. Among these volumes, Vellipsoid,mean and Vellipsoid,Heywood were in good agreement with VCT , according to single regression analyses and the resultant CCC values, with mean errors of 0.1% and 10.4%, respectively. CONCLUSION While Vellipsoid,Heywood approximated thyroid volumes with vastly reduced errors, we recommend utilizing three-dimensional thyroid volumetry if measurement accuracy is required.
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Affiliation(s)
- Naotoshi Fujita
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, Japan.,Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsuhiko Kato
- Functional Medical Imaging, Biomedical Imaging Sciences, Division of Advanced Information Health Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Abe
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Li ZT, Zhai R, Liu HM, Wang M, Pan DM. Iodine concentration and content measured by dual-source computed tomography are correlated to thyroid hormone levels in euthyroid patients: a cross-sectional study in China. BMC Med Imaging 2020; 20:10. [PMID: 32005176 PMCID: PMC6995181 DOI: 10.1186/s12880-020-0411-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/13/2020] [Indexed: 11/15/2022] Open
Abstract
Background The aim of this study was to investigate the correlation of the dual energy CT measured iodine concentration and total iodine content with blood measured thyroid parameters. Methods Forty-three patients with normal thyroid function at our hospital from August 2017 to October 2019 were included in this retrospective study. Dual energy CT was used to scan the neck of thyroid patients. The mean iodine concentration and thyroid tissue volume were measured to calculate the total iodine content of the thyroid. Relevant tests of triiodothyronine (FT3), total triiodothyronine (TT3), total thyroxine (TT4), free thyroxine (FT4), and thyroid hormone (TSH) were conducted. The correlation of the thyroid mean iodine concentration and total iodine content with blood-measured thyroid function was analysed. Result The total iodine content in the thyroid was positively correlated with FT3 but negatively correlated with TSH. The mean iodine concentration of the thyroid was positively correlated with both FT3 and TT3. Conclusion The thyroid iodine content measured by dual energy CT can be used to determine the human iodine nutritional status and evaluate thyroid function, which will facilitate the diagnosis and treatment of thyroid diseases.
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Semiautomated Renal Cortex Volumetry in Spectral Computed Tomography: Effect of Monoenergetic Reconstructions on Measurement Precision and Interobserver Variability. J Comput Assist Tomogr 2020; 44:138-144. [PMID: 31939895 DOI: 10.1097/rct.0000000000000952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to determine the influence of virtual monoenergetic images (vMEIs) on renal cortex volumetry (RCV) and estimation of split-renal function. METHODS Twenty-five patients (mean ± SD, 64.7 ± 9.9 years) underwent a contrast-enhanced dual-layer spectral detector computed tomography. Images were reconstructed with a reference standard (iterative model reconstruction, IMRRef), a newly spectral detector computed tomography algorithm (SPcon) and vMEI at 40, 60, 80, 100, and 120 keV. Two blinded independent readers performed RCV on all data sets with a semiautomated tool. RESULTS Total kidney volume was up to 15% higher in vMEI at 40/60 keV compared with IMRRef (P < 0.001). Total kidney volume with vMEI at 80/100 keV was similar to IMRRef (P < 0.001). Split-renal function was similar in all reconstructions at approximately 50% ± 3%. Bland-Altman analysis showed no significant differences (P > 0.05), except for 40 keV versus SPcon (P < 0.05). The time required to perform RCV was reasonable, approximately 4 minutes, and showed no significant differences among reconstructions. Interreader agreement was greatest with vMEI at 80 keV (r = 0.68; 95% confidence interval, 0.39-0.85; P < 0.0002) followed by IMRRef images (r = 0.67; 95% confidence interval, 0.37-0.84; P < 0.0003). IMRRef showed the highest mean Hounsfield unit for cortex/medulla of 223.4 ± 73.7/62.5 ± 19.7 and a ratio of 3.7. CONCLUSIONS Semiautomated RCV performed with vMEI and IMRRef/SPcon is feasible and showed no clinically relevant differences with regard to split-renal function. Low-kiloelectron volt vMEI showed greater tissue contrast and total kidney volume but no benefit for RCV. Moderate-kiloelectron volt vMEI (80 keV) results were similar to IMRRef with a faster postprocessing time.
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Abstract
Surgery for substernal goiters can be technically demanding. Extensive mediastinal extension brings the thyroid gland into close quarters with vital intrathoracic structures. Proper preoperative planning is required to determine the potential need for an extracervical approach. Assessing the risk of requiring an extracervical approach is typically based on findings from cross-sectional imaging of the neck and chest. This article addresses the important anatomical considerations when resecting a large substernal goiter and also reviews various extracervical approaches.
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Affiliation(s)
- Martin A Hanson
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, C-1064, New York, NY 10021, USA.
| | - Ashok R Shaha
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, C-1064, New York, NY 10021, USA.
| | - James X Wu
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, C-1064, New York, NY 10021, USA.
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Determining the Thyroid Gland Volume Causing Tracheal Compression: A Semiautomated 3D CT Volumetry Study. ACTA ACUST UNITED AC 2019; 55:medicina55050143. [PMID: 31100834 PMCID: PMC6572450 DOI: 10.3390/medicina55050143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 03/10/2019] [Accepted: 05/14/2019] [Indexed: 11/17/2022]
Abstract
Background and objectives: Increased thyroid gland volume (TV) may bring about tracheal compression, which is one of the causes of respiratory distress. The aim of this study was to investigate the relationship between TV and the severity of tracheal compression independent of patients’ symptoms using semiautomated three-dimensional (3D) volumetry (S3DV) reconstructed from computed tomography (CT) scans. Cut-off TVs leading to different levels of tracheal narrowing were evaluated. Materials and Methods: One hundred sixty-three contrast-enhanced head and neck CT examinations were retrospectively assessed. TVs were measured by S3DV. The degree of tracheal compression was measured at the point where the greatest percent reduction in the cross-sectional area of the trachea adjacent to the thyroid gland was observed. To determine the severity of compression, the tracheal compression ratio (TCR) was defined (TCR = A1 (the narrowest cross-sectional area of trachea)/A2 (the largest cross-sectional area of trachea)). Results: The mean tracheal narrowing was 15% (TCR = 0.85 ± 0.15) in the study population. Patients with more than 15% tracheal compression had significantly higher TV values than those with less than 15% tracheal compression (p < 0.001). In addition, a significant correlation was found between TV and tracheal compression (p < 0.001). Moreover, the receiver operating characteristic (ROC) curve analysis revealed that the cut-off levels for TV that predict a tracheal narrowing of 10%, 20%, 30%, and 40% were 19.75 mL, 21.56 mL, 24.54 mL, and 30.29 mL, respectively (p < 0.05). Conclusions: This study objectively demonstrated that larger thyroid glands cause more severe compression on the trachea. The results may be helpful during the decision-making process for thyroidectomies to be performed due to compression symptoms.
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汪 红, 陈 飞, 张 永, 黎 志, 王 映, 李 强. [Three-dimensional reconstruction of cervical CT vs ultrasound for estimating residual thyroid volume]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:373-376. [PMID: 31068305 PMCID: PMC6765687 DOI: 10.12122/j.issn.1673-4254.2019.03.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare the accuracy of three-dimensional reconstruction of cervical CT and ultrasound for estimating residual thyroid volume. METHODS We performed a retrospective analysis of 17 patients with 21 residual thyroid glands undergoing thyroidectomy surgery between February, 2017 and March, 2018 in our department. We compared the residual thyroid volume in preoperative ultrasound with the intraoperative measurement and the volume measured using threedimensional CT reconstruction before surgery. RESULTS The maximum vertical and anterioposterior diameters of the residual thyroid measured by preoperative ultrasound differed significantly from the volume data measured intraoperatively (P < 0.05), but the difference in the maximum left-right diameters was not statistically significant (P>0.05). The maximum vertical, leftright, and anteroposterior diameters estimated by three-dimensional reconstruction of cervical CT was all similar with those measured intraoperatively (P>0.05). CONCLUSIONS Compared with ultrasound examination, three-dimensional reconstruction of neck CT is more accurate for estimating the residual thyroid volume and provides more reliable evidence for clinical calculation of postoperative I131 dose for thyroid cancer.
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Affiliation(s)
- 红娟 汪
- />南方医科大学珠江医院普通外科,广东 广州 510282Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - 飞 陈
- />南方医科大学珠江医院普通外科,广东 广州 510282Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - 永泉 张
- />南方医科大学珠江医院普通外科,广东 广州 510282Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - 志超 黎
- />南方医科大学珠江医院普通外科,广东 广州 510282Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - 映 王
- />南方医科大学珠江医院普通外科,广东 广州 510282Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - 强 李
- />南方医科大学珠江医院普通外科,广东 广州 510282Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
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van Lierop ZY, Jentjens S, Anten MH, Wierts R, Stumpel CT, Havekes B, van Kroonenburgh MJ. Thyroid Gland 18F-FDG Uptake in Neurofibromatosis Type 1. Eur Thyroid J 2018; 7:155-161. [PMID: 30023349 PMCID: PMC6047496 DOI: 10.1159/000488706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/19/2018] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To investigate thyroid gland characteristics on 18F-FDG positron emission tomography/computed tomography (PET/CT) imaging in patients with neurofibromatosis type 1 (NF1). SUBJECTS AND METHODS Thyroid gland characteristics of patients with a clinical diagnosis of NF1 who underwent 18F-FDG PET/CT imaging for the first time to distinguish benign neurofibroma from malignant peripheral nerve sheath tumor (MPNST) at our institution (n = 69) were compared to PET/CT imaging of sarcoidosis (n = 25) and early stage lung cancer (T1N0M0 tumors, n = 15) patients. RESULTS Two NF1 patients (3%) showed a diffuse 18F-FDG uptake in the thyroid gland, 2 patients (3%) had an irregular uptake, and 7 patients (10%) had a focal uptake. Among the sarcoidosis patients, 1 showed a diffuse uptake (4%) and 1 had an irregular uptake (4%). In the early stage lung cancer group, 1 patient showed a diffuse uptake (7%) and 1 had a focal uptake (7%). NF1 patients had larger mean thyroid volume and mean SUVmax compared to sarcoidosis patients but not compared to early stage lung cancer patients. Four NF1 patients were diagnosed with multinodular goiter, 2 patients were diagnosed with benign chronic lymphocytic thyroiditis, 1 patient had metastasis to the thyroid, and 1 patient had medullary thyroid cancer. CONCLUSION Even though NF1 patients did not show an increased risk of thyroid incidentaloma on PET/CT compared to previous studies on non-thyroid cancer patients, the incidence shows that awareness of possible thyroid disease is important.
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Affiliation(s)
- Zoë Y.G.J. van Lierop
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
- **Zoë Y.G.J. van Lierop, MD, Department of Neurology, Maastricht University Medical Centre, PO Box 5800, NL-6202 AZ Maastricht (The Netherlands), E-Mail
| | - Sander Jentjens
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Monique H.M.E. Anten
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Neurofibromatosis Expert Team, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Connie T. Stumpel
- Neurofibromatosis Expert Team, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bas Havekes
- Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marinus J.P.G. van Kroonenburgh
- Neurofibromatosis Expert Team, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- *Marinus J.P.G. van Kroonenburgh, MD, PhD, Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, PO Box 5800, NL-6202 AZ Maastricht (The Netherlands), E-Mail
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Huh J, Lee IS, Kim KW, Park J, Kim AY, Lee JS, Yook JH, Kim BS. CT gastrography for volumetric measurement of remnant stomach after distal gastrectomy: a feasibility study. Abdom Radiol (NY) 2016; 41:1899-905. [PMID: 27251737 DOI: 10.1007/s00261-016-0792-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE To evaluate the feasibility of post-operative CT gastrography for volumetry of the remnant stomach in gastric cancer patients treated with distal gastrectomy. METHODS CT gastrography was performed with oral administration of effervescent granules in 35 gastric cancer patients who underwent distal gastrectomy. Two readers independently rated the degree of gastric distension on a four-point scale, one (near-total collapse) to four (well distended) and measured the volume of remnant stomach using either 3D or 2D volumetry. The inter-volumetry agreements between the 2D and 3D methods and the interobserver agreements between readers 1 and 2 were assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots. RESULTS The mean score of gastric distension was 3.4 ± 0.6 points and 3.4 ± 0.7 points from readers 1 and 2, respectively. We regarded CT images scored with 3-4 points as a technical success for reliable CT volumetry, which achieved a rate of 91.4% (32/35). For the inter-volumetry agreements between 3D and 2D volumetry, the ICCs were 0.9778 and 0.9814 from readers 1 and 2, respectively. The interobserver agreement between readers 1 and 2 was also excellent, with ICCs of 0.9961 and 0.9876 for 2D and 3D volumetry, respectively. On Bland-Altman plots, the means of differences between any pairs of volumetry measurements ranged from -31.1 to 3.2 cm(3), which may be an acceptable range of measurement variability. CONCLUSIONS Post-operative CT gastrography is feasible in patients treated with distal gastrectomy. Both 2D and 3D volumetry methods are comparable in measuring the remnant stomach volume.
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Affiliation(s)
- Jimi Huh
- Department of Radiology, Bioimaging Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - In-Seob Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Radiology, Bioimaging Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
| | - Jisuk Park
- Department of Radiology, Bioimaging Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea
| | - Ah Young Kim
- Department of Radiology, Bioimaging Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea
| | - Jong Seok Lee
- Department of Radiology, Bioimaging Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea
| | - Jeong-Hwan Yook
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byung-Sik Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kueckelhaus M, Turk M, Kumamaru KK, Wo L, Bueno EM, Lian CG, Alhefzi M, Aycart MA, Fischer S, De Girolami U, Murphy GF, Rybicki FJ, Pomahac B. Transformation of Face Transplants: Volumetric and Morphologic Graft Changes Resemble Aging After Facial Allotransplantation. Am J Transplant 2016; 16:968-78. [PMID: 26639618 DOI: 10.1111/ajt.13544] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/03/2015] [Accepted: 09/18/2015] [Indexed: 01/25/2023]
Abstract
Facial allotransplantation restores normal anatomy to severely disfigured faces. Although >30 such operations performed worldwide have yielded promising short-term results, data on long-term outcomes remain scarce. Three full-face transplant recipients were followed for 40 months. Severe changes in volume and composition of the facial allografts were noted. Data from computed tomography performed 6, 18 and 36 months after transplantation were processed to separate allograft from recipient tissues and further into bone, fat and nonfat soft tissues. Skin and muscle biopsies underwent diagnostic evaluation. All three facial allografts sustained significant volume loss (mean 19.55%) between 6 and 36 months after transplant. Bone and nonfat soft tissue volumes decreased significantly over time (17.22% between months 6 and 18 and 25.56% between months 6 and 36, respectively), whereas fat did not. Histological evaluations showed atrophy of muscle fibers. Volumetric and morphometric changes in facial allografts have not been reported previously. The transformation of facial allografts in this study resembled aging through volume loss but differed substantially from regular aging. These findings have implications for risk-benefit assessment, donor selection and measures counteracting muscle and bone atrophy. Superior long-term outcomes of facial allotransplantation will be crucial to advance toward future clinical routine.
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Affiliation(s)
- M Kueckelhaus
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - M Turk
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - K K Kumamaru
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - L Wo
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - E M Bueno
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - C G Lian
- Division of Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - M Alhefzi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - M A Aycart
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - S Fischer
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Plastic Surgery, BG University Hospital Ludwigshafen, Heidelberg University, Ludwigshafen, Germany
| | - U De Girolami
- Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - G F Murphy
- Division of Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - F J Rybicki
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - B Pomahac
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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