A novel radiological software prototype for automatically detecting the inner ear and classifying normal from malformed anatomy

BACKGROUND

To develop an effective radiological software prototype that could read Digital Imaging and Communications in Medicine (DICOM) files, crop the inner ear automatically based on head computed tomography (CT), and classify normal and inner ear malformation (IEM).

METHODS

A retrospective analysis was conducted on 2053 patients from 3 hospitals. We extracted 1200 inner ear CTs for importing, cropping, and training, testing, and validating an artificial intelligence (AI) model. Automated cropping algorithms based on CTs were developed to precisely isolate the inner ear volume. Additionally, a simple graphical user interface (GUI) was implemented for user interaction. Using cropped CTs as input, a deep learning convolutional neural network (DL CNN) with 5-fold cross-validation was used to classify inner ear anatomy as normal or abnormal. Five specific IEM types (cochlear hypoplasia, ossification, incomplete partition types I and III, and common cavity) were included, with data equally distributed between classes. Both the cropping tool and the AI model were extensively validated.

RESULTS

The newly developed DICOM viewer/software successfully achieved its objectives: reading CT files, automatically cropping inner ear volumes, and classifying them as normal or malformed. The cropping tool demonstrated an average accuracy of 92.25%. The DL CNN model achieved an area under the curve (AUC) of 0.86 (95% confidence interval: 0.81-0.91). Performance metrics for the AI model were: accuracy (0.812), precision (0.791), recall (0.8), and F1-score (0.766).

CONCLUSION

This study successfully developed and validated a fully automated workflow for classifying normal versus abnormal inner ear anatomy using a combination of advanced image processing and deep learning techniques. The tool exhibited good diagnostic accuracy, suggesting its potential application in risk stratification. However, it is crucial to emphasize the need for supervision by qualified medical professionals when utilizing this tool for clinical decision-making.

A scoping review of person-centred care strategies used in diagnostic Nuclear Medicine

INTRODUCTION

Person-centred care (PCC) emphasises the need for the health care professional to prioritise individual patient needs, thereby fostering a collaborative and emphatic environment that empowers patients to actively participate in their own care. This article will explore the purpose of PCC in Nuclear Medicine (NM), while discussing strategies that may be used to implement PCC during diagnostic NM examinations performed on adult patients.

METHODS

The scoping review was conducted in accordance with the Joanna Briggs Institute methodology. The search was performed on PubMed, Embase and Cinhal in June 2023 and included studies in English, Spanish, Portuguese and Italian. The research equation combined keywords and Medical Subject Heading terms (MeSH) related to person-centred care (PCC), for all types of nuclear medicine diagnostic examinations performed. Three independent review authors screened all abstracts and titles, and all eligible full-text publications were included in this scoping review.

RESULTS

Fifty-three articles, published between 1993 and 2022, met the inclusion criteria for this scoping review. Seven articles were published in 2015 while 56.6 % of all included studies were performed in Europe. Most studies (n = 39/53) focused on the patients only, with the identified patient benefits being: improve patient experience (67.9 %), increase patient comfort (13.2 %), increase patient knowledge (5.7 %), reduction of patient anxiety (9.4 %) and reduction of waiting/scan time (3.8 %).

CONCLUSION

The scoping review identified a lack of research investigating the use of person-centred care strategies in NM. Future research will focus on using an international survey to explore this topic in nuclear medicine departments overseas.

IMPLICATIONS FOR PRACTICE

By applying PCC principles, the NM professional can improve the patient care pathway and increase patient satisfaction, leading to enhanced clinical outcomes.

Applications of visualizing cochlear basal turn in cochlear implantation

Objective

To report a reliable method in obtaining optimal cochlear basal turn and cross-section (c/s) of internal auditory canal (IAC) supporting Cochlear implantation (CI) procedure.

Materials and Methods

Computer tomography (CT) and magnetic resonance image (MRI) scans of potential CI candidates from 2018 to 2022 from the tertiary center were considered for analysis. Slicer software was used in three-dimensional (3D) segmentation of inner ear and for capturing the cochlear basal turn.

Results

A total of 1932 head scans were made available for the analysis and out of which 1866 scans had normal anatomy (NA) inner ear. Incomplete partition (IP) type-I was identified in 19 ears, IP type-II in 27 ears, IP type-III in 6 ears, cochlear hypoplasia (CH) type-I in 6 ears, CH type-II in 1 ear, CH type-III in 3 ears, and CH type-IV is 3 ears, and enlarged vestibular aqueduct syndrome in 1 ear. 3D segmented inner ear helped in successfully obtaining the cochlear basal turn and the c/s of IAC in all anatomical types. Time taken to capture the cochlear basal turn with the help of 3D segmented inner ear was <1 min. Within the NA category, five cases showed scalar ossification, and its extent was identified in the cochlear basal turn.

Conclusion

The identification and the extent of ossification in the scala tympani, shape of the basal turn, and the cochlear size measurement in cochlear basal turn has high clinical relevance as this helps in surgical planning and in choosing appropriate electrode length. Level of evidence: Level 2 to the best of our understanding.

The Attrition and Migration Behaviour among Hungarian Radiographers

INTRODUCTION: Organizations are social systems where human resources are the most important factors. In recent years, healthcare employers have assigned a high priority to the recruitment of educated health professionals. The aim of our study was to identify the possible reasons behind the migration and attrition behaviour among Hungarian radiographers. We were interested whether the professional staff have ideas across borders which can be connected with attrition.MATERIAL & METHODS: In our cross-sectional retrospective study we used a self designed questionnaire and the Effort-Reward Imbalance (ERI) Questionnaire’s shortened version. Our target group were active radiographers with BSC radiography degree. The study sample counted 216 radiographers (n=216). For data analysis we used the SPSS 13.0. Variance analysis, paired sample T-test, Chi-square test, linear regression and descriptive statistics were used with the performed probability of 95% (p<0.05).RESULTS: 30.6% of responders (n=66) were considering working abroad, 40.3% (n=87) of responders remain in Hungary. At the age group of 20–30 we can observe significant relationship between the working opportunity abroad (p=0.001). The migration tendency was specific for radiographers with no children (n=54). We found a significant relationship between the working ability abroad and the radiographers’ years spent working in the healthcare system (p=0.008). 41.7% of respondents (n=90) think that it would be a favorable option to making a career change. We also found a significant relationship between the possibility of working abroad and the desire for higher wages and the lack of making career advancements as a radiographer (p=0.001; p=0.001).CONCLUSION: Correlation of our results with similar research was difficult because very few researchers put their interest into radiographers. In respect to other healthcare workers (eg.: nurses, physiotherapists) our result correlate well with the literature. Our research provides a broad view of the migration and attrition tendency among Hungarian radiographers and its underlying causes. According to our study changes should be implemented in the Hungarian system to keep the younger radiographers home.

Treatment of corn ethanol distillery wastewater using two-stage anaerobic digestion

In this study the mesophilic two-stage anaerobic digestion (AD) of corn bioethanol distillery wastewater is investigated in laboratory-scale reactors. Two-stage AD technology separates the different sub-processes of the AD in two distinct reactors, enabling the use of optimal conditions for the different microbial consortia involved in the different process phases, and thus allowing for higher applicable organic loading rates (OLRs), shorter hydraulic retention times (HRTs) and better conversion rates of the organic matter, as well as higher methane content of the produced biogas. In our experiments the reactors have been operated in semi-continuous phase-separated mode. A specific methane production of 1,092 mL/(L·d) has been reached at an OLR of 6.5 g TCOD/(L·d) (TCOD: total chemical oxygen demand) and a total HRT of 21 days (5.7 days in the first-stage, and 15.3 days in the second-stage reactor). Nonetheless the methane concentration in the second-stage reactor was very high (78.9%); the two-stage AD outperformed the reference single-stage AD (conducted at the same reactor loading rate and retention time) by only a small margin in terms of volumetric methane production rate. This makes questionable whether the higher methane content of the biogas counterbalances the added complexity of the two-stage digestion.