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Kalage D, Gupta P, Gulati A, Reddy KP, Sharma K, Thakur A, Yadav TD, Gupta V, Kaman L, Nada R, Singh H, Irrinki S, Gupta P, Das CK, Dutta U, Sandhu M. Contrast Enhanced CT Versus MRI for Accurate Diagnosis of Wall-thickening Type Gallbladder Cancer. J Clin Exp Hepatol 2024; 14:101397. [PMID: 38595988 PMCID: PMC10999705 DOI: 10.1016/j.jceh.2024.101397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/09/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Diagnosis of wall-thickening type gallbladder cancer (GBC) is challenging. Computed tomography (CT) and magnetic resonance imaging (MRI) are commonly utilized to evaluate gallbladder wall thickening. However, there is a lack of data comparing the performance of CT and MRI for the detection of wall-thickening type GBC. Aim We aim to compare the diagnostic accuracy of CT and MRI in diagnosis of wall-thickening type GBC. Materials and methods This prospective study comprised consecutive patients suspected of wall-thickening type GBC who underwent preoperative contrast-enhanced CT and MRI. The final diagnosis was based on the histopathology of the resected gallbladder lesion. Two radiologists independently reviewed the characteristics of gallbladder wall thickening at CT and MRI. The association of CT and MRI findings with histological diagnosis and the interobserver agreement of CT and MRI findings were assessed. Results Thirty-three patients (malignancy, 13 and benign, 20) were included. None of the CT findings were significantly associated with GBC. However, at MRI, heterogeneous enhancement, indistinct interface with the liver, and diffusion restriction were significantly associated with malignancy (P = 0.006, <0.001, and 0.005, respectively), and intramural cysts were significantly associated with benign lesions (P = 0.012). For all MRI findings, the interobserver agreement was substantial to perfect (kappa = 0.697-1.000). At CT, the interobserver agreement was substantial to perfect (k = 0.631-1.000). Conclusion These findings suggest that MRI may be preferred over CT in patients with suspected wall thickening type GBC. However, larger multicenter studies must confirm our findings.
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Affiliation(s)
- Daneshwari Kalage
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Gupta
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Gulati
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kakivaya P. Reddy
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kritika Sharma
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ati Thakur
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Thakur D. Yadav
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Gupta
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lileswar Kaman
- Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritambhra Nada
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harjeet Singh
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Santosh Irrinki
- Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Chandan K. Das
- Department of Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Usha Dutta
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manavjit Sandhu
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Huang CC, Sun PH, Wu PW, Huang CC, Chang PH, Fu CH, Lee TJ. Computed Tomographic Evaluations in Patients with Empty Nose Syndrome. Laryngoscope 2024; 134:2105-2110. [PMID: 38009472 DOI: 10.1002/lary.31204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE We aimed to evaluate computed tomography (CT) images of patients with empty nose syndrome (ENS), investigate the impact of reconstruction surgery on sinus inflammation, and identify the optimal airspace diameter after surgery. METHODS We conducted a retrospective case series analysis, identifying and enrolling patients with ENS with perioperative CT findings. The clinical characteristics of the participants were collected, and the modified Lund-Mackay (mLM) CT scores were determined. The anterior airspace diameter was evaluated by measuring the distance between the septum and the lateral nasal wall on the coronal plane at the level of the nasolacrimal duct. RESULTS Twenty patients with ENS and perioperative CT images were enrolled. The mean total mLM CT score and all subsite scores showed no significant changes after surgery. The Empty Nose Syndrome 6-item Questionnaire (ENS6Q) score, Sino-nasal Outcome Test-25 (SNOT-25) score, sleep symptoms domain, psychological domain, and empty nose symptoms domain were significantly associated with anterior airspace diameter in the regression analysis. CONCLUSION There was no significant difference in sinus inflammation between preoperative and postoperative CT evaluations. The anterior airspace diameters were significantly associated with ENS6Q and SNOT-25 scores. LEVEL OF EVIDENCE 4 Laryngoscope, 134:2105-2110, 2024.
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Affiliation(s)
- Chien-Chia Huang
- Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ping Hsueh Sun
- Department of Medical Education, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Pei-Wen Wu
- Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Che Huang
- Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Po-Hung Chang
- Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hsiang Fu
- Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ta-Jen Lee
- Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology, Xiamen Chang Gung Hospital, Xiamen, China
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Ramos EAA, Munhoz L, Milani BA, Arita ES. Bone quality assessment in patients with healing mandibular fracture sites: a computed tomography investigation. Gen Dent 2024; 72:50-55. [PMID: 38640006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
The objective of this retrospective study was to assess the bone quality of healing mandibular fracture sites by measuring the Hounsfield units (HU) on computed tomographic (CT) images obtained presurgery and postsurgery in patients treated with rigid internal fixation (RIF). The HU values of healing fracture sites were compared to those of corresponding nonfractured (control) sites on the opposing side and cervical vertebrae sites in the same patients. In total, 31 patients with 45 mandibular fractures treated with RIF underwent presurgical and postsurgical CT examinations. The scans performed after surgery (1, 3, 6, 12, or 18 months) were taken only when there was a need for radiographic evaluation due to a complaint of discomfort from the patient or when the surgeon needed to verify the postsurgical outcome, and each patient underwent only a single postsurgical CT. At the presurgical CT examination, the HU values were lower in the fracture sites than in the control sites. At 3 months postsurgery, the HU values in the fracture sites had increased as the mandibular bone healed. At 6 months postsurgery, the HU values in the fracture sites were higher than those of the control sites. At 12 and 18 months postsurgery, the HU values of both sites were similar. The HU values of the cervical vertebrae remained constant with time. These results suggest that, in patients who have been treated with RIF for mandibular bone fracture, HU values measured by CT vary across time, expressing the physiologic bone healing process.
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Li X, Hu X, Wang P, Hu G, Zhou B, Cai J. A large gastric splenosis mimicking gastrointestinal stromal tumor: A case report and literature review. Exp Ther Med 2024; 27:186. [PMID: 38533436 PMCID: PMC10964733 DOI: 10.3892/etm.2024.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/13/2024] [Indexed: 03/28/2024] Open
Abstract
Splenosis pertains to the phenomenon wherein a segment of the spleen undergoes detachment and becomes embedded in other anatomical regions subsequent to traumatic rupture or therapeutic resection, and then progressively establishing blood circulation to foster the regeneration of splenic tissue. Existing literature posits that splenosis predominantly manifests within the confines of the abdominal and pelvic cavities. The objective of the current study was to present an uncommon case involving the occurrence of splenosis within the gastric myometrium, thereby contributing to the current knowledge regarding splenosis. A 16-year-old female sought medical assistance owing to recurrent abdominal pain persisting for a duration of six months, and had a history of splenectomy two years prior. Gastroscopy, endoscopic ultrasound and computed tomography (CT) examination collectively identified a lesion in the submucosal prominence of the fundus of the stomach. Initial considerations based on imaging examinations leaned towards a gastrointestinal stromal tumor. Consequently, an endoscopic resection was undertaken. Remarkably, the pathological findings and histochemistry concurred with the alterations associated with ectopic spleen implantation, leading to a stable postoperative course. In conclusion, splenosis denotes the implantation of a segment of the spleen into extraneous anatomical sites, attributable to traumatic rupture or therapeutic resection. The preoperative diagnosis of splenosis can pose a challenge, potentially culminating in unnecessary radical clinical interventions. Therefore, the acquisition of a comprehensive medical history, with a particular focus on surgical and trauma events, emerges as pivotal for an accurate diagnosis. In light of novel diagnostic modalities, the non-invasive technology of nuclear medicine can efficaciously visualize ectopic splenic tissue, thereby averting superfluous surgical procedures. It is both feasible and imperative to implement individualized treatment strategies for patients afflicted with splenosis.
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Affiliation(s)
- Xiaotian Li
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
- Department of Nuclear Medicine, People's Hospital of Qianxinan Buyi and Miao Minority Autonomous Prefecture, Xingyi, Guizhou 562400, P.R. China
| | - Xianwen Hu
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Pan Wang
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Guiyun Hu
- Department of Nuclear Medicine, People's Hospital of Qianxinan Buyi and Miao Minority Autonomous Prefecture, Xingyi, Guizhou 562400, P.R. China
| | - Bin Zhou
- Department of Nuclear Medicine, People's Hospital of Qianxinan Buyi and Miao Minority Autonomous Prefecture, Xingyi, Guizhou 562400, P.R. China
| | - Jiong Cai
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
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Lin ST, Bolas NM, Sargan DR, Restif O, Peter VG, Pokora R, Patrick H, Foote AK, Murray RC. Comparison of cone-beam and fan-beam computed tomography and low-field magnetic resonance imaging for detection of proximal phalanx dorsoproximal osteochondral defects. Equine Vet J 2024; 56:484-493. [PMID: 37488678 DOI: 10.1111/evj.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Dorsoproximal osteochondral defects commonly affect the proximal phalanx, but information about diagnosis on computed tomography (CT) and magnetic resonance imaging (MRI) is limited. OBJECTIVES To assess CT and MRI diagnoses of osteochondral defects, describe the lesions and compare sensitivity and specificity of the modalities using macroscopic pathology as gold standard. STUDY DESIGN Cross-sectional study. METHODS Thirty-five equine cadaver limbs underwent standing cone-beam CT (CBCT), fan-beam CT (FBCT), low-field MRI and pathological examination. CT and MR images were examined for proximal phalanx dorsomedial and dorsolateral eminence osteochondral defects. Defect dimensions were measured. Imaging diagnoses and measurements were compared with macroscopic examination. RESULTS Fifty-six defects were seen over 70 potential locations. On CBCT and FBCT, osteochondral defects appeared as subchondral irregularity/saucer-shaped defects. On MRI, osteochondral defects were a combination of articular cartilage defect on dorsal images and subchondral flattening/irregularity on sagittal images. Subchondral thickening and osseous short tau inversion recovery hyperintensity were found concurrent with osteochondral defects. Compared with pathological examination, the sensitivity and specificity of diagnosis were 86% (95% confidence interval [95% CI] 75%-93%) and 64% (95% CI 38%-85%) for FBCT; 64% (95% CI 51%-76%) and 71% (95% CI 46%-90%) for CBCT; and 52% (95% CI 39%-65%) and 71% (95% CI 46%-90%) for MRI. Sensitivity of all modalities increased with defect size. Macroscopic defect dimensions were strongly correlated with CBCT (r = 0.76, p < 0.001) and moderately correlated with FBCT and MRI (r = 0.65, p < 0.001). Macroscopic measurements were significantly greater than all imaging modality dimensions (p < 0.001), potentially because macroscopy included articular cartilage pathology. MAIN LIMITATIONS Influence of motion artefact could not be assessed. CONCLUSIONS Osteochondral defects could be visualised using both CT and MRI with sensitivity increasing with defect size. Diagnostic performance was best using FBCT, followed by CBCT then MRI, but CBCT-measured defect size best correlated with macroscopic examination. MRI provided useful information on fluid signal associated with defects, which could represent active pathology.
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Affiliation(s)
- Szu-Ting Lin
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | | | - David R Sargan
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Olivier Restif
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Vanessa G Peter
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | - Rachel Pokora
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | | | | | - Rachel C Murray
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
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Messika-Zeitoun D, Burwash IG. Transforming the Art of the Assessment of AS Into a Systematic and More Robust Approach. JACC Case Rep 2024; 29:102286. [PMID: 38463455 PMCID: PMC10921239 DOI: 10.1016/j.jaccas.2024.102286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
| | - Ian G. Burwash
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
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Sakamoto S, Tani T, Baba K, Wakasa S, Irishio M, Kataoka T, Fukuda D. Leadless Pacemaker Implantation in Severe Kyphosis: Challenging Implantation for Tortuous IVC and Narrow RA. JACC Case Rep 2024; 29:102295. [PMID: 38532781 PMCID: PMC10963639 DOI: 10.1016/j.jaccas.2024.102295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024]
Abstract
Leadless pacemaker implantation is recognized as safe and effective for treating bradycardia. However, there are limited descriptions of its use in patients with complex anatomical considerations. Here, we present a case detailing the successful implantation of a leadless pacemaker with a tortuous inferior vena cava and a narrow right atrium.
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Affiliation(s)
- Shogo Sakamoto
- Department of Cardiovascular Medicine, Belland General Hospital, Higashiyama, Naka-ku, Sakai, Osaka, Japan
| | - Tomomi Tani
- Department of Cardiovascular Medicine, Belland General Hospital, Higashiyama, Naka-ku, Sakai, Osaka, Japan
| | - Kenji Baba
- Department of Cardiovascular Medicine, Belland General Hospital, Higashiyama, Naka-ku, Sakai, Osaka, Japan
| | - Shiho Wakasa
- Department of Cardiovascular Medicine, Belland General Hospital, Higashiyama, Naka-ku, Sakai, Osaka, Japan
| | - Moritoshi Irishio
- Department of Cardiovascular Medicine, Belland General Hospital, Higashiyama, Naka-ku, Sakai, Osaka, Japan
| | - Toru Kataoka
- Department of Cardiovascular Medicine, Belland General Hospital, Higashiyama, Naka-ku, Sakai, Osaka, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Asahimachi, Abeno-ku, Osaka, Japan
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Luengo D, Salmerón Á, Medina A, Pastor J, Caba M. Urothelial carcinoma masquerading as retroperitoneal fibrosis: A case report. Oncol Lett 2024; 27:195. [PMID: 38495831 PMCID: PMC10941066 DOI: 10.3892/ol.2024.14328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Retroperitoneal fibrosis, a rare and often idiopathic condition, poses significant diagnostic challenges. While most cases are considered idiopathic or immune-mediated, a small but important proportion are associated with malignant neoplasms, with implications for prognosis and management. The present study describes the case of a 69-year-old man who presented to the emergency department of the Virgen de las Nieves University Hospital (Granada, Spain), with a 2-week history of epigastric pain, vomiting and altered bowel habits. Laboratory investigations revealed previously undiagnosed renal insufficiency. An abdominal computed tomography (CT) scan showed extensive diffuse retroperitoneal infiltration extending from the periduodenal region to the pubic bone, resulting in gastric dilatation and hydronephrosis. A CT-guided retroperitoneal biopsy was performed and pathology confirmed the presence of urothelial carcinoma. This diagnosis led to the initiation of a chemotherapy regimen consisting of carboplatin and gemcitabine specifically designed for urothelial carcinoma. A follow-up 18F-FDG PET scan performed 6 months later showed a partial functional response. This case illustrates a rare presentation of urothelial carcinoma masked by extensive retroperitoneal fibrosis, and highlights the importance of accurate diagnosis in reducing tumor burden and improving the clinical status of patients.
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Affiliation(s)
- David Luengo
- Department of Radiology, Virgen de las Nieves University Hospital, 18014 Granada, Spain
| | - Ángela Salmerón
- Department of Radiology, Virgen de las Nieves University Hospital, 18014 Granada, Spain
| | - Antonio Medina
- Department of Radiology, Virgen de las Nieves University Hospital, 18014 Granada, Spain
| | - Javier Pastor
- Department of Pathological Anatomy, San Cecilio University Hospital, 18016 Granada, Spain
| | - Mercedes Caba
- Department of Pathological Anatomy, San Cecilio University Hospital, 18016 Granada, Spain
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Lau L, Low T, Ong YK, Xinni X. Endoscopic and Radiologic Central Compartment Disease as Predictors of Perennial Inhalant Allergen Sensitization in Chronic Rhinosinusitis. Am J Rhinol Allergy 2024; 38:178-184. [PMID: 38444214 DOI: 10.1177/19458924241237915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Central compartment atopic disease (CCAD) is a recently described variant of chronic rhinosinusitis (CRS) strongly associated with atopy. The association between central compartment disease (CCD) and inhalant allergy is not well established in South-East Asia, where perennial allergic rhinitis is common. OBJECTIVES The primary objective was to evaluate endoscopic and radiologic CCD as predictors of perennial allergen sensitization in primary CRS. The secondary objective was to compare clinical characteristics of CCAD with other CRS subtypes (CRSwNP and CRSsNP). METHODS A retrospective study of consecutive patients with primary CRS who underwent endoscopic sinus surgery at our institution was performed. Allergen sensitization was confirmed by skin or serum testing. Endoscopy records and computed tomography scans of paranasal sinuses were reviewed for CCD. The diagnostic accuracy of endoscopic and radiologic CCD in predicting atopy was calculated. RESULTS There were 104 patients (43 CCAD, 30 CRSwNP and 31 CRSsNP). Endoscopic CCD was significantly associated with aeroallergen sensitization (odds ratio (OR) 3.99, 95% confidence interval (CI) 1.65-9.67, P = 0.002). Endoscopic CCD predicted atopy with 57% sensitivity, 72% specificity, 69% positive predictive value and positive likelihood ratio of 2.05. Radiologic CCD was not associated with aeroallergen sensitization (OR 0.728, 95%CI 0.292-1.82, P = 0.496). There were more CCAD patients who reported hyposmia (86% vs 42%, P < 0.001) and had anosmia on olfactory testing than CRSsNP (65% vs 14%, P = 0.015). The prevalence of atopy was significantly higher in CCAD than CRSwNP and CRSsNP (70% vs 37% and 42%, P = 0.015 and P = 0.05, respectively). Median serum total immunoglobulin E was higher in CCAD (283 IU/ml) and CRSwNP (127 IU/ml) than CRSsNP (27 IU/ml, P = 0.006 and P = 0.042, respectively). CONCLUSIONS Endoscopic CCD was a better predictor of inhalant allergy than radiologic CCD in primary CRS, in a locale of perennial allergic rhinitis.
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Affiliation(s)
- Linus Lau
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore, Singapore
| | - Terese Low
- Department of Otolaryngology-Head and Neck Surgery, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Yew Kwang Ong
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore, Singapore
| | - Xu Xinni
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore, Singapore
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Thanasa E, Thanasa A, Grapsidi V, Xydias E, Kamaretsos E, Ziogas A, Paraoulakis I, Simopoulou E, Mousia M, Thanasas I. Bilateral obstructive uropathy and severe renal dysfunction associated with large prolapsed pedunculated submucosal leiomyoma of the uterus misdiagnosed as an intracervical fibroid: Report of a very rare case and a mini‑review of the literature. Med Int (Lond) 2024; 4:26. [PMID: 38628382 PMCID: PMC11019461 DOI: 10.3892/mi.2024.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/14/2024] [Indexed: 04/19/2024]
Abstract
Pedunculated submucosal leiomyomas of the uterus that prolapse into the vagina are common. In extremely rare cases, large pedunculated submucosal leiomyomas may lead to bilateral obstructive uropathy, causing severe renal dysfunction and potentially being misdiagnosed as intracervical leiomyoma. The present study describes the surgical treatment of a patient with a large prolapsed pedunculated submucosal uterine leiomyoma, which was misdiagnosed as an intracervical fibroid. The patient, of menopausal age, presented with uterine bleeding, anemia and severe renal dysfunction. Upon a physical examination, suspicion arose for a cervical leiomyoma, prompting the decision for imaging. Both transvaginal ultrasound and computed tomography, as well as magnetic resonance imaging confirmed the diagnosis of intracervical leiomyoma, accompanied by bilateral obstructive uropathy due to ureteral compression. The surgical management of the patient with laparotomy was decided. Intraoperatively, a large pedunculated submucosal uterine leiomyoma prolapsing into the vagina was identified. Total hysterectomy and bilateral salpingectomy-oophorectomy were performed. The immediate post-operative course was uneventful. At 6 months following surgery, the complete recovery of renal morphology and function was observed. The patient continues to undergo regular follow-up assessment to date. In the present study, a brief literature review is also provided, emphasizing the significant diagnostic and surgical challenges that may arise in the management of patients with large pedunculated submucosal uterine leiomyomas prolapsing into the vagina.
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Affiliation(s)
- Efthymia Thanasa
- Department of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Anna Thanasa
- Department of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vasiliki Grapsidi
- Department of Obstetrics and Gynecology, General Hospital of Trikala, 42100 Trikala, Greece
| | - Emmanouil Xydias
- Department of Obstetrics and Gynaecology, EmbryoClinic IVF, 55133 Thessaloniki, Greece
| | - Evangelos Kamaretsos
- Department of Obstetrics and Gynecology, General Hospital of Trikala, 42100 Trikala, Greece
| | - Apostolos Ziogas
- Department of Medicine, University of Thessaly, School of Health Sciences, 41334 Larissa, Greece
| | - Ioannis Paraoulakis
- Department of Obstetrics and Gynecology, General Hospital of Trikala, 42100 Trikala, Greece
| | | | - Maria Mousia
- Department of Pathology, General Hospital of Trikala, 42100 Trikala, Greece
| | - Ioannis Thanasas
- Department of Obstetrics and Gynecology, General Hospital of Trikala, 42100 Trikala, Greece
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Danner AL, Leonard K, Chandler J, Gendler A. Computed tomography-guided cannulated lag screw placement for treatment of ununited anconeal process: surgical technique, clinical outcome, and radiographic healing in 7 dogs. J Am Vet Med Assoc 2024; 262:1-7. [PMID: 38354475 DOI: 10.2460/javma.23.10.0569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE A novel technique and outcomes for correction of ununited anconeal process (UAP) via CT-guided cannulated lag screw placement in 7 canine patients is described. ANIMALS Cases of canine patients (7 patients/8 elbows) diagnosed with UAP that subsequently underwent CT-guided cannulated lag screw placement were retrospectively evaluated. CLINICAL PRESENTATION Pre- and postoperative exam findings (lameness and pain on range of motion) are presented. Preoperative radiographs and postoperative radiographs at 2 time points (approximately 8 weeks postoperatively and at the time of the most recent imaging; mean, 221 days; range, 85 to 828 days) were scored for degree of arthrosis and postoperative radiographs were evaluated for radiographic union. Complications were reported and stratified by severity and time postoperatively. RESULTS Minor perioperative (0 to 3 months postoperatively) complications included seroma formation (n = 1) and major perioperative complications involved development of surgical site infections (2), with 2 patients requiring implant removal in the perioperative period (44 and 82 days postoperatively). All patients achieved radiographic union, defined as partial or complete bridging of the anconeal process to the ulna within the study period (mean radiographic follow-up time 221 days postoperatively; range, 85 to 828 days; 5/8 joints partial bridging, 3/8 joints complete bridging) and pre- versus postoperative elbow arthrosis scores remained static in all patients. CLINICAL RELEVANCE The case outcomes described support the use of CT-guided cannulated lag screw placement as a feasible option for treatment of UAP.
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Affiliation(s)
- Alexa L Danner
- 1College of Veterinary Medicine, Washington State University,, Pullman, WA
| | | | - John Chandler
- 2WestVet Emergency and Specialty Center, Garden City, ID
| | - Andrew Gendler
- 2WestVet Emergency and Specialty Center, Garden City, ID
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12
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Ito T, Furuya M, Tanaka T, Yoshii Y, Murata M, Sasai K. Long-term effects of iopamidol as a contrast medium for computed tomography in Cloudy Catsharks Scyliorhinus torazame. J Aquat Anim Health 2024. [PMID: 38643364 DOI: 10.1002/aah.10219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/13/2024] [Accepted: 02/26/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE The use of computed tomography (CT) in aquarium animals, including elasmobranchs, has increased dramatically. To take advantage of CT, contrast medium is used to enhance internal organs and provide contrast since elasmobranchs lack visceral fat. In this study, the contrast effects of iopamidol were examined for up to 260 days after intravenous administration to establish the time course of the CT values for the target organs in eight mature Cloudy Catsharks Scyliorhinus torazame. METHODS A micro-CT system was used to measure the CT values of the designated region of interest in the target organs (ventricular cavity, kidneys, liver, gallbladder, ovarian follicles, uterine horn cavity) over time and the eggs laid, following administration of iopamidol (700 mg of iodine/kg). RESULT The CT values of the ventricular cavity and kidneys peaked at 30 min and showed low values after day 22. The CT values for the liver increased over time and peaked at day 200, whereas values for the gallbladder and ovarian follicles peaked on day 6, with the gallbladder showing a low value and the ovarian follicles still showing a high value on day 260. Computed tomography images with identifiable enhancement within bilateral uterine horns were followed from days 1 to 35. The mean and maximum CT values of yolk and jelly in eggs laid after day 30 were significantly higher than the values for eggs laid up to day 29; embryonic development was confirmed in 88.7% of the eggs. CONCLUSION There was no mortality or morbidity of the sharks during the experiment, indicating that the administration of iopamidol at 700 mg of iodine/kg did not result in any adverse effects for 260 days. This is the first study to describe the long-term contrast effects of iopamidol, thus contributing new information about the application of contrast studies in Cloudy Catsharks.
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Affiliation(s)
| | - Masaru Furuya
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
| | - Toshiyuki Tanaka
- Veterinary Medicine Center, Department of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
| | | | | | - Kazumi Sasai
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
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13
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Matsumoto Y, Ogihara N. Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism. Clin Anat 2024. [PMID: 38642017 DOI: 10.1002/ca.24171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/28/2024] [Accepted: 04/11/2024] [Indexed: 04/22/2024]
Abstract
The plantar aponeurosis (PA) is an elastic longitudinal band that contributes to the generation of a propulsive force in the push-off phase during walking and running through the windlass mechanism. However, the dynamic behavior of the PA remains unclear owing to the lack of direct measurement of the strain it generates. Therefore, this study aimed to visualize and quantify the PA behavior during two distinct foot postures: (i) neutral posture and (ii) windlass posture with midtarsal joint plantarflexion and metatarsophalangeal joint dorsiflexion, using computed tomography scans. Six healthy adult males participated in the experiment, and three-dimensional reconstruction of the PA was conducted to calculate its path length, width, thickness, and cross-sectional area. This study successfully visualized and quantified the morphological changes in the PA induced by the windlass mechanism, providing a precise reference for biomechanical modeling. This study also highlighted the interindividual variability in the PA morphology and stretching patterns. Although the windlass posture was not identical to that observed in the push-off phase during walking, the observed PA behavior provides valuable insights into its mechanics and potential implications for foot disorders.
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Affiliation(s)
- Yuka Matsumoto
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
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14
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Zeng Q, Zhou J, Ji Y, Wang H. A semiparametric Gaussian mixture model for chest CT-based 3D blood vessel reconstruction. Biostatistics 2024:kxae013. [PMID: 38637995 DOI: 10.1093/biostatistics/kxae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024] Open
Abstract
Computed tomography (CT) has been a powerful diagnostic tool since its emergence in the 1970s. Using CT data, 3D structures of human internal organs and tissues, such as blood vessels, can be reconstructed using professional software. This 3D reconstruction is crucial for surgical operations and can serve as a vivid medical teaching example. However, traditional 3D reconstruction heavily relies on manual operations, which are time-consuming, subjective, and require substantial experience. To address this problem, we develop a novel semiparametric Gaussian mixture model tailored for the 3D reconstruction of blood vessels. This model extends the classical Gaussian mixture model by enabling nonparametric variations in the component-wise parameters of interest according to voxel positions. We develop a kernel-based expectation-maximization algorithm for estimating the model parameters, accompanied by a supporting asymptotic theory. Furthermore, we propose a novel regression method for optimal bandwidth selection. Compared to the conventional cross-validation-based (CV) method, the regression method outperforms the CV method in terms of computational and statistical efficiency. In application, this methodology facilitates the fully automated reconstruction of 3D blood vessel structures with remarkable accuracy.
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Affiliation(s)
- Qianhan Zeng
- Guanghua School of Management, Peking University, Beijing, 100871, China
| | - Jing Zhou
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China
| | - Ying Ji
- Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Hansheng Wang
- Guanghua School of Management, Peking University, Beijing, 100871, China
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15
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Liang HH, Liu HY, Kosik RO, Chan WP, Chien LN. Association between repeat imaging and readmission in patients with acute ischemic stroke: a 16-year nationwide population-based study. Br J Radiol 2024:tqae082. [PMID: 38640490 DOI: 10.1093/bjr/tqae082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 12/04/2023] [Accepted: 04/15/2024] [Indexed: 04/21/2024] Open
Abstract
OBJECTIVES This study aims to evaluate such usage patterns and identify factors that may contribute to the need for repeat imaging in acute ischemic stroke patients, and determine the association between repeat imaging and readmission in Taiwan. METHODS We searched and analyzed data from the Taiwan National Health Insurance Research Database for patients admitted for acute ischemic stroke between 2002 and 2017. Cases where repeat brain imaging during the initial hospital admission occurred and where patients were readmitted within 30 days following discharge were documented. RESULTS Of a total of 195,016 patients with new onset ischemic stroke, 51,798 (26.6%) underwent repeat imaging during their initial admission. Factors associated with repeat brain imaging included younger age, longer hospital stay, use of rt-PA therapy (odds ratio = 2.10 [95% CI, 1.98-2.22]), more recent year of diagnosis, higher NIHSS score, and admission to a hospital offering a higher level of care. Repeat imaging was also associated with increased risk of ischemic stroke and all types of stroke readmission. CONCLUSIONS Repeat brain imaging of patients with stroke has increased in recent years, and it is associated with certain factors including age, length of stay, use of rt-PA, hospital level of care, and NIHSS score. It is also associated with increased readmission. ADVANCES IN KNOWLEDGE Knowledge of the associations of repeat imaging may help clinicians use repeat imaging more carefully and efficaciously.
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Affiliation(s)
- Han-Hsuan Liang
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Liu
- Health Data Analytical and Statistical Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Russell Oliver Kosik
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li-Nien Chien
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan
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16
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Cai E, Zheng Y, Wang M, Zeng M. Imaging Findings of Calcifying Nested Stromal-Epithelial Tumour of the Liver: A Case Report and Literature Review. Curr Med Imaging 2024; 20:CMIR-EPUB-139856. [PMID: 38639283 DOI: 10.2174/0115734056291871240327041053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND A calcifying nested stromal-epithelial tumour (CNSET) is an erratic primary liver malignant tumour frequently discovered in young girls and females. Neither its pathogenesis nor its nosogenesis is clearly known. While principally indolent, infrequent tumours with aggressive clinical progression have been defined. This paper describes a CNSET case with rare clinical and imaging features. CASE PRESENTATION A 17-year-old girl initially presented with enlarged lymph nodes near the main portal vein of the liver and a large liver tumour. Lesions were identified on the imaging findings obtained via positron emission tomography-computed tomography (CT) scanning, including an abnormal increase of heterogeneous glucose metabolism in the intrahepatic mass, with a maximum standardised uptake value of around 3.2. The CT imaging showed multiple dense shadows in the lesion, while the magnetic resonance imaging indicated a long T1 and a slightly longer T2. CONCLUSIONS This study summarises the imaging features of CNSETs to provide a reference for diagnosing liver tumours. In addition, the literature on the topics covered was systematically reviewed.
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Affiliation(s)
- Ermin Cai
- Department of Radiology, Zhuji People's Hospital, Shaoxing 311800, China
| | - Yiheng Zheng
- Department of Radiology, Zhuji People's Hospital, Shaoxing 311800, China
| | - Mingliang Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China
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17
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Zekavat A, Lioliou G, Roche I Morgo O, Maughan Jones C, Galea G, Maniou E, Doherty A, Endrizzi M, Astolfo A, Olivo A, Hagen CK. Phase contrast micro-CT with adjustable in-slice spatial resolution at constant magnification. Phys Med Biol 2024. [PMID: 38631365 DOI: 10.1088/1361-6560/ad4000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To report on a micro computed tomography (micro-CT) system capable of x-ray phase contrast imaging and of increasing spatial resolution at constant magnification.
Approach: The micro-CT system implements the edge illumination (EI) method, which relies on two absorbing masks with periodically spaced transmitting apertures in the beam path; these split the beam into an array of beamlets and provide sensitivity to the beamlets' directionality, i.e., refraction. In EI, spatial resolution depends on the width of the beamlets rather than on the source/detector point spread function (PSF), meaning that resolution can be increased by decreasing the mask apertures, without changing the source/detector PSF or the magnification.
Main results: We have designed a dedicated mask featuring multiple bands with differently sized apertures and used this to demonstrate that resolution is a tuneable parameter in our system, by showing that increasingly small apertures deliver increasingly detailed images. Phase contrast images of bar pattern-based resolution phantom and a biological sample (a mouse embryo) were obtained at multiple resolutions.
Significance: The new micro-CT system could find application in areas where phase contrast is already known to provide superior image quality, while the added tuneable resolution functionality could enable more sophisticated analyses in these applications, e.g., by scanning samples at multiple scales.
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Affiliation(s)
- Amir Zekavat
- Medical Physics and Bioengineering, UCL, Malet Place, Gower Street, London, London, WC1E6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Grammatiki Lioliou
- Medical Physics and Bioengineering, UCL, Malet Place, Gower Street, London, London, WC1E6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Oriol Roche I Morgo
- Medical Physics and Bioengineering, UCL, Malet Place, Gower Street, London, London, WC1E6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Charlotte Maughan Jones
- Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Gabriel Galea
- Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Eirini Maniou
- Medical Physics and Bioengineering, UCL, Malet Place, Gower Street, London, London, WC1E6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Adam Doherty
- Medical Physics and Bioengineering, UCL, Malet Place, Gower Street, London, London, WC1E6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Marco Endrizzi
- Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, Gower Street, London, WC1E 6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Alberto Astolfo
- University College London, Malet Place, London, wc1e6bt, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Alessandro Olivo
- Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, Malet Place, off Torrington Place, London, WC1E 6BT, London, WC1E 6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Charlotte Klara Hagen
- Medical Physics and Bioengineering, UCL, Malet Place, Gower Street, London, London, WC1E6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
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18
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Toide M, Tanaka H, Kobayashi M, Fujiwara M, Nakamura Y, Fukuda S, Kimura K, Waseda Y, Yoshida S, Tateishi U, Fujii Y. Stepwise algorithm using computed tomography and magnetic resonance imaging for differential diagnosis of fat-poor angiomyolipoma in small renal masses: A prospective validation study. Int J Urol 2024. [PMID: 38632863 DOI: 10.1111/iju.15464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES To validate the diagnostic accuracy of a stepwise algorithm to differentiate fat-poor angiomyolipoma (fp-AML) from renal cancer in small renal masses (SRMs). METHODS We prospectively enrolled 223 patients with solid renal masses <4 cm and no visible fat on unenhanced computed tomography (CT). Patients were assessed using an algorithm that utilized the dynamic CT and MRI findings in a stepwise manner. The diagnostic accuracy of the algorithm was evaluated in patients whose histology was confirmed through surgery or biopsy. The clinical course of the patients was further analyzed. RESULTS The algorithm classified 151 (68%)/42 (19%)/30 (13%) patients into low/intermediate/high AML probability groups, respectively. Pathological diagnosis was made for 183 patients, including 10 (5.5%) with fp-AML. Of these, 135 (74%)/36 (20%)/12 (6.6%) were classified into the low/intermediate/high AML probability groups, and each group included 1 (0.7%)/3 (8.3%)/6 (50%) fp-AMLs, respectively, leading to the area under the curve for predicting AML of 0.889. Surgery was commonly opted in the low and intermediate AML probability groups (84% and 64%, respectively) for initial management, while surveillance was selected in the high AML probability group (63%). During the 56-month follow-up, 36 (82%) of 44 patients initially surveyed, including 13 of 18 (72%), 6 of 7 (86%), and 17 of 19 (89%) in the low/intermediate/high AML probability groups, respectively, continued surveillance without any progression. CONCLUSIONS This study confirmed the high diagnostic accuracy for differentiating fp-AMLs. These findings may help in the management of patients with SRMs.
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Affiliation(s)
- Masahiro Toide
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Fujiwara
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Nakamura
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichiro Kimura
- Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Li Z, Liu D, Li Z. Mediastinal bronchial artery aneurysm and pulmonary hypoplasia with hemoptysis. Eur Heart J Cardiovasc Imaging 2024:jeae106. [PMID: 38630552 DOI: 10.1093/ehjci/jeae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Zihao Li
- Department of Radiology, Qilu Hospital of Shandong University Dezhou, Hospital (Dezhou People's Hospital), Dezhou, China
| | - Dan Liu
- Department of Radiology, Liaocheng Fifth People's Hospital, Liaocheng, China
| | - Zhao Li
- Department of Radiology, Liaocheng Hospital Affiliated to Shandong First Medical University (Liaocheng People's Hospital), Liaocheng, China
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20
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Mizutani A, Nagashima M, Ohira Y, Mimura T, Onuki M, Matsuoka R, Sekizawa A, Matsumoto K. Successful laparoscopic resection of retroperitoneal ectopic pregnancy between the abdominal aorta and inferior vena cava: A case report. J Obstet Gynaecol Res 2024. [PMID: 38634201 DOI: 10.1111/jog.15947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024]
Abstract
Retroperitoneal ectopic pregnancies are extremely rare; only a few cases having been reported. Here, we report laparoscopic removal of an asymptomatic retroperitoneal ectopic pregnancy from a 29-year-old woman who was referred to our hospital for a suspected ectopic pregnancy. Transvaginal ultrasound did not reveal a gestational sac in the uterus or pelvic cavity. However, abdominal contrast-enhanced computer tomography showed a gestational sac between the abdominal aorta and inferior vena cava. On laparoscopy, the gestational sac was confirmed to be in this retroperitoneal location and successfully removed with minimal bleeding. Histopathologic examination revealed chorionic villi surrounded by lymphatic tissue, suggesting lymphatic spread of the retroperitoneal ectopic pregnancy. In summary, contrast-enhanced computer tomography is very useful for locating the site of pregnancy in women suspected of having a retroperitoneal ectopic pregnancy. Timely diagnosis of a retroperitoneal ectopic pregnancy before bleeding occurs can enable their safe laparoscopic removal.
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Affiliation(s)
- Akane Mizutani
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Minoru Nagashima
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Yasuyuki Ohira
- Department of Pathology, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Takashi Mimura
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Mamiko Onuki
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Ryu Matsuoka
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
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Ichinokawa H, Takamochi K, Fukui M, Hattori A, Matsunaga T, Suzuki K. Investigating the predictive factors of thoracic aortic invasion and surgical outcomes in patients with primary lung cancer: A retrospective study. Thorac Cancer 2024. [PMID: 38623823 DOI: 10.1111/1759-7714.15311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND This study aimed to investigate predictors of thoracic aortic invasion in lung cancer patients using preoperative clinical and imaging characteristics and elucidate surgical outcomes in cases of aortic invasion. METHODS Of the 4751 lung cancer patients who underwent surgery at our hospital, we included 126 (6.8%) who underwent left-sided surgery and in whom tumor appeared to be in contact with the thoracic aorta on preoperative imaging. The patients were divided into two groups: group A, 23 patients (18%) who underwent combined aortic resection (+); group B, 103 patients (82%) who did not undergo combined aortic resection (-). RESULTS The percentage of aortic invasion for tumor diameter <3 cm, 3-4 cm, 4-5 cm, 5-7 cm, and >7 cm was 0%, 13%, 23%, 16%, and 35%, respectively. The percentages of aortic invasion were 27%, 16%, and 0% for tumor localization in the upper division, S6, and S10, respectively. Multivariate analysis revealed that aortic depression due to tumor or loss of fatty tissue between tumor and mediastinum in the chest CT significantly predicted aortic invasion (odds ratio = 23.83, 16.66). Group A demonstrated significantly more blood loss, longer operative time, prolonged hospital stay, and increased percentage of recurrent nerve palsy (13%) compared to group B. The 1-, 3-, and 5-year survival rates for patients in group A were 53.4%, 24.3%, and 24.3%, respectively. CONCLUSION If the chest CT of a patient demonstrates aortic depression due to tumor or loss of fatty tissue between tumor and mediastinum, aortic complications should be considered when planning surgery.
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Affiliation(s)
- Hideomi Ichinokawa
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Kazuya Takamochi
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Mariko Fukui
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Aritoshi Hattori
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Takeshi Matsunaga
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Kenji Suzuki
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
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Persits I, Mirzai S, Sarnaik KS, Volk MC, Yun J, Harb S, Puri R, Kapadia S, Krishnaswamy A, Chen PH, Reed G, Tang WHW. Low Muscle Mass by Preprocedural Computed Tomography Is Associated With Worse Short-Term Outcomes in Transcatheter Aortic Valve Replacement Recipients. Am J Cardiol 2024; 217:86-93. [PMID: 38432333 DOI: 10.1016/j.amjcard.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/03/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
Low muscle mass (LMM) is associated with worse outcomes in various clinical situations. Traditional frailty markers have been used for preoperative risk stratification in patients who underwent transcatheter aortic valve replacement (TAVR). However, preoperative imaging provides an opportunity to directly quantify skeletal muscle mass to identify patients at higher risk of procedural complications. We reviewed all TAVR recipients from January to December 2018 and included subjects with preprocedural chest computed tomography. Multi-slice automated measurements of skeletal muscle mass were made from the ninth to twelfth thoracic vertebrae and normalized by height squared to obtain skeletal muscle index (cm2/m2). LMM was defined as the lowest gender-stratified skeletal muscle index tertile. Strength testing was collected during pre-TAVR evaluation. Primary outcome was a composite of perioperative complications, 1-year rehospitalization, or 1-year mortality. In our cohort, 238 patients met inclusion criteria, and 80 (33.6%) were identified to have LMM. Patients with LMM were older with lower body mass index, decreased grip strength, lower hemoglobin A1c, and higher N-terminal pro-brain natriuretic peptide. They had greater rates of the composite outcome and 2-year all-cause mortality, which remained significant on multivariable adjustment (hazard ratio 1.71, 95% confidence interval 1.05 to 2.78, p = 0.030 and hazard ratio 2.31, 95% confidence interval 1.02 to 5.24, p = 0.045, respectively) compared with patients without LMM; there was no significant difference in 5-year all-cause mortality. In conclusion, LMM was associated with an increase in the primary composite outcome and 2-year all-cause mortality in TAVR recipients. Using automatic muscle processing software on pre-TAVR computed tomography scans may serve as an additional preoperative risk stratification tool.
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Affiliation(s)
- Ian Persits
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Saeid Mirzai
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio; Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Kunaal S Sarnaik
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - James Yun
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Serge Harb
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rishi Puri
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir Kapadia
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Amar Krishnaswamy
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Po-Hao Chen
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Grant Reed
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - W H Wilson Tang
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
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Yoshida K, Kobatake Y, Takashima S, Nishii N. Evaluation of muscle mass and intramuscular fatty infiltration in dogs with hypercortisolism and their association with prognosis. J Vet Intern Med 2024. [PMID: 38622799 DOI: 10.1111/jvim.17065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Muscle atrophy and intramuscular fatty infiltration, as well as their association with prognosis, have not been quantified in dogs with spontaneous hypercortisolism (HC). OBJECTIVE To quantitatively evaluate muscle atrophy and IM fatty infiltration in dogs with HC and determine their prognostic impact. ANIMALS Fifty-three dogs with HC and 66 control dogs without HC. METHODS Retrospective cohort study. Medical records and computed tomography images obtained between 2014 and 2021 were evaluated. Kaplan-Meier curves and log-rank tests were used to analyze the effect of muscle atrophy and IM fatty infiltration on the prognosis of dogs with HC. RESULTS Dogs with HC showed lower visually measured cross-sectional area (VCSA) and cross-sectional area based on attenuation (HCSA) than control dogs (median [interquartile range {IQR}]: 50.3 mm2/mm [36.2-67.8] vs 66.7 mm2/mm [48.0-85.9]; P < .001; 30.4 mm2/mm [13.7-57.2] vs 54.8 mm2/mm [39.7-71.5]; P < .001, respectively). Dogs with HC had lower epaxial muscle attenuation (L3HU) than control dogs (median [IQR]: 21.2 Hounsfield [HU] [12.4-28.2] vs 33.2 HU [22.6-43.6]; P < .001). Dogs with HC with lower HCSA or L3HU had shorter survival (median [IQR]: 670 days [222-673] vs 949 days [788-1074], P < .01; 523 days [132-670] vs 949 days [756-1074], P < .01, respectively) but not lower VCSA (median [IQR]: 673 days [132-788] vs 949 days [523 to not applicable]; P = .30). CONCLUSION AND CLINICAL IMPORTANCE Hypercortisolism in dogs causes muscle atrophy and IM fatty infiltration and is associated with poor prognosis.
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Affiliation(s)
- Kei Yoshida
- Joint Department of Veterinary Medicine, The United Graduate School of Veterinary Science, Gifu University, Gifu, Japan
| | - Yui Kobatake
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Science, Gifu University, Gifu, Japan
| | - Satoshi Takashima
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Science, Gifu University, Gifu, Japan
| | - Naohito Nishii
- Joint Department of Veterinary Medicine, The United Graduate School of Veterinary Science, Gifu University, Gifu, Japan
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Science, Gifu University, Gifu, Japan
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Ji X, Shang Y, Tan L, Hu Y, Liu J, Song L, Zhang J, Wang J, Ye Y, Zhang H, Peng T, An P. Prediction of High-Risk Gastrointestinal Stromal Tumor Recurrence Based on Delta-CT Radiomics Modeling: A 3-Year Follow-up Study After Surgery. Clin Med Insights Oncol 2024; 18:11795549241245698. [PMID: 38628841 PMCID: PMC11020727 DOI: 10.1177/11795549241245698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024] Open
Abstract
Background Medium- to high-risk classification-gastrointestinal stromal tumors (MH-GIST) have a high recurrence rate and are difficult to treat. This study aims to predict the recurrence of MH-GIST within 3 years after surgery based on clinical data and preoperative Delta-CT Radiomics modeling. Methods A retrospective analysis was conducted on clinical imaging data of 242 cases confirmed to have MH-GIST after surgery, including 92 cases of recurrence and 150 cases of normal. The training set and test set were established using a 7:3 ratio and time cutoff point. In the training set, multiple prediction models were established based on clinical data of MH-GIST and the changes in radiomics texture of enhanced computed tomography (CT) at different time periods (Delta-CT radiomics). The area under curve (AUC) values of each model were compared using the Delong test, and the clinical net benefit of the model was tested using decision curve analysis (DCA). Then, the model was externally validated in the test set, and a novel nomogram predicting the recurrence of MH-GIST was finally created. Results Univariate analysis confirmed that tumor volume, tumor location, neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), diabetes, spicy hot pot, CT enhancement mode, and Radscore 1/2 were predictive factors for MH-GIST recurrence (P < .05). The combined model based on these above factors had significantly higher predictive performance (AUC = 0.895, 95% confidence interval [CI] = [0.839-0.937]) than the clinical data model (AUC = 0.735, 95% CI = [0.6 62-0.800]) and radiomics model (AUC = 0.842, 95% CI = [0.779-0.894]). Decision curve analysis also confirmed the higher clinical net benefit of the combined model, and the same results were validated in the test set. The novel nomogram developed based on the combined model helps predict the recurrence of MH-GIST. Conclusions The nomogram of clinical and Delta-CT radiomics has important clinical value in predicting the recurrence of MH-GIST, providing reliable data reference for its diagnosis, treatment, and clinical decision-making.
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Affiliation(s)
- Xianqun Ji
- Department of Radiology and Surgery, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Emergency Internal Medicine and Orthopedics, Hubei Province Clinical Research Center of Parkinson’s Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Yu Shang
- Department of Radiology and Surgery, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Infectious Disease and Gastroenterology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Lin Tan
- Department of Radiology and Surgery, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Emergency Internal Medicine and Orthopedics, Hubei Province Clinical Research Center of Parkinson’s Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Yan Hu
- Department of Radiology and Surgery, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Infectious Disease and Gastroenterology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Junjie Liu
- Department of Radiology and Surgery, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Oncology, Gynaecology and Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Lina Song
- Department of Radiology and Surgery, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Oncology, Gynaecology and Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Junyan Zhang
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Infectious Disease and Gastroenterology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- Department of Oncology, Gynaecology and Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Jingxian Wang
- Department of Emergency Internal Medicine and Orthopedics, Hubei Province Clinical Research Center of Parkinson’s Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Infectious Disease and Gastroenterology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Yingjian Ye
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Oncology, Gynaecology and Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Haidong Zhang
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Oncology, Gynaecology and Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Tianfang Peng
- Department of Emergency Internal Medicine and Orthopedics, Hubei Province Clinical Research Center of Parkinson’s Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Oncology, Gynaecology and Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Peng An
- Department of Radiology and Surgery, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Stomatology and Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Oncology, Gynaecology and Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
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25
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Matusik PS, Mikrut K, Bryll A, Podolec M, Popiela TJ, Matusik PT. Prominent crista terminalis mimicking a right atrial mass: a systematic literature review and meta-analysis. Acta Radiol 2024:2841851241242461. [PMID: 38619912 DOI: 10.1177/02841851241242461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The crista terminalis is an anatomical structure localized on the posterolateral wall of the right atrium (RA). We performed a systematic review of the literature and meta-analysis concerning cases of unusual prominent crista terminalis mimicking RA mass. Moreover, we described the differential diagnosis of cardiac masses with the use of echocardiography, computed tomography, and cardiac magnetic resonance (CMR). We also emphasize the potential importance of this structure in electrophysiological procedures, including its role in exaggerated arrhythmias. Prominent crista terminalis may be a potential obstacle during invasive cardiac procedures or catheter ablation target. In analyzed cases, the crista terminalis was often erroneously interpreted as pathologic and at first confused with a thrombus or tumor during transthoracic echocardiography examination. The correct final diagnoses were mostly made with used transesophageal echocardiography or CMR. The most important imaging findings suggestive of prominent crista terminalis rather than tumor were a similar echogenicity/intensity with adjacent myocardium, the location on posterolateral wall of the RA, the phasic change in size, and no enhancement after contrast injection. We describe up to date and detailed imaging features for the differential diagnostics of selected intracardiac masses using various imaging techniques, including multimodality cardiac imaging. Familiarity with the anatomy and the imaging findings of the prominent crista terminalis will reduce misdiagnosis and avoid additional tests and unwarranted clinical interventions, while in patients considered for invasive cardiac procedures it might increase their efficacy and safety.
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Affiliation(s)
- Patrycja S Matusik
- Department of Diagnostic Imaging, University Hospital, Kraków, Poland
- Chair of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Mikrut
- Department of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Amira Bryll
- Department of Diagnostic Imaging, University Hospital, Kraków, Poland
- Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Podolec
- Department of Coronary Artery Disease and Heart Failure, St John Paul II Hospital, Kraków, Poland
- Center for Innovative Medical Education, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Diagnostic Imaging, University Hospital, Kraków, Poland
- Chair of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł T Matusik
- Department of Electrocardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
- Department of Electrocardiology, St John Paul II Hospital, Kraków, Poland
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26
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Wu G, Yang Y, Liu L. Chest CT radiomics is feasible in evaluating bone changes in chronic kidney diseases. Acta Radiol 2024:2841851241245972. [PMID: 38613341 DOI: 10.1177/02841851241245972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND Non-invasive imaging methods are still lacking for evaluating bone changes in chronic kidney diseases (CKD). PURPOSE To investigate the feasibility of chest CT radiomics in evaluating bone changes caused by CKD. MATERIAL AND METHODS In total, 75 patients with stage 1 CKD (CKD1) and 75 with stage 5 CKD (CKD5) were assessed using the chest CT radiomics method. Radiomics features of bone were obtained using 3D Slicer software and were then compared between CKD1 and CKD5 cases. The methods of maximum correlation minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) were used to establish a prediction model to determine CKD. The receiver operating characteristic (ROC) curve was used to determine the performance of the model. RESULTS Cases of CKD1 and CKD5 differed in 40 radiomics features (P <0.05). Using the mRMR and LASSO methods, five features were finally selected to establish a predication model. The area under the receiver operating characteristic curve of the model in the determination of CKD1 and CKD5 was 0.903 and 0.854, respectively, for the training and validation cohorts. CONCLUSION Chest CT radiomics is feasible in evaluating bone changes caused by CKD.
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Affiliation(s)
- Gang Wu
- Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
| | - Yongli Yang
- Internal Medicine of Nephropathy, Hubei No. 3 People's Hospital of Jianghan University, Wuhan, Hubei, PR China
| | - Liangjin Liu
- Department of Radiology, Hubei No. 3 People's Hospital of Jianghan University, Wuhan, Hubei, PR China
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27
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Dorismond C, Smetak MR, Perkins EL, Foust AM, Sarma A, Virgin FW. High Prevalence of Cochlear Nerve Deficiency in Pediatric Patients With Cochlear Aperture Stenosis. Otolaryngol Head Neck Surg 2024. [PMID: 38606641 DOI: 10.1002/ohn.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/04/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Cochlear nerve deficiency (CND) is a common radiologic finding among unilateral sensorineural hearing loss (USNHL) patients. It is generally detected with magnetic resonance imaging (MRI), which is associated with higher cost, less availability, and possible need for sedation. Therefore, identifying computed tomography (CT) findings, such as cochlear aperture stenosis (CAS), that can reliably predict CND is valuable. Our study aimed to determine the prevalence of CND in pediatric patients with CT-diagnosed CAS. STUDY DESIGN Retrospective study. SETTING Tertiary care center. METHODS We included pediatric patients diagnosed with CAS on temporal bone CT and with available temporal bone MRI. For each patient, an otolaryngologist and a pediatric neuroradiologist measured the cochlear aperture width on CT to confirm CAS (cochlear aperture < 1.4 mm) and assessed the status of the cochlear nerve on MRI. RESULTS Fifty-five patients, representing 65 ears, had CAS on CT measurement. Median cochlear aperture width in CAS ears was 0.70 mm (interquartile range [IQR]: 0.40-1.05 mm) versus 2.00 mm in non-CAS ears (IQR: 1.80-2.30 mm, P < .001). CND was found in 98.5% (n = 64/65) of CAS ears, while a normal cochlear nerve was found in 1.5% (n = 1/65) of CAS ears. CONCLUSION CND is highly prevalent among pediatric patients with CAS. This suggests that MRI may not be needed to assess for CND in USNHL patients with CAS, as initial CT may provide sufficient information to determine cochlear implant candidacy. We recommend thoughtful shared decision-making with parents of USNHL patients when determining whether to pursue MRI in the setting of a CAS diagnosis.
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Affiliation(s)
- Christina Dorismond
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Miriam R Smetak
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alexandra M Foust
- Department of Radiology, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Asha Sarma
- Department of Radiology, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Frank W Virgin
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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28
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Hu C, Chen G. Learning with privileged knowledge of multiple kernels via joint prediction for CT Kernel conversion. Med Phys 2024. [PMID: 38608647 DOI: 10.1002/mp.17055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Most existing models for CT kernel conversion take images reconstructed with a single predetermined source kernel as input and convert them to images that are reconstructed with a target kernel. However, these models can achieve even better performance if they leverage complementary information obtained from images reconstructed with multiple different kernels. In many clinical practice scenarios, only images with one kernel can be acquired. PURPOSE We propose a privileged knowledge learning framework that learns privileged knowledge of other source kernels available only in the training data (called privileged information) to guide the conversion from a specific single source kernel to the target kernel, via a joint prediction (JP) task. METHODS We construct an ensemble of kernel-specific (KS) tasks where a KS network (KSNet) takes images reconstructed with a specific source kernel as input and converts them to images reconstructed with the target kernel. Then, a JP task is designed to provide extra regularization, which helps each KSNet learn more informative feature representations for kernel conversion, such as detail and structure representations. Meanwhile, we use a cross-shaped window-based attention mechanism in the JP task to highlight the most relevant features to strengthen privileged knowledge learning, thereby alleviating the problems of redundant noise unrelated to images reconstructed with target kernel and inconsistent features that arise from images reconstructed with different kernels. All KSNets can be trained collaboratively by using a JP task to improve the performance of each individual KSNet. RESULTS We extensively evaluate our method on a clinical dataset with scanners from three manufacturers, that is, Siemens, GE and Philips. The experimental results demonstrate that our privileged knowledge learning framework is effective in improving CT kernel conversion. CONCLUSIONS Through both quantitative and qualitative research, our privileged knowledge learning framework improves the kernel conversion results, thereby contributing to the improvement of diagnostic accuracy and the advancement of comparative research in quantitative measurements.
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Affiliation(s)
- Chudi Hu
- The Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, School of Cyber Science and Engineering, Wuhan University, Wuhan, China
| | - Gang Chen
- The Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, School of Cyber Science and Engineering, Wuhan University, Wuhan, China
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29
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Ben-Dov T, Pan L, Gordon AJ, Taufique Z, Kassem F, Rickert S. Postoperative Upper Airway Volume Measurements Among Children With Craniofacial Abnormalities. Otolaryngol Head Neck Surg 2024. [PMID: 38613193 DOI: 10.1002/ohn.773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/09/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To measure postoperative airway volumes among patients with craniofacial abnormalities and compare them to normative values. STUDY DESIGN Retrospective, comparative study. SETTING Academic Medical Center. METHODS Retrospective analysis of imaging of children with craniofacial abnormalities treated at NYU Langone Health from January 2013 to February 2021. Upper airway volumes postcraniofacial surgery were measured using 3D processing software (Dolphin 3D, version 11.95). These values were compared with published normative values. RESULTS Twenty-one subjects were identified and compared to normative values. The postoperative oropharyngeal volumes were on average 43.7% smaller than the normative values (P < .001), and the total upper airway volumes were 31.6% smaller (P = .003). No significant differences were observed in the nasopharyngeal or hypopharyngeal volumes of the study cohort compared to the normative data. Among children ages 12 to 17 years (n = 13), the mean oropharyngeal volumes were 47.6% smaller than normal (P < .001), and the mean total upper airway volumes were 34.6% smaller than normal (P < .001). Among children ages 7 to 11 years (n = 8), the mean oropharyngeal volumes were 35.1% smaller than normal (P = .049), but no difference in mean total upper airway volume was observed. CONCLUSION In children with craniofacial anomalies, postoperative airway volumes remain lower than normative values. However, even a slight increase in airway volume can yield a substantial increase in flow rate. 3D airway evaluations are a valuable tool for surgical planning and analysis and can help with optimizing airway dynamics.
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Affiliation(s)
- Tom Ben-Dov
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Lydia Pan
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Alex J Gordon
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Zahrah Taufique
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Firas Kassem
- Department of Otorhinolaryngology-Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel and School of Medicine, Tel Aviv University, New York, New York, USA
| | - Scott Rickert
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
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Guimbretière G, Sénage T, Boureau AS, Roos JC, Bernard Q, Carlier B, Veziers J, Cueff C, Piriou N, Coste G, Fellah I, Lelarge C, Capoulade R, Jaafar P, Manigold T, Letocart V, Warin-Fresse K, Guérin P, Costa C, Vadori M, Galinañes M, Manez R, Soulillou JP, Cozzi E, Padler-Karavani V, Serfaty JM, Roussel JC, Le Tourneau T. Calcification of surgical aortic bioprostheses and its impact on clinical outcome. Eur Heart J Cardiovasc Imaging 2024:jeae100. [PMID: 38606926 DOI: 10.1093/ehjci/jeae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 02/01/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024] Open
Abstract
AIMS Aortic valve calcification (AVC) of surgical valve bioprostheses (BP) has been poorly explored. We aimed to evaluate in-vivo and ex-vivo BP AVC and its prognosis value. METHODS AND RESULTS Between 2011 and 2019, AVC was assessed using in-vivo computed tomography (CT) in 361 patients who had undergone surgical valve replacement 6.4±4.3 years earlier. Ex-vivo CT scans were performed for 37 explanted BP. The in-vivo CT scans were interpretable for 342 patients (19 patients [5.2%], were excluded). These patients were 77.2±9.1 years old and 64.3% were male. Mean in-vivo AVC was 307±500 Agatston unit (AU). The AVC was 562±570 AU for the 183 (53.5%) patients with structural valve degeneration (SVD) and 13±43 AU for those without SVD (p<0.0001). In-vivo and ex-vivo AVC were strongly correlated (r=0.88, p<0.0001). An in-vivo AVC>100 AU (n=147, 43%) had a specificity of 96% for diagnosing Stage 2-3 SVD (area under the curve=0.92). Patients with AVC>100 AU had a worse outcome compared with those with AVC≤100 AU (n=195). In multivariable analysis, AVC was a predictor of overall mortality (hazard ratio [HR] and 95% confidence interval=1.16[1.04-1.29]; p=0.006), cardiovascular mortality (HR=1.22[1.04-1.43]; p=0.013), cardiovascular events (HR=1.28 [1.16-1.41]; p<0.0001), and re-intervention (HR=1.15 [1.06-1.25]; p<0.0001). After adjustment for Stage 2-3 SVD diagnosis, AVC remained a predictor of overall mortality (HR=1.20 [1.04-1.39]; p=0.015) and cardiovascular events (HR=1.25 [1.09-1.43]; p=0.001). CONCLUSION CT scan is a reliable tool to assess BP leaflet calcification. An AVC>100 AU is tightly associated with SVD and it is a strong predictor of overall mortality and cardiovascular events.
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Affiliation(s)
- Guillaume Guimbretière
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | - Thomas Sénage
- L'institut du thorax, CHU Nantes, Nantes, France
- INSERM UMR 1246 - SPHERE, Nantes University, Tours University, Nantes, France
| | - Anne-Sophie Boureau
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | | | | | | | - Joelle Veziers
- INSERM, UMR 1229, RMeS, CHU Nantes, PHU4 OTONN, UNIV Nantes, Nantes, France
- UFR Odontologie, SC3M Plateform, UMS INSERM 016 - CNRS 3556, SFR François Bonamy, Nantes, France
| | - Caroline Cueff
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | - Nicolas Piriou
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | | | - Imen Fellah
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | | | - Romain Capoulade
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | | | | | | | | | - Patrice Guérin
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | - Cristina Costa
- Infectious Diseases and Transplantation Division, Bellvitge Biomedical Research Institute (IDIBELL) and Bellvitge University Hospital-ICS, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marta Vadori
- Transplant Immunology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Manuel Galinañes
- Department of Cardiac Surgery and Reparative Therapy of the Heart, Vall d'Hebron Research Institute (VHIR), University Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael Manez
- Infectious Diseases and Transplantation Division, Bellvitge Biomedical Research Institute (IDIBELL) and Bellvitge University Hospital-ICS, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jean-Paul Soulillou
- INSERM, UMR 1064, ITUN, CHU Nantes, Nantes, France; UNIV Nantes, Nantes, France
| | - Emanuele Cozzi
- Transplant Immunology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Vered Padler-Karavani
- Department of Cell Research and Immunology, The Shmunis School of Biomedicine and Cancer Research, The George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Jean-Michel Serfaty
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | - Jean-Christian Roussel
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
| | - Thierry Le Tourneau
- L'institut du thorax, CHU Nantes, Nantes, France
- L'institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes, Nantes, France
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Pautasso JJ, Michielsen K, Sechopoulos I. Technical note: Characterization, validation, and spectral optimization of a dedicated breast CT system for contrast-enhanced imaging. Med Phys 2024. [PMID: 38597897 DOI: 10.1002/mp.17069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The development of a new imaging modality, such as 4D dynamic contrast-enhanced dedicated breast CT (4D DCE-bCT), requires optimization of the acquisition technique, particularly within the 2D contrast-enhanced imaging modality. Given the extensive parameter space, cascade-systems analysis is commonly used for such optimization. PURPOSE To implement and validate a parallel-cascaded model for bCT, focusing on optimizing and characterizing system performance in the projection domain to enhance the quality of input data for image reconstruction. METHODS A parallel-cascaded system model of a state-of-the-art bCT system was developed and model predictions of the presampled modulation transfer function (MTF) and the normalized noise power spectrum (NNPS) were compared with empirical data collected in the projection domain. Validation was performed using the default settings of 49 kV with 1.5 mm aluminum filter and at 65 kV and 0.257 mm copper filter. A 10 mm aluminum plate was added to replicate the breast attenuation. Air kerma at the isocenter was measured at different tube current levels. Discrepancies between the measured projection domain metrics and model-predicted values were quantified using percentage error and coefficient of variation (CoV) for MTF and NNPS, respectively. The optimal filtration was for a 5 mm iodine disk detection task at 49, 55, 60, and 65 kV. The detectability index was calculated for the default aluminum filtration and for copper thicknesses ranging from 0.05 to 0.4 mm. RESULTS At 49 kV, MTF errors were +5.1% and -5.1% at 1 and 2 cycles/mm, respectively; NNPS CoV was 5.3% (min = 3.7%; max = 8.5%). At 65 kV, MTF errors were -0.8% and -3.2%; NNPS CoV was 13.1% (min = 11.4%; max = 16.9%). Air kerma output was linear, with 11.67 µGy/mA (R2 = 0.993) and 19.14 µGy/mA (R2 = 0.996) at 49 and 65 kV, respectively. For iodine detection, a 0.25 mm-thick copper filter at 65 kV was found optimal, outperforming the default technique by 90%. CONCLUSION The model accurately predicts bCT system performance, specifically in the projection domain, under varied imaging conditions, potentially contributing to the enhancement of 2D contrast-enhanced imaging in 4D DCE-bCT.
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Affiliation(s)
- Juan J Pautasso
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Koen Michielsen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ioannis Sechopoulos
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
- Dutch Expert Centre for Screening (LRCB), Nijmegen, The Netherlands
- Technical Medical Centre, University of Twente, Enschede, The Netherlands
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Szleper A, Lachowska M, Wojciechowski T, Niemczyk K. Computed tomography multi-planar and 3D image assessment protocol for detailed analysis of inner ear malformations in patients undergoing cochlear implantation counseling. Otolaryngol Pol 2024; 78:35-43. [PMID: 38623860 DOI: 10.5604/01.3001.0054.2567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
<b><br>Introduction:</b> Congenital inner ear malformations resulting from embryogenesis may be visualized in radiological scans. Many attempts have been made to describe and classify the defects of the inner ear based on anatomical and radiological findings.</br> <b><br>Aim:</b> The aim was to propose and discuss computed tomography multi-planar and 3D image assessment protocols for detailed analysis of inner ear malformations in patients undergoing cochlear implantation counseling.</br> <b><br>Material and methods:</b> A retrospective analysis of 22 malformed inner ears. CT scans were analyzed using the Multi-Planar Reconstruction (MPR) option and 3D reconstruction.</br> <b><br>Results:</b> The protocol of image interpretation was developed to allow reproducibility for evaluating each set of images. The following malformations were identified: common cavity, cochlear hypoplasia type II, III, and IV, incomplete partition type II and III, and various combinations of vestibule labyrinth malformations. All anomalies have been presented and highlighted in figures with appropriate descriptions for easier identification. Figures of normal inner ears were also included for comparison. 3D reconstructions for each malformation were presented, adding clinical value to the detailed analysis.</br> <b><br>Conclusions:</b> Properly analyzing CT scans in cochlear implantation counseling is a necessary and beneficial tool for appropriate candidate selection and preparation for surgery. As proposed in this study, the unified scans evaluation scheme simplifies the identification of malformations and reduces the risk of omitting particular anomalies. Multi-planar assessment of scans provides most of the necessary details. The 3D reconstruction technique is valuable in addition to diagnostics influencing the decision-making process. It can minimize the risk of misdiagnosis. Disclosure of the inner ear defect and its precise imaging provides detailed anatomical knowledge of each ear, enabling the selection of the appropriate cochlear implant electrode and the optimal surgical technique.</br>.
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Affiliation(s)
- Agata Szleper
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Poland
| | - Magdalena Lachowska
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland
| | - Tomasz Wojciechowski
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Poland
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Olstad K, Bugge MD, Ytrehus B, Kallerud AS. Closure of the neuro-central synchondrosis and other physes in foal cervical spines. Equine Vet J 2024. [PMID: 38594893 DOI: 10.1111/evj.14093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/14/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND The neuro-central synchondrosis (NCS) is a physis responsible for the growth of the dorsal third of the vertebral body and neural arches. When the NCS of pigs is tethered to model scoliosis, stenosis also ensues. It is necessary to describe the NCS for future evaluation of its potential role in equine spinal cord compression and ataxia (wobbler syndrome). OBJECTIVES To describe the NCS, including when it and other physes closed in computed tomographic (CT) scans of the cervical spine of foals, due to its potential role in vertebral stenosis. STUDY DESIGN Post-mortem cohort study. METHODS The cervical spine of 35 cases, comprising both sexes and miscellaneous breeds from 153 gestational days to 438 days old, was examined with CT and physes scored from 6: fully open to 0: fully closed. The dorsal physis, physis of the dens and mid-NCS were scored separately, whereas the cranial and caudal NCS portions were scored together with the respective cranial and caudal vertebral body physes. RESULTS The NCS was a pair of thin physes located in a predominantly dorsal plane between the vertebral body and neural arches. The mid-NCS was closed in C1 from 115 days of age, and in C2-C7 from 38 days of age. The dorsal physis closed later than the NCS in C1, and earlier than the NCS in C2-C7. The dens physis was closed from 227 days of age. The cranial and caudal physes were closing, but not closed from different ages in the different vertebrae of the oldest cases. MAIN LIMITATIONS Hospital population. CONCLUSIONS The NCS was a thin physis that contributed mainly to height-wise growth, but also width- and length-wise growth of the vertebral body and neural arches. The mid-NCS was closed in all cervical vertebrae from 115 days of age. The NCS warrants further investigation in the pathogenesis of vertebral stenosis.
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Affiliation(s)
- Kristin Olstad
- Department of Companion Animal Clinical Sciences, Equine Section, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Mari Dahl Bugge
- Department of Companion Animal Clinical Sciences, Equine Section, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Bjørnar Ytrehus
- Department of Biomedical Science and Veterinary Public Health, Pathology Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anne Selvén Kallerud
- Department of Companion Animal Clinical Sciences, Equine Section, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
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Tan S, Di Loreto M, Melsom S, Jefferies R, Padgham C, Boardman G, Saffar B. Post-CT-guided lung biopsy optimisation of the observation period by identifying patients at risk of delayed pneumothorax. J Med Imaging Radiat Oncol 2024. [PMID: 38591166 DOI: 10.1111/1754-9485.13646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Identify the risk factors for delayed pneumothorax after lung biopsy. METHODS A retrospective study of 355 CT-guided lung biopsies was performed at Fiona Stanley Hospital, Western Australia over 42 months. A comprehensive range of patient, lesion and procedural variables were recorded. All post-procedural complications including time, size of pneumothorax and post-biopsy radiographs were reviewed. Lasso logistic regression model was utilised to determine factors predicting patient complications. RESULTS A total of 167 patients (47%) developed a pneumothorax, in which 34% were significant, requiring longer observation or drain insertion. The majority of pneumothoraces occurred within the first hour (86%), with 90% detected at the time of the procedure. Then, 12% were detected more than 3 h post-procedure, of which 8 patients (5%) had a significant delayed pneumothorax. Factors increasing the likelihood of significant pneumothorax include the length of lung traversed, smaller nodule size, surrounding emphysema, increased age and lateral patient position with the lesion in the non-dependent aspect. Increasing patient age, longer length of lung traversed and smaller nodule diameter increase the risk of delayed onset of pneumothorax (more than 3 h). CONCLUSION The results of this study align with other studies indicating it is safe to discharge stable patients within an hour post-lung biopsy. However, specific risk factors, including age, small lesion size and deep lesions, may identify patients who could benefit from a longer observation period.
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Affiliation(s)
- Samantha Tan
- Medical Imaging Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Murray Di Loreto
- Medical Imaging Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Stephen Melsom
- Medical Imaging Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Reece Jefferies
- Department of Respiratory Medicine, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Christopher Padgham
- Department of Respiratory Medicine, Logan Hospital, QLD Health, Meadowbrook, Queensland, Australia
| | - Glenn Boardman
- South Metropolitan Health Service, Perth, Western Australia, Australia
| | - Bann Saffar
- Medical Imaging Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
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Jaber JR, Morales Bordon D, Arencibia A, Corbera JA, Conde-Felipe M, Ayala MD, Encinoso M. Correlation between Cross-Sectional Anatomy and Computed Tomography of the Normal Six-Banded Armadillo ( Euphractus sexcintus) Nasal Cavity and Paranasal Sinuses. Animals (Basel) 2024; 14:1135. [PMID: 38612374 PMCID: PMC11011167 DOI: 10.3390/ani14071135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
This research aimed to study the rostral part of the head of the six-banded armadillo, applying advanced imaging techniques such as CT. Furthermore, by combining the images obtained through this technique with anatomical cross-sections, an adequate description of the structures that constitute the rostral part of the head of this species is presented. This anatomical information could provide a valuable diagnostic tool for the clinical evaluation of different disorders in the six-banded armadillo's nasal cavity and paranasal sinuses.
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Affiliation(s)
- José Raduan Jaber
- Departamento de Morfología, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain;
| | - Daniel Morales Bordon
- Departamento de Patología Animal, Producción Animal, Bromatología y Tecnología de Los Alimentos, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain (M.C.-F.)
| | - Alberto Arencibia
- Departamento de Morfología, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain;
| | - Juan Alberto Corbera
- Departamento de Patología Animal, Producción Animal, Bromatología y Tecnología de Los Alimentos, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain (M.C.-F.)
- Hospital Veterinario, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain;
| | - Magnolia Conde-Felipe
- Departamento de Patología Animal, Producción Animal, Bromatología y Tecnología de Los Alimentos, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain (M.C.-F.)
| | - Maria Dolores Ayala
- Departamento de Anatomía y Anatomía Patológica Comparadas, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain
| | - Mario Encinoso
- Hospital Veterinario, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain;
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Ertürk ŞM, Toprak T, Cömert RG, Candemir C, Cingöz E, Akyol Sari ZN, Ercan CC, Düvek E, Ersoy B, Karapinar E, Tunaci A, Selver MA. Thorax computed tomography (CTX) guided ground truth annotation of CHEST radiographs (CXR) for improved classification and detection of COVID-19. Int J Numer Method Biomed Eng 2024:e3823. [PMID: 38587026 DOI: 10.1002/cnm.3823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/20/2023] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
Several data sets have been collected and various artificial intelligence models have been developed for COVID-19 classification and detection from both chest radiography (CXR) and thorax computed tomography (CTX) images. However, the pitfalls and shortcomings of these systems significantly limit their clinical use. In this respect, improving the weaknesses of advanced models can be very effective besides developing new ones. The inability to diagnose ground-glass opacities by conventional CXR has limited the use of this modality in the diagnostic work-up of COVID-19. In our study, we investigated whether we could increase the diagnostic efficiency by collecting a novel CXR data set, which contains pneumonic regions that are not visible to the experts and can only be annotated under CTX guidance. We develop an ensemble methodology of well-established deep CXR models for this new data set and develop a machine learning-based non-maximum suppression strategy to boost the performance for challenging CXR images. CTX and CXR images of 379 patients who applied to our hospital with suspected COVID-19 were evaluated with consensus by seven radiologists. Among these, CXR images of 161 patients who also have had a CTX examination on the same day or until the day before or after and whose CTX findings are compatible with COVID-19 pneumonia, are selected for annotating. CTX images are arranged in the main section passing through the anterior, middle, and posterior according to the sagittal plane with the reformed maximum intensity projection (MIP) method in the coronal plane. Based on the analysis of coronal MIP reconstructed CTX images, the regions corresponding to the pneumonia foci are annotated manually in CXR images. Radiologically classified posterior to anterior (PA) CXR of 218 patients with negative thorax CTX imaging were classified as COVID-19 pneumonia negative group. Accordingly, we have collected a new data set using anonymized CXR (JPEG) and CT (DICOM) images, where the PA CXRs contain pneumonic regions that are hidden or not easily recognized and annotated under CTX guidance. The reference finding was the presence of pneumonic infiltration consistent with COVID-19 on chest CTX examination. COVID-Net, a specially designed convolutional neural network, was used to detect cases of COVID-19 among CXRs. Diagnostic performances were evaluated by ROC analysis by applying six COVID-Net variants (COVIDNet-CXR3-A, -B, -C/COVIDNet-CXR4-A, -B, -C) to the defined data set and combining these models in various ways via ensemble strategies. Finally, a convex optimization strategy is carried out to find the outperforming weighted ensemble of individual models. The mean age of 161 patients with pneumonia was 49.31 ± 15.12, and the median age was 48 years. The mean age of 218 patients without signs of pneumonia in thorax CTX examination was 40.04 ± 14.46, and the median was 38. When working with different combinations of COVID-Net's six variants, the area under the curve (AUC) using the ensemble COVID-Net CXR 4A-4B-3C was .78, sensitivity 67%, specificity 95%; COVID-Net CXR 4a-3b-3c was .79, sensitivity 69% and specificity 94%. When diverse and complementary COVID-Net models are used together through an ensemble, it has been determined that the AUC values are close to other studies, and the specificity is significantly higher than other studies in the literature.
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Affiliation(s)
- Şükrü Mehmet Ertürk
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tuğçe Toprak
- Institute of Natural and Applied Sciences, Dokuz Eylul University, İzmir, Turkey
| | - Rana Günöz Cömert
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Cemre Candemir
- International Computer Institute, Ege University, Bornova, Turkey
| | - Eda Cingöz
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Nur Akyol Sari
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Celal Caner Ercan
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Esin Düvek
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Berke Ersoy
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Edanur Karapinar
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Atadan Tunaci
- Radiodiagnostics Department, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - M Alper Selver
- Electrical and Electronics Engineering Department, Dokuz Eylul University, Faculty of Engineering, İzmir, Turkey
- Izmir Health Technologies Development and Accelerator (BioIzmir), Dokuz Eylul University, İzmir, Turkey
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Kim YR, Yoon YS, Cha JG. Opportunistic Screening for Acute Vertebral Fractures on a Routine Abdominal or Chest Computed Tomography Scans Using an Automated Deep Learning Model. Diagnostics (Basel) 2024; 14:781. [PMID: 38611694 PMCID: PMC11011775 DOI: 10.3390/diagnostics14070781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 03/31/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVES To develop an opportunistic screening model based on a deep learning algorithm to detect recent vertebral fractures in abdominal or chest CTs. MATERIALS AND METHODS A total of 1309 coronal reformatted images (504 with a recent fracture from 119 patients, and 805 without fracture from 115 patients), from torso CTs, performed from September 2018 to April 2022, on patients who also had a spine MRI within two months, were included. Two readers participated in image selection and manually labeled the fractured segment on each selected image with Neuro-T (version 2.3.3; Neurocle Inc.) software. We split the images randomly into the training and internal test set (labeled: unlabeled = 480:700) and the secondary interval validation set (24:105). For the observer study, three radiologists reviewed the CT images in the external test set with and without deep learning assistance and scored the likelihood of an acute fracture in each image independently. RESULTS For the training and internal test sets, the AI achieved a 99.86% test accuracy, 91.22% precision, and 89.18% F1 score for detection of recent fracture. Then, in the secondary internal validation set, it achieved 99.90%, 74.93%, and 78.30%, respectively. In the observer study, with the assistance of the deep learning algorithm, a significant improvement was observed in the radiology resident's accuracy, from 92.79% to 98.2% (p = 0.04). CONCLUSION The model showed a high level of accuracy in the test set and also the internal validation set. If this algorithm is applied opportunistically to daily torso CT evaluation, it will be helpful for the early detection of fractures that require treatment.
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Affiliation(s)
- Ye Rin Kim
- Department of Radiology, College of Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Bucheon 14584, Republic of Korea
| | - Yu Sung Yoon
- Department of Radiology, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jang Gyu Cha
- Department of Radiology, College of Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Bucheon 14584, Republic of Korea
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Zhuang YY, Feng Y, Kong D, Guo LL. Discrimination between benign and malignant gallbladder lesions on enhanced CT imaging using radiomics. Acta Radiol 2024:2841851241242042. [PMID: 38584372 DOI: 10.1177/02841851241242042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND Gallbladder cancer is a rare but aggressive malignancy that is often diagnosed at an advanced stage and is associated with poor outcomes. PURPOSE To develop a radiomics model to discriminate between benign and malignant gallbladder lesions using enhanced computed tomography (CT) imaging. MATERIAL AND METHODS All patients had a preoperative contrast-enhanced CT scan, which was independently analyzed by two radiologists. Regions of interest were manually delineated on portal venous phase images, and radiomics features were extracted. Feature selection was performed using mRMR and LASSO methods. The patients were randomly divided into training and test groups at a ratio of 7:3. Clinical and radiomics parameters were identified in the training group, three models were constructed, and the models' prediction accuracy and ability were evaluated using AUC and calibration curves. RESULTS In the training group, the AUCs of the clinical model and radiomics model were 0.914 and 0.968, and that of the nomogram model was 0.980, respectively. There were statistically significant differences in diagnostic accuracy between nomograms and radiomics features (P <0.05). There was no significant difference in diagnostic accuracy between the nomograms and clinical features (P >0.05) or between the clinical features and radiomics features (P >0.05). In the testing group, the AUC of the clinical model and radiomics model were 0.904 and 0.941, and that of the nomogram model was 0.948, respectively. There was no significant difference in diagnostic accuracy between the three groups (P >0.05). CONCLUSION It was suggested that radiomics analysis using enhanced CT imaging can effectively discriminate between benign and malignant gallbladder lesions.
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Affiliation(s)
- Ying-Ying Zhuang
- Departments of Imaging, The Affiliated Huai'an No 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, PR China
| | - Yun Feng
- Departments of Imaging, The Affiliated Huai'an No 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, PR China
| | - Dan Kong
- Departments of Imaging, The Affiliated Huai'an No 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, PR China
| | - Li-Li Guo
- Departments of Imaging, The Affiliated Huai'an No 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, PR China
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Chelales E, von Windheim K, Banipal AS, Siebeneck E, Benham C, Nief CA, Crouch B, Everitt JI, Sag AA, Katz DF, Ramanujam N. Determining the Relationship between Delivery Parameters and Ablation Distribution for Novel Gel Ethanol Percutaneous Therapy in Ex Vivo Swine Liver. Polymers (Basel) 2024; 16:997. [PMID: 38611255 PMCID: PMC11013462 DOI: 10.3390/polym16070997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/22/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Ethyl cellulose-ethanol (ECE) is emerging as a promising formulation for ablative injections, with more controllable injection distributions than those from traditional liquid ethanol. This study evaluates the influence of salient injection parameters on forces needed for infusion, depot volume, retention, and shape in a large animal model relevant to human applications. Experiments were conducted to investigate how infusion volume (0.5 mL to 2.5 mL), ECE concentration (6% or 12%), needle gauge (22 G or 27 G), and infusion rate (10 mL/h) impacted the force of infusion into air using a load cell. These parameters, with the addition of manual infusion, were investigated to elucidate their influence on depot volume, retention, and shape (aspect ratio), measured using CT imaging, in an ex vivo swine liver model. Force during injection increased significantly for 12% compared to 6% ECE and for 27 G needles compared to 22 G. Force variability increased with higher ECE concentration and smaller needle diameter. As infusion volume increased, 12% ECE achieved superior depot volume compared to 6% ECE. For all infusion volumes, 12% ECE achieved superior retention compared to 6% ECE. Needle gauge and infusion rate had little influence on the observed depot volume or retention; however, the smaller needles resulted in higher variability in depot shape for 12% ECE. These results help us understand the multivariate nature of injection performance, informing injection protocol designs for ablations using gel ethanol and infusion, with volumes relevant to human applications.
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Affiliation(s)
- Erika Chelales
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Katriana von Windheim
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Arshbir Singh Banipal
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Elizabeth Siebeneck
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Claire Benham
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Corrine A. Nief
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Brian Crouch
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Jeffrey I. Everitt
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Alan Alper Sag
- Department of Radiology, Division of Vascular and Interventional Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - David F. Katz
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
| | - Nirmala Ramanujam
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; (K.v.W.); (A.S.B.); (C.A.N.)
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Min HK, Kim SH, Lee SH, Kim HR, Lee SH. Costotransverse joint ankylosis and their association with syndesmophyte progression in patients with radiographic axial spondyloarthritis. Ther Adv Musculoskelet Dis 2024; 16:1759720X241242852. [PMID: 38585281 PMCID: PMC10998487 DOI: 10.1177/1759720x241242852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Background Abnormal new bone formation can occur not only in the vertebral body but also can occur in facet, costovertebral, and costotransverse joints in radiographic axial spondyloarthritis (r-axSpA) patients. Little is known about the association between syndesmophyte progression and paravertebral joint ankylosis in r-axSpA. Objectives Costotransverse joint ankylosis in r-axSpA patients was measured. Furthermore, the association between syndesmophyte progression for 2 years assessed by computed tomography syndesmophyte score (CTSS) and facet, costovertebral, and costotransverse joints ankylosis were evaluated. Design Single-center, prospective, cohort study. Methods Whole spine CT images taken at baseline and 2-year follow-up were used to calculate the CTSS of the vertebral body. In addition, ankylosis of the facet/costovertebral/costotransverse joints was scored. CTSS (range, 0-552) and facet joint ankylosis (range, 0-46) were assessed at 23 vertebral units. Costovertebral joints at T1-T12 (range, 0-48) and costotransverse joints at T1-T10 (range, 0-20) were also assessed by independent two readers. Intraclass correlation coefficients (ICC) were calculated to determine inter-reader reliability. Odds ratios (OR) were calculated to identify the associations between syndesmophyte progression and the baseline status of facet, costovertebral, and costotransverse joints. Results In all, 50 patients with r-axSpA were included. Readers 1 and 2 identified C7-T3 (facet joints), T5-T7 and T12 (costovertebral joints), and T8-T9 (costotransverse joints), as common sites of ankylosis at baseline and at 2-year follow-up. The ICCs for the facet, costovertebral, and costotransverse joints at baseline were 0.876, 0.952, and 0.753, respectively. OR of baseline costovertebral and costotransverse joint ankylosis for predicting syndesmophyte progression of the vertebral body was 4.644 [95% confidence interval (CI), 2.295-9.398] and 1.524 (95% CI, 1.036-2.244), respectively. Conclusion Costotransverse joint ankylosis in r-axSpA patients can be measured semi-quantitatively on whole spine CT, and ankylosis of the costotransverse and costovertebral joints predicts the progression of syndesmophytes.Trial registration: Not applicable.
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Affiliation(s)
- Hong Ki Min
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Se Hee Kim
- Division of Rheumatology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Heon Lee
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Sang-Hoon Lee
- Division of Rheumatology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Republic of Korea
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Han AL, Lee HK, Shin SR. Diagnostic Performance of Insulin Resistance Indices for Identifying Metabolic Dysfunction-Associated Fatty Liver Disease. Metab Syndr Relat Disord 2024. [PMID: 38574322 DOI: 10.1089/met.2023.0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background/objectives: Insulin resistance (IR) plays an important role in metabolic dysfunction-associated fatty liver disease (MAFLD) pathogenesis. A modified triglyceride-glucose (TyG) index, including TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC), has been introduced to represent IR. This study aimed to investigate the diagnostic abilities of IR indices in MAFLD, in which fatty liver was diagnosed using computed tomography (CT). Subjects/methods: We retrospectively analyzed the clinical data and images of 852 adults aged ≥19 years who underwent abdominal CT. MAFLD was diagnosed based on the appearance of fatty liver on CT alongside at least one of the following three criteria: being overweight or obese, at least two metabolic risk abnormalities, and/or diabetes mellitus. IR indices were calculated by examining the following variables: homeostasis model assessment-IR, TyG index, TyG-BMI, TyG-WC, and visceral adiposity index. The diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve. Results: For all patients, the area under the curve (AUC) of the TyG index, TyG-BMI, and TyG-WC were 0.834, 0.938, and 0.942, respectively. In men, the AUC of the TyG index, TyG-BMI, and TyG-WC were 0.812, 0.928, and 0.934, respectively. In women, the AUC of the TyG index was 0.841, and TyG-BMI and TyG-WC were 0.940 and 0.953, respectively. The AUC values tended to increase in the following order: TyG index < TyG-BMI < TyG-WC. Women showed a higher AUC than men in all items, and the TyG-WC of women showed the highest value with AUC 0.953 (95% confidence interval [CI]: 0.892-1.000, P < 0.0001). The AUC of the TyG index was 0.858 (95% CI: 0.828-0.888, P < 0.0001). Conclusions: In conclusion, TyG-WC is a powerful surrogate marker for identifying MAFLD in clinical settings.
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Affiliation(s)
- A Lum Han
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Hee Kyung Lee
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Sae Ron Shin
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
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Björnson M, Svensson AM, He C, Sköld M, Nyrén S, Nygren-Bonnier M, Bruchfeld J, Runold M, Jalde FC, Kistner A. Residual radiological opacities correlate with disease outcomes in ICU-treated COVID-19. Front Med (Lausanne) 2024; 11:1263511. [PMID: 38633311 PMCID: PMC11021575 DOI: 10.3389/fmed.2024.1263511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/07/2024] [Indexed: 04/19/2024] Open
Abstract
Background Few studies consider both radiological and functional outcomes in COVID-19 survivors treated in the intensive care unit (ICU). We investigated clinical findings and pulmonary abnormalities on chest computed tomography (CT) and compared outcomes of severe versus mild-moderate acute respiratory distress syndrome (ARDS) on long-term follow-up. Methods This longitudinal cohort study included 118 COVID-19 patients (median age, 58 years; 79% men). Thoracic CT scans were performed 4, 10, and 22 months after hospital discharge. Two independent blinded radiologists analyzed the 10 months scans and scored the radiology findings semi-quantitatively, as no/minor versus widespread opacities [low-radiology opacity grade (ROG) versus high-ROG]. ARDS severity was based on the PaO2/FiO2 ratio. The 6 min walk test (6MWT) was performed after 3 and 9 months, and lung diffusion capacity for carbon monoxide (DLCO) and lung volume measurement after 9 and 15 months. Dynamic spirometry was done at all time points. Residual symptoms and health-related quality-of-life (HRQL) were evaluated using validated questionnaires. Results At 10 months, most patients (81/118; 69%) were classified as high-ROG, of which 70% had severe ARDS during hospitalisation; 69% of those with mild-moderate ARDS also had high-ROG. Patients with high-ROG had longer ICU stay and lower PaO2/FiO2 during hospitalisation (p < 0.01). At 9 months follow-up, patients with high-ROG had smaller lung volumes as % of predicted values [mean (±CI): 80 (77-84) vs. 93 (88-98) (p < 0.001)], lower DLCO as % of predicted values [74 (70-78) vs. 87 (82-92) (p < 0.001)], lower oxygen saturation during 6MWT (p = 0.02), and a tendency to more severe dyspnoea (p = 0.07), but no difference was found in HRQL compared with no/minor ROG (p = 0.92). A higher opacity score was related to lower DLCO at follow-up (r = -0.48, p < 0.001, Spearman rank test). Severe ARDS patients had slightly more severe fatigue at 9 months compared to mild-moderate, but no differences in dyspnoea or lung function at follow-up. Fibrotic-like changes were found in 93% of patients examined with CT scans at 2 years (55/118; 47%). Severe ARDS could predict widespread opacities (ROG > 25%) in most patients at follow-up at 10 months (AUC 0.74). Conclusion Residual radiological abnormalities in ICU-treated COVID-19 patients, evaluated for up to 2 years, relate to persisting symptoms and impaired lung function, demanding careful follow-up regardless of ARDS severity at hospitalisation.
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Affiliation(s)
- Mikael Björnson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Solna, Division of Infection Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Ann Mari Svensson
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia He
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Sköld
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sven Nyrén
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Malin Nygren-Bonnier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Women’s Health and Allied Health Professionals Theme, Medical Unit Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
| | - Judith Bruchfeld
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Solna, Division of Infection Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Michael Runold
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Francesca Campoccia Jalde
- Department of Cardiothoracic Surgery and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anna Kistner
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
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Richardson C, Cromer M, Tatem L, Wade R, Russell D. Polymicrobial Purulent Pericarditis From a Pancreatico-Pericardial Fistula. JACC Case Rep 2024; 29:102288. [PMID: 38465285 PMCID: PMC10918555 DOI: 10.1016/j.jaccas.2024.102288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/05/2024] [Accepted: 02/15/2024] [Indexed: 03/12/2024]
Abstract
A 54-year-old male with chronic pancreatitis presented with dyspnea. Computed tomography scans demonstrated a subdiaphragmatic fluid collection with pericardial fistulization. Pericardial fluid cultures were polymicrobial in nature. Purulent pericarditis is rare but carries a high mortality rate. We present the first documented case of pancreatico-pericardial fistulization causing purulent pericarditis.
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Affiliation(s)
- Christopher Richardson
- Division of Pulmonary, Allergy, & Critical Care Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mark Cromer
- Division of Internal Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Luis Tatem
- Division of Pulmonary, Allergy, & Critical Care Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Raymond Wade
- Division of Pulmonary, Allergy, & Critical Care Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Derek Russell
- Division of Pulmonary, Allergy, & Critical Care Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Tahara T, Usui E, Hada M, Ueno H, Kakuta T. Multimodality Imaging of Fabry Disease Cardiomyopathy Complicated With Coronary Vasospasm. JACC Case Rep 2024; 29:102257. [PMID: 38645294 PMCID: PMC11031653 DOI: 10.1016/j.jaccas.2024.102257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/29/2023] [Accepted: 01/23/2024] [Indexed: 04/23/2024]
Abstract
A 41-year-old man with resting angina was diagnosed with a coronary vasospasm and subsequently with Fabry disease exhibiting low serum α-galactosidase A activity. High computed tomography (CT)-derived extracellular volume was detected in the apical inferior wall of the left ventricle suggesting myocardial fibrosis, potentially from vasospasm-related ischemia and/or microvascular dysfunction.
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Affiliation(s)
- Tomohiro Tahara
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tokyo, Japan
| | - Eisuke Usui
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tokyo, Japan
| | - Masahiro Hada
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tokyo, Japan
| | - Hiroki Ueno
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tokyo, Japan
| | - Tsunekazu Kakuta
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tokyo, Japan
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Frittitta V, Costa G, Cannizzaro MT, Inserra C, Garretto V, Dipietro E, Strazzieri O, Motta S, Barbanti M, Tamburino C. Late Third Transcatheter Aortic Valve Replacement for Treatment of Persistent Paravalvular Regurgitation. JACC Case Rep 2024; 29:102259. [PMID: 38645284 PMCID: PMC11031654 DOI: 10.1016/j.jaccas.2024.102259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 04/23/2024]
Abstract
Paravalvular regurgitation remains a frequent finding after transcatheter aortic valve replacement and is associated with unfavorable outcomes if more-than-mild grade. In this case, a patient underwent a third transcatheter aortic valve replacement procedure for worsening symptoms due to severe paravalvular regurgitation. The case underlines the role of preprocedural planning in achieving treatment success.
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Affiliation(s)
- Valentina Frittitta
- Division of Cardiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Giuliano Costa
- Division of Cardiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
| | | | - Cristina Inserra
- Division of Radiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Valeria Garretto
- Division of Radiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Elena Dipietro
- Division of Cardiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Orazio Strazzieri
- Division of Cardiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Silvia Motta
- Division of Cardiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
| | | | - Corrado Tamburino
- Division of Cardiology, AOU Policlinico G. Rodolico-San Marco, Catania, Italy
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Rawashdeh M, Kashabash D, Kumar P, Saade C. The Diverse Utility of Contrast Media Delivery and Dosing During Computed Tomography: An International Assessment of Knowledge and Practices. Curr Radiopharm 2024; 17:CRP-EPUB-139528. [PMID: 38571349 DOI: 10.2174/0118744710293946240325051232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Despite the escalated production rate, the Iodinated Contrast Media (ICM) shortage continues, and demand outweighs supply. AIM The aim of this study is to investigate the knowledge and practice of ICM delivery in computed tomography (CT) among radiographers and radiologic technologists worldwide. METHODS An IRB-approved cross-sectional survey used Google Forms for data collection. It involved 94 CT radiographers from 27 countries and was divided into five sections. The first section gathered demographic information, followed by sections on experience, self-assessment of ICM reactions, and delivery technique. The third section explored ICM knowledge and its relation to CT parameters. The fourth and fifth sections focus on practices during pulmonary angiography CT and renal CT scans. Data analysis involved descriptive statistics, the Chi- Square test, and ANOVA. RESULTS Knowledge was assessed with seven questions, and a score of at least 3.5 was needed for categorization. The median score was two, indicating low knowledge. Specifically, 64.9% of the participants scored lower than the two scores. Years of experience are strongly correlated with the level of knowledge, with 51.6% of radiographers having more than 10 years of experience demonstrating adequate knowledge. 41.7% of respondents demonstrated adequate knowledge when their duty was focused on CT. Furthermore, wide practice variability exists in all CT pulmonary angiography protocols among radiographers with adequate and inadequate knowledge. CONCLUSION Inexperienced individuals showed knowledge gaps, leading to varied practices and highlighting the need for educational programs. The study underscores establishing standardized Protocols and Practice Guidelines (PPGs) for contrast media administration in Radiology Departments. Additionally, it emphasizes the importance of regular training programs, and international knowledge sharing. The potential for self-selection bias in the online survey sample is highlighted.
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Affiliation(s)
- Mohammad Rawashdeh
- Department of Medical Imaging, Faculty of Health Sciences, Gulf Medical University, Ajman, UAE
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Daniah Kashabash
- Department of Medical Imaging, Faculty of Health Sciences, Gulf Medical University, Ajman, UAE
| | - Praveen Kumar
- Department of Physiotherapy, Faculty of Health Sciences, Gulf Medical University, Ajman, UAE
| | - Charbel Saade
- Discipline of Medical Imaging & Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland
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Panzer S, Paladin A, Zesch S, Rosendahl W, Augat P, Thompson RC, Miyamoto MI, Sutherland ML, Allam AH, Wann LS, Sutherland JD, Rowan CJ, Michalik DE, Hergan K, Zink AR. Preservation of the heart in ancient Egyptian mummies: A computed tomography investigation with focus on the myocardium. Clin Anat 2024. [PMID: 38566474 DOI: 10.1002/ca.24151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/02/2024] [Accepted: 02/22/2024] [Indexed: 04/04/2024]
Abstract
The ancient Egyptians considered the heart to be the most important organ. The belief that the heart remained in the body is widespread in the archeological and paleopathological literature. The purpose of this study was to perform an overview of the preserved intrathoracic structures and thoracic and abdominal cavity filling, and to determine the prevalence and computed tomography (CT) characteristics of the myocardium in the preserved hearts of ancient Egyptian mummies. Whole-body CT examinations of 45 ancient Egyptian mummies (23 mummies from the Ägyptisches Museum und Papyrussammlung, Berlin, Germany, and 22 mummies from the Museo Egizio, Turin, Italy) were systematically assessed for preserved intrathoracic soft tissues including various anatomical components of the heart (pericardium, interventricular septum, four chambers, myocardium, valves). Additionally, evidence of evisceration and cavity filling was documented. In cases with identifiable myocardium, quantitative (measurements of thickness and density) and qualitative (description of the structure) assessment of the myocardial tissue was carried out. Heart structure was identified in 28 mummies (62%). In 33 mummies, CT findings demonstrated evisceration, with subsequent cavity filling in all but one case. Preserved myocardium was identified in nine mummies (five male, four female) as a mostly homogeneous, shrunken structure. The posterior wall of the myocardium had a mean maximum thickness of 3.6 mm (range 1.4-6.6 mm) and a mean minimum thickness of 1.0 mm (range 0.5-1.7 mm). The mean Hounsfield units (HU) of the myocardium at the posterior wall was 61 (range, 185-305). There was a strong correlation between the HU of the posterior wall of the myocardium and the mean HU of the muscles at the dorsal humerus (R = 0.77; p = 0.02). In two cases, there were postmortem changes in the myocardium, most probably due to insect infestation. To our knowledge, this is the first study to investigate the myocardium systematically on CT scans of ancient Egyptian mummies. Strong correlations between the densities of the myocardium and skeletal muscle indicated similar postmortem changes of the respective musculature during the mummification process within individual mummies. The distinct postmortem shrinking of the myocardium and the collapse of the left ventriclular cavity in several cases did not allow for paleopathological diagnoses such as myocardial scarring.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany
- Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany and Paracelsus Medical University, Salzburg, Austria
| | - Alice Paladin
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | | | | | - Peter Augat
- Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany and Paracelsus Medical University, Salzburg, Austria
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Michael I Miyamoto
- Division of Cardiology, Mission Heritage Medical Group, Providence Health, Mission Viejo, California, USA
| | - M Linda Sutherland
- Division of Cardiovascular Diseases, MemorialCare Health System, Laguna Hills, California, USA
| | - Adel H Allam
- Department of Cardiology, Al Azhar University, Cairo, Egypt
| | - L Samuel Wann
- Division of Cardiology, University of New Mexico, Albuquerque, New Mexico, USA
| | - James D Sutherland
- Division of Cardiovascular Diseases, MemorialCare Health System, Laguna Hills, California, USA
| | - Chris J Rowan
- Division of Cardiovascular Diseases, University of Nevada, Reno, Reno, Nevada, USA
| | - David E Michalik
- Department of Pediatrics, Irvine School of Medicine, University of California, Orange, California, USA
| | - Klaus Hergan
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Albert R Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
- Department of Biology II, Anthropology, Ludwig-Maximilians University Munich, Munich, Germany
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Trigui A, Toumi N, Fendri S, Saumtally MS, Zribi I, Akrout A, Mzali R, Ketata S, Dziri C, Amar MB, Boujelbene S. Cystic Echinococcosis of the Liver: Correlation Between Intra-Operative Ultrasound and Pre-Operative Imaging. Surg Infect (Larchmt) 2024; 25:213-220. [PMID: 38483340 DOI: 10.1089/sur.2023.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Background: Imaging plays an essential role in the management of hepatic hydatid cysts (HCE). The objective of our study was to determine the correlation between pre-operative ultrasound, computed tomography (CT), and intra-operative ultrasound (IOUS) in studying the characteristics and complications of HCE. Patients and Methods: This was a prospective, descriptive, and analytical study conducted in the General Surgery Department of Habib Bourguiba Hospital in Sfax. The study included patients with HCE who underwent conservative surgery between April 2017 and June 2022. Results: We enrolled 49 patients with 94 cysts. At the end of our study, IOUS allowed for better detection of HCE (98.8%) regardless of the number of cysts per patient. IOUS and CT were accurate in studying the location of cysts (κ = 1), whereas pre-operative abdominal ultrasound was less efficient (κ = 0.870). IOUS was the best examination for detecting exocysts (κ = 0.961), studying daughter cysts (κ = 0.823), and exploring vascular relations, but it was less effective (κ = 0.523) in detecting calcifications. Regarding classifications, ultrasound and CT had similar results. However, IOUS was most reliable in differentiating between CE3b and CE4 types (κ = 0.653). Ultrasound, CT, and IOUS were not sensitive in detecting latent HCE suppurations and cystobiliary fistulas. Conclusions: Performing IOUS is essential to prevent recurrences and reduce post-operative morbidity.
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Affiliation(s)
- Aymen Trigui
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Nozha Toumi
- Department of Radiology, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Sami Fendri
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mohammad Saad Saumtally
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Imen Zribi
- Department of General and Digestive Surgery, Hopital Regional Mahres, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Amira Akrout
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Rafik Mzali
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Salma Ketata
- Department of Anesthesiology, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Chadli Dziri
- University of Tunis El Manar, General Surgery; Honoris Medical Simulation Center, Tunisia
| | - Mohamed Ben Amar
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Salah Boujelbene
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
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Varghese BA, Cen SY, Jensen K, Levy J, Andersen HK, Schulz A, Lei X, Duddalwar VA, Goodenough DJ. Investigating the role of imaging factors in the variability of CT-based texture analysis metrics. J Appl Clin Med Phys 2024; 25:e14192. [PMID: 37962032 PMCID: PMC11005980 DOI: 10.1002/acm2.14192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/02/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE This study assesses the robustness of first-order radiomic texture features namely interquartile range (IQR), coefficient of variation (CV) and standard deviation (SD) derived from computed tomography (CT) images by varying dose, reconstruction algorithms and slice thickness using scans of a uniform water phantom, a commercial anthropomorphic liver phantom, and a human liver in-vivo. MATERIALS AND METHODS Scans were acquired on a 16 cm detector GE Revolution Apex Edition CT scanner with variations across three different nominal slice thicknesses: 0.625, 1.25, and 2.5 mm, three different dose levels: CTDIvol of 13.86 mGy for the standard dose, 40% reduced dose and 60% reduced dose and two different reconstruction algorithms: a deep learning image reconstruction (DLIR-high) algorithm and a hybrid iterative reconstruction (IR) algorithm ASiR-V50% (AV50) were explored, varying one at a time. To assess the effect of non-linear modifications of images by AV50 and DLIR-high, images of the water phantom were also reconstructed using filtered back projection (FBP). Quantitative measures of IQR, CV and SD were extracted from twelve pre-selected, circular (1 cm diameter) regions of interest (ROIs) capturing different texture patterns across all scans. RESULTS Across all scans, imaging, and reconstruction settings, CV, IQR and SD were observed to increase with reduction in dose and slice thickness. An exception to this observation was found when using FBP reconstruction. Lower values of CV, IQR and SD were observed in DLIR-high reconstructions compared to AV50 and FBP. The Poisson statistics were more stringently noted in FBP than DLIR-high and AV50, due to the non-linear nature of the latter two algorithms. CONCLUSION Variation in image noise due to dose reduction algorithms, tube current, and slice thickness show a consistent trend across phantom and patient scans. Prospective evaluation across multiple centers, scanners and imaging protocols is needed for establishing quality assurance standards of radiomics.
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Affiliation(s)
- Bino Abel Varghese
- Keck Medical CenterDepartment of RadiologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Steven Yong Cen
- Keck Medical CenterDepartment of RadiologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kristin Jensen
- Department of Physics and Computational RadiologyOsloNorway
| | | | | | - Anselm Schulz
- Department of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
| | - Xiaomeng Lei
- Keck Medical CenterDepartment of RadiologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Vinay Anant Duddalwar
- Keck Medical CenterDepartment of RadiologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - David John Goodenough
- Department of RadiologyGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
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Sakai H, Hasegawa I, Tsuzaki J, Okamoto S, Kurata T. Venous Malformation in the Anterior Mediastinum. Cureus 2024; 16:e58581. [PMID: 38644948 PMCID: PMC11031365 DOI: 10.7759/cureus.58581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 04/23/2024] Open
Abstract
Venous malformations (VMs) located in the anterior mediastinum are rare. Thus, diagnosis using imaging is often challenging, and they are typically diagnosed only after total tumor resection. Herein, we report a case of VM located in the anterior mediastinum diagnosed using computed tomography (CT) and magnetic resonance imaging (MRI). A 56-year-old woman presented for further evaluation of an anterior mediastinal mass observed during a chest CT. On CT, the mass was observed to have scattered calcifications and early and persistent enhancement with contrast material pooling dorsally in the delayed phase. On MRI, the mass was isointense on T1-weighted imaging and hyperintense on T2-weighted imaging without flow voids. From these images, we suspected the mass to be a VM, but the possibility of an arterial malformation/fistula could not be ruled out. Initially, a contrast material was injected via the arm, but to improve differentiation, it was also injected via the leg. The 4D-CT of the leg indicated no early enhancement of the mass; however, gradual enhancement was observed. This led to a definite diagnosis of VM. As she had no symptoms, we opted for a CT follow-up, and the mass remained stable for one year post-diagnosis. This case report underscores the usefulness of injecting contrast material through the leg in distinguishing VM from AVM/Fs in the anterior mediastinum.
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Affiliation(s)
- Hiroto Sakai
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
| | - Ichiro Hasegawa
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
| | - Junya Tsuzaki
- School of Medicine, Divison of Radiology, Keio University, Tokyo, JPN
| | - Saori Okamoto
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
| | - Tadayoshi Kurata
- Department of Diagnostic Radiology, Kawasaki Municipal Hospital, Kawasaki, JPN
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