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Koesbandono, Lukito AA, Muljadi R, Yuniarti M, Sindunata NA, Sarikie A, Pratama TA, Thio RS, Christanti J, Octavius GS. High Prevalence of Myocardial Bridging Detected in an Indonesian Population Using Multi-Detector Computed Tomography. Medicina (Kaunas) 2024; 60:794. [PMID: 38792977 DOI: 10.3390/medicina60050794] [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] [Received: 04/11/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Myocardial bridging (MB) is still not yet considered a significant finding in Indonesia both radiographically and clinically. Hence, this article aims to assess the prevalence of MB using multi-detector computed tomography (MDCT) and look at factors contributing to stenosis amongst patients with MB. Materials and Methods: This study is cross-sectional in a single centre, with consecutive sampling, looking at all patients who underwent a multi-detector computed tomography (MDCT) scan from February 2021 until February 2023. GraphPad Prism version 9.0.0 for Windows (GraphPad Software, Boston, MA, USA) was used to analyse the results. Results: There are 1029 patients with an MB, yielding a prevalence of 44.3% (95%CI 42.3-46.4). The left anterior descending vessel is the most commonly implicated, with 99.6%. Among those with stenosis, the middle portion of the bridging vessel is the most common site of stenosis (n = 269), followed by the proximal portion (n = 237). The severity of stenosis is more often moderate, with 30-50% (n = 238). Females (odds ratio [OR] of 1.8, 95%CI 1.4-2.3; p-value < 0.0001), older age (t-value 5.6, p-value < 0.0001), symptomatic patients (OR 1.4, 95% CI 1.1-1.9; p-value = 0.013), and higher mean coronary artery calcium score (t-value 11.3, p-value < 0.0001) are more likely to have stenosis. The degree of stenosis is significantly higher in the proximal stenosis group than in the middle stenosis group (t-value 27, p-value < 0.0001). Conclusions: Our research demonstrates that MB may prevent atheromatosis of the coronary segment distal to the MB and predispose the development of atherosclerosis in the section proximal to the bridge.
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Affiliation(s)
- Koesbandono
- Interventional Radiology Division, Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
- Department of Radiology, Siloam Hospital Lippo Village, Tangerang 15811, Indonesia
| | - Antonia Anna Lukito
- Department of Cardiology and Vascular Medicine, Siloam Hospital Lippo Village, Tangerang 15810, Indonesia
| | - Rusli Muljadi
- Department of Radiology, Siloam Hospital Lippo Village, Tangerang 15811, Indonesia
- Thoracic and Cardiovascular Imaging Division, Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | - Mira Yuniarti
- Department of Radiology, Siloam Hospital Lippo Village, Tangerang 15811, Indonesia
- Thoracic and Cardiovascular Imaging Division, Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | | | - Andreyano Sarikie
- Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | | | - Reynaldy Santosa Thio
- Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | - Jessica Christanti
- Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
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Celmer M, Międzybrodzki K, Patyk M, Pozowski P, Zaleska-Dorobisz U. Application of low-dose hydro-CT using SAFIRE in the evaluation of esophageal cancer. ADV CLIN EXP MED 2023; 32:1133-1138. [PMID: 37026973 DOI: 10.17219/acem/161160] [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] [Received: 10/12/2022] [Revised: 12/19/2022] [Accepted: 02/12/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The esophageal cancer treatment strategy depends on the tumor stage according to the tumor, node and metastasis (TNM) classification. One of the methods recommended for esophageal cancer assessment is computed tomography (CT). The CT imaging is especially important for patients with contraindications for gastroscopy, which is the primary method used for assessing esophageal diseases. OBJECTIVES The aim of this retrospective study was to evaluate the inter-rater reliability of low-dose hydro-CT with a sinogram-affirmed iterative reconstruction algorithm (SAFIRE) used for the staging of esophageal cancer by 2 independent radiologists. We also evaluated the application of this method for the diagnosis of esophageal cancer. MATERIAL AND METHODS Low-dose hydro-CT was performed in 65 patients, and the raw data were reconstructed with SAFIRE. Obtained images were retrospectively interpreted by 2 independent and experienced radiologists. Histopathological results were used as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the diagnosis of esophageal cancer were calculated for hydro-CT. The examination of the inter-rater reliability level in the assessment of the esophageal cancer stage in the TNM classification was performed by calculating Cohen's kappa coefficient (κ) with square weights and standard errors (SEs) for kappa. Independence tests were also performed (Fisher's exact test - two-tailed, and Pearson's χ2 test). RESULTS For the diagnosis of esophageal cancer with hydro-CT, a sensitivity of 93%, a specificity of 100%, a PPV of 100%, and a NPV of 88% were observed. In the statistical analyses for the T, N and M stages, κ values greater than 0.90 and significance levels of p < 0.001 were obtained. CONCLUSIONS Hydro-CT using low-dose techniques may be a valuable diagnostic method for staging and diagnosis of esophageal cancer, especially in patients with contraindications for invasive procedures.
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Affiliation(s)
- Milena Celmer
- Department of General and Paediatric Radiology, Wroclaw Medical University, Poland
| | | | - Mateusz Patyk
- Department of General and Paediatric Radiology, Wroclaw Medical University, Poland
| | - Patryk Pozowski
- Department of General and Paediatric Radiology, Wroclaw Medical University, Poland
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M SK, Sudhakaran R. Vascular Anatomy of Segment IV of the Liver in Live Liver Donors. Cureus 2023; 15:e46281. [PMID: 37908939 PMCID: PMC10614085 DOI: 10.7759/cureus.46281] [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: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Studies on the anatomy of the liver have helped surgeries such as liver resection. Liver resection is of significance in liver transplantation. In liver resection, the anatomy of segment IV is very important as it is more prone to ischemia. AIM The primary objective is to study the anatomical variations of the hepatic artery and hepatic vein of segment IV from MDCT images of the hepatic vasculature in living liver donors. This study aims to document the anatomy of the hepatic artery supplying segment IV and its venous drainage in 300 living liver donors. MATERIALS AND METHODS In this retrospective study, 600 MDCT images of hepatic vasculature were observed, and the interpretations were recorded. The origin of the artery to segment IV was documented. The observations of the hepatic vein were tabulated as classified in Nakamura's study. RESULTS Segment IV artery originates from the left hepatic artery (LHA) in 72% of the cases and the right hepatic artery (RHA) in 23%. Hepatic venous drainage of segment IV comprises type I, type II, and type III in 14.33%, 53.67%, and 30% of cases, respectively. Type I anatomy of the hepatic vein is preferred in both right and left lobe liver transplantation as the drainage from segment IV is safe. CONCLUSION Vascularity to segment IV is key in living liver donors, as donor safety is of utmost importance in the case of living donor liver transplantation.
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Affiliation(s)
- Shruthy K M
- Anatomy, A.C.S. Medical College and Hospital, Dr. M.G.R. Educational and Research Institute, Chennai, IND
| | - Rathi Sudhakaran
- Anatomy, Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, IND
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Takenaka Y, Beppu N, Otani M, Ito K, Imada A, Matsubara T, Song J, Kimura K, Kataoka K, Uchino M, Ikeuchi H, Ikeda M. Anatomical Validation of Internal Iliac Vessels Assessed by Three-dimensional Angiographic Analysis. J Anus Rectum Colon 2023; 7:186-196. [PMID: 37496569 PMCID: PMC10368437 DOI: 10.23922/jarc.2022-066] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/23/2023] [Indexed: 07/28/2023] Open
Abstract
Objectives Anatomical understanding of the internal iliac vessels is important with the increasing frequency of minimally-invasive pelvic surgery. We aimed to investigate the branch patterns of internal iliac vessels, especially the veins. Methods This study included 30 patients with 60 half-pelvises who underwent minimally-invasive pelvic surgery. Branch patterns were assessed on surgical videos with a multi-detector computed tomography-based three-dimensional simulation. Branch patterns of the superior gluteal artery and vein (SGA and SGV), inferior gluteal artery and vein (IGA and IGV), internal pudendal artery and vein (IPA and IPV), and obturator artery and vein (ObA and ObV) were investigated. Results In the most frequent internal iliac vein (IIV) branch pattern, 67% of SGV branched from the IIV, 95% of the IGV branched from the IPV and 82% of the ObV branched from the IPV. According to Adachi's classification, 62% of IIVs were Type I and 33% Type IV. Although IIV branch patterns are heterogeneous, in individual patients with the most frequent branch patterns, good correlation (75-100%) of the branch patterns was observed between the internal iliac artery (IIA) and IIV, and between the right and left IIVs. Conclusions This study clarified the branch patterns of IIV. In patients with the most frequent branch patterns, good correlation of the branch patterns was observed between the IIA and IIV, and between right and left IIV. We believe this helps secure the safety and standardization of minimally-invasive pelvic surgery.
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Affiliation(s)
- Yuya Takenaka
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Naohito Beppu
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Masaki Otani
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Kazuma Ito
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Ayako Imada
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Takaaki Matsubara
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Jihyung Song
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Kei Kimura
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Kozo Kataoka
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
| | - Motoi Uchino
- Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease Surgery, Hyogo Medical University, Hyogo, Japan
| | - Hiroki Ikeuchi
- Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease Surgery, Hyogo Medical University, Hyogo, Japan
| | - Masataka Ikeda
- Department of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Hyogo, Japan
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Guler I, Kavak RP. Pancreatic morphology/contour variations should be recognized and remembered. Niger J Clin Pract 2023; 26:749-755. [PMID: 37470648 DOI: 10.4103/njcp.njcp_619_22] [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: 07/21/2023]
Abstract
Background Pancreatic contour variations can be detected incidentally on computed tomography (CT). Recognition and remembering of these variations are important in volumetric measurements and surgery as well as in preventing misdiagnosis. Aim This study aims to evaluate the morphology/contour variations in the pancreas head-neck, body-tail, and uncinate process with multi-detector CT (MDCT) examinations (triple phase CT abdomen). Material and Method Around 1662 adult age (>18 years old) patients were evaluated retrospectively, and after exclusion criteria, 945 patients were included in the study. Aplasia and hypoplasia of the uncinate process were determined, and pancreatic contour variances were categorized according to the Ross et al. and Omeri et al. classifications. Pancreatic head-neck variants were categorized into Type I-anterior, Type II-posterior, and Type III-horizontal variations. Pancreatic body-tail variants were sectioned into Type Ia-anterior protrusion, Type Ib-posterior protrusion, and Types IIa-globular, IIb-lobulated, IIc-tapered, and IId-bifid pancreatic tail. Results Of the 945 patients, 481 (50.9%) were female. The mean age was 43.28 ± 10.49 (min. 20-max. 68). In the evaluations made according to the uncinate process morphology variant, hypoplasia was detected in 66 (7%) patients and aplasia in 12 (1.3%) patients. Pancreatic head-neck and body-tail contour variations were observed in 596 (63.1%) patients. The most common head-neck variation was Type II in 233 (24.6%) patients, followed by type III in 96 (10.2%). There were Type Ia in 83 (8.8%) patients and Type Ib in 14 (1.5%) patients. The pancreatic tail configuration was normal in 792 (83.8%) patients; it was Type IIa in 62 (6.6%) patients and IIb in 50 (5.3%) patients. The most common variation was head and tail in 33 (3.5%) patients. Discussion Pancreatic variations detected in CT examinations for distinct reasons are not rare; these variations should be recognized and remembered.
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Affiliation(s)
- I Guler
- Department of General Surgery, Ministry of Health, General Directorate of Public Hospitals, Ankara, Türkiye
| | - R P Kavak
- Department of Radiology, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
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Mitra A, Bhatnagar V, Agarwala S, Gupta AK, Jana M, Srinivas M, Dhua AK. Preoperative Triple-Phase Three-Dimensional- Multi-Detector Computed Tomography Imaging of the Hepatic Vascular Tree: An Accurate Road Map Prior to Tumor Resection in Hepatoblastoma. J Indian Assoc Pediatr Surg 2023; 28:233-241. [PMID: 37389399 PMCID: PMC10305947 DOI: 10.4103/jiaps.jiaps_113_22] [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: 08/15/2022] [Revised: 01/10/2023] [Accepted: 02/04/2023] [Indexed: 07/01/2023] Open
Abstract
Objective To evaluate the hepatic vasculature/tumor relations in hepatoblastoma patients with three-dimensional (3D) reformatted images after triple-phase multi-detector computed tomography (MDCT) and to compare these with the surgical findings to judge the accuracy of this investigation. Materials and Methods The study was carried out in hepatoblastoma patients after appropriate neo-adjuvant chemotherapy, prior to resection. Images were postprocessed at a dedicated workstation for multi-planar reformations, maximum intensity projection, curved planar reformations, and volume-rendered technique reconstructions. The reporting was done as per a specific protocol by both the radiologist and surgeon (per-operative findings) and the accuracy of MDCT ascertained as per concordance between the surgical and imaging findings. Results Fourteen children (13 boys, 1 girl) underwent surgery. Clinically, relevant information regarding vascular, tumor involvement, and interface with vessels was provided by the study in all cases. Although all tumors were deemed resectable on preoperative imaging, one procedure was abandoned due to an unanticipated portal cavernoma. While a few anatomical variations were unexpectedly encountered during surgery, there was good concordance overall between findings on imaging and surgical exploration. Conclusions MDCT with 3D reformatting provides accurate virtual representations of the hepatic tumor. This allows simulation of surgical resection with decreased risk of vascular injury and postoperative liver failure.
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Affiliation(s)
- Aparajita Mitra
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Veereshwar Bhatnagar
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Agarwala
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Arun Kumar Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - M. Srinivas
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Anjan Kumar Dhua
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
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Wang J, Xu J, Lei K, You K, Liu Z. Strategic Approach to Aberrant Hepatic Arterial Anatomy during Laparoscopic Pancreaticoduodenectomy: Technique with Video. J Clin Med 2023; 12:jcm12051965. [PMID: 36902752 PMCID: PMC10004589 DOI: 10.3390/jcm12051965] [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: 01/16/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND It is critical for every pancreatic surgeon to determine how to protect the aberrant hepatic artery intraoperatively in order to safely implement laparoscopic pancreatoduodenectomy (LPD). "Artery-first" approaches to LPD are ideal procedures in selected patients with pancreatic head tumors. Here, we described our surgical procedure and experience of aberrant hepatic arterial anatomy-LPD (AHAA-LPD) in a retrospective case series. In this study, we also sought to confirm the implications of the combined SMA-first approach on the perioperative and oncologic outcomes of AHAA-LPD. METHODS From January 2021 to April 2022, the authors completed a total of 106 LPDs, of which 24 patients underwent AHAA-LPD. We evaluated the courses of the hepatic artery via preoperative multi-detector computed tomography (MDCT) and classified several meaningful AHAAs. The clinical data of 106 patients who underwent AHAA-LPD and standard LPD were retrospectively analyzed. We compared the technical and oncological outcomes of the combined SMA-first approach, AHAA-LPD, and the concurrent standard LPD. RESULTS All the operations were successful. The combined SMA-first approaches were used by the authors to manage 24 resectable AHAA-LPD patients. The mean age of the patients was 58.1 ± 12.1 years; the mean operation time was 362 ± 60.43 min (325-510 min); blood loss was 256 ± 55.72 mL (210-350 mL); the postoperation ALT and AST were 235 ± 25.65 IU/L (184-276 IU/L) and 180 ± 34.43 IU/L (133-245 IU/L); the median postoperative length of stay was 17 days (13.0-26.0 days); the R0 resection rate was 100%. There were no cases of open conversion. The pathology showed free surgical margins. The mean number of dissected lymph nodes was 18 ± 3.5 (14-25); the number of tumor-free margins was 3.43 ± 0.78 mm (2.7-4.3 mm). There were no Clavien-Dindo III-IV classifications or C-grade pancreatic fistulas. The number of lymph node resections was greater in the AHAA-LPD group (18 vs. 15, p < 0.001). Surgical variables (OT) or postoperative complications (POPF, DGE, BL, and PH) showed no significant statistical differences in both groups. CONCLUSIONS In performing AHAA-LPD, the combined SMA-first approach for the periadventitial dissection of the distinct aberrant hepatic artery to avoid hepatic artery injury is feasible and safe when performed by a team experienced in minimally invasive pancreatic surgery. The safety and efficacy of this technique need to be confirmed in large-scale-sized, multicenter, prospective randomized controlled studies in the future.
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Muacevic A, Adler JR, Farooq F. Role of Multi-Detector Computed Tomography in the Diagnosis of Intestinal Obstruction. Cureus 2023; 15:e33730. [PMID: 36788830 PMCID: PMC9922381 DOI: 10.7759/cureus.33730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION There is a need to identify patients whose small bowel obstruction (SBO) can resolve spontaneously so that unnecessary surgical interventions are avoided. This study aimed to evaluate the diagnostic accuracy of multi-detector computed tomography (MDCT) in intestinal obstruction and find out the presence, level, causes, and degree of intestinal obstruction taking intraoperative findings as gold standard. METHODOLOGY This cross-sectional study was conducted analyzing 147 patients that were referred from emergency with abdominal pain, abdominal distension, inability to pass flatus, and aged 18-70 years from both genders. Computed tomography (CT) examinations were done and findings like intestinal dilatation, evidence of mesenteric fat stranding, and area of transition between the dilated and collapsed loops were noted. The final report was made by the radiologist while the operative findings were reviewed from the operative notes written by operative surgeons of the same patient. RESULTS In a total of 147 patients, mean age was 52.38±16.01 years. There were 76 (51.70%) males and 71 (48.30%) females. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of multi-detector computed tomography scan in diagnosing intestinal obstruction, taking operative findings as gold standard, were 98.39%, 65.22%, 93.85%, 88.24%, and 93.20%, respectively. CONCLUSION The multi-detector CT can be used routinely as a prime modality for detecting intestinal obstruction which will result in proper and timely management for reducing the morbidity and mortality of these particular patients.
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Tomii D, Okuno T, Lanz J, Stortecky S, Windecker S, Pilgrim T. Aortic annulus ellipticity and outcomes after transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2023; 101:199-208. [PMID: 36453455 DOI: 10.1002/ccd.30507] [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: 06/23/2022] [Revised: 11/10/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Elliptical shape of the aortic annulus has been associated with an increased risk of device failure after transcatheter aortic valve implantation (TAVI) compared with a circular annular shape. AIMS To assess the impact of annulus ellipticity on procedural outcomes and device performance in patients undergoing TAVI. METHODS In a prospective TAVI registry, aortic annulus ellipticity was assessed by preprocedural multidetector computed tomography. The annulus ratios, defined by the ratio of minimum and maximum annulus diameters measured in a transverse double oblique plane, were split into tertiles for comparisons between groups. RESULTS A total of 1732 patients undergoing TAVI between August 2007 and June 2020 were included in the present analysis. Patients in the tertile with the most elliptical shape of the annulus were more likely to be female (59.7% vs. 47.9%; p < 0.001) and had a higher Society of Thoracic Surgeons Predicted Risk of Mortality (5.4 ± 3.8 vs. 4.8 ± 3.5; p = 0.002). There were no significant differences in the rate of technical success (95.3% vs. 96.5%; p = 0.235), device success (83.6% vs. 86.5%; p = 0.118) and intended valve performance (90.7% vs. 91.7; p = 0.503) between patients in the most elliptical tertile and the rest. However, valve dislocation/embolization occurred more frequently in patients with elliptical as compared to circular annular shape (2.6% vs. 1.2%; p = 0.046). CONCLUSIONS Ellipticity of the aortic annulus does not affect procedural and device outcomes in patients undergoing TAVI irrespective of transcatheter heart valve design and generation. https:www.//clinicaltrials.gov. NCT01368250.
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Affiliation(s)
- Daijiro Tomii
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Taishi Okuno
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Jonas Lanz
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Stefan Stortecky
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Thomas Pilgrim
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
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Rayudu NM, Subburaj K, Mohan RE, Sollmann N, Dieckmeyer M, Kirschke JS, Baum T. Patient-Specific Finite Element Modeling of the Whole Lumbar Spine Using Clinical Routine Multi-Detector Computed Tomography (MDCT) Data-A Pilot Study. Biomedicines 2022; 10. [PMID: 35884872 DOI: 10.3390/biomedicines10071567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
(1) Background: To study the feasibility of developing finite element (FE) models of the whole lumbar spine using clinical routine multi-detector computed tomography (MDCT) scans to predict failure load (FL) and range of motion (ROM) parameters. (2) Methods: MDCT scans of 12 subjects (6 healthy controls (HC), mean age ± standard deviation (SD): 62.16 ± 10.24 years, and 6 osteoporotic patients (OP), mean age ± SD: 65.83 ± 11.19 years) were included in the current study. Comprehensive FE models of the lumbar spine (5 vertebrae + 4 intervertebral discs (IVDs) + ligaments) were generated (L1−L5) and simulated. The coefficients of correlation (ρ) were calculated to investigate the relationship between FE-based FL and ROM parameters and bone mineral density (BMD) values of L1−L3 derived from MDCT (BMDQCT-L1-3). Finally, Mann−Whitney U tests were performed to analyze differences in FL and ROM parameters between HC and OP cohorts. (3) Results: Mean FE-based FL value of the HC cohort was significantly higher than that of the OP cohort (1471.50 ± 275.69 N (HC) vs. 763.33 ± 166.70 N (OP), p < 0.01). A strong correlation of 0.8 (p < 0.01) was observed between FE-based FL and BMDQCT-L1-L3 values. However, no significant differences were observed between ROM parameters of HC and OP cohorts (p = 0.69 for flexion; p = 0.69 for extension; p = 0.47 for lateral bending; p = 0.13 for twisting). In addition, no statistically significant correlations were observed between ROM parameters and BMDQCT- L1-3. (4) Conclusions: Clinical routine MDCT data can be used for patient-specific FE modeling of the whole lumbar spine. ROM parameters do not seem to be significantly altered between HC and OP. In contrast, FE-derived FL may help identify patients with increased osteoporotic fracture risk in the future.
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Sultan OM, Alghazali DM, Al-Tameemi H, Abed M, Hawiji DA, Abu Ghniem MN, Al-Obaidi L, Abedtwfeq RH. Pattern and Age Distribution of COVID-19 on Pulmonary Computed Tomography. Curr Med Imaging 2021; 17:775-780. [PMID: 33357198 DOI: 10.2174/1573405616666201223144539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/05/2020] [Revised: 10/11/2020] [Accepted: 11/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND COVID-19 has emerged recently and has become a global concern. Computed tomography (CT) plays a vital role in the diagnosis. OBJECTIVES To characterize the pulmonary CT findings and distributions of COVID-19 infection in regard to different age groups. METHODS Chest CT scan of 104 symptomatic patients with COVID-19 infection from 7 Iraqi isolation centers were retrospectively analyzed between March 10th to April 5th, 2020. Patients were sub-classified according to their ages into three groups (young adult:20-39 years, middle age:40-59 years, and old age:60-90 years). RESULTS The most common findings were ground-glass opacities (GGO) (92.3%, followed by consolidation (27.9%), bronchovascular thickening (15.4%), and crazy-paving (12.5%). Less commonly, there were tree-in-bud (6.7%), pulmonary nodules (5.8%), bronchiectasis (3.8%), pleural effusion (1.9%), and cavitation (1%). There were no hallo signs, reversed hallo signs, and mediastinal lymphadenopathy. Pulmonary changes were unilateral in 16.7% and bilateral in 83.3%, central in 14.6%, peripheral in 57.3%, and diffuse (central and peripheral) in 28.1%. Most cases showed multi- lobar changes (70.8%), while the lower lobe was more commonly involved (17.7%) than the middle lobe/lingula (8.3%) and upper lobe (3.1%). In unilateral involvement, changes were more on the right (68.8%) than the left (31.2%) side. Compared with middle and old age groups, young adult patients showed significantly lesser frequency of consolidation (17% vs. 13.3% and 37%), diffuse changes 28.1% (14.2% vs. 35.3% and 40.5%), bilateral disease (71.4% vs. 94.1% and 85.2%), and multi-lobar involvement (51.4% vs. 82.4% and 81.4%) respectively. CONCLUSION Bilateral and peripheral GGO were the most frequent findings with the right and lower lobar predilection. The pattern and the distribution of CT changes seem to be age-specific.
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Affiliation(s)
- Omar Muayad Sultan
- College of Medicine, Lecturer of radiodiagnosis, Director of Medical Education Unit (MEU), Tikrit University, Tikrit, Iraq
| | - Dhia Mahdey Alghazali
- Department of Degnostic Imaging, Al-Imam Al-Hussein Medical City. Karbala 56001, Iraq
| | | | - Mohammed Abed
- Department of Radiology, Al-Yarmuk Teaching Hospital, Baghdad 10001, Iraq
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Çullu N, Yeniçeri İÖ, Özdemir MY, Altun İ, Doğan E. Evaluation of the morphological and clinical features of left anterior descending myocardial bridging with multi-detector computed tomography. Kardiochir Torakochirurgia Pol 2021; 18:87-91. [PMID: 34386049 DOI: 10.5114/kitp.2021.107469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/14/2021] [Indexed: 12/03/2022]
Abstract
Aim The aim of the study was to assess the incidence, localization, depth, length of myocardial bridging (MB) with left anterior descending (LAD), systolic compression ratio, atherosclerotic plaque localization and degree of stenosis by 256-slice multi-detector computed tomography (MDCT). Material and methods Computed tomography (CT) scans from a total of 3947 patients who underwent MDCT were reviewed retrospectively for LAD MB. A diastolic and systolic dataset with the best image quality was selected. Myocardial bridge was defined as a coronary artery with an intra-myocardial course. Myocardial bridging was divided into “deep” or “superficial”. The length and depth of the bridging segment were calculated. For each bridging segment, the presence of atherosclerosis was saved in a 2-cm-long segment proximal to the entry of the bridging segment. The degree of stenosis made by atherosclerotic plaques was determined. Results LAD myocardial bridging was detected in 410 (10.4%) patients. Among these, 97 (23.7%) patients had a deep and 313 (76.3%) patients had a superficial course. The mean LAD MB length was 20.28 ±9.63 mm and the depth was 1.72 ±1.11 mm. The systolic and diastolic mean diameter difference was 0.193 mm and the average compression ratio was 9.44%. Atherosclerotic plaques were found in 167 (40.7%) of 410 LAD MB. Atherosclerotic plaques were found in 50.5% of deep MB and 37.7% of superficial MB. Conclusions 256-slice MDCT coronary angiography has a high sensitivity to show myocardial bridging in LAD localization, to determine length, depth, compression ratio, atherosclerotic plaque localization and degree of stenosis.
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Jan YT, Tsai PS, Longenecker CT, Lin DC, Yun CH, Sung KT, Liu CC, Kuo JY, Hung CL, Wu TH, Lin JL, Hou CJY, Tsai CT, Chien CY, So A. Thoracic Aortic Calcification and Pre-Clinical Hypertension by New 2017 ACC/AHA Hypertension Guidelines. Diagnostics (Basel) 2021; 11:diagnostics11061027. [PMID: 34205037 PMCID: PMC8226485 DOI: 10.3390/diagnostics11061027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/26/2021] [Revised: 05/06/2021] [Accepted: 05/31/2021] [Indexed: 01/19/2023] Open
Abstract
The recently revised 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension (HTN) guidelines employ a lower blood pressure threshold to define HTN, aiming for earlier prevention of HTN-related cardiovascular diseases (CVD). Thoracic aortic calcification (TAC), a new surrogate marker of aging and aortic medial layer degeneration, and different stages of HTN, according to the 2017 ACC/AHA HTN guidelines, remain unknown. We classified 3022 consecutive asymptomatic individuals enrolled into four HTN categories using the revised 2017 ACC/AHA guidelines: normal blood pressure (NBP), elevated blood pressure (EBP), and stage 1 (S1) and stage 2 (S2) HTN. The coronary artery calcification score and TAC metrics (total Agaston TAC score, total plaque volume (mm3), and mean density (Hounsfield units, HU)) were measured using multi-detector computed tomography. Compared to NBP, a graded and significant increase in the TAC metrics was observed starting from EBP and S1 and S2 HTN, using the new 2017 ACC/AHA guidelines (NBP as reference; all trends: p < 0.001). These differences remained consistent after being fully adjusted. Older age (>50 years), S1 and S2 HTN, prevalent diabetes, and chronic kidney disease (<60 mL/min/1.73 m2) are all independently contributing factors to higher TAC risk using multivariate stepwise logistic regressions (all p ≤ 0.001). The optimal cutoff values of systolic blood pressure, diastolic blood pressure, and pulse pressure were 121, 74, and 45 mmHg, respectively, for the presence of TAC after excluding subjects with known CVD and ongoing HTN medication treatment. Our data showed that the presence of TAC starts at a stage of elevated blood pressure not categorized as HTN from the updated 2017 ACC/AHA hypertension guidelines.
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Affiliation(s)
- Ya-Ting Jan
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-T.J.); (P.-S.T.); (K.-T.S.)
- Department of Radiology, MacKay Memorial Hospital, Taipei 104, Taiwan;
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Mackay Junior College of Medicine, Nursing and Management, New Taipei City 112, Taiwan
| | - Pei-Shan Tsai
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-T.J.); (P.-S.T.); (K.-T.S.)
- Department of Radiology, MacKay Memorial Hospital, Taipei 104, Taiwan;
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Mackay Junior College of Medicine, Nursing and Management, New Taipei City 112, Taiwan
| | | | - Dao-Chen Lin
- Division of Endocrine and metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Department of Radiology, Taipei Veterans General Hospital, Taipei 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chun-Ho Yun
- Department of Radiology, MacKay Memorial Hospital, Taipei 104, Taiwan;
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Mackay Junior College of Medicine, Nursing and Management, New Taipei City 112, Taiwan
| | - Kuo-Tzu Sung
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-T.J.); (P.-S.T.); (K.-T.S.)
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Chuan-Chuan Liu
- Graduate Institute of Health Care Organization Administration, College of Public Health National Taiwan University, Taipei 100, Taiwan;
- Health Evaluation Center, MacKay Memorial Hospital, Taipei 104, Taiwan
- Department of Medical Technology, Yuanpei University of Science and Technology, Hsin-Chu City 306, Taiwan
| | - Jen-Yuan Kuo
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Chung-Lieh Hung
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan
- Graduate Institute of Health Care Organization Administration, College of Public Health National Taiwan University, Taipei 100, Taiwan;
| | - Tung-Hsin Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-T.J.); (P.-S.T.); (K.-T.S.)
- Correspondence: (T.-H.W.); (C.-Y.C.)
| | - Jiun-Lu Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan;
| | - Charles Jia-Yin Hou
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Cheng-Ting Tsai
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Chen-Yen Chien
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan; (J.-Y.K.); (C.-L.H.); (C.J.-Y.H.); (C.-T.T.)
- Mackay Junior College of Medicine, Nursing and Management, New Taipei City 112, Taiwan
- Division of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, Taipei 104, Taiwan
- Correspondence: (T.-H.W.); (C.-Y.C.)
| | - Aaron So
- Imaging Program, Lawson Health Research Institute, London, ON N6C 2R5, Canada;
- Department of Medical Biophysics, University of Western Ontario, London, ON N6A 3K7, Canada
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Stadelmann SA, Blüthgen C, Milanese G, Nguyen-Kim TDL, Maul JT, Dummer R, Frauenfelder T, Eberhard M. Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions. Diagnostics (Basel) 2021; 11:diagnostics11050837. [PMID: 34066913 PMCID: PMC8148527 DOI: 10.3390/diagnostics11050837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/07/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 12/01/2022] Open
Abstract
Lung nodules are frequent findings in chest computed tomography (CT) in patients with metastatic melanoma. In this study, we assessed the frequency and compared morphologic differences of metastases and benign nodules. We retrospectively evaluated 85 patients with melanoma (AJCC stage III or IV). Inclusion criteria were ≤20 lung nodules and follow-up using CT ≥183 days after baseline. Lung nodules were evaluated for size and morphology. Nodules with significant growth, nodule regression in line with RECIST assessment or histologic confirmation were judged to be metastases. A total of 438 lung nodules were evaluated, of which 68% were metastases. At least one metastasis was found in 78% of patients. A 10 mm diameter cut-off (used for RECIST) showed a specificity of 95% and a sensitivity of 20% for diagnosing metastases. Central location (n = 122) was more common in metastatic nodules (p = 0.009). Subsolid morphology (n = 53) was more frequent (p < 0.001), and calcifications (n = 13) were solely found in non-metastatic lung nodules (p < 0.001). Our data show that lung nodules are prevalent in about two-thirds of melanoma patients (AJCC stage III/IV) and the majority are metastases. Even though we found a few morphologic indicators for metastatic or non-metastatic lung nodules, morphology has limited value to predict the presence of lung metastases.
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Affiliation(s)
- Simone Alexandra Stadelmann
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (S.A.S.); (C.B.); (T.D.L.N.-K.); (T.F.)
| | - Christian Blüthgen
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (S.A.S.); (C.B.); (T.D.L.N.-K.); (T.F.)
| | - Gianluca Milanese
- Department of Medicine and Surgery (DiMeC), University of Parma, 43126 Parma, Italy;
| | - Thi Dan Linh Nguyen-Kim
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (S.A.S.); (C.B.); (T.D.L.N.-K.); (T.F.)
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (J.-T.M.); (R.D.)
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (J.-T.M.); (R.D.)
| | - Thomas Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (S.A.S.); (C.B.); (T.D.L.N.-K.); (T.F.)
| | - Matthias Eberhard
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (S.A.S.); (C.B.); (T.D.L.N.-K.); (T.F.)
- Correspondence: ; Tel.: +41-(0)44-255-9139; Fax: +41-(0)44-255-4443
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Okuno T, Heg D, Lanz J, Praz F, Gräni C, Langhammer B, Reineke D, Räber L, Wenaweser P, Pilgrim T, Windecker S, Stortecky S. Heart valve sizing and clinical outcomes in patients undergoing transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2021; 98:E768-E779. [PMID: 33857355 DOI: 10.1002/ccd.29700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/23/2020] [Revised: 02/17/2021] [Accepted: 03/14/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To investigate the impact of transcatheter heart valve (THV) sizing on procedural results and clinical outcomes following transcatheter aortic valve implantation (TAVI). BACKGROUND The impact of individual THV sizing for patients with borderline aortic annulus anatomy remains unclear. METHODS In the prospective BernTAVI registry, THV sizing conditions were retrospectively evaluated, and patients were categorized into three groups based on the recommendations and the sizing chart of the manufacturers: optimal sizing, borderline sizing (THV size located within 5% to each border of the optimal sizing recommendation), and suboptimal sizing (THV size outside the recommended range). The latter two groups were further subcategorized into THV-oversizing and THV-undersizing. The primary endpoint was a composite of all-cause death and unplanned repeat intervention at 1 year. RESULTS Out of a total of 1,638 patients who underwent TAVI, 9.5 and 15.6% of patients were categorized into the borderline and suboptimal sizing group, respectively. Device success was achieved in 87.4, 88.9, and 83.6% of patients with optimal, borderline, and suboptimal sizing, respectively. The primary endpoint occurred in 12.3% of patients with optimal sizing, 14.9% of patients with borderline sizing (HRadj 1.35, 95%CI 0.87-2.09), and in 17.4% of patients with suboptimal sizing (HRadj 1.42, 95%CI 1.01-1.99). Within the suboptimal sizing cohort, unfavorable outcomes were mainly associated with THV undersizing (device success: 76.4%, primary endpoint: 23.9%, HRadj 1.98, 95%CI 1.36-2.87). CONCLUSION Suboptimal TAVI prosthesis sizing is associated with an increased risk of all-cause death and unplanned repeat intervention within 1 year largely attributable to undersized THV prostheses.
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Affiliation(s)
- Taishi Okuno
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Dik Heg
- Clinical Trials Unit, University of Bern, Bern, Switzerland
| | - Jonas Lanz
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Fabien Praz
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Bettina Langhammer
- Department of Cardiac Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - David Reineke
- Department of Cardiac Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Lorenz Räber
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Peter Wenaweser
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Thomas Pilgrim
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Stefan Stortecky
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
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Lee G, Park H, Lee HY, Ahn JH, Sohn I, Lee SH, Kim J. Tumor Margin Contains Prognostic Information: Radiomic Margin Characteristics Analysis in Lung Adenocarcinoma Patients. Cancers (Basel) 2021; 13:cancers13071676. [PMID: 33918164 PMCID: PMC8037340 DOI: 10.3390/cancers13071676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/02/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary The tumor microenvironment is a dynamic area, with continuous interaction between tumor cells and their surrounding environment. We aimed to investigate the relationship between tumor radiomic margin characteristics and prognosis in patients with lung cancer. When compared to the model with clinical variables only (C-index = 0.738), the model incorporating clinical variables and radiomic margin characteristics (C-index = 0.753) demonstrated a higher C-index for predicting overall survival. In the model integrating both clinical variables and radiomic margin characteristics, convexity, Laplace of Gaussian (LoG) kurtosis 3, and roundness factor were independent predictive factors of overall survival. Our study showed that radiomic margin characteristics helped predict overall survival in patients with lung adenocarcinomas, thus implying that the tumor margin contains prognostic information. Abstract We aimed to investigate the relationship between tumor radiomic margin characteristics and prognosis in patients with lung cancer. We enrolled 334 patients who underwent complete resection for lung adenocarcinoma. A quantitative computed tomography analysis was performed, and 76 radiomic margin characteristics were extracted. The radiomic margin characteristics were correlated with overall survival. The selected clinical variables and radiomic margin characteristics were used to calculate a prognostic model with subsequent internal and external validation. Nearly all of the radiomic margin characteristics showed excellent reproducibility. The least absolute shrinkage and selection operator (LASSO) method was used to select eight radiomic margin characteristics. When compared to the model with clinical variables only (C-index = 0.738), the model incorporating clinical variables and radiomic margin characteristics (C-index = 0.753) demonstrated a higher C-index for predicting overall survival. In the model integrating both clinical variables and radiomic margin characteristics, convexity, a Laplace of Gaussian (LoG) kurtosis of 3, and the roundness factor were each independently predictive of overall survival. In addition, radiomic margin characteristics were also correlated with the micropapillary subtype, and the sphericity value was able to predict the presence of the micropapillary subtype. In conclusion, our study showed that radiomic margin characteristics helped predict overall survival in patients with lung adenocarcinomas, thus implying that the tumor margin contains prognostic information.
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Affiliation(s)
- Geewon Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- Department of Radiology and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon 16419, Korea;
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16419, Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
- Correspondence:
| | - Joong Hyun Ahn
- Biostatistics and Clinical Epidemiology Center, Samsung Biomedical Research Institute, Seoul 06351, Korea; (J.H.A.); (I.S.)
| | - Insuk Sohn
- Biostatistics and Clinical Epidemiology Center, Samsung Biomedical Research Institute, Seoul 06351, Korea; (J.H.A.); (I.S.)
| | - Seung-Hak Lee
- Department of Electronic Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Korea;
- Core Research and Development Center, Korean University Ansan Hospital, Ansan 15355, Korea
| | - Jhingook Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
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Sollmann N, Rayudu NM, Yeung LY, Sekuboyina A, Burian E, Dieckmeyer M, Löffler MT, Schwaiger BJ, Gersing AS, Kirschke JS, Baum T, Subburaj K. MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine? Diagnostics (Basel) 2021; 11:455. [PMID: 33800876 PMCID: PMC7998199 DOI: 10.3390/diagnostics11030455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/05/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022] Open
Abstract
Assessment of osteoporosis-associated fracture risk during clinical routine is based on the evaluation of clinical risk factors and T-scores, as derived from measurements of areal bone mineral density (aBMD). However, these parameters are limited in their ability to identify patients at high fracture risk. Finite element models (FEMs) have shown to improve bone strength prediction beyond aBMD. This study aims to investigate whether FEM measurements at the lumbar spine can predict the biomechanical strength of functional spinal units (FSUs) with incidental osteoporotic vertebral fractures (VFs) along the thoracolumbar spine. Multi-detector computed tomography (MDCT) data of 11 patients (5 females and 6 males, median age: 67 years) who underwent MDCT twice (median interval between baseline and follow-up MDCT: 18 months) and sustained an incidental osteoporotic VF between baseline and follow-up scanning were used. Based on baseline MDCT data, two FSUs consisting of vertebral bodies and intervertebral discs (IVDs) were modeled: one standardly capturing L1-IVD-L2-IVD-L3 (FSU_L1-L3) and one modeling the incidentally fractured vertebral body at the center of the FSU (FSU_F). Furthermore, volumetric BMD (vBMD) derived from MDCT, FEM-based displacement, and FEM-based load of the single vertebrae L1 to L3 were determined. Statistically significant correlations (adjusted for a BMD ratio of fracture/L1-L3 segments) were revealed between the FSU_F and mean load of L1 to L3 (r = 0.814, p = 0.004) and the mean vBMD of L1 to L3 (r = 0.745, p = 0.013), whereas there was no statistically significant association between the FSU_F and FSU_L1-L3 or between FSU_F and the mean displacement of L1 to L3 (p > 0.05). In conclusion, FEM measurements of single vertebrae at the lumbar spine may be able to predict the biomechanical strength of incidentally fractured vertebral segments along the thoracolumbar spine, while FSUs seem to predict only segment-specific fracture risk.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Nithin Manohar Rayudu
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore 487372, Singapore; (N.M.R.); (L.Y.Y.)
| | - Long Yu Yeung
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore 487372, Singapore; (N.M.R.); (L.Y.Y.)
| | - Anjany Sekuboyina
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
| | - Maximilian T. Löffler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 79106 Freiburg im Breisgau, Germany
| | - Benedikt J. Schwaiger
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
| | - Alexandra S. Gersing
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany;
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (N.S.); (A.S.); (E.B.); (M.D.); (M.T.L.); (B.J.S.); (J.S.K.); (T.B.)
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore 487372, Singapore; (N.M.R.); (L.Y.Y.)
- Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
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Naguib KI, Attia MA, Bashandy MS, Reihan MS, Dabash TA, El-Salam ABA, Helal HH, Bahbah EI. The role of trans-thoracic echocardiography in the assessment of aortic annular diameter. Medicine (Baltimore) 2021; 100:e24682. [PMID: 33655932 PMCID: PMC7939191 DOI: 10.1097/md.0000000000024682] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/15/2021] [Indexed: 01/04/2023] Open
Abstract
We aimed to compare two-dimension transthoracic echocardiogram (2D-TTE) and three-dimension transthoracic echocardiogram (3D-TTE) measurements of the aortic annular diameter using multi-detector CT (MDCT) as a gold standard.This prospective observational study included 50 consecutive patients who came to the cardiology department, Al-Azhar University Hospital, New Damietta, for MDCT coronary angiography. The study was carried out in the period from July 2016 until February 2017. All patients were subjected to informed consent, clinical history, physical examination, transthoracic echocardiography 2D and 3D, and MDCT.The aortic annular areas measured by MDCT and 3D-TTE were significantly larger than areas by 2D-TTE. A good correlation (r = 0.82) was observed between the areas obtained by 3D-TTE and MDCT; however, the correlation between the values by 2D-TTE and MDCT was rough (r = 0.30). Eccentricity Index (EI) values in 28% of the patients were greater than 0.1, that is, the aortic annulus was elliptical.Accuracy of aortic annular diameter measurement by 3D-TTE was superior to that by 2D-TTE. Three-D TTE and MDCT revealed that the shape of the aortic annulus was elliptical in 28% to 30% respectively of study subjects. There is a strong concordance between the minimum and the maximum diameter determine by 3D-TTE and MDCT.
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Affiliation(s)
| | | | | | | | | | | | | | - Eshak I. Bahbah
- Faculty of Medicine, Al-Azhar University, Damietta
- Medical Research Group of Egypt,.Egypt
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Chung YH, Lee BK, Kwon HM, Min PK, Choi EY, Yoon YW, Hong BK, Rim SJ, Kim JY. Coronary calcification is associated with elevated serum lipoprotein (a) levels in asymptomatic men over the age of 45 years: A cross-sectional study of the Korean national health checkup data. Medicine (Baltimore) 2021; 100:e24962. [PMID: 33655963 PMCID: PMC7939167 DOI: 10.1097/md.0000000000024962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/08/2021] [Indexed: 01/04/2023] Open
Abstract
Lipoprotein a (Lp (a)) and coronary artery calcification (CAC) are markers of coronary artery and cardiovascular diseases. However, the association between Lp (a) and CAC in asymptomatic individuals remains unclear. In this study, we aimed to determine the influence of Lp (a) on CAC in asymptomatic individuals.We included 2019 asymptomatic Korean adults who underwent testing for a coronary artery calcium score (CACS) and Lp (a) at the Gangnam Severance Hospital Health Checkup Center in Korea from January 2017 to August 2019. Participants were divided into 2 groups: CACS = 0 and CACS > 0. Factors affecting the CACS were analyzed by sex. Because age is a major risk factor for atherosclerosis, ≥45 years in men and ≥55 years in women, we further divided participants into 4 subgroups (≥45 and <45 in men, ≥55 and <55 in women). Factors affecting the CACS in the 4 groups were analyzed.There was a positive correlation between the CACS and traditional cardiovascular risk factors. Lp (a) positively correlated with the CACS in men (P < .01) and remained significant after multivariable logistic regression (P < .01). The same result was observed in men aged ≥45 years (P < .01).Lp (a) is an independently associated factor of CAC and a marker of coronary atherosclerosis in asymptomatic men aged ≥45 years. In asymptomatic men aged ≥45 years, Lp (a) should be measured, and intensive Lp (a)-lowering treatment should be considered.
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Dieckmeyer M, Sollmann N, El Husseini M, Sekuboyina A, Löffler MT, Zimmer C, Kirschke JS, Subburaj K, Baum T. Gender-, Age- and Region-Specific Characterization of Vertebral Bone Microstructure Through Automated Segmentation and 3D Texture Analysis of Routine Abdominal CT. Front Endocrinol (Lausanne) 2021; 12:792760. [PMID: 35154004 PMCID: PMC8828577 DOI: 10.3389/fendo.2021.792760] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To identify long-term reproducible texture features (TFs) of spinal computed tomography (CT), and characterize variations with regard to gender, age and vertebral level using our automated quantification framework. METHODS We performed texture analysis (TA) on baseline and follow-up CT (follow-up duration: 30-90 days) of 21 subjects (8 females, 13 males, age at baseline 61.2 ± 9.2 years) to determine long-term reproducibility. TFs with a long-term reproducibility error Δrel<5% were further analyzed for an association with age and vertebral level in a cohort of 376 patients (129 females, 247 males, age 62.5 ± 9.2 years). Automated analysis comprised labeling and segmentation of vertebrae into subregions using a convolutional neural network, calculation of volumetric bone mineral density (vBMD) with asynchronous calibration and TF extraction. Varianceglobal measures the spread of the gray-level distribution in an image while Entropy reflects the uniformity of gray-levels. Short-run emphasis (SRE), Long-run emphasis (LRE), Run-length non-uniformity (RLN) and Run percentage (RP) contain information on consecutive voxels of a particular grey-level, or grey-level range, in a particular direction. Long runs (LRE) represent coarse texture while short runs (SRE) represent fine texture. RLN reflects similarities in the length of runs while RP reflects distribution and homogeneity of runs with a specific direction. RESULTS Six of the 24 extracted TFs had Δrel<5% (Varianceglobal, Entropy, SRE, LRE, RLN, RP), and were analyzed further in 4716 thoracolumbar vertebrae. Five TFs (Varianceglobal,SRE,LRE, RLN,RP) showed a significant difference between genders (p<0.001), potentially being caused by a finer and more directional vertebral trabecular microstructure in females compared to males. Varianceglobal and Entropy showed a significant increase from the thoracic to the lumbar spine (p<0.001), indicating a higher degree and earlier initiation of trabecular microstructure deterioration at lower spinal levels. The four higher-order TFs showed significant variations between spine regions without a clear directional gradient (p ≤ 0.001-0.012). No TF showed a clear age dependence. vBMD differed significantly between genders, age groups and spine regions (p ≤ 0.001-0.002). CONCLUSION Long-term reproducible CT-based TFs of the thoracolumbar spine were established and characterized in a predominantly older adult study population. The gender-, age- and vertebral-level-specific values may serve as foundation for osteoporosis diagnostics and facilitate future studies investigating vertebral microstructure.
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Affiliation(s)
- Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- *Correspondence: Michael Dieckmeyer,
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Malek El Husseini
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Anjany Sekuboyina
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maximilian T. Löffler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology, University Medical Center, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Karupppasamy Subburaj
- Pillar of Engineering Product Development, Singapore University of Technology and Design, Singapore, Singapore
- Changi General Hospital, Singapore, Singapore
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Song P, Yan JY, Wang Y, Li X. Value of multi-detector computed tomography during intra-arterial infusion of contrast medium for locating insulinomas. J Int Med Res 2020; 48:300060519889432. [PMID: 32212878 PMCID: PMC7370806 DOI: 10.1177/0300060519889432] [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] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to evaluate the accuracy of multi-detector computed tomography (CT) during intra-arterial infusion of contrast medium (MDCT-IA) for locating insulinomas. Methods This retrospective study included patients with insulinomas who underwent surgery at the Chinese PLA General Hospital in 2013 to 2014. The patients’ case notes and investigation results were reviewed. Preoperative tumor localization was carried out by MDCT-IA and noninvasive methods including MDCT, magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS). Insulinoma localization using these methods was compared with the histologically confirmed location following surgical excision. Results Twelve insulinomas were identified in 12 patients, all of which were treated surgically. All patients received MDCT-IA (100%), 11 patients also underwent MRI (91.7%), seven underwent CT (58.3%), and all 12 underwent CEUS (100%). Tumor localization was determined successfully in 12/12 patients by MDCT-IA (100%), in 9/11 by MRI (81.8%), 4/7 by CT (57.1%), and 7/12 by CEUS (58.3%). Overall, MDCT-IA correctly localized 100% of the lesions. Conclusions MDCT-IA can be used to determine the preoperative localization of insulinomas.
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Affiliation(s)
- Peng Song
- Department of Interventional Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Jie-Yu Yan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Yan Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Xiao Li
- Department of Interventional Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical college, Beijing, China
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Lee S, Lee K, Kim H, An J, Han J, Lee T, Jeong H, Cho Y. Comparison of dental radiography and computed tomography: measurement of dentoalveolar structures in healthy, small-sized dogs and cats. J Vet Sci 2020; 21:e75. [PMID: 33016021 PMCID: PMC7533396 DOI: 10.4142/jvs.2020.21.e75] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/17/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Dental diseases are common in dogs and cats, and accurate measurements of dentoalveolar structure are important for planning of treatment. The information that the comparison computed tomography (CT) with dental radiography (DTR) is not yet reported in veterinary medicine. OBJECTIVES The purpose of this study was to compare the DTR with CT of dentoalveolar structures in healthy dogs and cats, and to evaluate the CT images of 2 different slice thicknesses (0.5 and 1.0 mm). METHODS We included 6 dogs (2 Maltese and 1 Spitz, Beagle, Pomeranian, mixed, 1 to 8 years, 4 castrated males, and 2 spayed female) and 6 cats (6 domestic short hair,8 months to 3 years, 4 castrated male and 2 spayed female) in this study. We measured the pulp cavity to tooth width ratio (P/T ratio) and periodontal space of maxillary and mandibular canine teeth, maxillary fourth premolar, mandibular first molar, maxillary third premolar and mandibular fourth premolar. RESULTS P/T ratio and periodontal space in the overall dentition of both dogs and cats were smaller in DTR compared to CT. In addition, CT images at 1.0 mm slice thickness was generally measured to be greater than the images at 0.5 mm slice thickness. CONCLUSIONS The results indicate that CT with thin slice thickness provides more accurate information on the dentoalveolar structures. Additional DTR, therefore, may not be required for evaluating dental structure in small-sized dogs and cats.
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Affiliation(s)
- Seunghee Lee
- College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Kichang Lee
- College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea.
| | - Hyeona Kim
- College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Jeongsu An
- College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Junho Han
- College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Taekwon Lee
- College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Hogyun Jeong
- College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Youngkwon Cho
- College of Health Sciences, Cheongju University, Cheongju 28503, Korea
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Lacagne AS, Brumpt E, Barrabé A, Pomero E, Chatelain B, Grillet F, Weber E, Malakhia A, Pons M, Aubry S, Meyer C, Sigaux N, Louvrier A. Diagnostic performance of mobile cone beam computed tomography versus conventional multi-detector computed tomography in orbital floor fractures: a study on human specimens. Int J Oral Maxillofac Surg 2020; 50:205-211. [PMID: 32921556 DOI: 10.1016/j.ijom.2020.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/27/2020] [Revised: 06/27/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the diagnostic accuracy of mobile cone beam computed tomography (MCBCT) versus multi-detector computed tomography (MDCT) in orbital floor fractures. Twenty-four fresh cadaver heads were used, and one orbital floor was fractured for each head by transconjunctival approach. MDCT and MCBCT were performed on each of the heads. The images obtained were then analysed independently by eight evaluators. The radiological characteristics of the orbital floor fractures were visualized with good interpretation agreement between the two images. The location of the fracture and enophthalmos were identified in a comparable manner with strong agreement (κ=0.93 and κ=0.85, respectively). Measurements of fatty hernias and bone defects showed a strong correlation between the two imaging modalities (Pearson coefficient between 0.64 and 0.71 and between 0.67 and 0.71, respectively). The fracture limits and the presence of bone fragments, an intrasinus fatty hernia, and a fracture of the associated medial orbital wall were visualized in both examinations with good agreement (κ=0.68, κ=0.51, κ=0.57, and κ=0.46, respectively). The soft tissue study showed superiority for MDCT, with a κ<0.0009. MCBCT showed good diagnostic performance in the study of orbital floor fracture characteristics.
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Affiliation(s)
- A S Lacagne
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France.
| | - E Brumpt
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Pomero
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - F Grillet
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Malakhia
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - M Pons
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
| | - S Aubry
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - N Sigaux
- Hospices Civils de Lyon, University Claude Bernard Lyon 1, Maxillofacial and Stomatology, Lyon-Sud Hospital Centre, Pierre-Benite, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
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Manolescu D, Oancea C, Timar B, Traila D, Malita D, Birsasteanu F, Tudorache V. Ultrasound mapping of lung changes in idiopathic pulmonary fibrosis. Clin Respir J 2019; 14:54-63. [PMID: 31675455 DOI: 10.1111/crj.13101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 07/26/2019] [Accepted: 10/27/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) is the most common and severe form of idiopathic interstitial pneumonia, accounted for 20% of cases of interstitial lung disease (ILD). In this study, we sought to compare the lung changes of IPF using a lung ultrasound (LUS) protocol of 12 zones with "current standard" high resolution computed tomography (HRCT) diagnostic method and overlap it with the functional pulmonary test as a complete clinical and imaging evaluation. METHODS Thirty-one patients were included in the study and performed HRCT and pulmonary functional tests (PFT). A 12-lung zones' LUS protocol was used and compared with HRCT and PFT. RESULTS The HRCT total fibrotic score had a correlation coefficient of 0.454 (P < 0.005) with predicted FVC and 0.713 with predicted DLCO (P < 0.001). Both the median of the number of B-lines and the average of the thickness of the pleural line obtained in the LUS assessment had a positively and statistically significant correlation with the HRCT fibrotic score P < 0.001. The pleural thickness of 2.4 mm is the cut-off value of the mild form of fibrosis with a sensitivity of 0.958 and a specificity of 0.994. CONCLUSION B-lines and the average thickness of the pleural line as LUS markers of the fibrotic interstitial syndrome are highly and positively correlated with HRCT score, FVC and DLCO. LUS as a complementary method in the clinical management of IPF could be used more often by skilled clinicians to assess patients in terms of possible diagnosis and monitoring of IPF.
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Affiliation(s)
- Diana Manolescu
- Department of Radiology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Cristian Oancea
- Department of Pulmonology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Bogdan Timar
- Department of Biostatistics and Medical Informatics, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Daniel Traila
- Department of Pulmonology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Daniel Malita
- Department of Radiology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Florica Birsasteanu
- Department of Radiology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Voicu Tudorache
- Department of Pulmonology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
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Ekingen A, Hatipoğlu ES, Hamidi C, Tuncer MC, Ertuğrul Ö. Splenic artery angiography: clinical classification of origin and branching variations of splenic artery by multi-detector computed tomography angiography method. Folia Morphol (Warsz) 2019; 79:236-246. [PMID: 31436304 DOI: 10.5603/fm.a2019.0088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/12/2019] [Revised: 06/15/2019] [Accepted: 07/03/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The splenic artery (SA) variations are rarely reported in the literature. Knowledge of the range of the SA and other arterial anomalies and their specific frequencies is very important ever for every visceral surgeon as well as for treatment of gastrointestinal bleeding, organ transplantation, transarterial chemoembolisation of neoplasm, infusion therapy, therapeutic arterial ligation, iatrogenic injuries. At the literature, there are more studies on the coeliac trunk, superior mesenteric artery and hepatic artery variations, but studies on the SA variations are uncommon. The studies on the SA variations are mostly in the form of case reports, but there are not many studies with large population on this issue. The purpose of this study was to evaluate the SA alone and to determine the variations determined separately from the other arteries. Accurate awareness of all the possible anatomic variations is crucial in the upper abdomen surgery. MATERIALS AND METHODS Seven hundred fifty patients undergoing multi-detector computed tomography angiography between 2015 and 2017 were retrospectively evaluated for the SA variations. We created a new classification system to determine anatomic variations of the SA. RESULTS Twenty-three different types were identified related to anatomic variations in the origin and branching pattern of the SA. While 596 (79.47%) patients had standard SA anatomy, 154 (20.53%) patients had variant SA anatomy. CONCLUSIONS The SA has quite different variation types and the practical context of the issue is of primary importance in surgery, gastroenterology, oncology and radiology. Liver and pancreas transplantation, splenectomy, embolisation of tumours of the abdominal organs, as well as other numerous diagnostic and therapeutic procedures, require detailed anatomical knowledge.
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Affiliation(s)
- A Ekingen
- Vocational High School of Health Services, University of Batman, Turkey
| | - E S Hatipoğlu
- Department of Anatomy, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey
| | - C Hamidi
- Department of Radiology, Private Bağlar Hospital, Diyarbakır, Turkey
| | - M C Tuncer
- Department of Anatomy, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey.
| | - Ö Ertuğrul
- Department of Radiology, Memorial Hospital, Diyarbakır, Turkey
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Rivas AE, Fischetti AJ, Le Roux AB, Hollinger C, Oehler DA, Paré JA. STANDING COMPUTED TOMOGRAPHY IN NONANESTHETIZED LITTLE PENGUINS ( EUDYPTULA MINOR) TO ASSESS RESPIRATORY SYSTEM ANATOMY AND MONITOR DISEASE. J Zoo Wildl Med 2019; 50:396-404. [PMID: 31260206 DOI: 10.1638/2018-0189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2019] [Indexed: 11/21/2022] Open
Abstract
Multidetector computed tomography (MDCT) scans were performed in clinically healthy, nonanesthetized, standing little penguins (Eudyptula minor) to determine reference ranges for air-sac and lung volumes, as well as lung density. Five of 15 clinically healthy birds were diagnosed with pulmonary granulomas on initial MDCT scans. Granulomas were not readily apparent on radiographs, even in cases where the entire normal pulmonary parenchymal architecture was effaced on the MDCT scan. Serial MDCT scans after antifungal and antimycobacterial therapies demonstrated a response to treatment. MDCT scanning in nonanesthetized little penguins proved to be a well-tolerated, non-invasive imaging modality for respiratory diseases that are otherwise difficult to diagnose, including aspergillosis and mycobacteriosis.
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Ebuchi K, Yoshitani K, Kanemaru E, Fujii T, Tsukinaga A, Shimahara Y, Ohnishi Y. Measurement of the Aortic Annulus Area and Diameter by Three-Dimensional Transesophageal Echocardiography in Transcatheter Aortic Valve Replacement. J Cardiothorac Vasc Anesth 2019; 33:2387-2393. [PMID: 31155456 DOI: 10.1053/j.jvca.2019.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 03/06/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Sizing of the aortic valve is crucial for transcatheter aortic valve replacement (TAVR). Multidetector computed tomography (MDCT) is used for sizing. Recently, three-dimensional transesophageal echocardiography (3DTEE) has enabled accurate measurement of the aortic annulus area and diameter in cases that are difficult to measure. The authors compared measurements of aortic annulus areas and diameters acquired by MDCT and 3DTEE. DESIGN Retrospective observational study. SETTING Single national center. PARTICIPANTS Sixty-eight patients who underwent TAVR replacement between September 2015 and March 2017. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The authors extracted and compared preoperative measurements of the aortic annulus area, as well as the long- and short-axis diameter, measured by MDCT and 3DTEE. There was no significant difference in the aortic annulus area (409 ± 74 v 414 ± 70 mm2, p = 0.15) or short-axis diameter (20.4 ± 2.0 v 20.6 ± 1.9 mm, p = 0.103) between 3DTEE and MDCT, but the long-axis diameter differed significantly (25.0 ± 2.4 v 25.8 ± 2.0 mm, p < 0.001), respectively. Prosthesis sizes based on 3DTEE and MDCT were the same, except in 3 patients who could not stay still during MDCT measurement; in those cases, prosthesis sizes based on 3DTEE were adopted. CONCLUSIONS Measurements of the aortic annulus area and diameter in TAVR were similar between 3DTEE and MDCT. Patients who have difficulty remaining still during MDCT measurement because of dementia should have their prostheses sized based on 3DTEE measurements.
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Affiliation(s)
- Keigo Ebuchi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenji Yoshitani
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - Eiki Kanemaru
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tasuku Fujii
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akito Tsukinaga
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yusuke Shimahara
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshiniko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Skala T, Tudos Z, Homola M, Moravec O, Kocher M, Cerna M, Ctvrtlik F, Odstrcil F, Langova K, Klementova O, Taborsky M. The impact of ECG synchronization during acquisition of left‑atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation - a prospective, randomized study. BRATISL MED J 2019; 120:177-183. [PMID: 31023034 DOI: 10.4149/bll_2019_033] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The impact of ECG gating during computed tomography (CT) acquisition of left atrium (LA) model on radiation dose, image quality and ablation event-free survival rate after catheter ablation (CA) of atrial fibrillation (AF) is not well defined. METHODS Sixty-two patients with paroxysmal atrial fibrillation were randomized for two types of LA CT (with vs without ECG gating) before CA. Pulmonary veins isolation was performed in all patients. Patients were followed for 12 months after CA. RESULTS There was no difference between the groups in CA length (131.61±32.57 vs 119.84±33.18 min; p=0.108), CA fluoroscopy time (4.48±2.19 vs 3.89±1.83 min; p=0.251), CA fluoroscopy dose (3.99±2.79 vs 3.91 vs2.91 Gy*cm2; p=0.735), visual data quality (1.77±0.88 vs 2.0±0.63; p=0.102) and registration error (2.42±0.72 vs 2.43±0.46 mm; p=0.612). We found a significant difference in CT Dose index (89.55±5.99 vs 19.19±4.33 mGy; p<0.0001) and Dose Length product (1438.87±147.75 vs 328.21±73.83 mGy*cm; p<0.0001). Twelve months after CA, 25 of 31 patients in the gated group and 24 of 31 patients in the non-gated group were free of AF (80.65 vs 77.42 %; p=0.838). CONCLUSION ECG gating of computed tomography of LA before AF ablation burdens patients with a four times higher radiation dose while improving neither the quality of CT model or fusion of CT with the electroanatomic map. As a result, it has no significant impact on arrhythmia recurrence rate after ablation (Tab. 3, Fig. 3, Ref. 25).
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Mathew RP, Xavier JV, Babukumar SM, Basti RS, Suresh HB. Clinicopathological and morphological spectrum of gastrointestinal stromal tumours on multi-detector computed tomography. Pol J Radiol 2018; 83:e545-53. [PMID: 30800192 DOI: 10.5114/pjr.2018.81362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose To describe the clinicopathological and morphological features of gastrointestinal stromal tumours (GISTs) on multi-detector computed tomography (MDCT). Material and methods MDCT (plain and post contrast) images of 25 confirmed cases of GISTs were retrospectively evaluated from our hospital database. The images were analysed for the location, size, growth pattern, attenuation pattern, relation to adjacent structures, presence or absence of ulceration, calcification, metastases, lymphadenopathy, and for any complications such as haemorrhage, intestinal obstruction, etc. Institutional Ethics Committee clearance was obtained prior to the commencement of the study. Statistics used included percentage frequency. Results Our study group comprised 14 males and 11 females. The mean age of our study population was 60 years (age range: 40 to 82 years). The mean tumour size was 11.7 cm. The stomach and small bowel accounted for 76% of the primary tumour site. The commonest imaging appearance of GIST observed in our study was that of an exophytic mass (76%) with a heterogenous pattern of enhancement (96%) with intratumoural necrosis (76%). MDCT demonstrated complications in three patients (12%). Six patients presented with metastatic foci (five to the liver and one to the lung), while lymphadenopathy was observed in five patients (20%). Associated complications included intestinal obstruction (8%) and retrogastric haematoma (4%). Incidental findings included uterine fibroid (n = 1), ovarian dermoid (n = 1), and chronic pancreatitis (n = 1). Conclusions GISTs are predominantly large tumours with a well circumscribed and exophytic pattern on MDCT, with or without cystic/necrotic areas, and they mostly show a heterogenous pattern of enhancement on post-contrast administration.
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Wei R, Lin K, Guo Y, Li J, Wang Y. [Feasibility analysis of predicting expression of Ki67 in pancreatic cystic neoplasm based on radiomics]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2019; 36:1-6. [PMID: 30887770 PMCID: PMC9929875 DOI: 10.7507/1001-5515.201805014] [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] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Indexed: 11/03/2022]
Abstract
This study aims to predict expression of Ki67 molecular marker in pancreatic cystic neoplasm using radiomics. We firstly manually segmented tumor area in multi-detector computed tomography (MDCT) images. Then 409 high-throughput features were automatically extracted and the least absolute shrinkage selection operator (LASSO) regression model was used for feature selection. After 200 bootstrapping repetitions of LASSO, 20 most frequently selected features made up the optimal feature set. Then 200 bootstrapping repetitions of support vector machine (SVM) classifier with 10-fold cross-validation were used to avoid overfitting and accurately predict the Ki67 expression. The highest prediction accuracy could achieve 85.29% and the highest area under the receiver operating characteristic curve (AUC) was 91.54% with a sensitivity (SENS) of 81.88% and a specificity (SPEC) of 86.75%. According to the results of experiment, the feasibility of predicting expression of Ki67 in pancreatic cystic neoplasm based on radiomics was verified.
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Affiliation(s)
- Ran Wei
- Department of Electronic Engineering, Fudan University, Shanghai 200433, P.R.China;Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai, Shanghai 200433, P.R.China
| | - Kanru Lin
- Department of Pancreatic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, P.R.China
| | - Yi Guo
- Department of Electronic Engineering, Fudan University, Shanghai 200433, P.R.China;Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai, Shanghai 200433,
| | - Ji Li
- Department of Pancreatic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, P.R.China
| | - Yuanyuan Wang
- Department of Electronic Engineering, Fudan University, Shanghai 200433, P.R.China;Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai, Shanghai 200433, P.R.China
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Bodanapally UK, Archer-Arroyo KL, Dreizin D, Shanmuganathan K, Schwartzbauer G, Li G, Fleiter TR. Dual-Energy Computed Tomography Imaging of Head: Virtual High-Energy Monochromatic (190 keV) Images Are More Reliable Than Standard 120 kV Images for Detecting Traumatic Intracranial Hemorrhages. J Neurotrauma 2019; 36:1375-1381. [PMID: 30328766 DOI: 10.1089/neu.2018.5985] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/12/2022] Open
Abstract
High-energy monochromatic (190 keV) images may be more reliable than standard 120 kV Images for detecting intracranial hemorrhages. We aimed to retrospectively compare virtual high monochromatic (190 keV) and standard 120 kV images from dual-energy computed tomography (CT; DECT) for the diagnosis of intracranial hemorrhages in traumatic brain injury (TBI). We analyzed admission CT studies in 100 trauma patients. Three radiologists independently reviewed four image sets: 120 kV and 190 keV (thin [1 mm] and thick [5 mm] section) images for the presence of various types of intracranial hemorrhages. The proportions of positive variables were compared and differences calculated by McNemar test and sensitivities determined by contingency tables. Randomly selected hemorrhagic lesions were analyzed for contrast index (CI). Thin-section 190 keV images were superior in the detection of subdural hematomas (SDH) (p < 0.0001), supratentorial contusions (p < 0.0001), and epidural hematomas (EDH) (p = 0.014), when compared with standard 120 kV images. However, 190 keV images were inferior to standard 120 kV images in diagnosis of subarachnoid hemorrhage (SAH) (thin-sections, p = 0.059; thick-sections, 0.0075). The 190 keV images yielded moderate increase in CI of contusions (Cohen's d > 0.53) and a large increase in CI of extra-axial hematomas (Cohen's d > 0.86). Our results indicate that virtual high monochromatic (190 keV, thin-section) images combined with standard 120 kV images may provide optimal diagnostic performance for evaluation of patients suspected of TBI.
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Affiliation(s)
- Uttam K Bodanapally
- 1 Department of Diagnostic Radiology and Nuclear Medicine, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Krystal L Archer-Arroyo
- 2 Department of Diagnostic Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - David Dreizin
- 1 Department of Diagnostic Radiology and Nuclear Medicine, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kathirkamanathan Shanmuganathan
- 1 Department of Diagnostic Radiology and Nuclear Medicine, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gary Schwartzbauer
- 3 Department of Neurosurgery, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Guang Li
- 1 Department of Diagnostic Radiology and Nuclear Medicine, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Thorsten R Fleiter
- 1 Department of Diagnostic Radiology and Nuclear Medicine, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
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Ma RH, Li G, Sun Y, Meng JH, Zhao YP, Zhang H. Application of fused image in detecting abnormalities of temporomandibular joint. Dentomaxillofac Radiol 2018; 48:20180129. [PMID: 30495970 DOI: 10.1259/dmfr.20180129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 01/25/2023] Open
Abstract
OBJECTIVES: To present a method for image fusion of cone beam CT (CBCT)/CT and MRI and to explore whether the image data sets fused in such a way could aid the detection of temporomandibular joint (TMJ) anatomical structures and lesions. METHODS: There were five cases included in this study. One case was space occupying lesion giant cell tumour of tendon sheaths, one case was chronic inflammation in the condyle, one case was articular disc calcification of the bilateral TMJs, and the other two cases were TMJ disorders (anterior disc displacement without reduction). The digital imaging and communications in medicine format data of CT/CBCT and MRI of the cases were collected, and then imported to the Amira visual software where the registration process was conducted. Based on the different scan model, the registration process could be separated into automatic registration of CT/CBCT with quadrature slice MR images and the semi-automatic registration of CT/CBCT with oblique slice MR images by altering the registration parameters. Rigid transform model and the similarity metric of normalization mutual information was used for registration in the present study. RESULTS: The relationship between the soft mass and hard tissue was shown clearly in the fused images when compared to sole observation of CBCT/CT or MR images. The fused images could define the tumour outline and the destructive bone clearly in the same image. The fused results helped the observers to ensure uncertain defects which could not be confirmed only by one image data set. CONCLUSIONS: The CT/CBCT and MR images could be fused to aid detection of TMJ anatomical structures and related lesions.
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Affiliation(s)
- Ruo-Han Ma
- 1 Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology , Beijing , China
| | - Gang Li
- 1 Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology , Beijing , China
| | - Yi Sun
- 2 Department of Imaging & Pathology, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven , Leuven , Belgium
| | - Juan-Hong Meng
- 3 Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology , Beijing , China.,4 Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology , Beijing , China
| | - Yan-Ping Zhao
- 1 Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology , Beijing , China.,4 Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology , Beijing , China
| | - Hao Zhang
- 4 Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology , Beijing , China.,5 Department of Prosthodontics, Peking University School and Hospital of Stomatology , Beijing , China
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Sato Y, Yanagawa M, Hata A, Enchi Y, Kikuchi N, Honda O, Nakanishi K, Tomiyama N. Volumetric analysis of the thymic epithelial tumors: correlation of tumor volume with the WHO classification and Masaoka staging. J Thorac Dis 2018; 10:5822-5832. [PMID: 30505490 PMCID: PMC6236181 DOI: 10.21037/jtd.2018.09.133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 05/22/2018] [Accepted: 05/20/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND The purpose of our study was to investigate the correlation between tumor volume (TV) and each subtype of thymic epithelial tumors (TETs) based on the World Health Organization (WHO) classification and Masaoka staging. METHODS Sixty-one consecutive patients (45 thymomas and 16 thymic carcinomas) were studied. All were classified according to Masaoka staging: 31 non-invasive TETs (stage I) and 30 invasive TETs (8 stage II, 11 stage III, 3 stage IVa, and 8 stage IVb). TV on computed tomography (CT) were semi-automatically calculated using our software. The correlation of TV with each WHO subtype and Masaoka staging was analyzed using Mann-Whitney U and Scheffe's F test. RESULTS Thymic carcinoma (mean ± SD, 117.5±143.6 cm3) was significantly larger than thymoma (53.4±78.4 cm3) (P=0.0016). Stage IVb tumor (190.8±156.8 cm3) was significantly larger than stage I (33.1±42.6 cm3) (P<0.05). Invasive TETs were significantly larger than non-invasive TETs (P=0.0016). TV >54.3 cm3 indicated invasive TETs. CONCLUSIONS TV of invasive TETs may be larger at the time of initial presentation. TV >54.3 cm3 indicates invasive TETs.
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Affiliation(s)
- Yukihisa Sato
- Department of Diagnostic Radiology, Osaka International Cancer Institute, Chuo-ku, Osaka, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Akinori Hata
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yukihiro Enchi
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Suita, Osaka, Japan
| | - Noriko Kikuchi
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Osamu Honda
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Katsuyuki Nakanishi
- Department of Diagnostic Radiology, Osaka International Cancer Institute, Chuo-ku, Osaka, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Abstract
Cystic metastases in renal cell carcinoma (RCC) are very rare. Very few case reports can be found in literature. Retroperitoneal cystic nodal metastases have been reported in head and neck tumors. We present a very interesting case of RCC that had disseminated intraperitoneal and retroperitoneal cystic metastases that mimicked systemic hydatidosis. A detailed color Doppler sonography was followed by plain and contrast-enhanced computed tomography on a 64-slice multi-detector scanner. Imaging features were more in favor of right RCC with cystic lymph nodal metastasis. However, rare possibility of incidental hydatid disease with RCC could not be ruled out. Biopsy from left inguinal lymph nodes was taken, which confirmed metastatic deposits from RCC.
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Affiliation(s)
- Amit Nandan Dhar Dwivedi
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | - Chandan Mourya
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
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Shi Z, Li X, You R, Li Y, Zheng X, Ramen K, Loosa VS, Cao D, Chen Q. Homogenously isoattenuating insulinoma on biphasic contrast-enhanced computed tomography: Little benefits of diffusion-weighted imaging for lesion detection. Oncol Lett 2018; 16:3117-3125. [PMID: 30127903 PMCID: PMC6096136 DOI: 10.3892/ol.2018.9037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/11/2017] [Accepted: 05/30/2018] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to evaluate the diagnostic benefit of diffusion-weighted imaging (DWI) in the detection of homogenous isoattenuating insulinoma on biphasic contrast-enhanced computed tomography (CT) preoperatively and to determine which magnetic resonance (MR) sequences exhibited the best diagnostic performance. A total of 44 consecutive patients who underwent biphasic contrast-enhanced CT and conventional MR imaging (MRI), including DWI on a 3T scanner, were identified retrospectively. Apparent diffusion coefficient (ADC) values of insulinomas and the surrounding pancreatic parenchyma were compared using a Wilcoxon signed-rank test. Receiver operating characteristic analysis was used to compare the diagnostic accuracy of four randomized image sets [T2-weighted image (WI), axial T1WI, DWI and T2WI + DWI] for each reader. Axial T1-weighted MRI exhibited the highest relative sensitivity for each reader; DWI alone exhibited the lowest relative sensitivity and the lower inter-reader agreement. There was no significant difference in lesion detection between T2WI and T2WI + DWI image sets for each reader. The ADC values of the insulinoma were significantly lower compared with those of the surrounding parenchyma. In conclusion, DWI does not benefit the detection of homogenous isoattenuating insulinoma. Axial T1WI is the optimal pulse sequence. Quantitative assessment of the tumor ADC values may be a useful tool to characterize identified pancreatic neoplasms.
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Affiliation(s)
- Zhenshan Shi
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Xiumei Li
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Ruixiong You
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Yueming Li
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Xianying Zheng
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Kamisha Ramen
- Department of Radiology, Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Vikash Sahadeo Loosa
- Department of Radiology, Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Qunlin Chen
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
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Malcolm KB, Dinwoodey DL, Cundiff MC, Regis SM, Kitts AKB, Wald C, Lynch ML, Al-Husami W, McKee AB, McKee BJ. Qualitative coronary artery calcium assessment on CT lung screening exam helps predict first cardiac events. J Thorac Dis 2018; 10:2740-2751. [PMID: 29997936 DOI: 10.21037/jtd.2018.04.76] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/06/2022]
Abstract
Results A total of 1,513 individuals underwent CTLS. Downstream data, pre-test cardiac risk factors and CAC scores were available for 88.3% (1,336/1,513). The average length of follow-up was 2.64 (SD ±0.72) years. There were a total of 43 events, occurring in 1.55% (6/386) of patients with mild CAC, 3.24% (11/339) of patients with moderate CAC, and 8.90% (26/292) of patients with marked CAC. There were no events among patients with no reported CAC (0/319). Using multivariable logistic modeling, the increased odds of an initial cardiac event was 2.56 (95% CI, 1.76-3.92, P<0.001) for mild CAC, 6.57 (95% CI, 3.10-15.4, P<0.001) for moderate CAC, and 16.8 (95% CI, 5.46-60.3, P<0.001) for marked CAC, as compared to individuals with no CAC. Time to event analysis showed distinct differences among the four CAC categories (P<0.001). Conclusions Qualitative coronary artery calcification scoring of CTLS exams may provide a novel method to help select individuals at elevated risk for an initial cardiac event.
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Affiliation(s)
- Katherine B Malcolm
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA.,Department of Internal Medicine, University of California, San Francisco, CA, USA
| | - Danya L Dinwoodey
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Michael C Cundiff
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Shawn M Regis
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Andrea K Borondy Kitts
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Christoph Wald
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Miranda L Lynch
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Wael Al-Husami
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Andrea B McKee
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Brady J McKee
- Department of Radiation Oncology, Radiology, Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
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Hashemzadeh S, Mehrafsa B, Kakaei F, Javadrashid R, Golshan R, Seifar F, Hajibonabi F, Salmannezhad Khorami F. Diagnostic Accuracy of a 64-Slice Multi-Detector CT Scan in the Preoperative Evaluation of Periampullary Neoplasms. J Clin Med 2018; 7:E91. [PMID: 29702569 DOI: 10.3390/jcm7050091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/21/2018] [Accepted: 04/23/2018] [Indexed: 01/28/2023] Open
Abstract
Periampullary tumors are highly malignant masses with poor prognosis. Surgical resection is the only treatment for patients with this disease. The preoperative evaluation of masses is essential to determine the tumor resectability and vascular invasion. The aim of this study was to determine the diagnostic accuracy of 64-slice multi-detector computed tomography (MDCT) in detecting the resectability of periampullary masses. A cross-sectional study was conducted on patients with a definite diagnosis of periampullary cancer. All the participants underwent an MDCT scan before the surgical pancreaticoduodenectomy. The preoperative results were compared to the intraoperative findings and the diagnostic accuracy was determined based on the sensitivity and specificity of the MDCT. From June 2015 until June 2016, 32 patients with periampullary carcinoma were enrolled in the study. Of 32 masses, one of them considered nonresectable because of the gross vascular invasion in th CT images. After the operation, the overall resectability rate was 81.3%. The sensitivity and specificity of MDCT for tumor resectability was 100% and 16.7%, respectively, with an overall accuracy of 84.4%. To sum up, MDCT had high sensitivity but low specificity in the preoperative evaluation of preampullary carcinomas. The low specificity resulted from the low accuracy of the CT scan in detecting vascular involvement.
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Cappabianca S, Belfiore MP, Reginelli A, Capasso R, Del Prete A, Petrillo M, Mascia P, Rossi C, Romano F, De Filippo M, Scialpi M, Gragnano F, Calabrò P, Belfiore G, Brunese L, Grassi R, Rotondo A. Mandatory Reporting of Coronary Artery Calcifications Incidentally Noted on Chest Multi-Detector Computed Tomography: A Multicentre Experience. Curr Vasc Pharmacol 2018; 17:92-98. [PMID: 29345585 DOI: 10.2174/1570161116666180117111856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/13/2017] [Revised: 01/08/2018] [Accepted: 01/08/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Coronary Artery Calcifications (CACs) are associated with coronary atherosclerosis and Cardiovascular (CV) events. In "non-cardiovascular" settings, CACs can be easily detected on chest Multi-Detector Computed Tomography (MDCT). Their evaluation may help to better stratify CV risk in the general population, especially for primary prevention. AIMS We retrospectively evaluated the relationship between CAC distribution and CV risk, determined by Framingham Risk Score (FRS), in a cohort of patients who underwent chest MDCT performed for several clinical indications. METHOD We retrospectively recruited 305 patients (194 men, 111 women; mean age 70.5 years) from 3 different Italian centres. Patients with coronary stent, pacemaker and/or CV devices were excluded from the study. Circumflex Artery (LCX), Left Main Coronary Artery (LMCA), left Anterior Descending artery (LAD) and right coronary artery (RCA) were analysed. RESULTS From a total population of 305 patients, 119 (39%) had low FRS (<10%), 115 (38%) had intermediate FRS (10-20%), and 71 (23%) had high FRS (>20%). The study identified 842 CACs located in decreasing order as follows: RCA (34.5%), LAD (32.3%), LCX (28%) and LMCA (13%). Statistical two-step analysis subdivided patients into two clusters according to FRS (risk threshold = 12.38%): cluster I (mean 9.34) and cluster II (mean 15.09). A significant association between CAC distribution and cluster II was demonstrated. CACs were mostly detected in patients with intermediate FRS. All patients (100%) with the highest CV risk showed intermediate RCA and LMCA involvement. CONCLUSION Radiologists can note the distribution of CACs on a chest MDCT and should mandatorily record them in their reports. Depending on CAC presence and location, these findings may have important clinical implications, mostly in asymptomatic patients with intermediate FRS. This information may reclassify a patients' CV risk and improve clinical management.
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Affiliation(s)
- Salvatore Cappabianca
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Maria Paola Belfiore
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Alfonso Reginelli
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Raffaella Capasso
- Department of Medicine and Health Sciences, University of Molise, 86100, Campobasso, Italy
| | - Alessandra Del Prete
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Mario Petrillo
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Paola Mascia
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Claudia Rossi
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Francesco Romano
- Department of Mental and Physical Health and University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Massimo De Filippo
- Department of Clinical Sciences, Section of Radiological Sciences, University Hospital of Parma, 43100, Parma, Italy
| | - Michele Scialpi
- Department of Surgical, Radiological and Odontostomatological Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, 06134, Perugia, Italy
| | - Felice Gragnano
- Department of Cardiothoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paolo Calabrò
- Department of Cardiothoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Belfiore
- Department of Diagnostic Imaging, "Sant'Anna and San Sebastiano" Hospital, 81100, Caserta, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences, University of Molise, 86100, Campobasso, Italy
| | - Roberto Grassi
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Antonio Rotondo
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
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Momosaka D, Togao O, Hiwatashi A, Yamashita K, Yoshimoto K, Mori M, Iwaki T, Honda H. Spindle cell/sclerosing rhabdomyosarcoma with intracranial invasion without destroying the bone of the skull base: a case report and literature review. Acta Radiol Open 2017; 6:2058460117727316. [PMID: 28839951 PMCID: PMC5564996 DOI: 10.1177/2058460117727316] [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: 06/02/2017] [Accepted: 07/29/2017] [Indexed: 11/16/2022] Open
Abstract
Spindle cell/sclerosing rhabdomyosarcoma (ssRMS) is a new subtype of rhabdomyosarcoma included in the World Health Organization soft tissue and bone tumor classification in 2013. Despite the increasing number of reported cases of ssRMS, the imaging characteristics of ssRMS are not established. Herein, we present the case of an elderly Japanese woman with ssRMS of the masticator space with intracranial invasion without destruction of the adjacent bone. Attention should be paid to the presence of intracranial infiltration that may indicate a worse prognosis. Tumor growth without bone destruction could be a key finding to differentiate ssRMSs from conventional subtypes of rhabdomyosarcoma.
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Affiliation(s)
- Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Megumu Mori
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Iwaki
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Suprasanna K, Kumar A. Surgically Relevant Bony Anatomical Variations in Paraclinoid Aneurysms-Three-Dimensional Multi-Detector Row Computed Tomography-Based Study. J Neurosci Rural Pract 2017; 8:330-334. [PMID: 28694608 PMCID: PMC5488549 DOI: 10.4103/jnrp.jnrp_416_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the proportion of surgically relevant anatomical variations such as caroticoclinoid foramen, interclinoid osseous bridge, and anterior clinoid pneumatization in patients with paraclinoid aneurysms based on computed tomography (CT) cerebral angiography studies. MATERIALS AND METHODS Fifty-four CT cerebral angiography studies showing paraclinoid aneurysms involving the cavernous, clinoid, and supraclinoid internal carotid artery (ICA) were retrospectively evaluated. Source images were processed for three-dimensional reconstructions to evaluate the presence and type of caroticoclinoid foramen, interclinoid osseous bridge, and multiplanar reconstructions with bone algorithm to study the type of pneumatization. RESULTS The study included 30 female and 24 male patients with mean age of 45.61 (10.47) years. Among the 108 sides studied in 54 patients, caroticoclinoid foramen was seen in 24 cases (22.22%), interclinoid osseous bridge was seen unilaterally in 1 case (0.9%), and pneumatization of anterior clinoid process occurred in 12 cases (11.11%). Incomplete caroticoclinoid foramen (11 cases) and Type I pneumatization (7 cases) were seen to be predominant subtypes. There was no statistically significant gender difference in the occurrence of caroticoclinoid foramen and anterior clinoid pneumatization. Seventy-four aneurysms were detected in 54 patients. Based on their location, 46 aneurysms involved supraclinoid ICA, 18 aneurysms in the clinoid segment, and 10 aneurysms in the cavernous segment. Caroticoclinoid foramen was most prevalent in clinoid aneurysms with 12 cases occurring in the clinoid segment. CONCLUSION Notable proportions of caroticoclinoid foramen and pneumatization occur in cases of paraclinoid aneurysm. Radiological reports should emphasize on these surgically relevant bony anatomical variations.
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Affiliation(s)
- K Suprasanna
- Department of Radiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Ashvini Kumar
- Department of Radiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Fowler J, Stieger-Vanegas SM, Vanegas JA, Bobe G, Poulsen KP. Comparison of Thoracic Radiography and Computed Tomography in Calves with Naturally Occurring Respiratory Disease. Front Vet Sci 2017; 4:101. [PMID: 28730151 PMCID: PMC5498470 DOI: 10.3389/fvets.2017.00101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 01/24/2017] [Accepted: 06/12/2017] [Indexed: 12/12/2022] Open
Abstract
Objective To evaluate the severity and extent of lung disease using thoracic computed radiography (CR) compared to contrast-enhanced multi-detector computed tomography (MDCT) of the thorax in calves with naturally occurring respiratory disease and to evaluate the feasibility and safety of performing contrast-enhanced thoracic multi-detector MDCT examinations in sedated calves. Furthermore, to evaluate if combining CR or MDCT with respiratory scoring factors will improve prediction of the chronicity of pulmonary disease in calves. Animals Thirty Jersey heifer calves ranging in age between 25 and 89 days with naturally occurring respiratory disease. Procedures All calves were evaluated via thoracic CR and contrast-enhanced MDCT. All calves were euthanized immediately following thoracic MDCT and submitted for necropsy. Imaging and histopathology results were compared with each other. Results Thoracic MDCT was superior for evaluation of pneumonia in calves due to the lack of summation in all areas of the lungs. Intravenously administered sedation provided an adequate plane of sedation for acquiring MDCT images of diagnostic quality, without the need for re-scanning. A diagnosis of pneumonia was made with equal rate on both thoracic CR and MDCT. Although mild differences in classification of lung pattern and extent of lung disease were seen when comparing an experienced and a less experienced evaluator, the overall differences were not statistically significant. The best intra- and inter-observer agreement was noted when evaluating the cranioventral aspects of the lungs in either modality. Clinical respiratory scoring is inadequate for diagnosing chronicity of pneumonia in calves with naturally occurring pneumonia. Conclusion and clinical importance Both imaging modalities allowed diagnosis of pneumonia in calves. The cranial ventral aspects of the lungs were most commonly affected. Thoracic CR and MDCT provided similar diagnostic effectiveness in diagnosing pneumonia. However, MDCT provided better assessment of subtle details, which may be otherwise obscured due to summation artifact.
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Affiliation(s)
- Jennifer Fowler
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States
| | - Susanne M Stieger-Vanegas
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States
| | - Jorge A Vanegas
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States
| | - Gerd Bobe
- Department of Animal and Rangeland Sciences, College of Agricultural Sciences, Oregon State University, Corvallis, OR, United States.,Linus Pauling Institute, Oregon State University, Corvallis, OR, United States
| | - Keith P Poulsen
- Wisconsin Veterinary Diagnostic Laboratory, Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, United States
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Nafakhi H, Almosawi A, Alnafakh H, Mousa W. The relationship of socioeconomic status with coronary artery calcification and pericardial fat. Kardiol Pol 2017; 75:368-375. [PMID: 28150282 DOI: 10.5603/kp.a2016.0187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 07/02/2016] [Revised: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little data currently exist supporting the correlation of socioeconomic status (SES) to markers of subclinical coronary atherosclerosis. AIM The main aim was to investigate the relationship of SES measured by economic status and educational level with coronary artery calcification (CAC) and pericardial fat volume (PFV) assessed by multi-detector computed tomography (MDCT). METHODS A total of 220 consecutive patients with suspected coronary artery disease, who underwent 64-slice MDCT angiography for assessment of coronary atherosclerosis, were recruited between January 2014 and March 2015. Of these, 186 patients were enrolled in this cross sectional study. RESULTS Low economic status patients showed higher PFV values; median (inter-quartile range [IQR] was 94 [50-140] cm3, p = 0.00001 and r = 0.37, compared to patients with high economic status, and this association persisted even after multiple logistic regression to conventional cardiac risk factors (p = 0.004, CI 7.3-30.4), while patients with low economic status reported a higher calcium score (but statistically non significant) (p = 0.12) compared to high economic status patients. Pa-tients with no formal education showed higher PFV (median [IQR] was 93 [48-140] cm3, p = 0.01) compared to patients with bachelor's degree (median [IQR] was 56 [28-92] cm3), but this association was attenuated after further adjustment for conventional cardiac risk factors (p = 0.1, CI -9.52-10.88), while CAC showed no significant correlation with educational level (p = 0.2, r = 0.117). CONCLUSIONS Socioeconomic status, particularly economic status measure, reported a significant inverse relationship with PFV independent of conventional cardiac risk factors.
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Li T, Zhang Y, Wang Y, Gao J, Jiang Y. Chest CT with iterative reconstruction algorithms for airway stent evaluation in patients with malignant obstructive tracheobronchial diseases. Medicine (Baltimore) 2016; 95:e4873. [PMID: 27684818 PMCID: PMC5265911 DOI: 10.1097/md.0000000000004873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of the study was to investigate the image quality of low-dose CT images with different reconstruction algorithms including filtered back projection (FBP), hybrid iterative reconstruction (HIR), and iterative model reconstruction (IMR) algorithms by comparison of routine dose images with FBP reconstruction, in patients with malignant obstructive tracheobronchial diseases.In total, 60 patients (59 ± 9.3 years, 37 males) with airway stent who are randomly assigned into 2 groups (routine-dose [RD] and low-dose [LD] group, 30 for each) underwent chest CT on a 256-slice CT (RD-group 120 kV, 250 mAs, LD-group 120 kV, 120 mAs). Images were reconstructed with filtered back projection (FBP) algorithm in the RD group, whereas with FBP, HIR and IMR algorithms in the LD group. Effective radiation dose of both groups was recorded. Image-quality assessment was performed by 2 radiologists according to structure demarcation near stents, artifacts, noise, and diagnostic confidence using a 5-point scale (1 [poor] to 5 [excellent]). Image noise and CNR were measured.The effective radiation dose of LD group was reduced 52.7% compared with the RD group (10.8 mSv ± 0.58 vs 5.1 mSv ± 0.26, P = 0.00). LD-IMR images enabled lowest image noise and best subjective image quality scores of all 4 indices, when compared with RD images reconstructed with FBP (RD-FBP) images (all P < 0.05). LD images reconstructed with and with HIR (LD-HIR) images enabled higher score in subjective image quality of artifacts (P < 0.05), whereas it showed no difference in the other subjective image-quality indices and image noise. Significant higher image noise and lower score of subjective image quality were observed in LD-FBP images (all P < 0.05).Both IMR and HIR improved image quality of low-dose chest CT by comparison of routine dose images reconstructed with FBP. Meanwhile, IMR allows further image quality improvement than HIR.
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Affiliation(s)
- Tingting Li
- Zhengzhou University, Zhengzhou, Henan Province
| | - Yonggao Zhang
- Zhengzhou University, Zhengzhou, Henan Province
- Correspondence: Yonggao Zhang, the first affiliated hospital of Zhengzhou University, Zhengzhou, Henan Province, China (e-mail: )
| | - Yadong Wang
- Zhengzhou University, Zhengzhou, Henan Province
| | - Jianbo Gao
- Zhengzhou University, Zhengzhou, Henan Province
| | - Yan Jiang
- Clinical Science Imaging System, Philips Healthcare, Shanghai, P.R. China
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Yuasa Y, Okitsu H, Goto M, Kuramoto S, Tomibayashi A, Matsumoto D, Edagawa H, Mori O, Tani R, Akagawa T, Kinoshita M, Akagawa Y, Tani H, Ohnishi N, Shirono R. Three-dimensional CT for preoperative detection of the left gastric artery and left gastric vein in laparoscopy-assisted distal gastrectomy. Asian J Endosc Surg 2016; 9:179-85. [PMID: 27122447 DOI: 10.1111/ases.12280] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 12/21/2014] [Revised: 01/21/2016] [Accepted: 02/01/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION We evaluated 3-D CT imaging for preoperative classification of the left gastric artery and vein in patients with early gastric cancer and estimated its clinical benefit. METHODS Between April 2009 and March 2014, 279 patients underwent preoperative 3-D CT using a 64-row multi-detector CT scanner, followed by laparoscopy-assisted distal gastrectomy. The 3-D CT images of the arterial and portal phases were reconstructed and fused. The operative outcomes were compared between patients who had not undergone 3-D CT (2007-2008) and who had undergone 3-D CT (2009-2011). RESULTS According to Adachi's classification, the numbers of type I, II, III, IV, V, and VI arterial patterns were 253, 15, 1, 3, 3, and 1, respectively. Three cases could not be classified. According to the Douglass classification, the left gastric vein flowed into the portal vein, splenic vein, junction of the portal vein and splenic vein, and left branch of the portal vein in 119, 111, 36, and 5 patients, respectively. The left gastric vein could not be visualized in six patients, and two patients could not be classified. In addition, the relation was absent for an Adachi type I vein and one of the "other" types of veins. The total operative time was significantly shorter with 3-D CT than without it (P = 0.01), and the degree of lymph-node dissection was significantly higher (P = 0.01). Inflammatory parameters and operative morbidity tended to decrease with 3-D CT. CONCLUSION Three-dimensional CT is a useful modality to visualize the vessel anatomy around the stomach, and it improves clinical effectiveness and reduces the invasiveness of surgery.
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Affiliation(s)
- Yasuhiro Yuasa
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Hiroshi Okitsu
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Masakazu Goto
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Shunsuke Kuramoto
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Atsushi Tomibayashi
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Daisuke Matsumoto
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Hiroshi Edagawa
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Osamu Mori
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Ryotaro Tani
- Department of Digestive Surgery, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Takuya Akagawa
- Department of Radiology, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Mitsuhiro Kinoshita
- Department of Radiology, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Yoko Akagawa
- Department of Radiology, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Hayato Tani
- Department of Radiology, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Norio Ohnishi
- Department of Radiology, Tokushima Red Cross Hospital, Komatsushima City, Japan
| | - Ryozo Shirono
- Department of Radiology, Tokushima Red Cross Hospital, Komatsushima City, Japan
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Kim JW, Choo KS, Jeon UB, Kim TU, Hwang JY, Yeom JA, Jeong HS, Choi YY, Nam KJ, Kim CW, Jeong DW, Lim SJ. Diagnostic performance and radiation dose of lower extremity CT angiography using a 128-slice dual source CT at 80 kVp and high pitch. Acta Radiol 2016; 57:822-8. [PMID: 26419254 DOI: 10.1177/0284185115604512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 04/02/2015] [Accepted: 08/12/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Multi-detector computed tomography (MDCT) angiography is now used for the diagnosing patients with peripheral arterial disease. The dose of radiation is related to variable factors, such as tube current, tube voltage, and helical pitch. PURPOSE To assess the diagnostic performance and radiation dose of lower extremity CT angiography (CTA) using a 128-slice dual source CT at 80 kVp and high pitch in patients with critical limb ischemia (CLI). MATERIAL AND METHODS Twenty-eight patients (mean, 64.1 years; range, 39-80 years) with CLI were enrolled in this retrospective study and underwent CTA using a 128-slice dual source CT at 80 kVp and high pitch and subsequent intra-arterial digital subtraction angiography (DSA), which was used as a reference standard for assessing diagnostic performance. RESULTS For arterial segments with significant disease (>50% stenosis), overall sensitivity, specificity, and accuracy of lower extremity CTA were 94.8% (95% CI, 91.7-98.0%), 91.5% (95% CI, 87.7-95.2%), and 93.1% (95% CI, 90.6-95.6%), respectively, and its positive and negative predictive values were 91.0% (95% CI, 87.1-95.0%), and 95.1% (95% CI, 92.1-98.1%), respectively. Mean radiation dose delivered to lower extremities was 266.6 mGy.cm. CONCLUSION Lower extremity CTA using a 128-slice dual source CT at 80 kVp and high pitch was found to have good diagnostic performance for the assessment of patients with CLI using an extremely low radiation dose.
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Affiliation(s)
- Jin Woo Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Ki Seok Choo
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Ung Bae Jeon
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Tae Un Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Jae Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Jeong A Yeom
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Hee Seok Jeong
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Yoon Young Choi
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Kyung Jin Nam
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Chang Won Kim
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Dong Wook Jeong
- Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Soo Jin Lim
- Department of Cardiology, Kim Hae Jungang Hospital, Republic of Korea
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Xu B, Gooley R, Seneviratne SK, Nasis A. Clinical utility of multi-detector cardiac computed tomography in structural heart interventions. J Med Imaging Radiat Oncol 2016; 60:299-305. [PMID: 26849957 DOI: 10.1111/1754-9485.12441] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 10/30/2015] [Accepted: 01/04/2016] [Indexed: 01/05/2023]
Abstract
In recent years, there have been major advances in structural interventional cardiology, which have revolutionized the practice of cardiology. Appropriate selection and follow-up of patients undergoing these structural heart interventions is vital. Multi-detector computed tomography (MDCT) has emerged as a key imaging modality in the peri-procedural assessment of patients undergoing multiple structural cardiac interventions. The purpose of this review is to provide an evidence-based clinical update on the roles of MDCT in both established and evolving structural heart interventions, including transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve implantation (TMVI). The utility of MDCT in the peri-procedural assessment of patients undergoing pulmonary vein isolation (PVI) for atrial fibrillation, cardiac resynchronization therapy (CRT) and left atrial appendage (LAA) closure will also be reviewed.
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Affiliation(s)
- Bo Xu
- MonashHEART, Monash Health, Melbourne, Victoria, Australia
| | - Robert Gooley
- MonashHEART, Monash Health, Melbourne, Victoria, Australia
| | | | - Arthur Nasis
- MonashHEART, Monash Health, Melbourne, Victoria, Australia
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Checefsky WA, Abidin AZ, Nagarajan MB, Bauer JS, Baum T, Wismüller A. Assessing vertebral fracture risk on volumetric quantitative computed tomography by geometric characterization of trabecular bone structure. Proc SPIE Int Soc Opt Eng 2016; 9785:978508. [PMID: 29367797 PMCID: PMC5777337 DOI: 10.1117/12.2216898] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The current clinical standard for measuring Bone Mineral Density (BMD) is dual X-ray absorptiometry, however more recently BMD derived from volumetric quantitative computed tomography has been shown to demonstrate a high association with spinal fracture susceptibility. In this study, we propose a method of fracture risk assessment using structural properties of trabecular bone in spinal vertebrae. Experimental data was acquired via axial multi-detector CT (MDCT) from 12 spinal vertebrae specimens using a whole-body 256-row CT scanner with a dedicated calibration phantom. Common image processing methods were used to annotate the trabecular compartment in the vertebral slices creating a circular region of interest (ROI) that excluded cortical bone for each slice. The pixels inside the ROI were converted to values indicative of BMD. High dimensional geometrical features were derived using the scaling index method (SIM) at different radii and scaling factors (SF). The mean BMD values within the ROI were then extracted and used in conjunction with a support vector machine to predict the failure load of the specimens. Prediction performance was measured using the root-mean-square error (RMSE) metric and determined that SIM combined with mean BMD features (RMSE = 0.82 ± 0.37) outperformed MDCT-measured mean BMD (RMSE = 1.11 ± 0.33) (p < 10-4). These results demonstrate that biomechanical strength prediction in vertebrae can be significantly improved through the use of SIM-derived texture features from trabecular bone.
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Affiliation(s)
- Walter A Checefsky
- Department of Electrical and Computer Engineering, University of Rochester, New York, United States
| | - Anas Z Abidin
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Mahesh B Nagarajan
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Jan S Bauer
- Institute for Diagnostic and Interventional Radiology, Technical University of Munich, Germany
| | - Thomas Baum
- Institute for Diagnostic and Interventional Radiology, Technical University of Munich, Germany
| | - Axel Wismüller
- Department of Electrical and Computer Engineering, University of Rochester, New York, United States
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
- Faculty of Medicine and Institute of Clinical Radiology, Ludwig Maximilian University, Munich, Germany
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Rudziński PN, Kruk M, Demkow M, Dzielińska Z, Pręgowski J, Witkowski A, Rużyłło W, Kępka C. Coronary artery computed tomography as the first-choice imaging diagnostics in patients with high pre-test probability of coronary artery disease (CAT-CAD). Postepy Kardiol Interwencyjnej 2015; 11:281-4. [PMID: 26677376 DOI: 10.5114/pwki.2015.55597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction The primary diagnostic examination performed in patients with a high pre-test probability of coronary artery disease (CAD) is invasive coronary angiography. Currently, approximately 50% of all invasive coronary angiographies do not end with percutaneous coronary intervention (PCI) because of the absence of significant coronary artery lesions. It is desirable to eliminate such situations. There is an alternative, non-invasive method useful for exclusion of significant CAD, which is coronary computed tomography angiography (CCTA). Aim We hypothesize that use of CCTA as the first choice method in the diagnosis of patients with high pre-test probability of CAD may reduce the number of invasive coronary angiographies not followed by interventional treatment. Coronary computed tomography angiography also seems not to be connected with additional risks and costs of the diagnosis. Confirmation of these assumptions may impact cardiology guidelines. Material and methods One hundred and twenty patients with indications for invasive coronary angiography determined by current ESC guidelines regarding stable CAD are randomized 1 : 1 to classic invasive coronary angiography group and the CCTA group. Results All patients included in the study are monitored for the occurrence of possible end points during the diagnostic and therapeutic cycle (from the first imaging examination to either complete revascularization or disqualification from the invasive treatment), or during the follow-up period. Conclusions Based on the literature, it appears that the use of modern CT systems in patients with high pre-test probability of CAD, as well as appropriate clinical interpretation of the imaging study by invasive cardiologists, enables precise planning of invasive therapeutic procedures. Our randomized study will provide data to verify these assumptions.
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Kühl JT, George RT, Mehra VC, Linde JJ, Chen M, Arai AE, Di Carli M, Kitagawa K, Dewey M, Lima JAC, Kofoed KF. Endocardial-epicardial distribution of myocardial perfusion reserve assessed by multidetector computed tomography in symptomatic patients without significant coronary artery disease: insights from the CORE320 multicentre study. Eur Heart J Cardiovasc Imaging 2015; 17:779-87. [PMID: 26341292 DOI: 10.1093/ehjci/jev206] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 03/18/2015] [Accepted: 08/02/2015] [Indexed: 12/15/2022] Open
Abstract
AIM Previous animal studies have demonstrated differences in perfusion and perfusion reserve between the subendocardium and subepicardium. 320-row computed tomography (CT) with sub-millimetre spatial resolution allows for the assessment of transmural differences in myocardial perfusion reserve (MPR) in humans. We aimed to test the hypothesis that MPR in all myocardial layers is determined by age, gender, and cardiovascular risk profile in patients with ischaemic symptoms or equivalent but without obstructive coronary artery disease (CAD). METHODS AND RESULTS A total of 149 patients enrolled in the CORE320 study with symptoms or signs of myocardial ischaemia and absence of significant CAD by invasive coronary angiography were scanned with static rest and stress CT perfusion. Myocardial attenuation densities were assessed at rest and during adenosine stress, segmented into 3 myocardial layers and 13 segments. MPR was higher in the subepicardium compared with the subendocardium (124% interquartile range [45, 235] vs. 68% [22,102], P < 0.001). Moreover, MPR in the septum was lower than in the inferolateral and anterolateral segments of the myocardium (55% [19, 104] vs. 89% [37, 168] and 124% [54, 270], P < 0.001). By multivariate analysis, high body mass index was significantly associated with reduced MPR in all myocardial layers when adjusted for cardiovascular risk factors (P = 0.02). CONCLUSION In symptomatic patients without significant coronary artery stenosis, distinct differences in endocardial-epicardial distribution of perfusion reserve may be demonstrated with static CT perfusion. Low MPR in all myocardial layers was observed specifically in obese patients.
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Affiliation(s)
- Jørgen Tobias Kühl
- Department of Cardiology, Rigshospitalet, University of Copenhagen, 2012, The Heart Centre, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Richard T George
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Vishal C Mehra
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jesper J Linde
- Department of Cardiology, Rigshospitalet, University of Copenhagen, 2012, The Heart Centre, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Marcus Chen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Andrew E Arai
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Marc Dewey
- Charitè Medical School, Humboldt, Berlin, Germany
| | - Joao A C Lima
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Klaus Fuglsang Kofoed
- Department of Cardiology, Rigshospitalet, University of Copenhagen, 2012, The Heart Centre, Blegdamsvej 9, 2100 Copenhagen, Denmark Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Abstract
Although hilar cholangiocarcinoma is relatively rare, it can be diagnosed on imaging by identifying its typical pattern. In most cases, the tumor appears to be centered on the right or left hepatic duct with involvement of the ipsilateral portal vein, atrophy of hepatic lobe on that side, and invasion of adjacent liver parenchyma. Multi-detector computed tomography (MDCT) and magnetic resonance cholangiopancreatography (MRCP) are commonly used imaging modalities to assess the longitudinal and horizontal spread of tumor.
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Affiliation(s)
- Mangal S Mahajan
- Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Cochin, Kerala, India
| | - Srikanth Moorthy
- Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Cochin, Kerala, India
| | - Sreekumar P Karumathil
- Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Cochin, Kerala, India
| | - R Rajeshkannan
- Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Cochin, Kerala, India
| | - Ramchandran Pothera
- Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Cochin, Kerala, India
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