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Diagnostics
Volume 13
Issue 10
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Diagnostics, Volume 13, Issue 10 (May-2 2023) – 160 articles

Cover Story (view full-size image): Ultra-high frequency ultrasound is suggested to open new possibilities for the diagnostics of pediatric anorectal conditions. The procedure and considerations behind the development of a new transrectal pediatric probe with 50 MHz center frequency were presented. Probe requirements according to patient anatomy, and clinicians’ and biomedical engineering’ prerequisites were collected within an expert group. Suitable probes on the market and in clinical use were reviewed. The requirements were transferred into the sketching of potential ultra-high frequency rectal ultrasound probes, followed by 3D prototype printing. Two prototypes were created and tested by five pediatric surgeons. A straight probe with an 8 mm head and shaft was preferred as it facilitated stability, ease of anal insertion, and ultra-high frequency-technique with elements in a linear array. View this paper
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16 pages, 10842 KiB  
Article
Evaluation of the Utilization of Near-Infrared Fluorescent Contrast Agent ASP5354 for In Vivo Ureteral Identification in Renal Diseases Using Rat Models of Gentamicin-Induced Acute Kidney Injury
by Katsunori Teranishi
Diagnostics 2023, 13(10), 1823; https://doi.org/10.3390/diagnostics13101823 - 22 May 2023
Cited by 2 | Viewed by 1050
Abstract
ASP5354 was recently developed as a near-infrared fluorescence (NIRF) contrast agent for intraoperative ureteral identification, and its use has been evaluated in healthy animals. However, the utilization of ASP5354 for ureteral identification has not been evaluated in animals with renal injury. In this [...] Read more.
ASP5354 was recently developed as a near-infrared fluorescence (NIRF) contrast agent for intraoperative ureteral identification, and its use has been evaluated in healthy animals. However, the utilization of ASP5354 for ureteral identification has not been evaluated in animals with renal injury. In this study, we assessed the application of ASP5354 for ureteral imaging using rat models of gentamicin-induced mild, moderate, and severe acute kidney injury (AKI), using a clinically available NIRF detection system. NIRF was detected in the abdominal cavity and ureters after laparotomy, and the efficiency of ASP5354 was evaluated based on the NIRF signal intensity over 60 min. After the intravenous injection of ASP5354 into rats with mild or moderate AKI, the ureters were clearly imaged at a high ratio of NIRF intensity in the ureter to that in the tissues around the ureter. Six days after intravenous injection, the use of ASP5354 in rats with moderate AKI did not affect the biochemical kidney functions or histopathological conditions of the kidney tissues, as compared to those with no injection of ASP5354. In rats with severe AKI, ureteral imaging was not effective due to the relatively strong NIRF expression in the tissues around the ureters. These data indicate that ASP5354 holds potential as a contrast agent for intraoperative ureteral identification in patients with limited renal injury. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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14 pages, 1781 KiB  
Review
Clinical and Dermoscopic Characteristics of Cutaneous Sarcomas: A Literature Review
by Zoe Apalla, Konstantinos Liopyris, Eirini Kyrmanidou, Christina Fotiadou, Dimitrios Sgouros, Aikaterini Patsatsi, Myrto-Georgia Trakatelli, Evangelia Kalloniati, Aimilios Lallas and Elizabeth Lazaridou
Diagnostics 2023, 13(10), 1822; https://doi.org/10.3390/diagnostics13101822 - 22 May 2023
Cited by 3 | Viewed by 2101
Abstract
Under the umbrella of cutaneous sarcomas (CS) we include a heterogeneous group of rare, malignant, mesenchymal neoplasia, such as dermatofibrosarcoma protuberans, atypical fibroxanthoma, cutaneous undifferentiated pleomorphic sarcoma, cutaneous angiosarcoma and leiomyosarcoma. Clinical presentation and histopathological examination are the cornerstone of CS diagnosis and [...] Read more.
Under the umbrella of cutaneous sarcomas (CS) we include a heterogeneous group of rare, malignant, mesenchymal neoplasia, such as dermatofibrosarcoma protuberans, atypical fibroxanthoma, cutaneous undifferentiated pleomorphic sarcoma, cutaneous angiosarcoma and leiomyosarcoma. Clinical presentation and histopathological examination are the cornerstone of CS diagnosis and classification. There are scarce data in the literature in regards to the clinical and dermatoscopic characteristics of CS and the role of dermatoscopy in their early identification. We performed a literature review, aiming to summarize current data on the clinical and dermatoscopic presentation of the most common types of cutaneous sarcomas that may facilitate early diagnosis and prompt management. Based on the available published data, CS are characterized by mostly unspecific dermatoscopic patterns. Dermatofibrosarcoma protuberans, Kaposi’s sarcoma, and in a lesser degree, cutaneous angiosarcoma, may display distinct dermatoscopic features, facilitating their early clinical recognition. In conclusion, dermatoscopy, in conjunction with the overall clinical context, may aid towards suspicion of CS. Full article
(This article belongs to the Special Issue Skin and Cutaneous Adnexal Tumors: Diagnosis and Management)
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21 pages, 6239 KiB  
Article
A Combined Method for Diabetes Mellitus Diagnosis Using Deep Learning, Singular Value Decomposition, and Self-Organizing Map Approaches
by Mehrbakhsh Nilashi, Rabab Ali Abumalloh, Sultan Alyami, Abdullah Alghamdi and Mesfer Alrizq
Diagnostics 2023, 13(10), 1821; https://doi.org/10.3390/diagnostics13101821 - 22 May 2023
Viewed by 1414
Abstract
Diabetes in humans is a rapidly expanding chronic disease and a major crisis in modern societies. The classification of diabetics is a challenging and important procedure that allows the interpretation of diabetic data and diagnosis. Missing values in datasets can impact the prediction [...] Read more.
Diabetes in humans is a rapidly expanding chronic disease and a major crisis in modern societies. The classification of diabetics is a challenging and important procedure that allows the interpretation of diabetic data and diagnosis. Missing values in datasets can impact the prediction accuracy of the methods for the diagnosis. Due to this, a variety of machine learning techniques has been studied in the past. This research has developed a new method using machine learning techniques for diabetes risk prediction. The method was developed through the use of clustering and prediction learning techniques. The method uses Singular Value Decomposition for missing value predictions, a Self-Organizing Map for clustering the data, STEPDISC for feature selection, and an ensemble of Deep Belief Network classifiers for diabetes mellitus prediction. The performance of the proposed method is compared with the previous prediction methods developed by machine learning techniques. The results reveal that the deployed method can accurately predict diabetes mellitus for a set of real-world datasets. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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16 pages, 17624 KiB  
Review
Clinical Use of Optical Coherence Tomography Angiography in Retinal Diseases
by Figen Batıoğlu, Özge Yanık, Sibel Demirel and Emin Özmert
Diagnostics 2023, 13(10), 1820; https://doi.org/10.3390/diagnostics13101820 - 22 May 2023
Cited by 4 | Viewed by 1797
Abstract
The advent of optical coherence tomography angiography (OCTA) is one of the cornerstones of fundus imaging. Essentially, its mechanism depends on the visualization of blood vessels by using the flow of erythrocytes as an intrinsic contrast agent. Although it has only recently come [...] Read more.
The advent of optical coherence tomography angiography (OCTA) is one of the cornerstones of fundus imaging. Essentially, its mechanism depends on the visualization of blood vessels by using the flow of erythrocytes as an intrinsic contrast agent. Although it has only recently come into clinical use, OCTA has become a non-invasive diagnostic tool for the diagnosis and follow-up of many retinal diseases, and the integration of OCTA in multimodal imaging has provided a better understanding of many retinal disorders. Here, we provide a detailed overview of the current applications of OCTA technology in the diagnosis and follow-up of various retinal disorders. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Diagnosis of Ophthalmology Disease)
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12 pages, 2900 KiB  
Article
Image-Based Numerical Analysis for Isolated Type II SLAP Lesions in Shoulder Abduction and External Rotation
by Javier A. Maldonado, Duvert A. Puentes, Ivan D. Quintero, Octavio A. González-Estrada and Diego F. Villegas
Diagnostics 2023, 13(10), 1819; https://doi.org/10.3390/diagnostics13101819 - 22 May 2023
Cited by 2 | Viewed by 1361
Abstract
The glenohumeral joint (GHJ) is one of the most critical structures in the shoulder complex. Lesions of the superior labral anterior to posterior (SLAP) cause instability at the joint. Isolated Type II of this lesion is the most common, and its treatment is [...] Read more.
The glenohumeral joint (GHJ) is one of the most critical structures in the shoulder complex. Lesions of the superior labral anterior to posterior (SLAP) cause instability at the joint. Isolated Type II of this lesion is the most common, and its treatment is still under debate. Therefore, this study aimed to determine the biomechanical behavior of soft tissues on the anterior bands of the glenohumeral joint with an Isolated Type II SLAP lesion. Segmentation tools were used to build a 3D model of the shoulder joint from CT-scan and MRI images. The healthy model was studied using finite element analysis. Validation was conducted with a numerical model using ANOVA, and no significant differences were shown (p = 0.47). Then, an Isolated Type II SLAP lesion was produced in the model, and the joint was subjected to 30 degrees of external rotation. A comparison was made for maximum principal strains in the healthy and the injured models. Results revealed that the strain distribution of the anterior bands of the synovial capsule is similar between a healthy and an injured shoulder (p = 0.17). These results demonstrated that GHJ does not significantly deform for an Isolated Type II SLAP lesion subjected to 30-degree external rotation in abduction. Full article
(This article belongs to the Special Issue Quantitative Imaging in Computed Tomography)
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8 pages, 7534 KiB  
Case Report
Conservative Management and Ultrasound Follow-Up of Parasitic Myoma: Our Experience and Literature Review
by Matteo Bruno, Erika Pelaccia, Christian Di Florio, Pierpaolo Palumbo, Laura Sollima, Manuela Ludovisi and Maurizio Guido
Diagnostics 2023, 13(10), 1818; https://doi.org/10.3390/diagnostics13101818 - 22 May 2023
Cited by 1 | Viewed by 2312
Abstract
A uterine fibroid is a benign smooth muscle neoplasm of the uterus. Parasitic fibroids (PMs) are a type of myoma that do not have any direct attachment to the uterus. PMs can arise from the implantation of tissue fragments generated during the morcellation [...] Read more.
A uterine fibroid is a benign smooth muscle neoplasm of the uterus. Parasitic fibroids (PMs) are a type of myoma that do not have any direct attachment to the uterus. PMs can arise from the implantation of tissue fragments generated during the morcellation process in previous laparoscopic myomectomies or hysterectomies. Transvaginal ultrasound (TV-US) may be helpful in the diagnosis of these benign tumors. Almost all the case reports in the literature suggest surgical management of parasitic fibroids. Conversely, we report an ultrasound-guided histological diagnosis and a non-surgical treatment of a parasitic myoma that arose twenty years after a total laparotomic hysterectomy and bilateral adnexectomy in a patient with multiple comorbidities, in order to offer a follow-up alternative to the management of this rare pathology. Our experience reveals that a non-surgical conservative approach can be considered as an alternative therapeutic option for the management of rare cases such as PMs in highly selected patients. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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11 pages, 350 KiB  
Article
Systolic Blood Pressure and Pulse Pressure Are Predictors of Future Cardiovascular Events in Patients with True Resistant Hypertension
by J. Mesquita Bastos, Lisa Ferraz, Flávio G. Pereira and Susana Lopes
Diagnostics 2023, 13(10), 1817; https://doi.org/10.3390/diagnostics13101817 - 22 May 2023
Cited by 3 | Viewed by 1113
Abstract
Given the increased risk of cardiovascular events associated with resistant hypertension, predictive cardiovascular prognosis is extremely important. Ambulatory blood pressure monitoring (ABPM) is mandatory for resistant hypertension diagnosis, but its use for prognosis is scarce. This observational longitudinal study included 258 patients (mean [...] Read more.
Given the increased risk of cardiovascular events associated with resistant hypertension, predictive cardiovascular prognosis is extremely important. Ambulatory blood pressure monitoring (ABPM) is mandatory for resistant hypertension diagnosis, but its use for prognosis is scarce. This observational longitudinal study included 258 patients (mean age of 60.4 ± 11.2 years; 61.2% male), who underwent 24 h ABPM in a hypertension unit from 1999 to 2019. The outcomes were global cardiovascular events (cerebrovascular, coronary, and other cardiovascular events). The mean follow-up period was 6.0 ± 5.0 years. Sixty-eight cardiovascular events (61 nonfatal) were recorded. Patients who experienced cardiovascular events were generally older, with higher rates of chronic kidney disease and prior cardiovascular events. The 24 h systolic blood pressure (hazard ratio 1.44; 95% CI 1.10–1.88), night systolic blood pressure (1.35; 95% CI 1.01–1.80), and 24 h pulse pressure (2.07; 95% CI 1.17–3.67) were independent predictors of global cardiovascular events. Multivariate Cox analysis revealed a higher risk of future cardiovascular events, particularly in patients with a 24 h daytime and nighttime pulse pressure > 60 mm Hg with respective hazard ratios of 1.95; 95% CI 1.01–3.45; 2.15; 95% CI 1.21–3.83 and 2.07; 95% CI 1.17–3.67. In conclusion, APBM is a fundamental tool not only for the diagnosis of resistant hypertension, but also for predicting future cardiovascular events. Full article
(This article belongs to the Special Issue Ambulatory Blood Pressure Monitoring to Diagnose and Manage Hypertension)
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21 pages, 5130 KiB  
Article
A Hybrid Technique for Diabetic Retinopathy Detection Based on Ensemble-Optimized CNN and Texture Features
by Uzair Ishtiaq, Erma Rahayu Mohd Faizal Abdullah and Zubair Ishtiaque
Diagnostics 2023, 13(10), 1816; https://doi.org/10.3390/diagnostics13101816 - 22 May 2023
Cited by 9 | Viewed by 2302
Abstract
One of the most prevalent chronic conditions that can result in permanent vision loss is diabetic retinopathy (DR). Diabetic retinopathy occurs in five stages: no DR, and mild, moderate, severe, and proliferative DR. The early detection of DR is essential for preventing vision [...] Read more.
One of the most prevalent chronic conditions that can result in permanent vision loss is diabetic retinopathy (DR). Diabetic retinopathy occurs in five stages: no DR, and mild, moderate, severe, and proliferative DR. The early detection of DR is essential for preventing vision loss in diabetic patients. In this paper, we propose a method for the detection and classification of DR stages to determine whether patients are in any of the non-proliferative stages or in the proliferative stage. The hybrid approach based on image preprocessing and ensemble features is the foundation of the proposed classification method. We created a convolutional neural network (CNN) model from scratch for this study. Combining Local Binary Patterns (LBP) and deep learning features resulted in the creation of the ensemble features vector, which was then optimized using the Binary Dragonfly Algorithm (BDA) and the Sine Cosine Algorithm (SCA). Moreover, this optimized feature vector was fed to the machine learning classifiers. The SVM classifier achieved the highest classification accuracy of 98.85% on a publicly available dataset, i.e., Kaggle EyePACS. Rigorous testing and comparisons with state-of-the-art approaches in the literature indicate the effectiveness of the proposed methodology. Full article
(This article belongs to the Special Issue AI/ML-Based Medical Image Processing and Analysis)
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15 pages, 3802 KiB  
Article
Diagnosing Melanomas in Dermoscopy Images Using Deep Learning
by Ghadah Alwakid, Walaa Gouda, Mamoona Humayun and N. Z Jhanjhi
Diagnostics 2023, 13(10), 1815; https://doi.org/10.3390/diagnostics13101815 - 22 May 2023
Cited by 9 | Viewed by 1658
Abstract
When it comes to skin tumors and cancers, melanoma ranks among the most prevalent and deadly. With the advancement of deep learning and computer vision, it is now possible to quickly and accurately determine whether or not a patient has malignancy. This is [...] Read more.
When it comes to skin tumors and cancers, melanoma ranks among the most prevalent and deadly. With the advancement of deep learning and computer vision, it is now possible to quickly and accurately determine whether or not a patient has malignancy. This is significant since a prompt identification greatly decreases the likelihood of a fatal outcome. Artificial intelligence has the potential to improve healthcare in many ways, including melanoma diagnosis. In a nutshell, this research employed an Inception-V3 and InceptionResnet-V2 strategy for melanoma recognition. The feature extraction layers that were previously frozen were fine-tuned after the newly added top layers were trained. This study used data from the HAM10000 dataset, which included an unrepresentative sample of seven different forms of skin cancer. To fix the discrepancy, we utilized data augmentation. The proposed models outperformed the results of the previous investigation with an effectiveness of 0.89 for Inception-V3 and 0.91 for InceptionResnet-V2. Full article
(This article belongs to the Special Issue Imaging Diagnosis for Melanoma 2.0)
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18 pages, 3736 KiB  
Article
Association between Cerebrospinal Fluid and Serum Biomarker Levels and Diagnosis, Injury Severity, and Short-Term Outcomes in Patients with Acute Traumatic Spinal Cord Injury
by Zhihui Yang, Seza Apiliogullari, Yueqiang Fu, Ayah Istanbouli, Sehajpreet Kaur, Iktej Singh Jabbal, Ahmed Moghieb, Zoha Irfan, Robert Logan Patterson, Milin Kurup, Lindsey Morrow, Michael Cohn, Zhiqun Zhang, Jiepei Zhu, Ronald L. Hayes, Helen M. Bramlett, M. Ross Bullock, W. Dalton Dietrich, Michael Y. Wang, Firas Kobeissy and Kevin W. Wangadd Show full author list remove Hide full author list
Diagnostics 2023, 13(10), 1814; https://doi.org/10.3390/diagnostics13101814 - 22 May 2023
Cited by 3 | Viewed by 1881
Abstract
Acute traumatic spinal cord injury (SCI) is recognized as a global problem that can lead to a range of acute and secondary complications impacting morbidity and mortality. There is still a lack of reliable diagnostic and prognostic biomarkers in patients with SCI that [...] Read more.
Acute traumatic spinal cord injury (SCI) is recognized as a global problem that can lead to a range of acute and secondary complications impacting morbidity and mortality. There is still a lack of reliable diagnostic and prognostic biomarkers in patients with SCI that could help guide clinical care and identify novel therapeutic targets for future drug discovery. The aim of this prospective controlled study was to determine the cerebral spinal fluid (CSF) and serum profiles of 10 biomarkers as indicators of SCI diagnosis, severity, and prognosis to aid in assessing appropriate treatment modalities. CSF and serum samples of 15 SCI and ten healthy participants were included in the study. The neurological assessments were scored on admission and at discharge from the hospital using the American Spinal Injury Association Impairment Score (AIS) grades. The CSF and serum concentrations of SBDP150, S100B, GFAP, NF-L, UCHL-1, Tau, and IL-6 were significantly higher in SCI patients when compared with the control group. The CSF GBDP 38/44K, UCHL-L1, S100B, GFAP, and Tau levels were significantly higher in the AIS A patients. This study demonstrated a strong correlation between biomarker levels in the diagnosis and injury severity of SCI but no association with short-term outcomes. Future prospective controlled studies need to be done to support the results of this study. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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13 pages, 1336 KiB  
Systematic Review
Clinical Applications of TSPO PET for Glioma Imaging: Current Evidence and Future Perspective—A Systematic Review
by Luca Filippi, Viviana Frantellizzi, Giuseppe De Vincentis, Orazio Schillaci and Laura Evangelista
Diagnostics 2023, 13(10), 1813; https://doi.org/10.3390/diagnostics13101813 - 21 May 2023
Cited by 4 | Viewed by 1447
Abstract
Our aim was to provide a comprehensive overview of the existing literature concerning the clinical applications of positron emission computed tomography (PET) with radiopharmaceuticals targeting the translocator protein (TSPO) in gliomas. A literature search for studies about TSPO PET in the last 10 [...] Read more.
Our aim was to provide a comprehensive overview of the existing literature concerning the clinical applications of positron emission computed tomography (PET) with radiopharmaceuticals targeting the translocator protein (TSPO) in gliomas. A literature search for studies about TSPO PET in the last 10 years (from 2013 to February 2023) was carried out on PubMed, Scopus, and Web of Science using the following keywords: “PET” AND “Gliomas” AND “TSPO”. The Critical Appraisal Skills Program checklist for diagnostic test studies was used for testing the quality of selected papers. Ten articles were selected, encompassing 314 glioma patients submitted to PET/CT (9/10) or PET/MRI (1/10) with TSPO ligands. Among the various available TSPO tracers, the most frequently used was the third-generation ligand, [18F]-GE-180. TSPO PET results were useful to identify anaplastic transformation in gliomas and for the prognostic stratification of patients bearing homogeneous genetic alterations. When compared to amino-acid PET, TSPO PET with [18F]-GE-180 presented superior image quality and provided larger and only partially overlapping PET-based volumes. Although biased by some issues (i.e., small sample size, most of the studies coming from the same country), preliminary applications of TSPO PET were encouraging. Further studies are needed to define implications in clinical practice and shape the role of TSPO PET for patients’ selection for potential TSPO-targeted molecular therapies. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Treatment of CNS Tumours)
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12 pages, 1096 KiB  
Review
Adrenal Failure: An Evidence-Based Diagnostic Approach
by Salomi Shaikh, Lakshmi Nagendra, Shehla Shaikh and Joseph M. Pappachan
Diagnostics 2023, 13(10), 1812; https://doi.org/10.3390/diagnostics13101812 - 21 May 2023
Cited by 2 | Viewed by 6251
Abstract
The diagnosis of adrenal insufficiency (AI) requires a high index of suspicion, detailed clinical assessment including detailed drug history, and appropriate laboratory evaluation. The clinical characteristics of adrenal insufficiency vary according to the cause, and the presentation may be myriad, e.g. insidious onset [...] Read more.
The diagnosis of adrenal insufficiency (AI) requires a high index of suspicion, detailed clinical assessment including detailed drug history, and appropriate laboratory evaluation. The clinical characteristics of adrenal insufficiency vary according to the cause, and the presentation may be myriad, e.g. insidious onset to a catastrophic adrenal crisis presenting with circulatory shock and coma. Secondary adrenal insufficiency (SAI) often presents with only glucocorticoid deficiency because aldosterone production, which is controlled by the renin angiotensin system, is usually intact, and rarely presents with an adrenal crisis. Measurements of the basal serum cortisol at 8 am (<140 nmol/L or 5 mcg/dL) coupled with adrenocorticotrophin (ACTH) remain the initial tests of choice. The cosyntropin stimulation (short synacthen) test is used for the confirmation of the diagnosis. Newer highly specific cortisol assays have reduced the cut-off points for cortisol in the diagnosis of AI. The salivary cortisol test is increasingly being used in conditions associated with abnormal cortisol binding globulin (CBG) levels such as pregnancy. Children and infants require lower doses of cosyntropin for testing. 21-hydoxylase antibodies are routinely evaluated to rule out autoimmunity, the absence of which would require secondary causes of adrenal insufficiency to be ruled out. Testing the hypothalamic–pituitary–adrenal (HPA) axis, imaging, and ruling out systemic causes are necessary for the diagnosis of AI. Cancer treatment with immune checkpoint inhibitors (ICI) is an emerging cause of both primary AI and SAI and requires close follow up. Several antibodies are being implicated, but more clarity is required. We update the diagnostic evaluation of AI in this evidence-based review. Full article
(This article belongs to the Special Issue A Laboratory Medicine Perspective on the Diagnosis and Management of Selected Endocrine Disorders)
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10 pages, 12663 KiB  
Case Report
The Role of Multimodality Imaging in the Diagnosis and Follow-Up of Malignant Primary Cardiac Tumors: Myxofibrosarcoma—A Case Report and Literature Review
by Adela Șerban, Alexandra Dădârlat-Pop, Raluca Tomoaia, Cătălin Trifan, Adrian Molnar, Simona Manole, Alexandru Achim and Mihai Suceveanu
Diagnostics 2023, 13(10), 1811; https://doi.org/10.3390/diagnostics13101811 - 20 May 2023
Cited by 2 | Viewed by 1331
Abstract
Cardiac tumors are a very rare but heterogenous group of diseases that may reveal themselves through a variety of nonspecific cardiac symptoms that may pose a challenge to the diagnostic process. Myxofibrosarcoma is a particularly rare type of cardiac tumor that carries a [...] Read more.
Cardiac tumors are a very rare but heterogenous group of diseases that may reveal themselves through a variety of nonspecific cardiac symptoms that may pose a challenge to the diagnostic process. Myxofibrosarcoma is a particularly rare type of cardiac tumor that carries a poor prognosis, thus making accurate and timely diagnosis essential. A 61-year-old woman presented with fatigue and shortness of breath during mild exercise, symptoms that have progressively worsened during the previous year. Multimodality imaging consisting of transthoracic and transesophageal echocardiography (TTE and TEE), cardiac magnetic resonance (CMR), cardiac computer tomography (CCT), and fluorodeoxyglucose positron emission computer tomography (18F-FDG PET-CT) was used for the diagnosis and postoperative follow-up of a myxofibrosarcoma. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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12 pages, 2101 KiB  
Article
Comparison of Three Algorithms for Predicting Infarct Volume in Patients with Acute Ischemic Stroke by CT Perfusion Software: Bayesian, CSVD, and OSVD
by Yunzhuo Yao, Sirun Gu, Jiayang Liu, Jing Li, Jiajing Wu, Tianyou Luo, Yongmei Li, Bing Ge and Jingjie Wang
Diagnostics 2023, 13(10), 1810; https://doi.org/10.3390/diagnostics13101810 - 20 May 2023
Viewed by 1097
Abstract
This study aimed to compare the performance of the Bayesian probabilistic method, circular Singular Value Decomposition (cSVD), and oscillation index Singular Value Decomposition (oSVD) algorithms in Olea Sphere for predicting infarct volume in patients with acute ischemic stroke (AIS). Eighty-seven patients suffering from [...] Read more.
This study aimed to compare the performance of the Bayesian probabilistic method, circular Singular Value Decomposition (cSVD), and oscillation index Singular Value Decomposition (oSVD) algorithms in Olea Sphere for predicting infarct volume in patients with acute ischemic stroke (AIS). Eighty-seven patients suffering from AIS with large vessel occlusion were divided into improvement and progression groups. The improvement group included patients with successful recanalization (TICI 2b-3) after thrombectomy or whose clinical symptoms improved after thrombolysis. The progression group consisted of patients whose clinical symptoms did not improve or even got worse. The infarct core volume from the Olea Sphere software was used as the predicted infarct volume (PIV) in the improvement group, whereas the hypoperfusion volume was used as the PIV in the progression group. We defined predicted difference (PD) as PIV minus final infarct volume (FIV) measured at follow-up imaging. Differences among the three algorithms were assessed by the Friedman test. Spearman correlation analysis was used to verify the correlation between PIV and FIV. In addition, we performed a subgroup analysis of the progression group based on collateral circulation status. The median [interquartile range (IQR)] of the PD and Spearman correlation coefficients (SCCs) between PIV and FIV for the improvement group (n = 22) were: Bayesian = [6.99 (−14.72, 18.99), 0.500]; oSVD = [−12.74 (−41.06, −3.46), 0.423]; cSVD = [−15.38 (−38.92, −4.68), 0.586]. For the progression group (n = 65), the median (IQR) of PD and SCCs were: Bayesian = [1.00 (−34.07, 49.37), 0.748]; oSVD = [−0.17 (−53.42, 29.73), 0.712]; cSVD = [66.55 (7.94, 106.32), 0.674]. The Bayesian algorithm in the Olea Sphere software predicted infarct volumes with better accuracy and stability than the other two algorithms in both the progression and improvement groups. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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9 pages, 1117 KiB  
Article
Robotic Hysterectomy with Ureter Identification and Uterine Artery Ligation for Benign Gynecological Conditions: An Early-Year Single-Center Experience
by Yi-Liang Lee, Kai-Jo Chiang, Chi-Kung Lin, Tai-Kuang Chao, Mu-Hsien Yu, Yung-Liang Liu and Yu-Chi Wang
Diagnostics 2023, 13(10), 1809; https://doi.org/10.3390/diagnostics13101809 - 20 May 2023
Viewed by 2487
Abstract
The use and application of robotic systems with a high-definition, three-dimensional vision system and advanced EndoWrist technology have become widespread. We sought to share our clinical experience with ureter identification and preventive uterine artery ligation in robotic hysterectomy. The records of patients undergoing [...] Read more.
The use and application of robotic systems with a high-definition, three-dimensional vision system and advanced EndoWrist technology have become widespread. We sought to share our clinical experience with ureter identification and preventive uterine artery ligation in robotic hysterectomy. The records of patients undergoing robotic hysterectomy between May 2014 and December 2015, including patient preoperative characteristics, operative time, and postoperative outcomes, were analyzed. We evaluated the feasibility and safety of using early ureteral identification and preventive uterine artery ligation in robotic hysterectomy in patients with benign gynecological conditions. Overall, 49 patients diagnosed with benign gynecological conditions were evaluated. The mean age of the patients and mean uterine weight were 46.2 ± 5.3 years and 348.7 ± 311.8 g, respectively. Robotic hysterectomy achieved satisfactory results, including a short postoperative hospital stay (2.7 ± 0.8 days), low conversion rate (n = 0), and low complication rate (n = 1; 2%). The average estimated blood loss was 109 ± 107.2 mL. Our results suggest that robotic hysterectomy using early ureteral identification and preventive uterine artery ligation is feasible and safe in patients with benign gynecological conditions. Full article
(This article belongs to the Special Issue Imaging of Gynecological Disease 2.0)
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10 pages, 1167 KiB  
Article
Three-Dimensional Measurements of the Palate and Dental Arch Perimeter as Predictors for Maxillary Palatal Canine Impaction—A Cone-Beam Computed Tomography Image Analysis
by Fadil Abdullah Kareem, Tara Ali Rasheed, Aras Maruf Rauf, Ranj Adil Jalal and Bestoon Mohammed Faraj
Diagnostics 2023, 13(10), 1808; https://doi.org/10.3390/diagnostics13101808 - 20 May 2023
Cited by 1 | Viewed by 1368
Abstract
(1) Background: Accurate diagnosis and treatment plans in orthodontics were facilitated by novel technologies. The prediction of occlusal problems is of utmost importance for clinicians. This present study aimed to find any possible correlation between unilateral and bilateral palatally impacted maxillary canine, palatal [...] Read more.
(1) Background: Accurate diagnosis and treatment plans in orthodontics were facilitated by novel technologies. The prediction of occlusal problems is of utmost importance for clinicians. This present study aimed to find any possible correlation between unilateral and bilateral palatally impacted maxillary canine, palatal dimensions, and maxillary arch perimeter using digital measurements and determine the factors that could be used as predictors for maxillary palatal canine impaction. (2) Method: A cross-sectional study was conducted on cone-beam computed tomography images of orthodontic patients aged 15 to 25. Palatal dimensions and maxillary arch perimeter were digitally measured using Materialize Interactive Medical Image Control System. (3) Results: A significant difference was found between the case and the study groups regarding palatal depth, length, and arch perimeter, except for the palatal width. A weak correlation was reported in palatal depth and length with canine impaction, whereas the correlation was moderate concerning the arch perimeter. They can be used as predictors for palatal canine impaction. (4) Conclusion: Palatal dimensions and dental arch perimeter affect maxillary palatal canine impaction. Deficient arch perimeter, palatal depth, and length could be helpful in the prediction of maxillary palatal canine impaction. Full article
(This article belongs to the Special Issue New Insights into Diagnosis of Orthodontics)
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16 pages, 2048 KiB  
Review
Medical Imaging of Inflammations and Infections of Breast Implants
by Elisabetta Giovannini, Laura Travascio, Giulia Anna Follacchio, Matteo Bauckneht, Benedetta Criscuoli, Camilla De Cataldo, Andrea Iozzelli, Andrea Cimini and Maria Ricci
Diagnostics 2023, 13(10), 1807; https://doi.org/10.3390/diagnostics13101807 - 20 May 2023
Viewed by 2596
Abstract
Breast implants are widely used for reconstructive and/or cosmetic purposes. Inflammations and infections of breast implants represent important complications in clinical practice. The proper management of complications is necessary: diagnostic imaging plays a key role in detecting sites of inflammation and/or infection. The [...] Read more.
Breast implants are widely used for reconstructive and/or cosmetic purposes. Inflammations and infections of breast implants represent important complications in clinical practice. The proper management of complications is necessary: diagnostic imaging plays a key role in detecting sites of inflammation and/or infection. The present review aims to illustrate the radiological findings of these conditions with different imaging techniques, such as mammography (MX), ultrasound (US), magnetic resonance imaging (MRI), and nuclear medicine imaging. A knowledge of these findings is essential for radiologists and nuclear medicine physicians to provide helpful information for the clinical management of these complications. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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27 pages, 7138 KiB  
Article
A Novel Deep Learning-Based Classification Framework for COVID-19 Assisted with Weighted Average Ensemble Modeling
by Gouri Shankar Chakraborty, Salil Batra, Aman Singh, Ghulam Muhammad, Vanessa Yelamos Torres and Makul Mahajan
Diagnostics 2023, 13(10), 1806; https://doi.org/10.3390/diagnostics13101806 - 19 May 2023
Cited by 2 | Viewed by 1652
Abstract
COVID-19 is an infectious disease caused by the deadly virus SARS-CoV-2 that affects the lung of the patient. Different symptoms, including fever, muscle pain and respiratory syndrome, can be identified in COVID-19-affected patients. The disease needs to be diagnosed in a timely manner, [...] Read more.
COVID-19 is an infectious disease caused by the deadly virus SARS-CoV-2 that affects the lung of the patient. Different symptoms, including fever, muscle pain and respiratory syndrome, can be identified in COVID-19-affected patients. The disease needs to be diagnosed in a timely manner, otherwise the lung infection can turn into a severe form and the patient’s life may be in danger. In this work, an ensemble deep learning-based technique is proposed for COVID-19 detection that can classify the disease with high accuracy, efficiency, and reliability. A weighted average ensemble (WAE) prediction was performed by combining three CNN models, namely Xception, VGG19 and ResNet50V2, where 97.25% and 94.10% accuracy was achieved for binary and multiclass classification, respectively. To accurately detect the disease, different test methods have been proposed and developed, some of which are even being used in real-time situations. RT-PCR is one of the most successful COVID-19 detection methods, and is being used worldwide with high accuracy and sensitivity. However, complexity and time-consuming manual processes are limitations of this method. To make the detection process automated, researchers across the world have started to use deep learning to detect COVID-19 applied on medical imaging. Although most of the existing systems offer high accuracy, different limitations, including high variance, overfitting and generalization errors, can be found that can degrade the system performance. Some of the reasons behind those limitations are a lack of reliable data resources, missing preprocessing techniques, a lack of proper model selection, etc., which eventually create reliability issues. Reliability is an important factor for any healthcare system. Here, transfer learning with better preprocessing techniques applied on two benchmark datasets makes the work more reliable. The weighted average ensemble technique with hyperparameter tuning ensures better accuracy than using a randomly selected single CNN model. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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15 pages, 2751 KiB  
Article
Single-Voxel MR Spectroscopy of Gliomas with s-LASER at 7T
by Martin Prener, Giske Opheim, Zahra Shams, Christian Baastrup Søndergaard, Ulrich Lindberg, Henrik B. W. Larsson, Morten Ziebell, Vibeke Andrée Larsen, Mark Bitsch Vestergaard and Olaf B. Paulson
Diagnostics 2023, 13(10), 1805; https://doi.org/10.3390/diagnostics13101805 - 19 May 2023
Cited by 2 | Viewed by 1469
Abstract
Background and Purpose: Magnetic resonance spectroscopy (MRS)—a method of analysing metabolites in vivo—has been utilized in several studies of brain glioma biomarkers at lower field strengths. At ultra-high field strengths, MRS provides an improved signal-to-noise-ratio and spectral resolution, but 7T studies on patients [...] Read more.
Background and Purpose: Magnetic resonance spectroscopy (MRS)—a method of analysing metabolites in vivo—has been utilized in several studies of brain glioma biomarkers at lower field strengths. At ultra-high field strengths, MRS provides an improved signal-to-noise-ratio and spectral resolution, but 7T studies on patients with gliomas are sparse. The purpose of this exploratory study was to evaluate the potential clinical implication of the use of single-voxel MRS at 7T to assess metabolic information on lesions in a pilot cohort of patients with grade II and III gliomas. Methods: We scanned seven patients and seven healthy controls using the semi-localization by adiabatic-selective refocusing sequence on a Philips Achieva 7T system with a standard dual-transmit head coil. The metabolic ratios were calculated relative to water and total creatine. Additionally, 2-hydroxyglutarate (2-HG) MRS was carried out in four of the patients, and the 2-HG concentration was calculated relative to water. Results: When comparing the tumour data to control regions in both patients and healthy controls, we found that the choline/creatine and myo-inositol/creatine ratios were significantly increased and that the N-acetylaspartate/creatine and the neurotransmitter glutamate/creatine ratios were significantly decreased. The N-acetylaspartate/water and glutamate/water ratios were also significantly decreased. The lactate/water and lactate/creatine ratios showed increases, although not significant. The GABA/water ratio was significantly decreased, but the GABA/creatine ratio was not. MRS spectra showed the presence of 2-HG in three of the four patients studied. Three of the patients, including the MRS 2-HG-negative patient, were operated on, and all of them had the IDH mutation. Conclusion: Our findings were consistent with the existing literature on 3T and 7T MRS. Full article
(This article belongs to the Special Issue Brain Magnetic Resonance Imaging)
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12 pages, 2677 KiB  
Article
Imaging Function and Relative Light Transmission of Explanted Opacified Hydrophilic Acrylic Intraocular Lenses
by Tadas Naujokaitis, Ramin Khoramnia, Grzegorz Łabuz, Chul Young Choi, Gerd U. Auffarth and Tamer Tandogan
Diagnostics 2023, 13(10), 1804; https://doi.org/10.3390/diagnostics13101804 - 19 May 2023
Viewed by 1322
Abstract
We evaluated the influence of intraocular lens (IOL) opacification on the optical performance of explanted hydrophilic acrylic IOLs. We performed a laboratory analysis of 32 Lentis LS-502-1 (Oculentis GmbH, Berlin, Germany) IOLs, explanted due to opacification, in comparison with six clear unused samples [...] Read more.
We evaluated the influence of intraocular lens (IOL) opacification on the optical performance of explanted hydrophilic acrylic IOLs. We performed a laboratory analysis of 32 Lentis LS-502-1 (Oculentis GmbH, Berlin, Germany) IOLs, explanted due to opacification, in comparison with six clear unused samples of the same IOL model. Using an optical bench setup, we obtained modulation transfer function (MTF), Strehl ratio, two-dimensional MTF, and United States Air Force (USAF) chart images. In addition, we assessed light transmission through the IOLs. The MTF values of opacified IOLs at 3-mm aperture were similar to those of clear lenses, with the median (interquartile range) values of 0.74 (0.01) vs. 0.76 (0.03) at the spatial frequency of 50 line pairs per millimeter in clear and opacified IOLs, respectively. The Strehl ratio of opacified lenses was not lower than that of clear lenses. The USAF-chart analysis showed a considerable reduction in brightness in opacified IOLs. The median (interquartile range) relative light transmission of opacified IOLs in comparison to clear lenses was 55.6% (20.8%) at the aperture size of 3 mm. In conclusion, the explanted opacified IOLs had comparable MTF values to those of clear lenses but significantly reduced light transmission. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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18 pages, 1801 KiB  
Review
Treatment of the Neutropenia Associated with GSD1b and G6PC3 Deficiency with SGLT2 Inhibitors
by Maria Veiga-da-Cunha, Saskia B. Wortmann, Sarah C. Grünert and Emile Van Schaftingen
Diagnostics 2023, 13(10), 1803; https://doi.org/10.3390/diagnostics13101803 - 19 May 2023
Cited by 10 | Viewed by 2569
Abstract
Glycogen storage disease type Ib (GSD1b) is due to a defect in the glucose-6-phosphate transporter (G6PT) of the endoplasmic reticulum, which is encoded by the SLC37A4 gene. This transporter allows the glucose-6-phosphate that is made in the cytosol to cross the endoplasmic reticulum [...] Read more.
Glycogen storage disease type Ib (GSD1b) is due to a defect in the glucose-6-phosphate transporter (G6PT) of the endoplasmic reticulum, which is encoded by the SLC37A4 gene. This transporter allows the glucose-6-phosphate that is made in the cytosol to cross the endoplasmic reticulum (ER) membrane and be hydrolyzed by glucose-6-phosphatase (G6PC1), a membrane enzyme whose catalytic site faces the lumen of the ER. Logically, G6PT deficiency causes the same metabolic symptoms (hepatorenal glycogenosis, lactic acidosis, hypoglycemia) as deficiency in G6PC1 (GSD1a). Unlike GSD1a, GSD1b is accompanied by low neutrophil counts and impaired neutrophil function, which is also observed, independently of any metabolic problem, in G6PC3 deficiency. Neutrophil dysfunction is, in both diseases, due to the accumulation of 1,5-anhydroglucitol-6-phosphate (1,5-AG6P), a potent inhibitor of hexokinases, which is slowly formed in the cells from 1,5-anhydroglucitol (1,5-AG), a glucose analog that is normally present in blood. Healthy neutrophils prevent the accumulation of 1,5-AG6P due to its hydrolysis by G6PC3 following transport into the ER by G6PT. An understanding of this mechanism has led to a treatment aimed at lowering the concentration of 1,5-AG in blood by treating patients with inhibitors of SGLT2, which inhibits renal glucose reabsorption. The enhanced urinary excretion of glucose inhibits the 1,5-AG transporter, SGLT5, causing a substantial decrease in the concentration of this polyol in blood, an increase in neutrophil counts and function and a remarkable improvement in neutropenia-associated clinical signs and symptoms. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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14 pages, 1931 KiB  
Article
Comparing CT and MR Properties of Artificial Thrombi According to Their Composition
by Rebeka Viltužnik, Aleš Kaučič, Aleš Blinc, Jernej Vidmar and Igor Serša
Diagnostics 2023, 13(10), 1802; https://doi.org/10.3390/diagnostics13101802 - 19 May 2023
Viewed by 787
Abstract
This study aims to determine whether and to what extent the structure and composition of thrombi can be assessed using NMR and CT measurements. Seven different thrombus models, namely, six RBC thrombi with hematocrit levels (HTs) of 0%, 20%, 40%, 60%, 80% and [...] Read more.
This study aims to determine whether and to what extent the structure and composition of thrombi can be assessed using NMR and CT measurements. Seven different thrombus models, namely, six RBC thrombi with hematocrit levels (HTs) of 0%, 20%, 40%, 60%, 80% and 100% and one platelet thrombus model, were analyzed using proton NMR at 100 MHz and 400 MHz, with measurements of T1 and T2 NMR relaxation times and measurements of the apparent diffusion coefficient (ADC). In addition, the thrombus models were CT-scanned in a dual-energy mode (80 kV and 140 kV) and in a single-energy mode (80 kV) to measure their CT numbers. The results confirmed that RBC thrombi can be distinguished from platelet thrombi by using ADC and CT number measurements in all three settings, while they cannot be distinguished by using T1 and T2 measurements. All measured parameters allowed for the differentiation of RBC thrombi according to their HT values, but the best sensitivity to HT was obtained with ADC and single-energy CT measurements. The importance of this study also lies in the potential application of its results for the characterization of actual thrombi in vivo. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnosis, and Medical Management of Blood Clots)
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14 pages, 16128 KiB  
Review
Primary Osseous Malignancies of the Spine
by Sisith Ariyaratne, Nathan Jenko, Karthikeyan P. Iyengar, Steven James, Jwalant Mehta and Rajesh Botchu
Diagnostics 2023, 13(10), 1801; https://doi.org/10.3390/diagnostics13101801 - 19 May 2023
Cited by 1 | Viewed by 2570
Abstract
Malignant primary vertebral tumours comprise an uncommon group of primary bone malignancies that can pose a diagnostic and therapeutic challenge. The most frequently encountered malignant primary vertebral tumours include chordoma, chondrosarcoma, Ewing sarcoma and osteosarcoma. These tumours often present with nonspecific symptoms, such [...] Read more.
Malignant primary vertebral tumours comprise an uncommon group of primary bone malignancies that can pose a diagnostic and therapeutic challenge. The most frequently encountered malignant primary vertebral tumours include chordoma, chondrosarcoma, Ewing sarcoma and osteosarcoma. These tumours often present with nonspecific symptoms, such as back pain, neurologic deficits and spinal instability, which can be confused for the more commonly encountered mechanical back pain and may delay their diagnosis and treatment. Imaging, including radiography, computed tomography (CT) and magnetic resonance imaging (MRI) is crucial for diagnosis, staging, treatment planning and follow-up. Surgical resection remains the mainstay of treatment for malignant primary vertebral tumours, but adjuvant radiotherapy and chemotherapy may be necessary for achieving complete tumour control depending on the type of tumour. In recent years, advances in imaging techniques and surgical approaches, such as en-bloc resection and spinal reconstruction, have improved the outcomes for patients with malignant primary vertebral tumours. However, the management can be complex due to the anatomy involved and the high morbidity and mortality associated with surgery. The different types of malignant primary vertebral lesions will be discussed in this article with an emphasis on the imaging features. Full article
(This article belongs to the Special Issue Diagnosis of Spinal Tumors 2.0)
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14 pages, 8955 KiB  
Article
Assessing the Effectiveness of Artificial Intelligence Models for Detecting Alveolar Bone Loss in Periodontal Disease: A Panoramic Radiograph Study
by Bilge Cansu Uzun Saylan, Oğuzhan Baydar, Esra Yeşilova, Sevda Kurt Bayrakdar, Elif Bilgir, İbrahim Şevki Bayrakdar, Özer Çelik and Kaan Orhan
Diagnostics 2023, 13(10), 1800; https://doi.org/10.3390/diagnostics13101800 - 19 May 2023
Cited by 4 | Viewed by 2668
Abstract
The assessment of alveolar bone loss, a crucial element of the periodontium, plays a vital role in the diagnosis of periodontitis and the prognosis of the disease. In dentistry, artificial intelligence (AI) applications have demonstrated practical and efficient diagnostic capabilities, leveraging machine learning [...] Read more.
The assessment of alveolar bone loss, a crucial element of the periodontium, plays a vital role in the diagnosis of periodontitis and the prognosis of the disease. In dentistry, artificial intelligence (AI) applications have demonstrated practical and efficient diagnostic capabilities, leveraging machine learning and cognitive problem-solving functions that mimic human abilities. This study aims to evaluate the effectiveness of AI models in identifying alveolar bone loss as present or absent across different regions. To achieve this goal, alveolar bone loss models were generated using the PyTorch-based YOLO-v5 model implemented via CranioCatch software, detecting periodontal bone loss areas and labeling them using the segmentation method on 685 panoramic radiographs. Besides general evaluation, models were grouped according to subregions (incisors, canines, premolars, and molars) to provide a targeted evaluation. Our findings reveal that the lowest sensitivity and F1 score values were associated with total alveolar bone loss, while the highest values were observed in the maxillary incisor region. It shows that artificial intelligence has a high potential in analytical studies evaluating periodontal bone loss situations. Considering the limited amount of data, it is predicted that this success will increase with the provision of machine learning by using a more comprehensive data set in further studies. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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16 pages, 2712 KiB  
Systematic Review
Artificial Intelligence-Based Opportunities in Liver Pathology—A Systematic Review
by Pierre Allaume, Noémie Rabilloud, Bruno Turlin, Edouard Bardou-Jacquet, Olivier Loréal, Julien Calderaro, Zine-Eddine Khene, Oscar Acosta, Renaud De Crevoisier, Nathalie Rioux-Leclercq, Thierry Pecot and Solène-Florence Kammerer-Jacquet
Diagnostics 2023, 13(10), 1799; https://doi.org/10.3390/diagnostics13101799 - 19 May 2023
Cited by 5 | Viewed by 2185
Abstract
Background: Artificial Intelligence (AI)-based Deep Neural Networks (DNNs) can handle a wide range of applications in image analysis, ranging from automated segmentation to diagnostic and prediction. As such, they have revolutionized healthcare, including in the liver pathology field. Objective: The present study aims [...] Read more.
Background: Artificial Intelligence (AI)-based Deep Neural Networks (DNNs) can handle a wide range of applications in image analysis, ranging from automated segmentation to diagnostic and prediction. As such, they have revolutionized healthcare, including in the liver pathology field. Objective: The present study aims to provide a systematic review of applications and performances provided by DNN algorithms in liver pathology throughout the Pubmed and Embase databases up to December 2022, for tumoral, metabolic and inflammatory fields. Results: 42 articles were selected and fully reviewed. Each article was evaluated through the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, highlighting their risks of bias. Conclusions: DNN-based models are well represented in the field of liver pathology, and their applications are diverse. Most studies, however, presented at least one domain with a high risk of bias according to the QUADAS-2 tool. Hence, DNN models in liver pathology present future opportunities and persistent limitations. To our knowledge, this review is the first one solely focused on DNN-based applications in liver pathology, and to evaluate their bias through the lens of the QUADAS2 tool. Full article
(This article belongs to the Special Issue Digital Pathology: Diagnosis, Prognosis, and Prediction of Diseases)
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16 pages, 571 KiB  
Article
Low Prevalence of HSV-1 and Helicobacter pylori in HNSCC and Chronic Tonsillitis Patients Compared to Healthy Individuals
by Joanna Katarzyna Strzelczyk, Agata Świętek, Dorota Hudy, Karolina Gołąbek, Jadwiga Gaździcka, Katarzyna Miśkiewicz-Orczyk, Wojciech Ścierski, Janusz Strzelczyk and Maciej Misiołek
Diagnostics 2023, 13(10), 1798; https://doi.org/10.3390/diagnostics13101798 - 19 May 2023
Cited by 2 | Viewed by 1421
Abstract
Recent studies identified viral and bacterial factors, including HSV-1 and H. pylori, as possible factors associated with diseases such as chronic tonsillitis and cancers, including head and neck squamous cell carcinoma (HNSCC). We assessed the prevalence of HSV-1/2 and H. pylori in [...] Read more.
Recent studies identified viral and bacterial factors, including HSV-1 and H. pylori, as possible factors associated with diseases such as chronic tonsillitis and cancers, including head and neck squamous cell carcinoma (HNSCC). We assessed the prevalence of HSV-1/2 and H. pylori in patients with HNSCC, chronic tonsillitis, and healthy individuals using PCR after DNA isolation. Associations were sought between the presence of HSV-1, H. pylori, and clinicopathological and demographic characteristics and stimulant use. HSV-1 and H. pylori were most frequently identified in controls (HSV-1: 12.5% and H. pylori: 6.3%). There were 7 (7.8%) and 8 (8.6%) patients with positive HSV-1 in HNSCC and chronic tonsillitis patients, respectively, while the prevalence of H. pylori was 0/90 (0%) and 3/93 (3.2%), respectively. More cases of HSV-1 were observed in older individuals in the control group. All positive HSV-1 cases in the HNSCC group were associated with advanced tumor stage (T3/T4). The prevalence of HSV-1 and H. pylori was highest in the controls compared to HNSCC and chronic tonsillitis patients, which indicates that the pathogens were not risk factors. However, since all positive HSV-1 cases in the HNSCC group were observed only in patients with advanced tumor stage, we suggested a possible link between HSV-1 and tumor progression. Further follow-up of the study groups is planned. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer: Volume II)
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17 pages, 2627 KiB  
Review
Approach to Pancreatic Head Mass in the Background of Chronic Pancreatitis
by Sidharth Harindranath and Sridhar Sundaram
Diagnostics 2023, 13(10), 1797; https://doi.org/10.3390/diagnostics13101797 - 19 May 2023
Viewed by 3335
Abstract
Chronic pancreatitis (CP) is a known risk factor for pancreatic cancer. CP may present with an inflammatory mass, and differentiation from pancreatic cancer is often difficult. Clinical suspicion of malignancy dictates a need for further evaluation for underlying pancreatic cancer. Imaging modalities remain [...] Read more.
Chronic pancreatitis (CP) is a known risk factor for pancreatic cancer. CP may present with an inflammatory mass, and differentiation from pancreatic cancer is often difficult. Clinical suspicion of malignancy dictates a need for further evaluation for underlying pancreatic cancer. Imaging modalities remain the mainstay of evaluation for a mass in background CP; however, they have their shortcomings. Endoscopic ultrasound (EUS) has become the go-to investigation. Adjunct modalities such as contrast-harmonic EUS and EUS elastography, as well as EUS-guided sampling using newer-generation needles are useful in differentiating inflammatory from malignant masses in the pancreas. Paraduodenal pancreatitis and autoimmune pancreatitis often masquerade as pancreatic cancer. In this narrative review, we discuss the various modalities used to differentiate inflammatory from malignant masses of the pancreas. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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12 pages, 2587 KiB  
Article
Strain Rate Changes during Stress Echocardiography Are the Most Accurate Predictors of Significant Coronary Artery Disease in Patients with Previously Treated Acute Coronary Syndrome
by Rafik Shenouda, Ibadete Bytyçi, Eman El Sharkawy, Noha Hisham, Mohamed Sobhy and Michael Y. Henein
Diagnostics 2023, 13(10), 1796; https://doi.org/10.3390/diagnostics13101796 - 19 May 2023
Viewed by 1091
Abstract
Background and Aims. Dobutamine stress echocardiography (DSE) is a well-established non-invasive investigation for the detection of ischemic myocardial dysfunction. The aim of this study was to evaluate the accuracy of myocardial deformation parameters measured by speckle tracking echocardiography (STE) in predicting culprit coronary [...] Read more.
Background and Aims. Dobutamine stress echocardiography (DSE) is a well-established non-invasive investigation for the detection of ischemic myocardial dysfunction. The aim of this study was to evaluate the accuracy of myocardial deformation parameters measured by speckle tracking echocardiography (STE) in predicting culprit coronary artery lesions in patients with prior revascularization and acute coronary syndrome (ACS). Methods. We prospectively studied 33 patients with ischemic heart disease, a history of at least one episode of ACS and prior revascularization. All patients underwent a complete stress Doppler echocardiographic examination, including the myocardial deformation parameters of peak systolic strain (PSS), peak systolic strain rate (SR) and wall motion score index (WMSI). The regional PSS and SR were analyzed for different culprit lesions. Results. The mean age of patients was 59 ± 11 years and 72.7% were males. At peak dobutamine stress, the change in regional PSS and SR in territories supplied by the LAD showed smaller increases compared to those in patients without culprit LAD lesions (p < 0.05 for all). Likewise, the regional parameters of myocardial deformation were reduced in patients with culprit LCx lesions compared to those with non-culprit LCx lesions and in patients with culprit RCA legions compared to those with non-culprit RCA lesions (p < 0.05 for all). In the multivariate analysis, the △ regional PSS (1.134 (CI = 1.059–3.315, p = 0.02)) and the △ regional SR (1.566 (CI = 1.191–9.013, p = 0.001)) for LAD territories predicted the presence of LAD lesions. Similarly, in a multivariable analysis, the △ regional PSS and the △SR predicted LCx culprit lesions and RCA culprit lesions (p < 0.05 for all). In an ROC analysis, the PSS and SR had higher accuracies compared to the regional WMSI in predicting culprit lesions. A △ regional SR of −0.24 for the LAD territories was 88% sensitive and 76% specific (AUC = 0.75; p < 0.001), a △ regional PSS of −1.20 was 78% sensitive and 71% specific (AUC = 0.76, p < 0.001) and a △ WMSI of −0.35 was 67% sensitive and 68% specific (AUC = 0.68, p = 0.02) in predicting LAD culprit lesions. Similarly, the △ SR for LCx and RCA territories had higher accuracies in predicting LCx and RCA culprit lesions. Conclusions. The myocardial deformation parameters, particularly the change in regional strain rate, are the most powerful predictors of culprit lesions. These findings strengthen the role of myocardial deformation in increasing the accuracy of DSE analyses in patients with prior cardiac events and revascularization. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Imaging)
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11 pages, 12696 KiB  
Case Report
FIP1L1–PDGFRα-Positive Loeffler Endocarditis—A Distinct Cause of Heart Failure in a Young Male: The Role of Multimodal Diagnostic Tools
by Andreea Varga, Diana Andreea Moldovan, Marian Pop, Istvan Benedek, Attila Kövecsi, Robert Adrian Dumbrava, Dragos Gabriel Iancu, Liviu Cristescu, Laurentiu Huma and Ioan Tilea
Diagnostics 2023, 13(10), 1795; https://doi.org/10.3390/diagnostics13101795 - 19 May 2023
Viewed by 1327
Abstract
The presence of the Fip1-Like1-platelet-derived growth factor receptor alpha (FIP1L1–PDGFRα) fusion gene represents a rare cause of hypereosinophilic syndrome (HES), which is associated with organ damage. The aim of this paper is to emphasize the pivotal role of multimodal diagnostic tools in the [...] Read more.
The presence of the Fip1-Like1-platelet-derived growth factor receptor alpha (FIP1L1–PDGFRα) fusion gene represents a rare cause of hypereosinophilic syndrome (HES), which is associated with organ damage. The aim of this paper is to emphasize the pivotal role of multimodal diagnostic tools in the accurate diagnosis and management of heart failure (HF) associated with HES. We present the case of a young male patient who was admitted with clinical features of congestive HF and laboratory findings of hypereosinophilia (HE). After hematological evaluation, genetic tests, and ruling out reactive causes of HE, a diagnosis of positive FIP1L1–PDGFRα myeloid leukemia was established. Multimodal cardiac imaging identified biventricular thrombi and cardiac impairment, thereby raising suspicion of Loeffler endocarditis (LE) as the cause of HF; this was later confirmed by a pathological examination. Despite hematological improvement under corticosteroid and imatinib therapy, anticoagulant, and patient-oriented HF treatment, there was further clinical progression and subsequent multiple complications (including embolization), which led to patient death. HF is a severe complication that diminishes the demonstrated effectiveness of imatinib in the advanced phases of Loeffler endocarditis. Therefore, the need for an accurate identification of heart failure etiology in the absence of endomyocardial biopsy is particularly important for ensuring effective treatment. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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15 pages, 2440 KiB  
Article
Deep Infiltrating Endometriosis: Diagnostic Accuracy of Preoperative Magnetic Resonance Imaging with Respect to Morphological Criteria
by Sebastian Harth, Fritz C. Roller, Felix Zeppernick, Ivo Meinhold-Heerlein and Gabriele A. Krombach
Diagnostics 2023, 13(10), 1794; https://doi.org/10.3390/diagnostics13101794 - 19 May 2023
Cited by 3 | Viewed by 2257
Abstract
Several current guidelines recommend imaging in the diagnostic work-up of deep infiltrating endometriosis (DIE). The purpose of this retrospective diagnostic test study was to evaluate the diagnostic accuracy of MRI compared to laparoscopy for the identification of pelvic DIE, considering lesion morphology using [...] Read more.
Several current guidelines recommend imaging in the diagnostic work-up of deep infiltrating endometriosis (DIE). The purpose of this retrospective diagnostic test study was to evaluate the diagnostic accuracy of MRI compared to laparoscopy for the identification of pelvic DIE, considering lesion morphology using MRI. In all, 160 consecutive patients were included who received pelvic MRI for evaluation of endometriosis between October 2018 and December 2020 and underwent subsequent laparoscopy within 12 months of the MRI examination. MRI findings were categorized for suspected DIE using the Enzian classification and were additionally graded using a newly suggested deep infiltrating endometriosis morphology score (DEMS). Endometriosis was diagnosed in 108 patients (all types, i.e., purely superficial and DIE), of which 88 cases were diagnosed with DIE and 20 with solely superficial peritoneal endometriosis (i.e., not deep infiltrating endometriosis/DIE). The overall positive and negative predictive values of MRI for the diagnosis of DIE, including lesions with assumed low and medium certainty of DIE on MRI (DEMS 1–3), were 84.3% (95% CI: 75.3–90.4) and 67.8% (95% CI: 60.6–74.2), respectively, and 100.0% and 59.0% (95% CI: 54.6–63.3) when strict MRI diagnostic criteria were applied (DEMS 3). Overall sensitivity of MRI was 67.0% (95% CI: 56.2–76.7), specificity was 84.7% (95% CI: 74.3–92.1), accuracy was 75.0% (95% CI: 67.6–81.5), positive likelihood ratio (LR+) was 4.39 (95% CI: 2.50–7.71), negative likelihood ratio (LR-) was 0.39 (95% CI: 0.28–0.53), and Cohen’s kappa was 0.51 (95% CI: 0.38–0.64). When strict reporting criteria are applied, MRI can serve as a method to confirm clinically suspected DIE. Full article
(This article belongs to the Special Issue Imaging of Gynecological Disease 2.0)
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