Research

12 pages, 5295 KiB

Open AccessArticle

Shoulder Magnetic Resonance Arthrography with the Internal and External Rotation Positions of the Humeral Head in the Evaluation of SLAP Lesions

by Marco Porta, Serena Capelli, Anna Caroli, Maurizio Balbi, Alessandra Surace, Francesca Serpi, Eugenio Annibale Genovese, Domenico Albano, Luca Maria Sconfienza, Sandro Sironi and Alberto Aliprandi

Diagnostics 2022, 12(9), 2230; https://doi.org/10.3390/diagnostics12092230 - 15 Sep 2022

Cited by 1 | Viewed by 1417

Abstract

We aimed to evaluate the diagnostic performance of shoulder MR arthrography (MRA) acquired in the neutral (N), internal rotation (IR), and external rotation (ER) positions of the shoulder to detect SLAP lesions. Three observers evaluated 130 MRAs to detect SLAP lesions and to [...] Read more.

We aimed to evaluate the diagnostic performance of shoulder MR arthrography (MRA) acquired in the neutral (N), internal rotation (IR), and external rotation (ER) positions of the shoulder to detect SLAP lesions. Three observers evaluated 130 MRAs to detect SLAP lesions and to calculate labral diastasis in this triple-blinded study. Sensitivity was much higher in the ER (92.5–97.5%) than in the N (60–72.5%) and IR (42.5–52.5%) positions, and the specificity of all the reviewers was 100% in all the positions. The diagnostic accuracy was higher in the ER too (97.7–99.2%). The diastasis length was significantly higher in the ER (median = 2.5–2.8 mm) than in the N (1 mm) and IR (0 mm) positions and was also significantly higher in those patients requiring surgery (p = 0.001). The highest inter-rater agreement values were observed in the ER both in SLAP detection (k = 0.982) and the diastasis length evaluation (ICC = 0.962). The diastasis length threshold in the ER that best separated the patients who did and did not require surgery was 3.1 mm (AUC = 0.833). In 14.6% of the cases, ER enabled the detection of SLAP lesions not identified in the N position. MRA with the ER improves the diagnosis of SLAP lesions and, together with the IR position, provides additional dynamic information about the diastasis of the lesions. It is recommended to perform additional ER and IR scans in the shoulder MRA protocol. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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18 pages, 6685 KiB

Open AccessArticle

Inter- and Intra-Rater Reliability of Ultrasound Measurements of Superficial and Deep Fasciae Thickness in Upper Limb

by Carmelo Pirri, Nina Pirri, Andrea Porzionato, Rafael Boscolo-Berto, Raffaele De Caro and Carla Stecco

Diagnostics 2022, 12(9), 2195; https://doi.org/10.3390/diagnostics12092195 - 09 Sep 2022

Cited by 8 | Viewed by 1841

Abstract

Ultrasound (US) imaging is increasingly the most used tool to measure the thickness of superficial and deep fasciae, but there are still some doubts about its reliability in this type of measurement. The current study sets out to assess the inter-rater and intra-rater [...] Read more.

Ultrasound (US) imaging is increasingly the most used tool to measure the thickness of superficial and deep fasciae, but there are still some doubts about its reliability in this type of measurement. The current study sets out to assess the inter-rater and intra-rater reliability of US measurements of superficial and deep fasciae thicknesses in the arm and forearm. The study involved two raters: the first (R1) is an expert in skeletal–muscle US imaging and, in particular, the US assessment of fasciae; the second (R2) is a radiologist resident with 1 year’s experience in skeletal–muscle US imaging. R2, not having specific competence in the US imaging of fasciae, was trained by R1. R1 took US images following the protocol by Pirri et al. 2021, and the US-recorded images were analyzed separately by the two raters in different sessions. Each rater measured both types of fasciae at different regions and levels of the arm and forearm. Intra- and inter-rater reliability was excellent for the deep fascia and good and excellent for the superficial fascia according to the different regions/levels (for example for the anterior region of the arm: deep fascia: Ant 1: ICC_2,2 = 0.95; 95% CI = 0.81–0.98; superficial fascia: Ant 1: ICC_2,2 = 0.85, 95% CI = 0.79–0.88). These findings confirm that US imaging is a reliable and cost-effective tool for evaluating both fasciae, superficial and deep. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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11 pages, 2568 KiB

Open AccessArticle

Characterization of Flexible Amorphous Silicon Thin-Film Transistor-Based Detectors with Positive-Intrinsic-Negative Diode in Radiography

by Bongju Han, Minji Park, Kyuseok Kim and Youngjin Lee

Diagnostics 2022, 12(9), 2103; https://doi.org/10.3390/diagnostics12092103 - 30 Aug 2022

Cited by 3 | Viewed by 1537

Abstract

Low-dose exposure and work convenience are required for mobile X-ray systems during the COVID-19 pandemic. We investigated a novel X-ray detector (FXRD-4343FAW, VIEWORKS, Anyang, Korea) composed of a thin-film transistor based on amorphous silicon with a flexible plastic substrate. This detector is composed [...] Read more.

Low-dose exposure and work convenience are required for mobile X-ray systems during the COVID-19 pandemic. We investigated a novel X-ray detector (FXRD-4343FAW, VIEWORKS, Anyang, Korea) composed of a thin-film transistor based on amorphous silicon with a flexible plastic substrate. This detector is composed of a thallium-doped cesium iodide scintillator with a pixel size of 99 μm, pixel matrix of 4316 × 4316, and weight of 2.95 kg. The proposed detector has the advantages of high-noise characteristics and low weight, which provide patients and workers with an advantage in terms of the dose and work efficiency, respectively. We performed a quantitative evaluation and an experiment to demonstrate its viability. The modulation transfer function, noise power spectrum, and detective quantum efficiency were identified using the proposed and comparative detectors, according to the International Electrotechnical Commission protocol. Additionally, the contrast-to-noise ratio and coefficient of variation were investigated using a human-like phantom. Our results indicate that the proposed detector efficiently increases the image performance in terms of noise characteristics. The detailed performance evaluation demonstrated that the outcomes of the use of the proposed detector confirmed the viability of mobile X-ray devices that require low doses. Consequently, the novel FXRD-4343FAW X-ray detector is expected to improve the image quality and work convenience in extended radiography. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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17 pages, 2997 KiB

Open AccessArticle

Reproducibility and Repeatability of Coronary Computed Tomography Angiography (CCTA) Image Segmentation in Detecting Atherosclerosis: A Radiomics Study

by Mardhiyati Mohd Yunus, Akmal Sabarudin, Muhammad Khalis Abdul Karim, Puteri N. E. Nohuddin, Isa Azzaki Zainal, Mohd Shahril Mohd Shamsul and Ahmad Khairuddin Mohamed Yusof

Diagnostics 2022, 12(8), 2007; https://doi.org/10.3390/diagnostics12082007 - 19 Aug 2022

Cited by 4 | Viewed by 2129

Abstract

Atherosclerosis is known as the leading factor in heart disease with the highest mortality rate among the Malaysian population. Usually, the gold standard for diagnosing atherosclerosis is by using the coronary computed tomography angiography (CCTA) technique to look for plaque within the coronary [...] Read more.

Atherosclerosis is known as the leading factor in heart disease with the highest mortality rate among the Malaysian population. Usually, the gold standard for diagnosing atherosclerosis is by using the coronary computed tomography angiography (CCTA) technique to look for plaque within the coronary artery. However, qualitative diagnosis for noncalcified atherosclerosis is vulnerable to false-positive diagnoses, as well as inconsistent reporting between observers. In this study, we assess the reproducibility and repeatability of segmenting atherosclerotic lesions manually and semiautomatically in CCTA images to identify the most appropriate CCTA image segmentation method for radiomics analysis to quantitatively extract the atherosclerotic lesion. Thirty (30) CCTA images were taken retrospectively from the radiology image database of Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. We extract 11,700 radiomics features which include the first-order, second-order and shape features from 180 times of image segmentation. The interest vessels were segmentized manually and semiautomatically using LIFEx (Version 7.0.15, Institut Curie, Orsay, France) software by two independent radiology experts, focusing on three main coronary blood vessels. As a result, manual segmentation with a soft-tissuewindowing setting yielded higher repeatability as compared to semiautomatic segmentation with a significant intraclass correlation coefficient (intra-CC) 0.961 for thefirst-order and shape features; intra-CC of 0.924 for thesecond-order features with p < 0.001. Meanwhile, the semiautomatic segmentation has higher reproducibility as compared to manual segmentation with significant interclass correlation coefficient (inter-CC) of 0.920 (first-order features) and a good interclass correlation coefficient of 0.839 for the second-order features with p < 0.001. The first-order, shape order and second-order features for both manual and semiautomatic segmentation have an excellent percentage of reproducibility and repeatability (intra-CC > 0.9). In conclusion, semi-automated segmentation is recommended for inter-observer study while manual segmentation with soft tissue-windowing can be used for single observer study. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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14 pages, 2412 KiB

Open AccessArticle

Nomogram and Carotid Risk Score for Predicting Moderate or High Carotid Atherosclerosis among Asymptomatic Elderly Recycling Volunteers

by Cheng-Lun Hsiao, Pei-Ya Chen, Po-Jen Hsu and Shinn-Kuang Lin

Diagnostics 2022, 12(6), 1407; https://doi.org/10.3390/diagnostics12061407 - 06 Jun 2022

Cited by 2 | Viewed by 1972

Abstract

Carotid atherosclerosis is associated with cardiovascular and cerebrovascular events. We explored an appropriate method for selecting participants without ischemic cerebrovascular disease but with various comorbidities eligible for a carotid ultrasound. This was a retrospective subgroup analysis of the carotid plaque burden from a [...] Read more.

Carotid atherosclerosis is associated with cardiovascular and cerebrovascular events. We explored an appropriate method for selecting participants without ischemic cerebrovascular disease but with various comorbidities eligible for a carotid ultrasound. This was a retrospective subgroup analysis of the carotid plaque burden from a previous study involving a vascular and cognitive survey of 956 elderly recycling volunteers (778 women and 178 men; mean age: 70.8 years). We used carotid ultrasound to detect the carotid plaque and computed the carotid plaque score (CPS). A moderate or high degree of carotid atherosclerosis (MHCA) was defined as CPS > 5 and was observed in 22% of the participants. The CPS had positive linear correlations with age, systolic blood pressure, and fasting glucose. We stratified the participants into four age groups: 60–69, 70–74, 75–79, and ≥80 years. Multivariable analysis revealed that significant predictors for MHCA were age, male sex, hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, and a nonvegetarian diet. Coronary artery disease and advanced age were the two strongest predictors. We chose the aforementioned seven significant predictors to establish a nomogram for MHCA prediction. The area under the receiver operating characteristic curve in internal validation with 10-fold cross-validation and the classification accuracy of the nomogram were 0.785 and 0.797, respectively. We presumed people who have a ≥50% probability of MHCA warranted a carotid ultrasound. A flowchart table derived from the nomogram addressing the probabilities of all models of combinations of comorbidities was established to identify participants who had a probability of MHCA ≥ 50% (corresponding to a total nomogram score of ≥15 points). We further established a carotid risk score range from 0 to 17 comprising the seven predictors. A carotid risk score ≥ 7 was the most optimal cutoff value associated with a probability of MHCA ≥ 50%. Both total nomogram score ≥ 15 points and carotid risk score ≥ 7 can help in the rapid identification of individuals without stroke but who have a ≥50% probability of MHCA—these individuals should schedule a carotid ultrasound. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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15 pages, 11848 KiB

Open AccessArticle

Radiomics Analysis on Gadoxetate Disodium-Enhanced MRI Predicts Response to Transarterial Embolization in Patients with HCC

by Roberto Cannella, Carla Cammà, Francesco Matteini, Ciro Celsa, Paolo Giuffrida, Marco Enea, Albert Comelli, Alessandro Stefano, Calogero Cammà, Massimo Midiri, Roberto Lagalla, Giuseppe Brancatelli and Federica Vernuccio

Diagnostics 2022, 12(6), 1308; https://doi.org/10.3390/diagnostics12061308 - 24 May 2022

Cited by 5 | Viewed by 2105

Abstract

Objectives: To explore the potential of radiomics on gadoxetate disodium-enhanced MRI for predicting hepatocellular carcinoma (HCC) response after transarterial embolization (TAE). Methods: This retrospective study included cirrhotic patients treated with TAE for unifocal HCC naïve to treatments. Each patient underwent gadoxetate disodium-enhanced MRI. [...] Read more.

Objectives: To explore the potential of radiomics on gadoxetate disodium-enhanced MRI for predicting hepatocellular carcinoma (HCC) response after transarterial embolization (TAE). Methods: This retrospective study included cirrhotic patients treated with TAE for unifocal HCC naïve to treatments. Each patient underwent gadoxetate disodium-enhanced MRI. Radiomics analysis was performed by segmenting the lesions on portal venous (PVP), 3-min transitional, and 20-min hepatobiliary (HBP) phases. Clinical data, laboratory variables, and qualitative features based on LI-RADSv2018 were assessed. Reference standard was based on mRECIST response criteria. Two different radiomics models were constructed, a statistical model based on logistic regression with elastic net penalty (model 1) and a computational model based on a hybrid descriptive-inferential feature extraction method (model 2). Areas under the ROC curves (AUC) were calculated. Results: The final population included 51 patients with HCC (median size 20 mm). Complete and objective responses were obtained in 14 (27.4%) and 29 (56.9%) patients, respectively. Model 1 showed the highest performance on PVP for predicting objective response with an AUC of 0.733, sensitivity of 100%, and specificity of 40.0% in the test set. Model 2 demonstrated similar performances on PVP and HBP for predicting objective response, with an AUC of 0.791, sensitivity of 71.3%, specificity of 61.7% on PVP, and AUC of 0.790, sensitivity of 58.8%, and specificity of 90.1% on HBP. Conclusions: Radiomics models based on gadoxetate disodium-enhanced MRI can achieve good performance for predicting response of HCCs treated with TAE. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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13 pages, 4535 KiB

Open AccessArticle

Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals

by Federica Vernuccio, Roberto Cannella, Giuseppe Cabibbo, Silvia Greco, Ciro Celsa, Francesco Matteini, Paolo Giuffrida, Massimo Midiri, Vito Di Marco, Calogero Cammà and Giuseppe Brancatelli

Diagnostics 2022, 12(5), 1187; https://doi.org/10.3390/diagnostics12051187 - 10 May 2022

Viewed by 1848

Abstract

Purpose: To assess whether HCC (LR-5) occurrence may be associated with the presence of Liver Imaging Reporting and Data System (LI-RADS) indeterminate observations in patients with hepatitis C virus infection treated with direct acting antiviral (DAA) therapy. Materials and methods: This retrospective study [...] Read more.

Purpose: To assess whether HCC (LR-5) occurrence may be associated with the presence of Liver Imaging Reporting and Data System (LI-RADS) indeterminate observations in patients with hepatitis C virus infection treated with direct acting antiviral (DAA) therapy. Materials and methods: This retrospective study included patients with HCV-related cirrhosis who achieved sustained virologic response (SVR) after DAA therapy between 2015 and 2019 and submitted to CT/MRI follow-ups with a minimum interval time of six months before and after DAA. Two blinded readers reviewed CT/MRI to categorize observations according to LI-RADS version 2018. Differences in rate of LI-RADS 5 observations (i.e., LR-5) before and after SVR were assessed. Time to LR-5 occurrence and risk factors for HCC after DAAs were evaluated by using Kaplan-Meier method and Cox proportional hazard model, respectively. Results: Our final study population comprised 115 patients (median age 72 years) with a median CT/MRI follow-up of 47 months (IQR 26–77 months). Twenty-nine (25.2%) patients were diagnosed with LR-5 after DAA. The incidence of LR-5 after DAAs was 10.4% (12/115) at one year and 17.4% (20/115) at two years. LR-5 occurrence after DAA was significantly higher in patients with Child Pugh class B (log-rank p = 0.048) and with LR-3 or LR-4 observations (log-rank p = 0.024). At multivariate analysis, Child-Pugh class B (hazard ratio 2.62, p = 0.023) and presence of LR-3 or LR-4 observations (hazard ratio 2.40, p = 0.048) were independent risk factors for LR-5 occurrence after DAA therapy. Conclusions: The presence of LR-3 and LR-4 observations significantly increases HCC risk following the eradication of HCV infection. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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10 pages, 1506 KiB

Open AccessArticle

Hip Preservation Surgery in Osteoarthritis Prevention: Potential Benefits of the Radiographic Angular Correction

by José M. Lamo-Espinosa, Adrián Alfonso, Elena Pascual, Jorge García-Ausín, Miguel Sánchez-Gordoa, Asier Blanco, Jorge Gómez-Álvarez and Mikel San-Julián

Diagnostics 2022, 12(5), 1128; https://doi.org/10.3390/diagnostics12051128 - 02 May 2022

Cited by 1 | Viewed by 2310

Abstract

Objective: The aim of the study is to describe the morphology associated with the development of osteoarthritis (OA) in three different age groups. These data will contribute to defining the morphology associated with early and late hip OA. Methods: We studied 400 hips [...] Read more.

Objective: The aim of the study is to describe the morphology associated with the development of osteoarthritis (OA) in three different age groups. These data will contribute to defining the morphology associated with early and late hip OA. Methods: We studied 400 hips in 377 patients who had undergone primary THA due to idiopathic OA. Three groups were compared: group 1 (n = 147), younger patients, aged up to 60 years; group 2 (n = 155), patients aged between 61 and 74 years; and group 3 (n = 98), aged 75 or over. Five independent researchers measured the hip angles and the mean values were used to build a database. Results: No differences between groups in sex distribution and BMI were detected. Less coverage of the head (extrusion index), higher Tönnis angle, lower Wiberg and alpha angles characterized early OA hips. These differences increased with age, being greater between group 2 and group 3 (p < 0.01). However, significant differences were still present in the comparison between group 1 and group 2 (p < 0.01)). No differences were detected between group 2 and group 3. Conclusion: Elevated acetabular angle, head extrusion and decreased Wiberg angle characterize hip osteoarthritis at younger ages and should be the focus of hip preservation surgery in terms of osteoarthritis prevention. Pincer-type FAI (higher Wiberg and lower Tönnis angle) and higher alpha angle (CAM) are correlated with the development of later OA. These results shed doubt on applying the hip preservation surgery concept in terms of osteoarthritis prevention in FAI, especially in Pincer-type FAI patients. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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10 pages, 1738 KiB

Open AccessArticle

Comparison of Two Kinds of Two-Dimensional Shear Wave Elastography Techniques in the Evaluation of Jaundiced Infants Suspected of Biliary Atresia

by Wenying Zhou, Jinyu Liang, Quanyuan Shan, Huadong Chen, Pengfei Gao, Qinghua Cao, Guotao Wang, Xiaoyan Xie and Luyao Zhou

Diagnostics 2022, 12(5), 1092; https://doi.org/10.3390/diagnostics12051092 - 27 Apr 2022

Cited by 2 | Viewed by 1435

Abstract

Purpose: To compare the reliability and performance of Supersonic shear wave elastography (S-SWE) and Toshiba shear wave elastography (T-SWE) in the diagnosis of biliary atresia (BA) and assessment of liver fibrosis among jaundiced infants suspected of BA. Material and Methods: A total of [...] Read more.

Purpose: To compare the reliability and performance of Supersonic shear wave elastography (S-SWE) and Toshiba shear wave elastography (T-SWE) in the diagnosis of biliary atresia (BA) and assessment of liver fibrosis among jaundiced infants suspected of BA. Material and Methods: A total of 35 patients with suspected BA who underwent both S-SWE and T-SWE examinations were prospectively included. Diagnostic performances of S-SWE and T-SWE in identifying BA were evaluated. The correlation between two types of SWE values and histological liver fibrosis stages by Metavir scores were investigated in 21 patients with pathology results. The intraclass correlation coefficients (ICCs) were calculated in 16 patients for inter- and intra-observer agreement. The area under the receiver operating characteristic curve (AUC) analysis was compared using a DeLong test. Results: There were 22 patients with BA and 13 patients without BA. The diagnostic performance of S-SWE was comparable to that of T-SWE (AUC 0.895 vs. 0.822, p = 0.071) in diagnosing BA. The AUCs of S-SWE in predicting liver fibrosis stages were from 0.676 to 1.000 and showed no statistical differences from that of T-SWE (from 0.704 to 1.000, all p > 0.05). T-SWE provided higher inter-operator agreement (ICC 0.990) and intra-operator agreement (ICCs 0.966–0.993), compared with that of S-SWE in a previous study (ICC 0.980 for inter-operator and 0.930–0.960 for intra-operator). Conclusions: For infants suspected of BA, T-SWE had good performances in the diagnosis of BA and the assessment of liver fibrosis compared with S-SWE. Furthermore, T-SWE showed higher measurement reproducibility than S-SWE. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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12 pages, 3416 KiB

Open AccessArticle

Assessment of Maxillary Molars Interradicular Septum Morphological Characteristics as Criteria for Ideal Immediate Implant Placement—The Advantages of Cone Beam Computed Tomography Analysis

by Zlata Rajkovic Pavlovic, Pavle Milanovic, Milica Vasiljevic, Nemanja Jovicic, Aleksandra Arnaut, Djurdjina Colic, Marijana Petrovic, Momir Stevanovic, Dragica Selakovic and Gvozden Rosic

Diagnostics 2022, 12(4), 1010; https://doi.org/10.3390/diagnostics12041010 - 16 Apr 2022

Cited by 2 | Viewed by 2463

Abstract

The aim of this study was to evaluate the interradicular septum bone morphometric characteristics using cone beam computed tomography (CBCT) images, as well as to establish quantitative shortcuts to allow clinicians to make a faster and more reliable plan for immediate implant placement [...] Read more.

The aim of this study was to evaluate the interradicular septum bone morphometric characteristics using cone beam computed tomography (CBCT) images, as well as to establish quantitative shortcuts to allow clinicians to make a faster and more reliable plan for immediate implant placement in the maxillary molars area. This retrospective quantitative study was conducted on CBCT images obtained from 100 patients. The morphometric analysis of the maxillary molars region was based on the parameters obtained on the sagittal and axial slices. The analysis performed on sagittal slices showed that the first maxillary molars had a wider interradicular septum when compared to the second molars, but the septum height in the first molars was significantly below the height in the second maxillary molars. The axial CBCT slices analysis showed that both interradicular septum perimeter and surface area were significantly more pronounced in the first than in the second maxillary molars. The interradicular furcation angle significantly correlated with the surface area (positively) and septum height (negatively) for both molars. The results of this study may recommend CBCT image analysis as a useful tool in predefining the circumstances that can allow for substantially better planning of immediate implant placement procedures in the region of maxillary molars. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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17 pages, 1854 KiB

Open AccessArticle

Machine Learning for Opportunistic Screening for Osteoporosis from CT Scans of the Wrist and Forearm

by Ronnie Sebro and Cynthia De la Garza-Ramos

Diagnostics 2022, 12(3), 691; https://doi.org/10.3390/diagnostics12030691 - 11 Mar 2022

Cited by 13 | Viewed by 2776 | Correction

Abstract

Background: We investigated whether opportunistic screening for osteoporosis can be done from computed tomography (CT) scans of the wrist/forearm using machine learning. Methods: A retrospective study of 196 patients aged 50 years or greater who underwent CT scans of the wrist/forearm and [...] Read more.

Background: We investigated whether opportunistic screening for osteoporosis can be done from computed tomography (CT) scans of the wrist/forearm using machine learning. Methods: A retrospective study of 196 patients aged 50 years or greater who underwent CT scans of the wrist/forearm and dual-energy X-ray absorptiometry (DEXA) scans within 12 months of each other was performed. Volumetric segmentation of the forearm, carpal, and metacarpal bones was performed to obtain the mean CT attenuation of each bone. The correlations of the CT attenuations of each of the wrist/forearm bones and their correlations to the DEXA measurements were calculated. The study was divided into training/validation (n = 96) and test (n = 100) datasets. The performance of multivariable support vector machines (SVMs) was evaluated in the test dataset and compared to the CT attenuation of the distal third of the radial shaft (radius 33%). Results: There were positive correlations between each of the CT attenuations of the wrist/forearm bones, and with DEXA measurements. A threshold hamate CT attenuation of 170.2 Hounsfield units had a sensitivity of 69.2% and a specificity of 77.1% for identifying patients with osteoporosis. The radial-basis-function (RBF) kernel SVM (AUC = 0.818) was the best for predicting osteoporosis with a higher AUC than other models and better than the radius 33% (AUC = 0.576) (p = 0.020). Conclusions: Opportunistic screening for osteoporosis could be performed using CT scans of the wrist/forearm. Multivariable machine learning techniques, such as SVM with RBF kernels, that use data from multiple bones were more accurate than using the CT attenuation of a single bone. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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15 pages, 3061 KiB

Open AccessArticle

Myelin-Weighted Imaging Presents Reduced Apparent Myelin Water in Patients with Alzheimer’s Disease

by Seung-Hyun Lim, Jiyoon Lee, Sumin Jung, Bokyung Kim, Hak Young Rhee, Se-Hong Oh, Soonchan Park, Ah Rang Cho, Chang-Woo Ryu and Geon-Ho Jahng

Diagnostics 2022, 12(2), 446; https://doi.org/10.3390/diagnostics12020446 - 09 Feb 2022

Cited by 2 | Viewed by 1664

Abstract

The purpose of this study was to investigate myelin loss in both AD and mild cognitive impairment (MCI) patients with a new myelin water mapping technique within reasonable scan time and evaluate the clinical relevance of the apparent myelin water fraction (MWF) values [...] Read more.

The purpose of this study was to investigate myelin loss in both AD and mild cognitive impairment (MCI) patients with a new myelin water mapping technique within reasonable scan time and evaluate the clinical relevance of the apparent myelin water fraction (MWF) values by assessing the relationship between decreases in myelin water and the degree of memory decline or aging. Twenty-nine individuals were assigned to the cognitively normal (CN) elderly group, 32 participants were assigned to the MCI group, and 31 patients were assigned to the AD group. A 3D visualization of the short transverse relaxation time component (ViSTa)-gradient and spin-echo (GraSE) sequence was developed to map apparent MWF. Then, the MWF values were compared between the three participant groups and was evaluated the relationship with the degree of memory loss. The AD group showed a reduced apparent MWF compared to the CN and MCI groups. The largest AUC (area under the curve) value was in the corpus callosum and used to classify the CN and AD groups using the apparent MWF. The ViSTa-GraSE sequence can be a useful tool to map the MWF in a reasonable scan time. Combining the MWF in the corpus callosum with the detection of atrophy in the hippocampus can be valuable for group classification. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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9 pages, 2482 KiB

Open AccessArticle

Percutaneous CT-Guided Biopsy of the Craniovertebral Junction: Safety, Diagnostic Yield, and Technical Notes

by Paolo Spinnato, Eugenio Rimondi and Giancarlo Facchini

Diagnostics 2022, 12(1), 168; https://doi.org/10.3390/diagnostics12010168 - 11 Jan 2022

Cited by 5 | Viewed by 1766

Abstract

The craniovertebral junction defined as the occiput, the atlas, and the axis is a complex bony region that contains vital neural and vascular structures. We report the experience of a single academic institution regarding CT-guided biopsy of this skeletal region. We reviewed all [...] Read more.

The craniovertebral junction defined as the occiput, the atlas, and the axis is a complex bony region that contains vital neural and vascular structures. We report the experience of a single academic institution regarding CT-guided biopsy of this skeletal region. We reviewed all of the CT-guided biopsies performed in our department, completed in the craniovertebral junction. We collected data in regard to biopsy procedures, patients’ vital statistics, and histopathological diagnosis. In total, 16 patients (8M and 8F; mean age 52; range 16–86 years old) were included in this series. In eight patients, the lesions were located in the atlas vertebra (8/16—50%), in six patients in the axis (37.5%), and in two patients in the occiput (12.5%). No complications were observed during or after the procedures. All of the procedures were technically successful. The biopsy was diagnostic in 13/16 patients (81.3%): four metastatic lesions (25%—three breast and one prostate cancers), four multiple myeloma bone lesions (25%), three aneurismal bone cysts (18.8%), one aggressive hemangioma (6.3%), and one pseudogout (6.3%). Moreover, in two-thirds (66.6%) of non-diagnostic histological reports, malignancies were excluded. CT-guided percutaneous biopsy is a safe tool and allows obtaining a histological diagnosis, in most cases, even in the most delicate site of the human skeleton—the craniovertebral junction. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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14 pages, 3200 KiB

Open AccessArticle

Applying Compressed Sensing Volumetric Interpolated Breath-Hold Examination and Spiral Ultrashort Echo Time Sequences for Lung Nodule Detection in MRI

by Yu-Sen Huang, Emi Niisato, Mao-Yuan Marine Su, Thomas Benkert, Ning Chien, Pin-Yi Chiang, Wen-Jeng Lee, Jin-Shing Chen and Yeun-Chung Chang

Diagnostics 2022, 12(1), 93; https://doi.org/10.3390/diagnostics12010093 - 31 Dec 2021

Cited by 7 | Viewed by 2026

Abstract

This prospective study aimed to investigate the ability of spiral ultrashort echo time (UTE) and compressed sensing volumetric interpolated breath-hold examination (CS-VIBE) sequences in magnetic resonance imaging (MRI) compared to conventional VIBE and chest computed tomography (CT) in terms of image quality and [...] Read more.

This prospective study aimed to investigate the ability of spiral ultrashort echo time (UTE) and compressed sensing volumetric interpolated breath-hold examination (CS-VIBE) sequences in magnetic resonance imaging (MRI) compared to conventional VIBE and chest computed tomography (CT) in terms of image quality and small nodule detection. Patients with small lung nodules scheduled for video-assisted thoracoscopic surgery (VATS) for lung wedge resection were prospectively enrolled. Each patient underwent non-contrast chest CT and non-contrast MRI on the same day prior to thoracic surgery. The chest CT was performed to obtain a standard reference for nodule size, location, and morphology. The chest MRI included breath-hold conventional VIBE and CS-VIBE with scanning durations of 11 and 13 s, respectively, and free-breathing spiral UTE for 3.5–5 min. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and normal structure visualizations were measured to evaluate MRI quality. Nodule detection sensitivity was evaluated on a lobe-by-lobe basis. Inter-reader and inter-modality reliability analyses were performed using the Cohen κ statistic and the nodule size comparison was performed using Bland–Altman plots. Among 96 pulmonary nodules requiring surgery, the average nodule diameter was 7.7 ± 3.9 mm (range: 4–20 mm); of the 73 resected nodules, most were invasive cancer (74%) or pre-invasive carcinoma in situ (15%). Both spiral UTE and CS-VIBE images achieved significantly higher overall image quality scores, SNRs, and CNRs than conventional VIBE. Spiral UTE (81%) and CS-VIBE (83%) achieved a higher lung nodule detection rate than conventional VIBE (53%). Specifically, the nodule detection rate for spiral UTE and CS-VIBE reached 95% and 100% for nodules >8 and >10 mm, respectively. A 90% detection rate was achieved for nodules of all sizes with a part-solid or solid morphology. Spiral UTE and CS-VIBE under-estimated the nodule size by 0.2 ± 1.4 mm with 95% limits of agreement from −2.6 to 2.9 mm and by 0.2 ± 1.7 mm with 95% limits of agreement from −3.3 to 3.5 mm, respectively, compared to the reference CT. In conclusion, chest CT remains the gold standard for lung nodule detection due to its high image resolutions. Both spiral UTE and CS-VIBE MRI could detect small lung nodules requiring surgery and could be considered a potential alternative to chest CT; however, their clinical application requires further investigation. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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11 pages, 1542 KiB

Open AccessArticle

The Effects of Suprabullar Pneumatization on the Orientation of Its Surrounding Anatomical Structures Relevant to the Frontal Drainage Pathway

by Nikma Fadlati Umar, Mohd Ezane Aziz, Norhafiza Mat Lazim and Baharudin Abdullah

Diagnostics 2022, 12(1), 52; https://doi.org/10.3390/diagnostics12010052 - 27 Dec 2021

Cited by 1 | Viewed by 5209

Abstract

Objective: The aim of this study was to evaluate the effects of suprabullar pneumatization on the orientation of the frontal sinus outflow structures and its association with the volume of anterior ethmoid sinus. Methods: A retrospective chart review of computed tomography of paranasal [...] Read more.

Objective: The aim of this study was to evaluate the effects of suprabullar pneumatization on the orientation of the frontal sinus outflow structures and its association with the volume of anterior ethmoid sinus. Methods: A retrospective chart review of computed tomography of paranasal sinuses (CTPNS) images was conducted. A total of 370 sides of the CTPNS of 185 patients were analyzed. Results: The course of anterior ethmoidal artery (AEA) along the skull base (p = 0.04) and position of AEA at the second lamella (p = 0.04) was significantly associated with the type of suprabullar pneumatization. The AEA is expected to be lower at the skull base and at a longer distance from the second lamella with the increase in grading of the suprabullar pneumatization. The distance of AEA to the second lamella (p < 0.001) and third lamella (p = 0.04) was significantly different depending on the type of suprabullar pneumatization, which indicates AEA is expected to be at a longer distance from the second lamella and third lamella in higher grade suprabullar pneumatization. The type of suprabullar pneumatization has a significant but weak association with the anterior ethmoid sinus volume (p = 0.04). Conclusions: There is a significant effect of the type of suprabullar pneumatization on the orientation of the surrounding anatomical structures at the frontal recess. The type of suprabullar pneumatization is influenced by the anterior ethmoid sinus volume, which suggests it has a possible role in the frontal drainage pathway. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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12 pages, 674 KiB

Open AccessArticle

Using IVIM Parameters to Differentiate Prostate Cancer and Contralateral Normal Tissue through Fusion of MRI Images with Whole-Mount Pathology Specimen Images by Control Point Registration Method

by Cheng-Chun Lee, Kuang-Hsi Chang, Feng-Mao Chiu, Yen-Chuan Ou, Jen-I. Hwang, Kuan-Chun Hsueh and Hueng-Chuen Fan

Diagnostics 2021, 11(12), 2340; https://doi.org/10.3390/diagnostics11122340 - 12 Dec 2021

Cited by 3 | Viewed by 2662

Abstract

The intravoxel incoherent motion (IVIM) model may enhance the clinical value of multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer (PCa). However, while past IVIM modeling studies have shown promise, they have also reported inconsistent results and limitations, underscoring the [...] Read more.

The intravoxel incoherent motion (IVIM) model may enhance the clinical value of multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer (PCa). However, while past IVIM modeling studies have shown promise, they have also reported inconsistent results and limitations, underscoring the need to further enhance the accuracy of IVIM modeling for PCa detection. Therefore, this study utilized the control point registration toolbox function in MATLAB to fuse T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) MRI images with whole-mount pathology specimen images in order to eliminate potential bias in IVIM calculations. Sixteen PCa patients underwent prostate MRI scans before undergoing radical prostatectomies. The image fusion method was then applied in calculating the patients’ IVIM parameters. Furthermore, MRI scans were also performed on 22 healthy young volunteers in order to evaluate the changes in IVIM parameters with aging. Among the full study cohort, the f parameter was significantly increased with age, while the D* parameter was significantly decreased. Among the PCa patients, the D and ADC parameters could differentiate PCa tissue from contralateral normal tissue, while the f and D* parameters could not. The presented image fusion method also provided improved precision when comparing regions of interest side by side. However, further studies with more standardized methods are needed to further clarify the benefits of the presented approach and the different IVIM parameters in PCa characterization. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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10 pages, 3221 KiB

Open AccessArticle

Quantification of Liver Fat Content after Radiofrequency Ablation for Liver Cancer: Correlation with Hepatic Perfusion Disorders

by Li-Shan Shen, Quan-Xi Li, Xiao-Wen Luo, Hui-Jun Tang, You-Jie Tang, Wen-Jie Tang and Ruo-Mi Guo

Diagnostics 2021, 11(11), 2137; https://doi.org/10.3390/diagnostics11112137 - 18 Nov 2021

Viewed by 2667

Abstract

Purpose: To quantitatively investigate the correlation between liver fat content and hepatic perfusion disorders (HPD) after radiofrequency ablation (RFA) for liver cancer using magnetic resonance imaging (MRI)-determined proton density fat fraction (PDFF). Materials and methods: A total of 150 liver cancer patients underwent [...] Read more.

Purpose: To quantitatively investigate the correlation between liver fat content and hepatic perfusion disorders (HPD) after radiofrequency ablation (RFA) for liver cancer using magnetic resonance imaging (MRI)-determined proton density fat fraction (PDFF). Materials and methods: A total of 150 liver cancer patients underwent liver MRI examination within one month after RFA and at four months after RFA. According to the liver fat content, they were divided into non-, mild, moderate, and severe fatty liver groups. The liver fat content and hepatic perfusion disorders were determined using PDFF images and dynamic contrast-enhanced MRI images. The relationship between the liver fat content and HPD was investigated. Results: At the first postoperative MRI examination, the proportion of patients in the nonfatty liver group with hyperperfused foci (11.11%) was significantly lower than that in the mild (30.00%), moderate (42.86%), and severe fatty liver (56.67%) groups (p < 0.05), whereas the proportions of patients with hypoperfused foci (6.67%, 7.5%, 5.71%, and 6.67%, respectively) were not significantly different among the four groups (p > 0.05). In the nonfatty liver group, the liver fat content was not correlated with hyperperfusion abnormalities or hypoperfusion abnormalities. By contrast, in the three fatty liver groups, the liver fat content was correlated with hyperperfusion abnormalities but was not correlated with hypoperfusion abnormalities. At the second postoperative MRI examination, six patients in the nonfatty liver group were diagnosed with fatty liver, including two patients with newly developed hyperperfusion abnormalities and one patient whose hypoperfusion abnormality remained the same as it was in the first postoperative MRI examination. Conclusion: There was a high correlation between the liver fat content and hyperperfusion abnormalities after RFA for liver cancer. The higher the liver fat content was, the higher the was risk of hyperperfusion abnormalities. However, there was little correlation between liver fat content and hypoperfusion abnormalities, and the increase in postoperative liver fat content did not induce or alter the presence of hypoperfused foci. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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13 pages, 3958 KiB

Open AccessArticle

Automated Screening for Abdominal Aortic Aneurysm in CT Scans under Clinical Conditions Using Deep Learning

by Alena-K. Golla, Christian Tönnes, Tom Russ, Dominik F. Bauer, Matthias F. Froelich, Steffen J. Diehl, Stefan O. Schoenberg, Michael Keese, Lothar R. Schad, Frank G. Zöllner and Johann S. Rink

Diagnostics 2021, 11(11), 2131; https://doi.org/10.3390/diagnostics11112131 - 17 Nov 2021

Cited by 12 | Viewed by 6038

Abstract

Abdominal aortic aneurysms (AAA) may remain clinically silent until they enlarge and patients present with a potentially lethal rupture. This necessitates early detection and elective treatment. The goal of this study was to develop an easy-to-train algorithm which is capable of automated AAA [...] Read more.

Abdominal aortic aneurysms (AAA) may remain clinically silent until they enlarge and patients present with a potentially lethal rupture. This necessitates early detection and elective treatment. The goal of this study was to develop an easy-to-train algorithm which is capable of automated AAA screening in CT scans and can be applied to an intra-hospital environment. Three deep convolutional neural networks (ResNet, VGG-16 and AlexNet) were adapted for 3D classification and applied to a dataset consisting of 187 heterogenous CT scans. The 3D ResNet outperformed both other networks. Across the five folds of the first training dataset it achieved an accuracy of 0.856 and an area under the curve (AUC) of 0.926. Subsequently, the algorithms performance was verified on a second data set containing 106 scans, where it ran fully automated and resulted in an accuracy of 0.953 and an AUC of 0.971. A layer-wise relevance propagation (LRP) made the decision process interpretable and showed that the network correctly focused on the aortic lumen. In conclusion, the deep learning-based screening proved to be robust and showed high performance even on a heterogeneous multi-center data set. Integration into hospital workflow and its effect on aneurysm management would be an exciting topic of future research. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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15 pages, 273 KiB

Open AccessArticle

Structured Reporting of Computed Tomography and Magnetic Resonance in the Staging of Pancreatic Adenocarcinoma: A Delphi Consensus Proposal

by Vincenza Granata, Giovanni Morana, Mirko D'Onofrio, Roberta Fusco, Francesca Coppola, Francesca Grassi, Salvatore Cappabianca, Alfonso Reginelli, Nicola Maggialetti, Duccio Buccicardi, Antonio Barile, Marco Rengo, Chandra Bortolotto, Fabrizio Urraro, Giorgia Viola La Casella, Marco Montella, Eleonora Ciaghi, Francesco Bellifemine, Federica De Muzio, Ginevra Danti, Giulia Grazzini, Carmelo Barresi, Luca Brunese, Emanuele Neri, Roberto Grassi, Vittorio Miele and Lorenzo Faggioni Show full author list Hide full author list

Diagnostics 2021, 11(11), 2033; https://doi.org/10.3390/diagnostics11112033 - 03 Nov 2021

Cited by 17 | Viewed by 2268

Abstract

Background: Structured reporting (SR) in radiology has been recognized recently by major scientific societies. This study aims to build structured computed tomography (CT) and magnetic resonance (MR)-based reports in pancreatic adenocarcinoma during the staging phase in order to improve communication between the radiologist [...] Read more.

Background: Structured reporting (SR) in radiology has been recognized recently by major scientific societies. This study aims to build structured computed tomography (CT) and magnetic resonance (MR)-based reports in pancreatic adenocarcinoma during the staging phase in order to improve communication between the radiologist and members of multidisciplinary teams. Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi process was used to develop the CT-SR and MRI-SR, assessing a level of agreement for all report sections. Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. Results: The final CT-SR version was built by including n = 16 items in the “Patient Clinical Data” section, n = 11 items in the “Clinical Evaluation” section, n = 7 items in the “Imaging Protocol” section, and n = 18 items in the “Report” section. Overall, 52 items were included in the final version of the CT-SR. The final MRI-SR version was built by including n = 16 items in the “Patient Clinical Data” section, n = 11 items in the “Clinical Evaluation” section, n = 8 items in the “Imaging Protocol” section, and n = 14 items in the “Report” section. Overall, 49 items were included in the final version of the MRI-SR. In the first round for CT-SR, all sections received more than a good rating. The overall mean score of the experts was 4.85. The Cα correlation coefficient was 0.85. In the second round, the overall mean score of the experts was 4.87, and the Cα correlation coefficient was 0.94. In the first round, for MRI-SR, all sections received more than a good rating. The overall mean score of the experts was 4.73. The Cα correlation coefficient was 0.82. In the second round, the overall mean score of the experts was 4.91, and the Cα correlation coefficient was 0.93. Conclusions: The CT-SR and MRI-SR are based on a multi-round consensus-building Delphi exercise derived from the multidisciplinary agreement of expert radiologists in order to obtain more appropriate communication tools for referring physicians. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

10 pages, 2461 KiB

Open AccessArticle

Ophthalmic Ultrasonography in Sub-Saharan Africa—A Kinshasa Experience

by Georgette Ngweme, M.T. Ngoyi Bambi, Longo Flavien Lutete, Ngoy Janvier Kilangalanga, Adrian Hopkins, Oliver Stachs, Rudolf Friedrich Guthoff and Thomas Stahnke

Diagnostics 2021, 11(11), 2009; https://doi.org/10.3390/diagnostics11112009 - 28 Oct 2021

Cited by 1 | Viewed by 1642

Abstract

The aim of this study was to analyze the use of the diagnostic B-scan ultrasound. Should it be made accessible to all surgical centers in Sub-Saharan Africa in order to (i) avoid unnecessary cataract surgery and (ii) evaluate extraocular pathology? This study was [...] Read more.

The aim of this study was to analyze the use of the diagnostic B-scan ultrasound. Should it be made accessible to all surgical centers in Sub-Saharan Africa in order to (i) avoid unnecessary cataract surgery and (ii) evaluate extraocular pathology? This study was conducted in Kinshasa from 2006 to 2019. Three hundred and twenty-three patients were included and separated into two groups. Group 1 included 262 patients with dense cataract. Group 2 consisted of 61 patients with pathologies of the ocular adnexa, and all were examined with a B-scan ultrasound. In group 1, there were 437 systematically screened eyes. Three hundred and ninety-eight eyes (91.08%) showed no abnormalities, 13 (2.97%) retinal detachments were identified, and 15 (3.43%) demonstrated a detached posterior hyaloid membrane. In the second group, 61 patients were examined (group 2). In 20 of them, surgery was performed for biopsy, tumor excision, mucoceles drainage, and palliative treatment. The need for routine B-scan examinations in dense cataract patients seems to be limited and can most likely be replaced by a thorough application of locally available examination techniques. B-scan application is recommended to manage orbital patients in the most cost-effective way. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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12 pages, 679 KiB

Open AccessArticle

Comparison of BSGI and MRI as Approaches to Evaluating Residual Tumor Status after Neoadjuvant Chemotherapy in Chinese Women with Breast Cancer

by Hongbiao Liu, Hongwei Zhan, Ying Zhang, Gangqiang He, Hui Wang, Qiaoxia Zhang and Lili Zheng

Diagnostics 2021, 11(10), 1846; https://doi.org/10.3390/diagnostics11101846 - 06 Oct 2021

Cited by 3 | Viewed by 1747

Abstract

Background: The present retrospective study was designed to evaluate the relative diagnostic utility of breast-specific gamma imaging (BSGI) and breast magnetic resonance imaging (MRI) as means of evaluating female breast cancer patients in China. Methods: A total of 229 malignant breast cancer patients [...] Read more.

Background: The present retrospective study was designed to evaluate the relative diagnostic utility of breast-specific gamma imaging (BSGI) and breast magnetic resonance imaging (MRI) as means of evaluating female breast cancer patients in China. Methods: A total of 229 malignant breast cancer patients underwent ultrasound, mammography, BSGI, and MRI between January 2015 and December 2018 for initial tumor staging. Of these patients, 73 were subsequently treated via definitive breast surgery following neoadjuvant chemotherapy (NAC), of whom 17 exhibited a complete pathologic response (pCR) to NAC. Results: BSGI and MRI were associated with 76.8% (43/56) and 83.9% (47/56) sensitivity (BSGI vs. MRI, p = 0.341) values, respectively, as a means of detecting residual tumors following NAC, while both these approaches exhibited comparable specificity in this diagnostic context. The specificity of BSGI for detecting residual tumors following NAC was 70.6% (12/17), and that of MRI was 58.8% (10/17) (BSGI vs. MRI, p = 0.473). Conclusion: These results demonstrate that BSGI is a useful auxiliary approach to evaluating pCR to NAC treatment. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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12 pages, 2555 KiB

Open AccessArticle

Lung Function Decline in Adult Asthmatics—A 10-Year Follow-Up Retrospective and Prospective Study

by Salvatore Bucchieri, Pietro Alfano, Palma Audino, Fabio Cibella, Giovanni Fazio, Salvatore Marcantonio and Giuseppina Cuttitta

Diagnostics 2021, 11(9), 1637; https://doi.org/10.3390/diagnostics11091637 - 07 Sep 2021

Cited by 1 | Viewed by 1789

Abstract

Asthma may have an impact on lung function decline but conflicting results are reported in forced expiratory volume in one second (FEV₁) decline. We aimed to describe the changes in FEV₁ in lifelong non-smoking adult asthmatic outpatients during a 10-year [...] Read more.

Asthma may have an impact on lung function decline but conflicting results are reported in forced expiratory volume in one second (FEV₁) decline. We aimed to describe the changes in FEV₁ in lifelong non-smoking adult asthmatic outpatients during a 10-year follow-up comparing years 1–5 (1st period) with years 6–10 (2nd period) to assess factors affecting these changes. A total of 100 outpatients performed spirometry every 3 months during a 10-year survey. FEV₁/Ht³ slope values of the 2nd period reduced significantly respect to the 1st period (p < 0.0001). FEV₁ slopes of years 1–5 and 6–10 were inversely associated with FEV₁ at enrolment (p = 0.02, p = 0.01, respectively). Reversibility and variability FEV₁ showed a significant effect on the 1st period slopes (p = 0.01 and p < 0.04, respectively). Frequent exacerbators in the 1st year had steeper FEV₁/Ht³ slopes in the 1st period (p = 0.01). The number of subjects using higher doses of ICS was significantly lower at the 10th years respect to the 5th and the 1st year (p < 0.001, p = 0.003, respectively). This study shows that FEV₁ decline in treated adult asthmatics non-smokers, over 10-year follow-up, is not constant. In particular, it slows down over time, and is influenced by FEV₁ at enrolment, reversibility, variability FEV₁ and exacerbation score in the 1st year. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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38 pages, 342 KiB

Open AccessArticle

Structured Reporting of Lung Cancer Staging: A Consensus Proposal

by Vincenza Granata, Roberto Grassi, Vittorio Miele, Anna Rita Larici, Nicola Sverzellati, Salvatore Cappabianca, Luca Brunese, Nicola Maggialetti, Andrea Borghesi, Roberta Fusco, Maurizio Balbi, Fabrizio Urraro, Duccio Buccicardi, Chandra Bortolotto, Roberto Prost, Marco Rengo, Elisa Baratella, Massimo De Filippo, Carmelo Barresi, Stefano Palmucci, Marco Busso, Lucio Calandriello, Mario Sansone, Emanuele Neri, Francesca Coppola and Lorenzo Faggioni Show full author list Hide full author list

Diagnostics 2021, 11(9), 1569; https://doi.org/10.3390/diagnostics11091569 - 30 Aug 2021

Cited by 16 | Viewed by 3501

Abstract

Background: Structured reporting (SR) in radiology is becoming necessary and has recently been recognized by major scientific societies. This study aimed to build CT-based structured reports for lung cancer during the staging phase, in order to improve communication between radiologists, members of the [...] Read more.

Background: Structured reporting (SR) in radiology is becoming necessary and has recently been recognized by major scientific societies. This study aimed to build CT-based structured reports for lung cancer during the staging phase, in order to improve communication between radiologists, members of the multidisciplinary team and patients. Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi exercise was used to build the structural report and to assess the level of agreement for all the report sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to perform a quality analysis according to the average inter-item correlation. Results: The final SR version was built by including 16 items in the “Patient Clinical Data” section, 4 items in the “Clinical Evaluation” section, 8 items in the “Exam Technique” section, 22 items in the “Report” section, and 5 items in the “Conclusion” section. Overall, 55 items were included in the final version of the SR. The overall mean of the scores of the experts and the sum of scores for the structured report were 4.5 (range 1–5) and 631 (mean value 67.54, STD 7.53), respectively, in the first round. The items of the structured report with higher accordance in the first round were primary lesion features, lymph nodes, metastasis and conclusions. The overall mean of the scores of the experts and the sum of scores for staging in the structured report were 4.7 (range 4–5) and 807 (mean value 70.11, STD 4.81), respectively, in the second round. The Cronbach’s alpha (Cα) correlation coefficient was 0.89 in the first round and 0.92 in the second round for staging in the structured report. Conclusions: The wide implementation of SR is critical for providing referring physicians and patients with the best quality of service, and for providing researchers with the best quality of data in the context of the big data exploitation of the available clinical data. Implementation is complex, requiring mature technology to successfully address pending user-friendliness, organizational and interoperability challenges. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

19 pages, 10602 KiB

Open AccessArticle

Enhance Portable Radiograph for Fast and High Accurate COVID-19 Monitoring

by Ngan Le, James Sorensen, Toan Bui, Arabinda Choudhary, Khoa Luu and Hien Nguyen

Diagnostics 2021, 11(6), 1080; https://doi.org/10.3390/diagnostics11061080 - 12 Jun 2021

Cited by 3 | Viewed by 3582

Abstract

This work aimed to assist physicians by improving their speed and diagnostic accuracy when interpreting portable CXRs as well as monitoring the treatment process to see whether a patient is improving or deteriorating with treatment. These objectives are in especially high demand in [...] Read more.

This work aimed to assist physicians by improving their speed and diagnostic accuracy when interpreting portable CXRs as well as monitoring the treatment process to see whether a patient is improving or deteriorating with treatment. These objectives are in especially high demand in the setting of the ongoing COVID-19 pandemic. With the recent progress in the development of artificial intelligence (AI), we introduce new deep learning frameworks to align and enhance the quality of portable CXRs to be more consistent, and to more closely match higher quality conventional CXRs. These enhanced portable CXRs can then help the doctors provide faster and more accurate diagnosis and treatment planning. The contributions of this work are four-fold. Firstly, a new database collection of subject-pair radiographs is introduced. For each subject, we collected a pair of samples from both portable and conventional machines. Secondly, a new deep learning approach is presented to align the subject-pairs dataset to obtain a pixel-pairs dataset. Thirdly, a new PairFlow approach is presented, an end-to-end invertible transfer deep learning method, to enhance the degraded quality of portable CXRs. Finally, the performance of the proposed system is evaluated by UAMS doctors in terms of both image quality and topological properties. This work was undertaken in collaboration with the Department of Radiology at the University of Arkansas for Medical Sciences (UAMS) to enhance portable/mobile COVID-19 CXRs, to improve the speed and accuracy of portable CXR images and aid in urgent COVID-19 diagnosis, monitoring and treatment. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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Review

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27 pages, 14361 KiB

Open AccessReview

The Role of Magnetic Resonance Enterography in Crohn’s Disease: A Review of Recent Literature

by Marysol Biondi, Eleonora Bicci, Ginevra Danti, Federica Flammia, Giuditta Chiti, Pierpaolo Palumbo, Federico Bruno, Alessandra Borgheresi, Roberta Grassi, Francesca Grassi, Roberta Fusco, Vincenza Granata, Andrea Giovagnoni, Antonio Barile and Vittorio Miele

Diagnostics 2022, 12(5), 1236; https://doi.org/10.3390/diagnostics12051236 - 15 May 2022

Cited by 4 | Viewed by 6627

Abstract

Inflammatory bowel disease (IBD) is the term used to identify a form of chronic inflammation of the gastrointestinal tract that primarily contemplates two major entities: ulcerative colitis (UC) and Crohn’s disease (CD). The classic signs are abdominal pain and diarrhoea that correlate with [...] Read more.

Inflammatory bowel disease (IBD) is the term used to identify a form of chronic inflammation of the gastrointestinal tract that primarily contemplates two major entities: ulcerative colitis (UC) and Crohn’s disease (CD). The classic signs are abdominal pain and diarrhoea that correlate with the localization of gastro-enteric disease, although in this pathology extraintestinal symptoms may coexist. The diagnosis of CD relies on a synergistic combination of clinical, laboratory (stool and biochemical), cross-sectional imaging evaluation, as well as endoscopic and histologic assessments. The purpose of this paper is to prove the role of imaging in the diagnosis and follow-up of patients with CD with particular focus on recent innovations of magnetic resonance enterography (MRE) as a pivotal diagnostic tool, analysing the MRE study protocol and imaging features during the various phases of disease activity and its complications. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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17 pages, 2205 KiB

Open AccessReview

Multiorgan Involvement in SARS-CoV-2 Infection: The Role of the Radiologist from Head to Toe

by Davide Ippolito, Federica Vernuccio, Cesare Maino, Roberto Cannella, Teresa Giandola, Maria Ragusi, Vittorio Bigiogera, Carlo Capodaglio and Sandro Sironi

Diagnostics 2022, 12(5), 1188; https://doi.org/10.3390/diagnostics12051188 - 10 May 2022

Cited by 1 | Viewed by 2039

Abstract

Radiology plays a crucial role for the diagnosis and management of COVID-19 patients during the different stages of the disease, allowing for early detection of manifestations and complications of COVID-19 in the different organs. Lungs are the most common organs involved by SARS-CoV-2 [...] Read more.

Radiology plays a crucial role for the diagnosis and management of COVID-19 patients during the different stages of the disease, allowing for early detection of manifestations and complications of COVID-19 in the different organs. Lungs are the most common organs involved by SARS-CoV-2 and chest computed tomography (CT) represents a reliable imaging-based tool in acute, subacute, and chronic settings for diagnosis, prognosis, and management of lung disease and the evaluation of acute and chronic complications. Cardiac involvement can be evaluated by using cardiac computed tomography angiography (CCTA), considered as the best choice to solve the differential diagnosis between the most common cardiac conditions: acute coronary syndrome, myocarditis, and cardiac dysrhythmia. By using compressive ultrasound it’s possible to study the peripheral arteries and veins and to exclude the deep vein thrombosis, directly linked to the onset of pulmonary embolism. Moreover, CT and especially MRI can help to evaluate the gastrointestinal involvement and assess hepatic function, pancreas involvement, and exclude causes of lymphocytopenia, thrombocytopenia, and leukopenia, typical of COVID-19 patients. Finally, radiology plays a crucial role in the early identification of renal damage in COVID-19 patients, by using both CT and US. This narrative review aims to provide a comprehensive radiological analysis of commonly involved organs in patients with COVID-19 disease. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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14 pages, 53853 KiB

Open AccessReview

Ultrasound for the Diagnosis of Biliary Atresia: From Conventional Ultrasound to Artificial Intelligence

by Wenying Zhou and Luyao Zhou

Diagnostics 2022, 12(1), 51; https://doi.org/10.3390/diagnostics12010051 - 27 Dec 2021

Cited by 11 | Viewed by 6998

Abstract

Biliary atresia is an aggressive liver disease of infancy and can cause death without timely surgical intervention. Early diagnosis of biliary atresia is critical to the recovery of bile drainage and long-term transplant-free survival. Ultrasound is recommended as the initial imaging strategy for [...] Read more.

Biliary atresia is an aggressive liver disease of infancy and can cause death without timely surgical intervention. Early diagnosis of biliary atresia is critical to the recovery of bile drainage and long-term transplant-free survival. Ultrasound is recommended as the initial imaging strategy for the diagnosis of biliary atresia. Numerous ultrasound features have been proved helpful for the diagnosis of biliary atresia. In recent years, with the help of new technologies such as elastography ultrasound, contrast-enhanced ultrasound and artificial intelligence, the diagnostic performance of ultrasound has been significantly improved. In this review, various ultrasound features in the diagnosis of biliary atresia are summarized. A diagnostic decision flow chart for biliary atresia is proposed on the basis of the hybrid technologies, combining conventional ultrasound, elastography and contrast-enhanced ultrasound. In addition, the application of artificial intelligence in the diagnosis of biliary atresia with ultrasound images is also introduced. Full article

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16 pages, 3546 KiB

Open AccessReview

Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: Role of the Radiologist and Oncologist in the Era of Precision Medicine

by Federica Vernuccio, Carlo Messina, Valeria Merz, Roberto Cannella and Massimo Midiri

Diagnostics 2021, 11(11), 2166; https://doi.org/10.3390/diagnostics11112166 - 22 Nov 2021

Cited by 7 | Viewed by 2773

Abstract

The incidence and mortality of pancreatic ductal adenocarcinoma are growing over time. The management of patients with pancreatic ductal adenocarcinoma involves a multidisciplinary team, ideally involving experts from surgery, diagnostic imaging, interventional endoscopy, medical oncology, radiation oncology, pathology, geriatric medicine, and palliative care. [...] Read more.

The incidence and mortality of pancreatic ductal adenocarcinoma are growing over time. The management of patients with pancreatic ductal adenocarcinoma involves a multidisciplinary team, ideally involving experts from surgery, diagnostic imaging, interventional endoscopy, medical oncology, radiation oncology, pathology, geriatric medicine, and palliative care. An adequate staging of pancreatic ductal adenocarcinoma and re-assessment of the tumor after neoadjuvant therapy allows the multidisciplinary team to choose the most appropriate treatment for the patient. This review article discusses advancement in the molecular basis of pancreatic ductal adenocarcinoma, diagnostic tools available for staging and tumor response assessment, and management of resectable or borderline resectable pancreatic cancer. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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11 pages, 1116 KiB

Open AccessReview

Multiparametric MRI and Radiomics in Prostate Cancer: A Review of the Current Literature

by Federico Midiri, Federica Vernuccio, Pierpaolo Purpura, Pierpaolo Alongi and Tommaso Vincenzo Bartolotta

Diagnostics 2021, 11(10), 1829; https://doi.org/10.3390/diagnostics11101829 - 03 Oct 2021

Cited by 13 | Viewed by 3553

Abstract

Prostate cancer (PCa) represents the fourth most common cancer and the fifth leading cause of cancer death of men worldwide. Multiparametric MRI (mp-MRI) has high sensitivity and specificity in the detection of PCa, and it is currently the most widely used imaging technique [...] Read more.

Prostate cancer (PCa) represents the fourth most common cancer and the fifth leading cause of cancer death of men worldwide. Multiparametric MRI (mp-MRI) has high sensitivity and specificity in the detection of PCa, and it is currently the most widely used imaging technique for tumor localization and cancer staging. mp-MRI plays a key role in risk stratification of naïve patients, in active surveillance for low-risk patients, and in monitoring recurrence after definitive therapy. Radiomics is an emerging and promising tool which allows a quantitative tumor evaluation from radiological images via conversion of digital images into mineable high-dimensional data. The purpose of radiomics is to increase the features available to detect PCa, to avoid unnecessary biopsies, to define tumor aggressiveness, and to monitor post-treatment recurrence of PCa. The integration of radiomics data, including different imaging modalities (such as PET-CT) and other clinical and histopathological data, could improve the prediction of tumor aggressiveness as well as guide clinical decisions and patient management. The purpose of this review is to describe the current research applications of radiomics in PCa on MR images. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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18 pages, 816 KiB

Open AccessReview

State of the Art in Artificial Intelligence and Radiomics in Hepatocellular Carcinoma

by Anna Castaldo, Davide Raffaele De Lucia, Giuseppe Pontillo, Marco Gatti, Sirio Cocozza, Lorenzo Ugga and Renato Cuocolo

Diagnostics 2021, 11(7), 1194; https://doi.org/10.3390/diagnostics11071194 - 30 Jun 2021

Cited by 17 | Viewed by 3332

Abstract

The most common liver malignancy is hepatocellular carcinoma (HCC), which is also associated with high mortality. Often HCC develops in a chronic liver disease setting, and early diagnosis as well as accurate screening of high-risk patients is crucial for appropriate and effective management [...] Read more.

The most common liver malignancy is hepatocellular carcinoma (HCC), which is also associated with high mortality. Often HCC develops in a chronic liver disease setting, and early diagnosis as well as accurate screening of high-risk patients is crucial for appropriate and effective management of these patients. While imaging characteristics of HCC are well-defined in the diagnostic phase, challenging cases still occur, and current prognostic and predictive models are limited in their accuracy. Radiomics and machine learning (ML) offer new tools to address these issues and may lead to scientific breakthroughs with the potential to impact clinical practice and improve patient outcomes. In this review, we will present an overview of these technologies in the setting of HCC imaging across different modalities and a range of applications. These include lesion segmentation, diagnosis, prognostic modeling and prediction of treatment response. Finally, limitations preventing clinical application of radiomics and ML at the present time are discussed, together with necessary future developments to bring the field forward and outside of a purely academic endeavor. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)

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