Diagnostics

Research

15 pages, 4218 KiB

Open AccessArticle

Diffusion-Weighted MR Imaging of the Thymus in Children with Non-Thymic Neoplasms

by Sook Min Hwang, Ji Eun Park, So-Young Yoo, Ji Hye Kim, Sun-Young Baek, Sung-Hoon Moon and Tae Yeon Jeon

Diagnostics 2023, 13(24), 3654; https://doi.org/10.3390/diagnostics13243654 - 13 Dec 2023

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Abstract

Purpose: To investigate the diffusion-weighted imaging (DWI) findings and apparent diffusion coefficient (ADC) value of the thymus in children under the age of 13 who have non-thymic neoplasms. Materials and Methods: From January 2021 to April 2023, a single-center retrospective study analyzed [...] Read more.

Purpose: To investigate the diffusion-weighted imaging (DWI) findings and apparent diffusion coefficient (ADC) value of the thymus in children under the age of 13 who have non-thymic neoplasms. Materials and Methods: From January 2021 to April 2023, a single-center retrospective study analyzed consecutive 191 thoracic MRI scans with DWI from 67 children (<13 years) with non-thymic neoplasms. The scans were categorized based on the presence of restricted diffusion on DWI. We analyzed the demographics, laboratory data, and MR findings of the thymus. Statistical differences were assessed using generalized estimating equations. Results: Forty-five percent (86/191) of the scans exhibited restricted diffusion in the thymus: multifocal (n = 65; 76%), focal (n = 19; 22%), and diffuse (n = 2; 2%) patterns. The restricted diffusion group demonstrated higher absolute lymphocyte counts, more prominent thymus sizes, and higher frequency of off-treatment status compared to the unrestricted diffusion group (p>0.05). The mean ADC value across all 191 scans was 1.80 × 10⁻³ mm²/s. No significant difference was observed in the ADC value related to restricted diffusion patterns, the MRI vendors, or the age at the time of the scan. Conclusions: Restricted diffusion was observed in 45% of the thymus in children with non-thymic neoplasms, with a mean ADC value of 1.80 × 10⁻³ mm²/s. Recognizing the DWI findings can prevent unnecessary invasive procedures, alleviating concerns for patients and families. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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13 pages, 2017 KiB

Open AccessArticle

Quantitative Study on the Breast Density and the Volume of the Mammary Gland According to the Patient’s Age and Breast Quadrant

by Sojin Shim, Jan Unkelbach, Anna Landsmann and Andreas Boss

Diagnostics 2023, 13(21), 3343; https://doi.org/10.3390/diagnostics13213343 - 30 Oct 2023

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Abstract

Objectives: Breast density is considered an independent risk factor for the development of breast cancer. This study aimed to quantitatively assess the percent breast density (PBD) and the mammary glands volume (MGV) according to the patient’s age and breast quadrant. We propose a [...] Read more.

Objectives: Breast density is considered an independent risk factor for the development of breast cancer. This study aimed to quantitatively assess the percent breast density (PBD) and the mammary glands volume (MGV) according to the patient’s age and breast quadrant. We propose a regression model to estimate PBD and MGV as a function of the patient’s age. Methods: The breast composition in 1027 spiral breast CT (BCT) datasets without soft tissue masses, calcifications, or implants from 517 women (57 ± 8 years) were segmented. The breast tissue volume (BTV), MGV, and PBD of the breasts were measured in the entire breast and each of the four quadrants. The three breast composition features were analyzed in the seven age groups, from 40 to 74 years in 5-year intervals. A logarithmic model was fitted to the BTV, and a multiplicative inverse model to the MGV and PBD as a function of age was established using a least-squares method. Results: The BTV increased from 545 ± 345 to 676 ± 412 cm³, and the MGV and PBD decreased from 111 ± 164 to 57 ± 43 cm³ and from 21 ± 21 to 11 ± 9%, respectively, from the youngest to the oldest group (p < 0.05). The average PBD over all ages were 14 ± 13%. The regression models could predict the BTV, MGV, and PBD based on the patient’s age with residual standard errors of 386 cm³, 67 cm³, and 13%, respectively. The reduction in MGV and PBD in each quadrant followed the ones in the entire breast. Conclusions: The PBD and MGV computed from BCT examinations provide important information for breast cancer risk assessment in women. The study quantified the breast mammary gland reduction and density decrease over the entire breast. It established mathematical models to estimate the breast composition features—BTV, MGV, and PBD, as a function of the patient’s age. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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18 pages, 4469 KiB

Open AccessArticle

Effect of Low Tube Voltage (100 kV) Combined with ASIR-V on the Visualization and Image Quality of the Adamkiewicz Artery: A Comparison with 120 kV Protocol

by Jiantao Deng, Ting Ma, Jing Yan, Siyi Wu, Gaowu Yan, Hongwei Li, Yong Li, Linwei Zhao, Xiaoping Fan, Morgan A. McClure and Anup Bhetuwal

Diagnostics 2023, 13(15), 2495; https://doi.org/10.3390/diagnostics13152495 - 27 Jul 2023

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Abstract

Objective: To evaluate the effect of low tube voltage (100 kV) combined with adaptive statistical iterative reconstruction-V (ASIR-V) on the visualization and image quality of the Adamkiewicz artery (AKA). Methods: One hundred patients were prospectively enrolled and randomly assigned into two groups (both [...] Read more.

Objective: To evaluate the effect of low tube voltage (100 kV) combined with adaptive statistical iterative reconstruction-V (ASIR-V) on the visualization and image quality of the Adamkiewicz artery (AKA). Methods: One hundred patients were prospectively enrolled and randomly assigned into two groups (both n = 50). Group A (100 kV) was reconstructed with filtered back projection (FBP) and ASIR-V from 10% to 100% with 10% intervals. Group B (120 kV) was only reconstructed with FBP. The objective image quality was evaluated by using CT values of the aorta (CT_Aorta), background noise, signal-to-noise ratio of the descending aorta (SNR_Aorta), and contrast-to-noise ratio of the spinal cord (CNR_{Spinal cord}). The subjective image quality and visualization scores of the AKA were assessed on a 5-point scale. Results: CT_Aorta was significantly higher in Group A than in Group B (p < 0.001). When ASIR-V weights were ≥60%, significant differences were found in the background noise, SNR_Aorta, and CNR_{Spinal cord} between the two groups (all p < 0.05). In Group A, compared with FBP, the subjective score gradually increased as ASIR-V increased to 80%, which decreased when ASIR-V exceeded 80%. The visualization scores of the AKA (≥60%) and the ability to detect vessel continuity (≥80%) gradually increased as the ASIR-V weights increased (p < 0.05). The effective radiation dose was reduced by about 40.36% in Group A compared to Group B. Conclusions: compared with conventional scanning protocol, using a combination of low tube voltage (100 kV) and 80% ASIR-V protocol could not only increase the visualization of the AKA, but also improve image quality and reduce the radiation doses. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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14 pages, 4840 KiB

Open AccessArticle

Deep Learning Convolutional Neural Network Reconstruction and Radial k-Space Acquisition MR Technique for Enhanced Detection of Retropatellar Cartilage Lesions of the Knee Joint

by Malwina Kaniewska, Eva Deininger-Czermak, Maelene Lohezic, Falko Ensle and Roman Guggenberger

Diagnostics 2023, 13(14), 2438; https://doi.org/10.3390/diagnostics13142438 - 21 Jul 2023

Cited by 3 | Viewed by 1069

Abstract

Objectives: To assess diagnostic performance of standard radial k-space (PROPELLER) MRI sequences and compare with accelerated acquisitions combined with a deep learning-based convolutional neural network (DL-CNN) reconstruction for evaluation of the knee joint. Methods: Thirty-five patients undergoing MR imaging of the knee at [...] Read more.

Objectives: To assess diagnostic performance of standard radial k-space (PROPELLER) MRI sequences and compare with accelerated acquisitions combined with a deep learning-based convolutional neural network (DL-CNN) reconstruction for evaluation of the knee joint. Methods: Thirty-five patients undergoing MR imaging of the knee at 1.5 T were prospectively included. Two readers evaluated image quality and diagnostic confidence of standard and DL-CNN accelerated PROPELLER MR sequences using a four-point Likert scale. Pathological findings of bone, cartilage, cruciate and collateral ligaments, menisci, and joint space were analyzed. Inter-reader agreement (IRA) for image quality and diagnostic confidence was assessed using intraclass coefficients (ICC). Cohen’s Kappa method was used for evaluation of IRA and consensus between sequences in assessing different structures. In addition, image quality was quantitatively evaluated by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements. Results: Mean acquisition time of standard vs. DL-CNN sequences was 10 min 3 s vs. 4 min 45 s. DL-CNN sequences showed significantly superior image quality and diagnostic confidence compared to standard MR sequences. There was moderate and good IRA for assessment of image quality in standard and DL-CNN sequences with ICC of 0.524 and 0.830, respectively. Pathological findings of the knee joint could be equally well detected in both sequences (κ-value of 0.8). Retropatellar cartilage could be significantly better assessed on DL-CNN sequences. SNR and CNR was significantly higher for DL-CNN sequences (both p < 0.05). Conclusions: In MR imaging of the knee, DL-CNN sequences showed significantly higher image quality and diagnostic confidence compared to standard PROPELLER sequences, while reducing acquisition time substantially. Both sequences perform comparably in the detection of knee-joint pathologies, while DL-CNN sequences are superior for evaluation of retropatellar cartilage lesions. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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Review

Jump to: Research, Other

11 pages, 273 KiB

Open AccessReview

Radio-Guided Lung Surgery: A Feasible Approach for a Cancer Precision Medicine

by Miriam Conte, Maria Silvia De Feo, Viviana Frantellizzi, Miriam Tomaciello, Francesco Marampon, Laura Evangelista, Luca Filippi and Giuseppe De Vincentis

Diagnostics 2023, 13(16), 2628; https://doi.org/10.3390/diagnostics13162628 - 09 Aug 2023

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Abstract

Background: Radio-guided surgery is a reliable approach used for localizing ground-glass opacities, lung nodules, and metastatic lymph nodes. Lung nodules, lymph node metastatic involvement, and ground-glass opacities often represent a challenge for surgical management and clinical work-up. Methods: PubMed research was conducted from [...] Read more.

Background: Radio-guided surgery is a reliable approach used for localizing ground-glass opacities, lung nodules, and metastatic lymph nodes. Lung nodules, lymph node metastatic involvement, and ground-glass opacities often represent a challenge for surgical management and clinical work-up. Methods: PubMed research was conducted from January 1997 to June 2023 using the keywords “radioguided surgery and lung cancer”. Results: Different studies were conducted with different tracers: technetium-99m-albumin macroaggregates, cyanoacrylate combined to technetium-99m-sulfur colloid, indium-111-pentetreotide, and fluorine-18-deoxyglucose. A study proposed naphthalocyanine radio-labeled with copper-64. Radio-guided surgery has been demonstrated to be a reliable approach in localizing a lesion, and has a low radiological burden for personnel exposure and low morbidity. The lack of necessity to conduct radio-guided surgery under fluoroscopy or echography makes this radio-guided surgery an easy way of performing precise surgical procedures. Conclusions: Radio-guided surgery is a feasible approach useful for the intraoperative localization of ground-glass opacities, lung nodules, and metastatic lymph nodes. It is a valid alternative to the existing approaches due to its low cost, associated low morbidity, the possibility to perform the procedure after several hours, the low radiation dose applied, and the small amount of time that is required to perform it. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

20 pages, 2846 KiB

Open AccessReview

Imaging of Tauopathies with PET Ligands: State of the Art and Future Outlook

by Miriam Conte, Maria Silvia De Feo, Marko Magdi Abdou Sidrak, Ferdinando Corica, Joana Gorica, Giorgia Maria Granese, Luca Filippi, Giuseppe De Vincentis and Viviana Frantellizzi

Diagnostics 2023, 13(10), 1682; https://doi.org/10.3390/diagnostics13101682 - 09 May 2023

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Abstract

(1) Background: Tauopathies are a group of diseases characterized by the deposition of abnormal tau protein. They are distinguished into 3R, 4R, and 3R/4R tauopathies and also include Alzheimer’s disease (AD) and chronic traumatic encephalopathy (CTE). Positron emission tomography (PET) imaging represents a [...] Read more.

(1) Background: Tauopathies are a group of diseases characterized by the deposition of abnormal tau protein. They are distinguished into 3R, 4R, and 3R/4R tauopathies and also include Alzheimer’s disease (AD) and chronic traumatic encephalopathy (CTE). Positron emission tomography (PET) imaging represents a pivotal instrument to guide clinicians. This systematic review aims to summarize the current and novel PET tracers. (2) Methods: Literature research was conducted on Pubmed, Scopus, Medline, Central, and the Web of Science using the query “pet ligands” and “tauopathies”. Articles published from January 2018 to 9 February, 2023, were searched. Only studies on the development of novel PET radiotracers for imaging in tauopathies or comparative studies between existing PET tracers were included. (3) Results: A total of 126 articles were found, as follows: 96 were identified from PubMed, 27 from Scopus, one on Central, two on Medline, and zero on the Web of Science. Twenty-four duplicated works were excluded, and 63 articles did not satisfy the inclusion criteria. The remaining 40 articles were included for quality assessment. (4) Conclusions: PET imaging represents a valid instrument capable of helping clinicians in diagnosis, but it is not always perfect in differential diagnosis, even if further investigations on humans for novel promising ligands are needed. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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Other

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15 pages, 821 KiB

Open AccessSystematic Review

Gender Determination Based on CBCT Maxillary Sinus Analysis: A Systematic Review

by Nikolas Christoloukas, Anastasia Mitsea, Aliki Rontogianni and Christos Angelopoulos

Diagnostics 2023, 13(23), 3536; https://doi.org/10.3390/diagnostics13233536 - 27 Nov 2023

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Abstract

Gender determination is an essential element for human identification in forensic medicine, to which the maxillary sinuses may contribute as they remain intact even after severe damage to the skull and other structures. Aim: To evaluate scientific evidence published over the last decade [...] Read more.

Gender determination is an essential element for human identification in forensic medicine, to which the maxillary sinuses may contribute as they remain intact even after severe damage to the skull and other structures. Aim: To evaluate scientific evidence published over the last decade to determine whether maxillary sinus dimensions and volume may constitute useful parameters for forensic identification and gender determination, based only on cone-beam computed tomography images (CBCT). Methods: This review adhered to the PRISMA statement’s criteria. Four databases were searched for articles published between January 2010 and April 2023. Results: Initially, 1719 records were identified. After screening, there were 2475 participants in the included studies. Of the fifteen articles selected, five reported data assessing only volumetric measurements of the maxillary sinus, seven reported data calculating only linear measurements and three reported data by combining findings of both linear and volumetric measurements of the maxillary sinus. Maxillary sinus volume was significantly higher in male participants. Maxillary sinus height was the best discriminating parameter for forensic identification with an overall accuracy ranging from 70% to 80%. Conclusions: Maxillary sinus measurements revealed anatomic variability between genders, and this approach can be applied as a complementary method for human identification. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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8 pages, 2217 KiB

Open AccessCase Report

Acute Coronary Syndrome with Non-Obstructive Plaque on Angiography and Features of Vulnerable Plaque on Intracoronary Optical Coherence Tomography

by Clarissa Campo Dall’Orto, Rubens Pierry Ferreira Lopes, Lara Vilela Eurípedes, Gilvan Vilella Pinto Filho and Marcos Raphael da Silva

Diagnostics 2023, 13(19), 3118; https://doi.org/10.3390/diagnostics13193118 - 03 Oct 2023

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Abstract

Optical coherence tomography (OCT) has a high spatial resolution and is useful in identifying coronary lesions with high-risk features (vulnerable plaques). These plaques are strongly associated with acute coronary syndrome (ACS). In this report, we present the case of a 43-year-old male patient [...] Read more.

Optical coherence tomography (OCT) has a high spatial resolution and is useful in identifying coronary lesions with high-risk features (vulnerable plaques). These plaques are strongly associated with acute coronary syndrome (ACS). In this report, we present the case of a 43-year-old male patient presenting with typical chest pain that began three hours prior to admission. The patient exhibited an elevation of the ST segments of the anterior and lateral walls. Invasive stratification revealed a 40% lesion in the middle segment of the left anterior descending (LAD) artery. The patient was given optimized clinical treatment as he had a nonobstructive lesion in the LAD at the time of angiography. During the treatment, the patient continued to complain of angina on exertion. A follow-up coronary angiography, along with OCT analysis of the middle-to-moderate lesion in the LAD, revealed a plaque predominantly rich in lipids with signs of vulnerability. A percutaneous coronary intervention was performed. The patient’s recovery was uneventful, and he was discharged the day after the procedure. This case illustrates the evolution of intravascular imaging, particularly OCT, in the detection of vulnerable plaques. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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4 pages, 1004 KiB

Open AccessInteresting Images

High-Grade Surface Osteosarcoma of the Rib Mimicking a Neurogenic Tumor: Radiologic and Pathologic Findings

by Kyungsoo Bae, Jin Il Moon, Hyo Jung An, Jae Jun Jung and Kyung Nyeo Jeon

Diagnostics 2023, 13(18), 2880; https://doi.org/10.3390/diagnostics13182880 - 08 Sep 2023

Viewed by 853

Abstract

Osteosarcoma commonly occurs in the intramedullary cavity of long bones such as the femur, tibia, and humerus in children and adolescents. Osteosarcoma occurring as a primary tumor in the chest wall is rare. Only a limited number of such cases have been documented [...] Read more.

Osteosarcoma commonly occurs in the intramedullary cavity of long bones such as the femur, tibia, and humerus in children and adolescents. Osteosarcoma occurring as a primary tumor in the chest wall is rare. Only a limited number of such cases have been documented in the existing literature. Herein, we present radiologic and pathologic findings of a high-grade surface osteosarcoma of the rib mimicking a neurogenic tumor in a 44-year-old woman. Full article

(This article belongs to the Special Issue What's New in Diagnostic Radiological Imaging?)

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13 pages, 1729 KiB

Open AccessSystematic Review

Head-to-Head Comparison between FDG and ¹¹C-Methionine in Multiple Myeloma: A Systematic Review

by Luca Filippi, Viviana Frantellizzi, Paola Bartoletti, Giuseppe De Vincentis, Orazio Schillaci and Laura Evangelista

Diagnostics 2023, 13(12), 2009; https://doi.org/10.3390/diagnostics13122009 - 09 Jun 2023

Cited by 1 | Viewed by 972

Abstract

The aim of this systematic review is to provide a comprehensive overview of the existing literature, comparing ¹⁸F-fluorodeoxyglucose (FDG) and ¹¹C-methionine (MET) for the imaging of multiple myeloma (MM) with positron emission computed tomography (PET/CT). Relevant studies published from 2013 up [...] Read more.

The aim of this systematic review is to provide a comprehensive overview of the existing literature, comparing ¹⁸F-fluorodeoxyglucose (FDG) and ¹¹C-methionine (MET) for the imaging of multiple myeloma (MM) with positron emission computed tomography (PET/CT). Relevant studies published from 2013 up to March 2023 were selected by searching Scopus, PubMed, and Web of Science. Selected imaging studies were analyzed using a modified version of the critical Appraisal Skills Programme (CASP). Ten studies encompassing 335 patients were selected. On a patient-based analysis, MET sensitivity ranged between 75.6% and 100%, resulting higher than that measured for FDG (0–100%). MET outperformed FDG for the detection of focal lesions, diffuse bone marrow involvement and mixed patterns. PET-derived parameters resulted higher for MET than for FDG, with a strong correlation with clinical variables (e.g., monoclonal component and beta-2-microglobulin levels, bone marrow infiltration, etc.), although FDG maintained a prognostic impact on outcome prediction. When compared to other tracers or imaging modalities, MET showed stronger correlation and inter-observer agreement than FDG. Although biased by the small cohorts and requiring confirmation through multicenter studies, preliminary findings suggest that MET–PET should be preferred to FDG for PET imaging of MM, or alternatively used as a complementary imaging modality. Some issues, such as tracer availability and the role of MET with respect to other emerging tracers (i.e., ⁶⁸Ga-pentixafor, ¹⁸F-FACBC and ¹⁸F-FET), should be the topic of further investigations. Full article

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