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Purpose: To evaluate the diagnostic potential of radiomic analyses based on machine learning that rely on contrast-enhanced computerized tomography (CT) for categorizing ovarian sex cord-stromal tumors (SCSTs) and epithelial ovarian cancers (EOCs). Methods: We included a total of 225 patients with 230 tumors, who were randomly divided into training and test cohorts with a ratio of 8:2. Radiomic features were extracted from each tumor and dimensionally reduced using LASSO. We used univariate and multivariate analyses to identify independent predictors from clinical features and conventional CT parameters. Clinic-radiological model, radiomics model and mixed model were constructed respectively. We evaluated model performance via analysis of the receiver operating characteristic (ROC) curve and area under ROC curves (AUCs), and compared it across models using the Delong test. Results: We selected a support vector machine as the best classifier. Both radiomic and mixed model achieved good classification accuracy with AUC values of 0.923/0.930 in the training cohort, and 0.879/0.909 in the test cohort. The mixed model performed significantly better than the model based on clinical radiological information, with AUC values of 0.930 versus 0.826 (p = 0.000) in the training cohort and 0.905 versus 0.788 (p = 0.042) in the test cohort. Conclusion: Radiomic analysis based on CT images is a reliable and noninvasive tool for identifying SCSTs and EOCs, outperforming experience radiologists. [ABSTRACT FROM AUTHOR]

Urolithiasis is a leading urological disorder where accurate preoperative identification of stone types is critical for effective treatment. Deep learning has shown promise in classifying urolithiasis from CT images, yet faces challenges with model size and computational efficiency in real clinical settings. To address these challenges, we developed a non-invasive prediction approach for determining urinary stone types based on CT images. Through the refinement and improvement of the self-distillation architecture, coupled with the incorporation of feature fusion and the Coordinate Attention Module (CAM), we facilitated a more effective and thorough knowledge transfer. This method circumvents the extra computational expenses and performance reduction linked with model compression and removes the reliance on external teacher models, markedly enhancing the efficacy of lightweight models. achieved a classification accuracy of 74.96% on a proprietary dataset, outperforming current techniques. Furthermore, our method demonstrated superior performance and generalizability on two public datasets. This not only validates the effectiveness of our approach in classifying urinary stones but also showcases its potential in other medical image processing tasks. These results further reinforce the feasibility of our model for actual clinical deployment, potentially assisting healthcare professionals in devising more precise treatment plans and reducing patient discomfort. [ABSTRACT FROM AUTHOR]

Objective·To summarize the clinical features, imaging features, and diagnosis and treatment experience of primary mediastinal yolk sac tumor (YST). Methods·Data of 29 patients with primary mediastinal YST, who attended Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine from September 2016 to May 2023, were collected and comprehensively analyzed, including imaging examination results, serum indicators, pathology reports and treatment methods. Results·There were 22 cases of pure YST and 7 cases of mixed YST comprising 28 males and 1 female. The mean age of onset was (24.5±5.9) years. The initial symptoms were chest tightness (34.5%), chest pain (27.8%), cough (34.5%), expectoration (34.5%) and no specific symptoms (24.1%). Chest computerized tomography (CT) enhancement showed that all the 29 lesions were located in the anterior mediastinum. The maximum diameter of the lesions ranged from 5.6 cm to 18.2 cm. The lesions were irregular in shape, uneven in density, partially cystic and solid in density. The enhancement scan showed the solid part was slightly and moderately enhanced, and the low-density area was not enhanced. Tumor boundary was not clear because tumors often compressed and invaded surrounding tissues. Among the 29 newly diagnosed patients, serum alpha-fetoprotein (AFP) was significantly increased in 28 cases (1 case was not tested). Patients received multidisciplinary comprehensive treatment, including chemotherapy (25/29), surgery (26/29), and radiotherapy (8/29). Seven patients directly received surgery after diagnosis. Nineteen patients received chemotherapy first and then surgery; 16 (84.2%) cases were evaluated as lesion shrinkage after chemotherapy. After surgery, 73.1% (19/26) patients had a significant decrease in serum AFP. After chemotherapy, 56.0% (14/25) patients had decreased serum AFP. Conclusion·Primary mediastinal YST usually occurs in middle-aged and young men, with certain clinical and radiographic features and elevated serum AFP, which requires multidisciplinary comprehensive treatment. [ABSTRACT FROM AUTHOR]

Introduction: We describe a first case of human congenital crico-thyroid dysplasia associated to a right sided aortic arch and an aberrant subclavian artery. Case presentation: Our patient presented with a two-weeks history of acute dyspnea, and reported hoarseness since his childhood. An urgent tracheotomy was performed, followed by direct laryngoscopy. Endoscopic examination showed a deviation of the dorsoventral axis of the larynx, with an obstructive submucosal swelling the area of the right false cord and aryepiglottic fold. Computed tomography conducted the following day confirmed the crico-thyroid dysplasia, an infected laryngocele, and the presence of a right sided aortic arch and an aberrant subclavian artery. Conclusion: The embryological basis of these anomalies is attributed to congenital defects of the development of the fourth and sixth pharyngeal arches. To our knowledge, the congenital crico-thyroid dysplasia has not been previously reported in human. This case underscores the importance of recognizing anatomical variations in laryngeal cartilages, understanding their embryological origins, and potential associated malformations. [ABSTRACT FROM AUTHOR]

This study aims to establish the local diagnostic reference levels for adult Chest-Abdomen-Pelvis (CAP)CT examination in a Moroccan hospital. DRLs were retrieved for the first time for CAP examination and were size-dependent. Data from 234 patients were collected retrospectively from one scanner for three months. CTDIvol, DLP and calculated SSDE were analyzed with IBM SPSS Statistics version 21. The proposed LDRLs in terms of CTDIvol, DLP and SSDE, the registered medians were 12.9 mGy, 849.3 mGy.cm and 18.16 mGy, respectively. Third quartile values were 15.65 mGy, 1014 mGy.cm and 20.75 mGy, respectively. The derived values were close to regional and international studies, with the exception of higher DLP quantity A comparison of CTDIvol and SSDE LDRLs has underlined the superiority of the SSDE. This result reflects from one side the morphologic nature of our small studied samplel. On the other side, the SSDE is correct for the misconception of the received dose, especially for lsimilar types of patients. The practice of the CAP CT examination has been studied and LDRLs related to DLP quantity revealed the necessity of application of radiation protection measures toward the length of scanned regions. On the other hand, LDRLs related to SSDE show an update of the received dose, higher than usually pretended using only CT outputs. Both results will lead practitioners to review the acquisition parameters and length of scanned regions and consider the patient’s morphology to reduce the dose received while keeping an interpretable exam. [ABSTRACT FROM AUTHOR]

Aim: Subepithelial lesions (SEL) of the gastrointestinal tract are lesions arising from the mucosa, submucosa or muscularis propria. This study is aimed to asses diagnostic characteristics of SELs on computerized tomography (CT) and to present the localization, size, CT attenuation and contrast enhancement patterns of the lesions that may aid in making correct diagnosis. Materials and Methods: Between December 2022 and March 2024, patients with a preliminary diagnosis of SEL on endoscopy or EUS and who underwent abdominal CT were retrospectively screened from the hospital database. Localization, size, pre-contrast and post-contrast Hounsfield Unit (HU) values of the lesions, and pathologic diagnoses were recorded and compared in patients with SEL. Results: Pathologic diagnosis was available in 25 (23.4%) patients with SEL detected on CT. Among these, the most common lesion was gastrointestinal stromal tumors (GIST, 52%). In 22 (20.6%) patients, the lesion was not detected on CT. The lesions that could not be seen on CT were less than 2 cm in size. Gastrointestinal distension was insufficient in the majority of patients in whom the lesion could not be visualized on CT. While the HU values increased by approximately 3 times in patients diagnosed with neuroendocrine tumors (median [interquartile ranges] 36.5 [32 - 40] vs. 101.5 [81.5 - 127.5]; p = 0.068), the increase was approximately 2 times in those with GIST (30 [29 - 38] vs. 70 [57 - 77]; p=0.003). Conclusion: This study presents several CT characteristics and pitfalls that may aid correct diagnosis of SELs with CT. SELs smaller than 2 cm in size and located in cardia are more likely to be missed with CT. Adequate gastric distention is crucial in correct diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Computerized tomography is an essential element of the early diagnostic stages of trauma care for hemodynamically stable patients. However, there are inherent challenges and risks associated with the intra-hospital transport of critically injured trauma patients to the radiology suite and during the scanning process itself. We examined the frequency and nature of adverse events during computerized tomography among critically injured patients. Methods: This is a retrospective cohort study of adverse event in critically injured adult (>18 years old) trauma patients who underwent emergent computerized tomographic scan following evaluation in the trauma bay over a 22-month period who were either admitted to the intensive care unit or the operating room post computerized tomography. Data was abstracted from the hospital's trauma registry and chart review of electronic medical records. The frequency of adverse events during computerized tomography and the associated patient transport phases was recorded. Multivariable logistic regression was performed to assess the impact of adverse event on 7-day in-hospital mortality. Results: Of the 526 critically injured trauma patients who underwent computerized tomographic scan during the study period, 17.3% (91/526) experienced one or more adverse event. The most common adverse events were hypotension n = 50 (9.5%), hypertension n = 18 (3.4%), initiation of vasopressors n = 11 (2.1%) and vomiting n = 8 (1.5%). One patient required re-intubation following endotracheal tube dislodgement and one patient required intubation following hypoxia post-sedation for agitation. Patient factors independently associated with adverse event were mechanical ventilation and blood product administration. When adjusted for injury severity score and age, patients who experienced adverse event were at increased odds of death (odds ratio: 2.2, 95% confidence interval: 1.11–4.36) compared to those who did not experience adverse event. Conclusion: Adverse events occur frequently in critically injured patients undergoing emergent trauma computerized tomography and may significantly impact clinical outcomes. This study provides important information to guide system and process-level improvements including optimized designs of the built environment and safety-informed protocols for high-risk patients undergoing emergent trauma computerized tomography. [ABSTRACT FROM AUTHOR]

Objective. Modern medical imaging plays a vital role in clinical practice, enabling non-invasive visualization of anatomical structures. Dynamic contrast enhancement (DCE) imaging is a technique that uses contrast agents to visualize blood flow dynamics in a time-resolved manner. It can be applied to different modalities, such as computed tomography (CT) and electrical impedance tomography (EIT). This study aims to develop a common theoretical and practical hemodynamic extraction basis for DCE modelling across modalities, based on the gamma-variate function. Approach. The study introduces a framework to generate time-intensity curves for multiple DCE imaging modalities from user-defined hemodynamic parameters. Thus, extensive datasets were simulated for both DCE-CT and EIT, representing different hemodynamic scenarios. Additionally, gamma-variate extensions to account for several physiological effects were detailed in a modality-agnostic manner, and three corresponding fitting strategies, namely nonlinear, linear, and a novel hybrid approach, were implemented and compared on the basis of accuracy of parameter estimation, first pass reconstruction, speed of computation, and failure rate. Main results. As a result, we found the linear method to be the most modality-dependent, exhibiting the greatest bias, variance and failure rates, although remaining the fastest alternative. The hybrid method at least matches the state-of-the-art nonlinear method's accuracy, while improving its robustness and speed by 10 times. Significance. Our research suggests that the hybrid method may bring noteworthy accuracy and efficiency improvements in handling the high-dimensionality of DCE imaging in general, being a step towards real-time processing. Moreover, our generative model presents a potential asset to produce benchmarking and data augmentation datasets across modalities. [ABSTRACT FROM AUTHOR]

Purpose: To identify a radiological map of laryngeal subsites whose involvement by the tumor could predict patients' functional outcomes after open partial horizontal laryngectomy (OPHL). Methods: The present retrospective analysis concerned 96 patients with glottic squamous cell carcinoma, who were radiologically staged with contrast-enhanced neck CT scans before undergoing supracricoid or supratracheal laryngectomy. A radiological map of patients' functional risk was developed by considering the distribution of functional outcomes in relation to the laryngeal subsites involved. The functional outcomes considered were: (i) decannulation at discharge; (ii) time to removal of the nasogastric feeding tube (NFT); (iii) postoperative complication rate; and (iv) length of hospital stay. Results: Involvement of the anterior supraglottis was related to a longer need for NFT, and a longer hospital stay (p = 0.003, and p = 0.003, respectively). Involvement of the posterior glottis negatively affected the time to decannulation, and the likelihood of postoperative complications (p = 0.000, and p = 0.002, respectively). Conclusions: Anterior glottic small tumors (without significant subglottic and/or supraglottic extension) are related to the best functional outcomes after OPHL, since the suprahyoid epiglottis and both the arytenoids are likely to be spared. [ABSTRACT FROM AUTHOR]

Objectives: Coronary artery calcification (CorCa) identifies high cardiovascular risk in the general population. In this setting, aortic valve calcification (AoCa) showed contradictory results. Our goal has been to assess the prognostic power of CorCa and AoCa in patients with chest pain who underwent an ECG-gated cardiac multidetector CT (cardiac-MDCT). Methods: A total of 528 patients without previous known coronary artery disease, with chest pain who underwent a cardiac-MDCT multidetector, were retrospectively recruited. The primary endpoint included death, acute coronary syndrome, stroke, and heart failure. Results: A total of 61 patients (11.6%) had an event during a mean follow-up of almost 6 years (5.95 ± 2.98). The most frequent event was acute coronary syndrome (6.4%). Total mortality was 4.5%. Patients with CorCa > 0 had more events than those without CorCa (17.3% versus 4.3%; p < 0.001). Likewise, when only patients without AoCa were considered (n = 118), clinical events were more frequent in those with CorCa (12.7% versus 3.6%; p = 0.004). After excluding patients with coronary artery disease, events were more frequent in those with CorCa (12.6% versus 4.3%; p = 0.004). The higher the Agatston score, the more frequent the events. Patients with AoCa > 0 had more events than those without (16.5% versus 7.3%; p < 0.001), but in patients without CorCa, no difference in events was seen (6.2% versus 3.6%; p = 0.471). A Cox regression analysis showed age, smoking, prior stroke, and CorCa but not AoCa to be independently related to events. Conclusions: In summary, CorCa, but not AoCa, is related to cardiovascular events in patients with chest pain who undergo a cardiac-MDCT. Clinical relevance statement: We show that coronary artery calcification, but not aortic valve calcification, detected in a coronary CT scan is tightly related to cardiovascular events. Although this is a message already shown by other groups in the general population, we do believe that this work is unique because it is restricted to patients with chest pain sent to coronary CT. In other words, our work deals with what we face in our routine everyday practice. Key Points: • The presence and the amount of coronary artery calcification are associated with cardiovascular events in patients with chest pain. • Aortic valve calcification is not associated with cardiovascular events in patients with chest pain. [ABSTRACT FROM AUTHOR]

This systematic review, conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, aims to comprehensively assess the current state of the art of imaging modalities for the evaluation of peritoneal carcinomatosis arising from malignant gynecological origins, with a focus on ovarian and endometrial cancers. A systematic search of relevant databases was performed, adhering to predetermined inclusion and exclusion criteria. Studies reporting the use of computed tomography (CT), magnetic resonance imaging (MRI), fluorodeoxyglucose (FDG) positron emission tomography (PET), PET/CT, and PET/MRI in the assessment of peritoneal carcinomatosis from gynecological malignancies were included. The review encompasses an overview of selected studies, highlighting the strengths and limitations of each imaging modality in diagnosing and characterizing peritoneal carcinomatosis. Overall, a wide variability in the reported accuracy of different imaging techniques emerges from literature, mainly due to the type of the study, technical issues, and patient characteristics. Although a meta-analysis could not be performed due to a scarcity of data, this systematic review provides valuable insights into the several imaging approaches used in peritoneal carcinomatosis of gynecological origin. The findings aim to inform clinical decision making and guide future research endeavors in this critical aspect of gynecological oncology. [ABSTRACT FROM AUTHOR]

Acquired subglottal stenosis is an unpredicted complication that can occur in some patients who have undergone prolonged endotracheal intubation. It is a narrowing of the airway at the level of the cricoid cartilage that can restrict airflow and cause breathing difficulty. Stenosis is typically treated with endoscopic airway dilation, with some patients experiencing multiple recurrences. The study highlights the potential of computational fluid dynamics as a noninvasive method for monitoring subglottic stenosis, which can aid in early diagnosis and surgical planning. An anatomically accurate human laryngeal airway model was constructed from computerized tomography (CT) scans. The subglottis cross-sectional area was narrowed systematically using ≈10% decrements. A quadratic profile was used to interpolate the transformation of the airway geometry from its modified shape to the baseline geometry. The numerical results were validated by static pressure measurements conducted in a physical model. The results show that airway resistance follows a squared ratio that is inversely proportional to the size of the subglottal opening (R ∝ A-2). The study found that critical constriction occurs in the subglottal region at 70% stenosis (upper end of grade 2). Moreover, removing airway tissue below 40% stenosis during surgical intervention does not significantly decrease airway resistance. [ABSTRACT FROM AUTHOR]

Purpose: Pilon fractures are often complex injuries involving severe soft tissue injury. Studies have shown pilon fractures may entrap soft tissue structures between fracture fragments. Staged fixation of pilon fractures with spanning external fixation (SEF) is important for soft tissue rest and plays an important role in the management of these injuries. While SEF has been shown to promote soft tissue rest prior to definitive fixation, no studies have shown the effect SEF has on entrapped structures (ES). The purpose of this study was to evaluate how SEF effects ES in pilon fractures. Methods: A retrospective review of 212 pilon fractures treated at our institution between 2010 and 2022 was performed. Patients with a CT scan pre-SEF and post-SEF met inclusion criteria. CTs were reviewed to characterize ES in pre- and post-SEF imaging. Results: Of the 19 patients with ES identified on CT pre-SEF, seven (36.8%) had full release of ES post-SEF and 12 (63.2%) had no release of ES. The posterior tibial tendon was the most commonly ES and remained entrapped in 62.5% of cases. Only 25% of 43-C3 fractures had release of ES post-SEF, while 100% of 43-C1 and 43-C2 fractures demonstrated complete release of ES post-SEF. Conclusion: Entrapped structures in pilon fractures are likely to remain entrapped post-SEF, with only one-third of our cohort demonstrating release. In 43-C3 patterns, if ES are identified on CT pre-SEF, surgeons should consider addressing these either through mini open versus open approaches at the time of SEF as they are likely to remain entrapped post-SEF. [ABSTRACT FROM AUTHOR]

Radiomics allows the extraction of quantitative imaging features from clinical magnetic resonance imaging (MRI) and computerized tomography (CT) studies. The advantages of radiomics have primarily been exploited in oncological applications, including better characterization and staging of oncological lesions and prediction of patient outcomes and treatment response. The potential introduction of radiomics in the clinical setting requires the establishment of a standardized radiomics pipeline and a quality assurance program. Radiomics and texture analysis of the liver have improved the differentiation of hypervascular lesions such as adenomas, focal nodular hyperplasia, and hepatocellular carcinoma (HCC) during the arterial phase, and in the pretreatment determination of HCC prognostic factors (e.g., tumor grade, microvascular invasion, Ki-67 proliferation index). Radiomics of pancreatic CT and MR images has enhanced pancreatic ductal adenocarcinoma detection and its differentiation from pancreatic neuroendocrine tumors, mass-forming chronic pancreatitis, or autoimmune pancreatitis. Radiomics can further help to better characterize incidental pancreatic cystic lesions, accurately discriminating benign from malignant intrapancreatic mucinous neoplasms. Nonetheless, despite their encouraging results and exciting potential, these tools have yet to be implemented in the clinical setting. This non-systematic review will describe the essential steps in the implementation of the radiomics and feature extraction workflow from liver and pancreas CT and MRI studies for their potential clinical application. A succinct overview of reported radiomics applications in the liver and pancreas and the challenges and limitations of their implementation in the clinical setting is also discussed, concluding with a brief exploration of the future perspectives of radiomics in the gastroenterology field. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis is the acute inflammation of the appendix vermiformis and is one of the leading emergency intra-abdominal surgeries. In the study; To investigate the effectiveness of preoperative USG and CT in the diagnosis of acute appendicitis. Materials and Methods: The records of 332 patients who underwent appendectomy between March 2018 and March 2023 were retrospectively examined. G ender, age, USG and CT r eports and pathology results of the patients were recorded. Sensitivity, specificity, positive predictive value and negative predictive values of USG and CT in the diagnosis of acute appendicitis were calculated separately. Results: The pathology result was reported as acute appendicitis in 312 of the patients, and was evaluated as normal in 20 of them. The pathology result of 254 of 261 patients, whose CT results were evaluated as compatible with acute appendicitis, was reported as acute appendicitis. In 7 patients, it was found to be normal appendicitis. Of 28 patients whose CT results were incompatible with acute appendicitis, the pathology result was positive i n 18 and negative in 10. Pathology results of 96 patients w hose USG results were compatible with acute appendicitis; Acute appendicitis was found in 90 patients and normal appendix in 6 patients. Pathology results of 41 patients whose USG results were evaluated as negative; It was reported to be compatible with acute appendicitis in 36 cases and normal in 5 cases. Conclusions: In our study, both the sensitivity and specificity of CT were found to be superior to USG, consistent with the literature. Researching IT effectiveness; We think that prospective studies comparing teleradiology reports and the reports of radiologists working in hospitals would be useful. [ABSTRACT FROM AUTHOR]

Computed tomography (CT) guided percutaneous biopsy is well established technique used to provide tissue from the thoracic lesions, both in lung parenchyma and mediastinum. However, ultrasound (US) guided biopsy of peripheral thoracic lesions should not be underestimated because it has the advantage of real time control and the absence of radiation exposure. In this retrospective study, which included 77 patients (59 men and 18 women) with peripheral lung lesions, we compared US and CT-guided biopsies analyzing the duration of the procedure, diagnostic accuracy, and complication rates, and we tried to determine correlation with needle diameter and lesion size. Both techniques have successfully provided samples for histology diagnosis (95.65% with US and 90.32% with CT). There is a significantly higher rate of all complications, and especially major complications in CT-guided biopsies--22.58% versus 2.17% (p = 0.001). CT-guided procedure lasts significantly longer than US-guided procedure (42.48 ± 5.12 compared to 16.80 ± 3.42 minutes). There is also a significant negative correlation between lesion size and duration of the procedure in CT-guided biopsy: the smaller the lesion, the longer the duration of the procedure. Although both techniques are very reliable and almost equally successful in obtaining samples for histopathology analysis, because of a higher rate of major complications and a longer duration of the procedure with CT guidance, ultrasound-guided biopsy should always be considered as the primary approach for peripheral lung lesions. [ABSTRACT FROM AUTHOR]

Limited type A aortic dissection (LTAAD) is a rare subtype of dissection that is confined within a well-defined border of the ascending aorta. These dissections may occur in the remaining native portion of the aortic root following aortic root replacement and can be complicated by malperfusion syndrome—a syndrome where dissections compromise the aortic branches and lead to end-organ ischemia. Because LTAAD is confined within the ascending aorta, malperfusion syndrome may preferentially affect the coronary arteries resulting in coronary malperfusion, myocardial infarction, and increased mortality. We report a case of LTAAD and malperfusion syndrome of the left main coronary artery which resulted in inadequate contrast opacification of the aorta and failure of the dissection protocol to trigger on computed tomography (CT). Upon further evaluation of the situation, the radiologist oversaw the manual triggering of CT acquisitions which yielded an actionable CT at 6 minutes post-contrast and real-time visualization of the patient's developing cardiac ischemia. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the relations between anatomical structures that are susceptible to inadvertent injuries during the surgery using preoperative computed tomography (CT) scans. 153 CT scans were reviewed and the distance from the lamina papyracea (LP) to the midline and the distance of the anterior ethmoidal artery (AEA) to the skull base were measured bilaterally. Also, the depth of olfactory fossa was measured and categorized using the Keros classification. The measurements were analyzed to determine whether LP-to-midline distance was correlated with the distance between the AEA and the skull base and Keros classification. Additionally, correlation of Keros classification with the distance from the AEA to the skull base was investigated. In a total of 306 measurements, 26 (%8.49) were classified as Keros type I, 200 (65.35%) as Keros type II and 80 (25.14%) as Keros type III. Statistically, LP-to-midline distances on the right and left sides were significantly associated with the distance from the AEA to the skull base on the same side (R:p < 0.001, L:p = 0.01) and the Keros classification on the same side (R:p < 0.001, L:p = 0.004). Also, a significant association was found between the Keros classification and the distance from the AEA to the skull base (R:p < 0.001, L:p = 0.02). The locations of anatomical structures are defined in relation to each other during the development of maxillofacial bones. CT scans should be examined and anatomical structures and relations among them reviewed very carefully before ESS. Otherwise, some accidental injuries may arise during the surgery while trying to avoid complications. [ABSTRACT FROM AUTHOR]

Chronic subdural haematoma is a common neurological condition especially among the elderly population. Its presentation can be unspecific but often attributed to pressure, cortical irritation, and/or vascular compromise. In the patients' cohort presented below, we have a series of cases where clinical history and examination did not result in an initial clinical diagnosis or suspicion of chronic subdural haematoma, with the diagnosis made only after brain imaging. We reviewed the literature regarding the aetiopathogenesis and clinical features of our patient cohort, which included a young woman with isolated right ptosis and pupillary dilatation, an elderly man with paraplegia, another elderly man with isolated right foot drop, and a young military man with no history of trauma. Our series re-emphasizes the sometimes non-specific and varied clinical presentation of chronic subdural haematoma. We reiterate the need for early brain imaging in patients who present with neurological disorder. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective observational study. Objective. The purpose of this study was to establish a CT classification system of anterolateral spinal ossification and analyze the effects of sagittal spinal parameters on ossification. Summary of Background Data. Patients with diffuse idiopathic skeletal hyperostosis often present with anterolateral ossification of the spine. Few reports consider anterolateral spinal ossification at each spinal level or explore the influence of sagittal alignment. Materials and Method. One hundred and twenty patients (79 males and 41 females) over 60 years old who underwent whole spinal CT scans from October 2018 to November 2021 were analyzed. Volume rendering technique images were used to assess the degree of anterolateral spinal ossification in each intervertebral space, and a classification system was established. Sagittal parameters, such as thoracic kyphosis, lumbar lordosis (LL), cervical lordosis, sacral slope, and thoracolumbar junction angle of the patients were measured. Multifactor stepwise linear regression analysis and ordered logistic regression analysis were used to study the effects of the sagittal parameters on ossification grades. Results. The median age of the study population was 67 years (63-72 IQR). The new classification system classifies the severity of anterolateral spinal ossification in each intervertebral space into grades 0 to 3 with an intra-observer intraclass correlation coefficient value of 0.909 and inter-observer intraclass correlation coefficient value of 0.900. Multivariate stepwise linear regression analysis showed that age (OR= 1.30, P<0.001), weight (OR= 1.23, P=0.013), and cervical lordosis (OR =1.19, P< 0.001) were significantly correlated with total ossification grade. Multifactor ordered logistic regression analysis showed that there was a statistically significant correlation between cervical lordosis and the ossification grades of each intervertebral space of T1~T4 (P=0.005), between thoracic kyphosis and each intervertebral space in T4~T12 (P= 0.019), and between thoracolumbar junction angle and each intervertebral space in T10~L3 (P= 0.025). LL was significantly and positively correlated with the ossification grades of each intervertebral space in T7~T11 (P=0.041). LL and sacral slope were significantly negatively correlated with the ossification grades of each intervertebral space in L3~S1 (P=0.047). Conclusion. Our new classification scheme demonstrated good accuracy and reliability for the evaluation of the severity of anterolateral spinal ossification. The effect of sagittal parameters on anterolateral spinal ossification was position-specific. The greater the kyphosis or the smaller the lordosis of a spinal region, the more severe the degree of ossification in the corresponding region. [ABSTRACT FROM AUTHOR]

Background and purpose: Several studies in the literature have attempted to subjectively assess the degree of visualization of different neurovascular structures using different contrast agents and concentrations. Given the recent contrast shortages, we aim to objectively compare the radiopacity achieved with four angiographic contrast agents used in clinical practice. Methods: Isovue 370, Visipaque 320, Omnipaque 300, and Isovue 300 were each drawn up at 25%, 50%, 75%, and 100% concentrations and compared against normal saline and air syringes. CT scans were obtained, and regions of interest were analyzed for radiopacity using Hounsfield unit (HU) measurements. An aneurysm model with different contrast concentrations was also scanned and dimensions compared. Two‐tailed t‐tests and Cohen's d coefficients were applied to assess for differences in mean HU measurements. Results: Isovue 370 and Isovue 300 had the highest and lowest mean HU, respectively (p <.001). Visipaque 320 at 25% concentration had the lowest mean HU at −.76. Statistically similar agents (p <.05) were Visipaque 320 and Omnipaque 300 at a 100% concentration (p =.30), and Omnipaque 300 and Isovue 300 at a 25% concentration (p =.73). Aneurysm dimensions among Isovue 370, Visipaque 320, and Omnipaque 300 were all similar, whereas with Isovue 300, the dimensions were significantly smaller (p <.05). Conclusion: Isovue 370 provides the highest HU radiopacity and the most accurate aneurysm measurements. Angiographic measurements obtained with Isovue 300 may underestimate the actual aneurysmal dimensions. Visipaque 320 and Omnipaque 300 at 100% concentration have similar mean HUs and are beneficial for patients with chronic kidney or cardiac disease. [ABSTRACT FROM AUTHOR]

Background: To explore computerized tomography (CT) imaging features of pulmonary fungal infection (PFI) in patients with acute leukemia (AL) after chemotherapy. Materials and Methods: Totally 116 AL patients who received chemotherapy in our hospital from June 2016 to April 2023 participated into this study, and the pulmonary fungal infection was confirmed by laboratory examination and clinical antifungal treatment. The CT image signs, lesion distribution, CT concomitant signs and main types of fungal infection were analyzed. Results: CT image signs of two main types, nodule/mass type and mixed type were recorded, with76 cases of nodular/mass type and 40 cases of mixed type. There were 372 lesions in nodules/mass cases, mainly in the upper lung (46.24%). In these 372 lesions, 113 micro-tubercle, 138 small nodules, 115 nodules and 6 masses were included. There were 88 cases of halo sign, 26 cases of cavity, and 25 cases of air crescent sign. Candida albicans was the most common pathogenic fungal strain, followed by aspergillus, candida tropicalis, candida glabrata, candida parapsilosis, cryptococcus, candida dubliniensis, mucor, candida krusei and candida rugosa. Conclusion: The CT manifestations of AL complicated with pulmonary fungal infection after chemotherapy were various, most of which had no characteristics, but the "halo sign" and "air crescent sign" had certain specificity. The combined CT and clinical manifestations can narrow the range of differential diagnosis. When the diagnosis still cannot be confirmed, diagnostic therapy or early diagnosis by fungal culture and histological examination can be performed. [ABSTRACT FROM AUTHOR]

Metal additive manufacturing (AM) is a disruptive production technology, widely adopted in innovative industries that revolutionizes design and manufacturing. The interest in quality control of AM systems has grown substantially over the last decade, driven by AM's appeal for intricate, high-value, and low-volume production components. Geometry-dependent process conditions in AM yield unique challenges, especially regarding quality assurance. This study contributes to the development of machine learning models to enhance in-process monitoring and control technology, which is a critical step in cost reduction in metal AM. As the part is built layer upon layer, the features of each layer have an influence on the quality of the final part. Layer-wise in-process sensing can be used to retrieve condition-related features and help detect defects caused by improper process conditions. In this work, layer-wise monitoring using optical tomography (OT) imaging was employed as a data source, and a machine-learning (ML) technique was utilized to detect anomalies that can lead to defects. The major defects analyzed in this experiment were gas pores and lack of fusion defects. The Random Forest Classifier ML algorithm is employed to segment anomalies from optical images, which are then validated by correlating them with defects from computerized tomography (CT) data. Further, 3D mapping of defects from CT data onto the OT dataset is carried out using the affine transformation technique. The developed anomaly detection model's performance is evaluated using several metrics such as confusion matrix, dice coefficient, accuracy, precision, recall, and intersection-over-union (IOU). The k-fold cross-validation technique was utilized to ensure robustness and generalization of the model's performance. The best detection accuracy of the developed anomaly detection model is 99.98%. Around 79.40% of defects from CT data correlated with the anomalies detected from the OT data. [ABSTRACT FROM AUTHOR]

Background: Sarcopenic obesity arises from increased muscle catabolism triggered by inflammation and inactivity. Its significance lies in its role in contributing to morbidity and mortality in gastric cancer. This study aims to explore the potential correlation between sarcopenia, sarcopenic obesity, and gastric cancer, as well as their effect on survival. Materials and methods: This retrospective study included 162 patients aged ≥ 18 years who were diagnosed with stomach cancer. Patient age, gender, diagnostic laboratory results, and cancer characteristics were documented. Sarcopenia was assessed using the skeletal muscle index (SMI) (cm2/m2), calculated by measuring muscle mass area from a cross-sectional image at the L3 vertebra level of computed tomography (CT). Results: Among the 162 patients, 52.5% exhibited sarcopenia (with cut-off limits of 52.4 cm2/m2 for males and 38.5 cm2/m2 for females), and 4.9% showed sarcopenic obesity. Average skeletal muscle area (SMA) was 146.8 cm2; SMI was 50.6 cm2/m2 in men and 96.9 cm2 and 40.6 cm2/m2 in women, respectively. Sarcopenia significantly reduced mean survival (p = 0.033). There was no association between sarcopenic obesity and mortality (p > 0.05), but mortality was higher in sarcopenic obesity patients (p = 0.041). Patient weight acted as a protective factor against mortality, supporting the obesity paradox. Tumor characteristics, metabolic parameters, and concurrent comorbidities did not significantly impact sarcopenia or mortality. Conclusion: Sarcopenia is more prevalent in the elderly population and is linked to increased mortality in gastric cancer patients. Paradoxically, higher body mass index (BMI) was associated with improved survival. Computed tomography offers a practical and reliable method for measuring muscle mass and distinguishing these distinctions. Trial registration: This study was approved by Istanbul Training and Research Hospital Clinical Research Ethics Committee of the University of Health Sciences (29.05.2020/2383). [ABSTRACT FROM AUTHOR]

Introduction: The third ventricle is a midline, slit-like cavity which is derived from the primitive forebrain vesicle, lying in the sagittal plane below the fornix and the corpus callosum. Much of the upper part of the lateral wall is occupied by the thalamus, that bulges convexly into the ventricle. The cerebral ventricular system acts as a marker of brain development and a predictor of neurodevelopmental outcomes. The thalamus is the gateway to the cerebral cortex. Virtually all sensory systems pass through the thalamus on their way to the cerebral cortex, and in turn, each part of the thalamus receives projections from the cortical area to which it projects. Materials and Methods: For the study, cranial computed tomography scans of 180 patients were studied. Anteroposterior diameter and transverse diameter of the third ventricle, thalamus, and intracranial cavity were measured and were compared with males and females of the studied population, and it was statistically analyzed. Results: The study showed an increase in the mean third ventricular anteroposterior and transverse diameter as age advances in the three age groups studied. There was no significant correlation in the anteroposterior or transverse diameter of the cranial cavity between the three age groups studied. Both anteroposterior and transverse diameters of the cranial cavity were larger in males when compared with females. Conclusion: The study in Indian adults is on morphometry of the third ventricle and thalamus by computerized tomography might help clinicians and radiologists to diagnose the pathologies ruling out the confronting effect of aging in third ventricular and thalamic dimensions. The study might also help in defining the age-specific third ventricular and thalamic diameters in the South Indian population. [ABSTRACT FROM AUTHOR]

The broadcast automatic dependent surveillance (ADS-B) system is a new-generation air traffic control system designed to avoid the waste of resources in secondary radars. The establishment of the spaceborne ADS-B system provides a broad prospect for ionospheric tomography. In this paper, the external observation information of the ionosphere is obtained by measuring the Faraday rotation angle, that is, the total electron content (TEC). Tomography research can be carried out all over the world to conduct large-scale ionospheric electron density research. The experiment selected two different regions and had a time resolution of two hours, a height resolution of 200 km, a latitude resolution of 2°, and a longitude resolution of 5°. Based on the simulated spaceborne ADS-B signal to invert the regional ionospheric electron density, the latitude, longitude, and height distributions of inversion result are basically consistent with those of the actual ionospheric electron density. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of USG and CT compared with MRCP in the patients with obstructive jaundice considering ERCP as the gold standard. Methodology: This cross-sectional study at Mayo Hospital, Lahore, spanned 6 months and included 71 cases meeting predefined criteria. A senior radiologist prepared all reports. The study used preliminary ultrasound, CECT abdomen, and MRCP for patients with cholestatic jaundice, comparing results with ERCP. MRCP showed higher diagnostic accuracy. Results: MRCP proved to be the most accurate in diagnostic accuracy. Its sensitivity and specificity for benign conditions were 94.87% and 93.75% while for CT it was 87.18% and 81.25% and for USG it was 84.62% and 90.63% respectively. For malignant conditions sensitivity and specificity for MRCP was 93.75% and 97.44% for CT it was 87.5% and 92.31% and for USG it was 81.25% and 89.74% respectively. Conclusion: The results of this study demonstrate that MRCP is a superior modality, exhibiting higher sensitivity, specificity, and diagnostic accuracy for evaluating both malignant and benign conditions in patients with obstructive jaundice compared to USG and contrast-enhanced CT. MRCP's specificity for various etiologies matches that of ERCP, which is considered the gold standard. While MRCP's cost and availability may be a concern, its non-invasiveness, contrast-free nature, and high diagnostic accuracy make it an ideal choice for evaluating patients with obstructive jaundice. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to distinguish the typical cervical vertebrae that cannot be separated from one another with the naked eye by using machine algorithms (ML) with measurements made on computerized tomography (CT) images and to show the differences of these vertebrae. Methods: This study was conducted by examining the 536 typical cervical vertebrae CT images of 134 (between the ages of 20 and 55) individuals. Measurements of cervical vertebrae were made on coronal, axial and sagittal section. 6 different combinations (Group 1: C3 -- C4, Group 2: C3 -- C5, Group 3: C3 -- C6, Group 4: C4 -- C5, Group 5: C4 -- C6, Group 6: C5 -- C6) were formed with parameters of each vertebrae and they were analyzed in ML algorithms. Accuracy (Acc), Matthews correlation coefficient (Mcc), Specificity (Spe), Sensitivity (Sen) values were obtained as a result of the analysis. Results: As a result of this study, the highest success was obtained with Linear Discriminant Analysis (LDA) and Logistic Regression (LR) algorithms. The highest Acc rate was found as 0.94 with LDA and LR algorithm in Groups 3 and Group 4, the highest Spe value was found as 0.95 with LDA and LR algorithm in Group 5, the highest Mcc value was found as 0.90 with LDA and LR algorithm in Group 5 and the highest Sen value was found as 0.94 with LDA and LR algorithm in Groups 3 and 5. Conclusions: As a conclusion, it was found that typical cervical vertebrae can be distinguished from each other with high accuracy by using ML algorithms. Keywords: Typical Cervical Vertebrae, Machine Learning Algorithms, [ABSTRACT FROM AUTHOR]

SARS-CoV-2 is a novel virus that has been affecting the global population by spreading rapidly and causing severe complications, which require prompt and elaborate emergency treatment. Automatic tools to diagnose COVID-19 could potentially be an important and useful aid. Radiologists and clinicians could potentially rely on interpretable AI technologies to address the diagnosis and monitoring of COVID-19 patients. This paper aims to provide a comprehensive analysis of the state-of-the-art deep learning techniques for COVID-19 classification. The previous studies are methodically evaluated, and a summary of the proposed convolutional neural network (CNN)-based classification approaches is presented. The reviewed papers have presented a variety of CNN models and architectures that were developed to provide an accurate and quick automatic tool to diagnose the COVID-19 virus based on presented CT scan or X-ray images. In this systematic review, we focused on the critical components of the deep learning approach, such as network architecture, model complexity, parameter optimization, explainability, and dataset/code availability. The literature search yielded a large number of studies over the past period of the virus spread, and we summarized their past efforts. State-of-the-art CNN architectures, with their strengths and weaknesses, are discussed with respect to diverse technical and clinical evaluation metrics to safely implement current AI studies in medical practice. [ABSTRACT FROM AUTHOR]

The early diagnosis of infectious diseases is demanded by digital healthcare systems. Currently, the detection of the new coronavirus disease (COVID-19) is a major clinical requirement. For COVID-19 detection, deep learning models are used in various studies, but the robustness is still compromised. In recent years, deep learning models have increased in popularity in almost every area, particularly in medical image processing and analysis. The visualization of the human body's internal structure is critical in medical analysis; many imaging techniques are in use to perform this job. A computerized tomography (CT) scan is one of them, and it has been generally used for the non-invasive observation of the human body. The development of an automatic segmentation method for lung CT scans showing COVID-19 can save experts time and can reduce human error. In this article, the CRV-NET is proposed for the robust detection of COVID-19 in lung CT scan images. A public dataset (SARS-CoV-2 CT Scan dataset), is used for the experimental work and customized according to the scenario of the proposed model. The proposed modified deep-learning-based U-Net model is trained on a custom dataset with 221 training images and their ground truth, which was labeled by an expert. The proposed model is tested on 100 test images, and the results show that the model segments COVID-19 with a satisfactory level of accuracy. Moreover, the comparison of the proposed CRV-NET with different state-of-the-art convolutional neural network models (CNNs), including the U-Net Model, shows better results in terms of accuracy (96.67%) and robustness (low epoch value in detection and the smallest training data size). [ABSTRACT FROM AUTHOR]

The Kaczmarz method is an iterative numerical method for solving large and sparse rectangular systems of linear equations. Gearhart, Koshy and Tam have developed an acceleration technique for the Kaczmarz method that minimizes the distance to the desired solution in the direction of a full Kaczmarz step. The present paper generalizes this technique to an acceleration scheme that minimizes the Euclidean norm error over an affine subspace spanned by a number of previous iterates and one additional cycle of the Kaczmarz method. The key challenge is to find a formulation in which all parameters of the least-squares problem defining the unique minimizer are known, and to solve this problem efficiently. When only a single Kaczmarz cycle is considered, the proposed affine search is more effective than the Gearhart-Koshy/Tam line-search, which in turn is more effective than the underlying Kaczmarz method. A numerical experiment from the context of computerized tomography suggests that the proposed affine search has the potential to outperform the the Gearhart-Koshy/Tam line-search and the underlying Kaczmarz method in terms of the computational cost that is needed to achieve a given error tolerance. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular disorders are an important cause of morbidity and mortality in children. The acute care of a child with an ischemic or hemorrhagic stroke or cerebral sinus venous thrombosis focuses on stabilizing the patient, determining the cause of the insult, and preventing secondary injury. Here, we review the use of both invasive and noninvasive neuromonitoring modalities in the care of pediatric patients with arterial ischemic stroke, nontraumatic intracranial hemorrhage, and cerebral sinus venous thrombosis. Methods: Narrative review of the literature on neuromonitoring in children with cerebrovascular disorders. Results: Neuroimaging, near-infrared spectroscopy, transcranial Doppler ultrasonography, continuous and quantitative electroencephalography, invasive intracranial pressure monitoring, and multimodal neuromonitoring may augment the acute care of children with cerebrovascular disorders. Neuromonitoring can play an essential role in the early identification of evolving injury in the aftermath of arterial ischemic stroke, intracranial hemorrhage, or sinus venous thrombosis, including recurrent infarction or infarct expansion, new or recurrent hemorrhage, vasospasm and delayed cerebral ischemia, status epilepticus, and intracranial hypertension, among others, and this, is turn, can facilitate real-time adjustments to treatment plans. Conclusions: Our understanding of pediatric cerebrovascular disorders has increased dramatically over the past several years, in part due to advances in the neuromonitoring modalities that allow us to better understand these conditions. We are now poised, as a field, to take advantage of advances in neuromonitoring capabilities to determine how best to manage and treat acute cerebrovascular disorders in children. [ABSTRACT FROM AUTHOR]

Background Continuity of care (CoC) is an important component of health care delivery that can have cost implications and improve patient outcomes. We analysed data obtained from the Department of Veterans Affairs to examine the relationship between CoC and use of image-oriented diagnostic tests in patients with comorbid chronic conditions. Methods A longitudinal, retrospective cohort study involving participants ≥18 years old, with comorbid diabetes and chronic kidney disease. We used a multivariate linear regression model to test whether greater care continuity, measured using a care continuity index (CCI), is associated with less frequent use of diagnostic tests. Results Total of 267,442 patients and 8,142,036 tests were included. Of the diagnostic tests we chose to evaluate, the 4 most frequently ordered tests were X-ray (45.6%), electrocardiogram (EKG, 16.8%), computerized tomography (CT, 13.4%), and magnetic resonance imaging (MRI, 3.4%). Overall, greater CCI was associated with fewer use of tests (P < 0.001). A 1 standard deviation (SD, 0.27) increase in CCI was associated with 4.2% decrease (P < 0.001) in number of tests. But a mixed pattern existed. For X-ray and EKG, greater continuity was associated with less testing, 6.2% (P < 0.001) and 3.3% (P < 0.05) reductions, respectively. Whereas, for CT and MRI, greater continuity was associated with more testing, 2.3% (P < 0.001) and 1.4% increases (P < 0.01), respectively. Conclusion Overall, greater CoC was associated with fewer use of tests, representing a greater presumed efficiency of care. This has implications for designing health care delivery. [ABSTRACT FROM AUTHOR]

Intraoperative cone beam computed tomography (CBCT) imaging has the potential to facilitate the surgical procedure. The current preliminary retrospective chart review investigated the benefits of intraoperative CBCT during laryngoplasty. This study examined 26 cases that underwent intraoperative CBCT imaging during laryngoplasty, with one patient who counted twice due to first and revision surgery. The visual quality of structures of interest (glottal shape, thyroid cartilage, arytenoid cartilage, and implants) was determined using intraoperative CBCT during laryngoplasty. Each patient also underwent an aerodynamic assessment. CBCT provided unique information, such as surgical landmarks in severe scarring, the subglottal shape, and the rotation angle of the arytenoid cartilage during arytenoid adduction. Nonetheless, 26.9% (7 of 26) of cases were affected by motion artifact, due to the long acquisition time. When motion artifact-negative cases were evaluated, 100% of glottal shape and more than 89% of thyroid cartilage were well visualized. All arytenoids were well-visualized in patients ≥ 50 years of age and without motion artifact, while CBCT failed to visualize the arytenoids in 2 of 4 patients who were < 50 years, due to the lack of calcifications. After medialization surgery, the yields of improved maximal phonation times (MPTs) in the motion artifact-negative and -positive groups were 8.7 sec and 3.4 sec, respectively (p = 0.032; Welch's t test). This comparison indicates intraoperative CBCT would contribute in MPT improvement, if CBCT is taken in measurable quality. The potential benefits of intraoperative CBCT during laryngoplasty were demonstrated. A corollary, prospective study is warranted to further confirmation. [ABSTRACT FROM AUTHOR]

Background: Obesity contributes to endometrial cancer (EC). However, it is not clear whether the distribution of adipose tissue affects the occurrence of endometrial carcinoma. This study aimed to evaluate the relationship between abdominal adipose tissue distribution and EC. Methods: We designed a case-control study with 115 women with EC and a control group. The total abdominal adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue were measured by single slice computerized tomography at the level of umbilicus. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) for the risk of EC associated with adipose tissue distribution. Furthermore, we analyzed the correlation between adipose tissue distribution and clinicopathologic features of endometrial carcinoma. Results: Multivariate analysis showed that a larger visceral adipose tissue ratio was associated with an increased risk of EC after adjusting for body mass index (BMI) and diabetes (OR = 1.046, 95% confidence interval = [1.008-1.079]). The ratio of International Federation of Obstetrics and Gynecology (FIGO) stage I and type I EC was higher in EC patients with larger visceral adipose tissue (84.5% vs 63.2%, P =.009; 91.4% vs 75.4%, P =.021). There was a higher positive ratio of progesterone receptor in EC patients with a larger subcutaneous adipose tissue area (91.2% vs 77.6%; P =.044). Conclusions: Higher visceral adipose tissue ratio, independent of BMI, was associated with an increased risk of EC. Therefore, this study demonstrated that women with normal BMI, but abnormal abdominal adipose tissue distribution, have an increased risk for EC. [ABSTRACT FROM AUTHOR]

Here in we present a 74‐year‐old case of esophago‐pericardial fistula with pericardial effusion and pneumopericardium. Bone‐related esophageal trauma was the cause of the esophago‐pericardial fistula. The esophago‐pericardial fistula was diagnosed with echocardiography, computerized tomography (CT) and endoscopy. Pericardiocentesis was performed for drainage the pericardial effusion. The esophago‐pericardial fistula was treated with covered self‐expandable esophageal stent. [ABSTRACT FROM AUTHOR]

• This study reports Enchodus from the Upper Cretaceous La Luna Formation (Colombia). • This new Enchodus report consists of three Jaw fragments and a skull fragment. • Enchodus distribution. New correlation in Coniacian-Santonian age in Northern Andes. [ABSTRACT FROM AUTHOR]

Children with compromised immune systems, whether due to primary or secondary immunodeficiencies, are susceptible to a broad spectrum of acute intrathoracic pathologies. These include infections, pulmonary edema, and malignancies. Pulmonary issues are common and perilous in this population, necessitating prompt and precise diagnosis for effective management. This review aims to provide an overview of such conditions, focusing on the imaging appearances of the most prevalent acute lung conditions affecting immunocompromised children. It emphasizes the critical importance of an integrated clinical and radiological approach when diagnosing these acute pulmonary disease states.Graphical Abstract: Children with compromised immune systems, whether due to primary or secondary immunodeficiencies, are susceptible to a broad spectrum of acute intrathoracic pathologies. These include infections, pulmonary edema, and malignancies. Pulmonary issues are common and perilous in this population, necessitating prompt and precise diagnosis for effective management. This review aims to provide an overview of such conditions, focusing on the imaging appearances of the most prevalent acute lung conditions affecting immunocompromised children. It emphasizes the critical importance of an integrated clinical and radiological approach when diagnosing these acute pulmonary disease states. [ABSTRACT FROM AUTHOR]

In recent years, especially during the COVID-19 pandemic, a large number of Computerized Tomography (CT) images are produced every day for the purpose of inspecting lung diseases. However, the diagnosis accuracy depends on the quality of CT imaging and low quality images may greatly affect clinical diagnosis, resulting in misdiagnosis. It is difficult to effectively rate the quality of massive CT images. To solve the above problems, we first constructed a dataset of 800 CT volumes for chest CT image quality assessment. Then we propose a multi-task model for chest CT image quality assessment and classification. This model can automatically classify CT image sequences of different visual inspection windows, and automatically estimate CT image quality score, to match the visual score from clinicians. The experimental results show that the window classification accuracy and the dose exposure classification accuracy of our model can reach 0.8375 and 0.8813 respectively. The Pearson Linear Correlation Coefficient (PLCC) and Root Mean Square Error (RMSE) between the model prediction results and the two radiologist's annotation average result reached 0.3288 and 1.9264. It shows that our model has a potential to mimic quality evaluation of experts. • The first dataset for chest CT-IQA without synthetic data is constructed. • A multi-task model of CT image classification and quality assessment is proposed. • Finetune the model using the clinician's manual annotation to improve the accuracy. [ABSTRACT FROM AUTHOR]

Medical image analysis and disease diagnosis have significantly improved with the use of AI and Machine Learning algorithms. Automated systems for medical image analysis will help the doctors and radiologists understand the anomaly in a short span of time and with better visualization. Such automated systems will help to reduce the time taken for diagnosis by experts. Recently, Computer Vision is industrialized with the advancements in algorithms and hardware. The proposed study aims to develop a computer vision solution for automatic segmentation and classification of ovarian tumours in discriminating between benign and malignant tumours by image‐to‐image translation approach using Conditional Generative Adversarial Network (cGAN). Our method uses a novel algorithm which segments and classifies the images in a single pipeline which makes the algorithm unique and useful. This research also aims to compare its diagnostic accuracy with that of an expert radiologist. The dataset used by in the present study is formulated with images obtained from a hospital and annotated by doctors from the hospital. The obtained results show the proposed study is promising for ovarian cancer segmentation and classification with an average segmentation score of 0.825 for benign and 0.765 for malignant and classification accuracy of 83% for benign and 79% for malignant, precision score of 85% for benign and 80% for malignant and F1 score of 81% for benign and 80.1% for malignant images. The proposed methodology is evaluated on the existing MRI images to perform segmentation and classification. The results obtained shows that the proposed methodology can perform well on other MRI images. In this study, proposed methodology is convenient as separate segmentation need not be done and is giving good result. The same MRI images are segmented using UNet and classified using RESNET 101 and results are compared with the proposed methodology. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the effect of the simulation program that can simulate the CT device and work online on the knowledge and skills of the students and the attitudes of the students related to this education. The questionnaires prepared by the researchers were applied before and after simulation training to vocational school students who were studying in the first year of the Medical Imaging Techniques (MIT) program and who accepted to participate in the study. The obtained data were evaluated by appropriate statistical methods. It was determined that 55.4% of the students had good technology use skills, and 94.6% of them not received any training on CT before. While there was a 42.9% level of knowledge about the procedures to be performed after the patient information was entered before the training, this rate increased to 67.9% after the training. A statistically significant difference was found between before and after the training (p<0.001). Simulation education is of great importance in terms of radiation safety and radiation health of students. The results of our study showed that students will have more knowledge about CT device before starting their professional internship. After the simulation, there was an increase in the knowledge of the participants about the CT protocol implementation steps. In the simulation program, the protocols to be used in pediatric and adult patients and the dose parameters given can be tried in more detail and the optimum values and protocols can be determined. [ABSTRACT FROM AUTHOR]

This study presents a fossil signature based on fractal dimension (FD) derived from computerized tomography (CT) images to differentiate between coprolites and body fossils. Coprolites are generally studied using destructive techniques like thin section study and geochemistry. Coprolites and body fossils collected from the Triassic terrestrial Gondwana deposits of India were chosen for the study. The presented CT-powered FD-based digital signature can properly distinguish coprolites from other fossils, without losing the structural features of the samples. The present study will further enhance the digitalized fossil research. [ABSTRACT FROM AUTHOR]

Objective: This study is aimed to investigate whether both pre‐operative full‐spine 3Dimensional computed tomography scan (3D CT) and X‐ray film were necessary for patients with severe ankylosing spondylitis (AS) kyphosis deformity. Methods: The research objects were selected from the inpatients with AS in our hospital from 2017 to 2019. A total of 42 patients were included in the study. On both the synthesized 2Dimensional (2D) lateral radiograph and X‐ray film, the globe kyphosis (GK), the lumber lordosis (LL), the thoracolumbar kyphosis (TLK) and the thoracic kyphosis (TK) were measured. And the angle seventh thoracic vertebra (T7), the angle twelfth thoracic vertebra (T12) and the angle third lumber vertebra (L3) were also measured. Two researchers with professional medical education were randomly selected to perform the measurement method and record the measurement data. Two researchers independently completed, recorded, and evaluated the accuracy and consistency of the measurement data. This study used intraclass correlation coefficient (ICC) to analyze the synthesized 2D lateral radiograph and general X‐ray film of 42 subjects by two researchers, in order to evaluate the consistency of data measurement results between the examiners. Through the comparison of the above parameters that the GK, LL, TLK, TK, angle T7, angle T12 and angle L3, the evaluation was made both pre‐operative full‐spine 3D CT and X‐ray film were necessary for patients with severe AS kyphosis deformity. Results: There was no significant difference between the GK, LL, TLK, TK, angle T7, angle T12, angle L3 on the synthesized 2D lateral radiograph and that on X‐ray film (P = 0.240, 0.324, 0.199, 0.095, 0.421, 0.087, 0.478). Agreement two researchers was excellent with ICC of the GK, LL, TLK, TK, angle T7, angle T12, angle L3 (0.977, 0.969, 0.986, 0.945, 0.947, 0.915, 0.857) on the synthesized 2D lateral radiograph. The Bland–Altman plot results that the measurement results of examiners are reliable and stable. Conclusion: By estimating the degree of spinal sagittal imbalance and measuring the Cobb angle, we can see that full‐length spine radiographs of the patients are unnecessary for patients with severe AS kyphosis deformity who will or have undergone preoperative spine 3D CT. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical significance of brucellosis spondylitis imaging in Yunnan province. Methods The data of 38 patients with Brucella spondylitis confirmed by clinical and laboratory examination in our hospital from January 2014 to November 2021 were collected，all of whom were local residents of Yunnan province. The data obtained from MRI and CT examination of the patients for the first time (37 cases of MRI examination， 26 cases of CT examination， 25 cases of MRI and CT examination at the same time) were retrospectively analyzed. Results In this study，37 cases (97.4%) were involved in lumbar vertebrae，37 cases (97.4%) were involved in multiple vertebrae，and 1 case (2.7%) only showed abscess formation at the posterior margin of vertebrae. It was found that the lesions mainly occurred at the upper and lower edges of the vertebral body， and the L4-5 vertebral bodies were most frequently involved，accounting for 44.7% (17/38）. One case (2.7%) had flattening of two affected vertebrae and four cases (10.5%) had mild spondylolisthesis of the affected vertebrae. 35 cases ( 92.1%) were associated with different degrees of bone destruction. Thirty-six patients ( 94.7%) suffered intervertebral disc damage. 24 cases (63.2%) had paraspinal and/or epidural abscess，and 2 cases (8.33%) had paraspinal abscess involving the right psoas major muscle. Conclusions The CT and MRI imaging manifestations of sporadic Brucella spondylitis in Yunnan are diverse，and the involvement of dead bone and abscess into the psoas major muscle and epidural abscess formation alone cannot completely exclude the disease. It is of guiding significance and reference value to clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

• Preoperative prediction of lymph node status has important guiding significance for surgical methods. • Models for predicting lymph node positivity was constructed based on the basic patient data and imaging data readily available to clinicians. • All models were validated for their clinical value by survival analysis. • The results of this study will provide a reference for accurate lymph node dissection during lung cancer surgery. To develop and validate nomograms for preoperative prediction of precision lymph node (LN) dissection in lung cancer. The prediction models of each group LNs (LNx) were developed in a primary cohort that consisted of 1380 patients with clinicopathologically confirmed lung cancer. Clinical characteristics and CT reports were extracted. Patients with LNx dissection were divided into training cohort and testing cohort. Nomograms were built through univariate and multivariate regression analysis in the training cohort and internally verified in the testing cohort. The accuracy of the models was verified by constructing survival analysis in patients without LNx dissection. Due to the lack of sufficient patients for LN1, 8, 13, a total of 10 nomograms were constructed in this study, including LN-2 ∼ 7, 9 ∼ 12. According to the nomogram of each group LN, the most common independent risk factors predicting LN status were CT-reported lymphadenectasis, tumor diameter and location, and the others include age, gender, and whether there were multiple nodules, etc. All models showed good discrimination, with the average C-index of 0.738 in the training cohort and 0.707 in the testing cohort. Survival analysis in patients without LNx dissection all showed the high accuracy of each nomogram to predict LN metastasis status and TNM staging. We constructed nomograms to predict the metastasis status of each group of lymph nodes based on clinical characteristics and CT reports. Surgeons can accurately determine the extent of lymph node dissection in patients with lung cancer based on our nomogram models before surgery. [ABSTRACT FROM AUTHOR]

Simple Summary: Body mass index may be an inappropriate metric for obesity in lung cancer as its use obscures the harm that obesity causes, which is noticeable when obesity is instead measured as visceral adiposity. Radiological assessment of visceral adiposity is practicable in lung cancer as patients undergo computerized tomography (CT) routinely, and this allows for the inclusion of visceral obesity as a meaningful variable in lung cancer studies. We used CT data to measure visceral adiposity of 994 non-small cell lung cancer (NSCLC) patients to obtain a profile of visceral obesity in NSCLC and associate it with demographic and tumor characteristics. While obesity measured by body mass index (BMI) has been paradoxically associated with reduced risk and better outcome for lung cancer, recent studies suggest that the harm of obesity becomes apparent when measured as visceral adiposity. However, the prevalence of visceral obesity and its associations with demographic and tumor features are not established. We therefore conducted an observational study of visceral obesity in 994 non-small cell lung cancer (NSCLC) patients treated during 2008–2020 at our institution. Routine computerized tomography (CT) images of the patients, obtained within a year of tumor resection or biopsy, were used to measure cross-sectional abdominal fat areas. Important aspects of the measurement approach such as inter-observer variability and time stability were examined. Visceral obesity was semi-quantified as visceral fat index (VFI), the fraction of fat area that was visceral. VFI was found to be higher in males compared to females, and in former compared to current or never smokers. There was no association of VFI with tumor histology or stage. A gene expression-based measure of tumor immunogenicity was negatively associated with VFI but had no bearing with BMI. Visceral obesity is appraisable in routine CT and can be an important correlate in lung cancer studies. [ABSTRACT FROM AUTHOR]

Background: In medico-legal cases for individual identification, the bone might play an important role in forensic sciences because bones can resist decomposition for a long time. It has been accounted for that maxillary sinus stay flawless even though the cranium & different bones might be seriously deformed in casualties who are burned & consequently, maxillary sinuses can be utilized for distinguishing proof for forensic purposes. From the skull, the maxillary sinus is located in the facial bones. It is possible to calculate the dimension of the Maxillary sinus using computed tomography scans of the skull and paranasal scans, which can be used to determine the correctness of maxillary sinuses for male and female sex determinations and may play an important role in forensic sciences. Methodology: The total participants (n = 70) will be included (35+35) in two groups consisting of males and females using SIEMENS SOMATOM 16 SLICE machine in patients referred to Acharya Vinoba Bhave Rural Hospital for CT head and paranasal sinuses scan. The patient will be positioned for the head and paranasal sinuses scan. The scan will include the vertex to mandible for the head and paranasal sinuses bottom of the Maxillary sinus to the top of the frontal sinuses. Reconstructed bone window images are used. The reconstructed bone window images of the maxillary sinus will be measured; depth, width, and height of the RT and LT sinuses in two patient groups, including male and female. Expected Results:The previous studies on maxillary sinus and their results say that the male subject values may be greater than the feminine subject. The maxillary sinus might be playing a vital role in individual identification in forensic sciences. Conclusion: In forensic medicine, gender determination is a crucial stage in the identification process. CT scan measures of the maxillary sinus may be helpful in forensic sciences to facilitate sex determination. However, with a relatively low-accuracy rate. When the entire skeleton is unavailable, the height, width, and length of the maxillary sinuses, along with other bones, can be utilized to determine gender. Previous studies on a similar topic suggest that the maxillary sinus might play an important role in individual identification in forensic and medico-legal cases. We aim to strengthen these studies and after reviewing the literature about the study, the conclusion will be discussed in the final research project. [ABSTRACT FROM AUTHOR]

Edge detection takes importance in image processing systems for computer-aided diagnosis, where sharp changes in pixel intensity are analyzed to obtain fast and accurate information about regions of interest to the specialist. A method for feature enhancement and edge detection in medical images was developed using image processing by analyzing the pixel distribution histogram and morphological gradient operation. Images from the MINI MIAS dataset and the COVID-CT dataset were used. The method is based on image processing and is applied to mammography and chest CT images, where blur filtering steps are accompanied by morphological gradient filtering, in addition to obtaining the threshold for edge detection by analyzing the point of maximum pixel concentration according to the distribution histogram. The processing is presented in a graphical user interface developed in Python language. The method is validated by comparison with other edge detection techniques such as the Canny Algorithm, and with deep learning methods such as Holistically-Nested Edge Detection. The proposed method improves image quality in both mammograms and CT scans compared to other techniques. It also presents the best performance considering internal and external edge detection, as well as an average response time of 1.054 seconds and 2.63 % of Central Processing Unit requirement. The developed system is presented as a support tool for use in computer-aided diagnosis processes due to its high efficiency in edge detection. [ABSTRACT FROM AUTHOR]

Intraorbital infections may lead to severe complications, necessitating rapid diagnosis and intervention. The decision process regarding the need for emergent imaging and possible surgical intervention is unclear in the literature. This retrospective cohort study included two major pediatric emergency departments in Israel between 2010 and 2020. Patients arriving at the emergency department with an admission diagnosis of intraorbital infection and at least one high-risk symptom for orbital involvement were included in the study. The main outcome measures were the computerized tomography (CT) timing and results, whether the case was managed surgically or conservatively and whether the patient returned to the same hospital with significant complications. Ninety-five patients were included; 70 underwent a CT scan in the first 24 h, and of those 21 were managed surgically; 16 were treated based on clinical findings alone, with no imaging performed. When comparing groups based on management, we found no significant differences based on presenting symptoms, duration of complaints, or severity of CT findings. However, having three or more high-risk presenting symptoms was associated with a greater likelihood of surgical intervention (multivariate logistic regression p = 0.069, odds ratio 1.73, 95% confidence interval 0.96–3.11; one-way ANOVA and Fisher's exact test p < 0.05). Conclusion: The decision to treat intraorbital infections at our institutions appears to be based on clinical impression of disease severity rather than radiologic findings. This suggests a need for further interdisciplinary studies to clarify optimal management. What is Known: • Orbital c ellulitis is associated with significant potential complications, necessitating rapid diagnosis and treatment. • Present literature provides insufficiently clear guidance on emergency department management. What is New: • Consideration of all relevant factors (clinical features, laboratory findings, timing of imaging, and conservative vs. surgical management) in a single retrospective cohort. • Our findings suggest that decision-making in practice may be guided by clinical impression rather than imaging. [ABSTRACT FROM AUTHOR]