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Aim: Three rounds of industrial action (IA) were carried out by junior doctors in the United Kingdom between March and June 2023. We investigated the impact of radiology registrars undertaking IA on the efficiency of a large teaching hospital's radiology department., Materials and Methods: This service evaluation was registered with the local Quality Surveillance Information System and involved analysing data pertaining to the computed tomography, magnetic resonance imaging, ultrasound, and x-ray studies performed before, during, and after periods of IA., Results: Across the three strike periods, there was a temporary 5-10% reduction in imaging studies, predominantly driven by decreases in x-ray and MRI studies. Urgent CT and MRI studies were reported faster during strikes, particularly for out-of-hours scans., Conclusion: Overall, patient safety in CT and MRI reporting remained uncompromised during strikes, and in some areas, the efficiency of the department improved. However, this does not take into account the significant displacement of consultants from non-clinical activities, who volunteered to cover during these IA periods, as well as the impact on other factors such as research output and medical training., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Radiographer commenting is a written account of suspected abnormalities identified on medical imaging examinations by the radiographer at the time of image acquisition. Radiographer comments were originally implemented to support emergency clinicians; however, they may also have the potential to support radiologists in reducing missed findings. Therefore, the aim of this study was to investigate if a newly implemented radiographer comment system could reduce the number of errors made in radiology reports for general X-rays. Incidental findings from multisite collaborative research led to the hypothesis that in some cases radiographer comments could accurately detect abnormal X-ray appearances that were not otherwise documented in the radiologist report, thereby enabling results to be revised and errors collaboratively reduced [1]., Methods: This study was conducted at an 800-bed hospital, where 92% of general radiographers self-selected to participate. Radiographer comments were provided to referring physicians through the electronic medical record and could be made for any emergency or inpatient general X-ray examinations. All comments made over a 12-month period were audited against the corresponding radiologist report. Radiologists were blinded to radiographer comments at the time of reporting. Where discrepancies between the radiographer comment and radiologist report arose, additional radiologist review or subsequent imaging reports were used to determine the accurate interpretation. The number of discrepant radiographer comments that were deemed true positive (TP) and provided new and correct diagnostic information compared to the radiologist report were identified. These were converted to a percentage of total radiographer comments that were therefore able to positively influence radiologist report accuracy. The number of discrepant cases where radiographer comments were deemed false positive (FP) was also measured and converted to a percentage of the total comments. Confidence intervals for both TP and FP binomial proportions were calculated using the Wilson Score Interval., Results: Over 12 months, 282 radiographer comments were made to alert clinically significant radiographic appearances on general X-ray. Of these, 32 radiographer comments were discrepant with the report. Of these 32 comments, 24 were deemed TP meaning they correctly identified a pathological imaging appearance that was not otherwise documented in the radiology report. Therefore, 8.5% of all radiographer comments added value by correctly identifying a pathology that was not otherwise documented, 95% CI (5.8% - 12.4%). This enabled results to be promptly amended and reporting errors collaboratively reduced. Conversely, eight (2.8%) radiographer comments were discrepant with the report but deemed FP and did not add value to the investigation, 95% CI (1.4% - 5.5%). The remaining 250 non-discrepant comments did not contribute to error reduction but provided real-time abnormality detection that benefitted managing teams., Conclusion: These findings are consistent with previous literature proposing radiographer comments may provide a safety net for radiologists due to factors such as direct patient contact, ability to expand on clinical history, and difference in accumulated expertise. This study demonstrates that radiographer comments may be effectively used as a multidisciplinary error-reduction tool to assist radiologists in their important role and improve clinical outcomes., (Copyright © 2024. Published by Elsevier Inc.)

Objectives: The catastrophic Beirut blast on August 4, 2020 at 6:07 pm resulted in extensive damage. Our study aims to categorize the injuries of patients who were transferred to the radiology department in the first 12 hours following the blast and to evaluate the disaster preparedness of the radiology department at Hôtel-Dieu de France Hospital in order to implement corrective action process., Methods: A total of 97 patients underwent imaging examinations, comprising 77 CT scans and 20 radiographs, which were retrospectively reviewed by 4 senior radiology residents. Patient injuries were classified according to blast injury categories. A full assessment of our disaster plan was done including staff shortage, examination time, patients triage and diagnostic performance of radiologists., Results: Tertiary injuries were the most prevalent (47.6%). Maxillofacial fractures and intracranial hemorrhage were the most common (54.3%). The radiology department encountered numerous challenges, including communication difficulties, staffing shortages and infrastructure damage. Nevertheless, the disaster management plan enabled the department to effectively navigate these obstacles despite many flaws and many lessons were learned., Conclusions: This study underscores the importance of an efficient response of the radiology team during mass casualty incidents and can inform future disaster preparedness efforts in health care settings.

Introduction: The radiology department plays an important role in healthcare settings, facilitating diagnoses using different imaging modalities, including ultrasound. However, this high-tech environment can pose various risks to patients. In this study, we aimed to describe the risk of patient safety incidents, and factors associated with the prevention of risks related to ultrasound examinations and the diagnostic work, from the perspective of Swedish radiographers., Methods: We conducted a qualitative study, based on the written answers to three open-ended questions addressed to Swedish radiographers in ultrasound units of radiology departments, between March 2022 and May 2023. Data from the responses were analyzed using content analysis., Results: A total of 22 radiographers participated in this study. The described risks were categorized into two groups: risk of tissue damage; and risk of missed, delayed, or incorrect diagnoses. Participants stated that patient safety relied on good organizational conditions-such as having enough time for ultrasound examinations and the diagnostic work, together with adequate technical equipment and new ultrasound devices not older than 5 years. As risk-prevention factors, the radiographers recommended ensuring adequate individual competence-for example, through recurrent mandatory education in ultrasound physics and safety performed by the hospital physicist, and by implementing a certificate with an identified level of expertise at every level of the ultrasound examination., Conclusions: Within ultrasound units in Sweden, collaborative individual, organizational, and technical factors are important for reducing the risks of tissue damage and of missed, delayed, or incorrect diagnoses., Implications for Practice: In ultrasound diagnostics, risk-preventing factors include the use of adequate technical equipment and ultrasound devices not older than 5 years, sufficient time for ultrasound examinations and diagnostic work, thoroughly education in all ultrasound methods and recurrent mandatory education in ultrasound physics performed by hospital physicists., Competing Interests: Conflict of interest statement None., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Magnetic resonance imaging (MRI) is an essential tool in pediatric imaging. It offers detailed, high-contrast images without ionizing radiation, making it particularly suitable for children. Creating an efficient MRI service is challenging given the balancing priorities of image quality and scan time and the overlying logistical challenges, including MRI safety protocols, the need for sedation in certain patient populations, and flexibility to accommodate patients at different phases of care. This paper reviews practical strategies to improve MRI operations and workflows in pediatric radiology, emphasizing protocol standardization and customization, scheduling optimization, and identification of key performance indicators (KPIs). Operational data through dashboards and reports enable continuous quality assessment and improvement, while specialized staff training ensures high imaging and patient safety standards. The strategies outlined in this paper highlight the importance of a comprehensive, patient-centered approach to MRI operations. By prioritizing efficiency, quality, and patient care, radiology departments can improve diagnostic outcomes and patient experience., Competing Interests: Declarations. Competing interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The last decade has seen a surge in the demand for imaging exams in emergency radiology (ER), necessitating an evolution in organizational systems for departments offering round-the-clock care, while safeguarding patient care quality and physician well-being to prevent burnout., Purpose: To develop a nationwide overview of ER organizations in France and identify structures that promote job satisfaction., Material and Methods: Two surveys were sent to 709 radiological centers across France from March to June 2022, inquiring about organizational aspects and quality of life (QOL), incorporating four validated QOL questionnaires. The organization of each center was mapped, and correlations between respondent characteristics and mental health were analyzed using Pearson's and Wilcoxon tests., Results: A total of 284 centers answered the organizational survey, with a response rate of about 41.6%. Among them, there were 32 university hospitals, 208 general hospitals, 2 teaching army hospitals, and 42 private facilities. Of these, night-time operations showed 14% on-site coverage, 12% on-call from home, 69% utilized external teleradiology, and 4% used in-house teleradiology. These trends persisted over weekends and holidays. Regarding the quality of working life, academic, general, and private radiologists are more satisfied with their practice compared to trainees. Depersonalization, part of the three dimensions of burnout, was high in every class, at 60% (n = 210/350)., Conclusion: Outside of university hospitals, most radiology centers in France no longer have on-site radiologists during off hours. Residents are prone to lower job satisfaction and quality of life than more experienced radiologists., Clinical Relevance Statement: The survey illustrates how French ER is structured, pointing out the escalating significance of teleradiology and noting that radiologists generally experience high job satisfaction while also confronting typical organizational challenges., Key Points: The need for continuous radiology coverage comes with unique logistical challenges, especially in ER. Night shifts show a significant reliance on teleradiology services, especially by external companies. Pay, shift patterns, and seniority affect the well-being of emergency radiologists, particularly the residents., Competing Interests: Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Dr G.H. Conflict of interest: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: One of the authors has significant statistical expertise. Informed consent: Only if the study is on human subjects: written informed consent was waived by the Institutional Review Board. Ethical approval: Institutional Review Board approval was obtained. Study subjects or cohorts overlap: None of the study subjects or cohorts have been previously reported. Methodology: Prospective Observational Multicenter study, (© 2024. The Author(s), under exclusive licence to European Society of Radiology.)

Radiology departments are increasingly tasked with managing growing demands on services including long waitlists for scanning and interventional procedures, human health resource shortages, equipment needs, and challenges incorporating advanced imaging solutions. The burden of system inefficiencies and the overuse of "low-value" imaging causes downstream impact on patients at the individual level, the economy and healthcare system at the societal level, and planetary health at an overarching level. Low value imaging includes those performed for an inappropriate clinical indication, with little to no value to the management of the patient, and resulting in healthcare resource waste; it is estimated that up to a quarter of advanced imaging studies in Canada meet this criterion. Strategies to reduce low-value imaging include the development and use of referral guidelines, use of appropriateness criteria, optimization of existing protocols, and integration of clinical decision support tools into the ordering provider's workflow. Additional means of optimizing system efficiency such as centralized intake models, improved access to electronic medical records and outside imaging, enhanced communication with patients and referrers, and the utilization of artificial intelligence will further increase the value of radiology provided to patients and care providers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Alison Harris currently serves as Vice-President of the Canadian Association of Radiologists.

Introduction: This study aimed to assess current practice in general x-ray rooms in three Irish hospitals. Evaluating the extent to which x-ray protocols are currently standardised can be considered as a preparatory step towards the larger goal of implementing optimisation in a diagnostic radiology department., Methods: Data on various aspects of general x-ray room exposures was manually collected and analysed to highlight variations with exposure factors in use and workload distribution across each of the ten hospital x-ray rooms included in the study., Results: Workload distribution for the x-ray rooms surveyed demonstrated the most commonly performed x-ray, the chest x-ray, to account for 44 % of exposures acquired, compared to the most recently published national statistic of 31 % 1 , suggesting a potential change in referral practices over the past decade. A high degree of protocol variation for the same imaging indications exists across the x-ray rooms included in the study, for example there were 14 protocols in routine use for shoulder imaging across the 10 x-ray rooms, spanning a wide range of tube potentials from 55 to 81 kVp., Conclusion: The lack of x-ray protocol standardisation (and associated image quality variation) prompts questions around the implementation of optimisation, as required by Irish legislation, for general x-ray protocols. National review of x-ray referral practices or most common general x-ray exposures in use would be welcomed, as deviations from the previously published dataset are locally evident., Implications for Practice: This body of work considers the variety of x-ray protocols in use for specific anatomical areas and outlines how similar analyses at a local level could provide a foundation for targeted optimisation exercises., Competing Interests: Conflict of interest statement None., (Copyright © 2025 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.)

Rationale and Objectives: Managing contrast reactions is critical as contrast reactions can be life-threatening and unpredictable. Institutions need an effective system to handle these events. Currently, there is no standard practice for assigning trainees, radiologists, non-radiologist physicians, or other non-physician providers for management of contrast reaction., Materials and Methods: The Association of Academic Radiologists (AAR) created a task force to address this gap. The AAR task force reviewed existing practices, studied available literature, and consulted experts related to contrast reaction management. The Society of Chairs of Academic Radiology Departments (SCARD) members were surveyed using a questionnaire focused on staffing strategies for contrast reaction management., Results: The task force found disparities in contrast reactions management across institutions and healthcare providers. There is a lack of standardized protocols for assigning personnel for contrast reaction management., Conclusion: The AAR task force suggests developing standardized protocols for contrast reaction management. The protocols should outline clear roles for different healthcare providers involved in these events., Competing Interests: Declaration of Competing Interest The authors have no relevant disclosure to this study. DHB receives funding from investigator-initiated studies from Takeda and Siemens., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Breastfeeding radiologists face challenges as they re-enter the workforce. Radiology employers can develop and implement a strategic plan to tangibly support breastfeeding radiologists through establishing lactation support infrastructure. This can be accomplished by implementing formal policies and procedures for lactation breaks, establishing lactation rooms that are clean, comfortable, and convenient to access, facilitating access to breast pumps for trainees, and building a comprehensive support system., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: This study aimed to evaluate the degree of gender disparity in leadership positions at the top 25 medical schools in North America compared to their affiliated radiology departments., Methods: The academic rank and leadership appointment of medical school and radiology faculty were obtained from publicly available official websites between June-November 2022. Gender was determined using self-identified pronouns on website biographies. Alternatively, gender API software was used. Finally, SCOPUS Elsevier was used to extract research output metrics including publication counts, citations, and h-indices. Statistical analysis was conducted using the IBM SPSS Statistics version 25 software., Results: 2216 individuals across 25 medical schools were included in this study. 1301 (58.7 %) were part of the medical school and 915 (41.3 %) were part of the affiliated radiology departments. Additionally, 1575 (71.1 %) were identified as men and 641 (28.9 %) as women. Rank biserial correlations showed a significant association between higher academic rank and male gender (r pb = 0.143, p < 0.001) regardless of affiliation (medical school leadership versus radiology faculty); this disparity was largest at the highest academic ranks. Male gender was associated with higher research productivity relative to female gender regardless of affiliation (p < 0.001). There were minimal statistical differences in leadership positions between genders, however the proportion of men holding the position of dean was two times higher than women., Conclusion: The underrepresentation of women in academic medicine is prevalent in the top-ranking medical institutions in North America and disproportionately involves senior academic ranks and leadership positions., Competing Interests: Declaration of competing interest Dr. Faisal Khosa is the recipient of the Michael Smith Health Research BC Award (2023-2028)., (Copyright © 2024. Published by Elsevier Inc.)

Background: Timely light exposure is a vital aspect to achieve better sleep and well-being. As there are risks with a disturbed circadian rhythm and benefits with light settings that stimulate the rhythm, the circadian effective light, circadian stimulus (CS), for radiographers was examined. Aim: The aim of the study was to compare radiographers' light environment on the workstations, at a university hospital in Southern Sweden in the form of CS and relate that to recommendations published by the Swedish Environmental Protection Agency. Method: A cross-sectional method has been applied. The measurements for CS were collected in all labs in the radiology department in the middle of January. Result: A total of 804 measures were evenly collected resulting in a median for the 19 labs, where the observed median for all labs was 0.091 CS which is significantly lower than the recommended value of 0.3 CS (p <.001). Comparing work light settings with maximum light levels in the brightest and darkest labs showed a significant difference (p <.001). Conclusion: The CS values in the labs, at the radiology department at a university hospital in Southern Sweden, do not reach the recommended values of circadian stimulus published by the Swedish Environmental Protection Agency when the radiographers themselves set the light. There is a potential for improvement as a significant difference could be seen between the chosen level of light and the maximum possible level of light. [ABSTRACT FROM AUTHOR]

Objective: To compare the relative efficacy of Magnetic Resonance Cholangiopancreatography (MRCP) versus ultrasound (USG) in detection of obstructive jaundice. Study Design: Prospective Cohort study. Setting: Department of Radiology, Pakistan Air Force Hospital, Islamabad. Period: September 2023 to March 2024. Methods: A total of 144 consecutive patients, irrespective of age and gender, with clinical and laboratory features of obstructive jaundice that were referred to the radiology department for further evaluation were included. All patients underwent USG followed by MRCP, and their findings were compared using surgery/histopathology/ERCP as the gold standard for the final diagnosis. Results: This study enrolled 144 patients with obstructive jaundice, split into two age groups: 18-50 years (47.22%) and 51-89 years (52.77%). The gender distribution includes 78 males (54.16%) and 66 females (45.83%). Common symptoms were jaundice (27.08%), weight loss (26.38%), abdominal pain (23.61%), and fever (22.91%). Among the patients, 65.28% were diagnosed with positive obstructive jaundice. Diagnostic comparison between ultrasound (USG) and magnetic resonance cholangiopancreatography (MRCP) showed MRCP's superior sensitivity (100%), specificity (90.91%), positive predictive value (96.67%), negative predictive value (100%), and diagnostic accuracy (97.50%) compared to USG. Conclusion: Obstructive jaundice slightly affects older adults more than younger individuals and shows a slight male predominance. The symptoms vary, necessitating comprehensive diagnostic approaches. MRCP outperforms USG in all diagnostic metrics, establishing it as a more reliable tool for accurately detecting obstructive jaundice. This underscores the need for accurate diagnostic and therapeutic strategies to manage this condition effectively. [ABSTRACT FROM AUTHOR]

Background: In this period following the COVID-19 pandemic, there is increasing evidence to indicate the presence of long-term sequelae in individuals who were infected with COVID-19. This study was performed to assess the proportion of CT abnormalities in patients who underwent CT imaging of the thorax at least 4 weeks after the date of RT-PCR confirmation of COVID-19 infection and to assess the severity of lung involvement using a semiquantitative CT scoring system in the above population. Methods: Institutional Review Board approval was obtained for this study. We conducted a retrospective study to assess the post-COVID-19 findings on CT imaging of thorax. The cases for analysis were obtained from the radiology department database of our Institution by performing a RIS-PACS search. The CT images were analyzed both in a qualitative manner and by using a semiquantitative score, which was correlated with spirometry. Results: A total of 192 CT imaging studies of various patients were reviewed as part of this study. The mean age of the study population was 50. The predominant CT abnormalities included ground glass opacities (87%), reticulations (77%), consolidations (52%), subpleural bands (65%), tractional bronchiectasis (59%), and air trapping (19%). The mean semiquantitative score obtained was 35.08 (range 0-80). There was a significantly higher score among diabetics and those with multiple comorbidities. There was a significant correlation between spirometric variables (FVC, FEV1) and the semiquantitative score. Conclusion: We qualitatively assessed the spectrum of post-COVID-19 sequelae in the lungs. The common findings included ground glass opacities, reticulations, and consolidations. The severity of post-COVID-19 sequelae quantified by the semiquantitative score showed a weak to moderate correlation with spirometry. [ABSTRACT FROM AUTHOR]

To examine factors impacting diagnostic evaluation of suspected deep vein thrombosis (DVT) by analyzing the test ordering patterns and provider decision-making within a universal health coverage system in Hungary.We analyzed test orders for suspected DVT between 2007 and 2020, and the financial framework influencing diagnostic practices. An anonymous survey was also conducted among Emergency Department physicians to explore factors influencing diagnostic decision-making.A total of 6,821 patients were identified. From 2008 to 2013, the most common diagnostic approach combined D-dimer and duplex ultrasound tests (64.5 %), followed by sole ultrasound (20.5 %) and sole D-dimer (15 %) testing. A marked shift occurred from 2014 onward, with sole ultrasound rising to 88 % of cases by 2018–2020, while combined testing and sole D-dimer orders decreased to 7.9 and 4 %, respectively. In survey results, time efficiency emerged as a key factor for bypassing D-dimer testing, cited by 75 % of physicians. 45 % believed D-dimer costs were comparable to or higher than duplex ultrasound. Financial analysis revealed that the outdated performance points system misrepresented actual costs, resulting in duplex ultrasound being significantly underfunded, which impacts the Radiology Department. This discrepancy contributes to higher national level expenses, driven by the increased reliance on ultrasound.We found diagnostic practices deviating from international diagnostic guidelines, with an increase in duplex ultrasound over D-dimer. This shift, allowed by an outdated financing structure, increases overall costs for the healthcare system. Revising financial frameworks to reflect true costs is essential for sustainable operations in universal health coverage systems. [ABSTRACT FROM AUTHOR]

Recent advancements in medical imaging, such as point shear wave elastography (pSWE), offer non-invasive methods to assess tissue stiffness and structural changes. This study explores the use of pSWE to evaluate pancreatic stiffness and dimensions in three different pancreas parts. This study was conducted at diagnostic radiology department, King Abdulaziz University Hospital, Jeddah, between June 2022 and November,2022. Thirty-one diabetic patients and thirty-one healthy controls were included. Ultrasound pSWE examination was performed using a ultrasound system (Philips Elite Epic 7) to measure stiffness across different pancreatic parts. Pancreatic stiffness was quantified in meters per second (m/s), and the dimensions of each pancreatic part were recorded. Different parameters, including age, sex, height, weight, body mass index (BMI), and comorbidities, were collected and analyzed. Diabetic patients exhibited significantly higher shear wave velocities (SWVs) compared to healthy controls, indicating increased pancreatic stiffness. The mean shear wave velocity was 1.7 m/s in diabetic versus 0.6 m/s in controls (p < 0.001). Additionally, the pancreatic head dimensions were significantly large in diabetic patients (2.1 cm vs. 1.8 cm; p = 0.003), while the body and tail part showed no significant differences. A positive correlation was found between SWVs and BMI. The findings underscore the potential of pSWE as a non-invasive diagnostic tool for early detection and monitoring of diabetes-related pancreatic alterations. Assessing pancreatic stiffness and dimensions through pSWE can help in identify patients at risk for pancreatic complications and optimize management strategies. Point shear wave elastography (pSWE) could be a useful, non-invasive tool for early detection of pancreatic changes in diabetic patients, identifying those at risk for complications. Integrating pSWE into routine diabetes check may enhance early interventions and improve outcomes. [ABSTRACT FROM AUTHOR]

This study presents a new multiple criteria group decision making (MCGDM) sorting method, named G-ARASsort – a new variant of the ARAS ranking method, to address a disaster management assessment problem through a group consensus. MCGDM sorting methods improve a decision-making problem by providing useful and unparalleled insights. Disaster management is one of the most critical areas of decision-making, where decisions are made under tremendous pressure. Radiology units play a central role in disaster management and the present study establishes a new disaster management assessment framework to assess their disaster readiness. The proposed method is applied to sort 37 radiology units into four ordered classes, defined through a Delphi panel. The results show that approximately 11% and 14% of the departments placed in the first (best) and the last (worst) classes, respectively. The findings can help the lower-class units improve their performance by using the upper-class units' performance as a yardstick. Additionally, healthcare directors can identify more reliable radiology units to turn to during disasters and prevent patient misallocation. A comparative analysis is also conducted to confirm the method's competency. [ABSTRACT FROM AUTHOR]

The purpose of this retrospective study was to assess facial and palatal alveolar wall thickness (AWT) in relation to sagittal root position (SRP) of maxillary anterior teeth using CBCT. A total of 102 CBCT images (60 women, 42 men) of maxillary anterior teeth were reviewed. SRP was classified according to Kan's classification, and AWT was evaluated at coronal (4 mm from the CEJ), mid-root, and apical (2 mm from the apex) levels of the facial and palatal aspects. Sex, age, and tooth type were analyzed as secondary variables. The SRP distribution was 76.6% class I, 11.3% class II, 0.8% class III, and 11.3% class IV. AWT, from thickest to thinnest, was found in palatal apical, then mid-root, then coronal levels, followed by facial coronal, then mid-root, then apical levels. AWT was thickest in SRP class II, followed by classes I and III, and least thick in class IV at all measured areas (P < .05). A significantly higher AWT was associated with class I in central incisors, class II in canine teeth and in men, and class IV in central incisors and canines. [ABSTRACT FROM AUTHOR]

Introduction: Quality assurance (QA) in medical imaging ensures consistently high-quality images at acceptable radiation doses. However, the applicability of the chest X-ray (CXR) QA tool in images with pathology, particularly infectious diseases like COVID-19, has not been explored. This study examines the utility of the European Guidelines for image quality in QA of CXRs with varying severity and types of infectious disease., Methods: A convenient sampling methodology was employed to recruit 25 participants (qualified radiographers: n = 13 and 4th-year undergraduate radiography students: n = 12) to evaluate 70 CXR images using the European Guidelines for image quality in CXRs. The image dataset comprised of COVID-19 and non-COVID-19 cases, which were randomly selected to reflect routine clinical practice variability. Participants independently rated image quality based on 10 criteria in the European guidelines on quality criteria for CXRs using a six-point Likert scale. Image quality ratings of normal and pathological CXR images were compared using a Kruskal-Wallis test. Spearman's ranked order correlation was used to assess the association between quality criteria ratings., Results: CXRs with no pathology or non-COVID pathologies exhibited statistically higher total QA scores compared to CXRs with COVID-19 and indeterminate COVID-19 (P < 0.001). This trend was evident across various QA factors, especially those associated with patient inspiration. Higher levels of infection corresponded to lower QA ratings. No differences were found between different pathologies regarding the medial border of the scapulae being outside the lung fields., Conclusions: Severe pathology negatively impacts the technical quality of CXRs with COVID-19 features without necessarily affecting their diagnostic value. The findings emphasise the need to prioritise diagnostic ability over technical quality when evaluating CXRs exhibiting diffuse signs of pathology., (© 2025 The Author(s). Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.)

Dimensions of the pelvic and skull bones are known to be sexually dimorphic in various population groups. The recovery of these bones is potentially beneficial in estimating the sex in forensic cases. Since both bones are not always available for forensic analysis, standards for sex estimation must be established for other bones of the postcranial skeleton. Previous studies have reported that postcranial skeletal elements (e.g. femur) perform like the pelvis and better than the cranium in sex estimation. Thus, this study explored the potential of CT-derived femoral measurements in sex estimation in a South African population. The sample consisted of 280 contemporary Black South Africans (50% sex ratio) whose scan reports are stored in the Radiology Department of Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. The Xiris and IntelliSpace software was used to reconstruct the images into 3D formats from which measurements were taken. Previously derived sex estimation equations of the femur were tested using data from the current study and these equations presented low average classification accuracies. Using discriminant function and logistic regression analyses, new sex estimation equations were formulated, and these new equations yielded average sex estimation classification accuracies of between 82.5 and 91.4% (by multivariable logistic regression) and 79.3–84.3% (by multivariable discriminant function). The results indicate that population-specific femoral measurements obtained by CT are more reliable than those obtained by direct osteometry and that the femur has a high sexual dimorphism with relevant forensic applications. [ABSTRACT FROM AUTHOR]

Early differentiation between causes of secondary postpartum hemorrhage (PPH) can sometimes be difficult and can cause serious complications if diagnosis and treatment are delayed. The study aimed to assess the efficacy of different imaging diagnostic criteria, which would help in differentiating between gestational trophoblastic neoplasia (GTN) from indeterminate benign causes; thus, aiding in making clinical decisions in a timely fashion. A comparative prospective study, were 33 patients complaining of 2ry PPH, with indeterminate diagnosis referred to the Radiology department female imaging unit between October 2020 and November 2022 for further assessment. Transvaginal ultrasound examination as well as functional MRI was done. The lesions were characterized and certain diagnostic criteria were evaluated. The lesion epicenter, margin and depth of myometrial invasion detected by dynamic MRI have significant role to differentiate between GTN and other benign conditions mainly RPOC with higher sensitivity, specificity and accuracy of MRI compared to US. The p value, sensitivity and specificity as well as the accuracy of MRI were: 0.006, 50 %, 92 %, and 81.8 %; 0.000, 87.5 %, 92 % and 90.9 %; 0.002, 87.5 %, 92 % and 90.9 % compared to 0.5, 50 %, 64 % and 60.6 %; 0.01, 87.5 %, 64 % and 69.7 %; 0.2, 87.5 %, 40 % and 51.5 % by US respectively. The overall performance of MRI to reach accurate final diagnosis is higher than the US with accuracy rate of 97 % compared to 63.6 % in indeterminate cases. MRI was found to show higher performance, compared to US in differentiating inconclusive cases of 2ry PPH. • It is difficult to differentiate between RPOC and GTD solely by clinical criteria. • US & MRI picture sometimes overlap in challenging cases of RPOC & GTD. • Different diagnostic criteria were needed to help in differentiating these cases. • New diagnostic imaging approaches were found to shows high accuracy. • MRI found to show more diagnostic accuracy than US in challenging cases. [ABSTRACT FROM AUTHOR]

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This study aimed to evaluate the movement pattern of two different distalization systems during the distalization of the maxillary dentition from the maxillary canine to the second molar tooth and the stresses in the periodontal ligament by anchoring the mandibular dentition using the finite element analysis method. A standard three-dimensional finite element model was created that simulates the mechanics planned to be implemented with maxillary and mandibular teeth, periodontal ligaments, cortical and trabecular bones. Two different distalization mechanics were applied to this model with the Carriere Distalizer appliance (CDA) and the clear splint appliance (CSA), and two scenarios were created. The amount of displacement of the teeth from the maxillary canine to the second molar tooth was calculated, and the von Mises stress distribution in the periodontal ligament of the relevant teeth was visualized with a color scale. The current study found that the distalization movement of the CDA and the CSA after the force applied by anchoring from the mandibular dentition was similar. Although the amount of distalization obtained with the CDA is higher, it is seen that the mass movement is more significant in the CSA. The CDA and CSA showed a similar distalization pattern. The current study findings suggest that the CSA can be added to the Class II distalization treatment options such as the CDA. [ABSTRACT FROM AUTHOR]

The article focuses on a case of a 3-month-old male with bicytopenia, diagnosed with autosomal recessive infantile malignant osteopetrosis after a series of tests. Topics include the diagnostic approach to macrocytic anemia, the role of peripheral blood smears in diagnosis, and treatment options such as hematopoietic stem cell transplantation for osteopetrosis.

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Background: This study compared the ventilatory variables and computed tomography (CT) features of patients with coronavirus disease 2019 (COVID-19) versus those of patients with pulmonary non–COVID-19-related acute respiratory distress syndrome (ARDS) during the early phase of ARDS. Methods: This prospective, observational cohort study of ARDS patients in Taiwan was performed between February 2017 and June 2018 as well as between October 2020 and January 2024. Analysis was performed on clinical characteristics, including consecutive ventilatory variables during the first week after ARDS diagnosis. Analysis was also performed on CT scans obtained within one week after ARDS onset. Results: A total of 222 ARDS patients were divided into a COVID-19 ARDS group (n = 44; 19.8%) and a non–COVID-19 group (all pulmonary origin) (n = 178; 80.2%). No significant difference was observed between the two groups in terms of all-cause hospital mortality (38.6% versus 47.8%, p = 0.277). Pulmonary non–COVID-19 patients presented higher values for mechanical power (MP), MP normalized to predicted body weight (MP/PBW), MP normalized to compliance (MP/compliance), ventilatory ratio (VR), peak inspiratory pressure (Ppeak), and dynamic driving pressure (∆P) as well as lower dynamic compliance from day 1 to day 7 after ARDS onset. In both groups, non-survivors exceeded survivors and presented higher values for MP, MP/PBW, MP/compliance, VR, Ppeak, and dynamic ∆P with lower dynamic compliance from day 1 to day 7 after ARDS onset. The CT severity score for each of the five lung lobes and total CT scores were all significantly higher in the non–COVID-19 group (all p < 0.05). Multivariable logistic regression models revealed that Sequential Organ Failure Assessment (SOFA) score was independently associated with mortality in the COVID-19 group. In the non–COVID-19 group, body mass index, immunocompromised status, SOFA score, MP/PBW and total CT severity scores were independently associated with mortality. Conclusions: In the early course of ARDS, physicians should be aware of the distinctions between COVID-19-related ARDS and non–COVID-19-related ARDS in terms of ventilatory variables and CT imaging presentations. It is also important to tailor the mechanical ventilation settings according to these distinct subsets of ARDS. [ABSTRACT FROM AUTHOR]

Background: Classifying uterine fibroid using the International Federation of Gynecology and Obstetrics (FIGO) classification system assists treatment decision-making and planning. This study aimed to study whether different fibroid locations influence clinical outcomes following uterine artery embolization (UAE). Methods: This is a retrospective cohort study of patients who underwent UAE for symptomatic uterine fibroid between December 2016 and January 2023 at our hospital. Changes in mean fibroid volume were compared based on MR images. Menstrual pain, excessive flow symptoms, and treatment satisfaction before UAE and 6 months after UAE were compared. Results: A total of 149 premenopausal patients (mean age 45.7 ± 2.7 years) were included for analysis (FIGO 2/3, n = 57; FIGO 4–7, n = 92). Baseline menstrual pain, fibroid, and uterine volume before UAE were comparable between the two FIGO groups (p > 0.05). The menstrual flow index was higher for the FIGO 2/3 group (mean ± SD [min–max]: 9.4 ± 1.4 [4–10] vs 8.0 ± 2.3 [0–10], p < 0.001). Six months after UAE, the improvements in menstrual flow index (mean ± SD]: -3.7 ± 2.6 vs -2.6 ± 2.2, p = 0.035), fibroid volume (mean ± SD: -54.7 ± 21.7% vs -39.8 ± 16.2%, p < 0.001), and uterine volume (mean ± SD: -38.2 ± 16.3% vs -31.1 ± 11.6%, p = 0.008) in the FIGO 2/3 group were significantly higher than the FIGO 4–7 group. Both groups had comparable improvements in menstrual pain index (-2.1 ± 2.6 vs -1.8 ± 2.5, p = 0.008) and 88% of the patients were satisfied or very satisfied overall. Conclusion: UAE treatment satisfaction was high for patients with fibroids at different FIGO stages. UAE treatment outcomes were better for patients with fibroids affecting the endometrium (FIGO 2/3). Level of evidence: 3B, Retrospective observational study. [ABSTRACT FROM AUTHOR]

The inferior colliculus is a key nucleus in the central auditory pathway, integrating acoustic stimuli from both cochleae and playing a crucial role in sound localization. It undergoes functional and structural development in childhood and experiences age-related degeneration later in life, contributing to the progression of age-related hearing loss. This study aims at finding out, whether the volume of the human inferior colliculus can be determined by analysis of routinely performed MRIs and whether there is any age-related variation. A further goal is to detect correlations between volume and existing hearing loss of the patients. A retrospective search in the data of the Regensburg ENT department was done. 123 MRI datasets were used to mark the voxels of the inferior colliculus on the MRI layers. The volumes could then be calculated by using the respective DICOM data and were correlated with age, gender and hearing status of the patients. Results suggested that a voxel-based method on routine clinical MRI stacks to determine the volume of the inferior colliculus is possible. The volume shows an age-dependency. There is a growth from infancy until adulthood and a significant decrease in patients over the age of 60 years. Left and right inferior colliculi do not show any systematic asymmetry in volume. There is no difference between females and males. In the group with asymmetric hearing (n = 13) a significant reduction of the volume on the deprived side (p = 0.036) was found. The proportion of subjects with severe hearing loss at least on one side was significantly higher in the old (>60 years) as compared to younger adults (10 to 60 years), suggesting that severe hearing loss may be associated with a reduced volume of the inferior colliculus in aged humans. [ABSTRACT FROM AUTHOR]

Background: Spacer-type tibial osteotomy have been proven a novel and effective osteotomy to treat osteoarthritis, while lack of comparison with other surgical methods in younger patients. This study aims to evaluate the short-term clinical outcomes of spacer-type tibial osteotomy versus open wedge high tibial osteotomy (OWHTO) and unicompartmental knee arthroplasty (UKA) for Kellgren-Lawrence (K-L) grade 3–4 osteoarthritis (OA) in patients younger than 65 years. Methods: This retrospective study analyzed a total of 224 patients with K-L grade 3–4 knee OA treated from March 2018 to November 2020. Three groups were created according to the operation type. The clinical outcomes recorded preoperatively and at 6, 12 and 24 months postoperatively were the range of motion (ROM), visual analogue scale (VAS), American Knee Society Score (KSS), Western Ontario and McMaster Universities Global (WOMAC) score, operation time, length of incision, relevant complications and failures. Radiographic parameters were measured to evaluate the correction of varus deformity. Results: The cohort comprised 224 patients; 70 underwent spacer-type tibial osteotomy, 73 underwent OWHTO, and 81 underwent UKA. The spacer group had the shortest incision (P = 0.000), least amount of bleeding (P = 0.000), and shortest operation time (P = 0.000). UKA achieved the most significant pain relief based on VAS (P = 0.014), KSS pain score (0.030), and WOMAC score (P = 0.000) at 6 months postoperatively, but there were no differences between three groups at 12 and 24 months postoperatively. The spacer and OWHTO groups achieved significantly greater ROM changes compared with the UKA group (all P = 0.000). The complication rate did not significantly differ between the three groups. No surgical failures were identified in HTO but two spacer dislocations in spacer group and three polyethylene dislocations in UKA. Conclusion: For younger patients with K-L grade 3–4 OA, OWHTO seems to be the most appropriate method through clinical comparisons. Although spacer-type tibial osteotomy offers shorter operation time and comparable clinical outcomes, it also has extended recovery phase, additional fibular incision and the risk of spacer dislocation, which did not appear to be superior to OWHTO and UKA under the indications outlined in this study. Trial registration: Retrospectively registered, QYFY WZLL 27,021. [ABSTRACT FROM AUTHOR]

Background: CA19-9 is a classical tumor marker and plays an important role in the diagnosis of biliary and pancreatic cancer. However, a few cases reported that the tumor maker CA19-9 is abnormally elevated in patients with calculous cholecystitis, but the relation between severity of calculous cholecystitis and serum CA19-9 level are still unknown. Methods: Total 105 calculous cholecystitis patients from first hospital were collected and divided into high serum CA19-9 group(high group, n = 35) and normal serum CA19-9 group(normal group, n = 70). Perioperative data including blood cell count, inflammatory markers, liver function, imaging and operation-related parameters from these patients were collected for analysis and verified with second group of 105 calculous cholecystitis patients from second hospital. Besides, the gallbladder specimens were collected for immunohistochemical staining and mRNA sequencing. Results: Abdominal pain occur in more than 90% patients in high group, which is similar with that of normal group. But WBC, neutrophils count, NLR, CRP level and IL-6 level is higher in high group than that of normal group. In addition, the gallbladder wall thickness, the operation duration and the operation conversion rate is also higher in high group, which is verified from second hospital. Higher expression of CA19-9 was found by immunohistochemical staining in gallbladder specimen and more autophagy pathway related genes enriched in high group. Conclusions: This study demonstrated that higher level of serum CA19-9 correlates with more severe cholecystitis in calculous cholecystitis patients for the first time, which will provide helpful information for clinical practice and basic research in related field. [ABSTRACT FROM AUTHOR]

Background: Vast volumes of routinely collected data (RCD) about patients are collated by health professionals. Leveraging this data – a form of real-world data - can be valuable for quality improvement and contributing to the evidence-base to inform practice. Examining routine data may be especially useful for examining issues related to social justice such as health inequities. However, little is known about the extent to which RCD is utilised in health fields and published for wider dissemination. Objectives: The objective of this scoping review is to document the peer-reviewed published research in allied health fields which utilise RCD and evaluate the extent to which these studies have addressed issues pertaining to social justice. Methods: An enhanced version of the Arksey and O'Malley's framework, put forth by Westphalm et al. guided the scoping review. A comprehensive literature search of three databases identified 1584 articles. Application of inclusion and exclusion criteria was piloted on 5% of the papers by three researchers. All titles and abstracts were screened independently by 2 team members, as were full texts. A data charting framework, developed to address the research questions, was piloted by three researchers with data extraction being completed by the lead researcher. A sample of papers were independently charted by a second researcher for reliability checking. Results: One hundred and ninety papers were included in the review. The literature was diverse in terms of the professions that were represented: physiotherapy (33.7%) and psychology/mental health professions (15.8%) predominated. Many studies were first authored by clinicians (44.2%), often with clinical-academic teams. Some (33.25%) directly referenced the use of their studies to examine translation of research to practice. Few studies (14.2%) specifically tackled issues pertaining to social justice, though many collected variables that could have been utilised for this purpose. Conclusion: Studies operationalising RCD can meaningfully address research to practice gaps and provide new evidence about issues related to social justice. However, RCD is underutilised for these purposes. Given that vast volumes of relevant data are routinely collected, more needs to be done to leverage it, which would be supported by greater acknowledgement of the value of RCD studies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the diagnostic value of ColorViz fused images from multi-phase computed tomography angiography (mCTA) using GE Healthcare's FastStroke software for newly diagnosed cerebral infarctions in patients with acute ischemic stroke (AIS). Methods: A total of 106 AIS patients with unilateral anterior circulation occlusion were prospectively enrolled. All patients underwent mCTA scans during the arterial peak phase, venous peak phase, and venous late phase. The vascular information from these mCTA phases was combined into a time-varying color-coded image using GE Healthcare's FastStroke software. All participants also underwent magnetic resonance diffusion-weighted imaging (MR-DWI) within three days. The diagnostic capability of the mCTA ColorViz fusion images for identifying newly diagnosed intracranial infarction was assessed using MR-DWI as the gold standard, focusing on the degree of delayed vascular perfusion and the number of visible blood vessels. Results: The mCTA ColorViz fusion images revealed ischemic changes in brain tissue, demonstrating a sensitivity of 88.7% for superficial infarctions and 48.5% for deep infarctions. Additionally, the subjective vascular grading score of the mCTA ColorViz fusion images showed a strong negative correlation with the infarct area identified by MR-DWI (r = − 0.6, P < 0.001). Conclusion: The mCTA ColorViz fusion images produced by FastStroke software provide valuable diagnostic insights for newly diagnosed cerebral infarction in AIS patients. The sensitivity of these images is notably higher for superficial infarctions compared to deep ones. This technique allows for relatively accurate detection of the ischemic extent and the likelihood of infarction in the superficial regions where lesions are located. [ABSTRACT FROM AUTHOR]

Background: Zygomatic implants are becoming an ideal treatment approach for implant-supported prosthesis treatment developed for the atrophic maxilla. This study aims to evaluate the amount and distribution of stress in implants and peri-implant bone using different implant-supported prosthesis configurations in Aramany Class I maxillary defects through 3-dimensional finite element analysis. Methods: A 3-dimensional finite element model of the Aramany class I defect was created. Three different implant-supported prostheses were modelled: model 1: 1 zygomatic implant and 3 dental implants, model 2: 1 zygomatic implant and 2 dental implants, and model 3: 2 zygomatic implants. Vertical and horizontal loads of 150 N were applied in 6 different ways to the defected and non-defective areas. Maximum principal stress and von mises stresses in the bone surrounding the implants were evaluated. Results: When all loading conditions were evaluated with both porcelain layer on Co-Cr framework and acrylic layer on acrylic framework, the highest maximum principal stress value was observed in Model 3. In contrast, the lowest value was observed in Model 1. The highest maximum principal stress occurred when a horizontal load was applied simultaneously to both the defective and non-defective areas. In contrast, the lowest value was observed when a vertical load was applied to the non-defective area. The von Mises stress values were found to be similar across all models when both restoration materials were used. Conclusions: Based on the results of this study, it can be concluded that increasing the number of implants in the non-defective area reduces the highest stress value while using acrylic as a restoration material slightly increases the stress value. [ABSTRACT FROM AUTHOR]

Background/Objectives: Despite standard preoperative fasting guidelines, residual gastric content can persist in some patients, increasing the risk of aspiration pneumonitis. Multiple patient-specific factors may predict gastric content retention, but their predictive accuracy is limited. We hypothesized that ultrasound would more reliably identify residual gastric content compared to a comprehensive questionnaire and aimed to determine the most practical approach for risk assessment in elective surgical patients. Methods: We conducted a prospective, observational study in adult patients scheduled for elective surgery at a single center. All participants adhered to an 8 h fasting period. The primary outcome was the incidence of a "full stomach" on ultrasound. Secondary outcomes included the Perlas risk classification, comparisons of established volume estimation formulas, correlations with self-reported fasting duration, agreement between questionnaire-based predictions and ultrasound findings, and the time efficiency of each method. Multivariable logistic regression and Cohen's kappa were used for analyses. Results: Data from 404 patients were analyzed. Despite prolonged fasting, 16.3% had a full stomach by ultrasound, suggesting incomplete gastric emptying. Early satiety and cholelithiasis significantly predicted a full stomach; prolonged fasting duration and female sex were protective. Questionnaire-based predictions demonstrated fair agreement with ultrasound (kappa = 0.327). The Michiko formula often yielded negative volumes, highlighting limitations in volume estimations. Ultrasound examination (3 min median) was faster than questionnaire completion (5 min). Conclusions: Ultrasound accurately detects residual gastric content, outperforming questionnaire-based assessments. Integrating it into routine preoperative evaluation may improve patient safety, although research is needed to refine volume estimation formulas and expand feasibility for patients with positioning limitations. [ABSTRACT FROM AUTHOR]

Background/Objectives: Artificial intelligence (AI) is gaining an increasing amount of influence in various fields, including medicine. In radiology, where diagnoses are based on collaboration between diagnostic devices and the professional experience of radiologists, AI intervention seems much easier than in other fields, but this is often not the case. Many times, the patients orient themselves according to the doctor, which is not applicable in the case of AI. Another limitation rests in the controversies regarding medico-legal liability. In the field of radio-imaging in Romania, the implementation of AI systems in diagnosis is at its beginning. An important aspect of this is raising awareness among the population about these assistive AI systems and, also, awareness of the technological evolution of AI among medical staff. This narrative review manuscript analyzes the existing literature data regarding the medico-legal aspects of AI application in radiology, highlighting the controversial aspects and the lack of statutory legislative regulations in Romania. Methods: A detailed search was conducted across three electronic databases including MEDLINE/PubMed, Scopus, and Web of Science, with 53 papers serving as the literature corpus of our review. Results: General requirements for artificial intelligence systems used in radiology have been established. In the radiological diagnostic process, there are five levels of AI system implication. Until now, completely autonomous AI systems have not been used. Regarding liability in the case of malpractice, at the currently accepted legislative level, most of the time, the radiologist is liable for their own fault or non-compliant use of diagnostic AI systems. Controversies arise in the case of radio-imaging diagnosis in which AI systems act autonomously. Conclusions: In order for AI diagnostic radio-imaging systems to be implemented, they must meet certain quality standards and be approved. The radiologist must know these systems, accept them, know their limits, and validate them in accordance with their degree of involvement in radiological diagnosis. Considering the evolution of technology in the Romanian medical system, including radiology, in the future, an alignment with the legal standards established/proposed at the European level is desired. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the impact of various weighting factors (WFs) on the quality of weighted average (WA) dual-energy computed tomography (DECT) non-contrast brain images and to determine the optimal WF value. Because they simulate standard CT images, 0.4-WA reconstructions are routinely used. Methods: In the initial phase of the research, quantitative and qualitative analyses of WA DECT images of an anthropomorphic head phantom, utilizing WFs ranging from 0 to 1 in 0.1 increments, were conducted. Based on the phantom study findings, WFs of 0.4, 0.6, and 0.8 were chosen for patient analyses, which were identically carried out on 85 patients who underwent non-contrast head DECT. Three radiologists performed subjective phantom and patient analyses. Results: Quantitative phantom image analysis revealed the best gray-to-white matter contrast-to-noise ratio (CNR) at the highest WFs and minimal noise artifacts at the lowest WF values. However, the WA reconstructions were deemed non-diagnostic by all three readers. Two readers found 0.6-WA patient reconstructions significantly superior to 0.4-WA images (p < 0.001), while reader 1 found them to be equally good (p = 0.871). All readers agreed that 0.8-WA images exhibited the lowest image quality. Conclusions: In conclusion, 0.6-WA reconstructions demonstrated superior image quality over 0.4-WA and are recommended for routine non-contrast brain DECT. [ABSTRACT FROM AUTHOR]

Pleural thickening can be the result of inflammation or infection but can also have a neoplastic origin. Depending on the clinical context, a pleural lesion or mass is often initially suspected of malignancy. Benign pleural tumors are rare, and their appearance on ultrasound (US) is also described less frequently than pleural metastases or malignancies. There are few descriptions of contrast-enhanced Ultrasound (CEUS) in particular. This review introduces the basics of transthoracic ultrasound (TUS) of the pleura and CEUS of the pleura and lung. CEUS is recommended for pulmonary applications in the EFSUMB guidelines in non-hepatic applications. This article provides an overview of the characteristics of benign pleural thickening, tumor-like lesions, and benign pleural tumors on transthoracic B-mode US with color Doppler imaging (CDI) and CEUS. In detail, characteristics in TUS and CEUS are described for infectious/inflammatory pleural thickening (empyema, tuberculous pleuritis, hemothorax, fibrothorax), pleural thickening in various systemic diseases, in tumor-like conditions (plaques, splenosis, endometriosis, mesothelial cysts, lymphangiomatosis) and benign tumors (lipoma, benign SFT, schwannoma, solitary extramedullary/extraosseous plasmacytoma). The descriptions are illustrated by corresponding US and CEUS images. [ABSTRACT FROM AUTHOR]

Simple Summary: The sublingua is an anatomical structure located under the tongue. In addition, prosimians have modified lower incisors and canines called the "dental comb", and classical authors assign the sublingua the role of a toothbrush. Comparative studies of macro and microanatomy are scarce or incomplete for primates. Thus, the putative function of this unique feature remains unclear. To better understand the functional significance of the sublingua, we studied this structure in Lemur catta and Varecia variegata specimens using histochemical staining techniques together with scanning electron microscopy with microanalysis. The new data obtained provide a fuller picture of the role assigned to sublingua so far in some prosimians, which seems that it could be more complex, in light of the morphological findings, than just dental hygiene. The sublingua is an anatomical structure located under the tongue. This rare organ can be present in some animals as a rudimentary structure, but among prosimian primates, such as lemurs and lorises, it is fully developed. In addition to the sublingua, prosimians have modified lower incisors and canines called "dental comb". The anatomy of sublingua has been studied macro and microanatomically since the early 19th century. Most authors argue that the sublingua is an oral morphological adaptation to develop a toothbrush's role in cleaning the dental comb. However, others assert that the functional role has yet to be established. Comparative studies of macro and microanatomy are scarce or incomplete for primates; thus, the putative function remains unclear. To better understand the functional significance of the sublingua, we studied this structure in Lemur catta and Varecia variegata specimens using histochemical staining techniques and scanning electron microscopy with microanalysis. The new data obtained provide a fuller picture of the role assigned to sublingua so far, which could be more complex. In light of the morphological findings, we should consider additional roles/functions of the sublingua, including but not limited to food processing, grooming or social behavior. [ABSTRACT FROM AUTHOR]

Background: Sturge–Weber Syndrome (SWS) is a rare, sporadic neurocutaneous disorder affecting the skin, brain, and eyes, due to somatic activating mutations in GNAQ or, less commonly, GNA11 gene. It is characterized by at least two of the following features: a facial capillary malformation, leptomeningeal vascular malformation, and ocular involvement. The spectrum of clinical manifestations includes headache, seizures, stroke-like events, intellectual disability, glaucoma, facial asymmetry, gingival hyperplasia, etc. An early diagnosis is crucial to guarantee an appropriate care, which is best performed in reference centres by multidisciplinary teams. The aim of this study was to develop a multidisciplinary expert consensus for diagnosis, treatment, and follow-up of all disease manifestations, according to the recommendations of the Italian Law on Rare Disease Care. Results: Through a Delphi consensus methodology, 28 recommendations have been developed concerning (i) dermatological SWS manifestations and related treatment timing and modalities, (ii) neurological referral, diagnosis, pharmacological treatment of neurological signs and symptoms, neurosurgical indications, neurocognitive evaluation and related treatment, psychosocial support and patient follow-up, (iii) diagnosis of ophthalmological manifestations, medical and surgical treatment, and follow-up, (iv) maxillofacial surgical treatment, (v) oral cavity assessment, care and follow-up, and (vi) primary care paediatrician/general practitioner involvement. Conclusions: The present consensus developed by a multidisciplinary group of experts from Italian reference centres comprises practical recommendations for SWS global management, including currently controversial issues. Specific statements for all disease aspects, from skin manifestations and neurological and ocular signs and symptoms to oral and maxillofacial care, are provided. They can be exploited to uniform clinical practice in reference centres, but also in other hospitals and outpatient settings. Though this consensus has been developed taking primarily into account the Italian National Health System organization and rules on rare disorders, it could be translated also to other countries. [ABSTRACT FROM AUTHOR]