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Malignant pleural effusion (MPE) is a manifestation of advanced cancer that requires a prompt and accurate diagnosis. Ultrasonography (US) and computed tomography (CT) are valuable imaging techniques for evaluating pleural effusions; however, their relative predictive ability for a malignant origin remains debatable. This prospective study aimed to compare chest US with CT findings as predictors of malignancy in patients with undiagnosed exudative pleural effusion. Fifty-four adults with undiagnosed exudative pleural effusions underwent comprehensive clinical evaluation including chest US, CT, and histopathologic biopsy. Blinded radiologists evaluated the US and CT images for features suggestive of malignancy, based on predefined criteria. Diagnostic performance measures were calculated using histopathology as a reference standard. Of the 54 patients, 33 (61.1%) had MPEs confirmed on biopsy. No significant differences between US and CT were found in detecting parietal pleural abnormalities, lung lesions, chest wall invasion, or liver metastasis. US outperformed CT in identifying diaphragmatic pleural thickening ≥10 mm (33.3% vs. 6.1%, p < 0.001) and nodularity (45.5% vs. 3%, p < 0.001), whereas CT was superior for mediastinal thickening (48.5% vs. 15.2%, p = 0.002). For diagnosing MPE, diaphragmatic nodularity detected by US had 45.5% sensitivity and 100% specificity, whereas CT mediastinal thickening had 48.5% sensitivity and 90.5% specificity. Both US and CT demonstrate reasonable diagnostic performance for detecting MPE, with particular imaging findings favoring a malignant origin. US may be advantageous for evaluating diaphragmatic pleural involvement, whereas CT is more sensitive to mediastinal abnormalities. [ABSTRACT FROM AUTHOR]

Purpose: Carpal tunnel syndrome (CTS) is a common condition characterized by compression of the median nerve (MN) within the carpal tunnel. Accurate diagnosis and assessment of CTS severity are crucial for appropriate management decisions. This study aimed to investigate the combined diagnostic utility of B-mode ultrasound (US) and shear wave elastography (SWE) for assessing the severity of CTS in comparison to electrodiagnostic tests (EDT). Materials and Methods: This prospective observational study was conducted over 9-month periods at a tertiary care hospital. A total of 48 patients (36 females, 12 males; mean age 44 ± 10.9 years; age range 28– 57 years) with clinically suspected CTS were enrolled. All patients underwent EDT, US, and SWE. Based on the EDT results, CTS cases were categorized into four groups: mild, moderate, severe, and negative. The cross-sectional area (CSA) and elasticity (E) of the MN were measured at the tunnel inlet (CSAu and Eu) and pronator quadratus region (CSAo and Eo). The differences (CSAu-CSAo and Eu-Eo) were calculated. The primary outcomes were the diagnostic performance of CSAu, CSAu-CSAo, Eu, and Eu-Eo in differentiating moderate/severe from mild/negative CTS compared to EDT findings. Secondary outcomes included a correlation of US/SWE parameters with EDT grades and between each other. ANOVA, correlation, regression, and receiver operating characteristic (ROC) curve analyses were performed. Results: CSAu and CSAu–CSAo increased progressively with worsening CTS severity. E measurements were significantly higher in moderate-to-severe CTS compared to mild or negative cases. The combined metric of CSAu-CSAo at a 5 mm threshold exhibited enhanced performance, with a higher sensitivity (83.3%), specificity (100%), and area under the curve (AUC) (0.98), surpassing the results of CSAu when used independently. Similarly, the SWE measurements indicated that Eu-Eo at a 56.1kPa cutoff achieved an AUC of 0.95, with a sensitivity of 93.3% and specificity of 94.4%, outperforming the metrics for Eu when used alone, which had an AUC of 0.93, with identical sensitivity and specificity values (93.3% and 94.4%, respectively). Conclusion: The integration of ultrasound, shear wave elastography, and electrodiagnostic tests provides a comprehensive approach to evaluate anatomical and neurological changes and guide management decisions for CTS. [ABSTRACT FROM AUTHOR]

Background: There is limited data in the literature regarding the role of nonarthrographic MRI for detecting biceps pulley (BP) lesions. Purpose: To assess the accuracy of nonarthrographic MRI for detecting BP lesions, and to evaluate the diagnostic value of various MRI signs (superior glenohumeral ligament discontinuity/nonvisibility, long head of biceps (LHB) displacement sign or subluxation/dislocation, LHB tendinopathy, and supraspinatus and subscapularis tendon lesions) in detecting such lesions. Study Type: Retrospective. Population: 84 patients (32 in BP‐lesion group and 52 in BP‐intact group‐as confirmed by arthroscopy). Field Strength/Sequence: 1.5‐T, T1‐weighted turbo spin echo (TSE), T2‐weighted TSE, and proton density‐weighted TSE spectral attenuated inversion recovery (SPAIR) sequences. Assessment: Three radiologists independently reviewed all MRI data for the presence of BP lesions and various MRI signs. The MRI signs and final MRI diagnoses were tested for accuracy regarding detecting BP lesions using arthroscopy results as the reference standard. Furthermore, the inter‐reader agreement (IRA) between radiologists was determined. Statistical Tests: Student's t‐tests, Chi‐squared, and Fisher's exact tests, and 4‐fold table test were used. The IRA was calculated using Kappa statistics. A P‐value <0.05 was considered statistically significant. Results: The sensitivity, specificity, and accuracy of nonarthrographic MRI for detecting BP lesions were 65.6%–78.1%, 90.4%–92.3%, and 81%–86.9%, respectively. The highest accuracy was noticed for the LHB displacement sign (84.5%–86.9%), and the highest sensitivity was registered for the LHB tendinopathy sign (87.5%). Furthermore, the highest specificity was observed for the LHB displacement sign and LHB subluxation/dislocation sign (98.1%–100%). The IRA regarding final MRI diagnosis and MRI signs of BP lesions was good to very good (κ = 0.76–0.98). Data Conclusion: Nonarthrographic shoulder MRI may show good diagnostic accuracy for detecting BP lesions. The LHB displacement sign could serve as the most accurate and specific sign for diagnosis of BP lesions. Level of Evidence: 3 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Understanding the consistency of pituitary macroadenomas is crucial for neurosurgeons planning surgery. This retrospective study aimed to evaluate the utility of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) as non-invasive imaging modalities for predicting the consistency of pituitary macroadenomas. This could contribute to appropriate surgical planning and therefore reduce the likelihood of incomplete resections. The study included 45 patients with pathologically confirmed pituitary macroadenomas. Conventional MRI sequences, DWIs, ADC maps, and pre- and post-contrast MRIs were performed. Two neuroradiologists assessed all of the images. Neurosurgeons assessed the consistency of the tumor macroscopically, and histopathologists examined it microscopically. The MRI findings were compared with postoperative data. According to the operative data, macroadenomas were divided into the two following categories based on their consistency: aspirable (n = 27) and non-aspirable tumors (n = 18). A statistically significant difference in DWI findings was found when comparing macroadenomas of different consistencies (p < 0.001). Most aspirable macroadenomas (66.7%) were hyperintense according to DWI and hypointense on ADC maps, whereas most non-aspirable macroadenomas (83.3%) were hypointense for DWI and hyperintense on ADC maps. At a cut-off value of 0.63 × 10−3 mm2/s, the ADC showed a sensitivity of 85.7% and a specificity of 75% for the detection of non-aspirable macroadenomas (AUC, 0.946). The study concluded that DWI should be routinely performed in conjunction with ADC measurements in the preoperative evaluation of pituitary macroadenomas. This approach may aid in surgical planning, ensure that appropriate techniques are utilized, and reduce the risk of incomplete resection. [ABSTRACT FROM AUTHOR]

There has been a notable increase in rhino-orbito-cerebral mucormycosis (ROCM) post-coronavirus disease 2019 (COVID-19), which is an invasive fungal infection with a fatal outcome. Magnetic resonance imaging (MRI) is a valuable tool for early diagnosis of ROCM and assists in the proper management of these cases. This study aimed to describe the characteristic MRI findings of ROCM in post-COVID-19 patients to help in the early diagnosis and management of these patients. This retrospective descriptive study was conducted at a single hospital and included 52 patients with COVID-19 and a histopathologically proven ROCM infection who were referred for an MRI of the paranasal sinuses (PNS) due to sino-orbital manifestations. Two radiologists reviewed all the MR images in consensus. The diagnosis was confirmed by histopathological examination. The maxillary sinus was the most commonly affected PNS (96.2%). In most patients (57.7%), multiple sinuses were involved with the black turbinate sign on postcontrast images. Extrasinus was evident in 43 patients with orbital involvement. The pterygopalatine fossa was involved in four patients. Three patients had cavernous sinus extension, two had pachymeningeal enhancement, and one had epidural collection. The alveolar margin was affected in two patients, and five patients had an extension to the cheek. The awareness of radiologists by the characteristic MRI features of ROCM in post-COVID-19 patients helps in early detection, early proper management, and prevention of morbid complications. [ABSTRACT FROM AUTHOR]

The numbers of cases and deaths due to the COVID-19 virus have increased daily all around the world. Chest X-ray is considered very useful and less time-consuming for monitoring COVID disease. No doubt, X-ray is considered as a quick screening method, but due to variations in features of images which are of X-rays category with Corona confirmed cases, the domain expert is needed. To address this issue, we proposed to utilize deep learning approaches. In this study, the dataset of COVID-19, lung opacity, viral pneumonia, and lastly healthy patients’ images of category X-rays are utilized to evaluate the performance of the Swin transformer for predicting the COVID-19 patients efficiently. The performance of the Swin transformer is compared with the other seven deep learning models, including ResNet50, DenseNet121, InceptionV3, EfficientNetB2, VGG19, ViT, CaIT, Swim transformer provides 98% recall and 96% accuracy on corona affected images of the X-ray category. The proposed approach is also compared with state-of-the-art techniques for COVID-19 diagnosis, and proposed technique is found better in terms of accuracy. Our system could support clinicians in screening patients for COVID-19, thus facilitating instantaneous treatment for better effects on the health of COVID-19 patients. Also, this paper can contribute to saving humanity from the adverse effects of trials that the Corona virus might bring by performing an accurate diagnosis over Corona-affected patients. [ABSTRACT FROM AUTHOR]

Since reporting cases of breast cancer are on the rise all over the world. Especially in regions such as Pakistan, Saudi Arabia, and the United States. Efficient methods for the early detection and diagnosis of breast cancer are needed. The usual diagnosis procedures followed by physicians has been updated with modern diagnostic approaches that include computer-aided support for better accuracy. Machine learning based practices has increased the accuracy and efficiency of medical diagnosis, which has helped save lives of many patients. There is much research in the field of medical imaging diagnostics that can be applied to the variety of data such as magnetic resonance images (MRIs), mammograms, X-rays, ultrasounds, and histopathological images, but magnetic resonance (MR) and mammogram imaging have proved to present the promising results. The proposed paper has presented the results of classification algorithms over Breast Cancer (BC) mammograms from a novel dataset taken from hospitals in the Qassim health cluster of Saudi Arabia. This paper has developed a novel approach called the novel spectral extraction algorithm (NSEA) that uses feature extraction and fusion by using local binary pattern (LBP) and bilateral algorithms, as well as a support vector machine (SVM) as a classifier. The NSEA with the SVM classifier demonstrated a promising accuracy of 94% and an elapsed time of 0.68 milliseconds, which were significantly better results than those of comparative experiments from classifiers named Naïve Bayes, logistic regression, K-Nearest Neighbor (KNN), Gaussian Discriminant Analysis (GDA), AdaBoost and Extreme Learning Machine (ELM). ELM produced the comparative accuracy of 94% however has a lower elapsed time of 1.35 as compared to SVM. Adaboost has produced a fairly well accuracy of 82%, KNN has a low accuracy of 66%. However Logistic Regression, GDA and Naïve Bayes have produced the lowest accuracies of 47%, 43% and 42%. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) is the most common cause of women's deaths worldwide. The mammography technique is the most important modality for the detection of BC. To detect abnormalities in mammographic images, the Breast Imaging Reporting and Data System (BI-RADs) is used as a baseline. The correct allocation of BI-RADs categories for mammographic images is always an interesting task, even for specialists. In this work, to detect and classify the mammogram images in BI-RADs, a novel hybrid model is presented using a convolutional neural network (CNN) with the integration of a support vector machine (SVM). The dataset used in this research was collected from different hospitals in the Qassim health cluster of Saudi Arabia. The collection of all categories of BI-RADs is one of the major contributions of this paper. Another significant contribution is the development of a hybrid approach through the integration of CNN and SVM. The proposed hybrid approach uses three CNN models to obtain ensemble CNN model results. This ensemble model saves the values to integrate them with SVM. The proposed system achieved a classification accuracy, sensitivity, specificity, precision, and F1-score of 93.6%, 94.8%, 96.9%, 96.6%, and 95.7%, respectively. The proposed model achieved better performance compared to previously available methods. [ABSTRACT FROM AUTHOR]

This paper proposes a fused methodology based upon convolutional neural networks and a shallow classifier to diagnose and differentiate breast cancer between malignant lesions and benign lesions. First, various pre-trained convolutional neural networks are used to calculate the features of breast ultrasonography (BU) images. Then, the computed features are used to train the different shallow classifiers like the tree, naïve Bayes, support vector machine (SVM), k-nearest neighbors, ensemble, and neural network. After extensive training and testing, the DenseNet-201, MobileNet-v2, and ResNet-101 trained SVM show high accuracy. Furthermore, the best BU features are merged to increase the classification accuracy at the cost of high computational time. Finally, the feature dimension reduction ReliefF algorithm is applied to address the computational complexity issue. An online publicly available dataset of 780 BU images is utilized to validate the proposed approach. The dataset was further divided into 80 and 20 percent ratios for training and testing the models. After extensive testing and comprehensive analysis, it is found that the DenseNet-201 and Mobile-Net-v2 trained SVM has an accuracy of 90.39% and 94.57% for the original and augmented BU images online dataset, respectively. This study concluded that the proposed framework is efficient and can easily be implemented to help and reduce the workload of radiologists/doctors to diagnose breast cancer in female patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the medical students' performance with and perception towards different multimedia medical imaging tools., Methods: The cross-sectional study was conducted at the College of Medicine, Qassim University, Saudi Arabia, from 2019 to 2020, and comprised third year undergraduate medical students during the academic year 2019-2020. The students were divided into tow groups. Those receiving multimedia-enhanced problem-based learning sessions were in intervention group A, while those receiving traditional problem-based learning sessions were in control group B. Scores of the students in the formative assessment at the end of the sessions were compared between the groups. Students' satisfaction survey was also conducted online and analysed. Data was analysed using SPSS 21., Results: Of the 130 medical students, 75(57.7%) were males and 55(42.3%) were females. A significant increase in the mean scores was observed for both male and female students in group A compared to those in group B (p<0.05). The perception survey was filled up by 100(77%) students, and open-ended comments were obtained from 88(88%) of them. Overall, 69(74%) subjects expressed satisfaction with the multimedia-enhanced problem-based learning sessions., Conclusions: Radiological and pathological images enhanced the students' understanding, interaction and critical thinking during problem-based learning sessions.