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Purpose: To investigate the effect of training data type on generalizability of deep learning liver segmentation models., Materials and Methods: This Health Insurance Portability and Accountability Act-compliant retrospective study included 860 MRI and CT abdominal scans obtained between February 2013 and March 2018 and 210 volumes from public datasets. Five single-source models were trained on 100 scans each of T1-weighted fat-suppressed portal venous (dynportal), T1-weighted fat-suppressed precontrast (dynpre), proton density opposed-phase (opposed), single-shot fast spin-echo (ssfse), and T1-weighted non-fat-suppressed (t1nfs) sequence types. A sixth multisource (DeepAll) model was trained on 100 scans consisting of 20 randomly selected scans from each of the five source domains. All models were tested against 18 target domains from unseen vendors, MRI types, and modality (CT). The Dice-Sørensen coefficient (DSC) was used to quantify similarity between manual and model segmentations., Results: Single-source model performance did not degrade significantly against unseen vendor data. Models trained on T1-weighted dynamic data generally performed well on other T1-weighted dynamic data (DSC = 0.848 ± 0.183 [SD]). The opposed model generalized moderately well to all unseen MRI types (DSC = 0.703 ± 0.229). The ssfse model failed to generalize well to any other MRI type (DSC = 0.089 ± 0.153). Dynamic and opposed models generalized moderately well to CT data (DSC = 0.744 ± 0.206), whereas other single-source models performed poorly (DSC = 0.181 ± 0.192). The DeepAll model generalized well across vendor, modality, and MRI type and against externally sourced data., Conclusion: Domain shift in liver segmentation appears to be tied to variations in soft-tissue contrast and can be effectively bridged with diversification of soft-tissue representation in training data. Keywords: Convolutional Neural Network (CNN), Deep Learning Algorithms, Machine Learning Algorithms, Supervised Learning, CT, MRI, Liver Segmentation Supplemental material is available for this article . © RSNA, 2023., Competing Interests: Disclosures of conflicts of interest: B.K. No relevant relationships. J.M. No relevant relationships. K.L. No relevant relationships. I.H.Z. No relevant relationships. E.B. No relevant relationships. M.C. No relevant relationships. Y.W. No relevant relationships. G.J. No relevant relationships. W.F.W. NIH 1R01-NS123275-01A1 and The Marcus Foundation (research funding not direct support for this study); consulting fees from Qure.ai; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Stanford AIMI Symposium 2021; participation on a Data Safety Monitoring Board or Advisory Board from University of Wisconsin-GE CT Protocols Partnership. M.R.B. Grants/contracts from Siemens Healthineers, Madrigal Pharmaceuticals, Carmot Therapeutics, Corcept, NGM Biopharmaceuticals, and Metacrine., (© 2023 by the Radiological Society of North America, Inc.)

The aim of this study is to validate a proposed definition of sarcopenia in predicting wait-list mortality. We retrospectively evaluated 355 adults (age ≥18 years) with cirrhosis listed for first-time LT from January 1, 2010, to April 1, 2018 from our center. Demographic, laboratory, and outcome data were collected in conjunction with computed tomography scans performed within 3 months of listing. Using imaging analysis software, the skeletal muscle index (SMI), which is a marker for sarcopenia-related mortality, was calculated. A survival analysis was performed to evaluate the association of the proposed sarcopenia definition of SMI <50 cm 2 /m 2 for men or <39 cm 2 /m 2 for women with wait-list mortality or delisting. Median SMI was 54.1 cm 2 /m 2 (range, 47-60 cm 2 /m 2 ). A total of 61 (17.2%) patients exhibited sarcopenia according to the proposed threshold, and 24.6% (57/232) of men were sarcopenic compared with 3.3% (4/123) of women (P < 0.001). Mean (standard deviation [SD]) SMI was also higher for men (56.6 ± 9.6 cm 2 /m 2 ) than for women (50.7 ± 8.0 cm 2 /m 2 ; P < 0.001). Median follow-up time among patients was 2.1 months (0-12 months), and 30 events were observed (hazard ratio, 0.98; 95% confidence interval, 0.95-1.02; P = 0.41). There was no statistically significant difference in time on the waiting list between patients with and without sarcopenia (P = 0.89) as defined at the threshold. Using the prespecified definitions of sarcopenia based on SMI, there was no statistically significant difference in mortality and delisting from the transplant waiting list between patients with and without sarcopenia in this population. Practice and region-specific patterns for pretransplant selection and median Model for End-Stage Liver Disease at transplant may affect SMI as a predictor of wait-list mortality., (Copyright © 2020 by the American Association for the Study of Liver Diseases.)

Objective: The aim of this study was to compare respiratory-triggered DIfferential Subsampling with Cartesian Ordering (rtDISCO) and breath-held Liver Acquisition with Volume Acquisition (LAVA) image quality., Methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective study, 25 subjects underwent T1 imaging with rtDISCO and LAVA before and after intravenous contrast. Three readers scored individual series and side-by-side comparisons for motion and noise. Eight clinical tasks were qualitatively assessed., Results: As individual series, readers rated rtDISCO images as more degraded by motion on both precontrast (mean rtDISCO score, 2.7; LAVA, 1.6; P < 0.001) and postcontrast images (rtDISCO, 2.4; LAVA, 1.8; P < 0.001). Readers preferred LAVA images based on motion on both precontrast (mean preference, -1.2; P < 0.001) and postcontrast images (mean preference, -0.7; P < 0.001) on side-by-side assessment. There was no preference between sequences for 6 of 8 clinical tasks on postcontrast images., Conclusions: Readers preferred LAVA with respect to motion but not noise; there was no preference in most of the tested clinical tasks.

Purpose: To develop a bipolar multi-echo MRI method for the accurate estimation of the adipose tissue fatty acid composition (FAC) using clinically relevant protocols at clinical field strength., Methods: The proposed technique jointly estimates confounding factors (field map, R 2 * , eddy-current phase) and triglyceride saturation state parameters by fitting multi-echo gradient echo acquisitions to a complex signal model. The noise propagation behavior was improved by applying a low-rank enforcing denoising technique and by addressing eddy-current-induced phase discrepancies analytically. The impact of the total echo train duration on the FAC parameter map accuracy was analyzed in an oil phantom at 3T. Accuracy and reproducibility assessment was based on in vitro oil phantom measurements at two field strengths (3T and 1.5T) and with two different protocols. Repeatability was assessed in vivo in patients (n = 8) with suspected fatty liver disease using test-retest acquisitions in the abdominal subcutaneous, perirenal and mesenteric fat depots., Results: Echo train readout durations of at least five times the conventional in-phase time were required for accurate FAC estimation in areas of high fat content. In vitro, linear regression and Bland-Altman analyses demonstrated strong (r > 0.94) and significant (P ≪ 0.01) correlations between measured and reference FACs for all acquisitions, with smaller overall intercepts and biases at 3T compared to 1.5T. In vivo, reported mean absolute differences between test and retest were 1.54%, 3.31%, and 2.63% for the saturated, mono-unsaturated, and poly-unsaturated fat component, respectively., Conclusions: Accurate and reproducible MRI-based FAC quantification within a breath-hold is possible at clinical field strengths., (© 2018 International Society for Magnetic Resonance in Medicine.)

Purpose: To evaluate factors that may affect successful ultrasound-guided percutaneous thrombin injection of iatrogenic femoral artery pseudoaneurysms (PSA)., Materials and Methods: This was an IRB-approved, HIPAA-compliant retrospective study of 326 consecutive subjects (138 males, 188 females; mean age 68 years, range 18-95) who underwent thrombin injection for treatment of femoral PSA; follow-up ultrasound was available in 145 subjects. The number of PSA lobes and dimensions, pre-procedure laboratory values (international normalized ratio [INR], activated partial thromboplastin time [aPTT], platelet count), and concomitant anticoagulation therapy were recorded., Results: Technical success was achieved in 98.2% (320/326) of subjects. Primary effectiveness (complete thrombosis at 24 h) was achieved in 74.5% (108/145). Twenty-five subjects underwent repeat thrombin injection, successful in 21 subjects, for a total effectiveness rate of 97.0% (129/133). No imaging factor was associated with technique failure, including number of lobes (p = 0.898), largest dimension (p = 0.344), or volume (p = 0.697). No statistically significant difference in pre-procedure INR, aPTT, or platelet count was found between subjects with CT and those with IT (p > 0.138). Anticoagulation therapy was associated with incomplete thrombosis (35.5% [38/107] for CT vs. 63.9% [23/26] for IT; p = 0.002)., Conclusion: Imaging-guided percutaneous thrombin injection has high technical success and effectiveness rates for the treatment of iatrogenic femoral artery PSA. Anticoagulation therapy was the only factor associated with incomplete thrombosis.

Purpose To identify changes in a broad panel of circulating angiogenesis factors after bland transcatheter arterial embolization (TAE), a purely ischemic treatment for hepatocellular carcinoma (HCC). Materials and Methods This prospective HIPAA-compliant study was approved by the institutional review board. Informed written consent was obtained from all participants prior to entry into the study. Twenty-five patients (21 men; mean age, 61 years; range, 30-81 years) with Liver Imaging Reporting and Data System category 5 or biopsy-proven HCC and who were undergoing TAE were enrolled from October 15, 2014, through December 2, 2015. Nineteen plasma angiogenesis factors (angiopoietin 2; hepatocyte growth factor; platelet-derived growth factor AA and BB; placental growth factor; vascular endothelial growth factor A and D; vascular endothelial growth factor receptor 1, 2, and 3; osteopontin; transforming growth factor β1 and β2; thrombospondin 2; intercellular adhesion molecule 1; interleukin 6 [IL-6]; stromal cell-derived factor 1; tissue inhibitor of metalloproteinases 1; and vascular cell adhesion molecule 1 [VCAM-1]) were measured by using enzyme-linked immunosorbent assays at 1 day, 2 weeks, and 5 weeks after TAE and were compared with baseline levels by using paired Wilcoxon tests. Tumor response was assessed according to modified Response Evaluation Criteria in Solid Tumors (mRECIST). Angiogenesis factor levels were compared between responders and nonresponders by mRECIST criteria by using unpaired Wilcoxon tests. Results All procedures were technically successful with no complications. Fourteen angiogenesis factors showed statistically significant changes following TAE, but most changes were transient. IL-6 was upregulated only 1 day after the procedure, but showed the largest increases of any factor. Osteopontin and VCAM-1 demonstrated sustained upregulation at all time points following TAE. At 3-month follow-up imaging, 11 patients had responses to TAE (complete response, n = 6; partial response, n = 5) and 11 patients were nonresponders (stable disease, n = 9; progressive disease, n = 2). In nonresponders, the percent change in IL-6 on the day after TAE (P = .033) and the mean percent change in osteopontin after TAE (P = .024) were significantly greater compared with those of responders. Conclusion Multiple angiogenesis factors demonstrated significant upregulation after TAE. VCAM-1 and osteopontin demonstrated sustained upregulation, whereas the rest were transient. IL-6 and osteopontin correlated significantly with radiologic response after TAE. © RSNA, 2017.

Purpose: To compare early outcomes of skin closure with octyl cyanoacrylate skin adhesive versus subcuticular suture closure., Materials and Methods: Over a 7-month period, 109 subjects (28 men and 81 women; mean age, 58.6 y) scheduled to undergo single-lumen implantable venous port insertion for chemotherapy were randomly assigned to skin closure with either octyl cyanoacrylate skin adhesive or absorbable subcuticular suture after suturing the deep dermal layer. Subjects were followed for episodes of infection or dehiscence within 3 months of port implantation. At 3 months, photographs of the healed incision were obtained and reviewed by a plastic surgeon in a blinded fashion who rated cosmetic scar appearance based on a validated 10-point cosmesis score., Results: Of subjects, 54 were randomly assigned to skin adhesive, and 55 were randomly assigned to subcuticular suture. No subjects had incision dehiscence. Infection rates at 3 months were similar between groups (2.1% vs 4.0%; P = 1.0). The mean cosmesis scores were 4.40 for skin adhesive and 4.46 for subcuticular suture (P = .898). The superficial skin closure time was 8.6 minutes for suture versus 1.4 minutes for skin adhesive (P < .001)., Conclusions: Scar cosmesis and patient outcomes did not significantly vary between skin adhesive versus subcuticular suture, although skin closure time was significantly less with skin adhesive., (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)

Myoma is a nonmalignant neoplasm rarely found in the oral cavity and even more rarely mentioned in the world's dental or surgical literature. Not one case of oral cavity leiomyoma has been reported in Poland. This article describes a case of leiomyoma of the oral cavity in a 51-year-old patient. To remove the tumor, a carbon dioxide laser was used. Because of the method used, perioperative bleeding was avoided, which enabled better visibility of the surgical area and minimized duration of the operation. The postoperative wound did not require sutures, and healing occurred without complications.

Non-Hodgkin lymphomas belong to the neoplasms of lymphoreticular system. They derive form lymphocytes or their precursors, and cells that form as a result of lymphocytes' transformation. In most cases, the extranodular localisation of the neoplasm is alimentary tract, particularly the stomach. Less frequent locations are the ovaries, kidneys, adrenal glands, caecum, anus area, and retroperitoneal space. Also the region of the head and neck, especially the salivary glands, eyeballs, naso-fauces, maxillary sinus, should be considered when talking about extranodular localization. However lymphomas in those regions rarely penetrate the orbital and cranial cavity. In very few cases non-Hodgkin lymphomas locate themselves in the fundus of the oral cavity and lips. The aim of the study is to present a patient with rarely occuring lymphoma of the soft palate. First complaints of pain have been noticed 3 months before the patient arrived in our hospital, and gradually intensified themselves, which caused problems during meals. The patient has lost 5 kg of weight since the beginning of the disease, and suffered from profuse night sweating. In local anaesthesia a biopsy specimen has been taken for histological examination. The result of the examination was: MALT lymphoma, CD20, CD3. The patient was qualified for chemotherapy according to CHOP scheme, in the Chair of Oncology of Medical University in Lodz. Next, the patient has been transferred to the Department of the Radiotherapy. The patient completed the treatment in good condition.

Introduction: The article describes rarely occurring fibrolipomas, which belong to the group of bening tumors. They are more frequent in males than in females, built mostly of fibrous connective tissue. Their surface is shiny, pink and plain. They are well separated from the surrounding tissues. The treatment of fibrolipomas is only surgical. Because there are few cases found in reference material, it seems right to present this problem here., Material and Methods: 6 patients were treated in the Oral Surgery Department of Medical University, between 1995-2004, because of the fibrolipomas. One of the six tumors was located on the upper lip, the remaining ones on the right or left buccal mucosa. All tumors occured in males, 60 years of age or above. The interwiev revealed that the tumor had begun growing 5-8 years before and their growth was painless. Medical history was irrelevant. Intra-oral examination revealed oval tumors of different size, on a wide base, ranging from a walnut to a mandarin. One of the six tumors (7,5 x 6,5 x 6 cm) protryded even when the mouth was shut. The surface of the tumors was plain, shiny and pink. They were easily movable against the seat, soft and painless. Performed morphology tests were normal. Because of clinical suspicion of fibrolipomas, there was no earlier histopathological verification, and the patients were qualified for surgical treatment. In local anaesthesia with 2% Lignocaine, the tumors were excised with the margin of surrounding tissue. Postoperative wounds were sutured in layers. The material was then sent to histopathological examination., Results: Received results of histological examination confirmed the preliminary diagnosis of fibrolipoma. In the course of treatment attention was paid on the symptoms of pain, oedema of the operated region and the healing of postoperative wounds. In the group of six patients, only in one case (where the tumor was located on the upper lip), oedema and pain complaints of the operated region were observed up to 2 days after the surgery. In the other patients the postoperative course was uneventful. The follow-up examination performed after 5 months and 4 years did not reveal any recurrences., Conclusions: Fibrolipomas occur usually in adults and are extremely rare in children. The asymptomatic course, allows them to grow for many years. In most cases, it is the cosmetic background that prompt the patients to seek dental assistance. Longterm interview and the clinical assessment of the tumor are the basis for the preliminary diagnosis. Nevertheless the final diagnosis must always be confirmed by histological examination.

Objective: To evaluate application of laser biostimulation in the treatment of antro-oral communications., Background Data: Sixty-one patients between the ages of 14 and 58 were subjected to biostimulation with laser light. Therapy was performed with a CTL 1106 biostimulative laser of 30 mW power with a tip-emitting light of 830-nm wavelength., Methods: Three cycles of laser irradiation were performed in a continuous mode. During one cycle, 3.5 min of extraoral irradiation of 4J with the contact "sweeping" method or the "woodpecker technique" was made through the facial skin to the suborbital region, 3.5 min of intraoral irradiation of 4J with the contact "point" method to the region of maxillary sinus floor, and 3.5 min of intraoral one of 4J with the contact "point" method to the alveolar process at the site of the antro-oral communication. The above cycle of irradiation was repeated for 4 days., Results: After 4 days of laser therapy, a complete closure of antro-oral communication occurred., Conclusion: Laser therapy can be recommended as an effective method of treatment in this type of complication following tooth extraction.

Fifty patients admitted to the clinic because of dental surgery were subjected to biostimulative laser therapy. Ophthalmological examinations were performed in each patient prior and after laserotherapy. The results were estimated according to the occurrence of lacrimation, redness of the conjunctiva, photophobia and the changed retinal reflex to the light. No pathological changes were revealed in the treated patients who had used protective glasses during the laserotherapy.

Vibrissa follicles were cauterized in late fetal or newborn rats to determine whether the relationships between brainstem and cortical changes observed after neonatal peripheral damage would also be obtained when vibrissa follicles were cauterized earlier in development. Vibrissa follicles were cauterized between embryonic day 15 (E-15) and the day of birth (P-0). The vibrissa-related representation in the brainstem was examined with cytochrome oxidase histochemistry, and that in the cortex was evaluated with either serotonin immunocytochemistry or anterograde labeling with Di-I when animals reached 6-8 days of age. There was a significant relationship between the ages at which lesions were carried out and the extent to which the representations of undamaged vibrissa follicles were altered in the brainstem and cortex. Peripheral lesions carried out between E-15 and E-18 resulted in significant increases in the cross-sectional areas of the patches corresponding to the undamaged vibrissa follicles in both the brainstem and cortex. Lesions at later ages resulted in significant increases only in the cortex. In some animals that sustained peripheral damage on E-20 and all of those that received lesions on P-0, there were aggregates of labeling in cortex that had no counterpart in the brainstem. Prenatal, but not postnatal, vibrissa follicle damage also reduced the overall dimensions of the cortical region devoted to the representation of these receptor organelles. Finally, there was a strong negative correlation between the magnitude of peripheral lesions (i.e., the number of vibrissa follicles ablated) and the extent of the reorganization in the brainstem and cortex.