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This article compares the use of multidetector computed tomography (MDCT) arthrography and computed tomography (CT)-like magnetic resonance imaging (MRI) arthrography for evaluating shoulder instability. The study found that both imaging techniques provide similar information for surgical planning, with strong positive correlations in measurements. MRI was found to be better at accurately depicting labrum lesions, while cartilage lesions were infrequent in the study. Overall, the results suggest that MRI measures, especially with CT-like sequences, are comparable to CT measures for assessing shoulder instability. [Extracted from the article]

Lumbar back pain is one of the main causes of disability around the world. Most patients will complain of back pain at least once in their lifetime. The degenerative spine is considered the main cause and is extremely common in the elderly population. Consequently, treatment-related costs are a major burden to the healthcare system in developed and undeveloped countries. After the failure of conservative treatments or to avoid daily chronic drug intake, invasive treatments should be suggested. In a world where many patients reject surgery and prefer minimally invasive procedures, interventional radiology is pivotal in pain management and could represent a bridge between medical therapy and surgical treatment. We herein report the different image-guided procedures that can be used to manage degenerative spine-related low back pain. Particularly, we will focus on indications, different techniques, and treatment outcomes reported in the literature. This literature review focuses on the different minimally invasive percutaneous treatments currently available, underlining the central role of radiologists having the capability to use high-end imaging technology for diagnosis and subsequent treatment, allowing a global approach, reducing unnecessary surgeries and prolonged pain-reliever drug intake with their consequent related complications, improving patients' quality of life, and reducing the economic burden. [ABSTRACT FROM AUTHOR]

Objectives: Metal artifacts remain a challenge in computed tomography. We investigated the potential of photon-counting computed tomography (PCD-CT) for metal artifact reduction using an iterative metal artifact reduction (iMAR) algorithm alone and in combination with high keV monoenergetic images (140 keV) in patients with dental hardware. Material and methods: Consecutive patients with dental implants were prospectively included in this study and received PCD-CT imaging of the craniofacial area. Four series were reconstructed (standard [PCD-CTstd], monoenergetic at 140 keV [PCD-CT140keV], iMAR corrected [PCD-CTiMAR], combination of iMAR and 140 keV monoenergetic [PCD-CTiMAR+140keV]). All reconstructions were assessed qualitatively by four radiologists (independent and blinded reading on a 5-point Likert scale [5 = excellent; no artifact]) regarding overall image quality, artifact severity, and delineation of adjacent and distant anatomy. To assess signal homogeneity and evaluate the magnitude of artifact reduction, we performed quantitative measures of coefficient of variation (CV) and a region of interest (ROI)–based relative change in artifact reduction [PCD-CT/PCD-CTstd]. Results: We enrolled 48 patients (mean age 66.5 ± 11.2 years, 50% (n = 24) males; mean BMI 25.2 ± 4.7 kg/m2; mean CTDIvol 6.2 ± 6 mGy). We found improved overall image quality, reduced artifacts and superior delineation of both adjacent and distant anatomy for the iMAR vs. non-iMAR reconstructions (all p < 0.001). No significant effect of the different artifact reduction approaches on CV was observed (p = 0.42). The ROI-based analysis indicated the most effective artifact reduction for the iMAR reconstructions, which was significantly higher compared to PCD-CT140keV (p < 0.001). Conclusion: PCD-CT offers highly effective approaches for metal artifact reduction with the potential to overcome current diagnostic challenges in patients with dental implants. Clinical relevance statement: Metallic artifacts pose a significant challenge in CT imaging, potentially leading to missed findings. Our study shows that PCD-CT with iMAR post-processing reduces artifacts, improves image quality, and can possibly reveal pathologies previously obscured by artifacts, without additional dose application. Key Points: • Photon-counting detector CT (PCD-CT) offers highly effective approaches for metal artifact reduction in patients with dental fillings/implants. • Iterative metal artifact reduction (iMAR) is superior to high keV monoenergetic reconstructions at 140 keV for artifact reduction and provides higher image quality. • Signal homogeneity of the reconstructed images is not affected by the different artifact reduction techniques. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the feasibility and limitations of deep learning–based coronary calcium scoring using positron emission tomography-computed tomography (PET-CT) in comparison with coronary calcium scoring using ECG-gated non-contrast-enhanced cardiac computed tomography (CaCT). Materials and methods: A total of 215 individuals who underwent both CaCT and PET-CT were enrolled in this retrospective study. The Agatston method was used to calculate the coronary artery calcium scores (CACS) from CaCT, PET-CT(reader), and PET-CT(AI) to analyse the effect of using different modalities and AI-based software on CACS measurement. The total CACS and CACS classified according to the CAC-DRS guidelines were compared between the three sets of CACS. The differences, correlation coefficients, intraclass coefficients (ICC), and concordance rates were analysed. Statistical significance was set at p < 0.05. Results: The correlation coefficient of the total CACS from CaCT and PET-CT(reader) was 0.837, PET-CT(reader) and PET-CT(AI) was 0.894, and CaCT and PET-CT(AI) was 0.768. The ICC of CACS from CaCT and PET-CT(reader) was 0.911, PET-CT(reader) and PET-CT(AI) was 0.958, and CaCT and PET-CT(AI) was 0.842. The concordance rate between CaCT and PET-CT(AI) was 73.8%, with a false-negative rate of 37.3% and a false-positive rate of 4.4%. Age and male sex were associated with an increased misclassification rate. Conclusions: Artificial intelligence–assisted CACS measurements in PET-CT showed comparable results to CACS in coronary calcium CT. However, the relatively high false-negative results and tendency to underestimate should be of concern. Clinical relevance statement: Application of automated calcium scoring to PET-CT studies could potentially select patients at high risk of coronary artery disease from among cancer patients known to be susceptible to coronary artery disease and undergoing routine PET-CT scans. Key Points: • Cancer patients are susceptible to coronary disease, and PET-CT could be potentially used to calculate coronary artery calcium score (CACS). • Calcium scoring using artificial intelligence in PET-CT automatically provides CACS with high ICC to CACS in coronary calcium CT. • However, underestimation and false negatives of CACS calculation in PET-CT should be considered. [ABSTRACT FROM AUTHOR]

Objectives: Repetitive unbalances and tensions generated by inspiratory efforts against an obstructive upper airway during sleep predispose the development of expiratory central airway collapse. In addition, structures of the upper airway between men and women have differences and could be the reasons for differences in obstructive sleep apnea (OSA) prevalence between genders. The present study aimed to evaluate the association between parameters of expiratory dynamic tracheal collapse measured using chest multidetector CT and objectively measured OSA severity between men and women. Materials and methods: A total of 901 participants who underwent chest CT and overnight in-home polysomnography from the Korean Genome and Epidemiology Study were cross-sectionally analyzed (women: 46.2%). The participants were divided into three groups based on OSA severity by apnea–hypopnea index (AHI). Multivariate linear regression analysis was performed to determine the effects of central airway collapse after adjustment for cardiovascular-related covariates. Results: In a multivariate analysis, percentages of expiratory lumen structure reductions involving area, diameter, and perimeter were associated with AHI (all p values < 0.05) and with OSA severity (moderate-to-severe OSA than no OSA: β = 3.30%, p = 0.03; β = 2.05%, p = 0.02; β = 1.97%, p = 0.02, respectively) in women, whereas men had only a greater percentage of expiratory wall thickness reduction in moderate-to-severe OSA than no OSA (β = 0.72%, p = 0.003). In addition, women with both mild OSA and moderate-to-severe OSA had higher expiratory tracheal collapse than men without OSA, and a moderate effect of sex was observed (p for interaction = 0.007). Conclusion: The expiratory dynamic tracheal collapse was independently associated with severity of OSA in women than in men. Clinical relevance statement: Differences of pharyngeal structures and inherent features of airways by genders may affect the dissimilarities in vulnerability to sleep apnea between men and women. Key Points: • The expiratory dynamic tracheal collapse was independently associated with severity of OSA in women than in men. • Women with over mild OSA had higher expiratory tracheal collapse than men without OSA, and moderate effect of sex was observed. • Structural differences of airway may affect differences in susceptibility of sleep apnea between genders. [ABSTRACT FROM AUTHOR]

The first-choice imaging test for visualization of thromboemboli in the pulmonary vasculature in patients with suspected acute pulmonary embolism (PE) is multidetector computed tomography pulmonary angiography (CTPA) – a readily available and widely used imaging technique. Through technological advancements over the past years, alternative imaging techniques for the diagnosis of PE have become available, whilst others are still under investigation. In particular, the evolution of artificial intelligence (AI) is expected to enable further innovation in diagnostic management of PE. In this narrative review, current CTPA techniques and the emerging technology photon-counting CT (PCCT), as well as other modern imaging techniques of acute PE are discussed, including CTPA with iodine maps based on subtraction or dual-energy acquisition, single-photon emission CT (SPECT), magnetic resonance angiography (MRA), and magnetic resonance direct thrombus imaging (MRDTI). Furthermore, potential applications of AI are discussed. • Multidetector CTPA is widely used in patients with suspected pulmonary embolism (PE). • Over the years, alternative imaging techniques for PE diagnosis have become available. • This review describes current and emerging imaging techniques for acute PE. • Artificial intelligence is expected to enable further innovation in imaging of PE. [ABSTRACT FROM AUTHOR]

This document contains abstracts from the Annual Meeting of the German Society of Skeletal Radiology (DGMSR) in 2024. The abstracts cover a range of topics in radiology research. One study compared routine CT scans with dedicated quantitative CT scans for assessing osteoporosis and fracture risk, finding that routine CT performed as well as QCT. Another study evaluated a deep learning-based FLAIR sequence for diagnosing inflammatory knee synovitis and found it to be equivalent to contrast-enhanced T1-weighted imaging. A third study explored the use of deep learning-based image reconstruction in accelerated turbo-spin-echo MRI of the knee at 7 Tesla, which improved image quality and reduced acquisition time. The fourth study investigated data augmentation strategies to improve AI models in analyzing torsional alignment. The final abstract examined the frequency of combined femoral and tibial torsional malalignment in symptomatic patients with patellar instability. Other studies in the document covered topics such as deltoid muscle fatty infiltration and shoulder function after reverse shoulder arthroplasty, diagnostic efficacy of MRI and low-dose CT in axial spondyloarthritis, and combining compressed sensing and deep learning for accelerated 3D-MRI sequences of the knee. Additionally, there were studies on quantifying tendon degeneration, radiopalmar ganglion cysts, and a versatile turbo spin echo platform for MRI of the knee joint. [Extracted from the article]

In the multi-target scenarios, we consider the problem of constant false alarm rate (CFAR) target detection. For the conventional CFAR algorithms, the multi-target detection performance is mainly limited by the interference target tolerance within the reference window. In this paper, we propose a local ordered statistic CFAR (OS-CFAR) target detector based on compressed sensing (CS) radar system to address the degradation of detection performance in multi-target scenarios. With the analog-information-converter (AIC), the radar intermediate frequency (IF) signal is compressively sampled into discrete linear measurements. At each detection stage, multiple signal components are generated by correlation tests between the sensing matrix and linear measurements. By support set merge and proxy pruning, the signal components with the largest energy are retained. These components are the echoes reflected from the targets. Since target components are output in decreasing order of correlation, the proposed detector only requires a local OS-CFAR decision in the interval where the least correlated target is located, rather than traversing the entire interval. By continuously updating the detection stage, all targets that satisfy the false alarm rate requirement can be screened out. Finally, the performance of the proposed detector in the multi-target scenarios is confirmed by simulation results. [ABSTRACT FROM AUTHOR]

Background: Benign nerve sheath tumors presenting as solitary retroperitoneal masses (RBNSTs) pose a complex diagnostic challenge for multidisciplinary teams regarding differential diagnosis, staging, and treatment planning. This article reviews the role played by different imaging techniques in assessing RBNSTs and elucidates their typical pathological features with a particular emphasis on the correlation between imaging and histological findings. Furthermore, some examples of retroperitoneal tumors that merit consideration in the process of differential diagnosis based on cross-sectional investigations (CSIs) are reported. The correlation between tissue architecture and appearance on imaging can help increase the accuracy of differential diagnosis with other retroperitoneal neoplasms at CSIs. Critical relevance statement: This educational review critically examines the correlation between imaging and histological features in solitary retroperitoneal benign nerve sheath tumors, offering valuable insights for improving the accuracy of differential diagnosis in clinical radiology. Key Points: RBNSTs are challenging to diagnose because they lack specific radiological features. Differential diagnosis of RBNSTs from other retroperitoneal neoplasms on imaging is complex. Surgical removal of RBNSTs is recommended for an accurate diagnosis. [ABSTRACT FROM AUTHOR]

Purpose The present study aimed to investigate the frequency and extent of compensatory common bile duct (CBD) dilatation after cholecystectomy, assess the time between cholecystectomy and CBD dilatation, and identify potentially useful CT findings suggestive of obstructive CBD dilatation. Materials and Methods This retrospective study included 121 patients without biliary obstruction who underwent multiple CT scans before and after cholecystectomy at a single center between 2009 and 2011. The maximum short-axis diameters of the CBD and intrahepatic duct (IHD) were measured on each CT scan. In addition, the clinical and CT findings of 11 patients who were initially excluded from the study because of CBD stones or periampullary tumors were examined to identify distinguishing features between obstructive and non-obstructive CBD dilatation after cholecystectomy. Results The mean (standard deviation) short-axis maximum CBD diameter of 121 patients was 5.6 (± 1.9) mm in the axial plane before cholecystectomy but increased to 7.9 (± 2.6) mm after cholecystectomy (p < 0.001). Of the 106 patients with a pre-cholecystectomy axial CBD diameter of < 8 mm, 39 (36.8%) showed CBD dilatation of ≥ 8 mm after cholecystectomy. Six of the 17 patients with long-term (> 2 years) serial follow-up CT scans (35.3%) eventually showed a significant (> 1.5-fold) increase in the axial CBD diameter, all within two years after cholecystectomy. Of the 121 patients without obstruction or related symptoms, only one patient (0.1%) showed IHD dilatation > 3 mm after cholecystectomy. In contrast, all 11 patients with CBD obstruction had abdominal pain and abnormal laboratory indices, and 81.8% (9/11) had significant dilatation of the IHD and CBD. Conclusion Compensatory non-obstructive CBD dilatation commonly occurs after cholecystectomy to a similar extent as obstructive dilatation. However, the presence of relevant symptoms, significant IHD dilatation, or further CBD dilatation 2-3 years after cholecystectomy should raise suspicion of CBD obstruction. [ABSTRACT FROM AUTHOR]

Subclavian steal syndrome (SSS) is a rare vascular condition characterized by retrograde blood flow in the vertebral artery, often discovered incidentally in asymptomatic patients. We present a 65-year-old male with recurrent transient ischemic attacks (TIAs) attributed to 99% stenosis at the origin of the left subclavian artery, leading to SSS. Diagnostic modalities included duplex ultrasound, confirming inverted left vertebral artery flow, and multi-slice computed tomography angiography, confirming the diagnosis. Despite an unsuccessful attempt at balloon angioplasty, successful vascular surgery was performed, establishing a left carotid-vertebral artery bypass. The patient recovered well without complications. This case underscores the importance of considering SSS in TIA cases, utilizing non-invasive diagnostic tools, and highlighting the successful management of symptomatic SSS through surgical intervention. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the performance of deep learning image reconstruction (DLIR) algorithm in dual-energy spectral CT (DEsCT) as a function of radiation dose and image energy level, in comparison with filtered-back-projection (FBP) and adaptive statistical iterative reconstruction-V (ASIR-V) algorithms. METHODS: An ACR464 phantom was scanned with DEsCT at four dose levels (3.5 mGy, 5 mGy, 7.5 mGy, and 10 mGy). Virtual monochromatic images were reconstructed at five energy levels (40 keV, 50 keV, 68 keV, 74 keV, and 140 keV) using FBP, 50% and 100% ASIR-V, DLIR at low (DLIR-L), medium (DLIR-M), and high (DLIR-H) settings. The noise power spectrum (NPS), task-based transfer function (TTF) and detectability index (d') were computed and compared among reconstructions. RESULTS: NPS area and noise increased as keV decreased, with DLIR having slower increase than FBP and ASIR-V, and DLIR-H having the lowest values. DLIR had the best 40 keV/140 keV noise ratio at various energy levels, DLIR showed higher TTF (50%) than ASIR-V for all materials, especially for the soft tissue-like polystyrene insert, and DLIR-M and DLIR-H provided higher d' than DLIR-L, ASIR-V and FBP in all dose and energy levels. As keV increases, d' increased for acrylic insert, and d' of the 50 keV DLIR-M and DLIR-H images at 3.5 mGy (7.39 and 8.79, respectively) were higher than that (7.20) of the 50 keV ASIR-V50% images at 10 mGy. CONCLUSIONS: DLIR provides better noise containment for low keV images in DEsCT and higher TTF(50%) for the polystyrene insert over ASIR-V. DLIR-H has the lowest image noise and highest detectability in all dose and energy levels. DEsCT 50 keV images with DLIR-M and DLIR-H show potential for 65% dose reduction over ASIR-V50% withhigher d'. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to compare Liver Imaging Reporting and Data System (LI-RADS) category 4/5 and category M (LR-M) of proliferative hepatocellular carcinomas (HCCs) in cirrhotic patients and evaluate their impacts on prognosis. Methods: This retrospective multi-reader study included cirrhotic patients with single treatment-naïve HCC ≤ 5.0 cm who underwent contrast-enhanced CT, MRI, and subsequent hepatic resection within 2 months. The percentages of CT/MRI LR-4/5 and LR-M in proliferative and non-proliferative HCCs were compared. Univariable and multivariable Cox proportional hazards regression analyses were performed to assess the association of LI-RADS categories (LR-4/5 vs. LR-M) and pathologic classification (proliferative vs. non-proliferative) with overall survival (OS) and recurrence-free survival (RFS). Subgroups of patients with proliferative and non-proliferative HCCs were analyzed to compare OS and RFS between LR-4/5 and LR-M. Results: Of the 204 included patients, 38 were classified as having proliferative HCC. The percentages of LR-M were higher in proliferative than non-proliferative HCC on both CT (15.8% vs. 3.0%, p = 0.007) and MRI (26.3% vs. 9.6%, p = 0.016). Independent of pathologic classification, CT and MRI LR-M were significantly associated with poorer OS (hazard ratio (HR) = 4.58, p = 0.013, and HR = 6.45, p < 0.001) and RFS (HR = 3.66, p = 0.005, and HR = 6.44, p < 0.001) than LR-4/5. MRI LR-M was associated with significantly poorer OS (p ≤ 0.003) and RFS (p < 0.001) than MRI LR-4/5 in both proliferative and non-proliferative HCCs. Conclusions: This multi-reader study showed that the percentages of LR-M were significantly higher in proliferative than non-proliferative HCCs. CT/MRI LR-M was significantly associated with poor OS and RFS, independent of the pathologic classification of proliferative versus non-proliferative HCCs. Clinical relevance statement: CT and MRI LI-RADS category M can be clinically useful in predicting poor outcomes in patients with proliferative and non-proliferative hepatocellular carcinomas. Key Points: • The percentages of LR-M tumors on both CT and MRI were significantly higher in proliferative than non-proliferative hepatocellular carcinomas. • Independent of pathologic classification, CT/MRI LR-M categories were correlated with poor overall survival and recurrence-free survival. • Patients with both proliferative and non-proliferative hepatocellular carcinomas categorized as MRI LR-M had significantly poorer overall survival and recurrence-free survival than those categorized as MRI LR-4/5. [ABSTRACT FROM AUTHOR]

With the introduction of multi-detector computed tomography (CT), the number of incidentally detected small lung nodules has dramatically increased. Determination of lung nodule malignancy is crucial, and an early diagnosis of these indeterminate lesions can lead to subsequent potentially curative treatment. However, there are some limitations to excising these nodules with sublobar resection in a minimally invasive thoracoscopic setting. Under thoracoscopy, although stapler-based wedge resection seems to be the preferred technique, particularly in patients whose lesions are located far from the edge of the lobe, the stapler can unexpectedly sacrifice normal pulmonary parenchyma. To overcome this issue, we have developed a wireless excision precision technique using cone-beam CT-guided electromagnetic navigation bronchoscopy in a minimally invasive thoracoscopic setting. Our technique is implemented in a hybrid operating room, and small tumors can be removed using a radiofrequency identification microchip without intraoperative fluoroscopy and do not require lung palpation under thoracoscopy. [ABSTRACT FROM AUTHOR]

The estimation of ancestry is important not only towards establishing identity but also as a required precursor to facilitating the accurate estimation of other attributes such as sex, age at death, and stature. The present study aims to analyze morphological variation in the crania of Japanese and Western Australian individuals and test predictive models based on machine learning for their potential forensic application. The Japanese and Western Australian samples comprise computed tomography (CT) scans of 230 (111 female; 119 male) and 225 adult individuals (112 female; 113 male), respectively. A total of 18 measurements were calculated, and machine learning methods (random forest modeling, RFM; support vector machine, SVM) were used to classify ancestry. The two-way unisex model achieved an overall accuracy of 93.2% for RFM and 97.1% for SVM, respectively. The four-way sex and ancestry model demonstrated an overall classification accuracy of 84.0% for RFM and 93.0% for SVM. The sex-specific models were most accurate in the female samples (♀ 95.1% for RFM and 100% for SVM; ♂91.4% for RFM and 97.4% for SVM). Our findings suggest that cranial measurements acquired in CT images can be used to accurately classify Japanese and Western Australian individuals into their respective population. This is the first study to assess the feasibility of ancestry estimation using three-dimensional CT images of the skull. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the diagnostic performance of multiphase hepatic CT parameters (non-contrast attenuation, absolute and relative washout ratios [APW and RPW, respectively], and relative enhancement ratio [RER]) and chemical-shift MRI (CS-MRI) for discriminating lipid-poor adrenal adenomas (with non-contrast CT attenuation > 10 HU) from metastases in patients with hepatocellular carcinoma (HCC). Methods: This retrospective study included HCC patients with lipid-poor adrenal lesions who underwent multiphase hepatic CT between January 2010 and December 2021. For each adrenal lesion, non-contrast attenuation, APW, RPW, RER, and signal-intensity index (SI-index) were measured. Each parameter was compared between adenomas and metastases. The area under the receiver operating characteristic curves (AUCs) and sensitivities to achieve 100% specificity for adenoma diagnoses were determined. Results: 104 HCC patients (78 men; mean age, 71.8 ± 9.6 years) with 63 adenomas and 48 metastases were identified; CS-MRI was performed in 66 patients with 49 adenomas and 21 metastases within one year of CT. Lipid-poor adenomas showed lower non-contrast attenuation (22.9 ± 7.1 vs. 37.9 ± 9.4 HU) and higher APW (40.5% ± 12.8% vs. 23.7% ± 17.4%), RPW (30.0% ± 10.2% vs. 12.4% ± 9.6%), RER (329% ± 152% vs. 111% ± 43.0%), and SI-index (43.3 ± 20.7 vs. 10.8 ± 13.4) than HCC metastases (all p <.001). AUC for non-contrast attenuation, APW, RPW, RER, and SI-index were 0.894, 0.786, 0.904, 0.969, and 0.902, respectively. The sensitivities to achieve 100% specificity were 7.9%, 25.4%, 30.2%, 63.5%, and 24.5%, respectively. Combined RER and APW achieved the highest sensitivity of 73.0%. Conclusion: Multiphase hepatic CT allows for better discrimination between lipid-poor adrenal adenomas and metastases relative to CS-MRI, especially when combined with RER and washout parameters. [ABSTRACT FROM AUTHOR]

Background: Non-variceal upper gastrointestinal bleeding is a common gastroenterological emergency associated with significant morbidity and mortality. Upper gastrointestinal endoscopy is currently recommended as the gold standard modality for both diagnosis and treatment. As historically played a limited role in the diagnosis of acute non-variceal upper gastrointestinal bleeding, multidetector-row computed tomography angiography is emerging as a promising tool in the diagnosis of non-variceal upper gastrointestinal bleeding, especially for severe cases. However, to date, evidence concerning the role of multidetector-row computed tomography angiography in the non-variceal upper gastrointestinal bleeding diagnosis is still lacking. Aim: The purpose of this study was to retrospectively investigate the diagnostic performance of emergent multidetector-row computed tomography angiography performed prior to any diagnostic modality or following urgent upper endoscopy to identify the status, the site, and the underlying etiology of severe non-variceal upper gastrointestinal bleeding. Methods: Institutional databases were reviewed in order to identify severe acute non-variceal upper gastrointestinal bleeding patients who were admitted to our bleeding unit and were referred for emergent multidetector-row computed tomography angiography prior to any hemostatic treatment (< 3 h) or following (< 3 h) endoscopy, between December 2019 and October 2022. The study aim was to evaluate the diagnostic performance of multidetector-row computed tomography angiography to detect the status, the site, and the etiology of severe non-variceal upper gastrointestinal bleeding with endoscopy, digital subtraction angiography, surgery, pathology, or a combination of them as reference standards. Results: A total of 68 patients (38 men, median age 69 years [range 25–96]) were enrolled. The overall multidetector-row computed tomography angiography sensitivity, specificity, and accuracy to diagnose bleeding status were 77.8% (95% CI: 65.5–87.3), 40% (95% CI: 5.3–85.3), and 75% (95% CI: 63.0–84.7), respectively. Finally, the overall multidetector-row computed tomography angiography sensitivity to identify the bleeding site and the bleeding etiology were 92.4% (95% CI: 83.2–97.5) and 79% (95% CI: 66.8–88.3), respectively. Conclusion: Although esophagogastroduodenoscopy is the mainstay in the diagnosis and treatment of most non-variceal upper gastrointestinal bleeding cases, multidetector-row computed tomography angiography seems to be a feasible and effective modality in detecting the site, the status, and the etiology of severe acute non-variceal upper gastrointestinal bleeding. It may play a crucial role in the management of selected cases of non-variceal upper gastrointestinal bleeding, especially those clinically severe and/or secondary to rare and extraordinary rare sources, effectively guiding timing and type of treatment. However, further large prospective studies are needed to clarify the role of multidetector-row computed tomography angiography in the diagnostic process of acute non-variceal upper gastrointestinal bleeding. [ABSTRACT FROM AUTHOR]

Background/Aim. Multidetector computed tomography pulmonary angiography (MCTPA) has emerged as the most suitable method for diagnosing acute pulmonary embolism (APE) in hemodynamically stable patients. In addition to its diagnostic role, MCTPA facilitates the measurement and calculation of certain parameters that can be used as prognostic markers for outcomes in APE. Since the introduction of the method, there have been a lot of studies that pointed out there may be a significant difference in the prognostic value of MCTPA for APE concerning sex. Methods. The study population consisted of consecutive patients with a diagnosis of APE confirmed by MCTPA. Positive MCTPA findings and a diagnosis of APE were established if the patient had at least one segmental artery thrombus. APE severity was estimated using the simplified Pulmonary Embolism Severity Index (sPESI). Allcause and APE-related intrahospital deaths were the coprimary outcomes of this study. Results. In total, 1,612 patients were enrolled in the study (750 men and 862 women). Women with a centrally positioned pulmonary thrombus detected on MCTPA were more likely to die from PE-related death than those without one (10.4% vs. 4.2%, respectively; p = 0.016). Women with a right ventricle (RV) and left ventricle (LV) diameter ratio (RV/LV) > 1 died almost twice as often as those with a ratio ≤ 1 (15.5% vs. 8.6%, respectively; p = 0.017). Women with an RV/LV > 1 detected with MCTPA were significantly more likely to die from PE than those with a ratio ≤ 1 (11% vs. 5.2%, respectively; p = 0.017). Women who died from PE-related causes had a significantly higher value of the embolic burden score system (EBSS) than did the surviving women (18.00 vs. 11.00, respectively; p = 0.025). Independently of age, sPESI, and renal function, the presence of a central thrombus [odds ratio (OR) 2.278, 95% confidence interval (CI): 1.050–4.944, p = 0.037] and the RV/LV ratio > 1 (OR 2.015, 95% CI: 1.042–3.893, p = 0.037) were associated with intrahospital PE-related death in women. Conclusion. In women, MCTPA parameters, a centrally placed thrombus, the RV/LV ratio, and the EBSS had prognostic significance for PE-related mortality. The RV/LV ratio had prognostic significance for all-cause intrahospital mortality. In men, the MCTPA parameters had no prognostic significance for both overall and PErelated mortality. [ABSTRACT FROM AUTHOR]

Introduction: Computed Tomography (CT) has revolutionized medical imaging, particularly in anatomically complex regions like the maxillofacial region. It stands as the preferred investigation for assessing facial bone fractures resulting from trauma. Objective: Frequency and Type of Fractures: To Describe the frequency and types of fractures in patients with maxillofacial injuries using multislice CT and 3D reconstruction. Comparison of Imaging Modalities: To Compare the utility of three-dimensional (3D) reconstructed images with two-dimensional axial images in evaluating maxillofacial injuries. Materials and methods: A cross-sectional study involved 180 patients (100 men, 80 women; Age: 10-65 years) with a history of maxillofacial trauma. A 128-slice CT scanner was utilized, and both axial and 3D images were reconstructed, including coronal Multiplanar Reconstruction (MPR). Results: Demographics showed male predominance, with the most common age group being 30-40 years. Road traffic accidents (RTA) were the most common mode of injury. Fracture distribution revealed maxillary and nasoethmoid fractures as most common. In imaging comparison, 3D images were similar or superior to axial images in most aspects, except for fractures involving thin bones in the orbitoethmoid and maxillary regions. Coronal reconstructed images were effective in detecting fractures in all examined regions. Interpretation and Conclusion: This study underscores the pivotal role of Multidetector Computed Tomography (MDCT) in evaluating maxillofacial injuries. The advantages of 3D reconstructed images, particularly in the identification of Le Fort fracture lines, are highlighted. Coronal reconstructed images outperformed in detecting fractures in the maxilla and orbit. However, the study recognizes the limited role of 3D images in assessing fractures in the naso-orbitoethmoid region, especially in cases with minimal displacement. [ABSTRACT FROM AUTHOR]

Objectives: Computed tomography (CT) and cone beam computed tomography (CBCT) represent the main imaging modalities used in rhinosinusitis patients and are also important in odontogenic sinusitis (OS) diagnostics. Reports, however, often lack information on dentition. Here, we aimed to determine how maxillary dentition is initially interpreted in rhinosinusitis patients' CT/CBCT reports and which dental findings in particular are potentially missed, thus needing more attention. Study design: CT/CBCT scans and radiological reports from 300 rhinosinusitis patients were analysed focusing specifically on dental findings. An experienced oral and maxillofacial radiologist re-evaluated the scans and the assessment was compared to the original reports using the McNemar test. Results: From the 300 original reports, 233 (77.7%) mentioned the maxillary teeth. The most frequent statement (126/300, 42.0%) was 'no apical periodontitis'. Apical periodontitis and severe alveolar bone loss were significantly overlooked (p < 0.001). Amongst the 225 patients for whom the CT/CBCT report initially lacked information on dental pathology, 22 patients were diagnosed with apical periodontitis and 16 with severe alveolar bone loss upon re-evaluation. Conclusions: Dental pathology remains underreported in rhinosinusitis patients' CT/CBCT reports. Because these reports affect OS diagnostics, a routine and structured review of the maxillary teeth by a radiologist is necessary. Such examinations should encompass the maxillary teeth. [ABSTRACT FROM AUTHOR]

We present a modular and cost-effective gamma ray computed tomography system for multiphase flow investigations in industrial apparatuses. It mainly comprises a 137Cs isotopic source and an in-house-assembled detector arc, with a total of 16 scintillation detectors, offering a quantum efficiency of approximately 75% and an active area of 10 × 10 mm2 each. The detectors are operated in pulse mode to exclude scattered gamma photons from counting by using a dual-energy discrimination stage. Flexible application of the computed tomography system, i.e., for various object sizes and densities, is provided by an elaborated detector arc design, in combination with a scanning procedure that allows for simultaneous parallel beam projection acquisition. This allows the scan time to be scaled down with the number of individual detectors. Eventually, the developed scanner successfully upgrades the existing tomography setup in the industry. Here, single pencil beam gamma ray computed tomography is already used to study hydraulics in gas–liquid contactors, with inner diameters of up to 440 mm. We demonstrate the functionality of the new system for radiographic and computed tomographic scans of DN110 and DN440 columns that are operated at varying iso-hexane/nitrogen liquid–gas flow rates. [ABSTRACT FROM AUTHOR]

Simple Summary: Ovarian cancer is the leading cause of death due to gynecologic malignancies. Peritoneal metastases represent the most common pathway for the spread of OC, both at the time of initial diagnosis and at recurrence. Accurate mapping of peritoneal metastases helps in planning the appropriate therapeutic strategy, predicting the likelihood of optimal cytoreduction, and identifying potentially unresectable or difficult disease sites that may require surgical technique modifications. Preoperative diagnostic work-up with multidetector CT (MDCT), MRI, including diffusion-weighted imaging (DWI), or FDG PET/CT plays a vital role in the accurate assessment of the extent of peritoneal carcinomatosis. In this article, the aim was to update the role of MDCT, MRI, including DWI, and FDG PET/CT in the detection of peritoneal metastases in ovarian cancer by conducting a systematic review and meta-analysis of the existing literature. This review aims to compare the diagnostic performance of multidetector CT (MDCT), MRI, including diffusion-weighted imaging, and FDG PET/CT in the detection of peritoneal metastases (PMs) in ovarian cancer (OC). A comprehensive search was performed for articles published from 2000 to February 2023. The inclusion criteria were the following: diagnosis/suspicion of PMs in patients with ovarian/fallopian/primary peritoneal cancer; initial staging or suspicion of recurrence; MDCT, MRI and/or FDG PET/CT performed for the detection of PMs; population of at least 10 patients; surgical results, histopathologic analysis, and/or radiologic follow-up, used as reference standard; and per-patient and per-region data and data for calculating sensitivity and specificity reported. In total, 33 studies were assessed, including 487 women with OC and PMs. On a per-patient basis, MRI (p = 0.03) and FDG PET/CT (p < 0.01) had higher sensitivity compared to MDCT. MRI and PET/CT had comparable sensitivities (p = 0.84). On a per-lesion analysis, no differences in sensitivity estimates were noted between MDCT and MRI (p = 0.25), MDCT and FDG PET/CT (p = 0.68), and MRI and FDG PET/CT (p = 0.35). Based on our results, FDG PET/CT and MRI are the preferred imaging modalities for the detection of PMs in OC. However, the value of FDG PET/CT and MRI compared to MDCT needs to be determined. Future research to address the limitations of the existing studies and the need for standardization and to explore the cost-effectiveness of the three imaging modalities is required. [ABSTRACT FROM AUTHOR]

Purpose: To determine if hepatic and splenic perfusion parameters are useful in identifying severe portal hypertension (SPH). Methods: The study enrolled 52 patients who underwent perfusion CT scan within one week before the hepatic venous pressure gradient (HVPG) measurement. A commercial software package was used for post-processing to generate hepatic and splenic perfusion parameters. Correlations were assessed using Pearson and Spearman rank correlation coefficients. Logistic regression was used to screen predictive parameters of SPH. The cut-off values of parameters for severe portal hypertension were calculated, as well as the sensitivity and specificity. Results: There was a significant difference between SPH and non-severe portal hypertension (NSPH) in blood volume of liver (BVLiver), hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP), portal venous perfusion (PVP), mean slope of increase in spleen (MSISpleen), BVSpleen, blood flow of spleen (BFSpleen), BVSpleen/Liver, and BVSpleen/Liver(P) (p < 0.05). The Spearman correlation coefficient was − 0.541 (p < 0.001) between BVSpleen/Live and HVPG and − 0.568 (p < 0.001) between BVSpleen/Liver(P) and HVPG. Using a BVSpleen/Liver value of 0.780 or BVSpleen/Liver(P) value of 1.061 as the cut-off value for the detection of SPH, the sensitivity and specificity were 94.7% and 72.7%, 100%, and 63.6% respectively. Conclusion: There was a moderate correlation between CT perfusion parameters BVSpleen/Liver, BVSpleen/Liver(P), and HVPG, which may be used to detect severe portal hypertension. [ABSTRACT FROM AUTHOR]

Introduction Jet aircraft pilots are exposed to huge pressure variation during flight, which affect physiological functions as systems, such as the respiratory system. Objectives The objective of the present investigation was to evaluate inflammatory changes of paranasal sinuses of jet aircraft pilots before and after a jet aircraft training program, using multislice computed tomography (CT), in comparison with a group of nonairborne individuals with the same age, sex, and physical health conditions. A second objective of the present study was to assess the association between the ostiomeatal complex obstruction and its anatomical variations. Methods The study group consisted of 15 jet aircraft pilots participating in the training program. The control group consisted of 41 nonairborne young adults. The 15 fighter pilots were evaluated before initiating the training program and after their final approval for the presence of inflammatory paranasal sinus disease. The ostiomeatal complex anatomical variations and obstructions were analyzed in pilots after the training program. Results Jet aircraft pilots presented higher incidence of mucosal thickening in maxillary sinus and anterior ethmoid cells than controls. Prominent ethmoidal bulla showed significant association with obstruction of the osteomeatal complex. Conclusions Jet aircraft pilots present increased inflammatory disease when compared with nonairborne individuals. The presence of a prominent ethmoidal bulla is associated with ostiomeatal complex obstruction. [ABSTRACT FROM AUTHOR]

Introduction: Coronary Artery Disease (CAD) is a major cause of morbidity and mortality worldwide; therefore, early diagnosis plays a crucial role in managing patients with CAD. Multidetector Computed Tomography (MDCT) allows non invasive visualisation of coronary arteries but has limited availability, involves radiation, and is costly. Carotid artery atherosclerosis can be assessed by Ultrasound (USG) in terms of Carotid Intima-media Thickness (CIMT) and carotid plaque assessment. These carotid USG parameters are associated with CAD and can be used to predict CAD in high-risk patients. Aim: To study the association and correlation between carotid artery atherosclerosis USG parameters (CIMT and carotid plaque) and CAD, using Computed Tomography Coronary Angiography (CTCA) as a reference. Materials and Methods: A cross-sectional study was conducted from January 2020 to October 2021 in the Department of Radiodiagnosis at Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. In the present study, 31 patients with suspected CAD were enrolled. All patients underwent CTCA followed by carotid artery USG within two weeks. The association and correlation between carotid artery atherosclerosis on USG and CAD on CTCA were examined. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and accuracy were calculated using CTCA as the reference standard. Categorical data were analysed using the Chi-square test, with a p-value of <0.05 considered statistically significant. Results: The mean age of the patients was 54.06±10.79 years. The CAD was observed in 14 (45.1%) cases, of which 13 (92.8%) had significant CAD. Nine patients had raised CIMT, of which eight had CAD. Raised CIMT and CAD showed a significant association with sensitivity, specificity, PPV, NPV, and accuracy of 57.14%, 94.12%, 88.89%, 72.73%, and 77.42%, respectively. A positive correlation was found between CIMT values and the number of vessels with significant CAD (r= +0.67). A total of 7 patients (22.5%) had the presence of carotid plaque, of which 6 (88.57%) had significant CAD. A significant association was found between CAD and the presence of carotid plaque. Carotid plaque had sensitivity, specificity, PPV, NPV, and accuracy of 50%, 100%, 100%, 70.83%, and 77.42%, respectively, in predicting CAD. A positive correlation was observed between carotid plaque burden and the number of vessels with significant CAD (r= +0.56). Conclusion: There is a significant association between carotid ultrasonography parameters (i.e., CIMT, carotid plaque) and CAD. CIMT is a more sensitive parameter than carotid plaque in predicting CAD. However, carotid plaque is more specific for predicting CAD. Carotid artery ultrasonography can be used as a screening tool for predicting CAD and should be included in the work-up of patients with suspected CAD. [ABSTRACT FROM AUTHOR]

Background: Upper oesophageal sphincter (UES) serves as an important anatomical and functional landmark during swallowing. However, the precise UES location before and during swallowing has not been well established. Objective: This study aimed to determine upper oesophageal sphincter (UES) location and displacement during swallowing accounting for sex, age, and height in healthy adults using 320‐row area detector computed tomography (320‐ADCT). Methods: Ninety‐four healthy adults (43 males; 22–90 years) underwent 320‐ADCT scanning while swallowing one trial of 10 mL honey thick barium. UES location at bolus hold and at maximum displacement and vertical displacement during swallowing were identified using the coordinates and the section classification of vertebrae (VERT scale). The differences and correlations of UES location and distance in terms of sex, age, and height were analysed using Mann–Whitney U test and Spearman's correlation coefficient. Results: UES locations at bolus hold and at maximum displacement were significantly lower and UES vertical displacement was significantly larger in males than in females (p <.001). UES location at bolus hold became lower with increasing age (r = −.312, p =.002), but the negative correlation was low at maximum displacement (r = −.230, p =.026), resulting in larger vertical distance with ageing. UES locations showed high negative correlation at bolus hold with height (r = −.715, p <.001), and showed moderate negative correlation at maximum displacement with height (r = −.555, p <.001), although this effect was unclear when analysed by sex. Conclusion: Males showed lower UES location and larger displacement than females. The impact of age was evident with lower location before swallowing and larger displacement during swallowing. Differences observed by sex were not completely explained by using the VERT scale to adjust for height. [ABSTRACT FROM AUTHOR]

Purpose: We investigated whether the quality of high-resolution computed tomography (CT) images of the temporal bone improves with deep learning reconstruction (DLR) compared with hybrid iterative reconstruction (HIR). Methods: This retrospective study enrolled 36 patients (15 men, 21 women; age, 53.9 ± 19.5 years) who had undergone high-resolution CT of the temporal bone. Axial and coronal images were reconstructed using DLR, HIR, and filtered back projection (FBP). In qualitative image analyses, two radiologists independently compared the DLR and HIR images with FBP in terms of depiction of structures, image noise, and overall quality, using a 5-point scale (5 = better than FBP, 1 = poorer than FBP) to evaluate image quality. The other two radiologists placed regions of interest on the tympanic cavity and measured the standard deviation of CT attenuation (i.e., quantitative image noise). Scores from the qualitative and quantitative analyses of the DLR and HIR images were compared using, respectively, the Wilcoxon signed-rank test and the paired t-test. Results: Qualitative and quantitative image noise was significantly reduced in DLR images compared with HIR images (all comparisons, p ≤ 0.016). Depiction of the otic capsule, auditory ossicles, and tympanic membrane was significantly improved in DLR images compared with HIR images (both readers, p ≤ 0.003). Overall image quality was significantly superior in DLR images compared with HIR images (both readers, p < 0.001). Conclusion: Compared with HIR, DLR provided significantly better-quality high-resolution CT images of the temporal bone. [ABSTRACT FROM AUTHOR]

Background & aims: A new nomenclature, Steatotic Liver Disease (SLD), has been proposed by consensus with sub-classifications and requires evidence-based validation. We assessed whether the presence and severity of SLD, as well as its sub-classifications, are associated with the progression of coronary atherosclerosis. Methods: This longitudinal cohort study included 13,811 adults who participated in repeated regular health screening examinations between January 1, 2004 and December 31, 2021 that included assessments of their coronary artery calcium (CAC) scores. SLD was defined using abdominal ultrasonography and classified as metabolic dysfunction associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and cryptogenic SLD. SLD severity was assessed using fibrosis-4 (FIB-4) scores. The progression of CAC scores was measured using multidetector CT scans. Results: The average duration of follow-up was 5.8 years. During follow-up, the annual rate of CAC progression in participants with and without SLD was 18% (95% CI 17%–19%) and 14% (95% CI 13%–14%) (p < 0.01), respectively. The multivariable ratios of progression rates when we compared participants with cryptogenic SLD, MASLD, or MetALD with those without SLD were 0.98 (95% CI 0.95–1.01), 1.03 (95% CI 1.03–1.04), and 1.07 (95% CI 1.04–1.09), respectively. The multivariable ratios of progression rates when we compared participants with SLD with FIB-4 score <1.3 and SLD with FIB-4 score ≥1.3 with those without SLD were 1.03 (95% CI 1.02–1.04), and 1.05 (95% CI 1.04–1.06), respectively. Conclusions: SLD was associated with a higher risk of coronary atherosclerosis, and the risk differed by sub-classifications and severity. These findings suggest that the newly proposed definition has clinical relevance in terms of stratifying cardiovascular disease risk. [ABSTRACT FROM AUTHOR]

Background: Pulmonary embolism (PE) is a sudden obstruction of pulmonary arteries usually associated with a high rate of mortality due to acute right ventricular failure. Early diagnosis is of much importance because most patients die within the first hours of presentation. Emergency management is usually highly valuable and right heart failure is potentially reversible. Multidetector computed tomography pulmonary angiography (CTPA) is the best diagnostic imaging modality to document acute pulmonary embolism. Overuse of CTPA increases the unrequired risk of radiation exposure, increasing the risk of malignancy, contrast-related anaphylaxis, and acute kidney injury. To abolish these issues, the simplified score for suspected acute pulmonary embolism using variable D dimer cut-off value in combination with clinical signs can exclude pulmonary embolism safely. Aim of the study: To evaluate the predictive accuracy of YEARS score in the diagnosis of pulmonary embolism compared to CTPA that might lead to a decrease in the overuse of CTPA. Methods: The study was held at the chest unit in Kasr ElAini hospitals. It included 50 patients, for which full history, examination, calculation of wells score, D-dimer, YEARS score, and CTPA were done. Results: The results showed that the YEARS score succeeded in predicting the presence or the absence of PE in 80% of the 50 enrolled patients in our study. YEARS score has a sensitivity of 90% and specificity of 65%. Conclusion: Patients with zero YEARS score and D-dimer ≥ 1000 ng/ml as well as those with ≥ 1 YEARS score and D-dimer ≥ 500 ng/ml are rendered PE likely by the YEARS algorithm with a sensitivity of 90%. Using years score, we can exclude pulmonary embolism in patients with zero YEARS score and a D-dimer ˂ 1000 ng/ml as well as in patients with ≥ 1 YEARS score and D-dimer ˂ 500 ng/ml with 65% specificity, thus decreasing overuse of CTPA in the diagnosis of PE. [ABSTRACT FROM AUTHOR]

Objective: To assess the correlation between pancreatic quantitative edge analysis as a surrogate of parenchymal stiffness and the incidence of postoperative pancreatic fistula (POPF), in patients undergoing pancreaticoduodenectomy (PD). Methods: All consecutive patients who underwent PD at our Institution between March 2018 and November 2019 with an available preoperative CT were included. Pancreatic margin score (PMS) was calculated through computer-assisted quantitative edge analysis on the margins of the pancreatic body and tail (the expected pancreatic remnant) on non-contrast scans with in-house software. Intraoperative assessment of pancreatic stiffness by manual palpation was also performed, classifying pancreatic texture into soft and non-soft. PMS values were compared between groups using an unpaired T-test and correlated with the intraoperative evaluation of stiffness and with the grading of postoperative pancreatic fistula according to the International Study Group on Pancreatic Surgery (ISGPS). Results: Patient population included 200 patients (mean age 64.6 years), 146 without onset of POPF (73%, non-POPF group), and 54 with POPF (27%, POPF group). A significant difference in PMS values was observed between POPF and non-POPF (respectively 1.88 ± 0.05 vs 0.69 ± 0.01; p < 0.0001). PMS values of pancreatic parenchymas intraoperatively considered "soft" were significantly higher than those evaluated as "non-soft" (1.21 ± 0.04 vs 0.73 ± 0.02; p < 0.0001). A significant correlation between PMS values and POPF grade was observed (r = 0.8316), even in subgroups of patients with soft (r = 0.8016) and non-soft (r = 0.7602) pancreas (all p < 0.0001). Conclusions: Quantitative edge analysis with dedicated software may stratify patients with different pancreatic stiffness, thus potentially improving preoperative risk assessment and strategies for POPF mitigation. Clinical relevance statement: This study proposes quantitative pancreas edge analysis as a predictor for postoperative pancreatic fistula. The test has high accuracy and correlation with fistula grade according to the International Study Group on Pancreatic Surgery. Key Points: • Prediction of postoperative pancreatic fistula (POPF) onset risk after pancreaticoduodenectomy is based only on intraoperative evaluation. • Quantitative edge analysis may preoperatively identify patients with higher risk of POPF. • Quantification of pancreatic stiffness through the analysis of pancreatic margins could be done on preoperative CT. [ABSTRACT FROM AUTHOR]

Objectives: The prognostic value of ground-glass opacity at preoperative chest CT scans in early-stage lung adenocarcinomas is a matter of debate. We aimed to clarify the existing evidence through a single-center, retrospective cohort study and to quantitatively summarize the body of literature by conducting a meta-analysis. Methods: In a retrospective cohort study, patients with clinical stage I lung adenocarcinoma were identified, and the prognostic value of ground-glass opacity was analyzed using multivariable Cox regression. Commercial artificial intelligence software was adopted as the second reader for the presence of ground-glass opacity. The primary end points were freedom from recurrence (FFR) and lung cancer-specific survival (LCSS). In a meta-analysis, we systematically searched Embase and OVID-MEDLINE up to December 30, 2021, for the studies based on the eighth-edition staging system. The pooled hazard ratios (HRs) of solid nodules (i.e., absence of ground-glass opacity) for various end points were calculated with a multi-level random effects model. Results: In a cohort of 612 patients, solid nodules were associated with worse outcomes for FFR (adjusted HR, 1.98; 95% CI: 1.17–3.51; p = 0.01) and LCSS (adjusted HR, 1.937; 95% CI: 1.002–4.065; p = 0.049). The artificial intelligence assessment and multiple sensitivity analyses revealed consistent results. The meta-analysis included 13 studies with 12,080 patients. The pooled HR of solid nodules was 2.13 (95% CI: 1.69–2.67; I2 = 30.4%) for overall survival, 2.45 (95% CI: 1.52–3.95; I2 = 0.0%) for FFR, and 2.50 (95% CI: 1.28–4.91; I2 = 30.6%) for recurrence-free survival. Conclusions: The absence of ground-glass opacity in early-stage lung adenocarcinomas is associated with worse postoperative survival. Clinical relevance statement: Early-stage lung adenocarcinomas manifesting as solid nodules at preoperative chest CT, which indicates the absence of ground-glass opacity, were associated with poor postoperative survival. There is room for improvement of the clinical T categorization in the next edition staging system. Key Points: • In a retrospective study of 612 patients with stage I lung adenocarcinoma, solid nodules were associated with shorter freedom from recurrence (adjusted hazard ratio [HR], 1.98; p = 0.01) and lung cancer-specific survival (adjusted HR, 1.937; p = 0.049). • Artificial intelligence-assessed solid nodules also showed worse prognosis (adjusted HR for freedom from recurrence, 1.94 [p = 0.01]; adjusted HR for lung cancer-specific survival, 1.93 [p = 0.04]). • In meta-analyses, the solid nodules were associated with shorter freedom from recurrence (HR, 2.45) and shorter overall survival (HR, 2.13). [ABSTRACT FROM AUTHOR]

Objective: To report the results of a dose survey conducted across 31 provinces in mainland China from 2017 to 2018 and to analyse the dose level to determine the national diagnostic reference levels (DRLs) for paediatric CT procedures. Methods: At least ten patients for each age group (0– < 1, 1– < 5, 5– < 10, 10– < 15 years) and each procedure (head, chest and abdomen) for each CT scanner were selected from four to eight hospitals in each province. The dose information (CTDIvol and DLP) was collected from the HIS or RIS-PACS systems. The median values in each CT scanner were considered the representative dose values for the paediatric patients in CT scanning. The national DRLs were estimated based on the 75th percentile distribution of the median values. Results: A total of 24,395 patients and 319 CT scanners were investigated across 262 hospitals. For paediatric CT scanning in 4 different age groups, the median (P50) and the 75th percentile (P75) of CTDIvol and DLP for each scanning procedure were calculated and reported. National DRLs were then proposed for each procedure and age group. Conclusion: The dose level of CT scanning for children in mainland China was reported for the first time. The DRLs for paediatric CT in the present study are similar to those in some Asian countries but higher than those in European countries. Clinical relevance statement: The paediatric CT is an extensively used tool in diagnosing paediatric disease; however, children are more sensitive to radiation. Establishing the diagnostic reference level of paediatric CT examination is necessary to reduce the dose of CT in children and promote the optimisation of medical exposure. Key Points: • The DRLs for 3 paediatric CT procedures (head, chest and abdomen) and 4 age groups (0– < 1, 1– < 5, 5– < 10, 10– < 15 years) were proposed in mainland China first time. • The examination parameter and dose for children need to be further optimised in China, especially to lower the tube voltage in paediatric CT. [ABSTRACT FROM AUTHOR]

Background: The coronary venous system is a commonly used route of entry to the heart. It is being used increasingly for various electrophysiological purposes, as cardiac resynchronization therapy (CRT) in treating arrhythmias and heart failure. Multi-detector Computed Tomography (MDCT) coronary angiography is an excellent non-invasive modality in visualizing cardiac veins anatomy as well as being an alternative tool for invasive retrograde cardiac venography. This study aimed to delineate the normal anatomy of the coronary venous system before CRT using MDCT coronary angiography with multi-planar reformation (MPR) and three-dimensional (3D) reconstruction. Methods: The study was done in Zagazig university hospitals in the period from June 2019 to February 2020. Thirty patients with normal heart rate were enrolled (60% males and 40% females; mean age: 55.87±12.02 years, range: 26–71 years), who underwent elective MDCT coronary angiography using 128-slice MDCT scanner (Ingenuity Phillips health care, best Netherlands). Results: The systolic phase of cardiac cycle (45%) was the best phase where most cardiac veins were best seen. Coronary Sinus (CS), Great Cardiac Vein (GCV), Anterior Interventricular Vein (AIV) and Middle Cardiac Vein (MCV) were visualized in all cases (100%). Thebesian valve was observed in (73%). The diameter of the CS ostium in the superoinferior direction (mean 17.2 ± 2.55) was significantly larger than that in the anteroposterior direction (mean 12.58 ± 2.44). Conclusions: This study showed that MDCT coronary angiography is a promising imaging modality in the delineation of cardiac veins anatomy. Also, it can offer information about their relationship with adjacent anatomical structures. [ABSTRACT FROM AUTHOR]

Objective: To describe the radiopathological characteristics of a new morphological "combined type" of gallbladder cancer (GBC) and compare it with the mass replacing gallbladder and thickening types of GBC. Materials and methods: The imaging and pathological details of consecutive patients with GBC between August 2020 and December 2022 were retrospectively reviewed. Two radiologists reviewed computed tomography/magnetic resonance imaging in consensus for the morphological type of GBC. The radiologists classified GBC as mass replacing gallbladder, wall thickening, and combined type. The combined type was defined as a mass arising from the thickened wall of an adequately distended gallbladder that extended exophytically into the adjacent liver parenchyma. The presence of calculi, site, and size of lesion, biliary/portal vein involvement, liver, lymph node, and omental metastases was compared among the various types. The pathological characteristics were also compared. Results: Of the 481 patients (median age 55 years, 63.2% females) included in the study, mass replacing gallbladder, wall thickening, and combined-type GBC were seen in 42.8% (206/481), 40.5% (195/481), and 16.6% (80/481) of patients, respectively. In the combined type of GBC, biliary/portal vein involvement was seen in 63.7% (51/80) and 7.5% (6/80) of patients. Liver, lymph node, and omental metastases were seen in 67.5% (54/80), 40% (32/80), and 41.2% (33/80) patients, respectively. Liver metastases were significantly more common in the combined type (p = 0.002). There were no significant differences in pathological characteristics among the various types. Conclusion: Combined-type GBC is less common than the mass replacing gallbladder and thickening types and is associated with a higher risk of liver metastases. [ABSTRACT FROM AUTHOR]

Morphologic changes in the brain through aging, as a physiologic process, may involve a wide range of variables including ventricular dilation, and sulcus widening. This study reports normal ranges of these changes as standard criteria. Normal brain computed tomography scans of 400 patients (200 males, 200 females) in every decade of life (20 groups each containing 20 participants) were investigated for subcortical/cortical atrophy (bicaudate width [BCW], third ventricle width [ThVW], maximum length of lateral ventricle at cella media [MLCM], bicaudate index [BCI], third ventricle index [ThVI], and cella media index 3 [CMI3], interhemispheric sulcus width [IHSW], right hemisphere sulci diameter [RHSD], and left hemisphere sulci diameter [LHSD]), ventricular symmetry. Distribution and correlation of all the variables were demonstrated with age and a multiple linear regression model was reported for age prediction. Among the various parameters of subcortical atrophy, BCW, ThVW, MLCM, and the corresponding indices of BCI, ThVI, and CMI3 demonstrated a significant correlation with age (R2=0.62). All the cortical atrophy parameters including IHSW, RHSD, and LHSD demonstrated a significant correlation with age (R2=0.63). This study is a thorough investigation of variables in a normal brain which can be affected by aging disclosing normal ranges of variables including major ventricular variables, derived ventricular indices, lateral ventricles asymmetry, cortical atrophy, in every decade of life introducing BW, ThVW, MLCM, BCI, ThVI, CMI3 as most significant ventricular parameters, and IHSW, RHSD, LHSD as significant cortical parameters associated with age. [ABSTRACT FROM AUTHOR]

The introduction of Spiral CT and Multidetector CT capable of multiplanar reconstructions has improved the diagnostic aspects of PNS by providing excellent details of anatomy, anatomic variants and pathology (inflammatory and neoplastic conditions) of PNS serving as pre-operative "ROAD MAP" called SSCT (Screening sinus CT) to the modern sinus surgeon to treat patients more effectively and reducing complications associated with Functional Endoscopic Sinus Surgery (FESS). History was taken from each patient followed by clinical examination. Basic investigations like routine blood examination and routine urine examination were done whenever required. Diagnosis was confirmed by characteristic imaging features of masses or post-operative histopathological reports. Follow up of the patients was done by taking details of treatment and procedures done on the patients. In this study, plain radiographic findings were sinus opacification (100%), bilateral nasal haziness (58.06%) and unilateral nasal haziness (41.93%). On MRI, obliteration of nasal cavity (100%), extension of mass (93.55%), mass effect (90.32%) and enlargement of ethmoid infundibulum (90.32%) were seen. In present study, CT and MRI were able to correctly diagnose ethmoidal polyp. [ABSTRACT FROM AUTHOR]

Background: Anti-fibrotic drugs for interstitial pulmonary fibrosis (IPF) have been developed. Physicians are becoming increasingly aware of the need for better diagnosis of IPF. Purpose: To evaluate whether a computer-aided system can improve the diagnostic performance of general radiologists in detecting the usual interstitial pneumonia (UIP) pattern on computed tomography (CT). Material and Methods: We included 60 CT datasets from 30 patients with IPF and 30 with idiopathic fibrosing non-specific interstitial pneumonia (fNSIP), all diagnosed by a multidisciplinary diagnosis (MDD) procedure that included surgical biopsy. We analyzed the CT data using a computer-aided system (Gaussian histogram normalized correlation: GHNC). Five general radiologists with <6 years of experience each interpreted these CT scans with and without the GHNC results. We compared the likelihoods of a UIP-pattern diagnosis with the likelihood of the same diagnosis by MDD using the average area under the curve (AUC) of the receiver operating characteristics (ROC). We also evaluated the association between the radiologists' diagnosis and survival using the Kaplan–Meier method. Results: In the ROC analysis, the AUC increased significantly from 0.731 without GHNC to 0.829 with GHNC (P = 0.0396). The diagnosis without GHNC was not significantly associated with survival for any radiologist, but the UIP diagnosis with GHNC was significantly associated with a worse prognosis for four out of five radiologists. Conclusion: The computer-aided system could increase the confidence level of UIP-pattern diagnosis by non-expert radiologists. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES The aortic root (AoR) rotation and its spatial morphology at the base of the heart were postulated but not described in every detail. AoR rotation modalities may play an important role in decision-making during AoR surgery and its outcome. The aim was to provide a detailed spatial anatomy of the AoR rotation and its relation to the vital surrounding structure. METHODS The AoR rotation and its relation to the surrounding structure were assessed in 104 patients with tricuspid aortic valve. The interatrial septum was chosen as a reference to describe AoR rotation that marked the midline of the heart base as a landmark for the AoR rotation direction. Intermediate, clockwise and counterclockwise AoR rotations were defined based on the mentioned reference structures. RESULTS The AoR rotation was successfully assessed in 104 patients undergoing ascending aorta and or AoR intervention by multidetector row computed tomography. AoR was positioned normally in 53.8% of cases (n  = 56) and rotated counterclockwise in 5.8% (n  = 6) and clockwise in 40.4% (n  = 42) of cases. In clockwise AoR rotation, the right coronary sinus was positioned in proximity to the right atrium and of the tricuspid valve, whereas in a counterclockwise rotation, the noncoronary sinus was placed over the tricuspid valve just over the membranous septum. CONCLUSIONS The AoR's rotation can be diagnosed using multidetector row computed tomography. Understanding the anatomy of the aortic valve related to rotational position helps guide surgical decision-making in performing AoR reconstruction. [ABSTRACT FROM AUTHOR]

The objective of this study is to determine whether the morphometric evaluation of the foramen magnum using computed tomography can be used as an accurate tool in estimating the sex of an individual. An extensive search of the databases, PubMed, ProQuest, Google Scholar, and Scopus, was carried out to procure articles that fulfilled the inclusion criteria. The AQUA tool was used to assess the quality of the included studies. A random effects model was used for the meta-analysis of the eligible studies using the STATA software, version 16, 2019 at 95% CI and p ≤ 0.05. Eleven eligible articles that measured the transverse and sagittal diameters of the foramen magnum using computed tomography were included in this study. The sagittal diameter of the foramen magnum was greater than the transverse diameter, and both the diameters were greater in males than in females. Meta-analysis revealed that both transverse and sagittal diameters were more reliable for male sex estimation. Since there is a dimensional variation between the male and female foramen magnum, it can be used for initial sex identification and also as an auxiliary to other advanced methods of sex estimation. [ABSTRACT FROM AUTHOR]

Objective: To search for any morphological variation contributing to aetiopathogenesis and the diagnosis of benign paroxysmal positional vertigo, we measured the sizes of the semicircular canals in patients with and without benign paroxysmal positional vertigo using multidetector computed tomography. Methods: Cranial bone computed tomography images of 30 benign paroxysmal positional vertigo patients and 30 control patients were acquired with a 128-slice computed tomography scanner and a transverse plane with a thickness of 0.67 mm. The inner diameter, height and width of the canals were measured. Results: The width of the anterior semicircular canals, and the width and height of the posterior semicircular canals of the affected ears in benign paroxysmal positional vertigo patients (n = 30) were significantly greater than in the control patients (n = 90; p = 0.001, p = 0.023, p = 0.003, respectively). Conclusion: In benign paroxysmal positional vertigo patients, the posterior and anterior semicircular canals are longer than those in people without benign paroxysmal positional vertigo. These morphological changes may contribute to elucidating the aetiopathogenesis and be used as a radiological sign for diagnosis of benign paroxysmal positional vertigo disease. [ABSTRACT FROM AUTHOR]

The middle colic artery usually arises from the superior mesenteric artery, but in rare cases it may arise from the coeliac trunk or its branches. The aim of this study was to investigate variant origins of the middle colic artery on computed tomography and anatomical dissection. Variant middle colic arteries were identified on computed tomography as part of an ongoing study investigating anatomical variations of vessels of the upper abdomen. Three-dimensional reconstructions were made to demonstrate the variant findings. Cadaveric dissections were performed as part of a routine dissection course. We report five cases of rare variant origins of the middle colic artery arising from the coeliac axis. Among these sites of origin were the coeliac trunk, the gastrosplenic trunk, the splenic artery, and the common hepatic artery. Four cases were identified on multi-detector computed tomography and one in a cadaver. In all cases, the vessels passed posterior to the body of the pancreas before entering the transverse mesocolon. Knowledge of middle colic artery variations is important to prevent inadvertent injury in digestive surgery, especially in the hepatopancreatic area. Variant origins of the middle colic artery are rare, and their knowledge is crucial to prevent unnecessary iatrogenic injury during abdominal surgery. [ABSTRACT FROM AUTHOR]

Background: To explore the capability and clinical significance of chest thin-section computed tomography (CT) for localization of mammographically detected clustered microcalcifications. Methods: A total of 69 patients with 71 mammographically detected clustered microcalcifications received surgical biopsy under the guidance of mammography (MG), CT was used to localize calcifications combined with MG if calcifications can be seen on CT. Intraoperative mammography of the specimens were performed in all cases for identification of the resected microcalcifications. The clinical, imaging and pathological information of these patients were analyzed. Results: A total of 42 (59.15%) cases of calcifications were localized by CT + MG, 29 (40.85%) cases were guided only by the mammography. All suspicious calcifications on the mammography were successfully removed. Pathological results showed 42 cases were cancer, 23 cases were benign, and 6 cases were atypical hyperplasia. The mean age in the CT + MG group was older than that of the MG group (54.12 vs. 49.27 years; P = 0.014). The maximum diameter of clusters of microcalcifications on mammography in the CT + MG group was larger than that of the MG group [(cranio-caudal view, 1.52 vs. 0.61 mm, P = 0.000; mediolateral oblique (MLO) view, 1.53 vs. 0.62 mm, P = 0.000)]. The gray value ratio (calcified area / paraglandular; MLO, P = 0.004) and the gray value difference (calcified area - paraglandular; MLO, P = 0.005) in the CT + MG group was higher than that of the MG group. Multivariate analysis showed that the max diameter of clusters of microcalcifications (MLO view) was a significant predictive factor of localization by CT in total patients (P = 0.001). Conclusions: About half of the mammographically detected clustered microcalcifications could be localized by thin-section CT. Maximum diameter of clusters of microcalcifications (MLO view) was a predictor of visibility of calcifications by CT. Chest thin-section CT may be useful for localization of calcifications in some patients, especially for calcifications that are only visible in one view on the mammography. [ABSTRACT FROM AUTHOR]

The benign and malignant status of solitary pulmonary nodules (SPNs) is a key determinant of treatment decisions. The main objective of this study was to validate the efficacy of machine learning (ML) models featured with dual-layer detector spectral computed tomography (DLCT) parameters in identifying the benign and malignant status of SPNs. 250 patients with pathologically confirmed SPN were included in this study. 8 quantitative and 16 derived parameters were obtained based on the regions of interest of the lesions on the patients' DLCT chest enhancement images. 6 ML models were constructed from 10 parameters selected after combining the patients' clinical parameters, including gender, age, and smoking history. The logistic regression model showed the best diagnostic performance with an area under the receiver operating characteristic curve (AUC) of 0.812, accuracy of 0.813, sensitivity of 0.750 and specificity of 0.791 on the test set. The results suggest that the ML models based on DLCT parameters are superior to the traditional CT parameter models in identifying the benign and malignant nature of SPNs, and have greater potential for application. [ABSTRACT FROM AUTHOR]

Objective. This study aims to explore the relationships between serum indoxyl sulfate (IS) and Klotho protein levels with vascular calcification in patients with chronic kidney disease (CKD) stages 3–5. Methods. From December 2021 to January 2023, a total of 108 CKD patients in stages 3–5 were enrolled in this cross-sectional investigation. Demographic information and routine clinical biochemistry test results were gathered. Serum levels of IS and Klotho were quantified through enzyme-linked immunosorbent assays. Furthermore, multislice spiral computed tomography was employed to evaluate vascular calcification. The association between serum IS or Klotho levels and abdominal aorta calcification was assessed using univariate analysis and logistic regression analyses. Results. With the progression of CKD stages, serum creatinine, phosphorus, intact parathyroid hormone (iPTH), serum IS, and abdominal aortic calcification exhibited incremental trends, while serum calcium and Klotho protein levels showed a diminishing trend, with statistically significant differences (P < 0. 05). Significant differences were observed in age, blood phosphorus, calcium, total parathyroid hormone, serum IS, and Klotho protein levels between patients with and without aortic calcification (P < 0. 05). Logistic regression analysis demonstrated that advanced age, high IS level, and low Klotho protein level were independent risk factors for abdominal aortic calcification in CKD patients (P < 0. 05). Conclusion. This study indicates elevated serum IS levels and decreased Klotho protein levels in CKD patients. High IS level and low Klotho level were independent risk factors for abdominal aortic calcification. [ABSTRACT FROM AUTHOR]

Background: Accurate assessment of stenosis site, degree, and length in post-intubation laryngotracheal stenosis patients is crucial for procedure selection and prognosis prediction. Despite being the preferred method, bronchoscopy has its drawbacks in severely ill patients, with potential complications and limitations in evaluating airway features beyond high-grade stenosis. Computed Tomography (CT) scans with multiplanar reconstructions are suggested as a safer and alternative diagnostic tool to overcome these limitations. The present work aims to compare the diagnostic performance of CT virtual bronchoscopy (VB) and multiplanar reformatting (MPR) with conventional bronchoscopy (CB) in post-intubation laryngotracheal stenosis patients. Methods: This prospective comparative study, enrolled 30 patients with post-intubation laryngotracheal stenosis from October 2020 to October 2022. All patients were subjected to detailed history taking, thorough clinical examination, endoscopic and radiological investigations. All patients went through CT examination, rigid bronchoscope and underwent tracheal resection anastomosis operation. The evaluated parameters were the length, diameter, and cranio-caudal extent of stenosis in all settings, and the results were compared. Results: No statistically significant differences between computed tomography virtual bronchoscopy and MPR with crico-tracheal resection operation results regarding length (p-value = 0.943), diameter (p-value = 0.939), and craniocaudal extent (p-value = 0.988). Regarding conventional bronchoscopy and crico-tracheal resection, a statistically significant difference in lumen diameter (p-value = 0.024) was noted. No significant difference in length (p-value = 0.943). No statistically significant difference (p-value = 0.951) as regards cranio-caudal extent. Conclusions: CT multiplanar reformatting and virtual bronchoscopy offer accurate, noninvasive assessment of laryngotracheal stenosis, surpassing conventional bronchoscopy. They prove beneficial for precise evaluation of lesion length and lumen diameter, especially beyond high-grade stenosis where conventional bronchoscopy faces limitations. These techniques serve as dependable alternatives for patients at risk for anesthesia, providing a safer diagnostic approach. [ABSTRACT FROM AUTHOR]

Objective: To investigate the feasibility of a radiomics model based on contrast-enhanced CT for preoperatively predicting early recurrence after curative resection in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods: One hundred and eighty-six patients with resectable PDAC who underwent curative resection were included and allocated to training set (131 patients) and validation set (55 patients). Radiomics features were extracted from arterial phase and portal venous phase images. The Mann-Whitney U test and least absolute shrinkage and selection operator (LASSO) regression were used for feature selection and radiomics signature construction. The radiomics model based on radiomics signature and clinical features was developed by the multivariate logistic regression analysis. Performance of the radiomics model was investigated by the area under the receiver operating characteristic (ROC) curve. Results: The radiomics signature, consisting of three arterial phase and three venous phase features, showed optimal prediction performance for early recurrence in both training (AUC = 0.73) and validation sets (AUC = 0.66). Multivariate logistic analysis identified the radiomics signature (OR, 2.58; 95% CI 2.36–3.17; p = 0.002) and clinical stage (OR, 1.60; 95% CI 1.15–2.30; p = 0.007) as independent predictors. The AUC values for risk evaluation of early recurrence using the radiomics model incorporating clinical stage were 0.80 (training set) and 0.75 (validation set). Conclusion: The radiomics-based model integrating with clinical stage can predict early recurrence after upfront surgery in patients with resectable PDAC. [ABSTRACT FROM AUTHOR]

Background: The association between adrenal size and metabolic profiles in patients with diabetes mellitus (DM) is unclear. This study was conducted to determine whether the adrenal thickness measured by computed tomography (CT) is correlated with the metabolic profiles of patients with DM. Methods: This was a cross‐sectional study including 588 Chinese hospitalized patients with DM without comorbidities or medications known to affect adrenal morphology or hormone secretion. Adrenal limb thickness was measured on unenhanced chest CT. Participants were stratified into tertiles according to their total adrenal limb thickness. Linear and logistic regression models were used to estimate the correlations. Results: After adjustment for sex and age, the adrenal thickness was positively associated with body mass index (BMI), waist circumference (WC), urinary albumin/creatinine ratio, and 24‐h urinary free cortisol (UFC) and negatively correlated with high‐density lipoprotein cholesterol. The sequential equation model (SEM) suggested UFC partially mediated the effect of adrenal limb thickness on WC by 12%. Adrenal thickness, but not UFC, was associated with a higher risk of existing hypertension (odds ratio [OR] = 3.78, 95% confidence interval [CI] 1.58, 9.02) and hyperlipidemia (OR = 2.76, 95% CI 1.03, 7.38), independent of age, gender, BMI, and WC. Conclusions: The adrenal thickness is independently associated with BMI, WC, cortisol levels, urinary albumin/creatinine ratio, hypertension, and dyslipidemia but not glycemic parameters in patients with diabetes. Our study encourages further studies to investigate the role of adrenal physiology in patients with diabetes. [ABSTRACT FROM AUTHOR]

Background: Different imaging techniques, such as multi-detector computed tomography (MDCT) scan and cone beam computed tomography(CBCT), are used to check the structure of the nose before rhinoplasty. This study aimed to evaluate the accuracy of two imaging techniques, MDCT scan, and CBCT, in diagnosing structural Variations in rhinoplasty for the first time. Methods: This diagnostic accuracy study was conducted on 64 rhinoplasty candidates who complained of snoring and sleep apnea or had a positive result in the examination with Cottle's maneuver or modified Cottle technique between February 2021 and October 2022 at 15- Khordad Hospital affiliated to Beheshti University of Medical Sciences. Before rhinoplasty, patients were randomly assigned to one of the CT and CBCT techniques with an equal ratio. Scans were assessed for the presence of Nasal septum deviation (NSD), Mucocele, Concha bullosa, and nasal septal spur by two independent radiologists. The findings of the two methods were evaluated with the results during rhinoplasty as the gold standard. Results: NSD was the most common anatomical variation based on both imaging techniques. The accuracy of CBCT for diagnosing Nasal Septum Deviation and Mucocele was 80% and 75%, respectively. The sensitivity, specificity, and accuracy of CBCT in detecting Concha bullosa were 81.3% and 83.3%, respectively. The Kappa coefficient between CBCT and intraoperative findings for diagnosing NSD and Concha Bullosa was 0.76 and 0.73, respectively (p < 0.05). Conclusion: CBCT can be considered a suitable method with high accuracy and quality to evaluate the anatomical variations before rhinoplasty. [ABSTRACT FROM AUTHOR]

This article, published in the journal Thoracic & Cardiovascular Surgeon, examines the changes in the geometry of the ascending aorta up to three years after thoracic endovascular aortic repair (TEVAR) for descending aortic dissection. The study analyzed 102 patients who underwent TEVAR at a single center in Germany. The results showed that there were no significant changes in the diameter, cross-area, or volume of the ascending aorta after the TEVAR procedure. However, there was a significant difference in the length of the ascending aorta between six months and three years post-op. The study also found that a history of coronary artery disease and increased body height were associated with decreased diameter and length of the ascending aorta one year after TEVAR. Overall, the findings suggest that TEVAR does not lead to ascending aortic enlargement after three years of follow-up, and certain patient characteristics may influence the changes in ascending aortic geometry. [Extracted from the article]

Objective This study investigated the safety and efficacy of sclerotherapy with intralesional bleomycin injection (IBI) for retrobulbar orbital low-flow vascular lesions under multi-slice computed tomography (CT) guidance. Methods Between January 2010 and September 2021, consecutive patients with retrobulbar orbital low-flow vascular lesions who underwent CT-guided IBI at a tertiary centre in Taiwan were enrolled. Their medical records and imaging data were retrospectively collected. Results This study enrolled 13 patients (7 male and 6 female patients; age range: 1-57 years; mean age: 25.9 years) with lymphatic malformation (LM, n  = 4), venolymphatic malformation (n  = 1), and venous malformation (VM, n  = 8). The overall radiological response rate was 76.9% (10 of 13); the radiological response rate was 75.0% in the VM group (6 of 8) and 75.0% in the LM group (3 of 4). Moreover, 3 patients (23.1%) had minor complications and 1 (7.7%) had a major complication. The mean clinical and radiological follow-up was 8.3 months and no recurrence or progression was reported. Conclusion CT-guided IBI is an effective and relatively safe minimally invasive treatment for retrobulbar orbital low-flow vascular lesions, with an overall radiological response rate of 76.9% in a mean of 1.5 sessions and a low complication rate. Advances in knowledge CT-guided sclerotherapy with IBI is a relatively safe, effective, and feasible alternative treatment option for retrobulbar orbital low-flow vascular lesions. [ABSTRACT FROM AUTHOR]