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Because osteoporotic vertebral fracture (OVF) on chest radiographs is commonly missed in radiological reports, we aimed to develop a software program which offers automated detection of compressive vertebral fracture (CVF) on lateral chest radiographs, and which emphasizes CVF detection specificity with a low false positivity rate.For model training, we retrieved 3,991 spine radiograph cases and 1,979 chest radiograph cases from 16 sources, with among them in total 1,404 cases had OVF. For model testing, we retrieved 542 chest radiograph cases and 162 spine radiograph cases from four independent clinics, with among them 215 cases had OVF. All cases were female subjects, and except for 31 training data cases which were spine trauma cases, all the remaining cases were post-menopausal women. Image data included DICOM (Digital Imaging and Communications in Medicine) format, hard film scanned PNG (Portable Network Graphics) format, DICOM exported PNG format, and PACS (Picture Archiving and Communication System) downloaded resolution reduced DICOM format. OVF classification included: minimal and mild grades with20% or ≥20-25% vertebral height loss respectively, moderate grade with ≥25-40% vertebral height loss, severe grade with ≥40%-2/3 vertebral height loss, and collapsed grade with ≥2/3 vertebral height loss. The CVF detection base model was mainly composed of convolution layers that include convolution kernels of different sizes, pooling layers, up-sampling layers, feature merging layers, and residual modules. When the model loss function could not be further decreased with additional training, the model was considered to be optimal and termed 'base-model 1.0'. A user-friendly interface was also developed, with the synthesized software termed 'Ofeye 1.0'.Counting cases and with minimal and mild OVFs included, base-model 1.0 demonstrated a specificity of 97.1%, a sensitivity of 86%, and an accuracy of 93.9% for the 704 testing cases. In total, 33 OVFs in 30 cases had a false negative reading, which constituted a false negative rate of 14.0% (30/215) by counting all OVF cases. Eighteen OVFs in 15 cases had OVFs of ≥ moderate grades missed, which constituted a false negative rate of 7.0% (15/215, i.e., sensitivity 93%) if only counting cases with ≥ moderate grade OVFs missed. False positive reading was recorded in 13 vertebrae in 13 cases (one vertebra in each case), which constituted a false positivity rate of 2.7% (13/489). These vertebrae with false positivity labeling could be readily differentiated from a true OVF by a human reader. The software Ofeye 1.0 allows 'batch processing', for example, 100 radiographs can be processed in a single operation. This software can be integrated into hospital PACS, or installed in a standalone personal computer.A user-friendly software program was developed for CVF detection on elderly women's lateral chest radiographs. It has an overall low false positivity rate, and for moderate and severe CVFs an acceptably low false negativity rate. The integration of this software into radiological practice is expected to improve osteoporosis management for elderly women.

There have been concerns that literature described radiological feature differences between drug-sensitive pulmonary tuberculosis (DS-PTB) and multidrug-resistant (MDR)-PTB were confounded by that MDR-PTB cases tend to have a longer history. Using history length matched DS-PTB and MDR-PTB cases from a well-defined urban region in Dalian, we retrospectively analysed the CT feature differences of these paired cases with a focus on pulmonary nodular (PN) consolidation and pulmonary cavity (PC).There were 33 consecutive MDR-PTB cases [inclusive of rifampicin-resistant (RR) cases, 27 males and 6 females, mean age: 49.2 years], with 19 cases had a history of1 month and 8 and 6 cases had a history of 1-6 and6 months respectively. To pair the MDR-PTB cases with history length, matched 33 cases of DS-PTB patients (21 males and 12 females, mean age: 56.5 years) were included. All patients were new PTB without HIV infection. The first CT exams prior to treatment were analysed.Compared with DS cases, MDR cases had a much higher prevalence of PN (75.76%MDR-TB is likely intrinsically more invasive than DS-TB. Multiple PN and Multiple PC are promising signs for the suspicion of MDR-PTB on chest imaging.

BACKGROUND: Early preeclampsia is associated with significant placental hypoperfusion. We explore the diagnostic value of placental diffusion-derived vessel density, a biomarker derived from diffusion-weighted magnetic resonance imaging, which measures in vivo vessel microperfusion, in the differential diagnosis of normal and early preeclampsia pregnancies. METHODS: This was a prospective study involving 29 controls and 17 singleton pregnancies affected by early preeclampsia. Nineteen pregnancies from 28 to 34 weeks of gestational age were included from the normal group for a comparison with the early preeclampsia group. Using a 3.0 T magnetic resonance imaging scanner, diffusion-weighted images were obtained with the diffusion weighting b values of 0, 20, and 40 s/mm 2 . DDVD mean was the mean of DDVD b0b20 and DDVD b0b40 , while DDVD b0b20 and DDVD b0b40 refer to the diffusion-derived vessel density values computed from b =0 and 20 s/mm 2 images, and from b =0 and 40 s/mm 2 images, respectively. The correlation between DDVD mean and gestational age was examined using a linear regression model. The area under the curve of the DDVD mean for early preeclampsia pregnancies detection was calculated by the receiver operating characteristic analysis. RESULTS: As gestational age increased, DDVD mean linearly decreased. DDVD mean was significantly decreased in the early preeclampsia pregnancies compared with the normal pregnancies (52.72±46.73 versus 213.34±93.50 au/pixel; P mean ) for discriminating between normal and early preeclampsia pregnancies regardless of fetal growth restriction was 0.954, and the area under the curve was 1.000 when early preeclampsia pregnancies without fetal growth restriction were excluded. CONCLUSIONS: DDVD mean , an in vivo vessel microperfusion measure, allowed total separation of normal and early preeclampsia pregnancies.

Developments in deep learning techniques have led to significant advances in automated abnormality detection in radiological images and paved the way for their potential use in computer-aided diagnosis (CAD) systems. However, the development of CAD systems for pulmonary tuberculosis (TB) diagnosis is hampered by the lack of training data that is of good visual and diagnostic quality, of sufficient size, variety, and, where relevant, containing fine-region annotations. This study presents a collection of annotations/segmentations of pulmonary radiological manifestations that are consistent with TB in the publicly available and widely used Shenzhen chest X-ray (CXR) dataset made available by the U.S. National Library of Medicine and obtained via a research collaboration with No. 3. People’s Hospital Shenzhen, China. The goal of releasing these annotations is to advance the state of the art for image segmentation methods toward improving the performance of the fine-grained segmentation of TB-consistent findings in digital chest X-ray images. The annotation collection comprises the following: (1) annotation files in JavaScript Object Notation (JSON) format that indicate locations and shapes of 19 lung pattern abnormalities for 336 TB patients; (2) mask files saved in PNG format for each abnormality per TB patient; and (3) a comma-separated values (CSV) file that summarizes lung abnormality types and numbers per TB patient. To the best of our knowledge, this is the first collection of pixel-level annotations of TB-consistent findings in CXRs.

IntroductionTo define what portion of older community men with what severity of radiographic osteoporotic-like vertebral fracture (OLVF) correspond to what low T-score status.MethodsThere were 755 community Chinese men (age: 76.4 ±6.7 years, range: 65-98 years) with thoracic and lumbar spine radiograph, and hip and lumbar spine bone mineral density measures. For each vertebra in a subject, a score of 0, -0.5, -1, -1.5, -2, -2.5, and -3 was assigned for no OLVF or OLVF of ResultsOLVFss of -2, -2.5, -3, corresponded to a mean femoral neck T-score of -2.297 (range: -2.355∼-2.247), -2.494 (range: -2.637∼ -2.363), and -2.773 (range: -2.898∼-2.643), a mean hip T-score of-2.311 (range: -2.420∼-2.234), -2.572 (range: -2.708∼-2.432), -2.911 (range: -3.134∼-2.708), a mean lumbar spine T-score of -2.495 (range: -2.656∼-2.403), - 2.931 (range: -3.255∼-2.656), and -3.369 (range: 3.525∼-3.258). The Pearson correlation value of OLVFss and T-score of femoral neck, hip and lumbar spine was r =0.21, 0.26, and 0.22 (all pConclusionA single severe grade OLVF (≥40% height loss) or OLVFss ≤-2.5 suggest osteoporosis suggest this subject is osteoporotic, or a single collapse grade (≥2/3 height loss) radiological OLVF or OLVF≤-3 meets osteoporosis diagnosis criterion. The results further highlight the difficulty of diagnosing osteoporotic vertebral fracture among Chinese older men.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a pandemic disease. Fast and accurate diagnosis of COVID-19 from chest radiography may enable more efficient allocation of scarce medical resources and hence improved patient outcomes. Deep learning classification of chest radiographs may be a plausible step towards this. We hypothesize that bone suppression of chest radiographs may improve the performance of deep learning classification of COVID-19 phenomena in chest radiographs. METHODS: Two bone suppression methods (Gusarev et al. and Rajaraman et al.) were implemented. The Gusarev and Rajaraman methods were trained on 217 pairs of normal and bone-suppressed chest radiographs from the X-ray Bone Shadow Suppression dataset (https://www.kaggle.com/hmchuong/xray-bone-shadow-supression). Two classifier methods with different network architectures were implemented. Binary classifier models were trained on the public RICORD-1c and RSNA Pneumonia Challenge datasets. An external test dataset was created retrospectively from a set of 320 COVID-19 positive patients from Queen Elizabeth Hospital (Hong Kong, China) and a set of 518 non-COVID-19 patients from Pamela Youde Nethersole Eastern Hospital (Hong Kong, China), and used to evaluate the effect of bone suppression on classifier performance. Classification performance, quantified by sensitivity, specificity, negative predictive value (NPV), accuracy and area under the receiver operating curve (AUC), for non-suppressed radiographs was compared to that for bone suppressed radiographs. Some of the pre-trained models used in this study are published at (https://github.com/danielnflam). RESULTS: Bone suppression of external test data was found to significantly (P0.05) improve or worsen classifier performance. CONCLUSIONS: Rajaraman suppression significantly improved classification performance in one classification architecture, and did not significantly worsen classifier performance in the other classifier architecture. This research could be extended to explore the impact of bone suppression on classification of different lung pathologies, and the effect of other image enhancement techniques on classifier performance.

This study estimated the bone mineral density (BMD) defined osteoporosis prevalence of Chinese women and Chinese men aged ≥50 years. The estimation was based on the 1994 WHO definition of osteoporosis and two assumptions: (I) fragility fracture (FF) risk among older Chinese is half of that of older US Caucasians; (II) FF risk among older Chinese men is half of that of older Chinese women. In addition, we also consider the FF risk among older Chinese is close to those of American Blacks. We estimated that the osteoporosis prevalence based on lumbar BMD, femoral neck BMD, total hip BMD would be 15.8%, 20.4%, and 15.2% for US Caucasian women, 6.7%, 7.8%, and 7.9% for US black women, 7.5%, 7.5%, and 6.7% for Chinese women, 1.8%, 5.7%, and 3.3% for US black men, and 2.0%, 3.8%, and 3.4% for Chinese men. To satisfy the above estimates of osteoporosis prevalence for the Chinese population, in addition to using a local reference database, we suggest that the T-score cutpoints for defining osteopenia and osteoporosis among older Chinese should be adjusted from the conventional WHO thresholds of -2.5 and -1.0. Our suggested revised cutpoint T-score for defining osteoporosis described in this article will be more in line with the original WHO definition and will allow a more meaningful international comparison of disease burden.

Supplemental material, Supplemental_Material_for_DiffusionMRIderivedVesselDensity_XiaoAndWang for Diffusion MRI Derived per Area Vessel Density as a Surrogate Biomarker for Detecting Viral Hepatitis B-Induced Liver Fibrosis: A Proof-of-Concept Study by Ben-Heng Xiao, Hua Huang, Li-Fei Wang, Shi-Wen Qiu, Sheng- Wen Guo and Yì Xiáng J. Wáng in SLAS Technology

Supplemental material for Dependence of intravoxel incoherent motion diffusion MR threshold b-value selection for separating perfusion and diffusion compartments and liver fibrosis diagnostic performance by Yì Xiáng J Wáng, Yáo T Li, Olivier Chevallier, Hua Huang, Jason Chi Shun Leung, Weitian Chen and Pu-Xuan Lu in Acta Radiologica

The professional moral and job satisfaction of medical profession remain highly disputed in media in China. On the other hand, there is wide disaffection of patients toward doctors in China. This survey aims to obtain a better understanding of the motivation of Chinese medical professionals.An anonymous online cross-sectional survey, AME survey III, was conducted using the platform provided by DXY (www.dxy.cn) during the period of September 10-23, 2015. In total 2,356 DXY users completed the survey, including 1,740 males and 617 females, with a mean age of 31.96±7.03 yrs.The reasons (multiple choices) for career disaffection included poor patient/doctor relationship (88.6%), imbalance between workload and pay (79.5%), could not enter the preferred specialty (14.14%), and working in small clinics with no career progress (11.17%). If given the choice to enter the specialty as well as the hospital grade of their choice, 73.8% dissatisfied respondents replied they would like to be a doctor. For the dis-satisfied respondents, university teacher appeared to be the most popular career choice. The cited high workload was considered to be due to (I) imbalance in geographical allocation of doctors and insufficient training of doctors; (II) many red-tapism formalities; (III) Chinese patients often have unreasonable requests; (IV) over-examination and over-treatment; (V) high pressure to publish papers. One hundred and twelve respondents have their child/children attending university or graduated from university, 25.0% of them are pursuing a career in medicine. Nine hundred and ninety respondents have child/children while did not reach university age yet, among them 23.62% would like their child/children to study medicine. 64.87% of the 2,356 participants favor China to open up medical market to qualified foreign medical organizations to take part in fair competition, and 57.91% favor the government supporting regulated private hospitals.The moral and motivation of medical doctors in China are likely to be similar to other continuously evolving societies. Cost-effective use of existing resources should be explored as the first priority.

Posterior reversible encephalopathy syndrome (PRES) is a rare but serious clinical-neuroradiological entity characterized by headache, vomiting, visual disturbances, altered mental status, seizures, and unconsciousness associated with the characteristic imaging findings including sub-cortical vasogenic edema at the bilateral parietal and occipital lobes. We describe a case of 28-year-old PRES patient secondary to delayed maternal postpartum eclampsia. This patient was not initially diagnosed with pre-eclampsia and PRES. The diagnosis was established after magnetic resonance imaging. After treatment this patient’s PRES resolved. Early diagnosis and treatment are the keys to reverse PRES. A literature review for PRES is provided in this report.

To assess the retention of gadolinium (Gd) in skin, liver, and bone following gadodiamide or gadoteric acid administration.Gd was measured in skin, liver and femur bone in female rats 10 weeks after administration of 17.5 mmol Gd/kg over 5 days of Gd agents. Rat skin microscopy, energy filtering transmission electron microscopy and elemental analysis were performed, and repeated after receiving the same dosage of gadodiamide in rats with osteoporosis induced with bilateral ovariectomy (OVX). The OVX was performed 60 days after the last injection of gadodiamide and animals sacrificed 3 weeks later.Gd concentration was 180-fold higher in the skin, 25-fold higher in the femur, and 30-fold higher in the liver in rats received gadodiamide than rats received gadoteric acid. The retention of Gd in the skin with gadodiamide was associated with an increase in dermal cellularity, and Gd encrustation of collagen fibers and deposition inside the fibroblasts and other cells. No differences in Gd concentration in liver, skin, and femur were observed between rats receiving gadodiamide with or without OVX.Gd tissue retention with gadodiamide was higher than gadoteric acid. Tissues Gd deposition did not alter following gadodiamide administration to ovariectomized rats.

Publication statistics was retrieved on carbon nanodots (C-dots) from 2004 up till 2014 using the web of Science(TM) search engine. The number of publications from Chinese authors increased exponentially during this period. Till 2014 China mainland authors contributed 47% of the total publications. Publications on pharmacology and toxicology lagged far behind the publications on chemistry and material science, indicating that research is not solidly moving toward the direction of application.

The U.S. National Library of Medicine has made two datasets of postero-anterior (PA) chest radiographs available to foster research in computer-aided diagnosis of pulmonary diseases with a special focus on pulmonary tuberculosis (TB). The radiographs were acquired from the Department of Health and Human Services, Montgomery County, Maryland, USA and Shenzhen No. 3 People’s Hospital in China. Both datasets contain normal and abnormal chest X-rays with manifestations of TB and include associated radiologist readings.